surgical instrument comprising firing limb supports

专利摘要:
  The present invention relates to a surgical instrument comprising a drive shaft, an end actuator pivotally coupled to the drive shaft around a pivot joint, and a firing system configured to move through the joint. linkage and the end actuator. The surgical instrument further comprises a means configured to facilitate the movement of the firing system through the articulation joint and the end actuator.
公开号:BR112019026756A2
申请号:R112019026756-5
申请日:2018-05-24
公开日:2020-09-01
发明作者:Frederick E. Shelton Iv；Jason L. Harris；Jeffrey S. Swayze
申请人:Ethicon Llc；
IPC主号:

专利说明:

[0001] [0001] The present invention relates to surgical instruments and, in various provisions, surgical instruments for stapling and cutting, and staple cartridges for use with them, which are designed for stapling and cutting tissue. BRIEF DESCRIPTION OF THE DRAWINGS
[0002] [0002] Several characteristics of the modalities described here, together with their advantages, can be understood according to the description presented below, considered together with the attached drawings, as shown below:
[0003] [0003] Figure 1 is a side elevation view of a surgical system that comprises a set of handles and multiple sets of interchangeable surgical tools that can be used with it;
[0004] [0004] Figure 2 is an exploded view of portions of the handle set and one of the interchangeable surgical tool sets shown in Figure 1;
[0005] [0005] Figure 3 is a perspective view of one of the interchangeable surgical tool sets represented in Figure 1;
[0006] [0006] Figure 4 is an exploded view of the interchangeable surgical tool set of Figure 3;
[0007] [0007] Figure 5 is another exploded view of a distal portion of the interchangeable surgical tool set of Figures 3 and 4;
[0008] [0008] Figure 6 is an exploded view of a distal portion of the interchangeable surgical tool set of Figures 3 to 5;
[0009] [0009] Figure 7 is an exploded view of a proximal portion of the interchangeable surgical tool set of Figures 3 to 6;
[0010] [0010] Figure 8 is an exploded view of a proximal portion of the interchangeable surgical tool set of Figures 3 to 7;
[0011] [0011] Figure 9 is another exploded view of a portion of the interchangeable surgical tool set of Figures 3 to 8;
[0012] [0012] Figure 10 is a perspective view of a proximal portion of the interchangeable surgical tool set of Figures 3 to 9;
[0013] [0013] Figure 11 is another perspective view of the proximal portion of the interchangeable surgical tool set of Figures 3 to 10;
[0014] [0014] Figure 12 is a perspective view of the cross section of the proximal portion of the interchangeable surgical tool set of Figures 3 to 11;
[0015] [0015] Figure 13 is another perspective view of the cross section of the proximal portion of the interchangeable surgical tool set of Figures 3 to 12;
[0016] [0016] Figure 14 is another perspective view of the cross section of the proximal portion of the interchangeable surgical tool set of Figures 3 to 13;
[0017] [0017] Figure 15 is a perspective view of the cross section of a distal portion of the interchangeable surgical tool set of Figures 3 to 14;
[0018] [0018] Figure 16 is a partial plan view of an end actuator of a surgical instrument according to at least one embodiment;
[0019] [0019] Figure 16A is a partial plan view of the end actuator of Figure 16 illustrating the end actuator pivoted in a first direction;
[0020] [0020] Figure 16B is a partial plan view of the end actuator of Figure 16 illustrating the end actuator pivoted in a second direction;
[0021] [0021] Figure 17 is a partial plan view of an end actuator of a surgical instrument according to at least one embodiment;
[0022] [0022] Figure 17A is a partial plan view of the end actuator of Figure 17 illustrating the end actuator pivoted in a first direction;
[0023] [0023] Figure 17B is a partial plan view of the end actuator of Figure 17 illustrating the end actuator pivoted in a second direction;
[0024] [0024] Figure 18 is a partial plan view of the end actuator of Figure 16;
[0025] [0025] Figure 19 is a partial plan view of the end actuator of Figure 17;
[0026] [0026] Figure 20 is a partial plan view of the end actuator of Figure 16 in an articulated position;
[0027] [0027] Figure 21 is a partial plan view of the end actuator of Figure 17 in an articulated position;
[0028] [0028] Figure 22 is a schematic illustration illustrating an articulation band of the end actuator of Figure 16;
[0029] [0029] Figure 23 is a schematic illustration of an articulation strip of the end actuator of Figure 17;
[0030] [0030] Figure 24 is a partial perspective view of the end actuator of Figure 17 illustrated with some components removed;
[0031] [0031] Figure 25 is a partial plan view of the extinguisher actuator
[0032] [0032] Figure 26 is a partial plan view of the end actuator of Figure 17 illustrated in an open and non-articulated configuration;
[0033] [0033] Figure 26A is a partial plan view of the end actuator of Figure 17 illustrated in an open and fully articulated configuration on the right;
[0034] [0034] Figure 26B is a partial plan view of the end actuator of Figure 17 illustrated in an open configuration and completely articulated to the left;
[0035] [0035] Figure 27 is a partial plan view of the end actuator of Figure 17 illustrated in a closed and non-articulated configuration;
[0036] [0036] Figure 27A is a partial plan view of the end actuator of Figure 17 illustrated in a closed and fully articulated configuration on the right;
[0037] [0037] Figure 27B is a partial plan view of the end actuator of Figure 17 illustrated in a closed configuration and completely articulated to the left;
[0038] [0038] Figure 28 is a partial plan view of the end actuator of Figure 17 illustrated in a non-articulated configuration;
[0039] [0039] Figure 29 is a partial plan view of the end actuator of Figure 17 in an articulated configuration;
[0040] [0040] Figure 30 is a partial plan view of the end actuator of Figure 17 illustrated in a non-articulated configuration;
[0041] [0041] Figure 30A is a partial plan view of the end actuator of Figure 17 illustrated in a fully articulated configuration on the right;
[0042] [0042] Figure 30B is a partial plan view of the end actuator of Figure 17 illustrated in a completely
[0043] [0043] Figure 31 is a partial plan view of the end actuator of Figure 17 illustrated in a non-articulated configuration;
[0044] [0044] Figure 31A is a partial plan view of the end actuator of Figure 17 illustrated in a fully articulated configuration on the right;
[0045] [0045] Figure 31B is a partial plan view of the end actuator of Figure 17 illustrated in a configuration completely articulated on the left;
[0046] [0046] Figure 32 is a partial perspective view of an end actuator according to at least one modality;
[0047] [0047] Figure 33 is a partial plan view of the end actuator of Figure 32;
[0048] [0048] Figure 34 is a cross-sectional view of the end actuator of Figure 32 illustrated in an unarticulated configuration;
[0049] [0049] Figure 34A is a cross-sectional view of the end actuator of Figure 32 illustrated in an articulated configuration;
[0050] [0050] Figure 34B is a cross-sectional view of the end actuator of Figure 32 illustrated in an articulated configuration;
[0051] [0051] Figure 35 is a partial perspective view of an end actuator according to at least one modality;
[0052] [0052] Figure 36 is a partial perspective view of the end actuator of Figure 35 illustrated with some components removed;
[0053] [0053] Figure 37 is a partial plan view of the end actuator of Figure 35 illustrated with some components removed;
[0054] [0054] Figure 38 is a partial elevation view of the end actuator of Figure 35 illustrated with some components removed;
[0055] [0055] Figure 39 is a cross-sectional view of the end actuator of Figure 35 illustrated in an unarticulated configuration;
[0056] [0056] Figure 39A is a cross-sectional view of the end actuator of Figure 35 illustrated in an articulated configuration;
[0057] [0057] Figure 39B is a cross-sectional view of the end actuator of Figure 35 illustrated in an articulated configuration;
[0058] [0058] Figure 40 is a partial cross-sectional view of an end actuator comprising an articulation system, including an articulation lock according to at least one model;
[0059] [0059] Figure 41 is a partial exploded view of the end actuator of Figure 40;
[0060] [0060] Figure 42 is an end view in cross section of the end actuator of Figure 40;
[0061] [0061] Figure 43 is a partial cross-sectional view of the end actuator of Figure 40 illustrating the articulation lock in an engaged condition;
[0062] [0062] Figure 44 is a partial cross-sectional view of the end actuator of Figure 40 illustrating the articulation lock in an unlocked condition;
[0063] [0063] Figure 45 is a partial cross-sectional view of the end actuator of Figure 40 illustrating the joint lock in a locked condition;
[0064] [0064] Figure 46 is a partial cross-sectional view of an end actuator that includes a sliding lock plate according to at least one embodiment;
[0065] [0065] Figure 47 is a partial cross-sectional view of another end actuator that includes a sliding lock plate according to at least one embodiment;
[0066] [0066] Figure 48 is a partial cross-sectional view of the end actuator of Figure 47 that illustrates the self-adjustment of the lock plate;
[0067] [0067] Figure 49 is a partial cross-sectional view of the end actuator of Figure 47 in a locked condition;
[0068] [0068] Figure 50 is a partial cross-sectional view of an end actuator that includes another sliding lock plate according to at least one embodiment;
[0069] [0069] Figure 51 is a partial cross-sectional view of the end actuator of Figure 50 illustrated in a locked condition;
[0070] [0070] Figure 52 is a partial cross-sectional view of the end actuator of Figure 50 illustrated in another locked condition;
[0071] [0071] Figure 53 is a partial cross-sectional view of an end actuator comprising an articulation system and an articulation lock according to at least one illustrated embodiment with some components removed;
[0072] [0072] Figure 53A is a partial cross-sectional view of the end actuator of Figure 53 articulated in a first direction;
[0073] [0073] Figure 53B is a partial cross-sectional view of the end actuator of Figure 53 articulated in a second direction;
[0074] [0074] Figure 54 is a partial cross-sectional view of the end actuator of Figure 53 in an unlocked condition;
[0075] [0075] Figure 55 is a partial cross-sectional view of the end actuator of Figure 53 in a partially locked condition;
[0076] [0076] Figure 56 is a partial cross-sectional view of the end actuator of Figure 53 in a locked condition;
[0077] [0077] Figure 57 is a graph illustrating the gradual lock of the end actuator of Figure 53;
[0078] [0078] Figure 58 is a partial cross-sectional view of an end actuator comprising an articulation system and an articulation lock according to at least one embodiment illustrated with some components removed;
[0079] [0079] Figure 59 is a partial cross-sectional view of the end actuator of Figure 58 illustrated in a partially locked condition;
[0080] [0080] Figure 60 is a partial cross-sectional view of the end actuator of Figure 58 in a locked condition;
[0081] [0081] Figure 61 is a partial cross-sectional view of an end actuator comprising an articulation system and an articulation lock according to at least one illustrated embodiment with some components removed;
[0082] [0082] Figure 62 is a partial cross-sectional view of the end actuator of Figure 61 illustrating the articulation lock moving towards the articulation system;
[0083] [0083] Figure 63 is a partial cross-sectional view of the end actuator of Figure 61 illustrating the joint lock engaged with the joint system;
[0084] [0084] Figure 64 is a partial cross-sectional view of the end actuator of Figure 61 illustrating the articulation lock in a locked condition;
[0085] [0085] Figure 65 is another partial cross-sectional view of the end actuator of Figure 61 that illustrates the joint lock in a locked condition;
[0086] [0086] Figure 66 is a partial cross-sectional view of an end actuator comprising an articulation system and an articulation lock according to at least one illustrated embodiment with some components removed;
[0087] [0087] Figure 67 is a partial cross-sectional view of the end actuator of Figure 66 illustrating the articulation lock engaged with the articulation system;
[0088] [0088] Figure 68 is a partial cross-sectional view of the end actuator of Figure 66 illustrating the articulation lock in a locked condition;
[0089] [0089] Figure 69 is a partial cross-sectional view of an end actuator comprising an articulation system and an articulation lock according to at least one illustrated embodiment with some components removed;
[0090] [0090] Figure 70 is a partial cross-sectional view of the end actuator of Figure 69 illustrating the articulation lock moving towards the articulation system;
[0091] [0091] Figure 71 is a partial cross-sectional view of the end actuator of Figure 69 illustrating the joint lock in a locked condition;
[0092] [0092] Figure 72 is a partial perspective view of an end actuator pivoting system according to at least one modality;
[0093] [0093] Figure 73 is a plan view of the end actuator pivoting system of Figure 72;
[0094] [0094] Figure 74 is an elevation view of the joint actuator system of the end actuator of Figure 72;
[0095] [0095] Figure 75 is a partial perspective view of a system
[0096] [0096] Figure 76 is a plan view of the joint actuator system of the end actuator of Figure 75;
[0097] [0097] Figure 77 is an elevation view of the end actuator pivoting system of Figure 75;
[0098] [0098] Figure 78 is a detailed view of the end actuator pivoting system of Figure 75;
[0099] [0099] Figure 79 is another view in detail of the joint actuator system of the end actuator of Figure 75;
[0100] [0100] Figure 80 is a perspective view of a surgical instrument according to at least one modality that comprises a drive shaft and an end actuator;
[0101] [0101] Figure 81 is a perspective view of the surgical instrument in Figure 80 that illustrates the articulated end actuator in relation to the drive shaft;
[0102] [0102] Figure 82 is a perspective view of the end actuator of Figure 80 in an open configuration;
[0103] [0103] Figure 83 is a partial elevation view of a firing member according to at least one embodiment;
[0104] [0104] Figure 84 is a plan view in partial cross section of the firing member of Figure 83;
[0105] [0105] Figure 85 is a partial cross-sectional view of a distal end of a staple cartridge with a shortened tip according to at least one embodiment;
[0106] [0106] Figure 86 is a partial cross-sectional view of a distal end of a staple cartridge with an elongated tip according to at least one embodiment;
[0107] [0107] Figure 87 is a top view of various internal components of the Figure 85 staple cartridge illustrating a triple staple driver extending over three longitudinal rows of staple cavities positioned on top of a portion of a wedge slide;
[0108] [0108] Figure 88 is a cross-sectional view of the triple clamp driver of Figure 87 illustrating the center line of the triple clamp driver in relation to the slider;
[0109] [0109] Figure 89 is a partial plan view of the staple cartridge of Figure 85 illustrating one side of the staple cartridge platform in cross section and showing the position of the slide of Figure 88 within the recesses defined in the shortened end of the cartridge after the completion of a firing course;
[0110] [0110] Figure 90 is a partial cross-sectional view of the staple cartridge of Figure 85 taken along line 90-90 in Figure 89 illustrating the position of the slide after the completion of a firing stroke;
[0111] [0111] Figure 91 is a diagram comparing the accessibility of the end actuators comprising the clamp cartridges in Figures 85 and 86 during a surgical procedure in a pelvic cavity;
[0112] [0112] Figure 92 is a partial perspective view of an end actuator comprising the clamp cartridge of Figure 85 and an opposed anvil shortened with a protective tip according to at least one modality;
[0113] [0113] Figure 93 is a partial elevation view of the end actuator of Figure 92;
[0114] [0114] Figure 94 is a partial plan view of an anvil modality represented in Figure 92 with a protective tip in an assembled configuration;
[0115] [0115] Figure 95 is a partial cross-sectional view of the anvil represented in Figure 94 taken along line 95-95 in
[0116] [0116] Figure 96 is a partial cross-sectional view of the anvil depicted in Figure 95 taken along line 96-96 in Figure 95 and illustrated in a partially disassembled configuration showing the geometry of a fixation feature on the anvil for co- connection to the corresponding geometry on the protective tip;
[0117] [0117] Figure 97 is a partial cross-sectional view of an additional anvil embodiment shown in Figure 92 in a partially disassembled configuration, illustrating a protective tip positioned within a temporary support;
[0118] [0118] Figure 98 is a cross-sectional view of the anvil represented in Figure 97 taken along line 98-98 in Figure 97 in a partially disassembled configuration, showing the geometry of a point-to-anvil fixation feature;
[0119] [0119] Figure 99 is a cross-sectional view of the anvil represented in Figure 97 taken along line 99-99 in Figure 97 in a mounted configuration, with the temporary support still attached;
[0120] [0120] Figure 100 is a cross-sectional view of a trocar sealing system before the insertion of an end actuator through it;
[0121] [0121] Figure 101 is a cross-sectional view of the trocar seal system of Figure 100 illustrating the end actuator shown in Figure 100 being inserted through it;
[0122] [0122] Figure 102 is a cross-sectional view of a trocar seal system of Figure 100 illustrating the insertion of the end actuator shown in Figure 100 through the same;
[0123] [0123] Figure 103 is a cross-sectional view of the trocar seal system in Figure 100 illustrating an end actuator comprising the shortened staple cartridge in Figure 85 and a shortened anvil with a protective tip being inserted through the same;
[0124] [0124] Figure 104 is a cross-sectional view of the trocar seal system of Figure 100 before an end actuator comprising the elongated cartridge of Figure 86 and a shortened anvil with a sharp tip being inserted through the same;
[0125] [0125] Figure 105 is a cross-sectional view of the trocar seal system of Figure 100 illustrating the end actuator shown in Figure 104 being inserted through it; and
[0126] [0126] Figure 106 is a cross-sectional view of the trocar seal system of Figure 100 illustrating the end actuator shown in Figure 104 being inserted through it;
[0127] [0127] Corresponding reference characters indicate corresponding parts through the various views. The exemplifications described herein illustrate various embodiments of the invention, in one form, and such exemplifications should not be considered to limit the scope of the invention in any way. DETAILED DESCRIPTION
[0128] [0128] The applicant for the present application holds the following US patent applications, which were filed on the same date as this application and which are each incorporated by reference in their respective totalities: - US patent application serial number __________, entitled SURGICAL INSTRUMENT COMPRISING AN OFFSET ARTICULA- TION JOINT; proxy document number END8207USNP / 170098;
[0129] [0129] The applicant for this application holds the following US patent applications that were filed on June 27, 2017, and which are each incorporated herein by reference in their respective totalities:
[0130] [0130] The applicant for this application holds the following US patent applications that were filed on December 21, 2016, and which are each incorporated herein by reference in their respective totalities: - US Patent Application No. serial number 15 / 386,185, entitled
[0131] [0131] The applicant for this application holds the following US patent applications that were filed on June 24, 2016, and which are each incorporated herein by reference in their respective totalities: - US Patent Application serial number 15 / 191,775, entitled STAPLE CARTRIDGE COMPRISING WIRE STAPLES AND STAM-PED STAPLES; - US Patent Application Serial No. 15 / 191.807, entitled STAPLING SYSTEM FOR USE WITH WIRE STAPLES AND STAM-PED STAPLES; - US Patent Application Serial No. 15 / 191,834, entitled "STAMPED STAPLES AND STAPLE CARTRIDGES USING THE SA-ME"; - US Patent Application Serial No. 15 / 191,788, entitled STAPLE CARTRIDGE COMPRISING OVERDRIVEN STAPLES; and - US Patent Application Serial No. 15 / 191,818, entitled STAPLE CARTRIDGE COMPRISING OFFSET LONGITUDINAL STA- PLE ROWS.
[0132] [0132] The applicant for this application has the following requests
[0133] [0133] The applicant for this application holds the following patent applications that were filed on April 1, 2016 and which are each incorporated herein by reference in their respective totalities: - US Patent Application Serial No. 15 / 089.325, entitled METHOD FOR OPERATING A SURGICAL STAPLING SYSTEM; - US Patent Application Serial No. 15 / 089,321, entitled MODULAR SURGICAL STAPLING SYSTEM COMPRISING A DISPLAY; - US Patent Application Serial No. 15 / 089,326, entitled SURGICAL STAPLING SYSTEM COMPRISING A DISPLAY INCLUDING A RE-ORIENTABLE DISPLAY FIELD; - US Patent Application Serial No. 15 / 089,263, entitled SURGICAL INSTRUMENT HANDLE ASSEMBLY WITH RECONFI- GURABLE GRIP PORTION; - US Patent Application Serial No. 15 / 089,262, entitled
[0134] [0134] The applicant for this application also holds the US patent applications identified below, which were filed on December 31, 2015, which are each incorporated by reference in their respective totalities. :
[0135] [0135] The applicant for this application also holds the US patent applications identified below, which were filed on February 9, 2016, which are each incorporated herein by reference in their respective totalities: - Application for US Patent Serial No. 15 / 019,220, entitled "SURGICAL INSTRUMENT WITH ARTICULATING AND AXIALLY TRANSLATABLE END EFFECTOR"; - US Patent Application Serial No. 15 / 019,228, entitled "SURGICAL INSTRUMENTS WITH MULTIPLE LINK ARTICULATION ARRANGEMENTS"; - US Patent Application Serial No. 15 / 019,196, entitled "SURGICAL INSTRUMENT ARTICULATION MECHANISM WITH SLOTTED SECONDARY CONSTRAINT"; - US Patent Application Serial No. 15 / 019,206, entitled "SURGICAL INSTRUMENTS WITH AN END EFFECTOR THAT IS
[0136] [0136] The applicant for this application also holds the US patent applications identified below, which were filed on February 12, 2016, which are each incorporated herein by reference in their respective totalities: - US Patent Application Serial No. 15 / 043,254, entitled
[0137] [0137] The applicant for this application holds the following patent applications that were filed on June 18, 2015 and which are each incorporated by reference in their respective totalities: - US Patent Application Serial No. 14 / 742,925, entitled SURGICAL END EFFECTORS WITH POSITIVE JAW OPENING ARRANGEMENTS, now US Patent Application Publication No. 2016/0367256; - US Patent Application Serial No. 14 / 742,941, entitled
[0138] [0138] The applicant for this application holds the following patent applications that were filed on March 6, 2015 and which are each incorporated herein by reference in their respective totalities:
[0139] [0139] The applicant for this application holds the following patent applications that were filed on February 27, 2015 and which are each incorporated herein by reference in their respective totalities: - US Patent Application No. serial number 14 / 633,576, entitled
[0140] [0140] The applicant for this application has the following requests
[0141] [0141] The applicant for this application holds the following patent applications that were filed on March 1, 2013 and which are each incorporated herein by reference in their respective totalities: - US Patent Application Serial No. 13 /782,295, entitled "ARTICULATABLE SURGICAL INSTRUMENTS WITH CONDUCTIVE PATHWAYS FOR SIGNAL COMMUNICATION", now US Patent Application Publication No. 2014/0246471; - US Patent Application Serial No. 13 / 782,323, entitled "ROTARY POWERED ARTICULATION JOINTS FOR SURGICAL INSTRUMENTS", now US Patent Application Publication No. 2014/0246472; - US Patent Application Serial No. 13 / 782,338, entitled "THUMBWHEEL SWITCH ARRANGEMENTS FOR SURGICAL INS- TRUMENTS", now US Patent Application Publication No. 2014 /
[0142] [0142] The applicant for this application also holds the following patent applications that were filed on March 14, 2013 and which are each incorporated herein by reference in their respective totalities: - US Patent Application No. series13 / 803.097, entitled "ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIERING DRIVE", now US Patent Application Publication No. 2014 /
[0143] [0143] The applicant for this application also holds the following patent application that was filed on March 7, 2014 and is hereby incorporated by reference in its entirety: - US Patent Application Serial No. 14 / 200,111, entitled MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT, now US patent No. 9,629,629.
[0144] [0144] The applicant for this application also holds the following patent applications that were filed on March 26, 2014 and which are each incorporated by reference in their respective totalities: - US Patent Application No. series14 / 226.106, entitled "POWER MANAGEMENT CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS", now US Patent Application Publication No. 2015/0272582; - US Patent Application Serial No. 14/226,099, entitled "STERILIZATION VERIFICATION CIRCUIT", now US Patent Application Publication No. 2015/0272581; - US Patent Application Serial No. 14/226,094, entitled "VERIFICATION OF NUMBER OF BATTERY EXCHANGES / PROCEDU-RE COUNT", now US Patent Application Publication No. 2015/0272580; - US Patent Application Serial No. 14/226,117, entitled "POWER MANAGEMENT THROUGH SLEEP OPTIONS OF SEGMENTED CIRCUIT AND WAKE UP CONTROL", now US Patent Application Publication No. 2015/0272574; - US Patent Application Serial No. 14/226,075, entitled "MODULAR POWERED SURGICAL INSTRUMENT WITH DETACHA- BLE SHAFT ASSEMBLIES", now, US Patent Application Publication No. 2015/0272579;
[0145] [0145] The applicant for this application also holds the following patent applications that were filed on September 5, 2014 and which are each incorporated herein by reference in their respective totalities: - US Patent Application No. series14 / 479,103, entitled "CIRCUITRY AND SENSORS FOR POWERED MEDICAL DEVICE", now US Patent Application Publication No. 2016/0066912; - US Patent Application Serial No. 14 / 479,119, entitled "ADJUNCT WITH INTEGRATED SENSORS TO QUANTIFY TISSUE COMPRESSION", now, US Patent Application Publication No. 2016/0066914; - US Patent Application Serial No. 14 / 478,908, entitled "MONITORING DEVICE DEGRADATION BASED ON COMPONENT EVALUATION", now, US Patent Application Publication No. 2016/0066910; - US Patent Application Serial No. 14 / 478,895, entitled "MULTIPLE SENSORS WITH ONE SENSOR AFFECTING A SECOND SENSOR'S OUTPUT OR INTERPRETATION", now, US Patent Application Publication No. 2016/0066909; - US Patent Application Serial No. 14 / 479,110, entitled POLARITY OF HALL MAGNET TO DETECT MISLOADED CARTRID-GE, now, US Patent Application Publication No. 2016/0066915; - US Patent Application Serial No. 14 / 479,098, entitled "SMART CARTRIDGE WAKE UP OPERATION AND DATA RETENTION", now, US Patent Application Publication No. 2016/0066911;
[0146] [0146] The applicant for this application also holds the following patent applications that were filed on April 9, 2014 and which are each incorporated herein by reference in their respective totalities: - US Patent Application n Serial No. 14/248,590, entitled "MOTOR DRIVEN SURGICAL INSTRUMENTS WITH LOCKABLE DUAL DRIVE SHAFTS", now, US Patent Application Publication No. 2014/0305987; - US Patent Application Serial No. 14 / 248,581, entitled
[0147] [0147] The applicant for this application also holds the following patent applications that were filed on April 16, 2013 and which are each incorporated by reference in their respective totalities: - US provisional patent application serial number 61 / 812.365, entitled "SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY A SINGLE MOTOR"; - US provisional patent application serial number 61 / 812,376, entitled "LINEAR CUTTER WITH POWER"; - US provisional patent application serial number 61 / 812,382, entitled "LINEAR CUTTER WITH MOTOR AND PISTOL GRIP"; - US provisional patent application serial number 61 / 812,385, entitled "SURGICAL INSTRUMENT HANDLE WITH MULTIPLE AC- TUATION MOTORS AND MOTOR CONTROL"; and - US provisional patent application serial number 61 / 812,372, entitled "SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY A SINGLE MOTOR ".
[0148] [0148] Numerous specific details are presented to provide a complete understanding of the structure, function, manufacture and general use of the modalities described in the specification and illustrated in the attached drawings. Well-known operations, components and elements have not been described in detail, so as not to obscure the modalities described in the specification. The reader will understand that the modalities described and illustrated in the present invention are non-limiting examples and, therefore, it can be understood that the specific structural and functional details disclosed in the present invention can be representative and illustrative. Variations and changes can be made to this, without deviating from the scope of the claims.
[0149] [0149] The terms "understands" (and any form of understanding, such as "understands" and "that understands"), "has" (and any form of has, such as "has" and "that has"), " includes "(and any form of includes, such as" includes "and" which includes ") and" contains "(and any form of contains, such as" contains "and" which contains ") are unrestricted linking verbs. As a result, a surgical system, device or apparatus that "comprises", "has", "includes" or "contains" one or more elements has those one or more elements, but is not limited to having only those one or more elements. Likewise, an element of a surgical system, device or apparatus that "comprises", "has", "includes" or "contains" one or more resources has those one or more resources, but is not limited to having only those one or more features.
[0150] [0150] The terms "proximal" and "distal" are used in the present invention with reference to a physician who handles the handle portion of the surgical instrument. The term "proximal" refers to the portion closest to the doctor, and the term "distal" refers to the portion located opposite the doctor. It will also be understood that, for the sake of convenience and clarity, spatial terms such as "vertical", "horizontal", "up" and "down" can be used in the present invention with respect to the drawings. However, surgical instruments can be used in many orientations and positions, and these terms are not intended to be limiting and / or absolute.
[0151] [0151] Various devices and exemplary methods are provided for performing laparoscopic and minimally invasive surgical procedures. However, the reader will readily understand that the various methods and devices disclosed in the present invention can be used in numerous surgical procedures and applications, including, for example, in relation to open surgical procedures. With the advancement of this Detailed Description, the reader will also understand that the various instruments disclosed here can be inserted into a body in any way, such as through a natural hole, through an incision or perforation formed in fabric, etc. . Functional portions or portions of the instrument's end actuator can be inserted directly into a patient's body or can be inserted via an access device that has a working channel through which the end actuator and the shaft elongated actuation of a surgical instrument can be advanced.
