Surgical instrument having a segmented flexible drive arrangement

Abstract

Surgical instruments having an axially movable firing member are disclosed that are driven by a series of drive components that are loosely linked to one another as they traverse an articulation joint of the surgical instrument. The drive components are configured to successively engage a rotary drive member that is positioned distal to the articulation joint such that the rotary drive member causes the drive components to form an axially rigid series of the drive components that are configured to be able to apply an axial drive motion to the firing member.

Description

[0001] Cross-references to related applications

[0002] This non-provisional application claims the benefit of U.S. Provisional Patent Application Serial No. 63 / 057,430, filed July 28, 2020, entitled “SURGICALINSTRUMENTS WITH TORSION SPINE DRIVE ARRANGEMENTS”, and U.S. Provisional Patent Application Serial No. 63 / 057,432, filed July 28, 2020, entitled “ARTICULATION JOINT ARRANGEMENTS FORSURGICAL INSTRUMENTS”, the disclosures of which are incorporated herein by reference in their entirety. Background Technology

[0003] This invention relates to surgical instruments, and in various arrangements, to surgical suturing and cutting instruments designed for suturing and cutting tissue, and staple cartridges used with them. The surgical instruments can be constructed for use in open surgery, but can also be applied to other types of surgery, such as laparoscopic surgery, endoscopic surgery, and robot-assisted surgery, and may include end effectors articulate relative to the axial portion of the instrument for precise positioning within the patient's body. Attached Figure Description

[0004] The novel features of various aspects are specifically set forth in the appended claims. However, the described aspects relating to both the organization and the method of operation are best understood by referring to the following description in conjunction with the accompanying drawings, wherein:

[0005] Figure 1 This is a perspective view of the surgical end effector portion of a surgical instrument according to at least one aspect of this disclosure;

[0006] Figure 2 It is in a closed orientation. Figure 1 A side view of the surgical end effector portion of the instrument;

[0007] Figure 3 yes Figure 2 End view of a surgical end effector;

[0008] Figure 4 yes Figure 2 A top view of the surgical end effector;

[0009] Figure 5 yes Figure 1 A disassembled component view of a part of a surgical instrument;

[0010] Figure 6 yes Figure 1 An exploded component view of the slender shaft assembly of a surgical instrument;

[0011] Figure 7 yes Figure 6 Another exploded component view of the slender shaft component;

[0012] Figure 8 This is an exploded component view of the firing system and the rotary drive system according to at least one aspect of this disclosure;

[0013] Figure 9 Is with Figure 8 A side view of the firing component, upper flexible ridge assembly, and lower flexible ridge assembly of the firing system, which are engaged with the rotary drive screw of the rotary drive system.

[0014] Figure 10 yes Figure 9 Cross-sectional view of the firing component, the upper flexible ridge assembly, and the lower flexible ridge assembly;

[0015] Figure 11 Is with Figure 9 Side view of the firing component engaged by the rotary drive screw, and the upper and lower flexible ridge assemblies;

[0016] Figure 12 It is along Figure 4 The line 12-12 cut Figure 4 Cross-sectional end view of a surgical end effector;

[0017] Figure 13 yes Figure 10 Exploded perspective view of two adjacent upper vertebral components of the upper flexible spinal assembly;

[0018] Figure 14 yes Figure 10 Exploded perspective view of two adjacent lower vertebral components of the lower flexible spinal assembly;

[0019] Figure 15 Is with Figure 9 A top view of the firing mechanism engaged by the rotary drive screw, as well as the upper and lower flexible ridge assemblies.

[0020] Figure 16 It is oriented towards joint movement. Figure 8 A perspective view of the CV drive shaft assembly of a rotary drive system;

[0021] Figure 17 It is based on at least one aspect of this disclosure and Figure 16 The CV drive shaft assembly drive engagement Figure 8 A perspective view of the firing system;

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

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

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

[0025] Figure 21 It is based on at least one aspect of this disclosure Figure 1 A perspective view of the rotary drive system of a surgical instrument coupled with its firing system.

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

[0027] Figure 23 yes Figure 22 Side view of the rotary drive screw;

[0028] Figure 24 It is driven and engaged with a part of the rotary drive screw. Figure 21 A partial cross-sectional side view of a portion of the lower flexible ridge assembly and a portion of the firing member;

[0029] Figure 25 It is located within the surgical end actuator of a surgical instrument. Figure 1 A perspective view of the firing element in its original or initial position;

[0030] Figure 26 This illustrates engagement with the rotary drive screw drive after the firing member has been driven distally from its original or initial position. Figure 21 Side views of the upper and lower flexible ridge components;

[0031] Figure 27 It is based on at least one aspect of this disclosure Figure 1 A partial cross-sectional perspective view of a portion of the surgical end effector, firing system, and rotary drive system of a surgical instrument, wherein the external elastomeric joint assembly of the articular joint is omitted for clarity.

[0032] Figure 28 yes Figure 27Another partial perspective view of a portion of the surgical end effector, firing system, and rotary drive system, wherein portions of the external elastomeric joint assembly and the slender shaft assembly of the articular motion joint are omitted for clarity.

[0033] Figure 29 It is an articulated movement relative to a portion of an elongated shaft assembly in a first direction, according to at least one aspect of this disclosure. Figure 27 A top view of the surgical end effector;

[0034] Figure 30 It is an articulation relative to a portion of an elongated shaft assembly in another direction, according to at least one aspect of this disclosure. Figure 29 Side view of a surgical end effector;

[0035] Figure 31 It refers to articulation of a portion of an elongated shaft assembly in multiple planes according to at least one aspect of this disclosure. Figure 29 A perspective view of a surgical end effector;

[0036] Figure 32 This is a side front view of a part of another surgical instrument employing another external elastomeric connector assembly, according to at least one aspect of this disclosure;

[0037] Figure 33 yes Figure 32 A partial cross-sectional perspective view of a surgical instrument;

[0038] Figure 34 yes Figure 32 A perspective view of a portion of the external elastomer connector assembly;

[0039] Figure 35 It is along Figure 19 The line is cut at 35-35. Figure 19 A cross-sectional end view of a portion of a surgical instrument;

[0040] Figure 36 It is along Figure 19 The line cut off at 36-36 Figure 19 A cross-sectional end view of a portion of a surgical instrument;

[0041] Figure 37 It is based on at least one aspect of this disclosure Figure 19 A partial cross-sectional perspective view of the anvil cap and a portion of the upper vertebral component of a surgical instrument;

[0042] Figure 38 It is based on at least one aspect of this disclosure Figure 19A side view of a portion of the surgical end effector of a surgical instrument, wherein the anvil of the surgical end effector is in the open position, and some parts of the surgical end effector are omitted for clarity;

[0043] Figure 39 It is based on at least one aspect of this disclosure Figure 38 A partial cross-sectional side view of a surgical end effector, wherein the anvil is in the open position and the firing member is in the original or initial position;

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

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

[0046] Figure 42 yes Figure 19 A partial side front view of a surgical end effector, wherein some parts of the surgical end effector are omitted for clarity, to show the anvil opening spring that applies an opening motion to the anvil, and wherein the firing member is in the original or initial position;

[0047] Figure 43 This occurs after the firing mechanism has moved a short distance proximally to apply a rapid closing motion to the anvil in order to achieve a gripping effect. 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, wherein the jaws of the surgical end effector are in the closed position and the firing member of the surgical end effector is in the closest position;

[0049] Figure 45 This occurs after the firing component has advanced distally to its final position within the surgical end effector. Figure 44 Another cross-sectional view of the surgical end effector;

[0050] Figure 46 It is a perspective view of part of another surgical instrument;

[0051] Figure 47 yes Figure 46 A side front view of a surgical end effector of a surgical instrument, wherein the jaws of the end effector are in the open position;

[0052] Figure 48yes Figure 48 Another side view of the surgical end effector, wherein the jaws of the surgical end effector are in the closed position;

[0053] Figure 49 yes Figure 46 A disassembled component view of a part of a surgical instrument;

[0054] Figure 50 yes Figure 46 A perspective view of the firing component of the firing system of a surgical instrument, as well as portions of the upper and lower flexible spine components.

[0055] Figure 51 yes Figure 50 A cross-sectional side view of a portion of the firing system depicted in the image;

[0056] Figure 52 yes Figure 51 Partial exploded component view of the upper flexible ridge assembly and the lower flexible ridge assembly depicted in the figure;

[0057] Figure 53 yes Figure 50 A partial cross-sectional end view of the upper part of the firing mechanism depicted in the image;

[0058] Figure 54 yes Figure 46 A cross-sectional side view of a surgical end effector of a surgical instrument, wherein the jaws of the surgical end effector are in the closed position;

[0059] Figure 55 yes Figure 46 A proximal view of the annular rib member of a movable exoskeleton assembly for surgical instruments.

[0060] Figure 56 yes Figure 55 A view of the distal side of the annular rib member;

[0061] Figure 57 yes Figure 55 and Figure 56 Side view of the annular rib member;

[0062] Figure 58 yes Figure 46 A partial cross-sectional view of a portion of a surgical instrument;

[0063] Figure 59 yes Figure 46 A side view of the articulated joint of a surgical instrument, in which the surgical end actuator of the surgical instrument is in a non-articular position.

[0064] Figure 60 yes Figure 59Another side view of the articulated joint, with the surgical end effector in the articulated position;

[0065] Figure 61 yes Figure 46 A partial perspective view of a portion of a surgical instrument, wherein the surgical end effector is omitted for clarity;

[0066] Figure 62 yes Figure 46 Another partial perspective view of a part of a surgical instrument;

[0067] Figure 63 yes Figure 46 Another partial perspective view of a part of a surgical instrument;

[0068] Figure 64 yes Figure 46 A perspective view of a portion of the slender shaft assembly of a surgical instrument and the CV drive shaft assembly;

[0069] Figure 65 yes Figure 64 Another perspective view of the CV drive shaft assembly and the elongated shaft assembly, wherein the drive cover embodiment is mounted around the CV drive shaft assembly;

[0070] Figure 66 yes Figure 64 Another perspective view of the CV drive shaft assembly and the elongated shaft assembly, wherein another drive cover embodiment is mounted around the CV drive shaft assembly;

[0071] Figure 67 yes Figure 64 Another perspective view of the CV drive shaft assembly and the elongated shaft assembly, wherein another drive cover embodiment is mounted around the CV drive shaft assembly;

[0072] Figure 68 yes Figure 46 A side view of a portion of the firing system of a surgical instrument, in which Figure 67 The drive cover is mounted around the CV drive shaft assembly;

[0073] Figure 69 yes Figure 68 Another side view of the firing system and a portion of the drive cover;

[0074] Figure 70 It is a cross-sectional view of part of another surgical instrument;

[0075] Figure 71 yes Figure 70 A cross-sectional end view of the surgical end actuator of a surgical instrument;

[0076] Figure 72 Is with Figure 70 A cross-sectional side view of the rotating drive nut engaged with the drive component of a surgical instrument;

[0077] Figure 73 This is a partial side view of the surgical end effector of another surgical instrument that employs a series of flexible connected drive components to drive the firing member through the surgical end effector.

[0078] Figure 74 Before engaging with the rotary drive gear in the surgical end effector Figure 73 A side view of a portion of a series of flexible connecting drive components of a surgical instrument;

[0079] Figure 75 This occurs after engagement with a rotary drive gear to form a rigid series of drive components. Figure 74 Another side view of this part of the drive component;

[0080] Figure 76 yes Figure 74 A partial cross-sectional view of a rotary drive system for surgical instruments, wherein a component of a series of flexible drive parts engages with its rotary drive gear.

[0081] Figure 77 It is a side view of a rotating firing system and firing component of another surgical instrument;

[0082] Figure 78 It is a side view of a rotating firing system and firing component of another surgical instrument;

[0083] Figure 79 It is a side view of a rotating firing system and firing component of another surgical instrument;

[0084] Figure 80 This is a partial view of another surgical instrument that uses a rotary-driven firing system to drive the firing member through a surgical end effector, wherein the anvil of the surgical end effector is in the open position;

[0085] Figure 81 yes Figure 80 Another partial side view of the surgical instrument and end effector, wherein the anvil of the end effector is in the closed position;

[0086] Figure 82 yes Figure 80 A perspective view of a portion of the rotary-driven firing system of a surgical instrument;

[0087] Figure 83 yes Figure 82 A top view of a portion of the rotary-driven firing system depicted in the image;

[0088] Figure 84 yes Figure 83 A perspective view of the guide components and rotary drive shaft of the rotary drive firing system;

[0089] Figure 85 Is it possible to... Figure 83 A perspective view of a portion of another flexible firing drive assembly used in conjunction with the firing drive system; and

[0090] Figure 86 Is it possible to... Figure 83 Another perspective view of another flexible firing drive component implementation used in conjunction with the firing drive system. Detailed Implementation

[0091] The applicant of this application owns the following U.S. patent applications filed on the same date as this application, each of which is incorporated herein by reference in its entirety:

[0092] - A U.S. patent application entitled "SURGICAL INSTRUMENTS WITH torsion spine drive arrangements", agent file number END9248USNP1 / 200084-1;

[0093] - A U.S. patent application entitled "SURGICAL INSTRUMENTS WITH FIRING MEMBER CLOSURE FEATURES", agent file number END9248USNP2 / 200084-2;

[0094] - A U.S. patent application entitled “SURGICAL INSTRUMENTS WITH FLEXIBLE BALL CHAIN ​​DRIVEARRANGEMENTS”, Agent’s File No. END9248USNP4 / 200084-4;

[0095] - A U.S. patent application entitled "SURGICAL INSTRUMENTS with DOUBLE SPHERICAL ARTICULATION JOINTs with pivotable links".

[0096] Agent's case file number END9248USNP5 / 200084-5;

[0097] - A U.S. patent application entitled "SURGICAL INSTRUMENTS with DOUBLE pivot ARTICULATION JOINTARRANGEMENTS"

[0098] Agent's case file number END9248USNP6 / 200084-6;

[0099] - A U.S. patent application entitled "SURGICAL INSTRUMENTS with combination function ARTICULATION JOINT ARRANGEMENTS"

[0100] Agent's case file number END9248USNP7 / 200084-7;

[0101] - A U.S. patent application entitled "METHOD OF OPERATING A SURGICAL INSTRUMENT", agent file number END9248USNP8 / 200084-8M;

[0102] - A U.S. patent application entitled "SURGICAL INSTRUMENTS WITH DUAL SPHERICAL ARTICULATION JOINTARRANGEMENTS"

[0103] Agent's case file number: end9248usnp9 / 200084-9;

[0104] - A U.S. patent application entitled "SURGICAL INSTRUMENTS WITH FLEXIBLE FIRING MEMBER ACTUATORCONSTRAINT ARRANGEMENTS", agent file number END9248USNP10 / 200084-10;

[0105] - U.S. patent application entitled "ARTICULATABLE SURGICAL INSTRUMENTS WITH ARTICULATION JOINTSCOMPRISING FLEXIBLE EXOSKELETON ARRANGEMENTS", Agent's File No. END9248USNP11 / 200084-11; and

[0106] - U.S. patent application entitled "SURGICAL INSTRUMENTS WITH DIFFERENTIAL ARTICULATION JOINTARRANGEMENTS FOR ACCOMMODATING FLEXIBLE ACTUATORS", Agent's File No. END9248USNP12 / 200084-12.

[0107] This document sets forth numerous specific details to provide a thorough understanding of the overall structure, function, manufacture, and use of the embodiments described in the specification and illustrated in the figures. Well-known operations, components, and elements are not described in detail to avoid obscuring the embodiments described in the specification. The reader will understand that the embodiments described and illustrated herein are non-limiting examples, and thus will recognize that the specific structural and functional details disclosed herein are representative and illustrative. Variations and changes may be made to these embodiments without departing from the scope of the claims.

[0108] The terms “comprise” (and any form of “comprise”, such as “comprises” and “comprising”), “have” (and any form of “have”, such as “has” and “having”), “include” (and any form of “include”, such as “includes” and “including”), and “contain” (and any form of “contain”, such as “contains” and “containing”) are open-ended linking verbs. Therefore, a surgical system, apparatus, or device that “comprises,” “haves,” “includes,” or “contains” one or more elements has, but is not limited to, having only those elements. Similarly, the elements of a system, apparatus, or device that “comprises,” “haves,” “includes,” or “contains” one or more features have, but are not limited to, having only those features.

[0109] The terms "proximal" and "distal" are used herein in relation to the clinician manipulating the handle portion of the surgical instrument. "Proximal" refers to the portion closest to the clinician, and "distal" refers to the portion furthest from the clinician's position. It should also be understood that, for brevity and clarity, spatial terms such as "vertical," "horizontal," "upper," and "lower" may be used in conjunction with accompanying drawings. However, surgical instruments are used in many orientations and locations, and these terms are not restrictive and / or absolute.

[0110] References to singular items should be understood to include plural items, and vice versa, unless otherwise explicitly stated or clearly evident from the text. Grammatical conjunctions are intended to express any and all transitions and connecting combinations of clauses, sentences, words, etc., unless otherwise stated or clearly evident from the context. Therefore, the term "or" should generally be understood to mean "and / or," etc.

