Surgical fastener

专利摘要:
motor-operated surgical clamp device with adjustment mechanisms for a tissue gap in the end effector. the present invention relates to a surgical clamp apparatus that has a cable, an elongated rod that has a proximal end connected to the cable and a distal end that extends from it. a distal end effector that includes an anvil that rotates at a proximal end thereof and is movable between an open position and a closed position. a cartridge containing a plurality of surgical fasteners, the cartridge being attached to the end effector. an electrically driven actuator for implanting surgical fasteners, the actuator including a power supply and a motor. surgical means, the actuator including a power supply and a motor. means for electrically adjusting the amount of space between said claws when said end effector is in said closed position.
公开号:BR112013002147B1
申请号:R112013002147-0
申请日:2011-07-26
公开日:2020-05-26
发明作者:Frederick E. Shelton
申请人:Ethicon Endo-Surgery, Inc；
IPC主号:

专利说明:

Descriptive Report of the Invention Patent for SURGICAL LOCKING APPLIANCE.
REMISSIVE REFERENCE TO RELATED DEPOSIT REQUESTS
[0001] This non-provisional application is a request for continuation in part of patent application serial number US 12 / 693,460, entitled Driven Surgical Stapler Improvements, by Steven G. Hall, filed on January 26, 2010, which claims the benefit of the provisional application for serial number US 61 / 150,382, entitled MotorDriven Surgical Stapler Improvements, authored by Steven G. Hall, filed on February 6, 2009, the complete descriptions of which are incorporated herein by reference in their respective totalities.
BACKGROUND
[0002] An example of a surgical stapler suitable for endoscopic applications is described in US Patent No. 5,465,895, which is incorporated by reference in this document in its entirety. Such device comprises an endoscopic surgical instrument that has different locking and unloading actions for fasteners. Another example of a motor-driven surgical stapler is presented in patent application publication No. 2007/0175958 A1, entitled Motor-Driven Surgical Cutting and Fastening Instrument With User Feedback System, published on August 2, 2007, which is by this one incorporated in full, as a reference. Excerpts from such a publication are presented here to detail its basic functions, enhancements, background and components. At the end, additional improvements to the system are presented.
[0003] Patent application publication No. US 2007/0175958
A1 provides in part that [a] doctor using this device is able to close the claw members over the tissue to position
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2/53 the fabric before firing clips. Once the doctor has determined that the claw members are holding the tissue properly, he can then fire the surgical stapler with a single firing motion or with multiple firing movements, depending on the device. The triggering of the surgical stapler causes the tissue to be cut and stapled. The use of simultaneous sectioning and stapling avoids complications that may arise during the sequential performance of these actions with different surgical instruments that, respectively, only section or staple the tissue.
[0004] A specific advantage of being able to close the tissue before firing is that the doctor can verify through an endoscope that the desired location for the cut has been achieved, including a sufficient amount of tissue that has been captured between opposite claws. Otherwise, the opposing jaws can be pulled very close together, specifically by squeezing the distal ends of them, and thus not effectively forming closed clips on the separate fabric. At the other extreme, an excessive amount of trapped tissue can cause ligation and incomplete firing.
[0005] Endoscopic staplers / cutters continue to increase in complexity and function with each generation. One of the main reasons for this is the search for less triggering force (FDD) to a level that all, or most, of surgeons can handle. A known solution to lower FDD is the use of C02 or electric motors. These devices did not prove to be much better than traditional handheld devices, but for different reasons. Surgeons typically prefer to experience force distribution proportional to that experienced by the end effector in forming the clamp to ensure that the
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3/53 cutting / stapling is complete, with the upper limit within the capabilities of many surgeons (usually about 66.7 to 133 N (15 to 30 Ibs)). They also typically want to maintain control in order to implant the clamp and be able to stop it at any time if the perceived forces on the device cable are too great or for another clinical reason. These user feedback effects are not achievable properly in current engine-driven endoscopic surgical instruments. As a result, there is a general lack of acceptance by doctors of motor-driven endoscopic surgical instruments in which the cutting / stapling operation is activated by merely pressing a button.
[0006] The previously mentioned discussion is only intended to illustrate some of the disadvantages present in the field of the invention at the moment, and should not be taken as a denial of the scope of the claims.
SUMMARY
[0007] In accordance with a general aspect of the present invention, a surgical clamp apparatus is provided that includes a cable and an elongated rod that has a proximal end attached to the cable. The elongated rod additionally has a distal end extending from it and is coupled to an end effector which comprises a pair of claws which are articulated at a proximal end of the same and movable between an open and closed position. The end effector has a cartridge attached to it that contains a plurality of surgical clips. The device additionally includes an actuator electrically equipped with a motor to implant the surgical fasteners. In various embodiments, the actuator comprises a power source and a motor. A first trigger is attached to the cable to move the end effector from the open to the closed position. A second trigger is attached to the cable
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4/53 to activate the actuator. The apparatus additionally comprises a first locking mechanism to prevent the current from flowing from the power source to the motor, unless the end effector is in its closed position. The apparatus additionally comprises a second locking mechanism which has a locked and unlocked position. The second locking mechanism being configured to prevent movement of the second trigger until the second locking mechanism is moved to the unlocked position.
[0008] In accordance with another general aspect of the present invention, a surgical fastener apparatus is provided which includes a cable that has an end effector operably coupled thereto. The end effector has a movable anvil supported on it. The movable anvil being movable between open and closed positions in response to the opening and closing movements applied to a closing trigger that is operationally supported on the handle. An actuator is movable on the end effector between an unactivated position and positions actuated on said end effector. An electric motor interacts operably with the actuator to selectively apply a drive movement distal to that to move the actuator from the unactivated position to the actuated positions and selectively apply a drive movement proximal to the actuator to retract it to the unattended position. acted from the acted positions. A power supply connected to the motor to electrically supply power to the motor. The device additionally comprises a current control circuit that is connected to the power source to control the current supplied to the motor from the power source. In several modalities, the current control circuit comprises a locking lock switch that is connected to the power source and the motor, so that,
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5/53 when the closing trigger is held in a locked position where the anvil is held in the closed position, the closing lock switch allows current to flow from the power source to the motor, and when the closing trigger is not is in the locked position, the locking lock switch prevents current from flowing from the power source to the motor. A starter is connected to the power source and the motor to prevent current from flowing from the power source to the motor unless the starter is manually activated.
[0009] In accordance with yet another general aspect of the present invention, a surgical fastener apparatus is provided that includes a cable that has an end effector operably coupled thereto. The end effector has a movable anvil supported on it. The movable anvil is movable between open and closed positions in response to the opening and closing movements applied to a closing trigger operatively supported on the handle. An actuator is movable on the end effector between an unactivated position and positions actuated on said end effector. An electric motor interacts operably with the actuator to selectively apply a drive movement distal thereto to move the actuator from the unactivated position to the actuated positions and selectively apply a drive movement proximal to the actuator to retract it to the unattended position. acted from the acted positions. A power supply connected to the motor to electrically supply power to the motor. A trigger trigger is operably supported on the cable and is movable between actuated and non-actuated positions. A fastener discharge switch is coupled to the power source and the motor and interfaces with the trigger so that, by moving the trigger trigger from the unactivated position to the actuated positions, the fastener discharge switch allows let the current flow to the
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6/53 motor to apply the distal drive movement to the actuator. A closing lock switch is connected to the power source and the motor, so that when the closing trigger is held in a locked position where the anvil is held in the closed position, the closing lock switch allows the current flows from the power source to the motor, and when the closing trigger is not in the locked position, the closing lock switch prevents current from flowing from the power source to the motor. In various embodiments, the apparatus comprises a movable locking member that is movable between a first position in which the movement of the second trigger from the unacted position to the acted positions is avoided, and a second position in which the second trigger can be moved from unacted position for acted positions.
[0010] In a general aspect, the present invention is directed to a motorized surgical instrument of cutting and fixation that provides feedback to the user regarding the position, force and / or implantation of the end effector. The instrument, in various modalities, also allows the operator to control the end effector, including the ability to stop implantation, if desired. The instrument can include two triggers on the same cable - a closing trigger and a trigger trigger - with separate actuating movements. When an instrument operator retracts the closing trigger, the tissue positioned on the end effector can be fixed by the end effector. Then, when the operator retracts the trigger, a motor can drive, via gear drive trains, a set of rotational main drive shafts, which causes the cutting instrument on the end effector to cut the trapped tissue.
[0011] In several modalities, the instrument can comprise a drive assistance system with feedback force of
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7/53 loading and control to reduce the firing force required to be exerted by the operator in order to finish the cutting operation. In such embodiments, the trigger trigger can be engaged with the gear drive train of the main drive shaft assembly. In this way, the operator can experience feedback in relation to the force that is applied to the cutting instrument. That is, the loading force on the trigger can be related to the loading force experienced by the cutting instrument. In addition, in such modalities, as the firing trigger is engaged with the gear drive train, the force applied by the operator can be added to the force applied to the engine.
[0012] According to several modalities, when the trigger is retracted in an adequate amount (for example, five degrees), an on and off switch can be activated, which sends a signal to the engine to turn at a specific rate , thus starting the actuation of the set of drive shafts and the end effector. According to other modalities, a proportional sensor can be used. The proportional sensor can send a signal to the engine to rotate at a rate proportional to the force applied to the trigger trigger by the operator. In this way, the rotational position of the firing trigger is, in general, proportional to the location where the cutting instrument is in the end effector (for example, completely distributed or completely retracted). Furthermore, the operator could stop the retraction of the firing trigger at some point in the movement to stop the engine, and thereby stop the cutting movements. In addition, sensors can be used to detect the start of actuation of the end effector (eg, position completely retracted) and the end of actuation (eg, position completely distributed), respectively. Consequently, the sensors can provide an adaptive control system to control the effector implantation
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8/53 end that is outside the engine's closed loop system, gear drive train, and end effector. [0013] In other modalities, the trigger trigger may not be directly engaged in the gear drive train used to act on the end effector. In such embodiments, a second motor can be used to apply forces to the trigger to simulate the implantation of the cutting instrument in the end effector. The second motor can be controlled based on additional speeds of the main drive shaft assembly, which can be measured by a rotary encoder. In such embodiments, the position of the rotational position of the trigger can be related to the position of the cutting instrument on the end effector. In addition, an on / off switch or a proportional switch can be used to control the main motor (ie, the motor that drives the main drive shaft).
[0014] In various implementations, the end effector can use a helical screw at the base of the end effector to drive the cutting instrument (for example, knives). In addition, the end effector may include a staple cartridge for stapling the separate tissue. According to other modalities, other means for fixing (or sealing) the separated fabric can be used, including RF energy and adhesives.
[0015] In addition, the instrument may include a mechanical closing system. The mechanical closure system may include an elongated channel that has a fixing element, such as an anvil, rotatably connected in the channel to the fixed tissue positioned on the end effector. The user can activate the end effector clamping action by retracting the closest trigger, which, through a mechanical closing system, causes the end effector clamping action. Since the fastener
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9/53 is locked in place, the operator can activate the cutting operation by retracting the separate trigger. This can cause the cutting instrument to move longitudinally along the channel in order to cut the tissue trapped by the end effector.