[0152] [0152] The surgical stapling system can comprise a drive shaft and an end actuator that extends from the drive shaft. The end actuator comprises a first jaw and a second jaw. The first claw comprises a staple cartridge. The staple cartridge is insertable into, and removable from, the first jaw; however, other modes are provided for in which a staple cartridge is not removable, or at least readily replaceable, from the first gripper. The second claw comprises an anvil configured to deform the clamps ejected from the staple cartridge. The second claw is pivoting relative to the first claw around a geometric axis of the lid; however, other modalities are foreseen in which the first claw is pivoting in relation to the second claw. The surgical stapling system additionally comprises an articulation joint configured to allow the end actuator to be rotated or articulated in relation to the drive shaft. The end actuator is rotatable about a pivot axis that extends through the pivot joint. Other modalities are foreseen that do not include an articulation joint.
[0153] [0153] The staple cartridge comprises a cartridge body. The cartridge body includes a proximal end, a distal end, and a platform that extends between the proximal end and the distal end. In use, the staple cartridge is positioned on the first side of the fabric to be stapled and the anvil is positioned on the second side of the fabric. The anvil is moved towards the staple cartridge to compress and secure the fabric against the platform. After that, the staples removably stored in the cartridge body can be implanted in the fabric. The cartridge body includes staple cavities defined therein, the staples are removably stored in the staple cavities. The staple cavities are arranged in six longitudinal rows. Three rows of staple cavities are positioned on a first side of a longitudinal slot and three rows of staple cavities are positioned on a second side of the longitudinal gap. Other arrangements of staple cavities and staples may be possible.
[0154] [0154] Staples are supported by staple actuators on the cartridge body. The actuators are movable between a first position, or a non-triggered position, and a second position, or a triggered position, to eject the clamps from the clamp cavities. The drivers are retained on the cartridge body by a retainer that extends around the bottom of the cartridge body and includes resilient members configured to secure the cartridge body and retain the seal on the cartridge body. The actuators are mobile between their non-triggered positions and their positions triggered by a slide. The slider is movable between a proximal position adjacent to the proximal end and a distal position adjacent to the distal end. The slider comprises a plurality of inclined surfaces configured to slide under the actuators and lift the actuators, and the clamps supported on it, towards the anvil.
[0155] [0155] In addition to the above, the slider is moved distally by a firing member. The firing member is configured to contact the slide and push the slide towards the distal end. The longitudinal slot defined in the cartridge body is configured to receive the firing member. The anvil also includes a slot configured to receive the firing member. The firing member also comprises a first cam that engages with the first claw and a second cam that engages with the second claw. As the firing member is advanced distally, the first cam and the second cam can control the distance, or fabric gap, between the staple cartridge platform and the anvil. The firing member also comprises a knife configured to make an incision in the tissue captured between the anvil and the staple cartridge. It is desirable for the knife to be positioned at least partially proximal to the inclined surfaces, so that the clamps are ejected in front of the knife.
[0156] [0156] Figure 1 depicts a surgical system powered by a motor 10 that can be used to perform a variety of procedures.
[0157] [0157] Figure 2 illustrates the attachment of the interchangeable surgical tool set 1000 to the handle set 500. It will be understood that any of the other interchangeable tool sets 3000, 5000 and 7000 can be coupled to the set of handle 500 in a similar manner. The fixing arrangement and process shown in Figure 2 can also be used in connection with the attachment of any of the interchangeable surgical tool sets 1000, 3000, 5000 and 7000 to a tool drive portion or drive housing. tool of a robotic system. The cable assembly 500 may comprise a cable compartment 502 that includes a pistol grip portion 504 that can be held and handled by the physician. As will be briefly discussed below, the handle set 500 operationally supports a plurality of drive systems 510, 530, which are configured to generate and apply various control movements to the corresponding portions of the interchangeable surgical tool set 1000, 3000, 5000 and / or 7000 that is operationally attached to it.
[0158] [0158] As seen in Figure 2, the handle assembly 500 may also include a handle structure 506 that operationally supports the plurality of drive systems. For example, the 506 grip structure can operationally support a "first" drive system or closing actuation system, generally referred to as 510, which can be used to apply closing and opening movements. to the interchangeable surgical tool set 1000, 3000, 5000 and 7000 that is fixed or operationally coupled to the handle set 500. In at least one form, the closing drive system 510 may include an actuator in the form of a closing trigger 512, pivotally supported by the grip structure 506. This arrangement allows the closing trigger 512 to be manipulated by a doctor, so that when the doctor holds the grip portion of the gun 504 of the handle set 500, closing trigger 512 can be easily rotated from an initial or "not actuated" position to an "actuated" position and, more particularly, to a completely compressed or completely actuated. In various forms, the closing drive system 510 additionally includes a set of closing links 514, which is pivotally coupled to the closing trigger 512 or otherwise interfaces with it. As will be discussed in more detail below, in the illustrated example, the closing hinge assembly 514 includes a transverse fixation pin 516 that facilitates attachment to a corresponding drive system in the surgical tool set. In use, to actuate the closing drive system 510, the physician presses the closing trigger 512 towards the pistol grip portion 504. As described in more detail in US Patent Application Serial No. 14 /226.142, entitled SURGICAL INSTRUMENT COMPRISING A SENSOR SYSTEM, now US Patent Application Publication No. 2015/0272575 which is hereby incorporated by reference in its entirety, the closing drive system 510 is configured to lock the closing trigger 512 in the fully depressed or fully actuated position when the doctor fully presses the closing trigger 512 to obtain the complete closing stroke. When the clinician wishes to unlock the closing trigger 512 to allow the closing trigger 512 to be propelled to the unacted position, the physician activates a set of closing release button 518 that allows the closing trigger to return to its unopened position. acted upon. The lock release button set 518 can also be configured to interact with various sensors that communicate with a microprocessor 560 in the grip set 500 to track the position of the closing trigger 512. An additional discussion in Regarding the configuration and operation of the closing release button assembly 518 can be found in US Patent Application Publication No. 2015/0272575.
[0159] [0159] In at least one form, the handle assembly 500 and the handle structure 506 can operationally support another drive system called in the present invention a trigger drive system 530, which is configured to apply movements the corresponding portions of the control
[0160] [0160] The 505 electric motor is configured to drive a longitudinally movable drive member axially in the distal and proximal directions depending on the polarity of the voltage applied to the motor. For example, when the motor is started in a rotating direction, the longitudinally movable drive member will be axially driven in a distal "DD" direction. When the 505 motor is started in the opposite rotating direction, the longitudinally movable drive member will be driven axially in a proximal "PD" direction. The grip set 500 may include a switch 513 that can be configured to reverse the polarity applied to the electric motor 505 by power source 522 or otherwise control the engine 505. The grip set 500 may also include a sensor or sensors that they are configured to detect the position of the drive member and / or the direction in which the drive member is being moved. The activation of motor 505 can be controlled by a trigger trigger 532 (Figure 1) pivotally held in the handle assembly 500. The trigger trigger 532 can be rotated between an unacted position and an acted position. The trigger trigger 532 can be moved to the unactivated position by means of a spring or other propensity arrangement so that when the doctor releases the trigger trigger 532, the trigger trigger 532 can be turned or , otherwise, returned to the unactivated position by means of the spring or the bias arrangement. In at least one shape, trigger trigger 532 can be positioned "distant" from closing trigger 512, as discussed above. As discussed in US Patent Application Publication 2015/0272575, the grip handle 500 can be equipped with a trigger trigger safety button to prevent the trigger trigger 532 from inadvertently operating. When the closing trigger 512 is in the unacted position, the safety button is contained in the handle assembly 500, where the doctor cannot readily access it and move it between a safety position, which prevents the trigger trigger 532 from operating and a position trigger in which trigger trigger 532 can be fired. When the physician presses the closing trigger 512, the safety button and trigger trigger 532 pivot downward, where they can then be manipulated by the physician.
[0161] [0161] In at least one form, the longitudinally movable drive member may have a toothed rack formed in it for engagement with a corresponding drive gear arrangement that interfaces with the motor. Additional details regarding those features can be found in US Patent Application Publication No. 2015/0272575. At least
[0162] [0162] Turning now to Figures 3 and 4, the interchangeable surgical tool set 1000 includes a surgical end actuator 1500 comprising a first claw 1600 and a second claw 1800. In one arrangement, the first claw 1600 comprises an elongated channel 1602 which is configured to operationally support a 1700 surgical staple / clamp cartridge inside. The second claw 1800 comprises an anvil 1810 which is pivotally supported in relation to the elongated channel 1602. The interchangeable surgical tool set 1000 includes a hinge system 1300 comprising a hinge joint 1302 and a hinge lock 1400 ( Figures 4 to 6), which can be configured to release the surgical end actuator 1500 in a desired articulated position in relation to a geometric axis of the drive axis SA1.
[0163] [0163] As can be seen further in Figures 4 and 7-9, the interchangeable surgical tool kit 1000 includes a tool frame assembly 1200 comprising a tool chassis 1210 that operationally supports a nozzle assembly 1240 therein. In one form, the nose assembly 1240 is comprised of nozzle portions 1242, 1244 as well as an actuator wheel portion 1246 that is configured to be coupled to the assembled nozzle portions 1242, 1244 by pressure couplings, piercings knots and / or screws, for example. Interchangeable surgical tool set 1000 includes a proximal closure set 1900 that is operationally coupled to a distal closure set 2000 that is used to close and / or open anvil 1810 of surgical end actuator 1500 as will be discussed additionally in detail below. In addition, the interchangeable surgical tool set 1000 includes a central column set 1250 that operationally supports the proximal closing set 1900 and is coupled to the surgical end actuator 1500. In various circumstances, to facilitate assembly, the central column assembly 1250 can be manufactured from an upper central column segment 1251 and a lower central column segment 1252 which are interconnected together by snap fit, adhesive and / or weld features, for example. In assembled form, the center column assembly 1250 includes a proximal end 1253 that is rotatably supported on the tool frame 1210. In one arrangement, for example, the proximal end 1253 of the center column assembly 1250 is attached to a central column bearing (not shown) that is configured to be supported within the tool chassis
[0164] [0164] As can be seen in Figures 4 and 5, the central column assembly 1250 additionally includes a segment of the drive shaft of the intermediate dorsum 1256 that has a diameter that is smaller than the diameter of the end proximal 1253 of the center column assembly 1250. The drive axis segment of the middle center column 1256 of the upper center column segment 1251 ends at an upper pin assembly feature 1260 and the drive axis segment of the middle center column of the segment of the lower center column 1252 ends in a lower pin assembly feature 1270. As can be seen in Figure 6, for example, the upper pin assembly feature 1260 is formed with a pin slot 1262 in it that is adapted to support an upper mounting connection 1264 on it. Similarly, the lower pin assembly feature 1270 is formed with a pin slot 1272 in it which is adapted to support a lower mounting link 1274 in a passable way. The top mounting link
[0165] [0165] Again with reference to Figures 6 and 15, the anvil 1810 includes an anvil body 1812 that ends at the anvil mounting portion 1820. The anvil mounting portion 1820 is movably supported or articulated in the elongated channel 1602 for selective pivoting displacement in relation to it around a fixed anvil pivot geometric axis PA1 (Figure 15) that is transversal to the geometric axis of the drive axis SA1. An anvil pivot member or pivot pin 1822 extends laterally outward on either side of the anvil mounting portion 1820 to be received on a corresponding pivot pin support 1614 formed on the vertical walls 1612 of the proximal end portion mal 1610 of the elongated channel 1602. The rotating pins of the anvil 1822 are pivotally retained in their corresponding rotating pin supports 1614 by the channel cover or anvil retainer 1630. The channel cover or anvil retainer 1630 includes a pair of fixing pins 1636 which are configured to be received in a retaining manner within the corresponding grooves or pin notches 1616 formed in the vertical walls 1612 of the proximal end portion 1610 of the elongated channel 1602.
[0166] [0166] The surgical end actuator 1500 is selectively pivoted around the pivot axis AA1 by the pivot system 1300. In one form, the pivot system 1300 includes the proximal pivot actuator 1310 that is coupled in a way pivoting to a hinge connection 1320. As can be seen in Figure 6, an offset clamping pin 1314 is formed at a proximal end 1312 of the proximal hinge driver 1310. A pivot hole 1316 is formed in the offset clamping pin 1314 and is configured to pivotally receive a proximal link pin 1326 formed at the proximal end 1325 of the link link
[0167] [0167] The movement of the anvil 1810 in relation to the elongated channel 1602 is effected by the axial movement of the set of the proximal closing system 1900 and the set of the distal closing system 2000. Now with reference to Figures 4 and 7, the set proximal closing system 1900 comprises a proximal closing tube
[0168] [0168] Now with reference to Figures 5 and 6, a distal portion 1930 of the proximal closing tube 1910 is attached to the distal closing assembly 2000. The distal closing assembly 2000 includes a hinge connector 2010 that is coupled to a segment of distal closure tube 2030. The segment of the distal closure tube 2030 has a diameter that is larger than the diameter of the distal portion 1930 of the proximal closure tube 1910. The 2010 connector has an end portion that extends proximally 2012 which is adapted to be received on a 1934 connection flange formed at the distal end of the distal portion 1930. The hinge connector 2010 can be retained on the 1934 connection flange by a suitable fastener, adhesive and / or sun arrangement - das, for example.
[0169] [0169] The interchangeable surgical tool set 1000 additionally includes a firing system commonly referred to as 2100. The firing system 2100 includes a firing member set 2110 that is supported for axial displacement within the column set center 1250. The firing member assembly 2110 includes a portion of the intermediate firing drive shaft 2120, which is configured to be connected to a distal cutting portion or cutter bar 2130. The firing member assembly 2110 can also be referred to in the present invention as a "second drive shaft" and / or a "second drive shaft assembly". As can be seen in Figure 5, the intermediate firing drive shaft portion 2120 may include a longitudinal slot 2124 at a distal end 2122 thereof, which can be configured to receive a proximal end 2132 of the cutter bar 2130. The longitudinal slot 2124 and the proximal end 2132 of the cutter bar 2130 are sized and configured to allow relative movement between them and may comprise a sliding joint 2134. The sliding joint 2134 may allow the portion of the intermediate firing drive axis 2120 of firing member assembly 2110 is moved to articulate end actuator 1500 without moving, or at least substantially moving, cutter bar 2130. Once the end actuator 1500 has been properly oriented, the intermediate firing drive shaft portion 2120 can be advanced distally until a proximal side wall of longitudinal slot 2124 enters in contact with a portion of the cutter bar 2130 in order to advance the cutter bar 2130 and fire the surgical staple / clamp cartridge 1700 positioned inside the elongated channel 1602. A proximal end 2127 of the portion of the disabling drive shaft intermediate stop 2120 has a firing pin fixing pin 2128 formed on it (Figure 8) which is configured to be seated on a coupling base that is on the distal end of the longitudinally movable drive member of the drive system 530 within the handle assembly 500. This arrangement facilitates the axial movement of the portion of the drive shaft of intermediate trigger 2120 through the actuation of the trigger drive system 530.
[0170] [0170] In addition to the above, the exchangeable tool set 1000 can include a 2200 gear set, which can be configured to selectively and releasably couple the proximal articulation actuator 1310 to the firing member 2100. In one form gear unit 2200 comprises a locking ring or locking sleeve 2210 positioned around the intermediate firing drive shaft portion 2120 of the firing system 2100, where locking sleeve 2210 can be rotated between a engaged position on the which locking sleeve 2210 couples the proximal articulation driver 1310 to the trigger member 2110 and a disengaged position, where the proximal articulation driver 1310 is not operably coupled to the trigger member 2110. When the locking sleeve 2210 is in its engaged position, the distal movement of the firing member assembly 2110 can move the proximal articulation actuator 1310 distally and correspondingly, the proximal movement of the firing member assembly 2110 can proximally move the proximal pivot actuator 1310. When the locking sleeve 2210 is disengaged, the motion of the firing member assembly 2110 is not transmitted to the trigger proximal hinge actuator 1310 and, as a result, the firing member assembly 2110 can move independently of the proximal pivot actuator 1310. In various circumstances, the proximal pivot actuator 1310 can be held in position by articulation lock 1400 when the proximal articulation trigger 1310 is not being moved in the proximal or distal direction by the trigger member assembly 2110.
[0171] [0171] The intermediate firing drive shaft portion 2120 of the firing member assembly 2110 is formed with two opposing planes 2121, 2123 with a driving notch 2126 formed thereon. See Figure 8. As can also be seen in Figure 13, locking sleeve 2210 comprises a cylindrical, or at least substantially cylindrical, body that includes a longitudinal opening 2212 that is configured to receive the portion of the intermediate firing drive axis 2120 through it. The locking sleeve 2210 comprises diametrically opposite and inward facing locking protrusions 2214, 2216 which, when the locking sleeve 2210 is in a position, are received in an engaging manner within the corresponding portions of the drive notch 2126 in the intermediate firing drive shaft 2120 and, when in another position, are not received within the drive notch 2126 to thereby allow relative axial movement between locking sleeve 2210 and the drive shaft portion of dis - intermediate stop 2120.
[0172] [0172] Now with reference to Figures 8 and 12 to 14, the locking sleeve 2210 additionally includes a locking member 2218 which is dimensioned to be movably received within a notch 1319 at a proximal end 1318 of the proximal articulation driver 1310. This arrangement allows the locking sleeve 2210 to rotate slightly in and out of the engagement with the intermediate firing drive shaft portion 2120 while remaining in engagement with the notch 1319 in the trigger. proximal joint 1310. For example, when locking sleeve 2210 is in its engaged position, locking protrusions 2214, 2216 are positioned within a drive notch 2126 in the portion of the intermediate firing shaft 2120 , so that a distal pushing force and / or a proximal pulling force can be transmitted from the trigger member 2110 assembly to the locking sleeve 2210. Such a pulling or prox pushing movement imal is then transmitted from the locking sleeve 2210 to the proximal articulation driver 1310 in order to articulate the surgical end actuator 1500. In effect, the firing member assembly 2110, the locking sleeve 2210 and the proximal pivot actuator 1310 will move together when locking sleeve 2210 is in its engaged (pivot) position. On the other hand, when the locking sleeve 1622 is in its disengaged position, the locking protrusions 2214, 2216 may not be received inside the drive notch 2126 in the portion of the intermediate trigger drive shaft 2120 and, as a result , a distal pushing force and / or a proximal pulling force may not be transmitted from the firing member assembly 2110 to the locking sleeve 2210 (and the proximal pivoting actuator 1310).
[0173] [0173] The relative movement of the lock sleeve 2210 between its engaged and disengaged positions can be controlled by the displacement assembly 2200 that interfaces with the proximal closing tube 1910 of the proximal closing assembly 1900. More specifically and with reference to the Figures 8 and 9, the displacement assembly 2200 additionally includes a displacement key 2240 which is configured to be received in a sliding manner within a key groove 2217 formed in the outer perimeter of the locking sleeve 2210. Such an arrangement allows the displacement key 2240 to move axially in relation to
[0174] [0174] The displacement assembly 2200 additionally includes a switching cylinder 2220 that is rotatably received in a proximal end portion of the proximal closing tube portion 1920. As can be seen in Figures 10 to 14 , the actuator pin 2242 extends through an axial slot segment 2222 in the switching cylinder 2220 and is movably received within an arcuate slot segment 2224 in the switching cylinder 2220. The torsion spring of the cylinder switch 2226 (Figures 12 to 14) is mounted on switch cylinder 2220 and engages the nozzle portion 1244 to apply a torsion or rotation inclination (arrow SR in Figures 10 and 11) that serves to rotate the switch cylinder 2220 until the actuator pin 2242 reaches the end of the arcuate screw segment 2224. See Figures 11 and 12. When in this position, the switch cylinder 2220 can provide a torsional polarization to the 2240 displacement key, do with that the locking sleeve 2210 rotates to its engaged position with the intermediate firing drive shaft portion 2120. This position also corresponds to the unacted configuration of the 1900 proximal closing assembly. In one arrangement, for example, the pin of actuator 2242 is located in the upper portion of the cam opening 1926 in the proximal closing tube portion 1920 when the proximal closing assembly 1900 is in an unacted configuration (anvil 1810 is in an open position spaced away from the staple cartridge / surgical fasteners 1700). When in this position, the actuation of the intermediate firing drive shaft portion 2120 will result in the axial movement of the proximal articulation actuator 1310. After the user has articulated the surgical end actuator 1500 to a desired orientation, the user can then actuate the 1900 proximal closure set. The actuation of the 1900 proximal closure set will result in the distal displacement of the proximal closing tube portion 1920 to finally apply a closing motion to the anvil 1810. This distal displacement the portion of the proximal closing tube 1920 will result in the opening of the cam 1926 interacting in a wandering manner with the cam surface 2243 on the actuator pin 2242 to thereby cause the displacement switch 2240 to rotate the locking sleeve 2210 in an AD actuation direction.
[0175] [0175] With reference again to Figures 8 to 13, the switching cylinder 2220 may additionally comprise openings at least partially circumferential 2228, 2230 defined therein, which can receive circumferential pins / assemblies 1245 extending from the nozzle portions 1242, 1244 and allow relative rotation, but not translation, between switch cylinder 2220 and nozzle assembly 1240. The nozzle pins 1245 extend through corresponding openings 1923 in the proximal closing tube portion 1920 to be seated in the locations of pins 1254 on the central column assembly 1250. See Figures 8 and 9. This arrangement allows the user to rotate the central column assembly 1250 around the geometric axis of the drive shaft by rotating the nozzle assembly 1240.
[0176] [0176] Also as shown in Figures 7 and 12-14, the interchangeable tool set 1000 can comprise a slide ring set 1230 that can be configured to conduct electrical energy to and / or from the surgical end actuator 1500 and / or transmit signals to and / or from the surgical end actuator 1500 back to a microprocessor 560 (Figure 2) on the handle assembly 500 or on the robotic system controller, for example. More details about the 1230 slip ring assembly and associated connectors can be found in US patent application Serial No. 13 / 803,086, currently ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK, currently US Patent Application Publication n ° 2014/0263541 and US patent application Serial No. 15 / 019,196, filed on February 9, 2016, entitled SURGICAL INSTRUMENT ARTICULATION MECHA-NISM WITH SLOTTED SECONDARY CONSTRAINT, each of which is incorporated herein by reference in its respective totalities, as well as in US Patent Application Serial No. 13 / 800,067 entitled STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, currently US Patent Application Publication- US Patent Application Serial No. 2014/0263552, which is here incorporated as a reference in its entirety. As also described in more detail in the aforementioned patent applications that have been incorporated herein, for reference, the interchangeable surgical tool set 1000 may also comprise at least one sensor that is configured to detect the position of the switch cylinder 2220.
[0177] [0177] Again with reference to Figure 2, the tool chassis 1210 includes at least one tapered clamping portion 1212 formed therein, which is adapted to be received inside a corresponding slot 507 formed inside the portion distal end of the handle structure 506 of the handle assembly 500. Several sets of interchangeable surgical tools employ a locking system 1220 to removably couple the interchangeable surgical tool assembly 1000 to the handle structure 506 of the handle assembly handle 500. In at least one way, as seen in Figure 7, the locking system 1220 includes a locking member or a locking fork 1222 that is movably coupled, for example, to the chassis of the tool 1210. The locking fork 1222 has a U-shape with two legs that extend outwards
[0178] [0178] The locking fork 1222 includes at least one locking hook 1227 which is adapted to contact the corresponding locking pin portion 1943 which is formed in the reciprocating closing element 1940. When the reciprocating closing element 1940 is in a non-actuated position, locking fork 1222 can be pivoted in a distal direction to unlock the interchangeable surgical tool set 1000 from handle set 500. When in this position, locking hooks 1227 do not come into contact with the portions of the lock pin 1943 on the reciprocating locking element 1940. However, when the reciprocating locking element 1940 moves to an actuated position, the locking fork 1222 is prevented from being pivoted to an unlocked position. In other words, if the doctor tried to rotate the locking fork 1222 to an unlocked position or, for example, if the locking fork 1222 was inadvertently collided or brought into contact in a way that could otherwise cause it to rotate distally, the locking hooks 1227 on the locking fork 1222 would contact the portions of the locking pin 1943 on the reciprocating closing element 1940 and prevent the movement of the locking fork 1222 to a locked position.
[0179] [0179] Still referring to Figure 6, the cutter bar 2130 may comprise a laminated beam structure that includes at least two layers of beam. Such beam layers may comprise, for example, stainless steel bands that are interconnected, for example, by welds and / or pins, for example, at the proximal ends and / or at other locations along the length thereof. In alternative modalities, the distal ends of the bands are not connected to allow the laminates or the bands to spread in relation to each other when the end actuator is articulated. Such an arrangement allows the cutter bar 2130 to be flexible enough to accommodate the articulation of the end actuator. Several laminated cutter bar provisions are presented in US Patent Application Serial No. 15 / 019.245, entitled
[0180] [0180] As can also be seen in Figure 6, a firing member or cutting member 2140 is attached to the distal end of the cutting bar 2130. In an exemplary form, the firing member 2140 comprises a portion of body 2142 that supports a knife or cutting portion of fabric 2144. Body portion 2142 protrudes through an elongated slot 1604 in the elongated channel 1602 and ends at a base member 2146 that extends laterally on each side of the body portion 2142. As the firing member 2140 is driven distally through the surgical staple / clamp cartridge 1700, the base member 2146 moves within a passage in the elongated channel 1602 which is located under the staple cartridge / surgical clamps 1700. In one arrangement, the body portion 2142 includes two central flaps that project laterally 2145 that can move above the central passage inside the clamp / surgical clamp cartridge
[0181] [0181] Again with reference to Figure 6, the trigger member 2140 is configured to interface operationally with a slide assembly 2150 that is operationally supported within a body 1702 of the staple cartridge / surgical clamps 1700. The assembly slide 2150 is slidably displaceable within the staple cartridge body / surgical clips 1702 from a proximal starting position adjacent to proximal end 1704 of cartridge body 1702 to a final position adjacent to distal end 1706 of cartridge body 1702 The cartridge body 1702 operationally supports within it a plurality of clip drivers which are aligned in rows on each side of a centrally arranged slot 1708. The centrally arranged slot 1708 allows the firing member 2140 to pass through it and cut the tissue that is stuck between the anvil 1810 and the staple cartridge / surgical clips 1700. The drivers are o associated with corresponding staple / fastener pockets 1712 that open through the upper platform surface 1710 of the cartridge body 1702. Each staple driver supports one or more staples or surgical fasteners therein. The slide assembly 2150 includes a plurality of inclined or wedge-shaped cams 2152 with each cam 2152 corresponding to a particular line of fasteners or drivers located on one side of the slot 1708.
[0182] [0182] To fix the interchangeable surgical tool set 1000 to the handle set 500, referred to in Figure 2, the doctor can position the tool frame 1210 of the interchangeable surgical tool set 1000 above or adjacent to the distal end of the handle structure 506, so that the tapered clamping portions 1212 formed in the tool frame 1210 are aligned with the slot slots 507 in the handle structure 506. The doctor can then move the handle assembly interchangeable surgical tool 1000 along an installation geometry axis IA which is perpendicular to the drive geometry SA to seat the tapered clamping portions 1212 in "operational engagement" with the corresponding receiving slots 507 at the distal end of the grip structure 506. When doing this, the pin for the firing drive shaft 2128 in the portion on the intermediate firing drive shaft 2120 it will also be seated on the fastening support 542 on the longitudinally movable drive member in the handle assembly 500 and the portions of the fastening pin 516 on the closing connection 514 will be seated on the corresponding hooks 1942 on the reciprocating closing element 1940. used in the present invention, the term "operational coupling" in reference to two components means that the two components are coupled together so that, by applying an actuation movement to them, the components perform their action, function and / or intended procedure.
[0183] [0183] During a typical surgical procedure, the doctor can introduce the surgical end actuator 1500 into the surgical site through a trocar or other opening in the patient to access the target tissue.
