surgical system attachable with staple cartridge and radio frequency cartridge and that has a plural

专利摘要:
The present invention relates to a set of interchangeable tools. The interchangeable tool set includes a first jaw configured to hold a staple cartridge for a first period of time and a radio frequency cartridge for a second period of time. A second claw is attached to the first claw. A surface of the second jaw defines a plurality of staple forming pockets configured to form staples applied from the staple cartridge. An electrically insulating material covers the segments of the second claw surface in addition to the staple forming pockets. The clamp-forming pockets define at least one return path for the radio frequency energy provided by the radio frequency cartridge.
公开号:BR112019027049A2
申请号:R112019027049-3
申请日:2018-06-12
公开日:2020-06-30
发明作者:Jeffrey D. Messerly；Frederick E. Shelton Iv；David C. Yates
申请人:Ethicon Llc；
IPC主号:

专利说明:

[0001] [0001] The present description refers to electrosurgical devices and, in several aspects, to compression jaw components that are designed to conduct electrical energy in a tissue compressed with them. BACKGROUND
[0002] [0002] In some respects, an electrosurgical device can be configured to induce a hemostatic seal in a tissue and / or between tissues. The hemostatic seal can be created by a combination of a compressive force applied to the tissue and an application of electrical energy to the tissue. In some aspects of an electrosurgical device, the compression force can be provided by compressing the tissue between the claw sets. Additionally, the electrical energy can be supplied by one or more electrodes arranged inside or on some components of the claw sets. The amount of electrical energy sufficient to effect the hemostatic seal may depend, in part, on the thickness, density and / or quality of the fabric to be sealed.
[0003] [0003] It can be understood that an application of excessive electrical energy to a tissue can result in burning or fibrosis of the tissue. However, applying insufficient electrical energy to a tissue can result in an ineffective hemostatic seal. Thus, it may be necessary for a user of the electrosurgical device to adjust the amount of electrical energy applied to the compressed tissue between the device's clamp sets based on the thickness, density and quality of the tissue. If a compressed tissue between the claw assemblies is essentially homogeneous, the user of the electrosurgical device can use simple controls to adjust the amount of electrical energy applied to the tissue. However, it can be recognized that some fabrics for hemostatic sealing are heterogeneous in any one or more of their thickness, density and / or quality. As a result, a single control over the amount of electrical energy applied to the compressed tissue between the gripper assemblies can result in burnt portions of the fabric as well as insufficiently sealed portions. It is therefore desirable to have an electrosurgical device that can be configured to apply a variety of electrical energies to a portion of compressed tissue between the claw assemblies. SUMMARY
[0004] [0004] In another aspect, a set of interchangeable tools is provided. The set of interchangeable tools comprises a first jaw configured to hold a staple cartridge for a first period of time and a radio frequency cartridge for a second period of time; a second jaw coupled to the first jaw, a surface of the second jaw defining a plurality of staple forming pockets configured to form the staples applied from the staple cartridge; an electrically insulating material covering segments of the second claw surface other than the staple-forming pockets, with the staple-forming pockets defining at least one return path for the radio frequency energy provided by the radio frequency cartridge.
[0005] [0005] In another aspect, a surgical tool kit is provided. The surgical tool set comprises an elongated channel configured to hold a staple cartridge for a first period of time and a radio frequency cartridge for a second period of time; and an anvil coupled to the elongated channel, the anvil comprising: a surface that faces the elongated channel and defines a plurality of staple-forming pockets configured to form staples applied from the staple cartridge; and an electrically insulating material that covers segments of the surface of the second jaw, the plurality of staple forming pockets providing a plurality of different return paths for the radio frequency energy provided by the radio frequency cartridge.
[0006] [0006] In another aspect, an interchangeable instrument set is provided. The interchangeable instrument set comprises an end actuator configured to couple in a release way to a drive shaft assembly, the end actuator comprising: an elongated channel configured to hold a staple cartridge during a first period of time and a radio frequency cartridge for a second period of time; and an anvil coupled to the elongated channel, the anvil comprising an electrically insulating material and defining a plurality of different return paths for the radio frequency energy provided by the radio frequency cartridge. FIGURES
[0007] [0007] The innovative characteristics of the aspects described here are presented with particularity in the attached claims. However, these aspects, both in terms of organization and methods of operation, can be better understood by referring to the description below, taken in conjunction with the attached drawings.
[0008] [0008] Figure 1 is a perspective view of a surgical system that includes a handle set attached to an interchangeable surgical tool set that is configured to be used in conjunction with conventional surgical clip / clamp cartridges and radio frequency (RF) cartridges according to one aspect of this description.
[0009] [0009] Figure 2 is an exploded perspective view of the surgical system in Figure 1, according to an aspect of this description.
[0010] [0010] Figure 3 is another perspective view explored of portions of the handle set and the interchangeable surgical tool set of Figures 1 and 2, according to one aspect of this description.
[0011] [0011] Figure 4 is an exploded view of a proximal portion of the interchangeable surgical tool set of Figures 1 to 3, according to an aspect of this description.
[0012] [0012] Figure 5 is another exploded view of a distal portion of the interchangeable surgical tool set of Figures 1 to 5, according to an aspect of this description.
[0013] [0013] Figure 6 is a partial cross-sectional view of the end actuator represented in Figures 1 to 5 that supports an RF cartridge in it and with the tissue trapped between the cartridge and the anvil, according to an aspect of this description.
[0014] [0014] Figure 7 is a partial cross-sectional view of the shoulder of Figure 6, according to an aspect of this description.
[0015] [0015] Figure 8 is another exploded view of a portion of the interchangeable surgical tool set of Figures 1 to 5, according to an aspect of this description.
[0016] [0016] Figure 9 is another exploded view of the interchangeable surgical tool set and the
[0017] [0017] Figure 10 is a perspective view of an RF cartridge and an elongated channel of the interchangeable surgical tool set of Figures 1 to 5, according to an aspect of this description.
[0018] [0018] Figure 11 is a partial perspective view of portions of the RF cartridge and the elongated channel of Figure 10 with a cutting member, according to an aspect of this description.
[0019] [0019] Figure 12 is another perspective view of the RF cartridge installed in the elongated channel of Figure 10 and which illustrates a portion of a flexible drive shaft circuit arrangement, in accordance with an aspect of this description.
[0020] [0020] Figure 13 is an end view in cross section of the RF cartridge and elongated channel of Figure 12, taken along lines 13-13 in Figure 12, according to an aspect of this description.
[0021] [0021] Figure 14 is a top cross-sectional view of a portion of the interchangeable surgical tool set in Figures 1 and 5 with its end actuator in an articulated position, according to an aspect of this description .
[0022] [0022] Figure 15 is a perspective view of an integrated circuit board layout and the RF generator plus the configuration, according to an aspect of this description.
[0023] [0023] Figures 16A and 16B are a block diagram of a control circuit for the surgical instrument of Figure 1 comprising two drawing sheets, according to one aspect of this description.
[0024] [0024] Figure 17 is a block diagram of the control circuit of the surgical instrument of Figure 1 that illustrates the interfaces between the handle assembly, the feeding assembly and the handle assembly, and the interchangeable drive shaft assembly. according to one aspect of this description.
[0025] [0025] Figure 18 is a schematic diagram of a surgical instrument configured to control various functions, according to an aspect of this description.
[0026] [0026] Figure 19 is a perspective view of various aspects of a surgical system, according to one aspect of this description.
[0027] [0027] Figure 20 is a partial cross-sectional view of an end actuator of the surgical system of Figure 19, according to an aspect of this description.
[0028] [0028] Figure 21 is a partial perspective view of a radio frequency cartridge supported by an elongated channel of the end actuator of Figure 20, according to one aspect of this description.
[0029] [0029] Figure 22 is an exploded perspective view of portions of a handle set and a set of interchangeable tools for the surgical system of Figure 19, according to one aspect of this description. DESCRIPTION
[0030] [0030] The applicant for the present application holds the following patent applications filed simultaneously with the same and which are each incorporated in this document as a reference in their respective totalities: Proxy document number END8184USNP / 170063, entitled "SURGICAL SYSTEM COUPLABLE WITH STAPLE CARTRIDGE AND RADIO FREQUENCY CARTRIDGE, AND METHOD OF USING SAMEY", by inventors Jeffrey D. Messerly et al., Deposited on June 28, 2017.
[0031] [0031] Electrosurgical devices can be used in many surgical operations. Electrosurgical devices can apply electrical energy to the tissue to treat the tissue. An electrosurgical device can comprise an instrument that has a distally mounted end actuator that comprises one or more electrodes. The end actuator can be positioned against the fabric, so that electric current can be introduced into the fabric. Electrosurgical devices can be configured for monopolar or bipolar operation. During monopolar operation, current can be introduced into the tissue by an active electrode (or source) in the end actuator and returned via a return electrode. The return electrode can be a grounding block located separately on a patient's body. During bipolar operation, the current can be introduced into the fabric and returned from it, respectively, by the active and return electrodes of the end actuator.
[0032] [0032] The end actuator can include two or more claw members. At least one of the claw members can have at least one electrode. At least one claw can be movable from a spaced position of the opposite claw to receive tissue in a position where the space between the claw members is less than that of the first position. This movement of the movable claw can compress the tissue retained between it. The heat generated by the current flow through the fabric in combination with the compression obtained by the movement of the claw can form hemostatic seals within the fabric and / or between fabrics and, therefore, can be particularly useful for sealing blood vessels, for example. The end actuator can comprise a cutting member. The cutting member can be movable in relation to the tissue and the electrodes to transpose the tissue.
[0033] [0033] Electrosurgical devices may also include mechanisms for securing tissue together, such as a stapling device, and / or mechanisms for cutting tissue, such as a tissue knife. An electrosurgical device may include a drive shaft to place the end actuator in a position adjacent to the tissue being treated. The drive shaft can be straight or curved, foldable or non-foldable. In an electrosurgical device that includes a straight and foldable drive shaft, the drive shaft can have one or more articulated joints to allow controlled flexing of the drive shaft. Such joints may allow a user of the electrosurgical device to place the end actuator in contact with the tissue at an angle to the drive axis when the tissue being treated is not readily accessible using an electrosurgical device. which has a straight, non-folding drive shaft.
