RU2721286C2 - Surgical instrument comprising systems for ensuring proper sequential operation of a surgical instrument - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: surgical stapling apparatus for treating patient's tissue according to the first version comprises a handle, a rod passing from said handle and an end effector. End effector extends from said rod. End effector is configured to change configuration into open configuration and closed configuration. Said end effector comprises a first branch, a second branch, a cartridge body, a bracket, a stop, a closing system, starting system and means for preventing return of said end effector into said open configuration until said retraction stroke is completed. Second jaw is movable to said first jaw to transfer said end effector to said closed configuration. Cartridge body includes recesses for staples. Staples are stored with possibility of removal in said cavities for brackets. Anvil is configured to deform said staples. Closing system is configured to move said second branch to said first jaw. Starting system comprises start-up pusher and cutting element, made with possibility of cutting fabric during cutting stroke and retraction of said cutting element during retraction stroke. Start-up pusher is configured to push said staples from said staple grooves to said stop during inrush stroke. Surgical stapling apparatus for treating patient's tissue according to the second version comprises a handle, a rod extending from said handle and an end effector extending from said rod. Said end effector is configured to change configuration into open configuration and closed configuration. Said end effector comprises a first branch, a second branch, a cartridge body, brackets, a stop, a closing system and a trigger system. Second jaw is movable to said first jaw while accommodating said end effector to said closed configuration. Cartridge body includes recesses for staples. Staples are stored with possibility of removal in said cavities for brackets. Anvil is configured to deform said staples. Closing system is configured to move said second branch to said first jaw. Starting system comprises staple extractor, cutting element and means to prevent retraction of said staple extractor, while said cutting element extends. Said starting system is configured to eject said staple extractor to said stop during inrush stroke and retract said staple ejector during retraction stroke. Splitting element is configured to cut the fabric during the cutting stroke, wherein said cutting member comprises a cutting edge that extends from said cartridge body during said cutting stroke. Surgical stapling apparatus for treating patient's tissue according to the third version comprises a handle, a rod extending from said handle, and an end effector extending from said rod. Said end effector is configured to change configuration into open configuration and closed configuration. Said end effector comprises a first branch, a second branch, a cartridge body, brackets, a stop, a tissue pin, a closure system, a drive for a tissue pin, a trigger system and a means of preventing retraction of said tissue pin. Said second jaw is movable to said first jaw with said end effector arranged in said closed configuration. Cartridge body includes recesses for staples. Staples are stored with possibility of removal in said cavities for brackets. Anvil is configured to deform said staples. Tissue pin is movable between the position withdrawn from the working position and the position put into working position. Said tissue pin is configured to grip the tissue in said end effector. Closing system is configured to move said second branch to said first jaw. Drive for tissue pin is configured to move said tissue pin between said inactivated position and said actuated position during withdrawal stroke from working state and retraction of said tissue pin into said position withdrawn from working position during retraction stroke. Starting system comprises a staple extractor, a cutting element and a device for preventing retraction of the above tissue pin, while the said cutting element extends. Said starting system is configured to eject said staple extractor to said stop during inrush stroke. Splitting element is configured to cut tissue during cutting stroke. Said cutting element comprises a cutting edge that extends from said cartridge body during said cutting stroke.

EFFECT: inventions provide proper sequence of surgical instrument operation.

15 cl, 65 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 drive a plurality of bracket ejectors located in the cassette and connected to the brackets to push the brackets against the stop and form laterally rows of deformed brackets 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.

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.

BRIEF DESCRIPTION OF GRAPHIC MATERIALS

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

in FIG. 1 is a perspective view of a surgical stapling instrument in accordance with at least one embodiment;

in FIG. 2 is a perspective view of the surgical stapling instrument of FIG. 1, with its components removed for illustrative purposes;

in FIG. 3 is an exploded perspective view of a surgical stapling instrument including a handle, a shaft, and an end effector in accordance with at least one embodiment;

in FIG. 4 is a partial cross-sectional side view of the handle of FIG. 3, illustrated in an expanded, not powered configuration;

in FIG. 5 is a partial cross-sectional side view of the handle of FIG. 3, illustrated in a clamped, not actuated configuration;

in FIG. 6 is a partial cross-sectional side view of the handle of FIG. 3, illustrated in a clamped, partially actuated configuration;

in FIG. 7 is a partial cross-sectional side view of the handle of FIG. 3, illustrated in a clamped, fully actuated configuration;

in FIG. 8 is a partial cross-sectional side view of the handle of FIG. 3, before returning to the expanded configuration;

in FIG. 9 is a side view of a surgical stapling instrument including a handle, a shaft, and an end effector in accordance with at least one embodiment;

in FIG. 10 is an exploded perspective view of a cassette with brackets for use with the surgical stapling instrument shown in FIG. 9;

in FIG. 11 is a perspective view illustrating a cassette with brackets shown in FIG. 10, complete with the surgical stapling instrument shown in FIG. 9;

in FIG. 12 is a cross-sectional view illustrating a cassette with brackets shown in FIG. 10, located in the end effector of the surgical instrument shown in FIG. 9, and illustrating an end effector in a clamped configuration;

in FIG. 13 is a cross-sectional view illustrating a cassette with brackets shown in FIG. 10, located in the end effector of the surgical instrument shown in FIG. 9, and illustrating staple ejectors of an end effector moved to an actuated configuration by a trigger system;

in FIG. 14 is a cross-sectional view illustrating a cassette with brackets shown in FIG. 10, located in the end effector of the surgical instrument shown in FIG. 9, and illustrating staple ejectors functionally disconnected from the launch system;

in FIG. 15 is a cross-sectional view illustrating a cassette with brackets shown in FIG. 10, located in the end effector of the surgical instrument shown in FIG. 9, and illustrating a cutting element driven by a trigger system;

in FIG. 16 is an exploded view of a surgical stapling instrument in accordance with at least one embodiment illustrated with components removed for purposes of illustration;

in FIG. 17 is a detailed view of a progress bar of a surgical stapling instrument shown in FIG. sixteen;

in FIG. 18 is a cross-sectional view of an end effector of a surgical stapling instrument, illustrated in a clamped but not actuated configuration;

in FIG. 19 is a cross-sectional view of an end effector shown in FIG. 18, illustrated in the staple actuation mode;

in FIG. 20 is a cross-sectional view of an end effector shown in FIG. 18 illustrating the movement between its staple actuation mode and the tissue cutting mode;

FIG. 21 is a cross-sectional view of an end effector shown in FIG. 18, illustrated in its mode of cutting tissue;

in FIG. 22 is an exploded view of a surgical stapling instrument in accordance with at least one embodiment illustrated with components removed for purposes of illustration;

in FIG. 23 is a partial cross-sectional view of the surgical stapling instrument shown in FIG. 22, illustrated in an expanded, non-actuated configuration;

in FIG. 23A is a detailed view of the transmission of the surgical stapling instrument of FIG. 22;

in FIG. 24 is a partial cross-sectional view of the surgical stapling instrument of FIG. 22, illustrated in a clamped configuration before starting;

in FIG. 25 is a partial cross-sectional view of the surgical stapling instrument of FIG. 22, illustrated in a clamped configuration after a starting stroke;

in FIG. 26 is a partial cross-sectional view of the surgical stapling instrument of FIG. 22, illustrated in a clamped, actuated configuration before a dissection stroke;

in FIG. 27 is a partial cross-sectional view of the surgical stapling instrument of FIG. 22, illustrated in a clamped, actuated configuration after a dissection stroke;

in FIG. 28 is a perspective view of the transmission of the surgical stapling instrument of FIG. 22;

in FIG. 28A is another perspective view of the transmission shown in FIG. 28;

in FIG. 29 is an exploded view of a surgical stapling instrument in accordance with at least one embodiment illustrated with components removed for purposes of illustration;

in FIG. 30 is a partial cross-sectional view of the surgical stapling instrument of FIG. 29, illustrated in an expanded, not powered configuration;

in FIG. 30A is a detailed view of the transmission of the surgical stapling instrument of FIG. 29, illustrated in a configuration that corresponds to an expanded, unengaged configuration shown in FIG. thirty;

in FIG. 31 is a partial cross-sectional view of the surgical stapling instrument of FIG. 29, illustrated in a clamped, not actuated configuration;

in FIG. 31A is a detailed view of the transmission of the surgical stapling instrument of FIG. 29, illustrated in a configuration that corresponds to a clamped, non-actuated configuration shown in FIG. 31;

in FIG. 32 is a partial cross-sectional view of the surgical stapling instrument of FIG. 29, illustrated in a clamped configuration in which brackets are brought out of a surgical instrument;

in FIG. 32A is a detailed view of the transmission of the surgical stapling instrument of FIG. 29, illustrated in a configuration that corresponds to a clamped, actuated configuration depicted in FIG. 32;

in FIG. 33 is a partial cross-sectional view of the surgical stapling instrument of FIG. 29, illustrated in a clamped configuration in which tissue is dissected with a surgical instrument;

in FIG. 33A is a detailed view of the transmission of the surgical stapling instrument of FIG. 29, illustrated in a configuration that corresponds to a clamped, actuated configuration depicted in FIG. 33;

in FIG. 34 is an exploded view of a surgical stapling instrument in accordance with at least one embodiment illustrated with components removed for purposes of illustration;

in FIG. 35 is a partial cross-sectional view of the surgical stapling instrument of FIG. 34, in an expanded, not powered configuration;

in FIG. 36 is a partial cross-sectional view of the surgical stapling instrument of FIG. 34, in a clamped configuration before starting;

in FIG. 37 is a partial cross-sectional view of the surgical stapling instrument of FIG. 34, in a clamped, actuated configuration before a dissection move;

in FIG. 38 is a partial cross-sectional view of the surgical stapling instrument of FIG. 34, in a clamped, actuated configuration after a dissection stroke;

in FIG. 39 is an exploded view of a surgical stapling instrument in accordance with at least one embodiment illustrated with components removed for purposes of illustration;

in FIG. 40 is a partial cross-sectional view of the handle of the surgical stapling instrument of FIG. 39 shown in an expanded configuration;

in FIG. 41 is a partial cross-sectional view of the handle depicted in FIG. 40, illustrated in the operation mode of stitching tissue;

in FIG. 42 is a partial cross-sectional view of the handle depicted in FIG. 40, illustrated in an actuated configuration;

in FIG. 43 is a partial cross-sectional view of the handle depicted in FIG. 40 illustrating a handle switchable between its operating mode for stitching tissue and the operating mode for dissecting tissue;

in FIG. 44 is a partial cross-sectional view of the handle depicted in FIG. 40, after a stroke with tissue dissection;

in FIG. 45 is a partial cross-sectional view of a surgical stapling instrument in accordance with at least one embodiment including a rail for actuating the staples, a cutting device, and a lock configured to hold the trigger bar in position when the cutting device advanced relative to the trigger rail;

in FIG. 46 illustrates the trigger rail shown in FIG. 45, in the actuated position, and a lock located behind the rail for actuating the brackets;

in FIG. 47 illustrates the cutting device shown in FIG. 45, in the actuated position;

in FIG. 48 illustrates the castle depicted in FIG. 45 disengaged from the rail for actuating the brackets so that the starter rail can be retracted;

in FIG. 49 is a partial cross-sectional view of a surgical stapling instrument in accordance with at least one alternative embodiment comprising a lock with a manual release;

in FIG. 50 is a partial cross-sectional view of a surgical stapling instrument in accordance with at least one embodiment illustrated in an expanded configuration;

in FIG. 51 is a partial cross-sectional view of the surgical stapling instrument of FIG. 50, illustrated in a clamped configuration;

in FIG. 52 is a partial cross-sectional view of the surgical stapling instrument of FIG. 50, illustrated in a staple-actuated configuration;

in FIG. 53 is a partial cross-sectional view of the surgical stapling instrument shown in FIG. 50, illustrated in a tissue cutting configuration;

in FIG. 54 is a partial perspective view of an end effector in accordance with at least one embodiment configured to sequentially actuate staples and dissect tissue captured by an end effector illustrated with components removed for illustration purposes;

in FIG. 55 is a partial perspective view of the end effector shown in FIG. 54, illustrated in the operating mode of actuating the brackets;

in FIG. 56 is a partial perspective view of the end effector shown in FIG. 54, illustrated in the operating mode of dissecting tissue;

in FIG. 57 is a partial cross-sectional perspective view of an end effector in accordance with at least one embodiment;

in FIG. 58 is a partial cross-sectional perspective view of the end effector shown in FIG. 57, illustrated in the operating mode of actuating the brackets;

in FIG. 59 is a partial perspective view of the end effector shown in FIG. 57, illustrated in the operating mode of tissue dissection;

in FIG. 60 is a partial cross-sectional view of a surgical stapling instrument in accordance with at least one embodiment;

in FIG. 61 is a partial cross-sectional view of the surgical stapling instrument of FIG. 60, illustrated in the operating mode of actuating the brackets;

in FIG. 62 is a partial cross-sectional view of the surgical stapling instrument shown in FIG. 60, transitioning between the operating mode of actuating the staples and the operating mode of dissecting the tissue;

in FIG. 63 is a partial cross-sectional view of the surgical stapling instrument shown in FIG. 60, in its operating mode, tissue dissection;

in FIG. 64 is a partial cross-sectional perspective view of a surgical stapling instrument in accordance with at least one embodiment illustrated in a partially actuated state; and

in FIG. 65 is a partial cross-sectional side view of the surgical stapling instrument of FIG. 64, illustrated in a partially powered state.

Corresponding elements in different views are indicated by the corresponding symbols. The illustrative examples presented herein demonstrate various embodiments of the present invention in one of its forms. These illustrative examples should not be construed as limiting the scope of the invention.

DETAILED DESCRIPTION

The applicant of this application owns 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 COMPRISING SEPARATE TISSUE SECURING AND TISSUE CUTTING SYSTEMS, Patent Attorney Dossier No. END7668USNP / 150103;

- US Patent Application No. __________, entitled SURGICAL INSTRUMENT COMPRISING SYSTEMS FOR PERMITTING THE OPTIONAL TRANSECTION OF TISSUE, Patent Attorney Dossier No. END7669USNP / 150104; and

- US Patent Application No. __________, entitled SURGICAL INSTRUMENT COMPRISING A SYSTEM FOR BYPASSING AN OPERATIONAL STEP OF THE SURGICAL INSTRUMENT, Patent Attorney File No. END7670USNP / 150105.

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. 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”), “contain” (and any of its forms, such as “holds” and “containing”) 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” are used herein to refer to the physician controlling the handle of a 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. In the course of this detailed description, the reader will be able to further appreciate that the various tools described in this document can be inserted into the body in any way - either through natural openings, or through an incision or a puncture hole made in the tissues, etc. p. The working part or the end clamps of such instruments can be inserted directly into the patient’s body or through an access device having a working channel through which the end clamp and the elongated shaft of the surgical instrument can be drawn.

