surgical stapler with angled anvil tip, angled staple cartridge tip, and tissue gripping features

专利摘要:
the present invention relates to a surgical instrument which includes a body portion, a drive shaft and an end actuator and which is operable to compress, staple and cut tissue. the end actuator includes an anvil and a staple cartridge. the anvil has a rigid arcuate tip configured to contact an angled surface of a nose portion of the staple cartridge. the staple cartridge includes gripping features along a staple platform that assists in gripping the fabric during clamping. the cartridge clamp platform can include multiple levels. the anvil also includes a slit with side portions that have curved ends for receiving portions of a firing bar to guide the firing bar during a cutting and stapling action.
公开号:BR112019016971A2
申请号:R112019016971
申请日:2018-02-13
公开日:2020-04-07
发明作者:L Baber Daniel；E Shelton Frederick Iv；J Bakos Gregory；L Harris Jason；P Schowalter Joseph
申请人:Ethicon Llc；
IPC主号:

专利说明:

Descriptive Report of the Invention Patent for SURGICAL STAPLER WITH INCLINED BIGORN TIP, ANGLED CLAMP CARTRIDGE TIP AND TISSUE PRESSURE RESOURCES.
BACKGROUND [0001] In some cases, endoscopic surgical instruments may be preferred over traditional open surgery devices, since a smaller incision can reduce recovery time and complications in the postoperative period. Consequently, some endoscopic surgical instruments may be suitable for placing a distal end actuator in a desired surgical site through the trocar cannula. These distal end actuators can engage tissue in a variety of ways to achieve a diagnostic or therapeutic effect (for example, cutter, claw, cutter, stapler, clip applicator, access device, drug delivery / gene therapy device and device for application of energy through the use of ultrasound, RF, laser, etc.). Endoscopic surgical instruments may include a drive shaft between the end actuator and a handle portion, which is handled by the clinician. Such a drive shaft can enable insertion to a desired depth and rotation around the longitudinal geometric axis of the drive shaft, thus facilitating the positioning of the end actuator on the patient. The positioning of an end actuator can be further facilitated by the inclusion of one or more joints or articulation features, allowing the end actuator to be selectively articulated or otherwise deflected in relation to the longitudinal geometric axis of the drive axis.
[0002] Examples of endoscopic surgical instruments include surgical staplers. Some of these staplers attach
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2/56 layers of fabric, cut through the attached fabric layers and insert staples into the fabric layers to substantially seal the cut fabric layers together, close to their cut ends. Surgical staplers for example only are disclosed in US Patent No. 4,805,823, entitled Pocket Configuration for Internal Organ Staplers, issued on February 21, 1989; US Patent No. 5,415,334, entitled Surgical Stapler and Staple Cartridge, issued May 16, 1995; US Patent No. 5,465,895, entitled Surgical Stapl er Instrument, issued November 14, 1995; US Patent No. 5,597,107, entitled Surgical Stapler Instrument, issued January 28, 1997; US Patent No. 5,632,432, entitled Surgical Instrument, issued May 27, 1997; US Patent No. 5,673,840, entitled Surgical Instrument, issued October 7, 1997; US Patent No. 5,704,534, entitled Articulation Assembly for Surgical Instruments, issued January 6, 1998; US Patent No. 5,814,055, entitled Surgical Clamping Mechanism, issued September 29, 1998; US Patent No. 6,978,921, entitled Surgical Stapling Instrument Incorporating an E-Beam Firing Mechanism, issued December 27, 2005; US Patent No. 7,000,818, entitled Surgical Stapling Instrument Having Separate Distinct Closing and Firing Systems, issued February 21, 2006; US Patent No. 7,143,923, entitled Surgical Stapling Inst rument Having a Firing Lockout for an Unclosed Anvil, issued December 5, 2006; US Patent No. 7,303,108, entitled Surgical Stapling Instrument Incorporating a Multi-Stroke Firing Mechanism with a Flexible Rack, issued December 4, 2007; US Patent No. 7,367,485, entitled Surgical Stapling Instrument Incorporating a Multistroke Firing Mechanism Having a Rotary Transmission, issued on May 6, 2008; US Patent No. 7,380,695, entitled Surgi cal Stapling
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3/56
Instrument Having a Single Lockout Mechanism for Prevention of Firing, granted on June 3, 2008; US Patent No. 7,380,696, entitled Articulating Surgical Stapling Instrument Incorporating to TwoPiece E-Beam Firing Mechanism, issued June 3, 2008; US Patent No. 7,404,508, entitled Surgical Stapling and Cutting Device, issued July 29, 2008; US Patent No. 7,434,715, entitled Surgical Stapling Instrument Having Multistroke Firing with Opening Lockout, issued October 14, 2008; US Patent No. 7,721,930, entitled Disposable Car tridge with Adhesive for Use with a Stapling Device, issued May 25, 2010; US Publication No. 2010/0264193, entitled Surgical Stapling Instrument with An Articulatable End Effector, published October 21, 2010; and in US Publication No. 2012/0239012, entitled Motor-Driven Surgical Cutting Instrument with Electric Actuator Directional Control Assembly, published on September 20, 2012. The description of each of the US patents and US Patent publications cited above is incorporated herein. as a reference.
[0003] Although the aforementioned surgical staplers are described as used in endoscopic procedures, it should be understood that these surgical staplers can also be used in open procedures and / or other non-endoscopic procedures. Just as an example, a surgical stapler can be inserted through a thoracotomy and, thus, between the patient's ribs, to reach one or more organs in a thoracic surgical procedure that does not use a trocar as a conduit for the stapler. Such procedures may include using the stapler to cut and close a blood vessel that travels to the lung. For example, vessels that go to an organ can be cut and closed by a stapler before the organ is removed from the chest cavity. Naturally, staplers
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4/56 can be used in many other scenarios and procedures.
[0004] Although various types of surgical stapling instruments and associated components have been produced and used, it is believed that no one before the inventor (s) has produced or used the invention described in the attached claims.
BRIEF DESCRIPTION OF THE DRAWINGS [0005] The attached drawings, which are incorporated into this specification and form part of it, illustrate modalities of the invention and, together with the general description provided above and the detailed description of the modalities provided below, serve to explain the principles of the present invention.
[0006] Figure 1 shows a perspective view of an exemplary surgical stapling instrument;
[0007] Figure 2 shows a side view of the instrument of Figure 1; [0008] Figure 3 shows a perspective view of an open end actuator for the instrument of Figure 1;
[0009] Figure 4A shows a side cross-sectional view of the end actuator of Figure 3, taken along line 4-4 of Figure 3, with the firing bar in a proximal position;
[0010] Figure 4B shows a side cross-sectional view of the end actuator of Figure 3, taken along line 4-4 of Figure 3, with the firing bar in a distal position;
[0011] Figure 5 shows a cross-sectional view of the end actuator of Figure 3, taken along line 5-5 of Figure 3;
[0012] Figure 6 shows an exploded perspective view of the end actuator of Figure 3;
[0013] Figure 7 shows a perspective view of the end actuator of Figure 3, positioned on the tissue and after having been actuated
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5/56 once on the fabric;
[0014] Figure 8 shows a perspective view of an alternative version of an end actuator with an angled anvil and an angled cartridge;
[0015] Figure 9 shows an enlarged side view of the end actuator of Figure 8;
[0016] Figure 10 shows an enlarged top view of the end actuator of Figure 8;
[0017] Figure 11 shows a perspective view of a distal portion of another alternative version of an end actuator, with a curved anvil tip, shown in an open configuration; [0018] Figure 12 shows a side view of the end actuator of Figure 11;
[0019] Figure 13 shows a side view of the end actuator of Figure 11, however shown in the closed configuration;
[0020] Figure 14 shows an enlarged side view of the distal portion of the end actuator of Figure 13;
[0021] Figure 15 shows a cross-sectional view of the anvil of the end actuator of Figure 11, taken along line 15-15 of Figure 12;
[0022] Figure 16 shows a cross-sectional view of an alternative version of an anvil for the end actuator of Figure 11, taken along a line in cross-section similar to the view of line 15-15 of Figure 12;
[0023] Figure 17 shows a partial perspective view of an alternative version of an anvil for the end actuator of Figure 11;
[0024] Figure 18 shows a partial perspective view of another alternative version of an anvil for the end actuator of Figure 11;
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6/56 [0025] Figure 19 shows an enlarged side view of the distal portion of an alternative version of an end actuator that has a cooperating rigid anvil tip with cartridge tip features; [0026] Figure 20 shows an enlarged side view of the distal portion of an alternative version of an end actuator that incorporates gripping features in the cartridge and is used with an anvil that has a rigid tipped tip;
[0027] Figure 21 shows an enlarged perspective view of the distal portion of the end actuator cartridge of Figure 20; and [0028] Figure 22 shows a perspective view of a distal portion of an alternative version of an end actuator, with a curved anvil tip, shown in an open configuration. [0029] In no way are the drawings intended to be limiting and it is envisaged that various modalities of the invention may be carried out in a variety of other ways, including those not necessarily represented in the drawings. The attached drawings incorporated and which form part of the specification illustrate various aspects of the present invention and, together with the description, serve to explain the principles of the invention. It should be understood, however, that this invention is not specifically limited to the provisions shown.
DETAILED DESCRIPTION [0030] The following description of specific examples of the invention should not be used to limit the scope of the present invention. Other examples, characteristics, aspects, modalities and advantages of the invention will be evident to those skilled in the art from the description below, which is, by way of illustration, one of the best ways contemplated for carrying out the invention. As will be understood, the invention may have other different and obvious aspects, all without departing from the invention. Consequently, the designs and
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7/56 descriptions should be considered as illustrative and not restrictive.
I · Exemplary surgical stapler [0031] Figures 1 to 7 show an exemplary surgical stapling and cutting instrument 10 that is sized for insertion, in a non-articulated state as shown in Figure 1, through a trocar cannula, in a location surgical procedure for a patient to perform a surgical procedure. Just as an example, such a trocar can be inserted into the patient's abdomen, between the patient's two ribs, or elsewhere. In some cases, instrument 10 is used without a trocar. For example, instrument 10 can be inserted directly through a thoracotomy or other type of incision. The instrument 10 of the present example includes a handle portion 20 connected to a drive shaft 22. The drive shaft 22 ends distally at a hinge joint 11, which is additionally coupled to an end actuator 12. It should be understood that terms such as proximal and distal are used in the present invention with reference to a physician who holds the handle portion 20 of the instrument 10. Thus, the end actuator 12 is distal from the most proximal handle portion 20. It will be understood that For convenience and clarity, spatial terms such as vertical and horizontal are used in the present invention in connection with the drawings. However, surgical instruments are used in many orientations and positions, and such terms are not intended to be limiting and absolute.
[0032] In some versions, drive shaft 22 is constructed in accordance with at least some of the teachings of US Patent Publication No. 2014/0239038, entitled Surgical Instrument with MultiDiameter Shaft, published on August 28, 2014, whose description is incorporated herein by way of reference. For example only
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8/56 further, the drive shaft 22 can be removable from the handle portion 20 according to at least some of the teachings of US Patent publication No. 2015/0272575, entitled Surgical Instrument Comprising a Sensor System, published on October 1 2015, the description of which is incorporated here for reference. In some other versions, the drive shaft 22 is not removable from the handle portion 20. Other suitable configurations of the drive shaft 22 will become apparent to those skilled in the art considering the teachings of the present invention.
[0033] After the articulation joint 11 and the end actuator 12 are inserted through the cannula passage of a trocar, the articulation joint 11 can be remotely articulated, as shown by the dashed line in Figure 1, through a control of articulation 13, so that the end actuator 12 can be deflected from the longitudinal axis LA of the drive shaft 22 at a desired angle α. The end actuator 12 can thus reach the back of an organ, or approach the tissue from a desired angle or for other reasons. In some versions, the pivot joint 11 allows deflection of the end actuator 12 along a single plane. In some other versions, the pivot joint 11 allows deflection of the end actuator along more than one plane. The hinge joint 11 and the hinge control 13 can be configured in accordance with the teachings of any of the numerous references that are cited in the present invention. Alternatively, the hinge joint 11 and / or the hinge control 13 can have any other suitable configuration. Just as an example, the articulation control 13 can, on the other hand, be configured as a button that rotates around a geometric axis that is perpendicular to the longitudinal geometric axis LA of the drive axis 22.
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9/56 [0034] In some versions, the hinge joint 11 and / or the hinge control 13 are constructed and operable in accordance with at least some of the teachings of US Patent Document No. 9,186,142, entitled Surgical Instrument End Effector Articulation Drive with Pinion and Opposing Racks, granted on November 17, 2015, the description of which is incorporated herein by reference. Joint 11 can also be constructed and operable in accordance with at least some of the teachings of US Publication No. 2014/0239038, entitled Surgical Instrument with Multi-Diameter Shaft, published on August 28, 2014, the description of which is incorporated herein as a reference. Other suitable forms that the joint 11 and joint control 13 can take will be apparent to those skilled in the art, in view of the teachings of the present invention.
[0035] The end actuator 12 of the present example includes a lower jaw 16 and a pivoting anvil 18. In some versions, the lower jaw 16 is constructed in accordance with at least some of the teachings of US Patent Application No. 2014/023904 4, entitled Installation Features for Surgical Instrument End Effector Cartridge, published on August 28, 2014, the description of which is incorporated herein by reference. Anvil 18 can be constructed according to at least some of the teachings of US Patent Publication No. 2014/0239042, entitled Integrated Tissue Positioning and Jaw Alignment Features for Surgical Stapler, published on August 28, 2014, the description of which is incorporated herein as a reference; at least some of the teachings in US Patent Application No. 2014/0239036, entitled Jaw Closure Feature for End Effector of Surgical Instrument, published on August 28, 2014, the description of which is incorporated herein by reference; and / or at least some of the teachings of US Patent Application No. 2014/0239037,
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10/56 entitled Staple Forming Features for Surgical Stapling Instrument, published on August 28, 2014, the description of which is incorporated herein by reference. Other suitable shapes that the lower claw 16 and anvil 18 can take will be apparent to those skilled in the art in view of the teachings of the present invention.
[0036] The grip portion 20 includes a pistol grip 24 and a closing trigger 26. The closing trigger 26 is pivoted towards the pistol grip 24 to cause the anvil 18 to clamp, or close, towards the claw. bottom 16 of the end actuator 12. Such anvil closure 18 is provided through a closing tube 32 and a closing ring 33, which travel longitudinally with respect to the handle portion 20 in response to the rotation of the closing trigger 26 in in relation to the pistol grip 24. The closing tube 32 extends along the length of the drive shaft 22. And the closing ring 33 is positioned distally from the hinge joint 11. The hinge joint 11 is operable to communicate / transmit longitudinal movement from the closing tube 32 to the closing ring 33.
[0037] The grip portion 20 also includes a trigger trigger 28. An elongated member not shown extends longitudinally through the drive shaft 22 and communicates a longitudinal trigger movement of the handle portion 20 to a trigger bar 14 in response the trigger trigger actuation 28. This distal translation of the trigger bar 14 causes stapling and cutting of the tissue stuck in the end actuator 12, as will be described in more detail below. Thereafter, triggers 26, 28 can be released to release tissue from end actuator 12. [0038] Figures 3 to 6 show end actuator 12 which employs a firing bar 14 with an E-profile to perform various
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11/56 functions. It should be understood that a rod with an E-profile is just an illustrative example. The firing bar 14 can take any other suitable shape, which includes, but is not limited to, shapes that do not have an E-profile. As can best be seen in Figures 4A and 4B, the firing bar 14 includes an upper pin oriented crosswise 38, a termination of the firing bar 44, an intermediate pin transversely oriented 46 and a cutting edge presented distally 48. The upper pin 38 is positioned and translatable within a longitudinal slot 42 of the anvil 18. The termination of the crossbar firing 44 slidably engages a lower surface of the lower jaw 16 when the firing bar 14 extends through the lower jaw groove 45 shown in Figure 4B which is formed in the lower jaw 16. The middle pin 46 slidably engages a upper surface of the lower jaw 16 that cooperates with the termination of the firing bar 44. Thus, the firing bar 14 positively spaces the end actuator 12 during firing. [0039] Some firing bars 14 with a different shape than the E profile may not have the upper pin 38, the middle pin 46 and / or the termination of the firing bar 44. Some such versions of instrument 10 may simply use the ring lock 33 or some other means for pivoting anvil 18 to a closed position and keeping anvil 18 in the closed position while the firing bar 14 advances to the distal position. For example only, the firing bar 14 and / or the associated locking features can be constructed and operable in accordance with at least some of the teachings of US Patent Publication No. 2014/0239041, entitled the Lockout Feature for Movable Cutting Member of Surgical Instrument, published on August 28, 2014, the description of which is incorporated herein by reference. Other suitable forms that the firing bar 14 can take will be evident to those skilled in the art in view of the
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12/56 teachings of the present invention.
[0040] Figure 3 shows the firing bar 14 of the present example located proximally and the anvil 18 pivoted to an open position, allowing an uns worn staple cartridge 37 to be removably installed in a channel of the lower claw 16. As best seen in Figures 5 and 6, the staple cartridge 37 of that example includes a cartridge body 70 that has an upper platform 72 and is coupled to a lower cartridge tray 74. As best seen in Figure 3, a vertical slot 49 is formed through part of the staple cartridge 37. As best seen in Figure 3, three rows of staple openings 51 are formed on the upper platform 72 on one side of the vertical slot 49, with another set of three rows of staple openings 51 formed on the upper platform 72 on the other side of the vertical slot 49. Obviously, any other suitable number of rows of clips (for example, two rows, four rows, any other number) can be f decorated. Referring back to Figures 4A to 6, a wedge slide 41 and a plurality of clamp drivers 43 are captured between the cartridge body 70 and tray 74, with the wedge slide 41 located proximally to the clamp drivers 43. The wedge slide 41 is movable longitudinally in the staple cartridge 37, while the staple actuators 43 are vertically movable in the staple cartridge 37. The staples 47 are also positioned on the cartridge body 70, above corresponding staple drivers 43. In In particular, each clamp 47 is driven vertically on the cartridge body 70 by a clamp driver 43 to push the clamp 47 out through an associated clamp opening 51. As best seen in Figures 4A, 4B and 6, the wedge slide 41 features sloping meat surfaces that force the clamp actuators 43 upward as the slide slides
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Wedge 13/56 41 is pushed distally through the staple cartridge 37.
[0041] In some versions, the staple cartridge 37 is constructed and operable in accordance with at least some of the teachings of US Patent Publication No. 2014/0239042, entitled Integrated Tissue Positioning and Jaw Alignment Features for Surgical Stapler, published on August 28, 2014, the description of which is incorporated herein by reference. In addition or alternatively, the staple cartridge 37 can be constructed and operable in accordance with at least some of the teachings of US Patent Publication No. 2014/0239044, entitled Installation Features for Surgical Instrument End Effector Cartridge, published on August 28 2014, the description of which is incorporated here for reference. Other suitable forms that the staple cartridge 37 can take will be apparent to those skilled in the art in view of the teachings of the present invention.
[0042] With the end actuator 12 closed as shown in Figures 4A and 4B by means of the distal advance of the closing tube 32 and the closing ring 33, the firing bar 14 is then advanced and placed in engagement with the anvil 18 when the upper pin 38 enters the longitudinal anvil slot 42. A pusher block 80 (shown in Figure 5) is located at the distal end of the firing bar 14, and is configured to engage the wedge slide 41, so that the slide wedge 41 is pushed distally by the pusher block 80 as the firing bar 14 is advanced distally through the staple cartridge 37 when the firing trigger 28 is actuated. During such firing, the cutting edge 48 of the firing bar 14 enters the vertical slot 49 of the staple cartridge 37, cutting the tissue trapped between the staple cartridge 37 and the anvil 18. As shown in Figures 4A and 4B, the middle
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14/56 and the pusher block 80 act together on the staple cartridge 37 by penetrating the vertical slot 49 in the staple cartridge 37, pushing the wedge slide 41 and placing it in contact with the staple actuators 43 which, for in turn, push the clamps 47 out through the clamp openings 51 and place them in contact with clamp forming pockets 53 (shown in Figure 3) on the inner surface of the anvil 18. Figure 4B shows the firing bar 14 fully translated distally after the fabric has been cut and stapled. It should be understood that the staple-forming pockets 53 are intentionally omitted in Figures 4A and 4B; however, staple-forming pockets 53 are shown in Figure 3. It should also be understood that anvil 18 is intentionally omitted in Figure 5.
