Surgical instrument with dual spherical articulation joint with pivotable link

Abstract

Surgical instruments having articulating joints including articulation link assemblies including a plurality of links configured to operably interface with a proximal joint member for movable travel in first and second transverse proximal travel paths relative to the proximal joint member. The plurality of links are further configured to operably interface with a distal joint member for movable travel in first and second transverse distal travel paths relative to the distal joint member.

Description

[0001] Cross Reference to Related Applications

[0002] This non-provisional application claims the benefit under 35 U.S.C. § 119(e) of U.S. Provisional Patent Application Serial No. 63 / 057,430, entitled SURGICAL INSTRUMENTS WITH TORSION SPINE DRIVE ARRANGEMENTS, filed July 28, 2020; and U.S. Provisional Patent Application Serial No. 63 / 057,432, entitled ARTICULATION JOINT ARRANGEMENTS FOR SURGICAL INSTRUMENTS, filed July 28, 2020, the disclosures of which are incorporated by reference herein in their entireties. BACKGROUND

[0003] The present disclosure relates to surgical instruments, and in various arrangements, to surgical stapling and cutting instruments designed to staple and cut tissue and staple cartridges used therewith. The surgical instruments can be configured for use in open surgical procedures, but can also be applied in other types of surgery, such as laparoscopic, endoscopic, and robotic-assisted surgery, and can include an end effector that can be articulated relative to a shaft portion of the instrument to facilitate precise positioning within a patient’s body. BRIEF DESCRIPTION OF DRAWINGS

[0004] The novel features of the various aspects are set forth with particularity in the appended claims. These aspects, together with their equivalents, can be best understood from the following description in conjunction with the accompanying drawings, in which:

[0005] Figure 1 is a perspective view of a surgical end effector portion of a surgical instrument in accordance with at least one aspect of the present disclosure;

[0006] Figure 2 is a side view of the surgical end effector portion of the instrument of Figure 1

[0007] Figure 3 is an end view of the surgical end effector of Figure 2

[0008] Figure 4 is a top view of the surgical end effector of Figure 2

[0009] Figure 5 is an exploded assembly view of a portion of the surgical instrument of Figure 1

[0010] Figure 6 is​​​​Figure 1 exploded assembly view of the elongate shaft assembly of the surgical instrument of

[0011] Figure 7 Figure 6 another exploded assembly view of the elongate shaft assembly of

[0012] Figure 8 exploded assembly view of a firing system and a rotary drive system in accordance with at least one aspect of the present disclosure;

[0013] Figure 9 side view of the firing member, the upper flexible spine assembly, and the lower flexible spine assembly of the firing system in engagement with the rotary drive screw of the rotary drive system of Figure 8

[0014] Figure 10 cross-sectional view of the firing member and the upper and lower flexible spine assemblies of Figure 9

[0015] Figure 11 side view of the firing member and the upper and lower flexible spine assemblies in engagement with the rotary drive screw of the rotary drive system of Figure 9

[0016] Figure 12 cross-sectional end view of the surgical end effector of Figure 4 Figure 4

[0017] Figure 13 Figure 10 exploded perspective view of two adjacent upper vertebra members of the upper flexible spine assembly of

[0018] Figure 14 exploded perspective view of two adjacent lower vertebra members of the lower flexible spine assembly of Figure 10

[0019] top view of the firing member and the upper and lower flexible spine assemblies in engagement with the rotary drive screw of the rotary drive system of Figure 15 Figure 9

[0020] Figure 16 perspective view of the CV drive shaft assembly of the rotary drive system of Figure 8

[0021] Figure 17 perspective view of the firing system of Figure 16 in driving engagement with the CV drive shaft assembly of Figure 8

[0022] ​​​​​​​​​​​Figure 18 yes Figure 16 A perspective view of a drive joint of a CV drive shaft assembly of the shaft assembly;

[0023] Figure 19 It is along Figure 4 The line 19-19 is intercepted Figure 4 a cross-sectional view of a portion of a surgical instrument;

[0024] Figure 20 yes Figure 1 A partial perspective view of a proximal end portion of a surgical end effector and portions of a firing system and a rotary drive system of a surgical instrument;

[0025] Figure 21 According to at least one aspect of the present disclosure Figure 1 A perspective view of a rotary drive system of a surgical instrument in driving engagement with a firing system thereof;

[0026] Figure 22 yes Figure 21 An exploded perspective view of the rotary drive screw and thrust bearing arrangement of the firing system;

[0027] Figure 23 yes Figure 22 A side view of a rotary drive screw;

[0028] Figure 24 is in driving engagement with a portion of the rotating drive screw Figure 21 a partial cross-sectional side view of a portion of a lower flexible spine assembly and a portion of a firing member;

[0029] Figure 25 It is located within the surgical end effector of a surgical instrument. Figure 1 a perspective view of the firing member in an original or starting position;

[0030] Figure 26 is shown in driving engagement with the rotary drive screw after the firing member has been driven distally from an original or starting position. Figure 21 a side view of an upper flexible spine assembly and a lower flexible spine assembly;

[0031] Figure 27 According to at least one aspect of the present disclosure Figure 1 a partially cut-away perspective view of a portion of a surgical end effector, a firing system, and a rotary drive system of a surgical instrument, wherein an external elastomeric joint assembly of the articulation joint is omitted for clarity;

[0032] Figure 28 yes Figure 27another partial perspective view of the surgical end effector, the firing system, and a portion of the rotary drive system of the surgical instrument of FIG. 1, wherein the outer elastomeric joint assembly of the articulation joint and portions of the elongate shaft assembly have been omitted for clarity;

[0033] Figure 29 is an articulating surgical end effector in another direction relative to a portion of an elongate shaft assembly in accordance with at least one aspect of the present disclosure Figure 27 is a top view of the surgical end effector of FIG. 1;

[0034] Figure 30 is an articulating surgical end effector in another direction relative to a portion of an elongate shaft assembly in accordance with at least one aspect of the present disclosure Figure 29 is a side view of the surgical end effector of FIG. 1;

[0035] Figure 31 is an articulating surgical end effector in another direction relative to a portion of an elongate shaft assembly in accordance with at least one aspect of the present disclosure Figure 29 is a perspective view of the surgical end effector of FIG. 1;

[0036] Figure 32 is a side elevational view of a portion of another surgical instrument employing another outer elastomeric joint assembly in accordance with at least one aspect of the present disclosure;

[0037] Figure 33 is a partial cross-sectional perspective view of the surgical instrument of FIG. 1; Figure 32

[0038] is a perspective view of a portion of the outer elastomeric joint assembly of FIG. 1; Figure 34 Figure 32 is a cross-sectional end view of a portion of the surgical instrument of FIG. 1 taken along line 35-35 thereof;

[0039] Figure 35 Figure 19 is a cross-sectional end view of a portion of the surgical instrument of FIG. 1 taken along line 36-36 thereof; Figure 19

[0040] Figure 36 Figure 19 Figure 19

[0041] Figure 37 is a partial cross-sectional perspective view of a portion of the anvil cap and upper vertebrae member of the surgical instrument of FIG. 1 in accordance with at least one aspect of the present disclosure; Figure 19

[0042] Figure 38 Figure 19 ​​​​​​​​a side view of a portion of a surgical end effector of a surgical instrument, wherein an anvil of the surgical end effector is in an open position and portions of the surgical end effector are omitted for clarity;

[0043] Figure 39 According to at least one aspect of the present disclosure Figure 38 A partial cross-sectional side view of a surgical end effector of FIG. 1 with the anvil in an open position and the firing member in a home or starting position;

[0044] Figure 40 yes Figure 39 Another cross-sectional side view of the surgical end effector with the anvil in a closed position;

[0045] Figure 41 yes Figure 39 another partial cross-sectional side view of a surgical end effector of with the anvil in a fully closed position and the firing member advanced distally through the surgical end effector;

[0046] Figure 42 yes Figure 19 a partial side elevational view of a surgical end effector of with portions of the surgical end effector omitted for clarity to illustrate an anvil opening spring imparting an opening motion to the anvil, and with the firing member in a home or starting position;

[0047] Figure 43 After the firing member has moved proximally a short distance to impart a rapid closing motion to the anvil for gripping purposes Figure 42 Another partial side view of the surgical end effector;

[0048] Figure 44 yes Figure 19 a cross-sectional view of a surgical end effector of claim 1, wherein the jaws of the surgical end effector are in a closed position and the firing member of the surgical end effector is in a proximal-most position;

[0049] Figure 45 After the firing member has been advanced distally to its final position within the surgical end effector Figure 44 Another cross-sectional view of a surgical end effector;

[0050] Figure 46 is a perspective view of another articulation joint embodiment for a surgical instrument, wherein the joint is in a non-articulation orientation;

[0051] Figure 47 Is in joint movement orientation Figure 46 Another perspective view of the articulated joint;

[0052] Figure 48 is an exploded assembly view of the articulation joint of Figure 46 ;

[0053] Figure 49 is an end view of the proximal joint member of the articulation joint of Figure 46 ;

[0054] Figure 50 is an end view of the distal joint member of the articulation joint of Figure 46 ;

[0055] Figure 51 is a cross-sectional view of the proximal joint member and a portion of the first link of the articulation joint in a first position of Figure 49 ;

[0056] Figure 52 is another cross-sectional view of the proximal joint member with the first link in another position of Figure 49 ;

[0057] Figure 53 is another cross-sectional view of the proximal joint member and the first link of Figure 51 ;

[0058] Figure 54 is another cross-sectional view of the proximal joint member and the first link of Figure 52 ;

[0059] Figure 55 is another perspective view of the articulation joint of Figure 46 depicting a virtual sphere for showing articulation travel between a proximal portion of the articulation joint relative to a distal portion of the articulation joint;

[0060] Figure 56 is another perspective view of the articulation joint of Figure 55 depicting virtual spheres related to the proximal joint member and the distal joint member of the articulation joint of Figure 46 ;

[0061] Figure 57 is a perspective view of a surgical end effector of a surgical instrument with its anvil in an open position;

[0062] Figure 58 is another perspective view of the surgical end effector of Figure 57 with a portion of the surgical end effector omitted to show the positions of various closure system components of the surgical instrument;

[0063] Figure 59 is a cross-sectional view of the surgical end effector and closure system components of Figure 58 with the anvil in an open position;

[0064] Figure 60 is another cross-sectional view of the surgical end effector and closure system components of Figure 58 , with the anvil in a closed position;

[0065] Figure 61 is a perspective view of the closure cam member in a starting position on the rotatable cam shaft, which starting position corresponds to Figure 59 the open position of the anvil of the surgical end effector of

[0066] Figure 62 is another perspective view of the closure cam member in an ending position on the rotatable cam shaft, which ending position corresponds to the closed position of the anvil as shown in Figure 60 ;

[0067] Figure 63 is another perspective view of the surgical end effector of Figure 57 , oriented about an articulation joint attached thereto in an articulated orientation;

[0068] Figure 64 is a top view of the distal joint portion of the articulation joint of Figure 63 , articulated relative to the proximal articulation joint portion of the articulation joint of Figure 63 ;

[0069] Figure 65 is an exploded assembly view of the articulation joint and rotary drive assembly of Figure 63 ;

[0070] Figure 66 is a cross-sectional view of the rotary drive assembly of Figure 65 ;

[0071] Figure 67 is another cross-sectional view of the rotary drive assembly of Figure 66 ;

[0072] Figure 68 is another perspective view of the surgical end effector and articulation joint of Figure 63 , with portions thereof omitted for clarity;

[0073] Figure 69 is an exploded assembly view of another surgical end effector and rotary driven closure system;

[0074] Figure 70 is a partial side view of a portion of the surgical end effector and rotary drive closure system of Figure 69 , with the anvil in a closed orientation;

[0075] Figure 71 is a partial perspective view of a surgical end effector and a portion of a rotary drive system of Figure 69 , with the anvil in an open orientation;

[0076] Figure 72 is a partial end view of a portion of the rotary camshaft and cam follower of the rotary drive system of Figure 69 , with the anvil in a position when the anvil is in an open position;

[0077] Figure 73 is another partial end view of the rotary camshaft and cam follower of Figure 72 , after the closure process has begun;

[0078] Figure 74 is another partial end view of the rotary camshaft and cam follower of Figure 72 , after the cam lobe on the rotary camshaft has cammed the cam follower into a position in which the anvil is pivoted to an open position;

[0079] Figure 75 is another perspective view of a portion of a surgical end effector and a rotary drive system of Figure 69 , with the anvil in a closed position;

[0080] Figure 76 is a perspective view of another rotary camshaft; and

[0081] Figure 77 is a partial side elevational view of a portion of a surgical end effector and a rotary drive system of Figure 76 , employing the rotary camshaft of Figure 20 , with the anvil in an open position. DETAILED DESCRIPTION

[0082] Applicant of the present application owns the following U.S. Patent Applications that were filed on even date herewith and which are each herein incorporated by reference in their respective entireties:

[0083] U.S. Patent Application entitled SURGICAL INSTRUMENTS WITH TORSION SPINE DRIVE ARRANGEMENTS, Attorney Docket No. END9248USNP1 / 200084-1 ;

[0084] U.S. Patent Application entitled SURGICAL INSTRUMENTS WITH FIRING MEMBER CLOSURE FEATURES, Attorney Docket No. END9248USNP2 / 200084-2;

[0085] - U.S. Patent Application Titled “SURGICAL INSTRUMENTS WITH SEGMENTED FLEXIBLE DRIVE ARRANGEMENTS,” Attorney Docket No. END9248USNP3 / 200084-3;

[0086] U.S. Patent Application Titled “SURGICAL INSTRUMENTS WITH FLEXIBLE BALLCHAIN ​​DRIVEARRANGEMENTS,” Attorney Docket No. END9248USNP4 / 200084-4;

[0087] - U.S. Patent Application Titled “SURGICAL INSTRUMENTS WITH DOUBLE PIVOTARTICULATION JOINTARRANGEMENTS”

[0088] Attorney Docket No. END9248USNP6 / 200084-6;

[0089] - U.S. Patent Application Titled “SURGICAL INSTRUMENTS WITH COMBINATION FUNCTION ARTICULATION JOINT ARRANGEMENTS,” Attorney Docket No. END9248USNP7 / 200084-7;

[0090] U.S. Patent Application Titled “METHOD OF OPERATING A SURGICALINSTRUMENT,” Attorney Docket No. END9248USNP8 / 200084-8M;

[0091] - U.S. Patent Application Titled “SURGICAL INSTRUMENTS WITH DUAL SPHERICAL ARTICULATION JOINTARRANGEMENTS”

[0092] Attorney Docket No. END9248USNP9 / 200084-9;

[0093] U.S. Patent Application Titled “SURGICAL INSTRUMENTS WITH FLEXIBLE FIRINGMEMBER ACTUATORCONSTRAINT ARRANGEMENTS,” Attorney Docket No. END9248USNP10 / 200084-10;

[0094] U.S. Patent Application entitled ARTICULATABLE SURGICAL INSTRUMENTS WITH ARTICULATION JOINTS COMPRISING FLEXIBLE EXOSKELETON ARRANGEMENTS, Attorney Docket No. END9248USNP11 / 200084-11; and

[0095] U.S. Patent Application entitled SURGICAL INSTRUMENTS WITH DIFFERENTIAL ARTICULATION JOINT ARRANGEMENTS FOR ACCOMMODATING FLEXIBLE ACTUATORS, Attorney Docket No. END9248USNP12 / 200084-12.

[0096] Numerous specific details are set forth herein to provide a thorough understanding of the overall structure, functioning, manufacture, and use of the embodiments as described and claimed herein. Well-known operations, components, and elements are not described in detail to avoid obscuring the embodiments described in the specification and claims. Readers of ordinary skill in the art will recognize that the embodiments described and shown herein are non-limiting examples and that the particular structural and functional details disclosed herein can be representative and illustrative. Variations and changes can be made to these embodiments without departing from the scope of the claims.

[0097] The terms "comprise," "comprises," "comprising," "have," "has," "having," "include," "includes," and "including" are open-ended transition terms that are used herein to convey aspiration, possibility, potential, or contingency. Thus, the expression "comprising" or "including" one or more elements or components is intended to mean that the systems, apparatuses, or devices "comprise," "have," "include," or "contain" the one or more elements or components, but do not exclude the presence of one or more other elements or components. Similarly, the expression "having" one or more features of an element of a system, apparatus, or device means that the element has those one or more features, but does not exclude the presence of one or more other features in the element.

[0098] The terms "proximal" and "distal" are used herein with reference to a clinician manipulating a handle portion of a surgical instrument. The term "proximal" refers to the portion of the device closest to the clinician and the term "distal" refers to the portion of the device furthest from the clinician. It will be further appreciated that, for convenience and clarity, spatial terms such as "vertical", "horizontal", "up", and "down", etc., are not to be construed as limiting vis-a-vis their ordinary meanings except to the extent that such terms are consistent with the context in which they are used in association with the description of the various embodiments.

[0099] References to items in the singular should be understood to include items in the plural, unless explicitly stated otherwise or clear from the text. Grammatical connections words are intended to express any and all combinations of connected items, sentences, words, etc., unless otherwise indicated or clearly contradicted by the text. Thus, the term "or" is intended to mean "and / or" unless otherwise indicated or clear from the context.

[0100] Unless otherwise indicated herein, numerical ranges expressly set forth herein are not intended to be limited to the specific values inclusive of the recited ranges only. Instead, each numerical range recited herein is intended to mean each and every concentrated range of values within that broader range, wherein each integer and decimal numeral within the range is incorporated in its entirety acting as a lower or upper limit to the broader range set forth herein. The words "about," "approximately," and the like, when used with respect to a numerical value such as a measurement, are meant to encompass normal fluctuations which one of ordinary skill in the art would recognize as acceptable in the art for such a measurement under the circumstances, unless otherwise indicated or unless it would be clear from the context that the word was used to indicate anything other than the approximations indicated. Similarly, when used with respect to a physical property, approximate words such as "about" or "substantially" are to be interpreted to contemplate a range of deviation that one of ordinary skill in the art would recognize as acceptable for the corresponding use, function, purpose, etc., as would be understood by one of ordinary skill in the art.