[0016] In various implementations, the instrument may include a set of rotational main drive shaft to drive the end effector. In addition, the main drive shaft can comprise an articulation joint so that the end effector can be articulated. The pivot joint may comprise, for example, a chamfer gear assembly, a universal joint, or a flexible torsion cable capable of imparting torsional force to the end effector.
[0017] Other aspects of the present invention are directed to various mechanisms for locking the closing trigger on a lower piston portion of the handle. Such modalities free up space in the cable directly above and behind the triggers for other components of the instrument, including components of the gear drive train and the mechanical closing system. [0018] The descriptions of the present invention show how a person could incorporate a self-contained endoscopic stapling device driven by battery powered gear.
BRIEF DESCRIPTION OF THE DRAWINGS
[0019] The aforementioned characteristics and other characteristics and advantages of this invention, and the manner 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, being that:
[0020] Figures 1 and 2 are seen in perspective of a
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10/53 surgical instrument for cutting and joining, according to various modalities of the present invention;
[0021] Figures 3 to 5 are exploded views of an end effector and an instrument stem in accordance with various embodiments of the present invention;
[0022] Figure 6 is a side view of the end effector according to various embodiments of the present invention;
[0023] Figure 7 is an exploded view of the instrument cable in accordance with various embodiments of the present invention;
[0024] Figures 8 and 9 are partial perspective views of the cable according to various embodiments of the present invention;
[0025] Figure 10 is a side view of the cable according to various embodiments of the present invention;
[0026] Figures 10A to 10B illustrate a proportional or key sensor that can be used according to various embodiments of the present invention;
[0027] Figure 11 is a schematic diagram of a current control circuit used in the instrument according to various modalities of the present invention;
[0028] Figure 12 is a side view of another cable according to various embodiments of the present invention;
[0029] Figure 13 is a schematic diagram of another current control circuit used in the instrument according to various modalities of the present invention;
[0030] Figure 14 is a schematic diagram of another current control circuit used in the instrument according to various modalities of the present invention;
[0031] Figure 15 is a schematic diagram of another circuit used in the instrument according to various modalities of the present invention;
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[0032] Figure 15A is a schematic diagram of another current control circuit used in the instrument according to various modalities of the present invention;
[0033] Figure 15B is a schematic diagram of another current control circuit used in the instrument according to various modalities of the present invention;
[0034] Figures 16 to 17 illustrate different mechanisms for locking the closing trigger according to various embodiments of the present invention;
[0035] Figure 18 is a schematic diagram of another current control circuit used in the instrument according to various modalities of the present invention;
[0036] Figure 19 is a cross-sectional view of an end effector embodiment of the present invention;
[0037] Figure 20 is a side elevation view of a set of knives or actuator modality of the present invention;
[0038] Figure 21 is a side elevation view of another set of knives or actuator modality of the present invention;
[0039] Figure 22 is a side elevation view of another set of knives or actuator modality of the present invention;
[0040] Figure 23 is a perspective view of the distal end of a surgical stapler, according to an embodiment of the present invention.
[0041] Figure 24 is a perspective view of the distal end of a surgical stapler according to an embodiment of the present invention with the cartridge removed from the channel.
[0042] Figure 25 is a view of a distal end of a surgical stapler according to an embodiment of the present invention, similar to Figure 1, showing a locked indicator. and
[0043] Figure 26 is a perspective view of the end
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12/53 proximal to a surgical stapler, according to an embodiment of the present invention.
DETAILED DESCRIPTION OF THE INVENTION
[0044] The owner of the application in question is also the owner of the following US patent applications that were filed on the same date as this application and which are incorporated herein by way of reference in their respective totalities:
[0045] US patent application entitled Motor Driven Surgical
Fastener Device With Cutting Member Reversing Mechanism, Legal registration number END6549USCIP1 / 100280CIP1; and
[0046] US patent application entitled Motor Driven Surgical
Fastener Device With Mechanisms For Adjusting a Tissue Gap Within the End Effector, Legal registration number END6548USCIP1 / 100271CIP1.
[0047] 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 three modalities are illustrated in the accompanying 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.
[0048] The reference from the beginning to the end of the specification of several modalities, some modalities, one modality, or the modality, an implementation or several implementations or similar, means that an attribute, structure, or characteristics described
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13/53 together with the modality is included in at least one modality. Therefore, the appearance of phrases in various modalities, in some modalities, in one modality or in the modality, an implementation or several implementations or the like, in places from beginning to end of the specification are not necessarily all referring to the same modality or implementation. In addition, the particular attributes, structures, or characteristics can be combined in any suitable way into one or more modalities or implementations. Therefore, the particular attributes, structures, or features illustrated or described in conjunction with a modality can be combined, in whole or in part, with the structures of the attributes, or features of one or more other modalities without limitation. These modifications and variations are intended to be included in the scope of the present invention.
[0049] The terms proximal and distal are used in the present invention with reference to a physician manipulating the handle portion of the surgical instrument. The term proximal refers to the portion closest to the doctor, and the term distal refers to the portion located farthest from the doctor. It will also be understood that, for the sake of convenience and clarity, spatial terms such as vertical, horizontal, up and down can be used in the present invention with respect to drawings. However, surgical instruments can be used in many orientations and positions, and these terms are not intended to be limiting and absolute.
[0050] Figures 1 and 2 represent a cutting and joining instrument 10 according to various modalities of the present invention. The illustrated modality is an endoscopic surgical instrument 10 and, in general, the instrument 10 described here are cutting and joining endoscopic surgical instruments. However, it must be observed in accordance with other modalities of
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14/53 present invention, that instrument 10 may be a non-endoscopic surgical cutting instrument, such as a laparoscopic instrument. [0051] The surgical instrument 10 shown in Figures 1 and 2 comprises a handle 6, a stem 8, and a hinged end effector 12 hingedly connected to the stem 8 to a hinge pivot 14. A hinge control 16 can be supplied adjacent to the cable 6 to rotate the end effector 12 over the hinge pivot 14. It will be understood that various modalities may include a non-pivoting end effector and, consequently, may not have a hinge pivot 14 or hinge control 16. In addition, in the illustrated embodiment, end effector 12 is configured to act as an endoscopic surgical instrument to hold, separate and staple tissue, although in other embodiments, different types of end effectors can be used, as end effectors for other types of surgical devices, such as tweezers, cutters, staplers, clamp applicators, access devices, gene / drug, ultrasound, RF or laser devices, etc.
[0052] The cable 6 of the instrument 10 can include a closing trigger 18 and a discharge trigger 20 to drive the end effector 12. It will be recognized that instruments that have end actuators directed to different surgical tasks can have numbers or types other than triggers or other controls suitable for operating end effector 12. End effector 12 is shown separately from cable 6 by a rod 8, preferably elongated. In one embodiment, a physician or operator of the instrument 10 can articulate the end effector 12 in relation to the stem 8 by using the joint control 16, as described in more detail in US Patent No. 7,670,334, entitled Surgical Instrument
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Having An Articulating End Effector, by Geoffrey C. Hueil et al., Hereby incorporated by reference in its entirety.
[0053] The end effector 12 includes in this example, among other things, an elongated groove 22 configured to operationally support a staple cartridge 34 therein and an articulated jaw member, such as an anvil 24, which are maintained at a spacing that ensures effective stapling and sectioning of the tissue attached to the end effector 12. The handle 6 includes a pistol grip 26 towards which a closing trigger 18 is pivoted by the doctor to lead to fixing or closing of the anvil 24 towards the elongated channel 22 of the end effector 12 to thereby fix the tissue positioned between the anvil claw 24 and the elongated channel 22. The discharge trigger 20 is further away from the closing trigger 18. When the trigger closing mechanism 18 is locked in the closed position, as described in more detail below, the trigger trigger 20 can rotate slightly towards the pistol grip 26 so that it can be reached by the operator with the use of one hand. Then the operator can pull the discharge trigger 20 pivotally towards the pistol grip 26 to cause stapling and sectioning of tissue attached to the end effector 12. In other embodiments, different types of fixation members in addition to the anvil 24 can be used, such as an opposing claw, etc.
[0054] The closing trigger 18 can be activated first.
When satisfied with the positioning of the end effector 12, the physician can retract the closing trigger 18 to the completely closed and locked position adjacent to the pistol grip 26. The discharge trigger 20 can then be actuated. The trigger trigger 20 returns to the open position (shown in Figures 1 and 2) when the
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16/53 doctor removes pressure, as described below, in more detail. A release button on cable 6 can, when pressed, release the lock on the closing trigger 18. The release button can be implemented in a number of ways, such as a sliding release button 160 shown in Figure 16, and / or button 172 shown in Figure 17.
[0055] Figures 3 to 6 show modalities of an end effector driven by rotation 12 and rod 8 according to various modalities. Figure 3 is an exploded view of the end actuator 12, according to various modalities. As shown in the illustrated embodiment, the end effector 12 may include, in addition to the previously mentioned channel 22 and anvil 24, a cutting instrument 32, a rail 33, a staple cartridge 34 which is removably seated in the channel 22 , and a helical screw rod 36. The cutting instrument 32 can be, for example, a knife. For use in the present invention that concerns at least one modality, the term actuator can refer to the knife and / or rail. The anvil 24 can be pivotally open and closed on the pivot pins 25 connected to the adjacent end of the channel 22. The anvil 24 can also include a flap 27 at its adjacent end which is inserted into a component of a mechanical closing system ( further described below) to open and close anvil 24. When the closing trigger 18 is actuated, i.e., extracted by a user of the instrument 10, the anvil 24 can rotate around the pivot pins 25 forming a closed or locked position. If the attachment of the end effector 12 is satisfactory, the operator can activate the trigger trigger 20 which, as explained in more detail above, causes knife 32 and rail 33 to run longitudinally along channel 22, thereby cutting the tissue fixed inside the end effector 12. The movement of the
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17/53 sliding support 33 along the channel 22 causes the staples (not shown) of the staple cartridge 34 to be driven through the separate fabric and in relation to the closed anvil 24, which turns the staples to join the separate fabric. In several embodiments, the rail 33 can be an integral component of the cartridge 34. US Patent No. 6,978,921, entitled Surgical Stapling Instrument Incorporating an E-beam Firing Mechanism, granted to Shelton, IV et al., Which is here incorporated, as a reference, provides more details on these two-motion cutting and joining instruments. The rail 33 can be part of the cartridge 34, so that when the knife 32 retracts after the cutting operation, the rail 33 does not retract.
[0056] Figures 4 and 5 are exploded views and Figure 6 is a side view of end effector 12 and stem 8 according to various modalities. As shown in the illustrated embodiment, the stem 8 can include an adjacent closing tube 40 and a distal closing tube 42 pivotally connected by a pivot connection 44. The distal closing tube 42 includes an opening system 45 within which tab 27 on anvil 24 is inserted to open and close anvil 24, as further described below. Arranged within the closing tubes 40, 42 may be an adjacent structuring tube 46. Arranged within the adjacent structuring tube 46 may be a main (or adjacent) rotational drive shaft 48 that communicates with a secondary (or distal) drive shaft 50 via a bevel gear assembly 52. The secondary drive shaft 50 is connected to a drive gear 54 which engages an adjacent drive gear 56 of the helical screw rod 36. The vertical bevel gear 52b can seat and rotate in an opening 57 at the distal end of the adjacent structuring tube 46. A distal structuring tube 58 can be used to close the
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18/53 secondary drive 50 and drive gears 54, 56. Collectively, main drive shaft 48, secondary drive shaft 50, and pivot assembly (for example, bevel gear assembly 52a-c) are some often referred to in the present invention as the main drive shaft assembly.