[0043] Figure 7 shows the end actuator 12 that was actuated for a single stroke through the fabric 90. As shown, the cutting edge 48 (omitted in Figure 7) cuts through the fabric 90, while the clip drivers 43 implant three alternating rows of staples 47 on the fabric 90 on each side of the cutting line produced by the cutting edge 48. Staples 47 are all oriented substantially parallel to the cutting line in this example, although it should be understood that staples 47 can be positioned in any suitable orientations. In the present example, end actuator 12 is removed from the trocar after the first stroke is completed, the consumed staple cartridge 37 is replaced with a new staple cartridge, and end actuator 12 is then reinserted through the trocar to reach the stapling site for additional cutting and stapling. This process can be repeated until the desired number of cuts and staples has been provided. It may be necessary to close anvil 18 to facilitate insertion and removal through the trocar; and can be
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15/56 it is necessary to open the anvil 18 to facilitate the replacement of the staple cartridge 37.
[0044] It should be understood that the cutting edge 48 can cut the fabric substantially contemporary to the implantation of staples 47 in the fabric during each actuation stroke. In the present example, the cutting edge 48 has a small delay in relation to the implantation of the staples 47, so that a staple 47 is pushed through the fabric just before the cutting edge 48 passes through the same region of the fabric, although it should be understood that this order can be reversed or that the cutting edge 48 can be directly synchronized with the adjacent staples. Although Figure 7 shows the end actuator 12 being actuated in two layers 92, 94 of fabric 90, it should be understood that the end actuator 12 can be actuated through a single layer of fabric 90 or more than two layers 92 , 94 of fabric. It should also be understood that the formation and positioning of staples 47 adjacent to the cutting line produced by the cutting edge 48 can substantially seal the tissue at the cutting line, thereby reducing or preventing bleeding and / or leakage from other body fluids in the cut-line. In addition, although Figure 7 shows the end actuator 12 being actuated in two juxtaposed flat layers 92, 94 of substantially flat tissue, it should be understood that the end actuator 12 can also be acted along a tubular structure as a blood vessel, a section of the gastrointestinal tract, etc. Figure 7 should not, therefore, be seen as a demonstration of any limitation of the uses contemplated for the end actuator 12. Various suitable scenarios and procedures in which the instrument 10 can be used will be apparent to those skilled in the art based on the teachings of present invention.
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16/56 [0045] In one version, instrument 10 provides motorized control of the firing bar 14. Exemplary components that can be used to provide motorized control of the firing bar 14 are shown and described in US Patent Publication No. 2014 / 0239043, entitled Distal Tip Features for End Effector of Surgical Instrument, published on August 28, 2014, the description of which is incorporated herein by reference. In addition to, or in place of, that was previously mentioned, at least part of the motorized control can be configured in accordance with at least some of the teachings of US Patent No. 8,210,411, entitled Motor-Driven Surgical Instrument, filed in 3 July 2012, the description of which is hereby incorporated by reference. In addition to or in place of what was previously mentioned, the operable resources for activating the firing bar 14 can be configured in accordance with at least some of the teachings of US Patent Publication No. 2012/0239012, the description of which is incorporated herein by way of of reference; and / or in accordance with at least some of the teachings of US Patent Publication No. 2012/0239012, the description of which is also incorporated by reference in the present invention. Other components, features and configurations suitable to provide the firing of the firing bar 14 will be evident to those skilled in the art, in view of the teachings of the present invention. It should also be understood that some other versions can provide manual activation of the firing bar 14, so that the engine can be omitted. By way of example only, the firing bar 14 can be operated in accordance with at least some of the teachings of any other reference to patents / publications cited in the present invention.
[0046] Instrument 10 may also include a locking key and a locking indicator as shown and described
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17/56 in US Publication No. 2014/0239043, entitled Distal Tip Features for End Effector of Surgical Instrument, published on August 28, 2014, the description of which is incorporated herein by reference. In addition, a locking key and / or lock indication 110 and associated components / features can be configured in accordance with at least some of the teachings of US Patent No. 7,644,848, entitled Electronic Lockouts and Surgical Instrument Including Same, granted in January 12, 2010, the description of which is incorporated by reference.
[0047] Instrument 10 also includes a manual return switch 116 configured to act as a retract feature, allowing the operator to quickly start retracting the firing bar 14 proximally during a firing stroke. In other words, the manual return switch 116 can be actuated manually when the firing bar 14 has only been partially distally advanced. The manual return key 116 can additionally provide functionality in accordance with at least some of the teachings of US Publication No. 2014/0239043, entitled Distal Tip Features for End Effector of Surgical Instrument, published on August 28, 2014, the description of which is incorporated herein by way of reference.
[0048] In describing the operation of the instrument 10, the use of the pivoting term and similar terms with the pivot base should not be read as necessarily requiring pivoting movement around a fixed geometric axis. In some versions, the anvil 18 rotates around a geometric axis that is defined by a pin (or similar feature) that slides along an elongated slot or a channel as the anvil 18 moves towards the lower claw 16. In In such versions, the geometric pivot axis moves along the path defined by the slot or channel while the anvil 18 pivots simultaneously in
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18/56 around that geometric axis. In addition, or alternatively, the pivot geometry axis can slide first along the slit / channel, with the anvil 18 then pivoting around the pivot geometry axis after the pivot geometry axis has slid a certain distance along the slit. /channel. It should be understood that such a sliding / transfer pivoting movement is covered by terms such as pivoting, pivots, pivoting, rotating, articulated and the like. Obviously, some versions may provide pivoting movement of the anvil 18 around a geometric axis that remains fixed and not translated into a slot or channel, etc.
[0049] It should be understood that instrument 10 can be configured and operable in accordance with at least some of the teachings of US Patent Application No. 4,805,823; US Patent No. 5,415,334; US Patent No. 5,465,895; US Patent No. 5,597,107; US Patent No. 5,632,432; US Patent No. 5,673,840; U S Patent No. 5,704,534; US Patent No. 5,814,055; US Patent No. 6,978,921; Pay US No. 7,000,818; US Patent No. 7,143,923; US Patent No. 7,303,108; US Patent No. 7,367,485; US Patent No. 7,380,695; U S Patent No. 7,380,696; US Patent No. 7,404,508; US Patent No. 7,434,715; Pay US No. 7,721,930; US Publication No. 2010/0264193; and / or 2 012/0239012. As indicated above, the disclosures of each of these patents and publications are hereby incorporated by reference. Additional exemplary modifications that can be provided for instrument 10 will be described in more detail below. Various suitable ways in which the teachings below can be incorporated into instrument 10 will be evident to those skilled in the art. Similarly, several suitable ways in which the teachings below can be combined with the various teachings of the patents / publications cited in the present invention will be apparent to those skilled in the art. It should also be understood
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19/56 that the teachings below are not limited to the instrument 10 or the devices taught in the patents cited in the present invention. The teachings below can be readily applied to several other types of instruments, including instruments that would not be classified as surgical staplers. Various other suitable devices and scenarios to which the teachings below can be applied will be apparent to those skilled in the art based on the teachings of the present invention.
IL Exemplary end actuator with visualization, insertion point and collection features [0050] In some cases, it may be desirable to provide the user with a better view of end actuator 12. In particular, as end actuator 12 is inserted at a surgical site, the user can rotate the drive shaft 22 of the instrument 10 during the procedure. As a result, end actuator 12 also rotates. As the end actuator 12 rotates, it may be desirable for the user to have visual access to the surgical site. For example, the user may wish to see the interface or contact between the fabric 90 and the end actuator 12. Since the end actuator 12 can be rotated about the longitudinal axis LA relative to the handle portion 20, the the user can see the surgical site so that the lower claw 16 of the end actuator is visible instead of the anvil 18. Alternatively, the end actuator 12 can be rotated so that when the user sees the end actuator 12, the anvil 18 is visible to the user. It may be desirable to provide visibility of the surgical site to the user beyond what is possible in the instrument 10 in Figure 1. For example, in the case of some surgical procedures where the fluid transport vessels are transected and stapled, it may be desirable to have visual confirmation that the anvil 18 and the lower claw
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20/56 completely cover the vessel to be cut, so that the vessel can be completely cut and stapled in a single actuation. In other words, the user may want to avoid cutting and stapling only a portion of a vase. Therefore, some means of monitoring and / or visual feedback can be desirable to let the user know that the end actuator 12 has been properly positioned in the surgical site for the anvil 18 and the lower claw 16 to fully grip the vessel. A potential way of monitoring the surgical site may include improving the visualization of the area adjacent to the distal tip of the lower jaw 16 and the anvil 18. In addition, not only can the visualization of the distal end of the end actuator 12 be desirable, but it can also it is desirable to construct the end actuator 12 so that the distal end of the anvil 18 is configured to push the fabric, for example, a large vessel proximally into the space between the anvil 18 and the lower claw 16 as the anvil 18 closes in towards the lower jaw 16.
[0051] Figure 8 shows an example end actuator 212 comprising an anvil 218 and a lower claw 216. It will be understood that end actuator 212 can be used in place of end actuator 12 of instrument 10. The end actuator 212 can be integrally formed with instrument 10 or, alternatively, it can be interchangeable with end actuator 12 of instrument 10.
[0052] The anvil 218 is intended to pivot in relation to the lower jaw 216. The anvil 218 and the lower jaw 216 can hold the fabric 90 in a similar way to the grip made by the anvil 18 and the lower jaw 16 shown in Figure 1. The End actuator 212 further comprises a cartridge 237 operable to be placed in the lower jaw 216 in a similar manner to the cartridge 37 shown in Figure 3.
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21/56 [0053] Anvil 218, as can be seen in Figures 8 to 10, has an elongated shape where the distal portion of anvil 218 is angled towards cartridge 237. The distal portion of anvil 218 is angled towards cartridge 237 so that the most distal tip 219 of the anvil 218 extends distally longitudinally beyond the cartridge 237. Although in some versions the distal tip 219 may extend a distance longitudinally equal to the cartridge 237 or proximal to the most distal in cartridge 237. In addition, anvil 218 is angled towards cartridge 237 through a smooth slope. As best seen in Figure 10, anvil 218 includes sides 241 that taper as they approach the most distal tip 219 of anvil 218. As an example, anvil 218 has a shape, in Figure 8, similar to that of a inverted ski The angled shape of the anvil 218 can provide easier insertion of the end actuator 212 into a surgical site. For example, the smooth slope or inverted ski tip shape of the anvil 218 can provide an atraumatic deflection surface of the fabric as the anvil 218 contacts or moves through the fabric. Such atraumatic deflection of the tissue may include pushing the tissue for example, a large vessel proximally into the space between the anvil 218 and the lower jaw 216 as the anvil 218 closes towards the lower jaw 216. When placed in a surgical location, the angled shape of anvil 218 can also provide better maneuverability of end actuator 212 and better visibility of the distal end of end actuator 212 in relation to anatomical structures at the surgical site. Other suitable variations of the anvil 218 will be apparent to those skilled in the art in view of the teachings of the present invention.
[0054] The purpose of the 237 cartridge is to contain staples similar to staples 47 shown in Figure 4A for insertion into the fabric.
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As shown in Figure 9, the distal end of cartridge 237 has a triangular profile. In particular, the distal end of the cartridge 237 comprises an upper tapered surface 239 and a lower tapered surface 238. Additionally, the distal end of the cartridge 237 comprises a tapered side surface 243 on each side. In the present example, each tapered side surface 243 of cartridge 237 generally aligns with the taper shown by sides 241 of anvil 218. Thus, as shown in Figure 10, side surfaces 243 of cartridge 237 do not extend outwardly from the longitudinal geometric axis LA of the end actuator 212 in addition to the sides 241 of the anvil 218. The upper tapered surface 239 and the lower tapered surface 238 end at the most distal end of the cartridge 237. The lower tapered surface 238 defines a line of sight 240 so that when end actuator 212 is inserted into a surgical site, the user can see along line of sight 240. Line of sight 240 extends along the edge of the lower tapered surface 238. It will be understood that the flat shape of the bottom tapered surface 238 can be operable to allow the user to see and / or almost see the distal tip 219 of the anvil 218. In particular, the line of sight 240 crosses the longitudinal geometric axis LA, which extends longitudinally through end actuator 212, to form a viewing angle Θ.
[0055] The viewing angle Θ can establish the relative visibility that a user has of distal tip 219. In particular, the user can see ahead of distal tip 219 along any line of sight that passes through the intersection of the view 240 and longitudinal geometric axis LA at viewing angle Θ. For example, as the viewing angle Θ increases, the user would have greater visibility of the area immediately in front of distal tip 219 from proximal vantage points; when the viewing angle Θ decreases, the user has
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23/56 less visibility of the area in front of the distal tip 219 from the proximal vantage points. In some versions, the viewing angle Θ defines an angle greater than 90 degrees. Additionally, in some versions, the viewing angle Θ defines an angle greater than 135 degrees. Other angles suitable for the viewing angle Θ will be evident to those skilled in the art in view of the teachings of the present invention. In the illustrated version, the user usually looks along line of sight 240 or along some other line of sight within the angle of view Θ, so the user has visibility along the line of sight as well as any area within the angle of view. vision θ. The underside of distal tip 219 is additionally slightly rounded to aid in the visibility of the intersection of the longitudinal LA axis with line of sight 240.
[0056] When tissue 90 is trapped between a closed cartridge 237 and anvil 218, the user can look along line of sight 240 or elsewhere within the viewing angle Θ to see, for example, precisely where anvil 218 attached the fabric 90. In addition, the user would be able to determine if the fabric is completely trapped between the anvil 218 and the cartridge 237 so that the fabric does not extend beyond the end of the end actuator 212. The user may also have ability to see the quality of the grip between the anvil 218 and the cartridge 237 against the fabric 90.
[0057] It will be understood that, in some cases, end actuator 212 can be rotated before, during or after gripping tissue 90. As a result, the tapered shape of anvil 218 can also provide more accessible view of distal tip 219 or substantially adjacent to distal tip 219. Tapering anvil 218 together with the bottom tapered surface 238 of cartridge 237 can additionally provide easier insertion than
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24/56 end actuator 212 in the tissue in an atraumatic manner. In addition, it may be easier to attach end actuator 212 through a trocar or other operable devices to introduce end actuator 212 into a surgical site due to the tapered end of end actuator 212. For example, since the distal tip 219 is attached to a trocar, the lower tapered surface 238 and the tapered shape of the anvil 218 can provide an insertion tip that guides the rest of the end actuator 212 in the trocar. In view of the teachings of the present invention, those skilled in the art will additionally recognize that visibility and maneuverability can be improved by the tapered design of both sides 241 of the anvil 218 and each side 243 of the cartridge 237.
[0058] In addition to the above, end actuator 212 and versions of instrument 10 incorporating end actuator 212 can be configured and operable in accordance with at least some of the teachings of US Patent Document No. 2014 / 9,186,142, entitled Surgical Instrument End Effector Articulation Drive with Pinion and Opposing Racks, published on November 17, 2015, the description of which is incorporated by reference, in US publication No. 2014/0239041, entitled Lockout Feature for Movable Cutting Member of Surgical Instrument , published on August 28, 2014, the description of which is incorporated herein by reference; US Patent Document No. 2014 / 9,517.0 65, entitled Integrated Tissue Positioning and Jaw Alignment Features for Surgical Stapler, published on August 13, 2016, the description of which is incorporated herein by reference; US publication No. 2014/0239036, entitled Jaw Closure Feature for End Effector of Surgical Instrument, published on August 28, 2014, the description of which is incorporated herein by reference; in US publication No. 2014/0239043,
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25/56 entitled Distal Tip Features for End Effector of Surgical Instrument, published on August 28, 2014, the description of which is incorporated herein by reference; US publication No. 2014/0239037, entitled Staple Forming Features for Surgical Stapling Instrument, published on August 28, 2014, the description of which is incorporated herein by reference; US Publication No. 2014/0239038, entitled Surgical Instrument with Multi-Diameter Shaft, published on August 28, 2014, the description of which is incorporated herein by reference; and / or US publication No. 2014/0239044, entitled Installation Features for Surgical Instrument End Effector Cartridge, published on August 28, 2014, the description of which is incorporated herein by reference. Additional modifications that can be incorporated into the 212 end actuator will be described in more detail below.
Ill · Exemplary end actuator with rigid curved anvil tip [0059] As noted above, the distal end configuration of end actuator 212 is different from the distal end configuration of end actuator 12: the different configuration of end actuator 212 provides different potential advantages. In particular, the configuration of the distal end of the end actuator 212 can provide improved maneuverability and improved visibility of the relationship between the distal end of the end actuator 212 and adjacent anatomical structures. In addition, the configuration of the distal end of the end actuator 212 can provide tissue collection effects by proximally pushing the tissue into the space between the anvil 218 and the lower jaw 216 as the anvil 218 is closed towards the jaw lower 216. In some cases, it may be desirable to provide an end actuator that has an angled distal anvil end configuration similar to that of anvil 218; and additionally
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26/56 also having a cartridge with a distal end configuration similar to that of cartridge 37. With a hybrid end actuator that has an anvil similar to anvil 218 and a cartridge similar to cartridge 37, the angled distal portion of the anvil may have a relatively steeper flexion angle, which can further promote tissue gripping effects as described in the present invention. The following description provides examples of end actuators that combine structural aspects of the anvil 218 and structural aspects of the cartridge 37, along with other structural features.
A. Exemplary cartridge and anvil orientation [0060] Figures 11 to 13 show an exemplary end actuator 312 comprising an anvil 318 and a lower jaw 316. It will be recognized that end actuator 312 can be used in place of the end actuator end 12 of instrument 10. The end actuator 312 can be integrally formed with instrument 10 or, alternatively, it can be interchangeable with end actuator 12 of instrument 10. The anvil 318 can pivot in relation to the lower claw 316. The anvil 318 and the lower jaw 316 can hold the fabric 90 similarly to the grip made by the anvil 18 and the lower jaw 16 shown in Figure 1. The end actuator 312 further comprises a cartridge 337 which can be placed in the lower jaw 316 so similar to cartridge 37 shown in Figure 3.
[0061] Anvil 318 comprises staple pockets 353, which are similar to staple pockets 53 of anvil 18. Anvil 318 further comprises an anvil slot 342 which is similar to anvil slot 42 of anvil 18. The difference between anvil 318 and anvil 18 is that the anvil 318 comprises an angled tip 319 at its distal end. For
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27/56 use in the present invention, terms such as angled, angled and curved should be understood as synonymous with each other when referring to the configuration of a distal end of a component of an end actuator. In other words, the slanted and curved terms (and their variations) can include a relationship between two straight features that define an angle together, so that the slanted and curved terms (and their variations) should not be understood as indicating that a component necessarily extends over an arc. In the present example, tip 319 is non-deflectable and thus tip 319 maintains its shape. Otherwise described, the tip 319 of the present example is rigid. In the present example, the anvil 318 and the associated tip 319 are made of metal, although other materials, such as plastic, ceramic and others, can be used as will be apparent to those skilled in the art in view of the teachings of the present invention.
[0062] The tip 319 comprises an outer surface 320 with a blunt end 321. Proximal to the tip 319, the anvil 318 comprises a body portion 322 that extends in a straight manner. In the illustrated example, the body portion 322 forms most of the anvil 318 so that most of the anvil 318 is straight. Referring to Figure 12, the anvil 318 further comprises an inner surface 324 along the point 319, and a lower surface 326 along the body portion 322 where the staple forming pockets 353 are located. In the present example, where the tip
319 has an inclined or angled configuration, the outer surface
320 and the inner surface 324 are angled with respect to the linear portion of the body 322 and the lower surface 326 of the anvil 318.
[0063] The cartridge 337 of the end actuator 312 comprises the distal tip 339. The tip 339 comprises the angled surface 341, the blunt end 343 and the curved bottom side 344. According to
