Power control circuit for electric surgical stapler

Abstract

The present invention discloses a device (10), which includes a body (100), a shaft (200), a suturing assembly (300) and a timing logic device (8014). The body includes a safety switch (8020), a firing actuator (150, 8016) and a motor (161). The suturing assembly is disposed at the distal end of the shaft, wherein the suturing assembly is configured to selectively move from an open position to a closed position to clamp tissue. The timing logic device (8014) is operably connected to the motor and is configured to detect the actuation of the safety switch (8020) and the firing actuator (8016). The timing logic device is also operable to detect the order in which the safety switch and the firing actuator are actuated, compare the detected order with a predetermined order, and in response to determining that the detected order is the same as the predetermined order, transmit a motor start signal (8032) to the motor (161).

Description

[0001] priority

[0002] This application claims the U.S. Provisional Patent Application No. 62 / 815,678, filed on March 8, 2019, entitled “Circular Surgical Stapler,” the disclosure of which is incorporated herein by reference. Background Art

[0003] In some surgical procedures (e.g., colorectal, bariatric, thoracic, etc. related surgeries), portions of a patient's digestive tract (e.g., gastrointestinal tract and / or esophagus, etc.) may be cut and removed to remove unwanted tissue or for other reasons. Once the tissue is removed, the remaining portions of the digestive tract may be joined together in an end-to-end, end-to-side, or side-to-side anastomosis. The anastomosis may provide a substantially unobstructed flow path from one portion of the digestive tract to another portion of the digestive tract without causing any type of leakage at the site of the anastomosis.

[0004] An example of an apparatus that can be used to provide anastomosis is a circular stapler. Some such staplers can operate to clamp tissue layers, cut through the clamped tissue layers, and drive staples through the clamped tissue layers, so that the tissue layers are basically sealed together near the cut ends of the tissue layers, thereby joining the two cut ends of the anatomical lumen together. The circular stapler is configured to be able to cut off tissue and seal tissue substantially at the same time. For example, the circular stapler can cut off the redundant tissue in the annular array of staples at the anastomosis portion, so as to provide a substantially smooth transition portion between the anatomical lumen segments engaged at the anastomosis portion. The circular stapler can be used in laparotomy or endoscopic surgery. In some cases, a part of the circular stapler is inserted through the naturally occurring orifice of the patient.

[0005] Examples of circular staplers are described in U.S. Pat. No. 5,205,459, entitled "Surgical Anastomosis Stapling Instrument," issued April 27, 1993; U.S. Pat. No. 5,271,544, entitled "Surgical Anastomosis Stapling Instrument," issued December 21, 1993; U.S. Pat. No. 5,275,322, entitled "Surgical Anastomosis Stapling Instrument," issued January 4, 1994; U.S. Pat. No. 5,285,945, entitled "Surgical Anastomosis Stapling Instrument," issued February 15, 1994; U.S. Pat. No. 5,292,053, entitled "Surgical Anastomosis Stapling Instrument," issued March 8, 1994; U.S. Pat. No. 5,292,053, entitled "Surgical Anastomosis Stapling Instrument," issued August 2, 1994; and U.S. Patent No. 5,333,773, entitled “Surgical Anastomosis Stapling Instrument”, issued on September 27, 1994; U.S. Patent No. 5,350,104, entitled “Surgical Anastomosis Stapling Instrument”, issued on July 9, 1996; and U.S. Patent No. 8,910,847, entitled “Low Cost Anvil Assembly for a Circular Stapler”, issued on December 16, 2014. The disclosure of each of the above-cited U.S. patents is incorporated herein by reference.

[0006] Some circular staplers may include an electric actuation mechanism. Examples of circular staplers with electric actuation mechanisms are described in the following patents: U.S. Publication No. 2015 / 0083772, published on March 26, 2015, entitled "Surgical Stapler with Rotary Cam Drive and Return", now abandoned; U.S. Patent No. 9,936,949, published on April 10, 2018, entitled "Surgical Stapling Instrument with Drive Assembly Having Toggle Features"; U.S. Patent No. 9,907,552, published on March 6, 2018, entitled "Control Features for Motorized Surgical Stapling Instrument"; and U.S. Patent No. 9,713,469, published on July 25, 2017, entitled "Surgical Stapler with Rotary Cam Drive". The disclosure of each of the above-referenced U.S. patent publications is incorporated herein by reference.

[0007] While various surgical stapling instruments and associated components have been made and used, it is believed that no one prior to the inventor has made or used the invention described in the appended claims. BRIEF DESCRIPTION OF THE DRAWINGS

[0008] While this specification results in claims that particularly point out and distinctly claim such technology, it is believed that such technology will be better understood from certain examples described below in conjunction with the accompanying drawings, wherein like reference numerals indicate the same elements, and wherein:

[0009] Figure 1 shows a perspective view of an exemplary circular stapler;

[0010] Figure 2 Shows Figure 1 A perspective view of a circular stapler with the battery pack removed from the handle assembly and the anvil removed from the stapling head assembly;

[0011] Figure 3 Show Figure 1 A perspective view of an anvil of a circular stapler;

[0012] Figure 4 Shows Figure 3 Another perspective view of the anvil;

[0013] Figure 5 Shows Figure 3 An exploded side elevation view of an anvil;

[0014] Figure 6 Shows that Figure 1 Use with circular staplers to replace Figure 3 A bottom plan view of an exemplary alternative anvil of an anvil;

[0015] Figure 7 Shows Figure 6 An enlarged bottom plan view of a portion of an anvil;

[0016] Figure 8 Shows Figure 6 an enlarged perspective view of a portion of an anvil;

[0017] Fig. 9 Shows Figure 1 A perspective view of a suturing head assembly of a circular stapler;

[0018] Fig.10 Shows Fig. 9 A perspective cutaway view of an inner body member of a suture head assembly;

[0019] Fig.11 Shows Fig. 9 An exploded perspective view of a suture head assembly;

[0020] Fig.12 Shows that it can be combined with Fig. 9 A perspective view of an exemplary alternative platform member in a suture head assembly of FIG.

[0021] Fig.13 Shows Fig.12 A top plan view of the platform component;

[0022] Fig.14A Shows Figure 3 The anvil relative to Fig. 9 A side elevation view of the suture head assembly in a first longitudinal position;

[0023] Fig. 14B Shows Figure 3 The anvil relative to Fig. 9 A side elevation view of the suture head assembly in a second longitudinal position;

[0024] Fig.15A Shows Figure 1 A cross-sectional side view of a distal end of a circular stapler of the embodiment of the present invention, wherein a contact switch of the circular stapler is in an open state;

[0025] Fig. 15B Shows Figure 1 A cross-sectional side view of the distal end of a circular stapler of FIG. 1, wherein the trocar and anvil of the circular stapler are translated proximally to Fig.15A The contact switch shown moves to a closed state;

[0026] Fig.16A Shows Fig.15A The contact switch is in Fig.15A An enlarged cross-sectional side view of an open state of the device;

[0027] Fig. 16B Shows Fig.15A An enlarged cross-sectional side view of a contact switch of FIG. 1 , wherein the contact switch is moved to the position by proximally translating the trocar and anvil of the circular stapler. Fig. 15B The closed state;

[0028] Fig.17 Shows Figure 1 An exploded perspective view of a circular stapler of FIG. 1 , wherein the various parts of the shaft assembly are shown separated from each other;

[0029] Fig.18 Shows Figure 1 A perspective view of a handle assembly of a circular stapler, wherein a housing portion is omitted to show internal components of the handle assembly;

[0030] Fig.19 Shows Figure 1 A perspective view of a suture head actuation assembly of a circular stapler;

[0031] Fig. 20 Shows Fig.19 A perspective view of a cam follower of a suture head actuation assembly;

[0032] Fig.21 Shows Fig. 20 Another perspective view of the cam follower;

[0033] Fig. 22 Shows Fig.19 A perspective view of a rotating cam of a suture head actuation assembly;

[0034] Fig.23 Shows Fig. 22 Another perspective view of the rotating cam;

[0035] Fig.24A Shows Fig.19 a side elevation view of a stapling head actuation assembly of wherein the rotating cam is in a first angular position and the cam follower is in a first pivot position;

[0036] Fig. 24B Shows Fig.19 a side elevation view of the stapling head actuation assembly of with the rotating cam in a second angular position and the cam follower in a second pivot position;

[0037] Fig.25A Shows Fig. 22a perspective view of a rotating cam, a rocker arm member, and a stop switch, wherein the rotating cam is in a first angular position and the rocker arm member is in a first pivot position;

[0038] Fig.25B Shows Fig. 22 Rotating cam, Fig.25A The rocker arm components and Fig.25A a perspective view of a stop switch of with the rotating cam in a fourth angular position and the rocker arm member in a second pivot position;

[0039] Fig.26A Shows Fig. 22 Rotating cam, Fig. 20 The cam follower and Fig.25A a schematic end view of a rocker arm member of wherein the rotating cam is in a first angular position, the cam follower is in a first pivot position, and the rocker arm member is in the first pivot position;

[0040] Fig.26B Shows Fig. 22 The rotating cam and Fig. 20 a schematic end view of a cam follower of the embodiment of the present invention, wherein the rotating cam is in a second angular position, the cam follower is in a second pivot position, and Fig.25A The rocker arm member is in a first pivot position;

[0041] Fig.26C Shows Fig. 22 The rotating cam and Fig. 20 Schematic end view of a cam follower of , wherein the rotating cam is in a third angular position, the cam follower is in a second pivot position, and Fig.25A The rocker arm member is in a first pivot position;

[0042] Fig.26D Shows Fig. 22 Rotating cam, Fig. 20 The cam follower and Fig.25A a schematic end view of a rocker arm member of wherein the rotating cam is in a fourth angular position, the cam follower is in a third pivot position, and the rocker arm member is in a second pivot position;

[0043] Fig.27A Shows Figure 3 an anvil located in the first segment of the digestive tract and Fig. 9 a cross-sectional side view of the suturing head assembly positioned within a second segment of the digestive tract with the anvil separated from the suturing head assembly;

[0044] Fig.27B Shows Figure 3 an anvil located in the first segment of the digestive tract and Fig. 9a cross-sectional side view of a suturing head assembly positioned within a second segment of the digestive tract, wherein an anvil is secured to the suturing head assembly;

[0045] Fig.27C Shows Figure 3 an anvil located in the first segment of the digestive tract and Fig. 9 a cross-sectional side view of the stapling head assembly positioned within a second segment of the digestive tract, wherein the anvil is retracted toward the stapling head assembly, thereby clamping tissue between the anvil and the stapling head assembly;

[0046] Fig.27D Shows Figure 3 an anvil located in the first segment of the digestive tract and Fig. 9 a cross-sectional side view of a suturing head assembly positioned within a second segment of the digestive tract, wherein the suturing head assembly is actuated to sever and suturing the clamped tissue;

[0047] Fig.27E Shows Fig.27A A cross-sectional side view of a first segment and a second segment of the digestive tract of being joined together at an end-to-end anastomosis;

[0048] Fig.28 Shows Fig.18 A perspective view of a bracket of the handle assembly;

[0049] Fig.29 Shows Fig.18 a perspective view of an indicator member of a handle assembly;

[0050] Fig. 30A Shows Figure 1 A perspective view of an anvil actuation assembly of a circular stapler of the type shown in FIG. 1 , wherein the actuation rod is in a first position;

[0051] Fig. 30B Shows Fig. 30A A perspective view of an anvil actuation assembly of the invention with the actuation rod moved to a second position to engage Fig.28 bracket;

[0052] Fig. 30C Shows Fig. 30A A perspective view of an anvil actuation assembly of FIG. 1 with the actuation rod moved to a third position to retract proximally Fig.28 bracket;

[0053] Fig.30D Shows Fig. 30A A perspective view of the anvil actuation assembly of , wherein the safety trigger is pivoted from a first position to a second position;

[0054] Fig.30E Shows Fig. 30AA perspective view of an anvil actuation assembly of with the firing trigger being pivoted from a first position to a second position;

[0055] Fig.31 Shows Fig.30D a perspective view of a safety trigger and associated vertical member;

[0056] Fig.32 Shows Fig.18 A perspective view of a user interface of a handle assembly;

[0057] Fig.33 Shows that it can be combined with Figure 1 A perspective view of an exemplary alternative indicator member in an apparatus of;

[0058] Fig.34 Shows Fig.33 Another perspective view of the indicator member;

[0059] Fig.35 Shows that it can be combined with Figure 1 A perspective view of an exemplary alternative indicator bracket in an apparatus of;

[0060] Fig.36 Shows Fig.33 Combination Fig.35 A perspective view of an indicator member of a bracket;

[0061] Fig.37 Shows Fig.33 can be combined with Figure 1 An exploded perspective view of an indicator member of an exemplary alternative base in an apparatus of

[0062] Fig.38A Shows Fig.33 of Fig.37 a side elevation view of an indicator member coupled to a base, wherein the indicator member is in a first angular position;

[0063] Fig.38B Shows Fig.33 of Fig.37 a side elevation view of the base coupled to the indicator member, wherein the indicator member is in a second angular position;

[0064] Fig.38C Shows Fig.33 of Fig.37 a side elevation view of the base coupled to the indicator member, wherein the indicator member is in a third angular position;

[0065] Fig.38D Shows Fig.33 of Fig.37 a side elevation view of the base coupled to the indicator member, wherein the indicator member is in a fourth angular position;

[0066] Fig.39A Shows Fig.33 The indicator component and Fig.35 a side elevation view of a bracket of the embodiment of the present invention, wherein the bracket is in a first longitudinal position and the indicator member is in a first angular position;

[0067] Fig.39B Shows Fig.33 The indicator component and Fig.35 a side elevation view of the bracket of claim 1, wherein the bracket is in the second longitudinal position and the indicator member is in the first angular position;

[0068] Fig.39C Shows Fig.33 The indicator component and Fig.35 a side elevation view of the bracket of claim 1, wherein the bracket is in a third longitudinal position and the indicator member is in a second angular position;

[0069] Fig.39D Shows Fig.33 The indicator component and Fig.35 a side elevation view of the bracket of claim 1, wherein the bracket is in a fourth longitudinal position and the indicator member is in a third angular position;

[0070] FIG. 40A to FIG. 40B shows the display operation Figure 1 A flowchart of exemplary steps of a circular stapler;

[0071] Fig.41 shows a perspective view of yet another exemplary alternative circular stapler;

[0072] Fig.42 Shows Fig.41 A perspective view of a circular stapler with a battery pack removed from a handle assembly of the circular stapler;

[0073] Fig.43 Shows Fig.42 A perspective view of a battery pack;

[0074] Fig.44 Shows Fig.42 A partially exploded perspective view of a battery pack;

[0075] Fig.45A Shows Fig.42 A perspective view of a handle assembly of FIG. 1 with the housing removed from the handle assembly and wherein Fig.42 The battery pack is spaced apart from the handle assembly;

[0076] Fig.45B Shows Fig.42 A perspective view of a handle assembly of FIG. 1 with the housing removed from the handle assembly and wherein Fig.42The battery pack is connected to the handle assembly;

[0077] Fig.46 Shows Fig.42 A perspective view of a handle assembly of FIG. 1 with the housing removed from the handle assembly and wherein Fig.42 The lower battery housing of the battery pack is in a first position relative to the handle assembly;

[0078] Fig.47 Shows Fig.46 in Fig.46 a detailed perspective view of the lower battery housing in a first position of the lower battery housing, wherein a battery discharge slide of the lower battery housing is in the first position relative to the body of the lower battery housing;

[0079] Fig.48 Shows Fig.46 Another detailed perspective view of the lower battery housing, wherein Fig.47 The battery discharge slide is in Fig.47 The first position;

[0080] Fig.49 Shows Fig.42 A perspective view of a handle assembly with the housing removed from the handle assembly, and wherein Fig.46 the lower battery housing of the handle assembly being moved distally to a second position relative to the handle assembly, and wherein the discharge initiation rail of the handle assembly is received within the lower battery housing in the first position;

[0081] Fig.50 Shows Fig.46 in Fig.49 A detailed perspective view of the lower battery housing in the second position, wherein Fig.47 The battery discharge slide is kept Fig.47 The first position of Fig.49 The discharge start rail receives the Fig.49 a first position within a lower battery housing;

[0082] Fig.51 Shows Fig.42 A perspective view of a handle assembly with the housing removed from the handle assembly, wherein Fig.46 The lower battery housing of the handle assembly moves distally to a third position so that Fig.50 The discharge starting rail is moved to the second position so that the discharge starting rail is aligned with the Fig.47 The battery discharge slide is engaged;

[0083] Fig.52 Shows Fig.46 in Fig.51 A detailed perspective view of the lower battery housing in the third position, wherein Fig.47The battery discharge slide is kept Fig.47 The first position of Fig.49 The discharge start rail receives the Fig.51 the lower battery housing in a second position such that the discharge initiation rail engages the battery discharge slide;

[0084] Fig.53 Shows Fig.42 A perspective view of a handle assembly with the housing removed from the handle assembly, wherein Fig.46 The lower battery housing of the handle assembly moves distally to a fourth position so that Fig.50 The discharge initiation guide rail is moved to the third position so that the discharge initiation guide rail is driven toward the proximal side. Fig.47 the battery discharge slide to a second position;

[0085] Fig.54 Shows Fig.46 in Fig.53 A detailed perspective view of the lower battery housing in the fourth position, wherein Fig.49 The discharge start rail receives the Fig.53 The third position is within the lower battery housing so that the discharge starter rail is driven Fig.47 The battery discharge slide moves to Fig.53 in the second position;

[0086] Fig.55 Shows Fig.42 A perspective view of a handle assembly with the housing removed from the handle assembly, wherein Fig.46 The lower battery housing is removed from the handle assembly so that Fig.50 The discharge start rail is removed from the lower battery housing, and wherein Fig.47 The battery discharge slide is kept Fig.53 The second position of Fig.52 The discharge contact of the battery pack is biased toward the positive contact of the battery pack;

[0087] Fig.56 Shows Fig.42 A detailed perspective view of the handle assembly of Fig.46 The lower battery housing is removed from the handle assembly, and wherein Fig.47 The battery discharge slide is kept Fig.53 The second position of Fig.55 The discharge contact direction Fig.55 The positive contact is biased;

[0088] Fig.57 Shows Fig.42 A detailed perspective view of the handle assembly of Fig.46 The lower battery housing is removed from the handle assembly, and wherein Fig.47 The battery discharge slide is kept Fig.53 The second position of Fig.55 The discharge contact direction Fig.55 The positive contact is biased;

[0089] Fig.58 Shows that it can be combined with Figure 1 A schematic diagram of an exemplary battery discharge circuit in a circular stapler of;

[0090] Fig.59A Shows Fig.18 A perspective view of a firing trigger and a motor start module of a handle assembly of FIG. 1 , wherein the firing trigger is in a non-actuated position;

[0091] Fig.59B Shows Fig.59A A perspective view of a firing trigger and a motor start module, wherein the firing trigger is in an actuated position;

[0092] Fig.60 Shows that it can be combined with Figure 1 A schematic diagram of a first exemplary control circuit in an apparatus of;

[0093] Fig.61 Shows Fig.18 Detailed view of the coil spring;

[0094] Fig.62 Shows Fig.17 Trocar actuating rod, Fig.18 The right base part and nut, Fig.35 Bracket, Fig.37 A bottom view of a left base portion and a first exemplary alternative coil spring;

[0095] Fig.63 Shows Fig.62 Detailed view of the coil spring;

[0096] Fig.64 shows a detailed view of a second exemplary alternative coil spring;

[0097] Fig.65 shows a detailed view of a third exemplary alternative coil spring;

[0098] Fig.66 An exemplary slidable coupling is shown with Fig.61 Helical spring connection Fig.35 A perspective view of the bracket;

[0099] Fig.67 Shows Fig.66 A detailed perspective view of the bracket, coil spring and slidable coupling;

[0100] Fig.68 Shown with Fig.66 An exploded perspective view of a slidable coupling member with a bracket and a coil spring separated;

[0101] Fig.69 Shows Fig.68 A detailed perspective view of a slidable coupling member;

[0102] Fig.70 Shows Fig.17 Trocar actuating rod, Fig.18 Nuts and coil springs, Fig.35 An exploded perspective view of a bracket and an exemplary guide bushing;

[0103] Fig.71 Shows Fig.70 An exploded perspective view of a guide bushing;

[0104] Fig.72 Shows Fig.62 A perspective view of a bracket and a coil spring of , but wherein the bracket includes a centering feature;

[0105] Fig.73 Shows Fig.62 A perspective view of a bracket and a coil spring of the embodiment of the present invention, but wherein the coil spring is disposed in a sleeve;

[0106] Fig.74 Shows Fig.73 A detailed perspective view of the coil spring and sleeve;

[0107] Fig.75 Shows Fig.35 A perspective view of a bracket disposed within the left base portion;

[0108] Fig.76 Shows Fig.75 Detailed perspective view of the bracket and left base section;

[0109] Fig.77 Shows Fig.76 A perspective view of the bracket and left base portion of the same, but viewed from another angle;

[0110] Fig.78 Shows Fig.75 A rear elevation view of the bracket and left base portion of the embodiment of the present invention, but wherein the left base portion includes a longitudinal rib;

[0111] Fig.79 Shows Fig.78 a right perspective view of the bracket and left base portion;

[0112] Fig.80 Shown by Fig.18A perspective view of a protrusion of the safety trigger of the right base portion interacting with a track defined by a first pawl and a second pawl; and

[0113] Fig.81 Shows Fig.80 A perspective view of a protrusion of a safety trigger interacting with another exemplary right base portion, the other exemplary right base portion including a raised portion located between a first pawl and a second pawl;

[0114] Fig.82 Shows that it can be combined with Figure 1 a schematic diagram of a second exemplary control circuit in an apparatus of;

[0115] Fig.83 shows the connection to Fig.82 A schematic diagram of an exemplary firing circuit of a control circuit;

[0116] Fig.84 shows the display operation Fig.83 A flowchart of exemplary steps of a firing circuit of

[0117] Fig.85 Shows Fig.82 for Figure 1 Schematic diagram of a portion of the control circuit that provides the firing signal to the motor of the instrument.

[0118] The drawings are not intended to be limiting in any way, and it is contemplated that various embodiments of the technology may be performed in a variety of other ways, including those not necessarily shown in the drawings. The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate several aspects of the technology and, together with the description, serve to explain the principles of the technology; however, it should be understood that the technology is not limited to the precise arrangements shown. DETAILED DESCRIPTION

[0119] The following description of certain examples of the present technology should not be used to limit the scope of the present technology. Other examples, features, aspects, embodiments and advantages of the present technology will become apparent to those skilled in the art from the following description, which is by way of example, one of the best ways contemplated for implementing the present technology. As will be appreciated, the technology described herein can have other different and obvious aspects, all of which do not depart from the present technology. Therefore, the drawings and descriptions should be regarded as illustrative in nature and not restrictive.

[0120] This patent application incorporates by reference the disclosures of the following patents: U.S. Publication No. 2015 / 0083772, published on March 26, 2015, entitled “Surgical Stapler with Rotary Cam Drive and Return”, now abandoned; U.S. Patent No. 9,907,552, published on March 6, 2018, entitled “Control Features for Motorized Surgical Stapling Instrument”; U.S. Patent No. 2016 / 0374672, published on December 29, 2016, entitled “Method of Applying an Annular Array of Staples to Tissue”; U.S. Patent Publication No. 2018 / 0132853, published on May 17, 2018, entitled “Circular Stapler with Recessed Deck”; U.S. Patent No. 2018 / 0132853, published on May 17, 2018, entitled “Staple Forming Pocket Configurations for Circular Surgical Stapler Anvil”; U.S. Patent Publication 2018 / 0132849, entitled “Hysteresis Removal Feature in Surgical Stapling Instrument” published on November 1, 2018; and U.S. Patent Publication 2018 / 0310938, entitled “Liquid-Immune Trigger Circuit for Surgical Instrument” published on November 1, 2018.

[0121] I. Overview of Exemplary Circular Stapling Surgical Instruments

[0122] Figure 1 to Figure 2An exemplary surgical circular stapling instrument (10) is shown that can be used to provide an end-to-end, side-to-side, or end-to-side anastomosis between two segments of an anatomical lumen (such as a portion of a patient's digestive tract). The instrument (10) of this example includes a handle assembly (100), an axis assembly (200), a suturing head assembly (300), and an anvil (400). The handle assembly (100) includes a housing (110) that defines a pistol grip (112) oriented obliquely. In some versions, the pistol grip (112) is vertically oriented. In some other versions, the pistol grip (112) is omitted. The handle assembly (100) also includes a user feedback feature (114) that allows observation of a movable indicator needle (1526), ​​as will be described in more detail below. In some versions, to provide visual context for indicator needle (1526), ​​a series of hash marks, colored areas, and / or other fixed indicators are positioned adjacent to user feedback feature (114), thereby facilitating an operator's assessment of the position of needle (1526) within user feedback feature (114). Various suitable alternative features and configurations for handle assembly (100) will be apparent to those of ordinary skill in the art in view of the teachings herein.

[0123] The device (10) of this embodiment also includes a battery pack (120). As will be described in more detail below, the battery pack (120) is operable to provide power to the motor (161) in the pistol grip (112). The battery pack (120) is removable from the handle assembly (100). Specifically, as Figure 1 to Figure 2 As shown, the battery pack (120) can be inserted into a socket (116) defined by the housing (110). Once the battery pack (120) is fully inserted into the socket (116), the latch (122) of the battery pack (120) can resiliently engage the internal features of the housing (110) to provide a snap-fit ​​engagement. To remove the battery pack (120), the operator can press the latch (122) inward to disengage the latch (122) from the internal features of the housing (110), and then pull the battery pack (120) proximally from the socket (116). It should be understood that the battery pack (120) and the handle assembly (100) can have complementary electrical contacts, pins and sockets, and / or other features that provide a path for electrical communication from the battery pack (120) to the electric components in the handle assembly (100) when the battery pack (120) is inserted into the socket (116). It should also be appreciated that in some versions, battery pack (120) is integrally integrated within handle assembly (100) such that battery pack (120) cannot be removed from handle assembly (100).

