TW200808254A - Surgical cutting and fastening instrument with distally mounted pneumatically powered rotary drive member - Google Patents

Abstract

A surgical instrument that includes a distal member configured to receive a pneumatically operated tool assembly therein. The instrument may also include an elongate shaft assembly that has a distal end portion that is coupled to the distal member and a proximal end portion. A pneumatically powered rotary drive member may be supported by the distal end portion of the elongate shaft assembly and may be configured to apply at least two rotary actuation motions to the pneumatically operated tool assembly upon receipt of at least one pneumatic drive signal from a source of pneumatic power. The pneumatically powered drive member may comprise a pneumatically powered motor. In various embodiments, the distal end portion of the elongate shaft member may articulate relative to the proximal end portion thereof and/or the distal end portion of the elongate shaft assembly may be detachable from the proximal end portion.

Description

200808254 IX. INSTRUCTIONS: [Technical field to which the invention pertains] Cochebenbori is generally concerned with surgical instruments, and more specifically for pneumatic external surgery i-, solid tools. The present invention is applicable to conventional endoscopes and open surgical instruments and can be applied to robot-assisted surgery. [Prior Art] ίο 15 20 Surgical cutting and fastening devices (stapers) have been used in the prior art to create a lengthwise incision and apply rows of staples to the sides of the incision. . Such instruments typically include a pair of cooperating jaw members that are configured to pass through the cannula channel when the crying system is to be used in an endoscope or laparoscopic application. One of the jaw members houses a staple, and the knot has at least two rows of laterally spaced staples. The other clip member defines an anvil that occupies a nail forming pocket that is aligned with the elbow row in the forehead. The apparatus includes a plurality of reciprocating wedges that pass through the opening in the ® when engaged from the distal end and engage the actuator supporting the staples to effect the firing of the staples toward the anvil.侔^ has developed a variety of different actions (four) and shot the expansion group - method. In the case of a bovine case, U.S. Patent No. 6,978,921 to the disclosure of the entire disclosure of which is incorporated herein by reference. Other surgical staple devices using battery powered motors have been developed. This device is disclosed in U.S. Patent No. 5,954,259 to the name of vi〇Ia et al. Other surgical staplers are actuated by a pressurized gas source. U.S. Pat. The cylinder is equipped with a sample f ^ base assembly that is actuated by the introduction of pressurized gas into the cylinder. The piston is constructed by the c-tube portion and the components in the handle member to act together; the second end of the piston is deployed in the end effector and the scalpel. Extend this: the meter-complex assembly will be mounted on the handle; in f: the component in the end effector section. In addition, when 10, 4: day: 'There will be a risk that the power source will be exhausted during the surgical procedure because; ==: the amount of gas remaining in the gas £. If it is in the firing or retracting === things, these devices lack devices that are easy to replace the container with 2 new valleys or auxiliary power sources. Another type of pneumatic surgical stapling device is disclosed in the certificate of 15 r = S2_151567. Such a device utilizes the movement of the motor 2 to produce a motion and utilizes the end effector. Such a device may be applied to a pneumatic device of a detachable 嶋=二卜界 power source such as a hospital's existing high-pressure air or gas supply source to the sump or the handle portion of the handle/handle portion. The gas is compressed to achieve the size of the gas cylinder required for the desired number of actuations of the device at the minimum f force. Us that have been designed for most applications should have a large gas cylinder = use or, in the case of smaller gas cylinders, such a gas cylinder would have unwanted high pressure. In addition, the use of detachable PCT is available for unlimited use of eth96425-end 20087 200808254 performance ability and therefore these arrangements may greatly change the example t-force - 曰 = = = = 喷 喷 喷 喷 喷 喷 喷 喷 喷 喷 喷 喷 喷 喷 喷 喷 喷 喷 喷 喷Single switch or start trigger start This assembly can be retracted by the drive train. Although it is then 'fired into a burst cycle and / phase pass|board machine total = = : Γ In addition, these conventional devices lack a 10,000-component device. Furthermore, these strong sites "manual fine-returning tools and firing rods maneuver exert additional force to assist the two clinicians to the hand of the transmission system. Lili to assist the firing mechanism to propel or slow the propulsion of the device therefore requires a kind There is no need to borrow gentry & μ and a pneumatic surgical staple to set the tactile sensation of the force encountered during the firing: it sets him == to provide notice of the time when it has been actuated and ready to be retracted. Yi Shida needs an economical and easily replaceable power source system. The number of such power sources can be replaced by the number of pneumatic surgical staples. It is also necessary to store gas more efficiently for surgical needles. Device eth96425-Finished 8 200808254 The inside of the powered gas cylinder _ Give more power to the clothes, so that a single gas cylinder is available again, need to be - heavy and useful, 5 manually retract the tool and hit the million : When the aerodynamic loss or interruption occurs, the pneumatic stapling device that needs and borrows the material from the state of the device. The device of the device: the terminal: the special selection of the long shaft assembly of the second: And / or its attached 10 In addition, it is required to have the above-mentioned features and a small type of terminal device, and it can be used with the detachable device configuration. The device is used in conjunction with the disposable terminal. [Invention] - In the construction of the present invention For a surgical instrument, including - 15 may comprise - a long shaft assembly 'the long shaft has a "end portion." The distal portion can be coupled to the distal end W and a distal end - to be distally advanced by the long shaft assembly. The transmission member can be configured to apply at least two rotational drive motions to the distal member after the transmission of the kinetic force from the gas 2 . In the alternative, the present invention is directed to a handle assembly and a closed drive train. The plant, can be packaged and constructed to create a closing motion: _ Open: The general mechanism can also be supported by the handle assembly to cause the beans. A drive generates at least a pneumatic drive signal. — (iv) Rod total eth96425-end 稹 9 200808254 , coupled to the handle assembly and with the closed drive and the force drive signal. - Pneumatic transmission ==, one heart can be supported by the ground and can be constructed to respond = the rolling force drive #唬 produces a rotary firing motion and a rotary back, ίο two! The appliance may further comprise a terminal that is consuming to the long shaft assembly. The end effector, in each non-limiting embodiment, can include a long channel that is sized to be received therein. - Shi Zhan can be pivoted: This is a long slot and this is a pivotal response to the opening and closing of the long axle assembly. A cutting and cutting member is operatively supported on the 击 for rotational squeezing from the pneumatic transmission member; the action is responsive. 1 曰 【 【 15 15 15 15 15 15 15 15 15 15 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 - Turning to the drawings, the same components are denoted by the same numerals in the figures. Fig. 1 shows the unique advantages of the invention. The embodiment includes a handle assembly, a long axis cutter total The terminal actuator a connected to the long shaft assembly 丨 (9) may include - the terminal end that is rotatably attached to the long shaft assembly by the 'bend, rabbit or belt pivoting The name of the invention applied for on January 10, 2006, and the surgicalinstrument HAV brain AN ARTICULating Najiao (10), the US patent application serial number! The content of the application, the manner of reference, is hereby incorporated by reference. However, with the detailed description of the present invention gradually eth96425-completely 10 5 10 15 20 200808254 = it will be understood that the embodiments of the present invention can be described in detail with respect to the acquisition, even as shown in Figure 1, crying The machine 302 and the firing trigger, the handle assembly 300 of 3 may include a closed trigger, and the instrument may be different for the different surgical two θ 2 end effectors. The number or type of pull is suitable for operating a controller of an end effector. The final ° ° hunting shown in Figure A is separated by a preferably elongated shaft assembly 100. The handle is fine. The 5th division can be used - the joint controller is used to make the terminal action ^ to live on the shaft assembly 1 Festival sports. The nephew understands that the spatial terminology such as staggered, horizontal, right, left, etc. is in the false and the bucket is the longitudinal axis of the 10 and the long axis rod assembly 100. The shaft & the shaft and the "bone 3" from the handle assembly The bottom is presented with an acute angle. However, in practice, surgical instruments can be oriented at a variety of different angles, and thus these spatial terms are relative: the surgical instrument 10 itself is used. ',, proximal (proximal wide-word in this specification is from the point of view of the clinician behind the handle assembly 3〇〇 'This clinician puts the end effector 12 away from himself. & In the present specification, "pressurized gas" means any gas suitable for use in a pneumatic system for use in a sterile loop j. Non-limiting examples of such media include compressed air, carbon dioxide (C〇2), Nitrogen, oxygen, argon, helium, sodium hydride, propane, isobutane, butane, chlorofluorocarbons, dimethyl sulfonate, methyl ethyl ether, nitrous oxide, hydrofluoride (Hfa) For example, eth96425-finished 11 200808254 HFA 134a (1,1,1,2, tetrafluoroethylene) or 1^8 2 heptafluoropropane). ,,1,2,3,3,3- 5 咅 In this ^ brother--the book, 'fluidically coupied y, a word coupled through a suitable line or other components to allow pressurized gas t line", 4:, :ΓΓ', gas supply line, Ge, gas path report & field, spring buckle a rigid or flexible conduit, pipe, pipe passage to pressurize gas from a component Appropriate 10 to the other-components from the _ force ^_月 book 'pneumatic signal' or "pneumatic transmission signal" means the second force, the source flow to the fluid is lightly coupled to the pressurized gas source in the second stream or The fluid engages the airflow between the components of the assembly 15 20 axis of the shaft to the axis" (where the 'longitudinal axis 〃 〃 妒 妒 近 近 近 近 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 The direction of the longitudinal axis is also substantially transverse. Figure 2 is an illustration - a decomposing assembly tool assembly 12 can be used in various embodiments of the present invention - a seed gas of 40% or an end effector. The description of the non-rolling force is based on the detailed removal of the invention, = Γ and therefore the assembly shown in the case is required to be added. It should be understood that the terminal function shown in the figure " is crying for customization for a particular surgical application. The end effector can be used in various embodiments of the present invention. As shown in the figure eth96425- 12 5 10 15 20 200808254, The terminal acts to cry into 〃 ”., the agency except;: 21 = firing mechanism (, 'the tool in the total nail cartridge, more (four) issued in one of the buckets for the nail steam also has a terminal effect 12 - the spacing of the anvil part relative to the nail. The E-shaped sniper file, shelton, IV, etc., the name of the invention = the machine, the point has been granted

