adapters with control systems to control multiple motors of an electromechanical surgical instrument

专利摘要:
The present invention relates to an adapter for use with an electromechanical surgical instrument. The adapter includes a drive shaft assembly and a surgical end actuator that is selectively pivotable and rotatable with respect to the drive shaft assembly through a range of hinged and rotated positions. The adapter includes a firing member that is axially displaceable through the end actuator. The adapter also includes a control system that interfaces operationally with an adapter hinge actuator set and a source of hinge movements on the electromechanical surgical instrument to cause the hinge movement source to apply the additional pivoting hinge movements. articulation actuator assembly, which are necessary to maintain the surgical end actuator in an articulated position during an application of axial firing movements to the firing member.
公开号:BR112020011900A2
申请号:R112020011900-8
申请日:2018-12-13
公开日:2020-11-24
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 provisions, surgical instruments for stapling and cutting, and staple cartridges for use with them, which are designed for stapling and cutting tissue. BRIEF DESCRIPTION OF THE DRAWINGS
[0002] [0002] Several characteristics of the modalities described here, together with their advantages, can be understood according to the description presented below, considered together with the attached drawings, as shown below:
[0003] [0003] Figure 1 is a 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 cross-sectional view 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 pivot 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 electromechanical surgical instrument of Figure 1;
[0013] [0013] Figure 11 is a perspective view of an alternative embodiment of the adapter;
[0014] [0014] Figure 12 is a side elevation view of a portion of a load unit of the adapter of Figure 11 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 perspective view of portions of an adapter that includes a provision for measuring an amount of mechanical stress experienced by an adapter pivoting actuator; and
[0025] [0025] Figure 23 is a flowchart representing a motor control method of an electromechanical surgical device attached to an adapter in Figure 22.
[0026] [0026] 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
[0027] [0027] 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: - US Patent Application Serial No. 15 / 843,485, entitled
[0028] [0028] 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.
[0029] [0029] 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.
[0030] [0030] 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.
[0031] [0031] 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 disclosed 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 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 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.
[0032] [0032] The surgical stapling system can comprise a drive shaft and an end actuator that extends from the drive shaft. The end actuator comprises a first jaw and a second jaw. The first 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 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.
[0033] [0033] 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.
[0034] [0034] 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. The slider is movable between a proximal position adjacent to the proximal end and a distal position adjacent to the distal end. The slider comprises a plurality of inclined surfaces configured to slide under the actuators and lift the actuators, and the staples held therein, towards the anvil.
[0035] [0035] 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.
[0036] [0036] 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 disclosed herein can be employed 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 ROTATAB LE STAPLE DEPLOYMENT ARRANGEMENTS ", which is incorporated herein by reference, in its entirety.
[0037] [0037] 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. The battery 101 can also be called here a set of handle 101. One form of surgical instrument 100, for example, is revealed 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 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.
[0038] [0038] As shown in Figure 3, an outer casing casing 10 includes a distal half-section 10a and a proximal half-section 10b which is pivotally connected to the distal half-section 10a by a hinge 16 located along the edge of the distal half-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 shell in a closed condition. The distal half-section 10a of the wrapper housing 10 defines a detection portion 20 that is configured to receive a corresponding drive coupling assembly 210 from adapter 200 (see Figure 5). Specifically, the distal half-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.
[0039] [0039] The connecting portion 20 of the distal half-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. guide rails 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 distal half-section 10a defines three openings 22a, 22b, 22c that they are formed on a surface of it facing the distal position and which are arranged on a plane or line common 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 additionally defines a female connection feature 26 (see Figure 2) formed on a surface of it. The female connection feature 26 selectively engages a male connection feature of adapter 200.
[0040] [0040] The distal half-section 10a of the wrapper casing 10 supports a toggle control button facing the distal side