[0124] The shaft assembly (200) extends distally from the handle assembly (100) and includes a preformed bend. In some versions, the preformed bend is configured to facilitate positioning of the suture head assembly (300) within the patient's colon. With reference to the teachings herein, various suitable bend angles and radii that can be used will be apparent to one of ordinary skill in the art. In some other versions, the shaft assembly (200) is straight, such that the shaft assembly (200) lacks a preformed bend. Various exemplary components that may be incorporated into the shaft assembly (200) will be described in more detail below.

[0125] The suturing head assembly (300) is located at the distal end of the shaft assembly (200). Figure 1 to Figure 2 As shown and as will be described in more detail below, the anvil (400) is configured to be removably coupled to the shaft assembly (200) adjacent to the suturing head assembly (300). Moreover, as will be described in more detail below, the anvil (400) and the suturing head assembly (300) are configured to cooperate to manipulate tissue in three ways, including clamping tissue, cutting tissue, and suturing tissue. The knob (130) at the proximal end of the handle assembly (100) can be rotated relative to the housing (110) to provide precise clamping of tissue between the anvil (400) and the suturing head assembly (300). When the safety trigger (140) of the handle assembly (100) is pivoted away from the firing trigger (150) of the handle assembly (100), the firing trigger (150) can be actuated to provide cutting and suturing of tissue.

[0126] II. Exemplary Anvils

[0127] A. Overview

[0128] In the following discussion of anvil (400), the terms "distal" and "proximal" (and variations thereof) will be used relative to the orientation of anvil (400) when anvil (400) is coupled to assembly (200) of instrument (10). Thus, proximal features of anvil (400) will be closer to an operator of instrument (10); whereas distal features of anvil (400) will be farther from an operator of instrument (10).

[0129] As in Figures 3 to 5As most clearly seen in the anvil (400) of the present embodiment includes a head (420) and a handle (410). The head (410) includes a proximal surface (412) that defines a plurality of nail forming pockets (414). In the present example, the nail forming pockets (414) are arranged in two concentric annular arrays. In some other versions, the nail forming pockets (414) are arranged in three or more concentric annular arrays. The nail forming pockets (414) are configured to deform the nail when the nail is driven into the nail forming pockets (414). For example, as is known in the art, each nail forming pocket (414) can deform a nail that is generally "U" shaped into a "B" shape. As shown in Figure 4 As best seen in FIG. 4 , proximal surface ( 412 ) terminates at an inner edge ( 416 ) that defines the outer boundary of an annular recess ( 418 ) surrounding stem ( 420 ).

[0130] The handle (420) defines a bore (422) and includes a pair of pivoting latch members (430) positioned in the bore (422). Figure 5 As best seen in the drawings, each latch member (430) includes a "T" shaped distal end (432), a rounded proximal end (434), and a latch shelf (436) positioned from the distal to the proximal end (434). The "T" shaped distal end (432) secures the latch member (430) within the aperture (422). The latch member (430) is positioned within the aperture (422) such that the proximal end (434) is positioned at the proximal end of a lateral opening (424) formed through the side wall of the handle (420). The lateral opening (424) thus provides clearance for the proximal end (434) and the latch shelf (436) to deflect radially outward from the longitudinal axis defined by the handle (420). However, the latch member (430) is configured to resiliently bias the proximal end (434) and the latch shelf (436) to pivot radially inwardly toward the longitudinal axis defined by the handle (420). The latch member (430) thus acts as a retaining fixture. This allows the anvil (400) to be removably secured to the trocar (330) of the suture head assembly (300), as will be described in more detail below. When the handle (420) is secured to the trocar (330) and the trocar (330) is retracted toward the proximal side, the inner diameter of the hole (314) in the inner core member (312) of the body member (310) laterally constrains the latch member (430) to maintain engagement between the latch shelf (436) and the proximal surface (338) of the head (334) of the trocar (330). This engagement prevents anvil (400) from being released from trocar (330) during firing of stapling head assembly (300). However, it should be understood that latching shelf (436) is merely optional. Any other suitable components, features, or techniques may be used to removably secure anvil (400) to trocar (330).

[0131] like Figure 3 to Figure 4 As best seen in the suturing head assembly (300), the handle (420) of the present example includes a set of longitudinally extending key teeth (426) spaced apart in an angular array around the handle (420). The proximal end of each key tooth (426) includes a corresponding lead-in edge (428). As described in more detail below, the key teeth (426) are configured to engage corresponding key teeth (316) of the inner body member (310) of the suturing head assembly (300) so as to consistently provide a predetermined angular alignment between the anvil (400) and the suturing head assembly (300). As also described below, this angular alignment ensures that the staple forming pockets (414) of the anvil (400) are always properly angularly aligned with the staple openings (324) of the suturing head assembly (300). Thus, in the present example, the key teeth (426) are precisely and consistently positioned relative to the staple forming pockets (414). In versions where the head (410) and handle (420) are initially formed as separate pieces and subsequently joined together, the machine or other device used to join the head (410) and handle (420) together may have appropriate indexing capabilities to reliably and consistently achieve the proper angular positioning of the head (410) and handle (420) to provide accurate and consistent positioning of the key teeth (426) relative to the nail forming pocket (414). Various suitable ways in which this result may be achieved will be apparent to those of ordinary skill in the art in view of the teachings herein. In some other versions, the head (410) and handle (420) are simultaneously formed together as a single, integral construction.

[0132] In some cases, it may be desirable to change the configuration and arrangement of the staple forming recesses (414) in the anvil (400). It should be understood that reconfiguring and rearranging the staple forming recesses (414) may result in reconfiguring and rearranging the staples (90) formed by the staple forming recesses (414). For example, the configuration and arrangement of the staple forming recesses (414) may affect the structural integrity of the anastomosis (70) secured by the staples (90). Additionally, the configuration and arrangement of the staple forming recesses (414) may affect the hemostasis achieved at the anastomosis (70) secured by the staples (90). The following description relates to several exemplary variations of the anvil (400), thereby providing a staple forming recess configuration and arrangement that is different from the configuration and arrangement of the staple forming recesses (414).

[0133] It should be understood that various alternatives to anvil (400) described below can be readily used with instrument (10) in place of anvil (400). It should also be understood that in some cases, it may be necessary to change the configuration and arrangement of the staple openings (324) in platform member (320) to complement the configuration and arrangement of alternative staple forming recesses described below. Various suitable ways of incorporating alternative anvils to anvil (400) described below into instrument (10) will be apparent to one of ordinary skill in the art in light of the teachings herein.

[0134] B. Exemplary Three-Dimensional Staple Forming Features

[0135] Figures 6 to 8 An exemplary alternative anvil (500) that can be used with a modified version of the instrument 10 is shown. Except for the differences described below, the anvil (500) of this example is constructed and operated just like the anvil (400). The anvil (500) of this example includes a proximal surface (506) that defines an inner annular array (502) of staple forming pockets (510, 530) and an outer annular array (504) of staple forming pockets (550, 570). The chamfered edge (508) extends around the outer periphery of the proximal surface (506). It should be understood that the anvil (500) can be fixed to the cannula needle (330), the proximal surface (506) can be used to compress tissue against the platform surface (322), and the staple driver (352) can drive the staples (90) through the tissue into the staple forming pockets (510, 530, 550, 570) so as to thereby form the staples (90) in the tissue.

[0136] like Figures 7 and 8 As best seen in the drawings, each nail forming recess (510) includes a nail entry surface (512) and a nail exit surface (514). The surfaces (512, 514) abut each other and define a concave depression. The concave depression formed by the surfaces (512, 514) is further defined by an inner wall (516), a first outer wall (518), a second outer wall (520), and a third outer wall (522). In this example, each of the walls (516, 518, 520, 522) is substantially flat. The wall (518) defines a relatively narrow tapered gap with the wall (516). The wall (522) defines a relatively wide gap with the wall (516). The wall (520) is inclined at an angle, thereby providing an inwardly inclined transition from the wall (522) to the wall (518). Therefore, the walls (518, 520, 522) together provide a broken line configuration. In this example, edge connecting wall (516) and wall (522) are substantially straight. Similarly, in this example, edge connecting wall (516) and wall (518) are substantially straight.

[0137] It should be understood that when the first leg of the nail (90) is driven into the nail forming pocket (510), the first leg first encounters the nail entry surface (512), bends approximately toward the second leg of the nail (90) along a first plane orthogonal to the axis of the unformed first leg, and then bends back proximally toward the crown of the nail (90). In addition, the first leg will eventually encounter the wall (520), which will provide a cam surface that bends the first leg along a second plane orthogonal to the axis of the unformed first leg. Specifically, the wall (520) and the subsequent wall (518) will deflect the first leg radially inward toward the central axis of the anvil (500). Therefore, the nail forming pocket (510) will eventually deflect the first leg of the nail (90) toward the proximal side and radially inward. The wall (516) will limit the extent to which the first leg of the nail (90) deflects radially inward.

[0138] Each nail forming recess (530) includes a nail entry surface (532) and a nail exit surface (534). The surfaces (532, 534) are adjacent to each other and define a concave depression. The concave depression formed by the surfaces (532, 534) is further defined by an outer wall (536), a first inner wall (538), a second inner wall (540) and a third inner wall (542). In this example, the walls (536, 538, 540, 542) are each substantially flat. The wall (538) defines a relatively narrow tapered gap with the wall (536). The wall (542) defines a relatively wide gap with the wall (536). The wall (540) is inclined at an angle, thereby providing an outwardly inclined transition from the wall (542) to the wall (538). Therefore, the walls (538, 540, 542) together provide a broken line configuration. In this example, edge connecting wall (536) and wall (542) are substantially straight. Similarly, in this example, edge connecting wall (536) and wall (538) are substantially straight.

[0139] It should be understood that when the second leg of the nail (90) is driven into the nail forming recess (530), the second leg first encounters the nail entry surface (532), bends approximately toward the first leg of the nail (90) along a first plane orthogonal to the axis of the unformed second leg, and then bends back proximally toward the crown of the nail (90). In addition, the second leg will eventually encounter the wall (540), which will provide a cam surface that bends the second leg along a second plane orthogonal to the axis of the unformed second leg. Specifically, the wall (540) and the wall (538) will deflect the second leg radially outward away from the central axis of the anvil (500). Therefore, the nail forming recess (530) will eventually deflect the second leg of the nail (90) toward the proximal side and radially outward. The wall (536) will limit the degree of radial outward deflection of the second leg of the nail (90).

[0140] Each nail forming pit (550) includes a nail entry surface (552) and a nail exit surface (554). The surfaces (552, 554) are adjacent to each other and define a concave depression. The concave depression formed by the surfaces (552, 554) is further defined by an outer wall (556), a first inner wall (558), a second inner wall (560) and a third inner wall (562). In this example, the walls (556, 558, 560, 562) are each substantially flat. The wall (558) defines a relatively narrow tapered gap with the wall (556). The wall (562) defines a relatively wide gap with the wall (556). The wall (560) is inclined at an angle, thereby providing an outwardly inclined transition from the wall (562) to the wall (558). Therefore, the walls (558, 560, 562) together provide a broken line configuration. In this example, edge connecting wall (556) and wall (562) are substantially straight. Similarly, in this example, edge connecting wall (556) and wall (558) are substantially straight.

[0141] It should be understood that when the second leg of the nail (90) is driven into the nail forming recess (550), the second leg first encounters the nail entry surface (552), bends approximately toward the first leg of the nail (90) along a first plane orthogonal to the axis of the unformed second leg, and then bends back proximally toward the crown of the nail (90). In addition, the second leg will eventually encounter the wall (560), which will provide a cam surface that bends the second leg along a second plane orthogonal to the axis of the unformed second leg. Specifically, the wall (560) and the wall (558) will deflect the second leg radially outward away from the central axis of the anvil (500). Therefore, the nail forming recess (550) will eventually deflect the second leg of the nail (90) toward the proximal side and radially outward. The wall (556) will limit the degree to which the second leg of the nail (90) deflects radially outward.

[0142] Each nail forming recess (570) includes a nail entry surface (572) and a nail exit surface (574). The surfaces (572, 574) are adjacent to each other and define a concave depression. The concave depression formed by the surfaces (572, 574) is further defined by an inner wall (576), a first outer wall (578), a second outer wall (580) and a third outer wall (582). In this example, the walls (576, 578, 580, 582) are each substantially flat. The wall (578) defines a relatively narrow tapered gap with the wall (576). The wall (582) defines a relatively wide gap with the wall (576). The wall (580) is inclined at an angle, thereby providing an inwardly inclined transition from the wall (582) to the wall (578). Therefore, the walls (578, 580, 582) together provide a broken line configuration. In this example, edge connecting wall (576) and wall (582) are substantially straight. Similarly, in this example, edge connecting wall (576) and wall (578) are substantially straight.

[0143] It should be understood that when the first leg of the nail (90) is driven into the nail forming pocket (570), the first leg first encounters the nail entry surface (572), bends approximately toward the second leg of the nail (90) along a first plane orthogonal to the axis of the unformed first leg, and then bends back proximally toward the crown of the nail (90). In addition, the first leg will eventually encounter the wall (580), which will provide a cam surface that bends the first leg along a second plane orthogonal to the axis of the unformed first leg. Specifically, the wall (580) and the subsequent wall (578) will deflect the first leg radially inward toward the central axis of the anvil (500). Therefore, the nail forming pocket (570) will eventually deflect the first leg of the nail (90) toward the proximal side and radially inward. The wall (576) will limit the extent to which the first leg of the nail (90) deflects radially inward.

[0144] like Figure 6 As best seen in FIG. 5 , staple forming pockets ( 510 , 530 , 550 , 570 ) are arranged such that a radius line (R ) extending outward from the center of anvil ( 500 ) is L ) passes through the area of ​​the nail entry surface (512) of the nail forming recess (510) and passes through the area of ​​the nail entry surface (552) of the nail forming recess (550). Therefore, the nail forming recesses (510, 550) overlap along the radial dimension. In addition, another radial line (R) extending outward from the center of the anvil (500) L ) passes through the area of ​​the nail entry surface (532) of the nail forming recess (530) and passes through the area of ​​the entry surface (572) of the nail forming recess (570). Therefore, the nail forming recesses (530, 570) overlap along the radial dimension. In addition, another radial line (R) extending outward from the center of the anvil (500) L) passes through the area of ​​the exit surface (574) of the staple forming recess (570) and passes through the area of ​​the exit surface (554) of the staple forming recess (550). Thus, the staple forming recesses (550, 570) overlap along the radial dimension. It should also be understood that the staple forming recesses (550, 570) in each pair of recesses (550, 570) interlock in this configuration. In addition, another radius line (R) extending outward from the center of the anvil (500) L ) through the area of ​​the staple exit surface (514) of the staple forming recess (510) and through the area of ​​the exit surface (534) of the staple forming recess (530). Thus, the staple forming recesses (510, 530) overlap along the radial dimension. It should also be understood that the staple forming recesses (510, 530) in each pair of recesses (510, 530) interlock in this configuration.

[0145] In this example, the inner annular array (502) and the outer annular array (504) are similarly configured such that the innermost dimple (510) in each pair of inner dimples (510, 530) is located to the left (at the left) of the pair of dimples (510, 530). Figure 7 and such that the innermost recess (570) of each pair of outer recesses (550, 570) is located to the left of the pair of recesses (550, 570) (in the view of FIG. 1 ); and such that the innermost recess (570) of each pair of outer recesses (550, 570) is located to the left of the pair of recesses (550, 570) (in the view of FIG. Figure 7 ).

[0146] Additionally, in the present example, the end of the wall (536) associated with the staple entry surface (532) includes a curved region (537) that curves slightly inwardly toward the center region of the anvil (500). It should be appreciated that the curved region (537) may be formed so as to maintain a minimum distance between the wall (536) and the wall (576), thereby maintaining a minimum distance between the staple forming pocket (530) and the staple forming pocket (570), which may further provide for more reliable manufacture of the anvil (500). Additionally, the curved region (537) may provide for different behaviors of the second leg of the staple (90) formed by the staple forming pocket (530). Such different behaviors may involve deflection of the anvil (500) and / or may cause the first and second legs of a given staple (90) to contact the corresponding surfaces (512, 532) at different times during actuation of the stapling head assembly (300).

[0147] It should also be appreciated that the presence of the curved region (537) provides the staple forming pocket (530) with a structural configuration that makes the staple forming pocket (530) unique relative to the other staple forming pockets (510, 550, 570). In contrast, the structural configuration of the staple forming pocket (510) is identical to the structural configuration of the staple forming pocket (570); whereas the structural configuration of the staple forming pocket (550) is a mirror image inversion of the structural configuration of the staple forming pockets (510, 570).

[0148] In this example, the spacing between the dimples (510, 530) in each pair of dimples (510, 530) is equal to the spacing between the dimples (550, 570) in each pair of dimples (550, 570). Thus, a staple (90) formed from the dimples (510, 530) will have the same crown width as a staple formed from the dimples (550, 570). However, in some other versions, the spacing between the dimples (510, 530) in each pair of dimples (510, 530) is less than the spacing between the dimples (550, 570) in each pair of dimples (550, 570). In this type of version, the dimples (550, 570) can be used to form a staple (90) having a longer crown width than a staple (90) formed using the dimples (510, 530). As another merely exemplary variation, the spacing between the dimples (510, 530) in each pair of dimples (510, 530) may be greater than the spacing between the dimples (550, 570) in each pair of dimples (550, 570). In this type of arrangement, the dimples (550, 570) may be used to form staples (90) having a shorter crown width than staples (90) formed using the dimples (510, 530). In other words, where at least two annular arrays of staples are formed, the staples (90) in one array may have a crown width that is greater, lesser, or the same as the staples (90) in the other annular array.

[0149] Also like Figure 7 As shown, the nail forming recesses (510, 530) are arranged so that they are not along the circumferential line (C L ) is completely centered, and the circumference line extends from the center of the anvil (500) along the surface (506) at a constant radius. The outermost area of ​​the nail entry surface (512, 532) is along the same circumference line (C L ) is radially centered. However, the nail forming recess (510) is relatively close to the circumferential line (C L ) is substantially inclined so that the nail exit surface (514) is inclined from the circumferential line (C L ) is positioned substantially radially inward. In contrast, the staple exit surface (534) is substantially along the circumferential line (C L ) is positioned, with a portion being positioned slightly radially outward from the circumferential line. In other words, although the staple forming recess (530) is positioned along the circumferential line (C L ) are substantially aligned, but the nail forming recess (510) is relatively aligned with the circumferential line (C L ) is substantially radially inwardly inclined, wherein the outermost area of ​​the nail entry surface (512, 532) is along the circumferential line (C L ) radially centered.

[0150] and Figures 7 and 8The view shown shows only a portion of the entire circumference of anvil (500), but it should be understood that Figures 7 and 8 The structure shown extends along the entire circumference of anvil (500). Figures 7 and 8 The views shown are simply provided as enlargements to show the structure in greater detail and are not intended to indicate that the structure shown only lies within a limited angular range along the circumference of anvil (500).

[0151] A person of ordinary skill in the art will appreciate that the staples formed by the anvil (500) will have a three-dimensional profile in which the legs are angularly offset from a plane passing through the crown of the staple; in addition to being generally bent toward each other. By way of example only, the staples formed using the anvil (500) may have an appearance similar to at least some of the staples shown and described in the following U.S. publications: U.S. Patent Publication 10,092,292, entitled "Staple Forming Features for Surgical Stapling Instrument" published on October 9, 2018, the disclosure of which is incorporated herein by reference. By way of further example only, the staples formed using the anvil (500) may have an appearance similar to at least some of the staples shown and described in the following U.S. publications: U.S. Publication 2018 / 0132849, entitled "Staple Forming Pocket Configurations for Circular Surgical Stapler Anvil" published on May 17, 2018, the disclosure of which is incorporated herein by reference.

[0152] In addition to or in lieu of the foregoing, anvil (400) may be further constructed and operated in accordance with at least some of the teachings of the following U.S. Patents: U.S. Patent 5,205,459, U.S. Patent 5,271,544, U.S. Patent 5,275,322, U.S. Patent 5,285,945, U.S. Patent 5,292,053, U.S. Patent 5,333,773, U.S. Patent 5,350,104, U.S. Patent 5,533,661, and / or U.S. Patent 8,910,847, the disclosures of which are incorporated herein by reference. Other suitable configurations will be apparent to one of ordinary skill in the art in view of the teachings herein.

[0153] III. Exemplary Suturing Head Assembly

[0154] A. Overview

[0155] like Figures 9 to 11As best seen in the drawings, the suture head assembly (300) of the present example is coupled to the distal end of the shaft assembly (200) and includes a main body member (310) and a slidable staple drive member (350). The main body member (310) includes a cylindrical inner core member (312) extending distally. The main body member (310) is securely fixed to the outer sheath (210) of the shaft assembly (200). Therefore, the main body member (310) and the outer sheath (210) together serve as a mechanical ground for the suture head assembly (300).

[0156] like Fig.10 As shown, the inner core member (312) of the main body member (310) defines a hole (314). A plurality of longitudinally extending key teeth (316) are equally spaced in an angled array within the hole (314). The distal end of the key teeth (316) includes a lead-in edge (318) that is configured to be complementary to the lead-in edge (428) of the key teeth (426) on the handle (420) of the anvil (400). Specifically, after the handle (420) is secured to the trocar (330), as described in more detail below, and when the anvil (400) is subsequently retracted proximally relative to the stapling head assembly (300), as also described in more detail below, the lead-in edges (318, 428) can cooperatively engage with each other to drive the anvil (400) to rotate relative to the trocar (330), thereby angularly aligning the key teeth (426) of the anvil (400) with the gap between the key teeth (316) of the body member (310). The gap between the key teeth (316) can be configured to have a width that is substantially equal to the width of the key teeth (426). In this way, when the key teeth (426) of the anvil (400) are positioned within the gap between the key teeth (316) of the body member (310), the anvil (400) can achieve a predetermined angular alignment relative to the stapling head assembly (300). This predetermined angular alignment ensures that the staple openings (324) of the platform member (320) are precisely aligned with the corresponding staple forming recesses (414, 510, 530) of the anvil (400). Thus, the key teeth (316, 426) are configured to cooperate with each other to ensure that staples ejected through the staple openings (324) are consistently and accurately driven into the corresponding staple forming recesses (414, 510, 530), regardless of the angular orientation of the anvil (400) relative to the stapling head assembly (300) when the anvil (400) is initially secured to the trocar (330).

[0157] The trocar (330) is coaxially positioned within the inner core member (312) of the main body member (310). As will be described in more detail below, the trocar (330) is operable to translate distally and proximally relative to the main body member (310) in response to the rotation of the knob (130) relative to the housing (110) of the handle assembly (100). The trocar (330) includes a shaft (332) and a head (334). The head (334) includes a pointed end (336) and a proximal surface (338) extending inwardly. Therefore, the shaft (332) provides a reduced outer diameter adjacent to the head (334), wherein the proximal surface (338) provides a transition between this reduced outer diameter of the shaft (332) and the outer diameter of the head (334). Although the end (336) is pointed in this example, the end (336) is not sharp. Thus, the tip (336) will not be susceptible to trauma to tissue due to accidental contact with the tissue. The head (334) and the distal portion of the shaft (332) are configured for insertion into the hole (422) of the anvil (400). The proximal surface (338) and the latch shelf (436) have complementary positions and configurations such that the latch shelf (436) engages the proximal surface (338) when the handle (420) of the anvil (400) is fully seated on the trocar (330). Thus, the anvil (400) is secured to the trocar (330) via the snap-fit ​​engagement formed by the latch member (430).

[0158] The staple drive member (350) is operable to longitudinally actuate within the body member (310) in response to activation of the motor (161), as will be described in more detail below. The staple drive member (350) includes two concentric annular arrays of staple drivers (352) presented distally. The staple drivers (352) are arranged to correspond to the arrangement of the staple forming recesses (414) described above. Therefore, each staple driver (352) is configured to drive a corresponding staple into a corresponding staple forming recess (414) when the suture head assembly (300) is actuated. It should be understood that the arrangement of the staple drivers (352) can be modified similarly to the arrangement of the staple forming recesses (414) described above. The staple drive member (350) also defines a hole (354) that is configured to coaxially receive the inner core member (312) of the body member (310). The annular array of bolts (356) protrudes distally from the surface presented distally around the hole (354).

[0159] The cylindrical knife member (340) is coaxially positioned within the nail driving member (350). The knife member (340) includes a sharp circular cutting edge (342) presented distally. The size of the knife member (340) is designed to allow the knife member (340) to define an outer diameter that is smaller than the diameter defined by the inner annular array of the nail driver (352). The knife member (340) also defines an opening configured to coaxially receive the inner core member (312) of the main body member (310). The opening (346) of the annular array formed in the knife member (340) is configured to be complementary to the bolt (356) of the annular array of the nail driving member (350), so that the knife member (340) is securely fixed to the nail driving member (350) via the bolt (356) and the opening (346). By way of example only, the stud (356) can be heat-riveted to the knife member (340) using techniques known in the art. Other suitable structural relationships between knife member (340) and staple drive member (350) will be apparent to those of ordinary skill in the art in view of the teachings herein.

[0160] The platform member (320) is securely fixed to the body member (310). The platform member (320) includes a platform surface (322) that is presented distally of two concentric annular arrays of nail openings (324). The nail openings (324) are arranged to correspond to the arrangement of the nail drivers (352) and nail forming recesses (414) described above. Therefore, each nail opening (324) is configured to provide a path for the corresponding nail driver (352) to drive the corresponding nail through the platform member (320) and into the corresponding nail forming recess (414) when the suture head assembly (300) is actuated. It should be understood that the arrangement of the nail openings (324) can be modified similarly to the arrangement of the nail forming recesses (414) described above. It should also be understood that various structures and techniques can be used to accommodate the nails in the suture head assembly (300) before the suture head assembly (300) is actuated. Such structures and techniques for containing staples within stapling head assembly (300) can prevent staples from accidentally falling through staple openings (324) before stapling head assembly (300) is actuated. Various suitable forms that such structures and techniques may take will be apparent to those of ordinary skill in the art in view of the teachings herein.

