Surgical instrument

专利摘要:
invention patent: damping device for endoscopic surgical stapler. the present invention relates to a surgical instrument including a rod and an effector end. the effector end may comprise a first jaw and a second jaw. the first jaw can be movable in relation to the second jaw between an open configuration and a closed configuration. the surgical instrument may comprise a cover assembly that can be operatively engaged with the first claw. the cover assembly may comprise a cover driver and a damping system. the cover trigger can be configured to close the first claw. the damping system can be configured to delay opening the lid actuator. the damping system may comprise an opening configured to receive the projection at a first end of the opening and a seal configured to form a fluid seal between said projection and said side wall of the opening.
公开号:BR112012016391B1
申请号:R112012016391-4
申请日:2010-12-06
公开日:2020-03-24
发明作者:Chad P. Boudreaux
申请人:Ethicon Endo-Surgery, Inc.；
IPC主号:

专利说明:

[0001] This application relates to the following commonly owned US Patent Applications filed at the same time, which are hereby incorporated by reference in their entirety:
(1) U.S. Patent Application Serial No. 11 / 821,425, entitled END EFFECTOR CLOSURE SYSTEM FOR A SURGICAL STAPLING INSTRUMENT, Attorney Reference No.
END6085USNP / 070054;
(2) U.S. Patent Application Serial No. 11 / 821,426, entitled SURGICAL STAPLING INSTRUMENT WITH AN ANTI-BACK UP MECHANISM, Attorney Reference No. END6100USNP / 070053;
(3) U.S. Patent Application Serial No. 11 / 821,347, entitled SURGICAL STAPLING INSTRUMENT WITH A RETURN MECHANISM, Attorney Reference No. END6091USNP / 070061;
(4) U.S. Patent Application Serial No. 11 / 821,455, entitled SURGICAL STAPLING INSTRUMENT WITH AN ARTCULATING END EFFECTOR, Attorney Reference No.
END6092USNP / 070062; and (5) U.S. Patent Application Serial No. 11 / 821,277, entitled SURGICAL STAPLING INSTRUMENTS, Attorney Reference No. END6099USNP / 070057.
1. Field of the Invention [0002] The present invention relates, in general, to surgical stapling instruments and, more particularly, to surgical staplers having a closing system that allows the closing of an effector end and allows a controlled opening effect of the effector end.
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2. Description of the Related Art [0003] As is known in the art, surgical staplers are often used to apply staples to soft tissues to reduce or eliminate bleeding from the soft tissue, especially when the tissue is being cut across, for example. Surgical staplers, such as an end cutter, for example, may comprise an end effector that can be moved, or articulated, in relation to an elongated stem assembly. End effectors are often configured to trap the soft tissue between the first and second jaw members, the first jaw member often including a staple cartridge that often includes an anvil. These surgical staplers may include a closing system to articulate the anvil in relation to the staple cartridge.
[0004] Staples are typically applied from the staple cartridge by an actuator that passes through a channel inside the staple cartridge, and causes the staples to be deformed in contact with the anvil and trap the soft tissue layers. Often, as is known in the art, staples are applied in several rows or rows of staples, to securely attach layers of fabric. The end effector also includes a cutting element such as a knife, for example, which is advanced between two rows of staples to section the soft tissue after the soft tissue layers have been stapled.
[0005] After the driver and the cutting member have advanced into the effector end, it is commonly necessary to retract the driver and / or the cutting member to their initial positions and release the first and second claw members from the effector end. Commonly surgical staplers have included an opening spring that returns a cover actuator to the open position of the aci
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3/66 of the lid, thus returning the first and second claw members to their original positions after a release button or articulated key on the surgical stapler has been triggered by the surgeon, for example. Such staplers, however, are commonly difficult to use, since such opening springs commonly apply an actuation force to the lid actuator that can, in various circumstances, cause the lid actuator to open and thus first and second claws of the effector end automatically open by the spring with excessive force, which can injure the tissue surrounding the effector end. An improvement is needed in what was previously mentioned. SUMMARY [0006] In one embodiment, a surgical instrument may comprise an elongated nail and an effector end. The effector end further comprises a first jaw and a second jaw. The first jaw can be movable in relation to the second jaw between an open configuration and a closed configuration. The surgical instrument may also comprise a cover assembly. The cover assembly can be operatively engaged with the first gripper. The cover assembly may comprise a cover driver and a damping system. The cover driver can be configured to be driven from a first position to a second position to close the first claw. The lid actuator can also comprise a projection. The damping system can be configured to delay opening the lid actuator. The damping system may comprise an opening and a seal. The opening can be configured to receive the projection at a first end of the opening. The opening may comprise a second end, the second end of which is smaller than the first end. The opening can be
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4/66 defined by a side wall of the opening. The seal can be configured to form a fluid seal between said protrusion and said side wall of the opening.
[0007] In one embodiment, a surgical instrument may comprise an elongated nail and an effector end. The effector end further comprises a first jaw and a second jaw. The first jaw can be movable in relation to the second jaw between an open configuration and a closed configuration. The surgical instrument may also comprise a cover assembly operatively engaged with the first claw. The lid assembly may comprise a lid driver configured to be operated from a first position to a second position to close the first jaw. The cover driver can comprise a piston. The cover assembly may further comprise a cylinder configured to receive the piston at a first end of the cylinder. The piston can be configured to move inside the cylinder. The cover assembly may also comprise a damping device configured to slow the return of the cover actuator from the second position to the first position, slowing the movement of the piston within the cylinder.
BRIEF DESCRIPTION OF THE DRAWINGS [0008] The characteristics mentioned above and other characteristics and advantages of this invention, and the way of obtaining them, will become more apparent and the invention itself will be better understood by reference to the following description of modalities of the invention, taken in conjunction with the attached drawings, as follows: [0009] Figure 1 is an elevation view of a surgical instrument according to an embodiment of the present invention;
[00010] Figure 2 is an elevation view of a portion of the handle of the surgical instrument of figure 1;
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5/66 [00011] Figure 3 is an elevation view of an end effector of the surgical instrument of figure 1;
[00012] Figure 4 is a top view of the end effector of figure 3;
[00013] Figure 5 is a perspective view of a joint of the surgical instrument of figure 1 with some components of the surgical instrument removed;
[00014] Figure 6 is a perspective view of an elongated stem and joint joint of the surgical instrument of figure 1 with some components of the surgical instrument removed;
[00015] Figure 7 is a partial perspective view of the cable portion and the elongated stem assembly of the surgical instrument of figure 1 with some components of the surgical instrument removed;
[00016] Figure 8 is an elevation view of the cable portion of figure 2 with some components of the surgical instrument removed;
[00017] Figure 9 is an elevation view of the cable portion of figure 2 with additional components of the surgical instrument removed;
[00018] Figure 10 is an elevation view of an effector of a joint locking mechanism and an end effector closure system according to an alternative embodiment of the present invention with some components of the surgical instrument removed;
[00019] Figure 11 is an elevation view of the surgical instrument of figure 10 illustrating the effector of the joint locking mechanism in an unlocked position and the closing system of the end effector in an open configuration;
[00020] Figure 12 is an elevation view of the surgical instrument in Figure 10 illustrating the effector of the locking mechanism.
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6/66 hinge in an unlocked position and the end effector closure system in a partially closed configuration;
[00021] Figure 13 is an elevation view of the surgical instrument of figure 10 illustrating the actuator of the articulation locking mechanism in a locked position and the closing system of the end effector in a closed configuration;
[00022] Figure 14 is an elevation view of a closing actuator of a closure system for the end effector of the surgical instrument of figure 1;
[00023] Figure 15 is a partial perspective view of the closing driver of figure 14;
[00024] Figure 16 is a partial elevation view of the closing actuator of figure 15;
[00025] Figure 17 is a perspective view of a trigger lock for the surgical instrument of figure 1;
[00026] Figure 18 is an elevation view of the trigger lock of figure 17;
[00027] Figure 19 is a detail view of a clip trigger trigger of the surgical instrument of figure 1 with some components of the surgical instrument removed;
[00028] Figure 20 is a perspective view of the trigger of figure 19;
[00029] Figure 21 is a partial view in detail of a trigger, latch, and trigger mechanism for triggering of figure 19;
[00030] Figure 22 is an elevation view of the tongue, the activation mechanism and a spring return of the trigger of the trigger of figure 19;
[00031] Figure 23 is an elevation view of the tongue of Figure 22;
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7/66 [00032] Figure 24 is a detail view of the trigger of figure 19 illustrating the pivoted tongue in a position to engage with the trigger link of the trigger of the trigger;
[00033] Figure 25 is a perspective view of the activation mechanism in Figure 22;
[00034] Figure 26 is a perspective view of a structure of the surgical instrument of figure 1;
[00035] Figure 27 is a detailed view of a trigger trigger for a surgical instrument according to an alternative embodiment of the present invention with some components of the surgical instrument removed;
[00036] Figure 28 is a detail view of the trigger of figure 27 illustrating a trigger tongue released from a trigger link;
[00037] Figure 29 is a perspective view of a return mechanism of the surgical instrument, according to claim 1, illustrating the trigger in a non-activated position with some components of the surgical instrument removed;
[00038] Figure 30 is a partial perspective view of the return mechanism of Figure 29 illustrating the trigger in a triggered position with some components of the return mechanism removed;
[00039] Figure 31 is an elevation view of the return mechanism of figure 29 arranged in the configuration illustrated in figure 30;
[00040] Figure 32 is an elevation view of the return mechanism of Figure 29 illustrating a return carriage of the return mechanism in a driven position;
[00041] Figure 33 is a partial perspective view of the return mechanism of Figure 29 with some components of the return mechanism removed;
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8/66 [00042] Figure 34 is a perspective view of the tongue and firing pin of figure 19;
[00043] Fig. 35 is a perspective view of the return mechanism of Fig. 29 illustrating the return carriage in a driven position and the trigger actuator back to its non-driven position;
[00044] Figure 36 is a partial perspective view of the return mechanism of figure 29 arranged in the configuration illustrated in figure 35, illustrating a return pin of the return mechanism operably engaged with the discharge driver;
[00045] Figure 37 is a partial perspective view of the return mechanism of Figure 29 illustrating the trigger in a triggered position after the rotation of the return pin;
[00046] Figure 38 is an additional perspective view of the return mechanism of Figure 29 arranged in the configuration illustrated in Figure 37;
[00047] Fig. 39 is a partial perspective view of the return mechanism of Fig. 29 illustrating the trigger actuator back to its non-actuated position;
[00048] Figure 40 is a perspective view of the return mechanism of Figure 29 illustrating the return carriage back to its non-driven position;
[00049] Figure 41 is a perspective view of the return mechanism of figure 29 arranged in the configuration of figure 40 illustrating the relative relationship between an inclined spring and the return pin of the return mechanism with some components of the return mechanism removed;
[00050] Figure 42 is a perspective view of the return mechanism of figure 29 arranged in the configuration of figure 40 illustrating the return carriage functionally engaged with the trigger pin of the trigger and the return pin of the trigger mechanism return
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9/66 to reset the trigger and the return mechanism to their initial settings;
[00051] Figure 43 is a detail view of a reel of the return mechanism of figure 29 illustrating the relative relationship between the return band of the return mechanism and the stapling structure of figure 26;
[00052] Figure 44 is a detail view of the spool of figure 43 illustrating the relative relationship between the return band and an alternative modality of the stapling structure in figure 26;
[00053] Figure 45 is a perspective view of a return mechanism for a surgical instrument according to an alternative embodiment of the present invention having an anti-recoil ratchet mechanism;
[00054] Figure 46 is an elevation view of the return mechanism of figure 45 having a return carriage in a non-driven position;
[00055] Figure 47 is a perspective view of the return mechanism of figure 45 with some components of the surgical instrument removed;
[00056] Figure 48 is a perspective view of a return gear, return pin, and anti-recoil latch of the ratchet mechanism of figure 45;
[00057] Figure 49 is another elevation view of the return mechanism of figure 45;
[00058] Figure 50 is a perspective view of the pivot joint of figure 5;
[00059] Figure 51 is a perspective view of the pivot joint in figure 5 with some components of the surgical instrument removed;
[00060] Figure 52 is a perspective view of the articulation joint
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10/66 tion of figure 5 with additional surgical instrument components removed;
[00061] Figure 53 is a perspective view of a locking element of the end effector of Figure 3;
[00062] Figure 54 is another perspective view of the end effector locking element of figure 53;
[00063] Figure 55 is a bottom view of the end effector locking element of Figure 53;
[00064] Figure 56 is an elevation view of the end effector locking element of figure 53;
[00065] Figure 57 is a partial perspective view of a joint of an anterior surgical instrument;
[00066] Figure 58 is a perspective view of the pivot joint of Figure 5 with some components of the end effector and elongated stem assembly removed;
[00067] Figure 59 is another perspective view of the pivot joint of figure 5 with some components of the end effector and elongated stem assembly removed;
[00068] Figure 60 is a perspective view of the locking element of the end effector of Figure 53 operatively engaged with a locking element of the elongated stem assembly;
[00069] Figure 61 is a perspective view of the locking element of the rod assembly of Figure 60;
[00070] Fig. 62 is a bottom view of the locking element of the end effector of Fig. 53 operatively engaged with the locking element of the rod assembly of Fig. 60;
[00071] Figure 63 is a perspective view of a joint of a surgical instrument according to an alternative embodiment of the present invention with some components of the surgical instrument removed;
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11/66 [00072] Figure 64 is a top view of an end effector locking element operatively engaged with a rod assembly locking element of the surgical instrument of figure 63;
[00073] Figure 65 is a perspective view of the locking element of the end effector operatively engaged with the locking element of the rod assembly of figure 64;
[00074] Figure 66 is a perspective view of the end effector locking element of figure 64;
[00075] Figure 67 is an elevation view of the end effector locking element of figure 64.
