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CN105025825A - 具有小齿轮和反向齿条的外科器械端部执行器关节运动驱动器 - Google Patents

具有小齿轮和反向齿条的外科器械端部执行器关节运动驱动器 Download PDF

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CN105025825A
CN105025825A CN201480011026.4A CN201480011026A CN105025825A CN 105025825 A CN105025825 A CN 105025825A CN 201480011026 A CN201480011026 A CN 201480011026A CN 105025825 A CN105025825 A CN 105025825A
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cam
cam wheel
end effector
securing rod
tooth
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CN105025825B (zh
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N·法内利
J·C·加格尔
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Ethicon Endo Surgery Inc
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/00234—Surgical instruments, devices or methods for minimally invasive surgery
    • A61B2017/00292—Surgical instruments, devices or methods for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/003—Steerable
    • A61B2017/00318—Steering mechanisms
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
    • A61B2017/00389—Button or wheel for performing multiple functions, e.g. rotation of shaft and end effector
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2946—Locking means

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
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  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)
  • Transmission Devices (AREA)

Abstract

本发明公开了一种设备，其包括主体和轴组件。所述轴组件与所述主体连通，并且包括端部执行器、第一凸轮齿轮、第二凸轮齿轮和锁定杆。所述端部执行器具有关节运动接头。所述第一凸轮齿轮可旋转地定位在所述轴组件内。所述第二凸轮齿轮在所述关节运动接头处与所述端部执行器连通。所述锁定杆朝远侧偏压以抵靠所述第二凸轮齿轮锁定。所述第一凸轮齿轮可旋转经过第一运动范围以使所述锁定杆相对于所述第二凸轮齿轮解锁。所述第一凸轮齿轮可旋转经过第二运动范围以使所述端部执行器在所述关节运动接头处旋转。

