TW200814963A - Pneumatically powered surgical cutting and fastening instrument with replaceable power sources - Google Patents

Abstract

A surgical instrument that includes a handle assembly that removably supports a source of pneumatic power. A pneumatically powered drive system is operably supported by the surgical instrument and is configured to be fluidically coupled to the source of pneumatic power. The handle assembly may be provided with a lockout system that is configured to block connection of the source of pneumatic power to the portion of the handle assembly and the pneumatically powered drive system after the source of pneumatic power is disconnected from the portion of the handle assembly and the pneumatically powered drive system a predetermined number of times. In alternative embodiments the handle assembly may be provided with attachment components that either break off or are otherwise disabled to prevent the reattachment of the source of pneumatic power to the handle assembly after the source has been detached therefrom.

Description

200814963 IX. DESCRIPTION OF THE INVENTION: TECHNICAL FIELD OF THE INVENTION 5 10 15 2〇 The present invention relates generally to surgical instruments, and more particularly to pneumatic outer cutting and fastening devices. The present invention is applicable to endoscopic and open surgical instruments and can be applied to robot-assisted surgery. [Prior Art] Surgical cutting and fastening devices (knotters) have been used in the prior art to make a longitudinal slit σ and apply a yoke to the side of the slit 3. These devices usually contain a pair of cooperating clip members. When the crying is performed by an endoscope or a laparoscope, the wealth component is ^== cannula channel. The storage of the clip members - the nailsmith, the second, there are two columns of horizontally spaced financial nails. The other jaw member defines a sum; the anvil f has a nail forming pocket aligned with the column of staples in the g. The wedges of the wedges are developed by the staples that are driven by the staples toward the actuators of the staples to perform the two pieces of the fasteners. Different actuation cutting and elbow deployment group; 7:; 2Γ; ^5Γ^ 上上夂Γ - a kind of surgical stapling instrument, which uses the manual driving action of the handle mechanism to cut the tissue and the elbow f Other surgical staples using a battery-powered motor: 22" Revealed in the Charter - 96422 Other surgical staplers are operated by a pressurized gas source. For example, 6 200814963 5 10 15 20 said that the certificate was given to Green. λ *,, m is a broadcaster, such as the Wu Guo patent No. 6,619,529, which reveals a branch: ... which uses one of the handles of the Garry gas source == factory to supply power. The cylinder is equipped with a piston assembly which is actuated by the entry of the two gases into the gas red. The piston is constructed at the distal end: the component within the end === - acts to cause the october to use one. The financial nails and scalpels are unfolding. However, the assembly of such a set of components is to transfer the movement of the piston mounted on the handle to the terminal at the end of the device to cry but the eight-members are connected to the components of the eight-two. In addition, when using this, 々: throw: risk of depletion of the power source during the surgical procedure, because ::, the method monitors the amount of gas remaining in the stagnation. If it is in the firing or = new container or auxiliary power source, it is easy to replace the depleted container with another. Another pneumatic surgical stapling device is disclosed in the patent application No. US 2006/0151567. This kind of strong, and specially installed car "is now used by the air motor or piston system supported by the device" to move to the terminal to cry. + Plug-in m-assisted and use this transport is powered by the detachable e-powered or an external power source such as the hospital. The other two or the carcass supply source, such as the pneumatics of the bowl or the container in the handle portion of the device, is to store a sufficient volume of pressurized gas to achieve the desired number of actuations of the I placed under pressure. Bottle Limit = Use = Devices designed for most applications/programs will require two = for H or for use with smaller gas cylinders ^ with unwanted high frequency. In addition, devices using the Removable Heart II 96422 7 200814963 must be reprocessed and resterilized. These arrangements may significantly change performance and may therefore be less desirable.

There are other problems with conventional pneumatic actuators (endocutter). For example, if the surgeon activates the device through a single switch or a trigger, the thief will perform or at least attempt to complete the firing cycle. The assembly can then be retracted by the drive train. Despite the use of the device disclosed in U.S. Patent No. 2, T2, the surgeon can pass through: the trigger (4) Wei and/or adjust the flow of gas delivered to the set, but there is no process to monitor the process. In addition, these devices are lacking in the case of = loss of operating pressure or due to the circumstances of the hand _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Health::2;;:=2Pneumatic surgical needle that can transfer the pneumatic production to the end effector assembly with a large number of components. It also requires a pneumatic surgical staple I 4 system and monitors the device. In the firing and retracting cycle, a state of aerodynamic exotropy is known. The power of the power encountered during the firing is the same: the surgeon provides the position that he has acted and is prepared to be economically and easily replaced by fJ.b # ^ # a ^ ^ ^ A ^ ^ ^ ^ ^ ^ 96422 In addition, there is a need for a method and apparatus for more efficiently storing gas in a petrol cylinder for supplying and powering the unit to the power supply unit, so that a single gas cylinder can be powered for more uses. 5

Further, a pneumatic stapling device having means for manually retracting the cutter and the firing rod assembly in the event of loss or interruption of aerodynamic forces is required. And a device having one or more of the above features and also having an end effector. The terminal device can selectively (4) selectively live on the handle assembly and the long shaft assembly portion to which the field is attached. Festival sports. 10 [Summary of the Invention] In a general view, the present invention is a slanting shackle-supplied to a sneaker, "for a surgical instrument, which includes a handle and a removably attached to the handle. Source of force. - A pneumatic transmission system can be constructed by the surgical instrument for fluid consumption of the aerodynamic source. A locking system is constructed to separate the pneumatic ~, Ό part and the pneumatic transmission system; the hand assembly is mainly for the Feng 嫡 嫡 、 , , , , , , , , , , , , , , , , , , , , , The main part and the connection of the pneumatic drive system. In another general view, Ben Yuming has a handle, and in January, it can be used for a surgical instrument.哕 tube: r: 'The main part of the tube-box area is formed. The center of the center of the knife can have a penetrating joint | cover the pick-up. The handle assembly can be further advanced to prevent the early component from covering the grip portion of the main portion. - The gas is releasably connected to the operatively supported main assembly of the handle assembly. The eight systems can be at least partially 96 422. The pneumatic transmission system can be in fluid communication with the main part of the tube compartment of the main part of the year 2008. — supported in the grip portion. A gas supply line can be two = 5 and is configured to be attached to the grip portion; 2: an aerodynamic source is itchy. A counter can be mismatched by the handle to the number of times the pick-up has been attached to the main portion. The grip portion is counted to prevent the (four) portion from being re-cut to the cymbal-number of people after the grip portion has been halved. [Embodiment] A knife. 10 15 The following description is by way of example with reference to the accompanying drawings, wherein夕一贝细 Dry out of this one to ϋ ϋ each figure with the same number to indicate the same components, figure! Disconnect the appliance 1〇. Figure! The actual two are shown as the sole surgical stapling and cutting rod assembly 100, and one connected to the second two: the handle assembly 300, the long axis is too private, the car is dry, and the The end effector 12 of the crucible is cut and pivotally attached to the long axle assembly car! Λ Λ The end effector of the turn, such as 鸠ΗΑνίΝΓ Δ\τ, the name of the invention is, SURGICALINSTRUMENT ==3 Weaving (3) LATING END EF_air of the United States specifically cited; brother 11/329, 〇 2 所 revealed by the content of the application, Huai Yi, n / and died in this article. But with the detailed description of the invention gradually used: It will be understood by those skilled in the art that embodiments of the present invention can be successfully implemented with respect to the configuration of the terminal mechanism of the 5-zone π mechanism and control, and: 1: will be further elaborated and even successfully utilized. There is no active end effector configuration. 96422 20 5 10 15 20 200814963 As shown in Figure 1, the handle assembly 3 of the appliance 10 is a machine 302 and a firing trigger 310. It should be understood that there is a problem with the door - only 1 & Terminal device for use | Ten pairs of different surgical machines or other suitable exercises A terminal two === The end effector 12 is divided into 300 by a shaft assembly 1 which is preferably not shown in the figure. The clinician can use the _day (four) device 'hand = 12 The joint movement is performed with respect to the shaft assembly (10). The effect is from the outside of the μ to the horizontal, horizontal, right, left, etc., and the spatial language is in the longitudinal axis of the false-Buco~10 and the long shaft assembly axis. And the trigger trace 31〇 from the bottom of the handle assembly (10) == can be more than 1 隹 际 , , 外科 外科 外科 外科 外科 外科 外科 外科 外科 外科 外科 外科 外科 外科 外科 外科 外科 外科 外科 外科 外科 外科 外科 外科 外科 外科 外科 外科 外科 外科 外科 外科 外科 外科 外科 外科 外科 外科 外科The use of 0 itself, · Alum injury and injury to a body 4 4 proximal (proximal) - the words in this view: this Linqing with the handle assembly 300 behind the clinician's point of view, this clinical division will be the terminal Actuator 12 is placed away from itself. As used in this specification, 'pressurized gas' means any gas suitable for use in a sterile loop system. Non-restrictive ^2 m carbon dioxide (c〇2) of such media , nitrogen, oxygen, nitrogen, gas gasification, propylene, isobutyl, butyl, chlorofluorocarbon ^, dimethyl ether 'A Base ethyl shout ' ^ Hua Ya said, nitrogen burning class (Teng), such as HFA 13 such as (1,1,1,2,-tetrafluoroethane) or 1^ 227 ( 1,1,1,2,3 3 3- Heptafluoropropane.) ' ' In this case, a fluidly coupled 7/--------------------------------------------------------------------------------------------------------------------------------------------------- In the present specification, 'used in, gas supply line, line, line' means a rigid or flexible conduit, pipe, two = formed to transport pressurized gas from the assembly to another component Appropriate one in this manual, ', pneumatic signal 1, pneumatic transmission signal Γ Γ 加? The source of gas flows to - or more of the fluid-coupled source of the pressurized gas; or the flow of water between the components that are brought together by the fluid. The tether is in the middle: the fork, and is substantially transverse to the longitudinal axis (where 'longitudinal (four) ίο 15 _ 20 庳: refers to a direction that is nearly perpendicular to the longitudinal axis. However, the solution is slightly offset from the longitudinal axis. The direction is also the large longitudinal axis. "" is also roughly loose and Λ2^~? used in the various embodiments of the present invention - the pneumatic assembly operator /, ~ into the end of the assembly diagram of the decomposition. Figure _4 The tool assembly 12 is constructed as an inner cut. The description of the Zhu Xi is gradually carried out. It will be understood that the detailed novel transmission configuration of the present invention 明 2 = Ming can also be imagined to be used to drive the sister construction. In addition, it is to be understood that the component 12 can be customized for a particular surgical system. The terminal actuators of the embodiments of the present invention are shown in Figure 2. 〇 2 function "12 (four) _ Ε beam firing mechanism (,, knife and her nail cylinder ^ (4) organization and firing in the two installed in the field of nails ^ more favorable control of the terminal action ^ - station part phase, needle with The diverse views of the pitch beam firing mechanism have been chartered: 96422, port 20 0814963

Shelt〇n, IV et al.'s invention name is 'Surgical Stapling

Instrument Incorporating An Ε Β 削 々 々 々 々 々 々 々 々 々 々 吴 吴 吴 吴 吴 吴 吴 吴 。 。 。 。 。 。 。 。 。 。 。 。 。 。 。 However, as the detailed description of the invention proceeds gradually & heat 4, the skilled artisan will appreciate that other tooling and firing mechanisms may be utilized without departing from the spirit and scope of the invention. . . In this specification, the firing mechanism means a pneumatic tool and/or a terminal for ίο 15 20 . . Or a portion that moves from an unactuated position in which the firing mechanism may be essentially in a resting state to the activated or terminal position that is or is set to the final position, and the shift in the fourth causes the edge I | One or more actions are completed in response to at least the __firing motion applied thereto. The firing mechanism may include, by way of example,: (i) a component that is fully supported by the pneumatic tool and interfaces with components in the surgical device; (") a combination of components within the pneumatic device and within the surgical device; An assembly that is placed, supported, and moved in and out of a pneumatic tool. In this specification, a slamming stroke means that the firing mechanism moves from an unactuated position to an actuated position. In the text, the retraction stroke " The firing mechanism moves back from the active position to the unactuated position.