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28/56 shown in Figures 13 and 14, when end actuator 312 is closed, blunt end 321 is longitudinally flush with blunt end 343 of cartridge 337. In this way, blunt end 321 and blunt end 343 end in the same longitudinal position, for example, so that blunt end 321 and blunt end 343 end in the same plane that extends perpendicularly through the longitudinal geometric axis of end actuator 312. In view of the teachings of the present invention, it will be apparent to those skilled in the art. technique that, in other examples, blunt end 321 may be located proximally to blunt end 343 of cartridge 337 when end actuator 312 is closed. Similarly, in some other examples, end actuator 312 can be configured so that the blunt end 321 of anvil 318 extends distally from the blunt end 343 of cartridge 337 when end actuator 312 is closed. Also in view of the teachings of the present invention, it will be apparent to those skilled in the art that, in other examples, one or both blunt ends 321,343 can be modified so that they do not have a blunt configuration, or that they may not have a blunt configuration and can be protected by a shield or a blunt cover.
[0064] Figure 14 illustrates an enlarged view of the distal end of the end actuator 312, shown in the closed position. As shown, in the closed position the inner surface 324 comes in partial contact with the angled surface 341 at the distal end of the end actuator 312. More proximally along the inner surface 324 and the angled surface 341, there is a gap or space 345 between the inner surface 324 and the angled surface 341 when end actuator 312 is closed.
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As shown in Figure 11, cartridge 337 comprises an upper platform 372. As shown in Figure 14, the upper platform 372 defines a plane P1. Similarly, the inner surface 324 defines a plane P2 and the angled surface 341 defines a plane P3. As also shown in Figure 14, the distal end of the end actuator 312 defines a vertical VA axis. The vertical geometric axis VA is generally orthogonal to the plane P1 defined by the upper platform 372.
[0065] Referring to Figure 14, with the configuration described above, as the inner surface 324 comes into partial contact with the angled surface 341 when the end actuator 312 is closed, the inner surface 324 is steeper compared to surface at an angle 341 to the VA vertical axis. For example, this is shown by the angle a4 formed at the intersection of the plane P2 with the vertical geometric axis VA which is smaller compared to the angle a3 formed at the intersection of the plane P3 with the vertical geometric axis VA. This steeper orientation associated with the inner surface 324 compared to the angled surface 341 is also shown by the angle a1 formed at the intersection of the plane P2 with the plane P1 which is smaller compared to the angle a2 formed at the intersection of the plane P3 with the plan P1.
[0066] In the present example, the inner surface 324 forms the angle a1 of about 35 degrees with the plane P1, which is the plane defined by the upper platform 372 as described above. In comparison, the angled surface 341 forms an angle a2 of about 25 degrees with the plane P1. Thus, in the present example, the inner surface 324 forms or defines the angle a1 with the plane P1 of about 10 degrees greater than the angle a2 formed or defined by the angled surface 341 and the plane P1. On the other hand, it could be said that the angled surface 341 forms or defines the angle a2 with the plane
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P1 of about 10 degrees less than the angle a1 formed or defined by the inner surface 324 and the plane P1.
[0067] Also in the present example, the inner surface 324 forms an a4 angle of about 55 degrees with the vertical geometric axis VA, which is the geometric axis defined by the distal end of the end actuator 312 as described above. In comparison, the angled surface 341 forms an a3 angle of about 65 degrees with the vertical VA axis. Thus, in the present example, the inner surface 324 forms or defines angle a4 with a vertical geometric axis VA of about 10 degrees less than the angle a3 formed or defined by the angled surface 341 and the vertical geometric axis VA. On the other hand, it could be said that the angled surface 341 forms or defines angle a3 with the vertical geometric axis VA of about 10 degrees greater than the angle a4 formed or defined by the inner surface 324 and the vertical geometric axis VA. In view of the teachings of the present invention, various modifications to the tips 319, 339 to modify the angles described above will become apparent to those skilled in the art.
B · Exemplary longitudinal anvil cracks and bottom surface [0068] In some cases, where the anvils have slanted tips, certain modifications can be made to the crevices and the bottom surface of the anvil to provide possible improvements in cutting and stapling. Some of these modifications or modified anvils are described below, and others will be evident to those skilled in the art in view of the teachings of the present invention.
[0069] Figure 15 shows a sectional view of anvil 318 illustrating anvil slot 342. As shown, slot 342 comprises a partial I-shape in cross section. In this way, the slot 342 comprises side portions 347 and a portion of top hat 355. The firing bar 314, which is similar to the firing bar
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31/56 firing 14 described above, is positionable in slot 342 in the same way that firing bar 14 is positionable in slot 42, as described above. As shown in the illustrated example in Figure 15, an upper pin 338 comprises a rectangular profile, so that the upper pin 338 is positioned in the side portions 347 of the slot 342. Additionally, a firing bar 314 partially extends in the top portion 355 The firing bar 314 and end actuator 312 are operable to perform a cutting and stapling action in the same manner as described above with respect to end actuator 12 and firing bar 14.
[0070] As seen in the example illustrated in Figure 15, the anvil 318 additionally comprises step portions 349 along each external side of the anvil 318 and which extend longitudinally. Each step portion 349 includes a row of staple forming pockets 353 in the present example. The step portions 349 are configured so that the bottom surface 326 of the anvil 318 comprises step portions 349, as well as lower portions 351. As shown in Figure 15, the lower portions 351 are present along each side of the slot. longitudinally extending anvil 342, and the lower portions 351 each include two rows of staple forming pockets 353. As described above, the stepped portions 349 are vertically displaced from and parallel to the lower portions 351 from the lower surface 326 of the anvil 318. In view of the teachings of the present invention, other configurations for the lower surface 326 of the anvil 318 and, in particular for the step portions 349 and lower portions 351, will be apparent to those skilled in the art. For example, in some instances the configuration for the bottom surface 326 complements the configuration of the upper platform 372 of cartridge 337. For example, cartridge 337 may have an upper platform of
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32/56 multiple levels 372 where elevated portions coincide with vertically displaced step portions 349.
[0071] Figure 16 shows a sectional view of another example anvil 418 for use with end actuator 312. Anvil 418 is similar in all aspects to anvil 318 except for its cross section, as described here. In this way, anvil 318 can be modified to incorporate the cross section of anvil 418 described below, instead of the cross section illustrated in Figure 15. Anvil 418 comprises anvil slot 442. As shown, slot 442 comprises a shape in Partial I in cross section. The partial I-shape of the slot 442 is modified from that shown in Figure 15 in relation to the anvil slot 342. For the anvil slot 442, the slot 442 comprises side portions 447 and the top portion 455. While the side portions 347 have a rectangular profile shape with straight ends, the side portions 447 have curved ends. The firing bar 414, which is similar to the firing bar 14 described above, is positionable in slot 442 in the same way that firing bar 14 is positionable in slot 42, as described above. As shown in the illustrated example in Figure 16, an upper pin 438 comprises a profile corresponding to the side portions 447 of the slot 442, so that the upper pin 438 is positioned in the side portions 447 of the slot 442. Additionally, a firing bar 414 extends partially in top hat portion 455, but to a lesser extent in comparison with firing bar 314 and top hat portion 355 of Figure 15, as described above. The firing bar 414 and end actuator 312 are operable to perform a cutting and stapling action in the same manner as described above with respect to end actuator 12 and firing bar 14.
[0072] With the anvil 418 and the slot 442, the clearance of the
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33/56 top hat 455 is represented by the distance over which the top hat portion 455 extends from the side portion 447. With the anvil 418 and the slot 442, the head hat portion 455 is less compared to the head gap top hat 355. Another difference between side portions 347 of anvil 318 and side portions 447 of anvil 418 is that the width of side portions 347 is greater than the width of side portions 447. This width of side portions 347, 447 defines the path in side portions 337, 447 to receive and retain the respective pins 338, 438, as described above.
[0073] Anvil 418 also differs from anvil 318, as shown in Figures 15 and 16, in which anvil 418 lacks stepped portions 349 as with anvil 318. Instead, anvil 418 comprises a uniformly flat bottom surface 426 , where the slot 442 divides the bottom side surface 426 into two sides, each side having three rows of staple forming pockets 453. In addition, compared to the anvil 318, the anvil 418 comprises a slightly wider profile slender in which the distance from the upper surface of the anvil 418 to the lower surface 426 is smaller compared to the same distance in the anvil 318. In view of the teachings of the present invention, it will be evident to those skilled in the art that, in other versions , anvil 418 can be modified in terms of dimensions and / or alteration of the bottom surface 426 to include step portions equal to or similar to step portions 349 of anvil 318.
C · Exemplary anvil tips [0074] In some cases, modifications may be made to the anvil tip to provide possible additional tissue capture benefits. Some of these modifications or modified anvil tips are described below, and others will be evident to those skilled in the art in view of the teachings in the present
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34/56 invention.
[0075] Figure 17 illustrates another example anvil 518 that can be used with end actuator 312 in place of anvil 318. Anvil 518 comprises an inclined tip 519, which is similar to the angled tip 319 described above. The tip 519 comprises the inner surface 524, which is similar to the inner surface 324 described above. However, the inclined tip 519 further comprises the projection 521 at its distal end. Projection 521 extends away from the inner surface 524 towards cartridge 337 when in use. Projection 521 comprises a flat surface 523 configured to make contact with the angled surface 341 of tip 339 of cartridge 337 when end actuator 312 is closed. The projection 521 further comprises the flange 525. The flange 525 extends transversely across the entire width of the tip 519.
[0076] When the end actuator 312 is closed, the projection 521 is intended to promote tissue capture and prevent the tissue from moving outwardly from the distal end of the end actuator 312. As an example, the projection 521 provides direct contact between tip 519 and tip 339 of cartridge 337, but at the same time, it provides a gap or space 345 proximal to the contact area, as described above. The space 345 provides a region where the tissue can be collected without being squeezed distally out from the distal end of the end actuator 312. In the examples using the anvil 518 with its projection 521, the gap or space 345 may be larger in comparison with examples of anvil tips without projection 521. In other words, in some examples, but not necessarily mandatory in all examples, when end actuator 312 is closed, through contact with tip 339, projection 521 is configured to decrease the angle
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35/56 that a plane defined by the inner surface 524 forms with the plane P1 defined by the upper platform 372. Thus, the inner surface 524 is steeper in relation to the upper platform 372 compared to the angled surface 341 of the cartridge 337 with respect to to the upper platform 372.
[0077] The tip 519 is additionally optionally configured as an insert for the body portion 522 of the anvil 518. In the present example, the longitudinal slot 542 ends with an opening 527 which is configured to receive a proximal member of the tip 519 so that the tip 519 is a rigid insert for the body portion 522 of the anvil 518. Some additional exemplary end actuators that have angled anvil tips insertable into the anvil body portions are described in US Patent Application No. of power of attorney document END8116USNP .0641882, entitled Surgical Stapler with Ready State Indicator, deposited on the same date as this application, whose description is hereby incorporated by reference; and also in US Patent Application No. of power of attorney document END8117USNP.0641884], entitled Surgical Stapler with Anvil Seating Detection, filed on the same date as this application, the description of which is incorporated herein by reference; Obviously, in other versions, the tip 519 is formed with the anvil 518 as a single piece and not an insert. In such cases, opening 527 can be omitted.
[0078] Figure 18 illustrates another example anvil 618 that can be used with end actuator 312 in place of anvil 318. Anvil 618 comprises an inclined tip 619, which is similar to the angled tip 319 described above. The tip 619 comprises the inner surface 624, which is similar to the inner surface 324 described above. However, the inclined tip 619 additionally comprises the projection 621 at its distal end. The 621 projection extends
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36/56 opposite the inner surface 624 towards cartridge 337 when in use. Projection 621 comprises a bulbous convex surface 623 which is configured to make contact with the angled surface 341 of tip 339 of cartridge 337 when end actuator 312 is closed.
[0079] When the end actuator 312 is closed, the projection 621 is intended to promote tissue capture and prevent the tissue from moving outwardly from the distal end of the end actuator 312. As an example, the projection 621 provides direct contact between tip 619 and tip 339 of cartridge 337, but at the same time, it provides a gap or space 345 proximal to the contact area, as described above. The space 345 provides a region where the tissue can be collected without being squeezed distally out from the distal end of the end actuator 312. In the examples using the anvil 618 with its 621 projection, the gap or space 345 may be larger in comparison with examples of anvil tips without projection 621. In other words, in some examples, but not necessarily mandatory in all examples, when end actuator 312 is closed, through contact with tip 339, projection 621 is configured to decrease the angle that a plane defined by the inner surface 624 forms with the plane P1 defined by the upper platform 372. Thus, the inner surface 624 is steeper in relation to the upper platform 372 compared to the angled surface 341 of the cartridge 337 in relation to the upper platform 372.
[0080] The tip 619 is additionally optionally configured as an insert for the body portion 622 of the anvil 618. In the present example, the longitudinal slot 642 ends with an opening 627 which is configured to receive a proximal member of the tip 619 so that the 619 tip is a rigid insert for the body portion
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622 of anvil 618. Some additional exemplary end actuators that have angled anvil tips insertable into the anvil body portions are described in US Patent Application No. proxy document END8116USNP.0641882, entitled Surgical Stapler with Ready State Indicator, filed on the same date as this application, the description of which is hereby incorporated by reference; and also in US Patent Application No. [ower of attorney document END8117USNP.0641884], entitled Surgical Stapler with Anvil Seating Detection, filed on the same date as this application, the description of which is hereby incorporated by reference. Obviously, in other versions, the tip 619 is formed with the anvil 618 as a single piece and not an insert. In such cases, opening 627 can be omitted.
[0081] In view of the teachings of the present invention, other ways of modifying the tips 319, 519, 619 of the respective anvils 318, 518, 618 to provide a uniform flat surface or one or more projections, as described above, will be apparent to those skilled in the art. in the technique. As will be understood in view of the teachings of the present invention, the angle associated with the angled angled tips, and / or additional features such as the projections described above, can help to capture the tissue, which also benefits walking applications as described above.
D · Exemplary cartridge options [0082] As will be described later, with end actuators that incorporate rigid angled tips, improved tissue gripping can be achieved using end actuators that have anvil tips and cartridge noses with cooperating resources. Such cooperating features may provide a fabric latch or stop that prevents trapped tissue from moving distally out of the distal end of the end actuator
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38/56 during a cutting and stapling action. Such cooperating features can also act as a tactile feedback feature to signal a user that they have completely attached the tissue, vessel or tubular structure, by the tactile feeling that the cooperating features have engaged or come into contact with the distal end. In gait applications, such cooperating elements can similarly act as a feedback feature or a structure to signal the user that he is at the end of the fabric path, as evidenced by the cooperating features that engage or contact the distal end as opposed to respective cooperating resources each come into contact with the fabric. In addition, in some cases, modifications can be made to the cartridge's upper platform configuration to provide possible improvements in cutting and stapling. Some of these modifications or modified cartridges are described below, and others will be apparent to those skilled in the art in view of the teachings in the present invention.
[0083] Figure 19 shows a distal portion of another exemplary end actuator 712 comprising anvil 718, lower jaw 716 and cartridge 737. It will be understood that end actuator 712 can be used in place of end actuator 12 of instrument 10. The end actuator 712 can be integrally formed with the instrument 10 or, alternatively, it can be interchangeable with the end actuator 12 of the instrument 10. The anvil 718 is intended to pivot in relation to the lower claw 716. The anvil 718 and the lower jaw 716 can hold the fabric 90 in a similar way to the grip made by the anvil 18 and the lower jaw 16 shown in Figure 1. The purpose of the cartridge 737 is to be placed in the lower jaw 716 in a similar way to the cartridge 37 shown in Figure 3.
[0084] The anvil 718 comprises an inclined tip 719 which is
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39/56 similar to the tip 619 described above, the tip 719 comprising a bulbous convex surface 723. The cartridge 737 comprises a recess or a ball-shaped indentation 725 that is shaped to complement the surface 723. In the present example, the rigid bulbous surface 723 of tip 719 and recess 725 are cooperative features configured to promote tissue capture. In one version, end actuator 712 is configured so that when end actuator 712 is closed, the rigid anvil tip 719 with the bulbous surface 723 does not come into contact with cartridge 737. In such cases, when attaching the tissue in a walking application, the bulbous surface 723 of the anvil tip 719 can push tissue 90 into recesses 725 and retain tissue 90 therein under compression to provide secure tissue capture during a cutting and stapling operation. In still other versions, the end actuator 712 can be configured so that the bulbous surface 723 contacts the recess 725 during the gripping. In such cases, when the fabric is attached in a walking application, the tactfully detected contact between the bulbous surface 723 and the recess 725 can act as a feedback device to detect the final cut in the walking operation as described above. In view of the teachings of the present invention, shapes other than the bulbous surface 723 and ball-shaped cutout 725 can be used to provide similar functionality, and such other shapes or modifications will be apparent to those skilled in the art in view of the teachings of present invention.
[0085] Figure 20 shows a distal portion of another example end actuator 812 comprising anvil 718 and lower jaw 716 as described above. The end actuator 812 additionally comprises a cartridge 837. It will be understood that
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40/56 the end actuator 812 can be used in place of the end actuator 12 of the instrument 10. The end actuator 812 can be integrally formed with the instrument 10 or, alternatively, it can be interchangeable with the end actuator 12 of the instrument 10. The anvil 718 is intended to pivot in relation to the lower jaw 716. The anvil 718 and the lower jaw 716 can hold the fabric 90 in a similar way to the grip made by the anvil 18 and the lower jaw 16 shown in Figure 1. The cartridge 837 is intended to be placed in the lower jaw 716 similarly to the cartridge 37 shown in Figure 3.
[0086] The anvil 718 comprises an inclined tip 719 which is similar to the tip 619 described above, the tip 719 comprising the bulbous surface 723. The cartridge 837 comprises a block 825 made of a flexible elastomer so that the block 825 is resilient. In the present example, the rigid bulbous surface 723 of tip 719 and block 825 are cooperating features configured to promote tissue capture. In a version with no fabric present, or when the attached fabric is positioned only in the straight portions of the end actuator 812, the end actuator 812 is configured so that when the end actuator 812 is closed, the rigid anvil tip 719 with bulbous surface 723 comes into contact with cartridge 837, and specifically bulbous surface 723 comes into contact with block 825 as shown in Figure 20. In other cases, when tissue is stuck in a walking application, bulbous surface 723 from the tip of the anvil 719 can compress the tissue 90 against the block 825 to provide secure tissue capture during a cutting and stapling operation. In such walking applications, when at the end of the fabric cut line, the contact between the bulbous surface 723 and the block 825 can be felt by the user so that these structures can act as a feedback feature
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41/56 to detect the final cut in the running operation as described above. In still other versions, the end actuator 812 can be configured so that the bulbous surface 723 does not come into contact with the block 825 during the gripping, with tissue present or not. In view of the teachings of the present invention, different shapes of the bulbous surface 723 and different features of block 825 can be used to provide similar functionality, and such other shapes, features or modifications will be apparent to those skilled in the art in view of the teachings of the present invention.
[0087] Figure 21 shows a closer view of cartridge 837. As shown in this illustrated version, cartridge 837 comprises a plurality of raised features 827 located on a nose portion 829 of cartridge 837. In the present example, the nose portion 829 comprises the distal tip 839 of the cartridge 837, which is angled, together with a lower platform portion 831 that extends in parallel with the upper platform 872 of the cartridge 837. The raised features 827 generally cover the top surface of the nose portion 829 and are evenly spaced. In the present example, the raised features 827 are rigid and comprise cylindrical projection members; however, in other versions the raised features 827 can be rigid raised bosses or can have any other suitable shape that protrudes from the top surface of the nose portion 829. As shown in Figure 21, raised features 827 generally surround the block 825, which is flexible as described above. In still some other versions, a surface texture can be imparted to the nose portion 829 by means of a plurality of chemical recesses or roughings applied to the nose portion surface 829.