[0034] [0034] The electrical energy applied by the electrosurgical devices can be transmitted to the instrument by a generator in communication with the handpiece. The electrical energy can be in the form of radio frequency energy ("RF"). RF energy is a form of electrical energy that can be in the frequency range of 200 kilohertz (kHz) to 1 megahertz (MHz). In application, an electrosurgical instrument can transmit RF energy at low frequency through the tissue, which causes friction, or ionic agitation, that is, resistive heating, which, therefore, increases the tissue temperature. Due to the fact that a sharp boundary is created between the affected tissue and the surrounding tissue, surgeons can operate with a high level of precision and control, without sacrificing adjacent non-target tissue. The low operating temperatures of the RF energy are useful for removing, shrinking or sculpting soft tissues while simultaneously cauterizing blood vessels. RF energy works particularly well in connective tissue, which mainly comprises collagen and shrinks when it comes in contact with heat.
[0035] [0035] RF energy can be in a frequency range described in document EN 60601-2-2: 2009 + A11: 2011, Definition
[0036] [0036] Figures 1 and 2 depict a motor-driven surgical system 10 that can be used to perform a variety of different surgical procedures. In the illustrated arrangement, the surgical system 10 comprises an interchangeable surgical tool set
[0037] [0037] In the illustrated aspect, the handle assembly 500 may comprise a handle compartment 502 that includes a pistol handle 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, which are configured to generate and apply various control movements to the corresponding portions of the interchangeable surgical tool set 1000. As shown 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 handle structure can operationally support a "first" closing drive system or system, generally designated as 510, which can be used to apply closing and opening movements to the assembly interchangeable surgical tool
[0038] [0038] 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 trigger movements to the portions corresponding to the interchangeable surgical tool set that is attached to it. As described in detail in US Patent Application Publication No. 0272575, the trigger drive system 530 may employ an electric motor 505 which is located in the pistol grip portion 504 of the grip assembly 500. In various forms, the 505 motor can be a brushed DC motor with a maximum speed of approximately 25,000 RPM, for example. In other arrangements, the 505 motor may include a brushless motor, a wireless motor, a synchronous motor, a stepper motor or any other suitable type of electric motor. The motor 505 can be powered by a power supply 522 which, in one form, can comprise a removable power source. The power source can support a plurality of lithium ion batteries ("Li ions") or other suitable ones therein. Several batteries connected in series or in parallel can be used as the 522 power source for the surgical system 10. In addition, the 522 power source can be replaceable and / or rechargeable.
[0039] [0039] The electric motor 505 is configured to axially drive a longitudinally movable driving member 540 (Figure 3) in the distal and proximal directions depending on the polarity of the motor. For example, when the 505 electric motor is driven in a direction of rotation, the longitudinally movable drive member will be axially driven in a distal "DD" direction. When motor 505 is driven in the opposite rotating direction, the longitudinally movable drive member 540 will be driven axially in the proximal direction "PD". The handle assembly 500 may include a key 513 that can be configured to reverse the polarity applied to the electric motor 505 by the power source 522 or otherwise control the motor
[0040] [0040] In at least one way, the longitudinal drive member
[0041] [0041] In the illustrated aspect, the interchangeable surgical tool set 1000 includes a surgical end actuator 1500 comprising a first jaw 1600 and a second jaw 1800. In one arrangement, the first jaw comprises an elongated channel 1602 which is configured to operationally support a conventional surgical (mechanical) staple / fastener cartridge 1400 (Figure 4) or a 1700 radio frequency (RF) cartridge (Figures 1 and 2) in it. The second claw 1800 comprises an anvil 1810 which is pivotally supported in relation to the elongated channel 1602. The anvil 1810 can be selectively moved towards and in the opposite direction to a surgical cartridge supported in the elongated channel 1602 and between the open positions and closed, by means of the closing drive system 510. In the illustrated arrangement, the anvil 1810 is pivotally supported on a proximal end portion of the elongated channel 1602 for selective pivoting displacement around a geometric pivot axis that it is transversal to the geometry axis of the drive shaft SA. The actuation of the closing drive system 510 may result in the distal axial movement of a proximal closing member or proximal closing tube 1910 which is attached to a 1920 hinge connector.
[0042] [0042] Returning to Figure 4, the hinge connector 1920 includes upper and lower protrusions 1922, 1924 that protrude distally from a distal end of the hinge connector 1920 to be movably coupled to a closing sleeve. end actuator or distal closing tube segment 1930. See Figure 3. The distal closing tube segment 1930 includes an upper protrusion 1932 and a lower protrusion (not shown) that project proximally from a proximal end of it. An upper double pivot link 1940 includes proximal and distal pins 1941, 1942 that engage the corresponding holes in the upper protrusions 1922, 1932 of the articulation connector 1920 and the distal closing tube segment 1930, respectively. Similarly, an upper double pivot link 1944 includes proximal and distal pins 1945, 1946 that engage the corresponding holes in the lower protrusions 1924 of the articulation connector tube segment 1920 and the distal closing tube segment 1930, respectively .
[0043] [0043] Still referring to Figure 4, in the illustrated example, the distal closing tube segment 1930 includes positive claw opening features or flaps 1936, 1938 that correspond to the corresponding portions of the anvil 1810 to apply opening movements to the anvil 1810, as the distal closing tube segment 1930 is retracted in the proximal direction PD to an initial position. Additional details related to the opening and closing of the 1810 anvil can be found in the US Patent Application, entitled "SURGI-CAL INSTRUMENT WITH POSITIVE JAW OPENING FEATURES", power of attorney document number END8208USNP / 170096, filed on the same date as this document , the description of which is hereby incorporated by reference in the present invention.
[0044] [0044] As shown in Figure 5, in at least one arrangement, the interchangeable surgical tool set 1000 includes a tool frame set 1200 comprising a tool frame 1210 that operationally supports a nozzle set 1240 on the same. As further discussed in detail in the US Patent Application, entitled "SURGICAL INSTRUMENT WITH AXI-ALLY MOVABLE CLOSURE MEMBER", power of attorney document END8209USNP / 170097, filed on the same date as this document, and which is hereby incorporated herein As a reference in its entirety in the present invention, the tool chassis 1210 and the nozzle arrangement 1240 facilitate the rotation of the surgical end actuator 1500 about a geometric axis of the drive shaft SA in relation to the tool chassis 1210. Such rotational displacement
[0045] [0045] As shown in Figure 4, the upper center column segment 1251 ends in a upper tab assembly feature 1260 and the lower central column segment 1252 ends in a lower tab assembly feature 1270. The upper tab assembly feature 1260 is formed with a tab groove 1262 in it which is adapted to mount a top assembly link 1264 in a passable manner. Similarly, the lower pin crimping 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 upper link 1264 includes a pivot socket 1266 in which it is displaced from the axis of the drive shaft SA. The pivot socket 1266 is adapted to pivot a pivot pin 1634 on it which is formed on a channel cover or anvil retainer 1630 which is attached to a proximal end portion 1610 of the elongated channel 1602. The lower mounting link 1274 includes the lower pivot pin 1276 which is adapted to be received within a pivot hole 1611 formed in the proximal end portion 1610 of the elongated channel 1602. The lower pivot pin 1276, as well as the pivot hole 1611 is displaced relative to to the drive shaft geometric axis SA. The lower pivot pin 1276 is vertically aligned with the pivot socket 1266 to define the AA pivot geometry axis around which the surgical end actuator 1500 can pivot in relation to the SA drive shaft geometry axis. See Figure 1. Although the hinge axis AA is transversal to the hinge axis of the drive shaft SA, in at least one arrangement, the hinge axis AA is laterally displaced from it and does not cross the axis. drive shaft geometry axis SA.
[0046] [0046] Returning to Figure 5, a proximal end 1912 of the proximal closing tube 1910 is rotationally coupled to a closing boom 1914 by a connector 1916 which is seated in an annular groove 1915 in the proximal closing tube segment
[0047] [0047] The trigger drive system 530 in the handle set 500 is configured to be operationally coupled to a trigger system 1300 that is operationally supported in the interchangeable surgical tool set 1000. The trigger system 1300 can include a portion intermediate firing drive shaft 1310 which is configured to be axially moved in the distal and proximal directions in response to the corresponding firing movements applied to it by the firing drive system 530. See Figure 4. As shown in Figure 5, a proximal end 1312 of the trigger drive shaft 1310 intermediate portion has a trigger drive shaft fixing tab 1314 formed therein that is configured to be seated on a fixing base 544 (Figure 3) located at the distal end of the longitudinally movable drive member 540 of the trigger drive system 530 within the assembly handle 500. This arrangement facilitates the axial movement of the intermediate portion of the trigger drive shaft 1310 through the actuation of the trigger drive system 530. In the illustrated example, the intermediate portion of the trigger drive shaft 1600 is configured for attachment to a distal cutting portion or knife bar 1320. As shown in Figure 4, knife bar 1320 is connected to a firing member or knife member 1330. The knife member 1330 comprises a body of knife 1332 which operationally supports a cutting blade of fabric 1334 therein. The knife body 1332 may additionally include flaps or anvil engaging features 1336 and channel engaging features or a foot 1338. Anvil engaging features 1336 can serve to apply additional closing movements to the anvil 1810 as the knife member 1330 is advanced distally through end actuator 1500.
[0048] [0048] In the illustrated example, the surgical end actuator 1500 is selectively pivotable about the geometric hinge axis AA by a hinge system 1360. In one form, hinge system 1360 includes proximal hinge driver 1370 which is pivotally coupled to a pivot link 1380. As can be seen more particularly in Figure 4, a displacement fixing tab 1373 is formed at a distal end 1372 of the proximal pivot driver 1370. A pivot hole 1374 is formed mounted on the displacement fixing tab 1373 and is configured to pivotally receive a proximal link pin 1382 formed at the proximal end 1381 of the link 1380. A distal end 1383 of the link link 1380 includes a pivot 1384 which is configured to receive, articulatively within it, a channel pin 1618 formed at the proximal end portion 1610 of the elongated channel 1602. rma, the axial movement of the proximal articulation actuator 1370 will thus apply articulation movements to the elongated channel 1602 to thereby cause the surgical end actuator 1500 to articulate around the AA articulation geometry axis in relation to the central column assembly 1250. In many circumstances, the proximal articulation driver 1370 can be held in position by the articulation lock 1390 when the proximal articulation driver 1370 is not being moved in the proximal or distal directions. Additional details related to an exemplary form of the 1390 hinge lock can be found in the US Patent Application, entitled "SURGICAL INSTRUMENT COMPRISING AN ARTICULATION SYSTEM LOCKABLE TO A