Description

具有小齿轮和反向齿条的外科器械端部执行器关节运动驱动器
背景技术
在一些情况下，内窥镜式外科器械可优于传统的开放式外科装置，因为较小切口可减少术后恢复时间和并发症。因此，一些内窥镜式外科器械可适于通过套管针的套管将远侧端部执行器放置在期望的手术部位处。这些远侧端部执行器(例如，内切割器、抓紧器、切割器、缝合器、施夹器、进入装置、药物/基因治疗递送装置、以及使用超声、RF、激光等的能量递送装置)可以多种方式接合组织，以达到诊断或治疗的效果。内窥镜式外科器械可包括轴，该轴位于端部执行器和由临床医生操纵的柄部部分之间。此轴可使能插入期望的深度并围绕轴的纵向轴线旋转，由此有利于将端部执行器在患者体内的定位。还可通过添加一个或多个关节运动接头或特征结构而进一步有利于端部执行器的定位，使端部执行器能够选择性地进行关节运动，或者以其它方式相对于轴的纵向轴线偏转。
内窥镜式外科器械的示例包括外科缝合器。一些此类缝合器能够操作以夹紧压制组织的层，切割穿过夹紧的组织的层，并驱动钉穿过组织的层，以在组织的层的被切断的端部附近将切断的组织层基本上密封在一起。仅示例性的外科缝合器公开于：1989年2月21日公布的名称为“PocketConfiguration for Internal Organ Staplers”的美国专利4,805,823；1995年5月16日公布的名称为“Surgical Stapler and Staple Cartridge”的美国专利5,415,334；1995年11月14日公布的名称为“Surgical Stapler Instrument”的美国专利5,465,895；1997年1月28日公布的名称为“Surgical StaplerInstrument”的美国专利5,597,107；1997年5月27日公布的名称为“Surgical Instrument”的美国专利5,632,432；1997年10月7日公布的名称为“Surgical Instrument”的美国专利5,673,840；1998年1月6日公布的名称为“Articulation Assembly for Surgical Instruments”的美国专利5,704,534；1998年9月29日公布的名称为“Surgical Clamping Mechanism”的美国专利5,814,055；2005年12月27日公布的名称为“Surgical StaplingInstrument Incorporating an E-Beam Firing Mechanism”的美国专利6,978,921；2006年2月21日公布的名称为“Surgical Stapling InstrumentHaving Separate Distinct Closing and Firing Systems”的美国专利7,000,818；2006年12月5日公布的名称为“Surgical Stapling Instrument having a FiringLockout for an Unclosed Anvil”的美国专利7,143,923；2007年12月4日公布的名称为“Surgical Stapling Instrument Incorporating a Multi-Stroke FiringMechanism with a Flexible Rack”的美国专利7,303,108；2008年5月6日公布的名称为“Surgical Stapling Instrument Incorporating a Multistroke FiringMechanism Having a Rotary Transmission”的美国专利7,367,485；2008年6月3日公布的名称为“Surgical Stapling Instrument Having a Single LockoutMechanism for Prevention of Firing”的美国专利7,380,695；2008年6月3日公布的名称为“Articulating Surgical Stapling Instrument Incorporating a Two-Piece E-Beam Firing Mechanism”的美国专利7,380,696；2008年7月29日公布的名称为“Surgical Stapling and Cutting Device”的美国专利7,404,508；2008年10月14日公布的名称为“Surgical Stapling Instrument HavingMultistroke Firing with Opening Lockout”的美国专利7,434,715；2010年5月25日公布的名称为“Disposable Cartridge with Adhesive for Use with aStapling Device”的美国公布7,721,930；2010年10月21日公布的名称为“Surgical Stapling Instrument with An Articulatable End Effector”的美国公布2010/0264193；和2012年9月20日公布的名称为“Motor-Driven SurgicalCutting Instrument with Electric Actuator Directional Control Assembly”的美国公布2012/0239012。上面所引用的美国专利和美国专利公布中的每一者的公开内容以引用方式并入本文。
尽管上文所涉及的外科缝合器被描述为用于内窥镜式手术，但应理解，此类外科缝合器也可用于开腹手术和/或其他非内窥镜式手术。仅以举例的方式，在胸廓外科手术中，外科缝合器可通过胸廓切开术插入，并由此位于患者肋骨之间以到达一个或多个器官，该胸廓外科手术不使用套管针作为缝合器的导管。此手术可包括使用缝合器来切断和闭合通向肺部的血管。例如，在从胸腔移除器官之前，可通过缝合器切断和闭合通向该器官的血管。当然，外科缝合器可用于各种其他情况和手术。
虽然已经制造和使用各种类型的外科缝合器械和相关部件，但据信在本发明人之前还无人制造或使用所附权利要求中描述的发明。
附图说明
并入本说明书并构成其一部分的附图示出了本发明的多个实施例，并且与上文所给出的本发明的一般说明和下文所给出的实施例的详细说明一起用于解释本发明的原理。
图1示出示例性关节运动外科缝合器械的透视图；
图2示出图1的器械的侧正视图；
图3示出图1A的器械中的打开的端部执行器的透视图；
图4A示出图3的端部执行器沿图3的线4-4截取的侧剖面图，其中击发梁处于近侧位置；
图4B示出图3的端部执行器沿图3的线4-4截取的侧剖面图，其中击发梁处于远侧位置；
图5示出图3的端部执行器沿图3的线5-5截取的端部剖面图；
图6示出图3的端部执行器的分解透视图；
图7示出图3的端部执行器的透视图，该端部执行器定位在组织处并且已经在组织中致动一次；
图8示出在图1的器械中使用的示例性控制电路的示意图；
图9示出图1的器械的柄部组件的侧正视图，其中移除了一半外壳；
图10示出图9的柄部组件的驱动组件部件的透视图；
图11示出图10的驱动组件的细长构件的透视图；
图12示出可结合到图1的器械中的示例性另选轴组件的顶部透视图；
图13A示出图12的轴组件的顶部平面图，其中端部执行器处于第一位置；
图13B示出图12的轴组件的顶部平面图，其中端部执行器处于第二关节运动位置；
图14示出图12的轴组件的近侧端部的透视图，该图示出关节运动钮以及内部运动部件；
图15示出图12的轴组件的近侧端部沿图14的线15-15截取的顶部剖面图；
图16示出处于居中位置的图12的轴组件的顶部平面图；
图17示出图12的轴组件的端部执行器和关节运动接头的透视分解图；
图18A示出处于第一位置的图12的轴组件的关节运动接头的顶部局部内视图；
图18B示出图12的轴组件的关节运动接头的顶部局部内视图，其中第一臂和第二臂使第一凸轮齿轮旋转；
图18C示出图12的轴组件的关节运动接头的顶部局部内视图，其中第一臂和第二臂使第二凸轮齿轮和第一凸轮齿轮进一步旋转；
图18D示出图12的轴组件的关节运动接头的顶部局部内视图，其中锁定杆将锁定齿弹性地定位在第一凸轮齿轮和第二凸轮齿轮的齿间；
图18E示出图12的轴组件的关节运动接头的顶部局部内视图，其中第一臂和第二臂使第一凸轮齿轮再进一步旋转；并且
图19示出图12的轴组件的凸轮齿轮与锁定杆之间接口的平面放大视图。
附图并非意在以任何方式进行限制，并且可以设想本发明的各种实施例能够以多种其他方式来执行，包括那些不必在附图中示出的方式。结合于本说明书并构成其一部分的附图示出了本发明的若干方面，并与具体实施方式一起用于说明本发明的原理；然而，应当理解本发明不受限于所示出的确定布置。
具体实施方式
本发明的某些示例的如下描述不应被用来限制本发明的范围。通过以下举例说明设想用于实施本发明的最佳方式之一的描述，本发明的其它示例、结构、方面、实施例和优点将对本领域的技术人员显而易见。正如将会意识到的，本发明能够具有其它不同且明显的方面，只要不脱离本发明即可。因此，附图和具体实施方式应被视为实质上是示例性的而非限制性的。
I.示例性外科缝合器
图1-7示出示例性外科缝合和切断器械10，在图1A中示出的非关节运动的状态下，其尺寸设定成穿过套管针的插管通道插入患者的手术部位，以便执行外科手术。仅以举例的方式，此类套管针可被插入患者的腹部，位于患者的两个肋骨之间或其他地方。在一些情况下，器械10不使用套管针。例如，器械10可通过胸廓切开术或其他类型切口直接插入。本示例的器械10包括连接到轴22的柄部部分20。轴22在远侧终止于关节运动接头11中，该关节运动接头11进一步与端部执行器12联接。应当理解，本文中使用的术语诸如“近侧”和“远侧”参照临床医生抓握器械10的柄部部分20而言。因此，端部执行器12相对于更近侧的柄部部分20位于远侧。还应当理解，为便利和清楚起见，本申请结合附图使用空间术语，例如“竖直”和“水平”。然而，外科器械是在多个取向和位置中使用的，并且这些术语并非意图进行限制，也并非绝对的。
在一些形式中，轴22是根据如下专利的教导内容中的一些构造的：与本文同一天提交的名称为“Surgical Instrument with Multi-Diameter Shaft”的美国专利申请[代理人案卷号END7181USNP.0599180]，其公开内容以引用方式并入本文。根据本文的教导内容，轴22的其他合适的构型对于本领域普通技术人员而言将是显而易见的。
一旦关节运动接头11和端部执行器12插入穿过套管针的管道通道，关节运动接头11就可以通过关节运动控件13向远处关节运动，如图1中的虚线示出的，使得端部执行器12可从轴22的纵向曲线LA以期望的角度(α)偏转。由此，端部执行器12可以从所需的角度或由于其他原因到达器官的后面或接近组织。在一些形式中，关节运动接头11使端部执行器12能够沿着单个平面偏转。在一些其他形式中，关节运动接头11使端部执行器能够沿着多于一个平面偏转。关节运动接头11和关节运动控件13可根据本文引用的多个参考中的任意参考中的教导内容来被构造。另选地，关节运动接头11和/或关节运动控件13可具有任何其它合适的构型。仅以举例的方式，关节运动控件13可代替地构造为钮，该钮围绕与轴22的纵向轴线LA垂直的轴线旋转。
下文更详细地描述了关节运动接头11和关节运动控件13的各种示例性替代部件、构型和可操作性。关节运动接头11也可根据根据如下专利的教导内容中的至少一些来构造和操作：美国专利申请[代理人案卷号END7181USNP.0599180]，该专利申请的全部公开内容以引用方式并入本文。考虑到本文的教导内容，关节运动接头11和关节控件13可以采用的各种其它合适的形式对于本领域普通技术人员而言将显而易见。
本示例的端部执行器12包括下钳口16和可枢转砧座18。在一些形式中，下钳口16是根据如下专利的教导内容中的至少一些来构造的：与本文同一天提交的名称为“Installation Features for Surgical Instrument End EffectorCartridge”的美国专利申请[代理人案卷号END7182USNP.0599227]，其公开内容以引用方式并入本文。砧座18可根据如下专利的教导内容中的至少一些来构造：与本文同一天提交的名称为“Integrated Tissue Positioning andJaw Alignment Features for Surgical Stapler”的美国专利申请[代理人案卷号END7176USNP.0599177]，其公开内容以引用方式并入本文；与本文同一天提交的名称为“Jaw Closure Feature for End Effector of Surgical Instrument”的美国专利申请[代理人案卷号END7177USNP.0599225]，其公开内容以引用方式并入本文；和/或与本文同一天提交的名称为“Staple Forming Featuresfor Surgical Stapling Instrument”的美国专利申请[代理人案卷号ENDEND7180USNP.0599175]，其公开内容以引用方式并入本文。考虑到本文的教导内容，下钳口16和砧座18可以采用的各种其它合适的形式对于本领域普通技术人员而言将显而易见。
柄部部分20包括手枪式握把24和闭合触发器26。闭合触发器26能够朝着手枪式握把24枢转，以使得砧座18朝着端部执行器12的下钳口16夹紧、或闭合。砧座18的此类闭合是通过闭合管32和闭合环33提供的，该闭合管32和闭合环33两者响应于闭合触发器26相对于手枪式握把24的枢转而相对于柄部部分20纵向地平移。闭合管32沿着轴22的长度延伸；并且闭合环33在远侧定位到关节运动接头11。关节运动接头11能够操作以将纵向运动从闭合管32传送/传输到闭合环33。
柄部部分20也包括击发触发器28。细长构件136(示于图11中)纵向延伸穿过轴22，并响应于击发触发器28的致动，将纵向击发运动从柄部部分20传送至击发梁14。击发梁14的这种远侧平移，使得端部执行器12中夹紧的组织被缝合和切断，如下文将更详细地描述的。然后，将触发器26、28释放以从端部执行器12释放该组织。
图3-6示出采用电子束形式的击发梁14来执行多种功能的端部执行器12。应当理解，电子束形式仅是例证性示例。击发梁14可采取任何其他合适形式，包括但不限于非电子束形式。如最佳见于图4A-4B，击发梁14包括横向取向的上部销38、击发梁顶盖44、横向取向的中部销46和在远侧呈现的切割刃48。上部销38被定位在砧座18的纵向砧座狭槽42内，并且能够在所述纵向砧座狭槽内平移。通过使击发梁14延伸穿过下钳口狭槽45(示于图4B中)，击发梁顶盖44以能滑动的方式接合下钳口16的下表面，下钳口狭槽是穿过下钳口16形成的。中部销46以能够滑动的方式接合下钳口16的顶表面，从而与击发梁顶盖44协作。因此，击发梁14在击发期间必然隔开端部执行器12。
一些非电子束形式的击发梁14可缺少上部销38、中部销46、和/或击发梁顶盖44。器械10的一些此类形式可仅仅依靠于闭合环33或一些其他特征结构，以在击发梁14推进到远侧位置中时，将砧座18枢转到闭合位置并将砧座18保持在闭合位置中。仅通过举例的方式，击发梁14和/或相关的闭锁特征结构可根据如下专利的教导内容中的至少一些来构造：与本文同一天提交的名称为“Lockout Feature for Movable Cutting Member of SurgicalInstrument”的美国专利申请[代理人案卷号END7175USNP.0599231]，其公开内容以引用方式并入本文。根据本文的教导内容，击发梁14可以采取的其他合适的形式对于本领域的普通技术人员将是显而易见的。
图3示出本示例的朝近侧定位的击发梁14和枢转到打开位置的砧座18，从而允许未耗尽的钉仓37可移除地安装到下钳口16的通道中。如最佳见于图5-6，本示例的钉仓37包括仓体70，该仓体呈现出上部平台72并与下部仓托盘74联接。如最佳见于图3，竖直狭槽49是穿过钉仓37的一部分形成的。还最佳见于图3，三排钉孔51在竖直狭槽49的一侧上穿过上部平台72形成，其中另一组三排钉孔51在竖直狭槽49的另一侧上穿过上部平台72形成。当然，可提供任何其他合适数量钉排(例如，两排、四排、或其他数量)。重新参见图4A-6，楔形滑动件41和多个钉驱动器43被捕获在仓体70和托盘74之间，其中楔形滑动件41位于钉驱动器43近侧。楔形滑动件41能够在钉仓37内纵向地活动；而钉驱动器43能够在钉仓37内竖直地活动。钉47也被定位在仓体70内，处于对应的钉驱动器43上方。具体地，每个钉47在仓体70内被钉驱动器43竖直地驱动，以将钉47驱动穿出相关的钉孔51。如最佳见于图4A-4B和6，楔形滑动件41存在倾斜凸起表面，当楔形滑动件41朝远侧驱动穿过钉仓37时，该倾斜凸起表面向上推动钉驱动器43。
在一些形式中，钉仓37根据如下专利的教导内容中的至少一些来构造和操作：美国专利申请[代理人案卷号END7176USNP.0599177]，其公开内容以引用方式并入本文。除此之外或作为另外一种选择，钉仓37可根据如下专利的教导内容中的至少一些来构造和操作：美国专利申请[代理人案卷号END7182USNP.0599227]，其公开内容以引用方式并入本文。根据本文的教导内容，钉仓37可采取的其他合适的形式对于本领域的普通技术人员将是显而易见的。
在通过朝远侧推进闭合管32和闭合环33以使端部执行器12如图4A-4B所示闭合的情况下，通过使上部销38进入纵向砧座狭槽42，将击发梁14推进至与砧座18接合。推块80(示于图5中)位于击发梁14的远侧端部处，并且被构造成能够接合楔形滑动件41，使得当激发触发器28被致动时，楔形滑动件41随着击发梁14被朝远侧推进穿过钉仓37，而被推块80朝远侧推动。在此类击发期间，击发梁14的切割刃48进入钉仓37的竖直狭槽49，从而切断夹紧在钉仓37和砧座18之间的组织。如图4A-4B所示，中间销46和推块80通过进入钉仓37内的狭槽49中来一起致动钉仓37，从而将楔形滑动件41驱动成与钉驱动器43发生向上凸轮接触，继而将钉47向外驱动穿过钉孔51并使钉47与砧座18的内表面上的钉成形凹坑53(示于图3中)形成接触。图4B示出在完成切断和缝合组织之后完全朝远侧平移的击发梁14。应当理解钉成形凹坑53在图4A-4B的视图中被有意省略；但钉成形凹坑53示出于图3中。还应当理解砧座18在图5中被有意省略。
图7示出端部执行器12，所述端部执行器已通过单个行程而被致动穿过组织90。如图所示，切割刃48(图7中模糊部分)已经切穿组织90，同时在切割刃48形成的切割线的每一侧上，钉驱动器43已经使交替的三排钉47驱动穿过组织90。在该示例中，钉47全部与切割线基本上平行地取向，但应当理解，钉47可被定位成任何适合的取向。在本示例中，在第一行程完成之后，端部执行器12从套管针撤回，用新的钉仓替换耗尽的钉仓37，然后将端部执行器12再次穿过套管针插入，以到达缝合部位用于进一步的切割和缝合。这个过程可以重复，直到提供了期望量的切口和钉47。可能需要将砧座18闭合以有利于通过套管针来插入和撤回；并且可能需要将砧座18打开以有利于替换钉仓37。
应当理解，在每个致动行程期间，切割刃48可在钉47被驱动穿过组织时基本上同时切断组织。在本示例中，切割刃48仅稍微落后于钉47的驱动，使得钉47正好在切割刃48穿过组织之前被驱动穿过该组织的相同区域，但应当理解，这个顺序可以颠倒，或者切割刃48可以直接与相邻的钉同步。虽然图7示出端部执行器12在组织90的两个层92、94中被致动，但应当理解，端部执行器12可被致动穿过组织90的单个层或者组织的多于两个层92、94。还应当理解，与切割刃48产生的切割线相邻的钉47的成形和定位可基本上密封所述切割线处的组织，从而减少或防止切割线处的出血和/或其它体液的渗漏。此外，尽管图7示出端部执行器12在组织的两个基本上平的相反的平面层92、94中致动，但应当理解端部执行器12也可在管状结构诸如血管、胃肠道的一部分等上致动。因此，不应将图7视为对端部执行器12的设想用途进行任何限制。根据本文的教导内容，可使用器械10的各种适合的情况和程序对于本领域的普通技术人员将是显而易见的。
应当理解，可以根据以下专利的教导内容中的任何内容来构造和操作器械10：美国专利4,805,823；美国专利5,415,334；美国专利5,465,895；美国专利5,597,107；美国专利5,632,432；美国专利5,673,840；美国专利5,704,534；美国专利5,814,055；美国专利6,978,921；美国专利7,000,818；美国专利7,143,923；美国专利7,303,108；美国专利7,367,485；美国专利7,380,695；美国专利7,380,696；美国专利7,404,508；美国专利7,434,715；美国专利7,721,930；美国公布2010/0264193；和/或2012/0239012。如上所述，这些专利/公布中的每一个中的公开内容均以引用方式并入本文。可提供用于器械10的附加示例性修改将更详细地描述于下文中。下述教导内容并入器械10中的各种适合方式对本领域的普通技术人员将显而易见。类似地，将下述教导内容与本文引用的专利的各种教导内容进行组合的各种适合方式对本领域的普通技术人员将是显而易见的。还应当理解，下述教导内容并不限于本文引用的专利中所教导的器械10或装置。以下教导内容可容易地施加于各种其他种类的器械，包括未被归类为外科缝合器的器械。根据本文的教导内容，可以应用下述教导内容的各种其它适合装置和情况对于本领域的普通技术人员将是显而易见的。
II.示例性机动化驱动特征结构
在本示例中，器械10提供对击发梁14的机动化控制。图8-11示出可被用来提供对击发梁14的机动化控制的示例性部件。具体地，图8示出示例性控制电路100，该控制电路100可被用来从电池组104(同样示于图1-2中)使用电力对电动马达102供电。电动马达102能够操作以将击发梁14纵向平移，如将在下文所详述。应当理解，整个控制电路100，包括马达102和电池组104，可被封装在柄部部分20内。图8示出作为打开的开关的击发触发器28，但应当理解该开关在击发触发器28致动时是闭合的。本示例的电路100包括必须是闭合的以便使电路100完整的安全开关106，但是应当理解安全开关106仅仅是任选的。可通过致动柄部部分20上的分开按钮、滑块、或其他特征结构来使安全开关106闭合。
本示例的电路100还包括闭锁开关108，该闭锁开关108默认是闭合的，但是被构造成能够响应于闭锁条件而自动打开。仅以举例的方式，闭锁条件可包括以下中的一者或多者：下钳口16中缺少仓37、下钳口16中存在耗尽的(例如，先前击发的)仓37、未充分闭合的砧座18、确定器械10已被击发很长时间、和/或任何其他合式的条件。根据本文中的教导内容，可以用来检测闭锁条件的各种传感器、算法和其他特征结构对本领域的普通技术人员是显而易见的。类似地，根据本文的教导内容，其他合适种类的闭锁条件对于本领域的普通技术人员将是显而易见的。应当理解，电路100是打开的，并因此当闭合开关108打开时，马达102不能够操作。闭锁指示器110(例如LED等)能够操作以提供对闭锁开关108的状态的视觉指示。仅以举例的方式，闭锁开关108、闭锁指示器110、和相关联的部件/功能可根据下述专利的教导内容中的至少一些来构造：2010年1月12日公布的名称为“Electronic Lockouts and Surgical Instrument Including Same”美国专利7,644,848，其公开内容以引用方式并入本文；
一旦击发梁14到达最远侧位置(例如，在切割行程的末端)，行程结束开关112自动转换到闭合位置，从而逆转施加到马达102的电压的极性。这逆转马达102的旋转方向，应当理解操作者在该操作阶段将使击发触发器28被释放。在该操作状态下，电流流过反向指示器114(例如LED)，以提供马达102方向已逆转的视觉指示。考虑到本文的教导内容，当击发梁14到达最远侧位置时，行程结束开关112可自动切换到闭合位置的各种合适方式，对于本领域的普通技术人员而言将显而易见。类似地，考虑到本文的教导内容，反向指示器114可以采用的各种合适的形式对于本领域的普通技术人员而言将显而易见。
本示例的柄部部分20还包括手动返回开关116，其也示于电路100中。手动返回开关116被构造成能够充当“紧急救助”(bailout)特征结构，使操作者在击发行程期间能够快速开始朝近侧回缩击发梁14。换句话讲，当击发梁14仅已被部分地朝远侧推进时，手动返回开关116可手动致动。手动返回开关116可提供与行程结束开关112类似的功能性，即逆转施加到马达102的电压的极性，以由此逆转马达102的旋转方向。同样，该逆转在视觉上可通过反向指示器114来指示。
在一些形式中，开关28、106、108、112、116中的一者或多者是的形式为微型开关。根据本文的教导内容，其它合适形式对于本领域的普通技术人员将是显而易见的。除此之外或作为前述的代替，电路100的至少一部分可根据如下专利的教导内容中的至少一些来构造：2012年7月3日提交的名称为“Motor-Driven Surgical Instrument”的美国专利8,210,411，其公开内容以引用方式并入本文。
图9-11示出可被用来提供对击发梁14的机动化控制的各种机械部件。具体地，图9示出封装在柄部部分20的手枪式握把24中的马达102。应当理解，电池组104(示于图1-2中)也可位于手枪式握把24中(例如，在马达102下方)和/或柄部部分20内其他地方。马达102具有与齿轮组件122联接的驱动轴120。齿轮组件122具有外部壳体(未示出)，并能够操作以驱动上部齿轮126，示于图10中。上部齿轮126与小齿轮128啮合，小齿轮128由固定在柄部部分20中的销129可旋转地支撑。因此应当理解，马达102的激活将最终使小齿轮128在柄部部分20内旋转。
正如还在图9-10中示出，平移齿条130包括齿132，该齿132与小齿轮128啮合使得齿条130在小齿轮128旋转时纵向平移。如图11中所示，齿条130与细长构件136联接，该细长构件136延伸穿过轴22并包括与击发梁14的近侧端部联接的远侧端部138。细长构件136在轴22内平移，使得细长构件136将齿条130的纵向运动传送到击发梁14。因此应当理解，马达102的激活将最终使击发梁14在端部执行器12内平移。具体地，马达102可朝远侧驱动击发梁14以切断组织90，以及将钉47驱动到组织90中。开关致动臂134从齿条130侧向延伸，并且定位成当击发梁14到达最远侧位置(例如，在组织90已经被切断且钉47已经被驱动到组织90中后)时接合行程结束开关112。如上所述，与行程结束开关112的接合自动地逆转马达102使击发梁14从最远侧位置返回到近侧位置，使砧座18能够枢转远离下钳口16以释放组织90。
使用术语“枢转”(以及与作为基础的“枢转”类似的术语)不应被解读为必须要求围绕固定轴线进行枢转运动。在一些形式中，砧座18围绕由销(或类似的特征结构)限定的轴线枢转，该销(或类似的特征结构)在砧座18朝下钳口16运动时，沿着细长狭槽或通道滑动。在此类形式中，枢转轴线沿着由狭槽和通道限定的路径平移，而砧座18同时围绕该轴线枢转。除此之外或作为另外一种选择，枢转轴线首先可沿着狭槽/通道滑动，然后砧座18在枢转轴线已经沿着狭槽/通道滑动到某距离后围绕该枢转轴线枢转。应当理解，此类滑动/平移枢转运动包含在术语诸如“枢转(pivot/pivots/pivoting)”、“枢转的”、“能够枢转”等内。当然，一些形式可提供砧座18围绕保持固定且不在狭槽或通道内平移的轴线的枢转运动等。
除此之外或作为前述的代替，可操作以驱动击发梁14的特征结构可根据如下专利的教导内容中的至少一些来构造：美国专利公布2012/0239012，其公开内容以引用方式并入本文；和/或美国公布2012/0239012，其公开内容以引用方式并入本文。考虑到本文的教导内容，用于提供击发梁14的机动的其它合适的部件、特征结构、和构型对本领域普通技术人员而言将显而易见。还应当理解，一些其他形式可提供对击发梁14的手动驱动，使得省略马达。仅以举例的方式，击发梁14可根据本文引用的任何其他专利/公布参考的教导内容中的至少一些进行致动。
III.示例性轴组件
应当理解，当使用者迫使器械10进入外科手术区域时，可能期望从特定角度接近将要夹紧、缝合或切割的组织。例如，一旦器械10的端部执行器12插入并穿过套管针、胸廓切口、或用于进入外科手术区域的其他通道，使用者想要对准的组织可能会定位在不可触及的位置，或相对于与轴22对齐的端部执行器12以歪斜角度定位。因此，可能期望器械10的一部分诸如端部执行器12进行关节运动，使得使用者能够将端部执行器12的砧座18和下钳口16成直角地或者说垂直地夹紧血管或其他组织。还将理解，使端部执行器12进行关节运动来将端部执行器12垂直地抵靠组织定位，可有利于在切割和缝合组织之前使组织完全就位并夹紧。除了关节运动之外，可能期望端部执行器12选择性地锁定在伸直或已关节运动的位置，使得使用者不用保持一致的手动偏压就可防止端部执行器12在关节运动点11发生枢转或弯曲。还可能期望在关节运动时自动锁定，而不需要致动单独的关节运动锁定结构特征。
图12示出示例性另选轴组件200，该轴组件可易于与图1的器械10结合。轴组件200提供关节运动以及对关节运动角度的选择性锁定，如下文中将更详细地描述。本示例的轴组件200包括旋转控件213、关节运动钮214，以及端部执行器212。旋转控件213可旋转地与图1的柄部部分20或任何其他合适部件(例如，机器人控制接口等)联接。旋转控件213能够操作以使轴组件200(包括关节运动钮214和端部执行器212)围绕轴组件200限定的纵向轴线(LA)相对于柄部部分20(或相对于旋转控件213可旋转地联接到的任何其他部件)旋转。这可用于将端部执行器212定位在围绕纵向轴线(LA)的期望的角度取向。
关节运动钮214部分容纳于关节运动钮外壳215内。外壳215通向细长轴232。轴组件200还包括相对于轴232在远侧定位的端部执行器212。端部执行器212包括关节运动接头211，关节运动接头211允许端部执行器212进行侧向关节运动，如下文中将更详细地描述。端部执行器212与图1的端部执行器12基本相同，除非下文另有说明。
图13A-B示出轴组件200以及端部执行器212响应于关节运动钮214的转动而进行的示例性运动。图13A示出关节运动钮214处于第一位置，在这种情况下，关节运动钮214和端部执行器212两者大体沿轴组件200的纵向轴线(LA)对齐。使用者可随后用手将关节运动钮214顺时针地旋转到第二位置，如图13B所示。响应于关节运动钮214的旋转，端部执行器212在关节运动接头211处枢转或弯曲到关节运动角度(α)，如图13B所示。在所示形式中，端部执行器212大体在关节运动钮214的旋转方向上进行关节运动，但是应当理解，端部执行器212可被构造成能够在关节运动钮214旋转的反方向上弯曲。换句话讲，当关节运动钮214顺时针旋转时，端部执行器212顺时针地侧向枢转，如图13B所示，但是在一些形式中，端部执行器212能够逆时针地枢转。图13B示出端部执行器212略微顺时针地侧向枢转。应当理解，关节运动钮214可进一步旋转以使端部执行器212在关节运动接头211处进一步侧向关节运动到任何合适角度(α)。例如，端部执行器212可以枢转直到在关节运动接头211上形成约90°角。在一些形式中，端部执行器212能够操作以更进一步枢转，使得端部执行器212相对于轴232形成锐角。参考本文的教导内容，端部执行器212的其他合适形式对于本领域的普通技术人员而言将是显而易见的。还应理解，关节运动钮214可相对于纵向轴线(LA)限定与端部执行器212和纵向轴线(LA)之间限定的关节运动角度(α)相同的角度。这种互补地成角度可在患者体外向操作者提供视觉反馈，从而指明端部执行器212的关节运动角度(α)。
端部执行器212的关节运动的机制将在下文中更详细地描述。应当理解，关节运动钮214可沿逆时针方向旋转，使端部执行器212以逆时针方式进行关节运动。因此，根据端部执行器212的关节运动的期望方向和/或程度，使用者可仅使关节运动钮214在某个方向上进行不同程度的旋转，使用者希望端部执行器212在这个方向上进行关节运动，以使端部执行器212进行不同程度的关节运动。
图14示出关节运动钮214，其中外壳215被移除以更清楚地示出关节运动钮214的内部工作结构。关节运动钮214与关节运动小齿轮250连通。关节运动小齿轮250与第一齿条252和第二齿条256连通。第一齿条252通过第一中间块254与第一臂242连通，而第二齿条256通过第二中间块256与第二臂240连通。
关节运动钮214一体地联接至关节运动小齿轮250。因此，当使用者转动关节运动钮214时，关节运动小齿轮250随着关节运动钮214一起旋转。随着关节运动小齿轮250旋转，关节运动小齿轮250会使第一齿条252和第二齿条256相应地沿相反方向平移。例如，如图15所示，关节运动小齿轮250与第一齿条252和第二齿条256连通，使得如果关节运动小齿轮250顺时针地旋转，则第一齿条252就朝近侧远离端部执行器212回缩，而第二齿条256朝远侧向端部执行器推进。此外，当关节运动小齿轮250逆时针地旋转时，第一齿条252朝远侧向端部执行器212推进，而第二齿条256朝近侧远离端部执行器212回缩。随着第一齿条252推进和回缩，第一臂242也以类似方式推进和回缩。类似地，随着第二齿条256推进和回缩，第二臂240也随第二齿条256推进和回缩。因此，旋转连接到关节运动小齿轮250的关节运动钮214使第一臂242和第二臂240随第一齿条252和第二齿条256来回运动。第一臂242和第二臂240的运动能够操作以引起端部执行器212中的其他部件运动，这将在下文中更详细地描述。
图16示出端部执行器212的更大视图，该端部执行器包括砧座218。第一臂242和第二臂240与第一凸轮齿轮230连通。因此，第一臂242和第二臂240的推进和回缩使第一凸轮齿轮230旋转，这将在下文中更详细地描述。
图17示出端部执行器212和关节运动接头211的分解图。端部执行器212包括砧座218、下钳口216、以及钉仓275。仓275包括钉驱动器243、仓体237、托盘274、以及楔形滑动件241。应当理解，砧座218、下钳口216、托盘274、仓体237、以及楔形滑动件241基本上类似于图6中示出的砧座18、下钳口16、托盘74、仓体37、以及楔形滑动件41。一般来讲，托盘274可移除地接纳在下钳口216中；托盘274、仓体237、以及钉驱动器243卡扣在一起，形成钉仓275。砧座218的近侧部分与下钳口216配合在钳口套筒270内，该钳口套筒与关节运动接头211连通。砧座218能够操作以响应于钳口套筒270的推进而紧靠仓体237，使得砧座218和仓体237可夹紧组织，该组织随后可被缝合和切割。具体地，在夹紧组织后，楔形滑动件241朝远侧驱动，向上推动钉驱动器243，这会驱动钉(未示出，但其原本定位在钉驱动器243上方)穿过组织并抵靠于砧座218，从而将钉锚定在组织中。在所示形式中，滑动件241由刀248驱动，该刀被固定至击发梁219并由击发梁219驱动。随着击发梁219推进，刀248切割组织，同时驱动滑动件241。
本示例的端部执行器212还包括弹性闭锁特征结构249，弹性闭锁特征结构249能够操作以与凸轮保持主体276合作，在下钳口216中未装载未击发仓275的情况下，选择性地限制刀248的推进。仅通过举例的方式，闭锁特征结构249以及相关联的部件可能够根据如下专利的教导内容中的至少一些来构造和操作：与本文同一天提交的名称为“Lockout Feature for MovableCutting Member of Surgical Instrument”的美国专利申请[代理人案卷号END7175USNP]，其公开内容以引用方式并入本文。
关节运动接头211包括若干部件，这些部件将在下文中更详细地描述。一般来讲，关节运动接头211包括第一凸轮齿轮230、第二凸轮齿轮231、凸轮保持主体276、通道销217、接头基部272、锁定杆262、以及弹簧264。
第一臂242朝远侧端接于第一钩子244，而第二臂240朝远侧端接于第二钩子246。钩子244,246与第一凸轮齿轮230的凸轮开口260连通。因此，当第一臂242朝端部执行器212推进而第二臂240回缩时，第一凸轮齿轮230逆时针地旋转。相反，当第一臂242回缩而第二臂240朝端部执行器212推进时，第一凸轮齿轮230顺时针地旋转。因此，当臂242,240经由钩子244,246在凸轮开口260上推动和拉动时，第一凸轮齿轮230如刚才所述相应地旋转。
第一凸轮齿轮230堆叠在第二凸轮齿轮231上。第二凸轮齿轮231和凸轮保持销279是凸轮保持主体276的一体特征结构。在一些形式中，第二凸轮齿轮231可单独地构造并与凸轮保持主体276牢固联接，使得当第二凸轮齿轮231旋转时，凸轮保持主体276也旋转。第一凸轮齿轮230与凸轮保持销279可旋转地联接，凸轮保持销279沿枢转轴线280与接头基部272的基部开口277轴向对齐。因此，第一凸轮齿轮230可相对于第二凸轮齿轮231和凸轮保持主体276围绕枢转轴线280旋转。锁定杆262与第一凸轮齿轮230和第二凸轮齿轮231选择性地连通，这将在下文中更详细地描述。锁定杆262还与弹簧264连通，该弹簧朝远侧偏压锁定杆262。接头基部272被成形为提供便于锁定杆262推进的底座和/或通道。锁定杆262还包括一对凸台287，这对凸台能够操作以接合接头基部272，从而限制锁定杆262朝远侧的运动。
IV.轴组件的示例性运动
如上所述，致动关节运动钮214能够操作以使臂242,240执行相反的推进和回缩。应当理解，臂242,240的这种运动能够操作以使第一凸轮齿轮230围绕凸轮保持销279旋转。第一凸轮齿轮230的旋转使第二凸轮齿轮231随凸轮保持主体276旋转。因此，关节运动接头211进行关节运动，从而在关节运动接头211处枢转端部执行器212。具体地，凸轮保持销279和基部开口274限定枢转轴线280，该枢转轴线大体上垂直于纵向轴线(LA)。端部执行器212响应第一凸轮齿轮230的旋转而围绕枢转轴线280枢转，这驱动第二凸轮齿轮231，如下文将更详细地描述。图18A-E示出旋转第一凸轮齿轮230以驱动端部执行器212进行关节运动的细节。
图18A示出在第一位置的关节运动接头211。锁定杆262朝远侧偏压以接合第二凸轮齿轮231。具体地，锁定杆262的远侧端部包括锁定齿236，锁定齿236配合在第一凸轮齿233与第二凸轮齿235之间并且邻接第二凸轮齿轮231，这可在图19中更详细地看到。由于弹簧264所提供的远侧偏压，锁定齿236形成可靠锁定，并且因此维持第二凸轮齿轮231的旋转位置。通过维持第二凸轮齿轮231的旋转位置，锁定杆262维持端部执行器212围绕枢转轴线280的角度定位，从而维持任何关节运动角度(α)。第一凸轮齿轮230包括一对凸轮翼部238,239，并且凸轮保持主体276包括一对凸台271,273。凸台271,273是第二凸轮齿轮231的一体特征结构，因此当凸台271,273旋转时，第二凸轮齿轮231也会旋转。应当理解，在图18A的第一位置中，凸轮翼部238,239和凸台271,273之间限定小间隙261。因此，凸轮翼部238,239和凸台271,273没有接触。将参考图18B-E在下文更详细地描述涉及凸轮翼部238,239与凸台271,273之间的接触的相互作用。在外科手术中，使用者可利用处于伸直位置的端部执行器212(如图18A所示)引导轴组件200穿过通道(例如，套管针、胸廓切口等等)到达外科手术区域。
图19示出处于图18A所示位置的锁定齿236的放大视图。如可在所示形式中看到的，锁定齿236具有大体上笔直的平行侧部286，平行侧部286能够操作以配合在第一凸轮齿233与第二凸轮齿235之间。锁定齿236的远侧端部具有倒圆尖端285，倒圆尖端285具有通向平行侧部286的成角度的侧部281。第二凸轮齿235中的每个齿235包括大体上笔直的平行侧部283以及成角度的侧部284。平行侧部283能够操作以接合锁定齿236的平行侧部286，从而防止在没有第一凸轮齿轮230的协助的情况下，锁定齿236沿第二凸轮齿235行进。至少一个侧部283与至少一个侧部286之间的这种接合还防止凸轮保持主体276围绕枢转轴线280旋转，从而防止端部执行器212在关节运动接头211处枢转。
一旦第一凸轮齿轮230旋转(如图18B-C所示并将在下文更详细地描述)，第一凸轮齿轮230的倒圆三角形齿233将顶靠在成角度的侧部281，并将由此响应于第一凸轮230的旋转将锁定杆262朝近侧驱动。应当理解，除了三角形外，齿233还可具有多种不同形状。锁定齿236朝近侧充分地运动，使得随着第一凸轮齿轮230继续旋转并且随着第二凸轮齿轮231旋转，锁定齿236成角度的侧部281随后最终可接合第二凸轮齿235的成角度的侧部284并沿所述成角度的侧部行进。这为将锁定杆262朝近侧驱动提供了进一步的凸轮动作。锁定齿236一旦越过第二凸轮齿235的成角度的侧部284，锁定齿236就会朝远侧返回到介于下一对第一凸轮齿233与第二凸轮齿235之间的位置，该位置与图19所示定位类似。出于说明目的，将介于一组第一凸轮齿233与第二凸轮齿235之间的锁定齿236推进至相邻组的第一凸轮齿233与第二凸轮齿235之间可被视为一个关节运动增量。当将锁定齿236朝远侧推进时，锁定齿236撞击在第二凸轮齿轮231的第二凸轮齿235之间。应当理解，锁定齿236不必延伸太远就足以撞击到第二凸轮齿轮231。例如，锁定齿236可仅仅朝远侧延伸，使得平行侧部283防止在没有第一凸轮齿233的协助的情况下，锁定齿236沿第二凸轮齿轮231行进。在所示形式中，凸台287接合接头基部272，从而防止锁定杆262发生进一步的远侧运动。
如上指出，操作者可能希望端部执行器212在关节运动接头211处枢转，以更好地相对于靶点组织定位端部执行器212。图18B示出关节运动接头211的第二位置，该第二位置是其响应于转动图14所示关节运动钮214而运动所至。在所示形式中，使用者已逆时针地转动关节运动钮214，这也使得关节运动小齿轮250逆时针地旋转。当关节运动小齿轮250逆时针地旋转时，第一齿条252相对于端部执行器212朝远侧运动，并且第二齿条256相对于端部执行器212朝近侧运动。因此，第一臂242和第二臂240(如图18B所示)运动，使得第一臂242朝端部执行器212推进，而第二臂240远离端部执行器212回缩。应当理解，所示形式的第一臂242和第二臂240的远侧部分未相对于彼此平行定位。相反，第一臂242和第二臂240相对于彼此倾斜地成角度，然而应当理解，第一臂242和第二臂240可以彼此平行定位。
臂242,240的运动(如图18B所示)致使第一凸轮齿轮230围绕枢转轴线280逆时针地旋转。当第一凸轮齿轮230旋转时，两个动作大体上同时地发生。第一凸轮齿233具有倒圆三角形状，这通过第一凸轮齿233接合成角度的侧壁281所引起的凸轮动作来促使锁定杆262朝远侧远离端部执行器212推动。同样，除了三角形外，齿233还可具有多种不同形状。弹簧264压缩以适应锁定杆262的近侧运动。因此，倒圆尖端285充分地朝近侧运动，以便越过平行侧部283。另外，凸轮翼部238,239随着第一凸轮齿轮230顺时针地旋转。由于这种旋转，凸轮翼部239消除与凸台273之间的间隙261并且接合凸台273。同时，凸轮翼部238可旋转地运动远离凸台271。应当理解，当在从图18A所示的构型过渡到图18B所示的构型期间，第一凸轮齿轮230和锁定杆262响应于臂242,240的运动而运动时，第二凸轮齿轮231以及相应地端部执行器212尚未运动。因此，在这个阶段，端部执行器212维持在伸直取向上。
图18C示出关节运动接头211的第三位置。应当理解，为使端部执行器212进行关节运动，使用者继续旋转关节运动钮214。臂242,240继续运动，使得第一臂242朝远侧运动并且第二臂240朝近侧运动。臂242,240的运动继续使第一凸轮齿轮230旋转，从而使凸轮翼部239进一步可旋转地运动，由此推动凸台273同样可旋转地运动。由于凸台273与第二凸轮齿轮231成一体，因此第二凸轮齿轮231开始旋转。随着第二凸轮齿轮231的旋转，由于成角度的侧部284顶靠在锁定齿236成角度的侧部281上，锁定杆262进一步朝近侧运动。因此，锁定齿236沿第二凸轮齿235行进。第二凸轮齿轮231会一直旋转，直到第二凸轮齿轮231的尖端288接合倒圆尖端285。第二凸轮齿轮235具有平行侧部283，使得锁定齿236的成角度的边缘281能够接合成角度的侧部284，但是这种接合仅在第一凸轮齿233将锁定齿236朝近侧推动以使倒圆尖端285越过平行侧部283之后发生。在沿第一凸轮齿233行进之前，由于平行侧部283接合平行侧部286，锁定齿236一般不能够沿第二凸轮齿235行进。还应理解，随着锁定齿236沿成角度的侧部284行进，锁定齿236与第一凸轮齿233脱离。还如图18C所示，锁定杆262和锁定齿236已运动至最近侧的位置，此时，第二凸轮齿尖端288刚好接触锁定齿236。另外，由于第二凸轮齿轮231旋转，凸轮保持主体276以及相应地通向端部执行器212的套筒270在逆时针方向上进行关节运动。
图18D示出关节运动区域211的第四位置。同样，应当理解，为使端部执行器212进一步地进行关节运动，使用者继续旋转关节运动钮214。臂242,240继续运动，使得第一臂242进一步朝远侧运动并且第二臂240进一步朝近侧运动。臂242,240的运动继续使第一凸轮齿轮230旋转，从而使凸轮翼部239进一步可旋转地推动凸台273。锁定齿236继续沿第二凸轮齿235行进，直到弹簧264所造成的远侧偏压使锁定杆262被推动到图18D所示的位置。应当理解，当锁定杆262卡扣到图18D所示位置中时，可听见或感觉到可听的咔嗒声或咯哒声。因此，使用者接收可听和/或触觉确认，其指示锁定齿236已从一组凸轮齿233,235之间运动到另一组凸轮齿之间，或者已旋转单个关节运动增量。当处于图18D所示位置时，第一凸轮齿轮230停止旋转，并且锁定齿236配合在凸轮齿233,235之间。套筒270以及相应地端部执行器212停止关节运动。可靠锁定已经形成，因为受端部执行器212上的横向力推动的第二凸轮齿轮231的任何旋转运动将会导致平行侧部286接合平行侧部283并且停止第二凸轮齿轮231的任何进一步旋转，这会锁定端部执行器212的关节运动。应当理解，从图18A所示的构型过渡到图18D所示的构型表示关节运动经过一个关节运动增量(或者说关节运动的增量)，其中关节运动距离大体上由第二凸轮齿235之间的间隔限定。
应当理解，当处于图18D所示位置时，端部执行器212已经进行关节运动，由此向使用者提供具有已关节运动的端部执行器212的轴组件200。应当理解，使用者可能希望在图18D所示位置中使用轴组件200，或者可能希望使端部执行器212进一步枢转一个或多个附加关节运动增量。在使用者未进一步旋转关节运动钮214的情况下，锁定齿236会锁定于第一凸轮齿233和第二凸轮齿235之间，这种锁定防止端部执行器212枢转以返回到伸直位置。一旦端部执行器212已关节运动到期望角度(α)，应当理解，使用者可致动击发梁213以驱动刀248，使其切割组织并驱动钉穿过组织。例如，刀248和击发梁213可通过例如能够弯曲的梁连通，使得击发梁213能够通过关节运动接头211的任何程度的枢转而推进。
图18E示出关节运动接头211的第五位置，此时，使用者希望端部执行器212进一步枢转。同样，应当理解，使用者继续旋转关节运动钮214。由此，臂242,240继续运动，使得第一臂242进一步朝远侧运动并且第二臂240进一步朝近侧运动。臂242,240的运动继续使第一凸轮齿轮230旋转，这使凸轮翼部239可旋转地推动凸台273。第一凸轮齿轮230和第二凸轮齿轮231如图18B-D所示那样以类似的方式运动，这使端部执行器212进一步进行关节运动，并且锁定在关节运动程度更大的位置。应当理解，使用者可继续旋转关节运动钮214，以使端部执行器212枢转至如使用者期望的程度。此外，使用者可以使关节运动钮214在相反方向上旋转，以使臂242,240和凸轮齿230,231在相反方向上运动，从而使端部执行器212在相反方向上进行关节运动。
如在图18A-18E所示的示例性致动中所见，第一凸轮齿轮230能够操作以通过将运动从臂242,240传递到第一凸轮齿轮230而解锁关节运动接头211并使端部执行器212在关节运动接头211处围绕枢转轴线280枢转。另外，第二凸轮齿轮231和锁定杆262一起锁定关节运动接头211，从而锁定端部执行器212相对于轴组件200的纵向轴线(LA)的角度(α)。
V.其他方面
应当理解，本文所述的教导内容、表达方式、实施例、示例等中的任何一者或多者可与本文所述的其他教导内容、表达方式、实施例、示例等中的任何一者或多者相结合。上述教导内容、表达方式、实施例、示例等不应视为彼此孤立。参考本文教导内容，其中本文教导内容可结合的各种合适方式将对本领域的普通技术人员显而易见。此类修改和变型旨在包括在权利要求书的范围内。
应当理解，所述以引用的方式并入本文中的任何专利、出版物或其他公开材料，无论是全文或部分，仅在所并入的材料与本公开中给出的定义、陈述或者其他公开材料不冲突的范围内并入本文。同样并且在必要的程度下，本申请明确阐述的公开内容取代了以引证方式并入本申请的任何冲突材料。以引用方式并入本文但与本文所述的现有定义、陈述或其它公开材料相冲突的任何材料或其部分，仅在所并入的材料和现有的公开材料之间不产生冲突的程度下并入本文。
上文所述的装置的形式可适用于由医疗专业人员进行的常规医疗处理和手术中、以及可适用于机器人辅助的医疗处理和手术中。仅以举例的方式，本文的各种教导内容可易于结合到机器人外科系统诸如Intuitive Surgical,Inc.(Sunnyvale,California)的DAVINCITM系统中。类似地，本领域的普通技术人员将认识到本文中的各种教导内容可易于结合如下专利中的任何专利的各种教导内容：1998年8月11日公布的名称为“Articulated Surgical InstrumentFor Performing Minimally Invasive Surgery With Enhanced Dexterity andSensitivity”的美国专利5,792,135，其公开内容以引用方式并入本文；1998年10月6日公布的名称为“Remote Center Positioning Device with FlexibleDrive”美国专利5,817,084，其公开内容以引用方式并入本文；1999年3月2日公布的名称为“Automated Endoscope System for Optimal Positioning”的美国专利5,878,193，其公开内容以引用方式并入本文；2001年5月15日公布的名称为“Robotic Arm DLUS for Performing Surgical Tasks”的美国专利6,231,565，其公开内容以引用方式并入本文；2004年8月31日公布的名称为“Robotic Surgical Tool with Ultrasound Cauterizing and Cutting Instrument”的美国专利6,783,524中，其公开内容以引用方式并入本文；2002年4月2日公布的名称为“Alignment of Master and Slave in a Minimally InvasiveSurgical Apparatus”的美国专利6,364,888，其公开内容以引用方式并入本文；2009年4月28日公布的名称为“Mechanical Actuator Interface Systemfor Robotic Surgical Tools”的美国专利7,524,320，其公开内容以引用方式并入本文；2010年4月6日公布的名称为“Platform Link Wrist Mechanism”的美国专利7,691,098，其公开内容以引用方式并入本文；2010年10月5日公布的名称为“Repositioning and Reorientation of Master/Slave Relationship inMinimally Invasive Telesurgery”的美国专利7,806,891，其公开内容以引用方式并入本文；2013年1月10日公布的名称为“Automated End EffectorComponent Reloading System for Use with a Robotic System”的美国公布2013/0012957，其公开内容以引用方式并入本文；2012年8月9日公布的名称为“Robotically-Controlled Surgical Instrument with Force-FeedbackCapabilities”的美国公布2012/0199630，其公开内容以引用方式并入本文；2012年5月31日公布的名称为“Shiftable Drive Interface for Robotically-Controlled Surgical Tool”的美国公布2012/0132450，其公开内容以引用方式并入本文；2012年8月9日公布的名称为“Surgical Stapling Instruments withCam-Driven Staple Deployment Arrangements”的美国公布2012/0199633，其公开内容以引用方式并入本文；2012年8月9日公布的名称为“Robotically-Controlled Motorized Surgical End Effector System with Rotary Actuated ClosureSystems Having Variable Actuation Speeds”的美国公布2012/0199631，其公开内容以引用方式并入本文；2012年8月9日公布的名称为“Robotically-Controlled Surgical Instrument with Selectively Articulatable End Effector”的美国公布2012/0199632，其公开内容以引用方式并入本文；2012年8月9日公布的名称为“Robotically-Controlled Surgical End Effector System”的美国公布2012/0203247，其公开内容以引用方式并入本文；2012年8月23日公布的名称为“Drive Interface for Operably Coupling a Manipulatable Surgical Toolto a Robot”的美国公布2012/0211546，其公开内容以引用方式并入本文；2012年6月7日公布的名称为“Robotically-Controlled Cable-Based SurgicalEnd Effectors”的美国公布2012/0138660，其公开内容以引用方式并入本文；和/或2012年8月16日公布的名称为“Robotically-Controlled SurgicalEnd Effector System with Rotary Actuated Closure Systems”的美国公布2012/0205421，其公开内容以引用方式并入本文。
上文所述的形式可被设计为单次使用后丢弃，或者它们可被设计为可多次使用。在上述任一种或两种情况下，都可对这些形式进行修复，以便在使用至少一次后再使用。修复可包括以下步骤的任意组合：拆卸装置、然后清洗或替换特定部件和随后进行重新组装。具体地，可拆卸所述装置的一些形式，并且可选择性地以任何组合形式来替换或取出所述装置的任意数量的特定部件或零件。在清洗和/或更换特定零件时，所述装置的一些形式可在修复设施中重新组装或者在即将进行手术前由用户重新组装以供随后使用。本领域的技术人员将会了解，装置修复可以利用多种技术进行拆卸、清洗/更换以及重新组装。这些技术的用途以及得到的重新修复装置均在本发明的范围内。
仅通过举例的方式，本文描述的版本在手术之前和/或之后可被消毒。在一种消毒技术中，将装置放置在闭合并密封的容器中，例如，塑料袋或TYVEK袋中。然后可将容器和装置放置在可穿透所述容器的辐射场中，诸如γ辐射、X射线或高能电子。辐射可将装置上和容器中的细菌杀死。消毒后的装置随后可存放在无菌容器中，以供以后使用。还可使用本领域已知的任何其他技术对装置消毒，包括但不限于β辐射或γ辐射、环氧乙烷或蒸汽。
上文已经示出和描述了本发明的多个实施例，可由本领域的普通技术人员在不脱离本发明范围的情况下进行适当修改来实现本文描述的方法和系统的进一步改进。已经提及了若干此类潜在修改形式，并且其它修改形式对本领域的技术人员将是显而易见的。例如，上文所讨论的示例、实施例、几何形状、材料、尺寸、比率、步骤等均是示例性的而非所要求的。因此，本发明的范围应根据下面的权利要求书来考虑，并且应理解为不限于说明书和附图中示出和描述的结构和操作细节。