[0161] like Fig. 9 As best seen in Figure 3, platform member (320) defines an inner diameter that is only slightly larger than the outer diameter defined by knife member (340). Thus, platform member (320) is configured to allow knife member (340) to translate distally to a point where cutting edge (342) is distal from platform surface (322).

[0162] B. Exemplary Tissue Gripping Features

[0163] It may be desirable to provide a type of suturing head assembly (300) that includes features that enhance grip of tissue during actuation of the suturing head assembly (300), thereby facilitating successful tissue cutting and staple deployment without increasing the risk of damaging patient tissue as the suturing head assembly (300) slides along the tissue during positioning of the suturing head assembly (300). Figure 12 to Figure 13 An example of a platform member (600) that provides enhanced tissue gripping without increasing the risk of tissue damage is shown. Platform member (600) may be easily incorporated into stapling head assembly (300) in place of platform member (320).

[0164] The platform member (600) of this example includes a first platform surface (622), a second platform surface (630), and two concentric annular arrays of nail openings (624). The nail openings (624) are arranged to correspond to the arrangement of the nail drivers (352) and nail forming recesses (414) described above. Therefore, each nail opening (624) is configured to provide a path for the corresponding nail driver (352) to drive the corresponding nail through the platform member (600) and into the corresponding nail forming recess (414) when the suture head assembly (300) coupled to the platform member (600) is actuated. The inner diameter defined by the platform member (600) is only slightly larger than the outer diameter defined by the knife member (340). Therefore, the platform member (600) is configured to allow the knife member (340) to translate distally to a point where the cutting edge (342) is away from the plane of the second platform surface (630).

[0165] In the present example, outer edge (620) spans around the entire circumference of platform member (600) with a consistent surface geometry. In the present example, outer edge (620) is configured to prevent outer edge (620) from snagging on tissue. In some versions, outer edge (620) has a curved profile. In some other versions, outer edge (620) has a chamfered profile. Alternatively, outer edge (620) may have any other suitable type of profile.

[0166] The second platform surface (630) is convex relative to the first platform surface (622), so that the first platform surface (622) is recessed relative to the second platform surface (630). As shown, the second platform surface (630) completely surrounds each nail opening (624), including the inner array of nail openings (624) and the outer array of nail openings (624). However, the first platform surface (622) extends inwardly between the nail openings (624) of the outer array of nail openings (624), thereby forming a gap (626) in the second platform surface (630) between the nail openings (624) of the outer array of nail openings (624).

[0167] A plurality of recesses (670) are spaced apart between the nail openings (624) of the inner annular array of nail openings (624). The shape of the recesses (670) of this example is generally similar to an isosceles triangle, wherein each triangle is defined by a pair of straight walls (674) and an inner annular wall (672) of equal length. The vertices formed by the walls (674) are positioned at the radially outermost points of the recesses (670). Specifically, these vertices are located at radial positions corresponding to the same circumference where the angled outermost points of the nail openings (624) are located. In other words, in this example, these vertices of the recesses (670) and the corresponding points of the nail openings (624) are all positioned at the same radial distance along the same circumference. Alternatively, the position and configuration of the recesses (670) may have any other suitable relationship to the position and configuration of the nail openings (624).

[0168] The recesses (670) of this example are joined together by a channel (680) defined between the inner annular wall (672) and the corresponding opposing annular wall (676). The walls (672, 676) are parallel to each other and are closely positioned relative to each other so that the channel (680) is substantially smaller than the recesses (670).

[0169] The gap (626), recess (670) and channel (680) are configured to receive tissue when the tissue is being compressed by the anvil (400) against the platform surface (622, 630), as described above. Specifically, when the anvil (400) is actuated via the knob (130) to compress the tissue between the anvil (400) and the platform surface (622, 630), a portion of the compressed tissue will enter the gap (626), recess (670) and channel (680). By allowing some of the tissue to enter the gap (626), recess (670) and channel (680), this can reduce the total pressure that would otherwise be applied to the tissue if the tissue was being compressed against a consistent flat platform surface similar to the platform surface (322). Therefore, the pressure on the tissue is only concentrated in the area where the pressure is actually needed-close to the nail opening (624). By reducing the total pressure on the tissue, the platform member (600) can reduce the risk of the tissue being broken due to excessive compression. In addition to reducing the overall pressure on the tissue, the entry of tissue portions into gaps (626), recesses (670), and channels (680) can provide a greater grip on the compressed tissue than can be achieved using a uniformly flat platform surface similar to platform surface (322). The enhanced tissue grip can promote cleaner cutting of knife member (340) and also promote more successful deployment of staples (90) in tissue. Thus, the presence of gaps (626), recesses (670), and channels (680) can both reduce the risk of excessive tissue compression and promote greater success in tissue cutting and stapling.

[0170] In the present example, the gap (626), the recess (670), and the channel (680) all extend to substantially the same depth relative to the second platform surface (630). In some other versions, the gap (626), the recess (670), and the channel (680) extend to different depths relative to the second platform surface (630). For example, the gap (626) may extend to a greater depth relative to the second platform surface (630) than the recess (670), or vice versa. It should also be understood that the gap (626) may alternate depths relative to the second platform surface (630), such that the gap (626) alternates between a relatively shallow gap (626) and a relatively deep gap (626) along at least a portion of the angular range of the platform member (600). Similarly, the recesses (670) may alternate depths relative to the second platform surface (630) such that the recesses (670) alternate between relatively shallow recesses (670) and relatively deep recesses (670) along at least a portion of the angular extent of the platform member (600). As yet another merely exemplary variation, the depth of a given gap (626) or recess (670) may vary within that particular gap (626) or recess (670). For example, the radially innermost region of a given gap (626) may be deeper or shallower than the radially outermost region of the same gap (626). Similarly, the region of each recess (670) near the apex may be deeper or shallower than the region of each recess (670) near the inner annular wall (672). Other suitable variations in the depth of gap (626), recess (670), and / or channel (680) that may be provided relative to second platform surface (630) will be apparent to those of ordinary skill in the art in view of the teachings herein.

[0171] The inner annular wall (672) extends uniformly along the entire circumference of the platform member (600). Specifically, the height of the uppermost edge of the inner annular wall (672) is uniform along the entire circumference of the platform member (600). Therefore, the uppermost edge of the inner annular wall (672) is configured to provide a consistent pressure against an adjacent annular region of the tissue when the tissue is being compressed against the platform member (600) by the anvil (400). This consistent pressure applied to the adjacent annular region of the tissue can also help to cleanly cut the tissue by the knife member (340), especially because the knife member (340) will cut the tissue at the uppermost edge of the inner annular wall (672) in close proximity. In this example, the uppermost edge of the inner annular wall (672) is substantially flush with the second platform surface (630). In some other variations, the uppermost edge of the inner annular wall (672) is convex or raised relative to the second platform surface (630). In other variations, the uppermost edge of inner annular wall (672) is recessed or indented relative to second platform surface (630).

[0172] C. Exemplary Anvil Joint Detection

[0173] In some versions of the instrument (10), it may be desirable to provide an instrument (10) having certain features that are configured to indicate whether the anvil (400) is properly attached to the trocar (330) of the suture head assembly (300). For example, if the anvil (400) is not properly attached to the trocar (330), the operator may receive audible and / or tactile feedback indicating incorrect attachment. In addition, if the anvil (400) is properly attached to the trocar (330), the operator may receive audible, tactile, and / or visual feedback indicating correct attachment. In addition or alternatively, the feature may be configured to prevent the suture head assembly (300) from firing unless the anvil (400) is properly attached to the trocar (330). For example, if the anvil (400) is not properly attached to the trocar (330), the suture head assembly (300) may be prevented from firing. If anvil (400) is properly attached to trocar (330), firing head suturing head assembly (300) may be activated. Various examples of such characteristic features are described in more detail below; other examples will be apparent to one of ordinary skill in the art in light of the teachings herein. In addition, the following teachings may be applied to devices used in a variety of other contexts.

[0174] exist FIG. 14A to FIG. 14B In the illustrated example, trocar (330) includes a colored region (333) that is longitudinally positioned at a location where the colored region (333) is exposed before the handle (420) is fully seated on the trocar (330). Fig.14A ); and when the handle (420) is fully seated in the trocar (330) ( Fig. 14B ) is covered when the colored area (333) is on the trocar (330). The colored area (333) may be colored using a color (e.g., orange) that is easily visible relative to adjacent areas of the trocar (330) and the handle (420). When the handle (420) is coupled to the trocar (330), the operator may observe the colored area (333) to ensure that the entire colored area (333) is obscured by the handle (420) before attempting to retract the combination of the trocar (330) and the anvil (400) relative to the suture head assembly (300). If the operator continues to see even a portion of the colored area (333), the operator may continue to press the anvil (400) onto the trocar (330) until the colored area (333) is completely obscured by the handle (420).

[0175] Even when trocar (330) includes visual feedback features such as colored region (333) to assist an operator in properly seating anvil (400) on trocar (330), it may still be desirable to include a sensor feature operable to detect whether anvil (400) is properly seated on trocar (330). To this end, FIG. 15A to FIG. 16B An exemplary switch assembly (2600) is shown incorporated into the suture head assembly (300) in this example. The switch assembly (2600) includes a dome switch (2610) and a resilient actuator spring (2602). The actuator spring (2602) is secured within a cavity (2606) formed within the body member (310). The dome switch (2610) is located between a pair of flanges (2612, 2614) of the actuator spring (2602) such that movement of the flange (2612) toward the flange (2614) will actuate the dome switch (2610).

[0176] When anvil (400) is properly secured to trocar (330) and retracted proximally as described herein, anvil (400) causes flange (2612) to move toward flange (2614) to actuate dome switch (2610). Actuation of dome switch (2610) may provide auditory, tactile, and / or visual feedback to the operator, indicating proper attachment. Various suitable features that may be used to provide such a response to actuation of dome switch (2610) will be apparent to one of ordinary skill in the art with reference to the teachings herein. Additionally, in the present example, actuation of dome switch (2610) may effectuate the firing of suture head assembly (300). In other words, unless dome switch (2610) has been actuated, suture head assembly (300) may not be fired in the present example.

[0177] After the anvil (400) is fixed to the trocar (330), the operator then rotates the knob (130) to retract the trocar (330) and the anvil (400) toward the proximal side, as described above. When the trocar (330) and the anvil (400) are correctly fixed to each other, the proximal retraction of the trocar (330) and the anvil (400) compresses the tissue of the tubular anatomical structure (20, 40) between the surface (412, 322) of the anvil (400) and the suturing head assembly (300), as described herein. When the trocar (330) and the anvil (400) are not correctly fixed to each other, the trocar (330) does not retract toward the proximal side with the anvil (400), so that the tissue of the tubular anatomical structure (20, 40) remains uncompressed. When the trocar (330) and the anvil (400) are properly secured to one another, as the trocar (330) and the anvil (400) are retracted proximally, the proximal end of the handle (420) of the anvil (400) engages with the raised portion (2604) of the flange (2612) of the actuator spring (2602), thereby driving the flange (2612) toward the flange (2614), thereby actuating the dome switch (2610), as shown in FIG. Fig. 15B and Fig. 16B shown.

[0178] In the present example, dome switch (2610) is not activated immediately upon properly placing handle (420) on trocar (330). Instead, trocar (330) and anvil (400) must be retracted proximally relative to suturing head assembly (300) by at least a certain distance before dome switch (2610) is activated. In the present example, dome switch (2610) is activated before anvil (400) reaches the "green zone" as described herein. In some other variations, dome switch (2610) is not activated until anvil (400) reaches the distalmost boundary of the "green zone" as described herein.

[0179] As described above, actuation of dome switch (2610) may provide audible, tactile, and / or visual feedback to the operator, indicating proper attachment. Furthermore, such actuation of dome switch (2610) initiates the firing of stapling head assembly (300). In other words, stapling head assembly (300) may not be fired unless dome switch (2610) has been actuated. Fig.60 An example manner in which dome switch (2610) may be integrated into control circuit (2700) is described in greater detail. Other examples will be apparent to those of ordinary skill in the art in view of the teachings herein.

[0180] In addition to or in lieu of the foregoing, suturing head assembly (300) may be further constructed and operated in accordance with at least some of the teachings of the following U.S. Patents: U.S. Patent 5,205,459, U.S. Patent 5,271,544, U.S. Patent 5,275,322, U.S. Patent 5,285,945, U.S. Patent 5,292,053, U.S. Patent 5,333,773, U.S. Patent 5,350,104, U.S. Patent 5,533,661, and / or U.S. Patent 8,910,847, the disclosures of which are incorporated herein by reference. Other suitable configurations will be apparent to one of ordinary skill in the art in view of the teachings herein.

[0181] IV. Exemplary Drive Assemblies

[0182] Fig.17 Various components of the shaft assembly (200) are shown coupling components of the suture head assembly (300) with components of the handle assembly (100). Specifically, and as described above, the shaft assembly (200) includes an outer sheath (210) extending between the handle assembly (100) and the body member (310). In this example, the outer sheath (210) is rigid and includes a preformed curved segment as described above.

[0183] The shaft assembly (200) further includes a trocar actuation rod (220) and a trocar actuation band assembly (230). The distal end of the trocar actuation band assembly (230) is securely secured to the proximal end of the shaft (332) of the trocar (330). The proximal end of the trocar actuation band assembly (230) is securely secured to the distal end of the trocar actuation rod (220). It should therefore be appreciated that the trocar (330) translates longitudinally relative to the outer sheath (210) in response to translation of the trocar actuation band assembly (230) and the trocar actuation rod (220) relative to the outer sheath (210). The trocar actuation band assembly (230) is configured to bend so that the trocar actuation band assembly (230) can advance along a preformed curve in the shaft assembly (200) when the trocar actuation band assembly (230) is longitudinally translated relative to the outer sheath (210). However, the trocar actuation band assembly (230) has sufficient column strength and tensile strength to transmit distal and proximal forces from the trocar actuation rod (220) to the shaft (332) of the trocar (330). The trocar actuation rod (220) is rigid. The clamp (222) is securely fixed to the trocar actuation rod (220) and is configured to cooperate with a complementary feature in the handle assembly (100) to prevent the trocar actuation rod (220) from rotating within the handle assembly (100) while still allowing the trocar actuation rod (220) to be longitudinally translated within the handle assembly (100). Trocar actuation rod (220) further comprises a coarse helical thread (224) and a fine helical thread (226). Details regarding the movement of trocar actuation rod (220) will be described in greater detail below.

[0184] The shaft assembly (200) further includes a suturing head assembly driver (240) slidably received within the outer sheath (210). The distal end of the suturing head assembly driver (240) is fixed to the proximal end of the staple drive member (350). The proximal end of the suturing head assembly driver (240) is fixed to the drive bracket (250) via a pin (242). It should be understood that the staple drive member (350) will translate longitudinally relative to the outer sheath (210) in response to the translation of the suturing head assembly driver (240) and the drive bracket (250) relative to the outer sheath (210). The suturing head assembly driver (240) is configured to bend so that when the suturing head assembly driver (240) is translated longitudinally relative to the outer sheath (210), the suturing head assembly driver (240) can advance along a preformed curve in the shaft assembly (200). However, stapling head assembly driver (240) has sufficient column strength to transmit distal forces from drive carriage (250) to staple drive member (350). Details regarding the movement of drive carriage (250) will be described in greater detail below.

[0185] Despite Fig.17210, but it should be understood that the shaft assembly (200) may also include one or more spacing elements within the outer sheath (210). Such spacing elements may be configured to support the trocar actuation belt assembly (230) and / or the suturing head assembly driver (240) as they translate through the outer sheath (210). For example, such spacing elements may prevent the trocar actuation belt assembly (230) and / or the suturing head assembly driver (240) from being crushed as they translate through the outer sheath (210). Various suitable forms that such spacing elements may take will be apparent to those of ordinary skill in the art in view of the teachings herein.

[0186] like Fig.18 As shown, the handle assembly (100) includes several components that can be operated to actuate the anvil (400) and the suturing head assembly (300). The handle assembly (100) also includes components that can be operated to selectively lock the trigger (140, 150) based on the position of the anvil (400) relative to the suturing head assembly (300). When the trigger (140, 150) is locked, the trigger (150) is prevented from firing the actuation of the suturing head assembly (300). Therefore, only when the position of the anvil (400) relative to the suturing head assembly (300) is within a predetermined range, the firing trigger (150) can be operated to initiate the actuation of the suturing head assembly (300). The components of the handle assembly (100) that provide the aforementioned operability will be described in more detail below.

[0187] A. Exemplary Anvil Actuation Assembly

[0188] The knob (130) protrudes proximally from the housing (110) of the handle assembly and is rotatable relative to the housing (110). Fig.19 As shown, the nut (160) is fixed to the distal end of the knob (130). In this example, the nut (160) is securely fixed to the distal end of the knob (130) so that the nut (160) will rotate integrally with the knob (130). The nut (160) and the knob (130) are configured to cooperate with the cannula needle actuation rod (220) so that the cannula needle actuation rod (220) is longitudinally translated relative to the housing (110) in response to the rotation of the nut (160) and the knob (130) relative to the housing (110). As described above, the cannula needle (330) will be longitudinally translated relative to the outer sheath (210) in response to the translation of the cannula needle actuation rod (220) relative to the outer sheath (210) and the housing (110).

[0189] A proximal portion of trocar actuation rod (220) is positioned within handle assembly (100) to engage nut (160) and knob (130). Specifically, trocar actuation rod (220) is positioned within handle assembly (100) such that coarse helical threads (224) will selectively engage a threaded engagement feature (not shown) within the interior of nut (160); and such that fine helical threads (226) will selectively engage a threaded engagement feature (not shown) within the interior of knob (130). In some versions, the threaded engagement feature of nut (160) comprises an inwardly directed protrusion; and the threaded engagement feature of knob (130) comprises a helical thread. Other suitable forms that such threaded engagement features may take will be apparent to one of ordinary skill in the art in view of the teachings herein.

[0190] In the present example, as nut (160) and knob (130) are rotated relative to housing (110), trocar actuation rod (220) travels proximally through a first range of longitudinal motion, wherein coarse helical threads (224) engage nut (160) to provide a relatively fast rate of translation. Within this range of motion, fine helical threads (226) do not engage knob (130). As nut (160) and knob (130) are further rotated relative to housing (110) after trocar actuation rod (220) completes the first range of motion, trocar actuation rod (220) will continue to travel proximally through a second range of longitudinal motion, wherein fine helical threads (226) engage knob (130) to provide a relatively slow rate of translation. Thus, trocar actuation rod (220) will translate proximally in a series of rapid translations based on the engagement between coarse helical threads (224) and nut (160) followed by the engagement between fine helical threads (226) and knob (130).

[0191] It will be appreciated that when anvil (400) is coupled to trocar (330), rotation of knob (130) will provide a corresponding translation of the anvil relative to stapling head assembly (300). It will also be appreciated that knob (130) can be rotated in a first angular direction (e.g., clockwise) to retract anvil (400) toward stapling head assembly (300); and can be rotated in a second angular direction (e.g., counterclockwise) to advance anvil (400) away from stapling head assembly (300). Thus, knob (130) can be used to adjust the gap distance (d) between opposing surfaces (412, 322) of anvil (400) and stapling head assembly (300) until a suitable gap distance (d) is achieved, such as Fig.27C As shown and described in more detail below.

[0192] B. Exemplary Suturing Head Actuation Assembly

[0193] Figures 19 to 26D Various components operable to actuate the suturing head assembly (300) are shown. These components include a motor (161), a gearbox (162), a rotating cam member (700), a cam follower (1600), a drive bracket (250), and a suturing head assembly driver (240). The gearbox (162) is coupled to the drive shaft of the motor (161) and is also coupled to the cam member (700). Thus, activation of the motor (161) causes the cam member (700) to rotate via the gearbox (162). By way of example only, the gearbox (162) may include a multi-stage planetary gearbox. Other suitable configurations that may be used for the gearbox (162) will be apparent to one of ordinary skill in the art in light of the teachings herein. The cam member (700) is configured to interact with the cam follower (1600) to pivot the cam follower (1600) about the pin (118) in two angular directions, as will be described in more detail below. Pin (118) is coupled to a base (eg, base (3690) as shown, including left and right base portions (3691, 3693) located within housing (110). Bushing (701) provides rotational support to cam member (700) relative to the base in housing (110).

[0194] The cam follower (1600) is pivotally coupled to the drive bracket (250) via a pair of integral pins (1602) which are received in complementary recesses (252) of the drive bracket (250). Figure 20 to Figure 21 As shown, the cam follower (1600) includes a first support feature (1604) and a second support feature (1610). The first support feature (1604) is composed of a rounded horizontally extending surface. The second support feature (1610) is formed to resemble a quarter-pie shape defined by a straight vertical surface (1612), a horizontally extending surface (1614), and a curved surface (1616). The second support feature (1610) protrudes proximally relative to the first support feature (1604).

[0195] Figure 22 to Figure 23The cam member (700) is shown in more detail. The cam member (700) includes a distal side (702), a distally protruding post (704), and an outer circumferential surface (706). A first cam feature (710) and a second cam feature (720) protrude distally from the distal side (702). The post (704) engages the bushing (701). The first cam feature (710) includes a first surface area (712), a second surface area (714), and a third surface area (716). The first surface area (712) is convexly defined by a relatively large radius of curvature, so that the first surface area (712) is almost flat. The second surface area (714) is convexly defined by a gradually increasing radius of curvature. The third surface area (716) is concavely defined by a relatively large radius of curvature. In addition to protruding distally from the distal side (702), the second cam feature (720) also protrudes outward from the outer circumferential surface (706). The second cam feature (720) includes a first surface region (722) and a second surface region (724). The first surface region (722) is substantially flat, while the second surface region (724) is concavely curved. The origin of the radius of curvature of each curved surface region (712, 714, 716, 724) is offset relative to the center of the post (704).

[0196] FIG. 24A to FIG. 24B The overall interaction between the cam follower (1600) and the first and second cam features (710, 720) is shown, but this interaction will be referred to below. FIG. 14A to FIG. 1 4D is described in more detail. When the cam member (700) is moved from Fig.24A Rotate the position shown to Fig. 24B In the position shown, the first cam member (710) compresses the first bearing feature (1604) of the cam follower (1600), causing the cam follower to pivot about the pin (118). FIG. 24A to FIG. 24B In the view shown, when the cam member (700) is moved from Fig.24A Rotate the position shown to Fig. 24B In the position shown, the cam follower (1600) pivots in a counterclockwise direction. FIG. 24A to FIG. 24B As can be seen in the transition of , this counterclockwise pivoting of the cam follower (1600) drives the drive bracket (250) and the stapling head assembly driver (240) distally, thereby actuating the stapling head assembly (300). As the cam member (700) continues to move toward Fig.24AWhen the cam member (720) is rotated back in the same direction from the position shown, the second cam member (720) engages and compresses the second bearing feature (1610) of the cam follower (1600), causing the cam follower (1600) to pivot in a clockwise direction about the pin (118). This clockwise pivoting of the cam follower (1600) about the pin (118) causes the drive carriage (250) and the stapling head assembly driver (240) to move toward the Fig.24A The position shown is retracted proximally.

[0197] See again Figure 22 to Figure 23 , the third cam feature (730) protrudes outward from the outer circumferential surface (706). The third cam feature (730) includes a first surface area (732) and a second surface area (734). The first surface area (732) is flat and oriented generally tangentially relative to the outer circumferential surface (706). The second surface area (732) is also flat and oriented radially outward relative to the outer circumferential surface (706). The third cam feature (730) is configured to interact with a rocker arm member (800). The rocker arm member (800) includes an integral pin (802), a support member (804) and a paddle (806). The pin (802) is pivotally coupled to a base in the housing (110) such that the rocker arm member (800) is pivotally coupled to the housing (110) about a longitudinal axis defined by the pin (802). The support member (804) is configured to interact with the third cam feature (730), as will be described in more detail below. The paddle (806) is configured to actuate the switch button (192) of the motor stop module (190), as will also be described in more detail below.

[0198] Fig.25A Shown with Fig.24A The cam member (700) is shown in the same position. At this stage, the second surface area (734) of the third cam feature (730) is adjacent to the support member (804) of the rocker arm member (800). Fig.25B Cam member (700) is shown in a position where cam member (700) has been rotated past Fig. 24B Position shown and facing Fig.24A However, the cam member (700) has not completed a full revolution. Fig.25BAt the stage shown, the first surface area (732) has engaged and compressed the support member (804), thereby causing the rocker member (800) to pivot about the longitudinal axis defined by the pin (802). This has caused the paddle (806) to actuate the switch button (192) of the motor stop module (190). When the switch button (192) is actuated, the motor stop module (190) reverses the polarity of the power supplied to the motor (161). This results in stopping the activation of the motor (161) once the actuation stroke of the suture head assembly (300) has been completed. By way of example only, the motor stop module (190) may be constructed and operated according to at least some of the teachings of U.S. Patent No. 9,907,552, published on March 6, 2018, the disclosure of which is incorporated herein by reference. With reference to the teachings herein, other suitable configurations will be apparent to those of ordinary skill in the art.