Some prior art surgical stapling instruments are disclosed in the following documents:

European Patent Application No. EP 795298 entitled LINEAR STAPLER WITH IMPROVED FIRING STROKE, which was filed March 12, 1997;

U.S. Patent No. 5,605,272, entitled TRIGGER MECHANISM FOR SURGICAL INSTRUMENTS, issued February 25, 1997;

U.S. Patent No. 5,697,543, entitled LINEAR STAPLER WITH IMPROVED FIRING STROKE, issued December 16, 1997;

US Patent Application Publication No. 2005/0246881 entitled METHOD FOR MAKING A SURGICAL STAPLER, published November 10, 2005;

US Patent Application Publication No. 2007/0208359, entitled METHOD FOR STAPLING TISSUE, published September 6, 2007;

US patent No. 4527724, entitled DISPOSABLE LINEAR SURGICAL STAPLING INSTRUMENT, which is issued July 9, 1985;

U.S. Patent No. 5,137,198, entitled FAST CLOSURE DEVICE FOR LINEAR SURGICAL STAPLING INSTRUMENT, issued August 11, 1992; and

US patent No. 5405073, entitled FLEXIBLE SUPPORT SHAFT ASSEMBLY, which is issued April 11, 1995, the full description of which is incorporated herein by reference.

In FIG. 1 and 2, a surgical stapling instrument 100 is described. The instrument 100 comprises a handle 110, a rod 140 extending from the handle 110, and an end effector 150. The handle 110 comprises a housing 111, a frame 114 extending along the rod 140, closing the trigger 120 and the trigger 130 The actuation of the closing trigger 120 causes the end effector 150 to move between the open configuration (FIG. 1) and the closed configuration. As shown primarily in FIG. 2, the closing trigger 120 is rotatably mounted on the handle housing 111 around the spindle 121 and includes a driving portion 122 that rotates distally when the closing trigger 120 moves between the open position (FIG. 1) and the closed position. The closing trigger 120 is part of a closing actuator, which further includes links 123 and closing rails 126. The links 123 are pivotally mounted to the driving portion 122 of the closing trigger 120 around the pin 124, and the links 123 are pivotally attached to the closing rails 126 around the pin 125. When the leading portion 122 of the closing release mechanism 120 is distally rotated, the leading portion 122 drives the closing rails 126 by moving the cassette 160 with the brackets of the end effector 150 to the stop 170 of the end effector 150 to clamp the fabric between the cassette 160 with brackets and an emphasis 170 during the closing stroke of the closing drive. The drive portion 122 comprises a lock groove 127 formed therein, which is configured to accommodate a distal end 117 of the closure lock 112 when the closure trigger 120 reaches its fully clamped position. The closure lock 112 is pivotally mounted on the handle housing 111 around the pivot pin 113 and is pushed by the drive portion 122 of the closure trigger 120 using a biasing member, such as, for example, a spring.

The triggering of the trigger 130 activates the staples stored with the possibility of extraction in the cassette 160 with brackets, to the stop 170. As shown mainly in FIG. 2, the trigger 130 is rotatably mounted on the handle housing 111 around the spindle 131 and includes a drive portion that rotates distally when the trigger 130 moves between the non-actuating position (FIG. 1) and the actuating position. The trigger 130 is part of the trigger actuator, which further includes a trigger rail 136, which is distally controlled when the trigger 130 moves to its actuating position. The trigger actuator also includes a bracket ejector and a cutting element that extend distally by the trigger rail 136 during the trigger stroke of the trigger drive. The frame 114, the closing rails 126 and the trigger rail 136 are surrounded or at least substantially surrounded by the rod body 144.

The handle 110 may further comprise a trigger return spring configured to return the trigger 130 to its position without being actuated to reset the trigger system after completion of the trigger and release the trigger 130 by a doctor. Similarly, the handle 110 may further comprise a closing return spring configured to return the closing release mechanism 120 to its open position and reset the closing system after loosening the closing lock 112 by a doctor to disengage the closing lock 112 with the lock groove 127.

With reference to the embodiment described in FIG. 1 and 2, the trigger 130 is stitched and dissected by tissue clamped in the end effector 150 in one stroke of the trigger 130. In addition, the embodiment described in FIG. 1 and 2, the doctor’s work with the tool does not provide an opportunity to pause between the functions of actuating the staples and cutting the tissue of the launch system. In addition, the tool does not provide the doctor with any feedback on whether the tool performs the function of forming a staple or the function of cutting tissue. Below are various improvements to this tool.

Surgical stapling instrument 200 is illustrated in FIG. 3-8 and is similar to the instrument 100 and / or other surgical instruments described herein in many respects. For example, as shown primarily in FIG. 4, the tool 200 includes a closing trigger 120, which when actuated distally drives the closing rails 126 to close the end effector of the tool 200. The actuation of the closing trigger 120 also at least partially advances the distal trigger rail 236 of the trigger system to a pre-prepared position from which the trigger 130 can then be actuated by actuating the staples from the cassette with staples located in the end effector. The trigger 130 comprises a drive portion 132 that is in line with the proximal end 133 of the trigger rail 236 as soon as the trigger rail 236 is moved to its pre-prepared position. At this point, referring now to FIG. 5, the trigger 130 can be actuated by moving the trigger rail 236 distally and actuating the brackets from the bracket cassette. However, the actuation of the trigger 130 and the distal advancement of the trigger rail 236 are limited by the limiter or switch 280. The switch 280 interrupts the distal advancement of the trigger rail 236 before the trigger rail 23 cuts through the tissue trapped in the end effector. For the purpose of dissecting the tissue, the switch 280 is actuated to release the trigger rail 236, as illustrated in FIG. 6, so that the starting stroke of the starting lever 130 can be completed, as illustrated in FIG. 7. Thus, actuation of the staples and dissection of the tissue may include separate and different working steps of the instrument 200. In such cases, the physician may choose when to cut the tissue and / or cut the tissue.

As discussed above and as shown primarily in FIG. 5, the trigger rail 236 is stopped by a switch 280 during the distal advancement of the trigger rail 236. The trigger rail 236 includes a groove 285 formed therein, and a switch 280 is detachably disposed in the slot 285. The switch 280 is pivotally mounted on the handle housing 111 around the pivot pin 281 and contains a locking tab 282 that is located in the groove 285. The trigger rail 236 can be extended distally using the trigger 130, until the proximal end of the groove 285 is brought into contact with the locking tab 282. At this point, an additional distal movement of the trigger the rails 236 are prevented by the locking tab 282. A spring 284 is located between the locking tab 282 and the handle body 111 to slide the locking tab 282 into the groove 285 and hold the locking tab 282 in position until the switch 280 is actuated, as illustrated in FIG. 6. When the switch 280 is actuated, the locking tab 282 rotates from the groove 285, and then the trigger rail 236 can again be extended distally, as illustrated in FIG. 7. When the trigger rail 236 extends toward the end of its launch stroke, the locking tab 282 can no longer coincide with the groove 285, and the spring 284 biases the locking tab 282 to the bottom surface of the trigger rail 236. When the trigger rail 236 retracts into position without being actuated after the tissue has been cut, the locking tab 282 may coincide with the groove 285 again, and the spring 284 may shift the locking tab 282 into the groove 285.

In addition to the above, the staples are completely formed at the point where the trigger rail 236 is stopped using the switch 280. In such cases, the fabric can be completely stapled with staples before the cutting portion of the trigger rail 236 extends to cut the fabric. Alternative embodiments are provided in which the brackets are only partially formed when the trigger rail 236 is stopped by the switch 280. In such embodiments, the fabric is cut at the same time as the staple formation is completed. In any case, there is a pause in the operation of the tool 200 after the first stage, which requires the intervention of a doctor to decide whether to carry out the second stage, despite the fact that both stages are carried out with the help of one actuation of the hook. On the other hand, the switch 280 stops the trigger 130 during its actuation stroke, and the stop function of the switch 280 must be disabled before the actuation stroke can be completed. Switch 280 may operate at a point in time that the physician considers appropriate. In some cases, the switch 280 may operate immediately after the switch 280 stops the trigger rail 236 or, alternatively, after a certain period of time. In some cases, the switch 280 may operate before stopping the trigger rail 236, thereby allowing selectively combining the first and second stages.

In addition to the above, the doctor may or may not remove his hand from the trigger 130 during the pause provided by the switch 280. In any case, it is desirable to prevent the trigger rod 236 from suddenly and / or inadvertently retracting. In this regard, the tool 200 further comprises a lock 290, which is arranged to hold the trigger rail 236 in a certain position with the possibility of release. Lock 290 contains a ratchet system; however, any suitable lock may be used. The lock 290 is mounted on the housing 111 with the possibility of rotation around the pivot pin 291 and contains a dog 292 passing from it, which is configured to engage with a ratchet tooth 295 formed on the trigger rail 236. The lock 290 further comprises a proximal tab 293 and a spring 294 located in the interval between the proximal tab 293 and the housing 111, which is capable of displacing the dog 292 into engagement with the tooth 295. When the dog 292 engages with the tooth 295, the lock 290 goes into a configuration that allows distal movement of the trigger rail 236, but at the same time prevents the proximal moving the trigger rail 236. The handle 210 of the tool 200 further comprises a switch 296 adapted to engage the proximal tab 293 of the lock 290, and rotate the dog 292 from the trigger rail 236, and disengage the dog 292 with the tooth 295. At this point, the trigger rail 236 can be dragged.

In order to retract the trigger rail 236, the doctor may press the closure lock 112 to disengage the closure lock 112 with the closure trigger 120 and ensure that the closure trigger 120 is moved to its position without being actuated (FIG. 4), and / or handle 210 may include a return spring configured to bias the closing trigger 120 to its position without actuation. In any case, moving the closing trigger 120 to its position without actuation can result in proximal pulling of the links 123, which can, in turn, pull the closing rails 126 and the trigger rail 236 proximally. More specifically, the pin 125 that connects the links 123 also passes through the longitudinal holes formed in the closure rails 126 and the trigger rail 236, such as, for example, the longitudinal hole 129 formed in the trigger rail 236, and when the links 123 are pulled proximally by the closure trigger 120, the pin 125 may be brought into contact with the proximal end of the opening 129 and the proximal end of the longitudinal holes formed in the closure rails 126 and pull the trigger rail 236 and the closure rails 126 proximally. The proximal movement of the trigger rail 236 can also push the trigger arm 120 back into its position without being brought into action, and / or starting The 1st arm 120 may be returned to its position without being actuated by a return spring. In any case, the lock 290 can be reset by depressing the switch 296 distally, allowing the dog 292 to reengage with the tooth 295 as soon as the trigger rail 236 is returned to its position without being actuated.

In addition to the above, the dog 292 can be configured to generate audible sounds, such as clicks, for example, as the teeth 295 of the trigger rail 236 slip under the dog 292. Such audible sounds can provide feedback to the surgeon providing confirmation that the trigger rail 236 moves distally. Such audible sounds can also provide feedback to the surgeon regarding the speed of the trigger rail 236, since sounds emitted at a faster pace indicate that the trigger rail 236 is moving at a higher speed, while sounds emitted at a lower pace, will indicate that the trigger rail 236 is moving at a lower speed.

A surgical stapling instrument 300 is illustrated in FIG. 9-15 and is similar to the instruments 100, 200 and / or other surgical instruments described herein in many respects. The tool 300 includes an end effector 350 including a cassette 360 with brackets and a stop 170. In use, the fabric is positioned between the cassette 360 with brackets and a stop 170 and then gripped by the end effector 350 using a folding tissue pin 379. The fabric pin 379 is stored in the cassette 360 with brackets in the pin cavity 378 and moves distally to the stop 170. The fabric pin 379 can be distally ejected when the cassette 360 moves to the closed position, as described in more detail below. The tissue pin 379 includes lateral clamping elements 377, which are configured to allow the doctor to push the pin 379 toward the stop 170 and / or pull the pin 379 into the cassette 360 with brackets. The cassette 360 with brackets contains side grooves 375 formed in it, configured to specify the direction of longitudinal movement of the clamping elements 377 and the pin 379 for the fabric. The movement of the tissue pin 379 is limited by a stop 170 and a proximal end plate 376.

As shown primarily in FIG. 9, the tool 300 further comprises a closing trigger 120, which, when actuated, drives the closing rails 126 distally to close the end effector 350 of the tool 300 and clamp the fabric between the cassette 360 with the brackets and the stop 170. The tool 300 also includes a trigger 130, which, when actuated, pushes the trigger rail 336 distally by pushing the brackets out of the cassette 360 with brackets located in the end effector 350. As shown in FIG. 10-15, the staple cartridge 360 includes a cartridge case 361 including a plurality of staple recesses 361a, 361b and a knife groove 366 formed therein. The recesses 361a for brackets are located on the first side of the groove 366 for the knife, and the recesses 361b for brackets are located on the second side of the groove 366 for the knife. Although not illustrated, the brackets are stored in the bracket recesses 361a, 361b and pushed out of the bracket recesses 361a, 361b when the bracket ejector 362 is moved to the stop 170 by the trigger rail 336. The bracket ejector 362 has a plurality of bracket supports or saddle supports 362a made with the possibility of moving the brackets stored in the recesses 361a for brackets, and many supports for brackets or saddle supports 362b made with the possibility of moving the brackets stored in the recesses 361b for brackets. The ejector 362 brackets further comprises longitudinal guides 368a and 368b, which are configured to control and / or contain the movement of the ejector 362 staples in a longitudinal path.

In addition to the above, the cassette 360 with brackets contains a cutting element or knife 367, which is slidably located in the groove 366 for the knife. The ejector 362 staples contains the first latch 364a for the knife and the second latch 364b for the knife, which are configured to hold the knife 366 and the ejector 362 staples together with the possibility of release, as described in more detail below. The ejector 362 staples contains a first heel joint 363a and a second heel joint 363b. The first latch 364a for the knife is rotatably located in the first heel joint 363a, and the second latch 364b for the knife is rotatably located in the second heel joint 363b. The first latch 364a for the knife and the second latch 364b for the knife are able to rotate between the clamped position (FIGS. 12 and 13), in which they are engaged with the knife 367, and the expanded position (FIGS. 14 and 15), in which they are pulled out engagement with the knife 367. When the first latch 364a for the knife and the second latch 364b for the knife are in their clamped position, the ejector 362 staples and knife 367 are moved together. In use, the staple ejector 362 and the knife 367 are distally pushed out using the trigger rail 336 with the staples moving between the non-actuated position (FIG. 12) and the actuated position (FIG. 13). As can be understood from FIG. 13, the cutting edge of the knife 367 does not exit from the cassette body 361 for cutting tissue trapped between the cassette body 361 and the stop 170 when the staple ejector 362 moves to its powered position. Instead, the knife 367 is in a prepared position below the surface of the platform of the cassette body 361.