Claims (20)

1.一种设备，所述设备包括：
(a)主体；和
(b)与所述主体连通的轴组件，其中所述轴组件包括：
(i)具有关节运动接头的端部执行器，
(ii)能够旋转地定位在所述轴组件内的第一凸轮齿轮，
(iii)在所述关节运动接头处与所述端部执行器连通的第二凸轮齿轮，和
(iv)被朝远侧偏压以抵靠所述第二凸轮齿轮锁定的锁定杆，其中所述第一凸轮齿轮能够旋转经过第一运动范围以使所述锁定杆相对于所述第二凸轮齿轮解锁，其中所述第一凸轮齿轮能够旋转经过第二运动范围以使所述端部执行器在所述关节运动接头处旋转。
2.根据权利要求1所述的设备，其中所述第一凸轮齿轮包括被构造成能够迫使所述第二凸轮齿轮旋转的多个凸轮翼部。
3.根据权利要求2所述的设备，其中所述第二凸轮齿轮包括被构造成能够接合所述多个凸轮翼部的多个凸台。
4.根据权利要求1所述的设备，所述设备还包括与第一臂和第二臂连通的关节运动钮，其中所述第一臂和所述第二臂与所述第一凸轮齿轮以相反的方式连通，其中所述关节运动钮被构造成能够旋转以执行所述第一臂和所述第二臂的相反运动。
5.根据权利要求1所述的设备，其中所述锁定杆包括锁定齿，其中所述第二凸轮齿轮包括第二凸轮齿，其中所述锁定杆被成形为与所述第二凸轮齿的形状互补。
6.根据权利要求5所述的设备，其中所述第二凸轮齿包括直壁。
7.根据权利要求5所述的设备，其中所述第一凸轮齿轮包括第一凸轮齿，其中所述第一凸轮齿具有倒圆形状。
8.根据权利要求5所述的设备，其中所述第一凸轮齿轮包括第一凸轮齿，其中所述第二凸轮齿轮包括第二凸轮齿，其中所述锁定齿能够定位在所述第一凸轮齿和所述第二凸轮齿之间。
9.根据权利要求8所述的设备，其中所述锁定齿被构造成能够卡扣到所述第一凸轮齿和所述第二凸轮齿之间的位置，其中所述锁定齿能够操作以便在所述锁定齿卡扣到所述第一凸轮齿和所述第二凸轮齿之间的所述位置时产生可听的咔嗒声。
10.根据权利要求8所述的设备，其中所述锁定齿被构造成能够卡扣到所述第一凸轮齿和所述第二凸轮齿之间的位置，其中所述锁定齿能够操作以便在所述锁定齿卡扣到所述第一凸轮齿和所述第二凸轮齿之间的所述位置时产生触觉点击反馈。
11.根据权利要求1所述的设备，其中所述第一凸轮齿轮包括凸轮翼部，其中所述第二凸轮齿轮包括凸台，其中所述凸轮翼部和所述凸台能够定位成使得所述凸轮翼部和所述凸台之间保持间隙。
12.根据权利要求1所述的设备，其中所述第一凸轮齿轮和所述第二凸轮齿轮与枢转轴线共轴对齐，其中所述枢转轴线垂直于所述端部执行器。
13.根据权利要求1所述的设备，其中所述第二凸轮齿轮包括具有平行侧部的第二凸轮齿，其中所述锁定杆包括具有平行侧部的锁定齿，其中所述锁定齿的所述平行侧部被构造成能够接合所述第二凸轮齿的所述平行侧部，从而防止所述第二凸轮齿轮旋转。
14.根据权利要求1所述的设备，其中所述锁定杆包括被构造成能够防止所述锁定杆的远侧运动超过预先确定的点的至少一个侧向延伸的凸台。
15.根据权利要求1所述的设备，所述设备还包括与所述锁定杆连通的弹簧，其中所述弹簧能够操作以使所述锁定杆朝远侧偏压。
16.一种设备，所述设备包括：
(a)主体；和
(b)与所述主体连通的轴组件，其中所述轴组件包括：
(i)定位在所述轴组件的远侧端部处的端部执行器，
(ii)定位在所述端部执行器的近侧端部处的关节运动接头，
(iii)定位在所述轴组件的所述远侧端部处的第一凸轮齿轮，其中所述第一凸轮齿轮被构造成能够旋转，
(iv)通过所述关节运动接头与所述端部执行器连通的第二凸轮齿轮，其中所述第二凸轮齿轮能够操作以在所述关节运动接头处驱动所述端部执行器的关节运动，和
(v)与所述第一凸轮齿轮和所述第二凸轮齿轮选择性地连通的锁定杆，其中所述锁定杆能够在远侧位置和近侧位置之间运动，其中所述锁定杆被构造成能够在所述锁定杆处于所述远侧位置时阻止所述第二凸轮齿轮旋转，其中所述锁定杆被构造成能够在所述锁定杆处于所述近侧位置时允许所述第二凸轮齿轮旋转，其中所述第一凸轮齿轮被构造成能够通过所述第一凸轮齿轮的旋转来将所述锁定杆从所述远侧位置驱动到所述近侧位置。
17.根据权利要求16所述的设备，其中所述锁定杆包括被构造成能够阻止所述第二凸轮齿轮的旋转运动的锁定齿。
18.根据权利要求16所述的设备，其中所述第一凸轮齿轮包括第一凸轮齿，其中所述第一凸轮齿具有被构造成能够允许所述锁定杆通过凸轮运动沿所述第一凸轮齿行进的形状。
19.根据权利要求16所述的设备，其中所述锁定杆被构造成能够在所述锁定杆与所述第二凸轮齿轮选择性地连通时产生可听的咔嗒声。
20.一种使用轴组件来使端部执行器进行关节运动的方法，所述轴组件包括第一凸轮齿轮、第二凸轮齿轮、第一臂、第二臂和锁定杆，其中所述第二凸轮齿轮与所述第一凸轮齿轮连通，其中所述第一臂和所述第二臂与所述凸轮齿轮连通，其中所述锁定杆与所述第一凸轮齿轮和所述第二凸轮齿轮选择性地连通，其中所述第二凸轮齿轮与所述端部执行器枢转连通，所述方法包括：
(a)致动所述第一臂和所述第二臂以使所述第一凸轮齿轮旋转；
(b)使所述第一凸轮齿轮旋转；
(c)使所述锁定杆在近侧方向上运动，使得所述锁定杆以顺序的方式沿所述第一凸轮齿轮和所述第二凸轮齿轮行进；
(d)使所述第二凸轮齿轮旋转，从而使所述端部执行器进行关节运动；以及
(e)使所述锁定杆在远侧方向上运动。
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Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN109219404A (zh) * 2016-04-01 2019-01-15 伊西康有限责任公司 具有能够围绕轴轴线选择性地旋转的外科端部执行器的可互换外科工具组件
CN110037762A (zh) * 2018-01-17 2019-07-23 柯惠Lp公司 带自返回组件的手术吻合器
CN110831511A (zh) * 2017-06-28 2020-02-21 爱惜康有限责任公司 包括具有壳体布置结构的轴的外科器械
CN111565648A (zh) * 2017-12-19 2020-08-21 爱惜康有限责任公司 被构造用于与不同控制器接口可互换使用的外科工具
CN114305558A (zh) * 2021-05-27 2022-04-12 天津瑞奇外科器械股份有限公司 一种外科器械及其操作方法

