SURGICAL INSTRUMENT SYSTEM AND SURGICAL KIT FOR USE WITH A SURGICAL INSTRUMENT SYSTEM

专利摘要:
surgical instrument system that includes replaceable end actuators. A surgical instrument system is disclosed that includes a housing and rotatable drive rod, a motor operatively coupled to the drive rod, and a plurality of replaceable end actuators that can be connected to the housing. each replaceable end actuator includes a drive screw that is rotated a fixed number of revolutions by the motor-driven rotating drive rod when the end actuator is connected to the housing. each end actuator additionally comprises a trigger element operatively coupled to the end actuator drive screw. the drive screw is configured to displace the firing element along a firing length as a result of the fixed number of revolutions. in certain embodiments, each replaceable end actuator may include a drive screw with a thread pitch adjusted to the firing length divided by the fixed number of revolutions.
公开号:BR112014032776B1
申请号:R112014032776-9
申请日:2013-06-21
公开日:2021-09-08
发明作者:Frederick E. Shelton Iv；Jerome R. Morgan
申请人:Ethicon Endo-Surgery, Inc；
IPC主号:

专利说明:

BACKGROUND
[0001] Over the years, a variety of minimally invasive (or "telasurgical") robotic systems have been developed to increase surgical dexterity as well as to allow a surgeon to operate a patient in an intuitive manner. Many such systems are disclosed in the following US patents which are all incorporated herein by reference in their respective entireties: US Patent No. 5,792,135 entitled "Articulated Surgical Instrument For Performing Minimally Invasive Surgery With Enhanced Dexterity and Sensitivity", US Patent No. 6,231,565, entitled "Robotic Arm DLUS For Performing Surgical Tasks", US Patent No. 6,783,524, entitled "Robotic Surgical Tool With Ultrasound Cauterizing and Cutting Instrument", US Patent No. 6,364,888, entitled "Alignment of Master and Slave In a Minimally Invasive Surgical Apparatus", US patent no. 7,524,320, entitled "Mechanical Actuator Interface System For Robotic Surgical Tools", US patent no. 7,691,098, entitled "Platform Link Wrist Mechanism", US patent no. No. 7,806,891, entitled "Repositioning and Reorientation of Master/Slave Relationship in Minimally Invasive Telesurgery", and US Patent No. 7,824,401, entitled "Surgical Tool With Writed Monopolar Electro surgical End Effectors". Many such systems, however, have been unable, in the past, to generate the magnitude of forces necessary to effectively cut and secure tissue. Furthermore, existing robotic surgical systems are limited in the number of different types of surgical devices they can operate. BRIEF DESCRIPTION OF THE DRAWINGS
[0002] The characteristics and advantages of this invention, and the way to achieve them, will become more evident and the invention itself will be better understood by reference to the following description of the exemplary embodiments of the invention, taken in conjunction with the drawings in annex, where:
[0003] Several exemplifying modalities are described in this document by way of example together with the following figures, as follows:
[0004] Figure 1 is a perspective view of an embodiment of a robotic controller;
[0005] Figure 2 is a perspective view of a robotic surgical arm car/manipulator of a robotic system that operationally supports a plurality of surgical tool modalities;
[0006] Figure 3 is a side view of the robotic surgical arm carriage/manipulator shown in Figure 2;
[0007] Figure 4 is a perspective view of a carriage structure with positioning links to operationally support robotic manipulators that can be used with surgical tool modalities;
[0008] Figure 5 is a perspective view of a surgical tool modality and a surgical end actuator modality;
[0009] Figure 6 is an exploded assembly view of a tool holder and adapter arrangement for attaching various surgical tool modalities to a robotic system;
[00010] Figure 7 is a side view of the adapter shown in Figure 6;
[00011] Figure 8 is a bottom view of the adapter shown in Figure 6;
[00012] Figure 9 is a top view of the adapter of Figures 6 and 7;
[00013] Figure 10 is a partial bottom perspective view of an embodiment of a surgical tool;
[00014] Figure 11 is an anterior perspective view of a portion of a surgical tool modality with some of its elements omitted for clarity;
[00015] Figure 12 is a rear perspective view of the surgical tool modality of Figure 11;
[00016] Figure 13 is a top view of the surgical tool modality of Figures 11 and 12;
[00017] Figure 14 is a partial top view of the surgical tool modality of Figures 11 to 13, with the manually actuatable drive gear in a non-actuated position;
[00018] Figure 15 is another partial top view of the surgical tool modality of Figures 11 to 14, with the manually actuatable drive gear in an initially actuated position;
[00019] Figure 16 is another partial top view of the surgical tool modality of Figures 11 to 15, with the manually actuatable drive gear in an actuated position;
[00020] Figure 17 is a rear perspective view of another surgical tool modality;
[00021] Figure 18 is a side elevation view of the surgical tool modality of Figure 17;
[00022] Figure 19 is a cross-sectional view of the surgical tool modality of Figure 5 with the end actuator separated from the proximal stem portion of the surgical tool;
[00023] Figure 20 is a side perspective view showing a portion of an interconnected quick release joint modality;
[00024] Figure 21 is a cross-sectional view of a quick-disconnect joint arrangement with the distal stem portion of the end actuator separated from the proximal stem portion;
[00025] Figure 22 is another cross-sectional view of the quick-disconnect joint modality of Figures 19 to 21, in which the distal rod portion was initially engaged with the proximal rod portion;
[00026] Figure 22A is a cross-sectional view of a snap-off joint arrangement, in which the distal rod portion was initially engaged with the proximal rod portion;
[00027] Figure 23 is another cross-sectional view of the quick release joint modality of Figures 19 to 22, in which the distal rod portion has been attached to the proximal rod portion;
[00028] Figure 23A is another cross-sectional view of the quick-disconnect joint mode of Figures 22A, in which the distal rod portion has been attached to the proximal rod portion;
[00029] Figure 23B is another cross-sectional view of the quick-disconnect joint mode of Figures 22A, 22B, in which the distal rod portion has been disengaged from the proximal rod portion;
[00030] Figure 24 is a cross-sectional view of the distal stem portion of Figures 19 to 23, taken along line 24-24 in Figure 21;
[00031] Figure 25 is a cross-sectional view of a portion of a swivel joint arrangement and end actuator;
[00032] Figure 26 is an exploded assembly view of a portion of the swivel joint and end actuator of Figure 25;
[00033] Figure 27 is a perspective view in partial cross section of the articulated joint and end actuator portions shown in Figure 26;
[00034] Figure 28 is a partial perspective view of one embodiment of end actuator and drive rod assembly;
[00035] Figure 29 is a partial side view of a drive rod assembly embodiment;
[00036] Figure 30 is a perspective view of a drive rod assembly embodiment;
[00037] Figure 31 is a side view of the drive rod assembly of Figure 31;
[00038] Figure 32 is a perspective view of a composite drive rod assembly embodiment;
[00039] Figure 33 is a side view of the composite drive rod assembly of Figure 33;
[00040] Figure 34 is another view of the drive rod assembly of Figures 30 and 31, assuming an arcuate or "bent" configuration;
[00041] Figure 34A is a side view of one embodiment of a drive rod assembly, assuming an arcuate or "bent" configuration;
[00042] Figure 34B is a side view of another embodiment of drive rod assembly, assuming an arcuate or "bent" configuration;
[00043] Figure 35 is a perspective view of a portion of another embodiment of drive rod assembly;
[00044] Figure 36 is a top view of the drive rod assembly embodiment of Figure 35;
[00045] Figure 37 is another perspective view of the drive rod assembly of Figures 35 and 36 in an arcuate configuration;
[00046] Figure 38 is a top view of the drive rod assembly mode shown in Figure 37;
[00047] Figure 39 is a perspective view of another type of drive rod assembly;
[00048] Figure 40 is another perspective view of the drive rod assembly embodiment of Figure 39 in an arcuate configuration;
[00049] Figure 41 is a top view of the drive rod assembly modality of Figures 39 and 40;
[00050] Figure 42 is a cross-sectional view of the drive rod assembly embodiment of Figure 41;
[00051] Figure 43 is a partial cross-sectional view of another embodiment of drive rod assembly;
[00052] Figure 44 is another cross-sectional view of the drive rod assembly modality of Figure 43;
[00053] Figure 45 is another cross-sectional view of a portion of another embodiment of drive rod assembly;
[00054] Figure 46 is another cross-sectional view of the drive rod assembly of Figure 45;
[00055] Figure 47 is a perspective view in partial cross section of an end actuator embodiment with the actuator anvil in an open position;
[00056] Figure 48 is another perspective view in partial cross section of the end actuator embodiment of Figure 47;
[00057] Figure 49 is a side cross-sectional view of the end actuator embodiment of Figures 47 and 48;
[00058] Figure 50 is another side cross-sectional view of the end actuator embodiment of Figures 47 to 49;
[00059] Figure 51 is a perspective view in partial cross section of the end actuator modality of Figures 47 to 50 with the anvil of the actuator in closed position;
[00060] Figure 52 is another perspective view in partial cross section of the end actuator embodiment of Figure 51;
[00061] Figure 53 is a side cross-sectional view of the end actuator embodiment of Figures 51 and 52, with the actuator anvil in a partially closed position;
[00062] Figure 54 is another side cross-sectional view of the end actuator modality of Figures 51 to 53, with the anvil in a closed position;
[00063] Figure 55 is a cross-sectional perspective view of another embodiment of end actuator and portion of another embodiment of elongated rod assembly;
[00064] Figure 56 is an exploded perspective view of one embodiment of a closure system;
[00065] Figure 57 is a side view of the closure system embodiment of Figure 56 with the anvil in the open position;
[00066] Figure 58 is a side cross-sectional view of the closure system mode of Figures 57 and 57, within an end actuator mode, wherein the actuator anvil is in an open position;
[00067] Figure 59 is another cross-sectional view of the closure system and end actuator embodiment of Figure 58 with the actuator anvil in closed position;
[00068] Figure 59A is an anterior perspective view of a portion of another surgical tool modality that employs the closure system modality of Figs. 56 to 59, with the actuating solenoid omitted for clarity;
[00069] Figure 60 is an exploded assembly view of another embodiment of end actuator;
[00070] Figure 61 is a partial perspective view of a drive system modality;
[00071] Figure 62 is a partial front perspective view of a portion of the drive system embodiment of Figure 61;
[00072] Figure 63 is a partial rear perspective view of a portion of the drive system embodiment of Figures 61 and 62;
[00073] Figure 64 is a partial cross-sectional side view of the drive system mode of Figures 61 to 63, in a first axial drive position;
[00074] Figure 65 is another side cross-sectional view of the drive system embodiment of Figures 61 to 64, in a second axial drive position;
[00075] Figure 66 is a cross-sectional view of an end actuator and drive system embodiment, wherein the drive system is configured to trigger the trigger member;
[00076] Figure 67 is another cross-sectional view of the end actuator and drive system mode, in which the drive system is configured to rotate the entire end actuator;
[00077] Figure 68 is a cross-sectional perspective view of a portion of an end actuator arrangement and a swivel joint arrangement;
[00078] Figure 69 is a cross-sectional side view of the end actuator and swivel joint arrangement shown in Figure 68;
[00079] Figure 70 is a cross-sectional view of another modality of end actuator and drive system, in which the drive system is configured to rotate the entire end actuator;
[00080] Figure 71 is another cross-sectional view of the end actuator and drive system mode of Figure 70, wherein the drive system is configured to trigger the trigger member of the end actuator;
[00081] Figure 72 is a cross-sectional side view of an end actuator embodiment;
[00082] Figure 73 is an enlarged cross-sectional view of a portion of the end actuator embodiment of Figure 72;
[00083] Figure 74 is a cross-sectional side view of another embodiment of end actuator, in which the triggering member of the actuator has been partially actuated by the firing stroke;
[00084] Figure 75 is another side cross-sectional view of the end actuator mode of Figure 74, in which the firing member has been actuated to the end of its firing stroke stroke;
[00085] Figure 76 is another side cross-sectional view of the end actuator mode of Figures 74 and 75, in which the trigger member of the actuator is being retracted;
[00086] Figure 77 is a cross-sectional side view of another embodiment of end actuator, in which the trigger member of the actuator has been partially actuated through its trigger stroke;
[00087] Figure 78 is an exploded assembly view of a portion of an implement drive rod mode;
[00088] Figure 79 is another cross-sectional side view of the end actuator of Figure 77, with the triggering member of the actuator at the stroke end of its trigger stroke;
[00089] Figure 80 is another cross-sectional side view of the end actuator of Figures 77 and 78, in which the trigger member is being retracted;
[00090] Figure 81 is a cross-sectional side view of another embodiment of end actuator, in which the firing member is at the stroke end of its firing stroke;
[00091] Figure 81A is an exploded assembly view of a modality of implement drive rod and bearing segment;
[00092] Figure 81B is an exploded view of another embodiment of implement drive rod and bearing segment;
[00093] Figure 82 is an exploded overall view of a firing member mode;
[00094] Figure 83 is a perspective view of the firing member of Figure 82;
[00095] Figure 84 is a cross-sectional view of the firing member of Figures 82 and 83 installed in a portion of an exemplary implement drive rod embodiment;
[00096] Figure 85 is an exploded assembly view of another mode of firing member;
[00097] Figure 86 is a rear perspective view of another embodiment of firing member;
[00098] Figure 87 is an anterior perspective view of the firing member embodiment of Figure 86;
[00099] Figure 88 is a perspective view of a trigger member, implement drive rod, triangular slide bracket assembly and alignment portion for a surgical end actuator;
[000100] Figure 89 is a side elevation view of the firing member, implement drive rod, triangular slide bracket assembly and alignment portion of Figure 88;
[000101] Figure 90 is a cross-sectional elevation view of the surgical end actuator of Figure 60 in a closed configuration without a staple cartridge installed in the actuator;
[000102] Figure 91 is a bottom view of a surgical end actuator that has a trigger lock according to several exemplary embodiments of the present description;
[000103] Figure 92 is a perspective view of a bottom portion of the surgical end actuator of Figure 91 in a closed and non-operational configuration;
[000104] Figure 93 is a cross-sectional elevation view of the surgical end actuator of Figure 91 in a closed, non-operational configuration;
[000105] Figure 94 is an end elevation view of the surgical end actuator of Figure 91 in an open and non-operational configuration;
[000106] Figure 95 is an end elevation view of the surgical end actuator of Figure 91 in a closed and non-operational configuration;
[000107] Figure 96 is an elevational cross-sectional view of the surgical end actuator of Figure 91 in a closed and operative configuration having a triangular slide support assembly and an alignment portion at a first set of positions thereon;
[000108] Figure 97 is another end elevation view of the surgical end actuator of Figure 91 in a closed and operational configuration;
[000109] Figure 98 is an exploded perspective view of a surgical end actuator with some of its components shown in cross section and others of its components omitted for clarity;
[000110] Figure 99 is a perspective view of the pressure element shown in Figure 98;
[000111] Figure 100 is a perspective view of the end actuator gearbox shown in Figure 98;
[000112] Figure 101 is a cross-sectional elevation view of the surgical end actuator of Figure 98 illustrating the pusher element in a second set of positions;
[000113] Figure 102 is a cross-sectional view of a portion of the surgical end actuator of Figure 98 illustrating the implement drive rod in a non-operating position;
[000114] Figure 103 is a cross-sectional view of a portion of the surgical end actuator of Figure 98 illustrating the pusher element in a first set of positions;
[000115] Figure 104 is a cross-sectional view of a portion of the surgical end actuator of Figure 98 illustrating the push element in a first set of positions and the implement drive rod in an operating position;
[000116] Figure 105 is a cross-sectional perspective view of an end actuator for a surgical instrument comprising a drive screw configured to drive a triggering member of the end actuator;
[000117] Figure 106A is a side view of a portion of a first drive screw for an end actuator comprising a first length, wherein the first drive screw includes a single thread;
[000118] Figure 106B is an end cross-sectional view of the first driver screw of Figure 106A;
[000119] Figure 107A is a side view of a portion of a second drive screw for an end actuator comprising a second length, wherein the second drive screw includes two threads;
[000120] Figure 107B is an end cross-sectional view of the second drive screw of Figure 107A;
[000121] Figure 108A is a side view of a portion of a third drive screw for an end actuator comprising a third length, wherein the third drive screw includes three threads;
[000122] Figure 108B is an end cross-sectional view of the third driver screw of Figure 108A;
[000123] Figure 109A is a side view of a portion of a fourth drive screw for an end actuator comprising a fourth length, wherein the fourth drive screw includes four threads;
[000124] Figure 109B is an end cross-sectional view of the fourth driver screw of Figure 109A;
[000125] Figure 110 is an exploded perspective view of a cutting blade for use with an end actuator having a drive screw;
[000126] Figure 111 is a perspective view of a gear arrangement for transmitting rotation from a drive rod to a drive screw of an end actuator, wherein the gear arrangement is shown with portions thereof removed for purposes of illustration;
[000127] Figure 112 is a perspective view of another surgical tool modality;
[000128] Figure 112A is a perspective view of the surgical tool end actuator arrangement of Figure 112;
[000129] Figure 113 is an exploded assembly view of a portion of the elongated rod assembly and quick-disconnect coupler arrangement shown in Figure 112;
[000130] Figure 114 is a perspective view of a portion of the elongated rod assembly of Figures 112 and 113;
[000131] Figure 115 is an enlarged, exploded perspective view of the exemplary quick-disconnect coupler arrangement depicted in Figures 112 to 114;
[000132] Figure 116 is a side elevation view of the quick disconnect coupler arrangement of Figures 112 to 115 with the locking ring thereof in an unlocked position;
[000133] Figure 117 is another side elevation view of the quick disconnect coupler arrangement of Figures 112 to 116 with the locking ring thereof in a locked position;
[000134] Figure 118 is a perspective view of another surgical tool modality;
[000135] Figure 119 is another perspective view of the surgical tool modality of Figure 118;
[000136] Figure 120 is a cross-sectional perspective view of the surgical tool embodiment of Figures 118 and 119;
[000137] Figure 121 is a cross-sectional perspective view of a portion of a hinge system;
[000138] Figure 122 is a cross-sectional view of the hinge system of Figure 121 in a neutral position;
[000139] Figure 123 is another cross-sectional view of the hinge system of Figures 121 and 122 in a hinged position;
[000140] Figure 124 is a side elevation view of a portion of the surgical instrument embodiment of Figures 118 to 120 with portions thereof omitted for clarity;
[000141] Figure 125 is a rear perspective view of a portion of the surgical instrument embodiment of Figures 118 to 120 with some portions omitted for clarity;
[000142] Figure 126 is an elevational rear view of a portion of the surgical instrument embodiment of Figures 118 to 120 with some portions omitted for clarity;
[000143] Figure 127 is an anterior perspective view of a portion of the surgical instrument embodiment of Figures 118 to 120 with some portions omitted for clarity;
[000144] Figure 128 is a side elevation view of a portion of the surgical instrument embodiment of Figures 118 to 120 with some portions omitted for clarity;
[000145] Figure 129 is an exploded assembly view of an exemplary reversing system embodiment of the surgical instrument embodiment of Figures 118 to 120;
[000146] Figure 130 is a perspective view of a lever arm embodiment of the reversing system of Figure 129;
[000147] Figure 131 is a perspective view of a knife retractor button of the reversing system of Figure 129;
[000148] Figure 132 is a perspective view of a portion of the surgical instrument embodiment of Figures 118 to 120, with some portions omitted for clarity, and with the lever arm in actuable engagement with the reverse gear;
[000149] Figure 133 is a perspective view of a portion of the surgical instrument embodiment of Figures 118 to 120, with some portions omitted for clarity, and with the lever arm in an unactuated position;
[000150] Figure 134 is another perspective view of a portion of the surgical instrument embodiment of Figures 118 to 120, with some portions omitted for clarity, and with the lever arm in actuable engagement with the reverse gear;
[000151] Figure 135 is a side elevation view of a portion of a cable assembly portion of the surgical instrument modality of Figures 118 to 20, with a shifter knob assembly moved to a position that will result in rotation of the actuator. end, when the drive rod assembly is actuated;
[000152] Figure 136 is another side elevation view of a portion of a cable assembly portion of the surgical instrument modality of Figures 118 to 120, with a displacer knob assembly moved to another position that will result in limb firing tripping on the end actuator when the drive rod assembly is actuated;
[000153] Figure 137 is a cross-sectional view of a portion of another surgical tool modality with a lockable hinge joint modality;
[000154] Figure 138 is another cross-sectional view of the surgical tool portion of Figure 137 hinged in a configuration;
[000155] Figure 139 is another cross-sectional view of the surgical tool portion of Figures 137 and 138 hinged in another configuration;
[000156] Figure 140 is a cross-section of an embodiment of a hinge locking system shown in Figure 137 taken along line 140-140 in Figure 137;
[000157] Figure 141 is a cross-sectional view of the hinge locking system of Figure 140 taken along line 141-141 in Figure 140;
[000158] Figure 142 is a cross-sectional view of a portion of the surgical tool of Figure 137 taken along line 142-142 in Figure 137;
[000159] Figure 143 illustrates the position of the lock wire, when the first and second lock rings are in a locked or locked configuration, after the end actuator is pivoted into a first pivot position illustrated in Figure 138;
[000160] Figure 144 illustrates a locking wire position, with the first and second locking rings relaxed to their respective unclamped or unlocked positions, after the end actuator is pivoted to the first pivot position illustrated. shown in Figure 138;
[000161] Figure 145 illustrates a lock wire position when the first and second lock rings are in a locked or locked configuration, after the end actuator is pivoted to a second pivot position illustrated in Figure 139;
[000162] Figure 146 illustrates the position of the locking wire, with the first and second locking rings relaxed to their respective unclamped or unlocked positions, after the end actuator is pivoted to the first pivot position illustrated in Figure 139 ;
[000163] Figure 147 is another view of the lock wire after the end actuator is pivoted relative to the elongated rod assembly;
[000164] Figure 148 is a cross-sectional view of another embodiment of end actuator with the actuator anvil assembly in the closed position;
[000165] Figure 149 is another cross-sectional view of the end actuator embodiment of Figure 148;
[000166] Figure 150 is another cross-sectional view of the end actuator modality of Figures 148 and 149 with the anvil assembly in the closed position;
[000167] Figure 151 is another cross-sectional view of the end actuator mode of Figures 148 to 150 illustrating the drive transmission configured to drive the trigger member;
[000168] Figure 152 is another cross-sectional view of the end actuator mode of Figures 148 to 151, with the drive transmission configured to rotate the entire end actuator around the longitudinal axis of the tool;
[000169] Figure 153 is a cross-sectional view of the end actuator of Figures 148 to 152 taken along line 153153 in Figure 148, with the drive transmission configured to actuate the anvil assembly;
[000170] Figure 154 is a cross-sectional view of the end actuator of Figures 148 to 153 taken along line 154154 in Figure 148, with the drive transmission configured to trigger the trigger member;
[000171] Figure 155 is a cross-sectional view of the end actuator of Figures 148 to 154 taken along line 155155 in Figure 148, with the drive transmission configured to actuate the anvil assembly;
[000172] Figure 156 is a cross-sectional view of the end actuator of Figures 148 to 155 taken along line 156156 in Figure 148;
[000173] Figure 157 is a cross-sectional perspective view of another embodiment of end actuator;
[000174] Figure 158 is a perspective view of an elongated channel of the end actuator of Figure 157;
[000175] Figure 159 is a perspective view of an anvil spring embodiment;
[000176] Figure 160 is a side cross-sectional view of the end actuator of Figure 157, with the anvil in a closed position after the trigger member is moved to its most distal position;
[000177] Figure 161 is a cross-sectional view of a portion of the end actuator of Figure 160 taken along line 161-161 in Figure 160;
[000178] Figure 162 is another side cross-sectional view of the end actuator of Figures 157, 160 and 161 with the trigger member being retracted;
[000179] Figure 163 is a cross-sectional view of a portion of the end actuator of Figure 162 taken along line 163-163;
[000180] Figure 164 is another side cross-sectional view of the end actuator of Figures 157 and 160 to 163, with the trigger member in its most proximal position;
[000181] Figure 165 is a cross-sectional view of the end actuator of Figures 157 and 160 to 164 taken along line 165-165 in Figure 164;
[000182] Figure 166 is another side cross-sectional view of the end actuator of Figures 157 and 160 to 165, after the solenoid pulls the closure tube to its most proximal position;
[000183] Figure 167 is a cross-sectional view of the end actuator of Figures 157 and 160 to 166 taken along line 167-167 in Figure 166;
[000184] Figure 168 is another side cross-sectional view of the end actuator of Figures 157 and 160 to 167 with the anvil in an open position and after the solenoid pulls the closure tube to its most proximal position;
[000185] Figure 169 is another side cross-sectional view of the end actuator of Figures 157 and 160 to 168, after the trigger member is moved to its home position;
[000186] Figure 170 is another side cross-sectional view of the end actuator of Figures 157 and 160 to 169 with the anvil assembly closed and the firing member ready to fire;
[000187] Figure 171 is a partial cross-sectional view of another quick-disconnect arrangement for attaching a distal stem portion, which can be attached to an end actuator, to a proximal stem portion that can be attached to a portion. tool mounting to a robotic system or to a cable assembly;
[000188] Figure 172 is another partial cross-sectional view of the quick release arrangement of Figure 171;
[000189] Figure 173 is an end view of the proximal rod portion of the quick-disconnect arrangement of Figures 171 and 172;
[000190] Figure 174 is a cross-sectional view of an axially movable locking ring embodiment of the quick release arrangement of Figures 171 and 172;
[000191] Figure 174A is a perspective view of the locking ring embodiment of Figure 174;
[000192] Figure 175 is another cross-sectional view of the quick release arrangement of Figures 171 and 172 illustrating the initial engagement of the distal and proximal drive rod portions;
[000193] Figure 176 is another cross-sectional view of the quick disconnect arrangement of Figures 171, 172 and 175 illustrating the initial coupling of corresponding pivot cable segments;
[000194] Figure 177 is another cross-sectional view of the quick release arrangement of Figure 175, after the distal drive rod portion is locked into the proximal drive rod portion; and
[000195] Figure 178 is another cross-sectional view of the quick release arrangement of Figure 176, after the corresponding pivot cable segments are locked together. DETAILED DESCRIPTION
[000196] The applicant of the present application also retains the following patent applications which were filed on the same date as the present application and which are each incorporated herein by reference in their respective entireties: US Patent Application Serial No., entitled "Flexible Drive Member", (attorney document no. END7131USNP/120135). U.S. Patent Application Serial No., entitled "Multi Functional Powered Surgical Device with External Dissection Features", (attorney document no. END7132USNP/120136). U.S. Patent Application Serial No., entitled "Coupling Arrangements for Attaching End Effectors to Drive Systems Therefor", (attorney document no. END7133USNP/120137). U.S. Patent Application Serial No. entitled "Rotary Actuatable Closure Arrangement for Surgical End Effector" (attorney document no. END7134USNP/120138). U.S. Patent Application Serial No. entitled "Surgical End Effectors Having Angled Tissue-Contacting Surfaces" (attorney document no. END7135USNP/12139). U.S. Patent Application Serial No., entitled "Inter changeable End Effector Coupling Arrangement", (attorney document no. END7136USNP/12140). U.S. Patent Application Serial No., entitled "Surgical End Effector Jaw and Electrode Configurations", (attorney document no. END7137USNP/12141). U.S. Patent Application Serial No., entitled "Multi Axis Articulating and Rotating Surgical Tools", (attorney document no. END7138USNP/12142). U.S. Patent Application Serial No., entitled "Differential Locking Arrangements for Rotary Powered Surgical Instruments" (attorney document no. END7139USNP/120143). U.S. Patent Application Serial No., entitled "Inter changeable Clip Applier," (attorney document no. END7140USNP/12144). U.S. Patent Application Serial No., entitled "Firing System Lockout Arrangements for Surgical Instruments", (attorney document no. END7141USNP/12145). U.S. Patent Application Serial No., entitled "Rotary Drive Shaft Assemblies for Surgical Instruments with Articulatable End Effectors", (attorney document no. END7142USNP/12466). U.S. Patent Application Serial No., entitled "Rotary Drive Arrangements for Surgical Instruments", (attorney document no. END7143USNP/12147). U.S. Patent Application Serial No., entitled "Robotically Powered Surgical Device With Manually-Actuatable Reversing System", (attorney document no. END7144USNP/120148). U.S. Patent Application Serial No., entitled "Repla ceable Clip Cartridge for a Clip Applier", (attorney document no. END7145USNP/12499). U.S. Patent Application Serial No., entitled "Empty Clip Cartridge Lockout", (attorney document no. END7146USNP/120150). U.S. Patent Application Serial No., entitled "Rotary Support Joint Assemblies for Coupling a First Portion of a Surgical Instrument", (attorney document no. END7148USNP/12052). U.S. Patent Application Serial No., entitled "Elec trode Connections for Rotary Driven Surgical Tools", (attorney document no. END7149USNP/120153).
[000197] The Applicant is also the owner of the following patent applications, which are each incorporated herein by reference, in their respective entireties: - US Patent Application Serial No. 13/118259, entitled "Surgical Instrument With Wireless Communication Between a Control Unit of a Robotic System and Remote Sensor", US Patent Application Publication No. 2011-0295270 A1; U.S. Patent Application Serial No. 13/118210 entitled "Robotically-Controlled Disposable Motor Driven Loading Unit", US Patent Application Publication No. 2011-0290855 A1; U.S. Patent Application Serial No. 13/118194 entitled "Robotically-Controlled Endoscopic Accessory Channel", US Patent Application Publication No. 2011-0295242; U.S. Patent Application Serial No. 13/118253 entitled "Robotically-Controlled Motorized Surgical Instrument", US Patent Application Publication No. 2011-0295269 A1; US Patent Application Serial No. 13/118278 entitled "Robotically-Controlled Surgical Stapling Devices That Produce Formed Staples Having Different Lengths", US Patent Application Publication No. 2011-0290851 A1; US Patent Application Serial No. 13/118190 entitled "Robotically-Controlled Motorized Cutting and Fastening Instrument", US Patent Application Publication No. 2011-0288573 A1 - US Patent Application Serial No. 13/118223, titled "Robotically-Controlled Shaft Based Rotary Drive Systems For Surgical Instruments", US Patent Application Publication No. 2011-0290854 A1; U.S. Patent Application Serial No. 13/118263 entitled "Robotically-Controlled Surgical Instrument Having Recording Capabilities", US Patent Application Publication No. 2011-0295295 A1; US Patent Application Serial No. 13/118272 entitled "Robotically-Controlled Surgical Instrument With Force Feedback Capabilities", US Patent Application Publication No. 2011-0290856 A1; US Patent Application Serial No. 13/118246 entitled "Robotically-Driven Surgical Instrument With E-Beam Driver", US Patent Application Publication No. 2011-0290853 A1; and - U.S. Patent Application Serial No. 13/118241 entitled "Surgical Stapling Instruments With Rotatable Staple Deployment Arrangements".
[000198] Certain exemplary embodiments will now be described to provide a general understanding of the principles of structure, function, fabrication and use of the disclosed devices and methods of the present invention. One or more examples of such exemplary embodiments are illustrated in the accompanying drawings. Those skilled in the art will understand that the devices and methods specifically described herein and illustrated in the accompanying drawings are non-limiting exemplary embodiments and that the scope of the various exemplary embodiments of the present invention is defined exclusively by the claims. Features illustrated or described in conjunction with one exemplary embodiment may be combined with features from other exemplary embodiments. Such modifications and variations are intended to be included within the scope of the present invention.
[000199] Figure 1 represents a master controller 12 that is used in conjunction with a robotic arm auxiliary carriage 20 of the type represented in Figure 2. The master controller 12 and the robotic arm auxiliary carriage 20, as well as their respective components and control systems, are collectively referred to herein as a robotic system 10. Examples of such systems and devices are set forth in US Patent No. 7,524,320 which is incorporated herein by reference. Thus, various details of such devices will not be described in detail in this document beyond what may be necessary to understand the various exemplary embodiments disclosed in this document. As is known, master controller 12 generally includes master controllers (generally represented as 14 in Figure 1) that are held by the surgeon and manipulated in space while the surgeon observes the procedure through a stereo display 16 . Master controllers 12 generally comprise manual input devices that move preferably with multiple degrees of freedom, and that often additionally have a handle that can be actuated to actuate the tools (for example, to close the clamping jaws, apply an electrical potential to an electrode, or the like).
[000200] As seen in Figure 2, the robotic arm carriage 20 is configured to actuate a plurality of surgical tools, generically designated as 30. Various robotic surgery systems and methods employing master controller and arm carriage arrangements robotics are disclosed in US Patent No. 6,132,368 entitled "Multi-Component Telepresence System and Method", the description of which is incorporated herein by reference in its entirety. As shown, robotic arm carriage 20 includes a base 22 on which, in the illustrated embodiment, three surgical tools 30 are supported. The surgical tools 30 are all supported by a series of hand swivel connections, generically called fit joints 32, and a robotic manipulator 34. These structures are illustrated in the present invention with protective covers that extend over much of the robotic connection. These protective covers can be optional, and can be limited in size or entirely eliminated to minimize the inertia that is encountered by the servomechanisms used to manipulate such devices, in order to limit the volume of moving components, and thus avoid collisions, and to limit the total weight of the trolley 20. The trolley 20 is generally of adequate dimensions for transporting the trolley 20 between operating rooms. Carriage 20 is configured to normally pass through conventional operating room doors and conventional hospital elevators. Cart 20 would preferably have a weight and would include a system of casters (or other means of transportation) that would allow cart 20 to be positioned adjacent to an operating table by a single attendant.
[000201] Now referring to Figure 3, robotic manipulators 34, as shown, include a link 38 that restricts movement of the surgical tool 30. Link 38 includes rigid links joined by swivel joints in a parallelogram arrangement, of so that surgical tool 30 rotates about a point in space 40, as more fully described in US Patent No. 5,817,084, the disclosure of which is incorporated herein by reference in its entirety. The parallelogram arrangement restricts rotation to turning about an axis 40a, sometimes called a pitch axis. The tie rods supporting the parallelogram connection are pivotally mounted on the adjustment joints 32 (Figure 2) so that the surgical tool 30 additionally rotates about an axis 40b, sometimes called the yaw axis. The pitch and yaw axes 40a, 40b intersect at the remote center 42, which is aligned along a shank 44 of the surgical tool 30. The surgical tool 30 may have additional degrees of oriented freedom, as supported by the manipulator 50, including the sliding movement of the surgical tool 30 along the longitudinal axis "LT-LT" of the tool. As the surgical tool 30 slides along the LT-LT axis of the tool relative to the manipulator 50 (arrow 40c), the remote center 42 remains fixed relative to base 52 of manipulator 50. Therefore, the entire manipulator is generally moved to reposition remote center 42. Link 54 of manipulator 50 is driven by a series of motors 56. These motors move actively link 54 in response to commands from a processor of a control system. Motors 56 are also employed to manipulate surgical tool 30. An alternate fit joint structure is illustrated in Figure 4. In this embodiment, a surgical tool 30 is supported by an alternate manipulator structure 50' between two tissue manipulation tools .
[000202] Other embodiments may incorporate a wide variety of alternative robotic structures, including those described in US Patent No. 5,878,193 entitled "Automated Endoscope System For Optimal Positioning", the description of which is incorporated herein by reference in its entirety. Additionally, although data communication between a robotic component and the processor of the robotic surgical system is described with reference to communication between surgical tool 30 and master controller 12, similar communication can occur between the circuitry of a manipulator, a joint an adjustment device, an endoscope or other image capture device, or the like, and the robotic surgical system processor for component compatibility verification, component type identification, component calibration communication (such as offset, or the like) , confirmation of component coupling to the robotic surgical system, or similar.
[000203] A surgical tool 100 that is well adapted for use with a robotic system 10 is shown in Figure 5. As can be seen from this figure, the surgical tool 100 includes a surgical tip actuator 1000 that comprises an endocutter. Surgical tool 100 generally includes an elongated rod assembly 200 that is operatively coupled to manipulator 50 by a tool mounting portion, generally designated 300. Surgical tool 100 additionally includes an interface 302 that mechanically and electrically couples to mounting portion of tool 300 to the manipulator. An interface 302 is illustrated in Figures 6 to 10. In the embodiment shown in Figures 6 to 10, the tool mounting portion 300 includes a tool mounting plate 304 that operatively supports a plurality of (four are shown in Figure 10) portions. of rotating body, discs or moving elements 306, each including a pair of pins 308 extending from a surface of the moving element 306. A pin 308 is closest to an axis of rotation of each of the elements. moved 306 than the other pin 308 in the same movable element 306, which helps to ensure positive angular alignment of the movable element 306. The interface 302 may include an adapter portion 310 that is configured to engage in mounting with a plate. assembly 304, as will be further discussed below. Adapter portion 310 illustrated includes an array of electrical connection pins 312 (Figure 8) that can be coupled to a memory structure by a circuit board within the mounting portion of tool 300. Although interface 302 is described herein as Referring to mechanical, electrical, and magnetic coupling elements, it should be understood that a wide variety of telemetry modalities could be used, including infrared, inductive coupling, or similar, in other modalities.
[000204] As can be seen in Figures 6 to 9, the adapter portion 310 generally includes a tool side 314 and a support side 316. A plurality of swivel bodies 320 are mounted on a floating plate 318 having a limited range of movement relative to the adapter structure surrounding normal to the main surfaces of the adapter 310. The axial movement of the floating plate 318 helps to disengage the swivel bodies 320 from the mounting portion of the tool 300 when levers or other locking formations along the sides of the tool mounting portion housing (not shown) are actuated. Other embodiments may employ other mechanisms/arrangements to releasably couple tool mounting portion 300 to adapter 310. In the embodiment of Figures 6 to 10, swivel bodies 320 are resiliently mounted to floating plate 318 by resiliently extending radial members in a circumferential indentation on the swivel bodies 320. The swivel bodies 320 can move axially with respect to the plate 318 by deflecting these resilient structures. When arranged in a first axial position (towards the tool side 314), the swivel bodies 320 are free to rotate without angular limitation. However, as the swivel bodies 320 move axially towards the tool side 314, tabs 322 (which extend radially from the swivel bodies 320) laterally engage detents in the floating plates so as to limit the angular rotation of the bodies. swivels 320 around their axes. This limited rotation can be used to help actionably engage swivel bodies 320 with drive pins 332 of a corresponding tool holder portion 330 of robotic system 10, as drive pins 332 will push. the swivel bodies 320 to the limited rotational position until the pins 332 are aligned with the openings 334' (and slide into them). The openings 334 on the tool side 314 and the openings 334' on the support side 316 of swivel bodies 320 are configured to precisely align the moving elements 306 (Figure 10) of the mounting portion of the tool 300 with the drive elements 336 of the tool holder 330. As described above with respect to the inner and outer pins 308 of moving elements 306, the openings 334, 334' are at different distances from the axis of rotation in their respective swivel bodies 306, so as to ensure that alignment is not 180 degrees from your intended position. Additionally, each of the openings 334 can be elongated slightly radially to adjustably receive the pins 308 in the circumferential orientation. This allows pins 308 to slide radially into openings 334 and compensate for any axial misalignment between tool 100 and tool holder 330, while minimizing any angular misalignment and kickback between the driven and driven elements. The openings 334 on the tool side 314 can be offset about 90 degrees from the openings 334' (shown in dashed lines) on the support side 316, as seen more clearly in Figure 9.
[000205] In the embodiment of Figures 6 to 10, an arrangement of electrical connector pins 340 is located on the support side 316 of the adapter 310 and the tool side 314 of the adapter 310 includes slots 342 (Figure 9) for receiving an arrangement of pins (not shown) from the mounting portion of tool 300. In addition to transmitting electrical signals between surgical tool 100 and tool holder 330, at least some of these electrical connections can be coupled to an adapter memory device 344 (Figure 8) by a circuit board of the 310 adapter.
[000206] In the embodiment of Figures 6 to 10, a removable latch arrangement 346 is employed to releasably secure adapter 310 to tool holder 330. For use herein, the term "tool drive assembly" when used in the context of robotic system 10, encompasses at least adapter 310 and tool holder 330 and which have been collectively and generically designated 110 in Figure 6. As seen in Figure 6, tool holder 330 includes a first arrangement. of locking pins 337 that are sized to be received in corresponding shackle slots 311 disposed in adapter 310. In addition, tool holder 330 has second locking pins 338 that are sized to be retained in corresponding locking shackles 313 on adapter 310. See Figure 8. A lock assembly 315 is movably supported on adapter 310 and has a pair of locking shackles 317 formed on the same as the adapter. must be slanted between a first locked position, in which the locking pins 338 are secured in their respective locking shackles 313, and an unlocked position, in which the shackles 317 are aligned with the shackles 313 to allow the second locking pins 338 are inserted or removed from the lock shackles 313. A spring or springs (not shown) are employed to guide the lock assembly into the locked position. A bead on tool side 314 of adapter 310 slidingly receives laterally extending tool mounting housing tabs (not shown).
