RU2727765C2 - Supporting designs of the launching bar, made with possibility of movement, for surgical instruments with possibility of hinged rotation - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: group of inventions relates to surgical stapling tools. Surgical instrument comprises an elongated shaft assembly which forms a shaft axis and comprises a surgical end effector functionally connected to it by means of a hinged joint. Surgical instrument includes a launching bar configured to move in a longitudinal direction, made with possibility to pass through hinged joint and with possibility of selective axial movement from initial position to end position. Middle support element is movably connected to the unit of elongated shaft and part of the surgical end effector. Proximal support link is proximal to the middle support element and is configured to provide lateral support to the proximal portion of the flexible trigger bar, crossing articulated joint. Distal support link is distal to the middle support member and is configured to provide lateral support to a distal portion of the flexible support bar intersecting the hinge joint.

EFFECT: invention provides improved location of target tissue.

16 cl, 96 dwg

Description

BACKGROUND OF THE INVENTION

The present invention relates to surgical instruments and, in various embodiments, to surgical stapling and cutting instruments and staple cassettes for use therewith.

The suturing instrument may include two interacting elongated jaws, each of which is adapted to be inserted into the patient's body and positioned relative to the tissue to be sutured and / or cut. In various embodiments, one of the jaws can support a staple cartridge with at least two rows of staples contained therein, and the second jaw can support an abutment with staple-forming indentations aligned with the rows of staples in the staple cartridge. As such, the stapling tool may further include a push rod and scalpel blade that are movable relative to the jaws for sequentially pushing the staples out of the staple cassette by cam surfaces on the push rod and / or cam surfaces on a wedge-shaped slide that are pushed pusher rod. In at least one embodiment, the cam surfaces are configured to drive a plurality of staple ejectors in the cassette and associated with the staples to push the staples against the abutment and form laterally disposed rows of deformed staples in the tissue sandwiched between the jaws. In at least one embodiment, the scalpel blade may follow the cam surfaces and cut tissue along a line between the rows of staples.

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

BRIEF DESCRIPTION OF THE GRAPHIC MATERIALS

The various elements of the embodiments described herein, along with their advantages, may be understood upon reading the description below in conjunction with the accompanying drawings, wherein:

in FIG. 1 is a perspective view of an embodiment of a surgical instrument and elongate stem assembly;

in FIG. 2 is an exploded assembled view of the components of the handle or body portion of the surgical instrument shown in FIG. 1;

in FIG. 3 is an exploded view of a portion of the elongate bore assembly;

in FIG. 4 is another exploded view of another portion of the elongate barrel assembly shown in FIG. 3;

in FIG. 5 is an exploded view of an embodiment of a portion of a surgical end effector and an embodiment of a closure sleeve;

in FIG. 6 is a partial cross-sectional view of a portion of the surgical end effector and closure sleeve structure shown in FIG. five;

in FIG. 7 is a perspective view of the structure of the surgical end effector and closure sleeve shown in FIG. 5 and 6, with a stop in the open position or configuration;

in FIG. 8 is another perspective view of the structure of the surgical end effector and closure sleeve shown in FIG. 5-7, with an emphasis in the closed position or configuration;

FIG. 9 is a perspective view of an embodiment of a surgical end effector and elongate stem assembly, portions thereof not shown for clarity;

in FIG. 10 is a top view of an embodiment of portions of the surgical end effector and elongate stem assembly shown in FIG. 9, with the surgical end effector in an articulated pivot position or configuration;

in FIG. 11 is an exploded fragmentary view of an embodiment of the end effector and elongate stem assembly portions shown in FIG. 9 and 10;

in FIG. 12 is a top plan view of portions of the surgical end effector and elongate stem assembly shown in FIG. 9-11;

in FIG. 13 is a perspective view of an embodiment of portions of the surgical end effector and elongate stem assembly shown in FIG. 9-12, with the surgical end effector in the articulated position or configuration;

in FIG. 14 is a top view of an embodiment of portions of the surgical end effector and elongate stem assembly shown in FIG. 9-13, with the surgical end effector in an articulated pivot configuration, some of its components shown in cross-section for clarity;

in FIG. 15 is a perspective view of another embodiment of a portion of the elongate barrel assembly;

in FIG. 16 is another perspective view of an embodiment of the elongate barrel assembly shown in FIG. 15, with the cover tube and cover sleeve components not shown for clarity;

in FIG. 17 is a top view of an embodiment of portions of the elongated barrel assembly shown in FIG. 15 and 16;

in FIG. 18 is a side elevational cross-sectional view of an embodiment of the elongate barrel assembly shown in FIG. 15-17, with a cassette with surgical staples installed at the site of the surgical end effector;

in FIG. 19 is another side elevational cross-sectional view of the elongate barrel assembly shown in FIG. 15-18, with a cassette with surgical staples installed in the area of the surgical end effector;

in FIG. 20 is a top plan view of portions of the surgical end effector and elongate stem assembly shown in FIG. 15-19, with the surgical end effector in the articulated position or configuration;

in FIG. 20A is a side elevational view of a portion of another embodiment of a surgical end effector and closure sleeve;

in FIG. 21 is a perspective view of another embodiment of a surgical end effector and elongate stem assembly, portions thereof not shown for clarity;

in FIG. 22 is an exploded view of an embodiment of the surgical end effector and elongate stem assembly portions shown in FIG. 21;

in FIG. 23 is a top view of an embodiment of portions of the surgical end effector and elongate stem assembly shown in FIG. 21 and 22;

in FIG. 24 is another top view of an embodiment of portions of the surgical end effector and elongate stem assembly shown in FIG. 21-23, parts thereof not shown for clarity;

in FIG. 25 is another top view of an embodiment of portions of the surgical end effector and elongate stem assembly shown in FIG. 21-24, with the surgical end effector in the articulated position or configuration;

in FIG. 26 is an exploded perspective view of another embodiment of a portion of an elongate bore assembly;

in FIG. 27 is an exploded assembled view of an embodiment of portions of another surgical end effector and elongate stem assembly;

in FIG. 28 is a partial perspective view of an embodiment of a portion of the elongate barrel assembly shown in FIG. 27, parts thereof not shown for clarity;

in FIG. 29 is another partial perspective view of an embodiment of portions of the elongate barrel assembly shown in FIG. 27 and 28, parts thereof not shown for clarity;

in FIG. 30 is another partial perspective view of an embodiment of portions of the elongate barrel assembly shown in FIG. 27-29, parts thereof not shown for clarity;

in FIG. 31 is a top view of an embodiment of portions of the surgical end effector and elongate stem assembly shown in FIG. 27-30, parts thereof not shown for clarity;

in FIG. 32 is another top view of an embodiment of portions of the surgical end effector and elongate stem assembly shown in FIG. 27-31, parts thereof not shown for clarity, and wherein the surgical end effector is in an articulated position or configuration;

in FIG. 33 is a side elevational view of an embodiment of portions of the surgical end effector and elongate stem assembly shown in FIG. 27-32, parts thereof not shown for clarity;

in FIG. 34 is a perspective view of an embodiment of portions of the surgical end effector and elongate stem assembly shown in FIG. 27-33, parts thereof not shown for clarity;

in FIG. 35 is another partial perspective view of an embodiment of portions of the surgical end effector and elongate stem assembly shown in FIG. 27-34, parts thereof not shown for clarity;

in FIG. 36 is an exploded, assembled view of an embodiment of portions of a distal launch rod assembly and embodiments of a side carrier;

in FIG. 37 is a perspective view of the distal launch rod assembly and side carriers shown in FIG. 36;

in FIG. 38 is an enlarged cross-sectional view of portions of the distal launch rod assembly and side carriers shown in FIG. 36 and 37;

in FIG. 39 is another cross-sectional view of the distal launch rod assembly and side carriers shown in FIG. 36-38;

in FIG. 40 is a side elevational view of an embodiment of a portion of a distal firing rod assembly attached to an embodiment of a firing element;

in FIG. 41 is a top plan view of an embodiment of a portion of the distal trigger rod assembly and the trigger embodiment shown in FIG. 40;

in FIG. 42 is a cross-sectional view of an embodiment of a portion of the distal launch rod assembly shown in FIG. 40 and 41 with side carriers mounted thereon, an embodiment of the distal launch rod assembly in a flexed position or configuration;

in FIG. 43 is a perspective view of an embodiment of the distal launch rod assembly and the side carrier embodiments shown in FIG. 42;

in FIG. 44 is a perspective view of an embodiment of portions of another surgical end effector and an embodiment of an elongate stem assembly, portions not shown for clarity, and with the surgical end effector in a pivotal position or configuration;

in FIG. 45 is a top plan view of an embodiment of a surgical end effector and an embodiment of an elongated stem assembly shown in FIG. 44;

in FIG. 46 is another top view of an embodiment of a surgical end effector and an embodiment of the elongate stem assembly shown in FIG. 45, parts of their pivot link shown in cross section;

in FIG. 47 is a partial perspective view of another embodiment of portions of a surgical end effector and an embodiment of an elongated stem assembly, portions thereof not shown for clarity;

in FIG. 48 is a top view of an embodiment of portions of a surgical end effector and an embodiment of an elongated stem assembly shown in FIG. 47, parts thereof not shown for clarity;

in FIG. 49 is another top view of an embodiment of a surgical end effector and an embodiment of the elongate stem assembly shown in FIG. 48;

in FIG. 50 is a top perspective view of an embodiment of portions of a surgical end effector and an embodiment of an elongated stem assembly shown in FIG. 47-49, parts thereof not shown for clarity, and wherein the surgical end effector is in an articulated position or configuration;

in FIG. 51 is another top perspective view of an embodiment of portions of a surgical end effector and an embodiment of an elongated stem assembly shown in FIG. 50;

in FIG. 52 is an enlarged perspective view of an embodiment of portions of a surgical end effector and an embodiment of an elongated stem assembly shown in FIG. 51;

in FIG. 53 is a top plan view of another embodiment of portions of a surgical end effector and an embodiment of an elongate stem assembly, portions not shown for clarity, and wherein the surgical end effector is shown in a non-pivot hinged position or configuration and in a pivoted position or configuration;

in FIG. 54 is a top view of an embodiment of a portion of the elongated barrel assembly shown in FIG. 53 with the articulation system in a neutral or pivotal non-rotated position or configuration and with portions of the elongate barrel assembly omitted for clarity;

in FIG. 55 is another top view of an embodiment of a portion of the elongate barrel assembly shown in FIG. 54 with the articulation system in a first articulated pivot position or configuration;

in FIG. 56 is another top view of an embodiment of a portion of the elongate barrel assembly shown in FIG. 54 and 55, with the articulation system in a second articulated pivot position or configuration;

in FIG. 57 is a partial perspective view of another embodiment of portions of the elongate barrel assembly shown in FIG. 53-56, and an embodiment of portions of the surgical end effector in an articulated non-rotated position or configuration, portions thereof not shown for clarity;

in FIG. 58 is another partial perspective view of an embodiment of a surgical end effector and an embodiment of an elongated stem assembly shown in FIG. 57, parts thereof not shown for clarity;

in FIG. 59 is a top view of an embodiment of a portion of another elongate barrel assembly, portions thereof not shown for clarity;

in FIG. 60 is a top view of an embodiment of portions of another articulation system in a neutral or non-rotated pivot position;

in FIG. 61 is a top view of an embodiment of the articulation drive disc of the articulation system shown in FIG. 60;

in FIG. 62 is a top view of an embodiment of the driven articulation disc of the articulation system shown in FIG. 60;

in FIG. 63 is another top view of an embodiment of the articulation system shown in FIG. 60 in a position or configuration after a pivot control motion was initially applied thereto;

in FIG. 64 is another cross-sectional view of the articulation system shown in FIG. 63, in an articulated pivot position or configuration;

in FIG. 65 is another top view of an embodiment of the articulation system shown in FIG. 63 and 64, in a second pivot position or configuration;

in FIG. 66 is a perspective view of another embodiment of a surgical end effector and jaw closure sleeve in a closed position or configuration;

in FIG. 67 is another perspective view of an embodiment of the surgical end effector and closure sleeve shown in FIG. 66 with jaws in open position or configuration;

in FIG. 68 is a side elevational view of an embodiment of the surgical end effector and closure sleeve shown in FIG. 66 and 67, with the closure sleeve shown in cross-section and the jaws in the open position or configuration;

in FIG. 69 is a side elevational view of an embodiment of the surgical end effector and closure sleeve shown in FIG. 66-68, in cross section and with jaws in an open position or configuration;

in FIG. 70 is an exploded view of the embodiment of the surgical end effector and closure sleeve shown in FIG. 66-69;

in FIG. 71 is an exploded view of another embodiment of a surgical end effector and closure sleeve;

in FIG. 72 is a perspective view of another embodiment of a surgical end effector and jaw closure sleeve in an open position or configuration;

in FIG. 73 is another perspective view of an embodiment of the surgical end effector and closure sleeve shown in FIG. 72, with jaws in closed position or configuration;

in FIG. 74 is an exploded perspective view of the embodiment of the surgical end effector and closure sleeve shown in FIG. 72 and 73;

in FIG. 75 is a side elevational view of an embodiment of the surgical end effector and closure sleeve shown in FIG. 72-74, with jaws in closed position or configuration;

in FIG. 76 is a rear perspective view of the embodiment of the surgical end effector shown in FIG. 72-75, with an embodiment of the closure sleeve shown in dash-dotted lines for clarity;

in FIG. 77 is a cross-sectional side view of an embodiment of the surgical end effector and closure sleeve shown in FIG. 72-76, with jaws in closed position or configuration;

in FIG. 78 is another cross-sectional side view including one embodiment of the surgical end effector cam washers and closure sleeve shown in FIG. 72-77, with jaws in closed position or configuration;

in FIG. 79 is another cross-sectional side view including one embodiment of the surgical end effector cam washers and closure sleeve shown in FIG. 72-78, with jaws in open position or configuration;

in FIG. 80 is a partial perspective view of another embodiment of a surgical end effector and jaw closure sleeve in an open position or configuration;

in FIG. 81 is a partial perspective view of an embodiment of the surgical end effector and closure sleeve shown in FIG. 80, with jaws in a closed position or configuration;

in FIG. 82 is an exploded perspective view of the embodiment of the surgical end effector and closure sleeve shown in FIG. 80 and 81;

in FIG. 83 is a side elevational view of an embodiment of the surgical end effector and closure sleeve shown in FIG. 80-82, wherein its jaws are in a closed position or configuration;

in FIG. 84 is a side elevational view of an embodiment of the surgical end effector and closure sleeve shown in FIG. 80-83, a portion of the closure sleeve shown in cross-section and its jaws in an open position or configuration;

in FIG. 85 is an exploded perspective view of another embodiment of a surgical end effector and closure sleeve;

in FIG. 86 is a side elevational view of an embodiment of the surgical end effector and closure sleeve shown in FIG. 85, with jaws in closed position or configuration;

in FIG. 87 is a side elevational view of an embodiment of the surgical end effector and closure sleeve shown in FIG. 85 and 86, with jaws in an open position or configuration, a portion of the cover sleeve shown in cross-section;

in FIG. 88 is a perspective view of a portion of another embodiment of the elongate barrel assembly;

in FIG. 89 is another perspective view of an embodiment of the elongate barrel assembly shown in FIG. 88, with some components not shown for clarity;

in FIG. 90 is another perspective view of the elongate barrel assembly shown in FIG. 88 and 89, with the surgical end effector in an articulated position or configuration;

in FIG. 91 is an exploded view of the assembly of the elongate barrel assembly shown in FIG. 88-90;

in FIG. 92 is a top view of the elongated barrel assembly shown in FIG. 88-91, with some components not shown for clarity, and the surgical end effector is hinged in one direction;

in FIG. 93 is another top view of the elongated barrel assembly shown in FIG. 88-92, with some components not shown for clarity, and the surgical end effector pivotally rotated in a different direction;

in FIG. 94 is a perspective view of an embodiment of a surgical staple cartridge; and

in FIG. 95 is a perspective view of another embodiment of a surgical staple cartridge.

Corresponding elements in different views are denoted by corresponding symbols. The illustrative examples provided 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 incorporated herein by reference in its entirety:

- US Patent Application No. __________ entitled SURGICAL END EFFECTORS WITH POSITIVE JAW OPENING ARRANGEMENTS, Patent Attorney Dossier No. END7675USNP / 150110;

- US Patent Application No. __________ entitled END EFFECTORS WITH DUAL CAM ACTUATED JAW CLOSING FEATURES, Patent Attorney Dossier No. END7677USNP / 150112;

- US Patent Application No. __________ entitled SURGICAL STAPLING INSTRUMENTS WITH LOCKOUT ARRANGEMENTS FOR PREVENTING FIRING SYSTEM ACTUATION WHEN A CARTRIDGE IS SPENT OR MISSING; Patent Attorney Dossier No. END7676USNP / 150111;

- US Patent Application No. __________ entitled ARTICULATABLE SURGICAL INSTRUMENTS WITH COMPOSITE FIRING BEAM STRUCTURES WITH CENTER FIRING SUPPORT MEMBER FOR ARTICULATION SUPPORT, Patent Attorney Dossier No. END7673USNP / 150108;

- US Patent Application No. __________ entitled DUAL ARTICULATION DRIVE SYSTEM ARRANGEMENTS FOR ARTICULATABLE SURGICAL INSTRUMENTS, Patent Attorney Dossier No. END7672USNP / 150107; and

- US Patent Application No. __________ entitled PUSH / PULL ARTICULATION DRIVE SYSTEMS FOR ARTICULATABLE SURGICAL INSTRUMENTS, Patent Attorney File No. END7671USNP / 150106.

The applicant of this application owns the following patent applications filed March 6, 2015, each of which is incorporated herein by reference in its entirety:

- US patent application No. 14 / 640,746 entitled POWERED SURGICAL INSTRUMENT;

- US patent application No. 14 / 640,795 entitled MULTIPLE LEVEL THRESHOLDS TO MODIFY OPERATION OF POWERED SURGICAL INSTRUMENTS;

- US patent application No. 14 / 640,832 entitled ADAPTIVE TISSUE COMPRESSION TECHNIQUES TO ADJUST CLOSURE RATES FOR MULTIPLE TISSUE TYPES; dossier of patent attorney No. END7557USNP / 140482;

- US patent application No. 14 / 640,935 entitled OVERLAID MULTI SENSOR RADIO FREQUENCY (RF) ELECTRODE SYSTEM TO MEASURE TISSUE COMPRESSION;

- US patent application No. 14 / 640,831 entitled MONITORING SPEED CONTROL AND PRECISION INCREMENTING OF MOTOR FOR POWERED SURGICAL INSTRUMENTS;

- US patent application No. 14 / 640,859 entitled TIME DEPENDENT EVALUATION OF SENSOR DATA TO DETERMINE STABILITY, CREEP, AND VISCOELASTIC ELEMENTS OF MEASURES;

- US patent application No. 14 / 640,817 entitled INTERACTIVE FEEDBACK SYSTEM FOR POWERED SURGICAL INSTRUMENTS;

- US patent application No. 14 / 640,844 entitled CONTROL TECHNIQUES AND SUB-PROCESSOR CONTAINED WITHIN MODULAR SHAFT WITH SELECT CONTROL PROCESSING FROM HANDLE;

- US patent application No. 14 / 640,837 entitled SMART SENSORS WITH LOCAL SIGNAL PROCESSING;

- US patent application No. 14 / 640,765 entitled SYSTEM FOR DETECTING THE MIS-INSERTION OF A STAPLE CARTRIDGE INTO A SURGICAL STAPLER;

- US patent application No. 14 / 640,799 entitled SIGNAL AND POWER COMMUNICATION SYSTEM POSITIONED ON A ROTATABLE SHAFT; and

- US patent application No. 14 / 640,780 entitled SURGICAL INSTRUMENT COMPRISING A LOCKABLE BATTERY HOUSING.

The applicant of this application owns the following patent applications filed February 27, 2015, each of which is incorporated herein by reference in its entirety:

- US patent application No. 14 / 633,576 entitled SURGICAL INSTRUMENT SYSTEM COMPRISING AN INSPECTION STATION;

- US patent application No. 14 / 633,546 entitled SURGICAL APPARATUS CONFIGURED TO ASSESS WHETHER A PERFORMANCE PARAMETER OF THE SURGICAL APPARATUS IS WITHIN AN ACCEPTABLE PERFORMANCE BAND;

- US patent application No. 14 / 633,576 entitled SURGICAL CHARGING SYSTEM THAT CHARGES AND / OR CONDITIONS ONE OR MORE BATTERIES;

- US patent application No. 14 / 633,566 entitled CHARGING SYSTEM THAT ENABLES EMERGENCY RESOLUTIONS FOR CHARGING A BATTERY;

- US patent application No. 14 / 633,555 entitled SYSTEM FOR MONITORING WHETHER A SURGICAL INSTRUMENT NEEDS TO BE SERVICED;

- US patent application No. 14 / 633,542 entitled REINFORCED BATTERY FOR A SURGICAL INSTRUMENT;

- US patent application No. 14 / 633,548 entitled POWER ADAPTER FOR A SURGICAL INSTRUMENT;

- US patent application No. 14 / 633,526 entitled ADAPTABLE SURGICAL INSTRUMENT HANDLE;

- US patent application No. 14 / 633,541 entitled MODULAR STAPLING ASSEMBLY; and

- US patent application No. 14 / 633,562 entitled SURGICAL APPARATUS CONFIGURED TO TRACK AN END-OF-LIFE PARAMETER.

The applicant of this application owns the following patent applications, filed December 18, 2014, each of which is incorporated herein by reference in its entirety:

- US patent application No. 14 / 574,478 entitled SURGICAL INSTRUMENT SYSTEMS COMPRISING AN ARTICULATABLE END EFFECTOR AND MEANS FOR ADJUSTING THE FIRING STROKE OF A FIRING;

- US patent application No. 14 / 574,483 entitled SURGICAL INSTRUMENT ASSEMBLY COMPRISING LOCKABLE SYSTEMS;

- US patent application No. 14 / 575,139 entitled DRIVE ARRANGEMENTS FOR ARTICULATABLE SURGICAL INSTRUMENTS;

- US patent application No. 14 / 575.148 entitled LOCKING ARRANGEMENTS FOR DETACHABLE SHAFT ASSEMBLIES WITH ARTICULATABLE SURGICAL END EFFECTORS;

- US patent application No. 14 / 575,130 entitled SURGICAL INSTRUMENT WITH AN ANVIL THAT IS SELECTIVELY MOVABLE ABOUT A DISCRETE NON-MOVABLE AXIS RELATIVE TO A STAPLE CARTRIDGE;

- US patent application No. 14 / 575,143 entitled SURGICAL INSTRUMENTS WITH IMPROVED CLOSURE ARRANGEMENTS;

- US patent application No. 14 / 575,117 entitled SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTORS AND MOVABLE FIRING BEAM SUPPORT ARRANGEMENTS;

- US patent application No. 14 / 575,154 entitled SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTORS AND IMPROVED FIRING BEAM SUPPORT ARRANGEMENTS;

- US patent application No. 14 / 574,493 entitled SURGICAL INSTRUMENT ASSEMBLY COMPRISING A FLEXIBLE ARTICULATION SYSTEM; and

- US patent application No. 14 / 574,500 entitled SURGICAL INSTRUMENT ASSEMBLY COMPRISING A LOCKABLE ARTICULATION SYSTEM.

The applicant of this application owns the following patent applications filed March 1, 2013, each of which is incorporated herein by reference in its entirety:

- US Patent Application No. 13 / 782,295 entitled Articulatable Surgical Instruments With Conductive Pathways For Signal Communication, now US Patent Application Publication No. 2014/0246471;

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

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

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

- US Patent Application No. 13 / 782,460 entitled Multiple Processor Motor Control for Modular Surgical Instruments, currently US Patent Application Publication No. 2014/0246478;

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

- US Patent Application No. 13 / 782,481 entitled Sensor Straightened End Effector During Removal Through Trocar, now US Patent Application Publication No. 2014/0246479;

- U.S. Patent Application No. 13 / 782,518 entitled Control Methods for Surgical Instruments with Removable Implement Portions, currently U.S. Patent Application Publication No. 2014/0246475;

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

- US Patent Application No. 13 / 782,536 entitled Surgical Instrument Soft Stop, currently US Patent Application Publication No. 2014/0246476.

The applicant of this application also owns the following patent applications filed March 14, 2013, each of which is incorporated herein by reference in its entirety:

- US Patent Application No. 13 / 803,097 entitled ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE, currently US Patent Application Publication No. 2014/0263542;

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

- US Patent Application No. 13 / 803,053 entitled INTERCHANGEABLE SHAFT ASSEMBLIES FOR USE WITH A SURGICAL INSTRUMENT, currently US Patent Application Publication No. 2014/0263564;

- US Patent Application No. 13 / 803,086 entitled ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK, currently US Patent Application Publication No. 2014/0263541;

US Patent Application No. 13 / 803,210 entitled SENSOR ARRANGEMENTS FOR ABSOLUTE POSITIONING SYSTEM FOR SURGICAL INSTRUMENTS, currently US Patent Application Publication No. 2014/0263538;

US Patent Application No. 13 / 803,148 entitled MULTI-FUNCTION MOTOR FOR A SURGICAL INSTRUMENT, currently US Patent Application Publication No. 2014/0263554;

- US Patent Application No. 13 / 803,066 entitled DRIVE SYSTEM LOCKOUT ARRANGEMENTS FOR MODULAR SURGICAL INSTRUMENTS, currently US Patent Application Publication No. 2014/0263565;

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

- US Patent Application No. 13 / 803,130 entitled DRIVE TRAIN CONTROL ARRANGEMENTS FOR MODULAR SURGICAL INSTRUMENTS, currently US Patent Application Publication No. 2014/0263543; and

- US Patent Application No. 13 / 803,159 entitled METHOD AND SYSTEM FOR OPERATING A SURGICAL INSTRUMENT, currently US Patent Application Publication No. 2014/0277017.

The applicant of this application belongs to the following patent application filed on March 7, 2014, which is fully incorporated into this document by reference:

- US Patent Application No. 14 / 200,111 entitled CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS, currently US Patent Application Publication No. 2014/0263539.

The applicant of this application owns the following patent applications, filed March 26, 2014, each of which is incorporated herein by reference in its entirety:

- US patent application No. 14 / 226,106 entitled POWER MANAGEMENT CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS;

- US patent application No. 14 / 226,099 entitled STERILIZATION VERIFICATION CIRCUIT;

- US patent application No. 14 / 226,094 entitled VERIFICATION OF NUMBER OF BATTERY EXCHANGES / PROCEDURE COUNT;

- US patent application No. 14 / 226,117 entitled POWER MANAGEMENT THROUGH SLEEP OPTIONS OF SEGMENTED CIRCUIT AND WAKE UP CONTROL;

- US patent application No. 14 / 226,075 entitled MODULAR POWERED SURGICAL INSTRUMENT WITH DETACHABLE SHAFT ASSEMBLIES;

- US patent application No. 14 / 226,093 entitled FEEDBACK ALGORITHMS FOR MANUAL BAILOUT SYSTEMS FOR SURGICAL INSTRUMENTS;

- US patent application No. 14 / 226,116 entitled SURGICAL INSTRUMENT UTILIZING SENSOR ADAPTATION;

- US patent application No. 14 / 226,071 entitled SURGICAL INSTRUMENT CONTROL CIRCUIT HAVING A SAFETY PROCESSOR;

- US patent application No. 14 / 226,097 entitled SURGICAL INSTRUMENT COMPRISING INTERACTIVE SYSTEMS;

- US patent application No. 14 / 226,126 entitled INTERFACE SYSTEMS FOR USE WITH SURGICAL INSTRUMENTS;

- US patent application No. 14 / 226,133 entitled MODULAR SURGICAL INSTRUMENT SYSTEM;

- US patent application No. 14 / 226,081 entitled SYSTEMS AND METHODS FOR CONTROLLING A SEGMENTED CIRCUIT;

- US patent application No. 14 / 226,076 entitled POWER MANAGEMENT THROUGH SEGMENTED CIRCUIT AND VARIABLE VOLTAGE PROTECTION;

- US patent application No. 14 / 226,111 entitled SURGICAL STAPLING INSTRUMENT SYSTEM; and

- US patent application No. 14 / 226,125 entitled SURGICAL INSTRUMENT COMPRISING A ROTATABLE SHAFT.

The applicant of this application also owns the following patent applications filed on September 5, 2014, each of which is incorporated herein by reference in its entirety:

- US patent application No. 14 / 479,103 entitled CIRCUITRY AND SENSORS FOR POWERED MEDICAL DEVICE;

- US patent application No. 14 / 479,119 entitled ADJUNCT WITH INTEGRATED SENSORS TO QUANTIFY TISSUE COMPRESSION;

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

- US patent application No. 14 / 478,895 entitled MULTIPLE SENSORS WITH ONE SENSOR AFFECTING A SECOND SENSOR'S OUTPUT OR INTERPRETATION;

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

- US patent application No. 14 / 479,098 entitled SMART CARTRIDGE WAKE UP OPERATION AND DATA RETENTION;

- US patent application No. 14 / 479,115 entitled MULTIPLE MOTOR CONTROL FOR POWERED MEDICAL DEVICE; and

- US patent application No. 14 / 479,108 entitled LOCAL DISPLAY OF TISSUE PARAMETER STABILIZATION.

The applicant of this application also owns the following patent applications filed on April 9, 2014, each of which is incorporated herein by reference in its entirety:

US Patent Application No. 14 / 248,590 entitled MOTOR DRIVEN SURGICAL INSTRUMENTS WITH LOCKABLE DUAL DRIVE SHAFTS, currently US Patent Application Publication No. 2014/0305987;

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

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

US Patent Application No. 14 / 248,588 entitled POWERED LINEAR SURGICAL STAPLER, currently US Patent Application Publication No. 2014/0309666;

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

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

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

- US Patent Application No. 14 / 248,586 entitled DRIVE SYSTEM DECOUPLING ARRANGEMENT FOR A SURGICAL INSTRUMENT, currently US Patent Application Publication No. 2014/0305990; and

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

The applicant of this application also owns the following patent applications filed April 16, 2013, each of which is incorporated herein by reference in its entirety:

- US Provisional Patent Application No. 61 / 812,365 entitled SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY A SINGLE MOTOR;

- US Provisional Patent Application No. 61 / 812,376 entitled LINEAR CUTTER WITH POWER;

- US Provisional Patent Application No. 61 / 812,382 entitled LINEAR CUTTER WITH MOTOR AND PISTOL GRIP;

- US Provisional Patent Application No. 61 / 812,385 entitled SURGICAL INSTRUMENT HANDLE WITH MULTIPLE ACTUATION MOTORS AND MOTOR CONTROL; and

- US Provisional Patent Application No. 61 / 812,372 entitled SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY A SINGLE MOTOR.

This document provides the details necessary to understand the general design, functionality, manufacturing, and application of the various embodiments described in the specification and illustrated in the accompanying drawings. The well-known principles of operation, components and elements have not been described in detail herein, so as not to obscure the understanding of 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 structural and functional features described in this document may be indicative or explanatory in nature. Variations and modifications to the embodiments described and illustrated herein may be made within the scope of the claims.

The terms "comprise" (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 "inclusive"), "contain" (and any of its forms, such as "contains" and "containing") are unrestricted connecting verbs. As a result, a surgical system or device that “contains,” “has,” “includes,” or “contains” one or more features, possesses the one or more features, but is not limited to only that one or more features. Likewise, an element of a system or device that “contains,” “has,” “includes,” or “contains” one or more elements, possesses that one or more elements, but is not limited to only those one or more elements.

The terms "proximal" and "distal" are defined herein in relation to the physician operating the handle of the surgical instrument. The term "proximal" refers to the site closest to the physician, and the term "distal" refers to the site farthest from the physician. It is also suggested that, for convenience and clarity, spatial terms such as "vertical", "horizontal", "up" and "down" are used in this document in relation to figures. However, since the use of surgical instruments involves many orientations and positions, these terms should not be construed as limiting and / or absolute.

Various examples of devices and methods have been proposed for performing laparoscopic and minimally invasive surgical procedures. However, the reader will be well aware that the various methods and devices described herein can be used in a variety of surgical procedures and applications, including, for example, those associated with open surgery. In the course of this detailed description, the reader will be able to further appreciate that the various instruments described in this document can be inserted into the body in any way - both through natural openings and through an incision or puncture hole made in tissues, etc. Working parts or portions of the end effectors of such instruments can be inserted directly into the patient's body or through an access device that has a working channel through which the end effector and an elongated stem of the surgical instrument can be passed.

The surgical stapling system may comprise a stem and an end effector extending from the stem. The end effector may include a first jaw and a second jaw. The first branch contains a staple cassette. The cassette with staples is designed to be inserted into and removed from the first branch; however, other embodiments are contemplated in which the staple cartridge is non-removable from the first jaw, or at least is quick-replaceable from the first jaw. The second branch contains a stop made with the possibility of deformation of the staples ejected from the cassette with staples. The second jaw is made with the possibility of rotation relative to the first jaw about the closing axis; however, other embodiments are contemplated in which the first jaw is rotatable relative to the second jaw. The surgical stapling system further comprises a pivot joint configured to rotate or pivot the end effector relative to the shaft. The end effector is rotatable about an articulation axis passing through the articulation. Other embodiments are contemplated that do not include articulation.