[0057] A bearing 38, positioned at a distal end of the clamp groove 22, receives the helical screw 36, allowing the helical screw 36 to rotate freely in relation to the groove 22. The helical screw rod 36 can interconnect a threaded opening ( not shown) of knife 32 so that the rotation of the shank 36 causes the knife 32 to rotate in a distal position or in a proximal direction (depending on the direction of rotation) through the clamp channel 22. Consequently, when the main drive rod 48 rotates by applying a triggering motion to the trigger trigger 20 (as explained in more detail below), the chamfer gear assembly 52a ac causes the secondary drive rod 50 to rotate, which in turn, because of the engagement of the drive gears 54, 56, it makes the helical screw rod 36 rotate, which causes the knife drive member 32 to run longitudinally along the channel 22 to cut any fabric stuck within the end effector 12. The rail 33 can be produced from, for example, plastic, and can have an inclined distal surface. As the sliding support 33 passes through the channel 22, the sloping front surface can push up or activate the staples on the staple cartridge through the fixed fabric and against the anvil 24. The anvil 24 forms or turns the staples, thus stapling the cut fabric. When knife 32 is retracted, scalpel 32 and rail 33 can be disengaged, thus leaving rail 33 at the distal end of channel 22.
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[0058] Figures 7 to 10 illustrate an exemplary modality of an endoscopic surgical instrument powered by a motor and, in particular, its handle, which provides users' opinions regarding the position and loading force of the cutting instrument 32 in the effector end 12. In addition, the modality can use the energy supplied by the user when retracting the trigger trigger 20 to power the device (a mode called assisted effort). The modality can be used with the modalities described above of the end effector driven by rotation 12 and of the rod 8. As shown in the illustrated modality, the cable 6 includes external lower side parts 59, 60 and external upper side parts 61, 62 that fit together to form the outside of the cable 6 in general. In various embodiments, the rotary driven end effector can be powered by a motor 65 which is arranged in an upper portion of the pistol handle portion 26 of the cable and motorized by a power source 64. Power source 64 may comprise a battery or alternating current supply. In a preferred embodiment, the power source 64 comprises a Li-ion battery that is supported on the handle portion of the pistol 26 of the cable 6. According to various embodiments, the motor 65 can be a brushed DC motor, which has a maximum speed of approximately 5000 RPM. Motor 65 can drive a 90 degree bevel gear set 66 comprising a first bevel gear 68 and a second bevel gear 70. Bevel gear set 66 can drive a planet gear set 72. Planet gear set 72 can include a pinion gear 74 connected to a drive shaft 76. Pinion gear 74 can drive an annular coupling gear 78 that drives a helical gear drum
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20/53 by means of a drive rod 82. A ring 84 can be threaded onto the drum with helical gear 80. Therefore, when motor 65 spins, ring 84 is forced to move along the helical gear drum 80 , by means of the bevel gear set 66, the planetary gear set 72 and the annular gear 78, interposed there.
[0059] Cable 6 may also include an operating motor switch 110 (see Figure 10) in communication with trigger trigger 20 to receive a trigger motion from trigger trigger 20 when the trigger trigger has been removed (or closed) towards the pistol handle portion 26 of the cable 6 by the operator to thereby perform the cutting / stapling operation by the end effector 12. The engine starter 110 can be a proportional sensor such as example, a rheostat or a variable resistor. When trigger trigger 20 is engaged, motor starter 110 allows current to flow from power source 64 to motor 65. When motor starter 110 is a variable resistor or similar, the rotation of the motor 65 can generally be proportional to the amount of movement of trigger trigger 20. That is, if the operator pulls or closes trigger trigger 20 just a little, the engine speed 65 is relatively low. When the trigger trigger 20 is pulled completely (or is in the completely closed position), the rotation of the motor 65 is at its maximum. In other words, the stronger the user pulls the trigger 20, the greater the voltage applied to the motor 65, generating higher rotation rates.
[0060] Cable 6 may include an intermediate piece of cable 104 adjacent to the upper portion of the trigger trigger 20. Cable 6 may also include a bias spring 112 which is connected between columns in the intermediate piece of cable 104 and the trigger of firing
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20. The bias spring 112 can place the trigger 20 in its fully open position. In this way, when the operator releases the trigger trigger 20, the return spring 112 pulls the trigger trigger 20 to its open position, thus deactivating the engine starter 110, to stop the rotation of the motor 65. In addition, because of the polarization spring 112, any time a user closes the trigger 20, he will feel resistance to the closing operation, thus providing the user with feedback related to the amount of rotation exerted by the motor 65. Additionally, the operator can interrupt the trigger trigger retraction 20 to thereby deactivate the engine starter 110 and interrupt engine 65. Thus, the user can stop the implantation of end effector 12, thus providing a measure of operation control cutting / fixing to the operator.
[0061] The distal end of the helical gear drum includes a distal drive rod 120 that drives a ring gear 122, which corresponds to a pinion gear 124. Pinion gear 124 is connected to the main drive shaft 48 of the assembly of the main drive shaft. In this way, the rotation of the motor 65 causes the main drive shaft assembly to rotate, which causes the end effector 12 to act, as described above.
[0062] The ring 84 threaded to the drum with helical gear can include a column 86 which is arranged inside a slot 88 of an arm provided with slits 90. The arm provided with slits 90 has an opening 92 at its opposite end 94 which it receives a pivot pin 96 which is connected between the outer side parts of the cable 59, 60. The pivot pin 96 is also arranged through an opening 100 in the trigger trigger 20 and an opening 102 in the intermediate part of the cable 104.
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[0063] In addition, cable 6 may include a reverse motor wrench (or end-of-travel wrench) 130 and an engine stop wrench (or start of travel) 142. In several embodiments, the motor reversal wrench 130 can be a limit switch located at the distal end of the helical gear drum 80, so that the threaded ring 84 on the helical gear drum 80 contacts, and activates, the motor reversal switch 130, when the ring 84 reaches the distal end of the helical gear drum 80. The motor reversal switch 130, when activated, sends a signal (that is, allows the current to flow) to the motor 65 to reverse its direction of rotation, thus collecting the knife 32 of end actuator 12 following the cutting operation.
[0064] The engine stop switch 142 can be, for example, a normally closed limit switch. In various embodiments, it can be located at the adjacent end of the helical gear drum 80 so that ring 84 activates key 142 when ring 84 reaches the adjacent end of helical gear drum 80.
[0065] In operation, when an operator of the instrument 10 applies an actuation movement to the trigger trigger 20, the motor starter 110 detects the position of the trigger trigger 20 and sends a signal (that is, allows the current flow) to engine 65 to cause rotation ahead of engine 65, for example, at a rate proportional to the force used by the operator to pull the trigger
20. The forward rotation of the motor 65, in turn, rotates the annular gear 78 present at the distal end of the planetary gear assembly 72, thus rotating the helical gear drum 80, and making the ring 84 threaded in the helical gear drum 80 moves distally along said helical gear drum 80. Rotating the drum with
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23/53 helical gear 80 also directs the main drive shaft assembly as described above which, in turn, leads to the positioning of knife 32 on end effector 12. That is, knife 32 and rail 33 are driven to cross the channel 22 is distal longitudinally, thus cutting the fabric attached to the end actuator 12. Furthermore, the stapling operation of the end effector 12 is carried out in modalities in which a staple type end effector 12 is used.
[0066] When the cutting / stapling operation of end effector 12 is finished, ring 84 on the helical gear drum 80 will have reached the distal end of the helical gear drum 80, thus causing the motor reversing switch 130 is activated, which sends a signal (i.e., allows current to flow) to motor 65 to cause motor 65 to reverse its rotation. This in turn causes the knife 32 to retract and also causes the ring 84 on the helical gear drum 80 to move back to the adjacent end of the helical gear drum 80.
[0067] The intermediate part of the cable 104 includes a shoulder at the rear 106 that mates with the slotted arm 90, as is better shown in Figures 8 and 9. The intermediate part of the cable 104 also has a movement lock forward 107 which is coupled to the trigger trigger 20. The movement of the slotted arm 90 is controlled, as explained above, by the rotation of the motor 65. When the slotted arm 90 rotates counterclockwise as the ring 84 travels from the adjacent end of the helical gear drum 80 to the distal end, the middle cable piece 104 will be free to rotate counterclockwise. This way, as the user removes the trigger trigger 20, the trigger trigger 20 will engage with the front movement locking device 107
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24/53 of the median cable piece 104, causing the median cable piece 104 to rotate counterclockwise. Due to the rear part shield 106 that engages the slotted arm 90, however, the middle cable piece 104 will only be able to rotate counterclockwise as far as the slotted arm 90 allows. In this way, if the motor 65 stops rotating for some reason, the slotted arm 90 will stop rotating, and the user will not be able to further remove the trigger trigger 20, due to the fact that the middle cable piece 104 is not free to rotate counterclockwise due to the slotted arms 90.
[0068] Figures 10A and 10B illustrate two states of keys or variable sensors that can be used as the motor starter 110 according to various embodiments of the present invention. The motor starter 110 may include a face portion 280, a first electrode (A) 282, a second electrode (B) 284, and a compressible dielectric material 286 between electrodes 282 and 284, such as, for example, a electroactive polymer (EAP). The engine starter 110 can be positioned so that face portion 280 contacts trigger trigger 20 when retracted. Consequently, when trigger trigger 20 is retracted, dielectric material 286 is compressed, as shown in Figure 10B, so that electrodes 282 and 284 are closer together. Since the distance b between electrodes 282 and 284 is directly related to the impedance between electrodes 282 and 284, the greater the distance, the greater the impedance, and the shorter the distance, the lower the impedance. In this way, the amount of compression of the dielectric material 286 caused by the retraction of the trigger trigger 20 (denoted as force F in Figure 10B) is proportional to the impedance between electrodes 282 and 284, which can be used to proportionally control the motor 65.
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[0069] The components of an exemplary closing system for closing (or fixing) the anvil of end effector 12 by retracting the closing trigger 18 are also shown in Figures 7 to 10. In the illustrated embodiment, the closing system includes a joint 250 connected to the closing trigger 18 by a pivot pin 251 inserted through openings aligned both on the closing trigger 18 and on the joint 250. A pivot pin 252, around which the closing trigger 18 rotates, is inserted through another opening in the closing trigger 18 that is offset in relation to where the pin 251 is inserted in the closing trigger 18. In this way, the retraction of the closing trigger 18 causes the upper part of the closing trigger 18, to which the gasket 250 is fixed through pin 251, turn counterclockwise. The distal end of joint 250 is connected, through a pin 254, to a first closing bracket 256. The first closing bracket 256 connects to a second closing bracket 258. Collectively, closing brackets 256 and 258 define a opening in which the proximal end of the proximal closing tube 40 (see Figure 4) is supported and maintained so that the longitudinal movement of the closing supports 256 and 258 causes a longitudinal movement of the proximal closing tube 40. Instrument 10 includes also, a closing rod 260 disposed within the adjacent closing tube 40. The closing rod 260 may include an opening 261 within which a column 263 in one of the outer parts of the cable, such as the outer lower side part 59 in the illustrated mode, it is arranged to connect the closing rod 260 to the cable 6 in a fixed manner. In this way, the adjacent closing tube 40 is capable of moving longitudinally in in relation to the closing rod 260. The closing bar 260 may also include a distal collar 267 that fits within a cavity 269 in the adjacent structuring tube 46 and is therein
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26/53 maintained by a cover 271 (see Figure 4).
[0070] In operation, when gasket 250 rotates due to retraction of the closing trigger 18, the closing clamps 256, 258 cause the adjacent closing tube 40 to move distally (that is, in the direction away from the cable end of the instrument 10), which causes the distal closing tube 42 to move distally, which causes the anvil 24 to rotate around the pivot pins 25 to the closed or secured position. When the closing trigger 18 is released from the locked position, the adjacent closing tube 40 is caused to slide approximately, which causes the distal closing tube 42 to slide approximately, which, due to the flap 27 which is inserted in the window 45 of the distal closing tube 42, causes the anvil 24 to rotate around the pivot pins 25 to the open or non-clamped position. In this way, by retracting and locking the closing trigger 18, an operator can trap the fabric between the anvil 24 and the groove 22, and can loosen the fabric after the cutting / stapling operation by unlocking the closing trigger 20 from the locked position .
[0071] Figure 11 is a schematic diagram of a current control circuit of the instrument 10 according to various modalities of the present invention; When an operator initially pulls the trigger trigger 20 after locking the closing trigger 18, the engine starter 110 is activated, allowing current to flow through it. If the normally open switch 130 of the motor reversal sensor is open (meaning that the end effector end of actuation has not been reached), the current will flow to a single pole and double actuator relay 132. As the reversal of motor 130 is not closed, inductor 134 of relay 132 will not be energized, so relay 132 will be in its non-energized state. The circuit also includes a
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27/53 cartridge locking switch 136. If end actuator 12 includes a staple cartridge 34, switch 136 will be in the closed state, allowing current to flow. Otherwise, if end actuator 12 does not include a clamp cartridge 34, key 136 is open, thereby preventing battery 64 from feeding motor 65.
[0072] When staple cartridge 34 is present, the key
136 is closed, which energizes a single pole relay and single drive 138. When relay 138 is energized, current flows through relay 136, through the variable resistor (motor start) switch 110, to motor 65 through of a double pole relay and double drive 140, thus energizing the motor 65 and allowing it to turn in a progressive direction.