[000207] Now referring to Figures 5 and 11 to 16, the mounting portion of the tool 300 operatively supports a plurality of drive systems to generate various forms of control movements necessary to operate a particular type of end actuator that is coupled to the distal end of the elongated rod assembly 200. As shown in Figures 5 and 11 to 13, the tool mounting portion 300 includes a first drive system, generally designated 350, which is configured to receive a "first" pivotal movement. output of the tool drive assembly 110 of robotic system 10 and converting that first output rotary motion into a first control rotary motion to be applied to the surgical end actuator. In the illustrated embodiment, the first control rotary motion is employed to rotate the elongated rod assembly 200 (and surgical end actuator 1000) about a longitudinal axis LT-LT of the tool.
[000208] In the embodiment of Figures 5 and 11 to 13, the first drive system 350 includes a tubular gear segment 354 that is formed (or fixed) on the proximal end 208 of a proximal closure tube segment 202 of the rod assembly elongate 200. The proximal end 208 of the proximal tube segment 202 is pivotally supported on the tool mounting plate 304 of the tool mounting portion 300 by a front support pedestal 352 that is mounted on the tool mounting plate 304. See Figure 11. The tubular gear segment 354 is held in meshed engagement with a first swivel gear assembly 360 which is operatively supported on the tool mounting plate 304. As seen in Figure 11, the swivel gear assembly 360 comprises a first motor rotary gear 362 which is coupled to a corresponding first disk of the disks or driven elements 306 on the support side 316d the tool mounting plate 304, when the tool mounting portion 300 is coupled to the tool drive assembly 110. See Figure 10. The swivel gear assembly 360 further comprises a first swivel driven gear 364 which is rotatably supported on the tool mounting plate 304. The first driven swivel gear 364 is in meshed engagement with a second driven swivel gear 366 which, in turn, is in meshed engagement with the tubular gear segment 354. The application of a first swivel movement output by the drive assembly from tool 110 of robotic system 10 to the corresponding driven element 306 will thus cause the rotation of the sprocket drive gear 362. The rotation of the sprocket drive gear 362 ultimately results in the rotation of the assembly elongated shaft 200 (and surgical end actuator 1000) around the tool's longitudinal axis LT-LT (represented by s eta "R" in Figure 5). Those skilled in the art will understand that application of an exit rotary motion by tool drive assembly 110 in one direction will result in rotation of elongated rod assembly 200 and surgical end actuator 1000 about the longitudinal axis LT-LT of the tool in a first direction of rotation, and that an application of the outward rotary motion in an opposite direction will result in rotation of the elongated rod assembly 200 and surgical end actuator 1000 in a second direction of rotation that is opposite to the first direction of rotation.
[000209] In the embodiment of Figures 5 and 11 to 16, the mounting portion of the tool 300 additionally includes a second drive system, generically designated as 370, which is configured to receive a "second" output rotary movement corresponding to starting from the drive assembly of the tool 110 of the robotic system 10 and converting this second output movement into a second rotary control movement that will be applied to the surgical end actuator. The second drive system 370 includes a second motor rotary gear 372 which is coupled to a second member or corresponding driven disk 306 on the support side 316 of the tool 304 mounting plate when the tool 300 mounting portion is coupled to the assembly. of tool drive 110. See Figure 10. The second drive system 370 further comprises a first driven slewing gear 374 which is rotatably supported on the tool mounting plate 304. The first driven slewing gear 374 is in meshed engagement with a rod gear 376 which is movably and non-rotatably mounted on a proximal segment of the drive rod 380. In this illustrated embodiment, the rod gear 376 is non-rotatably mounted on the proximal segment of the drive rod 380 by means of of a series of axial keyways 384 that enable the stem gear 376 to move axially in the segment. proximal end of actuation rod 380, although it is non-rotatably secured thereto. Rotation of the proximal segment of drive rod 380 results in the transmission of a second control rotary motion to surgical end actuator 1000.
[000210] The second drive system 370 in the embodiment of Figures 5 and 11 to 16 includes a displacement system 390 to selectively and axially move the proximal segment of the drive rod 380, which places the gear of the rod 376 in engagement meshed with the first slewing gear moved 374 and withdraws it from the meshed engagement. For example, as seen in Figures 11 to 13, the proximal segment of the actuating rod 380 is supported within a second support pedestal 382 which is secured to the tool mounting plate 304 such that the proximal segment of the rod drive 380 can move axially and rotate with respect to second support pedestal 382. In at least one form, displacement system 390 additionally includes a displacement yoke 392 that is slidably supported on tool mounting plate 304. Proximal segment of drive rod 380 is supported on shifter yoke 392 and has a pair of rings 386 around it so that displacement of shifter yoke 392 on tool mounting plate 304 results in axial movement of the proximal segment of drive rod. drive 380. In at least one form, displacement system 390 additionally includes a displacement solenoid 394 that forms an operational interface with the yoke. shifter 392. Shifter solenoid 394 receives control power from robotic controller 12 so that when shifter solenoid 394 is activated, shifter fork 392 is moved in the distal direction "DD".
[000211] In this illustrated embodiment, a rod spring 396 is positioned at the tip on the proximal segment of the drive rod 380, between the rod gear 376 and the second support pedestal 382, to force the rod gear 376 in the proximal direction " PD" and in meshed engagement with the first driven slewing gear 374. See Figures 11, 13 and 14. The rotation of the second motor slewing gear 372 in response to the output slewing movements generated by the robotic system 10 ultimately results in the segment rotation proximal of the drive shaft 380 and the other drive shaft components attached to it (drive shaft assembly 388) around the longitudinal axis LT-LT of the tool. Those skilled in the art will understand that the application of a rotary exit motion by the tool drive assembly 110 in one direction will result in the rotation of the proximal segment of the drive rod 380 and ultimately the other drive rod components attached to the even in a first direction, and an application of the outward rotational motion in an opposite direction will result in rotation of the proximal segment of drive rod 380 in a second direction that is opposite to the first direction. When it is desirable to move the proximal segment of actuation rod 380 in the distal direction "DD", as will be discussed in more detail below, the robotic controller 12 activates the displacer solenoid 390 to displace the displacer yoke 392 in the distal direction "DD".
[000212] Figures 17 and 18 illustrate another mode that employs the same components of the mode shown in Figures 5 and 11 to 16, except that that mode employs a drive motor powered by battery 400 to transmit the drive movements swivel for the proximal segment of the drive rod 380. Such an arrangement enables the mounting portion of the tool to generate larger output swivels and torque which can be advantageous when different forms of end actuators are employed. As can be seen in those figures, the motor 400 is secured to the tool mounting plate 304 by a support structure 402 so that a drive gear 404 that is coupled to the motor 400 is held in meshed engagement with the rod gear. 376. In the embodiment of Figures 17 and 18, the support structure 402 is configured to releasably engage the locking notches 303 formed in the mounting plate of the tool 304, which are designed to facilitate the attachment of a housing element ( not shown) to mounting plate 304 when motor 400 is not employed. Thus, to employ motor 400, the physician removes the housing from the tool 304 mounting plate and then inserts the legs 403 of the support structure into the locking notches 303 in the tool 304 mounting plate. The proximal segment of the drive rod 380 and the other drive rod components attached to it are rotated about the tool's longitudinal axis LT-LT upon activation of motor 400. As shown, motor 400 is battery powered. In such an arrangement, however, the motor 400 interfaces with the robotic controller 12 so that the marrobotic system 10 controls the activation of the motor 400. In alternative embodiments, the motor 400 can be activated manually by an on-off switch ( not shown) mounted on the motor 400 itself or on the mounting portion of the tool 300. In still other embodiments, the motor 400 can receive power and control signals from the robotic system.
[000213] The modality illustrated in Figures 5 and 11 to 16 includes a manually actuatable reversing system, generically designated as 410, to manually apply a reverse rotary motion to the proximal segment of the drive rod 380, in case the motor fails or if the power supplied to the robotic system is lost or interrupted. Such a manually actuatable reversing system 410 may also be particularly useful, for example, when the drive rod assembly 388 jams or becomes stuck in any way that prevents reverse rotation of the drive rod components with motor power alone. In the illustrated embodiment, the mechanically actuatable reverser system 410 includes a motor gear assembly 412 that is selectively engageable with the second moved swivel gear 376 and can be manually actuated to apply a reverse rotary motion to the proximal segment of the drive rod 380 The drive gear assembly 412 includes a reverse gear 414 that is movably mounted on the tool mounting plate 304. The reverse gear 414 is rotatably positioned on the end of a pivot shaft 416 that is movably mounted on the tool. mounting plate of tool 304 through a slot 418. See Figure 12. In the embodiment of Figures 5 and 11 through 16, manually actuatable reverser system 410 further includes a manually actuatable drive gear 420 that includes a body portion 422 having a arcuate gear segment 424 formed therein. Body portion 422 is pivotally coupled to tool 304 mounting plate for selective pivotal movement about an actuator axis A-A (Figure 11) that is substantially normal to tool 304 mounting plate.
[000214] Figures 11 to 14 represent the manually-actuable reversing system 410 in a first, non-actuated position. In an exemplary form, an actuator cable portion 426 is formed on the body portion 422 or otherwise secured thereto. Actuator handle portion 426 is sized relative to tool 304 mounting plate so that a small amount of interference is established between handle portion 426 and tool 304 mounting plate to hold handle portion 426 in the first position not acted upon. However, when desiring to manually actuate the motor gear set 412, the clinician can easily overcome the interference fit by applying a pivoting motion to the cable portion 426. As can also be seen in Figures 11 through 14, when the gear set motor 412 is in the first non-actuated position, arcuate gear segment 424 is out of meshed engagement with reverse gear 414. When desiring to apply a reverse rotary drive motion to the proximal segment of drive rod 380, the clinician begins to apply a pivotal ratchet movement to drive gear 420. As drive gear 420 begins to rotate about actuation shaft AA, a portion of body 422 contacts a portion of reverse gear 414 and axially moves reverse gear 414 in the distal direction DD, withdrawing the drive rod gear 376 from the engaged engagement with the first swivel gear moved 374 from the second drive system 370. See Figure 15. As drive gear 420 is rotated, arcuate gear segment 424 is placed in meshed engagement with reverse gear 414. Continuing ratchet movement of drive gear 420 results in applying a reverse rotary drive motion to the drive rod gear 376 and finally to the proximal segment of the drive rod 380. The clinician may continue to apply the ratchet motion to the drive gear assembly 412 as many times as possible. required to completely release or reverse the associated component(s) of the end actuator. After a desired amount of reverse rotation is applied to the proximal segment of drive rod 380, the physician returns drive gear 420 to the non-actuated or home position, where arcuate gear segment 416 is out of geared engagement with the gear. of drive rod 376. In this position, rod spring 396 re-presses rod gear 376 into meshed engagement with first swivel driven gear 374 of second drive system 370.
[000215] In use, the clinician can input control commands to the controller or control unit of the robotic system 10, which will "robotically generate" output movements that will ultimately be transferred to the various components of the second drive system 370. For use herein, the terms "robotically generated" or "robotically generated" refer to motions that are created by driving or controlling the robotic system motors and other drive components. These terms are different from the terms "manually actuatable" or "manually generated", which refer to actions taken by the clinician that result in control movements generated independently of those movements that are generated by energizing the robotic system's motors. Applying robotically generated control movements to the second drive system in a first direction results in the application of a first rotary drive movement to drive rod assembly 388. When drive rod assembly 388 is rotated in a first direction of rotation, the trigger member 1200 is moved in the distal direction "DD" from its home position towards its end position on the end actuator 1000. The application of robotically generated control movements to the second drive system in a second direction results in the application of a second rotary drive movement to drive rod assembly 388. When drive rod assembly 388 is rotated in a second direction of rotation, trigger member 1200 is moved in the proximal direction "PD" from its final position towards its initial position on the end actuator 1000. When the clinician wants to manually apply the movement In the control rotary position to the actuating rod assembly 388, the actuating rod assembly 388 is rotated in the second direction of rotation, which causes the firing member 1200 to move in the proximal direction "PD" on the end actuator. Other modalities containing the same components are configured so that manual application of a control rotary motion to the drive rod assembly could cause the drive rod assembly to rotate in the first direction of rotation, which could be used to help the robotically generated control movements moving the firing member 1200 in the distal direction.
[000216] The drive rod assembly that is used to trigger, close and rotate the end actuator can be manually actuated and displaced, allowing the end actuator to be released and removed from the surgical site, and also from the abdomen, even in the cases of failure of the motor(s), loss of power to the robotic system or other electronic failure. Actuation of the cable portion 426 results in the manual generation of drive or control forces that are applied to the drive rod assembly 388' by the various components of the manually actuatable reversing system 410. If the cable portion 426 is in its non-state, When actuated, it will be forced out of the actuatable engagement with the reversing gear 414. The start of actuation of the cable portion 426 shifts the tilting force. Cable 426 is configured so that actuation is repeated as many times as necessary to fully release trigger member 1200 and end actuator 1000.
[000217] As illustrated in Figures 5 and 11 to 16, the tool mounting portion 300 includes a third drive system 430 that is configured to receive a "third" corresponding output rotary movement from the tool drive assembly 110 of the robotic system 10 and convert this third exit spin into a third control spin. The third drive system 430 includes a third drive pulley 432 which is coupled to a third member or corresponding driven disk 306 on the support side 316 of the tool 304 mounting plate when the tool 300 mounting portion is coupled to the tool assembly. tool drive 110. See Figure 10. Third drive pulley 432 is configured to apply a third control spin (in response to corresponding output spins applied thereto by robotic system 10) to a corresponding third drive cable 434 that can be used to apply various control or manipulation motions to the end actuator that is operatively coupled to the stem assembly 200. As can be seen more particularly in Figures 11 and 12, the third drive cable 434 extends around a third drive spindle assembly 436. Third drive spindle assembly 436 is pivotally mounted. attached to the tool 304 mounting plate, and a third tension spring 438 is secured between the third drive spindle assembly 436 and the tool 304 mounting plate to maintain a desired amount of tension in the third drive cable 434 As can be seen in the figures, the cable end portion 434A of the third drive cable 434 extends around an upper portion of a grommet 440 which is secured to the tool mounting plate 304, and the cable end portion 434B extends around a pulley or spacer 442 in the sprocket 440. Those skilled in the art will understand that the application of a third outgoing rotary motion by tool drive assembly 110 in one direction will result in rotation of the third drive pulley 432 in a first direction and cause the cable end portions 434A and 434B to move in opposite directions to apply control motions to the 1000 end actuator or elongated rod assembly 2 00, as will be discussed in more detail below. That is, when the third drive pulley 432 is rotated in a first direction of rotation, the end portion of cable 434A moves in a distal direction "DD", and the end portion of cable 434B moves in a proximal direction "PD" . Rotation of the third drive pulley 432 in an opposite direction of rotation causes the end portion of cable 434A to move in a proximal "PD" direction and the end portion of cable 434B to move in a distal "DD" direction.
[000218] The tool 300 mounting portion illustrated in Figures 5 and 11 to 16 includes a fourth drive system 450 that is configured to receive a corresponding "fourth" output rotary movement from the system tool 110 drive assembly robotic 10 and convert this fourth spin-out movement into a fourth spin-control movement. The fourth drive system 450 includes a fourth drive pulley 452 which is coupled to a fourth member or corresponding driven disk 306 on the support side 316 of the tool 304 mounting plate when the tool 300 mounting portion is coupled to the tool assembly. tool drive 110. See Figure 10. Fourth drive pulley 452 is configured to apply a fourth control rotary motion (in response to corresponding output rotary motions applied thereto by robotic system 10) to a fourth drive cable 454 which can be used to apply various manipulative or control movements to the end actuator that is operatively coupled to the stem assembly 200. As can be seen more particularly in Figures 11 and 12, the fourth drive cable 454 extends around of a fourth drive spindle assembly 456. The fourth drive spindle assembly 456 is pivotally mounted to the drive plate. 304 tool assembly, and a fourth tension spring 458 is secured between the fourth drive spindle assembly 456 and the tool 304 mounting plate to maintain a desired amount of tension on the fourth drive cable 454. The cable end portion 454A of the fourth drive cable 454 extends around a lower portion of the sling 440 which is secured to the mounting plate of the tool 304, and the end portion of the cable 454B extends around a sheave or spacer 462 in the sling. 440. Those skilled in the art will understand that applying an output rotary motion by the tool drive assembly 110 in one direction will result in the fourth drive pulley 452 rotating in a first direction and causing the cable end portions 454A and 454B move in opposite directions to apply control motions to the end actuator or elongated stem assembly 200, as discussed in more detail below. That is, when the fourth drive pulley 452 is rotated in a first direction of rotation, the end portion of the cable 454A moves in a distal "DD" direction and the end portion of the cable 454B moves in a proximal "PD" direction. Rotation of the fourth drive pulley 452 in an opposite direction of rotation causes the end portion of cable 454A to move in a proximal "PD" direction and the end portion of cable 454B to move in a distal "DD" direction.
[000219] The surgical tool 100 depicted in Figure 5 includes an articulated joint 700. In such an embodiment, the third drive system 430 may also be called "first joint drive system" and the fourth drive system 450 may be called in the present document "second articulation drive system". Similarly, the third drive cable 434 may be referred to as the "first proximal pivot cable" and the fourth drive cable 454 may be referred to herein as the "second proximal pivot cable".
[000220] The mounting portion of the tool 300 of the embodiment illustrated in Figures 5 and 11 to 16 includes a fifth drive system, generally designated 470, which is configured to axially displace a drive rod assembly 490. drive rod 490 includes a drive rod proximal segment 492 that extends through the drive rod proximal segment 380 and drive rod assembly 388. See Figure 13. Fifth drive system 470 includes a movable drive yoke 472 which is slidably supported on the mounting plate of the tool 304. The drive rod proximal segment 492 is supported on the drive yoke 372 and has a pair of retainer balls 394 therein so that the displacement drive yoke 372 in the tool mounting plate 304 results in axial movement of the drive rod proximal segment 492. In at least one exemplary manner, what The 370 drive system additionally includes a 474 drive solenoid that forms an operating interface with the 472 drive yoke. The 474 drive solenoid receives control power from the robotic controller 12. The actuation of the 474 drive solenoid at a first direction will cause the actuating rod assembly 490 to move in the distal direction "DD", and actuating the actuating solenoid 474 in a second direction will cause the actuating rod assembly 490 to move in the direction proximal "PD". As seen in Figure 5, end actuator 1000 includes an anvil portion that can be moved between open and closed positions by applying axial closing motions to a closing system. In the embodiment illustrated in Figures 5 and 11 to 16, the fifth drive system 470 is employed to generate such closing movements. Thus, the fifth drive system 470 can also be called the "close drive".
[000221] The embodiment shown in Figure 5 includes a surgical end actuator 1000 that is secured to the mounting portion of the tool 300 by the elongated rod assembly 200. In that illustrated embodiment, the elongated rod assembly includes a coupling arrangement in the form a quick-disconnect arrangement or joint 210 that facilitates quick attachment of a distal portion 230 of stem assembly 200 to a proximal stem portion 201 of stem assembly 200. Quick-disconnect joint 210 serves to facilitate engagement and quick disengagement of a plurality of drive train components used to transmit control motions from a source of drive motions to an end actuator operatively coupled thereto. In the embodiment illustrated in Figures 5 and 19, for example, the quick-disconnect joint 210 is employed to couple a distal stem portion 230 of end actuator 1000 to a proximal stem portion 201.
[000222] Referring now to Figures 19 to 23, the quick-disconnect coupling or joint arrangement 210 includes a proximal coupler element 212 that is configured to operatively support proximal drive train assemblies, and a distal coupler element 232 that is configured to operatively support at least one and preferably a plurality of distal drive train assemblies. In the embodiment of Figures 5 and 19, the third drive system 430 (i.e., a first joint drive system) and the fourth drive system 450 (i.e., a second joint drive system) are employed to apply motions. of swivel to swivel joint 700. For example, third drive system 430 serves to apply control motions to the first proximal swivel cable 434 which has cable end portions 434A, 434B to swivel end actuator 1000 into first and second pivot directions around pivot joint 700. Similarly, fourth drive system 450 serves to apply control motions to second proximal pivot cable 454 having cable end portions 454A, 454B for pivoting end actuator 1000 in the third and fourth directions of articulation.
[000223] Referring to Figure 20, the proximal coupler element 212 has a first pair of diametrically opposed first slots 214, and a second pair of diametrically opposed second slots 218 (only one slot 218 can be seen in Figure 20). A first tie rod or proximal hinge formation 222 is supported in each of the opposing first slots 214. A second tie rod or proximal hinge formation 226 is supported in each of the second slots 218. The end portion of the handle 434A extends through one slot in one of the proximal hinge rods 222 and is secured thereto. Similarly, the end portion of cable 434B extends through a slot in the other proximal pivot rod 222 and is secured thereto. The end portion of the handle 434A and its corresponding tie rod or proximal hinge formation 222 and the end portion of the handle 434B and its corresponding tie rod or proximal hinge formation 222 are collectively referred to as a "first proximal hinge drive train assembly " 217. The end cable portion 454A extends through a slot in one of the proximal pivot rods 226 and is secured thereto. The end portion of cable 454B extends through a slot in the other proximal pivot rod 226 and is secured thereto. The cable end portion 454A and its corresponding proximal pivot or pivot formation 226 and the corresponding cable end portion 454B and its corresponding proximal pivot or pivot formation 226 will collectively be referred to as a "second proximal pivot drive train assembly" 221.
[000224] As seen in Figure 21, the distal stem portion 230 includes a distal outer portion of the tube 231 that supports the distal coupler element 232. The distal coupler element 232 has a first pair of diametrically opposed first slots 234 and one second pair of second diametrically opposed slots 238. See Figure 20. A first pair of tie rods or distal hinge formations 242 is supported in the first opposing slots 234. A second pair of tie rods or distal hinge formations 246 is supported in the second pair of slots 238. A first distal cable segment 444 extends through one of the first slots 234 and a slot in one of the distal pivot rods 242 to be secured thereto. A primary distal cable segment 445 extends through the other of the first slots 234 and through a slot in the other distal pivot rod 242 and to be secured thereto. The first distal cable segment 444 and its corresponding distal pivot rod 242 and the primary distal cable segment 445 and its corresponding distal pivot rod 242 are collectively referred to as a "first distal pivot drive train assembly" 237. second distal cable segment 446 extends through one of the second slots 238 and a slot in one of the distal hinge rods 246 and to be secured thereto. A secondary distal cable segment 447 extends through the other second slot 238 and through a slot in the other distal pivot rod 246 and to be secured thereto. The second distal cable segment 446 and its corresponding distal pivot rod 246 and the secondary distal cable segment 447 and its corresponding distal pivot rod 246 are collectively referred to as a "second distal pivot drive train assembly" 241.
[000225] Each of the proximal pivot rods 222 has a toothed end 224 formed in a spring arm portion 223 thereof. Each of the proximal pivot rods 226 has a toothed end 227' formed in a spring arm portion 227 thereof. Each distal pivot rod 242 has a toothed end 243 that is configured to be meshedly coupled with the toothed end 224 of a corresponding one of the proximal pivot rods 222. Each distal pivot rod 246 has a toothed end 247 that is configured to be meshedly coupled with the toothed end 228 of a corresponding proximal pivot rod 226. When the rods or proximal pivot formations 222, 226 are meshedly connected with the distal pivot rods 242, 246, respectively, the first and the second proximal pivot drive train assemblies 217 and 221 are operatively coupled to the first and second distal pivot drive train assemblies 237 and 241, respectively. Thus, the actuation of the third and fourth drive systems 430, 450 will apply actuation movements to the distal segments of cables 444, 445, 446, 447, as will be discussed in more detail below.
[000226] In the embodiment of Figures 19 to 23, a distal end 250 of the proximal outer segment of tube 202 has a series of spring-loaded fasteners 252 therein extending distally into slots 254 configured to receive arm portions of spring 223, 227 corresponding. See Figure 21 (spring arm portion 227 is not shown in Figure 21 but can be seen in Figure 20). Each spring-loaded fastener 252 has a detent 256 therein which is adapted to engage corresponding cavities 258 formed in the proximal pivot rods 222, 226 when the proximal pivot rods 222, 226 are in the neutral position (Figure 23). When the clinician wishes to remove or attach an end actuator 1000 to the proximal stem portion 201, the third and fourth drive systems 430, 450 are placed in their neutral, non-actuated positions.
[000227] The proximal coupler element 212 and the distal coupler element 232 of the quick release joint 210 operatively support corresponding portions of a drive element coupling assembly 500 to releasably couple the drive rod proximal segment 492 to a distal segment of the drive stem 520. The drive stem proximal segment 492 comprises a proximal axial drive train assembly 496 and the drive stem distal segment 520 comprises a distal axial drive train assembly 528. The element coupling assembly drive 500 comprises a drive rod formation or coupler 502 which comprises a receiving formation or first magnet 504, such as a rare earth magnet, etc., which is secured to the distal end 493 of the rod's distal segment drive 520. The first magnet 504 has a receiving cavity 506 formed therein to receive a second formation or distal magnet 510. As seen in Figure 21, distal magnet 510 is secured to a tapered mounting element 512 which is secured to a proximal end 522 of distal drive rod 520.
[000228] The proximal coupler element 212 and the distal coupler element 232 of the quick release joint 210 operatively support other corresponding portions of a drive element coupling assembly 500 to releasably couple the proximal segment of the drive rod 380 with a distal segment of drive stem 540. The proximal segment of drive stem 380, in at least one exemplary form, comprises a proximal swivel drive train assembly 387 and the distal segment of drive stem 540 comprises a drive train assembly distal swivel 548. When the proximal swivel drive train assembly 387 is operatively coupled to the distal swivel drive train assembly 548, the drive rod assembly 388 is formed to transmit control swivels to the end actuator 1000. In mode illustrated exemplary, a proximal end 542 of segment di This drive rod 540 has a plurality (eg four, but only two can be seen in Figure 21) of formations or hook fasteners 544 formed therein. Each hook fastener 544 has a locking hook 546 formed therein that is sized to be received in corresponding slots, holes, or latch formations 383 in a distal end 381 of the proximal segment of drive rod 380. Fasteners 544 extend through of a backing ring 545 seated on the proximal end 542 of the distal segment of the drive rod 540.
[000229] In the embodiment shown in Figures 19 to 23, the drive element coupling assembly 500 additionally includes an unlocking tube 514 to aid in the disengagement of the first and second magnets 504, 510, when the physician separates the actuator from end 1000 of the proximal rod portion 201 of surgical tool 100. The unlocking tube 514 extends through the proximal segment of the actuating rod 380 and its proximal end 517 projects outward from the proximal end 385 of the proximal segment of the actuating rod 380 , as shown in Figure 19. Unlocking tube 514 is sized relative to the proximal segment of drive rod 380 to be axially movable therein by applying an "UL" unlocking motion applied to its proximal end 517. A cable (not shown) is attached to the proximal end 517 of the unlocking tube to facilitate manual application of the "UL" unlocking movement to the unlocking tube 514 or the "UL" unlocking movement. Other embodiments that are otherwise identical to the embodiment of Figures 19 to 23 employ an unlocking solenoid (not shown) that is attached to tool mounting plate 304 and powered by robotic controller 12, or a separate battery attached thereto. is used to apply the unlocking movement.
[000230] In the illustrated exemplary embodiment, the quick release coupling or joint arrangement 210 also includes an outer locking ring 260 that is slidably positioned on the distal end 204 of the proximal outer tube portion 202. The outer locking ring 260 it has four inwardly extending detents 262 which extend into a corresponding slot among the slots 254 in the proximal outer tube portion 202. The use of the quick-disconnect joint 210 can be understood by referring to Figures 21 to 23. Figure 21 illustrates the conditions of the proximal stem portion 201 and the distal stem portion 230 before being coupled together. As can be seen in this figure, the spring arm portions 223, 227 of the proximal pivot rods 224, 226, respectively, are naturally and radially outwardly relaxed. Locking ring 260 is moved to its most proximal position in proximal outer tube 202, where detents 262 are at the proximal end of slots 254 therein. When the clinician desires to secure the end actuator 1000 to the proximal stem portion 201 of the surgical tool 100, the clinician places the distal stem portion 230 in axial alignment and mating engagement with the proximal stem portion 201 as shown in Figure 22. As seen in this figure, distal magnet 510 is seated within cavity 506 in drive rod coupler 502 and is magnetically secured to proximal magnet 504 to thereby couple the distal segment of drive rod 520 to the proximal rod segment drive train 492. Such action thus operatively couples the distal axial drive train assembly 528 to the proximal axial drive train assembly 496. In addition, as the rod portions 201, 230 are joined together, the fasteners with hook 544 are flexed inward until hooks 546 formed therein enter locking openings 383 in distal end portion 381 of the proximal segment of the actuating rod. 380. When the hooks 546 are seated within their respective locking holes 383, the distal segment of the actuating rod 540 is coupled to the proximal segment of the actuating rod 380. In this way, such action operationally couples the assembly of the distal swivel drive train 548 to the proximal drive train assembly 387. Thereby, when the distal coupler element 232 and the proximal coupler element 212 are placed in axial alignment and engage in the manner described above and the locking ring 260 is moved to its most proximal position in the proximal outer tube 202, the distal drive train assemblies are operatively coupled to the proximal drive train assemblies.
[000231] When the clinician wishes to separate the end actuator 1000 from the proximal stem portion 201 of the surgical tool 100, the clinician returns the third and fourth drive systems 430, 450 to their neutral positions. The clinician may then slide the locking ring 260 proximally on the proximal outer segment of the tube 202 to the starting position as shown in Figure 22. When in that position, the spring arm portions of the proximal hinge rods 222, 226 cause the toothed portions thereof to disengage the toothed portions of the distal pivot rods 242, 246. The clinician may then apply a UL unlocking motion to the proximal end 517 of the unlocking tube 514 to move the unlocking tube 514 and the unlocking ring 516 attached thereto in the distal direction "DD". As the unlocking ring 516 moves distally, it forces the hook fasteners 544 out of engagement with their respective holes 383 in the distal end portion 381 of the proximal segment of the drive rod 380 and contacts the portion of tapered mount 512 to force distal magnet 510 out of magnetic engagement with proximal magnet 504.
[000232] Figures 22A, 23A and 23B represent an alternative coupling arrangement or 210" quick release joint assembly that is similar to the 210 quick release joint described above, except that an electromagnet 504' is employed to couple the distal segment of the drive stem 520 to the proximal segment of the drive stem 492'. As seen in these figures, the proximal segment of the drive stem 492' is hollow to accommodate conductors 505 that extend from a power source electrical in the robotic system 10. The conductors 505 are wrapped around a piece of iron 508. When the clinician places the distal rod portion 230 in engagement with the proximal rod portion 201, as shown in Figure 22A, electrical current may be passed through conductors 505 in a first direction to cause magnet 504' to attract magnet 510 to coupling engagement, as shown in Figure 23A. end 1000 of the proximal stem portion 201 of the surgical tool 100, the clinician returns the third and fourth drive systems 430, 450 to their neutral positions. The clinician may then slide locking ring 260 proximally on the proximal outer segment of tube 202 to the starting position shown in Figure 22A. When in this position, the spring arm portions of the proximal pivot rods 222, 226 cause the toothed portions thereof to disengage the toothed portions of the distal pivot rods 242, 246. The clinician may then apply an unlocking motion. UL to the proximal end 517 of the unlocking tube 514 to move the unlocking tube 514 and the unlocking ring 516 attached thereto in the distal "DD" direction. In addition, electrical current can be passed through the 505 conductors in an opposite direction so that repulsion occurs between the 504’ electromagnet and the 510 magnet to aid in the separation of the rod segments. As the clinician moves the unlocking tube distally, the unlocking ring 516 forces the hook fasteners 544 out of engagement with their respective holes 383 in the distal end portion 381 of the proximal segment of the drive rod 380 and enters. in contact with the tapered mounting portion 512 to further separate the shank segments.
[000233] The coupling arrangements or quick disconnect joint assemblies described above can offer many advantages. For example, such arrangements may employ a single release/engagement movement so that they cannot be left half engaged. Such engagement movements can be employed to simultaneously operatively couple several drive train assemblies, where at least some drive train assemblies transmit control movements that differ from control movements transmitted by other drive train assemblies. For example, some drive trains may provide control rotary motions and be longitudinally displaceable to transmit axial control motions, and some may only transmit axial or control rotary motions. Other drive train assemblies can provide push/pull motions to operate various end actuator systems/components. The unique and innovative locking ring arrangement ensures that the distal drive train assemblies are locked into their respective proximal drive train assemblies, or that they are unlocked and can be separated from them. When locked together, all drive train assemblies are radially supported by the locking ring, which prevents any decoupling.
[000234] The surgical tool 100, shown in Figures 5 and 11 to 16, includes a swivel joint 700 that cooperates with the third and fourth drive systems 430, 450, respectively, to articulate the end actuator 1000 around the shaft longitudinal "LT" of the tool. Hinged joint 700 includes a proximal socket tube 702 which is secured to the distal end 233 of the distal outer portion of tube 231 and defines a proximal ball socket 704 therein. See Figure 25. A proximal ball element 706 is movably positioned within the proximal ball socket 704. As seen in Figure 25, the proximal ball element 706 has a central drive passage 708 that allows the sec. the distal portion of the drive rod 540 extends through it. In addition, the proximal ball element 706 has four hinge passages 710 therein that facilitate the passage of distal segments of cables 444, 445, 446, 447 therethrough. As can be seen further in Figure 25, the swivel joint 700 further includes an intermediate swivel tube segment 712 which has an intermediate ball socket 714 formed therein. Intermediate ball socket 714 is configured to movably support therein an end actuator ball 722 formed in a connecting tube of end actuator 720. The distal segments of cables 444, 445, 446, 447 extend through passageways cables 724 formed in the end actuator ball 722 and are secured thereto by lugs 726 received within corresponding passages 728 in the end actuator ball 722. Other fastening arrangements can be employed to secure the distal segments of the cables 444, 445 , 446, 447 to the ball of end actuator 722.
[000235] A unique and innovative swivel bearing joint assembly, generically designated 740, is shown in Figures 26 and 27. The illustrated swivel bearing joint assembly 740 includes a connector portion 1012 of the end actuator gearbox 1010 which is substantially cylindrical in shape. A first annular race 1014 is formed on the circumference of the cylindrical shaped connector portion 1012. The swivel bearing joint assembly 740 additionally comprises a distal socket portion 730 formed in the end actuator connector tube 720, as shown in the Figures. 26 and 27. Distal socket portion 730 is dimensioned with respect to cylindrical connector portion 1012 such that connector portion 1012 is free to rotate within socket portion 730. A second annular track 732 is formed in a wall internal 731 of the distal socket portion 730. There is an opening 733 through the distal socket 730 which communicates with the second annular track 732 therein. As can also be seen in Figures 26 and 27, the swivel bearing joint assembly 740 additionally includes a bearing ring 734. In various exemplary embodiments, the bearing ring 734 comprises a plastically deformable substantially circular ring having a cutout. 735 in it. The cutout forms free ends 736, 737 in bearing ring 734. As seen in Figure 26, bearing ring 734 is substantially annular in shape in its natural, unforced state.
[000236] To couple a surgical end actuator 1000 (e.g., a first portion of a surgical instrument) to the hinge joint 700 (e.g., a second portion of a surgical instrument), the cylindrical-shaped connector portion 1012 is inserted into the distal socket portion 730 to place the second annular race 732 in substantial alignment with the first annular race 1014. One of the free ends 736, 737 of the bearing ring is then inserted into the aligned annular races 1014, 732 through the opening 733 in the distal socket portion 730 of the end actuator connector tube 720. To facilitate easy insertion, the opening or slot 733 has an oblique surface 738 formed thereon. See Figure 26. Bearing ring 734 is essentially rotated into position and, as it tends to form a circle or ring, it does not escape through opening 733 once installed. After the bearing ring 734 is inserted into the aligned annular races 1014, 732, the end actuator connector tube 720 will be pivotally secured to the connector portion 1012 of the end actuator drive housing 1010. end actuator drive 1010 rotate around the tool's longitudinal axis LT-LT relative to end actuator end tube 720. Bearing ring 734 serves as the bearing surface on which the actuator drive housing end 1010 then rotates. Every side load attempts to deform bearing ring 734, which is supported and contained in mated races 1014, 732, preventing damage to bearing ring 734. Those skilled in the art will understand that such a simple and effective gasket assembly employs the bearing 734 forms a highly slippery contact surface between the rotating portions 1010, 730. If during assembly one of the free ends 736, 737 manages to exit through the opening 733 (see, for example, Figure 27), the joint assembly with swivel mount 740 can be disassembled by removing the bearing ring element 732 through opening 733. The swivel bearing joint assembly 740 allows for easy assembly fabrication and also provides good support for the end actuator, while at the same time which facilitates its rotating manipulation.
[000237] Articulated joint 700 facilitates the articulation of the end actuator 1000 around the longitudinal axis LT of the tool. For example, when it is desirable to pivot end actuator 1000 in a first direction "FD", as shown in Figure 5, robotic system 10 can drive third drive system 430 so that third drive spindle assembly 436 (Figures 11 to 13) is rotated in a first direction, thus stretching the terminal portion of the proximal cable 434A and finally the distal cable segment 444 in the proximal "PD" direction and releasing the terminal portion of the proximal cable 434B and the segment of distal cable 445 to thereby cause the ball of end actuator 722 to rotate within socket 714. Similarly, to pivot end actuator 1000 in a second direction "SD" opposite to the first direction FD, the robotic system 10 can drive the third drive system 430 so that the third drive spindle assembly 436 is rotated in the second direction, thereby stretching the end portion of the proximal cable 434B and ultimately the cable segment. distal cable 445 in the proximal "PD" direction and releasing the end portion of the proximal cable 434A and the distal cable segment 444 to thereby cause the ball of the end actuator 722 to rotate within the socket 714. When it is desirable to articulate the end actuator 1000 in a third second direction "TD", as shown in Figure 5, robotic system 10 can drive fourth drive system 450 so that fourth drive spindle assembly 456 is rotated in a third direction, stretching thus the proximal cable end portion 454A and finally the distal cable segment 446 in the proximal "PD" direction and releasing the proximal cable end portion 454B and the distal cable segment 447 to thereby make the ball of end actuator 722 rotate inside socket 714. Similarly, to pivot end actuator 1000 in a fourth "FTH" direction opposite the third direction TD, robotic system 10 can drive the fourth steel system. drive 450 so that the fourth drive spindle assembly 456 is rotated in a fourth direction, thereby stretching the terminal portion of the proximal cable 454B and finally the distal cable segment 447 in the proximal "PD" direction and releasing the portion proximal cable terminal 454A and distal cable segment 446 to thereby cause the ball of end actuator 722 to rotate within socket 714.
[000238] The end actuator mode represented in Figures 5 and 11 to 16 employs rotary and longitudinal movements that are transmitted from the mounting portion of the tool 300 through the elongated rod assembly for actuation purposes. The drive rod assembly employed to transmit these rotational and longitudinal movements (eg, twisting, tensioning and compressing movements) to the end actuator is relatively flexible to facilitate the articulation of the end actuator around the swivel joint. Figures 28 and 29 illustrate an alternative drive rod assembly 600 that may be employed in conjunction with the embodiment illustrated in Figure 5 and 11 through 16 or in other embodiments. In the embodiment shown in Figure 5, which employs the quick release joint 210, the proximal segment of the drive rod 380 comprises a segment of the drive rod assembly 600, and the distal segment of the drive rod 540 similarly comprises , another segment of drive rod assembly 600. Drive rod assembly 600 includes a drive tube 602 that has a series of annular junction segments 604 cut into it. In this illustrated embodiment, drive tube 602 comprises a distal portion of the proximal segment of drive rod 380.