As can be seen in FIG. 12 and 13, the trigger rail 336 is brought into contact with the first latch 364a for the knife and the second latch 364b for the knife by distally pushing the ejector 362 staples. As shown in FIG. 11-13, the first knife latch 364a is engaged with the knife support 369 so that the movement of the staple ejector 362 can be transmitted to the knife 367. More specifically, the first knife latch 364a comprises a rib 365a located in a recess 369a formed in the knife support 369, and similarly, the second knife latch 364b comprises a rib 365b located in a recess 369b formed in the knife support 369. The ribs 365a, 365b are securely placed in their respective recesses 369a, 369b so that the driving force transmitted by the trigger rail 336 is transmitted to the bracket ejector 362 and the knife 367 with deformation of the brackets when the stop 170 is counteracted. The ribs 365a, 365b and the recesses 369a, 369b are made so that the ribs 365a, 365b remain engaged with the recesses 369a, 369b until a threshold force is reached at which, at this point, the knife latches 364a, 364b move outward from the knife support 369, as illustrated in FIG. 14 and 15. The threshold force may include the force necessary, for example, to fully form the bracket. At this point, the trigger rail 336 is no longer in functional engagement with the bracket ejector 362, and the trigger rail 336 can move distally relative to the bracket ejector 362. The trigger rail 336 can then be brought into contact with the knife support 369 directly by driving the knife 367 to the stop 170 and dissecting the fabric. As can be seen in FIG. 15, the knife 367 moves relative to the ejector 362 staples after the ejector 362 staples is disconnected from the knife 367.

In addition to the above, the trigger system of the tool 300 comprises two separate and different steps — a first step or step with staples activated and a second step or step with cutting the fabric. The actuation of the latches 364a, 364b for the knife defines the boundary between the two steps. When the latches 364a, 364b for the knife are clamped with the knife 367, the starting system is in its state with the actuation of the staples. When the latches 364a, 364b for the knife are opened with the knife 367, the trigger system is at its stage with cutting the fabric. These two steps are separate and different, and there is no overlap between them; however, embodiments are provided in which at least some overlap between the two steps may take place.

A surgical stapling instrument 400 is illustrated in FIG. 16 and 17 and is similar to the instruments 100, 200, 300 and / or other surgical instruments described herein in many respects. For example, tool 400 includes a handle 410 including a housing 411 that is similar to housing 111 in many ways. The tool 400 further comprises closing rails 126, which, in addition to the above, move the cassette with brackets to the stop to clamp the fabric between them. As discussed above, the closing trigger 120 is actuated by distally moving the closing rails 126. As also discussed above, the closing trigger 120 also moves the trigger rail 136 to a pre-prepared position when the closing trigger 120 is actuated. The trigger 130 can then be actuated by distally moving the trigger rail 136, and actuating the staples from the cassette with the staples, and then dissecting the fabric. Thus, it can be said that the trigger rail 136 moves distally during all three operating states — a closed operating state, an operational state with brackets activated, and an operational state with tissue dissection. Tool 400 further comprises a progress bar that shows the operating status of tool 400, as discussed in more detail below.

In addition to the above, as shown primarily in FIG. 17, the progress bar contains boundary indications 418 on the trigger rail 136. The boundary indications 418 comprise protrusions extending away from the trigger rail 136; however, in various other cases, the boundary symbols 418 may include signs, for example, printed on the trigger rail 136. The progress bar further comprises a run bar 415 located in a window 414 formed in the handle body 411. The run strip 415 contains characters 416 that correspond to the three operating states of the tool 400. For example, characters 416 comprise a first “clamp” sign that corresponds to an operating state with tissue clamping, a second “stitching” sign that corresponds to an operating state with cloth clamping, and the third sign is "cutting", which corresponds to the working state with dissection of the tissue. The execution bar 415 further comprises three lines 417 that correspond to the end of the operating states. In use, the boundary symbols 418 on the launching rail 136 are in line with the first line 417 when the closing stroke is completed, as illustrated in FIG. 17, with a second line 417 when the staples are fully actuated, and a third line 417 when the cutting stroke is completed. On the other hand, the boundary indications 418 move distally along the runway 415 as the trigger rail 136 moves distally with the advancement indication of the trigger rail 136. Such movements of the boundary indications 418 are observed by the operator of the surgical instrument 400 through the window 414 formed in the handle body 411. In at least one embodiment, the portion of the run strip 415 associated with the clamped operating state may have a first color, such as, for example, green, the portion of the run strip 415 associated with the clamped operating state may have a second color, such as, for example, yellow, and a portion of the run strip 415 associated with the working state of dissecting the fabric, may have a third color, such as, for example, red. In alternative embodiments, the execution strip 415 may be mounted on the trigger rail 136, and the boundary symbols 418 may extend from the handle housing 411.

A surgical stapling instrument 500 is illustrated in FIG. 18-21. Tool 500 is similar to tools 100, 200, 300 and / or 400 in many ways. The tool 500 comprises an end effector 550 comprising a cassette 560 with brackets and an abutment 170. The cassette 560 with brackets comprises a cassette body 561 including recesses 561a for the brackets formed therein. The staples are retrievable in brackets 561a. The cassette 560 with brackets further comprises a pusher 562 of brackets containing pushers 562a, which are configured to move the brackets to the stop 170 and push the brackets from the recesses 561a for brackets. Tool 500 further comprises a trigger rail 536 configured to push the ejector 562 of the brackets distally to the stop 170. The ejector 562 of the brackets includes proximal flanges 564 that engage with the trigger rail 536 as the trigger rail 536 extends distally. When the end effector 550 is in an expanded, but without actuating, configuration, as illustrated in FIG. 18, the flanges 564 are located in the channel 568 formed in the cartridge 561. In fact, the flanges 564 are bent or displaced inward by the side walls of the channel 568 and slide along the side walls as the staple ejector 562 moves distally. Flanges 564 are engaged and held in their inwardly curved position by the side walls of the channel throughout the brackets starting stroke. The end of the starting stroke of the staples is shown in FIG. nineteen.

The cassette 560 with brackets further comprises a cutting element 567 arranged to move into a knife groove 566 formed in the cartridge case 561. The cutting member 567 includes a base 569 that is sandwiched between the flanges 564 so that as the staple ejector 562 moves distally with the trigger rail 563, the cutting member 567 moves with the staple ejector 562. Referring again to FIG. 19, which shows the end of the starting stroke of the brackets, it should be noted that the cutting element 567 still does not exit the cassette body 561. Thus, the operation of actuating the staples of the tool 500 is separate and different from the operation of dissecting the tissue of the tool 500. The tool 500 proceeds from its operation of actuating the staples to its operation of dissecting the tissue when the flanges 564 release the cutting element 567. When comparing FIG. 19 and 20, it should be noted that the flanges 564 spring outward when the proximal ends of the flanges 564 are no longer biased inward by the side walls of the channel 568. More specifically, the flanges 564 bend outward as soon as they release the distal end 565 of the channel 568. At this point, the flanges 564 are no longer engaged with the cutting member 567. Furthermore, at this point, the flanges 564 are no longer engaged with the trigger rail 536, and as a result, the trigger rail 536 no longer pushes the staple ejector 562 distally. Instead, the trigger rail 536 can be brought into direct contact with the base 569 of the cutting element 567 and advance the cutting element 567 distally when the trigger rail 536 extends distally, as illustrated in FIG. 21, with the dissection of tissue trapped between the stop 170 and the cassette 560 with brackets.

In addition to the above, the point at which the tool 500 switches between the staple operating mode and the tissue cutting operation mode is a function of the distance the trigger rail 536 has moved. Other tools described in this document switch between the operating mode with the staples activated and the operating mode with cutting the fabric, depending on, for example, the force transmitted through the trigger rail of the tool. In some embodiments, a combination of both switching approaches may be used.

A surgical stapling instrument 600 is illustrated in FIG. 22-28A. Instrument 600 is similar to instruments 100, 200, 300, 400, 500 and / or other surgical instruments described herein in many respects. The tool 600 includes a handle 610 that includes a closing trigger 620 configured to control a closure or clamping system, and a trigger 630 configured to control the trigger system. The closing trigger 620 is capable of pivoting between the non-actuated position (FIG. 24) and the actuated position (FIG. 25). The tool closing system 600 is similar to the tool closing system 100 in many respects, and its description is not repeated here for purposes of brevity. In various instances, tool 600 includes a locking system that prevents the trigger 630 from being actuated before the closing trigger 620 is actuated.

In addition to the above, the closing trigger 620 includes a drive portion 622 that pushes the links 123 distally with the terminal end effector of the surgical instrument 600 clamped onto the tissue. The leading part 622 contains a slot 628 formed in it so that the leading part 622 can move relative to the rod 634, which passes through the slot 628.

The tool trigger system 600 is separate and distinct from the closing system. The launch system has two separate and different operating functions, that is, the function of actuating the staples and the function of dissecting the tissue. The actuation function of the staples is performed during the first actuation of the trigger 630, and the cutting function is performed during the second actuation of the trigger 630. Like the above, the trigger 630 is rotatably connected to the housing 111 around the spindle 131 As shown primarily in FIG. 23, 23A, 28, and 28A, the trigger 630 includes a gear portion 632 that is engaged with the drive gear 633. The drive gear 633 is mounted on a shaft 634 that is rotatably mounted to the handle body 111. More specifically, the drive gear 633 is mounted on the first portion 634a of the shaft 634 so that the drive gear 633 and the shaft portion 634a are rotated together. Thus, the actuation or rotation of the trigger 630 leading to the rotation of the driving gear 633 and the first part 634a of the rod.

As also shown in FIG. 28 and 28A, the rod 634 further comprises a second portion 634b that is selectively engaged with the first portion 634a along the ratchet partition surface 639. When the second rod portion 634b is operatively engaged with the first portion 634a, the rotation of the first portion 634a is transmitted to the second portion 634b, and the portions 634a, 634b of the first and second rods rotate together. A secondary drive gear 635 is mounted on the second shaft portion 634b such that the drive gear 635 rotates with the second shaft portion 634b. The drive gear 635 is engaged with the gear portion 637 formed at the proximal end of the trigger rail 636. In use, now referring to FIG. 25, the ratchet partition surface 639 is configured to transmit rotational movement of the trigger 630 to the trigger rail 636 and move the trigger rail 636 distally (direction D in FIG. 28) when the trigger 630 is actuated.

In addition to the above, as also shown in FIG. 25, the first actuation of the trigger 630 leads to the pushing of the trigger rail 636 distally with the actuation of the staples. After the first actuation, the surgeon can release the trigger hook 630 and allow the return spring to functionally connect with the trigger hook 630 to return the trigger hook 630 back to its position without actuation, as illustrated in FIG. 26. Alternatively, the surgeon may manually return the trigger 630 to its position without actuation. In any case, the ratchet partition surface 639 is configured to rotate the first shaft portion 634a relative to the second shaft portion 634b when the trigger 630 returns to its position without being actuated. More specifically, the first shaft portion 634a comprises ratchet teeth which slide relative to corresponding ratchet teeth formed on the second shaft portion 634b when the trigger 630 returns to its position without being actuated. In order to accommodate such relative movement of the first rod portion 634a, it is possible to offset from the second rod portion 634b. The handle 610 further comprises a biasing element, such as a spring, for example, configured to re-engage the first shaft portion 634a with the second shaft portion 634b as soon as the trigger 630 returns to its position without being actuated.

As also shown in FIG. 26, the reader should understand that the trigger rail 636 extends only partially during the first stroke of the trigger hook 630. Such partial advancement of the trigger rail 630 during the first stroke of the trigger hook 630 activates the brackets stored in the end effector of the tool 600, or ensures complete formation them, but does not provide dissection of tissue trapped in the end effector. Referring now to FIG. 27, the trigger 630 can be actuated a second time with full advancement of the trigger rail 630 and dissection of the fabric. As indicated above, the actuation or rotation of the trigger 630 drives the drive gear 633, the shaft 634 and the secondary drive gear 635 to advance the trigger rail 636 distally. In various cases, the surgeon may refuse to dissect the tissue and may instead release the tissue after actuation of the staples. In such cases, the surgeon will not actuate the trigger 630 a second time. In various cases, the solutions described above with respect to tool 600 may be applied, for example, to tools 400 and / or 500.

Surgical stapling instrument 700 is illustrated in FIG. 29-33A. Instrument 700 is similar to instruments 100, 200, 300, 400, 500, 600 and / or other surgical instruments described herein in many respects. The tool 700 includes a handle 710 that includes a closing trigger 620 configured to control closure or clamping of the fabric, a system and trigger 630 configured to control the trigger system. The closing trigger 620 is capable of pivoting between the non-actuated position (FIG. 30) and the actuated position (FIG. 31). The tool closing system 700 is similar to the tool closing system 100 in many respects, and its description is not repeated here for purposes of brevity. In various cases, tool 700 includes a locking system that prevents the trigger 630 from being actuated before the closing trigger 620 is actuated.

The tool starting system 700 is separate and distinct from the closing system. The launch system has two separate and different operating functions, that is, the function of actuating the staples and the function of dissecting the tissue. As described in more detail further below, actuation of the trigger 630 provides both functions. The trigger 630 is rotatably mounted on the handle 710 around the spindle 131 and includes the gear portion 632. The teeth of the gear portion 632 are engaged with the drive gear 733, which is rotatably mounted in the handle 710 around the shaft 734. The shaft 734 further comprises two cam protrusions, i.e., a first cam protrusion 735a and a second cam protrusion 735b mounted thereon. The first cam protrusion 735a is adapted to engage and advance the rail 736a to actuate the brackets, and the second cam protrusion 735b is adapted to engage and advance the rail 736b to cut the fabric. The cam protrusions 735a, 735b are mounted on the shaft 734 so that they rotate with the shaft 734.

Before actuating the trigger 630, as shown in FIG. 31, the first cam protrusion 735a is in line with the first cam surface 737a formed at the proximal end of the rail 736a for actuating the brackets, and the second cam protrusion 735b is in line with the second cam surface 737b formed at the proximal end of the rail 736b for cutting the fabric. The first cam protrusion 735a and the second cam protrusion 735b are interposed on the shaft 734. When the trigger 630 is in its position without being actuated, as illustrated in FIG. 31, the first cam protrusion 735a is adjacent to the first cam surface 737a, and the second cam protrusion 735b is separated from the second cam surface 737b.