[0101] Any and all examples or exemplary language (e.g., "such as", "for instance", etc.) provided herein are intended merely to better illuminate embodiments and therefore does not indicate a limitation on the scope of embodiments otherwise claimed. No language in the specification should be construed as indicating any non-claimed element as essential to the practice of embodiments.

[0102] Various exemplary devices and methods are provided for performing laparoscopic and minimally invasive surgical procedures. However, as those skilled in the art will readily appreciate, the various methods and devices disclosed herein can be used in numerous surgical procedures and applications including, for example, in connection with open surgical procedures. As the present DETAILED DESCRIPTION proceeds, one will further appreciate that the various instruments disclosed herein are capable of being used in any surgical procedure where it is desirable to insert an instrument into a body, such as through a natural orifice, through an incision or puncture hole formed in tissue, etc. The working or end effector portion of the instrument can be inserted directly into a patient's body or can be inserted through an access device having a working channel, through which an end effector and elongated shaft of a surgical instrument can be advanced.

[0103] During various laparoscopic surgical procedures, it is common practice to insert the surgical end effector portion of a surgical instrument through a trocar needle that has been installed in the abdominal wall of a patient to access a surgical site located within the patient's abdomen. In its simplest form, a trocar needle is a pen-like instrument having a sharp triangular point at one end that is typically used inside a hollow tube known as a cannula or sleeve to form an opening into the body through which the surgical end effector can be introduced. This arrangement forms an access port into a body cavity through which the surgical end effector can be inserted. The inner diameter of the cannula of the trocar needle inevitably limits the size of the end effector and drive support shaft of a surgical instrument that can be inserted through the trocar needle.

[0104] Regardless of the specific type of surgical procedure being performed, once the surgical end effector is inserted into the patient through the trocar cannula, it is often necessary to move the surgical end effector relative to the shaft assembly positioned within the trocar cannula in order to properly position the surgical end effector relative to the tissue or organ to be treated. This movement or positioning of the surgical end effector relative to the shaft portion held within the trocar cannula is commonly referred to as "articulation" of the surgical end effector. Various articulation joints have been developed to attach the surgical end effector to the associated shaft to facilitate such articulation of the surgical end effector. It is contemplated that in many surgical procedures it would be desirable to employ a surgical end effector having as large an articulation range as possible.

[0105] Due to the size constraints imposed by the trocar sleeve, the size of the articulation joint components must be set so as to freely pass through the trocar sleeve. These size constraints also limit the size and composition of various drive members and components that operably interface with the motors and / or other control systems supported in a housing, which can be hand-held or part of a larger automated system. In many cases, these drive members must operably pass through the articulation joint to operably couple to or interface with the surgical end effector. For example, one such drive member is typically used to apply articulation control motions to the surgical end effector. During use, the articulation drive member can be unactuated to position the surgical end effector in a non-articulated position to facilitate insertion of the surgical end effector through the trocar, and then actuated to articulate the surgical end effector to a desired position as the surgical end effector enters the patient.

[0106] Accordingly, the aforementioned size constraints present a number of challenges to developing articulation systems that can achieve the desired range of articulation, as well as accommodate the various different drive systems required to operate the various features of a surgical end effector. Moreover, once the surgical end effector has been positioned in a desired articulation position, the articulation system and articulation joint must be able to hold the surgical end effector in that locked position during actuation of the end effector and completion of the surgical procedure. Such articulation joint arrangements must also be able to withstand the external forces experienced by the end effector during use.

[0107] There are a variety of surgical end effectors that are configured to both cut and staple tissue. Such surgical end effectors generally include a first jaw feature that supports a surgical staple cartridge and a second jaw that includes an anvil. The jaws are supported relative to one another such that they can be moved between open and closed positions to position and clamp target tissue therebetween. Many of these surgical end effectors employ an axial motion firing member. In some end effector designs, the firing member is configured to engage both the first and second jaws such that when the firing member is initially advanced distally, it moves the jaws to the closed position. Other end effector designs employ a separate closure system that is independent of and distinct from the system that operates the firing member.

[0108] The staple cartridge includes a cartridge body. The cartridge body includes a proximal end, a distal end, and a deck extending between the proximal end and the distal end. In use, the staple cartridge is positioned on a first side of tissue to be stapled and the anvil is positioned on a second side of the tissue. The anvil is moved toward the staple cartridge to compress and clamp the tissue against the deck. Staples that are removably stored in the cartridge body can then be deployed into the tissue. The cartridge body includes staple cavities defined therein, wherein the staples are removably stored in the staple cavities. The staple cavities are arranged in six longitudinal rows. Three rows of staple cavities are positioned on a first side of the longitudinal slot and three rows of staple cavities are positioned on a second side of the longitudinal slot. Other arrangements of staple cavities and staples are also possible.

[0109] The staples are supported by staple drivers in the cartridge body. The drivers are movable between a first or un-fired position and a second or fired position to eject the staples from the staple cartridge. The drivers are retained in the cartridge body by a retainer that extends around the bottom of the cartridge body and includes resilient members that are configured to grasp the cartridge body and retain the retainer to the cartridge body. The drivers are movable between their un-fired position and their fired position by a sled. The sled is movable between a proximal position adjacent the proximal end and a distal position adjacent the distal end. The sled includes a plurality of ramp surfaces that are configured to slide under the drivers toward the anvil and lift the drivers, and the staples are supported on the drivers.

[0110] In addition to the above, in these surgical end effectors, the sled is moved distally by a firing member. The firing member is configured to contact the sled and push the sled toward the distal end. A longitudinal slot defined in the cartridge body is configured to receive the firing member. The anvil further includes a slot configured to receive the firing member. The firing member further includes a first cam that engages the first jaw and a second cam that engages the second jaw. As the firing member is advanced distally, the first and second cams can control the distance between the deck of the staple cartridge and the anvil or the tissue gap. The firing member further includes a knife configured to cut tissue captured intermediate the staple cartridge and the anvil. It is desirable for the knife to be positioned at least partially proximate the ramped surface such that staples are ejected prior to the knife.

[0111] Many surgical end effectors employ an axially movable firing beam that is attached to a firing member and used to apply axial firing and retraction motions to the firing member. Many such firing beams include a laminate construction that causes the firing beam to have some degree of flexure about an articulation joint. As the firing beam traverses the articulation joint, it can apply a disarticulation force to the joint and can cause the beam to buckle. To prevent the firing beam from buckling under pressure, the articulation joint is often provided with a transverse support or "blowout" plate feature to support the portion of the beam that traverses the articulation joint. For example, to advance the firing beam through an angle greater than sixty degrees requires a substantial axial force. This axial force must be applied to the firing member in a balanced manner to avoid binding of the firing member with the jaws as the firing member is moved distally. Any binding of the firing member with the jaws can result in component damage and wear and requires an increased amount of axial drive force to drive the firing member through the clamped tissue.

[0112] Other end effector designs employ a firing member that is driven by a rotary power. In many such designs, a rotary drive shaft extends through an articulation joint and interfaces with a rotatable firing member drive shaft that is rotatably supported within one of the jaws. The firing member threadably engages the rotatable firing member drive shaft, which is driven through the end effector as the rotatable firing member drive shaft is rotated. Such arrangements require the support jaw to be larger to accommodate the firing member drive shaft. In such devices, the lower end of the firing member is often operably interfaced with the drive shaft, which can also result in forces being applied that tend to unbalance the firing member as it is driven distally.

[0113] Figures 1-4One form of a surgical instrument 10 is shown that can address many of the challenges faced by surgical instruments having articulatable end effectors configured to both cut and fasten tissue. In various embodiments, the surgical instrument 10 can comprise a hand-held device. In other embodiments, the surgical instrument 10 can comprise an automated system, such as sometimes referred to as a robotic control system. In various forms, the surgical instrument 10 includes a surgical end effector 1000 operably coupled to an elongated shaft assembly 2000. The elongated shaft assembly 2000 can be operably attached to a housing 2002. In one embodiment, the housing 2002 can comprise a handle configured to be grasped, manipulated, and actuated by a clinician. In other embodiments, the housing 2002 can comprise an accommodation or otherwise operable support of at least a portion of a robotic system configured to generate and apply at least one control motion that can be used to actuate the surgical end effectors disclosed herein and their respective equivalents. Moreover, various components can be "accommodated" or included in the housing, or various components can be "associated" with the housing. In such instances, the components can not be housed within or directly supported by the housing. For example, the surgical instruments disclosed herein can be used with various robotic systems, instruments, components, and methods disclosed in U.S. Patent No. 9,072,535 entitled SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS, which is hereby incorporated by reference in its entirety.

[0114] In one form, the surgical end effector 1000 includes a first jaw 1100 and a second jaw 1200. In the illustrated arrangement, the first jaw 1100 includes an elongated channel 1110 that includes a proximal end 1112 and a distal end 1114 and is configured to operably support a surgical staple cartridge 1300 therein. The surgical staple cartridge 1300 includes a cartridge body 1302 having an elongated slot 1304 therein. A plurality of surgical staples or fasteners (not shown) are stored in the cartridge body on drivers (not shown) arranged in rows on each side of the elongated slot 1304. The drivers are each associated with a corresponding staple cavity 1308 that is exposed through a cartridge deck surface 1306. The surgical staple cartridge 1300 can be replaced after the staples / fasteners have been expelled therefrom. Other embodiments can be envisioned wherein the elongated channel 1110 and / or the entire surgical end effector 1000 can be discarded after the surgical staple cartridge 1300 has been used. For example, such an end effector arrangement can be referred to as a "disposable loading unit".

[0115] In the illustrated arrangement, the second jaw 1200 includes an anvil 1210 comprising an elongated anvil body 1212 comprising a proximal end 1214 and a distal end 1216. In one arrangement, a pair of reinforcing rods or members 1213 may be supported in the anvil body 1212 to provide increased hardness and rigidity to the anvil body 1212. The anvil body 1212 comprises a staple-forming lower surface 1218 facing the first jaw 1100 and may comprise a series of staple-forming dimples (not shown) corresponding to each of the staples or fasteners in the surgical staple cartridge 1300. The anvil body 1212 may further comprise a pair of downwardly extending tissue retaining features 1220 formed adjacent the proximal end 1214 of the anvil body 1212. A tissue stop feature 1220 extends from each side of the anvil body 1212 such that the distal end 1222 on each tissue stop corresponds to the proximal-most staple / fastener in the surgical staple cartridge 1300. When the anvil 1210 is moved to a closed position toward tissue positioned between the staple forming lower surface 1218 of the anvil 1210 and the staple cartridge deck surface 1306 of the surgical staple cartridge 1300, the tissue contacts the distal end 1222 of the tissue stop feature 1220 to prevent the tissue from moving proximally past the proximal-most staple / fastener, thereby ensuring that the cut tissue is also stapled. When the surgical staple cartridge is "fired," as will be discussed in further detail below, the staples / fasteners supported in each staple cavity are driven out of the staple cavity 1308, through the clamped tissue, and into contact with the staple forming lower surface 1218 of the anvil 1210.

[0116] like Figure 5 and Figure 6 12, the proximal end 1214 of the anvil body 1212 includes an anvil mounting portion 1230 including a pair of laterally extending mounting pins 1232 configured to be received in corresponding mounting brackets or pivot brackets 1120 formed in the proximal end 1112 of the elongated channel 1110. The mounting pins 1232 may be pivotally retained within the mounting brackets 1120 by an anvil top cover 1260, which may be attached to the proximal end 1112 of the elongated channel 1110 by a mechanical snap feature 1261 configured to engage a retaining structure 1113 on the elongated channel 1110. Figure 5 In other arrangements, the anvil cap 1260 can be attached to the elongated channel 1110 by welding, adhesive, etc. Such an arrangement facilitates the anvil 1210 to be rotated in the open position (about the pivot axis PA) relative to the surgical staple cartridge 1300 mounted in the elongated channel 1110. Figure 1 ) and closed position ( Figures 2-5pivotally travels between an open position and a closed position. Such a pivot axis PA can be referred to herein as being "fixed" in that the pivot axis does not translate or otherwise move when the anvil 1200 is pivoted from the open position to the closed position.

[0117] In the illustrated arrangement, the elongate shaft assembly 2000 defines a shaft axis SA and includes a proximal shaft portion 2100 that is operably interfaced with a housing of a control portion (e.g., a hand-held unit, a robotic tool driver, etc.) of the surgical instrument 10. The elongate shaft assembly 2000 further includes an articulation joint 2200 that is attached to the proximal shaft portion 2100 and the surgical end effector 1000. In various circumstances, the proximal shaft portion 2100 includes a hollow outer tube 2110 that can be operably coupled to the housing 2002. See Figure 2 . As can be seen in Figure 6 The proximal shaft portion 2100 can further include a rigid proximal support shaft 2120 that is supported within the hollow outer tube 2110 and that extends from the housing to the articulation joint 2200. The proximal support shaft 2120 can include first and second halves 2120A, 2120B that can be coupled together by, for example, welding, adhesive, etc. The proximal support member 2120 includes a proximal end 2122 and a distal end 2124 and includes an axial conduit 2126 that extends therethrough from the proximal end 2122 to the distal end 2124.

[0118] As discussed above, many surgical end effectors employ a firing member that is pushed distally through a surgical staple cartridge by an axially movable firing beam. The firing beam is typically attached to the firing member in a central region of the firing member body. This attachment location can cause the firing member to be unbalanced as it is advanced through the end effector. This imbalance can cause undesirable friction between the firing member and the end effector jaw. The creation of this additional friction can require a higher firing force to be applied to overcome this friction and can cause undesirable wear to portions of the jaw and / or firing member. The application of a higher firing force to the firing beam can cause undesirable flexing of the firing beam as it traverses the articulation joint. This additional flexing can cause the articulation joint to disarticulate, particularly when the surgical end effector is articulated at relatively high articulation angles. The surgical instrument 10 employs a firing system 2300 that addresses many of these issues, if not all of them, as well as other issues.

[0119] As can be seen in Figures 5-11As can be seen, in at least one embodiment, the firing system 2300 includes a firing member 2310 that includes a vertically extending firing member body 2312 that includes a top firing member feature 2320 and a bottom firing member feature 2350. A tissue-cutting knife 2314 is attached to or formed in the vertically extending firing member body 2312. See Figure 9 and Figure 11 In at least one arrangement, it is desirable for the firing member 2310 to pass through the anvil body 1212 with low friction, high strength, and high stiffness. In the illustrated arrangement, the top firing member feature 2320 includes a top tubular body 2322 having a top axial conduit 2324 extending therethrough. See Figure 10 The bottom firing member feature 2350 includes a bottom tubular body 2352 having a bottom axial conduit 2354 extending therethrough. In at least one arrangement, the top firing member feature 2320 and the bottom firing member feature 2350 are integrally formed with the vertically extending firing member body 2312. As shown, Figure 12 The anvil body 1212 includes an axially extending anvil slot 1240 that has a "keyhole" like cross-sectional shape. Similarly, the elongate channel 1110 includes an axially extending channel slot 1140 that also has a keyhole cross-sectional shape.

[0120] Conventional firing member arrangements employ long, flexible cantilevered wings that extend from the top and bottom portions of the firing member. These cantilevered wings slideably pass through slots in the anvil and channel that are typically cut with a rectangular t-shaped cutter, which tends to create a higher friction surface. Such long cantilevered wings have a minimum surface area in contact with the anvil and channel and can result in these components being scuffed. The keyhole shaped channel slot 1140 and keyhole shaped anvil slot 1240 can be cut with a circular t-shaped cutter and can be finished with a reamer / drill, which will result in a lower friction surface. Additionally, the top tubular body 2322 and bottom tubular body 2352 tend to be stiffer than existing cantilevered wing arrangements and have an increased surface area in contact with the anvil and channel, respectively, which can reduce scuffing and create a stronger sliding connection. In other words, because the anvil slot 1240 and channel slot 1140 are keyhole shaped and remove less material than conventional rectangular slots, this geometry and increased material can make the anvil and channel stiffer when compared to existing arrangements.

[0121] Turning to Figures 9-11In one arrangement, the firing system 2300 further includes an upper flexible spine assembly 2400 operably coupled to the top firing member feature 2320 and a lower flexible spine assembly 2500 operably coupled to the bottom firing member feature 2350. In at least one embodiment, the upper flexible spine assembly 2400 includes an upper series 2410 of upper vertebra members 2420 that are loosely coupled together by an upper flexible coupler member 2402 that is attached to the top firing member feature 2320. The upper flexible coupler member 2402 can include a top cable 2404 that extends through a top axial conduit 2324 in the top firing member feature 2320, and a distal end 2406 of the top cable 2404 is attached to a retainer ferrule 2408 that is fixed with the top axial conduit 2324.

[0122] As Figure 13 As can be seen in FIGS. 27-29, each upper vertebra member 2420 includes an upper vertebra body portion 2422 having a proximal end 2424 and a distal end 2428. An upper hollow conduit 2429 extends through the upper vertebra body portion 2422 to accommodate the upper flexible coupler member 2402 therethrough. Each upper vertebra member 2420 further includes a downwardly extending upper drive feature or upper vertebra member tooth 2450 that protrudes from the upper vertebra body portion 2422. Each upper vertebra member tooth 2450 has a helical proximal upper face portion 2452 and a helical distal upper face portion 2454. Each proximal end 2424 of the upper vertebra body portion 2422 has an upper proximal mating feature 2426 therein, and each distal end 2428 has an upper distal mating feature 2430 formed therein. In at least one embodiment, the upper proximal mating feature 2426 includes a concave recess 2427, and each upper distal mating feature 2430 includes a convex bump 2431. When arranged in the upper series 2410, the convex bump 2431 on one upper vertebra member 2420 contacts and mates with the concave recess 2427 on an adjacent upper vertebra member 2420 in the upper series 2410 to hold the upper vertebra members 2420 in general alignment so that the helical proximal upper face portion 2452 and the helical distal upper face portion 2454 on each respective upper tooth 2450 can be drivingly engaged by the rotary drive screw 2700, as will be discussed in further detail below.

