![]() SURGICAL INSTRUMENT
专利摘要:
surgical instrument. The present invention relates to a surgical instrument that may include a stem, an end effector and a pivot joint configured to allow the end effector to rotate relative to the stem about the pivot joint. the surgical instrument may further comprise a first pivot actuator for rotating the end effector in a first direction, and a second pivot actuator for rotating the end effector in a second direction. linkage actuators can be configured to push the end effector. linkage actuators can take on different configurations depending on whether they are subjected to a compressive load or a tensile load. the hinge joint may comprise a hinge structure which forms a proximal joint with the stem and a distal joint with the end effector. the joints may comprise fixed axis joints and/or ball-and-socket joints, for example. the articulation joint may comprise links that are of different sizes to facilitate articulation of the articulation joint. 公开号:BR112017012999B1 申请号:R112017012999-0 申请日:2015-12-10 公开日:2022-01-04 发明作者:Frederick E. Shelton Iv;Jerome R. Morgan;Jason L. Harris;Jeffrey S. Swayze;Chester O. Baxter Iii 申请人:Ethicon Llc; IPC主号:
专利说明:
BACKGROUND [0001] The present invention relates to surgical instruments and, in various embodiments, surgical stapling and cutting instruments and staple cartridges for use therewith. [0002] A stapling instrument may include a pair of cooperating elongated jaw members, each jaw member being adapted to be inserted into a patient and positioned with respect to tissue to be stapled and/or cut. In various embodiments, one of the jaw members can support a staple cartridge with at least two laterally spaced rows of staples contained therein, and the other jaw member can support an anvil with staple-forming pockets aligned with the rows of staples. in the staple cartridge. In general, the stapling instrument may additionally include a pusher bar and a knife blade that are slidable relative to the gripper member to sequentially eject staples from the staple cartridge through cam surfaces on the pusher bar and/or cam surfaces. on a wedge rail which is pushed by the push rod. In at least one embodiment, the cam surfaces may be configured to activate a plurality of staple drivers loaded by the cartridge and associated with the staples to push the staples against the anvil and form laterally spaced rows of deformed staples in the tissue trapped between the staples. claw limbs. In at least one embodiment, the knife blade can follow the cam surfaces and cut the fabric along a line between the staple rows. Examples of such stapling instruments are disclosed in US Patent No. 7,794,475 entitled "SURGICAL STAPLES HAVING COMPRESSIBLE OR CRUSHABLE MEMBERS FOR SECURING TISSUE THEREIN AND STAPLING INSTRUMENTS FOR DEPLOYING THE SAME", the entire disclosure of which is incorporated herein by reference. . [0003] The aforementioned discussion is only intended to illustrate various aspects of the related art in the field of the invention at the time and should not be taken as a denial of the scope of the claims. BRIEF DESCRIPTION OF THE DRAWINGS [0004] Numerous features of the modalities described in this document, together with their advantages, can be understood according to the description presented below, considered together with the attached drawings, as follows: [0005] Figure 1 is a plan view of an end effector of a surgical stapling instrument comprising a staple cartridge, an anvil and a closure tube configured to move the anvil between an open position and a closed position; [0006] Figure 2 is a partial perspective view of the end effector of Figure 1 illustrated with portions removed to illustrate a fixed axis pivot joint; [0007] Figure 3 is a perspective view of a hinge joint according to at least one embodiment; [0008] Figure 4 is a plan view of the pivot joint of Figure 3 in a non-hinged configuration; [0009] Figure 5 is a plan view of the hinge joint of Figure 3 in a hinged configuration; [0010] Figure 6 is an elevation view of a linkage actuator comprising a wire illustrated in an unloaded condition; [0011] Figure 7 is an elevation view of the linkage actuator of Figure 6 illustrated in a loaded condition in which it experiences a compressive load; [0012] Figure 8 is an elevation view of the linkage actuator of Figure 6 illustrated in a loaded condition in which it experiences a pulling load; [0013] Figure 9 is a plan view of a hinge joint, according to at least one illustrated embodiment in a non-hinged configuration; [0014] Figure 10 is a plan view of the hinge joint of Figure 9 illustrated in a hinged configuration; [0015] Figure 11 is a longitudinal cross-sectional view of the pivot joint of Figure 9 taken along line 11-11 in Figure 9; [0016] Figure 12 is a cross-sectional view of the pivot joint of Figure 9 taken along line 12-12 in Figure 9; [0017] Figure 13 is a cross section of an articulation joint according to at least one alternative embodiment; [0018] Figure 14 is a plan view of a hinge joint, according to at least one illustrated embodiment in a non-hinged configuration; [0019] Figure 15 is a plan view of the pivot joint of Figure 14 illustrated in a pivoted configuration; [0020] Figure 16 is a perspective view of a flexible pivoting platform configured to support a firing member, according to at least one embodiment; [0021] Figure 17 is an exploded view of the flexible platform of Figure 16; and [0022] Figure 18 is a perspective view of a flexible platform configured to support a firing member according to at least one embodiment. [0023] Corresponding reference characters indicate the corresponding parts across the various views. The exemplifications described herein illustrate various embodiments of the invention, in one form, and such exemplifications should not be considered as limiting the scope of the invention in any way. DETAILED DESCRIPTION [0024] The applicant of the present application holds the following patent applications which were filed on the same date as the present application and which are each incorporated herein by reference in their entirety: - Patent Application Serial No. US, entitled SURGICAL INSTRUMENT SYSTEMS COMPRISING AN ARTICULATABLE END EFFECTOR AND MEANS FOR ADJUSTING THE FIRING STROKE OF A FIRING MEMBER; Lawyer's Precedent No. END7415USNP/140289; - Patent Application Serial No. U.S., entitled SURGICAL INSTRUMENT ASSEMBLY COMPRISING LOCKABLE SYSTEMS; Lawyer's Precedent No. END7416USNP/140291; - Patent Application Serial No. U.S., entitled DRIVE ARRANGEMENTS FOR ARTICULATABLE SURGICAL INSTRUMENTS, Lawyer's Precedent No. END7418USNP/140292; - Patent Application Serial No. U.S., entitled LOCKING ARRANGEMENTS FOR DETACHABLE SHAFT ASSEMBLIES WITH ARTICULATABLE SURGICAL END EFFECTORS, Attorney's Precedent No. END7417USNP/140293; - Patent application U.S. Serial No., entitled SURGICAL INSTRUMENT WITH AN ANVIL THAT IS SELECTIVELY MOVABLE ABOUT A DISCRETE NON-MOVABLE AXIS RELATIVE TO A STAPLE CARTRIDGE, Attorney's Precedent No. END7485USNP/140295; - Patent Application Serial No. U.S., entitled SURGICAL INSTRUMENTS WITH IMPROVED CLOSURE ARRANGEMENTS; Lawyer's Precedent No. END7486/140296; - U.S. Patent Application Serial No., entitled SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTORS AND MOVABLE FIRING BEAM SUPPORT ARRANGEMENTS, Attorney's Precedent No. END7489USNP/140299; - Patent application U.S. Serial No., entitled SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTORS AND IMPROVED FIRING BEAM SUPPORT ARRANGEMENTS, Attorney's Precedent No. END7491USNP/140301; and - Patent Application Serial No. U.S., entitled SURGICAL INSTRUMENT ASSEMBLY COMPRISING A LOCKABLE ARTICULATION SYSTEM; Lawyer's Precedent No. END7494USNP/140304. [0025] The applicant of the present application is the author of the following patent applications that were filed on March 1, 2013 and which are all incorporated herein by reference in their entirety: - Patent Application Serial No. US 13 /782,295, titled ARTICULATABLE SURGICAL INSTRUMENTS WITH CONDUCTIVE PATHWAYS FOR SIGNAL COMMUNICATION, now Patent Application Publication No. US 2014/0246471; - U.S. Patent Application Serial No. 13/782,323, entitled ROTARY POWERED ARTICULATION JOINTS FOR SURGICAL INSTRUMENTS, now Rotary U.S. Patent Publication No. 2014/0246472; - Patent Application U.S. Serial No. 13/782,338, entitled THUMBWHEEL SWITCH ARRANGEMENTS FOR SURGICAL INSTRUMENTS, now U.S. Patent Publication No. 2014/0249557; - U.S. Patent Application Serial No. 13/782,499, entitled ELECTROMECHANICAL SURGICAL DEVICE WITH SIGNAL RELAY ARRANGEMENT, now U.S. Patent Application Publication No. 2014/0246474; - Patent Application U.S. Serial No. 13/782,460, entitled MULTIPLE PROCESSOR MOTOR CONTROL FOR MODULAR SURGICAL INSTRUMENTS, now U.S. Patent Publication No. 2014/0246478; - Patent Application U.S. Serial No. 13/782,358, entitled JOYSTICK SWITCH ASSEMBLIES FOR SURGICAL INSTRUMENTS, now U.S. Patent Publication No. 2014/0246477; - Patent Application U.S. Serial No. 13/782,481, entitled Sensor STRAIGHTENED END EFFECTOR DURING REMOVAL THROUGH TROCAR, now U.S. Patent Publication No. 2014/0246479; - Patent Application U.S. Serial No. 13/782,518, entitled CONTROL METHODS FOR SURGICAL INSTRUMENTS WITH REMOVABLE IMPLEMENT PORTIONS, now U.S. Patent Publication No. 2014/0246475; - U.S. Patent Application Serial No. 13/782,375, entitled ROTARY POWERED SURGICAL INSTRUMENTS WITH MULTIPLE DEGREES OF FREEDOM, now U.S. Patent Application Publication No. 2014/0246473; and - U.S. Patent Application Serial No. 13/782,536, entitled SURGICAL INSTRUMENT SOFT STOP, filed September 29, 2012, now U.S. Patent Application Publication No. 2014/0246476; [0026] The applicant of the present application also holds the following patent applications which were filed on March 14, 2013 and which are each incorporated herein by reference in their entirety: - Patent Application Serial No. US 13 /803,097, titled ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE, now Patent Application Publication No. US 2014/0263542; - Patent Application U.S. Serial No. 13/803,193, entitled CONTROL ARRANGEMENTS FOR A DRIVE MEMBER OF A SURGICAL INSTRUMENT, now U.S. Patent Publication No. 2014/0263537; - Patent Application Serial No. U.S. 13/803,053, entitled INTERCHANGEABLE SHAFT ASSEMBLIES FOR USE WITH A SURGICAL INSTRUMENT, now U.S. Patent Publication No. 2014/0263564; - Patent Application Serial No. U.S. 13/803,086, entitled ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK, now Patent Application Publication No. U.S. 2014/0263541; - Patent Application U.S. Serial No. 13/803,210, entitled SENSOR ARRANGEMENTS FOR ABSOLUTE POSITIONING SYSTEM FOR SURGICAL INSTRUMENTS, now U.S. Patent Application Publication No. 2014/0263538; - Patent Application Serial No. U.S. 13/803,148, entitled MULTI-FUNCTION MOTOR FOR A SURGICAL INSTRUMENT, now Patent Application Publication No. U.S. 2014/0263554; - Patent Application U.S. Serial No. 13/803,066, entitled DRIVE SYSTEM LOCKOUT ARRANGEMENTS FOR MODULAR SURGICAL INSTRUMENTS, now U.S. Patent Application Publication No. 2014/0263565; - Patent Application Serial No. U.S. 13/803,117, entitled ARTICULATION CONTROL SYSTEM FOR ARTICULATABLE SURGICAL INSTRUMENTS, now Patent Application Publication No. U.S. 2014/0263553; - Patent Application Serial No. U.S. 13/803,130, entitled DRIVE TRAIN CONTROL ARRANGEMENTS FOR MODULAR SURGICAL INSTRUMENTS, now Patent Application Publication No. U.S. 2014/0263543; and - U.S. Patent Application Serial No. 13/803,159, entitled METHOD AND SYSTEM FOR OPERATING A SURGICAL INSTRUMENT, now U.S. Patent Publication No. 2014/0277017. [0027] The applicant of the present application also holds the following patent application which was filed on March 7, 2014 and which is incorporated herein by reference in its entirety: - Patent Application Serial No. US 14/200,111, titled CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS, now Patent Publication No. US 2014/0263539. [0028] The applicant of the present application also holds the following patent applications that were filed March 26, 2014 and which are each incorporated herein by reference in their respective entirety: Patent Application Serial No. US 14 /226.106, entitled POWER MANAGEMENT CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS; U.S. Patent Application Serial No. 14/226,099 entitled STERILIZATION VERIFICATION CIRCUIT; U.S. Patent Application Serial No. 14/226,094 entitled VERIFICATION OF NUMBER OF BATTERY EXCHANGES/PROCEDURE COUNT; U.S. Patent Application Serial No. 14/226,117 entitled POWER MANAGEMENT THROUGH SLEEP OPTIONS OF SEGMENTED CIRCUIT AND WAKE UP CONTROL; U.S. Patent Application Serial No. 14/226,075 entitled MODULAR POWERED SURGICAL INSTRUMENT WITH DETACHABLE SHAFT ASSEMBLIES; Patent Application U.S. Serial No. 14/226,093 entitled FEEDBACK ALGORITHMS FOR MANUAL BAILOUT SYSTEMS FOR SURGICAL INSTRUMENTS; U.S. Patent Application Serial No. 14/226,116 entitled SURGICAL INSTRUMENT UTILIZING SENSOR ADAPTATION; U.S. Patent Application Serial No. 14/226,071 entitled SURGICAL INSTRUMENT CONTROL CIRCUIT HAVING A SAFETY PROCESSOR; U.S. Patent Application Serial No. 14/226,097 entitled SURGICAL INSTRUMENT COMPRISING INTERACTIVE SYSTEMS; U.S. Patent Application Serial No. 14/226,126 entitled INTERFACE SYSTEMS FOR USE WITH SURGICAL INSTRUMENTS; U.S. Patent Application Serial No. 