[0111] Unless otherwise specified herein, the numerical ranges listed herein are not intended to be limiting, but rather refer individually to any or all values ​​falling within that range, and each individual value within that range is incorporated into this disclosure as individually referenced herein. When used with numerical values, the terms “about,” “approximately,” etc., should be interpreted as indicating a deviation as would be understood by one of ordinary skill in the art for satisfactory use for the intended purpose. Similarly, when used with reference to physical characteristics, approximate terms such as “about” or “substantially” should be interpreted as envisioning a range of deviations as would be understood by one of ordinary skill in the art for satisfactory use for the corresponding application, function, purpose, etc.

[0112] Any and all examples or exemplary language (“e.g.,” “such as,” etc.) provided herein are intended merely to better illustrate embodiments and are not intended to limit the scope of embodiments. No language in the specification should be construed as indicating that any element not protected by the claims is necessary for implementing the embodiments.

[0113] Various exemplary apparatuses and methods are provided for performing laparoscopic and minimally invasive surgical procedures. However, the reader will readily understand that the various methods and apparatuses disclosed herein can be used in a wide range of surgical procedures and applications, including, for example, in combination with open surgery. Continuing to refer to this specific embodiment, the reader will further understand that the various instruments disclosed herein can be inserted into the body in any manner, such as through natural cavities, through incisions or puncture holes formed in tissue, etc. The working portion or end effector portion of the instrument can be inserted directly into the patient's body or through an access device having a working channel through which the end effector and elongated shaft of the surgical instrument can be advanced.

[0114] During various laparoscopic surgical procedures, it is common practice to access surgical sites located within the patient's abdomen by inserting the surgical end-effector portion of a surgical instrument through a cannula already embedded in the patient's abdominal wall. In its simplest form, the cannula is a pen-shaped instrument with a sharp triangular dot at one end, typically used within a hollow tube called a cannula or trocar to form an opening into the body through which the surgical end-effector is introduced. This arrangement forms an entrance into the body cavity through which the surgical end-effector is inserted. The inner diameter of the cannula inevitably limits the size of the end-effector and drive support shaft of the surgical instrument that can be inserted through the cannula.

[0115] Regardless of the specific type of surgical procedure performed, once a surgical end effector is inserted into the patient through a cannula, it is typically necessary to move the end effector relative to the shaft assembly positioned within the cannula to properly position it relative to the tissue or organ being treated. This movement or positioning of the end effector relative to the shaft portion held within the cannula is generally referred to as the "articular movement" of the surgical end effector. Various articulation joints have been developed to attach the end effector to an associated shaft to facilitate this articulation. It is anticipated that in many surgical procedures, it will be desirable to use surgical end effectors with the largest possible range of articulation.

[0116] Due to the dimensional constraints imposed by the size of the cannula, the dimensions of the articulation joint components must be configured to allow free insertion through the cannula. These dimensional constraints also limit the size and composition of various drive members and components operatively coupled to a motor and / or other control system supported within a housing, which may be handheld or part of a larger automated system. In many cases, these drive members must operatively pass through the articulation joint to be operatively coupled to or operatively coupled to a surgical end effector. For example, one such drive member is typically used to apply articulated motion control to a surgical end effector. During use, the articulation drive member may be deactivated to position the surgical end effector in a non-articular position to facilitate insertion of the surgical end effector through the cannula, and then actuated to articulate the surgical end effector to the desired position as it enters the patient's body.

[0117] Therefore, the aforementioned dimensional constraints pose numerous challenges to the development of articulation systems that can achieve the desired range of motion and are suitable for the various drive systems required to operate the different features of a surgical end effector. Furthermore, once the surgical end effector is positioned in the desired articulation location, 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 an articulation joint arrangement must also be able to withstand the external forces experienced by the end effector during use.

[0118] Various surgical end effectors exist that are configured to cut and suture tissue. Such surgical end effectors typically include a first jaw feature supporting a surgical cartridge and a second jaw including an anvil. The jaws are supported relative to each other, allowing them to move between an open and closed position to position and hold target tissue therebetween. Many of these surgical end effectors employ an axially moving firing member. In some end effector designs, the firing member is configured to engage the first and second jaws such that when the firing member is initially advanced distally, it moves the jaws to a closed position. Other end effector designs employ a separate closure system independent of and different from the system operating the firing member.

[0119] The staple cartridge includes a cartridge body. The cartridge body includes a proximal end, a distal end, and a platform extending between the proximal and distal ends. In use, the staple cartridge is positioned on a first side of the tissue to be sutured, and an anvil is positioned on a second side of the tissue. The anvil moves toward the staple cartridge to compress the tissue and hold it against the platform. Staples, removably stored in the cartridge body, can then be deployed into the tissue. The cartridge body includes staple cavities defined within the cartridge body, in which staples are removably stored. The staple cavities are arranged in six longitudinal rows. Three rows of staple cavities are positioned on a first side of the longitudinal slots, and three rows of staple cavities are positioned on a second side of the longitudinal slots. Other arrangements of the staple cavities and staples are also possible.

[0120] The nail is supported by a nail actuator within the cartridge. The actuator is movable between a first or non-firing position and a second or firing position to eject the nail from the cartridge. The actuator is retained within the cartridge by a retainer extending around the bottom of the cartridge and including a resilient member configured to grip the cartridge and hold the retainer to the cartridge. The actuator is movable between its non-firing position and its firing position by a slider. The slider is movable between a proximal position adjacent to the proximal end and a distal position adjacent to the distal end. The slider includes multiple ramp surfaces configured to slide beneath the actuator toward the anvil and to lift the actuator, on which the nail is supported.

[0121] In addition to the above, in these surgical end effectors, a slider is moved distally by a firing member. The firing member is configured to contact the slider and push it distally. A longitudinal slot defined in the cartridge is configured to receive the firing member. The anvil also includes a slot configured to receive the firing member. The firing member also includes a first cam engaging a first jaw and a second cam engaging a second jaw. As the firing member advances distally, the first and second cams control the distance or tissue gap between the cartridge platform and the anvil. The firing member also includes a blade configured to cut into tissue captured between the cartridge and the anvil. It is desirable that the blade be positioned at least partially close to the ramp surface so that the staples are fired before the blade.

[0122] Many surgical end effectors employ an axially movable firing beam attached to a firing member and used to apply axial firing and retraction motion to the firing member. Many such firing beams include a laminated construction that allows for a degree of deflection around the articulated joint. When the firing beam traverses the articulated joint, it can apply disarticulated forces to the joint and cause beam buckling. To prevent buckling under pressure, the articulated joint typically features a transverse support or "blowout" plate feature to support the portion of the beam that traverses the articulated joint. For example, a significant axial force is required to advance the firing beam through angles greater than sixty degrees. This axial force must be applied in a balanced manner to the firing member to prevent engagement with the jaws as the firing member moves distally. Any engagement between the firing member and the jaws can lead to component damage and wear, and requires an increased amount of axial drive force to propel the firing member through the gripped tissue.

[0123] Other end effector designs employ a firing member driven by rotary power. In many of these designs, a rotary drive shaft extends through a joint and engages with a rotatable firing member drive shaft, which is rotatably supported within one jaw of the jaws. The firing member is threadedly engaged with the rotatable firing member drive shaft, and as the rotatable firing member drive shaft rotates, the firing member is driven through the end effector. This arrangement requires a larger support jaw to accommodate the firing member drive shaft. In such devices, the lower end of the firing member is typically operably engaged with the drive shaft, which can also result in the application of forces that tend to unbalance the firing member when it is driven distally.

[0124] Figures 1 to 4One form of surgical instrument 10 is illustrated, which addresses many of the challenges faced by surgical instruments having articulated end effectors configured to cut and fasten tissue. In various embodiments, surgical instrument 10 may include a handheld device. In other embodiments, surgical instrument 10 may include an automated system, such as sometimes referred to as a robotic control system. In various forms, surgical instrument 10 includes a surgical end effector 1000 operatively coupled to an elongated shaft assembly 2000. The elongated shaft assembly 2000 may be operatively attached to a housing 2002. In one embodiment, housing 2002 may include a handle configured to be grasped, manipulated, and actuated by a clinician. In other embodiments, housing 2002 may include housing or otherwise operatively supporting at least one 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 corresponding equivalents. Furthermore, various components may be “received” or contained within the housing, or various components may be “associated” with the housing. In such instances, components may not be received within the housing or may be 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 WITHROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS,” the entire contents of which are incorporated herein by reference.

[0125] In one embodiment, 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 comprising a proximal end 1112 and a distal end 1114 and is configured to operably support a surgical cartridge 1300 therein. The surgical cartridge 1300 includes a body 1302 having an elongated slot 1304 therein. A plurality of surgical staples or fasteners (not shown) are stored in the body on actuators (not shown) arranged in rows on each side of the elongated slot 1304. Each actuator is associated with a corresponding staple cavity 1308 exposed via a cartridge platform surface 1306. The surgical cartridge 1300 can be replaced after the staples / fasteners have been ejected therefrom. Other embodiments are contemplated in which the elongated channel 1110 and / or the entire surgical end effector 1000 can be discarded after the surgical cartridge 1300 has been used. For example, such an end effector arrangement can be referred to as a "one-time loading unit".

[0126] In the illustrated arrangement, the second jaw 1200 includes an anvil 1210, which includes an elongated anvil body 1212, comprising a proximal end 1214 and a distal end 1216. In one arrangement, a pair of reinforcing bars or members 1213 may be supported in the anvil body 1212 to provide increased stiffness and rigidity to the anvil body 1212. The anvil body 1212 includes a staple-formed lower surface 1218 facing the first jaw 1100 and may include a series of staple-formed recesses (not shown) corresponding to each of the staples or fasteners in the surgical staple cartridge 1300. The anvil body 1212 may also include a pair of downwardly extending tissue stop features 1220 formed adjacent to 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 of each tissue stop corresponds to the nearest side staple / fastener in the surgical cartridge 1300. When the anvil 1210 moves to the closed position toward the tissue positioned between the staple-forming lower surface 1218 of the anvil 1210 and the cartridge platform surface 1306 of the surgical cartridge 1300, the tissue contacts the distal end 1222 of the tissue stop feature 1220 to prevent proximal movement of the tissue past the nearest side staple / fastener, thereby ensuring that the cut tissue is also sutured. When the surgical cartridge is “fired” as will be discussed in further detail below, the staple / fastener supported in each cavity is driven out of the cavity 1308, through the clamped tissue, and into contact with the staple-forming lower surface 1218 of the anvil 1210.

[0127] like Figure 5 and Figure 6 As can be seen, the proximal end 1214 of the anvil body 1212 includes an anvil mounting portion 1230, which includes 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 are pivotally held within the mounting brackets 1120 by an anvil top cover 1260, which is attached to the proximal end 1112 of the elongated channel 1110 via a mechanical snap-fit ​​feature 1261 configured to engage a retaining structure 1113 on the elongated channel 1110. See also Figure 5 In other arrangements, the anvil top cover 1260 can be attached to the elongated channel 1110 by welding, adhesive, etc. This arrangement facilitates the anvil 1210 in the open position relative to the surgical staple cartridge 1300 mounted in the elongated channel 1110 about the pivot axis PA. Figure 1 ) and closed position ( Figures 2 to 5The pivot axis PA is referred to as "fixed" in this document because the pivot axis does not translate or otherwise move when the anvil 1200 pivots from the open position to the closed position.

[0128] In the illustrated arrangement, the elongated shaft assembly 2000 defines an axis SA and includes a proximal shaft portion 2100 operably engageable with the housing of a control portion of the surgical instrument 10 (e.g., a handheld unit, robotic tool actuator, etc.). The elongated shaft assembly 2000 also includes an articulated joint 2200 attached to the proximal shaft portion 2100 and the surgical end effector 1000. In various cases, the proximal shaft portion 2100 includes a hollow outer tube 2110 operably coupled to the housing 2002. See also Figure 2 .like Figure 6 As can be seen, the proximal shaft portion 2100 may further include a rigid proximal support shaft 2120, which is supported within the hollow outer tube 2110 and extends from the housing to the articulated joint 2200. The proximal support shaft 2120 may include a first half 2120A and a second half 2120B that can be joined 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 extending from the proximal end 2122 through it to the distal end 2124.

[0129] As discussed above, many surgical end effectors employ a firing member that is pushed distally through the surgical cartridge by an axially movable firing beam. The firing beam is typically attached to the firing member in the central region of the firing member body. This attachment location can cause imbalance in the firing member as it is advanced through the end effector. This imbalance can induce undesirable friction between the firing member and the end effector jaws. This additional friction may require a higher firing force to overcome, and can cause undesirable wear on the jaws and / or portions of the firing member. Applying a higher firing force to the firing beam can cause undesirable deflection of the firing beam as it traverses the articulation joint. This additional deflection can cause the articulation joint to disengage from joint motion, particularly when the surgical end effector performs joint motion at a relatively high angle of articulation. Surgical instrument 10 employs a firing system 2300, which, while not solving all these problems, addresses many of them, as well as others.

[0130] like Figures 5 to 11As can be seen, in at least one embodiment, the firing system 2300 includes a firing member 2310, which includes a vertically extending firing member body 2312, the firing member body including a top firing member feature 2320 and a bottom firing member feature 2350. A tissue cutting blade 2314 is attached to or formed within the vertically extending firing member body 2312. See also... 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 also 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 a vertically extending firing member body 2312. Figure 12 As shown, the anvil body 1212 includes an axially extending anvil slot 1240 having a cross-sectional shape similar to a "keyhole". Similarly, the elongated channel 1110 includes an axially extending channel slot 1140 that also has a keyhole cross-sectional shape.

[0131] Traditional firing mechanism arrangements employ long, flexible cantilevered wings extending from the top and bottom portions of the firing mechanism. These cantilevered wings slide through slots in the anvil and channel, which are typically cut with a rectangular T-cutter, often resulting in high-friction surfaces. Such long cantilevered wings have minimal surface areas in contact with the anvil and channel, and can lead to abrasion of these components. The keyhole channel slot 1140 and keyhole anvil slot 1240 can be cut with a circular T-cutter and can be finished with a reamer / drill, resulting in lower-friction surfaces. Furthermore, the top tubular body 2322 and bottom tubular body 2352 tend to be stiffer than existing cantilevered wing arrangements and have increased surface areas in contact with the anvil and channel, respectively, which reduces abrasion and creates a stronger sliding connection. In other words, because the anvil slot 1240 and the channel slot 1140 are keyhole shaped and remove less material than conventional rectangular slots, the geometry and the added material allow for a more rigid anvil and channel compared to existing arrangements.

[0132] Go to Figures 9 to 11In one arrangement, the firing system 2300 further includes an upper flexible spine assembly 2400 operably coupled to a top firing member feature 2320 and a lower flexible spine assembly 2500 operably coupled to a bottom firing member feature 2350. In at least one embodiment, the upper flexible spine assembly 2400 includes an upper series 2410 of upper vertebral members 2420 loosely coupled together via an upper flexible connector member 2402 attached to the top firing member feature 2320. The upper flexible connector member 2402 may include a top cable 2404 extending 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 collar 2408 fixed to the top axial conduit 2324.

[0133] like Figure 13 As can be seen, each upper vertebral component 2420 includes an upper vertebral body portion 2422 having a proximal end portion 2424 and a distal end portion 2428. An upper hollow conduit 2429 extends through the upper vertebral body portion 2422 to accommodate an upper flexible connector component 2402 passing therethrough. Each upper vertebral component 2420 also includes a downwardly extending upper drive feature or upper vertebral component tooth 2450 projecting from the upper vertebral body portion 2422. Each upper vertebral component tooth 2450 has a helical proximal upper face portion 2452 and a helical distal upper face portion 2454. Each proximal end portion 2424 of the upper vertebral body portion 2422 has an upper proximal mating feature 2426 therein, and each distal end portion 2428 has an upper distal mating feature 2430 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 protrusion 2431. When arranged in the upper series 2410, the convex protrusion 2431 on one upper vertebral member 2420 contacts and engages with the concave recess 2427 on an adjacent upper vertebral member 2420 in the upper series 2410 to maintain the upper vertebral members 2420 generally aligned, such that the helical proximal upper face portion 2452 and the helical distal upper face portion 2454 on each corresponding upper tooth 2450 can be induced to engage by a rotary drive screw 2700, as will be discussed in further detail below.

[0134] Similarly, in at least one embodiment, the lower flexible spine assembly 2500 includes a lower series 2510 of lower vertebral members 2520, which are loosely connected together by a lower flexible connector member 2502 attached to the bottom firing member feature 2350. The lower flexible connector member 2502 may include a lower cable 2504 extending through a bottom axial conduit 2354 in the bottom firing member feature 2350, and a distal end 2506 of the bottom cable 2504 is attached to a retainer collar 2508 fixed to the bottom axial conduit 2354.