[0199] FIG. 26A to FIG. 26D The diagram schematically illustrates the interaction between the features of the cam member (700), the cam follower (1600), and the rocker arm member (800) as the cam member (700) rotates. FIG. 26A to FIG. 26D In each stage shown, the rotation of the cam member (700) is driven by the motor (161) and the gear box (162). Fig.26A Shown with Fig.24A and Fig.25A 1 and 12. The cam member (700) is shown in the same position. At this stage, the first bearing feature (1604) of the cam follower (1600) is positioned on the first surface area (712) and the bearing member (804) or rocker member (800) is adjacent to the second surface area (734) of the third cam feature (730). Also at this stage, the knife member (340) and the staple drive member (350) are in the proximal position, so that the stapling head assembly (300) is in a non-actuated state. When the cam member (700) is rotated to Fig.26B In the position shown, the second surface area (714) compresses the support member (1604), thereby driving the support member (1604) upward. This causes the cam follower (1600) to pivot about the pin (118) to Fig. 24B Thus, the cam follower (1600) drives the knife member (340) and the staple drive member (350) distally via the drive bracket (250) and the stapling head assembly driver (240). Fig.26B The stage shown is in the actuated state. In some versions, cam member (700) is rotated through an angular range of approximately 270° in order to transition stapling head assembly (300) from the non-actuated state to the actuated state.

[0200] After the stapling head assembly (300) has been actuated, the cam member (700) continues to rotate to Fig.26C At this stage, the first surface area (722) of the second cam member (720) begins to engage the curved surface (1616) of the second bearing feature (1610) of the cam follower (1600). As the cam member (700) continues to rotate to Fig.26D In the position shown, the second surface area (724) engages the curved surface (1616) of the second support feature (1610), thereby driving the second support feature (1610) downward. This causes the cam follower (1600) to move about the pin (118) from Fig. 24B The position shown is towards Fig.24A Thus, cam follower (1600) drives knife member (340) and staple drive member (350) proximally via drive bracket (250) and stapling head assembly driver (240). In addition, first surface area (732) has engaged and compressed support member (804), causing rocker arm member (800) to move in a proximal direction. Fig.26D The stage shown is pivoted about a longitudinal axis defined by pin (802). Fig.26D Zhongyu Fig.25B Therefore, the motor stop module (190) has been Fig.26D The phase shown is actuated.

[0201] It should be understood from the above that cam member (700) is operable to drive knife member (340) and staple drive member (350) distally, then drive knife member (340) and staple drive member (350) proximally and by FIG. 26A to FIG. 26D The cam member (700) is provided to actuate the motor stop module (190) by rotating in a single angular direction within the range of motion shown in FIG. FIG. 26A to FIG. 26D The complete sequence of operation is shown and described above by rotating through an approximately 355° range of angular motion. More specifically, and by way of further example only, a first 270° rotation of cam member (700) may provide distal movement of knife member (340) and staple drive member (350); while a remaining 85° rotation of cam member (700) may provide proximal movement of knife member (340) and staple drive member (350) and actuation of motor stop module (190). Other suitable ways in which knife member (340), staple drive member (350), and motor stop module (190) may be actuated will be apparent to one of ordinary skill in the art in view of the teachings herein.

[0202] C. Exemplary Clamp and Firing Sequences

[0203] FIG. 27A to FIG. 27E An apparatus (10) is shown for forming an anastomosis (70) between two tubular anatomical structures (20, 40). By way of example only, the tubular anatomical structures (20, 40) may include a segment of a patient's esophagus, a segment of a patient's colon, other segments of a patient's digestive tract, or any other tubular anatomical structure. Fig.27A As shown, anvil (400) is positioned in one tubular anatomical structure (20), and suturing head assembly (300) is positioned in another tubular anatomical structure (40). In versions where tubular anatomical structures (20, 40) include segments of a patient's colon, suturing head assembly (300) may be inserted via the patient's rectum. It should also be understood that FIG. 27A to FIG. 27E The procedure shown is an open surgical procedure, although the procedure may alternatively be performed laparoscopically. Various suitable ways in which instrument (10) can be used to form anastomosis (70) during laparoscopic surgery will be apparent to those of ordinary skill in the art in view of the teachings herein.

[0204] like Fig.27A As shown, the anvil (400) is positioned in the tubular anatomical structure (20) so that the handle (420) protrudes from the open severed end (22) of the tubular anatomical structure (20). In this example, the purse-string suture (30) is arranged around the middle area of ​​the handle (420) to generally fix the position of the anvil (400) in the tubular anatomical structure (20). In some other variations, the purse-string suture (30) is tightened around the proximal end of the handle (420). In some such variations, the proximal end of the handle (420) may include a notch or other feature to securely capture the purse-string suture (30). Continuing with this example, the suture head assembly (300) is positioned in the tubular anatomical structure (40) so that the cannula needle (330) protrudes from the open severed end (42) of the tubular anatomical structure (20). The purse-string suture (50) is disposed around the middle region of the shaft (332) to substantially fix the position of the suture head assembly (300) in the tubular anatomical structure (40). The suture head assembly (300) is then pushed distally to ensure that the suture head assembly (300) is fully seated at the distal end of the tubular anatomical structure (40).

[0205] Next, anvil (400) is secured to trocar (330) by inserting trocar (330) into aperture (422), as shown. Fig.27BAs shown. Latching member (430) engages head (334) of trocar (330), thereby providing a secure fit between anvil (400) and trocar (330). The operator then rotates knob (130) while holding housing (110) stationary via pistol grip (112). This rotation of knob (130) causes trocar (330) and anvil (400) to retract proximally. Fig.27C As shown, this proximal retraction of the trocar (330) and the anvil (400) compresses the tissue of the tubular anatomical structure (20, 40) between the anvil (400) and the surface (412, 322) of the suturing head assembly (300). When this occurs, the operator can observe tactile resistance or feedback via the knob (130) as the knob (130) is turned, wherein such tactile resistance or feedback indicates that the tissue is being compressed. When the tissue is compressed, the operator can visually observe the position of the needle (1526) within the user feedback feature (114) to determine whether the gap distance (d) between the opposing surfaces (412, 322) of the anvil (400) and the suturing head assembly (300) is appropriate; and make any necessary adjustments via the knob (130).

[0206] Once the operator has appropriately set the gap distance (d) via the knob (130), the operator actuates the safety trigger (140) (eg, Fig.30D The operator then actuates the firing trigger (150) (as shown in FIG. Fig.30E This causes the paddle (158) to actuate the switch of the motor start module (180), thereby actuating the motor to rotate the cam member (700) (as shown in FIG. FIG. 26A to FIG. 26D This rotation of the cam member (700) is achieved by Fig.27D The knife member (340) and the staple drive member (350) are shown to be driven distally to actuate the stapling head assembly (300). When the knife member (340) is translated distally, the cutting edge (342) of the knife member (340) cuts the excess tissue located within the annular recess (418) of the anvil (400) and the interior of the knife member (340).

[0207] like Figure 4 As shown, the anvil (400) of this example includes a breakaway washer (417) within an annular recess (418). Fig.27C The location shown to Fig.27DWhen the full range of distal motion is completed in the position shown, this washer (417) is broken by the knife member (340). When the knife member (340) reaches the end of its distal motion, the gradually increasing radius of curvature of the second surface area can provide an increased mechanical advantage, thereby providing a greater force to break the washer (417). Of course, in some versions, the breakable washer (417) can be completely omitted. In versions that include a washer (417), it should be understood that the washer (417) can also act as a cutting plate for the knife member (340) to cut tissue.

[0208] When the nail driving member (350) is Fig.27C The position shown is translated distally to Fig.27D When in the position shown, the staple driving member (350) drives the staples (90) through the tissue of the tubular anatomical structure (20, 40) and into the staple forming recesses (414) of the anvil (400). The staple forming recesses (414) deform the driven staples (90) into a "B" shape as known in the art; or into a three-dimensional shape as described above with respect to the anvil (500). Thus, the formed staples (90) secure the ends of the tissue together.

[0209] The operator has Fig.27D After actuating the suturing head assembly (300) as shown, the operator rotates the knob (130) to drive the anvil (400) distally away from the suturing head assembly (300), thereby increasing the gap distance (d) to facilitate the release of tissue between the surfaces (412, 322). The operator then removes the instrument (10) from the patient's body, with the anvil (400) still secured to the cannula needle (330). Referring again to the example in which the tubular anatomical structure (20, 40) includes a segment of the patient's colon, the instrument (10) can be removed via the patient's rectum. With the instrument (10) removed, the tubular anatomical structure (20, 40) is secured together at the anastomosis (70) by two annular arrays of staples (90), as shown. Fig.27E The inner diameter of the stapling portion (70) is defined by the severed edge (60) left by the knife member (340).

[0210] V. Exemplary Security Components

[0211] As described above, the knob (130) can be used to adjust the gap distance (d) between the opposing surfaces (412, 322) of the anvil (400) and the suture head assembly (300). Setting the appropriate gap distance (d) before actuating the suture head assembly (300) is crucial to the success of the anastomosis. For example, if the gap distance (d) is too large, the nails deployed at the anastomotic site may not be fully formed by the nail forming recesses (414). This may cause leakage at the anastomotic site, and in some cases may ultimately lead to separation of the anatomical lumen segments engaged at the anastomotic site. If the gap distance (d) is too small, the internal structure of the tissue compressed between the surfaces (412, 322) may be damaged to the extent that the structural integrity of the tissue is impaired. This can prevent the tissue from fully retaining the formed nails, which in turn may cause leakage or other failure of the anastomotic portion. It may therefore be desirable to provide the operator with some form of feedback indicating whether the gap distance (d) is within an appropriate range. It may also be desirable to prevent the operator from actuating the suture head assembly (300) unless the gap distance (d) is within an appropriate range.

[0212] A. Exemplary Trigger Blocking Features and Anvil Position Indicators

[0213] Figures 28 to 30E Components are shown that provide feedback to the operator to indicate that the gap distance (d) is within the proper range; and if the gap distance (d) is not within the proper range, the operator is prevented from actuating the stapling head assembly (300). FIG. 30B to FIG. 30C As best seen in Figure 1 , carriage (1500) is constructed and positioned to move in response to movement of trocar actuation rod (220). Fig.28 As best seen in the Figure 1 , the bracket (1500) includes a rigid body (1502) that defines a first slot (1504), a second slot (1506), and a third slot (1508). In some variations, the third slot (1508) is omitted. Fig.35 An example of this variation will be described.

[0214] In the present example, vertical member (1510) is positioned at the proximal end of body (1502) and defines opening (1512). Trocar actuation rod (220) extends coaxially through opening (1512). Fig.18As shown, the coil spring (170) is interposed between the proximal end of the vertical member (1510) and a rigid spacer feature defined by a base (e.g., base (3690) described below) located within the housing (110). The rigid spacer feature forms a support journal for the nut (160). The spacer is fixed within the base in the housing (110) and thereby provides a ground for the proximal end of the coil spring (170), so that the coil spring (170) resiliently applies a distal bias to the bracket (1500) via the vertical member (1510). The bracket (1500) also includes a laterally presented flange (1516) at the distal end of the body (1502). The flange (1516) defines a narrow slot (1514).

[0215] like FIG. 30B to FIG. 30C As best seen in FIG. 1 , indicator member ( 1520 ) is configured to pivot in response to translation of bracket ( 1500 ). Fig.29 As best seen in the accompanying drawings, the indicator member (1520) includes a vertical arm (1522), a snap-on pin (1524) that projects laterally from the lower end of the arm (1522), an indicator needle (1526) that projects laterally from the upper end of the arm (1522), and a coupling pin (1528) that projects laterally from the middle region of the arm (1522). The snap-on pin (1524) is configured to snap into a complementary recess provided by a base (e.g., a left base portion (3691) of a base (3690 described below) that is located within the housing (110). The snap-on pin (1524) thereby secures the indicator member (1520) to the base, but still allows the indicator member (1520) to pivot relative to the base about the longitudinal axis of the snap-on pin (1524). The indicator needle (1526) is positioned to be received by the handle assembly. The user feedback feature (114) of (100) is visible, thereby visually indicating the pivot position of the indicator member (1520). The coupling pin (1528) is slidably received in the slot (1514) of the flange (1516) of the bracket (1500). This engagement between the indicator member (1520), the base in the housing (110) and the bracket (1500) provides pivotal movement of the indicator member (1520) in response to translation of the bracket (1500).

[0216] The bracket (1500) is configured to selectively prevent and allow actuation of the triggers (140, 150). Specifically, the slots (1504, 1506) of the bracket (1500) are configured to selectively provide clearance for actuation of the triggers (140, 150). FIG. 30A to FIG. 30EAs shown, the safety trigger (140) is pivotally coupled to the first vertical member (144). The first vertical member (144) is coupled to a base (e.g., base (3690) described below) located within the housing (110) such that the first vertical member (144) is configured to translate upward in response to the safety trigger (140) pivoting toward the pistol grip (112). However, the body (1502) of the bracket (1500) is configured to prevent such movement of the first vertical member (144) and the safety trigger (140) by engaging the upper end (146) of the first vertical member (144). Thus, the body (1502) blocks movement of the first vertical member (144) and the safety trigger (140) until the bracket (1500) moves to a position where the slot (1506) is aligned with the upper end (146), thereby providing clearance for upward movement of the first vertical member (144). It should be appreciated, therefore, that safety trigger (140) cannot be pivoted toward pistol grip (112) until slot (1506) is positioned above upper end (146).

[0217] Similarly, firing trigger (150) is pivotally coupled to second upstand (154). Second upstand (154) is coupled to a base (e.g., base (3690) described below) located within housing (110) such that second upstand (154) is configured to translate upwardly in response to pivoting of firing trigger (150) toward pistol grip (112). However, body (1502) of bracket (1500) is configured to prevent such movement of second upstand (154) and firing trigger (150) by engaging upper end (156) of second upstand (154). Even if the safety trigger (140) is pivoted and retracted to otherwise allow movement of the firing trigger (150), the body (1502) prevents movement of the second upstand (154) and the firing trigger (150) until the cradle (1500) moves to a position where the slot (1504) is aligned with the upper end (156), thereby providing clearance for upward movement of the second upstand (154). It should be understood that, even if the safety trigger (140) is pivoted and retracted to otherwise allow movement of the firing trigger (150), the firing trigger (150) cannot pivot toward the pistol grip (112) until the slot (1504) is above the upper end (156).

[0218] The third slot (1508) is configured to receive a downwardly projecting boss (223) of the fixture (222) that is rigidly fixed to the trocar actuation rod (220). Although a base (e.g., base (3690) described below) located within the housing (110) is configured to allow the carriage (1500) to translate longitudinally relative to the base, the base includes rails, channels, and / or other features that prevent the carriage (1500) from rotating relative to the base. Thus, the positioning of the boss (223) in the slot (1508) prevents the fixture (222) and the trocar actuation rod (220) from rotating relative to the base. Nevertheless, the boss (223) and the slot (1508) still allow the carriage (1500) to translate longitudinally within the housing (110), as will be described in more detail below. As noted herein, the third slot (1508) is merely optional and may be omitted in some versions.

[0219] FIG. 30A to FIG. 30E The above components at various operation stages are shown. Fig. 30A 4, the trocar actuation rod (220) is in the most distal position, so that the trocar (330) is in the most distal position. At this stage, the operator can couple the anvil (400) to the trocar (330) by inserting the trocar (330) into the hole (422) until the latch member (430) is fixed to the head (334) of the trocar (330). The operator then rotates the knob (130), which rotates the nut (160). As the knob (130) and nut (160) are rotated, the engagement between the coarse helical threads (224) of the trocar actuation rod (220) and the complementary features of the nut (160) causes the trocar actuation rod (220) to retract proximally at a relatively rapid rate, causing the trocar actuation rod (220) to reach the distal end. Fig. 30B This proximal retraction of trocar actuation rod (220) provides for the retraction of trocar (330) and anvil (400). Fig. 30A Move to the position shown Fig. 30B In the position shown, the bracket (1500) remains stationary. This is due to the fact that the clamp (222) is Fig. 30A The stage shown is spaced apart from riser (1510) and does not engage riser (1510) until trocar actuation rod (220) reaches Fig. 30B to the position shown.

[0220] On arrival Fig. 30B After the stage shown, the operator may continue to rotate knob (130) and nut (160), which causes trocar actuation rod (220) to further retract proximally, as shown. Fig. 30CThis will inevitably cause the trocar (330) and anvil (400) to retract further toward the proximal side. Fig. 30B Move to the position shown Fig. 30C When the bracket (1500) is in the position shown, the clamp (222) squeezes the bracket (1500), thereby driving the bracket (1500) proximally. This proximal movement of the bracket (1500) causes the indicator member (1520) to be moved from the bracket (1500) due to the positioning of the pin (1528) in the slot (1514) of the flange (1516). Fig. 30B The position shown pivots to Fig. 30C Position shown.

[0221] When the indicator member (1520) is Fig. 30B The position shown pivots to Fig. 30C When the position of the indicator needle (1526) is shown, the operator can observe the position of the indicator needle (1526) through the user feedback feature (114) of the handle assembly (100). As described in more detail below, in order to provide visual content for the indicator needle (1526), ​​a series of hash marks, colored areas and / or other fixed indicators are positioned adjacent to the user feedback feature (114), thereby facilitating the operator to assess the position of the needle (1526) within the user feedback feature (114). It should be understood that the position of the pointer (1526) within the user feedback feature (114) will indicate the longitudinal position of the cannula needle (330) and the anvil (400). Therefore, the position of the pointer (1526) within the user feedback feature (114) will indicate the gap distance (d) between the opposing surfaces (412, 322) of the anvil (400) and the suturing head assembly (300). While observing the position of pointer (1526) within user feedback feature (114), the operator can rotate knob (130) in a clockwise or counterclockwise direction to further retract or advance trocar (330) and anvil (400), thereby providing fine adjustment of gap distance (d) until the desired gap distance (d) is obtained within an appropriate range.

[0222] In order to Fig. 30C The stages shown provide fine control over the adjustment of gap distance (d), with trocar actuation rod (220) being in a longitudinal position where fine helical threads (226) engage complementary features of knob (130) and coarse helical threads (224) disengage complementary features of nut (160). In some versions, once trocar actuation rod (220) reaches Fig. 30BIn the longitudinal position shown (i.e., when clamp (222) first engages riser (1510)), coarse helical threads (224) disengage from nut (160) and fine helical threads (226) begin to engage knob (130). In some other versions, the transition from engagement via coarse helical threads (224) to engagement via fine helical threads (226) occurs at Fig. 30B The stages shown and Fig. 30C The transition from coarse to fine may occur at some time between the stages shown. Other suitable stages at which the transition from coarse to fine may occur will be apparent to one of ordinary skill in the art in light of the teachings herein. It should also be understood that some alternative versions of trocar actuation rod (220) may have only a single thread segment, wherein the pitch of the thread is consistent along the length of the thread. In other words, trocar actuation rod (220) need not necessarily have two different thread segments (224, 226) having different pitches.

[0223] exist Fig. 30C At the stage shown, the slot (1506) is aligned with the upper end (146) to provide clearance for upward movement of the first vertical member (144). Similarly, the slot (1504) is aligned with the upper end (156) to provide clearance for upward movement of the second vertical member (154). In the present example, the size and position of the slots (1504, 1506) are set so that the slots (1504, 1506) only provide clearance for upward movement of the vertical members (144, 154) when the gap distance (d) is within a clinically acceptable range. By way of example only, the "clinically acceptable range" of gap distance (d) may be between about 0.110 inches and about 0.040 inches. As another merely illustrative example, the "clinically acceptable range" of gap distance (d) may be between about 0.110 inches and about 0.020 inches. Even when the slots (1504, 1506) are as Fig. 30C As shown, the safety trigger (140) is positioned to provide clearance for upward movement of the vertical members (144, 154). Fig. 30C In the non-actuated position shown, the safety trigger (140) still prevents the firing trigger (150) from moving around the pin (152) ( Fig. 9 ) pivotal movement. Therefore, in order to enable the firing trigger (150) to move, the operator will need to first actuate the first safety trigger (140) around the pin (142) ( Fig. 9 )from Fig. 30C The position shown is actuated to Fig.30D Position shown.

[0224] like Fig.30D As shown, when the safety trigger (140) is Fig. 30C The position shown pivots to Fig.30DIn the position shown, the upper end (146) passes through the slot (1506). It should be understood that this movement of the upper end (146) FIG. 30A to FIG. 30B The stage shown is not possible (when gap distance (d) is too large) because body (1502) will physically prevent upward movement of riser (144), thereby physically preventing pivotal movement of safety trigger (140). In the present example, a cover (not shown) incorporated into knob (130) prevents knob (130) from rotating to the point where anvil (400) is retracted too far proximally (causing gap distance (d) to be too small). In some other variations, even if knob (130) allows anvil (400) to be retracted too far proximally (causing gap distance (d) to be too small), body (1502) will physically prevent upward movement of riser (144), thereby physically preventing pivotal movement of safety trigger (140) in the event that the operator retracts trocar (330) and anvil (400) too far proximally (causing gap distance (d) to be too small). Regardless of whether body (1502), knob (130), or some other feature prevents actuation when gap distance (d) is too small, it should be understood that instrument (10) only allows actuation of safety trigger (140) when gap distance (d) is within a clinically acceptable range.

[0225] As described above, safety trigger (140) is configured to prevent actuation of firing trigger (150) until safety trigger (140) has been actuated. Once safety trigger (140) has been actuated, the operator may remove firing trigger (150) from the firing chamber. Fig.30D The position shown is actuated to Fig.30E As shown in the location. Fig.30E As shown, as the firing trigger (150) is moved from Fig.30D The position shown pivots to Fig.30E In the position shown, upper end (156) passes through slot (1504). It should be understood that even in the absence of safety trigger (140), such movement of upper end (156) is FIG. 30A to FIG. 30B The stage shown is also not possible (when the gap distance (d) is too large) because the body (1502) will physically prevent the upward movement of the vertical member (154), thereby physically preventing the pivotal movement of the firing trigger (150). Therefore, even in the absence of the safety trigger (140), the firing trigger (150) may only be actuated when the gap distance (d) is within a clinically acceptable range.

[0226] The firing trigger (150) of the present example includes an integral actuating paddle (158). Fig.30D The position shown pivots to Fig.30EWhen the firing trigger (150) is moved from the firing position, the paddle (158) is pivoted forward. Fig.30D The position shown pivots to Fig.30E When in the position shown, it is possible to actuate Fig. 9 The motor starter module (180) is connected to the battery pack (120) and the motor (161), so that the motor starter module (180) is configured to provide power from the battery pack (120) to start the motor (161) in response to the paddle (158) actuating the switch of the motor starter module (180). Fig.30D The position shown pivots to Fig.30E When the suture head assembly (300) is in the position shown, the motor (161) will be activated. Such activation of the motor (161) will actuate the suture head assembly (300), as described in more detail below.

[0227] like Fig.31 As shown, the safety trigger (140) of this example includes a laterally extending pawl protrusion (141). The protrusion (141) is configured to cooperate with a corresponding pawl recess (not shown) of a portion of a base (e.g., the base (3690) described below) to selectively hold the safety trigger (140) in place. FIG. 30D to FIG. 30E In other words, the protrusion (141) is configured to prevent the safety trigger (140) from being turned from the upward flip position ( FIG. 30D to FIG. 30E ) to the flipped down position ( FIG. 30A to FIG. 30C However, the protrusion (141) enables the operator to intentionally turn the safety trigger (140) in the flipped-up position ( FIG. 30D to FIG. 30E ) and the flipped down position ( FIG. 30A to FIG. 30C )

[0228] Also like Fig.31 As shown, the first vertical member (144) defines a lateral notch (148) below the upper end (146) of the first vertical member (144). The lateral notch (148) is configured to be able to be turned when the safety trigger 140 is in the upward flip position ( FIG. 30D to FIG. 30E) provides clearance for longitudinal movement of the carriage (1500) thereafter, wherein the first vertical member (144) is in the upper position. For example, if the operator achieves the first longitudinal position of the anvil (400) and the trocar (330) while the anvil (400) is in the position of the "green zone" as described herein, the operator actuates the safety trigger (140) to the flip-up position, and then the operator again manipulates the knob (130) to reposition the anvil (400), the carriage (1500) will translate during this repositioning of the anvil (400). In the event that the operator repositions the anvil (400) outside of the "green zone", the carriage (1500) will be in a longitudinal position where the slot (1506) is no longer aligned with the upper end (146) of the first vertical member (144). Thus, in the event that the operator repositions the anvil (400) outside of the "green zone" after actuating the safety trigger (140) to the flipped-up position, the first vertical member (144) will not be sheared or otherwise damaged. If the anvil (400) is moved out of the "green zone" after the safety trigger (140) is actuated to the flipped-up position, the yoke (1500) will still prevent the firing trigger (150) from being actuated because the slot (1504) is not aligned with the upper end (156) of the second vertical member (154) when the anvil (400) is outside of the "green zone".

[0229] B. Exemplary User Interface Features

[0230] As described above, when the indicator member (1520) is Fig. 30B The position shown pivots to Fig. 30C When the position shown in FIG. 1 is reached, the operator may observe the position of indicator needle (1526) within user feedback feature (114) of handle assembly (100). Fig.32 As best seen in Figure 1 , the user feedback feature (114) of the present example includes a graphical indicator (3550) that includes fixed linear indicia (3552, 3554, 3556), graphical representations of staples (3560, 3562), and a check mark graphic (3564). The user feedback feature (114) further defines a window (3570) through which the indicator needle (1526) is viewable. In some variations, the user feedback feature (114) further includes a field (3566) that may indicate a diameter associated with a size of the stapling head assembly (300), a size of the staples in the stapling head assembly (300), a size of the gap defined between the anvil (400) and the stapling head assembly (300), and / or other information. By way of example only, the field (3566) may indicate a stapling head assembly (300) size of 23 mm, 25 mm, 29 mm, or 31 mm.