Instrument Ineorp〇rating Αη ε:β ":3 StJllng US Patent No. 6,978,921 #refers to ^nng^Brit" is incorporated herein. The relevant part of the patent is cited, and those skilled in the art will understand The detailed description is gradually configured without departing from the spirit and scope of the present invention. In the present specification, ', 'striking mechanism' means a pneumatic tool and/or a solid part, which may be the essence of one from the firing mechanism. The restless position of the restless movement moves to - the shifted position to the final position of the activated, the end position == = the tool completes the - or ί action by touching at least the firing motion applied thereto. The firing mechanism, for example May include: (1) a component that is fully supported by the pneumatics and interfaces with components in the surgical device; (li) a combination of components located within the pneumatic tool and within the surgical device; or (called by an external device and The components that move in and out of the pneumatic tool. In this specification, the burst travel means the actual movement of the firing mechanism from the unactuated position to the actuated position. In the text, the 'retraction stroke' means the firing mechanism has been made. The moving position is moved back to the return movement of the unactuated position. As shown in Figure 2, the terminating end effector 12 includes a distal member that, in each non-limiting embodiment, includes a long channel 2 Pivot th96425- 13 200808254 The translated anvil 40 is attached to the long channel. The long channel 2 is configured to receive a sub-bearing a magazine 50 that responds to the tool assembly 3〇 to drive the staple 70 is in shaped contact with the anvil 40. It should be understood that although an easily replaceable staple is advantageously provided herein, a staple E of the present invention can be permanently fixed or integrated into the long channel 20. In various embodiments, the firing mechanism or tool assembly 3 is included in the vertical spacing pin that controls the distance between the end effectors 12. In particular, the upper Deng pins 32 are arranged to enter the anvil 4 and the long channel. 2 枢 之 ί ί ί ί ί ί ί ί ί ί ί ί ί ί 42 42 42 42 42 42 42 42 42 42 42 42 42 42 42 42 42 42 42 42 42 42 42 42 42 42 42 42 42 42 42 42 42 42 = side propulsion. Any slight upward deflection of the stone accounted for 40 is given by the upper pin服服, 、, ° ° - Λ 成 成 G G G 亦 亦 亦 成 3 3 3 3 3 G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G G The anvil 40 is maximally clamped between the pocket 40 and the slot a 20. In each of the embodiments, one of the cutter assemblies 30 is formed in one of the lower surfaces of the magazine 50 and the long channel 20 36. , the middle pin of the firing transmission slot (not shown) in ^, against the "two text: Jin: and drive the nails 70 in the ancient movement. The intermediate pin 36 is held by the Guan Yuzhan / Yuedong It is advantageous to resist the end effector 12 at its distal end. However, the unique new look of the embodiments of the present invention returns to; 2:; the use of the assembly configuration is achieved. Between the pins 36, the soil cooker assembly 30 is interposed between the upper pin 32 and the middle; one of the cutting edges 38 is located across the nail 匣 5 位于 located near eth96425 - 槁 14 200808254 2 wrong slot 54 To cut off the lost tissue. The exact positioning of the tool assembly 3G with respect to a, 20 and anvil 40 ensures efficient cutting. The bottom surface of each of the actual anvils 40 may have a plurality of staple forming pockets therein (not shown). The staple forming pockets are arranged to correspond to the magazines 50 when the magazines 5 are received therein. One of the plurality of nail holes in the upper surface of the ^ ^ 各 各 ' ' ' ' ' 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 The recesses 24, 26 of the long channel 20 are frictionally and releasably engaged. ίο 15 20 士士ϋ 2: 'The nail 匣 5 〇 includes a 匣 main body 卜 a wedge-shaped skid 1 transmission Α 66, elbow 7G , and -& pallet 68. In the group ,, in the factory 8 8 will be the mold slider 64, the nail driver 66 and the nail 70 is held inside the S body 51. Long groove k k 20 fine by The long shaft assembly 100 is coupled to the L two rod assembly including a distal ridge or a skeleton segment no side money skeleton segment 13G. The long channel π has an attached octa 22 disposed on the proximal side, and the mother-attachment hole receives one The upper channel member 114 UG Λ ) ) ) ) ) ) ) u u u u u 亦 亦 亦 亦 亦 亦 亦 亦 亦 亦 亦 亦 亦 亦 亦 亦 亦 亦 砧 砧 砧 砧 砧 砧 砧 砧 砧 砧 砧 砧 砧 砧 砧 砧 砧 砧In the ridge assembly 102 And comprising a distal closure section proximally closed section (10). As will be explained below, the closure is pivoted relative to the axial assembly 102 of the ridge assembly 102, and the heart is 7020 pivoted. #夕动β致石占40 Relative to the long channel and her locking pin 112 is mounted in the distal ridge segment 110 as a knife--one locking device. The distal side and the near field are formed on the top of the distal ridge segment to be bordered therebetween. ^ eth96425-End 15 200808254 ^The upper arm 116's Jie}曰在-Cylinder assembly 5 二一达 The spring extends to the far side of the lower arm... ^ 3 0 , ^ # ^3 5 ";τ7 " Γ ^ ^ ^ # 5 10 15 The example can include the following. It should be understood that the real, i lockout or no lockout device. In the embodiment of Figures 1-6, the terminal is to be pulled to cry 12 Table 1 owe ^ ^ can be hunted by bending for proximal closure (four); Τ9 = Γ rotation of the mirror cable or belt combination of movement. Cooked feathers this dry rf assembly 3 〇〇) for the live oysters will be It is understood that such a configuration is only one of many configuration configurations that can be paired with these types of gamma. In this embodiment, the proximal end of the distal 110 has a hub 122 thereon. The proximal ridge segment i The distal U has a shank 34 for the through hole 136. The proximal ridge 130 is positioned relative to the distal 5 segment 110 such that the aperture 136 is coaxially aligned with the aperture 124 of the hub 122 such that the pivot pin 13 8 can pass therethrough. See Figure 4. This configuration pivots about the pivot axis A_A relative to the proximal spine 13A at the assembly end effector 12. As in this embodiment, the end effector 12 is used to live the end effector 12 Festival sports. In particular, the straps 1 50, 1 60 can extend distally toward the hinge pivot 104 as shown in Figures 2 and 3. The strap 150 can be passed along the proximal side of the proximally closed tube section 19 穿过 through the proximal closure tube section where it bypasses the belt member i 6 〇 and spans to the right side of the nearly 20 side closure tube section. Among them, the belt 丨 5 〇 can be mechanically connected to the Yi 12 2 at the connection point 12 3 , for example. Similarly, the band 16 can pass the proximal closure tube section along the right side of the proximal closure tube section 190 where it bypasses the band member ι5 〇 and spans to the left side of the proximal closure tube section 190. Wherein the strap 160 is mechanically coupled to the hub 122 at a connection point 125. 16 eth96425-完槁 200808254 Figure 3 is a top plan view of the end effector and ridge assembly 1〇2 with the closed tube assembly 100 shown in dashed lines. Fig. 4 is a partial side sectional view showing the same portion of the device 1'''''''' As shown in Figure 4, in accordance with a non-limiting embodiment, the bands 15 and 160 are shown offset from one another to prevent interference with each other during movement. For example, the U 带 is shown at a position lower than the band 160. In another non-limiting embodiment, the straight orientation of the lead of strips 150 and 160 can be reversed. As also shown in Figures 2 and 3, the strap member 150 extends around a pin 140 in the tang portion 134 of the proximal frame section 13b. Similarly, the band 142 extends in the shank portion 134 of the proximal skeletal section 13A. See also Figure 2. The belt portions I50 and 160 can extend from the hub 22 and extend along the proximal closure tube section 190 to the joint controller 2A shown in FIG. The joint controller 2A can include a hinge slider 202, a frame 204, and a closure member 2〇6. The strap portions 150, 160 can pass through the slot slider 2' 2 via slots 208 or other apertures, although it should be understood that the strap portions 150, 160 can be lightly coupled to the slider 15 202 by any suitable means. The hinge slider 2〇2 can be a one-piece as shown in Fig. 5, or can comprise two components in a non-limiting embodiment with a boundary defining a slot 208 therebetween. In a non-limiting embodiment, the hinge slide 汕2曰 can include a plurality of slots, for example, with each slot corresponding to one of the belt portions 15 〇, 。. The closure 206 can cover the components of the controller 2 to prevent fragmentation. In various embodiments, the strap portions 150, 160 can be anchored to the frame 204 at attachment points 21, 2, 2 near the slot 208. By way of non-limiting example of Figure 5, the strap portions 150, 160 are pre-bently bent from the attachment points 21A, 212 to the slots 208 near the longitudinal axis of the proximal closure tube section 19A. Eth96425-End 17 200808254 It should be understood that the belt portions 15〇, 160 can be anchored to any of the closer slots 208 of the appliance 10 near the proximal side, including the handle assembly 3〇〇. In use, the embodiment of Fig. 2 can have one of the unjointed motion positions as shown in Fig. 3. The joint controller 200 and belts 150, 160 are shown in a centered position about 5 of the longitudinal axis of the shaft assembly 100. Thus, the terminal action state 12 is in a neutral or unjointed motion position. In Figure 6, the hinge control % 200 is shown as the hinge slide 202 being pushed through the joint frame to the right of the shaft assembly 100. Therefore, the belts 150, 16〇 are bent toward the right side of the shaft assembly 1〇〇. It can be seen from the figure that the bending of the belt 150 to the right exerts a lateral force on the hub 122 at a pivot point of the biasing hub 122. This offset force causes the hub 22 to rotate about the hinge pivot 104, causing the end effector 12 to pivot to the right as shown. It should be understood that pushing the joint slider 2〇2 to the left side of the shaft assembly 1〇〇 can exert a lateral force on the belts 150, 160, so that the belts 15〇, 16〇^ = all toward the shaft Bend to the left of 100. The bend of the belt 16 then exerts a lateral force on the chapter 122 which is offset from the pivot point of the hub as previously described. This in turn causes the hub 122 to rotate about the hinge pivot, causing the end effector 12 to pivot to the left. In various embodiments, the shaft assembly 100 is constructed from a closed tube assembly 17 ridge assembly 1〇2. See Figure 2. The closure tube assembly 17A includes a side closure tube section 180 and a proximal closure tube section 19A. The distal closure, = section and proximal closure tube section 19G can be made of a polymer or other material. The proximal closure tube section 19() is hollow and has an axial passage 191 that penetrates the extension 2, the axial passage being configured to receive a portion of the ridge assembly 102. 18 eth96425-完穣200808254 In the embodiment shown in Figures 2 and 4, the 'use-double pivot closure joint' understands that the invention is not limited to a double pivot closure ^ contains any suitable closure tube or sleeve, U is completely absent Closing the tube or 5^2: as shown in Fig. 4' The distal closing tube section 180 has an upper and lower anvil opening/closing tab 46 causing the anvil 40 to be opened; Γ = pivotal horseshoe shape The aperture 185 and the tongue, detail 10, 190, similarly have a lower shank 194 that extends laterally from the upper handle 174 to the side. An upper double pivot flanks 74 include distal and proximal arms that protrude upwardly, respectively, and are respectively engaged with the latch holes 183 protruding toward the proximal side and a pair of #丨丨*山丫日]## extension pin holes 193 . The joint configuration is more scooped. The upper side of the upper shank 192 is downwardly inserted. The 丄 further includes a lower double pivot link 177. The shank and the proximal side of the connecting rod are engaged with the shaft lock 178. Show: Lower:! The cymbal pin is respectively engaged with the lower shank 194 in the proximally protruding lower side, the side pin hole 187 and a lower shank proximal pin hole 195 in the distally projecting tang. 20 moves to shift in the far = flat to m, for example, in response to the closing of the machine 310, the oil into 102 Ρ closed accounted for 4 〇. Shizhan 40 caused the back of the horseshoe shaped hole 185 to collide with the stone to occupy 40 "4" 46 due to the closing of the closed tube assembly 170 at the gate/β/main side of the ridge. The result is that the stone occupying area is turned to the closed position. To = : / ' causes the closure tube assembly 170 to move proximally on the ridge assembly (10) to the ground ί (10) resulting in the tongue 1δ6 contact = th96425 - the full name 19 200808254 The stone occupies 40 pivots to the open position. Figure 7 illustrates an exploded assembly view of one of the non-limiting handle assemblies of one embodiment of the present invention. In the embodiment shown in FIG. 7, the handle assembly has a hand grip configuration and is composed of a right casing member 32 and a double member 330, and the casing members are - Polymer or other suitable material is molded or otherwise manufactured and designed to match. The casing members 320 and 330 may be attached by shorting piles and sockets that are molded, otherwise molded or otherwise formed, and/or attached by adhesives, screws, bolts, and the like. Together. The upper casing member 32's upper portion VIII 322 and one of the left casing members 33 对应 are correspondingly fitted to the upper portion 323 to form a main casing portion designated 340. Similarly, the right upper housing member 32 upper upper grip portion 324 mates with the lower housing member lower grip portion 344 to form a grip portion generally designated 342. In the embodiment illustrated in Figure 7, the entire grip portion 342 is integrated with the main housing portion 34A. 15 Such a configuration may be particularly suitable for applications where the pressurized gas source is permanently mounted within the grip knife 342. This configuration is also suitable for use in a control assembly in which the pressurized gas source is coupled to the handle assembly via one or more ports on the housing assembly other than the handle assembly 300. In other embodiments, as will be described in more detail below, the grip portion 342 is detachable from the main housing portion 34A. As the detailed description of the present invention 20 proceeds, this configuration provides a number of benefits and advantages. However, those skilled in the art will appreciate that the handle assembly 3 can be provided in a variety of different shapes and sizes. For the sake of simplicity of the drawing, Fig. 7 only illustrates the components for controlling the axial movement of the closing tube assembly 17 of the opening and closing of the final control anvil. As shown in Fig. 20 eth96425 - om. 200808254, a closed shuttle 400 coupled to the closure trigger 3〇2 by a link assembly 430 is supported within the main housing portion 34〇. The closure shuttle 4 can also be fabricated as two sections 4, 2, 4, 4 that are molded or otherwise fabricated from a polymer or other suitable material and designed to fit together. For example, in the example of the yoke shown in Fig. 7, the right portion 402 can be provided with a fastening pin 403 designed to be received in a corresponding socket (not shown) of the left portion 404. The right and left portions 402, 404 can be otherwise held together by fastening members and/or adhesives and/or bolts, screws, clips, and the like. As shown, a stop groove 196 is provided in the proximal end 1 of the proximal closure tube section i9〇. The right portion 402 of the closure shuttle 400 has a right stop flange section 405 adapted to engage with the left side portion 4〇4 of the closing shuttle 4〇〇: a left stop flange section ( Cooperating to form a stop flange assembly extending into the retaining groove 196 of the proximal closure section 190. Also shown in Figure 7, a right ridge assembly stop post 326 extends inwardly from the right casing member 15 320. This post 326 extends into an elongated slot or window 406 in the right portion of the closed shuttle. A similar closed shuttle stop post (not shown) extends inwardly from the left casing member 330 and is intended to be received in another window or slot 4 〇 8 of the left portion 404 of the closing shuttle. These stop posts are used to immovably secure the proximal end 133 (not shown in Fig. 7) of the near (four) 20 segments 130 to the handle assembly 300 while permitting the closure shuttle 40 to move relative to the handle assembly sleeve. The stop post can be mechanically attached to the proximal end of the proximal spine 13 by, for example, a bolt, a screw, an adhesive, a snap feature, and the like. Further, the closing shuttle 400 is provided with laterally extending guide rails 41A, 4n. The obstruction 41 is constructed to be slidably received in the right side of the right casing member 32, eth96425 - finished bare 200808254 and the rail 411 is constructed to be slidably received in the left casing member 33 Guides (not shown). Ίο 15 20 The closing shuttle 400 and the closure tube assembly 170 are moved in the distal direction (the axial movement of the arrow ^ is generated by the closure trigger 302 moving toward the grip portion 342 of the handle assembly 3〇〇, and the closing shuttle 4 is The axial movement in the proximal direction (arrows, 〇") is caused by the movement of the closure trigger 3〇2 away from the grip portion 342. In each of the cases, the closure shuttle 400 is provided with a closed link assembly. 430 is attached to its connector tab 412. See Figures 8 and 9. The closure link assembly 430 includes a yoke portion 432 that is pivotally pinned to the connector tab by a pin 414. In the case of 43 〇, the closing arm %μ, the child closing port # is not pivotally pinned to a vehicle assembly 3〇4 formed on the closing trigger 302 by a closing pin 436. 3〇2 is pivotally mounted in the handle assembly 3〇〇 by a = male shaft pin 306 extending between the right casing member 32G and the left casing portion. When the bed doctor wants to close #4G To clamp the tissue into the terminal 12, the clinician pulls the trigger 302 to the grip portion 342. As the clinician pulls the closure trigger 302 to the grip portion 342, closed people and corpse her ^ 430 according to the far side, c" Fang 妒 red „ talent even cup assembly 430... two shuttle 4 〇 0 until the closed link assembly is private until the locked position shown in Figure 8. At this, = 430 will tend to hold the closed shuttle = please move to the locked position, close the tube assembly 2: the through side moves, causing the closing/opening of the tongue and the tube section 180 on the anvil 40 The closed side of the closed side is closed to the closed (clamped) position ^ 5 and the proximal end is touched to pivot the stone 〇 25 25 25 25 25 25 25 2008 2008 2008 2008 2008 2008 2008 2008 2008 2008 2008 2008 2008 2008 2008 2008 2008 2008 2008 2008 2008 2008 2008 2008 2008 2008 2008 2008 2008 2008 2008 The closure trigger 302 can be provided with a releasable locking mechanism 301 adapted to engage the grip portion 342 and releasably retain the closure trigger 302 in the locked position. It is also possible to releasably hold the closure shuttle 400 in the locked position using other locking devices. 5. In the embodiment illustrated in Figures 8, 8A, 8B, and 9, the closure trigger 302 includes a flexible longitudinal arm 303 from which a lateral pin 305 extends. The arms 303 and pin 305 may, for example, be Made of molded plastic, the hand grip portion 342 of the handle assembly 300 includes an opening 350. The opening has a laterally extending wedge 352 therein. When the closure trigger 302 is retracted, the pin 305 engages the wedge 10 352 and the pin 305 is forced downward by the lower surface 354 of the wedge 352 (and even if the arm 303 is clockwise Directional rotation. When the pin 305 passes completely through the lower surface 354, the clockwise force on the arm 303 is removed, and the pin 305 is rotated in a counterclockwise direction to cause the pin 305 to rest in one of the recesses 356 behind the wedge 352 to lock and close. Trigger 302. Pin 305 is further retained in the locked position by a slidable stop 358 15 extending from wedge 352. To unlock the closure trigger 302, the operator can further pressure the closure trigger 302, causing the pin 305 to engage one of the openings 350 to tilt the rear wall 359, forcing the pin 305 up through the squeezing stop 358. The pin 305 can then freely exit one of the upper channels of the opening 360 such that the closure trigger 302 is no longer locked to the hand 20 gun grip portion 342. Further details of this configuration can be found in the application of the certificate of January 31, 2006, to Shelton, IV et al., entitled "Surgical Instrument Having A Removable Battery", US Patent Application Serial No. ll/344,020 The relevant portions of this patent application are incorporated herein by reference. Other release lock configurations are also available. 23 eth96425 - Finishing 200808254 In various embodiments of the present invention, the tool assembly 30 can have a generally rigid piston rod portion 35 that is connected from 1 ===: the piston rod portion is a portion of the transmission member 500 that is The distal ridge segment 110 can fall 5 Γ::= contraction motion). In the embodiment shown in Figures 3, 4, 10, and 11, the cow 500 includes a two-stage pneumatically actuated cylinder assembly 501. 30 may include a one-piece assembly or it may be provided in multiple parts to facilitate 10 Γ ο including right. For example, as shown in FIGS. 1A and 11 , the arbor assembly 2 / pin 32 , the cap 34 , the intermediate pin 36 , and the knife 38 The far end of the stem is the hole 33 of one of the projections 37. The Qiu class m force is stored in the hole 33 and/or by the adhesive agent, the splicing i 15 two r: near = 2 = body XI yi zh, the long pass into the brother of a rolling cylinder housing 510 two channels / 16 a first open distal end, including a first rolling cylinder housing 520, the second cylinder housing having a 20, a closed proximal end 522 having a first piston head 528 formed at 1 'the younger brother- The piston head is driven by a second, cylinder housing 51 with respect to the first axial direction. The first wall 511 produces a proximal nip 515 that is substantially distal to the first piston head 528. The first far side 4 of the first cylinder housing 510 has an inwardly extending first flange 517 formed thereon, the first eth96425-finished 24 200808254 flange for sliding tightly with the second cylinder housing 52 The seal defines a second cylinder region 518 between the proximal side of the first gas scorpion flange 517 and the first living head on the surface of the first bulge. The live base is like _, and the 527 passes through the first piston 5 528. 10 and η, the proximal end of the movable base rod 35 extends through the second cylinder housing end 524 into the second axial passage. The 3 ί type is attached to the proximal end of the piston rod 35. The second piston head 530 =: the two axial passages 526 are sized to create a substantially airtight sliding seal with the second cylinder housing-wall 521 to define a second rainbow zone 532. The second distal end of the second gas red housing 52 is more like an inwardly extending second flange 525 for: the base cup 35 is established - substantially hermetic sliding seal to be in the second A fourth cylinder region 534 is defined between the proximal side of the flange μ and the distal side of the second piston head 530. 15 20 As shown in Figures 3 and 4, the cylinder assembly 5〇1 is mounted within the distal spine section ο. In various embodiments, a pair of trunnions 519 are provided at the proximal end of the first cylinder housing 51〇. The trunnion 519 is received within the trunnion aperture ιι 9 of the distal spine u〇 to enable the cylinder assembly 501 to pivot about a pivot axis within the distal spine segment 。i 。. See Figure 3. First The gas supply line or the air supply duct = 0 extends from one of the handle assembly 3's directional control valves 61 (Figs. 8 and 9) to the first proximal end 512 of the first cylinder housing 51. The side closure section 190 is configured to supply pressurized gas through the first cylinder housing 5 to the first first gas inlet 512 or the first gas supply port 513 or opening. See Figures (3) and n. In addition, a first gas supply line 542 extends from the directional control valve 61 0 through the proximal closed official section 1 90 and is near the distal end 5 of the first cylinder housing 5 25 25 eth96425 - complete ίο 15 20 200808254 = connected ^ first cylinder The casing is controlled to pass the pressurized gas into the cylinder area 518 via the second port 529. Referring to Figure 8-n, the elongation and retraction of the firing mechanism or the tool assembly 3 will be described in detail. 8 and 9, the gas supply line 5, the directional valve (4), which is mounted in the handle housing as part of the system 600. In various embodiments, the valve may be hunted by - The switch housing 612 or button can be used to switch between the forward (elongation) and reverse (retraction) positions by means of a selector switch 612 or button. See Figure 1. In the embodiment shown in Figures 8 and 9. A removable pressurized gas source 620 is used. As will be described in more detail below, 'such a pressurized gas source includes a gas cylinder 622 that may be refilled with a preferred pressurized gas. However, those skilled in the art will It is understood that a non-replaceable/re-inflatable pressurized gas source (a gas cylinder) can also be utilized effectively. In still other embodiments, the handle assembly 3 can be provided for supply from an external pressurized gas source 618. For example, the pressurized gas port 616 can be coupled to the compressed air supply 618 in the facility through a flexible gas supply line 6丨7. See Figure 8B. The removal will be described in more detail below. / Unique renewed view of the refillable gas cylinder 622. However, in order to explain the piston rod 35 and the tool assembly 3〇 Elongation and retraction 'It can be seen from the figure that pressurized gas flows from the gas cylinder 622 (or external pressure source 6 8 ) through the gas supply line 65 5 into a variable force driver that may include a conventional proportional valve 660. And specifically shown in 55, the proportional valve 660 is coupled to a gas supply link 662 attached to a start trigger 67. In the present specification, ', the variable force drive assembly" includes at least a proportional valve 66〇 and The trigger 670 and its corresponding equivalent structure are activated. In various embodiments, the trigger 67 〇 26 eth96425 - finished 200808254 f is supported near the firing trigger 31Q 'the firing trigger by means - on the right side a component 320 and the left machine A pivot pin extending between the shell members 33 is pivotally mounted to the handle assembly 300. Opening the trigger 67 〇 inwardly to the firing trigger 3 10 会 pressure causes the proportional valve 66 〇 to increase the flow of pressurized gas from the gas cylinder 5 622 into a supply line 68 耦 coupled to the directional valve 61 〇 rate. Depending on the position of the directional valve 6H), pressurized gas may flow into the supply line 54A or 542. For example, when the directional valve 6 is actuated by the clinician to fire the tool assembly 30, the pressurized gas is allowed to pass the first of the first piston heads 528 through the supply line 540 after the start trigger 67 is actuated. The opening 527 enters the first cylinder region 515 and flows into the third cylinder region 532. As the pressurized emulsion enters the third red valley 532, the second piston head 53 urges the piston rod % distally. The gas located in the fourth cylinder chamber is discharged through the exhaust port 523 of the second cylinder housing 520. Similarly, the gas contained in the second cylinder region 518 is permitted to be discharged into the second gas supply line through the second opening 529. 15 The second gas supply line 542 sends the exhaust gas to the directional valve 010, and finally, the f is pulled out. . The continuous application of pressurized gas to the first cylinder region 515 and the f three cylinder region 532 causes the tool assembly 30 to extend completely through the terminal action: 12. The cutter assembly 3 is passed through the end effector 12, which cuts the final assembly into the medium-clamped tissue and fires the staples in the nails (which drive the staples into contact with the lower surface of the anvil 40) . Once the tool assembly 3 has been advanced to its most distal position within the end effector 12, the clinician releases the activation trigger 670 to interrupt the application of pressurized gas. To retract the firing mechanism or tool assembly 30, the clinician manually moves the selector switch 612 or the appropriate button to adjust the directional valve 61 成 to the retracted position ^ eth96425 - Finish 27 200808254 ίο 15 20 Start pressing the trigger 670, The pressurized gas flows into the second gas supply line 542: the gas flowing through the second gas supply line 542 enters the second cylinder area 518', causing the i-th cylinder housing 52 to be retracted proximally into the first cylinder housing . f The gas in the cylinder area 515 is allowed to be discharged into the first supply line 'β via the first supply port 513. The gas from the state of the first gas supply line is oriented to the valve 6U) and discharged therefrom. Once the pressurized gas entering the second cylinder region 518 has caused the second gas red housing 52 to be retracted into the first cylinder housing 5Η as shown in FIG. 1A, the gas passing through the second opening 529 can pass the first The exhaust port 523 of the cylinder double body 510 flows into the fourth cylinder region. = the pressurized gas enters the fourth cylinder section 534' and the second piston head 53 〇 pulls the live soil = 5 into the second cylinder housing 52 往 proximally. The third cylinder section says that the gas enters the first cylinder zone 515 through the first opening 527 and is discharged from the cylinder-in-cylinder zone in the manner described above. In each of the examples in this month, a variable force actuator in the form of a proportional valve 66〇 is used to move the proportional valve 660 to the actuating position with a magazine or other biasing device (not shown). When in the unactuated position, the proportional valve 660 〇, , , ^ constitutes to prevent any gas from flowing from the gas source 620 or 618 through the valve 66 bore (not shown). Therefore, when the drive trigger 670 is in the inactive position, the device is essentially in a closed state. In the embodiment, the 'proportion wide 660 can be lightly connected to the start trigger _ by the air supply link arm 662 1 , so that when the clinician starts the trigger 67 挤压, the link arm (6) leads to The ratio 阙 _ (four) f rate increases through the valve 66G. Therefore, the quick squeezing start trigger increases the firing rate of the device and slows down the squeezing start trigger. eth96425-End 2008 28 200808254 The rate of 670 slows down the firing rate. Thus, the gas flow rate allowed to pass through the proportional valve 660 is substantially proportional to the manual force applied to the activation trigger 670. In other embodiments, the proportional valve 660 can be electronically controlled such that after the trigger is actuated, the ratio is 660 Digitally discharge gas. The proportional valve 660 releases a small amount of gas in a pulsed manner, and the trigger 67 is activated by a larger force, and the closer the pulse interval is. This configuration is used to selectively adjust the volume of gas used to actuate the device. Also, in still other embodiments, the drive mechanism can include a different type of mechanism that is not pivotally supported relative to the handle assembly as the activation trigger 67. For example, the trigger can be activated by a magazine drive slide switch or the like. Accordingly, the protection provided to these embodiments of the invention should not be limited to the use of a pivoting drive trigger embodiment. Further, in each of the embodiments, a pressure gauge 541 can be lightly coupled to the gas supply line 540 as shown in Figs. 8 and 8a. A window 543 can be provided through the handle assembly, a corresponding portion, to enable the clinician to view the dynamometer 541, or other configurations can be used to allow the clinician to be in use 541. See Figure 7. In the case of 夂 夂 丨丄 丨丄 丨丄 韦 韦 韦 韦 , , , , , , , , , , , , , 541 541 541 541 541 541 541 541 541 541 541 541 541 541 541 541 541 541 541 541 541 541 541 541 541 541 ^, In the back of the powers encountered by the company, it is necessary to activate some of the non-limiting examples of the firing mechanism. If this is also the force directly in the gas red assembly within 5 〇 1 can be activated. The other side is: fruit: move = force required to shake the milk cylinder assembly 501 eth96425 - finish 29 200808254 = ^ will have to release more gas into the cylinder assembly 5Gl fully actuated the firing mechanism. The pressure gauge is used to provide a proportional reading of the force the end effector is experiencing. The wooden business division is in the second of his road. This towering exit permit was released by the 詈 詈 540.闵 挪 挪 , , , , , , , , 汴 汴 汴 〆 〆 〆 〆 〆 〆 〆 “ “ “ “ “ “ “ “ 后续 后续 后续 后续 后续 后续 后续 后续 后续 后续 后续 后续 后续 后续 后续 后续 后续 后续 后续 后续 后续 后续 后续 后续 后续 后续