[0135] like Figure 14 As can be seen, each lower vertebral component 2520 includes a lower vertebral body portion 2522 having a proximal end portion 2524 and a distal end portion 2528. A lower hollow conduit 2529 extends through the lower vertebral body portion 2522 to accommodate a lower flexible connector component 2502 passing therethrough. Each lower vertebral component 2520 also includes an upwardly extending lower drive feature or lower vertebral component tooth 2550 projecting upward from the lower vertebral body portion 2522. Each lower vertebral component tooth 2550 has a helical proximal lower face portion 2552 and a helical distal lower face portion 2554. Each proximal end portion 2524 of the lower vertebral body portion 2522 has a lower proximal mating feature 2526 therein, and each distal end portion 2528 has a lower distal mating feature 2530 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 vertebral member 2520 contacts and engages with the concave recess 2527 on an adjacent lower vertebral member 2520 in the lower series 2510 to maintain the lower vertebral members 2520 generally aligned, such that the helical proximal lower face portion 2552 and the helical distal lower face portion 2554 on each corresponding lower vertebral member tooth 2550 can be induced to engage by a rotary drive screw 2700, as will be discussed in further detail below.

[0136] Now go to Figure 5 , Figure 7 and Figure 8In at least one arrangement, the firing drive system 2300 further includes a rotary drive screw 2700 configured to driveably engage with the upper series 2410 of the upper vertebral member 2420 and the lower series 2510 of the lower vertebral member 2520. In the illustrated arrangement, the rotary drive screw 2700 is driven by a rotary drive system 2600 including a proximal rotary drive shaft 2610 rotatably supported within an axial conduit 2126 within a proximal support shaft 2120. See also Figure 7 The proximal rotary drive shaft 2610 includes a proximal end 2612 and a distal end 2614. The proximal end 2612 may engage with a gearbox 2004 or other arrangement driven by a motor 2006 or other rotary motion source housed in a surgical instrument housing. See also Figure 2 This rotational motion source causes the proximal rotational drive shaft to rotate about the axis SA within the axial conduit 2126 in the proximal support shaft 2120.

[0137] The proximal rotary drive shaft 2610 is operatively supported within the elongated shaft assembly 2000 at a location adjacent to the articulated joint 2200, and is operatively engaged with a constant velocity (CV) drive shaft assembly 2620 that "crosses" or extends axially through the articulated joint 2200. Figure 8 , Figure 16 and Figure 17 As can be seen, 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 section 2632 formed by an attachment shaft 2634 configured to be non-rotatably received within a similarly shaped connector cavity 2616 in the distal end 2614 of the proximal rotary drive shaft 2610. The proximal shaft section 2632 is operatively engaged with a series 2640 of movably coupled drive joints 2650.

[0138] like Figure 18 As can be seen, in at least one arrangement, each drive connector 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 2662 configured to rotatably receive a proximal spherical portion 2652 of an adjacent drive connector 2650 therein. Each proximal spherical portion 2652 includes a pair of diametrically opposed engagement pins 2654 configured to movably receive in corresponding pin slots 2664 in the distal spherical portion 2660 of an adjacent drive connector 2650, such as... Figure 16As can be seen in the image. The proximal ball portion 2652P of the nearest-side drive connector 2650P is rotatably received in the distal socket portion 2636 of the proximal shaft section 2632, as shown in the image. Figure 16 As shown. The engaging pin 2654P is received within the corresponding pin slot 2637 in the distal socket portion 2636. As... Figure 16 As can be further seen, the farthest drive connector 2650D in the series 2640 of the movably connected drive connector 2650 is movably connected to the far CV drive shaft 2670.

[0139] In at least one arrangement, the distal CV drive shaft 2670 includes a proximal spherical portion 2672, which is sized to be movably received in a socket 2662D in the distal drive connector 2650D. The proximal spherical portion 2672 includes an engagement pin 2674, which is movably received in a pin slot 2664D in the distal drive connector 2650D. The distal CV drive shaft 2670 also includes a distally extending shaft 2676 configured to be non-rotatably coupled to a rotary drive screw 2700 positioned distal to the articulated joint 2200. The distal CV drive shaft 2670 includes a flange 2677 and a mounting sleeve portion 2678 for receiving a thrust bearing housing 2680 thereon.

[0140] In the illustrated arrangement, when the series 2640 of the movably connected drive joints 2650 undergoes articulation, the engagement pin 2674 remains in the corresponding pin slot 2664 of the adjacent drive joint 2650. Figure 18 In the example shown, each drive joint may be able to make approximately 18 degrees of articulation in both the pitch and yaw directions. Figure 16 The angles of the series 2640 of drive joints 2650 are shown, where each drive joint 2650 in this series makes a full articulation of 90 degrees in both the pitch and yaw directions, resulting in an angle α of approximately 100.9 degrees. In this arrangement, the outer surface of each distal spherical portion 2660 extends over the outer surface of the adjacent or contiguous proximal spherical portion 2652, thus allowing unrestricted movement up to an 18-degree limit. The rigid design and limited small angles allow the series 2640 of movablely connected drive joints 2650 to bear high loads with a generally large angular torsion.

[0141] In the illustrated arrangement, the articulation joint 2200 includes an articulation joint spring 2230 supported within an external elastomer joint assembly 2210. The external elastomer joint assembly 2210 includes a distal end 2212 attached to the proximal end 1112 of the elongated channel 1110. For example, as... Figure 6As can be seen, the distal end 2212 of the external elastomeric connector assembly 2210 is attached to the proximal end 1112 of the elongated channel 1110 by a pair of headed screws 2722, which extend through the distal mounting bushing 2720 and are threadedly received in the proximal end 1112 of the elongated channel 1110. The proximal end 2214 of the elastomeric connector assembly 2210 is attached to the distal end 2124 of the proximal end support shaft 2120 by a pair of headed screws 2732, which extend through the proximal mounting bushing 2750 and are threadedly received in a threaded insert 2125 mounted within the distal end 2124 of the proximal support member 2120.

[0142] To prevent the drive joint 2650 from buckling during joint movement, a series 2640 of the movably coupled drive joint 2650 extends through at least one low-friction joint movement joint spring 2730 supported within the external elastomeric joint assembly 2210. See also Figure 19 The articulated joint spring 2730 is sized relative to the drive joint 2650 to provide a small radial clearance between them. The articulated joint spring 2730 is designed to axially bear the joint load, which can be significantly lower than the torsional firing load. The joint spring is longer than the series 2640 of the drive joint 2650, making the drive joint axially loose. If the "hard stack" of the series 2640 of the drive joint 2650 is longer than the hard stack of the articulated joint spring 2730, the drive joint 2650 can act as a joint motion compression limiter, causing both the firing load and the joint motion load to be axially dissipated through the series 2640 of the drive joint 2650. When the firing load is axially dissipated through the series 2640 of the drive joint 2650, the load may attempt to straighten the articulated joint 2200, or in other words, cause disengagement from the joint motion. If the hard stack of the articulated joint spring 2730 is longer than the hard stack of the series 2640 of the drive joint 2730, the firing load will be contained within the end effector, and neither of the firing loads can be dissipated by the drive joint 2650 or by the spring 2650.

[0143] To further ensure that the drive joints 2650 are always engaged with each other, a proximal drive spring 2740 is used to apply an axial biasing force to the series 2640 of the drive joints 2650. For example, as Figure 8 , Figure 19 and Figure 20As can be seen, the proximal drive spring 2740 is positioned between the proximal mounting bushing 2734 and the support flange formed between the distal insertion portion 2636 and the proximal cylinder portion 2638 of the proximal shaft section 2632. In one arrangement, the proximal drive spring 2740 may include an elastomeric O-ring / bushing received on the proximal cylinder portion 2638 of the proximal shaft section 2632. The proximal drive spring 2740 slightly biases the drive joints 2650 together to reduce any play that may occur during joint movement. This ensures that the drive joints 2650 torsionally transmit the load. However, it should be understood that in at least one arrangement, the proximal drive spring 2740 does not apply a sufficiently high axial load such that the firing load translates through the joint movement joint 2200.

[0144] like Figure 9 and Figure 10 As can be seen, the top firing member feature 2320 on the firing member 2310 includes a distal upper firing member tooth segment 2330, which corresponds to half of the upper tooth 2450 on each upper vertebral member 2420. Additionally, a proximal upper firing member tooth 2336, identical to the upper tooth 2450 on each upper vertebral member 2420, is spaced apart from the distal upper firing member tooth segment 2330. The distal upper firing member tooth segment 2330 and the proximal upper firing member tooth 2336 can be integrally formed with the top firing member feature 2320 of the firing member 2310. Similarly, the bottom firing member feature 2350 of the firing member 2310 includes a distal lower firing member tooth 2360 and a proximal lower firing member tooth 2366 integrally formed on the bottom firing member feature 2350. For example, in at least one arrangement, the firing member 2310 having rigidly attached teeth 2330, 2336, 2360 and 2366 can be manufactured as a single integral part using conventional metal injection molding technology.

[0145] As described above, each of the upper vertebral members 2520 is movably received on an upper flexible connector member 2402 in the form of a top cable 2404. As described 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 vertebral members 2520 is movably received on a lower flexible connector 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, may engage with an emergency arrangement supported in the housing to retract the firing member 2310 to its original or initial position in the event of failure of the firing member drive system.

[0146] Turn to Figure 8 The axial length AL of the upper series 2410 of the upper vertebral component 2420 u The axial length AL of the lower series 2510 of the lower vertebral component 2520. l The lengths must be equal and sufficiently long to allow the firing member 2310 to be fully advanced distally from its original or initial position to the distal end position within the cartridge, while the nearest upper vertebral member 2420 of the upper series 2410 of the upper vertebral member 2420 and the nearest lower vertebral member 2520 of the lower series 2510 of the lower vertebral member 2520 remain engaged with the rotary drive screw 2700. Figure 8 As can be seen, the upper compression limiting spring 2421 is configured to engage with the nearest upper vertebral member 2420P in the upper series 2410 of the upper vertebral member 2420. The upper compression limiting spring 2421 is journal-connected to the top cable 2404 and is held in bias engagement with the nearest upper vertebral member 2420P by an upper spring retainer 2423, which is held in place by an upper collar 2425 pressed onto the top cable 2404. The top cable 2404 extends through the upper hyaluronic acid tube 2433 supported in the proximal support shaft. Similarly, the lower compression limiting spring 2521 is configured to engage with the nearest lower vertebral member 2520P in the lower series 2510 of the lower vertebral member 2520. The lower compression spring 2521 is journal-connected to the lower cable 2504 and held in bias engagement with the nearest lower vertebral member 2520P by a lower spring retainer 2523, which is held in place by a lower collar 2525 pressed onto the lower cable 2504. The lower cable 2504 extends through a lower hyaluronic acid tube 2533 supported in a proximal support shaft.

[0147] When the upper vertebral member 2420 and the lower vertebral member 2520 are angled by the articulation joint (after the end effector has been positioned in the articulated position), in each series 2410, 2510, the gap between the corresponding vertebral members 2420, 2520 increases, causing the springs 2421, 2521 to become tighter. The compression limiting springs 2421, 2521 provide sufficient slack to the cables 2404, 2504 so that the angle formed by the vertebral members 2420, 2520 can pass through the most extreme articulation angle. If the cables 2404, 2504 are pulled too tight, the spring retainers 2423, 2523 will contact their respective nearest vertebral members 2420P, 2520P. This compression-limiting arrangement ensures that the vertebral components 2420, 2520 in their respective series 2410, 2510 always remain sufficiently close together, such that the rotary drive screw 2700 will always engage these vertebral components in a manner discussed in further detail below. When the vertebral components 2420, 2520 are aligned again, the compression-limiting springs 2421, 2521 can be partially relaxed while still maintaining some compression between the vertebral components.

[0148] As described above, when the upper vertebral member 2420 is arranged according to the upper series 2410 and the lower vertebral member 2520 is arranged according to the lower series 2510, the convex protrusions and concave recesses in each vertebral member, as well as the compression limiter spring, are used to maintain the upper and lower vertebral members in relative linear alignment so as to drive engagement by rotating the drive screw 2700. Figure 9 and Figure 10 As can be seen, when the upper vertebral member 2420 is linearly aligned, the upper teeth 2450 are spaced apart by an opening space generally designated 2460, which facilitates drive engagement with the helical drive thread 2170 on the rotary drive screw. Similarly, when the lower vertebral member 2520 is linearly aligned, the lower vertebral member teeth 2550 are spaced apart by an opening space generally designated 2560, which facilitates drive engagement with the helical drive thread 2170 of the rotary drive screw 2700.

[0149] Go to Figure 8 and Figure 22 The rotary drive screw 2700 includes a screw body 2702 having a socket 2704 therein for receiving a distally extending shaft 2676 of the distal CV drive shaft 2670. An internal radial groove 2714 ( Figure 10A plurality of ball bearings 2716 are formed in the screw body 2702 to support therein. In one arrangement, for example, 12 ball bearings 2716 are used. 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 are used to distribute the axial load of the rotary drive screw 2700 and significantly reduce friction through the rolling motion of the balls.

[0150] like Figure 23 As can be seen, a helical drive thread 2710 is arranged around the screw body 2702 and serves to form a proximal threaded chuck feature 2712. The proximal threaded chuck feature 2712 has a first pitch 2713, and the remaining portion of the helical drive thread 2710 has a second pitch 2715 different from the first pitch 2713. Figure 22 and Figure 23 In the diagram, region 2718 shows the location 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 rotary drive screw 2700 captures and "hooks" or driveably engages each upper vertebral member 2420 and each lower vertebral member 2520. Figure 24 As can be seen, the proximal end 2717 of the helical drive thread 2710, having a first pitch 2713, is scooped into the opening space 2560 between two adjacent lower vertebral member teeth 2550A and 2550B. Simultaneously, the central portion 2719 of the helical drive thread 2710, having a second pitch 2715, engages with the helical distal lower face portion 2554 on the lower vertebral member tooth 2550B and the helical proximal lower face portion 2552 on the proximal lower firing member tooth 2366. It should also be understood that when the firing member 2310 is driven distally, the scooping feature 2712, when scooping the lower vertebral member tooth 2550B, may not contact the helical distal lower face portion 2554A of the lower vertebral member tooth 2550A. The helical drive thread 2710 interacts with the teeth 2450 of the upper vertebral member 2420 in a similar manner.

[0151] A power screw is a screw with a complete 360-degree nut surrounding it. Rotation of the power screw causes the nut to advance or move longitudinally. However, in this arrangement, due to space constraints, the complete 360-degree nut cannot be fitted within the end effector. In a general sense, the upper flexible ridge assembly 2400 and the lower flexible ridge assembly 2500 include radially / longitudinally segmented "power screw nuts" rotatably driven by a rotary drive screw 2700. When the rotary drive screw rotates 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 series 2410 and the lower series 2510 are constrained to rotate about the rotary drive screw 2700 and can only move longitudinally. In one arrangement, the upper vertebral member 2420 in the upper series 2410 and the lower vertebral member 2520 in the lower series 2510 each rotate around the drive screw 2700 at an angle of less than ten degrees.

[0152] Figure 25 The firing element 2310 is shown in its original or initial position. (Example) Figure 25 As can be seen, a portion of the helical drive thread 2710 on the rotary drive screw 2700 engages between the distal upper firing member tooth section 2330 and the proximal upper firing member tooth 2336, and another portion of the helical drive thread 2710 engages between the distal lower firing member tooth 2360 and the proximal lower firing member tooth 2366 on the firing member 2310. This arrangement allows the rotary drive screw 2700 to precisely control the distal and proximal movement of the firing member 2310, as will be discussed in further detail below, which results in precise movement of the anvil 1210. Once the firing member 2310 has been sufficiently advanced distally during the firing stroke, the helical drive thread 2710 operatively engages the teeth on the upper and lower vertebrae. See also Figure 26 .

[0153] The surgical instrument 10 also includes an articulation system 2240 configured to apply articulation to the surgical end effector 1000, causing the surgical end effector to articulate relative to the elongated shaft assembly 2000. In at least one arrangement, for example, the articulation system includes four articulation cables 2242, 2246, 2250, and 2254 extending through the elongated shaft assembly 2000. See also Figure 27In the illustrated arrangement, articulation cables 2242 and 2246 pass through the proximal mounting bushing 2750, the proximal end 2214 of the elastomeric connector assembly 2210, and the central rib section 2216 to be secured to the distal end 2212 of the elastomeric connector assembly 2210 or other portions of the surgical instrument. Similarly, articulation cables 2250 and 2254 extend through the proximal mounting bushing 2750, the proximal end 2214 of the elastomeric connector assembly 2210, and the central rib section 2218 to be secured to the distal end 2212 of the elastomeric connector assembly 2210 or other portions of the surgical end effector. Cables 2242, 2246, 2250, and 2254 are operatively connected to an articulation control system supported within the housing of the surgical instrument 10. For example, the proximal portions of each cable 2242, 2246, 2250, and 2254 may be wound around a corresponding rotary reel or cable management system 2007 in the housing portion of the surgical instrument 10. Figure 2 On the reel or cable management system, each cable 2242, 2246, 2250, and 2254 is configured to be deployed and retracted in a desired manner. The reel / cable management system can be motor-driven or manually driven (ratchet arrangement, etc.). Figure 29 The surgical end effector 1000 is shown performing joint movements relative to the elongated shaft assembly 2000 through a first joint motion plane. Figure 30 The surgical end effector 1000 is shown performing joint movements relative to the elongated shaft assembly 2000 through a second joint motion plane. Figure 31 The surgical end effector 1000 is shown performing joint movements relative to the elongated shaft assembly 2000 through multiple joint motion planes.

