surgical end actuators with gripping sets configured to increase claw opening ranges

专利摘要:
The present invention relates to an end actuator for use with a surgical instrument. The end actuator includes a first and a second gripper that are pivotally coupled to each other for pivoting displacement around a pivot axis between the open and closed positions by a dynamic gripping assembly that is selectively movable between an initial position and a final position in relation to the first and second claws. At least a portion of the dynamic gripping assembly extends proximally beyond the pivot axis when in the initial position to facilitate improved grab openings.
公开号:BR112020011799A2
申请号:R112020011799-4
申请日:2018-12-12
公开日:2020-11-17
发明作者:Frederick E. Shelton Iv；Jason L. Harris
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 a resource of the external wrap 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 articulation set 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 system of the electro-mechanical surgical instrument 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 load 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 display arrangements within it;
[0019] [0019] Figure 17 is a cross-sectional view of the end 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 perspective view of a portion of another adapter load unit with its claws in an open position;
[0025] [0025] Figure 23 is a side elevation view of the load unit of Figure 22;
[0026] [0026] Figure 24 is a perspective view of the loading unit of Figure 23 after the dynamic gripping assembly was initially placed in positive contact with the positive channel opening features in a channel of the dynamic loading unit;
[0027] [0027] Figure 25 is a side elevation view of the load unit of Figure 24;
[0028] [0028] Figure 26 is another side elevation view of the loading unit of Figures 22 to 25 with its claws in a completely open position;
[0029] [0029] Figure 27 is a side elevation view of a portion of another adapter load unit with its claws in a fully open position;
[0030] [0030] Figure 28 is another side elevation view of the load unit in Figure 27 with its claws in a partially open position;
[0031] [0031] Figure 29 is another side elevation view of the loading unit of Figures 27 and 28 with its claws in a completely open position;
[0032] [0032] Figure 30 is a side elevation view of a portion of another adapter load unit with its claws in a fully open position;
[0033] [0033] Figure 31 is another side elevation view of the load unit in Figure 30 with its claws in a partially closed position;
[0034] [0034] Figure 32 is another side elevation view of the loading unit of Figures 30 and 31 with its claws in a closed position before the start of a firing stroke;
[0035] [0035] Figure 33 is a side elevation view of a portion of another adapter load unit with its claws in a fully open position; and
[0036] [0036] Figure 34 is a side elevation view of a portion of another adapter load unit with its claws in a fully open position;
[0037] [0037] 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
[0038] [0038] 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 n Serial No. US 15 / 843,485, entitled SEALED
[0039] [0039] Numerous specific details are presented to provide a complete understanding of the structure, function, manufacture and general use of the modalities described in the specification and illustrated in the attached drawings. Well-known operations, components and elements have not been described in detail, so as not to obscure the modalities described in the specification. The reader will understand that the modalities described and illustrated in the present invention are non-limiting examples and, therefore, it can be understood that the specific structural and functional details disclosed in the present invention can be representative and illustrative. Variations and changes can be made to this, without departing from the scope of the claims.
[0040] [0040] 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 device that "comprises", "has", "includes" or "contains" one or more resources has those one or more resources, but is not limited to possess only those one or more resources.
[0041] [0041] The terms "proximal" and "distal" are used in the present invention with reference to a physician who handles the handle portion of a 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 drawings. However, surgical instruments can be used in many orientations and positions, and these terms are not intended to be limiting and / or absolute.
[0042] [0042] Several exemplary devices and methods are provided for performing laparoscopic and minimally invasive surgical procedures. However, the reader will readily understand that the various methods and devices disclosed in the present invention can be used in numerous surgical procedures and applications, including, for example, in relation to open surgical procedures. With the advancement of this Detailed Description, the reader will also understand that the various instruments disclosed here can be inserted into a body in any way, such as through a natural orifice, through an incision or perforation formed in fabric, etc. Functional portions or portions of the instrument's end actuator can be inserted directly into a patient's body or can be inserted via an access device that has a working channel through which the end actuator and shaft long drive of a surgical instrument can be advanced.
[0043] [0043] 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 gripper; however, other modalities are provided for in which a staple cartridge is not removable, or at least promptly 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 in relation to the first claw around a geometric axis of the cover; however, other modalities are foreseen in which the first claw is pivoting in relation to the second claw. The surgical stapling system additionally comprises an articulation joint configured to allow the end actuator to be rotated or articulated in relation to the drive shaft. The end actuator is rotatable about a geometric pivot axis that extends through the pivot joint. Other modalities are foreseen that do not include an articulation joint.
[0044] [0044] 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 hold the fabric against the platform. After that, the staples removably stored in the cartridge body can be implanted in the fabric. The cartridge body includes staple cavities defined therein, the staples are removably stored in the staple cavities. The staple cavities are arranged in six longitudinal rows. Three rows of staple cavities are positioned on a first side of a longitudinal slot and three rows of staple cavities are positioned on a second side of the longitudinal slot. Other staple cavity and staple arrangements may be possible.
[0045] [0045] 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 actuators 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. The slide is movable between a proximal position adjacent to the proximal end and a distal position adjacent to the distal end. The slide comprises a plurality of inclined surfaces configured to slide under the actuators and lift the actuators, and the staples supported on it, towards the anvil.