Families Citing this family (622)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9060770B2 (en) 2003-05-20 2015-06-23 Ethicon Endo-Surgery, Inc. Robotically-driven surgical instrument with E-beam driver
US20070084897A1 (en) 2003-05-20 2007-04-19 Shelton Frederick E Iv Articulating surgical stapling instrument incorporating a two-piece e-beam firing mechanism
US8215531B2 (en) 2004-07-28 2012-07-10 Ethicon Endo-Surgery, Inc. Surgical stapling instrument having a medical substance dispenser
US11998198B2 (en) 2004-07-28 2024-06-04 Cilag Gmbh International Surgical stapling instrument incorporating a two-piece E-beam firing mechanism
US11890012B2 (en) 2004-07-28 2024-02-06 Cilag Gmbh International Staple cartridge comprising cartridge body and attached support
US9072535B2 (en) 2011-05-27 2015-07-07 Ethicon Endo-Surgery, Inc. Surgical stapling instruments with rotatable staple deployment arrangements
US7669746B2 (en) 2005-08-31 2010-03-02 Ethicon Endo-Surgery, Inc. Staple cartridges for forming staples having differing formed staple heights
US9237891B2 (en) 2005-08-31 2016-01-19 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical stapling devices that produce formed staples having different lengths
US10159482B2 (en) 2005-08-31 2018-12-25 Ethicon Llc Fastener cartridge assembly comprising a fixed anvil and different staple heights
US11484312B2 (en) 2005-08-31 2022-11-01 Cilag Gmbh International Staple cartridge comprising a staple driver arrangement
US7934630B2 (en) 2005-08-31 2011-05-03 Ethicon Endo-Surgery, Inc. Staple cartridges for forming staples having differing formed staple heights
US11246590B2 (en) 2005-08-31 2022-02-15 Cilag Gmbh International Staple cartridge including staple drivers having different unfired heights
US20070106317A1 (en) 2005-11-09 2007-05-10 Shelton Frederick E Iv Hydraulically and electrically actuated articulation joints for surgical instruments
US20110024477A1 (en) 2009-02-06 2011-02-03 Hall Steven G Driven Surgical Stapler Improvements
US11278279B2 (en) 2006-01-31 2022-03-22 Cilag Gmbh International Surgical instrument assembly
US7845537B2 (en) 2006-01-31 2010-12-07 Ethicon Endo-Surgery, Inc. Surgical instrument having recording capabilities
US7753904B2 (en) 2006-01-31 2010-07-13 Ethicon Endo-Surgery, Inc. Endoscopic surgical instrument with a handle that can articulate with respect to the shaft
US11224427B2 (en) 2006-01-31 2022-01-18 Cilag Gmbh International Surgical stapling system including a console and retraction assembly
US20110295295A1 (en) 2006-01-31 2011-12-01 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical instrument having recording capabilities
US8186555B2 (en) 2006-01-31 2012-05-29 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting and fastening instrument with mechanical closure system
US8820603B2 (en) 2006-01-31 2014-09-02 Ethicon Endo-Surgery, Inc. Accessing data stored in a memory of a surgical instrument
US20120292367A1 (en) 2006-01-31 2012-11-22 Ethicon Endo-Surgery, Inc. Robotically-controlled end effector
US11793518B2 (en) 2006-01-31 2023-10-24 Cilag Gmbh International Powered surgical instruments with firing system lockout arrangements
US8708213B2 (en) 2006-01-31 2014-04-29 Ethicon Endo-Surgery, Inc. Surgical instrument having a feedback system
US8992422B2 (en) 2006-03-23 2015-03-31 Ethicon Endo-Surgery, Inc. Robotically-controlled endoscopic accessory channel
US8322455B2 (en) 2006-06-27 2012-12-04 Ethicon Endo-Surgery, Inc. Manually driven surgical cutting and fastening instrument
US10568652B2 (en) 2006-09-29 2020-02-25 Ethicon Llc Surgical staples having attached drivers of different heights and stapling instruments for deploying the same
US20080078802A1 (en) 2006-09-29 2008-04-03 Hess Christopher J Surgical staples and stapling instruments
US11980366B2 (en) 2006-10-03 2024-05-14 Cilag Gmbh International Surgical instrument
US11291441B2 (en) 2007-01-10 2022-04-05 Cilag Gmbh International Surgical instrument with wireless communication between control unit and remote sensor
US8652120B2 (en) 2007-01-10 2014-02-18 Ethicon Endo-Surgery, Inc. Surgical instrument with wireless communication between control unit and sensor transponders
US8840603B2 (en) 2007-01-10 2014-09-23 Ethicon Endo-Surgery, Inc. Surgical instrument with wireless communication between control unit and sensor transponders
US8684253B2 (en) 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 (en) 2007-01-11 2021-06-22 Cilag Gmbh International Staple cartridge for use with a surgical stapling instrument
US8540128B2 (en) 2007-01-11 2013-09-24 Ethicon Endo-Surgery, Inc. Surgical stapling device with a curved end effector
US7735703B2 (en) 2007-03-15 2010-06-15 Ethicon Endo-Surgery, Inc. Re-loadable surgical stapling instrument
US8893946B2 (en) 2007-03-28 2014-11-25 Ethicon Endo-Surgery, Inc. Laparoscopic tissue thickness and clamp load measuring devices
US8931682B2 (en) 2007-06-04 2015-01-13 Ethicon Endo-Surgery, Inc. Robotically-controlled shaft based rotary drive systems for surgical instruments
US11564682B2 (en) 2007-06-04 2023-01-31 Cilag Gmbh International Surgical stapler device
US7753245B2 (en) 2007-06-22 2010-07-13 Ethicon Endo-Surgery, Inc. Surgical stapling instruments
US11849941B2 (en) 2007-06-29 2023-12-26 Cilag Gmbh International Staple cartridge having staple cavities extending at a transverse angle relative to a longitudinal cartridge axis
US7819298B2 (en) 2008-02-14 2010-10-26 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with control features operable with one hand
US8758391B2 (en) 2008-02-14 2014-06-24 Ethicon Endo-Surgery, Inc. Interchangeable tools for surgical instruments
US8636736B2 (en) 2008-02-14 2014-01-28 Ethicon Endo-Surgery, Inc. Motorized surgical cutting and fastening instrument
US8573465B2 (en) 2008-02-14 2013-11-05 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical end effector system with rotary actuated closure systems
RU2493788C2 (ru) 2008-02-14 2013-09-27 Этикон Эндо-Серджери, Инк. Хирургический режущий и крепежный инструмент, имеющий радиочастотные электроды
US7866527B2 (en) 2008-02-14 2011-01-11 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with interlockable firing system
US11986183B2 (en) 2008-02-14 2024-05-21 Cilag Gmbh International Surgical cutting and fastening instrument comprising a plurality of sensors to measure an electrical parameter
US9179912B2 (en) 2008-02-14 2015-11-10 Ethicon Endo-Surgery, Inc. Robotically-controlled motorized surgical cutting and fastening instrument
US20130153641A1 (en) 2008-02-15 2013-06-20 Ethicon Endo-Surgery, Inc. Releasable layer of material and surgical end effector having the same
US11272927B2 (en) 2008-02-15 2022-03-15 Cilag Gmbh International Layer arrangements for surgical staple cartridges
US9005230B2 (en) 2008-09-23 2015-04-14 Ethicon Endo-Surgery, Inc. Motorized surgical instrument
US11648005B2 (en) 2008-09-23 2023-05-16 Cilag Gmbh International Robotically-controlled motorized surgical instrument with an end effector
US8210411B2 (en) 2008-09-23 2012-07-03 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting instrument
US9386983B2 (en) 2008-09-23 2016-07-12 Ethicon Endo-Surgery, Llc Robotically-controlled motorized surgical instrument
US8608045B2 (en) 2008-10-10 2013-12-17 Ethicon Endo-Sugery, Inc. Powered surgical cutting and stapling apparatus with manually retractable firing system
US8517239B2 (en) 2009-02-05 2013-08-27 Ethicon Endo-Surgery, Inc. Surgical stapling instrument comprising a magnetic element driver
US8444036B2 (en) 2009-02-06 2013-05-21 Ethicon Endo-Surgery, Inc. Motor driven surgical fastener device with mechanisms for adjusting a tissue gap within the end effector
CN102341048A (zh) 2009-02-06 2012-02-01 伊西康内外科公司 动力手术缝合器的改进
US8220688B2 (en) 2009-12-24 2012-07-17 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting instrument with electric actuator directional control assembly
US8851354B2 (en) 2009-12-24 2014-10-07 Ethicon Endo-Surgery, Inc. Surgical cutting instrument that analyzes tissue thickness
US8783543B2 (en) 2010-07-30 2014-07-22 Ethicon Endo-Surgery, Inc. Tissue acquisition arrangements and methods for surgical stapling devices
US11925354B2 (en) 2010-09-30 2024-03-12 Cilag Gmbh International Staple cartridge comprising staples positioned within a compressible portion thereof
US9386988B2 (en) 2010-09-30 2016-07-12 Ethicon End-Surgery, LLC Retainer assembly including a tissue thickness compensator
US11812965B2 (en) 2010-09-30 2023-11-14 Cilag Gmbh International Layer of material for a surgical end effector
US8978954B2 (en) 2010-09-30 2015-03-17 Ethicon Endo-Surgery, Inc. Staple cartridge comprising an adjustable distal portion
US9282962B2 (en) 2010-09-30 2016-03-15 Ethicon Endo-Surgery, Llc Adhesive film laminate
US10945731B2 (en) 2010-09-30 2021-03-16 Ethicon Llc Tissue thickness compensator comprising controlled release and expansion
US9629814B2 (en) 2010-09-30 2017-04-25 Ethicon Endo-Surgery, Llc Tissue thickness compensator configured to redistribute compressive forces
US11298125B2 (en) 2010-09-30 2022-04-12 Cilag Gmbh International Tissue stapler having a thickness compensator
US9839420B2 (en) 2010-09-30 2017-12-12 Ethicon Llc Tissue thickness compensator comprising at least one medicament
US9232941B2 (en) 2010-09-30 2016-01-12 Ethicon Endo-Surgery, Inc. Tissue thickness compensator comprising a reservoir
US9364233B2 (en) 2010-09-30 2016-06-14 Ethicon Endo-Surgery, Llc Tissue thickness compensators for circular surgical staplers
US8695866B2 (en) 2010-10-01 2014-04-15 Ethicon Endo-Surgery, Inc. Surgical instrument having a power control circuit
AU2012250197B2 (en) 2011-04-29 2017-08-10 Ethicon Endo-Surgery, Inc. Staple cartridge comprising staples positioned within a compressible portion thereof
US11207064B2 (en) 2011-05-27 2021-12-28 Cilag Gmbh International Automated end effector component reloading system for use with a robotic system
US9044230B2 (en) 2012-02-13 2015-06-02 Ethicon Endo-Surgery, Inc. Surgical cutting and fastening instrument with apparatus for determining cartridge and firing motion status
JP6105041B2 (ja) 2012-03-28 2017-03-29 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． 低圧環境を画定するカプセルを含む組織厚コンペンセーター
CN104379068B (zh) 2012-03-28 2017-09-22 伊西康内外科公司 包括组织厚度补偿件的保持器组件
CN104321024B (zh) 2012-03-28 2017-05-24 伊西康内外科公司 包括多个层的组织厚度补偿件
US9101358B2 (en) 2012-06-15 2015-08-11 Ethicon Endo-Surgery, Inc. Articulatable surgical instrument comprising a firing drive
US9364230B2 (en) 2012-06-28 2016-06-14 Ethicon Endo-Surgery, Llc Surgical stapling instruments with rotary joint assemblies
US9649111B2 (en) 2012-06-28 2017-05-16 Ethicon Endo-Surgery, Llc Replaceable clip cartridge for a clip applier
BR112014032776B1 (pt) 2012-06-28 2021-09-08 Ethicon Endo-Surgery, Inc Sistema de instrumento cirúrgico e kit cirúrgico para uso com um sistema de instrumento cirúrgico
US9289256B2 (en) 2012-06-28 2016-03-22 Ethicon Endo-Surgery, Llc Surgical end effectors having angled tissue-contacting surfaces
US20140005718A1 (en) 2012-06-28 2014-01-02 Ethicon Endo-Surgery, Inc. Multi-functional powered surgical device with external dissection features
US11202631B2 (en) 2012-06-28 2021-12-21 Cilag Gmbh International Stapling assembly comprising a firing lockout
CN104487005B (zh) 2012-06-28 2017-09-08 伊西康内外科公司 空夹仓闭锁件
US20140001231A1 (en) 2012-06-28 2014-01-02 Ethicon Endo-Surgery, Inc. Firing system lockout arrangements for surgical instruments
US9186142B2 (en) * 2013-02-28 2015-11-17 Ethicon Endo-Surgery, Inc. Surgical instrument end effector articulation drive with pinion and opposing racks
US9795379B2 (en) * 2013-02-28 2017-10-24 Ethicon Llc Surgical instrument with multi-diameter shaft
US9717497B2 (en) 2013-02-28 2017-08-01 Ethicon Llc Lockout feature for movable cutting member of surgical instrument
US9517065B2 (en) 2013-02-28 2016-12-13 Ethicon Endo-Surgery, Llc Integrated tissue positioning and jaw alignment features for surgical stapler
RU2669463C2 (ru) 2013-03-01 2018-10-11 Этикон Эндо-Серджери, Инк. Хирургический инструмент с мягким упором
RU2672520C2 (ru) 2013-03-01 2018-11-15 Этикон Эндо-Серджери, Инк. Шарнирно поворачиваемые хирургические инструменты с проводящими путями для передачи сигналов
US9351727B2 (en) 2013-03-14 2016-05-31 Ethicon Endo-Surgery, Llc Drive train control arrangements for modular surgical instruments
US9629629B2 (en) 2013-03-14 2017-04-25 Ethicon Endo-Surgey, LLC Control systems for surgical instruments
US9700318B2 (en) * 2013-04-09 2017-07-11 Covidien Lp Apparatus for endoscopic procedures
US9775610B2 (en) * 2013-04-09 2017-10-03 Covidien Lp Apparatus for endoscopic procedures
US9814460B2 (en) 2013-04-16 2017-11-14 Ethicon Llc Modular motor driven surgical instruments with status indication arrangements
BR112015026109B1 (pt) 2013-04-16 2022-02-22 Ethicon Endo-Surgery, Inc Instrumento cirúrgico
US20150053746A1 (en) 2013-08-23 2015-02-26 Ethicon Endo-Surgery, Inc. Torque optimization for surgical instruments
JP6416260B2 (ja) 2013-08-23 2018-10-31 エシコン エルエルシー 動力付き外科用器具のための発射部材後退装置
US9962161B2 (en) 2014-02-12 2018-05-08 Ethicon Llc Deliverable surgical instrument
JP6462004B2 (ja) 2014-02-24 2019-01-30 エシコン エルエルシー 発射部材ロックアウトを備える締結システム
US9690362B2 (en) 2014-03-26 2017-06-27 Ethicon Llc Surgical instrument control circuit having a safety processor
US9820738B2 (en) 2014-03-26 2017-11-21 Ethicon Llc Surgical instrument comprising interactive systems
US9743929B2 (en) 2014-03-26 2017-08-29 Ethicon Llc Modular powered surgical instrument with detachable shaft assemblies
BR112016021943B1 (pt) 2014-03-26 2022-06-14 Ethicon Endo-Surgery, Llc Instrumento cirúrgico para uso por um operador em um procedimento cirúrgico
BR112016023698B1 (pt) 2014-04-16 2022-07-26 Ethicon Endo-Surgery, Llc Cartucho de prendedores para uso com um instrumento cirúrgico
US20150297223A1 (en) 2014-04-16 2015-10-22 Ethicon Endo-Surgery, Inc. Fastener cartridges including extensions having different configurations
US10010324B2 (en) 2014-04-16 2018-07-03 Ethicon Llc Fastener cartridge compromising fastener cavities including fastener control features
US9801628B2 (en) 2014-09-26 2017-10-31 Ethicon Llc Surgical staple and driver arrangements for staple cartridges
BR112016023807B1 (pt) 2014-04-16 2022-07-12 Ethicon Endo-Surgery, Llc Conjunto de cartucho de prendedores para uso com um instrumento cirúrgico
JP6612256B2 (ja) 2014-04-16 2019-11-27 エシコン エルエルシー 不均一な締結具を備える締結具カートリッジ
US10335147B2 (en) 2014-06-25 2019-07-02 Ethicon Llc Method of using lockout features for surgical stapler cartridge
US9693774B2 (en) 2014-06-25 2017-07-04 Ethicon Llc Pivotable articulation joint unlocking feature for surgical stapler
US10456132B2 (en) 2014-06-25 2019-10-29 Ethicon Llc Jaw opening feature for surgical stapler
US10314577B2 (en) 2014-06-25 2019-06-11 Ethicon Llc Lockout engagement features for surgical stapler
JP6625569B2 (ja) * 2014-06-25 2019-12-25 エシコン エルエルシーＥｔｈｉｃｏｎ ＬＬＣ 外科用ステープラ用の枢動可能な関節動作ジョイントの係止解除特徴部
USD798686S1 (en) * 2014-09-05 2017-10-03 Mohammed Ali Barakat Ergonomical trigger handle
BR112017004361B1 (pt) 2014-09-05 2023-04-11 Ethicon Llc Sistema eletrônico para um instrumento cirúrgico
US9724094B2 (en) 2014-09-05 2017-08-08 Ethicon Llc Adjunct with integrated sensors to quantify tissue compression
US11311294B2 (en) 2014-09-05 2022-04-26 Cilag Gmbh International Powered medical device including measurement of closure state of jaws
US10105142B2 (en) 2014-09-18 2018-10-23 Ethicon Llc Surgical stapler with plurality of cutting elements
US11523821B2 (en) 2014-09-26 2022-12-13 Cilag Gmbh International Method for creating a flexible staple line
JP6648119B2 (ja) 2014-09-26 2020-02-14 エシコン エルエルシーＥｔｈｉｃｏｎ ＬＬＣ 外科ステープル留めバットレス及び付属物材料
US10076325B2 (en) 2014-10-13 2018-09-18 Ethicon Llc Surgical stapling apparatus comprising a tissue stop
EP3010080B1 (en) 2014-10-15 2022-02-23 Ethicon Endo-Surgery, Inc. Surgical instrument battery pack with voltage polling
US9974539B2 (en) 2014-10-15 2018-05-22 Ethicon Llc Surgical instrument battery pack with voltage polling
US9924944B2 (en) 2014-10-16 2018-03-27 Ethicon Llc Staple cartridge comprising an adjunct material
US11141153B2 (en) 2014-10-29 2021-10-12 Cilag Gmbh International Staple cartridges comprising driver arrangements
US10517594B2 (en) 2014-10-29 2019-12-31 Ethicon Llc Cartridge assemblies for surgical staplers
US9844376B2 (en) 2014-11-06 2017-12-19 Ethicon Llc Staple cartridge comprising a releasable adjunct material
US10736636B2 (en) 2014-12-10 2020-08-11 Ethicon Llc Articulatable surgical instrument system
US9844375B2 (en) 2014-12-18 2017-12-19 Ethicon Llc Drive arrangements for articulatable surgical instruments
US10085748B2 (en) 2014-12-18 2018-10-02 Ethicon Llc Locking arrangements for detachable shaft assemblies with articulatable surgical end effectors
US9844374B2 (en) 2014-12-18 2017-12-19 Ethicon Llc Surgical instrument systems comprising an articulatable end effector and means for adjusting the firing stroke of a firing member
US9987000B2 (en) 2014-12-18 2018-06-05 Ethicon Llc Surgical instrument assembly comprising a flexible articulation system
US10245027B2 (en) 2014-12-18 2019-04-02 Ethicon Llc Surgical instrument with an anvil that is selectively movable about a discrete non-movable axis relative to a staple cartridge
BR112017012996B1 (pt) 2014-12-18 2022-11-08 Ethicon Llc Instrumento cirúrgico com uma bigorna que é seletivamente móvel sobre um eixo geométrico imóvel distinto em relação a um cartucho de grampos
US10188385B2 (en) 2014-12-18 2019-01-29 Ethicon Llc Surgical instrument system comprising lockable systems
US10117649B2 (en) * 2014-12-18 2018-11-06 Ethicon Llc Surgical instrument assembly comprising a lockable articulation system
CN104546043B (zh) * 2015-01-19 2016-08-31 上海逸思医疗科技有限公司 一种控弯机构及具有控弯机构的外科器械
CN104546048B (zh) * 2015-01-19 2016-11-16 上海逸思医疗科技有限公司 一种外科器械及其控弯机构
US10180463B2 (en) 2015-02-27 2019-01-15 Ethicon Llc Surgical apparatus configured to assess whether a performance parameter of the surgical apparatus is within an acceptable performance band
US20160249910A1 (en) 2015-02-27 2016-09-01 Ethicon Endo-Surgery, Llc Surgical charging system that charges and/or conditions one or more batteries
US11154301B2 (en) 2015-02-27 2021-10-26 Cilag Gmbh International Modular stapling assembly
US9808246B2 (en) 2015-03-06 2017-11-07 Ethicon Endo-Surgery, Llc Method of operating a powered surgical instrument
US9901342B2 (en) 2015-03-06 2018-02-27 Ethicon Endo-Surgery, Llc Signal and power communication system positioned on a rotatable shaft
US10441279B2 (en) 2015-03-06 2019-10-15 Ethicon Llc Multiple level thresholds to modify operation of powered surgical instruments
US10245033B2 (en) 2015-03-06 2019-04-02 Ethicon Llc Surgical instrument comprising a lockable battery housing
US10548504B2 (en) 2015-03-06 2020-02-04 Ethicon Llc Overlaid multi sensor radio frequency (RF) electrode system to measure tissue compression
US10687806B2 (en) 2015-03-06 2020-06-23 Ethicon Llc Adaptive tissue compression techniques to adjust closure rates for multiple tissue types
US9993248B2 (en) 2015-03-06 2018-06-12 Ethicon Endo-Surgery, Llc Smart sensors with local signal processing
US10617412B2 (en) 2015-03-06 2020-04-14 Ethicon Llc System for detecting the mis-insertion of a staple cartridge into a surgical stapler
US9924961B2 (en) 2015-03-06 2018-03-27 Ethicon Endo-Surgery, Llc Interactive feedback system for powered surgical instruments
JP2020121162A (ja) 2015-03-06 2020-08-13 エシコン エルエルシーＥｔｈｉｃｏｎ ＬＬＣ 測定の安定性要素、クリープ要素、及び粘弾性要素を決定するためのセンサデータの時間依存性評価
US10136891B2 (en) 2015-03-25 2018-11-27 Ethicon Llc Naturally derived bioabsorbable polymer gel adhesive for releasably attaching a staple buttress to a surgical stapler
US10349939B2 (en) 2015-03-25 2019-07-16 Ethicon Llc Method of applying a buttress to a surgical stapler
US10548593B2 (en) 2015-03-25 2020-02-04 Ethicon Llc Flowable bioabsorbable polymer adhesive for releasably attaching a staple buttress to a surgical stapler
US10863984B2 (en) 2015-03-25 2020-12-15 Ethicon Llc Low inherent viscosity bioabsorbable polymer adhesive for releasably attaching a staple buttress to a surgical stapler
US10478187B2 (en) 2015-03-25 2019-11-19 Ethicon Llc Biologically derived extracellular matrix with infused viscous absorbable copolymer for releasably attaching a staple buttress to a surgical stapler
US10172618B2 (en) 2015-03-25 2019-01-08 Ethicon Llc Low glass transition temperature bioabsorbable polymer adhesive for releasably attaching a staple buttress to a surgical stapler
US10568621B2 (en) 2015-03-25 2020-02-25 Ethicon Llc Surgical staple buttress with integral adhesive for releasably attaching to a surgical stapler
US10172617B2 (en) 2015-03-25 2019-01-08 Ethicon Llc Malleable bioabsorbable polymer adhesive for releasably attaching a staple buttress to a surgical stapler
US10213201B2 (en) 2015-03-31 2019-02-26 Ethicon Llc Stapling end effector configured to compensate for an uneven gap between a first jaw and a second jaw
RU2719956C2 (ru) * 2015-06-18 2020-04-23 ЭТИКОН ЭлЭлСи Двухтактные системы привода шарнира для хирургических инструментов, выполненных с возможностью шарнирного поворота
RU2717936C2 (ru) 2015-06-18 2020-03-26 ЭТИКОН ЭлЭлСи Конструкции системы двухшарнирного привода для хирургических инструментов с возможностью шарнирного поворота
US10368861B2 (en) * 2015-06-18 2019-08-06 Ethicon Llc Dual articulation drive system arrangements for articulatable surgical instruments
US10201348B2 (en) 2015-07-28 2019-02-12 Ethicon Llc Surgical stapler cartridge with compression features at staple driver edges
US10194912B2 (en) 2015-07-28 2019-02-05 Ethicon Llc Surgical staple cartridge with outer edge compression features
US10314580B2 (en) 2015-07-28 2019-06-11 Ethicon Llc Surgical staple cartridge with compression feature at knife slot
US11058425B2 (en) 2015-08-17 2021-07-13 Ethicon Llc Implantable layers for a surgical instrument
US11039832B2 (en) 2015-08-24 2021-06-22 Cilag Gmbh International Surgical stapler buttress applicator with spent staple cartridge lockout
US10639039B2 (en) 2015-08-24 2020-05-05 Ethicon Llc Surgical stapler buttress applicator with multi-zone platform for pressure focused release
US10349940B2 (en) 2015-08-24 2019-07-16 Ethicon Llc Surgical stapler buttress applicator with state indicator
US10166023B2 (en) 2015-08-24 2019-01-01 Ethicon Llc Method of applying a buttress to a surgical stapler end effector
US10342542B2 (en) 2015-08-24 2019-07-09 Ethicon Llc Surgical stapler buttress applicator with end effector actuated release mechanism
US10342532B2 (en) 2015-08-24 2019-07-09 Ethicon Llc Surgical stapler buttress applicator with multi-point actuated release mechanism
US10105139B2 (en) 2015-09-23 2018-10-23 Ethicon Llc Surgical stapler having downstream current-based motor control
US10363036B2 (en) 2015-09-23 2019-07-30 Ethicon Llc Surgical stapler having force-based motor control
US10327769B2 (en) 2015-09-23 2019-06-25 Ethicon Llc Surgical stapler having motor control based on a drive system component
US10238386B2 (en) 2015-09-23 2019-03-26 Ethicon Llc Surgical stapler having motor control based on an electrical parameter related to a motor current
US10299878B2 (en) 2015-09-25 2019-05-28 Ethicon Llc Implantable adjunct systems for determining adjunct skew
US10314578B2 (en) 2015-09-29 2019-06-11 Ethicon Llc Battery drain circuit for surgical instrument
US10182813B2 (en) 2015-09-29 2019-01-22 Ethicon Llc Surgical stapling instrument with shaft release, powered firing, and powered articulation
US10561420B2 (en) 2015-09-30 2020-02-18 Ethicon Llc Tubular absorbable constructs
US10736633B2 (en) 2015-09-30 2020-08-11 Ethicon Llc Compressible adjunct with looping members
US10980539B2 (en) 2015-09-30 2021-04-20 Ethicon Llc Implantable adjunct comprising bonded layers
US11890015B2 (en) 2015-09-30 2024-02-06 Cilag Gmbh International Compressible adjunct with crossing spacer fibers
US11141159B2 (en) 2015-10-15 2021-10-12 Cilag Gmbh International Surgical stapler end effector with multi-staple driver crossing center line
US10342535B2 (en) 2015-10-15 2019-07-09 Ethicon Llc Method of applying staples to liver and other organs
US20170105727A1 (en) 2015-10-15 2017-04-20 Ethicon Endo-Surgery, Llc Surgical stapler with progressively driven asymmetric alternating staple drivers
US10265073B2 (en) 2015-10-15 2019-04-23 Ethicon Llc Surgical stapler with terminal staple orientation crossing center line
US10952730B2 (en) 2015-10-15 2021-03-23 Ethicon Llc End effector for surgical stapler with varying curve and taper
US10499917B2 (en) 2015-10-15 2019-12-10 Ethicon Llc Surgical stapler end effector with knife position indicators
US10265069B2 (en) 2015-10-15 2019-04-23 Ethicon Llc Surgical staple cartridge with varying staple crown width along a curve
US10226251B2 (en) 2015-10-15 2019-03-12 Ethicon Llc Surgical staple actuating sled with actuation stroke having minimized distance relative to distal staple
CN105434002B (zh) * 2015-10-16 2017-11-17 逸思（苏州）医疗科技有限公司 一种执行器可弯转的外科器械
US10314588B2 (en) 2015-10-29 2019-06-11 Ethicon Llc Fluid penetrable buttress assembly for a surgical stapler
US10517592B2 (en) 2015-10-29 2019-12-31 Ethicon Llc Surgical stapler buttress assembly with adhesion to wet end effector
US10441286B2 (en) 2015-10-29 2019-10-15 Ethicon Llc Multi-layer surgical stapler buttress assembly
US10433839B2 (en) 2015-10-29 2019-10-08 Ethicon Llc Surgical stapler buttress assembly with gel adhesive retainer
US10357248B2 (en) 2015-10-29 2019-07-23 Ethicon Llc Extensible buttress assembly for surgical stapler
US10251649B2 (en) 2015-10-29 2019-04-09 Ethicon Llc Surgical stapler buttress applicator with data communication
US10499918B2 (en) 2015-10-29 2019-12-10 Ethicon Llc Surgical stapler buttress assembly with features to interact with movable end effector components