[0123] Similarly, in at least one embodiment, the lower flexible spine assembly 2500 includes a lower series 2510 of lower vertebra members 2520 that are loosely coupled together by lower flexible coupler members 2502 that are attached to the bottom firing member features 2350. The lower flexible coupler members 2502 can include lower cables 2504 that extend through bottom axial conduits 2354 in the bottom firing member features 2350, and distal ends 2506 of the bottom cables 2504 are attached to retainer collars 2508 that are fixed with the bottom axial conduits 2354.

[0124] As Figure 14 can be seen, each lower vertebra member 2520 includes a lower vertebra body portion 2522 having a proximal end 2524 and a distal end 2528. A lower hollow conduit 2529 extends through the lower vertebra body portion 2522 to accommodate the lower flexible coupler members 2502 therethrough. Each lower vertebra member 2520 also includes an upwardly extending lower drive feature or lower vertebra member tooth 2550 that projects upwardly from the lower vertebra body portion 2522. Each lower vertebra member tooth 2550 has a helical proximal lower face portion 2552 and a helical distal lower face portion 2554. Each proximal end 2524 of the lower vertebra body portion 2522 has a lower proximal mating feature 2526 therein, and each distal end 2528 has a lower distal mating feature 2530 formed therein. In at least one embodiment, the lower proximal mating feature 2526 includes a concave recess 2527, and each lower distal mating feature 2530 includes a convex protrusion 2531. When arranged in the lower series 2510, the convex protrusion 2531 on one lower vertebra member 2520 contacts and mates with the concave recess 2527 on an adjacent lower vertebra member 2520 in the lower series 2510 to hold the lower vertebra members 2520 in general alignment so that the helical proximal lower face portion 2552 and the helical distal lower face portion 2554 on each respective lower vertebra member tooth 2550 can be drivingly engaged by the rotary drive screw 2700, as will be discussed in further detail below.

[0125] Turning now to Figure 5 , Figure 7 and Figure 8In at least one arrangement, the firing drive system 2300 further includes a rotary drive screw 2700 that is configured to drivingly interface with the upper series 2410 of the upper vertebral members 2420 and the lower series 2510 of the lower vertebral members 2520. In the illustrated arrangement, the rotary drive screw 2700 is driven by a rotary drive system 2600 that includes a proximal rotary drive shaft 2610 that is rotatably supported within an axial channel 2126 within the proximal support shaft 2120. See Figure 7 . The proximal rotary drive shaft 2610 includes a proximal end 2612 and a distal end 2614. The proximal end 2612 is interfaceable with a gear box 2004 or other arrangement driven by a motor 2006 or other source of rotary motion housed in the housing of the surgical instrument. See Figure 2 . Such a source of rotary motion causes the proximal rotary drive shaft to rotate within the axial channel 2126 in the proximal support shaft 2120 about a shaft axis SA.

[0126] The proximal rotary drive shaft 2610 is operably supported within the elongate shaft assembly 2000 adjacent the articulation joint 2200 and is in operable interface with a constant velocity (CV) drive shaft assembly 2620 that "straddles" or extends axially through the articulation joint 2200. As can be seen in Figure 8 、 Figure 16 and Figure 17 , in at least one arrangement, the CV drive shaft assembly 2620 includes a proximal CV drive assembly 2630 and a distal CV drive shaft 2670. The proximal CV drive assembly 2630 includes a proximal shaft segment 2632 that is comprised of an attachment shaft 2634 that is configured to be non-rotatably received within a similarly shaped coupler cavity 2616 in the distal end 2614 of the proximal rotary drive shaft 2610. The proximal shaft segment 2632 is in operable interface with a series 2640 of articulatable drive joints 2650.

[0127] As can be seen in Figure 18 , in at least one arrangement, each drive joint 2650 includes a first or distal spherical portion 2660 and a second or proximal spherical portion 2652. The distal spherical portion 2660 is larger than the proximal spherical portion 2652. The distal spherical portion 2660 includes a socket cavity 2662 that is configured to rotatably receive the proximal spherical portion 2652 of an adjacent drive joint 2650 therein. Each proximal spherical portion 2652 includes a pair of diametrically opposed engagement pins 2654 that are configured to movably receive in a corresponding pin slot 2664 in the distal spherical portion 2660 of an adjacent drive joint 2650, as can be seen in Figure 16The proximal ball portion 2652P of the proximal-most drive joint 2650P is rotatably received in a distal socket portion 2636 of the proximal shaft segment 2632, as shown. An engagement pin 2654P is received within a corresponding pin slot 2637 in the distal socket portion 2636. As further shown in Figure 16 Figure 16 As further shown in

[0128] In at least one arrangement, the distal CV drive shaft 2670 includes a proximal spherical portion 2672 sized to be movably received in a socket cavity 2662D in the distal-most drive joint 2650D. The proximal spherical portion 2672 includes an engagement pin 2674 movably received in a pin slot 2664D in the distal-most drive joint 2650D. The distal CV drive shaft 2670 further includes a shaft stem 2676 extending distally configured to be non-rotatably coupled to a rotary drive screw 2700 positioned distal to the articulation joint 2200. The distal CV drive shaft 2670 includes a flange 2677 and a mounting cylinder portion 2678 for receiving a thrust bearing housing 2680 thereon.

[0129] In the illustrated arrangement, as the series 2640 of movably coupled drive joints 2650 are articulated, the engagement pin 2674 remains in the corresponding pin slot 2664 of the adjacent drive joint 2650. In Figure 18 In the example shown, each drive joint is capable of approximately 18 degrees of articulation in the pitch direction and the yaw direction. Figure 16 The angle of the series 2640 of drive joints 2650 is shown at a time when each drive joint 2650 in the series has been fully articulated ninety degrees in the pitch direction and the yaw direction, which results in an angle a of approximately 100.9 degrees. In this arrangement, the outer surface of each distal spherical portion 2660 passes over the outer surface of the adjacent or abutting proximal spherical portion 2652, allowing unrestricted movement until the 18 degree limit is reached. The rigid design and limited small angle allows the series 2640 of movably coupled drive joints 2650 to torsionally carry high loads at a generally large angle.

[0130] In the illustrated arrangement, the articulation joint 2200 includes an articulation joint spring 2230 supported within an outer elastomeric joint assembly 2210. The outer elastomeric joint assembly 2210 includes a distal end 2212 attached to the proximal end 1112 of the elongated channel 1110. For example, as Figure 6 ​As can be seen, the distal end 2212 of the outer elastomeric joint assembly 2210 is attached to the proximal end 1112 of the elongated channel 1110 by a pair of headed screws 2722 that extend through a distal mounting bushing 2720 to be threadably received in the proximal end 1112 of the elongated channel 1110. The proximal end 2214 of the elastomeric joint assembly 2210 is attached to the distal end 2124 of the proximal end support shaft 2120. The proximal end 2214 of the elastomeric joint assembly 2210 is attached to the distal end 2124 of the proximal support member 2120 by a pair of headed screws 2732 that extend through a proximal mounting bushing 2750 to be threadably received in a threaded insert 2125 that is mounted within the distal end 2124 of the proximal support shaft 2120.

[0131] To prevent the drive joints 2650 from flexing during articulation, the series 2640 of movably coupled drive joints 2650 extend through at least one low-friction articulation joint spring 2730 that is supported within the outer elastomeric joint assembly 2210. See Figure 19 . The articulation joint spring 2730 is sized relative to the drive joints 2650 such that a slight radial clearance is provided between the articulation joint spring 2730 and the drive joints 2650. The articulation joint spring 2730 is designed to axially carry articulation joint loads that can be significantly lower than the torsional firing loads. The joint spring is longer than the series 2640 of drive joints 2650 such that the drive joints are axially loose. If the "hard stack" of the series 2640 of drive joints 2650 is longer than the hard stack of the articulation joint spring 2730, the drive joints 2650 can act as an articulation compression limiter, resulting in the firing loads and the articulation loads being axially resolved through the series 2640 of drive joints 2650. When the firing loads are axially resolved through the series 2640 of drive joints 2650, the loads can attempt to straighten the articulation joint 2200, or in other words, cause disarticulation. If the hard stack of the articulation joint spring 2730 is longer than the hard stack of the series 2640 of drive joints 2730, the firing loads will be contained within the end effector and neither the firing loads will be resolved through the drive joints 2650 or through the spring 2650.

[0132] To further ensure that the drive joints 2650 are always engaged with one another, a proximal drive spring 2740 is employed to apply an axial biasing force to the series 2640 of drive joints 2650. For example, as Figure 8 , Figure 19 and Figure 20As can be seen in FIGS. 27A and 27B, the proximal drive spring 2740 is positioned between the proximal mounting bushing 2734 and a support flange formed between the distal socket portion 2636 and the proximal barrel portion 2638 of the proximal shaft section 2632. In one arrangement, the proximal drive spring 2740 can comprise an elastomeric O-ring / bush received on the proximal barrel portion 2638 of the proximal shaft section 2632. The proximal drive spring 2740 biases the drive joints 2650 slightly together to reduce any play that can occur during articulation. This ensures that the drive joints 2650 transmit loads torsionally. It will be appreciated, however, that in at least one arrangement, the proximal drive spring 2740 does not exert a high enough axial load such that the firing load translates through the articulation joint 2200.

[0133] As Figure 9 and Figure 10 As can be seen in FIGS. 27A and 27B, the proximal drive spring 2740 is positioned between the proximal mounting bushing 2734 and a support flange formed between the distal socket portion 2636 and the proximal barrel portion 2638 of the proximal shaft section 2632. In one arrangement, the proximal drive spring 2740 can comprise an elastomeric O-ring / bush received on the proximal barrel portion 2638 of the proximal shaft section 2632. The proximal drive spring 2740 biases the drive joints 2650 slightly together to reduce any play that can occur during articulation. This ensures that the drive joints 2650 transmit loads torsionally. It will be appreciated, however, that in at least one arrangement, the proximal drive spring 2740 does not exert a high enough axial load such that the firing load translates through the articulation joint 2200.

[0134] As noted above, each of the upper vertebra members 2520 is movably received on an upper flexible coupler member 2402 in the form of a top cable 2404. As noted above, the distal end 2406 of the top cable 2404 is fixed to the top firing member feature 2320 of the firing member 2310. Similarly, each of the lower vertebra members 2520 is movably received on a lower flexible coupler member 2502 in the form of a lower cable 2504. The distal end 2506 of the lower cable 2504 is fixed to the bottom firing member feature 2350 of the firing member 2310. In at least one arrangement, the top cable 2404 and the bottom cable 2504 extend through the proximal shaft portion 2100 and, as will be discussed in further detail below, can interface with an emergency arrangement supported in the housing to retract the firing member 2310 to its original or home position in the event of a firing member drive system failure.

[0135] Turning again to Figure 8 the axial length AL of the upper series 2410 of the upper vertebra members 2420 u and the axial length AL of the lower series 2510 of the lower vertebra members 2520 l are equal and must be long enough to facilitate full distal advancement of the firing member 2310 from the original or home position to the distal-most end position within the cartridge while the proximal-most upper vertebra member 2420 of the upper series 2410 of the upper vertebra members 2420 and the proximal-most lower vertebra member 2520 of the lower series 2510 of the lower vertebra members 2520 remain in driving engagement with the rotary drive screw 2700. As Figure 8 can be seen, the upper compression limiting spring 2421 is configured to interface with the proximal-most upper vertebra member 2420P of the upper series 2410 of the upper vertebra members 2420. The upper compression limiting spring 2421 is journaled on the top cable 2404 and held in biasing engagement with the proximal-most upper vertebra member 2420P by an upper spring retainer 2423 which is held in place by an upper collar 2425 crimped on the top cable 2404. The top cable 2404 extends through an upper hypotube 2433 supported in the proximal support shaft. Likewise, the lower compression limiting spring 2521 is configured to interface with the proximal-most lower vertebra member 2520P of the lower series 2510 of the lower vertebra members 2520. The lower compression spring 2521 is journaled on the lower cable 2504 and held in biasing engagement with the proximal-most lower vertebra member 2520P by a lower spring retainer 2523 which is held in place by a lower collar 2525 crimped on the lower cable 2504. The lower cable 2504 extends through a lower hypotube 2533 supported in the proximal support shaft.

[0136] When the upper vertebral members 2420 and the lower vertebral members 2520 are angled by the articulation joints (after the end effector has been positioned in an articulated position), in each series 2410, 2510, the gap between the respective vertebral members 2420, 2520 increases, which causes the springs 2421, 2521 to become tighter. The compression-limiting springs 2421, 2521 provide enough slack to the cables 2404, 2504, respectively, to enable the angle of the vertebral members 2420, 2520 to pass through the most extreme articulation angles. If the cables 2404, 2504 are pulled too tight, the spring retainers 2423, 2523 will contact their respective proximal-most vertebral members 2420P, 2520P. This compression-limiting arrangement ensures that the vertebral members 2420, 2520 always remain close enough together in their respective series 2410, 2510 so that the rotary drive screw 2700 will always drivingly engage these vertebral members in the manner discussed in further detail below. When the vertebral members 2420, 2520 are again in straight alignment, the compression-limiting springs 2421, 2521 can partially relax while still maintaining some compression between the vertebral members.

[0137] As noted above, when the upper vertebral members 2420 are arranged in the upper series 2410 and the lower vertebral members 2520 are arranged in the lower series 2510, the male protuberances and the female recesses in each vertebral member, as well as the compression-limiter springs, serve to hold the upper and lower vertebral members in relative linear alignment for driving engagement by the rotary drive screw 2700. As can be seen in Figure 9 and Figure 10 When the upper vertebral members 2420 are in linear alignment, the upper teeth 2450 are spaced apart from one another by open spaces generally designated 2460, which facilitate driving engagement with the helical drive threads 2170 on the rotary drive screw 2700. Similarly, when the lower vertebral members 2520 are in linear alignment, the lower vertebral member teeth 2550 are spaced apart from one another by open spaces generally designated 2560, which facilitate driving engagement with the helical drive threads 2170 of the rotary drive screw 2700.

[0138] Turning to Figure 8 and Figure 22 , the rotary drive screw 2700 includes a screw body 2702 having a socket 2704 therein for receiving the distally extending shaft 2676 of the distal CV drive shaft 2670. An internal radial groove 2714( Figure 10formed in the screw body 2702 for supporting a plurality of ball bearings 2716 therein. In one arrangement, for example, twelve ball bearings 2716 are employed. The radial grooves 2714 support the ball bearings 2716 between the screw body 2702 and the distal end of the thrust bearing housing 2680. The ball bearings 2716 function to distribute the axial load of the rotationally driven screw 2700 and significantly reduce friction through the rolling motion of the balls.

[0139] As Figure 23 can be seen, the helical drive thread 2710 is disposed about the screw body 2702 and functions to form a proximal threaded pocket feature 2712. The proximal threaded pocket feature 2712 is formed with a first pitch 2713 and the remaining portion of the helical drive thread 2710 is formed with a second pitch 2715 that is different than the first pitch 2713. In Figure 22 and Figure 23 , the region 2718 illustrates where the first pitch 2713 and the second pitch 2715 converge. In at least one embodiment, the first pitch 2713 is greater than the second pitch 2715 to ensure that the rotationally driven screw 2700 captures and “pockets” or drivingly engages each of the upper vertebral member 2420 and each of the lower vertebral member 2520. As Figure 24 can be seen, the proximal end 2717 of the helical drive thread 2710 having the first pitch 2713 has been pocketed into the open space 2560 between two adjacent lower vertebral member teeth 2550A and 2550B, while the central portion 2719 of the helical drive thread 2710 having the second pitch 2715 is drivingly engaged with the helical shaped distal lower face portion 2554 on the lower vertebral member tooth 2550B and the helical shaped proximal lower face portion 2552 on the proximal lower firing member tooth 2366. It should also be appreciated that as the firing member 2310 is driven distally, the pocketed feature 2712 can not contact the helical shaped distal lower face portion 2554A of the lower vertebral member tooth 2550A as it pockets the lower vertebral member tooth 2550B. The helical drive thread 2710 interacts with the teeth 2450 of the upper vertebral member 2420 in a similar manner.

[0140] A power screw is a screw with a full 360 degree nut around it. Rotation of the power screw causes the nut to longitudinally advance or move. In the present arrangement, however, due to space constraints, a full 360 degree nut cannot fit within the end effector. In a general sense, the upper and lower flexible spine assemblies 2400, 2500 comprise a radially / longitudinally segmented "power screw nut" that is rotatably driven by a rotary drive screw 2700. When the rotary drive screw is rotated in a first rotational direction, the rotary drive screw 2700 longitudinally drives one or more vertebral members in each of the upper and lower series of vertebral members, while the vertebral members 2420, 2520 remain in the same position radially. The upper and lower series 2410, 2510 are constrained to rotate around the rotary drive screw 2700 and can only move longitudinally. In one arrangement, the upper vertebral members 2420 in the upper series 2410 and the lower vertebral members 2520 in the lower series 2510 each rotate around the rotary drive screw 2700 at an angle of less than ten degrees.

[0141] Figure 25 The firing member 2310 is shown in a home or starting position. As can be seen in Figure 25 As can be seen in FIG. 27, a portion of the helical drive threads 2710 on the rotary drive screw 2700 are engaged between the distal upper firing member tooth segment 2330 and the proximal upper firing member tooth 2336, and another portion of the helical drive threads 2710 are engaged between the distal lower firing member tooth 2360 and the proximal lower firing member tooth 2366 on the firing member 2310. This arrangement enables the rotary drive screw 2700 to precisely control the distal and proximal movement of the firing member 2310, which, as will be discussed in further detail below, can result in precise movement of the anvil 1210. Once the firing member 2310 has been advanced distally sufficiently during the firing stroke, the helical drive threads 2710 operably interface with the teeth on the upper and lower vertebrae. See FIG. 28. Figure 26 .