[0073] When the end actuator 12 reaches the end of its path, the motor reversal switch 130 will be activated, thus closing the motor reversal switch 130 and energizing relay 134. This makes relay 134 assume its energized state, which causes the current to bypass the locking switch on cartridge 136 and variable resistor 110 and pass, instead, both to the normally closed double and double actuator relay 142 and back to the motor 65, but in a way that, via relay 140, makes motor 65 reverse its rotational direction.
[0074] Because the motor stop switch 142 is normally closed, the current will flow back to relay 134 to keep it closed until the motor stop switch 142 opens. When the knife 32 is completely retracted, the engine stop switch 142 is activated, causing the engine stop switch 142 to open, thereby removing power from the engine 65.
[0075] In other modalities, instead of a proportional type switch 110, a sensor or switch of the type on-off could be
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28/53 used. In such modalities, the rate of rotation of the engine 65 would not be proportional to the force applied by the operator. Instead, engine 65 would generally rotate at a constant rate. But the operator would still feel force feedback because trigger trigger 20 is installed on the gear drive train.
[0076] As indicated above, there are several steps within the function of a stapler that, in general, must be performed in an established order. For example, once the closing trigger is locked, the firing cycle can be triggered. After the knife has been completely installed, then system retraction is the next sequential step. With the inclusion of a power supply in addition to the user (ie batteries or tires) the ability to reduce the steps initiated by the user (and therefore the complexity of the device) the system itself, as discussed above, can begin to complete these steps by yourself.
[0077] It may be desirable, however, for the user to be able to intuitively delay, slow down or interrupt these otherwise automatic actions. For example, the same actuation button that would allow firing to start on a tactile feedback device, such as the devices presented in US Patent Application Serial No. 11 / 344,035, now US Patent No. 7,422,139, the description of which is here incorporated by reference, in its entirety, it could be used to delay or interrupt an automatic return system by the user who presses the button during retraction.
[0078] For example, Figures 12 and 13 illustrate another embodiment of the present invention in which a retraction trigger 121 is held on the trigger trigger 20 to travel through it. More specifically, the retract trigger 121 is pivotally supported on the trigger trigger pin 96 and protrudes through a groove (not shown) on the trigger trigger 20. A spring 125 is
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29/53 fixed between a coupling portion 123 of the trigger trigger 100 and a mounting portion 127 of the retract trigger 121 to tilt the retract trigger 121 in an unacted position. A second, normally closed, retract switch 131 is mounted inside the cable and is oriented so that, as the trigger trigger 20 is moved from a fully actuated position to a completely unacted position, an activation portion 129 of the retraction trigger 121 does not activate retraction key 131. However, mounting portion 127 and activation portion 129 of retraction trigger 121 are thus configured so that activation portion 129 can be brought into contact with the key retraction 131 when pressing the retract trigger 121 towards the trigger trigger 20 regardless of where the trigger trigger 20 is located during the retraction process.
[0079] As discussed above, when end effector 12 reaches the end of its path, the end of path switch 130 will be activated. As shown in the example in Figure 13, the retract switch 131 is in series with the limit switch 130. As the retract switch 131 is normally closed, relay 134 will be energized when both switches 130, 131 are closed. This causes relay 134 to assume its energized state, which causes the current to bypass the locking sensor cartridge 136 and variable resistor 110. Current flows to the double pole relay, double movement 140 and motor 65, but in a way that, through relay 140, causes motor 65 to reverse its rotational direction. Because the start-of-travel switch 142 is closed, current will flow back to relay 134 to keep it closed until switch 142 opens. When knife 32 is fully retracted, the start-of-travel switch 142 is opened, thereby removing power from motor 65. If, however, the user wishes to delay the
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30/53 retraction process, the user can press the retraction trigger 121 to activate the variable resistance portion 133 of the retract switch 131. When the retraction trigger 121 is not pressed, the resistance of the variable resistance portion 133 is the minimum. When trigger 121 is pressed, the resistance of the variable resistance portion 133 increases in proportion to the pressing force of retraction trigger 121 to reduce the current to motor 65. The additional depression of retraction trigger 121 will delay the retraction process until the normally closed contact portion 135 of the retract switch 131 opens and interrupts the current flow to the motor 65. In several ways, once the user releases the retract trigger 121, the spring 125 will move the trigger retraction 121 to an unactivated position and contact portion 135 of switch 131 will return to the normally closed position and thereby allow the chain to flow back to motor 65 to complete the retraction process.
[0080] The exclusive and innovative features of the retraction key and retraction trigger provisions described above can also be used in conjunction with the various modalities presented in patent application publication No. US 2010/007674 A1, and patent No. US 7,422,139, which have both been incorporated by reference in their respective totalities. For example, Figure 14 shows another embodiment of a current control circuit invention. When (i) the engine starter (or trip) 110 is closed (it is shown in an open state in Figure 14), (ii) the safety switch 240 is closed (it is shown open in Figure 14) indicating that the device security is set, and (iii) the normally-closed locking switch 242 is opened, indicating that the instrument is not in a locking condition, current flows through the security switch 240, through the locking indicator
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31/53
244 (which can be an LED, as shown in Figure 14) for motor 65. When the end of the cutting path is reached, the end-of-travel or direction switch 130 is activated, reversing the direction of motor 65 (with the trigger key 110 also being released). In this state, current also flows through a reverse direction indicator 246, such as an LED, providing a visual indication that the direction of the motor has been reversed.
[0081] As shown in Figure 14, the circuit can also comprise a manual return switch 248. The operator can manually actuate this switch if the cut-off instrument 32 has only been partially triggered. Activating the manual return key 248 can cause the motor 65 to reverse the rotation, causing the cutting instrument 32 to return to its original position. If the user wishes to delay or interrupt the retraction process, the user presses the retraction trigger 121 to activate the variable resistance portion 133 of the retract switch 131. When the trigger 121 is pressed, the resistance increases in proportion to the force of pressure to reduce the current to the motor 65. The additional depression of the retract trigger 121 will delay the retraction process until the normally closed contact portion 135 of the retract switch 131 opens and interrupts the current flow to the motor 65 In various modalities, once the user releases retract trigger 121, spring 125 will move retraction trigger 121 to an unacted position and contact portion 135 of switch 131 will return to the normally closed position and allow , thereby allowing the chain to flow back to motor 65 to complete the retraction process.
[0082] Additional configurations for motorized surgical instruments are presented in patent application publication No. US 2010/0076474 A1, entitled Motor-Driven Surgical Cutting
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Instrument, which is fully incorporated by reference. For example, Figure 15 is a schematic diagram of another control circuit in accordance with various embodiments of the present invention. In various embodiments, the motor control circuit may include one or more integrated circuits (ICs), such as, for example, a processor, memory, microcontroller, time circuits, etc. In other embodiments, the motor control circuit may not comprise any ICs. Such a non-IC current control circuit can be advantageous, as it is often difficult, complicated, and costly to sterilize a surgical instrument, including ICs.
[0083] When an operator initially applies an actuation movement to the trigger trigger 20 after locking the closing trigger 18, the motor starter 110 is activated (or closed), allowing the current to flow through it. If the normally open switch 130 of the motor reversal sensor is open (meaning that the end effector end has not been reached), the current will flow to a single-pole, double-motion relay 132. When the motor reversal 130 is not closed, a coil 134 of relay 132 will not be energized, therefore, relay 132 will be in its non-energized state.
[0084] As shown in Figure 15, the circuit can also include a resistive element 144 and a switch 146 connected in parallel, with the elements in parallel connected in series with relay 132. Resistive element 144 and switch 146 are also connected to the power source 64. The switch 146 can be controlled by a control circuit 148 which is responsive to the cutting instrument position sensor 150. According to various modalities, the control circuit 148 can open the switch 146 when the instrument section 32 is (i) very close to the beginning of its path and (ii) very close to the end of its path. For example, the control circuit can open the switch when the instrument
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33/53 cut 32 is (i) 0.00254 cm (0.001 inch) from the starting point of its course and (ii) 0.00254 cm (0.001 inch) from the end of its course, as determined by the instrument position sensor cut-off 150. With switch 146 open, current flows through resistive element 144, and then through relay 132, relay 138, motor start sensor switch 110, to motor 65. The current that flowing through resistive element 144 reduces the magnitude of the current delivered to motor 65, thereby reducing the power delivered by motor 65. Thus, when the cutting instrument 32 is (i) very close to the beginning of its path or ( ii) very close to the end of its path, the power released for engine 65 is reduced. Conversely, once the cutting instrument 32 moves far enough from its start or end point of the movement point, the control circuit 148 can close the switch 146, thereby shortening the resistive element 144, increasing thus the current for the motor 65, thus increasing the power delivered by the motor.
[0085] According to various modalities, the current control circuit additionally includes locking sensor switches 136a ad that collectively define an interlock circuit 137 through which the current of relay 132, when de-energized, passes in order that the electrical operation of motor 65 is started. Each locking sensor switch 136a to d can be configured to maintain an open switch (i.e., non-conductive) state or a closed switch (i.e., conductive) state responsive to the presence or absence, respectively, of a corresponding condition. Any of the corresponding conditions, if they are present when the instrument 10 is triggered, can result in an unsatisfactory cutting and stapling operation and / or damage to the instrument 10. Conditions to which the lock sensor keys 136a-d can respond include , for example, (a) the absence of staple cartridge 34 in channel 22, (b) a
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34/53 presence of a worn (for example, previously fired) staple cartridge 34 in channel 22, and (c) an open (or otherwise insufficiently closed) position of anvil 24 in relation to channel 22. Other conditions to which locking sensor switches 136ad can respond, as component wear, can be inferred based on an accumulated number of triggering operations produced by instrument 10. Consequently, in several modalities, if any of these conditions exist, the sensor switches corresponding locking devices 136a-d maintain a state of open switch, thus preventing the passage of the current necessary to start the operation of the motor 65. The passage of the current through the locking sensors 136a-d is allowed, in several modalities, only after all the conditions have been remedied. It will be understood that the conditions described above are provided by way of example only, and that additional locking sensor switches to respond to other conditions detrimental to the operation of the instrument 10 may be provided. It will likewise be understood that, for modalities in which one or more of the conditions described above may not exist or which do not raise concerns, the number of locking sensor switches may be less than that shown.
[0086] As shown in Figure 15, the locking sensor switch 136a can be implemented using a normally open switch configuration so that a closed switch state is maintained when the staple cartridge 34 is in a corresponding position upon proper receipt by channel 22. When staple cartridge 34 is not installed in channel 22, or is improperly installed (for example, misaligned), the lock sensor switch 136a maintains an open key state. The lock sensor switch 136b can
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35/53 be implemented using a normally open switch configuration so that a closed switch state is maintained only when an unused staple cartridge 34 (i.e., a staple cartridge 34 that has a rail 33 in position not triggered) is present in channel 22. The presence of a worn staple cartridge 34 in channel 22 causes the locking sensor key 136b to maintain an open key state. The lock sensor switch 136c can be implemented using a normally open switch configuration so that a closed switch state is maintained when the anvil 24 is in a closed position in relation to channel 22. The lock sensor switch lock 136c can be controlled, according to a delay reset, in which a closed key state is maintained only after the anvil 24 is in the closed position for a predetermined period of time. [0087] The locking sensor switch 136d can be implemented using a normally closed switch configuration so that a closed switch state is maintained only when the cumulative number of shots produced by instrument 10 is less than a predetermined number . The lock sensor switch 136d may be in communication with a counter 139 configured to maintain a count representative of the cumulative number of trigger operations performed by the instrument 10, compared to the predetermined number count, and to control the key state of the switch. 136d locking sensor based on comparison. Although shown separately in Figure 15, it will be understood that counter 139 may be integral with the locking sensor key 136d to form a common device. Preferably, counter 139 is implemented as an electronic device that has an input for incrementing the count maintained based on the transition from a separate electrical signal supplied thereto.