[0049] [0049] In addition to the above, the interchangeable surgical tool set 1000 can include a set of displacer 1100 that can be configured to selectively and releasably couple the proximal articulation driver 1310 to the firing system 1300. According to shown in Figure 5, in one form, the shifter assembly 1100 includes a locking collar or locking sleeve 1110 positioned around the middle portion of the firing axle 1310 of the firing system 1300, in which the locking sleeve 1110 can be rotated between an engaged position, in which the locking sleeve 1110 operationally couples the proximal articulation driver 1370 to the trigger member 1300 assembly, and a disengaged position, in which the proximal articulation driver 1370 does not it is operationally coupled to the firing member assembly 1300. When the locking sleeve 1110 is in its engaged position, the distal movement of the firing member assembly 130 0 can move the proximal articulation actuator 1370 distally, and correspondingly, the proximal movement of the trigger member assembly 1300 can proximally move the proximal articulation actuator
[0050] [0050] In the illustrated arrangement, the intermediate portion of the firing drive shaft 1310 of the firing member assembly 1300 is formed with two opposite flat sides with a driving notch 1316 formed there.
[0051] [0051] In the illustrated example, the relative movement of the locking sleeve 1110 between its engaged and disengaged positions can be controlled by the displacer assembly 1100 that interfaces with the 1910 proximal closing tube. Still referring to Figure 5 , the shifter assembly 1100 additionally includes a shifter key 1120 which is configured to be slidably received within a key groove formed on the outer perimeter of the locking sleeve 1110. This arrangement allows the shifter key 1120 moves axially in relation to the locking sleeve 1110. As discussed in more detail in the US Patent Application, entitled "SURGICAL INSTRUMENT WITH AXIALLY MOVABLE CLOSURE MEMBER", proxy document number END8209USNP / 170097, filed on the same date as present document, the description of which is incorporated by reference in the present invention, a portion of the shifter key 1120 is configured to interact cam with a cam opening (not shown) in the proximal closing tube portion 1910. In addition, in the illustrated example, the shifter assembly 1100 additionally includes a key drum 1130 which is pivotally received in a portion of proximal end of the proximal closing tube portion 1910. A portion of the shifter key 1120 extends through an axial slot segment in the key drum 1130 and is movably received within an arcuate slot segment in the key drum 1130 The key drum torsion spring 1132 is mounted on the key drum 1130 and engages a portion of the nozzle assembly 1240 to apply a rotation or torque force that serves to rotate the key drum 1130 to the key portion of displacer 1120 reach an end portion of the cam opening in the proximal closing tube portion
[0052] [0052] In an arrangement, for example, when the proximal closing tube 1910 is in a non-actuated configuration (anvil 1810 is in an open position spaced in the opposite direction to the cartridge mounted in the elongated channel 1602) the intermediate portion of the firing drive shaft 1310 will result in axial movement of the proximal pivot actuator 1370 to facilitate pivoting of the 1500 end actuator. Once the user has pivoted the surgical end actuator 1500 for a desired orientation , the user can then act the proximal closing tube portion
[0053] [0053] As also illustrated in Figures 5 and 15, the interchangeable surgical tool set 1000 can comprise a set of slip ring 1150 that can be configured to conduct electrical energy to and / or from the surgical end actuator 1500 and / or communicate signals to and / or from the surgical end actuator 1500 back to an integrated circuit board 1152 while facilitating the rotational displacement of the drive shaft and end actuator 1500 around the geometric axis of the drive in relation to the tool chassis 1210 by rotating the nozzle assembly 1240. As shown in Figure 15, at least
[0054] [0054] An exemplary version of the interchangeable surgical tool set 1000 disclosed in the present invention can be used in connection with a standard (mechanical) surgical clamp cartridge 1400 or a 1700 cartridge that is configured to facilitate cutting the tissue with the knife limb and seal the cut tissue using radio frequency (RF) energy. Again with reference to Figure 4, a cartridge of the conventional or standard mechanical type 1400 is shown. Such cartridge arrangements are known and may comprise a cartridge body 1402 that is sized and shaped to be removably received and supported in the elongated channel 1602. For example, the cartridge body 1402 can be configured to be removably retained in pressure engagement with the elongated channel 1602. The cartridge body 1402 includes an elongated slot 1404 to accommodate the displacement axis of knife member 1330 therethrough. The cartridge body 1402 operationally supports a plurality of clip drivers (not shown) which are aligned in rows on each side of a centrally arranged elongated slot 1404. The drivers are associated with corresponding clip / fastener pockets 1412 that open through the upper platform surface 1410 of the cartridge body 1402. Each of the clamp drivers holds one or more clamps or surgical clips (not shown) on it. A slide assembly 1420 is supported within a proximal end of cartridge body 1402 and is located proximal to the drivers and fasteners in an initial position when cartridge 1400 is new and not fired. Slider assembly 1420 includes a plurality of inclined or wedge-shaped cams 1422 with each cam 1422 corresponding to a specific line of fasteners or drivers located on one side of slot 1404. Slider assembly 1420 is configured to be placed in contact and driven by knife member 1330, as the knife member is driven distally through the fabric that is trapped between the anvil and the 1410 cartridge platform surface. As the drives are driven upward towards the platform surface of the cartridge 1410, the fastener (or fasteners) supported on them is driven out of their pockets for staples 1412 and through the fabric that is stuck between the anvil and the cartridge.
[0055] [0055] Still with reference to Figure 4, the anvil 1810, in at least one shape, includes an anvil mounting portion 1820 that has a pair of anvil sleeves 1822 that project laterally from it to be received articulated in corresponding trunnion bases 1614 formed in the vertical walls 1622 of the proximal end portion 1610 of the elongated channel 1602. The rotating pins of the anvil 1822 are articulated in their corresponding rotating pin bases 1614 by the channel cover or anvil retainer 1630. The anvil mounting portion 1820 is movably or pivotally supported in the elongated channel 1602 for selective pivoting displacement with respect to it around a fixed anvil pivot geometric axis that is transversal to the geo- axis. metric of the SA drive shaft. As shown in Figures 6 and 7, in at least one shape, the anvil 1810 includes an anvil body portion 1812 that is manufactured from an electrically conductive metallic material, for example, and has a lower staple forming surface 1813 which has a series of fastener forming pockets 1814 formed therein on each side of a centrally arranged anvil slot 1815 which is configured to slide the knife member 1330 therein. Anvil slit 1815 opens into an upper opening 1816 that extends longitudinally through anvil body 1812 to accommodate anvil engagement features 1336 on knife member 1330 during firing. When a staple cartridge / conventional mechanical surgical clamps 1400 is installed in the elongated channel 1602, the clamps / clamps are activated through the T fabric and in formation contact with the corresponding clamp forming pockets
[0056] [0056] In the illustrated arrangement, the interchangeable surgical tool set 1000 is configured with a trigger member locking system, generally referred to as 1640. See Figure 8. As shown in Figure 8, the elongated channel 1602 includes a su - lower surface or lower portion 1620 that has two vertical side walls 1622 that project from it. A centrally arranged longitudinal channel slot 1624 is formed through the lower portion 1620 to facilitate axial displacement of the knife member 1330 therethrough. The channel slot 1624 opens in a longitudinal passage 1626 that accommodates the channel or foot engagement feature 1338 in the knife member 1330. The passage 1626 serves to define two protruding inwardly extending portions 1628 that serve to engage the portions corresponding to the 1338 channel or foot hitch feature. The triggering member locking system 1640 includes proximal openings 1642 located on each side of channel slot 1624 that are configured to receive corresponding portions of the 1338 channel or foot hitch feature when knife member 1330 is in an initial position. A knife locking spring 1650 is supported at the proximal end 1610 of the elongate channel 1602 and serves to force the knife member 1330 downwards. As shown in Figure 8, knife lock spring 1650 includes two distal end spring arms 1652 that are configured to engage corresponding center channel engagement features 1337 with knife body 1332. Spring arms 1652 are configured to tilt the 1337 center channel hitch features down. In this way, when in the initial position (not fired), knife member 1330 is tilted down so that the channel or foot engagement features 1338 are received into the corresponding proximal openings 1642 in the elongated channel 1602. When in the locked position, if someone tries to advance knife 1330 distally, central channel engaging features 1137 and / or foot 1338 could engage vertical projections 1654 in elongate channel 1602 (Figures 8 and 11) and knife 1330 could not be fired.
[0057] [0057] Still referring to Figure 8, the trigger member locking system 1640 also includes an unlocking assembly 1660 formed or supported at a distal end of the trigger member body 1332. The unlocking assembly 1660 includes a protrusion that extends distally 1662 which is configured to engage an unlock feature 1426 formed in slide set 1420 when slide set 1420 is in its initial position in an untapped surgical staple cartridge 1400. Thus, when a Surgical staple cartridge not fired 1400 is properly installed in the elongated channel 1602, the protrusion 1662 in the unlocking set 1660 comes into contact with the unlocking feature 1426 in the slide set 1420 which serves to tilt the knife member 1330 upwards , so that the central channel hitch 1137 and / or foot 1338 features clean the vertical projections 1654 at the bottom of the channel 1620 to facilitate the axial passage of the knife member 1330 through the elongated channel 1602. If a partially fired cartridge 1400 is inadvertently installed in the elongated channel, the slide assembly 1420 will not be in the starting position and the knife member 1330 will remain in the locked position.
[0058] [0058] The attachment of the interchangeable surgical tool set 1000 to the handle set 500 will now be described with reference to Figures 3 and 9. To start the coupling process, the doctor can position the tool frame 1210 of the set interchangeable surgical tool 1000 above or adjacent to the distal end of the grip structure 506 so that the tapered clamping portions 1212 formed on the tool frame 1210 are aligned with the slot slots 507 in the grip structure 506 The physician can then move the interchangeable surgical tool set 1000 along an installation axis IA that is perpendicular to the drive axis SA to seat the tapered clamping portions 1212 in "operating engagement" with the corresponding recess recesses 507 at the distal end of the grip structure 506. When doing this, the drive shaft fixing tab 1314 the intermediate portion of the firing drive shaft 1310 will also be seated on the base 544 on the longitudinally movable driving member 540 within the handle assembly 500 and the portions of a pin 516 on a closing link 514 will be seated on the corresponding hooks 1917 on the 1914 closing shuttle. As used in the present invention, the term "operable hitch" in reference to two components means that the two components are sufficiently engaged with each other so that, by applying an actuation motion to the components can perform the intended action, function and / or procedure. In addition, during this process, the integrated connector 1154 in the surgical tool set 1000 is coupled to the compartment connector 562 which communicates with the microprocessor 560 which is supported in the handle set 500 or robotic system controller, for example.