14/226,133 entitled MODULAR SURGICAL INSTRUMENT SYSTEM; US Patent Application Serial No. 14/226,081 entitled SYSTEMS AND METHODS FOR CONTROLLING A SEGMENTED CIRCUIT; US Patent Application Serial No. 14/226,076 entitled POWER MANAGEMENT THROUGH SEGMENTED CIRCUIT AND VARIABLE VOLTAGE PROTECTION; U.S. Patent Application Serial No. 14/226,111 entitled SURGICAL STAPLING INSTRUMENT SYSTEM; and US Patent Application Serial No. 14/226,125 entitled SURGICAL INSTRUMENT COMPRISING A ROTATABLE SHAFT. [0029] The applicant of the present application also holds the following patent applications which were filed on September 5, 2014 and which are each incorporated herein by reference in their respective entirety: - Patent Application Serial No. US 14 /479,103, entitled CIRCUITRY AND SENSORS FOR POWERED MEDICAL DEVICE; - Patent Application No. U.S. 14/479,119, entitled ADJUNCT WITH INTEGRATED SENSORS TO QUANTIFY TISSUE COMPRESSION; - Patent application No. U.S. 14/478,908, entitled MONITORING DEVICE DEGRADATION BASED ON COMPONENT EVALUATION; - Patent Application No. U.S. 14/478,895, entitled MULTIPLE SENSORS WITH ONE SENSOR AFFECTING A SECOND SENSOR'S OUTPUT OR INTERPRETATION; - Patent application No. U.S. 14/479,110, entitled USE OF POLARITY OF HALL MAGNET DETECTION TO DETECT MISLOADED CARTRIDGE; - Patent Application Serial No. U.S. 14/479,098, entitled SMART CARTRIDGE WAKE UP OPERATION AND DATA RETENTION; - Patent Application Serial No. U.S. 14/479,115, entitled MULTIPLE MOTOR CONTROL FOR POWERED MEDICAL DEVICE; and - Patent Application U.S. Serial No. 14/479,108 entitled LOCAL DISPLAY OF TISSUE PARAMETER STABILIZATION. [0030] The applicant of the present application also holds the following patent applications that were filed on April 9, 2014 and which are each incorporated herein by reference in their entirety: - Patent Application Serial No. US 14 /248,590, titled MOTOR DRIVEN SURGICAL INSTRUMENTS WITH LOCKABLE DUAL DRIVE SHAFTS, now Patent Application Publication No. US 2014/0305987; - Patent Application U.S. Serial No. 14/248,581, entitled SURGICAL INSTRUMENT COMPRISING A CLOSING DRIVE AND A FIRING DRIVE OPERATED FROM THE SAME ROTATABLE OUTPUT, now U.S. Patent Application Publication No. 2014/0305989; - Patent Application Serial No. U.S. 14/248,595, entitled SURGICAL INSTRUMENT SHAFT INCLUDING SWITCHES FOR CONTROLLING THE OPERATION OF THE SURGICAL INSTRUMENT, now Patent Application Publication No. U.S. 2014/0305988; - U.S. Patent Application Serial No. 14/248,588, entitled POWERED LINEAR SURGICAL STAPLER, now U.S. Patent Application Publication No. 2014/0309666; - Patent Application Serial No. U.S. 14/248,591, entitled TRANSMISSION ARRANGEMENT FOR A SURGICAL INSTRUMENT, now Patent Application Publication No. U.S. 2014/0305991; - Patent Application Serial No. U.S. 14/248,584, entitled MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH ALIGNMENT FEATURES FOR ALIGNING ROTARY DRIVE SHAFTS WITH SURGICAL END EFFECTOR SHAFTS, now patent application publication No. 2014/0305994; - U.S. Patent Application Serial No. 14/248,587, entitled POWERED SURGICAL STAPLER, now U.S. Patent Application Publication No. 2014/0309665; - U.S. Patent Application Serial No. 14/248,586, entitled DRIVE SYSTEM DECOUPLING ARRANGEMENT FOR A SURGICAL INSTRUMENT, now U.S. Patent Application Publication No. 2014/0305990; and - U.S. Patent Application Serial No. 14/248,607, entitled MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH STATUS INDICATION ARRANGEMENTS, now U.S. Patent Application Publication No. 2014/0305992. [0031] The applicant of the present application also holds the following patent applications which were filed on April 16, 2013 and which are each incorporated herein by reference in their respective entirety: - Provisional Patent Application Serial No. US 61/812,365, entitled SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY A SINGLE MOTOR; - Patent Application Serial No. U.S. 61/812,376, entitled LINEAR CUTTER WITH POWER; - Patent Application Serial No. U.S. 61/812,382, entitled LINEAR CUTTER WITH MOTOR AND PISTOL GRIP; - Provisional Patent Application Serial No. U.S. 61/812,385, entitled SURGICAL INSTRUMENT HANDLE WITH MULTIPLE ACTUATION MOTORS AND MOTOR CONTROL; and - Provisional patent application U.S. Serial No. 61/812,372, entitled SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY A SINGLE MOTOR. [0032] Numerous specific details are presented to provide a thorough understanding of the structure, function, fabrication and general use of the modalities as described in the specification and illustrated in the accompanying drawings. Well-known operations, components and elements have not been described in detail so as not to obscure the modalities described in the specification. The reader will understand that the embodiments described and illustrated in the present invention are non-limiting examples, and therefore, it can be understood that the specific structural and functional details disclosed in the present invention may be representative and illustrative. Variations and changes may be made to this without deviating from the scope of the claims. [0033] The terms "comprises" (and any form of comprises, such as "comprises" and "which comprises"), "has" (and any form of has, such as "has" and "which has"), "includes" (and any form of includes, such as "includes" and "which includes") and "contains" (and any form of contains, such as "contains" and "which contains") are unrestricted linking verbs. As a result, a system, device or surgical device that "comprises", "has", "includes" or "contains" one or more elements has those one or more elements, but is not limited to having only those one or more elements. . Likewise, an element of a system, device or surgical device that "comprises", "has", "includes" or "contains" one or more features has those one or more features, but is not limited to having only those one or more features. or more resources. [0034] The terms "proximal" and "distal" are used in the present invention with reference to a physician who manipulates the handle portion of the surgical instrument. The term "proximal" refers to the portion closest to the physician, and the term "distal" refers to the portion located away from the physician. It will also be understood that, for the sake of convenience and clarity, spatial terms such as "vertical", "horizontal", "upwards" and "downwards" may be used in the present invention in connection with the drawings. However, surgical instruments can be used in many orientations and positions, and these terms are not intended to be limiting and/or absolute. [0035] Various exemplary devices and methods are provided for performing laparoscopic and minimally invasive surgical procedures. However, the reader will readily understand that the various methods and devices disclosed in the present invention can be used in numerous surgical procedures and applications, including, for example, in connection with open surgical procedures. As the present Detailed Description advances, the reader will further understand that the various instruments disclosed herein may be inserted into a body in any manner, such as through a natural orifice, through an incision or perforation formed in tissue, etc. Functional portions or end actuator portions of instruments may be inserted directly into a patient's body or may be inserted via an access device that has a working channel through which the end actuator and elongated drive shaft of a surgical instrument can be advanced. [0036] The surgical stapling system may comprise a rod and an end effector that extends from the rod. The end effector comprises a first jaw and a second jaw. The first jaw comprises a staple cartridge. The staple cartridge is insertable and removable from the first jaw; however, other embodiments are envisaged in which a staple cartridge is not removable, or at least readily replaceable, from the first jaw. The second jaw comprises an anvil configured to deform staples ejected from the staple cartridge. The second jaw is pivotable with respect to the first jaw around a closing geometric axis; however, other embodiments are envisaged in which the first jaw is pivotable with respect to the second jaw. The surgical stapling system further comprises a pivot joint configured to allow the end effector to be pivoted or pivoted with respect to the stem. The end effector is rotatable about a pivot axis that extends through the pivot joint. Other embodiments are envisaged which do not include an articulation joint. [0037] The staple cartridge comprises a cartridge body. The cartridge body includes a proximal end, a distal end, and a support that extends between the proximal end and the distal end. In use, the staple cartridge is positioned on a first side of the fabric to be stapled and the anvil is positioned on a second side of the fabric. The anvil is moved towards the staple cartridge to compress and hold the tissue against the support. Thereafter, staples detachably stored in the cartridge body can be distributed on the fabric. The cartridge body includes staple cavities defined therein, the staples being removably stored in the staple cavities. The clamp cavities are arranged in six longitudinal rows. Three rows of staple cavities are positioned on a first side of a longitudinal slot and three rows of staple cavities are positioned on a second side of the longitudinal slot. Other arrangements of clamp cavities and clamps may be possible. [0038] The staples are held by staple drivers in the cartridge body. The actuators are movable between a first position, or unfired position, and a second position, or fired position, for ejecting staples from staple cavities. The actuators are retained in the cartridge body by a retainer which extends around the bottom of the cartridge body and includes resilient members configured to secure the cartridge body and retain the retainer in the cartridge body. Triggers are movable between their non-triggered positions and their slider-triggered positions. The slider is movable between a proximal position adjacent the proximal end and a distal position adjacent the distal end. The slider comprises a plurality of inclined surfaces configured to slide under the actuators and lift the actuators, and the clamps supported thereon, towards the anvil. [0039] In addition to the above, the slider is moved distally by a triggering member. The trigger member is configured to contact the slider and push the slider towards the distal end. The longitudinal slot defined in the cartridge body is configured to receive the firing member. The anvil also includes a slot configured to receive the firing member. The firing member further comprises a first cam that engages the first jaw and a second cam that engages the second jaw. As the firing member is advanced distally, the first cam and second cam can control the distance, or tissue gap, between the staple cartridge holder and the anvil. The firing member also comprises a knife configured to make an incision in the tissue captured between the anvil and the staple cartridge. It is desirable that the knife be positioned at least partially proximal to the inclined surfaces, so that the staples are ejected in front of the knife. [0040] A surgical instrument 100 is illustrated in Figures 1 and 2. The surgical instrument 100 comprises a stem 120, an end effector 130 and a pivot joint 140 pivotally connecting the end actuator 130 to the stem 120. end cap 130 comprises a first jaw 132 that includes a second staple cartridge. The staple cartridge includes a cartridge body and a plurality of staples removably stored therein. The staple cartridge is readily removable from the first jaw 132, so that the staple cartridge can be replaced after it has been at least partially used. In alternative embodiments, the staple cartridge is not readily removable from the first jaw 132. In any event, the end effector 130 further comprises a second jaw 134. The second jaw 134 comprises an anvil configured to deform the staples when the staples are ejected. of the staple cartridge. The second jaw 134 is movably coupled to the first jaw 132 and is rotatable between an open position and a closed position (Figure 1) to secure the tissue against the staple cartridge. In alternative embodiments, the first jaw 132 is movably coupled to the second jaw 134 and is rotatable between an open position and a closed position. [0041] A proximal end of the end effector 130 comprises a channel retainer 146. The channel retainer 146 comprises a pivot opening 147 defined therein. A rod structure 120 comprises a pivot pin received closely within pivot opening 147. Pivot opening 147 prevents movement of end effector 130 relative to rod 120 so that end effector 130 can pivot about. of a pivot axis 190. The pivot axis 190 comprises a fixed pivot axis and the movement of the end effector 130 comprises a circular path around the pivot axis 190. The pivot joint 140 allows a degree of of freedom for end effector 130. Channel retainer 146 comprises a partially circumferential arrangement of locking teeth 148 extending around the proximal perimeter thereof. The rod 120 includes a latch 180 movable between an unlocked position in which the end effector 130 can be pivoted with respect to the rod 120 and a locked position in which the latch 180 is engaged with a latch tooth 148. When the