The staple cassette contains the cassette body. The cassette body includes a proximal end, a distal end, and a platform extending between the proximal end and the distal end. In use, the staple cassette is positioned on the first side of the fabric to be stitched and the abutment is positioned on the second side of the fabric. The stop moves to the cassette with staples to compress and press the fabric against the platform. Thereafter, the staples stored in the removable cassette body can be placed in the tissue. The cassette body includes staple cavities formed therein, while the staples are removably stored in the staple cavities. The staple cavities are arranged in six longitudinal rows. Three rows of staple cavities are located on the first side of the longitudinal groove and three rows of staple cavities are located on the second side of the longitudinal groove. Other designs of staples and staple cavities are possible.

In the cassette body, the staples are supported by staple ejectors. The ejectors are movable between a first or non-activated position and a second or activated position to push the staples out of the staple cavities. The ejectors are held in the cassette body by a retainer that extends around the lower part of the cassette body and includes elastic elements configured to grip the cassette body and hold the retainer relative to the cassette body. The ejectors are made with the possibility of moving between their non-activated 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 plurality 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 is moved distally by the trigger. The trigger element is adapted to contact with the slide and push the slide towards the distal end. A longitudinal groove formed in the cassette body is adapted to receive a trigger element. The stop also includes a groove adapted to receive the trigger. The trigger further comprises a first cam that interacts with the first jaws and a second cam that interacts with the second jaws. When the trigger is extended distally, the first cam and the second cam allow control of the distance, or tissue gap, between the platform of the staple cassette and the stop. The trigger also contains a scalpel capable of dissecting tissue captured between the cassette with staples and the stop. It is desirable to at least partially position the scalpel proximal to the ramped surfaces so that the staples are pushed out before the scalpel.

FIG. 1-4 show a surgical cutting and stapling instrument with a motor 10, which may or may not be used repeatedly. In the illustrated embodiment, the surgical instrument 10 has a housing 12 that includes a handle 14 that can be gripped, manipulated, and activated by a clinician. Body 12 is operatively attachable to elongate shaft assembly 200 that has an operatively associated end effector 300 that is configured to perform one or more surgical tasks or interventions. The elongated barrel assembly 200 may be interchangeable with other barrel assemblies in various ways, as described, for example, in U.S. Patent Application No. 14 / 226,075 entitled MODULAR POWERED SURGICAL INSTRUMENT WITH DETACHABLE SHAFT ASSEMBLIES, the contents of which are incorporated herein by reference in their entirety. In other designs, the elongated barrel assembly may not be interchangeable with other barrel assemblies and is essentially a special non-removable part of the tool.

As you study the present detailed description, it will be understood that the shapes of the replaceable stem assemblies described herein can also be effectively applied in connection with robotic-controlled surgical systems. Thus, the term "housing" can also encompass a housing or similar part of a robotic system that contains or otherwise functionally supports at least one drive system configured to generate and apply at least one control motion that can be used to drive the effect of the elongated barrel assemblies described herein and their respective equivalents. The term "frame" can refer to a portion of a hand-held surgical instrument. The term "frame" can also represent a portion of a robotic controlled surgical instrument and / or a portion of a robotic system that can be used to functionally control a surgical instrument. For example, the stem assemblies described herein can be used with a variety of robotic systems, tools, components, and methods described in U.S. Patent Application No. 13 / 118,241 entitled SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS, currently patent application publication US patent No. 2012/0298719, which is fully incorporated into this document by reference.

The housing 12 shown in FIG. 1 is shown in conjunction with an elongated shaft assembly 200 that includes a surgical end effector 300 including a surgical cutting and stapling device that is operatively capable of supporting a staple cartridge 304 therein. Body 12 may be adapted for use with barrel assemblies that include end effectors adapted to support cassettes with staples of various sizes and types, have different barrel lengths, sizes, types, etc. In addition, body 12 can be efficiently be used with a variety of barrel assemblies, including those that are configured to apply other motions and forms of energy, such as, for example, radio frequency (RF) energy, ultrasonic energy and / or motion, in the form of end effector designs adapted for use in various areas of application and procedures. Moreover, end effectors, rod assemblies, handles, surgical instruments and / or surgical instrument systems may use any suitable fastener or fasteners to fix tissue. For example, a fastener cassette containing a plurality of removably stored fasteners may be removably inserted and / or attached to an end effector of the stem assembly.

FIG. 1 shows a housing 12 or handle 14 of a surgical instrument 10 with a replaceable elongated barrel assembly 200 operatively associated therewith. As shown in FIG. 1, the handle 14 may comprise a pair of interconnected handle body segments 16 and 18 that can be connected by screws, latches, glue, etc. In the illustrated design, the handle body segments 16 and 18 collectively form a pistol grip portion 19 that can be gripped hand that the doctor can manipulate. As will be further described in more detail below, the handle 14 functionally supports a plurality of drive systems that are configured to generate and apply various control motions to respective portions of the removable barrel assembly attached thereto.

As shown in FIG. 2, handle 14 may further include a frame 20 operatively supporting a plurality of drive systems. For example, frame 20 may functionally support a first system, or a closing drive system, generally referred to as member 30, which may be implemented to apply closing and opening movements to an elongate barrel assembly 200 that is operatively associated with or attached thereto. In at least one form, the closure drive system 30 may include an actuator in the form of a closure trigger 32 that is rotationally supported by the frame 20. In particular, as shown in FIG. 2, the closing trigger 32 is pivotally connected by a pin 33 to the housing 14. This design allows the physician to manipulate the closure trigger 32 such that when the physician grasps the pistol grip portion 19 of the handle 14, the closure trigger 32 can easily be pivoted from a home, or non-activated, position to an activated position, more specifically to a fully depressed or fully activated position. The closing trigger 32 can be biased to an unactivated position by a spring or other biasing mechanism (not shown). In various forms, the closure actuator system 30 further includes a closure member assembly 34 that is rotationally coupled to the closure trigger 32. As shown in FIG. 2, the cover link assembly 34 may have a first cover link 36 and a second cover link 38 that are pivotally connected to the cover trigger 32 by a pin 35. The second cover link 38 may also be referred to herein as a fastener and have a transverse fastening pin 37.

As shown in FIG. 2, the first cover link 36 may have a blocking wall or end 39 configured to cooperate with a cover mechanism release assembly 60 pivotally connected to the frame 20. In at least one form, the cover mechanism release assembly 60 may comprise assembly 62 a release button, which has a distally projecting locking pawl 64. The release button assembly 62 can be rotated counterclockwise by a release spring (not shown). When the clinician pushes the closure trigger 32 and moves it out of the non-activated position towards the pistol grip portion 19 of the handle 14, the first closure link 36 rotates upward to the point at which the locking pawl 64 engages the locking wall 39 on the first closure link 36. thereby preventing the closing trigger 32 from returning to a non-activated position. Thus, the closure 60 release assembly serves to lock the closure trigger 32 in a fully activated position. When the physician needs to unlock the closure trigger 32 so that it can move to the non-activated position, the physician simply rotates the closure release button assembly 62 so that the locking pawl 64 disengages from the locking wall 39 on the first closure link 36. After the locking pawl 64 is disengaged from the first cover link 36, the cover trigger 32 can be rotated back to a non-activated position. It is also possible to implement other locking and releasing mechanisms of the closing trigger mechanism.

When the closure trigger 32 is moved from a non-activated position to an activated position, the closure release button 62 pivots between a first position and a second position. The pivot of the closing mechanism release button 62 may be called upward pivot; however, at least a portion of the cover mechanism release button 62 pivots towards the printed circuit board 100. As shown in FIG. 2, the closure release button 62 may include a extending arm 61 and a magnetic member 63, such as, for example, a permanent magnet mounted on the arm 61. When the closure release button 62 pivots from its first position to a second position, the magnetic element 63 may move toward printed circuit board 100. Printed circuit board 100 may include at least one sensor that is configured to detect movement of magnetic element 63. In at least one embodiment, a Hall sensor may be mounted on the bottom surface of printed circuit board 100 ... The Hall sensor may be configured to detect changes in the magnetic field surrounding the Hall sensor caused by movement of the magnetic element 63. The Hall sensor may, for example, communicate with a microcontroller that may determine if the closing mechanism release button 62 is in a first position that is associated with an unactivated position of the closure trigger 32 and an open end effector configuration, in a second position that is associated with an activated position of the closure trigger 32 and a closed end effector configuration, and / or any position between the first and second positions.

In the structure shown, handle 14 and frame 20 may also functionally support another drive system, referred to herein as trigger drive system 80, adapted to apply triggering motions to respective portions of the replaceable barrel assembly attached thereto. The starter drive system 80 may also be referred to herein as the second drive system. The starter drive system 80 may utilize an electric motor 82 that is housed in the pistol grip portion 19 of the handle 14. In various forms, the motor 82 may be a DC brushed motor drive with a maximum swing speed of, for example, approximately 25,000 rpm. In other designs, the motor may include a brushless motor, a wireless motor, a synchronous motor, a stepping motor, or any other suitable electric motor. Motor 82 may be powered by a power supply 90, which in one form may comprise a removable power supply 92. As shown, for example, in FIG. 2, the power supply 92 may include a proximal body portion 94 that is configured to attach to a distal body portion 96. The proximal body portion 94 and the distal body portion 96 are configured to functionally support a plurality of batteries 98 therein. Each battery 98 may be, for example, a lithium ion ("LI") or other suitable battery. The distal portion 96 of the housing is removably operatively attached to the control PCB assembly 100, which is also operatively connected to the motor 82. A number of series-connected batteries 98 can be used as a power source for the surgical instrument 10. In addition, the power supply 90 can be replaceable and / or rechargeable.

As briefly described above with respect to various other forms, the electric motor 82 includes a rotatable barrel (not shown) operatively interacting with a gear assembly 84 that is mounted to be in gear engagement with a set or rack of drive teeth 122 at the longitudinal movement of the actuator 120. During use, the voltage polarity provided by the power supply 90 allows the electric motor 82 to rotate in a clockwise direction, the polarity of the voltage applied to the electric motor by the battery can be reversed to operate the electric motor 82 in the direction counterclock-wise. When the electric motor 82 rotates in one direction, the drive member 120 will be driven in the axial distal direction DD. When the motor 82 is driven in the opposite direction of rotation, the drive member 120 will be driven axially in the proximal direction PD. Handle 14 may have a switch that can be configured to reverse polarity applied to motor 82 by power supply 90. As in other forms described herein, handle 14 can also include a sensor configured to detect position the drive member 120 and / or the direction in which the drive member 120 moves.

The actuation of the motor 82 is controlled by a trigger 130 rotationally supported on a handle 14. The trigger 130 can be rotated between an inactive position and an activated position. Trigger 130 can be biased to an unactivated position by spring 132 or other biasing mechanism so that when a physician releases trigger 130 it can be rotated or otherwise returned to an unactivated position by spring 132 or a biasing mechanism. In at least one form, the firing trigger 130 may be located away from the closure trigger 32, as discussed above. In at least one form, the trigger safety button 134 can be pivotally mounted to the closing trigger 32 by means of a pin 35. The safety button 134 may be located between the trigger 130 and the cover trigger 32 and have a protruding pivot arm 136. See FIG. 2. When the closing trigger 32 is in the non-activated position, the safety button 134 is contained in the handle 14 where the physician cannot easily access it and move it between the safe position preventing activation of the trigger 130 and the trigger position in which the trigger 130 can be pressed. When the physician pushes the closing trigger 32, the safety button 134 and the trigger 130 rotate downward and in this position the physician can manipulate them.

As described above, handle 14 includes a closure trigger 32 and a firing trigger 130. The trigger 130 can be pivotally mounted on a closure trigger 32. When the closure trigger 32 is moved from a non-activated position to an activated position, the trigger 130 can go down, as briefly described above. After the safety button 134 has been moved to the firing position, the firing trigger 130 can be depressed to operate the trigger motor of the surgical instrument. In various cases, handle 14 may include a tracking system configured to determine the position of the closure trigger 32 and / or the position of the trigger 130.

As indicated above, in at least one form, the longitudinally movable drive element 120 has a rack of drive teeth 122 formed thereon for gearing with a corresponding drive gear 86 of the gear assembly 84. The at least one mold also includes a manually operated emergency assembly 140 configured to allow a physician to manually retract a drive member 120 that is movable longitudinally if motor 82 becomes unavailable. The emergency assembly 140 may include a lever or emergency handle assembly 142, which is manually rotatable into ratchet engagement with the teeth 124 of the actuator 120. Thus, the physician can manually pull the actuator 120 with the emergency handle assembly 142 to move the actuator 120 with a ratchet in the proximal direction PD. US Patent Application Publication No. 2010/0089970 discloses emergency mechanisms and other components, mechanisms and systems that may also be used with the various tools disclosed herein. US Patent Application No. 12 / 249,117 entitled POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY RETRACTABLE FIRING SYSTEM, now US Patent No. 8,608,045, is hereby incorporated by reference in its entirety.

As shown in FIG. 1 and 3, the elongated shaft assembly 200 includes a surgical end effector 300 that includes an elongated bore 302 that is operatively capable of supporting a staple cartridge 304 therein. The end effector 300 may further include an abutment 310 that is pivotally supported about the elongate bore 302. As will be described in more detail below, the surgical end effector 300 may be pivotable relative to the elongate shaft assembly about the articulation joint 270. As shown in FIG. 3 and 4, the bore assembly 200 may further include a proximal body or mouthpiece 201 consisting of mouthpiece portions 202 and 203. The barrel assembly 200 further includes a closure tube 260 that can be used to close and / or open the stop 310 of the end effector 300. As shown in FIG. 4, the barrel assembly 200 includes a rod 210 that may be configured to stationary support the barrel frame portion 212 and the articulation locking member 350. For more information on the design and operation of the articulation retention member 350, see U.S. Patent Application No. 13 / 803,086 entitled ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK, now published in U.S. Patent Application Publication No. 2014/0263541, the contents of which are incorporated in their entirety in this document by reference. Shaft 210 may be configured to first slidably support trigger 220 and secondly slide support cover tube 260 that extends around shaft 210. Shaft 210 also slidably supports proximal articulation actuator 230. The proximal articulation actuator 230 has a distal end 231 that is operatively operable with the articulation locking element 350. In one design, the articulation latching member 350 mates with a hinge frame 352 that is operatively operative to engage a guide pin (not shown) of an end effector frame (not shown).

In the illustrated structure, the rod 210 includes a proximal end 211 that is pivotally supported in the chassis 240. For example, in one design, the proximal end 211 of the rod 210 has threads 214 therein for threaded attachment to a rod support 216 that is supported on the chassis 240. See FIG. 3. This arrangement facilitates pivotal attachment of the rod 210 to the chassis 240 such that the rod 210 can selectively rotate about the barrel axis SA-SA relative to the chassis 240. The barrel assembly 200 also includes a cover shuttle 250 that is slidably supported in chassis 240. in such a way that it can move about it along the axis. As shown in FIG. 3, the cover shuttle 250 includes a pair of proximally protruding hooks 252 that are configured to attach to an attachment pin 37 that is attached to the second cover link 38, as will be described in further detail below. See FIG. 2. The proximal end 261 of the cover tube 260 is connected to the cover shuttle 250 for rotation relative thereto. For example, a U-shaped connector 263 is inserted into an annular groove 262 in the proximal end 261 of the closure tube 260 and is held within the vertical slots 253 in the closure shuttle 250. See FIG. 3. This arrangement serves to secure the cover tube 260 to the cover shuttle 250 for axial movement with it, while allowing the cover tube 260 to rotate relative to the cover shuttle 250 about the barrel axis SA-SA. The closure spring 268 bears on the closure tube 260 and serves to bias the closure tube 260 in the proximal direction PD, which may serve to pivot the closure trigger to an unactivated position when the barrel assembly 200 is operatively associated with the handle 14.

As also noted above, the barrel assembly 200 further includes a trigger 220 that is supported for axial movement within the barrel shaft 210. Trigger 220 includes an intermediate trigger portion 222 configured to attach to a distal cutting portion of trigger rod 280. Trigger 220 may also be referred to herein as a "second barrel" and / or a "second barrel assembly." As can be shown in FIG. 4, the intermediate portion 222 of the launch shaft may include a longitudinal slot 223 at its distal end that may be configured to receive a tongue 284 of the proximal end 282 of the distal launch rod 280. The longitudinal slot 223 and the proximal end 282 may be shaped and sized so as to provide relative movement therebetween, and may comprise a sliding joint 286. The sliding joint 286 may move the intermediate portion 222 of the firing barrel 220 for movement so as to pivot the surgical end effector 300 without moving or at least essentially without moving the distal trigger rod 280. After the surgical end effector 300 has acquired an acceptable orientation, the intermediate portion 222 of the trigger barrel can be advanced distally until the proximal sidewall of the longitudinal slot 223 contacts the tongue ohm 284 to advance the launch rod 280 and will not position a cassette clip that can be supported by the end effector 300. As further shown in FIG. 4, the barrel shaft 210 has an elongated opening or opening 213 to facilitate assembly and insertion of the intermediate portion 222 of the firing barrel into the barrel frame 210. After insertion of the intermediate section 222 of the launch barrel, the upper frame segment 215 of the frame can be engaged with the frame 212 of the barrel, enclosing the intermediate section 222 of the launch barrel and the launch rod 280. Further description of the operation of the launch element 220 is given in US patent application No. 13 / 803,086, present the time of publication of the application for US patent No. 2014/0263541.

In addition to the above, the barrel assembly 200 shown includes a clutch assembly 400 that may be configured to selectively and releasably connect the articulation actuator 230 and the trigger 220. In one form, the clutch assembly 400 includes a retaining ring, or a sleeve 402 disposed around trigger 220, wherein the locking sleeve 402 is pivotable between an engaged position in which the locking sleeve 402 connects the articulation actuator 360 to the trigger 220, and a disengaged position in which the articulating actuator 360 is not operatively connected with trigger 200. When retainer sleeve 402 is in its engaged position, distal movement of trigger 220 may move articulation actuator 360 distally, and accordingly, proximal movement of trigger 220 may move proximal actuator articulation member 230 proximally. When the retaining sleeve 402 is in its disengaged position, the movement of the trigger 220 is not transmitted to the proximal articulation actuator 230, whereby the trigger 220 can move independently of the proximal articulation actuator 230. In various circumstances, the proximal articulation actuator 230 may be held in position by the articulation locking member 350 when the proximal articulation actuator 230 is not moved proximally or distally by the actuator 220.

As shown in FIG. 4, an anchor sleeve 402 may comprise a cylindrical or at least substantially cylindrical body including a longitudinal bore 403 formed to receive a trigger 220. An anchor sleeve 402 may include diametrically inward-facing retaining protrusions 404 and an outwardly facing retaining member 406. Retaining protrusions 404 may be configured to selectively engage with trigger 220. More specifically, when the latch sleeve 402 is in its engaged position, the latch protrusions 404 may be positioned within the drive slot 224 formed in trigger 220 such that the distal push force and / or the proximal pulling force may be transmitted from trigger 220 to anchor sleeve 402. When the anchor sleeve 402 is in its engaged position, the second anchor member 406 is positioned within an actuator slot 232 formed in the proximal actuator the articulation belt 230 such that the distal pushing force and / or the proximal pulling force applied to the fixing sleeve 402 can be transmitted to the proximal articulation actuator 230. As a result, when the retaining sleeve 402 is in its engaged position, the trigger 220, the retaining sleeve 402, and the proximal articulation actuator 230 will move together. On the other hand, when the latching sleeve 402 is in its disengaged position, the latching lugs 404 may not be located within the actuator slot 224 of the trigger 220, so that the distal push force and / or the proximal pulling force may not be transmitted from the trigger member 220 to the latch sleeve 402. Accordingly, distal pushing force and / or proximal pulling force may not be transmitted to the proximal articulation actuator 230. In such circumstances, trigger 220 may slide proximally and / or distally relative to the retaining sleeve 402 and the proximal articulation actuator 230.

As also shown in FIG. 4, the elongate barrel assembly 200 further includes a switch drum 500 that is rotatably disposed on a cover tube 260. The switch drum 500 includes a hollow barrel segment 502 that has a barrel bushing 504 formed thereon to receive an outwardly projecting drive pin 410. In various circumstances, the drive pin 410 extends through slot 267 into a longitudinal slot 408 provided in the retaining sleeve 402 to axially move the retaining sleeve 402 as it engages the proximal articulation actuator 230. The pivotal torsion spring 420 is configured to engage with the barrel sleeve 504 on the switch drum 500 and a portion of the mouthpiece body 203 for applying bias to the switch drum 500. The switch drum 500 may further comprise formed therein at least partially annular holes 506 which, as shown in FIG. 5 and 6 may be configured to accommodate annular posts extending from mouthpiece portions 202, 203 and to provide relative rotation, but not translational movement, between switch drum 500 and proximal mouthpiece 201. The posts also extend through holes 266 in cover tube 260 and are fixed in the recesses in the stem 210 of the barrel. However, rotation of the mouthpiece 201 to the point at which the posts reach the end of their respective slots 506 in the switch drum 500 causes the switch drum 500 to rotate about the barrel axis SA-SA. Rotation of the switch drum 500 ultimately causes the drive pin 410 and retainer sleeve 402 to rotate between an engaged and a disengaged position. Thus, the mouthpiece 201 can essentially be used to operatively interact and release the pivot drive system and the starting drive system in various ways, as detailed in US Patent Application No. 13 / 803,086, now US Patent Application Publication No. 2014/0263541.

As also shown in FIG. 3 and 4, elongate shaft assembly 200 may comprise slip ring assembly 600, which may be configured, for example, to conduct electrical power to and / or from end effector 300 and / or transmit signals to and / or from surgical end effector 300. him. Slip ring assembly 600 may include a proximal connecting flange 604 that is mounted on a chassis flange 242 extending from the chassis 240 and a distal connecting flange 601 that is located within a slot provided in the barrel bodies 202, 203. The proximal coupling flange 604 may include a first face, and the distal coupling flange 601 can include a second face that is adjacent to and movable relative to the first face. The distal connecting flange 601 is rotatable relative to the proximal connecting flange 604 about the bore axis SA-SA. The proximal connecting flange 604 may include a plurality of concentric or at least substantially concentric conductors 602 provided in its first face. Connector 607 may be mounted on the proximal side of distal connecting flange 601 and may have multiple contacts (not shown), each contact corresponding to and in electrical contact with one of the conductors 602. This design allows relative rotation between the proximal connecting flange 604 and the distal connecting flange 601 while maintaining electrical contact between them. The proximal connecting flange 604 may include an electrical connector 606 that provides signal exchange between the conductors 602 and the barrel PCB 610, for example, mounted on the barrel chassis 240. In at least one case, a plurality of wire harness may extend between electrical connector 606 and barrel PCB 610. Electrical connector 606 may extend proximally through a connector hole 243 formed in chassis mounting flange 242. See FIG. 7. US Patent Application No. 13 / 800,067, entitled STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, filed March 13, 2013, now US Patent Application Publication No. 2014/0263552, is hereby incorporated by reference in its entirety. US Patent Application No. 13 / 800,025, entitled STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, filed March 13, 2013, now US Patent Application Publication No. 2014/0263551, is hereby incorporated by reference in its entirety. Additional information regarding slip ring assembly 600 is provided in US Patent Application No. 13 / 803,086, currently US Patent Application Publication No. 2014/0263541.

As described above, the elongate stem assembly 200 may include a proximal portion that is fixedly mounted to the handle 14 and a distal portion that is pivotable about the longitudinal axis SA-SA of the stem. The rotatable distal portion of the barrel can be rotated relative to the proximal portion around the slip ring assembly 600 as described above. The distal connecting flange 601 of the slip ring assembly 600 may be disposed in the rotatable distal portion of the barrel. In addition, in addition to the above, the switch drum 500 may also be located in the rotatable distal portion of the barrel. By rotating the rotatable distal portion of the barrel, the distal connecting flange 601 and the switch drum 500 can rotate synchronously. In addition, the switch drum 500 is pivotable between a first position and a second position relative to the distal connecting flange 601. When the switch drum 500 is in its first position, the pivot drive system (e.g., the proximal articulation actuator 230) can be operatively disconnected from the firing system. and thus the end effector 300 of the barrel assembly 200 may not rotate during operation of the trigger drive system. When the switch drum 500 is in its second position, the pivot drive system (e.g., the proximal articulation drive member 230) can functionally interact with the trigger drive system, and thus the end effector 300 of the barrel assembly 200 can pivot during operation of the trigger drive system. ... When the switch drum 500 moves between its first position and the second position, the switch drum 500 moves relative to the distal connecting flange 601. In various cases, the barrel assembly 200 may include at least one sensor configured to detect the position of the switch drum 500.

As also shown in FIG. 4, cover tube assembly 260 includes a two-pivot cover sleeve assembly 271. In accordance with various shapes, the two-pivot closure sleeve assembly 271 includes an end effector closure sleeve 272 that includes distally projecting upper and lower shanks 273, 274. The upper double-pivot link 277 includes upwardly projecting distal and proximal pivot pins that engage respectively with an upper distal pin hole in the upper proximal protruding shank 273 and with an upper proximal pin hole in the upper distal protruding shank 264 on the closure tube 260. The lower double pivot link 278 includes an upwardly projecting distal and proximal pivot pins with, respectively, a lower distal pin hole in a lower proximal shank 274 and with a lower proximal pin hole in a lower distal shank 265. See also FIG. 6.

FIG. 5-8 illustrate one form of a surgical end effector 300 operably attachable to an elongated stem assembly of a surgical instrument of the type described above or other surgical instrument designs that includes a closure system configured to generate control movements for axial movement of the closure member, configured to apply closing and opening movements to portions of the surgical end effector. In the example shown, as will be further described in more detail below, the surgical end effector is pivotable relative to the proximal portion of the elongate stem assembly around the articulation joint substantially designated 339. In other designs, replaceable stem assemblies cannot be articulated. As shown in FIG. 6, articulation 339 defines a pivot axis B-B about which surgical end effector 300 can selectively pivot. In the example shown, pivot axis B-B is substantially transverse to the stem axis SA-SA of the elongate stem assembly.

The illustrated surgical end effector 300 includes a first jaw 308 and a second jaw 309 configured to selectively move relative to the first jaw 308 between an open position (FIG. 7) and various closed positions (FIG. 8). In the illustrated embodiment, first jaw 308 includes an elongated bore 302 that is operatively capable of supporting surgical staple cassette 304 and second jaw 309 includes abutment 310. However, other surgical jaw designs may be used without departing from the spirit and scope of the present invention. As shown in FIG. 5, a support tray 305 may be attached to the surgical staple cassette 304 to provide additional support as well as to prevent the staple ejectors (not shown) that are retained in the staple recesses 306 formed in the surgical staple cassette 304 prior to use from cassettes with surgical staples. As shown in FIG. 5, elongated bore 302 has a proximal end portion 320 that includes two vertical side walls 322. Anvil 310 includes an anvil body 312 on which a clip-forming surface 313 is formed. The proximal end 314 of an anvil body bifurcates about a trigger slot 315. which forms a pair of stop attachment arms 316. Each anchor attachment arm 316 includes a ramped top surface 321 and also includes a laterally protruding anchor journal 317 and a cam groove 318 that forms a cam surface or "slotted cam surface 319." See FIG. 5. One of the cam grooves 318 may be referred to herein as the “first cam groove”, with its cam surface being referred to as the “first cam surface”. Similarly, another cam groove 318 may be referred to as a "second cam groove", with its cam surface being referred to herein as a "second cam surface". In each side wall 322 of the elongated channel 302, a pin seat 324 is provided for receiving a corresponding one of the stop pins 317 therein. This structure serves to connect with the ability to move the stop 310 to the elongated channel 302 for selective passage with the possibility of rotation about the axis A-A of the stop, bounded by the slots 324 of the trunnion and extending transversely relative to the axis SA-SA of the barrel. See FIG. 6.

In the illustrated structure, the stop 310 is pivotally movable relative to the elongated channel 302 and the surgical staple cartridge 304 held therein to the open position by a pair of opening cams 354 that can be releasably retained in the stop actuator element, or are detachably attached, or permanently attached, or can be performed with it in one piece. In the illustrated embodiment, the stop actuator member comprises an end effector cover sleeve 272. See FIG. 5. Each opening cam 354 includes an outer housing portion 356 that has an inwardly protruding cam tab 358. The outer housing portion 356 of at least one structure is configured to snap into releasable engagement within a corresponding cam opening 355 formed in the cover end effector sleeve 272. For example, the outer body portion 356 may include a stop beveled portion 357 that snaps into engagement with a corresponding wall portion of the end effector closure sleeve that forms the cam opening 355. Another portion of the outer body portion 356 may have a member 359 formed thereon. a sharp bend that is configured to fit within a portion of the end effector cover sleeve 272 adjacent to the cam hole 355. Other snap tab designs may also be used to detachably attach the outer housing portion 356 to the end effector cover sleeve 272. For example, in other designs, the outer housing portion may be non-snap-engaging with the end effector cover sleeve 272. In such designs, the outer portions of the housing can be held in position by a circular ferrule that extends around the outer circumference of the end effector closure sleeve over the outer portions of the opening cam housing and crimps in place. The ferrule serves to grip the outer portions of the housing against the outer surface of the end effector closure sleeve. To provide an end effector closure sleeve with a relatively smooth or continuous outer surface that can advantageously prevent damage to adjacent tissue and / or accumulation of tissue / fluid and the like between such components, the ferrule can actually be squeezed into an annular recess formed in end effector cover sleeve.

When the opening cams 350 are installed in the end effector closure sleeve 272, each cam tab 358 extends through an elongated groove 326 in a corresponding side wall 322 of an elongated channel 302 for placement within a corresponding cam groove 318 in an abutment 310. See FIG. 6. In this arrangement, the opening cams 350 are diametrically opposed to each other in the end effector closure sleeve. During use, the closure tube 260 translates distally (in the direction DD) to close the stop 310, for example, in response to actuation of the closure trigger 32. When the closure tube 260 translates in the distal direction DD so as to bring the distal end 275 of the closure end effector sleeves 272 in contact with the closing edge 311 on the stop body 312, stop 310 closed. In particular, the distal end 275 of the end effector closure sleeve 272 extends over the top surfaces 321 of the abutment attachment arms 316 as the closure tube 260 moves distally to initiate rotation of the abutment 310 into the closed position. In one design, for example, the closure of the stop 310 is solely caused by the contact of the end effector closure sleeve 272 with the stop 310, and not caused by the interaction of the opening cams with the stop. However, in other designs, the opening cams may be positioned to distally also apply closing movements to the stop as the cover tube 260 moves. The anvil 310 is opened by a proximal translational movement of the closure tube 260 in the proximal direction PD, which causes the cam tabs 358 to move in the proximal direction PD within the cam slots 318 on the cam surfaces 319 to pivot the anchor 310 to the open position, as shown in FIG. 6 and 7.

In the embodiment 300 of the surgical end effector, two opening cams are used to effect positive opening of the end effector jaws, even when under load. Other designs are likely to use only one opening cam or more than two opening cams without departing from the spirit and scope of the present invention. In the example shown, the opening cams are detachably coupled to the end effector closure sleeve to facilitate easy assembly or disassembly of the surgical end effector components to the elongate shaft assembly. Such configurations also allow for more compact or shorter articulation designs that further facilitate more efficient manipulation of the surgical end effector within a confined space within a patient. To facilitate the detachment of those opening cams that snap in place, additional strategically positioned openings may be provided in the end effector closure sleeve to allow insertion of a lever member to raise the opening cams out of the end effector closure sleeve. In other constructions, the opening cam (s) may (s) be formed in one piece with the abutment actuator element or end effector closure sleeve. For example, each of the opening jaws may include a tab cut or otherwise formed into a wall of an abutment actuator member or end effector closure sleeve, which subsequently flexes, collapses, or permanently deforms inwardly so as to engage a corresponding cam surface on the second jaw. ... For example, the tongue may be bent inwardly ninety degrees relative to the outer wall of the end effector closure sleeve. Such designs avoid the need for separate open cam components. In other embodiments, a pin or pins may be used attached to the second jaw and configured to extend over corresponding cam surfaces on the first jaw. The pin or pins can, for example, be depressed into the first jaw, notched and subsequently depressed and / or welded to the first jaw. Although the opening cam designs described above have been described in the context of a surgical end effector that is configured to support a surgical staple cartridge and includes a stop that is movable relative to the surgical staple cartridge, the reader will appreciate that opening cam designs can also be used. with other structures of the end effector, which have the jaw (s) made (s) to move relative to each other.

FIG. 9 and 10 show an elongate barrel assembly, designated member 200 ', which utilizes many of the members of the elongate barrel assembly 200 described above. In the example shown, the elongate barrel assembly 200 'includes a double-pivot link structure, designated member 800, which utilizes a pivot locking member 810 similar to the previously described pivot locking member 350. Those components of the articulation locking member 810 that are different from those of the articulation locking member 350 and which may be necessary to understand the operation of the articulation locking member 350 will be discussed in more detail below. Additional information regarding articulation retaining member 350 can be found in U.S. Patent Application No. 13 / 803,086 entitled ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK, now published U.S. Patent Application Publication No. 2014/0263541, the contents of which are incorporated herein in their entirety by links. The articulation locking member 810 may be configured and operable to selectively lock the surgical end effector 300 in various articulated positions. This arrangement allows the surgical end effector 300 to rotate or pivot relative to the trunk closure tube 260 when the articulation retainer 810 is in its unlocked state.