[0059] [0059] During a typical surgical procedure, the doctor can insert the surgical end actuator 1500 into the surgical site through a trocar or other opening in the patient to access the target tissue. In doing so, the physician typically axially aligns the surgical end actuator 1500 along the geometric axis of the drive shaft SA (non-articulated state). Since the export actuator
[0060] [0060] As indicated above, the surgical tool set
[0061] [0061] As shown in Figures 10 to 12, in at least one arrangement, the RF surgical cartridge 1700 includes a cartridge body 1710 that is sized and shaped to be received and removably supported in the elongated channel 1602. For example, the cartridge body 1710 can be configured to be removably retained by pressure engagement with the elongated channel 1602. In various arrangements, the cartridge body 1710 can be manufactured from a polymeric material, such as, for example, a engineering thermoplastic such as liquid crystal polymer (LCP) liquid crystal polymer Vectra'Y and the elongated channel 1602 can be made from metal. In at least one aspect, the cartridge body 1710 includes an elongated centrally arranged slot 1712 that extends longitudinally through the cartridge body to accommodate the longitudinal displacement of the knife 1330 therethrough. As shown in Figures and 11, a pair of locking engagement tails 1714 extends proximally from the cartridge body 1710. Each locking input tail 1714 has a locking block 1716 formed on the underside of it. sized to be received within a corresponding proximal opening portion 1642 at channel bottom 1620. Thus, when cartridge 1700 is properly installed in elongated channel 1602, locking tails 1714 cover openings 1642 and protrusions 1654 to hold knife 1330 in an unlocked position ready for firing.
[0062] [0062] Now with reference to Figures 10 to 13, in the illustrated example, the cartridge body 1710 is formed with a central electrode block arranged centrally 1720. As can be seen more particularly in Figure 6, the elongated slot 1712 extends through the center of the electrode block 1720 and serves to divide the block 1720 into a left block segment 1720L and a right block segment 1720R. A right flexible circuit set 1730R is attached to the right block segment 1720R and a left flexible circuit set 1730L is attached to the left block segment 1720L. In at least one arrangement, for example, the straight flexible circuit 1730R comprises a plurality of 1732R electrical conductors which may include, for example, wider electrical conductors / conductors for RF purposes and thinner electrical conductors for conventional stapling that are supported or fixed or embedded in a 1734R right insulating sheath / member that is fixed to the 1720R right block. In addition, the 1730R right flexible circuit assembly includes a 1736R "phase one" proximal right electrode and a 1738R "phase two" distal right electrode. Similarly, the left flexible circuit set 1730L comprises a plurality of 1732L electrical conductors which may include, for example, wider electrical conductors / conductors for RF and conductive purposes.
[0063] [0063] In at least one arrangement, the RF energy is supplied to the surgical tool kit 1000 by a conventional RF generator 400 via a supply lead 402. In at least one arrangement, the supply lead 402 includes a set of male plug 406 that is configured to be plugged into corresponding female connectors 410 that are attached to a segmented RF circuit 1160 on an 1152 integrated circuit board. See Figure
[0064] [0064] Again with reference to Figure 10, in at least one illustrated arrangement, the elongated channel 1602 includes a channel circuit 1670 supported in a recess 1621 that extends from the proximal end 1610 of the elongated channel 1602 to a distal location 1623 in the lower portion of the elongated channel 1620. The channel circuit 1670 includes a proximal contact portion 1672 that contacts a distal contact portion 1169 of the flexible drive shaft circuit strip 1164 for electrical contact therewith. A distal end 1674 of the channel circuit 1670 is received within a corresponding wall recess 1625 formed in one of the walls of the channel 1622 and is folded over and fixed to an upper edge 1627 of the channel wall 1622. A series of contacts Corresponding posts 1676 are provided at the distal end 1674 of channel circuit 1670, as shown in Figure. 10. As can also be seen in Figure 10, an end 1752 of a flexible cartridge circuit 1750 is attached to the distal integrated chip 1740 and is affixed to the distal end portion of the cartridge body
[0065] [0065] Figures 16A and 16B are a block diagram of a control circuit 700 of the surgical instrument 10 of Figure 1 which comprises two drawing sheets according to an aspect of this description. Referring mainly to Figures 16A and 16B, a handle assembly 702 can include an engine 714, which can be controlled by an engine driver 715 and can be employed by the trigger system of the surgical instrument 10. In various ways, the motor 714 can be a direct current (dc) drive motor with brushes with a maximum rotation speed of approximately 25,000 rpm. In other arrangements, the 714 motor may include a brushless motor, a wireless motor, a synchronous motor, a stepper motor or any other suitable electric motor. The motor starter
[0066] [0066] The drive shaft assembly 704 can include a drive shaft controller 722 that can communicate with a safety controller and a power management controller 716 through an interface, while the shaft assembly drive 704 and power supply 706 are coupled to cable assembly 702. For example, the interface may comprise a first portion of interface 725, which may include one or more electrical connectors for coupling coupling with the corresponding electrical connectors of the drive shaft assembly, and a second portion of interface 727, which may include one or more electrical connectors for coupling coupling with the corresponding electrical connectors of the power supply, to enable electrical communication between the controller of the drive. drive shaft assembly 722 and power management controller 716 while drive shaft assembly 704 and power supply 706 are coupled to the handle assembly 702. One or more communication signals can be transmitted through the interface to communicate one or more of the power requirements of the interchangeable drive shaft assembly 704 to the management controller power
[0067] [0067] The interface can facilitate the transmission of one or more communication signals between the energy management controller 716 and the controller of the drive shaft assembly 722 by routing these communication signals through a main controller 717 located in the assembly cable 702, for example. In other circumstances, the interface can facilitate a direct communication line between the power management controller 716 and the drive shaft assembly controller 722 via cable assembly 702, while the drive shaft assembly 704 and the power set 706 are coupled to the cable set 702.
[0068] [0068] The main controller 717 can be any single-core or multi-core processor, such as those known under the trade name ARM Cortex by Texas Instruments. In one respect, the main controller 717 may be a Core Cor- tex-M4F LM4F230H5QR ARM processor, available from Texas Instruments, for example, which comprises an integrated 256 KB single cycle flash memory, or other memory non-volatile, up to 40 MHz, a seek-ahead buffer to optimize performance above 40 MHz, a 32-cycle single-cycle serial random access memory
[0069] [0069] The safety controller can be a safety controller platform that comprises two families based on controllers, such as TMS570 and RM4x known under the trade name of Hercules ARM Cortex R4, also from Texas Instruments. The safety controller can be configured specifically for IEC 61508 and ISO 26262 safety critical applications, among others, to provide advanced integrated safety features while providing scalable performance, connectivity and memory options.
[0070] [0070] The power supply 706 may include a power management circuit which may comprise the power management controller 716, a power modulator 738 and a current sensing circuit 736. The power management circuit may be configured to modulate the battery's output power based on the power needs of the 704 drive shaft assembly, while the 704 drive shaft assembly and the 706 power supply assembly are coupled to the 702 cable assembly. power management 716 can be programmed to control the power modulator 738 from the power output of the power supply 706 and the current sensor circuit 736 can be employed to monitor the power output of the power supply 706 to provide feedback to the power management controller 716 on the battery power output so that the power management controller 716 can adjust the output d and power from the power supply 706 to maintain a desired output. The power management controller 716 and / or the drive shaft assembly controller 722 may each comprise one or more processors and / or memory units that can store multiple software modules.
[0071] [0071] The surgical instrument 10 (Figures 1 to 5) can comprise an output device 742 that can include devices to provide sensory feedback to a user. Such devices may comprise, for example, visual feedback devices (for example, a monitor with LCD screen, LED indicators), hearing feedback devices (for example, a speaker, a bell) or devices tactile feedback (eg haptic actuators). In certain circumstances, output device 742 may comprise a screen 743 which may be included in cable assembly 702. The drive shaft assembly controller 722 and / or the power management controller 716 may provide feedback to a user of the surgical instrument 10 via the output device 742. The interface can be configured to connect the drive shaft assembly controller 722 and / or the power management controller 716 to the output device 742. The device output 742 can instead be integrated with the supply set 706. In these circumstances, communication between the output device 742 and the drive shaft set controller 722 can be done via the interface, while the drive shaft assembly 704 is coupled to the cable assembly 702.
[0072] [0072] The control circuit 700 comprises circuit segments configured to control the operations of the powered surgical instrument 10. A safety controller segment (segment 1)
[0073] [0073] The acceleration segment (segment 3) comprises an accelerometer. The accelerometer is configured to detect the movement or acceleration of the energized surgical instrument 10. Input from the accelerometer can be used to transition to and from a suspend mode, identify the orientation of the energized surgical instrument, and / or identify when the surgical instrument is dropped. In some examples, the acceleration segment is coupled to the safety controller and / or the main controller 717.
[0074] [0074] The screen or display segment (segment 4) comprises a screen connector coupled to the main controller 717. The screen connector couples the primary controller 717 to a screen through one or more drivers of the integrated circuits of the screen. The drivers of the integrated circuits of the screen may be integrated with the screen and / or may be located separately from the screen. The display may comprise any suitable display, such as an organic light emitting diode (OLED) display, a liquid crystal display (LCD), and / or any other suitable display. In some examples, the screen segment is coupled to the safety controller.