Mi, as in Fig. 2, the end effector 12 includes a distal member that, in each non-limiting embodiment, includes a long channel 20 with a pivotable: anvil 4 attached to The long channel. The long channel 20 is configured to receive a sub-supporting nail 50 which is in contact with the stone assembly for the tool assembly. It should be understood that although this should be replaced by an easily replaceable Nail, a staple II of 96422 13 200814963 can be permanently fixed or integrated into the long channel 2〇 in accordance with the teachings of the present invention. In various embodiments, the firing mechanism or tool assembly 3G is included in the firing control terminal. The vertical spacing pin between the actuators 12. In particular: the upper pin 32 is arranged to enter the vicinity of the 柩 axis between the stone 〇 4 〇 and the long channel (9) 5: the anvil 42. See Figure 4' When the anvil 4 is fired in the closed state, the upper pin 32 is advanced in the longitudinal direction of the slot extending through the stone to the far side. Any slight upward deflection of the rock accountant 40 is given. One of the downward force overcomes. The tool assembly 30 also includes a knife bar cap 34 that is coupled upwardly to form a 1 - channel slot 23 (Fig. 2) in the long channel 2, thereby engaging the upper pin When the 组织, 田万石占40 and the long channel 20 sandwich too much tissue, the stone is occupied, and the long channel 20 is slightly closer to each other. In various embodiments, the tool assembly, such as the secondmost, may include an intermediate pin that is fired through a transmission slot (not shown) through one of the lower surfaces of one of the magazines 5'' and the upper surface of the long channel buckles. Win 36, thereby driving the elbow 7 in it as described below. The intermediate sales advantageously resist any tendency of the terminal fairy 12 to be turned off by the _ sliding against the long channel 20. However, the unique new features of various embodiments of the present invention can also be achieved through the use of other tool assembly configurations. Referring back to FIG. 2, a straight edge of the cutting edge % between the upper pin 32 and the intermediate pin 36 on the cutter assembly 30 is traversed by one of the nails 5 位于 on the side of the pin. To cut off the clamped tissue. The exact positioning of the tool assembly 3〇 associated with the long channel 20 and the station 4〇 ensures efficient cutting. In each of the embodiments, the lower surface of the station 4G may have a plurality of nail forming holes (not shown) therein, and the nail forming holes are arranged to be received in the long groove of the 96422 14 200814963. The inner time corresponds to the % of the upper surface 56 of the nail E5G. In various embodiments, the staple E50 can be snap-fitted into the long channel 2〇. In particular, the elongated features 6〇, 62 of the staple E50 are frictionally and releasably engaged with the recesses 24, 26 of the long channel 2, respectively. Ίο 15 As also shown in Fig. 2, the staple E 5 〇 includes a £ body 51, a wedge-shaped slider 64, a staple driver 66, a staple 7 〇, and a quinque plate 68. At the time of assembly, the S-pad 68 holds the wedge slider 64, the toggle actuator 66, and the nail 7 内侧 inside the s main body 51. The long channel 2G is attached to the handle assembly 3GG' by a long shaft assembly ι (9). The long shaft assembly includes a distal ridge or a skeleton segment ιι = near (four) or a skeleton segment 13G. The long channel 2G has an appendage member 22 disposed on the proximal side and a corresponding channel member 114 formed on the distal end of the distal ridge segment η 每. The long channel 2G also has a rock-accumulating cam slot 28 that pivotally receives the stone occupying 40 of the corresponding stone-occupant pivot 43. A closure sleeve assembly 170 is placed over the total ridge 102 and includes a distal closure tube section 18 , and a side closure tube section! 90. The closure sleeve assembly η will be described as will be described below. The axial movement relative to the ridge assembly 102 causes the rock to pivot. 7 Cut, as shown in Fig. 2, a lock spring 112 is mounted in the distal spine section 110 as a latching member of the blade. Distal and proximal square holes! J 、, J3 20 is formed at the top of the distal ridge 110 ± with a clamping rod 115 defining a receiving 126 on one of the locking dies 112, the lower arm 118 of the locking spring extending distally in the cylinder, A downward force is applied to one of the distal ends of the 501 to support the piston rod portion 35 projecting from the cutter assembly 30, as will be described below. It should be understood that embodiments may include other types of latching devices or no latching devices at all. 96422 15 200814963 For the proximal closure of the two 9 = motion. 3) = ΓΓ is the proximal end of the ridge section in). In this embodiment, there is a kill U2 on the far side, /, on the top. The proximal ridge section 13 is far away from the soil /, the shank 134 of the through hole 136. The proximal spine segment 130 is positioned relative to the = side spine segment m such that the bore 136 is coaxial with the bore 124 of the hub 122. 10 = allows a pivot pin 138 to pass therethrough. See Figure 4. This configuration pivots around the pivotal ridge (4) in the vicinity of the side ridge section (4). As described above, this embodiment utilizes the belt to cause the end effector 12 to perform a joint motion. In particular, the straps 150, 16 can extend distally toward the hinge pivot 104 as shown in Figures 2 and 3. The strap 150 can be closed along the proximal side of the tube section 19 to the left side 15 through the proximal closure tube section where it bypasses the strap member 160 and spans to the right side of the proximal side closure tube section. Wherein, the belt 15 can be mechanically coupled to the hub 122 at the connection point 123, for example. Similarly, the band 16 can pass through the proximal closure tube section along the right side of the proximal closure tube section I90 where it bypasses the strap member 15A and spans to the left side of the proximal closure tube section 190. The strap 16 can be mechanically coupled to the hub 122 at the 20 connection point 125. Figure 3 is a top plan view of the end effector and ridge assembly 1 , 2 with the closed tube assembly 1 以 shown in dashed lines. Figure 4 is a partial side cross-sectional view of the same portion of the appliance 10. 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, 96422 16 200814963 j, tribute 150 is shown in a position below the band 6 〇. In another non-limiting example of a yoke, the straight orientation of the leads of strips 150 and 160 can be reversed. As also shown in Figures 2 and 3, the strap member 15 extends around a pin 140 in the tang portion 134 of the proximal frame segment 13〇. Similarly, the pin 142 in the 5 tang portion 134 of the band 16 about the proximal skeletal section 13 延伸 extends. See also Figure 2. The belt portions 150 and 160 can extend from the hub 122 and extend along the proximal closure tube section 190 L to the joint controller 2 shown in FIG. 5. The joint controller 200 can include a joint slider 202 , a frame 204 and a closure 206. The strap portions 150, 160 can pass through the slot slider 2〇2 via slots 2〇8 or other apertures, but it should be understood that the strap portions 15〇, 16〇 can be coupled to the slider 202 by any suitable means. The hinge slider 2〇2 can be a one-piece as shown in Figure 5, or can comprise two components in a non-limiting embodiment with a parent boundary defining a slot 208 therebetween. In a non-limiting embodiment, the hinge slide 2〇2 may comprise a plurality of slots, for example, with each slot corresponding to one of the belt portion 15〇, the work (9) 15. The closure member 2〇6 can cover the components of the controller 2〇〇 to prevent debris from entering. In various embodiments, the strap portions 150, 160 can be anchored to the frame 204 at attachment points 210, 212 that are proximal to the slot 208. The non-limiting example of Figure 5 shows that the strap portions 150, 160 are pre-bent from the attachment points 210, 212 to the slots 208 near the longitudinal axis of the proximal side closure tube section 19A. It will be appreciated that the strap portions 150, 160 can be anchored to any of the closer slots 208 of the appliance 1 靠近 near the proximal side, including the handle assembly 3 〇〇. In use, the embodiment of Figure 2 can have one of the unjointed motion positions as shown in Figure 3. The joint controller 200 and belts 150, 160 are shown in a centered position at a longitudinal axis of the shaft assembly 100 at approximately 96422 17 200814963. Thus, the terminal 12 is in a neutral or unjointed position. In Figure 6, the joint controller 200 is shown with the hinge slide 2〇2 pushed through the joint frame to the right of the shaft assembly 100. Therefore, the belts 15〇, 16〇 are bent toward the right 5 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 that is offset from the pivot point of the hub 122. This offset force causes the hub 122 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, 16〇1〇 both face the shaft. The rod assembly is bent to the left of 1〇〇. 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 22 as previously described. This then causes the kill 122 to pivot about the hinge of the joint, 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 〇 15 sets of j ridge assemblies 102. See Figure 2. The closure tube assembly 17A includes a distal closure tube segment 180 and a proximal closure tube segment 190. The distal closure tube section 18〇 and the proximal closure tube section 19〇 can be made of a polymer or other suitable material. The proximal closure tube section 19 is hollow and has a penetratingly extending axial passage Siam 191 that is sized to receive a portion of the 20 ridge assembly 102 therein. In the embodiment shown in Figures 2 and 4, a double pivot closure joint Π 2 is used. It should be understood that the present invention is not limited to a dual pivot closed joint design and may include any suitable closure tube or sleeve, or no closure tube or sleeve at all. With particular reference to Figure 4, the distal closure tube section 18A has tangs 1 82, Λ 184 projecting proximally from the upper and lower portions 96422 18 200814963. The transport side closing pipe section 180 is further provided with a wide open/closed tongue 46. The horseshoe is pivoted when it is opened. See the detail. The 'closed section (10) similarly has a distal extension. 174 spoons into the V main Γ side extension? Lower tang 194. The distal and proximal pivots of the upper double pivot link ο 3 4 are respectively engaged with a shaft pin which is respectively joined to the proximal side of the temple and the temple pivoting m... the upper distal side of the shank 182 15 is 83 and an upper proximal pin hole (9) in the upper tang 192 protruding distally. The joint arrangement further includes a lower double pivot link π having distal and proximal pivot pins 178, 179 projecting downwardly (not shown in Figure 2, but seen in Figure 4), the pivot pins respectively The lower σρ distal latch hole j 87 in a proximally projecting lower tang 184 and a lower proximal latch bore 95 in the distally projecting tang 194 are engaged. In use, the closure tube assembly 170 translates distally, for example, in response to closing the trigger 31 to close the anvil 40. The anvil 40 is translated distally on the ridge assembly 102 by the closure tube assembly 17 and causes the back of the horseshoe hole 85 to impact the tab 46 on the station 4 and causes the anvil 40 to pivot to the closed position to close. To open the station 40, axially moving the closure tube assembly no in the proximal direction on the ridge assembly ι 2 causes the tab 186 to contact and push against the tab 46 to open the anvil 40 to the opening position. Figure 7 illustrates an exploded assembly view of one of the non-limiting handle assemblies 3 of one of the various embodiments of the present invention. In the embodiment shown in Figure 7, the handle assembly has a one-hand % grip type configuration and is comprised of a right housing member 320 and a left unit 96422 19 20 200814963 housing member 330, which are A polymer or other suitable material is molded or otherwise fabricated and designed to fit together. The casing members 320 and 330 may be formed by snap-on features, short piles and sockets molded or otherwise formed therein, and/or by adhesives, screws, bolts, clips, and the like Attached together. The upper portion of the right casing member 320 '322 cooperates with one of the left casing members 330 corresponding to the upper portion 323 to form a main casing portion designated 340. Similarly, the right upper housing member 320_ 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 illustrated embodiment of Figure 7, the entire grip portion 342 is integral with the main housing portion 340. Such a configuration may be particularly suitable for applications where the pressurized gas source is permanently mounted within the grip portion 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 detail below, the grip portion 342 is detachable from the main housing portion 340. This configuration provides a number of benefits and advantages as the detailed description of the present invention proceeds gradually. However, those skilled in the art will appreciate that the handle assembly 300 can be provided in a variety of different shapes and sizes. For the sake of simplicity, Figure 7 illustrates only the components used to control the axial movement of the closure tube assembly 170 that ultimately controls the opening and closing of the anvil 40. As shown, a closure shuttle 400 that is coupled to the closure trigger 302 by a linkage assembly 430 is supported within the main housing portion 340. The closure shuttle 400 can also be fabricated as two portions 402, 404 that are molded or otherwise fabricated from a polymer or other suitable material and that are designed to fit together. For example, in Figure 7 where 96422 20 200814963 is not implemented, the right part of the technique may have a fastening check 4〇3 designed to be received in the corresponding socket of the left sub-frame (Fig. ♦ not shown). The right and left portions 402, 404 can be otherwise held in place by fastening members and/or adhesives and/or bolts, screws, clips, and the like. A stop groove 196 is provided in the proximal end of the proximal closure tube section 190 as shown in FIG. The right portion of the closure shuttle 400 has a right stop flange section 405 that is adapted to engage with a left stop flange section on the left side of the closing shuttle 4 (8) (not shown) Cooperating to form a stop flange assembly that extends into the retaining groove 196 of the proximal closure tube section 190. 1 〇 #如® 7' The right ridge assembly stop pile 326 extends inwardly from the right casing member 320. This post 326 extends into the elongated slot or window 406 of the right portion 4〇2 of the closed shuttle 4〇〇. 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. The stop posts are used to immovably fix the proximal end 133 (not shown in FIG. 7) of the proximal spine segment 130 to the proximal end of the proximal stalk portion 130 while axially moving relative to the handle assembly 3〇〇. The handle assembly is 300. 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 guides 41A, 411. The track 4 〇 2 is slidably received in the track guide 328 of the right casing member 32 ,, and the 411 is configured to be slidably received in one of the left casing members (not shown) Show). The axial movement of the closure shuttle 400 and the closure tube assembly 170 in the distal direction (arrows, c//) is by the closure trigger 302 toward the handle assembly 3 握 grip portion 96422 21 200814963 5 10 15 20 points Movement of 342 occurs and axial movement of the closure shuttle 400 in the proximal direction (arrows, D...) is produced by movement of the closure trigger 302 away from the grip portion 342. In each embodiment +, the closure shuttle has - The connector tab 412 is attached to the closure link assembly 430. See Figures 8 and 9. The closure link assembly 430 includes a portion 432 that is pivotally pinned to the M2 by a pin 414. The closure link assembly 43A further has a closure arm that is pivotally pinned to a yoke assembly 3〇4 formed on the closure trigger 3〇2 by a closure pin 436 as shown in FIG. The closure trigger is pivotally mounted within the handle assembly 300 by a pivot lock 306 extending between the right housing member 320 and the left housing portion 33. When the bed physician wants to close the anvil 4 When the tissue is clamped within the terminal applicator 12g, the clinician pulls the trigger 302 to the grip portion 342. As the clinical officer closes the wrench 3〇2 is pulled to the grip portion 342, and she moves in the far w direction to close the shuttle until the closure is closed; ^ 430 moves to the locked position shown in Fig. 8. When in this position, the link assembly 430 tends to The closing shuttle 4〇〇 is held in the locked position. As it is closed, it is moved to the locked position, and the closing tube assembly 170 is moved away from the ridge assembly 102, causing the closing/opening of the tongue on the anvil 4 The proximal end of the horseshoe shaped aperture 185 of the side closure section 180 is brought into contact to pivot the anvil to the closed (clamped) position. In each of the shell examples, to further maintain the shuttle 4 (10) in the closed position, the trigger 302 can be closed. There is a releasable mechanism adapted to engage the grip portion 342 and releasably retain the closure trigger 302 in a relatively positional position. It is also possible to releasably hold the closure shuttle in the locked position 96422 22 200814963 using other locking devices. In the embodiment illustrated in Figures 8, 8A, 8B, and 9, the closure trigger 302 includes a flexible longitudinal arm 303 from which the lateral pin 305 extends. The arm 303 and the pin 305 are, for example, moldable. Made of plastic. The handle portion 342 of the handle assembly 300 includes a Port 350, the opening having a side, extending wedge 352 therein. When the closure trigger 302 is retracted, the pin 305 engages the wedge '352 and the pin 305 is forced downward by the lower surface 354 of the wedge 352 (even The arm 303 is rotated in a clockwise direction. When the pin 305 completely passes the lower surface 354 φ, the clockwise force on the arm 303 is removed, and the pin 305 is rotated in the counterclockwise direction to cause the pin 305 to stop at the back of the wedge 352. The trigger 301 is thus closed by the lock 10 in the mouth 356. The pin 305 is further retained in the locked position by a flexible stop 358 extending from the wedge 352. To unlock the closure trigger 302, the operator can further squeeze 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 flexible 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 grip portion 342. Further details of this configuration can be found in the January 31, 2006 application. The application of the name to Shelton, IV et al., Surgical Instrument Having A Removable Battery, US Patent Application Serial No. 11/344,020 And, the relevant portion 20 of this patent application is incorporated herein by reference. Other release lock configurations are also available. In various embodiments of the invention, the tool assembly 30 can have a generally rigid piston rod portion 35 extending therefrom or otherwise attached thereto, the piston rod portion being a portion of the transmission member 500 that is distally ridged 110 is operatively supported and configured to impart at least two drive motions to the tool assembly 30 (eg, 96422 23 200814963 firing motion and retraction motion). In Figures 3, 4, 1 and , the transmission member comprises - two-stage pneumatically actuated gas (four). 5 10 15 Xin 20 30 may comprise a one-piece assembly or it may be provided in multiple parts to assemble the benefit 10 . For example, as shown in Figures 10 and u, the knife 30 includes an upper pin 32, a cap 34, an intermediate pin 36, and a soil-forming side portion. The distal portion 31 can be provided therein with a hole 33 that is stapled = one of the projections 37 on the distal end of the receiving live + plug stem portion 35. The projections 37 can be received in the holes 33 by friction and/or held in a similar manner by adhesion. The pressing or hole k includes a first cylinder housing 51〇, the first gas-filled housing has a first-closed proximal end 512 and a first-in-one in the first gas red shell 51〇 A first open distal end 514 within the axial passage 516. The gas red assembly 〇1 also includes a first cylinder housing 520 having a first proximal end 522 and a second open distal end 524 that opens into a second axial passage 526. The second closed proximal end 522 has a first piston head 528 formed thereon, and the first piston head is sized to be opposite to the first axial passage 516 by a first wall 511 of the cylinder-cylinder casing 51. The substantially airtight sliding jaw seals to define a first cylinder region 515 on the distal side of the first proximal end 512 from the proximal side y1 of the first piston head 528. The first distal end 514 of the helium-red-red housing 51 has an inwardly extending first flange η? formed thereon for establishing an outer wall surface of the second cylinder housing 52〇 A substantially gas seal defines a second reddish region 518 between the proximal side of the first flange 517 and the return side of the first piston head 528. A first port 527 penetrates the first piston head 528. The proximal end of the piston rod 35 extends through the second open distal end 524 of the second cylinder housing 520 into the second axial passage 526 as shown in Figures 1A and 96422 24 200814963. A second piston head 53 is or is otherwise attached to the proximal end of the piston rod 35. The second piston head is sized relative to the second axial passage 526 for producing a substantially airtight sliding seal with the second wall 521 of the second cylinder housing 5 5 > 20 to define a first and third cylinder region 532 . The second distal end 524 of the second cylinder housing 52 further has an inwardly extending second flange 525 formed thereon for establishing a substantially airtight sliding seal with the piston rod 35 for A fourth cylinder zone brother 4 is defined between the proximal side of the second flange 25 and the distal side of the second piston head 530. 10, as shown in Figures 3 and 4, the cylinder assembly 501 is mounted in the distal spine section 110. In various embodiments, a pair of trunnions 519 are provided on the proximal end of the first cylinder housing 51A. The trunnion 519 is received within the trunnion aperture 119 of the distal spine segment 11 () to enable the cylinder assembly 501 to pivot within the distal spine segment 11 with a pivot axis B B of %. See Figure 3. A first air supply line or air supply conduit 15 540 攸 handle assembly 3 directional control valve 61 〇 (Figs. 8 and 9) extends • f over, coupled to the first end of the first cylinder housing 510 The proximal side of the 512 is closed, and the section 190 is supplied with pressurized gas through the first cylinder housing 51, the first proximal end 512 = a first air supply port 513 or opening. See Figures 10 and u. In addition, a second air supply line 542 extends from the directional control valve 61 穿过 through the proximal side closure: a section 19 连接 and is coupled to the first cylinder housing 510 near the distal end 514 of the first cylinder housing 51 借A second crucible 529 feeds pressurized gas into the second cylinder region 518. Figure 8-11 shows the extension and retraction of the firing mechanism or tool assembly. As shown in Figures 8 and 9, the gas supply lines 54A and 542 are connected to the 96422 25 200814963 10 15 20 directional valve 610, which is housed in the handle housing 350. . In various embodiments, the directional valve 610 may be switched between a forward (elongation) and an inverted (retracted) position by a selectable switch 612 or button that is permeable to the handle housing 35. See Fig. 1 in the embodiment shown in Figs. 8 and 9, using a removable pressurized f body source 62G as will be described in more detail below, such a pressurized gas source comprising - may be used at a monthly rate A gas cylinder 622 that is refilled with pressurized gas. However, those skilled in the art will appreciate that an irreplaceable/refillable pressurized gas source (% cylinder) can also be utilized effectively. In still other embodiments, the handle assembly 3 can have a port for supplying pressurized gas from an external pressurized gas source 618, for example, the state 10 can be permeable to a flexible gas supply. Line 017 is coupled to a compressed air supply 618 in the facility. See Figure 8Β. The unique novelty of the removable/refillable gas cylinder 622 will be described in more detail below. However, in order to explain the elongation and retraction of the piston rod 35 and the cutter assembly 3, it can be seen that the pressurized gas flows from the gas cylinder 622 (or the external pressure source 618) through a gas supply line 65, which may include a conventional Variable force drive for proportional valve 660. As particularly shown in Figures 9 and 55, the proportional valve is coupled to a supply air link 662 that is attached to a start trigger 670. In the δ brothers book, V, the variable force drive assembly, at least includes the proportional valve 060 and the start trigger 670 and their corresponding equivalent structures. In various embodiments, the trigger is activated adjacent to the firing trigger 31A that is pivotally coupled by a pivot pin 37 that extends between the right housing member 320 and the left housing member 330. The handle assembly is 3 inches. Pressing the trigger 67 〇 inwardly toward the firing trigger 310 causes the proportional valve 66 to increase the flow rate of pressurized gas from the gas cylinder 96422 26 200814963 622 into the gas supply line 680 of the directional valve 610. Depending on the position of the directional valve 610, pressurized gas will flow into the supply line: 54 〇 or 542. For example, when the directional valve 61 is actuated by the clinician to fire the tool assembly 30, the pressurized gas is allowed to flow through the gas supply line 54 via the first piston head 528 after the activation trigger 67 is actuated. An opening My' flows into the first cylinder region 515 and flows into the third cylinder region 532. As the pressurized gas enters the third cylinder region 532, the second piston head 53 urges the force toward the distal side. The gas located in the fourth cylinder region is discharged through the exhaust port 523 of the second gas 520. Similarly, the gas containing 10 in the second cylinder zone 518 is permitted to be discharged through the second opening 529 into the second gas supply line 5, . The second gas supply line 542 sends the exhaust gas to the directional valve 6 〇 and is finally discharged from the directional valve. Continued application of pressurized gas to the first gas zone and the third cylinder zone 532 causes the tool assembly 30 to extend completely through the end effector 12. As the tool assembly 30 passes through the end effector I], it cuts off the clamped tissue in the final 15-end effector and fires the staples 7〇 in the staples 5〇 (driving the staples and the underside of the anvil 40) Forming contact occurs). Once the tool assembly % has advanced to its most distal position within the end effector 12, the physician = release trigger trigger 670 to interrupt the application of pressurized gas. To retract the firing mechanism or tool assembly 30, the clinician manually moves the 20-way selector switch 612 or the appropriate button to adjust the directional valve 61 成 to the retracted position and begins to squeeze the trigger 670, causing pressurized gas to flow into the qi. Within line 542. The gas flowing through the second gas supply line 542 enters the first #%, and the second cylinder area 518' causes the cylinder housing 520 to be retracted proximally into the first cylinder housing 510. The gas in the first cylinder region 515 is allowed to be discharged into the first gas supply line 540 via the first supply port η) 96422 27 200814963. The gas entering through the first gas supply line 540 enters the valve 610 and is thereby discharged. Upon entering the second cylinder region 518, the gas has caused the second cylinder housing 52 to be retracted into the first cylinder as shown in FIG. 1A, and the gas passing through the second opening 529 can pass the fifth step at this time. The cylinder housing 51 has an exhaust port 523 and flows into the fourth cylinder region 534. The pressurized gas enters the fourth cylinder region 534, and the second piston head 530 pulls the living rod 35 proximally into the second cylinder housing 52A. The gas in the third cylinder region enters the first cylinder region 515 through the first opening 527, and is discharged from the first cylinder region in the aforementioned manner. 10 Variable force actuators in the form of proportional valves 060 in various embodiments of the invention may utilize springs or other biasing means (not shown) to bias the ratio 阙_ to the unactuated position. When in the unactuated position, the proportional valve 660 can be constructed to prevent any gas from flowing from the gas source 620 or 618 through an orifice (not shown) in the valve 66. Therefore, when the driver trigger 67 is in the U-actuated position, the device is essentially in a closed state. In the foregoing embodiment, the proportional valve 66 is mechanically coupled to the activation trigger 670 by the air supply link arm 662, so that when the clinician presses the trigger 670 to the trigger trigger ji, the link The arm 662 causes the proportional valve 66 to permit the gas flow rate to increase through the valve 66. Therefore, a quick squeeze to activate the trigger 20 670 may result in an increased firing rate of the device, and a slower rate of squeezing the trigger 670^ will slow down the firing rate. Therefore, the flow rate of gas allowed to pass through the proportional valve 66 is approximately proportional to the manual force applied to the start trigger 67. In other embodiments, the proportional valve 660 can be electronically controlled such that after the trigger is actuated at 96422 28 200814963, the proportional 阙 660 is digitally vented from the gas. The ratio 阙 660 releases a small amount of gas in a pulse, and the trigger 670 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. 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 trigger trigger 670. For example, the trigger can be a spring driven slip 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. 10 Further, in each of the embodiments, ^ - the force e 541 may be fluidly coupled to the gas supply line 540 as shown in Figures 8 and 8A. A window 543 can be provided through a corresponding portion of the handle handle to enable the clinician to view the pressure gauge 541, or can be configured to allow the clinician to view the pressure gauge 541 during use. See Figure 7. In various embodiments, the pressure gauge 54i can include a pressure gauge or a gauge disc gauge. In these non-limiting real terms: a meter 3 provides a response to the force encountered in the firing stroke; two; it will be understood that in some non-limiting embodiments 1 :: 2 the required force is directly It can be used in the total phase of the cylinder. If the force is small, the cylinder assembly 5()1 does not need to be large, so it is necessary to release more gas into the piston pressure to fully actuate the firing mechanism. The force j 5G1 increases the proportion of the force in which the terminal actuator is being subjected to = to the clinician. In other embodiments, the pop-up exit 545 can be provided as shown in Figure 8C. 96422 29 200814963 5 10 15 20 In the gas supply line 540. This sound outlet permits a small amount of gas to be released from the gas supply line 540. The subsequent whistle scale due to gas discharge rises as the pressure increases. The clinician can then establish a feeding scale and firing. The association with which the mechanism is subjected. Therefore, the configuration provides a clinician with a feedback to monitor the firing force experienced by the transmission system 500 and the final firing mechanism. 曰/Non-limiting embodiments may also be provided for Fire The device automatically informs the clinician of the device when it has reached the end of the firing process. For example, as shown in Figure 4, a limit switch 546 can be provided in the distal ridge 11 用以 for detecting a U The activation member 547 is embedded or otherwise attached to the firing bar. The actuating member 547 is positioned such that when the firing rod 35 and the firing mechanism reach the end of the firing stroke, the activation member 547 is detected by the limit switch M6, which can be electrically coupled to the directional control valve 61 to transmit a valve to the valve Appropriate signal. Upon receipt of this signal, the directional control valve 61 can be configured to automatically switch to the retracted position and permit the firing mechanism to be retracted. Further, the limit switch 546 can be surface-attached to a component that is generally designated 549 in FIG. In various embodiments, the indicator member can provide deafness to the clinician. A combination of a visual signal or a combination of sound and visual signals indicates that the firing mechanism has reached the end of the firing stroke. For example, the indicating component can include a sound generating device, a "two", a vibration generating device, a ^ analog, or a combination of such devices. The limit switch and associated control group can be supplied by a battery (not shown) supported in the housing assembly 300 or it can be supplied with power from an external power source. Accordingly, each of the non-limiting embodiments of the present invention may be provided with a device for providing a view to the clinician 96422 30 200814963 and/or a sound sniper device and/or a device for use in The crying of the end of the smuggling. The s mechanism automatically retracts to the unactuated position as shown in Figure 4, 1〇 and ^5 5 15 (4). When the knife is confirmed to be ^;; the outlet portion 39 can be formed at the piston position, and the 笪, 〜8, and 3〇 are fully retracted as shown in FIG. 4. Since the cylinder bore 118 is applied to the distal end of the cylinder assembly 5〇1, it is pivoted downward and the further step is at the distal spine u. The inward guide finger 9n + , the locking projection 39 on the tongue/tongue button 35 is dropped into the opening 21 of the disk 9 . This configuration is used to lock the protruding knife and:: the frictional engagement of the portion of the long channel 20 of the opening to make = and: lock r retracted position. As shown in the figure, lock i and leave the locking opening in the long channel 20. Skilled in the art, other shanks can be successfully employed without departing from the spirit and scope of the present invention. Fig. 6 shows an alternative embodiment of the present invention, in which the transmission member, the singularity of the squirrel, and the configuration of the cylinder assembly, which are different from the above-described cylinder assembly, are explained below. For example, in the present embodiment, the piston rod 35 is retracted by the spring 850, 852. As shown in Figures 12 and 13, the three oxygen cylinder assembly 800 includes a first housing 81A having a first closed end 812 and a penetrating first air supply port 813. A first reading, 840 is attached to the first closed end 812 to supply pressurized gas through the first oxygen supply 813. In this embodiment, the first cylinder housing 81 is not closed to the second opening 529 mentioned in the foregoing embodiments. A second cylinder housing 82 is slidably received within the first cylinder housing 810 and has a second closed proximal end 822 formed on the second closed proximal end. A first 5 cylinder region 815 is defined between the first closed end 812 and the first piston head 828. A first retraction spring 850 is provided between the first piston head 828 and a first flange 817 formed on the distal end of the first cylinder housing 810. The first retracting spring 850 is used to bias the second cylinder housing 82 to the retracted position in the first cylinder 810 as shown in FIG. 12. The tongue plug lever 35 has a predetermined size of 10, ^ second The stepped end % of the second distal end 824 of the cylinder housing 820. The flange 825 is formed on the retracted end 824 to produce a substantially side seal with the stepped 4 knives '35 of the piston rod 35. A second piston head is provided with a stepped piston rod section 35 on the proximal end to define a third tempering 1 832 between the second piston head and the first piston head 828. - The first opening 15 20 penetrates the first piston head m to allow air to pass between the first gas zone and the second cylinder zone 832. - a second retracting spring 852 as shown in Figure 12: two is provided between the second flange 825 and the second piston head to bias the second and stepped piston rod 35, as shown in Figure 12 to the second The fully retracted position within the cylinder double body 820. This issue (4) implements the financial affairs of the financial sector. As shown in Fig. 16, the hand, the heart, and the heart are 300 as before.  This artisan === replaces the additive gas source 620. However, the cooked source uses the irreplaceable addition of i gas and I; In still other embodiments, the handle assembly 300 can be configured with a 阙 610 and associated components attached to the external IG inlet 616. See Figure 16Α. For example, the appliance 10 can be accessed through a flexible air supply line 617 through a dust-tight air line in the facility through 96422 32 200814963. To make this benefit, the clinician moves the directional control valve selector switch (Fig. 1) or button to the forward (elongation) position and begins to squeeze the trigger 65 7 0, permitting pressurized gas from the gas cylinder 6 2 2 (or external air source 6) 8) The air supply line 680 passes through the directional control valve 61 and flows into the air supply line 84. The pressurized gas flows from the first supply line 840 through the first supply port 8丨3 into the first gas = zone 8丨5, and flows into the third cylinder zone 10832 through the first opening m. The gas entering the third cylinder region 832 causes the second piston head mo and the stepped portion 35 of the piston rod 35 to move distally. After the second piston head 10 has moved to a fully extended position (Fig. 13), the gas continuing into the first cylinder region 815 biases the second housing 82 to its fully extended position. Once the cutter assembly 30 has advanced to its most distal position within the end effector 12, the clinician releases the activation trigger 67 to interrupt the application of pressurized gas. When the squatting mechanism or the tool assembly is 3 ,, the clinician moves the directional valve 15 selection switch 612 to the reverse (retracted) position, where the 〇 〇 is connected to one of the directional valves 61 排气mouth. The third gas red zone milk and the gas in the cylinder zone 815 are allowed to be discharged via the first gas supply line ,), and are discharged in the line 840 and finally through the directional valve 61. As the gas leaves the third cylinder region 832, the second retraction spring 852 retracts the piston rod h into the second cylinder housing 82_. Similarly, as the gas white body leaves the first cylinder region 815', the first cylinder casing 520 retracts the second cylinder casing 520 into the first cylinder casing 81. Also in this embodiment, a pressure gauge 541 can be fluidly coupled to the gas supply line 840 as shown in Figures 16 and i6A, which can be used as described above to provide the clinician with an end effector being subjected to 96422 33 200814963. A ^ ° shell of strength. In other embodiments, an audio outlet 545 can be as shown in FIG.