As described above, when the proximal articulation actuator 230 is operatively engaged with the actuator 220 via the engagement system 400, the actuator 220 can move the proximal articulation actuator 230 proximally and / or distally. For example, proximal movement of trigger 220 can move proximal articulation actuator 230 proximally, and similarly distal movement of trigger 220 may move proximal articulation actuator 230 distally. Movement of the proximal articulation actuator 230 (proximal or distal) may unlock the articulation locking member 810, as described in further detail below. As shown, for example, in FIG. 9, the elongate barrel assembly 200 'includes a barrel frame 812 that is somewhat proportional to the first distal articulation actuator 820. The first distal articulation actuator 820 is supported within the elongate shaft assembly 200 'for selective longitudinal movement in the distal direction DD and the proximal direction PD in response to respective pivot control movements applied thereto. The barrel frame 812 includes a distal end portion 814 that has a downwardly projecting pivot pin (not shown) configured to be pivoted inwardly a pivot pin hole 328 formed in the proximal end portion 320 of the elongated bore 302. See, for example, similar designs shown in FIG. 5. This arrangement facilitates pivotal passage of the elongated bore 302 of the surgical end effector 300 relative to the barrel frame 812 about the pivot pivot axis B-B defined by the pivot pin hole 328. As indicated above, the pivot axis B-B is located transverse to the barrel axis SA-SA formed by the elongate barrel assembly 200 '.

As shown in FIG. 9, the first articulation actuator 820 includes a first or distal anchoring cavity 822 and a second or proximal securing cavity 824 formed therein, the first securing cavity 822 and the second securing cavity 824 being separated by an intermediate frame member 825. The articulation locking member 810 may further include at least one first locking member 826 at least partially disposed within the first locking cavity 822, which may be configured to hinder or prevent proximal movement of the first articulation actuator 820. In the embodiment shown, for example, in FIG. 9, there are three first retaining members 826 located within the first retaining cavity 822, which together act in a similar parallel manner and can collectively act as a single retaining member. Other embodiments are contemplated in which more than three or less than three first locking elements 826 can be used. Similarly, the articulation locking element 810 may further include at least one second locking element 828 at least partially disposed within the second locking cavity 824 which may be configured to hinder or prevent distal movement of the first distal articulation actuator 820. With regard to the specific embodiment shown in FIG. 9, there are three second retaining members 828 located within the second retaining cavity 824, all of which can act in a similar parallel manner and can collectively act as a single retaining member. Other embodiments are contemplated in which more than three or less than three second retaining members 828 may be used.

In addition to the above, as shown advantageously in FIG. 9, each first retaining member 826 is slidably supported on a skeleton rail 830 and includes a retaining shank 827. Each of the first retaining members 826 has a retaining hole (not shown) formed to receive a skeleton rail 830 therethrough. The retaining shank 827 may be located within the first retaining cavity 822, and the retaining hole can be slidably engaged with a frame guide 830 mounted on the barrel frame 812. The first locking elements 826 are not oriented in a perpendicular structure with respect to the frame guide 830; rather, the first anchoring elements 826 are positioned and aligned at an oblique angle to the frame rail 830 such that the edges or side walls of the anchor holes engage with the frame rail 830. Moreover, interaction between the side walls of the anchor holes and the frame rail 830 can create a resistive force or frictional force therebetween, which can impede relative movement between the first locking members 826 and the frame guide 830 and, as a result, resist the proximal push force P applied to the first distal articulation actuator 820. In other words, the first retaining members 826 can prevent or at least impede the rotation of the surgical end effector 300 in the direction indicated by the arrow 821. When torque is applied to the end effector 300 in the direction indicated by the arrow 821, the proximal push force P will be transmitted to the distal actuator. pivot element 820. The proximal push force P will only be used to stimulate the locking engagement between the first anchoring members 826 and the frame rail 830. More specifically, the proximal push force P may be transmitted to the shanks 827 of the first anchor members 826, which can cause the first anchor members 826 pivot and decrease the angle formed between the first anchoring members 826 and the frame rail 830, thereby increasing the adhesion between the side walls of the anchor holes and the frame rail 830. Subsequently, the first anchor members 826 may eventually block the movement of the first distal articulation actuator 820 in one direction.

To release the first retaining members 826 and allow the surgical end effector 300 to rotate in the direction indicated by arrow 821, the proximal articulation actuator 230 may be extended proximally to straighten or at least substantially straighten the first retaining members 826 perpendicularly or at least essentially perpendicular position. In this position, the grip or drag force between the side walls of the fixing holes and the frame guide 830 can be sufficiently reduced or eliminated so that the distal articulation actuator 820 can be moved proximally. To straighten the first locking members 826, the proximal articulation actuator 230 may be extended proximally such that the distal arm 233 of the proximal articulation actuator 230 contacts the first locking members 826 by extending and pivoting the first locking members 826 to their erect position. In various circumstances, the proximal articulation actuator 230 may continue to be extended proximally until the proximal arm 235 extending therefrom contacts or abuts the proximal actuator wall 832 of the first distal articulation actuator 820 and extends the distal actuator 820 pivot proximally to pivot the surgical end effector 300. Basically, a proximal pulling force can be applied from the proximal articulation actuator 230 to the distal articulation actuator 820 by interaction between the proximal articulation 235 and the proximal wall of the actuator 832 through the first distal actuator 820 to the end effector 300, as will be further described below, to pivot the end effector 300 in the direction indicated by arrow 8 21. After pivoting the surgical end effector 300 in an acceptable manner in the direction indicated by arrow 821, the first distal articulation actuator 820 can be released under various circumstances, allowing the articulation locking member 810 to re-lock the first distal articulation actuator 820 and the end effector 300 in position.

Simultaneously with the above, as also shown in FIG. 9, the second locking members 828 can remain in the angular position while the first locking members 826 are locked and unlocked as described above. The reader will appreciate that although the second locking elements 828 are angularly positioned relative to the bore guide 830, the second locking elements 828 are not configured to interfere with or at least substantially impede proximal movement of the first distal articulation actuator 820. When the first distal articulation actuator 820 and the articulation retainer 810 slide proximally as described above, the second retainer members 828 can slide distally along the frame rail 830, in various circumstances without changing or at least substantially not changing their angular alignment with respect to frame rail 830. While the second anchoring members 828 permit proximal movement of the first distal articulation actuator 820 and the articulation retaining member 810, the second anchoring members 828 may be configured to selectively prevent or at least impede distal movement of the distal articulation actuator 820 as described in more detail below.

Each second locking element 828 may include a locking hole (not shown) and a locking shank 829. The locking shank 829 can be positioned within the second locking cavity 824 and the locking hole can be slidably engaged with a skeleton guide 830 mounted on a barrel frame 812. The frame rail 830 passes through the holes in the second retaining members 828. The second retaining members 828 are not oriented in a perpendicular structure with respect to the frame rail 830; rather, the second anchoring members 828 are positioned and aligned at an oblique angle to the frame rail 830 such that the edges or side walls of the anchor holes engage with the frame rail 830. Moreover, interaction between the side walls of the anchor holes and the frame rail 830 can create a resistive force or a frictional force therebetween, which can impede relative movement between the second anchoring members 828 and the frame guide 830 and, as a result, resist the distal force D applied to the first distal articulation actuator 820. In other words, the second anchoring members 828 can prevent or at least impede the rotation of the surgical end effector 300 in the direction indicated by the arrow 823. When torque is applied to the end effector 300 in the direction indicated by the arrow 823, the distal pulling force D will be transmitted to the first distal articulation drive member 820. The distal pulling force D will only be used to stimulate the locking engagement between the second anchoring members 828 and the frame rail 830. More specifically, the distal pulling force D may be transmitted to the shanks 829 of the second anchoring members 828, which can cause the second anchor members 828 to rotate and reducing the angle formed between the second anchoring members 828 and the frame rail 830, thereby increasing the adhesion between the side walls of the anchor holes and the frame rail 830. Subsequently, the second anchor members 828 may eventually block the movement of the first distal articulation actuator 820 into one direction.

To release the second retention members 828 and allow the surgical end effector 300 to pivot in the direction indicated by arrow 823, the proximal articulation actuator 230 may be pushed distally to straighten or at least substantially straighten the second retention members 828 perpendicular or at least essentially perpendicular position. In this position, the grip or resistance force between the side walls of the fixing holes and the frame guide 830 can be sufficiently reduced or eliminated so that the first distal articulation actuator 820 can be distally displaced. To straighten the second anchoring members 828, the proximal articulation actuator 230 can be pushed distally such that the proximal articulation actuator 235 of the proximal articulation actuator 230 contacts the second anchoring members 828, pushing and pivoting the second locking members 828 into their straightened position. In various circumstances, the proximal articulation actuator 230 may continue to be pushed distally until the distal articulation 233 extending therefrom engages or abuts the distal actuator wall 833 on the first distal articulation actuator 820 and pushes the first distal actuator. an articulation member 820 distally to pivot the end effector 300. As such, a distal pushing force can be applied from the proximal articulation actuator 230 to the first distal articulation actuator 820 by interaction between the distal articulation 233 and the distal drive wall 833, such a pushing force can be transmitted through the first distal articulation actuator 820 to pivot end effector 300 in the direction indicated by arrow 823. After pivoting surgical end effector 300 suitably in the direction of arrow 823, the first distal articulation actuator 820 can be released under various circumstances, allowing the articulation retaining member 810 to re-lock the first distal articulation actuator 820 and end effector 300 in position.

Simultaneously with the above, the first locking elements 826 can remain in the angular position, while the second locking elements 828 are locked and unlocked, as described above. The reader will understand that although the first locking elements 826 are located and aligned in an angular position relative to the barrel guide 830, the first locking elements 826 are not configured to impede or at least substantially impede the distal movement of the first distal articulation actuator 820. When the first distal articulation actuator 820 and the articulation latching member 810 slide distally as described above, the first latching members 826 can slide distally along the frame rail 830, in various circumstances, without changing or at least substantially changing their angular alignment in with respect to the frame rail 830. While the first locking elements 826 allow for distal movement of the first distal articulation actuator 820 and the articulation locking element 810, the first locking elements 826 may be configured to selectively prevent or at least impede proximal movement of the first distal articulation actuator 820 pivot joint as described above.

In light of the above, the locking articulation member 810 in the locked state may be configured to resist proximal and distal movements of the first distal articulation actuator 820. With regard to resistance, the articulation locking member 810 may be configured to prevent, or at least substantially prevent, proximal and distal movements of the first distal articulation actuator 820. Collectively, resistance to proximal movement of the first distal articulation actuator 820 is provided by the first locking members 826 when the first locking members 826 are in their locked orientation, and the distal movement of the first distal articulation actuator 820 is resisted by the second locking members 828 when the second locking members 828 are in their locked orientation as described above. In other words, the first locking elements 826 comprise a first one-sided locking, and the second locking elements 828 comprise a second one-way locking that locks in the opposite direction.

As described in connection with the exemplary embodiment shown in FIG. 9 and 10, the initial proximal movement of the proximal articulation actuator 230 may unlock the proximal movement of the first distal articulation actuator 820 and the articulation locking member 810, while further proximal movement of the proximal articulation actuator 230 may actuate the first distal the articulation actuator 820 and the articulation retaining member 810 proximally. Likewise, initial distal movement of the proximal articulation actuator 230 may unlock distal movement of the first distal articulation actuator 820 and the articulation locking member 810, while additional distal movement of the proximal articulation actuator 230 may actuate the first distal articulation actuator 820 and the articulation retaining member 810 distally. This general principle is described in connection with several additional embodiments disclosed below. If such a description is duplicate or substantially supplementary to the above description, such description will not be repeated for brevity.

As shown in FIG. 9 and 10, the double pivot structure 800 is configured to provide a “push pull” structure when a pivot force is applied thereto through the first distal articulation actuator 820. As shown in these figures, the first distal articulation actuator 820 has a first actuator bar 842 formed therein. The first articulation rod 844 projects distally from the first distal articulation actuator 820 and is attached to the first movable connector 850 which attached to the first distal articulation actuator 820 via a first ball joint 852. The first connector 850 is also pivotally attached to the proximal end portion 320 of the elongated bore 302 via a first pin 854 as shown in FIG. 9. The double pivot link structure 800 further comprises a second distal articulation actuator 860 on which a second actuator bar 862 is formed. The second distal articulation actuator 860 is movably held within the elongated shaft assembly 200 'for longitudinal movement in the distal direction DD and proximal direction of PD. A second articulation rod 864 projects distally from a second distal articulation actuator 860 and is attached to a second movable connector 870 that is attached to a second distal articulation actuator 860 by a second ball joint 872. The second connector 870 is also attached to pivot to the proximal end portion 320 of the elongated bore 302 by means of the second pin 874, as shown in FIG. 9. As shown in FIG. 9, the first connector 850 is attached to the elongated bore 302 on one side of the bore axis SA, and the second connector 870 is attached to the elongated bore 302 on the opposite side of the bore axis. Thus, by simultaneously pulling out one of the connectors 850, 870 and pushing the other connector 850, 870, the surgical end effector 300 will pivot about the pivot axis B-B about the elongate stem assembly 200 '. Although the structures shown, the connectors 850, 870, which facilitate relative movement between the first and second distal articulation actuators 820, 860, respectively, and the elongated bore 302, are constructed from relatively rigid components, other designs may use relatively “flexible” connector structures. For example, cable (s), etc. may (may) pass through one or both of the distal articulation actuators 820, 860, connectors 850, 870, and ball joints 852, 872 to connect to an extension channel to facilitate transmission to him of pivot movements.

As shown also in FIG. 9 and 10, the proximal gear 880 and the distal gear 882 are located centrally between the first drive rack 842 and the second drive rack 862 and are in gearing therewith. In alternative embodiments, only one gear or more than two gears may be used. Thus, at least one gear is used. The proximal gear 880 and the distal gear 882 are pivotally supported in the barrel frame 812 for free rotation relative thereto so that when the first distal articulation drive element 820 moves in the distal direction DD, the gears 870, 872 serve to drive the second distal articulation actuator 860 in the proximal direction PD. Similarly, when pulling the first distal articulation actuator 820 in the proximal direction PD, the gears 880, 882 drive the second distal articulation actuator 860 in the distal direction DD. Thus, to pivot end effector 300 about pivot axis BB in the direction indicated by arrow 821, pivot actuator 230 operably engages trigger 220 via clutch system 400 such that trigger 220 moves or pushes proximal actuator articulation member 230 in the proximal direction PD. Moving the proximal articulation actuator 230 in the proximal direction also moves the first distal articulation actuator 820 in the proximal direction. When the first distal articulation actuator 820 moves in the proximal direction, the gears 880, 882 serve to drive the second distal articulation actuator 860 in the distal direction DD. Such movement of the first and second distal articulation actuators 820, 860 causes the surgical end effector 300, and more particularly the elongated channel 302 of the surgical end effector 300, to rotate about the articulation axis BB in the direction of articulation indicated by arrow 821. Conversely, for the articulated by rotating the end effector 300 in the direction of the arrow 823, the trigger 220 is actuated to push the first distal articulation drive member 820 in the distal direction DD. When the first distal articulation actuator 820 is moved distally, the gears 880, 882 serve to drive the second distal articulation actuator 860 in the proximal direction PD. Such movement of the first and second distal articulation actuators 820, 860 causes the surgical end effector 300, and more particularly the elongated channel 302 of the surgical end effector 300, to rotate about the articulation axis B-B in the articulation direction indicated by arrow 823.

The solid double-pivot design 800 and variations thereof can provide a greater pivot range for the surgical end effector than other surgical end effector configurations that are pivotable. In particular, the solid pivot link designs described herein can facilitate pivot pivot ranges in excess of 45-50 degrees, which are typically achieved by other pivotable end effector designs. The use of at least one gear for interaction between the distal articulation actuators provides "push" and "retraction" of the end effector into position and can also reduce the degree of end effector "slip" or unwanted or unintentional movement during use. The solid double pivot link designs described herein also include an articulation system that has improved strength characteristics over other articulation system designs.

As briefly described above, the intermediate portion 222 of the launch barrel is operably operative to interact with a distal cutter or launch rod 280. The distal launch rod 280 may have a multi-layer structure. This design allows the distal trigger rod 280 to flex sufficiently when the surgical end effector 300 pivots about the pivot axis B-B. The distal launch rod 280 is supported for axial movement within the barrel assembly 200 'and is slidably supported by two vertical side support walls 330 formed at the proximal end of the elongated bore 302. As shown in FIG. 11, a distal firing rod 280 is attached to a firing element 900 that includes a vertically extending firing element housing 902 having a cutting tissue surface or blade 904. Additionally, a wedge-shaped sled 910 may be positioned within the surgical staple cassette 304 to contact the firing device. element 900 with its setting in motion. When actuator 900 is driven distally through cassette body 304, beveled surfaces 912 on wedge-shaped sleds 910 contact staple ejectors to actuate retained ejectors and surgical staples upwardly into surgical staple cassette 304.

A number of difficulties can arise when working with end effectors that use launch rods or actuators and which are pivotable over a range of, for example, forty-five degrees. To facilitate functional pivoting of such end effectors, the firing element or firing rod must be flexible enough to provide such a pivot range. However, the launch rod or launch element must also not deform under the compressive launch loads. Various base plate or safety plate designs have been developed to provide additional support for the launch rod or launch element. Some of these constructs are described in US Pat. No. 6,964,363, entitled SURGICAL STAPLING INSTRUMENT HAVING ARTICULATION JOINT SUPPORT PLATES FOR SUPPORTING A FIRING BAR, and US Pat. which are fully incorporated herein by reference. The safety plates, which provide essentially resistance to deformation, are generally difficult to bend, which increases the forces that must be overcome by the articulation system. Other launch rod support designs are described in US Patent Application No. 14 / 575,117 entitled SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTORS AND MOVABLE FIRING BEAM SUPPORT ARRANGEMENTS, the entire contents of which are incorporated herein by reference.

As shown in FIG. 11-15, the elongate shaft assembly 200 'further comprises a plurality of support link assembly 920 for providing lateral support to the distal launch rod 280 as the surgical end effector 300 pivots about the pivot axis B-B. As shown in FIG. 11, the plurality of support link assembly 920 includes a middle support member 922 that is movable to the surgical end effectors 300 as well as the elongate shaft assembly 200 '. For example, the middle support member 922 is pivotally attached to the proximal end 320 of the elongated bore 302 so that it can pivot about the pivot axis PA. As shown in FIG. 11, the middle abutment 922 includes a distally protruding tab 923 that has a distal pivot pin hole 924 for receiving a vertical abutment pin 332 formed at the proximal end portion 320 of the elongated bore 302. As further shown in FIG. 11, the middle abutment 922 further includes a proximally protruding tab 926 having an elongated proximal groove 928. The proximal groove 928 is slidably accommodated for the middle abutment pin 816 formed at the frame portion 812. This arrangement allows the middle support member 922 to pivot and move, for example, axially, relative to the elongate barrel assembly 200 '. As shown in FIG. 11-13, the middle support member 922 further includes a centrally located groove 930 for movably receiving a distal launch rod 280 therethrough.

As shown in FIG. 11-15, the plurality of support link assembly 920 further comprises a proximal support link 940 and a distal support link 950. The proximal support link 940 includes an elongated proximal body 942 that has a rounded proximal nasal portion 943 and a rounded distal nasal portion 944. The proximal support link 940 further includes a pair of downwardly projecting opposing proximal abutment walls 945, 946, between which a proximal slot 947 is formed. Similarly, distal abutment member 950 includes an elongated distal housing 952 that has a rounded proximal nasal portion 953 and a rounded distal nasal portion 954. The distal abutment 950 further includes a pair of downwardly extending opposing distal abutment walls 955, 956, between which a distal groove 957 is formed. As shown in FIG. 14, a flexible distal launch rod 280 is configured to pass between the proximal abutment walls 945, 946 of the proximal abutment 940 and the distal abutment walls 955, 956 of the distal abutment 950. The proximal abutment wall 945 includes an inwardly facing proximal arcuate surface 948, and the proximal abutment the support wall 946 includes an inwardly facing proximal arcuate support surface 949 opposing an inwardly facing proximal arcuate surface 948. The proximal arcuate support surfaces 948, 949 serve to provide lateral support to the lateral portions of the proximal portion of the flexible distal launch rod 280 as it flexes during pivot pivoting the end effector and moving the articulation. The radially rounded surfaces may correspond to the outer radius of the distal launch rod 280 depending on the direction of the pivot. Similarly, distal support wall 955 includes an inwardly facing distal arcuate surface 958, and distal support wall 956 includes an inwardly facing distal arcuate support surface 959 opposing said distal arcuate surface 958. Distal arcuate support surfaces 958, 959 serve to provide lateral support portions of the lateral side of the distal portion of the distal trigger rod 280 as it is bent during pivoting of the surgical end effector 300 and movement of the pivot joint. The distal arcuate surfaces 958, 959 may correspond to the outer radius of the distal launch rod 280 depending on the direction of the pivot. As shown in FIG. 12 and 13, the distal end 217 of the shaft shaft 210 includes a distally facing arcuate shaft recess 218 into which a rounded proximal nasal portion 943 of the proximal support link 940 extends. The rounded distal nasal portion 944 of the proximal support link 940 is pivotally disposed in the arcuate proximal recess 932 in the middle abutment 922. In addition, the rounded proximal nasal portion 953 of the distal abutment is positioned in an arcuate distal abutment depression 934 at the distal end of the middle abutment 922. The rounded distal nose portion 954 of the distal abutment 950 is movable internally A V-shaped channel cavity 334 formed in the vertical side support walls 330 that are formed at the proximal end 320 of the elongated channel 302.

The multiple support link assembly can provide higher lateral support for the flexible multilayer launch rods when the rod is flexed through large pivot angles. These designs also prevent the launch rod from bending under high loads and relatively large pivot angles. The elongated support links in conjunction with the center support member serve to provide improved lateral support for the launch rod throughout the pivot area over many prior support designs. In alternative designs, the support links may be configured to actually interact with the middle support member at different pivot angles. U-shaped support links facilitate installation and serve to provide support for the flexible support rods on each side as well as on the top of the boom to prevent the launch rod from tilting upward during articulated launch.

In embodiments in which the trigger includes a cutting tissue surface, it may be desirable for the elongate shaft assembly to be configured to prevent the trigger from unintentionally extending if the unused staple cassette is not properly supported in the elongated bore 302 of the surgical end effector. 300. For example, if there is no staple cassette at all and the trigger is advanced distally through the end effector, the tissue will be cut but not stapled. Likewise, if an exhausted staple cassette is present in the end effector (i.e., a staple cassette from which at least some staples have already been activated) and the trigger is advanced, the tissue will be cut, but may not be completely stapled (or may not sewn at all). It should be understood that such cases can lead to undesirable catastrophic results during surgery. In each of US Pat. No. 6,988,649, entitled SURGICAL STAPLING INSTRUMENT HAVING A SPENT CARTRIDGE LOCKOUT, US Pat. No. 7,044,352, entitled SURGICAL STAPLING INSTRUMENT HAVING A SINGLE LOCKOUT MECHANISM FOR PREVENTION, and SURGICAL STAPLING INSTRUMENT No. 7, HAVENTION OF FIRING, US Pat. LOCKOUT MECHANISM FOR PREVENTION OF FIRING, various designs for locking the trigger are described. Each of these US patents is incorporated herein by reference in its entirety.

Such interlock designs can be used effectively with a variety of surgical stapling instruments. However, these designs, in particular, may not be suitable for use in combination with various surgical stapling instruments described herein, which use relatively compact and short articulation configurations. For example, in FIG. 15-19, a surgical end effector 300 is shown that is operatively attached to an elongate shaft assembly 200 'via an articulation joint 270'. The elongated shaft assembly 200 'forms the shaft axis SA-SA, and the articulation 270' facilitates selective articulation of the surgical end effector 300 relative to the elongated shaft assembly 200 'about the articulation axis B - B, which is transverse to the shaft axis SA-SA. In the illustrated embodiment, a solid double-pivot link structure 800 (as described above) may be used to selectively apply pivot movements to the surgical end effector 300. The elongated shaft assembly 200 'comprises a distal firing rod 280 of the type described above, configured to selectively axially move within the surgical end effector 300 from a home position to an end position when firing movements are applied thereto. The distal launch rod 280 extends through the articulation joint 270 'and is flexible about the articulation axis B-B to accommodate the articulated pivot of the surgical end effector 300 in various ways described herein. In the illustrated embodiment, the articulation joint 270 'includes a middle abutment 922 that is movably attached to the distal end 814 of the barrel frame 812 and the proximal end 320 of the elongated bore 302. As described above, the middle abutment 922 includes a distal protruding tab 923, which has a distal pivot pin hole 924 for receiving a vertical abutment pin 332 formed at the proximal end portion 320 of the elongated bore 302. The middle abutment member 922 further includes a proximally protruding tongue 926 having an elongated proximal groove 928. The proximal groove 928 is formed the slidably accommodated middle support pin 816 formed in the frame portion 812. The middle support member 922 further includes a centrally located groove 930 for axially positioning the distal launch rod 280 therethrough. The middle support member 922 provides lateral support for the distal launch rod 280 during articulation of the surgical end effector 300 about the articulation axis BB, while while facilitating axial movement of the distal launch rod 280 therethrough during launch.

In the illustrated embodiment, the trigger rod locking assembly 980 is used to prevent the distal trigger rod 280 from unintentionally moving from the home position to the end position if the unactivated surgical staple cassette 304 has not been functionally positioned in the cassette support member or elongated channel 302. As shown in FIG. ... 15-19, the launch rod locking assembly 980 in one shape includes a locking cam or retainer 281 formed in the distal launch rod 280 so that it projects upwardly from its upper surface. The biasing member 984 is supported on and attached to the middle support member 922. As shown, for example, in FIG. 16, biasing member 984 is substantially flat and includes a window 985 configured to receive retaining cam 281 during articulation of the surgical end effector 300. Thus, when the surgical end effector 300 pivots around axis BB, the biasing member 984 does not apply any displacement or loading force to distal trigger rod 280. With this feature, the additional amount of pivot forces required to pivot the surgical end effector 300 about the pivot axis B-B can be avoided. The biasing member 984 may be tack welded to the middle support member 922, or may be attached to it by other means of attachment such as screws, pins, glue, etc. Window 985 may also form an anchor tape or portion 986 that serves for contact with the locking cam 281 when the distal trigger rod 280 is in the rest position. The locking cam 281 may be formed with a distally facing ramp surface 283 and an facing proximally ramped surface 285 to reduce the amount of starting and retracting forces for axial movement of the distal launch rod 280. See FIG. nineteen.

As described above, the distal firing rod 280 is operatively attached to the firing element 900, which includes the cutting tissue surface 904 on the firing element body 902. In alternative designs, the cutting tissue surface may be attached or otherwise formed on the distal launch rod 280, or may be directly supported by a portion of the distal launch rod. In the structure shown, a laterally extending tab 905 is formed on the lower portion of the trigger housing 902. The trigger housing 902 further includes a wedge-shaped sled engaging member 906 that is configured to engage the wedge-shaped sleds in the surgical staple cassette 304, as will further detailed below.

FIG. 18 shows an "unused" or "unactivated" surgical staple cassette 304 that has been properly seated in elongated channel 302. As shown in this figure, the wedge-shaped sled 910 is housed in the staple cassette 304 in the “non-activated” (most proximal) position. Wedge sled 910 includes an facing proximally ramped surface 914 configured to engage with wedge sled engaging member 906 on trigger 900 to thereby displace trigger 900 upwardly indicated by arrow 988 such that the bottom portion and tab 905 of the trigger 900 can easily release the locking wall 307 formed by the locking hole 303 on the bottom of the elongated channel 302. In this position, the distal trigger rod 280 and the trigger 900 can be extended distally within the elongated channel 302, or rather cassette 304 s installed therein. surgical staples from the starting position shown in FIG. 18 into an end position along with the surgical staple cassette 304, with the wedge-shaped slide 910 pushing out all the surgical staples that were functionally supported in the surgical staple cassette 304. In such designs, after the trigger 900 is fully fired (i.e., after being fully extended from its home position to the end position within the surgical staple cassette 304), the firing member 900 is retracted back to the home position shown in FIG. 19. Since in the cassette 304 with staples, the wedge-shaped sled 910 has been extended by the trigger 900 distally to the end position, and the trigger 900 is not attached to the wedge-shaped sled 910, when the trigger 900 is pulled back to its original position, the wedge-shaped sled 910 remains in the final position inside the cassette 304 with surgical staples and do not return with the trigger 900 back to its original position. Thus, the surgical staple cassette 304 is said to be in a "used", "spent", or "activated" state. As shown in FIG. 19, in the absence of the wedge-shaped sled in the unactivated state, the lower part of the body portion 902 as well as the tab 905 of the trigger 900 extend into the locking hole 303 in the lower part of the elongated channel 302 due to the biasing movement applied by the locking tape 986 of the displacement element 984 to the locking cam 281 on the distal trigger rod 280. If, in this position, the clinician inadvertently attempts to reuse a spent staple cassette, body portion 902 and / or tab 905 will come into contact with wall 307 in elongated canal 302 and prevent movement from home position to end position ... Thus, the trigger rod locking assembly 980 prevents the distal trigger rod 280 and trigger member 900 from extending from the home position to the end position if an unactivated or unused surgical staple cassette has not been properly / functionally inserted into the elongated channel of the surgical end effector. It will also be appreciated that the release rod locking assembly 980 also prevents the distal launch rod 280 from extending unless a staple cartridge has been inserted into the elongated channel 302 at all. In addition to positioning the surgical end effector pivot 300 about the pivot axis BB without applying additional load to the distal trigger rod, which could result in increased pivot forces required to pivot the surgical end effector, the trigger rod lock assembly 980 does not apply additional load to the trigger. element and / or distal trigger rod after distal extension behind the fixing wall, regardless of whether the end effector jaws are open or closed.

FIG. 20A shows another embodiment of a pivotable surgical end effector 300 'that utilizes a firing rod locking assembly 980' comprising a displacement member 984 'mounted within an end effector closure sleeve 272. As shown, for example, in this figure, the biasing member 984 'applies a biasing force to the ramped or tapered portion 283' of the distal launch rod 280 '. The launch rod locking assembly 980 'otherwise operates in the same manner as described above with respect to the launch rod locking assembly 980. More specifically, biasing member 984 'applies a biasing force to distal firing rod 280' which forces the distal firing rod 280 'and an attached firing member downwardly within the elongated channel. If an unused wedge-shaped surgical staple cassette or other staple ejection member in the non-activated position has not been properly inserted into the elongated channel or cassette support member so as to functionally interact with the trigger member or trigger bar to move the trigger / trigger bar out of engagement with with the fixing wall, then the axial extension of the trigger / trigger rod from the home to the end position will be prevented.

FIG. 21-25, a portion of another elongate stem assembly 1200 is shown, similar to elongate stem assembly 200 described above, except for various differences that are described in more detail below. Those components of the elongate shaft assembly 1200 detailed above have similar reference numerals and, for brevity, will not be described in more detail than may be necessary to understand the operation of the shaft assembly 1200, for example, when used with portions of the surgical instrument 10 as described. higher. As shown in FIG. 21, the elongate barrel assembly 1200 includes an articulation locking member 1810 that is substantially similar to the articulation locking member 810 and operates in substantially the same manner. As shown in FIG. 22, elongate barrel assembly 1200 includes a barrel frame 1812 that has a proximal cavity 1815 configured to move a proximal portion 1821 of a first distal articulation actuator 1820 therein. The first distal articulation actuator 1820 is movable within the elongate shaft assembly 1200 for selective longitudinal movement in the distal direction DD and the proximal direction PD in response to pivot control movements applied thereto. The shaft frame 1812 further includes a distal end portion 1814 having a pivot pin 1818 formed thereon. The pivot pin 1818 is pivotally positioned within a pivot pin hole (not shown) in the proximal end portion 1320 of the elongated bore 1302 of the surgical end effector 1300. This arrangement facilitates the passage of the elongated bore 1302 relative to the barrel frame 1812 with a pivot (i.e., pivot) about the pivot axis BB defined by the pivot pin hole and the pin 1818. The barrel frame 1812 further includes a centrally located cavity 1817 and a distal slot 1819, located between the distal end 1814 and the centrally located cavity 1817.

The barrel assembly 1200 further includes a second distal articulation actuator 1860 that includes an endless member 1862 pivotally mounted to a proximal roller 1840 and a distal roller 1340. As shown in FIG. 22, a proximal roller 1840 is pivotally mounted on a roller spindle 1842 that is mounted within a centrally located cavity 1817 within a barrel frame 1812. The distal roller 1340 is held non-rotatably at or formed thereon the proximal end 1320 of the elongated bore 1302 of the surgical end effector 1300. In one form, endless element 1862 is a cable that is made of, for example, stainless steel, tungsten, aluminum, titanium, and the like. The cable can be braided or stranded with varying numbers of strands to achieve desired levels of tensile strength and flexibility. For example, in various designs, cable 2382 can have a diameter in the range of 0.08 to 0.2 centimeters (0.03 to 0.08 inches), and more preferably in the range of 0.1 to 0.2 centimeters (0.05 -0.08 inches). For example, the preferred cable can be made from 300 series stainless steel, from semi-solid to fully solid. In various designs, the cable can also be coated with, for example, Teflon®, copper, etc., for example, to improve lubricity and / or to reduce elongation. A first eyelet 1863 is attached to one end of the cable, and a second eyelet 1864 is attached to the second end of the cable, for example by crimping. The cable is stretched under tension while the ends and / or lugs 1863, 1864 are welded, glued, or mechanically secured to each other to form an endless member 1862. The spindle 1842 may include a cam mount that engages the proximal roller 1840 so that move roller 1840 proximally. Other types of tensioning structures, such as belt tensioners, tie-down structures, etc., can also be used to tension endless member 1862.

