adapters with trigger stroke detection arrangements for use in connection with electromechanical sur

专利摘要:
The present invention relates to an adapter for use with an electromechanical surgical instrument. The adapter includes an end actuator with a first and a second gripper that are movable between the open and closed positions relative to each other by a dynamic gripping member that is axially movable through the end actuator in a firing stroke. The adapter includes trigger stroke detection arrangements to monitor an axial position of the dynamic gripping assembly as it moves within the trigger stroke.
公开号:BR112020011795A2
申请号:R112020011795-1
申请日:2018-12-13
公开日:2020-11-17
发明作者:Frederick E. Shelton Iv；Jason L. Harris；Jerome R. Morgan
申请人:Ethicon Llc；
IPC主号:

专利说明:

[0001] [0001] The present invention relates to surgical instruments and, in various arrangements, to surgical instruments for stapling and cutting, and staple cartridges for use with them, which are designed for stapling and cutting tissue. BRIEF DESCRIPTION OF THE DRAWINGS
[0002] [0002] Several characteristics of the modalities described here, together with their advantages, can be understood according to the description presented below, considered together with the attached drawings, as shown below:
[0003] [0003] Figure 1 is a perspective view of an electromechanical surgical instrument;
[0004] [0004] Figure 2 is a perspective view of a distal end of a portion of the electromechanical surgical instrument in the surgical system of Figure 1;
[0005] [0005] Figure 3 is an exploded view of the set of an external wrapping resource and the electromechanical surgical instrument of Figure 2;
[0006] [0006] Figure 4 is a rear perspective view of a portion of the electromechanical surgical instrument in Figure 2;
[0007] [0007] Figure 5 is a partial exploded view of the assembly of a portion of an adapter and the electromechanical surgical instrument of the surgical system of Figure 1;
[0008] [0008] Figure 6 is an exploded view of the assembly of a portion of the adapter of Figure 5;
[0009] [0009] Figure 7 is a perspective view in cross section of a portion of an adapter pivot assembly;
[0010] [0010] Figure 8 is a perspective view of the pivot assembly of Figure 7;
[0011] [0011] Figure 9 is another perspective view of the articulation assembly of Figure 8;
[0012] [0012] Figure 10 is an exploded view of the set of a load unit used in the electromechanical surgical instrument system of Figure 1;
[0013] [0013] Figure 11 is a perspective view of an alternative modality of the adapter;
[0014] [0014] Figure 12 is a side elevation view of a portion of a load unit for the Figure 11 adapter with its claws in an open position;
[0015] [0015] Figure 13 is another side elevation view of a portion of the load unit of Figure 11 with its portions shown in cross section and its claws in a closed position;
[0016] [0016] Figure 14 is a bottom view of a portion of the loading unit of Figure 13 with its portions shown in cross section;
[0017] [0017] Figure 15 is a perspective view of a portion of the loading unit of Figure 14 with a portion of the outer tube shown in imaginary lines;
[0018] [0018] Figure 16 is a cross-sectional view of a proximal portion of another adapter that employs several sealing arrangements within it;
[0019] [0019] Figure 17 is an end cross-sectional view of a portion of the adapter of Figure 16;
[0020] [0020] Figure 18 is a side elevation view of another adapter;
[0021] [0021] Figure 19 is a cross-sectional view of a portion of the adapter of Figure 18;
[0022] [0022] Figure 20 is a rear perspective view of portions of another adapter;
[0023] [0023] Figure 21 is a cross-sectional view of another adapter;
[0024] [0024] Figure 22 is a side elevation view of an adapter tool set with the dynamic gripping set in an initial position and the claws otherwise shown in a closed position for clarity;
[0025] [0025] Figure 23 is a cross-section and partial perspective view of a trigger system sensor unit or an adapter system;
[0026] [0026] Figure 24 is a partial side cross-sectional view of the sensor unit of the trigger system of Figure 23 in an initial position;
[0027] [0027] Figure 25 is another partial side cross-sectional view of the sensor unit of the trigger system of Figures 23 and 24 after the trigger system has completed a closing stroke and before starting a trigger stroke;
[0028] [0028] Figure 26 is another partial side cross-sectional view of the sensor unit of the trigger system of Figures 23 to 25 after the trigger system has completed the trigger course;
[0029] [0029] Figure 27 is a diagrammatic representation of portions of the trigger unit of the trigger system of Figures 23 to 26 as the trigger system is moved from a start position to an end position; and
[0030] [0030] Figure 28 is a graphical representation of a displacement measured by the sensor unit of the trigger system of Figures 23 to 26 based on the distance of the trigger stroke of a dynamic gripping set.
[0031] [0031] Corresponding reference characters indicate corresponding parts through the various views. The exemplifications described herein illustrate various embodiments of the invention, in one form, and such exemplifications should not be considered to limit the scope of the invention in any way. DETAILED DESCRIPTION
[0032] [0032] The applicant for this application holds the following US patent applications that were filed on December 15, 2017 and which are each incorporated herein by reference in their respective totalities: - patent application Serial No. US 15 /843,485, entitled
[0033] [0033] Numerous specific details are presented to provide a complete understanding of the structure, function, manufacture and general use of the modalities described in the specification and illustrated in the attached drawings. Well-known operations, components and elements have not been described in detail, so as not to obscure the modalities described in the specification. The reader will understand that the modalities described and illustrated in the present invention are non-limiting examples and, therefore, it can be understood that the specific structural and functional details described in the present invention can be representative and illustrative. Variations and changes can be made to this, without departing from the scope of the claims.
[0034] [0034] The terms "understands" (and any form of understands, such as "understands" and "that understands"), "has" (and any form of has, such as "has" and "that has"), "includes" (and any form of includes, such as "includes" and "which includes") and "contains" (and any form of contains, such as "contains" and "which contains") are unrestricted linking verbs. As a result, a surgical system, device or apparatus that "comprises", "has", "includes" or "contains" one or more elements has those one or more elements, but is not limited to having only those one or more elements. Likewise, an element of a surgical system, device or apparatus that "comprises", "has", "includes" or "contains" one or more resources has those one or more resources, but is not limited to having only those one or more features.
[0035] [0035] The terms "proximal" and "distal" are used in the present invention with reference to a physician who handles the handle portion of the surgical instrument. The term "proximal" refers to the portion closest to the doctor, and the term "distal" refers to the portion located opposite the doctor. It will also be understood that, for the sake of convenience and clarity, spatial terms such as "vertical", "horizontal", "up" and "down" can be used in the present invention with respect to the drawings. However, surgical instruments can be used in many orientations and positions, and these terms are not intended to be limiting and / or absolute.
[0036] [0036] Various devices and exemplifying methods are provided for performing laparoscopic and minimally invasive surgical procedures. However, the reader will readily understand that the various methods and devices described in the present invention can be used in a number of surgical procedures and applications, including, for example, in relation to open surgical procedures. With the advancement of this Detailed Description, the reader will also understand that the various instruments described here can be inserted into a body in any way, such as through a natural orifice, through an incision or perforation formed in tissue, etc. Functional portions or portions of the instrument end actuator can be inserted directly into a patient's body or can be inserted via an access device that has a working channel through which the end actuator and the elongated drive shaft surgical instrument can be advanced.
[0037] [0037] The surgical stapling system may comprise a drive shaft and an end actuator that extends from the drive shaft. The end actuator comprises a first jaw and a second jaw. The first jaw comprises a staple cartridge. The staple cartridge is insertable into, and removable from, the first jaw; however, other modalities are provided for in which a staple cartridge is not removable, or at least readily replaceable, from the first gripper. The second claw comprises an anvil configured to deform the staples ejected from the staple cartridge. The second claw is pivoting relative to the first claw around a geometric axis of the lid; however, other modalities are foreseen in which the first claw is pivoting in relation to the second claw. The surgical stapling system also comprises an articulation joint configured to allow the end actuator to be rotated or articulated in relation to the drive shaft. The end actuator is rotatable about a geometric pivot axis that extends through the pivot joint. Other modalities are foreseen that do not include an articulation joint.
[0038] [0038] The staple cartridge comprises a cartridge body. The cartridge body includes a proximal end, a distal end, and a platform that extends between the proximal end and the distal end. In use, the staple cartridge is positioned on a first side of the fabric to be stapled and the anvil is positioned on a second side of the fabric. The anvil is moved towards the staple cartridge to compress and secure the fabric against the platform. After that, the staples removably stored in the cartridge body can be implanted in the fabric. The cartridge body includes staple cavities defined therein, the staples being removably stored in the staple cavities. The staple cavities are arranged in six longitudinal rows. Three rows of staple cavities are positioned on a first side of a longitudinal slot and three rows of staple cavities are positioned on a second side of the longitudinal slot. Other arrangements of staple cavities and staples may be possible.