[00076] Figure 68 is an elevation view of another embodiment of the surgical instrument of the present invention;
[00077] Figure 69 is an elevation view of a cable portion of the surgical instrument of figure 68 with some components of the surgical instrument omitted for reasons of clarity;
[00078] Figure 70 is a side elevation view of a cover actuator of the cover assembly of the surgical instrument of figure 68;
[00079] Figure 71 is a partial perspective view of the closing actuator of figure 70;
[00080] Figure 72 is a partial perspective view of the closing actuator of figures 70 and 71;
[00081] Figure 73 is a partial elevation view of the cable portion of Figure 69 with some components of the surgical instrument removed for clarity purposes and illustrating an actuator of the surgical instrument cover in an open position;
[00082] Figure 74 is another view in partial elevation of the cable portion of figure 73 with some components of the surgical instrument removed for clarity purposes and illustrating a lid actuator
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12/66 of the surgical instrument in a closed position;
[00083] Figure 75 is a perspective view of a trigger lock for the surgical instrument of Figure 68;
[00084] Figure 76 is a perspective view of a trigger lock for the surgical instrument of Figure 68;
[00085] Figure 77 is an elevation view of a portion of the cable of Figure 68 with some components of the surgical instrument removed for clarity;
[00086] Figure 78 is another partial elevation view of the surgical instrument of Figure 68 with some components omitted for the sake of clarity and illustrating a portion of the discharge mechanism thereof;
[00087] Figure 79A is a partial perspective view of a portion of the lid driver and the embodiment of the cable portion of the present invention illustrating the activation of the lid driver from the open to the closed position;
[00088] Figure 79B is another partial perspective view of a portion of the lid driver and the embodiment of the cable portion of the present invention illustrating the activation of the lid driver from the closed to the open position;
[00089] Figure 80 is a partial side elevation view of a handle portion of a surgical instrument with some components of the surgical instrument removed for reasons of clarity and illustrating another embodiment of the damping system of the present invention;
[00090] Figure 81 is a partial side elevation view of a handle portion of a surgical instrument with some components of the surgical instrument removed for reasons of clarity and illustrating another embodiment of the damping system of the present invention; and [00091] Figure 82 is an elevation view of a portion of the
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13/66 the cable portion of figure 68 with some components of the surgical instrument removed for reasons of clarity to illustrate portions of an embodiment of the trigger mechanism of the present invention; and [00092] Figure 83 is a partial perspective view of the trigger mechanism portion of Figure 78 with some components omitted for reasons of clarity.
[00093] The corresponding reference characters indicate the corresponding parts through the various views. The exemplifications described herein illustrate preferred 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 [00094] Certain exemplary modalities will now be described to provide a general understanding of the principles of structure, function, manufacture and use of the devices and methods described here. One or more examples of such modalities are illustrated in the attached drawings. Those of ordinary skill in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are exemplary non-limiting modalities, and that the scope of the various modalities of the present invention is defined only by the claims. The aspects illustrated or described in connection with an exemplary modality can be combined with the aspects of other modalities. These modifications and variations are intended to be included in the scope of the present invention.
[00095] In various modalities, a surgical instrument, according to the present invention, can be configured to insert surgical clips into the soft tissue, for example. In at least one embodiment, referring to figures 1 to 4, the surgical instrument 100 may include the cable portion 102, the elongated stem assembly 104 and the
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14/66 effector end 106. In various embodiments, referring to figures 3 and 4, effector end 106 may include staple cartridge channel 108 and staple cartridge 110, where staple cartridge 110 can be configured to removably store the staples in it. In at least one embodiment, end effector 106 may additionally include an anvil 112 that can be pivotally connected to the staple cartridge groove 108 and can be pivoted between the open and closed positions by an effector closure system. To position the staples of the staple cartridge 110, the surgical instrument 100 may additionally include a staple trigger configured to traverse the staple cartridge 110 and a trigger trigger configured to advance the staple trigger within the staple cartridge. In various embodiments, anvil 112 can be configured to deform at least a portion of the clamps as they are installed from the clamp cartridge. Although various modalities of an end effector closure system and a trigger actuator are described in additional details below, various modalities of end effector closure systems and trigger actuators are disclosed in US Patent No. 6,905,057, entitled SURGICAL STAPLING INSTRUMENT INCORPORATING A FIRING MECHANISM HAVING A LINKED RACK TRANSMISSION, granted on June 14, 2005, and in US Patent No. 7,044,352, entitled SURGICAL STAPLING INSTRUMENT HAVING A SINGLE LOCKOUT MECHAMISN FOR PERVENTION OF FIRING, FIRING OF FIRING OF FIRING May 2006, the complete descriptions of which are incorporated herein by reference.
[00096] In various embodiments, a surgical instrument according to the present invention may include a system for moving, or articulating, an end effector in relation to a stem assembly
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15/66 elongated of the surgical instrument. In at least one embodiment, referring to figures 3 to 7, the surgical instrument 100 may include the joint joint 114 that can movably connect the effector end 106 and the elongated stem assembly 104. In various embodiments, the joint of the hinge 114 may allow the effector end 106 to move relative to the stem assembly 104 in a single plane or, alternatively, in multiple planes. In any event, the hinge joint 114 can include one or more pivot axes 116 (figure 5) around which the effector end 106 can be hinged. In various modalities, referring to figures 5 and 6, the surgical instrument 100 may also include a locking mechanism 118 that can fix, or lock the relative relationship between the effector end 106 and the elongated stem assembly 104. At least at least one embodiment, the locking mechanism 118 can include the locking member 120 which can be slid in relation to the effector end 106 and engage the effector end 106 in order to avoid, or at least partially inhibit the relative movement between the effector end 106 and the stem assembly 104. In at least one embodiment, the locking member 120 can be configured to engage at least one of the teeth 312 (figures 5 and 6) of the effector end 106, so that the interaction between the locking member 120 and teeth 312 can prevent, or at least partially inhibit, effector end 106 from rotating around axis 116 as described in further detail below.
[00097] In several modalities, referring to figures 7 to 9, the locking mechanism 118 can also include the actuator 122 which can be connected in a functional way to the locking member 120. In at least one mode, the actuator 122 can include pin 124 which can be received into groove 121 in lock member 120 so that when actuator 122 is slid in relation to the portion
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16/66 of cable 102, pin 124 may be in a boundary position with a side wall of the groove 121 and induce the locking member 120 in relation to the effector end 106. In at least one embodiment, the actuator 122 can be pulled away from the effector end 106, that is, proximally, to disengage the locking member 120 from the effector end 106. Although not shown, other modalities are provided for where the actuator 122 can be moved distally, or even rotated, in order to disengage the member locking mechanism 120 of the effector end 106. In any event, the locking mechanism 118 can also include the return spring 126 (Figure 6) which can be configured to move the locking member 120 towards the effector end 106, that is it is distally to engage lock member 120 with effector end 106 after actuator 122 has been released. Other locking mechanisms are described in US patent application serial number 11 / 100,772, entitled SURGICAL INSTRUMENT WITH ARTICULATING SHAFT WITH SINGLE PIVOT CLOSURE AND DOUBLE PIVOT FRAME GROUND, filed on April 7, 2005, US patent application no. series 11 / 238,358, entitled SURGICAL INSTRUMENT WITH ARTICULATING SHAFT WITH RIGID FIRING BAR SUPPORTS, filed on 29, 2005, and US patent application serial number 11 / 491,626, entitled SURGICAL STAPLING AND CUTTING DEVICE AND METHOD FOR USING THE DEVICE, filed on July 24, 2006, the complete descriptions of which are incorporated herein by reference.
[00098] In various modalities, with reference to figures 1 and 2, the actuator 122 can be bypassed so that the surgeon can grab the outer surface of the actuator 122 and pull the actuator 122 proximally, as described above. To move the actuator 122, in at least one mode, a surgeon can place one hand on the handle of cable 127, for example, and place his other hand on the actuator
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17/66 ador 122 so that the surgeon can move the actuator 122 in relation to the handle of the cable 127. In other several modalities, referring to figures 10 to 13, the actuator 122 'can be configured so that a surgeon can just need a hand to operate the surgical instrument. More particularly, in at least one embodiment, the actuator 122 'may include hooks, or projections 115, extending from them, which may allow the surgeon to hold the handle of the cable 127 with one hand and extend at least one finger of that hand distally, to hold at least one projection 115 and pull actuator 122 'proximally, as described above. Although actuator 122 'is described here as having projections 115, actuator 122, or any other suitable actuator may also include projections 115 and / or any other suitable features that may assist a surgeon in operating the surgical instrument 100 with one hand. In at least one embodiment, the projections 115 can be at least partially comprised of and / or coated with an elastic or soft-touch material, which can optimize the surgeon's footprint in the projections 115 and can provide other ergonomic benefits to the surgeon. In various embodiments, actuator 122 ', for example, can be operatively engaged with stem assembly 104 so that effector end 106 and stem assembly 104 can rotate about a longitudinal axis by actuator 122'. In such embodiments, a surgeon can orient effector end 106 at a surgical site by articulating effector end 106 as described above and / or rotating effector end 106 in position. In at least one embodiment, the surgeon can rotate the actuator 122 'by placing a finger against one of the projections 115 and applying force to it. In various modalities, the surgeon can hold the actuator 122 'in position by placing a finger against a projection 115 and resisting any unwanted movement
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18/66 of the actuator 122 'and, correspondingly, of the end effector 106.
[00099] In various embodiments, a surgical instrument according to the present invention, may include a system for closing, or attaching an end effector to the soft tissue, for example. In at least one embodiment, referring to figures 2, 5, 8 and 9, the surgical instrument 100 may include the cap actuator 128, the actuator link 130, the actuator 132 and the cap tube 134. In various embodiments , in the actuation of the lid actuator 128, the lid actuator 128 can be configured to move the link of the actuator 130, the actuator 132, and the lid tube 134 distally. More particularly, in at least one embodiment, the drive link 130 can include a first end connected pivotally to driver 128 and a second end connected pivotally to driver 132 so that rotation of driver 128 towards the handle of the cable 127 can direct the drive link 130 forward and slide driver 132 along the axis defined by drive guide 136 (figure 8). In various embodiments, driver 132 can include projections 133 extending from it, which can be received slidingly within slots 135 on driver guide 136, so that slots 135 can define a path for driver 132 as that it is moved. In various embodiments, the closing tube 134 can be operatively engaged with the driver 132 so that when the driver 132 is moved in the distal position as described above, the closing tube 134 can engage with the anvil 112 and pivot the anvil 112 down. Referring primarily to figure 5, the cap tube 134 can be configured to slide over the hinge joint 114 and the pivot anvil 112 in relation to the staple cartridge 110. In at least one embodiment, as shown in figure 9, the closing tube
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134 may include a proximal end having the projection 135 extending from it, which can be received in the slot 131 in the driver 132 so that the displacement of the driver 132 is transmitted to the closing tube 134.