latch 180 is engaged with a lock tooth 148, lock 180 inhibits end effector 130 from rotating about pivot joint 140. [0042] The stem 120 further includes a proximal closure tube 121 that is movable with respect to a stem structure 120. The proximal closure tube 121 is coupled to a distal closure tube 131 of the end effector 130. More specifically, distal tube 131 is rotatably coupled to closure tube 121 by connections 143. Each connection 143 comprises a proximal projection 144 positioned within an opening defined in proximal closure tube 121. Each connection 143 further comprises a distal projection 145 positioned within an opening defined in the distal closure tube 131. The proximal projections 144 define a first pivot axis and the distal projections 145 define a second pivot axis. The first and second pivot axes defined by links 143 allow the closure tube to accommodate concurrent articulation of end effector 130 at articulation joint 140 and translation of the closure tube relative to the articulation joint. The connections 143 provide two degrees of freedom between the closure tube 121 and the closure tube 131. In many cases, the two degrees of freedom allow compound movements of the closure tube. [0043] In addition to the above, the closure tube 131 is operatively engaged with the second jaw 134. The closure tube 131 comprises a window 133 and the second jaw 134 comprises an actuating flap 135 that extends into the window 133 When closure tube 131 is pushed proximally, a distal side wall of window 133 contacts tab 135 and rotates second jaw 134 away from first jaw 132 into a closed position. As closure tube 131 is pulled distally, a proximal side wall of window 133 contacts tab 135 and rotates second jaw 134 toward first jaw 132. [0044] The surgical instrument 100 further comprises a triggering member 150. The triggering member 150 extends through the stem 120 and the hinge joint 140 and into the end effector 130. The triggering member 150 is movable distally through the end effector 130 for ejecting staples from the staple cartridge, clamping tissue positioned intermediate the first jaw 132 and second jaw 134, and/or cutting tissue positioned intermediate the first jaw 132 and second claw 134. Firing member 150 comprises a plurality of side portions that generally move together; however, the side portions of the trigger member 150 may shift relative to each other to accommodate the end-effector articulation 130. In several cases, the trigger member 150 folds into the articulation joint 140, which creates a internal radius of curvature on one side of trigger member 150 and an external radius of curvature on the other side of trigger member 150. The internal radius of curvature is less than the external radius of curvature and, in addition to the above, each of the layers of the trigger member may have to travel different lengths of path through the hinge joint 140, thus creating relative movement between the layers of the trigger member. Firing member 150 may further include at least one angled surface configured to eject staples from the staple cartridge and/or a cutting edge configured to cut tissue, as described above. [0045] A surgical instrument 200 is illustrated in Figures 3 to 5. The surgical instrument 200 comprises a stem 220, an end effector 230 and a pivot joint 240 pivotally connecting the end actuator 230 to the stem 220. end cap 230 comprises a first jaw that includes a staple cartridge channel 239 configured to receive a staple cartridge. The staple cartridge includes a cartridge body and a plurality of staples removably stored therein. The staple cartridge is readily removable from the cartridge channel 239 so that the staple cartridge can be replaced once it has been at least partially used. In alternative embodiments, the staple cartridge is not readily removable from the first jaw. In any event, the end effector 230 additionally comprises a second claw. The second jaw includes an anvil configured to deform the staples when the staples are ejected from the staple cartridge. The second jaw is movably coupled to the cartridge channel 239 and is rotatable between an open position and a closed position to clamp the fabric against the staple cartridge. In alternative embodiments, the first jaw is movably coupled to the second jaw and is rotatable between an open position and a closed position. [0046] The stem 220 comprises a frame or spine 221 and a closure tube which is slidable with respect to the spine 221. The stem closure tube 220 may be the same or similar to the closure tube discussed above in connection with the embodiment of Figures 1 and 2, for example. The rod spine 221 is pivotally connected to a joint frame or spine 241 of the articulation joint 240. The rod spine 221 comprises pivot openings 224 defined on opposite sides of the distal end thereof. The joint spine 241 comprises proximal extensions 242 extending proximally therefrom, which each include a pivot pin 244 received closely in pivot openings 224. Pivot openings 224 and pivot pins 244 cooperate to form a proximal pivot axis about which joint spine 241 can be pivoted. [0047] The joint spine 241 of the pivot joint 240 is pivotally connected to an end effector spine 231 of the end effector 230. The end effector spine 231 comprises pivot apertures 235 defined on opposite sides their proximal end. The joint spine 241 further comprises distal extensions 243 extending distally therefrom, each including a pivot pin 245 received closely in pivot openings 235. The pivot openings 235 and pivot pins 245 cooperate to form an axle. distal joint geometry around which the end effector 230 can be pivoted. As discussed above, pivot joint 240 comprises two pivot axes. Each pivot axis may comprise a fixed pivot axis; however, the presence of the two geometric axes fixed within the hinge joint 240 endows the hinge joint 240 with two degrees of freedom. The two degrees of freedom allow the pivot joint 240 to be subjected to compound motions. Thus, certain embodiments employing the hinge joint 240 and closure tube 240 of Figures 1 and 2 may have a structure capable of compound movements and, in addition, a closure tube capable of compound movements. [0048] The end effector 230 is pivotable in a first direction and a second direction around the pivot joint 240. The first pivot direction and the second pivot direction remain in a common plane. Surgical instrument 200 further includes a pivot system configured to pivot end effector 230 in the first and second directions. The articulation system comprises a first articulation actuator 247a and a second articulation actuator 247b. First pivot actuator 247a and second pivot actuator 247b extend through stem 220 to a handle assembly of a surgical instrument. The first linkage actuator 247a and the second linkage actuator 247b can be pushed distally and/or pulled proximally through a linkage drive system in the cable assembly, for example. [0049] A pivot wire 248a is attached to the first pivot actuator 247a. A pivot wire 248a extends through an opening 246a defined in the joint post 241 of the pivot joint 240. The pivot wire 248a is received closely in the opening 246a and is slidable relative to the opening 246a. Pivot wire 248a comprises a distal end 249a mounted in cartridge channel 239. Pivot wire 248a can be pushed distally and/or pulled proximally by first pivot actuator 247a. When pivot wire 248a is pushed distally, pivot wire 248a can rotate end effector 230 in the direction indicated in Figure 5. When pivot wire 248a is pushed distally, pivot wire 248a can rotate end effector 230 in the opposite direction. [0050] A pivot wire 248a is attached to the second pivot actuator 247b. Pivot wire 248b extends through opening 246b defined in joint post 241 of pivot joint 240. Pivot wire 248b is received closely in opening 246b and is slidable relative to opening 246b. Pivot wire 248b comprises a distal end 249b mounted in cartridge channel 239. Pivot wire 248b can be pushed distally and/or pulled proximally by second pivot actuator 247b. When pivot wire 248b is pulled proximally, pivot wire 248b can rotate end effector 230 in the direction indicated in Figure 5. When pivot wire 248b is pushed distally, pivot wire 248b can rotate end effector end 230 in an opposite direction. [0051] In several cases, the first linkage actuator 247a and the second linkage actuator 247b can be actuated independently and/or simultaneously. In at least one example, the first linkage actuator 247a can be pushed distally, while the second linkage actuator 247b is pulled proximally. Similarly, the first linkage actuator 247a can be pulled proximally, while the first linkage actuator 247b is pushed distally. In certain instances, one of the linkage actuators 247a, 247b may be actuated without actuation of the other. [0052] As described above, the first pivot actuator 247a can push the first pivot wire 248a distally. Similarly, second pivot actuator 247b can push pivot wire 247b distally. Generally, the movement of a wire can be unpredictable when experiencing a compressive load, especially as a result of lateral buckling, for example. In the present document, improvements are described that facilitate the use of wires to articulate the end effector 230. [0053] In several cases, in addition to the above, the first opening 246a defined in the joint post 241 may be sized and configured to prevent lateral buckling of the first hinge wire 248a. Referring to Figure 4, first opening 246a constrains hinge wire 248a between its proximal end which is attached to first hinge actuator 247a and its distal end 2249a which is mounted to end effector 230. In such cases, the hinge wire hinge 248a can slide into first opening 246a without yielding to push end effector 230 around hinge joint 240 in the direction shown in Figure 5. Similarly, second opening 246b defined in joint spine 241 can be sized and configured to prevent lateral buckling of the second pivot wire 248b. Referring to Figure 4, the second opening 246b constrains the pivot wire 248b between its proximal end, which is attached to the second pivot actuator 247b, and its distal end 249b, which is mounted to the end effector 230. In such cases, pivot wire 248b can slide into second opening 246b without yielding to push end effector 230 around pivot joint 240 in a direction opposite to that illustrated in Figure 5. [0054] Referring now to Figures 6 to 8, the first pivot wire 248a may be composed of a spring, such as a coil spring, for example. When the end effector 230 is in a non-pivoting position, as illustrated in Figure 4, the first pivot wire 248a is in the configuration illustrated in Figure 6. When the first pivot wire 248a is pushed distally to pivot the end effector 230 in the direction illustrated in Figure 5, the first pivot wire 248a can compress. In such cases, the coils of the first pivot wire 248a move closer together. In at least one such occurrence, the coils of the first hinge wire 248a may contact each other when the first hinge wire 248a is compressed. When the coils of the first pivot wire 248a are closer together, the first pivot wire 248a is more resistant to lateral buckling, and as a result, the first pivot wire 248a is able to transmit a compressive load to the effector. end 230. [0055] When the first pivot wire 248a is pushed distally to articulate the end effector 230 in the opposite direction to that illustrated in Figure 5, the first pivot wire 248a may stretch. In such cases, the coils of the first pivot wire 248a move further away from each other, as illustrated in Figure 7. Although the coils are spaced apart from each other, the first pivot wire 248a is under tension under such circumstances and is less susceptible to lateral buckling. Furthermore, the first pivot wire 248a is capable of transmitting a pulling force to the end effector 230 when the first pivot wire 248a is in an extended condition. [0056] The second hinge wire 248b operates in substantially the same manner as the first hinge wire 248a. As a result, the end effector 230 can be pushed in any articulation direction. In addition, the end effector 230 can be pulled in any articulation direction. The pivot wires 248a, 248b can be composed of any material, such as stainless steel, for example. In at least one example, the wires may comprise a cross-sectional diameter between approximately 0.015" and 0.030", for example. [0057] The composite pivot joint 240 may allow the end effector 230 to be pivoted up to, including, and/or above 90 degrees, for example. To achieve a 90 degree pivot of the end effector 230, for example, the pivot joint only needs to pivot 45 degrees around the first fixed pivot axis and 45 degrees around the second fixed pivot axis, in at least An example. Other instances are provided where the hinge joint 240 pivots a first degree about the first fixed hinge axis and a second degree about the second fixed hinge axis which is different from the first degree. In at least one such instance, the sum of the first and second degrees can equal 90 degrees, for example. [0058] A surgical instrument 300 is illustrated in Figures 9 to 12. The surgical instrument 300 comprises a stem 320, an end effector 330 and a pivot joint 340 pivotally connecting the end actuator 330 to the stem 320. end cap 330 comprises a first jaw that includes a staple cartridge