10 15

20 Use the Γ in the road for reading, the sound outlet can be as described above; 5 - 玖Γ provide a five-bed physician to monitor the drive train, the system 500 is subject to the rank: two | The sound feedback mechanism of the hitting force. In other examples, a limit switch 546 (Fig. 15) can be provided in the distal side to detect activating member 547 buckles I2 and 2) embedded in the firing bar 35, thereby automatically controlling the orientation. The switch 610 and/or provides a visual and/or acoustic signal that the #发机构 has reached the end of the firing stroke. In a further embodiment of the invention, wherein the transmission member 500 comprises a bellows assembly contact. The bellows assembly can be attached to the distal end portion 31 (four) end 902 of the arbor assembly 30. The distal end 902 has a protrusion 904 formed thereon. The projection is sized to be received in the knives. The projection 904 can be received within the aperture 3 by friction and/or held by an adhesive, agitation or the like. The distal side 31 can be constructed as previously described. The bellows assembly 900 further includes an expandable/retractable bellows portion 910' which is sized to elongate and retract within the distal-corrugated tube passage 117 as shown in FIG. The bellows portion 9 is formed with a wire confinement ring 912 and attached to a base portion 914' that is non-movably attached to the distal ridge segment 11 or the ridge segment 110 One body part. The pedestal 914 can be attached to the distal spine 110 by an adhesive, a screw. A gas supply 916 passes through the wave 914 and a gas supply line 940 is attached to the gas supply 916. The gas supply line ‘二上96422 34 200814963 is also coupled to the handlebar assembly 3〇〇. The 疋 控制 控制 控制 控制 控制 α α α α α α α α 丰 丰 丰 丰 赤 赤 赤 赤 922 922 922 922 922

St two vacuum 埠 920 connected. Vacuum (4) For example, the fine is attached to a flexible line 632 - directly to the information source, the person a source 630. The vacuum source can be one of the long-term vacuum supply lines in Hanshi. The inspection οοη, from a flexible vacuum line 632, can be connected to a vacuum source 63〇 to allow the appliance. The watcher is free to manipulate the ίο 15 20 This appliance can be equipped with the closed tube assembly ΐ7〇* closed trigger η as described above. The n-structure can be clamped in the end effector as described above. After the tissue 6 is clamped into the terminal effector 12, the clinician can fire the appliance as described below. The clinician will use the selector switch 612 for the directional control valve _ (the figure or button is moved to the forward (elongated) position and the squeezing start trigger 670 is started. As the start trigger _ is squeezed, the proportional 阙 660 permits the pressurized gas from The pressure source 62A (Fig. 21) or 618 (Fig. 2ia) is directed to the control valve 610. The directional control valve 61 allows the pressurized gas to flow into the bellows 91 through the supply line 940, causing the bellows to extend distally. As the bellows 910 extends distally, it drives the cutter assembly 3 to cut the tissue clamped by the end effector through the terminal action state 12, and drives the staples 70 in the nail % to form the bottom surface of the anvil 40. Contact. After the tool assembly 3 has been brought to its most distal position in the end effector 12, the clinician releases the start trigger 670. To retract the tool assembly 3, the clinician will use it for orientation. The selector switch 612 of the control valve 610 is moved to the retracted position to permit the vacuum source 630 to be coupled to the supply line 940. The application of vacuum to the supply line 940 causes the bellows 910 to retract to its retracted position as shown in Figure 18. 35 200814963 Bellows 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, residual vacuum within the supply line 940 can be used to maintain the bellows 910 in the retracted position. 5 In the embodiment shown in Figure 21, a removable source of pressurized gas '620 is used. As will be detailed below, the source of pressurized gas includes a gas cylinder 622 that may be refillable. The skilled artisan will appreciate that a non-replaceable/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 A port 616 for supplying pressurized gas is externally applied to the source of the pressurized gas. For example, the device 1 can be coupled to the compressed air line of the facility through a flexible gas supply line 617. See Fig. 21A. 15 20 Also here In an embodiment, a pressure gauge 541 can be fluidly coupled to the gas supply line 940 as shown in Figures 21 and 2ia, which can function as described above and be used to provide the clinician with the force that the end effector is suffering. Proportional reading. In other implementations Wherein, a sound outlet 545 can be provided in the gas supply line 940 as shown, and the sound outlet can function as described above and be used to provide the clinician with a means for monitoring the drive system 5 and the final firing mechanism. A sound feedback mechanism that is subjected to the firing force. In the alternative embodiment, a limit switch 546 (Fig. 18) can be provided in the distal spine U〇 for detecting activation of a bellows assembly 900. Member 912, (Fig. 20), thereby automatically controlling the directional switch 61 and/or providing the visual and/or acoustical of the finger or tool assembly 3 〇 having reached the end of the firing stroke 96422 36 200814963 Figure 22-27 illustrates a The gangless disposable end effector i 2 of the previous embodiment is used. As shown in Fig. 2, the 4th inch is new, the quality can be used to end the crying n s,,, α 23, this embodiment is any of the transmission members in this detailed description. However, the single shaft assembly can be connected to a proximal shaft assembly by means of an integral marking as a miscellaneous = inch new quick-release joint.

15: The end effector 12 has been used, the terminal for (4) 12 and the basin f 3 can be combined with the own distal shaft assembly 1010 side _... heart and the following 'far, retracted side & 1110 and one far away The side closure tube region proximal shaft cup assembly 1020 includes a proximal ridge segment 1150, a proximal closure tube segment 1190, and a release (four) 1200. ,