[0184] [0184] An end actuator 10500 of a surgical instrument 10000 is illustrated in Figures 16 to 16B. The end actuator 10500 comprises a 10600 cartridge gripper (Figure 18), including a staple cartridge 10700 and, in addition, an anvil 10800 configured to deform staples ejected from the staple cartridge 10700. In use , the anvil 10800 can be rotated between an open, unfixed position and a closed and secured position; however, the 10600 cartridge gripper can be rotatable towards the anvil 10800 in other embodiments. The surgical instrument 10000 additionally comprises a drive shaft 10100 where the end actuator 10500 is pivotally connected to the drive shaft 10100 around a hinge joint 10200. In use, the end actuator 10500 is rotatable around the articulation joint 10200 between a fully articulated right position (Figure 16A), indicated by the angle ɵR, and a fully articulated left position (Figure 16B), indicated by the angle ɵL - and / or any suitable position between them. As discussed in greater detail below, the ɵR and ɵL angles are limited by the design of the surgical instrument's hinge driver system
[0185] [0185] Referring to Figure 18, the driving shaft 10100 of the surgical instrument 10000 comprises an external closing tube that includes an external housing 10110 that is movable distally to engage the anvil 10800 and move the anvil 10800 towards to the staple cartridge 10700. The drive shaft 10100 additionally comprises a portion of the distal housing 10130 pivotally connected to the outer housing 10110 by two connector plates 10120 positioned on opposite sides of the hinge joint 10200. Each connector plate 10120 is connected to the housing - external element 10110 on a pivot 10115 and, similarly, to the portion of the distal housing 10130 on a pivot 10125. Connecting plates 10120 allow the closing tube to slide in relation to the articulation joint 10200 when the end actuator 10500 is in an articulated position and, as a result, the anvil 10800 can be opened and closed while the end actuator 10500 is in a position articulation. In addition to the above, the distal housing 10130 comprises an opening defined there configured to receive a flap that extends from the proximal end of the anvil 10800 - whose side wall is configured to engage the flap and transfer a proximal or opening movement from the closing tube to the 10800 anvil.
[0186] [0186] An end actuator 11500 of a surgical instrument 11000 is illustrated in Figures 17 to 17B. The 11500 end actuator comprises a 11600 cartridge gripper (Figure 19), including a 11700 staple cartridge and, in addition, a 11800 anvil configured to deform staples ejected from the 11700 staple cartridge. In use , the anvil 11800 can be rotated between an open position, not fixed and a closed and fixed position; however, arrangements are made in which the cartridge claw 11600 is movable in relation to the anvil 11800. The surgical instrument 11000 additionally comprises a drive shaft 11100 in which the end actuator 11500 is pivotally connected to the drive shaft 11100 to the around a hinge joint
[0187] [0187] Referring to Figure 19, the drive shaft 11100 of the surgical instrument 11000 comprises an external closing tube that includes an external housing 11110 which is movable distally to engage the anvil 11800 and move the anvil 11800 towards to the staple cartridge 11700. The drive shaft 11100 additionally comprises a distal housing 11130 swiveled to the outer housing 11110 by two connector plates 11120 positioned on opposite sides of the articulation joint
[0188] [0188] Again with reference to Figure 18, the surgical instrument 10000 additionally comprises a hinge actuator system 10300 that includes a hinge actuator actuator 10310 that extends through an interior opening 10105 defined in the tube closure 10110 of drive shaft 10100. The hinge actuator actuator 10310 comprises a distal end operably engaged with the grip of the 10600 end actuator cartridge 10500. More specifically, the distal end of the hinge actuator actuator 10310 comprises an opening, or slot, 10320 defined therein, and the grip of the cartridge 10600 comprises a pin 10620 that extends into the slot 10320. When the hinge actuator actuator 10310 is pushed distally, the end actuator 10500 is driven to the right (Figure 16A) around a fixed geometric axis defined by a pivot 10210 that swivelly connects the car's claw tucho 10600 to a drive shaft structure 10100. Correspondingly, end actuator 10500 is rotated to the left (Figure 16B) around pivot 10210 when hinge actuator actuator 10310 is pulled proximally.
[0189] [0189] Again with reference to Figure 19, the surgical instrument 11000 additionally comprises a hinge actuator system 11300 that includes a hinge actuator actuator 11310 that extends through an inner opening 11105 defined in the tube closure 11110. The hinge actuator system 11300 additionally comprises a hinge connection 11320 pivotally coupled to a distal end of the hinge actuator actuator 11310 around a pin 11315. Similarly, the connection pivot 11320 is rotatably coupled to the 11600 cartridge jaw around a 11620 drive pin that extends through an opening defined in the 11320 pivot connection. When the 11310 pivot actuator is pushed distally, the end actuator 11500 is driven to the right (Figure 17A) around a fixed geometry axis defined by a pivot 11210 that swivels g drives cartridge 11600 to a drive shaft structure 11100. Correspondingly, end actuator 11500 is rotated to the left (Figure 17B) around pivot 11210 when hinge actuator 11310 is pulled proximally.
[0190] [0190] In addition to the above, the hinge connection 11320 of the hinge system 11300 allows the end actuator 11500 to be hinged over a wider range of hinge angles than the end actuator 10500 for a given , or equal, stroke length of hinge actuators 10310 and 11310. A side-by-side comparison of end actuators 10500 and 11500 is provided in Figures 20 and 21 illustrating end actuators 10500 and 11500 in their fully articulated configurations. right - and also illustrating that the 11500 end actuator can be further hinged to the right than the 10500 end actuator. A similar comparison can be made showing the 10500 and 11500 end actuators in their fully hinged configurations on the left. In addition, Figure 22 represents the entire articulation range of the 10500 end actuator while Figure 23 represents the entire articulation range of the 11500 end actuator.
[0191] [0191] Again with reference to Figure 22, the articulation actuator 10310 of the surgical instrument 10000 is advanced in a distal stroke length (DSL) in relation to its non-articulated position to fully articulate the end actuator 10500 to the right. Correspondingly, the articulation actuator 10310 is retracted to a proximal stroke length (PSL) in relation to its non-articulated position to fully articulate the end actuator 10500 to the left. The distal stroke length
[0192] [0192] In addition to the above, joint actuator 10310 is configured to torque the first claw 10600 of end actuator 10500 through pin 10620 to rotate end actuator 10500 around joint 10200. Again with reference to Figure 22, a lateral torque arm defined between pivot joint 10210 of articulation joint 10200 and pin 10620 has a length TAC1 when end actuator 10500 is in its non-articulated position. The length TAC1 is measured in an orthogonal direction with respect to a longitudinal geometric axis 10190 that extends through the joint pivot joint 10210. Similarly, the lateral torque arm defined between the joint joint 10210 and the pin 10620 has a TAR1 length when the end actuator 10500 is fully pivoted to the right and, similarly, a TAL1 length when end actuator 10500 is fully pivoted to the left - both lengths are measured orthogonally in relative to the longitudinal geometric axis 10190. Notably, the lengths TAR1 and TAL1, and the torque arms they define, are the same, or at least substantially the same. In addition, the lengths TAR1 and TAL1 are smaller than the length of the non-articulated lateral torque arm TAC1. In this way, the largest torque arm, or mechanical advantage, of the 10300 articulation system exists when the end actuator 10500 is in its unarticulated position.
[0193] [0193] In at least one case, the length of the TAC1 arm is approximately 0.180 ", the length of the TAR1 arm is approximately 0.130" and the length of the TAL1 arm is approximately 0.130 ", for example.
[0194] [0194] In addition to the above, the articulation actuator 11310 of the surgical instrument 11000 is configured to torque the first claw 11600 of the end actuator 11500 through pin 11620 to rotate the end actuator 11500 around the pivot joint 11200. Referring to Figures 23, 28 and 30, a lateral torque arm (LTA) defined between pivot joint 11210 of pivot joint 11200 and pin 11620 is defined by a TAC2 length when the end actuator 11500 is in its non-articulated position. The length TAC2 is measured in an orthogonal direction in relation to a longitudinal axis 11190 that extends through the joint pivot joint 11210. Notably, the longitudinal axis 11190 is offset and parallel to the center line of the axis of drive 11100, as discussed in greater detail below in connection with Figure 25. Similar to the above, the lateral torque arm defined between the joint joint 11210 and the pin 11620 is defined by a length TAR2 when the end actuator 11500 it is fully articulated to the right (Figure 30A) and, similarly, a TAL2 length when the end actuator 11500 is completely articulated to the left (Figure 30B) - both lengths are measured orthogonally to each other to the longitudinal geometric axis 11190. Remarkably, the length TAR2 is greater than the length of the non-articulated lateral torque arm TAC1 and the length TAL2 is longer. the length of the non-articulated lateral torque arm TAC1. In addition, the lengths TAR2 and TAL2, and the torque arms they define, are not the same. Instead, the length of the torque arm articulated to the right TAR2 is considerably longer than the length of the torque arm articulated to the left TAL2. In fact, the length of the torque arm articulated to the right TAR2 and the length of the torque arm articulated to the left TAL2 extend in different directions. Such an arrangement provides a greater pushing torque arm compared to a smaller pulling torque arm. In several cases, as a result, the retract pull force applied by the 11310 pivot actuator to pivot the 11500 end actuator to the left (Figure 30B) may be, or may need to be, greater than the force distal push to articulate end actuator 11500 to the right (Figures 29 and 30A). Advantageously, the 11310 pivot actuator can accommodate such greater pulling force as the 11310 pivot actuator is not subject to warping failure when being pulled.
[0195] [0195] In at least one case, the length of the TAC2 arm is approximately 0.149 ", the TAR2 length is approximately 0.154" and the length of the TAL2 arm is approximately 0.015 ", for example.
[0196] [0196] In addition to the above, the 11000 surgical instrument is configured and arranged to provide a high torque to the 11500 end actuator while, at the same time, providing a wide range of articulation, or sweeping, in response to an articulation stroke. short section. Namely, several design reasons for these relationships can be established and used to design the surgical instrument
[0197] [0197] The examples provided above for the first reason were based on the length of the torque arm (TA) when the end actuator 11500 is in its fully pivoted position to the right. This specific position of the 11500 end actuator is notable because the 11310 hinge actuator is compressed and can be warped when the load transmitted through it is excessive. That said, the first reason could also be used to analyze any suitable position of the 11500 end actuator, such as its non-articulated position and its completely articulated to the left, for example. In at least one case, the length of the non-articulated torque arm (TA) is 6.17 mm, resulting in a ratio value of 0.54 for a stroke length (SL) of 11.43 mm, for example. example. In addition, in at least one case, the length of the fully articulated torque arm to the left (TA) is 1.41 mm, resulting in a ratio value of 0.12 for a stroke length (SL) of 11.43 mm, for example.
[0198] [0198] A second reason includes the arc length at which the 11620 drive pin is swept when the 11500 end actuator is pivoted between its fully pivoted position to the right and its fully pivoted position to the left, ie that is, its scanning arc length (ALS). More specifically, the second reason comprises the sweeping arc length (ALS) of the drive pin 11620 divided by the length of the complete articulation stroke (SL) of the articulation actuator
[0199] [0199] A third reason comprises the sum of the length of the torque arm fully articulated to the right (TA) and the length of the sweeping arc (ALS) of the drive pin 11620 divided by the length of the complete articulation stroke (SL). The value of this third reason is dimensionless. In at least one case, the length of the fully articulated torque arm to the right (TA) is 0.154 ", the length of the sweeping arc (ALS) of the drive pin 11620 is 0.387" and the length of the articulation stroke complete (SL) is 0.275 ", resulting in a ratio value of 1.97, for example. In at least one case, the torque arm length fully articulated to the right (TA) is 2.79 mm, the length The scan arm (ALS) of the drive pin 11620 is 12.94 mm and the length of the complete articulation stroke (SL) is 11.43 mm, resulting in a ratio value of 1.38, for example. Higher ratio values for the third ratio indicate more efficient articulation systems In many cases, the value for the third ratio is greater than 1.0, such as between 1.0 and 3.0, for example. case, the third ratio value is approximately 2.0 or greater than 2.0, for example.
[0200] [0200] Similar to the above, the third reason could be used to evaluate the articulation system when the 11500 end actuator is in any suitable position, such as in its non-articulated and completely articulated positions to the left, for example.
[0201] [0201] A fourth reason comprises the product of the length of the torque arm fully articulated to the right (TA) and the length of the sweeping arc (ALS) of the drive pin 11620 divided by the length of the complete articulation stroke (SL). The value of this fourth reason is not dimensionless and is instead measured at a distance. In at least one case, the length of the torque arm fully articulated to the right (TA) is 0.154 ", the length of the sweeping arc (ALS) of the drive pin 11620 is 0.387" and the length of the complete articulation stroke ( SL) is 0.275 ", resulting in a ratio value of 0.217", for example. This value can be dimensionless by dividing it by the stroke length (SL) again, resulting in a value of 0.79. In at least one case, the length of the torque arm fully articulated to the right (TA) is 2.79 mm, the length of the scanning arm (ALS) of the drive pin 11620 is 12.94 mm and the length of the complete articulation stroke (SL) is 11.43 mm, resulting in a ratio value of 3.15 mm, for example. In certain cases, the value for the fourth ratio is about 3.1 mm, but between 0.9 mm and 5.4 mm, for example. Similar to the above, this value can be dimensionless by dividing it by the stroke length (SL) again, resulting in a value of 0.28. Higher ratio values for the fourth ratio indicate more efficient articulation systems.
[0202] [0202] Similar to the above, the fourth reason could be used to evaluate the articulation system when the 11500 end actuator is in any suitable position, such as in its non-articulated and fully articulated positions to the left, for example .
[0203] [0203] As discussed above, end actuator 11500 is pivotally mounted to drive shaft 11100 around a fixed pivot 11210 of joint 11200. Now referring to Figures 24 and 25, the drive shaft 11100 comprises 11220 distal mounting tabs that extend from and are fixedly mounted to the structure, or central column, of the drive shaft
[0204] [0204] As discussed above, the drive shaft 11100 closure tube is movable distally to engage the end actuator 11800 burr jaw and move the 11800 burr jaw towards a 11700 staple cartridge positioned on the 11600 cartridge gripper. In other words, the closing tube is configured to move the 11800 anvil from an open position (Figures 26 to 26B) to a closed position (Figures 27 to 27B) to secure the a patient's tissue against the staple cartridge 11700. In such cases, the closing tube, which comprises housing 11110, connector plates 11120 and distal housing 11130 slide distally from the hinge joint 11200 during a stroke closing. When the end actuator 11500 is in an open, non-articulated configuration, now with reference to Figure 26, the connector plates 11120 extend in a direction that is slightly transverse to the central longitudinal axis LA of the drive axis 11100. More specifically, - te, an AC geometry axis extending between joints 11115 and 11125 is slightly transverse in relation to the longitudinal geometry LA of the drive axis 11100 when the end actuator
[0205] [0205] In several cases, in addition to the above, the orientation of the CA axis will change in relation to a longitudinal axis that extends between the proximal end and the distal end of the 11500 end actuator. In at least one In this case, the AC geometry axis is transversal to such a geometry axis of the longitudinal end actuator, except in a configuration in which the AC geometry axis will be parallel to the geometry axis of the longitudinal end actuator.
[0206] [0206] In addition to the above, the orientation of a geometric axis AA defined between the pivot pivot 11210 and the distal pivot 11125 of the 11120 connector plates changes as the end actuator 11500 is pivoted. Referring to Figure 26, the AA axis extends at an angle β with respect to the CA axis when the end actuator 11500 is in an open, non-articulated configuration. When the 11500 end actuator is in an open configuration on the right (Figure 26A), the angle β decreases. When the 11500 end actuator is pivoted in an open configuration on the left (Figure 26B), the angle β increases. At no time, however, the AA axis is collinear with or parallel to the CA axis when the 11500 open end actuator is pivoted. Instead, the AA axis is transverse to the CA axis when the end actuator 11500 is pivoted in an open configuration.
[0207] [0207] With reference to Figure 27, the AA axis extends at an angle γ to the CA axis when the end actuator 11500 is in a closed, non-articulated configuration. When the 11500 end actuator is pivoted in a closed configuration to the right (Figure 27A), the angle γ increases. When the 11500 end actuator is pivoted in a closed configuration to the left (Figure 27B), the δ angle increases. At no time, however, the AA axis is collinear with the CA axis when the 11500 end actuator is articulated in a closed configuration, and / or any other configuration between an open configuration and a closed configuration. Instead, the geometric axis AA is transversal to the geometric axis AC when the end actuator 11500 is articulated in a closed configuration and / or in any other configuration between an open configuration and a closed configuration.
[0208] [0208] Again with reference to Figures 20 and 21, the design of the surgical instrument 11000 can shorten the end actuator 11500 compared to the end actuator 10500. In addition, the distance between the joint joint 10200 and the proximal end of the staple line that is applied to a patient's tissue by the end actuator 10500 is an L1 distance - while the distance between the hinge joint 11200 and the proximal end of the staple line that is applied by the 11500 end actuator is an L2 distance , which is shorter than the distance L1.
[0209] [0209] Now with reference to Figures 40 to 45, the surgical instrument 11000 additionally comprises a hinge lock 11400 configured to selectively lock the hinge actuator system 11300 and the end actuator 11500 in position. The hinge lock 11400 comprises a distal end 11402 mounted on a structure 11180 of the drive shaft 11100. More particularly, the structure of the drive shaft 11180 comprises pins, or projections, 11182 received and / or pressed.
[0210] [0210] In addition to the above, the proximal end 11404 of joint lock 11400 comprises one or more teeth 11406 defined therein that are configured to engage the joint actuator actuator 11310. As shown in Figure 40, teeth 11406 they are arranged in a longitudinal matrix; however, any suitable arrangement can be used. The actuator of the 11310 hinge actuator comprises a 11316 longitudinal tooth array defined therein that is configured to be engaged by the hinge lock 11406 teeth. With reference to Figure 41, the structure of the drive shaft 11180 further comprises a longitudinal tooth array 11186 defined therein that is configured to be engaged by the teeth of the joint lock 11406. When the joint lock 11400 is in a fully locked state, as described in greater detail below, the teeth of the joint lock pivot 11406 are engaged with the teeth of the drive actuator 11316 and the teeth of the drive shaft structure 11186, so that hinge lock 11400 locks the hinged actuator actuator 11310 to the drive shaft structure 11180 and prevents, or at least inhibits, the relative movement between the 11310 hinge actuator actuator and the 11180 drive shaft structure.
[0211] [0211] In addition to the above, hinge lock 11400 is configurable in three states - a self-locking state, an unlocked state, and a fully locked state. When the hinge lock 11400 is in a self-locking state, referring to Figure 43, the hitch teeth 11406 of the hinge lock 11400 are engaged with the teeth of the 11316 actuator actuator and the teeth of the drive shaft structure 11186. In in such cases, hinge lock 11400 can withstand some force transmitted through the hinge actuator actuator 11310; However, the proximal and / or distal movement of the 11310 hinge actuator actuator can overcome the clamping force 11400 clamping force and move the hinge lock 11400 to its unlocked configuration, as shown in Figure 44 In such cases, hinge lock 11400 may flex or deflect laterally in the opposite direction to actuator actuator 11310. Hinge lock 11400 comprises a spring element 11403 that extends between distal portion 11402 and proximal portion 11404 which is configured to return resiliently, or at least tilt, the articulation lock towards its self-locked configuration (Figure 42). As a result, the 11300 pivot drive system can lock and unlock itself even as a result of its own movement and pivot the 11500 end actuator, unless the 11400 pivot lock is placed in its fully locked position, as discussed below .
[0212] [0212] As discussed further above, the drive shaft 11100 of the surgical instrument 11000 comprises a closing tube 11110 which is advanced distally during a closing stroke to close the 11500 end actuator. Before the closing stroke, the lock pivot 11400 is movable between its self-locking and unlocked configurations to allow the 11500 end actuator to be pivoted by the 11300 pivot drive system. However, during the closing stroke, the 11110 closing tube is configured to engage the hinge lock 11400 and place or fix hinge lock 11400 in its completely locked configuration. More specifically, the closure tube 11110 comprises a projection, or flap, 11118 configured to engage a cam surface 11408 defined on the rear side of the joint lock 11400 and prevent the teeth of the joint lock 11406 from dismembering from actuator 11316 actuator teeth and drive shaft structure 11186 teeth. When closing tube 11110 is retracted proximally to open end actuator 11500, flap 11118 disengages from hinge lock 11400 and lock pivot 11400 is free to move between its self-locked and unlocked positions, as discussed above, so that the 11500 end actuator can be pivoted once again.
[0213] [0213] The surgical instrument 11000 described above is further illustrated in figures 80 to 82. The surgical instrument 11000 comprises a drive shaft 11100 that is configured for use with a trocar that has a defined passage in it. The drive shaft of the 11100 surgical instrument comprises different diameters at different points along the length of the drive shaft of the 11100 surgical instrument. Among other things, the drive shaft of the 11100 surgical instrument comprises a central region 11160 comprising a diameter smaller than any other region of the driving axis of the surgical instrument
[0214] [0214] Referring to Figures 80 and 81, the driving axis of the surgical instrument 11100 additionally comprises a proximal region 11150 and a distal region 11170. The proximal region 11150 of the driving axis of the surgical instrument 11000 is located adjacent to a set 11140 nozzle for the drive shaft
[0215] [0215] In addition to the above, the proximal region 11150 defines a central longitudinal geometric axis. The central region 11160 extends along the longitudinal geometric axis and is centered in relation to the central longitudinal geometric axis. Each of the proximal region 11150 and central region 11160 define a circular profile, although they can understand any suitable configuration. The distal region 11170 is not centered in relation to the central longitudinal geometric axis. Instead, the distal region 11170 is displaced laterally with respect to the central longitudinal geometric axis. In addition, more of the cross section and / or perimeter of the distal region 11170 is positioned on a first side of the central longitudinal geometric axis than a second side. In at least one example, the distal region 11170 comprises an enlargement that extends to one side of the central longitudinal axis. In addition, the 11170 distal region does not define a circular profile.
[0216] [0216] Still with reference to Figures 80 and 81, the central region 11160 comprises a second width that is smaller than the first width of the proximal region 11150. The central region additionally comprises a second width that is smaller than the third width of the distal region 11170. The proximal region 11150 additionally comprises a different width than the width of the distal region 11170. For example, the width of the proximal region 11150 is less than the width of the distal region 11170, but it is even greater than the width of the central region 11160. Similarly, the width of the proximal region 11150 is greater than the width of the distal region 11170 and the width of the central region
[0217] [0217] With reference to Figures 80 to 82, the drive axis of the surgical instrument 11100 of the surgical instrument 11000 is configured
[0218] [0218] The 11150 proximal region comprises a scaled or tapered region, close to the proximal end of the 11100 surgical instrument drive axis, where the 11100 surgical instrument drive axis translates from the 11150 proximal region to the central region 11160. The 11160 central region additionally comprises a staggered, or tapered region, close to the distal end of the 11100 surgical instrument drive shaft, where the 11100 surgical instrument drive shaft transitions from the 11160 central region to the distal region 11170.
[0219] [0219] Still with reference to Figures 80 and 81, the proximal region 11150 comprises a first circumference, the central region 11160 comprises a second circumference and the distal region 11170 comprises a third circumference. The circumference of the proximal region 11150 is different from the circumference of the central region 11160, due to the difference in diameters of such portions of the driving axis of the surgical instrument 11100. Similarly, the circumference of the central region 11160 and the circumference of the distal region 11170 are different. The circumference of the proximal region 11150 and the circumference of the distal region 11170 are the same, but they may be different in other modalities.
[0220] [0220] Again with reference to Figures 80 and 81, the drive shaft of the surgical instrument 11100 comprises a single piece of material formed, although the drive shaft of the surgical instrument 11100 can comprise multiple pieces of material that are combined to form a single drive shaft for the cohesive surgical instrument, in other cases. The pieces of material can be assembled using any suitable process. The drive shaft of the 11100 surgical instrument is configured to operate with a variety of surgical arrangements not limited to the surgical stapling instruments described above. The drive shaft of the 11100 surgical instrument can be used with other surgical instruments that have adjustable end actuators. Other surgical instruments may include, for example, ultrasonic surgical devices, clip applicators and fastener applicators. In addition, the drive shaft of the 11100 surgical instrument is configured to be used with any surgical instrument where the use of a trocar passage is suitable.
[0221] [0221] In addition to the above, the outer tube 11110 of the drive shaft 11100 comprises a proximal end 11150 and a longitudinal portion 11160 comprising a diameter, or width, which is narrower than the diameter, or width, of the ex- proximal tremor 11150. That said, the surgical instrument 11000 is configured and arranged to provide a high torque for the end actuator 11500 while, at the same time, the longitudinal portion 11160 comprises a narrow diameter. Namely, at least a design ratio for this relationship can be established and used to design the 11000 surgical instrument. For example, a ratio comprises the diameter of the longitudinal portion 11160 (D) divided by the length of the torque arm fully articulated to the right (TA). The value of this ratio is dimensionless. In at least one case, the diameter of the longitudinal portion 11160 (D) is 0.316 "and the length of the torque arm (TA) is 0.154", resulting in a ratio value of 2.06, for example. Lower values for this ratio indicate more efficient articulation systems. In many cases, the value for this ratio is less than 2.0, such as between 1.0 and 2.0, for example. In at least one case, the ratio value is between 2.0 and 3.0, for example. In certain cases, the ratio value is less than 3.38, for example.
[0222] [0222] In addition to the above, the outer tube 11110 of the drive shaft 11100 includes a longitudinal portion 11160 and an enlarged distal end 11170 (Figure 80). Again with reference to Figure 40, the entire hinge lock 11400 is positioned on the longitudinal portion 11160 and not on the widened distal end 11170. However, arrangements are provided in which at least a portion of the hinge lock 11400 is positioned at the end extended distal 11170. In at least one of these Cases, the hinge lock 11400 is mounted on the drive shaft structure so that the distal end 11402 of the hinge lock 11400 is at the increased distal end 11170 of the outer tube
[0223] [0223] Now returning to Figure 46, a surgical instrument 14000 comprises a drive shaft 14100, an end actuator 11500 and, in addition, a pivot drive system including a pivot actuator 14310 configured to pivot the 11500 end actuator. The 14100 drive shaft comprises a hinge lock system configured to selectively lock the 14310 hinge actuator actuator and the 14500 end actuator in position. The hinge lock system comprises a hinge lock 14400 that includes the proximal and distal ends mounted on a frame 14180 of the drive shaft 14100. In at least one aspect, the hinge lock 14400 comprises a fixed beam and / or simply supported on both ends. The hinge lock 14400 further comprises an intermediate portion 14404 positioned in a cavity 14184 defined in the drive shaft structure 14180 which is configured to move laterally towards and away from a hinge actuator actuator 14310 of the system hinge actuator 14300. Similar to the above, hinge lock 14400 comprises one or more spring portions 14403 configured to allow hinge lock 14400 to flex toward and away from hinge actuator 14310 .
[0224] [0224] In addition to the above, the intermediate portion 14404 of the hinge lock 14400 comprises one or more teeth 14406 defined therein that are configured to engage the hinge actuator actuator 14310. The teeth 14406 are arranged in one longitudinal arrangement; however, any suitable arrangement can be used. The articulation actuator actuator 14310 comprises a longitudinal tooth array 14316 defined therein that are configured to be engaged by the articulation lock 14406 teeth. The articulation lock system additionally comprises a 14420 locking plate positioned sliding frame in the drive shaft cavity 14184 which includes a longitudinal tooth array 14226 defined in the same as it is also configured to be engaged by the teeth of the joint lock 14406. When the joint lock 14400 is in a completely locked, as described in greater detail below, the hinge lock teeth 14406 are engaged with the teeth of the actuator actuator 14316 and the teeth of the lock plate 14226, so that hinge lock 14400 locks the actuator lock 14310 pivot position and prevents, or at least inhibits, the relative movement between the 14310 pivot actuator actuator and the structure that of the drive shaft 14180.
[0225] [0225] Locking plate 14420 comprises a shoulder-shaped part 14424 which is positioned under the actuator of the 14310 articulation actuator. The teeth of locking plate 14426 are defined on a side edge of the shoulder-shaped part 14424 and are substantially aligned with the teeth 14316 defined in the actuator of the joint actuator 14310. In at least one case, the teeth of the actuator of the joint actuator 14316 are aligned along a first geometric axis of the teeth and the teeth of the lock plate 14406 are defined along a second geometric axis of the teeth that is parallel, or at least substantially parallel, to the first geometric axis of the teeth. In several cases, the actuator teeth of the 14316 actuator are defined in a plane that is parallel to a plane including the teeth of the lock plate 14406. Such arrangements allow the 14400 hinge lock to engage the lock plate simultaneously 14420 and the articulation actuator
[0226] [0226] Again with reference to Figure 46, the locking plate 14420 is slidable longitudinally inside the cavity 14184; however, the longitudinal movement of the locking plate 14420 is limited by the proximal and distal end walls 14427. As a result, the locking plate 14420 can float within the cavity of the drive shaft 14184 between the end walls 14427. In In many cases, the teeth of the 14426 lock plate may not be completely aligned with the teeth of the 14316 actuator actuator when the 14400 pivot lock engages teeth 14426 and 14316. In such cases, the 14420 lock plate may move longitudinally, to some degree, so that the teeth of the 14426 lock plate are aligned with the teeth of the 14316 actuator actuator. In many cases, the 14420 lock plate can move in response to a force lock applied to it by the 14400 hinge lock. In at least one case, the 14420 lock plate may be allowed to move distally at a tooth pitch distance and proximally to a pitch distance from within relative at u a centralized position, for example, where a step distance from within is the distance between the peaks of the adjacent lock teeth 14426 of the lock plate 14420. In other cases, the lock plate 14420 may be allowed to move 1/4 of a step distance distally from within and proximally 1/4 of a tooth step distance in relation, for example, to its centralized position. In many cases, the 14420 lock plate can move proximally and distally.