In addition to the above, the trigger 630 is actuated by moving the rail 736a to actuate the staples and the rail 736b to cut the fabric during one stroke of the trigger 630. The first part of the actuation of the trigger triggers the rail 736a to drive the action of the staples distally, and the second part of the actuation of the trigger triggers the rail 736b to cut the tissue distally. The first part does not overlap the second part of the actuation of the trigger. On the other hand, the staple actuation process is completed before starting the tissue cutting process. In use, the inclined plane 738a of the first cam protrusion 735a biases the rail 736a to act distally while the inclined plane 738a passes by the first cam surface 737a. At this point, the cylindrical cam portion 739a of the first cam protrusion 735a is in line with the first cam surface 737a, and the rake 736a no longer extends distally with the first cam protrusion 735a. In various other embodiments, the implementation of the cylindrical cam portion 739a of the first cam protrusion 735a may complete the staple formation process. In such cases, the inclined plane 738a of the first cam protrusion 735a initiates the staple forming process, and the cylindrical cam portion 739a completes the staple forming process. In at least one case, the inclined plane 738a can complete the staple formation process to a greater extent than the cylindrical part 739a of the cam. In such cases, the staples quickly seize the fabric and then slowly close with a complete bond of the fabric to them. Alternatively, the cylindrical cam portion 739a may complete the staple formation process to a greater extent than the inclined plane 738a. In such cases, the compression pressure applied by the brackets may be applied for a longer time, which may better allow liquids to flow out of the fabric during the brace formation process. In any case, the second cam protrusion 735b is separated from the inclined plane 738a by the cylindrical cam portion 739a. As the rod 734 rotates with the trigger 630, as illustrated in FIG. 32 and 32A, the second cam protrusion 735b is rotated to come into contact with the second cam surface 737b and the stapling-cutting process is completed, as illustrated in FIG. 33 and 33A.

In various cases, in addition to the above, tool 700 may include a limiter that delimits the transition between the staple actuation process and the tissue cutting process. The limiter, for example, may impede or delay the movement of the start lever 630 after the rail 736a has been fully extended to engage the brackets and before the rail 736b has been extended to cut the fabric. The handle 710 may include a release limiter, which, immediately after actuation, may allow the surgeon to complete the trigger stroke of the trigger lever 630. This embodiment may allow the surgeon to decide whether to perform the function of cutting the tissue of the tool 700. In some cases, the tool 700 may generate tangible feedback, such as audible and / or tactile feedback, for example, as the trigger lever 630 passes while switching between the staple actuation function and the tissue cutting function.

In various alternative embodiments, in addition to the above, the process of cutting tissue may at least partially overlap with the process of forming staples. In such embodiments, the first cam protrusion 735a and the second cam protrusion 735b are arranged and mounted on the shaft 734 such that the first cam protrusion 735a can move the rail 736a to engage the brackets at the same time that the second cam protrusion 735b drives the rail 736b for cutting tissue.

In addition to the above, the trigger 630 can be returned to its position without actuation after actuation with actuation of the staples and / or dissection of the tissue. The handle 710 may include a return spring meshed with the trigger 630, which is biased to return the trigger 630 to its position without actuation. In addition to or instead of the above, tool 700 may include one or more biasing elements engaged with rails 736a, 736b that are configured to return rails 736a, 736b to their position without being actuated. As the trigger lever 630 returns to its position without being actuated, the gear 632 rotates the drive gear 733, the shaft 734 and the cam protrusions 735a, 735b in the opposite direction, disengaging the cam protrusions 735a, 735b with the racks 736a, 736b, respectively.

Surgical stapling instrument 800 is illustrated in FIG. 34-38. Instrument 800 is similar to instruments 100, 200, 300, 400, 500, 600 and / or 700 in many respects and / or other surgical instruments described herein. Tool 800 comprises a handle 810 that includes a closing trigger 620 configured to control a tissue closing or clamping system. The tool 800 further comprises a trigger 830a configured to control the staple actuation system, and a cutting trigger 830b configured to control the tissue cutting system. The closing trigger 620 is capable of pivoting between the non-actuated position (FIG. 35) and the actuated position (FIG. 36). The tool closing system 800 is similar to the tool closing system 100 in many respects, and its description is not repeated here for purposes of brevity. In various instances, tool 800 includes a locking system that prevents the trigger 830a and / or trigger 830b from being activated for cutting before the closing trigger 620 is actuated.

The tool trigger system 800 is separate and distinct from the closing system. The actuation of the trigger 830a controls the actuation system of the brackets with the deformation of the brackets stored with the possibility of extraction in the end effector of the tool 800. The trigger 830a is mounted on the handle 810 with the possibility of rotation around the spindle 131 between the position without actuation (FIG. 36) and the enacted provision (FIG. 37). The trigger 830a comprises a curved cam element 832a extending therefrom which moves distally when the trigger 830a is actuated, as illustrated in FIG. 36. The cam element 832a is brought into contact with the proximal end 837a of the rail 836a to actuate the brackets when the cam element 832a extends distally to move and warp the brackets that can be removed in the end effector of the tool 800.

The tool cutting system 800 is separate and distinct from the starting system and the closing system. The actuation of the cutting trigger 830b controls the fabric cutting system to cut the fabric trapped in the end effector of the tool 800. The cutting trigger 830b is mounted on the handle 810 with the possibility of rotation around the spindle 131 between the position without actuation (FIG. 37) and the enacted provision (FIG. 38). The cutting trigger 830b comprises a curved cam element 832b extending therefrom which moves distally when the cutting trigger 830b is actuated, as illustrated in FIG. 38. The cam member 832b is brought into contact with the proximal end 837b of the tissue cutting rail 836b when the cam member 832b extends distally to cut the tissue.

The start lever 830a rotates in the first travel range with the completion of the starting stroke of the trigger rail 836a, and the cutting lever 830b rotates in the second travel range with the completion of the cutting stroke of the trigger rail 836b. The starting stroke has the same length or at least substantially the same length as the cutting stroke; However, other embodiments are provided in which the length of the starting stroke is different from the length of the cutting stroke. In addition, the first range of motion of the trigger lever 830a is the same or at least substantially the same as the second range of motion of the lever 830b for cutting; However, other embodiments are provided in which the first range of motion is different from the second range of motion.

As also shown in FIG. 37 and 38, the trigger 830a comprises a recess 839 formed therein. The recess 839 is configured to accommodate, or at least partially accommodate, a cutting arm 830b therein. As illustrated in FIG. 36, the cutting lever 830b is inserted into the starting lever 830a when the starting lever 830a and the cutting lever 830b are in their positions without being actuated. When the trigger 830a moves to its actuating position, as illustrated in FIG. 37, the levers 830a, 830b can be disconnected as the cutting lever 830b can remain behind in its position without being actuated. Accordingly, actuating the cutting lever 830b can reinsert the lever 830b into the start lever 830a, as illustrated in FIG. 38.

In addition to the above, the individual and different levers 830a, 830b may provide an opportunity for the staple actuation system and the tissue cutting system of the selective tool 800 in a separate and different manner. On the other hand, the surgeon is able to simultaneously operate the levers 830a, 830b of the tool 800. In such cases, the tool 800 will simultaneously stitch and cut tissue trapped in the end effector. Alternatively, in at least one embodiment, the tool 800 may include a locking device configured to prevent the actuation of the cutting arm 830b to be prevented before the actuation of the trigger lever 830a is completed. In such embodiments, the surgeon will not be able to simultaneously actuate the levers 830a and 830b, but there will still be the possibility of selectively actuating the cutting lever 830b. In a further alternative embodiment, the cutting lever 830b can be released at some point during the actuation of the trigger lever 830a so that the levers 830a, 830b can be respectively actuated simultaneously if the surgeon needs it. Such an embodiment can ensure that the staples are at least partially actuated or at least sufficiently actuated before cutting the fabric.

A surgical stapling instrument 900 is illustrated in FIG. 39-44. Instrument 900 is similar to instruments 100, 200, 300, 400, 500, 600, 700, 800 and / or other surgical instruments described herein in many respects. The tool 900 comprises a handle 910 including a body 911 that closes the trigger 620, configured to control a tissue closing or clamping system, and a trigger 930a configured to control one staple actuation system and a second tissue cutting system. The closing trigger 620 is capable of pivoting between the non-actuated position (FIG. 40) and the actuated position (FIG. 41). The tool closing system 900 is similar to the tool closing system 100 in many respects, and its description is not repeated here for purposes of brevity. In various instances, tool 900 includes a locking system that prevents the trigger 930 from being actuated before the closing trigger 620 is actuated.

In addition to the above, the trigger 930 is mounted on the handle housing 911 with the possibility of rotation around the spindle 131 between the non-actuated position (FIG. 41) and the actuated position (FIG. 42). As described in more detail below, the trigger 930 controls the staple actuation system during the first actuation of the trigger 930 (FIG. 42) and the tissue cutting system during the second actuation of the trigger 930 (FIG. 43). The trigger 930 comprises a curved cam part 932 that moves distally when the trigger 930 is actuated. The cam portion 932 is brought into contact with the cam plate 985 when the cam portion 932 is rotated distally. The cam plate 985 is slide-mounted on the handle housing 911. The cam plate 985 has a possibility of longitudinal sliding when it is distally ejected by the cam part 932. The cam plate 985 comprises a leading groove formed between the tabs 986, 987 extending from the distal end of the cam plate 985. The leading groove is arranged to accommodate the proximal end of the rack 936a for actuating the brackets so that when the cam plate 985 is distally extruded, the cam plate 985 drives the trigger rail 936a distally to actuate the staples stored for retrieval in the end effector of the tool 900. More specifically, the distal tab 986 is brought into contact with the proximal end 987a of the rail 936a to actuate the brackets to eject the trigger rail 936a distally.

In addition to the above, the cam plate 985 is also slidable to the side. More specifically, the cam plate 985 is slidably engaged between the first position in which the cam plate 985 is operatively engaged with the rail 936a for actuating the brackets (FIGS. 41 and 42) and the second position in which the cam plate 985 is made with the possibility of functional engagement with the rail 936b for cutting tissue (FIG. 43 and 44). The handle 910 further comprises a pusher block 980 meshed with the cam plate 985. The pusher block 980 includes a push pin 981 extending from it, which extends through the handle body 911. The push block 980 may include another pressure pin 981 extending through the handle body 911 in the opposite direction. In any case, the user of the surgical instrument 900 can move the block pusher 980 between its first position and its second position by applying force to one of the push pins 981. When the block pusher 980 is in its second position, the tissue cutting rail 936b is in the lead a groove formed between the tabs 986 and 987. At this point, the cam plate 985 is operatively connected to the fabric cutting rail 936b, and subsequent actuation of the trigger 930 will trigger the fabric cutting system.

In use, instrument 900 is located in the patient, and the end effector of instrument 900 is positioned relative to the tissue to be treated. The closing trigger 620 is then actuated with the end effector clamped onto the fabric. At this point, the block pusher 980 is located in its first position and is in functional engagement with the rail 936a to actuate the brackets. Actuating the trigger 930 then advances the rail 936a to actuate the brackets distally; However, this actuation of the trigger 930 does not advance the fabric cutting rail 936b since the cam-operated slide 985 is not engaged with the fabric cutting rail 936b. After actuating the trigger 930, the trigger 930 can be released and returned to its position without actuation, as illustrated in FIG. 43. Like the above, the handle 910 may include a return spring configured to return the trigger 930 to its position without actuation. As also illustrated in FIG. 43, the trigger rail 936a remains in its activated position when the trigger 930 returns to its position without being actuated. Turning now to the consideration of FIG. 44, the pusher unit 980 can be moved to its second position to disengage the pusher unit 980 with the rail 936a to engage the brackets and engage the pusher unit 980 with the rail 936b for cutting the fabric. The actuation of the trigger 930 can then lead to the advancement of the lath 936b for cutting the tissue distally to cut the fabric; however, the surgeon has the opportunity not to cut the tissue, and at the same time, he can release the tissue from the end effector without actuating the trigger 930 a second time. The handle 910 may include a trip mechanism configured to return the closing trigger 620 and the closing system back to their positions without being actuated. In any case, the tool 900 may include one or more of the return springs and / or release mechanisms to reset the rails 936a, 936b to their position without actuation. In at least one case, the rails 936a, 936b can be reset when the end effector re-opens.

As discussed above, the staple rail 936a remains in its distal actuation position, with the trigger 930 re-actuated by moving the rail 936b to cut the tissue distally. In various cases, the trigger rail 936a may remain in its actuated position, for example, due to frictional forces between the trigger rail 936a and the tool frame 900; however, such frictional force can be overcome, and the trigger rail 936a can be pushed proximally. In some cases, we now turn to the consideration of FIG. 45, the rail for actuating the staples and / or the rail for cutting tissue may include means for constructively holding the rails in an actuated or at least partially actuated position.

In at least one illustrative embodiment, in addition to the above, the surgical instrument 1000 comprises a handle 1010 including a handle body 1011. The tool 1000 further comprises a rail 1036a for actuating the staples, configured to eject and deform the staples stored with the possibility of removal in the end effector of the tool 1000, when the trigger rail 1036a is distally ejected. The tool 1000 also includes a fabric cutting rail 1036b configured to dissect the tissue captured in the end effector of the tool 1000. The handle 1010 comprises a lock 1090, for example, which is configured to hold the trigger rail 1036a in a specific position while the rail 1036b for cutting is driven. The lock 1090 comprises a first end mounted on the handle housing 1011, and a second, or cantilever, end 1092 that is engaged with the gear portion 1093a of the trigger rail 1036a. Toothed section 1093a contains a longitudinal row of teeth, which is configured to provide distal movement of the trigger rail 1036a relative to the lock 1090, as illustrated in FIG. 46, and preventing proximal movement of the trigger rail 1036a relative to the lock 1090, while the lock 1090 is released from the trigger rail 1036a.

In addition to the above, the lock 1090 is actually sequentially placed behind each tooth of the tooth portion 1093a as the trigger rail 1036a passes the lock 1090. In the event that the surgeon has to pause the advancement of the trigger rail 1036a at some point during the trigger stroke of the trigger rail 1036a , the lock 1090 can hold the trigger rail 1036a in a certain position until the trigger stroke resumes. Upon completion of the start-up stroke of the brackets, the lock 1090 is located behind the closest tooth of the start-up rail 1036a. At this point, the lock 1090 is held in engagement with the trigger rail 1036a using the rail 1036b to cut the fabric. The cutting bar 1036b comprises a toothed portion 1093b formed thereon, which, like the aforementioned, includes a longitudinal row of teeth that is configured to distally move the cutting bar 1036b relative to the lock 1090, as illustrated in FIG. 47, and to prevent the proximal movement of the cutting bar 1036b relative to the lock 1090 until the cutting bar 1036b has completed the cutting stroke, as illustrated in FIG. 48. At this point, the lock 1090 can slide off the ends of the trigger rail 1036a, and the cutting rail 1036b is disengaged from the rails 1036a and 1036b.