[000239] The drive tube 602 comprises a hollow metallic tube (stainless steel, titanium, etc.) which has a series of annular junction segments 604 formed therein. Annular junction segments 604 comprise a plurality of loosely interlocking "swallowtail" shapes 606 which are, for example, cut into drive tube 602 with the use of lasers and serve to facilitate flexible movement between adjacent hinge segments. 604. See Figure 29. Such an original tube laser cut creates a hollow flexible drive tube that can be used in compression, tension and twisting. Such an arrangement employs a full diameter cut that promotes the fit between adjacent parts by means of a "puzzle piece" configuration. These cuts are then repeated along the length of the hollow drive tube in a given arrangement, and are sometimes "turned" or rotated to alter the tension or torsional performance.
[000240] Figures 30 to 34 illustrate alternative examples of microannular junction segments 604' comprising a plurality of laser cut shapes 606' that appear to be approximately shaped like a normal letter "T" and an inverted letter "T" with a notched portion, loosely interlocked. The annular joint segments 604, 604' essentially comprise multiple microarticulator twist joints. That is, each joint segment 604, 604’ can transmit torque and at the same time facilitate relative articulation between each ring joint segment. As shown in Figures 30 and 31, the joint segment 604D' at the distal end 603 of the drive tube 602 has a 608D mounting ring distal portion that facilitates attachment to other drive components to drive the end actuator or portions of the quick-release joint, etc., and the joint segment 604P' at the proximal end 605 of the drive tube 602 has a mounting ring proximal portion 608P' that facilitates attachment to other drive components or release joint portions. fast.
[000241] The range of motion between the joints for each particular 600 drive rod assembly can be increased by increasing the spacing in the laser cuts. For example, to ensure that the joint segments 604' preserve coupling without significantly decreasing the ability of the drive tube to articulate within the desired ranges of motion, a secondary retainer element 610 is employed. In the embodiment shown in Figures 32 and 33, the secondary retainer element 610 comprises a spring 612 or other spirally wound element. In several exemplary embodiments, distal end 614 of spring 612 corresponds to distal portion of mounting ring 608D and is more tightly wound than central portion 616 of spring 612. Similarly, proximal end 618 of spring 612 is more tightly wound. than the central portion 616 of the spring 612. In other embodiments, the retainer element 610 is installed in the drive tube 602 with a desired pitch so that the retainer element also functions, for example, as a flexible drive thread to engage. if operationally on other control components threaded on the end actuator and/or the control system. Those skilled in the art will also understand that the retainer element can be installed in such a way as to have a variable pitch to effect transmission of the desired control rotary motions as the drive rod assembly is rotated. For example, the variable pitch arrangement of the retaining element can be used to improve opening/closing and firing movements that would benefit from different linear strokes in the same rotational movement. In other embodiments, for example, the drive rod assembly comprises a variable pitch thread on a flexible hollow drive rod that can be flexed back and forth through a ninety degree angle. In still other embodiments, the secondary retainer member comprises an elastomeric liner or tube 611 applied around the exterior or circumference of drive tube 602 as illustrated in Figure 34A. In yet another embodiment, for example, the elastomeric liner or tube 611' is installed in the hollow passage 613 formed within the drive tube 602 as shown in Figure 34B.
[000242] Such drive rod arrangements comprise a composite torsional drive shaft that allows superior load transmission while providing desirable axial articulation range. See, for example, Figures 34 and 34A-B. That is, these composite drive rod assemblies allow for a wide range of motion while retaining the ability to transmit torque in both directions, as well as facilitating, through them, tensional and compressive control movements. In addition, the hollow nature of such drive rod arrangements facilitates the passage of other control components therethrough while providing better application of tension. For example, some other embodiments include a flexible inner cable that extends through the drive rod assembly and can assist in aligning the joint segments while providing the ability to apply tension motion across the drive rod assembly. drive. Furthermore, such drive rod arrangements are relatively easy to manufacture and assemble.
[000243] Figures 35 to 38 represent a 620 segment of a 600’ drive rod assembly. This modality includes junction segments 622, 624 that are laser cut into the original tube material (eg stainless steel, titanium, polymer, etc.). Joining segments 622, 624 preserve a loose fit because cutouts 626 are radial and somewhat tapered. For example, each of the protrusion portions 628 has a tapered portion on the outer circumference 629 that is received in a socket 630 that has a tapered inner wall portion. See, for example, Figures 36 and 38. Thus, no assembly is needed to join the joint segments 622, 624. As can be seen in the figures, the joint segment 622 has opposite hinged protrusion portions 628 cuts at each end thereof which are hingedly received in corresponding sockets 630 formed in adjoining splice segments 624.
[000244] Figures 35 to 38 illustrate a small segment of the 600’ drive rod assembly. Those skilled in the art will understand that the bosses/sockets can be cut along the entire length of the drive rod assembly. That is, the splice segments 624 may have opposing sockets 630 cut into them to facilitate mating with the adjoining pivot segments 622 and complete the length of the drive rod assembly 600’. In addition, the junction segments 624 have an angled end portion 632 cut therein to facilitate articulation of the junction segments 624 with respect to the junction segments 622, as illustrated in Figures 37 and 38. In the illustrated embodiment, each protrusion 628 has a hinge limit portion 634 which is adapted for contact with a corresponding hinge stop 636 formed in the joint segment 622. See Figures 37 and 38. Other embodiments, which may be identical to segment 620 in all other respects, do not contain hinge limit portions 634 and stops 636.
[000245] As noted above, the range of motion between the joints for each particular drive rod assembly can be increased by increasing the spacing in laser cuts. In such embodiments, to ensure that the junction segments 622, 624 remain joined without significantly decreasing the ability of the drive tube to articulate in all desired ranges of motion, a secondary retainer element in the form of a coating or elastomeric sleeve 640. Other embodiments employ other forms of retainer elements disclosed herein and their equivalent structures. As can be seen in Figure 35, the splice segments 622, 624 are capable of rotating around "PA-PA" pivot shafts defined by pivoting lugs 628 and corresponding sockets 630. To obtain an expanded range of articulation, the 600’ drive rod assembly can be rotated around the TL-TL tool axis while rotating around the PA-PA pivot axes.
[000246] Figures 39 to 44 represent a segment 640 of another drive rod assembly 600". The drive rod assembly 600" comprises a multi-segment drive system that includes a plurality of interconnected joint segments 642 that form a hollow flexible drive tube 602". A splice segment 642 includes a ball connector portion 644 and a socket portion 648. Each splice segment 642 can be fabricated, for example, by metal injection molding "MIM" and be fabricated from 17-4, 17-7, 420 stainless steel. Other embodiments may be machined parts from 300 or 400 series stainless steel, 6065 or 7071 aluminum or titanium. Other embodiments could be filled nylon or molded parts. not with plastic, Ultem, ABS, polycarbonate or polyethylene, for example. As can be seen from the figures, the 644 ball connector is hexagonal in shape. That is, the 644 ball connector has six arcuate surfaces 646 fo secured therein and is adapted to be swivelly received in same-shaped sockets 650. Each socket 650 has a hexagonally shaped outer portion 652 formed by six flat surfaces 654 and an inner radially shaped portion 656. See Figure 42. All the joint segments 642 is identical in construction, except that the socket portions of the last joint segments that form the distal and proximal ends of the drive rod assembly 600 can be configured to operably mate with the joint components. corresponding control. Each ball connector 644 has within it a hollow passage 645 which cooperates to form a hollow passage 603 through the hollow flexible drive tube 602".
[000247] As can be seen in Figures 43 and 44, the interconnected junction segments 642 are contained within a retainer element 660, which comprises a tube or sleeve made of a flexible polymeric material, for example. Figure 45 illustrates a flexible inner core element 662 extending through the interconnected junction segments 642. The inner core element 662 comprises a solid element made of a polymeric material or a hollow tube or sleeve made of a flexible polymeric material. Fig. 46 illustrates another embodiment, in which a retainer element 660 and an inner core element 662 are employed.
[000248] The 600" Drive Rod Assembly facilitates the transmission of rotational and translational motion through a swivel joint of variable radius. The hollow nature of the 600" Drive Rod Assembly provides room for additional control components or a tractor element (eg a flexible cable) to facilitate the transmission of tension and compression loads. In other embodiments, however, the splice segments 624 do not provide a hollow passage through the drive rod assembly. In such embodiments, for example, the spherical connector portion is solid. The rotary movement is translated through the edges of the hexagonal surfaces. Tighter tolerances can allow for a greater load capacity. With the use of a cable or other tractor element across the centerline of the 600" drive rod assembly, the entire 600" drive rod assembly can be rotated, flexed, pushed, and pulled without limiting the range of motion. For example, the 600" drive rod assembly can form an arcuate drive path, a straight drive path, a spiral drive path, etc.
[000249] Figures 5 and 47 to 54 illustrate a surgical end actuator 1000 that can be effectively employed with the robotic system 10. The end actuator 1000 comprises an endocutter 1002 having a first jaw 1004 and a second jaw. - of the jaw 1006 which is selectively movable relative to the first jaw 1004. In the embodiment illustrated in Figures 5 and 47 to 54, the first jaw 1004 comprises a support member 1019 in the form of an elongated channel 1020 that is configured to operatively support a 1030 staple cartridge in it. Second jaw 1006 comprises an anvil assembly 1100. As seen in Figures 47, 49, 53 and 55, anvil assembly 1100 comprises an anvil body 1102 having a clamp forming surface 1104 thereon. Anvil body 1102 has a passage 1106 that is adapted to align with mounting holes 1022 in elongated channel 1020. A pivot pin or trunnion (not shown) is inserted through holes 1022 and passage 1104 to pivotally engage. the anvil 1100 to the elongated channel 1020. Such an arrangement allows the anvil assembly 1100 to be selectively rotated about a closing axis "CA-CA" that is substantially transverse to the longitudinal axis "LT-LT" of the tool (Figure 48) between an open position, where the staple forming surface 1104 is spaced apart from the cartridge base 1044 of the staple cartridge 1040 (Figures 47 to 50), and closed positions (Figures 51 to 54), where the staple forming surface clamp 1104 on anvil body 1102 is in confronting relationship with the base of cartridge 1042.
[000250] The embodiment of Figures 5 and 47 to 54 employs a closure assembly 1110 that is configured to receive opening and closing movements from the fifth drive system 470. The fifth drive system 470 serves to advance and retract axially a actuation rod assembly 490. As described above, actuation rod assembly 490 includes a actuation rod proximal segment 492 that forms an operable interface with actuation solenoid 474 to receive axial control motions thereof. Proximal segment of drive stem 492 is coupled to a distal segment of drive stem 520 through drive stem coupler 502. The distal segment of drive stem 520 is somewhat flexible to facilitate articulation of end actuator 1000 at around the 700 articulated joint and also facilitate the axial transmission of closing and opening movements through it. For example, the distal segment of drive rod 520 may comprise a laminated structure or cable of titanium, stainless steel or nitinol.
[000251] The closure assembly 1110 includes a closure rod 1112 that is pivotally secured to the elongated channel 1020. As can be seen in Figures 48, 51 and 52, the closure rod 1112 has an opening 1114 therein through the which the distal end 524 of the distal segment of the drive rod 520 extends. A ball 526 or other formation is secured to the distal segment of drive rod 520 to thereby secure the distal end 524 of the distal segment of drive rod 520 to closure rod 1112. closure assembly 1110 additionally includes a pair of discs cam discs 1120 which are rotatably mounted on the side faces of elongated channel 1020. One cam disc 1120 is rotatably supported on one side face of elongated channel 1020 and the other cam disc 1120 is rotatably supported on the other. side face of elongated channel 1020. See Figure 60. A pair of pivot rods 1122 is secured between each cam disc 1120 and closure rod 1112. will result in the rotation of the cam discs 1120. Each cam disc 1120 additionally has an actuator pin 1124, protruding from the disc, which is slidably received in a u. a corresponding cam slot 1108 in anvil body 1102.
[000252] The actuation of the second jaw 1006 or anvil assembly 1100 will now be described. Figures 47 to 50 illustrate the anvil assembly 1100 in the open position. After the end actuator 1000 is positioned relative to the tissue to be cut and stapled, the robotic controller 12 can activate the actuating solenoid 474 in the first direction or distal direction "DD", ultimately resulting in distal movement of the yoke. drive rod 472, which causes the drive rod assembly 490 to move in the distal "DD" direction. Such movement of the actuating rod assembly 490 results in distal movement of the distal segment of actuating rod 520, which causes the closing rod 1112 to rotate from the open position to the closed position (Figures 51 to 54). Such movement of closing rod 1112 causes cam discs 1120 to rotate counterclockwise ("CCW"). As the cam discs rotate in the "CCW" direction, the interaction between the actuator pins 1124 and their respective cam slots 1108 causes the anvil assembly 1100 to rotate closed over the target tissue. To release target tissue, actuation solenoid 474 is activated to pull actuation rod assembly 490 in the proximal "PD" direction, which results in reverse pivotal displacement of closure rod 1112 to the open position, which, finally, it causes the 1100 anvil assembly to rotate back to the open position.
[000253] Figures 55 to 59 illustrate another closure system 670 to apply the opening and closing movements to the anvil 1100. As can be seen in Figure 56, for example, the closure system 670 includes a first element or mounting block 672 pivotally supporting a first closure rod segment 680. The first closure rod segment 680 has a substantially semicircular cross-sectional shape. A proximal end 682 of the first closure rod segment 680 has a first ball connector 684 therein which is pivotally supported within a first mounting socket 673 formed in mounting block 672. To facilitate pivoting end actuator 1000 by the swivel joint 700, the first closure rod segment 680 also has a first serrated portion 686 that coincides with the swivel joint 700, as illustrated in Figures 58 and 59. The closure system 670 additionally includes a second element or mounting block 674 which pivotally supports a second closure rod segment 690. The second closure rod segment 690 has a substantially semicircular cross-sectional shape. A proximal end 692 of the second closure rod segment 690 has a second ball connector 694 therein which is pivotally supported within a second mounting socket 675 formed in the second mounting block 674. To facilitate actuator pivoting of end 1000 by the swivel joint 700, the second closure rod segment 690 also has a second serrated portion 696 that coincides with the swivel joint 700, as illustrated in Figures 58 and 59.
[000254] As can also be seen in Figure 56, the closure system 670 additionally has a first pivot rod 676 which is secured to a distal end 682 of the first closure rod segment 680. The first pivot rod 676 has a first protrusion hinge 677 formed therein which is configured to be pivotally supported within a first socket 683 formed at the distal end 682 of the first closure rod segment 680. Such an arrangement allows the first pivot rod 676 to rotate with respect to the first closure segment. closure rod 680. Similarly, a second pivot rod 678 is secured to a distal end 691 of the second closure rod segment 690 so that it can rotate with respect thereto. The second pivot rod 678 has a second hinged boss 1679 formed therein that is configured to extend through an opening in the first hinged boss 677 to be pivotally supported within a second socket 692 at a distal end 1691 of the second segment of closure rod 690. Furthermore, as can be seen in Figure 56, the first and second pivot rods 676, 678 are movably fitted together via a key 716 on the second pivot rod 678 which is slidably received. within a slot 717 in the first pivot rod 676. In at least one embodiment, the first pivot rod 676 is secured to each of the cam discs 1120 by first link arms 687 and the second pivot rod 678 is secured to each. between cam discs 1120 by second link arms 688.
[000255] In the illustrated mode, the closing system 670 is actuated by the actuating solenoid 474. The actuating solenoid 474 is configured to form an operational interface with one of the first and second mounting blocks 672, 674 to apply motions of axial closing and opening thereto. As can be seen in Figures 56 to 59, such a drive arrangement may further comprise a first pivot rod and gear assembly 695 which is movably secured to the first mounting block 672 by a pin 685 extending in a slot. 696 in the first pivot rod and gear assembly 695. Similarly, a second pivot rod and gear assembly 697 is movably secured to the second mounting block 674 by a pin 685 that extends into a slot 698 in the second assembly of pivot rod and gear 697. The first pivot rod and gear assembly 695 has a first bevel gear 699A pivotally mounted thereto, and the second pivot rod and gear assembly 697 has a second bevel gear 699B pivotally attached thereto . Both the first and second bevel gears 699A, 699B are mounted in meshing engagement with an idler gear 689 pivotally mounted on the tool mounting plate 302. See Figure 59A. Thus, when the first mounting block 672 is advanced in the "DD" distal direction, which also results in movement of the first closing rod segment 680, and the first pivot rod 676 in the DD distal direction, the bevel gears 689, 699A, 699B will result in movement of the second closure rod 690 and the second pivot rod 678 in the proximal "PD" direction. Similarly, when the first mounting block 672 is advanced in the proximal "PD" direction, which also results in movement of the first closure rod segment 680, and the first pivot rod 676 in the proximal PD direction, the bevel gears 689 , 699A, 699B will result in movement of the second closing rod 690 and the second pivot rod 678 in the distal "DD" direction.
[000256] Figure 58 illustrates the anvil 1100 in the open position. As seen in this figure, the first closing rod 680 is slightly proximal to the second closing rod 690. To close the anvil, the actuating solenoid 474 is actuated to axially advance the first closing rod 680 in the distal direction "DD" . Such action causes the first pivot rod 676 and first link arms 687 to rotate the cam discs 1120 counterclockwise ("CCW"), as shown in Figure 59. Such movement also results in movement of the second cam rod. closure 690 in the proximal direction, which causes the second pivot rod 678 and second link arms 688 to also pull cam discs 1120 counterclockwise ("CCW"). To open the anvil, the actuating solenoid 474 applies an axial control motion to the first mounting block 672 to return the first and second control rod segments 680, 690 to the positions shown in Figure 58.
[000257] The 1000 end actuator embodiment illustrated in Figure 60 includes a drive arrangement, generically designated as 748, which facilitates selective application of control rotary motions to the 1000 end actuator. The 1000 end actuator includes a member of trigger 1200 which is threadably positioned on an implement drive rod 1300. As seen in Figure 61, implement drive rod 1300 has a bearing segment 1304 formed therein that is rotatably supported in a bearing bushing 1011. Implement drive rod 1300 has an implement drive gear 1302 that operatively meshes with a swivel transmission, generically designated 750, which forms an operative interface with elongated channel 1020 and is operatively supported by a portion. of the elongated rod assembly 200. In an exemplary form, the swivel transmission 750 includes an internal assembly. differential lock 760. As seen in Figures 64 and 65, the differential interlock assembly 760 includes a differential case 762 that is configured to selectively rotate with respect to the end actuator drive housing 1010 and rotate with the actuator housing of end 1010.
[000258] The distal segment of the drive rod 540 is attached to a sun gear shaft 752 which has a sun gear 754 attached thereto. In this way, the sun gear 754 will rotate when the distal segment of the drive rod 540 is rotated. Sun gear 754 will also move axially with the distal segment of drive rod 540. Differential interlock assembly 760 additionally includes a plurality of planetary gears 764 that are rotatably secured to differential case 762. In at least one embodiment , for example, three 764 planetary gears are employed. Each planetary gear 764 is in meshed engagement with a first end actuator rack 1016 formed within the end actuator drive housing 1010. In the illustrated exemplary embodiment shown in Figure 60, the end actuator drive housing 1010 is non-rotatably secured to the elongated channel 1020 by a pair of opposing locking tabs 1018 (only one locking tab 1018 can be seen in Figure 60) to corresponding locking slots 1024 (only one locking slot 1024 can be seen in Figure 60) formed at the proximal end 1021 of the elongated channel 1020. Other methods of non-movably securing the end actuator drive housing 1010 to the elongate channel 1020 may be employed, or the end actuator drive housing 1010 may be formed integrally with the elongated channel 1020. Therefore, rotation of the 1010 end actuator gearbox will result in rotation. elongate channel 1020 of end actuator 1000.
[000259] In the embodiment shown in Figures 61 to 65, the differential interlock assembly 760 additionally includes a second rack 766 that is formed within the differential box 762 for meshed engagement with the sun gear 754. The differential interlock assembly 760 includes also a third rack 768 formed in differential box 762 which is in meshed engagement with implement drive gear 1302. Rotation of differential box 762 within end actuator drive box 1010 will ultimately result in gear rotation. implement motor 1302 and implement drive rod 1300 fixed to it.
[000260] When the clinician wishes to rotate the end actuator 1000 around the longitudinal axis LT-LT of the distal tool to the hinge joint 700 to position the end actuator in a desired orientation with respect to the target tissue, the robotic controller 12 can activate displacer solenoid 394 to axially move the proximal segment of drive rod 380 so that sun gear 754 is moved to a "first axial position" shown in Figures 65, 67, and 70. As described in detail above, the Distal segment of actuation stem 540 is operatively coupled to proximal segment of actuation stem 380 through quick-disconnect joint 210. In this way, axial movement of proximal segment of actuation stem 380 may result in axial movement of the distal segment of drive rod 540, sun gear shaft 752 and sun gear 754. As further described above, displacement system 390 controls the motion. axial movement of the proximal segment of the drive rod 380. When in the first axial position, the sun gear 754 is in meshed engagement with the planet gears 764 and the second rack 766 to thereby cause the planet gears 764 and the gear housing. differential 762 rotate as a unit as the sun gear 754 is rotated.
[000261] The rotation of the proximal segment of the drive stem 380 is controlled by the second drive system 370. The rotation of the proximal segment of the drive stem 380 results in the rotation of the distal segment of the drive stem 540 of the sun gear shaft 752 and sun gear 754. Such rotation of differential case 762 and planetary gears 764 as a unit applies a rotary motion to end actuator 1010 gearbox of sufficient magnitude to overcome a first amount of friction F1 between the gearbox of the end actuator 1010 and the distal socket portion 730 of the intermediate link tube 712 to thereby cause the gearbox of the end actuator 1010 and the end actuator 1000 attached thereto to rotate around the longitudinal axis " LT-LT" of the tool in relation to the tube with distal socket 730. Thus, when in such a position, the end actuator gearbox of 1010, the 762 differential case and 764 planetary gears all rotate together as a unit. Due to the fact that implement rod 1300 is supported by bushing bearing 1011 in the end actuator drive housing, implement rod 1300 also rotates with end actuator drive housing 1010. See Figure 61. Thus, rotation of the gearbox of end actuator 1010 and end actuator 1000 does not result in relative rotation of implement drive rod 1300, which would result in displacement of trigger member 1200. In the illustrated exemplary mode, such Rotation of the 1000 distal end actuator of the swivel joint 700 does not result in rotation of the entire elongated rod assembly 200.
[000262] When it is desired to apply a rotary drive motion to implement drive rod 1300 to drive trigger member 1200 within end actuator 1000, sun gear 754 is axially positioned in a "second axial position" to disengage the second rack 766, while meshing planetary gears 764 as shown in Figures 61, 62, 64, and 66. Thus, when you want to rotate implement drive rod 1300, robotic controller 12 activates the solenoid displacer 394 to axially position sun gear 754 in meshed engagement with planet gears 764. When in this second axial position or "firing position," sun gear 754 meshingly engages planet gears 764 only.
[000263] The rotation of the proximal segment of the drive stem 380 can be controlled by the second drive system 370. The rotation of the proximal segment of the drive stem 380 results in the rotation of the distal segment of the drive stem 540 of the sun gear shaft. 752 and sun gear 754. As sun gear 754 is rotated in a first firing direction, planetary gears 764 are also rotated. As the 764 planetary gears rotate, they also cause the 762 differential case to rotate. The rotation of the differential box 762 causes the implement rod 1300 to rotate due to the meshed engagement of the implement drive gear 1302 with the third rack 768. Due to the amount of friction F1 that exists between the gearbox of the end actuator 1010 and distal socket portion 730 of intermediate pivot tube 712, rotation of the planet gears 764 does not result in rotation of end actuator housing 1010 relative to intermediate pivot tube 712. Thus, rotation of the drive rod assembly results in rotation of implement drive rod 1300 without rotating the entire end actuator 1000.
[000264] Such unique and innovative 750 swivel transmission comprises a single drive system that can selectively rotate the end actuator 1000 or trigger the trigger member 1200, depending on the axial position of the swivel drive rod. One advantage that can be provided by such an arrangement is that it simplifies the drives that need to be transverse to the articulated joint 700. It also translates the center drive to the base of the elongated channel 1020, so that the implement drive rod 1300 may exist under the 1040 staple cartridge to drive the trigger member 1200. The ability of an end actuator to pivot distal to the swivel joint can greatly enhance the ability to position the end actuator relative to target tissue.
[000265] As noted above, when the drive stem assembly is positioned in a first axial position, rotation of the drive stem assembly may result in rotation of the entire 1000 end actuator distal to the 700 swivel joint. of the drive rod is positioned in a second axial position (in one example, proximal to the first axial position), rotation of the drive rod assembly may result in rotation of the implement drive rod 1300.
[000266] The rotary transmission mode represented in Figures 64 and 65 includes a differential locking system 780, which is configured to retain the drive rod assembly in the first and second axial positions. As can be seen in Figures 64 and 65, the differential locking system 780 comprises a first retainer formation 756 on the sun gear shaft 752 which corresponds to the first axial position of the drive rod assembly and a second retainer formation 758 on the gear shaft sol 752 which corresponds to the second axial position of the drive rod assembly. In the illustrated exemplary embodiment, the first retainer formation comprises a first radial locking groove 757 on the sun gear shaft 752 and the second retainer formation 758 comprises a second radial locking groove 759 formed on the sun gear shaft 752. locking grooves 757, 759 cooperate with at least one spring activated locking element 784 which is adapted to retentively engage locking grooves 757, 759 when the drive rod assembly is in the first and second positions. axials, respectively. The locking elements 784 have a tapered tip 786 and are movably supported within the differential case 762. A radial wave spring 782 can be employed to apply a changing force to the locking elements 784, as shown in Figure 63. When the drive rod assembly is axially moved to the first position, the locking elements 784 snap into engagement with the first radial locking groove 7576. See Figure 65. When the drive rod assembly is axially moved to the second position axially, the locking elements 784 snap-fit into engagement with the second radial locking groove 759. See Figure 64. In alternative embodiments, the first and second retainer formations may comprise, for example, cavities corresponding to each of the locking elements 784. Also in alternative embodiments, where the drive rod assembly can be axially positioned in a manner. is of two axial positions, additional retaining formations can be employed, which correspond to each of these axial positions.
[000267] Figures 70 and 71 illustrate an alternative differential locking system 790 that is configured to ensure that the drive rod assembly is kept locked in one of a plurality of predetermined axial positions. The 790 differential locking system is configured to ensure that the drive rod assembly can be positioned in one of the first and second axial positions and is not inadvertently positioned in another axial position where the drive system is not properly operational. In the embodiment shown in Figures 70 and 71, the differential locking system 790 includes a plurality of locking springs 792 that are secured to the drive rod assembly. Each locking spring 792 is formed with first and second locking depressions 794, 796 that are separated by a sharpened peak portion 798. The locking springs 792 are located to cooperate with a sharpened locking member 763 formed in the differential case 762. Thus, when the sharpened locking elements 763 are seated in the first locking depression 794, the drive rod assembly is retained in the first axial position and, when the sharpened locking elements 763 are seated in the second locking depressions 796, the rod assembly drive is held in the second axial position. The sharp peak portion 798 between the first and second locking depressions 794, 796 ensures that the drive rod assembly is in one of the first and second axial positions and is not stuck in an axial position between these two axial positions. If additional axial positions are desired, the locking springs can be provided with additional locking depressions that correspond to the desired axial positions.
[000268] Referring to Figures 60, 72 and 73, an abutment bearing 1030 is supported within a pedestal 1026 in the elongated channel 1020. The distal end portion 1306 of the implement drive rod 1300 is rotatably received within the thrust bearing 1030 and protrudes through it. A retaining ring 1032 is attached or otherwise secured to the distal end 1030, as shown in Figure 73, to complete the installation. The use of thrust bearing 1030 in this manner can cause firing member 1200 to be "pulled" as it is fired from an initial position to a final position within elongated channel 1020. Such an arrangement can minimize the risk of warping of the 1300 implement drive rod under high load conditions. The unique and innovative mounting location and arrangement of the 1030 thrust bearing can result in load seating that increases with anvil load, which further increases end actuator stability. Such a mounting arrangement can essentially serve to place the implement drive rod 1300 in tension during the high load trigger cycle. This can avoid the need for drive system gears to either rotate implement drive rod 1300 or to resist buckling of rod 1300. Use of retaining ring 1032 can also make the arrangement easy to manufacture and assemble. Firing member 1200 is configured to engage the anvil and retain the anvil a desired distance from the base of the cartridge, as firing member 1200 is driven from home position to end position. In this arrangement, for example, as the firing member 1200 moves distally down into the elongated channel 1020, the length of the portion of the anvil, which resembles a cantilever beam, becomes shorter and stiffer, thereby increasing , the magnitude of downward load occurring at the distal end of the elongated channel 1020, further increasing the bearing seat load.
[000269] One of the advantages of using rotating drive elements to trigger, close, rotate, etc. may include the ability to use the high mechanical advantage of the drive rod to accommodate the high loads required to perform these instrument tasks . However, when employing such rotary drive systems, it may be desirable to track the number of revolutions at which the drive rod is driven to prevent damage or catastrophic failure to the drive screw and other instrument components, in the case of the drive rod or component of trailing end actuator to be actuated a large distance in the distal direction. Thus, some systems that include swivel drive rods have in the past employed encoders to track engine speeds or sensors to monitor the axial position of the moving component. The use of encoders and/or sensors requires the need for additional wiring, electronics and processing power to accommodate such a system, which can increase instrument costs. Also, system reliability can be a little difficult to predict and its reliability depends on software and processors.
[000270] Figures 74 to 76 represent a mechanical stroke limiter system 1310 to limit the linear stroke of the firing member 1200 when the firing member 1200 is triggered from an initial position to an end position. Stroke limiter system 1310 employs an implement drive rod 1300’, whereby the threads 1308 on implement drive rod 1300’ do not extend to the distal end 1306 of the drive rod 1300’. For example, as seen in Figures 74 to 76, implement drive rod 1300' includes an unthreaded section 1309. Trigger member 1200 has a body portion 1202 with a series of internal threads 1204 that are adapted to threadably form an interface with the threads 1308 on the implement drive rod 1300', so that, as the implement drive rod 1300' is rotated in a first firing direction, the trigger 1200 is triggered in the distal direction "DD" until it contacts the unthreaded section 1309, at which point the trigger member 1200 stops its distal advance. That is, trigger member 1200 will advance distally until internal threads 1204 on trigger member 1200 disengage from threads 1308 on implement drive rod 1300’. Any additional rotation of implement drive rod 1300’ in the first direction will not result in further distal advancement of trigger member 1200. See, for example, Figure 75.
[000271] The illustrated exemplary mechanical stroke limiter system 1310 includes a distal pusher element 1312 that is configured to be contacted by trigger member 1200 after trigger member 1200 is advanced to the end of its distal stroke (i.e., the trigger member will no longer advance distally with the implement drive rod rotation in the first rotation direction). In the embodiment shown in Figures 74 to 76, for example, biasing element 1312 comprises a spring bundle 1314 which is positioned within elongated channel 1020, as shown. Figure 74 illustrates the bundle of springs 1314 before contact by the firing member 1200 and Figure 75 illustrates the bundle of springs 1314 in a compressed state after being contacted by the firing member 1200. When in this position, the bundle of springs 1314 serves to tilt trigger member 1200 in the proximal "PD" direction to allow internal threads 1204 on trigger member 1200 to re-engage implement drive rod 1300' when implement drive rod 1300' is rotated in a second retraction direction. As implement drive rod 1300’ is rotated in the second retract direction, trigger member 1200 retracts in the proximal direction. See Figure 76.
[000272] Figures 77 to 80 illustrate another stroke limiter system 1310'. Stroke limiter system 1310' employs a two-part implement drive rod 1300". In at least one form, for example, implement drive rod 1300" includes a proximal implement drive rod segment 1320 that has a socket 1324 on a distal end 1322 thereof, and a distal segment of the drive rod 1330 having a protrusion 1334 protruding from a proximal end 1332 thereof. Protrusion 1334 is sized and shaped to be received within socket 1324 such that threads 1326 on the proximal segment of drive rod 1320 cooperate with threads 1336 on the distal segment of drive rod 1330 to form a continuous drive thread 1340 As seen in Figures 77, 79 and 80, a distal end 1338 of the distal segment of drive rod 1330 extends through a thrust bearing 1032 that is movably supported on the distal end 1023 of elongated channel 1020. that is, thrust bearing 1032 is movable axially within elongated channel 1020. A distal biasing member 1342 is supported within elongated channel 1020 for contact with thrust bearing 1032. Figure 78 illustrates firing member 1200 which is driven in the distal direction "DD" when the 1300" implement drive rod is driven in a first direction of rotation. Figure 79 illustrates the trigger member 1200 at the distal end. such of its course. Further rotation of implement drive rod 1300" in the first direction of rotation causes thrust bearing 1032 to compress pusher element 1342 and also allows distal rod segment 1330 to slip if proximal segment 1320 continues to rotate. between the proximal and distal implement drive rod segments 1320, 1330 prevents the trigger member 1200 from being further advanced distally, which could ultimately damage the instrument. However, after the first rotary movement is discontinued , pusher element 1342 serves to tilt distal rod segment 1320 in the proximal direction so that protrusion 1334 is seated in socket 1324. Thereafter, rotation of implement rod 1300" in a second rotation direction results in movement of firing member 1200 in the proximal "PD" direction as shown in Figure 80.
[000273] Figure 81 illustrates another stroke limiter system 1310". In this embodiment, the implement drive rod 1300 has a protrusion 1350 formed therein that is sized and shaped to be received within a socket 1352 in the bearing segment 1304 which has implement drive gear 1302 formed in the same or otherwise attached thereto. Figures 81A and 81B illustrate different protrusions 1350' (Figure 81A) and 1350" (Figure 81B) that are configured to releasably engage corresponding sockets 1352' and 1352", respectively. Bundle of springs 1314 is positioned to be contacted by firing member 1200 after firing member 1200 has reached the end of its stroke. Additional rotation of implement drive rod 1300 will cause that the protrusion 1350, 1350', 1350" slide out of the socket 1352, 1352', 1352", respectively, to thus prevent further rotation of the implement rod 1300. When applying motion r Optional to implement drive rod 1300 is discontinued, spring bundle 1314 applies a tilting motion to trigger member 1200 to finally tilt implement drive rod 1300 in the proximal direction "PD" to seat the boss 1350 in socket 1352. Rotating implement drive rod 1300 in the second direction of rotation will result in retracting trigger member 1200 in the proximal direction "PD" to the home position. When firing member 1200 returns to home position, anvil 1100 can then be opened.
[000274] In the illustrated exemplary embodiment, the firing member 1200 is configured to engage the anvil 1100 when the firing member 1200 is driven distally through the end actuator to positively space the anvil from the staple cartridge to ensure that staples are properly formed, specifically when an amount of tissue is clamped that makes this spacing inadequate. Other forms of firing members which are configured to engage and space the staple cartridge anvil or elongated channel and which may be employed in this embodiment, and others are disclosed in US Patent No. 6,978,921 entitled "Surgical Stapling Instrument Incorporating an Ebeam Firing Mechanism", the description of which is incorporated herein by reference in its entirety. As can be seen in Figures 82 and 83, body portion 1202 of firing member 1200 includes a foot portion 1206 that upwardly engages channel slot 1028 in elongated channel 1020. See Figure 60. knife body includes a pair of laterally projecting upper fins 1208. When fired with anvil 1100 closed, upper fins 1208 advance distally into a longitudinal anvil slot 1103 that extends distally through anvil 1100. Any minimal deflection for anvil 1100. up on anvil 1100 is compensated by a downward force imparted by upper fins 1208.
[000275] In general, the loads required to close and advance the firing member, i.e. "firing" the firing member, could conceivably exceed 90.7 kg (200 pounds). Such strength requirements, however, may require the internal threads 1204 on the firing member to comprise relatively thin threads of a power-type thread configuration, such as Acme threads. Additionally, to provide sufficient support for the upper fins 1208 to prevent the firing member 1200 from snapping together as it is driven distally through the end actuator, it may be desirable that at least 5 to 15 threads on the firing member are engaged with the threads on the implement drive rod at a given time. However, conventional fabrication methods may be inadequate for forming sufficient threads in the body of firing member 1202 within an opening of 0.2 centimeter to 0.38 centimeter (0.08 inch to 0.150 inch) in diameter and with sufficient thread depth.
[000276] Figures 82 to 84 illustrate a 1200' firing member that contemplates at least some of the aforementioned challenges. As can be seen in these figures, the body portion 1202' of the firing member has a hollow rod socket 1210 extending therethrough which is sized to receive the implement rod therethrough. Internal threads in this embodiment are formed by a series of rods 1214 that extend transversely through holes 1212 in rod socket 1210, as shown. As seen in Figure 84, pins 1214 rest on the smaller pitch diameter of threads 1308 on implement drive rod 1300.
[000277] Figure 85 illustrates another 1200" firing member that can also address at least some of the manufacturing challenges discussed above. As can be seen from this figure, the 1202" body portion of the 100" firing member has a socket. hollow rod 1210 extending therethrough which is sized to receive the implement rod therethrough. A pair of apertures 1216 is formed in body portion 1202" as shown. Internal threads 1220 in this embodiment are formed into plugs 1218 which are inserted into openings 1216 and are secured thereto by welding, adhesive, etc. Figures 86 and 87 illustrate another firing member 1200", wherein access to the interior of socket 1210 is via access windows 1230A, 1230B formed in body portion 1202". For example, a pair of access windows 1230A is provided through one side of the socket portion 1210 to allow internal thread segments 1232 to be formed within the opposite wall of the socket 1210. Another access window 1230B is provided through the opposite side of the socket portion 1210, so that a central internal thread segment 1234 can be formed on the opposite wall between internal thread segments 1232. Thread segments 1232, 1234 cooperate to threadably engage threads 1308 on the drive rod of implement 1300.
[000278] End actuator 1000 is configured to detachably support a 1040 staple cartridge therein. See Figure 60. The staple cartridge 1040 includes a cartridge body 1042 that is configured to be operatively seated with the elongated channel 1020. The cartridge body 1042 has an elongated slot 1046 therein to accommodate the firing member 1200. of cartridge 1042 further defines an upper surface designated herein as cartridge base 1044. In addition, two rows of staggered clip apertures 1048 are provided on each side of elongated slot 1046. Clip apertures 1048 operatively support clip drivers corresponding 1050s that support one or two surgical clips (not shown) therein. A variety of such clamp driver arrangements are known and can be employed without departing from the character and scope of the various exemplary embodiments of the invention.
[000279] The firing member arrangements also employ a triangular slide support assembly 1250 to actuate contact with the staple drivers operatively supported within the staple cartridge 1040. As seen in Figure 60, the triangular slide support assembly 1250 includes at least two wedges 1252 that are oriented to engage contact with lines of staple drivers operatively supported within staple cartridge 1040. As firing member 1200 is actuated distally, the triangular slide holder assembly 1250 moves with firing member 1220 and wedges 1252 therein force drivers 1050 upwards toward closed anvil 1100. As drivers 1050 are driven upward, surgical clips supported thereon are driven out of their respective openings 1048 for forming contact with the clamp forming surface 1104 of the closed anvil 1100.