[0039] [0039] The clamps are supported by clamp actuators on the cartridge body. The actuators are movable between a first position, or non-triggered position, and a second position, or triggered position, to eject the clamps from the clamp cavities. The drivers are retained in the cartridge body by a retainer that extends around the bottom of the cartridge body and includes resilient members configured to secure the cartridge body and retain the retainer in the cartridge body. The actuators are mobile between their non-triggered positions and their positions triggered by a slider.
[0040] [0040] In addition to the above, the slider is moved distally by a firing member. The firing member is configured to contact the slide and push the slide towards the distal end. The longitudinal slot defined in the cartridge body is configured to receive the firing member. The anvil also includes a slot configured to receive the firing member. The firing member further comprises a first cam that engages the first claw and a second cam that engages the second claw. As the firing member is advanced distally, the first cam and the second cam can control the distance, or fabric span, between the staple cartridge platform and the anvil. The firing member also comprises a knife configured to make an incision in the tissue captured between the anvil and the staple cartridge. It is desirable for the knife to be positioned at least partially proximal to the inclined surfaces, so that the clamps are ejected in front of the knife.
[0041] [0041] Figure 1 shows a motor-driven surgical system (electromechanical) 1 that can be used to perform a variety of different surgical procedures. As can be seen in that Figure, an example of surgical system 1 includes a hand-held electromechanical surgical instrument with a motor 100 that is configured for selective fixation to it of a plurality of different surgical instrument implements (here called "adapters") that they are each configured for operation and manipulation by the electromechanical hand-held surgical instrument equipped with a motor. As shown in Figure 1, the hand-held surgical instrument 100 is configured for selective connection with an adapter 200 and, in turn, adapter 200 is configured for selective connection with end actuators that comprise a single-use load unit (from "single use loading unit" ("SULU")) or a disposable loading unit ("DLU") or a multiple use load unit ("multiple use loading unit" " MULU "). In another embodiment of the surgical system, various forms of the adapter 200 can also be effectively employed with a tool drive set from a robotically controlled or automated surgical system. For example, the sets of the surgical instrument described here can be employed with various robotic systems, instruments, components and methods such as those described in US Patent No. 9,072,535, but not limited to them, entitled "SURGICAL
[0042] [0042] As shown in Figures 1 and 2, the surgical instrument 100 includes a battery 101 and an external wrapper wrap 10 which is configured to selectively receive and substantially terminate the battery 101. Battery 101 can also be called here a set of handle 101. One form of surgical instrument 100, for example, is described in international publication No. WO 2016/057225 A1, international application No. PCT / US2015 / 051837, entitled HANDHELD ELECTROMECHANICAL SURGICAL SYSTEM, the disclosure of which is incorporated herein by way of reference. Various features of the surgical instrument 100 will not be disclosed here beyond what is necessary to understand the various characteristics of the inventions disclosed in the present invention, it being understood that additional details can be obtained by reference to WO 2016/057225 A1 and other references incorporated here as a reference.
[0043] [0043] As shown in Figure 3, an outer wrapper casing 10 includes a half distal section 10a and a half proximal section 10b which is pivotally connected to the half distal section 10a by a hinge 16 located along the top edge of the sock distal section 10a and the proximal half section 10b. When joined together, the distal and proximal half sections 10a, 10b define a wrap cavity 10c within which the battery 101 is selectively located. Each of the distal and proximal half sections 10a, 10b includes a respective upper wrap portion 12a, 12b and a respective lower wrap portion 14a, 14b. The lower wrap portions 14a, 14b define a snap-fit closure feature 18 to selectively secure the lower wrap portions 14a, 14b to each other and to keep the wrapper wrap 10 in a closed condition. The distal half section 10a of the wrapper housing 10 defines a detection portion 20 which is configured to receive a corresponding drive coupling assembly 210 from adapter 200 (see Figure 5). Specifically, the half distal section 10a of the wrapper housing 10 has a recess that receives a portion of the drive coupling assembly 210 from adapter 200 when adapter 200 is coupled to surgical instrument 100.
[0044] [0044] The connecting portion 20 of the half distal section 10a defines a pair of guide rails that extend axially 21a, 21b and project radially inward from their internal side surfaces, as shown in Figure 5. The rails guide 21a, 21b assist in rotating orientation of adapter 200 relative to surgical instrument 100 when adapter 200 is coupled to surgical instrument 100. Connecting portion 20 of the distal half section
[0045] [0045] The half distal section 10a of the wrapper housing 10 supports a toggle control button facing the distal side 30. The toggle control button 30 is capable of being operated in a left, right, upward direction and downward by applying a corresponding force or a depressive force to it. The distal half section 10a of the wrapper casing 10 supports a right side pair of control buttons 32a, 32b (see Figure 3); and a right side pair of control buttons 34a, 34b (see Figure 2). The control buttons on the right side 32a, 32b and the control buttons on the left side 34a, 34b are capable of being activated by applying a corresponding force or a depressive force to them. The proximal half section 10b of the wrapper casing 10 supports a control button on the right side 36a (see Figure 3) and a control button on the left side 36b (see Figure 2). The control button on the right side 36a and the control button on the left side 36b are capable of being activated by applying a corresponding force or a depressive force to them.
[0046] [0046] The wrapper wrap 10 includes a set of sterile barrier plate 60 selectively supported on the half distal section 10a. Specifically, the sterile barrier plate assembly 60 is disposed behind the connecting portion 20 of the distal half section 10a and within the cavity of the casing 10c of the casing 10. The plate assembly 60 includes a plate 62 which rotatably supports three axes coupling drive 64a, 64b, 64c (see Figures 3 and 5). Each coupling drive shaft 64a, 64b, 64c extends from opposite sides of the plate 62 and has a trilobed cross section profile. Each coupling drive shaft 64a, 64b, 64c extends through the respective openings 22a, 22b, 22c of the connecting portion 20 of the distal half section 10a when the sterile barrier plate assembly 60 is disposed within the housing cavity 10c of the wrapper housing 10. The plate assembly 60 further includes an electrical passage connector 66 supported on plate 62. The passage connector 66 extends from opposite sides of plate 62. The passage connector 66 defines a plurality of path paths. contact, each of which includes an electrical conduit to extend an electrical connection across plate 62. When plate assembly 60 is disposed within the cavity of the casing 10c of the casing 10, the distal ends of the coupling drive shaft 64a , 64b, 64c and a distal end of the passage connector 66 are arranged or located within the connecting portion 20 of the distal half section 10a of the wrapper housing 10, and They are configured to connect electrically and / or mechanically to the corresponding corresponding features of adapter 200.
[0047] [0047] With reference to Figures 3 and 4, the battery or grip assembly 101 includes an inner grip housing 110 that has a lower housing portion 104 and an upper housing portion 108 that extends from and / or which is supported on the lower housing portion 104. The lower housing portion 104 and the upper housing portion 108 are separated into a half distal section 110a and a half proximal section 110b connectable to the half distal section 110a by a plurality of fasteners. When joined together, the distal and proximal half sections 110a, 110b define the inner casing of the grip 110 which has an inner casing cavity 110c within which a battery core assembly 106 is located. The battery core assembly 106 is configured to control the various operations of the surgical instrument 100.
[0048] [0048] The half distal section 110a of the inner grip handle 110 supports a distal toggle control interface 130 which is in operational alignment with the distal toggle control button 30 of the wrapper housing 10. In use, when battery 101 is arranged within the wrapper casing 10, the actuation of the toggle control button 30 exerts a force on the toggle control interface 130. The half distal section 110a of the inner handgrip 110 also supports a right side pair of control (not shown) and a left side pair of control interfaces 132a, 132b. In use, when battery 101 is disposed within the casing of the casing 10, the actuation of one of the right side pair of control buttons or the left side pair of the control button of the distal half section 10a of the casing of the casing 10 exerts a force on a respective pair among the right side pair of control interfaces 132a, 132b or the left side pair of control interfaces 132a, 132b of the half distal section 110a of the inner grip 110.
[0049] [0049] With reference to Figures 1 to 5, the inner handle housing 110 provides a housing in which a battery core assembly 106 is located. The battery core assembly 106 includes a battery circuit 140, a circuit board of controller 142 and a rechargeable battery 144 configured to supply power to any of the electrical components of surgical instrument 100. Controller circuit board 142 includes a motor controller circuit board 142a, a main controller circuit board 142b and a first ribbon cable 142c interconnecting the motor controller circuit board 142a and the main controller circuit board 142b. The battery core assembly 106 further includes a display screen 146 supported on the main controller circuit board 142b. The display screen 146 is visible through a clear or transparent window 110d (see Figure 3) provided in the proximal half section 110b of the inner grip 110. It is provided that at least a portion of the inner grip 110 can be manufactured from from a transparent hard plastic or similar. It is also envisaged that the wrapper 10 may include a window formed thereon (in visual record with the display screen 146 and with the window 110d of the proximal half section 110b of the inner wrapper 110, and / or the wrapper 10 it can be made of a transparent rigid plastic or similar.