The distal spine segment 1110 cooperates with the proximal spine segment 115 to form a ridge assembly 030. In this embodiment, the distal ridge segment niG can be substantially identical to the distal ridge 1 described above, with the difference that the respective proximal ends are different. Similarly, the proximal ridge 1150 can be substantially identical to the proximal ridge 13 前 previously described, with the difference that the distal ends are different to allow the distal ridge 10 and the proximal ridge 1150 to be non-pivoted. . Again, in this embodiment, the distal closure tube segment 1180 can be substantially identical to the distal closure tube segment 180 described herein, with the difference being different at its proximal end. Similarly, the proximal closure tube segment 1190 can be substantially identical to the previously described proximal closure segment 19G, with the difference that the distal ends are different to allow the distal closure tube segment 118 and the proximal closure tube segment 119 to be non-pivoting. Ground 96422 37 5 10 15 20 200814963 Attached to each other. As shown in Fig. 23, a lock amp 112 is used as a latching means for the living base 35 in the distal ridge section nJ. The distal and proximal square holes (1) ji (1) are formed on top of the distal ridge segment 111G to define therebetween - a clamping rod 1115 for receiving the lock , ΐ = 2 =, and the lower arm ι ΐ 8 extending to the distal side of the (4) = the cylinder assembly - Apply on the distal end - downward force. It should be understood that each case may include other types of latching devices or no latching devices at all. The proximal end 1114 of the 'passing side ridge & 1110 has a distal connector portion (1) 6 formed thereon. See Figures 24 and 27. For example, as shown in Fig. 24, the distal connector σ knife 八 has a first side supply air itch ιιπ. - A second distal air supply port 112 is provided in the distal connection portion 1116 and is coupled to a second air supply line segment %. As shown in Fig. 23, the first: the gas supply line section 54 (^ is connected to the younger brother of the first gas-chasing shell - for the fourth gas supply line section 542, the second gas supply line section 542, a distal end of the casing 51 The second air supply port 529. The first air supply nozzle is not protruded from the first-distal air supply port 1117 in the near side direction. A second air supply nozzle portion 1122 is supplied from the second air supply.珲112G protrudes outward in the proximal direction. Similarly, the distal end 1152 of the proximal ridge segment 115 has a second connecting portion 1154. The second connecting portion 11 has - (d) the other-first-supply air path The first proximal side air supply port 1156 is disposed. The second connector portion = more in the middle of the other second air supply line portion 542" two proximal air supply ports 1160. The first proximal side is provided The pneumatic heart is configured to receive the first air supply nozzle 1118 (Fig. 27) at its 96422 38 200814963 = removal, and the second proximal sputum 1160 is sized to be removably received therein a nozzle (10). As shown in Fig. 24*27, a first loop seal (10) is combined with a disc-aid air supply flap 1156 to be inserted in the first proximal side i, the air pocket 1156 when the first nozzle ιι 8 is inserted. Gas line area 54〇, i another ίο 15 20 , forming a substantially (four) (or liquid-tight) seal between the gas line segments 540". Although coupled in this manner, the first gas supply line section 54 is And other" ϊ 形 ^ ^ - gas supply line • the same, - second 〇 ring seal 1162 :: brother a proximal air supply 埠 1160 combined to insert in the second air supply nozzle U22 =:: proximal air supply 埠譲 (d) Forming another substantially airtight (or liquid helium, ^ solution ^ 2 formation - second gas supply line 542) between the second gas supply line section 542 and the second gas supply line section 542. Skilled by the skilled person = detachable configuration, quick release configuration to removably connect the first supply line to another first supply line section 540" and to the air section 542' Removably connected to another second air supply: zone: the spirit and scope of the present invention is removed. The m connector portion 1116 and the proximal connector portion 4 can be paid by For example, the connector portion 1116 can be provided with another recess that cooperates with the notch portion 1155 of the proximal connecting blade 1154. a proximal air supply port 1160. This unique new attachment configuration prevents the first nozzle (10) from accidentally attaching to the second type = 96422 39 200814963 for the port 1160 and the second nozzle 1122 for accidental attachment to the first proximal side. The balloon 1156 can utilize other key configuration to ensure that the distal connector portion 1116 and the proximal connector portion 1154 are coupled in the correct orientation. As also shown in Figures 24 and 27, the distal end 1152 of the proximal spine 1150 has 5 - a hollow sleeve portion 117 that protrudes distally. The hollow sleeve portion is sized to receive the proximal end 1114 of the distal spine 111〇 therein. To releasably lock the distal spine segment 1110 to the proximal spine segment 115, a pair of phase 10= stop members 1124 are formed on the proximal end 1114 of the distal spine segment 111〇. The stop 1124 is positioned on the flexible tab 1126 that is cut or otherwise formed in the distal spine 10 1110 such that when the proximal end 1114 of the distal spine 111 turns into the hollow sleeve of the proximal spine 115 When the barrel portion 117 〇 and the first nozzle 1J18 is sealingly coupled with the first proximal air supply port 1156 and the second nozzle 1122 is sealingly coupled with the second proximal air supply port 1160, the blocking member 1124 is received in the hollow sleeve portion 1170 Corresponding to the opening 1172. See Figures 24 and 15 27. The following is a description of the releasable attachment of the distal closure tube segment 1190 to the proximal closure tube segment 1190 as shown in Figures 24-27. As shown in these figures, the proximal end 1182 of the distal closure tube section 1180 has at least two plug-type locking tabs 1184 projecting therefrom in a proximal direction. Each of the locking tabs 1184 has a tapered locking member 2 formed thereon, the wedge being sized to receive in a corresponding locking opening 1194 of the proximal closure tube section 1190. When in the position shown in Figures 26 and 27, the distal spine 111〇 is locked to the proximal spine ΐ5ΐ to form the spine assembly 1030, and the distal closed tubular section 118〇 is locked to the proximal closed S苢 zone# again 1190 to form a closed tube assembly n78. This configuration permits closure 96422 200814963 The tube assembly 1178 is moved proximally and distally on the ridge assembly 1030 in various manners as previously described to open and close the anvil 4 on the end effector 12. Ίο 15 20 To attach the distal shaft assembly 1010 to the proximal shaft assembly 1〇2〇, the user has the proximal shaft assembly 1〇1〇 proximal 1〇 as shown in Figure 24. 12 is aligned with the distal end 1〇22 of the proximal axial hub assembly 1020 and then the distal end 1〇12 is inserted into the proximal end 1022. When the stop 1124 is received into the locking opening 1172 and the locking die 1186 is received within the opening 1194, the distal shaft assembly 1〇1〇 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 assembly 1178 to move distally as described above. The shank % can be driven by actuating the trigger 67 珂 as described in the text. To facilitate easy removal of the distal shaft assembly ΗΠ0 from the proximal shaft assembly _, various embodiments employ a -release sleeve configuration. In these embodiments, a release sleeve section 12GG is slidably fitted over the proximal ridge segment U5G between the proximal ridge segment 1150 and the proximal closure tube segment 119. In various embodiments, the proximal end of the release sleeve 1200 can be provided with a release button that passes through the corresponding slot in the proximal end 1195 of the proximal closure tube section 119. See Figures 22 and 3 for this configuration. The permissible release sleeve 'axially abuts the proximal (4) (10) axially on the proximal two segments 115G obstructing axial travel of the proximal closure tube segment 1190 on the ridge assembly 1〇3〇. As best shown in Fig. 27, the distal end (four) of the release sleeve 12 is chamfered inwardly and oriented such that it is adjacent to the adjacent tube section, and the tube is locked open π 1194. To enable the distal shaft assembly shaft assembly, the maker moves the release (four) slot 1196 toward the ^ 96422 41 200814963 to move the release sleeve 1200 distally. As the beveled distal end U04 of the release sleeve i2 contacts the locking wedge 1186, the locking wedge 1186 is moved inwardly away from the opening 10 of the proximal closure tube section 119G. The further advancement of the 1200 in the distal direction causes the release, and the second beveled inner edge 12〇6 of the barrel 1200 contacts the locking stop 44 so that the locks are biased inwardly away from the The engagement of the 1172 in the proximal ridge ΐ5〇 allows the distal shaft assembly 1010 to be disengaged from the proximal ridge assembly 1020. The non-embodiments of Figures 22-28 can be effectively used with the cylinder assembly #1 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 FIGS. 3 and 3, the side connector portion 1116 has only one port formed therein to be connected to the 1 line segment 940'. A first air supply nozzle 13〇2 is shown from the first pass. The side air supply port 1300 protrudes in the proximal direction. Similarly, the connector portion #154 is only - lightly connected to the other - the first gas supply line segment state, 'the proximal side supply port 1306. The proximal air supply port 13 The crucible 6 is configured to removably receive the first air supply nozzle 1302 therein. As shown in Figures 29 and 3, a loop seal (10) 8 is combined with the proximal air supply port _ to the air supply nozzle 13 〇 2 Inserted proximally, within the first gas supply line section 94, within the gas cylinder 1306, forms a substantially airtight (or liquid-tight) seal with the other first gas supply, the road zone # 940. When the faces are joined together, the first gas supply line section 94 is connected to the 94". A first gas supply line 940 is formed. The gas supply line 940 can then supply the pressurized air lip to the cylinder assembly 800 or the bellows assembly 900 in the direction described above. 0 96422 42 200814963 FIG. 32 illustrates an alternative cutting movable surgical cutting and stapling instrument 2000 There is a pneumatic joint assembly 2002 that can be used with the end effector 12 and the closure tube assembly 170 described above. This embodiment can also use the cylinder assembly 501 described above. As shown in Figures 33-35, the joint assembly 2002 includes a ridge assembly 2004 that includes a distal spine section 2010 having a pivot. The shaft member 2014 protrudes from the proximal end 2012 of the distal spine. . The pivot member 2014 has a driver piece 2016 protruding therefrom. As shown in Figure 35, the cylinder 501 is pivotally mounted on the trunnion 519 within the distal spine section 2010. The reel member 2014 is pivotally received within a pivot bearing pocket 2034 formed on the distal end 2032 of the proximal spine 10 2030. The pivot member 2014 is free to pivot relative to the proximal ridge member 2030 about the pivot axis E-E. See Figure 36. As shown in Figure 35, the distal end 2032 of the proximal spine 2030 has a groove 2036 formed therein for receiving a portion of the first gas supply line 540. Similarly, a second groove 2038 is provided in the distal end 15 2032 of the proximal spine 2030 for receiving the second gas supply line 542. The gas supply lines 540, 542 _ bypass the pivot bearing pocket 2034 into the proximal end 2012 of the distal spine section 2010, wherein it is attached to the cylinder assembly 501 in various manners as previously described. Those skilled in the art will appreciate that a sufficient amount of relaxation of the supply lines 540 and 542 can be provided within the hollow proximal ridge 2030 to allow the distal ridge segment 2010 to be centered about the pivot axis EE relative to the proximal ridge 20 segment 2030. Pivot. By supporting the supply lines 540, 542 in the grooves 2036, 2038, respectively, these supply lines do not interfere with the axial movement of the closure tube assembly 170 relative to the ridge assembly 2004. As also shown in Figure 35, a first vertical supply air passage 2040 is provided in communication with the 轴承 bearing pocket 2034. Similarly, a second vertical air supply passage 2050 is also provided in communication with the pivot bearing pocket 2034 as shown in FIG. A third air supply line 2042 extending from a switch assembly 21 of the handle assembly 300 communicates with the wrong air supply passage 2040, and a fourth air supply extending from the switch assembly 21 (9) The line 2052 is in communication with the second vertical channel 2〇5〇. To assemble the joint assembly 2002, the pivot member 2014 is inserted into the shank housing 2034 and a cover 2060 is attached to the proximal ridge 2030 with screws 2 〇 62 or other suitable tying members as shown. Therefore, the pressurized gas entering the first vertical supply passage 2040 from the third gas supply line 2 2, 10 causes the distal ridge segment 2010 to pivot in the direction of the pivot axis E_E, and from the fourth supply The pressurized gas of the 10 gas line 2052 entering the second vertical gas supply 槔2〇5〇 causes the distal ridge segment 2010 to pivot with respect to the proximal ridge segment 2〇3〇 with the pivot axis E_E as the center and in the G〃 direction. . See Figure 34. Referring to Figures 37-45, the construction and operation of the switch assembly 21A of each embodiment will be described below. In various non-limiting embodiments, switch assembly 2100 includes a switch block 2110 having a supply port 2112 therein. The gas supply port 2112 is coupled to the gas supply line 051 for receiving pressurized gas from the pressurized gas source 62 (Fig. 44) or 618 (Fig. 45). In particular, a gas supply line 651 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 215A of a selector member assembly 2130 therein. A pivot rod 2151 protrudes from the bottom of the main body portion 2150 and is pivotally mounted in the pivot hole 2111 of the switch block 211''. 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 tamper seals 2152, 2154 or other suitable sealing members may be provided as shown in Figures 38 and 39, 96422 44 200814963 5 to provide a substantially airtight relationship between the body portion (10) of the selector member assembly 213 and the switch block 2110. seal. A short rod 2156 projects from the body portion 2150 to receive a selector handle 2158. Rotation of the selector handle (1) $ causes the body portion 2150 to rotate within the switch cavity 2114. As shown in Fig. 39, the air supply port 2112 is connected to one of the air supply passages 2116 of the switch block 211, and the air supply passage communicates with a tube 2118 which is also formed in the switch block 211A. The main body portion 2150 of the selector member assembly 2130 has a penetrating central air supply port 2160 that communicates with the header region 2118. The third air supply passage 2〇45 1〇 is provided in the switch block 2110. See Figure 40. The third air supply passage 2〇45 extends between the switching chamber 2114 and a third air supply port 2〇44, and the third air supply line 204曰2 is attached to the third air supply port. Similarly, a fourth air supply passage 2055 is provided in the switch block 211A and extends between the switch chamber 2114 and a fourth air supply port 2054, and the fourth air supply line 2〇52 is attached to the fourth supply unit 1 15埠. When the selector member assembly 213 is positioned as shown in FIG. 4A, the pressurized gas entering the switch block 211 via the air supply_2112 into the air supply passage 2116 enters the official tank area 2118 and may flow into the central air supply. Channel 216〇. However, the pressurized gas will be blocked at the end of the central air supply passage 216. Thus, the switch is in the "off" position in Figure 4. 20 To pivot the distal spine section 2010 to the right (as opposed to the position shown in Figure 34), pivot the selector member assembly 2130 to the map. 41. As shown in the figure, the pressurized gas that enters the switch block 2110 through the air supply passage 2116 through the air supply passage 2112 and enters the header box region 2118 is transferred to the third air supply passage through the central air supply port 2160. Within 2〇45 and the third gas supply line 2(10)2 96422 45 , 200814963 then the helium gas flows into the first staggered gas supply passage 2040 and contacts the driver piece 2〇16 on the pivot member 2014 to force the pivot member 2〇 14 moves in the direction of 10 15 20. The pressurized gas on the opposite side of the driver chip 2〇16 enters the first staggered passage 2050 and flows into the fourth gas supply line 2〇52. As the pressurized gas enters the switch block 211G The fourth port 2054 flows into the fourth gas supply passage 2055 and flows into one of the main portion 215, the fourth exhaust passage = 7^0. The fourth exhaust passage 217 is connected to the main body of the selector member assembly 213 One of the shovel 215 turns into an undercut venting zone 2155. See Figure 43. Therefore, The pressurized gas in the four gas supply line 2052 is discharged through the fourth exhaust passage 217q and is discharged outside the switch via the undercut exhaust region 2155. To pivot the transport side ridge to the position shown in Fig. 34, the clinical The physician rotates the selector member assembly 213G such that the central air supply passage 216 () extends between the official, tank region 2118 and the fourth air supply passage 2〇55. Therefore, the water supply passage 651 flows into the air supply passage 2116 and The pressurized gas flowing into the header tank region 2 ι 8 flows into the fourth gas supply passage through the central air supply passage 216. The pressure gas flows out of the fourth air supply port 2054 to the fourth gas supply line. Line 2052 transfers the pressurized gas to the second 妒 = gas passage 2050. As the pressurized gas enters the second misdirected supply, the driver plate 2 〇 16 causes the pivot member 2 〇 14 to The y-direction pivot = the gas gas on the opposite side of the drive plate passes through the first - ° (the gas passage 2040 flows into the third gas supply line 2042. The gas enters the third supply line 2G42 from the first view, leaving the Wo - The milk is transported within 2045 and flows into the supply; - one of the second exhaust passages 218 of the 2150 is divided into two. This 2180 is oriented to vent gas through the undercut venting zone 5. K 96422 46 200814963 Another unique novel feature of the present invention is an automatic neutral feature configuration that allows the clinician to simply select by releasing The switch handle 2158 locks the distal ridge segment 2〇1〇 (and the end effector 12) in a phase. It is intended to move the position of the joint. More specifically, a recursive Bo 2 5190 constructed as shown in the figure The ampules shown in Figures 40, 41 and 43 are in the switch block 211A. In order to hold the spring 219 〇 in the switch block 2110, a pair of opposing knobs 2192 2194 底部 the bottom surface 2113 of the switch block 2110 protrude. The spring 2190 • is not held in the slots Μ%, 94% of the knobs Μ%, ^94. The kite is shown in Figure 43. As shown in Fig. 43, a return lever 2153 protrudes from the main body portion 2150 of the selector member 10 to 2130. The return lever 2153 is received between the free ends 2196, 2198 of the returning boar 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 knob 2158 to cause the body portion 2150 of the selector member assembly 213〇15 to move in a rotational direction corresponding to the desired joint motion. Spring is moving. When the clinician rotates the body portion 215, it is rotated against the force generated by one of the free ends 2196, 2198 of the return 箬 2190. Once the clinician has turned the end effector 12 to the desired position, he or she releases the selector handle 2158 and the return spring 219 〇 moves the body portion 215 to the closed position, which maintains the end effector 12 in that position. If the clinician wants to adjust the articulated position of the end effector U, he or she can rotate the selector handle 2158 in the desired direction to obtain the desired position and then release the handle 2158 to maintain the end effector 12 in that position. Figure 44 illustrates a non-limiting embodiment of the present invention with a switch 2100 96422 47 200814963 5

10 Configuration of the control system components used. As shown, a removable source of pressurized gas 620 is used. The gas flowing from the source 620 flows through the supply line 65 to the proportional valve 660 and through the supply line 651 to the port 2112 in the switch assembly 2100. In the embodiment of Figure 44, source 620 includes a replaceable/refillable gas cylinder 622 that is supported within grip portion 342 of housing assembly 3. The gas cylinder 622 can be refillable. However, those skilled in the art will appreciate that the non-replaceable/refillable pressurized gas source (gas cylinder) can also be effectively utilized. In other embodiments, the handle assembly 3 can be provided with a port 616 for supplying pressurized gas from an external pressurized gas source 618. For example, the appliance can be coupled to a collapsed air line (not shown) of the facility via a flexible supply line 617. See Figure 45. 15