[0088] The cartridge 837 additionally comprises a plurality of elevated features 833 located on the upper platform 872 of the
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42/56 cartridge 837. The raised features 833 extend along both sides of the vertical slot 849. In the present example, the raised features 833 are rigid and provide improved fabric hold. It must be understood that both the elevated resources 827, 833 can be called grasping resources. The 833 raised features are configured in the illustrated version as pairs of U-shaped members where each member faces the other. In view of the teachings of the present invention, other formats and configurations for the raised resources 2242, 833 will be evident to those skilled in the art. In addition, although the present example shows cartridge 837 with both elevated features 827, 833, in other versions the cartridge 837 may have only elevated features 827. In still other versions, cartridge 837 may have only elevated features 833. In still other versions, the cartridge 837 may have none of the elevated features 827, 833, similarly to cartridge 37, for example.
[0089] Figure 22 shows another example end actuator 912 comprising an anvil 918, a lower claw 916 and a cartridge 937. It will be recognized that end actuator 912 can be used in place of end actuator 12 of instrument 10. The end actuator 912 can be integrally formed with the instrument 10 or, alternatively, it can be interchangeable with the end actuator 12 of the instrument 10. The anvil 918 can pivot in relation to the lower jaw 916. The anvil 918 and the lower jaw 916 they can hold the fabric 90 in a similar way to the grip made by the anvil 18 and the lower jaw 16 shown in Figure 1. The purpose of the cartridge 937 is to be placed in the lower jaw 916 in a similar way to the cartridge 37 shown in Figure 3. Alternatively, in some versions where end actuator 912 is removable from the rest of instrument 10, cartridge 937 can be
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43/56 permanently attached to the lower claw 916.
[0090] As shown in Figure 22, end actuator 912 combines anvil 918, which has an inclined tip 919, with cartridge 937, which has an angled surface 941 along a distal tip 939 of cartridge 937, similar to the configuration of end actuator 312 described above. In the present example, end actuator 912 includes additional features, and specifically a 972 multi-level clamp platform from cartridge 937. In the illustrated version, the 972 multi-level clamp platform comprises three levels located along each side of a vertical slot 949 that splits cartridge 937 in half lengthwise. An outer level 973 on each side includes a row of clip openings 951 that extend longitudinally along the surface of the cartridge 937. An inner level 975 on each side includes a row of clip openings 951 that extend longitudinally along the surface. cartridge 937. And finally an intermediate level 977 on each side, between the outer level 973 and the inner level 975, includes a row of clip openings 951 that extend longitudinally along the surface of the 937 cartridge. As shown, the levels external 973 of the multi-level staple platform 972 are offset from the intermediate levels 977. The intermediate levels 977 of the multi-level staple platform 972 are offset from the internal levels 975. In the present example, the level offset is configured in steps, with an increase of a step from one level to the next, as the levels approach vertical gap 949. In view of the teachings of the pr In this invention, other ways to configure the 972 multi-level staple platform will be evident to those skilled in the art.
[0091] In the present example, the multi-level staple platform 972 of the 937 cartridge comprises a plurality of features
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44/56 elevated 953 that have the same configuration as the elevated features 833 described above in relation to the end actuator 812. As described above, the elevated features 953 are configured to provide improved grip and tissue capture. While in the present example the cartridge 937 includes raised features 953, in other versions 953 the raised features can be omitted so that the multi-level staple platform 972 comprises a flat surface along each level. Additionally, in the present example, the angled surface 941 is shown as flat, but in other versions 941 the angled surface can include raised features 827 as described above. In view of the teachings of the present invention, other ways of configuring the end actuator 912 will be apparent to those skilled in the art.
IV · Exemplary combinations [0092] The following examples refer to several non-exhaustive ways in which the teachings of the present invention can be combined or applied. It should be understood that the following examples are not intended to restrict coverage of any claims that may be made at any time in this application or in subsequent filings of this application. No rights waiver is intended. The following examples are provided for illustrative purposes only. It is contemplated that the various teachings of the present invention can be arranged and applied in several other ways. It is also contemplated that some variations may omit certain features mentioned in the examples below. Therefore, none of the aspects or resources mentioned below should be considered as of critical importance, unless the contrary is explicitly indicated at a later date, by the inventors or by a successor in the interest of the inventors. If any claims are made in this application or in
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45/56 subsequent deposits related to this order that include additional resources in addition to those mentioned below, it should not be assumed that these additional resources have been added for any reason related to patentability.
Example 1 [0093] An apparatus comprising: (a) a body portion; (b) a drive shaft that extends distally from the body portion; and (c) an end actuator in communication with the drive shaft, the end actuator being movable between an open and a closed configuration, the purpose of the end actuator is to compress, staple and cut fabric and being that the end actuator comprises: (i) a cartridge configured to retain one or more clamps, the cartridge comprising a nose portion having an angled surface, (ii) an anvil comprising a proximal body portion and a tip extending distally from the body portion, the tip comprising an inclined configuration and iii a plurality of gripping features positioned along a cartridge clamp platform, with the plurality of gripping features being configured to come into contact with the tissue trapped in the end actuator when in the closed configuration. Example 2 [0094] The apparatus of Example 1, wherein the tip comprising the inclined configuration is rigid.
Example 3 [0095] The apparatus of any one or more of Examples 1 to 2, wherein the nose portion of the cartridge comprises a curved underside. Example 4 [0096] The apparatus of any one or more of Examples 1 to 3, wherein the nose portion of the cartridge comprises a first
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46/56 blunt end, and where the tip of the anvil comprises a second blunt end.
Example 5 [0097] The apparatus of Example 4, in which, when the end actuator is in the closed configuration, the second blunt end is longitudinally aligned with the first blunt end.
Example 6 [0098] The apparatus of any one or more of Examples 1 to 5, wherein the tip comprises an inner surface, where, when the end actuator is in the closed configuration, a distal portion of the inner surface is configured to enter in contact with the angled surface of the nose portion of the cartridge when there is no tissue present in the end actuator.
Example 7 [0099] The apparatus of Example 6, wherein the internal surface of the tip has an angled configuration.
Example 8 [0100] The apparatus of any one or more of Examples 6 to 7, wherein, when the end actuator is in the closed configuration with no tissue present in the end actuator, the internal surface of the tip and the angled surface of the portion nose plates are configured to define a space between them.
Example 9 [0101] The apparatus of any one or more of Examples 1 to 8, in which the staple platform defines a first plane, the tip comprising an internal surface that defines a second plane, and the surface being at an angle the nose portion defines a third plane, the second plane and the third plane are not coplanar.
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47/56
Example 10 [0102] The apparatus of Example 9, wherein a first angle formed by a first intersection of the second plane with the first plane is greater than a second angle formed by a second intersection of the third plane with the first plane.
Example 11 [0103] The apparatus of any one or more of Examples 9 to 10, wherein the inner surface of the tip is steeper than the angled surface of the nose portion.
Example 12 [0104] The apparatus of any one or more of Examples 1 to 11, wherein the tip of the anvil comprises a projection at a distal end of the tip.
Example 13 [0105] The apparatus of Example 12, wherein the projection comprises a flat portion configured to contact the angled surface of the nose portion when the end actuator is in the closed configuration.
Example 14 [0106] The apparatus of Example 12, wherein the projection comprises a bulb member.
Example 15 [0107] The apparatus of Example 14, wherein the angled surface of the nose portion comprises a complementary feature to the tip bulb member.
Example 16 [0108] The apparatus of any one or more of Examples 1 to 15, wherein the cartridge clamp platform comprises a multilevel clamp platform.
Example 17
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48/56 [0109] An apparatus comprising: (a) a body portion; (b) a drive shaft that extends distally from the body portion; and (c) an end actuator in communication with the drive shaft, the end actuator being movable between an open and a closed configuration, the purpose of the end actuator is to compress, staple and cut fabric and being that the end actuator comprises: (i) a cartridge configured to contain one or more clamps, the cartridge comprising a clamp platform and a nose portion having an angled surface, the angled surface comprising a block resilient, and (ii) a rigid anvil comprising a proximal body portion and a tip extending distally from the body portion, the tip comprising an inclined configuration, the tip additionally comprising a projection configured to enter in contact with the block when the end actuator is in the closed configuration with no fabric present in the end actuator.
Example 18 [0110] The apparatus of Example 17, wherein the end actuator further comprises a first plurality of gripping features positioned along the cartridge clamp platform and a second plurality of gripping features positioned along the angled surface the nose portion, the first and second pluralities of gripping features being configured to contact the tissue attached to the end actuator when in the closed configuration.
Example 19 [0111] The apparatus of any one or more of Examples 17 to 18, wherein the anvil comprises a bottom surface comprising a plurality of staple forming pockets, the
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The lower surface additionally comprises at least a portion with steps.
Example 20 [0112] An apparatus comprising: (a) a body portion; (b) a drive shaft that extends distally from the body portion; and (c) an end actuator in communication with the drive shaft, the end actuator being movable between an open and a closed configuration, the purpose of the end actuator is to compress, staple and cut fabric and being that the end actuator comprises: (i) a cartridge configured to contain one or more clamps, the cartridge comprising a clamp platform and a nose portion, the nose portion comprising an inclined surface and the platform The staple clip comprises a plurality of gripping features configured to contact the tissue attached to the end actuator when in the closed configuration, and (ii) an anvil comprising a proximal body portion and a tip extending distally from the body portion, the tip comprising an inclined configuration, the body portion comprising a longitudinal slot having a Partial I with side portions that have curved ends configured to receive a pin from a firing bar. V · Other components [0113] It should be understood that any one or more of the teachings, expressions, modalities, examples, etc. described here can be combined with any one or more of the other teachings, expressions, modalities, examples, etc. that are described in the present invention. The teachings, expressions, modalities, examples, etc. described above should therefore not be seen as isolated from each other. Various ways appropriate by
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50/56 which teachings of the present invention can be combined will become readily apparent to those skilled in the art in view of the teachings of the present invention. These modifications and variations are intended to be included in the scope of the appended claims.
[0114] It should also be understood that the teachings of the present invention can be readily combined with various teachings from US Patent Application No. [ower of attorney document END8113USDP.0641895], entitled Surgical Stapler Buttress Assembly with Adhesion to Wet End Effector, filed on the same date as this application, the description of which is hereby incorporated by reference. Various suitable ways in which the teachings of the invention can be combined with the teachings of US Patent Application No. [ower of attorney document END8113USDP.0641895] will be apparent to those skilled in the art. [0115] It should also be understood that the teachings of the present invention can be readily combined with various teachings from US Patent Application No. [roxy document END8114USDP.0641876], entitled Circular Surgical Stapler Buttress Assembly with Adhesion to Wet End Effector, filed on the same date as this application, the description of which is hereby incorporated by reference. Various suitable ways in which the teachings of the invention can be combined with the teachings of US Patent Application No. [ower of attorney document END8114USDP.0641876] will be apparent to those skilled in the art. [0116] It should also be understood that the teachings of the present invention can be readily combined with various teachings from US Patent Application No. [ower of attorney document END8115USNP.0641880], entitled Surgical Stapler with Anvil Seating Detection, filed on the same date as this application, the description of which is hereby incorporated by reference. Many ways
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51/56 that the teachings of the invention can be combined with the teachings of US Patent Application No. [ower of attorney document END8115USNP.0641880] will be apparent to those skilled in the art.
[0117] It should also be understood that the teachings of the present invention can be readily combined with various teachings from US Patent Application No. [ower of attorney document END8116USNP.0641882], entitled Surgical Stapler with Ready State Indicator, filed on the same date as this application, the description of which is hereby incorporated by reference. Various suitable ways in which the teachings of the invention can be combined with the teachings of US Patent Application No. [ower of attorney document END8116USNP.0641882] will be apparent to those skilled in the art.
[0118] It should also be understood that the teachings of the present invention can be readily combined with various teachings from US Patent Application No. [ower of attorney document END8117USNP.0641884], entitled Surgical Stapler with Anvil Seating Detection, filed on the same date as this application, the description of which is hereby incorporated by reference. Various suitable ways in which the teachings of the invention can be combined with the teachings of US Patent Application No. [ower of attorney document END8117USNP.0641884] will be apparent to those skilled in the art.
[0119] It should also be understood that the teachings of the present invention can be readily combined with various teachings from US Patent Application No. [ower of attorney document END8118USDP.0641887], entitled Surgical Stapler with Anvil Seating Detection, filed on the same date as this application, the description of which is hereby incorporated by reference. Many ways
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52/56 that the teachings of the invention can be combined with the teachings of US Patent Application No. power of attorney document END8118USDP.0641887 will be apparent to those skilled in the art.
[0120] It should be understood that any patent, publication or other description material that, in whole or in part, is said to be incorporated herein by reference, is incorporated herein only to the extent that the incorporated material does not enter in conflict with the definitions, statements, or other description materials presented in this description. Accordingly, and as necessary, the description as explicitly presented herein replaces any conflicting material incorporated by reference to the present invention. Any material, or portion thereof, that is incorporated herein by reference, but which conflicts with the definitions, statements, or other description materials contained herein, will be incorporated here only to the extent that there is no conflict between the embedded material and the existing description material.
[0121] Versions of the devices described above may have application in conventional medical treatments and procedures conducted by a medical professional, as well as application in medical treatments and procedures assisted by robotics. Just as an example, several teachings of the present invention can readily be incorporated into a robotic surgical system such as the DAVINCI ™ system from Intuitive Surgical, Inc., Sunnyvale, California, USA. Similarly, those skilled in the art will recognize that various teachings presented here can be readily combined with various teachings from: US Patent No. 5,792,135, entitled Articulated Surgical Instrument For Performing Minimally Invasive Surgery With Enhanced Dexterity and Sensitivity, granted on 11
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53/56 August 1998, the description of which is incorporated herein by way of reference; US Patent No. 5,817,084, entitled Remote Center Positioning Device with Flexible Drive, issued October 6, 1998, the description of which is incorporated herein by reference; US Patent No. 5,878,193, entitled Automated Endoscope System for Optimal Positioning, issued on March 2, 1999, the description of which is incorporated herein by reference; US Patent No. 6,231,565, entitled Robotic Arm DLUS for Performing Surgical Tasks, issued May 15, 2001, the description of which is incorporated herein by reference; US Patent No. 6,783,524, entitled Robotic Surgical Tool with Ultrasound Cauterizing and Cutting Instrument, issued on August 31, 2004, the description of which is incorporated herein by reference; US Patent No. 6,364,888, entitled Al ignment of Master and Slave in a Minimally Invasive Surgical Apparatus, issued April 2, 2002, the description of which is incorporated herein by reference; US Patent No. 7,524,320, entitled Mechanical Actuator Interface System for Robotic Surgical Tools, issued April 28, 2009, the description of which is incorporated herein by reference; US Patent No. 7,691,098, entitled Platform Link Wrist Mechanism, issued April 6, 2010, the description of which is incorporated herein by reference; US Patent No. 7,806,891, entitled Repositioning and Reorientation of Master / Slave Relationship in Minimally Invasive Telesurgery, granted on October 5, 2010, the description of which is incorporated herein by reference; US Publication No. 2013/0012957, entitled Automated End Effector Component Reloading System for Use with a Robotic System, published on January 10, 2013, the description of which is incorporated herein by reference; US Publication No. 2012/0199630, entitled Robotically-Controlled Surgical Instrument with Force-Feedback Capabilities, published on August 9, 2012, the description of which is incorporated herein by reference; Publication
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54/56
US No. 2012/0132450, entitled Shiftable Drive Int erface for Robotically Controlled Surgical Tool, published on May 31, 2012, the description of which is incorporated herein by reference; US Publication No. 2012/0199633, entitled Surgical Stapling Instruments with CamDriven Staple Deployment Arrangements, published on August 9, 2012, the description of which is incorporated herein by reference; US Publication No. 2012/0199631, entitled Robotically-Controlled Motorized Surgical End Effector System with Rotary Actuated Closure Systems Having Variable Actuation Speeds, published on August 9, 2012, the description of which is incorporated herein by reference; US publication No. 2012/0199632, entitled Robotically-Controlled Surgical Instrument with Selectively Articulatable End Effector, published on August 9, 2012, the description of which is incorporated herein by reference; US Publication No. 2012/02032 47, entitled Robotically-Controlled Surgical End Effector System, published on August 9, 2012, the description of which is incorporated herein by reference; US Publication No. 2012/0211546, entitled Drive Interface for Operably Coupling a Manipulatable Surgical Tool to a Robot, published on August 23, 2012; US publication No. 2012/0138660, entitled Robotically-Controlled Cable-Based Surgical End Effectors, published on June 7, 2012, the description of which is incorporated herein by reference; and / or US Publication No. 2012/0205421 entitled Robotically-Controlled Surgical End Effector System with Rotary Actuated Closure Systems, published on August 16, 2012, the description of which is incorporated herein by reference.
[0122] Versions of the devices described above can be designed to be discarded after a single use, or can be designed to be used multiple times. The versions can, in either or both cases, be reconditioned for reuse after at least one use. Reconditioning can include
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55/56 any combination of the steps for disassembling the device, followed by cleaning or changing specific parts and subsequent reassembly. In particular, some versions of the device can be disassembled and any number of parts or parts of the device can be selectively replaced or removed in any combination. With cleaning and / or changing specific parts, some versions of the device can be reassembled for subsequent use, in a reconditioning facility or by a user immediately before a surgical procedure. Those skilled in the art will understand that the reconditioning of a device can use a variety of disassembly, cleaning / replacement and reassembly techniques. The use of these techniques, as well as the resulting refurbished device, are all within the scope of this application. [0123] Just as an example, the versions described here can be sterilized before and / or after a procedure. In a sterilization technique, the device is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and the device can then be placed in a radiation field, such as gamma radiation, X-rays or high-energy electrons, which can penetrate the container. Radiation can kill bacteria on the device and the container. The sterile device can then be stored in a sterile container for later use. The device can also be sterilized using any other known technique, including, but not limited to, beta or gamma radiation, ethylene oxide or water vapor.
[0124] Having shown and described various modalities of the present invention, further adaptations of the methods and systems described in the present invention can be made by means of suitable modifications by a person skilled in the art without departing from the scope of the present invention. Several of these possible modifications
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56/56 were mentioned, and others will be evident to those skilled in the art. For example, the examples, modalities, geometries, materials, dimensions, proportions, steps and the like discussed above are illustrative and are not mandatory. Consequently, the scope of the present invention should be considered in accordance with the following claims, and it should be understood that it is not limited to the details of structure and operation shown and described in the specification and drawings.