[0046] [0046] In addition to the above, the slider is moved distally by a firing member. The firing member is configured to contact the slide and push the slide towards the distal end. The longitudinal slot defined in the cartridge body is configured to receive the firing member. The anvil also includes a slot configured to receive the firing member. The firing member also comprises a first cam that engages with the first claw and a second cam that engages with the second claw. As the firing member is advanced distally, the first cam and the second cam can control the distance, or fabric 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 that the knife is positioned at least partially proximal to the inclined surfaces, so that the staples are ejected in front of the knife.
[0047] [0047] 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 to selectively fix it to a plurality of different surgical instrument implements (here called "adapters" ) which are each configured for actuation 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 comprising a single-use load unit (from the English "single use loading unit" ("SULU")) or a disposable load unit (from the English "disposable loading unit" ("DLU") or a multiple use load unit (from the English "multiple use loading unit" "MULU"). In another modality of the surgical system, several forms of the adapter 200 can also be used effectively with a tool drive set of a robotically controlled or automated surgical system. surgical here disclosed can be used with various robotic systems, instruments, components and methods such as those disclosed in US Patent No. 9,072,535, but not limited to them, entitled "SURGICAL STAPLING INSTRUMENTS WITH ROTA TABLE STAPLE DE- PLOYMENT ARRANGEMENTS ", which is incorporated herein by reference, in its entirety.
[0048] [0048] As shown in Figures 1 and 2, the surgical instrument 100 includes a battery 101 and an outer wrapper wrap 10 which is configured to selectively receive and substantially terminate the battery 101. The battery 101 can also be called here a set of handle 101. One form of surgical instrument 100, for example, is disclosed in international publication No. WO 2016/057225
[0049] [0049] 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 envelope portion 12a, 12b and a respective lower envelope 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 casing 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.
[0050] [0050] 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 the adapter 200 relative to the surgical instrument 100 when the adapter 200 is coupled to the surgical instrument 100. The connecting portion 20 of the half distal section 10a defines three openings 22a, 22b, 22c that are formed on a surface of it facing the distal position and that are arranged on a plane or common line with respect to each other. The connecting portion 20 of the distal half section 10a also defines an elongated slit 24 also formed on the surface thereof facing the distal position. The connecting portion 20 of the distal half-section 10a further defines a female connecting feature 26 (see Figure 2) formed on a surface thereof. The female connection feature 26 selectively engages a male connection feature of adapter 200.
[0051] [0051] 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 downwards by applying a corresponding force or a depressive force to it. The distal half section 10a of the wrapper housing 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.
[0052] [0052] 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 arranged 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 rotates to support three coupling drive axes 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 of the cavity of the casing 10c of the casing of the casing 10. The plate assembly 60 additionally includes an electrical passage connector 66 supported on plate 62. The passage connector 66 extends from the opposite sides of plate 62. The passage connector 66 defines a plurality of contact paths, each of which includes an electrical conduit for extending an electrical connection across plate 62. When plate assembly 60 is disposed within envelope cavity 10c of envelope 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 housing of envelope 10, and are configured to engage electrically and / or mechanically to the corresponding corresponding features of adapter 200.
[0053] [0053] 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 it in 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.
[0054] [0054] The half distal section 110a of the inner handle casing 110 supports a distal toggle control interface 130 that is in operational alignment with the distal toggle control button 30 of the casing 10. In use, when the battery 101 is disposed within the casing of the 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 interfaces (not shown) and one 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 handle.
[0055] [0055] With reference to Figures 1 to 5, the internal locking 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 plate controller circuit board 142 and a rechargeable battery 144 configured to supply power to any electrical components of the surgical instrument 100. Controller circuit board 142 includes motor controller circuit board 142a, controller circuit board main 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 additionally 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 further provided that the wrapper casing may include a window formed therein (in visual alignment with the display screen 146 and with the window 110d of the half proximal section 110b of the inner casing of the grip 110 and / or the casing of the wrapper 10 can be manufactured from a transparent rigid plastic or similar.
[0056] [0056] The battery core assembly 106 additionally includes a first motor 152, a second motor 154 and a third motor 156 which are supported by an engine mount 148 and are each electrically connected to the circuit board of 142 controller and battery
[0057] [0057] 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 dimensioned to accommodate the components of the adapter set 200. The external tube 206 is dimensioned for endoscopic insertion, in particular, so that the external tube can pass through a typical trocar port, cannula or similar. The housing of the button 202 is sized to not enter the trocar port, cannula or the like. The button 202 casing is configured and adapted to connect to the connection portion 20 of the outer casing casing 10 of the surgical instrument 100.
[0058] [0058] Adapter 200 is configured to convert a rotation of the first or second coupling drive axes 64a, 64b of 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 that pivotally supports a first pivotal proximal drive shaft
[0059] [0059] The drive coupling set 210 of adapter 200 also includes a first, a second and a third bias member 224, 226, 228 disposed distally from the respective first, second and third sleeves of connector 218, 220 and 222. Each member of propensity 224, 226 and 228 is arranged around the respective first, second and third rotating proximal drive axes 212, 214 and 216. Propensity members 224, 226 and 228 act on the respective gloves of connector 218, 222 and 220 to help keep the gloves of connector 218, 222 and 220 attached to the distal end of the respective coupling drive axes 64a, 64b and 64c of surgical instrument 100 when adapter 200 is connected to surgical instrument 100 .
[0060] [0060] Also in the illustrated arrangement, adapter 200 includes the first, second and third drive conversion assemblies 240, 250, 260, respectively, which are each arranged in the inner housing 204 and tube assembly external 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 axes 64a, 64b and 64c of surgical instrument 100 into axial translation of an actuator or pivot bar 258 of the adapter 200, to effect the articulation of the end actuator 500; rotating an annular gear 266 of adapter 200 to rotate adapter 200; or axial translation of a distal drive member 248 of adapter 200 to effect the closing, opening and firing of the end actuator