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It will be understood that a mechanical counter configured to maintain count based on a mechanical input (for example, trigger trigger retraction 20) can be used instead. When implemented as an electronic device, any distinct signal present in the electrical circuit that transits once for each triggering operation can be used for the input of counter 139. As shown in Figure 15, for example, the distinct electrical signal resulting from the actuation of the limit switch sensor 130 can be used. Counter 139 can control the key state of the locking sensor key 136d so that a closed key state is maintained when the maintained count is less than a predetermined number stored in counter 139. When the maintained count is equal to the predetermined number , counter 139 causes locking sensor switch 136d to maintain an open switch state, thereby preventing current from passing through it. It will be understood that the predetermined number stored by counter 139 can be selectively adjusted as needed. According to various modalities, counter 304 may be in communication with an external screen (not shown), such as an LCD screen, integral with the instrument 10 to indicate to a user the count maintained or the difference between the predetermined number and the count maintained.
[0088] According to various modalities, the interlock circuit 137 can comprise one or more indicators visible to the user of the instrument 10 to display a situation of at least one of the locking sensor switches 136a-d. More details regarding these indicators can be found in US Patent Application Publication No. 2007/0175956, entitled Electronic Lockouts and Surgical Instrument Including Same, which is incorporated herein in full by reference. This order also includes arrangements and configurations of exemplifying assemblies
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37/53 for the lock sensor keys 136a-d.
[0089] In the illustrated mode, when the locking sensor switches 136a a-d collectively maintain a closed switch state, a single pole relay and single drive 138 is energized. When relay 138 is energized, current flows through relay 138, through the motor starter sensor 110, to motor 65 through a double pole relay and double drive 140, thus energizing motor 65 and allowing it rotates in a progressive direction. According to various modalities, such as the relay 138 output, once energized, keeps relay 138 in an energized state until relay 132 is energized, interlock circuit 137 will not work to prevent the operation of motor 165 once started , even if one or more of the interlock sensor keys 136a-d subsequently maintains an open key state. In other embodiments, however, it may be necessary, or otherwise desirable, to connect interlock circuit 137 and relay 138 so that one or more of the locking sensor switches 136a-d need to maintain a closed key state in order to to sustain the operation of motor 165 once started.
[0090] The rotation of the motor in the forward direction causes the ring to move distally and thus deactivates the motor stop sensor switch 142 in various modalities. Since switch 142 is normally closed, a solenoid 141 connected to switch 142 can be energized. Solenoid 141 can be a conventional pressing type solenoid that, when energized, causes a plunger (not shown) to be axially extended. The plunger extension can operate to retain the closing trigger 18 in the stowed position, thereby preventing the anvil 24 from opening while a firing operation is in progress (i.e., while switch 142 is not actuated). By de-energizing solenoid 141, the
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38/53 the plunger is retracted, so that manual release of the closing trigger 18 is possible.
[0091] When the actuating member portion reaches the most distal end of its path, the reversing switch of motor 130 will be activated, thus closing switch 130 and energizing relay 132. This causes relay 132 to assume its energized state (not shown in Figure 11) that causes the current to bypass the interlock circuit 137 and the motor start sensor switch 110, and instead causes the current to flow into the double pole and drive relay normally closed double 140 and back to motor 65, but through relay 140, which causes motor 65 to reverse its rotational direction. Because the engine stop sensor switch 142 is normally closed, current will flow back to relay 132 to keep it energized until switch 142 opens. When knife 32 is fully retracted, engine stop sensor switch 142 is activated, causing switch 142 to open, thereby removing power from engine 65, and de-energizing solenoid 141.
[0092] In the embodiment shown in Figure 15, a normally closed retract switch 137 is used, which interfaces with the retract trigger 121 (not shown in Figure 15). When the retract switch 137 is activated, it opens to interrupt the current flow to the motor 65. In alternative modes (figure 15A), the normally closed retract switch 137 could be replaced by a variable resistor 137 'that interfaces with the retract trigger 121. In such a mode, when the retract trigger 121 is not pressed, the resistance of the variable resistor is minimal, to allow the maximum current to flow to the motor 65. When pressed, the resistance increases proportionally relative to the pressing force, to reduce the current to the motor. Such resistor
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39/53 variable can also be replaced by the retraction key 131, as described above (see Figure 15B).
[0093] Prevention of accidental actuation for an endoscopic surgical instrument equipped with a motor: With the introduction of systems equipped with a motor that no longer limit the function of the device in the user's strength capacities, inadvertent initiation of the firing cycle can become an much more prevalent issue. It will be easier to impact the activation control and cause the instrument to start firing, thus preventing the cartridge from locking or even congesting it in the tissue, as the user did not realize that it has already started firing. Several locking provisions are presented in US Patent No. 7,644,848, entitled Electronic Lockouts and Surgical Instrument Including Same with Swayze et al., The description of which is incorporated herein by reference, in its entirety. In order to eliminate this issue, secondary unlocking keys or buttons could be used to unlock the trigger mechanism. This is very similar to the two key systems used in the chainsaw industry, as well as in the war industry to protect against accidental actuation. A secondary switch can either release the lock on the trigger or merely energize the drive in the control.
[0094] As mentioned above, when using a motorized two-movement instrument, the operator first pulls back and locks the closing trigger 18. Figures 16 and 17 show a modality of a way to lock the closing trigger 18 to the portion pistol grip 26 of the cable 6. In the illustrated embodiment, the pistol grip portion 26 includes a hook 150 which is pulled to rotate counterclockwise around a pivot point 151 by a torsion spring 152. In addition , the closing trigger 18 includes a closing bar 154. As the operator pulls the
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40/53 closing trigger 18, closing bar 154 engages an inclined portion 156 of hook 150 thus rotating hook 150 upward (or clockwise in Figures 16 and 17) until closing bar 154 passes completely through the inclined portion 156, pass into a recessed slot 158 of the hook 150, which locks the closing trigger 18 in place. The operator can release the closing trigger 18 by pressing a release slide button 160 on the rear or opposite of the pistol grip portion 26. Pressing the release slide button 160 rotates the hook 150 clockwise so that the closing bar 154 is released from the recessed slot 158. Other provisions for releasably locking the closing trigger 18 are shown in US Patent No. 7,422,139 which has been incorporated by reference.
[0095] As can be seen in Figures 16 and 17, in various modalities, a locking key 151 can be mounted on hook 150 so that it is activated only when hook 150 is locked in place. However, the locking key 151 can be mounted on the handle portion of the gun 26 for activation by the closing trigger 18 when the closing trigger 18 is locked in position. In yet other alternative embodiments, the locking key 151 is mounted on the end effector so that it is activated only when the anvil or other movable portion is in the closed position. Regardless of the specific location of the lock latch key 151, in various embodiments, the lock latch key is a normally open key that will be closed by locking the closing trigger 18 or otherwise manipulating the end effector to a position closed.
[0096] Figure 18 is a schematic diagram of an electrical circuit of the instrument 10, according to various modalities of the present invention, which illustrate the use of the
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41/53 closing 151. As can be seen in that Figure, the current will not be allowed to flow from battery 64 to motor 65 even if a cartridge is present, unless the locking key 151 is closed. Thus, motor 65 cannot be operated unless the closing trigger is in the closed locked position, which also reflects that the end effector is in the closed state.
[0097] Various modalities may also include a starter switch 153 that must be activated by the surgeon before the current is allowed to flow from the battery 64 to the other circuit components and, finally, to the motor 65. The starter 153 is normally open and can be located in a convenient location on cable 6. See Figure 1. Thus, in these modalities, even if the end effector contains a cartridge and the closing trigger 18 is locked in a closed position , the chain will not be allowed to flow to the motor 65 until the start switch 153 is closed by the surgeon. In alternative embodiments, the starter 153 may comprise a mechanical key that prevents the trigger trigger 20 from being physically rotated towards the pistol grip portion, unless the key 153 is moved to an actuated position.
[0098] Active adjustable clamp height for an endoscopic surgical instrument equipped with a motor: The clamp height that is adjustable to the thickness and type of the tissue has been in demand for many years. More recently, US Patent Application Serial No. 11 / 231,456, filed on September 21, 2005, now US Patent No. 7,407,078 and US Patent Application No. 11 / 540,735, filed on September 29 2006, now US Patent No. 7,467,740, the descriptions of which are hereby incorporated by reference in their respective totalities, in general involve a support or flexible coupling member that
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42/53 would allow the span of the instrument to increase with loads induced by thicker tissue in the device. This passive variable staple height allows the thickness of the fabric to create larger staple shapes.
[0099] With the introduction of the power supply inside the instrument, it allows the use of electricity to change the height of an internal element inside the dynamic coupling element that would actively alter the height of the clamp by the surgeon or configure the instrument at the height desired. This internal element could be a material with shape memory and electricity alters its temperature and, therefore, allows it to change its physical height due to the present configuration. Another viable method would be the inclusion of an electroactive polymer (WBS) which, by introducing an electric field, allows it to change its height and width. Still, a third modality would be to use a traditional linear electric stepped element that can rotate a small adjustable threaded element within the coupling beam that would adjust its height.
[00100] More specifically and with reference to Figures 19 and 20, an end effector 12 of various embodiments of the present invention is shown in cross section with the anvil 24 in a closed or locked position. As can be seen, the cutting instrument or knife 32 has a lower actuator portion 37 that has a threaded sleeve or nut portion 37 'that is configured to threadably engage the helical thread rod 36. In addition, a fin 39 protrudes laterally on each side of the nut portion 37 to confront corresponding slide portions 23 of the channel 22. As can also be seen in Figure 19, knife 32 has an upper actuator portion 41 which is sized to be received within a longitudinal T-shaped groove 43 in the anvil 24.
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As can be seen in Figure 19, a pair of upper retaining pins 41 'protrude laterally on each side of the upper actuator portion 41 of knife 32. Each upper retaining pin 41' is configured to extend into a corresponding portion of the groove in T shape 43 provided on anvil 24. Thus, as knife 32 is guided distally through end effector 12, fins 39 and retaining pins 41 'serve to limit the amount of space between anvil 24 and cartridge 34 up to a maximum amount of predetermined space.
[00101] Several modalities of the present invention are provided with means to adjust the amount of space between the anvil 24 and the cartridge 34 installed inside the channel 22. For example, in some modalities, each fin 39 supports a rail contact 45 for contact slide with corresponding electrical contacts 47 that are mounted within each slide portion 23 of channel 22. Electrical contacts 47 are elongated and extended within channel 22 so that rail contacts 45 are always in contact with their corresponding electrical contact 47 as knife 32 is guided inside channel 22. Electrical contacts 47 are connected to the power source or battery 64 and are configured to receive current from it when motor 65 is equipped with a motor to guide knife 32 distally. Also in certain embodiments, an electrically responsive height adjustment member 49 is mounted on each retaining pin 41 ', as shown in Figure 19. The height adjustment members 49 are electrically coupled to the rail contacts 45 to receive electrical current from them . In various embodiments, the height adjustment members 49 can comprise material with memory so that, when electrified, it changes its physical height due to a pre-adjusted configuration. Thus, depending on the amount of current received, the members of
Petition 870190123505, of 11/26/2019, p. 46/65
44/53 height adjustment member 49 can expand and force anvil 24 towards cartridge 34, thereby reducing the amount of space between them. The amount of such material is proportional to the amount of current received and is known. A control circuit (not shown) can be employed to control the amount of expansion and, therefore, the amount of space between the anvil 24 and the cartridge 34. In other embodiments, the height adjustment material comprises an electroactive polymer (EAP) ) which is retained in a pocket on pin 41 or is otherwise attached to it.
[00102] Figure 21 illustrates another modality that is similar to the modality represented in Figure 19. However, in this modality, the height adjustment members 49 are mounted on the anvil 24 and receive current from the power source through conductors fixed directly to them . Thus, in this modality, contacts 43 and 45, as described above, are not necessary.