权利要求:
Claims (20)
[1]
1. Apparatus, characterized by comprising:
(a) a body portion;
(b) a drive shaft that extends distally from the body portion; and (c) an end actuator in communication with the drive shaft, where the end actuator is movable between an open configuration and a closed configuration, where the end actuator is operable to compress, staple and cut fabric, and wherein the end actuator comprises:
(i) a cartridge configured to contain one or more clamps, the cartridge comprising a nose portion having an angled surface, (ii) an anvil comprising a proximal body portion and a tip extending distally from the body portion, where the tip comprises an arcuate configuration, and (iii) a plurality of gripping features positioned along a cartridge clamp platform, where the plurality of gripping features are configured to contact the fabric stuck to the end actuator when in the closed configuration.
[2]
Apparatus according to claim 1, characterized in that the tip comprising the arcuate configuration is rigid.
[3]
Apparatus according to claim 1, characterized in that the nose portion of the cartridge comprises a curved underside.
[4]
Apparatus according to claim 1, characterized in that the nose portion of the cartridge comprises a first blunt end, and wherein the end of the anvil comprises a second blunt end.
[5]
5. Apparatus according to claim 4, characterized
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2/5 but when the end actuator is in the closed configuration, the second blunt end will be longitudinally aligned with the first blunt end.
[6]
Apparatus according to claim 1, characterized in that the tip comprises an internal surface, in which, when the end actuator is in the closed configuration, a distal portion of the internal surface is configured to contact the angled surface the nose portion of the cartridge when tissue is not present in the end actuator.
[7]
Apparatus according to claim 6, characterized in that the internal surface of the tip has an angled configuration.
[8]
Apparatus according to claim 6, characterized in that, when the end actuator is in the closed configuration with no fabric present in the end actuator, the inner surface of the tip and the angled surface of the nose portion of the cartridge are configured to define a space between them.
[9]
Apparatus according to claim 1, characterized in that the clamp platform defines a first plane, in which the tip comprises an internal surface that defines a second plane, and in which the angled surface of the nose portion defines a third plane, where the second plane and the third plane are not coplanar.
[10]
Apparatus according to claim 9, characterized in that a first angle formed by a first intersection of the second plane with the first plane is greater than a second angle formed by a second intersection of the third plane with the first plane.
[11]
Apparatus according to claim 9, characterized in that the internal surface of the tip is steeper compared to the angled surface of the nose portion.
[12]
12. Apparatus according to claim 1, characterized
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3/5 because the tip of the anvil comprises a projection at a distal end of the tip.
[13]
Apparatus according to claim 12, characterized in that the projection comprises a flat portion configured to contact the angled surface of the nose portion when the end actuator is in the closed configuration.
[14]
Apparatus according to claim 12, characterized in that the projection comprises a bulb member.
[15]
Apparatus according to claim 14, characterized in that the angled surface of the nose portion comprises a complementary feature to the tip bulb member.
[16]
Apparatus according to claim 1, characterized in that the cartridge clamp platform comprises a multilevel clamp platform.
[17]
17. Apparatus, characterized by comprising:
(a) a body portion;
(b) a drive shaft that extends distally from the body portion; and (c) an end actuator in communication with the drive shaft, in which the end actuator is movable between an open configuration and a closed configuration, in which the end actuator is operable to compress, staple and cut fabric and in that the end actuator comprises:
(i) a cartridge configured to contain one or more clamps, the cartridge comprising a clamp platform and a nose portion having an angled surface, the angled surface comprising a resilient block, and (ii) a rigid anvil comprising a proximal body portion and a tip extending distally from the
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4/5 body, in which the tip comprises an arcuate configuration, in which the tip further comprises a projection configured to contact the block when the end actuator is in the closed, tissue-free configuration present in the end actuator.
[18]
Apparatus according to claim 17, characterized in that the end actuator further comprises a first plurality of gripping features positioned along the cartridge clamp platform, and a second plurality of gripping features positioned along the surface in nose portion angle, in which the first and second pluralities of gripping features are configured to come into contact with the tissue trapped between the end actuator when in the closed configuration.
[19]
Apparatus according to claim 17, characterized in that the anvil comprises a bottom side surface comprising a plurality of staple forming pockets, wherein the bottom side surface further comprises at least a stepped portion.
[20]
20. Apparatus, characterized by comprising:
(a) a body portion;
(b) a drive shaft that extends distally from the body portion; and (c) an end actuator in communication with the drive shaft, in which the end actuator is movable between an open configuration and a closed configuration, in which the end actuator is operable to compress, staple and cut fabric and in that the end actuator comprises:
(i) a cartridge configured to retain one or more staples, the cartridge comprising a staple platform and a nose portion, the nose portion comprising a surface
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5/5 at an angle, and in which the clamp platform comprises a plurality of gripping features configured to contact the tissue trapped between the end actuator when in the closed configuration, and (ii) an anvil comprising a proximal portion body and a tip extending distally from the body portion, where the tip comprises an arcuate configuration, where the body portion comprises a longitudinal slot that has a partial "I" shaped profile with side portions that have arcuate ends configured to receive a pin from a firing bar.