[0061] [0061] Still with reference to Figure 6, the first transmission / force conversion / rotation set 240 includes the first rotary proximal drive shaft 212 which, as described above, is rotatorily supported within the internal housing set 204. The first rotating proximal drive shaft 212 includes a non-circular or shaped end portion configured to connect with the first sleeve of connector 218 that is connected to the respective first coupling drive shaft 64a of the surgical instrument 100 The first rotating proximal drive shaft 212 includes a threaded distal end portion 212b. The first transmission / force conversion / rotation assembly 240 additionally includes a drive coupling nut 244 that threadably engages with the threaded distal end portion 212b of the first rotating proximal drive shaft 212 and which is arranged slidingly inside the outer tube 206. The drive coupling nut 244 is slidably keyed within the proximal core tube portion of the outer tube 206 so that it is prevented from turning according to the first rotating proximal drive axis 212 is rotated. In this way, 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.
[0062] [0062] The first transmission / power conversion / rotation assembly 240 additionally includes a distal drive member 248 that is mechanically engaged with the drive coupling nut 244, so that the axial movement of the coupling nut drive 244 results in a corresponding amount of axial movement of the distal drive member 248. The distal end portion of the distal drive member 248 supports a connecting member 247 configured and sized for selective engagement with a hitch member 546 of a drive assembly 540 of end actuator 500 (Figure 10). Coupling nut 244 and / or distal drive member 248 functions as a force transmission member for the end actuator components
[0063] [0063] Still referring to Figure 6, the second drive conversion set 250 of the adapter 200 includes a second proximal drive shaft 214 that is pivotally supported within the inner housing assembly 204. The second drive shaft provides rotating ximal 214 includes a non-circular or shaped end portion configured to connect to the second coupling drive axis 64c of the surgical instrument 100. The second rotating proximal drive axis 214 additionally includes a configured distal threaded end portion 214a for screwing a hinge bearing housing 253 out of a hinge bearing assembly 252. Referring to Figures 6 to 9, the hinge bearing housing 253 supports a hinge bearing 255 provided with a raceway inner 257 which is rotatable independently of an outer race 259. The housings 252 has a profile external non-circular, for example, teardrop shaped, which is arranged in a sliding and non-rotating way inside a complementary hole (not shown) of the hub of the inner housing 204a. The second drive conversion set 250 of the adapter 200 additionally includes a pivot bar 258 provided with a proximal portion which is attached to the inner race 257 of the pivot bearing 255. A distal portion of the pivot bar 258 it includes a slot 258a, which is configured to receive a hook 562 of the pivot link 560 (Figure 10) of the end actuator 500. The pivot bar 258 functions as a force transmitting member for the components of the ex-actuator tremidade 500. In the arrangement illustrated and as further discussed in WO 2016/057225 A1, the hinge bearing assembly 252 is both rotatable and longitudinally translatable and is configured to allow free and unimpeded rotary movement of the end actuator 500 when its first and second claw members 610, 700 are in an approximate position and / or when claw members 610, 700 are articulated.
[0064] [0064] 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 by in turn, causes the articulation bar 258 to be axially translated in relation to the outer tube 206. As the articulation bar 258 is translated axially, the articulation bar 258 being coupled to the articulation link 258 of the end actuator 500, does with which the axial translation of the articulation link 560 of the end actuator 500 makes an articulation of the tool set 600. The articulation bar 258 is attached to the inner race 257 of the articulation bearing 253 and is thus free to rotate around of the longitudinal geometric axis in relation to the outer race 259 of the hinge bearing 253.
[0065] [0065] As shown in Figure 6, the adapter includes a third drive conversion set 260 that is supported on the inner housing assembly 204. The third drive conversion set 260 includes an annular rotation gear 266 which is fixedly attached to the external housing of button 202 and connected to it. The 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 additionally 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 portion non-circular or shaped end that is configured to connect 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 sprocket 216a from the third rotary proximal drive shaft 216 to 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 from the third coupling drive shaft 64b of the surgical instrument 100, the sprocket 216a from 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 the button 202 causes the outer tube 206 to rotate around the longitudinal geometric axis of the adapter 200. As the outer tube 206 is rotated, the end actuator 500 that is connected to a portion of distal end of adapter 200, is also rotated about a longitudinal geometric axis of adapter 200.
[0066] [0066] Adapter 200 additionally 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 / separating button 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 flange or protrusion that is configured to fit by pressing behind a corresponding flange or protrusion 20 of surgical instrument 100. As also discussed in WO 2016/057225 A1, adapter 200 can additionally include a locking mechanism 280 for fixing the axial position of the distal drive member 248. As can be seen in Figure 21, for example, locking mechanism 280 includes a button 282 that is slidably supported on the outer casing of the button 202. The lock button 282 is connected to an actuation bar (not shown) that extends longitudinally through the outer tube 206. The actuation bar moves with a movement of the lock button 282. In operation, to lock the position and / or orientation of the distal actuating member 248, a user moves the lock button 282 from a distal position to a proximal position, thereby causing the lock (not shown) to move to the proximal position so that a distal face of the lock comes out of contact with the cam actuation member 288, rotate into the recess 249 of the distal actuation member 248. In this way, the distal actuation member 248 is prevented from moving distal and / or proximal. When the lock button 282 is moved from the proximal position to the distal position, the distal end of the actuation bar moves distally into the lock (not shown), against the propensity of a propensity member (not shown) ), to force the cam actuation member 28 out of the recess 249, thus enabling unimpeded axial translation and radial movement of the distal drive member 248.