As shown in FIG. 22, endless member 1862 is coupled to distal end 1821 of first distal articulation actuator 1820 via connector assembly 1830. The connector assembly 1830 includes an upper connector portion 1832 formed at a distal end 1822 of a first distal articulation actuator 1820 and a lower connector portion 1834. Lower connector portion 1834 is formed with two stocks 1835 configured to receive tabs 1862, 1864. A pair of fastening pins 1836 is configured to press into holes 1837 in upper connector portion 1832 to secure the two connector portions 1832 and 1834 to each other. You can use other designs of fasteners, screws, rivets, glue. When endless member 1862 is mounted on rollers 1840 and 1340, connector assembly 1830 is free to move axially within distal slot 1819 in barrel frame 1812 in response to axial movement of first distal articulation actuator 1820. Pivot movements generated by axial movement of the first distal articulation actuator 1820 are transmitted to the second distal articulation actuator 1860 or to the endless member 1862. Attached to the endless member 1862 is a fastening ball or eyelet 1866 that is received in a groove or recess 1342 formed in the distal roller 1340. Thus, the movement of the endless member 1862 is transmitted to the surgical end effector 1300 and, more specifically, to the elongated channel 1302 of the surgical end effector 1300 to pivot the end effector about the pivot axis BB. Thus, when the first distal articulation actuator 1820 moves in the distal direction DD, the endless member 1862 causes the surgical end effector 1300 to articulate about the articulation axis B-B in the articulation direction represented by arrow 823. See FIG. 21. Likewise, when the first distal articulation actuator 1820 is moved in the proximal direction PD, the endless member 1862 causes the surgical end effector 1300 to pivot about the articulation axis B-B in the direction of articulation represented by arrow 821. See FIG. 21 and 25. As shown in FIG. 21, the pivot direction 823 is opposite to the pivot direction 821.

FIG. 26-31 show portions of another elongate stem assembly 2200, similar to elongate stem assembly 200 described above, except for various differences that are described in more detail below. Those components of elongate stem assembly 2200 detailed above have the same reference numerals and, for brevity, will not be described in more detail than may be necessary to understand the operation of elongate stem assembly 2200, for example, when used with portions of surgical instrument 10. as described above. As shown in FIG. 26, elongate barrel assembly 2200 includes a proximal body, or mouthpiece 201, comprised of mouthpiece portions 202 and 203. The elongate shaft assembly 2200 further includes an abutment actuator in the form of a closure tube 2260 that can be used to close and / or open the operatively attached abut 2310 of the surgical end effector 2300. As shown in FIG. 26, elongate shaft assembly 2200 includes a proximal shaft 2210 operably operable with an articulation retention member 2350. The proximal shaft 2210 may be configured to firstly slide the trigger 2220 therein and secondly to slide the cover tube 2260 that extends around the proximal shaft 2210. The proximal shaft 2210 also slidably supports the proximal actuator 2230 articulated joint. The proximal articulation actuator 2230 has a distal end 2231 that is operatively operable with the articulation retaining member 2350.

In the illustrated design, the proximal shaft 2210 includes a proximal end 2211 that is pivotally supported on a chassis 240. For example, in one design, the proximal end 2211 of the proximal shaft 2210 has threads 2214 formed thereon for threaded attachment to a rod support configured to be supported on the chassis. 240. This arrangement facilitates rotational attachment of the proximal rod 2210 to the chassis 240 such that the proximal rod 2210 can selectively pivot about the axis SA-SA of the barrel relative to the chassis 240. The proximal end of the closure tube 2260 is attached to a closure shuttle supported on the chassis, as detailed described above. When the elongate shaft assembly 2200 is operatively connected to the handle or body of the surgical instrument 10, operation of the closure trigger extends the closure tube 2260 distally.

As also noted above, the elongate stem assembly 2200 further includes a trigger 2220 that is supported for axial movement within the proximal shaft 2210. The trigger 2220 includes an intermediate trigger portion 2222 configured to attach to the distal cutting or trigger assembly 2280. rods. See FIG. 27. The intermediate portion 2222 of the firing shaft may include a longitudinal slot 2223 in its distal end that may be configured to receive a tab at the proximal end of the distal firing rod assembly 2280. The longitudinal groove 2223 and the proximal end of the distal launch rod assembly 2280 may be shaped and sized to allow relative movement therebetween, and may include a sliding joint. The sliding joint can move the intermediate portion 2222 of the firing barrel of the firing actuator 2220 to move so as to pivot the end effector 300 without moving, or at least substantially without moving the distal firing rod assembly 2280. Once the surgical end effector 2300 has acquired an acceptable orientation, the intermediate portion 2222 of the firing barrel can be extended distally until the proximal sidewall of the longitudinal slot 2223 contacts the tab to extend the distal trigger rod assembly 2280 and position the staple out of the cassette. that may be supported in end effector 300. Proximal shaft 2210 is also associated with distal shaft 2212.

Similar to elongate barrel assembly 2200, the elongated barrel assembly 200 shown includes a clutch assembly 2400 that may be configured to selectively and releasably connect a proximal articulation actuator 2230 and a trigger 2220. In one form, clutch assembly 2400 includes a retaining ring. or a sleeve, 2402 disposed about a trigger 2220, wherein the locking sleeve 2402 is pivotable between an engaged position where the locking sleeve 2402 connects the proximal articulation actuator 2230 to the trigger 2220, and a disengaged position in which the proximal articulation actuator 2230 is not operatively associated with trigger 2220. When retainer sleeve 2402 is in its engaged position, in addition to the above, distal movement of trigger 2220 may move proximal articulation actuator 2230 distally, and accordingly, proximal movement of actuator 2220 may move proximal articulation actuator 2230 proximally. When locking sleeve 2402 is in its disengaged position, movement of trigger 2220 is not communicated to proximal articulation actuator 2230, whereby trigger 2220 can move independently of proximal articulation actuator 2230. Under various circumstances, the proximal articulation actuator 2230 may be held in position by the articulation locking member 2350 when the proximal articulation actuator 2230 is not moved proximally or distally by the actuator 2220.

As described above, retaining sleeve 2402 may include a cylindrical or at least substantially cylindrical body including a longitudinal bore 2403 formed to receive trigger 2220. Retaining sleeve 2402 may include diametrically inward facing retaining protrusions 2404 and outwardly facing retaining member 2406. Latching lugs 2404 may be configured to selectively engage with trigger 2220. More specifically, when latching sleeve 2402 is in its engaged position, latching lugs 2404 may be positioned within a drive slot 2224 formed in trigger 2220 such that the distal a pushing force and / or a proximal pulling force may be transmitted from trigger 2220 to an anchor sleeve 2402. When an anchor sleeve 2402 is in its engaged position, a second retaining member 2406 is positioned within the drive slot 2232, formed in the articulation actuator 2230 such that the distal thrust force and / or the proximal pulling force applied to the fixing sleeve 2402 can be transmitted to the proximal articulation actuator 2230. As a result, when the locking sleeve 2402 is in its engaged position, the trigger 2220, the locking sleeve 2402, and the proximal articulation actuator 2230 will move together. On the other hand, when the latching sleeve 2402 is in its disengaged position, the latching protrusions 2404 may not be located within the actuator slot 2224 of the trigger 2220, so that the distal push force and / or the proximal pulling force may not be transmitted from the trigger 2220 to the latch sleeve 2402. Accordingly, distal pushing force and / or proximal pulling force may not be transmitted to proximal articulation actuator 2230. In such circumstances, actuator 2220 may slide proximally and / or distally relative to retaining sleeve 2402 and proximal articulation actuator 2230.

As also described above, the elongated barrel assembly 2200 further includes a switch drum 2500 that is rotatably disposed on the cover tube 2260. The switch drum 2500 includes a hollow barrel segment 2502 that has a bushing 2504 formed thereon to receive an outwardly projecting drive pin 2410. In various circumstances, the drive pin 2410 extends through a slot into a longitudinal slot provided in the locking sleeve 2402 to provide axial movement of the locking sleeve 2402 when it engages the articulation drive member 2230. The pivoting torsion spring 2420 is configured to engage with the sleeve 2504 on the switch drum 2500 and a portion of the mouthpiece body 203 for applying a biasing force to the switch drum 2500. The switch drum 2500 may further comprise at least partially annular holes 2506 formed therein, which may be configured to accommodate annular posts extending from the mouthpiece halves 202, 203 and to provide relative rotation, but not translational movement, between switch drum 2500 and the proximal mouthpiece 201. As described above, rotation of the switch drum 2500 ultimately results in rotation of the drive pin 2410 and retaining sleeve 2402 between the engaged and disengaged positions. Thus, the mouthpiece 201 can essentially be used to operatively interact and release the pivot drive system and the starter drive system in various ways as described above, as well as in U.S. Patent Application No. 13 / 803,086, currently U.S. Patent Application Publication No. 2014 / 0263541.

As also shown in FIG. 27, cover tube assembly 2260 includes a two-pivot cover sleeve assembly 2271. In accordance with various shapes, the two-pivot cover sleeve assembly 2271 includes an end effector cover sleeve 2272 with distally protruding upper and lower shanks. The upper double pivot link 2277 includes an upwardly projecting distal and proximal pivot pins that engage respectively with an upper distal pin hole in the upper proximally protruding shank and an upper proximal pin hole in the upper distal protruding shank on the closing tube 2278. Lower double pivot link includes an upwardly projecting distal and proximal pivot pins that engage respectively with a lower distal pin hole in the lower proximally protruding shank and with a lower proximal pin hole in the lower distal protruding shank.

The elongate stem assembly 2200 also includes a surgical end effector 2300 similar to the surgical end effector 300 described above. As shown in FIG. 27, a surgical end effector 2300 includes an elongated bore 2302 operatively capable of supporting a surgical staple cassette 2304. The elongated channel 2302 has a proximal end portion 2320 that includes two vertical sidewalls 2322. The surgical end effector 2300 further includes an abutment 2310 that has an abutment body 2312 on which a lower staple-forming surface 2313 is formed. The proximal end 2314 of the body 2312 the stop is bifurcated about the groove 2315 of the trigger to form two fastening branches 2316 of the stop. Each stop attachment branch 2316 includes a laterally projecting stop journal 2317. A journal slot 2324 is provided in each side wall 2322 of the elongate channel 2302 to receive a corresponding one of the abutment trunnions 2317. Such a structure serves to movably attach the stop 2310 to the elongated conduit 2302 for selective pivotal movement between the open and closed (or clamped) positions. The stop 2310 moves to the closed position by extending the distal closure tube 2260, and more specifically the closure sleeve 2272, of the end effector upward toward the tapered attachment arms 2316 that cause the stop 2310 to move distally during rotation to the closed position. End effector closure sleeve 2272 is provided with a horseshoe-shaped opening 2273 configured to engage a vertical tab 2318 on end effector abut 2310 2310. To open abut 2310, end effector closure tube 2260, and more particularly end effector closure sleeve 2272, is moved proximally. Thus, the central portion of the tongue, defined by the horseshoe-shaped hole 2273, cooperates with the tongue 2318 on the stop 2310 to rotate the stop 2310 back to the open position.

FIG. 26, 28 and 29, as noted above, the elongate barrel assembly 2200 includes an articulation latch member 2350 that is substantially similar to the articulation latch members 350 and 810 described above. Those components of the articulation locking member 2350 that are different from those of the articulation locking member 350 and are necessary to understand the operation of the articulation locking member 350 will be described in more detail below. As described above, an articulation latching member 2350 is capable of and is operable to selectively lock the end effector 2300 in position. Such structures allow the surgical end effector 2300 to rotate or pivot relative to the trunk closure tube 2260 when the articulation retaining member 2350 is in its unlocked state. When the proximal articulation actuator 2230 is operatively engaged with the trigger 2220 via the clutch system 2400, in addition to the above, the trigger 2220 may move the proximal articulation actuator 2230 proximally and / or distally. Movement of the proximal articulation actuator 2230 (proximal or distal) may unlock the articulation locking member 2350 as described above. This embodiment includes a proximal retention adapter member 2360 that is movably held between the proximal shaft 2210 and the distal shaft 2212. The proximal retention adapter 2360 includes a retention cavity 2362 for receiving first retention members 2364 and second retention members 2366 mounted on a frame rail 2368 that extends between the proximal frame 2210 and the distal frame 2212. The articulation latching member 2350 operates in accordance with the various methods described above, and description will not be further presented herein for brevity.

As shown in FIG. 26, 28, and 29, a first distal articulation actuator 2370 is attached to a proximal retention adapter 2360. The first distal articulation actuator 2370 is operatively attached to a second distal articulation actuator 2380 that operatively interacts with the elongated bore 2302 of the end effector 2300. The second the distal articulation drive element 2380 comprises a cable 2382 pivotally mounted on a proximal roller 2383 and a distal roller 2392. The distal roller 2392 is held non-rotatably on or integrally formed with an end effector mounting assembly 2390 and includes a retainer or recess 2396. In the example shown, the end effector mount 2390 is non-movable to the proximal end 2320 of the elongated bore 2302 by a spring pin 2393 that passes through a hole in the end effector mount 2390. orifice and bore 2394 at proximal end 2320 of elongated bore 2302. Proximal roller 2383 is pivotally held on distal shaft 2212. The distal end of distal shaft 2212 has a pivot pin 2213 formed thereon and pivotally positioned within pivot pin hole 2395 formed in the end effector mounting member 2390. This arrangement facilitates the passage of the elongated bore 2302 relative to the distal shaft 2212 to pivot (i.e., pivot) about the pivot axis B-B defined by the pivot pin hole 2395 and the pin 2213.

In one form, the 2382 cable can be made from, for example, stainless steel, tungsten, aluminum, titanium, etc. The cable can be braided or stranded with varying numbers of strands to achieve desired levels of tensile strength and flexibility. For example, in various designs, cable 2382 can have a diameter in the range of 0.08 to 0.2 centimeters (0.03 to 0.08 inches), and more preferably in the range of 0.1 to 0.2 centimeters (0.05 -0.08 inches). For example, the preferred cable can be made from 300 series stainless steel, from semi-solid to fully solid. In various designs, the cable can also be coated with, for example, Teflon®, copper, etc., for example, to improve lubricity and / or to reduce elongation. In the example shown, cable 2382 has a tab 2384 attached to one end and a tab 2385 attached to the other end, such as by crimping. The first distal articulation actuator 2370 includes a pair of spaced wedges 2372, 2374 spaced sufficiently apart to accommodate tabs 2384, 2385. For example, the proximal wedge 2372 includes a proximal slot 2373 for receiving a portion of the cable 2382 adjacent to tab 2384, and distal wedge 2374 includes a distal slot 2375 for receiving a corresponding portion of cable 2382 adjacent to ear 2385. Slots 2373 and 2375 are appropriately sized relative to tabs 2384, 2385 to prevent tabs 2384 from being pulled through them. 2385. The proximal slot 2375 is angled relative to the distal slot 2375 so as to grip the corresponding portion of the cable 2382 therein. See FIG. 30. Attached to endless member 2382 is an attachment ball or tab 2398 that is received in a retainer or recess 2396 formed in distal roller 2392. See FIG. 31. Thus, when the first distal articulation actuator 2370 is axially retracted in the proximal direction PD in the manner described above, the endless member 2382 will pivot the end effector 2300 in the direction represented by arrow 2376 in FIG. 31. Conversely, when the first distal articulation actuator 2370 is axially extended in the distal direction DD, the surgical end effector 2300 is articulated in the direction represented by arrow 2399 in FIG. 31. In addition, the proximal and distal wedges 2372, 2374 are spaced a sufficient distance apart so that the tabs 2384, 2385 are positioned therebetween. The tension wedge 2378 is used as shown in FIG. 29-32 to apply sufficient tension to cable 2382 so that when the cable is actuated, it will apply a pivot motion to end effector 2300. In an alternative design shown in FIG. 35, the proximal wedge 2374 'is not initially attached to the first articulation actuator 2370. A proximal wedge 2374 'is positioned on a first distal articulation actuator 2370 so as to engage lugs 2384 and 2385 between distal wedge 2372 and proximal wedge 2374'. The proximal wedge 2374 'is moved towards the distal wedge 2372 until sufficient tension is created in the cable 2382, after which the proximal wedge 2374' is attached to the first distal articulation actuator 2370. For example, the proximal wedge 2374 'can be attached to the first distal articulation actuator 2370 by laser welding or other suitable attachment means or attachment structure.

As shown in FIG. 36-39, a surgical instrument includes, for example, a firing rod center support 2286 configured to pass through the articulation to provide support for the firing rod assembly 2280. In one form, the firing rod center support member 2286 comprises a flexible plate or band and includes a downwardly extending distal attachment tab 2287 that is attached to the surgical end effector and an upwardly extending proximal end portion 2288 that is attached to the elongate shaft assembly. In at least one design, the distal retaining tab 2287 is secured to the end effector mounting assembly 2390 by a spring pin 2393, and the proximal end portion 2288 is secured to the distal shaft 2212 by pins (not shown). A central launch rod support member 2286 is positioned along the centerline or axis of the barrel of the device and serves to provide support for the launch rod during articulation. This is in contrast to designs that use "blow" plates or side support plates, which are placed on the sides of the launch rod and are thus offset from the barrel axis, increasing their tension and compression forces during articulation. In the example shown, a longitudinally movable flexible launch rod assembly 2280 comprises a multi-layer rod structure that includes at least two rod layers, wherein at least one rod layer is configured to extend adjacent to one side of the central the launch rod support member, and wherein at least one other rod member is configured to extend adjacent to the other side of the launch rod central support member. In the example shown, two layers 2282 and 2284 of the laminate are configured to extend adjacent to each side of the flexible tension carrier. See, for example, FIG. 35 and 36. In various embodiments, the layers 2282 and 2284 of the laminate may comprise, for example, stainless steel strips that are bonded together at their proximal ends, such as by welding or pinning, while their respective distal ends are not bonded together to allow the laminates or tapes to stretch relative to each other as the end effector pivots. Each pair of layers of laminate or tapes 2282, 2284 is represented as a side launch tape assembly 2285 of launch rod assembly 2280. Thus, as shown in FIG. 36, one side firing band assembly 2285 is held on each side of a central articulation bar 2286 for axial movement relative thereto by a series of side carriers 2290. Each side carrier 2290 may be made of, for example, stainless steel, aluminum, titanium, liquid crystal polymeric material, plastic material, nylon, acrylonitrile butadiene styrene (ABS), polyethylene, etc., and is formed with opposing arcuate ends 2292. Each side carrier 2290 also has an axial passage 2294 therethrough to accommodate side launch tape assemblies 2285 and central articulation rod 2286. As is particularly evident in FIG. 38, each axial passage is formed by two opposing arcuate surfaces 2295 that facilitate movement of the side carriers 290 on the longitudinally movable jib assembly 2280. Side carriers 2290 are disposed in series on side launch band assemblies 2285 and center articulation bar 2286 such that opposite arcuate ends 2292 abut corresponding arcuate ends 2292 of adjacent side carriers 2290. See, for example, FIG. 36 and 37.

As also shown in FIG. 37, it can be seen that the proximal end portion 2288 of the central articulation shaft 2286 extends downwardly for attachment to the distal shaft 2212. The distal end 2287 of the firing rod assembly 2280 is attached to a firing element 2900 of, for example, the type and construction described above. As shown in this figure, the trigger 2900 includes a vertically extending trigger housing 2902 that has a cutting surface or blade 2904. In addition, a wedge-shaped sled 2910 may be mounted within the surgical staple cassette 2304 to contact the trigger 2900 with setting it in motion. When actuator 2900 is actuated distally through cassette body 2304, beveled surfaces 2912 of wedge sled 2910 contact the staple ejectors to actuate retained ejectors and surgical staples upward into cassette 2304. Launch rod assembly 2280 operates in accordance with various methods described above. ... As the launch rod assembly 2280 is extended distal to the articulation, the side carriers 2290 help withstand bending loads on the launch rod assembly 2280. Side carriers 2290 can also reduce the amount of force required to pivot the end effector and to accommodate larger pivot angles when compared to other articulation designs. The fixed launch rod center support 2286 is used to carry the tensile loads that are generated during pivot and launch.

As described above, the launch rod assembly comprises a multi-layer rod structure that includes at least two rod layers. When extending the launch rod assembly distally (during launch), the launch rod assembly substantially bifurcates near the central launch rod support so that portions of the launch rod assembly (i.e., layers of laminate) extend on both sides of the central launch rod support.

FIG. 40-43, a portion of another launch rod assembly 2280 'is shown that is attached to the launch element 2900. As shown in these figures, the launch rod assembly 2280 comprises a multi-layer structure that includes two outer side rods or two layers 2282', each of which has a thickness indicated as a, and four central layers 2284 ', each of which has a thickness indicated as b. In at least one design, for example, "a" can be about 0.01-0.02 centimeters (0.005-0.008 inches), and more preferably 0.02 centimeters (0.008 inches), and "b" can be about 0, 02 - 0.030 centimeters (0.008 - 0.012 inches), and more preferably 0.025 centimeters (0.010 inches). However, other thicknesses can be used. In the example shown, a is less than b. In other designs, a is greater than b. For example, in alternative designs, laminates can be composed of three different thicknesses "a", "b", "c" where "a" = 0.015 centimeters (0.006 inches), “b” = 0.02 centimeters (0.008 inches), a "c" = 0.025 centimeters (0.010 inches) (with the thickest laminate or tape at the center of the knot). Various designs may have an odd number of laminates or tapes, with c being the single thickest layer in the center.

The composition of the laminate is important because of the amount of stress applied to the rod assembly and is based on its thickness and distance from the center line of the bend. Thicker laminates or tapes that are closer to the centerline may experience the same stress levels as thinner ones that are farther from the centerline because they have to bend more, given the fact that they stacked on top of each other. The radius of curvature is more pronounced on the inside of the curve, further from the centerline. At the same radius of curvature, thicker laminates or tapes tend to experience greater internal stress than thinner laminates. Thus, thinner side laminates or ribbons having the smallest radius of curvature may have the same plastic deformation probability as thicker ones closer to the centerline.

In other words, when the end effector pivots in one direction, the laminates or tapes located far from the direction of the hinge have the largest bending radius, and the laminates or tapes located closest to the direction of the hinge have the smallest bending radius. However, the opposite is true when the end effector pivots in the opposite direction. Laminates on the inside of a multi-layer stack experience the same deflection, but their bend radius always falls within the range of outside materials. Thus, to maintain flexibility, it may be necessary to place thinner laminates outside the stack. However, adding thicker materials on the inside will provide additional benefits to maximize stiffness and flexural resistance. Alternatively, if the end effector needs to pivot in only one direction, laminates or tapes placed far from the pivot direction will experience the largest bend radius, and laminates or tapes located near the pivot direction will have the smallest bend radius. However, since the end effector does not pivot in the opposite direction, the converse is no longer true and therefore the stack of laminate does not need to be symmetrical. Thus, in such a structure, it would be desirable for the thinnest laminate or tape to have the smallest bend radius (laminate or tape on the pivot direction side).

In another design, laminates or tapes can be made from different metals with different strengths and modulus. For example, the outer laminates or tapes can be the same thickness as the inner laminates or tapes, with the inner laminates or tapes being 300 series stainless steel and the outer laminates or tapes being titanium or nitinol.

As shown also in FIG. 42 and 43, the distal launch rod assembly 2280 'can be effectively used with a variety of lateral carriers 2290 described above. It will be appreciated that the distal launch rod assembly 2280 may also be used in conjunction with the central articulation rod 2286 in the manner described above such that some of it the plies or side rods (or tapes or laminates) are axially extended along the sides of the center articulation bar. In some embodiments, the layers extending on each side of the center articulation shaft 2286 may have the same thickness, composition, shape, and configuration. In other designs, the layer or layers running along one side of the center pivot bar may have a different thickness and / or composition and / or shape compared to the thickness and / or composition and / or shape of the layer or layers running along the opposite side of the center bar. articulation to achieve the desired range of motion and flexibility while maintaining the desired stiffness to avoid bending during launch.

FIG. 44-46, a portion of another elongate stem assembly 3200 is shown that includes a surgical end effector 300 of the type and construction described above. You can also use other forms of surgical end effectors. The elongate shaft assembly 3200 also includes a longitudinally movable flexible launch rod assembly 3280 that is attached to the actuator 900. In alternative designs, the distal end of the launch rod assembly 3280 may be configured to perform various actions within the surgical end effector. , and there is no need to attach a trigger to it. A flexible launch rod assembly 3280 may comprise a multi-layer rod structure of the various types described herein. One design uses at least two compression bands to provide lateral support to the flex rod assembly 3280 as it crosses the articulated joint. In the embodiments shown, a total of four compression bands are used to provide lateral support to the flexible launch rod as it crosses the articulation joint. For example, elongate shaft assembly 3200 further includes a stem 3210 that includes a distal end 3217 having two distal cavities or slots 3219 formed therein and two proximal cavities or slots 3219 '. One distal cavity 3219 accommodates the first proximal end 3904 of the first compression band 3900 located on one side 3281 of said flexible launch rod assembly 3280, and the other distal cavity 3219 accommodates the second proximal end 3905 of a second compression band 3901 located on the other side 3283 of the launch rod assembly 3280. The first compression band 3900 includes a first distal end 3902 that is positioned within a corresponding vertical side support wall 330 formed at the proximal end 320 the elongated channel 302 of the surgical end effector 300. Similarly, the second compression band 3901 includes a second distal end 3907 that is also positioned within a corresponding vertical lateral support wall 330 formed at the proximal end 320 of the elongated channel 302 of the surgical end effector 300. The first and second distal compression straps 3900, 3901 can be made of spring steel or the like, and proximal ends 3904, 3905 can be bent into a U-shape to form a biasing portion configured to be positioned within distal slots 3219 as shown. This design allows the first and second distal compression bands 3900, 3901 to flex in response to the articulated pivot of the surgical end effector 300, while the proximal ends 3904, 3905 are held within respective distal slots 3219.

As shown also in FIG. 44-46, the elongate barrel assembly 3200 further includes a third compression band 3910 and a fourth compression band 3911. Similar to the first and second compression bands 3900, 3901, the third and fourth compression bands 3910, 3911 may be made of spring steel. As shown in FIG. 44-46, a third compression strap 3910 may be located between the first compression strap 3900 and the side 3281 of the launch rod assembly 3280, and the fourth compression strap 3911 may be located between the second compression strap 3901 and the other side 3283 of the flexible launch strap assembly 3280. Each of the third proximal end 3914 of the third compression tape 3910 and the fourth proximal end 3915 of the fourth compression tape 3911 may be folded into a U-shape to form a biasing portion configured to move within a corresponding proximal cavity 3219 'in the rod 3210. The third distal end 3912 of the third compression band 3910 and the fourth distal end 3917 of the fourth compression band 3911 are mounted in the respective side support wall 330 in the surgical end effector 300.

The elongate shaft assembly 3200 further comprises a support link assembly 3920 that is movable to provide additional lateral support for the flexible launch rod assembly 3280 when the end effector 300 pivots about the pivot axis. As shown in FIG. 44-46, a movable support link assembly 3920 comprises a middle support member 3922 movably associated with a surgical end effector 300 as well as an elongate stem assembly 3200. In one embodiment, the middle abutment 3922 is pivotally attached to the proximal end 320 of the elongated bore 302. The median abutment 3922 further includes a proximally protruding tab 3926 having an elongated proximal slot 3928. The proximal slot 3928 is configured to receive a formed on the shaft 3210 middle support pin 3211, sliding. This design allows relative pivot and axial movement between the middle support member 3922 and the rod 3210 of the elongate barrel assembly 3200 so as to accommodate a greater pivot range while maintaining dynamic movement to maintain sufficient lateral support on the launcher assembly 3280. As shown in FIG. 44-46, the middle support member 3922 further includes a centrally located groove 3930 for axially positioning the launch rod assembly 3280 therethrough.

As further shown in FIG. 44-46, the movable support link assembly 3920 further comprises an elongate movable pivot link 3940. Pivot link 3940 includes a central body portion 3942 having a proximally protruding proximal nasal portion 3943 and a distal protruding distal nasal portion 3944. Pivot link 3940 further includes a first downwardly projecting side support wall 3945 and a second downwardly projecting side support wall 3946 between which formed the groove 3947 of the rod. As shown in FIG. 46, the launch rod assembly 3280 is configured to pass between the first and second side support walls 3945, 3946 during actuation of the launch rod assembly 3280 and pivot of the surgical end effector 300. Additionally, in the illustrated structure, for example, the first compression band 3900 extends between the first side abutment 3945 and the third compression band 3910, and the second compression band 3901 extends between the second side abutment 3946 and the fourth compression band 3911. The first side abutment 3945 includes an inwardly facing first arcuate surface 3948, and the second lateral abutment wall 3946 includes an inwardly facing second arcuate surface 3949. The first and second arcuate surfaces 3948, 3949 serve to provide lateral support to the launcher assembly 3280 as it flexes during articulation of the end effector 300. The radially rounded surfaces may correspond the outer radius of the launch rod assembly 3280 and compression bands 3900, 3901, 3910, 3911, depending on the direction and degree of articulation. As shown also in FIG. 44 and 45, the distal end 3217 of the stem 3210 includes a pair of right and left opposing stem slots 3218 into which the rounded proximal protruding proximal nasal portion 3943 of the pivot link 3940 extends depending on the direction in which the surgical end effector pivots about the axis hinge rotation. Likewise, right and left opposed abutment slots 3932 are provided in the middle abutment 3922 to accommodate the distally protruding distal nose portion 3944 of the pivot link 3940 depending on the direction in which the end effector pivots. This design of the slots serves to properly align the pivot link 3940 in a direction suitable to accommodate the direction of the pivot pivot while providing lateral support for the pivot link 3940.

FIG. 47-51, another elongate stem assembly 4200 is shown, similar in some respects to elongate stem assembly 2200 described above, except for various differences that are described in more detail below. Those components of the elongate stem assembly 2200 that are detailed above will have similar reference numerals and, for brevity, will not be described in more detail than may be necessary to understand the operation of the elongate stem assembly 4200, for example, when used with portions of the surgical instrument 10. as described above. As seen in FIG. 47, in at least one example, elongate barrel assembly 4200 includes a pivot locking member 2350. As described in detail above, the articulation latch assembly 2350 includes a proximal articulation latch adapter 2360 associated (eg, attached) to a first distal articulation actuator 4370. As shown in FIG. 47 and 50, a first distal articulation actuator 4370 includes a first proximal rack segment 4371 and a first distal rack segment 4373 formed at a distal end 4372. The elongate shaft assembly 4200 also includes a second distal articulation actuator 4380. which includes a second proximal rack segment 4381 and a second distal rack segment 4383 formed at a distal end 4382.

The first distal articulation actuator 4370 and the second distal articulation actuator 4380 are axially movable relative to the distal shaft assembly 4212 in the proximal direction PD and the distal direction DD. As shown in FIG. 50, the first proximal rack segment 4371 and the second proximal rack segment 4381 are in meshing with a proximal power transmission gear 4390 which is pivotally held by the distal stem assembly 4212. Similarly, the first distal rack segment 4373 and the second distal rack segment 4383 are in gear engagement with the distal power transmission gear assembly 4392. Specifically, in at least one design, the distal power transmission gear assembly 4392 includes a gear 4393 meshed with a first distal rack segment 4373 and a second distal rack segment 4383. The distal power transmission gear assembly 4392 further includes a pinion gear 4394 that is geared with an idler gear 4395. The idler gear 4395 is in turn held in gear engagement with a driven gear 4306 formed at the proximal end portion 4320 of the elongated channel 4302 of the surgical end effector 4300. Surgical end effector 4300 may otherwise be similar to surgical end effector 2300 and include an abutment 4310 that can be opened and closed in various ways described above. As shown in FIG. 48, 49 and 51, distal shaft assembly 4212 may include an upper shaft portion 4212A and a lower shaft portion 4212B. Each of the distal power transmission gear assembly 4392, the idler gear 4395, and the driven gear portion 4306 of the elongated bore 4302 is pivotally attached to or retained on the lower portion 4212B of the distal rod assembly 4212.

The elongate barrel assembly 4200 shown in FIG. 47 includes a launch rod assembly 3280 attached to a launch element (not shown). The launch rod assembly 3280 may comprise a multi-layer rod structure of the types described herein. The operation of the trigger is detailed above and will not be repeated for brevity. As shown also in FIG. 47, a launch rod support member 4400 of the type described in US Patent Application No. 14 / 575,117 entitled SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTORS AND MOVABLE FIRING BEAM SUPPORT ARRANGEMENTS, the contents of which are incorporated herein by reference in their entirety, is used to provide support launch rod assembly 3280 during pivotal rotation of the surgical end effector 4300. FIG. 52 illustrates the application of distal launch rod assembly 2280 to elongate shaft assembly 4200. As shown in this figure, a plurality of side carriers 2290 are used in the manner described above to support the distal launch rod assembly 2280 as the surgical end effector 4300 pivots.