[0050] [0050] The battery core assembly 106 further includes a first motor 152, a second motor 154 and a third motor 156 which are supported by a motor support 148 and are each electrically connected to the controller circuit board 142 and battery 144. Motors 152, 154, 156 are disposed between the motor controller circuit board 142a and the main controller circuit board 142b. Each motor 152, 154, 156 includes a respective motor drive shaft 152a, 154a, 156a extending therefrom. Each motor drive shaft 152a, 154a, 156a has a trilobed cross section profile to transmit rotating forces or torque. Each motor 152, 154, 156 is controlled by a respective motor controller. The rotation of the motor drive shafts 152a, 154a, 156a by the respective motors 152, 154, 156 works to drive the drive shafts and / or gear components of the adapter 200 to perform the various operations of the surgical instrument 100. In particular , the motors 152, 154, 156 of the battery core assembly 106 are configured to drive the drive shafts and / or gear components of the adapter 200.
[0051] [0051] As shown in Figures 1 and 5, surgical instrument 100 is configured to perform selective connection to adapter 200 and, in turn, adapter 200 is configured to perform selective connection to an end actuator 500. Adapter 200 includes an outer shell of the button 202 and an outer tube 206 that extends from a distal end of the shell of the button 202. The shell of the button 202 and the outer tube 206 are configured and sized to accommodate the adapter assembly components
[0052] [0052] Adapter 200 is configured to convert a rotation of the first or second coupling drive axes 64a, 64b of the surgical instrument 100 into axial translation useful for operating a drive assembly 540 and a pivot link 560 of the end actuator 500, as shown in Figure 10, and as will be described in more detail below. As shown in Figure 6, adapter 200 includes the proximal inner casing assembly 204 which pivotally supports a first rotary proximal drive axis 212, a second rotary proximal drive axis 214 and a third rotary proximal drive axis 216 within it. Each proximal drive shaft 212, 214, 216 functions as a rotation receiving member to receive rotational forces from the respective coupling drive axes 64a, 64b and 64c of the surgical instrument 100. In addition, the drive coupling assembly 210 of the adapter 200 is also configured to rotatably support the first, second and third sleeves of connector 218, 220 and 222, respectively, arranged in a plane or common line with respect to each other. Each connector sleeve 218, 220, 222 is configured to pair with the respective first, second and third coupling drive axes 64a, 64b, 64c of the surgical instrument 100, as described above. Each sleeve of connector 218, 222, 220 is further configured to pair with a proximal end of the respective first, second and third proximal drive axes 212, 214, 216 of adapter 200.
[0053] [0053] The drive coupling assembly 210 of adapter 200 also includes a first, a second and a third member of bias 224, 226, 228 disposed distally from the respective first, second and third sleeves of connector 218, 220 and
[0054] [0054] Also in the illustrated arrangement, adapter 200 includes the first, the second and the third drive conversion assemblies 240, 250, 260, respectively, which are each arranged in the inner shell assembly 204 and outer tube 206 Each drive conversion set 240, 250, 260 is configured and adapted to transmit or convert a rotation of a first, second and third coupling drive axis 64a, 64b and
[0055] [0055] Still with reference to Figure 6, the first transmission / force conversion / rotation set 240 includes the first rotating proximal drive shaft 212 which, as described above, is pivotally supported within the inner housing assembly 204. The first rotary proximal drive shaft 212 includes a non-circular or shaped end portion configured to connect to the first connector sleeve 218 that is connected to the respective first coupling drive shaft 64a of the surgical instrument 100. The first rotary proximal drive shaft 212 includes a threaded distal end portion 212b. The first transmission / force / rotation assembly 240 further includes a drive coupling nut 244 that threadably engages the threaded distal end portion 212b of the first rotating proximal drive shaft 212 and that is slidably arranged within of the outer tube 206. The drive coupling nut 244 is slidably keyed within the proximal core tube portion of the outer tube 206 so as to be prevented from rotating as the first rotating proximal drive shaft 212 is rotated. Thus, as the first rotating proximal drive shaft 212 is rotated, the drive coupling nut 244 is moved along the threaded distal end portion 212b of the first rotating proximal drive shaft 212 and, in turn, through and / or along the outer tube 206.
[0056] [0056] The first transmission / power conversion / rotation set 240 further includes a distal drive member 248 which is mechanically engaged with the drive coupling nut 244, so that the axial movement of the drive coupling nut 244 results in a corresponding amount of axial movement of the distal drive member
[0057] [0057] Still referring to Figure 6, the second drive conversion set 250 of adapter 200 includes a second proximal drive shaft 214 that is rotatably supported within the inner casing assembly 204. The second rotary proximal drive shaft 214 includes a non-circular or shaped end portion configured to connect to the second coupling drive shaft 64c of the surgical instrument 100. The second rotating proximal drive shaft 214 further includes a threaded distal end portion 214a configured to threadably engage a hinge bearing housing 253 of a hinge bearing assembly 252. Referring to Figures 6 to 9, the hinge bearing housing 253 supports a hinge bearing 255 provided with an inner race 257 that is independently rotatable with respect to a outer race 259. The housings 252 has a non-circular outer profile, for example, teardrop shaped, which is arranged in a sliding, non-rotating manner within a complementary hole (not shown) of the hub of the inner housing 204a.
[0058] [0058] In operation, as the second proximal drive shaft 214 is rotated, the hinge bearing assembly 252 is axially translated along the threaded distal end portion 214a of the second proximal drive shaft 214, which in turn makes with the pivot bar 258 being axially translated in relation to the outer tube 206. As the pivot bar 258 is translated axially, the pivot bar 258 being coupled to the pivot link 560 of the end actuator 500, causes the translation axial link 560 of end actuator 500 to articulate the tool set
[0059] [0059] As shown in Figure 6, adapter 200 includes a third drive conversion assembly 260 that is supported on the inner casing assembly 204. The third drive conversion assembly 260 includes a rotary ring gear 266 that is supported by fixed mode in the external housing of the button 202 and connected to it. Annular gear 266 defines an internal set of gear teeth 266a and includes a pair of diametrically opposed protrusions extending radially 266b. The projections 266b are configured to be arranged within the recesses defined in the outer casing of the button 202, so that the rotation of the annular gear 266 results in the rotation of the outer casing of the button 202, and vice versa. The third drive conversion assembly 260 further includes a third rotary proximal drive axis 216 which, as described above, is pivotally supported within the inner casing assembly 204. The third rotary proximal drive axis 216 includes a non-circular end portion or formatted that is configured for connection to the third connector 220. The third rotary proximal drive shaft 216 includes a gear wheel 216 keyed to a distal end of it. A reversing sprocket 264 interengages the sprocket 216a of the third rotary proximal drive shaft 216 with the gear teeth 266a of the annular gear 266. In operation, as the third rotary proximal drive shaft 216 is rotated due to a rotation of the third coupling drive shaft 64b of surgical instrument 100, the sprocket 216a of the third rotary proximal drive shaft 216 engages the reversing gear 264 causing the reversing gear 264 to rotate. As the reversing gear 264 rotates, the annular gear 266 also rotates, thus causing the outer casing of button 202 to rotate. Rotating the outer casing of button 202 causes outer tube 206 to rotate around the longitudinal axis of adapter 200. As outer tube 206 is rotated, end actuator 500 that is connected to a distal end portion of the adapter 200, is also rotated about a longitudinal axis of the adapter 200.
[0060] [0060] Adapter 200 also includes a fixing / separating button 272 (Figure 5) that is supported on a stem 273 (Figure 6) that protrudes from the drive coupling assembly 210 of adapter 200. The fixing button / separation 272 is provided by a bias member (not shown), which is arranged in or around stem 273, for an unactivated condition. The button 272 includes a lip or protrusion that is configured to fit by pressing behind a corresponding lip or protrusion 20 of surgical instrument 100. As also discussed in WO
[0061] [0061] Again with reference to Figure 6, adapter 200 includes an electrical assembly 290 supported on and in the outer housing of the button 202 and in the internal housing assembly 204. The electrical assembly 290 includes a plurality of electrical contact sheets 292, supported on a 294 circuit board, for electrical connection with the connector of the wrapping plate assembly of the wrapper 10 of the surgical instrument 100. The electrical assembly 290 enables the calibration and communication information (ie information on the life, system information, power information) to be transmitted to the circuit board of the surgical instrument 100 through an electrical receptacle portion of the battery core assembly 106 of the surgical instrument 100. Electrical assembly 290 further includes a strain gauge 296 which is electrically connected to the circuit board 294. The strain gauge 296 is mounted inside the inner housing assembly 204 to restrict the rotation of the 296 strain gauge relative to it. The rotary proximal drive shaft 212 extends through the effort meter 296 to enable the effort meter 296 to provide closed loop feedback for a triggering / gripping load shown by the first rotary proximal drive shaft 212. The electrical assembly 290 it also includes a slip ring 298 which is arranged in a sliding and non-rotating manner along the drive coupling nut 244 of the outer tube 206. The slip ring 298 is in electrical connection with the circuit board 294 and serves to enable the rotation of the the first rotating proximal drive shaft 212 and the axial translation of the drive coupling nut 244, while still maintaining the electrical contact of the slip ring 298 with at least one other electrical component inside the adapter 200, while enabling the others electrical components rotate around the first rotating proximal drive shaft 212 and the coupling nut drive device 244.