[0067] [0067] 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 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 pass connector of the wrapper plate assembly 10 of the surgical instrument 100. The electrical assembly 290 enables calibration and communication information (ie information information about the life cycle, system information, force 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. The electrical assembly 290 additionally includes a strain gauge 296 that is electrically connected to the circuit board 294. The strain gauge 296 is mounted inside the housing assembly internal cro 204 to restrict the rotation of the effort meter 296 with respect to it. The rotary proximal drive axis 212 extends through the effort meter 296 to enable the effort meter 296 to provide closed loop feedback for a trigger / hold load shown by the first rotary proximal drive axis 212. The assembly electrical 290 also includes a slip ring 298 which is slidably and non-rotatively disposed along the drive coupling nut 244 of outer tube 206. slip ring 298 is electrically connected to circuit board 294 and serves to enable the rotation of 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, enabling at the same time that the other electrical components rotate around the first rotating proximal drive shaft 212 and the drive coupling 244.
[0068] [0068] Still with reference to Figure 6, the enclosure set included
[0069] [0069] Returning 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 revealed in the Order Publication US Patent Application No. 2010/0301097, entitled LOA-DING 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 Application Publication 2015/0374371, entitled ADAPTER ASSEMBLIES FOR INTERCONNECTING SURGICAL LOADING UNITS AND HANDLE AS-SEMBLIES, whose disclosures of each of these references, in their entirety, are incorporated here for reference. It is also envisaged that the end actuator 500 can be configured for multiple uses (MULU) such as those end actuators disclosed in US Patent Application Publication 2017/0095250, entitled MULTI-USE LOADING UNIT, whose disclosures of each of these references, in their entirety, are incorporated here by way of reference.
[0070] [0070] The surgical instrument 100 fires clips, 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 held 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.
[0071] [0071] 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 clamp retaining slots 706, which are configured as openings in a contact surface with the fabric 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 longitudinally through them. The cartridge assembly 701 is removable from channel 720 after the clips have been fired from cartridge body 702. Another removable cartridge assembly is capable of being loaded into channel 720, so that surgical instrument 100 can be actuated more once to fire additional fasteners or clips. More details on 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.
[0072] [0072] The cartridge set 701 is pivoting in relation to the anvil set 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 link link 560. In one arrangement, the drive assembly 540 includes a flexible drive bar 542 that has a distal end 544 and a proximal engagement section. 546. A proximal end of engagement 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. O drive member 548 defines a proximal orifice that receives a connecting member 247 from drive tube 246 of the first drive conversion set 240 of adapter 200 when end actuator 500 is attached to the distal end of the adapter
[0073] [0073] The end actuator 500 additionally includes a housing assembly 530 comprising an outer housing 532 and an inner housing 534 which is arranged within the outer housing 532.
[0074] [0074] Referring to Figure 10, for example, anvil set 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
[0075] [0075] Tool set 600 includes a mounting set 800 comprising an upper mounting portion 810 and a lower mounting portion 812. A mounting tail 632 projects proximally from a proximal end 631 of the cover. anvil 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 upper mounting portion 810 also extends through an opening 634 in the mounting tail 632. The coupling members 820 each include a proximal interlocking portion 824 that is configured to be received in corresponding grooves formed in distal ends of the outer shell 532 and the inner shell 534. The proximal structural part 520 of the end actuator 500 includes a pivot link 560 that has one end proximal hook-shaped 562. The hinge link 560 is dimensioned to be slidably positioned inside a slot in the inner casing. A pair of H 830 block assemblies are located 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 drive bar 542 during articulation and firing of the surgical stapling apparatus 10. Each H-830 block assembly includes a flexible body 832 that includes a proximal end fixedly attached to the distal end of the outer casing 532 and a distal end that is attached fixedly to the mounting set 800. In one arrangement, a distal end 564 of the pivot link is pivotally attached to the right H-block set 830. Axial movement of the pivot link 560 will cause the tool set articulate in relation to structural part 520.
[0076] [0076] 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 that has a proximal end portion 910 that has a first "FD" diameter and that is mounted inside the outer shell of button 202. A proximal end portion 910 can be coupled to the inner casing 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 distal end 914, as can be seen in Figure 11. As can be seen in Figures 10 and 11, an outer sleeve 570 of the proximal structural part 520 of 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 greater 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 components and adapter joint 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.
[0077] [0077] 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 guide 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 coupling feature 556 is formed on one end
[0078] [0078] 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 grip set dynamic 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 gripper assembly 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 tissue.
[0079] [0079] 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, here called an undisturbed position stopped or initial. In particular, the coupling area 730 is partially defined by flat coupling surfaces 732 that provide a gap between the channel engagement tabs 559 in the dynamic gripping assembly 550 to enable the cartridge assembly 701 to rotate to a completely open position.
[0080] [0080] 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 housing assembly, which can cause a short circuit and failure of the electrical components supported inside. In addition, due to limited access to the inside of the adapter's outer tube, such debris and fluids are difficult to remove, which can prevent or reduce the adapter's ability to reuse.
[0081] [0081] 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 fluid / debris from infiltrating into and proximal to the proximal inner liner assembly 204. In addition, at least one 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 set of proximal inner liner 204. At least a third liner seal 233 can be provided around a hub 205 of proximal inner liner 204 to establish a seal between hub 205 and the outer liner of button 202. The first, second and second third seals 230, 232, 233 may comprise, for example, sealing rings made from rubber or other suitable material.