[0227] [0227] In addition to the above, the 14400 hinge lock is configurable in three states - a self-locking state, an unlocked state and a fully locked state. When articulation lock 14400 is in a self-locking state, teeth 14406 of articulation lock 14400 are engaged with the teeth of the actuator 14316 and the teeth of the drive shaft structure 14186. In such cases, the hinge 14400 can withstand some force transmitted through the hinge actuator actuator 14310; however, the proximal and / or distal movement of the 14310 hinge actuator actuator can overcome the clamping force of the hinge lock 14400 and move the hinge lock 14400 to its unlocked configuration. In such cases, the 14400 articulation lock can flex or deflect laterally in the opposite direction to the 11500 actuator actuator, so that the 11500 end actuator can be articulated. Similar to the above, the spring elements 14403 of the hinge lock 14400 can resiliently return, or at least tilt, the hinge lock 14400 towards its self-locking configuration. As a result, the hinge driver system can lock and unlock itself as a result of its own movement, unless it is placed in its fully locked position, as discussed below.
[0228] [0228] Similar to the above, the drive shaft 14100 of the surgical instrument 14000 comprises a closing tube that is advanced distally during a closing stroke to close the 11500 end actuator. Before the closing stroke , the 14400 pivot lock is movable between its self-locking and unlocked configurations to allow the 11500 end actuator to be pivoted by the pivot drive system. During the closing stroke, the closing tube is configured to engage the 14400 hinge lock and place, lock and / or secure the 14400 hinge lock in its fully locked configuration. More specifically, the closing tube comprises a cam 14118 configured to engage a cam surface 14405 defined on the rear side of the articulation lock 14400 and prevent the teeth of the articulation lock 14406 from separating from the teeth of the actuator 14316 and drive shaft structure teeth 14186. Cam 14118 comprises an inclined surface 14115 which engages a correspondingly inclined surface defined on cam surface 14405, although any suitable arrangement can be used. When the closing tube is retracted proximally to allow the end actuator 11500 to be opened, the flap 14118 disengages from the hinge lock 14400 and the hinge lock 14400 is free to move between its self-locked and unlocked positions, as discussed above, so that end actuator 11500 can be pivoted once again.
[0229] [0229] When hinge lock 14400 moves to its configuration completely locked by the closing tube, again with reference to Figure 46, hinge lock 14400 pushes lock plate 14420 against a side wall 14183 from the drive shaft cavity 14184. Actually, the hinge lock 14400 engages the lock plate 14420 with enough force to secure the lock plate 14420 against the side wall 14183, so that the lock plate 14420 cannot move, or at least move substantially, longitudinally with respect to the drive shaft structure 14180. Locking plate 14420 comprises one or more projections 14422 extending therefrom that are configured to enter, crack and / or deflect the side wall 14183 of the drive shaft cavity 14184 when the lock plate 14420 is pushed against the side wall 14183 to prevent, or at least reduce the possibility of the lock plate 14420 s and move longitudinally in relation to the drive shaft structure
[0230] [0230] In addition to the above, the drive shaft structure 14180 comprises one or more cavities, or openings, defined therein that are configured to allow and / or facilitate deflection of the sidewall 14183. For example, as shown in Figure 46, the drive shaft structure 14180 comprises cavities 14182 defined therein that are aligned, or at least substantially aligned, with the projections 14422. When the lock plate 14420 is disposed laterally by the closing, as discussed above, side wall 14183 moves elastically into cavities 14182 and lock plate 14420 is locked in position. In such cases, the engagement between the drive shaft structure 14180 and the locking plate 14420 prevents the actuator of the 14310 hinge actuator from moving longitudinally and locks the end actuator 11500 in position. When the closing tube is retracted and disengaged from the Articulation Lock 14400, the side wall 14183 can return to its non-flexed state and move the lock plate 14420 laterally. At such a point, locking plate 14420 is unlocked and end actuator 11500 can be pivoted, as described above.
[0231] [0231] A 15000 surgical instrument is illustrated in Figures 47 to 49 and is similar to the 14000 surgical instrument in many respects, most of which will not be repeated here, for the sake of brevity. Among other things, the 15000 surgical instrument comprises a drive shaft, an 11500 end actuator and a hinge actuator system including a 14310 hinge actuator actuator. The 15000 surgical instrument comprises additions
[0232] [0232] A surgical instrument 16000 is illustrated in Figures 50 to 52 and is similar to surgical instruments 14000 and 15000 in many respects, most of which will not be repeated here, for the sake of brevity. Among other things, the 16000 surgical instrument comprises a drive shaft, an 11500 end actuator and a hinge actuator system including a 16310 joint actuator. Referring mainly to Figure 50, the 16000 surgical instrument it additionally comprises an articulation lock system that includes a 16400 articulation lock that is, similar to the above, configurable in a self-locking configuration, an unlocked configuration and a completely locked configuration. The hinge lock system further comprises a lock plate 16420 which is similar to the lock plate 14420 in many respects. For example, lock plate 16420 is movable laterally in engagement with wall 14183, as shown in Figure 51. In addition, for example, lock plate 16420 is movable longitudinally to float in a suitable locked position on the which teeth 16426 of lock plate 16420 are engaged with teeth 16406 of joint lock 16400, as shown in Figure 52. In addition, teeth 16406 of joint lock 16400, teeth 16426 of lock plate 16420 and teeth locking devices 16316 of the 16310 articulation trigger are configured and arranged to provide a plurality of positions, or permutations of positions, in which the 16400 articulation lock can lock the 16310 articulation driver to the 16420 locking plate. For example, the hinge lock system has achieved a completely locked configuration in a set of positions illustrated in Figure 51 and a completely locked configuration in a different set of positions illustrated in Figure 51. o in Figure 52.
[0233] [0233] The adaptability discussed above of the joint locking system can be achieved through tooth steps of the joint locking teeth 16406, the teeth of the articulation trigger 16316 and the teeth of the locking plate 16426. For example, with reference -
[0234] [0234] A 17000 surgical instrument is illustrated in Figures 53 to 56 and is similar to the 11000 surgical instrument in many respects, most of which will not be repeated here, for the sake of brevity. The surgical instrument 17000 comprises a drive shaft, an end actuator 11500 pivotally connected to the drive shaft around an articulation joint 11200 and a joint actuator system configured to articulate the actuator. end around the pivot joint
[0235] [0235] In addition to the above, the articulation actuator 17310 comprises a longitudinal tooth rack 17316 defined therein and the articulation lock 17400 comprises a longitudinal tooth rack 17406 defined therein. When the articulation lock 17400 is in its unlocked position, as shown in Figures 53 and 54, the teeth 17406 of the articulation lock 17400 are not engaged with the teeth 17316 of the joint actuator 17310. In such cases, the actuator pivot 17310 can move freely in relation to pivot lock 17400 to pivot end actuator 11500. When pivot lock 17400 is in a partially locked position, as illustrated
[0236] [0236] In addition to the above, the surgical instrument 17000 does not include a bias member configured to move the 17400 hinge lock towards the 17310 hinge actuator other than a closing member, or tube, 17110. The tube Closing 17110 is configured to engage hinge lock 17400 and move hinge lock 17400 from its unlocked position (Figure 54) to its partially locked (Figure 55) and completely locked (Figure 56) positions. Similar to the above, the closing tube 17110 comprises a cam 17118 configured to engage a defined cam surface over the hinge lock 17400, although other arrangements can be used. The 17110 closing tube is configured to move the 17400 hinge lock between its unlocked position and its partially locked position when the 17110 closing tube is moved distally through a partial closing stroke (PCs) that at least partially - it closes the end actuator 11500. In such cases, the end actuator 11500 of the surgical instrument 17000 can be used to hold a patient's tissue, for example. The 17110 closing tube is configured to move the 17400 hinge lock to its fully locked position when the 17110 closing tube is moved distally through a complete closing stroke (FCS) that completely closes the end actuator. 11500. In such cases, the 11500 end actuator of the 17000 surgical instrument can be used to hold a patient's tissue, for example.
[0237] [0237] As discussed above, the locking force applied to the 17310 hinge actuator by the 17400 hinge lock increases as the 17110 closing tube advances distally. In other words, the joint locking force is a function of the stroke of the 17110 closing tube. In addition to the above, with reference now to Figure 57, the locking force between the 17310 joint drive and the hinge 17400 is represented by line 17101. As shown in Figure 57, the hinge lock teeth 17406 initially engage with the hinge trigger teeth 17316 during the partial closing stroke. In at least one case, such initial engagement of teeth 17406 and 17316 occurs after approximately 0.050 "of the closing stroke of closing tube 17110, although any suitable distance can be used. Notably, such initial engagement of teeth 17406 and 17316 does not necessarily coincide with the end of the partial closure course, instead it can occur at some point during the partial closure course (PCS) .This also occurs at some point during the total closure course (FCS). such an initial engagement does not comprise a coupling lock force, instead a coupling lock force between teeth 17406 and 17316 is only established at some point during the total closing stroke (FCS). In at least one case, the entire course of closure
[0238] [0238] An 18000 surgical instrument is illustrated in Figures 58 to 60 and is similar to surgical instruments 11000 and 17000 in many respects, most of which will not be repeated here, for the sake of brevity. The surgical instrument 18000 comprises a drive shaft, a 11500 end actuator pivotally connected to the drive shaft around a pivot joint and a pivot system configured to pivot the 11500 end actuator. The drive shaft comprises a structure 18180 including the first and second longitudinal racks of teeth 18186 which are parallel, or at least substantially parallel to each other, although the racks of teeth 18186 may extend transversely with respect to each other. The surgical instrument 18000 additionally comprises a hinge lock 18400 and a closing member including a cam 18118. The hinge lock 18400 includes a first locking arm 18410 configured to engage the first 18186 longitudinal tooth rack and a second locking arm. lock 18420 configured to engage the second 18186 longitudinal tooth rack. Referring mainly to figures 59 and 60, the first lock arm 18410 comprises a first cam surface 18415 defined therein and the second lock arm 18420 comprises a second cam surface 18425 defined therein that is configured to be brought into contact by cam 18118 during a closing stroke of the closing member and displaced or flexed out in a fully locked engagement with the longitudinal racks of the teeth 18186. In addition, one or both lock arms 18410 and 18420 also engage the locking air the 11500 end actuator into place when locking arms 18410 and
[0239] [0239] Once displaced or flexed in their fully locked states, locking arms 18410 and 18420 define a longitudinal slot 18430 between them, which is configured to allow cam 18118 to pass through it for the remainder of the closing, for example. In addition, in such cases, the cam 18118 forces the articulation lock 18400 in engagement with the frame 18180 and securely fixes the lock arms 18410 and 18420 in their completely locked positions.
[0240] [0240] In at least one alternative modality, in addition to the above, the first locking arm 18410 of the articulation lock 18400 can be configured to engage the 18180 drive shaft structure of the 18000 surgical instrument, while the second locking arm 18420 of the 18400 hinge lock can be configured to engage the 18000 surgical instrument hinge system.
[0241] [0241] A 19000 surgical instrument is illustrated in Figures 61 to 65 and is similar to the 11000 surgical instrument in many respects, most of which will not be repeated here, for the sake of brevity. The surgical instrument 19000 comprises a drive shaft 19100 including a closing member 19110, an end actuator 11500 pivotally connected to the drive shaft 19100 around a pivot joint 11200 and a drive system. pivot 19300 including a pivot actuator 19310 configured to pivot end actuator 11500 around pivot joint 11200. Referring primarily to Figure 61, surgical instrument 19000 further comprises a pivot lock 19400 configured to selectively lock the 19300 hinge actuator system and lock the end actuator 11500 in position. The drive shaft
[0242] [0242] In addition to the above, the drive shaft structure 19180 comprises a proximal guide protrusion 19182 and a distal guide protrusion 19184. The proximal guide protrusion 19182 extends into an elongated lateral slot defined at a proximal end 19402 of the lock articulation 19400 and, similarly, the distal guide protrusion 19184 extends into a lateral elongated slot defined at a distal end 19404 of the articulation lock 19400. The lateral elongated slots allow the pivot 19400 moves laterally towards and away from pivot trigger 19310, as described above. The elongated side slits also define the lateral path of the 19400 hinge lock and prevent, or at least substantially avoid, the longitudinal movement of the 19400 hinge lock in relation to the drive shaft structure
[0243] [0243] In addition to the above, the hinge lock 19400 additionally comprises a longitudinal cam slot 19408 defined therein and the closing member 19110 comprises a cam pin 19188 positioned in the cam slot 19408. When the closing member 19110 is in a non-actuated or open position (Figure 61), cam pin 19188 is positioned in a proximal portion 19408a of cam slot 19408. When closing member 19110 is moved distally to a partially actuated, or partially closed, as shown in Figure 62, cam pin 19188 moves to a central portion 19408b of cam slot 19408. In such cases, cam pin 19188 moves pivot lock 19400 toward pivot driver 19310. In such cases, however, the 19406 teeth of the articulation lock 19400 may not be engaged with the teeth 19316 of the articulation driver 19310, and as a result, the articulation driver 19310 may still move to articulate end actuator 11500 with respect to drive shaft 19100. As a result, end actuator 11500 can be articulated when the closing stroke of closing member 19110 has only been partially completed.
[0244] [0244] When closing member 19110 is moved further distally, as shown in Figure 63, cam pin 19188 moves to a distal portion 19408c of the cam slot
[0245] [0245] In addition to the above, the articulation lock 19400 is not raised or lowered transversely in relation to the structure of the drive shaft 19180 during the partial closing stroke of the closing member 19110 (Figures 61 to 63). Instead, hinge lock 19400 is lifted upwards so that the teeth 19406 of hinge lock 19400 fully engage teeth 19316 of hinge driver 19310 and lock hinge driver 19310 in position during the portion. end or last of the closing stroke of the closing member 19110, as shown in Figure 64. The hinge lock 19400 moves upwards by means of a different cam pin extending from the closing member 19110, that is, the cam pin 19189 that engages the hinge lock 19400 at the end of the closing stroke of the closing member 19110. Notably, the cam pin 19189 is not engaged with the hinge lock 19400 at the beginning of the closing stroke or during the partial closing stroke of the closing member 19110. At most, the cam pin 19189 can slide the bottom of the articulation lock 19400 during the partial closing stroke. That said, with reference mainly to Figure 65, the hinge lock 19400 comprises a cutout, or recess, 19409 defined therein that provides a gap between the cam pin 19189 and the hinge lock 19400 during the partial closing stroke. That said, the 19189 cam pin contacts the 19400 hinge lock when the 19189 cam pin reaches the end of the
[0246] [0246] Again with reference to Figure 65, the teeth 19316 of the articulation drive 19310 are angled, or inclined, in relation to the longitudinal geometric axis of the drive shaft 19100. The 19406 locking teeth of the 19400 articulation lock are not angled, or are angled in a different orientation with respect to teeth 19316. As a result, the locking teeth 19406 of the hinge lock 19400 can be partially engaged with the teeth 19316 of the hinge lock 19310 when the hinge lock 19400 it is in its lowered position (Figure 63) and fully engaged with teeth 19316 when the articulation lock 19400 is in its raised position (Figure 64).
[0247] [0247] In order to unlock the articulation system 19300 from the surgical instrument 19000, the closing member 19110 must be retracted to disengage the cam pin 19189 from the articulation lock 19400 so that the articulation lock 19400 can return to its lowered position. Once the 19189 cam pin has been disengaged from the 19400 hinge lock, the proximal retraction of the 19188 cam pin can drive the 19400 hinge lock down as the 19188 cam pin is pulled proximally through the slot cam pin 19408. In addition, cam pin 19188 can move pivot lock 19400 away from pivot driver 19310 when it is pulled proximally. In various embodiments, the drive shaft 19110 can comprise one or more bias members, such as springs, for example, configured to bend or push the hinge lock 19400 down to quickly reset the hinge lock to an unlocked position.
[0248] [0248] A 20000 surgical instrument is illustrated in Figures 66 to 68 and is similar to surgical instruments 11000, 17000, 18000 and 19000 in many respects, most of which will not be repeated here, for the sake of brevity. The surgical instrument 20000 comprises a drive shaft that includes a locking tube 20110, an end actuator 11500 rotatably mounted to the drive shaft around an articulation joint 11200 and an articulation system configured to articulate the end actuator 11500 in relation to the drive shaft. Similar to the above, the pivot system comprises a pivot connection 20320 pivotally attached to the end actuator 11500 and, in addition, a pivot actuation 20310 pivotally attached to the pivot connection 20320. In use, the pivot 20310 moves proximally and / or distally to activate the 20320 hinge link and link the end actuator
[0249] [0249] In addition to the above, the articulation lock system additionally comprises locking arms 20405 extending from the drive shaft structure to a central opening defined in the articulation lock gear 20400 and, when the closing tube 20110 is moved distally during a closing stroke to close the end actuator 11500, a cam, or wedge 20118 of the closing tube 20110 is configured to engage the lock arms 20405 and extend the lock arms 20405 out in engagement with the 20400 hinge lock gear. Since the 20405 lock arms are engaged with the 20400 hinge lock gear, the 20405 lock arms can prevent the 20400 hinge lock gear from rotating. and also the longitudinal movement of the hinge actuator 20310. In such cases, the locking arms 20405 may prevent, or at least substantially prevent, the hinge of the end actuator 11500 at is that the wedge 20118 of the closing tube 20110 is retracted proximally during an opening stroke and the locking arms 20405 return resiliently to their non-flexed, or unlocked configurations.
[0250] [0250] In addition to the above, the articulation system of the surgical instrument 20000 can be placed in an unlocked configuration (Figure 66), a partially locked configuration (Figure 67) and a completely locked configuration (Figure 68). The articulation system can be placed in its partially locked configuration (Figure 67) when the 20110 closing tube is advanced distally through a partial closing stroke (PCS). In such cases, the end actuator 11500 is at least partially closed but can still be pivoted, although the locking arms 20405 can be partially engaged with the pivoting lock gear 20400. More particularly, the locking gear articulation lock 20400 can still rotate despite the displacement created by the partial engagement of the lock arms 20405 against the articulation lock gear 20400. In at least one case, the PCS is approximately 0.050 ", for example. The articulation system can be placed in its completely locked configuration (Figure 68) when the closing tube 20110 is advanced distally through a full closing stroke (PCS) In such cases, the end actuator 11500 is completely closed and cannot be pivoted until the articulation system returns to its partially locked and / or unlocked configurations.
[0251] [0251] A 21000 surgical instrument is illustrated in Figures 69 to 71 and is similar to surgical instruments 11000, 17000, 18000, 19000 and 20000 in many respects, most of which will not be repeated here, for the sake of brevity. The surgical instrument 21000 comprises a drive shaft that includes a closing member 21110, an end actuator 11500 pivotally mounted to the drive shaft around a joint 11200 and an articulation system that includes a drive actuator. articulation 21130 configured to articulate end actuator 11500 in relation to the drive shaft. The surgical instrument 21000 further comprises a hinge lock system comprising a hinge lock gear 21400 pivotally mounted to a drive shaft structure about a fixed geometric axis. The articulation lock gear 21400 comprises an annular tooth array 21406 which is in engagement with a longitudinal array of teeth 21316 defined in the articulation actuator 21310. As a result, with reference in general to Figure 69, the lock gear articulation
[0252] [0252] In addition to the above, the articulation locking system of the surgical instrument 21000 additionally comprises a mobile locking element 21405 that is mounted slidingly to the drive shaft structure. More specifically, with reference mainly to Figure 69, the locking element 21405 comprises a guide projection 21402 extending from it and extending into a lateral elongated slot 21403 defined in the drive shaft structure that is configured to allow the locking element 21405 slide laterally towards and / or in the opposite direction to the hinge actuator 21310. In addition, referring mainly to Figure 70, locking element 21405 slides laterally inside a defined opening in the locking gear articulation 21400 between an unlocked position (Figure 69) and a locked position (Figure 71). The locking element 21405 comprises an annular matrix of the locking teeth 21407 and the gear of the hinge lock 21400 comprises an annular matrix of the locking teeth 21408 defined around its internal opening and, when the locking element 21405 is in in its unlocked position (Figure 69), the locking teeth 21407 of the locking element 21405 are not engaged with the locking teeth 21408 of the hinge locking gear 21400. When the locking element 21405 is in its locked position (Figure 71) , the locking teeth 21407 of the locking element 21405 are engaged with the locking teeth 21408 of the pivoting locking gear 21400 so that the pivoting locking gear 21400 cannot rotate and, as a result, the pivoting actuator 21300 is prevented from moving longitudinally to joints
[0253] [0253] Figures 69 to 71 illustrate the distal progression of closing member 21110 during a closing course. Figure 69 illustrates the closing member 21110 in a non-actuated or open position. In such a position, the closing member 21110 is not engaged with the locking element 21405. Figure 70 illustrates the closing member 21110 in a partially closed position in which the closing member 21110 has end actuator 11500 at least partially closed. In such a position, a cam surface 21115 of the closing member 21110 engaged the locking member 21405. In at least one case, the closing member 21110 moves distally approximately 0.050 "from its open position (Figure 69) to its partially closed position (Figure 70) Figure 71 illustrates the closing member 21110 in a completely closed position in which the closing member 21110 has the end actuator 11500 completely closed In such a position, the cam surface 21115 moved by the locking element 21405 and the locking element 21405 was displaced by the total thickness of the closing member 21110.
[0254] [0254] In view of the above, a surgical instrument may include a joint locking system configured to prevent the surgical instrument end actuator from being articulated and / or unintentionally driven back by a load, or torque, applied to the end actuator. At least a portion of the articulation lock system can move in engagement with a surgical instrument articulation drive system to prevent articulation of the end actuator. In at least one case, a hinge lock can be an integral part of the hinge drive system, as described in more detail below.
[0255] [0255] With reference to Figures 72 to 74, a surgical instrument
[0256] [0256] In addition to the above, teeth 22336 of inclined gear 22330 are in engagement with teeth 22346 of an inclined gear 22340 which is pivotally mounted around a rotary pivoting screw 22350. More specifically, the inclined gear 22340 comprises a nut portion that includes an at least partially threaded opening that is threadably engaged with the hinge drive screw 22350. When the inclined gear 22340 is rotated in a first direction by the drive articulation 22310 through the inclined gear 22330, the gear
[0257] [0257] In addition to the above, the pitch of the threads on the 22350 threaded pivot screw can be selected to prevent indentation within the pivot drive system
[0258] [0258] Referring to Figures 75 to 79, a 23000 surgical instrument comprises a drive shaft and a 23300 hinge drive system that is configured to pivot an end actuator, such as an 11500 end actuator, for example - plo, of the surgical instrument 23000 in relation to the drive axis. The 23300 hinge drive system comprises a 23310 hinge drive and a 23320 pinion gear.
[0259] [0259] In addition to the above, the teeth 23336 of the worm gear 23330 are in engagement with the teeth 23346 of a worm thread 23340 which is rotatably mounted to the drive shaft structure. The worm thread 23340 comprises a pinion gear 23350 mounted fixedly to it so that the pinion gear 23350 rotates with the worm thread 23340 around a common axis of rotation. The pinion gear 23350 is operationally coupled to a translatable articulated output actuator 23360. More specifically, the pinion gear 23350 comprises teeth 23356 that are in engagement with a tooth rack 23366 defined in the output driver 23360 When worm thread 23340 is rotated in a first direction by hinge driver 23310 through worm gear 23330, pinion gear 23350 drives output driver 23360 distally. Correspondingly, worm 23340 and pinion gear 23350 drive output driver 23360 proximally when worm 23340 is rotated in a second direction by worm gear 23330. In addition, the actuator end cap 11500 is rotated in a first direction when the output driver 23350 is driven distally by the drive system 23330 and in a second direction when the output driver 23350 is driven proximally by the articulation drive system tion 23330.
[0260] [0260] In addition to the above, the pitch of the threads on the worm thread 23340 can be selected to avoid indentation within the 23300 hinge drive system. In other words, a steep pitch of the threads defined on the worm thread 23340 , for example, would be able to withstand a force and / or torque transmitted proximally from the end actuator 11500 through the articulation drive system 23300 and can prevent the end actuator 11500 from being unintentionally articulated. As such, the thread pitch can serve as an integral hinge lock with the 23300 hinge drive system.
[0261] [0261] A surgical instrument 12000, illustrated in Figures 32 to 34B, is similar to the surgical instrument 11000 in several aspects, most of which will not be repeated here, for the sake of brevity. In addition to a drive shaft 11100, an end actuator 11500 and a hinge joint 11200, the surgical instrument 12000 additionally comprises a clamp firing system 12900, for example, including a firing bar 12910 extending through the articulation joint 11200. In use, the firing bar 12910 is translatable distally to carry out a staple firing stroke and retracts proximally after at least a portion of the staple firing stroke has been completed. The firing bar 12910 extends through a channel, or slot, 11190 defined in the structure 11180 of the driving shaft 11100 which is configured to receive and / or guide firing bar 12910 closely as firing bar 12910 moves in relation to to the drive shaft
[0262] [0262] In addition to the above, channels 11190 and 11590 do not extend into the articulation joint 11200 and, in addition, the firing bar 12910 may not be supported within the articulation joint 11200. When the actuator of end 11500 is in a non-hinged configuration (Figure 34), the 12910 firing bar is unlikely to warp within the 11120 hinge joint during the clamp firing stroke - however, the probability of the 12910 firing bar warping laterally during the clamp firing stroke it increases when the 11500 end actuator is in an articulated configuration (Figures 34A and 34B). To reduce the possibility of such deformation, the surgical instrument 12000 additionally comprises a firing rod support 12400 configured to support firing rod 12910. The firing rod support 12400 comprises a proximal portion 12410 connected to the structure of the drive shaft 11180, a distal portion 12430 connected to the structure of the end actuator 11580 and an intermediate portion 12420 extending between the proximal portion 12410 and the distal portion 12430. Portions 12410, 12420 and 12430 of the bar support firing 12400 are formed integrally; however, other modalities are envisaged in which the portions 12410, 12420 and 12430 are assembled together and / or comprise separate components.
[0263] [0263] In addition to the above, the distal portion 12430 of the firing bar 12400 is fixedly mounted to the support of the end actuator 11580 and does not move, or at least substantially move, in relation to the structure of the actuator. far end
[0264] [0264] In several cases, the firing rod 12910 is comprised of a plurality of parallel layers, or at least substantially parallel. The layers are attached to a distal cutting member and can partially translate or slide longitudinally in relation to each other - especially within the articulation joint
[0265] [0265] In addition to or instead of the 12400 firing bar holder, the surgical instrument 12000 comprises one or more dividers that separate and control the firing bar layers 12910. Referring to Figures 34 to 34B, the 11110 drive shaft comprises a divider 12920 positioned within the layers of the 12910 firing bar. Two layers of the 12910 firing bar are positioned on one side of the 12920 divider, while two layers are positioned on the other side of the 12920 divider, although any suitable arrangement can be used. The divider 12920 prevents half the layers of the firing bar 12910 from extending outwards when the end actuator 11500 is pivoted. In other words, the 12920 divider prevents the two rightmost layers of the firing bar from expanding to the left when the 11500 end actuator is pivoted to the right (Figure 34A) and, similarly, the divider 12920 prevents the two leftmost layers of the firing bar from widening to the right when the 11500 end actuator is pivoted to the left (Figure 34B). The divider 12920 extends through the hinge joint 11200 and the firing bar support 12400 and into the end actuator 11500, and can flex when the end actuator 11500 is pivoted. Consequently, in such cases, divider 12920 is flexible. The divider 12920 is mounted on the 11180 frame of the 11110 drive shaft and does not move relative to the 11180 frame; however, modalities are provided for in which the divider 12920 is not mounted to the 11180 structure and can float within the layers of the firing bar.