[0041] [0041] The wrapper wrap 10 includes a set of sterile barrier plate 60 selectively supported on the distal half-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 that rotatably supports 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 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 additionally 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 paths of contact, each of which includes an electrical conduit to extend an electrical connection through 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 through connector 66 are arranged or situated within the connecting portion of the distal half-section 10a of the wrapper housing 1 0, and are configured to engage electrically and / or mechanically to the corresponding corresponding features of adapter 200.
[0042] [0042] Referring 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 distal half-section 110a and a proximal half-section 110b connectable to the distal half-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.
[0043] [0043] The distal half-section 110a of the inner grip handle 110 supports a distal toggle control interface 130 that is in operational alignment with the distal toggle control button 30 of the wrapper housing 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 distal half-section 110a of the inner handgrip 110 also supports a right side pair of control interfaces (not shown) and a left side pair of control interfaces 132a, 132b. In use, when battery 101 is disposed within the wrapper housing 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 wrapper housing 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 distal half-section 110a of the inner grip handle.
[0044] [0044] 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 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 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 envisaged that at least a portion of the inner grip 110 can be manufactured from a transparent hard plastic or similar. It is further provided that the wrapper casing may include a window formed thereon (in visual alignment with the display screen 146 and with the window 110d of the proximal half-section 110b of the inner casing of the grip 110 and / or the casing of the wrapper 10 may be manufactured from a transparent rigid plastic or similar.
[0045] [0045] The battery core assembly 106 additionally 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.
[0046] [0046] 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
[0047] [0047] 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 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.
[0048] [0048] The drive coupling assembly 210 of adapter 200 also includes a first, a second and a third bias members 224, 226, 228 disposed distally from the respective first, second and third sleeves of connector 218, 220 and
[0049] [0049] 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 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 axes 64a, 64b and 64c of surgical instrument 100 into axial translation of a driver or pivot bar 258 of adapter 200 to pivot end actuator 500; rotating an annular gear 266 of adapter 200 to rotate adapter 200; or the axial translation of a distal drive member 248 of adapter 200 to effect the closing, opening and firing of end actuator 500.
[0050] [0050] 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 conversion / rotation assembly 240 additionally 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 disposed 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.
[0051] [0051] The first transmission / power conversion / rotation set 240 additionally 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
[0052] [0052] 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 additionally includes a threaded distal end portion 214a configured to threadably engage a pivot bearing housing 253 of a pivot bearing assembly
[0053] [0053] 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 258 of the end actuator 500, causes the translation axial link 560 of end actuator 500 to articulate the tool set
[0054] [0054] As shown in Figure 6, the adapter includes a third drive conversion set 260 that is supported on the inner casing assembly 204. The third drive conversion set 260 includes a rotary ring gear 266 that is supported so fixed to the external housing of 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 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 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.
[0055] [0055] Adapter 200 additionally includes a fixing / separating button 272 (Figure 5) which 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 flange or protrusion that is configured to snap together behind a corresponding flange or protrusion 20 of surgical instrument 100. As also discussed in WO 2016/057225 A1, adapter 200 may additionally include a locking mechanism 280 to fix the axial position of the distal drive member 248. As can be seen in Figure 21, for example, the locking mechanism 280 includes a button 282 that is slidably supported on the outer housing of the button 202. The lock 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 lock button 282 from a distal position to a proximal position, thus causing the lock (not shown) to move to the proximal position of 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 performing distal movement 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 bending 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.
[0056] [0056] 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. 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, force information) are transmitted to the surgical instrument 100 circuit board via an electrical receptacle portion of the battery core assembly 106 of the surgical instrument 100. Electrical assembly 290 additionally includes a strain gauge 296 which is electrically connected to the circuit board 294. The strain gauge 296 is mounted inside the enclosure assembly in suit 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.