[0062] [0062] Still referring to Figure 6, the inner shell assembly 204 includes a hub 205 that has a distally oriented annular wall 207 that substantially defines an outer profile. The hub 205 includes a substantially teardrop-shaped recess or orifice that is shaped and shaped to receive the hinge bearing assembly 252 slidingly inside it. The inner casing assembly 204 further includes an annular plate 254 which is attached to a distal face of the distally oriented annular wall 207 of hub 204a. The annular plate 254 defines an opening 254a along it which is dimensioned and formed therein so as to be aligned with the second proximal drive axis 214 and to rotatively receive a distal tip therefrom. In this way, the distal tip of the second proximal drive axis 214 is supported and prevented from moving radially away from a longitudinal rotating axis of the second proximal drive axis 214 as the second proximal drive axis 214 is rotated to axially translate the hinge bearing assembly 252.
[0063] [0063] Going back to Figure 10, in one example, the end actuator 500 can be configured for a single-use ("disposable load unit - DLU") and to be similar to those DLUs described in US patent application publication N ° 2010/0301097, entitled LOADING UNIT HAVING DRIVE ASSEMBLY LOCKING MECHANISM, currently US patent application No. 9,795,384, publication of US patent application No. 2012/0217284, entitled LOCKING MECHANISM FOR USE WITH LOADING UNITS, currently US patent N No. 8,292,158, and publication of US patent application No. 2015/0374371, entitled ADAPTER ASSEMBLIES FOR
[0064] [0064] The surgical instrument 100 shown triggers staples, but can be adapted to trigger any other fastener such as clips and two-part fasteners. In the illustrated arrangement, end actuator 500 comprises a loading unit 510. The loading unit 510 comprises a proximal structural part 520 and a tool set 600. Tool set 600 includes a pair of claw members including a first member claw 610 comprising an anvil set 612 and a second claw member 700 comprising a cartridge set 701. One claw member is pivoting relative to the other to enable the fabric to be gripped between the claw members. The cartridge assembly 701 is movable in relation to the anvil assembly 612 and is movable between an open or non-secured position and a closed or approximate position. However, the anvil set 612, or both the cartridge set 701 and the anvil set 612, can be movable.
[0065] [0065] The cartridge assembly 701 has a cartridge body 702 and, in some cases, a backing plate 710 which are fixed to a channel 720 by a snap connection, a stop, a lock, or by another connection type. The cartridge assembly 701 includes fasteners or clamps 704 that are mobilely supported in a plurality of laterally spaced staple retaining slots 706, which are configured as openings in a fabric contact surface 708. Each slot 706 is configured to receive a fastener or clip inside. Cartridge body 702 also defines a plurality of cam wedge slots that accommodate clip pushers 709 and which open at the bottom (i.e., in the direction opposite to the fabric contact surface) to enable an actuating slide 712 pass lengthwise through them. The cartridge assembly 701 is removable from channel 720 after the clips have been released from cartridge body 702. Another removable cartridge assembly is capable of being loaded into channel 720, so that surgical instrument 100 can be actuated once more. to fire additional fasteners or clips. More details about the cartridge assembly can be found, for example in US Patent Application Publication No. 2017/0095250, as well as in several other references that have been incorporated into the present invention for reference.
[0066] [0066] The cartridge assembly 701 is pivoting in relation to the anvil assembly 612 and is movable between an open or non-clamped position and a closed or clamped position for insertion through the trocar cannula. The proximal structural part 520 includes at least one drive assembly 540 and a pivot link 560. In one arrangement, the drive assembly 540 includes a flexible drive bar 542 having a distal end 544 and a proximal engagement section 546. A proximal end of the engaging section 546 includes diametrically opposing inwardly extending fingers 547 that engage a hollow drive member 548 to securely secure drive member 548 to the proximal end of bar 542. Drive member 548 defines a proximal orifice that receives a connecting member 247 of the drive tube 246 of the first drive conversion set 240 of the adapter 200 when the end actuator 500 is attached to the distal end of the adapter 200.
[0067] [0067] The end actuator 500 further includes a housing assembly 530 comprising an outer housing 532 and an inner housing 534 which is arranged within the outer housing 532. The first and second tabs 536 are each arranged on a outer surface of a proximal end 533 of outer shell 532 and are configured to operationally engage the distal end of adapter 200, as discussed in more detail in WO 2016/057225 A1.
[0068] [0068] Referring to Figure 10, for example, anvil assembly 612 includes an anvil cover 630 and an anvil plate 620, which includes a plurality of staple-forming depressions. The anvil plate 620 is attached to the underside of the anvil cover
[0069] [0069] Tool set 600 includes a mounting set 800 comprising an upper mounting portion 810 and a lower mounting portion 812. A mounting tail 632 protrudes proximally from a proximal end 631 of anvil cover 630 A distally located pivot element 814 extends from each upper and lower mounting portion 810 and 812 through the openings 822 that are formed in the coupling members 820. In at least one arrangement, the pivot element 814 of the portion of upper assembly 810 also extends through an opening 634 in the mounting tail 632. The coupling members 820 each include a proximal interlocking portion 824 which is configured to be received in corresponding grooves formed at distal ends of the outer shell 532 and the inner shell 534. The proximal structural portion 520 of the end actuator 500 includes a pivot link 560 that has a proximal end hook-shaped 562. The pivot link 560 is sized to be slidably positioned inside a slot in the inner casing. A pair of H 830 block assemblies are positioned adjacent to the distal end of the outer casing 532 and adjacent to the distal end 544 of the axial drive assembly 540 to prevent warping and swelling out of the flexible actuation bar 542 during articulation and firing of the surgical stapling apparatus 10. Each H-block set 830 includes a flexible body 832 that includes a proximal end fixedly attached to the distal end of the outer shell 532 and a distal end that is fixedly attached to the set of assembly 800. In one arrangement, a distal end 564 of the pivot link is pivotally attached to the set of right H-blocks 830. Axial movement of the pivot link 560 will cause the tool set to pivot with respect to the part structural 520.
[0070] [0070] Figures 11 to 15 illustrate an adapter 200 'which is substantially identical to the adapter 200 described above, except for the differences shown below. As can be seen in Figure 11, adapter 200 'includes an outer tube 206 which has a proximal end portion 910 which has a first diameter "FD" and which is mounted within the outer housing of button 202. The proximal end portion 910 can be coupled to the inner shell assembly 204 or otherwise supported therein in the forms discussed in more detail in WO 2016/057225 A1, for example. The proximal end portion 910 extends proximally from a central tube portion 912 that has a second "SD" diameter. In the illustrated embodiment, an end actuator 500 is coupled to a distal end 914 of a drive shaft assembly 203 or outer tube 206. The outer tube 206 defines a longitudinal geometric axis LA that extends between the proximal end portion 910 and the distal end 914, as seen in Figure 11. As seen in Figures 10 and 11, an outer sleeve 570 of the proximal structural part 520 of the end actuator 500 has a distal end portion 572 and a proximal end portion 574. The proximal end portion 574 has an SD 'diameter that is approximately equal to the second SD diameter of the central tube portion 912. The distal end portion 572 has a third "TD" diameter. In one arrangement, FD and TD are approximately equal and larger than SD. Other provisions are contemplated in which FD and TD are not the same, but each is greater than SD. However, it is preferable that in most cases FD and TD be dimensioned for endoscopic insertion through a typical trocar port, cannula or similar. In at least one arrangement (Figure 11), the outer sleeve 570 is formed with a flat side or with side cutout 576 to facilitate improved access within the patient, while effectively accommodating the various drive and hinge components of the adapter 200 '. In addition, the provision of a reduced diameter to the central tube portion 912 can give the adapter 200 'better thoracic access between the ribs.
[0071] [0071] In at least one arrangement, channel 720, which can be machined or made of sheet metal, includes a pair of proximal holes 722 (Figure 10) that are configured for alignment with a pair of corresponding holes 636 in the anvil cover 630 to receive corresponding pins or protuberances 638 (Figure 12) to facilitate a pivoting relationship between the anvil set 612 and the cartridge set 701. In the illustrated example, a dynamic gripping set 550 is fixed to or formed at the distal end 544 of the flexible actuating bar 542. The dynamic gripping assembly 550 includes a vertical structural part 552 that has a fabric cutting surface 554 formed on or attached to it. See Figure 10, for example. An anvil engaging feature 556 is formed on one end of structural part 552 and comprises an anvil engaging tab 557 projecting from each side of structural part 552. Similarly, a channel engaging feature 558 it is formed on the other end of the structural part 552 and comprises a channel engaging tab 559 that projects from each side of the structural part 552. See Figure 15.