[0082] [0082] In other embodiments, it may be desirable that the first and second seals 230, 232 are located on adapter 200 directly in relation to the electronic components housed within the outer housing of button 202. For example, to prevent it from flowing - debris / debris obstructs / short-circuits the sliding ring assembly 298, it is desirable to establish seals between the various mobile components of adapter 200 that are operationally supported within the outer tube 206 at a location or locations that they are each distal to the sliding ring assembly 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 / pad / housing supported inside the external tube 206 and configured to facilitate the axial movement of the drive member distal 248, as well as the hinge bar 258 while establishing a fluid-tight seal between the cushion and / or outer tube and the distal drive member 248 and the hinge bar 258. See Figures 18 and 20. On As illustrated in Figure 19, for example, the first seal 230 may additionally have cleaning features 231 that also slidably engage the distal drive member 248 to prevent fluids / debris from infiltrating in the proximal direction PD into the inner casing assembly proximal 204. In at least one arrangement to allow the collection of debris and fluids in the outer tube 206 distal to the first and second seals 230, 232, at least two discharge ports 236, 238 are healthy the supplied inside the outer tube
[0083] [0083] The ability to open the claws of a cutter at a wide angle allows more tissue to be placed between them. In addition, the ability to open the jaws at a greater angle also makes it easier for the user to remove the fabric from between the jaws after the stapling process has been completed which helps to simplify the cartridge refill process when refillable units are used. - used. Thus, it is desirable to optimize the speeds and forces necessary to open the claws of an end actuator such as an end cutter. In the past, a variety of methods have been employed to open the claws of an end cutter. In one arrangement, a spring was used to apply a prong opening force to the claws. However, these spring opening arrangements can increase the amount of forces required to close the jaws. They can also have relatively limited movement and can be difficult to install inside the end actuator.
[0084] [0084] Figures 22 to 25 illustrate the use of an alternative channel 720 'of a second claw. Channel 720 'may be identical to channel 720 described above, except for the differences noted below. In the illustrated arrangement, for example, channel 720 'includes a positive channel opening feature 740 comprising a ramp surface 742 which is located on each side of a central slot 724 in channel 720'. Each ramp 742 ends on a flat top surface 744. As can be seen further in Figure 22, a channel protrusion 725 is formed on each side of the elongated central slot 724 on the upper side of channel 720 '. During the firing operation, the structural part 552 of the dynamic gripping assembly 550 extends through the central slot 724 and the channel latches 559 engage slidingly with the projections of the channel 725 extending along each side of the central slot 724 to hold the cartridge assembly 701 over the target tissue.
[0085] [0085] Figures 22 and 23 illustrate a position of the dynamic pressure set 550 as it is retracted in the proximal direction PD. As can be seen in these Figures, the channel hitch tabs 559 have not yet come in contact with the ramps 742 of the positive channel opening features 740. Figures 24 and 25 illustrate the initial contact of the channel hitch tabs. channel 559 with the ramp portions 742 of the corresponding positive channel opening features 740. As can be seen in Figure 25, channel 720 'started to open (that is, move away from anvil set 612). Figure 26 illustrates the position of the dynamic gripping assembly 550 in its initial position, in which the channel 720 'is in its fully open position. As can be seen in that Figure, for example, the channel hitch tabs 559 are engaged with the flat top surfaces 744 of the ramps 742. Such an arrangement can be used to open the claws (anvil set 612 and cartridge set 701) without using a spring or springs. However, other variations are foreseen, in which an opening spring is also used in addition to the positive channel opening features 740.
[0086] [0086] Figures 27 to 29 illustrate an alternative arrangement in which, in addition to the positive channel opening features 740 on channel 720 ', positive channel opening features 627 are provided at a proximal end 621 of the anvil plate 620 '. The anvil plate 620 'may be identical to the anvil plate 620 described above, except for the differences noted below. The positive anvil opening features 627 each comprise an anvil opening ramp 628 provided on each side of the elongated slot 622 (see Figure 10). As discussed above, the anvil plate has an elongated slot 622 that defines two elongated protrusions 624 over which the anvil engagement tabs 557 of the dynamic gripping assembly 550 move. The positive channel opening features 740 in the channel
[0087] [0087] Another resource used by a 720 ”channel refers to closing branches formed on channel 720”. Channel 720 ”can be identical to channel 720 'or 720 described above, except for the differences noted below. As can be seen in Figures 30 to 32, for example, a first segment on the closing ramp 726a is formed on each side of the elongated slot (not shown) in channel 720 ”. Each first segment on the ramp 726a transitions to a segment on the ramp of the horizontal plateau 727 which, in turn, transitions to a second segment on the ramp 728. Each second segment on the ramp 728 makes the transition to a corresponding protrusion of channel 725. In one arrangement, the slope of each of the first segments on the ramp 726a is equal to the slope of the second segments on the ramp 728. In other arrangements, the slope coefficients are different. Figure 30 illustrates the position of the channel hitch tabs 559 on the dynamic gripping assembly 550 when the jaws 610 ”, 700” are in their fully open position. Figure 31 illustrates a position of the dynamic gripping assembly 550 after it has been moved distally to bring the channel engagement tabs 559 into sliding engagement with the proximal closing ramp segments 726a in order to initiate the process of claw closure. Figure 32 illustrates another position of the dynamic gripping assembly 550 after it has moved further in the distal direction DD, so as to bring the channel engagement tabs 559 in sliding engagement with the plateau ramp segment 727 and before start a firing stroke in which the channel latches 559 slide into the channel projections 725 on channel 720 ”.
[0088] [0088] Another desirable attribute for surgical end actuators refers to "claw opening". "Claw opening" can refer to the angle between a staple forming surface on the anvil plate and a contact surface with the staple cartridge tissue. In existing versions of DLU, SULU and MULU, the upper channel hitch or tab on the dynamic gripping unit, when the dynamic gripping unit is in its closest or first position, is generally positioned directly above or distal to a claw pivot geometric axis around which the cartridge assembly rotates in relation to the anvil assembly. Such arrangements commonly limit the opening of the claws in relation to each other by more than 18 to 23 mm, for example.