[0142] The surgical instrument 10 further comprises an articulation system 2240 that is configured to apply articulation to the surgical end effector 1000 to articulate the surgical end effector relative to the elongate shaft assembly 2000. In at least one arrangement, for example, the articulation system comprises four articulation cables 2242, 2246, 2250, and 2254 that extend through the elongate shaft assembly 2000. See FIG. 22. Figure 27In the illustrated arrangement, articulation cables 2242, 2246 pass through proximal mounting bushing 2750, the proximal end 2214 of elastomeric joint assembly 2210, and a central rib segment 2216 to be fixed to the distal end 2212 of elastomeric joint assembly 2210 or other portion of the surgical instrument. Likewise, articulation cables 2250 and 2254 extend through proximal mounting bushing 2750, the proximal end 2214 of elastomeric joint assembly 2210, and a central rib segment 2218 to be fixed to the distal end 2212 of elastomeric joint assembly 2210 or other portion of the surgical end effector. Cables 2242, 2246, 2250, and 2254 are operably interfaced with an articulation control system supported in the housing of surgical instrument 10. For example, a proximal portion of each cable 2242, 2246, 2250, and 2254 can be wrapped around a corresponding rotary spool or cable management system 2007 Figure 2 ) in the housing portion of surgical instrument 10 that is configured to pay out and retract each cable 2242, 2246, 2250, and 2254 in a desired manner. The spool / cable management system can be motor driven or manually driven (ratchet arrangement, etc.). Figure 29 Articulation of surgical end effector 1000 relative to elongated shaft assembly 2000 through a first articulation plane is shown. Figure 30 Articulation of surgical end effector 1000 relative to elongated shaft assembly 2000 through a second articulation plane is shown. Figure 31 Articulation of surgical end effector 1000 relative to elongated shaft assembly 2000 through a plurality of articulation planes is shown.

[0143] Figures 32-34 An alternative articulation joint 2200' in the form of an elastomeric joint assembly 2210' is shown. As Figure 33As shown, each articulation cable passes through a corresponding spring 2215' mounted in a rib 2216' of the elastomeric joint assembly 2210'. For example, cable 2242 extends through spring 2244. Cable 2246 extends through spring 2248. Cable 2250 extends through spring 2252 and cable 2254 extends through spring 2256. As described above, the end effector is articulated by pulling and releasing the appropriate cables 2242, 2246, 2250, and 2254. To achieve higher articulation angles with greater joint stability, each of the springs 2244, 2248, 2252, and 2256 can be slid through the rib of the elastomeric joint to push the end effector and pull the cables extending therethrough. When cables 2242, 2246, 2250, and 2254 are tensioned, springs 2244, 2248, 2252, and 2256 will also retract into the ribs. Each of springs 2244, 2248, 2252, and 2256 is loosely mounted on a specific cable passing therethrough. Each cable and corresponding spring may terminate at or otherwise be coupled to a corresponding solid rod supported in elongated shaft assembly 2000 and may be pushed and pulled from its proximal end. When the cable is pulled, the corresponding spring will bear little or no load. When the spring is pushed, the cable will bear little load but will help limit the end effector's motion. This interaction between the cables and springs can, for example, facilitate the generation of higher articulation angles approaching ninety degrees.

[0144] Because the radial / longitudinal segmented power screw nut arrangement disclosed herein does not have the same limitations as a 360 degree nut, the upper vertebral members 2420 in the upper series 2410 and the lower vertebral members 2520 in the lower series 2510 are constrained to ensure that their loads are transferred to the firing member in the longitudinal direction. In order to maintain each of the upper vertebral members 2420 in the desired orientation and to prevent the upper vertebral members 2420 from becoming obstructed or losing orientation while traversing the articulation joint 2200, the upper vertebral members 2420 are aligned to pass through an upper sleeve 2470 that extends through the upper portion of the outer elastomeric joint assembly 2210 of the articulation joint 2200. See Figure 27 、 Figure 28 and Figure 35The distal end 2472 of the upper sleeve 2470 is supported in the proximal end 1112 of the elongated channel 1110 and the proximal end 2474 of the upper sleeve 2470 is supported in the distal end of the proximal support shaft 2120. The upper sleeve 2470 is made of a polymer or plastic material that has a low coefficient of friction and is flexible to enable the upper sleeve 2470 to bend with the outer elastomeric joint assembly 2210. The upper sleeve 2470 protects the upper vertebral member 2420 from contacting the outer elastomeric joint assembly 2210, which is made of an elastomeric material that can have a higher coefficient of friction than the coefficient of friction of the material of the upper sleeve 2470. In other words, the upper sleeve 2470 forms a low-friction, flexible, continuous, uninterrupted, and fully encapsulated path for the upper vertebral member 2420 as it traverses the articulating joint 2200.

[0145] Similarly, a lower sleeve 2570 is used to support the lower vertebral members 2520 as they pass through the articulation joint 2200. A distal end 2572 of the lower sleeve 2570 is supported in the proximal end of the elongated channel, and the proximal end of the lower sleeve 2570 is supported in the distal end of the proximal support shaft 2120. Like the upper sleeve 2470, the lower sleeve 2570 is made of a polymer or plastic material that has a low coefficient of friction and is flexible, to enable the lower sleeve 2570 to bend with the outer elastomeric joint assembly 2210. The lower sleeve 2570 protects the lower vertebral members 2520 from contacting the outer elastomeric joint assembly 2210 as they pass through the articulation joint 2200. In other words, the lower sleeve 2570 forms a low-friction, flexible, continuous, uninterrupted, and fully encapsulated path for the lower vertebral members as they traverse the articulation joint 2200. In various embodiments, the upper sleeve 2470 and the lower sleeve 2570 are configured to bend freely without kinking. To prevent kinking in the sleeves, in at least one arrangement, the sleeves 2470, 2570 are supported within the outer elastomeric joint assembly 2210 so that the sleeves can move axially. For example, as the articulation joint is angled upward, the lower sleeve 2570 can slide distally and have a large bend radius; in the same example, the upper sleeve 2470 can slide proximally and have a tighter bend radius. With the axial movement, the amount of material that is exposed outside the joint assembly 2210 is reduced, which material can otherwise be prone to kinking under a tight bend radius. In at least one arrangement, a distal end 2472 of the upper sleeve 2470 is formed with an upper pocket 2476 that is configured to deliver the upper vertebral members 2420 into the anvil top cover 1260. Similarly, a distal end of the lower sleeve 2570 can be formed with a lower pocket that is configured to deliver the lower vertebral members 2520 into the channel slots 1140 in the elongated channel 1110.

[0146] As described above, the anvil mounting portion 1230 includes a pair of laterally extending mounting pins 1232 that are configured to be received in corresponding mounting brackets or pivot brackets 1120 formed in the proximal end 1112 of the elongated channel 1110. The mounting pins 1232 are pivotally held within the mounting brackets 1120 by an anvil top cover 1260 that is attached to the proximal end 1112 of the elongated channel 1110 in the manner described above. The anvil top cover 1260 includes a proximal end 1262 and a distal end 1264, and has a keyhole-shaped vertebral conduit 1266 extending therethrough to accommodate the passage of the top firing member feature 2320 and the upper vertebral members 2420 therethrough. Figure 36The vertebrae conduit 1266 in the anvil top cover 1260 is shown. When the rotary drive screw 2700 applies a load to the upper vertebra member 2420, the vertebra member 2420 will tend to tilt about Figure 37 Region A in the above drawing shows where the upper vertebra member 2420 is not yet tilted, so the upper vertebra member teeth 2450 are still at right angles to the helical drive member 2710 on the rotary drive screw 2700, and can experience higher pressure line contact. Figure 37 Region B in the above drawing shows where the upper vertebra member 2420 stops tilting. To ensure that most of the load remains in the longitudinal direction to perform useful work, the amount that the upper vertebra member teeth 2450 are angled must be the same as the amount that the upper vertebra member 2420 is tilted. Thus, as the upper vertebra member 2420 tilts, the upper vertebra member teeth 2450 will still maintain surface contact with the helical drive member 2710 on the rotary drive screw 2700, and all of the load will be directed longitudinally rather than vertically. The slightly angled upper vertebra member teeth 2450 can behave like a square thread as the vertebra member 2420 tilts, and better distribute the load to reduce pressure contact. By directing most of the load in the longitudinal direction, vertical loads are avoided that can cause friction to build up that would counteract the longitudinal load. The upper vertebra member 2420 reacts similarly as it passes down through the lock hole shaped anvil slot 1240. Likewise, the lower vertebra member 2520 reacts similarly as it passes through the lock hole shaped axial extension slot 1140 in the elongated channel 1110.

[0147] In the illustrated arrangement, the anvil 1210 is moved to an open position by a pair of anvil springs 1270 that are supported within the proximal end of the elongated channel. See Figure 38 , Figure 42 and Figure 43 . The springs 1270 are positioned to apply a pivotal biasing force to corresponding anvil control arms 1234 that can be integrally formed with and extend downwardly from the anvil mounting portion 1230. See Figures 39-41 .

[0148] Figure 39 Portions of the anvil 1210, the firing member 1210, and the anvil top cover 1260 are shown as the anvil 1210 is opened ( Figure 40 ), as the anvil 2310 is partially closed ( Figure 41 ), and after the firing member has been distally advanced from the original or starting position ( Figure 39 ). As Figure 40As can be seen, when the firing member 2310 is in the home or starting position, the top firing member feature 2320 is fully received within the vertebrae channel 1266 in the anvil top cover 1260. During the firing stroke, the top firing member feature 2320 and the superior vertebrae members 2420 in the superior series 2410 must transition from the vertebrae channel 1266 in the anvil top cover 1260 to the keyhole-shaped anvil slot 1240. Accordingly, it is desirable to minimize any gap "G" between the anvil mounting portion 1230 and the distal end 1264 of the anvil top cover 1260. To minimize this gap G while facilitating unimpeded pivotal travel of the anvil 1210, the distal end 1264 of the anvil top cover 1260 is formed with a curved top cover surface 1265 that matches a curved mating surface 1231 on the anvil mounting portion 1230. Both surfaces 1265, 1231 are curved and concentric about the pivot axis PA or some other reference point. This arrangement allows radial movement of the anvil 1210 and does not interfere with the anvil top cover 1260 while maintaining a minimal gap G therebetween. The gap G between the anvil mounting portion 1230 and the distal end 1264 of the anvil top cover 1260 is significantly shorter than the length of the superior vertebrae members 2420, which facilitates easy transition of each superior vertebrae member 2420 from the vertebrae channel 1266 in the anvil top cover 1260 to the keyhole-shaped anvil slot 1240. Moreover, to further assist the top firing member feature 2320 in transitioning into the keyhole-shaped anvil slot 1240, a ramped surface 1241 is formed adjacent the curved mating surface 1231 on the anvil mounting portion 1230. When the firing member 2310 is initially advanced distally from the home or starting position, the distal end of the top firing member feature 2320 contacts the ramped surface 1241 and begins to apply a closure motion to the anvil 1210, as Figure 41 As can be seen. Further distal advancement of the firing member 2310 during the firing stroke or firing sequence causes the top firing member feature to enter the keyhole-shaped anvil slot 1240 to fully close the anvil 1210 and maintain the anvil 1210 in the closed position during the firing sequence. See Figure 15 .

[0149] Generally, the highest firing forces established in an endocutter are associated with cutting and stapling tissue. If those same forces were available to close the anvil, the forces generated during pre-clamping and grasping of the tissue could also be higher. In at least one arrangement, the firing member body 2312 further includes a firing member wing or tab 2355 extending from each lateral side of the firing member body 2312. See Figure 36 and Figure 42The firing member wing 2355 is positioned to contact the corresponding anvil control arm 1234 when the firing member 2310 is driven in the proximal direction PD from the home or starting position to quickly close the anvil 1210 for grasping purposes. In at least one arrangement, when the firing member 2310 is in the home or starting position, the firing member wing 2355 is distal of the anvil control arm 1234, as shown in FIGS. 27 and 28. As the firing member 3210 is moved proximally, the firing member wing 2355 pushes the anvil control arm 1234 (in the pivoting direction C) against the bias of the anvil spring 1270. See FIGS. 29 and 30. In one arrangement, the firing member 2310 need only be moved a short distance D to cause the anvil 1210 to pivot to the closed position. For example, in one embodiment, the distance D can be approximately 0.070 inches long. This short distance movement allows for a quick response. Because the anvil pivot point or pivot axis PA is relatively far from the firing member wing 2355, this creates a substantial moment arm, so proximal movement of the firing member 2310 (and the firing member wing 2355) results in a high pre-compression torque being applied to the anvil 1210 to move the anvil 1210 to the closed position. Thus, the firing member wing 2355 can be referred to herein as a "pre-compression feature." See FIGS. 29 and 30. Figure 42 Figure 43 In one arrangement, the firing member 2310 need only be moved a short distance D to cause the anvil 1210 to pivot to the closed position. For example, in one embodiment, the distance D can be approximately 0.070 inches long. This short distance movement allows for a quick response. Because the anvil pivot point or pivot axis PA is relatively far from the firing member wing 2355, this creates a substantial moment arm, so proximal movement of the firing member 2310 (and the firing member wing 2355) results in a high pre-compression torque being applied to the anvil 1210 to move the anvil 1210 to the closed position. Thus, the firing member wing 2355 can be referred to herein as a "pre-compression feature." See FIGS. 29 and 30. Figure 19 Thus, by advancing the firing member 2310 proximally a short distance D to quickly pivot the anvil 1210 to the closed position, the clinician can use the surgical end effector 1000 to grasp and manipulate tissue between the anvil 1210 and the surgical staple cartridge 1300 without cutting the tissue and forming staples.

[0150] The firing member 2310 can be moved in the proximal direction PD by rotating the rotary drive screw 2700 in the second rotational direction. Thus, when the firing member 2310 is in the "home" or starting position, the anvil 1210 can be biased to the fully open position by the anvil spring 1270. Activating the rotary drive system 2600 to apply rotary motion to the rotary drive screw 2700 in the first rotational direction will cause the firing member 2310 to advance distally from the home or starting position to apply anvil closure motions to the anvil 1210 to move the anvil into closure to clamp tissue between the anvil 1210 and the surgical staple cartridge 1300. Continued rotation of the rotary drive screw in the first rotational direction will cause the firing member 2310 to continue to advance distally through the surgical end effector 1000. As the firing member 2310 is moved distally, the firing member 2310 contacts the sled 1312 (FIG. 26) that is supported in the surgical staple cartridge 1300. The firing member 2310 pushes the sled 1312 distally through the surgical staple cartridge 1300 to eject surgical staples from the surgical staple cartridge 1300 and form the staples against the anvil 1210 to join the clamped tissue to itself. Figure 2 ​) and drive the sled 1312 distally through the staple cartridge body 1302. When the firing member 2310 is in the original or starting position, the surgeon can wish to use the surgical end effector to grasp and manipulate tissue. To do this, the rotary drive system is actuated to apply a second rotary drive motion to the rotary drive screw 2700 in a second rotary direction opposite to the first rotary direction. This rotary motion of the rotary drive screw 2700 in the second rotary direction will drive the firing member 2310 proximally from the starting position and cause the anvil 1210 to quickly pivot to the closed position. Thus, according to at least one embodiment, the "original or starting position" of the firing member 2310 is not its most proximal position.

[0151] If during the firing process, the rotary drive system 2600 stops rotating, the firing member 2310 can become stuck within the surgical end effector. In this situation, the top firing member feature 2320 can remain engaged with the anvil 1210 and the bottom firing member feature 2350 can remain engaged with the elongate channel 1110, thereby preventing the surgeon from moving the anvil 1210 to the open position to release tissue clamped between the anvil 1210 and the surgical staple cartridge 1300. This can occur, for example, if the motor or other control arrangement that provides the rotary drive motion to the rotary drive shaft 2610 fails or otherwise becomes inoperative. In this situation, the firing member 2310 can be retracted to the original or starting position within the surgical end effector 1000 by pulling the top cable 2404 and the lower cable 2504 in the proximal direction. For example, the proximal portions of the top cable 2404 and the lower cable 2505 can be wound onto a rotary spool or cable management system 2009 Figure 44 ) within a housing portion of the surgical instrument 10 that is configured to pay out the top cable 2404 and the lower cable 2504 during the firing stroke and also retract the cables 2404, 2504 in the proximal direction if the firing member 2310 needs to be retracted. The cable management system 2009 can be motor driven or manually driven (ratchet arrangement, etc.) to apply the retraction motion to the cables 2404, 2504. As the cables 2404, 2504 are retracted, the upper vertebra member 2420 and the lower vertebra member 2520 will cause the rotary drive screw 2700 to rotate in reverse.

[0152] Whether the rotary drive screw 2700 will rotate in reverse can be determined using the following equation that depends on the lead (L), the pitch diameter (d p ), the tooth angle (a), and the friction (m):

[0153]

[0154] If the above equation holds, the rotary drive screw 2700 can be self-locking. To a great extent, in many cases, for an endo-cutter, the pitch diameter is mostly fixed, but the lead and the angle of the teeth are variable. Because the upper vertebra member teeth 2450 and the lower vertebra member teeth 2550 are mostly square, the rotary drive screw 2700 is more likely to be back drivable (cos(90) = 1). The lead of the upper vertebra member teeth 2450 and the lower vertebra member teeth 2550 can also be advantageous because the rolling friction between the vertebra members 2420, 2520 and the rotary drive screw 2700 is more likely to enable the rotary drive screw 2700 to be back driven. Thus, in an emergency, the surgeon can pull on the upper cable 2404 and the lower cable 2504 in the proximal direction to fully retract the firing member 2310 for a quick "panic" withdrawal.