Si:: Association: Therefore _ provides feedback to the clinician. The sound of the force and the sounding force experienced by the final firing mechanism can also be used to automatically notify the clinician at the end of the firing of the firing mechanism (4). For example, if the test-two-limit_546 can be provided in the distal spine segment 11G to activate the member = ^ buried or otherwise attached to the firing bar 35 to reach the hit two: piece 54 mountain The 7f positioning causes the activation member 547 to be restricted when the firing bar 35 and the firing 546 detect the end of the cymbal. The valve is operatively coupled to the directional control valve 610 to illuminate the appropriate signal. ^ Can be constructed to automatically switch back to $ control valve 61 〇 In addition, the limit ❸ w permits the firing mechanism to be retracted. Instructions: - Sound signal, one view;;: Provided by the bed doctor Indicates that the firing mechanism has arrived at the firing:;: Two, the number of the combination, the pieces may include - the sound produces the farm =: end. For example, a combination of a light-emitting body, a vibration generating device, an eth96425, a full-length 30 200808254 == thing, or such a device. Restriction switch and associated control group: A battery (not shown) supported by the housing assembly can be supplied with power from an external source. Thus, the second or second non-controlling embodiment may be provided to provide the clinician with a view: or a trumpet signal indicating that the firing mechanism has reached the end of the firing stroke = and/or - for use in the firing mechanism The pneumatic force is automatically retracted to the device in the unactuated position. Ίο 15 20 Female mouth shown in Figures 4, 10 and u, the locking projection 39 can be formed on the piston: the department/part. When the tool assembly 30 is in the fully retracted arm 118 as shown in FIG. 4, a side ridge section UTR cylinder assembly 501 is applied to the distal end of the cylinder assembly 501. The trunnion 519 can be installed in a far-reaching manner. 2, the distal end of the cylinder assembly 501 is further advanced in the distal ridge section 110, causing the lock projections 39 on the piston rod 35 to fall into the tur lock opening 21. This configuration is used to bring the ϋ out of the retracted position by the frictional engagement of the locking portion and the long groove 2G portion of the oil-forming, locking opening. As shown in Figures 10 and 11, the locking projections are: 易 斜 斜 斜 斜 斜 斜 斜 斜 斜 斜 斜 斜 斜 斜 斜 斜 斜 斜 斜 斜 斜 斜 斜 斜 斜 斜π π-bar locking arrangement without departing from the invention includes a diagram exemplifying another embodiment of the invention in which the transmission member 500 5〇1 is similar, the sound of the sound, the structure of the heart cylinder, and the configuration of the cylinder Chengzhong, use ^ text to explain. For example, in the present embodiment, the piston rod 35 is retracted by 850, 852. As shown in Figures 12 and 13 eth96425 - 稹 31 200808254 The second cylinder assembly 800 includes a - first housing 81 〇, the first housing having a first closing 812 and a penetrating first air supply 埠 813. A first air supply, spring path 840 is attached to the first closed end 812 to supply the additive gas through the first:: gas 埠 813. In this embodiment, the first cylinder housing 81 is not closed to the second opening 529 mentioned in the various embodiments. The second cylinder housing 82 is slidably received within the first cylinder housing 81 and has a second closed proximal end 822 formed on the second closed proximal end. A first cylinder region = 15 is defined between the first closed end 812 and the first piston head 828. The first retractable spring 850 is provided on the first piston head 828 and is formed on the distal end of the cylinder housing 810. Between the first flanges 817. The first retracting spring 850 is used to bias the second cylinder housing 82 to the retracted position in the first cylinder 8/0 as shown in FIG. The piston rod 35 has a predetermined size for entering the stepped end 35 of the second end portion 824 of the first cylinder formation 82G. A second flange 825 is formed on the second distal end 824 to create a substantially side seal with the piston rod % step 15 > - A second piston head 83 is provided on the proximal end of the stepped piston rod section 35 to define a third cylinder zone 832 between the second piston head (4) and the first piston head 828. A first opening 8" 27 penetrates the first piston head 828 to allow air to pass between the first cylinder region 815 and the second cylinder region 832. - a second retracting spring (four) is provided between the second flange 825 and the second piston head 83A as shown in Fig. 12 2 to bias the second piston head 830 and the stepped piston rod 35, as shown in Fig. 12. Move to the fully retracted position within the second cylinder housing 820. This embodiment of the present invention can be operated in the following manner. As shown in Figure 16, the handle assembly 300 is provided as previously described - a replaceable pressurized gas source 62A. However, the cooked eth96425-end 32 ίο 15 20 tool assembly 30 has been advanced to its most distal position within the end effector 12. The e-bed physician releases the activation trigger 670 to interrupt the application of pressurized gas. To retract the firing mechanism or tool assembly 3, the clinician moves the orientation selector switch 612 to the reverse (retracted) position, wherein the first gas supply line 200808254 will understand that the technique can also be used effectively. Can not change the I gas source (when the baby bottle is smashed). In still other embodiments, the handle assembly 3 can be provided with a control compartment 61 and a corresponding group (four) source 618. See Figure 16 eight. For example, the appliance material is passed through a flexible supply line 617_ to the compressed air line of the facility. To operate the appliance, the clinician will orient the control valve selector switch 612 (Fig. or button to the advance (elongate) position and begin to squeeze the trigger 670, permitting pressurized gas from the gas cylinder 622 (or external source Μ The third pressurized gas flows from the first gas supply line 84 through the first gas supply port 813 into the first cylinder region 815 through the gas supply line 680 through the directional control valve 61 and flows into the gas supply line 84, through the first opening 827. Flowing into the third cylinder zone = 2. The gas entering the third cylinder zone 832 causes the second piston head and the stepped portion 35 of the base cup 35 to move distally. The second piston head has moved to a fully extended position ( After Figure 13), the gas continuing into the first cylinder zone 8 biases the second housing 820 to its fully extended position. Once 840 is connected to one of the directional valves 61, the third venting zone and the third The gas in a cylinder region 815 is allowed to be discharged into the gas supply line 840 via the first gas supply line 813 and finally discharged through the directional valve 610. As the gas leaves the third cylinder region 832, the second retraction spring 852 causes the piston rod The stepped portion 35' of 35 is retracted into the second cylinder casing In the same way, with the gas eth96425-complete 槔33 200808254 body second shrink spring 850 makes the second "shell also in this embodiment" a pressure gauge 54 丨 J and solid 彳 Α β Α 5 10 15 20 = Defaced to the gas supply line, the pressure gauge can be used as described above and used to provide the clinician with the end effector being subjected to a proportional reading. In other embodiments, an acoustic outlet 545 is as supplied In line 840, the sound outlet can be provided to the shouting physician as previously described - to monitor the sound feedback mechanism of the firing force experienced by the firing mechanism. In the second: a limit switch 546 ( Figure 15) μ is provided on the distal side and within 0 to detect an activation member 547 (Figs. 12 and 13) embedded in the firing bar 35, thereby automatically controlling the directional switch 6ι and indicating that the firing mechanism has reached the firing stroke A visual and/or audible signal at the end. Further, in another embodiment, the transmission member includes a corrugated official assembly 900. The bellows assembly 9 can be attached to the knife cup. The distal end of the distal portion of the assembly 30 is 3〇2. The protrusion 904 is formed thereon, and the protruding orbiting hair is larger than the size of the sputum for accommodating in the portion = 3^=33. The protruding portion 9〇4 may be received in the hole by friction and/or The fine portion 31 can be constructed as described above. The distal portion 31 can also be constructed as described above. The corrugated official assembly 900 further includes an expandable person retracting the bellows portion 91 〇 'this portion is sized for use The bellows passage 117 is elongated and retracted in the distal ridge segment as shown in Fig. 18. The bellows portion 910 can be formed as shown in Fig. 20 without the wire restraining ring 9 i2 and attached to a base portion eth96425 - Finish 34 200808254 5 10 914 'The base portion is immovably attached to the distal ridge segment 11 〇 or includes the body portion of the distal ridge segment 11G. The base 914 can be attached to the distal spine section 11G by an adhesive, a screw or the like. The air supply port 916 passes through the bellows base 914 and a gas supply line 940 is attached to the air supply port 916. The gas supply line 940 is also connected to the orientation control room 61 in the handle assembly 300. Referring to Figure 21, the 21A directional control valve 610 is also in communication with a vacuum port 92 安装 mounted in the handle assembly 300 via a vacuum line 922. The vacuum 埠 92 〇 example (4) can be attached to a vacuum source 63 藉 by a flexible line 632. This vacuum source can be a permanent vacuum supply line in the facility. A flexible vacuum line M2 can be coupled from the crucible 920 to the vacuum source 630 to allow the clinician to freely manipulate the appliance. It can be configured with the closure tube assembly 17〇 and the closure trigger 31〇 described above. Thus, the tissue can be clamped in the end effector 12 in the manner previously described. After the tissue has been clamped into the terminal effector 12, the clinician can = slap the slap. The clinician moves the selector switch 612 (Fig. 1) or button for the orientation control room (4) to the advance (elongation) position and begins the squeezing start trigger 670. As the start trigger 67 is squeezed, the proportional valve _ permits pressurized gas to flow from the pressure source (10) (Fig. 21) or 618 (Fig. 2) to the directional control valve 61. The directional control valve 61 allows the pressurized gas to flow through the supply line 940 into the bellows 91, causing the bellows to extend distally. As the bellows 910 extends distally, it drives the cutter assembly through the end effector 12 to sever the tissue clamped by the end effector' and drives the staples 70 within the nail curse into forming contact with the bottom surface of the anvil 40. After the tool assembly 3〇 has been brought to its farthest position in the end effector 12, the eth96425 is completed. 200808254 The bed physician releases the start trigger 670. To retract the tool assembly 3, the clinician moves the selector switch 612 for the directional control valve 610 to the retracted position to permit the vacuum source 630 to be coupled to the gas supply line 940. Applying a vacuum to the supply line 940 causes the bellows 910 to retract to its retracted position as shown in FIG. After the 5 corrugated officer 910 has been fully retracted, the clinician can move the selector switch 612 or button to a position that causes the directional control valve to stop applying vacuum to the supply line 940. However, the residual vacuum in the gas supply line 940 can be used to maintain the bellows: 1 在 in the retracted position. In the embodiment shown in Figure 21, a removable source of pressurized gas 10 620 is used. As will be described in more detail below, the pressurized gas source includes a gas cylinder 622 which may be refillable. Those skilled in the art will appreciate that an irreplaceable/refillable pressurized gas or pressurized fluid source (a gas cylinder) can also be effectively utilized. In other embodiments, the handle assembly 300 can be provided with a port 616 for supplying pressurized gas to an externally pressurized gas source. For example, the appliance 1 can be coupled to the compressed air line of the facility through a flexible air supply line 617.夂 See Figure 21A. In the same embodiment, a pressure gauge 541 can be fluidly coupled to the gas supply line 94A as shown in Figures 21 and 〇. The pressure gauge can function as described above and is used to provide the clinician with an end effector. The ratio of the 2 〇 of the force ^ is proportional. In other embodiments, an audible outlet can be provided in the air supply line 94 as shown in FIG. 2 JR, and the sound outlet can be used to provide a clinician with a function to monitor the transmission system 5 as described above. The sound feedback machine that has withstood the firing force experienced by the second-most mechanism is only awkward. In other alternative embodiments, the limit switch 546 (Fig. 18) can be provided in the distal eth96425-end 36 200808254 ridge segment 110 for detecting - oil (the plan, thereby automatically setting the 900 The starting component commits, the hair mechanism or the tool assembly 3. The sound signal is provided to indicate the sound. I 仃 仃 钿 5 10 10 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 5 10 5 5 10 10 10 10 图 10 — — — — — — — The abandonment end effector 12 is removed. The 4-inch new Pubei can use the end effector 12 and the front diagram of the present invention. Any of the transmission members 500 in the order of each of the monks is used. The actuator 12 can be a disposable shaft assembly 1010, the distal shaft pinching her π ― 丄 about the 遂 side of the 猸 pull report into a bad can be marked by a whole 10 (9) ^ unique new secret joints detachable pure In the near-side coffee. Once the end effector 12 has been used, the terminal action = and the basin side shaft assembly can be removed from the proximal shaft total: delete: can be discarded. Then can be - together with its own distal The shaft assembly is detached and the new sterile end effector 12 is attached to the proximal shaft, and the assembly is completed to complete another The procedure is as follows. As will be described in detail below, the distal shaft assembly 1010 includes a distal ridge segment ιπο and a distal closure tube region 4 and 117 proximal shaft assembly 1020 including a proximal ridge segment 11 $ 〇, one ^

The side closure tube section 1190 and a release sleeve 1200. The distal ridge segment 1110 cooperates with the proximal ridge segment 1150 to form a ridge assembly 20^30. In this embodiment, the distal spine segments 111 can be substantially identical to the distal spin segments 110 described above, with the difference that the respective proximal ends are different. Similarly, the proximal ridge segment 1150 can be substantially identical to the proximal ridge segment 130 described above, with the difference that the distal ends are different to allow the distal ridge segment 111 近 and the proximal ridge segment n 5 〇 to be non-pivotablely coupled together. Again, in this embodiment, the distal closure tube section eth96425 - complete 37 200808254 =0 can be substantially identical to the distal closure tube section (10) described above with the difference that the proximal end is different. Similarly, the proximal closed tube section ιΐ9〇 can be substantially the same as the previous section =: section 190 'the difference is that the distal end is different with 5 10 = side closure (four) segment 118G and the proximal closed f segment are said to be non-twisting each other Attached. As shown in Fig. 23, a lock spring 112 is mounted in the distal spine section 1110 as a means for the active base rod 35. The distal and proximal square holes uu, (1) 3 are formed on the top of the distal ridge segment 1110 to define a receiving lock spring therebetween, and the upper arm of the lock spring 1115 118: The said applies a downward force on one of the distal ends of the cylinder assembly. It should be understood that the mouthpiece embodiment may include other types of latching means or a proximal end Ul4 having no latcher y at all with a distal connector portion 1116 formed thereon. See Figures 24 and 27. For example, as shown in Fig. 24, the right side connector σ knife 八 has a first remote air supply unit 1117 coupled to the first air supply line section 540. A second distal supply port 112 is provided in the distal connection portion liy and is coupled to the second supply line segment (4). As shown in FIG. 23, the first air supply line section 54 is lightly connected to the first air supply port 513 and the second air supply line section 542 of the first cylinder housing ho, and the second casing 5H is consumed. The second gas supply enthalpy (2) in the distal end. A first air supply nozzle portion 1118 projects from the first-distal air supply port 1117 in the proximal direction as shown. - The second air supply nozzle portion 1122 protrudes outward from the first side of the air supply port n2G. Similarly, the distal end U52 of the proximal ridge segment 1150 has a second connector eth96425-38 200808254 portion 1154' the second connector portion has a road segment 540, the first near gamma a step 1, Chaos, mercury φ # , /, gas 皋 I156. The second connector portion 1154, the other second gas supply line section 542, has a second proximal side t, 矹埠 1160. The first proximal air supply port 接收 ΐ 接收 接收 接收 接收 接收 接收 接收 接收 接收 接收 接收 接收 接收 接收 接收 接收 接收 接收 接收 接收 接收 接收 接收 接收 近 近 近 近 近 近 近 近 近 近 近 近 近 近 近 近 近 近 近 近 近The second air supply nozzle 112 2 is received in addition to the ground. As shown in Fig. 2, ο π - a _ mouth 4 and 27 do not, a first 〇 ring seal 1158 盥 ίο 15 20 brother: near: air supply 埠 1156 combined to insert the first nozzle 1118 first; The gas cylinder 1156 (four) forms a substantially airtight (or liquid-tight) seal between the first gas supply line section 540 and another first::=:f 540". := When the faces are joined together, the first The gas supply line section is "Ο, and thin, gas supply line 540. Similarly, the second 0 ring seal _ 21, the shell 1 ', the gas raft 1160 is combined to be inserted into the second gas supply line section 542 when the second gas supply nozzle 1122 is inserted into the second gas supply line section 542, and The other brother - the gas supply line section 549" less bow: 丄,. ~ ^ only) 42 forms another substantially airtight (or liquid mountain mountain closed field in this way when the second gas supply The line segments: 42 and 542" form a second gas supply line 542. Familiar =; = his detachable shank configuration, quick release configuration, the first supply line and another first gas supply line segment 540 Removably connecting the money second gas supply line section 542 to the other: the gas supply line area 542, the soil is removably connected without the spirit and scope of the present invention. 1116 and the proximal connector portion 115 4 can be constructed to be coupled together in an orientation. For example, as shown in Figure 24, the distal connector portion 1116 can be configured with a proximal connector portion. Eth96425-End 39 200808254 Another notch portion 1 of one of the notch portions 1155 of 1854 is ensured that the first nozzle 1118 is engaged with the first proximal side = 5 10 1 during installation 5 is joined to the second proximal air supply port 116 by a two nozzle m2. This novel attachment arrangement prevents the first nozzle 1118 from accidentally attaching to the second: the gas supply magnolia and the second nozzle 1122 are accidentally attached to the first Neck 1156. Other key type configurations can be utilized to ensure that the distal connector portion UK盥 side connector portion 1154 is coupled in the correct orientation. As also shown in Figures 24 and 27, the distal ridge segment 115 has a distal end ιΐ52- a hollow sleeve portion 117G projecting distally. The hollow sleeve portion _ is sized to receive the proximal end ιι 4 of the distal spine 111〇 therein. To releasably lock the distal spine The proximal ridge segment 115〇, a pair of opposing suffocating members 1124 are formed on the proximal end η" of the distal ridge segment ln〇. The stop 1124 is positioned in the distal ridge segment 1110 via (iv) or otherwise formed. The flexible tab 1126 is such that when the proximal end 1114 of the distal ridge segment (1) is inserted into the hollow sleeve portion ι 7 of the proximal ridge segment 1150 and the first nozzle 1118 is sealingly coupled to the first proximal air supply port 1156 and When the second nozzle uni second proximal air supply port 116G is sealingly coupled, the f stop member (four) is housed in the hollow sleeve portion 1 170 corresponds to the opening 1172. See Figures 24 and 27 〇2〇» The following reference to Figure 24_27 illustrates the release of the distal closure tube segment 810 to the proximal closure = s zone & 1190. As shown in these figures The proximal end 1182 of the distal closure tube segment 1180 has at least two plug-type locking tabs 1184 projecting therefrom in a proximal direction. Each locking tab 11 has a tapered locking wedge 1186 formed thereon. The wedge is sized to be used in the proximal closure 40 eth96425 - in the corresponding locking opening 1194 of the tube section 1190. When in Figures 26 and 27