[0154] Figures 32 to 34 An alternative articulated joint 2200' in the form of an elastomeric joint assembly 2210' is shown. For example... Figure 33As shown, each articulation cable passes through a corresponding spring 2215' in the rib 2216' of the elastomer 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 a higher articulation angle with greater joint stability, each of the springs 2244, 2248, 2252, and 2256 is slidable through the rib of the elastomer joint to push the end effector and pull the cable extending therethrough. When cables 2242, 2246, 2250, and 2254 are tensioned, springs 2244, 2248, 2252, and 2256 also retract into the ribs. Each of springs 2244, 2248, 2252, and 2256 is loosely positioned on a specific cable passing through it. Each cable and its corresponding spring may terminate at or otherwise connect to a corresponding solid rod supported in the elongated shaft assembly 2000 and may be pushed and pulled from its proximal end. When the cable is pulled, the corresponding spring will bear a small load or no load. When the spring is pushed, the cable will bear a small load but will help limit the movement of the end effector. This interaction between the cable and the spring can, for example, facilitate the generation of higher joint angles approaching ninety degrees.

[0155] Because the radial / longitudinal segmented power screw nut arrangement disclosed herein does not have the same limitations as the 360-degree nut, the upper vertebral member 2420 in the upper series 2410 and the lower vertebral member 2520 in the lower series 2510 are constrained to ensure that their load is transmitted to the firing member in the longitudinal direction. To maintain each upper vertebral member 2420 in the desired orientation, and to prevent the upper vertebral member 2420 from being obstructed or losing orientation when traversing the articulated joint 2200, the upper vertebral member 2420 is aligned to pass through the upper sleeve 2470, which extends through the upper portion of the external elastomeric joint assembly 2210 of the articulated joint 2200. See also 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 with a low coefficient of friction and is flexible, so that the upper sleeve 2470 can bend together with the external elastomeric joint assembly 2210. The upper sleeve 2470 protects the upper vertebral member 2420 from contact with the external elastomeric joint assembly 2210, which is made of an elastic material, which may have a higher coefficient of friction than the material of the upper sleeve 2470. In other words, when the upper vertebral member 2420 traverses the articular joint 2200, the upper sleeve 2470 forms a low-friction, flexible, continuous, uninterrupted, and fully enclosed path for the upper vertebral member.

[0156] Similarly, the lower sleeve 2570 is used to support the lower vertebral members 2520 as they pass through the articulation joint 2200. The 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. Similar to the upper sleeve 2470, the lower sleeve 2570 is made of a polymer or plastic material with a low coefficient of friction and is flexible, so that the lower sleeve 2570 can bend together with the external elastomeric joint assembly 2210. The lower sleeve 2570 protects the lower vertebral members 2520 from contacting the external elastomeric joint assembly 2210 as they pass through the articulation joint 2200. In other words, as the lower vertebral member 2520 traverses the articulation joint 2200, the lower sleeve 2570 forms a low-friction, flexible, continuous, uninterrupted, and fully enclosed path for the lower vertebral member. In various embodiments, the upper sleeve 2470 and lower sleeve 2570 are configured to bend freely without kinking. To prevent kinking within the sleeves, in at least one arrangement, the sleeves 2470, 2570 are supported within the external elastomeric joint assembly 2210, allowing axial movement of the sleeves. For example, when the articulation joint is angled upwards, the lower sleeve 2570 can slide distally with a large bending radius; in the same example, the upper sleeve 2470 can slide proximally with a tighter bending radius. This axial movement reduces the amount of material exposed outside the joint assembly 2210, which would otherwise be prone to kinking at the tighter bending radius. In at least one arrangement, the distal end 2472 of the upper sleeve 2470 is formed with an upper sling 2476, which is configured to convey the upper vertebral member 2420 into the anvil cap 1260. Similarly, the distal end of the lower sleeve 2570 may be formed with a lower sling, which is configured to convey the lower vertebral member 2520 into the channel slot 1140 in the elongated channel 1110.

[0157] As described above, the anvil mounting portion 1230 includes 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 are pivotally held within the mounting brackets 1120 by an anvil top cover 1260, which 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 member 2420. Figure 36The vertebral conduit 1266 in the anvil top cover 1260 is shown. When the rotary drive screw 2700 applies a load to the upper vertebral member 2420, the vertebral member 2420 will tend to rotate around... Figure 37 Region A is tilted, so the upper vertebral component tooth 2450 is no longer perpendicular to the rotary drive screw 2700, but may experience line contact with higher pressure. Figure 37 Region B in the diagram shows where the upper vertebral member 2420 stops tilting. To ensure that most of the load remains in the longitudinal direction to perform useful work, the angle of the upper vertebral member teeth 2450 must be the same as the amount of tilt of the upper vertebral member 2420. Therefore, when the upper vertebral member 2420 tilts, the upper vertebral member teeth 2450 will still maintain surface contact with the helical drive member 2710 on the rotary drive screw 2700, and all the load will be guided longitudinally rather than vertically. When the vertebral member 2420 tilts, the slightly angled upper vertebral member teeth 2450 can behave like a square thread and better distribute the load to reduce pressure contact. By guiding most of the load in the longitudinal direction, vertical loads that could cause friction to build up and counteract the longitudinal load are avoided. The upper vertebral member 2420 reacts similarly as it passes downward through the keyhole-shaped anvil slot 1240. Similarly, the lower vertebral component 2520 reacts in a similar manner when passing through the keyhole-shaped axially extending channel slot 1140 in the elongated channel 1110.

[0158] In the arrangement shown, the anvil 1210 is moved to the open position by a pair of anvil springs 1270 supported within the proximal end of the elongated channel. See also Figure 38 , Figure 42 and Figure 43 Spring 1270 is positioned to apply a pivoting bias force to corresponding anvil control arms 1234, which are integrally formed with and extend downward from the anvil mounting portion 1230. See also Figure 38 .

[0159] Figures 39 to 41 This shows what happens when the anvil 1210 is open ( Figure 39 When the anvil 2310 is partially closed ( Figure 40 ) and after the firing component has advanced distally from its original or initial position ( Figure 41 The anvil 1210, firing member 1210, and anvil top cover 1260 of the anvil. For example... Figure 39As can be seen, when the firing member 2310 is in the original or initial position, the top firing member feature 2320 is fully received within the vertebral channel 1266 in the anvil top cover 1260. During the firing stroke, the top firing member feature 2320 and the upper vertebral member 2420 in the upper series 2410 must transition from the vertebral channel 1266 in the anvil top cover 1260 to the keyhole-shaped anvil slot 1240. Therefore, 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 unobstructed pivoting 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 the curved mating surface 1231 on the anvil mounting portion 1230. The two surfaces 1265 and 1231 are curved and concentric about the pivot axis PA or some other reference point. This arrangement allows the anvil 1210 to move radially without interfering with the anvil top cover 1260, while maintaining a minimum clearance G between them. The clearance 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 upper vertebral member 2420, which facilitates the easy transition of each upper vertebral member 2420 from the vertebral canal 1266 in the anvil top cover 1260 to the keyhole-shaped anvil slot 1240. Furthermore, to further aid the transition of the top firing member feature 2320 into the keyhole-shaped anvil slot 1240, the curved mating surface 1231 adjacent to the anvil mounting portion 1230 forms an inclined surface 1241. When the firing member 2310 is initially advanced distally from its original or starting position, the distal end of the top firing member feature 2320 contacts the inclined surface 1241 and begins to apply a closing motion to the anvil 1210, such as Figure 40 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, completely closing the anvil 1210 and holding the anvil 1210 in the closed position during the firing sequence. See also Figure 41 .

[0160] Typically, the highest firing force established in an endoscopic cutter is associated with cutting and suturing tissue. If those same forces are available for closing the anvil, the forces generated during pre-clamping and gripping of the tissue can also be high. In at least one arrangement, the firing member body 2312 also includes firing member wings or tabs 2355 extending from each lateral side of the firing member body 2312. See also Figure 15 and Figure 36The firing member wing 2355 is positioned to contact the corresponding anvil control arm 1234 when the firing member 2310 is driven from its original or initial position in the proximal direction PD to rapidly close the anvil 1210 for gripping purposes. In at least one arrangement, when the firing member 2310 is in its original or initial position, the firing member wing 2355 is located distal to the anvil control arm 1234, such as... Figure 42 As shown. When the firing member 3210 moves 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 also Figure 42 In one arrangement, the firing member 2310 only needs to move a short distance D to pivot the anvil 1210 to the closed position. For example, in one embodiment, the distance D may be approximately 0.070 inches. This short movement allows for rapid response. Because the anvil pivot point or pivot axis PA is relatively far from the firing member wing 2355, this generates a considerable moment arm, so the 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 it to the closed position. Therefore, the firing member wing 2355 may be referred to herein as the "pre-compression feature". See also Figure 43 Therefore, by advancing the firing member 2310 proximally a short distance D to rapidly 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 cartridge 1300 without cutting the tissue and forming staples.

[0161] The firing member 2310 can be moved in the proximal direction PD by rotating the rotary drive screw 2700 in the second rotational direction. Therefore, when the firing member 2310 is in the "original" or initial 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 rotational motion to the rotary drive screw 2700 in the first rotational direction will cause the firing member 2310 to be advanced distally from the original or initial position to apply anvil closing motion to the anvil 1210 to move the anvil into a closed position, thereby clamping the target tissue between the anvil 1210 and the surgical cartridge 1300. Continued rotation of the rotary drive screw in the first rotational direction will cause the firing member 2310 to continue to be advanced distally through the surgical end effector 1000. As the firing member 2310 moves distally, it contacts the slide 1312 supported in the surgical cartridge 1300. Figure 19The slider 1312 is driven distally through the staple cartridge body 1302. When the firing member 2310 is in the initial or starting position, the surgeon may wish to use a surgical end effector to grasp and manipulate tissue. For this purpose, the rotary drive system is actuated to apply a second rotary drive motion to the rotary drive screw 2700 in a second rotational direction opposite to the first rotational direction. This rotational movement of the rotary drive screw 2700 in the second rotational direction will drive the firing member 2310 proximally from the starting position and cause the anvil 1210 to pivot rapidly to the closed position. Therefore, according to at least one embodiment, the "initial or starting position" of the firing member 2310 is not its proximal position.

[0162] If the rotary drive system 2600 stops rotating during firing, the firing member 2310 may become stuck within the surgical end effector. In this case, the top firing member feature 2320 may remain engaged with the anvil 1210, and the bottom firing member feature 2350 may remain engaged with the elongated 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 cartridge 1300. This may occur, for example, if the motor or other control arrangement providing rotary drive motion to the rotary drive shaft 2610 fails or otherwise becomes inoperable. In this case, the firing member 2310 can be retracted to its original or initial position within the surgical end effector 1000 by pulling the top cable 2404 and the lower cable 2504 in a proximal direction. For example, the proximal portions of the top cable 2404 and the lower cable 2505 may be wound around a rotating reel or cable management system 2009 in the housing portion of the surgical instrument 10. Figure 2 On the rotating reel or cable management system, the top cable 2404 and the lower cable 2504 are configured to be released during the firing stroke, and to retract the cables 2404 and 2504 in a 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 a retraction motion to the cables 2404 and 2504. When the cables 2404 and 2504 are retracted, the upper vertebral member 2420 and the lower vertebral member 2520 will cause the rotary drive screw 2700 to rotate in the opposite direction.

[0163] It can be used depending on the lead (L) and pitch circle diameter (d) p The following equations, using tooth angle (α) and friction (μ), determine whether the rotary drive screw 2700 will rotate in the opposite direction:

[0164]

[0165] If the above equation holds, the rotary drive screw 2700 can be self-locking. To a large extent, in many cases, for endoscopic cutters, the pitch circle diameter is mostly fixed, but the lead and tooth angle are variable. Because the upper vertebral component teeth 2450 and the lower vertebral component teeth 2550 are mostly square, the rotary drive screw 2700 is more likely to be reversibly driven (cos(90) = 1). The lead of the upper vertebral component teeth 2450 and the lower vertebral component teeth 2550 can also be advantageous, because the rolling friction between the vertebral components 2420, 2520 and the rotary drive screw 2700 is more likely to enable the rotary drive screw 2700 to be reversibly driven. Therefore, in an emergency, the surgeon can pull the upper cable 2404 and the lower cable 2504 in the proximal direction to fully retract the firing member 2310 for a quick "emergency" maneuver.

[0166] As described above, the housing 2002 can support the relative controlled movement of the rotary drive system 2600 and various cable management systems employed in conjunction with the firing system 2300 and the joint motion control system 2240. This housing can be handheld or included as part of a larger automated surgical system. The firing system 2300, the joint motion control system 2240, and the rotary drive system 2600 can, for example, be motor-controlled and operated by one or more control circuits.

[0167] One method of using surgical instrument 10 may involve using surgical instrument 10 to cut and suture target tissue within a patient using laparoscopic techniques. For example, one or more trocars may have been placed through the abdominal wall of the patient to provide access to target tissue within the patient. A surgical end effector 1000 may be inserted through one trocar, and one or more cameras or other surgical instruments may be inserted through other trocars. In order for surgical end effector 1000 to be able to insert through the trocar, surgical end effector 1000 is positioned in a non-articular orientation, and jaws 1100 and 1200 must be closed. In order to hold jaws 1100 and 1200 in the closed position for insertion purposes, for example, a rotary drive system 2600 may be actuated to apply a second rotational motion to rotary drive screw 2700, thereby causing firing member 2310 to move proximally from an initial position to move anvil 1210 (jaws 1200) to the closed position. See also Figure 44 The rotary drive system 2600 is deactivated to hold the firing member 2310 in this position. Once the surgical end effector has been inserted into the abdomen through the cannula, the rotary drive system 2600 can be activated to drive the rotary drive screw 2700 distally back the firing member 2310 to the initial position, where the anvil spring 1270 will pivot the anvil 1210 to the open position. See also Figure 38 .

[0168] Once inside the abdomen and before engaging the target tissue, the surgeon may 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 elongated shaft assembly 2000 received within the cannula. 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 or adjacent tissue by activating the rotary drive system to rotate the rotary drive screw in a second rotational direction to move the firing member proximally, thereby rapidly closing the anvil 1210 to grasp tissue between the anvil 1210 and the surgical cartridge 1300. The anvil 1210 can be opened by reversing the rotation of the rotary drive screw 2700. The process can be repeated as needed until the target tissue has been properly positioned between the anvil 1210 and the surgical cartridge 1300.

[0169] Once the target tissue has been positioned between the anvil 1210 and the surgical cartridge, the surgeon can initiate the closing 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, it applies a closing motion to the anvil 1210 and moves it from the open position to the closed position in the manner discussed above. As the firing member 2310 moves distally, it holds the anvil 1210 in the closed position, thereby clamping the target tissue between the anvil 1210 and the surgical cartridge 1300. As the firing member 2310 moves distally, it contacts the slider 1312 supported in the surgical cartridge 1300 and also drives the slider 1312 distally through the cartridge body 1302. The slider 1312 continuously drives a row of actuators supported in the staple cartridge toward the target tissue being held. Each actuator has one or more surgical staples or fasteners supported thereon, which are then driven through the target tissue and make contact with the underside of the anvil 1210. As the firing member 2310 moves distally, its tissue cutting blade 2314 cuts through the sutured tissue.

[0170] The firing member 2310 has been driven distally to the end position within the surgical end effector 1000. Figure 45Subsequently, the rotary drive system 2600 is reversed, causing the firing member 2310 to retract proximally to its original or starting position. Once the firing member 2310 has returned to its starting position, the anvil spring 1270 will pivot the anvil 1210 to the open position, allowing the surgeon to release the sutured tissue from the surgical end effector 1000. Once the sutured tissue has been released, the surgical end effector can be withdrawn from the patient through a cannula. To do this, the surgeon must first actuate the joint motion control system 2240 to return the surgical end effector 1000 to a non-joint position and actuate the rotary drive system to drive the firing member 2310 proximally from its original or starting position to close the jaws. Afterward, the surgical end effector 1000 can be withdrawn through a cannula. If the firing system becomes inoperable during the firing process or during the retraction process, 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 ways described herein.

[0171] Figures 46 to 68 Another surgical instrument 22010 is shown, which is identical or very similar in many respects to the surgical instrument 10 described above, except for the various differences discussed below. Similar to surgical instrument 10, surgical instrument 22010 addresses many of the challenges faced by surgical instruments having articulated end effectors configured to cut and fasten tissue. In various embodiments, surgical instrument 22010 may include a handheld device. In other embodiments, surgical instrument 22010 may include an automated system, such as sometimes referred to as a robot control system. In various forms, surgical instrument 22010 includes a surgical end effector 23000 operatively coupled to an elongated shaft assembly 24000. The elongated shaft assembly 24000 may be operatively attached to a housing that is handheld or otherwise incorporates part of a robotic system, as discussed above.