[0266] [0266] A surgical instrument 13000, illustrated in Figures 35 to 39B, is similar to surgical instruments 11000 and 12000 in several respects, most of which will not be repeated here, for the sake of brevity. In addition to a drive shaft 13100, an end actuator 13500 and a hinge joint 11200, the surgical instrument 13000 additionally comprises a clamp firing system 12900, for example, including a firing bar 12910 that extends through the gasket articulation 11200. In use, the firing bar 12910 is translatable distally to perform a staple firing stroke and retracts proximally after at least a portion of the staple firing stroke has been completed. With reference mainly to Figures 39 to 39B, the firing bar 12910 extends through a channel, or slot, 13190 defined in the structure 13180 of the driving shaft 13100 which is configured to receive and / or guide the firing bar 12910 as the firing rod 12910 moves in relation to the drive shaft 11100. Similarly, the end actuator 13500 comprises a channel, or slot, defined in the 13580 structure of the end actuator 13500 which is also configured to receive closely and / or guide firing bar 12910 as firing bar 12910 moves relative to end actuator 13500.
[0267] [0267] When the 13500 end actuator is in a con-
[0268] [0268] In addition to the above, the first side plate 13410 comprises a distal portion 13416 which is fixedly mounted to the end actuator support 13580 and does not move, or at least move substantially, in relation to the actuator structure. end adapter 13580. Similarly, the second side plate 13420 comprises a distal portion 13426 that is fixedly mounted to the end actuator 13580 structure and does not move, or at least move substantially, with respect to the end actuator structure 13580. The first side plate 13410 comprises a proximal portion 13412 that is slidably mounted on the drive shaft structure 13180, so that the first side plate 13410 can translate in relation to the drive shaft structure 13180 when the actuator end plate 13500 is articulated. The proximal portion 13412 comprises a head that is slidable within a chamber, or cavity, 13185 defined within the structure of the drive shaft 13180 that can limit the displacement of the firing bar support 13400. Similarly, the second side plate 13420 comprises a proximal portion 13422 which is slidably mounted on the drive shaft structure 13180 so that the firing rod holder 13400 can shift in relation to the drive shaft structure 13180 when the actuator end end 13500 is articulated. The proximal portion 13422 comprises a head that is slidable within the chamber 13185 defined within the structure of the drive shaft 13180 which can also limit the displacement of the firing bar holder
[0269] [0269] The first side plate 13410 comprises a flexible portion 13414 positioned on the articulation joint 11200 that allows the distal portion 13416 of the first side plate 13410 to flex in relation to the proximal portion 13412 and accommodate the actuator joint. end 13500. The flexible portion 13414 extends laterally from the first side plate 13410 and comprises a hinge including the spans 13413 defined therein, which allow rotation within the first side plate 13410. In addition to or instead of exposed above, the first side plate 13410 comprises longitudinal openings 13415 defined therein that allow the first side plate 13410 to flex inside the 13500 end actuator and accommodate the hinge of the 13500 end actuator. The first plate side 13410 can comprise any number and configuration of suitable openings and / or recesses defined therein in any suitable location that is configured for pe allow the first side plate 13410 to flex during the hinge of end actuator 13500. Similarly, the second side plate 13412 comprises a flexible portion 13424 positioned on the hinge joint 11200 that allows the distal portion 13426 of the second plate side 13420 flexes in relation to the proximal portion 13422 and accommodates the end actuator 13500 joint. The flexible portion 13424 extends laterally from the first side plate 13420 and comprises a hinge including the gaps defined therein, which allow rotation within second side plate 13420. In addition to or instead of the above, the second side plate 13420 comprises longitudinal openings defined therein that allow the second side plate 13420 to flex within the end actuator 13500 and accommodate the end actuator joint - 13500. The second side plate 13420 can comprise any number and configuration of openings and / or suitable recesses defined therein in any suitable location that is configured to allow the second side plate 13420 to flex during the articulation of the end actuator 13500.
[0270] [0270] In addition to the above, the side plates 13410 and 13420 are flexible and can resiliently return to their non-flexed configurations when the end actuator 13500 is returned to its non-articulated configuration. In several cases, the side plates 13410 and 13420 comprise springs that resiliently tilt the 13500 end actuator in its non-articulated configuration.
[0271] [0271] A 24900 firing member is illustrated in Figures 83 and 84 and can be used with any of the surgical stapling instruments disclosed here. The firing member 24900 comprises a firing bar 24910 which, similar to the above, comprises
[0272] [0272] Layers 24911 and 24912 of firing bar 24910 are welded to the distal cutting member 24920 in welds 24930. As shown in Figure 84, a first weld 24930 is present on a first side of firing member 24900 and a second weld 24930 is present on a second side of the firing member 24900. The first weld 24930 penetrates a first outer layer 24911 and the adjacent inner layer 24912. In several cases, the first weld 24930 penetrates entirely through the adjacent inner layer 24912 and / or also penetrates the other inner layer 24912. The second weld 24930 penetrates a second outer layer 24911 and the adjacent inner layer 24912. In several cases, the second weld 24930 penetrates entirely through the layer adjacent inner 24912 and / or also penetrates the other inner layer 24912.
[0273] [0273] With reference principally to Figure 83, each weld 24930 of firing member 24900 comprises a weld line that is configured to firmly secure firing bar 24910 to cutting member 24920 and, at the same time, provide a cone
[0274] [0274] In addition to the above, each 24930 weld additionally comprises a distal hook weld portion 24932 and a proximal hook weld portion 24933. Each hook weld portion 24932 and 24933 comprises a longitudinal portion that is aligned with , or is parallel to the longitudinal firing (FA) axis of firing member 24900 and is sheared when a longitudinal firing force is transmitted through firing member 24900. In addition, each weld portion of hook 24932 and 24933 comprises a joining portion that is orthogonal, or at least substantially orthogonal, to the longitudinal firing (FA) geometric axis and is placed under tension and / or compression when a longitudinal firing force is transmitted through the member firing unit 24900. Notably, each set of hook weld portions 24932 and 24933 comprises an interlocking connection between firing bar 24910 and cutting member 24920 that can carry three allow a flow of stress between them without fail and / or cause inadequate performance.
[0275] [0275] Each 24930 weld is generally L-shaped, for example; however, 24930 welds can comprise any suitable configuration.
[0276] [0276] Although surgical instruments 10000, 11000, 12000, 13000, 14000, 15000, 16000, 17000, 18000, 19000, 20000, 21000, 22000 and 23000 are surgical staplers, their designs can be readily adapted to other surgical instruments that have articulated end actuators, among others. Such other surgical instruments may include, for example, clip applicators, fastener applicators and / or surgical instruments capable of providing electrical and / or vibrational energy to the tissue.
[0277] [0277] Figure 86 shows a surgical staple cartridge 25100 comprising an elongated tip 25150 located at a distal end thereof, generically designated as 25102. The elongated tip 25150 has a base 25152 which is defined by a first length 25154 extending by a distance between the end of the staple line 25056 and a distal tip 25142 of the staple cartridge 25100. The distal tip 25142 is formed at an angle σ from the base 25152 of the staple cartridge 25100. The distal tip 25142 on the clamps 25100 is positioned and configured to serve as a stop area for a wedge slide, not shown, of the trigger system after completing a clamp trigger course.
[0278] [0278] In an effort to shorten the overall length of the staple cartridge without sacrificing the length of the stapled tissue, the surgical staple cartridge 25200 shown in Figure 85 comprises a cartridge body 25210 including a shortened tip 25250 located at a distal end thereof, generically referred to as 25202. The shortened tip 25250 has a base 25252 which is defined by a second length 25254 that extends a distance between the end of the staple line
[0279] [0279] When comparing the staple cartridges 25200 and 25100 shown in Figures 85 and 86, respectively, the reader should recognize that the second length 25254 is shorter than the first length 25154. As a result, the staple cartridge length 25200 beyond the end of the 25056 staple line is minimized to allow for improved spatial access in a surgical site, among other things. The shortened tip 25250 also prevents the rounded distal tip 25242 from perforating a seal in a trocar system, as is further discussed below. In addition, a person will recognize that the angle γ of the rounded distal tip 25242 of the staple cartridge 25200 to the base 25252 is greater than the angle σ of the sharp distal tip 25142 of the staple cartridge 25100 to the base 25152. For example, the rounded distal tip 25242 can extend at an angle of approximately 45 to 50 degrees from the base 25252 of the staple cartridge 25200, while the sharp distal tip 25142 can extend at an angle of approximately 30 degrees in with respect to the base 25152 of the staple cartridge 25100. The steeper angle of the rounded distal tip 25242 provides increased stability in all distal regions of the structure of the staple cartridge 25200.
[0280] [0280] Figure 89 is a plan view of the staple cartridge 25200; The cartridge body 25210 of the staple cartridge 25200 comprises an elongated slot 25230 that extends from a proximal end 25204 of the staple cartridge 25200 towards the shortened distal tip 25250. A plurality of staple cavities 25220 are formed within the body of cartridge 25210. Staple cavities 25220 extend between proximal end 25204 and distal end 25202 of the staple cartridge
[0281] [0281] Figure 87 illustrates a modality of a triple clamp driver 25240 within the clamp cartridge 25200 to support and drive three clamps 25260. Clamp driver 25240 comprises a first portion of driver 25342, a second portion of driver 25344 and a third portion of driver 25346. A central base member 25348 connects the first portion of driver 25342 and the third portion of driver 25346 to the second portion of driver 25344. The first portion of driver 25342 is po - positioned at least partially distal to the second portion of the 25344 drive. Additionally, the third portion of the 25346 drive is positioned at least partially distal to the second portion of the 25344 drive. Several of the first 25240 clamp drivers are slidably mounted inside the corresponding staple cavities 25220 from the three longitudinal rows 25221, 25222, 25223 on one side of the elongated slot 25230. In other words, c The first staple driver 25240 is configured to support three staples 25260: a staple 25260 stored within a staple cavity 25220 in the first longitudinal row 25221; a clip 25260 stored inside a staple cavity 25220 in the second longitudinal row 25222; a clip 25260 stored inside a cavity of clips 25220 in the third longitudinal row 25223. Due to the distal position of the first portion of the driver 25342 and the third portion of the driver 25346 in relation to the second portion of the driver 25344, the clips 25260 are fired in a back arrow setting. As shown in Figure 89, the last clamps 25260 in the first longitudinal row 25221 and in the third longitudinal row 25223 are closer to the shortened end 25250 of the staple cartridge 25200 than the last clamp 25260 in the second longitudinal row 25222.
[0282] [0282] On the other side of the elongated slot 25230, a plurality of second clip drivers are mounted within the corresponding clip cavities 25220 in the three longitudinal rows 25224, 25225, 25226. Similar to the clip driver 25240, each of the seconds Staple actuators comprise a first portion of driver 25342, a second portion of driver 25344 and a third portion of driver 25346. A central base member 25348 connects the first portion of driver 25342 and the third portion of driver 25346 to the second portion of the driver 25344. The first portion of the driver 25342 is positioned at least partially distal to the second portion of the driver
[0283] [0283] The first portion 25342 of the clip driver 25240 has a first support column for the front 25352 and a first support column for the back 25354 projecting upwards from a first base of the driver portion. The first support column 25352 and the first support column 25354 are spaced from each other and collectively form a first clamp support to hold a clamp 25260 in a vertical position (ie the pins clamp facing the anvil). Similarly, the second clamp portion 25344 has a second front support column 25362 and a second back support column 25364 projecting upwardly from a second base of the driver portion. The second back support column 25362 and the second back support column 25364 are spaced apart and collectively form a second clamp support to hold a clamp 25260 in an upright position (ie the clamp pins facing the anvil). The third portion of the driver 25346 has a third support column for the front 25372 and a third support column for the back 25374 projecting upwards from a third base of the driver portion. The third front support column 25372 and the third rear support column 25374 are spaced from one another and collectively form a third clamp support to hold a clamp 25260 in a vertical position (ie, the clamp pins facing the anvil).
[0284] [0284] The center of mass of the first and third portions of the driver 25342, 25346 is represented by the dashed line D-D. Similarly, the dashed line P-P represents the center of mass of the second portion of the 25344 driver. The combined center of mass of the triple clamp driver 25240 is shown in Figures 87 and 88 as the dashed line C-C. As such, the 25240 clamp actuator is less likely to roll forward. Notably, C-C is closer to D-D than P-P, which makes the 25240 clip driver very stable.
[0285] [0285] As discussed above, the central base member 25348 of the clip driver 25240, shown in Figure 88, attaches the first portion of the driver 25342 and the third portion of the driver 25346 to the second portion of the driver 25344. The base member cen - tral 25348 extends laterally between the proximal ends of the first and third backing columns 25354, 25374 in the first and third portions of the driver 25342, 25346, respectively, and the proximal end of the second supporting column to the front 25362 on the second portion of the driver 25344. As can be seen in Figure 90, the central base member 25348 has an angled backward edge 25349 adapted to be engaged by a wedge slide 25270, as will be discussed further in detail below. Due to the extension of the central base member 25348 between all three portions of the driver 25342, 25344, 25346, the midpoint of the rear-facing edge 25349 can be forked into a portion that is closest to the first portion 25342 and a portion which is closest to the third portion 25346. Such an arrangement can balance the moments created during firing and the formation of the staples 25260 stored within the staple cavities 25220.
[0286] [0286] Referring mainly to Figure 89, each staple cavity 25220 defined in the cartridge body 25210 of the staple cartridge 25200 comprises a proximal wall 25264 and a distal wall 25262. The reverse orientation of the arrow formed by the arrangement of the first, second, and third portions of driver 25342, 25344, 25346 of triple clamp driver 25240 discussed above, reduces the forward and / or side scrolling of clamp driver 25240 during a clamp firing stroke. In several cases, the distal end of the first forward support column 25352 and the distal end of the third forward support column 25372 are pushed into the distal walls 25262 of their respective clamp cavities 25220, which stabilize the driver 25240 Thus, when slide 25270 (Figure 89) raises the staple driver 25240 upward during the staple firing stroke, two distal walls 25262 of the staple cavities 25220 provide an opposite force against the columns forward support 25352, 25372, preventing any unwanted movement or rolling of the 25240 clamp actuator.
[0287] [0287] As shown in Figures 87 to 90, the elongated slot 25230 of the staple cartridge 25200 is configured to receive a portion of a trigger assembly 25280. The trigger assembly 25280 is configured to push the slider 25270 distally to eject tying the staples 25260 stored within the staple cavities 25220 and deforming the staples 25260 against an anvil positioned opposite the staple cartridge 25200. More specifically, a coupling member 25282 pushes the wedge slide 25270 distally from the staple cartridge 25200. The cuvette slider
[0288] [0288] Again with reference to Figure 87, the positioning of the first, second and third portions of the driver 25342, 25344, 25346 of the clip driver 25240 between or adjacent to an inner rail 25272 and an outer rail 25274 of the wedge slider 25270 provides increased lateral stability. Two rails, an inner track 25272 and an outer track 25274, span the clamp driver 25240 to provide greater support and stability.
[0289] [0289] Figure 89 represents the wedge slide 25270 of the firing set 25280 stopped at the shortened tip 25250 after the completion of the staple firing stroke. The shortened tip 25250 comprises a plurality of openings 25292, 25294 at the distal end of the shortened tip 25250 to receive the four rails 25272, 25274. The shortened tip 25250 further comprises an opening 25296 configured to receive the central sliding member 25276 of the slider in wedge 25270. Thus, the portions of the rails 25272, 25274 and the central sliding member 25276 of the wedge slide 25270 are exposed at the distal end 25202 of the staple cartridge 25200. The openings 25292, 25294 are continuations of channels 25212, 25214 within which the Rails 25272, 25274 of the wedge slider 25270 slide. Two Internal openings 25292 are configured to receive the two internal rails 25272 of the wedge slide 25270, while two external openings 25294 are configured to receive the two external rails 25274 of the wedge slide 25270. One central opening 25296 in the center of the distal portion 25202 of the shortened tip 25250 is configured to receive the central member 25276 of the wedge slide 25270. The openings 25292, 25294, 25296 at the distal end 25202 of the shortened tip 25250 allow the staple firing stroke to be completed and the slide wedge 25270 stop at a shortened distal end.
[0290] [0290] Again with reference to Figure 89, the staple cartridge 25200 additionally includes projections 25262 that extend around the proximal and distal ends of the staple cavities 25220. Projections 25262 in the first longitudinal row 25221 are shown to be unique , while the projections in the second and third longitudinal rows 25222, 25223 are shown to be connected. The 25262 projections are configured to provide additional support for the 25260 clamps as they are fired up and out of their 25220 clamp cavities. In addition, the 25264 projections formed on the most distal clamp cavity 25220 are angled to control the flow of tissue in the end actuator. A more detailed discussion of the projections can be found in US Patent Application Publication 2015/0297228, entitled FASTENER CARTRIDGES IN-CLUDING EXTENSIONS HAVING DIFFERENT CONFIGURATIONS, filed on June 30, 2014, whose disclosure is incorporated by reference.
[0291] [0291] Figure 91 illustrates some of the advantages obtained from using the shortened staple cartridge 25200 in Figure 85 instead of the extended staple cartridge 25100 in Figure 86. Both
[0292] [0292] In addition to the above, the staple cartridge 25200 is part of a first end actuator 25202 in a first surgical instrument 25201, which also includes an anvil
[0293] [0293] In addition to the above, in use, the physician inserts the 25202 end actuator through a cannula, or trocar, and into a patient when the 25202 end actuator is in its non-articulated condition. Once through the trocar, the end actuator 25202 can be articulated as shown in Figure
[0294] [0294] The first end actuator 25202 is able to reach an X1 distance from the pelvic floor within the pelvic cavity during an LAR procedure. The second end actuator 25102 is capable of reaching an X2 distance from the pelvic floor within the pelvic cavity during an LAR procedure. The distance X1 is shorter than the distance X2, allowing the first surgical instrument 25201 to be placed more deeply in the pelvic cavity than the second surgical instrument 25101, giving the surgeon the ability, among other things, to target, acces - heal and remove a larger matrix of diseased tissue from the colon. In addition, the articulation capabilities of the first 25201 surgical instrument enable deeper access to tissue within the surgical site while inflicting minimal trauma to the surrounding tissue. The first end actuator 25202 is capable of being articulated to a greater degree than the second end actuator 25102, since β is greater than α. For example, the first end actuator 5202 can be pivoted to an angle 115 degrees from the first drive axis 25206, while the second end actuator 2 can be pivoted only up to an angle 135 degrees from the second drive axis drive 25106.
[0295] [0295] As shown in Figure 91, staple cartridge 25100 and anvil 25103 for end actuator 25102 are approximately the same length, but staple cartridge 25100 is noticeably longer than anvil 25103. again, staple cartridge 25200 and anvil 25203 of end actuator 25202 are of substantially the same length, if not the same length. In any case, the difference in length between the staple cartridge 25200 and the anvil 25203 of the end actuator 25202, if any, is much smaller than that of the end actuator 25102.
[0296] [0296] An extreme difference between the distal end of a staple cartridge and the distal end of an anvil can cause damage to a trocar when the end actuator is inserted through it. Referring to Figure 92, an end actuator 25810 comprises a distal end 25802, a beaker 25820 and a staple cartridge 25830. The staple cartridge 25830 has a shortened and rounded nose 25840 similar to the shortened nose 25250 on the staple cartridge 25200 in Figure
[0297] [0297] As can be seen in Figures 92 and 93, the protective tip 25822 of the anvil 25820 has a first curved or angled outer surface 25824, and a second curved or angled outer surface 25826 configured to form a stubby distal end over anvil 25820. The first angled outer surface 25824 extends downwardly from a top surface 25828 of the whisker 25820 at a first angle φ. The second angled outer surface 25826 extends downwardly from the first angled outer surface 25824 towards the staple cartridge 25830 at a second angle θ. The second angle θ is greater than the first angle φ. Several modalities are predictions in which the angle θ measures, for example, approximately 90 degrees. Other modalities of the protective tip 25822 are provided for having only one of a first inclined external surface 25824 or a second inclined external surface 25826. The first inclined external surface 25824 serves to deflect a centering ring from a trocar seal assembly during insertion of the end actuator 25810 through the trocar. When the second angle θ is 90 degrees apart, and / or when the first and second curved outer surfaces 25824, 25826 are not continuous, the anvil 25820 can pierce through a trocar seal or can displace the center ring - creation of a trocar sealing system, as will be discussed in greater detail below.
[0298] [0298] A protective tip can be attached to an anvil in any suitable way. Figures 94 to 99 illustrate exemplary modalities of protective tips formed separately 25922, 26022, and various methods for attaching them to an anvil. As shown in Figures 94 to 96, a distal portion of an anvil 25920 comprises a fixing feature that includes fixing members 25927, 25929 that are configured to fit in a retentive manner with the complementary retaining channels 25926, 25928 formed in the protective tip 25922. More specifically, a central retaining channel 25928 is formed within protective tip 25922 to receive a central fixing member 25929 of the anvil
[0299] [0299] In addition, or alternatively to the above, the protective tip 25922 can be attached to the anvil 25920 using the rivets
[0300] [0300] Figures 97 to 99 illustrate another modality of a tip fixation arrangement. A distal portion of an anvil 26020 comprises fixing members 26027 which are configured to fit retentively with the complementary retention channels 26026 defined in the protective tip 26022. In addition, a central retention channel 26028 defined within the protective tip 26022 is configured to receive a central fixing member 26029 of anvil 26020. Figure 98 is a cross-sectional view of anvil 26020 of Figure 97 taken along line 98-98 in Figure 97 in a disassembled configuration showing alignment of the retention channels 26026, 26028 with their respective fixing members 26027, 26029. Figure 99 is a cross-sectional view of anvil 26020 in Figure 97, taken along line 99-99 in Figure 97 in a mounted configuration . Protective tip 26022 is attached to the 26020 anvil using a compression fitting. The central retaining member 26029 is snapped into the central retaining channel 26028, remaining in place due to the geometry of the central retaining channel 26028. The central retaining member 26029 of the anvil 26020 in Figure 98 has a trapezoidal shape which is imitated by the central retention channel 26028. An elongated slot 26094 extends longitudinally from a proximal end 26004 of the anvil 26020 towards the distal end 26002 of the anvil 26020. The elongated slot 26094 is configured to receive a portion of the firing set discussed here.
[0301] [0301] In addition, or as an alternative to the above, the protective tip 26022 can be fixed to the anvil 26020 by means of adhesives such as, for example, cyanoacrylates, light-curable acrylics, polyurethanes, silicones, epoxies and / or curable adhesives by ultraviolet, for example, HENKEL LOCTITE®. In various embodiments, a combination of fixing members and retaining channels can be provided on the anvil 26020 and the protective tip 26022. Still other forms of fixations and fixing arrangements can be used to fix the protective tip 26022 to the anvil 26020. Figures 97 to 99 additionally illustrate means to assist a user in attaching the protective tip 26022 to the anvil 26020. Figure 97 illustrates the protective tip 26022 positioned removably within a temporary support. 26030. In order to releasably secure the protective tip 26022 to the anvil 26020, the user presses the temporary support 26030 and the anvil 26020 together. The temporary support 26030 can provide an additional sterilization barrier to the protective tip 26022 while the protective tip 26022 is attached to the anvil 26020. In addition, the temporary support 26030 provides the user with an object that is more substantial to hold when attaching the protective tip. - log 26022 to anvil 26020, since the protective tip 26022 may be small in size. It is envisaged that the temporary support 26030 can be used in various types of protective tips, including the other modalities presented in the present invention.
[0302] [0302] Several protective anvil tips have been described and shown in the present invention as being used in conjunction with a linear end actuator. Those skilled in the art will readily understand, however, that the protective anvil tips described herein can be used together with a variety of different end actuator configurations, such as curved end actuators and other types of end actuators without moving away of the spirit and scope of the present revelation. Thus, the protective tip described above should not be limited to use only in conjunction with linear end actuators and / or staplers.
[0303] [0303] Figures 100 to 106 illustrate an exemplary practical application of the various end actuators described here when they are inserted through a trocar seal system before being introduced into a surgical site. The trocar seal system 27040 of Figures 100 to 106 comprises a housing 27042 configured to support a floating seal assembly 27050 and a central opening 27044 configured to receive a surgical instrument. The floating seal assembly 27050 comprises a first seal port 27052 and a second seal port 27054 that work together to prevent gas from escaping from an inflated cavity in a patient during a surgical procedure. The floating seal assembly 27050 additionally comprises a centering ring 27058 which is configured to guide a surgical instrument through the central opening 27044 of the 27040 trocar seal system. The 27050 floating seal assembly is attached to the 27042 housing of the trocar seal 27040 through a resilient annular element 27056.
[0304] [0304] Figure 100 shows an example end actuator 27000 comprising an anvil 27010 and a staple cartridge 27020. The staple cartridge 27020 comprises a shortened and rounded nose 27022 similar to the shortened nose 25250 shown on the cartridge staples 25200 in Figure 85. The distal end 27202 of anvil 27010 is pointed and does not have a protective tip, as shown in Figure 92. As can be seen in Figure 100, anvil 27010 is longer shorter than the staple cartridge 27020. In other words, the shortened tip 27022 of the staple cartridge 27020 extends longitudinally beyond the distal end 27002 of the anvil 27010. Before inserting the end actuator 27000 through the sealing system trocarte 27040, the first seal port 27052 and the second seal port 27054 extend inward to prevent gas from escaping the surgical site. Figure 101 represents the 27000 end actuator of Figure 100 partially inserted in the 27040 trocar seal system. The shortened tip 27022 of the staple cartridge 27020 is the first component of the 27000 end actuator to come into contact with the first and second shutter doors 27052, 27054 of the trocar seal system 27040, tilting the floating seal assembly 27050 to one side. Due to its rounded shape, the shortened tip 27022 does not damage the second seal door 27054 despite exerting a force on it.
[0305] [0305] Figure 102 represents the end actuator 27000 of Figures 100 and 101 when the end actuator 27000 was additionally introduced into the central opening 27044 of the trocar seal system 27040. After the initial contact of the shortened staple cartridge tip 27022 With the trocar40 sealing system 27040, the pointed distal end 27002 of the anvil 27010 comes into contact with the first sealing port 27052 of the 27040 trocar system. In several cases, the distal tip pointed
[0306] [0306] Figure 104 shows an exemplary end actuator 27100 comprising an anvil 27110 and a staple cartridge 27120. The staple cartridge 27120 comprises an elongated and pointed nose 27122 similar to the elongated nose 25150 shown on the cartridge staples 25100 in Figure 86. The distal end 27102 of anvil 27110 is pointed and does not have a protective tip, like the one shown in Figure 92. Anvil 27110 has a shorter length than the staple cartridge 27120. In other words , the elongated tip 27122 of the staple cartridge 27120 extends longitudinally beyond the distal end 27102 of the mustache 27110. Before the insertion of the end actuator 27100 through the trocar seal system 27040, the first seal port 27052 and the second seal port 27052 27054 seal port of the 27040 trocar seal system extends inward to prevent gas from escaping from the surgical site. Figure 105 represents end actuator 27100 of Figure 104 when end actuator 27100 is initially inserted into the trocar seal system 27040. The elongated tip 27122 of staple cartridge 27120 is the first component of the end actuator 27000 to contact the first and second sealing doors 27052, 27054 of the trocar seal system 27040, tilting, or pre-shifting, the floating seal assembly 27050 to one side, as discussed above.
[0307] [0307] Figure 106 represents the end actuator 27100 of Figures 104 and 105 when the end actuator 27100 was additionally introduced into the central opening 27044 of the trocar seal system 27040. After the initial contact of the elongated tip 27100 of the staple cartridge 27120, the pointed distal end 27102 of the anvil 27110 comes into contact with the first sealing port 27052 of the trocar seal system 27040. In several cases, the pointed distal end 27102 of the anvil 27110 may break the first sealing port 27052 of the 27040 trocar seal system as the contact between the elongated tip 27122 and the second seal port 27054 displaced the position of the 27050 floating seal assembly.
[0308] [0308] As discussed in the present invention, a first staple cartridge can comprise a first cartridge length and a second staple cartridge can comprise a second cartridge length that is different from the first cartridge length. In several cases, an end actuator of a surgical stapling instrument may comprise a cartridge gripper configured to receive the first staple cartridge and, in an alternative embodiment, the second staple cartridge. In other words, the cartridge gripper is configured to receive the first staple cartridge and the second staple cartridge, but not at the same time. The first staple cartridge and the second staple cartridge individually comprise a proximal end that is aligned with a detail of the proximal cartridge jaw when it is positioned on the cartridge jaw. When the first cartridge length is longer than the second cartridge length, for example, the distal end of the first staple cartridge would be positioned farther from the detail of the proximal cartridge gripper given the distal end of the second cartridge of staples. The reader should understand that the second cartridge length may be longer than the first cartridge length in other cases.