[0075] [0075] The drive shaft segment (segment 5) comprises controls for an interchangeable drive shaft assembly 500 coupled to surgical instrument 10 (Figures 1 to 5) and / or one or more controls for a 1500 end actuator coupled to the interchangeable drive shaft assembly 500. The drive shaft segment comprises a drive shaft connector configured to couple main controller 717 to a drive shaft PCBA. The drive shaft PCBA comprises a low power microprocessor with a ferroelectric random access memory (FRAM), a toggle switch, a drive shaft release Hall effect switch, and a shaft PCBA EEPROM memory. drive. The drive shaft PCBA EEPROM comprises one or more parameters, routines and / or programs specific to the interchangeable drive shaft assembly 500 and / or the drive shaft PCBA. The drive shaft PCBA can be coupled to the interchangeable drive shaft assembly 500 and / or can be integral with the surgical instrument 10. In some examples, the drive shaft segment comprises a second drive shaft EEPROM drive. The second EEPROM of the drive shaft comprises a plurality of algorithms, routines, parameters and / or other data corresponding to one or more sets of drive shafts 500 and / or end actuators 1500 that can interface with the surgical instrument energized
[0076] [0076] The position encoder segment (segment 6) comprises one or more magnetic encoders of the rotation angle position. One or more magnetic encoders of the rotation angle position are configured to identify the rotational position of the motor 714, an interchangeable drive shaft assembly 500 and / or an end actuator 1500 of the surgical instrument 10 (Figures 1 to 5). In some instances, the magnetic encoders of the rotation angle position can be coupled to the safety controller and / or the main controller 717.
[0077] [0077] The motor circuit segment (segment 7) comprises a motor 714 configured to control the movements of the energized surgical instrument 10 (Figures 1 to 5). The motor 714 is coupled to the main microcontroller processor 717 by an H bridge driver comprising one or more H bridge field effect transistors (FETs) and a motor controller. The H bridge actuator is also coupled to the safety controller. A motor current sensor is coupled in series with the motor to measure the current drain from the motor. The motor current sensor is in signal communication with the main controller 717 and / or with the safety processor. In some instances, the 714 motor is coupled to an electromagnetic interference (EMI) filter on the motor.
[0078] [0078] The motor controller controls a first motor signal and a second motor signal to indicate the status and position of motor 714 to main controller 717. Main controller 717 provides a high pulse width modulation signal (PWM), a low PWM signal, a direction signal, a synchronization signal, and a motor restart signal to the motor controller via a buffer. The supply segment is configured to supply a segment voltage to each of the circuit segments.
[0079] [0079] The energy segment (segment 8) comprises a battery coupled to the safety controller, the main controller 717, and additional circuit segments. The battery is coupled to the circuit segmented by a battery connector and a current sensor. The current sensor is configured to measure the total current drain from the segmented circuit. In some examples, one or more voltage converters are configured to provide predetermined voltage values for one or more circuit segments. For example, in some examples, the segmented circuit may comprise 3.3 V voltage converters and / or 5 V voltage converters. A voltage amplification converter is configured to provide a voltage rise to a predetermined amount, such as up to 13 V. The voltage amplifier converter is configured to supply additional voltage and / or current during operations that require a lot of energy and to avoid blackouts or low power conditions.
[0080] [0080] A plurality of keys are coupled to the safety controller and / or to the main controller 717. The keys can be configured to control the operations of the surgical instrument 10 (Figures 1 to 5), of the segmented circuit, and / or indicate a state of the surgical instrument 10. An ejection port switch and an ejection Hall switch are configured to indicate the status of an ejection port. A plurality of hinge keys, such as a left hinge key for the left side, a right hinge key for the left side, a central hinge key for the left side, a key on the left side left pivot to the right side, a right pivot key to the right side and a central pivot key to the right side are configured to control the articulation of an interchangeable drive shaft assembly 500 (Figures 1 and 3) and / or the end actuator 300 (Figures 1 and 4). A reverse key on the left side and a reverse key on the right side are attached to the main controller 717. The keys on the left side which comprise the key on the left pivot side for the left side, the key on the right pivot side for the the left side, the central articulation key for the left side and the reverse key for the left side are coupled to the primary controller 717 by a flex connector on the left. The keys on the right side comprising the key on the left pivot side for the right side, the key on the right pivot side for the right side, the central pivot key for the right side, and the reverse key on the right side are coupled main controller 717 via a right-hand flex connector. A trip key, a clamping release key, and a key attached to the drive shaft are coupled to the main controller 717.
[0081] [0081] Any suitable mechanical, electromechanical, or solid state keys can be used to implement the plurality of keys, in any combination. For example, the keys can limit the keys operated by the movement of components associated with the surgical instrument 10 (Figures 1 to 5) or the presence of an object. These switches can be used to control various functions associated with the surgical instrument 10. A limit switch is an electromechanical device that consists of an actuator mechanically connected to a set of contacts. When an object comes into contact with the actuator, the device operates the contacts to make or break an electrical connection. Limit switches are used in a variety of applications and environments because of their robustness, ease of installation and reliable operation. They can determine the presence or absence, passage, positioning and end of an object's displacement. In other implementations, the switches can be solid-state switches that work under the influence of a magnetic field, such as Hall effect devices, magnetic resistive devices (MR), giant magnet resistive devices ("GMR" - magneto-resistive gi- ant ), magnetometers, among others. In other implementations, the switches can be solid state switches that operate under the influence of light, such as optical sensors, infrared sensors, ultraviolet sensors, among others. In addition, the switches can be solid-state devices such as transistors (for example, FET, junction FET, metal oxide semiconductor FET (MOSFET), bipolar, and the like). Other switches may include switches without an electrical conductor, ultrasonic switches, accelerometers, inertia sensors, among others.
[0082] [0082] Figure 17 is another block diagram of the control circuit 700 of the surgical instrument of Figure 1 that illustrates the interfaces between the handle assembly 702 and the feeding assembly 706 and between the handle assembly 702 and the interchangeable drive shaft assembly 704, according to one aspect of this description. Cable assembly 702 may comprise a main controller 717, a drive shaft assembly connector 726 and a power assembly connector 730. Power assembly 706 may include a power assembly connector 732, a circuit
[0083] [0083] The surgical instrument 10 (Figures 1 to 5) can comprise an output device 742 for sensory feedback to a user. Such devices may comprise visual feedback devices (for example, a monitor with an LCD screen, LED indicators), hearing feedback devices (for example, a speaker, a bell) or tactile feedback devices (for example , haptic actuators). In certain circumstances, output device 742 may comprise a screen 743 that may be included in cable assembly 702. The drive shaft assembly controller 722 and / or the power management controller 716 can provide feedback to a user of surgical instrument 10 through output device 742. Interface 727 can be configured to connect the drive shaft assembly controller 722 and / or the power management controller 716 to output device 742 Output device 742 can be integrated with supply set 706. Communication between output device 742 and drive shaft assembly controller 722 can be done through interface 725 while the interchangeable drive shaft assembly 704 it is coupled to the cable assembly 702. Having described a control circuit 700 (Figures 16A, 16B and 6) to control the operation of the surgical instrument 10 (Figures 1 to 5), the description now turns to various configurations of the surgical instrument (Figures 1 to 5) and the control circuit 700.
[0084] [0084] Figure 18 is a schematic diagram of a surgical instrument 600 configured to control various functions according to an aspect of this description. In one aspect, the surgical instrument 600 is programmed to control the distal translation of a displacement member, such as the beam with a | 614. The surgical instrument 600 comprises an end actuator 602 which can comprise an anvil 616, a beam with a profile in | 614 and a removable staple cartridge 618 that can be interchanged with an RF cartridge 609 (shown in dashed line). The end actuator 602, the anvil 616, the beam with profile | 618 and the RF cartridge 609 can be configured as described here, for example, in relation to Figures 1 to 15. For brevity and clarity of the description, various aspects of the present description can be described with reference to Figure 18. It will be understood that the components shown schematically in Figure 18 such as control circuit 610, sensors 638, position sensor 634, end actuator 602, beam with profile in | 614, staple cartridge 618, RF cartridge 609, anvil 616, are described in connection with Figures 1 to 17 of the present description.
[0085] [0085] Consequently, the components shown schematically in Figure 18 can be readily replaced by the equivalent physical and functional components described in connection with Figures 1 to 17. For example, in one aspect, the control circuit 610 can be implemented according to control circuit 700 shown and described in connection with Figures 16 and 17. In one aspect, sensors 638 can be implemented as a limit switch, an electromechanical device, solid state switches, Hall effect devices, magnetoresistive devices (MR) giant magnetor-resistive devices (GMR), magnetometers, among others. In other implementations, 638 sensors can be solid state switches that operate under the influence of light, such as optical sensors, infrared sensors, ultraviolet sensors, among others. In addition, the switches can be solid state devices such as transistors (for example, FET, junction FET, metal oxide semiconductor FET (MOSFET), bipolar, and the like). In other implementations, 638 sensors can include driverless electric switches, ultrasonic switches, accelerometers, inertia sensors, among others. In one aspect, the 634 position sensor can be implemented as an absolute positioning system, which comprises a rotating magnetic absolute positioning system implemented as a rotating magnetic position sensor, with a single integrated circuit,
[0086] [0086] The position, movement, displacement and / or translation of a member of linear displacement, such as the beam with profile in | 614, can be measured by an absolute positioning system, sensor arrangement and position sensor represented as position sensor 634. Due to the beam with profile in | 614 be coupled to a longitudinally movable drive member 540, the beam position with | 614 can be determined by measuring the position of the longitudinally movable drive member 540 using the position sensor 634. Consequently, in the following description, the position, displacement and / or translation of the beam with profile in | 614 can be obtained by the position sensor 634, as described here. A control circuit 610, like the control circuit 700 described in Figures 16A and 16B, can be programmed to control the translation of the displacement member, such as the beam with | 614, as described in the present invention. The control circuit 610, in some examples, may comprise one or more microcontrollers, microprocessors or other suitable processors to execute the instructions that cause the processor or processors to control the displacement member, for example, the beam with profile in | 614, in the manner described. In one aspect, a timer / counter 631 provides an output signal, such as elapsed time or a digital count, to control circuit 610 to correlate the beam position with | 614, as determined by the position sensor 634, with the output of the timer / counter circuit 631 so that the control circuit 610 can determine the position of the beam with profile in | 614 at a specific time (t) in relation to an initial position. The timer / counter circuit 631 can be configured to measure elapsed time, count external events or measure external events.