20 Figures 46-48 illustrate the use of the articulated joint assembly 2〇〇2 with the quick-release joint 1000 of the type and construction described above. But in this configuration, she: uses four mouthwashes. As shown in Fig. 47, the 'distal connector portion (1) 6; has a first distal air supply port 1U7 coupled to the first air supply line portion 54A. - a second distal air supply tan is provided in the distal connector portion (1) 6 and is consuming - the second air supply line segment 542. :1丨丨8 as shown in the figure from the first-distal air supply 璋: two τ: two gas nozzle part 1122 from the second gas supply (four). The proximal side side connector portion 1116 further has a third distal air supply port 1120 that is in contact with a first section 2042, and the tenth side of the Seto, the soil The connector portion 1116 has ten line segments 2052. _ 坌 视 且 且 且 且 且 且 且 且 且 且 视 视 视 视 视 视 视 视 视 视 视 视 视 视 视 视 视 视 视 视 视 视 视 视 视 视 视 视 视 视 视 视 视 视 视 视 视 视 视 视 视 视 视From the fourth air supply port 112〇, similarly to the outer four protruding milk nozzle portion in the proximal direction, the proximal ridge segment 1150 is far away from: - (10), the second connector portion has a _ there: the first == The gas supply near the side is 1156. The second connector portion: the second example: the second air supply line section 542, the second: the side supply aperture 1160. The first side of the gas supply 1156 is constructed to be removably received by the first gas supply nozzle 1118 埠, 1160 is sized to be used for A 甘 _ A ^ 仏 仏 仏 ί ίο (10). As shown in Fig. 47m, the second air supply nozzle is received to receive the ring seal 1158 and the first proximal air supply. ^ In the / - He mouth 1118 inserted into the first - proximal gas supply 1156 road area, 540, and another first gas supply line section = caused by rolling (or liquid tight) seal. When coupled in this manner =:, the first - gas supply line section 540, and 54G" 3 '2 gas line 540. Similarly, a second. The ring seal 1162 is combined with: near: = 埠 116G to The second air supply nozzle 1122 is inserted into the second proximal side of the supply: 1160, and is disposed in the second air supply line section 542 to form another substantially airtight (or liquid tight) seal with __. When the mode is lightly connected, the second gas supply line sections 542, and 542" form a second gas supply line 542. Further, the distal end (10) of the ridge section 115 has a second connector portion Ρμ^; the connector portion has a third proximal air supply port 1156 coupled to the other third gas supply line region 42". The second connector portion 1154; is further coupled to the other fourth gas supply line section 2〇52, the fourth 96422 49 200814963 5 ίο 15 20 proximal air supply port 1160'. The third proximal side An air supply port 1156 is configured to removably receive a third air supply nozzle 1118 therein, and a fourth proximal air supply port, 1160, is sized to be removably received therein a fourth air supply nozzle ^ 122. As shown in Figure 47, a third zero ring seal 1158 is combined with a third proximal air supply port, 1156' to be inserted into the third proximal air supply port at the third nozzle 1118. k forms a substantially airtight (or liquid tight) seal between the second supply line section 2G42 and the other third supply line section 2042". When the surface is connected in this manner, the third gas supply line sections 2G42, and 2042" are connected to form a third line 2042. Similarly, a fourth loop seal ΐ 62, and; for t 埠 1160, In combination with the fourth air supply nozzle 1122, the fourth nipple 116G is inserted, (4) in the fourth gas supply line section, the disk-fourth gas supply line section 2052, and the Pi-shaped #. 20% of another substantially airtight (or liquid tight) ^ 2052^.  The spirit and scope of the fourth gas supply line section 2052 when 1 1 is joined together. As described in the paragraph, as the internal cutter system becomes more variable, it becomes more difficult to change the difficult axis of the pneumatic system that generates the necessary transmission force.得比: Easy = The motor drives the rotary transmission to move the joint movement == The movement can easily make a great difference in terms of long and manageable or generating capacity:: The length of the shaft and the diameter of the shaft are 糸The effectiveness of the system will be limited by the size of the motor in the far field: the length of the pinning mechanism, although the application, the diameter of the shaft 96924 50 200814963, the expected size prevents the motor from being positioned at the far end of the system while providing Full energy drives the system. The following embodiments address these problems and deficiencies associated with drive motors. As will be described in more detail below, these embodiments utilize a pneumatic motor to transmit rotational 5 power to a rotary driven internal cutter. Air motors typically produce torque and revolutions per minute that are proportional to the pressure and volume of the gas delivered to the motor. In the non-limiting embodiment illustrated in Figures 49-56, a rotational motion is transmitted from the air motor to the end effector using a articulation _shaft assembly. However, those skilled in the art will appreciate that the unique novel aspects of these embodiments of the present invention can also be effectively combined with other known rotary driven end effectors and other rotational transmission motions to the inner cutter using a flexible drive shaft configuration. Use of surgical instruments. Moreover, the unique novel aspects of these embodiments of the present invention can be effectively used in conjunction with non-joint end effector configurations. Figures 49-56 illustrate a surgical cutting and stapling instrument 15 〇〇 15 of the present invention utilizing a rotary driven inner cutter 1512. There are a variety of rotary driven internal 10 cutters and other surgical instruments. For example, a rotary inner cutter configuration discloses a US 20 patent application filed on January 31, 2006, to Shelton, IV et al., entitled, Motor Driven Surgical Cutting and Fastening Instrument With Adaptive User Feedback 77 The relevant part of the patent application is incorporated herein by reference. Other examples are disclosed in U.S. Patent Application Serial No. (KLNG No. 96422 51 200814963 050704/END5779 USNP), filed on June 27, 2006, to Shelton, et al., entitled vv Manually Driven Surgical Cutting and Fastening Instrument. The relevant portions of this patent application are incorporated herein by reference. Figure 50 is an exploded view of a terminal effector i5i2 in accordance with various non-limiting embodiments. As shown in this exemplary embodiment, the end effector m2 can include a long slot i that is sized to receive a pneumatic operating tool. The pneumatic operating tool of each non-limiting embodiment includes an internally operatively operative member 15 (e) g 50 . This embodiment includes a wedge-shaped skid total (four)^ having a knife portion 1538 on the skid assembly. The wedge-shaped sliding sample assembly (10) (four) is a screw drive screw 156. A bearing 1522 at the end 1521 of the long channel (10) receives the screw drive screw 156, allowing the screw drive screw 156 to freely rotate relative to the long channel (10). The screw drive screw (10) can be coupled with the "threaded opening (in the figure) of the wedge slider assembly (10) to cause the rotation of the drive screw 156G to cause the wedge slide total 30 to be in the & fully extended or actuated position - Translating distally or proximally between fully retracted or unactuated positions (depending on the direction of rotation and passing through the long slot 1520', the elbows that are supported within the staples in the fully extended or actuated position are all According to this, when the # helical drive screw WO is rotated in one direction, the wedge-shaped skid assembly 153 is driven to the far side to cut the tissue clamped in the end effector 1512 and the nail is broken. The inner staples cause the staples to make a form contact with the bottom surface of the anvil 4 pivotally coupled to the long channel 1. The slider portion 1532 of the wedge slider assembly 1530 can be made, for example, of plastic, and There may be a slanted distal surface 1534. As the wedge sled assembly 153 traverses the long channel 152 〇, the slanted front w surface 1534 pushes or pushes the staple within the 匣5〇 through the clip 96422 52 200814963 Tight organization and resistance to station 40. Station 40 flips the elbow from The stapled tissue is stapled. When the modular slip assembly 15 350 is retracted, the knife portion 1 $ 3 § and the bone sled portion 1532 can be separated, thereby leaving the slider portion 1532 in the long slot. The distal end of the track 1520. Those skilled in the art will appreciate that other pneumatic motors can be used as tools and other firing mechanisms. Figures 51 and 52 illustrate a rotational motion of a pneumatic motor from a handle assembly 3 (10) to a screw drive screw. The drive shaft configuration of the 1560. As seen with reference to Figure 51, this embodiment can be slidably fitted over a ridge assembly i 54 运用 using the closure tube assembly closure official assembly 170 detailed above, the ridge assembly 10 A proximal ridge 1542 that rotatably supports a main rotating (or proximal) drive shaft 1544 that is coupled to the primary (or distal) via a helical gear assembly 1550 that includes gears 1552, 1554, 1556 The drive shaft 1546 is coupled. The secondary drive shaft 1546 is coupled to a drive gear 1548 that is coupled to one of the proximal drive gears 1562 of the screw drive screw 1560. The vertical oblique 5 gear 1552 is pivotally supported on the proximal ridge One of the distal ends of segment 1542 can be opened within 1 The secondary drive shaft 1546 and the drive gears 1548, 1554 are closed by a side ridge section 1570. In summary, the main drive shaft 544, the secondary drive shaft 1546, and the joint assembly (such as the helical gear assembly 1550) are As used herein, the main drive shaft assembly " is shown in Figures 53 and 54. Each embodiment of the appliance 1500 is powered by an aerodynamic source in the form of a pressurized gas source 620. In the embodiment shown in these figures, source 620 includes a replaceable/refillable gas cylinder 622 that is supported within grip portion 642 of housing assembly 3. The gas cylinder 622 can be refillable. However, those skilled in the art will appreciate that an alternative/re-inflatable pressurized gas source that does not utilize 96422 53 200814963 can be utilized effectively (handle assembly 300 can be provided with one meter, metered open. In one embodiment, pressurized gas Tankou outside & pressurized gas source shoulder supply novel 1 point more == removable / refillable gas cylinder (2) unique action device 1512, how the transmission system provides rotary motion to the terminal ° ° (5) W see The pressurized gas is passed under pressure from the external pressure source 618 of the gas cylinder 622 1 through a supply 妗 攸 攸 攸 622 622 622 622 622 622 。 。 。 。 。 。 。 。 比例 比例 比例 比例 比例 比例 比例 比例 比例. .  , θ . . .  , Attached to a start trigger 070 for two two 1c / Fig. 53 and 58 ° in each of the embodiments 'starting the trigger machine J f / 310 ^ # machine j by & A pivot pin 37 that extends between the right housing member 32G and the left housing member 330 is pivotally coupled to the handle assembly. Relative position trigger 310, It may be made of plastic or other suitable material and has a portion having a generally U-shaped loose cross section to accommodate the trigger (4) as shown. The clinical teacher can place his or her hand on the grip portion of the housing assembly 3, causing the next three fingers to trigger at the relative position 31〇. And the index finger is in the start, Trigger 670. Will trigger the trigger 67 〇 to the relative position trigger η〇,  The V-proportional proportional valve 660 allows the gas to flow from the source 62 (or 618 of Figure 53) through the valve to a supply line 68 into the directional control valve 1610 under pressure.  As shown in Figure 56, The directional control valve 161 has a forward position section 1620, a stop section 163〇, And an inversion section 164〇. Control valve section 96422 54 200814963 1620, 1630, 164 〇 can be by a button 1612 protruding through the handle housing 300, 1614 manual switching. See Figure 56. Two gas supply/exhaust lines 00, The 1710 extends from the directional control valve 161〇 to a conventional air motor 173. Therefore, When the clinician switches control valve 1610 to the advanced position,  The intrusion 1622 allows pressurized gas to cause the air motor 1730 to pass from the gas supply line 68 to the first direction dn in the helium line (10), which is described in detail below. This causes a rotary motion 'month ί ♦ axis 1544, In a firing stroke, the mold slide is driven to total ίο 15 20 532 and the knife portion 1538 is distally passed through the end effector Μι]. The sister passes the gas leaving the air motor (10) from the road mo through the exhaust gas 680 when the 161G is switched to the reverse position. The milk body is allowed to flow through the gas supply line 171 into the air motor through the gas supply line 171, and exits the pneumatic horse S through the air supply/exhaust line 17 to discharge the exhaust gas (6) 2 . When the control is in the stop position’: Body penetration = and the gas supply/exhaust material 1710 is closed and the gas supply line 17 is closed; ^ Road Exhaust 埠 1632. See Figure 56.  The inverse strong master as shown in Fig. 56 further shows that the output shaft (7) 2 of the air motor WO has the first transmission gear 1734, The first transmission gear is sprayed onto the second output of the input shaft 1738 of the two-four-spindle gear assembly 1740. 6·. The planetary gear assembly 1740 has an output shaft 1742, The 1545 conventional coupling member 1743 is coupled to the proximal end of the transmission shaft 1544 and is turbulently transmitted to the proximal end of the transmission shaft. therefore, When the control valve 1732 ^ the gear assembly 1740 adds a rotational motion to the 96422 55 200814963, the drive shaft 1544 causes the wedge sled assembly 153 and the knife portion 1538 to be clamped in the end effector 1512 by the staples 50. It organizes and drives the staples in the magazine 50 into forming contact with the anvil 40. When the control 阙161〇 switches to the reverse position, The output shaft 1732 of the air motor 1730 applies a reverse 5 rotational motion to the drive shaft 1544 to retract the wedge slider assembly 153 and the knife portion 1538 through the magazine 5 in a proximal direction.  The embodiment shown in Figures 49-56 also has the operability of the instrument and is Physicians offer a variety of unique and unique features in a variety of forms of feedback.  This allows the clinician to monitor the position of the wedge sled assembly 153 and the knife portion 10% 10 within the staple raft 50 as it advances and retracts on the transport side. Referring again to Figure 56, it can be seen that a feedback gear is provided on the drive shaft or on the output shaft 1742 of the planetary assembly 1740. The feedback gear 175 is engaged with a tool position gear η% mounted on a threaded knife position shaft 1754.  The knife position axis 1754 can be supported by a suitable # bearing arrangement (not shown in Figure 15) that facilitates its free rotation. A proximal limit switch 176A is coupled to the proximal end η% _ of the shaft 1754, And a distal limit switch 1770 is coupled to the distal end 1758 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 a wedge slip, The assembly 1530 and the knife portion 1538 are rotated 20% in the direction of the nail by 5〇, The knife finger 178 〇 also moves to the distal side to restrict the opening of the switch port. The distal limit switch 177 is oriented such that when the wedge slider 1530 and the blade portion 1 1 Γ are at the farthest position, Knife Indicator _ Actuating the distal limit ‘ ^ A window is provided to the left housing member 330 (or the right housing member 320, This depends on the position of the knife position axis 1754 within the housing assembly 300) 96422 56 200814963 , The clinician (4) phase cutter refers to the position of w(10) to determine (four) configuration (wedge assembly 1530 and knife portion 1538) within its firing stroke. The device is provided to the clinician to monitor the position of the wedge 1530 during the retraction stroke.  5 10 15 20 and in various embodiments, Available - extended from the gas supply line (4): : The distal auxiliary line 1772 of the switch 1770. A distal limit switch 774 can be provided between the distal limit switch (4) and the directional control valve 161, so that 'when the wedge sled assembly (10) and the knife portion 1538 have completed the hand stroke and the knife indicator 178 is actuated distally Limit switch (4), The distal limit switch Π70 allows the gas to flow under pressure from the supply line (4) to the distal limit switch line 1774 and into the directional control valve 161〇, This would cause the directional control valve 1610 to automatically switch to the inverted position and 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 (10), The reverse rotational motion is transmitted to the knife position axis 1754 to drive the knife position indicator = 80 toward the proximal limit switch 1 to move back. - Near side auxiliary line 丽 = can limit the switch on the near side!  6 6 延伸 extends between the gas supply line 6 5 ,, The second proximal limit switch is actuated when the knife position indicator 1780 actuates the proximal limit switch 166 (meaning that the wedge slider 1530 and the knife portion 1538 have moved to their fully retracted position)! 660 thus permits the gas to flow into a proximal limit switch line 1664 and flow into the directional control target 161 〇 π thereby causing the directional control valve 1610 to automatically switch to the stop position.  In various embodiments, a first whistle 1790 or other suitable sounding device can be coupled to the distal limit switch line 1774 (or the distal limit switch 177 96) 96422 57 200814963 , , Having caused the distal limit switch 1770 to be actuated at the end of the firing stroke, the air passing through the distal limit switch circuit 774 causes the first air stag 179 to provide an audible signal to the clinician indicating that the wedge sled/tool has reached the firing stroke The end. same, A second whistle 1792 or other suitable audible device can be in communication with the proximal restriction switch 1760, Causing when the proximal limit switch '1760 is actuated at the end of the return line, The air passing through the proximal limit switch line 1764 causes the second whistle 1792 to provide the clinician with another audible signal indicating that the wedge sled/knife has reached the end of the _ stroke. In the case of Li He ^, for example, A battery powered light emitting diode or other signaling device can be associated with the distal and proximal limit switches 177, 176〇 contact to provide the user with another indication that the wedge sled/tool has reached the end of the firing stroke and/or the retraction stroke. In an alternate embodiment, Gas flute 1790, The 1792 can be replaced with a pressure sensing H or a pressure phase indicating which device (4) reaches the end of the firing stroke and/or the retraction stroke.  ^ In the various embodiments shown in Figures 49-56, The air motor is supported. In the embodiment shown in Figures 52A and 52B, Air motor ^,  = in the side ridge section 110. Motor drive shaft 1546, There is a transmission gear 1548' thereon, The drive gear meshes with the proximal side of the screw drive screw 1560 = the move gear 1562. Fig. 52A illustrates the use of the distally mounted air motor with a joint joint 1〇4 as described in Fig. The embodiment shown in Fig. 52B uses a pneumatic joint assembly 2 2 as previously described. These far-mounted air motor configurations can also be used with appliances that use other joint configurations. Or the rider is not used with respect to the handle assembly or the attached long shaft assembly. Those skilled in the art will appreciate that the 96422 58 200814963 side-mounted air motor configuration minimizes the power loss that may be encountered in the embodiment through the elongated axle configuration. The motor is supported in the handle assembly and the firing and retracting movement must be transmitted through the joint joint to the final actuator. Embodiments such as those illustrated in Figures 52A and 52B require only two lines 5 Π 10 and 1760 to pass through the joint to align with the motor 173. Energy Supply. Lines ' and 1760 may include flexible tubing or the like and do not limit the articulation joint as compared to other embodiments that require one or more transmission members to pass through the joint.  The embodiments of the present invention can be constructed to provide the user with a tactile feedback regarding the relative position of the firing assembly of the device. In some embodiments,  10 This is by pulling the stroke monitoring member or relative position trigger 31, The manner in which the forward and retracting motions are applied to the drive shaft or firing mechanism applied to the I-set is more specific and is described with reference to Figures 53-55. This embodiment can include a feedback link assembly 1800, The feedback link assembly is available in various non-limiting embodiments, Include a threaded manual feedback shaft 18〇1, The shaft is attachable to the thread _ rotatably mounted at the relative position trigger 31〇, One of the upper attachment plate portions Μ] • a nut member 334. The distal end of the manual feedback shaft 18〇1 has a universal joint portion that supports a manual feedback gear 1804. The manual readback gear is incompatible with the second knife position wheel 1752. When the directional control valve 16 is in the forward position,  The pneumatic horse 1730 drive shaft 1544 causes the firing mechanism in the form of a wedge slider 153 〇 = trowel 1538 to be driven distally through the cylinder (fire stroke). The feedback gear 175 〇 drives the knife position gear 1752, The riding window wheel drives the manual feedback gear 18〇4. Then manually return the gear 8〇4 to turn the manual feedback shaft. The manual feedback shaft triggers the relative position trigger 31 due to its engagement with the nut thread. Pull to the handle total &  3〇〇 grip 96422 59 200814963 =342 ' thus providing the clinician with a representative of the wedge sled 1530 and the knife portion 1538, , Tactile 1 shows. Those skilled in the art will understand that the physician at ίο 15 20 ^ attempts to trigger the relative position 31 〇, The handle of the handle assembly 300 is pivoted by 342. The manual feedback of the shaft 1801 and the nut 334 prevents any movement thereof. Yes, Relative position trigger 31, It will be related to the automatic sliding of the camber 153 〇 = the advancement and retraction of the knife portion 1538. This configuration is available to the clinician - only need to grasp the relative position trigger training in the surgical procedure. The wedge-shaped skid assembly 153 〇 and the knife portion 1538 (fire-fighting mechanism) that can be passed: Automatic tactile indication of advancement and retraction. Because the *匕' clinician can get this feedback without looking at any f West. This configuration provides the clinician with a one-handed non-visual feedback of the firing mechanism between the actuated position and the actuated position and when the firing mechanism returns from the activated position to the unactuated position.  Embodiments may further have an additional feedback configuration, generally designated 333. for example, As shown in Figure 53_56, Relative position trigger,  The attachment plate portion 332 can be provided with a slot that is at the junction of the fish spring handle 337 and the inner spring arm 337 when the pin 37 is centered on the pin 37 击 during the firing and retracting stroke. 335, With  ^Sis and the similarity of the upper attachment plate portion 332 with the relative position trigger 31,  The end of the =% U 337 falls into each of the sequential slot milks and is used (in order) to apply a force to the upper attachment plate portion 332. This force is triggered by the clinician grasping the relative position 31〇, Time _ feels. therefore, With the phase = trigger, then 'advance, The clinical material will receive - (d) an additional tactile feedback motion corresponding to the movement of the firing mechanism to confirm the relative position trigger 310, (and the final firing mechanism) advances during the firing stroke or retracts in the line 96422 60 200814963 Cheng = retracted, No matter what the circumstances. also, As the spring arm 337 = the tip falls into each of the sequential slots, This may produce a sound, 喀 = towering to provide the clinician with information about the firing mechanism through the firing trip and back, The voice feedback of the movement of the process. therefore, This embodiment provides a series of (to _ _ _) sounds about the movement of the firing mechanism between the unactuated position and the activated position.  Those skilled in the art will appreciate that the appliance 1500 exhibits an improvement that is far superior to the conventional pneumatic incision misalignment configuration. for example, Embodiments provide a means for a 10-bed medical = monitoring firing mechanism (wedge sled/tool) to be driven through its firing line. In some embodiments, When the wedge sled/knife reaches the end of its burst stroke, it automatically retracts. Once in full retraction t, control, The valve can be automatically switched to a stop position to interrupt the supply of air from source 618 = 62 = to air motor 173 . However, if during the start-up process the clinician wants to stop the wedge sled/tool pushing it far inside the cylinder, he or she can simply switch the control valve 161〇 to the inverted position and continue to activate the trigger 670 to pneumatic The motor bore 30 supplies pressurized gas until the county skid/tool moves to the desired retracted position. In addition, The unique new spoon = the trigger on the position 3 1〇' in the clinician grabs the relative position trigger Η. ,  20th day: , The clinician provides a perceptible manual or tactile feedback. also, The lining can get an audible signal when the wedge sled/knife has reached the end of the firing stroke and/or has been fully retracted.  ^ This artist will also understand the uniqueness provided by the travel monitoring device. _ or the bellows assembly _ can also be connected by connecting each of these transmission members with a push/pull flexible cable (not shown) or a rigid member (for the embodiment of the 64422 200814963 non-job) To the upper plate portion 332 or the relative position trigger 31, The other portions cause the propulsion and retraction of the transmission members to be directly or indirectly coupled to the relative position trigger (10),  • 5 ways to get. This unique and novel configuration can also be used in conjunction with the embodiments described below with reference to Figure 7 (d).  10 15 20 As mentioned earlier, The feedback link assembly automatically moves the relative position not only at a rate corresponding to the rate at which the second motion is struck, In order to provide the device to the division - to monitor the progress of the firing mechanism, Retrieving the coupling thread will effectively block or significantly limit the manual pivoting relative position trigger 3! Oh, Other devices of the ability. In Shengjing, Relative position trigger, The time that will move = the rod assembly makes it move. In still other embodiments, Manual movement of any pivoting line = = occurs when actuated to prevent the tilting) or another cylinder (the force of the trigger 670 on the trigger 670). for example, The appearance of the red force will cause the gas to release. But before the firing machine, Relative position trigger 匕 = will also stop moving, Relative position plate machine 3ΐ0, Motion, but in other embodiments,  Constructed to enable the clinician = feed U 1_ can also be built to assist the drive: = during the course: A pneumatic motor 1730 adds dynamic force to the moving parts, This is to allow the clinician to advance the squatting or stop the firing mechanism when the clinician wants it. In this case, the feedback shaft 1801 can be formed to have a trapezoidal pattern or other 62 200814963 thread configuration or configuration, This 箄 screw is a good _ _ 哥 Thread configuration will actually permit the clinician to phase ίο 15 20 on the position of money 31G, The wire pressure thereby exerts a -rotational force on the shaft dirt by its connection with the material 334. Since a rotational motion is added to the axis, the clinical Lushi also applies a rotational force to the gear 18G4. The gear is fitted to a gear 175() that fits over the drive shaft 1544. therefore, If the firing mechanism encounters resistance, the clinician can squeeze the relative position trigger mg, Mechanically generated power is applied to the drive shaft 1M4. If the clinician wants to slow down or stop the movement of the hand mechanism, The clinician can trigger 310 on the relative position, Force, The trigger then resists/slows the rotation of the shaft 18〇1 and the gear 18〇4 and eventually resists/slows the rotation of the drive shaft 1544.  Each of the embodiments is provided with a material storage member for supplying gas under pressure to be placed in the form of a removable gas cylinder (2), In several embodiments, the 'removable gas cylinder 622 can be - loaded with a gas and can be refilled. In other embodiments, Removable gas storage: Tile 622 can be refilled. for example, The gas cylinder 622 can include a conventional disposable gas cylinder filled with carbon dioxide. - Once the gas cylinder is exhausted,  The user removes it from the handle assembly and replaces it with a new full load cylinder. Others use gas as compressed air, for example. Carbon dioxide (c〇2), Nitrogen, ,  Milk, Chlorine gas, Helium, Sodium hydride, 丙院, Isobutane, Ding burning, two: Class dimethyl ether, Methyl ethyl ether, Nitrous oxide, Hydrofluorocarbons ) · HFA 134a ( 1, 1, 1, 2, -tetrafluoroethane) or jjFA 227 i ϋ, 2, 3, 3, 3. Heptafluoropropane). This configuration provides a far better than the conventional pneumatic 笙^二/, Improved configuration. However, the number of times the appliance is available depends on the volume of gas that can be stored in the gas cylinder and the need to maintain the sterility of the device 96422 63 200814963.  The gas cylinder 622 used in other embodiments of the present invention stores a non-gaseous state under a storage pressure. A material that evaporates in a liquid state and at least partially liquid when the device is operated at a lower pressure. Examples of the liquid body which can be used in these examples include nitrous oxide, Dimethyl ether, Mercaptoethyl ether, Sodium hydride,  Acrylic, Isobutyl, Ding burning, Hydrofluorocarbon (HFA):  UFA 134a (1) 1, 1 2 _ tetrafluoroethylene bromide or carbon dioxide (c〇2) at 10 press.  10 15 20 Figure 57 illustrates a non-limiting example of a gas cylinder 622, It is provided with one of the liquid substances 624 described above. Benin cylinder 622 can be steel, Or a material that is compatible with the liquid/vapor of (10) and capable of withstanding the internal pressure generated therein. When using this manual ^ ^ ^ ^ ^ ^ ^ ^, Clinicians often have multiple locations (including bumps up and down =; The 2 assembly 300 is turned over to achieve the desired position of the end effector 12. Therefore, in some embodiments, To prevent liquid from moving into the control system during such maneuvers, - Diaphragm 626:  Within the Bedding 720. Diaphragm &7丄# ,  ^ »,  The pancreatic month 626 can block the passage of liquids but is permitted by: The second yoke 628 is made of the material of the diaphragm 626. therefore,  The handle assembly can be freely manipulated _ without the liquid material 624 entering the valve 1610 and/or the air motor (4) The (four)-body configuration 'gas cylinder (2) can be used in two or one to facilitate the liquid material 624 and the membrane coffee to be installed therein.  The Chang seal member is constructed in this embodiment. also, Available - 里 埠 (二? The liquid-tight coat between the Ws is dry (not shown) to fill the gas cylinder 622.  96422 64 200814963 In the embodiment shown in FIG. 57, When the clinician switches the directional control valve i6i〇 to the advanced position and actuates the proportional valve 660, The pressure within the gas cylinder 622 is reduced. This pressure reduction causes the liquid material 624 to begin to vaporize. The vapor 628 passes through the membrane 626 and is used to supply the various control systems described above. therefore, By reducing the pressure in the gas cylinder 622, The liquid 624 is opened and gasified and the pressurized steam 628 is used to energize the device.  Other embodiments may use liquids that require combustion to convert the liquid to its gaseous state. An example of such a liquid is propane, Butane and other petrochemical products. A conventional button igniter or other igniter system can be utilized to ignite the liquid stagnation. In these 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 be specifically designed to convert from a solid to a liquid via a heat input at low pressure and low temperature, A phase change material that transforms from a solid to a gaseous or from a liquid to a gas. Examples of such materials are paraffin waxes and various blends of sodium. These phase change materials may have a large volume change with heat input to the system. Such devices use a device such as a burner to provide the necessary thermal energy to the material. also, Components that may be exposed to heat from these devices will be designed to safely dissipate heat during use and protect the clinician and be constructed from materials that achieve this goal.  