[0309] [0309] In addition to the above, the end actuator comprises a movable anvil claw relative to the cartridge claw between an open, or not clamped position, and a closed, or clamped position. In alternative embodiments, the jaw of the cartridge is mobile in relation to the jaw of the anvil. In any case, the anvil claw comprises a distal anvil end that is supported by the first staple cartridge and the second staple cartridge, depending on which staple cartridge is positioned in the cartridge claw. The distal anvil end is supported at a first location on the first cartridge jaw and at a second location on the second cartridge jaw. In many cases, the first location and the second location may not be at the same distance from the detail of the given proximal cartridge grip. In some cases, however, they may be at the same distance from the detail of the given cartridge jaw. In addition, in many cases, the first location is located at a first distance from the distal end of the first staple cartridge while the second location is located at a second, or different, distance from the distal end of the second staple cartridge. Bobby pins. In use, a patient's tissue will be positioned between the anvil clamp and the cartridge claw but, however, the staple cartridge support locations will still support the anvil claw, or the attachment load applied by the anvil claw.
[0310] [0310] In several cases, in addition to the above, the distal anvil end may extend distally beyond the distal end of the first staple cartridge when the end actuator is in a closed configuration and the first staple cartridge is positioned in the grip of the cartridge and, similarly, the distal end of the anvil may extend distally beyond the distal end of the second staple cartridge when the end actuator is in a closed configuration and the second staple cartridge is positioned in the cartridge grip. . However, when the first cartridge length is longer than the second cartridge length, in many cases, the distal anvil tip may extend distally beyond the distal end of the second staple cartridge, but may not extend distally beyond the distal end of the first staple cartridge. In such cases, the anvil claw may be longer than the second staple cartridge when the second staple cartridge is positioned in the cartridge claw, but shorter than the first staple cartridge when the first staple cartridge is positioned on the cartridge grip. In some cases, the anvil claw is the same length as the first staple cartridge or the second staple cartridge.
[0311] [0311] In addition to the above, the anvil claw will deflect when it moves to its closed position. Due to the different cartridge lengths of the staple cartridges, the deflection of the anvil claw can be different depending on which staple cartridge is positioned in the cartridge claw. As a result, the staple gap between the anvil clamp and the staple actuators of the first cartridge claw may be different from the staple gap between the anvil clamp and the staple drivers of the second cartridge jaw. In some cases, the gap in the staple formation gap is negligible, and staples ejected from the first staple cartridge and the second staple cartridge will be formed at the same height, or at least at the lowest suitable heights and enough to staple the tissue captured between the anvil jaw and the cartridge jaw. In such cases, the unformed height of the clamps on the first clamp cartridge can be equal to the unformed height of the clamps on the second clamp cartridge. In other cases, the unformed height of the clamps on the first clamp cartridge is different from the unformed height of the clamps on the second clamp cartridge. In such cases, the higher staples can be used on the first staple cartridge and the shorter staples can be used on the second staple cartridge, for example, depending on the deflection and / or anticipated orientation of the anvil claw when closed against the first and second staple cartridges. In at least one of these cases, each of the staples in the first staple cartridge has an unformed height in a first unformed height range and each of the staples in the second staple cartridge has an unformed height in a second height range not formed. In some cases, the first unformed height band is completely different from the second unformed height band whereas in other cases, the first unformed height band partially overlaps the second unformed height band.
[0312] [0312] As discussed above, the first staple cartridge and the second staple cartridge are selectively positioned on the end actuator's cartridge jaw and, in addition to the above, the cartridge jaw additionally comprises a support or surface bottom set to support staple cartridges when they are seated on the cartridge gripper. Such support may comprise a vertical detail. In several cases, the first support location on the first staple cartridge and the second support location on the second staple cartridge, discussed above, have the same vertical distance from the vertical detail of the cartridge grip. The vertical distance is measured orthogonally from the vertical reference, but it can be measured in any suitable way. In other cases, the first support location on the first staple cartridge has a different vertical height from the second support location on the second staple cartridge. In such cases, the orientation and / or deflection of the anvil claw when the anvil claw is in its secured position may be different as a result of the first local support location and the second support location having different vertical heights. Such different vertical heights can occur when the distal end, or tip, of the first staple cartridge, is different from the distal end of the second staple cartridge, among other reasons.
[0313] [0313] Many of the surgical instrument systems described here are driven by an electric motor; however, the surgical instrument systems described here can be induced in any suitable way. In several examples, the surgical instrument systems described herein can be induced, for example, by a manually operated trigger. In certain cases, the motors disclosed in this document may comprise a portion or portions of a robotically controlled system. In addition, any of the end actuators and / or tool sets shown in the present invention can be used with a robotic surgical instrument system. US Patent Application Serial No. 13 / 118,241, entitled "SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS", now US Patent Application Publication No. 2012/0298719, for example, reveals several examples of a robotic surgical instrument system with more details.
[0314] [0314] The surgical instrument systems described here have been described in connection with staple implantation and deformation; however, the embodiments described in the present invention are not so limited. Several modalities are foreseen, which implant fasteners in addition to staples, such as claws or tacks, for example. In addition, several modalities are contemplated, which use any suitable means to seal the fabric. For example, an end actuator, according to various modalities, may comprise electrodes configured to heat and seal the tissue. Likewise, for example, an end actuator according to certain modalities, can apply vibrational energy to seal the tissue. Examples
[0315] [0315] Example 1 - A surgical instrument comprising an end actuator. The end actuator comprises a cartridge jaw and an anvil jaw, one of which between the cartridge jaw and the anvil jaw is rotatable with respect to the other around a geometric axis of the cover. The surgical instrument additionally comprises a drive shaft that comprises a structure that defines a geometric axis of longitudinal drive shaft and a closing actuator, the closing actuator being translatable in relation to the structure. The closing actuator comprises a proximal portion, a distal portion and a connection. The connection is pivotally connected to the proximal portion around a geometric axis of the proximal connection and to the distal portion around a geometric axis of the distal connection. The geometric axis of the proximal connection and the geometric axis of the distal connection define a geometric axis of the longitudinal connection between them. The surgical instrument additionally comprises an articulation joint, the end actuator being swivelly connected to the drive axis around an articulation axis defined by the articulation joint. The end actuator is articulated in an articulation plane between a non-articulated position and an articulated position, the articulation axis being displaced from the geometric axis of the longitudinal drive axis. The geometric axis of the longitudinal link is not collinear with the geometric axis of the longitudinal drive axis when the end actuator is in the non-hinged or hinged position.
[0316] [0316] Example 2 - The surgical instrument of Example 1, with the geometric axis of the proximal connection being positioned along the geometric axis of the longitudinal drive axis.
[0317] [0317] Example 3 - The surgical instrument of Example 1 or 2, the cartridge jaw comprising a staple cartridge that includes the staples removably stored therein.
[0318] [0318] Example 4 - The surgical instrument of Example 3, the staple cartridge being replaceable.
[0319] [0319] Example 5 - The surgical instrument of Example 3 or 4, which additionally comprises a firing actuator that is separate and distinct from the closing actuator, the firing actuator being operable to eject the clips from the cartridge of staples.
[0320] [0320] Example 6 - The surgical instrument of Example 3, 4 or 5, the geometric axis of the longitudinal connection not being parallel to the said geometric axis of the longitudinal drive axis when the end actuator is in said non-articulated position or in the articulated position.
[0321] [0321] Example 7 - The surgical instrument of Example 3, 4 or 5, the end actuator additionally comprising a geometric axis of the longitudinal end actuator. The geometrical axis of the longitudinal end actuator is collinear with the geometric axis of the longitudinal drive axis when the end actuator is in the non-articulated position. The end actuator additionally comprises a distal end positioned along the geometric axis of the longitudinal end actuator, whereby the distal connection geometry axis is displaced in relation to a geometrical axis extending between the distal end and the geometric axis proximal connection when the end actuator is in the non-articulated position and in the articulated position.
[0322] [0322] Example 8 - A surgical instrument comprising an end actuator. The end actuator comprises a geometric axis of the longitudinal end actuator, a distal end positioned along the geometric axis of the end actuator, a cartridge jaw and an anvil jaw, one of which is between the cartridge jaw and the anvil claw is rotatable relative to the other around a geometric axis of the lid. The surgical instrument additionally comprises a drive shaft which comprises a structure that defines a geometric axis of longitudinal drive shaft and a translatable closing actuator in relation to the structure. The closing actuator comprises a proximal portion, a distal portion and a connection. The connection is pivotally connected to the proximal portion around a geometric axis of the proximal connection and to the distal portion around a geometric axis of the distal connection. The surgical instrument additionally comprises an articulation joint, with the end actuator being rotatably connected to the drive shaft around a joint axis defined by the articulation joint. The end actuator is articulated in an articulation plane between a non-articulated position and an articulated position, the articulation axis being displaced from the geometric axis of the longitudinal drive axis. The geometric axis of the end actuator
[0323] [0323] Example 9 - The surgical instrument of Example 8, with the geometric axis of proximal connection and the geometric axis of distal connection defining a geometric axis of longitudinal connection. The geometrical axis of the longitudinal link is not collinear with the geometrical axis of the longitudinal drive axis when the end actuator is in the non-articulated position or in the articulated position.
[0324] [0324] Example 10 - The surgical instrument of Example 9, the geometric axis of the longitudinal connection not being parallel to the geometric axis of the longitudinal drive axis when the end actuator is in the non-articulated position or in the articulated position.
[0325] [0325] Example 11 - The surgical instrument of Example 8, 9 or 10, with the geometric axis of the proximal connection being positioned along the geometric axis of the longitudinal drive axis.
[0326] [0326] Example 12 - The surgical instrument of Example 8, 9, 10 or 11, the cartridge jaw comprising a staple cartridge that includes the staples removably stored therein.
[0327] [0327] Example 13 - The surgical instrument of Example 12, since the staple cartridge is replaceable.
[0328] [0328] Example 14 - The surgical instrument of Example 12 or 13, which additionally comprises a trigger actuator that is separate and distinct from the closing actuator, the trigger actuator being able to eject the clips from the cartridge of staples.
[0329] [0329] Example 15 - A surgical instrument comprising an end actuator. The end actuator comprises a geometric axis of the longitudinal end actuator, a distal end positioned along the geometric axis of the end actuator, a first jaw and a second jaw, one of which between the first jaw and the second jaw is rotating relative to the other between an open position and a closed position. The surgical instrument additionally comprises a drive shaft which comprises a structure that defines a geometric axis of longitudinal drive shaft and a translatable closing actuator in relation to the structure. The closing actuator comprises a proximal portion, a distal portion and a connection. The connection is pivotally connected to the proximal portion around a geometric axis of the proximal connection and to the distal portion around a geometric axis of the distal connection. The surgical instrument additionally comprises a hinge joint, the end actuator being swiveled to the drive shaft around a hinge axis defined by the hinge joint. The end actuator is articulated between a non-articulated position and an articulated position, the articulation axis being positioned laterally in relation to the geometric axis of the longitudinal drive axis. The geometric axis of the longitudinal end actuator is aligned with the geometric axis of the longitudinal drive axis when the end actuator is in the non-hinged position. The geometric axis of the distal connection is positioned laterally in relation to a geometric axis that extends between the distal end of the end actuator and the geometric axis of the proximal connection when the first jaw is in the open position, in the closed position and in any position. position between the open position and the closed position.
[0330] [0330] Example 16 - The surgical instrument of Example 15, feeling
[0331] [0331] Example 17 - The surgical instrument, according to Example 15 or 16, the geometric axis of the longitudinal connection not being parallel to the geometric axis of the longitudinally driven axis when the first claw is in the closed position , regardless of whether the end actuator is in the non-articulated or articulated position.
[0332] [0332] Example 18 - The surgical instrument of Example 15, 16 or 17, the geometric axis of the proximal connection being positioned along the geometric axis of the longitudinal drive axis.
[0333] [0333] Example 19 - The surgical instrument of Example 15, 16, 17 or 18, the first claw comprising a staple cartridge that includes the staples removably stored therein.
[0334] [0334] Example 20 - The surgical instrument of Example 19, since the staple cartridge is replaceable.
[0335] [0335] Example 21 - The surgical instrument of Example 19 or 20, which additionally comprises a trigger actuator that is separate and distinct from the closing actuator, the trigger actuator being able to eject the clips from the cartridge of staples.
[0336] [0336] Example 22 - A surgical instrument that comprises a drive axis that comprises a proximal end, a distal end and a longitudinal geometric axis that extends between the proximal end and the distal end. The surgical instrument additionally comprises an end actuator
[0337] [0337] Example 23 - The surgical instrument of Example 22, since the end actuator is positionable in a non-articulated position that is aligned with the longitudinal geometric axis. The end actuator is moved through a first arc length when the end actuator moves from the non-hinged position to the first fully hinged position. The end actuator is moved through a second arc length when the end actuator moves from the non-hinged position to the second fully hinged position.
[0338] [0338] Example 24 - The surgical instrument of Example 23, since the first arc length is equal to the second length
[0339] [0339] Example 25 - The surgical instrument of Example 23, since the first arc length and the second arc length are different.
[0340] [0340] Example 26 - The surgical instrument of Example 22, 23, 24 or 25, the ratio being between 1.1 and 1.4.
[0341] [0341] Example 27 - The surgical instrument of Example 22, 23, 24, 25 or 26, the fixation site being displaced through a length of articulation arc when the end actuator moves between the first fully articulated position and the second position is fully articulated.
[0342] [0342] Example 28 - The surgical instrument of Example 27, whereby the surgical instrument is configured so that an articulation ratio comprising the articulation arc length and the articulation stroke length is maximized.
[0343] [0343] Example 29 - The surgical instrument in Example 28, the articulation ratio being between 1.2 and 1.7.
[0344] [0344] Example 30 - The surgical instrument of Example 27, 28 or 29, the surgical instrument being configured in such a way that a ratio comprising the product of the articulation arc length and the lateral moment arm for the length of articulation stroke is maximized.
[0345] [0345] Example 31 - The surgical instrument in Example 30, the ratio being between 1 and 3.
[0346] [0346] Example 32 - The surgical instrument of Example 22, 23, 24, 25, 26, 27, 28, 29, 30 or 31, the end actuator additionally comprising a staple cartridge comprising staples stored in removable mode on it.
[0347] [0347] Example 33 - The surgical instrument of Example 32, since the staple cartridge is replaceable.
[0348] [0348] Example 34 - A surgical instrument comprising a drive shaft comprising a proximal end, a distal end and a longitudinal geometric axis that extends between the proximal end and the distal end. The surgical instrument additionally comprises an end actuator which comprises an end actuator structure pivotally coupled to the drive shaft around a pivot pivot, the pivot pivot defining a pivot axis. - fixed linkage, and the fixed linkage axis is positioned laterally offset in relation to the longitudinal geometric axis. The surgical instrument additionally comprises an articulation actuator coupled to the structure of the end actuator in a fixation location. The articulation actuator is movable in a proximal position to rotate the end actuator to a first fully articulated position and a distal position to rotate the end actuator to a second fully articulated position. The proximal position and the distal position define an articulation stroke of the articulation trigger. The articulation stroke has a length of articulation stroke, in which a lateral moment arm is defined between the fixation location and the fixed articulation axis. The lateral moment arm is orthogonal to the longitudinal geometric axis. The surgical instrument is configured so that a ratio between the lateral moment arm and the joint stroke length is greater than 1.
[0349] [0349] Example 35 - The surgical instrument in Example 34, the ratio being between 1.1 and 1.4.
[0350] [0350] Example 36 - The surgical instrument of Example 34 or 35, the fixation site being displaced by a length of articulation arc when the end actuator moves between the first fully articulated position and the second position completely articulated.
[0351] [0351] Example 37 - The surgical instrument of Example 36, since the surgical instrument is configured so that a joint ratio comprising the articulation arc length and the articulation stroke length is maximized.
[0352] [0352] Example 38 - The surgical instrument in Example 37, the articulation ratio being between 1.2 and 1.7.
[0353] [0353] Example 39 - The surgical instrument of Example 36, since the surgical instrument is configured so that a ratio comprising the product of the articulation arc length and the lateral moment arm for the articulation stroke length - tion is maximized.
[0354] [0354] Example 40 - The surgical instrument in Example 39, the articulation ratio being between 1 and 3.
[0355] [0355] Example 41 - The surgical instrument of Example 34, 35, 36, 37, 38, 39 or 40, the end actuator additionally comprising a staple cartridge comprising staples removably stored therein.
[0356] [0356] Example 42 - The surgical instrument of Example 41, since the staple cartridge is replaceable.
[0357] [0357] Example 43 - A surgical instrument that comprises a drive axis that comprises a proximal end, a distal end and a longitudinal geometric axis that extends between the proximal end and the distal end. The surgical instrument additionally comprises an end actuator which comprises an end actuator structure pivotally coupled to the drive shaft around a pivot pivot, the pivot pivot defining a pivot axis. - fixed linkage, and the fixed linkage axis is positioned laterally offset in relation to the longitudinal geometric axis. The
[0358] [0358] Example 44 - A surgical instrument comprising a drive shaft comprising a proximal end, a distal end and a longitudinal geometric axis extending between the proximal end and the distal end. The surgical instrument additionally comprises an end actuator comprising an end actuator structure pivotally coupled to the drive axis around a pivot pivot, the pivot pivot defining a pivot axis. fixed articulation, and the fixed articulation axis is positioned laterally offset in relation to the longitudinal geometric axis. The surgical instrument additionally comprises an articulation actuator coupled to the end actuator structure in a fixation location, the articulation actuator being movable in a proximal position to rotate the end actuator to a first position fully articulated and a distal position to rotate the end actuator to a second fully articulated position. The proximal position and the distal position define an articulation stroke of the articulation actuator, and the articulation stroke has a length of articulation stroke. A side arm is defined between the attachment location and the fixed pivot axis. The surgical instrument additionally comprises a means to increase the arm from the lateral moment while limiting the articulation stroke.
[0359] [0359] Example 45 - A surgical instrument comprising a drive shaft comprising a proximal end, a distal end, a longitudinal geometric axis that extends between the proximal end and the distal end and an outer housing comprising a radius drive axis defined in relation to the longitudinal geometric axis. The surgical instrument additionally comprises an end actuator that comprises an end actuator structure pivotally coupled to the drive shaft around a pivot pivot, the pivot pivot defining a fixed pivot axis, and being that the fixed pivot axis is positioned laterally offset from the longitudinal geometric axis. The surgical instrument additionally comprises an articulation actuator coupled to the structure of the end actuator in a fixation location, the articulation actuator being proximally movable to rotate the end actuator in a first direction, the actuator being articulation is distally movable to rotate the end actuator in a second direction which is opposite to the first direction. A side moment arm is defined between the attachment location and the fixed pivot axis. The lateral moment arm is orthogonal to the longitudinal geometric axis, with a ratio between the driving axis radius and the lateral moment arm being less than 1.4.
[0360] [0360] Example 46 - The surgical instrument in Example 45, the ratio being less than 1.3.
[0361] [0361] Example 47 - The surgical instrument in Example 45, with the ratio being less than 1.2.
[0362] [0362] Example 48 - The surgical instrument of Example 45, with the ratio being less than 1.1.
[0363] [0363] Example 49 - The surgical instrument of Example 45, 46, 47 or 48, the end actuator being rotatable in a first distance in the first direction and a second distance in the second direction, and the first distance and the second distance are the same.
[0364] [0364] Example 50 - The surgical instrument of Example 45, 46, 47 or 48, the end actuator being rotatable through a first band in the first direction and a second band in the second direction, and the first track and the second track are not the same.
[0365] [0365] Example 51 - The surgical instrument of Example 45, 46, 47, 48, 49 or 50, which additionally comprises a staple cartridge that includes the staples removably stored therein.
[0366] [0366] Example 52 - The surgical instrument of Example 51, since the staple cartridge is replaceable.
[0367] [0367] Example 53 - The surgical instrument of Example 45, 46, 47, 48, 49, 50, 51 or 52, the external housing defining an internal opening, and the radius of the drive shaft is defined by the opening internal.
[0368] [0368] Example 54 - The surgical instrument of Example 53, feeling
[0369] [0369] Example 55 - The surgical instrument of Example 45, 46, 47, 48, 49, 50, 51, 52, 53 or 54, the drive axis comprising a first longitudinal portion and a second longitudinal portion, the driving shaft radius of the outer housing comprises a first driving shaft radius in the first longitudinal portion and a second driving shaft radius in the second longitudinal portion, and the first driving shaft radius is different from the second driving shaft radius.
[0370] [0370] Example 56 - A drive shaft assembly comprising a drive shaft comprising a proximal end, a distal end, a longitudinal geometric axis extending between the proximal end and the distal end and an outer housing comprising a radius of the drive axis defined in relation to the longitudinal geometry axis. The drive shaft assembly additionally comprises an end actuator that comprises an end actuator structure pivotally coupled to the drive shaft around a pivot pivot, the pivot pivot defining a pivot axis. fixed articulation, and the fixed articulation axis is positioned laterally offset in relation to the longitudinal geometric axis. The drive shaft assembly additionally comprises an articulation actuator coupled to the end actuator structure at a clamping location. The articulation actuator is proximally movable to rotate the end actuator in a first direction, the articulation actuator is movable distally to rotate the end actuator in a second direction which is opposite to the first direction. A side moment arm is defined between the attachment location and the fixed pivot axis. The lateral moment arm is orthogonal to the longitudinal geometric axis, and the drive shaft assembly is configured so that a ratio between the radius of the drive axis and the lateral moment arm is minimized.
[0371] [0371] Example 57 - The drive shaft set in Example 56, the ratio being less than 1.4.
[0372] [0372] Example 58 - The driving shaft set in Example 56, the ratio being less than 1.1.
[0373] [0373] Example 59 - The drive shaft assembly of Example 56, 57 or 58, which additionally comprises a staple cartridge that includes the staples removably stored therein.
[0374] [0374] Example 60 - The drive shaft assembly of Example 59, in which the staple cartridge is replaceable.
[0375] [0375] Example 61 - The drive shaft assembly of Example 56, 57, 58, 59 or 60, the outer housing defining an internal opening, and the driving shaft radius is defined by the internal opening .
[0376] [0376] Example 62 - The drive shaft set in Example 56, 57, 58, 59, 60 or 61, the drive shaft comprising a first longitudinal portion and a second longitudinal portion. The driving shaft radius of the outer housing housing comprises a first driving shaft radius in the first longitudinal portion and the second driving shaft radius in the second longitudinal portion. The first radius of the drive shaft is different from the second radius of the drive shaft.
[0377] [0377] Example 63 - A surgical instrument comprising a drive shaft comprising an external housing comprising a driving shaft radius. The surgical instrument additionally comprises an end actuator that comprises an end actuator structure rotatingly coupled to the drive shaft around a pivot pivot, with the pivot pivot defining a pivot axis, and the pivot axis being positioned laterally offset from the center line of the drive shaft. The surgical instrument additionally comprises an articulation actuator coupled to the structure of the end actuator in a fixation location. The articulation actuator is proximally movable to rotate the end actuator in a first direction in a first fully articulated position, the articulation actuator being movable distally to rotate the end actuator in a second direction in a completely articulated position. A lateral moment arm is defined between the attachment location and the articulation axis. The lateral moment arm is orthogonal to the center line of the drive shaft, and the ratio between the radius of the drive axis and the lateral moment arm is between 1 and 1.4.
[0378] [0378] Example 64 - A surgical instrument comprising a drive shaft and an end actuator. The end actuator comprises a proximal end, a distal end, a first jaw and a second jaw. The first jaw is movable in relation to the second jaw between an open position and a closed position, and one of the first jaw and the second jaw comprises a staple cartridge including removably stored staples. The surgical instrument additionally comprises a joint joint, the end actuator being swiveled connected to the actuation axis around the joint joint. The surgical instrument additionally comprises an articulation rod operationally
[0379] [0379] Example 65 - The surgical instrument, according to Example 64, with the control elements being positioned inside the joint.
[0380] [0380] Example 66 - The surgical instrument of Example 64 or 65, the first claw comprising the staple cartridge.
[0381] [0381] Example 67 - The surgical instrument of Example 64 or 65, the second claw comprising the staple cartridge.
[0382] [0382] Example 68 - The surgical instrument of Example 64, 65, 66 or 67, the cutting member being welded to the firing bar.
[0383] [0383] Example 69 - The surgical instrument of Example 64, 65, 66, 67 or 68, the control elements being connected to each other.
[0384] [0384] Example 70 - The surgical instrument of Example 64, 65, 66, 67 or 68, the control elements being disconnected from each other.
[0385] [0385] Example 71 - The surgical instrument of Example 64, 65, 66, 67, 68, 69 or 70, the control elements being disconnected from each other.
[0386] [0386] Example 72 - The surgical instrument of Example 64, 65, 66, 67, 68, 69, 70 or 71, the articulation joint defining a fixed axis of rotation around which the end actuator is rotated.
[0387] [0387] Example 73 - A surgical instrument that comprises a drive shaft that defines a longitudinal geometric axis and an end actuator. The end actuator comprises a proximal end, a distal end, a first claw and a second claw. The first claw is movable in relation to the second claw between an open position and a closed position. The surgical instrument additionally comprises a pivot joint, the end actuator being pivotally connected to the drive shaft around the pivot joint. The surgical instrument additionally comprises an articulation connection operatively connected to the end actuator, the articulation connection being movable distally to rotate the end actuator in a first direction, and the articulation connection is movable proximally to rotate the end actuator in a second direction; The surgical instrument comprises additions
[0388] [0388] Example 74 - The surgical instrument of Example 73, since the control elements are positioned inside the articulation joint.
[0389] [0389] Example 75 - The surgical instrument of Example 73 or 74, the first jaw comprising a staple cartridge.
[0390] [0390] Example 76 - The surgical instrument of Example 73 or 74, the second claw comprising a staple cartridge.
[0391] [0391] Example 77 - The surgical instrument of Example 73, 74, 75 or 76, the cutting member being welded to the firing bar.
[0392] [0392] Example 78 - The surgical instrument of Example 73, 74, 75, 76 or 77, the control elements being connected to each other.
[0393] [0393] Example 79 - The surgical instrument of Example 73, 74,
[0394] [0394] Example 80 - The surgical instrument of Example 73, 74, 75, 76, 77, 78 or 79, the drive shaft comprising a drive shaft structure, and the support being mounted on the structure drive shaft.
[0395] [0395] Example 81 - A surgical instrument comprising a drive shaft that defines a longitudinal geometric axis and an end actuator. The end actuator comprises a proximal end, a distal end, a first claw and a second claw. The first claw is movable in relation to the second claw between an open position and a closed position. The surgical instrument additionally comprises a pivot joint, the end actuator being pivotally connected to the drive shaft around the pivot joint. The surgical instrument additionally comprises a hinge connection operatively connected to the end actuator. The articulation connection is movable distally to rotate the end actuator in a first direction, the articulation connection is movable proximally to rotate the end actuator in a second direction. The surgical instrument additionally comprises a grip member configured to engage the first grip and move the first grip towards the closed position during a grip stroke. The gripping member is slid in relation to the hinge joint during the gripping stroke. The surgical instrument additionally comprises a set of trigger clips. The clamp firing assembly comprises a cutting member and a firing member. The cutting member is movable through the end actuator during a clamp firing stroke. The firing member comprises a plurality of flexible layers attached
[0396] [0396] Example 82 - The surgical instrument of Example 81, with the first jaw comprising a staple cartridge.
[0397] [0397] Example 83 - The surgical instrument of Example 81, with the second claw comprising a staple cartridge.
[0398] [0398] Example 84 - A surgical instrument comprising a drive shaft and an end actuator. The end actuator comprises a proximal end, a distal end, a longitudinal geometric axis that extends between the proximal end and the distal end, a first jaw and a second jaw. The first jaw is movable in relation to the second jaw between an open position and a closed position. The surgical instrument additionally comprises an articulation joint, with the end actuator being swiveled to the drive shaft around the articulation joint. The surgical instrument additionally comprises a set of trigger clips. The clamp firing assembly comprises a movable cutting member through the end actuator during a clamp firing stroke, the cutting member comprising a first portion configured to engage the first jaw and a second portion configured to engage the second claw. The clamp firing assembly further comprises a firing member comprising a plurality of flexible layers welded to the cutting member along a weld line. The welding line comprises
[0399] [0399] Example 85 - The surgical instrument of Example 84, with the first jaw comprising a staple cartridge.
[0400] [0400] Example 86 - The surgical instrument of Example 84, with the second claw comprising a staple cartridge.
[0401] [0401] Example 87 - The surgical instrument of Example 84, 85 or 86, the second jaw comprising a staple cartridge.