[0072] [0072] As indicated above, the anvil set 612 includes an anvil plate 620. The anvil plate 620 includes an elongated slot 622 that is configured to accommodate structural part 552 of the dynamic grip set 550 as per the dynamic grip set 550 is axially advanced during the firing process. The elongated slot 622 is defined between two protrusions of the anvil plate 624 that extend along each side of the elongated slot 622. See Figure 10. As the dynamic gripping set 550 is advanced distally, the engagement tabs anvil 557 slidably engage the protrusions of the anvil plate 624 to keep the anvil assembly 612 attached to the target tissue. Similarly, during the firing operation, the structural part 552 of the dynamic gripping assembly 550 extends through a central slot in the channel 720 and the channel latches 559 engage in a sliding manner with the projections of the channel 725 extending run along each side of the central channel slot to keep the cartridge assembly 701 attached to the target fabric.
[0073] [0073] Returning to Figures 13 and 15, channel 720 defines a coupling area generically designated as 730 which is configured to accommodate the dynamic gripping set 550 when it is in its most proximal position, called here an un triggered position or initial. In particular, the coupling area 730 is partially defined by flat coupling surfaces 732 that provide a gap between the channel engagement flaps 559 in the dynamic gripping assembly 550 to enable the cartridge assembly 701 to rotate to a fully open position. An inclined or actuating surface of the cam 726 extends from a distal end of each of the coupling surfaces 732. The inclined surface 726 is engaged by the dynamic gripping assembly 550 to move the anvil assembly 612 and the cartridge assembly 701 in relation to each other.
[0074] [0074] During the use of conventional adapters, debris and bodily fluids can migrate into the adapter's external tube and hinder the operation of the adapter's articulation and triggering systems. In flagrant cases, such debris and fluids seep into the adapter's internal casing assembly, which can cause a short circuit and failure of the electrical components supported inside it. In addition, due to limited access to the interior of the adapter's external tube, such debris and fluids are difficult to remove, which can prevent or reduce the adapter's ability to reuse.
[0075] [0075] Returning to Figures 16 and 17, in one arrangement, at least one first seal 230 is provided between the proximal inner liner assembly 204 and the first rotating proximal drive shaft 212 to prevent infiltration of fluid / debris inside and proximal to the proximal inner liner assembly 204. In addition, at least a second seal 232 is provided between the pivot bar 258 and the outer tube 206 to prevent fluids / debris from passing between them and entering the proximal inner liner assembly 204. By at least a third housing seal 233 can be provided around a hub 205 of the proximal inner housing 204 to establish a seal between hub 205 and the outer housing of button 202. The first, second and third seals 230, 232, 233 may comprise, for example, seal rings made from rubber or other suitable material.
[0076] [0076] In other embodiments, it may be desirable that the first and second seals 230, 232 are located on adapter 200 distally from the electronic components housed within the outer housing of button 202. For example, to prevent fluids / debris obstruct / short-circuit the slip ring assembly 298, it is desirable to establish seals between the various moving components of the adapter 200 that are operationally supported within the outer tube 206 at a location or locations that are each distal from the assembly sliding ring 298, for example. The seals 230, 232 can be supported on the wall of the external tube and / or on the mounting member 234 or on another mounting member / cushion / enclosure supported inside the external tube 206 and configured to facilitate the axial movement of the distal drive member 248 , as well as the pivot bar 258 while establishing a fluid-tight seal between the cushion and / or outer tube and the distal drive member 248 and the pivot bar
[0077] [0077] Figure 22 illustrates a 7500 surgical end actuator comprising a portion of an adapter 7200 that is configured to be used in conjunction with an electromechanical surgical instrument 100, for example. In the illustrated arrangement, the 7500 surgical end actuator comprises a 7510 loading unit. The 7510 loading unit comprises a proximal structural part 7520 and a 7600 tool set. The 7600 tool set includes a pair of claw members that includes a first claw 7610 comprising an anvil set 7612 and a second claw 7700 comprising a set of cartridge 7701. One claw member is pivoting relative to the other to enable the fabric to be gripped between the claw members. The cartridge assembly 7701 is movable in relation to the anvil assembly 7612 and is movable between an open or non-clamped position and a closed or approximate position. However, the anvil set 7612 or both the 7701 cartridge set and the anvil set 7612 can be movable.
[0078] [0078] The 7701 cartridge set is identical to the 701 cartridge set described in detail above. The loading unit 7510 includes a dynamic gripping assembly 550 that is attached to or formed at the distal end of the flexible drive bar 542. The dynamic gripping assembly 550 includes a vertical structural part 552 that has a fabric cutting surface 554 formed on it or attached to it. An anvil engaging feature 556 is formed on one end of structural part 552 and comprises an anvil engaging tab 557 projecting from each side of structural part 552. Similarly, a channel engaging feature 558 it is formed on the other end of the structural part 552 and comprises a channel engaging tab 559 that projects from each side of the structural part 552. As indicated above, the flexible actuation bar 542 interfaces with a actuation member hollow 548 (Figure 10) which is configured to be attached to an axially movable firing member or a distal drive member 248 (Figure 6) of the adapter 7200 to which it is attached. As also described above, the distal drive member 248 is configured to be axially advanced in the distal and proximal directions when the proximal drive axis 212 is rotated. In particular, a threaded portion 212b is configured to threadably engage a drive coupling nut 244 which is attached to the distal drive member 248. Drive coupling nut 244 is slidably received on a mounting pad 299 which it allows the drive coupling nut 244 to move axially, but prevents the drive coupling nut 244 from turning. The proximal drive shaft 212 is configured to receive rotary movements from an origin of rotary movements (motor 152, for example) on the electromechanical surgical instrument 100 (see Figure 4). The drive of the motor 152 will result in the rotation of the proximal drive shaft 212 and the axial displacement of the distal drive member 248 when the adapter 7200 is coupled to the electromechanical surgical instrument 100. As also discussed above, the motor 152 is part of a set of battery core 106 and is electrically connected to controller circuit board 142 and battery 144. See Figure 4.
[0079] [0079] Again with reference to Figure 22, the dynamic gripping set 550 is configured to move axially through the first and second grips via a trigger stroke FS that extends from an initial position SP of the gripping set dynamic 550 to an end position EP of the dynamic grip set 550. When the dynamic grip set 550 is located in the starting position (shown in continuous lines in Figure 22), the grips 7610, 7700 would be in their fully open position. However, to illustrate the portions of the firing stroke, Figure 22 illustrates the claws 7610 and 7700 in a closed position. When the dynamic gripping set 550 is axially advanced in a distal direction DD from the starting position through a proximal portion PFSA of the FS firing stroke, the distal gripping set 550 will move the claws 7610, 7700 from the fully open position to a closed position CP. As the distal grip set 550 continues to move distally from the closed position CP through a PFSB portion of the FS trigger stroke, the dynamic grip set 550 keeps the claws 7610, 7700 in the closed position, but has not yet found the fabric that was stuck between the claws 7610, 7700. As can be seen in Figure 22, for example, the first claw 7610 includes fabric stops extending upwards 7646 that prevent the fabric that is stuck between the claws 7610, 7700 extends proximally beyond that point. This point, designated as the trigger point FP in Figure 22, coincides with the locations of the closest proximal fasteners that are stored in the staple cartridge 702 that is mounted in the cartridge assembly 7701. Such an arrangement ensures that when the cutting surface 554 in the assembly of dynamic gripping finds the clamped fabric for the first time, the fabric separated in this way will be stapled or fastened. As the dynamic grip set 550 is driven distally from the trigger point FP via an intermediate IFS portion of the trigger stroke FS, the dynamic grip set triggers or causes most of the fasteners stored in the body of cartridge 702 is ejected from it into the forming hook with the first gripper
[0080] [0080] As the dynamic gripping set 550 is advanced distally through the triggering stroke FS, it may be useful to control the output of rotating movements of the motor 152. For example, more energy may be required to advance the dynamic gripping set 550 through the intermediate portion of the IFS firing stroke than is necessary to advance the dynamic gripping set 550 through a proximal portion of the firing stroke PFS and a distal portion of the firing stroke DFS due to the additional resistance encountered when cutting the stuck tissue and shoot the fasteners through it. In addition, as the dynamic gripping set 550 passes through the intermediate IFS firing stroke, the amount of energy required after it passes through the midpoint of the middle firing stroke may begin to decrease due to the reduction in the resistance of the trigger. tissue due to the migration of fluids from that remaining portion of the trapped tissue, for example.
[0081] [0081] In the illustrated example, end actuator 7500 is configured for use in conjunction with adapter 7200. Adapter 7200 is identical to adapter 200 except for the differences indicated in the present invention. In one arrangement, adapter 7200 employs a means to determine when dynamic gripping assembly 550 is axially located within the intermediate portion of the firing stroke and to communicate a signal indicative of that position back to a motor control circuit 152 to control the motor output 152. In one form, the determining means comprises a trigger system sensor unit generically designated as 7300. In the illustrated example shown in Figures 23 to 26, sensor unit 7300 comprises a fixed sensor 7310 which is mounted inside the inner shell assembly 204 or outer tube 206. The fixed sensor 7310 may comprise a Hall effect sensor that is connected or otherwise communicates with the electrical assembly 290 (Figure 6) which serves to enable the communication of corresponding signals to a motor controller circuit of surgical instrument 100 that controls motor 152, for example.