[000100] In various embodiments, as described above, the locking mechanism 118 can prevent, or at least partially inhibit, the relative movement between the effector end 106 and the stem assembly 104. In circumstances where the soft tissue is stapled between the anvil 112 and the staple cartridge 110, for example, the relative movement between the effector end 106 and the stem assembly 104 can apply a shear force to the soft tissue stapled between them, which can injure it. In various embodiments, with reference to figures 10 to 13, to prevent, or at least reduce the relative movement between end effector 106 and stem assembly 104 when end effector 106 is closed, the closing system of the effector of end can be configured to engage locking mechanism 118 to prevent actuator 122 'from being moved to its unlocked position. In fact, in at least one embodiment, the actuation of the closing actuator 128 may not only close the end effector 106, but may also prevent the locking mechanism 118 from being unlocked. In various modalities, referring to figures 10 to 13, the surgical instrument 100 'can include the actuator 132 which can be configured to be in a borderline position, or be positioned very adjacent to the actuator 122' when the actuator 132 moves distally through the actuator 128 and thus prevent actuator 122 'from moving proximally, as described above in relation to actuator 122. More particularly, before actuator 132 is actuated, as shown in figures 10 and 11, actuator 122' can be slid proximally in order to slide the locking member 120 in relation to the effector end 106 and
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20/66 lock the joint joint 114. In the actuation of the actuator 132, however, with reference to figure 13, the actuator 132 can be configured to be in a borderline position, or be positioned adjacent to the actuator 122 ', so that the actuator 122 'cannot move proximally to disengage locking member 120 from effector end 106. As a result, the effector end closure system can prevent effector end 106 from being hinged after being closed, thereby reducing the possibility that a shear force will be transmitted to the soft tissue stapled to it.
[000101] In addition to the above, the end effector closure system can provide feedback to the surgeon that the end effector has been closed and, for the surgeon to unlock and articulate the end effector, the surgeon must first reopen at least partially the end effector before it can be articulated. More particularly, due to the interaction between actuator 132 and actuator 122 'when end effector 106 is closed, when the surgeon tries to proximally pull actuator 122' to unlock joint pivot 114, actuator 132 can substantially avoid that actuator 122 'moves, thereby signaling to the surgeon that end effector 106 is closed and that it must be opened before actuator 122' can be moved and the pivot joint is unlocked. In various embodiments, such an end effector closure system can prevent the surgeon from damaging the surgical instrument and / or the captured tissue that is within, or surrounding, the end effector. More particularly, in at least one embodiment, when the cap tube 134 has been advanced close to the anvil 112, as described above, the cap tube 134 can apply force to the anvil 112 to hold the anvil 112 in a closed position, and in various circumstances, this force can create frictional forces
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21/66 at the joint joint 114 which can inhibit, if not prevent, the effector end 106 from rotating around the joint joint 114. In modalities without the effector end closure system described above, if a surgeon attempts to overcome these forces friction without first, at least partially, opening the effector end, the surgeon can flex or rupture one or more components of the surgical instrument, for example. In various embodiments of the present invention, however, actuator 132 can, for example, prevent the surgeon from releasing joint lock 120 as described above, and as a result, the surgeon may not have the opportunity to unlock the joint joint 114 let alone articulate end effector 106.
[000102] In various embodiments, a surgical instrument according to the present invention can include an end effector closure system that can position the anvil 112, for example, in an open position, a closed position, and a partially closed position . In at least one embodiment, a surgeon can move the anvil 112 to a partially closed position and assess whether the end effector should be positioned or articulated before the anvil 112 is moved to its closed position. In such embodiments, the anvil 112 can be moved relative to the soft tissue positioned intermediate to the anvil 112 and the staple cartridge 110, without applying a shear force, or without at least a substantial shear force, to the soft tissue before that the anvil 112 is completely closed. In at least one embodiment, the anvil 112 can be configured so that it does not trap the soft tissue positioned between the anvil 112 and the staple cartridge 110 when it is in its partially closed position. Alternatively, anvil 112 can be configured to apply a slight force
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22/66 gripping soft tissue when anvil 112 is in its partially closed position, before applying greater gripping force when it is moved to its closed position. In at least one such embodiment, the surgical instrument may include a driver that can move between a first position (figure 11) that corresponds to the open position of the anvil 112, a second position (figure 12) that corresponds to its partially closed position , and a third position (figure 13) that corresponds to its closed position. In various embodiments, with reference to figures 8 and 9, the driver 128 can be pivotally mounted to the compartment 103 of the cable portion 102, so that the driver 128 can be rotated around the pin 129 between its first, second or third position . In various embodiments, with reference to figures 8, 9, 17 and 18, the surgical instrument 100 may additionally include a trigger lock 148 that can be configured to engage the trigger 128 and lock the trigger 128 selectively in at least one of its first, second, and third positions described above. In at least one embodiment, the driver 128 may include the pivot end 138 comprising the cam surface 140, the first notch 142 and the second notch 144 where the lock of the driver 148 can be configured to engage the first notch 142 and the second notch 144. More particularly, the surgical instrument 100 may additionally include, with reference to figures 8 and 9, a trigger lock spring 150, which can be configured to tilt the trigger portion 149 of the trigger lock 148 against the surface of cam 140, so that when the first notch 142 or the second notch 144 is aligned with the driven portion 149, the spring of the actuator latch 150 can push the driven portion 149 into the first notch 142 or second notch 144, respectively. In at least one modality, referring primarily to
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23/66 and figures 8 and 9, the driver lock 148 can be pivotally mounted to the compartment 103 of the cable portion 102 via pin 151. In various embodiments, the driver lock spring 150 can be an intermediate button portion compressed 152 of the actuator latch 148 and housing 103, so that the actuator latch spring 150 can rotate the actuator latch 148 around the pin 151 and tilt the actuator latch 148 down against the surface of the actuator cam 140 128.
[000103] In addition to the above, in at least one embodiment, the first notch 142 can be aligned with the follower portion 149 when the driver 132 is moved to the second position and the anvil 112 is moved to the partially closed position. In various embodiments, the follower portion 149 can be securely retained within the first notch 142, so that the lock of the driver 148 may need to be disengaged manually from the driver 132 before the driver 132 can be moved to its third position and / or returned to your first position. In at least one embodiment, referring to figures 8 and 9, a surgeon can depress the button portion 152 of the lock member 148 so that the lock member 148 is rotated around pin 151 and the driven portion 149 is lifted up and out of engagement with driver 128. In other various embodiments, the first notch 142 can be configured so that the driven portion 149 can slide out of the first notch 142 in applying force to the driver 132. In any case event, after the driven portion 149 is disengaged from the first notch 142, a surgeon can selectively move the trigger 132 to its third position or release the trigger 132 and allow the trigger spring, for example, to return the trigger 132 to its first position. In at least one alternative embodiment, the first notch 142 and the follower portion 149 can be
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24/66 configured so that after driver 132 has been moved to its second position, driver 132 must be moved to its third position, before it can be returned to its first position. In each case, in at least one embodiment, the second notch 144 of the driver 132 may be aligned with the follower portion 149 when the driver 132 is moved to its third position and the anvil 112 is moved to its closed position. Similar to the first notch 142, the second notch 144 can be configured to retain the driven portion 149 therein until the locking member 148 is disengaged from the driver 132 and / or sufficient force is applied to the driver 132 to displace the driven portion 149 from the second notch 144. Consequently, in various embodiments, an actuator spring can move the actuator 132 from its third position to its second position where the surgeon may need, similar to the case above, to disengage the actuated portion 149 from the first notch 142. In at least one alternative embodiment, the first notch 142 can be configured so that the driven portion 149 can slide past the first notch 142 and allow the driver 132 to move from its third position to its first position without requiring the surgeon to dislodge the driven portion 149 of the first notch 142.
[000104] In addition to the above, although not shown, the button portion 152 of the locking element 148 can be embedded, for example, inside the surgical instrument compartment 103, when the closing actuator 128 is in its first position. In alternative embodiments, the portion of button 152 may be positioned flush with compartment 103 or it may extend slightly from compartment 103. In any case, in at least one embodiment, portion of button 152 may move outwardly relative to the compartment 103 when the cover trigger
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25/66
128 moves to its second position. This movement can provide visual feedback to the surgeon that the anvil of the surgical instrument is in its partially closed state. In addition, the movement of the button portion 152 can also be accompanied by auditory and / or tactile feedback. In any case, a surgeon can access the button portion 152 after it has been moved externally, so that the locking element 148 can be disengaged from the actuator 128, as described above. In various embodiments, the button portion 152 can move externally further when the actuator 128 is moved from its second position to its third position. Similar to the above, this movement can provide a visual suggestion to the surgeon that the anvil is now in its closed position and can be accompanied by auditory and / or tactile feedback, as described above. Although button 152 is described above as having outward movement as the actuator 128 is advanced between its first and second positions, the invention is not limited by this. On the contrary, button 152, or any other suitable indicator, can provide feedback to the surgeon in any appropriate manner.
[000105] In alternative modalities, although it is not illustrated, the anvil 112 can be maintained, or retained, in more than the three positions described above, that is, in its open, closed, and partially closed positions. In at least one embodiment, the anvil 112 can be retained in the open, closed, and two or more intermediate positions. In such embodiments, the anvil 112 could be advanced through these intermediate positions and apply an increasingly greater force to the soft tissue captured in the end effector 106, as the anvil 112 is moved towards its closed position. In at least one embodiment, similar to that described above, driver 132 could include a plurality of notches
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26/66 that could correspond with the various intermediate positions of the anvil 112. In several alternative modalities, although not shown, the closing system of the effector end could include a ratchet assembly that could allow the driver 132 and, correspondingly , the anvil 112 are held in a plurality of positions. In these embodiments, the anvil 112 and the driver 132 could be held in place by a tongue pivotally engaged with a ratchet wheel operatively engaged with the driver 132.
[000106] In various embodiments, with reference to figures 10 to 13, the relative movement between the actuator 122 'and the cable portion 102', as described above, can be limited to control the extent to which the locking element 120 can be shifted. More particularly, referring to figures 10 and 11, the distal portion of the actuator 122 'can include the protrusion 123 extending from that which can be received in the cavity 125 where the displacement of the actuator 122' can be limited by the proximal wall 117 and the distal wall 119 of cavity 125. In at least one embodiment, when the actuator 128 is in its first position, as shown in figures 10 and 11, the actuator 122 can move from a distal position where the projection 123 can be in position bordering the distal wall 119, as shown in figure 10, in a more proximal position in which the protrusion 123 is not in a boundary position with the distal wall 119, as shown in figure 11. In this more distal position, as described above, the locking member 120 can be disengaged from effector end 106 and effector end 106 can be rotated relative to stem assembly 104. When actuator 128 is in its second position, with reference to figure 12, the actuator 132 can limit the movement range of the actuator 122 'so that the projection 123 cannot be positioned against the proximal wall 117. At least
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27/66 minus one modality, however, actuator 122 'can move proximally a sufficient distance to disengage lock member 120 from effector end 106. Under these circumstances, a surgeon can reposition effector end 106 while anvil 112 can be partially closed in the soft tissue, for example. When the actuator 128 is in its third position, as illustrated in figure 13, the actuator 132 can force the actuator 122 'in a distal position so that the projection 132 is in a boundary position, or adjacent to the distal wall 119, and the actuator 122 'cannot be moved sufficiently to unlock the hinge joint 114.
[000107] In various embodiments, a surgical instrument in accordance with the present invention, may include a trigger trigger configured to advance a cutting element and / or staple trigger within an end effector, as described above. In at least one embodiment, referring to figures 8, 9 and 19-25, the trigger trigger of the surgical instrument 100 may include trigger trigger 160, trigger first trigger 162, trigger second trigger 164, and trigger firing member 166. In various embodiments, firing trigger 160 can be operatively engaged with at least one of firing member 166 and firing connections 162 and 164 in order to advance knife bar 168 into elongated stem assembly 104. In at least one embodiment, the knife bar 168 can be operatively engaged with a cutting member (not shown) and a staple driver (not shown) at the effector end 106 where the cutting member can be configured to incise the fabric, for example example, and the staple driver can be configured to position the staples of the staple cartridge 110. The cutting elements and staple actuators are well presented in US Patent Nos. 6,905,057 and 7. 044,352, which were previously incorporated by reference in this part
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28/66, and as a result, these devices are not described in more detail in this document. Other cutting elements and clip drivers are presented in US patent application serial number 11 / 541.123, entitled SURGICAL STAPLES HAVING COMPRESSIBLE OR CRUSHABLE MEMBERS FOR SECURING TISSUE THEREIN AND STAPLING INSTRUMENTS FOR DEPLOYING THE SAME, filed September 29, 2006 , and in US Patent Application Serial No. 11 / 652,169, entitled SURGICAL STAPLING DEVICE WITH A CURVED CUTTING MEMBER, filed on January 11, 2007, the complete descriptions of which are incorporated herein by reference.