[0057] [0057] Still with reference to Figure 6, the inner casing assembly 204 includes a hub 205 that has a distally oriented annular wall 207 that substantially defines an external 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 shell assembly 204 additionally 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.
[0058] [0058] 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 disclosed in US Patent Application No. 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 publication of US Patent Application No. 2015/0374371, entitled
[0059] [0059] 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.
[0060] [0060] 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 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.
[0061] [0061] The cartridge assembly 701 is pivoting relative 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.
[0062] [0062] 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
[0063] [0063] With reference 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
[0064] [0064] 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.
[0065] [0065] 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, providing a reduced diameter to the central tube portion 912 can give the adapter 200 'better thoracic access between the ribs.
[0066] [0066] 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 to align 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.
[0067] [0067] 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 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 fabric.
[0068] [0068] 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. A similar actuation surface of the cam could be provided in the anvil assembly 612 in other embodiments. It is envisaged that the inclined surfaces 726 can also facilitate the alignment and / or engagement between the channel 720 and the support plate 620 and / or the cartridge body 702. As the drive assembly 540 is advanced distally (fired) , the channel latches 559 in the dynamic gripping assembly 550 engage with the corresponding inclined surfaces 726 to apply a closing movement to the cartridge assembly 701 thereby closing the cartridge assembly 701 and the anvil assembly 612. The additional distal translation of the dynamic gripper assembly 550 causes the actuation slide 712 to move distally through the cartridge body 702, which causes the cam wedges 713 of the actuation slide 712 to engage sequentially with the clamp pushers 709 to move the staple pushers 708 vertically into the staple retaining slots 709 and eject staples 704 into the staple-forming depressions of anvil plate 620. Subsequent to ejection of the staples 704 from the retaining slots 706 (and in the fabric), the cutting edge 554 of the dynamic gripping assembly 550 cuts the stapled fabric as the fabric cutting edge 554 in the vertical structural part 552 of the dynamic gripping assembly 550 moves distally through a central slot 703 of the cartridge body 702. After the clips 704 have been ejected from the cartridge body 702 and a user wishes to use the same instrument 10 to fire additional clips 704 (or another type of fastener or knife), the User can remove charge unit 510 from adapter 200 'and replace it with another new or unused charge unit. In an alternate arrangement, the user can simply remove the worn 702 cartridge body and replace it with a new unstruck or worn 702 cartridge body.
[0069] [0069] 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 firing systems. In flagrant cases, such debris and fluids get into the adapter's internal housing assembly, which can cause a short circuit and failure of the electrical components supported inside. Additionally, 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 reusability.
[0070] [0070] 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 proximal rotating drive shaft
[0071] [0071] 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
[0072] [0072] When using an adapter 200 and electromechanical surgical instrument 100, the surgical end actuator 500 is, in general, positioned in a non-articulated position (the longitudinal geometric axis defined by the proximal compartment portion is axially aligned with the longitudinal geometric axis LA of the adapter drive shaft assembly) to enable the surgical end actuator 500 to be inserted through a trocar cannula into the patient. Once the surgical end actuator 500 has been inserted into the patient, the physician can activate the source of rotary actuating movements (motor 156) to apply a number of rotary articulation movements to the rotary articulation drive shaft 214 on adapter 200 for move the articulation actuator or bar 258 axially by an amount necessary to articulate the surgical end actuator 500 in a desired articulated position. Once the surgical end actuator 500 has been articulated in the desired articulated position, the motor 156 is deactivated so that the articulated end actuator 500 remains articulated during the firing stroke.
[0073] [0073] After the surgical end actuator 500 has been articulated to the desired articulated position and the source of rotary articulation movements has been disabled in the electromechanical surgical instrument 100, the doctor activates the source of rotary trigger movements (motor 152) to apply an initial amount of rotary firing movements to the rotary firing drive shaft 214 on adapter 200 to axially displace the distal drive member 248 to finally cause dynamic gripping assembly 550 on surgical end actuator 500 to move from the starting position to a shooting position.