FIG. 53-58, another elongate stem assembly 5200 is shown, similar in some aspects to elongate stem assembly 2200 described above, except for various differences that are described in more detail below. Those components of the elongate stem assembly 5200 detailed above with respect to elongate stem assembly 2200 will be identified by the same reference numerals and, for brevity, will not be described in more detail than may be necessary to understand the operation of the elongate stem assembly 5200, for example, when use with areas of the surgical instrument 10 as described above.

Similar to elongate stem assembly 2200, the elongate stem assembly 5200 illustrated includes a clutch assembly 2400 operable with an articulation system 5600 that is configured to apply pivot push and pull movements to an operatively associated surgical end effector 300. B In this embodiment, clutch assembly 2400 includes a latching ring, or latch sleeve, 2402 disposed around trigger 2220, latch sleeve 2402 being pivotable between an engaged position where latch sleeve 2402 operatively interacts with trigger system 5600 with trigger 2220 , and a disengaged position in which the articulation system 5600 is not operatively associated with trigger 2220. As shown specifically in FIG. 54-56, in the illustrated example, the articulation system 5600 comprises an articulation disc or pivot member 5602 held for pivot movement within the mouthpiece 201. The articulation disc 5602 is pivotally driven by an actuator assembly 5610. In the example shown, the drive connection assembly 5610 includes a drive pin 5612 attached to the articulation disc 5602. The pivot drive link 5614 is operatively attached to the drive pin 5612 via a connector 5616 to facilitate some movement of the pivot drive link 5614 relative to the drive pin 5612. See FIG. 54-56. The pivot drive link 5614 includes a drive connector 5618 configured to engage with an outwardly facing locking member 2406 on the locking sleeve 2402 upon actuation. See FIG. 53.

As described above, the retaining sleeve 2402 may comprise a cylindrical or at least substantially cylindrical body including a longitudinal hole 2403 formed to receive a trigger 2220. See FIG. 53. Retaining sleeve 2402 may include diametrically inwardly facing retaining protrusions 2404 and outwardly facing retaining member 2406. Retaining protrusions 2404 may be configured to selectively engage with trigger 2220. More specifically, when retaining sleeve 2402 is in its engaged position, retaining protrusions 2404 may be positioned within an actuator slot 2224 formed in trigger 2220 such that distal thrust and / or proximal pulling force can be transmitted from trigger 2220 to anchor sleeve 2402. When retainer sleeve 2402 is in its engaged position, facing outwardly, the locking member 2406 is received within the drive slot 5619 in the drive connector 5618, as shown in FIG. 53 so that a distal pushing force and / or a proximal pulling force applied to anchor sleeve 2402 can be transferred to the articulation drive member 5614. As a result, when the retaining sleeve 2402 is in its engaged position, the trigger 2220, the retaining sleeve 2402, and the articulation drive member 5614 will move together. On the other hand, when the latching sleeve 2402 is in its disengaged position, the latching protrusions 2404 may not be located within the actuator slot 2224 of the trigger 2220, so that the distal push force and / or the proximal pulling force may not be transmitted from the trigger 2220 to the latch sleeve 2402. Accordingly, no driving force DF may be applied to the articulation disc 5602. In such circumstances, actuator 2220 may slide proximally and / or distally relative to retaining sleeve 2402 and proximal articulation actuator 2230.

As also described above, the elongate barrel assembly 5200 further includes a switch drum 2500 that is rotatably disposed on the cover tube 2260. See FIG. 53. Switch drum 2500 includes a hollow barrel segment 2502 that has a bushing 2504 formed thereon to accommodate an outwardly projecting drive pin 2410. Under various circumstances, the drive pin 2410 extends into a longitudinal slot 2401 provided in the retaining sleeve 2402 to provide axial movement of the retaining sleeve 2402 when it interacts with the articulation drive link 5614. The rotary torsion spring 2420 is configured to engage with the barrel sleeve 2504 on the switch drum 2500 and a portion of the mouthpiece body 201 for applying a biasing force to the switch drum 2500. As also described above, the switch drum 2500 may further comprise at least partially annular holes formed therein, which may be configured to accommodate annular posts extending from the mouthpiece halves and provide relative rotation, but not translational movement, between switch drum 2500 and a mouthpiece body 201. As described above, rotation of the switch drum 2500 ultimately causes the drive pin 2410 and the locking sleeve 2402 to rotate between the engaged and disengaged positions. Thus, the mouthpiece body 201 can essentially be used to operatively engage and release the articulation system 5600 and the actuator system in various ways described above, as well as in U.S. Patent Application Publication No. 13 / 803,086, currently U.S. Patent Application Publication No. 2014 / 0263541.

As also shown in FIG. 53-56, the illustrated example pivot system 5600 further includes a "first" or right pivot 5620 and a "second" or left pivot 5640. The first pivot 5620 includes a first pivot 5622, which includes a first an articulation pin 5624 that is movable within the first articulation groove 5604 in the articulation disc 5602. A first articulation link 5622 is movably attached to a first articulation connector 5626 that is configured to engage with an articulation retaining member 2350. As described above, the articulation locking member 2350 may be configured and operable to selectively lock the surgical end effector 300 in position. Such structures allow the surgical end effector 300 to rotate or pivot relative to the trunk closure tube 2260 when the articulation retaining member 2350 is in its unlocked state. When pivot actuator 5614 is operatively engaged with trigger 2220 via clutch system 2400, in addition to the above, trigger 2220 may rotate pivot disc 6502 to move first pivot 5620 proximally and / or distally. Movement of the first connector 5626 of the first articulation 5620 (proximal or distal) may unlock the articulation locking member 2350 as described above. The proximal retention adapter 2360 includes a retention cavity 2362 for receiving first retention members 2364 and second retention members 2366 mounted on a frame rail that extends between the proximal frame 2210 and the distal frame. The operation of the articulation latching member 2350 is carried out in accordance with the various methods described above, and for brevity, description will not be further presented herein. As shown in FIG. 53, a first distal articulation actuator 5370 is attached to a proximal retention adapter 2360. The first distal articulation actuator 5370 is operatively attached to the proximal end 320 of the elongated channel 302 of the surgical end effector 300.

As also noted above, the articulation system 5600 in the example shown further includes a "second" or left pivot joint 5640. As shown in FIG. 54-56, the second pivot joint 5640 includes a second pivot link 5642 that includes a second pivot pin 5644 that is movably positioned within a second pivot slot 5606 in the pivot disc 5602. The second articulation link 5642 is attached to a second articulation rod 5646 that is attached to the proximal end 320 of the elongated channel 302 of the surgical end effector 300. As shown in FIG. 54, the articulation system 5600 further includes a first biasing member.

5628 articulation that is located within the first articulation groove 5604, and a second articulation biasing member 5648 that is located within the second articulation groove 5606. FIG. 54 shows an articulation system 5600 in a neutral or non-rotated articulation configuration. As shown in this figure, the first articulation pin 5624 contacts the first articulation displacement member 5628 and the second articulation pin 5644 contacts the second articulation displacement member 5648. However, in the neutral position, the first and second articulation biasing members 5628, 5648 may not be in a compressed state. FIG. 55 shows the application of the drive force DF to the articulation disc 5602 in the proximal direction PD by the articulation drive member 5614 in the manner described above. The application of driving force DF in the proximal direction PD pivots the articulation disc 5602 in the pivot direction represented by arrow 5601. When the articulation disc 5602 pivots in the pivot direction 5601, the end of the second articulation groove contacts the second articulation pin 5644 and applies a pushing force. the second articulation joint 5640 and ultimately to the second articulation bar 5646. Conversely, the first articulation biasing member 5628 causes the first articulation pin 5624 to move in the direction represented by arrow 5601 within the first articulation slot 5604 such that pulling force is applied to the first articulation joint 5620 in the proximal direction PD. This proximal pulling force is transmitted to the first distal articulation actuator 5370 via the articulation retaining member 2350. Such "push and pull movements" applied to the surgical end effector cause the surgical end effector 300 to pivot about the pivot axis in the direction represented by arrow 5300. See FIG. 53. When the articulation disc 5602 is in the position shown in FIG. 55, the second articulation biasing member 5648 may be in a compressed state and the first articulation biasing member may not be compressed. Thus, once the drive force DF is no longer applied to the articulation drive member 5614, the second articulation biasing member 5648 can bias the articulation disc 5602 back to the neutral position, as shown in FIG. 54.

Conversely, when a driving force DF is applied to the articulation drive member 5614 in the distal direction DD, as shown in FIG. 56, the pivot disc 5602 pivots in the pivot direction represented by arrow 5603. When the pivot disc 5602 pivots in the pivot direction 5603, the end of the first pivot groove 5604 contacts the first pivot pin 5624 and applies a push force to the first pivot point 5620 account to the first distal articulation actuator 5370 through the articulation locking element 2350. In addition, the second articulation biasing member 5648 causes the second articulation pin 5644 to move in the direction of arrow 5603 within the second articulation slot 5606 such that pulling force is applied to the second articulation joint 5640 in the proximal direction PD. This proximal pulling force is transmitted to the second articulation shaft 5646. Such "push-and-pull" movements applied to the surgical end effector 300 cause the surgical end effector 300 to pivot about the pivot axis in the direction represented by arrow 5302. See FIG. 53. When the articulation disc 5602 is in the position shown in FIG. 56, the first articulation biasing member 5628 may be in a compressed state and the second articulation biasing member 5648 may not be compressed. Thus, once the drive force DF is no longer applied to the articulation drive member 5614, the first articulation biasing member 5628 can bias the articulation disc 5602 back to the neutral position, as shown, for example, in FIG. 54.

FIG. 57 shows the attachment of the distal end portion 814 of the barrel frame 812 to a surgical end effector 300 that is operatively associated with an elongate barrel assembly 5200. As described above, the distal end portion 814 has a downwardly projecting pivot pin (not shown) configured to be pivotally positioned within a pivot pin hole (not shown) formed in the proximal end portion 320 of the elongated channel 302. This arrangement facilitates passage of the elongated channel 302 with rotation relative to the barrel frame 812 about the pivot pivot axis BB bounded by the pivot pin hole. As shown also in FIG. 57, the first distal articulation actuator 5370 is attached to the first connector 850 by the first ball joint 852. The first connector 850 is also pivotally attached to the proximal end portion 320 of the elongated bore 302 via a first pin 854 as shown in FIG. 57. Likewise, second articulation rod 5646 is attached to second connector 870 by second ball joint 872. Second connector 870 is also pivotally attached to proximal end portion 320 of elongated bore 302 via second pin 874 as shown in FIG. 57.

As shown in FIG. 53 and 58, elongate barrel assembly 5200 may also include a launch rod assembly 2280 attached to a launch element 900 of the type described above. The launch rod assembly 2280 is attached to the launch element 2220 and can be extended and retracted axially in accordance with the various methods described above. The elongate shaft assembly 5200 may further comprise a plurality of support link assembly 920 to provide lateral support to the distal launch rod 2280 as the surgical end effector 300 pivots about the pivot axis B-B. As shown in FIG. 58, the plurality of support link assembly 920 includes a middle support member 922 that is pivotally attached to the proximal end 320 of the elongated bore 302 in the manner described above. The middle abutment 922 further includes a centrally located groove 930 for axially extending the distal launch rod 2280 therethrough. The plurality of abutment link assembly 920 further comprises a proximal abutment link 940 and a distal abutment link 950. The proximal abutment link 940 includes a housing portion 942 that has a rounded proximal end 943 and a rounded distal end 944. The proximal abutment 940 further includes a pair of downwardly projecting side abutment walls 945, between which a proximal groove is formed. Similarly, distal abutment 950 includes a housing portion 952 that has a rounded proximal end 953 and a rounded distal end 954. Distal abutment 950 further includes a pair of downwardly projecting side abutment walls 955, between which a distal groove is formed. As shown in FIG. 58, distal launch rod 2280 is configured to pass between lateral abutment walls 945 of proximal abutment 940 and lateral abutment walls 955 of distal abutment 950. Each abutment wall 945 and 955 includes an inwardly facing arcuate surface as described above. The abutment surfaces serve to provide lateral support for the distal launch rod 2280 as it flexes during pivotal rotation of the surgical end effector 300. In addition, the closure tube assembly 2260 may include a double-pivot closure sleeve assembly of the type described above, operably operative to abut against surgical end effector 300. Operation of the closure tube assembly 2260 causes the surgical effector abutment to open and close in accordance with the various methods described above.

FIG. 59 shows a portion of another elongate stem assembly 5700, which may be substantially similar to elongate stem assembly 5200. except for the differences described below. In particular, the articulation disc 5702 of the articulation system 5701 is rotated by a worm gear motor 5710 which is functionally supported in the mouthpiece body 201. For example, in one embodiment, driven gear 5703 is integrally formed with or otherwise fixedly attached to articulation disc 5702 such that it meshes with worm drive 5712 of engine 5710. In the example shown, the first rod or member The articulation 5720 can be directly attached to a portion of the surgical end effector in any of the various ways that are described herein. A first articulation pin 5722 is attached to a first articulation rod 5720 and is positioned within a first arcuate articulation groove 5704 formed in an articulation disc 5702. The first articulation biasing member 5705 is positioned within the first articulation slot 5704 for biasing contact with the first articulation pin 5722. Similarly, the second stem or articulation member 5730 may be directly or indirectly attached to the surgical end effector portion in accordance with any of the various methods described herein. A second articulation pin 5732 is attached to a second articulation rod 5730 and is positioned within a second arcuate articulation groove 5706 formed in an articulation disc 5702. A second articulation biasing member 5707 is positioned within a second articulation slot 5706 for biasing contact with a second articulation pin 5732.

FIG. 59 depicts an articulation system 5701 in a neutral or non-rotated articulation configuration. As shown in this figure, the first articulation pin 5722 contacts the first articulation displacement member 5705 and the second articulation pin 5732 contacts the second articulation displacement member 5707. However, in the neutral position, the first and second articulation biasing members 5705, 5707 may not be in a compressed state. Actuation of the motor 5710 to rotate the articulation disc 5702 in the direction of rotation represented by arrow 5601 will apply a pulling motion to the first articulation rod 5720 to cause the first articulation rod 5720 to move in the proximal direction PD, and will also apply a pushing motion to the second articulation rod 5730 to cause the second articulation rod 5730 to move in the distal direction DD. Conversely, actuating the motor 5710 to rotate the articulation disc 5702 in the direction of rotation represented by arrow 5603 will apply a pushing motion to the first articulation rod 5720 to cause the first articulation rod 5720 to move in the distal direction DD, and will also apply a pulling motion towards the second articulation rod 5730 to cause the second articulation rod 5730 to move in the proximal direction PD. Such "push and pull movements" applied to the surgical end effector cause the surgical end effector to pivot about the pivot axis in accordance with the various methods described above.

FIG. 60-65, another articulation system 5800 is shown that may be used with the various elongate stem and effector assembly designs described herein. However, in this embodiment, the articulation system 5800 comprises a dual-articulation disc assembly 5810 that includes a drive articulation disc 5820 and a driven articulation disc 5830. Both pivot discs 5820, 5830 may, for example, be pivotally held within the mouthpiece housing of the elongate barrel assembly such that both discs 5820, 5830 are independently rotatable about a common axis. In various embodiments, drive motions may be applied to the articulation drive disc 5820 by the articulation drive member 5614 and firing element structure 2220, as described above. In other embodiments, rotary drive motions may be applied to the articulation drive disc 5820 by a worm gear motor 5710 in accordance with the method described above.

FIG. 61 depicts one form of drive disc 5820. As shown in this figure, drive disc 5820 includes a first pair of first arcuate articulation grooves 5822L, 5822R, each having a first arcuate length FL. In addition, the drive pivot disc 5820 further includes an ejector slot 5824 that is centrally located between the first pivot slots 5822, as shown in FIG. 61. Depending on the method used to drive the pivot drive disc 5820, the pivot drive link 5614 or worm gear motor 5710 may interact with the pivot drive disc 5820 in accordance with the various methods described above to apply rotational motion to the drive pivot. articulated disc 5820. FIG. 62 shows one form of driven articulation disc 5830. As shown in this figure, the driven articulation plate 5830 includes a second pair of second arcuate articulation grooves 5832L, 5832R, each having a second arcuate length SL that is less than the first arcuate length FL. In addition, the driven articulation disc 5830 further includes a drive post 5834 configured to move within the ejector slot 5824.

As shown in FIG. 60 and 63-65, the articulation system 5800 further comprises a first articulation rod 5840 that may be directly or indirectly attached to a portion of the surgical end effector in accordance with any of the various methods described herein. A first articulation pin 5842 is attached to a first articulation rod 5720 and is positioned within respective first and second arcuate articulation grooves 5822L, 5832L. Similarly, a second stem or articulation member 5850 can be directly attached to a portion of the same surgical end effector in accordance with any of the various methods described herein. A second articulation pin 5852 is attached to a second articulation rod 5850 and is positioned within respective first and second arcuate articulation grooves 5822R, 5832R. FIG. 60 shows the articulation system 5800 in a "zero" position in which the surgical end effector is free to move. FIG. 63 shows the position of the pivot system 5800 when the rotational motion is initially applied to the drive pivot plate 5820 in the direction represented by arrow 5860. As shown in this figure, with the initial pivot of the drive pivot plate 5820, the pivot grooves 5822L, 5832L are offset from each other. and the articulation grooves 5822R, 5832R are offset from each other, but the motion has not yet been transferred to the articulation rods 5840, 5850. FIG. 64 shows the position of the articulation system 5800 while continuing to apply a rotational motion to the drive articulation disk 5820 in the direction represented by arrow 5860 sufficient to achieve, for example, pivot the surgical end effector seventy-five degrees relative to the bore axis. As shown in this figure, a pushing motion is applied to the first articulation rod 5840 to cause the first articulation rod 5840 to move axially in the distal direction DD, and a pulling motion is applied to the second articulation rod 5850 to cause the second articulation rod 5850 to move. in the proximal direction PD along the axis. Movement of the first and second articulation rods 5840, 5850 in opposite directions results in articulation of the operatively interacting surgical end effector. FIG. 65 shows the position of the articulation system 5800 when a rotational motion is applied to the drive articulation disc 5820 in the opposite direction, represented by arrow 5862, which is sufficient to achieve, for example, a pivot pivot of the surgical end effector seventy-five degrees relative to the bore axis in the opposite pivot direction. ... As shown in this figure, a pushing motion is applied to the second articulation rod 5850 to cause the second articulation rod 5850 to move axially in the distal direction DD, and a pulling motion is applied to the first articulation rod 5840 to cause the first articulation rod 5840 to move. in the proximal direction PD along the axis. Such opposing movements of the first and second articulation rods 5840, 5850 result in articulation of the operatively attached surgical end effector. In one configuration, the first articulation rod 5840 can apply only pulling force to the surgical end effector by rotating the articulation actuator disc 5820 a sufficient distance to achieve a seventy-five degree articulation range.

FIG. 66-70 show a surgical end effector 6300 that includes first and second jaws configured to move simultaneously between open and closed positions relative to the shaft axis SA-SA. The first and second jaws can have different surgical jaw designs without departing from the spirit and scope of the present invention. Accessing the target tissue with the jaws of the surgical end effector can sometimes be challenging. The maneuverability of a surgical end effector, in particular a surgical end effector that is capable of cutting and stitching tissue, can be increased by minimizing the distance between the point at which the jaws are held relative to each other and the most proximal staple positions. For example, in those surgical end effectors that use only one movable jaw (i.e., one of the jaws is locked to the axis of the shaft), it may be necessary that one movable jaw has a relatively large range of movement to accommodate the target. fabrics. This greater range of motion can make it difficult to use the end effector to preferentially position the target tissue. The surgical end effector 6300 uses a first and a second jaw that moves relative to each other and to the axis of the trunk about a common pivot axis. This design makes it possible to reduce the distance between the pivot axis and the most proximal staple positions compared to the same distance on some surgical end effectors, which, for example, use only one jaw that is movable.

In the example shown, the first jaw 6310 includes an elongated bore 6312 that is operatively capable of supporting a surgical staple cassette 6320 therein. As shown in FIG. 70, staple cassette 6320 is operatively capable of supporting a plurality of staple ejectors 6322 on which staple ejectors 6322 are operatively supported. Staple ejectors 6322 are movably held within respective ejector slots 6321 formed in surgical staple cassette 6320. Staple ejectors 6322 are retained within a corresponding ejector slot 6321 by a cassette tray 6330 that is clamped or otherwise attached to a surgical staple cassette 6320. Pushers 6322 staples are arranged in rows on each side of the elongated groove 6326 in the cassette 6320 with surgical staples to provide an axial passage of the trigger 6340. Wedge-shaped sled 6350 are held movable inside the cassette 6320 with surgical staples and are made to engage with the transmission of the driving force element 6340 when actuator 6340 is driven from a home position adjacent the proximal end of the surgical staple cassette 6320 to an end position within the distal portion of the surgical staple cassette 6320. As described above, when driving the wedge sled 6350 distally through the surgical staple cassette 6320, the wedge sled 6350 engages the staple ejectors 6322 to drive them against the cassette platform surface 6323. Trigger 6340 includes a tissue cutting surface 6346 that serves to cut tissue sandwiched between the jaws when trigger 6340 is distally driven. A distal launch rod (not shown) of various types described herein is operatively attached to the launch element 6340 as well as to the intermediate section 2222 of the launch barrel or to another design of launch system. The operation of the intermediate firing section 2222 to push and pull the distal firing rod is described in detail above and will not be repeated for brevity. Other designs of the launch rod and the launch system (with a motor and also with a manual drive) can also be used to actuate the trigger without departing from the spirit and scope of the present invention.

The illustrated surgical end effector 6300 is also configured to selectively pivot about a pivot axis B-B that is substantially transverse to the shaft axis SA-SA. As shown in FIG. 66-70, surgical end effector 6300 includes an end effector mounting assembly 6390 pivotally mountable on, for example, a distal barrel frame (not shown) that includes a pivot shaft pivotally positioned inside mounting hole 6392 in end effector mounting assembly 6390. The articulation of the surgical end effector 6300 may be accomplished by the articulation locking member and first and second articulation rod structures of the type described above. As shown in FIG. 70, the end effector assembly 6390 further includes a pair of opposing laterally extending trunnion pins 6394. Trunnion pins 6394 extend laterally from opposite sides 6391 of end effector mount 6390, which also forms a recess region 6395 adapted to receive trigger 6340. Trunnion pins 6394 serve to form a pivot axis PA-PA around which pivot the first and second jaws 6310, 6360. The proximal end 6314 of the first jaw 6310 or elongated bore 6312 includes a pair of opposed, U-shaped or open slots 6316 configured to receive a corresponding one of the trunnion pins 6394. This arrangement serves to mount the first jaw 6310 in a movable or rotatable manner on the end effector mounting assembly 6390.

на первой бранше 6310 и соответствующей точкой

на второй бранше 6360 при нахождении первой и второй браншей в соответствующем полностью открытом положении представлено как

. Первую и вторую точки

и

называют «соответствующими» друг другу. Например, каждая из первой точки

и второй точки

могут находиться на общей линии или оси, проходящей между ними и расположенной перпендикулярно оси SA-SA ствола. Расстояние вдоль дугообразного пути между другой точкой

на первой бранше 6310 и осью SA-SA ствола представлено как

, а расстояние вдоль другого дугообразного пути между другой соответствующей точкой

на второй бранше и осью SA-SA ствола представлено как

. Точку

и точку

также называют соответствующими друг другу. Например, точка

и точка

могут находиться на общей линии или оси, проходящей между ними и расположенной перпендикулярно оси SA-SA ствола. В показанной конструкции расстояние

, на которое вторая бранша 6360 или упор 6362 перемещается из полностью открытого в закрытое положение, в котором формирующая скобу поверхность упора 6362 расположена вдоль оси SA-SA ствола, больше расстояния

, на которое первая бранша 6310 или кассета 6320 с хирургическими скобами перемещается из полностью открытого положения в закрытое положение, в котором поверхность платформы кассеты расположена вдоль оси SA-SA ствола. Например, по меньшей мере в одной конструкции вторая бранша или упор будет открываться или перемещаться на 2/3 расстояния

(или на другое расстояние вдоль другого пути перемещения между браншами), а первая бранша или кассета со скобами будет открываться или перемещаться на 1/3 расстояния

(или на другое расстояние вдоль другого пути перемещения между браншами) таким образом, что по существу одна бранша достигнет своего полностью закрытого положения быстрее или раньше, чем другая бранша достигнет своего полностью закрытого положения, даже если закрывающее движение или движения изначально прилагались к обеим браншам в одно и то же или почти в одно и то же время. Например, кулачковые поверхности на первой и второй браншах могут быть сконструированы/выполнены с возможностью достижения разной скорости/скоростей перемещения браншей без отхода от сущности и объема этого варианта осуществления настоящего изобретения. Между проксимальным концом 6314 первой бранши 6310 и проксимальным концом 6370 второй бранши 6360 может быть расположена открывающая пружина 6380 (ФИГ. 70) для смещения первой и второй браншей 6310, 6360 в открытое положение при расположении закрывающей гильзы 6272 концевого эффектора в исходном или неактивированном положении. См. ФИГ. 67-69.The illustrated surgical end effector 6300 further comprises a second jaw 6360 that may include an abutment 6362. The illustrated abutment 6362 includes an abutment body 6364 that includes an elongated groove 6366 with two staple-forming surfaces 6368 that are formed on each of its sides. The stop 6362 further has a proximal end portion 6370 having a pair of U-shaped or open slots 6372 also configured to receive a corresponding one of the pins 6394. This arrangement serves to mount a second jaw 6360 with the ability to move or rotate on the mounting assembly 6390 of the end effector such that the first and second jaws can move relative to each other and relative to the axis SA-SA of the barrel. The first and second jaws 6310 and 6360 may be movably actuated by the various types of closure systems described herein. For example, a first closure drive system of the type described herein can be used to actuate the closure tube in accordance with the method described above. The closure tube may also be attached to an end effector closure sleeve 6272, which can be pivotally attached to the closure tube by a two-pivot closure sleeve assembly in accordance with the method described above. As described above, for example, the axial movement of the cover tube may be controlled by actuating the cover trigger 32. As shown in FIG. 67-69, an end effector closure sleeve 6272 extends over an end effector mount 6390 and is configured to engage a proximal end 6370 of a second jaw 6360 as well as a proximal end 6314 of a first jaw 6310. At least one the cam surface 6336 such that when the distal end 6274 of the end effector closure sleeve 6272 contacts the cam surface (s) 6336, the first jaw 6310 moves in a curved path toward the second jaw and the axis SA-SA of the barrel. Similarly, at the proximal end portion 6370 of the second jaw 6360, one or more cam surfaces 6376 may be formed such that upon contact with the distal end 6274 of the end effector closure sleeve 6272, the second jaw 6360 moves towards the first jaw 6310 and the bore axis SA-SA. Cam surfaces 6336, 6376 can be configured and positioned relative to each other such that the first and second jaws close at different "closing speeds" or at different closing times in relation to each other. One such configuration is shown in FIG. 68. As shown in FIG. 68, the distance along the arcuate path between the point

on the first branch 6310 and the corresponding point

on the second jaw 6360 with the first and second jaws in the corresponding fully open position is represented as

... First and second points

and

are called "appropriate" to each other. For example, each of the first point

and second point

can be on a common line or axis between them and perpendicular to the axis SA-SA of the trunk. Distance along an arcuate path between another point

on the first branch 6310 and the SA-SA axis of the barrel is represented as

, and the distance along another arcuate path between another corresponding point

on the second branch and the SA-SA axis of the barrel is represented as

... Point

and point

also called matching. For example, point

and point

can be on a common line or axis between them and perpendicular to the axis SA-SA of the trunk. In the shown construction, the distance

, to which the second jaw 6360 or stop 6362 moves from a fully open to a closed position, in which the bracket-forming surface of the stop 6362 is located along the axis SA-SA of the barrel, greater than the distance

on which the first jaw 6310 or staple cassette 6320 is moved from a fully open position to a closed position in which the cassette platform surface is located along the axis SA-SA of the barrel. For example, in at least one design, the second jaw or stop will open or move 2/3 of the distance.

(or another distance along a different path between jaws), and the first jaw or staple cassette will open or move 1/3 of the distance

(or another distance along a different path of travel between the jaws) such that essentially one jaw reaches its fully closed position faster or earlier than the other jaw reaches its fully closed position, even if a closing movement or movements were originally applied to both jaws in the same or almost the same time. For example, the cam surfaces on the first and second jaws may be designed / configured to achieve different speeds / speeds of movement of the jaws without departing from the spirit and scope of this embodiment of the present invention. An opening spring 6380 (FIG. 70) may be positioned between the proximal end 6314 of the first jaw 6310 and the proximal end 6370 of the second jaw 6360 to bias the first and second jaws 6310, 6360 into the open position when the end effector closure sleeve 6272 is in a rest or non-activated position. See FIG. 67-69.

To move the first and second jaws 6310, 6360 to the closed position (FIG. 66), the clinician actuates the closure system to move the end effector closure sleeve 6272 in the distal direction DD to simultaneously bring the cam surface (s) into contact. 6336 at the proximal end 6314 of the first jaw 6310 and cam surface (s) 6376 at the proximal end 6370 of the second jaw 6360 for displacing the first and second jaws 6310, 6360 towards each other (and the axis of the SA-SA trunk) into position, shown in FIG. 66. By holding the end effector closure sleeve 6272 in this position, the first and second jaws 6310 and 6360 are held in the closed position. Thereafter, the firing system can be actuated to axially extend the firing element 6340 distally through the surgical end effector 6300. As shown in FIG. 70, trigger 6340 may have a tab portion 6342 that is slidably engaged with a slotted passage 6374 in an abutment 6362 and a top tab portion 6344 configured to slide within a slotted passage 6318 in elongated channel 6312. See FIG. 69. Thus, this design of the trigger serves to positively retain the first and second jaws 6310, 6360 in the design with the desired spacing during the triggering of the trigger (i.e., during activation of the staples and cutting the tissue clamped between the first and second jaws 6310 , 6360). The lid 6315 of the first jaw is detachably attached to the elongated channel 6312, and the lid 6363 of the second jaw is detachably attached to the stop 6362 for assembly purposes, as well as to prevent tissue and / or biological fluids from entering the first and second jaws that may interfere or interfere with the operation of the launch element 6340.

FIG. 71 shows another surgical end effector 6300 ', similar to the surgical end effector 6300. As shown in this figure, the surgical end effector 6300' comprises two jaws configured to move simultaneously between open and closed positions relative to the shaft axis SA-SA. In the example shown, the first jaw 6310 'includes an elongated bore 6312' that is configured to support a surgical staple cassette 6320 '. The staple cassette 6320 'is operatively capable of supporting a plurality of staple ejectors 6322 on which the staple ejectors 6324 are operatively supported. The staple ejectors 6322 are movably held within respective ejector recesses 6321' formed in the staple cassette 6320 '. Staple ejectors 6322 are retained within a corresponding ejector recess 6321 'by a cassette tray 6330' that is clamped or otherwise attached to a surgical staple cassette 6320 '. Staple ejectors 6322 are arranged in rows on each side of the elongated slot 6326 'in the surgical staple cassette 6320 to provide axial passage of the trigger 6340' therein. Wedge-shaped sled 6350 'are held movable within cassette 6320' with surgical staples and configured to engage with the transmission of driving force by trigger 6340 'when triggering element 6340' is set in motion from an initial position adjacent to the proximal end of cassette 6320 'with surgical staples , to an end position within the distal portion of the staple cassette 6320 '. As described above, when driving the wedge sled 6350 'distally through the surgical staple cassette 6320', the wedge sled 6350 'engages the staple ejectors 6322 to drive them against the cassette platform surface 6323'. Trigger 6340 'includes a tissue cutting surface 6346' that serves to cut tissue sandwiched between the jaws when trigger 6340 is driven distally. A distal launch rod (not shown) of various types described herein is operatively attached to the launch element 6340 'as well as to the intermediate section 2222 of the launch barrel or to another design of launch system. The operation of the intermediate firing section 2222 to push and pull the distal firing rod is described in detail above and will not be repeated for brevity. Other designs of the launch rod and the launch system (with a motor and also with a manual drive) can also be used to actuate the trigger without departing from the spirit and scope of the present invention.

The illustrated surgical end effector 6300 'is also selectively pivotable about a pivot axis B-B that is substantially transverse to the trunk axis SA-SA. The end effector 6300 'includes an end effector mounting assembly 6390' that is pivotally mountable to, for example, a distal barrel frame that includes a pivot pin pivotally positioned within a mounting hole 6392 'in the mounting node 6390 'end effector. The articulation of the surgical end effector 6300 'may be accomplished by the articulation locking member and first and second articulation rod structures of the type described above. As shown in FIG. 71, the end effector assembly 6390 'further includes a pair of opposed laterally extending trunnion pins 6394'. Trunnion pins 6394 'extend laterally from opposite sides 6391' of end effector mounting 6390 ', which also forms a recessed region 6395' adapted to receive trigger 6340 '. The pins 6394 'of the trunnion serve to form a pivot axis PA-PA around which the first and second jaws 6310', 6360 'can be rotated. The proximal end 6314 'of the first jaw 6310' or elongated bore 6312 'includes a pair of opposed, U-shaped or open slots 6316' configured to receive a corresponding one of the trunnion pins 6394 '. This arrangement serves to mount the first jaw 6310 'for movement or rotation on the end effector mounting assembly 6390'.