[0231] When the operator rotates the knob (130) to adjust the longitudinal position of the anvil (400) relative to the suture head assembly (300), the operator can observe the position of the indicator needle (1526) through the window (3570). Initially, the indicator needle (1526) may be positioned at or near the distal end of the window (3570). As the anvil (400) continues to move proximally, the indicator needle (1526) will eventually move proximally relative to the window (3570). The operator can observe the position of the indicator needle (1526) relative to the fixed linear markers (3552, 3554, 3556). The most distal marker (3552) and the most proximal marker (3556) may represent the boundaries of the "green zone", which is an acceptable range of distances between the anvil (400) and the suture head assembly (300) for successfully actuating the suture head assembly (300). Thus, if indicator needle (1526) is located distally of the most distal marking (3552), the distance between anvil (400) and stapling head assembly (300) is too large; whereas, if indicator needle (1526) is located proximal to the most proximal marking (3556), the distance between anvil (400) and stapling head assembly (300) is too small. Marking (3554) is longitudinally positioned between markings (3552, 3556). Graphic representation (3560) indicates a relatively taller formed staple (e.g., for relatively thick tissue); whereas graphical representation (3562) indicates a relatively shorter formed staple (e.g., for relatively thin tissue). Thus, graphical representations (3560, 3562) may facilitate an operator to determine whether and how to achieve a desired formed staple height by selecting an appropriate corresponding spatial relationship between indicator needle (1526) and markings (3552, 3554, 3556) based on tissue observation or otherwise.

[0232] In the present example, window (3570) is illuminated via a light emitting diode (LED) (not shown), thereby further facilitating viewing of indicator needle (1526) in window (3570). Additionally, when stapling head assembly (300) completes a stapling and cutting cycle, check mark graphic (3564) is illuminated via another LED (not shown). Thus, the operator may further rely on the illumination of check mark graphic (3564) to confirm that the stapling and cutting cycle has been completed, thereby verifying that it is safe to advance anvil (400) distally away from stapling portion (70) and remove instrument (10) from the patient. By way of example only, the LED associated with window (3570) may be configured to emit white visible light, while the LED associated with check mark graphic (3564) may be configured to emit green visible light. In some versions, control circuit (2700) is configured to provide illumination of the LED associated with window (3570) upon insertion of battery pack (120) into housing (110).

[0233] C. Exemplary Hysteresis Avoidance Features

[0234] As mentioned above, indicator member (1520) and user feedback feature (114) cooperate to provide visual feedback to the operator indicating the longitudinal position of anvil (400) relative to stapling head assembly (300). One of ordinary skill in the art will recognize that precision and accuracy in this positioning may be critical to the successful formation of anastomosis (70). Therefore, the real-time accuracy of the feedback provided by indicator member (1520) and user feedback feature (114) may be critical to the successful formation of anastomosis (70).

[0235] Some versions of the carriage (1500) and indicator member (1520) may provide a degree of hysteresis such that there is a slight lag time between adjustment of the longitudinal position of the anvil (400) relative to the stapling head assembly (300) and the position of the indicator member (1520) in the user feedback feature (114). This hysteresis may be attributable to manufacturing tolerances and / or other factors. This hysteresis may compromise the real-time accuracy of the feedback provided by the indicator member (1520) and the user feedback feature (114), which in turn may compromise the success of the anastomosis (70). Therefore, it may be desirable to configure the carriage (1500), indicator member (1520), and associated features to eliminate or at least minimize such hysteresis, thereby promoting greater real-time accuracy of the feedback provided by the indicator member (1520) and the user feedback feature (114), thereby promoting a greater chance of success in the formation of the anastomosis (70).

[0236] Figures 33 to 39D Exemplary alternative features that may be incorporated into instrument (10) to facilitate greater real-time accuracy of visual feedback indicating the longitudinal position of trocar (330) and anvil (400) relative to the stapling head assembly are shown. Specifically, Figure 33 to Figure 34 An exemplary alternative indicator member (3600) that may be used in place of indicator member (1520) is shown; and Fig.35 An exemplary alternative bracket (3650) is shown that may be used in place of bracket (1500).

[0237] like Figure 33 to Figure 34As shown, the indicator member (3600) of this example includes a vertical arm (3604), a snap-on pin (3602) protruding laterally from the lower end of the arm (3604), an indicator needle (3606) protruding laterally from the upper end of the arm (3604), and a coupling pin (3608) protruding laterally from the middle area of ​​the arm (3604). The snap-on pin (3602) is configured to snap into a complementary recess provided by the base (3690), as described below. As described above with respect to the indicator needle (1526), ​​the indicator needle (3606) is positioned to be visible in the user feedback feature (114) of the handle assembly (100), thereby visually indicating the pivot position of the indicator member (3600), which will indicate the longitudinal position of the anvil (400) relative to the stapling head assembly (300). The coupling pin (3608) is configured to fit into the opening (3672) of the flange (3670) of the bracket (3650), as described below. As also described below, this engagement between the indicator member (3600), the base (3690) and the bracket (3650) provides pivotal movement of the indicator member (3600) in response to translation of the bracket (3650). Unlike the indicator member (1520) described above, the indicator member (3600) of this example includes a resilient arm (3610) that protrudes upward and is resiliently biased to define an oblique angle relative to the vertical arm (3604). As described in more detail below, the resilient arm (3610) is configured to interact with the base (3690) to provide a resilient angular bias to the indicator member (3600).

[0238] like Fig.35 As shown, the bracket (3650) of this example includes a rigid body 3656 that defines a first slot (3660) (which is similar to the first slot (1504) described above) and a second slot (3658) (which is similar to the second slot (1506) described above). An upstand (3652) (which is similar to the upstand (1510) described above) is positioned at the proximal end of the body (3656) and defines an opening (3654) (which is similar to the opening (1512) described above). The opening (3654) is sized to receive the trocar actuation rod (220); and the upstand (3652) is configured to engage the coil spring (170), just as the similar features of the bracket (1500) described above. The bracket (3650) also includes a distally presented flange (3670) that defines an opening (3672). Opening (3672) extends between distal edge (3674) and proximal edge (3676). Bracket (3650) includes a proximal portion and a distal portion.

[0239] like Fig.36As shown, and as mentioned above, the pin (3608) is configured to fit within the opening (3672) of the flange (3670). The width of the opening (3672) is greater than the width of the pin (3608) such that the pin (3608) cannot contact both edges (3674, 3676) at the same time. This structural relationship between the width of the opening (3672) and the width of the pin (3608) provides a certain degree of loss of motion between the bracket (3650) and the indicator member (3600), as described below with reference to FIG. 39A to FIG. 39D described.

[0240] Fig.37 An exemplary left base portion (3691) of a base (3690) that may be incorporated into the shaft assembly (100) is shown. The base (3690) is configured to provide mechanical grounding relative to a movable component of the handle assembly (100). The left base portion (3691) of the base (3690) of this example includes a distally presented ridge (3692) that is positioned to engage with the resilient arm (3610) of the indicator member (3600). Fig.37 As shown, snap pin (3602) is configured to be inserted into base (3690). Snap pin (3602) thereby secures indicator member (3600) to base (3690), but still allows indicator member (3600) to pivot relative to base (3690) about the longitudinal axis of snap pin (3602).

[0241] FIG. 38A to FIG. 38D Various angular positions of indicator member (3600) relative to base (3690) are shown as trocar (330) and anvil (400) are retracted proximally relative to stapling head assembly (300). Specifically, Fig.38A The indicator member (3600) is shown in a first angular orientation. This first angular orientation would be associated with the trocar (330) and anvil (400) being in a most distal position relative to the stapling head assembly (300). For example, this orientation may be associated with the trocar (330) and anvil (400) being in a most distal position relative to the stapling head assembly (300). Fig. 30A and Fig.27B . With indicator member (3600) in this first angular orientation, resilient arm (3610) is not in contact with ridge (3692) of base (3690) such that a gap is defined between resilient arm (3610) and ridge (3692).

[0242] As the operator rotates knob (130) to retract trocar (330) and anvil (400) proximally relative to stapling head assembly (300), carriage (3650) ultimately pulls pin (3608) proximally, thereby causing indicator member (3600) to pivot clockwise (in a clockwise direction) relative to base (3690). FIG. 38A to FIG. 38DDuring this clockwise pivoting motion, the resilient arm (3610) eventually contacts the ridge (3692) of the base (3690), as shown in FIG. Fig.38B As shown. Fig.38A and Fig.38B During the stage shown, resilient arm (3610) is in an unstressed state. However, as the operator continues to rotate knob (130) to retract trocar (330) and anvil (400) proximally relative to stapling head assembly (300), carriage (3650) continues to pull pin (3608) proximally, thereby causing indicator member (3600) to further rotate clockwise relative to base (3690). This results in deformation of resilient arm (3610), as shown in FIG. Fig.38C In this example, before anvil (400) reaches the "green zone" mentioned above, resilient arm (3610) contacts ridge (3692) and begins to deform.

[0243] In the elastic arm (3610) as Fig.38C In the deformed state shown, the resilient arm (3610) is in a stressed state, causing the indicator member (3600) to rotate in a counterclockwise direction (in FIG. 38A to FIG. 38D Regardless of the stressed state of resilient arm (3610), the operator may continue to rotate knob (130) to further retract trocar (330) and anvil (400) proximally relative to stapling head assembly (300), thereby causing indicator member (3600) to further pivot clockwise relative to base (3690), ultimately reaching Fig.38D 4. The state shown in FIG. 4 shows a state in which resilient arm (3610) is in a state of tension. At this stage, resilient arm (3610) may engage vertical arm (3604) such that resilient arm (3610) cannot be further deformed. In some versions, bracket (3650) may not be able to translate far enough proximally to prevent resilient arm (3610) from being squeezed against vertical arm (3604). When the operator reverses the rotation of knob (130) to advance anvil (400) distally while resilient arm (3610) is in a stressed state, resilient arm (3610) will drive indicator member (3600) to rotate counterclockwise.

[0244] As mentioned above, this structural relationship between the width of opening (3672) and the width of pin (3608) provides a certain degree of lossy motion between bracket (3650) and indicator member (3600). FIG. 39A to FIG. 39B Shown in. Fig.39A The bracket (3650) is shown in the most distal position. This operating state is similar to Fig.38AThe illustrated operating state corresponds to this. At this stage, the proximal edge (3676) of opening (3672) is engaged with pin (3608); and pin (3608) is spaced apart from the distal edge (3674) of opening (3672).

[0245] As carriage (3650) translates proximally with trocar (330) and anvil (400), carriage (3650) eventually reaches Fig.39B 3674 of the opening (3672) engages the pin (3608); and the pin (3608) is spaced apart from the proximal edge (3676) of the opening (3672). Fig.39A The stage shown transitions to Fig.39B During the stage shown, the indicator member (3600) has not yet pivoted. Fig.39A The position shown is translated to Fig.39B In the position shown, the indicator member (3600) remains stationary. FIG. 38A to FIG. 38D In the context of the stages shown, the indicator member (3600) is Fig.39A The stages shown and Fig.39B The indicated phase will remain Fig.38A In the present example, opening (3672) is sized and configured such that before anvil (400) has reached the distance associated with the "green zone" as described above, Fig.39B Pin (3608) will engage distal edge (3674) of opening (3672) as shown. Furthermore, resilient arm (3610) will contact ridge (3692) before anvil (400) has reached the distance associated with the "green zone" as described above. Thus, indicator pin (3606) will not be positioned proximal to the distal-most marking (3552) in user feedback feature (114) until indicator member (3600) has reached the distal edge (3674) of opening (3672). Fig.38B This arrival will not occur until the carriage (3650) has reached the position shown. Fig.39B to the position shown.

[0246] As carriage (3650) continues to translate proximally with trocar (330) and anvil (400), carriage (3650) eventually reaches Fig.39C The vertical position shown. Fig.39B The stages shown and Fig.39C During the range of motion between the stages shown, distal edge (3674) of flange (3670) compresses pin (3608) to drive pin (3608) proximally, thereby driving indicator member (3600) to Fig.39C The location shown. FIG. 39A to FIG. 39DThe base (3690) is omitted, but one of ordinary skill in the art will recognize that due to the elastic arms (3610) and ridges (3692) being Fig.39B The stage shown transitions to Fig.39C During the engagement between the stages shown, the resilient arm (3610) will be deformed (and therefore stressed). One of ordinary skill in the art will also recognize that Fig.39C The relationship between the bracket (3650) and the indicator member (3600) shown will be in accordance with FIG. 38B to FIG. 38D The transitions between the phases shown are associated with the full range of motion provided.

[0247] As mentioned above, after the anastomosis (70) has been formed, or when the operator is adjusting the gap distance (d) between the anvil (400) and the stapling head assembly (300), the operator can drive the cannula needle (330) and the anvil (400) distally. When this occurs, the carriage (3650) will also translate distally. This will cause Fig.39D Since the bracket (3650) is already in the proximal position (e.g., Fig.39C 3600). As a result, resilient arm (3610) is in a stressed state, thereby causing indicator member (3600) to pivot distally. Due to this resilient bias, pin (3608) remains engaged with distal edge (3674) of opening (3672) as yoke (3650) moves distally. As the operator continues to rotate knob (130) to drive trocar (330) and anvil (400) distally, the distally translated yoke (3650) allows resilient arm (3610) to move indicator member (3600) back toward FIG. 39A to FIG. 39B The indicator member (3600) reaches the pivot position shown. FIG. 39A to FIG. 39B After the pivot position shown, the distal edge (3674) disengages from the pin (3608) and the carriage (3650) can continue to translate distally through a range of motion before reaching Fig.39A The vertical position is shown.

[0248] In the present example, as trocar (330) and anvil (400) are retracted proximally toward stapling head assembly (300), Fig.39A The stages shown and Fig.39B the lossy movement between the bracket (3650) and the indicator (3600) between the stages shown, and Fig.38A The stages shown and Fig.38B The lossy motion between resilient arm (3610) and ridge (3692) between the stages shown removes hysteresis from the motion of indicator arm (3600). Likewise, as trocar (330) and anvil (400) are advanced distally away from stapling head assembly (300), Fig.39B The stages shown and Fig.39A the lossy movement between the bracket (3650) and the indicator (3600) between the stages shown, and Fig.38B The stages shown and Fig.38A The wasting motion between the resilient arm (3610) and the edge (3692) between the stages shown removes hysteresis from the motion of the indicator arm (3600). This wasting motion will occur when the anvil (400) is outside the "green zone" mentioned above during advancement and retraction. Thus, the wasting motion will reduce the likelihood that the operator will be misled into believing that the anvil (400) is in the "green zone" due to hysteresis, which may otherwise cause the indicator needle (3606) to remain between the markings (3552, 3556) when the anvil (400) is actually outside the "green zone".

[0249] VI. Exemplary Operation Routines

[0250] Although the above reference FIG. 27A to FIG. 27E The sequence described relates to how an operator may use the instrument (10) during a surgical procedure, but it should be understood that FIG. 27A to FIG. 27E Before, during, and after the illustrated procedure, there are various routines that may be performed within instrument (10). FIG. 40A to FIG. 40B Shown in FIG. 27A to FIG. 27E Various steps in exemplary process (4000) that may be performed by instrument (10) are shown before, during, and after the procedure. It should be understood that various steps of process (4000) are merely optional and may be omitted if desired.

[0251] In the present example, process (4000) begins with an operator inserting a battery pack (120) into a socket (116) of a handle assembly (100), as shown in block (4002). In some versions, inserting the battery pack (120) into the socket (116) automatically triggers one or more additional steps in process (4000). For example, as shown in block (4004), inserting the battery pack (120) into the socket (116) may automatically activate a discharge switch that begins discharging power from the battery pack (120) once the battery pack (120) is removed from the housing (110). By way of example only, such automatic discharge of power from the battery pack (120) may be provided in accordance with at least some of the other teachings herein. Additionally or alternatively, automatic discharge of power from the battery pack (120) may be provided in accordance with at least some of the following teachings. Other suitable ways to automatically discharge power from battery pack (120) when battery pack (120) is inserted into socket (116) will be apparent to those of ordinary skill in the art in view of the teachings herein. Alternatively, in some versions, the steps shown in block (4004) are simply omitted.

[0252] In addition to or as an alternative to automatically initiating the depletion of power from the battery pack (120), inserting the battery pack (120) into the socket (116) may also mechanically unlock the ability to retract the trocar (330) and anvil (400) proximally, as shown in box (4006). By way of example only, such unlocking of the ability to retract the trocar (330) and anvil (400) proximally may be provided in accordance with at least some of the other teachings herein. Other suitable ways in which the ability to retract the trocar (330) and anvil (400) proximally when the battery pack (120) is inserted into the socket (116) will be apparent to one of ordinary skill in the art in view of the teachings herein. Alternatively, in some versions, the steps shown in box (4006) are simply omitted.

[0253] It should also be appreciated that insertion of battery pack (120) into receptacle (116) may provide the necessary electrical connections within the circuit that actuates stapling head assembly (300), as indicated by block (4008). In other words, when battery pack (120) is not present, the circuit that actuates stapling head assembly will lack the necessary electrical connections. In some other versions, instrument (10) may be capable of receiving power from some other source such that a complete circuit operable to actuate stapling head assembly (300) may be formed without insertion of battery pack (120) into receptacle (116).

[0254] In some versions, inserting battery pack (120) into receptacle (116) may also mechanically unlock the ability to actuate safety trigger (140), as indicated at block (4010). Various suitable ways in which inserting battery pack (120) into receptacle (116) may mechanically unlock the ability to actuate safety trigger (140) will be apparent to those of ordinary skill in the art in view of the teachings herein. Alternatively, in some versions, the step shown in block (4010) is simply omitted.

[0255] Regardless of whether process (4000) ultimately includes the steps shown in boxes (4004, 4006, 4008, 4010) (or the extent to which they are included), process (4000) may continue by inserting anvil (400) into anatomical structure (20), as shown in box (4012). This step is also Fig.27A As shown above. FIG. 40A to FIG. 40B The process (4000) shown in FIG. 4 is followed by securing the anvil (400) to the trocar (330) as shown in block (4014). This step is also shown in FIG. Fig.27B As shown above. FIG. 40A to FIG. 40BThe process (4000) shown in FIG. 4 is then followed by the anvil (400) and the trocar (330) being retracted proximally to compress the tissue of the anatomical structure (20, 40), as shown in box (4016). This step is also Fig.27C As shown in FIG. 401 , the operator rotates the knob (130) to achieve the appropriate gap distance (d), as shown in box (4018). This step is also FIG. 30B to FIG. 30C and Fig.27C As shown above.

[0256] In some examples, the apparatus (10) includes an electromechanical feature that monitors the gap distance (d) and provides feedback to the operator related to the gap distance (d). By way of example only, such a feature may be provided in accordance with at least some of the other teachings of the present invention. With reference to the teachings herein, other suitable ways for the apparatus (10) to monitor the gap distance (d) and provide feedback to the operator about the gap distance (d) will be apparent to one of ordinary skill in the art. For those types of apparatus (10) having such capabilities, the process (4000) includes such monitoring of the gap distance (d), as shown in box (4020). In some other types, the steps shown in box (4020) are omitted. The apparatus (10) may provide auditory, visual and / or tactile feedback related to the gap distance (d), as shown in box (4022). In the event that the gap distance (d) is about to fall below a clinically acceptable range (i.e., the anvil (400) is too close to the stapling head assembly (300)), the instrument (10) may provide an indication to the operator that the anvil (400) needs to be advanced distally to increase the gap distance (d), as shown in box (4024). In some other versions, the step shown in box (4024) is omitted. Thus, some versions may lack an electromechanical feature that monitors the gap distance (d) and provides feedback to the operator related to the gap distance (d). In some such versions, a purely mechanical feature (e.g., an indicator needle (3606), etc.) may be used to monitor the gap distance (d) and provide feedback to the operator related to the gap distance (d).

[0257] Regardless of whether the instrument (10) includes an electromechanical feature that monitors the gap distance (d) and provides feedback to the operator regarding the gap distance (d), the bracket (1500) will move to a position that deactivates the actuation of the safety trigger (140) when the gap distance (d) reaches a clinically acceptable range, as shown in box (4026). This positioning of the bracket (1500) is also Fig. 30C Once the carriage (1500) has been moved to the unlocked position, the operator may actuate the safety trigger (140), as shown in box (4028). This actuation of the safety trigger (140) is also Fig.30DOnce the safety trigger (140) has been actuated, the operator may actuate the firing trigger (150), as shown in box (4030). This actuation of the firing trigger (150) is also Fig.30E As shown above.

[0258] Once the operator actuates the firing trigger (150), the instrument (10) will complete the actuation stroke of the stapling head assembly (300), as shown in box (4032), regardless of what the operator subsequently does with the firing trigger (150). In other words, once the operator actuates the firing trigger (150), the components that actuate the stapling head assembly (300), namely the motor (161) and the remaining components that couple the motor (161) to the stapling head assembly (300), will effectively be fully dedicated to actuating the stapling head assembly (300), even if the operator further manipulates the firing trigger (150). By way of example only, in accordance with at least some of the teachings of U.S. Patent No. 9,907,552, entitled “Control Features for Motorized Surgical Stapling Instrument,” issued on March 6, 2018, the disclosure of which is incorporated herein by reference, the instrument (10) may include components that are entirely dedicated to actuation of the stapling head assembly (300) in response to actuation of the firing trigger (150). Alternatively, in accordance with the teachings below, the instrument (10) may include components that provide entirely dedicated to actuation of the stapling head assembly (300) in response to actuation of the firing trigger (150).

[0259] The actuation stroke of the suturing head assembly (300) includes distal and proximal movement of various components, as shown in box (4034). This alternating movement FIG. 24A to FIG. 24B and FIG. 26A to FIG. 26D As shown above, distal motion is also Fig.27D As shown above.

[0260] In some versions of the instrument (10), the instrument (10) may include a feature that detects strain within the firing mechanism when the firing mechanism completes the actuation stroke of the suture head assembly (300), as shown in box (4036). By way of example only, such sensing may be provided in accordance with at least some of the other teachings of the present invention. Other suitable ways in which the instrument (10) may incorporate features that sense strain in the firing system will be apparent to one of ordinary skill in the art in view of the teachings herein. Alternatively, these features may be omitted, thereby omitting the steps shown in box (4036). In the case of including such features, if the sensing feature detects that the strain has exceeded a threshold, the instrument (10) may provide an audible, visual, and / or tactile indication, as shown in box (4038). Of course, in some versions, the steps shown in box (4038) may be omitted.

[0261] In addition to or as an alternative to features that detect strain in the firing mechanism during the actuation stroke of the suturing head assembly (300), some versions of the instrument (10) may include a switch or other type of sensor that detects whether a portion of the firing mechanism has traveled a desired distance during the actuation stroke, as shown in box (4040). By way of example only, such sensing may be provided in accordance with at least some of the other teachings of the present invention. Other suitable ways in which the instrument (10) may incorporate features that sense whether the firing mechanism has completed sufficient travel will be apparent to one of ordinary skill in the art in view of the teachings herein. Alternatively, such features may be omitted, thereby omitting the steps shown in box (4040). In the case of including such features, the instrument (10) may provide an audible, visual, and / or tactile indication, as shown in box (4042), when the sensing features detect that the actuation stroke of the suturing head assembly (300) has been successfully completed.

[0262] Once stapling head assembly (300) has been successfully actuated, anvil (400) may be advanced distally from stapling head assembly (300), and instrument (10) may be removed from the patient, as indicated at block (4044). After instrument (10) has been removed from the patient, the operator may remove battery pack (120) from handle assembly (100), as indicated at block (4046).

[0263] As described above, the above steps of process (4000) are merely illustrative examples. With reference to the teachings herein, the apparatus (10) may be used in various other ways, which will be apparent to one of ordinary skill in the art. In addition, with reference to the teachings herein, the apparatus (10) may have various other functions, which will be apparent to one of ordinary skill in the art. It should be understood that some variations of the apparatus (10) may not be able to perform some steps of process (4000). In addition, some versions of the apparatus (10) may be able to perform steps not included in process (4000).

[0264] As described above with reference to block (4032), it may be desirable to ensure that the firing mechanism for the stapling head assembly (300) completes a full actuation stroke in response to actuation of the firing trigger (150). In other words, it may be desirable to prevent subsequent manipulation of the firing trigger (150) from having any effect on the firing mechanism completing the actuation stroke of the stapling head assembly (300). In some cases, the instrument (10) may incorporate a mechanical feature that ensures that the full actuation stroke of the stapling head assembly (300) is completed in response to actuation of the firing trigger (150), regardless of subsequent manipulation of the firing trigger (150). Examples of such mechanical features are described in U.S. Patent No. 9,907,552, entitled “Control Features for Motorized Surgical Stapling Instrument,” published on March 6, 2018, the disclosure of which is incorporated herein by reference. In addition to or as an alternative to the use of such mechanical features, instrument (10) may include electronic components that ensure that a full actuation stroke of stapling head assembly (300) is completed in response to actuation of firing trigger (150), regardless of subsequent manipulation of firing trigger (150). Several examples of such electronic features are described in greater detail below, while additional examples will be apparent to those of ordinary skill in the art in view of the teachings herein.

[0265] VII. Exemplary Battery Packs with Self-Discharge Features

[0266] Figures 41 to 57 An instrument (10) is shown that includes an exemplary battery pack (5600) that is configured to operate substantially similarly to the battery pack (120) described above, except for any differences discussed below. For example, as discussed above with reference to the battery pack (120), the battery pack (5600) is operable to provide power to the motor (161) in the pistol grip (112). The battery pack (5600) is removable from the handle assembly (100). Specifically, as described above with reference to the battery pack (120), the battery pack (5600) is operable to provide power to the motor (161) in the pistol grip (112). Figure 41 to Figure 42 and FIG. 45A to FIG. 45BAs shown, the battery pack (5600) can be inserted into a socket (116) defined by the housing (110). Once the battery pack (5600) is fully inserted into the socket (116), the latch (5602) of the battery pack (5600) can resiliently engage the internal features of the housing (110) to provide a snap-fit ​​engagement. To remove the battery pack (5600), the operator can press the latch (5602) inward to disengage the latch (5602) from the internal features of the housing (110), and then pull the battery pack (5600) proximally from the socket (116). It should be understood that the battery pack (5600) and the handle assembly (100) can have complementary electrical contacts, pins and sockets, and / or other features that provide a path for electrical communication from the battery pack (5600) to the electric components in the handle assembly (100) when the battery pack (5600) is inserted in the socket (116).