[0089] [0089] One aspect of the present disclosure involves the formation of an "anchoring" or "parking" area for the dynamic grip member when the dynamic grip member is in its most proximal or initial position. For example, Figure 33 illustrates an end actuator 1500 that includes an anchoring or parking area 730 for dynamic grip set 550 when dynamic grip set 550 is in its most proximal or initial position. According to another aspect, as described above, the dynamic gripping assembly 550 includes a vertically extending structural part 552 that has an anvil hitch feature 556 that comprises an anvil hitch or flange 557 extending from each side side of structural part 552. In addition, the dynamic gripping assembly 550 includes a channel engaging feature 558 comprising a channel engaging flange or flange 559 extending laterally from each lateral side of structural part 552. As used in this context, the term "flange" denotes a flat feature that extends transversely or perpendicularly from structural part 552. Thus, when viewed from one end, the set of dynamic gripping 550 resembles a beam with an I-profile and can be called a dynamic gripping member with an I-profile here. As can be seen in Figure 33, a portion of the hitch flanges of channel 559 extends proximally to pin 638 which pivotally couples cartridge assembly 701 to anvil assembly 612 and which defines a claw pivot axis JA around which the anvil and channel can move between positions open and closed. In addition, although not visible in Figure 33, in at least one arrangement, a portion of each of the anvil hitch flanges 557 also extends proximal to the JA claw pivot axis when the gripping assembly beam-shaped dynamic with I 550 profile is in the parking or initial position. This distance is identified as "PDD4" distance in Figure 33, for example.
[0090] [0090] A lower end of structural part 552 of the I-beam beam dynamic gripping assembly 550 extends through an elongated slot (not shown) in channel 1720. A first bottom surface 1726 is formed at a proximal end - barely 1725 of channel 1720 on each side of the elongated slot. Each first bottom surface 1726 ends distally on a second cam surface or closing ramp 1727 that corresponds to each channel hitch flange 559 in the I-beam beam dynamic gripping assembly 550. When the channel hitch flanges 559 engage with its second corresponding closing cam surface 1727, the cartridge assembly and the anvil assembly 612 begin to close or revolve towards each other due to the interaction of the anvil engaging flanges with the corresponding surfaces on the anvil plate and the cam actuation action of the channel hitch tabs with the corresponding second closing cam surfaces 1727 in channel 1720. After the beam-gripping set with I 550 profile has moved distally to a point where the channel engagement flanges 559 disengage from the second closing cam surfaces 1727, the channel input flanges 550 engage at third the corresponding closing surfaces 1728 at the bottom of the channel 1720 to keep the anvil assembly and the cartridge assembly closed and to resist deflection throughout the firing process (that is, according to the beam-shaped dynamic gripping set with profile in I is distally advanced through cartridge assembly 701).
[0091] [0091] In the illustrated arrangement, when the beam-gripping set with I 550 profile is in the closest or first position, the 559 channel engaging flanges are proximal to the second closing cam surfaces 1727 even though they are in contact with the first lower surface 1727 to limit or otherwise restrict the claws (anvil set 612, cartridge set 701) in that amount of claw opening represented as angle Θ1 between a staple forming surface 625 on the anvil plate 620 and the tissue contact surface 708 of the cartridge body 702). In the illustrated arrangement, for example, the dynamic gripping assembly in the form of a beam with an I 550 profile may have to move distally X distance from the initial position until the 559 channel engaging flanges begin to engage by cam actuation with the second closing cam surfaces 1727 to initiate the jaw closure process. In that arrangement, the actuating slide 1712 has an SL length and the cartridge body 702 has a tip portion 718 that has an NL length that extends beyond the distal end of the channel 1720.
[0092] [0092] According to another general aspect, Figure 34 illustrates another end actuator 1500 'that includes a parking or anchoring area 730' for the dynamic gripping set 550 when the dynamic gripping set 550 is in its most proximal or initial position. A first lower surface 1726 'is formed at a proximal end 1725 of channel 1720' on each side of the elongated slot. Each first lower surface 1726 'ends distally on a second cam surface or closing ramp 1727' that corresponds to each channel hitch flange 559 in the I-beam beam dynamic gripping assembly 550. When the hitch flanges of channel 559 engage by cam actuation to its corresponding second closing cam surface 1727 ', the cartridge assembly 701 and the anvil assembly 612 begin to close or revolve towards each other due to the interaction of the flanges of anvil engagement 557 with the corresponding surfaces on the anvil plate 620 and of the cam actuation action of the channel engagement flanges 559 with the corresponding second closing cam surfaces 1727 'in the channel 1720'. After the I-beam beam dynamic pressure set 550 has moved distally to a point where the channel engagement flanges 559 disengage from the second closing cam surfaces 1727 ', the engagement cam flanges of channel 559 attaches to the corresponding third closing surfaces 1728 'at the bottom of channel 1720 to keep the anvil set and the cartridge set closed throughout the firing process (ie, according to the beam-shaped dynamic gripping set with I profile is distally advanced through cartridge assembly 701 'to its final position).
[0093] [0093] In the illustrated arrangement, when the dynamic gripping set in beam form with I 550 profile is in the most pro-
[0094] [0094] Example 1 - End actuator for use with a surgical instrument. In at least one example, the end actuator comprises a cartridge assembly that defines a longitudinal geometric axis that extends between a proximal end and a distal end thereof. The cartridge assembly has the first and second closing cam surfaces on it. An anvil assembly is pivotally coupled to the cartridge assembly around a pivot axis that is transverse to the longitudinal axis so that the cartridge assembly and the anvil assembly are movable relative to each other. another between a completely open position and a completely closed position. The end actuator additionally comprises a dynamic gripping set in the form of a beam with an I-profile that comprises a structural part that has at least one anvil engagement feature and at least one cartridge engagement feature that protrudes from it. The beam-shaped dynamic gripping set with an I-profile is selectively movable between an initial position that corresponds to the completely open position in which at least a portion of at least one cartridge engaging feature is proximal to the pivot axis and a final position in relation to the anvil assembly, so that when the dynamic beam-shaped assembly with I-profile is moved distally from the initial position, the at least one cartridge engagement feature interacts by cam actuation with the first closing cam surface to impart a closing movement to the cartridge assembly to move the cartridge assembly and anvil assembly to the fully closed position, and then engaging the second closing cam surface to retain the cartridge assembly in the fully closed position until the dynamic beam-shaped assembly with I-profile has been moved to the final position.
[0095] [0095] Example 2 - End actuator, according to Example 1, in which at least one cartridge engaging feature is in contact with the first closing cam surface when the beam-gripping dynamic assembly with I profile is in the starting position.
[0096] [0096] Example 3 - End actuator, according to Example 1 or 2, in which at least one cartridge engagement feature gives the cartridge assembly closing movement immediately by distal advancement of the gripping assembly beam-shaped dynamic with I-shaped profile from the starting position.
[0097] [0097] Example 4 - End actuator, according to Examples 1, 2 or 3, in which the first closing cam surface is inclined in relation to the second closing cam surface.