The illustrated surgical end effector 6300 'further comprises a second jaw 6360' which may include an abutment 6362 '. The illustrated stop 6362 'includes a stop body 6364' that includes an elongated slot 6366 'and two staple-forming surfaces formed on each side thereof. The stop 6362 'further has a proximal end portion 6370' having a pair of U-shaped or open slots 6372 'also configured to receive a corresponding one of the pins 6394'. This arrangement serves to mount a second jaw 6360 'with the ability to move or rotate on the mounting assembly 6390' of the end effector. The first and second jaws 6310 'and 6360' are movably actuated by the various types of closure systems described herein. For example, the first closure drive system 30 can be used to drive closure tube 260 in accordance with the method described herein. The cover tube 260 may also be attached to the end effector cover sleeve 6272, which can be pivotally attached to the cover tube 260 via a two-pivot cover sleeve assembly 271 in accordance with the method described above. As described, for example, above, the axial movement of the closure tube 260 may be controlled by actuating the closure trigger 32. The end effector closure sleeve 6272 extends over the end effector assembly 6390 'and is configured to engage the proximal end 6370' of the second jaw 6360 'and also the proximal end 6314' of the first branch 6310 '. At the proximal end 6314 'of the first jaw 6310', at least one cam surface 6336 'may be formed such that when the distal end 6274 of the end effector closure sleeve 6272 contacts the cam surfaces 6336', the first jaw 6310 'moves in a curved path towards the second jaw 6360 'and SA-SA barrel axles. Similarly, at the proximal end portion 6370 'of the second jaw 6360', one or more cam surfaces 6376 'may be formed such that upon contact with the distal end 6274 of the end effector closure sleeve 6272, the second jaw 6360' moves towards the first jaw 6310 'and axis SA- SA trunk. A spring (not shown) may be disposed between the proximal end 6314 'of the first jaw 6310' and the proximal end 6370 'of the second jaw 6360' to bias the first and second jaws 6310 ', 6360' into the open position when the end effector closure sleeve 6272 is positioned in the original or non-activated position.

To move the first and second jaws 6310 ', 6360' into the closed position, the clinician activates the closure system to move the end effector closure sleeve 6272 in the distal direction DD to simultaneously bring the cam surface (s) 6336 'into contact on the proximal end 6314 'of the first jaw 6310' and the cam surface (s) 6376 'at the proximal end 6370' of the second jaw 6360 'for displacement of the first and second jaws 6310', 6360 'towards each other (and the axis of the SA- SA). By holding the end effector closure sleeve 6272 in this position, the first and second jaws 6310 'and 6360' are held in the closed position. Thereafter, the firing system can be actuated to axially extend the firing element 6340 'distally through the surgical end effector 6300'. The trigger 6340 'may have a top tongue portion 6344' that is slidable with a passageway 6374 'with slots in an abutment 6362' and a tab portion 6342 'that is slidably placed within a slotted passage in an elongated channel 6312 '. Thus, this design of the trigger serves to positively hold the first and second jaws 6310 ', 6360' in the desired spacing design during triggering (i.e., during activation of the staples and cutting the tissue sandwiched between the first and second jaws 6310 ', 6360'). The cover 6315 'of the first jaw is detachably attached to the elongated channel 6312', and the cover 6363 'of the second jaw is detachably attached to the stop 6362' for assembly purposes, as well as to prevent tissue and / or biological fluids from entering the first and second jaws that may obstruct or interfere with trigger 6340 '.

Surgical end effector embodiments described herein that use jaws that both move relative to each other and relative to the axis of the shaft can provide various advantages over other surgical end effector designs where one of the jaws is fixed and does not move. for example, relative to the axis of the trunk. In such configurations, it is often desirable for one movable jaw to have a relatively large range of movement relative to the stationary jaw to allow manipulation, positioning and subsequent clamping of target tissue therebetween. In embodiments in which both jaws are movable, each jaw does not require such a large range of motion to manipulate, position, and clamp the target tissue between the jaws. This reduction in stop movement can, for example, provide improved tissue placement. Such designs can also minimize the distance between the pivot and the positions of the first brackets. In addition, the trigger can always remain in engagement with the movable jaws (stop and elongated bore), even during opening and closing actions.

FIG. 72-79, another surgical end effector 6400 is shown operably attachable to an elongate stem assembly of the types described herein that defines the stem axis SA-SA. Surgical end effector 6400 contains two jaws configured to move simultaneously between open and closed positions relative to the axis SA-SA of the trunk. The first and second jaws can contain a variety of different surgical corresponding jaw designs. In the example shown, the first jaw 6410 comprises an elongated channel 6412 configured to support a surgical staple cartridge 6420. As with the various surgical staple cassettes described above, the surgical staple cassette 6420 is operatively capable of supporting a plurality of staple ejectors (not shown) on which surgical staples (not shown) are operatively supported. The staple ejectors are movably held within respective ejector recesses formed in the surgical staple cassette 6420. Staple ejectors are arranged in rows on each side of an elongated groove (not shown) in the surgical staple cassette 6420 to provide axial passage of the trigger 6440. Wedge-shaped sleds (not shown) are movable within the surgical staple cassette 6420 and are configured to engage with the transmission of the driving force by the trigger element 6440 when the trigger element 6440 is set in motion from the initial position adjacent to the proximal end of the surgical staple cassette 6420 to the final position within the distal portion of the surgical staple cassette 6420. As described above, when the wedge sled is driven distally through the surgical staple cassette 6420, the wedge sleds engage in power transmission with the staple ejectors to drive them against the surface of the cassette platform (not shown). Trigger 6440 includes a cutting tissue surface 6446 that serves to cut tissue sandwiched between the jaws when trigger 6440 is distally driven. A distal launch rod (not shown) of various other types described herein is operatively attached to the launch element 6440 as well as to the intermediate section 2222 of the launch barrel or other design of launch system. The operation of the intermediate firing section 2222 to push and pull the distal firing rod is described in detail above and will not be repeated for brevity. Other designs of the launch rod and the launch system (with a motor and also with a manual drive) can also be used to actuate the trigger without departing from the spirit and scope of the present invention.

The illustrated surgical end effector 6400 is also selectively pivotable about a pivot axis B-B that is substantially transverse to the shaft axis SA-SA. As shown in FIG. 72-79, surgical end effector 6400 includes an end effector mounting assembly 6490 that is pivotally mountable on, for example, a distal barrel frame that includes a pivot pin pivotally positioned within mounting hole 6492 in the end effector assembly 6490. The articulation of the surgical end effector 6400 may be accomplished by the articulation locking member and first and second articulation rod structures of the type described above. As shown in FIG. 74, a pair of cam washers 6500 are non-movable by a spring pin 6502, for example, to an end effector mount 6490. As further shown in FIG. 74, each cam disc 6500 has a cam groove 6504 having a closure wedge portion 6505 and an opening wedge portion 6507. A closure wedge portion 6505 is formed from two opposing closure cam surfaces 6506, and an opening wedge portion 6507 is formed from two opposing opening cam surfaces 6508. The elongated channel 6412 includes two proximally extending actuator arms 6416, each of which has a trunnion opening gear 6418 and a trunnion closing pin 6419 protruding laterally therefrom. The opening and closing pins 6418 and 6419 of the trunnion are positioned within the cam groove 6504 of the corresponding cam disc 6500. This arrangement serves to mount the first jaw 6410 movably or pivotally onto the end effector assembly 6490.

The illustrated surgical end effector 6400 further comprises a second jaw 6460 that may include an abutment 6462. The illustrated abutment 6462 includes an abutment body 6464 that includes an elongated groove 6466 with two staple-forming surfaces 6468 that are formed on each of its sides. Anchor 6462 further has a proximal end portion 6470 that includes two protruding and proximally extending activator arms 6472. Each activator arm 6472 has a trunnion opening gear 6474 and a laterally protruding trunnion closing pin 6476, which is also located within the cam groove 6504 of the corresponding cam washer 6500. This arrangement serves to mount a second jaw 6460 with the ability to move or rotate on the mounting end effector assembly 6490.

The first and second jaws 6410 and 6460 are movably actuated by various types of closure system described herein. For example, the first closure actuator system 30 may be used to actuate the closure tube in accordance with the method described herein. The closure tube 260 may also be attached to an end effector closure sleeve 6572, which can be pivotally attached to the closure tube via a two-pivot closure sleeve assembly in accordance with the method described above. As described, for example, above, the axial movement of the cover tube can be controlled by actuating the cover trigger. As shown in FIG. 77 and 78, the end effector cover sleeve 6572 extends over the end effector assembly 6490 as well as the first jaw activator arms 6416 and the second jaw activator arms 6472. When the cover sleeve 6572 is extended, the distal end 6574 of the cover sleeve 6572 contacts the proximal end 6411 the first jaws 6410 and the proximal end 6461 of the second jaws 6460 and moves the first and second jaws 6410, 6460 in the distal direction DD. As the first and second jaws 6410, 6460 move distally, the closure pins 6419, 6476 feed the closure wedge portion 6505 of the cam groove 6504, and the closure cam surfaces 6506 are driven from the cam by the first and second jaws 6410, 6460 towards each other in the closed position (FIG . 73, 75, 77 and 78).

To facilitate opening of the first and second jaws 6410, 6460 with closure sleeve 6572, a closure sleeve 6572 is provided with two inwardly protruding opening tongues 6576 configured to engage with closure pins 6419, 6476 when closing sleeve 6572 is retracted in the proximal direction of the PD by the closure system. For example, as shown in FIG. 72 and 76, when the closure sleeve 6572 is moved in the proximal direction PD, the opening tabs 6576 contact the closure pins 6419, 6476 and also drive the closure pins 6419, 6476 in the proximal direction. The proximal movement of the closing pins 6419, 6476 causes the opening pins 6418 and 6474 to be inserted into the opening wedge portion 6507 of the cam washer grooves 6504. The opening cam surfaces 6508 interact with the opening pins 6418, 6474 and cause the actuator arms 6416 and 6472 to swing openly on the respective swinging surfaces 6417 and 6475, as shown in FIG. 76 and 79. As with the constructions described above, in which each of the first and second jaws moves relative to the bore axis SA-SA, the closure wedge 6505 and the opening wedge portion 6507 can be configured to close the first and second jaws at different closing speeds or at different closing times relative to each other when a closing motion is applied to them.

FIG. 80-84, another surgical end effector 7400 is shown that includes two jaws, one jaw movable relative to the other jaw between an open and a closed position. In the example shown, first jaw 7410 includes an abutment 7412. The illustrated abutment 7412 has an abutment body 7414 having a proximal end portion 7416 that is non-movable to an end effector mounting assembly 7430. For example, the proximal end portion 7416 includes two vertical side walls 7418, each of which has a mounting hole 7419. See FIG. 82. End effector mounting assembly 7430 is positioned between vertical sidewalls 7418 and secured thereto by a spring pin 7421 that extends through them into holes 7419. End effector mounting assembly 7430 is pivotally mountable, for example, on a distal frame the barrel, which includes a pivot pin configured to be pivotally placed within a mounting hole 7432 in an end effector mounting assembly 7430. The 7400 surgical end effector articulation may be accomplished with the articulation retainer and first and second articulation rod structures of the type described above, or with any of the various articulation and articulation rod systems and / or rod / cable designs described herein. without departing from the spirit and scope of the present invention. As shown also in FIG. 80 and 82, the stop body 7414 also includes an elongated groove 7422 with two shackle forming surfaces 7424 formed on each of its sides.

Surgical end effector 7400 further includes a second jaw 7440 that includes an elongated bore 7442 configured to support a surgical staple cassette 7450. As with certain surgical staple cassettes described above, the surgical staple cassette 7450 is operatively capable of supporting a plurality of staple ejectors (not shown) on which surgical staples (not shown) are operatively supported. The staple ejectors are movably held within respective ejector grooves 7452 formed in the surgical staple cassette 7450. Staple ejectors are arranged in rows on each side of the elongated groove 7454 in the 7450 surgical staple cassette to provide axial passage of the 7460 trigger. Cassette tray 7451 is attached to the 7450 staple cassette to prevent the staple ejectors from falling out of the corresponding ejector grooves 7452 when manipulating the surgical end. effector 7400 in various orientations. Wedge-shaped slide 7462 is held movable inside the cassette 7450 with surgical staples and is configured to engage with the transmission of driving force by the trigger element 7460 when the trigger element 7460 is set in motion from the initial position adjacent to the proximal end of the cassette 7450 with surgical staples, to the final position inside the distal section of the 7450 cassette with surgical staples. As described above, when driving the wedge sled 7462 distally through the surgical staple cassette 7450, the wedge sled 7462 engages the staple ejectors to drive them against the surface of the cassette platform (not shown). Trigger 7460 includes a tissue cutting surface 7464 that serves to cut tissue sandwiched between jaws 7410, 7440 as trigger 7460 is distally driven. A distal launch rod 280, or other various types described herein, is operatively attached to the launch element 7460 and also to the intermediate section 2222 of the launch barrel or other design of launch system. The operation of the intermediate firing section 2222 to push and retract the distal firing rod 280 is described in detail above and will not be repeated for brevity. Other designs of the launch rod and the launch system (with a motor and also with a manual drive) can also be used to actuate the trigger without departing from the spirit and scope of the present invention. The cover 7415 of the first jaw is detachably attached to the stop 7412, and the cover 7441 of the second jaw is detachably attached to the second jaw 7440 for assembly purposes, as well as to prevent tissue and / or biological fluids from entering the first and second jaws that may interfere or interfere with the operation of the trigger. element 6340.

As shown in FIG. 82, elongated bore 7442 includes a proximal end portion 7444 that has two side portions 7445. Each side portion 7445 has a corresponding U-shaped or open slot 7446 adapted to receive a corresponding pivot pin 7426 laterally protruding from the proximal end portion 7416 of the abutment body 7414. This arrangement serves to move or rotate the second jaw 7440 or elongated bore 7442 to the first jaw 7410 or abutment 7412. As is particularly evident in FIG. 80, 82 and 84, at the proximal end 7444 of the elongated channel 7442, closure ramp segments 7447 are formed. In addition, each lateral side 7445 of the proximal end portion 7444 has a lateral recessed region 7448 defined therein. Each lateral recessed region 7448 is positioned proximal to a corresponding closure ramp segment 7447. An opening ramp or cam 7449 is formed adjacent the proximal end of each lateral recessed region 7448. Each opening ramp or cam 7449 terminates at a top surface 7580. See FIG. 82 and 84.

The second jaw 7440 or elongated bore 7442 may be movable relative to the first jaw 7410 or abutment 7412 by means of the various types of closure systems described herein. For example, a closure actuator system of the type described herein can be used to drive a closure tube of the types described herein, as detailed above. The cover tube can also be attached to an end effector cover sleeve 7572, which can be pivotally attached to the cover tube by means of a two-pivot structure in accordance with the method described above. As described, for example, above, the axial movement of the cover tube can be controlled by actuating the cover trigger. In other designs, the cover tube can be axially moved by a robotic control system or the like. As shown in FIG. 80, 81, 83 and 84, an end effector closure sleeve 7572 extends over an end effector assembly 7430 as well as a proximal end portion 7444 of an elongated bore 7442 of a second jaw 7440. An end effector closure sleeve 7572 includes two diametrically opposed end effector opening members 7574 made operatively with the proximal end portion 7444 of the second jaw 7440 or elongated bore 7442. In the illustrated embodiment, the opening members 7574 comprise inwardly projecting opening tabs 7576 formed in the end effector closure sleeve portions 7572.

The second jaw 7440 is moved to the closed position (FIGS. 81 and 83) by extending the end effector closure sleeve 7572 in the distal direction DD. When the end effector closure sleeve 7572 is moved, the distal end 7575 contacts the oblique closure segments 7447 formed at the proximal end 7444 of the elongated canal 7442 and serves to drive the elongated canal 7442 from the cam to the stop 7412. After the end effector closure sleeve 7552 is moved into its most distal position distal end 7575 contacts an abutting surface 7443 on elongated channel 7442 to maintain a closure load or closing force on elongated channel 7442. See FIG. 81 and 83. When the end effector closure sleeve 7572 is in the fully closed position, the ends of the opening tabs 7576 are positioned in the corresponding lateral recessed regions 7448. To move the second jaw 7440 or elongated bore 7442 into the open position, the closure system is actuated to move the closure sleeve 7572 into proximal direction of PD. As the end effector closure sleeve 7572 moves, the proximal opening tabs 7572 extend up the corresponding opening ramp or cam 7449 at the proximal end portion 7444 of the elongated bore 7442 for cam actuation or rotation of the elongated bore 7442 away from an abutment 7412. Each tab extends upward on the cam 7449 onto the top surface 7580 and serves to positively hold the elongated channel 7442 in the fully open position. See FIG. 84.

FIG. 85-87, another surgical end effector 8400 is shown that includes two jaws 8410, 8440 configured to move simultaneously between open and closed positions relative to the shaft axis SA-SA. In the illustrated example, the first jaw 8410 includes an abutment 8412. The illustrated abutment 8412 has an abutment body 8414 having a proximal end portion 8416 that is movable with an end effector adapter 8600. As shown in FIG. 85, end effector adapter 8600 includes two distally extending distal walls 8602, each of which has a lateral pivot pin 8604 projecting laterally therefrom. Each lateral pivot pin 8604 is positioned within a corresponding U-shaped or open slot 8418 formed in the walls 8417 on the lateral side of the proximal end portion 8416 of the abutment 8412. See FIG. 85. This arrangement allows the elongated channel 8412 to move or rotate relative to the end effector adapter 8600. As further shown in FIG. 85, the end effector adapter 8600 is non-movably attached to the end effector mount 8430. For example, the end effector adapter 8600 further includes two vertical sidewalls 8606, each with a mounting hole 8608. The end effector mounting assembly 8430 is positioned between and non-movable vertical sidewalls 8606 by a spring pin 8421 that passes through them into holes 8608. The effector mount 8430 is pivotally mountable, for example, on a distal barrel frame that includes a pivot pin pivotally positioned within the mounting hole 8432 in the end effector mount 8430. The 8400 surgical end effector articulation may be accomplished with the articulation retainer and first and second articulation stem structures of the type described above, or using any of the various articulation and articulation stem and / or stem / cable structures described herein. without departing from the spirit and scope of the present invention. As shown also in FIG. 85, anvil body 8414 also includes an elongated slot 8422 with two staple-forming surfaces 8424 formed on each of its sides.

The surgical end effector 8400 further includes a second jaw 8440 that includes an elongated bore 8442 configured to support the surgical staple cassette 8450. As with certain surgical staple cassettes described above, the surgical staple cassette 8450 is operatively capable of supporting a plurality of staple ejectors (not shown) on which surgical staples (not shown) are operatively supported. The staple ejectors are movably held within respective ejector recesses 8452 formed in the surgical staple cassette 8450. Staple ejectors are arranged in rows on each side of the elongated slot 8454 in the 8450 surgical staple cassette to provide axial passage of the 8460 trigger. The cassette tray 8451 is attached to the staple cassette 8450 to prevent the staple ejectors from falling out of the corresponding ejector groove 8452 when manipulating the surgical end. effector 8400 in various orientations. Wedge-shaped slide 8462 is held movable within the surgical staple cassette 8450 and is configured to engage with the transmission of drive force by the trigger 8460 when the trigger 8460 is driven from an initial position adjacent to the proximal end of the surgical staple cartridge 8450 to an end position inside the distal section of the 8450 cassette with surgical staples. As described above, when driving the wedge sled 8462 distally through the surgical staple cassette 8450, the wedge sled 8462 engages the staple ejectors to drive them against the surface of the cassette platform (not shown). Trigger 8460 includes a tissue cutting surface 8464 that serves to cut tissue sandwiched between jaws 8410, 8440 while driving trigger 8460 distally. The distal launch rod 280, or other various types described herein, is operatively attached to the launch element 8460 as well as to the intermediate section 2222 of the launch barrel or other design of launch system. The operation of the intermediate firing section 2222 to push and retract the distal firing rod 280 is described in detail above and will not be repeated for brevity. Other designs of the launch rod and the launch system (with a motor and also with a manual drive) can also be used to actuate the trigger without departing from the spirit and scope of the present invention. The cover 8415 of the first jaw is detachably attached to the stop 8412, and the cover 8441 of the second jaw is detachably attached to the second jaw 8440 for assembly purposes and to prevent tissue and / or biological fluids from entering the first and second jaws that may interfere or interfere with the operation of the trigger. element 8460.

As shown in FIG. 85, elongated bore 8442 includes a proximal end portion 8444 that has two lateral side portions 8445. Each side portion 8445 has a corresponding U-shaped or open slot 8446 configured to receive a corresponding side pivot pin 8604 protruding laterally from the end effector adapter 8600. Such a structure serves to move or rotate the second jaw 8440 or elongated bore 8442 on the first jaw 8410 or abutment 8412. As also shown in FIG. 85, at the proximal end 8444 of the elongated channel 8442, closure ramp segments 8447 are formed. In addition, each lateral side 8445 of the proximal end portion 8444 has a second lateral recessed region 8448 defined therein. Each second lateral recessed region 8448 is positioned proximal to a corresponding second closure ramp segment 8447. A second opening ramp or cam 8449 is formed adjacent the proximal end of each second lateral recessed region 8448. Each second opening ramp or cam 8449 ends at a second upper surface 8450. Similarly, a first recessed region 8420 is formed at the bottom of each side wall 8417 of the proximal end portion 8416 of abutment 8412. A first opening ramp or cam 8426 is formed adjacent the proximal end of each first lateral recessed region 8420. Each first opening ramp or cam 8426 ends at a first top surface 8428.

The second jaw 8440 or elongated bore 8442 and the first jaw 8410 or abutment 8412 can simultaneously move between open and closed positions by means of various types of closure systems described herein. For example, closure actuator system 30 can be used to actuate closure tube 260 in accordance with the method described herein. The cover tube 260 can also be attached to an end effector cover sleeve 8572, which can be pivotally attached to the cover tube 260 by means of a two-pivot structure in accordance with the method described above. As has been described, for example, above, the axial movement of the cover tube 260 may be controlled by actuating the cover trigger 32. In other designs, the cover tube may be axially moved by a robotic control system, etc. As shown in FIG. 86 and 87, end effector closure sleeve 8572 extends over end effector mount 8430, end effector adapter 8600, proximal end portion 8444 of elongated canal 8442 of second jaw 8440 and proximal end portion 8416 of first jaw 8410 or abutment 8412. the effector includes two diametrically opposed first opening members 8574 operably operable with the proximal end portion 8416 of the first jaw 8410. In the illustrated embodiment, the first opening members 8574 comprise inwardly projecting first opening tabs 8576 formed in end effector closure sleeve portions 8572 ... Likewise, the end effector closure sleeve 8572 further includes two diametrically opposed second opening members 8580 operatively operable with the proximal end portion 8444 of the second jaw 8440. In the illustrated embodiment, the second opening members 8580 comprise inwardly projecting second opening tabs 8582 formed in end effector closure sleeve portions 8572.

The first and second jaws 8410, 8440 are simultaneously moved to the closed position (FIG. 86) by extending the end effector closure sleeve 8572 in the distal direction DD. When the end effector closure sleeve 8572 is displaced distally, the distal end 8575 contacts the lower portion of the proximal end portion 8416 of the first jaw 8410 or abutment 8412, as well as the closure ramp segments 8447 formed at the proximal end 8444 of the elongated canal 8442, and serve to drive from the cam of the first and second jaws 8410, 8440 to each other. After movement of the end effector closure sleeve 8572 to its most distal position, the distal end 8575 of the end effector closure sleeve 8572 contacts first abutment surfaces 8419 on the first jaw 8410 or abutment 8412, as well as second abutment surfaces 8443 on the second jaw 8440 or elongated bore 8442 for maintaining a closing load or closing force on both jaws 8410, 8440. See FIG. 86. When the end effector closure sleeve 8572 is in a fully closed position, the ends of the first opening tongues 8576 are positioned in the respective first side recessed regions 8420, and the ends of the second side recessed regions 8420 are located in the respective second side recessed regions 8448. To move the first and second jaws 8410, 8440 apart to open positions, the closure system is actuated to move closure sleeve 8572 in the proximal direction PD. When the end effector closure sleeve 8572 is moved proximally, the first opening tabs 8576 extend up the corresponding first opening ramp or cam 8426 at the bottom of the proximal end portion 8416 of the first jaw 8410 to be driven away from the cam or pivot the first jaw 8410 or abutment 8412 away from the second jaws 8440 or elongated bore 8442, and second latch tabs 8582 extend upwardly along corresponding second ramps 8449 at the proximal end portion 8444 of elongated bore 8442 for cam actuation or pivoting of elongated bore 8442 away from the first jaw or abutment 8412. Each of the first of tongues 8576 extends up the corresponding cam or slope 8426 to the corresponding first locking surface 8428, and each of the second tongues 8582 extends up the corresponding second cam or slope 8449 to the corresponding second locking surface 8450, so that laugh the first and second branches 8410, 8400 in the open position. The reader will understand that the axial position of the first tabs 8576 relative to the second tabs 8582 can be provided to simultaneously move the first and second jaws apart from each other, or they can be axially displaced so that one of the jaws moves before the other jaw moves.

FIG. 88-93 show portions of another surgical instrument 9010 that includes a surgical end effector 9300 that operatively interacts with an elongate stem assembly 9200. Surgical end effector 9300 is similar to surgical end effector 300, which is detailed above, and includes a first jaw in the form of an elongated channel 9302, which is configured to functionally support cassette 304 with surgical staples. The illustrated surgical end effector 9300 further includes a second jaw in the form of an abutment 310 that is supported by an elongated bore 9302 for movement relative thereto. The stop 310 can be movably actuated by the closure system described above and shown in FIG. 88 and 91. For example, the first closure drive system can be used to drive closure tube 260 in accordance with the method described herein. The cover tube 260 is attached to an end effector cover sleeve 272, which is pivotally attached to the cover tube 260 by a two-pivot cover sleeve assembly 271, in accordance with the method described above. As has been described, for example, above, the axial movement of the cover tube 260 may be controlled by actuating the cover trigger. As also described above, the closure sleeve 272 includes opening cams that serve to move the stop 310 to an open position. During use, the cover tube 260 translates distally (in the direction of DD) to close the stop 310, for example, in response to actuation of the cover trigger. The stop 310 is closed by a distal translational movement of the cover tube 260 in the distal direction DD, as well as the end effector cover sleeve 272 which is pivotally attached thereto. When the end effector closure sleeve 272 is driven distally, the cam tabs 358 of the opening cams 354 move distally within the cam grooves 318 in the stop 310 for operative interaction or over the cam surfaces 319 to drive from the cam portion 312 of the stop housing 310 from the cassette 304 s open position with surgical staples. The stop 310 is closed by translational movement of the cover tube 260 distally in the distal direction DD until the distal end 275 of the end effector cover sleeve 272 extends upwardly to the contact stop attachment arms 316, causing the cam tabs 358 to move in the proximal direction PD within the slots 318 for the cam on the cam surfaces 319 to pivot the stop 310 to the open position.

For example, as shown in FIG. 91, elongate barrel assembly 9200 includes a two-piece barrel or rod frame assembly 9812 on which the closure tube assembly 260 is placed. The shaft assembly 9812 includes a proximal shaft portion 9814 and a distal shaft portion 9816. The proximal shaft portion 9816 can be pivotally mounted into a handle or housing (not shown) in various ways described herein to facilitate rotation of the surgical end effector 9300 about the shaft axis SA. Although not shown, surgical instrument 9010 may also include a firing rod structure and any of the various firing drive system constructs described herein for propelling the firing element through the surgical staple cassette in accordance with various methods described above. As shown in FIG. 91, distal shaft portion 9816 includes a distal end portion 9818 that has an upwardly projecting pivot pin 9819 pivotally positioned within a pivot pin hole 9328 formed in proximal end portion 9320 of elongated bore 9302. Such a structure facilitates passage of the elongated the channel 9302 of the surgical end effector 9300 with rotation relative to the rod assembly 9812 about the pivot axis BB defined by the pivot pin hole 9328. As indicated above, the pivot axis B-B is transverse to the barrel axis SA-SA defined by the elongate barrel assembly 9200.

As shown in FIG. 91, elongate barrel assembly 9200 further includes an articulation system, generally referred to as element 9900, which includes a first articulation rod 9910 and a second articulation rod 9920. The first articulation shaft 9910 operatively interacts with a first articulation motor 9912 that is operatively supported in the handle or body of the surgical instrument or in a portion of the robotic control system. As shown in FIG. 92 and 93, a first articulation rod 9910 is attached to a first articulation nut 9914 that is threadedly mounted on a first threaded drive shaft 9916 of a first articulation motor 9912. Rotation of the first rifled drive shaft 9916 in the first pivot direction will result in distal extension of the first articulation rod 9910 in the distal direction DD, and rotation of the first rifled drive shaft 9916 in the second or opposite direction of rotation will result in proximal extension of the first articulation rod 9910 in the proximal direction PD.

The illustrated articulation system 9900 further includes a second articulation rod 9920 that operatively interacts with a second articulation motor 9922 that is operatively supported in the handle or body of a surgical instrument or in a region of a robotic control system. As shown in FIG. 92 and 93, a second articulation rod 9920 is attached to a second articulation nut 9924 that is threaded to fit onto a second threaded drive shaft 9926 of a second articulation motor 9922. Rotation of the second rifled drive shaft 9926 in the first direction of rotation will cause the second articulation rod 9920 to be proximally extended in the proximal direction PD, and rotation of the second rifled drive shaft 9926 in the second or opposite direction of rotation will result in distal extension of the second articulation drive rod 9920 in the distal direction DD.

The articulation system 9900 further includes a cross-connect assembly 9940 that is operatively attached to the first and second articulation rods 9910, 9920. As shown in FIG. 91, cross-connect assembly 9940 includes a middle abutment 9950 pivotally attached to the proximal end 9320 of elongated canal 9302 by a first pin 9952. Mid abutment 9950 further includes a proximal connecting tab 9954 that includes a groove 9956 for receiving a second pin 9958 for pivotally attaching the proximal connecting tab 9954 to the distal end portion 9818 of the distal shaft portion 9816. The pin and slot design facilitates pivotal and axial movement of the middle support member 9950 relative to the rod assembly 9812. The middle support member 9950 further includes a groove 9960 for receiving a launch rod therethrough. The middle support member 9950 serves to provide lateral support to the launch rod as it is bent to accommodate the articulation of the 9300 surgical end effector.

As is particularly evident in FIG. 92 and 93, the middle support member 9950 has a proximal link tongue portion 9970 that facilitates the attachment of the first and second pivot pins 9910, 9920 thereto. In particular, the distal end 9911 of the first articulation bar 9910 is pivotally attached to the first pivot link 9972, which is pivotally attached to the proximal portion 9970 of the connecting tab. Likewise, the distal end 9921 of the second articulation bar 9920 is pivotally attached to a second articulation link 9974, which is pivotally attached to the proximal portion 9970 of the connecting tab of the middle support member 9950. In FIG. 92 shows the articulation of the surgical end effector 9300 in the direction of arrow 9980. As shown in this figure, the first threaded drive shaft 9916 of the first articulation motor rotates in the first pivot direction to drive the first articulation rod 9910 in the distal direction. In addition, the second threaded drive shaft 9926 of the second articulation motor 9922 is rotated in the second pivot direction to retract the second articulation rod 9920 in the proximal direction. The first and second articulation motors 9912, 9922 are controlled by a computer control system, and as shown in FIG. 92, the distance that the first articulation rod 9910 moves in the distal direction is not equal to the distance that the second articulation rod 9920 moves in the proximal direction.

FIG. 93 shows the articulation of the surgical end effector 9300 in the direction of arrow 9982. As shown in this figure, the second threaded drive shaft 9926 of the second articulation motor 9922 is rotated in the first pivot direction to drive the second articulation rod 9920 in the distal direction. In addition, the first threaded drive shaft 9916 of the first articulation motor 9912 rotates in the second pivot direction to retract the first articulation rod 9910 in the proximal direction. The first and second articulation motors 9912, 9922 are controlled by a computer control system, and as shown in FIG. 92, the distance that the second articulation rod 9920 moves in the distal direction is not equal to the distance that the first articulation rod 9910 moves in the proximal direction. In alternative designs, only one articulation motor can be used to pivot the end effector. In such structures, for example, the second link may be proximally coupled to the first link through a rack and pinion structure similar to the rack and pinion structures described herein.

FIG. 94 and 95 show surgical staple cassettes 9304 and 9304 ', each of which includes a light element 9305 to illuminate the distal end of the surgical end effector in which it is retained. Each of the cassettes 9304, 9304 'with staples may have conductors (not shown) that are located on the underside of the cassette or on the sides of the cassette, which are made with the possibility of electrical contact with the corresponding conductors in the elongated channel, which communicate with the power source located in handle or tool body. Thus, when the cassette 9304, 9304 is properly positioned in the elongated bore of the surgical end effector, the light element 9305 can be powered from an electrical source in the handle or housing via the appropriate conductors.