[0267] As in Fig.43 As best seen in the figure, the battery pack (5600) includes an upper battery housing (5610) and a lower battery housing (5620). The upper battery housing (5610) and the lower battery housing (5620) are configured to be secured to each other via ultrasonic welding (or using any other suitable technique) to provide a rigid housing surrounding a plurality of batteries (5630). The lower battery housing (5620) includes a positive battery contact (5622) configured to be connected to the positive terminal of the battery (5630) and a negative battery contact (5624) configured to be connected to the negative terminal of the battery (5630). The lower battery housing (5620) also includes a discharge contact (5626). The proximal end of the positive battery contact (5622) is biased toward the discharge contact (5626). As will be discussed in more detail below, the contact between the positive battery contact (5622) and the discharge contact (5626) is configured to discharge power from the battery (5630). Figures 46 to 57 Housing (110) of device (10) and upper housing (5610) and batteries (5630) of battery pack (5600) have been omitted to facilitate understanding of the operation of battery pack (5600).

[0268] The lower battery housing (5620) includes a battery discharge slide (5628) slidably disposed in a channel (5621) formed in the lower battery housing (5620), such that the battery discharge slide (5628) is configured to be able to translate longitudinally within the channel (5621) relative to the lower battery housing (5620). Figure 46 to Figure 48 As shown, in the initial position, the battery discharge slide (5628) is located in the channel (5621) between the discharge contact (5626) and the proximal end of the positive battery contact (5622) to prevent the discharge contact (5626) from contacting the positive battery contact (5622).

[0269] like Figures 49 to 50 As shown, when the battery pack (5600) is inserted into the socket (116) of the housing (110), the flange (111) of the right base portion (3693) of the base (3690) is directed toward the channel (5621) of the lower battery housing (5620) through the opening (5618) formed in the distal end of the lower battery housing (5620).

[0270] like Figure 51 to Figure 52 As shown, when the battery pack (5600) is further inserted into the socket (116) of the housing (110), the flange (111) further passes through the opening (5618) and enters the channel (5621), so that the proximal end of the flange (111) contacts the distal end of the battery discharge slide (5628).

[0271] like Figure 53 to Figure 54 As shown, when the battery pack (5600) is further inserted into the socket (116) of the housing (110) to the point where the battery pack (5600) is fully seated within the socket (116), the flange (111) further passes through the opening (5618) and enters the channel (5621), so that the flange (111) drives the battery discharge slide (5628) proximally within the channel (5621). In this position, the battery discharge slide (5628) is no longer located between the positive battery contact (5622) and the discharge contact (5626). However, the flange (111) is now positioned between the positive battery contact (5622) and the discharge contact (5626). It will therefore be appreciated that when the battery pack (5600) enters the receptacle (116), the battery discharge slide (5628) and flange (111) cooperate with each other to prevent contact between the positive battery contact (5622) and the discharge contact (5626).

[0272] As in Fig.54 As best seen in the figure, when the battery discharge slide (5628) is driven proximally, the pawl (5629) of the battery discharge slide (5628) engages with the pawl (5619) formed in the side wall of the channel (5621) to "lock" the battery discharge slide (5628) in the proximal position. Figure 55 to Figure 57As shown, when the battery pack (5600) is removed, the flange (111) is removed from the lower battery housing (5620) so that the flange (111) is no longer located between the positive battery contact (5622) and the discharge contact (5626). Therefore, when the battery discharge slide (5628) is in the proximal position, the proximal end of the positive battery contact (5622) contacts the discharge contact (5626) to discharge the power of the battery (5630). Therefore, it should be understood that the insertion and removal of the battery pack (5600) from the housing (110) will eventually exhaust the battery (5630). In other words, the battery pack (5600) will be exhausted after a single use. This power discharge will further eliminate the potential available energy from the battery contacts (5622, 5624) so ​​as to limit the chance of the battery pack (5600) igniting flammable materials when disposed.

[0273] Fig.58 An exemplary battery discharge circuit (5700) that can be used to discharge a battery (5630) is shown, as described above. As shown, the circuit (5700) of this example includes a discharge switch (5640) that is closed when the battery pack (5600) is inserted into the housing (110). In this example, the discharge switch (5640) remains open before the battery pack (5600) is initially inserted into the housing (110); and remains closed even after the battery pack (5600) is removed from the housing (110). When the discharge switch (5640) is closed, the battery (5630) is placed in communication with a pair of discharge resistors (5642). The discharge resistors (5642) are placed in series with each other and in parallel with the remaining circuit (2700) of the device (10). When the discharge switch (5640) is closed, the discharge resistor (5642) will continuously discharge power from the battery (5630). In some other variations, discharge switch (5640) remains open until battery pack (5600) is removed from housing (110). In other words, battery discharge circuit (5700) may be configured such that discharge switch (5640) is closed only when battery pack (5600) is removed from housing (110).

[0274] Likewise Fig.58As shown, the battery discharge circuit (5700) of this example also includes a fuse (5650). By way of example only, the fuse (5650) may include a positive temperature coefficient (PTC) current limiting device. The fuse (5650) can therefore control the current during the discharge of the battery (5630) so as to minimize any temperature rise in the battery pack (5600) and / or its components. For example, the fuse (5650) can be configured to limit the temperature of the battery pack (5600) and / or its components to below the ignition point of common materials encountered during use or disposal. Based on the teachings of this article, various suitable materials and configurations that can be used to form the fuse (5650) will be apparent to those of ordinary skill in the art.

[0275] VIII. Exemplary Startup Circuit

[0276] The firing trigger (150) is operable to start the motor (161) to thereby actuate the suturing head assembly (300). The safety trigger (140) is operable to selectively obstruct actuation of the firing trigger (150) based on the longitudinal position of the anvil (400) relative to the suturing head assembly (300). Thus, the firing trigger (150) may not be actuated until the safety trigger (140) has been actuated. The handle assembly (100) further includes a component operable to selectively lock both triggers (140, 150) based on the position of the anvil (400) relative to the suturing head assembly (300). When the triggers (140, 150) are locked, the safety trigger (140) is prevented from moving to allow actuation of the firing trigger (150), and the firing trigger (150) is prevented from initiating actuation of the suturing head assembly (300). Thus, firing trigger (150) can only be operated to initiate actuation of stapling head assembly (300) when the position of anvil (400) relative to stapling head assembly (300) is within a predetermined range. By way of example only, such a lockout feature may be constructed and operated in accordance with at least some of the teachings of U.S. Patent No. 10,307,157, entitled “Surgical Stapler with AnvilSeating Detection,” issued on June 4, 2019, the disclosure of which is incorporated herein by reference.

[0277] like FIG. 59A to FIG. 59B As best seen in FIG. 1 , the firing trigger (150) of the present example includes an integral actuation paddle (158). When the safety trigger (140) has been actuated to allow the firing trigger (150) to be actuated, the firing trigger (150) is actuated from the safety trigger (140). Fig.59A The position shown pivots to Fig.59BWhen the firing trigger (150) is moved from the firing position, the paddle (158) is pivoted forward. Fig.59A The position shown pivots to Fig.59B The position shown activates the switch (182) of the motor start module (180) (see Fig.60 The switch (182) of the motor starter module (180) is in communication with the battery pack (120) and the motor (161), so that the motor starter module (180) is configured to provide power from the battery pack (120) to start the motor (161) in response to the paddle (158) actuating the switch (182) of the motor starter module (180). Fig.59A The position shown pivots to Fig.59B When the suture head assembly (300) is in the position shown, the motor (161) is activated. Such activation of the motor (161) will actuate the suture head assembly (300) as described herein. By way of example only, such actuation may be implemented in accordance with at least some of the teachings of U.S. Publication No. 2016 / 0374666, entitled “Surgical Stapler with Reversible Motor,” published on December 29, 2016, the disclosure of which is incorporated herein by reference. Fig.60 Example ways in which motor activation module (180) may be integrated into control circuit (2700) are described in greater detail. Other examples will be apparent to those of ordinary skill in the art in view of the teachings herein.

[0278] As described above, paddle (806) is configured to actuate switch button (192) of motor stop module (190) at the end of the actuation stroke of suturing head assembly (300). In the present example, when switch button (192) is actuated, motor stop module (190) reverses the polarity of the power supplied to motor (161). This results in dynamic braking of motor (161) once the actuation stroke of suturing head assembly (300) has been completed. By way of example only, motor stop module (190) may be constructed and operated in accordance with at least some of the teachings of U.S. Patent No. 9,907,552, issued March 6, 2018, the disclosure of which is incorporated herein by reference. Other suitable configurations will be apparent to one of ordinary skill in the art in view of the teachings herein.

[0279] One of ordinary skill in the art will recognize that during normal use of the instrument (10), at least certain portions of the instrument (10) may be exposed to various fluids, including, but not limited to, patient fluids, saline, and the like. By way of example only, areas of the instrument (10) that may be most susceptible to liquid intrusion may include the stapling head assembly (300) and features on or near the underside of the handle assembly (100) where liquid may tend to collect after running down the shaft assembly (200). One of ordinary skill in the art will also recognize that when some circuit components are exposed to liquid, the performance of such circuit components may be impaired. For example, liquid may impair the function of some circuits and circuit components. In the case of surgical instruments similar to the instrument (10), impaired circuits may cause features (e.g., the motor (161) and, therefore, the stapling head assembly (300)) to activate prematurely, which may provide undesirable results. Therefore, it may be desirable to provide a version of the instrument (10) in which liquid intrusion into particular circuit components will not impair the performance of such circuits and circuit components by causing premature activation or other undesirable effects.

[0280] Although the following examples are provided in the context of instrument (10) variations, the same teachings may be readily incorporated into various other types of surgical instruments. Other types of instruments to which the following teachings may be applied will be apparent to those of ordinary skill in the art.

[0281] Fig.60 An exemplary control circuit (2700) that may be incorporated into the device (10) is shown. The circuit (2700) is configured such that liquid intrusion into the dome switch (2610) and the motor start module (180) will not impair the performance of the dome switch (2610), the motor start module (180), or the motor stop module (190). Therefore, the dome switch (2610) and the motor start module (180) are located within a liquid immune region (2750) of the circuit (2700). As shown, the circuit (2700) of this example includes a number of transistors (2710, 2712, 2714, 2716, 2718), a number of resistors (2720, 2722, 2724, 2726, 2728, 2730, 2732, 2734, 2736), a number of Schottky diodes (2740, 2742, 2744, 2746), a Zener diode (2748) and a capacitor (2749). As also shown, the battery pack (120), the motor (161), the motor start module (180), the switch button (192), the dome switch (2610) and the LEDs (2702, 2704) are also incorporated into the circuit (2700). In this example, the control circuit (2700) is configured to enable the current flowing to the dome switch (2610) to be less than the current flowing to the motor (161).

[0282] In this example, the transistor (2710), the motor starter module (180), and the resistors (2720, 2722) are all located within the liquid immune region (2750) of the circuit (2700). The transistor (2710) of this example has a relatively low voltage threshold and is in communication with the dome switch (2610), the motor starter module (180), and other components that are ultimately connected to the motor (161). In this example, the switch (182) of the motor starter module (180) is configured such that the switch (182) remains in a closed state by default. Therefore, when the paddle (158) engages the motor starter module (150) in response to the operator pivoting the firing trigger (180), the paddle (158) switches the switch (182) of the motor starter module (180) from a closed state to an open state.

[0283] Transistor (2710) and associated components of circuit (2700) are configured to provide activation of motor (161) only when the switch of motor activation module (180) is in an open state (which would indicate that firing trigger (150) has been fully actuated) and when dome switch (2610) is in a closed state (which would indicate that anvil (400) is properly coupled to trocar (330)). Thus, when the switch of motor activation module (180) is in a closed state (which would indicate that firing trigger (150) has not been fully actuated), motor (161) will not be activated, even if dome switch (2610) is in a closed state. Similarly, when dome switch (2610) is in an open state (which would indicate that anvil (400) is not properly coupled to trocar (330)), motor (161) will not be activated, even if the switch of motor activation module (180) is in an open state.

[0284] One of ordinary skill in the art will recognize that a switch that is flooded with liquid may tend to become damaged, which may have the effect of closing the switch prematurely. Thus, in an alternative version of the circuit (2700) in which the motor (161) is activated when the switch of the motor activation module (180) is switched from an open state to a closed state, liquid intrusion may damage the switch, thereby effectively providing a closed state before the firing trigger (150) is actuated. In other words, in an alternative version of the circuit (2700) in which the motor (161) is activated when the switch of the motor activation module (180) is switched from an open state to a closed state, liquid intrusion may result in premature activation of the motor (161), and therefore the suturing head assembly (300). However, by requiring the switch of the motor activation module (180) to be in an open state to provide activation of the motor (161), the circuit (2700) of the present example prevents the motor (161), and therefore the suturing head assembly (300), from being prematurely activated by liquid intrusion.

[0285] When dome switch (2610) is in an open state (i.e., when anvil (400) has not yet actuated dome switch (2610) as described above), transistor (2710) acts as a closed switch ("open"). When dome switch (2610) is in a closed state (i.e., when anvil (400) has actuated dome switch (2610) as described above), transistor (2710) will behave as an open switch ("closed"). One of ordinary skill in the art will recognize that because the emitter (the point connecting transistors (2714, 2716)) is connected to a 0V battery, the voltage threshold of transistor (2714) is equal to or greater than 0.7V. When the point where capacitor (2749), resistor (2728, 726) and transistor (2714) are connected exceeds this threshold, transistor (2714) will act as a closed switch ("open"), thereby allowing motor (161) to start.

[0286] In this example, transistor (2714) has a relatively low voltage threshold. Therefore, transistor (2714) is able to recognize the open state of switch (182) of motor start module (180) even if motor start module (180) is submerged in a conductive liquid, because the liquid provides sufficient resistivity so that it does not form the equivalent of a closed switch. The resistivity of the liquid will reduce the voltage but not to a level below the low voltage threshold of transistor (2710), thus allowing transistor (2710) to recognize that switch (182) has been opened.

[0287] In addition to or as an alternative to providing the configurations of circuit (2700) described above, various electronic components may be coated with a liquid-impermeable coating to provide at least a degree of immunity to liquid intrusion. For example, in some versions, one or more printed circuit boards (e.g., circuit boards on which LEDs (2702, 2704) are mounted) of circuit (2700) may be coated with a liquid-impermeable coating. Additionally or alternatively, either or both of LEDs (2702, 2704) may be coated with a liquid-impermeable coating. Other features of circuit (2700) that may be coated with a liquid-impermeable coating will be apparent to one of ordinary skill in the art in view of the teachings herein.

[0288] In some versions where a liquid-impermeable coating is used on one or more components of the circuit (2700), the liquid-impermeable coating may include a UV-cured polyurethane coating. In some versions, the liquid-impermeable coating is transparent. By making the coating transparent, this can maintain the legibility of the coated features (e.g., either or both of the LEDs (2702, 2704)) that are intended to be viewed. In addition, in versions where one or both of the LEDs (2702, 2704) are coated, the use of a transparent coating can prevent light emitted from the coated LEDs (2702, 2704) from being transmitted along the coating (i.e., "bleeding"). Various other suitable materials that can be used to provide such coatings and various methods that can be used to apply such coatings will be apparent to those of ordinary skill in the art in view of the teachings herein.

[0289] IX. Exemplary Conical Coil Springs

[0290] As described above, the instrument (10) may include a body (e.g., a handle assembly (100)), a shaft (e.g., a shaft assembly (200)), a suturing head assembly (e.g., a suturing head assembly (300)), and an anvil (e.g., anvil (400)). The shaft assembly (200) extends distally from the handle assembly (100), and the suturing head assembly (300) is positioned at the distal end of the shaft assembly (200). The handle assembly (100) includes a base (e.g., a base (3690) that may include a left base portion (3691) and a right base portion (3693)), a bracket (3650), and a coupling (e.g., a nut (160)).

[0291] Fig.61 Shows Fig.18 Detailed view of a coil spring (170) of FIG. As shown, the coil spring (170) includes a proximal end (6012), a distal end (6014), and a spiral coil (6016) disposed between the proximal end (6012) and the distal end (6014). The proximal end (6012) and the distal end (6014) can be ground to have flat ends.

[0292] It is desirable to prevent the distal end (6014) of coil spring (170) from potentially inadvertently becoming stuck (e.g., pinched) between bracket (3650) and base (3690) as coil spring (170) moves between the first position and the second position as safety trigger (140) is actuated. Additionally, it would be beneficial to ensure that coil spring (170) is properly installed within an instrument (e.g., instrument (10)). Thus, Fig.61The coil spring (170) is interchangeable with the first exemplary conical coil spring (6110), the second exemplary conical coil spring (6210), and the third exemplary conical coil spring (6310), as described below with reference to Figure 62 to Figure 65 In other words, conical coil springs (6110, 6210, 6310) may be used in place of coil spring (170) and may be suitably incorporated into instrument (10) without further modification.

[0293] A. First Exemplary Conical Coil Spring

[0294] Figure 62 to Figure 63 A first exemplary conical coil spring (6110) is shown. Fig.62 Shows Fig.17 A trocar actuating rod (220) Fig.18 The right base portion (3693) and the nut (160) of the base (3690) Fig.35 Bracket (3650), Fig.37 1 and 160. As previously described, the bracket (3650) (also referred to as the safety release plate) is configured to move between a first position and a second position relative to the left base portion (3691) and the right base portion (3693) of the base (3690) when selectively activated by a user. As described above, it is also contemplated that the bracket (1500) can be used in place of the bracket (3650). As shown, the conical coil spring (6110) is disposed between the bracket (3650) and the nut (160).

[0295] like Figure 62 to Figure 63 As shown, the conical coil spring (6110) includes a proximal end (6112), a distal end (6114), and a conical coil body (6115) disposed between the proximal end (6112) and the distal end (6114). The conical coil body (6115) includes a plurality of conical coils (6116). The conical coil spring (6110) includes at least one inactive coil (6118) disposed at the distal end (6114) of the conical coil spring (6110). An active coil is a coil that stores and releases energy (e.g., a conical coil (6116). In contrast, an inactive coil (i.e., a non-active coil) is a coil that does not store and release energy, so that the inactive coil does not contribute to the motive force of the coil spring. Fig.63Three dead coils (6118) are shown, however, more or fewer dead coils (6118) are contemplated. The dead coils (6118) can prevent the distal end (6114) of the conical coil spring (6110) from being inadvertently stuck (e.g., clamped) between the bracket (3650) and the base (3690). The dead coils (6118) are also configured to prevent the conical coil spring (6110) from getting stuck on the fine helical threads (226) of the cannula needle actuation rod (220). The dead coils (6118) can also help identify the orientation of the conical coil spring (6110) to ensure that the conical coil spring (6110) is properly installed in an instrument (e.g., instrument (10)).

[0296] like Figure 62 to Figure 63 As shown, the rearwardly curved portion (6120) generally disposed at the distal end (6114) is bent rearwardly by a distance (d1) toward the proximal end (6112). The rearwardly curved portion (6120) also ensures that the conical coil spring (6110) is properly installed in an instrument (e.g., instrument (10), and ensures that the instrument cannot be assembled incorrectly (where the proximal end (6112) or the distal end (6114) is disposed between the bracket (3650) and the left base portion (3691) of the base (3690)). Fig.63 Shows Fig.62 Detailed view of a conical coil spring (6110). The proximal end (6112) of the conical coil spring (6110) has a first circumference (C1a). Similarly, the distal end (6114) of the conical coil spring (6110) has a second circumference (C2a) that is smaller than the first circumference (C1a). The second circumference (C2a) that is smaller than the first circumference (C1a) enables the distal end (6114) of the conical coil spring (6110) having a diameter (D) to include a rearwardly curved portion (6120) that curves adjacent to the outer side (6122) of the conical coil body (6115) without protruding beyond the first circumference (C1a) of the proximal end (6112) of the conical coil spring (6110). Due to the conical shape, the conical coil spring (6110) can fit in the same space as the coil spring (170), even for the conical coil spring (6110) including the backward bent portion (6120).

[0297] like Fig.62 As shown, the nut (160) includes a proximal flange (6020) that is smaller than the first circumference (C1a) of the conical coil spring (6110). Fig.62As shown, the nut (160) includes a main body portion (6022) that is larger than the first circumference (C1a) of the conical coil spring (6110). The main body portion (6022) includes an opening (such as a proximal flange (6020) extending through the proximal flange (6020) of the nut (160) and the main body portion (6022) of the nut (160). Fig.18 3650) such that the opening is configured to receive a trocar actuation rod (220) therethrough. The proximal end of the trocar actuation rod (220) extends through an opening (3654) in the upright member (3652) of the carriage (3650) and through the conical coil spring (6110).

[0298] In lieu of or in addition to incorporating a tapered coil spring (6110, 6210, 6310) in place of coil spring (170), a weld (not shown) may fixably couple a distal end (6014) of coil spring (170) or a distal end (6114, 6214, 6314) of a tapered coil spring (6110, 6210, 6310) to bracket (3650). Similarly, although not shown, adjacent coils of the proximal end (6012) of coil spring (170) or the proximal end (6112, 6212, 6312) of the conical coil spring (6110, 6210, 6310) and / or adjacent coils of the distal end (6014) of coil spring (170) or the distal end (6114, 6214, 6314) of the conical coil spring (6110, 6210, 6310) may be welded together. Alternatively or in addition to incorporating a conical coil spring (6110, 6210, 6310) in place of coil spring (170), alternative spring ends may also be incorporated.

[0299] B. Second Exemplary Conical Coil Spring

[0300] Fig.64 A detailed view of a second exemplary conical coil spring (6210) is shown. As described above, the conical coil spring (6210) can be used to replace the coil spring (170) or the conical coil spring (6110). As shown, the conical coil spring (6210) includes a proximal end (6212), a distal end (6214), and a conical coil body (6215) disposed between the proximal end (6212) and the distal end (6214). The conical coil body (6215) includes a conical coil coil (6216). The conical coil spring (6210) includes at least one inactive coil (6218) disposed at the distal end (6214) of the conical coil spring (6210). Fig.64Two dead coils (6218) are shown, however, more or fewer dead coils (6218) are envisioned. The dead coil (6218) prevents the distal end (6214) of the conical coil spring (6210) from being inadvertently clamped between the bracket (3650) and the base (3690). The dead coil (6218) is also configured to prevent the conical coil spring (6210) from getting stuck on the fine spiral thread (226) of the cannula needle actuation rod (220). The dead coil (6218) can help identify the orientation of the conical coil spring (6210) to ensure the correct installation of the conical coil spring (6210). The proximal end (6212) of the conical coil spring (6210) has a first circumference (C1b). Similarly, the distal end (6214) of the conical coil spring (6210) has a second circumference (C2b) that is smaller than the first circumference (C1b). The second circumference (C2b) being smaller than the first circumference (C1b) ensures proper installation of the conical coil spring (6210).

[0301] C. Third Exemplary Conical Coil Spring

[0302] Fig.65 A detailed view of a third exemplary conical coil spring (6310) is shown. As described above, the conical coil spring (6310) can be used to replace the coil spring (170) or the conical coil spring (6110, 6210). As shown, the conical coil spring (6310) includes a proximal end (6312), a distal end (6314), and a conical coil body (6315) disposed between the proximal end (6312) and the distal end (6214). The conical coil body (6315) includes a conical coil coil (6316). The conical coil spring (6310) includes at least one inactive coil (6318) disposed at the distal end (6314) of the conical coil spring (6310). Fig.65Three dead coils (6318) are shown, however, more or fewer dead coils (6318) are envisioned. The dead coils (6318) prevent the distal end (6314) of the conical coil spring (6310) from being inadvertently clamped between the bracket (3650) and the base (3690). The dead coils (6318) are also configured to prevent the conical coil spring (6310) from getting stuck on the fine spiral threads (226) of the cannula needle actuation rod (220). The dead coils (6318) can help identify the orientation of the conical coil spring (6310) to ensure the correct installation of the conical coil spring (6310). The proximal end (6312) of the conical coil spring (6310) has a first circumference (C1c). Similarly, the distal end (6314) of the conical coil spring (6310) has a second circumference (C2c) that is smaller than the first circumference (C1c). The second circumference (C2c) being smaller than the first circumference (C1c) ensures proper installation of the conical coil spring (6310).

[0303] X. Additional Modifications

[0304] Alternatively or in addition to incorporating conical coil springs (6110, 6210, 6310) in place of coil spring (170), further modifications may be incorporated into instrument (10). Figures 66 to 74 As shown, these additional modifications may include an exemplary slidable coupling (6410), an exemplary guide bushing (6510), an exemplary centering feature (6612) on an exemplary bracket (6610), and / or an exemplary sleeve (6710). Other modifications are also contemplated. For example, although not shown, the left base portion (3691) may also include a cutout that is configured to prevent the distal end (6014) of the coil spring (170) or the distal end (6114, 6214, 6314) of the conical coil spring (6110, 6210, 6310) from being clamped.

[0305] like Fig.35 and Fig.66 As shown, the bracket (3650) is configured to move between a first position and a second position along a longitudinal axis when selectively activated by a user. The bracket (3650) includes a proximal portion (3678) and a distal portion (3680). The proximal portion (3678) includes an outward expansion portion (3682) arranged along the longitudinal axis. The proximal portion (3678) also includes a vertical member (3652) arranged perpendicular to the outward expansion portion (3682). The vertical member (3652) of the bracket (3650) includes an inner surface (3686) and an outer surface (3688) (see Fig.68 ).