The tube assembly Π78 is on the ridge assembly 1〇3〇 according to the former ^ 1178. This configuration permits the various modes described above to be moved proximally and distally to open and close the anvil 4 on the end effector 12. To attach the distal shaft assembly 1010 to the proximal shaft assembly 1〇2〇, the user aligns the distal shaft assembly 1〇1〇 proximal ι〇ΐ2 as shown in FIG. The distal end 1〇22 of the proximal shaft assembly 1020 then inserts the distal end 1〇12 into the proximal end 10 1022. When the stop 1124 is received into the locking opening ι 72 and the locking wedge 1186 is received into the opening 1194, the distal shaft assembly ι〇ι is locked to the proximal shaft assembly 1020. The rocker 40 can be closed by pivoting the closure trigger 310 to the grip portion 342 of the handle assembly 3 by causing the closure trigger assembly 1178 to move distally by grasping the closure trigger 310 in the manner previously described. The shank % 15 can be actuated by actuating the trigger 67 依 as described above. To facilitate easy removal of the distal shaft assembly 1010 from the proximal shaft assembly 1〇2, various embodiments employ a release sleeve configuration. In these embodiments, a release sleeve section 1200 is slidably fitted over the proximal ridge section 115A between the proximal ridge section 1150 and the proximal closure tube section 119A. In various embodiments, the proximal end of the 20 release sleeve 1200 can be provided with a release button 12〇4 that passes through one of the proximal ends 1195 of the proximal closure tube section 1190. See Figures 22 and 31. This configuration permits release sleeve 12 to move axially distally and proximally on proximal ridge segment 1150 without obstructing axial travel of proximal closure tube segment 1190 over ridge assembly 1030. 41 eth96425-完稹5 10 15 20 200808254 钭切和图έ-Ζ: The month is not able to release the distal end of the release sleeve 1200 1202 inward:: increase the orientation so that it is adjacent to the proximal closed tube section ιΐ9 The opening of the second two openings is 1194. To release the distal shaft assembly 1010 from the proximal side, the user moves the release button in the slot 1196 to the distal side 冋 200 on the side. As the release sleeve 1200 = contacts the locking wedge 1186, the locking wedge (10) moves inwardly with the locking opening (10) in the proximal closure tube section u 9 ( (4) ^^^ finer in the distal direction The movement will cause the release, and the inner edge of the beveled inner edge 12〇6 contacts the locking stop 1124 w so that the lock of the alpha and the like is biased inwardly away from the proximal ridge segment 11::! Engaged to allow the distal shaft assembly 1010 to be disengaged from the proximal ridge assembly 1020. The embodiment shown in Figures 22-28 can be effectively used with the cylinder assembly # described above. The embodiment shown in Figures 29 and 30 can be used effectively with the previously described = cylinder assembly 800 or bellows assembly 9". As shown in Figures 3 and 3, the side connector portion 1116 has only a "mouth"! The fan is formed therein to be lightly connected to the air supply line portion 940. A first air supply nozzle 13 is shown as shown in the figure. The first-distal air supply port 1300 protrudes in a proximal direction. Similarly, the connector portion 1#154 has only one proximal air supply port 1306 coupled to the other first air supply line segment 9. The proximal air supply port 1306 is configured to removably receive the first air supply nozzle 1 therein. As shown in Figures 29 and 30, the 〇 ring seal 13 结合 is combined with the proximal air supply port 13 〇 6 to be in the first air supply line section 940 when the air supply nozzle 13 〇 2 is inserted into the proximal air supply port 1306. Forming a substantially airtight (or liquid-tight) seal with another first gas supply line section 940". When 42 eth96425-end 5 10 15 20 200808254 is coupled in a manner in a manner Take the _--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Road 940 can be based on the body. ', ~ into 800 or bellows assembly 900 to supply pressurized gas 2_ Figure: 1 shows - instead of the surgical cutting of the movable joint and the needle device π 〇 use! A = live joint assembly 2002 as described in the fairy 12 and the closed tube assembly. This embodiment can also be used with a ridged 赤Γ H. - as shown in Figure 33-35, the joint assembly 2002 package 4. The ridge assembly includes a distal ridge segment 2010 having a pivot 20 = projecting from the proximal end 2 〇 12 of the distal ridge segment. The spigot member is projecting from the sheet 2 〇 16 as shown in Fig. Cylinder assembly at The shaft 519 is pivotally mounted within the distal spine 2〇1〇. 20^, = 2〇14 is pivotally received in a pivot bearing pocket 2 formed on the proximal spine shield 2032 Within the crucible 34. The pivot member 2〇14 is free to be dragged relative to the proximal ridge member 2 〇3 about the pivot axis E_E. See Figure 36. As shown in Figure 35, the proximal ridge segment 2〇 3远端 distal end 2〇32=one groove 2036 formed therein to accommodate the first gas supply line 54〇, similarly, a second groove 2038 is provided at the distal end of the proximal ridge segment 2〇3〇 2032 is used to accommodate the second gas supply line 542. The gas supply line 54〇, the branch 2 bypasses the pivot bearing socket 2034 and enters the proximal end 2〇12 of the distal ridge segment 2〇1〇, which is described in various manners as previously described. Attached to the cylinder assembly 5〇1. It will be understood by those skilled in the art that a sufficient amount of relaxation of the supply lines 54〇= and 542 can be provided within the hollow proximal ridge 2〇3〇 to allow the distal ridge 2 to The 〇1〇 can be freely pivoted about the pivot axis E_E with respect to the proximal ridge segment 2030. By supplying the gas supply lines eth96425-43 200808254 54〇, 542 in the grooves 2036, 2〇38, respectively, these gas supply lines Will do To the axis of the closure tube assembly 170 relative to the ridge assembly 2〇〇4 ίο 15 20 also as shown in Figure 35, a first staggered air supply passage 2〇4〇 provides a 1 stem bearing to communicate with 2034. Similarly A second vertical air supply passage 2 is provided in communication with the pivot bearing housing 2〇34 as shown in Fig. 35. A third extension from the ampule in the handle assembly 300 of one of the switch assemblies 21〇〇 The gas supply line 'road handle 2042 is difficult to communicate with the first-right straight supply air passage, and the fourth supply air line 2052 from the switch assembly fan extension is in communication with the second vertical straight passage 2〇5〇. To assemble the joint assembly 2002, the pivot member 2〇14 is inserted into the pivot bearing socket 2034 and a cover 2〇6〇 is attached to the proximal ridge by screws 2〇62 or other suitable tie as shown. Paragraph 2〇3〇. Therefore, the pressurized gas entering the first vertical supply passage 2〇4〇 from the third gas supply line causes the distal ridge section 2010 to pivot with the pivot axis E_E as the center, and the ρ direction, and from the fourth supply. The entry of the pressurized gas into the second vertical supply port 2〇5〇 of the line 2052 causes the crotch side ridge segment 2010 to pivot relative to the proximal ridge segment 2〇3〇 with the pivot axis E_E as the center. See Figure 34. > Makeup Figures 37-45, the construction and operation of the switch assembly 2 of each embodiment will be described below. In various non-limiting embodiments, the switch assembly includes a switch block 211A having a supply port 2112 therein. The gas supply port 2112 is coupled to a gas supply line 651 for receiving pressurized gas from a pressurized gas source 62 (Fig. 44) or 618 (Fig. 45). In particular, a gas supply line 1 can extend from the gas supply line 650 to the cornice 2112. A switch cavity 2114 is provided in the switch block 2110 and is sized to pivotally receive a body portion 2150 of a selector member assembly 2130 therein. A pivot rod 2151 protrudes from the main 44 eth96425 - 撝 200808254 The bottom portion of the body portion 2150 is pivotally mounted in the pivot hole 2111 of the switch block 2 (10). See Figure 39. This configuration permit selector member assembly 213 is selectively rotated about the switch axis H-H. See Figure 38. A pair of 〇 % seals 2152, 2154 or other suitable sealing members may be provided as shown in Figures 5% and 5 to establish a substantially airtight seal between the body portion 215 of the selector member assembly 213 and the switch block 2110. A short rod 2156 protrudes from the main body; minute 2150 to receive a selector handle 2158. Rotation of the selector knob η% causes the body portion 2150 to rotate within the switch cavity 2114. As shown in Fig. 39, the air supply port 2U2 and one of the air supply passages of the switch block 2110 are connected to each other, and the air supply passage communicates with a header box region 2118 which is also formed in the switch block 211A. The body portion 215 of the selector member assembly 2130 has a penetrating central air supply port 2 i 6 连通 that communicates with the tube header region 2118. A third air supply passage U is provided in the switch block 2110. See Figure 4〇. The third air supply passage (9) extends between the 15 switching chamber 2114 and a third air supply port 2044, and the third air supply line 2042 is attached to the third air supply port. Similarly, a fourth air supply channel 2055 Provided in the switch block 2110 and extending between the switch cavity 2114 and a fourth air supply port 2054, the fourth gas supply line 2〇52 is attached to the fourth supply port. When the selector member assembly 2130 is as shown The positioning shown at 40, through the supply air 20埠2112, enters the switch block 2110 into the supply air channel 2116, and the pressurized gas enters the tube header region 2118 and may flow into the central air supply passage 216. However, the pressurized gas may be blocked. At the end of the central air supply passage 216. Therefore, it is in the 'off' position in Figure 40. To pivot the distal spine section 2010 to the right (opposite to the position shown in Figure 34) Finish 45 5 10 15 20 200808254 8 Guards pivots the selected member assembly 2130 to the position shown in Figure 41. As shown in the figure, the switch block 211 is accessed via the air supply port 2112, passes through the air supply passage Λ 2116, and enters the official box area 2118. The pressurized gas inside is passed through the central air supply brake to the second air supply passage 2045 and the third air supply line 2〇42 2=4 plus the body flow first in the straight air supply passage chest and contact the frame, 6,, 2014 on the drive piece 201 6 to force the pivot member 2〇14 to move in a direction. The driver piece 2〇16 The pressurized gas on the opposite side enters the straight passage 2050 and flows into the fourth gas supply line 2 () 52. As the additive enters the fourth port 2〇54 in the switch block 2110, it flows into the fourth, milk. The second exhaust passage 2170 is connected to one of the selector member total & 2130 = ί 2150. See Fig. 43. Therefore, 1 is passed through 2055 and flows into the main body portion 215A. The pressurized gas in the four gas supply line 2052 is discharged through the fourth exhaust passage μ% and is discharged outside the switch via the undercut exhaust region 2丨55. The pure yang is pivoted to the distal ridge segment 2〇10 to the target 34 When the position is indicated by the patient, the clinician ^ 隹 择 selector member assembly 213G causes the central air supply passage 2160 to extend between the official two tank area 2118 and the fourth air supply passage 2 〇 55. Therefore, the milk, the road 651 ☆ The pressurized gas entering the gas supply passage 2116 and flowing into the η" of the pipe collecting tank area flows into the fourth gas supply passage 通过 through the central air supply passage 216. The domain gas flows out of the fourth gas supply port 2054 to the fourth gas supply line. The fourth gas supply line 2〇52 transfers the pressurized gas to the second channel. As the pressurized gas enters the second misdirected gas supply The channel drive sheet 2016 pivots the pivot member 2014 in the Gy/direction. See Figure 34. The gas gas on the opposite side of the driver chip 2G16 passes through the first eth96425-46 200808254 vertical gas supply passage 2040 into the third supply. The three gas supply lines enter the first gas leaving the wood one, the hole is forced into 2045 and flows into the third exhaust passage 218 of the main part. Section: 5 10 15 Channel 2180 is oriented to vent gas through undercut venting zone 2155. Another unique novel feature of the present invention is the automatic neutral configuration that allows the clinician to lock the distal spine (and the end effector 12) in the desired position by simply releasing the selector switch handle 2158. . More specifically, the reversing stem 2190 constructed as shown in the figure is mounted in the switch block 2 (10) as shown in Figs. 4, 41 and 43. The spring 2190 is held in the switch block 211, and the opposing knobs 21 92, 2194 protrude from the bottom surface 2 113 of the switch block 2 110.弹 〇 219 〇 ^ Do not be held in the slots 2193, 219 " 5 of the rounded parts 2192, 2194. See Figure 43. As shown in Fig. 43, a return lever 2153 protrudes from the main body portion 215 of the selector member oil 2U0. The return lever 2153 is received between the free ends 2196, 2198 of the reversal ^ 2190. Figure 43 illustrates the body portion 2150 in a neutral or closed position. Thus, when the clinician wants to cause the end effector 12 to perform a joint motion, he or she rotates the selector handle 2158 to cause the main body portion 2150 of the selector member assembly 213 to move in the direction of rotation corresponding to the desired joint motion. 2 turbulence. When the clinician turns the body portion 215〇, it rotates against the force generated by one of the free ends 2196, 2198 of the return 箬 2190. Once the clinician has turned the terminal effector 12 to the desired position, he Or she releases the selector handle 2158 and the return spring 2190 moves the body portion 2150 to the closed position which ultimately causes the actuator 12 to remain in that position. If the clinician wants to tune eth96425 - finish 47 5 10 15 20 200808254 The positive terminal acts as a live motion position of $12, and he or she simply turns the selector handle (10) to obtain the desired position and then the pad = can hold the end effector 12 in that position. Use the diagram: 2::=9 Each non-limiting embodiment of the month is associated with the configuration of the switch 2100. As shown, a removable, two::it 6: 'gas flowing from source 62〇 through the gas supply line 65 0 /claw is used Go to proportional valve 660 and pass The donor time mei1, -r ΟΡΪ, 仏虱, 泉路 651 flows to the switch assembly 2100. In the embodiment shown in Fig. 44, the source 62A includes a replaceable/refillable gas cylinder 622, which The gas cylinder is supported within = 342. The gas cylinder 622 can be refillable. Two: = two effective use non-replaceable, refilling the service source (finance bottle). In other embodiments, the handle The assembly 3 can be configured to: supply the pressure of the pressurized gas from the external pressurized gas source 618. ::5:: ^ can be coupled to the facility through a flexible gas supply line 617 The milk line (not shown). See Figure 45. Figure 46_48 illustrates the joint joint her 忐2009 re? & ^:,, shape month m " " m 2GG2 configuration with the aforementioned t and structure The use of w quick release connector 1〇〇〇. However, four passes are used here. As for the private - soil T,,, heart, as shown in Figure 47, the transport side connector portion 1116 has a second-to-first air supply line section 54, the first distal air supply: - brother - The distal air supply port 112 is provided in the distal connector portion ι ι 6 in a second air supply line segment 542. - the first air supply nozzle portion I does not protrude from the first-distal air supply port 1117

7 The second air supply nozzle portion lm protrudes outward from the second air supply direction. w u W eth96425 - omni- tion 48 200808254 The distal connector portion (1) 6 further has a third distal air supply port 1117 that is coupled to a third gas supply line section 2042. A fourth distal air supply port 20' is provided in the distal connector portion 1116 and is reduced to a fourth air supply portion 2052'. - The third air supply nozzle portion ιι 8 is projected from the front side: the distal air supply port 1117' in the proximal direction as shown. A fourth air supply nozzle portion 1122' protrudes outward from the fourth air supply port 112'. Similarly, the proximal ridge segment 115 is located at the distal end 1152 portion 1154, and the second is remotely connected to the bus. The 刀 ^ knife has a first proximal air supply port 1156 coupled to the other first gas supply line ίο 15 20 ; The second connector portion ι 54 is coupled to the second t St 虱埠 1160 of the other second air supply line segment 542". The first proximal air supply port 1156 is configured to receive the first supply in the basin 1160t ^ a gas nozzle 1118, and a second proximal air supply port 112 7/& amp size for removably receiving therein: a gas supply nozzle 埠 1156 I figure 47 ^ ' a first ring seal 1158 and When a near-side air supply is in the first port, a nozzle 1118 is inserted into the first proximal air supply port 1156 540, and second, the line segment 54 is connected to the other-first air supply line section. One ^Second Μ (or liquid-tight) (4). When it is consumed in this way - the gas supply line burst = 54G, r compliant, the joint forms a gas supply 璋 116 〇 人 ” ” ” ” ” ” ” ” The side air vent 1 air supply nozzle 1122 is inserted into the second proximal side for sealing into another substantially airtight (or liquid tight) seal. When coupled, the second gas supply line sections 542, and 542" form a second gas supply line 542. 542 eth96425 - 穣 49 200808254 again "115 〇 distal end 1152 has a second connection The device portion has a third proximal air supply port 6 coupled to the other segment Γ2. The second connector portion is further connected to the other-fourth gas supply line section 5 and the lower-level air bee 116〇. The third near side is for...156,#_二= The privately-accepted brother 2 gas supply mouthpiece (1)8, 1160, has been set large], used to be too sweet and can be used in it. Removably receiving the fourth air supply nozzle as shown in FIG. 47, the third 0 ring seal 1158 is combined with the first air valve 1156 to provide 10 1156 on the near side of the third nozzle and the first one. Gas green, cockroach, bird 8 inserted into the younger side of the third gas supply 埠 在 在 在 在 在 在 弟 弟 弟 弟 弟 弟 在 在 在 在 在 在 在 在 204 204 204 204 204 204 204 204 204 204 204 204 204 204 204 204 At the beginning, the first H ^ = Μ (four). When the line is connected to the flute-striped line section 2042, and 2042", a second line 2042 is formed. The same, one first. Four near-side air supply 埠 116〇, the community to ^ flute 162 and the 15th near ^ gas 埠 116G, inside the fourth gas supply line section touch, four gas supply line section 2052, between γ ^ /, Brother sealed. When in this way, lightly connect = airtight (or liquid tight) and please, when formed together, 'the fourth gas supply line section is purchased, and other detachable light combination can be utilized... white, the technical person will understand 20 Spirit and scope. _ 、 斥 配置 而不 而不 如 如 如 如 如 如 如 如 如 如 如 如 如 如 如 如 如 如 如 如 如 如 如 如 如 如 如 如 如 如 如 如 如 如 如 如 如 如 如 如These questions can be easily solved by the difficult axis of the pneumatic system to be driven. :;=: Motor drives the rotary drive. The %-turn motion can easily be transmitted on a long, flexible or ^96425 50 200808254 movable joint drive shaft. Despite the tremendous progress that has been made in terms of capacity, the effectiveness of these systems: and the size of the torque side long shaft and the size of the shaft can be steeped to the far: or ... the size limit. In many; today: use: nail area = motor is positioned at the far end of the system with the same point as the following to solve the problems associated with the transmission motor and the lack of these problems, these examples use 1. > 10 15 20 Power transmission to - rotary driven inner cutter. Air motors typically produce a torque proportional to the pressure and volume of the gas to the motor and every eight; In the non-limiting embodiment shown in Figure 56, the -== rotary motion is transmitted from the air motor to the end effector. : A unique novelty of these embodiments of the present invention: there are other known rotary driven end effectors and other transmissions that use a flexible drive shaft configuration to transmit the rotary drive motion to the inner cutter. The unique novelty of using these two embodiments of the invention is effective: it is used in conjunction with a non-live type terminal effector configuration. Figures 49-56 illustrate a surgical cutting and stapling instrument μ (8) of the present invention utilizing a rotary driven internal cutter i 5! There are a variety of rotary driven internal cutters and other surgical instruments. For example, a rotary inner cutter configuration reveals the application for the certificate of Sheh〇n iv et al., and the Motor Driven Surgical Cutting and

。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 Other examples are disclosed in the US Patent Application (KLNG N〇5 〇 5〇) by Shelton, IV et al., entitled “Manually Driven Surgical Cutting and Fastening Instrument”. 704/END5779USNP) 'The relevant part of this patent application is hereby incorporated by reference. FIG. 50 is an exploded view of a terminal effector i5i2 according to various non-limiting embodiments. As shown in this exemplary embodiment, The end effector 1512 can include a long channel of a predetermined size for receiving a pneumatically operated tool. Each of the non-limiting embodiments of the pneumatic operating tool includes an internally operable firing mechanism, the needle g 5G. This embodiment includes —Wedge-shaped sliding rubber ς 1530 The skid assembly has a knife A 1538. The wedge-shaped sliding sample assembly = 3^0, onto a screw drive screw 156 。. A bearing located in the long groove: the distal end 1521 The 1522 receives the screw drive screw 156〇, allowing the screw 15 to rotate, and the moving screw 156〇 is free to rotate relative to the long channel 152. The screw drive screw 1560 can be threaded with one of the wedge slider assemblies 153〇 (in the figure = No) again Thus, causing the rotation of the drive screw 156 to cause the wedge sled total = 1530 to be translated distally or proximally between the fully extended or actuated position and the fully retracted or unadjusted position (depending on the direction of rotation) Passing the long/stop 1520' wherein the staples supported in the staples in the fully extended or actuated position have all been fired. Accordingly, the wedge sled assembly 153 is rotated when the screw drive screw 1560' is rotated. The ankle is driven distally through the 'T匣5〇 to cut the tissue clamped in the end effector 1512 and fire the staples in the staples 5〇 to pivotally couple the staples to an anvil that is pivotally coupled to the long channel 1520. 4〇eth96425-End 52 200808254 The forming surface of the bottom surface is formed. Wedge-shaped skid = lift: the column can be made of plastic, ... 5 2 = the form slip sample assembly 1530 across the long channel 152 to the surface (10) The elbow in the nail M 5G can be pushed up or the belt is woven and pressed against the stone to occupy 4 〇. The stone occupies 4 〇 turns the elbow, thereby nailing the cut tissue. When the wedge sled assembly 153 When the chin is retracted, the knife portion 1538 and the slide 3 can be separated to leave the slider portion 1532 at the long groove end. Those skilled in the art will appreciate that other pneumatically operated tools can be used. Other values: Μ An example of a drive shaft configuration for moving from the handle assembly 300 to the pneumatic motor to the helical drive screw (10). As can be seen, this embodiment can utilize the closure tube assembly 170 detailed in the text. The official assembly 170 is slidably fitted over a ridge assembly 154, which rotatively supports a main assembly. Rotating (or proximally) the proximal 5 side spine section 1542 of the drive shaft 1544 via the -including gears 1552, 1554, 1556 f oblique ui wheel, 4 into 1550 and primary (or distal) drive shaft 丨 5仏Contact. And the transmission shaft 1546 is connected to a transmission gear 1548 which is connected to one of the proximal transmission teeth * i (6) of the screw. The vertical bevel gear 1552 is pivotally supported in one of the distal ends of the proximal spine section 1542. The secondary drive shaft 1546 and the drive μ wheels 1548, 1554 can be closed by a distal spine 1570. In summary, the main drive shaft 1544, the secondary drive shaft 1546, and the joint assembly (such as the helical gear assembly 155 〇) are sometimes referred to herein as the main drive shaft assembly as shown in Figures 53 and 54. It is shown that each embodiment of the appliance 1500 is powered by an aerodynamic source in the form of a pressurized 53 eth96425-completed 200808254 gas source 620. The dried apricots in these patterns