[0082] [0082] Still with reference to Figures 23 to 26, the sensor unit 7300 also comprises a sensor actuator 7320 that is mounted on a coupling arm of the sensor 7330 that interfaces in a mobile way with the drive coupling nut 244. In In one way, the sensor coupling arm 7330 includes a proximal support flap 7332 on which the sensor actuator 7320 is supported. In one arrangement, the 7320 sensor actuator comprises a magnet that is configured to be detected by the Hall effect sensor 7310. The coupling arm of the 7330 sensor also includes a distal mounting tab 7334 that is configured to be received slidingly within an axial groove 7350 provided in the drive coupling nut 244. The proximal support flap 7332 is provided for axial sensing alignment so that the sensor actuator 7320 can be detected by the fixed sensor 7310. In the illustrated arrangement, for example, proximal support flap 7332 is provided for axial sensing alignment by a proximal spring 7352 and a distal spring 7354 which are mounted on the inner shell assembly 204 or the outer tube 206.
[0083] [0083] Figures 24 to 27 illustrate an actuation stroke of the drive coupling nut 244 that corresponds to the trigger stroke FS of the dynamic gripping assembly 550. Figure 24 illustrates the position of the drive coupling nut 244 when the assembly Dynamic Grip 550 is in the home position. As can be seen in this figure, the drive coupling nut 244 actuated the sensor coupling arm 7330 proximally so that the sensor actuator 7320 is proximal to the fixed sensor 7310 and out of detection with it. This initial position of the 7320 sensor actuator is designated as SSA in Figure 27. When the rotary drive shaft 212 is initially rotated, the drive coupling nut 244 is axially driven in the distal direction DD through a proximal PAS portion of the stroke. AS performance. The proximal portion PAS of the actuation stroke AS corresponds to the proximal portion PFS of the trigger stroke FS of the dynamic gripping assembly 550. The drive coupling nut 244 is driven to an AFP trigger point (Figure 27) that corresponds to the FP trigger point (Figure 22) of dynamic grip set 550. As the drive coupling nut 244 approaches the AFP trigger point, springs 7352 and 7354 serve to move the sensor actuator 7320 to detection alignment with the fixed sensor 7310. As the drive coupling nut 244 is driven distally from the AFP trip point via an IAS intermediate portion of the AS travel path, springs 7352, 7354 serve to bring the actuator sensor 7320 for sensing alignment with the fixed sensor 7310. After the drive coupling nut 244 moves distally through a first portion of the intermediate actuation stroke IAS1, the springs 7 352, 7354 are used to tilt the sensor actuator 7320 to a midpoint of the SMP sensor that corresponds to the midpoint of the trigger portion FS of the dynamic gripping assembly 550. As the drive coupling nut 244 moves via the IAS intermediate portion of the actuation stroke, springs 7352, 7354 tilt the 7320 actuator sensor for a sensing alignment with the fixed sensor 7310. Then signals indicating the position of the dynamic gripping assembly can be transmitted by the fixed sensor 7310 to the motor control circuit as the drive nut 244 moves through the entire portion of the intermediate actuation stroke IAS.
[0084] [0084] Example 1 - An adapter for use with an electromechanical surgical instrument. In at least one example, the adapter comprises a surgical end actuator that includes an anvil and a cartridge assembly that is operably coupled to the anvil, so that the anvil and the cartridge assembly are movable relative to each other between positions open and closed. The cartridge assembly operationally stores a plurality of fasteners therein. A dynamic gripping assembly is selectively movable axially within the surgical end actuator through a firing stroke in which, when the dynamic gripping assembly is moved from an initial position in a distal axial direction through a proximal portion of the firing stroke, the dynamic gripping assembly moves the anvil and the cartridge assembly from a fully open to a closed position. When the dynamic gripping assembly is distally advanced through an intermediate portion of the firing stroke, the dynamic gripping assembly causes at least most grippers that are stored in the cartridge assembly to be ejected from it. When the dynamic grip set is advanced distally through a distal portion of the firing stroke, the dynamic grip set causes any remaining fasteners that are stored in the cartridge set to be ejected from it. The adapter also comprises means for determining when the dynamic gripping assembly is axially located in the intermediate portion of the firing stroke and communicating a signal indicative of the location of the dynamic gripping assembly to the electromechanical surgical instrument.
[0085] [0085] Example 2 - The adapter according to Example 1, in which the means for determining are configured to determine when the dynamic gripping assembly is axially located at a midpoint of the intermediate portion of the firing stroke and then communicating another said signal to the electromechanical surgical instrument indicative of the location of the midpoint.
[0086] [0086] Example 3 - The adapter according to Examples 1 or 2, in which the adapter further comprises a trigger drive system that includes a rotary drive shaft that is configured to interface operationally with a source of drive movements rotary instruments on the electromechanical surgical instrument. An axially movable firing member interfaces operationally with the rotary drive shaft and is configured to move the dynamic gripping assembly axially through the actuation stroke in response to the rotation of the rotary drive shaft.
[0087] [0087] Example 4 - The adapter according to Examples 1 or 3, in which the signal communicated to the electromechanical surgical instrument is used to control the origin of the rotating drive movements in the electromechanical surgical instrument.
[0088] [0088] Example 5 - The adapter according to Example 3, in which the axially movable firing member is moved through an actuation stroke in response to an application of rotating movements to it. In at least one example, the actuation course comprises a portion of the proximal actuation course that corresponds to the proximal portion of the firing course and a portion of the intermediate actuation course that corresponds to the intermediate portion of the firing course. The actuation course also comprises a portion of the distal actuation course that corresponds to the distal portion of the firing course. The means for determining when the dynamic gripping assembly is axially located in the intermediate portion of said firing stroke comprises means for determining when the axially movable firing member is axially situated in the portion of the intermediate firing stroke and for communicating a signal indicating the location of said axially movable firing member.
[0089] [0089] Example 6 - The adapter of Example 5, the means for determining when the axially movable firing member is axially situated in the portion of the intermediate actuation stroke comprise a sensor that is positioned adjacent to a portion of the firing member axially movable within the adapter and an actuator sensor that interfaces mobile with the axially movable trigger member portion and is configured to be detected by the sensor only when the axially movable trigger member is in the intermediate actuation stroke portion.
[0090] [0090] Example 7 - The adapter according to Example 6, in which the actuator sensor is provided for sensing alignment with the sensor when the axially movable firing member is located within the portion of the intermediate actuation stroke.
[0091] [0091] Example 8 - The adapter according to Example 7, in which the actuator sensor is supported on a sensor coupling arm that is movably supported over the axially movable firing member portion so that when the axially movable firing member is in the proximal actuating stroke portion or distal actuating portion, the axially movable firing member portion causes the sensor coupling arm to move the sensor actuator out of detection alignment with the sensor.
[0092] [0092] Example 9 - The adapter according to Examples 5, 6, 7 or 8, in which the adapter further comprises an adapter housing assembly that is configured to be operationally coupled to the electromechanical surgical instrument and an external tube assembly which defines a longitudinal geometric axis between a proximal end and a distal end thereof. The proximal end is operationally coupled to the adapter housing assembly. The outer tube assembly operationally supports the axially movable firing member therein and the sensor adjacent to the axially movable firing member portion.
[0093] [0093] Example 10 - The adapter according to Examples 5, 6, 7, 8 or 9, in which the sensor comprises a Hall effect sensor and in which the actuator sensor comprises a magnet.
[0094] [0094] Example 11 - The adapter according to Examples 8, 9 or 10, wherein the sensor coupling arm comprises a first engagement portion which is received slidably within an axial slot in the trigger member portion axially mobile and a second portion that operationally supports the actuator sensor in it.