[0306] A. Exemplary Slidable Couplings

[0307] Figure 66 to Figure 69 Various perspective views of the slidable coupling (6410) are shown. Specifically, Fig.66 The use of a slidable coupling (6410) and Fig.61 The spiral spring (170) is connected Fig.35 A perspective view of a bracket (3650) is provided. Fig.67 Shows Fig.66 Detailed perspective view of Fig.68 Shows Fig.66 The slidable connector (6410) is configured to retain the coil spring (170) and the distal end (6114) of the vertical member (3652). Figure 68 to Figure 69 As shown, the slidable coupling (6410) includes a body portion (6412) that can be shaped to generally correspond to the profile of the vertical member (3652). The slidable coupling (6410) includes a first arm (6414) and a second arm (6416) longitudinally spaced apart from the body portion (6412). As shown, the slidable coupling (6410) is integrally formed as a single piece. For example, the slidable coupling (6410) can be formed by one or more stamping operations (e.g., from a sheet of metal).

[0308] like Fig.69As shown, the first arm (6414) is connected to the main body (6412) by a first lateral portion (6418), and the second arm (6416) is connected to the main body (6412) by a second lateral portion (6420). The main body (6412) includes an arcuate upper portion (6422) including an arcuate opening (6424) configured to receive the proximal end of the cannula needle actuation rod (220). As previously described, the arcuate upper portion (6422) can be formed to roughly correspond to the profile of the vertical member (3652). The first arm (6414) and the second arm (6416) respectively include a first upwardly extending portion (6426) and a second upwardly extending portion (6428) and a first inner surface (6430) and a second inner surface (6432). As shown, the first inner surface (6430) and the second inner surface (6432) of the first arm (6414) and the second arm (6416) together with the inner surface (6434) of the main body portion (6412) are configured to be able to longitudinally retain the distal end (6014) of the coil spring (170) and the vertical member (3652) of the bracket (3650). Specifically, the inner surface (6434) of the main body portion (6412) is disposed against the inner surface (3686) of the vertical member (3652). In addition, the outer surface (3688) of the vertical member (3652) is disposed against the distal end (6014) of the coil spring (170), and the distal end (6014) of the coil spring (170) is also disposed against the first inner surface (6430) and the second inner surface (6432) of the first arm (6414) and the second arm (6416). Additionally, the first lateral portion (6418) and the second lateral portion (6420) center the coil spring (170) by defining the coil spring (170) in a direction perpendicular to the longitudinal direction.

[0309] The first lateral portion (6418) is Fig.69 The slidable coupling (6410) is partially obscured from view in the instrument (10) but is a mirror image of the second lateral portion (6420). This prevents lateral movement of the coil spring (170). In this way, the slidable coupling (6410) prevents the distal end (6014) of the coil spring (170) or the distal end (6114, 6214, 6314) of the tapered coil spring (6110, 6210, 6310) from being clamped. Alternatively or in addition, the slidable coupling (6410) may be incorporated into the instrument (10) to incorporate a tapered coil spring (6110, 6210, 6310) in place of the coil spring (170).

[0310] B. Exemplary Guide Bushings

[0311] Figure 70 to Figure 71 An exemplary guide bushing (6510) is shown. Fig.70 Shows Fig.17A trocar actuating rod (220) Fig.18 The nut (160) and the coil spring (170) and Fig.35 An exploded perspective view of the bracket (3650) and guide bushing (6510). Fig.71 Shows Fig.70 A detailed perspective view of the guide bushing (6510) of the nail. Fig.70 As shown, the guide bushing (6510) is configured to be connected between the vertical member (3652) and the coil spring (170). The guide bushing (6510) includes a generally annular body (6512). If desired, the guide bushing (6510) can be fixedly connected to the vertical member (3652) using a variety of methods (e.g., adhesive or welding). The body (6512) includes a first portion (6514) having a first outer diameter (OD1) and a second portion (6516) (e.g., a receiving portion) having a second outer diameter (OD2). The first outer circumference (OD1) is larger than the circumference (C) of the distal end (6014) of the coil spring (170), and the second outer circumference (OD2) is smaller than the circumference (C) of the distal end (6014) of the coil spring (170). The trocar actuating rod (220) is configured to pass through the opening (6518) of the guide bushing (6510). As shown, the second portion (6516) includes a protrusion (6018) configured to hold the distal end (6014) of the coil spring (170). As shown, the protrusion (6018) includes an arcuate surface (6522) that increases the outer diameter of the second portion (5614) moving toward the first portion (6514). In this way, the guide bushing (6510) can prevent the distal end (6014) of the coil spring (170) or the distal end (6114, 6214, 6314) of the conical coil spring (6110, 6210, 6310) from being clamped. Alternatively or in addition, the guide bushing (6510) can be incorporated into the instrument (10) to incorporate the conical coil spring (6110, 6210, 6310) instead of the coil spring (170).

[0312] C. Exemplary Centering Features

[0313] Fig.72 Shows Fig.62610 and an exemplary alternative bracket (6610) including an exemplary centering feature (6612). Bracket (6610) is similar to bracket (3650), but wherein bracket (6610) further includes a centering feature (6612). Similar to bracket (3650), bracket (6610) is shown as including an upright member (6652) similar to upright member (3652), an opening (6654) similar to opening (3654), an outward flare (6682) similar to outward flare (3682), and an outer surface (6688) similar to outer surface (3688). Other features of bracket (6610) are not shown, which may be similar or identical to bracket (3650).

[0314] As shown, the centering feature (6612) is disposed on the outer surface (6688) of the bracket (6610). The centering feature (6612) is configured to hold the distal end (6114) of the conical coil spring (6110). The centering feature includes a first protrusion (6614) and a second protrusion (6616). As shown, the first protrusion (6614) and the second protrusion (6616) are separated by an opening (6654). The first protrusion (6614) includes a first inner surface (6618), and the second protrusion (6616) includes a second inner surface (6620). The first inner surface (6618) and the second inner surface (6620) allow the trocar actuation rod (220) to pass through unimpeded. Although the centering feature (6612) is shaped as a cube, it is contemplated that the centering feature (6612) may have various shapes and sizes. The first protrusion (6614) and the second protrusion (6616) may be integrally formed as a single piece with the bracket (6610), or alternatively, the first protrusion (6614) and the second protrusion (6616) may be subsequently fixably coupled to the bracket (6610) using various methods (e.g., adhesives or welding). The centering feature (6612) may prevent the distal end (6114) of the conical coil spring (6110) from moving laterally (i.e., in a direction perpendicular to the longitudinal axis). In this way, the centering feature (6612) may prevent the distal end (6014) of the coil spring (170) or the distal ends (6114, 6214, 6314) of the conical coil springs (6110, 6210, 6310) from being clamped. Alternatively or in addition, centering feature (6612) may be incorporated into instrument (10) to incorporate a conical coil spring (6110, 6210, 6310) in place of coil spring (170).

[0315] D. Exemplary Sleeves

[0316] Figure 73 to Figure 74 An exemplary sleeve (6710) is shown. Fig.73 Shows Fig.62 A perspective view of the bracket (3650) and the conical coil spring (6110), but wherein the conical coil spring (6110) is partially disposed within the sleeve (6710). Fig.74 Shows Fig.73 Detailed perspective view of a conical coil spring (6110) and sleeve (6710). The sleeve (6710) includes a body (6712) having a proximal end (6714) and a distal end (6716). The body (6712) includes an inner surface (6718) and an outer surface (6720). The sleeve (6710) includes a proximal wall (6722) and an internal opening (6724) that is configured to allow the trocar actuation rod (220) to extend therethrough. The sleeve (6710) circumferentially surrounds the proximal end (6112) of the conical coil spring (6110) and is configured to prevent the proximal end (6112) (i.e., the tail) from being accidentally clamped. Alternatively or in addition, sleeve (6710) may be incorporated into instrument (10) to incorporate a conical coil spring (6110, 6210, 6310) in place of coil spring (170).

[0317] XI. Exemplary Base

[0318] A. Left base portion without longitudinal ribs

[0319] Figure 75 to Figure 77 Shows Fig.35 Various views of the bracket (3650) disposed within the left base portion (3691). Fig.76 Shows Fig.75 Detailed perspective view of the bracket (3650) and left base portion (3691). Fig.77 Shown from another angle Fig.76 1 and 1. A perspective view of the bracket (3650) and the left base portion (3691). As shown, the left base portion (3691) includes a first vertically extending rib (3696) and a second vertically extending rib (3698) extending substantially perpendicular to the longitudinal axis (LA).

[0320] B. Exemplary left base portion with longitudinal ribs

[0321] Figure 78 to Figure 79 An exemplary alternative left base portion (6750) is shown which is similar to left base portion (3691), but wherein left base portion (6750) includes longitudinal ribs (6756). Fig.78 Shows Fig.35 Rear elevation view of the bracket (3650) disposed within the left base portion (6750) of the longitudinal rib (6756). Fig.79 Shows Fig.78Right perspective view of the bracket (3650) and left base portion (6750).

[0322] The proximal portion (3678) of the bracket (3650) includes an outwardly flared portion (3682) disposed along the longitudinal axis (LA). The proximal portion (3678) also includes a vertical member (3652) disposed perpendicular to the outwardly flared portion (3682). The outwardly flared portion (3682) includes an outwardly flared distal surface (3684). The vertical member (3652) of the bracket (3650) includes an inner surface (3686) and an outer surface (3688). The left base portion (6750) includes a first vertically extending rib (6752) and a second vertically extending rib (6754) extending approximately perpendicular to the longitudinal axis (LA). The longitudinally extending rib (6756) extends approximately parallel to the longitudinal axis (LA) and is adjacent to the first vertically extending rib (6752). The longitudinally extending rib (6756) is configured to prevent the bracket (3650) from contacting the first vertically extending rib (6752). Thus, the longitudinal rib (6756) can prevent the bracket (3650) from being fixed (e.g., stuck). The second vertically extending rib (6754) is adjacent to the longitudinally extending rib (6756). The coil spring (170) or the conical coil spring (6110, 6210, 6310) is configured to be disposed between the vertical member (3652) of the bracket (3650) and the nut (160).

[0323] XII. Exemplary Guide Tracks

[0324] A. Guide rail without raised parts

[0325] Fig.80 Shown from another angle Fig.31 of Fig.18A perspective view of a protrusion (141) of a safety trigger (140) interacting with a right base portion (3693) of the present invention. As shown, the right base portion (3693) includes a protrusion (6812). The protrusion (6812) includes a guide track (6814). The guide track (6814) includes a first pawl (6816) and a second pawl (6818) separated by a channel (6820). The first pawl (6816) is configured to receive the protrusion (141) of the safety trigger (140) in a safe engagement position (i.e., a locked position). The second pawl (6818) is configured to receive the protrusion (141) of the safety trigger (140) in a safe disengagement position (i.e., a ready-to-fire position). The channel (6820) is configured to receive the protrusion (141) of the safety trigger (140) when the safety trigger (140) moves between the safe engagement position and the safe disengagement position. The safety trigger (140) is configured to transition from an engaged position preventing actuation of the instrument (10) to a disengaged position enabling actuation of the instrument (10) when selectively activated by a user.

[0326] In other words, the protrusion (141) is configured to cooperate with the first pawl (6816) of the right base portion (3693) to selectively hold the safety trigger (140) in the FIG. 30D to FIG. 30E The protrusion (141) is configured to prevent the safety trigger (140) from being in the upward flip position ( FIG. 30D to FIG. 30E ) to the flipped down position ( FIG. 30A to FIG. 30C ) of unintentional movement.

[0327] B. Exemplary Guide Tracks with Raised Portions

[0328] As previously referenced Fig.80 As described, the safety trigger (140) is configured to be able to transition from an engaged position that prevents actuation of an instrument (e.g., instrument (10)) to a disengaged position that enables actuation of the instrument when selectively activated by a user. It is desirable to allow the safety trigger (140) to be actuated only within a desired tissue gap range. The instrument (10) can be fired when the safety trigger (140) remains in an intermediate position (not within the first pawl (6816) and the second pawl (6818) of the guide track (6814). Therefore, it is desirable to prevent the safety trigger (140) from being able to be in an intermediate position, which may be outside the indicated desired tissue gap range. Preventing the safety trigger (140) from remaining in the intermediate position can be achieved by forcing the safety trigger (140) to only reach one of the following two acceptable positions: (1) a safe engaged position (i.e., locked), or (2) a safe disengaged position (i.e., ready to fire).

[0329] Fig.81A perspective view of a protrusion (141) of a safety trigger (140) interacting with an exemplary alternative right base portion (6910) is shown. The right base portion (6910) includes a protrusion (6912). The protrusion (6912) includes a guide track (6914). The guide track (6914) includes a first pawl (6916), a second pawl (6918), a channel (6920), and a protrusion (6922). Compared to an exemplary alternative right base portion (6910) that does not include a protrusion (6922), the right base portion (6910) includes a protrusion (6912). The protrusion (6912) includes a guide track (6914). The guide track (6914) includes a first pawl (6916), a second pawl (6918), a channel (6920), and a protrusion (6922). Fig.80 different, Fig.81 The guide track (6914) includes a raised portion (6922) that protrudes outwardly (e.g., upwardly) from the channel (6920). The raised portion (6922) is configured to push the safety trigger (140) to an engaged position or a disengaged position and not allow the safety trigger (140) to remain in an intermediate position. In other words, the raised portion (6922) of the guide track (6914) forces one of two discrete positions that force a binary on / off switch of the safety trigger 140 that prevents firing outside of a desired tissue gap range.

[0330] like Fig.81 As shown, the raised portion (6922) includes a peak (6924) that defines the farthest point at which the raised portion (6922) is disposed away from the surface of the channel (6920). As shown, the peak (6924) is centrally disposed (i.e., in the middle therebetween) between the first pawl (6916) and the second pawl (6918). The raised portion (6922) includes a first downwardly inclined surface (6926) that slopes downward from the peak (6924) to the first pawl (6916). Similarly, the raised portion (6922) includes a second downwardly inclined surface (6928) that slopes downward from the peak (6924) to the second pawl (6918). As shown, the first downwardly inclined surface (6926) slopes downward the entire distance between the peak (6924) and the first pawl (6916), and the second downwardly inclined surface (6928) slopes downward the entire distance between the peak (6924) and the second pawl (6918). The first downwardly inclined surface (6926) and the second downwardly inclined surface (6928) retain the safety trigger (140) in either the safely engaged position or the safely disengaged position. Thus, the raised portion (6922) forces the safety trigger 140 into one of only two acceptable positions: (1) the safely engaged position (i.e., locked), or (2) the safely disengaged position (i.e., cocked). This reduces the likelihood that the safety trigger (140) may remain in an intermediate position between the engaged and disengaged positions, which would be undesirable.

[0331] The first pawl (6916) is configured to receive the protrusion (141) of the safety trigger (140) in the safety engagement position (i.e., the locked position). The second pawl (6918) is configured to receive the protrusion (141) of the safety trigger (140) in the safety disengagement position (i.e., the ready-to-fire position). The raised portion (6922) is configured to receive the protrusion (141) of the safety trigger (140) when the safety trigger (140) moves between the engagement position and the disengagement position. As shown, the guide track (6914) is integrally formed as a single piece with the right base portion (6910).

[0332] XIII. Exemplary Safety Monitoring Features

[0333] As previously referenced FIG. 15A to FIG. 16B , Figure 28 to Figure 31 and FIG. 59A to FIG. 59B As shown, the various components are operable to permit and initiate the firing stroke of stapling head assembly (300) (see Figure 1 ). For example, these components may include the carriage (1500), the firing trigger (150), the safety trigger (140), and the dome switch (2610). More specifically, the motor (161) is configured to be activated and thereby actuate the drive carriage (250) in response to actuation of the dome switch (2610) that occurs only after the anvil (400) is properly attached to the cannula needle (330) and the firing actuation of the firing trigger (150) (which is only permitted after the safety trigger (140) is pivoted to the disengaged position). Therefore, in order to achieve a firing stroke (i.e., a suturing operation in which the knife member (340) and the staple drive member (350) have been extended distally and then retracted proximally via the drive carriage (250)), the dome switch (2610) and the firing trigger (150) must first be actuated. In some circumstances, it may be desirable to configure instrument (10) such that motor (161) initiates a firing stroke only in response to dome switch (2610) and firing trigger (150) being sequentially actuated, thereby preventing accidental premature firing of instrument (10). This exemplary configuration is described in more detail below.

[0334] Fig.82Another exemplary control circuit (7000) (or "motherboard") that may be incorporated into the apparatus (10) is shown. The control circuit (7000) may be included in place of the control circuit (2700) and may provide substantially the same or similar functionality unless otherwise described below. As shown, the control circuit (7000) of this example includes a number of transistors (7006, 7008, 7010), a number of resistors (7012, 7014, 7016, 7018, 7020, 7022, 7024, 7026), a number of Schottky diodes (7028, 7030, 7032, 7034, 7036, 7038), and a number of capacitors (7040, 7042, 7044, 7046, 7048, 7050, 7052, 7054). As also shown, the battery pack (120), motor (161), voltage regulator (7056), gate driver (7058), timer circuit (7002) including timing device (7060), and LEDs (7062, 7064) are also incorporated into the control circuit (7000).

[0335] In this example, the voltage regulator (7056) may include, for example, the MCP1702 low quiescent current LDO regulator manufactured by Microchip Technology Inc. The gate driver (7058) may include, for example, the SM74101 miniature 7A MOSFET gate driver manufactured by Texas Instruments. The timing device (7060), i.e., a component of the timer circuit (7002), may include, for example, the LMC555 CMOS low power timer manufactured by Texas Instruments or the STM6524 6-pin smart reset manufactured by STMicroelectronics NV. In addition, the control circuit (7000) may include a detachable firing circuit (or "firing pad") (shown in FIG. Fig.83 The circuit (7000) may further include a connector (7066) to a detachable stop circuit (or "stop board") (not shown) that generates and transmits a signal indicative of a firing actuation of firing trigger (150) to control circuit (7000), such as a signal generated by motor start module (180). Circuit (7000) may also include a connector (7068) to a detachable stop circuit (or "stop board") (not shown) that generates and transmits a signal indicative of a motor stop signal (such as a signal generated by motor stop module (190)) to circuit (7000).

[0336] Fig.83One exemplary version of a firing circuit (8000) is shown for coupling to a control circuit (7000) via a connector (7066) operable as a safety monitoring feature to ensure that dome switch (2610) (see FIG. 15A to FIG. 16B ) and a firing switch (150) (see FIG. 59A to FIG. 59B ) has been actuated in the correct timing sequence before the circular stapler (10) activates the motor (161) to complete the firing stroke. As shown, the firing circuit (8000) of this example includes a number of resistors (8002, 8004, 8006, 8008) and a capacitor (8010). As also shown, a transistor (8012), a sequential logic device (8014) and a firing switch (8016) are also incorporated into the firing circuit (8000). In this example, the transistor (8012) may include, for example, a BC847BW NPN general purpose transistor manufactured by Nexperia BV. The sequential logic device (8014) may include, for example, a 74LVC74A dual D-type flip-flop manufactured by NExperia BV. The firing switch (8016) may include, for example, a KSC441 tactile switch manufactured by C&K Components. Additionally, firing circuit (8000) may include connector (7066) to couple firing circuit (8000) to a detachable circuit, such as control circuit (7000) (or "motherboard") ( Fig.82 ), the detachable circuit (or "motherboard") may receive a signal from the firing circuit (8000) indicative of a firing actuation of the firing trigger (150), such as a motor start signal generated by a motor start module (180).

[0337] In some examples, firing circuit (8000) may be operably coupled to safety switch (8020). Safety switch (8020) may be included in place of dome switch (2610), but may be similar in structure and function to dome switch (2610), and thus may be compatible with switch assembly (2600) (see FIG. 15A to FIG. 16B ) for providing feedback to firing circuit (8000) regarding the positioning of anvil (400). Firing circuit (8000) is also operable to receive positioning feedback associated with firing trigger (150). As shown, firing switch (8016) is operably coupled to and switched by actuation of firing trigger (150), and thus may be included in place of a switch of motor activation module (180) (see FIG. 59A to FIG. 59B). Similar to the examples described herein, when anvil (400) is properly secured to trocar (330) and retracted proximally to activate safety switch (8020) as described herein, firing trigger (150) may be actuated to actuate firing switch (8016), thereby providing cutting and stapling of tissue. By way of example only, in accordance with at least some of the teachings of U.S. Patent No. 10,307,157, entitled “Surgical Stapler with Anvil Seating Detection,” published on June 4, 2019, the disclosure of which is incorporated herein by reference, instrument (10) may include components that are entirely dedicated to actuation of stapling head assembly (300) in response to actuation of firing trigger (150).

[0338] In some cases, it may be desirable to modify the circular stapler (10) to incorporate a safety monitoring feature operable to ensure that the safety switch (8020) is actuated prior to actuation of the firing switch (8016). Specifically, it may be desirable to ensure that the safety switch (8020) and the firing switch (8016) are actuated sequentially prior to the circular stapler (10) initiating a firing stroke in the event of a user error or mechanical failure of one or more firing system components (such as the firing trigger (150), the firing switch (8016), the safety switch (8020), the anvil (400), the flanges (2612, 2614), or other components that effect a successful firing stroke). As described in greater detail below, an exemplary safety monitoring feature in the form of a sequencing circuit or device may be included to ensure that the safety switch (8020) is actuated prior to actuation of the firing switch (8016). It should be appreciated that such safety monitoring features may be included to detect if a component of circular stapler (10) fails to operate properly, fails to prevent an unintended firing stroke, or fails to ensure safe and correct use of circular stapler (10) in the manner described above.

[0339] like Fig.83As shown, the sequential logic device (8014) may include a 74LVC74A dual D-type flip-flop manufactured by NExperia BV, which is a 14-pin analog integrated circuit that can act as a dual positive edge triggered logic device that can be operated to modify the output state when one or more clock pulse inputs transition from low to high. The sequential logic device (8014) may include a first latch (8017) that can be operated via pins 1-6 and a second latch (8018) that can be operated via pins 8-13. Pin 7 (not shown) and pin 14 (not shown) can be connected to a ground source and a voltage source, respectively. Pins 1-4 (8021, 8022, 8023, 8024) of the first latch (8017) can be operated as data inputs, and pin 5 (8025) can be operated as a true data output of the first latch (8017). Pins 10-13 (8026, 8027, 8028, 8029) of the second latch (8018) can operate as data inputs, and pin 8 (8030) can operate as a complementary data output of the second latch (8018).

[0340] like Fig.83As shown, input pin 3 (8023) ("clock" input) can be connected to transistor (8012). When the safety switch (8020) is actuated and the circuit is completed, transistor (8012) is activated, thereby providing a supply voltage to pin 3 (8023). When the "clock" input at pin 3 (8023) changes from a low clock supply voltage to a high clock supply voltage, when the safety switch (8020) is actuated, the first "edge-triggered" event combines with the high input at pin 1 (8021), the high input at pin 2 (8022) and the high input at pin 4 (8024), and the output at output pin 5 (8025) changes to a high output. The high output at pin 5 (8025) can be provided as an input to the second latch (8018) at input pin 13 (8029). Then, input pin 10 (8026), pin 12 (8028) and pin 13 (8029) are each connected to a high input voltage, and the second latch (8018) waits for a transition from a low voltage to a high voltage at the "clock" input pin 11 (8027) before changing the output at the complementary output pin 8 (8030), i.e., a second "edge triggered" event. Prior to receiving the second edge triggered event, the complementary output pin 8 (8030) maintains a high output voltage, which is opposite to the output voltage provided at the true data output pin 9 (not shown). Once the firing trigger (150) actuates the firing switch (8016), the firing switch (8016) moves from the inactive circuit position (8040) to the active circuit position (8042), thereby causing the "clock" input pin 11 (8027) to transition from a low voltage input to a high voltage input, i.e., a second edge triggered event. This transition causes the complementary output pin 8 (8030) to output a motor start signal (8032) that transitions from a high voltage output to a low voltage output. Fig.82 , the motor start signal (8032) can be operably connected to the gate driver (7058) and / or to the timing device (7060) to start the motor (161) and power it.

[0341] Fig.84 An exemplary method (9000) for operating a firing circuit of an electric surgical stapler, such as the firing circuit (8000) of the electric surgical stapler (10), is shown, as described herein. First, at step (9002), the safety switch (8020) and the firing switch (8016) are determined by the firing circuit (8000) to be in an unactivated state before the anvil (400) is closed or before the anvil (400) is attached to the trocar (330). For example, referring to Fig.83In the firing circuit (8000), if the transistor (8012) is operating in an open circuit state, or if the output voltage at pin 5 (8025) is in a low state, the safety switch (8020) can be determined to be in an unactuated state. If the firing switch (8016) is operating in an open circuit or closed circuit state, such as if the firing switch is in a non-active circuit position (8040), the firing switch (8016) can be determined to be in an unactuated state. If the firing circuit (8000) determines at this stage that either of the switches (8016, 8020) has been actuated, the circuit (8000) prevents the activation of the motor (161) for firing the stapling head assembly (300). If the control circuit (7000) determines affirmatively with respect to step (9002), the firing circuit (8000) proceeds to step (9004).

[0342] At step (9004), the firing circuit (8000) determines whether the safety switch (8020) is actuated, such as by the transistor (8012) operating in a closed circuit state, or the output voltage at pin 5 (8025) is in a high state. Upon determining that the safety switch (8020) has been actuated, the control circuit (7000) proceeds to step (9006). At step (9006), the firing circuit (8000) determines whether the safety switch (8020) is in an actuated state, such as by determining whether the firing switch (8016) is operating in a closed circuit (or "live circuit") state, for example, whether the firing switch (8016) is in an active circuit position (8042). Upon determining that the firing switch (8016) is in the actuated state, the firing circuit (8000) proceeds to step (9008) where the firing circuit (8000) determines whether the safety switch (8020) is actuated before or simultaneously with the firing switch (8016). This can be determined, for example, by utilizing a sequential logic device (e.g., a circuit) such as the sequential logic device (8014). As described above, the sequential logic device (8014) can be configured to first determine that the safety switch (8020) has been actuated by monitoring the first edge-triggered latch switch (8017), and then by utilizing the output of the first edge-triggered latch switch (8017) as an input to a second edge-triggered latch switch (8018), wherein the second edge-triggered latch switch (8018) is triggered by the actuation of the firing trigger (8016). Finally, at step (9008), and once the determination of step (9006) has been made and the timing actuation has been found to be correct, the firing circuit (8000) optionally sends a motor start signal to the motor (161) via the control circuit (2700, 7000).