[000108] In several modalities, referring primarily to figures 19 and 20, trigger trigger 160 can be articulated to the surgical instrument compartment 103 (figures 8 and 9) by pin 161. In use, in at least one mode, trigger trigger 160 can be pivoted around pin 161 in order to advance trigger member 166 and trigger connections 162 and 164 distally. In various embodiments, trigger trigger 160 may include grooves 159, where grooves 159 may be configured to receive trigger pin 172. In various embodiments, when trigger trigger 160 is engaged, or rotated, from the position shown in the figure 2 to a position adjacent to the cable handle 127, the side walls of the slots 159 can be configured to engage and advance the trigger pin 172 in a distal position. In at least one embodiment, with reference to figure 23, the trigger driver may further include tongue 170, where tongue 170 may include aperture 171. In various embodiments, aperture 171 may be configured to receive at least a portion firing pin 172 so that when firing pin 172 is advanced distally by trigger 160, firing pin 172 can also
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29/66 advance the tongue 170 in the distal position in the same way. In various embodiments, with reference to Figure 24, tongue 170 can tooth 174 and trigger member 166 can include recess 167, where recess 167 can be configured to receive tooth 174. In use, when tongue 170 advances distally by the trigger pin 172 and the tooth 174 is engaged with a side wall of the recess 167, the tongue 170 can advance the trigger member 166 distally in the same way. In various embodiments, the tongue 170 can be advanced distally by the firing pin 172 along a substantially linear path. In such embodiments, the grooves 159 can include the arcuate profiles that can, in cooperation with the trigger pin 172, convert the rotational movement of the trigger trigger 160 into the translational movement of the tongue 170. In at least one embodiment, the force applied to the tongue 170 it can be substantially, if not entirely, directed in the distal direction. In such embodiments, as a result, the possibility of the tongue 170 being stuck or immobilized against the structure of the stapler 184 can be reduced.
[000109] In several embodiments, the tongue 170 can be rotated between a first position where the tongue 170 is operatively disengaged from the trigger member 166 and a second position, referring to Figures 19 and 20, where the tongue 170 is operatively engaged with the trigger member 166. Referring primarily to figures 21 to 25, the trigger driver may further include the tilt mechanism 178 which can be configured to revolve the tongue 170 between its first and second positions. In use, when the trigger actuator 160 is actuated, the tongue 170 can move, at least initially, in relation to the tilting mechanism 178 so that at least a portion of the tongue 170 can be in a position bordering the tilting mechanism 178 and the tongue swivel 170 for
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30/66 up and into the operational coupling with the trigger member 166. In at least one embodiment, the tongue 170 may include, referring primarily to figure 23, the groove 175 that can be configured to receive the projection 179 (figure 25) extending from the central portion of the tilt mechanism 178. In at least one embodiment, as the tongue 170 advances distally, the proximal wall 176 of the groove 175 may come into contact with a cam surface on the projection 179 and, due to under the force applied to the tongue 170 by the rotating pin 172, the tongue 170 can be hinged or rotated upwards, so that the tooth 174 can be positioned in the recess 167 of the trigger member 166 as described above. After the tongue 170 has been pivoted, the tongue 170 can drag the tilt mechanism 178 distally as the tongue 170 advances towards the effector end 106. More particularly, in at least one embodiment, the tilt mechanism 178 may include deformable members 180 that can be received into the grooves 182 in the stapler structure 184 so that the interaction between the deformable members 180 and the stapler structure 184 at least partially inhibits the movement of the tilting mechanism 178 in relation to the structure of the stapler 184. Established otherwise , due to the static frictional forces between the deformable members 180 and the side walls of the grooves 182, a sufficient force to overcome these frictional forces must be applied to the tilting mechanism 178 before the tilting mechanism 178 can be 'dragged' in relation to the structure of stapler 184.
[000110] After trigger trigger 160 has been triggered and trigger member 166 has advanced, trigger 160 can be released and returned to its non-triggered position shown in Figure 2 and latch 170 can be disengaged from trigger member 166 and retracted to its initial position illustrated in figure 19. More particu
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31/66 larly, in at least one embodiment, the surgical instrument 100 may further include an actuator spring (not shown) operatively engaged with actuator 160 and compartment 103, for example, where the actuator spring can be configured to rotate the trigger 160 around the pin 161 and direct the trigger pin 172 proximally after the tongue 170 has been disengaged from the trigger member 166. In various embodiments, the tongue 170 can be disengaged from the trigger member 166 when it is pivoted from its second position, as shown in Figure 24, to its first position, as described above, by the tilt mechanism 178. In such embodiments, the tongue 170 can be moved, at least initially, in relation to the tilt mechanism 178 so that the distal wall 177 of the groove 175 can come into contact with a second cam surface on the projection 179 and can, due to the force applied to the trigger pin 172 by the driver 160 or return spring 186, turn the tongue 170 downwards so that the tooth 174 of the tongue 170 can be disengaged from the recess 167 in the trigger member 166. Consequently, the driver 160 and / or the return spring 186 can pull, or retract , the tongue 170 with respect to the trigger member 166. In various embodiments, similar to that described above, the tongue 170 can be configured to drag the tilting mechanism 178 proximally into the groove 182. As a result of what has been described above, the tongue 170 does not it must be tilted in its first or second positions. In various circumstances, the tongue 170 can be rotated freely between its first and second positions without having to overcome the force applied to it by a tilt spring. In fact, in several modalities, the force to move the tongue 170 between its first and second positions needs only to overcome the gravitational weight of the tongue 170 and any frictional force between the tongue 170 and the components.
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32/66 surrounding the surgical instrument.
[000111] Once the tongue 170 has returned to its original position, in at least one embodiment, tooth 174 of tongue 170 may no longer be aligned with the recess 167 in trigger member 166. On the contrary, referring to In general to figures 19 and 20, the tooth 174 of the tongue 170 can be aligned with the recess 163 in the first connection of the trigger 162. More particularly, the first connection of the trigger 162 can be pivotally connected to the trigger member 166 so that, when the trigger member 166 is advanced distally, as described above, trigger member 166 can pull the first connection of trigger 162 to the position that trigger member 166 previously occupied. As a result, by means of a second actuation of the firing trigger 160, the tongue 170 can be pivoted from its first position to its second position, so that tooth 174 is operatively engaged with recess 163 and tongue 170 can advance the firing link 162 in the distal position. In at least one embodiment, trigger connection 162 can push trigger member 166 and knife bar 168 distally and, correspondingly, advance the cutting member and staple driver distally within effector end 106. Consequently, the tongue 170 can again be pivoted from its second position to its first position and can be retracted from the first trigger connection 162. Once the tongue 170 has returned to its original position for the second time, tooth 174 of the tongue 170 may no longer be aligned with the recess 163 of the first connection of the trigger 162. Conversely, similar to the described above, tooth 174 may be aligned with the recess 165 in the second connection of the trigger 164 and the process described above can be repeated.
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33/66 [000112] Although not illustrated, a surgical instrument according to the present invention can include more than two, or less than two trigger connections in order to advance the cutting member and the clip driver to their desired positions in the effector end 106. In various embodiments, although not shown, trigger member 166 may include more than one recess 167 so that tongue 170 can directly advance trigger member
166 towards effector end 106 more than once. In at least one of these embodiments, the tongue 170 can be retracted after advancing the firing element 166 in a distal position, as described above, so that when the tongue 170 is activated upward again, the tongue 170 can engage in another recess
167 on the firing element 166 and advancing the firing element 166 towards the end effector 106 again. As a result, in at least one embodiment, trigger links 162 and 164 may not be necessary.
[000113] In various embodiments, a surgical instrument may include one or more spring elements configured to move the tongue 170 in at least one of its first and second positions. In at least one embodiment, with reference to Figures 27 and 28, the trigger can include a tongue 170 ', a trigger pin 172, and an activation mechanism 178' in which, similarly to the above, the mechanism of activation 178 'can be configured to pivot tongue 170' upward when tongue 170 'is advanced in the distal position. The trigger actuator may also include the pivot spring 188 which can be functionally connected to the tongue 170 'so that when the tongue 170' is hinged upwards in its second position, as shown in figure 27, the tongue 170 'can flex, or resiliently flex, the pivot spring 188. After tongue 170' has moved forward, tongue 170 '
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34/66 can be pivoted down in its first position by the pivot spring 188 as shown in figure 28. More particularly, due to the potential energy stored in the pivot spring 188 when it is flexed, the spring 188 can move the tongue 170 ' downwards since the tongue 170 'is no longer held in its second position by the tilting mechanism 178' and the trigger pin 172. Consequently, as described above, the tongue 170 'can be retracted in relation to the trigger member 166 and / or to trigger connections 162 and 164. In various embodiments, tilt mechanism 178 'may not include a second cam surface for pivoting tongue 170 into its first position. In such embodiments, the tongue 170 'can be retracted by a force applied to the firing pin 172, as described above. In various alternative embodiments, although not shown, activation mechanism 178 'and tongue 170' may also include cooperative features to pivot tongue 170 'down in its first position.
[000114] In various modalities, referring to figures 19 and 20, the surgical instrument 100 can also include a strip 190 that can be configured to move the trigger member 166 and the trigger connections 162 and 164 in relation to the effector end 106. In at least one embodiment, a first end of strip 190 can be connected to trigger member 166, for example, so that when trigger member 166 is distally advanced, strip 190 can be pulled distally in the same way. In various alternative embodiments, the strip 190 may be connected to the first connection of the trigger 162 and / or to the second connection of the trigger 164. In at least one embodiment, the strip 190 may be positioned around at least a portion of the spool, or coil 192 so that when strip 190 is pulled by trigger member 166, the
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35/66 band 190 can be positioned, or unwound from spool 192. In at least one embodiment, a second end of band 190 can be connected to spool 192 so that band 190 cannot be readily disengaged from spool 192 under conditions operating modes of the surgical instrument 100. In any event, when the band 190 is pulled by the trigger member 166, the spool 192 can be rotated clockwise or anti-clockwise, depending on the way in which the band 190 is positioned at the around spool 192. In order to retract trigger member 166, spool 192 can be rotated in an opposite direction to move trigger member 166, and trigger links 162 and 164 proximally and twist strip 190 around spool 192.
[000115] In various embodiments, the strip 190 can be screwed around the spool 192 so that the strip 190 is wound around a substantially cylindrical surface on the spool 192. In at least one embodiment, the distance between an axis of rotation of the spool 192 and the cylindrical surface can be substantially equidistant around the perimeter of the spool 192. In these embodiments, the mechanical advantage of the spool 192 can remain substantially constant as the web 190 is pushed proximally as described above, and the capacity for the spool 192 applying a tensile force to the web 190 may remain substantially the same. In alternative embodiments, however, the spool 192 can be configured to provide a variable mechanical advantage. In at least one embodiment, the spool 192 may include a non-cylindrical surface on which the web 190 can be wrapped so that the distance between the axis of rotation of the spool 192 and the non-cylindrical surface is not equidistant around the perimeter of the spool 192. In these modalities, as a result, the capacity for the reel 192 to apply
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36/66 a tractive force on the strip 190 may change as the strip 190 is wound around the spool 192. In at least one embodiment, the spool 192 can act as a cam and can include a shape that can be optimized to provide strength additional to band 190 when it is initially retracted, that is, when the force to retract the cutting member, for example, may be at its maximum.
[000116] In various modalities, referring to figures 29 to 42, trigger trigger 160 can be selectively engaged with a return mechanism of surgical instrument 100. In at least one mode, when trigger trigger 160 is engaged in a manner functional with the triggering element 166 by means of the tongue 170, as described above, an actuation of the triggering factor 160 can advance the triggering member 166 in a distal position and, when the triggering factor 160 is engaged in a functional way with the element trigger 166 by means of band 190, actuation of trigger trigger 160 can retract trigger element 166 proximally In various embodiments, the return mechanism can be manually triggered to disengage trigger trigger 160 from trigger member 166 and to operatively engage trigger trigger 160 with spool 192. In at least one embodiment, the return mechanism may include the return carriage 194 that can be pivotally mounted in the surgical instrument compartment 103, so that the return carriage 194 can be pivoted between a first position, not driven, as shown in figure 29, and a second position, or driven, as shown in figure 32. In at least one such embodiment, the return carriage 194 may include a portion of the push button 195 which, when a force is applied to it, can be configured to move the return carriage 194 from its non-driven position to the its triggered position.