[0098] [0098] Example 5 - End actuator, according to Examples 1, 2, 3 or 4, wherein the at least one cartridge engaging feature comprises a flat flange that extends laterally from the structural part.
[0099] [0099] Example 6 - End actuator, according to Examples 1, 2, 3, 4 or 5, in which a portion of each cartridge engaging feature is not in engagement with the cartridge assembly when the gripping assembly I-beam dynamic beam is in the starting position.
[0100] [0100] Example 7 - Surgical instrument, according to Examples 1, 2, 3, 4, 5 or 6, in which the beam-shaped dynamic gripping set with I profile comprises a tissue cutting surface .
[0101] [0101] Example 8 - End actuator, according to Examples 1, 2, 3, 4, 5, 6 or 7, in which the cartridge assembly comprises a channel that is pivotally coupled to the bi-assembly - gorna and that defines the first and second closing cam surfaces. A surgical staple cartridge is operationally supported within the channel.
[0102] [0102] Example 9 - End actuator, according to Example 8, in which the first staple cartridge is removably attached to the channel.
[0103] [0103] Example 10 - Surgical load unit comprising a set of casings that have a set of tools operatively coupled to it. The tool set comprises a cartridge set that defines a longitudinal geometric axis that extends between a proximal end and a distal end thereof. The cartridge assembly has the first and second closing cam surfaces on it. An anvil assembly is pivotally coupled to the cartridge assembly around a pivot axis that is transverse to the longitudinal geometry axis such that the cartridge assembly and the anvil assembly are mobile relative to each other a completely open position and a completely closed position. The tool set additionally comprises a beam-shaped dynamic gripping set with an I-profile that comprises a structural part that has at least one anvil engaging feature and at least one cartridge engaging feature projecting from it. . The beam-shaped dynamic gripping set with I-profile is selectively movable between an initial position that corresponds to the fully open position in which at least a portion of the at least one cartridge engaging feature is proximal to the pivot axis and a final position in relation to the anvil assembly, so that when the dynamic beam-shaped assembly with I-profile is moved distally from the initial position, the at least one cartridge engagement feature interacts by cam actuation with the first closing cam surface to provide a closing movement to the cartridge assembly to move the cartridge assembly and the anvil assembly to the fully closed position and then engage the second mounting surface. closing cam to retain the cartridge assembly in the fully closed position until the dynamic beam-shaped assembly with I-profile has been moved to the final position.
[0104] [0104] Example 11 - Surgical loading unit, according to
[0105] [0105] Example 12 - Surgical loading unit, according to Example 10 or 11, in which at least one cartridge engaging feature is in contact with the first closing cam surface when the dynamic gripping assembly I-beam is in the starting position.
[0106] [0106] Example 13 - Surgical loading unit, according to Examples 10, 11 or 12, in which at least one cartridge latching feature provides the closing movement to the cartridge assembly immediately by distal advancement of the cartridge assembly dynamic beam-shaped gripping with I-shaped profile from the initial position.
[0107] [0107] Example 14 - Surgical loading unit, according to Examples 10, 11, 12 or 13, in which the first closing cam surface is inclined with respect to the second closing cam surface.
[0108] [0108] Example 15 - Surgical loading unit, according to Examples 10, 11, 12, 13 or 14, in which the at least one cartridge delivery feature comprises a flat flange that extends laterally to from the structural part.
[0109] [0109] Example 16 - Surgical loading unit, according to Examples 10, 11, 12, 13, 14 or 15, in which the beam-shaped dynamic gripping set with I-profile comprises a cutting surface of fabric.
[0110] [0110] Example 17 - Surgical loading unit, according to Examples 10, 11, 12, 13, 14, 15 or 16, in which the cartridge assembly comprises a channel that is pivotally coupled to the anvil assembly and which defines the first and second closing cam surfaces. A surgical staple cartridge is operationally supported within the channel.
[0111] [0111] Example 18 - Surgical loading unit, according to Example 17, in which the first surgical staple cartridge is removably attached to the channel.
[0112] [0112] Many of the surgical instrument systems described here are driven by an electric motor; however, the surgical instrument systems described here can be induced in any suitable manner. In several examples, the surgical instrument systems described herein can be induced, for example, by a manually operated trigger. In certain cases, the motors disclosed in this document may comprise a portion or portions of a robotically controlled system. In addition, any of the end actuators and / or tool sets shown in the present invention can be used with a robotic surgical instrument system. US Patent Application Serial No. 13 / 118,241, entitled
[0113] [0113] The surgical instrument systems described here have been described in connection with the implantation and deformation of the clamps; however, the modalities described in the present invention are not limited in this way. 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.
[0114] [0114] Although several devices have been described here in connection with certain modalities, modifications and variations of these modalities can be implemented. Specific resources, structures or characteristics can be combined in any appropriate way in one or more modalities. Therefore, the specific features, structures or features illustrated or described in connection with a modality can be combined, in whole or in part, with the resources, structures or features of one or more other modalities, without limitation. In addition, where materials are revealed for certain components, other materials can be used. In addition, according to several 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 aforementioned description and the following claims are intended to cover all such modifications and variations.
[0115] [0115] The devices disclosed herein can be designed to be discarded after a single use, or can be designed to be used multiple times. In either case, however, a device can be reconditioned for reuse after at least one use. Reconditioning 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 team can dismantle 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,
[0116] [0116] The devices revealed here can be processed before surgery. First, a new or used instrument can be obtained and, if necessary, cleaned. The instrument can then be sterilized. In a sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and the instrument can then be placed in a radiation field that can penetrate the container, such as gamma radiation, X-rays and / or high-energy electrons. Radiation can kill bacteria on the instrument and the container. The sterile instrument can then be stored in a sterile container. The sealed container can keep the instrument sterile until it is opened 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.
[0117] [0117] 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 (18)
[1]