[0087] [0087] Control circuit 610 can generate a 622 motor setpoint signal. The 622 motor setpoint signal can be supplied to a 608 motor controller. The 608 motor controller can comprise one or more circuits configured to provide a motor 624 drive signal to motor 604 to drive motor 604, as described here. In some examples, motor 604 may be a brushed direct current (DC) electric motor, such as motor 505 shown in Figure 1. For example, the speed of motor 604 may be proportional to the drive signal of motor 624. In In some examples, the 604 motor may be a brushless DC electric motor and the 624 motor drive signal may comprise a pulse width modulated (PWM) signal supplied to one or more 604 motor stator bearings. In addition, in some examples, the motor controller 608 can be omitted, and the control circuit 610 can generate the motor 624 drive signal directly.
[0088] [0088] The 604 motor can receive power from an energy source
[0089] [0089] Control circuit 610 can be in communication with one or more sensors 638. Sensors 638 can be positioned on end actuator 602 and adapted to work with surgical instrument 600 to measure the various derived parameters such as distance the span as a function of time, the compression of the tissue as a function of time and the deformation of the anvil as a function of time. The 638 sensors can comprise, for example, a magnetic sensor, a magnetic field sensor, an effort meter, a pressure sensor, a force sensor, an inductive sensor such as an eddy current sensor, a sensor resistive, a capacitive sensor, an optical sensor and / or any other sensors suitable for measuring one or more parameters of the end actuator 602. The 638 sensors may include one or more sensors.
[0090] [0090] The one or more 638 sensors may comprise a strain gauge, such as a microstrain gauge, configured to measure the magnitude of the mechanical stress on the anvil 616 during a tight condition. The effort meter provides an electrical signal whose amplitude varies with the magnitude of the effort. The 638 sensors can comprise a pressure sensor configured to detect a pressure generated by the presence of compressed tissue between the anvil 616 and the staple cartridge 618. The 638 sensors can be configured to detect the impedance of a section of tissue located between the anvil 616 and the staple cartridge 618 which is indicative of the thickness and / or the integrity of the fabric situated between them.
[0091] [0091] The 638 sensors can be configured to measure the forces exerted on the 616 anvil by the closing drive system. For example, one or more sensors 638 may be at an interaction point between the closing tube 1910 (Figures 1a4) and the anvil 616 to detect the closing forces applied by the closing tube 1910 to the anvil 616. The forces exerted on the anvil 616 can be representative of the tissue compression experienced by the section of tissue captured between the anvil 616 and the staple cartridge 618. The one or more sensors 638 can be positioned at various points of interaction throughout the closing drive system for detect the closing forces applied to the anvil 616 by the closing drive system. The one or more sensors 638 can be sampled in real time during a gripping operation by a processor, as described in Figures 16A and 16B. The control circuit 610 receives sample measurements in real time to provide and analyze the time-based information and evaluate, in real time, the closing forces applied to the anvil 616.
[0092] [0092] A current sensor 636 can be used to measure the current drained by the 604 motor. The force required to advance the beam with profile in | 614 corresponds to the current drained by the motor
[0093] [0093] The RF 400 power source is coupled to the end actuator 602 and is applied to the RF cartridge 609 when the RF cartridge 609 is loaded on the end actuator 602 in place of the clamp cartridge 618. Control circuit 610 controls the supply of RF energy to the RF cartridge 609.
[0094] [0094] Electrosurgical instruments apply electrosurgical energy to seal the tissue. However, at times, the fabric can be sealed with staples released by a staple cartridge, and at other times, the fabric can be sealed by applying electrosurgical energy. This requires the user to have two separate instruments. Therefore, it would be desirable to provide an elongated drive shaft for use with a surgical stapler in which an interchangeable RF cartridge is used in place of a staple cartridge. In situations where an interchangeable RF cartridge is used in place of a staple cartridge, this description provides several techniques for covering selected surfaces with non-conductive coatings to determine the electrical path of energy applied by radio frequency (RF) when the Interchangeable RF are used in place of the staple cartridge.
[0095] [0095] Figure 19 is a perspective view of a surgical system 4000. The surgical system 4000 is similar to the surgical system powered by motor 10 in that the surgical system 4000 is configured to be used in together with conventional surgical clamp / stapler cartridges 1400 and radio frequency cartridges 1700. However, the 4000 surgical system is different from the motor-driven surgical system 10 in that the surgical system 4000 also it is configured to be used in conjunction with radio frequency cartridges 4002 which are similar to, but different from, radio frequency cartridges 1700 and are described in more detail below. The surgical system 4000 is also different from the surgical system powered by motor 10 in that the surgical system 4000 includes a trigger system 4004 (see Figure 22) which is similar to, but different from the trigger system 1300 motor-operated surgical system 10 and is described in more detail below.
[0096] [0096] As shown in Figure 19, surgical system 4000 includes a handle set 4006 and a set of interchangeable tools 4008 attachable to handle set 4006. Handle set 4006 is similar or identical to handle set 500 and the 4008 interchangeable tool set is similar or identical to the 1000 interchangeable tool set. The 4008 interchangeable tool set includes a 4010 end actuator that includes a first 4012 jaw and a second 4014 jaw. The first 4012 jaw includes an elongated channel 4016 which is configured to removably support the radio frequency cartridge 4002. According to various aspects, the elongated channel 4016 can also be configured to removably support the clamp cartridge / surgical stapler 1400 and the 1700 radio frequency cartridge. The second claw 4014 comprises an anvil
[0097] [0097] Figure 20 is a partial cross section of the end actuator 4010 of the surgical system 4000, according to several aspects, showing the interface between the radio frequency cartridge 4002 and the anvil 4018 when the end actuator 4010 is in a completely closed position. For simplicity purposes, the elongated channel 4016 is not shown in Figure 20. The radio frequency cartridge 4002 is similar to the radio frequency cartridge 1700, but it is different in that the radio frequency cartridge 4002 includes a platform surface of a 4020 cartridge that defines at least two 4022 protrusions. Although only one of the 4022 protrusions is shown in the cross section of Figure 20, it will be recognized that a first of the 4022 protrusions is positioned on one side of a centrally elongated slot arranged 4024 of the radio frequency cartridge 4002 and a second one of the protrusions 4022 is positioned on the opposite side of the centrally elongated slot 4024 of the radio frequency cartridge 4002 (see, for example, Figure 21).
[0098] [0098] The radio frequency cartridge 4002 is also different from the radio frequency cartridge 1700 in that the radio frequency cartridge 4002 includes insulating housing members 4026 that define, respectively, the 4028 protrusions that are associated with the 4022 protrusions. Although only one of the members of the insulating enclosure 4026 and one of the protrusions 4028 are shown in the cross section of Figure 20, it will be recognized that one of the first of the members of the insulating enclosure 4026 and one of the first the protrusions 4028 are positioned on one side of the centrally arranged elongated slot 4024 of the radio frequency cartridge 4002 and a second one of the members of the insulating housing 4026 and a second one of the protrusions 4028 are positioned on the opposite side of the centrally elongated slot 4024 of radio frequency cartridge 4002 (see, for example, Figure 21). The protrusions 4028 are positioned between the protrusions 4022 on the platform surface of the 4020 cartridge and the anvil 4018 of the 4008 interchangeable tool set.
[0099] [0099] The radio frequency cartridge 4002 is also different from the radio frequency cartridge 1700 in that the radio frequency cartridge 4002 additionally includes flexible circuit assemblies 4030 that define, respectively, 4032 protrusions that are associated with protrusions 4022 and protrusions 4022 4028 protrusions. Although only one of the 4030 flexible circuit assemblies and one of the 4032 protrusions are shown in the
[0100] [0100] An example of an RF cartridge that conducts RF energy through the tissue of an electrode to an internal surface of a staple pocket is shown in Figures 6 and 7. Consequently, going back briefly to Figures 6 and 7, it is A partial cross-sectional view of the end actuator 1500 shown in Figures 1 to 5 is shown, holding an RF 1700 cartridge (Figures 10 to 12) 4002 (Figures 19 and 21) inside it and the T fabric sandwiched between the 1400 cartridge ( Figure 4) and the anvil 1810 and a partial cross-sectional view of the anvil 1810. In the example illustrated in Figures 6 and 7, the anvil 1810 comprises non-conductive masking except in the pockets 1814, so that all surfaces not involved in the formation of staples they are masked and coated with an electrically insulating non-conductive 1819 material creating a variation in the return path surface containing cavities and minimizing the extent of encrustation and the adhesion of the tec gone experienced by flat opposite electrodes.
[0101] [0101] Figure 21 is a partial perspective view of the radio frequency cartridge 4002 supported by the elongated channel 4016, according to several aspects. As described above, the radio frequency cartridge 4002 includes flexible circuit assemblies 4030 and protrusions 4032 on each side of the centrally arranged elongated slot 4024. For simplicity purposes, the insulating enclosure members 4026 are not shown in Figure 21. Additionally, it will be recognized that protrusions 4022, 4028 are hidden from view in Figure 21.
[0102] [0102] Figure 22 is an exploded perspective view of portions of the handle set 4006 and the set of interchangeable tools 4008, according to various aspects. The 4006 handle set is similar or identical, in many respects, to the 500 handle set. The 4008 interchangeable tool set is similar to the 1000 interchangeable tool set, but is different in that the associated 4004 firing system portion the set of interchangeable tools 4008 is different from the portion of the trigger system 1300 associated with the system of interchangeable tools 1000. The portion of the trigger system 4004 associated with the handle set 4006 is similar or identical to the portion of the system trigger 1300 associated with the handle set