[000280] Several exemplary end actuator embodiments disclosed herein may also employ a unique and innovative firing lock arrangement that will prevent the physician from inadvertently advancing or "firing" the firing member when a cartridge is not present, a cartridge has not been properly seated inside the end actuator and/or when a used cartridge remains installed in the end actuator. For example, as will be discussed in more detail below, the trigger lock arrangement may interact with implement drive rod 1300 and/or trigger member 1200 to prevent accidental advancement of trigger member 1200 when one of the conditions mentioned above.
[000281] In the illustrated exemplary mode, rotation of the implement drive rod 1300 in a first rotational or "trigger" direction will cause the trigger member 1200 to be driven distally through the staple cartridge 1040, if the shot 1200 is correctly aligned with elongated slot 1046 in cartridge body 1042 (Figure 60), channel slot 1028 in elongated channel 1020, and anvil slot 1103 in anvil 1100, for example. Referring primarily to Figure 90, elongated slot 1046, channel slot 1028 and/or anvil slot 1103 can guide firing member 1200 as it moves along the path through surgical end actuator 1000 , for example, during a firing blow. When firing member 1200 is in the operational configuration, channel slot 1028 is configured to receive foot portion 1206 of firing member 1200 and anvil slot 1103 is configured to receive upper fins 1208 of firing member 1200, for example. When a portion of firing member 1200 is positioned in channel slot 1028 and/or anvil slot 1103, firing member 1200 may be aligned or substantially aligned with axis A. Channel slot 1028 and/or a anvil slot 1103 can guide the firing member 1200 and maintain the alignment of the firing member 1200 with the axis A as the firing member 1200 moves from the initial position to the secondary position with respect to the cartridge body 1042. for example.
[000282] As discussed briefly above, in several surgical staple cartridge examples, surgical staples are supported on movable staple drivers supported on the cartridge body. Several exemplary end actuator embodiments employ a 1250 triangular slide support assembly that is configured to contact the staple drivers when the triangular slide support assembly is driven distally through the staple cartridge to drive the clips out of their respective cavities in the cartridge body and to forming contact with the closed anvil. In at least one exemplary embodiment, triangular slide holder 1250 is positioned within staple cartridge 1040. In this way, each new staple cartridge 1040 has its own triangular slide holder operatively supported thereon. When the clinician properly inserts a new staple cartridge 1040 into the elongated channel, the triangular slide holder 1250 is configured to frame implement drive rod 1300 and engage firing member 1200 in the manner illustrated in Figures 60, 88 and 89, by example. As can be seen in these figures, the exemplary triangular slide support assembly 1250 may comprise a slide support body 1414, a flange 1410, and wedges 1252. The slide support body 1414 can be positioned around a portion of the drive rod of implement 1300, when the triangular slide support assembly 1250 is positioned in the elongated channel 1020. The slide support body 1414 can be structured so that the slide support body 1414 prevents contact with the implement drive rod 1300 when the body Sliding support body 1414 is positioned around implement drive rod 1300. Sliding support body 1414 may comprise an outline 1412, for example, that curves over and/or around implement drive rod 1300. embodiment, for example, a flange 1410 extends between the sliding support body 1414 and each of the wedges 1252. ante 1414 has a notch 1415 therein which is configured to receive a portion of firing member body 1203. Referring primarily to Figure 89, flange 1410 may extend substantially parallel to foot portion 1206 of firing member 1200 when firing member 1200 engages triangular slide bracket assembly 1250.
[000283] After a new staple cartridge 1040 is properly installed in the elongated channel 1020, the initial actuation of the firing member 1200 (for example, upon rotation of the implement drive rod 1300) causes a portion of the body to firing member 1203 enters notch 1415 in triangular slide holder 1250, which thus results in alignment of firing member 1200 with elongated slot 1046 in cartridge body 1042 (Figure 60), channel slot 1028 in elongated channel 1020 and the anvil slot 1103 in the anvil 1100 to allow the firing member 1250 to be advanced distally through the staple cartridge 1040. Therefore, the triangular slide holder may also be referred to herein as an "alignment element". If the staple cartridge 1040 has been improperly installed in the elongated channel, activation of firing member 1200 will not result in engagement aligned with notch 1415 in triangular slide holder 1250, and firing member 1200 will remain out of alignment with the slot. of channel 1028 in elongated channel 1020 and anvil slot 1103 in anvil 1100, to thereby prevent firing member 1250 from being fired.
[000284] After a new staple cartridge 1040 is properly installed in the elongated channel 1020, the physician fires the firing member by applying a first rotary motion to the implement drive rod 1300. After the firing member 1250 is driven distally through the 1250 staple cartridge to its most distal position, a reverse swivel is applied to the implement drive rod 1300 to return the trigger member 1250 to its home position external to the 1040 surgical staple cartridge for the used cartridge is removed from the elongated channel 1020 and a new staple cartridge is installed in it. As firing member 1250 returns to its home position, triangular slide holder 1250 remains at the distal end of the staple cartridge and does not return with firing member 1200. Thus, as firing member 1200 moves proximally outward of the staple cartridge 1040 and anvil slot 1103 in the anvil, the pivotal movement of implement drive rod 1300 causes firing member 1200 to rotate slightly in a non-operating position. That is, when the firing member 1200 is in the non-operational position (outside of the cartridge), in case the physician removes the used cartridge 1040 and fails to replace it with a new cartridge that contains a new triangular slide holder 1250 and, then, closing anvil 1110 and attempting to fire firing member 1200, as there is no triangular slide bracket present to align firing member 1200, firing member 1200 will not be able to advance distally through elongated channel 1020. prevents clinician from inadvertently firing firing member 1200 when no cartridge is installed.
[000285] In such an exemplary embodiment, the firing member 1200 can be substantially aligned with a geometric axis A, when the firing member 1200 is oriented in an operational configuration such that the firing member 1200 can move along a trajectory set through end actuator 1000. The axis A may be substantially perpendicular to the staple forming surface 1104 of the anvil 1100 and/or the cartridge base 1044 of the staple cartridge 1040 (Figure 60). In other exemplary embodiments, axis A may be angularly oriented with respect to staple forming surface 1104 of anvil 1100 and/or cartridge base 1044 of staple cartridge 1040. Additionally, in at least one exemplary embodiment, axis axis A may extend through the center of surgical end actuator 1000 and, in other exemplary embodiments, axis A may be positioned on either side of the center of surgical end actuator 1000.
[000286] Figures 91 to 97 illustrate an exemplary form of a surgical end actuator 1400 that employs a unique and innovative trigger lock arrangement. As can be seen in Figures 91 to 95, when trigger member 1200 is in the home position, trigger member 1200 is in a non-operational configuration that prevents its distal advancement through the end actuator due to misalignment of the trigger member. 1200 with channel slot 1028 and anvil slot 1103. Trigger member 1200 may be held in non-operational configuration by a trigger lock, generally designated 1418. Referring primarily to Figures 91 to 93, in at least one form, for example, the firing lock 1418 includes a first locking notch or groove 1402 that is formed in the elongated channel 1020. In other exemplary embodiments, however, the first locking notch 1402 may form an opening in the first jaw 1004 at the second jaw 1006, elongated channel 1020 and/or anvil 1100, for example. In several exemplary embodiments, first locking notch 1402 is located on surgical end actuator 1400 such that first locking notch 1402 retentively engages a portion of firing member 1200 when firing member 1200 is in the non-operational configuration. . First locking notch 1402 may be close to, adjacent to and/or connected to channel slot 1028 in elongated channel 1020, for example. Referring primarily to Figure 91, channel slit 1028 may have a slit width along its length. In at least one exemplary embodiment, first locking notch 1402 may extend from channel slot 1028 such that the combined width of channel slot 1028 and first locking notch 1402 exceeds the slot width of channel slot 1028. As can be seen in Figure 91, when firing member 1200 is in the non-operational configuration, foot portion 1206 of firing member 1200 extends into first locking notch 1402 to thus prevent its accidental distal advancement. through the elongated channel 1020.
[000287] After a new staple cartridge 1040 is properly installed in the elongated channel 1020, the initiation of the firing stroke causes the firing member to engage the triangular slide holder 1250 positioned within the staple cartridge 1040, which moves the firing member 1200 for actuated alignment with elongated slit 1046 in cartridge body 1042, channel slit 1028 in elongated channel 1020 and anvil slit 1103 in anvil 1100 to allow firing member 1250 to be distally advanced through the same. As firing member 1200 moves from the home position to the secondary position with respect to staple cartridge 1040, firing member 1200 may move past the first locking notch 1402, for example. The first locking notch 1402 may have a length of approximately 0.64 centimeters (0.25 inches), for example. In some other exemplary embodiments, the first locking notch 1402 may have a length from approximately 0.38 centimeter (0.15 inch) to approximately 0.64 centimeter (0.25 inch), for example, or from approximately 0.64 centimeter (0.25 inch) to approximately 2.5 centimeters (1.0 inch), for example.
[000288] Referring primarily to Figures 93 and 94, the surgical end actuator 1400 can be structured to accommodate the upper fins 1208 of the triggering member 1200 when the triggering member 1200 is in the non-operating configuration. For example, firing lock 1418 may include a second locking groove or notch 1404 in anvil 1100. In the illustrated exemplary embodiment, for example, second locking notch 1404 may be close to, adjacent to and/or connected to the slot of anvil 1103 on anvil 1100, for example. Anvil slot 1103 may have a slot width along its length. In at least one exemplary embodiment, second locking notch 1404 may extend from anvil slot 1103 such that the combined width of anvil slot 1103 and second locking notch 1404 exceeds the anvil slot slot width. 1103. Second locking notch 1404 may extend a length or distance in surgical end actuator 1400. Trigger member 1200 may be structured to engage second locking notch 1404 along its length thereof, as the member trigger 1200 is in non-operational setting. As firing member 1200 moves from the home position to the secondary position with respect to the staple cartridge 1040, the firing member 1200 may move past the second locking notch 1404, for example. The second locking notch 1404 may have a length of approximately 0.64 centimeters (0.25 inches), for example. In some other exemplary embodiments, the second locking notch 1404 may be from approximately 0.38 centimeters (0.15 inches) to approximately 0.64 centimeters (0.25 inches), for example, or from approximately 0 .64 centimeters (0.25 inches) to approximately 2.5 centimeters (1.0 inches), for example. Referring primarily to Figure 93, first locking notch 1402 may extend from channel slot 1028 in a first X direction and second locking notch 1404 may extend from anvil slot 1103 in a second Y direction. In at least one exemplary embodiment, the first X direction may be substantially laterally opposed to the second Y direction. In such exemplary embodiments, foot portion 1206 of firing member 1200 may revolve in first locking notch 1402 and upper fins 1208 of firing member 1200 may revolve in second locking notch 1404 when firing member 1200 moves to the non-operational configuration.
[000289] Referring primarily to Figures 92 to 94, when the firing member 1200 is oriented in the non-operational configuration, the corresponding portions of the firing member 1200 engage the first and second locking notches 1402, 1404. The firing member 1200 may be positioned at least partially within the first and second locking notches 1402, 1404 when firing member 1200 is in the non-operational configuration. Firing member 1200 may move to the first and second locking notches 1402, 1404 when firing member 1200 moves to the non-operational configuration. Additionally, when firing member 1200 is oriented in the operational configuration, firing member 1200 can disengage first and second locking notches 1402, 1404.
[000290] A portion or portions of the surgical end actuator 1400 may block the trigger member 1200 and limit or prevent movement of the trigger member 1200 through the surgical end actuator 1400 when the trigger member 1200 is oriented in the non-operating configuration (See, for example, Figure 95). For example, first jaw 1004, second jaw 1006, elongated channel 1020 and/or anvil 1100 can be configured to lock firing member 1200 when it is in the operational configuration. In some exemplary embodiments, first locking notch 1402 has a first locking edge or surface 1406 (Figures 91 and 92) formed therein, and second locking notch 1404 has a second locking edge or surface 1408 formed therein ( Figure 94). Attempts to fire firing member 1200 while firing member 1200 is in the non-operational configuration will result in corresponding portions of firing member 1200 contacting one of the first or second locking surface 1406, 1408 to prevent the firing member 1200 from moving from the home position towards the secondary positions. In at least one exemplary embodiment, surgical end actuator 1400 need not have both first locking edge 1406 and second locking edge 1408.
[000291] Figures 97 to 104 illustrate another exemplary modality of surgical end actuator 1500 that employs another exemplary firing lockout arrangement. For example, as can be seen in these figures, a surgical end actuator 1500 may comprise elongated channel 1020, implement drive rod 1300 and trigger member 1200. Surgical end actuator 1500 may also comprise a gearbox of the end actuator 1510 (see, for example, Figure 100). Similar to the end actuator drive housing 1010 described herein, the end actuator drive housing 1510 may comprise a bushing bearing 1511 and the third rack or housing drive element 768. The bushing bearing 1511 can be structured so that bearing segment 1304 of implement drive rod 1300 can be movably positioned on bushing bearing 1511. Bearing segment 1304 can move on bushing bearing 1511 as the drive rod 1300 implement moves between a non-operating position and an operating position as described in this document. Bushing bearing 1511 may comprise a bore 1512 that has an elongated cross-section, such as, for example, a cross-sectional shape that comprises an oval shape, an ellipse, and/or semicircles that have longitudinal and/or parallel sides therebetween. . In such exemplary embodiments, bearing segment 1304 may be positioned against or near a first side of bore 1512, such as a first semicircle, when implement drive rod 1300 is in the non-operating position. Additionally, bearing segment 1304 may be positioned against or near a second side of bore 1512, such as a second semicircle, when implement drive rod 1300 is in the operating position.
[000292] Implement drive rod 1300 can be movable between the non-operating position and the operating position. As described in the present invention, a pusher member 1520 and/or a portion of the staple cartridge 1040 can move the implement drive rod 1300 between the non-operating position and the operating position, for example. In the illustrated and other embodiments, the implement drive gear 1302 of the implement drive rod 1300 can be engaged with the third rack 768 of the end actuator drive box 1510 when the implement drive rod 1300 is in the operational position. Implement drive gear 1302 can be an outer gear, for example, and the third rack 768 can be an inner gear, for example. Implement drive gear 1302 can move into engagement with third rack 768 when implement drive rod 1300 moves from the non-operating position to the operating position. Additionally, implement drive gear 1302 can be disengaged from third rack 768 when implement drive rod 1300 is in the non-operating position. In at least one exemplary embodiment, implement drive gear 1302 may move out of engagement with third rack 768 when implement drive rod 1300 moves from the operating position to the non-operating position. Similar to other exemplary embodiments described herein, when implement drive rod 1300 is engaged with third rack 768 in end actuator drive housing 1510, drive system 750 (Figure 61) can drive trigger member 1200 through elongated channel 1020 of surgical end actuator 1500, for example, during a firing stroke.
[000293] Referring mainly to Figures 101 and 102, the bearing segment 1304 can be positioned against the first side of the hole 1512 of the bushing bearing 1511, when the implement drive rod 1300 is in the non-operating position. A retaining pin 1514 (Figures 98, 100, 101 and 103) can be structured to tilt bearing segment 1304 against the first side of hole 1512 so that implement drive rod 1300 is held in the non-operating position, by for example, and implement drive gear 1302 is held out of engagement with third rack 768, for example. In some exemplary embodiments, detent 1514 may be spring activated so that detent 1514 exerts a force on bearing segment 1304 to move implement drive rod 1300 toward the non-operating position. Implement drive rod 1300 may remain in the non-operating position until another force overcomes the force exerted by retaining pin 1514 to move implement drive rod 1300 towards the operating position, for example, and implement drive gear 1302 for coupling with the third rack 768, for example.
[000294] Referring mainly to Figures 103 and 104, the bearing segment 1304 can be positioned against the second side of the hole 1512 of the bushing bearing 1511, when the implement drive rod 1300 is in the operating position. In several exemplary embodiments, the force exerted by retaining pin 1514 (Figures 98, 100, 101, and 103) can be overcome to move bearing segment 1304 against the second side of hole 1512 so that implement drive rod 1300 is in the operating position, for example, and implement drive gear 1302 is engaged with third rack 768, for example. As described in the present invention, the biasing member 1520 can exert a force on the bearing segment 1304 that overcomes the force exerted by the retaining pin 1515, for example.
[000295] The surgical end actuator 1500 may comprise the pusher element 1520, which can be movable between a first set of positions (see, for example, Figure 103) and a second set of positions (see, for example, the Figure 101). The second set of positions may be distal to the first set of positions with respect to the end actuator drive housing 1510. When pusher element 1520 is in the first set of positions, pusher element 1520 can be structured to move the drive rod of implement 1300 to operational position, for example. When pusher element 1520 is in the second set of positions, pusher element 1520 can release implement drive rod 1300 so that implement drive rod can return to the non-operating position, for example.
[000296] The pusher element 1520 can be an independent element that can be positioned on the surgical end actuator 1500. The pusher element 1520 can be movably retained in the surgical end actuator 1500, for example, and can be operatively engageable with the 1040 staple cartridge, for example. Staple cartridge 1040 may comprise presser member 1520. In some exemplary embodiments, presser member 1520 may be integrally formed with triangular slide holder assembly 1250 of staple cartridge 1040, for example, and presser member 1520 may be retained. movably in the staple cartridge 1040, for example. In such exemplary embodiments, pressure member 1520 may move through elongated channel 1020 as triangular slide support assembly 1250 and/or firing member 1200 move through elongated channel 1020, e.g., during a stroke. shooting.
[000297] Referring primarily to Figure 99, the pusher element 1520 may comprise a tilt body 1522 and legs 1526 extending from the tilt body 1522. The tilt body 1522 can be positioned around a portion of the rod of implement drive 1300 on surgical end actuator 1500. In some exemplary embodiments, tilt body 1522 may be structured so that tilt body 1522 avoids contact with implement drive rod 1300 when tilt body 1522 is positioned around implement drive rod 1300. Tilt body 1522 may comprise a contour 1524, for example, that curves over and/or around implement drive rod 1300. Legs 1526 may extend along of a portion of elongated channel 1020 and/or on either side of implement drive rod 1300. Pressing element 1520 may also comprise at least one. an extension or wedge 1528. As described in the present invention, wedge 1528 can movably engage bush bearing 1511 and/or bearing segment 1304 to move the implement drive rod into the operating position. Pressing element 1520 may also comprise at least one spring 1530. Spring 1530 may be deformable between an initial configuration (Figure 101) and deformed configurations (Figure 103), for example. Spring 1530 can retain biasing element 1520 in the first set of positions relative to end actuator drive housing 1510 until a force deforms spring 1530 from the initial configuration to a deformed configuration. When spring 1530 moves from the initial configuration to the deformed configuration, the biasing element 1520 can move from the second set of positions to the first set of positions with respect to the drive housing of the end actuator 1510.
[000298] Referring primarily to Figure 101, prior to inserting the staple cartridge 1040 (Figure 103) into the elongated channel 1020, the spring 1530 may be in the initial configuration, for example, and the pressing element 1520 may be in the second set of positions, for example. Detent pin 1514 may retain bearing segment 1304 against the first side of bore 1512, for example. In such exemplary embodiments, implement drive rod 1300 may be held in the non-operating position by retaining pin 1514.
[000299] Now referring to Figure 103, installation of the staple cartridge 1040 in the elongated channel 1020 moves the biasing member 1520 proximally against the force of the springs 1530 to a first set of positions, where the wedge 1528 engages movably sleeve bearing 1511 and bearing segment 1304 to tilt bearing segment 1304 and implement drive gear 1302 of implement drive rod 1300 to meshed engagement with third rack 768. After that, actuation of the firing drive system, as described in the present invention, will result in firing of firing member 1200. In some exemplary embodiments, a portion of staple cartridge 1040 is configured to directly contact presser element 1520 to move presser element 1520 for the first set of positions. In other exemplary embodiments, a portion of staple cartridge 1040 is configured to contact another element in surgical end actuator 1500, such as trigger member 1200, to operatively move pusher element 1520 to the first set of positions. . In still other exemplary embodiments, staple cartridge 1040 has presser member 1520 integrally formed therewith.
[000300] In several exemplary embodiments, the pusher element 1520 can move through the elongated channel 1020 of the surgical end actuator 1500 as the trigger member 1200 and/or the triangular slide support assembly 1250 are driven through the elongated channel. 1020 by implement drive rod 1300, for example, during a firing stroke, as described in the present invention. Presser member 1520 may be integrally formed with and/or secured to triangular slide support assembly 1250 of staple cartridge 1040. In such exemplary embodiments, when staple cartridge 1040 is initially seated in elongated channel 1020, the slide support assembly triangular 1250 and presser element 1520 may be positioned in a home position relative to staple cartridge 1040 and/or elongate channel 1020. The initial position of presser element 1520 may correspond to the first set of positions such that presser element 1520 movably engages bushing bearing 1511 of end actuator drive housing 1510 to move implement drive rod 1300 into operating position, as described in the present invention. During the firing stroke, the triangular slide support assembly 1250 and the pusher member 1520 can be moved away from the first set or initial set of positions, for example. Pusher element 1520 can move to the second set of positions, for example. When pusher element 1520 moves past the first set of positions and into the second set of positions, pusher element 1520 can no longer engage bushing bearing 1511 of end actuator drive housing 1510 to keep the drive rod from implement 1300 in operational configuration. Although pusher element 1520 cannot tilt implement drive gear 1302 of implement drive rod 1300 into engagement with third rack 768, when pusher element 1520 moves to the second set of positions, channel slot 1028 , anvil slot 1103 and/or elongated slot 1046 in staple cartridge 1040 serve to guide trigger member 1200 in a trigger orientation that retains implement drive gear 1302 of implement drive rod 1300 in meshed engagement with the third rack 768 and thus prevents the implement drive rod 1300 from returning to the non-operating position during the firing stroke.
[000301] In at least one exemplary modality, the firing member 1200 and/or the implement drive rod 1300 can drive the triangular sliding support set 1250 and/or the pressing element 1520 for the second set of positions during the stroke shooting. In several exemplary embodiments, after the firing stroke is completed, the firing member 1200 may return to the initial position, however, the triangular slide support assembly 1250, including the presser member 1520, may remain in the second set of positions, by example. Trigger member 1200 may return to a proximal position on surgical end actuator 1500, for example, and pusher element 1520 may remain in a distal position on surgical end actuator 1500, for example. When the trigger member 1200 is in the home position and the pusher element 1520 is in the second set of positions, the bearing segment 1304 of the implement drive rod 1300 can move in the bush bearing 1511 so that the drive rod moves. implement 1300 moves to the non-operating position, for example, and implement drive gear 1302 moves out of engagement with third rack 768, for example. In several exemplary modes, implement drive rod 1300 may remain in the non-operating position until pusher element 1520 retracts to the first set of positions and/or until a replacement pusher element 1520 is positioned on the first set of positions, for example. For example, used staple cartridge 1040 is removed from elongated channel 1020 and replaced with a replacement staple cartridge 1040, which may comprise a press element 1520 located in its first positions. When replacement staple cartridge 1040 is positioned in elongated channel 1020, pusher member 1520 thereof moves implement drive gear 1302 into engagement with third rack 768, for example, and into operating position, for example. . In such exemplary embodiments, surgical end actuator 1500 can be prevented from being fired again when no cartridge 1040 or a used cartridge 1040 is seated in elongated channel 1020. Also, if the staple cartridge has not been properly seated in elongated channel 1020 so that pusher element 1520 has not moved implement drive rod 1300 into meshed engagement with third rack 768, firing member 1200 cannot be fired.
[000302] As described above, a surgical instrument system can include a surgical box, replaceable end actuator assemblies that can be connected to the surgical box for use during a surgical practice and then disconnected from the box after they have been used, and a motor and/or an actuator configured to trigger the tip actuator. In a variety of circumstances, a surgeon can choose from a number of different replaceable tip actuators for use during a surgical procedure. For example, a surgeon may first select a first replaceable end actuator configured to staple and/or make an incision in a patient's tissue that includes a staple cartridge length of approximately 15 millimeters ("mm"), for example , to make a first cut in the patient's tissue. In such an embodiment, a cutting blade and/or a sliding staple drive holder can be advanced along the approximately 15mm length of the staple cartridge by a driving screw, in order to cut and staple approximately 15mm of fabric from patient. The surgeon can then select a second replaceable end actuator, also configured to staple and/or make a patient tissue incision, which may include a staple cartridge length of approximately 30 mm to make a second cut in the tissue from the patient. In such an embodiment, a cutting blade and/or a sliding staple drive holder can be advanced along the approximately 30mm length of the staple cartridge by a drive screw in order to cut and staple approximately 30mm of fabric from the patient. The surgeon may also select a replaceable end actuator configured to staple and/or make an incision in patient tissue that includes a staple cartridge length of approximately 45 mm to make an incision in the patient tissue. In such an embodiment, a cutting blade and/or a sliding staple drive holder can be advanced along the approximately 45mm length of the staple cartridge by a drive screw in order to cut and staple approximately 45mm of fabric from the patient. The surgeon can also select a replaceable end actuator, which can also be configured to staple and/or make an incision in patient tissue, and includes a staple cartridge length of approximately 60 mm, to make a cut in patient tissue. . In such an embodiment, a cutting blade and/or a sliding staple drive holder can be advanced along the approximately 60mm length of the staple cartridge by a drive screw in order to cut and staple approximately 60mm of fabric from the patient. The 15mm, 30mm, 45mm and/or 60mm lengths of the end actuators discussed above are exemplary. Other lengths can be used. In certain embodiments, a first end actuator may include a staple cartridge having a length of x, a second end actuator may include a staple cartridge having a length of approximately 2*x, a third end actuator may include a staple cartridge that is approximately 3*x in length, and a fourth end actuator may include a staple cartridge that is approximately 4*x in length, for example.
[000303] In some surgical instrument systems that use replaceable end actuators that have different lengths, the drive screws on each of the different replaceable end actuators may be identical, except that the length of each drive screw may be different to accommodate the different length of the associated replaceable end actuator. For example, a replaceable end actuator comprising a 30 mm staple cartridge may require a drive screw that is longer than the drive screw of a replaceable end actuator comprising a 15 mm staple cartridge. In each case of such surgical instrument systems, however, each drive screw using the same thread pitch and/or thread, described in more detail below, may require the motor to rotate the drive rod a different number of revolutions. , depending on the length of the end actuator that is used for each end actuator to be fully tripped. For example, a drive screw that delivers a 30 mm firing stroke may require twice as many revolutions to fully actuate as compared to a drive screw that delivers a 15 mm firing stroke. In such surgical instrument systems, electronic communication between the surgical box and the replaceable end actuator can be used to ensure that the electric motor in the surgical box rotates a correct number of revolutions for the length of the fixed replaceable end actuator. For example, a replaceable end actuator may include an electronic circuit that can be identified by the surgical instrument system so that the surgical instrument system can rotate the motor a correct number of revolutions for the attached end actuator. In addition to or in place of the above, the replaceable end actuator may include a sensor that detects when an end actuator has been fully actuated. In such a mode the sensor may be in signal communication with an in-box controller configured to stop the motor when the proper signal is received. While adequate for its intended purposes, such electronic communication between the surgical box and the replaceable end actuator can add to the complexity and/or cost of such surgical instrument systems.
[000304] As described above, the extremity actuator having different lengths can be used in the same surgical instrument system. In the surgical instrument systems described above, replaceable end actuators that have different trigger lengths include drive screws that rotate a different number of times to accommodate the different trigger lengths. In order to accommodate the different number of revolutions required for different drive screws, the motor driving the drive screw is operated for a longer or shorter time, and/or a greater number of revolutions or a smaller number of revolutions, depending on whether it is Longer trigger length or shorter trigger length required. The replaceable end actuator modalities described below enable a surgical instrument system comprising a motor configured to rotate a defined or fixed number of revolutions to drive end actuators with different firing lengths. Operating the motor at a fixed number of revolutions can eliminate the need for the surgical instrument system to identify the length of the end actuator. Each end actuator in the embodiments described below includes a drive screw with a thread pitch and/or thread that allows an actuating portion of an end actuator, such as a cutting blade, for example, to travel the entire length. of a particular end actuator in the fixed number of engine revolutions.
[000305] Referring to Figure 105, a 1700 drive screw can be turned in a first direction to move a 1730 cutter blade of a 1740 end actuator in a distal direction indicated by arrow E. In use, the 1700 drive screw can be rotated a set or fixed number of times to advance cutter blade 1730 to a full firing length, indicated by length L in Figure 105. For each revolution of drive screw 1700, in certain embodiments, cutter blade 1730 can be moved in the direction of arrow E by an amount equal to the thread pitch, thread, and/or distance between adjacent turns of thread 1708 in driver screw 1700, as described in more detail below. In various embodiments, a first drive screw can include a first set of features that define a first shot length, while a second drive screw can include a second set of features that define a second shot length, wherein the first set of features may be different from the second set of features.
[000306] Now with reference to Figures 106A, 107, 108A and 109A, in addition to the above mentioned, the distance between thread turns on a drive screw can be proportional to the angle of threads on the drive screw. In other words, the angle at which the threads are disposed on a drive screw can be a characteristic of a drive screw which defines the lead screw pitch and/or thread. A longer lead screw for use on a longer end actuator may use a larger thread pitch and/or thread than a shorter lead screw for use on a shorter end actuator, in modes where the drive screws, and a motor that drives the drive screws, rotate a fixed number of revolutions. The drive screw 1700 in Figure 106A includes a single thread A disposed at an angle α with respect to the longitudinal axis 1701 in the drive screw 1700, where thread A defines a thread pitch and/or thread having a length X. A Figure 106B shows a cross-sectional view of the driver screw 1700 and the single thread A. In certain embodiments, the driver screw 1700 may include more than one thread, as described more fully below.
[000307] Figure 107A shows a 1700’ driver screw that may include a first thread A’ and a second thread B’. Figure 107B shows a cross-sectional view of the 1700’ drive screw, where the first thread A’ and the second thread B’ are positioned approximately 180° out of phase with each other on the 1700’ drive screw. In various embodiments, a drive screw with a first thread A’ and a second thread B’ can increase the number of threads per unit length, compared to a drive screw that uses a single thread A’ or B’. In the case where a drive screw includes more than one thread, the distance of one turn of a first thread to an adjacent turn of a second thread is called a "thread pitch". The distance from one turn of a thread to the next turn of the same thread is called the "thread thread". For a drive screw with a single thread, the thread pitch and thread are the same. For example, and with reference to Figure 107A, the distance of one turn of thread A’ to an adjacent turn of thread B’ defines the lead screw thread pitch 1700’. The distance of one turn of thread A’ to the next turn of thread A’ defines the lead screw thread 1700’. Thus, the lead screw thread 1700’ in Figure 107A is equal to X’ and the thread pitch is equal to X’/2. The driver screw 1700 shown in Figures 106A and 106B has a single thread, and therefore the pitch and thread are both equal to X. stop, such as a 1730 cutter blade and/or staple driver, for example, will travel during a single revolution of the drive screw.
[000308] Again with reference to Figure 107A, the first thread A' and the second thread B' are each disposed at an angle β with respect to the longitudinal axis 1701 of the driving screw 1700'. Angle β is less than angle α and the lead screw X’ of the 1700’ drive screw in Figure 107A is larger than the X thread of the 1700 drive screw shown in Figure 106A. For a single rotation of the 1700’ drive screw, a cutter blade will move an X’ length along the 1700’ drive screw. For example, the thread X' may be twice the thread pitch or thread X of the driver screw 1700 shown in Figure 106A, where, as a result, a cutting blade is engaged with the driver screw. 1700' of Figure 107A will move twice the distance during a single revolution of drive screw 1700', as would a cutter blade engaged with drive screw 1700 of Figure 106A.
[000309] Figure 108A shows a 1700'' drive screw that may include a first thread A'', a second thread B'', and a third thread C'', each extending at an angle Y with respect to the axis. length 1701 of the 1700'' drive screw. Figure 108B is a cross-sectional view of the 1700’’ driver screw and shows threads A’’, B’’ and C’’ arranged approximately 120° out of phase. Angle y is smaller than angle β in Figure 107A and the lead screw X’’ of the 1700’’ lead screw in Figure 108A is larger than the X’ thread of the 1700’ lead screw shown in Figure 107A. Similarly, Figure 109A shows a driving screw 1700''' which may include a first thread A''', a second thread B''', a third thread C''' and a fourth thread D''', each of which extends at an angle δ with respect to the longitudinal axis Z of the drive screw 1700'''. Figure 109B is a cross-sectional view of the 1700’’' drive screw and shows the threads arranged approximately 90° out of phase. Angle δ is smaller than angle Y and lead screw X’’’ of drive screw 1700’’’ greater than that of drive screw 1700’’ in Figure 108A.
[000310] An exemplary surgical instrument system may include a housing and a motor in the housing configured to rotate a fixed number of revolutions which results in a drive screw of a connected replaceable end actuator rotating 30 revolutions, for example. The surgical instrument system may additionally include a plurality of replaceable surgical stapler end actuators, each of the end actuators may include a cutting blade and/or staple driver actuated by the drive screw, per example. In at least one such embodiment, a replaceable first end actuator may include a staple cartridge having a length of 15 mm, for example. The 1700 Trigger Screw shown in Figures 2A and 2B can be used on the first replaceable end actuator. Thread X can be set to 0.5mm, for example, so that the cutter blade and/or staple driver can travel the 15mm length of the staple cartridge in the 30 revolutions of the 1700 drive screw. A second replaceable end actuator may include a staple cartridge that has a length of 30 mm, for example, and a drive screw, such as the drive screw 1700'' illustrated in Figures 107A and 107B, for example. The 1700' drive screw X' thread can be set to 1.0 mm, for example, so that the cutter blade and/or staple driver can travel the 30 mm length of the staple cartridge at 30 mm. 1700' drive screw revolutions. Similarly, a replaceable third end actuator with a staple cartridge that has a length of 45 mm, for example, may include a drive screw, such as the 1700'' drive screw in Figures 108A and 108B, which has a thread of 1.5 mm X'' thread, for example, so that the cutting blade and/or staple driver travels the 45 mm length of the staple base in 30 revolutions of the 1700'' drive screw. A replaceable fourth end actuator with a staple cartridge that has a length of 60 mm, for example, may include a drive screw, such as the 1700''' drive screw in Figures 109A and 109B, which has a thread. 2.0 mm X''', for example, so that the cutting blade and/or staple driver travels the 60 mm length of the staple base in 30 revolutions of the 1700''' drive screw.
[000311] Figure 110 shows the 1730 cutter blade of Figure 105 removed from the remainder of the 1740 end actuator. The 1730 cutter blade includes a passage 1732 through which the drive screw 1700 passes. Side portions 1736 form inner walls of passage 1732 and may include recesses, such as grooves 1734, for example, which are configured to receive threads 1708 in drive screw 1700. Grooves 1734 are oriented at an angle ε that corresponds to the angle of the threads 1708 in driver screw 1700. For example, if threads 1708 are set to angle α, shown in Figure 106A, then the angle ε of grooves 1734 can also be set to angle α. Correspondingly, the angle ε of the grooves 1734 can be adjusted to the angles β, δ and/or Y, for example, of the corresponding drive screw used with them.
[000312] In various embodiments, as illustrated in the exploded view of Figure 110, the side portions 1736 may be mounted in apertures 1738 defined in a shank portion 1746 of the cutter blade 1730. In certain embodiments, a cutter blade 1730 may comprise integral side portions. In at least one embodiment, the side portions may comprise a suitable groove angle ε which corresponds to an angle of the threads 1708 in a drive screw 1700 which may be formed in the passage 1732 defined therein. Providing a 1730 cutting blade with a suitable groove angle ε for a particular drive screw can be accomplished in a number of ways. In certain embodiments, a generic cutting blade 1730 may be provided that does not include side portions 1736 mounted in the openings 1738 of the shank portion 1746 thereof, wherein several sets of side portions 1736 may be provided so that a desired set of portions 1736 sides can be selected from the various 1736 side portion sets and then mounted on the generic 1730 cutter blade so that such set can be used with a specific drive screw. For example, a first set of side portions 1736, when mounted on cutter blade 1730, can configure cutter blade 1730 for use with a first drive screw and second set of side portions 1736, when mounted on cutter blade 1730 , can configure the 1730 cutter blade to be used with a second drive screw, and so on. In certain other embodiments, a cutting blade 1730 may be provided with side portions formed integrally with it. In at least one such embodiment, the grooves 1734 may be formed, for example, with a valve, at the angle ε which corresponds to the angle of the threads 1708 of a particular drive screw 1700.
[000313] Figure 111 illustrates the drive screw 1700 coupled to a drive rod 1750 through an intermediate gear 1720 disposed between them. The 1750 drive rod is rotated by a motor. As described above, the motor can complete a fixed or defined number of revolutions and, as a result, the drive rod 1750 can rotate a fixed number of revolutions R. In certain embodiments, the number of revolutions R rotated by the drive rod 1750 can be equal to the fixed number of revolutions rotated by the engine. In alternative embodiments, the number of revolutions R rotated by the drive rod 1750 can be greater or less than the fixed number of revolutions rotated by the motor. In various embodiments, one or more gears disposed between the motor and the drive rod 1750 can cause the drive rod 1750 to complete more or fewer revolutions than the motor. In certain embodiments, drive rod 1750 may include an outer slotted gear 1752 that encircles and/or affixed to distal end 1754 of drive rod 1750. External slotted gear 1752 may engage an internal slotted gear 1724 defined in idler gear 1720a in order to transmit the rotation of drive rod 1750 to idler gear 1720. As a result, in at least one embodiment, idler gear 1720 can complete the same revolutions R as drive shaft 1750.
[000314] Idler gear 1720 may include a second gear 1722 which is engaged with a gear 1712 that surrounds and/or is secured to a proximal end 1702 of drive screw 1700. Second gear 1722 of idler gear 1720 defines a first diameter D1 and gear 1712 at proximal end 1702 of drive screw 1700 defines a second diameter D2. The second diameter D2 can be different from the first diameter D1. When the first diameter D1 and the second diameter D2 are different, they can define a gear ratio that is different from 1:1. As shown in Figure 111, in certain embodiments, diameter D1 can be larger than diameter D2 so that drive screw 1700 completes more revolutions R' than revolutions R rotated by drive rod 1750 and idler gear 1720. , diameter D1 can be smaller than diameter D2 so that drive screw 1700 turns less revolutions R' than revolutions R rotated by drive rod 1750 and idler gear 1720.