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---

BR112021000666A2|2021-04-13|EXTREMITY ACTUATOR COMPONENT FOR SURGICAL CLAMPING WITH JOINT AND ASYMMETRIC DEFORMABLE TIP

---

BR112021000554A2|2021-04-06|METHOD OF SURGICAL STAPLING WITH EXTREMITY ACTUATOR COMPONENT WITH A CURVE TIP

---

US20180325516A1|2018-11-15|Method of surgical stapling with end effector component having a curved tip

---

BR112021000661A2|2021-05-11|COMPONENT OF SURGICAL STAPLING END ACTUATOR WITH DEFORMABLE TIP WITH EMPTY SPACE

---

BR112015020550B1|2021-11-23|DEVICE

---

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---

BR112015020714B1|2021-12-28|APPARATUS AND METHOD FOR ARTICULATING AN END ACTUATOR

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BR112016030398B1|2021-11-09|ENDOSCOPIC SURGICAL INSTRUMENT

同族专利:

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公开号 | 公开日

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WO2018152083A1|2018-08-23|

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US10758231B2|2020-09-01|

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CN110505846A|2019-11-26|

---

JP2020508129A|2020-03-19|

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EP3363378A1|2018-08-22|

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EP3363378B1|2021-09-01|

---

US20180235619A1|2018-08-23|

引用文献:

---

公开号 | 申请日 | 公开日 | 申请人 | 专利标题

---

---

JPS5637801B2|1975-02-24|1981-09-02|

---

US4805823A|1988-03-18|1989-02-21|Ethicon, Inc.|Pocket configuration for internal organ staplers|

---

US5300087A|1991-03-22|1994-04-05|Knoepfler Dennis J|Multiple purpose forceps|

---

US6364888B1|1996-09-09|2002-04-02|Intuitive Surgical, Inc.|Alignment of master and slave in a minimally invasive surgical apparatus|

---

US5657429A|1992-08-10|1997-08-12|Computer Motion, Inc.|Automated endoscope system optimal positioning|

---

US5397324A|1993-03-10|1995-03-14|Carroll; Brendan J.|Surgical stapler instrument and method for vascular hemostasis|

---

US5415334A|1993-05-05|1995-05-16|Ethicon Endo-Surgery|Surgical stapler and staple cartridge|

---

DE69417229T2|1993-05-14|1999-07-08|Stanford Res Inst Int|SURGERY DEVICE|

---

US5403312A|1993-07-22|1995-04-04|Ethicon, Inc.|Electrosurgical hemostatic device|

---

US5452837A|1994-01-21|1995-09-26|Ethicon Endo-Surgery, Inc.|Surgical stapler with tissue gripping ridge|

---

US5597107A|1994-02-03|1997-01-28|Ethicon Endo-Surgery, Inc.|Surgical stapler instrument|

---

US5465895A|1994-02-03|1995-11-14|Ethicon Endo-Surgery, Inc.|Surgical stapler instrument|

---

US5704534A|1994-12-19|1998-01-06|Ethicon Endo-Surgery, Inc.|Articulation assembly for surgical instruments|

---

US5632432A|1994-12-19|1997-05-27|Ethicon Endo-Surgery, Inc.|Surgical instrument|

---

US5814055A|1995-09-19|1998-09-29|Ethicon Endo-Surgery, Inc.|Surgical clamping mechanism|

---

US5792135A|1996-05-20|1998-08-11|Intuitive Surgical, Inc.|Articulated surgical instrument for performing minimally invasive surgery with enhanced dexterity and sensitivity|

---

US6231565B1|1997-06-18|2001-05-15|United States Surgical Corporation|Robotic arm DLUs for performing surgical tasks|

---

US6459926B1|1998-11-20|2002-10-01|Intuitive Surgical, Inc.|Repositioning and reorientation of master/slave relationship in minimally invasive telesurgery|

---

US6331181B1|1998-12-08|2001-12-18|Intuitive Surgical, Inc.|Surgical robotic tools, data architecture, and use|

---

US6783524B2|2001-04-19|2004-08-31|Intuitive Surgical, Inc.|Robotic surgical tool with ultrasound cauterizing and cutting instrument|

---

CA2451824C|2001-06-29|2015-02-24|Intuitive Surgical, Inc.|Platform link wrist mechanism|

---

US9597078B2|2003-04-29|2017-03-21|Covidien Lp|Surgical stapling device with dissecting tip|

---

US8714429B2|2003-04-29|2014-05-06|Covidien Lp|Dissecting tip for surgical stapler|

---

US20040243151A1|2003-04-29|2004-12-02|Demmy Todd L.|Surgical stapling device with dissecting tip|

---

US7380695B2|2003-05-20|2008-06-03|Ethicon Endo-Surgery, Inc.|Surgical stapling instrument having a single lockout mechanism for prevention of firing|

---

US9060770B2|2003-05-20|2015-06-23|Ethicon Endo-Surgery, Inc.|Robotically-driven surgical instrument with E-beam driver|

---

US6978921B2|2003-05-20|2005-12-27|Ethicon Endo-Surgery, Inc.|Surgical stapling instrument incorporating an E-beam firing mechanism|

---

US7143923B2|2003-05-20|2006-12-05|Ethicon Endo-Surgery, Inc.|Surgical stapling instrument having a firing lockout for an unclosed anvil|

---

US7380696B2|2003-05-20|2008-06-03|Ethicon Endo-Surgery, Inc.|Articulating surgical stapling instrument incorporating a two-piece E-beam firing mechanism|

---

US7434715B2|2003-09-29|2008-10-14|Ethicon Endo-Surgery, Inc.|Surgical stapling instrument having multistroke firing with opening lockout|

---

US7303108B2|2003-09-29|2007-12-04|Ethicon Endo-Surgery, Inc.|Surgical stapling instrument incorporating a multi-stroke firing mechanism with a flexible rack|

---

US7367485B2|2004-06-30|2008-05-06|Ethicon Endo-Surgery, Inc.|Surgical stapling instrument incorporating a multistroke firing mechanism having a rotary transmission|

---

US8579176B2|2005-07-26|2013-11-12|Ethicon Endo-Surgery, Inc.|Surgical stapling and cutting device and method for using the device|

---

US8800838B2|2005-08-31|2014-08-12|Ethicon Endo-Surgery, Inc.|Robotically-controlled cable-based surgical end effectors|

---

US20110295295A1|2006-01-31|2011-12-01|Ethicon Endo-Surgery, Inc.|Robotically-controlled surgical instrument having recording capabilities|

---

US7845537B2|2006-01-31|2010-12-07|Ethicon Endo-Surgery, Inc.|Surgical instrument having recording capabilities|

---

US7644848B2|2006-01-31|2010-01-12|Ethicon Endo-Surgery, Inc.|Electronic lockouts and surgical instrument including same|

---

US8992422B2|2006-03-23|2015-03-31|Ethicon Endo-Surgery, Inc.|Robotically-controlled endoscopic accessory channel|

---

US8403196B2|2006-09-08|2013-03-26|Covidien Lp|Dissection tip and introducer for surgical instrument|

---

US8136711B2|2006-09-08|2012-03-20|Tyco Healthcare Group Lp|Dissection tip and introducer for surgical instrument|

---

US7721930B2|2006-11-10|2010-05-25|Thicon Endo-Surgery, Inc.|Disposable cartridge with adhesive for use with a stapling device|

---

US8684253B2|2007-01-10|2014-04-01|Ethicon Endo-Surgery, Inc.|Surgical instrument with wireless communication between a control unit of a robotic system and remote sensor|

---

US8496153B2|2007-03-29|2013-07-30|Covidien Lp|Anvil-mounted dissecting tip for surgical stapling device|

---

US8931682B2|2007-06-04|2015-01-13|Ethicon Endo-Surgery, Inc.|Robotically-controlled shaft based rotary drive systems for surgical instruments|

---

US8308040B2|2007-06-22|2012-11-13|Ethicon Endo-Surgery, Inc.|Surgical stapling instrument with an articulatable end effector|

---

US9179912B2|2008-02-14|2015-11-10|Ethicon Endo-Surgery, Inc.|Robotically-controlled motorized surgical cutting and fastening instrument|

---

US8758391B2|2008-02-14|2014-06-24|Ethicon Endo-Surgery, Inc.|Interchangeable tools for surgical instruments|

---

US8573465B2|2008-02-14|2013-11-05|Ethicon Endo-Surgery, Inc.|Robotically-controlled surgical end effector system with rotary actuated closure systems|

---

US9585657B2|2008-02-15|2017-03-07|Ethicon Endo-Surgery, Llc|Actuator for releasing a layer of material from a surgical end effector|

---

US8210411B2|2008-09-23|2012-07-03|Ethicon Endo-Surgery, Inc.|Motor-driven surgical cutting instrument|

---

US9386983B2|2008-09-23|2016-07-12|Ethicon Endo-Surgery, Llc|Robotically-controlled motorized surgical instrument|

---

US8220688B2|2009-12-24|2012-07-17|Ethicon Endo-Surgery, Inc.|Motor-driven surgical cutting instrument with electric actuator directional control assembly|

---

US8328061B2|2010-02-02|2012-12-11|Covidien Lp|Surgical instrument for joining tissue|

---

US8348124B2|2011-02-08|2013-01-08|Covidien Lp|Knife bar with geared overdrive|

---

US9198662B2|2012-03-28|2015-12-01|Ethicon Endo-Surgery, Inc.|Tissue thickness compensator having improved visibility|

---

US10478182B2|2012-10-18|2019-11-19|Covidien Lp|Surgical device identification|

---

US9717497B2|2013-02-28|2017-08-01|Ethicon Llc|Lockout feature for movable cutting member of surgical instrument|

---

US9808248B2|2013-02-28|2017-11-07|Ethicon Llc|Installation features for surgical instrument end effector cartridge|

---

US9795379B2|2013-02-28|2017-10-24|Ethicon Llc|Surgical instrument with multi-diameter shaft|

---

US9517065B2|2013-02-28|2016-12-13|Ethicon Endo-Surgery, Llc|Integrated tissue positioning and jaw alignment features for surgical stapler|

---

US9622746B2|2013-02-28|2017-04-18|Ethicon Endo-Surgery, Llc|Distal tip features for end effector of surgical instrument|

---

US9186142B2|2013-02-28|2015-11-17|Ethicon Endo-Surgery, Inc.|Surgical instrument end effector articulation drive with pinion and opposing racks|

---

US9839421B2|2013-02-28|2017-12-12|Ethicon Llc|Jaw closure feature for end effector of surgical instrument|

---

US10092292B2|2013-02-28|2018-10-09|Ethicon Llc|Staple forming features for surgical stapling instrument|

---

US9687232B2|2013-12-23|2017-06-27|Ethicon Llc|Surgical staples|

---

US9936952B2|2014-02-03|2018-04-10|Covidien Lp|Introducer assembly for a surgical fastener applying apparatus|

---

US9913642B2|2014-03-26|2018-03-13|Ethicon Llc|Surgical instrument comprising a sensor system|

---

US10456132B2|2014-06-25|2019-10-29|Ethicon Llc|Jaw opening feature for surgical stapler|

---

US10335147B2|2014-06-25|2019-07-02|Ethicon Llc|Method of using lockout features for surgical stapler cartridge|

---

US10292701B2|2014-06-25|2019-05-21|Ethicon Llc|Articulation drive features for surgical stapler|

---

BR112017005984A2|2014-09-26|2017-12-19|Ethicon Llc|surgical clamp arrangements and trigger for staple cartridges|

---

US10194912B2|2015-07-28|2019-02-05|Ethicon Llc|Surgical staple cartridge with outer edge compression features|

---

USD836198S1|2017-02-17|2018-12-18|Ethicon Llc|Staple cartridge for a surgical stapler|US9060770B2|2003-05-20|2015-06-23|Ethicon Endo-Surgery, Inc.|Robotically-driven surgical instrument with E-beam driver|

---

US20070084897A1|2003-05-20|2007-04-19|Shelton Frederick E Iv|Articulating surgical stapling instrument incorporating a two-piece e-beam firing mechanism|

---

US8215531B2|2004-07-28|2012-07-10|Ethicon Endo-Surgery, Inc.|Surgical stapling instrument having a medical substance dispenser|

---

US10159482B2|2005-08-31|2018-12-25|Ethicon Llc|Fastener cartridge assembly comprising a fixed anvil and different staple heights|

---

US9237891B2|2005-08-31|2016-01-19|Ethicon Endo-Surgery, Inc.|Robotically-controlled surgical stapling devices that produce formed staples having different lengths|

---

US7934630B2|2005-08-31|2011-05-03|Ethicon Endo-Surgery, Inc.|Staple cartridges for forming staples having differing formed staple heights|

---

US11246590B2|2005-08-31|2022-02-15|Cilag Gmbh International|Staple cartridge including staple drivers having different unfired heights|

---

US7669746B2|2005-08-31|2010-03-02|Ethicon Endo-Surgery, Inc.|Staple cartridges for forming staples having differing formed staple heights|

---

US20070106317A1|2005-11-09|2007-05-10|Shelton Frederick E Iv|Hydraulically and electrically actuated articulation joints for surgical instruments|

---

US7845537B2|2006-01-31|2010-12-07|Ethicon Endo-Surgery, Inc.|Surgical instrument having recording capabilities|

---

US20120292367A1|2006-01-31|2012-11-22|Ethicon Endo-Surgery, Inc.|Robotically-controlled end effector|

---

US7753904B2|2006-01-31|2010-07-13|Ethicon Endo-Surgery, Inc.|Endoscopic surgical instrument with a handle that can articulate with respect to the shaft|

---

US20110295295A1|2006-01-31|2011-12-01|Ethicon Endo-Surgery, Inc.|Robotically-controlled surgical instrument having recording capabilities|

---

US11207064B2|2011-05-27|2021-12-28|Cilag Gmbh International|Automated end effector component reloading system for use with a robotic system|

---

US8708213B2|2006-01-31|2014-04-29|Ethicon Endo-Surgery, Inc.|Surgical instrument having a feedback system|

---

US8186555B2|2006-01-31|2012-05-29|Ethicon Endo-Surgery, Inc.|Motor-driven surgical cutting and fastening instrument with mechanical closure system|

---

US11224427B2|2006-01-31|2022-01-18|Cilag Gmbh International|Surgical stapling system including a console and retraction assembly|

---

US8820603B2|2006-01-31|2014-09-02|Ethicon Endo-Surgery, Inc.|Accessing data stored in a memory of a surgical instrument|

---

US8322455B2|2006-06-27|2012-12-04|Ethicon Endo-Surgery, Inc.|Manually driven surgical cutting and fastening instrument|

---

US8360297B2|2006-09-29|2013-01-29|Ethicon Endo-Surgery, Inc.|Surgical cutting and stapling instrument with self adjusting anvil|

---

US8652120B2|2007-01-10|2014-02-18|Ethicon Endo-Surgery, Inc.|Surgical instrument with wireless communication between control unit and sensor transponders|

---

US8684253B2|2007-01-10|2014-04-01|Ethicon Endo-Surgery, Inc.|Surgical instrument with wireless communication between a control unit of a robotic system and remote sensor|

---

US11039836B2|2007-01-11|2021-06-22|Cilag Gmbh International|Staple cartridge for use with a surgical stapling instrument|

---

US7735703B2|2007-03-15|2010-06-15|Ethicon Endo-Surgery, Inc.|Re-loadable surgical stapling instrument|

---

US8893946B2|2007-03-28|2014-11-25|Ethicon Endo-Surgery, Inc.|Laparoscopic tissue thickness and clamp load measuring devices|

---

US8931682B2|2007-06-04|2015-01-13|Ethicon Endo-Surgery, Inc.|Robotically-controlled shaft based rotary drive systems for surgical instruments|