[0074] [0074] Figure 22 illustrates an adapter portion 8200, which is otherwise identical to adapter 200 described above. As can be seen in this Figure, the 8200 adapter includes an 8210 control system that interfaces operationally with the hinge actuator 258 and is configured to transmit electrical signals back to an engine 156 motor control circuit, which applies the movements swivel joint on the electromechanical surgical instrument. In the illustrated arrangement, for example, the control system 8210 includes a strain gauge 8212 that is attached to the hinge actuator 258. Leads 8214 for the strain gauge extend through an opening 8218 in an inner pad 8216 that can be mounted in the internal housing 204 to be coupled to a connector 8219, which can interface with a slip ring arrangement (not shown) that is in electrical contact with the electrical assembly 290, for example. In such an arrangement, taps 8214 are long enough to enable the drive shaft assembly 203 'to rotate around the longitudinal LA axis. In an alternative arrangement, taps 8214 are attached to a connector that is supported inside the internal housing 204 and configured for electrical interface with the sliding ring 298 of the electrical assembly 290 (Figure 6). In such an arrangement, the slip ring 298 is in electrical communication with a circuit board 294. Circuit board 294 includes a plurality of electrical contact foils 292 for electrical connection to the through connector 66 of plate assembly 60 in the housing surgical instrument wrap 100. Such an arrangement facilitates the passage of signals from the 8212 strain gauge to the motor controller the Circuit Board 142a in the surgical instrument 100.
[0075] [0075] Figure 23 illustrates the actions of an 8220 method to control various features of the 8200 adapter, when operationally coupled to the surgical instrument 100, or another system equipped with a motor, after the surgical end actuator 500 of the 8200 adapter has been inserted into the patient. When a trocar is employed, the surgical end actuator 500 is in an un-hinged position with the claws 610, 700 closed to allow the surgical end actuator 500 to pass through the trocar cannula. Once surgical end actuator 500 has been inserted into the patient, anvil 612 and cartridge assembly 701 of surgical end actuator 500 are opened to the fully open position. This can be done by reversing motor 152 (through manual controls or automatic controls) to move the dynamic gripping set 550 back to its initial position. Thereafter, the end actuator 500 is then pivoted to a desired pivoted position (action 8222). This is achieved by the actuation of the source of rotating articulation movements (motor 156) in the surgical instrument 100 or another system equipped with a motor (through manual controls or automatic commands). In the example in Figure 23, gripping action 8224 covers first opening the jaws (if the end actuator was hinged to the desired hinged position with the jaws closed) and then attaching the jaws to a target tissue. This is accomplished by reversing motor 152 or another motor-driven system (through manual controls or automatic controls) to move the dynamic gripping set 550 back to its initial position (if the claws are closed) and then trigger the motor 152 (through manual controls or automatic commands) to move the dynamic gripping set 550 from its initial position to its firing position (action 8224).
[0076] [0076] Still with reference to Figure 23, once the target tissue was trapped between the claws (anvil set 612 and cartridge set 701), the axial position of the articulation driver 258 can be recorded, as well as the quantity of mechanical stress experienced by the articulation driver 258 is registered by the motor control circuit (action 8226). Other means can also be employed to determine and record the articulated position of the surgical end actuator.
[0077] [0077] Example 1 - An adapter for use with an electromechanical surgical instrument. In at least one example, the adapter comprises an adapter compartment assembly that is configured to be operationally coupled to the electromechanical surgical instrument. A drive shaft assembly 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. A surgical end actuator is operationally coupled to the distal end of the drive shaft assembly for selective articulation in relation to the drive shaft assembly. An articulation actuator assembly is configured to interface operationally with a source of rotary articulation movements on the electromechanical surgical instrument when the adapter compartment assembly is operatively coupled to it, in order to apply axial articulation movements to the surgical end actuator. to move the surgical end actuator to a desired hinged position. A trigger member assembly is configured to form an operational interface with a source of rotary trigger movements on the electromechanical surgical instrument when the adapter compartment assembly is operatively coupled to it to apply axial trigger movements to the surgical end actuator, while the surgical end actuator is in the desired hinged position. The adapter additionally comprises a control system that interfaces operationally with the articulation actuator assembly and the source of rotary articulation movements on the electromechanical surgical instrument to cause the source of rotary articulation movements to apply additional rotary articulation movements to the assembly articulation actuators, which are necessary to maintain the surgical end actuator in the desired articulated position during an application of axial firing movements to the surgical end actuator.
[0078] [0078] Example 2 - The adapter of Example 1, the articulation actuator set comprising a rotating articulation drive shaft that is configured to form an operational interface with the source of rotating articulation movements in the electromechanical surgical instrument when the adapter compartment assembly is operationally coupled to it. A pivot actuator interfaces operationally with the pivot pivot drive shaft and the surgical end actuator and is configured to move axially in response to the rotation of the pivot pivot drive shaft to articulate the surgical end actuator within a range of articulated guidelines. The control system additionally comprises means to monitor the mechanical stress experienced by the articulation actuator during the application of axial firing movements to the surgical end actuator and to transmit a signal that corresponds to a magnitude of the mechanical stress to a control circuit for the source of rotating joint movements in the electromechanical surgical instrument.