US10085745B2 (en) 2015-10-29 2018-10-02 Ethicon Llc Extensible buttress assembly for surgical stapler
US10238388B2 (en) 2015-10-29 2019-03-26 Ethicon Llc Surgical stapler buttress assembly with humidity tolerant adhesive
US10265068B2 (en) 2015-12-30 2019-04-23 Ethicon Llc Surgical instruments with separable motors and motor control circuits
US10292704B2 (en) 2015-12-30 2019-05-21 Ethicon Llc Mechanisms for compensating for battery pack failure in powered surgical instruments
US10368865B2 (en) 2015-12-30 2019-08-06 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
JP6911054B2 (ja) 2016-02-09 2021-07-28 エシコン エルエルシーＥｔｈｉｃｏｎ ＬＬＣ 非対称の関節構成を備えた外科用器具
US10588625B2 (en) 2016-02-09 2020-03-17 Ethicon Llc Articulatable surgical instruments with off-axis firing beam arrangements
US11213293B2 (en) 2016-02-09 2022-01-04 Cilag Gmbh International Articulatable surgical instruments with single articulation link arrangements
US10258331B2 (en) 2016-02-12 2019-04-16 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10448948B2 (en) 2016-02-12 2019-10-22 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
US11224426B2 (en) 2016-02-12 2022-01-18 Cilag Gmbh International Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10485542B2 (en) 2016-04-01 2019-11-26 Ethicon Llc Surgical stapling instrument comprising multiple lockouts
US10617413B2 (en) 2016-04-01 2020-04-14 Ethicon Llc Closure system arrangements for surgical cutting and stapling devices with separate and distinct firing shafts
US10743850B2 (en) * 2016-04-04 2020-08-18 Ethicon Llc Surgical instrument with locking articulation drive wheel
EP3442430B1 (en) * 2016-04-12 2021-07-14 Applied Medical Resources Corporation Reload shaft assembly for surgical stapler
US10492783B2 (en) 2016-04-15 2019-12-03 Ethicon, Llc Surgical instrument with improved stop/start control during a firing motion
US10335145B2 (en) 2016-04-15 2019-07-02 Ethicon Llc Modular surgical instrument with configurable operating mode
US10426467B2 (en) 2016-04-15 2019-10-01 Ethicon Llc Surgical instrument with detection sensors
US10456137B2 (en) 2016-04-15 2019-10-29 Ethicon Llc Staple formation detection mechanisms
US10405859B2 (en) 2016-04-15 2019-09-10 Ethicon Llc Surgical instrument with adjustable stop/start control during a firing motion
US11179150B2 (en) 2016-04-15 2021-11-23 Cilag Gmbh International Systems and methods for controlling a surgical stapling and cutting instrument
US10357247B2 (en) 2016-04-15 2019-07-23 Ethicon Llc Surgical instrument with multiple program responses during a firing motion
US11607239B2 (en) 2016-04-15 2023-03-21 Cilag Gmbh International Systems and methods for controlling a surgical stapling and cutting instrument
US10828028B2 (en) 2016-04-15 2020-11-10 Ethicon Llc Surgical instrument with multiple program responses during a firing motion
US10433840B2 (en) 2016-04-18 2019-10-08 Ethicon Llc Surgical instrument comprising a replaceable cartridge jaw
US11317917B2 (en) 2016-04-18 2022-05-03 Cilag Gmbh International Surgical stapling system comprising a lockable firing assembly
US20170296173A1 (en) 2016-04-18 2017-10-19 Ethicon Endo-Surgery, Llc Method for operating a surgical instrument
US10653420B2 (en) 2016-04-20 2020-05-19 Ethicon Llc Compliant compensation features for end effector of surgical stapling instrument
US10258337B2 (en) 2016-04-20 2019-04-16 Ethicon Llc Surgical staple cartridge with severed tissue edge adjunct
US10363032B2 (en) 2016-04-20 2019-07-30 Ethicon Llc Surgical stapler with hydraulic deck control
US10285700B2 (en) 2016-04-20 2019-05-14 Ethicon Llc Surgical staple cartridge with hydraulic staple deployment
US10499912B2 (en) 2016-07-13 2019-12-10 Ethicon Llc Apparatus for hydraulic assisted fracture of liver parenchyma
WO2018086046A1 (zh) * 2016-11-10 2018-05-17 天津瑞奇外科器械股份有限公司 具有互锁功能的外科手术器械
US10542981B2 (en) 2016-11-14 2020-01-28 Ethicon Llc Atraumatic stapling head features for circular surgical stapler
US10758229B2 (en) 2016-12-21 2020-09-01 Ethicon Llc Surgical instrument comprising improved jaw control
US10813638B2 (en) 2016-12-21 2020-10-27 Ethicon Llc Surgical end effectors with expandable tissue stop arrangements
US11419606B2 (en) 2016-12-21 2022-08-23 Cilag Gmbh International Shaft assembly comprising a clutch configured to adapt the output of a rotary firing member to two different systems
MX2019007311A (es) 2016-12-21 2019-11-18 Ethicon Llc Sistemas de engrapado quirurgico.
US10542982B2 (en) 2016-12-21 2020-01-28 Ethicon Llc Shaft assembly comprising first and second articulation lockouts
US10835247B2 (en) 2016-12-21 2020-11-17 Ethicon Llc Lockout arrangements for surgical end effectors
US10980536B2 (en) 2016-12-21 2021-04-20 Ethicon Llc No-cartridge and spent cartridge lockout arrangements for surgical staplers
US10426471B2 (en) 2016-12-21 2019-10-01 Ethicon Llc Surgical instrument with multiple failure response modes
US20180168598A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Staple forming pocket arrangements comprising zoned forming surface grooves
US20180168608A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Surgical instrument system comprising an end effector lockout and a firing assembly lockout
MX2019007295A (es) 2016-12-21 2019-10-15 Ethicon Llc Sistema de instrumento quirúrgico que comprende un bloqueo del efector de extremo y un bloqueo de la unidad de disparo.
US10856868B2 (en) 2016-12-21 2020-12-08 Ethicon Llc Firing member pin configurations
US11134942B2 (en) 2016-12-21 2021-10-05 Cilag Gmbh International Surgical stapling instruments and staple-forming anvils
US10537325B2 (en) 2016-12-21 2020-01-21 Ethicon Llc Staple forming pocket arrangement to accommodate different types of staples
MX2019007304A (es) * 2016-12-21 2019-10-21 Ethicon Llc Unidad de vástago que comprende primero y segundo bloqueos de articulación.
US20180168575A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Surgical stapling systems
JP7010956B2 (ja) 2016-12-21 2022-01-26 エシコン エルエルシー 組織をステープル留めする方法
US10893864B2 (en) 2016-12-21 2021-01-19 Ethicon Staple cartridges and arrangements of staples and staple cavities therein
CN110099619B (zh) 2016-12-21 2022-07-15 爱惜康有限责任公司 用于外科端部执行器和可替换工具组件的闭锁装置
US20180168615A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Method of deforming staples from two different types of staple cartridges with the same surgical stapling instrument
US20180168625A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Surgical stapling instruments with smart staple cartridges
US11103244B2 (en) 2017-02-17 2021-08-31 Cilag Gmbh International Surgical stapling end effector jaw with tip deflecting toward other jaw
US10485544B2 (en) * 2017-02-17 2019-11-26 Ethicon Llc End effector having extension features for mating with adjuncts
US11564687B2 (en) 2017-02-17 2023-01-31 Cilag Gmbh International Method of surgical stapling with end effector component having a curved tip
US10716564B2 (en) 2017-02-17 2020-07-21 Ethicon Llc Stapling adjunct attachment
US10828031B2 (en) 2017-02-17 2020-11-10 Ethicon Llc Surgical stapler with elastically deformable tip
US10806451B2 (en) 2017-02-17 2020-10-20 Ethicon Llc Surgical stapler with cooperating distal tip features on anvil and staple cartridge
US10729434B2 (en) 2017-02-17 2020-08-04 Ethicon Llc Surgical stapler with insertable distal anvil tip
US10758231B2 (en) 2017-02-17 2020-09-01 Ethicon Llc Surgical stapler with bent anvil tip, angled staple cartridge tip, and tissue gripping features
US11272930B2 (en) 2017-02-17 2022-03-15 Cilag Gmbh International Method of surgical stapling with end effector component having a curved tip
US11564684B2 (en) 2017-02-17 2023-01-31 Cilag Gmbh International Surgical stapling end effector component with tip having varying bend angle
WO2018175467A1 (en) * 2017-03-21 2018-09-27 Intuitive Surgical Operations, Inc. Locking system for medical device drive system
US10327767B2 (en) 2017-06-20 2019-06-25 Ethicon Llc Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation
US10881396B2 (en) 2017-06-20 2021-01-05 Ethicon Llc Surgical instrument with variable duration trigger arrangement
USD879808S1 (en) 2017-06-20 2020-03-31 Ethicon Llc Display panel with graphical user interface
US11517325B2 (en) 2017-06-20 2022-12-06 Cilag Gmbh International Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured displacement distance traveled over a specified time interval
USD890784S1 (en) 2017-06-20 2020-07-21 Ethicon Llc Display panel with changeable graphical user interface
US10881399B2 (en) 2017-06-20 2021-01-05 Ethicon Llc Techniques for adaptive control of motor velocity of a surgical stapling and cutting instrument
US10624633B2 (en) 2017-06-20 2020-04-21 Ethicon Llc Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument
US11382638B2 (en) 2017-06-20 2022-07-12 Cilag Gmbh International Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified displacement distance
USD879809S1 (en) 2017-06-20 2020-03-31 Ethicon Llc Display panel with changeable graphical user interface
US10368864B2 (en) 2017-06-20 2019-08-06 Ethicon Llc Systems and methods for controlling displaying motor velocity for a surgical instrument
US10813639B2 (en) 2017-06-20 2020-10-27 Ethicon Llc Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on system conditions
US10307170B2 (en) 2017-06-20 2019-06-04 Ethicon Llc Method for closed loop control of motor velocity of a surgical stapling and cutting instrument
US11090046B2 (en) 2017-06-20 2021-08-17 Cilag Gmbh International Systems and methods for controlling displacement member motion of a surgical stapling and cutting instrument
US10888321B2 (en) 2017-06-20 2021-01-12 Ethicon Llc Systems and methods for controlling velocity of a displacement member of a surgical stapling and cutting instrument
US10779820B2 (en) 2017-06-20 2020-09-22 Ethicon Llc Systems and methods for controlling motor speed according to user input for a surgical instrument
US10646220B2 (en) 2017-06-20 2020-05-12 Ethicon Llc Systems and methods for controlling displacement member velocity for a surgical instrument
US11071554B2 (en) 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
US11653914B2 (en) 2017-06-20 2023-05-23 Cilag Gmbh International Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument according to articulation angle of end effector
US10390841B2 (en) 2017-06-20 2019-08-27 Ethicon Llc Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation
US10980537B2 (en) 2017-06-20 2021-04-20 Ethicon Llc Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified number of shaft rotations
US10888324B2 (en) 2017-06-27 2021-01-12 Ethicon Llc Powered surgical instrument with independent selectively applied rotary and linear drivetrains
US10856869B2 (en) 2017-06-27 2020-12-08 Ethicon Llc Surgical anvil arrangements
US10828029B2 (en) 2017-06-27 2020-11-10 Ethicon Llc Surgical stapler with independently actuated drivers to provide varying staple heights
US10993716B2 (en) 2017-06-27 2021-05-04 Ethicon Llc Surgical anvil arrangements
US10163309B1 (en) 2017-06-27 2018-12-25 Ethicon Llc Surgical instrument with integrated and independently powered displays
US11266405B2 (en) 2017-06-27 2022-03-08 Cilag Gmbh International Surgical anvil manufacturing methods
US10511065B2 (en) 2017-06-27 2019-12-17 Ethicon Llc Battery powered surgical instrument with dual power utilization circuits for dual modes
US11071548B2 (en) 2017-06-27 2021-07-27 Cilag Gmbh International Powered circular stapler with reciprocating drive member to provide independent stapling and cutting of tissue
US10835218B2 (en) 2017-06-27 2020-11-17 Ethicon Llc Apparatus and method to determine end of life of battery powered surgical instrument
US11090049B2 (en) 2017-06-27 2021-08-17 Cilag Gmbh International Staple forming pocket arrangements
US11324503B2 (en) 2017-06-27 2022-05-10 Cilag Gmbh International Surgical firing member arrangements
US10772629B2 (en) 2017-06-27 2020-09-15 Ethicon Llc Surgical anvil arrangements
US10987103B2 (en) 2017-06-27 2021-04-27 Ethicon Llc Powered surgical instrument with latching feature preventing removal of battery pack
US10667812B2 (en) 2017-06-27 2020-06-02 Ethicon Llc Modular powered electrical connection for surgical instrument with features to prevent electrical discharge
US10090616B1 (en) 2017-06-27 2018-10-02 Ethicon Llc Surgical instrument handle assembly with feature to clean electrical contacts at modular shaft interface
US10639018B2 (en) 2017-06-27 2020-05-05 Ethicon Llc Battery pack with integrated circuit providing sleep mode to battery pack and associated surgical instrument
EP4070740A1 (en) * 2017-06-28 2022-10-12 Cilag GmbH International Surgical instrument comprising selectively actuatable rotatable couplers
US10211586B2 (en) 2017-06-28 2019-02-19 Ethicon Llc Surgical shaft assemblies with watertight housings
USD906355S1 (en) 2017-06-28 2020-12-29 Ethicon Llc Display screen or portion thereof with a graphical user interface for a surgical instrument
US11246592B2 (en) 2017-06-28 2022-02-15 Cilag Gmbh International Surgical instrument comprising an articulation system lockable to a frame
US10639037B2 (en) 2017-06-28 2020-05-05 Ethicon Llc Surgical instrument with axially movable closure member
US10716614B2 (en) 2017-06-28 2020-07-21 Ethicon Llc Surgical shaft assemblies with slip ring assemblies with increased contact pressure
US11259805B2 (en) 2017-06-28 2022-03-01 Cilag Gmbh International Surgical instrument comprising firing member supports
USD854151S1 (en) 2017-06-28 2019-07-16 Ethicon Llc Surgical instrument shaft
USD869655S1 (en) 2017-06-28 2019-12-10 Ethicon Llc Surgical fastener cartridge
USD851762S1 (en) 2017-06-28 2019-06-18 Ethicon Llc Anvil
US11564686B2 (en) 2017-06-28 2023-01-31 Cilag Gmbh International Surgical shaft assemblies with flexible interfaces
US10765427B2 (en) 2017-06-28 2020-09-08 Ethicon Llc Method for articulating a surgical instrument
US11696759B2 (en) 2017-06-28 2023-07-11 Cilag Gmbh International Surgical stapling instruments comprising shortened staple cartridge noses
US10903685B2 (en) 2017-06-28 2021-01-26 Ethicon Llc Surgical shaft assemblies with slip ring assemblies forming capacitive channels
US10898183B2 (en) 2017-06-29 2021-01-26 Ethicon Llc Robotic surgical instrument with closed loop feedback techniques for advancement of closure member during firing
US11007022B2 (en) 2017-06-29 2021-05-18 Ethicon Llc Closed loop velocity control techniques based on sensed tissue parameters for robotic surgical instrument
US10932772B2 (en) 2017-06-29 2021-03-02 Ethicon Llc Methods for closed loop velocity control for robotic surgical instrument
US10258418B2 (en) 2017-06-29 2019-04-16 Ethicon Llc System for controlling articulation forces
US10398434B2 (en) 2017-06-29 2019-09-03 Ethicon Llc Closed loop velocity control of closure member for robotic surgical instrument
US11471155B2 (en) 2017-08-03 2022-10-18 Cilag Gmbh International Surgical system bailout
US11944300B2 (en) 2017-08-03 2024-04-02 Cilag Gmbh International Method for operating a surgical system bailout
US11974742B2 (en) * 2017-08-03 2024-05-07 Cilag Gmbh International Surgical system comprising an articulation bailout
US11304695B2 (en) 2017-08-03 2022-04-19 Cilag Gmbh International Surgical system shaft interconnection
US10729501B2 (en) 2017-09-29 2020-08-04 Ethicon Llc Systems and methods for language selection of a surgical instrument
US11399829B2 (en) 2017-09-29 2022-08-02 Cilag Gmbh International Systems and methods of initiating a power shutdown mode for a surgical instrument
USD907648S1 (en) 2017-09-29 2021-01-12 Ethicon Llc Display screen or portion thereof with animated graphical user interface
US10796471B2 (en) 2017-09-29 2020-10-06 Ethicon Llc Systems and methods of displaying a knife position for a surgical instrument
US10743872B2 (en) 2017-09-29 2020-08-18 Ethicon Llc System and methods for controlling a display of a surgical instrument
USD917500S1 (en) 2017-09-29 2021-04-27 Ethicon Llc Display screen or portion thereof with graphical user interface
US10765429B2 (en) 2017-09-29 2020-09-08 Ethicon Llc Systems and methods for providing alerts according to the operational state of a surgical instrument
USD907647S1 (en) 2017-09-29 2021-01-12 Ethicon Llc Display screen or portion thereof with animated graphical user interface
US10993759B2 (en) 2017-10-20 2021-05-04 Ethicon, Inc. Hypothermic linear surgical staplers and methods of use
US11134944B2 (en) 2017-10-30 2021-10-05 Cilag Gmbh International Surgical stapler knife motion controls
US11090075B2 (en) 2017-10-30 2021-08-17 Cilag Gmbh International Articulation features for surgical end effector
US10842490B2 (en) 2017-10-31 2020-11-24 Ethicon Llc Cartridge body design with force reduction based on firing completion
US10779903B2 (en) 2017-10-31 2020-09-22 Ethicon Llc Positive shaft rotation lock activated by jaw closure
US10743875B2 (en) 2017-12-15 2020-08-18 Ethicon Llc Surgical end effectors with jaw stiffener arrangements configured to permit monitoring of firing member
US11197670B2 (en) 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
US11006955B2 (en) 2017-12-15 2021-05-18 Ethicon Llc End effectors with positive jaw opening features for use with adapters for electromechanical surgical instruments
US10828033B2 (en) 2017-12-15 2020-11-10 Ethicon Llc Handheld electromechanical surgical instruments with improved motor control arrangements for positioning components of an adapter coupled thereto
US10743874B2 (en) 2017-12-15 2020-08-18 Ethicon Llc Sealed adapters for use with electromechanical surgical instruments
US10687813B2 (en) 2017-12-15 2020-06-23 Ethicon Llc Adapters with firing stroke sensing arrangements for use in connection with electromechanical surgical instruments
US10966718B2 (en) 2017-12-15 2021-04-06 Ethicon Llc Dynamic clamping assemblies with improved wear characteristics for use in connection with electromechanical surgical instruments
US10779825B2 (en) 2017-12-15 2020-09-22 Ethicon Llc Adapters with end effector position sensing and control arrangements for use in connection with electromechanical surgical instruments
US11071543B2 (en) 2017-12-15 2021-07-27 Cilag Gmbh International Surgical end effectors with clamping assemblies configured to increase jaw aperture ranges
US10869666B2 (en) 2017-12-15 2020-12-22 Ethicon Llc Adapters with control systems for controlling multiple motors of an electromechanical surgical instrument
US10779826B2 (en) 2017-12-15 2020-09-22 Ethicon Llc Methods of operating surgical end effectors
US11033267B2 (en) 2017-12-15 2021-06-15 Ethicon Llc Systems and methods of controlling a clamping member firing rate of a surgical instrument
US10729509B2 (en) 2017-12-19 2020-08-04 Ethicon Llc Surgical instrument comprising closure and firing locking mechanism
US10835330B2 (en) 2017-12-19 2020-11-17 Ethicon Llc Method for determining the position of a rotatable jaw of a surgical instrument attachment assembly
USD910847S1 (en) 2017-12-19 2021-02-16 Ethicon Llc Surgical instrument assembly
US10716565B2 (en) 2017-12-19 2020-07-21 Ethicon Llc Surgical instruments with dual articulation drivers
US11045270B2 (en) 2017-12-19 2021-06-29 Cilag Gmbh International Robotic attachment comprising exterior drive actuator
US11129680B2 (en) 2017-12-21 2021-09-28 Cilag Gmbh International Surgical instrument comprising a projector
US11369368B2 (en) 2017-12-21 2022-06-28 Cilag Gmbh International Surgical instrument comprising synchronized drive systems
US11311290B2 (en) 2017-12-21 2022-04-26 Cilag Gmbh International Surgical instrument comprising an end effector dampener
US11076853B2 (en) 2017-12-21 2021-08-03 Cilag Gmbh International Systems and methods of displaying a knife position during transection for a surgical instrument
US10517692B2 (en) 2018-01-17 2019-12-31 Auris Health, Inc. Surgical platform with adjustable arm supports
US10799257B2 (en) 2018-03-23 2020-10-13 Ethicon Llc Seal for surgical instrument
US10631861B2 (en) 2018-03-23 2020-04-28 Ethicon Llc Slip ring assembly for surgical instrument
US10779828B2 (en) 2018-03-23 2020-09-22 Ethicon Llc Surgical instrument with capacitive electrical interface
US10842517B2 (en) 2018-03-23 2020-11-24 Ethicon Llc Surgical instrument with compressible electrical connector
US11026681B2 (en) 2018-03-23 2021-06-08 Cilag Gmbh International Surgical instrument with recessed contacts and electrically insulating barriers
US10639038B2 (en) 2018-03-23 2020-05-05 Ethicon Llc Staple cartridge with short circuit prevention features
US10631860B2 (en) 2018-03-23 2020-04-28 Ethicon Llc Surgical instrument with electrical contact under membrane
US10849614B2 (en) 2018-05-18 2020-12-01 Ethicon Llc Articulation control features for suturing instrument
US10667875B2 (en) 2018-06-27 2020-06-02 Auris Health, Inc. Systems and techniques for providing multiple perspectives during medical procedures
WO2020016723A2 (en) 2018-07-16 2020-01-23 Ethicon Llc Surgical stapling end effector jaw with tip deflecting toward other jaw
WO2020016724A2 (en) 2018-07-16 2020-01-23 Ethicon Llc Method of surgical stapling with end effector component having a curved tip
US11160550B2 (en) 2018-07-16 2021-11-02 Cilag Gmbh International Surgical stapling end effector component with articulation and asymmetric deformable tip
JP7494162B2 (ja) 2018-07-16 2024-06-03 エシコン エルエルシー 様々な屈曲角度を有する先端部を有する外科用ステープル留めエンドエフェクタ構成要素
US10912561B2 (en) 2018-07-16 2021-02-09 Ethicon Llc Buttress applier cartridge for surgical stapler having end effector with deflectable curved tip
US10786252B2 (en) 2018-07-16 2020-09-29 Ethicon Llc Surgical stapling end effector component with deformable tip having void
US10912558B2 (en) 2018-07-16 2021-02-09 Ethicon Llc Surgical stapling end effector component with deformable tip having thick distal end
US11179154B2 (en) 2018-07-16 2021-11-23 Cilag Gmbh International Surgical stapling end effector component with deformable tip skewing in multiple planes
US10973515B2 (en) 2018-07-16 2021-04-13 Ethicon Llc Permanent attachment means for curved tip of component of surgical stapling instrument
US10779821B2 (en) 2018-08-20 2020-09-22 Ethicon Llc Surgical stapler anvils with tissue stop features configured to avoid tissue pinch
US10912559B2 (en) 2018-08-20 2021-02-09 Ethicon Llc Reinforced deformable anvil tip for surgical stapler anvil
US11083458B2 (en) 2018-08-20 2021-08-10 Cilag Gmbh International Powered surgical instruments with clutching arrangements to convert linear drive motions to rotary drive motions
US11291440B2 (en) 2018-08-20 2022-04-05 Cilag Gmbh International Method for operating a powered articulatable surgical instrument
US11324501B2 (en) 2018-08-20 2022-05-10 Cilag Gmbh International Surgical stapling devices with improved closure members
US11045192B2 (en) 2018-08-20 2021-06-29 Cilag Gmbh International Fabricating techniques for surgical stapler anvils
US11253256B2 (en) 2018-08-20 2022-02-22 Cilag Gmbh International Articulatable motor powered surgical instruments with dedicated articulation motor arrangements
US11207065B2 (en) 2018-08-20 2021-12-28 Cilag Gmbh International Method for fabricating surgical stapler anvils
US10842492B2 (en) 2018-08-20 2020-11-24 Ethicon Llc Powered articulatable surgical instruments with clutching and locking arrangements for linking an articulation drive system to a firing drive system
US10856870B2 (en) 2018-08-20 2020-12-08 Ethicon Llc Switching arrangements for motor powered articulatable surgical instruments
US11039834B2 (en) 2018-08-20 2021-06-22 Cilag Gmbh International Surgical stapler anvils with staple directing protrusions and tissue stability features
USD914878S1 (en) 2018-08-20 2021-03-30 Ethicon Llc Surgical instrument anvil
KR20210062043A (ko) 2018-09-17 2021-05-28 아우리스 헬스, 인코포레이티드 동시 의료 절차를 위한 시스템 및 방법
EP3856065A4 (en) 2018-09-28 2022-06-29 Auris Health, Inc. Robotic systems and methods for concomitant endoscopic and percutaneous medical procedures
CN111134751A (zh) * 2018-11-02 2020-05-12 上海逸思医疗科技有限公司 一种执行器可弯转的外科器械
WO2020131186A1 (en) 2018-12-20 2020-06-25 Auris Health, Inc. Systems and methods for robotic arm alignment and docking
US11701109B2 (en) 2018-12-28 2023-07-18 Cilag Gmbh International Surgical stapler with sloped staple deck for varying tissue compression
US11166724B2 (en) 2018-12-28 2021-11-09 Cilag Gmbh International Adhesive distribution on buttress for surgical stapler
US11166725B2 (en) 2018-12-28 2021-11-09 Cilag Gmbh International Configuration of buttress for surgical stapler
US11033269B2 (en) 2018-12-28 2021-06-15 Cilag Gmbh International Method of applying buttresses to surgically cut and stapled sites
USD901686S1 (en) 2018-12-28 2020-11-10 Ethicon Llc Applicator for surgical stapler buttress
US11272935B2 (en) 2018-12-28 2022-03-15 Cilag Gmbh International Curved tip surgical stapler buttress assembly applicator with opening feature for curved tip alignment
US10905424B2 (en) 2018-12-28 2021-02-02 Ethicon Llc Curved tip surgical stapler buttress assembly applicator with proximal alignment features
USD926318S1 (en) 2018-12-28 2021-07-27 Cilag Gmbh International Surgical stapler deck with tissue engagement recess features
USD903115S1 (en) 2018-12-28 2020-11-24 Ethicon Llc Applicator for a surgical stapler buttress
USD922576S1 (en) 2018-12-28 2021-06-15 Cilag Gmbh International Applicator tray for a buttress applicator for a surgical stapler
USD933220S1 (en) 2018-12-28 2021-10-12 Cilag Gmbh International Buttress assembly for a surgical stapler
US11116505B2 (en) 2018-12-28 2021-09-14 Cilag Gmbh International Applicator for surgical stapler buttress
US20200205822A1 (en) 2018-12-28 2020-07-02 Ethicon Llc Surgical stapler buttress with tissue in-growth promotion
USD926317S1 (en) 2018-12-28 2021-07-27 Cilag Gmbh International Surgical stapler deck with tissue engagement cleat features