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37/66 [000117] When the return carriage 194 is positioned in its non-driven position illustrated in figures 29 to 31, the trigger driver 160 can be configured to advance the trigger member 166 as described above and the gear portion 158 of the driver 160 can be operationally engaged with the drive gear 196. In various embodiments, the gear portion 158 and the drive gear 196 can be operatively engaged so that a rotation of the driver 160 around pin 161 can direct the drive gear 196 around an axis defined by the return pin 198. In at least one embodiment, when the return carriage 194 is in its non-driven position, the drive gear 196 can be configured to rotate freely around the return pin 198 so that the rotation of the drive gear 196 is not transmitted, or at least is not substantially transmitted to the return pin 198. More In particular, with reference to Figure 30, the key 199 of the return pin 198 can be tilted out of engagement with the drive gear 196 so that the rotation of the drive gear 196 is not transmitted to the key gear 206 and the spool 192. As a result, an actuation of the drive gear 160 does not rotate, or at least substantially rotate the spool 192 when the return carriage 194 is in its non-driven position.
[000118] After the cutting element and the clip driver have been advanced into the end effector 106, the return carriage 194 can be moved to its driven position. In various embodiments, with reference to Figure 30, the spool 192 may include a cam element 202 extending therefrom, which can contact the return carriage 194 and rotate the return carriage 194 downwards. In at least one embodiment, the cam element 202 may come into contact
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38/66 contact with the return carriage 194 during the final actuation of the reactivator 160 which advances the cutting member and the clamp driver at the effector end 106. In at least one embodiment, the cam element 202 may come into contact with the return carriage 194 after the third actuation of the trigger actuator 160. In various modalities, referring to figures 32 to 35, when the gear carriage 194 moves to its driven position, the return carriage 194 can be configured to operatively engage the drive gear 196 as spool 192. In at least one embodiment, referring to figures 33 and 35, the return carriage 194 may include the tilt spring 200 where, when the return carriage 194 is in its position not actuated, the spring 200 can be located in the position shown in figure 33 and, when the return carriage 194 moves in its actuated position shown in figure 35, the spring 200 can come in contact with the return pin 198 and the inclination of the return pin 198 towards the drive gear 196. In at least one embodiment, with reference to figure 31, the drive gear 196 may include a D-shaped cavity 197 in this place which can, under certain circumstances explained below, receiving key 199 extending from a return pin 198 and operatively engaging the gear of the driver 196 with the gear of the key 206 and the spool 192. In various embodiments, the movement of the return car 194 in its position triggered can be accompanied by a sound and / or tactile feedback to inform the surgeon that the return mechanism of the surgical instrument has been engaged with the trigger 160.
[000119] In addition to the above, when the return pin 198 is slid towards the gear of the driver 196, the D-shaped cavity 197 can be positioned so that the key 199 does not immediately enter the cavity 197. On the contrary, with
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39/66 reference to figure 31, the spring 200 can tilt the return pin 198 so that the key 199 is initially bordering the face 204 of the drive gear 196. After the driver 160 is released and returns to its un-driven position however, the D-shaped cavity 197 can be rotated and aligned with key 199, so that spring 200 can tilt key 199 into cavity 197 as shown in figure 36. In at least one embodiment, with reference to figure 31, when the return pin 198 is slid towards the drive gear 196, one end of the return pin 198 can be received in the slot 193 in the return carriage 194 as illustrated in figure 32. After the key 199 has been inserted into cavity 197, subsequent actuation of the driver 160 may cause the surface of the driver 210 of the D-shaped cavity 197 to be in a boundary position with the key 199 and turn the return pin 198 to a position tion illustrated in figures 37 and 38. In fact, an actuation of the actuator 160, in at least one mode, can turn key 199 approximately halfway through a revolution so that key 199, which initially extends substantially downwards ( figure 36), can be turned so that the key 199 extends substantially upwards (figure 37). Consequently, the driver 160 can be released and the driver gear 194 can be rotated with respect to the key 199 where the key 199 can remain oriented substantially upward, as shown in figures 39 to 41.
[000120] In various embodiments, referring mainly to figure 38, the gear of the key 206 can be operatively engaged with the return pin 198 so that the rotation of the return pin 198 can be transmitted to the gear of the key 206. In at least one embodiment, the key gear 206 may include a key shaped opening 212 that can be configured to
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40/66 slidingly receive key 199 from return pin 198. In at least one embodiment, key 199 can be operatively engaged with both recesses 197 of drive gear 196 and opening 212 of key gear 206 when the return pin 198 is engaged with the drive gear 196. In several alternative embodiments, the gear of the key 206 can be fixedly mounted to the return pin 198. In such embodiments, when the return pin 198 is slid in relation to the gear of the driver 196, the gear of the key 206 can also be slid in relation to the gear of the driver 196. In various embodiments, generally referring to figure 38, the spool 192 may include the sprocket 216 mounted thereon, where the wheel gear 216 can be operationally engaged with key gear 206 so that rotation of key gear 206 can be transmitted to spool 192. In at least one embodiment, gear of the key 206, when it is slid towards the gear of the driver 196 as described above, it can be slid in operational engagement with the spool 192. In alternative modalities, the sprocket 216 can be configured so that the gear of the key 206 is in an operational engagement with it regardless of whether the gear of the key 206 has been tilted toward the gear of the driver 196.
[000121] As a result of the above, when the return carriage 194 is positioned in its driven position, illustrated in figure 32, an actuation of the driver 160 can rotate the spool 192 and wrap the web 190 around at least a portion of the same. In the event that the key 199 cannot be operatively engaged with the drive gear 196 when the return carriage 194 is driven, the spool 192 can be manually rotated to retract track 190. In at least one such mode, referring to
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41/66 if figures 33 and 37, the pin, or lock 218, can be operatively engaged with the spool 192 so that the rotation of the pin 218 can effect the rotation of the spool 192. In several modalities, a surgeon can insert the pin 218 through an opening in the surgical instrument compartment 103 and engaging pin 218 with the spool 192. In at least one embodiment, the surgical instrument 100 may also include a counting mechanism (not shown) that can count the performances of the actuator 160 and, in at least one such mode, pin 218, for example, can be operatively engaged with the counting mechanism to rotate the spool 192. In various embodiments, as a result, the surgical instrument can include a first or primary actuator to wind the spool 192 and a second driver that can be configured to wind the spool 192 in place of the first actuator.
[000122] In several embodiments, as described above, the spool 192 can be configured to pull the web 190 and retract the trigger element 166 and the trigger links 162 and 164 proximally. More particularly, as described above, the firing element 166 and firing links 162 and 164 can be retracted with respect to tongue 170 to reposition firing element 166 and firing links 162 and 164 to their starting positions. In such modalities, specifically in the modalities where the tongue 170 is pivoting as described above, the return mechanism of the surgical instrument 100 can be additionally configured to secure the tongue 170 out of the operating engagement with the trigger member 166 and the trigger connections 162 and 164 while they move in relation to the tongue 170. More particularly, when the return carriage 194 moves to its driven position illustrated in figure 35, the return carriage 194 can be configured to contact an end of the trigger pin 172 and slide the
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42/66 trigger pin 172 towards latch 170 so that trigger pin 172 engages latch 170 and prevents latch 170 from pivoting upwards. More particularly, with reference to figure 34, the trigger pin 172 can include the first end 220 which can include a beveled and / or round surface, for example, where, when the return carriage 194 comes into contact with the first end 220, return carriage 194 can push trigger pin 172 toward latch 170. In at least one embodiment, latch 170 can include recess 173 that can be configured to receive key 222 extending from trigger pin 172 when the trigger pin 172 moves towards the tongue 170. When the key 222 and the recess 173 are operatively engaged, the trigger pin 172 can prevent the tongue 170 from pivoting upwardly within the engagement as a trigger member 166 and the trigger connections 162 and 164.
[000123] After the firing element 166 and firing links 162 and 164 have been retracted, a new staple cartridge 110 can be attached to end effector 106 and surgical instrument 100 can be reset, so that it can be used to make incisions and staple the soft tissue again. In various modalities, referring to figures 39 to 42, the return car 194 can move from its driven position shown in figure 32 to its non-driven position shown in figure 40. In at least one mode, the return car 194 can be rotated or pivoted upwards when a force is applied to a portion of button 195. Alternatively, the return carriage 194 can move upwards when, with reference to figure 29, the actuator lock 148 is rotated upwards to disengage the actuated portion 149 of the cap actuator 128 in order to reopen effector end 106 as described above. More particularly, when a force is applied to the
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43/66 button portion 152 of the actuator latch 148, the actuator latch 148 can be rotated upwards so that the projection 147 extending from it can contact the return carriage 194 and move it 194 also upward. In any case, with reference to figure 42, when the return carriage 194 moves upwards to its non-activated position, the return carriage 194 can disengage the trigger pin 172 from the tongue 170 and, in addition, disengage the return 198 of the drive gear 196. More particularly, the return carriage 194 can be configured to be in a boundary position with the chamfered or rounded end 221 of the trigger pin 172 so that when the return carriage 194 is rotated upwards, return carriage 194 can slide return pin 172 away from tongue 170 and disengage key 222 from recess 173. Similarly, when return carriage 194 moves upward, a side wall of slot 193 can be configured to contact one end of the return pin 198 and slide the return pin 198 away from the drive gear 196 to disengage the key 199 from the D-shaped recess 197. In summary, at least in the mod In addition, when the button portion 152 of the locking member 148 is pressed and the return carriage 194 moves upwards, the surgical instrument can be restarted and can be reused again.
[000124] Although the surgical instruments described above can be reset after the cutting member and the clamp driver have been fully advanced at the effector end 106, the button portion 195 of the return carriage 194, for example, can be pressed after the cutting member and clamp driver have only been partially advanced into effector end 106. In various embodiments, return carriage 194 may further include
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44/66 the guide pin 191 extending between the opposite sides of the return carriage 194. In at least one such embodiment, the guide pin 191 can be slidably received inside the guide slot 185 (figure 31) in the structure 184 so that slot 185 and pin 191 can define a path for return carriage 194. In various embodiments, guide pin 191 and guide slot 185 can be configured to ensure that return carriage 194 engages trigger pin 172 and the return pin 198 and reset the surgical instrument when the return carriage 194 moves from its driven position to its non-driven position as described above.
[000125] In various embodiments, the surgical instrument 100 may further include a brake to prevent, or at least partially inhibit the trigger driver from advancing and / or retracting the cutting member and the clamp driver, for example, within one end effector 106. In at least one embodiment, with reference to figure 43, the structure 184 can include the brake surface 187 where the brake surface 187 can be configured to apply a braking force to the strip 190. More particularly, when the strip 190 is pulled proximally and / or distally as described above, structure 184 can be configured so that strip 190 slides over brake surface 187 and a frictional force is created between them. In various embodiments, with reference to figure 44, the brake surface 187 'can be configured so that the path of the web 190 between the firing element 166 and the spool 192 is interrupted by the brake surface 187' and a significant normal force can be applied to band 190.
[000126] In at least one embodiment, the strip 190 can be engaged with the brake surface 187 'when the strip 190 is at rest so that a static frictional force between the strip 190 and the brake surface 187' can prevent , at least initially, that the
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45/66 track 190 moves relative to the brake surface 187 'when a pulling force is applied to track 190. When the pulling force applied to track 190 exceeds the static frictional force, track 190 can move in to the brake surface 187 '. Such modalities can be particularly useful when the actuator 160 is actuated more than once to advance the cutting member and / or the clamp actuator within the effector end 106. More particularly, after actuation of the actuator 160, the tongue 170 can be retracted with respect to trigger member 166 as described above and, in various embodiments, the frictional force between band 190 and brake surface 187 'can prevent, or at least partially inhibit, trigger member 166 and / or trigger connections 162 and 164 move proximally, and / or in a distal position, as tongue 170 is retracted. As a result of the above, the alignment between the tooth 174 of the tongue 170 and the recesses in the firing element 166 and firing links 162 and 164 can be maintained when the tongue 170 is moved in relation thereto.
[000127] Similarly, in at least one embodiment, the hardness of the band 190 can also assist in holding the firing element 166 and firing links 162 and 164 in the proper position. More particularly, in order for the trigger member 166 to 'move backwards', or to move proximally, the trigger member 166 might have to push the strip 190 proximally and, in fact, wrap the strip 190 around the spool 192. In various embodiments, the hardness of the strip 190 may be such that a significant force to wrap the strip 190 around the spool 192 is required and, as a result, the firing member 166 can be held in place. To further increase the force required to wrap web 190 around spool 192, with reference to figure 44, the path of web 190 can be controlled so that it does not wrap around spool 192 in a
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46/66 tangential direction. More particularly, if the trajectory of the web 190 is such that it is wound on the spool 192 in a non-tangential direction, a portion of the force transmitted through the web 190 will be lost, thus resulting in a weak mechanical advantage for winding the spool 192.