The surgical instrument systems described in this document are driven by an electric motor; however, the surgical instrument systems described herein can be propelled in any suitable manner. In various cases, the surgical instrument systems described herein may, for example, be driven by a manual trigger. The motor or motors may contain part or parts of a robotic control system.

Surgical instrument systems described in this document have been described in relation to staple placement and deformation; however, the embodiments described herein are not limited to this application. Various embodiments are contemplated in which, for example, fasteners other than staples are placed, such as clips or wide head nails. In addition, various embodiments are contemplated using any suitable means to seal the fabric. For example, an end effector in accordance with various embodiments may comprise electrodes configured to heat and seal tissue. In addition, an end effector in accordance with specific embodiments may, for example, apply vibrational energy to seal tissue.

The surgical instrument systems described herein are powered by one or more electric motors; however, the surgical instrument systems described herein can be propelled in any suitable manner. In various cases, the surgical instrument systems described herein may, for example, be driven by a manual trigger.

Examples of

Example 1 Surgical instrument containing a surgical end effector. The surgical end effector comprises a first jaw and a second jaw that is movably held relative to the first jaw between an open position and a closed position. The surgical instrument further comprises a cover that is axially movable in response to the application of the closing and opening movements. The closing element contains at least one opening cam protruding from it, made with the possibility of engaging the corresponding cam surface with the grooves on the second jaw so that when applying an opening movement to the closing element, at least one opening cam engages with the ability to move with a corresponding cam surface with grooves to move the second jaw to the open position, and when applying a closing movement to the closing element, the closing element engages with the second jaws to move the second jaw to one of the closed positions.

Example 2: The surgical instrument of Example 1, wherein the at least one opening cam is a first opening cam that extends laterally inward from the closure member and engages a first one of the respective slotted cam surfaces. A second opening cam extends laterally inward from the cover and engages a second one of the corresponding slotted cam surfaces.

Example 3: The surgical instrument of Example 2, wherein the second opening cam is diametrically opposed to the first opening cam on the closure.

Example 4 The surgical instrument of Examples 1, 2, or 3, wherein at least one opening cam is detachably attached to the closure member.

Example 5 The surgical instrument of Examples 1, 2, 3, or 4, wherein at least one opening cam is snap-engaging with the cover member.

Example 6 The surgical instrument of Examples 1, 2 or 3, wherein at least one opening cam is integrally formed in the closure member.

Example 7. The surgical instrument of examples 1, 2, 3 or 6, in which at least one opening cam is crimped in the wall of the closure member in such a way that the crimp section of the wall can move through the corresponding section of the first jaw so that the corresponding cam surface with grooves on the second branch with the ability to move.

EXAMPLE 8 The surgical instrument of Examples 1, 2, 3, 4, 5, 6 or 7, wherein at least one opening cam extends inwardly through a portion of the first jaw to engage a corresponding slotted cam surface.

Example 9. The surgical instrument of examples 1, 2, 3, 4, 5, 6, 7 or 8, in which the second jaw contains a pair of laterally extending trunnions, configured to be pivotally placed in the corresponding trunnion sockets in the first jaw for facilitating the passage of the second branch with a turn relative to the first branch.

Example 10. The surgical instrument of examples 1, 2, 3, 4, 5, 6, 7, 8 or 9, in which the first jaw is configured to functionally support a cassette with surgical staples, and the second jaw contains a stop.

Example 11 Surgical Instrument Containing a Surgical End Effector. The surgical end effector comprises a first jaw and a second jaw that is pivotally held on the first jaw for selective movement relative thereto between an open position and a closed position. The second jaw contains the first and second cam surfaces. The surgical instrument further comprises an end effector closure sleeve that includes a first opening cam extending laterally inward from the end effector closure sleeve through a portion of the first jaw for operative interaction with the first cam surface. The second opening cam extends laterally inward from the end effector closure sleeve through another portion of the first jaw for operative engagement with the second cam surface such that when an opening motion is applied to the closure sleeve, the first opening cam is movably engaged with the first cam. surface, and the second opening cam engages with the ability to move with the second cam surface to move the second jaw to the open position, and when the closing movement is applied to the closing sleeve of the end effector, the closing sleeve of the end effector engages with the ability to move with the second jaws to move the second branches in one of the closed positions.

Example 12 The surgical instrument of Example 11, wherein the first and second opening jaws are detachably attached to the end effector closure sleeve.

Example 13 The surgical instrument of Example 11, wherein the first and second opening cams have permanent deformations in the end effector closure sleeve.

Example 14: The surgical instrument of Examples 11 or 13, wherein the first and second opening cams are formed by crimping the end effector closure sleeve.

Example 15: The surgical instrument of Example 14 wherein the first and second opening jaws are crimped at 90 degrees relative to adjacent portions of the outer surface of the end effector closure sleeve.

Example 16: The surgical instrument of Examples 11, 12, 13, 14, or 15, wherein the first opening cam protrudes through the first slot in the first jaw to functionally interact with the first cam surface in the second jaw, and the second opening cam protrudes with the ability to move through the second slot in the first jaw for functional interaction with the second cam surface in the second jaw.

Example 17: The surgical instrument of Examples 11, 12, 13, 14, 15, or 16, wherein the second jaw comprises a pair of laterally extending trunnions that can be pivotally positioned in respective pin seats in the first jaw to facilitate passage of the second jaw with a turn relative to the first branch.

Example 18 The surgical instrument of Examples 11, 12, 13, 14, 15, 16 or 17, wherein the first jaw is configured to functionally support the surgical staple cassette, and wherein the second jaw contains a stop.

Example 19 A surgical instrument comprising a housing and a closure system that is functionally supported by the housing and configured to create opening and closing movements. The elongated barrel assembly functionally interacts with the body. The elongated shaft assembly comprises an end effector closure sleeve configured to axially displace in response to the application of closing and opening movements thereto. The surgical instrument additionally contains a surgical end effector, which contains an elongated channel, which functionally interacts with the elongated shaft assembly and is configured to functionally support the cassette with surgical staples therein. The stop is movably held on the elongated channel for selective movement relative thereto between the open position and the closed positions. The surgical instrument also includes at least two opening cams that protrude from the end effector closure sleeve such that when an opening movement is applied to the end effector closure sleeve, at least two opening cams functionally interact with corresponding cam surfaces on the abutment in a first direction to move the stop in the open position, and when a closing movement is applied to the end effector closure sleeve, the end effector closure sleeve operatively interacts with the stop in the second direction to cause the stop to move to one of the closed positions.

Example 20 The surgical instrument of Example 19, wherein at least one opening cam is formed in an end effector closure sleeve.

Example 21. A surgical instrument containing an elongated shaft assembly that forms the shaft axis. The end effector mounting assembly is movably connected to the elongated barrel assembly for selective pivot rotation about a pivot axis that is transverse to the barrel axis. The first and second jaws are movably connected to the end effector mounting assembly in such a way that both the first and second jaws are movable relative to each other and the barrel axis around a common pivot axis between the open position and the closed positions. The first jaw has a first point and the second jaw has a second point, with the first and second points located along a common axis that is perpendicular to the axis of the trunk. The first point represents the first distance from the bore axis when the first jaw is in the open position and the second point represents the second distance from the bore axis when the second jaw is in the open position and the second distance is different from the first distance. The surgical instrument additionally contains means for displacing the first and second jaws from each other to an open position and means for applying closing movements to the first and second jaws for movement

the first and second jaws to each other in the closed position.

Example 22. The surgical instrument of Example 21, wherein one of the first and second jaws comprises an elongated channel configured to functionally support a cassette with surgical staples, and wherein the other of the first and second jaws contains a stop.

Example 23. The surgical instrument of example 21, in which the first jaw contains a cassette with surgical staples, and the second jaw contains a stop, and the second distance is greater than the first distance.

Example 24. The surgical instrument of Examples 21, 22 or 23, further comprising a trigger supported for axial movement between the first and second jaws when the first and second jaws are in one of the closed positions.

Example 25 The surgical instrument of Examples 21, 22, 23 or 24, wherein the end effector assembly comprises a pair of flanks. Each lateral side contains a laterally projecting trunnion pin defining an axis of rotation. Each of the first and second jaws is pivotally held on each of the laterally projecting pins of the trunnion.

Example 26. The surgical instrument of Examples 21, 22, 23, 24 or 25, wherein the biasing means comprises a spring positioned between the first and second jaws.

Example 27. The surgical instrument of Examples 21, 22, 23, 24, 25, or 26, wherein the means for applying the closing movements comprises an axially displaceable end effector closure sleeve that is configured to simultaneously engage with portions of the first and second jaws when axial movement of the end effector closure sleeve in the first direction.

Example 28. The surgical instrument of Examples 21, 22, 23, 24, 25, 26 or 27, further comprising an axially movable trigger supported for axial movement between the first and second jaws when the first and second jaws are in one of the closed provisions.

Example 29 The surgical instrument of Example 28, wherein the trigger comprises a cutting surface.

Example 30. A surgical instrument comprising an elongated shaft assembly that forms a shaft axis. The end effector mounting assembly is movably connected to the elongated barrel assembly for selective pivot rotation about a pivot axis that is transverse to the barrel axis. The first and second jaws are movably connected to the end effector mounting assembly in such a way that both the first and second jaws are movable relative to each other and the axis of the barrel between the open position and the closed positions in such a way that the application to the first and second jaws The closing motion causes one of the first and second jaws to move to one of the closed positions at a closing speed that is different from the other closing speed with which the other of the first and second jaws moves to the closed position. The surgical instrument further comprises means for selectively applying a closing movement to the first and second jaws and an opening movement to the first and second jaws to selectively move the first and second jaws from the closed positions to the open position.

Example 31. The surgical instrument of Example 30 further comprising an axially movable trigger supported for axial movement between the first and second jaws when the first and second jaws are in one of the closed positions.

Example 32 The surgical instrument of Examples 30 or 31 further comprising a first cam slot on the end effector mounting assembly. The first cam slot defines a first closing wedge portion and a first opening wedge portion. A second cam groove is also provided on the end effector mounting assembly. The second cam groove defines a second closing wedge portion and a second opening wedge portion. The first jaw contains a pair of first opening members and a pair of first closure members, one of the first opening members and one of the first closing members being movable within the first cam slot. Another of the first cover members and the other of the first cover members are positioned within the second cam groove. The second jaw comprises a pair of second opening members and a pair of second closing members, one of the second opening members and one of the second closing members being movable within the first cam slot. The other of the second opening members and the other of the second closing members are movably disposed within the second cam slot. The selective application means is adapted to move the first and second jaws in the first direction so as to cause one of the first closure members and one of the second closure members to move movably into the first closure wedge portion, the other of the first closure members and the other of the second of the closing elements to move with the possibility of movement into the second closing wedge section, so as to force the first and second jaws to move towards each other in one of the closed positions. The selective application means is further configured to move the first and second jaws in the second direction so as to cause one of the first opening members and one of the second opening members to move into the first opening wedge portion, and the other of the first opening members and another of the second opening members move into the second opening wedge section, thereby causing the first and second jaws to move from each other to the open position.

Example 33 The surgical instrument of Example 32 wherein a first cam slot is formed in a first cam washer associated with an end effector mounting assembly. A second cam slot is formed in a second cam washer associated with the end effector mounting assembly.

EXAMPLE 34 The surgical instrument of Examples 32 or 33, wherein the selective application means comprises an end effector closure sleeve that is axially movable in response to the application of closing and opening movements thereto. The end effector closure sleeve includes a first opening tab that corresponds to one of the first opening members and one of the second opening members for operative contact therewith when the end effector closure sleeve is moved in a second direction. The second opening tab corresponds to the other of the first opening members and the other of the second opening members for operative contact therewith when the end effector closure sleeve is moved in the second direction.

Example 35. The surgical instrument of examples 30, 31, 32, 33 or 34, in which one of the first and second jaws contains an elongated channel configured to functionally support a cassette with surgical staples therein, and the other of the first and second jaws contains a stop ...

Example 36. The surgical instrument of Examples 31, 32, 33, 34, or 35 further comprising a trigger supported for axial movement between the first and second jaws when the first and second jaws are in one of the closed positions.

Example 37. A surgical instrument comprising a first jaw and a second jaw that are pivotally held relative to each other for selective pivotal movement between an open position and a closed position. The closing element is made with the possibility of axial movement in response to the application of closing and opening movements thereto. The closing element contains at least two inwardly projecting opening tongues, made with the possibility of functional interaction with the corresponding sections of at least one of the first and second jaws when applying opening movements to the closing element to move at least one of the first and second jaws to the open position ...

Example 38. The surgical instrument of Example 37, wherein at least one of the at least two inwardly projecting opening tabs is integrally formed into the closure member.

Example 39 The surgical instrument of Example 37, wherein each of the at least two inwardly projecting opening tongues is detachably attached to the closure member.

Example 40. The surgical instrument of Examples 37, 38, or 39, wherein one of the first and second jaws comprises an elongated channel configured to functionally support a surgical staple cartridge therein, and wherein the other of the first and second jaws comprises a stop.

Example 41. A surgical suturing instrument comprising an elongated shaft assembly that forms a shaft axis. The surgical end effector is operatively coupled to the elongated shaft assembly by means of an articulated articulation such that the surgical end effector is selectively articulated with respect to the elongated shaft assembly about a pivot axis that is transverse to the shaft axis. The surgical end effector comprises a cassette support element configured to functionally support a cassette with surgical staples therein. A longitudinally movable firing rod passes through the articulated joint and is selectively axially movable from a starting position to an end position within the surgical end effector. The surgical instrument further comprises a launch rod blocking assembly, which comprises a displacement element functionally supported on a pivot joint and configured to apply a displacement motion to a longitudinally movable launch rod to displace the longitudinally movable launch rod to a locked position in which the movement of the longitudinally movable trigger rod from the initial to the final position is prevented if an unactivated cassette with surgical staples is not functionally supported in the cassette support element.

Example 42. The surgical suturing instrument of Example 41, wherein the biasing member is retained on a middle abutment that interacts with the cassette support and elongate shaft assembly. The middle support element is configured to laterally support the longitudinally movable firing rod during pivoting of the surgical end effector about the pivot axis.

Example 43: The surgical stapling instrument of Examples 41 or 42, wherein the biasing member is configured to avoid applying biasing motion to the longitudinally movable firing rod when the surgical end effector is pivotable.

Example 44. The surgical stapling instrument of Examples 41, 42 or 43, wherein the longitudinally movable firing bar comprises a locating cam formed at its portion for engaging with a biasing member.

Example 45. The surgical suturing instrument of Example 44, wherein the biasing member comprises a flat body having a window disposed therein such that a locking cam protrudes into the window during pivotal rotation of the surgical end effector.

Example 46: The Surgical Suturing Instrument of Examples 41, 42, 43, 44, or 45, wherein a biasing member biases a longitudinally movable firing bar to a locked position when a firing motion is initially applied to a longitudinally movable firing bar in the event that an unactivated cassette with surgical staples is not functionally supported in the support element of the cassette.

Example 47. The surgical stapling instrument of Examples 41, 42, 43, 44, 45, or 46, wherein the non-activated surgical staple cassette comprises a plurality of surgical staples operatively supported within the cassette body and wedge-shaped sleds configured to axially move through the cassette body for pushing surgical staples out of it when moving the wedge-shaped slide from an inactive position to an activated position. The wedge-shaped slide is made with the possibility of functional interaction with the launch rod, made with the possibility of movement in the longitudinal direction, when the launch rod, made with the possibility of movement in the longitudinal direction, is in the initial position, and the wedge-shaped slide is in the non-activated position.

Example 48: The surgical stapling instrument of Examples 41, 42, 43, 44, 45, or 46, wherein the biasing member displaces the firing bar to the locked position when the firing motion is initially applied to the firing bar if the wedge-shaped sled in the surgical staple cassette is supported in the support element of the cassette, are not in a non-activated position within the cassette with surgical staples and in functional interaction with the launch bar that is movable in the longitudinal direction.

Example 49 The surgical stapling instrument of Example 48, wherein the wedge-shaped sled is configured to prevent the launch rod from entering the locked position when the wedge-shaped sled is in an unactivated position and upon application of an initial firing motion to the longitudinally movable launch rod.

Example 50. A surgical stapling instrument comprising a surgical end effector that comprises an elongated channel that is operatively capable of supporting a surgical staple cassette therein. The stop is supported relative to the elongated channel in such a way that one of the stop and the elongated channel is configured to selectively move relative to the other of the stop and the elongated channel between open and closed positions. The surgical instrument further comprises an elongated shaft assembly that forms a shaft axis and includes an articulation that is operatively associated with the surgical end effector to facilitate selective articulation of the surgical end effector relative to the elongated shaft assembly about a pivot axis that is transverse to the shaft axis. The elongated barrel assembly further comprises a closing assembly configured to be axially displaceable in response to closing movements applied to it. The closure assembly comprises a distal closure segment and a proximal closure segment that is movable with the closure distal segment to accommodate pivotal rotation of the surgical end effector about the articulation axis. The proximal segment of the closure element is adapted to move one of the stop and the elongated channel between open and closed positions when closing movements are applied to the closure assembly. The surgical stapling instrument further comprises a longitudinally movable firing rod that passes through the articulated joint and is selectively axially movable from a starting position to an end position within the surgical end effector. A launch rod that is movable in the longitudinal direction is made with the possibility of functional interaction with the corresponding section of the unactivated cassette with surgical staples, which is functionally supported in the elongated channel when the launch rod is movable in the longitudinal direction is in the initial position. The surgical stapling instrument further comprises a trigger rod locking assembly, which comprises a displacement member operatively supported on the distal segment of the closure member to bias the longitudinally movable trigger bar to a locked position that prevents the longitudinally movable trigger bar from moving from the initial position to the final position in the event that an unactivated cassette with surgical staples is not functionally supported in the elongated canal.

Example 51 The surgical stapling instrument of Example 50, wherein the longitudinally movable firing bar has an inclined portion adapted to engage the displacement member when the longitudinally movable firing bar is in the rest position.

Example 52. Surgical stapling instrument of examples 50 or 51, in which the unactivated surgical staple cassette contains a plurality of surgical staples, functionally supported within the cassette body, and wedge-shaped sled, made with the axial movement through the cassette body to eject the surgical staples therefrom during movement wedge-shaped sled from non-activated position to activated position. The wedge-shaped slide is made with the possibility of functional interaction with the launch rod, made with the possibility of movement in the longitudinal direction, when the launch rod, made with the possibility of movement in the longitudinal direction, is in the initial position, and the wedge-shaped slide is in the non-activated position.

Example 53 The surgical stapling instrument of Example 52, wherein the wedge-shaped sled is configured to prevent the launch rod from entering the locked position when the wedge-shaped sled is in an unactivated position and upon application of an initial firing motion to the longitudinally movable launch rod.

Example 54. A surgical suturing instrument comprising an elongated shaft assembly that forms a shaft axis. The surgical end effector is operatively coupled to the elongated shaft assembly by means of an articulated articulation such that the surgical end effector is selectively articulated with respect to the elongated shaft assembly about a pivot axis that is transverse to the shaft axis. The surgical end effector comprises a cassette support element configured to functionally support a cassette with surgical staples therein. The surgical stapling instrument further comprises a longitudinally movable firing rod including a portion extending through the articulated joint and selectively axially movable from a home position to an end position within the surgical end effector. A launch rod that is movable in the longitudinal direction is made with the possibility of functional interaction with the corresponding section of the unactivated cassette with surgical staples, which is functionally supported in the support element of the cassette when the launch rod is movable in the longitudinal direction is in its initial position. The surgical stapling instrument further includes means for providing lateral support to a portion of the longitudinally movable firing rod that extends through the articulation when the surgical end effector articulates about the articulation axis. The means for providing further comprises means for preventing movement of the longitudinally movable launch rod from the initial position to the final position in the event that an unactivated cassette with surgical staples is not functionally supported in the cassette support element.

Example 55 The surgical stapling instrument of Example 54, wherein the lateral support means further comprises a middle support member movably attached to the cartridge support member and elongate shaft assembly. The middle support element contains a groove for placement through it with the ability to move a section made with the ability to move in the longitudinal direction of the launch rod. The means for preventing comprises a biasing member supported on a middle support member and configured to apply a biasing motion to a longitudinally movable launch rod to move it to a locked position in which the longitudinally movable launch rod is prevented from moving from from the initial position to the final position if the unactivated cassette with surgical staples is not functionally supported in the cassette support element.

Example 56 The surgical suturing instrument of Example 55, wherein a longitudinally movable firing bar comprises a locking cam formed at a portion of a longitudinally movable firing bar for engagement with a biasing member.

Example 57 The surgical suturing instrument of Example 56, wherein the biasing member comprises a flat body having a window positioned therein such that a locking cam protrudes into the window during pivotal rotation of the surgical end effector.

Example 58. The surgical stapling instrument of Examples 54, 55, 55, or 57, wherein the non-activated surgical staple cassette comprises a plurality of surgical staples operatively supported within the cassette body and wedge-shaped sleds configured to axially move through the cassette body to be ejected therefrom surgical staples when moving the wedge-shaped sled from the non-activated position to the activated position. The wedge-shaped slide is made with the possibility of functional interaction with the launch rod, made with the possibility of movement in the longitudinal direction, when the launch rod, made with the possibility of movement in the longitudinal direction, is in the initial position, and the wedge-shaped slide is in the non-activated position.

Example 59 The surgical stapling instrument of Example 58, wherein the wedge-shaped sled is configured to prevent the launch rod from entering the locked position when the wedge-shaped sled is in an unactivated position and upon application of an initial firing motion to the longitudinally movable launch rod.

Example 60. A surgical instrument comprising an elongated shaft assembly that forms a shaft axis. The surgical end effector is operatively coupled to the elongated shaft assembly by means of an articulated articulation such that the surgical end effector is selectively articulated with respect to the elongated shaft assembly about a pivot axis that is transverse to the shaft axis. The longitudinally movable flexible launch rod is adapted to flexibly pass through the articulated joint and is configured to selectively axially move from the initial position to the final position within the surgical end effector. The middle support member is movably connected to the elongated shaft assembly and a portion of the surgical end effector. The middle abutment includes a middle body portion that includes a proximal end and a distal end. A launch rod slot extends between this proximal end and a distal end and is configured to move each lateral side of a portion of the flexible launch rod passing through the articulation joint. The surgical instrument further comprises a proximal support link that includes an elongated proximal body positioned proximal to the middle support member and configured to laterally support the proximal portions of the flexible launch rod lateral side crossing the articulation joint. The proximal support link is movable with the proximal end of the middle support member. The surgical instrument further comprises a distal support link, which comprises an elongated distal body located distally relative to the middle support element and configured to laterally support the corresponding distal portions of the flexible launch rod lateral side crossing the articulation joint. The distal support link is movable with the distal end of the middle support member.

Example 61 The surgical instrument of Example 60, wherein the elongated proximal abutment body comprises a proximal dorsal element and two downwardly extending opposing proximal abutment walls. One of the proximal abutment walls is positioned adjacent to one of the proximal portions of the flexible launch rod lateral side crossing the articulation joint. Another of the opposing proximal abutment walls is positioned adjacent to the other proximal portion of the flexible launch rod lateral side crossing the articulation joint. The elongated distal body of the distal abutment includes a distal upper element and two downwardly extending opposite distal abutment walls. One of the distal support walls is positioned adjacent to one of the distal portions of the lateral side of the flexible launch rod crossing the articulation. Another opposing distal abutment wall is positioned adjacent to another distal portion of the flexible launch rod lateral side crossing the articulation joint.

EXAMPLE 62 The surgical instrument of Example 61, wherein one of the proximal abutment walls includes a proximal arcuate surface facing one of the proximal portions of the side of the flexible launch rod intersecting the pivot joint, and wherein the other of the proximal abutment walls includes another proximal arcuate surface facing the other of the proximal portions of the flexible launch rod lateral side that intersects the articulation joint. One of the distal support walls includes a distal arcuate surface facing one of the distal portions of the flexible launch rod lateral side intersecting the articulation. The other of the distal abutment walls includes another distal arcuate surface facing the other of the distal portions of the flexible launch rod lateral side crossing the articulation.

Example 63. The surgical instrument of Examples 61 or 62, wherein the proximal end of the middle abutment comprises an arcuate proximal recess configured to move the distal nasal portion of the proximal upper member of the proximal abutment therein. The distal end of the middle support element contains a distal arcuate recess, configured to accommodate the proximal nasal portion of the distal upper element of the distal support link with the ability to move.

Example 64. The surgical instrument of Examples 60, 61, 62, or 63, wherein the middle abutment is pivotally coupled to a portion of the surgical end effector for pivotal movement about it about an axis of rotation. The middle support element is connected to the elongated barrel assembly for pivoting and axial movement relative to it.

Example 65 The surgical instrument of Example 64, wherein the middle abutment is secured to the elongated shaft assembly by a proximal pin extending through the elongated slot in the middle abutment.

Example 66. The surgical instrument of Examples 60, 61, 62, 63, 64, or 65, wherein the elongated shaft assembly comprises a distal shaft having a distal shaft recess configured to move a proximal nasal portion of the proximal upper member therein.

Example 67. The surgical instrument of Examples 60, 61, 62, 63, 64, 65, or 66, wherein the surgical end effector portion comprises a channel recess configured to move a distal nasal portion of the distal upper member.

Example 68. The surgical instrument of Examples 60, 61, 62, 63, 64, 65, 66, or 67, wherein the surgical end effector portion comprises an elongated channel that is operatively capable of supporting a surgical staple cartridge therein.

Example 69. The surgical instrument of Example 68 further comprising a stop that is supported relative to the elongated channel such that one of the stop and the elongated channel is selectively movable relative to the other of the stop and the elongated channel between open and closed positions.

Example 70. A surgical instrument comprising an elongated stem assembly that forms the axis of the stem and includes right and left opposing stem slots formed at its distal end. The surgical end effector is operatively coupled to the elongated shaft assembly by means of an articulated articulation such that the surgical end effector is selectively articulated with respect to the elongated shaft assembly about a pivot axis that is transverse to the shaft axis. The longitudinally movable flexible launch rod is adapted to flexibly pass through the articulated joint and is configured to selectively axially move from the initial position to the final position within the surgical end effector. The middle support member is movably connected to the elongated shaft assembly and a portion of the surgical end effector. The middle support element contains a middle section of the body, which includes right and left opposite support slots formed in its distal end, and a launch rod groove made with the possibility of supporting with the possibility of movement of the lateral side sections of the flexible launch rod made with the possibility of movement in the longitudinal direction crossing the articulated joint. The articulated link is made with the possibility of lateral support of the lateral side portions made with the possibility of movement in the longitudinal direction of the flexible launch rod, crossing the articulated joint. The articulated link comprises a proximally protruding proximal nasal section configured to engage with the ability to move any one of the right and left opposing bore slots when flexing the longitudinally movable flexible launch rod in response to the articulated rotation of the surgical end effector about the articulation axis ... The distal protruding distal nasal portion is capable of engaging with the ability to move any one of the right and left opposing support slots in the movable support element when flexing the longitudinally movable flexible launch rod in response to the articulated rotation of the surgical end effector about the axis hinge rotation.

Example 71. The surgical instrument of Example 70, wherein the pivot link further comprises a first side support wall disposed adjacent to one of the lateral portions of the longitudinally movable flexible launch rod and a second lateral support wall adjacent to the other sections of the lateral side made with the possibility of movement in the longitudinal direction of the flexible launch rod.

Example 72. The surgical instrument of Example 71, wherein the first side abutment wall includes a first arcuate surface facing one of the lateral portions of the longitudinally movable launch rod, and wherein the second side abutment wall includes a second arcuate surface facing another of the side portions of the longitudinally movable flexible launch rod.

EXAMPLE 73 The surgical instrument of Examples 71 or 72, further comprising a first compression band that extends between one portion of the side of the longitudinally movable launch rod and the first side support wall. The first compression band comprises a first distal end that is supported on the surgical end effector and a first proximal end that is movably held on the elongated shaft assembly. The second compression band extends between another side portion of the longitudinally movable launch rod and the second side support wall. The second compression band includes a second distal end that is supported on the surgical end effector and a second proximal end that is movably held on the elongated shaft assembly.

Example 74 The surgical instrument of Example 73, further comprising a third compression band that extends between one portion of the side of the longitudinally movable launch rod and the first compression band. The third compression band comprises a third distal end that is supported on the surgical end effector and a third proximal end that is movably held on the elongated shaft assembly. The fourth compression strap extends between another portion of the longitudinally movable launch rod and the second compression strap. The fourth compression band comprises a fourth distal end that is supported on the surgical end effector and a fourth proximal end that is movably held on the elongated shaft assembly.

Example 75. A surgical instrument comprising an elongated shaft assembly that forms a shaft axis. The surgical end effector is operatively coupled to the elongated shaft assembly by means of an articulated articulation such that the surgical end effector is selectively articulated with respect to the elongated shaft assembly about a pivot axis that is transverse to the shaft axis. The longitudinally movable flexible launch rod is adapted to flexibly pass through the articulated joint and is configured to selectively axially move from the initial position to the final position within the surgical end effector. The middle support element is movably connected to the elongated shaft assembly for pivotal and axial movement relative to it and is pivotally connected to the surgical end effector. The surgical instrument further comprises a U-shaped proximal support link that contains a proximal superior element and two proximal lateral elements. The U-shaped proximal support link extends over the proximal portion of the longitudinally movable flexible launch rod such that one of the proximal side members is adjacent to one side of the proximal portion of the longitudinally movable flexible launch rod and the other of the proximal side members is disposed adjacent to the other side of the proximal portion of the longitudinally movable flexible launch rod. The proximal upper element is movable with the middle support element. The surgical instrument further comprises a U-shaped distal support link, which contains a distal upper element and two distal side elements. The U-shaped distal support link extends over the distal portion of the longitudinally movable flexible launch rod such that one of the distal side members is adjacent to one side of the distal portion of the longitudinally movable flexible launch rod and the other of the distal side members is located adjacent to the other side of the distal portion of the longitudinally movable flexible launch rod. The distal top element is movable with the middle support element.

Example 76 The surgical instrument of Example 75, wherein the proximal top member is movable with the elongate stem assembly and the distal top member is movable with a portion of the surgical end effector.

Example 77. The surgical instrument of Examples 75 or 76, wherein the proximal dorsal member comprises a first proximal protruding proximal nasal region that slides into a distal recess formed in an elongated trunk assembly and a first distal protruding distal nasal region that extends from the ability to move into the proximal recess in the middle support element. The distal upper member comprises a second proximal protruding proximal nasal portion that slides into a distal recess in the middle support member, and a second distal protruding distal nasal region that slides movably into a channel recess in the surgical end effector.

Example 78 The surgical instrument of Examples 75, 76, or 77, wherein one of the two proximal side members comprises a proximal arcuate surface facing one side of the proximal portion of a longitudinally movable flexible launch rod. Another of the proximal side members includes another proximal arcuate surface facing the other side of the proximal portion of the longitudinally movable flexible launch rod. One of the two distal side members comprises a distal arcuate surface facing one lateral side of the distal portion of a longitudinally movable flexible launch rod. Another of the distal side members includes another distal arcuate surface facing the other distal side of the distal portion of the longitudinally movable flexible launch rod.

Example 79. The surgical instrument of Examples 75, 76, 77, or 78, wherein the middle abutment is movably connected to an elongated surgical end effector bore that is operatively capable of supporting a surgical staple cartridge therein.

Example 80 A surgical instrument comprising an elongated shaft assembly that forms the shaft axis. The surgical end effector is operatively coupled to the elongated shaft assembly by means of an articulated articulation such that the surgical end effector is selectively articulated with respect to the elongated shaft assembly about a pivot axis that is transverse to the shaft axis. The central support member of the launch rod extends through the articulated joint and contains a distal end associated with the surgical end effector and a proximal end attached to the elongated shaft assembly. The longitudinally movable assembly of the flexible launch rod is configured to flexibly pass through the articulated joint and is configured to selectively axially move from the initial position to the final position within the surgical end effector. A flexible launch rod assembly capable of moving in the longitudinal direction comprises a plurality of rod layers held relative to each other in such a way that at least one of the rod layers is movable on one side of the central support element of the launch rod, and along at least another of the rod layers is movable on the other side of the central support element of the launch rod. A plurality of lateral support elements correspond to the support of the central launch rod and are supported in portions of at least one of the layers of the launch rod, made with the possibility to move with the possibility of movement on the side of the central support element of the launch rod, and at least another of the layers of the rod is made with the possibility of passing with the ability to move on the other side of the central support element of the launch rod.

Example 81. The surgical instrument of example 80, in which at least one of the layers of the rod, which is movable on one side of the central support element of the launching rod, contains two layers of the rod, and wherein at least another of the rod layers, made with the possibility of passing along the other side of the central support element of the launch rod, contains two other rod layers.

Example 82. The surgical instrument of Examples 80 or 81, wherein the side carriers are movable relative to one another.