[000315] The gear ratio between the second gear 1722 of the idler gear 1720 and the gear 1712 of the drive screw 1700 can be set so that the drive screw 1700 completes a certain number of revolutions when the drive rod 1750 completes its fixed number of revolutions. If idler gear 1722 is part of the replaceable end actuator assembly, then the gear ratio between idler gear 1722 and drive screw 1700 in each replaceable end actuator assembly can be set so that the motor in the surgical box can rotate a fixed number of revolutions. For example, with reference to Figure 111, assuming the 1750 drive rod rotates 30 fixed revolutions and the replaceable surgical stapler includes a 15 mm staple cartridge and if the end actuator includes a drive screw with a thread of 0.25 mm thread, then the drive screw will complete 60 revolutions to advance a cutter blade and/or staple driver the 15 mm length of the staple cartridge. In at least one embodiment, idler gear 1720 can be sized so that second inner gear 1722 has a diameter D1 that is twice the diameter D2 of outer gear 1712 of drive screw 1700. As a result, drive screw 1700 will complete 60 revolutions when the 1750 drive rod completes 30 revolutions. If a second replaceable surgical stapler includes a 30 mm staple cartridge, then a drive screw with a 0.25 mm thread will complete 120 revolutions to advance a cutting blade and/or staple driver the length of 30 mm. The idler gear 1720 of the replaceable surgical stapler can be sized so that the second inner gear 1722 has a diameter D1 that is four times the diameter D2 of the outer gear 1712 of the drive screw 1700. As a result, the drive screw 1700 will complete 120 revolutions. when the 1750 drive rod completes 30 revolutions.
[000316] Again with reference to Fig. 105, in certain embodiments a firing trajectory of the firing member, e.g. cutting blade 1730, may be linear. In certain modalities, the firing trajectory can be curved and/or curvilinear. In certain embodiments, drive screw 1708 may be flexible to allow drive screw 1708 to follow lateral movements of the firing member along a curved and/or curvilinear path, for example. In certain embodiments, the trigger member may be flexible or may include at least one flexible portion to allow portions of the trigger member to move laterally relative to drive screw 1708, e.g., along a curved and/or curvilinear path , while the remaining portions of the firing member are not displaced laterally relative to the drive screw 1708. In certain embodiments, the firing length can be defined by the distance moved by the firing member along the firing path, regardless of the total net displacement . In various embodiments, the firing length can be defined by the total net displacement of the firing member, regardless of the firing path.
[000317] In several embodiments, a kit can be provided for use with a surgical instrument system that includes a number of replaceable end actuators that are of different lengths. In certain embodiments, the kit may include a selection of replaceable end actuators that are different lengths from which a surgeon may choose for use in a surgical operation on a patient. The kit can also include multiple replaceable end actuators of each length. In certain embodiments, the kit can include a sequence of replaceable end actuators of different lengths, where the sequence is predetermined for a particular surgical procedure. For example, a given surgical procedure may first require a 15 mm incision, then a second 15 mm incision, and finally a 30 mm incision. A surgical kit for this surgical procedure can include three replaceable end actuators configured to make an incision and staple a patient's tissue. The first two replaceable end actuators can include a length of approximately 15 mm and the third replaceable end actuator can include a length of approximately 30 mm.
[000318] Figures 112 to 117 illustrate another exemplary elongated rod assembly 2200 that has another exemplary 2210 quick-disconnect coupler arrangement therein. In at least one form, for example, the quick-disconnect coupler arrangement 2210 includes a proximal coupler element 2212 in the form of a proximal outer segment of tube 2214 having tubular gear segment 354 therein that is configured to interface with the first drive system 350 in the manner described above. As discussed above, the first drive system 350 serves to rotate the elongated rod assembly 2200 and end actuator 1000 operatively coupled thereto about the longitudinal axis "LT-LT" of the tool. The proximal outer segment of tube 2214 has a "recessed" distal end portion 2216 that is configured to receive a locking tube segment 2220 therein. The quick release arrangement 2210 additionally includes a distal coupler element 2217 in the form of a distal outer portion of tube 2218 that is substantially similar to the distal outer portion of tube 231 described above, except that the distal outer portion of tube 2218 includes a recessed proximal end portion 2219. A distal outer formation or "swallowtail" gasket 2226 is formed at the end of the proximal end portion 2219 of distal outer tube segment 2218 which is configured to operabably engage a proximal outer formation or "swallowtail" gasket 2228 that is formed in the distal end portion 2216 of the proximal outer segment of tube 2214.
[000319] The exemplary embodiment shown in Figures 112 to 117 employs an exemplary embodiment of the closure system 670 described above. The 2210 quick-disconnect coupler arrangement is configured to facilitate operational coupling of proximal closure drive train assemblies to corresponding distal drive train assemblies. For example, as seen in Figure 113, elongated rod assembly 2200 may include a first proximal closing drive train assembly in the form of a first proximal closing rod segment 2230 and a first proximal closing drive train assembly. closure in the form of a first distal closure rod segment 2240 which are configured to be connected together via the quick-disconnect coupler arrangement 2210. That is, in at least one exemplary form, the first segment of Proximal closure stem 2230 has a first-form closure gasket or "swallowtail" junction segment 2234 formed on a distal end 2232 thereof. Similarly, the first distal closure rod segment 2240 has a second closure gasket formation or a "dovetail" junction segment 2244 formed at a proximal end 2242 thereof, which is adapted to laterally slidingly engage. the first dovetail joint segment 2234. Still referring to Figure 113, the elongated rod assembly 2200 may include a second proximal closure drive train assembly in the form of a second proximal closure rod segment 2250 and a second distal closure drive train assembly in the form of a second distal closure rod segment 2260 which are configured to be connected together through the quick-disconnect coupler arrangement 2210. That is, in at least one form Exemplary, the second proximal closure stem segment 2250 has a third closure joint formation or "dover tail joint segment" line" 2254 formed at a distal end 2252 thereof. Similarly, the second distal closure stem segment 2260 may have a fourth closure joint formation or "dovetail" closure junction segment 2264 formed at a proximal end 2262 of the second distal closure stem segment 2260 that is adapted to laterally engage the third "swallowtail" joint segment 2254.
[000320] In the illustrated embodiment and others, the first proximal closure stem segment 2230 and the second proximal closure stem segment 2250 extend through the proximal segment of the drive stem 380’. The proximal drive rod segment 380' comprises a proximal swivel drive train assembly 387' and the drive rod distal segment 540' comprises a distal swivel drive train assembly 548'. When the proximal swivel drive train assembly 387' is operatively coupled to the distal swivel drive train assembly 548', the drive rod assembly 388' is formed to transmit control rotary motions to the end actuator 1000. In at least In an exemplary embodiment, the proximal segment of the drive stem 380' is substantially similar to the proximal segment of the drive stem 380 described above, except that the distal end 381' of the proximal segment of the drive stem 380' it has a "dovetail" drive joint or 2270 distal formation formed therein. Similarly, the distal segment of drive stem 540' may be substantially similar to the distal segment of drive stem 540 described above, except that a "swallowtail" drive joint or proximal formation 2280 is formed at the end. proximal 542' thereof, which is adapted to actionably engage the distal "dovetail" drive joint 2270 via the quick-disconnect coupler arrangement 2210. The first distal closure rod segment 2240 and the second rod segment of distal closure 2260 may also extend through the distal segment of drive rod 540'.
[000321] This exemplary embodiment may also include a swivel coupling joint 2300 that interfaces with the third and fourth drive cables 434, 454. As can be seen in Figure 113, the swivel coupling joint 2300 comprises a tube of proximal hinge 2302 having a proximal ball joint segment 2306 formed on a distal end 2304 thereof. Proximal pivot tube 2302 includes passages 2308 for receiving cable end portions 434A', 434B', 454A', 454B' therethrough. A proximal ball joint segment 2310 is movably supported on the proximal ball segment 2306. Proximal cable segments 434A', 434B', 454A', 454B' extend through passages 2308 to be secured to the proximal ball joint segment 2310. The proximal pivot tube 2302, the proximal ball joint segment 2310, and the proximal cable segments 434A', 434B', 454A', 454B' may collectively be referred to as a proximal pivot drive train portion 2314.
[000322] The exemplary pivot coupling joint 2300 may also comprise a distal pivot tube 2320 having a distal ball joint segment 2324 formed at a proximal end 2322 thereof. Distal ball joint segment 2324 has a first "dovetail" gasket or distal formation 2325 formed therein, which is adapted to actionably engage a first "dovetail" gasket or proximal formation 2307 formed in the proximal ball joint segment. 2306 such that when the first distal "dovetail" gasket 2325 actuates the first proximal "dovetail" gasket 2307, the distal ball joint segment 2324 and the proximal ball joint segment 2306 form a ball assembly built-in articulator. Furthermore, the pivot coupling joint 2300 further comprises a distal ball segment 2330 which is supported on the distal ball joint segment 2324 and has a second "dovetail" joint or distal formation 2332 formed therein, which is adapted to actionably engage a second "dovetail" joint or proximal formation 2312 in the proximal ball joint segment 2310. The distal segments of cables 444, 445, 446, 447 are secured to the distal ball segment 2340 and extend through passages 2328 in distal pivot tube 2320. When joined together, proximal ball joint segment 2310 and distal ball joint segment 2324 form a pivot ball 2340 which is movably seated over the inner pivot ball. Distal pivot tube 2320, distal ball segment 2340, and distal segments of cables 444, 445, 446, 4447 may collectively be referred to as a proximal pivot drive train assembly 2316.
[000323] As seen in Figure 115, the distal portions of the elongated rod assembly 2200 can be mounted so that the following junction segments are held in alignment with each other by the distal coupler 2217 or distal outer portion of the tube 2218 to form a distal "dovetail" gasket assembly, generally designated as 2290: 2226, 2332, 2325, 2280, 2244, and 2264. Similarly, elongated rod assembly 2200 may be mounted so that the proximal coupler element 2212 or proximal outer segment of tube 2214 retains the following splice segments in alignment with each other to form a proximal "swallowtail" joint assembly, generally designated 2292: 2228, 2312, 2307, 2270, 2234 and 2254.
[000324] End actuator 1000 can be operatively coupled to elongated rod assembly 2200 as follows. To begin fixation, the physician moves the lock tube segment 2220 to a first unlocked position, shown in Figures 115 and 116. As can be seen in these figures, the lock tube segment has a boundary segment 2224 formed in its distal end 2222. When in the unlocked position, abutment segment 2224 projects distally beyond the proximal "dovetail" joint assembly 2292 to form a boundary surface for laterally joining the distal "dovetail" joint assembly 2290 with the proximal "swallowtail" gasket assembly 2292. That is, the clinician may laterally align the distal "swallowtail" gasket assembly 2290 with the proximal "swallowtail" gasket assembly 2292 and then slide the assembly 2290 distal "dovetail" gasket assembly 2290 to side engagement with proximal "dovetail" gasket assembly 2292 until distal "dovetail" gasket assembly 2290 contacts segment threshold 2224, at which point all corresponding distal and proximal junction segments are simultaneously interconnected. Thereafter, the clinician can move the locking tube segment 2220 distally to a second locked position, as shown in Figure 117. When in this position, the locking tube segment 2220 covers the quick release joint 2210 and prevents any relative lateral movement between the distal dovetail assembly 2290 and the proximal dovetail assembly 2292.
[000325] Although the various exemplary modalities described above are configured to form an operational interface with a robotic system and are at least partially driven by a robotic system, the elongated rod and end actuator components can be effectively employed in conjunction with portable instruments. For example, Figures 118 through 120 depict a portable surgical instrument 2400 that can employ various components and systems described above to operatively actuate an end actuator 1000 coupled thereto. In the exemplary embodiment shown in Figures 118 to 120, a quick release joint 2210 is employed to couple the end actuator 1000 to the elongated rod assembly 2402. To facilitate the articulation of the end actuator 1000 around the pivot joint 700, the proximal portion of the elongated rod assembly 2402 includes a manually actuatable pivot drive 2410.
[000326] Referring now to Figures 121 to 123, in at least one exemplary form, the pivot drive 2410 includes four axially movable sliding pivot elements that are movably positioned at the tip of the proximal segment of the drive rod 380' between the proximal outer segment of tube 2214 and proximal segment of actuation rod 380'. For example, the pivot cable segment 434A' is secured to a first sliding pivot element 2420 which has a first pivot driver rod 2422 protruding therefrom. Pivot cable segment 434B' is secured to a second sliding articulation element 2430 which is diametrically opposed to the first sliding articulation element 2420. The second sliding articulating element 2430 has a second sliding articulation rod 2432 projecting therefrom. The pivot cable segment 454A' is secured to a third sliding pivot element 2440 which has a third pivot driver rod 2442 protruding therefrom. Pivot cable segment 454B' is secured to a fourth sliding articulation element 2450 which is diametrically opposed to the third sliding articulating element 2440. A fourth articulating drive rod 2452 protrudes from the fourth sliding articulating element 2450. The actuating rods The pivoting elements 2422, 2432, 2442, 2452 facilitate the application of pivot control movements to the sliding pivot elements 2420, 2430, 2440, 2450, respectively, by means of a pivot ring assembly 2460.
[000327] As can be seen in Figure 121, the pivoting drive rods 2422, 2432, 2442, 2452 movably pass through a mounting ball 2470 that is positioned at the tip of a proximal outer segment of tube 2404. In one embodiment, the 2470 mounting ball can be manufactured in segments that are joined together by suitable fastening arrangements (eg, welding, adhesive, screws, etc.). As shown in Figure 109, swivel drive rods 2422 and 2432 extend through slots 2472 in the proximal outer segment of tube 2404 and slots 2474 in mounting ball 2470 to allow sliding pivot elements 2420, 2430 to move axially in in relation to them. Although not shown, swivel drive rods 2442, 2452 extend through similar slots 2472, 2474 in the proximal outer segment of tube 2404 and mount ball 2470. Each of swivel drive rods 2422, 2432, 2442, 2452 projects out of mating slots 2474 in mounting ball 2470 to be operatively received into mating mounting sockets 2466 in pivot ring assembly 2460. See Figure 122.
[000328] In at least one exemplary way, the pivot ring assembly 2460 is manufactured by joining a pair of ring segments 2480, 2490 by means of, for example, welding, adhesive, snap-on features, screws, etc. ., to form the pivot ring assembly 2460. The ring segments 2480, 2490 cooperate to form the mounting sockets 2466. Each of the pivot drive rods has a mounting ball 2468 formed therein that is adapted to be movably received within a mating mounting socket 2466 on pivot ring assembly 2460.
[000329] Several exemplary embodiments of the 2410 pivot drive may also include an exemplary 2486 locking system configured to retain the 2460 pivot ring assembly in an actuated position. In at least one exemplary form, the locking system 2486 comprises a plurality of locking tabs formed on the pivot ring assembly 2460. For example, the ring segments 2480, 2490 may be fabricated from a rubber material or slightly flexible polymer. Ring segment 2480 has a series of flexible locking proximal tabs 2488 formed thereon and ring segment 2490 has a series of flexible locking distal tabs 2498 formed therein. Each locking tab 2388 has at least one locking tab 2389 formed therein and each locking tab 2398 has at least one locking tab 2399 therein. Locking detents 2389, 2399 can serve to establish a desired amount of locking friction with the pivot ball so as to retain the pivot ball in position. In other exemplary embodiments, locking detents 2389, 2390 are configured to engage a plurality of corresponding locking cavities formed on the outer circumference of mounting ball 2470.
[000330] The operation of the hinge drive 2410 can be understood by referring to Figures 122 and 123. Figure 122 illustrates the hinge drive 2410 in a non-articulated position. In Figure 123, the physician manually tilted the pivot ring assembly 2460 to cause the sliding pivot element 2420 to move axially in the distal direction "DD", thus advancing the pivot cable segment 434A' distally. Such movement of the pivot ring assembly 2460 also results in axial movement of the sliding pivot element 2430 in the proximal direction, which ultimately pulls the pivot cable 434B in the proximal direction. These push and pull motions of link cable segments 434A’, 434B’ will result in the 1000 end actuator linking with respect to the tool's longitudinal axis "LT-LT" in the manner described above. To reverse the articulation direction, the clinician simply reverses the orientation of the articulation ring assembly 2460 to thereby cause the sliding articulation element 2430 to move in the distal direction "DD" and the sliding articulating element 2420 to move. move in the proximal "PD" direction. The Pivot Ring Assembly 2460 can be similarly actuated to apply desired compression and traction motions to the Pivot Cable Segments 454A', 454B'. The friction created between the locking detents 2389, 2399 and the outer circumference of the mounting ball serves to hold the pivot drive 2410 in position after the end actuator 1000 is pivoted to the desired position. In alternative exemplary embodiments, when locking detents 2389, 2399 are positioned to be received in corresponding locking cavities in the mounting ball, the mounting ball will be held in position.
[000331] In the illustrated exemplary embodiment and others, the elongated rod assembly 2402 forms an operational interface with a 2500 cable assembly. An exemplary 2500 cable assembly embodiment comprises a pair of cable frame segments 2502, 2504 that are joined together to form a housing for the various components and drive systems, as discussed in more detail below. See, for example, Figures 118 and 119. Cable housing segments 2502, 2504 can be joined by screws, snap-on features, adhesive, etc. Once coupled, the handle segments 2502, 2504 can form a handle assembly 2500 that includes a handle portion 2506.
[000332] To facilitate selective rotation of the end actuator 1000 about the longitudinal axis "LT=LT" of the tool, the elongated rod assembly 2402 can interface with a first drive system, generically designated as 2510. drive theme 2510 includes a manually actuatable swivel nipple 2512 that is pivotally supported on the cable assembly 2500 so that the swivel nipple can be rotated relative to the cable assembly as well as moved axially between a locked position and an unlocked position.
[000333] The surgical instrument 2400 may include a closure system 670, as described above, to apply opening and closing movements to the anvil 1100 of the end actuator 1000. In this exemplary modality, however, the closure system 670 is actuated by a closing trigger 2530 which is pivotally mounted to the handle frame assembly 2520 which is supported within the handle housing segments 2502, 2504. The closing trigger 2530 includes a drive portion 2532 which is mounted in a manner. hinged to a 2531 pivot pin supported within the 2520 handle frame assembly. See Figure 124. Such an exemplary arrangement facilitates pivoting movement toward and away from the grip portion 2506 of the 2500 handle assembly. to be seen in Figure 124, the closing trigger 2530 includes a closing rod 2534 that is connected to the first pivot rod and gear assembly 695 by a wire. closure 2535. Thus, when the closure trigger 2530 is pressed towards the grip portion 2506 of the cable assembly 2500 to the actuated position, the closure rod 2534 and the closure wire 2535 cause the first set of pivot rod and gear 695 move the first closure rod segment 680 in the distal "DD" direction to close the anvil.
[000334] The surgical instrument 2400 may also include a 2536 closing trigger locking system to retain the closing trigger in the actuated position. In at least one exemplary form, the lock trigger locking system 2536 includes a lock locking element 2538 pivotally coupled to the handle frame assembly 2520. As seen in Figures 125 and 126, the element The closure locking rod 2538 has a locking arm 2539 formed therein which is configured to move over an arcuate portion 2537 of the closure rod 2532 as the closure trigger 2530 is actuated toward the handle portion 2506. close trigger 2530 is depressed to the fully actuated position, locking arm 2539 drops behind the end of close rod 2532 and prevents close trigger 2530 from returning to its non-actuated position. In this way the anvil 1100 will be locked in its closed position. To allow the closing trigger 2530 to return to its non-triggered position and thus result in movement of the anvil between the closed position and the open position, the physician simply depresses the locking element of the lock 2538 until the locking arm 2539 it disengages from the end of the closure rod 2532 to thereby allow the closure rod 2532 to move to the non-actuated position.
[000335] Close trigger 2532 is returned to the non-triggered position by a 2540 close feedback system. For example, as seen in Figure 124, an exemplary form of the 2540 close trigger feedback system includes a closing trigger sliding member 2542 which is connected to the closing rod 2534 by a closing trigger yoke 2544. The closing trigger sliding member 2542 is slidably supported within a channel 2522 in the cable frame assembly 2520 A return spring of the close trigger 2546 is positioned within the channel 2520 to apply a changing force to the sliding member of the close trigger 2542. Thus, when the physician actuates the close trigger 2530, the trigger yoke closure trigger 2544 moves the closure trigger slide element 2542 in the distal direction "DD", compressing the closure trigger 2546 return spring. The 2536 close trigger lock theme is disengaged and the close trigger 2530 is released, the close trigger 2546 return spring moves the 2542 close trigger slider in the proximal direction "PD" to thereby pivot the trigger close 2530 to home position, not triggered.
[000336] The surgical instrument 2400 can also employ any of the several exemplary drive rod assemblies described above. In at least one exemplary form, the surgical instrument 2400 employs a second drive system 2550 to apply control rotary motions to a proximal drive rod assembly 380’. See Figure 128. The second drive system 2550 may include a 2552 motor assembly operatively supported on the handle portion 2506. The 2552 motor assembly may be powered by a 2554 battery, which is removably attached to the 2500 cable assembly, or powered by an alternating current source. A second drive gear 2556 is operatively coupled to the drive rod 2555 of the motor assembly 2552. The second drive gear 2556 is supported into the meshed engagement with a second swivel driven gear 2558 which is secured to the proximal segment of the drive rod 380 ' of the drive rod assembly. In at least one form, for example, second drive gear 2556 is also axially movable on motor drive shaft 2555 relative to motor assembly 2552 in the directions shown by the arrow "U" in Figure 128. A pusher element, for example, a coil spring 2560 or similar element, is positioned between the second drive gear 2556 and the motor housing 2553 and serves to force the second drive gear 2556 on the motor drive shaft 2555 into meshed engagement with a first segment. of gear 2559 in the second gear driven 2558.
[000337] The second drive system 2550 may also include a trigger trigger assembly 2570 that is movably fixed, e.g., pivotally, to the cable frame assembly 2520. In at least one exemplary fashion, for example, firing trigger assembly 2570 includes a first rotary actuation trigger 2572 which cooperates with a corresponding switch/contact (not shown) which is in electrical communication with motor assembly 2552 and which, upon activation, causes motor assembly 2552 applies a first rotary drive motion to second driven gear 2558. In addition, firing trigger assembly 2570 additionally includes a retractor drive trigger 2574 that is pivotal relative to the first rotary drive trigger. The 2574 retractor actuation trigger forms an operational interface with a switch/contact (not shown) that is in electrical communication with the 2552 motor assembly and which, upon activation, causes the 2552 motor assembly to apply a second motion of rotary drive to second gear driven 2558. The first rotary drive movement results in rotation of the drive rod and implement drive rod assembly in the end actuator to cause the trigger member to move distally in the end actuator 1000. Conversely, the second swivel drive movement is opposite to the first swivel drive movement and will ultimately result in the drive rod and implement drive rod assembly rotating in a direction of rotation that results in proximal or retraction of the trigger member on the 1000 end actuator.
[000338] The illustrated embodiment also includes a manually actuable safety element 2580 which is pivotally secured to the closing trigger actuating portion 2532 and is selectively pivotable between a first "safe" position, which the safety element 2580 prevents physically the pivoting displacement of the firing trigger assembly 2570 and a second "off" position where the clinician can freely depress the firing trigger assembly 2570. As can be seen in Figure 124, it is provided in the actuation portion. of closing trigger 2532 a first cavity 2582 corresponding to the first position of the security element 2580. When the security element 2580 is in the first position, a detent (not shown) in the security element 2580 is received within the first cavity. 2582. A second cavity 2584 is also provided in the closing trigger actuating portion 2532 and corresponds to the second position of the securing element. 2580. When security element 2580 is in the second position, the detent in security element 2580 is received within second cavity 2582.
[000339] In at least some exemplary ways, the surgical instrument 2400 may include a mechanically actuatable reversing system, generically designated as 2590, to mechanically apply a reverse rotary motion to the proximal segment of the drive rod 380' in the event of assembly failure 2552 engine or loss or interruption of battery power. Such a mechanical reverse system 2590 may also be particularly useful, for example, when components of the drive stem system operatively coupled to the proximal segment of drive stem 380' jam or become trapped in any way that prevents reverse rotation of the components. of drive rod with engine power only. In at least one exemplary form, the mechanically actuatable reverser system 2590 includes a reverse gear 2592 that is pivotally mounted on a shaft 2524A formed in the cable frame assembly 2520 in meshed engagement with a second gear segment 2562 in the second 2558 driven gear. See Figure 126. Thus, the 2592 reverse gear rotates freely about the 2524A shaft as the 2558 second driven gear rotates the drive shaft proximal segment 380' of the drive shaft assembly.
[000340] In various exemplary forms, the mechanical reverser system 2590 additionally includes a manually actuatable actuator 2594 in the form of a lever arm 2596. As can be seen in Figures 129 and 130, the lever arm 2596 includes a portion fork 2597 having elongated slots 2598 therethrough. Shaft 2524A extends through slot 2598A and an opposing second shaft 2598B formed in cable housing assembly 2520 extends through the other elongated slot to movably secure lever arm 2596. Additionally, lever arm 2596 has an actuating fin 2597 formed therein that can meshingly engage the reverse gear 2592. There is a detent or interference that holds the lever arm 2596 in the non-actuated state until the clinician exerts substantial force to actuate the same. This prevents accidental triggering when inverted. Other embodiments may employ a spring to force the lever arm into the non-actuated state. Several exemplary embodiments of the mechanical reversing system 2590 additionally include a knife retractor knob 2600 that is movably positioned on the handle frame assembly 2520. As seen in Figures 129 and 130, knife retractor knob 2600 includes a release tab. 2602 which is configured to engage the upper portion of the second drive gear 2556. The knife retractor knob 2600 is forced into a disengaged position by a knife retractor spring 2604. When in the disengaged position, the disengagement tab 2602 is forced out of the in engagement with the second drive gear 2556. In this way, while the clinician does not wish to activate the mechanical reversing system 2590 by pressing the knife retractor button 2600, the second drive gear 2556 is in meshed engagement with the first gear segment 2559 of the second driven gear 2558.
[000341] When the clinician wishes to apply a reverse rotary drive motion to the proximal segment of the drive rod 380', the clinician presses the knife retractor button 2600 to disengage from the second motor gear 2556 the first gear segment 2559 in the second gear 2558. Thereafter, the clinician applies a pivotal ratchet motion to the manually actuatable driver 2594, which causes the 2597 gear vane therein to drive the 2592 reverse gear. The 2592 reverse gear is in meshed engagement with the second gear segment 2562 in second driven gear 2558. Continuing ratchet movement of manually actuatable drive 2594 results in the application of a reverse rotary drive movement to second gear segment 2562 and ultimately to the proximal segment of drive rod 380' . The clinician may continue to progressively advance the 2594 actuator as many times as necessary to fully release or reverse the associated component(s) of the end actuator. After applying the desired number of reverse twists to the proximal segment of actuation shaft 380', the clinician releases knife retractor knob 2600 and actuator 2594 to their respective home or non-actuated positions in which vane 2597 is disengaged from the reverse gear 2592 and the second drive gear 2556 is again in meshed engagement with the first gear segment 2559 in the second driven gear 2558.
[000342] The surgical instrument 2400 can also be employed with an end actuator 1000 that includes a swivel transmission 750, as described in detail above. As discussed above, when the drive rod assembly is in an axial first position, the rotary motion applied thereto results in the entire end actuator 1000 rotating around the longitudinal axis "LT-LT" of the tool distal to the swivel joint 700 When the drive rod assembly is in the second position, the rotary motion applied to it results in the implement drive rod rotating, which ultimately causes the trigger member to actuate within the 1000 end actuator.
[000343] The surgical instrument 2400 can employ a displacement system 2610 to selectively and axially displace the proximal segment of the drive shaft 380', which places the shaft gear 376 in meshed engagement with the first moved swivel gear 374 and withdraws. that of the engaged hitch. For example, the proximal segment of the actuating rod 380' is movably supported within the cable frame assembly 2520 so that the proximal segment of the actuating rod 380' can move axially and rotate therein. In at least one exemplary form, displacement system 2610 additionally includes a displacement yoke 2612 that is slidably supported by handle frame assembly 2520. See Figures 124 and 127. a pair of rings 386 (shown in Figures 124 and 128) around them such that displacement displacer yoke 2612 in handle frame assembly 2520 results in axial movement of the proximal segment of drive rod 380'. In at least one form, displacement system 2610 further includes a shifter button assembly 2614 that forms an operative interface with shifter yoke 2612 and extends through a slot 2505 in cable housing segment 2504 of cable assembly 2500. See Figures 135 and 136. A displacer spring 2616 is mounted to the handle frame assembly 2520 to engage the proximal segment of drive rod 380'. See Figures 127 and 134. Spring 2616 serves to provide the clinician with an audible click and tactile feedback as shifter knob assembly 2614 is slidably positioned between the first axial position, shown in Figure 135, where the rotation of the The drive rod assembly results in the 1000 end actuator rotating around the "LT-LT" longitudinal axis of the tool relative to the 700 swivel joint (shown in Figure 67), and the second axial position, shown in Figure 136, at that rotation of the drive rod assembly results in axial movement of the trigger member on the end actuator (illustrated in Figure 66). As such, such an arrangement enables the clinician to easily slidingly position the shifter knob assembly 2614 while holding the handle assembly 2500.
[000344] Figures 137 to 147 illustrate a lockable articulated joint 2700 which, in an exemplary embodiment, is substantially identical to the articulated joint 700 described above, except for the differences discussed below. In an exemplary embodiment, the swivel joint 2700 is locked and unlocked by a hinge lock system 2710. The swivel joint 2700 includes a tube with proximal socket 702 that is secured to the distal end 233 of the distal outer portion of tube 231 and defines a proximal ball socket 704 in it. See Figure 137. A proximal ball element 706 that is secured to an intermediate pivot tube segment 712 is movably positioned within the proximal ball socket 704 within the proximal socket tube 702. As seen in Figure 137 , the proximal ball element 706 has a central drive passage 708 that allows the distal segment of the drive rod 540 to extend therethrough. In addition, the proximal ball element 706 has four hinge passages 710 therein that facilitate the passage of distal segments of cables 444, 445, 446, 447 therethrough. As can be seen further in Figure 137, the intermediate pivot tube segment 712 has an intermediate ball socket 714 formed therein. Intermediate ball socket 714 is configured to movably support therein an end actuator ball 722 formed in a connecting tube of end actuator 720. The distal segments of cables 444, 445, 446, 447 extend through passageways cables 724 formed in the end actuator ball 722 and are secured thereto by lugs 726 received within corresponding passages 728 in the end actuator ball 722. Other fastening arrangements can be employed to secure distal segments of the cables 444, 445, 446, 447 to end actuator ball 722.
[000345] As seen in Figure 137, an exemplary form of the hinge lock system 2710 includes a locking element or wire 2712 that extends through the distal outer portion of tube 231 of the elongated rod and tube assembly. with proximal socket 702. Locking wire 2712 has a proximal end 2720 that is secured to a transfer disk 2722 that is operatively supported on cable portion 2500 (generally represented by dashed lines in Figure 137). For example, transfer disk 2722 is mounted on a spindle 2724 that is coupled to a protrusion 2726 formed on cable 2500. An actuator wire or cable 2730 is secured to transfer disk 2722 and can be manually actuated (i.e., , pushed or pulled) by the doctor. In other embodiments, where the surgical instrument is attached to the robotic system, the actuator handle 2730 may be configured to receive control movements from the robotic system to actuate the transfer disc 2722.
[000346] As can be seen in Figures 143 to 146, the locking wire 2712 has a pair of unlocking wedges 2714, 2716 formed at its distal end 2715. The first unlocking wedge 2714 is configured to form a operatively interface with the ends 2742, 2744 of a distal locking ring 2740 that is positioned on the intermediate pivot tube 712. In its normal "locked" state, as shown in Figure 143, the distal locking ring 2740 applies a clamping force or locking circumferentially extending in the intermediate pivot tube 712 to press the intermediate pivot tube 712 onto the ball of the end actuator 722 to prevent its movement within the socket 714. As seen in Figures 143 to 146, as ends 2742, 2744 of distal locking ring 2740 are tapered to define a tapered or V-shaped opening 2746 therebetween, which is configured to receive the first die. unlocking 2714 between them.
[000347] As can be further seen in Figures 143 to 146, the second locking wedge 2716 is configured to interface with the ends 2752, 2754 of a proximal locking ring 2750 that is positioned on the proximal socket tube 702 In its normal "locked" state, as shown in Figure 143, the proximal locking ring 27450 applies a squeezing or locking force extending circumferentially to the proximal socket tube 702 to press the proximal socket tube 702 onto the proximal ball element 706 to prevent its movement within the proximal ball socket 704. As seen in Figures 143 through 146, the ends 2752, 2754 of the proximal locking ring 2750 are tapered to define a tapered opening or V-shaped 2756 therebetween which is configured to receive the second unlocking wedge 2716 therebetween.
[000348] When the articulated joint 2700 is unlocked by the actuation of the articulation lock system 2710, the end actuator 1000 can be selectively articulated in the various ways described above, actuating the distal segments of the cables 444, 445, 446, 447 The actuation of the hinge lock system 2710 can be understood from reference to Figures 138, 139 and 143 to 146. Figure 143 represents the positions of the first and second unlocking wedges 2714, 2716 in relation to the locking rings distal and proximal 2740, 2750. When in this state, the locking ring 2740 prevents movement of the ball of the end actuator 722 within the socket 714 and the locking ring 2750 prevents the proximal ball element 706 from moving within the socket 704. To unlock the articulated joint 2700, the actuation cable 2726 is pulled in the proximal "PD" direction, which ultimately results in the locking wire 2712 being pushed in the distal direction "DD" to the mos position. shown in Figure 144. As seen in Figure 144, the first unlocking wedge 2714 has moved distally between the ends 2742, 2744 of the distal locking ring 2740 to expand the ring 2740 to relieve the clamping force applied to the intermediate pivot tube 712 to allow end actuator ball 722 to move within socket 714. Similarly, second unlocking wedge 2716 moved distally between ends 2752, 2754 of proximal locking ring 2750 to expand the ring 2750 in order to relieve squeezing force on proximal socket tube 702 to allow proximal ball element 706 to move within socket 704. When in this unlocked position, the hinge system can be actuated to apply actuating motions. to the distal segments of cables 444, 445, 446, 447 in the ways described above, to articulate the end actuator 1000, as illustrated in Figures 138 and 139. Figures 143 and 144 illustrate the position of the first and second locking wedges 2714, 2716 after the end actuator 1000 is pivoted to the position shown in Figure 138. Similarly, Figures 145, 146 illustrate the position of the first and second locking wedges 2714, 2716, after the end actuator 1000 is pivoted to the position shown in Figure 139. After pivoting the end actuator to the desired position, the physician (or robotic system) applies a propulsion motion of the actuation cable to rotate the transfer disc 2722 and move the lock wire 2712 to the position shown in Figures 143, 145, to thereby allow the lock rings 2740, 2750 to assume the locked or locked to hold the 1000 end actuator in this locked position.
[000349] Figures 148 to 156 illustrate another modality of end actuator 2800 which, in an exemplary form, is substantially identical to end actuator 1000, except for the differences discussed below. The 2800 End Actuator includes a 2810 anvil assembly that is opened and closed by applying a rotary closing motion thereto. Anvil assembly 2810 is pivotally supported over an elongated channel 2830 for selective movement between an open position (Figures 148 and 149) and a closed position (Figures 150 to 153). Elongated channel 2830 may be substantially identical to elongated channel 1020 described above, except for the differences discussed below. For example, in the illustrated embodiment, elongated channel 2830 has an end actuator connector housing 2832 formed therein that can be coupled to an end actuator connector tube 720 by bearing ring 734, as described above. As seen in Figure 148, the end actuator connector box 2832 operatively supports a swivel drive assembly 2860 therein.
[000350] As can be seen in Figures 148 and 149, the anvil assembly 2810 includes a pair of anvil swivel pins 2812 (only one swivel pin can be seen in Figure 148) that are movably received within pin slots swivels 2814 formed in elongated channel 2830. The underside of anvil assembly 2810 additionally has an anvil opening ramp 2816 formed therein for pivotal engagement with an anvil pivot pin 1201' on firing member 1200'. Firing member 1200’ may be substantially identical to Firing member 1200 described above, except for the differences noted. In addition, anvil assembly 2810 additionally includes a closure pin 2818 that is configured for operative engagement with a swivel closure rod 2910 that receives swivel closure motions from swivel drive assembly 2860, as will be discussed in more detail. below. Firing member 1200' is pivotally positioned on an implement drive rod 1300 which is pivotally supported within an elongated channel 2830 configured to support a surgical staple cartridge therein (not shown). Implement drive rod 1300 has a bearing segment 1304 formed therein that is rotatably supported on a bushing bearing 2834 formed in the end actuator connector housing 2832.
[000351] In the exemplary illustrated embodiment, the swivel drive assembly 2860 includes a swivel drive rod 2870 that extends longitudinally through the elongated rod assembly to form an operational interface with the mounting portion of the tool (if the end actuator 2800 is actuated by a robotic system) or with the firing trigger of a cable assembly (if the 2800 end actuator is operated manually). For embodiments employing a swivel joint, the portion of swivel drive rod 2870 that extends through swivel joint 700 may comprise any of the flexible drive rod assemblies disclosed herein. If no swivel joint is employed, the swivel drive rod may be rigid. As can be seen more particularly in Figures 148 and 149, the swivel drive rod 2870 has a swivel drive head 2872 formed therein or attached thereto which has a first rack 2874 formed therein. Furthermore, the swivel drive head 2872 additionally has a second rack 2876 formed therein for selectively engaged engagement with a shift gear 2882 secured to a swivel shift rod 2880.
[000352] Displacer rod 2880 may comprise any of the rotary drive rod assemblies described above and extends through the elongated rod assembly to form an operating interface with a mounting portion of tool 300 (if end actuator 2800 is driven by a robotic system) or the cable assembly (if the end actuator is manually operated). In either case, shifter rod 2800 is configured to receive longitudinal displacement motions to longitudinally move shifter gear 2882 within rotary drive head 2872 and rotary drive movements to rotate shifter gear 2882, as will be discussed in more detail below.
[000353] As can be further seen in Figures 148 and 149, the swivel transmission assembly 2860 additionally includes a transfer gear assembly 2890 having a body 2892, a portion of which is pivotally supported within a cavity 2873 in the head of swivel drive 2872. Body 2892 has a spindle 2894 which pivotally extends through a spindle mounting hole 2838 formed in a bulkhead 2836 in end actuator connector housing 2832. Body 2892 additionally has a 2896 shift rack formed therein for selectively engaged engagement with shift gear 2882 on rotating shift rod 2880. A transfer gear 2900 is mounted on a transfer gear spindle 2902 which protrudes from body 2892 and is slidably received within the arcuate slot 2840 in bulkhead 2836. See Figures 155 and 156. Transfer gear 2900 is in meshed engagement with the first rack 2874 formed in the swivel drive head 2872. As seen in Figures 153 to 156, the arcuate slot 2840 has a centrally disposed flexible detent 2842 projecting therein. Detent 2842 is formed on a mat 2844 formed by a detent relief slit 2846 formed adjacent arcuate slit 2840 as shown in Figure 155.
[000354] The swivel closure rod 2910 has a bearing portion 2912 which is pivotally supported through a corresponding opening in the bulkhead 2836. The swivel closure rod 2910 additionally has a closure drive gear 2914 which is configured for selective mesh engagement with the transfer gear 2900. The implement drive rod 1300 also has an implement drive gear 1302 that is configured for selective in mesh engagement with the transfer gear 2900.
[000355] The operation of the 2800 end actuator will now be explained with reference to Figures 148 to 155. Figures 148 and 149 illustrate the 2800 end actuator with the 2810 anvil assembly in the open position. To move anvil assembly 2810 to the closed position shown in Figure 150, shifter rod 2880 is located so that shifter gear 2882 is in meshed engagement with shifter rack 2896 on body 2892. Shifter rod 2880 can be rotated to cause body 2892 to rotate to place transfer gear 2900 into meshed engagement with closure drive gear 2914 on closure rod 2910. See Figure 153. When in this position, lock detent 2842 retains transfer gear spindle 2902 in that position. Thereafter, swivel drive rod 2870 is rotated to apply rotary motion to transfer gear 2900, which ultimately rotates closure rod 2910. As closure rod 2910 is rotated, a spindle portion swivel 2916 which is in engagement with closure pin 2818 on anvil assembly 2810 results in anvil assembly 2810 moving proximally, causing anvil assembly 2810 to rotate about anvil pivot pin 1201' on the member. 1200' shot. Such action causes the anvil assembly 2810 to be pivoted to the closed position shown in Figure 150. When the clinician wishes to drive the firing member 1200' distally down the elongated channel 2830, the displacer rod 2880 is again rotated to pivot the transfer gear spindle 2902 to the position shown in Figure 154. Again, lock detent 2842 retains transfer gear spindle 2902 in that position. Thereafter, rotary drive rod 2870 is rotated to apply rotary motion to drive gear 1302 on implement drive rod 1300. Rotation of implement drive rod 1300 in one direction causes trigger member 1200' to be actuated in the "DD" distal direction. Rotating implement drive rod 1300 in an opposite direction will cause trigger member 1200’ to be retracted in the proximal "PD" direction. Thus, in applications where firing member 1200' is configured to cut and fire staples within a staple cartridge mounted in elongated channel 2830, after firing member 1200' is moved to its most distal position within the channel elongated 2830, swivel drive motion applied to implement drive rod 1300 by swivel drive rod assembly 2870 is reversed to retract firing member 1200' back to its initial position shown in Figure 150. To release target tissue of the end actuator 2800, the clinician again rotates the displacer rod 2800 to once again place the transfer gear 2900 in meshed engagement with the drive gear 2914 on the closing drive rod 2910. After that, a reverse rotation is applied to the transfer gear 2900 by swivel drive rod 2870 to make the closing drive rod 2910 rotate the ac spindle 2916 and thereby cause the 2810 anvil assembly to move distally and rotate to the open position shown in Figures 148 and 149. When the clinician wishes to rotate the entire 2800 end actuator around the longitudinal axis "LT-LT " of the tool, the shifter rod is longitudinally shifted to place shifter gear 2882 into meshed engagement simultaneously with second rack 2876 on rotary drive head 2872 and shifter rack 2896 on transfer gear body 2892, as shown in Figure 152. Thereafter, rotation of the 2880 swivel drive rod causes the entire 2800 end actuator to rotate around the tool's longitudinal axis "LT-LT" with respect to the 720 end actuator end tube.