[0155] As described above, the housing 2002 can support relative control motions of the rotary drive system 2600 and various cable management systems employed in connection with the firing system 2300 and the articulation control system 2240, which housing can be hand-held or part of a larger automated surgical system. The firing system 2300, the articulation control system 2240, and the rotary drive system 2600 can be, for example, motor-controlled and operated by one or more control circuits.

[0156] One method of using the surgical instrument 10 can involve using the surgical instrument 10 to cut and staple target tissue within a patient's body using laparoscopic techniques. For example, one or more trocars can have been placed through the patient's abdominal wall to provide access to target tissue within the patient's body. The surgical end effector 1000 can be inserted through one trocar and one or more cameras or other surgical instruments can be inserted through the other trocars. In order for the surgical end effector 1000 to be inserted through the trocar cannula, the surgical end effector 1000 is positioned in an unarticulated orientation and the jaws 1100 and 1200 must be closed. In order to maintain the jaws 1100 and 1200 in the closed position for insertion purposes, for example, the rotary drive system 2600 can be actuated to apply a second rotary motion to the rotary drive screw 2700, which causes the firing member 2310 to move proximally from the starting position to move the anvil 1210 (jaw 1200) to the closed position. See Figure 38 . The rotary drive system 2600 is deactivated to maintain the firing member 2310 in that position. Once the surgical end effector has been passed through the trocar into the abdomen, the rotary drive system 2600 can be activated to drive the rotary drive screw 2700 distally to move the firing member 2310 back to the starting position, where the anvil spring 1270 will pivot the anvil 1210 to the open position. See Figures 46-48 .

[0157] Once inside the abdomen and prior to engaging the target tissue, the surgeon can need to articulate the surgical end effector 1000 into a favorable position. The articulation control system 2240 is then actuated to articulate the surgical end effector in one or more planes relative to the portion of the elongate shaft assembly 2000 that is received within the cannula of the trocar. Once the surgeon has oriented the surgical end effector 1000 in the desired position, the articulation control system 2240 is deactivated to hold the surgical end effector 1000 in the articulated orientation. The surgeon can then use the surgical end effector to grasp the target tissue or adjacent tissue by activating the rotary drive system to rotate the rotary drive screw in the second rotational direction to move the firing member proximally to cause the anvil 1210 to rapidly close to grasp tissue between the anvil 1210 and the surgical staple cartridge 1300. The anvil 1210 can be opened by reversing the rotation of the rotary drive screw 2700. This process can be repeated as desired until the target tissue has been properly positioned between the anvil 1210 and the surgical staple cartridge 1300.

[0158] Once the target tissue has been positioned between the anvil 1210 and the surgical staple cartridge, the surgeon can begin the closure and firing process by activating the rotary drive system 2600 to drive the firing member 2310 distally from the starting position. As the firing member 2310 moves distally from the starting position, the firing member 2310 applies closure motions to the anvil 1210 and moves the anvil 1210 from the open position to the closed position in the manner discussed above. As the firing member 2310 moves distally, the firing member 2310 holds the anvil 1210 in the closed position to clamp the target tissue between the anvil 1210 and the surgical staple cartridge 1300. As the firing member 2310 moves distally, the firing member 2310 contacts and also drives the sled 1312 supported in the surgical staple cartridge 1300 distally through the cartridge body 1302. The sled 1312 continuously drives the rows of drivers supported in the cartridge distally toward the clamped target tissue. Each driver has one or more surgical staples or fasteners supported thereon that are subsequently driven through the target tissue and into contact with the underside of the anvil 1210. As the firing member 2310 moves distally, the tissue-cutting knife 2314 thereon cuts through the stapled tissue.

[0159] Once the firing member 2310 has been driven to the end position within the surgical end effector 1000, the surgeon can release the trigger 2610 to deactivate the rotary drive system 2600. The surgeon can then remove the surgical end effector 1000 from the trocar and the patient. The surgical end effector 1000 can then be replaced with a new surgical end effector 1000 and the procedure repeated as necessary. Figure 47) After the firing stroke is complete, the rotation drive system 2600 is reversed, which causes the firing member 2310 to retract proximally to the original or starting position. Once the firing member 2310 has returned to the starting position, the anvil spring 1270 will pivot the anvil 1210 to the open position to enable the surgeon to release the stapled tissue from the surgical end effector 1000. Once the stapled tissue has been released, the surgical end effector can be withdrawn from the patient through the trocar cannula. To do so, the surgeon must first actuate the articulation control system 2240 to return the surgical end effector 1000 to the unarticulated position and actuate the rotation drive system to drive the firing member 2310 proximally from the original or starting position to close the jaws. Thereafter, the surgical end effector 1000 can be withdrawn through the trocar cannula. If the firing system becomes inoperative during the firing stroke or during the retraction stroke, the surgeon can retract the firing member 2310 to the starting position by applying a pulling motion to the cables 2404, 2505 in the proximal direction in various manners described herein.

[0160] Figure 47 Another form of articulation joint 18200 is shown that includes a proximal joint member 18210 and a distal joint member 18250. The proximal joint member 18210 is configured to attach to the distal end of an elongated shaft assembly 18100 Figures 46-48 ) that is coupled to a housing or other portion of a surgical instrument in various manners disclosed herein. The distal joint member 18250 can be attached to a closure tube arrangement 18110 Figure 48 ) that is configured to apply closure and / or opening motions to movable jaws of an end effector 18000. In alternative arrangements, the distal joint member 18250 can be attached to one of the end effector jaws or other mounting portions of the end effector 18000. For example, the distal joint member 18250 can be attached to an elongated channel of an endoscopic cutter arrangement in various manners disclosed herein. In at least one arrangement, for example, the shaft assembly 18100 defines a shaft axis SA and the end effector 18000 defines an end effector axis EA. The articulation joint facilitates selective articulation of the end effector 18000 relative to the shaft assembly 18100 in an articulation plane between an unarticulated position in which the end effector axis EA is axially aligned with the shaft axis SA and an articulated position in which the end effector axis EA is not aligned with the shaft axis SA.

[0161] As Figure 48, the proximal joint member 18210 includes a proximal mounting hub 18212. For example, the proximal mounting hub can be configured to be inserted into the hollow outer shaft or tube portion 18102 of the slender shaft assembly 18100 and attached thereto by welding, adhesive, etc. The illustrated example also includes a distally facing collar portion 18214 that defines a distally facing mounting area generally designated 18220. See Figure 49 To accommodate various control shafts / drive members through the articulation joint 18200, the proximal joint member 18210 also includes a proximal central conduit 18216 that extends through the proximal mounting hub 18212 into the distally-facing mounting area 18220. In the illustrated example, the proximal central conduit 18216 is configured to accommodate a proximal drive shaft 18310 that is part of the rotary drive system 18300. In other arrangements, a flexible drive shaft (not shown) may extend through the proximal central conduit 18216.

[0162] Distal connector member 18250 includes a distal mounting hub 18252 configured to be inserted into the hollow outer shaft 18114, or closure tube, or mounting hub of surgical end effector 18000 and attached thereto by welding, adhesive, or the like. Surgical end effector 18000 may include any of the examples of surgical end effectors disclosed herein. The illustrated example also includes a proximally facing collar portion 18254 defining a proximally facing mounting area, generally designated 18260. Furthermore, distal connector member 18250 also includes a distal central conduit 18256 extending from distally facing mounting area 18220 through distal mounting hub 18252. In the illustrated example, distal central conduit 18256 is configured to accommodate a distal drive shaft 18330 as part of a rotary drive system 18300, or in other embodiments, distal central conduit 18256 may support another portion of a flexible drive shaft arrangement.

[0163] The illustrated example also includes an articulation connector assembly 19000 that extends between the proximal joint member 18210 and the distal joint member 18250 and is configured to operably interface therewith to facilitate articulation of the distal joint member 18250 (and the surgical end effector coupled thereto) relative to the proximal joint member 18210 (and the elongated shaft assembly 18100 coupled thereto). Figure 49As can be seen, the articulation link assembly 19000 includes a first link 19010, a second link 19030, and a third link 19050. Each of the links 19010, 19030, and 19050 is movably captured between the proximal joint member 18210 and the distal joint member 18250, but as will be discussed in further detail below, none of the links 19010, 19030, 19050 are directly attached to either of the proximal joint member 18210 and the distal joint member 18250.

[0164] In one example, the first link 19010 includes a rigid first link body 19012 that defines a first proximal end 19014 and a first distal end 19018. The first proximal end 19104 has a first proximal saddle 19016 formed therein that is configured to be pivotally received on a corresponding first proximal mounting lug 18222 formed in the distal-facing mounting region 18220. The first proximal mounting lug 18222 has an arcuate proximal pivot surface 18223 thereon and defines a first proximal pivot axis FPPA. See Figures 51-54 . The first proximal saddle 19016 includes a U-shaped proximal pivot surface 19017 that is configured to rollably or movably interface with the arcuate proximal pivot surface 18223 on the first proximal mounting lug 18222 such that the first link 19010 is movable in multiple directions or in multiple proximal travel paths relative to the proximal joint member 18210 about the first proximal pivot axis FPPA. For example, the first proximal saddle 19016 is movable in a first proximal travel path FPTP and a second proximal travel path SPTP relative to the first proximal pivot axis FPPA. In at least one arrangement, the first proximal travel path FPTP is transverse to the second proximal travel path SPTP. See Figure 50 and Figure 50 .

[0165] The first distal end 19108 includes a first distal saddle 19020 formed therein that is configured to be pivotally received on a corresponding first distal mounting lug 18262 formed in the proximal-facing mounting region 18260. The first distal mounting lug 18262 has an arcuate pivot surface 18263 and defines a first distal pivot axis FDPA. See Figure 49The first distal saddle 19020 includes a U-shaped pivot surface 19022 that is configured to rollably or movably interface with the arcuate pivot surface 18263 on the first distal mounting lug 18262 such that the first link 19010 is movable in multiple directions or in multiple distal travel paths relative to the distal joint member 18250 about the first distal pivot axis FDPA. For example, the first distal saddle 19020 is movable relative to the first distal pivot axis FDPA in a first distal travel path FDTP and a second distal travel path SDTP. In at least one arrangement, the first distal travel path FDTP is transverse to the second distal travel path SDTP. See FIGS. 19A and 19B. Figure 49 .

[0166] The second link 19030 includes a rigid second link body 19032 that defines a second proximal end 19034 and a second distal end 19038. The second proximal end 19034 has a second proximal saddle 19036 formed therein that is configured to pivotally receive on a corresponding second proximal mounting lug 18224 formed in the distally-facing mounting region 18220. The second proximal mounting lug 18224 has a second arcuate proximal pivot surface 18225 thereon and defines a second proximal pivot axis SPPA. See FIGS. 19A and 19B. Figure 50 . The second proximal saddle 19036 includes a second U-shaped proximal pivot surface 19037 that is configured to rollably or movably interface with the second arcuate proximal pivot surface 18225 on the second proximal mounting lug 18224 such that the second link 19030 is movable in multiple directions or in multiple proximal travel paths relative to the proximal joint member 18210 about the second proximal pivot axis SPPA. For example, the second proximal saddle 19036 is movable relative to the second proximal pivot axis SPPA in a first proximal travel path FPTP and a second proximal travel path SPTP. In at least one arrangement, the first proximal travel path FPTP is transverse to the second proximal travel path SPTP. See FIGS. 19A and 19B. Figure 50 .

[0167] The second distal end 19038 includes a second distal saddle 19040 that is configured to pivotally receive on a corresponding second distal mounting lug 18264 formed in the proximally-facing mounting region 18260. See FIGS. 19A and 19B. Figure 49The second distal mounting lug 18264 has a second arcuate distal pivot surface 18265 and defines a second distal pivot axis SDPA. The second distal saddle 19040 includes a second U-shaped distal pivot surface 19042 that is configured to rollably interface with the second arcuate distal pivot surface 18265 on the second distal mounting lug 18264 such that the second link 19030 is movable in multiple directions or in multiple distal paths relative to the distal joint member 18250 about the second distal pivot axis SDPA. For example, the second distal saddle 19040 is movable relative to the second distal pivot axis SDPA in a first distal travel path FDTP and a second distal travel path SDTP. In at least one arrangement, the first distal travel path FDTP is transverse to the second distal travel path SDTP. See FIGS. 19 and 20. Figure 49 .

[0168] The third link 19050 includes a rigid third link body 19052 that defines a third proximal end 19054 and a third distal end 19058. The third proximal end 19054 has a third proximal saddle 19056 formed therein that is configured to pivotally receive over a corresponding third proximal mounting lug 18226 formed in the distally facing mounting region 18220. The third proximal mounting lug 18226 has a third arcuate proximal pivot surface 18227 and defines a third proximal pivot axis TPPA. See FIGS. 19 and 20. Figure 50 . The third proximal saddle 19056 includes a third U-shaped proximal pivot surface 19057 that is configured to rollably or movably interface with the third arcuate proximal pivot surface 18227 on the third proximal mounting lug 18226 such that the third link 19050 is movable in multiple directions or in multiple travel paths relative to the proximal joint member 18210 about the third proximal pivot axis TPPA. For example, the third proximal saddle 19056 is movable relative to the third proximal pivot axis TPPA in a first proximal travel path FPTP and a second proximal travel path SPTP. In at least one arrangement, the first proximal travel path FPTP is transverse to the second proximal travel path SPTP. See FIGS. 19 and 20. Figure 50 .

[0169] The third distal end 19058 includes a third distal saddle 19060 that is configured to pivotally receive over a corresponding third distal mounting lug 18266 formed in the proximally facing mounting region 18260. See FIGS. 19 and 20. Figure 46The third distal mounting lug 18266 includes a third arcuate distal pivot surface 18267 and defines a third distal pivot axis TDPA. The third distal saddle 19060 includes a third U-shaped distal pivot surface 19062 that is configured for rollable or movable dynamic interfacing with the third arcuate distal pivot surface 18267 on the third distal mounting lug 18266 such that the third link 19050 is movable relative to the distal joint member 18250 about the third distal pivot axis TDPA in multiple directions or in multiple distal travel paths. For example, the third distal saddle 19060 is movable relative to the third distal pivot axis TDPA in a first distal travel path FDTP and a second distal travel path SDTP. In at least one arrangement, the first distal travel path FDTP is transverse to the second distal travel path SDTP. See FIGS. 19 and 20. In at least one arrangement, the third distal pivot axis TDPA is transverse to the first proximal pivot axis TP A and the second proximal pivot axis SP A. See FIGS. 19 and 20. Figure 55 .

[0170] In the illustrated arrangement, none of the links 19010, 19030, and 19050 are directly attached to either of the proximal joint member 18210 or the distal joint member 18250. Rather, the link assembly 19000 is supported in movable pivotal engagement with the proximal joint member 18210 and the distal joint member 18250 by a cable-based articulation system 18400. In the illustrated example, the articulation joint 18200 is operably controlled by a cable control system 18400 that includes four flexible actuator members in the form of cables 18410, 18420, 18430, and 18440 that extend through the elongate shaft assembly to be operably interfaced with a cable control system that can be supported within a housing of a surgical instrument. The cable control system can include a number of cable support members / drive wheels, pulleys, etc. that are controlled by one or more corresponding motors that are controlled by a control circuit portion of the surgical instrument. The cable control system is configured to manage tensioning (pulling) and pay-out of the cables at precise times during the articulation process. As Figure 56As can be seen in FIG. 184, cable 18410 extends through a corresponding conduit 18412 in proximal joint member 18210 into a corresponding conduit 18414 in distal joint member 18250, and has a retainer lug (not shown) thereon to prevent it from pulling through distal joint member 18250. Cable 18420 extends through a corresponding conduit 18422 in proximal joint member 18210, and into a corresponding conduit in distal joint member 18250, and has a retainer lug (not shown) thereon to prevent it from pulling through distal joint member 18250. Cable 18430 extends through a corresponding conduit 18432 in proximal joint member 18210 into a corresponding conduit 18434 in distal joint member 18250, and has a retainer lug (not shown) thereon to prevent it from pulling through distal joint member 18250. Cable 18440 extends through a corresponding conduit 18442 in proximal joint member 18210 into a corresponding conduit 18444 in distal joint member 18250, and has a retainer lug (not shown) thereon to prevent it from pulling through distal joint member 18250. Thus, in one sense, cables 18410, 18420, 18430, and 18440 span articulation joint 18200 to impart articulation to distal joint member 18250.

[0171] By applying tension to various cables and simultaneously allowing the remaining cables to relax, distal joint member 18250 can be selectively articulated in multiple directions relative to proximal joint member 18210. As in Figure 55 and Figure 48 As can be seen in FIG. 1900, linkage assembly 19000 facilitates articulation of a distal virtual sphere VDS that is substantially proximal to rolling relative to a virtual proximal sphere VPS. In the illustrated arrangement, rotary drive system 18300 further includes a central "dog bone" drive shaft 18320 having a spherical proximal end 18322 that is received in a proximal socket 18312 in proximal drive shaft 18310 and movably retained therein by a corresponding pin 18324. Central drive shaft 18320 further has a spherical distal end 18326 that is received within a distal socket 18332 in distal drive shaft 18330 and movably retained therein by a corresponding pin 18328. Other flexible drive shaft arrangements (rotary and / or non-rotary) can also be employed. As in Figures 57-59As can also be seen, the three links 19010, 19030, and 19050 are configured to have a geometry that places the distal end of each link 180 degrees (about the longitudinal axis) from the proximal end of the link. Each respective link 19010, 19030, and 19050 "arrives" about the central drive shaft 18320. In other words, the first link 19010 defines a first link axis FLA. The second link 19030 defines a second link axis SLA and the third link 19050 defines a third link axis TLA. In one arrangement, the links 19010, 19030, and 19050 are supported relative to one another such that the first link axis FLA, the second link axis SLA, and the third link axis TLA are transverse to one another. See Figure 59 The particular geometry of the lug and saddle arrangement defines a linkage 19000 that moves the distal joint member 18250 relative to the proximal joint member 18210 as if it were a ball rolling on another ball. The cables hold the links in compression such that the saddle is held in movable abutment with its corresponding lugs in the proximal and distal joint members 18210, 18250 without otherwise being directly coupled thereto (e.g., without a pin or other arrangement).