USD932621S1 (en) 2018-12-28 2021-10-05 Cilag Gmbh International Buttress assembly for a surgical stapler
US11103243B2 (en) 2018-12-28 2021-08-31 Cilag Gmbh International Curved tip surgical stapler buttress assembly applicator with compression layer pocket feature
US11202628B2 (en) 2018-12-28 2021-12-21 Cilag Gmbh International Surgical stapler with tissue engagement features around tissue containment pin
US11432817B2 (en) 2018-12-28 2022-09-06 Cilag Gmbh International Packaging for surgical stapler buttress
US11259804B2 (en) 2018-12-31 2022-03-01 Cilag Gmbh International Frame for surgical stapler and associated method of manufacture with stamping
US11134941B2 (en) 2018-12-31 2021-10-05 Cilag Gmbh International Cartridge receiving jaw for surgical stapler and associated method of manufacture with stamping
US11103245B2 (en) 2018-12-31 2021-08-31 Cilag Gmbh International Knife for surgical stapler and associated method of manufacture with MIM and hip
US11051809B2 (en) 2018-12-31 2021-07-06 Cilag Gmbh International Cartridge receiving jaw for surgical stapler and associated method of manufacture with MIM
US11141777B2 (en) 2018-12-31 2021-10-12 Cilag Gmbh International Multi-piece jaw assembly for surgical clip applier
US11291450B2 (en) 2018-12-31 2022-04-05 Cilag Gmbh International Anvil for circular surgical stapler and associated method of manufacture with MIM
US11607217B2 (en) 2018-12-31 2023-03-21 Cilag Gmbh International Surgical stapler shaft formed of segments of different materials
US11317912B2 (en) 2019-01-30 2022-05-03 Cilag Gmbh International Surgical stapler with rotatable distal tip
US11304697B2 (en) 2019-01-30 2022-04-19 Cilag Gmbh International Surgical stapler with deflectable distal tip
US11439391B2 (en) 2019-01-30 2022-09-13 Cilag Gmbh International Surgical stapler with toggling distal tip
US11857277B2 (en) 2019-02-08 2024-01-02 Auris Health, Inc. Robotically controlled clot manipulation and removal
US11696761B2 (en) 2019-03-25 2023-07-11 Cilag Gmbh International Firing drive arrangements for surgical systems
US11147553B2 (en) 2019-03-25 2021-10-19 Cilag Gmbh International Firing drive arrangements for surgical systems
US11147551B2 (en) 2019-03-25 2021-10-19 Cilag Gmbh International Firing drive arrangements for surgical systems
US11172929B2 (en) 2019-03-25 2021-11-16 Cilag Gmbh International Articulation drive arrangements for surgical systems
US11369448B2 (en) 2019-04-08 2022-06-28 Auris Health, Inc. Systems, methods, and workflows for concomitant procedures
US11266403B2 (en) 2019-04-26 2022-03-08 Cilag Gmbh International Tissue cutting washer for right angle surgical stapler
US11324504B2 (en) 2019-04-26 2022-05-10 Cilag Gmbh International Cartridge based lockout mechanism for right angle surgical stapler
US11202629B2 (en) 2019-04-26 2021-12-21 Cilag Gmbh International Clamping based lockout mechanism for right angle surgical stapler
US11166721B2 (en) 2019-04-26 2021-11-09 Cilag Gmbh International Staple retainer for surgical stapler cartridge
USD938029S1 (en) 2019-04-26 2021-12-07 Cilag Gmbh International Staple retainer for surgical stapler cartridge
US11253254B2 (en) 2019-04-30 2022-02-22 Cilag Gmbh International Shaft rotation actuator on a surgical instrument
US11452528B2 (en) 2019-04-30 2022-09-27 Cilag Gmbh International Articulation actuators for a surgical instrument
US11426251B2 (en) 2019-04-30 2022-08-30 Cilag Gmbh International Articulation directional lights on a surgical instrument
US11903581B2 (en) 2019-04-30 2024-02-20 Cilag Gmbh International Methods for stapling tissue using a surgical instrument
US11432816B2 (en) 2019-04-30 2022-09-06 Cilag Gmbh International Articulation pin for a surgical instrument
US11471157B2 (en) 2019-04-30 2022-10-18 Cilag Gmbh International Articulation control mapping for a surgical instrument
US11648009B2 (en) 2019-04-30 2023-05-16 Cilag Gmbh International Rotatable jaw tip for a surgical instrument
US20200375596A1 (en) 2019-05-28 2020-12-03 Ethicon Llc Nozzle Fluid Ingress Prevention Features for Surgical Stapler
CN114007521A (zh) 2019-06-26 2022-02-01 奥瑞斯健康公司 用于机器人臂对准和对接的系统和方法
US11399837B2 (en) 2019-06-28 2022-08-02 Cilag Gmbh International Mechanisms for motor control adjustments of a motorized surgical instrument
US11660163B2 (en) 2019-06-28 2023-05-30 Cilag Gmbh International Surgical system with RFID tags for updating motor assembly parameters
US11291451B2 (en) 2019-06-28 2022-04-05 Cilag Gmbh International Surgical instrument with battery compatibility verification functionality
US11426167B2 (en) 2019-06-28 2022-08-30 Cilag Gmbh International Mechanisms for proper anvil attachment surgical stapling head assembly
US11553971B2 (en) 2019-06-28 2023-01-17 Cilag Gmbh International Surgical RFID assemblies for display and communication
US11627959B2 (en) 2019-06-28 2023-04-18 Cilag Gmbh International Surgical instruments including manual and powered system lockouts
US11361176B2 (en) 2019-06-28 2022-06-14 Cilag Gmbh International Surgical RFID assemblies for compatibility detection
US11684434B2 (en) 2019-06-28 2023-06-27 Cilag Gmbh International Surgical RFID assemblies for instrument operational setting control
US11464601B2 (en) 2019-06-28 2022-10-11 Cilag Gmbh International Surgical instrument comprising an RFID system for tracking a movable component
US11298127B2 (en) 2019-06-28 2022-04-12 Cilag GmbH Interational Surgical stapling system having a lockout mechanism for an incompatible cartridge
US11853835B2 (en) 2019-06-28 2023-12-26 Cilag Gmbh International RFID identification systems for surgical instruments
US11219455B2 (en) 2019-06-28 2022-01-11 Cilag Gmbh International Surgical instrument including a lockout key
US11241235B2 (en) 2019-06-28 2022-02-08 Cilag Gmbh International Method of using multiple RFID chips with a surgical assembly
US11259803B2 (en) 2019-06-28 2022-03-01 Cilag Gmbh International Surgical stapling system having an information encryption protocol
US11497492B2 (en) 2019-06-28 2022-11-15 Cilag Gmbh International Surgical instrument including an articulation lock
US11523822B2 (en) 2019-06-28 2022-12-13 Cilag Gmbh International Battery pack including a circuit interrupter
US11051807B2 (en) 2019-06-28 2021-07-06 Cilag Gmbh International Packaging assembly including a particulate trap
US11298132B2 (en) 2019-06-28 2022-04-12 Cilag GmbH Inlernational Staple cartridge including a honeycomb extension
US11224497B2 (en) 2019-06-28 2022-01-18 Cilag Gmbh International Surgical systems with multiple RFID tags
US11638587B2 (en) 2019-06-28 2023-05-02 Cilag Gmbh International RFID identification systems for surgical instruments
US11376098B2 (en) 2019-06-28 2022-07-05 Cilag Gmbh International Surgical instrument system comprising an RFID system
US11771419B2 (en) 2019-06-28 2023-10-03 Cilag Gmbh International Packaging for a replaceable component of a surgical stapling system
US12004740B2 (en) 2019-06-28 2024-06-11 Cilag Gmbh International Surgical stapling system having an information decryption protocol
US11478241B2 (en) 2019-06-28 2022-10-25 Cilag Gmbh International Staple cartridge including projections
US11246678B2 (en) 2019-06-28 2022-02-15 Cilag Gmbh International Surgical stapling system having a frangible RFID tag
CN114375182A (zh) 2019-09-10 2022-04-19 奥瑞斯健康公司 用于使用共享机器人自由度进行运动学优化的系统和方法
EP4034349A1 (en) 2019-09-26 2022-08-03 Auris Health, Inc. Systems and methods for collision detection and avoidance
US11931033B2 (en) 2019-12-19 2024-03-19 Cilag Gmbh International Staple cartridge comprising a latch lockout
US11464512B2 (en) 2019-12-19 2022-10-11 Cilag Gmbh International Staple cartridge comprising a curved deck surface
US11844520B2 (en) 2019-12-19 2023-12-19 Cilag Gmbh International Staple cartridge comprising driver retention members
US11559304B2 (en) 2019-12-19 2023-01-24 Cilag Gmbh International Surgical instrument comprising a rapid closure mechanism
US12035913B2 (en) 2019-12-19 2024-07-16 Cilag Gmbh International Staple cartridge comprising a deployable knife
US11234698B2 (en) 2019-12-19 2022-02-01 Cilag Gmbh International Stapling system comprising a clamp lockout and a firing lockout
US11291447B2 (en) 2019-12-19 2022-04-05 Cilag Gmbh International Stapling instrument comprising independent jaw closing and staple firing systems
US11304696B2 (en) 2019-12-19 2022-04-19 Cilag Gmbh International Surgical instrument comprising a powered articulation system
US11576672B2 (en) 2019-12-19 2023-02-14 Cilag Gmbh International Surgical instrument comprising a closure system including a closure member and an opening member driven by a drive screw
US11504122B2 (en) 2019-12-19 2022-11-22 Cilag Gmbh International Surgical instrument comprising a nested firing member
US11446029B2 (en) 2019-12-19 2022-09-20 Cilag Gmbh International Staple cartridge comprising projections extending from a curved deck surface
US11529139B2 (en) 2019-12-19 2022-12-20 Cilag Gmbh International Motor driven surgical instrument
US11529137B2 (en) 2019-12-19 2022-12-20 Cilag Gmbh International Staple cartridge comprising driver retention members
US11911032B2 (en) 2019-12-19 2024-02-27 Cilag Gmbh International Staple cartridge comprising a seating cam
US11701111B2 (en) 2019-12-19 2023-07-18 Cilag Gmbh International Method for operating a surgical stapling instrument
US11607219B2 (en) 2019-12-19 2023-03-21 Cilag Gmbh International Staple cartridge comprising a detachable tissue cutting knife
WO2021137109A1 (en) 2019-12-31 2021-07-08 Auris Health, Inc. Alignment techniques for percutaneous access
KR20220123087A (ko) 2019-12-31 2022-09-05 아우리스 헬스, 인코포레이티드 경피 접근을 위한 정렬 인터페이스
KR20220123273A (ko) 2019-12-31 2022-09-06 아우리스 헬스, 인코포레이티드 해부학적 특징부 식별 및 표적설정
CN111248961B (zh) * 2020-01-17 2020-12-08 盈甲医疗器械制造（上海）有限公司 手动旋转与电动弯转切换装置及其电动吻合器
USD975278S1 (en) 2020-06-02 2023-01-10 Cilag Gmbh International Staple cartridge
USD974560S1 (en) 2020-06-02 2023-01-03 Cilag Gmbh International Staple cartridge
USD966512S1 (en) 2020-06-02 2022-10-11 Cilag Gmbh International Staple cartridge
USD975851S1 (en) 2020-06-02 2023-01-17 Cilag Gmbh International Staple cartridge
USD975850S1 (en) 2020-06-02 2023-01-17 Cilag Gmbh International Staple cartridge
USD976401S1 (en) 2020-06-02 2023-01-24 Cilag Gmbh International Staple cartridge
USD967421S1 (en) 2020-06-02 2022-10-18 Cilag Gmbh International Staple cartridge
US11672559B2 (en) 2020-06-17 2023-06-13 Cilag Gmbh International Surgical stapler with cartridge pan retention features
EP4171427A4 (en) 2020-06-29 2024-08-07 Auris Health Inc SYSTEMS AND METHODS FOR DETECTING CONTACT BETWEEN A LINK AND AN EXTERNAL OBJECT
CN115734765A (zh) 2020-06-30 2023-03-03 奥瑞斯健康公司 具有碰撞接近度指示器的机器人医疗系统
US11497494B2 (en) 2020-06-30 2022-11-15 Cilag Gmbh International Surgical stapler cartridge retainer with ejector feature
US11357586B2 (en) 2020-06-30 2022-06-14 Auris Health, Inc. Systems and methods for saturated robotic movement
US20220015761A1 (en) 2020-07-16 2022-01-20 Ethicon Llc Firing circuit and control algorithm for surgical stapler
US11638582B2 (en) 2020-07-28 2023-05-02 Cilag Gmbh International Surgical instruments with torsion spine drive arrangements
US11413040B2 (en) 2020-09-16 2022-08-16 Cilag Gmbh International Apparatus and method to apply buttress to end effector of surgical stapler with authentication
US11419605B2 (en) 2020-09-16 2022-08-23 Cilag Gmbh International Apparatus and method to close end effector of surgical stapler onto buttress
US11564683B2 (en) 2020-09-16 2023-01-31 Cilag Gmbh International Apparatus and method to apply buttress to end effector of surgical stapler via driven member
US11559306B2 (en) 2020-09-16 2023-01-24 Cilag Gmbh International Apparatus and method to detect full seating of buttress applicator in end effector of surgical stapler
US11660093B2 (en) 2020-09-16 2023-05-30 Cilag Gmbh International Method of applying buttress to end effector of surgical stapler
US11452523B2 (en) 2020-09-16 2022-09-27 Cilag Gmbh International Apparatus and method to apply buttresses separately to jaws of end effector of surgical stapler
US11766261B2 (en) 2020-09-16 2023-09-26 Cilag Gmbh International Apparatus and method to apply buttress to end effector of surgical stapler via fixed base
US11617577B2 (en) 2020-10-29 2023-04-04 Cilag Gmbh International Surgical instrument comprising a sensor configured to sense whether an articulation drive of the surgical instrument is actuatable
US11844518B2 (en) 2020-10-29 2023-12-19 Cilag Gmbh International Method for operating a surgical instrument
US11717289B2 (en) 2020-10-29 2023-08-08 Cilag Gmbh International Surgical instrument comprising an indicator which indicates that an articulation drive is actuatable
US11896217B2 (en) 2020-10-29 2024-02-13 Cilag Gmbh International Surgical instrument comprising an articulation lock
US11779330B2 (en) 2020-10-29 2023-10-10 Cilag Gmbh International Surgical instrument comprising a jaw alignment system
US12053175B2 (en) 2020-10-29 2024-08-06 Cilag Gmbh International Surgical instrument comprising a stowed closure actuator stop
US11534259B2 (en) 2020-10-29 2022-12-27 Cilag Gmbh International Surgical instrument comprising an articulation indicator
US11517390B2 (en) 2020-10-29 2022-12-06 Cilag Gmbh International Surgical instrument comprising a limited travel switch
USD1013170S1 (en) 2020-10-29 2024-01-30 Cilag Gmbh International Surgical instrument assembly
US11452526B2 (en) 2020-10-29 2022-09-27 Cilag Gmbh International Surgical instrument comprising a staged voltage regulation start-up system
US11931025B2 (en) 2020-10-29 2024-03-19 Cilag Gmbh International Surgical instrument comprising a releasable closure drive lock
USD980425S1 (en) 2020-10-29 2023-03-07 Cilag Gmbh International Surgical instrument assembly
US12064112B2 (en) 2020-11-04 2024-08-20 Cilag Gmbh International Surgical stapler end effector sled having cartridge biasing feature
US11701112B2 (en) 2020-11-04 2023-07-18 Cilag Gmbh International Surgical stapler end effector sled having staple driver support feature
US11553912B2 (en) 2020-11-04 2023-01-17 Cilag Gmbh International Surgical stapler end effector sled having multiple surface finishes
US11540826B2 (en) 2020-11-04 2023-01-03 Cilag Gmbh International Surgical stapler end effector sled having cartridge wall support feature
US11832814B2 (en) 2020-11-04 2023-12-05 Cilag Gmbh International Surgical stapler end effector sled having tapered distal end
US11653915B2 (en) 2020-12-02 2023-05-23 Cilag Gmbh International Surgical instruments with sled location detection and adjustment features
US11627960B2 (en) 2020-12-02 2023-04-18 Cilag Gmbh International Powered surgical instruments with smart reload with separately attachable exteriorly mounted wiring connections
US11890010B2 (en) 2020-12-02 2024-02-06 Cllag GmbH International Dual-sided reinforced reload for surgical instruments
US11849943B2 (en) 2020-12-02 2023-12-26 Cilag Gmbh International Surgical instrument with cartridge release mechanisms
US11737751B2 (en) 2020-12-02 2023-08-29 Cilag Gmbh International Devices and methods of managing energy dissipated within sterile barriers of surgical instrument housings
US11944296B2 (en) 2020-12-02 2024-04-02 Cilag Gmbh International Powered surgical instruments with external connectors
US11678882B2 (en) 2020-12-02 2023-06-20 Cilag Gmbh International Surgical instruments with interactive features to remedy incidental sled movements
US11744581B2 (en) 2020-12-02 2023-09-05 Cilag Gmbh International Powered surgical instruments with multi-phase tissue treatment
US11653920B2 (en) 2020-12-02 2023-05-23 Cilag Gmbh International Powered surgical instruments with communication interfaces through sterile barrier
US11744583B2 (en) 2021-02-26 2023-09-05 Cilag Gmbh International Distal communication array to tune frequency of RF systems
US11793514B2 (en) 2021-02-26 2023-10-24 Cilag Gmbh International Staple cartridge comprising sensor array which may be embedded in cartridge body
US11950779B2 (en) 2021-02-26 2024-04-09 Cilag Gmbh International Method of powering and communicating with a staple cartridge
US11812964B2 (en) 2021-02-26 2023-11-14 Cilag Gmbh International Staple cartridge comprising a power management circuit
US12108951B2 (en) 2021-02-26 2024-10-08 Cilag Gmbh International Staple cartridge comprising a sensing array and a temperature control system
US11751869B2 (en) 2021-02-26 2023-09-12 Cilag Gmbh International Monitoring of multiple sensors over time to detect moving characteristics of tissue
US11925349B2 (en) 2021-02-26 2024-03-12 Cilag Gmbh International Adjustment to transfer parameters to improve available power
US11980362B2 (en) 2021-02-26 2024-05-14 Cilag Gmbh International Surgical instrument system comprising a power transfer coil
US11730473B2 (en) 2021-02-26 2023-08-22 Cilag Gmbh International Monitoring of manufacturing life-cycle
US11696757B2 (en) 2021-02-26 2023-07-11 Cilag Gmbh International Monitoring of internal systems to detect and track cartridge motion status
US11723657B2 (en) 2021-02-26 2023-08-15 Cilag Gmbh International Adjustable communication based on available bandwidth and power capacity
US11749877B2 (en) 2021-02-26 2023-09-05 Cilag Gmbh International Stapling instrument comprising a signal antenna
US11950777B2 (en) 2021-02-26 2024-04-09 Cilag Gmbh International Staple cartridge comprising an information access control system
US11701113B2 (en) 2021-02-26 2023-07-18 Cilag Gmbh International Stapling instrument comprising a separate power antenna and a data transfer antenna
US11717291B2 (en) 2021-03-22 2023-08-08 Cilag Gmbh International Staple cartridge comprising staples configured to apply different tissue compression
US11737749B2 (en) 2021-03-22 2023-08-29 Cilag Gmbh International Surgical stapling instrument comprising a retraction system
US11806011B2 (en) 2021-03-22 2023-11-07 Cilag Gmbh International Stapling instrument comprising tissue compression systems
US11826042B2 (en) 2021-03-22 2023-11-28 Cilag Gmbh International Surgical instrument comprising a firing drive including a selectable leverage mechanism
US11759202B2 (en) 2021-03-22 2023-09-19 Cilag Gmbh International Staple cartridge comprising an implantable layer
US11723658B2 (en) 2021-03-22 2023-08-15 Cilag Gmbh International Staple cartridge comprising a firing lockout
US11826012B2 (en) 2021-03-22 2023-11-28 Cilag Gmbh International Stapling instrument comprising a pulsed motor-driven firing rack
US11944336B2 (en) 2021-03-24 2024-04-02 Cilag Gmbh International Joint arrangements for multi-planar alignment and support of operational drive shafts in articulatable surgical instruments
US11857183B2 (en) 2021-03-24 2024-01-02 Cilag Gmbh International Stapling assembly components having metal substrates and plastic bodies
US12102323B2 (en) 2021-03-24 2024-10-01 Cilag Gmbh International Rotary-driven surgical stapling assembly comprising a floatable component
US11849945B2 (en) 2021-03-24 2023-12-26 Cilag Gmbh International Rotary-driven surgical stapling assembly comprising eccentrically driven firing member
US11786243B2 (en) 2021-03-24 2023-10-17 Cilag Gmbh International Firing members having flexible portions for adapting to a load during a surgical firing stroke
US11849944B2 (en) 2021-03-24 2023-12-26 Cilag Gmbh International Drivers for fastener cartridge assemblies having rotary drive screws
US11744603B2 (en) 2021-03-24 2023-09-05 Cilag Gmbh International Multi-axis pivot joints for surgical instruments and methods for manufacturing same
US11896219B2 (en) 2021-03-24 2024-02-13 Cilag Gmbh International Mating features between drivers and underside of a cartridge deck
US11786239B2 (en) 2021-03-24 2023-10-17 Cilag Gmbh International Surgical instrument articulation joint arrangements comprising multiple moving linkage features
US11903582B2 (en) 2021-03-24 2024-02-20 Cilag Gmbh International Leveraging surfaces for cartridge installation
US11793516B2 (en) 2021-03-24 2023-10-24 Cilag Gmbh International Surgical staple cartridge comprising longitudinal support beam
US11832816B2 (en) 2021-03-24 2023-12-05 Cilag Gmbh International Surgical stapling assembly comprising nonplanar staples and planar staples
US11896218B2 (en) 2021-03-24 2024-02-13 Cilag Gmbh International Method of using a powered stapling device
US11607218B2 (en) 2021-04-30 2023-03-21 Cilag Gmbh International Translatable barrel cam of a robotic surgical system
US11937892B2 (en) 2021-04-30 2024-03-26 Cilag Gmbh International Variable jaw closure of a robotic surgical system
US11826047B2 (en) 2021-05-28 2023-11-28 Cilag Gmbh International Stapling instrument comprising jaw mounts
US11944340B2 (en) 2021-06-11 2024-04-02 Cilag Gmbh International Suction and irrigation valve and method of priming same in a robotic surgical system
CN113243955B (zh) * 2021-06-18 2022-05-03 苏州优脉瑞医疗科技有限公司 一种钉仓角度精确定位的吻合器
US11986182B2 (en) 2021-08-16 2024-05-21 Cilag Gmbh International Multi-position restraining member for sled movement
US11957336B2 (en) 2021-08-16 2024-04-16 Cilag Gmbh International Proximally located firing lockout mechanism for surgical stapler
US11944297B2 (en) 2021-08-16 2024-04-02 Cilag Gmbh International Variable response motor control algorithm for powered surgical stapler
US11992209B2 (en) 2021-08-16 2024-05-28 Cilag Gmbh International Multi-threshold motor control algorithm for powered surgical stapler
US12102321B2 (en) 2021-08-16 2024-10-01 Cilag Gmbh International Methods of operating a robotic surgical stapler
US20230049736A1 (en) 2021-08-16 2023-02-16 Cilag Gmbh International Firing member tracking feature for surgical stapler
US12029508B2 (en) 2021-08-16 2024-07-09 Cilag Gmbh International Adjustable power transmission mechanism for powered surgical stapler
US20230052307A1 (en) 2021-08-16 2023-02-16 Cilag Gmbh International Deflectable firing member for surgical stapler
US12089842B2 (en) 2021-08-16 2024-09-17 Cilag Gmbh International Firing bailout system for powered surgical stapler
US20230050707A1 (en) 2021-08-16 2023-02-16 Cilag Gmbh International Firing system features for surgical stapler
US11779332B2 (en) 2021-08-16 2023-10-10 Cilag Gmbh International Powered surgical stapler having independently operable closure and firing systems
US12011164B2 (en) 2021-08-16 2024-06-18 Cilag Gmbh International Cartridge-based firing lockout mechanism for surgical stapler
US11992210B2 (en) 2021-08-16 2024-05-28 Cilag Gmbh International Multiple-sensor firing lockout mechanism for powered surgical stapler
US11857190B2 (en) 2021-08-31 2024-01-02 Cilag Gmbh International Surgical stapler buttress with variable length feature
US12004744B2 (en) 2021-09-27 2024-06-11 Cilag Gmbh International Staple and staple-forming pocket arrangements for surgical staplers
US20230107231A1 (en) 2021-09-27 2023-04-06 Cilag Gmbh International Overlapping staple pattern for surgical stapler
US11877745B2 (en) 2021-10-18 2024-01-23 Cilag Gmbh International Surgical stapling assembly having longitudinally-repeating staple leg clusters
US11957337B2 (en) 2021-10-18 2024-04-16 Cilag Gmbh International Surgical stapling assembly with offset ramped drive surfaces
US11980363B2 (en) 2021-10-18 2024-05-14 Cilag Gmbh International Row-to-row staple array variations
US11992218B2 (en) 2021-10-18 2024-05-28 Cilag Gmbh International Metal injection molded anvil for circular surgical stapler
US11937816B2 (en) 2021-10-28 2024-03-26 Cilag Gmbh International Electrical lead arrangements for surgical instruments
US12089841B2 (en) 2021-10-28 2024-09-17 Cilag CmbH International Staple cartridge identification systems
US20230139479A1 (en) 2021-10-29 2023-05-04 Cilag Gmbh International Displaceable adjunct attachment features for surgical stapler
US11950781B2 (en) 2021-10-29 2024-04-09 Cilag Gmbh International Discrete adjunct attachment features for surgical stapler
US11998204B2 (en) 2021-10-29 2024-06-04 Cilag Gmbh International Compressible adjunct for surgical stapler
US20230293172A1 (en) 2022-03-15 2023-09-21 Cilag Gmbh International Surgical stapler cartridge with integrated rfid feature
US11931029B2 (en) 2022-03-23 2024-03-19 Cilag Gmbh International Firing limit feature for powered surgical stapler
US12082811B2 (en) 2022-03-24 2024-09-10 Cilag Gmbh International Surgical stapler anvil jaw with variable firing member slot
US20230301657A1 (en) 2022-03-25 2023-09-28 Cilag Gmbh International Thermally formed tissue cushion adjunct for surgical stapler end effector
US20230301656A1 (en) 2022-03-25 2023-09-28 Cilag Gmbh International Tissue cushion adjuncts for surgical stapler end effector
US20230301674A1 (en) 2022-03-25 2023-09-28 Cilag Gmbh International Tissue cushion adjunct for surgical stapler end effector
US12114882B2 (en) 2022-03-25 2024-10-15 Cilag Gmbh International Surgical stapler features for stapling variable thickness tissue
US12082834B2 (en) 2022-03-25 2024-09-10 Cilag Gmbh International Tissue cushion adjunct with staple leg support features for surgical stapler end effector
EP4351437A1 (en) 2022-03-29 2024-04-17 Cilag GmbH International Surgical stapler cartridge with support features
WO2023187646A1 (en) 2022-03-29 2023-10-05 Cilag Gmbh International Surgical stapler cartridge with 3d printable features
US20230310000A1 (en) 2022-03-31 2023-10-05 Cilag Gmbh International Buttress applicator system for surgical stapler
WO2024075052A1 (en) 2022-10-06 2024-04-11 Cilag Gmbh International Surgical stapler with discretely positionable distal tip
US11896327B1 (en) 2022-12-28 2024-02-13 Cilag Gmbh International Tissue sensing circuit for surgical instrument
WO2024173228A1 (en) * 2023-02-13 2024-08-22 Endosound, Inc. Devices, systems, and methods for guiding an endoscope instrument and selectively moving an attachable ultrasound assembly
WO2024218631A1 (en) 2023-04-17 2024-10-24 Cilag Gmbh International Surgical stapler anvil having staple forming pockets with laterally varying orientations