[0095] [0095] Example 12 - An adapter for use with an electromechanical surgical instrument. In at least one example, the adapter comprises an adapter housing assembly that is configured to be operationally coupled to the electromechanical surgical instrument. The adapter further comprises a drive shaft assembly that defines a longitudinal geometric axis that extends between a proximal end and a distal end thereof. The proximal end is operationally coupled to the adapter housing assembly. The surgical load unit is operationally coupled to the distal end of the drive shaft assembly for selective articulation in relation to the drive shaft assembly. In at least one example, the surgical loading unit comprises an anvil and a cartridge assembly operably coupled to the anvil, so that the anvil and the cartridge assembly are movable with respect to each other between the open and closed positions. The cartridge assembly operationally stores a plurality of fasteners therein. A dynamic gripping assembly is axially selectively movable within the surgical end actuator through a firing stroke, and when the dynamic gripping assembly is moved from an initial position in a distal axial direction through a proximal portion of the stroke The dynamic gripping assembly moves the anvil and cartridge assembly from a fully open to a closed position, and when the dynamic gripping assembly is distally advanced through an intermediate portion of the firing stroke, the gripping assembly dynamic causes at least most of the fasteners that are stored in the cartridge assembly to be ejected from it. When the dynamic grip set is advanced distally through a distal portion of the firing stroke, the dynamic grip set causes any remaining fasteners that are stored in the cartridge set to be ejected from it. The adapter further comprises a trigger drive system that includes a rotary drive shaft that is configured to interface operationally with a source of rotary drive movements in the electromechanical surgical instrument and an axially movable trigger member that interfaces operationally with the set dynamic gripping and is configured to move the dynamic gripping assembly axially through an actuation stroke that corresponds to the firing stroke. The adapter further comprises means for determining when the dynamic gripping assembly is axially located in the intermediate portion of the firing stroke and communicating a signal indicative of the location of the dynamic gripping assembly to the electromechanical surgical instrument to control the origin of the rotating actuation movements.
[0096] [0096] Example 13 - The adapter according to Example 12, in which the means for determining are configured to determine when the dynamic gripping assembly is axially located at a midpoint of the intermediate portion of the firing stroke and communicating another signal to the electromechanical surgical instrument indicating the location of the midpoint.
[0097] [0097] Example 14 - The adapter according to Examples 12 or 13, in which the actuation stroke comprises a portion of the proximal actuation stroke that corresponds to the proximal portion of the firing stroke and a portion of the intermediate actuation stroke that corresponds to to the intermediate portion of the firing stroke. The actuation course also comprises a portion of the distal actuation course that corresponds to the distal portion of the firing course. The means for determining when the dynamic gripping assembly is axially located in the intermediate portion of the firing stroke comprises means for determining when the axially movable firing member is axially situated in the portion of the intermediate firing stroke and communicating a signal indicating the location of the limb axially movable firing range to the electromechanical surgical instrument.
[0098] [0098] Example 15 - The adapter according to Example 14, wherein the means for determining when the axially movable firing member is axially located in the portion of the intermediate actuation stroke comprises a sensor that is positioned adjacent to a portion of the member axially movable firing trigger on the adapter and an actuator sensor that interfaces with the axially movable firing member portion and is configured to be detected by the sensor only when the axially movable firing member is in the intermediate actuation stroke portion.
[0099] [0099] Example 16 - The adapter according to Example 15, in which the actuator sensor is supported on a sensor coupling arm that is movably supported on the axially movable firing member portion, so that when the axially movable firing member is in the proximal actuating stroke portion or distal actuating portion, the axially movable firing member portion causes the sensor coupling arm to move the sensor actuator out of detection alignment with the sensor.
[0100] [0100] Example 17 - The adapter according to Examples 15 or 16, wherein the drive shaft assembly comprises an outer tube assembly that defines a longitudinal geometric axis that extends between a proximal end and a distal end thereof. The proximal end is operationally coupled to the adapter housing assembly. The outer tube assembly operationally supports the axially movable firing member therein. The outer tube assembly also operationally supports the sensor adjacent to the axially movable firing member portion.
[0101] [0101] Example 18 - The adapter according to Examples 15, 16 or 17, in which the sensor comprises a Hall effect sensor and in which the actuator sensor comprises a magnet.
[0102] [0102] Example 19 - The adapter according to Examples 15, 16 or 17, wherein the sensor coupling arm comprises a first engagement portion which is received slidingly within an axial slot in the trigger member portion axially mobile and a second portion that operationally supports the actuator sensor in it.
[0103] [0103] Example 20 - An adapter for use with an electromechanical surgical instrument. In at least one example, the adapter comprises a surgical end actuator comprising a first jaw and a second jaw operatively coupled to the first jaw, so that the first and second jaws are movable with respect to each other between the open and closed. A dynamic gripping assembly is axially selectively movable within the surgical end actuator over an axial stroke distance, and when the dynamic gripping assembly passes axially through an initial portion of the axial stroke distance, the gripping assembly dynamic moves the first and second claws from a fully open position to a closed position. When the dynamic gripping assembly passes axially through an intermediate portion of the axial travel distance, the dynamic gripping assembly applies at least one actuation motion to at least one of the first and second grips. When the dynamic gripping assembly passes axially through a distal portion of the axial travel distance, the dynamic gripping assembly applies another actuation movement to at least one of the first and second grips. The adapter also comprises means for determining when the dynamic gripping assembly is axially located in the middle portion of the axial travel distance and communicating a signal indicative of the location of the dynamic gripping assembly to the electromechanical surgical instrument.
[0104] [0104] Many of the surgical instrument systems described here are driven by an electric motor; however, the surgical instrument systems described herein can be induced in any suitable manner. In several examples, the surgical instrument systems described herein can be induced, for example, by a manually operated trigger. In certain cases, the engines described in this document may comprise a portion or portions of a robotically controlled system. In addition, any of the end actuators and / or tool sets shown in the present invention can be used with a robotic surgical instrument system. US patent application Serial No. 13 / 118,241, entitled SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS, now US patent No.
[0105] [0105] The surgical instrument systems described here have been described in connection with the implantation and deformation of the clamps; however, the embodiments described in the present invention are not so limited. Several modalities are foreseen, which implant fasteners in addition to staples, such as claws or tacks, for example. In addition, several modalities are contemplated, which use any suitable means to seal the fabric. For example, an end actuator, according to various modalities, may comprise electrodes configured to heat and seal the tissue. Likewise, for example, an end actuator according to certain modalities, can apply vibrational energy to seal the tissue.
[0106] [0106] Although several devices have been described here in connection with certain modalities, modifications and variations of these modalities can be implemented. The specific resources, structures or characteristics can be combined in any suitable way in one or more modalities. Therefore, the specific resources, structures or characteristics illustrated or described in connection with a modality may be combined, in whole or in part, with the resources, structures or characteristics of one or more other modalities, without limitation. In addition, where materials for certain components are described, other materials can be used. In addition, according to various modalities, a single component can be replaced by multiple components and multiple components can be replaced by a single component, to perform one or more specific functions. The description mentioned above and the following claims are intended to cover all such modifications and variations.
[0107] [0107] The devices described here can be designed to be discarded after a single use, or they can be designed to be used multiple times. In either case, however, a device can be reconditioned for reuse after at least one use. Reconditioning can include any combination of steps including, but not limited to, disassembling the device followed by cleaning or replacing specific parts of the device and subsequent reassembly of the device. In particular, a reconditioning facility and / or surgical staff can disassemble a device and, after cleaning and / or replacing particular parts of the device, the device can be reassembled for subsequent use. Those skilled in the art will understand that reconditioning a device can use a variety of techniques to disassemble, clean / replace and reassemble. The use of these techniques, as well as the resulting refurbished device, are all within the scope of this application.
[0108] [0108] The devices described here can be processed before surgery. First, a new or used instrument can be obtained and, if necessary, cleaned. The instrument can then be sterilized. In a sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and the instrument can then be placed in a radiation field that can penetrate the container, such as gamma radiation, X-rays and / or high-energy electrons. Radiation can kill bacteria on the instrument and the container. The sterile instrument can then be stored in a sterile container. The sealed container can keep the instrument sterile until it is opened at the medical facility. A device can also be sterilized using any other known technique, including, but not limited to, beta radiation, gamma radiation, ethylene oxide, plasma peroxide and / or water vapor.
[0109] [0109] Although this invention has been described as having exemplary designs, the present invention can be further modified within the spirit and scope of the disclosure.
It is intended, therefore, that this application covers any variations, uses or adaptations of the invention with the use of its general principles.