channel 339 configured to receive a staple cartridge. The staple cartridge includes a cartridge body and a plurality of staples removably stored therein. The staple cartridge is readily removable from the cartridge channel 339 so that the staple cartridge can be replaced once it has been at least partially used. In alternative embodiments, the staple cartridge is not readily removable from the first jaw. In any event, the end effector 330 additionally comprises a second claw. The second jaw includes an anvil configured to deform the staples when the staples are ejected from the staple cartridge. The second jaw is movably coupled to the cartridge channel 339 and is rotatable between an open position and a closed position to clamp the fabric against the staple cartridge. In alternative embodiments, the first jaw is movably coupled to the second jaw and is rotatable between an open position and a closed position. [0059] The rod 320 comprises a frame or spine 321 and a closure tube which is slidable with respect to the spine 321. The closure tube may comprise any suitable closure tube. In various instances, the stem closure tube 320 may be the same or similar to the closure tube discussed above, in connection with the embodiment of Figures 1 and 2, for example. The rod spine 331 is pivotally connected to a flexible neck 341 or flex joint structure of the articulation joint 340. The flexible neck 341 is composed of a flexible material. Flexible neck 341 can be elastically deformed when the end effector is pivoted to accommodate the joint. Flexible neck 341 comprises a ball member which extends proximally therefrom. The ball member 342 forms a ball and socket joint with a proximal socket 344 defined in the spine 321 of the stem 320. In many cases, the ball and socket joint proximal may allow the flexible neck 341 to be pivoted with respect to the stem 320. Flexible neck 341 can pivot with respect to a longitudinal axis of rod 320 in any suitable direction. Such articulation is in addition to the articulation flexibility that the flexible neck 341 provides. [0060] Flexible neck 341 of articulation joint 340 is also pivotally connected to a spine or end effector structure 331 of end effector 330. Flexible neck 341 comprises a ball member that extends distally to from the same. The ball member 343 forms a ball and socket joint with a distal socket 345 defined in the spine 331 of the end effector 330. In various instances, the ball and socket joint may allow the flexible neck 341 to be pivoted relative to the effector. 330. Flexible neck 341 can pivot with respect to a longitudinal axis of end effector 330 in any suitable direction. Such articulation is in addition to the articulation flexibility that the flexible neck 341 provides. As a result, the pivot joint 340 comprises several degrees of freedom. Thus, certain embodiments that employ the articulation joint 340 may have a structure capable of compound movements. Such compound movements may or may not be limited by the closure tube that extends around the structure. In certain instances, the closure tube may comprise a weakened and/or flexible portion that is coextensive with and/or overlaps the hinge joint 340. In other instances, the closure tube, such as the closure tube of Figures 1 and 2, for example, can limit degrees of freedom through the flexible structure of surgical instrument 300. [0061] The end effector 330 is pivotable in at least a first direction and a second direction around the pivot joint 340; however, end effector 330 may be pivotable in any suitable number of directions. The first articulation direction and the second articulation direction can remain in a common plane. Surgical instrument 300 further includes a pivot system configured to pivot end effector 330 in the first and second directions. The articulation system comprises a first articulation actuator 348a and a second articulation actuator 348b. First pivot actuator 348a and second pivot actuator 348b extend through stem 320 to a handle assembly of a surgical instrument. The first linkage actuator 348a and the second linkage actuator 348b can be pushed distally and/or pulled proximally through a linkage drive system in the cable assembly, for example. [0062] In at least one example, the first pivot actuator 348a may comprise a first pivot wire 348a. The hinge wire 348a extends through an opening 346a defined in the flexible neck 341 of the hinge joint 340. More specifically, the opening 346a extends through a number of vertebral flanges 347 of the flexible neck 341 and the hinge wire 348a extends through of vertebral flanges 347. Pivot wire 348a is received closely in opening 346a and is slidable relative to opening 346a. Pivot wire 348a comprises a distal end 349a fixedly mounted to cartridge channel 339. Pivot wire 348a may be pushed distally and/or pulled proximally. When pivot wire 348a is pushed distally, pivot wire 348a can rotate end effector 330 in the direction indicated in Figure 10. When pivot wire 248a is pushed distally, pivot wire 248a can rotate end effector 230 in the opposite direction. [0063] In at least some instances, the second pivot actuator 348b may comprise a second pivot wire 348b. The pivot wire 348b extends through an opening 346b defined in the flexible neck 341 of the pivot joint 340. More specifically, the opening 346b extends through the vertebral flanges 347 of the flexible neck 341 and the pivot wire 348b extends through the vertebral flanges 347. Pivot wire 348b is received closely in opening 346b and is slidable relative to opening 346b. Pivot wire 348b comprises a distal end 249b mounted in cartridge channel 239. Pivot wire 348b can be pushed distally and/or pulled proximally. When pivot wire 348b is pulled proximally, pivot wire 348b can rotate end effector 330 in the direction indicated in Figure 10. When pivot wire 348b is pushed distally, pivot wire 348b can rotate end effector end 230 in an opposite direction. [0064] In several cases, the first linkage actuator 348a and the second linkage actuator 348b can be actuated independently and/or simultaneously. For example, the first linkage actuator 348a can be pushed distally, while the second linkage actuator 348b is pulled proximally. Similarly, the first linkage actuator 348a can be pulled proximally while the second linkage actuator 348b is pushed distally. In certain instances, one of the linkage actuators 348a, 348b may be actuated without actuation of the other. [0065] Referring again to Figure 10, the composite pivot joint 340 may allow the end effector 330 to be pivoted up to, including and/or above 90 degrees, for example. To achieve 90 degree articulation of the end effector 330, for example, the distal ball and socket joint can provide A degrees of articulation, the flexible neck 341 can bend to provide B degrees of articulation, and the ball and socket joint proximal can provide C degrees of articulation, the sum of A, B and C equaling ninety degrees, for example. In at least one instance, the distal ball and socket joint can provide up to 15 degrees of articulation and the proximal ball and socket joint can also provide up to 15 degrees of articulation, for example. In other cases, the distal ball and socket joint and the proximal ball and socket joint may provide different degrees of articulation. In certain cases, the flexible neck 341 can provide up to 54 degrees of articulation, for example, and the distal and proximal ball and socket joints can provide the necessary joint balance. In at least one example, the distal ball and socket joint can provide between approximately 20 to 30 degrees of articulation, the flexible neck 341 can provide between approximately 20 to 30 degrees of articulation, and the proximal ball and socket joint can also provide between approximately 20 to 30 degrees of articulation, for example. [0066] Referring primarily to Figure 12, the first linkage actuator 348a and/or the second linkage actuator 348b may have a circular cross-section, for example. In such cases, the moment of inertia of each linkage actuator 348a, 348b is the same around any bending axis extending through the center thereof. Other embodiments are considered, in which a linkage actuator comprises a non-circular cross-sectional geometry. Referring now to Figure 13, an articulation system may include a flexible neck 441. Flexible neck 441 is similar to flexible neck 341 in many respects. The flexible neck comprises a first opening 446a which is configured to slidably receive a first pivot actuator 448a therein. First opening 446a and first linkage actuator 448a are rectangular. This configuration provides the first linkage actuator 448a with different or unequal moments of inertia. Based on the arrangement of the first linkage actuator 448a depicted in Figure 13, the first linkage actuator 448a is more conducive to lateral flexion. The first pivot actuator 448a is closely received in the first opening 446a so that the side walls of the first opening 446a can prevent side buckling of the first pivot actuator 448a when the first pivot actuator 448a is compressed. [0067] The flexible neck comprises a second opening 446b which is configured to slidably receive a second pivot actuator 448b therein. The second opening 446b and the second pivot actuator 448b are rectangular. This configuration provides the second linkage actuator 448b with different or unequal moments of inertia. Based on the arrangement of the second linkage actuator 448b depicted in Figure 13, the second linkage actuator 448a is more conducive to lateral flexion. The second pivot actuator 448b is closely received in the second opening 446b so that the side walls of the second opening 446a can prevent side buckling of the second pivot actuator 448b when the second pivot actuator 448b is compressed. The first linkage actuator 448a and the second linkage actuator 448b are parallel and symmetrical, but embodiments are contemplated in which the linkage actuators are not parallel and/or symmetrical, for example. In addition, other modalities are considered in which only one articulation actuator is used. Certain modalities are contemplated in which more than two articulation actuators are used. [0068] Referring again to Figure 12, the flexible neck 341 comprises a central longitudinal opening defined therein, which is configured to slidably receive a firing member 350 therein. Firing member 350 is configured to eject staples from the staple cartridge positioned in end effector 330, which is discussed further above. The trigger member 350 may also comprise a cutting portion configured to cut the fabric to be stapled. In any case, the longitudinal opening comprises a first side side 351a configured to support a first side of the firing member 350 and a second side side 351b configured to support a second side of the firing member 350. The firing member 350 is placed in compression as it is advanced distally, and the first sidewall 315a and the second sidewall 351b may be configured to prevent lateral buckling of the triggering member 350. [0069] In addition to the above, the firing member 350 may be supported in any suitable manner. As discussed above, firing member 350 may be supported directly by flexible neck 341. As the reader will request, flexible neck 341 is secured at its proximal end to rod 320 and at its distal end to end effector 330. Other embodiments are provided in which the trigger member 350, and/or any other trigger element, is supported by a cantilever member that is attached to only one of the rod 320 and the end effector 330, for example. Referring now to Figure 18, a surgical instrument may include a tubular member or a platform 790 configured to slidably support the trigger member 350, for example. Tubular member 790 comprises an elongate body 791 that includes a proximal end 792 mounted on the shaft of a surgical instrument. Elongate body 791 further includes a distal end 793 and a longitudinal opening 794 extending therethrough. Similar to the above, longitudinal aperture 794 is configured to slidably support a trigger member, such that trigger element 350, for example, is thereon. Also similarly to the above, the side walls of the longitudinal opening 794 are configured to laterally support the firing member 350. [0070] In addition to the above, with reference again to Figure 18, the tubular member 790 is mounted on the stem of a surgical instrument and extends through an articulation joint that connects an end effector of the surgical instrument to the stem. When the end effector is pivoted, the tubular member 790 can flex to accommodate the pivot. The distal end 793 of the tubular member is not mounted to the end effector and thus the tubular member 790 comprises a rod mounted cantilever. Such an arrangement provides the firing member 350 with independent support for that of the hinge structure. In such cases, the tubular member 790 can move with respect to the hinge structure. When the firing member 350 is advanced through the longitudinal opening 794, the firing member 350 is slidably supported by the side walls of the longitudinal opening. Tubular member 790 is composed of an integral piece of material; however, tubular member 790 may comprise a set of components. [0071] Returning now to Figures 16 and 17, a surgical instrument may include a tubular member or a platform or assembly 