[0172] like Figure 49As can be seen, in one embodiment, the surgical end effector 23000 includes a first jaw 23100 and a second jaw 23200. In the illustrated arrangement, the first jaw 23100 includes an elongated channel 23110, which includes a proximal end 23112 and a distal end 23114 and is configured to operably support the surgical cartridge 1300 therein. The elongated channel 23110 has an open bottom for easy assembly and a channel cover 23113 configured to be attached (welded, etc.) to the elongated channel to cover the opening and increase the rigidity of the elongated channel 23110. In the illustrated arrangement, the second jaw 23200 includes an anvil 23210, which includes an elongated anvil body 23212, which includes a proximal end 23214 and a distal end 23216. In one arrangement, an anvil cover 23213 is provided to facilitate assembly of the device and to increase the rigidity of the anvil when the anvil 23210 is attached (welded, etc.) to the anvil body 23212. The anvil body 23212 includes a nail-shaped lower surface 23218 facing the first jaw 23100 and may include a series of nail-shaped recesses (not shown) corresponding to each of the nails or fasteners in the surgical staple cartridge 1300. The proximal end 23214 of the anvil body 23212 includes an anvil mounting portion 23230, which includes a pair of laterally extending mounting pins 23232 configured to be received in corresponding mounting brackets or pivot brackets 23120 formed in the proximal end 23112 of the elongated channel 23110. Mounting pin 23232 is pivotally held within mounting bracket 23120 via an anvil top cover 23260, which can be attached to the proximal end 23112 of elongated channel 23110 by screw 23261. In other arrangements, anvil top cover 23260 can be attached to elongated channel 23110 by welding, adhesive, etc. Such arrangements facilitate the anvil 23210 in the open position relative to surgical staple cartridge 1300 mounted in elongated channel 23110 about pivot axis PA. Figure 47 ) and closed position ( Figure 48 The pivot axis PA is referred to herein as "fixed" because the pivot axis does not translate or otherwise move when the anvil 23210 pivots from the open position to the closed position.

[0173] In the arrangement shown, the anvil 23210 is moved to the open position by a pair of anvil springs 23270 supported within the proximal end 23112 of the elongated channel 23110. See also Figure 49 and Figure 62 Spring 23270 is positioned to apply a pivoting bias force to the corresponding portion of anvil 23210 to apply an opening force thereto. See also Figure 47 .

[0174] In the illustrated arrangement, the elongated shaft assembly 24000 defines an axis SA and includes a proximal shaft portion 24100 operatively connectable to the housing of a control portion (e.g., a handheld unit, robotic tool actuator, etc.) of the surgical instrument 22010. The elongated shaft assembly 24000 also includes an articulated joint 24200 attached to the proximal shaft portion 24100 and the surgical end effector 23000. In various cases, the proximal shaft portion 24100 includes components operatively connectable to the hollow outer tube 24110 within the housing in various manners discussed above. Figure 49 As can be seen, the proximal shaft portion 24100 may further include a rigid proximal support shaft 24120, which is supported within the hollow outer tube 24110 and extends from the housing to the articulated joint 24200. The rigid proximal support shaft 24120 may include a first half 24120A and a second half 24120B that can be joined together by, for example, welding, adhesive, etc. The rigid proximal support shaft 24120 includes a proximal end 24122 and a distal end 24124, and includes an axial conduit 24126 extending from the proximal end 24122 through it to the distal end 24124.

[0175] As discussed above, many surgical end effectors employ a firing member that is pushed distally through the surgical cartridge by an axially movable firing beam. The firing beam is typically attached to the firing member in the central region of the firing member body. This attachment location can cause imbalance in the firing member as it is advanced through the end effector. This imbalance can induce undesirable friction between the firing member and the end effector jaws. This additional friction may require a higher firing force to overcome, and can cause undesirable wear on the jaws and / or portions of the firing member. Applying a higher firing force to the firing beam can cause undesirable deflection of the firing beam as it traverses the articulation joint. This additional deflection can cause the articulation joint to disengage from joint motion, particularly when the surgical end effector performs joint motion at a relatively high angle of articulation. Surgical instrument 22010 employs a firing system 24300 that is identical or very similar in many respects to the firing system 2300 discussed above. Therefore, the following discussion will only cover those aspects of the firing system 24300 required for understanding the operation of the surgical instrument 22010.

[0176] like Figures 50 to 54As can be seen, in at least one embodiment, the firing system 24300 includes a firing member 24310, which includes a vertically extending firing member body 24312, the firing member body including a top firing member feature 24320 and a bottom firing member feature 24350. A tissue cutting blade 24314 is attached to or formed within the vertically extending firing member body 24312. See also... Figure 50 and Figure 51 In at least one arrangement, it is desirable for the firing member 24310 to pass through the anvil body 23212 with low friction, high strength, and high stiffness. In the illustrated arrangement, the top firing member feature 24320 includes a T-shaped body 24322 having two laterally extending tabs 24323 projecting therefrom and a top axial conduit 24324 extending therethrough. See also Figure 53 The bottom firing member feature 24350 includes a T-shaped body 24352 having two laterally extending tabs 24353 protruding from it and a bottom axial channel 24354 extending through it. See also Figure 50 In at least one arrangement, the top firing member feature 24320 and the bottom firing member feature 24350 are integrally formed with the vertically extending firing member body 24312. For example... Figure 54 As can be seen, the anvil body 23212 includes an axially extending anvil slot 23240 that defines two opposing flanges 23241 for slidably receiving laterally extending tabs 24323 thereon. Similarly, the elongated channel 23110 includes an axially extending channel slot 23140 that defines an axially extending channel flange 23141 that is configured to slidably receive laterally extending tabs 24353 thereon.

[0177] In the illustrated arrangement, the firing system 24300 includes an upper flexible spine assembly 24400 operatively coupled to a top firing member feature 24320 of the firing member 24310. In at least one embodiment, the upper flexible spine assembly 24400 includes an upper series 24410 of upper vertebral members 24420, which are loosely coupled together by an upper flexible connector member 24440 extending through each of the upper vertebral members 24420 and attached to the top firing member feature 24320.

[0178] like Figure 52As can be seen, each upper vertebral component 24420 is substantially T-shaped when viewed from one end of each upper vertebral component. In one aspect, each upper vertebral component 24420 includes an upper vertebral body portion 24422 having a proximal end portion 24424 and a distal end portion 24428. Each upper vertebral component 24420 also includes a downwardly extending upper drive feature portion or upper vertebral component tooth 24450 projecting from the upper vertebral body portion 24422. Each upper vertebral component tooth 24450 has a helical proximal upper face portion 24452 and a helical distal upper face portion 24454. Each proximal end portion 24424 of the upper vertebral body portion 24422 has an arcuate or slightly concave curved shape, and each distal end portion 24428 has an arcuate or slightly convex curved shape. When arranged in the upper series 24410, the convex distal end 24428 on one upper vertebral member 24420 contacts and engages with the concave proximal end 24424 on the adjacent upper vertebral member 24420 in the upper series 24410 to maintain general alignment of the upper vertebral members 24420 such that the helical proximal upper face portion 24452 and helical distal upper face portion 24454 on each corresponding upper vertebral member tooth 24450 can be engaged by a rotary drive screw 2700 in a driven manner using the various methods disclosed herein. These curved mating surfaces on the upper vertebral members 24420 allow for better load transfer between them, even when they are tilted.

[0179] In at least one embodiment, an upper alignment member 24480 is used to assist in the alignment of the upper vertebral members 24420 in the upper series 24410. In one arrangement, the alignment member 24480 includes a spring member or metal cable that may be made of nitinol wire, spring steel, etc., and is formed with a distal upper annular end 24482 and two upper support portions 24484 that extend through corresponding upper conduits 24425 in each upper vertebral body portion 24422. An upper flexible connector member 24440 extends through an upper conduit 24429 in each upper vertebral member of the upper vertebral members 24420 to attach to the firing member 24310. Specifically, the distal end portion 24442 extends through a top axial conduit 24324 in the top firing member feature portion 24320 and is secured therein by an upper retaining lug 24444. The proximal portion of the upper flexible connector member 24440 can be engaged with a corresponding rotary reel or cable management system of various types and designs disclosed herein, which is used to release and tighten the upper flexible connector member 24440 during operation and joint movement of the surgical end effector 23000 to maintain a desired amount of tension therein. The cable management system can be motor-driven or manually driven (ratchet arrangement, etc.) to maintain the desired amount of tension in the upper flexible connector member 24440. The amount of tension in each flexible connector member can be varied according to the relative positioning of the surgical end effector 23000 and the elongated shaft assembly 24000.

[0180] The firing system 24300 also includes a lower flexible spine assembly 24500 operatively coupled to the bottom firing member feature 24350. The lower flexible spine assembly 24500 includes a lower series 24510 of lower vertebral members 24520, which are loosely coupled together by a lower flexible connector member 24540 extending through each of the lower vertebral members 24520 and attached to the bottom firing member feature 24350. Figure 52As can be seen, each upper vertebral component 24520 is substantially T-shaped when viewed from one end of each lower vertebral component. In one aspect, each lower vertebral component 24520 includes a lower vertebral body portion 24522 having a proximal end portion 24524 and a distal end portion 24528. Each lower vertebral component 24520 also includes an upwardly extending lower drive feature portion or lower vertebral component tooth 24550 projecting from the lower vertebral body portion 24522. Each lower vertebral component tooth 24550 has a helical proximal lower face portion 24552 and a helical distal lower face portion 24554. The proximal end portion 24524 of each lower vertebral body portion 24522 has an arcuate or slightly concave curved shape, and each distal end portion 24528 has an arcuate or slightly convex curved shape. When arranged in the lower series 24510, the convex distal end 24528 on the upper vertebral member 24520 contacts and engages with the concave proximal end 24524 on the adjacent lower vertebral member 24520 in the lower series 24510 to maintain the lower vertebral members 24520 generally aligned, such that the helical proximal lower face portion 24552 and helical distal lower face portion 24554 on each corresponding lower vertebral member tooth 24550 can be driven to engage by the rotary drive screw 2700 in various methods disclosed herein. These curved mating surfaces on the lower vertebral members 24520 allow the lower vertebral members 24520 to better transmit loads between them, even when they are tilted.

[0181] In at least one embodiment, a lower alignment member 24580 is used to assist in the alignment of the lower vertebral members 24520 in the lower series 24510. In one arrangement, the lower alignment member 24580 includes a spring member or metal cable that may be made of nitinol wire, spring steel, etc., and is formed with a distal lower annular end 24582 and two lower support portions 24584 that extend through corresponding lower conduits 24525 in each lower vertebral body portion 24522. A lower flexible connector member 24540 extends through a bottom axial conduit 24529 in each lower vertebral member 24520 to attach to the firing member 24310. Specifically, the distal end portion 24542 of the lower flexible connector member 24540 extends through the bottom axial conduit 24354 in the bottom firing member feature portion 24350 and is secured therein by a lower retaining lug 24544. The proximal portion of the lower flexible connector member 24540 can be engaged with a corresponding rotary reel or cable management system of various types and designs disclosed herein, which is used to release and tighten the lower flexible connector member 24540 during operation and joint movement of the surgical end effector 23000 to maintain a desired amount of tension therein. The cable management system can be motor-driven or manually driven (ratchet arrangement, etc.) to maintain the desired amount of tension in the lower flexible connector member 24540. The amount of tension in each flexible connector member can be varied according to the relative positioning of the surgical end effector 23000 and the elongated shaft assembly 24000.

[0182] According to at least one aspect, a large surface area facilitates the distribution of force between vertebral members when they are pushed, preventing them from twisting relative to each other. The available area in the anvil and channel is limited, and the anvil and channel must remain rigid. The T-shaped upper vertebral member 24420 and the T-shaped lower vertebral member 24520 are designed to fit within the limited space available in the anvil 23210 and the elongated channel 23110, while ensuring ample area for distributing the firing load. The curved surfaces on each upper vertebral member 24420 and each lower vertebral member 24520 allow each of those vertebrae to better transmit the load between them, even when they are tilted. The upper alignment member 24480 and the lower alignment member 24580 also serve to prevent the upper vertebral member 24420 and the lower vertebral member 24520 from twisting relative to each other. The large surface area also helps prevent abrasion of the vertebral members and / or the anvil and channel. The upper flexible ridge assembly 24400 and the lower flexible ridge assembly 24500 are otherwise operably connected to the rotary drive screw 2700 as disclosed herein. If the firing drive system 24300 fails during the firing stroke, the upper flexible connector member 24440 and the lower flexible connector member 24540 can also be used, as discussed above, to retract the firing member 24310 to its initial position.

[0183] like Figure 51 As can be seen, the top firing member feature 24320 on the firing member 24310 includes a distal upper firing member tooth segment 24330, which corresponds to half of the upper vertebral member tooth 24450 on each upper vertebral member 24420. Additionally, two proximal upper firing member teeth 24336, identical to the upper vertebral member teeth 24450 on each upper vertebral member 24420, are spaced apart from the distal upper firing member tooth segment 24330. The distal upper firing member tooth segment 24330 and the proximal upper firing member teeth 24336 can each be integrally formed with the top firing member feature 24320 of the firing member 24310. Similarly, the bottom firing member feature 24350 of the firing member 24310 includes a distal lower firing member tooth 24360 and two proximal lower firing member teeth 24366 integrally formed on the bottom firing member feature 24350. For example, in at least one arrangement, the firing member 24310 having rigidly attached teeth 24330, 24336, 24360 and 24366 can be manufactured as a single integral part using conventional metal injection molding techniques. Those skilled in the art will recognize that the firing member 24310 operates in substantially the same manner as the firing member 2310 as described in detail herein.

[0184] Now go to Figure 55Regarding 58, according to at least one aspect, the articular joint 24200 includes a movable exoskeleton assembly 24800. In one form, the movable exoskeleton assembly 24800 includes a series 24802 of movably engaged annular rib members 24810. Figures 55 to 57 As can be seen, each annular rib member 24810 includes a first or proximal side 24820, which includes a convex or dome-shaped portion 24822. Each annular rib member 24810 also includes a concave or disc-shaped second or distal side 24830. Each annular rib member 24810 also includes an upper ridge conduit 24840 and a lower ridge conduit 24842, the upper ridge conduit being configured to accommodate an upper flexible ridge assembly 24400 passing through it, and the lower ridge conduit being configured to accommodate a lower flexible ridge assembly 24500 passing through it. Additionally, each annular rib member 24810 includes four articulation conduits 24850, 24852, 24854, and 24856 to accommodate articulation actuators in the form of articulation cables 24242, 2446, 24250, and 24254 passing through them. See also Figure 49 Each annular rib member 24810 also includes a central drive conduit 24860, which is configured to accommodate a constant speed (CV) drive shaft assembly 2620 passing through it.

[0185] like Figure 58As can be seen, the movable exoskeleton assembly 24800 includes a proximal attachment rib 24870 configured to attach the movable exoskeleton assembly 24800 to the distal end 24124 of the proximal support shaft 24120 via a headed screw 24880 or other suitable fastener arrangement. The proximal attachment rib 24870 includes a first or distal side 24872, which is concave or disc-shaped to receive or movably engage with a convex or dome-shaped portion 24822 of the proximal side 24820 of the nearest annular rib member 24810P. Similarly, the movable exoskeleton assembly 24800 includes a distal attachment rib 24890 configured to attach the movable exoskeleton assembly 24800 to the proximal end 23112 of the elongated channel 23110 via a headed screw 24882 or other suitable fastener. The distal attachment rib 24890 includes a first or proximal side 24892 comprising a convex or dome-shaped portion 24894 configured to be received in or movably engaged with the concave or disc-shaped distal side 24832 of the distal annular rib member 24810D. In various embodiments, the annular rib members 24810, 24810P, and 24810D may be made of any suitable metal (e.g., stainless steel, titanium, etc.) or other suitable materials. Annular rib members 24810, 24810P, and 24810D can be formed by suitable stretching or forming operations, by machining, or by casting. The proximal side 24820 and the distal side 24830 can be polished or otherwise finished to a desired smooth surface to reduce friction and facilitate movement between the annular rib members 24810, 24810P, and 24810D. According to one aspect, all edges on each annular rib member 24810, 24810P, and 24810D are rounded to facilitate relative movement between the annular rib members. The proximal attachment rib 24870 and the distal attachment rib 24890 can be formed with similar properties.

[0186] The surgical instrument 22010 also includes an articulation system 24240 configured to apply articulation to the surgical end effector 23000, causing the surgical end effector 23000 to articulate relative to the elongated shaft assembly 24000. In at least one arrangement, for example as described above, the articulation system 24240 includes four articulation cables 24242, 24246, 24250, and 24254 extending through the elongated shaft assembly 24000. See also Figure 49In the illustrated arrangement, articulation cables 24242, 24246 pass through the proximal attachment rib 24870 and through each of the annular ribs 24810P, 24810, and 24810D to be secured to the distal attachment rib 24890. In one arrangement, for example, each of the articulation cables 24242, 24246 is secured to the distal attachment rib 24890 by a corresponding attachment lug 24243. See also Figure 61 and Figure 63 Similarly, joint motion cables 24250 and 24254 extend through the proximal attachment rib 24870 and through each of the annular rib members 24810P, 24810 and 24810D to be secured to the distal attachment rib 24890 by the corresponding attachment lug 24243.