[0079] [0079] Example 3 - The adapter of Examples 1 or 2, the trigger member assembly comprising a rotary trigger drive axis which is configured to interface operationally with the source of rotary trigger movements in the electromechanical surgical instrument, and an axially movable firing member that interfaces operationally with the rotary firing drive shaft and is configured to apply axial firing movements to a portion of the surgical end actuator.
[0080] [0080] Example 4 - The adapter of Examples 1, 2 or 3, the surgical end actuator comprising a first jaw and a second jaw that is pivotally coupled to the first jaw, so that the first jaw and the second jaw jaws are movable relative to each other between a completely open position and a closed position, and the surgical end actuator portion comprises a dynamic gripping assembly that is configured to apply closing movements to the first and second jaws after a initial amount of axial displacement.
[0081] [0081] Example 5 - The adapter of Example 4, the first claw comprising an anvil and the second claw comprising a cartridge assembly.
[0082] [0082] Example 6 - The adapter of Example 5, the cartridge assembly comprising a channel movably coupled to the anvil and a clamp cartridge, which is operationally supported in the channel and which operationally stores a plurality of clamps within it .
[0083] [0083] Example 7 - The adapter of Examples 4, 5 or 6, the dynamic gripping set comprising a fabric cutting surface and being configured to eject the plurality of grips from the gripping cartridge, according to the dynamic gripping set is driven from an initial trigger position to an end position within the surgical end actuator.
[0084] [0084] Example 8 - The adapter of Examples 1, 2, 3, 4, 5, 6 or 7, the surgical end actuator comprising a proximal compartment portion, which includes a proximal end and a distal end, and defines a longitudinal geometric axis that extends between them. The proximal end is configured to be operationally coupled to the distal end of the drive shaft assembly. A set of tools is pivotally coupled to the proximal compartment portion for selective articulation in relation to it around a geometric axis of articulation, which is transversal to the longitudinal geometric axis.
[0085] [0085] Example 9 - The adapter of Example 8, the proximal compartment portion operationally supporting an articulation link, which is coupled to the tool set and is configured for operable fixation to the articulation actuator set when the proximal compartment is operationally coupled to the distal end of the drive shaft assembly.
[0086] [0086] Example 10 - The adapter of Examples 8 or 9, the tool set comprising a first jaw and a second jaw that is pivotally coupled to the first jaw, so that the first and second jaws are movable one in relation to the other between the open and closed positions.
[0087] [0087] Example 11 - The adapter of Example 10, the surgical end actuator additionally comprising a dynamic gripping set, which is configured to apply closing movements to the first and second jaws after an initial amount of axial displacement thereof . A flexible drive beam is supported for axial movement within the proximal compartment portion and is configured to be operationally coupled to the trigger member assembly when the proximal compartment portion is operationally coupled to the distal end of the drive shaft assembly. The flexible drive beam also interfaces operationally with the dynamic gripping set.
[0088] [0088] Example 12 - The adapter of Example 2, the means of monitoring the mechanical stress experienced by the articulation actuator during the application of axial firing movements to the surgical end actuator and transmitting a signal that corresponds to a magnitude of the Mechanical tension for a control circuit of the source of rotary articulation movements in the electromechanical surgical instrument comprises a stress meter that interfaces operationally with the articulation actuator.
[0089] [0089] Example 13 - An electromechanical surgical system that comprises a set of drive axes that define a longitudinal geometric axis that extends over a proximal end and a distal end thereof. A surgical end actuator is operationally coupled to the distal end of the drive shaft assembly for selective articulation in relation to the drive shaft assembly. The surgical end actuator comprises an axially movable dynamic assembly to apply actuation movements to portions of the surgical end actuator. The system further comprises a source of rotary trigger movements and a trigger member assembly that interfaces operationally with the source of rotary trigger movements to apply axial trigger movements to the axially movable dynamic assembly on the surgical end actuator. The system further comprises a source of rotary articulation movements and a joint actuator assembly, which is configured to form an operational interface with the source of rotary articulation movements to apply axial articulation movements to the surgical end actuator, to move the surgical end actuator to a desired articulated position. A control system interfaces operationally with the pivot actuator assembly and the source of rotary pivot movements and is configured to cause the pivot joint source to apply additional pivot joint movements to the pivot actuator assembly, the which are necessary to maintain the surgical end actuator in the desired articulated position during an application of axial firing movements to the axially movable dynamic assembly on the surgical end actuator.