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN1911183A (zh) * 2005-08-01 2007-02-14 伊西康内外科公司 具有关节运动轴锁定机构的外科器械
EP1915953B1 (en) * 2006-10-06 2011-06-01 Tyco Healthcare Group LP Surgical instrument including a locking assembly
US20120298719A1 (en) * 2011-05-27 2012-11-29 Ethicon Endo-Surgery, Inc. Surgical stapling instruments with rotatable staple deployment arrangements

Family Cites Families (60)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4805823A (en) 1988-03-18 1989-02-21 Ethicon, Inc. Pocket configuration for internal organ staplers
US5307976A (en) 1991-10-18 1994-05-03 Ethicon, Inc. Linear stapling mechanism with cutting means
US5657429A (en) 1992-08-10 1997-08-12 Computer Motion, Inc. Automated endoscope system optimal positioning
US5415334A (en) 1993-05-05 1995-05-16 Ethicon Endo-Surgery Surgical stapler and staple cartridge
JP2665052B2 (ja) 1993-05-14 1997-10-22 エスアールアイ インターナショナル 遠隔中心位置決め装置
US5465895A (en) 1994-02-03 1995-11-14 Ethicon Endo-Surgery, Inc. Surgical stapler instrument
US5597107A (en) 1994-02-03 1997-01-28 Ethicon Endo-Surgery, Inc. Surgical stapler instrument
US5704534A (en) 1994-12-19 1998-01-06 Ethicon Endo-Surgery, Inc. Articulation assembly for surgical instruments
US5632432A (en) * 1994-12-19 1997-05-27 Ethicon Endo-Surgery, Inc. Surgical instrument
US5814055A (en) 1995-09-19 1998-09-29 Ethicon Endo-Surgery, Inc. Surgical clamping mechanism
US5662667A (en) 1995-09-19 1997-09-02 Ethicon Endo-Surgery, Inc. Surgical clamping mechanism
US5792135A (en) 1996-05-20 1998-08-11 Intuitive Surgical, Inc. Articulated surgical instrument for performing minimally invasive surgery with enhanced dexterity and sensitivity
US6364888B1 (en) 1996-09-09 2002-04-02 Intuitive Surgical, Inc. Alignment of master and slave in a minimally invasive surgical apparatus
US6331181B1 (en) 1998-12-08 2001-12-18 Intuitive Surgical, Inc. Surgical robotic tools, data architecture, and use
US6231565B1 (en) 1997-06-18 2001-05-15 United States Surgical Corporation Robotic arm DLUs for performing surgical tasks
US6459926B1 (en) 1998-11-20 2002-10-01 Intuitive Surgical, Inc. Repositioning and reorientation of master/slave relationship in minimally invasive telesurgery
RU2161450C1 (ru) * 1999-07-22 2001-01-10 Каншин Николай Николаевич Хирургический сшиватель
US6783524B2 (en) 2001-04-19 2004-08-31 Intuitive Surgical, Inc. Robotic surgical tool with ultrasound cauterizing and cutting instrument
EP1408846B1 (en) 2001-06-29 2012-03-07 Intuitive Surgical Operations, Inc. Platform link wrist mechanism
US6978921B2 (en) 2003-05-20 2005-12-27 Ethicon Endo-Surgery, Inc. Surgical stapling instrument incorporating an E-beam firing mechanism
US7143923B2 (en) 2003-05-20 2006-12-05 Ethicon Endo-Surgery, Inc. Surgical stapling instrument having a firing lockout for an unclosed anvil
US7044352B2 (en) 2003-05-20 2006-05-16 Ethicon Endo-Surgery, Inc. Surgical stapling instrument having a single lockout mechanism for prevention of firing
US7380695B2 (en) 2003-05-20 2008-06-03 Ethicon Endo-Surgery, Inc. Surgical stapling instrument having a single lockout mechanism for prevention of firing
US9060770B2 (en) 2003-05-20 2015-06-23 Ethicon Endo-Surgery, Inc. Robotically-driven surgical instrument with E-beam driver
US7380696B2 (en) 2003-05-20 2008-06-03 Ethicon Endo-Surgery, Inc. Articulating surgical stapling instrument incorporating a two-piece E-beam firing mechanism
US7434715B2 (en) 2003-09-29 2008-10-14 Ethicon Endo-Surgery, Inc. Surgical stapling instrument having multistroke firing with opening lockout
US7303108B2 (en) 2003-09-29 2007-12-04 Ethicon Endo-Surgery, Inc. Surgical stapling instrument incorporating a multi-stroke firing mechanism with a flexible rack
US7367485B2 (en) * 2004-06-30 2008-05-06 Ethicon Endo-Surgery, Inc. Surgical stapling instrument incorporating a multistroke firing mechanism having a rotary transmission
US7559450B2 (en) 2005-02-18 2009-07-14 Ethicon Endo-Surgery, Inc. Surgical instrument incorporating a fluid transfer controlled articulation mechanism
US8579176B2 (en) 2005-07-26 2013-11-12 Ethicon Endo-Surgery, Inc. Surgical stapling and cutting device and method for using the device
US8800838B2 (en) 2005-08-31 2014-08-12 Ethicon Endo-Surgery, Inc. Robotically-controlled cable-based surgical end effectors
US20110295295A1 (en) 2006-01-31 2011-12-01 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical instrument having recording capabilities
US7644848B2 (en) 2006-01-31 2010-01-12 Ethicon Endo-Surgery, Inc. Electronic lockouts and surgical instrument including same
US20120292367A1 (en) * 2006-01-31 2012-11-22 Ethicon Endo-Surgery, Inc. Robotically-controlled end effector
US7845537B2 (en) 2006-01-31 2010-12-07 Ethicon Endo-Surgery, Inc. Surgical instrument having recording capabilities
US8992422B2 (en) 2006-03-23 2015-03-31 Ethicon Endo-Surgery, Inc. Robotically-controlled endoscopic accessory channel
US7721930B2 (en) 2006-11-10 2010-05-25 Thicon Endo-Surgery, Inc. Disposable cartridge with adhesive for use with a stapling device
US8684253B2 (en) * 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
US7490749B2 (en) 2007-03-28 2009-02-17 Ethicon Endo-Surgery, Inc. Surgical stapling and cutting instrument with manually retractable firing member
US7798386B2 (en) 2007-05-30 2010-09-21 Ethicon Endo-Surgery, Inc. Surgical instrument articulation joint cover
US7549564B2 (en) 2007-06-22 2009-06-23 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with an articulating end effector
US8931682B2 (en) 2007-06-04 2015-01-13 Ethicon Endo-Surgery, Inc. Robotically-controlled shaft based rotary drive systems for surgical instruments
US8308040B2 (en) 2007-06-22 2012-11-13 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with an articulatable end effector
US7658311B2 (en) 2007-06-22 2010-02-09 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with a geared return mechanism
US7753245B2 (en) 2007-06-22 2010-07-13 Ethicon Endo-Surgery, Inc. Surgical stapling instruments
US7703653B2 (en) 2007-09-28 2010-04-27 Tyco Healthcare Group Lp Articulation mechanism for surgical instrument
US8006365B2 (en) * 2008-01-30 2011-08-30 Easylap Ltd. Device and method for applying rotary tacks
US9179912B2 (en) * 2008-02-14 2015-11-10 Ethicon Endo-Surgery, Inc. Robotically-controlled motorized surgical cutting and fastening instrument
US8573465B2 (en) 2008-02-14 2013-11-05 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical end effector system with rotary actuated closure systems
US9386983B2 (en) 2008-09-23 2016-07-12 Ethicon Endo-Surgery, Llc Robotically-controlled motorized surgical instrument
US8210411B2 (en) 2008-09-23 2012-07-03 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting instrument
US8517239B2 (en) * 2009-02-05 2013-08-27 Ethicon Endo-Surgery, Inc. Surgical stapling instrument comprising a magnetic element driver
US8220688B2 (en) 2009-12-24 2012-07-17 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting instrument with electric actuator directional control assembly
US10092292B2 (en) 2013-02-28 2018-10-09 Ethicon Llc Staple forming features for surgical stapling instrument
US9717497B2 (en) 2013-02-28 2017-08-01 Ethicon Llc Lockout feature for movable cutting member of surgical instrument
US9839421B2 (en) 2013-02-28 2017-12-12 Ethicon Llc Jaw closure feature for end effector of surgical instrument
US9517065B2 (en) 2013-02-28 2016-12-13 Ethicon Endo-Surgery, Llc Integrated tissue positioning and jaw alignment features for surgical stapler
US9808248B2 (en) 2013-02-28 2017-11-07 Ethicon Llc Installation features for surgical instrument end effector cartridge
US9186142B2 (en) * 2013-02-28 2015-11-17 Ethicon Endo-Surgery, Inc. Surgical instrument end effector articulation drive with pinion and opposing racks
US9795379B2 (en) 2013-02-28 2017-10-24 Ethicon Llc Surgical instrument with multi-diameter shaft