[00103] Figure 22 illustrates an alternative knife set 32 'which is substantially identical to the knife set 32 described above, except that retaining pins 41' are mounted on a separate upper actuator portion 302 which is selectively movable in one direction vertical VD with respect to a lower portion 300 of the knife set 32 '. A second motor 304 can be mounted on the lower portion 300 and have a lead thread 306 that threadably engages a nut portion 308 of the upper retainer portion 302. The upper retainer portion has a T-shaped tongue portion 310 slidably extending into a correspondingly shaped groove 312 in the lower portion 300 to prevent rotation of the upper retainer portion 302 relative to the lower retainer portion 300 while allowing the upper retainer portion 302 to move
Petition 870190123505, of 11/26/2019, p. 47/65
45/53 vertically with respect to it. In this way, the distance between the upper and lower retainer portions 302, 300 can be adjustable when driving the second motor 304. Consequently, if the surgeon wants to reduce the amount of space between the anvil 24 and the cartridge 34, the second motor 304 it is equipped with a motor to rotate in a first direction to attract the upper retainer portion 302 towards the lower retainer portion 300. If, however, the surgeon wishes to increase the amount of space between the anvil 24 and the cartridge 34, the second motor 304 is rotated in the opposite direction.
[00104] Various embodiments of the present invention include methods of illuminating the end effector and methods of illuminating the surgical site when using an endoscopic surgical instrument equipped with a motor. Currently, when the end effector is at or near its implantation position, it may be difficult for the surgeon to visualize the treatment site as there are shadows cast by adjacent structures as well as the end effector may even be entirely behind a structure. Figure 23 generally illustrates a distal end 402 of a surgical stapler 400 of various modalities of the present invention, which includes an anvil 404, a cartridge body 406, and channel 408. As seen in the Figure mentioned, a light source additional 410 can be positioned at the end of the cartridge body 406 to illuminate the fabric 401. This light source 410 could be any combination of practical means that convert electrical energy into light, including, but not limited to, semiconductor (such as LED), a conventional incandescent or filament, electroluminescent or laser lamp that can be equipped with a motor from a battery supported on the instrument cable or in other modalities, equipped with an alternating current motor. Such provisions would allow the surgeon to not only illuminate the
Petition 870190123505, of 11/26/2019, p. 48/65
46/53 treatment directly, as it would also allow the backlighting of structures to see the internal components, such as vasculature, and facilitate the use of a laser pointer through a traditional scope to highlight areas of interest to others.
[00105] In several embodiments, one or more contacts 420 are provided at the rear of the 406 cartridge body that are configured to engage contacts 422 within channel 408. See Figure 24. This would allow the surgeon to energize the lights 410 as needed when energize the adjusted contact via a switch positioned on cable 430. This switch can even have variable intensity, as one previously described could control the actuation speed of the main device. Other lighting arrangements to illuminate the end of an anvil fixed to a circular surgical stapler are presented in patent application publication No. US 2010/0096435 A1, entitled Surgical Stapling Instrument With Apparatus For Providing Anvil Position Feedback, published on April 22 2010, the full description of which is incorporated herein by reference.
[00106] The publication of patent application n ° US 2007/0175949 A1, entitled Surgical Instrument Having a Feedback System, published on August 2, 2007, the complete description of which is incorporated by reference, further presents in Figures 45 to 47 of that Publication output displays that could show, among other things, this feedback of position of the end actuator, locking situation, number of shots, etc. This would minimize one of the most difficult issues for the user, which is to identify the situation of a device, specifically the situation of locking the device without acting on the device. An additional feedback that would be of great help to the user would be immediate feedback on the situation of the cartridge when it is loaded. As in the application above, the same
Petition 870190123505, of 11/26/2019, p. 49/65
47/53 could be wrapped around the locking indication on cable 430. A 432 indicator (such as an LED, glass lamp, LCD, sonic announcer, vibrator, etc.) could only be associated with the situation of a means of locking the cartridge or mechanism in such a way that it provides this information to the surgeon. This LED could be located on cable 430. See Figure 26. Alternatively, an indicator 434 could be located near distal end 402 that would provide immediate information to the surgeon and loader whether the cartridge is ready for use or not. See Figure 25. This can be achieved with a key or set of contacts associated directly with the mechanical lock. The switch or contacts complete a circuit in such a way that the indicator provides adequate information. This complete contact adjustment could take place through a conductive element inside the sliding support (part 33 in patent application publication No. US 2007/0175958) and the two contacts could be in the proximal position of the channel (part 22). Another way of detecting the locking situation is indirectly through the instrument situation (Example 1: cartridge loaded and no attempt to fire would indicate that the lock is not engaged; Example 2: instrument fired and no new cartridge installed would indicate that the lock is engaged, etc.). Another method would be to place the LED or visual indication on the cartridge itself. When the cartridge is snapped in place it creates a contact that provides drive to the cartridge. If the cartridge is triggered, not only the mechanical lock for advancing the knives, but the cartridge circuit illuminates the LED on the cartridge informing the surgeon on the scope monitor that the cartridge is locked. This could be further expanded by placing a small battery or other charge accumulator inside the cartridge itself to eliminate the need for a drive connection to the main device. In addition, the
Petition 870190123505, of 11/26/2019, p. 50/65
48/53 cartridge could be adjusted to illuminate the lock light whenever the device is closed to inform the user that there is a spent cartridge in the device.
[00107] The indication feedback for articulation equipped with motor and cartridge color: The indication of the type of cartridge installed (color) and angle of articulation is considered useful to the surgeon. The articulation angle indication could be indicated in several ways including numerically or graphically as in an arc of LEDs. The location of this indication could be on the cable at a convenient location or on the axis of the device closest to the end effector. The end effector feedback could be passive or active. The active would turn on additional LEDs to show the angle. The passive could simply show a lit half circle so that the surgeon could sense how articulated the end effector is. As surgical procedures are further explored, they become more and more obvious to the fact that the surgeon's eyes need to be focused on the surgical sites and not on the instrument handle. One also begins to realize the surgeon's need for complete feedback on the situation through the device. The pivot angle could be illuminated as part of the pivot joint itself. With lights, LEDs, etc. denoting the divergent angles or even a small LCD denoting the angles in degrees. This would allow the surgeon to have some feedback on the angles outside the line so that he can easily navigate back to the correct angle after removal and reinsertion. Another issue is the obvious indication of which color cartridge is in the device. This can be done through a color-coded light matrix on the end actuator or on the cartridge. This information could also be transmitted back to the cable to display a redundant display to ensure that there is minimal confusion
Petition 870190123505, of 11/26/2019, p. 51/65
49/53 as to which cartridge is in the claws. Another improvement could include a small spring-beam contact connected to the cartridge's proximal platform that indicates whether minimum tissue pressure has been achieved between the jaws. This minimum pressure would, at a minimum, indicate whether a thick tissue cartridge is being used in thin tissue applications, as it would not light up if insufficient tissue pressure on the platform is present.
[00108] There is a possible need for a method for introducing non-sterile batteries (possibly with integral electronics with batteries if programmable logic becomes a key customer need). There is already a patent within the orthopedic drill industry for inserting non-sterile batteries into a separately re-usable sterile device. This innovation is expected to optimize this concept when using the sterile disposable device packaging to protect the sterility of the instrument when inserting non-sterile batteries. Another improvement would be the inclusion of an incubation door designed inside the instrument and that can be closed after the package has been inserted but before the device is removed from the final sterile packaging. This incubation could then contain the non-sterile battery that could contaminate the sterile surgical field. The methods of the present invention could include an additional layer of packaging that would have a perforated area into which the battery could be pushed through, both breaking through the extra layer and allowing the battery to pass through and going with the battery electrode set only to be broken. through the exposed pin tips of the battery in the complete insertion. An alternative to this would be to have internal gun terminals (deep inside the battery protection cavity) break through the sterile barrier and seat inside the pin holes in the batteries. THE
Petition 870190123505, of 11/26/2019, p. 52/65
The 50/53 incubation could then be closed via the sterile package that seals the system. The gun could then be used in the sterile field normally, just like any other sterile device.
[00109] Position Locator I modalities linear encoder and load control of motor parameters: US patent no.
6,646,307 and No. 6,716,223 present the mechanisms for measuring rotation and torque related to control motor parameters and optimization of parameters based on the identification of configurations and end effector loading. Patent application publication No. 2007/0175958 shows a method using a threaded length of the primary shaft in Figures 8 to 13 as this type of linear motion control could be used to control trigger locations. The same type of method could be used for electronic linear control methods. The end effector could identify the length and types mechanically by compressing at least one spring-activated plunger, which could identify the type, and length the cable would allow the engine to run. The motor rotation could be converted from rotary movements to linear frame or cable movements, which could then be used to adjust the motor voltage, current, and speed to affect the desired linear motion of the control blade. The control blade could then be directly coupled to the knife trigger movements. This control blade could have discontinuous or continuous stop locations that the identifier plunger marks as the linear displacement goes to maximum before retraction.
[00110] The identification of modular refills with linear actuation: A useful reaction for a surgical instrument is the ability to identify which end effector was fixed on the instrument. In the case of a surgical stapler equipped with
Petition 870190123505, of 11/26/2019, p. 53/65
51/53 engine, several different types of end effector could be attached. In addition, a type of end effector can have at least one function and / or feedback that is selectively used or enabled. The means for identifying the end effector shown here are attached. Note that the type of end effector mentioned below is not limited to mechanically, pneumatically or hydraulically coupled end actuators. The instrument can take different actions, adjustment operation parameters, indication of available functions etc., as a result of the detection of this end effector.
[00111] The end effector has an electrical connection that is made when it is attached to the instrument. The instrument communicates with the end effector and reads at least one of several types of signals. A switch position or contact position indicates which type of end effector is present. A passive element is measured by impedance and the result indicates which type of end effector is present.
[00112] The end effector has a radio frequency connection with the instrument and data is transferred in at least one direction between the end effector and the instrument.
[00113] The end effector has an acoustic connection with the instrument and data is transferred in at least one direction between the end effector and the instrument.
[00114] The end effector has an optical connection with the instrument and data is transferred in at least one direction between the end effector and the instrument.
[00115] The end effector has a mechanical connection that engages elements (such as keys or contacts) in the instrument that identifies it and thereby data is transferred in at least one direction between the end effector and the instrument.
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52/53
[00116] Although, the present invention has been illustrated by describing various modalities and although the illustrative modalities have been described in considerable detail, it is not the applicants' intention to restrict or in any way limit the scope of the claims attached to such details. Additional advantages and modifications can be readily available to those skilled in the art.
[00117] For example, although the modalities described above have advantages for an endoscopically employed stapling and surgical cutting instrument 10, similar modalities can be used in other medical procedures. In general, it is accepted that endoscopic procedures are more common than laparoscopic procedures. Consequently, the present invention has been discussed in terms of endoscopic procedures and devices. However, terms such as endoscopic should not be interpreted to limit the present invention to a surgical instrument for use only in conjunction with an endoscopic tube (i.e., a trocar). On the contrary, it is believed that the present invention can be used in any procedure where access is limited to a small incision, including, but not limited to, laparoscopic procedures, as well as open procedures.
[00118] Any patent, application, or other information, in whole or in part, that is cited as incorporated herein by reference, is incorporated only to the extent that the incorporated material does not conflict with existing definitions and statements, or with any other descriptive material presented in this description. Accordingly, the description as explicitly stated herein replaces any conflicting material incorporated herein by reference.
[00119] Although this invention has been described as having
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53/53 exemplary drawings, 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 with the use of its general principles. In addition, this application is intended to cover such changes to the present description, in accordance with known or customary practice in the technique to which this invention belongs.