[0090] [0090] Example 14 - The electromechanical surgical system of Example 13, the surgical end actuator comprising a first jaw and a second jaw which is pivotally coupled to the first jaw, so that the first jaw and the second jaw are movable in relation to each other between a completely open position and a closed position, and the mobile dynamic assembly is configured to apply closing movements to the first and second jaws after an initial amount of axial displacement thereof.
[0091] [0091] Example 15 - The electromechanical surgical instrument of Example 14, the first jaw comprising an anvil and the second jaw comprising a cartridge assembly.
[0092] [0092] Example 16 - The electromechanical surgical system of Example 15, the cartridge assembly comprising a channel that is pivotally coupled to the anvil. A fastener cartridge is operationally supported in the channel and operationally stores a plurality of fasteners within it.
[0093] [0093] Example 17 - The electromechanical surgical system of Example 16, the mobile dynamic set comprising a tissue cutting surface and is configured to eject said plurality of fasteners from the fastener cartridge, as the mobile dynamic set is axially driven from an initial firing position to an end position within the surgical end actuator.
[0094] [0094] Example 18 - The electromechanical surgical system of Examples 13, 14, 15, 16 or 17, the source of rotary firing movements and the source of rotating articulation movements being supported on a compartment and the set of drive shaft is configured to be removably coupled to the compartment.
[0095] [0095] Example 19 - The electromechanical surgical system of Examples 13, 14, 15, 16, 17 or 18, the control system comprising means for monitoring the mechanical stress experienced by the joint actuator assembly during the application of axial firing to the axially movable dynamic member in the surgical end actuator and to transmit a signal that corresponds to a magnitude of the mechanical stress to a control circuit for the source of rotating articulation movements.
[0096] [0096] Example 20 - The method for controlling the operation of a surgical instrument that includes an articulating surgical end actuator with claws that are movable between the open and closed positions by an axially displaceable dynamic gripping set, which is configured to eject the fasteners stored in one of the claws and cut the fabric stuck between them. In at least one Example, the method comprises activating a source of joint movements to apply a joint movement to a joint member, which is coupled to the surgical end actuator to move the surgical end actuator to a desired joint position, and then disable the joint movement source. The method further comprises applying a first amount of axial firing motion to the axially displaceable dynamic gripping assembly to move the claws to a closed position to secure the fabric between them. The method further includes registering an amount of mechanical stress experienced by the hinge member when in that desired hinged position and applying a second amount of axial firing motion to the axially displaceable dynamic gripping assembly, to cause the dynamic gripping assembly to cut the tissue and eject the fasteners stored in one of the jaws. The method further comprises measuring a magnitude and direction of any change in the amount of mechanical stress on the joint member during said application of the second amount of axial firing movement, and reactivating the source of joint movements to apply additional joint movements to the member of articulation based on the measure of change to keep the surgical end actuator in the desired articulation position.
[0097] [0097] 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 motors disclosed in this document may comprise a portion or portions of a robotically controlled system. In addition, any of the end actuators and / or tool sets shown in the present invention can be used with a robotic surgical instrument system. US Patent Application Serial No. 13 / 118,241, entitled SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS, now US patent No.
[0098] [0098] 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.
[0099] [0099] Although several devices have been described here in connection with certain modalities, modifications and variations of these modalities can be implemented. The specific resources, structures or characteristics can be combined in any suitable way in one or more modalities. Therefore, the resources, structures or specific features illustrated or described in connection with a modality 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 are revealed for certain components, 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.
[0100] [0100] The devices disclosed here 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 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.
[0101] [0101] 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.
[0102] [0102] 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, said adapter being characterized by comprising: 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 compartment assembly; a surgical end actuator operably coupled to said distal end of said shaft assembly for selective articulation with respect to said drive shaft assembly; an articulation actuator set configured to interface operationally with a source of rotary articulation movements in the electromechanical surgical instrument when said adapter compartment assembly is operatively coupled thereto to apply axial articulation movements to said surgical end actuator to move said surgical end actuator to a desired articulated position; a trigger member set configured to interface operationally with a source of rotary trigger movements in the electromechanical surgical instrument, when said adapter compartment assembly is operatively coupled thereto, and to apply axial trigger movements to said surgical end actuator, while said surgical end actuator is in said desired articulated position; and a control system which interfaces operationally with said joint actuator set and the source of rotary joint movements in the electromechanical surgical instrument to cause the source of rotary joint movements to apply additional rotary joint movements to said actuator set of articulation, which are necessary to keep said surgical end actuator in said desired articulated position during an application of axial firing movements to said surgical end actuator.