[000128] In various embodiments, the surgical instrument 100 may include a brake that can be engaged with the spool 192, or any other suitable component of the trigger, to prevent the trigger element 166 and / or trigger links 162 and 164 are retracted unintentionally, for example. In at least one embodiment, although not shown, the brake can be moved between a first position and a second position, where, when the brake is in the first position, it can apply a first braking force to the web 190, for example . In at least one of these modalities, the brake can apply, when in the second position, a second braking force to the web 190, for example, which can be greater than or less than the first braking force. In several alternative modes, the brake may not be engaged with the band 190 or any other portion of the trigger when the brake is in the second position. In various embodiments, although not shown, the surgical instrument 100 may include a holding mechanism that can apply a braking force to the spool 192 and / or the strip 190. In at least one such embodiment, the holding mechanism may include a holding device. ball and a spring element for tilting the ball holder against the spool 192 and / or the band 190.
[000129] In various embodiments, the surgical instrument 100 may include a ratchet that may allow the spool 192 to rotate in a first direction but can, in various circumstances, prevent the spool 192 from turning in the opposite direction to the first direction. At least
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47/66 a modality, referring to figures 45 and 49, the surgical instrument 100 may include the ratchet assembly 230, where the ratchet assembly 230 may include the ratchet wheel 232 and the ratchet tongue 234. In various embodiments , the ratchet wheel 232 may operate in substantially the same manner as the key gear 206 described above, with the exception that, with reference primarily to figures 47 and 48, the ratchet wheel 232 may include ratchet teeth 236 which may, due to the ratchet engagement with the ratchet tongue 234, prevent the ratchet wheel 232 from rotating clockwise, for example, when the return carriage 194 'is in its non-driven position (figure 47). More particularly, each ratchet tooth 236 can include a flat surface 240 where, with reference to figure 48, at least one of the flat surfaces 240 can be in a boundary position with the edge 235 of the tongue 234 and thereby prevent the wheel from turnstile 232 is turned clockwise.
[000130] Each ratchet tooth 236 can additionally include an inclined surface 238, where the inclined surfaces 238 can be configured to slide below the tongue 234 when the ratchet wheel 232 is turned counterclockwise. As a result of the above, the ratchet assembly 230 may allow the web 190 to be pulled distally by the firing element 166, for example, but which prevents, or at least substantially inhibits, the web 190 from being moved proximally. , at least when the return car 194 is in its non-driven position. When the return carriage 194 'is pivoted downwards in its driven position, as described above in relation to the return carriage 194, the ratchet wheel 232 can be slid towards the drive gear 196' and out of the operating gear with the ratchet tongue 234. Consequently, as a result, the
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48/66 ratchet 232 can be rotated in the direction of clockwise or counterclockwise without interference, or at least substantial interference from the ratchet tongue 234. In various alternative modes where the ratchet wheel 232 does not slide towards the gear actuator 196 ', the ratchet tongue 234 can move down and out of the operating engagement with the ratchet teeth 236 when the return carriage 194' and moves to its driven position. In each case, when the return carriage 194 'is in its driven position, the drive gear 196' and the return pin 198 'can rotate the ratchet wheel 232 and cam 192' to retract the web 190 and the element 166.
[000131] In various embodiments, with reference to figure 50, the surgical instrument 100 can include the effector end 106 and the elongated stem assembly 104, where the effector end 106 and the stem assembly 104 can be pivotally connected by hinge joint 114. As outlined above, the hinge joint 114 may allow the effector end 106 to be moved, or pivoted, in relation to the stem 106 assembly around axis 116. In various circumstances, a surgeon may articulate effector end 106 to more easily access a surgical site within a patient's body. More particularly, a surgeon can insert end effector 106 and stem assembly 104 through a cannula inserted at least partially into a patient's body and, once end effector 106 has passed through the cannula, the effector end 106 may be pivoted, or articulated, to position end effector 106 in relation to soft tissue, for example, at the surgical site that must be stapled and / or in which incisions will be made. Once the end effector 106 has been positioned, the relative relationship between the end effector
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49/66
106 and stem assembly 104 can be fixed, or locked, by a locking mechanism, as described in more detail below. [000132] In at least one embodiment, referring to figures 51 and 52, the joint joint 114 may include the end member locking member 300 and the pivot 302. In various embodiments, with reference to figures 53 to 56, the end effector locking element 300 may include a connector portion 320 that can secure the locking element 300 to end effector 106 and with reference to figure 52 the stem assembly 104 may include a pivot connector 342, wherein pivot connector 342 can include a pivot 302 extending from it. In various embodiments, the locking element 300 may include an opening 301 that can be sized and configured to receive at least a pivot portion 302 therein. In at least one embodiment, pivot 302 and aperture 301 can be configured so that effector end 106 can rotate freely around axis 116. In other various embodiments, pivot 302 and aperture 301 can be configured so that the friction between pivot 302 and opening 301 can resist, while allowing relative movement between the effector end 106 and the stem assembly 104. Although not shown, the hinge joint 114 can include more than one axis, or pivot, around which the effector end 106 can be rotated.
[000133] In various modalities, a surgeon can articulate the effector end 106 in relation to the stem assembly 104 by pushing the effector end 106 against a side wall cavity around a surgical site, for example, and applying force to the stem assembly 104 so that effector end 106 articulates around axis 116. Consequently, if the surgeon wishes to decentralize effector end 106, that is, orient effector end 106 and stem assembly 104 along
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50/66 of a line, the surgeon can place the effector end 106 against a side wall of the cavity once again, for example, and apply force to the stem assembly 104 as described above. In various embodiments, referring to Figures 51 and 52, the surgical instrument 100 may include a recentralization mechanism that can automatically decentralize, or at least substantially recentralize, the effector end 106 in relation to the stem assembly 104. In various embodiments, the locking member of the effector end 300 may include centering surfaces 316 and the elongated stem assembly 104 may include centering shafts 328 and activation elements 330, where activating elements 330 can be configured to tilt centering rods 328 against centering surfaces 316. In at least one such embodiment, the centering surfaces 316 can be arranged on substantially opposite sides of the axis 116 so that the centering rods 328 can apply a torque substantially equal, or moment, to the lock member 300 and in the absence of a additional motivating force, forming the effector end 106 in a substantially centralized position. When the end effector 106 is articulated by such a force of movement, as described above, the locking element 300 can be configured to move one of the centering rods 328 proximally and to compress the activating element 330 in a functional manner therewith. . More particularly, the activating element 330 can be positioned between a guide 331 and at least one projection 329 extending from the centering rod 328, so that when the projection 329 is moved proximally by the rod 328, the activation element 330 is compressed between them. After removing the movement force, the compressed activating member 330 can expand and rotate the locking element
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300 to its central position via the centering rod 328, or to a position where the torque applied by the activation elements 330 is substantially balanced. Although the activation element 330 is illustrated as a spiral spring, the activation element 330 can include any other suitable elastic element.
[000134] In various embodiments, a locking mechanism can be used to secure the end effector 106 in its articulated position even after the motivating force has been removed. In at least one embodiment, referring to figures 53 to 56, the effector end lock member 300 may include a first portion having a first surface 308, a second portion having a second surface 304, teeth 312 and defined recesses 314 between teeth 312 where, as further described in further detail below, teeth 312 and recesses 314 can be configured to be operatively engaged with a rod assembly locking member in order to secure, or lock the relative relationship between the end effector 106 and stem assembly 104. In various embodiments, teeth 312 and recesses 314 can be positioned between the first surface 308 and the second surface 304. In at least one embodiment, the first surface 308 can extend from opening 301 up to the first perimeter 310, and the second surface 304 can extend from the opening 301 to the second perimeter 306. In several embodiments, the first perimeter 310 can define a first plane and a second perimeter 306 can define a second plane, where teeth 312 and recesses 314 can be positioned between the first and the second planes. In embodiments where the first perimeter 310 is different from the second perimeter 306, teeth 312 may extend at an angle, or chamfer, between them. In several modalities, a
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52/66 tooth 312 can intercept the first perimeter 310 at a point farther from axis 116 than a point where tooth 312 intersects the second perimeter 306. In at least one embodiment, at least one of teeth 312 can define a first axis 313 which can extend between the first surface 308 and the second surface 304 in a direction that is not perpendicular to the first surface 308 and / or the axis of rotation 116. In such embodiments, the teeth 312 can slide over the soft tissue , for example, which is positioned adjacent to the hinge joint 114. In other words, due to the angled or chamfered surfaces of teeth 112, the likelihood that teeth 112 will catch, or find the soft tissue surrounding the hinge joint 114 when the effector end 106 is hinged can be reduced. In at least one embodiment, teeth 312 may not extend beyond the first perimeter 310 so that, if at least a portion of the first perimeter 310 comes into contact with the soft tissue, for example, the first perimeter 310 and the teeth 312 can, as above, slide easily in relation to the soft tissue.
[000135] In addition to the above, the modalities of the present invention can provide significant advantages over previous surgical instruments. More particularly, with reference to figure 57, the hinge joints of the previous end effectors included locking elements, such as locking element 299, for example, which include teeth 298 extending outwardly from the perimeter of the locking element . As a result, when the end effector is pivoted in relation to the stem assembly of the surgical instrument, teeth 298 can grasp, or impact, the surrounding soft tissue and potentially cause trauma to it. In various circumstances, tissue can be trapped between adjacent teeth 298 so that when the
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53/66 end is articulated, the soft tissue can be taken to the articulation joint and can be squeezed by the relatively moving joint components. In the embodiments of the present invention, in which the teeth of the locking element are angled, or chamfered, as described above and illustrated in Figure 58, the soft tissue can slide more easily over the teeth and reduce the possibility of the soft tissue being pulled into inside the joint.
[000136] As described above, referring to figures 59 to 62, the surgical instrument 100 can additionally include the locking member 120 which can be slid in relation to the effector end 106 and can be operatively fixed with the effector end 106 to avoid , or at least limit the relative movement between the stem assembly 104 and the effector end 106. In at least one embodiment, the latch member 120 can be configured to engage at least one of the teeth 312, so that the effector end 106 moves with respect to lock member 120. More particularly, lock member 120 can include end portion 338 and stem portion 340, where end portion 338 can include recess 336 that can be configured to receive a tooth 312 from the locking member 300 in a tight fit, or even in an adjusted interference ratio. In various alternative embodiments, the locking portion 338 can be received within at least one of the recesses 314 in an exact fit, or forced fit relationship, similar to the above. In any case, surgical instrument 100 may additionally include spring 126 which can be configured to tilt lock member 120 in engagement with effector end lock member 300. In the event that recess 336 is not aligned with a tooth 312, in at least one embodiment, the tilt force applied to the locking member 120 by spring 126 may
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54/66 cause lock member 120 to contact and rotate lock member of effector end 300 around shaft 116 until one of teeth 312 is aligned as recess 336. In various embodiments, spring 126 can comprise any suitable activation element including a coil spring, leaf spring or other activation material.
[000137] In various alternative embodiments, referring to figures 63 to 67, a surgical instrument may include the effector end lock member 350 which comprises opening 301, a first portion including a first surface 358, a second portion including a second surface 354 (Fig. 67) and connector portion 320. Effective end lock member 350 may also comprise teeth 362 and recesses 364 defined between teeth 362 where, in at least one embodiment, teeth 362 and recesses 364 can be positioned between a first surface 358 and the second surface 354. In various embodiments, referring to figures 65 to 67, teeth 362 may not extend beyond the first perimeter 357 of the first surface 358 and / or the second perimeter 353 of the second surface 354. In at least one embodiment, the teeth 362 can be completely positioned, or contained between a first surface 358 and a second unda surface 354. In at least one alternative embodiment, teeth 362 may partially extend from the first perimeter 357 and / or the second perimeter 353. In various embodiments, the first perimeter 357 and the second perimeter 353 may define an external surface between the same where the recesses 364 can be defined on the outer surface. As a result of the features described above, the end effector locking element 350 can slide relative to the soft tissue positioned adjacent to the hinge joint without impacting the soft tissue. In
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55/66 various modes, teeth 362 can be blunted or rounded to facilitate the relative sliding described above. In at least one embodiment, referring to figures 63 to 65, a locking mechanism can be configured to engage at least one of the teeth 362 and recesses 364 and can include the locking member 382 comprising the end portion 388 and the stem portion 390. In at least one embodiment, similar to the above, end portion 388 may include recesses 394 that can be configured to engage at least one of teeth 362, for example.