权利要求:
Claims (7)
[1]
1. Surgical fastening device (10) comprising:
a cable (6);
an end effector (12) operable coupled to the cable, the end effector comprises:
an elongated channel (22) configured to support a cartridge (34) therein;
a movable anvil (24) supported on the elongated channel for selective movement towards the elongated channel for a closed position and away from the elongated channel for an open position;
an actuator element (32) movably supported within the elongated channel and selectively movable from a proximal position not acted to positions acted within the elongated channel, in which the apparatus is characterized by the fact that:
anvil further comprises an elongated groove (43) therein;
actuator element comprises:
a lower actuating portion (37) slidingly interconnecting to the elongated channel;
an upper actuating portion (41) configured to project in an elongated groove; and a retaining element (41 ') projecting from each side of the upper actuating portion in a direction that is transversal to the elongated groove in the anvil; and a height adjustment element (49) on each retaining element, or on the anvil adjacent to each side of the elongated groove to confront the relationship with the retaining elements, to selectively adjust a spacing between the anvil
Petition 870190123505, of 11/26/2019, p. 57/65
[2]
2/4 and the elongated channel when the anvil is in that closed position in response to the electric current applied to it.
2. Surgical fastening device (10), according to claim 1, characterized by the fact that it still comprises an elongated rod (8) that has a proximal end attached to the handle and a distal end extending from it, the effector end piece comprising a pair of claws hinged at a proximal end thereof and movable between the open and closed positions, and an electrically actuator equipped to implant surgical fasteners, the actuator comprising the actuator element, a power supply (64) and a motor (65), in which the actuator element is mobile in response to the activation movements received from the motor.
[3]
3. Surgical fastening device (10), according to claim 2, characterized by the fact that height adjustment elements are in each of the retaining elements, each height adjustment element positioned between the retaining element and a portion corresponding to the anvil and in electrical communication with the power supply, each height adjustment element having a thickness that increases in response to the electric current from the power supply.
[4]
4. Surgical fastening device (10), according to claim 2, characterized by the fact that height adjustment elements are on the anvil corresponding to each of the retaining elements in the upper actuator portion, each of the adjustment elements of height positioned between the corresponding retaining element and the anvil and in electrical communication with the power supply, each height adjustment element having a thickness that increases in response to the electric current from the power supply.
Petition 870190123505, of 11/26/2019, p. 58/65
3/4
[5]
5. Surgical fastening device (10), according to claim 3, characterized by the fact that it still comprises:
at least one electrical contact (47) in the elongated channel and communicating electrically with the power supply; and at least one sliding contact (45) in the lower actuator, at least one sliding contact in sliding electrical contact with a correspondent of at least one electrical contact in the elongated channel and in electrical communication with the height adjustment elements to transmit the electric current for such.
[6]
6. Surgical fastening device (10) comprises:
a cable (6);
an end effector (12) operable coupled to the cable, the end effector comprises:
an elongated channel (22) configured to support a cartridge (34) therein;
a movable anvil (24) supported on the elongated channel for selective movement towards the elongated channel for a closed position and away from the elongated channel for an open position;
an actuator element (32 ') movably supported within the channel and selectively movable from an unactivated proximal position to positions actuated within the elongated channel in response to drive movements applied to it by a first electrically equipped motor ( 65) supported on the cable, in which the device is characterized by the fact that:
anvil further comprises an elongated groove (43) therein;
actuator element comprises:
a lower actuating portion (300) slidingly interconnecting to the elongated channel;
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4/4 an upper actuating portion (302) configured to project in an elongated and mobile groove in relation to the lower actuator potion;
a retaining element (41 ') projecting from each side of the upper actuating portion in a direction that is transversal to the elongated groove in the anvil; and a second electrically equipped motor (304) coupled to the upper and lower actuator portions to selectively move the upper actuator portion in relation to the lower actuator portion in response to the electric current applied to it, to selectively adjust a spacing between the anvil and the elongated groove when the anvil is in the closed position.
[7]
7. Surgical fastening device (10), according to claim 6, characterized by the fact that it still comprises: at least one electrical contact (47) in the elongated channel and communicating electrically with the power supply; and at least one sliding contact (45) in the lower actuator, in at least one sliding contact in sliding electrical contact with a correspondent of at least one electrical contact in the elongated channel and in electrical communication with the second electric motor.