The "Medium" source 620 includes a replaceable/refillable gas cylinder 622 within the grip portion 642 of the gas LI. The gas cylinder can be used for the purpose of dragging this technology. It will be understood that it can also be used effectively: the gas source (gas cylinder). In other embodiments, a 璋π 616 is provided for supplying a chaotic body from an external pressurized gas source. For example, the appliance ι can be lightly connected to the compressed air line of the facility through a gas supply line 6i7: see Figure 53. 1 , y , ίο 15 The details of the removable / refillable gas cylinder 622 are described in more detail in order to explain how the drive system provides rotational motion to the terminal: = 12' The ink gas passes under pressure from the gas cylinder 6 or the source 618 of the ^4 source for the 4-wire 465 (into a conventional proportional valve, the valve 660 is coupled to a supply trigger) Γ/62 n ® 53 and 58 ° In various embodiments, the start trigger 670 is supported in the vicinity of the - travel monitoring member or the relative position firing trigger, the trigger extending from the right housing member 320 to the left housing A pivot lock 37 is pivotally engaged between the members 330 to the handle assembly. The relative position trigger 3 10 can be made of plastic or other suitable material and has a portion of the 20-to-semi-shaped cross-face. Accommodate the starter plate as shown. The clinician can place his or her hand on the grip portion 342 of the housing assembly 3 such that the next three fingers are in the relative position of the trigger 31 〇, and the index finger position On the starter 670. The trigger 67 will be activated and the trigger will be moved inward relative position. 3 ^ Dusting will cause the ratio 66 〇 allows the gas to flow from the source 62 〇 under pressure (or eth96425 - 538 of 200808254 53A) through the valve to a gas supply line 680 into the directional control room 1610. 5 10 15 20 The directional control valve 161 has a forward position section 1620, a stop section 1630, and an inverted section 164. The control valve sections 1620, 1630, 1640 can be protruded by a button that passes through the handle housing 3 Manual switching with 1614. See Figures 49 and 56. Two supply/exhaust lines 1700, 1710 extend from directional control valve 1610 to a conventional air motor 1 730. Thus, when the clinician switches the control valve! In the advanced position, the forward passage 1622 allows the pressurized gas to flow from the supply line 68 to the supply/exhaust line 1700, causing the air motor 173 to drive the motor drive shaft 1732 in a first direction (which will be further detailed below). This causes the rotational motion to be transmitted to the drive shaft 1544, which drives the wedge-shaped skid assembly 1532 and the knife portion 1538 distally through the end effector bn during the firing stroke. The gas exiting the air motor 173 through the gas line 1710 is transmitted through - Exhaust 淳 two MM row When the control unit 1610 is switched to the inverted position, the gas passing through the supply line 171 is allowed to flow into the air motor through the gas supply line 171 (10). The gas passing through the air supply/exhaust line 1700 exits the air motor 1730. When the control room is in the stop position (10) and the air supply line _ is _ and the air supply line exhaust 埠 1632. See Fig. 56. 1700 is connected as shown further in Fig. 56, the output σ of the air motor 173 在 has a The first transmission gear 1734, the first-mounted-to-planetary gear assembly 1740 #2 is integrated with the moving gear (10). The second transmission of the planetary gear assembly (10) two = 1742, the transmission eth96425 - the complete name 55 200808254 = fine: the two-axis member 1743 is lightly connected to the proximal end of the transmission shaft (10):: the rotary motion is transmitted to the transmission shaft Near end. Therefore, when the control is advanced to the forward position 'the output of the air motor 173() is pumped 1732 through 5 10 = minus / 1736 and the planetary gear assembly 1740 will - rotate the motion plus = drive shaft 1544 to cause the wedge sled assembly (four) and the knife The portion 5 8 cuts the clamped tissue in the terminal fairy 1512 by the nail (4) and drives the solid nail in the t L to form contact with the stone core 40. When the control room 1610 \ to the 卞 position 'the output shaft 1 732 of the air motor 1730 applies a reverse = rotary motion to the drive shaft 1544 to retract the wedge sled assembly (10) and the knife/knife 1538 in a proximal direction By nailing 5匣. The embodiment shown in Figures 49-56 also has a more advanced and unique feature that enhances the operability of the instrument and provides multiple forms of feedback to the physician, enabling the clinician to monitor the wedge sled assembly 153 and the knife portion. Μ% The position within the nail when propelled and retracted distally within the staple 50. Referring again to Fig. 56, it can be seen that a feedback gear 175 is provided on the drive train 1544 or on the wheel exit 1742 of the ui wheel assembly 1740. The feedback gear 175 is engaged with a tool position gear PM mounted on a threaded knife position shaft 1754. The knife position axis 1754 can be supported by a suitable bearing arrangement (not shown) that facilitates its free rotation. A proximal limit switch 176A is coupled to the proximal end 1756 20 of the shaft 1754, and a distal limit switch 177A is coupled to the distal end 1 of the shaft 1754. A knife indicator 1780 is threaded onto the knife position axis 1754 for distal and proximal movement on the knife position axis. When the drive shaft 1544 is caused to cause the wedge sled assembly 1530 and the knife portion 1538 to rotate distally through the magazine 5', the knife indicator 1780 also moves proximally toward the distal limit switch 177. Eth96425-End 56 200808254 The metaphysical limit switch 1770 is oriented such that when the wedge skid 〇 53 〇 and the knife portion 1538 are in the most distal position, the knife indicator 178 〇 actuates the distal limit switch 1770. A window is provided to the left casing member 33A (or the right casing member 320曰, depending on the position of the knife position axis 1754 within the casing assembly 3〇〇) 5 so that the clinician can see the knife indicator 178〇 The position is used to determine the position of the firing mechanism (wedge assembly 1530 and knife portion 1538) within its firing stroke and to provide the clinician with means for monitoring the position of the wedge assembly 1530 during the retraction stroke. Also in various embodiments, a distal auxiliary line 1772 extending from the gas supply line 050 to the remote limit switch 1770 can be provided. - The distal limit switch ^1774 can be provided between the distal limit switch 1770 and the directional control valve 161. Thus, when the wedge sled assembly 1530 and the knife portion 1538 have completed the bursting process and the knife indicator 178 is actuating the distal limit switch 177, the distal limit switch 1770 exaggerates the flow of gas from the supply line 4 65 under pressure. To the far side, make the switch line 1 774 and flow into the directional control valve! 6! In the case, this would cause the directional control valve 161() to automatically switch to the inverted position in various embodiments and thereby cause the air motor 1730 to reverse and eventually apply a reverse rotational motion to the drive shaft 1544. When the air motor 173 turns the drive shaft 1544, the reverse rotational motion is transmitted to the knife position shaft 1754 to thereby drive the knife position indicator to move back toward the proximal limit switch 176. A proximal auxiliary line π" = can extend between the proximal limit switch 丨 66 〇 and the gas supply line 65 ,, causing the field position finger 178 〇 to actuate the proximal limit switch 166 〇 (meaning wedge, lunar skid When 1530 and knife portion 1538 have been moved to their fully retracted position), proximal limit switch 1660 thus permits gas to flow into a proximal limit switch line eth96425-end 57 200808254 way 1664 and flow into directional control valve 161 to cause orientation The control valve 1610 automatically switches to the stop position. ίο 15 20 In various embodiments, the first whistle 1790 or other suitable sounding device can be in communication with the distal limit switch line 1774 (or the distal limit switch 177 ,), resulting in When the distal limit switch 177 is actuated at the end of the firing stroke, the first flute 1 is provided to the clinician by the air of the retracting limit switch line 774 - the audible signal indicates that the wedge sled/tool has reached the firing stroke Similarly, the second whistle (10) or other suitable sounding device can be in communication with the proximal limit switch 176, such that when the proximal limit switch 1760 is actuated at the end of the return stroke, The air passing over the proximal limit switch line 1764 causes the second air sling 1792 to provide the clinician with another audible signal indicating that the wedge sled/tool has reached the end of the retraction stroke. In one embodiment, 'for example, the battery Powered LEDs or other episodes can be associated with the distal and proximal limit switches (7 (μ to provide the user with a Γ Γ 4 / when the tool has reached the end of the firing stroke and / or the retraction stroke = 2 ^ In an alternative embodiment, the 'air squirt 179 〇, 1792 can be replaced with a pressure sensing or pressure gauge to indicate the end of the squeezing stroke. 1 饤 饤 彳 彳 彳 及 及 及 及 及 及 及 及 及 及 及 49 In each of the implementations shown in Fig. 56, the air motor is supported by the handle 绚 located in the distal ridge η. The motor drive shaft (10), at the gear 1548, the transmission gear meshes with the whirl, and the capture is recognized. % is the proximal drive return wheel 1562 of the enemy screw 1560. Figure 52 exemplifies the use of the joint joint 104 described in the distal installation month ij. Figure 52: Β 者 二 己 己 己 己 己 所 所 13 Use the same as eth96425-finished 58 5 10 15 20 200808254 The head configuration can also be matched with Putian Gan ^ This temple is connected to the side of the women's air motor remotely installed pneumatic ^ ^ This artist will understand this; the power loss encountered in the configuration is minimized, and the == drive total The inner and the firing and retracting movements are connected to the actuators, such as Fig. 52 and 52ϊ^_; that is, the joints are transmitted to the terminal 1710 and the m〇 passes, and the mi 施 example requires only two lines and (10) may include powering the motor 1730'. Other embodiments of the line (7) 0 transmission member through the joint are not required and the array may be constructed to provide the user with a cry - this is by monitoring the trip, In the second embodiment, the drive shaft or firing mechanism at I is set to the 仏 仏 addition. More specifically, and referring to Figure 53_55, this? The linkage assembly 1800, the feedback linkage/example may include a feedback including a right disc, the main cup (10), in a non-limiting embodiment of the mouth, the feedback shaft 1801, the shaft may be attached by a thread Connected to -j: the ground is installed in the relative position trigger 31〇, which: connect: the universal joint part of the two-feed gear read, the branch is manually returned to the knife position gear 1752. Each of the fixed & μ feedback wheel meshes /15; ^j 1〇^ ^, the getter shaft 1544 causes the firing mechanism in the form of a wedge and a knife portion to be driven to the far second = eth96425 - 槁 59 5 10 15 20 200808254 τ! ft: private). The feedback gear 1750 drives the knife position gear 1752, while the jog = manual manual feedback gear _. Then manually return the gear τ port feed shaft, which is driven by the screw 334 of the nut 334, and pulls the relative position trigger 310 to the grip portion of the handle assembly 3〇〇 to provide the clinician with a representative wedge slip . And the knife section knife 15 3 8 advancement, negative reputation /, the community one touched the buckle. Those skilled in the art will understand that if the =2 = relative position trigger 310, toward the handle assembly 300 丨! The dynamic feedback shaft 1801 and the nut 334 will prevent any of its eves, and the relative position triggers, and will (4) automatically pivot and advance the retraction and retraction of the wedge slip 1530 裎: 1538. This configuration to the clinician === her grasp of the relative position trigger in the whole process: :,: r heart assembly 1530 and knife part 1538 (fired mechanism) Qin and 4: ί automatic tactile indication. Therefore, the clinician does not have to look at any of this to give this feedback. This configuration provides the clinician with the progress of the firing mechanism between the position and the activated position and when the firing mechanism has moved from the activated position to the unactuated position (10). Each of the embodiments can be further advanced with another contact feedback configuration labeled 333 as a whole. For example, as shown in Fig. 53.56, the relative position trigger, the plate portion 332 can be provided with a series of relative position triggers 31 经 designed to be pivoted and retracted during the pivoting, with the pin 37 〇 pivoted The slot 335, the cymbal, the cymbal and the like which are mounted at the interface of one of the spring arms 337 in the handle assembly 300, although the attachment plate portion 332 is pulled with the relative position, the end of the spring arm 337 is turned off. Insert into each of the sequential slots 335 and apply a force to the upper attachment plate portion M2 with 乂 (sequence). This force is in the clinical eth96425-end 60 5 10 15 20 200808254. The physician grasps (4) the position trigger 31G, Time (four) sensory. (4) ^Lathe trigger MG, advance, the clinician will get - _ the additional tactile feedback movement of the library in the firing, to confirm the relative position X (and the final firing mechanism) to push back between the firing strokes ' Under what circumstances. Also, as the end of the slinger 33 7 7 掉 掉 每 每 每 每 每 每 每 每 每 每 每 每 可能 可能 可能 可能 可能 可能 可能 可能 可能 可能 可能 可能 可能 可能 可能 可能 可能 可能 可能 可能 可能 可能 可能 可能 可能 可能 可能 。 可能 。 Thus, this embodiment provides a series of (f::) improvements in the firing mechanism between the inactive position and the activated position. Those skilled in the art will appreciate that the appliance (10) exhibits - far better than conventional air conditioning. It is to be noted that embodiments provide a means for the proximity sensor (wedge sled/tool) to be driven through its firing position. In some embodiments, when the wedge sled/tool 3 is at the end of its f-stroke Automatic retraction. Once in the fully retracted control valve, it can be automatically switched to the stop position to interrupt the air supply from the source (4) or = to the air motor 1730. However, if the bed chef wants to stop the wedge sled during the start-up process / The tool is pushed distally within the gas red or she can simply switch the control valve 161 () to the inverted position and 2 actuate the trigger 67 to supply the pressurized gas to the air motor 173G until the 2 slip/tool moves to the desired In addition, the unique and novel: the position trigger 31G' triggers the relative position trigger 31〇, 3 provides the clinician with a sensible manual or tactile feedback. In addition, the U teacher can slide in the wedge /The tool has reached the end of the firing stroke and/or has finished eth96425-Finished ίο 15 20 200808254 Acquires an audible signal when fully retracted. Newly resolved to the unique 500, 800 or bellows assembly provided by the stroke monitoring device _ Also: by:: push/pull flexible (not shown) or rigid embodiment) connect each of these transmission members to the upper attachment = Γ, 2 or relative position field 310, the other Partially causing these transmissions

The square, and the back ^ are directly or indirectly connected to the relative position trigger 310, cut. This unique and novel configuration can also be used in conjunction with the following examples. W: The "return link assembly 1" of L means not only corresponds to the firing machine: two movements; the rate of the rate automatically moves relative position plate 31. , provided by the teacher - to supervise the process of the organization, give back to the talents, and the heart can be used to use the singer +, 3 a s t, and the bed doctor will effectively block Or significantly limit Pro = manual pivoting relative position trigger 31G, the ability of the other == embodiment of the 'relative position trigger 310, will move the time 2 (four) the link assembly to make it move. In still other embodiments, one or seven of the seven can be used, or another gas cylinder (the unscrewing machine in the figure is opposite to the trigger 310' of the manual movement. For example, the emergence of the power of the start and the upper The gas is released, but before the firing machine f starts to move, the relative position trigger 3U) is not allowed to actually move and if the firing mechanism stops moving, the relative position trigger will stop. However, in other implementations, the feedback link assembly 1800 can also be built eth96425-finished 62 200808254 ==1: has the ability to move the sinusoidal components with the air motor during the firing stroke to facilitate clinical When the doctor wants to push the example, the second and second stop firing mechanism is promoted. In these embodiments, the threaded fitting f^1 can be formed to have a trapezoidal thread or their threading configuration would actually permit the clinician to apply dust to the phase and trigger 310 and thereby thereby Connecting with the nut 334 ίο 15 20 = A wide axis L applies a rotational force. Since a rotational motion is applied to the shaft, the shifting force is applied to the gear 18G4, and the gear is incompatible with the gear Ρ 50 on the moving shaft 1544. Thus, if the firing mechanism 4 encounters resistance, the clinician can apply mechanically generated power to the drive shaft 11/4 by squeezing the relative position trigger 3ig. The clinician wants to slow or prevent the movement of the firing mechanism, the clinician can The relative position triggers the force, which then resists/slows the rotation of the shaft 18〇1 and the gear 18〇4 and ultimately resists/slows the rotation of the drive shaft 1544. The various embodiments described above are used in conjunction with a removable gas cylinder 622 for supplying gas under pressure to operate the device. In various embodiments, the removable gas cylinder 622 can be filled with high pressure gas from the beginning and can no longer be refilled. For example, the gas cylinder 622 can include a conventional disposable gas cylinder filled with carbon dioxide. Once the gas cylinder is used up, the user removes it from the handle assembly and replaces it with a new fully loaded gas cylinder. Other available gases are, for example, compressed air, carbon dioxide (C〇2) 'nitrogen, oxygen, argon, helium, sodium hydride, propane, isobutane, butane, fluorine gas carbides, dinonyl ethers. , methyl ethyl ether 'nitrous oxide, hydrofluoroalkane (Hfa ) : HFA 134a (1,1,1,2,-tetrafluoroethane) or HFA 227 ( 1,1,1,2,3, 3,3_heptafluoropropene eth96425- finished 63 200808254 Hyun). This configuration provides a much better alternative to conventional pneumatic surgical instrument configurations, but the number of times the device is available depends on the volume of storage in the gas cylinder and the need to effectively maintain the sterility of the device. * Others of the invention The gas cylinder 622 used in the embodiment stores a gas which is in a liquid state under a storage pressure and is in a gaseous state when the device is operated at a lower pressure. Examples of the liquid usable in these embodiments include cerium oxide, Methyl ether, methyl ethyl ether, sodium hydride, propane, isobutane, butane 'hydrofluoroalkane (HFA): HFAl34a (1,1,1,2,_tetrafluoroethane:) ίο 15 20 or 1^ 227 (1,1,1,2,3,3,3-heptafluoropropane)' and higher pressure carbon (co2). - Figure 57 illustrates a non-limiting example of a gas cylinder 622, which contains There is one of the liquids 624 described above. The gas cylinder 622 can be made of steel, aluminum or other materials compatible with the liquid/vapor stored therein and capable of withstanding the internal pressure generated therein. When talking about types of crying, clinicians often have multiple positions (including upside down: The handle assembly 300 is flipped over to achieve the desired position of the end effector 12. Thus, in these embodiments, a film is prevented from moving undesirably away from the gas cylinder 622 into the control system during such manipulations. The sheet 626 is provided in a gas cylinder 622. The diaphragm 626 can be made of a material that blocks the passage of liquid but permits vapor 628 formed by the liquid to pass through the membrane 626. Thus, the clinician can freely manipulate the handle assembly. There is no risk of liquid 624 entering the directional control valve 1610 and/or the air motor 173. Although the gas cylinder 622 is shown in a unitary configuration, the gas cylinder 622 can be made from two or more components to facilitate liquid production. The object 624 and the diaphragm 626 are mounted therein. The etheal sealing member can be used to establish a liquid-tight seal between the parts of the gas cylinder in this embodiment when the sealing member is used. In the embodiment shown in FIG. 57, when the clinician switches the directional control valve 1610 to the forward position and operates at a ratio of 阙66〇, the pressure in the reservoir bottle is small, This pressure reduction will lead The liquid 624 begins to vaporize and is vaporized, 628 through the membrane 626 and is used to energize the various control systems described above. Thus, by reducing the pressure within the gas cylinder 622, the liquid begins to vaporize and utilizes pressurized vapor. 628 provides energy to the apparatus. Other embodiments may use liquids that require combustion to convert liquids into their gas state 10. Examples of such liquids are propane, butane, and other petrochemical products. A conventional push button igniter may be utilized. Or other igniter system to ignite the liquid. In such applications, other components of the device may be fabricated from materials and means that are capable of safely dissipating any heat/smoke generated thereby. Still other embodiments may use phase change materials that have been specifically engineered to convert to a liquid state, a solid state to a gaseous state, or a liquid state to a gaseous state via a hot input 15 at a low pressure and a low temperature. Examples of such materials are paraffin wax and various blends of sodium. These meal materials may vary in volume as heat is input into the system. Such devices use a device such as a burner to provide the necessary thermal energy to the material. Again, components that may be exposed to heat from these devices will be designed to safely dissipate heat during use and protect the clinician and construct the material to achieve this goal. The embodiment shown in Fig. 57 can be used with the various types of gas cylinders described above and provides many advantages over other embodiments in which the gas cylinder is permanently mounted within the handle assembly 3〇〇. More specifically, and referring to Fig. 57, the gas cylinder 622 65 eth96425 - finished 200808254 two: the cavity 5 formed in the grip portion 342 of the handle assembly 300 is easy. / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / / In addition to the cover (not shown). In various embodiments, the end 630 of the material L is screwed into - one of the tube header blocks 632 has a threaded opening. The threaded opening 634 is in communication with an air supply passage 636, the supply needle valve: 38, and closed. In particular, in various embodiments, breaking into the official header block 632 causes the air supply passage 636 to be configured for rotation 10. The needle valve 638 is opened and closed. However, other valves or flow control can be used. A conventional pressure gauge 640 can be installed in fluid communication with the air supply passage 636 in order to provide the clinician with a cylinder pressure during use. A pressure gauge window 642 can be provided in the grip portion 342 to allow the user to view the pressure gauge 640 in use. See Figure 49. As shown in Figures 57 and 58, the gas cylinder 622 can be supported within a removable grip portion 342 that is removably attached to a main portion that projects downwardly from the main handle portion 340. Attached portion 344. The detachable grip portion 342 can be engaged with the primary attachment portion 344 by any suitable configuration. For example, in accordance with various embodiments, the engagement of the removable grip portion 342 with the primary attachment portion 20 344 can be accomplished by a linear sliding configuration as shown. As shown, for example, in Figures 57-59 and 61, the release grip portion 342 further includes first and second upper rails 367 and first and second lower slides 368. As also shown in these figures, the first upper rail 367 defines a ramp 369. The upper rail 367 is designed to be received within a corresponding area defined by the panels 38A and 382 eth9642 5-final 66 200808254 in the main handle portion 340. The surgical instrument can further include a locking system 19A. For example, the latching system 19, shown in more detail in 59 and 64-69, is configured to be detached; the grip portion 342 is separated from the primary attachment portion 344 by a predetermined number of times to block the main attachment portion 344 and the detachable grip. Connect part (4) to the second: the number can be any number of times. This configuration may be particularly advantageous in ensuring that the sterility of the device is effective, maintained, by limiting the number of times an I can be used. For example, according to various embodiments, the latching system 阻 can be coupled to the detachable grip portion (4) after the detachment 342 is removed from the main attachment portion 344 twice. Although the figure shows that the latching system 1900 is mostly located within the main housing portion 34A, it should be understood that the latching system i9 can be in the majority of the portion 342 in accordance with other embodiments. As shown in FIG. 59, the latching system 1900 includes a counter 19〇2, and a blocking assembly 19〇4 coupled to the counter 1902. The counter 19〇2 is configured to advance as the detachable grip portion 342 is detached from the main (four) portion 344 of the handle assembly 3〇〇. As shown in Fig. 59, the counter, 19〇2, is coupled to a shaft 1906 which is supported by a hub 19卯 connected to the right casing member 32〇. The counter 1902 includes an indexing wheel 1910 coupled to the shaft 1906 and a biasing member 1912 coupled to the indexing wheel 1910. The biasing member ΐ9ΐ2 may include a torsion spring constructed to bias the indexing wheel 191 in a counterclockwise direction. See Figure 59. The indexing wheel 1910 defines protrusions 1914, 1914, 1914" that cooperate with the blocking assembly 1904 to limit the indexing wheel 191's push = eth96425 · 槁 67 200808254 one of the parts 1914" constructed It is configured to cooperate with the barrier assembly 1904 to resist the attachment of the unloading grip portion 342 to the primary attachment portion 344 after the grip portion 342 has been detached from the primary attachment portion 344 a predetermined number of times. Although the distribution wheel 1910 is shown as defining the protrusions 1914, 1914, 1914", it is to be understood that, according to other embodiments, the indexing wheel 1910 can be defined to cooperate with the blocking assembly 19〇4 to limit the advancement of the indexing wheel 1910. Gap, and one of the gaps can