[000138] Various embodiments of the present invention may further comprise a surgical instrument 400 that can be configured to insert surgical clips into the soft tissue, for example. The surgical instrument 400 can comprise many of the components used in the various modalities described earlier in this document. Thus, the specific details regarding the operation and construction of such components will not be further discussed here further than is necessary to explain the unique and new additional features used by the surgical instrument 400.
[000139] Referring to figures 68 to 69, surgical instrument 400 may include a portion of handle 402, an elongated stem assembly 404 and an effector end 406. In one embodiment, effector end 406 may also include a anvil 412, or the first claw, which can be pivotally connected to a staple cartridge channel 408, or a second claw, which can be pivoted between open and closed positions or configurations, by an effector end closure system, or a cover set. The closing system can comprise, for example, a link of the actuator 430, an actuator 432 and the cap tube 434 and,
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56/66 except for the differences discussed below, it can operate in the various ways described above. The cap tube 434 can be configured to interact with the anvil 412 in a known manner, so that as the cap tube 434 moves distally, a cap motion is applied to the anvil 412.
[000140] In various embodiments of the present invention, the movement of the cap tube 434 can be controlled by means of a cap driver 428 which is operatively mounted to the cable portion 402. More particularly and with reference to figure 69, the cap driver cover 428 can be pivotally coupled to the cable assembly 402 by a pin 429 and be movable between a first open position and a second closed position. As can also be seen in figure 70, the cover actuator 428 can also have a guiding notch 500 formed in this place that is adjacent to a hole in pivot 502 to facilitate the attachment of the linkage of the actuator 430 to it through a hole in the pivot 506 which is received in the hole of pivot 502. See figure 73. The linkage of the driver 430 can also be articulated to the driver 432, so that the rotation of the driver of cover 428 from the first position to the second position directs the link of driver 430 distally, which also slides driver 432 distally. In various embodiments, the cover tube 434 is operatively engaged with the actuator 432 so that when the actuator 432 moves distally, the cover tube 434 applies closing movements to the anvil 412. Similarly, when the cover 428 moves from the second position to the first position, the link of the driver 430 moves proximally, which causes the driver 432 to slide proximally in the same way. As the actuator 432 slides proximally, it causes the tube of the lid 434 to apply an opening movement to the anvil 412.
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57/66 [000141] In various embodiments, the cover actuator 428 is normally tilted to the open position (figures 69 and 73) by an opening spring 486. In at least one embodiment, opening spring 486 interacts with the actuator 432 to tilt the actuator 432 in the proximal direction and, in doing so, move the cover actuator 428 to the first position or the open position. The movement of the cover actuator 428 to the second position or the closed position compresses the opening spring 486 so that when the surgeon releases the actuator 428 (unless it is otherwise locked in position) the opening spring 428 will tilt actuator 432 and cover actuator 428 to the open position.
[000142] The surgical instrument 400 may also include a lock on the actuator 448 to lock the lid actuator 428 in at least one of its first or second positions. More particularly and with reference to figures 74 and 75, the actuator latch 448 can include an arcuate neck portion 449 that ends at a portion of the locking tip 600. The actuator latch 448 can be pivotally coupled to the compartment 403 of the cable portion 402 through pin 451. See figure 74. When assembled as shown in figures 73 and 74, a trigger lock spring 450 is used to apply actuating force to trigger lock 448 so that the arched neck 449 is slanted into the sliding hitch with a cam surface 440 formed at a pivot end 438 of the cover driver 428. See figures 70 to 73. In various embodiments, at least one notch 442 is provided at pivot end 438 of the cover trigger 428 which interrupts the cam surface 440. In the illustrated embodiment, the notch 442 corresponds to the (second) fully closed position of the cover trigger 428 c as illustrated in figure 74. In alternative modalities, additional notches 442 can be
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58/66 provided where each notch corresponds to a particular position of the cover driver 428 (and the anvil 412).
[000143] During use, as the cover actuator 428 is pivoted towards the handle of the cable 427, the cam surface 440 moves along the arched neck portion 449 of the actuator lock 448 until the tip portion of the locking 600 of actuator lock 448 engages one or more notches 442 in this place. Since the locking tip portion 600 engages a notch 442, the cover driver 428 is retained in that corresponding position. Thus, in the embodiment shown in figure 74, for example, the cover driver 428 is retained in the closed position by the lock on the driver 448. This is due to the fact that the opening spring 428 is tilting the cover driver 428 in such a way. in order to force the notch 442 into engagement with the locking tip portion 600. In one embodiment, the locking tip portion 600 can be securely retained within the notch 442 so that the trigger lock 448 may need to be manually disengaged from the reactivate 428 before the driver 428 can be moved into an alternate position and / or returned to its first position by the force exerted by the opening spring 486. For example, a surgeon can depress a portion of the button 452 of the trigger lock 448 so that driver lock 448 is pivoted around pin 451 and the locking tip portion 600 moves out of engagement with notch 442 on open driver 428. In other In various embodiments, the notch 442 can be configured so that the locking tip portion 600 can slide out of the notch 442 in a force application to the cover trigger 428. In any case, after the locking tip portion 600 having been disengaged from slot 442, a surgeon can selectively move the cap 428 driver to a position
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59/66 alternatively or release cover driver 428 and allow opening spring 486, for example, to return to cover driver 428 to its first position.
[000144] In certain applications, it may be desirable to control the speed at which the lid driver 428 and anvil 412 and / or the staple cartridge channel 408 return to their respective open positions when the surgeon releases the lid driver 428 or pivots the locking member to an unlocked position. This reduction in the speed of opening of driver 428 and anvil 412 and / or the staple cartridge channel 408 can reduce and / or eliminate damage to the tissue surrounding effector 406 caused by the rapid opening of anvil 412 and / or the staple cartridge 408. In this way, various embodiments of the present invention can utilize a unique, new damping system.
[000145] Referring again to figures 69 to 73, one embodiment of the damping system of the present invention may comprise a projection 441 extending from the pivot end 438 of the cover driver 428. The projection 441 may have any shape in section appropriate cross-section. However, in the illustrated embodiment, the projection comprises a cylindrical piston that has an arched shape that is sized and shaped to extend into a passage 437 that is provided in the cable portion
402 of the surgical instrument. In an embodiment in which the cable portion 402 is formed from two compartment portions 403, 453, half of the passage 437 can be formed in the compartment
403 (figure 77) and the other half of passage 437 can be formed in compartment 453 (figure 78). In this way, passage 437 is formed when the two compartment portions 403, 453 are joined by coupling by screws, pressure fittings, etc. A 456 gasket, or any other fluid sealing device
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60/66 may be provided between compartment portions 403, 453 to form a substantially fluid-tight sealed passage 437.
[000146] In one embodiment, the projection 441 is sized to project into the passage 437 through a first open end 455. The passage 437 can also have a second closed end 457 that is configured to restrict the fluid expelled from the passage 437 when the projection 441 is forced into this place as a result of the cover driver 428 being tilted or otherwise moved to an open position. In one embodiment, an opening may be provided through the second end 457 of passage 437 to allow fluid to flow through passage 437 to a fluid passage 405 formed in the cable compartment 403 that exits to the atmosphere. The fluid can be any fluid suitable for slowing the movement into the projection 441 into the passage 437 to thereby slow the corresponding movements of the cover driver 428 and the anvil 412 and / or the cartridge channel of clamps 408. In one embodiment, the fluid can be air or any other suitable gas, for example. In other embodiments, the fluid can be a hydraulic fluid or any other suitable fluid, for example. The opening of the second end 457 can be smaller than an opening in the first end 455 of the passage 437. The opening can be formed in the second end 457 or can be formed in a portion inserted in the second end 457.
[000147] In various embodiments, the projection 441 can be dimensioned and shaped in relation to the passage 437 so that a substantially fluid-tight sliding seal is established between the projection 441 and the side wall 483 of the passage
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437. In one embodiment, for example, at least one O-ring can be provided 481 in the projection 441 or in the wall of the passage 437 to achieve such a fluid-tight seal, while facilitating the sliding displacement of the projection 441 within the passage 437. See figure 73.
[000148] With reference to figures 79A and 79B, a modification of the damping system may include a valve 401 which is located adjacent to the second end 457 of passage 437. In one embodiment, valve 401 may comprise a flapper valve which is sized to cover a first opening 407 in passage 437. See figure 79A. In various embodiments, valve 401 may comprise a valve body 418 and a hinge 411. Valve 401 may also have a second opening 409 which is smaller than the first opening 407. Valve 401 is movable between an open position (figure 79A) and a closed position (figure 79B). For example, when the lid actuator 428 is operated to close anvil 412 and / or the staple cartridge channel 408, valve 401 is pulled into the open position. As the projection 441 is drawn in the UD upward direction, air is drawn through the fluid passage 405 and the opening 407 into the passage 437 (represented by the arrows). Such movement of valve 401 to an open position allows the lid actuator 428 to be operated with little or minimal drag from the damping system. When the lid actuator 428 moves to an open position and the projection 441 moves down into passage 437 (represented by the arrow DD in figure 79B), valve 401 is forced into the closed position by the air located between the projection 441 and the bottom of passage 437. When valve 401 moves to the closed position as shown in figure 79B, at least some of the remaining air can escape from passage 437 through
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62/66 of the second opening 409 in valve 401 (represented by the arrow dc). Various embodiments of the damping system may also include a valve lock projection 413 that extends into the side wall 483 of passage 437 to limit the displacement of the valve body opening 418. See figure 79A.
[000149] Figure 80 illustrates an alternative damping system modality. As can be seen in that figure, a damping spring can be positioned inside the passage to tilt the projection 441 in the upward direction UD that corresponds to the closed position of the reactivate 428. The force of the damping spring 494 may be less than the force supplied by the opening spring 486 of the surgical instrument, so that the reactivate 428 is not normally inclined to the closed position. Thus, when the surgeon releases the cover driver 428 from the closed position, the opening spring 486 tilts the cover driver 428 to the open position. However, the damping spring 494 resists such movement, and thus slows the opening of the cover driver 428 and anvil 412.
[000150] Figure 81 illustrates yet another embodiment of the damping system of the present invention. 86, projection 441 can be configured to be operatively engaged with an alternative damping system. In this embodiment, a bladder 495 is provided inside passage 437. Bladder 495 can tilt projection 441 in the upward direction UD which corresponds to the closed position of reactivator 428. The tilt force generated by bladder 495 may be less than the force provided by the opening spring 486 of the surgical instrument, so that the driver 428 is not normally inclined to the closed position. In this way, when the surgeon releases the cover 428 actuator from the closed position, the spring
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63/66 opening 486 tilts the cover driver 428 to the open position. However, bladder 495 resists such movement, and thus slows the opening of the lid 428 and anvil 412 actuator. Bladder 495 can contain any suitable fluid such as air or hydraulic fluid, for example.
[000151] Surgical instrument 400 may also include a trigger actuator that is configured to advance a cutting member and / or staple actuator within an effector end, as described above. In at least one embodiment, the trigger actuator may include, for example, a trigger actuator 460 that can interleatically engage a first trigger gear 462 that interleaves interlaced with a trigger member 466. See figures 82 and 83. The trigger gear 462 can comprise two sets of teeth of gear 470, 471. In one embodiment, trigger actuator 460 may have a series of teeth 469 in this place that can be configured to operatively engage a first set of teeth 470 on trigger gear 462 and the gear rotary trigger 462 in direction d1 when trigger trigger 460 is pivoted from a first position to a second position around pin 461. As the first gear 462 is rotated, the second set of teeth of gear 471, which are interlocked trigger member 466 causes trigger member 466 to be distally driven ent, which ultimately drives a knife bar (not shown) or another implement provided inside the effector end 406 (figure 69). When the trigger driver 460 is pivoted in an opposite direction to return it to the first position, the trigger gear 462 rotates in the direction d2 due to the engagement between the teeth of gear 469 and 470 which also
Petition 870190092927, of 9/17/2019, p. 66/82
64/66 propels the firing member in the proximal direction to retract the knife bar.