权利要求:
Claims (20)
[1]
1. Adapter for use with an electromechanical surgical instrument, characterized in that the adapter comprises: a surgical end actuator comprising: an anvil; a cartridge assembly operatively coupled to said anvil so that said anvil and the cartridge assembly are movable with respect to each other between the open and closed positions, said cartridge assembly operationally storing a plurality of fasteners therein; and an axially moving dynamic gripping set selectively within said surgical end actuator through a firing stroke, when said dynamic gripping set is moved from an initial position in a distal axial direction through a proximal portion of said firing stroke, said dynamic gripping assembly moves said anvil and cartridge assembly from a completely open to a closed position, and when said dynamic gripping assembly is distally advanced through an intermediate portion of the said firing stroke, said dynamic gripping set causes at least a majority of said grips stored in said cartridge assembly to be ejected from it, and when said dynamic gripping set is distally advanced through a distal portion of the said firing stroke, said dynamic gripping set causes any of said remaining fasteners stored in said c the cartridge assembly are ejected from it and wherein said adapter further comprises: means for determining when said dynamic gripping assembly is axially located in said intermediate portion of said firing stroke and communicating a signal indicative of said location of said assembly of dynamic grip on the electromechanical surgical instrument.
[2]
2. Adapter according to claim 1, characterized in that said means for determining are configured to determine when said dynamic gripping set is axially located at a midpoint of said intermediate portion of said firing stroke and communicating another said signal to said electromechanical surgical instrument indicative of said location of the midpoint.
[3]
3. Adapter, according to claim 1, characterized in that it also comprises a trigger drive system, which comprises: a rotary drive shaft configured to make an operational interface with a source of rotary drive movements in the electromechanical surgical instrument; and an axially movable firing member which interfaces operationally with said rotary drive axis and is configured to axially move said dynamic gripping assembly through said actuation stroke in response to the rotation of said rotary drive axis.
[4]
4. Adapter, according to claim 3, characterized in that said signal communicated to the electromechanical surgical instrument is used to control the origin of the rotating drive movements in the electromechanical surgical instrument.
[5]
5. Adapter, according to claim 3, characterized in that said axially movable firing member is moved through an actuation stroke in response to an application of said rotating movements to it, said actuation stroke comprising: a portion of the proximal actuation stroke that corresponds to said proximal portion of said firing stroke;
a portion of the intermediate actuation stroke that corresponds to said intermediate portion of said firing stroke; and a portion of the distal actuation stroke that corresponds to said distal portion of said firing stroke and wherein said means for determining when said dynamic gripping set is axially located in said intermediate portion of said firing stroke comprises means for determining when said axially mobile firing member is axially located in said portion of the intermediate actuation stroke and communicating a signal indicative of said location of said axially mobile firing member to the electromechanical surgical instrument.
[6]
Adapter according to claim 5, characterized in that said means for determining when said axially movable firing member is axially located in said portion of the intermediate actuation stroke comprise: a sensor positioned adjacent to a portion of said member of axially movable firing on said adapter; and an actuator sensor that movably interfaces with said portion of said axially movable firing member and is configured to be detected by said sensor only when said axially movable firing member is in said portion of the intermediate actuation stroke.
[7]
7. Adapter according to claim 6, characterized in that said actuator sensor is provided for detection alignment with said sensor when said axially movable firing member is located within said portion of the intermediate actuation stroke.
[8]
Adapter according to claim 7, characterized in that said actuator sensor is supported on a sensor coupling arm which is movably supported on said portion of said axially movable firing member, so that when said axially movable firing member is in said portion of the proximal actuating stroke or said portion of the distal actuating stroke, said portion of said axially movable firing member causes said sensor coupling arm to move said sensor actuator to out of said detection alignment with said sensor.
[9]
9. Adapter according to claim 6, characterized in that said adapter further comprises: an adapter housing assembly that is configured to be operationally coupled to the electromechanical surgical instrument; and an outer tube assembly that defines a longitudinal geometric axis between a proximal end and a distal end thereof, said proximal end being operationally coupled to said adapter housing assembly, said external tube assembly supporting operationally said axially movable firing member therein and said outer tube assembly operationally supporting said sensor adjacent to said portion of said axially movable firing member.
[10]
10. Adapter according to claim 6, characterized in that said sensor comprises a Hall effect sensor and wherein said actuator sensor comprises a magnet.
[11]
An adapter according to claim 8, characterized in that said sensor coupling arm comprises a first engagement portion which is received slidably within an axial slot in said portion of said axially movable firing member and a second portion which operationally supports said actuator sensor in it.
[12]
12. Adapter for use with an electromechanical surgical instrument, characterized in that said adapter comprises: a set of adapter housing that is configured to be operationally coupled to the electromechanical surgical instrument; a drive shaft assembly defining a longitudinal geometric axis between a proximal end and a distal end thereof, said proximal end being operatively coupled to said adapter housing assembly; a surgical load unit operatively coupled to said distal end of said drive shaft assembly for selective articulation in relation to said drive shaft assembly, said surgical loading unit comprising: an anvil; a cartridge assembly operatively coupled to said anvil so that said anvil and the cartridge assembly are movable with respect to each other between the open and closed positions, said cartridge assembly operationally storing a plurality of fasteners therein; and an axially moving dynamic gripping set selectively within said surgical end actuator through a firing stroke, when said dynamic gripping set is moved from an initial position in a distal axial direction through a proximal portion of said firing stroke, said dynamic gripping assembly moves said anvil and cartridge assembly from a completely open to a closed position, and when said dynamic gripping assembly is distally advanced through an intermediate portion of the said firing stroke, said dynamic gripping set causes at least a majority of said grips stored in said cartridge assembly to be ejected from it, and when said dynamic gripping set is distally advanced through a distal portion of the said firing stroke, said dynamic gripping set causes any of said remaining fasteners stored in said c the cartridge assembly are ejected from it and the said adapter also comprises: a firing system comprising: a rotary drive shaft configured to interface with an origin of rotary drive movements in the electromechanical surgical instrument; and an axially movable firing member which interfaces operationally with said dynamic gripping set and configured to move said dynamic gripping set axially through an actuation stroke corresponding to said firing stroke; and means for determining when said dynamic gripping set is axially located in said intermediate portion of said firing stroke and communicating a signal indicative of said location of said dynamic gripping set to the electromechanical surgical instrument to control the origin of the rotating drive movements .
[13]
13. Adapter according to claim 12, characterized in that said means for determining are configured to determine when said dynamic gripping set is axially located at a midpoint of said intermediate portion of said firing stroke and communicating another said signal to said electromechanical surgical instrument indicative of said location of the midpoint.
[14]
14. Adapter according to claim 12, characterized in that said actuation course comprises: a portion of the proximal actuation course that corresponds to said proximal portion of said firing course; a portion of the intermediate actuation stroke that corresponds to said intermediate portion of said firing stroke; and a portion of the distal actuation stroke that corresponds to said distal portion of said firing stroke and wherein said means for determining when said dynamic gripping set is axially located in said intermediate portion of said firing stroke comprises means for determining when said axially mobile firing member is axially located in said portion of the intermediate actuation stroke and communicating a signal indicative of said location of said axially mobile firing member to the electromechanical surgical instrument.
[15]
Adapter according to claim 14, characterized in that said means for determining when said axially movable firing member is axially located in said portion of the intermediate actuation stroke comprise: a sensor positioned adjacent to a portion of said member of axially movable firing on said adapter; and an actuator sensor that movably interfaces with said portion of said axially movable firing member and is configured to be detected by said sensor only when said axially movable firing member is in said portion of the intermediate actuation stroke.
[16]
16. Adapter according to claim 15, characterized in that said actuator sensor is supported on a sensor coupling arm that is movably supported on said portion of said axially movable firing member, so that when said axially movable firing member is in said portion of the proximal actuating stroke or said portion of the distal actuating stroke, said portion of said axially movable firing member causes said sensor coupling arm to move said sensor actuator to out of said detection alignment with the sensor.
[17]
An adapter according to claim 16, characterized in that said drive shaft assembly comprises an external tube assembly that defines a longitudinal geometric axis between a proximal end and a distal end thereof, said proximal end being operatively coupled said adapter housing assembly, said external tube assembly operably supporting said axially movable firing member therein and said external tube assembly operatively supporting said sensor adjacent to said portion of said member axially mobile firing.
[18]
18. Adapter according to claim 15, characterized in that said sensor comprises a Hall effect sensor and wherein said actuator sensor comprises a magnet.
[19]
19. Adapter according to claim 16, characterized in that said sensor coupling arm comprises a first engagement portion which is received slidably within an axial slot in said portion of said axially movable firing member and a second portion which operationally supports said actuator sensor in it.
[20]
20. Adapter for use with an electromechanical surgical instrument, characterized in that said adapter comprises: a surgical end actuator comprising: a first claw; a second jaw operatively coupled to said first jaw so that the first and second jaws are movable with respect to each other between the open and closed positions; and an axially movable dynamic gripping assembly selectively within said surgical end actuator across an axial stroke distance, wherein when said dynamic gripping assembly passes axially through an initial portion of said axial stroke distance, said dynamic grip set moves said first and second grips from a completely open position to a closed position, and when said dynamic grip set passes axially through an intermediate portion of said axial travel distance, said dynamic grip set applies at least one actuation movement in at least one of said first and second grips, and when said dynamic gripping set passes axially through a distal portion of said axial travel distance, said dynamic gripping set applies another actuation movement in at least one of said first and second claws, and in which said adapter also comprises: means for determining when said dynamic grip set is axially located in said intermediate portion of said axial travel distance and communicating a signal indicative of said location of said dynamic grip set to the electromechanical surgical instrument.

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同族专利:

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公开号 | 公开日

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EP3498185A1|2019-06-19|

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CN111465358A|2020-07-28|

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WO2019116318A1|2019-06-20|

---

US10687813B2|2020-06-23|

---

US20190183495A1|2019-06-20|

---

JP2021506393A|2021-02-22|

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法律状态:
2021-12-07| 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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US15/843,514|2017-12-15|

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US15/843,514|US10687813B2|2017-12-15|2017-12-15|Adapters with firing stroke sensing arrangements for use in connection with electromechanical surgical instruments|

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PCT/IB2018/060057|WO2019116318A1|2017-12-15|2018-12-13|Adapters with firing stroke sensing arrangements for use in connection with electromechanical surgical instruments|

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