[0103] [0103] The portion of the firing system 4004 associated with the interchangeable tool set 4008 includes a nozzle assembly 4042, an intermediate portion of the firing drive shaft 4044, a firing shaft fixing tab 4046, a firing bar knife 4048, a knife member / firing member 4050 and a proximal closing tube that are similar or identical to the nozzle assembly 1240, to the intermediate portion of the firing drive shaft 1310, to the firing shaft fixing tab 1314, knife bar 1320, knife member / firing member 1330 and proximal closing tube 1910. However, the portion of the firing system 4004 associated with the interchangeable tool set 4008 is different from that of the firing system 1300 associated with the interchangeable tool set 1000, as the portion of the trigger system 4004 associated with the interchangeable tool set 4008 additionally includes a mat electrically insulating material 4056 (an electrically non-conductive material) that works by preventing radio frequency energy from inadvertently passing from the portion of the trigger system 4004 associated with the set of interchangeable tools 4008 to the handle set 4006. In situations where power of radio frequency is applied to surgical instrument 4000, the firing member / knife member 4050 can conduct radio frequency energy. Without the electrically insulating material 4056, the firing member / knife member 4050 may inadvertently conduct radio frequency energy through knife bar 4048, through the intermediate portion of drive shaft 4044 and / or through the shaft fixing tab trigger trigger 4046 for the trigger system portion 4004 associated with the handle assembly 4006.
[0104] [0104] According to various aspects, the electrically insulating material 4056 is a coating that covers the locking tab for the 4046 drive shaft. When the locking tab for the 4046 drive shaft is seated on the fixation 4040 on the handle set 4006, the electrically insulating material 4056 works by electrically isolating the longitudinal drive member 4036 from the trigger drive system 4034 and the handle set 4006 from the interchangeable tool set 4008. In other words, the member longitudinal drive 4036 and the handle set 4006 are protected against inadvertent reception of radio frequency energy from the set of interchangeable tools 4008. According to other aspects, the electrically insulating material 4056 can also cover other portions trigger system 4004 to electrically isolate the 4036 longitudinal drive member and handle 4006 of the 4008 interchangeable tool set. For example, the electrical material
[0105] [0105] The aspects of the surgical instrument can be practiced without the specific details revealed in the present invention. Some aspects were shown as block diagrams instead of details. Parts of this description can be presented in terms of instructions that operate on data stored in a computer's memory. In general, the aspects described here, which can be implemented, individually and / or collectively, by a wide range of hardware, software, firmware, or any combination thereof, can be seen as being composed of several types of "circuits" electrical ". Consequently, "electrical circuit" includes, but is not limited to, electrical circuits that have at least one separate electrical circuit, electrical circuits that have at least one integrated circuit, electrical circuits that have at least one integrated circuit to apply specific circuits, electrical circuits that form a general-purpose computer device configured by a computer program (for example, a general-purpose computer or processor configured by a computer program that at least partially performs the processes and / or devices described herein), electrical circuits that form a memory device (for example,
[0106] [0106] The previously mentioned description presented aspects of the devices and / or processes through the use of block diagrams, flowcharts, and / or examples, which may contain one or more functions and / or operation. Each function and / or operation within such block diagrams, flowcharts or examples can be implemented, individually and / or collectively, by a wide range of hardware, software, firmware or virtually any combination thereof. In one aspect, several portions of the subject described here can be implemented by means of application-specific integrated circuits (ASICs), field programmable port arrangements (FPGAs), digital signal processors (DSPs), programmable logic devices (PLDs), circuits, registers and / or software components, for example, programs, subroutines, logic and / or combinations of hardware and software components, logic gates, or other integrated formats. Some aspects disclosed here, in whole or in part, can be implemented in an equivalent way in integrated circuits, such as one or more computer programs running on one or more computers (for example, as one or more programs operating on one or more computer systems), as one or more programs operating on one or more processors (for example, as one or more programs operating on one or more microprocessors), as firmware, or virtually as any combination thereof, and that designing the circuitry and / or writing the code for the software and firmware would be within the scope of practice of a person skilled in the art in the light of this description.
[0107] [0107] The mechanisms of the disclosed subject can be distributed as a program product in a variety of ways, and an illustrative aspect of the subject described here is applicable regardless of the specific type of signal transmission media used to effectively execute the distribution. Examples of a signal transmission medium include, but are not limited to, the following: recordable media such as a floppy disk, a hard disk drive, a compact disc (CD), a digital video disc (DVD), digital tape, computer memory, etc .; and a transmission type media, such as digital and / or analog communication media (for example, a fiber optic cable, a waveguide, a communications link with an electrical conductor, a communication link without an electrical conductor (for example, example, transmitter, receiver, transmission logic, reception logic), etc.).
[0108] [0108] The previously mentioned description of one or more aspects has been presented for purposes of illustration and description. This description is not intended to be exhaustive or to limit the invention to the precise form disclosed. Modifications or variations are possible in light of the above teachings. These aspects were chosen and described with the purpose of illustrating the principles and practical application to, thus, enable the person skilled in the art to use the aspects and with the modifications, as they are convenient to the specific use contemplated. It is intended that the claims presented in the annex define the global scope.
[0109] [0109] Various aspects of the subject described in this document are defined in the following numbered examples: Example 1. A set of interchangeable tools comprising: a first claw configured to hold a staple cartridge for a first period of time and a cartridge radio frequency for a second period of time; a second claw coupled to the first claw, with a surface of the second claw defining a plurality of staple forming pockets configured to form the staples applied from the staple cartridge; an electrically insulating material covering segments of the surface of the second claw other than the staple forming pockets, with the staple forming pockets defining at least a return path for the radio frequency energy provided by the radio frequency cartridge.
Example 2. The set of interchangeable tools, according to Example 1, the set of interchangeable tools being configured to be releasably attachable to a set of handles and at least one component positioned in the set of interchangeable tools comprises electrical insulation to electrically isolate the handle assembly from inadvertent radiofrequency energy from the interchangeable tool set.
Example 3. The set of interchangeable tools, according to one or more of Example 1 and Example 2, the set of interchangeable tools being configured to be releasably coupled to a handle set and being at least one component positioned in the set of interchangeable tools comprises electrical insulation to electrically isolate the handle assembly from inadvertent radio frequency energy from the set of interchangeable tools.
Example 4. The set of interchangeable tools, according to one or more from Example 1 to Example 3, with the plurality of staple forming pockets comprising: a first plurality of staple forming pockets positioned on a first side of an anvil slit centrally arranged; and a second plurality of staple forming pockets positioned on a second side of the centrally arranged anvil slot.
Example 5. The set of interchangeable tools, according to one or more of Examples 1 to Example 4, with the plurality of staple forming pockets providing a plurality of different return paths for the radio frequency energy provided by the radio frequency cartridge .
Example 6. The set of interchangeable tools, according to one or more of Examples 1 to Example 5, with the surface segments of the second claw facing the first claw.
Example 7. The set of interchangeable tools, according to one or more from Example 1 to Example 6, which additionally comprises a firing system positioned in the set of interchangeable tools, the firing system being configured for to be coupled to a handle assembly, the trigger system being electrically isolated to electrically isolate the handle assembly from an inadvertent radiofrequency energy.
Example 8. The set of interchangeable tools, according to one or more from Example 1 to Example 7, which additionally comprises a staple cartridge.
Example 9. The set of interchangeable tools, according to one or more from Example 1 to Example 8, the surgical system additionally comprising the radio frequency cartridge.
Example 10. The set of interchangeable tools, according to Example 9, the radiofrequency cartridge comprising at least two protuberances that collectively provide a minimum span distance between the first and the second jaws.
7O / 71 Example 11. A surgical tool set comprising: an elongated channel configured to hold a staple cartridge for a first period of time and a radio frequency cartridge for a second period of time; and an anvil coupled to the elongated channel, the anvil comprising: a surface that faces the elongated channel and defines a plurality of staple forming pockets configured to form staples applied from the staple cartridge; and an electrically insulating material that covers segments of the surface of the second claw, the plurality of staple-forming pockets providing a plurality of different return paths for the radio frequency energy provided by the radio frequency cartridge.
Example 12. The surgical tool set according to Example 11, the elongated channel and the anvil collectively forming an end actuator.
Example 13. The surgical tool set of one or more from Example 11 to Example 12, the plurality of staple forming pockets comprising: a first plurality of staple forming pockets positioned on a first side of an anvil slit centrally willing; and a second plurality of staple forming pockets positioned on a second side of the centrally arranged anvil slot.
Example 14. The surgical tool set, according to one or more from Example 11 to Example 13, with the surface segments of the second claw being other than the staple forming pockets.
Example 15. The surgical tool set, according to one or more from Example 11 to Example 14, the surgical tool set additionally comprising the staple cartridge.
7TUTI Example 16. The surgical tool set according to one or more from Example 11 to Example 15, the surgical tool set additionally comprising the radiofrequency cartridge.
Example 17. The surgical tool set according to Example 16, the radiofrequency cartridge comprising at least two protrusions that collectively provide a minimum span distance between the elongated channel and the anvil.
Example 18. An interchangeable instrument set comprising: an end actuator configured to be releasably coupled to a drive shaft assembly, the end actuator comprising: an elongated channel configured to hold a staple cartridge for a first period of time and a radio frequency cartridge for a second period of time; and an anvil coupled to the elongated channel, the anvil comprising an electrically insulating material and defining a plurality of different return paths for the radio frequency energy provided by the radio frequency cartridge.
Example 19. The set of interchangeable tools, according to Example 18, with the electrically insulating material facing the elongated channel.
Example 20. The interchangeable tool set, according to one or more of Example 18 and Example 19, which further comprises the radio frequency cartridge.