1. End actuator for use with a surgical instrument characterized by comprising: a cartridge assembly that defines a longitudinal geometric axis between a proximal end and a distal end thereof, said cartridge assembly comprising a first and a second - gathers closing cam surfaces on it; an anvil set pivotally coupled to said cartridge assembly around a pivot axis that is transverse to the longitudinal geometric axis, such that said cartridge set and said anvil set are movable relative to one the other between a completely open position and a completely closed position; a beam-shaped dynamic gripping set with an I-profile comprising: a structural part; at least one anvil hitch that protrudes from said structural part; and at least one cartridge engaging feature that projects from said structural part and in which said beam-shaped dynamic gripping set with I-profile is selectively movable between an initial position that corresponds to said completely open position in that at least a portion of said at least one cartridge engaging feature is proximal to said pivot axis and a final position in relation to said anvil set, so that when said beam-shaped dynamic set with profile in I is moved distally from said initial position, said at least one cartridge engagement feature interacts by cam actuation with said first closing cam surface to confer a closing movement.
plugging said cartridge assembly and moving said cartridge assembly and said anvil assembly to said completely closed position and then engaging said second closing cam surface to retain said cartridge assembly in said completely closed position until said dynamic beam-shaped assembly with I-profile has been moved to said final position.
[2]
End actuator according to claim 1, characterized in that said at least one cartridge engagement feature is in contact with said first closing cam surface when said dynamic beam-shaped gripping assembly with profile in I is in said initial position.
[3]
End actuator according to claim 1, characterized in that said at least one cartridge engaging feature gives said closing movement to said cartridge assembly immediately by distal advancement of said dynamic gripping assembly beam with I-shaped profile from said initial position.
[4]
End actuator according to claim 1, characterized in that said first closing cam surface is inclined with respect to the second closing cam surface.
[5]
End actuator according to claim 1, characterized in that said at least one cartridge engaging feature comprises a flat flange which extends laterally from said structural part.
[6]
End actuator according to claim 1, characterized in that a portion of each said cartridge engaging feature is not engaging with said cartridge assembly when said beam-shaped dynamic gripping assembly with profile in I is in said initial position.
[7]
End actuator according to claim 1, characterized in that said beam-shaped dynamic gripping assembly with I-profile comprises a fabric cutting surface.
[8]
End actuator according to claim 1, characterized in that said cartridge assembly comprises: a channel pivotally coupled to said anvil assembly and defining said first and second closing cam surfaces; and a surgical staple cartridge operationally supported by said channel.
[9]
End actuator according to claim 8, characterized in that said surgical clamp cartridge is removably attached to said channel.
[10]
10. Surgical load unit characterized comprising: a set of casing; a set of tools operatively coupled to said set of casing, said set of tools comprising: a set of cartridge defining a longitudinal geometric axis between a proximal end and a distal end of it, said set of cartridge comprising a first and second closing cam surfaces on it; an anvil assembly pivotally coupled to said cartridge assembly around a pivot axis that is transverse to said longitudinal geometric axis, such that said anvil assembly and said cartridge assembly are movable relative to each other another between a completely open position and a completely closed position; a beam-shaped dynamic gripping set with an I-profile comprising: a structural part; at least one anvil hitch that protrudes from said structural part; and at least one cartridge engaging feature that projects from said structural part and in which said beam-shaped dynamic gripping set with I-profile is selectively movable between an initial position that corresponds to said completely open position in that at least a portion of said at least one cartridge engaging feature is proximal to said pivot axis and a final position in relation to said anvil set, so that when said beam-shaped dynamic set with profile in I is moved distally from said initial position, said at least one cartridge engagement feature interacts by cam actuation with said first closing cam surface to impart closing movement to said cartridge assembly and moving said cartridge assembly and said anvil assembly to said completely closed position and then engaging said second closing cam surface to retain said cartridge assembly in the said position completely closed until said dynamic set in the form of beam with I-shaped profile has been moved to said final position.
[11]
11. Surgical loading unit, according to claim 10, characterized in that said set of tools is pivotally coupled to said set of casing for selective piercing displacement in relation to it.
[12]
12. Surgical loading unit, according to claim 10, characterized in that said at least one cartridge engaging feature is in contact with said first closing cam surface when said dynamic gripping assembly beam with I profile is in said initial position.
[13]
13. Surgical loading unit, according to claim 10, characterized in that said at least one cartridge engaging feature gives said closing movement to said cartridge set immediately by distal advancement of said dynamic gripping set beam-shaped with I-shaped profile from said initial position.
[14]
Surgical loading unit according to claim 10, characterized in that said first closing cam surface is inclined in relation to said second closing cam surface.
[15]
15. Surgical loading unit according to claim 10, characterized in that said at least one cartridge engaging feature comprises a flat flange that extends laterally from said structural part.
[16]
16. Surgical loading unit according to claim 10, characterized in that said beam-shaped dynamic gripping set with I-profile comprises a tissue cutting surface.
[17]
17. Surgical loading unit according to claim 10, characterized in that said cartridge assembly comprises: a channel pivotally coupled to said anvil assembly and defining said first and second closing cam surfaces; and a surgical staple cartridge operationally supported within said channel.
[18]
18. Surgical loading unit, according to claim 17, characterized in that said surgical staple cartridge is removably attached to said channel.

类似技术:

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同族专利:

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公开号 | 公开日

---

US11071543B2|2021-07-27|

---

JP2021506398A|2021-02-22|

---

US20190183498A1|2019-06-20|

---

CN111465359A|2020-07-28|

---

WO2019116271A1|2019-06-20|

---

EP3498190A1|2019-06-19|

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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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US15/843,535|2017-12-15|

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US15/843,535|US11071543B2|2017-12-15|2017-12-15|Surgical end effectors with clamping assemblies configured to increase jaw aperture ranges|

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PCT/IB2018/059962|WO2019116271A1|2017-12-15|2018-12-12|Surgical end effectors with clamping assemblies configured to increase jaw aperture ranges|

---