[2]
2. Adapter according to claim 1, characterized in that said articulation actuator assembly comprises: a rotary articulation drive shaft configured to form an operational interface with the source of rotary articulation movements in the electromechanical surgical instrument when said adapter compartment assembly is operationally coupled to it; and a pivot actuator which interfaces operationally with said pivot pivot drive shaft and said surgical end actuator and configured to move axially in response to the rotation of said pivot pivot drive shaft to articulate said end actuator surgical through a range of articulated orientations, and said control system comprises means to monitor the mechanical stress experienced by said articulation actuator during said application of axial firing movements to said surgical end actuator and to transmit a signal which corresponds to the magnitude of the said mechanical tension to a control circuit for the source of rotating articulation movements in the electromechanical surgical instrument.
[3]
3. Adapter according to claim 1, characterized in that said trigger member assembly comprises: a rotary trigger drive axis configured to interface operationally with the source of rotary trigger movements in the electromechanical surgical instrument; and an axially movable firing member which interfaces operationally with said rotary firing drive shaft and is configured to apply axial firing movements to a portion of said surgical end actuator.
[4]
4. Adapter according to claim 3, characterized in that said end actuator comprises: a first jaw; and a second claw pivotally coupled to said first claw, so that said first claw and said second claw are movable with respect to each other between a completely open position and a closed position, and said portion of said The surgical end actuator comprises a dynamic gripping set configured to apply closing movements to said first and second grips after an initial amount of axial displacement thereof.
[5]
Adapter according to claim 4, characterized in that said first claw comprises an anvil and said second claw comprises a cartridge assembly.
[6]
Adapter according to claim 5, characterized in that said cartridge assembly comprises: a channel pivotally coupled to said anvil; and a fastener cartridge operably supported on said channel and operationally storing a plurality of fasteners within it.
[7]
Adapter according to claim 6, characterized in that said dynamic gripping assembly comprises a fabric cutting surface and is configured to eject said plurality of grips from said gripper cartridge, as said dynamic gripping assembly is driven from an initial firing position to an end position within said surgical end actuator.
[8]
Adapter according to claim 1, characterized in that said surgical end actuator comprises: a proximal portion of compartment comprising a proximal end and a distal end and defining a longitudinal geometric axis disposed between them, said configured proximal end to be operationally coupled to said distal end of said drive shaft assembly; and a set of tools pivotally coupled to said proximal compartment portion for selective articulation in relation to it around a geometric axis of articulation, which is transversal to said longitudinal geometric axis.
[9]
Adapter according to claim 8, characterized in that said proximal compartment portion operationally supports an articulation link coupled to said tool set and configured for operable fixation to said articulation actuator set when said compartment portion proximal is operatively coupled to said distal end of said drive shaft assembly.
[10]
Adapter according to claim 9, characterized in that said set of tools comprises: a first jaw; and a second claw pivotally coupled to said first claw, so that the first and second claws are movable with respect to each other between the open and closed positions.
[11]
11. Adapter according to claim 10, characterized in that said surgical end actuator further comprises: a dynamic gripping set configured to apply closing movements to said first and second grips after an initial amount of axial displacement thereof; and a flexible drive beam supported for axial movement within said proximal compartment portion and configured to be operatively coupled to said trigger member assembly when said proximal compartment portion is operatively coupled to said distal end of said axis assembly drive, said flexible drive beam making operational interface with said dynamic gripping set.
[12]
12. Adapter according to claim 2, characterized in that said means for monitoring the mechanical stress experienced by said articulation actuator during said application of axial firing movements to said surgical end actuator and for transmitting a corresponding signal at a magnitude of said mechanical tension for a control circuit for the source of rotary articulation movements in the electromechanical surgical instrument comprising a stress meter which is mounted on said articulation actuator.
[13]