[0187] In one arrangement, each of the articulation cables 24242, 24246, 24250, and 24254 extends through a corresponding helical spring 24896, which is supported in a cavity 24125 in the distal end 24124 of a rigid proximal support shaft 24120. Additionally, each helical spring 24896 is associated with a tension lug 24897, which is also journal-connected to and secured to each of the respective articulation cables 24242, 24246, 24250, and 24524 to achieve a desired amount of compression in each spring 24896. This compression serves to hold the annular rib members 24810P, 24810, and 24810D to each other and to movably engage with the proximal attachment rib 24870 and the distal attachment rib 24890. Cables 24242, 24246, 24250, and 24254 are operatively connected to a joint motion control system supported within the housing of surgical instrument 22010. For example, as discussed above, the proximal portion of each cable 24242, 24246, 24250, and 24254 can be wound around a corresponding rotary reel or cable management system 2007 within the housing portion of surgical instrument 22010. Figure 2 On the reel or cable management system, each cable 24242, 24246, 24250, and 24254 is configured to be extended and retracted in a desired manner. The reel / cable management system can be motor-driven or manually driven (ratchet arrangement, etc.). Figure 59 The articulation joint 24200 in a non-articular motion position is shown, and Figure 60 A joint motion connector in a joint motion configuration is shown. This arrangement allows the surgical end effector 23000 to perform joint motion relative to the elongated shaft assembly 24000 through multiple joint motion planes.

[0188] like Figure 49 , Figure 58 and Figure 64 As can be seen, the surgical instrument 22010 employs a constant velocity (CV) drive shaft assembly 2620, which spans or extends axially through the articular motion joint 24200. The operation and configuration of the CV drive shaft assembly 2620 have been described in detail above and will not be repeated here except where necessary for understanding the operation of the surgical instrument 22010. In short, as discussed above, 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 formed by an attachment shaft 2634 configured to be non-rotatably received within a similarly shaped connector cavity 2616 in the distal end 2614 of the proximal rotary drive shaft 2610. The proximal shaft segment 2632 is operatively engaged with a series 2640 of movably coupled drive joints 2650. Figure 58 As can be seen from the preceding description, to ensure that the drive joints 2650 engage with each other, a proximal drive spring 2740 is used to apply an axial biasing force to the series 2640 of the drive joints 2650. For example, as Figure 58 As can be seen, the proximal drive spring 2740 is positioned between the proximal mounting bushing 2734 and the support flange formed between the distal insertion portion 2636 and the proximal cylinder portion 2638 of the proximal shaft section 2632. In one arrangement, the proximal drive spring 2740 may include an elastomeric O-ring received on the proximal cylinder portion 2638 of the proximal shaft section 2632. The proximal drive spring 2740 slightly biases the drive joints 2650 together to reduce any play that occurs during joint movement. This ensures that the drive joints 2650 torsionally transmit the load. However, it should be understood that in at least one arrangement, the proximal drive spring 2740 does not apply a sufficiently high axial load such that the firing load translates through the joint movement joint 2200.

[0189] To further prevent the drive joint 2650 from buckling during joint movement, a series 2640 of the movably coupled drive joints 2650 extend through at least one low-friction drive cover 24730, which extends through a central drive conduit 24860 in each of the annular rib members 24810. Figure 63 and Figure 65In the depicted arrangement, the drive cover 24730 includes an externally cut hypotube and an internally cut hypotube 24732. This hypotube 24732 may be made of metal (e.g., stainless steel) and has multiple series of incisions or slits therein that can be made using a laser cutter. In the illustrated arrangement, the hypotube 24732 may be manufactured with an upper release conduit 24734 that provides a clearance for the upper flexible spine assembly 24400 to pass over it during surgery when the surgical end effector 23000 is in one or more joint movement positions. Furthermore, the hypotube 24732 may have a lower release conduit 24736 to provide a similar clearance for the lower flexible spine assembly 24500. Figure 65 It can also be seen that the hysteresis tube 24732 can be shaped to have lateral tab portions 24738 opposite in diameter to provide lateral stability during joint movement. Figure 66 An alternative drive cover 24730' including an internally cut submersible tube 24732' is shown. Figure 58 , Figure 67 , Figure 68 and Figure 69 An alternative drive cover 24730” is shown, comprising a flexible heat-shrinkable tube 24732” applied to a constant speed (CV) drive shaft assembly 2620. In other arrangements, the drive cover may also include a helical spring or a helical member.

[0190] Various embodiments of this disclosure offer advantages over previous surgical endoscopic cutter configurations capable of articulation. For example, pushing the firing member forward in an articulated end effector typically requires a large force, and this force must be balanced. For instance, when firing the firing member at an angle greater than sixty degrees, it becomes very difficult to push the beam through the articulated joint. The joint also experiences significant loads, which can cause the articulated joint to disengage from the articulation. By employing an upper flexible drive arrangement and a lower flexible drive arrangement (each flexible as it passes through the articulated joint, but then becoming rigid as it is distal to the articulated joint), a large degree of articulation (e.g., articulation angles exceeding seventy degrees) is allowed while balancing loads are applied to the firing member, which are constrained to the firing member but not to the articulated joint. In other words, torsional loads, rather than longitudinal loads, are applied proximally to the articulated joint, and these longitudinal loads can cause the end effector to disengage from the articulation. The torsional load is converted into a longitudinal load at a location distal to the articulated joint. Therefore, the rotary drive screw is used to effectively convert torsional motion or load into longitudinal load, which is applied to the firing member at a location distal to the articulated joint.

[0191] Furthermore, by longitudinally decomposing the threaded drive arrangement, which passes through the articulated joint, the length of the surgical end effector is effectively reduced. For example, each individual vertebral tooth is significantly shorter than the pitch of multiple rigidly connected threads. The vertebra can be angled as it passes through the articulated joint. This flexible interconnection allows the rotary drive screw to be tightly positioned to the articulated joint, whereas if all the threads were rigidly connected, the rotary drive screw would be significantly spaced from the articulated joint.

[0192] Figures 70 to 73 Another surgical end effector 4000 is shown that can be used with surgical instrument 3010, which is similar in many respects to surgical instrument 10. Except for the differences discussed below, surgical end effector 4000 may be similar to surgical end effector 1000. Surgical end effector 4000 is operatively coupled to an elongated shaft assembly 5000. Elongated shaft assembly 5000 may be operatively attached to a housing portion of surgical instrument 3010. The housing may include a handle configured to be grasped, manipulated, and actuated by a clinician. In other embodiments, the housing may include housing of a robotic system or otherwise operatively supporting a portion of at least one drive 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 corresponding equivalents.

[0193] In at least one embodiment, the surgical end effector 4000 includes a first jaw 4100 and a second jaw 4200. In the illustrated arrangement, the first jaw 4100 includes an elongated channel 4110 comprising a proximal end 4112 and a distal end 4114 and is configured to operably support the surgical staple cartridge 1300 therein. In the illustrated arrangement, the second jaw 4200 includes an anvil 4210, which may be similar to the anvil 1210 described above. In the illustrated arrangement, the elongated shaft assembly 5000 defines an axis SA and includes a proximal shaft section operably engaged with the housing of a control portion (e.g., a handheld unit, robotic tool actuator, etc.) of the surgical instrument 3010. The elongated shaft assembly 5000 also includes an articulated joint 5200 attached to the proximal shaft portion and the surgical end effector 4000.

[0194] The elongated shaft assembly 5000 may include a proximal end 4112 attached to the elongated channel 4110 and a distal spine assembly 5010 of the articular joint 5200. See also Figure 70The distal spinal assembly 5010 is immovably supported in the distal external cannula section 5020, which is operatively engaged with the surgical end effector 4000. The elongated shaft assembly 5000 also includes a proximal spinal member (not shown) operatively engaged with the proximal end of the articulation joint 5200 and operatively attached to or otherwise operatively engaged with the housing of the surgical instrument 3010. The proximal external cannula section 5030 extends from the articulation joint 5200 back to the housing for operative engagement therewith.

[0195] Surgical instrument 3010 employs a firing drive system 4300, which includes a firing member 4310 comprising a vertically extending firing member body 4312, the firing member body including a top firing member feature and a bottom firing member feature. A tissue cutting blade 4314 is attached to or formed within the vertically extending firing member body 4312. The firing drive system 4300 includes a rotary drive nut 4400 configured to rotatably drive a series 4600 of drive components 4610 operably engaged with the firing member 4310. The rotary drive nut 4400 includes a flexible proximal section 4410 spanning a joint joint 5200 and a threaded distal section 4420 distal to the joint joint 5200. The distal section 4420 includes a series of variable pitch threads 4430, with a coarser pitch 4432 at the proximal end and a narrower pitch 4434 at the distal end or exit end. See also Figure 72 The threaded rotary drive nut 4400 includes a proximal drive gear 4440 that meshes with a distal drive gear 4510 attached to the rotary drive shaft 4500. See also Figure 70 The rotary drive shaft 4500 can be connected to a gearbox / motor arrangement supported in the housing of the surgical instrument 3010. Rotation of the rotary drive shaft 4500 causes the drive nut 4400 to rotate about the shaft axis SA.

[0196] The rotary drive nut 4400 includes a proximal section 4410 and a distal section 4420. The threaded distal section 4420 is located distal to the articulated joint 5200 and is configured to threadably engage a series 4600 of drive components 4610, which are loosely connected together by a flexible chain 4640. In at least one arrangement, for example, each drive component 4610 includes a vertically extending plate member 4612, each vertically extending plate member including a top end 4614 and a bottom end 4618. The top end 4614 includes a top threaded section 4616, and the bottom end 4418 includes a bottom threaded section 4620. The top threaded section 4616 and the bottom threaded section 4620 are configured to threadably engage with the threads 4430 of the rotary drive nut 4400. The series 4600 of the drive components 4610 are configured to flexibly pass through the articulated joint 5200 and enter the vertical conduit 5012 in the distal ridge assembly 5010. Rotation of the drive nut 4400 in a first rotational direction causes the series 4600 of the drive components 4610 to move axially in the distal direction, and rotation of the drive nut 4400 in a second rotational direction causes the series 4600 of the drive components 4610 to move axially in the proximal direction.

[0197] Go to Figure 72 In at least one arrangement, each drive member 4610 further includes a distally projecting latching feature 4630. Each latching feature 4360 is configured to be releasably received in a latching cavity 4364 formed in an adjacent drive member 4610 immediately adjacent to the latching feature distal to it. When the drive members 4610 are latched together, these drive members form an axial rigidity series 4600AR for applying axial drive movement to the firing member 5310 to drive the firing member 5310 through the surgical end effector 4000 from a starting position to an ending position and then back from the ending position to the starting position. Figure 72 As can be seen, when the drive member 4610 enters the threaded distal section 4420 of the rotary drive nut 4400, these drive members are loosely connected together. When the drive member 4610 is threadedly engaged with the fine-pitch thread 4430 in the threaded distal section 4420 of the rotary drive nut 4400, the latching feature 4630 is received in a latching manner within a corresponding latching cavity 4364 in the distally adjacent drive member 4610 to form an axial rigidity series 4600AR of the drive member 4610. In one arrangement, the distal drive member 4610 may be configured to engage the firing member 4310 in a similar latching manner, or in another arrangement, the distal drive member may be non-removably attached to the firing member 4310.

[0198] In the illustrated example, the drive components 4610 in the series 4600 of drive components are flexibly connected together, allowing them to move relative to each other to accommodate the articulated joint, and eliminating the need for the reinforcing support plate typically required when pushing the firing beam through the articulated joint. When the series of drive components 4610 enters and is actuated by the threaded distal section 4420 distal to the articulated joint, the drive components 4610 form an axially rigid series of drive components for driving the firing member 4310 through the surgical end effector 4000. The anvil 4210 can be pivoted to an open position by springs or other arrangements in various ways disclosed herein, and then closed by the firing member 4310 when it is driven distally from the starting position to the ending position in various ways discussed herein. Other jaw control arrangements may also be employed to control the opening and closing of the jaws.

[0199] Figures 73 to 76 Another surgical end effector 6000 employing a drive system 6300 is shown, which includes a series 6600 of flexible connecting drive components 6610 that can be used to traverse the articular motion joint 6200 and rigidly advance the firing member 6130 through the surgical end effector 6000. The surgical end effector 6000 may include a channel 6010 configured to operably support a surgical staple cartridge (not shown). An anvil 6020 is pivotally coupled to the channel 6010 and can be moved between an open and closed position by means of the firing member 6130 or other closure system arrangement. The anvil 6020 can be moved to the open position by means of springs or other arrangements in various ways disclosed herein.

[0200] Go to Figure 74 In at least one arrangement, each drive member 6610 includes a drive member body 6612 having a proximal side 6614, a distal side 6616, and a threaded section 6620 formed on a bottom surface 6618. Each drive member 6610 also includes a latching feature 6630 projecting proximally. Each latching feature 6630 includes a neck feature 6632 having a spherical latching head 6634 formed at its end. The latching feature 6630 is configured to be movably received within a latching cavity 6336 formed in an adjacent drive member 6610 immediately adjacent to the distal side of the latching feature. To facilitate movable attachment of the drive members 6610 in a movably continuous arrangement, the spherical latching head 6634 is inserted through a tapered conduit 6338 in the drive member body 6612 and into the latching cavity 6636. The size and shape of the spherical latch head 6634 relative to the latch cavity 6636 are set such that when Figure 74The arrangement shown allows for relative movement between the drive components 6610. However, when the drive components are axially aligned such that the distal side 6616 of one drive component 6610 abuts against the proximal side 6614 of the drive component immediately adjacent to the distal side of the drive component, the drive components 6610 form an axially rigid series 6600AR of the drive components that can drive the firing member 6130 through the surgical end effector 6000.

[0201] like Figure 73 As can be seen, a series 6600 of drive components 6610 are driven by a flexible rotary drive system 6700. In one arrangement, the flexible rotary drive system 6700 includes a flexible rotary drive shaft 6710 that passes through an articulated joint 6210 and includes a rotary drive gear 6720 configured to threadedly engage threaded sections 6620 on each drive component 6610. The flexible rotary drive shaft 6710 can be rotated by a motor / gear arrangement supported in the housing of a surgical instrument. The portion 6600F of the series 6600 of drive components 6610 proximal to the rotary drive gear 6720 remains flexibly connected or “loose.” When the drive components 6610 are threadedly engaged by the rotary drive gear 6720, these drive components are driven through a conduit in a channel 6010, which causes the drive components to form an axially rigid series 6600AR for driving the firing member 6130 through the surgical end effector 6000.

[0202] When firing system components traverse the articulated joint, the torsional load applied to these components is less likely than the axial load to disengage the articulated joint from its articulation. The various embodiments disclosed herein transfer the torsional load to a longitudinal load located distal to the articulated joint. Because the longitudinal load is contained within the end effector, disengagement from the articulation is prevented. Figure 77An example of a firing system 6800 that can provide such advantages is shown. The firing system 6800 includes a firing member 6810 configured to be operably supported in a surgical end effector in various ways described herein. A flexible spring-like follower 6820 is attached to the firing member 6810. This flexible spring-like follower 6820 can span an articulation joint region 6840, which allows for a relatively large range of articulation. The flexible spring-like follower 6820 is configured to be axially driven across the articulation joint region 6840 by a rotatably supported flexible spring-like torsional drive member 6830. The flexible spring-like torsional drive member 6830 includes a threaded insert 6832 configured to thread-engage the spring-like follower 6820 at a location 6841 distal to the articulation joint region 6840. The flexible spring-like torsional drive member 6830 can be rotated by a motor / gear arrangement supported within the housing of a surgical instrument. When the flexible spring-shaped torsion drive member 6830 rotates in the first direction, the flexible spring-shaped driven member 6820 translates longitudinally to drive the firing member 6810. The rotation of the flexible torsion drive member 6830 in the second direction will cause the flexible spring-shaped driven member to move proximally.

[0203] Figure 78 Another firing system 6850 is shown, which includes a firing member 6860 configured to be operably supported in a surgical end effector in various manners described herein. The firing member 6860 is driven by a firing member drive assembly 6861, which includes a series 6862 of spherical ball members 6870 connected together by a flexible cable 6872. This series 6862 of the flexible spherical ball members 6870 spans an articulation joint region 6840, which allows for a relatively large range of articulation. The series 6862 of the flexible spherical ball members 6870 is configured to be axially driven by a rotatably supported flexible torsional drive member 6880 to span an articulation joint region 6890. The flexible torsional drive member 6880 includes an insert 6882 configured to operatively engage at a position 6892 distal to the articulation joint region 6890 of the spherical ball member 6870. The flexible torsional drive member 6880 can be rotated by a motor / gear arrangement supported within the housing of the surgical instrument. When the flexible torsional drive member 6880 rotates in a first direction, the spherical members 6870 are driven distally into contact with each other, forming an axially rigid series 6862AR that translates longitudinally to drive the firing member 6860 distally. Rotation of the flexible torsional drive member 6880 in a second direction will cause the series of spherical members 6870 to move proximally.