Λ 20 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 can be received in a cavity 671 formed in the grip portion 342 of the handle assembly 3. In order to get in and out of the cavity 671, The grip portion 342 can be easily opened by two light 96422 65 200814963. The jaws or jaws are provided with a removable cover (not shown) that is snapped or otherwise removably attached thereto. In various embodiments, The drain end 63 of the gas cylinder 622 is screwed into one of the tube header blocks 632 with a threaded opening 634. The threaded opening 634 is connected to a gas supply passage 6%. The air supply 5 passage is opened and closed by a needle valve 638. In particular, In each of the tenth embodiment,  The needle valve 638 is suspected to enter the official compartment block 632 such that the air supply passage 636 can be opened and closed by rotating the needle width 638. However, other valves or flow control configurations are also possible.  In order to provide the clinician with one of the cylinder pressures during use, The conventional pressure gauge 640 can be installed in fluid communication with the air supply passage 630. = Pressure gauge window 642 can be provided in grip portion 342 to allow the user to view pressure gauge 040 in use. See Figure 49.  ,  Long figure 57#58, The air reservoir tile 622 can be supported in a detachable grip portion 342. The grip portion is removably attached to a main handle from the main! The main attachment portion (4) of the portion 5 340 that protrudes downward.  • (4) can be engaged with the primary attachment portion 344 by any suitable configuration. : :  ^ condition, According to various embodiments, The engagement of the removable grip portion 342 with the primary attachment portion 344 can be accomplished by a linear sliding configuration as shown.  As shown in the picture, For example, in Figures 57_59 and 61, The releasable grip portion 20 includes the first and second upper rails 367 and the first and second lower rails 368 ° as shown in these figures. The first upper portion of the slippery nine 367 defines a slope 369. The upper rail 367 is designed to be received within a corresponding region 384 defined by the panels 380 and 382 in the main handle portion 340.  The surgical instrument can further include a latching system 1_. For example, the latching system shown in more detail in Figures 96422 66 200814963 2 and 64 69 is the number of main attachment portions 344 and the removable grip portion that are blocked by the removable grip portion 342 and the primary attachment portion 344. The number of times can be any number of times. This configuration may be particularly limited by limiting the number of times a device can be used to ensure that it is maintained. for example, 栌 every ^ ..., The garden is effective, 4 to rely on the mouth, for example, The latching system 1900 can block the heart portion 344 from attaching to the detachable grip portion 342 after the primary attachment portion 344 is detached twice. Although ίο == _ most of the bits are in the main housing portion 34〇, It should be understood that the latching system 1900 can be mostly in the accessible portion 342.  Flying grip, as shown in Figure 59, The locking system boo includes a counter 19〇2, And a blocking assembly 1904 coupled to the counter 1902. The counter 1902 is configured to advance as the detachable grip portion 342 is detached from the main == portion 344 of the handle assembly 3''. As shown in Figure 59, The counter 19〇2 is connected to the Xinyi axis 1906. The shaft is supported by a hub 19〇8 that is coupled to the right casing member 32〇. Counting benefit 1902 includes an indexing wheel 191 躺 lying on the shaft 19〇6,  And a biasing member 1912 coupled to the indexing wheel 1910. The biasing member 1912 can include, for example, a torsion spring configured to bias the indexing rim 9 in a counterclockwise direction 20 . See Figure 59.  The indexing wheel 1910 defines a protrusion 1914, 1914’, 1914, , , The projections cooperate with the blocking assembly 1904 to limit the advancement of the indexing wheel. One of the projections 1914" is configured to cooperate with the barrier assembly 19〇4 to resist the 9642 67 200814963 detachable grip portion 342 attached to the primary attachment after the grip portion 342 is detached from the primary attachment portion 344 a predetermined number of times Part 344. Although the sound wheel 1910 is not defined as the protrusion 1914, 1914, , 1914", According to other embodiments, the indexing wheel 191() can define a gap that is formed by the barrier assembly chest to limit the advancement of the indexing wheel 1910. And one of these gaps can be: : : The 43 person 42 is detached from the main attachment portion 344 a predetermined number of times to cooperate with the barrier to block the detachable grip portion 342 from being attached to the main attachment portion 344.  Ίο 15 20 Axis 1906 is configured to permit the indexing wheel 191 to be reset to a ^. for example, The shaft 1906 can define a hexagonal opening 1916, And the octagonal tool can pass through one of the openings 1918 of the left casing member 330 (shown, 60) Insert, , The angular opening 1916 then rotates clockwise to reset the indexing wheel 1910 to a previous position.  As shown in Figure 59, The barrier assembly 19〇4 includes a barrier member 192〇,  "Barrier member guide 1922 A question member 1924, And a biasing member 26. The shutter member 1924 is in contact with the blocking member 192, Can be rotatably connected to the barrier member guide 1922, And with the protrusion i9i4, MM, , (9) 4" = limit the indexing wheel 1910 to advance. The biasing member 1926 is lightly connected to the gate. The biasing member 1926 can include, for example, a torsion spring configured to bias the jaw 1924 in a clockwise direction. The operation of the latching system 1900 is described in more detail below with reference to Figure 64.69.  as the picture shows, For example, as shown in Figure 59_63, The handle assembly 3 includes a release system 193 that is configured to initiate the action of the removable grip portion (4) from the primary attachment portion 344. The release system 193 is located within the primary attachment portion 344 and includes a release illusion 932. And first and second release members 1934 that are attached or integrated to release button 96422 68 200814963 1932. 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 194, in contact with the first and second release pins 1938, And first and second ejection springs 942 in contact with the first and first lower rails 368.  • See Figure 62. As shown in Figure 59, The free end 1941 of the spring 1940 extends through a corresponding hole 321 of the right casing member 320 and a corresponding hole 331 of the left casing member 33 〇 φ into the corresponding hole 3 72 in the upper rail 367 so as to be detachable The grip portion 342 remains engaged with the primary attachment portion 344.  10 to initiate the action of the detachable grip portion 342 from the grip attachment portion 344, Push the release button 1932, The first and second release members 1934 and the corresponding release ramp 1936 are also advanced. With the release ramp 1936 advanced,  The release ramp 1936 causes the first and second release pins 1938 to change position. A change in the corresponding position of the first and second release pins 1938 results in the first 15 two locks, m. Moving the upper rails 367 up to the second rails 10 allows the first and second upper rails 367 to disengage from their engagement with the lock springs. As the detachable grip portion 342 is removed from the main grip attachment portion 344, The first and second ejection springs 1942 each release their stored energy, Thereby, a force is applied to the first and second lower rails 368, respectively. This force assists the detachable grip 20 . The file 342 is separated from the main grip attachment portion 344. It should be understood that according to the bean embodiment, The release system B30 can include an initial detachable grip portion 342 adapted to release the primary grip attachment portion &  Other components and configurations of the role of 344.  ,  芩 Makeup Figures 57 and 58, The distal end 637 of the air supply passage 636 has a point 639 96422 69 200814963 formed thereon to enable 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. In particular, 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. When the distal end 637 of the air supply passage 636 is inserted through, a large liquid-tight or hermetic seal is achieved therebetween. The sterility of the area within the tube collection chamber 644 is maintained while the distal end 637 of the air supply passage 636 is removed.  • Also shown in Figures 57 and 58, The gas supply line 650 is fluidly coupled to the tube collection chamber 644 such that pressurized gas entering the collection chamber 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 of the air supply passage 636 has pierced the sterile diaphragm 646. To assist the distal end 637 of the air supply passage 636 to be inserted through the sterile diaphragm, A compression spring 649 is provided between the wall of the removable grip portion 342 15 and the header block 632. This configuration provides some to the tube header block 632 at the distal end of the air supply passage 636 when the 637 is inserted through the diaphragm 646. elasticity〃.  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 20 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 pushing the slide 637 into the corresponding passage 384. The barrier member 1920 extends through one of the apertures 381 of the panel 380 into one of the channels 384. See Figure 59. As the first and second upper slides advance 367, The ramp 369 on one of the first upper slides 367 touches 96422 70 200814963 and strikes the barrier member 1920 and causes the barrier member to move upward toward the indexing wheel "7". As the blocking member 192 pushes toward the indexing wheel 1910, The blocking member 192 导致 causes the shutter member 1924 to move away from the indexing wheel 1910. See Figure 65. As the first upper slide 367 and the ramp 369 continue to advance, The blocking member 192 continues for 5 to advance toward the indexing wheel 1910. When the grip portion 352 is fully engaged to the main portion \ 35^, The blocking member 192 〇 touches the detecting portion 1914 that is originally in contact with the shutter member 1924, Thereby, the indexing wheel 191 is prevented from being advanced as shown in FIG.  _ After the grip portion 342 begins to detach from the main attachment portion 344, The first and second upper rails 367 are advanced in opposite directions. The bevel 369 of the first upper rail tearing edge = allows the blocking member 192 to be removed from the indexing wheel 191. As the barrier member 1920 is removed from the indexing wheel 191, The blocking member 192A allows the shutter member 1924 to advance toward the indexing wheel 191 and skips the projection 1914 as shown in FIG. As the grip portion 342 is detached from the main attachment portion, The blocking member 1920 is moved far enough away from the indexing wheel 191 to release its contact with the projection i9i4 = and allows the indexing wheel 1910 to rotate until a second projection 1914, As shown in Fig. 68, contact with the shutter member 1924 occurs.  This 蚪Counter benefit 1902 has advanced to a position, And the grip portion can be attached to the main attachment portion 344 again. The attach/separate loop can be repeated. Figure 68 illustrates a second reattachment procedure. When, for example, the main attachment portion 344, The barrier member touches the figure; ; The contact = out = 19U" thereby preventing the index wheel 191 () from advancing. At the end of the second cycle, When the grip portion 342 is disengaged from the main attachment portion 344, Closed member〗 々 A third protruding portion 1914" is touched as shown in FIG. The third protrusion (9) is configured to prevent the shutter member MM from being removed from the 96422 200814963 wheel 1910 by the blocking member 192. You and ^1 stand the Qiu Ba 342d to attach the part 344 to the grip two / i or attached to a replacement grip part). therefore, Based on these two! ? :  The surgical instrument is effectively a two-use device. However, those who are accustomed to this skill will understand that if the index wheel (4) defines more protrusions or gaps, the number of uses can be increased. In other embodiments of the invention, But constructed so that the panels 382, Or the handle assembly is repeated (four) = the first part or parts are separated or otherwise invalidated, To prevent the grip portion 342 or other grip portion from being attached to the handle assembly again.  Ίο - Figure 70_83 illustrates another unique new pneumatic surgical pair and tight SJ device side in accordance with the present invention, It provides the clinician with the ability to monitor the firing stroke while also providing the ability to manually retract the firing assembly of the skirt.  This embodiment can be used in conjunction with the terminal effector 12 or other terminal configurations described above.  ,  The elongated ridge assembly 3102 of the Ρβ (four) embodiment may include a proximal ridge segment 31〇4 attached to the 1-5 segment. In an alternate embodiment, S-shaped ridges • 3102 can include - a single component. The elongate ridge assembly 31〇2 is generally hollow and non-movably coupled to the housing assembly 300. As shown in Figures 79 and 8〇, The proximal end 3105 of the side ridge section can be attached to the housing by a right attachment roll 3110 projecting from the right side casing member 32 and a left attachment roll 3 ι 2 attached from the left casing member 33 to make. The distal end of the elongate ridge member 3102 can be attached to the long channel 20 as previously described.  And in this embodiment, An elongate closure tube 3190 extends from the handle assembly 3'' to the end effector. The distal end 3192 of the closure tube 3190 has a penetrating horseshoe-shaped aperture 3194 and is used to move the shaft 964 against the ridge member 31 〇 2 on the shaft member 96422 72 200814963 to open to the ground as described above and on the anvil 4 The tongue 46 interacts.  As shown in Figure 71, A shuttle assembly 3400 coupled to the closure trigger by a linkage assembly 43 is supported within the main housing portion 34A. The shuttle assembly 34 can also be fabricated from a polymer or other suitable material that is molded or otherwise fabricated and that is designed to fit together. 34〇4 constitutes. Part ' 3402, 3404 may be a fastening member and/or an adhesive and/or a bolt, Screw,  Clip, And the likes are held together. The right portion 34〇2 of the shuttle assembly 34〇〇 has a right stop flange section 3405, The right stop flange section is adapted to cooperate with a left stop flange section (not shown in the figure) on the left portion 3404 of the shuttle assembly 3400 to form an elongated closure tube that can be extended as described above. A stop flange assembly in the proximal end 3196 of the 3190 - a stop groove (not shown).  The proximal end 3104 of the elongate ridge member 3102 extends into an opening 3403 formed in the distal end of the shuttle assembly 34〇〇, And the left stop member 3112 extending through the right stop pile 311 and the opening 3408 of the opening 3406 respectively located in the right portion 3402 and the left portion 34〇4 is non-movably attached to the right casing member_ 320. In addition, Shuttle assembly 34〇〇 has a laterally extended guide 34ι〇, 34 ιι.  The 3410 is constructed to be slidably received in one of the right casing members 32, corresponding to the obedience, And the rail 3 411 is constructed to be slidably received in one of the left guide members 330 in the corresponding guide. therefore, The shuttle assembly μ (10) and the closed 20-joint tube 3190 are axially movable relative to the ridge assembly 31〇2 attached to the handle assembly 3〇〇.  Shuttle assembly 3400 and elongated closure tube 3190 in the distal direction (arrow, , The axial movement in c/r) is generated by the closing trigger 302 moving toward the grip portion 342 of the handle assembly 3〇〇, And the shuttle assembly 3400 is in the proximal direction (arrow, , D" The axial movement in 96422 73 200814963 is generated by the closure trigger 302 moving away from the grip portion 342.  In various embodiments, The shuttle assembly 3400 has 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 yoke portion 3432 that is pivotally pinned to the connector tab 1 34 by a pin 3414. The closed link assembly 3430 has a closing arm ' 3434, The closure arm is pivotally pinned to a vehicle assembly 304 formed on the closure trigger 302 by a closure pin 436 as shown in FIG. The closure trigger 302 is pivotally mounted within the handle assembly 300 by a pivot pin 306 extending between the right housing member 320 and the left housing portion 330.  10 When the clinician wants to close the anvil 40 and clamp the tissue within 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 closed link assembly 3430 moves the shuttle assembly 3400 in the distal 'VC〃 direction until the closed link assembly 3430 moves to the locked position shown in FIG. When in this position, Even the 15 bar assembly 3430 would tend to hold the shuttle assembly 3400 in the locked position.  • As the shuttle assembly 3400 moves to the locked position, The closure tube 3190 moves distally over the ridge assembly 3102, The closing/opening tab 46 on the anvil 40 is brought into contact by the proximal end of the horseshoe shaped hole 3194 of the distal end 3192 of the closure tube section 3190 to pivot the anvil 40 to the closed (clamped) position. To further keep the shuttle 20 to 3400 in the closed position, A locking mechanism 301 as described above can be used.  As mentioned earlier, Embodiments of the present invention utilize a unique novel retraction bar assembly 4000 to enable a clinician to monitor the progress of the firing and retraction strokes and provide the ability to manually retract a firing bar 4030. As shown in Figure 72, Retraction rod 96422 74 200814963 Assembly 4000 includes a retraction rod 4010 that is slidably pinned to a push rod 4020. In particular, The retracting rod 4010 has a penetrating elongated slot 4012,  The slot slidably receives two pins 4014 of a predetermined size for attaching the retracting rod 4010 to the push rod 4020. A retracting grip 4016 can be attached to the proximal end 4011 of the retracting 5 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 Figure 72, The proximal end 4032 10 of the firing bar 4030 has a connector portion 4034 formed thereon. The connector portion is sized to receive one of the distal ends 4022 of the push rod 4020 corresponding to the molded connector 10 aperture 4024. therefore, The push rod 4020 can be used to push the firing rod 4030 axially in a distal direction 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 rectangle, The square or similar cross-sectional shape is attached to the distal end 31 of the cutter 15 assembly 30 as previously described or to a different type of arbor and other end effector assemblies that require a sinuous axial movement to actuate.  72-77 include various figures of the shuttle assembly 3400. As shown in these figures, The left shuttle portion 3404 includes two spaced vertical support walls 3416,  3418, The support walls define a pusher opening 3420 therebetween. The distal end 4022 of the push rod 4020 20 extends through the push rod opening 3420 to be coupled to the proximal end 4032 of the firing rod 4030. As shown in Figure 72, The proximal end 4026 of the push rod 4020 is coupled to a V'Z-shaped connector member 4040. In particular, The proximal end 4026 of the push rod has a connecting post 4028 protruding therefrom, The connecting post can be received in an opening 96422 75 200814963 4049 of one of the attachment tabs 4042 on 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 or other suitable tie member. The distal end 4045 of the Z-connector member 4040 has a distal attachment tab 4046 thereon. The distal attachment tab is adapted to be coupled to a live cylinder 5040 that protrudes from a pneumatic cylinder assembly 5000.  * As shown in Figure 79, the cylinder assembly 5000 includes a first cylinder housing 5010. The first cylinder housing has a first closed proximal end 5012 and a first open distal end 5014 that opens into one of the first axial passages 5016 of the first cylinder housing 5010. The cylinder assembly 5000 also includes a second cylinder housing 5020.  The second cylinder housing has a second proximal end 5022 and a second open distal end 5024 that opens into a second axial passage 5026. The second proximal end 5022 has a first piston head 5028 formed thereon. The first piston head is sized relative to the first axial passage 5016 for producing a substantially airtight sliding seal with the first wall 5011 of the first cylinder housing 5010 for distally of the first proximal end 5012 A first cylinder region _ 5015 is defined between the proximal sides 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. The first flange is configured to establish a substantially airtight sliding seal with the outer wall surface of the second cylinder housing 5020 to define 20 - second between the proximal side of the first flange 5017 and the distal side of the first piston head 5028 Cylinder block 5018.  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 cylinder 9640 76 200814963 cylinder 5040. The second piston head 5046 is sized relative to the second axial passage 5026 for creating a substantially airtight sliding seal with the second wall 5021 of the second cylinder housing 5020 to define a third cylinder region 5032. The second distal end 5024 of the second cylinder housing 5020 further has an inwardly extending second flange 5025 formed thereon. The second flange is for establishing a substantially airtight sliding seal with the piston cylinder 5040 to define a fourth cylinder region 5034 between the proximal side of the second flange 5025 and the distal side of the second piston head 5030.  A 10 opening 5047 extends through the second piston head 5046 into a passage 5048 of the piston cylinder 5040.  10 As shown in Figures 79 and 80, The cylinder assembly 5000 is mounted within the housing assembly 300. A first air supply line or air supply conduit 5050 extends from one of the handle assembly 300 directional control valves 610 to be coupled to the first proximal end 5012 of the first cylinder housing 5010 for supplying pressurized gas through the first cylinder housing 5010 One of the first proximal ends 5012 is a first air supply port 5013 or an opening. In addition, A second air supply line 15 or air supply conduit 5052 extends from the directional control valve 610 to the distal end 5014 of the first cylinder housing _ 5010 and is coupled to the first cylinder housing 5010 for pressurization via a second cymbal 5029 Gas is fed into the second cylinder region 5018. See Figure 78.  Referring to Figures 78 and 79, The elongation and retraction of the firing bar 4030 will now be described in detail. As shown in Figure 78, The gas supply lines 5050 and 5052 are coupled to a conventional directional valve 1610. The valve is part of a drive system 1600 that is housed within the handle assembly 300. The directional control valve 1610 has a forward position section 1620, a stop section 1630, And an inversion section 1640. Control valve section 1620, 1630, The 1640 can be manually switched by buttons 1612 96422 77 200814963 and (6) 4 protruding through the handle housing 300. In various embodiments, A removable pressurized gas source 620 is used. See Figures 71 and 81-83. However, those skilled in the art will appreciate 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 have a port 616 for supplying pressurized gas from a source of external pressurized gas 618. for example,  The appliance 3010 can be coupled to a compressed air supply 618 in the facility via a flexible supply line 617. See Figure 81A.  # a Pressurized gas flows from a gas cylinder 622 (or external pressure source 618) through a gas supply line 650 into a conventional proportional valve 66. As shown in Figure 78,  The 1-inch proportional valve 660 is coupled to a supply air link 662 attached to a start trigger 67A. In various embodiments, The start trigger 670 is supported near the firing trigger 31〇" The trigger trigger is pivotally engaged with the handle assembly 300 by a cymbal pin 37 () extending between the right housing member 320 and the left housing member 330. Squeezing the start trigger 67 〇 inwardly toward the firing trigger 31 causes the proportional 15 valve 660 to permit more pressurized gas to flow through the supply line pair into the directional 阙 • 2 〇. Depending on the position of the directional valve 161, Pressurized gas will flow into the gas supply, , Within the road 5050 or 5052. for example, When the directional valve 61 is actuated by the clinical master to extend the firing rod 3〇, The control valve 161 〇 is switched to the forward position f such that the 4-inlet passage 1622 permits the pressurized gas to flow from the supply line 68 into the air supply, Within the road 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 进入^ into the first cylinder area 5015 and passes through the first base, The opening 5027 of the 5 〇 28 enters the third cylinder zone 5032. Pressurized gas entering the third cylinder region 5032 also enters the hollow piston cylinder 5〇4〇 through the opening 5047 of the second piston head 5046 and forces the piston cylinder to move distally 96422 78 200814963. The gas located in the fourth cylinder region 5034 is exhausted through the exhaust port 5023 of the second cylinder housing 5020. Similarly, Gas located in the second cylinder region 5018 is allowed to escape into the second gas supply line 5052 through the second opening 5029. The second gas supply line 5052 sends the discharged gas to the passage 1624 of the directional valve 1610, This is finally discharged from the exhaust passage 1632. Continue to the first cylinder area 5015, Third cylinder zone 5032 The application of pressurized gas to the passage 5048 of the piston cylinder 5040 causes the piston cylinder 5040 to extend distally as shown in Figures 73 and 79. As the piston cylinder 5040 extends distally, The Z-connector 4040 is also extended distally by its attachment to the distal end 5044 of the piston cylinder 5040. The Z-shaped connector 4040 forces the push rod 4020 to move distally. Thus, the firing rod 4030 is forced to move also distally. As the firing bar 4030 moves distally, The distal end portion 31 of the cutter assembly 30 attached to the firing rod is advanced through the magazine 50 to sever the tissue clamped by the end effector 12 and fire the staple. Once the tool assembly 30 has been advanced to its farthest side 15 position in the end effector 12, The clinician releases the trigger 670 to interrupt the application of pressurized gas.  The present embodiment may also be provided with means for indicating when the tool assembly 30 has reached its most distal position within the staple cartridge 50. In particular, A distal auxiliary line 1772 extending from the gas supply line 650 to the distal limit switch 1770 can be provided. A distal limit switch line 1774 is provided between the distal limit switch 2770 and the directional control valve 1610. therefore, When the tool assembly 30 has completed the firing stroke, The distal limit switch 1770 is oriented relative to a portion of the cylinder assembly 5000 such that the cylinder assembly is partially actuated by one of the distal limit switches. The distal limit switch 1770 permits air to flow under pressure from the supply line 650 to the distal limit switch line 1774 and into the directional control valve 1610 96422 79 200814963 5 10 15 20, This, in various embodiments, causes the directional control valve 161 to automatically switch to the inverted position/this causes the firing rod 4030 to retract as described below. In each of the embodiments, a first whistle 1790 or other suitable vocal device can be provided with the distal side (or the distal limit switch 17 is provided by the 1790 to the clinician) The tool assembly 3〇 has reached the end of the firing stroke. The gas flute 1790 can be replaced with a pressure switch pressure gauge or the like to provide the L-bed master with a time when the tool assembly 30 reaches one of the end of the firing stroke (6) when the pneumatic force is retracted to the firing rod side. The clinician can press the button 670 Λ 161G (4) to the inverted position and start squeezing the trigger ΓΙ'Λ gas into the second gas supply line 5052. Flow through the first -, "The gas entering the second cylinder zone 5〇18 of the road 5052 causes the first cylinder housing 5020 to be broken into green.  ,  " f wide brother inside a cylinder housing 5010. The first cylinder is supplied to the first through the first air supply opening 5013. ρ, ^1Λ The gas entering the rolling line 5040 is set to =1”. This is discharged from the exhaust gas 1632. The second gas red is red. The body has caused the second gas red shell to smash into the first One gas ΓΠ The gas passing through the second opening 5029 can now flow through the fourth cylinder area of the human body through the venting port 5_. The body enters the fourth gas red zone 5034, and the second piston lion will The 5040 is pulled into the second cylinder housing 5 in the near side. The gas in the third cylinder £5032 is « « η η; 孔 孔 孔 孔 孔 孔 孔 孔 孔 孔 孔 孔 孔 孔 孔 孔 孔 孔 孔 孔 孔 孔 孔 孔 孔 孔 孔 孔 孔 孔 孔 孔 孔 孔 孔 孔=: 5 10 15 20 门门1: Γ The proximal auxiliary line 1662 is also extended between the proximal-side limit two f and the common-gas line 65G. The proximal limit switch 1660 is connected to the assembly 5000 or the connector is oriented. When the firing rod side 乂兀 king, ''but back to the day' proximal limit switch 丨 76 〇 is actuated then permits air to flow into the proximal limit switch line 1764 and into the directional control valve (6) 〇 = fixed one way control valve 1610 automatically switches to Stop position. In an alternative embodiment 2 gas 1792 or other suitable sounding device can be connected to the proximal side: 〇 connected, resulting in The proximal restriction switch 76 〇 at the end of the retraction stroke, when actuated, the second edema 1792 is actuated by the air of the proximal restriction switch line 1764 to provide the clinician with another audible signal indicating the firing bar 4 (10) 〇 and the knife, 30 has reached the end of the retraction stroke. In other embodiments, for example, a battery powered light emitting diode or other signaling device can be associated with the distal and proximal restriction switches 1770, 1760 to provide a wedge to the user. ^ Another indication when the skid/tool has reached the end of the firing stroke and/or the retraction stroke. It will be readily understood by those skilled in the art that if the clinician wants to stop the firing stroke and retract the firing rod during the firing stroke and The cutter, he or she must do so by manually switching the control valve 1610 to the inverted position. In the example described above, the clinician did not use the unique novel retraction rod assembly 4000 of this embodiment of the invention. The reduction of the rod has several advantages. First of all, if during the firing or retracting stroke, the aerodynamic force is caused by an empty gas supply bottle 620 or because of an unexpected interruption of the supply of pressurized gas. 96422 81 200814963 Loss, the clinician can simply grasp the grip 4016 attached to the proximal end of the retraction rod and manually pull the rod proximally to the firing rod by manually switching the control valve 1610 to the inverted position Manually retract the firing bar (and tool assembly 30) in a fully retracted manner. See Figure 83. Switching the control valve 1610 to the inverted '5 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 its most proximal position as shown in Figure 83 before initiating the firing stroke. When in this position, as the gas 10 cylinder assembly 5000 pushes the connector 4040, the push rod 4020 and the firing rod 4030 distally, the push rod 4020 will retract the rod by its pin connection with the retraction rod 4010. The 4010 is then pulled to the far side. In various embodiments, the length of the retraction rod 4010 is provided such that when the firing rod 4030 is fully extended, no portion of the retraction rod 4010 protrudes from the handle assembly 300. Therefore, the clinician can judge the progress of the firing stick 4030 and the cutter assembly 30 by observing the portion of the retracting rod 4010 protruding from the handle portion 300. In an alternate embodiment shown in Figures 72A and 83A, the retraction rod 4010 can have at least one, and preferably at least two notches 4015 to receive the pin 4014. 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 20. In particular, as the firing bar 4030 is retracted, the pusher 4020 causes the retraction bar 4010 to advance proximally beyond the housing assembly 300 as the pin 4014 engages the notch 4015. Accordingly, the clinician can determine the distance traveled by the firing bar 4030 during the retraction stroke 96422 82 200814963 by observing the retraction rod 4010 to highlight the distance outside the handle assembly 300. However, when the appliance is not in use, the retraction lever 4〇ι can be pushed into the handle assembly as shown in Figure 81. Although several embodiments of the invention have been described, it will be understood by those skilled in the art For example, in accordance with various embodiments, a single component can be replaced with multiple components, and multiple components can be replaced with a single component, # to perform one or more known functions. Therefore, the present application is intended to cover all such modifications, changes, and adaptations without departing from the spirit and scope of the scope of the accompanying claims. x