690 configured to slidably support the trigger member 350, for example. Tubular member assembly 690 comprises an elongate body 691 that includes a proximal end 692 mounted on the shaft of a surgical instrument. Elongate body 691 further includes a distal end 693 and a longitudinal opening 694 extending therethrough. Similar to the above, longitudinal aperture 694 is configured to slidably support a trigger member, such that trigger element 350, for example, is thereon. Also similarly to the above, the side walls of the longitudinal opening 694 are configured to laterally support the firing member 350. The tubular member assembly 690 extends through a hinge joint that connects an end effector of the surgical instrument to the stem. When the end effector is hinged, the tubular member assembly 690 can flex to accommodate the hinge. When the firing member 350 is advanced through the longitudinal opening 694 of the firing member assembly 690, the firing member 350 is slidably supported by the side walls of the longitudinal opening 694. [0072] The tubular member assembly 690 comprises a first side slot 695 positioned on a first side of the longitudinal opening 694 and a second side slot 695 positioned on a second side of the longitudinal opening 694. A first rupture plate 696 is positioned on the first side slit 695 and a second break plate 696 is positioned in the second side slit 695. Side break plates 696 are configured to support firing member 350 and prevent side buckling of firing member 350. Side break plates 696 they are flexible and can resiliently support the firing member 350. In other embodiments, the lateral break plates 696 are rigid. In either case, the side break plates 696 can slide into the side slots 695. This relative movement between the side break plates 696 and the elongate body 691 can facilitate flexing of the tubular member assembly 690 when the end effector is pivoted. . In various cases, side break plates 696 can slide into side slots 695 to relieve tension created within tubular member assembly 690 when the end effector is pivoted. [0073] In various cases, the side break plates 696 can directly support the firing member 350. The side break plates 696 can be composed of any suitable material. In at least one instance, the lateral rupture plates 696 are composed of a lubricating material, such as teflon, carbon filled nylon and/or any other filled polymer, for example. The materials of the lateral rupture plates 696, the elongate body 691 and/or the trigger member 350 can be selected so that the crystal structures of the selected materials provide a low coefficient of friction therebetween. In other instances, tubular member assembly 690 may include spacers 697 positioned at an intermediate position between the firing member 350 and the lateral rupture plates 696. A first spacer 697 is positioned at an intermediate position between a first side of the firing member 696. trigger 350 and first rupture plate 696 and a second spacer 697 are positioned at an intermediate position between a second side of trigger member 350 and second rupture plate 696. Spacers 697 may be composed of any suitable material. In at least one instance, the spacers 697 are composed of a lubricating material, such as teflon, carbon-filled nylon, and/or any other filled polymer, for example. The materials of the lateral rupture plates 696 and spacers 697 can be selected so that the crystal structures of the selected materials provide a low coefficient of friction therebetween. In addition, the materials of spacers 697 and trigger member 350 can be selected so that the crystal structures of the selected materials provide a low coefficient of friction therebetween. [0074] In many instances, the side sides of the elongated body 691 may be solid. In other instances, with reference to Figures 17 and 18, windows 699 may be defined on the lateral sides of the elongate body 691. The upper and lower portions of the elongate body 691 are connected by lateral supports 698 that extend therebetween. Such an arrangement can allow the elongate body 691 to flex when the end effector is pivoted and, at the same time, provide sufficient structural lateral support for the firing member 350 and the side breakout plates 696. [0075] In addition to the above, the distal end 693 of the tubular member assembly 690 is mounted to the end effector. Due to the relative movement between the lateral rupture plates 696 and the elongate body 691, the lateral rupture plates 696 provide the firing member 350 with support independent of that of the hinge structure. [0076] A surgical instrument 500 is illustrated in Figures 14 and 15. The surgical instrument 500 comprises a stem 520, an end effector and a pivot joint 540 which pivotally connects the end effector to the stem 520. hinge 540 comprises two different types of links, i.e., a plurality of first links 541 and a plurality of second links 542. First links 541 and second links 542 are arranged in an alternating arrangement. A second link 542 is intermediated between each first link 541; however, any suitable provision could be used. Each first connection 541 comprises a first outside diameter and each said second connection 542 comprises a second outside diameter. The first outside diameter is larger than the second outside diameter. First connections 541 and second connections 542 are circular and, in such cases, the diameters of first connections 541 and 542 may comprise circular diameters; however, any suitable configuration can be used. In embodiments in which the first links 541 and/or the second links 542 are non-circular, the first diameter of the first links 541 may comprise a first lateral width of the first links 541 and similarly the second diameter of the second links 542 may comprising a second lateral width of second links 542. [0077] As illustrated in Figure 15, the second minor diameter of the second links 542 allows the first links 541 to pivot over the second links 542 when the end effector is pivoted. In such cases, the first links 541 may rotate in the lateral space of the second links 542. To facilitate such relative rotation between the first links 541 and the links 542, each first link 541 may comprise a beveled protuberance 543 extending from its proximal and distal sides. Correspondingly, each second connection 542 may comprise a chamfered recess defined on opposite sides thereof that receive the chamfered protrusions 543. In at least one instance, the chamfered protrusions 543 and the chamfered recesses may be domed-shaped, for example. In either case, the interface between each chamfered protrusion 543 and chamfered recess provides a hinge joint within the hinge joint 540 around which the first links 541 can pivot. [0078] The pivot interface 544 is present between a frame 521 of the stem 520 and the second most proximal connection 542. The pivot interface 544 is similar to the bulge 543 in many respects. A pivot interface 544 may also be present between the end effector and the second most distal connection 542. [0079] In addition to the above, the end effector of the surgical instrument 500 can be pivoted with respect to the stem 520 and around the pivot joint 540 by means of a pivot actuation system. The linkage actuation system comprises a first linkage actuator 348a and a second linkage actuator 348b. First pivot actuator 348a extends through stem 520 and a first longitudinal opening 547a defined at first links 541, wherein a distal end of first pivot actuator 348a is mounted on the end effector. Each first connection 541 comprises a portion of the first opening 547a. Notably, the first opening 547a does not extend through the second connections 542. Similarly, the second pivot actuator 348b extends through the rod 520 and a second longitudinal opening 547b defined in the first connections 541, wherein a distal end of the second 348b linkage actuator is mounted on the end effector. Each first connection 541 comprises a portion of the second opening 547b. Notably, second opening 547b does not extend through second connections 542. [0080] In the non-pivot configuration of the pivot joint 540, referring to Figure 14, the first pivot actuator 348a and the second pivot actuator 348b can be pulled proximally to hold the pivot joint 540 in a compressed configuration. In such cases, the end effector can be pulled proximally to bias the first links 541 and second links 542 to contact one another and the second most proximal link 542 to engage with the stem 520. The first actuator pivot 348a and second pivot actuator 348b are positioned on opposite sides of, and equally spaced from, the longitudinal axis of pivot joint 540. As a result, pivot actuators 348a, 348b tend to re-center the first links 541 when an equal pulling force is applied to the linkage actuators 348a, 348b. Put another way, when an equal pulling force P is applied to the pivot actuators 348a, 348b, the pivot joint 540 is moved to and/or maintained in a non-hinged configuration. [0081] When an imbalance in pulling forces applied to actuators 348a, 348b is present, in addition to the above, the end effector may be pivoted. For example, if a first pulling force P1 is applied to the first linkage actuator 348a and a second pulling force P2 is applied to the second linkage actuator 348b, where the second pulling force P2 is less than the first pulling force traction P1, the end effector can articulate in the direction indicated in Figure 15. Similarly, if the second traction force P2 is greater than the first traction force P1, the end effector can articulate in a direction that is opposite in the direction indicated in Figure 15. [0082] Similar to the above, the first links 541 and the second links 542 comprise central openings extending therethrough which are configured to slidably receive a trigger member therein. The central openings of the links 541, 542 are aligned with the longitudinal axis of the rod 520 when the end effector is in its non-hinged position. As discussed above, first links 541 may shift inwardly with respect to second links 542 when the end effector is pivoted. In such cases, the central openings of the first links 541 may shift inwardly with respect to the central openings of the second links 542. Furthermore, in addition to the above, the first links 541 may rotate with respect to the second links 542, thereby changing the trajectory on which the firing member will travel through the center openings. Displacement and/or rotation of the first links 541 relative to the second links 542 dynamically affect the guide radius of curvature for the trigger member. The guide radius of curvature is displaced inwardly toward the inner radius of curvature of the pivot joint 540. Such inward displacement of the guide radius of curvature may tend to shorten the trajectory of the firing member through the pivot joint 540 when the end effector is in a hinged position. [0083] As set out in the simultaneously filed and jointly owned US patent application entitled SURGICAL INSTRUMENT SYSTEMS COMPRISING AN ARTICULATABLE END EFFECTOR AND MEANS FOR ADJUSTING THE FIRING STROKE OF A FIRING MEMBER, Attorney Dossier No. END7415USNP/140289, which was previously incorporated by way of reference, the firing stroke for a firing member to complete a firing stroke may be proportional to the degree to which the end effector of the surgical instrument is pivoted. Put another way, it was previously experienced that the more the end effector is hinged, the longer the firing trajectory becomes for a firing member to complete a firing stroke. With respect to the embodiments of Figures 14 and 15, the more the end effector is pivoted, the more inwardly displaced becomes the firing path for the firing member. This inward displacement of the firing path for the firing member at least partially compensates for, or deflects, changes in firing course that may occur when the end effector is pivoted. [0084] First links 541 and second links 542 may be composed of any suitable material. In various instances, the first links 541 are composed of a first material and the second links 542 are composed of a second material that is different from the first material. In certain embodiments, the first links 541 may be composed of metal, such as stainless steel, for example. The second links 542 may be composed of a lubricated material, such as Ultem filled with carbon, for example. Examples [0085] Example 1 - A surgical instrument comprises a stem comprising a stem structure and an end effector comprising an end effector structure and a jaw movable relative to the end effector structure. The surgical instrument further comprises a hinge joint that comprises a hinge structure that includes a proximal hinge end, a distal hinge end, a first hinge joint that connects the proximal hinge end to the stem structure, and a second hinge joint that connects the distal hinge end to the end effector structure. The surgical instrument further comprises a triggering system movable with respect to the rod structure, the hinge structure and the end effector structure, the triggering system comprising a cutting member movable with respect to the end effector structure. far end. [0086] Example 2 - The surgical instrument of Example 1 further comprises an outer tube movable with respect to the articulation joint, wherein the outer tube is