[0204] Figure 79 Another firing system 6950 is shown, which includes a firing member 6960 configured to be operably supported in a surgical end effector in various ways described herein. A laser-cut hypotube follower 6970 is attached to the firing member 6960. This flexible follower 6970 can span an articulation joint region 6940, which allows for a relatively large range of articulation. The flexible follower 6970 is configured to be axially driven across the articulation joint region 6940 by a rotatably supported flexible torsional drive member 6980. The flexible torsional drive member 6980 includes a threaded insert 6982 configured to threadably engage a laser incision 6972 on the flexible follower 6970 at a location 6942 distal to the articulation joint region 6940. The flexible torsional drive member 6980 can be rotated by a motor / gear arrangement supported in the housing of a surgical instrument. When the flexible torsion drive member 6980 rotates in the first direction, the flexible follower member 6970 translates longitudinally to drive the firing member 6960. The rotation of the flexible torsion drive member 6980 in the second direction will cause the flexible follower member 6970 to move proximally.

[0205] Pushing the firing beam forward in an articulated end effector typically requires a significant amount of force, and this force must be balanced. For example, it is often difficult to push the firing beam through an articulated joint that has been articulated to an angle greater than sixty degrees. When the firing beam crosses the articulated joint, it can apply a significant load to the articulated joint components, which can cause the articulated joint to disengage from the articulation. Figures 80 to 84 A firing drive system 7300 is shown, comprising a flexible upper drive belt 7320 and a flexible lower drive belt 7330 attached to a firing member 7310, the firing member being configured to move within a surgical end effector 7000 between a starting position and an ending position. Figures 80 to 82 As can be seen, the flexible upper drive belt 7320 includes a plurality of spaced-apart upper drive teeth 7322, which are configured to thread-engage helical threads 7342 on the rotary drive nut 7340. Similarly, the flexible lower drive belt 7330 includes a plurality of spaced-apart lower drive teeth 7332, which are configured to thread-engage helical threads 7342 on the rotary drive nut 7340. In at least one arrangement, the flexible upper drive belt 7320 and the flexible lower drive belt 7330 are formed of a metallic material and are welded to or otherwise attached to the firing member 7310. This arrangement is used to balance the firing load applied to the firing member 7310.

[0206] A rotary drive nut 7340 is received on a flexible rotary drive shaft 7350, which is centrally positioned between a flexible upper drive belt 7320 and a flexible lower drive belt 7330 and traverses the articulated joint region generally designated 7200. The flexible rotary drive shaft 7350 is rotatable by a motor / gear arrangement supported within the housing of the surgical instrument. When the flexible rotary drive shaft 7350 rotates in a first direction, the flexible upper drive belt 7320 and the flexible lower drive belt 7330 drive the firing member 7310 distally. Rotation of the flexible rotary drive shaft 7350 in a second direction causes the flexible upper drive belt 7320 and the flexible lower drive belt 7330 to pull the firing member 7310 proximally. In at least one arrangement, the flexible upper drive belt 7320 and the flexible lower drive belt 7330 pass through a guide member 7360 surrounding the rotary drive nut 7340 to prevent the flexible upper drive belt 7320 and the flexible lower drive belt 7330 from bypassing the rotary drive nut 7340 during actuation of the flexible rotary drive shaft 7350. See also Figure 84 .

[0207] In the illustrated arrangement, the firing member 7310 is configured to move through a surgical end effector 7000, which includes a first jaw 7010 and a second jaw 7030, the second jaw being configured to move relative to the first jaw 7010. In one embodiment, the first jaw 7010 includes an elongated channel 7012 configured to operably support a surgical staple cartridge therein. See also Figure 80 and Figure 81 The second jaw 7030 includes an anvil 7032, which is pivotally supported on the elongated channel 7012 and movable relative to the elongated channel 7012 between an open position and a closed position. Figure 82 As can be seen, in at least one form, the firing member 7310 includes a shape commonly referred to as an "E-beam". The firing member 7310 includes a vertically extending firing member body 7312 having a lower base feature 7314 including two laterally extending tabs 7315 configured to slidably engage the elongated channel 7012 when the firing member is axially driven within it. Furthermore, a pair of upper tabs 7316 protrude from the upper portion of the firing member body 7312 to engage the anvil 7032 when the firing member 7310 is driven distally through a closed anvil 7032. During the firing stroke, the tabs 7315 and 7316 can be used to space the anvil 7032 relative to the surgical cartridge supported in the elongated channel 7012. The firing member body 7312 also includes a tissue cutting feature 7318. The tab 7316 can also be used to apply a closing motion to the anvil 7032 when the firing member 7310 moves from the starting position to the distal side.

[0208] In the example shown, the firing drive system 7300 can also be used to apply opening and closing movements to the anvil 7032. Figures 80 to 83 As can be seen, the closing nut 7370 is threadedly received on the flexible rotary drive shaft 7350. The closing nut 7370 includes a cam pin 7372 that extends laterally from each side of the closing nut 7370 to be received in a corresponding cam slot 7036 in the anvil mounting portion 7034 of the anvil 7032. See also... Figure 80 and Figure 81 This cam pin 7372 prevents the closing nut 7370 from rotating together with the flexible rotary drive shaft 7350, such that rotation of the flexible rotary drive shaft 7350 causes axial movement of the closing nut 7370. Therefore, rotation of the flexible rotary drive shaft 7350 in the first direction causes the closing nut 7370 to move distally and moves the anvil 7032 from the open position to the closed position via a cam. Rotation of the flexible rotary drive shaft 7350 in the second rotational direction causes the closing nut 7370 to move proximally and moves the anvil 7032 via a cam back to the open position. Thus, for example, alternating rotation of the flexible rotary drive shaft 7350 allows the surgeon to quickly open and close the anvil 7032 for gripping purposes.

[0209] Figure 85 An alternative firing drive assembly 7302 is shown, which includes a flexible upper drive belt 7320' having upper drive teeth 7322' and a flexible lower drive belt 7330' having lower drive teeth 7332', the flexible lower drive belt being formed from a single piece of material such as metal. The flexible upper drive belt 7320' also includes an upper reinforcing tab 7324' similar to an upper tab 7316 on the firing member 7310, which is configured to pass through an anvil 7032, and a lower reinforcing tab 7334 similar to a tab 7315 on the firing member 7310, which is configured to pass through a channel 7012. Figure 86 An alternative firing drive assembly 7302' is shown, which is made of two belt assemblies 7302A and 7302B laminated together to form a flexible upper drive belt 7320" with upper drive teeth 7322" and a flexible lower drive belt 7330" with lower drive teeth 7332". Each belt assembly 7302A, 7302B also includes upper reinforcing tabs 7324A" and 7324B" and lower reinforcing tabs 7334A" and 7334B" respectively configured to pass through the anvil 7032 and the elongated channel 7012.

[0210] For example, the firing drive system 7300 is used to apply a uniform drive motion to the firing member 7310 and can accommodate articulation angles greater than seventy degrees. Furthermore, because the rotary drive nut 7340 engages the flexible upper drive belt 7320 and the flexible lower drive belt 7330 at a position distal to the articulation joint region 7200, the linear firing load is limited to the end effector and does not pass through the articulation joint.

[0211] Example 1—A surgical instrument comprising an elongated shaft having a surgical end effector coupled thereto via an articulated joint configured to facilitate selective articulation of the surgical end effector relative to the elongated shaft. The surgical end effector includes a firing member supported for axial travel within the surgical end effector between a starting position and an ending position. A drive assembly includes a series of drive members operably supported by the elongated shaft and configured to traverse the articulated joint and operably engage with the firing member. The drive members are loosely coupled to each other as they traverse the articulated joint and are configured to sequentially engage a rotary drive member located distal to the articulated joint, such that the rotary drive member causes each drive member to become rigidly latched to the preceding drive member, forming an axially rigid distal series of drive members configured to apply axial drive motion to the firing member to drive the firing member between the starting and ending positions.

[0212] Example 2—A surgical instrument according to Example 1, wherein each drive component is configured to thread-engage a rotary drive member.

[0213] Example 3—A surgical instrument according to Example 1 or 2, wherein the rotation drive member includes a hollow threaded member supported for rotation at a position distal to the joint joint, and wherein at least a portion of the series of drive members is configured to continuously thread-engage the hollow threaded member.

[0214] Example 4—A surgical instrument according to Example 3, wherein, when the hollow threaded member rotates in a first rotational direction, a distal drive member in a series of loosely connected drive members threadedly engages the rotary drive member such that the loosely connected drive member is continuously pulled distally to operably thread-engage with the rotary drive member. Each drive member in the series of loosely connected drive members is latched to rigidly engage with a drive member distally adjacent to it, forming an axially rigid distal series of drive members.

[0215] Example 5—A surgical instrument according to Example 4, wherein when the rotary drive member rotates in the second rotational direction, the rotary drive member pulls the axially rigid distal series of drive members proximally, such that when each drive member in the axially rigid distal series of drive members is operably engaged with the rotary drive member, the rotary drive member disengages the drive member from the distally adjacent drive member in the axially rigid distal series of drive members to re-establish a loosely connected series of drive members.

[0216] Example 6—A surgical instrument according to Example 1, 2, 3, 4 or 5, wherein each of at least a portion of the series of drive components includes a threaded portion on its outer periphery.

[0217] Example 7—A surgical instrument according to Examples 1, 2, 3, 4 or 6, wherein each drive component is loosely connected to an adjacent drive component in a series of drive components via a corresponding flexible member.

[0218] Example 8—A surgical instrument according to Examples 1, 2, 3, 4, 5, 6, or 7, wherein at least some of the drive components in the series of drive components include a drive component body and a latching cavity, the drive component body having a latching feature projecting distally therefrom, the latching cavity being located in the proximal end of the drive component body. The latching cavity is configured to receive, in a latching manner, the latching feature of a proximal adjacent drive component in the series of drive components.

[0219] Example 9—A surgical instrument according to Example 8, wherein the drive component body is configured to thread-engage a rotary drive member.

[0220] Example 10—A surgical instrument according to Example 9, wherein the hollow threaded member includes an internal thread, the internal thread including a variable pitch.

[0221] Example 11—A surgical instrument according to Examples 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10, wherein the surgical end effector includes a first jaw including a first conduit configured to slidably receive an upper portion of a firing member. The surgical end effector further includes a second jaw configured to move relative to the first jaw between an open position and a closed position, and the second jaw including a second conduit configured to receive a lower portion of a firing member. The first and second conduits are also configured to receive corresponding portions of the drive members in an axially rigid distal series of drive members.

[0222] Example 12—A surgical instrument comprising an elongated shaft having a surgical end effector coupled thereto via an articulated joint configured to facilitate selective articulation of the surgical end effector relative to the elongated shaft. The surgical end effector includes a firing member supported for axial travel within the surgical end effector between a starting position and an ending position. A drive conversion member is supported at a position distal to the articulated joint. A flexible drive assembly is supported by the elongated shaft and axially traverses the articulated joint. The flexible drive assembly is configured to accommodate articulation of the surgical end effector and is operatively engaged with the drive conversion member such that, when actuated, the drive conversion member converts a portion of the flexible drive assembly into an axially rigid drive member segment, which is axially driven distally by the drive conversion member to apply axial drive motion, thereby moving the firing member between the starting and ending positions.

[0223] Example 13—A surgical instrument according to Example 12, wherein the drive conversion member is configured to thread-engage a flexible drive assembly.

[0224] Example 14—A surgical instrument according to Example 12 or 13, wherein the drive conversion member includes a hollow threaded member, the hollow threaded member including an internal thread, the internal thread including a variable pitch.

[0225] Example 15—A surgical instrument according to Examples 12, 13, or 14, wherein the surgical end effector includes a first jaw and a second jaw, the second jaw being configured to move relative to the first jaw between an open position and a closed position. A firing member is configured to apply a closing motion to the second jaw to move the second jaw from an open position to a closed position when the firing member moves distally from a starting position to an end position via an axially rigid drive member segment.

[0226] Example 16—A surgical instrument according to Example 15, wherein a first jaw includes a channel configured to operably support a surgical staple cartridge, the cartridge including a cartridge body in which a plurality of surgical staples are operably supported. The surgical staple cartridge also includes a cartridge slide movably supported within the cartridge body and configured to move within the cartridge body between a start position and an end position to drive surgical staples from the cartridge body. A second jaw includes an anvil supported for pivoting relative to the surgical staple cartridge between an open position and a closed position. A firing member is configured to drive the cartridge slide from the start position to the end position when the firing member is driven from the start position to the end position.

[0227] Example 17—A surgical instrument according to Examples 12, 13, 14, 15, or 16, wherein the drive conversion member is actuable in a first actuation direction and a second actuation direction. When the drive conversion member is actuated in the first actuation direction, it converts that portion of the flexible drive assembly into an axially rigid drive member segment, and wherein when the drive conversion member is actuated in the second actuation direction, it drives the axially rigid drive member segment in a proximal direction.

[0228] Example 18—A surgical instrument according to Example 17, wherein when the drive conversion member is actuated in the second actuation direction, the drive conversion member re-converts the axially rigid drive member segment into that portion of the flexible drive assembly.

[0229] Example 19—A surgical instrument according to Examples 12, 13, 14, 15, 16, 17 or 18, wherein, by applying an axial emergency movement to the flexible drive assembly, the firing member can be moved from a position distal to the starting position without actuating the drive conversion member.

[0230] Example 20—A surgical instrument comprising an elongated shaft having a surgical end effector coupled thereto via an articulated joint configured to facilitate selective articulation of the surgical end effector relative to the elongated shaft. The surgical end effector includes a firing member supported for axial travel within the surgical end effector between a starting position and an ending position. A loosely coupled drive member is operably supported by the elongated shaft and traverses the articulated joint to accommodate articulation of the surgical end effector relative to the elongated shaft. The surgical instrument further includes means for converting a portion of the loosely coupled drive member distal to the articulated joint into a rigid drive member configured to apply axial driving motion to the firing member to drive the firing member between the starting and ending positions.

[0231] As used in any aspect of this document, the term "control circuitry" may refer to, for example, hardwired circuitry systems, programmable circuitry systems (e.g., computer processors including one or more individual instruction processing cores, processing units, processors, microcontrollers, microcontroller units, controllers, digital signal processors (DSPs), programmable logic devices (PLDs), programmable logic arrays (PLAs), field-programmable gate arrays (FPGAs)), state machine circuitry systems, firmware storing instructions executed by the programmable circuitry system, and any combination thereof. Control circuitry can be implemented collectively or individually as part of a larger system, such as integrated circuits (ICs), application-specific integrated circuits (ASICs), system-on-a-chip (SoCs), desktop computers, laptop computers, tablet computers, servers, smartphones, etc. Therefore, as used herein, "control circuit" includes, but is not limited to, electronic circuits having at least one discrete circuit, electronic circuits having at least one integrated circuit, electronic circuits having at least one application-specific integrated circuit, electronic circuits 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 implements the methods and / or devices described herein, or a microprocessor configured by a computer program that at least partially implements the methods and / or devices described herein), electronic circuits forming a memory device (e.g., forming a random access memory), and / or electronic circuits forming a communication device (e.g., a modem, a communication switch, or an optoelectronic device). Those skilled in the art will recognize that the subject matter described herein can be implemented in analog or digital modes, or some combination thereof.

[0232] Although several forms have been illustrated and described, the applicant does not intend to limit or restrict the scope of the appended claims to such details. Many modifications, variations, alterations, substitutions, combinations, and equivalents of these forms can be made without departing from the scope of this disclosure, and those skilled in the art will recognize such modifications, variations, alterations, substitutions, combinations, and equivalents. Furthermore, alternatively, the structure of each element associated with a described form can be described as a device for providing the function performed by said element. Additionally, where materials for certain components are disclosed, other materials may also be used. Therefore, it should be understood that the foregoing detailed descriptions and the appended claims are intended to cover all such modifications, combinations, and variations falling within the scope of the forms disclosed in this invention. The appended claims are intended to cover all such modifications, variations, alterations, substitutions, modifications, and equivalents.

[0233] One or more components may be referred to herein as “constructed to be,” “possibly constructable to be,” “operable / operationally,” “suitable / appropriate,” “capable,” “adapted / fittable,” etc. Those skilled in the art will recognize that, unless the context otherwise requires, “constructed to be” generally encompasses components in an active state and / or an inactive state and / or a standby state.

[0234] Those skilled in the art will recognize that, in general, the terminology used herein, and particularly in the appended claims (e.g., the text of the appended claims), is typically intended to be “open” terms (e.g., the term “comprising” should be interpreted as “including but not limited to,” the term “having” should be interpreted as “at least having,” the term “including” should be interpreted as “comprising but not limited to,” etc.). Those skilled in the art will also understand that if a specific number of statements in the introduced claims is intended, such an intention will be explicitly stated in the claims, and if no such statement is present, such an intention does not exist. For example, to aid understanding, the appended claims below may contain the use of the introductory phrases “at least one” and “one or more” to introduce the claims. However, the use of such phrases should not be construed as implying that introducing a claim statement with the indefinite article "a" or "an" limits any particular claim containing such an introductory claim statement to a claim containing only one such statement, even when the same claim includes the introductory phrase "one or more" or "at least one" and indefinite articles 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 a claim statement.