15

20 The device disclosed herein can be designed to be disposed of after a single use, or it can be designed to be used multiple times. But no matter what kind of device, the device can be re-adjusted for reuse after at least 2 people use it. The realignment job can include the following steps: combination: disassemble the device, then clean or replace specific parts, and (4) reassemble. In particular, the particular component of any number of devices that can be decomposed m can be selectively #changed or removed in any combination. After the components are cleaned and/or replaced, the device can be reassembled for later use at - after adjusting the facility or by a surgical team - after the surgical procedure. Those skilled in the art will appreciate that the re-adjustment of the device can employ many different techniques for decomposing/replacement, and reassembly. The use of such techniques and the resulting re-adjustment devices are all within the scope of this application. Preferably, the invention described herein will be processed prior to surgery. Hundreds of first to get - brand new or expected equipment, and if necessary, to publish = the appliance. The appliance can then be sterilized. In a disinfection technique, the device is placed in a closed-closed sealed container such as a plastic bag or a τγν跋8 bag 96422 83 200814963 ^ Then the barn and the device are placed in a light shot capable of penetrating the container This radiation is, for example, r radiation, x-rays, or higher energy electrons. This f kills the bacteria on the container and the container. The sterilized device is then placed in a hot container. The sealed container holds the device: it is opened in the medical facility. It is called in the book. In all or part of this document, the patents, publications, or any of the disclosures are incorporated herein by reference in their entirety. Too 々 Φ 古 古 , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , The extent to which conflicts arise between the content of the content of the human content is incorporated. 〃There is no such thing as 15 blessings; • The content of this Λ Λ Λ 保护 保护 保护 不应 不应 不应 不应 不应 不应 不应 不应 不应 不应 不应 不应 不应 不应 不应 不应 不应 不应 不应 不应 不应 不应 不应 不应The examples should be considered as examples and not in the spirit of the invention. Changes and modifications are made without departing from the spirit of the invention. The equivalents, changes and changes are included in the scope of the application. [FIG. 1] FIG. 1 is a perspective view of an embodiment of a surgical cutting and fastening device of one embodiment of the present invention; The top view of the end effector of Figure 3, Figure 1 and Figure 2, wherein the anvil portion 96422 84 200814963 has been removed from it and the closed tube assembly is drawn in dashed lines; the side view of the end effector of 0 疋囷3 a cross-sectional view in which the stone portion is attached and in an open position; the garden 5 is a top cross-sectional view of a portion of the joint controller used in various embodiments of the present invention; - Figure 6 is a Figure 1 A top cross-sectional view of the joint of the end effector; FIG. 7 is an exploded, isometric view of an embodiment of a closure tube assembly and a support assembly that is supported in a handle assembly, wherein the housing is assembled The other components are omitted for the sake of simplicity; Figure 8 is a cross-sectional view of the housing assembly configuration of various embodiments of the present invention; / Figure 8A is a closed trigger locking system that can be used with embodiments of the present invention. Partial partial cross-sectional view; Figure 8B is another embodiment of the present invention A cross-sectional view of a handle assembly embodiment in which a pressurized gas source is outside the handle assembly; 15 Figure 8C is a cross-sectional view of another handle assembly embodiment of the present invention; • ® 9 is - Figure 8 handle assembly - FIG. 1 is a side view of a shank arrangement and a firing transmission member including a two-stage cylinder assembly in accordance with one embodiment of the present invention, wherein the cylinder assembly is shown in cross section; 1 〇 another side view of the arbor and two-stage cylinder arrangement 'where the shank is in the extended position; FIG. 12 is a side view of another arbor and firing transmission member arrangement of the present invention, wherein the shank is retracting Figure 1 is a side view of the arbor and cylinder arrangement of Figure 12, wherein 96422 85 200814963 is in an extended position; Figure 14 is a housing shown in Figures 12 and 13 FIG. 15 is a side cross-sectional view of the end effector and ridge assembly of FIG. 14 with the anvil portion attached thereto and in an open position; FIG. 15 is a top plan view of the end effector and ridge assembly of the cylinder and arbor; FIG. 16疋一 can be combined with the embodiment shown in Figure 12·15 A cross-sectional view of the handle assembly;

Ίο 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 pressurized gas source is outside the handle assembly; Figure 16B is a cross-sectional view of another handle assembly embodiment of the present invention; Figure 11 is a top 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 18 is an end effector and ridge of the embodiment shown in Figure π Figure 19 is a partial cross-sectional view of the bellows assembly of the embodiment shown in Figures 19 and 18; Figure 20 is an enlarged view of a portion of the bellows assembly of Figure 19; BRIEF DESCRIPTION OF THE DRAWINGS FIG. 21A is a cross-sectional view of another embodiment of a handle assembly that can be used in conjunction with the embodiment of FIGS. 17-20, wherein The pressurized gas source is outside the handle assembly; S 1B is a cross-sectional view of another handle assembly embodiment; FIG. 22 is a perspective view of another surgical cutting and fastening device in accordance with other embodiments of the present invention; 86 200814963 Figure 23 is / Figure 22 2 is a side cross-sectional view of the end effector and ridge assembly of the embodiment, and FIG. 24 is a quick release joint configuration of the embodiment of FIGS. 22 and 23 before the distal shaft assembly is coupled to the proximal shaft assembly Sectional view; ^ 5 Figure 25 is a plan view of the proximal shaft assembly taken along line 25_25 of Figure 24; 10 Figure 26 is a distal shaft assembly attached to the proximal shaft assembly a partial perspective view in which a portion of the distal shaft assembly is omitted for simplicity; FIG. 27 is a side cross-sectional view of the joint assembly of the embodiment of FIGS. 24-26, wherein the distal shaft assembly has been Coupled to the proximal shaft assembly; Fig. 28 is a perspective view of a portion of the distal shaft assembly prior to attachment to the proximal shaft; a portion of Fig. 29 is shown in Fig. 12-16A Another fast of the embodiment

Partial cross-sectional view of the joint with the emperor; A 15 Fig. 30 is - along the line 3 of Fig. 29 (the proximal shaft assembly surface view taken by the MG, Fig. 3! is an embodiment that can be used in conjunction with the embodiment shown in Fig. 22_30 A perspective view of a portion; Fig. 32 is a view of another surgical cutting and fastening device 20 of the present invention, which uses the pneumatic actuation joint of the various embodiments of the present invention. Fig. 33 is - Fig. 32 Embodiments will be a partial perspective view of a portion of the distal joint of the distal ridge to the spine; a close-up view of FIG. 33 is another perspective view of the joint joint configuration of FIG. 33, except that the distal spine is illustrated relative to the near The side ridge section performs the joint movement; the vessel private 96422 87 200814963 Fig. 35 is an exploded assembly view of the joint joint arrangement of Figs. 33 and 34; Fig. 36 is a side sectional view of the joint assembly of Fig. 33·35; Fig. 3 7 is a perspective view of an embodiment of the switch assembly of the present invention; ^ is a side view of a switch assembly of Fig. 37; and Fig. 39 is a view of the total of Figs. 37 and 38 taken along line 39-39 of Fig. 37. - a cutaway view; Fig. 40 is a cross-sectional view of the switch_assembly taken in the off position taken along line 40-40 of Fig. 38; Fig. 41 is in a Figure 37_4 is another sectional view of the switch assembly; Figure 42 is a cross-sectional view of the switch assembly of Figure 41 taken along line 42_42 of Figure 41; Figure 43 is a switch assembly of Figure 37-42 Bottom view; 15

20, FIG. 44 is a cross-sectional view of a handle assembly having the switch assembly of FIGS. 37-43 and having a source of pressurized gas; and FIG. 45 is a cross-sectional view of the handle assembly having the switch assembly of FIGS. 37-43 therein; 'And wherein the pressurized gas source is outside the handle assembly; Figure 46 is a perspective view of another surgical stapling and cutting device of the present invention: pumping:: using the joint joint embodiment shown in Figure 33_36 and Figure 2 quick release Example of a joint; assembly: =:=;:= Figure taken at line 48-48 of the distal shaft joint V::::7 - Example 96422 88 200814963