In addition to the above, the lock 1090 is held in a curved configuration by the rails 1036a and 1036b so that the lock 1090 can elastically expand and actually disengage from the racks 1036a and 1036b after the passage of the tooth sections 1093a and 1093b past the castle 1090. The tooth section 1093a formed on a flexible bracket 1094a extending proximally from the trigger rail 1036a, and a toothed portion 1093b is formed on a flexible bracket 1094b extending proximally from the cutting rail 1036b. Toothed sections 1093a and 1093b are jointly bent with lock 1090. In any case, rails 1036a and 1036b can be returned to their positions without actuating after disengaging lock 1090 with toothed sections 1093a and 1093b, respectively. In various cases, one or more return springs may be connected to the rails 1036a and 1036b to return the rails 1036a and 1036b to their position without actuation.

Turning now to the consideration of FIG. 49, the tool 1000 may include a reset lever, such as, for example, a lever 1190, which can disengage the lock 1090 from the trigger rail 1036a and / or the trigger rail 1036b for cutting before the end of the trigger stroke and / or cutting stroke of the tool 1000. Lever 1190 comprises a first end 1191 that is rotatably mounted on the handle body by means of a pivot pin 1193, and in addition a second end 1192 that is able to engage with a lock 1090. A push button 1194 is operatively engaged with a first end 1191 of a lever 1190 and is configured to turning the second end 1192 of the lever 1190 engaged with the lock 1090, as illustrated in FIG. 49 when the push button 1194 is released. In such cases, the lever 1190 bends the second end 1092 of the lock 1090 from the rails 1036a and 1036b and disengages the lock 1090 from the gear sections 1093a and 1093b. At this point, the rails 1036a and 1036b can be pulled into their positions without actuation. Such a descent actuation system may allow the tool 1000 to quickly open and release from the fabric at any suitable point during the operation of the tool 1000. The push button 1194 can be loosened to release the lock 1090 during the starting stroke, after the starting stroke, during the cutting stroke and / or after a cutting stroke.

As shown in FIG. 50-53, the surgical instrument 1200 comprises an end effector 1250 and a closing system configured to close the end effector 1250. The end effector 1250 comprises a cassette 1260 with brackets and a stop 170. The cassette 1260 with brackets comprises a cassette body 161, a plurality of recesses for the brackets formed in the cassette case, and staples stored with the possibility of extraction in the recesses for the brackets. The cassette 1260 with brackets is arranged to move toward the stop 170 between the open position (FIG. 50) and the closed position (FIG. 51) with compression of the fabric between the cassette body 161 and the stop 170. The tool 1200 further comprises a closing rail 126 mounted on the body 161 cassette. The closure rail 126 can be extended distally to move the cartridge 1260 with brackets distally and retracted proximally with the movement of the cartridge 1260 with brackets proximal. The end effector 1250 further comprises a guide rail 168 configured to set the direction of the cartridge 1260 with brackets along the longitudinal axis as the cartridge 1260 with brackets moves proximal and distal.

As shown primarily in FIG. 50 and 51, the distal advancement of the closure rail 126 also allows the distal pin 379 to be distally advanced to grip the tissue into the end effector 1250. More specifically, the closure rail 126 includes a drive pin 128a extending away from it, which is engaged with one or more drives 372 for the pin for the fabric as you move the closing rail 126 distally. The actuators for the fabric pin 372 are mounted on the frame of the shaft 114 to rotate around the pivot pin 118 and are arranged to move between the position without actuation (FIG. 50) and the actuated position (FIG. 51). Each tissue pin drive 372 includes a drive portion 373 adapted to engage and push out the base 374 of the tissue pin 379. The tissue pin 379 is slidably held in the cavity 378 formed in the end effector 1250 so that the movement of the tissue pin 379 is limited by a longitudinal path. The stop 170 includes a pin hole 179 formed therein, which is configured to receive the tissue pin 379 when the tissue pin 379 reaches its full operational state.

In addition to the above, the cassette 1260 with brackets moves to the stop 170 before putting the pin 379 for fabric into operation. In such cases, the fabric is sequentially clamped and then captured in the end effector 1250; however, alternative embodiments are provided in which the fabric is simultaneously clamped using the cassette 1260 and gripped into the end effector 1250 using a tissue pin 379. Other embodiments are provided in which the tissue pin 379 is brought into operation before moving the cassette 1260 with braces distally with tissue compression.

In addition to the above, the cassette 1260 with brackets further comprises pushers 162 brackets configured to move the brackets to the stop 170. The stop 170 includes forming pockets 171 formed in it, which are made with the possibility of deformation of the brackets. As described in more detail below, the pushers 162 of the brackets are pushed distally using the trigger rail 1236. As also shown in FIG. 50 and 51, the closure rail 126 further comprises a second drive pin 128b extending away from it, which is adapted to engage the trigger rail 1236 and move the trigger rail 1236 distally to the cartridge 1260 when the cartridge 1260 moves distally with tissue clamping. Thus, the relative position of the trigger rail 1236 and the cassette 1260 with brackets can be supported or at least substantially maintained during closing of the end effector 1250.

The trigger rail 1236 does not push the ejectors 162 brackets directly; rather, the trigger rail 1236 directly pushes the intermediate ejector 1263, which transfers the movement of the trigger rail 1236 to the ejectors 162 brackets. More specifically, the intermediate ejector 1263 contains a plurality of connecting rods 1264 extending distally from it, which are brought into contact with the mating surface 1265 formed on the proximal side of the ejectors 162 brackets. When the trigger rail 1236 extends distally with the deformation of the brackets in response to the stop 170, as illustrated in FIG. 52, connecting rods 1264 transmit power between the trigger rail 1236 and the bracket ejector 162.

Each of the connecting rods 1264 is connected to the intermediate ejector 1263 with the possibility of rotation around the pivot pin 1266. Each connecting rod 1264 is made and installed so that it can transmit a certain amount of force to the ejectors 162 brackets, and when the force transmitted through the connecting rods 1264 exceeds the threshold force, the connecting rods 1264 can be rotated into the folded position, as illustrated in FIG. 53. The threshold force is chosen so that it coincides with the force necessary to deform the brackets into their configured or actuated configurations; however, it should be understood that the range of forces may be suitable for deformation of the brackets with a suitable formed height, and the threshold force may be anywhere in this suitable range or exceed this range. In any case, folding the connecting rods 1264 allows the intermediate pusher 1263 to move relative to or towards the pushers 162 of the brackets, and at this point the pushers 162 of the brackets no longer move to the stop 170. In addition, at this point, the process of actuating the brackets ends, and now a possible relative the movement between the intermediate ejector 1263 and the ejectors 162 staples is used to bring into operation the cutting element or knife to the stop 170 to cut the fabric. The knife cutting progress begins when the connecting rods 1264 begin to fold, and ends when the connecting rods 1264 are brought into contact with the abutment surface 1239 formed on the intermediate ejector 1263. As a result of the above, the cutting operation of the fabric is separate and different from the operation of activating the staples. In addition, the operation of actuating the staples and the operation of cutting tissue are carried out sequentially and without overlapping. This design prevents dissection of the tissue before the complete formation of staples.

The reader should understand that the operator of the surgical instrument 1200 can pull the trigger rail 1236 into its position without being actuated at any point during the operation of actuating the brackets of the instrument 1200. More specifically, the trigger rail 1236 can be returned proximally while it is being contacted. with a second driving pin 128b of the closing rail 126. The reader should also understand that the surgical instrument operator can open the end effector 1250 and move the cassette 1260 with brackets from the stop 170 at any point during the operation of actuating the staples of the tool 1200. On the other hand, the tool 1200 includes a locking system configured to prevent opening of the end effector 1250 during a tissue cutting operation. In addition, the knife-shaped member must be fully retracted using the trigger rail 1236 before the tissue pin 379 can be retracted and / or before the end effector 1250 can be opened. Such a locking system is illustrated in FIG. 51-53.

As shown in FIG. 51, each connecting rod 1264 of the staple actuation system comprises a locking pin 1267 extending from it. Each locking pin 1267 is located in a lock groove formed in the cassette body 161, where each locking groove comprises a first part 1268 and a second part 1269. As discussed in more detail below, the locking pins 1267 are located in the first parts 1268 during the stapling operation and in the second parts 1269 during the operation of cutting tissue. During the operation of forming the staples of the tool 1200, the locking pins 1267 slide distally in the first parts 1268 of the locking grooves, as illustrated in FIG. 52. In fact, the locking pins 1267 can move proximally and distally in the first parts 1268, thereby enabling the trigger rail 1236 to selectively extend and retract during the stapling operation, as described above. In addition, this movement of the pins 1267 in the first parts 1268 allows the cassette 1261 with brackets to selectively move proximally from the stop 170 of the tool 1200, which is also indicated above, in order to open the end effector 1250. However, during the tissue cutting operation, the locking pins 1267 enter the second parts 1269 slots for the castle. At this point, the side walls of the second parts 1269 prevent the cassette body 161 from being retracted relative to the trigger rail 1236. Thus, the cassette 1260 with brackets is locked in place when the cutting element is exposed or possibly exposed. In such cases, the end effector 1250 cannot be opened while the cutting element is retracted or at least sufficiently retracted. The cutting element is retracted when the trigger rail 1236 extends proximally. As the actuation element 1236 extends proximally, the locking pins 1267 are moved from the second parts 1269 of the grooves for the lock in the first parts 1268 and remove the lock from the housing 161 of the cartridge. At this point, the locking pin 379 may be retracted and / or the end effector 1250 may be opened.

An alternative implementation of the mechanism of stitching and cutting tissue of a surgical instrument 1300 is illustrated in FIG. 54-56. The tool 1300 contains a jaw 1360 with a cassette with staples, which contains, first, a plurality of ejectors 1362 staples made with the possibility of pushing staples from the cassette 1360 with staples with stapling tissue, and, second, the element 1367 in the form of a knife made with the possibility of dissecting the fabric. The ejectors 1362 staples and the element 1367 in the form of a knife are brought into operation by actuating the element 1336; however, as discussed below, the operationalization of the pushers 1362 of the staples and the knife-shaped member 1367 is spaced apart in time. The trigger element 1336 contains a tooth portion 1369, which is moved or transmitted distally in the direction D to move the ejectors 1362 staples and element 1367 in the form of a knife. Tool 1300 further comprises a gear 1366 that is operatively engaged or engaged with the gear portion 1369, which includes a plurality of rotating gears. The gear portion 1369 and gear 1366 are configured to convert the translational motion of the trigger element 1336 into the rotational motion of the gear 1366.

Gear 1366 includes first and second secondary gears 1368. Each secondary gear 1368 is mounted on a shaft 1363 so that the shaft 1363 and the gear 1368 are rotated together. The gear train 1366 additionally contains secondary cams 1364a, 1364b for actuating the brackets mounted on each of the rods 1363. In the illustrated embodiment, each rod 1363 contains the first and second cams 1364a for operating the brackets mounted on it, which rotate with a shaft 1383. Each cam 1364a comprises a contour surface that is adapted to engage with a mating surface 1365a formed at the bottom of the brackets ejectors 1362. When the cams 1364a rotate using the rods 1363, the cam profiles rotate between the first orientation associated with the position without actuating the ejector 1362 brackets (FIG. 54), and the second orientation associated with the actuated position of the ejectors 1362 brackets (FIG. 55) . For example, the difference between the first orientation and the second orientation is approximately 180 degrees. This movement of the cams 1364a and the pushers 1362 of the brackets constitute the starting stroke of the tool 1300, and the peaks of the cams 1364a are brought into contact with the mating surface 1365a when the pushers 1362 of the brackets reach the end of the starting stroke, as illustrated in FIG. 55.

In addition to the above tool 1300 includes four cams 1364a for actuating the brackets; however, any suitable number of cams 1364a may be used. Four cams 1364a for actuating the staples are located and mounted relative to the mating surface 1365a to provide a balanced or symmetrical load during the stroke on the ejector 1362 staples. When comparing FIG. 54 and 55, the reader should understand that cams 1364a for actuating the staples move the ejectors 1362 staples relative to the element 1367 in the form of a knife. Element 1367 in the form of a knife is brought into operation regardless of the ejectors 1362 staples, as discussed below.

The gear train 1366 further comprises a secondary tissue cutting cam 1364b mounted on each of the rods 1363. The cams 1364b are configured to bring a knife member 1367 into working condition. Like the above, the cams 1364b rotate between the first orientation (FIG. 54) and the second orientation (FIG. 55) during the staple actuation process discussed above; however, the cams 1364b do not push the ejectors 1362 staples or element 1367 in the form of a knife distally during this rotation. Referring now to FIG. 56, subsequent rotation of the shaft 1363 and cams 1364b engages the cams 1364b with the mating surface 1365b of the knife member 1367, which pushes the knife member 1367 distally to cut the stitched fabric. This subsequent rotation also rotates the peaks of the cams 1364a to actuate the brackets to disengage from the mating surface 1365a. In such cases, the pushers 1362 staples can be returned back, or they can be provided with the possibility of back pulling into the cassette 1360 with staples as the tissue is cut.

As discussed above, the cams 1364a and 1364b are located and mounted on the rods 1363 so that the operation of actuating the staples and the operation of cutting the fabric do not occur simultaneously. In some cases, the cams 1364a and 1364b may be set so that there is a delay between the operations of actuating the staples and cutting the fabric. In at least one such case, cams 1364a and / or cams 1364b may include a cylindrical portion of the cam that provides a pause between the staple actuation operation and the tissue cutting operation. Such a pause may allow the surgeon to be able to stop the tool 1300 between the starting stroke of the staples and the stroke with cutting tissue. In alternative embodiments, the cams 1364a and 1365b may be located and mounted on the rods 1363 so that there is overlap between the operation of actuating the staples and the operation of cutting the fabric. This overlap provides quick tool actuation.

An alternative implementation of the mechanism of stitching and cutting tissue of a surgical instrument 1400 is illustrated in FIG. 57-59. The tool 1400 comprises a jaw 1460 with a cassette with brackets including a cassette body 1461, a plurality of staple ejectors 1462 configured to eject the staples from the cassette body 1461 with tissue stapling, and a knife element 1467 adapted to dissect the fabric. The pushers 1462 staples and the element 1467 in the form of a knife are brought into operation by actuating the element 1436; however, as discussed below, the operationalization of the ejectors 1462 staples and the element 1467 in the form of a knife is spaced in time. The ejectors 1462 brackets and the element 1467 in the form of a knife move distally between the first position, or the position without actuating (FIG. 57), and the second position (FIG. 58), which corresponds to the end of the process of actuating the brackets. The knife-shaped member 1467 can then be moved relative to the staple ejectors 1462 to a third position, as illustrated in FIG. 59.