---

US7753245B2|2007-06-22|2010-07-13|Ethicon Endo-Surgery, Inc.|Surgical stapling instruments|

---

US8573465B2|2008-02-14|2013-11-05|Ethicon Endo-Surgery, Inc.|Robotically-controlled surgical end effector system with rotary actuated closure systems|

---

US9179912B2|2008-02-14|2015-11-10|Ethicon Endo-Surgery, Inc.|Robotically-controlled motorized surgical cutting and fastening instrument|

---

US7819298B2|2008-02-14|2010-10-26|Ethicon Endo-Surgery, Inc.|Surgical stapling apparatus with control features operable with one hand|

---

US8636736B2|2008-02-14|2014-01-28|Ethicon Endo-Surgery, Inc.|Motorized surgical cutting and fastening instrument|

---

JP5410110B2|2008-02-14|2014-02-05|エシコン・エンド−サージェリィ・インコーポレイテッド|Surgical cutting / fixing instrument with RF electrode|

---

US8758391B2|2008-02-14|2014-06-24|Ethicon Endo-Surgery, Inc.|Interchangeable tools for surgical instruments|

---

US7866527B2|2008-02-14|2011-01-11|Ethicon Endo-Surgery, Inc.|Surgical stapling apparatus with interlockable firing system|

---

US9585657B2|2008-02-15|2017-03-07|Ethicon Endo-Surgery, Llc|Actuator for releasing a layer of material from a surgical end effector|

---

US9005230B2|2008-09-23|2015-04-14|Ethicon Endo-Surgery, Inc.|Motorized surgical instrument|

---

US8210411B2|2008-09-23|2012-07-03|Ethicon Endo-Surgery, Inc.|Motor-driven surgical cutting instrument|

---

US9386983B2|2008-09-23|2016-07-12|Ethicon Endo-Surgery, Llc|Robotically-controlled motorized surgical instrument|

---

US8608045B2|2008-10-10|2013-12-17|Ethicon Endo-Sugery, Inc.|Powered surgical cutting and stapling apparatus with manually retractable firing system|

---

US8517239B2|2009-02-05|2013-08-27|Ethicon Endo-Surgery, Inc.|Surgical stapling instrument comprising a magnetic element driver|

---

US20110024477A1|2009-02-06|2011-02-03|Hall Steven G|Driven Surgical Stapler Improvements|

---

US8444036B2|2009-02-06|2013-05-21|Ethicon Endo-Surgery, Inc.|Motor driven surgical fastener device with mechanisms for adjusting a tissue gap within the end effector|

---

US8220688B2|2009-12-24|2012-07-17|Ethicon Endo-Surgery, Inc.|Motor-driven surgical cutting instrument with electric actuator directional control assembly|

---

JP6224070B2|2012-03-28|2017-11-01|エシコン・エンド−サージェリィ・インコーポレイテッドＥｔｈｉｃｏｎ Ｅｎｄｏ−Ｓｕｒｇｅｒｙ，Ｉｎｃ．|Retainer assembly including tissue thickness compensator|

---

US9364233B2|2010-09-30|2016-06-14|Ethicon Endo-Surgery, Llc|Tissue thickness compensators for circular surgical staplers|

---

US9320523B2|2012-03-28|2016-04-26|Ethicon Endo-Surgery, Llc|Tissue thickness compensator comprising tissue ingrowth features|

---

BR112013027794B1|2011-04-29|2020-12-15|Ethicon Endo-Surgery, Inc|CLAMP CARTRIDGE SET|

---

US9629814B2|2010-09-30|2017-04-25|Ethicon Endo-Surgery, Llc|Tissue thickness compensator configured to redistribute compressive forces|

---

JP6305979B2|2012-03-28|2018-04-04|エシコン・エンド−サージェリィ・インコーポレイテッドＥｔｈｉｃｏｎ Ｅｎｄｏ−Ｓｕｒｇｅｒｙ，Ｉｎｃ．|Tissue thickness compensator with multiple layers|

---

US10945731B2|2010-09-30|2021-03-16|Ethicon Llc|Tissue thickness compensator comprising controlled release and expansion|

---

US9861361B2|2010-09-30|2018-01-09|Ethicon Llc|Releasable tissue thickness compensator and fastener cartridge having the same|

---

US8777004B2|2010-09-30|2014-07-15|Ethicon Endo-Surgery, Inc.|Compressible staple cartridge comprising alignment members|

---

US8695866B2|2010-10-01|2014-04-15|Ethicon Endo-Surgery, Inc.|Surgical instrument having a power control circuit|

---

US9072535B2|2011-05-27|2015-07-07|Ethicon Endo-Surgery, Inc.|Surgical stapling instruments with rotatable staple deployment arrangements|

---

US9044230B2|2012-02-13|2015-06-02|Ethicon Endo-Surgery, Inc.|Surgical cutting and fastening instrument with apparatus for determining cartridge and firing motion status|

---

MX350846B|2012-03-28|2017-09-22|Ethicon Endo Surgery Inc|Tissue thickness compensator comprising capsules defining a low pressure environment.|

---

US9101358B2|2012-06-15|2015-08-11|Ethicon Endo-Surgery, Inc.|Articulatable surgical instrument comprising a firing drive|

---

US9364230B2|2012-06-28|2016-06-14|Ethicon Endo-Surgery, Llc|Surgical stapling instruments with rotary joint assemblies|

---

US9289256B2|2012-06-28|2016-03-22|Ethicon Endo-Surgery, Llc|Surgical end effectors having angled tissue-contacting surfaces|

---

RU2636861C2|2012-06-28|2017-11-28|Этикон Эндо-Серджери, Инк.|Blocking of empty cassette with clips|

---

US20140005718A1|2012-06-28|2014-01-02|Ethicon Endo-Surgery, Inc.|Multi-functional powered surgical device with external dissection features|

---

US11197671B2|2012-06-28|2021-12-14|Cilag Gmbh International|Stapling assembly comprising a lockout|

---

US20140001231A1|2012-06-28|2014-01-02|Ethicon Endo-Surgery, Inc.|Firing system lockout arrangements for surgical instruments|

---

RU2672520C2|2013-03-01|2018-11-15|Этикон Эндо-Серджери, Инк.|Hingedly turnable surgical instruments with conducting ways for signal transfer|

---

RU2669463C2|2013-03-01|2018-10-11|Этикон Эндо-Серджери, Инк.|Surgical instrument with soft stop|

---

US9687230B2|2013-03-14|2017-06-27|Ethicon Llc|Articulatable surgical instrument comprising a firing drive|

---

US9629629B2|2013-03-14|2017-04-25|Ethicon Endo-Surgey, LLC|Control systems for surgical instruments|

---

US10136887B2|2013-04-16|2018-11-27|Ethicon Llc|Drive system decoupling arrangement for a surgical instrument|

---

US20150053746A1|2013-08-23|2015-02-26|Ethicon Endo-Surgery, Inc.|Torque optimization for surgical instruments|

---

MX369362B|2013-08-23|2019-11-06|Ethicon Endo Surgery Llc|Firing member retraction devices for powered surgical instruments.|

---

US9962161B2|2014-02-12|2018-05-08|Ethicon Llc|Deliverable surgical instrument|

---

US11259799B2|2014-03-26|2022-03-01|Cilag Gmbh International|Interface systems for use with surgical instruments|

---

US10004497B2|2014-03-26|2018-06-26|Ethicon Llc|Interface systems for use with surgical instruments|

---

JP6612256B2|2014-04-16|2019-11-27|エシコンエルエルシー|Fastener cartridge with non-uniform fastener|

---

US10561422B2|2014-04-16|2020-02-18|Ethicon Llc|Fastener cartridge comprising deployable tissue engaging members|

---

US9757128B2|2014-09-05|2017-09-12|Ethicon Llc|Multiple sensors with one sensor affecting a second sensor's output or interpretation|

---

BR112017004361A2|2014-09-05|2017-12-05|Ethicon Llc|medical overcurrent modular power supply|

---

BR112017005981A2|2014-09-26|2017-12-19|Ethicon Llc|surgical staplers and ancillary materials|

---

US9801627B2|2014-09-26|2017-10-31|Ethicon Llc|Fastener cartridge for creating a flexible staple line|

---

US10076325B2|2014-10-13|2018-09-18|Ethicon Llc|Surgical stapling apparatus comprising a tissue stop|

---

US9924944B2|2014-10-16|2018-03-27|Ethicon Llc|Staple cartridge comprising an adjunct material|

---

US11141153B2|2014-10-29|2021-10-12|Cilag Gmbh International|Staple cartridges comprising driver arrangements|

---

US9844376B2|2014-11-06|2017-12-19|Ethicon Llc|Staple cartridge comprising a releasable adjunct material|

---

US10736636B2|2014-12-10|2020-08-11|Ethicon Llc|Articulatable surgical instrument system|

---

US9844375B2|2014-12-18|2017-12-19|Ethicon Llc|Drive arrangements for articulatable surgical instruments|

---

US10085748B2|2014-12-18|2018-10-02|Ethicon Llc|Locking arrangements for detachable shaft assemblies with articulatable surgical end effectors|

---

US9987000B2|2014-12-18|2018-06-05|Ethicon Llc|Surgical instrument assembly comprising a flexible articulation system|

---

US9844374B2|2014-12-18|2017-12-19|Ethicon Llc|Surgical instrument systems comprising an articulatable end effector and means for adjusting the firing stroke of a firing member|

---

US9968355B2|2014-12-18|2018-05-15|Ethicon Llc|Surgical instruments with articulatable end effectors and improved firing beam support arrangements|

---

US11154301B2|2015-02-27|2021-10-26|Cilag Gmbh International|Modular stapling assembly|

---

US10548504B2|2015-03-06|2020-02-04|Ethicon Llc|Overlaid multi sensor radio frequencyelectrode system to measure tissue compression|

---

US9901342B2|2015-03-06|2018-02-27|Ethicon Endo-Surgery, Llc|Signal and power communication system positioned on a rotatable shaft|

---

US9924961B2|2015-03-06|2018-03-27|Ethicon Endo-Surgery, Llc|Interactive feedback system for powered surgical instruments|

---

US9808246B2|2015-03-06|2017-11-07|Ethicon Endo-Surgery, Llc|Method of operating a powered surgical instrument|

---

US9993248B2|2015-03-06|2018-06-12|Ethicon Endo-Surgery, Llc|Smart sensors with local signal processing|

---

US10687806B2|2015-03-06|2020-06-23|Ethicon Llc|Adaptive tissue compression techniques to adjust closure rates for multiple tissue types|

---

US10441279B2|2015-03-06|2019-10-15|Ethicon Llc|Multiple level thresholds to modify operation of powered surgical instruments|

---

US10617412B2|2015-03-06|2020-04-14|Ethicon Llc|System for detecting the mis-insertion of a staple cartridge into a surgical stapler|

---

US10245033B2|2015-03-06|2019-04-02|Ethicon Llc|Surgical instrument comprising a lockable battery housing|

---

US10390825B2|2015-03-31|2019-08-27|Ethicon Llc|Surgical instrument with progressive rotary drive systems|

---

US11058425B2|2015-08-17|2021-07-13|Ethicon Llc|Implantable layers for a surgical instrument|

---

US10238386B2|2015-09-23|2019-03-26|Ethicon Llc|Surgical stapler having motor control based on an electrical parameter related to a motor current|

---

US10327769B2|2015-09-23|2019-06-25|Ethicon Llc|Surgical stapler having motor control based on a drive system component|

---

US10105139B2|2015-09-23|2018-10-23|Ethicon Llc|Surgical stapler having downstream current-based motor control|

---

US10299878B2|2015-09-25|2019-05-28|Ethicon Llc|Implantable adjunct systems for determining adjunct skew|

---

US10285699B2|2015-09-30|2019-05-14|Ethicon Llc|Compressible adjunct|

---

US10561420B2|2015-09-30|2020-02-18|Ethicon Llc|Tubular absorbable constructs|

---

US10980539B2|2015-09-30|2021-04-20|Ethicon Llc|Implantable adjunct comprising bonded layers|

---

US10265068B2|2015-12-30|2019-04-23|Ethicon Llc|Surgical instruments with separable motors and motor control circuits|

---

US10368865B2|2015-12-30|2019-08-06|Ethicon Llc|Mechanisms for compensating for drivetrain failure in powered surgical instruments|

---

US10292704B2|2015-12-30|2019-05-21|Ethicon Llc|Mechanisms for compensating for battery pack failure in powered surgical instruments|

---

US11213293B2|2016-02-09|2022-01-04|Cilag Gmbh International|Articulatable surgical instruments with single articulation link arrangements|

---

US10413291B2|2016-02-09|2019-09-17|Ethicon Llc|Surgical instrument articulation mechanism with slotted secondary constraint|

---

US11224426B2|2016-02-12|2022-01-18|Cilag Gmbh International|Mechanisms for compensating for drivetrain failure in powered surgical instruments|

---

US10376263B2|2016-04-01|2019-08-13|Ethicon Llc|Anvil modification members for surgical staplers|

---

US10617413B2|2016-04-01|2020-04-14|Ethicon Llc|Closure system arrangements for surgical cutting and stapling devices with separate and distinct firing shafts|

---

US10405859B2|2016-04-15|2019-09-10|Ethicon Llc|Surgical instrument with adjustable stop/start control during a firing motion|

---

US10492783B2|2016-04-15|2019-12-03|Ethicon, Llc|Surgical instrument with improved stop/start control during a firing motion|

---

US10357247B2|2016-04-15|2019-07-23|Ethicon Llc|Surgical instrument with multiple program responses during a firing motion|

---

US10828028B2|2016-04-15|2020-11-10|Ethicon Llc|Surgical instrument with multiple program responses during a firing motion|

---

US10426467B2|2016-04-15|2019-10-01|Ethicon Llc|Surgical instrument with detection sensors|

---

US10456137B2|2016-04-15|2019-10-29|Ethicon Llc|Staple formation detection mechanisms|

---

US10335145B2|2016-04-15|2019-07-02|Ethicon Llc|Modular surgical instrument with configurable operating mode|

---

US11179150B2|2016-04-15|2021-11-23|Cilag Gmbh International|Systems and methods for controlling a surgical stapling and cutting instrument|

---

US10368867B2|2016-04-18|2019-08-06|Ethicon Llc|Surgical instrument comprising a lockout|

---

US10542981B2|2016-11-14|2020-01-28|Ethicon Llc|Atraumatic stapling head features for circular surgical stapler|

---

US20180168625A1|2016-12-21|2018-06-21|Ethicon Endo-Surgery, Llc|Surgical stapling instruments with smart staple cartridges|

---

US10736629B2|2016-12-21|2020-08-11|Ethicon Llc|Surgical tool assemblies with clutching arrangements for shifting between closure systems with closure stroke reduction features and articulation and firing systems|

---

US10888322B2|2016-12-21|2021-01-12|Ethicon Llc|Surgical instrument comprising a cutting member|

---

US10675026B2|2016-12-21|2020-06-09|Ethicon Llc|Methods of stapling tissue|

---

US20180168598A1|2016-12-21|2018-06-21|Ethicon Endo-Surgery, Llc|Staple forming pocket arrangements comprising zoned forming surface grooves|

---

US11134942B2|2016-12-21|2021-10-05|Cilag Gmbh International|Surgical stapling instruments and staple-forming anvils|

---

US11160551B2|2016-12-21|2021-11-02|Cilag Gmbh International|Articulatable surgical stapling instruments|

---

US20180168633A1|2016-12-21|2018-06-21|Ethicon Endo-Surgery, Llc|Surgical stapling instruments and staple-forming anvils|

---

US10426471B2|2016-12-21|2019-10-01|Ethicon Llc|Surgical instrument with multiple failure response modes|

---

US20180168618A1|2016-12-21|2018-06-21|Ethicon Endo-Surgery, Llc|Surgical stapling systems|

---

US20180168608A1|2016-12-21|2018-06-21|Ethicon Endo-Surgery, Llc|Surgical instrument system comprising an end effector lockout and a firing assembly lockout|

---

JP2020501779A|2016-12-21|2020-01-23|エシコン エルエルシーＥｔｈｉｃｏｎ ＬＬＣ|Surgical stapling system|

---

US11191539B2|2016-12-21|2021-12-07|Cilag Gmbh International|Shaft assembly comprising a manually-operable retraction system for use with a motorized surgical instrument system|

---

US11179155B2|2016-12-21|2021-11-23|Cilag Gmbh International|Anvil arrangements for surgical staplers|