[000356] Figures 157 to 170 illustrate another modality of end actuator 3000 that employs traction-type movements to open and close the anvil assembly 3010. The anvil assembly 3010 is movably supported on an elongated channel 3030 for movement selective between an open position (Figures 168 and 169) and a closed position (Figures 157, 160 and 170). Elongated channel 3030 may be substantially identical to elongated channel 1020 described above, except for the differences discussed below. Elongated channel 3030 may be coupled to a drive housing of end actuator 1010 in the manner described above. End actuator drive housing 1010 may also be coupled to end actuator end tube 720 by bearing ring 734 as described above. As seen in Figure 157, the end actuator drive housing 1010 can support a drive 748 and rotary drive 750 arrangement, as described above.
[000357] As seen in Figure 160, the anvil assembly 3010 includes a pair of anvil swivel pins 3012 (only one swivel pin can be seen in Figure 160) which are movably received within corresponding swivel pin slots 3032 formed in elongated channel 3030. The underside of anvil assembly 2810 additionally has an anvil aperture notch 3016 formed therein for pivotal engagement with upper fins 1208 on firing member 3100. See Figure 168. The firing member 3100 may be substantially identical to firing member 1200 described above, except for the differences noted. In the illustrated embodiment, the end actuator 3000 additionally includes an anvil spring 3050 that is configured to apply a changing force on the anvil pivot pins 3012. One form of anvil spring 3050 is illustrated in Figure 159. As can be seen in this figure, the anvil spring 3050 may be fabricated from metal wire and have two opposing spring arms 3052 that are configured to affect the anvil swivel pins 3012 when the anvil swivel pins are received within their respective slots. swivel pin 3032. Furthermore, as can be seen further in Figure 159, anvil spring 3050 has two mounting loops 3054 formed therein which are adapted to be movably supported on corresponding spring pins 3034 formed in elongated channel 3030 See Figure 158. As will be discussed more fully below, the anvil spring 3050 is configured to revolve on spring pins 3034 within the ca. elongated channel 3030. As can be seen more particularly in Figure 158, a portion 3035 of each side wall of the elongate channel is recessed to provide space for movement of the anvil spring 3050.
[000358] As can be seen in Figures 157 and 160 to 170, the end actuator 3000 additionally includes a closure tube 3060 which is movably supported in the elongated channel 3030 for selective longitudinal movement thereon. To facilitate longitudinal movement of closure tube 3060, the embodiment shown in Figures 157 and 160 to 170 includes a closure solenoid 3070 that is connected to closure tube 3060 by a connecting arm 3072 that is pivotally or otherwise secured. mode attached to closure tube 3030. When solenoid is actuated, connecting arm 3072 is actuated in the distal direction, which engages closure tube 3060 distally at the end of elongated channel 3030. As it moves distally, closure tube 3060 causes anvil assembly 3010 to revolve to a closed position. In an alternative embodiment, the solenoid may comprise an annular solenoid mounted on the distal end of the end actuator 1010 gearbox. The closure tube would be fabricated from a metallic material that could be magnetically attracted and repelled by the annular solenoid to result in the longitudinal movement of the closure tube.
[000359] In at least one form, the 3060 end actuator additionally includes a unique 3080 anvil locking system to retain the 3010 anvil assembly locked in position when it is closed over the target tissue. In one form, as seen in Figure 157, the anvil locking system 3080 includes an anvil locking bar 3082 that extends transversely through the elongated channel 3030 so that the ends thereof are received within the bar openings. mating locks 3036 formed in elongated channel 3030. See Figure 158. With reference to Figure 161, when closure tube 3060 is in its most distal "closed" position, the ends of lock bar 3082 protrude laterally out through the openings of lock bar 3036 and extend beyond the proximal end of closure tube 3060 to prevent it from moving proximally out of position. The 3082 lock bar is configured to engage a 3076 solenoid contact held in the 1010 end actuator drive housing. The 3076 solenoid contact is wired to a control system to control the 3070 solenoid. The control system includes an electrical power source supplied by a battery or other electrical power source in the robotic system or cable assembly, whichever the case.
[000360] Trigger member 3100 is pivotally positioned on an implement drive rod 1300 which is pivotally supported within an elongated channel 2830 that is configured to support a surgical staple cartridge therein (not shown). Implement drive rod 1300 has a bearing segment 1304 formed therein that is rotatably supported on a bushing bearing 2834 formed in the end actuator connector box 2832 and forms an operating interface with the rotatable drive 750 in the manner described above. Rotation of implement drive rod 1300 in one direction causes trigger member 3100 to be driven distally through elongated channel 3030 and rotation of implement drive rod 1300 in an opposite direction of rotation will cause the trigger member to 1200" trigger is retracted in the proximal "PD" direction. As seen in Figures 157 and 160 to 170, the 3100 trigger member has a 3102 actuating bar configured to engage the 3082 locking bar, as will be discussed in more detail below.
[000361] The 3080 anvil locking system additionally includes an anvil pull assembly 3090 to selectively pull the anvil into wedge locking engagement with the 3060 closure tube, after the 3060 closure tube is moved into position distal end, in which the distal end of closure tube 3060 is in contact with an anvil shoulder 3013 formed on anvil assembly 3010. In one form, anvil drive assembly 3090 includes a pair of anvil drive cables 3092 which are attached to the proximal end of the anvil assembly 3010 and protrude proximally through the elongated shank assembly to the mounting portion of the tool or handle assembly, whichever the case. The pull cables 3092 can be attached to an actuator mechanism on the cable assembly, or be coupled to one of the drive systems on the mounting portion of the tool that is configured to apply tension to the cables 3092.
[000362] Operation of end actuator 3000 will now be described. Figures 168 and 169 illustrate the anvil assembly 3010 in an open position. Figure 168 illustrates firing member 3100 in its most proximal position, where a new staple cartridge (not shown) can be mounted in elongated channel 3030. Closure tube 3060 is also in its most proximal unactuated position. In addition, as can be seen in Figure 167, when firing member 3100 is in its most proximal position, actuation bar 3102 has forced the latch bar into engagement with solenoid contact 3076, which allows the solenoid to is activated for the next closing sequence. In this way, to begin the closing process, the rotary drive rod 752 is actuated to move the firing member 3100 to its home position shown in Figure 169. When in this position, the actuating bar 3102 has moved in the direction proximal enough that latch bar 3082 comes out of engagement with solenoid contact 3076 so that when power is supplied to the solenoid control circuit, solenoid rod 3072 is extended. Control power is then applied - automatically or through a switch or other control mechanism on the cable assembly - to solenoid 3070, which moves closure tube 3060 distally until the distal end of closure tube 3060 enters contact with shoulder 3013 on anvil assembly 3010 to cause the anvil assembly to revolve closed over firing member 1200", as shown in Figure 162. As seen in this figure, latch bar 3082 is positioned to prevent the movement of the closure tube 3060 in the proximal direction. When in this position, the physician then applies tension to the pull cables 3092 to pull the proximal end of the anvil assembly 3010 into wedge engagement with the closure tube 3060 to lock the 3010 anvil assembly in the closed position. After that, the 1200" firing member can be driven in the distal direction through the tissue trapped in the 3000 end actuator. After the process d and shooting is completed. The implement drive rod is rotated in an opposite direction to return the trigger member 3100 to its home position, in which the actuating bar 3102 has once again contacted the lock bar 3082 to flex it into contact with the solenoid contact 3076 and to pull the ends of the lock bar 3082 into the openings 3036 in the elongated channel 3030. In this position, when power is supplied to the solenoid control system, the solenoid 3070 retracts the closure tube 3060 at the proximal direction to its open or initial position shown in Figures 167 and 168. As closure tube 3060 moves proximally out of engagement with anvil assembly 3010, anvil spring 3050 applies a shifting force to the 3012 anvil swivel pins to move the anvil assembly to the open position shown in Figure 168.
[000363] Figures 171 to 178 illustrate another exemplary elongated rod assembly 3200 that has another exemplary 3210 quick-disconnect coupler arrangement therein. In at least one form, for example, the quick-disconnect coupler arrangement 3210 includes a proximal coupler element 3212 in the form of a proximal outer segment of tube 3214 which, in one arrangement, may have a tubular gear segment 354 thereon. which is configured to interface with the first drive system 350 in the manner described above, when the device is to be robotically controlled. In another embodiment, however, the proximal outer segment of tube 3214 may interface with a manually actuatable rotation nozzle 2512 mounted on a cable assembly in the manner described above. As discussed above, the first drive system 350 in a robotically controlled application or the rotation nozzle 2512 in a portable arrangement serves to rotate the elongated rod assembly 3200 and the end actuator operatively coupled thereto about the longitudinal axis "LT -LT" of the tool. See Figure 171. The proximal outer segment of tube 3214 has a "recessed" distal end portion 3216 that is configured to receive a locking ring thereon.
[000364] In the exemplary embodiment depicted in Figures 171 to 178, the elongated rod assembly 3200 includes a proximal segment of drive rod 380" which may be substantially identical to the proximal segment of drive rod 380 described above, except for the differences discussed below, and be configured to receive control pivotal and axial motions by the robotic system or cable assembly in the various ways disclosed herein. The illustrated embodiment can be used with a swivel joint 700, as described above, and include swivel cables 434 and 454 that may be coupled to the pivot control drives in the various ways described herein. Proximal loading material 3220 is provided within the proximal outer segment of tube 3214 to provide axial support for the pivot cable end portions 434A, 434B , 454A, 454B. Each end portion of the pivot cable 434A, 434B, 454A, 4 54B extends through a corresponding proximal hinge passage 3222 provided through proximal loading material 3220. Each end portion of the hinge cable 434A, 434B, 454A, 454B additionally has a proximal hinge clip 3224 attached thereto which is configured to slide into mating hinge passage 3222. Proximal hinge cleats 3224 may be fabricated from polymeric or metallic material and each has a pair of flexible cleat arms 3226 each having a fastener hook 3228 formed. in the same. Similarly, the proximal segment of the drive rod 380" is movably received in a rod passage 3230 in the proximal load material 3220. A drive rod connecting clip 3240 therein. In an exemplary form, the clip drive rod connection bar 3240 is formed with a central tubular connector portion 3242 and two flexible clamp arms 3244 thereon that each have a fastener hook 3248 thereon.
[000365] As can be further seen in Figures 171, 172 and 176 to 178, the quick release arrangement 3210 additionally includes a distal coupler element 3250 in the form of a distal outer tube segment 3252 which is substantially similar to the distal outer portion. of tube 231 described above, except that the distal outer tube segment 3252 includes a recessed proximal end portion 3254. The distal outer tube segment 3252 is operatively coupled to an end actuator 1000 of the various types disclosed herein. and includes a drive stem 540" distal segment which may be substantially similar to the drive stem 540 distal segment described above, except for the differences noted above. A distal loading material 3260 is provided within the distal outer tube segment 3252 to provide axial support for the distal swivel cable segments 444, 445, 446, 447. distal hinge 444, 445, 446, 447 extends through a corresponding distal hinge passage 3262 provided through distal loading material 3260. Each distal hinge cable segment 444, 445, 446, 447 additionally has a bayonet-type column distal hinge bracket 3270 attached thereto which is configured to slide between cleat arms 3226 of corresponding proximal hinge cleat 3224. Each bayonet-type distal hinge cleat 3270 is configured to be retentively engaged by securing hooks 3228 to corresponding cleat arms 3226. Similarly, the distal segment of drive rod 540" is movably received in a distal rod passage 3264 in distal loading material 3260. A bayonet-type column of distal drive rod 3280 is secured to the proximal end. of the distal segment of the drive rod 540" so that it can protrude proximally beyond the ti columns. p 3270 Distal Pivot Bayonet Column. Figure 172 illustrates the position of the 3280 Distal Drive Rod Bayonet-Type Column (in dashed lines) in relation to the 3270 Distal Pivot Bayonet-Type Columns. Distal 3280 is configured to be retentively engaged by securing hooks 3248 to corresponding cleat arms 3244 on drive rod connection cleat 3240.
[000366] As seen in Figures 171 to 178, the exemplary quick-disconnect coupler arrangement 3210 additionally includes an axially movable locking ring 3290 that is movably positioned in the recessed proximal end portion 3254 of the distal outer tube segment. 3252. As can be seen more particularly in Figure 174, one form of locking ring 3290 includes an outer locking sleeve 3292 that is sized to be slidably received in recessed portions 3216, 3254 of the proximal outer segment of tube 3214 and of the 3254 distal outer tube segment, respectively. The outer locking sleeve 3292 is coupled to the central locking body 3294 by a bridge 3295. The bridge 3295 is configured to slide through a distal slot 3255 in the recessed portion 3254 of the distal outer tube segment 3254, as well as a proximal slot 3217 in the recessed portion 3216 of the proximal outer tube segment 3214 which is slidably received within the recessed proximal end portion 3254 of the distal outer tube segment 3252 and may also slideably extend in the recessed portion 3216 of the proximal outer tube segment 3214. As can be seen further in Figure 174, the central locking body 3294 has a plurality of passages 3296 for receiving the tabs and hinge columns therethrough. Similarly, the central locking body 3294 has a central actuating rod passage 3298 for movably receiving the distal segment of actuating rod 540" therein.
[000367] The use of the exemplary quick disconnect coupler arrangement 3210 will now be described. Referring primarily to Figures 171 and 172, distal coupler element 3250 is axially aligned with proximal coupler element 3212 such that bridge 3295 is aligned with slot 3217 in recessed portion 3216 of the proximal outer segment of tube 3214 and the column of the bayonet-style distal drive rod 3280 is aligned with center tubular connector portion 3242 on proximal drive rod connector clip 3240. Thereafter, distal coupler element 3250 is placed in adjoining engagement with proximal coupler element 3212 to make with the 3280 Distal Drive Rod Bayonet-Type Post to slide into the center tubular segment 3214 and finally into the retaining engagement with the securing hooks 3248 on the 3240 Proximal Drive Rod Connector Clip. 3270 distal hinge bayonet-type connector column is retentively engaged by the retaining hooks 3228 on the connector clips of proximal hinge 3224, as shown in Figures 176. It will be noted that as the 3280 distal drive rod bayonet-type column is inserted between the 3244 cleat arms, the 3244 cleat arms flex outward until the hooks fasteners 3248 engage a shoulder-shaped shoulder 3281 on column 3280. Similarly, as each of the 3270 distal pivot bayonet-type columns is inserted between their corresponding connector arms 3226, the connector arms 3226 flex outward until the fastener hooks 3228 engage a shoulder-shaped shoulder 3271 on the column 3270. After the distal segment of the drive rod 540" is connected to the proximal segment of the drive rod 380" and the distal pivot cable segments 444, 445, 446, 447 to be connected to the pivot cable end portions 434A, 434B, 454A, 454B respectively, the user can then slide the outer locking sleeve 32 92 proximally to the position shown in Figures 177 and 178. When in that position, the central locking body 3294 prevents the clip arms 3244, 3226 from flexing outwardly to thereby lock the distal coupler element 3250 to the proximal coupler element 3212 To disconnect the distal coupler element 3250 from the proximal coupler element 3212, the user moves the outer locking sleeve 392 to the position shown in Figures 175 and 176 and thereafter pulls the coupler elements 3250, 3212 separately. As opposing axial separating motions are applied to the coupler elements 3250, 3212, the clip arms 3244 and 3226 are allowed to flex out of engagement with the distal drive rod bayonet-type column and the bayonet-type columns of distal joint, respectively. NON-LIMITING EXAMPLES
[000368] An exemplary form comprises a surgical tool for use with a robotic system that includes a tool drive assembly that is operatively coupled to a robotic system control unit that operates via input commands entered by a operator and is configured to robotically generate exit movements. In at least one exemplary form, the surgical tool includes a drive system that is configured to interface with a corresponding portion of the tool drive assembly of the robotic system to receive the robotically generated output motions therefrom. A drive rod assembly forms an operational interface with the drive system and is configured to receive robotically generated output movements from the drive system and apply the control movements to a surgical end actuator that forms an operational interface with the drive rod assembly. A manually actuatable control system forms an operational interface with the drive rod assembly to selectively apply manually generated control motions to the drive rod assembly.
[000369] In conjunction with another general exemplary form, a surgical tool is provided for use with a robotic system that includes a tool drive assembly that is operatively coupled to a robotic system control unit that is operated by means of of input commands entered by an operator and is configured to provide at least one output rotary motion for at least one rotary body portion supported on the tool drive assembly. In at least one exemplary form, the surgical tool includes a surgical end actuator comprising at least one component portion that is selectively movable between the first and second positions with respect to at least one other component portion thereof, in response to the control movements applied to it. An elongated rod assembly is operatively coupled to the surgical end actuator and comprises at least one gear driven portion that is in operative communication with the at least one selectively movable component portion. A mounting portion of the tool is operatively coupled to the elongated shank assembly and is configured to form an operative interface with the tool drive assembly when coupled thereto. At least one exemplary form further comprises a tool mounting portion comprising a moved element that is rotatably supported on the tool mounting portion and is configured to engage engagement with a corresponding portion among at least the body portions. tool drive assembly rotary to receive corresponding rotary output movements therefrom. A drive system is in operative engagement with the moved element to apply robotically generated actuating movements thereto to cause the corresponding portion among at least the gear driven portions to apply at least one control movement to the selectively movable component . A manually actuatable reversing system forms an operational interface with the elongated rod assembly to selectively apply manually generated control motions to it.
[000370] According to another exemplary general form, a surgical tool is provided for use with a robotic system that includes a tool drive assembly that is operatively coupled to a robotic system control unit that is operated by means of of input commands entered by an operator and is configured to robotically generate rotating output movements. In at least one exemplary form, the surgical tool comprises a rotary drive system that is configured to interface with a corresponding portion of the tool drive assembly of the robotic system to receive the robotically generated rotary output motions therefrom. A swivel drive rod assembly forms an operational interface with the swivel drive system and is configured to receive the robotically generated output swivels from the swivel drive system and apply swivel drive motions to a surgical end actuator that forms a operating interface with the swivel drive rod assembly. A manually actuatable reversing system forms an operational interface with the swivel drive rod assembly to selectively apply manually generated swivel drive motions to the swivel drive rod assembly.
[000371] Another exemplary form comprises a surgical stapling device that includes an elongated shank assembly that has a distal end and defines a longitudinal axis of the tool. The device further includes an end actuator comprising an elongated channel assembly that includes a portion that is configured to operatively support a surgical staple cartridge therein. An anvil is movably supported relative to the elongated channel assembly. The surgical stapling device further comprises a swivel joint that couples the elongated channel assembly to the distal end of the elongated rod assembly to facilitate selective rotation of the elongated channel assembly about the longitudinal axis of the tool relative to the distal end of the elongated rod assembly.
[000372] Another exemplary form comprises a joint assembly with swivel support for coupling a first portion of a surgical instrument to a second portion of a surgical instrument. In at least one exemplary form, the swivel joint assembly comprises a first annular track on the first portion and a second annular track on the second portion and which is configured for substantial alignment with the first annular track when the second portion is joined with the first portion. A bearing ring is supported within the first and second annular races.
[000373] In conjunction with another exemplary general form, a pivot bearing joint assembly is provided for coupling a surgical end actuator to an elongated rod assembly of a surgical instrument. In at least one exemplary form, the pivot bearing joint assembly comprises a cylindrical shaped connector portion on the surgical end actuator. A first annular track is provided on the circumference of the connector portion. A socket is provided on the elongated stem and is sized to receive the cylindrical shaped connector portion thereon so that the cylindrical shaped connector portion can rotate freely with respect to the socket. A second annular race is provided on an inner wall of the socket and is configured for substantial alignment with the first annular race when the cylindrical shaped connector portion is received within the socket. An opening is provided in the socket in communication with the second annular race. A bearing ring element having a free end can be inserted through the opening in the aligned first and second annular races.
[000374] In conjunction with another exemplary general form, a method for pivotally coupling a first portion of a surgical instrument to a second portion of a surgical instrument is provided. In various exemplary forms, the method comprises forming a first annular track on the first portion and forming a second annular track on the second portion. The method further includes inserting the first portion into the second portion so that the first and second annular races are in substantial alignment and inserting a bearing ring within the aligned first and second annular races.
[000375] Another exemplary form comprises a drive rod assembly for a surgical instrument that includes a plurality of movably interconnected junction segments that are interconnected to form a flexible hollow tube. A flexible secondary retainer element is installed in flexible retainer engagement with the plurality of movably interconnected joint segments to retain the socket joint segments in mobile interconnected engagement while facilitating flexion of the rod assembly. drive.
[000376] According to another general exemplary form, a composite drive rod assembly is provided for a surgical instrument that includes a plurality of movably interconnected junction segments that are cut into a hollow tube by a laser and that have a distal end and a proximal end. A secondary flexible retainer element is installed in flexible retainer engagement with the plurality of movably interconnected joint segments to retain the socket joint segments in mobile interconnected engagement and at the same time facilitate flexing of the rod assembly. drive.
[000377] According to yet another exemplary general form, there is provided a drive rod assembly for a surgical instrument that includes a plurality of movably interconnected joint segments, wherein at least some joint segments comprise a portion. of spherical connector that is formed from their substantially arcuate surfaces. A socket portion is sized to movably receive the ball connector portion of an adjoining junction segment thereon. A hollow passage extends through each ball connector portion to form a passage through the drive rod assembly. The drive rod assembly may also include a flexible secondary retainer element installed in flexible retainer engagement with the plurality of movably interconnected joint segments for retaining the joint segments in mobile interconnected engagement, at the same time at which facilitates the flexion of the drive rod assembly.
[000378] Another exemplary form comprises a method for forming a flexible drive rod assembly for a surgical instrument. In several exemplary embodiments, the method comprises providing a hollow rod and cutting a plurality of joint segments movably interconnected in the hollow rod with a laser. The method further comprises installing a secondary retainer element in the hollow rod to retain the movably interconnected joint segments in movable interconnected engagement, while facilitating flexion of the drive rod assembly.
[000379] In conjunction with another exemplary form, a method for forming a flexible drive rod assembly for a surgical instrument is provided. In at least one exemplary embodiment, the method comprises providing a hollow rod and cutting a plurality of joint segments movably interconnected in the hollow rod with a laser. Each junction segment comprises a pair of opposing protrusions, each protrusion having a tapered portion on the outer circumference that is received within a corresponding socket that has a tapered inner wall portion that cooperates with the tapered portion on the outer circumference of the corresponding protrusion. to movably retain the corresponding protrusion thereon.
[000380] Another exemplary general form comprises a rotary drive arrangement for a surgical instrument that has a surgical end actuator operatively coupled thereto. In an exemplary form, the rotary drive arrangement includes a rotary drive system that is configured to generate rotary drive motions. A drive rod assembly forms an operative interface with the rotary drive system and is selectively axially movable between a first position and a second position. A swivel transmission forms an operational interface with the drive rod assembly and the surgical end actuator so that when the drive rod assembly is in the first axial position, one of the swivel drive motions is applied to the rod assembly drive by the rotary drive system causes the rotary drive to apply a first control rotary motion to the surgical end actuator, and when the drive rod assembly is in the second axial position, the application of the rotary drive motion to the rod assembly Drive by the swivel drive system causes the swivel drive to apply a second control swivel motion to the surgical end actuator.
[000381] In conjunction with another exemplary general form, a surgical tool is provided for use with a robotic system that includes a tool drive assembly that is operatively coupled to a robotic system control unit that is operated by means of of input commands entered by an operator and is configured to generate output movements. In at least one exemplary form, the surgical tool comprises a tool mounting portion that is configured to form an operational interface with a portion of the robotic system. A rotary drive system is operatively supported by the tool mounting portion and interfaces with the tool drive assembly to receive corresponding output motions therefrom. An elongated rod assembly operatively extends from the mounting portion of the tool and includes a drive rod assembly that forms an operational interface with the rotary drive system. The drive rod assembly is selectively movable axially between a first position and a second position. The surgical tool further comprises a surgical end actuator that is rotatably coupled to the elongated rod assembly for selective rotation with respect thereto. A swivel transmission forms an operating interface with the drive rod assembly and the surgical end actuator so that when the drive rod assembly is in the first axial position, one of the swivel drive motions is applied to the drive rod assembly. drive by the rotary drive system causes the rotary transmission to apply a first rotary control motion to the surgical end actuator, and when the drive rod assembly is in the second axial position, the application of the rotary drive motion to the drive rod assembly by the rotary drive system causes the rotary transmission to apply a second control rotary motion to the surgical end actuator.
[000382] In conjunction with yet another exemplary general form, a surgical instrument is provided that comprises a cable assembly and a drive motor that is operationally supported by the cable assembly. An elongated rod assembly operatively extends from the cable assembly and includes a drive rod assembly that forms an operative interface with the drive motor and is selectively axially movable between a first position and a second position. A surgical end actuator is rotatably coupled to the elongated stem assembly for selective rotation relative to it. A swivel transmission forms an operational interface with the drive rod assembly and the surgical end actuator so that when the drive rod assembly is in the first axial position, a rotary drive motion is applied to the drive rod assembly. drive by drive motor causes the rotary transmission to apply a first control rotary motion to the surgical end actuator, and when the drive rod assembly is in the second axial position, the application of the rotary drive motion to the surgical end rod assembly. drive by drive motor causes the rotary transmission to apply a second control rotary motion to the surgical end actuator.
[000383] Several exemplary embodiments also comprise a differential locking system for a surgical instrument that includes a surgical end actuator that is powered by a swivel drive rod assembly that is movable between a plurality of distinct axial positions. In at least one form, the differential locking system comprises at least one retainer formation in the swivel drive rod assembly that corresponds to each of the distinct axial positions. At least one locking element is operatively supported relative to the swivel drive rod assembly for retentive engagement with the at least one retainer formation when the swivel drive rod assembly is moved to the distinct axial positions associated therewith.
[000384] In conjunction with another exemplary general form, a differential locking system for a surgical instrument is provided that includes a surgical end actuator powered by a swivel drive rod assembly that is movable between a first axial position and a second position axial. In at least one exemplary form, the differential locking system comprises a differential box that forms an operational interface with the swivel drive rod assembly and the surgical end actuator. At least one spring activated locking element operatively supported by the differential box for retentive engagement with a first portion of the swivel drive rod assembly, when the swivel drive rod assembly is in the first axial position, and the at least one spring activated locking element additionally configured to retentively engage a second portion of the swivel drive rod assembly when the swivel drive rod assembly is in the second axial position.
[000385] In conjunction with yet another exemplary general form, a differential locking system for a surgical instrument is provided that includes a surgical end actuator that is powered by a swivel drive rod assembly that is movable between a first axial and axial position. a second axial position. In at least one exemplary form, the differential locking system comprises a differential box that forms an operational interface with the swivel drive rod assembly and surgical end actuator. At least one spring element is provided in a portion of the swivel drive rod assembly, each spring element defining a first detent position that corresponds to the first axial position of the swivel drive rod assembly and a second detent position that corresponds to the second axial position of the swivel drive rod assembly. A locking element is operatively supported by the differential box and corresponds to each of the at least one spring elements for retentive engagement therewith, so that the locking element retentively engages the corresponding spring element in the first retaining position when the swivel drive rod assembly is in the first axial position, and the locking element retentively engages the corresponding spring element in the second retaining position when the swivel drive rod assembly is in the second axial position.
[000386] Several other exemplary embodiments comprise a surgical instrument that includes an end actuator and a proximal swivel drive train assembly that is operatively coupled to a source of control and axial swivel motions. The proximal swivel drive train assembly is longitudinally displaceable in response to applications of axial control movements thereto. The surgical instrument further includes a distal swivel drive train assembly that is operatively coupled to the end actuator to apply control swivel motions thereto. A proximal axial drive train assembly is operatively coupled to another source of axial control movements. A distal axial drive train assembly is operatively coupled to the end actuator to apply axial control movements thereto. The instrument further comprises a coupling arrangement for simultaneously attaching and detaching the swivel drive train assembly proximal to the distal swivel drive train assembly and the axial drive train assembly proximal to the distal axial drive train assembly.
[000387] In conjunction with another general aspect, a coupling arrangement for attaching an end actuator is provided that includes a plurality of distal drive train assemblies that are configured to apply a plurality of control movements to the end actuator to the assemblies of corresponding proximal drive trains that communicate with a source of drive motions. In an exemplary form, the coupling arrangement comprises a proximal locking formation at a distal end of each proximal drive train assembly and a proximal coupler element that is configured to operatively support each proximal drive train assembly thereon, so that the proximal attachment formations thereon are retained in substantial mating alignment. A distal lock formation is provided on a proximal end of each distal drive train assembly. Each distal locking formation is configured to operatively engage a proximal locking formation at the distal end of a corresponding proximal drive train when placed in mating engagement therewith. A distal coupler element is operatively coupled to the end actuator and is configured to operatively support each distal drive train thereon to retain the distal attachment formations thereon in substantial coupling alignment. A locking ring is movable from an unlocked position, where the distal drive train assemblies can be decoupled from the corresponding proximal drive train assemblies, to a locked position, where the distal drive train assemblies are retained in engagement coupled with their corresponding proximal drive train assemblies.
[000388] In conjunction with another general aspect, a surgical instrument is provided that includes an end actuator that is configured to perform surgical activities in response to actuation movements applied to it. An exemplary form of the instrument further includes a source of drive movements and a first proximal drive train assembly that forms an operative interface with the source of drive movements to receive corresponding first drive movements therefrom. A second proximal drive train assembly forms an operative interface with the source of drive movements to receive corresponding second drive movements therefrom. A first distal drive train assembly forms an operational interface with the end actuator and is configured to receive corresponding first drive movements from the first proximal drive train assembly when it is operatively coupled thereto. A second distal drive train assembly forms an operative interface with the end actuator and is configured to receive corresponding second drive movements from the second proximal drive train assembly when it is operatively coupled thereto. The instrument further comprises a coupling arrangement that includes a first coupling element operatively supporting the first and second proximal drive train assemblies thereon. The coupling arrangement further includes a second coupling element that operatively supports the first and second distal drive train assemblies thereon and is configured for axial alignment with the first coupling element, so that when the second coupling element coupling is axially aligned with the first coupling element, the first distal drive train assembly is in axial alignment with the first proximal drive train assembly for operative engagement therewith, and the second distal drive train assembly is in axial alignment with the second proximal drive train assembly for operative engagement therewith. A locking ring is movably positioned on one of the first and second coupling elements and is configured to move between an unlocked position, wherein the first and second distal drive train assemblies are separable from the first and second proximal drive train assemblies, respectively, and a locked position, wherein the first and second distal drive train assemblies are retained in operative engagement with the first and second proximal drive train assemblies, respectively.
[000389] According to another general aspect, a surgical cartridge is provided that includes a cartridge body that defines a trajectory therethrough to operationally receive a firing member of a surgical instrument. The surgical cartridge further includes an alignment element that is operatively supported on the cartridge body and is configured to move the triggering member from a non-operational configuration, wherein the triggering member is trajectory misaligned to an operational configuration, where the trigger member is in alignment with the trajectory when the trigger member is triggered in contact with it.
[000390] According to yet another general aspect, an end actuator for a surgical instrument is provided. In at least one form, the end actuator comprises a support member having a slit and a locking notch that is adjacent to the slit. The end actuator further comprises a trigger member which is movable between a non-operational configuration and an operational configuration, wherein the trigger member is aligned with the slot and is structured to translate in the slot when it is in the configuration. operational and, wherein the trigger member is engaged with the locking notch and misaligned with the slot when it is in the non-operational configuration.
[000391] Another exemplary embodiment comprises a surgical instrument that includes an elongated channel that is configured to removably support a cartridge therein. In at least one form, the cartridge comprises a cartridge body and an alignment element that is movably supported within the cartridge body for movement from a first position to a second position thereon. The surgical instrument also comprises a trigger member that is operatively supported relative to the elongated channel for movement between an initial position and an end position by applying actuating motions thereto. The firing member is unable to move from the start position to the end position, except when the firing member is in operative engagement with the alignment element in the cartridge body.
[000392] Another exemplary embodiment comprises an end actuator for a surgical instrument. In at least one form, the end actuator comprises an elongated channel that is configured to releasably support a cartridge therein. A trigger member is operatively supported relative to the elongated channel for movement between a start and end position. An implement drive rod is in operative engagement with the trigger member to move the trigger member between start and end positions by applying actuating motions thereto from a drive arrangement. The implement drive rod is movable from a non-operational position, where the implement drive rod is out of operational engagement with the drive arrangement to an operational position, where the implement drive rod is in operational engagement with the drive arrangement. The end actuator further comprises an alignment element that is movably supported for contact with the implement drive rod to move the implement drive rod from the non-operating position to the operating position by installing a cartridge. in the elongated channel.
[000393] Another exemplary embodiment includes a surgical instrument comprising an elongated channel and a cartridge that is removably supported in the elongated channel. A trigger member is operatively supported relative to the elongated channel for movement between a start and end position. An implement drive rod is in operative engagement with the trigger member to move the trigger member between start and end positions by applying actuating motions thereto from a drive arrangement. The implement drive rod is movable from a non-operational position, where the implement drive rod is out of operational engagement with the drive arrangement to an operational position, where the implement drive rod is in operational engagement with the drive arrangement. The surgical instrument further comprises an alignment element that is movably supported for contact with the implement drive rod to move the implement drive rod from the non-operating position to the operating position upon installation. of a cartridge in the elongated channel.
[000394] The devices described herein may be designed to be disposed of after a single use, or they may be designed to be used multiple times. In either case, however, the device can be refurbished for reuse after at least one use. Reconditioning can include any combination of steps of disassembling the device, followed by cleaning or replacing particular parts, and subsequent reassembly. In particular, the device can be disassembled, and any number of parts or particular parts of the device can be selectively exchanged or removed, in any combination. After cleaning and/or changing particular parts, the device can be reassembled for subsequent use in a reconditioning facility or by a surgical team immediately prior to a surgical procedure. Those skilled in the art will appreciate that reconditioning a device can use a variety of techniques for disassembly, cleaning/exchange, and reassembly. The use of such techniques, and the resulting refurbished device, are all within the scope of this order.
[000395] Although the present invention has been described herein in conjunction with certain exemplary embodiments disclosed, many modifications and variations to those exemplary embodiments can be implemented. For example, different types of end actuators can be employed. Also, where materials are disclosed for certain components, other materials may be used. The aforementioned description and the following claims are intended to cover all such modifications and variations.
[000396] Any patent, publication or other descriptive material, in whole or in part, which is said to be incorporated into the present invention by way of reference, is incorporated into the present invention only to the extent that the incorporated materials do not enter. in conflict with existing definitions, statements or other descriptive material presented in this description. Accordingly, and to the extent necessary, the description as explicitly stated herein supersedes any conflicting material incorporated herein by reference. Any material, or portion thereof, which is hereby incorporated by reference into the present invention, but which conflicts with existing definitions, statements, or other descriptive materials set forth herein will be incorporated herein only to the extent that no conflict. will appear between the embodied material and the existing descriptive material.