[0235] Furthermore, even when a specific number of claims is explicitly stated, those skilled in the art should recognize that such a statement should generally be interpreted as referring to at least the number stated (e.g., in the absence of other modifiers, a bare statement of "two statements" generally means at least two statements, or two or more statements). Moreover, in cases where conventions such as "at least one of A, B, and C" are used, such constructions are generally intended to have a meaning that those skilled in the art will understand (e.g., "a system having at least one of A, B, and C" will 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 cases where conventions such as "at least one of A, B, or C" are used, such constructions are generally intended to have a meaning that those skilled in the art will understand (e.g., "a system having at least one of A, B, or C" should 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 should also understand that, generally, unless the context otherwise indicates, any transitional words and / or phrases presenting two or more alternative terms in the detailed description, claims, or drawings should be understood to cover the possibility of including one of the terms, any one of the terms, 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".

[0236] With respect to the appended claims, those skilled in the art will understand that the operations described herein can generally be performed in any order. Furthermore, although various operation flowcharts are shown in one or more sequences, it should be understood that the various operations may be performed in other orders than those shown, or may be performed simultaneously. Unless the context otherwise requires, examples of such alternative orderings may include overlapping, interleaving, interruption, reordering, incremental, preparatory, supplementary, simultaneous, reverse, or other altered orderings. Moreover, unless the context otherwise requires, terms such as “in response to,” “related,” or other past tense adjectives are generally not intended to exclude such variations.

[0237] It is worth noting that any reference to "one aspect," "one aspect," "one example," or "one example" means that the specific feature, structure, or characteristic described in connection with said aspect is included in at least one aspect. Therefore, the phrases "in one aspect," "in one aspect," "in one example," and "in one example" appearing in various places throughout the specification do not necessarily refer to the same aspect. Furthermore, specific features, structures, or characteristics may be combined in one or more aspects in any suitable manner.

[0238] Any patent application, patent, non-patent publication, or other public material mentioned in this specification and / or listed in any application data sheet is incorporated herein by reference, provided that the incorporated material is inconsistent with this specification. Therefore, and to the extent necessary, the disclosures expressly listed herein replace any conflicting material incorporated herein by reference. Any material or portion thereof allegedly incorporated herein by reference that conflicts with existing definitions, statements, or other public materials listed herein will be incorporated only to the extent that the incorporated material does not conflict with existing public materials.

[0239] In summary, many beneficial effects resulting from employing the concepts described herein have been described. For illustrative and descriptive purposes, one or more of the specific embodiments described above have been provided. These embodiments are not intended to be exhaustive or limited to the precise forms disclosed in the invention. Modifications or variations may be made to the invention in accordance with the teachings above. The one or more forms chosen and described are intended to illustrate the principles and practical applications, thereby enabling those skilled in the art to utilize various forms and modifications suitable for the intended particular use. The claims filed herein are intended to define the full scope.

[0240] The surgical instrument system described herein has been described in conjunction with the deployment and variations of the staples; however, the embodiments described herein are not limited thereto. For example, various embodiments are contemplated for deploying fasteners other than staples, such as clamps or pins. Furthermore, various embodiments utilizing any suitable means for sealing tissue are contemplated. For example, the end effector according to various embodiments may include electrodes configured to heat and seal tissue. Additionally, for example, the end effector according to some embodiments may apply vibrational energy to seal tissue.

[0241] Many of the surgical instrument systems described herein are actuated by electric motors; however, they can be actuated in any suitable manner. In various instances, for example, the surgical instrument systems described herein may be actuated by manually operated triggers. In some instances, the motors disclosed herein may comprise one or more parts of a robot control system. Furthermore, any end effector and / or tooling assembly disclosed herein may be used with a robotic surgical instrument system. For example, U.S. Patent Application Serial No. 13 / 118,241 (now U.S. Patent 9,072,535), entitled “SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENTARRANGEMENTS,” discloses several examples of robotic surgical instrument systems in more detail.

[0242] The following patent disclosures are incorporated herein by reference in their entirety:

[0243] U.S. Patent 5,403,312, entitled “ELECTROSURGICAL HEMOSTATIC DEVICE”, published on April 4, 1995;

[0244] U.S. Patent 7,000,818, published on February 21, 2006, entitled “SURGICAL STAPLING INSTRUMENT HAVINGSEPARATE DISTINCT CLOSING AND FIRING SYSTEMS”;

[0245] U.S. Patent 7,422,139, published on September 9, 2008, entitled “MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING INSTRUMENT WITH TACTILE POSITION FEEDBACK”;

[0246] U.S. Patent 7,464,849, entitled “ELECTRO-MECHANICAL SURGICAL INSTRUMENT WITH CLOSURE SYSTEM AND ANVIL ALIGNMENT COMPONENTS”, published on December 16, 2008;

[0247] U.S. Patent 7,670,334, published on March 2, 2010, entitled “SURGICAL INSTRUMENT HAVING AN ARTICULATINGEND EFFECTOR”;

[0248] U.S. Patent 7,753,245, entitled “SURGICAL STAPLING INSTRUMENTS”, published on July 13, 2010;

[0249] U.S. Patent 8,393,514, entitled “SELECTIVELY ORIENTABLE IMPLANTABLE FASTENER CARTRIDGE”, was published on March 12, 2013.

[0250] U.S. Patent Application Serial No. 11 / 343,803 entitled “SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES” is now U.S. Patent No. 7,845,537.

[0251] U.S. Patent Application Serial No. 12 / 031,573, entitled “SURGICAL CUTTING AND FASTENING INSTRUMENTHAVING RF ELECTRODES”, filed on February 14, 2008;

[0252] U.S. Patent Application Serial No. 12 / 031,873 (now U.S. Patent No. 7,980,443), filed on February 15, 2008, entitled “END EFFECTORS FOR A SURGICAL CUTTING AND STAPLING INSTRUMENT”.

[0253] The U.S. patent application serial number 12 / 235,782 entitled “MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT” is now U.S. Patent 8,210,411;

[0254] The U.S. patent application serial number 12 / 235,972 entitled “MOTORIZED SURGICAL INSTRUMENT” is now U.S. Patent 9,050,083;

[0255] U.S. Patent Application Serial No. 12 / 249,117 entitled “POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY RETRACTABLE FIRING SYSTEM” is now U.S. Patent No. 8,608,045.

[0256] U.S. Patent Application Serial No. 12 / 647,100, entitled “MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT WITH ELECTRIC ACTUATOR DIRECTIONAL CONTROL ASSEMBLY”, filed on December 24, 2009, is now U.S. Patent No. 8,220,688.

[0257] U.S. Patent Application Serial No. 12 / 893,461, entitled “STAPLE CARTRIDGE”, filed on September 29, 2012, is now U.S. Patent No. 8,733,613.

[0258] U.S. Patent Application Serial No. 13 / 036,647, entitled “SURGICAL STAPLING INSTRUMENT”, filed on February 28, 2011, is now U.S. Patent No. 8,561,870.

[0259] U.S. Patent Application Serial No. 13 / 118,241 entitled “SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS” is now U.S. Patent No. 9,072,535.

[0260] U.S. Patent Application Serial No. 13 / 524,049, entitled “ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE”, filed on June 15, 2012, is now U.S. Patent No. 9,101,358.

[0261] U.S. Patent Application Serial No. 13 / 800,025, entitled “STAPLE CARTRIDGE TISSUE THICKNESS SENSORSYSTEM”, filed on March 13, 2013, is now U.S. Patent No. 9,345,481.

[0262] U.S. Patent Application Serial No. 13 / 800,067, entitled “STAPLE CARTRIDGE TISSUE THICKNESS SENSORSYSTEM”, filed on March 13, 2013, is now published as U.S. Patent Application 2014 / 0263552.

[0263] U.S. Patent Application No. 2007 / 0175955, filed January 31, 2006, entitled “SURGICAL CUTTING AND FASTENING INSTRUMENT WITH CLOSURE TRIGGER LOCKING MECHANISM”; and

[0264] U.S. Patent Application No. 2010 / 0264194, entitled “SURGICAL STAPLING INSTRUMENT WITH ANARTICULATABLE END EFFECTOR”, filed on April 22, 2010, is now U.S. Patent No. 8,308,040.

[0265] While various apparatuses have been described herein in conjunction with certain embodiments, numerous modifications and variations of these embodiments are also possible. In one or more embodiments, specific features, structures, or characteristics can be combined in any suitable manner. Therefore, without limitation, specific features, structures, or characteristics shown or described in conjunction with one embodiment may be combined wholly or partially with features, structures, or characteristics of one or more other embodiments. Additionally, where materials for certain components are disclosed, other materials may also be used. Furthermore, according to various embodiments, a single component may be replaced by multiple components, and multiple components may be replaced by a single component to perform a given one or more functions. The above detailed description and the following claims are intended to cover all such modifications and variations.

[0266] The device disclosed herein may be designed for single-use disposal or for multiple-use applications. However, in either case, the device can be refurbished and reused after at least one use. Refurbishment may include any combination of the following steps, including but not limited to disassembling the device, subsequently cleaning or replacing specific components of the device, and subsequently reassembling the device. Specifically, refurbishment facilities and / or surgical teams may disassemble the device and, after cleaning and / or replacing specific components, reassemble the device for subsequent use. Those skilled in the art will understand that various techniques can be used for disassembly, cleaning / replacement, and reassembly of the device. The use of such techniques and the resulting repaired device are within the scope of this application.

[0267] The device disclosed herein can be processed prior to surgery. First, new or used instruments are obtained and cleaned as needed. Then, the instruments can 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 radiation field that can penetrate the container, such as gamma radiation, X-rays, and / or high-energy electrons. The radiation kills bacteria on the instrument and in the container. The sterilized instrument can then be stored in a sterile container. Sealing the container keeps the instrument sterile until it is opened in a medical facility. The device can also be sterilized using any other techniques known in the art, including but not limited to beta radiation, gamma radiation, ethylene oxide, plasma peroxide, and / or vapor.

[0268] Although the invention has been described as having an exemplary design, further modifications can be made to the invention within the spirit and scope of this disclosure. Therefore, this application is intended to cover any variations, uses, or alterations of the invention using the general principles of the invention.

Claims

1. A surgical instrument, comprising: Slender shaft; A surgical end effector, the surgical end effector being coupled to the elongated shaft via an articulated joint, wherein the articulated joint is configured to facilitate selective articulation of the surgical end effector relative to the elongated shaft, and wherein the surgical end effector includes a firing member supported for axial travel within the surgical end effector between a start position and an end position. and A drive assembly comprising a series of drive members operably supported by the elongated shaft, wherein the drive members are configured to traverse the articulated joint to operably engage with the firing member, wherein the drive members are loosely coupled to each other when traversing the articulated joint, and wherein the drive members are configured to sequentially engage a rotary drive member located distal to the articulated joint, such that the rotary drive member causes each of the drive members to become rigidly latched to the preceding drive member to form an axially rigid distal series of drive members, the axially rigid distal series of drive members being configured to apply an axial drive motion to the firing member to drive the firing member between the starting position and the ending position.

2. The surgical instrument according to claim 1, wherein, Each of the drive components is configured to thread into the rotary drive member.

3. The surgical instrument according to claim 2, wherein, The rotary drive component includes a hollow threaded member supported for rotation distal to the articulated joint, and wherein at least a portion of the drive components in the series are configured to continuously thread-engage the hollow threaded member.

4. The surgical instrument according to claim 3, wherein, When the hollow threaded member rotates in the first rotational direction, the distal drive member of the series of loosely connected drive members threadedly engages the rotary drive member such that the loosely connected drive member is continuously pulled distally to operably thread-engage with the rotary drive member, wherein each of the series of loosely connected drive members is latched to rigidly engage with the distally adjacent drive member to form an axially rigid distal series of drive members.

5. The surgical instrument according to claim 4, wherein, When the rotary drive member rotates in the second rotational direction, the rotary drive member pulls the axially rigid distal series of the drive components proximally, such that when each of the drive components in the axially rigid distal series of the drive components is operably engaged with the rotary drive member, the rotary drive member disengages the drive component from the distally adjacent drive component in the axially rigid distal series of the drive components, thereby re-establishing the loosely connected series of drive components.

6. The surgical instrument according to claim 5, wherein, Each of the at least a portion of the series of drive components includes a threaded portion on its outer periphery.

7. The surgical instrument according to claim 1, wherein, Each of the drive components is loosely connected to an adjacent drive component in the series of drive components via a corresponding flexible member.

8. The surgical instrument according to claim 3, wherein, At least some of the drive components in the series include: Drive component body; A latching feature portion protrudes distally from the drive member body; and A latching cavity in the proximal end of the drive component body, wherein the latching cavity is configured to receive, in a latching manner, the latching feature on the drive component body of the proximal adjacent drive component in the series of drive components.

9. The surgical instrument according to claim 8, wherein, Each of the drive components is configured to thread into the rotary drive member.

10. The surgical instrument according to claim 9, wherein, The hollow threaded component includes an internal thread, and the internal thread includes a variable pitch.

11. The surgical instrument according to claim 1, wherein, The surgical end effector includes: A first jaw, wherein the first jaw includes a first conduit configured to slidably receive an upper portion of the firing member; and A second jaw, wherein the second jaw is configured to move relative to the first jaw between an open position and a closed position, wherein the second jaw includes a second conduit configured to receive a lower portion of the firing member, and wherein the first conduit and the second conduit are configured to receive corresponding portions of each of the drive members in an axially rigid distal series of the drive members.

12. A surgical instrument comprising: Slender shaft; A surgical end effector, the surgical end effector being coupled to the elongated shaft via an articulated joint, wherein the articulated joint is configured to facilitate selective articulation of the surgical end effector relative to the elongated shaft, and wherein the surgical end effector includes a firing member supported for axial travel within the surgical end effector between a start position and an end position. A drive conversion component is supported on the distal side of the joint motion joint; and A flexible actuation assembly, supported by the elongated shaft and axially extending through the articulated joint, wherein the flexible actuation assembly is configured to accommodate the articulated motion of the surgical end effector, and wherein the flexible actuation assembly is operatively engaged with the drive conversion member such that, when the drive conversion member is actuated, the drive conversion member converts a portion of the flexible actuation assembly into an axially rigid drive member segment, wherein the drive conversion member axially drives the axially rigid drive member segment distally to apply axial drive motion to the firing member, thereby moving the firing member between the starting position and the ending position.

13. The surgical instrument according to claim 12, wherein, The drive conversion member is configured to thread into the flexible drive assembly.

14. The surgical instrument according to claim 13, wherein, The drive conversion component includes a hollow threaded component, which includes an internal thread with a variable pitch.

15. The surgical instrument according to claim 12, wherein, The surgical end effector includes: First jaws; and The second jaw, wherein the second jaw is configured to move relative to the first jaw between an open position and a closed position, and wherein the firing member is configured to apply a closing motion to the second jaw to move the second jaw from the open position to the closed position when the firing member moves in the distal direction from the starting position to the ending position via the axially rigid drive member segment.

16. The surgical instrument according to claim 15, wherein, The first jaw includes a channel configured to operably support a surgical staple cartridge, wherein the surgical staple cartridge includes: A chamber, wherein a plurality of surgical nails are operably supported; and A cartridge slider movably supported within the cartridge body, wherein the cartridge slider is configured to move within the cartridge body between a start position and an end position to drive the surgical staples from the cartridge body, and wherein the second jaw includes an anvil supported for pivoting relative to the surgical staple cartridge between an open position and a closed position, and wherein the firing member is configured to drive the cartridge slider from the start position to the end position when the firing member is driven from the start position to the end position.

17. The surgical instrument according to claim 12, wherein, The drive conversion member can be actuated in a first actuation direction and a second actuation direction, wherein when the drive conversion member is actuated in the first actuation direction, the drive conversion member converts the portion of the flexible drive assembly into the axially rigid drive member segment, and wherein when the drive conversion member is actuated in the second actuation direction, the drive conversion member drives the axially rigid drive member segment in the proximal direction.

18. The surgical instrument according to claim 17, wherein, When the drive conversion member is actuated in the second actuation direction, the drive conversion member converts the axial rigid drive member segment back into the portion of the flexible drive assembly.

19. The surgical instrument according to claim 18, wherein, By applying an axial emergency movement to the flexible drive assembly, the firing member can move from a position distal to the starting position to the starting position without actuating the drive conversion member.

20. A surgical instrument comprising: Slender shaft; A surgical end effector, the surgical end effector being coupled to the elongated shaft via an articulated joint, wherein the articulated joint is configured to facilitate selective articulation of the surgical end effector relative to the elongated shaft, and wherein the surgical end effector includes a firing member supported for axial travel within the surgical end effector between a starting position and an ending position; A loosely coupled drive member, operably supported by the elongated shaft and traversing the articulated joint, wherein the loosely coupled drive member is configured to accommodate articulated movements of the surgical end effector relative to the elongated shaft; and A means for converting a portion of the loosely coupled drive member distal to the articulated joint into a rigid drive member, the rigid drive member being configured to apply axial drive motion to the firing member to drive the firing member between the starting position and the ending position.

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