[0343] XIV. Exemplary Soft Motor Starting Features

[0344] See again Fig.82 , a motor start signal (8032) is provided from the firing circuit (8000) to the circuit (7000) via the connector (7066). As shown, in addition to one or more other components that may include transistors (7008, 7010), the motor start signal (8032) may optionally be provided to one or both of a gate driver (7058) and a timer circuit (7060) for selectively powering the motor (161). In one example, the gate driver (7058) may include a SM74101 miniature 7A MOSFET gate driver manufactured by Texas Instrument, which may provide a gate drive current signal (7072) to power the motor (161).

[0345] In some cases, it may be desirable to modify the circular stapler (10) to incorporate a soft motor start feature operable to prevent a large current from being inrushed into the motor (161). If the voltage drops excessively, the control circuit (7000) components may not function properly and / or may lose power. Such an event may result in undervoltage and / or damage to the control circuit (7000) components, including the motor (161). As described in more detail below, an exemplary soft motor start feature in the form of a charging circuit may be included to ensure that the motor start signal more slowly starts the motor (161). Therefore, it should be understood that such a soft motor start feature may be included to more slowly charge the voltage of the motor start signal provided to the motor (161) in the manner described above.

[0346] Fig.85 A motor charging circuit (7070) is shown that can be incorporated into a control circuit (2700, 7000). The motor charging circuit (7070) receives a gate drive current signal (7072) configured to power a motor (161) and provides a motor braking output (7076) to a transistor (7008) configured to be activated to stop the motor (161), and provides a motor starting output (7074) to a transistor (7010) configured to be activated to start the motor (161). More specifically, when the gate driver (7058) provides a gate drive current signal (7072) indicating that the motor (161) is to be disabled, the transistors (7008, 7010) will receive the motor braking output (7076) and disable the motor (161). When the gate driver (7058) provides a gate drive current signal (7072) indicating that the motor (161) should be started, the transistors (7008, 7010) will receive the motor start output (7074) and reverse to start the motor (161) and provide the gate drive current signal (7074) to the motor.

[0347] Continue to see Fig.85, the motor charging circuit (7070) may include a voltage divider via resistors (7022, 7024), and in combination with a Schottky diode (7038), reduces the gate drive current signal (7072) and forces the gate drive current signal (7072) current to flow through node (7078). At node (7078), the capacitor (7052) charges upon receiving the voltage from the voltage divider (7022, 7024). Thus, the motor start output (7074) provides a voltage signal to the motor (161) that ramps up more slowly, resulting in a slower motor start than without the charging circuit (7070). Thus, this feature may be incorporated to prevent or limit large current inrushes into the motor (161).

[0348] XV. Exemplary Combinations

[0349] The following examples relate to various non-exhaustive ways in which the teachings herein may be combined or applied. The following examples are not intended to limit the coverage of any claims that may be proposed at any time in this patent application or in the subsequent submissions of this patent application. It is not intended to make a disclaimer. The following examples are provided only for illustrative purposes. It is expected that the various teachings herein may be arranged and applied in a variety of other ways. It is also contemplated that some variations may omit certain features mentioned in the following examples. Therefore, any of the aspects or features mentioned below should not be considered decisive, unless otherwise, for example, by the inventor or the successor of the inventor concerned clearly indicates so at a later date. If any claim proposed in this patent application or in the subsequent submissions related to this patent application includes additional features other than those mentioned below, these additional features should not be assumed to be added for any reason related to patentability.

[0350] Example 1

[0351] A device comprising: (a) a body, the body comprising: (i) a safety switch, (ii) a firing actuator and (iii) a motor; (b) a shaft, the shaft extending distally from the body; (c) a suturing assembly, the suturing assembly being disposed at a distal end of the shaft, wherein the suturing assembly is configured to selectively move from an open position to a closed position to clamp tissue, wherein the safety switch is configured to be in an actuated state when the suturing assembly is in the closed position, wherein the suturing assembly can be actuated by the motor to drive a plurality of staples into the suturing assembly in response to actuation of the firing actuator. and (d) a timing logic device operably connected to the motor, wherein the timing logic device is configured to detect actuation of the safety switch and is configured to detect actuation of the firing actuator, wherein the timing logic device is operable to: (i) detect a sequence in which the safety switch and the firing actuator are actuated, (ii) compare the detected sequence with a predetermined sequence, and (iii) in response to determining that the detected sequence is the same as the predetermined sequence, transmit a motor start signal to the motor.

[0352] Example 2

[0353] A device as in Example 1 wherein the sequential logic device is configured to prevent activation of the motor in response to determining that the detected sequence is different from the predetermined sequence.

[0354] Example 3

[0355] A device according to any one or more of embodiments 1-2, wherein the predetermined sequence includes actuation of the safety switch occurring prior to actuation of the firing actuator.

[0356] Example 4

[0357] A device according to any one or more of embodiments 1-2, wherein the predetermined sequence includes actuation of the safety switch occurring simultaneously with actuation of the firing actuator.

[0358] Example 5

[0359] The apparatus of any one or more of embodiments 1-4, wherein the sequential logic device comprises an analog integrated circuit.

[0360] Example 6

[0361]

[0026] The apparatus of Example 4, wherein the safety switch is operable to provide a signal to the analog integrated circuit in response to actuation of the safety switch, wherein the firing actuator is operable to subsequently provide the motor start signal to the motor.

[0362] Example 7

[0363] A device as in embodiment 4, wherein the integrated circuit includes one or more latching switches configured for an edge triggered mode of operation.

[0364] Example 8

[0365] The apparatus according to Example 4, wherein the integrated circuit includes a first latch switch and a second latch switch, wherein an input end of the first latch switch is operably connected to the safety switch, and wherein an input end of the second latch switch is operably connected to the firing actuator.

[0366] Example 9

[0367] The apparatus of embodiment 4, wherein the integrated circuit comprises a first latching switch and a second latching switch, wherein an input terminal of the second latching switch is configured to receive a clock output signal from the first latching switch.

[0368] Example 10

[0369] The apparatus of any one or more of embodiments 1 to 9, wherein the sequential logic device comprises a programmable digital processor.

[0370] Embodiment 11

[0371] An apparatus according to any one or more of embodiments 1 to 10, wherein the motor is configured to be in a non-startable state before the timing logic device determines the correct timing sequence, and wherein the motor is configured to be in a startable state after the timing logic device determines the correct timing sequence.

[0372] Example 12

[0373] The apparatus of any one or more of embodiments 1 to 11, further comprising a transistor having an input and an output, wherein the safety switch is operably coupled to the input of the transistor, and the sequential logic device is operably coupled to the output of the transistor.

[0374] Embodiment 13

[0375] According to the device described in any one or more of Examples 1 to 12, the suturing assembly also includes an anvil, which is operably connected to the body and is configured to move distally and proximally relative to the body, wherein the anvil is configured to actuate the safety switch when the anvil is pushed proximally.

[0376] Embodiment 14

[0377] According to the device described in any one or more of Examples 1 to 13, the main body also includes: a safety trigger operably connected to the firing actuator, wherein the safety trigger in a first position is configured to prohibit actuation of the firing actuator, and the safety trigger in a second position is configured to allow actuation of the firing actuator.

[0378] Embodiment 15

[0379] According to the device described in any one or more of Examples 1 to 14, the main body includes a base, the base has a guide track configured to receive a protrusion of the safety trigger, wherein the guide track includes: (A) a first pawl, the first pawl is configured to receive the protrusion of the safety trigger in an engaged position, (B) a second pawl, the second pawl is configured to receive the protrusion of the safety trigger in a disengaged position, (C) a channel arranged between the first pawl and the second pawl, the channel is configured to receive the protrusion when the safety trigger moves between the engaged position and the disengaged position, and (D) a raised portion protruding from the channel, the raised portion being configured to push the safety trigger to the engaged position or the disengaged position.

[0380] Example 16

[0381] A method for operating an electric surgical stapler, wherein the electric surgical stapler includes a body and a stapling assembly, wherein the body includes a control circuit, a firing trigger, a motor and a timing logic device, wherein the stapling assembly is operably connected to the body and includes a movable anvil and a safety switch, wherein the stapling assembly can be selectively actuated by the motor to staple tissue, the method comprising: (a) transmitting a safety signal to the timing logic device in response to actuation of the safety switch; (b) transmitting a firing signal to the timing logic device in response to actuation of the firing trigger; (c) (d) based on the determination, transmitting a motor start signal to the control circuit; (e) transmitting the motor start signal from the control circuit to the motor to actuate the suturing assembly; (f) starting the motor when the motor start signal is received from the control circuit; and (g) actuating the suturing assembly with the motor in the start state to drive the staples into the tissue.

[0382] Embodiment 17

[0383] The method according to Example 16 also includes: retracting the anvil in a proximal direction relative to the body.

[0384] Embodiment 18

[0385] The method according to Example 17 also includes: actuating the safety switch in response to retraction of the anvil.

[0386] Embodiment 19

[0387] A method according to any one or more of Examples 16 to 18, wherein the timing logic device is configured to prevent activation of the motor in response to determining that transmission of the safety signal to the timing logic device does not occur prior to or simultaneously with transmission of the firing signal to the timing logic device.

[0388] Embodiment 20

[0389] A device comprising: (a) a body comprising: (i) a safety switch, (ii) a firing actuator and (iii) a motor; (b) a shaft extending distally from the body and comprising an anvil; (c) a suturing assembly disposed at a distal end of the shaft, wherein the suturing assembly is configured to selectively move from an open position to a closed position to clamp tissue, wherein the suturing assembly is operable to drive a plurality of staples into the clamped tissue in response to activation of the motor; and (d) a timing logic device, the timing logic device being coupled to the anvil The device is operably connected to the motor, wherein the timing logic device is configured to detect actuation of the safety switch and is configured to detect actuation of the firing actuator, wherein the timing logic device is operable to: (i) detect the order in which the safety switch and the firing actuator are actuated, (ii) compare the detected order with a predetermined order, and (iii) in response to determining that the detected order is the same as the predetermined order, transmit a motor start signal to the motor, wherein the motor is configured to be able to start upon receiving the motor start signal.

[0390] XVI. Miscellaneous

[0391] It should also be understood that any one or more of the teachings, expressions, embodiments, examples, etc. described herein may be combined with any one or more of the other teachings, expressions, implementations, examples, etc. described herein. Therefore, the above teachings, expressions, implementations, examples, etc. should not be considered isolated from each other. Various suitable ways in which the teachings herein can be combined will be apparent to those of ordinary skill in the art based on the teachings herein. Such modifications and variations are intended to be included within the scope of the claims.

[0392] In addition, any one or more of the teachings of this document may be combined with any one or more of the teachings disclosed in the following patent applications: U.S. application entitled "Circular Surgical Stapler" filed on the same date as this application [Agent Reference Number 9091USNP1]; U.S. application entitled "Timer Circuit to Control Firing of Powered Surgical Stapler" filed on the same date as this application in 2018 [Agent Reference Number END9091USNP2]; U.S. application entitled "Electrical Potential Shifting Circuit for Powered Surgical Stapler" filed on the same date as this application in 2018 [Agent Reference Number END9091USNP4]; and / or U.S. application entitled "Staple Height Indicator for Powered Surgical Stapler" filed on the same date as this application [Agent Reference Number END9091USNP5]. The disclosure of each of these U.S. patent applications is incorporated herein by reference.

[0393] At least some of the teachings herein may also be combined with one or more of the teachings of the following patents: U.S. Publication No. 2015 / 0083772, entitled “Surgical Stapler with Rotary Cam Drive and Return,” published on March 26, 2015, the disclosure of which is incorporated herein by reference; U.S. Publication No. 2015 / 0083773, entitled “Surgical Stapling Instrument with Drive Assembly Having Toggle Features,” published on March 26, 2015, the disclosure of which is incorporated herein by reference; U.S. Publication No. 2015 / 0083774, entitled “Control Features for Motorized Surgical Stapling Instrument,” published on March 26, 2015, the disclosure of which is incorporated herein by reference; U.S. Publication No. 2015 / 0083775, entitled “Surgical Stapler with Rotary Cam Drive and Return,” published on March 26, 2015, the disclosure of which is incorporated herein by reference; and U.S. Publication No. 2015 / 0083775, entitled “Surgical Stapler with Electromechanical Lockout,” published on December 29, 2016, the disclosure of which is incorporated herein by reference; U.S. Publication No. 2016 / 0374665, entitled “Surgical Stapler with Electromechanical Lockout,” published on December 29, 2016, the disclosure of which is incorporated herein by reference; U.S. Publication No. 2016 / 0374666, entitled “Surgical Stapler with Reversible Motor,” published on December 29, 2016, the disclosure of which is incorporated herein by reference; U.S. Publication No. 2016 / 0374667, entitled “Surgical Stapler with Anvil Seating Detection,” published on December 29, 2016, the disclosure of which is incorporated herein by reference; and U.S. Publication No. 2016 / 0374668, entitled “Surgical Stapler with Anvil Seating Detection,” published on December 29, 2016, the disclosure of which is incorporated herein by reference; U.S. Publication No. 2016 / 0374673 entitled “Surgical Stapler with Ready State Indicator” published on December 29, 2016, the disclosure of which is incorporated herein by reference; U.S. Publication No. 2016 / 0374681 entitled “Surgical Stapler with Ready State Indicator” published on December 29, 2016, the disclosure of which is incorporated herein by reference;U.S. Publication No. 2016 / 0374671, published on December 29, 2016, entitled “Surgical Stapler with Anvil State Indicator,” the disclosure of which is incorporated herein by reference; U.S. Publication No. 2016 / 0374668, published on December 29, 2016, entitled “Surgical Stapler with Incomplete Firing Indicator,” the disclosure of which is incorporated herein by reference; U.S. Publication No. 2016 / 0374669, published on December 29, 2016, entitled “Bailout Assembly for Surgical Stapler,” the disclosure of which is incorporated herein by reference; U.S. Publication No. 2016 / 0374684, published on December 29, 2016, entitled “Firing Assembly for Circular Stapler,” the disclosure of which is incorporated herein by reference; U.S. Publication No. 2016 / 0374685, published on December 29, 2016, entitled “Anvil Stabilization Features U.S. Patent Application No. 2016 / 0374670, entitled “Method of Applying an Annular Array of Staples to Tissue”, filed on December 29, 2017, the disclosure of which is incorporated herein by reference; U.S. Patent Application No. 15 / 350,513, entitled “Circular Stapler with Recessed Deck”, filed on November 14, 2016, the disclosure of which is incorporated herein by reference; U.S. Patent Application No. 15 / 350,593, entitled “Atraumatic Stapling Head Features for Circular Surgical Stapler”, filed on November 14, 2016, the disclosure of which is incorporated herein by reference; U.S. Patent Application No. 15 / 350,593, entitled “Atraumatic Stapling Head Features for Circular Surgical Stapler”, filed on November 14, 2016, the disclosure of which is incorporated herein by reference; U.S. Patent Application No. 15 / 350,593, entitled “Staple Forming Pocket Configurations for Circular Surgical Stapler”, filed on November 14, 2016, the disclosure of which is incorporated herein by reference; Stapler", the disclosure of which is incorporated herein by reference;U.S. Patent Application 15 / 350,624, filed on November 14, 2016, entitled “Circular Surgical Stapler with Angularly Asymmetric Deck Features,” the disclosure of which is incorporated herein by reference; U.S. Patent Application 15 / 581,546, filed on April 28, 2017, entitled “Hysteresis Removal Feature in Surgical Stapling Instrument,” the disclosure of which is incorporated herein by reference; and / or U.S. Patent Application 15 / 581,640, filed on April 28, 2017, entitled “Liquid-Immune Trigger Circuit for Surgical Instrument,” the disclosure of which is incorporated herein by reference. Various suitable ways in which the teachings herein may be combined with the teachings of the patents, publications, and patent applications cited above will be apparent to those of ordinary skill in the art. ;

[0394] At least some of the teachings herein may be readily combined with the teachings of one or more of the following patents: U.S. Patent 7,794,475, published on September 14, 2010, entitled “Surgical Staples Having Compressible or Crushable Members for Securing Tissue Therein and Stapling Instruments for Deploying the Same,” the disclosure of which is incorporated herein by reference; U.S. Patent Publication 2014 / 0151429, published on June 5, 2014, entitled “Anvil Introduction System with Dilation Feature,” the disclosure of which is incorporated herein by reference; U.S. Publication 2014 / 0144968, published on May 29, 2014, entitled “Surgical Staple with Integral Pledget for Tip Deflection,” the disclosure of which is incorporated herein by reference; U.S. Patent Publication 2014 / 0144968, published on May 29, 2014, entitled “Surgical Stapler with Varying Staple Widths along Different Circumferences”, the disclosure of which is incorporated herein by reference; U.S. Patent Publication 2014 / 0144969, entitled “Pivoting Anvil for Surgical Circular Stapler”, published on May 29, 2014, the disclosure of which is incorporated herein by reference; U.S. Patent Publication 2014 / 0151430, entitled “Circular Anvil Introduction System with Alignment Feature”, published on June 5, 2014, the disclosure of which is incorporated herein by reference; U.S. Patent Publication 2014 / 0166717, entitled “Circular Stapler with Selectable Motorized and Manual Control, Including a Control Ring”, published on June 19, 2014, the disclosure of which is incorporated herein by reference;U.S. Patent Publication No. 2014 / 0166728, published on June 19, 2014, entitled “Circular Stapler with Selectable Motorized and Manual Control, Including a Control Ring,” the disclosure of which is incorporated herein by reference; and / or U.S. Publication No. 2014 / 0166718, published on June 19, 2014, entitled “Motor Driven Rotary Input Circular Stapler with Lockable Flexible Shaft,” the disclosure of which is incorporated herein by reference. Various suitable ways in which such teachings may be combined will be apparent to those of ordinary skill in the art. ;

[0395] Although the examples herein have been provided in the context of circular stapling instruments, it should be understood that the various teachings herein may be readily applied to various other types of surgical instruments. By way of example only, the various teachings herein may be readily applied to linear stapling devices (e.g., endoscopic cutters). For example, the various teachings herein may be readily combined with the various teachings of the following patents: U.S. Publication 2012 / 0239012, entitled "Motor-Driven Surgical Cutting Instrument with Electric Actuator Directional Control Assembly," published on September 20, 2012, the disclosure of which is incorporated herein by reference, and / or U.S. Publication 2010 / 0264193, entitled "Surgical Stapling Instrument with An Articulatable End Effector," published on October 21, 2010, the disclosure of which is incorporated herein by reference, which will be apparent to one of ordinary skill in the art. As another merely illustrative example, the various teachings herein may be readily applied to electric electrosurgical devices. For example, various teachings herein can be readily combined with various teachings of U.S. Publication No. 2012 / 0116379, entitled "Motor Driven Electrosurgical Device with Mechanical and Electrical Feedback," published on May 10, 2012, the disclosure of which is incorporated herein by reference, as will be apparent to one of ordinary skill in the art. Other suitable types of devices to which the teachings herein can be applied, as well as the various ways in which the teachings herein can be applied to such devices, will be apparent to one of ordinary skill in the art.

[0396] It should be understood that any patent, patent publication, or other public material, whether in whole or in part, allegedly incorporated herein by reference is incorporated herein only to the extent that the incorporated material does not conflict with existing definitions, statements, or other public materials described in the present disclosure. Therefore, and to the extent necessary, the disclosure explicitly listed herein supersedes any conflicting material incorporated herein by reference. Any material or portion thereof allegedly incorporated herein but conflicting with existing definitions, statements, or other public materials listed herein will be incorporated only to the extent that there is no conflict between the incorporated material and the existing public materials.

[0397] The above-described device versions may be used in conventional medical treatments and surgeries performed by medical professionals, as well as robotic-assisted medical treatments and surgeries. By way of example only, the various teachings herein may be readily incorporated into a robotic surgical system, such as the DAVINCI® by Intuitive Surgical, Inc. (Sunnyvale, California). TM system.

[0398] The patterns described above can be designed to be discarded after a single use, or they can be designed to be able to be used multiple times. In either case or both, these patterns can be repaired to be reused after at least one use. Repair can include any combination of the following steps: disassembling the device, then cleaning or replacing specific parts and subsequently reassembling. Specifically, some patterns of the device can be disassembled, and any number of specific parts or parts of the device can be selectively replaced or removed in any combination. When cleaning and / or replacing specific parts, some patterns of the device can be reassembled at a repair facility or reassembled by the user before surgery is about to be performed for subsequent use. Those skilled in the art will appreciate that the repair of the device can be disassembled, cleaned / replaced, and reassembled using a variety of techniques. The use of such technology and the resulting repair device are all within the scope of the present application.

[0399] By way of example only, the types described herein may be sterilized before and / or after surgery. In one sterilization technique, the device is placed in a closed and sealed container such as a plastic bag or a TYVEK bag. The container and device may then be placed in a field of radiation that can penetrate the container, such as gamma radiation, x-rays, or high-energy electrons. The radiation may kill bacteria on the device and in the container. The sterilized device may then be stored in a sterile container for later use. The device may also be sterilized using any other technique known in the art, including but not limited to beta or gamma radiation, ethylene oxide, or steam.

[0400] Various embodiments of the present invention have been shown and described, and further improvements of the methods and systems described herein may be achieved by appropriate modifications by those of ordinary skill in the art without departing from the scope of the present invention. Several such possible modifications have been mentioned, and other modifications will be apparent to those of skill in the art. For example, the embodiments, embodiments, geometries, materials, dimensions, ratios, steps, etc. discussed above are illustrative and not required. Therefore, the scope of the present invention should be considered in light of the following claims, and should be understood not to be limited to the details of the structure and operation shown and described in the specification and drawings.

Claims

1. A circular surgical suturing instrument, comprising: (a) a subject, said subject comprising: (i) a firing actuator, and (ii) motor; (b) a shaft extending distally from the body; (c) a suturing assembly disposed at a distal end of the shaft, wherein the suturing assembly includes a safety switch, wherein the suturing assembly is configured to be selectively movable from an open position to a closed position to clamp tissue, wherein the safety switch is configured to be activated when the suturing assembly is in the closed position, wherein the suturing assembly is actuable by the motor to drive a plurality of staples into the clamped tissue in response to actuation of the firing actuator; and (d) a timing logic device operably coupled to the motor, wherein the timing logic device is configured to detect actuation of the safety switch and configured to detect actuation of the firing actuator, wherein the timing logic device is operable to: (i) detecting the sequence in which the safety switch and the firing actuator are actuated, (ii) comparing the detected sequence with a predetermined sequence, and (iii) in response to determining that the detected sequence is the same as the predetermined sequence, transmitting a motor activation signal to the motor.

2. The circular surgical stapling instrument according to claim 1, wherein: The sequential logic device is configured to prevent activation of the motor in response to determining that the detected sequence is different from the predetermined sequence.

3. The circular surgical stapling instrument according to claim 1, wherein: The predetermined sequence includes actuation of the safety switch occurring prior to actuation of the firing actuator.

4. The circular surgical stapling instrument according to claim 1, wherein: The predetermined sequence includes the safety switch actuation occurring simultaneously with the firing actuator actuation.

5. The circular surgical stapling instrument according to claim 1, wherein: The sequential logic device includes an analog integrated circuit.

6. The circular surgical stapling instrument according to claim 5, wherein: The safety switch is operable to provide a signal to the analog integrated circuit in response to actuation of the safety switch, wherein the firing actuator is operable to subsequently provide the motor start signal to the motor.

7. The circular surgical stapling instrument according to claim 5, wherein: The analog integrated circuit includes one or more latching switches configured for an edge triggered mode of operation.

8. The circular surgical stapling instrument according to claim 5, wherein: The analog integrated circuit includes a first latching switch and a second latching switch, wherein an input end of the first latching switch is operably coupled to the safety switch, wherein an input end of the second latching switch is operably coupled to the firing actuator.

9. The circular surgical stapling instrument according to claim 5, wherein: The analog integrated circuit includes a first latch switch and a second latch switch, wherein an input terminal of the second latch switch is configured to receive a clock output signal from the first latch switch.

10. The circular surgical stapling instrument according to claim 1, wherein: The sequential logic device includes a programmable digital processor.

11. The circular surgical stapling instrument according to claim 1, wherein: The motor is configured to be in a non-startable state before the sequential logic device determines a predetermined sequence, wherein the motor is configured to be in a startable state after the sequential logic device determines the predetermined sequence.

12. The circular surgical stapling instrument of claim 1, further comprising a transistor having an input and an output, wherein the safety switch is operably coupled to the input of the transistor and the sequential logic device is operably coupled to the output of the transistor.

13. The circular surgical stapling instrument of claim 1, wherein the stapling assembly further comprises an anvil operably connected to the body and configured to move distally and proximally relative to the body, wherein the anvil is configured to actuate the safety switch when the anvil is advanced proximally.

14. The circular surgical stapling instrument according to claim 1, wherein: The subject also includes: A safety trigger is operably connected to the firing actuator, wherein the safety trigger in a first position is configured to inhibit actuation of the firing actuator, and the safety trigger in a second position is configured to allow actuation of the firing actuator.

15. The circular surgical stapling instrument according to claim 1, wherein: The body includes a base having a guide track configured to receive a protrusion of a safety trigger, wherein the guide track includes: (A) a first pawl configured to receive the protrusion of the safety trigger in an engaged position, (B) a second pawl configured to receive the protrusion of the safety trigger in a disengaged position, (C) a channel disposed between the first pawl and the second pawl, the channel being configured to receive the protrusion when the safety trigger moves between the engaged position and the disengaged position, and (D) a raised portion protruding from the channel, the raised portion being configured to push the safety trigger to the engaged position or the disengaged position.

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