In addition to the above, the trigger element 1436 includes an inclined mating surface 1464 formed thereon. When using the pushers 1462, the brackets and the knife-shaped element 1467 are distally pushed out using the mating surface 1464 to actuate the brackets from the cassette body 1461. More specifically, the mating surface 1464 pushes the knife element 1467 distally, which in turn pushes the pushers 1462 distally, at least during the process of actuating the staples. The knife-shaped member 1467 comprises rollers 1465a and 1465b that are brought into contact with an inclined surface 1464. The rollers 1465a and 1465b are mounted on the knife-shaped member 1467 to rotate around the driving pins 1469a and 1469b, respectively. Driving pins 1469a and 1469b are located in driving grooves 1463a and 1463b, respectively, formed in a frame 1468 that connects the pushers 1462 of the brackets. The driving pins 1469a, 1469b are adapted to fit snugly against the distal side walls of the driving grooves 1463a, 1463b, respectively, when the knife-shaped member 1467 is distally pushed out by the trigger 1436. Thus, the staple actuation force is transmitted from the trigger rail 1436 to the pushers 1462 brackets by means of a leading inclined plane 1464, rollers 1465a, 1465b, driving pins 1469a, 1469b and driving grooves 1463a, 1463b. The distal movement of the ejectors 1462 staples is limited by the abutment surface 1466 formed, for example, on the casing 1461 of the cartridge. When the bracket ejector frame 1468 is brought into contact with the abutment surface 1466, as shown in FIG. 58, the starting stroke of the tool 1400 is completed. At this point, only a part of the cutting surface of the knife element 1467 exits the cassette body 1461; however, the fabric is not yet exposed to the cutting surface. More specifically, the jaw or emphasis opposite the cassette 1460 with brackets may include a cavity that is configured to accommodate the protruding portion of the cutting surface, and as a result, the possibility of the knife element 1467 to cut the fabric at a given point during operation of the tool 1400 is eliminated.

As discussed above, the distal movement of the ejectors 1462 brackets and the element 1467 in the form of a knife is limited by the abutment surface 1466 at the end of the starting stroke, and as a result, the additional distal or longitudinal movement of the trigger rail 1436 will no longer be transformed into the distal or longitudinal movement of the ejectors 1462 brackets and element 1467 in the form of a knife. Instead, as shown in FIG. 59, the additional distal movement of the trigger rail 1436 is converted to lateral movement of the knife element 1467. More specifically, the additional distal movement of the inclined surface 1464 generates a counteracting force between the knife-shaped member 1467 and the currently stationary ejector frame 1468, which biases the knife-shaped member 1467 toward the downward inclined surface 1464. The lateral movement of the knife-shaped member 1467 is facilitated by the rollers 1465a, 1465b; however, the knife-shaped member 1467 can slide along a leading inclined plane 1464 in response to the continued distal movement of the trigger 1436 without the aid of the rollers 1465a, 1465b.

In addition to the above, the knife-like element 1467 cuts the stitched fabric as it moves to the side through the cassette 1460 with staples. The knife-shaped member 1467 is displaced along the cutting axis, which is the transverse longitudinal axis of the actuation formed when the trigger 1436 is moved. The cutting axis is perpendicular or at least substantially perpendicular to the actuation axis; however, any suitable structure may be used. Also in addition to the above, the cutting stroke of the knife-shaped element 1467 begins at the end of the starting stroke of the ejectors 1462; however, it is contemplated that a delay may be provided between the cutting stroke and the starting stroke.

Many of the surgical instruments described in this document use a single trigger rail to power the staple system and tissue cutting system. Such instruments can be advantageous due to the use of auditory and / or tactile feedback, with the help of which some information about the current operating state of the surgical instrument can be transmitted to the user of the surgical instrument. In at least one example, the trigger rail of a surgical instrument may include a first row of teeth and a second row of teeth that can slide relative to one or more snapping elements in the handle of the surgical instrument. During the operation of actuating the staples of the surgical instrument, the interaction between the first row of teeth and the snapping element can generate sounds in the form of clicks and / or vibration. The first row of teeth can be located on the trigger rail so that feedback is generated, for example, near the end of the trigger stroke. With this feedback, the surgeon can slow down the advancement of the trigger bar if he intends to at least suspend the operation of the surgical instrument between the operating mode of actuating the staples and, for example, the operating mode with tissue cutting. Alternatively, the surgeon may choose not to cut the tissue. The second row of teeth can be located on the cutting rail so that feedback is generated, for example, near the end of the cutting stroke. In some embodiments, a series of teeth may be located on the trigger rail so that feedback is generated between the operating mode of actuating the staples and the operating mode of cutting the tissue. The feedback described above can also be used in tools that include a rail for actuating staples and a separate rail for cutting tissue.

Surgical instrument 1500 is described in FIG. 61-64. Tool 1500 includes a shaft 1540 and a circular end effector 1550 that uses a lumen, for example, for stitching and dissection. [Included by reference.] The end effector 1550 includes a cassette 1560 with brackets, including a circular cassette case 1561 and a plurality of brackets stored with the possibility of removal in the cassette 1561 in a row in a circle. The cassette 1560 with brackets further comprises pushers 1562 brackets made with the possibility of pushing the brackets from the housing 1561 of the cartridge. The pushers 1562 staples are also arranged in a row in a circle and connected to a common frame of the pushers; however, any suitable structure may be used. For example, pushers 1562 brackets may not be connected to each other. The end effector 1550 further comprises a circular stop 1570 configured to compress a portion of the lumen relative to the cassette body 1561. The stop 1570 is attached to the closing drive 1526, which passes through the rod 1540. The closing drive 1526 is configured to move the stop 1570 to the cassette 1560 with brackets and from it between the clamped and unpressed positions. In all FIG. 61-64 illustrates an emphasis 1570 in a clamped position. The emphasis 1570 further comprises a row of circular forming pockets 1571 arranged to deform the brackets as the brackets are ejected from the cassette 1560 with brackets.

The surgical instrument 1500 further comprises a cutting element 1567, configured to dissect tissue captured between the stop 1570 and the cassette 1560 with brackets. In use, the pushers 1562 of the staples move the staples in response to the stop 1570 during the stapling process (FIG. 61), and the cutting element 1567 cuts the fabric during the process of cutting the fabric (FIG. 63). As discussed below, the process of forming staples and the process of cutting tissue occur sequentially, and there is no overlap between them; however, embodiments are provided in which the stapling process and the tissue cutting process can be carried out or at least partially carried out simultaneously.

In addition to the above, and as shown primarily in FIG. 60, the bracket ejectors 1562 and the cutting element 1567 are stored in the non-actuated position in the terminal cassette 1560 with brackets when the emphasis 1570 is moved to its clamped position. The pusher pushers 1562 and the cutting element 1567 are then distally moved using the trigger element 1536 during the process of forming the brackets with the deformation of the brackets, as illustrated in FIG. 61. More specifically, the distal end 1538 of the trigger element 1536 engages with a clamping ring 1539 located between the trigger element 1536 and the ejectors 1562, and the cutting element 1567, which, in turn, is engaged with the ejectors 1562 and the cutting element 1567. The starting stroke of the pushers 1562 staples ends when the pushers 1562 are brought into contact with the proximal side of the casing 1561. In particular, the cutting member 1567 does not exit the cassette body 1561 during the stapling process; instead, the cutting member 1567 remains located in the cassette body 1561 during the stapling process, even if it moves toward the stop 1570.

Once the pushers 1562 staples reach the bottom of the cassette body 1561, the surgeon can understand that the process of forming staples completed. At this point, the surgeon can then retract trigger 1536 and skip the tissue cutting step if he so desires. Alternatively, the surgeon may apply a pushing force to the trigger element 1536 with the destruction of the clamping ring 1539, as illustrated in FIG. 62. This pushing force is greater than the force required to actuate the brackets. As a result, the surgeon will feel a noticeable increase in the force necessary to advance the trigger element 1536 beyond the end of the trigger launch of the staples. In order to start a tissue cutting stroke, the surgeon needs to make a conscious choice regarding the increase in force that he exerts on the trigger element 1536, if the trigger element 1536 is set in motion using a manually controlled lever. The clamping ring 1539 can be designed so that it can withstand forces up to a threshold force, where after reaching the threshold force or exceeding it, the distal end 1538 of the trigger element 1536 can push the clamping ring 1539.

In some cases, in addition to the above, the clamping ring 1539 can be designed to break or suddenly fail as soon as the threshold force exerted on the clamping ring 1539 is reached. In at least one such case, the clamping ring 1539 may comprise a weakened portion that contributes to failure of the clamping ring 1539 in a predetermined area, such as, for example, an annular groove 1537. In some cases, the distal end 1538 of the trigger 1536 may include a cutting portion that cuts through the clamping ring 1539. In any case the clamping ring 1539 can act as a safety lock, which must fail before the cutting stroke can begin.

As soon as the clamping ring 1539 is destroyed, or dissected, or otherwise fails, as shown in FIG. 63, the clamping ring 1539 will comprise two separate parts — a first part 1539a that can be distally pushed out with a trigger 1536, and a second part 1539b that remains behind. The groove 1537 lies between the first part 1539a and the second part 1539b of the clamping ring 1539. The groove 1537 makes the clamping ring 1539 sufficiently brittle so that the clamping ring 1539 breaks as soon as the corresponding level of force is applied to the clamping ring 1539. In at least one case, the clamping ring 1539 is made, for example, of plastic. The first part 1539a of the clamping ring is distally pushed using the trigger element 1536 with the movement of the cutting element 1567 distally with the completion of the cutting stroke of the tool 1500.

In addition to or instead of a manually operated lever, the tool 1500 may include an electric motor configured to move the trigger element 1536. At least one sensor configured to detect the loads experienced by the trigger element can also be used in such a system. , and, in addition, a control device in communication with the load sensor and the electric motor, which can control the operation of the electric motor based on data received from the load sensor. Such a system can determine that the pushers 1562 brackets have reached the lower limit, and in response to this stops the electric motor. Such a suspension may allow the surgeon to choose whether to open the stop 1570 after the actuation of the staples or instruct the control device to carry out the process of cutting tissue. The tool 1500 may include a first button, for example, which can be actuated by the surgeon to open the stop 1570, and a second button, for example, which can be actuated by the surgeon to carry out the tissue cutting process.

In addition to the above, each surgical instrument described herein may include or may be modified to include one or more manually controlled triggers and / or one or more electric motors for controlling the instrument. Surgical Instruments 100, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1200, 1300, 1400, and 1500 may include a manually operated closure system that transfers forces from the closure trigger to the end effector of the surgical instrument . For example, tool 100 includes a manually operated closing system configured to transmit pivotal movement of the closing trigger 120 to end effector 150. In alternative embodiments, any of the tools described herein may include an electric motor configured to control tool closing system. Similar to the above, the tools may further include a control system configured to control the electric motor in response to one or more of the input from the surgeon and / or data received from one or more sensors of the tool.

In addition to or instead of the above, surgical instruments 100, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1200, 1300, 1400, and 1500 may include a manually-controlled trigger system that transfers power from the trigger mechanism to the end effector of a surgical instrument. For example, tool 100 includes a manually-controlled starting system configured to transmit rotational movement of the starting mechanism 130 to end effector 150. In alternative embodiments, any of the tools described herein may include an electric motor configured to control the starting tool system. Similar to the above, the tools may further include a control system configured to control the electric motor in response to one or more of the input from the surgeon and / or data received from one or more sensors of the tool.

The reader should understand that surgical instruments 100, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1200, 1300 and 1400 are often used during surgical methods in which one or more large incisions are made in a patient to provide access to the surgical field inside the patient. Such surgical techniques are often referred to as “open” surgical techniques. The solutions presented in this document are adaptable to surgical methods in which instruments are inserted through one or more of the trocars or cannulas, which, for example, provide access areas for the patient through smaller incisions. Open surgical methods often provide the surgeon with a better understanding of the surgical field, while laparoscopic surgical methods often lead to smaller scars on the patient’s body. Tool 1500 is configured to be inserted through a natural opening in the body, such as, for example, the anus of a patient. The solutions presented in this document are adaptable to surgical methods in which instruments are inserted through one or more natural openings of the patient’s body.

The reader must understand that the staples of surgical instruments 100, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1200, 1300, 1400 and 1500 are brought into operation longitudinally, that is, along, parallel or essentially parallel the longitudinal axis formed by the shaft of the surgical instrument. Other embodiments are provided in which the brackets are brought into operation along one or more axes that are perpendicular to the longitudinal axis. In FIG. 64 and 65, one such illustrative surgical instrument is described, that is, surgical instrument 1600. The surgical instrument 1600 comprises a jaw 1660 with a cassette with brackets and an emphasis 1670 for the jaw. The jaw 1660 with a cassette with brackets and / or an emphasis 1670 for the jaws made with the possibility of movement with clamping tissue between them. The jaw 1660 with a cassette with brackets comprises a cassette body 1661 including a plurality of recesses for the brackets formed therein. The cassette jaw 1660 further comprises a plurality of staples 1669 stored retrievable in the recesses for the staples, and a plurality of ejectors 1662 staples configured to eject the staples 1669 from the recesses for staples. The tool 1600 further comprises a trigger rail 1636, which is arranged to move distally with the elevation of the ejectors 1662 staples and staples 1669 to the stop 1670 for the jaws. The jaw stop 1670 includes pockets 1671 for forming brackets that are capable of deforming the brackets 1669, as illustrated in FIG. 64 and 65. The solutions presented herein are adaptable to a surgical instrument 1600 or the like.

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 branch contains an emphasis made with the possibility of deformation of the brackets ejected from the cartridge 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 or movable 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 staples 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 body 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 arranged to move between their inactive positions and activated positions using a 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 a lot of 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 pushed out before the scalpel.

The surgical instrument systems described herein have been described in connection with the placement and deformation of staples; however, the embodiments described herein are not limited to this application. Various embodiments are provided in which, for example, fasteners other than staples, for example, clamps or wide-nailed nails, are placed. In addition, various embodiments are provided in which any suitable means for sealing the fabric is used. For example, an end effector in accordance with various embodiments may comprise electrodes adapted to heat and seal the tissue. In addition, the end effector in accordance with particular embodiments may, for example, apply vibrational energy to seal the tissue.

Examples

Example 1. A surgical stapler for treating patient tissue comprises a handle, a rod extending from the handle, and an end effector extending from the rod, where the end effector is configured to change to an open configuration and a closed configuration. The end effector comprises a first jaw, a second jaw, where the second jaw is movable to the first jaw with the end effector in a closed configuration, the cassette body including recesses for staples, staples stored with the possibility of extraction in recesses for staples, and an emphasis made with the possibility of deformation of the brackets. The surgical stapler further comprises a closure system configured to move the second jaw to the first jaw, a trigger system comprising a trigger ejector configured to push the brackets from the recesses for the brackets to the stop during the launch stroke, and a cutting member configured to cut the tissue during the cutting stroke and retraction of the cutting element during the retraction stroke, and means for preventing the end effector from returning to the open configuration until the retraction stroke is completed.