权利要求:
Claims (13)
[0001]
1. Surgical instrument system, characterized in that it comprises: a housing that includes a motor-driven drive rod (1750), the motor-driven drive rod (1750) being configured to rotate a defined number of revolutions during a trigger trigger; a first end actuator assembly (1740) configured to be coupled and uncoupled from the housing, the first end actuator defining a first firing path having a first firing length, the first end actuator assembly comprising : a first trigger element (1730) configured to travel a path along the first trigger path; and a first drive screw (1700) configured to be operatively coupled to and operatively decoupled from the motor driven drive rod (1750), the first drive screw (1700) being configured to engage the first trigger element, so that rotation of the first drive screw (1700) causes the first trigger element to move along the first trigger path, and the first drive screw (1700) is configured to cause the first trigger element to trigger (1730) travels the first trigger length when the motor-driven drive rod (1750) rotates the set number of revolutions; and a second end actuator assembly configured to be coupled and uncoupled from the housing, the second end actuator defining a second firing path having a second firing length, and the second firing length being different from the one. first trigger length, the second end actuator assembly comprising: a second trigger element configured to travel a path along said second trigger path; and a second drive screw (1700') configured to be operatively coupled and operatively decoupled from the motor-driven drive rod, the second drive screw being configured to engage the second firing element so that the rotation of the second drive screw causes the second trigger element to travel along the second trigger path, and the second trigger screw is configured to cause the second trigger element to travel the second trigger length when the trigger rod motor driven drive rotates the set number of revolutions.
[0002]
2. Surgical instrument system according to claim 1, characterized in that the first drive screw (1700) comprises a first thread (A) that defines a first thread of the thread, the second drive screw ( 1700') comprises a second thread (A', B') which defines a second thread of the thread, the first thread of the thread being different from the second thread of the thread.
[0003]
3. Surgical instrument system according to claim 1, characterized in that the fixed number of revolutions rotated by the motor-driven drive rod (1750) is a first fixed number of revolutions, with the first drive screw (1700) rotates a second fixed number of revolutions when the motor-driven drive rod (1750) rotates the first fixed number of revolutions, the first drive screw (1700) including at least one thread (A), and being that the thread (A) on the first drive screw (1700) defines a thread of the thread equal to the first firing length of the first firing element divided by the second fixed number of revolutions.
[0004]
4. Surgical instrument system according to claim 3, characterized in that the second fixed number of revolutions is equal to the first fixed number of revolutions.
[0005]
5. Surgical instrument system according to claim 3, characterized in that the second fixed number of revolutions is different from the first fixed number of revolutions.
[0006]
6. Surgical instrument system according to claim 3, characterized in that the second drive screw (1700') rotates a third fixed number of revolutions when the motor-driven drive rod rotates the first fixed number of revolutions , whereby the second drive screw (1700') includes at least one thread (A, A', A", A"', B', B", B"',C", C"', D"' ), and wherein the thread in the second drive screw (1700') defines a thread equal to the second firing length of the second firing element divided by the third fixed number of revolutions.
[0007]
7. Surgical instrument system according to claim 6, characterized in that the third fixed number of revolutions is equal to the second fixed number of revolutions.
[0008]
8. Surgical instrument system according to claim 6, characterized in that the third fixed number of revolutions is different from the second fixed number of revolutions.
[0009]
9. Surgical instrument system according to claim 6, characterized in that the at least one thread of the second drive screw (1700') comprises a first thread (A') and a second thread (B'), the first thread (A') and the second thread (B') being arranged on the second drive screw 180° out of phase with each other.
[0010]
10. Surgical instrument system according to claim 6, characterized in that the at least one thread of the second drive screw (1700) comprises a first thread (A''), a second thread (B'') and a third thread (C''), whereby the first thread (A'), the second thread (B') and the third thread (C'') are arranged on the second drive screw (1700') 120° out of phase with each other.
[0011]
11. Surgical instrument system according to claim 6, characterized in that the at least one thread of the second drive screw (1700') comprises a first thread (A''''), a second thread (B ''''), a third thread (C'''') and a fourth thread (D''''), the first thread (A''''), the second thread (B'''') ), the third thread (C'''') and the fourth thread (D'''') are arranged on the second drive screw (1700') 90° out of phase with each other.
[0012]
12. Surgical instrument system according to claim 1, characterized in that the first drive screw (1700) comprises a first thread (A) arranged at a first angle to a longitudinal axis of the first drive screw (1700), the first angle defining a first thread of the thread, the second drive screw (1700') comprising a second thread (A', A", A"', B', B", B" ",C", C"', D"') arranged at a second angle in relation to a longitudinal axis of the second drive screw (1700'), the second angle defining a second thread of the thread, the first angle is greater than the second angle, and the second thread of the thread is greater than the first thread of the thread.
[0013]
13. Surgical kit for use with a surgical instrument system, wherein the surgical instrument system includes a motor configured to rotate the drive rod (1750) a defined number of revolutions during a firing action, the instrument kit being surgical instrument characterized in that it comprises: a first end actuator assembly (1740) configured to be coupled and uncoupled from the surgical instrument system, the first end actuator (1740) defining a first firing path having a first firing length, the first end actuator assembly comprising: a first firing element (1730) configured to travel a path along said first firing trajectory; and a first drive screw (1700) configured to be operatively coupled and operatively decoupled from the motor-driven drive rod (1750), the first drive screw (1700) being configured to engage the first trigger element (1730) , so that rotation of the first drive screw (1700) causes the first trigger element (1730) to move along the first trigger path, and the first drive screw (1700) being configured to do causing the first firing element (1730) to travel the first firing length when the actuating rod (1750) rotates the set number of revolutions; and a second end actuator assembly configured to be coupled and uncoupled from the surgical instrument system, the second end actuator defining a second firing path having a second firing length, and wherein the second firing length is different from the first trigger length, the second end actuator assembly comprising: a second trigger element configured to travel a path along the second trigger path; and a second drive screw (1700') configured to be operatively coupled to and operatively decoupled from the motor-driven drive rod, the second drive screw (1700') being configured to engage the second firing element so that rotation of the second drive screw (1700') causes the second trigger element to move along the second trigger path, and with the second drive screw (1700') being configured to cause the second trigger travel the second trigger length when the drive rod rotates the set number of revolutions.