[0402] [0402] Example 88 - The surgical instrument of Example 84, 85, 86 or 87, the firing member comprising a first lateral side and a second lateral side, and the said welding line is present in the first side and on the second side.
[0403] [0403] Example 89 - A surgical instrument comprising a drive shaft comprising a drive shaft structure and an end actuator. The end actuator comprises a proximal end, a distal end, a first jaw and a second jaw. The first claw is movable in relation to the second claw between an open position and a closed position. The surgical instrument additionally comprises an articulation joint, with the end actuator being swiveled to the drive shaft around the articulation joint. The surgical instrument further comprises a clamp firing assembly comprising a movable cutting member through the end actuator during a clamp firing course. The clip firing assembly additionally comprises a firing member, the firing member comprising a plurality of flexible layers attached to the cutting member, and the firing member extending through the hinge joint. The surgical instrument additionally comprises a lateral spring support positioned adjacent to the dis-
[0404] [0404] Example 90 - The surgical instrument of Example 89, since the first jaw comprises a staple cartridge.
[0405] [0405] Example 91 - The surgical instrument of Example 89, since the second jaw comprises a staple cartridge.
[0406] [0406] Example 92 - The surgical instrument of Example 89, 90 or 91, the lateral spring support comprising a first lateral spring support positioned along a first lateral side of the firing member. The surgical instrument additionally comprises a second lateral spring support positioned along a second lateral side of the firing member.
[0407] [0407] Example 93 - A surgical instrument comprising a drive shaft and an end actuator. The end actuator comprises a proximal end, a distal end, a first jaw and a second jaw. The first jaw is movable in relation to the second jaw between an open position and a closed position, and one of the first jaw and the second jaw comprises a staple cartridge including removably stored staples. The surgical instrument additionally comprises a joint joint, the end actuator being swiveled connected to the actuation axis around the joint joint. The surgical instrument additionally comprises a hinge rod operatively connected to the end actuator, the hinge rod being movable distally to rotate the end actuator in a first direction, and the hinge rod is movable proximally to rotate the end actuator in a second direction. The surgical instrument additionally comprises a firing bar comprising a plurality of flexible layers, the firing bar being movable through the articulation joint during a staple firing stroke. The surgical instrument additionally comprises a first flexible support positioned on a first side of the firing bar, a second flexible support positioned on a second side of the firing bar and a plurality of control elements, with each control element comprises an opening defined therein. The firing bar extends through the openings, with the first flexible support, the second flexible support and the control elements configured to keep the flexible layers together.
[0408] [0408] Example 94 - The surgical instrument of Example 93, since the first flexible support and the second flexible support extend through at least some of the openings of the control element.
[0409] [0409] Example 95 - A surgical instrument comprising an end actuator comprising a proximal end and a distal end. The surgical instrument additionally comprises a drive shaft. The drive shaft comprises a structure, a locking plate movable in relation to the structure, and the locking plate comprises a first longitudinal rack of locking teeth. The drive shaft additionally comprises a pivot joint, the end actuator being swiveled to the drive shaft by the pivot joint. The drive shaft comprises a pivot actuator operationally connected to the end actuator, the pivot actuator being movable distally to rotate the end actuator in a first direction, and proximally to rotate the end actuator in a second direction . The act-
[0410] [0410] Example 96 - The surgical instrument of Example 95, since the first longitudinal rack of the locking teeth is defined in the foreground and the second longitudinal rack of the locking teeth is defined in the background. The foreground and the background are different.
[0411] [0411] Example 97 - The surgical instrument of Example 95 or 96, the locking plate being slid in relation to the structure.
[0412] [0412] Example 98 - The surgical instrument of Example 95, 96 or 97, the structure comprising a recess and the locking plate is positioned inside the recess. The recess comprises a proximal end wall configured to limit the proximal movement of the lock plate within the recess. The recess further comprises a distal end wall configured to limit the distal movement of the locking plate within the recess.
[0413] [0413] Example 99 - The surgical instrument of Example 98, which comprises a biasing member positioned end to end wall proximal and the lock paca.
[0414] [0414] Example 100 - The surgical instrument of Example 98, which comprises a bias member positioned end to end distal wall and locking latch.
[0415] [0415] Example 101 - The surgical instrument of Example 95, 96, 97, 98, 99 or 100, with the surgical end actuator comprising a first jaw and a second jaw, the first jaw being movable in relation to the second claw between an open position and a closed position. The surgical instrument additionally comprises a gripping member configured to move the first gripper in the direction of the closed position during a gripping stroke. The closing member is configured to engage the articulation lock during the gripping stroke and keep the articulation lock in the locked position.
[0416] [0416] Example 102 - The surgical instrument of Example 101, the drive axis defining a longitudinal geometric axis. The structure comprises a flexible portion, the closing member being configured to push the locking plate against the flexible portion and to deflect the flexible portion laterally in relation to the longitudinal geometric axis.
[0417] [0417] Example 103 - The surgical instrument of Example 102, the flexible portion comprising a side wall on the side and a defined cavity behind the side wall on the side. The side wall of the side is configured to flex into the cavity.
[0418] [0418] Example 104 - The surgical instrument of Example 95, 96, 97, 98, 99, 100, 101, 102 or 103, the joint lock being provided in engagement with the lock plate and the joint actuator dog.
[0419] [0419] Example 105 - The surgical instrument of Example 95, 96, 97, 98, 99, 100, 101, 102, 103 or 104, the end actuator additionally comprising a staple cartridge comprising stored staples of removable mode on it.
[0420] [0420] Example 106 - The surgical instrument of Example 105,
[0421] [0421] Example 107 - The surgical instrument of Example 105 or 106, the end actuator comprising a first jaw and a second jaw. The first claw is movable in relation to the second claw between an open position and a closed position. The first claw comprises a staple cartridge.
[0422] [0422] Example 108 - The surgical instrument of Example 105 or 106, the end actuator comprising a first jaw and a second jaw. The first claw is movable in relation to the second claw between an open position and a closed position. The first claw comprises the staple cartridge.
[0423] [0423] Example 109 - The surgical instrument of Example 95, 96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107 or 108, the first rack comprising locking teeth comprising teeth spaced at a first step. The second longitudinal locking tooth rack comprises teeth spaced in a second step, the second step being different from the first step. The third longitudinal locking tooth rack comprises teeth spaced in a third step, the third step being different from the first step and the second step.
[0424] [0424] Example 110 - A surgical instrument comprising an end actuator and a drive shaft. The end actuator comprises a proximal end and a distal end. The drive shaft comprises a structure comprising a first longitudinal rack of locking teeth. The drive shaft additionally comprises an articulation joint, the end actuator being swiveled connected to the drive shaft by the articulation joint. The drive shaft additionally comprises a pivot actuator operationally connected to the end actuator. The articulation actuator is movable distally to rotate the end actuator in a first direction and the articulation actuator is movable proximally to rotate the end actuator in a second direction. The articulation actuator comprises a second longitudinal rack of locking teeth. The drive shaft additionally comprises a hinge lock comprising a third longitudinal rack of lock teeth. The articulation lock is positioned in an unlocked position in which the articulation actuator can move in relation to the structure and a locked position in which the third longitudinal rack of the locking teeth is engaged with the first longitudinal rack of teeth. of the structure lock and the second longitudinal rack of locking teeth of the articulation actuator to prevent the proximal and distal movement of the articulation actuator.
[0425] [0425] Example 111 - The surgical instrument of Example 110, the structure comprising a sliding lock plate, and the first longitudinal locking tooth rack is defined on the lock plate.
[0426] [0426] Example 112 - The surgical instrument of Example 110 or 111, the end actuator comprising a staple cartridge that includes the staples removably stored therein.
[0427] [0427] Example 113 - A surgical instrument comprising an end actuator and a drive shaft. The drive shaft comprises a structure and an articulation joint, whereby the end actuator is pivotally connected to the drive shaft by the articulation joint. The drive shaft additionally comprises a pivot actuator operationally connected to the end actuator. The pivot actuator is movable in a first direction to rotate the end actuator in one direction and the pivot actuator is movable in a second direction to rotate the end actuator in the other direction. The drive shaft additionally comprises an articulation lock that can be positioned in a first position in which the articulation actuator can move in relation to the structure and a second position in which the articulation lock is engaged with the structure and the articulation actuator. to limit the movement of the articulation actuator in the first and second directions.
[0428] [0428] Example 114 - The surgical instrument of Example 113, the end actuator comprising a staple cartridge that includes the staples removably stored therein.
[0429] [0429] Example 115 - A surgical instrument comprising an end actuator head configurable in an open configuration and in a closed configuration. The surgical instrument additionally comprises a drive shaft. The drive shaft comprises a longitudinal geometric axis and an articulation joint, the head of the end actuator being rotatably connected to the drive axis by the articulation joint. The drive shaft additionally comprises a pivot actuator operationally connected to the head of the end actuator. The pivot actuator is movable in a first direction to rotate the end actuator head in one direction and the pivot actuator is movable in a second direction to rotate the end actuator head in another direction. The articulation actuator comprises at least one lock projection that extends laterally in relation to the longitudinal geometric axis. The drive shaft additionally comprises an articulation lock comprising at least two projections that extend laterally in relation to the longitudinal geometric axis. The joint lock
[0430] [0430] Example 116 - A surgical instrument comprising an end actuator comprising a proximal end, a distal end, a first claw and a second claw. The first jaw is movable in relation to the second jaw between an open position and a closed position. The surgical instrument additionally comprises a drive shaft that comprises a structure, the structure comprising a first longitudinal locking tooth rack. The drive shaft additionally comprises a pivot joint, the end actuator being swiveled to the drive shaft by the pivot joint. The drive shaft comprises a pivot actuator operationally connected to the end actuator, the pivot actuator being movable distally to rotate the end actuator in a first direction, and proximally to rotate the end actuator in a second direction . The articulation actuator comprises a second longitudinal rack of locking teeth. The drive shaft further comprises a hinge lock comprising a third group of lock teeth. The articulation lock is positioned in a disengaged position in which the third group of locking teeth is not engaged with the structure and the articulation actuator, and in a engaged position in which the third group of locking teeth is engaged with said first longitudinal rack of locking teeth and said second longitudinal rack of locking teeth to prevent proximal and distal movement of the articulation actuator. The drive shaft additionally comprises a gripping member configured to move the first gripper in the direction of the closed position during a gripping stroke. The closing member is configured to engage the articulation lock during the gripping stroke and to move the articulation lock from the open to the closed position.
[0431] [0431] Example 117 - The surgical instrument of Example 116, the first longitudinal rack of the locking teeth being defined in a foreground. The second longitudinal rack of the lock teeth is defined in the background. The foreground and the background are different.
[0432] [0432] Example 118 - The surgical instrument of Example 116 or 117, the end actuator additionally comprising a staple cartridge comprising the staples removably stored therein.
[0433] [0433] Example 119 - The surgical instrument of Example 118, the staple cartridge being replaceable.
[0434] [0434] Example 120 - The surgical instrument of Example 118 or 119, the end actuator comprising a first jaw and a second jaw. The first claw is movable in relation to the second claw between an open position and a closed position. The first claw comprises a staple cartridge.
[0435] [0435] Example 121 - The surgical instrument of Example 118 or 119, the end actuator comprising a first jaw and a second jaw. The first claw is movable in relation to the second claw between an open position and a closed position. The first claw comprises the staple cartridge.
[0436] [0436] Example 122 - The surgical instrument of Example 116, 117, 118, 119, 120 or 121, the first longitudinal rack of locking teeth comprising teeth spaced at a first step. The second longitudinal locking tooth rack comprises teeth spaced in a second step, the second step being different from the first step. The third group of lock teeth comprises teeth spaced in a third step, the third step being different from the first step and the second step.
[0437] [0437] Example 123 - The surgical instrument of Example 116, 117, 118, 119, 120, 121 or 122, the drive axis defining a longitudinal geometric axis. The articulation lock comprises a locking plate sliding laterally in relation to the longitudinal geometric axis between the disengaged position and the engaged position. The structure comprises a proximal guide protrusion and a distal guide protrusion. The locking plate comprises a proximal lateral slit and a distal lateral slit, with the proximal guide protrusion extending to the proximal lateral slit and the distal guide protrusion extending to the distal lateral slit. The proximal guide protuberance and the distal guide protuberance cooperate to define the lateral path of the lock plate.
[0438] [0438] Example 124 - The surgical instrument of Example 123, the lock plate comprising a lock slot that includes the side walls defined therein. The closing member comprises a lock actuator that extends into the lock slot. The lock actuator is configured to engage a side wall to move the lock plate from the disengaged position to the engaged position during the closing stroke.
[0439] [0439] Example 125 - The surgical instrument of Example 124, the closing member being movable through a retraction course to allow the first claw to be moved to the open position. The lock actuator is configured to engage one of the side walls of the lock slot to move the lock plate from the engaged position to the disengaged position during the retracting stroke.
[0440] [0440] Example 126 - The surgical instrument of Example 124, the closing member being movable through an opening stroke to move the first claw to the open position. The lock trigger is configured to engage one of the side walls of the lock slot to move the lock plate from the engaged position to the disengaged position during the opening stroke.
[0441] [0441] Example 127 - The surgical instrument of Example 116, 117, 118, 119, 120, 121, 122, 123, 124, 125 or 126, in which the articulation lock comprises a deflecting lock arm for the position engaged by the closing member.
[0442] [0442] Example 128 - The surgical instrument of Example 116, 117, 118, 119, 120, 121, 122, 123, 124, 125 or 126, the articulation lock comprising a first locking arm and a second locking arm hangs. The closing member comprises a wedge positioned between the first locking arm and the second locking arm during the closing stroke to deflect the articulation lock to the engaged position.
[0443] [0443] Example 129 - The surgical instrument of Example 128, the third group of locking teeth being present in the first locking arm and said second locking arm.
[0444] [0444] Example 130 - The surgical instrument of Example 128 or 129, the first locking arm being configured to engage the first longitudinal locking tooth rack and the second locking arm is configured to engage the second longitudinal racking locking teeth.
[0445] [0445] Example 131 - A surgical instrument comprising an end actuator comprising a first jaw and a second jaw. The first jaw is movable in relation to the second jaw between an open position and a closed position. The surgical instrument additionally comprises a drive shaft. The drive shaft comprises a frame and a movable locking plate in relation to the structure, the locking plate comprising a first group of locking teeth. The drive shaft additionally comprises a pivot joint, the end actuator is swiveling connected to the drive shaft by the pivot joint. The drive shaft additionally comprises a pivot actuator operationally connected to the end actuator, the pivot actuator being configured to rotate the end actuator in a first direction and in a second direction. The articulation actuator comprises a second group of locking teeth. The drive shaft comprises a hinge lock comprising a third group of lock teeth. The articulation lock is positioned in a disengaged position in which the third group of locking teeth is not engaged with the locking plate, the structure and the articulation actuator, and in an engaged position in which the third group of teeth locking mechanism is engaged with the first group of locking teeth and said second group of locking teeth to prevent the articulation of the end actuator. The drive shaft additionally comprises a gripping member configured to move the first gripper towards the closed position during a gripping stroke. The closing member is configured to engage the hinge lock during the gripping stroke and move the hinge lock from the open to the closed position.
[0446] [0446] Example 132 - The surgical instrument of Example 131,
[0447] [0447] Example 133 - A surgical instrument comprising an end actuator comprising a first jaw and a second jaw. The first jaw is movable in relation to the second jaw between an open position and a closed position. The surgical instrument additionally comprises a drive shaft. The drive shaft comprises a frame, the frame comprising a first group of lock teeth. The drive shaft additionally comprises a pivot joint, the end actuator being pivotally connected to the drive shaft by the pivot joint. The drive shaft additionally comprises a pivot actuator operationally connected to the end actuator, the pivot actuator being configured to rotate the end actuator in a first direction and in a second direction. The drive shaft additionally comprises an articulation lock comprising a gear including a second group of teeth in engagement with the first group of teeth, the gear being pivotally mounted to the structure. The drive shaft additionally comprises a gripping member configured to move the first gripper in the direction of the closed position during a gripping stroke. The closing member is configured to engage the gear during the closing stroke to prevent the end actuator from being pivoted.
[0448] [0448] Example 134 - The surgical instrument of Example 133, the end actuator additionally comprising a staple cartridge that includes the staples removably stored therein.
[0449] [0449] Example 135 - A surgical instrument comprising an end actuator comprising a first jaw and a second jaw.
[0450] [0450] Example 136 - A surgical instrument comprising an end actuator comprising a first jaw and a second jaw. The first jaw is movable in relation to the second jaw between an open position and a closed position. The surgical instrument additionally comprises a drive shaft. The drive shaft comprises a frame, a movable locking member in relation to the frame and a pivot joint, the end actuator being swiveled to the drive shaft by the pivot joint. The drive shaft additionally comprises a pivot actuator operationally connected to the end actuator, the pivot actuator being configured to rotate the end actuator in a first direction and in a second direction. The drive shaft additionally comprises an articulation lock that can be positioned in a disengaged position in which the articulation lock is not engaged with said immobilizing member and the articulation actuator and in an engaged position in which the articulation lock is engaged. - connected with the immobilization member and the articulation actuator to inhibit the articulation of the end actuator; The drive shaft additionally comprises a gripping member configured to move the first gripper in the direction of the closed position during a gripping stroke. The closing member is configured to engage the hinge lock during the gripping stroke and move the hinge lock from the open to the closed position.
[0451] [0451] Example 137 - A surgical instrument that can be inserted through a trocar. The surgical instrument comprises a handle and a drive shaft that extends from the handle. The drive shaft comprises a frame, a proximal portion connected to the handle, a distal portion comprising an end actuator and a hinge joint, the end actuator being rotatable around the hinge joint. The drive shaft additionally comprises an articulation actuator operationally connected to the end actuator, since the articulation actuator is selectively movable to rotate the end actuator in a first direction and in a second direction. The drive shaft additionally comprises an external housing that can be slid in relation to the structure. The outer housing comprises a distal non-round housing portion adjacent the articulation joint and a longitudinal round housing portion extending between the proximal portion and the distal portion of the non-round housing portion. The longitudinal round housing portion comprises a first diameter. The distal non-round housing portion comprises a second diameter. The first diameter is smaller than the second diameter. The distal non-round housing portion and the longitudinal round housing portion are sized and configured to be inserted through the trocar into a surgical site. The drive shaft additionally comprises a hinge lock configured to engage the hinge actuator and prevent rotation of the end actuator, the hinge lock being positioned within the non-distal housing portion.
[0452] [0452] Example 138 - The surgical instrument of Example 137, the end actuator comprising a staple cartridge that includes the staples removably stored therein.
[0453] [0453] Example 139 - The surgical instrument of Example 138, the end actuator additionally comprising an anvil configured to deform the clamps. The anvil is rotatable in relation to the staple cartridge.
[0454] [0454] Example 140 - The surgical instrument of Example 138,
[0455] [0455] Example 141 - The surgical instrument of Example 137, 138, 139 or 140, the staple cartridge being replaceable.
[0456] [0456] Example 142 - The surgical instrument of Example 137, 138, 139, 140 or 141, the end actuator being replaceable.
[0457] [0457] Example 143 - The surgical instrument of Example 137, 138, 139, 140, 141 or 142, the longitudinal round housing portion defining a longitudinal geometric axis. The distal non-round housing portion is displaced eccentrically in relation to the longitudinal geometric axis.
[0458] [0458] Example 144 - The surgical instrument of Example 137, 138, 139, 140, 141, 142 or 143, the proximal portion of the drive shaft comprising a connector that includes a lock configured to releasably secure the drive shaft to the handle.
[0459] [0459] Example 145 - The surgical instrument of Example 137, 138, 139, 140, 141, 142, 143 or 144, the articulation lock being completely positioned in the distal non-round housing portion.
[0460] [0460] Example 146 - The surgical instrument of Example 137, 138, 139, 140, 141, 142, 143 or 144, the articulation lock comprising a fixed portion mounted to the structure and a movable lock portion within the distal non-round housing.
[0461] [0461] Example 147 - The surgical instrument of Example 146, the articulation lock comprising a fixed portion mounted to the structure and a movable lock portion within the distal non-round housing portion.
[0462] [0462] Example 148 - A surgical instrument insertable through a trocar. The surgical instrument comprises a handle and a drive shaft that extends from the handle. The drive shaft comprises a frame, a proximal portion that can be attached to the handle, a distal portion comprising an end actuator and an articulation joint, the end actuator being rotatable around the articulation joint. The drive shaft additionally comprises a pivot actuator operationally connected to the end actuator, the pivot actuator being movable to rotate the end actuator in a first direction and in a second direction. The drive shaft additionally comprises an external housing that can be slid off the frame. The outer housing comprises a portion of the distal housing adjacent to the articulation joint, the portion of the distal housing comprising an unrimped perimeter comprising a width. The external housing additionally comprises a housing portion that extends between the proximal portion and the distal housing portion. The longitudinal housing portion comprises a substantially rounded perimeter comprising a diameter, the diameter being less than the width. The distal housing portion and the longitudinal housing portion are sized and configured to be inserted through the trocar into a surgical site. The drive shaft additionally comprises an articulation lock configured to engage the articulation actuator and prevent rotation of the end actuator, the articulation lock being positioned inside the distal housing portion.
[0463] [0463] Example 149 - The surgical instrument of Example 148, the end actuator comprising a staple cartridge that includes the staples removably stored therein.
[0464] [0464] Example 150 - The surgical instrument of Example 148 or 149, the staple cartridge being replaceable.
[0465] [0465] Example 151 - The surgical instrument of Example 148, 149 or 150, the end actuator being replaceable.
[0466] [0466] Example 152 - The surgical instrument of Example 148, 149, 150 or 151, the articulation lock being completely positioned in the distal housing portion.
[0467] [0467] Example 153 - The surgical instrument of Example 148, 149, 150 or 151, the hinge lock comprising a fixed portion mounted to the structure and a movable lock portion within the distal housing portion.
[0468] [0468] Example 154 - The surgical instrument of Example 153, the fixed portion being in the longitudinal housing portion.
[0469] [0469] Example 155 - A surgical instrument that comprises a handle and a removable drive shaft that extends from the handle. The removable drive shaft comprises a frame, a proximal lock that can be attached to the handle, a distal portion comprising an end actuator and a joint joint, the end actuator being rotatable around the articulation joint. The removable drive shaft additionally comprises an articulation actuator configured to articulate end actuator 230 in a first direction and in a second direction. The removable drive shaft additionally comprises an external tube translatable in relation to the structure. The outer tube comprises a portion of the distal tube adjacent to the hinge joint, the portion of the distal tube comprising a non-round perimeter comprising a width. The outer tube further comprises a portion of the longitudinal tube. The longitudinal tube portion comprises a substantially round perimeter comprising a diameter, the diameter being less than the width. The distal tube portion and the longitudinal tube portion are sized and configured to be inserted through the trocar into a surgical site. The removable drive shaft additionally comprises an articulation lock configured to engage the articulation actuator and prevent rotation of the end actuator, the articulation lock being positioned inside the distal tube portion.
[0470] [0470] Example 156 - A surgical stapling instrument system comprising a handle, a mouthpiece and an elongated drive shaft. The elongated drive axis comprises a proximal end, a distal end, a proximal region that comprises a first diameter, a central region that comprises a second diameter, the central region defining a longitudinal geometric axis, and a distal region that comprises a third diameter. The first diameter is different from the second diameter and the distal region is displaced laterally in relation to the longitudinal geometric axis. The surgical stapling instrument system additionally comprises an end actuator comprising a first claw. The first gripper comprises an elongated channel and a staple cartridge comprising a plurality of staples, the staple cartridge being operatively supported in the elongated channel. (i) The end actuator comprises a second jaw, the second jaw being movable in relation to the first jaw. The surgical stapling instrument additionally comprises a pivot joint rotatingly connecting the end actuator to the elongated drive shaft, a firing member configured to move within the end actuator and a configured firing system to apply a firing motion to the firing member.
[0471] [0471] Example 157 - The surgical stapling instrument system of Example 156, the first diameter being larger than the second diameter.
[0472] [0472] Example 158 - The surgical stapling instrument system of Example 156 or 157, the second diameter being smaller than the third diameter.
[0473] [0473] Example 159 - The surgical stapling instrument system of Example 156, 157 or 158, the third diameter being smaller than the first diameter and larger than the second diameter.
[0474] [0474] Example 160 - The surgical stapling instrument system of Example 156, 157, 158 or 159, the second gripper comprising an anvil configured to deform the clamps.
[0475] [0475] Example 161 - The surgical stapling instrument system of Example 156, 157, 158, 159 or 160, the distal region of the elongated drive shaft comprising at least one flat side.
[0476] [0476] Example 162 - The surgical stapling instrument system of Example 156, 157, 158, 159, 160 or 161, the distal region being not completely cylindrical.
[0477] [0477] Example 163 - A surgical stapling instrument that comprises an elongated drive shaft. The elongated drive shaft comprises a proximal end, a distal end and a first width at the proximal end, with the first width of the elongated drive shaft transitioning to a second width in the center of the elongated drive shaft. the second width of the elongated drive shaft transitions to a third width at the distal end of the elongated drive shaft. The distal end of the elongated drive shaft is not cylindrical, the distal end comprising a widening that extends laterally in relation to the second width, and the first, second and third widths are different. The surgical stapling instrument additionally comprises an end actuator configured to be attached to the distal end of the elongated drive shaft. The end actuator comprises a first jaw and a second jaw, the first jaw being movable in relation to the second jaw. The surgical stapling instrument further comprises a hinge assembly configured to apply hinge movements to the end actuator, a trigger member and a trigger system configured to apply a trigger movement to the trigger member.
[0478] [0478] Example 164 - The surgical stapling instrument of Example 163, the first width being greater than the second width.
[0479] [0479] Example 165 - The surgical stapling instrument of Example 163 or 164, the second width being less than the third width.
[0480] [0480] Example 166 - The surgical stapling instrument of Example 163, 164 or 165, the third width being less than the first width and greater than the second width.
[0481] [0481] Example 167 - The surgical stapling instrument of Example 163, 164, 165 or 166, the distal end of the elongated drive shaft being configured to fit through a 12 mm cannula passage.
[0482] [0482] Example 168 - The surgical stapling instrument of Example 163, 164, 165, 166 or 167, with the center of the elongated drive shaft comprising a width that is less than 10 mm.
[0483] [0483] Example 169 - A surgical stapling instrument that comprises an elongated drive shaft. The elongated drive axis comprises a proximal end, a distal end, a proximal region comprising a first circumference, a central region comprising a second circumference, with the central region defining a central longitudinal geometric axis, and a distal region comprising a third circumference. The first circle is different from the second circle, and the third circle is offset from the second circle. The surgical clamp instrument further comprises an end actuator configured to be attached to the distal end of the elongated drive shaft. The end actuator comprises a gripper cartridge gripper and an anvil. The surgical clamp instrument further comprises an articulation system configured to apply articulation movements to the end actuator, a firing member, the firing member being configured to move through the end actuator, and a firing system configured to apply firing and retracting movements to the firing member.
[0484] [0484] Example 170 - The surgical fastening instrument of Example 169, the first circumference being greater than the second circumference.
[0485] [0485] Example 171 - The surgical stapling instrument of Example 169 or 170, the second circumference being smaller than the third circumference.
[0486] [0486] Example 172 - The surgical stapling instrument of Example 169, 170 or 171, the third circumference being smaller than the first circumference and larger than the second circumference.
[0487] [0487] Example 173 - The surgical fastening instrument of Example
[0488] [0488] Example 174 - The surgical fastening instrument of Example 169, 170, 171, 172 or 173, with the distal region of the elongated drive shaft comprising at least one flat side.
[0489] [0489] Example 175 - The surgical fastening instrument of Example 169, 170, 171, 172, 173 or 174, with the central region comprising a region that is scaled up at the distal end.
[0490] [0490] Example 176 - A surgical instrument comprising a housing and a drive shaft extending from the housing comprising an external tube portion. The outer tube portion includes a proximal tube portion, the proximal tube portion defining a longitudinal geometric axis, and an elongated intermediate tube portion extending distally from the proximal tube portion, the tube portion being intermediate is centered along the longitudinal geometric axis. The outer tube portion additionally includes a distal tube portion that extends distally from the intermediate tube portion, the distal tube portion being laterally displaced with respect to the longitudinal geometric axis, and the distal tube portion with - includes an extension that extends to one side of the longitudinal geometric axis. The outer tube portion additionally includes a tapered narrowing defined between the intermediate tube portion and the distal tube portion.
[0491] [0491] Example 177 - The surgical instrument of Example 176, which additionally comprises an end actuator and a hinge joint pivotally connecting the end actuator to the distal tube portion.
[0492] [0492] Example 178 - The surgical instrument of Example 177, the end actuator comprising a staple cartridge that includes the staples removably stored therein.