Example 2. The surgical stapler of example 1, where the tool allows the end effector to return to the open configuration during the starting stroke.

Example 3. The surgical stapler of examples 1 or 2, where the tool allows the end effector to return to the open configuration after the start of the stroke and before the start of the cutting stroke.

Example 4. The surgical stapler of examples 1, 2 or 3, further comprising a tissue pin, configured to move between the disengaged position and the operational position, where the tissue pin is configured to grip tissue into an end effector, and a drive for the tissue pin, configured to pull the tissue pin between the disengaged position and the put into operational state position during the disengagement stroke and the pin for the tissue in the disengaged position during the discharge stroke, where the tool prevents the pin for the fabric from being pulled out of position during the cutting stroke.

Example 5. The surgical stapler of examples 1, 2 or 3, further comprising a tissue pin, configured to move between the disengaged position and the operational position, where the tissue pin is configured to grip tissue into an end effector, and a drive for the tissue pin, configured to pull the tissue pin between the disengaged position and the put into operational state position during the disengagement stroke and the pin for the tissue in the disengaged position during the discharge stroke, where the tool prevents the pin for the fabric from being pulled out of position during the starting stroke.

Example 6. A surgical stapler for treating a patient’s tissue, comprising a handle, a shaft extending from the handle, and an end effector extending from the rod, where the end effector is configured to change to an open configuration and a closed configuration. The end effector comprises a first jaw, a second jaw, where the second jaw is movable to the first jaw with the end effector in a closed configuration, the cassette body including recesses for staples, staples stored with the possibility of extraction in recesses for staples, and an emphasis made with the possibility of deformation of the brackets. The surgical stapler further comprises a closure system configured to move the second jaw to the first jaw, a trigger system comprising an ejector configured to push the brackets from the recesses for the brackets to the stop during the start-up stroke, and a cutting element configured to cut the tissue into a cutting stroke time, where the cutting element comprises a cutting edge that exits the cassette body during the cutting stroke, and means for preventing the closing system from returning to the open configuration while the cutting element exits.

Example 7. The surgical stapler of example 6, where the tool allows the end effector to return to the open configuration during the starting stroke.

Example 8. The surgical stapler of examples 6 or 7, where the tool allows the end effector to return to the open configuration after the completion of the start-up stroke and before the start of the cutting stroke.

Example 9. The surgical stapler of examples 6, 7 or 8, where the tool allows the end effector to return to the open configuration after completion of the starting stroke and before the exit of the cutting element.

Example 10. The surgical stapler of examples 6, 7, 8, or 9, further comprising a tissue pin configured to move between the disengaged position and the put into operational state position, where the tissue pin is capable of gripping tissue at an end an effector and a drive for the tissue pin, configured to pull the tissue pin between the disengaged position and the put into operational state position during the disengaging stroke the pinning and retraction of the tissue pin into the retracted position during the retraction stroke, where the means prevents the retraction of the tissue pin from the retracted position, while the cutting element exits.

Example 11. The surgical stapler of examples 6, 7, 8, or 9, further comprising a tissue pin configured to move between a position that was taken out of an operating state and a position put into an operational state, where the tissue pin is capable of gripping tissue at an end an effector and a drive for the tissue pin, configured to pull the tissue pin between the disengaged position and the put into operational state position during the disengaging stroke hardening and retracting the tissue pin to the retracted position during the retraction stroke, where the means prevents retracting the tissue pin to the retracted position during the starting stroke.

Example 12. A surgical stapler for treating patient tissue, comprising a handle, a shaft extending from the handle, and an end effector extending from the rod, where the end effector is configured to change to an open configuration and a closed configuration. The end effector comprises a first jaw, a second jaw, where the second jaw is movable to the first jaw with the end effector in a closed configuration, the cassette body including recesses for staples, staples stored with the possibility of extraction in recesses for staples, and an emphasis made with the possibility of deformation of the brackets. The surgical stapler further comprises a closure system configured to move the second jaw to the first jaw, a trigger system comprising a bracket ejector, where the trigger system is configured to push the bracket ejector to the stop during the launch stroke and retract the bracket ejector during the retraction stroke, and a cutting element configured to cut the fabric during the cutting stroke, where the cutting element contains a cutting edge that extends from the box office during the cutting stroke, and means for preventing the retraction of the ejector staples, while the cutting element comes out.

Example 13. The surgical stapler of example 12, where the tool allows the end effector to return to the open configuration during the starting stroke.

Example 14. The surgical stapler of examples 12 or 13, where the tool allows the end effector to return to the open configuration after the start of the stroke and before the start of the cutting stroke.

Example 15. The surgical stapler of examples 12, 13 or 14, where the tool allows the end effector to return to the open configuration after the start of the stroke and before the exit of the cutting element.

Example 16. The surgical stapler of examples 12, 13, 14, or 15, further comprising a tissue pin configured to move between the position that was taken out of the operating state and the position brought into the operational state, where the tissue pin is capable of gripping the tissue at the end an effector and a drive for the tissue pin, configured to pull the tissue pin between the disengaged position and the put into operational state position during the disengagement stroke standing and retracting the tissue pin in the retracted position during the retraction stroke, where the means prevents retracting the tissue pin in the retracted position during the cutting stroke.

Example 17. The surgical stapler of examples 12, 13, 14, or 15, further comprising a tissue pin configured to move between the disengaged position and the put into operational position position, where the tissue pin is capable of gripping tissue at an end an effector and a drive for the tissue pin, configured to pull the tissue pin between the disengaged position and the put into operation state during the disengagement stroke and the tissue pin in the disengaged position during the discharge stroke where the means prevents the pin for tissue from being pulled out of position during the start-up stroke.

Example 18. A surgical stapler for treating tissue of a patient, comprising a handle, a shaft extending from the handle, an end effector extending from the rod, where the end effector is configured to change to an open configuration and a closed configuration. The end effector contains the first jaw, the second jaw, where the second jaw is movable to the first jaw with the end effector in a closed configuration, the cassette body, including the recesses for the brackets, staples stored with the possibility of extraction in the recesses for the brackets, emphasis, made with the possibility of deformation of the staples, and a pin for fabric, made with the possibility of movement between the disengaged position and the entered position, where the pin for fabric is made with the ability to capture tissue into the end effector. The surgical stapler further comprises a closure system configured to move the second jaw to the first jaw, a tissue pin drive configured to move the tissue pin between the position taken out of operation and the position entered into working state during the bringing up state and retracting the tissue pin into the retracted position during the retraction stroke, a trigger system comprising a bracket ejector, where the trigger system the volume is made with the possibility of pushing the ejector brackets to the stop during the starting stroke, and a cutting element made with the possibility of cutting the fabric during the cutting stroke, where the cutting element contains a cutting edge that comes out of the cassette during the cutting stroke, and means to prevent retraction a tissue pin while the cutting element comes out.

Example 19. The surgical stapler of example 18, where the tool allows the end effector to return to the open configuration during the starting stroke.

Example 20. The surgical stapler of examples 18 or 19, where the tool allows the end effector to return to the open configuration after the start of the stroke and before the start of the cutting stroke.

Example 21. The surgical stapler of examples 18, 19 or 20, where the tool allows the end effector to return to the open configuration after the start of the stroke and before the exit of the cutting element.

Example 22. A surgical stapler for treating tissue of a patient, comprising a handle, a shaft extending from the handle, and an end effector extending from the shaft, comprising a first jaw, a second jaw, where one of the first jaw and the second jaw is movable relative to the other first jaws, cartridge case, including recesses for staples, staples stored with the possibility of extraction in recesses for staples, and an emphasis made with the possibility of deformation of staples. The surgical stapler further comprises a trigger system configured to push the brackets out of the bracket recesses to the stop during the launch stroke and cutting the fabric during the cutting stroke after the completion of the launch stroke.

Example 23. The surgical stapler of example 22, where the trigger system includes a trigger rail, and the trigger rail is made with the possibility of movement to the end effector with the implementation of the starting stroke and the cutting progress.

Example 24. The surgical stapler of examples 22 or 23, further comprising a stopper configured to stop the trigger rail after the trigger stroke.

Example 25. The surgical stapler of Example 24, wherein the stop is manually actuated to release the trigger so that the trigger can carry out a cutting stroke.

Example 26. The surgical stapler of examples 22, 23, 24 or 25, where the trigger system further comprises a staple ejector configured to eject staples from the recesses for staples, and a cutting element configured to cut tissue, where the cutting element is moved with the ejector staples during the starting stroke and where the cutting element does not cut the fabric during the starting stroke.

Example 27. The surgical stapler of Example 26, wherein the cutting element is connected to the staple ejector during the starting stroke and where the cutting element is disconnected from the staple ejector during the cutting stroke.

Example 28. The surgical stapler of examples 26 or 27, further comprising a clip that holds releasably the cutting element with the bracket ejector during the starting stroke of the trigger element, where the clip is configured to release the cutting element from the bracket ejector when the force transmitted through trigger element, exceeds the threshold force.

Example 29. The surgical stapler of examples 26 or 27, further comprising a clamp that holds releasably the ejector staples with the cutting element during the starting stroke of the trigger element, and a clamping device configured to hold the clamp releasably held in place during clamping the starting stroke and ensuring the bias of the clamp to the open position with the release of the starting element out of engagement with the starting rail during the cutting stroke.

Example 30. The surgical stapler of examples 22, 23, 24, 25, 26, 27, 28 or 29, where the handle contains a trigger hook, operatively connected to the trigger element, while the trigger is able to rotate in the first range of motion and the second range of motion wherein the trigger moves the trigger along the trigger path when the trigger moves in the first range of motion, and the hook moves the trigger along the cutting path when the trigger moves in the second range of motion.

Example 31. The surgical stapler of Example 30, wherein the first range of motion is separate from the second range of motion.

Example 32. The surgical stapler of examples 30 or 31, where the first range of motion and the second range of motion occur during one actuation of the trigger.

Example 33. The surgical stapler of examples 22, 23, 24, 25, 26, 27, 28, 29, 30, 31 or 32, further comprising an indicator configured to provide a first indication when the starting stroke is completed, and a second indication, when the cutting stroke is completed, and the first display is different from the second display.

Example 34. The surgical stapler of Example 33, wherein the first indication comprises one of visual indications, auditory indications and tangible indications, and the second indication comprises one visual indications, auditory indications and tangible indications.

Example 35. The surgical stapler of Example 30, wherein the first range of motion occurs during one actuation of the trigger, and where the second range of motion occurs during another actuation of the trigger.

Example 36. The surgical stapler of Example 30, further comprising an indicator configured to provide a first indication when one actuation of the trigger is completed, and provide a second indication when another actuation of the trigger is completed, and wherein the first indication is different from the second display.

Example 37. The surgical stapler of examples 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, or 36, where the trigger system comprises a trigger rail configured to eject staples from the recesses for the brackets during the starting stroke, and a cutting device configured to cut the fabric during the cutting stroke.

Example 38. The surgical stapler of Example 37, wherein the trigger system further comprises a trigger, wherein the trigger bar moves to the end effector while actuating the trigger, and the cutting device moves to the end effector while actuating the trigger .

Example 39. The surgical stapler of Example 38, wherein the trigger is capable of switching between a first position in which the trigger is operatively engaged with the trigger and a second position in which the trigger is operatively engaged with the cutting device.

Example 40. The surgical stapler of examples 38 or 39, further comprising a switching mechanism configured to automatically disengage the trigger hook from the trigger rail and engage the cutting device after the trigger stroke.

Example 41. The surgical stapler of examples 38, 39 or 40, further comprising a switching mechanism configured to manually release the trigger from the mesh with the trigger rail and engage the cutting device after the trigger.

Example 42. The surgical stapler of Example 37, wherein the trigger system further comprises a trigger, wherein the trigger rail moves to the end effector during the first actuation of the trigger, and the cutting device moves to the end effector during the second actuation trigger hook.

Example 43. The surgical stapler of Example 37, wherein the trigger system further comprises a trigger hook that is operatively engaged with the trigger rail, while actuating the trigger moves the trigger rail along the trigger path, and the cutting trigger is functional meshing with the cutting device, while actuating the trigger for cutting moves the cutting device along the cutting path.

Example 44. The surgical stapler of examples 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, or 43, where the starting system is further configured to suspend the operation of the surgical stapler after the completion of the start-up stroke, thereby enabling the user of the surgical stapler to optionally choose whether to cut using the surgical stapler.

Example 45. A surgical stapler for treating a patient’s tissue, comprising a handle, a shaft extending from the handle, and an end effector extending from the shaft, comprising a first jaw, a second jaw, where one of the first jaw and the second jaw is movable relative to the other first jaws, cartridge case, including recesses for staples, staples stored with the possibility of extraction in recesses for staples, and an emphasis made with the possibility of deformation of staples. The surgical stapler further comprises a trigger rail configured to push the brackets out of the recesses for the brackets during the launch stroke, a cutting device configured to cut tissue during the cutting stroke, a trigger hook that is operatively engaged with the trigger rail, the action of the trigger moves the trigger over the trigger, and the trigger for cutting is in functional engagement with the cutting device, while actuating the trigger for cutting moves the cutting device along the cutting path.

Example 46. A surgical stapler for treating patient tissue, comprising a handle, a shaft extending from the handle, and an end effector extending from the shaft, comprising a first jaw, a second jaw, where one of the first jaw and the second jaw is movable relative to the other first jaws, cartridge case, including recesses for staples, staples stored with the possibility of extraction in recesses for staples, and an emphasis made with the possibility of deformation of staples. The surgical stapler further comprises a trigger system configured to push the brackets out of the recesses for the brackets toward the stop during the launch stroke, a cutting system configured to cut the tissue during the cutting stroke, and means for preventing the cutting stroke from being carried out by the cutting system while the trigger system will not complete the starting stroke.

Example 47. A surgical stapler for treating patient tissue, comprising a handle, a shaft extending from the handle, and an end effector extending from the rod. The end effector comprises a first jaw, a second jaw, where one of the first jaw and the second jaw is movable relative to the other first jaw, the cassette body including recesses for staples, staples stored with the possibility of extraction in recesses for staples, and an emphasis, made with the possibility of deformation of the brackets. The surgical stapler further comprises a trigger system configured to push the brackets out of the bracket recesses to the stop during the launch stroke and cut the fabric during the cutting stroke after the launch stroke is completed, and means for providing the surgical instrument user with the ability to choose whether to cut with using a surgical stapler after starting.

Example 48. The surgical stapler of Example 47, further comprising feedback means for providing an indication of when the starting stroke is completed.

Example 49. The surgical stapler of examples 47 or 48, further comprising feedback means for providing an indication when the trigger system is near the end of the trigger stroke.

Example 50. The surgical stapler of examples 47, 48 or 49, further comprising feedback means for providing an indication when the cutting progress is completed.