configured to move the jaw between an open position and a closed position. [0087] Example 3 - The surgical instrument of Examples 1 and 2 which further comprises a first pivot wire attached to the joint effector structure, wherein the first pivot wire is configured to rotate the end effector in a first direction, and a second pivot wire securely attached to the end effector frame, wherein the second pivot wire is configured to rotate the end effector in a second direction. [0088] Example 4 - The surgical instrument of Example 3, wherein the first joint wire is configured to push the end effector in the first direction, and where the second joint wire is configured to push the end effector in the second direction. [0089] Example 5 - The surgical instrument of Examples 3 or 4, wherein the first joint wire comprises a first configuration when subjected to a compressive load, and a second configuration when subjected to a tensile load. [0090] Example 6 - The surgical instrument of Examples 3, 4 or 5, wherein the hinge structure comprises a hinge wire channel, wherein the first hinge wire extends through the hinge wire channel, and in that the joint wire channel is configured to constrain the configuration of the first joint wire. [0091] Example 7 - The surgical instrument of Examples 3, 4, 5 or 6, wherein the first pivot wire comprises a first coil spring and the second pivot wire comprises a second coil spring. [0092] Example 8 - The surgical instrument of Examples 1, 2, 3, 4, 5, 6 or 7, wherein the articulation structure comprises a flexible neck. [0093] Example 9 - The surgical instrument of Examples 1, 2, 3, 4, 5, 6, 7 or 8, wherein the first pivot joint comprises a first fixed pivot axis. [0094] Example 10 - The surgical instrument of Examples 1, 2, 3, 4, 5, 6, 7, 89, wherein the second pivot joint comprises a second fixed pivot axis. [0095] Example 11 - The surgical instrument of Example 10, wherein the first pivot axis is parallel to the second fixed pivot axis. [0096] Example 12 - The surgical instrument of Examples 1, 2, 3, 4, 5, 6, 7 or 8, wherein the first pivot joint comprises a ball-and-socket joint. [0097] Example 13 - The surgical instrument of Examples 1, 2, 3, 4, 5, 6, 7, 8 or 12, wherein the first pivot joint comprises a ball-and-socket joint. [0098] Example 14 - The surgical instrument of Examples 1, 2, 3, 4, 5, 6, 7, 9, 10, 11, 12, 13 or, characterized in that the joint structure comprises a rigid spine. [0099] Example 15 - The surgical instrument of Examples 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13 or 14, wherein the end effector comprises a staple cartridge comprising staples releasably stored therein, wherein the triggering system is configured to eject the staples from the staple cartridge. [0100] Example 16 - The surgical instrument of Examples 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14 or 15, wherein the hinge structure comprises a plurality frame members including a plurality of first frame members and a plurality of second frame members, wherein the first frame members and the second frame members are arranged in an alternating arrangement. [0101] Example 17 - The surgical instrument of Example 16, wherein each first frame member is defined by a first diameter, wherein each second frame member is defined by a second diameter, and wherein the second diameter is less than the first diameter. [0102] Example 18 - The surgical instrument of Examples 16 or 17, wherein each first frame member comprises a beveled surface that interfaces with a second frame member. [0103] Example 19 - A surgical instrument comprising a stem comprising a stem structure and an end effector comprising an end effector structure and a jaw movable relative to the end effector structure, and an articulation joint . The hinge joint comprises a proximal hinge end, a distal hinge end, a first ball-and-socket hinge joint that connects the proximal hinge end to the rod frame, and a second ball-and-socket hinge joint. -socket that connects the distal joint end to the end effector structure. The surgical instrument further comprises, first, a first pivot actuator securely attached to the end effector structure, wherein the first pivot actuator is configured to push the end effector in a first direction around the pivot joint. and secondly, a second linkage actuator securely attached to the end effector structure, wherein the second actuator and linkage is configured to push the end effector in a second direction around the linkage joint. [0104] Example 20 - An assembly for use with a surgical instrument comprising a shank portion, an end effector and an articulation joint comprising a plurality of connections including a plurality of first connections, each first connection comprising a first actuator opening and a second actuator opening, and wherein each first connection is defined by a first diameter, and a plurality of second connections, wherein each second connection is defined by a second diameter, wherein the second diameter is smaller than the first diameter. The assembly further comprises a first linkage actuator secured to the end effector, wherein the first linkage actuator extends through the first actuator openings of the first links, and wherein the first linkage actuator does not extend through the second links and , secondly, a second articulation actuator attached to the end effector, wherein the second articulation actuator extends through the second actuator openings of the first connections, and wherein the second articulation actuator does not extend through the second connections . [0105] Example 21 - The assembly of Example 20, wherein each first connection comprises a compression surface configured to be pressed against an adjacent second connection. [0106] Example 22 - The assembly of Example 21, wherein the compression surface comprises a beveled surface. [0107] Example 23 - An assembly for use with a surgical instrument comprising a stem portion, an end effector, a trigger member movable with respect to the end effector, and a hinge joint, wherein the hinge joint connects rotatably the end effector to the stem portion. The hinge joint comprises a plurality of connections including a plurality of first connections, each first connection comprising a first opening, and a plurality of second connections, each second connection comprising a second opening, wherein the first connections are configured to move relative to the second links when the end effector is pivoted, wherein the first apertures and the second apertures define a firing member path through the hinge joint to the firing member, and wherein the length of the path of the trigger member is dynamically adjusted when the first links move relative to the second links. [0108] Full disclosures of: U.S. Patent No. 5,403,312 entitled ELECTROSURGICAL HEMOSTATIC DEVICE, which was issued April 4, 1995; U.S. Patent No. 7,000,818 entitled SURGICAL STAPLING INSTRUMENT HAVING SEPARATE DISTINCT CLOSING AND FIRING SYSTEMS, which was issued February 21, 2006; U.S. Patent No. 7,422,139 entitled MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING INSTRUMENT WITH TACTILE POSITION FEEDBACK, which was issued September 9, 2008; U.S. Patent No. 7,464,849 entitled ELECTROMECHANICAL SURGICAL INSTRUMENT WITH CLOSURE SYSTEM AND ANVIL ALIGNMENT COMPONENTS, which was issued December 16, 2008; U.S. Patent No. 7,670,334 entitled SURGICAL INSTRUMENT HAVING AN ARTICULATING END EFFECTOR, which was issued March 2, 2010; U.S. Patent No. 7,753,245 entitled SURGICAL STAPLING INSTRUMENTS, which was issued July 13, 2010; U.S. Patent No. 8,393,514 entitled SELECTIVELY ORIENTABLE IMPLANTABLE FASTENER CARTRIDGE, which was issued March 12, 2013; U.S. Patent Application Serial No. 11/343,803 entitled SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES; now U.S. Patent No. 7,845,537; U.S. Patent Application Serial No. 12/031,573 entitled SURGICAL CUTTING AND FASTENING INSTRUMENT HAVING RF ELECTRODES, filed February 14, 2008; Patent Application U.S. Serial No. 12/031,873 entitled END EFFECTORS FOR A SURGICAL CUTTING AND STAPLING INSTRUMENT, filed February 15, 2008, now U.S. Patent No. 7,980,443; U.S. Patent Application Serial No. 12/235,782 entitled MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT, currently U.S. Patent 8,210,411; U.S. Patent Application Serial No. 12/249,117 entitled POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY RETRACTABLE FIRING SYSTEM, now U.S. Patent No. 8,608,045; U.S. Patent Application Serial No. 12/647,100 entitled MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT WITH ELECTRIC ACTUATOR DIRECTIONAL CONTROL ASSEMBLY, filed December 24, 2009; now U.S. Patent No. 8,220,688; U.S. Patent Application Serial No. 12/893,461, titled STAPLE CARTRIDGE, filed September 29, 2012, now U.S. Patent No. 8,733,613; U.S. Patent Application Serial No. 13/036,647, titled SURGICAL STAPLING INSTRUMENT, filed February 28, 2011, now U.S. Patent No. 8,561,870; U.S. Patent Application Serial No. 13/118,241, entitled SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS, now U.S. Patent Application Publication No. 2012/0298719; U.S. Patent Application Serial No. 13/524,049 entitled ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE, filed June 15, 2012; now U.S. Patent Application Publication No. 2013/0334278 ; Patent Application U.S. Serial No. 13/800,025 entitled STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, filed March 13, 2013; U.S. Patent Application Serial No. 13/800,067 entitled STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, filed March 13, 2013; Patent Application Publication No. U.S 2007/0175955, titled SURGICAL CUTTING AND FASTENING INSTRUMENT WITH CLOSURE TRIGGER LOCKING MECHANISM, filed January 31, 2006; and U.S. Patent Application Publication No. 2010/0264194, titled SURGICAL STAPLING INSTRUMENT WITH AN ARTICULATABLE END EFFECTOR, filed April 22, 2010, now U.S. Patent No. 8,308,040, are incorporated herein by reference. [0109] While various modalities of the devices have been described herein in connection with certain disclosed modalities, many modifications and variations of these modalities can be implemented. In addition, where materials for certain components are disclosed, other materials may be used. Furthermore, according to various embodiments, a single component may be replaced by multiple components and multiple components may be replaced by a single component to perform one or more specified functions. The aforementioned description and the following claims are intended to encompass all such modifications and variations. [0110] Devices disclosed herein may be designed to be discarded after a single use, or may be designed to be used multiple times. In either case, however, the device may be refurbished for reuse after at least one use. Overhaul can include any combination of the steps of disassembling the device, followed by cleaning or replacing specific parts and subsequent reassembly. In particular, the device can be disassembled and any number of specific parts or parts of the device can be selectively replaced or removed, in any combination. Upon cleaning and/or replacement of specific parts, the device can be reassembled for subsequent use at the refurbishment facility or by a surgical team, immediately prior to a surgical procedure. Those skilled in the art will understand that refurbishing a device can use a variety of techniques to disassemble, clean/replace, and reassemble. The use of such techniques and the resulting refurbished device are within the scope of this application. [0111] Preferably, the invention described herein will be processed prior to surgery. First, a new or used instrument is obtained and, if necessary, cleaned. The instrument can then be sterilized. In a sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and instrument are then placed in a field of radiation that can penetrate the container, such as gamma radiation, X-rays, or high-energy electrons. Radiation kills bacteria on the instrument and container. The sterilized instrument can then be stored in a sterile container. The sealed container keeps the instrument sterile until it is opened in the medical facility. [0112] While this invention has been described as having exemplary designs, the present invention may be further modified within the spirit and scope of the description. This application is therefore intended to cover any variations, uses or adaptations of the invention using its general principles. [0113] Any patent, publication or other descriptive material, in whole or in part, which is deemed to be incorporated by way of reference to the present invention, is incorporated into the present invention only to the extent that the materials incorporated do not conflict. with existing definitions, statements or other descriptive materials presented in this description. Accordingly, and to the extent necessary, the description as explicitly presented herein supersedes any conflicting material incorporated into the present invention by reference. Any material, or portions thereof, which is incorporated herein by reference, but which conflicts with existing definitions, statements, or other descriptive materials presented herein, is incorporated herein only to the extent that there is no conflict between the material embedded and existing description material.