[000152] Various embodiments of the present invention may also include a triggering locking system that prevents the instrument 400 from being triggered unless the lid trigger is locked in a closed position. In this way, the instrument's anvil must be held in the closed position before the knife bar can be fired. For example, in one embodiment, referring to Fig. 78, trigger gear 462 may include a notch 498. Notch 498 may be integrally formed in second gear 468. In one embodiment, notch 498 may be formed in a separate portion which can be attached to the second gear 468 by welding, welding or any other suitable fastening methods. The triggering locking system can also include a movable locking bar 497 which has a distal end 490 and a proximal end 491. See figure 83. The distal end 490 of locking bar 497 can include a first notch 492 which is sized to allow locking bar 497 to unclog teeth 471 of second gear 468. The proximal end 491 of locking bar 497 can include a second notch 499 that can be configured to engage actuated portion 650 of actuator lock 448 When locking bar 497 is engaged with notch 498 in trigger gear 462, trigger gear 462 cannot rotate and therefore the instrument cannot be triggered. When the lid driver 428 has been closed, the latch of the trigger 448 is pivoted to a position where the driven portion 650 disengages the proximal notch 499 on the locking bar 497. When the locking bar 497 and the driven portion 650 have been disengaged, the locking bar 497 is free
Petition 870190092927, of 9/17/2019, p. 67/82
65/66 to move proximally to allow trigger trigger 460 to close and thereby cause rotation of trigger gear 462 which results in triggering the instrument in the manner described above. When trigger trigger 460 returns to its open position, and button portion 452 of trigger lock 448 has been released to allow cover trigger 428 to return to its open position, trigger portion 650 can reengage the locking member 497 in order to prevent the device from being triggered, unless the cover driver 428 has moved again and locked in the closed position.
[000153] The devices described here can be designed to be discarded after a single use, or they can be designed for use multiple times. In either case, however, the device can be reconditioned for reuse after at least one use. Reconditioning can include any combination of steps to disassemble the device, followed by cleaning or replacing particular parts, and subsequent reassembly. In particular, the device can be disassembled, in any number of particular parts or parts of the device can be selectively replaced or removed, in any combination. When cleaning and / or replacing particular parts, the device can be reassembled for subsequent use in a reconditioning facility or by a surgical team immediately before a surgical procedure. Those skilled in the art will appreciate that the reconditioning of a device can use a variety of techniques for disassembly, cleaning / replacement, and reassembly. The use of such techniques, and the resulting reconditioned device, are all within the scope of the present patent application.
[000154] Preferably, the present invention described here
Petition 870190092927, of 9/17/2019, p. 68/82
66/66 will be processed before surgery. First, a new or used instrument is 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 are then placed in a radiation field that can penetrate the container, such as gamma radiation, X-rays, or high-energy electrons. The radiation kills bacteria on the instrument and the container. The sterile instrument can then be stored in a sterile container. The sterile container keeps the instrument sterile until it is opened at the medical facility.
[000155] Although this invention has been described as having exemplary designs, the present invention can be further modified within the spirit and scope of the description. It is therefore intended that this application covers any variations, uses or adaptations of the invention using its principles general. In addition, this application is intended to cover such changes to the present description, as is known or customary in the art to which this invention belongs.

权利要求:
Claims (15)
[1]
1. Surgical instrument (100, 400) having a handle portion (102, 402) that is operatively coupled with an effector end (106, 406) that has an effector end portion that is selectively movable between an open position and a position closed, the surgical instrument (100, 400) comprising:
a closing system operatively interfacing with the effector end portion to selectively transmit the opening and closing movements there;
a cover actuator (128, 428) movably coupled with the cable portion (102, 402) and being selectively movable between the first and second positions, the cover actuator (128, 428) interacting with the closing system so that the movement of the lid driver (128, 428) from the first position to the second position causes the closing system to apply the closing movements to the effector portion of the movable end, and in which the movement of the lid driver (128 , 428) from the second position to the first position causes the closing system to apply the opening movement to the moving end effector portion; and characterized by the fact that it comprises a damping system supported by the cable portion (102, 402) and interacting with the cover driver (128, 428) to delay the movement of the cover driver (128, 428) from the second position to the first position by applying an actuation force to it.
[2]
2. Surgical instrument (400), according to claim 1, characterized by the fact that the damping system comprises:
a passage (437) formed in the cable portion (402) and
Petition 870190092927, of 9/17/2019, p. 70/82
2/8 having a first end (455) with a first opening (407) there and a second closed end (457);
a projection (441) on the cover driver (428) that extends into the passage (437) through the opening at the first end (455), the projection (441) being dimensioned in relation to the passage (437) to establish a seal substantially fluid-proof slider thereby as the lid driver (428) moves from the first position to the second position; and a second opening (409) through the second closed end (457) of the passage (437), the second opening (409) being sized to allow fluid between the projection (441) and the second closed end (457) of the passage ( 437) pass through it at a predetermined controlled rate as the lid driver (428) moves from the first position to the second position.
[3]
3. Surgical instrument (400), according to claim 1, characterized by the fact that the damping system comprises:
a passage (437) formed in the cable portion (402) and having a first end (455) with a first opening (407) in this place and a second end (457) with a second opening (409) in this place;
a projection (441) on the cover driver (428) that extends into the passage (437) through the opening at the first end (455), the projection (441) being dimensioned in relation to the passage (437) to establish a seal substantially fluid-proof slider thereby as the lid driver (428) moves from the first position to the second position; and a movable valve element (401) mounted inside the passage (437) and movable between a first position of the valve, in
Petition 870190092927, of 9/17/2019, p. 71/82
3/8 that the movable valve element (401) blocks the second opening (409) when the lid driver (428) moves from the second position to the first position and a second position of the valve that exposes the second opening (409) when the lid driver (428) moves from the first position to the second position; and a third opening in the valve element (401) which is smaller than the second opening (409).
[4]
4. Surgical instrument (400) according to claim 1, characterized in that it additionally comprises a first activating element (450) in the compartment to apply a first actuation force to the cover actuator (428) to tilt the actuator the cover (428) from the second position to the first position by discontinuing the application of the actuation force to this and in which the damping system additionally comprises:
a passage (437) formed in the cable portion (402) and having a first end (455) with a first opening (407) in this place and a second closed end (457);
a projection (441) on the cover driver (428) which extends into the passage (437) through the opening at the first end (455); and a second activating element (495) in the passage (437) between the projection (441) and the second closed end (457), the second activating element (495) applying a second actuation force to the projection (441), in that the second acting force is less than the first acting force.
[5]
5. Surgical instrument (400) according to claim 4, characterized in that the second activating element (450) comprises a spring.
[6]
6. Surgical instrument (400), according to
Petition 870190092927, of 9/17/2019, p. 72/82
4/8 claim 4, characterized by the fact that the second activation element (495) comprises a bladder.
[7]
7. Surgical instrument (100, 400), according to claim 1, characterized by the fact that it additionally comprises an actuator lock (148, 448) in the cable portion (102, 402) to selectively lock the lid actuator ( 128, 428) in at least one of the first and second positions.
[8]
8. Surgical instrument (100, 400), according to claim 1, characterized by the fact that the surgical instrument (100, 400) additionally comprises:
a trigger member (166, 466) movably supported within the effector end (106, 406);
a firing system supported by the cable portion (102, 402) and interacting with the firing member (166, 466) to pop a firing motion thereto;
a trigger trigger (160, 460) movably supported by the cable portion (102, 402) between a triggered position and an untriggered position, and interacting with the triggering system to make the triggering system provide the triggering motion to the trigger member (166, 466) by applying another actuation movement to the trigger trigger (160, 460); and a trigger lock (148, 448) operably supported on the cable portion (102, 402) and interacting with the cover trigger (128, 428) and trigger trigger (160, 460) to retain the trigger trigger (160, 460) in the non-triggered position, when the cover driver (128, 428) is not held in the second position.
[9]
9. Surgical instrument (100, 400), according to claim 8, characterized by the fact that the actuator lock (148, 448) is configured to selectively retain the lid actuator (128, 428) in the second position.
Petition 870190092927, of 9/17/2019, p. 73/82
5/8
[10]
10. Surgical instrument (100, 400), according to claim 1, characterized by the fact that it comprises:
an elongated rod (104, 404) coupled with the cable portion (102, 402);
wherein the elongated rod (104, 404) has a tube closing portion and where the effector end (106, 406) is coupled with the elongated rod (104, 404), the effector end (106, 406) further comprising :
a first claw (412); and a second claw (408), in which the first claw (412) is movable in relation to the second claw (408) between an open position and a closed position by applying opening and closing movements to that by a portion of tube the elongated stem cap (104, 404);
and further in that a closure system is supported by the cable portion (102, 402) and interoperably interfaces with the effector end portion via the pipe closure portion;
and also in that the movement of the lid actuator (128, 428) from the first position to the second position causes the lid actuator (128, 428) to apply the closing movements to the portion portion of the closing tube, and in that the movement of the lid driver (128, 428) from the second position to the first position causes the closing system to apply the opening movement to the tube portion of the lid.
[11]
11. Surgical instrument (400), according to claim 10, characterized by the fact that the damping system comprises:
a passage (437) formed in the cable portion (402) and having a first end (455) with a first opening (407) in this place and a second closed end (457);
Petition 870190092927, of 9/17/2019, p. 74/82
6/8 a projection (441) on the cover driver (428) that extends into the passage (437) through the opening (407) at the first end (455), the projection (441) being dimensioned in relation to the passage ( 437) to establish a substantially fluid-tight sliding seal therewith as the cover driver (428) moves from the first position to the second position; and a second opening (409) through the second closed end (457) of the passage (437), the second opening (409) being sized to allow fluid between the projection (441) and the second closed end (457) of the passage ( 437) pass through it at a predetermined controlled rate as the lid driver (428) moves from the first position to the second position.
[12]
12. Surgical instrument (400), according to claim 10, characterized by the fact that the damping system comprises:
a passage (437) formed in the cable portion (402) and having a first end (455) with a first opening (407) in this place and a second end (457) with a second opening (409) in this place;
a projection (441) on the cover driver (428) that extends into the passage (437) through the opening (407) at the first end (455), the projection (441) being dimensioned in relation to the passage (437) for establishing a substantially fluid-proof sliding seal therewith as the lid driver (428) moves from the first position to the second position; and a movable valve element (401) mounted within the passage (437) and movable between a first position of the valve, wherein the movable valve element (401) blocks the second opening (409) when the lid actuator (428) moves from second
Petition 870190092927, of 9/17/2019, p. 75/82
7/8 position for the first position and a second position of the valve that exposes the second opening (409) when the lid actuator (428) moves from the first position to the second position; and a third opening in the valve element (401) which is smaller than the second opening (409).
[13]
13. Surgical instrument (400), according to claim 10, characterized by the fact that it additionally comprises a first activation element (450) in the compartment to apply a first actuation force to the cover actuator (428) to guide the actuator the cover (428) from the second position to the first position by discontinuing the application of the actuation force to this and in which the damping system additionally comprises:
a passage (437) formed in the cable portion (402) and having a first end (455) with a first opening (407) there and a second closed end (457);
a projection (441) on the cover driver (428) that extends into the passage (437) through the opening (407) at the first end (455); and a second activating element (495) in the passage (437) between the projection (441) and the second closed end (457), the second activating element (495) applying a second actuation force to the projection (441), in that the second acting force is less than the first acting force.
[14]
14. Surgical instrument (400) according to claim 13, characterized in that the second activation element (495) comprises a spring.
[15]
15. Surgical instrument (100, 400), according to claim 10, characterized by the fact that the damping system comprises a passage (437) formed in the portion
Petition 870190092927, of 9/17/2019, p. 76/82
8/8 cable (102, 402) having a first end (455) with a first opening (407) there and a second end (457), the damping system comprising a projection (441) on the cover driver (128, 428) extending into the passage (437) through the opening at the first end (455).

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法律状态:
2019-01-08| B06F| Objections, documents and/or translations needed after an examination request according [chapter 6.6 patent gazette]|

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2019-07-23| B06U| Preliminary requirement: requests with searches performed by other patent offices: procedure suspended [chapter 6.21 patent gazette]|

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2020-01-21| B09A| Decision: intention to grant [chapter 9.1 patent gazette]|

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2020-03-24| B16A| Patent or certificate of addition of invention granted|Free format text: PRAZO DE VALIDADE: 20 (VINTE) ANOS CONTADOS A PARTIR DE 06/12/2010, OBSERVADAS AS CONDICOES LEGAIS. |

优先权:

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申请号 | 申请日 | 专利标题

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US12/650,334|US8267300B2|2009-12-30|2009-12-30|Dampening device for endoscopic surgical stapler|

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US12/650,334|2009-12-30|

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PCT/US2010/059143|WO2011081791A1|2009-12-30|2010-12-06|Dampening device for endoscopic surgical stapler|

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