[0493] [0493] Example 179 - A surgical instrument comprising a housing comprising an electric motor. The surgical instrument additionally comprises a drive shaft extending from the housing, the drive shaft comprising a frame and an end actuator. The end actuator comprises a first jaw, a second jaw, the first jaw being rotatable with respect to the second jaw, a staple cartridge that comprises staples stored in a removable way, and an anvil configured to deform the clamps . The surgical instrument additionally comprises a closing system configured to move the first claw towards the second claw during a closing stroke, an articulation joint rotatingly connecting the end actuator to the drive shaft, a locking system articulation configured to articulate the end actuator in relation to the drive shaft and a trigger system operationally coupled with the electric motor. A firing system is configured to eject the staples from the staple cartridge during a staple firing stroke. The surgical instrument additionally comprises a first rotating member configured to selectively transmit the movement of the firing system to the articulation system and a second rotating member rotatingly mounted to the structure, the second rotating member being operationally engaged with the system of articulation. The closing system is configured to engage the second rotating member during the closing stroke to lock the pivot system in place and prevent the end actuator from pivoting.
[0494] [0494] Example 180 - The surgical instrument of Example 179, in which the closure system comprises a closing tube that surrounds the structure. The closing system additionally comprises a wedge configured to engage the second rotating member and locking the second rotary in position during the closing stroke.
[0495] [0495] Example 181 - The surgical instrument of Example 179 or 180, with the first rotatable member being pivotally mounted inside the structure.
[0496] [0496] Example 182 - The surgical instrument of Example 179, 180 or 181, the second rotating member comprising a gear engaged with a tooth rack defined in the articulation system.
[0497] [0497] Example 183 - The surgical instrument of Example 179, 180, 181 or 182, the first claw comprising a staple cartridge and the second claw comprising the anvil.
[0498] [0498] Example 184 - The surgical instrument of Example 179, 180, 181 or 182, the first claw comprising the anvil and the second claw comprising the staple cartridge.
[0499] [0499] Example 185 - The surgical instrument of Example 179, 180, 181, 182, 183 or 184, the housing comprising a handle.
[0500] [0500] Example 186 - The surgical instrument of Example 179, 180, 181, 182, 183, 184 or 185, the housing being fixed to a robotic surgical system.
[0501] [0501] Example 187 - The surgical instrument of Example 179, 180, 181, 182, 183, 184, 185 or 186, the first rotating member being configured to operationally disengage the articulation system from the firing system during the course of closure.
[0502] [0502] Example 188 - The surgical instrument of Example 179, 180, 181, 182, 183, 184, 185, 186 or 187, the artery system being
[0503] [0503] Example 189 - The surgical instrument of Example 179, 180, 181, 182, 183, 184, 185, 186, 187 or 188, the closure system being retractable after the closing stroke to open the first grapple and unlock the articulation system.
[0504] [0504] Example 190 - The surgical instrument of Example 179, 180, 181, 182, 183, 184, 185, 186, 187, 188 or 189, the second rotating member being rotatable around a protuberance that extends from the structure. The protrusion comprises a first brake arm and a second brake arm, the closing system being configured to engage the first and second brake arms during the closing stroke and prevent rotation of the second rotating member .
[0505] [0505] Example 191 - The surgical instrument of Example 179, 180, 181, 182, 183, 184, 185, 186, 187, 188, 189 or 190, the second rotating member comprising an annular matrix of teeth, and being that the closing system is configured to engage the annular matrix of the teeth during the closing stroke and to prevent the rotation of the second rotating member.
[0506] [0506] Example 192 - A surgical instrument comprising a housing comprising a swivel inlet, a drive shaft extending from the housing, the drive shaft comprising a frame and an end actuator. The end actuator comprises a first jaw and a second jaw, the first jaw being rotatable with respect to the second jaw. The surgical instrument additionally comprises a closing system configured to close the first jaw during a closing stroke, an articulation joint rotatingly connecting the end actuator to the drive shaft,
[0507] [0507] Example 193 - The surgical instrument of Example 192, further comprising a staple cartridge that includes the staples removably stored therein.
[0508] [0508] Example 194 - A surgical instrument comprising a housing comprising a rotating inlet, a drive shaft extending from the housing, the drive shaft comprising a frame, and an end actuator. The end actuator comprises a first jaw and a second jaw, the first jaw being rotatable with respect to the second jaw. The surgical instrument additionally comprises a closing system configured to close the first jaw during a closing stroke, an articulation joint pivotally connecting the end actuator to the drive shaft, an articulation system configured to articulate the ex-actuator tremor in relation to the drive shaft and a trigger system operationally engaged with the swivel inlet. The trigger system is configured to move through the end actuator.
[0509] [0509] Example 195 - The surgical instrument of Example 194, further comprising a staple cartridge that includes the staples removably stored therein.
[0510] [0510] Example 196 - A staple cartridge assembly comprising a proximal end, a distal end, a cartridge body comprising a rounded tip at the distal end, a plurality of staple cavities defined in the cartridge body, being whereas the plurality of staple cavities extends longitudinally from the proximal end to the distal end, a plurality of staples stored removably within the plurality of staple cavities, an actuator configured to support at least one of the plurality of clips, and a movable slide towards the distal end during a firing stroke. The slider comprises a first ramp and a second ramp, the first ramp being laterally displaced in relation to the second ramp. The first ramp and the second ramp are configured to lift the actuator, the rounded tip of the cartridge body comprising a first recess formed within the distal end configured to receive the first ramp of the slider after the end of the firing stroke and a second recess formed within the distal end configured to receive the second slider ramp after the firing stroke is completed.
[0511] [0511] Example 197 - The staple cartridge set of Example 196, the first ramp and the second ramp being exposed at the distal end upon completion of the firing stroke.
[0512] [0512] Example 198 - the clamp cartridge set of Example 196 or 197, the driver comprising a first portion of the driver configured to support a first clamp, a second portion of the driver configured to support a second clamp and a third portion of the driver configured to support a third clamp.
[0513] [0513] Example 199 - The staple cartridge assembly of Example 198, the actuator additionally comprising a central base member that connects the first portion of the actuator, the second portion of the actuator and the third portion of the actuator.
[0514] [0514] Example 200 - The staple cartridge assembly of Example 199, the first portion of the driver comprising a first support column forward comprising a proximal end and the second portion of the driver comprising a second support column forward that comprises a distal end. The central base member extends longitudinally between the proximal end of the first support column forwards and the distal end of the second support column forwards.
[0515] [0515] Example 201 - The staple cartridge assembly of Example 196, 197, 198, 199 or 200, the central base member comprising a backward inclined wall configured to be engaged by the slide.
[0516] [0516] Example 202 - The staple cartridge assembly of the
[0517] [0517] Example 203 - A staple cartridge assembly comprising a proximal end, a distal end, a cartridge body comprising a shortened tip at the distal end and a row of staples removably stored in the cartridge body. The row of staples extends longitudinally from the proximal end to the distal end. The row of clamps comprises a more distal clamp and a more proximal clamp. The staple cartridge assembly additionally comprises actuators, each actuator being configured to support at least one of the staples, and a movable slide towards the distal end. The slide comprises a ramp configured to lift the actuators and the clamps towards an anvil positioned opposite the clamp cartridge assembly during a firing stroke. The slider additionally comprises a base, in which a shortened tip length extends from the most distal clamp to the distal end, and whereas the shortened tip length is shorter than the base of the slider.
[0518] [0518] Example 204 - the staple cartridge assembly of Example 203, further comprising the anvil, the anvil having a protective tip at the distal end.
[0519] [0519] Example 205 - The staple cartridge assembly of Example 203 or 304, further comprising the anvil, with the distal end of the shortened tip extending beyond the distal end of the anvil.
[0520] [0520] Example 206 - The staple cartridge set of Example 203, 204 or 205, the slider ramp being exposed at the distal end after the firing stroke is completed.
[0521] [0521] Example 207 - An end actuator for a surgical stapling instrument. The end actuator comprises a staple cartridge assembly. The staple cartridge assembly comprises a proximal end, a distal end, a cartridge body comprising a shortened tip at the distal end, staples removably stored in the body of the cartridge, a driver configured to hold at least one of the staples and a movable slide towards the far end. The slide comprises a ramp configured to lift the actuator and at least one clamp. The slider additionally comprises a base, the shortened tip of the cartridge body being shorter than the base of the slider. The end actuator additionally comprises an anvil. The anvil comprises a staple-forming surface comprising a plurality of staple-forming pockets. The anvil additionally comprises a rounded distal tip that extends downwards towards the staple cartridge assembly.
[0522] [0522] Example 208 - The end actuator of Example 207, the rounded distal tip being removably attached to the bib.
[0523] [0523] Example 209 - The end actuator of Example 207 or 208, the anvil additionally comprising a structure comprising a fixation element configured to facilitate the fixation of the rounded distal tip to the structure.
[0524] [0524] Example 210 - The end actuator of Example 207, 208 or 209, the anvil comprising a distal end, and the distal end of the staple cartridge assembly extending beyond the distal end of the anvil.
[0525] [0525] Example 211 - A staple cartridge assembly comprising a cartridge body, a proximal end, a distal end, a slot configured to receive a cutting member and a first row of staples removably stored in the body of the cartridge, the first row of clamps extending between the proximal end and the distal end along a first side of the slot. The staple cartridge assembly additionally comprises a second row of staples removably stored in the cartridge body, the second row of staples extending between the proximal end and the distal end along the first row staples on the first side of the slot. The staple cartridge assembly additionally comprises a third row of staples removably stored in the cartridge body, the third row of staples extending between the proximal end and the distal end along the second row of staples on the first side of the slot. The staple cartridge assembly further comprises a driver configured to hold a first staple in the first row of staples, a second staple in the second row of staples, and a third staple in the third row of staples, the second staple it is closer to the proximal end than the first clamp and the third clamp.
[0526] [0526] Example 212 - The staple cartridge assembly of Example 211, the first staple, the second staple, and the third staple forming a backward arrow configuration.
[0527] [0527] Example 213 - The staple cartridge set of Example 211 or 212, which additionally comprises a slide designed to lift the driver towards an anvil positioned opposite the staple cartridge set.
[0528] [0528] Example 214 - The staple cartridge assembly of Example 211, 212 or 213, which further comprises a bi-fold
[0529] [0529] Example 215 - The staple cartridge assembly of Example 214, the distal end of the staple cartridge extending distally from the distal end of the anvil.
[0530] [0530] Example 216 - A staple cartridge system that comprises a configurable end actuator in an open configuration and a closed configuration. The end actuator comprises an anvil jaw and a cartridge jaw. The cartridge gripper is configured to receive a staple cartridge. The cartridge gripper comprises a detail of the reference cartridge. The staple cartridge system further comprises a first staple cartridge. The first staple cartridge comprises a first platform configured to support a patient's tissue, the first staple cavities defined on the first platform, the first staples removably stored in the first staple cavities, and a first proximal end. The first proximal end is aligned with a detail of the cartridge claw when the first staple cartridge is positioned on the cartridge claw. The first staple cartridge additionally comprises a first distal end, a first cartridge length being defined between the first proximal end and the first distal end. The staple cartridge system further comprises a second staple cartridge. The second staple cartridge comprises a second platform configured to support a patient's tissue, the second staple cavities defined in the second platform, the second staples removably stored in the second staple cavities, and a second proximal end. The second proximal end is aligned with a detail of the cartridge grip when the second staple cartridge is positioned in the cartridge grip. The second staple cartridge further comprises a second distal end, with a second cartridge length defined between the second proximal end and the second distal end, the anvil being supported by a first location on the first staples when the end actuator is in the closed configuration and the first staple cartridge is positioned in the cartridge grip. The anvil is supported by a second location on the second staple cartridge when the end actuator is in the closed configuration and the second staple cartridge is positioned on the cartridge grip. The first location is a first orthogonal distance away from the cartridge support detail when the first staple cartridge is positioned in the cartridge grip and the second location is a second orthogonal distance away from the cartridge support detail when the second staple cartridge is positioned in the cartridge grip. The first orthogonal distance is different from the second orthogonal distance. The anvil claw deflects differently in response to whether the first clamp cartridge or the second clamp cartridge is positioned in the cartridge claw.
[0531] [0531] Example 217 - The staple cartridge system of Example 216, the second cartridge length being different from the first cartridge length.
[0532] [0532] Example 218 - The staple cartridge system of Examples 216 or 217, the second cartridge length being shorter than the first cartridge length.
[0533] [0533] Example 219 - The staple cartridge system of Example 216, 217 or 218, the second orthogonal distance being shorter than the first orthogonal distance.
[0534] [0534] Example 220 - The staple cartridge system of Example 216, 217 or 218, the second orthogonal distance being higher than the first orthogonal distance.
[0535] [0535] Example 221 - The staple cartridge system of Examples 216, 217, 219 or 220, the second cartridge length being longer than the first cartridge length.
[0536] [0536] Example 222 - The staple cartridge system of Example 216, 217, 218 or 221, the second orthogonal distance being shorter than the first orthogonal distance.
[0537] [0537] Example 223 - The staple cartridge system of Example 216, 217, 218 or 221, the second orthogonal distance being higher than the first orthogonal distance.
[0538] [0538] Example 224 - The staple cartridge system of Example 216, 217, 218, 219, 220, 221, 222 or 223, the second location being closer to the second distal end than the first location of the first distal end.
[0539] [0539] Example 225 - The staple cartridge system of Example 216, 217, 218, 219, 220, 221, 222 or 223, the second location being positioned posterior to the second distal end than the first location of the first distal end.
[0540] [0540] Example 226 - The staple cartridge system of Example 216, 217, 218, 219, 220, 221, 222, 223, 224 or 225, the anvil claw comprising a distal anvil tip. The first length of the cartridge is adjusted so that the tip of the distal anvil extends beyond the first distal end, with the second length of the cartridge being adjusted so that the tip of the distal anvil does not extend beyond the second distal end.
[0541] [0541] Example 227 - The staple cartridge system of Example 216, 217, 218, 219, 220, 221, 222, 223, 224, 225 or 226, with the anvil jaw experiencing a first deflection when the actuator end is in the closed configuration and the first staple cartridge is positioned in the cartridge grip. The anvil jaw experiences a second deflection when the end actuator is in the closed configuration and the second clip cartridge is positioned in the cartridge jaw. The second deflection is greater than the first deflection.
[0542] [0542] Example 228 - The staple cartridge system of Example 216, 217, 218, 219, 220, 221, 222, 223, 224, 225, 226 or 227, with each first clamp comprising an unformed height within a first strip of unformed height, each second clamp comprising an unformed height within a second unformed height strip, and the second unformed height strip comprising heights that are higher than the heights in the first unformed height.
[0543] [0543] Example 229 - The staple cartridge system of Example 216, 217, 218, 219, 220, 221, 222, 223, 224, 225, 226 or 227, with each first clamp comprising an unformed height within a first strip of unformed height, each second clamp comprising an unformed height within a second unformed height strip, and the second unformed height strip comprising heights that are shorter than the heights in the first unformed height.
[0544] [0544] Example 230 - The staple cartridge system of Example 216, 217, 218, 219, 220, 221, 222, 223, 224, 225, 226, 227, 228 or 229, with each first staple comprising a height not formed within a first strip of height not formed, since each second clamp comprises a height not formed within a second strip of height not formed, and the second strip of height not being different from the first strip of height unformed height, but partially overlaps with the first unformed height range.
[0545] [0545] Example 231 - The staple cartridge system of Example 216, 217, 218, 219, 220, 221, 222, 223, 224, 225, 226, 227, 228, 229 or 230, the anvil claw being comprises a tip of the distal anvil, the first length of the cartridge being adjusted so that the tip of the distal anvil extends beyond the first distal end, and the second length of the cartridge is adjusted so that the tip of the distal anvil is shorter than the second distal end.
[0546] [0546] Example 232 - The staple cartridge system of Example 216, 217, 218, 219, 220, 221, 222, 223, 224, 225, 226, 227, 228, 229, 230 or 231, the jaw being the anvil is rotatable in relation to the claw of the cartridge.
[0547] [0547] Example 233 - The staple cartridge system of Example 216, 217, 218, 219, 220, 221, 222, 223, 224, 225, 226, 227, 228, 229, 230 or 231, the jaw being of the cartridge is rotatable in relation to the anvil claw.
[0548] [0548] Example 234 - The staple cartridge system of Example 216, 217, 218, 219, 220, 221, 222, 223, 224, 225, 226, 227, 228, 229, 230, 231, 232 or 233, the first distal end comprising a first cartridge tip and the second distal end comprising a second cartridge tip. The second cartridge tip is more rounded than the first cartridge tip.
[0549] [0549] Example 235 - The staple cartridge system of Example 216, 217, 218, 219, 220, 221, 222, 223, 224, 225, 226, 227, 228, 229, 230, 231, 232, 233 or 234, the first distal end comprising a first cartridge tip and the second distal end comprising a second cartridge tip. The second cartridge tip is shorter than the first cartridge tip.
[0550] [0550] The totality of the disclosures of: - US patent No. 5,403,312, entitled "ELECTROSURGICAL HEMOSTATIC DEVICE", which was granted on April 4, 1995; - US patent No. 7,000,818, entitled "SURGICAL STA-
[0551] [0551] Although several devices have been described here in connection with certain modalities, modifications and variations of these modalities can be implemented. The specific resources, structures or characteristics can be combined in any suitable way in one or more modalities. Therefore, the resources, structures or specific features illustrated or described in connection with a modality can be combined, in whole or in part, with the resources, structures or characteristics of one or more other modalities, without limitation. In addition, where materials for certain components are revealed, other materials can be used. In addition, according to various modalities, a single component can be replaced by multiple components and multiple components can be replaced by a single component, to perform one or more specific functions. The description mentioned above and the following claims are intended to cover all such modifications and variations.
[0552] [0552] The devices disclosed herein can be designed to be discarded after a single use, or can be designed to be used multiple times. In either case, however, a device can be reconditioned for reuse after at least one use. Reconditioning may include any combination of the steps including, but not limited to, disassembling the device followed by cleaning or replacing specific parts of the device and subsequent reassembly of the device. In particular, a reconditioning facility and / or surgical team can disassemble a device and, after cleaning and / or replacing particular parts of the device, the device can be reassembled for subsequent use. Those skilled in the art will understand that reconditioning a device can use a variety of techniques to disassemble, clean / replace and reassemble. The use of these techniques, as well as the resulting reconditioned device, are all within the scope of this application.
[0553] [0553] The devices revealed here can be processed before surgery. First, a new or used instrument can be obtained and, if necessary, cleaned. The instrument can then be sterilized. In a sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and the instrument can then be placed in a radiation field that can penetrate the container, such as gamma radiation, X-rays and / or high-energy electrons. Radiation can kill bacteria on the instrument and the container. The sterile instrument can then be stored in a sterile container. The sealed container can keep the instrument sterile until it is opened in the medical facility. A device can also be sterilized using any other known technique, including, but not limited to, beta radiation, gamma radiation, ethylene oxide, plasma peroxide and / or water vapor.
[0554] [0554] Although this invention has been described as having
[0555] [0555] Any patent, publication or other description material, in whole or in part, that is said to be incorporated into the present invention as a reference, is incorporated into the present invention only to the extent that the embedded materials do not conflict with existing definitions, statements or other description material presented in this description. Accordingly, and to the extent necessary, the disclosure as explicitly presented herein replaces any conflicting material incorporated by reference to the present invention. Any material, or portion thereof, which is incorporated herein by reference, but which conflicts with the definitions, statements, or other disclosure materials contained herein, will be incorporated here only to the extent that there is no conflict. between the embedded material and the existing developer material.

权利要求:
Claims (31)
[1]
1. Surgical instrument characterized by comprising: a drive shaft; an end actuator, comprising: a proximal end; a distal end; a first claw; and a second claw, in which said first claw is movable in relation to said second claw between an open position and a closed position, and in which one of said first claw and said second claw comprises a cartridge of staples including staples removably stored therein; an articulation joint, in which said end actuator is pivotally connected to said drive axis around said articulation joint; a pivot rod operationally connected to said end actuator, in which said pivot rod is movable distally to rotate said end actuator in a first direction, and in which said pivot rod is movable proximally; to rotate said end actuator in a second direction; a closing tube configured to engage said first claw and to move said first claw towards said closed position during a closing stroke, wherein said closing tube is slidable over said hinge joint during said stroke closing; and a clamp firing assembly, comprising: a movable cutting member through said end actuator during a clamp firing course; a firing bar fixed to said cutting member, wherein said firing bar comprises a plurality of flexible layers, and wherein said firing bar extends through said hinge joint; a support positioned within said flexible layers, wherein said support is positioned proximally to said articulation joint; and a plurality of control elements, in which each said control element comprises an opening defined therein, in which said firing bar extends through said openings, and in which said control elements are configured to maintain said flexible layers together.
[2]
2. Surgical instrument, according to claim 1, characterized in that said control elements are positioned inside said articulation joint.
[3]
Surgical instrument according to claim 1, characterized in that said first claw comprises said staple cartridge.
[4]
Surgical instrument according to claim 1, characterized in that said second claw comprises said staple cartridge.
[5]
5. Surgical instrument according to claim 1, characterized in that said cutting member is welded to said firing bar.
[6]
6. Surgical instrument, according to claim 1, characterized by said control members being connected to each other.
[7]
7. Surgical instrument, according to claim 1, characterized in that said control elements are not connected to each other.
[8]
8. Surgical instrument, according to claim 1,
characterized in that said support is mounted on said structure.
[9]
9. Surgical instrument according to claim 1, characterized in that said articulation joint defines a fixed axis of rotation around which said end actuator is rotated.
[10]
10. Surgical instrument characterized by comprising: a driving axis that defines a longitudinal geometric axis; an end actuator, comprising: a proximal end; a distal end; a first claw; and a second claw, wherein said first claw is movable in relation to said second claw between a loose position and a clamped position; an articulation joint, in which said end actuator is pivotally connected to said drive axis around said articulation joint; a pivot connection operatively connected to said end actuator, wherein said pivot connection is movable distally to rotate said end actuator in a first direction, and wherein said pivot connection is movable proximally to rotate the said end actuator in a second direction; a gripping member configured to engage said first gripper and moving said first gripper towards said clamped position during a closing stroke, wherein said gripping member is slidable with respect to said hinge joint during said gripping stroke grasp; and a set of trigger clips, comprising:
a movable cutting member through said end actuator during a clamp firing stroke; a firing member, wherein said firing member comprises a plurality of flexible layers attached to said cutting member, wherein said flexible layers are configured to slide longitudinally with respect to each other, and wherein said firing member extends through said articulation joint; and control elements, in which each said control element comprises an opening defined therein, in which said firing bar extends through said openings and in which said control members are configured to maintain said flexible layers together.
[11]
11. Surgical instrument, according to claim 10, characterized in that said control elements are positioned inside said articulation joint.
[12]
Surgical instrument according to claim 10, characterized in that said first claw comprises a staple cartridge.
[13]
13. Surgical instrument according to claim 10, characterized in that said second claw comprises a staple cartridge.
[14]
14. Surgical instrument according to claim 10, characterized in that said cutting member is welded to said firing bar.
[15]
15. Surgical instrument, according to claim 10, characterized in that said control members are connected to each other.
[16]
16. Surgical instrument, according to claim 10, characterized in that said control elements are not connected
with each other.
[17]
17. Surgical instrument according to claim 10, characterized in that said drive shaft comprises a drive shaft structure, and in which said support is mounted on said drive shaft structure.
[18]
18. Surgical instrument characterized by comprising: a driving axis that defines a longitudinal geometric axis; an end actuator, comprising: a proximal end; a distal end; a first claw; and a second claw, wherein said first claw is movable in relation to said second claw between a loose position and a clamped position; an articulation joint, in which said end actuator is pivotally connected to said drive axis around said articulation joint; a pivot connection operatively connected to said end actuator, wherein said pivot connection is movable distally to rotate said end actuator in a first direction, and wherein said pivot connection is movable proximally to rotate the said end actuator in a second direction; a gripping member configured to engage said first gripper and moving said first gripper towards said clamped position during a closing stroke, wherein said gripping member is slidable with respect to said hinge joint during said gripping stroke grasp; and a set of trigger clips, comprising:
a movable cutting member through said end actuator during a clamp firing stroke; a firing member, wherein said firing member comprises a plurality of flexible layers attached to said cutting member, wherein said flexible layers are configured to slide longitudinally with respect to each other, and wherein said firing member extends through said articulation joint; a support positioned between two said flexible layers; and means for limiting lateral displacement between said flexible layers.
[19]
19. Surgical instrument according to claim 18, characterized in that said first claw comprises a staple cartridge.
[20]
20. Surgical instrument according to claim 18, characterized in that said second claw comprises a staple cartridge.
[21]
21. Surgical instrument characterized by comprising: a drive shaft; an end actuator, comprising: a proximal end; a distal end; a longitudinal geometric axis extending between said proximal end and said distal end; a first claw; and a second claw, wherein said first claw is movable in relation to said second claw between a loose position and a clamped position; an articulation joint, in which said end actuator is pivotally connected to said drive axis around said articulation joint; and a clamp firing assembly, comprising: a movable cutting member through said end actuator during a clamp firing course, wherein said cutting member comprises a first portion configured to engage said first claw and a second portion configured to engage said second claw; and a firing member comprising a plurality of flexible layers welded to said cutting member along a weld line, wherein said weld line comprises a longitudinal portion and a transverse portion extending orthogonally with respect to the weld. said longitudinal portion.
[22]
22. Surgical instrument according to claim 21, characterized in that said first jaw comprises a staple cartridge.
[23]
23. Surgical instrument according to claim 21, characterized in that said second claw comprises a staple cartridge.
[24]
24. Surgical instrument, according to claim 21, characterized in that said welding line is L-shaped.
[25]
25. Surgical instrument according to claim 21, characterized in that said firing member comprises a first lateral side and a second lateral side, and wherein said weld line is present on said first lateral side and said second side.
[26]
26. Surgical instrument characterized by comprising: a drive shaft that comprises a drive shaft structure; an end actuator, comprising: a proximal structure;
a distal end; a first claw; and a second claw, wherein said first claw is movable in relation to said second claw between a loose position and a clamped position; an articulation joint, in which said end actuator is pivotally connected to said drive axis around said articulation joint; a clamp firing assembly, comprising: a movable cutting member through said end actuator during a clamp firing course; and a firing member, wherein said firing member comprises a plurality of flexible layers attached to said cutting member, and wherein said firing member extends through said hinge joint; and a lateral spring support positioned adjacent to said firing member, comprising: a distal end mounted on said proximal structure of said end actuator; and a proximal end configured to slide in relation to said drive shaft structure
[27]
27. Surgical instrument according to claim 26, characterized in that said first jaw comprises a staple cartridge.
[28]
28. Surgical instrument according to claim 26, characterized in that said second claw comprises a staple cartridge.
[29]
29. Surgical instrument according to claim 26, characterized in that said lateral spring support comprises a first lateral spring support positioned next to a first lateral side of said firing member, and wherein said surgical instrument co additionally comprises a second lateral spring support positioned next to a second lateral side of said firing member.
[30]
30. Surgical instrument characterized by comprising: a drive shaft; an end actuator, comprising: a proximal end; a distal end; a first claw; and a second claw, in which said first claw is movable in relation to said second claw between an open position and a closed position, and in which one of said first claw and said second claw comprises a cartridge of staples including staples removably stored therein; an articulation joint, in which said end actuator is pivotally connected to said drive axis around said articulation joint; a pivot rod operatively connected to said end actuator, wherein said pivot rod is movable distally to rotate said end actuator in a first direction, and in which said pivot rod is movable proximally to rotate said end actuator in a second direction; a firing bar comprising a plurality of flexible layers, wherein said firing bar is movable through said hinge joint during a clip firing course; a first flexible support positioned on a first side of said firing bar; a second flexible support positioned on a second layer
that of said firing bar; and a plurality of control elements, in which each said control element comprises an opening defined therein, in which said firing bar extends through said openings, and in which said first flexible support, said second flexible support and said control elements are configured to keep said flexible layers together.
[31]
31. Surgical instrument according to claim 30, characterized by said first flexible support and said second flexible support extending through at least some of said control element openings.

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同族专利:

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公开号 | 公开日

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JP2020525181A|2020-08-27|

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CN110799128A|2020-02-14|

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法律状态:
2021-11-23| 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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US15/635,808|2017-06-28|

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US15/635,808|US11259805B2|2017-06-28|2017-06-28|Surgical instrument comprising firing member supports|

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PCT/IB2018/053711|WO2019002978A2|2017-06-28|2018-05-24|Surgical instrument comprising firing member supports|

---