[0172] Closing an anvil requires a system that meets many requirements. The closure system needs to respond quickly to hand motions of a surgeon operating a hand-held system to which the robotic system or end effector is attached. The closure system must also be able to exert sufficient load on the tissue to ensure proper staple formation. It should also be easy to back out in the event of a failure to close. These features should all be obtainable within as small a footprint as possible to ensure sufficient maneuverability within a patient.

[0173] Figure 60 A surgical end effector 20000 is shown that includes a closure system 20400 that can address many, if not all, of the foregoing challenges. In the illustrated example, the surgical end effector 20000 includes an elongate channel 20100 that is configured to operably support a surgical staple cartridge 20300 therein. The surgical end effector 20000 also includes an anvil 20200 that is configured to move relative to the surgical staple cartridge 20300 between open and closed positions to clamp tissue therebetween. As Figure 61 and Figure 62As can be seen in the drawings, the closing system 20400 includes a rotationally driven closing cam member 20410 configured to impart a closing motion to the anvil 20200. In one arrangement, the closing cam member 20410 is supported on a rotatable cam shaft 20420 having a driven gear 20422 formed thereon. The driven gear 20422 is supported in meshing engagement with a rotating closing gear 20660 that is drivable by a motor / gearbox arrangement supported in a housing of a surgical instrument to which the surgical end effector is operably attached. Figure 59 and Figure 61 As can be seen in FIG, the cam shaft 20420 includes a spiral drive groove 20424 configured to receive the drive pin 20412 on the closing cam member 20410. Rotation of the cam shaft 20420 in a first rotational direction will cause the closing cam member 20410 to rotate in a distal direction DD from the starting position ( Figure 50 and Figure 62 ) moves to the end position ( Figure 58 and Figure 58 ).

[0174] In one arrangement, the anvil 20200 includes an anvil mounting portion 20210 comprising two mounting arms 20212, each having a slot therein configured to receive a corresponding pivot pin 20216 projecting from a proximal end of the elongated channel 20100. Figure 60 The closing cam member 20410 also includes two closing cams 20414 corresponding to the anvil mounting arms 20212 of the anvil 20200. In one arrangement, the anvil 20200 can be biased to Figure 63 and 59 The anvil 20200 is moved to the closed position by actuating the rotary closing gear 20660 to drive the closing cam member 20410 distally from the starting position to the end position. When the closing cam member 20410 is driven distally, the closing cam 20414 contacts the corresponding mounting arm 20212 and causes the anvil 20200 to pivot to the closed position. Figures 63-65 Shown in closed position.

[0175] Figure 65 The surgical end effector 20000 is shown attached to an articulation joint 20500 that employs a rotary drive assembly 20600 for transmitting rotary drive motion across the articulation joint 20500. In the illustrated example, the rotary drive assembly 20600 includes nested universal joints that allow the surgical end effector 20000 to roll distally of the articulation joint 20500. For example, a two-sided joint arrangement may be employed, wherein each joint may be angled approximately seventy degrees (for a total of one hundred and forty degrees).

[0176] In one arrangement, the articulation joint 20500 includes a proximal joint member 20510 that is attachable to an outer tube member of an elongate shaft assembly that is coupled to or operably interfaced with a housing of a surgical instrument. In alternative arrangements, the proximal joint member 20510 can be integrally formed on a distal end of the outer tube member of the elongate shaft. As Figure 65 As can be seen in FIG. 20, the proximal joint member 20510 includes a distally projecting upper pivot tang 20520 and a distally projecting lower pivot tang 20530. The articulation joint 20500 further includes a distal joint member 20540 that is attached to the surgical end effector 20000. In one example, the distal joint member 20540 is attached to a proximal end of the elongate channel 20100 and includes a proximally projecting upper pivot tang 20550 and a proximally projecting lower pivot tang 20560. In the illustrated example, the distally projecting upper pivot tang 20520 is formed with a series of proximal articulation gear teeth 20522 and the proximally projecting upper pivot tang 20550 is formed with a series of distal articulation gear teeth 20552. The distally projecting lower pivot tang 20530 is formed with an arcuate proximal surface 20532 and the proximally projecting lower pivot tang 20560 is formed with an arcuate distal surface 20562. In one example, a rotary drive assembly 20600 extends through the articulation joint 20500 and is configured to hold the proximal articulation gear teeth 20522 in meshing engagement with the distal articulation gear teeth 20552 to facilitate pivotal travel therebetween. In addition, in at least one arrangement, the arcuate distal end surface 20562 and the arcuate proximal end surface 20532 can be rockingly engaged with one another for support. This arrangement allows the surgical end effector 20000 to articulate relative to the elongate shaft assembly through a single articulation plane upon application of an articulation control motion to the surgical end effector 20000. Such articulation control motions can be applied to the surgical end effector by cables or other articulation members (not shown) that extend from a control system in the surgical instrument housing and across the articulation joint 20500 to operably interface with the surgical end effector.

[0177] Turning to FIG. 21, Figure 59 The rotary drive system 20600 includes a series of nested shaft systems 20610, 20710, and 20810. As Figure 60As can be seen, the "first" axis system 20610, which is centrally located, includes a first proximal shaft member 20620 that is attached to, or otherwise operably interfaced with, a corresponding first rotary drive system supported by the housing of the surgical instrument. For example, the first rotary drive system can include a corresponding motor / gear arrangement configured to rotate the first proximal shaft member 20620. The first axis system 20610 further includes a first center shaft 20630 that includes a shaft body 20632 with a first spherical proximal end 20634 that is rotatably supported in a first spherical proximal cup 20622 on the first proximal shaft member 20620. The first center shaft 20630 is movably pinned within a cavity 20624 in the first spherical proximal cup 20622 by a first proximal pin 20636 that extends through an arcuate slot 20635 in the first spherical proximal end 20634. The first center shaft 20630 further includes a first spherical distal end 20640 that is rotatably supported in a first spherical distal cup 20652 attached to a first distal shaft member 20650. The first center shaft 20630 is movably pinned within a cavity 20654 in the first spherical distal cup 20652 by a first distal pin 20644 that extends through an arcuate slot 20642 in the first spherical distal end 20640. In one arrangement, for example, the first distal shaft member 20650 can be configured to apply rotary motion to a closure gear 20660 to apply rotary closure motion to the rotatable cam shaft 20420 in the manner described above. See, e.g., Figures 65-67 and Figure 59 Thus, in at least one arrangement, actuation of the first rotary drive system to cause rotation of the first proximal shaft member 20620 will result in actuation of the closure system 20400 to move the anvil 20200 from an open position to a closed position.

[0178] Referring to Figure 60The second shaft system 20710 includes a second proximal shaft member 20720 that is attached to or otherwise operably interfaced with a corresponding second rotary drive system supported by the housing of the surgical instrument. For example, the second rotary drive system can include a corresponding motor / gear arrangement configured to rotate the second proximal shaft member 20720. The second shaft system 20710 further includes a second hollow central shaft 20730 that includes a hollow shaft body 20732 having a second spherical proximal end 20734. In one arrangement, the second hollow central shaft 20730 can be manufactured as two segments that are welded or otherwise coupled together. The second spherical proximal end 20734 defines a second central proximal cavity 20735 that is configured to movably receive the first spherical proximal cup 20622 of the first proximal shaft member 20620 therein. The second spherical proximal end 20734 is configured to be rotatably supported in a second spherical proximal cup 20722 on the second proximal shaft member 20720. The second hollow central shaft 20730 is movably pinned within a cavity 20724 in the second spherical proximal cup 20722 by a second proximal pin segment 20736 extending from the second spherical proximal end 20734 to be movably received within a corresponding arcuate slot 20726 in the second spherical proximal cup 20722 on the second proximal shaft member 20720. The second hollow central shaft 20730 further includes a second spherical distal end 20740. The second spherical distal end 20740 defines a second central distal cavity 20742 that is configured to movably receive the first spherical distal cup 20652 of the first distal shaft member 20650 therein. The second hollow central shaft 20730 is movably pinned within a cavity 20754 in the second spherical distal cup 20752 by a second distal pin segment 20746 extending from the second spherical distal end 20740 to be movably received within a corresponding arcuate slot 20756 in the second spherical distal cup 20752 on the second distal shaft member 20750.

[0179] In one arrangement, the second distal shaft member 20750 can be configured to apply rotary motion to a first rotary drive gear 20760 that is in meshing engagement with a driven gear 20762 that is attached to a rotary drive shaft 20770 that is rotatably supported in the elongate channel 20100. See Figure 68 、 Figure 59 and Figure 60 . As Figure 68 、 Figure 59 and Figures 65-67As shown, the surgical end effector 20000 further includes a firing member 20310 that is threadably engaged with a rotary drive shaft 20770. Rotation of the rotary drive shaft 20770 in a first rotary direction will cause the firing member 20310 to move distally from a starting position Figures 69-75 through the surgical end effector 20000 to an ending position. Selection of the rotary drive shaft 20770 in an opposite rotary motion will drive the firing member 20310 from the ending position back to the starting position. Thus, in at least one arrangement, actuation of the second rotary drive system to cause rotation of the second proximal shaft member 20720 will result in actuation of the firing member 20310 to cut and staple tissue clamped between the anvil 20200 and the surgical staple cartridge 20300.

[0180] Referring to Figure 69The third shaft system 20810 includes a third proximal shaft member 20820 that is attached to, or otherwise operably interfaced with, a corresponding third rotary drive system supported by the housing of the surgical instrument. For example, the third rotary drive system can include a corresponding motor / gear arrangement configured to rotate the third proximal shaft member 20820. The third shaft system 20810 further includes a third hollow center shaft 20830 that includes a hollow shaft body 20832 having a third spherical proximal end 20834. In one arrangement, the third hollow center shaft 20830 can be manufactured as two sections welded or otherwise coupled together. The third spherical proximal end 20834 defines a third proximal cavity 20835 that is configured to movably receive the second spherical proximal cup 20722 of the second proximal shaft member 20720 therein. The third spherical proximal end 20834 is configured to be movably supported in a third proximal socket 20824 in the third proximal shaft member 20820. The third spherical proximal end 20834 is axially movable within the third proximal socket 20824 and is attached thereto by a third proximal pin section 20836 that extends from the third spherical proximal end 20834 to be movably received within a corresponding axial slot 20824 in the third proximal socket 20824 on the third proximal shaft member 20820. The third center shaft 20830 further includes a third spherical distal end 20840. The third spherical distal end 20840 defines a third center distal cavity 20842 that is configured to movably receive the second spherical distal cup 20752 of the second distal shaft member 20750 therein. The third spherical distal end 20840 is movably pinned within a third distal socket 20852 on the third distal shaft 20850. The third spherical distal end 20840 is axially movable within the third distal socket 20852 and is attached thereto by a third distal pin section 20846 that extends from the third spherical distal end 20840 to be movably received within a corresponding axial slot 20854 in the third distal socket 20850.

[0181] In one arrangement, the third distal shaft member 20850 can be configured to apply rotational motion to the surgical end effector 20000 to cause the surgical end effector 20000 to rotate about the shaft axis SA. In one arrangement, for example, the third distal shaft member 20850 can be directly attached (welded) to the elongate channel 20100. Thus, in at least one arrangement, actuation of the third rotary drive system to cause rotation of the third proximal shaft member 20820 will cause rotation of the third distal shaft member 20850 and the surgical end effector 20000. In the illustrated arrangement, intermeshing gear teeth 20522 and 20552 on the upper proximal pivot tang 20520 and the upper distal pivot tang 20550 force the center of the shaft system to remain at the same center distance as articulation occurs. Such a shaft system is very strong and durable while maintaining a tight articulation joint, while also facilitating distal roll of the surgical end effector.

[0182] Highly articulating robotic and hand-held endoscopic stapling instruments require the generation of significant forces to clamp onto thick tissue. Moving forces through highly articulating joints (e.g., sixty degrees and greater) is challenging. Many robots and hand-held motors are slow, and their ability to generate sufficient torque is limited. Figure 71 A surgical end effector 21000 is shown that can address many, but not all, of these challenges. As can be seen in Figure 70 the cross-sectional view of FIG. 27, the surgical end effector 21000 includes a first jaw 21100 that includes an elongate channel 21110 that is configured to operably support a surgical staple cartridge 21300 therein. The surgical end effector 21000 further includes a second jaw 21200 that includes an anvil 21210 that is pivotally coupled to the elongate channel 21110 about a fixed pivot axis PA. The anvil 21210 is pivotable between open Figure 70 and closed positions Figure 71 by a rotary driven closure system 21400.

[0183] In one arrangement, the closure system 21400 includes a closure drive shaft 21410 that is configured for rotation by a corresponding source of rotational motion (motor, etc.) in the housing of a surgical instrument to which the end effector is attached. The closure drive shaft 21410 can include a flexible shaft arrangement that can flex and simultaneously transmit torque through an articulation joint. The closure drive shaft 21410 is attached to a rotating cam shaft 21420 that has a closure cam lobe 21422 formed thereon. In one arrangement, an opening bushing 21430 is movably journaled on the rotating cam shaft 21420 and is configured to engage an opening tab 21222 on the anvil mounting portion 21220 of the anvil 21210. An opening spring 21440 is positioned on the rotating cam shaft 21420 to bias the opening bushing 21430 distally into contact with the opening tab 21222 on the anvil 21210. As can be seen in Figure 72 FIGS. 16-18, when the opening bushing 21430 is moved distally, it contacts the opening tab 21222 which causes the anvil 21210 to pivot about the pivot axis PA to an open position (FIG. 18). Figure 74 ) about the pivot axis PA.

[0184] In one example, the anvil 21210 is pivoted from the open position to the closed position by rotating the rotating cam shaft 21420 from the first rotational position shown in Figure 69 to the final rotational position shown in Figure 70 . As can be seen in Figure 71 and Figure 72 , the closure system 21400 further includes a cam follower 21450 that is movably supported in the anvil mounting portion 21220 and is configured to be in movable contact with the closure cam lobe 21422 on the rotating cam shaft 21420. Figure 73 and Figure 73 illustrate the position of the closure cam lobe 21422 when the anvil 21210 is in the open position. When in this position, the anvil mounting portion 21220 has been pivoted past the closure cam lobe 21422 so that the cam follower 21450 is not in contact with the closure cam lobe 21422. When the rotating cam shaft 21420 begins to rotate, the closure cam lobe 21422 contacts the cam follower 21450 Figure 74 and cam follows the cam follower 21450 in contact with the pivot bracket 12224 in the anvil mounting portion 21220 (upwardly in Figure 75 to the position shown in Figure 76 where the cam follower 21452 has pivoted the anvil 21210 to the closed position Figure 77). When the anvil 21210 is pivoted to the closed position, the opening tab 21222 biases the opening bushing 21430 proximally on the rotary cam shaft 21420 against the bias of the opening spring 21440. Thus, when the rotary cam shaft 21420 is rotated in the opposite direction, the anvil opening spring 21440 biases the opening bushing 21430 distally into contact with the opening tab 21222 to pivot the anvil 21210 back to the open position.

[0185] ​ Another rotary cam shaft 21420' is shown that is identical to the rotary cam shaft 21420 except that the distal end 21426 of the rotary cam shaft 21420' further includes an opening cam 21426 that is configured to engage the opening tab 21222 on the anvil 21210 to move the anvil 21210 to the open position. Thus, when the rotary cam shaft 21420' is in the first rotational position, the opening cam 21426 has cammed the anvil opening tab 21222 to pivot the anvil 21210 to the open position. See ​ To close the anvil, the rotary cam shaft 21420' is rotated in the closing direction to cause the cam lobe 21422 to cam the cam follower 21450 upwardly to thereby pivot the anvil 21210 into the closed position. The anvil 21210 can then be returned to the open position by rotating the rotary cam shaft 21420' back to the first rotational position. In alternative arrangements, the opening bushing 21430 and the opening spring 21440 can be used in conjunction with the rotary cam shaft 21420'.

[0186] It will be appreciated that the foregoing embodiments of the closure system 21400 facilitate applying a relatively fast closure and opening motion to the anvil 21210. In various arrangements, the cam profile can be formed to establish a low mechanical advantage at the beginning and a relatively high mechanical advantage at the end when the anvil 21210 begins to compress tissue. This closure system arrangement employs fewer components than many other closure system designs. This arrangement also provides additional space at the proximal end of the end effector to accommodate electronics and other mechanisms in the end effector.

[0187] Example 1 - A surgical instrument comprising a shaft assembly defining a shaft axis. The surgical instrument further comprises a surgical end effector defining an end effector axis and coupled to the shaft assembly by an articulation joint configured to facilitate articulation of the surgical end effector relative to the shaft assembly in an articulation plane between an unarticulated position in which the end effector axis is axially aligned with the shaft axis and an articulated position in which the end effector axis is not axially aligned with the shaft axis. The articulation joint comprises a proximal joint member coupled to the shaft assembly and a distal joint member coupled to the surgical end effector. The articulation joint further comprises an articulation linkage assembly comprising a plurality of links. Each link is configured to operably interface with the proximal joint member for movable travel relative thereto in a first proximal travel path and a second proximal travel path transverse to the first proximal travel path. Each link is further configured to operably interface with the distal joint member for movable travel relative thereto in a first distal travel path and a second distal travel path transverse to the first distal travel path. The articulation linkage assembly defines a central conduit extending between the plurality of links. The surgical instrument further comprises a drive member extending through the proximal joint member, the central conduit, and the distal joint member so as to operably interface with the surgical end effector. The at least two flexible actuator members span the articulation joint and operably interface with the distal joint member to apply articulation thereto.

[0188] Example 2 - The surgical instrument of Example 1, wherein the plurality of links comprises three links.