Example 51. The surgical stapler of examples 47, 48, 49 or 50, further comprising feedback means for providing an indication when the trigger system is near the end of the cutting stroke.

Example 52. The surgical stapler of examples 47, 48, 49, 50, or 51, further comprising a visual indicator strip including a first range and a second range, where the first range shows the starting stroke and the second range showing the cutting stroke.

Example 53. The surgical stapler of examples 47, 48, 49, 50, 51, or 52, wherein the means comprises a stopper configured to stop the launch system after the start-up stroke, and wherein the stopper is configured to selectively release the surgical stapler by the user.

Example 54. A surgical stapler for treating a patient’s tissue, comprising a handle, a shaft extending from the handle, and an end effector extending from the shaft, comprising a first jaw, a second jaw, where one of the first jaw and the second jaw is movable relative to the other first jaws, cartridge case, including recesses for staples, staples stored with the possibility of extraction in recesses for staples, and an emphasis made with the possibility of deformation of staples. The surgical stapler further comprises a trigger system configured to push the staples from the recesses for the brackets to the stop during the launch stroke, a cutting system configured to cut the tissue during the cutting stroke after completion of the launch stroke, and means for suspending the surgical stapler to provide the user with a surgical stapler the ability to choose whether or not to carry out the cutting course using a surgical stapler.

Example 55. The surgical stapler of Example 54, further comprising feedback means for providing an indication of when the starting stroke is completed.

Example 56. The surgical stapler of examples 54 or 55, further comprising feedback means for providing an indication when the trigger system is near the end of the trigger stroke.

Example 57. The surgical stapler of examples 54, 55 or 56, further comprising feedback means for providing an indication when the cutting progress is completed.

Example 58. The surgical stapler of examples 54, 55, 56 or 57, further comprising feedback means for providing an indication when the cutting system is near the end of the cutting stroke.

Example 59. The surgical stapler of examples 54, 55, 56, 57 or 58, further comprising a visual indicator strip including a first range and a second range, where the first range shows the start of the start stroke and the second range shows the execution of the cutting stroke.

Example 60. The surgical stapler of examples 54, 55, 56, 57, 58, or 59, wherein the trigger system comprises a trigger, a trigger rail that is operatively engaged with the trigger, the actuation of the trigger pushing the trigger towards the end the effector during the starting stroke, and a tactile feedback generator meshed with the starting rail.

Example 61. The surgical stapler of Example 60, wherein the tactile feedback generator is configured to generate a series of sounds that become louder as the launch stroke is performed.

Example 62. The surgical stapler of Examples 60 or 61, wherein the tactile feedback generator is silent during the first part of the starting stroke and is audible during the second part of the starting stroke.

Example 63. The surgical stapler of examples 60, 61 or 62, where the tactile feedback generator is configured to generate a number of sounds at a speed that increases as the launch progresses.

Example 64. The surgical stapler of Examples 60, 61, 62, or 63, wherein the tactile feedback generator generates tangible feedback when the trigger rail reaches the end of its trigger stroke.

Example 65. The surgical stapler of examples 54, 55, 56, 57, 58, 59, 60, 61, 62, 63 or 64, where the tool contains a stopper configured to stop the launch system after the start stroke, and the limiter is made with the possibility of selective release by the user of a surgical stapler.

Example 66. A surgical stapler for treating tissue of a patient, comprising a handle, a shaft extending from the handle, and an end effector extending from the shaft, comprising a first jaw, a second jaw, where one of the first jaw and the second jaw is movable relative to the other first jaws, cartridge case, including recesses for staples, staples stored with the possibility of extraction in recesses for staples, and an emphasis made with the possibility of deformation of staples. The surgical stapler further comprises a trigger system configured to push the brackets out of the recesses for the brackets to the stop during the trigger stroke, a cutting system configured to cut the tissue during the cutting stroke after the trigger stroke is completed, and a feedback generator configured to indicate movements between the starting stroke and the cutting stroke.

Example 67. A surgical stapler for treating patient tissue, comprising a handle, a shaft extending from the handle, and an end effector extending from the rod, where the end effector is configured to change to an open configuration and a closed configuration. The end effector comprises a first jaw, a second jaw, where the second jaw is movable to the first jaw with the end effector in a closed configuration, the cassette body including recesses for staples, staples stored with the possibility of extraction in recesses for staples, and an emphasis made with the possibility of deformation of the brackets. The surgical stapler further comprises a closure system configured to move the second jaw to the first jaw, and a trigger system comprising a bracket ejector, where the trigger system is configured to push the bracket ejector to the stop during the launch stroke and retract the bracket ejector during the retraction stroke, and a cutting element configured to cut the fabric during the cutting stroke, where the cutting element contains a cutting edge that exits the cassette body during the cutting stroke. The surgical stapler further comprises a locking device configured to prevent retraction of the staple ejector during the starting stroke, and a bypass element configured to overcome the blocking so that the staple ejector can be retracted during the starting stroke.

Example 68. A surgical stapler for treating a patient’s tissue, comprising a handle, a shaft extending from the handle, and an end effector extending from the rod, where the end effector is configured to change to an open configuration and a closed configuration. The end effector comprises a first jaw, a second jaw, where the second jaw is movable to the first jaw with the end effector in a closed configuration, the cassette body including recesses for staples, staples stored with the possibility of extraction in recesses for staples, and an emphasis made with the possibility of deformation of the brackets. The surgical stapler further comprises a closure system configured to move the second jaw to the first jaw, and a trigger system comprising a bracket ejector, where the trigger system is configured to push the bracket ejector to the stop during the launch stroke and retract the bracket ejector during the retraction stroke, and a cutting element configured to cut the fabric during the cutting stroke, where the cutting element contains a cutting edge that exits the cassette body during the cutting stroke. The surgical stapler further comprises a lock configured to prevent retraction of the staple ejector before the end of the cutting stroke, and a bypass element configured to overcome the lock so that the staple ejector can be retracted before the end of the cutting stroke.

Example 69. A surgical stapler for treating tissue of a patient, comprising a handle, a shaft extending from the handle, and an end effector extending from the rod, where the end effector is configured to change to an open configuration and a closed configuration. The end effector comprises a first jaw, a second jaw, where the second jaw is movable to the first jaw with the end effector in a closed configuration, the cassette body including recesses for staples, staples stored with the possibility of extraction in recesses for staples, and an emphasis made with the possibility of deformation of the brackets. The surgical stapler further comprises a closure system configured to move the second jaw to the first jaw, and a trigger system comprising a bracket ejector, where the trigger system is configured to push the bracket ejector to the stop during the launch stroke and retract the bracket ejector during the retraction stroke, and a cutting element configured to cut the fabric during the cutting stroke, where the cutting element contains a cutting edge that exits the cassette body during the cutting stroke. The surgical stapler further comprises a locking device configured to prevent retraction of the cutting element during the cutting stroke, and a bypass element configured to overcome locking so that the cutting element can be retracted during the cutting stroke.

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;

U.S. 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 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;

US patent application No. 12 / 235,782, entitled MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT, currently US 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;

U.S. 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 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 U.S. Patent No. 9072535;

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

US Patent Application No. 13 / 800,025, entitled STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, filed March 13, 2013, the current publication of US Patent Application No. 2014/0263551;

US Patent Application No. 13 / 800,067, entitled STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, filed March 13, 2013, currently publishing US patent application No. 2014/0263552;

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

U.S. Patent Application Publication No. 2010/0264194, entitled SURGICAL STAPLING INSTRUMENT WITH AN ARTICULATABLE END EFFECTOR, filed April 22, 2010, currently US 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.

The devices described herein can be disposed of after a single use, or they can be made multiple 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 rebuild the device. The use of such techniques, as well as the resulting reconditioned device are included in the scope of this application.

By way of example only, the versions described herein may undergo processing prior to surgery. Firstly, a new or used tool can be obtained and processed if necessary. Then the instrument can be sterilized. According to one sterilization method, the instrument is placed in a closed and sealed container, such as a plastic bag or a Tyvek bag (TYVEK). Then the container with the tool can be placed in the field of radiation capable of penetrating into the container, such as gamma radiation, x-ray radiation or a beam of fast electrons. Radiation can kill bacteria on the surface of the instrument and in the container. After that, the sterilized instrument can be stored in a sterile container. A sealed container can keep the instrument sterile until it becomes necessary to use it in a medical facility. The device can also be sterilized using any other technique known in the art, including, but not limited to, beta or gamma radiation, ethylene oxide, plasma peroxide or steam.

Although the present invention is described as having examples of configurations, the present invention can be further modified within the spirit and scope of the description. Therefore, it is intended that this application cover all possible variations, methods of applying or adapting the invention using its general principles.

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, the description, expressly set forth herein, to the extent that this is necessary, prevails over any conflicting material incorporated herein by reference. Any material or part thereof, indicated as incorporated herein by reference, but contrary to existing definitions, provisions or other description materials set forth herein, will be included only to the extent that there is no conflict between the material included and the existing description material .

Claims (64)

1. A surgical stapler for treating tissue of a patient, comprising: handle; a rod extending from the specified handle; an end effector extending from said rod, where said end effector is configured to change into an open configuration and a closed configuration, and where said end effector comprises: first jaw; the second branch, where the specified second branch is configured to move to the specified first branch to translate the specified end effector into the specified closed configuration; cassette case including recesses for staples; staples stored with the possibility of extraction in the indicated recesses for staples; and emphasis made with the possibility of deformation of these brackets; a closing system configured to move said second branch to said first branch; a launch system comprising: a trigger ejector configured to eject said brackets from said recesses for the brackets to said stop during the starting stroke; and a cutting member configured to cut the fabric during the cutting and retraction stroke of said cutting member during the retraction stroke; and means for preventing the return of said end effector to said open configuration until said retraction stroke is completed. 2. The surgical stapler according to claim 1, wherein said means allows said end effector to return to said open configuration during said starting stroke. 3. The surgical stapler according to claim 1, wherein said means allows said end effector to return to said open configuration after completion of said starting stroke and before the beginning of said cutting stroke. 4. The surgical stapler according to claim 1, further comprising: a tissue pin configured to move between a position that has been taken out of an operating state and a position put into an operational state, wherein said tissue pin is capable of gripping a tissue at said terminal effector; and a drive for the tissue pin, configured to pull the specified tissue pin between the indicated disengaged position and the specified put into operation state during the disengaging state and the specified tissue pin in the specified disengaged position during the lead, while this means prevents the retraction of the specified pin for the fabric in the specified disengaged position during the specified course of cutting. 5. The surgical stapler according to claim 1, further comprising: a tissue pin configured to move between a position that has been taken out of an operating state and a position put into an operational state, where said tissue pin is capable of gripping a tissue in said terminal effector; and a drive for the tissue pin, configured to pull the specified tissue pin between the indicated disengaged position and the specified put into operation state during the disengaging state and the specified tissue pin in the specified disengaged position during the lead, while this means prevents the retraction of the specified pin for the fabric in the specified disengaged position during the specified starting stroke. 6. A surgical stapler for treating tissue of a patient, comprising: handle; a rod extending from the specified handle; an end effector extending from said rod, where said end effector is configured to change into an open configuration and a closed configuration, and where said end effector comprises: first jaw; the second branch, where the specified second branch is configured to move to the specified first branch with the placement of the specified end effector in the specified closed configuration; cassette case including recesses for staples; staples stored with the possibility of extraction in the indicated recesses for staples; and emphasis made with the possibility of deformation of these brackets; a closing system configured to move said second branch to said first branch; a launch system comprising: the ejector brackets, while the specified starting system is configured to push the indicated ejector brackets to the specified stop during the starting stroke and retract the specified ejector brackets during the retraction; and a cutting element configured to cut the fabric during the cutting stroke, where the specified cutting element contains a cutting edge that leaves the specified cassette body during the specified cutting stroke; and means for preventing the retraction of the indicated ejector staples, while the specified cutting element. 7. The surgical stapler of claim 6, wherein said means allows said end effector to return to said open configuration during said starting stroke. 8. The surgical stapler according to claim 6, wherein said means allows said end effector to return to said open configuration after completion of said starting stroke and before the beginning of said cutting stroke. 9. The surgical stapler according to claim 6, wherein said means allows said end effector to return to said open configuration after completion of said starting stroke and before the exit of said cutting element. 10. The surgical stapler according to claim 6, further comprising: a tissue pin configured to move between a position that has been taken out of an operating state and a position put into an operational state, where said tissue pin is capable of gripping a tissue in said terminal effector; and a drive for the tissue pin, configured to pull the specified tissue pin between the indicated disengaged position and the specified put into operation state during the disengaging state and the specified tissue pin in the specified disengaged position during the lead, while this means prevents the retraction of the specified pin for the fabric in the specified disengaged position during the specified course of cutting. 11. The surgical stapler according to claim 6, further comprising: a tissue pin configured to move between a position that has been taken out of an operating state and a position put into an operational state, where said tissue pin is capable of gripping a tissue in said terminal effector; and a drive for the tissue pin, configured to pull the specified tissue pin between the indicated disengaged position and the specified put into operation state during the disengaging state and the specified tissue pin in the specified disengaged position during the lead, while this means prevents the retraction of the specified pin for the fabric in the specified disengaged position during the specified starting stroke. 12. A surgical stapler for treating tissue of a patient, comprising: handle; a rod extending from the specified handle; an end effector extending from said rod, where said end effector is configured to change into an open configuration and a closed configuration, and where said end effector comprises: first jaw; the second branch, where the specified second branch is configured to move to the specified first branch with the placement of the specified end effector in the specified closed configuration; cassette case including recesses for staples; staples stored with the possibility of extraction in the indicated recesses for staples; emphasis made with the possibility of deformation of these brackets; and a tissue pin configured to move between a position that has been taken out of an operating state and a position put into an operational state, where said tissue pin is capable of gripping a tissue in said terminal effector; a closing system configured to move said second branch to said first branch; a drive for the tissue pin, configured to move the specified tissue pin between the indicated disengaged position and the specified put into operation state during the disengaging operation and retracting the specified tissue pin to the specified disengaged position during retraction stroke; a launch system comprising: the ejector brackets, while the specified starting system is configured to push the specified ejector brackets to the specified stop during the starting stroke; and a cutting element configured to cut the fabric during the cutting stroke, where the specified cutting element contains a cutting edge that leaves the specified cassette body during the specified cutting stroke; and means for preventing the retraction of the specified tissue pin while the specified cutting element exits. 13. The surgical stapler of claim 12, wherein said means allows said end effector to return to said open configuration during said starting stroke. 14. The surgical stapler of claim 12, wherein said means allows said end effector to return to said open configuration after completing said starting stroke and before starting said cutting stroke. 15. The surgical stapler of claim 12, wherein said means allows said end effector to return to said open configuration after completion of said starting stroke and before the exit of said cutting element.

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