After the grip portion 342 is detached from the primary attachment portion 344 a predetermined number of times, it cooperates with the barrier assembly 1904 to block the detachable grip portion 342 from attaching the portion 344. The I 10 Axis 1906 is configured for use with the dry mouth for the wheel 1 910 to the 15 20 position. For example, the shaft 1906 can define a hexagonal opening i9i6, and a hexagonal tool can pass through one of the left casing members 33 = Fig. _ insert six (four) open π 1910, and then turn clockwise to hunt The indexing wheel 1910 is reset to a previous position. As shown in Fig. 59, the barrier assembly 19〇4 includes a barrier member guide member 1922, a gate member Cong, and —=6. The member 1924 and the barrier member i92 are members 1924. The biasing 2:9:: is biased and moved, and the second 26 is coupled to the inter-gate member 1924. According to a clockwise square, the brother can include a twist to the 64-69 in more detail. spring. Referring now to the drawings, the operation of the field lockout system 1900 is described. As shown, for example, Figure 59-63斛- 4 ^ construction configuration to initiate the detachable G, the handle assembly 3GG includes - the detachable grip portion 342 is detached from the main attachment portion eth96425 - Finish 68 200808254 344 The acting release system 193〇. The release system 193 is located within the primary attachment 344 and includes a release button 1932, and a release member 1934 that is coupled or integrated with the release button. The first and second release members 1934 each define a release ramp 1936. The release system 193 further includes first and second release pins 1938 in contact with the respective release ramps 1936, first and second lock springs 1940 in contact with the first and second release pins 1938, and slides with the first and second lower portions The first and second ejection springs 942 that are in contact with 368 are engaged. See Figure 62. As shown in FIG. 59, the free end 1941 of the spring 194 穿过 passes through a corresponding hole 321 of the right casing member 320 and a corresponding hole 331 of the left casing member 33〇1 伸 extends into the upper rail 367. The aperture 372 is thereby secured to engage the removable grip portion 342 with the primary attachment portion 344. To initiate the action of the detachable grip portion 342 from the grip attachment portion 344, the release button 1932 is advanced, causing the first and second release members 1934 and the corresponding release ramp 1936 to also advance. As the release ramp 1936 advances, the 15 release ramp 1936 causes the first and second release pins 1938 to change position. A change in the corresponding position of the first and first release pins 1938 causes the first and second lock springs 1940 to move upwardly out of the aperture 372 of the upper slide 367 by a sufficient amount to allow the first and second upper slide rails 367 to disengage therefrom. Engagement with the lock spring. As the detachable grip portion 342 is removed from the primary grip attachment portion 344, the first 20 = second ejector spring 1942 each releases its stored energy, thereby respectively aligning the first and second lower rails 368 Give a force. This force assists the detachable grip portion 342 from being disengaged from the primary grip attachment portion 344. It should be understood that, in accordance with other embodiments, the release system 1930 can include other components and/or groups that are adapted to initiate the action of the removable grip portion 342 from the primary grip attachment portion 344 eth96425 - completion 69 200808254. Referring to Figures 57 and 58, a distal end 637 of the air supply passage 636 has a point 639 formed thereon to allow the distal end 637 to pierce the sterile sealing membrane 646 mounted in one of the primary attachment portions 344 in the closed tube collection chamber 644. . Specifically, the distal end 637 of the air supply passage 636 is inserted through a port 645 of the manifold 644. The sterile membrane 646 can be made of any suitable puncturable material that can be sterilized, with a substantially liquid or hermetic seal therebetween as the distal end 637 of the gas supply passage 636 is inserted therethrough, and is far from the gas supply passage 636. The sterility of the area within the tube collection chamber 644 is maintained while the end 637 is removed. 10 also as shown in Figures 57 and 58, the gas supply line 650 is fluidly coupled to the manifold 644 such that pressurized gas entering the manifold 644 from the supply line 636 flows into the supply line 650. Figure 57 illustrates the detachable grip portion 342 attached prior to the primary attachment portion 644. FIG. 58 illustrates the grip portion 342 attached to the main attachment portion 344. As shown in Figure 58, the distal end 637 15 of the air supply passage 636 has pierced the sterile diaphragm 646. To assist insertion of the distal end 637 of the air supply passage 636 through the sterile diaphragm, a compression spring 649 is provided between the wall of the removable grip portion 342 and the header block 632. This configuration provides some ''elastic 〃' to the header block 632 as the distal end 637 of the air supply passage 636 is inserted through the diaphragm 646. Figures 64-69 illustrate the relative positions of the components of the latching system 1900 at different times during the attachment/separation procedure. Figure 64 illustrates the relative position of the grip portion 342 prior to first fully engaging the primary attachment portion 344. The shutter member 1924 is in contact with the projection 1914 to prevent the indexing wheel 1910 from advancing. The grip portion 342 is attached to the attachment portion 344 by the slide rail 637 being pushed into the corresponding passage 384. The barrier member 1920 extends through the aperture 381 70 eth96425-end 200808254 of the panel 380 into the channel 384. See Figure 59. As the first and second upper slides 367 advance, the ramp (10) on one of the first upper slides 367 strikes the stone barrier member 1920 and causes the barrier member to rotate upwardly toward the indexing. As the barrier member 1920 is advanced toward the indexing wheel 191, the blocking member 192A 5 causes the closure member 1924 to move away from the indexing wheel 191. See figure & As the first upper slide 367 and the ramp 369 continue to advance, the blocking member 192 continues to advance toward the minute f wheel 191. When the grip portion 352 is fully engaged with the main portion 351, the blocking member 1920 touches the projection 1914 which is originally in contact with the shutter member, thereby preventing the indexing wheel 191 from being advanced as shown in FIG. 1〇 - After the grip portion 342 begins to disengage from the primary attachment portion 344, the first and second upper slide rails 367 are advanced in opposite directions, and the first upper slide 367 boundary = slope 369 allows the barrier member 1920 to pass from the indexing wheel 191 〇 Remove. As the barrier member 1920 is removed from the indexing wheel 1910, the blocking member 192A allows the shutter member 1924 to advance toward the indexing wheel 191 and skips the projection 15 1914 as shown in FIG. As the grip portion 342 is detached from the primary attachment portion, the barrier member 1920 is moved away from the indexing wheel 1910 far enough to release its contact with the projection 1914 and allows the indexing wheel 1910 to rotate until a second projection 1914, As shown in Fig. 68, contact with the shutter member 1924. This day-to-day count of 1902 has advanced one position and the grip portion 342 can be reattached to the primary attachment portion 3 again. The attach/separate loop can be repeated. Figure 68 illustrates a second reattachment procedure. When the grip portion 342 is fully engaged with the primary attachment portion 344, the barrier member 192" touches the projection 1914 as shown in Figure 69" thereby preventing the indexing wheel 1910 from advancing. At the end of the second cycle, when the grip portion 342 Upon disengagement from the primary attachment portion 344, the shutter member 1924 eth96425-end 槁ίο 15 20 200808254 touches a third projection 1914" as shown in FIG. The first configuration is configured to be removed by the blocking member 192 () resistance = 1914" wheel 1910, and you are yang shi tong κ #再件 1924 from the branch ... 42 : the attachment portion 344 is attached to the grip again ―4 knife 342 (or attached to a replacement grip part). Therefore, two

In one embodiment, the surgical instrument is effectively crying for a two-use type and it will be understood by those skilled in the art that the number of uses can be increased if the indexing wheel 1910 defines a more/over. ^ or notched view 70_83 illustrates another cutting and fastening device 3 010 ' in accordance with the present invention which provides the clinician with the ability to monitor the firing schedule: while also providing the manual retraction of the firing assembly of the device. This embodiment can be used in conjunction with the terminal effector 12 or device configuration described above. The fine ridge assembly side of this embodiment may include a proximal ridge segment attached to the segment 3H)6. In the #代 embodiment, the elongate ridge 3102 can comprise a single component. The elongate ridge assembly 31〇2 is generally mid-* and movably coupled to the housing assembly 300. As shown in Figures 79 and 80, the proximal end 3105 of the crotch portion can be attached to the right attachment post 3110 projecting from the right casing member 32 and a left attachment post m2 projecting from the left casing member 33. Housing assembly. The distal end of the elongated ridge member 31〇2 can be coupled to the long channel 20 as previously described. & Also, in this embodiment, an elongate closure tube 3190 extends from the handle assembly 3'' to the end effector 12. The distal end 3192 of the closure tube 3190 has a penetrating horseshoe shaped hole 3194 and is used to axially move the closure tube 319 against the ridge member 31A2 in a manner as described above with the opening/closing tab on the anvil 4粍 Interactive. Eth96425 - Finishing 72 200808254 5 10 15 20 As shown in FIG. 71, a shuttle assembly 3400 coupled to the closure trigger 3〇2 by the link assembly 43〇 is supported within the main housing portion 34〇. The shuttle assembly 34A can also be constructed of two components 3402, 3404 that are molded or otherwise fabricated from a polymer or other suitable material and designed to fit together. The members 3402, 3404 can be held together by fastening members and/or adhesives and/or bolts, screws, clips, and the like. The right portion of the shuttle assembly 34A has a right stop flange section 3405 adapted to engage with a left stop flange section on the left portion 3404 of the shuttle assembly 3400 (Fig. Cooperating to form a stop groove assembly (not shown) (4) of the proximal end 3196 of the elongate closure tube 319q in a manner described above. The proximal end 3 104 of the elongate ridge member 3 102 extends into the opening 3403 formed in the distal end of the shuttle assembly 34〇〇 and is extended through the right portion 3402 and the left subdivision 3404, respectively. The right stop pile 311 of the opening 3406 and the left stop pile 3112 of the opening 3408 are non-movably attached to the right casing member 320. In addition, the shuttle assembly 3400 is provided with laterally extending guide rails 34A, 34丨i. The track 3410 is configured to be slidably received within a pair of right side casing members = track guides, and the track 3411 is configured to be slidably received in the left hand, and one of the members 33 is corresponding to the track guide. Thus, the shuttle assembly 3400 and the closure: tube 3190 can be pivoted relative to the ridge assembly 3102 attached to the handle assembly 300, 3400, and the elongated closure tube 319 〇 in the distal direction (arrow, 〇 movement system) The grip is made privately by the closure trigger 302 toward the handle assembly, and the axial movement of the shuttle assembly 3400 in the proximal direction (arrows, jy/) is generated by the closure trigger 302 moving away from the grip portion 342. Eth96425-End 73 200808254 5 In various embodiments, the shuttle assembly 3400 is provided with a connector tab 3412 to which the closure link assembly 3430 is attached. See Figures 71 and 72. The closure link assembly 3430 includes a The yoke portion 3432 of the connector tab 3412 is pivotally pinned by a pin 3414. The closing link assembly 343 has a closing arm 3434' which is closed by a closing pin as shown in FIG. The pivotable pin is coupled to a yoke assembly 3〇4 formed on the closure trigger 302. The closure trigger 3〇2 is pivoted by a pivot pin extending between the right housing member 320 and the left housing portion 33〇. The 306 is pivotally mounted within the handle assembly 3〇〇. 10 15 When the clinician wants to close the anvil 4 and place the tissue clip During the end effector 12, the clinician pulls the trigger 302 to the grip portion 342. As the clinician pulls the closure trigger 302 to the grip portion 342, the closure link is moved 3340 to the distal side, C 〃 direction The shuttle assembly 34 〇〇 until the closure link assembly 3430 is moved to the unlocked position of Figure 71. When in this position, the linkage assembly 3430 will tend to hold the shuttle assembly 34〇〇 in the locked position. The Ik shuttle assembly 3400 is moved to the locked position 'the closure tube 3' is moved distally on the ridge 3102, causing the closure/opening tab on the anvil 40 to be closed by the horseshoe shaped hole 3194 of the distal end 3192 of the closure tube section 3190. The proximal end touches to pivot the anvil 40 to the closed (clamped) position. To further keep the shuttle 3400 in the closed position, a lock as described above / 20 301 can be used. The various embodiments of the invention utilize a unique novel retraction lever assembly 4000 to enable the clinician to monitor the progress of the firing and retraction strokes and to #manually retract the ability to fire the rod 4030. As shown in Figure 72, the retraction rod is total. , into 4_include - slidably pinned to - the retraction side of the push rod Eth96425-End 74 200808254 4010. In particular, the retracting rod 4010 has a penetrating elongated slot 4012 that slidably receives two pins 4014 for a predetermined size to attach the retracting rod 4010 In the push rod 4020, a retracting grip 4016 can be attached to the proximal end 4011 of the retracting rod 4010. The push rod 4020 has a distal end 4022 designed to interface with the proximal end of an elongate firing rod 4030. As shown in FIG. 72, the proximal end 4032 of the firing bar 4030 has a connector portion 4034 formed thereon that is sized to receive a corresponding one of the distal ends 4022 of the push rod 4020. . Therefore, the push rod 4020 can be used to push the firing rod 4 0 3 0 axially in a distal direction 10 for a firing stroke or to pull the firing rod 4030 in a proximal direction for a retracting stroke. Those skilled in the art will appreciate that the firing bar 4030 extends through the ridge assembly 3102. In an alternate embodiment, the firing bar 4030 can have a rectangular, square or similar cross-sectional shape and is attached to the distal end 31 of the tool assembly 30 as previously described or to a different type of toolholder and other needs 15 An end effector assembly that is actuated by an axial movement. 72-77 include various figures of the shuttle assembly 3400. As shown in these figures, the left shuttle portion 3404 includes two spaced apart vertical support walls 3416, 3418 that define a pusher opening 3420 therebetween. The distal end 4022 of the push rod 4020 extends through the push rod opening 3420 to be coupled to the proximal end 4032 of the firing rod 4030 20. As shown in Figure 72, the proximal end 4026 of the push rod 4020 is coupled to a Z" connector assembly 4040. In particular, the pusher proximal end 4026 has a connecting post 4028 projecting therefrom that can be received in one of the openings 4049 of the attachment tab 4042 of the proximal end 4041 of the Z-shaped connector component 4040. See Figure 72. However, the proximal end 4026 of the push rod 4020 can be attached to the attachment tab 4042 by a screw 75 eth96425-finish 200808254 staple or other suitable tie. The distal end 4045 of the redundant connector member 4040 has a distal attachment tab 4046 thereon that is adapted to be coupled to a piston cylinder 5040 that projects from a pneumatic cylinder assembly 5000. 5, the cylinder assembly 5000 includes a first cylinder housing 5010 having a first closed proximal end 5012 and a first axial direction into the first cylinder housing 5010. A first open distal end 5014 within the channel 5016. The cylinder assembly 5000 also includes a second cylinder housing 5020 having a second proximal end 5022 and a second open distal end 5024 that opens into a second shaft 10 channel 5026. The second proximal end 5022 has a first piston head 5028 formed thereon, the first piston head being sized relative to the first axial passage 5016 for generating a general relationship with the first wall 5011 of the first cylinder housing 5010. The hermetic sliding seal defines a first cylinder region 15 5015 between the distal side of the first proximal end 5012 and the proximal side of the first piston head 5028. The first distal end 5014 of the first cylinder housing 5010 further has an inwardly extending first flange 5017 formed thereon for establishing a substantially airtight relationship with the outer wall surface of the second cylinder housing 5020. The sliding seal defines a second cylinder region 5018 between the proximal side of the first flange 5017 and the distal side of the first piston head 5028. A first passage 5027 penetrates the first piston head 5028. As shown in Figure 79, a piston cylinder 5040 extends through the second open distal end 5024 of the second cylinder housing 5020 into the second axial passage 5026. Piston cylinder 5040 has a proximal end 5042 and a closed distal end 5044. A second piston head 5046 is formed on the proximal end 5042 of the piston cylinder 5040. The second piston head 5046 is sized to the transport 5026 relative to the second shaft 76 eth96425 - 穣 200808254 for creating a substantially airtight sliding seal with the second cylinder 5021 of the second cylinder housing 5 〇 2 借 to define a The third cylinder region 5032. The second distal end % of the first cylinder housing 5〇2〇 further has an inwardly extending second flange 5〇25 formed thereon for establishing a substantial gas with the piston cylinder 5〇1〇 The tight sliding seal defines a fourth cylinder region $ between the distal sides of the proximal side of the second flange 5025. The opening 5047 passes over the second piston head 5〇46. It is passed into one of the channels 5048 of the piston cylinder 5〇4〇. As shown in 79 and 80, the cylinder assembly 5000 is mounted on the housing assembly 300 = the first gas supply line or the air supply conduit 5050 from one of the handle assemblies 300. Extending to the control valve 610 to be coupled to the first cylinder housing 5〇1〇 first proximal end, 七, seven pressurized gas passing through the first cylinder housing 1 〇 first proximal end 5012; The gas supply line 5013 or the opening. In addition, a second gas supply line or milk supply guide 5052 extends from the orientation control 阙6 J 〇 to the distal end of the first cylinder housing 15 5 010 5 01 4 correction, a 'from ^ Connected to the first cylinder housing 501 in the vicinity to feed pressurized gas into the second cylinder region 5018 via a second # 5029. See Figure 20 - Figure 78 and 79, detailing the firing rod 4〇3 The elongation and the return of the second/two 78 are not: the gas supply lines 5050 and 5052 are coupled to the conventional valve system, which is mounted in the handle assembly _, a drive system, / knife. The directional control valve 1610 has A forward position section 1620, 16^, an area 1 and an If30, and an inverted section 1640. The control valve section, 640 can be replaced by a button 1612 and a hand that protrudes through the handle housing 300. In various embodiments, the removable pressurized gas eth96425 is used to complete the 77 200808254 body source 620. See Figures 71 and 81-83. However, those skilled in the art will appreciate that the non-replaceable/re-inflatable can also be utilized effectively. A pressurized gas source (a gas cylinder). In still other embodiments, the handle assembly 3 can have a port 616 for supplying pressurized gas from an external pressurized gas source 618. For example, 5, the appliance 3010 can be coupled to the compressed air supply 618 in the facility through a flexible air supply line 617. See Figure 8 1A. The wide pressurized gas is passed from the gas cylinder 622 (or external pressure source 618). The gas, spring road 650 enters the conventional proportional valve 660. As shown in particular in Figure 78, the proportional valve 660 is coupled to an attachment A trigger link 67 662 is activated to trigger 67. In various embodiments, the trigger trigger 67 is supported adjacent to the firing trigger 3 (7), which is coupled to the left housing member 330 by a right housing member 32. An extended yaw pin 37 is pivotally coupled to the handle assembly 3. The firing of the trigger 670 inwardly toward the firing trigger 31 causes the proportional valve 660 to permit more pressurized gas to pass through a supply. Line 680 flows into directional valve 15 1610. Depending on the position of the directional valve 161, pressurized gas may flow into the supply line 5050 or 5052. For example, when the directional valve 6 〇 is actuated by the clinician to elongate the firing bar 30, the control valve 161 〇 switches to the advanced position causing the advancement passage 1622 to permit pressurized gas to flow from the supply line 68 into the supply line 5050. The gas flowing through the gas supply line 5〇5〇 passes through the first gas supply port 5013 of the closed end ', 〇= into the first cylinder difference 15 and passes through the opening 5027 in the first=plug head 5028 and enters the third cylinder area. 5〇32. The pressurized gas entering the first cylinder region 5032 also enters the hollow piston cylinder 5〇4〇 through the opening of the second piston head 5046 and forces the piston cylinder to move the gas in the fourth cylinder region 5034 to the far side. Exhaust through the second cylinder casing eth96425 - end 78 ίο 15 20 200808254 5020 exhaust π 5G23. Similarly, the gas located in the second cylinder is allowed to pass through the second opening 5〇29 into the second air supply passage 1624, thereby finally discharging from the exhaust passage 1632. The application of pressurized gas to a cylinder region 5015, a third cylinder region 5〇32, and a red side of the piston 5048 causes the piston cylinder 5〇4 to extend distally as shown. As the piston-cylinder lion extends distally, the z-shaped 4040 is also attached to the distal end 5 () 44 of the piston cylinder 5 to force the pusher side to move distally toward the side of the connector, thereby forcing吏# The hair shaft side is also moved to the far side. As the side of the firing rod is moved distally, the total force of the tool attached to the firing rod 3〇 distal end portion is broken through 50 to cut the tissue clamped by the end effector 12 and fire the toggle needle. - The tool assembly 30 has been advanced to its distal position in the end effector 12. The bed physician releases the activation trigger 67 to interrupt the application of pressurized gas. The yoke example may also be provided with means for indicating when the tool assembly 30 has reached its most distal position within the nail = 50. In particular, the supply line 650 can be extended to the distal auxiliary line 1772 of the distal limit switch 丨77〇. A distal limit switch line 1774 is provided between the distal limit switch 770 and the directional control valve 161 。. Thus, when the tool assembly 30 has been fired, the distal limit switch 1770 is oriented relative to the cylinder assembly 5000 portion such that the cylinder assembly is partially actuated by one of the distal limit switches. Under pressure from the supply line 650 / spring to the retraction limit switch line 1774 and into the directional control valve 1610, in each embodiment, the directional control valve 1610 is automatically switched to the position 79 eth9M25-end 808200808254: $ As the following is expected, the side of the rod is retracted. In each implementation, a first whistle 1790 or other suitable stalk, line 1774 (or distal limit switch 177). "The retracting limit opening switch is moved at the end of the firing stroke, compared to the far side limiting line 嘱 air actuation!; The far (4) sound signal indicates the tool assembly % (4) - In the embodiment, the whistle (10) can be exchanged The pressure is up to the end of the door. In the alternative s, 6, the battle & force switch pressure gauge or the like to the no: the bed asks the cutter assembly 30 when the end of the firing stroke is reached ίο 15 20 To retract the firing rod 4 by pneumatic force, the clinician can press the button 12 to switch the control valve 1 61 倒 to the reverse 彳.7Π _ ^ 』U and position and start to press the trigger 670 to start the pressurized gas. Flowing into the second one - 1 /, the gas line 5 0 5 2. The gas flowing through the first gas supply line 5052 enters the 筮 々 version of the eight 弟 虱 虱 虱 区 50 50 50 50 50 导致 导致 导致 导致 导致 导致 导致 导致 导致 导致 导致 导致 导致 导致 第二 第二Into the first cylinder, "hole cylinder body 5010. The gas in the first Weng cylinder area 5 01 5 is allowed to be discharged into the first (the gas line 5040) via the first, Tiandi supply opening 5013. The gas entering the directional valve 161 is passed through the gas of the __, VII, and milk line 5040. 0 and thus from the exhaust port 1 ^ ^. Once the pressurized gas entering the second cylinder region 5018 has caused the 筮 - ^ + and other Chin-a cylinder housing 5020 to retract into the first cylinder housing 5010, Through the first _ ^ brother - the opening 5029 of the gas can now flow through the exhaust port of the brother cylinder 5010 and the mouth 5023 into the four cylinder area 5034. ^ Pressurized gas enters the fourth gas zone 5G34, the first The second piston head 5〇46 pulls the living base cylinder 5040 into the second cylinder housing 近. The liquefied gas in the third cylinder region 5032 passes through the first opening to enter the first cylinder region, thereby The method described in the article is exhausted. With the piston cylinder $ please be retracted, 80 eth96425-end 808200808254 z-shaped connection n 4_ to the near side and then pull with 4020 and firing rod 4030. Extending between the near-close limit 5 10 15 20 杲 650. The proximal limit switch 1660 -; the milk cylinder assembly 5000 or the connector 4〇4〇 orientation When fully retracted, the 'near limit switch (10) is actuated and then permitted; the gas production two proximal limit switch line 1764 and the flow 4 to the control valve i6i 〇 = brother 1 flute 1792 or other appropriate sounding device can be closed 1760, Causes the proximal limit switch! In the retraction stroke = two = through the proximal limit switch circuit 丨 7 6 4 air actuation second to the clinician to provide another - voice money indicates the firing bar · has reached the end of the retraction stroke. In other embodiments, the battery-powered light-emitting diode or other signaling device/ΓΙΓΙ1770, 1760 is associated to provide the user with a horizontal slider--to the firing stroke and/or the retraction stroke. Another finger at the end: Α white This technique will easily understand that if the clinician wants to shoot the stroke === stop the stroke and retract the firing rod and the cutter, he or she must also switch the control valve 1610 to The manner of inverting the position is carried out. In the example described above, 'the clinician does not use this embodiment of the invention = the novel retractable rod assembly 4_. The retracting rod has several advantages. First place: if firing or returning In the process of shrinking the stroke The aerodynamic force is such that, due to an accidental interruption of the supply of pressurized gas, the accidental bed physician can simply switch the control valve 1610 to eth96425 by hand - 81 5 10 15 20 200808254 ^ Turn: set, grasp (four) to the (four) pole near the (four) side and pull the rod in the direction of = until the firing rod has been fully retracted to manually retract the firing rod cutter assembly 30). Tea is shown in Figure 83. Switching control 161 到 to the reverse 奎 position will cause the gas in the cylinder assembly to drain when the shank is retracted. Another advantage provided by this embodiment of the present invention is the ability to visually monitor the firing process of the firing rod and knife portion moving distally during the firing stroke. This advantage can be achieved simply by pulling the retraction rod to the most proximal position of Figure 83 prior to the squeezing stroke. When in this position, the connector 4〇4〇, the push rod 4〇2〇 and the firing rod 4〇3〇 are pushed side by side with the assembly 5000, and the push rod 4020 is supported by the retracting rod 4〇. The pin 310 is connected and the retracting rod 4010 is pulled to the far side. In each of the embodiments, the length of the retracting rod side is provided such that when the firing rod side is fully extended, no portion of the retracting rod side protrudes from the handle assembly. Therefore, clinicians can borrow