[0189] Embodiment 3 - The surgical instrument of Embodiment 2, wherein the three links include a first link configured to operably interface with the proximal joint member for movable travel relative thereto in a first proximal travel path and another first proximal travel path transverse to the first proximal travel path. The first link is further configured to operably interface with the distal joint member for movable travel relative thereto in a first distal travel path and another first distal travel path transverse to the first distal travel path. The three links also include a second link configured to operably interface with the proximal joint member for movable travel relative thereto in a second proximal travel path and another second proximal travel path transverse to the second proximal travel path. The second link is configured to operably interface with the distal joint member for movable travel relative thereto in a second distal travel path and another second distal travel path transverse to the second distal travel path. The three links also include a third link configured to operably interface with the proximal joint member for movable travel relative thereto in a third proximal travel path and another third travel path transverse to the third proximal travel path. The third link is further configured to operably interface with the distal joint member for movable travel relative thereto in a third distal travel path and another third distal travel path transverse to the third distal travel path.

[0190] Embodiment 4 - The surgical instrument of Embodiments 1, 2, or 3, wherein each link includes a proximal saddle configured to movably interface with a corresponding proximal mounting lug on the proximal joint member and a distal saddle configured to movably interface with a corresponding distal mounting lug on the distal joint member.

[0191] Embodiment 5 - The surgical instrument of Embodiment 4, wherein each proximal mounting lug defines an arcuate proximal pivot surface. Each proximal saddle includes a U-shaped proximal pivot surface configured to movably interface with the arcuate proximal pivot surface on the proximal mounting lug to facilitate travel of the link on the proximal mounting lug in the first proximal travel path and the second proximal travel path. Each distal mounting lug defines an arcuate distal pivot surface. Each distal saddle includes a U-shaped distal pivot surface configured to movably interface with the arcuate distal pivot surface on the distal mounting lug to facilitate travel of the link on the distal mounting lug in the first distal travel path and the second distal travel path.

[0192] Example 6 - The surgical instrument of Example 5, wherein each proximal mounting lug defines a proximal lug axis, and wherein the first proximal travel path comprises a first arcuate proximal travel path along the proximal lug axis. The second proximal travel path comprises a second arcuate proximal travel path about the proximal lug axis. Each distal mounting lug defines a distal lug axis, and wherein the first distal travel path comprises a first arcuate distal travel path along the distal lug axis. The second distal travel path comprises a second arcuate distal travel path about the distal lug axis.

[0193] Example 7 - The surgical instrument of Examples 1, 2, 3, 4, or 6, wherein a portion of the drive member extending through the articulation joint is flexible.

[0194] Example 8 - The surgical instrument of Examples 1, 2, 3, 4, 5, 6, or 7, wherein the drive member comprises a proximal drive shaft comprising a distal end operably supported in the proximal joint member. A distal drive shaft comprises a proximal end operably supported in the distal joint member. A central drive shaft spans between the proximal joint member and the distal joint member and comprises a proximal end configured to operably interface with the distal end of the proximal drive shaft. The central drive shaft further comprises a distal end configured to operably interface with the proximal end of the distal drive shaft.

[0195] Example 9 - The surgical instrument of Example 8, wherein the proximal drive shaft is configured to impart rotational drive motion to the central drive shaft.

[0196] Example 10 - The surgical instrument of Examples 1, 2, 3, 4, 5, 6, 7, 8, or 9, wherein the at least two flexible actuator members comprise four cables spanning the articulation joint and operably interfacing with the distal articulation joint member to impart articulation to the distal articulation joint member.

[0197] Example 11 - The surgical instrument of Examples 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10, wherein each link is unattached to the proximal joint member and the distal joint member.

[0198] Example 12 - The surgical instrument of Examples 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11, wherein each link remains in movable contact with the proximal joint member and the distal joint member.

[0199] Example 13 - A surgical instrument comprising a shaft assembly defining a shaft axis and a surgical end effector defining an end effector axis. The surgical end effector is coupled to the shaft assembly by an articulation joint configured to facilitate articulation of the surgical end effector relative to the shaft assembly in an articulation plane between an unarticulated position in which the end effector axis is axially aligned with the shaft axis in the articulation plane and an articulated position in which the end effector axis is not axially aligned with the shaft axis. The articulation joint comprises a proximal joint member coupled to the shaft assembly and a distal joint member coupled to the surgical end effector. The articulation joint further comprises an articulation linkage assembly comprising a first link configured to operably interface with the proximal joint member for movable travel relative thereto in a first proximal travel path and another first proximal travel path transverse to the first proximal travel path. The first link is further configured to operably interface with the distal joint member for movable travel relative thereto in a first distal travel path and another first distal travel path transverse to the first distal travel path. The articulation linkage assembly further comprises a second link configured to operably interface with the proximal joint member for movable travel relative thereto in a second proximal travel path and another second proximal travel path transverse to the second proximal travel path. The second link is further configured to operably interface with the distal joint member for movable travel relative thereto in a second distal travel path and another second distal travel path transverse to the second distal travel path. The articulation linkage assembly further comprises a third link configured to operably interface with the proximal joint member for movable travel relative thereto in a third proximal travel path and another third travel path transverse to the third proximal travel path. The third link is further configured to operably interface with the distal joint member for movable travel relative thereto in a third distal travel path and another third distal travel path transverse to the third distal travel path. The surgical instrument further comprises at least two flexible actuators spanning the articulation joint and operably interfacing with the distal joint member to apply articulation thereto.

[0200] Example 14 - The surgical instrument of Example 13, wherein the first link defines a first link axis. The second link defines a second link axis. The third link defines a third link axis. The first link axis, the second link axis, and the third link axis are transverse to one another.

[0201] Embodiment 15 - The surgical instrument of Embodiments 13 or 14, wherein the first link, the second link, and the third link are arranged relative to one another to define a central channel extending between the first link, the second link, and the third link and configured to operably support a drive member therein.

[0202] Embodiment 16 - The surgical instrument of Embodiments 13, 14, or 15, wherein the first link includes a first proximal saddle configured to movably interface with a corresponding first proximal mounting lug on the proximal joint member and a first distal saddle configured to movably interface with a corresponding first distal mounting lug on the distal joint member. The second link includes a second proximal saddle configured to movably interface with a corresponding second proximal mounting lug on the proximal joint member and a second distal saddle configured to movably interface with a corresponding second distal mounting lug on the distal joint member. The third link includes a third proximal saddle configured to movably interface with a corresponding third proximal mounting lug on the proximal joint member and a third distal saddle configured to movably interface with a corresponding third distal mounting lug on the distal joint member.

[0203] Embodiment 17 - The surgical instrument of Embodiment 16, wherein the first proximal mounting lug defines a first arcuate proximal pivot surface. The first proximal saddle includes a first U-shaped proximal pivot surface configured to movably interface with the first arcuate proximal pivot surface on the first proximal mounting lug to facilitate the first link traveling in the first proximal travel path and another first proximal travel path on the first proximal mounting lug. The second proximal mounting lug defines a second arcuate proximal pivot surface. The second proximal saddle includes a second U-shaped proximal pivot surface configured to movably interface with the second arcuate proximal pivot surface on the second proximal mounting lug to facilitate the second link traveling in the second proximal travel path and another second proximal travel path on the second proximal mounting lug. The third proximal mounting lug defines a third arcuate proximal pivot surface. The third proximal saddle includes a third U-shaped proximal pivot surface configured to movably interface with the third arcuate proximal pivot surface on the third proximal mounting lug to facilitate the third link traveling in the third proximal travel path and another third proximal travel path on the third proximal mounting lug.

[0204] Embodiment 18 - A surgical instrument according to Embodiment 17, wherein the first distal mounting lug defines a first arcuate distal pivot surface. The first distal saddle includes a first U-shaped distal pivot surface configured to movably interface with the first arcuate distal pivot surface on the first distal mounting lug to facilitate travel of the first link on the first distal mounting lug in the first distal travel path and another first distal travel path. The second distal mounting lug defines a second arcuate distal pivot surface. The second distal saddle includes a second U-shaped distal pivot surface configured to movably interface with the second arcuate distal pivot surface on the second distal mounting lug to facilitate travel of the second link on the second distal mounting lug in the second distal travel path and another second distal travel path. The third distal mounting lug defines a third arcuate distal pivot surface. The third distal saddle includes a third U-shaped distal pivot surface configured to movably interface with the third arcuate distal pivot surface on the third distal mounting lug to facilitate travel of the third link on the third distal mounting lug in the third distal travel path and another third distal travel path.

[0205] Example 19 - The surgical instrument of Example 18, wherein the first proximal mounting lug defines a first proximal lug axis. The first proximal travel path comprises a first arcuate proximal travel path along the first proximal lug axis, and the other first proximal travel path comprises another first proximal arcuate travel path extending about the first proximal lug axis. The second proximal mounting lug defines a second proximal lug axis. The second proximal travel path comprises a second arcuate proximal travel path along the second proximal lug axis, and the other second proximal travel path comprises another second proximal arcuate travel path extending about the second proximal lug axis. The third proximal mounting lug defines a third proximal lug axis. The third proximal travel path comprises a third arcuate proximal travel path extending along the third proximal lug axis. The other third proximal travel path comprises another third proximal arcuate travel path extending about the third proximal lug axis. The first distal mounting lug defines a first distal lug axis. The first distal travel path comprises a first arcuate distal travel path extending along the first distal lug axis. The other first distal travel path comprises another first distal arcuate travel path extending about the first distal lug axis. The second distal mounting lug defines a second distal lug axis. The second distal travel path comprises a second arcuate distal travel path extending along the second distal lug axis. The other second distal travel path comprises another second distal arcuate travel path extending about the second distal lug axis. The third distal mounting lug defines a third distal lug axis. The third distal travel path comprises a third arcuate distal travel path extending along the third distal lug axis. The other third distal travel path comprises another third distal arcuate travel path extending about the third distal lug axis.

[0206] Example 20 - The surgical instrument of Example 19, wherein the first proximal lug axis, the second proximal lug axis, and the third proximal lug axis are transverse to one another, and wherein the first distal lug axis, the second distal lug axis, and the third distal lug axis are transverse to one another.

[0207] As used in any aspect herein, the term “control circuitry” can refer to, for example, hardwired circuitry, programmable circuitry (for example, a computer processor including one or more individual instruction processing cores, processing units, processors, microcontrollers, microcontroller units, controllers, digital signal processors (DSPs), programmable logic devices (PLD), programmable logic arrays (PLA), field programmable gate arrays (FPGA)), state machine circuitry, firmware that stores instructions executed by programmable circuitry, and any combination thereof. The control circuitry can be implemented in collective or individual components of an electronic system, for example, an integrated circuit (IC), an application-specific integrated circuit (ASIC), a system on chip (SoC), a desktop computer, a laptop computer, a tablet computer, a server, a smart phone, and the like. As used herein, “control circuitry” includes, but is not limited to, electronic circuitry with at least one discrete electrical circuit, electronic circuitry having at least one integrated circuit, electronic circuitry having at least one application specific integrated circuit (ASIC), electronic circuitry forming a general purpose computing device configured by a computer program (e.g., a general purpose computer configured by a computer program that at least partially carries out the processes and / or devices described herein, or a microprocessor configured by a computer program that at least partially carries out the processes and / or devices described herein), electronic circuitry forming a memory device (e.g., forms of random access memory), and / or electronic circuitry forming a communications device (e.g., a modem, communications switch, or optical-electrical equipment). Those skilled in the art will recognize that the subject matter described herein can be implemented in an analog or digital form, or a combination thereof, as some embodiments of the subject matter described herein can be implemented to include both analog and digital aspects. Embodiments of the subject matter described herein can be implemented as software code to be executed on a

[0208] Although a number of forms have been exemplified and described, it is the intent of the applicant that the scope of the appended claims not be limited to the forms described herein. Many modifications, variations, alterations, substitutions, combinations, and equivalents of the forms described herein will occur to those skilled in the art upon reading the foregoing description. Additionally, it is intended that each element of each form described herein be implemented by equivalent structures as those described within the scope of the claims. Furthermore, although exemplary aspects are described herein, it is to be understood that no single aspect is intended to represent a complete disclosure of all the forms of the claimed application. The claimed application is intended to cover all modifications, equivalents, and alternatives falling within the scope of the claims. Similarly, the claims are intended to cover each distinct implementation of a described form.

[0209] One or more components may be referred to herein as being "configured to be able to," "configurable to be able to," "operable / operably," "suitable / adaptable to," "able to," "conformable / conform to," etc. Those skilled in the art will recognize that, unless the context indicates otherwise, "configured to be able to" may generally encompass components in an active state and / or components in an inactive state and / or components in a standby state.

[0210] Those skilled in the art will recognize that, in general, the terms used herein, and in particular in the appended claims (e.g., the bodies of the appended claims), are generally intended to be "open" terms (e.g., the term "including" should be interpreted as "including but not limited to," the term "having" should be interpreted as "having at least," the term "comprising" should be interpreted as "including, but not limited to," etc.). Those skilled in the art will also understand that if a specific number of an introduced claim recitation is intended, such an intent will be explicitly recited in the claim, and in the absence of such recitation, no such intent is present. For example, to aid understanding, the following appended claims may contain use of the introductory phrases "at least one" and "one or more" to introduce claims. However, the use of such phrases should not be construed as implying that introducing a claim recitation by the indefinite article "a" or "an" limits any particular claim containing such introduced claim recitation to claims containing only one such recitation, even when the same claim includes the introductory phrases "one or more" or "at least one" and an indefinite article such as "a" or "an" (e.g., "a" and / or "an" should generally be interpreted as meaning "at least one" or "one or more"); this also applies to the use of definite articles used to introduce claim recitations.

[0211] In addition, even if a specific number of claim recitations is explicitly recited, those skilled in the art will recognize that such recitation should generally be interpreted to mean at least the recited number (e.g., a bare recitation of "two recitations," without other modifiers, generally means at least two recitations, or two or more recitations). Furthermore, in those instances where a convention similar to "at least one of A, B, and C, etc." is used, generally, such construction is intended to have the meaning that one skilled in the art would understand the convention (e.g., "a system having at least one of A, B, and C" would include, but is not limited to, systems having only A, only B, only C, A and B together, A and C together, B and C together, and / or A, B, and C together, etc.). In those instances where a convention similar to "at least one of A, B, or C, etc." is used, generally, such construction is intended to have the meaning that one skilled in the art would understand the convention (e.g., "a system having at least one of A, B, or C" would include, but is not limited to, systems having only A, only B, only C, A and B together, A and C together, B and C together, and / or A, B, and C together, etc.). Those skilled in the art will also understand that, generally, unless the context indicates otherwise, transitional words and / or phrases presenting two or more alternative terms in the detailed description, claims, or drawings should be understood to encompass the possibility of including one, either, or both of the terms. For example, the phrase "A or B" will generally be understood to include the possibility of "A" or "B" or "A and B."

[0212] With respect to the appended claims, those skilled in the art will understand that the operations described therein may generally be performed in any order. In addition, although various operational flow charts are presented in one or more sequences, it will be understood that the various operations may be performed in an order other than the order shown, or the various operations may be performed simultaneously. Unless the context dictates otherwise, examples of such alternative orderings may include overlapping, interleaved, interrupted, reordered, incremental, preliminary, supplemental, simultaneous, reverse, or other altered orderings. Furthermore, unless the context dictates otherwise, terms such as "responsive to," "related to," or other past tense adjectives are generally not intended to exclude such variations.

[0213] It is worth noting that any reference to "one aspect," "an aspect," "an example," or "an example" means that the specific features, structures, or characteristics described in connection with the aspect are included in at least one aspect. Therefore, the phrases "in one aspect," "in an aspect," "in an example," and "in an example" appearing in various places throughout this specification do not necessarily refer to the same aspect. Furthermore, specific features, structures, or characteristics may be combined in any suitable manner in one or more aspects.

[0214] Any patent application, patent, non-patent publication, or other disclosure material referred to in this specification is hereby incorporated by reference in its entirety only to the extent that the incorporated material is consistent with the disclosure in this specification. Accordingly, and to the extent necessary, the disclosure herein supersedes any contradictory or disparate disclosures in the incorporated material. Any material, or portion thereof, that is said to be incorporated by reference in this specification, but which contradicts directly or otherwise contradicts any aspect of the present disclosure, is only incorporated to the extent that the contradictory material is consistent with the overall scope of the present disclosure.

[0215] In general, an overall description of many of the advantageous effects that result from the concepts described herein has been presented. The foregoing detailed description has set forth various embodiments of the application via one or more forms. These embodiments are not intended to be exhaustive or to limit the application to the precise forms disclosed. Alterations, modifications, and variations will become apparent to those skilled in the art. The one or more forms described are intended to illustrate principles and practical application of the present application. Accordingly, the claims are intended to define the scope of the application and not the precise forms disclosed. Claims submitted herewith are intended to be considered part of this disclosure.

[0216] The surgical instrument systems described herein have been described in connection with the deployment and deformation of staples; however, the embodiments described herein are not so limited. For example, various embodiments are envisioned that deploy fasteners other than staples, such as clips or tacks. Moreover, various embodiments are also envisioned that utilize any suitable device for sealing tissue. For example, an end effector according to various embodiments can comprise electrodes configured to heat and seal tissue. Additionally, for example, an end effector according to certain embodiments can apply vibratory energy to seal tissue.

[0217] Many of the surgical instrument systems described herein are actuated by electric motors; however, the surgical instrument systems described herein can be actuated in any suitable manner. In various instances, for example, the surgical instrument systems described herein can be actuated by manually operated triggers. In certain instances, the motors disclosed herein can comprise part or parts of a robotic control system. Moreover, any of the end effector and / or tool assemblies disclosed herein can be used with a robotic surgical instrument system. For example, U.S. Patent Application Serial No. 13 / 118,241, entitled SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS, now U.S. Patent 9,072,535, discloses several examples of robotic surgical instrument systems in greater detail.