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公开号 | 公开日

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EP2598050A1|2013-06-05|

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JP5847816B2|2016-01-27|

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US9486214B2|2016-11-08|

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US8444036B2|2013-05-21|

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AU2011282922B2|2013-10-10|

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WO2012015795A1|2012-02-02|

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CA2806423C|2018-09-04|

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US10420550B2|2019-09-24|

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CN103037781B|2016-01-20|

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JP2013532555A|2013-08-19|

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AU2011282922A1|2013-02-07|

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US20170007239A1|2017-01-12|

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EP2598050B1|2016-08-17|

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US20130256371A1|2013-10-03|

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PL2598050T3|2017-04-28|

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CN103037781A|2013-04-10|

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BR112013002147A2|2016-05-31|

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EP2598050B8|2016-09-28|

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US20110011915A1|2011-01-20|

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法律状态:
2018-12-26| B06F| Objections, documents and/or translations needed after an examination request according art. 34 industrial property law|

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2019-09-03| B06U| Preliminary requirement: requests with searches performed by other patent offices: suspension of the patent application procedure|

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2020-03-24| B09A| Decision: intention to grant|

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2020-05-26| B16A| Patent or certificate of addition of invention granted|Free format text: PRAZO DE VALIDADE: 20 (VINTE) ANOS CONTADOS A PARTIR DE 26/07/2011, 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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US12/846,237|2010-07-29|

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PCT/US2011/045313|WO2012015795A1|2010-07-29|2011-07-26|Motor driven surgical fastener device with mechanisms for adjusting a tissue gap within the end effector|

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