The progress of the striking rod 4030 and the cutter assembly 3 is judged by observing the portion of the retracting rod 4〇1〇 protruding from the grip portion 3〇〇. X. In an alternative embodiment shown in Figures 72A and 83A, the retraction rod 4〇1〇 may have at least two, preferably at least two notches 4〇15 to receive the pin 4〇14. Those skilled in the art will appreciate that this configuration provides the clinician with the ability to visually monitor the progress of the firing bar 4030 and the tool assembly 30 during the retraction stroke. In particular, as the firing bar 4〇3〇 is retracted, the pusher 4〇2〇 causes the retracting bar 4010 to advance proximally beyond the housing assembly 300 due to the pin 4014 engaging the notch 4015. Therefore, the clinician can judge the distance that the firing rod 4 〇 3 已 has traveled during the retracting stroke by observing the retracting rod 4 〇 〇 〇 protruding the distance of the hand assembly 300 。. However, when the appliance is not in use, the retracting lever 4〇1〇 can be eth%425-end稹 82 200808254 Push into the handle assembly as shown in Figure 81. 5 10 15 20 While several modifications of the present invention have been described, it will be appreciated that many modifications, changes and adaptations may be devised by those skilled in the art. For example, in accordance with various embodiments, a single 1 =: two: and multiple components can be replaced with a single component to perform a known function of the second. Therefore, the request is intended to cover all such modifications and changes without departing from the scope of the accompanying patent application: spirit and scope. & %咧 ^The device disclosed by the invention can be designed to be discarded after a single use, and can be designed to be used multiple times. But no matter what kind of device, the device can be re-adjusted for reuse after being used. Re-adjustment can be awesome: Decompose the garment, then clean or replace specific parts, then assemble. The device can be decomposed and loaded

The pieces may be selectively replaced in any combination: J = clean and / or replaced, the device may be - re-adjusted or Ϊ:: 夕卜科 team immediately after the surgical procedure for reassembly for later learning of this skill It will be understood that the re-adjustment of the device can be applied to many different techniques of decomposition, cleaning, and reassembly. The use of these techniques, as well as the line/I re-equipment, are all within the scope of this application. #理仏来来/^ ^ The brothers described in the book will have a new or used appliance before surgery and disinfect the appliance if necessary. In the disinfection technique, the oral device is placed in a closed examination and crying. Then put the plastic bag or TYVEK (S) bag /, placed in a radiation field that can penetrate the container eth96425 - 槁 83 200808254 2::! For example, 7 radiation, x-ray, or higher energy electrons . This J 疒 2: bacteria on the raft and in the container. The sterilized device is then placed in the device. The sealed container holds the sterility until _ is opened in the medical facility. u直引 s Gu Jie 5 10 15 20 In this specification, it is said to incorporate all or part of the contents of this article, the disclosure, or any public part is only incorporated by the content: not touch: Ming: The definition, statement, or other part of the publicity section 'and the extent necessary, this specification clearly states: Neigu replaces any part of the conflict in this article. It is hereby incorporated by reference in its entirety that any content or part of the definitions, statements, or other public notices set forth in this specification will only be such as not to cause a conflict between the content of the person and the content of the content. Incorporate. The contents of the present invention are not intended to be construed as limited to the particular embodiments. Therefore, the examples are to be considered as illustrative and not restrictive. Changes and modifications may be made by others without departing from the spirit of the invention. All the equivalents, changes and changes in the spirit of the invention as defined in the scope of the patent application are within the scope of coverage. BRIEF DESCRIPTION OF THE DRAWINGS FIG. 1 is a partial exploded view of an embodiment of the present invention; FIG. 3 is a diagram of an end effector configuration of an embodiment of the present invention; FIG. 2 is a top view of the end effector, wherein the anvil portion has been removed therefrom and the closure tube assembly is drawn in dashed lines; eth96425 - 稹 稹 84 200808254 Figure 4 is a side cross-sectional view of the end effector of Figure 3, wherein the anvil A portion is attached thereto and is in an open position; FIG. 5 is a top cross-sectional view of a portion of a joint controller that can be used in various embodiments of the present invention; 5 10 15 20 FIG. 6 is a live action of the end effector shown in FIG. FIG. 7 is an exploded, isometric view of an embodiment of a closure tube assembly and a shuttle arrangement supported within the handle assembly, wherein other components housed within the housing assembly are omitted Figure 8 is a cross-sectional view showing a configuration of a housing assembly in accordance with an embodiment of the present invention; Figure 8A is a partial cross-sectional view of a portion of a closure trigger locking system that can be used in conjunction with embodiments of the present invention; 8B疋Another handle assembly of the invention FIG. 8C is a cross-sectional view of another handle assembly embodiment of the present invention; FIG. 9 is another cross-sectional view of the handle assembly of FIG. 8; Figure 1 is a side view of a shank arrangement and a firing transmission member including a two-stage shovel assembly in accordance with one embodiment of the present invention, wherein the cylinder assembly is shown in cross section; The other side of the rod and the two-stage cylinder arrangement is in the extended position, and the eight-center cutter rod is in the extended position; the side view of the other cutter rod and the firing transmission member of the present invention is returned, wherein 77 曰t 1 ^ dry is being retracted 1 is a cross-sectional view of the cylinder assembly; FIG. 13 is another side view of the arbor and cylinder arrangement, wherein the knives are in an extended position; 85 eth96425-end 稹200808254 FIG. 14 is a housing diagram 12 and 13 are top views of the end effector and ridge assembly of the cylinder and arbor arrangement; Figure 15 is a side cross-sectional view of the end effector and ridge assembly of Fig. 14, wherein the anvil portion is attached thereto and is Open position; 5 Figure 16 is a combination with Figure 12-15 Figure 16A is a cross-sectional view of another handle assembly that can be used in conjunction with the embodiment of Figures 12-15, wherein the source of pressurized gas is outside the handle assembly; Figure 16B is a view of the present invention. A cross-sectional view of another handle assembly embodiment; FIG. 1 is a plan view of another shank and ridge assembly supporting another firing transmission member in the form of a bellows assembly in accordance with another embodiment of the present invention; Figure 17 is a side cross-sectional view showing the arrangement of the end effector and the ridge assembly of the embodiment shown in Figure 17; Figure 19 is a partial cross-sectional assembly view of the bellows assembly of the embodiment shown in Figures 17 and 18. Figure 20 is a view Figure 19 is a cross-sectional view of an embodiment of a handle assembly that can be used in conjunction with the embodiment shown in Figure 17_2. Figure 21A is a view of the embodiment shown in Figure 17_2. Figure 2B is a cross-sectional view of another embodiment of the handle assembly of the present invention; Figure 22 is a cross-sectional view of another embodiment of the handle assembly of the present invention; Figure 22 is a cross-sectional view of another embodiment of the handle assembly of the present invention; Another surgical cutting and fastening device of the embodiment Figure 23 is a cross-sectional view of the end effector of the embodiment of Figure 22 and the side of the ridge assembly 86 eth96425 - complete 200808254; Figure 24 is a side shaft of the embodiment of Figures 22 and 23. The assembly is coupled to the proximal shaft. The upright joint is disposed at a distance of 25. A section of the proximal shaft assembly taken along line 25_25^5 of Fig. 24 is attached to Fig. 26 - attached to A distal perspective view of the proximal shaft assembly, the portion of which is a portion of the distal shaft assembly that has been omitted for the purpose of the embodiment of Figure 27 - Figure 24-26, wherein the distal shaft The rod assembly has been lightly attached to the front view of the proximal shaft tr-section; the attachment to the proximal shaft is generally shown in Figure 29 - a portion of the alternative joint configuration that can be used in the embodiment of Figure 12-16A FIG. 30 is a cross-sectional view of the smear and 〇r soil along the line 30_30 of FIG. 29; the sectional view 31 of the proximal shaft assembly taken at 0 is a combination with the embodiment shown in FIG. 22_30. A perspective view of a portion of the assembly; a shaft 20 Figure 32 is a perspective view of another surgical cutting and fastening device of the present invention - using the pneumatic actuation of various embodiments of the present invention Figure 33 is a partial perspective view of a portion of the embodiment shown in Figure 32 attaching a distal ridge to one of the proximal ridges of the iliac joint; Figure 34 is a view of the joint configuration of Figure 33 a perspective view in which the cover has been removed and the distal ridge segment is illustrated as a joint motion with respect to the proximal ridge segment. FIG. 35 is an exploded assembly view of the articulated joint configuration of FIGS. 33 and 34; eth96425-End 87 Figure 08 is a side cross-sectional view of the joint assembly of Figures 33-35; Figure 37 is a perspective view of an embodiment of the switch assembly of the present invention; Figure 38 is a side view of the switch assembly of Figure 37; 5 10 15 Figure 39 is a cross-sectional view taken along line 39_39 of Figure 37 and "opened; oil raft 4"" is a cross-sectional view of the switch in the closed position taken along line 4〇-40 of Figure ; Fig. 41 is a different port 1J curve diagram of the switch assembly of Fig. 37_4 in an activated position; sectional view Fig. 疋 - Fig. 43 of the switch assembly of Fig. 41 taken along line 42 42 of Fig. 41 Figure 37-42 is a bottom view of the switch assembly; source: a section of the handle assembly having the switch assembly of Figure 37_43 and equipped with a pressurized gas Figure 2: 疋I has a handle assembly view of the switch assembly of Figures 37-43 inside and the pressurized gas source is outside the handle assembly; Figure, a perspective quick release of a surgical staple and cutting instrument Figure 49 is a perspective view of another surgical cutting and fastening device of the present invention. eth96425-完槁88 200808254