13. Electromechanical surgical system, characterized by comprising: a set of drive axes that define a longitudinal geometric axis between a proximal end and a distal end thereof; a surgical end actuator operatively coupled to said distal end of said drive shaft assembly for selective articulation with respect to said drive shaft assembly, said surgical end actuator comprising an axially movable dynamic assembly for applying actuation movements to portions said surgical end actuator;
a source of rotating firing movements; a trigger member assembly which interfaces operationally with said source of rotary trigger movements to apply axial trigger movements to said axially movable dynamic assembly on said surgical end actuator; a source of rotating articulation movements; assembly of a pivot actuator configured to interface operationally with said source of pivoting pivot movements to apply axial pivot movements to said surgical end actuator to move said surgical end actuator to a desired pivot position; and a control system that interfaces operationally with said articulation actuator set and said source of rotary articulation movements and being configured to cause said source of rotary articulation movements to apply additional rotary articulation movements to said set articulation actuators, which are necessary to maintain said surgical end actuator in said desired articulated position during an application of axial firing movements to the axially movable dynamic assembly in said surgical end actuator.
[14]
14. Electromechanical surgical system, according to claim 13, characterized in that said end actuator comprises: a first jaw; and a second claw pivotally coupled to said first claw so that said first claw and said second claw are movable with respect to each other between a completely open position and a closed position, and said moving dynamic assembly is configured to apply closing movements to said first and second jaws after an initial amount of axial displacement thereof.
[15]
Electromechanical surgical system according to claim 14, characterized in that said first claw comprises an anvil and said second claw comprises a cartridge assembly.
[16]
Electromechanical surgical system, according to claim 15, characterized in that said cartridge assembly comprises: a channel pivotally coupled to said anvil; and a fastener cartridge operably supported on said channel and operationally storing a plurality of fasteners within it.
[17]
17. Electromechanical surgical system, according to claim 16, characterized in that said moving dynamic assembly comprises a tissue cutting surface and is configured to eject said plurality of fasteners from said fastening cartridge, according to said moving dynamic assembly is axially driven from an initial firing position to an end position within said surgical end actuator.
[18]
18. Electromechanical surgical system, according to claim 13, characterized in that said source of rotary firing movements and said source of rotary articulation movements are supported on a compartment and said drive shaft set is configured to be removably coupled to said compartment.
[19]
19. Electromechanical surgical system, according to claim 13, characterized in that said control system comprises means for monitoring the mechanical stress experienced by said joint actuator set during said application of axial firing movements to said axially movable dynamic member in said surgical end actuator and for transmitting a signal that corresponds to a magnitude of said mechanical tension to a control circuit for said source of rotary articulation movements.
[20]
20. Method for controlling the operation of a surgical instrument, which includes a surgical end actuator including jaws that are movable between the open and closed positions by an axially displaceable dynamic gripping set that is configured to eject fasteners stored in one of the claws and cut the tissue trapped between them, said method comprising: activating a source of articulation movements to apply a articulation movement to a articulation member coupled to the surgical end actuator to move the surgical end actuator to a desired articulated position and then disable the source of articulation movements; applying a first amount of axial firing movement to the axially displaceable dynamic gripping assembly to move the claws to a closed position to secure the fabric between them; record “one - amount of mechanical stress experienced by the articulation member when in that desired articulated position; applying a second amount of axial firing motion to the axially displaceable dynamic gripping assembly to cause the dynamic gripping assembly to cut the fabric and eject the fasteners stored in one of the claws; measuring a magnitude and direction of any change in the amount of mechanical stress on the joint member during said application of the second amount of axial firing movement; and reactivating the source of pivot movements to apply additional pivot movements to the pivot member based on the change measurement to maintain the surgical end actuator in the desired pivot position during said application of the second amount of axial firing movement.
AND NA): = "X V / i% O
GO

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同族专利:

---

公开号 | 公开日

---

CN111465360A|2020-07-28|

---

WO2019116315A1|2019-06-20|

---

JP2021506392A|2021-02-22|

---

US20190183493A1|2019-06-20|

---

US10869666B2|2020-12-22|

---

EP3498188A1|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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US15/843,501|2017-12-15|

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US15/843,501|US10869666B2|2017-12-15|2017-12-15|Adapters with control systems for controlling multiple motors of an electromechanical surgical instrument|

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PCT/IB2018/060052|WO2019116315A1|2017-12-15|2018-12-13|Adapters with control systems for controlling multiple motors of an electromechanical surgical instrument|

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