权利要求:
Claims (16) [0001] 1. Surgical instrument, comprising: a rod (220) comprising a rod structure (221); an end effector (230) comprising: an end effector structure (231); and a jaw movable with respect to the end effector structure (231); a hinge joint (240) comprising: a hinge structure (241) comprising: a proximal hinge end (242); and a distal hinge end (243); a first hinge joint that connects the proximal hinge end (242) to the rod structure (221); and a second hinge joint that connects the distal end (243) to the end effector structure (231); a firing system movable with respect to the rod structure (221), the hinge structure (241) and the end effector structure (231), wherein the firing system comprises a cutting member movable relative to the end effector structure (231). end effector (231); a first pivot wire (248a) fixedly secured to said end effector frame (231), wherein said first pivot wire (248a) is configured to rotate said end effector (230) in a first direction; and a second pivot wire (248b) securely attached to the end effector frame (231), wherein the second pivot wire (248b) is configured to rotate the end effector (230) in a second direction; characterized in that: the first pivot wire (248a) comprises a first coil spring and the second pivot wire (248b) comprises a second coil spring. [0002] 2. Surgical instrument, according to claim 1, characterized in that it further comprises an external tube (121) movable in relation to the articulation joint (240), in which the external tube (121) is configured to move the gripper between an open position and a closed position. [0003] 3. Surgical instrument according to claim 1 or 2, characterized in that the first joint wire (248a) is configured to push the end effector (230) in the first direction, and wherein the second joint wire (248b) is configured to push the end effector (230) in the second direction. [0004] 4. Surgical instrument according to claim 1, 2 or 3, characterized in that the first joint wire (248a) comprises a first configuration when subjected to a compressive load, and a second configuration when subjected to a load of traction. [0005] 5. Surgical instrument according to any one of the preceding claims, characterized in that the articulation structure (241) comprises a articulation wire channel (246a), wherein the first articulation wire (248a) extends through of the pivot wire channel (246a), and wherein the pivot wire channel (246a) is configured to constrain the configuration of the first pivot wire (248a). [0006] 6. Surgical instrument according to any one of claims 1 to 5, characterized in that the joint structure (241) comprises a flexible neck (341). [0007] 7. Surgical instrument according to any one of claims 1 to 6, characterized in that the first joint joint comprises a first geometric axis of fixed pivot (244). [0008] 8. Surgical instrument, according to any one of claims 1 to 7, characterized in that the second joint joint comprises a second geometric axis of fixed pivot (245). [0009] 9. Surgical instrument, according to claim 8, characterized in that the first pivot axis (244) is parallel to the second fixed pivot axis (245). [0010] 10. Surgical instrument according to any one of claims 1 to 6, characterized in that the first joint joint comprises a ball-and-socket joint (342, 344). [0011] 11. Surgical instrument according to any one of claims 1 to 6, characterized in that the second joint joint comprises a ball-and-socket joint (343, 345). [0012] 12. Surgical instrument according to any one of claims 1 to 5 and 7 to 11, characterized in that the joint structure comprises a rigid spine (241). [0013] 13. Surgical instrument according to any one of claims 1 to 12, characterized in that the end effector (230) comprises a staple cartridge comprising staples removable therein, and that the triggering system is configured to eject the staples from the staple cartridge. [0014] A surgical instrument according to any one of claims 1 to 13, characterized in that the articulation frame (241) comprises a plurality of frame members including: a plurality of first frame members (541); and a plurality of second frame members (542), wherein the first frame members (541) and second frame members (542) are arranged in an alternating arrangement. [0015] 15. Surgical instrument according to claim 14, characterized in that each first frame member (541) is defined by a first diameter, wherein each second frame member (542) is defined by a second diameter, and where the second diameter is smaller than the first diameter. [0016] 16. Surgical instrument according to claim 14 or 15, characterized in that each first frame member (541) comprises a chamfered surface (543) that interfaces with said second frame member (542).
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同族专利:
公开号 | 公开日 CN107106172B|2020-01-17| CN107106172A|2017-08-29| WO2016100069A1|2016-06-23| JP6728179B2|2020-07-22| EP3034014B1|2018-07-18| EP3034014A2|2016-06-22| BR112017012999A2|2018-01-02| RU2017125442A|2019-01-21| US10806448B2|2020-10-20| US20210100550A1|2021-04-08| US20190090870A1|2019-03-28| EP3034014A3|2016-09-14| US20160174970A1|2016-06-23| US9987000B2|2018-06-05| RU2719014C2|2020-04-16| RU2017125442A3|2019-06-26| MX2017008113A|2018-03-06| JP2018505710A|2018-03-01|
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staple| US4198734A|1972-04-04|1980-04-22|Brumlik George C|Self-gripping devices with flexible self-gripping means and method| GB1339394A|1972-04-06|1973-12-05|Vnii Khirurgicheskoi Apparatur|Dies for surgical stapling instruments| US3819100A|1972-09-29|1974-06-25|United States Surgical Corp|Surgical stapling instrument| USRE28932E|1972-09-29|1976-08-17|United States Surgical Corporation|Surgical stapling instrument| US3892228A|1972-10-06|1975-07-01|Olympus Optical Co|Apparatus for adjusting the flexing of the bending section of an endoscope| US3821919A|1972-11-10|1974-07-02|Illinois Tool Works|Staple| US3959879A|1973-02-26|1976-06-01|Rockwell International Corporation|Electrically powered grass trimmer| US3944163A|1973-03-24|1976-03-16|Kabushiki Kaisha Tokai Rika Denki Seisakusho|Seat belt retractor| US3826978A|1973-04-03|1974-07-30|Dynalysis Of Princeton|Waveguide refractometer| US3863940A|1973-04-04|1975-02-04|Philip T Cummings|Wide opening collet| US3808452A|1973-06-04|1974-04-30|Gte Automatic Electric Lab Inc|Power supply system having redundant d. c. power supplies| SU511939A1|1973-07-13|1976-04-30|Центральная Научно-Исследовательская Лаборатория При 4-М Главном Управлении|Apparatus for imposing arcuate suture on the greater curvature of the stomach| JPS5033988U|1973-07-21|1975-04-11| US3885491A|1973-12-21|1975-05-27|Illinois Tool Works|Locking staple| JPS552966Y2|1974-02-08|1980-01-24| JPS543B2|1974-02-28|1979-01-05| US3952747A|1974-03-28|1976-04-27|Kimmell Jr Garman O|Filter and filter insertion instrument| US3863639A|1974-04-04|1975-02-04|Richard N Kleaveland|Disposable visceral retainer| CA1015829A|1974-05-23|1977-08-16|Kurt Pokrandt|Current sensing circuitry| US4459519A|1974-06-24|1984-07-10|General Electric Company|Electronically commutated motor systems and control therefor| US4169990A|1974-06-24|1979-10-02|General Electric Company|Electronically commutated motor| US3894174A|1974-07-03|1975-07-08|Emhart Corp|Insulated staple and method of making the same| DE2442260A1|1974-09-04|1976-03-18|Bosch Gmbh Robert|CRAFT MACHINE| US4321746A|1978-11-01|1982-03-30|White Consolidated Industries, Inc.|Tool changer for vertical boring machine| US3955581A|1974-10-18|1976-05-11|United States Surgical Corporation|Three-stage surgical instrument| DE2530261C2|1974-10-22|1986-10-23|Asea S.p.A., Mailand/Milano|Programming device for a manipulator| US4129059A|1974-11-07|1978-12-12|Eck William F Van|Staple-type fastener| US3950686A|1974-12-11|1976-04-13|Trw Inc.|Series redundant drive system| GB1491083A|1975-03-19|1977-11-09|Newage Kitchens Ltd|Joint assemblies| US4108211A|1975-04-28|1978-08-22|Fuji Photo Optical Co., Ltd.|Articulated, four-way bendable tube structure| SU566574A1|1975-05-04|1977-07-30|Всесоюзный научно-исследовательский и испытательный институт медицинской техники|Apparatus for applying linear agraffe suture on organs and tissue| US4185701A|1975-05-19|1980-01-29|Sps Technologies, Inc.|Tightening apparatus| 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Jarvik Robert|Surgical' clip applicator| SU674747A1|1976-11-24|1979-07-25|Всесоюзный научно-исследовательский и испытательный институт медицинской техники|Apparatus for mechanical suturing of tissues| FR2446509B1|1977-04-29|1981-07-03|Garret Roger| SU728848A1|1977-05-24|1980-04-25|Всесоюзный научно-исследовательский и испытательный институт медицинской техники|Surgical suturing arrangement| US4573468A|1977-05-26|1986-03-04|United States Surgical Corporation|Hollow body organ stapling instrument and disposable cartridge employing relief vents| US4304236A|1977-05-26|1981-12-08|United States Surgical Corporation|Stapling instrument having an anvil-carrying part of particular geometric shape| US4135517A|1977-07-21|1979-01-23|Minnesota Mining And Manufacturing Company|Femoral prosthesis trial fitting device| CA1124605A|1977-08-05|1982-06-01|Charles H. Klieman|Surgical stapler| US4452376A|1977-08-05|1984-06-05|Charles H. Klieman|Hemostatic clip applicator| USD261356S|1977-09-07|1981-10-20|Ofrex Group Limited|Strip of insulated cable clips| US6264617B1|1977-09-12|2001-07-24|Symbiosis Corporation|Radial jaw biopsy forceps| US4226242A|1977-09-13|1980-10-07|United States Surgical Corporation|Repeating hemostatic clip applying instruments and multi-clip cartridges therefor| US4154122A|1977-09-16|1979-05-15|Severin Hubert J|Hand-powered tool| US4106620A|1977-10-03|1978-08-15|Brimmer Frances M|Surgical blade dispenser| JPS6060024B2|1977-10-19|1985-12-27|Hitachi Ltd| US4241861A|1977-12-20|1980-12-30|Fleischer Harry N|Scissor-type surgical stapler| US4900303A|1978-03-10|1990-02-13|Lemelson Jerome H|Dispensing catheter and method| US4190042A|1978-03-16|1980-02-26|Manfred Sinnreich|Surgical retractor for endoscopes| US4207898A|1978-03-27|1980-06-17|Senco Products, Inc.|Intralumenal anastomosis surgical stapling instrument| US4321002A|1978-03-27|1982-03-23|Minnesota Mining And Manufacturing Company|Medical stapling device| US4274304A|1978-03-29|1981-06-23|Cooper Industries, Inc.