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN1911183A (zh) * 2005-08-01 2007-02-14 伊西康内外科公司 具有关节运动轴锁定机构的外科器械
EP1915953B1 (en) * 2006-10-06 2011-06-01 Tyco Healthcare Group LP Surgical instrument including a locking assembly
US20120298719A1 (en) * 2011-05-27 2012-11-29 Ethicon Endo-Surgery, Inc. Surgical stapling instruments with rotatable staple deployment arrangements

Cited By (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN109219404A (zh) * 2016-04-01 2019-01-15 伊西康有限责任公司 具有能够围绕轴轴线选择性地旋转的外科端部执行器的可互换外科工具组件
CN109219404B (zh) * 2016-04-01 2021-08-13 伊西康有限责任公司 具有能够围绕轴轴线选择性地旋转的外科端部执行器的可互换外科工具组件
CN110831511A (zh) * 2017-06-28 2020-02-21 爱惜康有限责任公司 包括具有壳体布置结构的轴的外科器械
CN110831511B (zh) * 2017-06-28 2023-04-28 爱惜康有限责任公司 包括具有壳体布置结构的轴的外科器械
CN111565648A (zh) * 2017-12-19 2020-08-21 爱惜康有限责任公司 被构造用于与不同控制器接口可互换使用的外科工具
CN111565648B (zh) * 2017-12-19 2024-05-07 爱惜康有限责任公司 被构造用于与不同控制器接口可互换使用的外科工具
CN110037762A (zh) * 2018-01-17 2019-07-23 柯惠Lp公司 带自返回组件的手术吻合器
CN110037762B (zh) * 2018-01-17 2024-04-09 柯惠Lp公司 带自返回组件的手术吻合器
CN114305558A (zh) * 2021-05-27 2022-04-12 天津瑞奇外科器械股份有限公司 一种外科器械及其操作方法
CN114305558B (zh) * 2021-05-27 2024-02-23 天津瑞奇外科器械股份有限公司 一种外科器械及其操作方法

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