权利要求:
Claims (20)
[1]
1. Set of interchangeable tools, characterized by comprising: a first claw configured to hold a staple cartridge for a first period of time and a radio frequency cartridge for a second period of time; a second jaw coupled to the first jaw, wherein a surface of the second jaw defines a plurality of staple forming pockets configured to form the staples applied from the staple cartridge; and an electrically insulating material covering segments of the surface of the second claw other than the clamp forming pockets, where the clamp forming pockets define at least one return path for the radio frequency energy provided by the radio frequency cartridge.
[2]
2. Set of interchangeable tools, according to claim 1, the set of interchangeable tools being characterized by being configured to be releasably attachable to a handle set and in which at least one component is located in the set of handles. interchangeable tools comprise electrical insulation to electrically isolate the handle assembly from inadvertent radiofrequency energy from the interchangeable tool set.
[3]
3. Set of interchangeable tools, according to claim 1, the set of interchangeable tools being characterized by being configured to be releasably attachable to a handle set and in which at least one component is located in the set of handles. interchangeable tools comprise electrical insulation to electrically isolate the handle assembly from inadvertent radiofrequency energy from the interchangeable tool set.
[4]
Interchangeable tool set according to claim 1, characterized in that the plurality of staple forming pockets comprises: a first plurality of staple forming pockets positioned on a first side of a centrally arranged anvil slot; and a second plurality of staple forming pockets positioned on a second side of the centrally arranged anvil slit.
[5]
5. Set of interchangeable tools according to claim 1, characterized in that the plurality of staple forming pockets provide a plurality of different return paths for the radio frequency energy supplied by the radio frequency cartridge.
[6]
6. Set of interchangeable tools, according to claim 1, characterized in that the surface segments of the second claw are facing the first claw.
[7]
7. Set of interchangeable tools, according to claim 1, characterized in that it additionally comprises a firing system positioned in the set of interchangeable tools, in which the firing system is configured to be coupled to a handle set, in which the trigger system is electrically isolated to electrically isolate the handle assembly from inadvertent radiofrequency energy.
[8]
Interchangeable tool set according to claim 1, characterized in that it additionally comprises a staple cartridge.
[9]
9. Set of interchangeable tools, according to claim 1, characterized in that the surgical system additionally comprises the radio frequency cartridge.
[10]
10. Set of interchangeable tools according to claim 9, characterized in that the radio frequency cartridge comprises at least two protuberances that collectively provide a minimum span distance between the first and the second jaws.
[11]
11. Surgical tool set, characterized by comprising: an elongated channel configured to hold a staple cartridge for a first period of time and a radio frequency cartridge for a second period of time; and an anvil coupled to the elongated channel, the anvil comprising: a surface that faces the elongated channel and defines a plurality of staple forming pockets configured to form staples applied from the staple cartridge; and an electrically insulating material covering segments of the surface of the second claw, in which the plurality of staple forming pockets provides a plurality of different return paths for the radio frequency energy provided by the radio frequency cartridge.
[12]
12. Surgical tool set, according to claim 11, characterized in that the elongated channel and the anvil collectively form an end actuator.
[13]
13. Surgical tool set, according to claim 11, characterized in that the plurality of staple forming pockets comprises:
a first plurality of staple forming pockets positioned on a first side of a centrally arranged anvil slit; and a second plurality of staple forming pockets positioned on a second side of the centrally arranged anvil slit.
[14]
14. Surgical tool set, according to claim 11, characterized in that the segments of the second claw surface are other than the staple formation pockets.
[15]
15. Surgical tool set, according to claim 11, characterized by additionally comprising the staple cartridge.
[16]
16. Surgical tool set, according to claim 11, characterized by additionally comprising the radiofrequency cartridge.
[17]
17. Surgical tool set, according to claim 16, characterized in that the radiofrequency cartridge comprises at least two protuberances that collectively provide a minimum span distance between the elongated channel and the anvil.
[18]
18. Interchangeable tool set, comprising: an end actuator configured to be releasably coupled to a drive shaft assembly, where the end actuator comprises: an elongated channel configured to hold a staple cartridge during a first period of time and a radio frequency cartridge for a second period of time; and an anvil coupled to the elongated channel, in which the anvil comprises an electrically insulating material and defines a plurality of different return paths for the radio frequency energy provided by the radio frequency cartridge.
[19]
19. Interchangeable tool set according to claim 18, characterized in that the electrically insulating material faces the elongated channel.
[20]
20. Interchangeable tool set according to claim 18, characterized in that it additionally comprises the radio frequency cartridge.

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同族专利:

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公开号 | 公开日

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JP2020525235A|2020-08-27|

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WO2019003012A1|2019-01-03|

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US20190000535A1|2019-01-03|

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CN110831518A|2020-02-21|

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US11103301B2|2021-08-31|

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EP3420939A1|2019-01-02|

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法律状态:
2021-11-03| 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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US15/636,134|US11103301B2|2017-06-28|2017-06-28|Surgical system coupleable with staple cartridge and radio frequency cartridge, and having a plurality of radio-frequency energy return paths|

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US15/636,134|2017-06-28|

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PCT/IB2018/054274|WO2019003012A1|2017-06-28|2018-06-12|Surgical system coupleable with staple cartridge and radio frequency cartridge, and having a plurality of radio-frequency energy return paths|

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