---

US10779823B2|2016-12-21|2020-09-22|Ethicon Llc|Firing member pin angle|

---

US20190000481A1|2017-02-17|2019-01-03|Ethicon Llc|Method of Surgical Stapling with End Effector Component Having a Curved Tip|

---

US11103244B2|2017-02-17|2021-08-31|Cilag Gmbh International|Surgical stapling end effector jaw with tip deflecting toward other jaw|

---

US10709448B2|2017-06-05|2020-07-14|Grena Usa Llc|Linear cutter stapler|

---

US10368864B2|2017-06-20|2019-08-06|Ethicon Llc|Systems and methods for controlling displaying motor velocity for a surgical instrument|

---

US11090046B2|2017-06-20|2021-08-17|Cilag Gmbh International|Systems and methods for controlling displacement member motion of a surgical stapling and cutting instrument|

---

USD879809S1|2017-06-20|2020-03-31|Ethicon Llc|Display panel with changeable graphical user interface|

---

US10881399B2|2017-06-20|2021-01-05|Ethicon Llc|Techniques for adaptive control of motor velocity of a surgical stapling and cutting instrument|

---

USD879808S1|2017-06-20|2020-03-31|Ethicon Llc|Display panel with graphical user interface|

---

US10813639B2|2017-06-20|2020-10-27|Ethicon Llc|Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on system conditions|

---

US10881396B2|2017-06-20|2021-01-05|Ethicon Llc|Surgical instrument with variable duration trigger arrangement|

---

US10779820B2|2017-06-20|2020-09-22|Ethicon Llc|Systems and methods for controlling motor speed according to user input for a surgical instrument|

---

US10888321B2|2017-06-20|2021-01-12|Ethicon Llc|Systems and methods for controlling velocity of a displacement member of a surgical stapling and cutting instrument|

---

US10980537B2|2017-06-20|2021-04-20|Ethicon Llc|Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified number of shaft rotations|

---

US10646220B2|2017-06-20|2020-05-12|Ethicon Llc|Systems and methods for controlling displacement member velocity for a surgical instrument|

---

US11071554B2|2017-06-20|2021-07-27|Cilag Gmbh International|Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on magnitude of velocity error measurements|

---

US10327767B2|2017-06-20|2019-06-25|Ethicon Llc|Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation|

---

US10624633B2|2017-06-20|2020-04-21|Ethicon Llc|Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument|

---

USD890784S1|2017-06-20|2020-07-21|Ethicon Llc|Display panel with changeable graphical user interface|

---

US10307170B2|2017-06-20|2019-06-04|Ethicon Llc|Method for closed loop control of motor velocity of a surgical stapling and cutting instrument|

---

US10772629B2|2017-06-27|2020-09-15|Ethicon Llc|Surgical anvil arrangements|

---

US11266405B2|2017-06-27|2022-03-08|Cilag Gmbh International|Surgical anvil manufacturing methods|

---

US11141154B2|2017-06-27|2021-10-12|Cilag Gmbh International|Surgical end effectors and anvils|

---

US10993716B2|2017-06-27|2021-05-04|Ethicon Llc|Surgical anvil arrangements|

---

US10856869B2|2017-06-27|2020-12-08|Ethicon Llc|Surgical anvil arrangements|

---

US10765427B2|2017-06-28|2020-09-08|Ethicon Llc|Method for articulating a surgical instrument|

---

USD869655S1|2017-06-28|2019-12-10|Ethicon Llc|Surgical fastener cartridge|

---

USD854151S1|2017-06-28|2019-07-16|Ethicon Llc|Surgical instrument shaft|

---

US11246592B2|2017-06-28|2022-02-15|Cilag Gmbh International|Surgical instrument comprising an articulation system lockable to a frame|

---

US20190000474A1|2017-06-28|2019-01-03|Ethicon Llc|Surgical instrument comprising selectively actuatable rotatable couplers|

---

USD906355S1|2017-06-28|2020-12-29|Ethicon Llc|Display screen or portion thereof with a graphical user interface for a surgical instrument|

---

US10639037B2|2017-06-28|2020-05-05|Ethicon Llc|Surgical instrument with axially movable closure member|

---

US10716614B2|2017-06-28|2020-07-21|Ethicon Llc|Surgical shaft assemblies with slip ring assemblies with increased contact pressure|

---

US11259805B2|2017-06-28|2022-03-01|Cilag Gmbh International|Surgical instrument comprising firing member supports|

---

US10903685B2|2017-06-28|2021-01-26|Ethicon Llc|Surgical shaft assemblies with slip ring assemblies forming capacitive channels|

---

US11007022B2|2017-06-29|2021-05-18|Ethicon Llc|Closed loop velocity control techniques based on sensed tissue parameters for robotic surgical instrument|

---

US10898183B2|2017-06-29|2021-01-26|Ethicon Llc|Robotic surgical instrument with closed loop feedback techniques for advancement of closure member during firing|

---

US10932772B2|2017-06-29|2021-03-02|Ethicon Llc|Methods for closed loop velocity control for robotic surgical instrument|

---

US10398434B2|2017-06-29|2019-09-03|Ethicon Llc|Closed loop velocity control of closure member for robotic surgical instrument|

---

WO2019036490A1|2017-08-14|2019-02-21|Standard Bariatrics, Inc.|End effectors, surgical stapling devices, and methods of using same|

---

US10743872B2|2017-09-29|2020-08-18|Ethicon Llc|System and methods for controlling a display of a surgical instrument|

---

US10796471B2|2017-09-29|2020-10-06|Ethicon Llc|Systems and methods of displaying a knife position for a surgical instrument|

---

USD917500S1|2017-09-29|2021-04-27|Ethicon Llc|Display screen or portion thereof with graphical user interface|

---

USD907648S1|2017-09-29|2021-01-12|Ethicon Llc|Display screen or portion thereof with animated graphical user interface|

---

US10729501B2|2017-09-29|2020-08-04|Ethicon Llc|Systems and methods for language selection of a surgical instrument|

---

US10765429B2|2017-09-29|2020-09-08|Ethicon Llc|Systems and methods for providing alerts according to the operational state of a surgical instrument|

---

USD907647S1|2017-09-29|2021-01-12|Ethicon Llc|Display screen or portion thereof with animated graphical user interface|

---

US11090075B2|2017-10-30|2021-08-17|Cilag Gmbh International|Articulation features for surgical end effector|

---

US11134944B2|2017-10-30|2021-10-05|Cilag Gmbh International|Surgical stapler knife motion controls|

---

US10842490B2|2017-10-31|2020-11-24|Ethicon Llc|Cartridge body design with force reduction based on firing completion|

---

US10779903B2|2017-10-31|2020-09-22|Ethicon Llc|Positive shaft rotation lock activated by jaw closure|

---

US11197670B2|2017-12-15|2021-12-14|Cilag Gmbh International|Surgical end effectors with pivotal jaws configured to touch at their respective distal ends when fully closed|

---

US11006955B2|2017-12-15|2021-05-18|Ethicon Llc|End effectors with positive jaw opening features for use with adapters for electromechanical surgical instruments|

---

US10779826B2|2017-12-15|2020-09-22|Ethicon Llc|Methods of operating surgical end effectors|

---

US10828033B2|2017-12-15|2020-11-10|Ethicon Llc|Handheld electromechanical surgical instruments with improved motor control arrangements for positioning components of an adapter coupled thereto|

---

US10966718B2|2017-12-15|2021-04-06|Ethicon Llc|Dynamic clamping assemblies with improved wear characteristics for use in connection with electromechanical surgical instruments|

---

US11071543B2|2017-12-15|2021-07-27|Cilag Gmbh International|Surgical end effectors with clamping assemblies configured to increase jaw aperture ranges|

---

US10687813B2|2017-12-15|2020-06-23|Ethicon Llc|Adapters with firing stroke sensing arrangements for use in connection with electromechanical surgical instruments|

---

US11033267B2|2017-12-15|2021-06-15|Ethicon Llc|Systems and methods of controlling a clamping member firing rate of a surgical instrument|

---

US10779825B2|2017-12-15|2020-09-22|Ethicon Llc|Adapters with end effector position sensing and control arrangements for use in connection with electromechanical surgical instruments|

---

US10743875B2|2017-12-15|2020-08-18|Ethicon Llc|Surgical end effectors with jaw stiffener arrangements configured to permit monitoring of firing member|

---

US10869666B2|2017-12-15|2020-12-22|Ethicon Llc|Adapters with control systems for controlling multiple motors of an electromechanical surgical instrument|

---

US10743874B2|2017-12-15|2020-08-18|Ethicon Llc|Sealed adapters for use with electromechanical surgical instruments|

---

US11045270B2|2017-12-19|2021-06-29|Cilag Gmbh International|Robotic attachment comprising exterior drive actuator|

---

USD910847S1|2017-12-19|2021-02-16|Ethicon Llc|Surgical instrument assembly|

---

US10835330B2|2017-12-19|2020-11-17|Ethicon Llc|Method for determining the position of a rotatable jaw of a surgical instrument attachment assembly|

---

US11020112B2|2017-12-19|2021-06-01|Ethicon Llc|Surgical tools configured for interchangeable use with different controller interfaces|

---

US10716565B2|2017-12-19|2020-07-21|Ethicon Llc|Surgical instruments with dual articulation drivers|

---

US10729509B2|2017-12-19|2020-08-04|Ethicon Llc|Surgical instrument comprising closure and firing locking mechanism|

---

US11129680B2|2017-12-21|2021-09-28|Cilag Gmbh International|Surgical instrument comprising a projector|

---

US10743868B2|2017-12-21|2020-08-18|Ethicon Llc|Surgical instrument comprising a pivotable distal head|

---

US11076853B2|2017-12-21|2021-08-03|Cilag Gmbh International|Systems and methods of displaying a knife position during transection for a surgical instrument|

---

US11179154B2|2018-07-16|2021-11-23|Cilag Gmbh International|Surgical stapling end effector component with deformable tip skewing in multiple planes|

---

US10973515B2|2018-07-16|2021-04-13|Ethicon Llc|Permanent attachment means for curved tip of component of surgical stapling instrument|

---

US11160550B2|2018-07-16|2021-11-02|Cilag Gmbh International|Surgical stapling end effector component with articulation and asymmetric deformable tip|

---

US10786252B2|2018-07-16|2020-09-29|Ethicon Llc|Surgical stapling end effector component with deformable tip having void|

---

US10912561B2|2018-07-16|2021-02-09|Ethicon Llc|Buttress applier cartridge for surgical stapler having end effector with deflectable curved tip|

---

US10912558B2|2018-07-16|2021-02-09|Ethicon Llc|Surgical stapling end effector component with deformable tip having thick distal end|

---

US10779821B2|2018-08-20|2020-09-22|Ethicon Llc|Surgical stapler anvils with tissue stop features configured to avoid tissue pinch|

---

USD914878S1|2018-08-20|2021-03-30|Ethicon Llc|Surgical instrument anvil|

---

US10856870B2|2018-08-20|2020-12-08|Ethicon Llc|Switching arrangements for motor powered articulatable surgical instruments|

---

US10912559B2|2018-08-20|2021-02-09|Ethicon Llc|Reinforced deformable anvil tip for surgical stapler anvil|

---

US11083458B2|2018-08-20|2021-08-10|Cilag Gmbh International|Powered surgical instruments with clutching arrangements to convert linear drive motions to rotary drive motions|

---

US11207065B2|2018-08-20|2021-12-28|Cilag Gmbh International|Method for fabricating surgical stapler anvils|

---

US10842492B2|2018-08-20|2020-11-24|Ethicon Llc|Powered articulatable surgical instruments with clutching and locking arrangements for linking an articulation drive system to a firing drive system|

---

US11045192B2|2018-08-20|2021-06-29|Cilag Gmbh International|Fabricating techniques for surgical stapler anvils|

---

US11039834B2|2018-08-20|2021-06-22|Cilag Gmbh International|Surgical stapler anvils with staple directing protrusions and tissue stability features|

---

US11253256B2|2018-08-20|2022-02-22|Cilag Gmbh International|Articulatable motor powered surgical instruments with dedicated articulation motor arrangements|

---

US11202628B2|2018-12-28|2021-12-21|Cilag Gmbh International|Surgical stapler with tissue engagement features around tissue containment pin|

---

US11116505B2|2018-12-28|2021-09-14|Cilag Gmbh International|Applicator for surgical stapler buttress|

---

WO2020136481A1|2018-12-28|2020-07-02|Ethicon Llc|Curved tip surgical stapler buttress assembly applicator with opening feature for curved tip alignment|

---

USD926318S1|2018-12-28|2021-07-27|Cilag Gmbh International|Surgical stapler deck with tissue engagement recess features|

---

USD932621S1|2018-12-28|2021-10-05|Cilag Gmbh International|Buttress assembly for a surgical stapler|

---

USD922576S1|2018-12-28|2021-06-15|Cilag Gmbh International|Applicator tray for a buttress applicator for a surgical stapler|

---

US11103243B2|2018-12-28|2021-08-31|Cilag Gmbh International|Curved tip surgical stapler buttress assembly applicator with compression layer pocket feature|

---

USD933220S1|2018-12-28|2021-10-12|Cilag Gmbh International|Buttress assembly for a surgical stapler|

---

US10905424B2|2018-12-28|2021-02-02|Ethicon Llc|Curved tip surgical stapler buttress assembly applicator with proximal alignment features|

---

US11166725B2|2018-12-28|2021-11-09|Cilag Gmbh International|Configuration of buttress for surgical stapler|

---

USD901686S1|2018-12-28|2020-11-10|Ethicon Llc|Applicator for surgical stapler buttress|

---

USD926317S1|2018-12-28|2021-07-27|Cilag Gmbh International|Surgical stapler deck with tissue engagement cleat features|

---

US11033269B2|2018-12-28|2021-06-15|Cilag Gmbh International|Method of applying buttresses to surgically cut and stapled sites|

---

USD903115S1|2018-12-28|2020-11-24|Ethicon Llc|Applicator for a surgical stapler buttress|

---

US11166724B2|2018-12-28|2021-11-09|Cilag Gmbh International|Adhesive distribution on buttress for surgical stapler|

---

US20200237368A1|2019-01-30|2020-07-30|Ethicon Llc|Surgical stapler with toggling distal tip|

---

US20200237370A1|2019-01-30|2020-07-30|Ethicon Llc|Surgical stapler with deflectable distal tip|

---

US20200237369A1|2019-01-30|2020-07-30|Ethicon Llc|Surgical stapler with rotatable distal tip|

---

US20200289112A1|2019-03-13|2020-09-17|Covidien Lp|Surgical stapler anvil with directionally biased staple pockets|

---

US11172929B2|2019-03-25|2021-11-16|Cilag Gmbh International|Articulation drive arrangements for surgical systems|

---

US11147551B2|2019-03-25|2021-10-19|Cilag Gmbh International|Firing drive arrangements for surgical systems|

---

US11147553B2|2019-03-25|2021-10-19|Cilag Gmbh International|Firing drive arrangements for surgical systems|

---

US11253254B2|2019-04-30|2022-02-22|Cilag Gmbh International|Shaft rotation actuator on a surgical instrument|

---

US11224497B2|2019-06-28|2022-01-18|Cilag Gmbh International|Surgical systems with multiple RFID tags|

---

US11259803B2|2019-06-28|2022-03-01|Cilag Gmbh International|Surgical stapling system having an information encryption protocol|

---

US11246678B2|2019-06-28|2022-02-15|Cilag Gmbh International|Surgical stapling system having a frangible RFID tag|

---

US11219455B2|2019-06-28|2022-01-11|Cilag Gmbh International|Surgical instrument including a lockout key|

---

US11051807B2|2019-06-28|2021-07-06|Cilag Gmbh International|Packaging assembly including a particulate trap|

---

US11241235B2|2019-06-28|2022-02-08|Cilag Gmbh International|Method of using multiple RFID chips with a surgical assembly|

---

US20210128335A1|2019-11-04|2021-05-06|Standard Bariatrics, Inc.|Systems and methods of performing surgery using laplace's law tension retraction during surgery|

---

US11234698B2|2019-12-19|2022-02-01|Cilag Gmbh International|Stapling system comprising a clamp lockout and a firing lockout|

法律状态:
2021-10-19| B350| Update of information on the portal [chapter 15.35 patent gazette]|

优先权:

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申请号 | 申请日 | 专利标题

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US15/435,631|US10758231B2|2017-02-17|2017-02-17|Surgical stapler with bent anvil tip, angled staple cartridge tip, and tissue gripping features|

---

PCT/US2018/017931|WO2018152083A1|2017-02-17|2018-02-13|Surgical stapler with bent anvil tip, angled staple cartridge tip, and tissue gripping features|

---