Example 83. The surgical instrument of examples 80, 81, or 82, in which each of the lateral support elements comprises an axial passage for positioning therein with the possibility of movement of sections of at least one of the layers of the rod, which are made with the possibility of passing with the possibility of moving to one side of the launch rod central support element, and at least another of the rod layers that are movable on the other side of the launch rod central support element.

Example 84. The surgical instrument of Examples 80, 81, 82, or 83, wherein the portion of the surgical end effector associated with the elongate shaft assembly by means of a pivot joint comprises an elongated channel operatively capable of supporting a surgical staple cartridge therein.

Example 85. The surgical instrument of Example 84 further comprising a stop that is supported relative to the elongated channel such that one of the stop and the elongated channel is selectively movable relative to the other of the stop and elongated channel between open and closed positions.

Example 86. The surgical instrument of Examples 80, 81, 82, 83, 84 or 85, wherein the distal end of the central firing rod support protrudes below the bottom surface of the longitudinally movable flexible firing rod assembly for attachment to the surgical end effector, and the proximal end of the central launch rod support protrudes above the top surface of the longitudinally movable flexible launch rod assembly for attachment to the elongate barrel assembly.

Example 87 The surgical instrument of Example 86 wherein the distal end of the firing rod center support is attached to the elongated bore of the surgical end effector and the proximal end of the firing rod center support is attached to the shaft portion of the elongated shaft assembly.

Example 88 The surgical instrument of Examples 80, 81, 82, 83, 84, 85, 86, or 87, wherein at least two of the plurality of lateral carriers include arcuate end surfaces and are constructed at portions along of at least one of the rod layers, which are movable on one side of the central support element of the launch rod, and at least one other of the rod layers, which are movable on the other side of the central support of the launch rod element in such a way that one of the arcuate end surfaces on one of the at least two side support members is adjacent to the other of the arcuate end surfaces on the other of the at least two side support members.

Example 89: The surgical instrument of Example 83 wherein each axial passage comprises a pair of spaced inner arcuate surfaces configured to facilitate pivotal movement of each of the side carriers on a longitudinally movable flexible launch rod.

Example 90 A surgical instrument comprising an elongated shaft assembly that forms the shaft axis. The surgical end effector is operatively coupled to the elongated shaft assembly by means of an articulated articulation such that the surgical end effector is selectively articulated with respect to the elongated shaft assembly about a pivot axis that is transverse to the shaft axis. The central support element of the launch rod is aligned in the axial direction along the barrel axis and passes through the articulated joint. The central support element of the launch rod contains a distal end associated with a surgical end effector and a proximal end attached to the elongated shaft assembly. The surgical instrument further comprises a longitudinally movable assembly of a flexible launch rod, which contains a plurality of rod layers configured to extend axially along a central support element of the launch rod such that at least one of the rod layers extends on each lateral to the side of the central support element of the launch rod when the articulation is crossed by the longitudinally movable assembly of the flexible launch rod. The means are movable on a longitudinally movable flexible launch rod to laterally support a portion of the longitudinally movable flexible launch rod intersecting the articulation when the surgical end effector pivots about the pivot axis.

Example 91 The surgical instrument of Example 90 wherein the distal end of the central firing rod support extends below the bottom surface of the longitudinally movable firing rod assembly for attachment to the surgical end effector. The proximal end of the launch rod center support protrudes above the top surface of the longitudinally movable flexible launch rod assembly for attachment to the elongated barrel assembly.

Example 92. The surgical instrument of Examples 90 or 91, wherein the portion of the surgical end effector connected to the elongate shaft assembly by means of an articulated articulation comprises an elongated channel operatively capable of supporting a surgical staple cassette therein.

Example 93. The surgical suturing instrument of Example 92, further comprising a stop that is supported relative to the elongated channel such that one of the stop and the elongated channel is selectively movable relative to the other of the stop and the elongated channel between open and closed positions.

Example 94 The surgical instrument of Examples 90, 91, 92 or 93 further comprising a trigger attached to the distal end of the longitudinally movable flexible trigger bar assembly.

Example 95. A surgical instrument comprising an elongated shaft assembly that forms a shaft axis. The surgical end effector is operatively coupled to the elongated shaft assembly by means of an articulated articulation such that the surgical end effector is selectively articulated with respect to the elongated shaft assembly about a pivot axis that is transverse to the shaft axis. The central support element of the launch rod is aligned in the axial direction along the barrel axis and passes through the articulated joint. The central support element of the launch rod contains a distal end associated with a surgical end effector and a proximal end attached to the elongated shaft assembly. The surgical instrument further comprises a longitudinally movable flexible launch rod assembly, which comprises a plurality of rod layers such that a longitudinally movable flexible launch rod assembly extends distally, the longitudinal movement of a flexible launch rod assembly the rods are bifurcated near the central launch rod support so that sections of the longitudinally movable flexible launch rod assembly extend adjacent to each side of the launch rod central support

Example 96. The surgical instrument of Example 95, further comprising means that are movably held on a longitudinally movable flexible firing rod assembly for laterally supporting a portion of the longitudinally movable flexible launch rod assembly intersecting the articulation joint, when the surgical end effector pivots about the pivot axis.

EXAMPLE 97 The surgical instrument of Example 95, wherein the lateral support means comprises a plurality of lateral carriers that are supported by a longitudinally movable flexible launch rod assembly. Each of the side bearing members is independently movable on a longitudinally movable flexible launch rod assembly.

Example 98: The surgical instrument of Examples 95, 96, or 97 wherein the distal end of the central support member of the firing rod protrudes below the bottom surface of the longitudinally movable flexible launch rod assembly for attachment to the surgical end effector, and the proximal end of the central support member the launch rod protrudes above the upper surface of the longitudinally movable flexible launch rod assembly for attachment to the elongated barrel assembly.

Example 99: The surgical instrument of Example 97, wherein each of the side carriers includes an axial passage therethrough that includes a pair of spaced apart inner arcuate surfaces to facilitate pivotal movement of each of the side carriers on the longitudinally movable assembly flexible launch rod.

Example 100. Surgical instrument containing an elongated shaft assembly that forms the shaft axis. The surgical end effector is pivotally coupled to the elongated shaft assembly to selectively pivot relative to the elongated shaft assembly about a pivot axis that is transverse to the shaft axis. The surgical instrument further comprises an articulation system that includes a first distal articulation actuator that is supported for selective longitudinal movement in the distal direction and the proximal direction in response to corresponding articulation movements applied thereto. The first distal articulation actuator is operatively associated with the surgical end effector. The articulation system further comprises a second distal articulation actuator that is supported for longitudinal movement in the distal and proximal directions. The second distal articulation actuator is operatively coupled to the surgical end effector. At least one gear is in gear engagement with the first distal articulation drive element and the second distal articulation drive element such that when the first distal articulation drive element moves in the distal direction, at least one gear is configured with the ability to drive the second distal articulation drive element in the proximal direction to pivot the surgical end effector about the articulation axis in the first articulation direction, and when the first distal articulation drive element moves in the proximal direction, at least one toothed the wheel drives the second distal articulation drive element in the distal direction to pivot the surgical end effector about the pivot axis in the second articulation direction rotation opposite to the first direction of pivot rotation.

Example 101 The surgical instrument of Example 100 wherein the first distal articulation actuator is pivotally coupled to the surgical end effector and wherein the second distal articulation actuator is pivotally attached to the surgical end effector.

Example 102: The surgical instrument of Examples 100 or 101 wherein a first distal articulation actuator is attached to the surgical end effector via a first movable connector and wherein a second distal articulation actuator is attached to the surgical end effector via a second connector , made with the possibility of movement.

Example 103: The surgical instrument of Example 102, wherein a first movable connector is attached to a first distal articulation actuator via a first ball joint and wherein a second distal articulation actuator is attached to a second movable connector , by means of the second ball joint.

Example 104. The surgical instrument of Examples 100, 101, 102, or 103, further comprising means for selectively locking the surgical end effector in a plurality of pivotal positions relative to the elongate shaft assembly.

Example 105 The surgical instrument of Example 104, wherein the selective locking means comprises means for selectively preventing longitudinal movement of the distal articulation actuator in the proximal and distal directions.

Example 106. The surgical instrument of Examples 104 or 105 further comprising a proximal articulation actuator operatively interacting with a source of proximal and distal articulation movements. The proximal articulation actuator operatively interacts with the selective prevention means to selectively release the selective prevention means and cause the selective prevention means to apply proximal and distal articulation movements to the first distal articulation actuator.

Example 107. The surgical instrument of Examples 100, 101, 102, 103, 104, 105, or 106, in which the portion of the surgical end effector pivotally associated with the elongate shaft assembly comprises an elongated channel configured to functionally support a cassette with surgical staples.

Example 108. The surgical stapling instrument of Example 107, further comprising a stop that is supported relative to the elongated channel such that one of the stop and the elongated channel is selectively movable relative to the other of the stop and the elongated channel between open and closed positions.

Example 109. A surgical instrument comprising an elongated shaft assembly that forms a shaft axis. The surgical end effector is pivotally coupled to the elongated shaft assembly to selectively pivot relative to the elongated shaft assembly about a pivot axis that is transverse to the shaft axis. The surgical instrument further comprises an articulation system that includes a first distal articulation actuator that is supported for selective longitudinal movement in the distal direction and in the proximal direction in response to corresponding articulation movements applied thereto. The first distal articulation actuator is operatively associated with the surgical end effector. The articulation system further comprises a second distal articulation actuator that comprises an endless member operatively interacting with the first distal articulation actuator and a surgical end effector. The endless member is supported on the elongate shaft assembly to selectively pivot in response to longitudinal movement of the first distal articulation actuator such that when the first distal articulation actuator moves distally, the endless member causes the surgical end effector to pivot about an axis pivot in the first pivot direction, and when the first distal articulation actuator moves proximally, the endless member causes the surgical end effector to pivot about the pivot axis in the second pivot direction opposite the first pivot direction.

Example 110 The surgical instrument of Example 109 wherein the endless member is pivotally held on a proximal roller that is mounted on the elongate shaft assembly and a distal roller on the surgical end effector.

Example 111 The surgical instrument of Example 110, wherein the endless member is operatively attached to the distal roller by a securing tab attached to the endless member and configured to be received in an attachment recess in the distal roller.

Example 112. The surgical instrument of Examples 109, 110, or 111, wherein the endless member has a cable length including a first tab attached to a first end of the cable, a second tab attached to a second end of the cable. The second tab is also attached to the first tab to form an endless member.

EXAMPLE 113 The surgical instrument of Example 112, wherein the distal articulation actuator comprises first and second beds for receiving first and second tabs.

Example 114. The surgical instrument of Examples 110 or 111, wherein a distal roller is formed on an elongated channel of the surgical end effector. The elongated channel is made with the possibility of functional support in it of the cassette with surgical staples.

Example 115 The surgical instrument of Examples 110 or 111, wherein a distal roller is formed on an end effector mounting assembly that is attached to an elongated portion of the surgical end effector channel. The elongated channel is made with the possibility of functional support in it of the cassette with surgical staples.

Example 116. The surgical instrument of Examples 114 or 115, further comprising a stop that is supported relative to the elongated channel such that one of the stop and the elongated channel is selectively movable relative to the other of the stop and the elongated channel between open and closed positions.

Example 117. A surgical instrument comprising an elongated shaft assembly that forms a shaft axis. The surgical end effector is pivotally coupled to the elongated shaft assembly to selectively pivot relative to the elongated shaft assembly about a pivot axis that is transverse to the shaft axis. The surgical instrument further comprises an articulation system that includes a first distal articulation actuator that is supported for selective longitudinal movement in the distal direction and in the proximal direction in response to corresponding articulation movements applied thereto. The first distal articulation actuator is operatively associated with the surgical end effector. The articulation system further comprises a second distal articulation actuator that is supported for longitudinal movement in the distal and proximal directions. The second distal articulation actuator is operatively coupled to the surgical end effector. The articulation system further comprises a drive means that interacts with the first distal articulation drive member and the second distal articulation drive member such that when the first distal articulation drive member moves distally, the drive means drives the second distal articulation drive member pivot in the proximal direction to pivot the surgical end effector about the pivot axis in the first pivot direction, and when the first distal articulation drive element is moved proximally, the drive means drives the second distal articulation drive element in the distal direction for the articulation pivoting the surgical end effector about the pivot axis in a second pivot direction opposite to the first direction hinge rotation.

Example 118. The surgical instrument of Example 117, wherein the surgical end effector comprises an elongated channel that is operatively capable of supporting a surgical staple cartridge therein. The stop is supported relative to the elongated channel in such a way that one of the stop and the elongated channel is configured to selectively move relative to the other of the stop and the elongated channel between open and closed positions.

Example 119. A surgical instrument comprising an elongated shaft assembly that forms a shaft axis. The surgical end effector is pivotally coupled to the elongated shaft assembly to selectively pivot relative to the elongated shaft assembly about a pivot axis that is transverse to the shaft axis. The surgical instrument further comprises an articulation system that includes a pivot articulation member supported for pivot movement about a pivot axis that is transverse to the axis of the trunk. The first distal articulation actuator assembly operatively interacts with the articulation pivot and is supported for selective longitudinal distal and proximal movement in response to respective pivot movements applied thereto from the articulation pivot. The first assembly of the distal articulation actuator operatively interacts with the surgical end effector. The second distal articulation actuator assembly operatively interacts with the articulation pivot and is supported for longitudinal movement in the distal and proximal directions. The second distal articulation actuator assembly operatively interacts with the surgical end effector. The articulation system further comprises means for selectively pivoting the articulation pivot member in the first and second pivot directions about the pivot axis such that when the articulation pivot member is rotated in the first pivot direction by the selective pivot means, the first assembly of the distal articulation actuator articulation is longitudinally driven in the distal direction, and the second distal articulation actuator is simultaneously moved proximally to pivot the surgical end effector about the pivot axis in the first pivot direction, and when the articulation pivot is rotated in the second pivot direction by means for selective rotation, the first assembly of the distal articulation drive element is longitudinally driven in the proximal direction, and the second The th node of the distal articulation drive element is simultaneously moved in the distal direction to pivot the surgical end effector about the pivot axis in the second pivot direction about the pivot axis opposite to the first pivot direction.

Example 120. The surgical instrument of Example 119, wherein the articulation pivot comprises a pivot disc and wherein the first distal articulation actuator assembly comprises a first articulation actuator portion that is movably held within the first articulation groove in the articulation pivot disk, and wherein the second distal articulation actuator assembly comprises a second articulation actuator portion that is movably held within a second articulation groove in the articulation pivot disk.

Example 121 The surgical instrument of Examples 119 or 120 further comprising a first biasing member that cooperates with a first portion of the articulation actuator to bias the first distal articulation actuator assembly to a first neutral pivot position when the selective pivot means is not activated. The second biasing member cooperates with a second portion of the articulation actuator to bias the second distal articulation actuator assembly to a second neutral pivot position when the selective pivot means is not activated.

Example 122. The surgical instrument of Examples 119, 120, or 121, wherein the first distal articulation actuator assembly comprises a first articulation pivot member movable with the articulation pivot member. The first pivot joint is pivotally coupled to the first pivot link. The first articulation connector operatively interacts with the surgical end effector. The second distal articulation joint includes a second articulation link that is movable with the pivot articulation element, and the second articulation element is rotatably coupled to the second articulation link and functionally interacts with the surgical end effector.

Example 123 The surgical instrument of Example 122, wherein the first distal articulation actuator assembly further comprises a articulation locking member assembly that operatively interacts with the first articulation joint connector and the surgical end effector and is configured to selectively lock the surgical end effector in the plurality articulated positions relative to the elongated barrel assembly.

Example 124. The surgical instrument of Example 123 further comprising a first articulation member that operatively interacts with the articulation retention member assembly and the surgical end effector.

Example 125 The surgical instrument of Example 124 wherein the first articulation member is coupled to the surgical end effector via a first movable connector and wherein the second articulation member is coupled to the surgical end effector via a second movable connector.

Example 126. The surgical instrument of Example 126, wherein the first articulation member is coupled to a first movable connector via a first ball joint, and wherein the second articulation member is coupled to a second movable connector via a second ball joint. hinge.

Example 127 The surgical instrument of Examples 119, 120, 121, 122, 123, 124, 125, or 126, wherein the selective rotation means comprises a motor that is in gear engagement with a pivot pivot member.

Example 128. The surgical instrument of Examples 119, 120, 121, 122, 123, 124, 125 or 126, further comprising a longitudinally movable trigger, and wherein the selective rotation means comprises a motor that is configured to generate rotary output motions, and a switching device that functionally interacts with the engine and a longitudinally movable starting element, and an articulation drive link that is operatively operative to interact with the articulated pivot element. The switching device is movable between a first position in which actuation of the engine results in the application of axial pivot movements to the articulation drive link, so as to cause the pivot element of the articulation to rotate about the pivot axis, and a second position in which actuation actuates the motor leads to the application of axial starting movements to the starting element made with the possibility of movement in the longitudinal direction

Example 129. A surgical instrument comprising an elongated shaft assembly that forms a shaft axis. The surgical end effector is pivotally coupled to the elongated shaft assembly to selectively pivot relative to the elongated shaft assembly about a pivot axis that is transverse to the shaft axis. The surgical instrument further comprises an articulation system that includes a pivotable drive element supported for pivotal movement about a pivot axis that is transverse to the shaft axis. The pivot driven member is supported for pivotal movement relative to the pivot drive member about the pivot axis. The pivot driven member operatively interacts with the pivot drive member such that application of pivot control movements to the pivot drive element causes the pivot drive member to rotate about the pivot axis. The first distal articulation actuator assembly operatively interacts with the at least pivotable follower and is supported for selective longitudinal movement in the distal direction and in the proximal direction in response to rotation of the at least first pivot follower. The first assembly of the distal articulation actuator operatively interacts with the surgical end effector. The articulation system further comprises a second distal articulation actuator assembly that operatively interacts with at least the pivot driven member and is supported for longitudinal movement in the distal and proximal directions. The second distal articulation actuator assembly operatively interacts with the surgical end effector. The pivot system further comprises means for selectively applying pivot control motions to the pivot drive member to cause the pivot drive member to pivot about the pivot axis and thereby cause the pivot driven member to pivot about the pivot axis such that when the pivot driven member pivots in the first direction of rotation, the first distal articulation actuator assembly is longitudinally driven in the distal direction, and the second distal articulation actuator simultaneously moves proximally to pivot the surgical end effector about the articulation axis in the first articulation direction, and when the pivot follower pivots in the second pivot direction, the first distal articulation actuator assembly is driven longitudinally into the prox in the imal direction, and the second assembly of the distal articulation actuator is simultaneously displaced in the distal direction to pivot the surgical end effector about the pivot axis in the second pivot direction about the pivot axis opposite to the first pivot direction.

Example 130. The surgical instrument of Example 129, wherein the pivotable drive member comprises a pivot articulation drive disc, and wherein the second pivot driven member comprises a pivot articulation driven drive disc, and wherein the first distal articulation drive member assembly comprises a first drive member portion articulation drive that is movably held within respective first articulation grooves in each of the rotatable articulation drive disc and the rotatable articulation driven disc, and wherein the second distal articulation drive member assembly comprises a second articulation drive member portion that is retained with the ability to move within the respective second articulation grooves in each of the rotatable articulation drive disc and the rotary driven articulation disc.

Example 131. The surgical instrument of Examples 129 or 130, wherein the first distal articulation actuator assembly comprises a first articulation link that is movably movable with a pivot driver, a rotatable follower, and a first articulation member that is pivotally coupled to the first hinge link. The first articulation member functionally interacts with the surgical end effector. The second distal articulation joint contains a second articulated link, which interacts with the ability to move with the rotary driving element and the rotary driven element, and the second articulation element is connected with the ability to rotate with the second articulated link and functionally interacts with the surgical end effector.

Example 132 The surgical instrument of Example 131, wherein the first articulation member is coupled to the surgical end effector via a first movable connector and the second articulation member is coupled to the surgical end effector via a second movable connector.

Example 133. The surgical instrument of Example 132, wherein the first articulation member is coupled to a first movable connector via a first ball and the second articulation member is coupled to a second movable connector via a second ball. hinge.

Example 134. The surgical instrument of Examples 129, 130, 131, 132, or 133, wherein the selective application means comprises a motor in gear engagement with a pivot drive member.

Example 135. The surgical instrument of Examples 129, 130, 131, 132 or 133, further comprising a longitudinally movable trigger, and wherein the selective application means comprises a motor that is configured to generate rotational output motions. The selective application means further comprises a switching device that operatively interacts with a motor and a longitudinally movable starting element, and an articulated drive link that is operatively in interaction with the rotary driving element. The switching device is movable between a first position in which actuation of the engine results in the application of axial pivot movements to the articulated drive link, so as to cause the pivot drive element to rotate about the pivot axis, and a second position in which actuation in the action of the motor results in the application of axial starting motions to the longitudinally movable starting element.

Example 136. A surgical instrument comprising an elongated shaft assembly that forms a shaft axis. The surgical end effector is pivotally coupled to the elongated shaft assembly to selectively pivot relative to the elongated shaft assembly about a pivot axis that is transverse to the shaft axis. The surgical instrument further comprises an articulated articulation system that comprises means operatively associated with the surgical end effector for pivoting the surgical end effector about the articulated pivot axis, and means for selectively generating rotational movements. The articulation system further comprises a pivot element that operatively interacts with the means for generating rotational motion and the means for articulating rotation in such a way that the application of rotational movements to the pivot element from the side of the selective generation means causes the means for articulating rotation to simultaneously apply opposite axial movements of the articulating rotation to the surgical end effector, wherein one opposite axial movement is applied to a point of attachment on the surgical end effector that is laterally offset to one side of the pivot axis, and wherein another opposite axial motion is applied to another point of attachment on the surgical end effector, which is offset laterally to the other lateral side from the pivot axis.

Full description:

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US Patent Application No. 13 / 036,647, entitled SURGICAL STAPLING INSTRUMENT, filed Feb. 28, 2011, now 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 Application Publication No. 2012/0298719;

US patent application No. 13 / 524,049 entitled ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE; by day June 15, 2012; currently US patent application No. 2013/0334278;

US Patent Application No. 13 / 800,025, entitled STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, filed March 13, 2013, now US Patent Application Publication No. 2014/0263551;

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

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

Published US Patent Application No. 2010/0264194, entitled SURGICAL STAPLING INSTRUMENT WITH AN ARTICULATABLE END EFFECTOR, filed April 22, 2010, now US Patent No. 8,308,040; incorporated herein by reference.

Although various embodiments of articles are described herein in connection with certain disclosed embodiments, various modifications and changes may be made to the article. Also, for some components for which materials are disclosed, you can use other materials. In addition, according to various embodiments, one component may be replaced by several components and several components by one component (to perform certain functions). The above description and the appended claims cover all such changes and additions.

The devices described herein can be configured to be recycled after a single use, or they can be configured to be used multiple times. However, in any case, the device can be restored for reuse after at least one use. Refurbishment can 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 a refurbishing workshop or by the surgical team just prior to surgery. It will be apparent to those skilled in the art that various disassembly, cleaning, replacement and reassembly techniques can be used to rebuild a device. The use of such techniques, as well as the resulting reconditioned device, are within the scope of this application.

By way of example only, the versions described in this document may be processed prior to surgery. First, a new or used instrument can be obtained and repaired if necessary. The instrument can then be sterilized. In one sterilization method, the instrument is placed in a sealed and sealed container such as a plastic bag or TYVEK bag. The instrument container can then be placed in a field of radiation capable of penetrating the container, such as gamma rays, X-rays, or a fast electron beam. Radiation can kill bacteria on the surface of the instrument and in the container. The sterilized instrument can then be stored in a sterile container. The sealed container can keep the instrument sterile until a medical facility requires it. 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 has been described as having exemplary configurations, the present invention may be further modified within the spirit and scope of the description. Therefore, it is assumed that the present application covers all possible variations, methods of application or adaptation of the invention by applying its general principles.

Any patent, publication or other disclosure material, in whole or in part, which is indicated as incorporated herein by reference, is incorporated herein only to the extent that the incorporated material does not contradict existing definitions, provisions and other disclosure material presented herein. description. Thus, the description expressly set forth herein, to the extent 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 disclosure materials set forth herein, will be included only to the extent that no conflict arises between the included material and the existing disclosure material. ...

Claims (49)

1. A surgical instrument containing: elongated barrel assembly defining the barrel axis; a surgical end effector operably coupled to the elongated shaft assembly by means of a pivotal articulation such that the surgical end effector is selectively articulated with respect to the elongated shaft assembly about a pivot axis that is transverse to the shaft axis; a longitudinally movable firing rod, configured to curvaturely cross the articulation and selectively axially move from a home position to an end position within the surgical end effector; a middle support member movably connected to the elongated shaft assembly and a portion of the surgical end effector, the middle support member comprising a middle body portion that includes a proximal end and a distal end, and a launch rod slot extending between them that is configured to maintaining, when moving each side, a portion of the flexible launch rod crossing the articulation; a proximal support link, which contains an elongated proximal body located proximal to the middle support element and configured to laterally support the proximal portions of the flexible launch rod lateral side crossing the articulated joint, the proximal support link movably interacting with the proximal end of the middle support element; wherein the elongated proximal body contains proximal superior element; and two downwardly extending opposing proximal abutment walls, with one of the proximal abutment walls positioned adjacent to one of the proximal side portions of the flexible launch rod crossing the pivot joint, and with the other of the opposite proximal support walls positioned adjacent to the other of the proximal sidewall portions flexible launch rod, crossing the articulated joint, and while the specified surgical instrument additionally contains: a distal support link that contains an elongated distal body located distally relative to the middle support element and configured to laterally support the corresponding distal portions of the lateral side of the flexible launch rod intersecting the articulated joint, wherein the distal support link is movable with the distal end of the middle support element and contains distal upper element and two downwardly extending opposite distal support walls, with one of the distal support walls positioned adjacent to one of the distal side portions of the flexible launch rod crossing the pivot joint, and with the other of the opposite distal support walls positioned adjacent to the other of the distal side side portions a flexible launch rod that crosses the articulated joint while the proximal end of the middle support element contains an arcuate proximal recess configured to accommodate the distal nasal portion of the proximal upper element of the proximal support link with the ability to move, and the distal end of the middle support element contains a distal arcuate recess configured to accommodate the proximal nasal portion of the distal the upper element of the distal support link with the ability to move. 2. The surgical instrument of claim 1, wherein one of the proximal abutment walls includes a proximal arcuate surface facing one of the proximal portions of the side of the flexible launch rod crossing the articulation, and wherein the other of the proximal abutment walls includes another proximal arcuate surface facing another of the proximal portions of the side of the flexible launch rod crossing the articulation, and wherein one of the distal support walls includes a distal arcuate surface facing one of the distal portions of the side of the flexible launch rod crossing the articulation articulation, and the other of the distal abutment walls includes another arcuate surface facing the other of the distal portions of the side of the flexible launch rod intersecting the articulation. 3. The surgical instrument of claim 1, wherein the middle support element is rotatably associated with a portion of the surgical end effector for rotary movement relative to it about the pivot axis, and wherein the middle support element is associated with the elongated shaft assembly for rotary and axial movement relative to it ... 4. The surgical instrument of claim 3, wherein the middle abutment is attached to the elongated shaft assembly by a proximal pin passing through the elongated slot in the middle abutment. 5. The surgical instrument of claim 1, wherein the elongated shaft assembly comprises a distal shaft having a distal shaft recess configured to move the proximal nasal portion of the proximal upper element therein. 6. The surgical instrument of claim 5, wherein the surgical end effector portion comprises a canal recess configured to move the distal nasal portion of the distal upper element therein. 7. The surgical instrument of claim 1, wherein the surgical end effector portion comprises an elongated channel that is capable of being supported therein to allow the surgical staple cassette to operate. 8. The surgical instrument of claim 7, further comprising an abutment that is supported relative to the elongated channel such that one of the abutment and the elongated channel is selectively movable relative to the other of the abutment and the elongated channel between open and closed positions. 9. A surgical instrument containing: an elongated stem assembly defining the stem axis and containing right and left opposite stem recesses formed at its distal end; a surgical end effector operably coupled to the elongated shaft assembly by means of a pivotal articulation such that the surgical end effector is selectively articulated with respect to the elongated shaft assembly about a pivot axis that is transverse to the shaft axis; a longitudinally movable flexible launch rod, capable of flexing the articulation and selectively axially displacing from a home position to an end position within the surgical end effector; a middle support member movably connected to the elongated shaft assembly and a portion of the surgical end effector, a middle support member comprising a middle body portion that includes right and left opposing support recesses formed at its distal end and a launch rod slot, configured to support the longitudinal movement of the lateral side portions of the longitudinally movable flexible launch rod crossing the articulation; a hinge link configured to laterally support portions of the side side of a longitudinally movable flexible launch rod crossing the hinge joint, the hinge link comprising a proximally protruding proximal nasal portion configured to engage with the ability to move any one of the right and left opposite the bore notches upon flexion of the longitudinally movable flexible launch rod in response to articulation of the surgical end effector about the articulation axis; and a distally protruding distal nasal portion capable of engaging with the ability to move any one of the right and left opposing support recesses in the moveable support member upon flexion of the longitudinally movable flexible launch rod in response to pivotal rotation of the surgical end effector around pivot axis. 10. The surgical instrument of claim 9, wherein the articulated link further comprises: a first side support wall disposed adjacent to one of the sidewall portions of the longitudinally movable flexible launch rod; and a second side support wall disposed adjacent to another of the side portions of the longitudinally movable flexible launch rod. 11. The surgical instrument of claim 10, wherein the first side support wall includes a first arcuate surface facing one of the side portions of the longitudinally movable flexible launch rod, and wherein the second side support wall includes a second arcuate surface facing another of the lateral side portions of the longitudinally movable flexible launch rod. 12. The surgical instrument of claim 10, further comprising: a first compression band that extends between one portion of a lateral side of a longitudinally movable flexible launch rod and a first side abutment wall, the first compression band comprising a first distal end supported on the surgical end effector and a first proximal end supported with the ability movement on the elongated barrel assembly; and a second compression band that extends between another side portion of the longitudinally movable flexible launch rod and a second side abutment wall, the second compression band comprising a second distal end supported on the surgical end effector and a second proximal end supported with the ability movement on the elongated barrel assembly. 13. The surgical instrument of claim 12, further comprising: a third compression band that extends between one portion of the longitudinally movable flexible launch rod and the first compression band, the third compression band comprising a third distal end supported on the surgical end effector and a third proximal end movably supported on the node of the elongated barrel; and a fourth compression band that extends between another side portion of the longitudinally movable flexible launch rod and a second compression band, the fourth compression band comprising a fourth distal end supported on the surgical end effector and a fourth proximal end movable on the node of the elongated barrel. 14. Surgical instrument containing: elongated barrel assembly defining the barrel axis; a surgical end effector operably coupled to the elongated shaft assembly by means of a pivotal articulation such that the surgical end effector is selectively articulated with respect to the elongated shaft assembly about a pivot axis that is transverse to the shaft axis; a longitudinally movable firing rod, configured to curvaturely cross the articulation and selectively axially move from a home position to an end position within the surgical end effector; a middle support member movably coupled to the elongated shaft assembly for pivotal and axial movement relative thereto, and is pivotally coupled to the surgical end effector; A U-shaped proximal support link that includes a proximal upper member and two proximal side members, with the U-shaped proximal support member extending over the proximal portion of the longitudinally movable flexible launch rod such that one of the proximal side members is adjacent with one lateral side of the proximal section of the longitudinally movable flexible launch rod, and the other of the proximal side elements is located adjacent to the other side of the proximal section of the longitudinally movable flexible launch rod, while the proximal upper element is configured interactions when moving with the middle support element and the elongated barrel node and contains: a first proximal protruding proximal nasal portion that moves movably into a distal recess formed in the elongated trunk assembly; and and a first distal protruding distal nasal portion that is movable into a proximal recess in the middle abutment, and the surgical instrument further comprises a U-shaped distal abutment that comprises a distal upper element and two distal side elements, wherein the U-shaped distal the support link passes over the distal section of the longitudinally movable flexible launch rod in such a way that one of the distal side elements is located adjacent to one lateral side of the distal section of the longitudinally movable flexible launch rod and the other from the distal side elements is located adjacent to the other lateral side of the distal section made with the ability to move in the longitudinal direction of the flexible launch rod, while the distal upper element is made to interact when moving with the middle reference e element and with part of the surgical end effector, and contains a second proximally projecting proximal nasal region that moves movably into a distal recess in the middle abutment; and a second distal protruding distal nasal region that slides into a canal recess in the surgical end effector. 15. The surgical instrument of claim 14, wherein one of the two proximal side members comprises a proximal arcuate surface facing one lateral side of a proximal portion of a longitudinally movable flexible launch rod, and wherein the other of the proximal side members includes itself another proximal arcuate surface facing the other lateral side of the proximal portion of a longitudinally movable flexible launch rod, and wherein one of the two distal side members comprises a distal arcuate surface facing said one lateral side of the distal portion movable in the longitudinal direction of the flexible launch rod, and while the other of the distal side members contains another distal arcuate surface facing the specified other distal side of the distal portion made with the possibility yu displacement in the longitudinal direction of the flexible launch rod. 16. The surgical instrument of claim 14, wherein the middle abutment is movably coupled to an elongated channel of the surgical end effector that is capable of being supported therein to allow the surgical staple cassette to operate.

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