[0218] The entire disclosure of the following patents is hereby incorporated by reference herein:

[0219] U.S. Patent 5,403,312, entitled “ELECTROSURGICAL HEMOSTATIC DEVICE,” issued on April 4, 1995;

[0220] U.S. Patent 7,000,818, entitled “SURGICAL STAPLING INSTRUMENT HAVING SEPARATE DISTINCT CLOSING AND FIRING SYSTEMS,” issued on February 21, 2006;

[0221] U.S. Patent 7,422,139, entitled “MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING INSTRUMENT WITH TACTILE POSITION FEEDBACK,” issued on September 9, 2008;

[0222] U.S. Patent 7,464,849, issued on December 16, 2008, entitled “ELECTRO-MECHANICAL SURGICAL INSTRUMENT WITH CLOSURE SYSTEM AND ANVIL ALIGNMENT COMPONENTS”;

[0223] U.S. Patent 7,670,334, entitled “SURGICAL INSTRUMENT HAVING AN ARTICULATING END EFFECTOR,” issued on March 2, 2010;

[0224] U.S. Patent 7,753,245, entitled “SURGICAL STAPLING INSTRUMENTS,” issued on July 13, 2010;

[0225] U.S. Patent 8,393,514, entitled “SELECTIVELY ORIENTABLE IMPLANTABLE FASTENER CARTRIDGE,” issued on March 12, 2013;

[0226] U.S. patent application serial number 11 / 343,803, entitled “SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES,” now U.S. Patent 7,845,537;

[0227] U.S. Patent Application Serial No. 12 / 031,573, entitled SURGICAL CUTTING AND FASTENING INSTRUMENT HAVING RF ELECTRODES, filed February 14, 2008;

[0228] U.S. Patent Application Serial No. 12 / 031,873, entitled END EFFECTORS FOR A SURGICAL CUTTING AND STAPLING INSTRUMENT, filed February 15, 2008, now U.S. Patent No. 7,980,443;

[0229] U.S. Patent Application Serial No. 12 / 235,782, entitled MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT, now U.S. Patent No. 8,210,411;

[0230] U.S. Patent Application Serial No. 12 / 235,972, entitled MOTORIZED SURGICAL INSTRUMENT, now U.S. Patent No. 9,050,083;

[0231] U.S. Patent Application Serial No. 12 / 249,117, entitled POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY RETRACTABLE FIRING SYSTEM, now U.S. Patent No. 8,608,045;

[0232] U.S. Patent Application Serial No. 12 / 647,100, entitled MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT WITH ELECTRIC ACTUATOR DIRECTIONAL CONTROL ASSEMBLY, filed December 24, 2009, now U.S. Patent No. 8,220,688;

[0233] U.S. Patent Application Serial No. 12 / 893,461, entitled STAPLE CARTRIDGE, filed September 29, 2012, now U.S. Patent No. 8,733,613;

[0234] U.S. Patent Application Serial No. 13 / 036,647, entitled SURGICAL STAPLING INSTRUMENT, filed February 28, 2011, now U.S. Patent No. 8,561,870;

[0235] U.S. Patent Application Serial No. 13 / 118,241, entitled “SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENTARRANGEMENTS,” now U.S. Patent No. 9,072,535;

[0236] U.S. Patent Application Serial No. 13 / 524,049, filed June 15, 2012, entitled “ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE,” now U.S. Patent No. 9,101,358;

[0237] U.S. Patent Application Serial No. 13 / 800,025, filed on March 13, 2013, entitled “STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM,” now U.S. Patent No. 9,345,481;

[0238] U.S. Patent Application Serial No. 13 / 800,067, filed on March 13, 2013, and entitled “STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM,” now U.S. Patent Application Publication No. 2014 / 0263552;

[0239] U.S. Patent Application Publication No. 2007 / 0175955, entitled “SURGICAL CUTTING AND FASTENING INSTRUMENTWITH CLOSURE TRIGGER LOCKING MECHANISM,” filed January 31, 2006; and

[0240] U.S. Patent Application Publication No. 2010 / 0264194, filed April 22, 2010, entitled “SURGICAL STAPLING INSTRUMENT WITH ANARTICULATABLE END EFFECTOR,” now U.S. Patent No. 8,308,040.

[0241] While various devices have been described herein with regard to certain embodiments, many modifications and variations to these embodiments can be implemented. In one or more embodiments, specific structural and functional details disclosed herein are not to be interpreted as limiting, but merely as a basis for the claims and as a representative basis for teaching. Accordingly, the terms of a claim should not be construed as limiting the scope of the disclosure to the precise structure described in the specification and claims. In another embodiment, well-known structures and functions have not been described in detail in order to avoid obscuring aspects of the present disclosure. This application is intended to cover any and all variations of the application using the general principles disclosed herein. It is to be understood that both the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of the application, as claimed.

[0242] The devices disclosed herein can be designed to be disposed of after a single use, or they can be designed to be used multiple times. In either case, however, a device can be reconditioned for reuse after at least one use. Reconditioning can include any combination of the steps including, but not limited to, disassembly of the device, followed by cleaning and / or replacement of particular pieces, and subsequent reassembly of the device. In particular, a reconditioning facility and / or surgical team can disassemble a device and, after cleaning and / or replacing particular parts of the device, can reassemble the device for subsequent use. Those skilled in the art will appreciate that reconditioning of a device can utilize a variety of techniques for disassembly, cleaning / replacement, and reassembly. Use of such techniques, and the resulting reconditioned device, are all within the scope of the present application.

[0243] The devices disclosed herein can be processed before surgery. First, a new or used instrument can be obtained and, if necessary, cleaned. The instrument can then be sterilized. In one sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and instrument can then be placed in a field of radiation that can penetrate the container, such as gamma radiation, x-rays, and / or high-energy electrons. The radiation can kill bacteria on the instrument and in the container. The sterilized instrument can then be stored in the sterile container. The sealed container can keep the instrument sterile until it is opened in the medical facility. Sterilization can also be done using any other technique known in the art, including but not limited to beta radiation, gamma radiation, ethylene oxide, plasma, and / or steam.

[0244] While this application has been described as having exemplary designs, the present application can be further modified within the spirit and scope of the disclosure. This application is therefore intended to cover any variations, uses, or adaptations of the application using its general principles.

Claims

1. A surgical instrument comprising: a shaft assembly, wherein the shaft assembly defines a shaft axis; A surgical end effector, wherein the surgical end effector defines an end effector axis, wherein the surgical end effector is coupled to the shaft assembly via an articulation joint, the articulation joint being configured to facilitate articulation of the surgical end effector relative to the shaft assembly in an articulation plane between a non-articulated position in which the end effector axis is axially aligned with the shaft axis and an articulated position in which the end effector axis is not axially aligned with the shaft axis, wherein the articulation joint comprises: a proximal joint member coupled to the shaft assembly; a distal joint member coupled to the surgical end effector; and an articulation connector assembly comprising a plurality of links, wherein each link is configured to be operably coupled to the proximal joint member for movable travel relative to the proximal joint member in a first proximal travel path and a second proximal travel path transverse to the first proximal travel path, and wherein each link is configured to be operably coupled to the distal joint member for movable travel relative to the distal joint member in a first distal travel path and a second distal travel path transverse to the first distal travel path, wherein the articulation connector assembly defines a central conduit extending between the plurality of links, and wherein the surgical instrument further comprises: a drive member extending through the proximal connector member, the central conduit, and the distal connector member to operably interface with the surgical end effector; and At least two flexible actuator members span the articulation joint and are operably coupled to the distal joint member to impart articulation thereto.

2. The surgical instrument according to claim 1, wherein The plurality of links includes three links.

3. The surgical instrument according to claim 2, wherein: The three connecting rods include: a first link configured to be operably coupled to the proximal joint member for movable travel relative to the proximal joint member in a first proximal travel path and another first proximal travel path transverse to the first proximal travel path, and wherein the first link is configured to be operably coupled to the distal joint member for movable travel relative to the distal joint member in a first distal travel path and another first distal travel path transverse to the first distal travel path; a second link configured to be operably coupled to the proximal joint member for movably traveling in a second proximal travel path relative to the proximal joint member and in another second proximal travel path transverse to the second proximal travel path, and wherein the second link is configured to be operably coupled to the distal joint member for movably traveling in a second distal travel path relative to the distal joint member and in another second distal travel path transverse to the second distal travel path; and a third link configured to be operably connected to the proximal joint member for movably traveling in a third proximal travel path and another third travel path transverse to the third proximal travel path relative to the proximal joint member, and wherein the third link is configured to be operably connected to the distal joint member for movably traveling in a third distal travel path and another third distal travel path transverse to the third distal travel path relative to the distal joint member.

4. The surgical instrument according to claim 1, wherein Each of the connecting rods comprises: a proximal saddle configured to movably engage corresponding proximal mounting lugs on the proximal connector member; and A distal saddle is configured to movably engage a corresponding distal mounting lug on the distal joint member.

5. The surgical instrument according to claim 4, wherein: Each of the proximal mounting lugs defines an arcuate proximal pivot surface, wherein each of the proximal saddles includes a U-shaped proximal pivot surface, and the U-shaped proximal pivot surface is configured to be movably connected to the arcuate proximal pivot surface on the proximal mounting lug to facilitate the link to travel on the proximal mounting lug in the first proximal travel path and the second proximal travel path, wherein each of the distal mounting lugs defines an arcuate distal pivot surface, wherein each of the distal saddles includes a U-shaped distal pivot surface, and the U-shaped distal pivot surface is configured to be movably connected to the arcuate distal pivot surface on the distal mounting lug to facilitate the link to travel on the distal mounting lug in the first distal travel path and the second distal travel path.

6. The surgical instrument according to claim 5, wherein: Each of the proximal mounting lugs defines a proximal lug axis, wherein the first proximal travel path includes a first arcuate proximal travel path along the proximal lug axis, wherein the second proximal travel path includes a second arcuate proximal travel path about the proximal lug axis, and wherein each of the distal mounting lugs defines a distal lug axis, wherein the first distal travel path includes a first arcuate distal travel path along the distal lug axis, and wherein the second distal travel path includes a second arcuate distal travel path about the distal lug axis.

7. The surgical instrument according to claim 1, wherein: A portion of the drive member extending through the articulation joint is flexible.

8. The surgical instrument according to claim 1, wherein The driving member comprises: a proximal drive shaft including a distal end operably supported in the proximal hub member; a distal drive shaft including a proximal end operably supported in the distal hub member; and a central drive shaft spanning between the proximal joint member and the distal joint member, wherein the central drive shaft includes a proximal end configured to operably interface with the distal end of the proximal drive shaft, and wherein the central drive shaft also includes a distal end configured to operably interface with the proximal end of the distal drive shaft.

9. The surgical instrument according to claim 8, wherein The proximal drive shaft is configured to impart a rotational drive motion to the central drive shaft.

10. The surgical instrument according to claim 1, wherein The at least two flexible actuator members include four cables spanning the articulation joint and operably coupled to the distal joint member to impart articulation thereto.

11. The surgical instrument according to claim 10, wherein: Each link of the plurality of links is not attached to the proximal joint member and the distal joint member.

12. The surgical instrument according to claim 11, wherein Each of the plurality of links is held in movable contact with the proximal joint member and the distal joint member.

13. A surgical instrument comprising: a shaft assembly, wherein the shaft assembly defines a shaft axis; A surgical end effector, wherein the surgical end effector defines an end effector axis, wherein the surgical end effector is coupled to the shaft assembly via an articulation joint, the articulation joint being configured to facilitate articulation of the surgical end effector relative to the shaft assembly in an articulation plane between a non-articulation position in which the end effector axis is axially aligned with the shaft axis in the articulation plane and an articulation position in which the end effector axis is not axially aligned with the shaft axis, wherein the articulation joint comprises: a proximal joint member coupled to the shaft assembly; a distal joint member coupled to the surgical end effector; and An articulation connector assembly, comprising: a first link configured to be operably coupled to the proximal joint member for movable travel relative to the proximal joint member in a first proximal travel path and another first proximal travel path transverse to the first proximal travel path, and wherein the first link is configured to be operably coupled to the distal joint member for movable travel relative to the distal joint member in a first distal travel path and another first distal travel path transverse to the first distal travel path; a second link configured to be operably coupled to the proximal joint member for movably traveling in a second proximal travel path relative to the proximal joint member and in another second proximal travel path transverse to the second proximal travel path, and wherein the second link is configured to be operably coupled to the distal joint member for movably traveling in a second distal travel path relative to the distal joint member and in another second distal travel path transverse to the second distal travel path; and A third link, the third link being configured to be operably connected to the proximal joint member for movably traveling in a third proximal travel path and another third travel path transverse to the third proximal travel path relative to the proximal joint member, and wherein the third link is configured to be operably connected to the distal joint member for movably traveling in a third distal travel path and another third distal travel path transverse to the third distal travel path relative to the distal joint member, wherein the surgical instrument further comprises at least two flexible actuator members, and wherein the at least two flexible actuator members span the articulation joint and are operably connected to the distal joint member to apply articulation to the distal joint member.

14. The surgical instrument according to claim 13, wherein: The first link defines a first link axis, wherein the second link defines a second link axis, wherein the third link defines a third link axis, and wherein the first link axis, the second link axis, and the third link axis are transverse to each other.

15. The surgical instrument according to claim 14, wherein: The first, second, and third links are arranged relative to one another to define a central conduit extending therebetween, wherein the central conduit is configured to operably support a drive member therein.

16. The surgical instrument according to claim 13, wherein: The first connecting rod comprises: a first proximal saddle configured to movably interface with a corresponding first proximal mounting lug on the proximal connector member; and a first distal saddle configured to movably engage a corresponding first distal mounting lug on the distal joint member, wherein the second link comprises: a second proximal saddle configured to movably interface with a corresponding second proximal mounting lug on the proximal connector member; and a second distal saddle configured to movably interface with a corresponding second distal mounting lug on the distal joint member, and wherein the third link comprises: a third proximal saddle configured to movably interface with a corresponding third proximal mounting lug on the proximal connector member; and A third distal saddle is configured to movably engage a corresponding third distal mounting lug on the distal joint member.

17. The surgical instrument according to claim 16, wherein: The first proximal mounting lug defines a first arcuate proximal pivot surface, wherein the first proximal saddle includes a first U-shaped proximal pivot surface, the first U-shaped proximal pivot surface being configured to movably interface with the first arcuate proximal pivot surface on the first proximal mounting lug to facilitate travel of the first link on the first proximal mounting lug in the first proximal travel path and the other first proximal travel path, wherein the second proximal mounting lug defines a second arcuate proximal pivot surface, wherein the second proximal saddle includes a second U-shaped proximal pivot surface, the second U-shaped proximal pivot surface being configured to movably interface with the second proximal mounting lug. The second arcuate proximal pivot surface on the lug is movably connected to facilitate the second link to travel in the second proximal travel path and the other second proximal travel path on the second proximal mounting lug, and wherein the third proximal mounting lug defines a third arcuate proximal pivot surface, wherein the third proximal saddle includes a third U-shaped proximal pivot surface, and the third U-shaped proximal pivot surface is configured to be movably connected to the third arcuate proximal pivot surface on the third proximal mounting lug to facilitate the third link to travel in the third proximal travel path and the other third proximal travel path on the third proximal mounting lug.

18. The surgical instrument according to claim 17, wherein: The first distal mounting lug defines a first arcuate distal pivot surface, wherein the first distal saddle includes a first U-shaped distal pivot surface, the first U-shaped distal pivot surface being configured to movably engage the first arcuate distal pivot surface on the first distal mounting lug to facilitate travel of the first link on the first distal mounting lug in the first distal travel path and the other first distal travel path, wherein the second distal mounting lug defines a second arcuate distal pivot surface, wherein the second distal saddle includes a second U-shaped distal pivot surface, the second U-shaped distal pivot surface being configured to movably engage the second distal mounting lug. The second arcuate distal pivot surface on the lug is movably connected to facilitate the second link to travel in the second distal travel path and the other second distal travel path on the second distal mounting lug, and the third distal mounting lug defines a third arcuate distal pivot surface, wherein the third distal saddle includes a third U-shaped distal pivot surface, and the third U-shaped distal pivot surface is configured to be movably connected to the third arcuate distal pivot surface on the third distal mounting lug to facilitate the third link to travel in the third distal travel path and the other third distal travel path on the third distal mounting lug.

19. The surgical instrument according to claim 18, wherein The first proximal mounting lug defines a first proximal lug axis, wherein the first proximal travel path includes a first arcuate proximal travel path along the first proximal lug axis, wherein the another first proximal travel path includes another first proximal arcuate travel path about the first proximal lug axis, wherein the second proximal mounting lug defines a second proximal lug axis, wherein the second proximal travel path includes a second arcuate proximal travel path along the second proximal lug axis, wherein the another second proximal travel path includes another second proximal arcuate travel path extending about the second proximal lug axis, wherein the third proximal mounting lug defines a third proximal lug axis, wherein the third proximal travel path includes a third arcuate proximal travel path along the third proximal lug axis, wherein the another third proximal travel path includes another third proximal arcuate travel path extending about the third proximal lug axis, The first distal mounting lug defines a first distal lug axis, wherein the first distal travel path includes a first arcuate distal travel path along the first distal lug axis, wherein the another first distal travel path includes another first distal arcuate travel path extending about the first distal lug axis, wherein the second distal mounting lug defines a second distal lug axis, wherein the second distal travel path includes a second arcuate distal travel path along the second distal lug axis, wherein the another second distal travel path includes another second distal arcuate travel path extending along the second distal lug axis, wherein the third distal mounting lug defines a third distal lug axis, wherein the third distal travel path includes a third arcuate distal travel path along the third distal lug axis, wherein the another third distal travel path includes another third distal arcuate travel path extending about the third distal lug axis.

20. The surgical instrument of claim 19, wherein: The first, second, and third proximal lug axes are transverse to one another, and wherein the first, second, and third distal lug axes are transverse to one another.

Images