49 is a perspective view of another surgical cutting and fastening utility of the present invention. FIG. 49 is a combination of the end effector used in the embodiment shown in FIG. 49. An exploded assembly view of the terminal, ridge assembly and closure tube assembly used; - Figure 52 is a cross-sectional view of the end effector, ridge assembly and closure tube of Figure 51, wherein the anvil portion is omitted for simplicity; 10A is a side cross-sectional view of a terminal action, ridge, and closure tube assembly of another non-limiting embodiment of the invention in which the air motor is supported away from the handle assembly ; . Figure 52B is a side cross-sectional view of the terminal, ridge assembly and closure tube assembly of another non-limiting embodiment of the present invention, wherein the air motor is supported away from the handle assembly; Figure 53 is a A cross-sectional view of a handle assembly that can be used with the embodiment of Figure 49; Figure 53A is a cross-sectional view of another handle assembly that can be used in conjunction with the embodiment of Figure 49, wherein the source of pressurized gas is outside the handle assembly; Figure 54 Figure 5 is a side elevational view of the handle assembly of the relative position of the embodiment of the present invention; Figure 56 is a side view of a control system of the present invention for use with embodiments of the present invention; BRIEF DESCRIPTION OF THE DRAWINGS Fig. 57 is a cross-sectional view showing a detachable grip portion of a main attachment portion 96422 89 200814963 of one embodiment of the handle assembly of the present invention; Fig. 58 is a view showing a detachable grip A partial cross-sectional view of a main attachment portion of a handle portion of one of the embodiments of the present invention; FIG. 59 is a partial cross-sectional view of the detachable grip portion and the main attachment portion of FIG. 58 Red related component Illustrated in FIG. 59 is a cross-sectional view of the detachable _ grip portion and the main attachment portion taken along line 6〇_6〇 of FIG. 59; FIG. 61 is a cross-sectional view along FIG. FIG. 62 is a cross-sectional view of the detachable grip portion and the main attachment portion of FIGS. 58, 59 and 6 taken from line 61_61; FIG. 62 is a detachable grip portion of Fig. 58 61 taken along line 62_62 of Fig. 59 and mainly Figure 63 is a partial cross-sectional view of the detachable grip portion and the main attachment portion of Figure 58_62 taken along line 63_63 of Figure 59; = Figure 64 - the present invention in an initial position In the second embodiment of the latching system embodiment, the second embodiment of the latching system exemplifies the action of the latching system to the attachment of the main attachment portion of the handle assembly, 20 Figure 66 is Figure 64 and The closure of 65 is from the a, 4 ^ lock system before the second part of the grip part is removed from the main attachment part of the handle assembly; Figure 67 is the lock line of Figure 64_66 ^ έΒ jh -IP 4 ^ίτ Another schematic diagram of V ', , , , , exemplifying the system components in the grip part (four) connected to the main attachment Figure 68 is another schematic view of the latching abundance of Figure 64-67, illustrating the system 96422 90 200814963 assembly during the second attachment of the grip portion to the primary attachment portion Position, FIG. 69 is another schematic diagram illustrating a latching system after the grip portion has been attached a second time and last time to the primary attachment portion; FIG. 70 is a perspective view of another surgical cutting and fastening device of the present invention. Figure 71 is a cross-sectional view of a handle assembly that can be used with the appliance of Figure 70; Figure 72 is an exploded view of the shuttle and retractor assembly of the various embodiments of the present invention; ' ίο 72A疋 is an unassembled view of the shuttle and retracting rod assembly of another embodiment of the present invention; and FIG. 73 is a combined view of the assembly shown in FIG. 72, wherein the cylinder assembly is in a fully extended position; Rear view of the shuttle assembly of the present invention; Figure 75 is another rear view of the shuttle assembly, wherein the retraction rod and the push rod extend into the push # opening and the push rod is attached to the connector member; a rear perspective view of the left part of the shuttle assembly; Figure 77 left part of the shuttle assembly Another rear perspective view; Fig. 78 is a simplified view of a control system configuration 2〇 of the embodiment shown in Figs. 7〇-77; Fig. 79 is a handle assembly configuration of the embodiment shown in Figs. 70-78. Figure 10 is a plan view of the handle assembly, wherein the cylinder assembly is in an extended position; Figure 80 is another top cross-sectional view of the handle assembly of the embodiment shown in Figures 70-79, wherein the cylinder assembly is in a retracted position; 91 200814963 FIG. 81 is a cross-sectional view of the handle assembly of the embodiment shown in FIGS. 70-80; FIG. 81A is a cross-sectional view of an embodiment of the handle assembly of the embodiment shown in FIG. 7A-8. The pressure gas source is outside the handle assembly; FIG. 82 is another cross-sectional view of the handle assembly of FIG. 81, wherein the gas red assembly FIG. 83 is a retracted view; and another sectional view of the handle assembly of 81, wherein Cylinder assembly

10 15

Figure 83A is a handle assembly of the embodiment of -@72B wherein the cylinder assembly is retracted and the firing rod is in its proximal most position. Fig. [Major component symbol description] 10 Surgical stapling and cutting device 12 End effector 20 Long channel 21 Locking opening 22 Attachment hole 23 Channel groove 24 Recession 26 Recession 28 Anvil cam slot 20 30 Total cutter 31 distal part 32 upper pin 33 hole 3 4 knife bar 96422 92 200814963 35 piston rod 35' stepped portion 36 intermediate pin 37 protrusion, 38 cutting edge \ 39 locking protrusion 39' proximal slope _ 39" far Side bevel 40 anvil 10 42 anvil 43 anvil pivot 44 longitudinal anvil slot 46 anvil open / close tongue 50 nail 匣 15 51 匣 main body, • 54 vertical slot hole 56 nail 匣 upper surface 58 nail hole 60 nail lengthening Feature portion 20 62 staple extension feature 64 wedge slider 66 staple driver 68 匣 plate 70 elbow 96422 93 200814963 100 long shaft assembly 102 ridge assembly 104 pivot 110 distal ridge segment 5 111 far Side square hole '112 lock spring 113 proximal square hole Xin 114 channel anchoring member Π 5 clamp rod 10 116 lock spring upper arm 117 bellows passage 118 lock spring lower arm 122 hub 123 connection point 15 124 hole _ 125 connection point 130 Side ridge section 134 tang 136 hole 20 138 pivot pin 140 pin 142 pin 150 belt member 160 belt member 9642 2 94 200814963 170 Closed tube assembly 172 Double 闭合 shaft closed joint 174 Upper double pivot link 175 Far pivot pin • 5 176 Proximate pivot lock 177 Lower double pivot link 178 Distal pivot pin • 179 Proximal pivot pin 180 distal closure tube segment 10 182 upper tang 183 pin hole 184 lower tang 185 horseshoe hole 186 tongue 15 187 pin hole 190 proximal closed tube section 191 axial channel 192 upper tang 193 pin Hole 20 194 Lower tang 195 Pin hole 196 Stop groove 200 Joint controller 202 Joint slide 96422 95 200814963

Ίο 15

204 frame 206 closure 208 slot 210 connection point 212 connection point 300 handle assembly 301 releasable locking mechanism 302 closure trigger 303 flexible longitudinal arm 304 assembly 305 pin 3 0 6 axis pin 310 firing trigger 310 'relative position Trigger 320 right side casing member 321 hole 322 right side casing member upper portion 323 left casing member upper portion 324 right casing member lower portion grip portion 326 right ridge assembly stop pile 328 obstruction guide 330 left machine Shell member 331 hole 332 upper attachment plate portion 96422 96 20 200814963 333 haptic feedback configuration 334 left side casing member lower grip portion; nut portion (Fig. 55) 335 slot 337 spring arm, 340 main housing portion '342 grip Part 344 main attachment part • 350 opening 352 wedge 10 354 wedge lower surface 356 notch 358 can be flexed 359 opening 350 inclined rear wall 360 opening 15 367 upper sliding 368 lower sliding 3 69 inclined 370 pivot Pin 372 hole 20 380 panel 382 panel 384 upper sliding storage channel 400 closing shuttle 402 shuttle right part 96422 97 200814963 403 fastening bolt 404 shuttle left part 405 right stop flange section 406 Slot 408 Slot 410 Guide 411 Guide • 412 Connector Tab 414 Pin 10 430 Closed Link Assembly 432 Vehicle Section 434 Closing Arm 436 Closing Pin 500 Transmission Member 15 501 Cylinder Assembly • 510 First Cylinder Housing Body 511 first wall 512 first proximal end 513 first air supply port 20 514 first distal end 515 first cylinder region 516 first axial passage 517 first flange 518 second cylinder region 96422 98 200814963 519 trunnion 520 Second cylinder housing 521 second wall 522 second proximal end _5 523 exhaust port ' 524 second distal end 525 second flange _ 526 second axial passage 527 first passage 10 528 first piston head 529 Second air supply port 530 second piston head 532 third cylinder area 534 fourth cylinder area 15 540 first gas supply line 10 540 'first gas supply line section 540" first gas supply line section 541 pressure gauge 542 Two gas supply line 20 542' second gas supply line section 542" second gas supply line section 543 window 545 sound outlet 546 limit switch 96422 99 200814963 547 activation member 549 indicator member 600 drive system 610 directional control valve *5 612 selector switch ^ 616 埠 617 flexible supply line H 618 external pressurized gas source 620 removable / refillable pressurized gas source 10 622 gas cylinder 624 liquid 626 diaphragm 628 vapor 630 vacuum source ; gas cylinder drain end (Figure 57-58) 15 632 flexible vacuum line; tube set box block (Figure 57-58) _ 634 threaded port 636 gas supply channel 637 distal end 638 needle valve 20 639 points 640 pressure 642 pressure gauge peep window 644 closed tube set room 645 埠 mouth 96422 100 200814963

Ίο 15

646 sterile diaphragm 649 compression spring 650 gas supply line 651 gas supply line 660 proportional valve 662 gas supply link arm 670 start trigger 671 cavity 680 gas supply line 800 cylinder assembly 810 first cylinder housing 812 first closed end 813 First air supply port 815 first cylinder region 817 first flange 820 second cylinder housing 822 second closed proximal end 824 second distal end 825 second flange 827 first opening 828 first piston head 830 second piston Head 832 third cylinder area 840 first gas supply line 96422 20 200814963 850 first retraction spring 852 spring 900 bellows assembly 902 distal end 5 904 projections 910 expandable/retractable bellows portion 912 wire confinement ring B 912 'starting member 914 base portion 10 916 air supply 920 vacuum 922 vacuum line 940 gas supply line 940 ' gas supply line section 15 940 " gas supply line section _ 1000 quick release joint 1000 ' quick release Connector 1010 distal shaft assembly 1012 proximal end 20 1020 proximal shaft assembly 1022 distal end 1030 ridge assembly 1110 distal ridge segment 1111 distal square hole 96422 102 200814963 1113 proximal square hole 1114 proximal 1115 clamp

Ίο 15

1116 distal connector portion 1117 first distal air supply port 1117' third distal air supply port 1118 first air supply nozzle portion 1118' third air 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 ridge segment 1152 distal end 1154 second connector portion 115 5 concave Port portion 1156 first proximal air supply 埠 1156' third proximal air supply 埠 1158 first Ο ring seal 1158 'third Ο ring seal 1160 second proximal air supply 埠 96422 103 20 200814963 1160 'fourth proximal side Air supply 埠 1162 second Ο ring seal 1162' fourth Ο ring seal 1170 hollow sleeve portion 5 1172 locking opening - 1178 closing tube assembly 1180 distal closing tube section • 1182 proximal end 1184 locking tongue 10 1186 locking wedge 1190 Proximal closed tube section 1194 locking opening 1195 proximal end 1196 slot 15 1200 release sleeve 10 1202 distal end 1204 release button 1206 second beveled inner edge 1300 first distal air supply port 20 1306 proximal air supply port 1308 Ο Ring seal 1500 surgical cutting and stapling instrument 1512 end effector 1520 long slot 96422104 200 814 963

Ίο 15 1521 distal 1522 bearing 1530 wedge sled assembly 1532 sled part 1538 knife part 1540 ridge assembly 1542 proximal ridge section 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 96422 20 200814963 1614 button 1620 forward position area Segment 1622 forward passage 1624 passage 1630 stop section 1632 exhaust 埠 1640 reverse section

Ίο 15

1660 proximal limit switch 1662 proximal auxiliary line 1664 proximal limit switch line 1700 air supply/exhaust line 1710 air supply/exhaust 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 shaft 96422 106 20 200814963 1756 proximal end 1758 distal 1760 proximal limit switch 1770 distal limit switch 5 1772 distal Auxiliary line '1774 far side limit switch line 1780 knife indicator _ 1790 first whistle 1792 second whistle 10 1800 feedback link assembly 1801 threaded manual feedback shaft 1802 universal joint part 1804 manual feedback gear 1900 locking system 15 1902 counter • 1904 barrier assembly 1906 shaft 1908 hub 1910 indexing wheel 20 1912 biasing member 1914 projection 1914 'protrusion 1914" projection 1916 hexagonal opening 96422 107 200814963 1918 opening 1920 barrier member 1922 barrier member guide 1924 Member 5 1926 Bias member * 1930 Release system 1932 Release button • 1934 Release member 1 936 release bevel 10 1938 release pin 1940 lock spring 1942 ejector spring 2000 surgical cutting and stapling instrument 2002 pneumatic joint assembly 15 2004 ridge assembly • 2010 distal ridge segment 2012 proximal 2014 pivot member 2016 drive plate 20 2030 proximal ridge section 2032 distal end 2034 pivot bearing socket 2036 groove 2038 groove 96422 108 200814963 2040 first vertical air supply passage 2042 third gas supply line 2042 'third gas supply line section 2042" third gas supply line section 5 2044 Third air supply 埠^ 2045 Third air supply channel 2050 Second vertical air supply channel m 2052 Fourth gas supply line 2052' Fourth gas supply line section 10 2052" Fourth gas supply line section 2054 Fourth Air supply 埠 2055 Fourth air supply passage 2060 Cover 2062 Screw 15 2100 Switch assembly 2110 Switch block 2111 Pivot hole 2112 Air supply 113 2113 Switch block bottom surface 20 2114 Switch chamber 2116 Air supply channel 2118 Pipe header box 2130 selection Member assembly 2150 body portion 96422 109 200814963 2151 frame shaft 2152 0 ring seal 2153 return rod 2154 0 ring seal 5 2155 undercut exhaust zone - 2156 short rod 2158 selector handle • 2160 central air supply 170 2170 fourth exhaust passage 10 2180 third exhaust passage 2190 return spring 2192 round projection 2193 slot 2194 round projection 15 2195 slot • 2196 free end of the return spring 2198 Reversing spring free end 3010 Pneumatic surgical cutting and fastening device 3102 Ridge assembly 20 3104 Proximal ridge segment 3105 Proximal end 3106 Distal ridge segment 3110 Right stop post 3112 Left stop post 96422 110 200814963 3190 Closed tube 3192 Distal end 3194 horseshoe hole 3196 ridge assembly proximal end '5 3400 shuttle assembly • 3402 shuttle assembly right part 3403 opening • 3404 shuttle assembly left part 3405 right stop flange section 10 3406 opening 3408 opening 3410 Guide 3411 guide 3412 connector piece 15 3414 pin φ 3416 vertical support wall 3418 vertical support wall 3420 push rod opening 3430 closed link assembly 20 3432 light part 3434 closed arm 4000 retracting rod assembly. 4010 retracting rod 4011 Proximal 96422 111 200814963 4012 slot 4014 pin

Ίο 15 4015 notch 4016 retracting grip 4020 push rod 4022 distal end 4024 connector hole 4026 push rod proximal end 4028 connection post 4030 firing rod 4032 proximal end 4034 connector portion 4040 Z-shaped connector part 4041 proximal end 4042 attached Tab 4045 Z-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 An open distal 96422 112 20 200814963

Ίο 15 5015 first cylinder region 5016 first axial passage 5017 first flange 5018 second cylinder region 5020 second cylinder housing 5021 second wall 5022 second proximal end 5023 exhaust port 5024 second open distal end 5025 Second flange 5026 second axial passage 5027 first passage 5028 first piston head 5029 second 埠 5032 third cylinder region 5034 fourth cylinder region 5040 piston cylinder 5042 proximal end 5044 closed distal end 5046 second piston head 5047 opening 5048 Channel 5050 first gas supply line 5052 second gas supply line 96422 20

Claims (1)

200814963 X. Patent application scope · 1· A surgical instrument comprising: a handle assembly; an aerodynamic source portion; removably attached to one of the handle assemblies 10 2 · an oxygen transmission system /,,,八_ „灯益丹口” is constructed to be fluidly coupled to the aerodynamic source; and m system, which is combined with the handle assembly to read the aerodynamic source from the main part of the handle assembly and the ^ :: [After the number of turns, the aerodynamic source is blocked: the hand assembly ί; σ uniform and the connection of the pneumatic transmission system. 、心^ 稷 The surgical instrument is operatively supported 15 3· 4. If applying The first item of the patent range is supported in a grip portion in which the main portion of the handle assembly can be removed from the grip portion as in the second item of the patent application. The first item of the patent application includes a refillable cassette. The surgical instrument, wherein the pneumatic power source, the grip portion is removably attached to the external device, the pneumatic power source external device, wherein the pneumatic power source 5. 20 w〒 patent scope 6包杯兮,^ Behavioural, where the lock =Γ: an attachment portion of the assembly that is disabled after the source has been unloaded a predetermined number of times. As in the scope of claim 2, the external appliance includes a counter that is constructed for the total handle Advance when the main part is separated. The locking system in the grip part from 96422 114 200814963 For example, in the scope of application for patent application No. 6, the counter package 10 an indexing wheel; and a biasing member that is lightly attached to the indexing wheel. The accessory device of claim 6, wherein the locking system further comprises a blocking assembly coupled to the counter, wherein the blocking assembly is configured to separate the grip portion from the main portion a predetermined number of times The connection of the grip portion to the main portion is then blocked. If the application is outside the scope of the patent application, it is counted as a resettable counter. TM 10· 15 11· 20; Patent Application No. 1 of the external device, wherein the pneumatic transmission system is fluidly coupled to one of the main portions of the handle assembly: the box region has an access port formed therein, The second rotor is covered so that the gas is discharged from the gas source: the transmission is maintained, the sterility of the pneumatic transmission system is maintained, and the gas supply line is constructed for use in the aerodynamic source. Connected to the handle to pierce the barrier. Taking the method of the king's knife, the method includes the following: the surgical device of the first item of the patent application scope; and disinfecting the surgical instrument; and /, will be 0 The state of the sea is stored in a sterile container. A surgical instrument comprising: a handle assembly comprising: · 115 12. 200814963 ίο 13. 14. 15 15. 20 a main part having a first attachment means thereon; and - two trowels having a a second attachment device, the second attachment member cooperates with the first attachment means to enable the grip portion to be at the main portion 'and wherein at least one of the first and second attachments σ is configured to be used in the grip Disassembling the main portion to become disabled to prevent the grip portion from being attached to the main portion again; an air power source located in the grip portion, and: a pneumatic transmission member 'in the grip A portion is attached to the main portion of the handle assembly in fluid communication with the source of an aerodynamic force. "Scope No. 12 Foreign Instruments, wherein the aerodynamic source J is moved away from the grip portion. :Application:::Scope No. 12 Foreign Instruments' which is a refillable gas cylinder. A surgical instrument The method includes: a handle assembly, comprising: - a main portion having a tube header region therein, the one receiving the cartridge; a barrier member covering the access panel; and: a grip portion for releasing Connected to the main portion; a pneumatic transmission system that is at least partially operatively supported within a main portion of the master, the pneumatic transmission system being in fluid communication with one of the main portions; a source of force located within the grip portion; 96422 116 200814963 a gas supply line fluidly coupled to the aerodynamic source and configured to be received by the access device when the grip portion is attached to the main portion s tens of benefits, which is supported by the handle assembly for counting the number of times the grip portion has been attached to the main portion; and 5 a barrier connection portion that cooperates with the counter to be in the grip portion: Attached to the main part After the predetermined number of times again to prevent the handle portions attached to the main portion. • 16. > 5 patent applications for the patent scope, wherein the barrier connection = a plurality of grip portions 10 constructed to support an aerodynamic source internally, any of the grip portions have been attached in any combination Attaching any of the grip portions to the main portion of the handle assembly is prevented after the predetermined portion of the handle assembly is predetermined. 17. The scope of the invention, wherein the surgical instrument is substantially sterile, and wherein the gas supply line pierces the barrier and forms a penetration after the grip portion is attached to the main portion Receiving a hole, the barrier exposed member is made of an automatic closing material, such that when the gas supply line is moved away from the receiving hole, the receiving hole is closed so that when the grip portion has been detached from the main portion Maintain the sterility of the tube header area. 18. The apparatus of claim 15, wherein the counter is a resettable counter. 19. If the patent application scope is 15 foreign surgical devices, the pneumatic power source can be removed from the grip portion. 2〇. ^Applicable to the 15th foreign language appliance, wherein the pneumatic power source includes a refillable cassette. 96422 117