|In-line reversing mechanism| US4198982A|1978-03-31|1980-04-22|Memorial Hospital For Cancer And Allied Diseases|Surgical stapling instrument and method| SU1036324A1|1978-03-31|1983-08-23|Всесоюзный научно-исследовательский и испытательный институт медицинской техники|Surgical suturing device| GB2024012B|1978-04-10|1982-07-28|Johnson & Johnson|Oxygen-generating surgical dressing| US4180285A|1978-05-11|1979-12-25|Reneau Bobby J|Articulated ball connector for use with pipeline| DE2839990C2|1978-09-14|1980-05-14|Audi Nsu Auto Union Ag, 7107 Neckarsulm|Method for remelt hardening the surface of a workpiece rotating about its axis of rotation, which surface is at a different distance from the axis of rotation| SU886897A1|1978-12-25|1981-12-07|Всесоюзный Научно-Исследовательский Институт Медицинской Техники|Surgical apparatus for applying side gastroenterostomy| SE419421B|1979-03-16|1981-08-03|Ove Larson|RESIDENTIAL ARM IN SPECIAL ROBOT ARM| SU886900A1|1979-03-26|1981-12-07|Всесоюзный научно-исследовательский и испытательный институт медицинской техники|Surgical apparatus for applying line sutures| US4340331A|1979-03-26|1982-07-20|Savino Dominick J|Staple and anviless stapling apparatus therefor| JPS55138634A|1979-04-16|1980-10-29|Kansai Electric Power Co Inc:The|Fault diagnosis apparatus of apparatus| US4512038A|1979-04-27|1985-04-23|University Of Medicine And Dentistry Of New Jersey|Bio-absorbable composite tissue scaffold| US4274398A|1979-05-14|1981-06-23|Scott Jr Frank B|Surgical retractor utilizing elastic tubes frictionally held in spaced notches| US4261244A|1979-05-14|1981-04-14|Senco Products, Inc.|Surgical staple| US4289131A|1979-05-17|1981-09-15|Ergo Instruments, Inc.|Surgical power tool| US4272662A|1979-05-21|1981-06-09|C & K Components, Inc.|Toggle switch with shaped wire spring contact| US4275813A|1979-06-04|1981-06-30|United States Surgical Corporation|Coherent surgical staple array| US4272002A|1979-07-23|1981-06-09|Lawrence M. Smith|Internal surgical stapler| US4296654A|1979-08-20|1981-10-27|Mercer Albert E|Adjustable angled socket wrench extension| US4250436A|1979-09-24|1981-02-10|The Singer Company|Motor braking arrangement and method| US4357940A|1979-12-13|1982-11-09|Detroit Neurosurgical Foundation|Tissue pneumatic separator structure| SU1022703A1|1979-12-20|1983-06-15|Всесоюзный научно-исследовательский и испытательный институт медицинской техники|Device for correcting and fixing vertebral column of patients ill with scoliosis surgical apparatus for applying compression sutures| US4278091A|1980-02-01|1981-07-14|Howmedica, Inc.|Soft tissue retainer for use with bone implants, especially bone staples| CA1205525A|1980-02-01|1986-06-03|Russell H. Taggart|Current detector| US4376380A|1980-02-05|1983-03-15|John D. Brush & Co., Inc.|Combination lock| US4429695A|1980-02-05|1984-02-07|United States Surgical Corporation|Surgical instruments| AU534210B2|1980-02-05|1984-01-12|United States Surgical Corporation|Surgical staples| JPS56112235A|1980-02-07|1981-09-04|Vnii Ispytatel Med Tech|Surgical suturing implement for suturing staple| US4368731A|1980-02-12|1983-01-18|Schramm Heinrich W|Pistol-type syringe| US4396139A|1980-02-15|1983-08-02|Technalytics, Inc.|Surgical stapling system, apparatus and staple| US4317451A|1980-02-19|1982-03-02|Ethicon, Inc.|Plastic surgical staple| US4319576B1|1980-02-26|1986-02-25| US4312363A|1980-02-26|1982-01-26|Senco Products, Inc.|Surgical tissue thickness measuring instrument| US4361057A|1980-02-28|1982-11-30|John Sigan|Handlebar adjusting device| US4289133A|1980-02-28|1981-09-15|Senco Products, Inc.|Cut-through backup washer for the scalpel of an intraluminal surgical stapling instrument| US4296881A|1980-04-03|1981-10-27|Sukoo Lee|Surgical stapler using cartridge| 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Surgical Corporation|Surgical stapling apparatus having self-contained pneumatic system for completing manually initiated motion sequence| AU542936B2|1980-10-17|1985-03-28|United States Surgical Corporation|Self centering staple| JPS5778844A|1980-11-04|1982-05-17|Kogyo Gijutsuin|Lasre knife| US4430997A|1980-11-19|1984-02-14|Ethicon, Inc.|Multiple clip applier| US4500024A|1980-11-19|1985-02-19|Ethicon, Inc.|Multiple clip applier| US4347450A|1980-12-10|1982-08-31|Colligan Wallace M|Portable power tool| US4451743A|1980-12-29|1984-05-29|Citizen Watch Company Limited|DC-to-DC Voltage converter| SU1235495A1|1980-12-29|1986-06-07|Всесоюзный научно-исследовательский и испытательный институт медицинской техники|Apparatus for placing compression anastomoses| US4382326A|1981-01-19|1983-05-10|Minnesota Mining & Manufacturing Company|Staple supporting and staple removing strip| US4394613A|1981-01-19|1983-07-19|California Institute Of Technology|Full-charge indicator for battery chargers| 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Prof. Dr.med. 2400 Lübeck Krüger|Medical instrument| US4406621A|1981-05-04|1983-09-27|Young Dental Manufacturing Company, Inc.|Coupling ensemble for dental handpiece| US4383634A|1981-05-26|1983-05-17|United States Surgical Corporation|Surgical stapler apparatus with pivotally mounted actuator assemblies| JPS6149981B2|1981-06-23|1986-10-31|Terumo Corp| US4485816A|1981-06-25|1984-12-04|Alchemia|Shape-memory surgical staple apparatus and method for use in surgical suturing| FR2509490B1|1981-07-09|1985-02-22|Tractel Sa|RELEASE MECHANISM FOR TRACTION EQUIPMENT ACTING ON A CABLE THROUGH IT| US4486928A|1981-07-09|1984-12-11|Magnavox Government And Industrial Electronics Company|Apparatus for tool storage and selection| US4373147A|1981-07-23|1983-02-08|General Signal Corporation|Torque compensated electric motor| US4475679A|1981-08-07|1984-10-09|Fleury Jr George J|Multi-staple cartridge for surgical staplers| US4417890A|1981-08-17|1983-11-29|Baxter Travenol Laboratories, Inc.|Antibacterial closure| US4632290A|1981-08-17|1986-12-30|United States Surgical Corporation|Surgical stapler apparatus| US4576167A|1981-09-03|1986-03-18|United States Surgical Corporation|Surgical stapler apparatus with curved shaft| US4461305A|1981-09-04|1984-07-24|Cibley Leonard J|Automated biopsy device| JPS5844033A|1981-09-11|1983-03-14|Fuji Photo Optical Co Ltd|Adaptor type treating tool introducing apparatus for endoscope| JPS6116456B2|1981-10-08|1986-04-30|Kenichi Mabuchi| US4402445A|1981-10-09|1983-09-06|United States Surgical Corporation|Surgical fastener and means for applying same| DE3277287D1|1981-10-15|1987-10-22|Olympus Optical Co|Endoscope system with an electric bending mechanism| US4483562A|1981-10-16|1984-11-20|Arnold Schoolman|Locking flexible shaft device with live distal end attachment| US4809695A|1981-10-21|1989-03-07|Owen M. Gwathmey|Suturing assembly and method| US4416276A|1981-10-26|1983-11-22|Valleylab, Inc.|Adaptive, return electrode monitoring system| US4415112A|1981-10-27|1983-11-15|United States Surgical Corporation|Surgical stapling assembly having resiliently mounted anvil| JPH0131895B2|1981-11-04|1989-06-28|Olympus Optical Co| US4423456A|1981-11-13|1983-12-27|Medtronic, Inc.|Battery reversal protection| JPS5887494U|1981-12-05|1983-06-14| US4442964A|1981-12-07|1984-04-17|Senco Products, Inc.|Pressure sensitive and working-gap controlled surgical stapling instrument| US4724840A|1982-02-03|1988-02-16|Ethicon, Inc.|Surgical fastener applier with rotatable front housing and laterally extending curved needle for guiding a flexible pusher| US4586502A|1982-02-03|1986-05-06|Ethicon, Inc.|Surgical instrument actuator with non-collinear hydraulic pistons| US4448194A|1982-02-03|1984-05-15|Ethicon, Inc.|Full stroke compelling mechanism for surgical instrument with drum drive| US4471781A|1982-02-03|1984-09-18|Ethicon, Inc.|Surgical instrument with rotatable front housing and latch mechanism| US4480641A|1982-02-05|1984-11-06|Ethicon, Inc.|Tip configuration for a ligating clip applier| US4478220A|1982-02-05|1984-10-23|Ethicon, Inc.|Ligating clip cartridge| US4471780A|1982-02-05|1984-09-18|Ethicon, Inc.|Multiple ligating clip applier instrument| DE3204532C2|1982-02-10|1983-12-08|B. Braun Melsungen Ag, 3508 Melsungen|Surgical skin staple| SU1114405A1|1982-02-23|1984-09-23|Всесоюзный научно-исследовательский и испытательный институт медицинской техники|Surgical suturing apparatus for placing compression anastomoses on the organs of digestive tract| DE3210466A1|1982-03-22|1983-09-29|Peter Dipl.-Kfm. 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decorative metal plate attached thereto| US4790225A|1982-11-24|1988-12-13|Panduit Corp.|Dispenser of discrete cable ties provided on a continuous ribbon of cable ties| US4676245A|1983-02-09|1987-06-30|Mamoru Fukuda|Interlocking surgical staple assembly| JPS59163608A|1983-03-08|1984-09-14|Hitachi Koki Co Ltd|Jigsaw| JPS59168848A|1983-03-11|1984-09-22|Ethicon Inc|Antiseptic surgical apparatus made of nonmetal having affinity to organism| US4652820A|1983-03-23|1987-03-24|North American Philips Corporation|Combined position sensor and magnetic motor or bearing| US4506671A|1983-03-30|1985-03-26|United States Surgical Corporation|Apparatus for applying two-part surgical fasteners| US4569346A|1983-03-30|1986-02-11|United States Surgical Corporation|Safety apparatus for surgical occluding and cutting device| US4530357A|1983-04-18|1985-07-23|Pawloski James A|Fluid actuated orthopedic tool| GB2138298B|1983-04-21|1986-11-05|Hundon Forge Ltd|Pellet implanter| 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法律状态:
2020-03-10| B06U| Preliminary requirement: requests with searches performed by other patent offices: procedure suspended [chapter 6.21 patent gazette]| 2021-10-13| B09A| Decision: intention to grant [chapter 9.1 patent gazette]| 2022-01-04| B16A| Patent or certificate of addition of invention granted [chapter 16.1 patent gazette]|Free format text: PRAZO DE VALIDADE: 20 (VINTE) ANOS CONTADOS A PARTIR DE 10/12/2015, OBSERVADAS AS CONDICOES LEGAIS. |
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申请号 | 申请日 | 专利标题 US14/574,493|2014-12-18| US14/574,493|US9987000B2|2014-12-18|2014-12-18|Surgical instrument assembly comprising a flexible articulation system| PCT/US2015/064912|WO2016100069A1|2014-12-18|2015-12-10|Surgical instrument assembly comprising a flexible articulation system| 相关专利
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