类似技术:

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BR112014032755B1|2021-11-03|DRIVE STEM ASSEMBLY FOR A SURGICAL INSTRUMENT AND METHOD FOR FORMING A FLEXIBLE DRIVE STEM ASSEMBLY FOR A SURGICAL INSTRUMENT

同族专利:

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公开号 | 公开日

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US20200275928A1|2020-09-03|

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引用文献:

---

公开号 | 申请日 | 公开日 | 申请人 | 专利标题

---

---

US20070084897A1|2003-05-20|2007-04-19|Shelton Frederick E Iv|Articulating surgical stapling instrument incorporating a two-piece e-beam firing mechanism|

---

US8215531B2|2004-07-28|2012-07-10|Ethicon Endo-Surgery, Inc.|Surgical stapling instrument having a medical substance dispenser|

---

US11246590B2|2005-08-31|2022-02-15|Cilag Gmbh International|Staple cartridge including staple drivers having different unfired heights|

---

US7669746B2|2005-08-31|2010-03-02|Ethicon Endo-Surgery, Inc.|Staple cartridges for forming staples having differing formed staple heights|

---

US9237891B2|2005-08-31|2016-01-19|Ethicon Endo-Surgery, Inc.|Robotically-controlled surgical stapling devices that produce formed staples having different lengths|

---

US20070106317A1|2005-11-09|2007-05-10|Shelton Frederick E Iv|Hydraulically and electrically actuated articulation joints for surgical instruments|

---

US11207064B2|2011-05-27|2021-12-28|Cilag Gmbh International|Automated end effector component reloading system for use with a robotic system|

---

US7845537B2|2006-01-31|2010-12-07|Ethicon Endo-Surgery, Inc.|Surgical instrument having recording capabilities|

---

US11224427B2|2006-01-31|2022-01-18|Cilag Gmbh International|Surgical stapling system including a console and retraction assembly|

---

US8186555B2|2006-01-31|2012-05-29|Ethicon Endo-Surgery, Inc.|Motor-driven surgical cutting and fastening instrument with mechanical closure system|

---

US8684253B2|2007-01-10|2014-04-01|Ethicon Endo-Surgery, Inc.|Surgical instrument with wireless communication between a control unit of a robotic system and remote sensor|

---

US11039836B2|2007-01-11|2021-06-22|Cilag Gmbh International|Staple cartridge for use with a surgical stapling instrument|

---

US8931682B2|2007-06-04|2015-01-13|Ethicon Endo-Surgery, Inc.|Robotically-controlled shaft based rotary drive systems for surgical instruments|

---

US7753245B2|2007-06-22|2010-07-13|Ethicon Endo-Surgery, Inc.|Surgical stapling instruments|

---

US8573465B2|2008-02-14|2013-11-05|Ethicon Endo-Surgery, Inc.|Robotically-controlled surgical end effector system with rotary actuated closure systems|

---

US9585657B2|2008-02-15|2017-03-07|Ethicon Endo-Surgery, Llc|Actuator for releasing a layer of material from a surgical end effector|

---

US8210411B2|2008-09-23|2012-07-03|Ethicon Endo-Surgery, Inc.|Motor-driven surgical cutting instrument|

---

US9386983B2|2008-09-23|2016-07-12|Ethicon Endo-Surgery, Llc|Robotically-controlled motorized surgical instrument|

---

US8608045B2|2008-10-10|2013-12-17|Ethicon Endo-Sugery, Inc.|Powered surgical cutting and stapling apparatus with manually retractable firing system|

---

US8517239B2|2009-02-05|2013-08-27|Ethicon Endo-Surgery, Inc.|Surgical stapling instrument comprising a magnetic element driver|

---

US20110024477A1|2009-02-06|2011-02-03|Hall Steven G|Driven Surgical Stapler Improvements|

---

JP6305979B2|2012-03-28|2018-04-04|エシコン・エンド−サージェリィ・インコーポレイテッドＥｔｈｉｃｏｎ Ｅｎｄｏ−Ｓｕｒｇｅｒｙ，Ｉｎｃ．|Tissue thickness compensator with multiple layers|

---

JP6224070B2|2012-03-28|2017-11-01|エシコン・エンド−サージェリィ・インコーポレイテッドＥｔｈｉｃｏｎ Ｅｎｄｏ−Ｓｕｒｇｅｒｙ，Ｉｎｃ．|Retainer assembly including tissue thickness compensator|

---

US10945731B2|2010-09-30|2021-03-16|Ethicon Llc|Tissue thickness compensator comprising controlled release and expansion|

---

US9861361B2|2010-09-30|2018-01-09|Ethicon Llc|Releasable tissue thickness compensator and fastener cartridge having the same|

---

US9072535B2|2011-05-27|2015-07-07|Ethicon Endo-Surgery, Inc.|Surgical stapling instruments with rotatable staple deployment arrangements|

---

US9101358B2|2012-06-15|2015-08-11|Ethicon Endo-Surgery, Inc.|Articulatable surgical instrument comprising a firing drive|

---

US20140001231A1|2012-06-28|2014-01-02|Ethicon Endo-Surgery, Inc.|Firing system lockout arrangements for surgical instruments|

---

US9364230B2|2012-06-28|2016-06-14|Ethicon Endo-Surgery, Llc|Surgical stapling instruments with rotary joint assemblies|

---

US11197671B2|2012-06-28|2021-12-14|Cilag Gmbh International|Stapling assembly comprising a lockout|

---

RU2636861C2|2012-06-28|2017-11-28|Этикон Эндо-Серджери, Инк.|Blocking of empty cassette with clips|

---

RU2669463C2|2013-03-01|2018-10-11|Этикон Эндо-Серджери, Инк.|Surgical instrument with soft stop|

---

US9629629B2|2013-03-14|2017-04-25|Ethicon Endo-Surgey, LLC|Control systems for surgical instruments|

---

CN109602496B|2013-08-15|2021-07-20|直观外科手术操作公司|Robotic instrument driven element|

---

WO2015023834A1|2013-08-15|2015-02-19|Intuitive Surgical Operations, Inc.|Instrument sterile adapter drive features|

---

JP6674377B2|2013-08-15|2020-04-01|インテュイティブ サージカル オペレーションズ， インコーポレイテッド|Apparatus with proximal and distal driven discs|

---

MX369362B|2013-08-23|2019-11-06|Ethicon Endo Surgery Llc|Firing member retraction devices for powered surgical instruments.|

---

US20150053746A1|2013-08-23|2015-02-26|Ethicon Endo-Surgery, Inc.|Torque optimization for surgical instruments|

---

US9962161B2|2014-02-12|2018-05-08|Ethicon Llc|Deliverable surgical instrument|

---

US11259799B2|2014-03-26|2022-03-01|Cilag Gmbh International|Interface systems for use with surgical instruments|

---

JP6612256B2|2014-04-16|2019-11-27|エシコンエルエルシー|Fastener cartridge with non-uniform fastener|

---

US9757128B2|2014-09-05|2017-09-12|Ethicon Llc|Multiple sensors with one sensor affecting a second sensor's output or interpretation|

---

BR112017004361A2|2014-09-05|2017-12-05|Ethicon Llc|medical overcurrent modular power supply|

---

BR112017005981A2|2014-09-26|2017-12-19|Ethicon Llc|surgical staplers and ancillary materials|

---

US9924944B2|2014-10-16|2018-03-27|Ethicon Llc|Staple cartridge comprising an adjunct material|

---

US11141153B2|2014-10-29|2021-10-12|Cilag Gmbh International|Staple cartridges comprising driver arrangements|

---

US9968355B2|2014-12-18|2018-05-15|Ethicon Llc|Surgical instruments with articulatable end effectors and improved firing beam support arrangements|

---

US11154301B2|2015-02-27|2021-10-26|Cilag Gmbh International|Modular stapling assembly|

---

US10548504B2|2015-03-06|2020-02-04|Ethicon Llc|Overlaid multi sensor radio frequencyelectrode system to measure tissue compression|

---

US10245033B2|2015-03-06|2019-04-02|Ethicon Llc|Surgical instrument comprising a lockable battery housing|

---

US9993248B2|2015-03-06|2018-06-12|Ethicon Endo-Surgery, Llc|Smart sensors with local signal processing|

---

US11058425B2|2015-08-17|2021-07-13|Ethicon Llc|Implantable layers for a surgical instrument|

---

US10238386B2|2015-09-23|2019-03-26|Ethicon Llc|Surgical stapler having motor control based on an electrical parameter related to a motor current|

---

US10299878B2|2015-09-25|2019-05-28|Ethicon Llc|Implantable adjunct systems for determining adjunct skew|

---

US10980539B2|2015-09-30|2021-04-20|Ethicon Llc|Implantable adjunct comprising bonded layers|

---

US10265068B2|2015-12-30|2019-04-23|Ethicon Llc|Surgical instruments with separable motors and motor control circuits|

---

US10292704B2|2015-12-30|2019-05-21|Ethicon Llc|Mechanisms for compensating for battery pack failure in powered surgical instruments|

---

US10368865B2|2015-12-30|2019-08-06|Ethicon Llc|Mechanisms for compensating for drivetrain failure in powered surgical instruments|

---

US11213293B2|2016-02-09|2022-01-04|Cilag Gmbh International|Articulatable surgical instruments with single articulation link arrangements|

---

US11224426B2|2016-02-12|2022-01-18|Cilag Gmbh International|Mechanisms for compensating for drivetrain failure in powered surgical instruments|

---

US11179150B2|2016-04-15|2021-11-23|Cilag Gmbh International|Systems and methods for controlling a surgical stapling and cutting instrument|

---

US10335145B2|2016-04-15|2019-07-02|Ethicon Llc|Modular surgical instrument with configurable operating mode|

---

US10357247B2|2016-04-15|2019-07-23|Ethicon Llc|Surgical instrument with multiple program responses during a firing motion|

---

US10456137B2|2016-04-15|2019-10-29|Ethicon Llc|Staple formation detection mechanisms|

---

US10368867B2|2016-04-18|2019-08-06|Ethicon Llc|Surgical instrument comprising a lockout|

---

US11179155B2|2016-12-21|2021-11-23|Cilag Gmbh International|Anvil arrangements for surgical staplers|

---

US20180168598A1|2016-12-21|2018-06-21|Ethicon Endo-Surgery, Llc|Staple forming pocket arrangements comprising zoned forming surface grooves|

---

US11160551B2|2016-12-21|2021-11-02|Cilag Gmbh International|Articulatable surgical stapling instruments|

---

US10675026B2|2016-12-21|2020-06-09|Ethicon Llc|Methods of stapling tissue|

---

US11191539B2|2016-12-21|2021-12-07|Cilag Gmbh International|Shaft assembly comprising a manually-operable retraction system for use with a motorized surgical instrument system|

---

JP2020501779A|2016-12-21|2020-01-23|エシコン エルエルシーＥｔｈｉｃｏｎ ＬＬＣ|Surgical stapling system|

---

US20180168618A1|2016-12-21|2018-06-21|Ethicon Endo-Surgery, Llc|Surgical stapling systems|

---

US11134942B2|2016-12-21|2021-10-05|Cilag Gmbh International|Surgical stapling instruments and staple-forming anvils|

---

US10307170B2|2017-06-20|2019-06-04|Ethicon Llc|Method for closed loop control of motor velocity of a surgical stapling and cutting instrument|

---

US11090046B2|2017-06-20|2021-08-17|Cilag Gmbh International|Systems and methods for controlling displacement member motion of a surgical stapling and cutting instrument|

---

US11071554B2|2017-06-20|2021-07-27|Cilag Gmbh International|Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on magnitude of velocity error measurements|

---

US11266405B2|2017-06-27|2022-03-08|Cilag Gmbh International|Surgical anvil manufacturing methods|

---

US11141154B2|2017-06-27|2021-10-12|Cilag Gmbh International|Surgical end effectors and anvils|

---

US11259805B2|2017-06-28|2022-03-01|Cilag Gmbh International|Surgical instrument comprising firing member supports|

---

US11246592B2|2017-06-28|2022-02-15|Cilag Gmbh International|Surgical instrument comprising an articulation system lockable to a frame|

---

US10639037B2|2017-06-28|2020-05-05|Ethicon Llc|Surgical instrument with axially movable closure member|

---

US20190000474A1|2017-06-28|2019-01-03|Ethicon Llc|Surgical instrument comprising selectively actuatable rotatable couplers|

---

US11090075B2|2017-10-30|2021-08-17|Cilag Gmbh International|Articulation features for surgical end effector|

---

US11103268B2|2017-10-30|2021-08-31|Cilag Gmbh International|Surgical clip applier comprising adaptive firing control|

---

US11141160B2|2017-10-30|2021-10-12|Cilag Gmbh International|Clip applier comprising a motor controller|

---

US11134944B2|2017-10-30|2021-10-05|Cilag Gmbh International|Surgical stapler knife motion controls|

---

US11229436B2|2017-10-30|2022-01-25|Cilag Gmbh International|Surgical system comprising a surgical tool and a surgical hub|

---

US11197670B2|2017-12-15|2021-12-14|Cilag Gmbh International|Surgical end effectors with pivotal jaws configured to touch at their respective distal ends when fully closed|

---

US11071543B2|2017-12-15|2021-07-27|Cilag Gmbh International|Surgical end effectors with clamping assemblies configured to increase jaw aperture ranges|

---

US11020112B2|2017-12-19|2021-06-01|Ethicon Llc|Surgical tools configured for interchangeable use with different controller interfaces|

---

US11129680B2|2017-12-21|2021-09-28|Cilag Gmbh International|Surgical instrument comprising a projector|

---

US10743868B2|2017-12-21|2020-08-18|Ethicon Llc|Surgical instrument comprising a pivotable distal head|

---

US11076853B2|2017-12-21|2021-08-03|Cilag Gmbh International|Systems and methods of displaying a knife position during transection for a surgical instrument|

---

US11266468B2|2017-12-28|2022-03-08|Cilag Gmbh International|Cooperative utilization of data derived from secondary sources by intelligent surgical hubs|

---

US11179208B2|2017-12-28|2021-11-23|Cilag Gmbh International|Cloud-based medical analytics for security and authentication trends and reactive measures|

---

US11096693B2|2017-12-28|2021-08-24|Cilag Gmbh International|Adjustment of staple height of at least one row of staples based on the sensed tissue thickness or force in closing|

---

US11202570B2|2017-12-28|2021-12-21|Cilag Gmbh International|Communication hub and storage device for storing parameters and status of a surgical device to be shared with cloud based analytics systems|

---

US11132462B2|2017-12-28|2021-09-28|Cilag Gmbh International|Data stripping method to interrogate patient records and create anonymized record|

---

US11213359B2|2017-12-28|2022-01-04|Cilag Gmbh International|Controllers for robot-assisted surgical platforms|

---

US10758310B2|2017-12-28|2020-09-01|Ethicon Llc|Wireless pairing of a surgical device with another device within a sterile surgical field based on the usage and situational awareness of devices|

---

US11166772B2|2017-12-28|2021-11-09|Cilag Gmbh International|Surgical hub coordination of control and communication of operating room devices|

---

US11234756B2|2017-12-28|2022-02-01|Cilag Gmbh International|Powered surgical tool with predefined adjustable control algorithm for controlling end effector parameter|

---

US20190206551A1|2017-12-28|2019-07-04|Ethicon Llc|Spatial awareness of surgical hubs in operating rooms|

---

US11257589B2|2017-12-28|2022-02-22|Cilag Gmbh International|Real-time analysis of comprehensive cost of all instrumentation used in surgery utilizing data fluidity to track instruments through stocking and in-house processes|

---

US11160605B2|2017-12-28|2021-11-02|Cilag Gmbh International|Surgical evacuation sensing and motor control|

---

US11253315B2|2017-12-28|2022-02-22|Cilag Gmbh International|Increasing radio frequency to create pad-less monopolar loop|

---

US11100631B2|2017-12-28|2021-08-24|Cilag Gmbh International|Use of laser light and red-green-blue coloration to determine properties of back scattered light|

---

US11259830B2|2018-03-08|2022-03-01|Cilag Gmbh International|Methods for controlling temperature in ultrasonic device|

---

US11207067B2|2018-03-28|2021-12-28|Cilag Gmbh International|Surgical stapling device with separate rotary driven closure and firing systems and firing member that engages both jaws while firing|

---

US11219453B2|2018-03-28|2022-01-11|Cilag Gmbh International|Surgical stapling devices with cartridge compatible closure and firing lockout arrangements|

---

US11197668B2|2018-03-28|2021-12-14|Cilag Gmbh International|Surgical stapling assembly comprising a lockout and an exterior access orifice to permit artificial unlocking of the lockout|

---

US20190298350A1|2018-03-28|2019-10-03|Ethicon Llc|Methods for controlling a powered surgical stapler that has separate rotary closure and firing systems|

---

US11090047B2|2018-03-28|2021-08-17|Cilag Gmbh International|Surgical instrument comprising an adaptive control system|

---

US11213294B2|2018-03-28|2022-01-04|Cilag Gmbh International|Surgical instrument comprising co-operating lockout features|

---

US11166716B2|2018-03-28|2021-11-09|Cilag Gmbh International|Stapling instrument comprising a deactivatable lockout|

---

US11207065B2|2018-08-20|2021-12-28|Cilag Gmbh International|Method for fabricating surgical stapler anvils|

---

USD914878S1|2018-08-20|2021-03-30|Ethicon Llc|Surgical instrument anvil|

---

US11253256B2|2018-08-20|2022-02-22|Cilag Gmbh International|Articulatable motor powered surgical instruments with dedicated articulation motor arrangements|

---

US11083458B2|2018-08-20|2021-08-10|Cilag Gmbh International|Powered surgical instruments with clutching arrangements to convert linear drive motions to rotary drive motions|

---

US10912559B2|2018-08-20|2021-02-09|Ethicon Llc|Reinforced deformable anvil tip for surgical stapler anvil|

---

US11045192B2|2018-08-20|2021-06-29|Cilag Gmbh International|Fabricating techniques for surgical stapler anvils|

---

US11039834B2|2018-08-20|2021-06-22|Cilag Gmbh International|Surgical stapler anvils with staple directing protrusions and tissue stability features|

---

US11259807B2|2019-02-19|2022-03-01|Cilag Gmbh International|Staple cartridges with cam surfaces configured to engage primary and secondary portions of a lockout of a surgical stapling device|

---

US11147553B2|2019-03-25|2021-10-19|Cilag Gmbh International|Firing drive arrangements for surgical systems|

---

US11172929B2|2019-03-25|2021-11-16|Cilag Gmbh International|Articulation drive arrangements for surgical systems|

---

US11147551B2|2019-03-25|2021-10-19|Cilag Gmbh International|Firing drive arrangements for surgical systems|

---

US11253254B2|2019-04-30|2022-02-22|Cilag Gmbh International|Shaft rotation actuator on a surgical instrument|

---

US11224497B2|2019-06-28|2022-01-18|Cilag Gmbh International|Surgical systems with multiple RFID tags|

---

US11051807B2|2019-06-28|2021-07-06|Cilag Gmbh International|Packaging assembly including a particulate trap|

---

US11259803B2|2019-06-28|2022-03-01|Cilag Gmbh International|Surgical stapling system having an information encryption protocol|

---

US11219455B2|2019-06-28|2022-01-11|Cilag Gmbh International|Surgical instrument including a lockout key|

---

US11246678B2|2019-06-28|2022-02-15|Cilag Gmbh International|Surgical stapling system having a frangible RFID tag|

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US11241235B2|2019-06-28|2022-02-08|Cilag Gmbh International|Method of using multiple RFID chips with a surgical assembly|

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US11234698B2|2019-12-19|2022-02-01|Cilag Gmbh International|Stapling system comprising a clamp lockout and a firing lockout|

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CN113384351A|2021-06-21|2021-09-14|哈尔滨理工大学|Novel multi-degree-of-freedom friction locking mechanism suitable for surgical operation positioning arm|

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CN114010325A|2022-01-07|2022-02-08|北京威高智慧科技有限公司|Power fast-assembling device, power device and surgical robot|

法律状态:
2018-12-04| B06F| Objections, documents and/or translations needed after an examination request according [chapter 6.6 patent gazette]|

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2019-12-17| B15K| Others concerning applications: alteration of classification|Free format text: AS CLASSIFICACOES ANTERIORES ERAM: A61B 19/00 , A61B 17/072 Ipc: A61B 17/072 (1990.01), A61B 34/30 (2016.01), A61B |

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2019-12-31| B06U| Preliminary requirement: requests with searches performed by other patent offices: procedure suspended [chapter 6.21 patent gazette]|

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2021-06-29| B09A| Decision: intention to grant [chapter 9.1 patent gazette]|

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2021-09-08| B16A| Patent or certificate of addition of invention granted [chapter 16.1 patent gazette]|Free format text: PRAZO DE VALIDADE: 20 (VINTE) ANOS CONTADOS A PARTIR DE 21/06/2013, 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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US13/536,360|2012-06-28|

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US13/536,360|US9226751B2|2012-06-28|2012-06-28|Surgical instrument system including replaceable end effectors|

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PCT/US2013/047068|WO2014004300A1|2012-06-28|2013-06-21|Surgical instrument system including replaceable end effectors|

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