Figure 50 is an exploded assembly view of an end effector configuration that can be used in conjunction with the embodiment of Figure 49; Figure 51 is an end effector that can be used in conjunction with the embodiment of Figure 49 with a 5 set, ridge assembly and closure Figure 52 is a side cross-sectional view of the end effector, ridge assembly and closure tube assembly of Figure 51, wherein the anvil portion is omitted for simplicity; Figure 52A is a A further non-limiting embodiment of the terminal acts as a side cross-sectional view of the ridge assembly and closure tube assembly, wherein the air motor 10 is supported away from the handle assembly; Figure 52B is another embodiment of the present invention The end effect of the non-limiting embodiment is a side cross-sectional view of the ridge assembly and the closure tube assembly, wherein the air motor is supported away from the handle assembly; FIG. 53 is an embodiment of FIG. A cross-sectional view 53A of the handle assembly used is a d-side view of another handle assembly that can be used in conjunction with the embodiment of Figure 49, wherein the source of gas is external to the handle assembly; Figure 54 is the handle assembly of Figure 53. Another cross-sectional view; 20 Figure 55 is - an embodiment of the present invention A side view of the position firing trigger; ^ wire per figure / 6 can be combined with the control system of the present invention used in various embodiments of the present invention, a schematic diagram of the dead shell example; eight Figure 57 from the handle assembly of the present invention A cross-sectional view of a removable grip portion of one of the main attachment portions of the embodiment; eth96425 - Finish 89 200808254 Figure 5: Yes - shows the removable grip portion coupled to one of the handles of various embodiments of the present invention Partial cross-sectional view of a portion of the main attachment portion; ^ Figure 59 is a sectional view of the detachable grip portion and the main attachment portion of Figure 58: a cross-sectional view in which the tube header and cylinder related components are omitted for simplicity Figure 6A is a cross-sectional view of the portable grip portion and the main attachment portion of the figure % and % taken along line 6〇_6 of Figure 59; ίο Figure 61 is a diagram taken along line 61_61 of Figure 59. A cross-sectional view of the detachable grip portion and the main attachment portion of %, 59, and 6 ;; Fig. 62 is a cross-sectional view of the grip 4 of Fig. 58_61 taken along line 62_62 of Fig. 59 and the main attachment portion; 63 is a detachable grip portion of Fig. 58·62 taken along line 63_63 of Fig. 59, mainly attached Partial another partial cross-sectional view; 15 schematic view of another embodiment of the latching system of the present invention in the initial position of the latching system of FIG. 5, FIG. 64, illustrating the latching system beginning with the grip portion The movement of the main attachment portion of the handle assembly, 20 Figure 2 is another simplified diagram of the locking system of 64 and 5 before the second portion of the grip portion is disengaged from the handle ... into the main attachment portion; 67 is another simplified diagram of the latching system of FIGS. 64-66 illustrating the position of the system component when the grip portion has been attached to the primary attachment portion; FIG. 10 is another simplified view of the latching system of FIGS. 64-67, illustrating the system The position of the assembly during the second attachment of the grip portion to the primary attachment portion; eih96425 - Finish 90 200808254 Figure 69 is a block diagram illustrating the locking system after the grip portion has been attached for the second time and last attached to the primary attachment portion Figure 70A - perspective view of a surgical cutting and fastening device of the present invention; Figure 71 is a cross-sectional view of an embodiment of a handle assembly for use with the device shown in Figure 70; Figure 72 Example shuttle And an exploded assembly view of the retracting rod assembly; Fig. 72A is a partial exploded view of the shuttle and retracting rod assembly of another embodiment of the present invention; and Fig. 73 is a combination view of the assembly shown in Fig. 72, wherein The cylinder assembly is in a fully extended position; Fig. 74 is a rear view of the shuttle assembly of the present invention; Fig. 75 is a rear view of the shuttle assembly of Fig. 74, wherein the retracting rod and the push rod 15 extend into the push rod Inside the opening and the push rod is attached to the connector member; Figure 76 is a rear perspective view of the left portion of the shuttle assembly; Figure 77 is another rear perspective view of the left portion of the shuttle assembly; Figure 78 is an available view Figure 7 is a schematic view of the configuration of the control system of the embodiment shown in Figure 7-77; Figure 79 is a top cross-sectional view of the handle assembly configuration of the embodiment of Figures 70-78 wherein the cylinder assembly is in an extension Figure 80 is another top cross-sectional view of the handle assembly configuration of the embodiment shown in Figure 7〇_79, wherein the cylinder assembly is in a retracted position; Figure 81 is an embodiment of Figure 7〇_8〇 Sectional view of the handle assembly; 91 eth96425 - Finishing 200808254 Figure 81A is a handle that can be used in the embodiment of Figures 70-80 A cross-sectional view of an embodiment of the assembly in which the source of pressurized gas is outside the handle assembly; and 另一2, another cross-sectional view of the handle assembly of Fig. 81, wherein the total elongation of the cylinder, 5 Fig. 83 is the handle assembly of Fig. 81 Retraction; and another cross-sectional view in which the cylinder assembly Fig. 3A is the handle of the embodiment shown in Fig. 7 2B in which the cylinder assembly is retracted and the firing rod is in its most proximal position. ° [Main component symbol description] 10 10 Surgical stapling and cutting device 12 end effector 2 〇 long channel 21 locking opening 22 attachment hole 15 20 23 channel groove 24 recess 26 recess 28 anvil cam slot 3 〇Cutter assembly 31 distal portion 32 upper pin 33 hole 34 knife bar cap 3 5 piston rod eth96425 - end 92 200808254 35' stepped portion 36 intermediate pin 37 projection 38 cutting edge 5 39 locking projection 39' proximal Bevel 39" distal bevel 40 stone account 42 anvil 10 4 3 station frame axis 44 longitudinal station slot 46 anvil open / close tongue 50 nail 匣 51 匣 body 15 54 vertical slot hole 56 nail 匣 upper surface 58 nail hole 60 spike extension feature 62 staple extension feature 20 64 wedge slider 66 staple driver 6 8 匣 pallet 7 0 knuckle 100 long shaft assembly 93 eth96425 200808254 5 10 15 102 ridge assembly 104 Pivot 110 distal ridge 111 distal square hole 112 lock spring 113 proximal square hole 114 channel tin member 115 clamp rod 116 lock spring upper arm 117 bellows passage 118 lock spring lower arm 122 single 123 connection point 124 L 125 connection point 130 proximal ridge 134 tang 136 138 pivot pin 140 142 pin 150 belt member 160 belt member 170 closure tube assembly 20 200808254 172 double pivot closure joint 174 upper double frame shaft link 175 distal pivot pin 17 6 proximal pivot pin 5 177 lower double pivot link 17 8 Distal pivot pin 17 9 proximal pivot pin 180 distal closure tube segment 1 8 2 upper tang 10 183 pin hole 184 lower tang 185 horseshoe hole 186 tongue 187 pin hole 15 190 proximal closure tube segment 191 axial Channel 192 Upper tang 193 Pin hole 194 Lower tang 20 195 Pin hole 19 6 Stop groove 200 Joint controller 202 Joint slider 204 Frame 95 eth96425 200808254 206 Closer 208 Slot 210 Connection point 212 Connection point 5 300 Handle assembly 301 releasable locking mechanism 302 closure trigger 303 flexible longitudinal arm 304 扼 assembly 10 305 pin 306 pivot pin 310 firing trigger 310 'relative position trigger 320 right side casing member 15 321 hole 322 right upper casing member upper portion Part 323 left casing member upper portion 324 right casing member lower portion grip portion 326 right ridge assembly stop pile 20 328 track guide 330 left casing member 331 hole 332 upper attachment plate portion 333 tactile feedback configuration 96 Eth96425 - End 200808254 334 Lower grip part under the left casing member; Nut portion (Fig. 55) 335 Slot 337 Spring arm 340 Main housing portion 5 342 Grip portion 344 Main attachment portion 350 Opening 352 Wedge 354 Wedge lower surface 10 356 notch 358 can be slanted 359 opening 350 inclined rear wall 360 opening 367 upper rail 15 368 lower rail 369 bevel 3 7 0 pivot pin 372 hole 380 panel 20 382 panel 384 upper sliding storage Channel 400 close shuttle 402 shuttle right portion 403 fastening pin 97 eth96425 - complete 200808254 5 10 15 404 shuttle left portion 405 right stop flange segment 406 slot 408 slot 410 rail 411 guide 412 connector tongue Sheet 414 pin 430 closed link assembly 432 fortunate portion 434 closing arm 436 closing pin 500 transmission member 501 cylinder assembly 510 first cylinder housing 511 first wall 512 first proximal end 513 first air supply port 514 first Distal 515 first cylinder region 516 first axial passage 517 first flange 518 second cylinder region 519 trunnion 98 eth96425 - end 20 200808254 520 second cylinder housing 521 second wall 522 second Proximal end 523 exhaust port 5 524 second distal end 525 second flange 526 second axial passage 527 first passage 528 first piston head 10 529 second air supply port 530 second piston head 532 third cylinder region 534 Fourth cylinder zone 540 first gas supply line 15 540' first gas supply line section 540" first gas supply line section 541 pressure gauge 542 second gas supply line 542 'second gas supply line section 20 542" Second air supply line section 543 window 545 sound outlet 546 limit switch 547 actuating member 99 eth96425 200808254 549 indicating member 600 driver system 610 directional control valve 612 selection switch 5 616 port 617 flexible supply line 618 external pressurized gas source 620 removable / refillable pressurized gas source 622 gas cylinder 10 624 liquid 626 diaphragm 628 vapor 630 vacuum source; gas cylinder drain end (Figure 57-58) 632 flexible vacuum line; tube set box (Fig. 57-58) 15 634 threaded mouth 636 gas supply channel 637 distal end 638 needle width 639 point 20 640 pressure gauge 642 pressure gauge peep window 644 closed tube set chamber 645 mouth 646 sterile diaphragm 100 eth96425 200808254 649 compression Spring 650 gas supply line 651 gas supply line 660 ratio Valve 5 662 gas supply link arm 670 starts trigger 671 cavity 680 gas supply line 800 cylinder assembly 10 810 first cylinder housing 812 first closed end 813 first air supply port 815 first cylinder area 817 first flange 15 820 second cylinder housing 822 second closed proximal end 824 second distal end 825 second flange 827 first opening 20 828 first piston head 830 second piston head 832 third cylinder region 840 first gas supply line 850 First retracting spring 200808254 852 spring 900 bellows assembly 902 distal end 904 projection 5 910 expandable/retractable bellows portion 912 wire confinement ring 912 'actuating member 914 base portion 916 gas supply 10 920 vacuum 埠922 vacuum line 940 gas supply line 940' gas supply line section 940" gas supply line section 15 1000 quick release joint 1000' quick release joint 1010 distal shaft assembly 1012 proximal end 1020 proximal shaft assembly 20 1022 distal end 1030 ridge assembly 1110 distal ridge segment 1111 distal square hole 1113 proximal square hole 102 eth96425 200808254 5 10 15 20 1114 proximal end 1115 clamping rod 1116 distal connector portion 1117 first distal air supply 璋1117, third-distal air supply 埠1118 first Air nozzle portion 1118, third-supply nozzle portion 1119 notch portion 1120 second distal air supply port 1120, fourth distal air supply port 1122 second air supply nozzle portion 1122, fourth air supply nozzle portion 1124 Stop member 1126 flexible tongue 1150 proximal spine 1152 distal end 1154 second connector portion 1155 notch portion 1156 first proximal air supply port 1156, third-proximal air supply port 1158 first 0 ring seal 1158 , third-0 ring seal 1160 second proximal air supply 埠 1160, fourth proximal air supply 埠 103 eth96425 200808254 5 10 15 20 1162 second Ο ring seal 1162' fourth Ο ring seal 1170 hollow sleeve portion 1172 Locking opening 1178 closing tube assembly 1180 distal closing tube section 1182 proximal end 1184 locking tab 1186 locking wedge 1190 proximal closing tube section 1194 locking opening 1195 proximal end 1196 slot 1200 release sleeve 1202 distal end 1204 release button 1206 Two beveled inner edge 1300 first distal air supply 306 1306 proximal air supply 埠 1308 Ο ring seal 1500 surgical cutting and stapling instrument 1512 end effector 1520 long channel 1521 distal end 104 eth96425 200808254 5 10 15 1522 bearing 1530 Wedge slip Skid assembly 1532 sled portion 1538 knife portion 1540 ridge assembly 1542 proximal ridge segment 1543 opening 1544 main drive shaft 1545 proximal end 1546 secondary drive shaft 1546' motor drive shaft 1548 transmission gear 1548' transmission gear 1550 helical gear assembly 1552 helical gear 1554 transmission gear 1556 helical gear 1560 transmission screw 1562 proximal transmission gear 1570 distal ridge segment 1600 drive system 1610 directional control valve 1612 button 1614 button 105 th96425 - stable 20 200808254 5 10

1620 Forward position section 1622 Forward channel 1624 Channel 1630 Stop section 1632 Exhaust 埠 1640 Reverse section 1660 Proximity limit switch 1662 Proximity auxiliary line 1664 Proximity limit switch line 1700 Air supply/exhaust line 1710 Air supply/discharge Gas line 1730 Air motor 1730, Air motor 1732 Output shaft 1734 First transmission gear 1736 Second transmission gear 1738 Input shaft 1740 Planetary gear assembly 1742 Output shaft 1743 Coupling member 1750 Feedback gear 1752 Knife position gear 1754 Knife position axis 1756 End 106 eth96425 20 200808254 1758 Remote 1760 proximal limit switch 1770 distal limit switch 1772 distal auxiliary line 5 1774 distal limit switch line 1780 knife indicator 1790 first whistle 1792 second whistle 1800 feedback link assembly 10 1801 threaded manual feedback shaft 1802 universal joint part 1804 manual feedback gear 1900 locking system 1902 counter 15 1904 blocking assembly 1906 shaft 1908 hub 1910 indexing wheel 1912 biasing member 20 1914 projection 1914 'protrusion 1914" projection 1916 hexagonal opening 1918 opening 107 eth96425 200808254 5 10

20 1920 Barrier member 1922 Barrier member guide 1924 Brake member 1926 Bias member 1930 Release system 1932 Release button 1934 Release member 1936 Release bevel 1938 Release pin 1940 Lock spring 1942 Eject spring 2000 Surgical cutting and stapling instrument 2002 Pneumatic joint Assembly 2004 ridge assembly 2010 distal ridge segment 2012 proximal 2014 frame member 2016 driver plate 2030 proximal ridge segment 2032 distal end 2034 pivot bearing socket 2036 groove 2038 groove 2040 first vertical gas supply channel 108 eth96425 200808254 2042 third Gas supply line 2042' third gas supply line section 2042" third gas supply line section 2044 third gas supply 埠 5 2045 third gas supply passage 2050 second vertical supply air passage 2052 fourth gas supply line 2052' Four gas supply line section 2052" fourth gas supply line section 10 2054 fourth gas supply 埠 2055 fourth gas supply passage 2060 cover 2062 screw 2100 switch assembly 15 2110 switch block 2111 pivot hole 2112 gas supply 113 2113 switch block Bottom surface 2114 switch cavity 20 2116 gas supply channel 2118 pipe header zone 2130 selector component assembly 2150 body portion 2151 pivot bar 109 eth96425 200808254 5 10 15 20 2152 0 ring seal 2153 return rod 2154 0 ring seal 2155 undercut exhaust zone 2156 short rod 2158 selector handle 2160 central air supply 埠 2170 fourth exhaust passage 2180 third exhaust passage 2190 Spring 2192 Rounded part 2193 Slot 2194 Rounded part 2195 Slot 2196 Free end of return spring 2198 Free end 3010 of reversing spring Pneumatic surgical cutting and fastening device 3102 Ridge assembly 3104 Proximal ridge 3105 Proximal 3106 Distal ridge segment 3110 Right stop post 3112 Left stop post 3190 Closing tube 110 eth96425 200808254 3192 Distal 3194 Horseshoe hole 3196 Ridge assembly proximal 3400 shuttle assembly 5 3402 Shuttle assembly right part 3403 Opening 3404 shuttle total Left part 3405 right stop flange section 3406 opening 10 3408 opening 3410 rail 3411 guide 3412 connector piece 3414 pin 15 3416 vertical support wall 3418 vertical support wall 3420 push rod opening 3430 closed link assembly 3432 yoke Part 20 3434 Close Arm 4000 Retraction Rod Assembly 4010 Retraction Rod 4011 Proximity 4012 Slot eth96425 111 200808254 4014 Pin 5 10 15 20 4015 Notch 4016 Retracting Grip 4020 Putter 4 022 distal 4024 connector hole 4026 push rod proximal end 4028 connection post 4030 firing rod 4032 proximal end 4034 connector portion 4040 Z-shaped connector member 4041 proximal end 4042 attachment tab 4045 Z-shaped connector member distal end 4046 Distal attachment tab 4049 opening 5000 pneumatic cylinder assembly 5010 first cylinder housing 5011 first wall 5012 first closed proximal end 5013 first air supply port 5014 first open distal end 5015 first cylinder region 112 eth96425 200808254 5016 First axial passage 5017 first flange 5018 second cylinder region 5020 second cylinder housing 5 5021 second wall 5022 second proximal end 5023 exhaust port 5024 second open distal end 5025 second flange 10 5026 second Axial passage 5027 first passage 5028 first piston head 5029 second 埠 5032 third cylinder region 15 5034 fourth cylinder region 5040 piston cylinder 5042 proximal end 5044 closed distal end 5046 second piston head 20 5047 opening 5048 passage 5050 first Gas supply line 5052 second gas supply line

Claims (1)

200808254, Application for Patent Park·· A surgical instrument includes: a distal member that is constructed with an I-assembly; then a Cann-Pneumatically operated long-shaft assembly having a split and a proximal portion; And the distal end portion of the member is coupled to a pneumatic rotary transmission member, partially supported and fluidly constrained to the distal end of the long shaft # assembly. ίο 5· 15 20 4· is configured to rotate the transmission member from the aerodynamic force The pneumatic transmission signal supported by the distal member is then at least two rotationally driven. w Staying as a tool assembly application The components of the scope of the patent application include a pneumatic motor. The member of the rotary transmission, such as the scope of the application of the patent application, is configured to move toward a movement after receiving a flow of gas from the original transmission of the distal member in the gas, and from the total of the two tools Applying the pneumatic force supported by the rotating striking member: the remote moving after receiving the other gas flow. The rotating tool assembly applies a rotation back to the retracting port. By a $ μ /, τ and a long-axis cup end portion. 9 The movable joint is pivotally coupled to the mechanically driven device of the fourth aspect of the patent application. Connector eth96425·Finished 114 5· 200808254 6· 5 10 15 10 20 If the application for the fourth part of the scope of patent application is driven by pneumatic force, , the middle 4 is the joint, and the patent application is the second item. And the ^ knife can be selectively disengaged from the proximal end of the long shaft rod assembly = surrounding the first item of the external appliance, wherein the long shaft total μ extension portion and the proximal portion of one of the selective /, τ t Within it - can be detached from the length The proximal portion of the rod assembly. The optional apparatus of claim 4, further comprising: a handle assembly; and a structure supported by the handle assembly and used with the aerodynamic source: The second movable member is operatively coupled to the drive mechanism to construct the pneumatic signal from the one of the ninth item of the patent scope, wherein the drive mechanism can control the member in the machine, and the pneumatic power source and the The rotary transmission member is in fluid communication; & a trigger trigger is operatively supported by the handle assembly and operably coupled to the variable flow control member for selectively operating the ac fluid control member. a method for treating an instrument for surgery, the method comprising: obtaining the surgical instrument according to claim 1 of the claimed patent; eth96425-end 115 11 200808254 12. 5 10 15 20 disinfecting the surgical instrument; The appliance is stored in a sterile container. - The surgical instrument comprises: a handle assembly; a closed drive train 'which is activated by the handle culvert and is opened (4), supported and constructed - a moving mechanism, which is contacted by the starting-air power source to selectively generate the 1' moving mechanism and the number; the seat is sent to the J-power driving mechanism 2; = the handle assembly and the closing transmission The signal, the start and close movements, and the at least-pneumatic drive-pneumatic rotary drive configuration are partially operatively supported and responsive to one of the distal ends of the long shaft assembly and constructed by the Putian* ... The drive signal is moved; and a rotary firing motion and a rotary retractor include: the surface of the long shaft assembly is connected to the long shaft, and the terminal is configured as a long channel A staple long shaft assembly 3 is accommodated in the long channel and is responsive to the opening and closing movements from the door; and the inner member and the pair of members are operatively supported In the long slot and in response to the firing and retracting eth96425-$116 200808254 5 10 15 20 movement from the rotating transmission member. 13. The components other than the scope of claim 12 include a pneumatic motor. Wherein, the rotary transmission 14. = the patent portion of the 12th item of the patented portion of the distal portion _ by the first, the middle shaft of the long shaft rod of the proximal portion of the long shaft rod. The master assembly is pivotally consumable. 15. If the patent application is in the 14th item, the external appliance... is mechanically driven. "The joint joint W" Please refer to the 14th item of the patent scope to be pneumatically driven. /, the live joint of the joint. 17. If the patent part of the 12th item is cried, the distal part can be selectively The main shaft of the unloading shaft = the total end portion of the shaft to allow the near-end portion of the long-end rod assembly (4) to be attached to the proximal portion/(four) portion of the long-axis rod assembly, as in claim 12 The surgical instrument is located outside the handle assembly. A surgical instrument includes: a handle assembly; a t-axis assembly having an operational portion connected to a known portion of the handle assembly, the long shaft The rod assembly further has a distal end portion; operably supporting a device attached to the long shaft rod assembly and a pneumatic operating tool assembly; and - for responding to a gas power source from the Shaw's fluid shank At least one pneumatic transmission signal generates at least one rotational driving force for application to the pneumatically operated tool supported by the operably supporting device by the 19. eth96425-stable 117 200808254, the generating device being comprised of the long shaft assembly Remote support. 20. Patent application Surgical instrument 18 of the first, wherein the pneumatic power train is supported by the assembly of the handle. 5 118 eth96425- End rotten