Surgical instrument having a differential articulation joint arrangement for accommodating a flexible actuator

Abstract

Surgical instruments including an articulation joint configured to establish an upper passage and a lower passage through the articulation joint. The upper and lower passages are parallel to each other when the surgical instrument is in an unarticulated position and concentric with each other when the surgical instrument is articulated. An upper flexible firing assembly slidably extends through the upper passage and a lower flexible firing assembly slidably extends through the lower passage. The upper and lower flexible firing assemblies interface with a firing member and a differential drive assembly configured to apply axial drive motions to the upper and lower flexible firing assemblies.

Description

[0001] Cross Reference to Related Applications

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[0022] ​​​​​​​​​​​Figure 18 yes Figure 16 A perspective view of 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 the surgical end effector, the firing system, and a portion of the rotary drive system of the surgical instrument of FIG. 1, wherein the outer elastomeric joint assembly of the articulation joint and portions of the elongate shaft assembly have been omitted for clarity;

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

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

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

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

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

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

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

[0040] Figure 36 Figure 19 Figure 19

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

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

[0043] Figure 39 is a partial cross-sectional side view of a surgical end effector of a surgical instrument in accordance with at least one aspect of the present disclosure, wherein the anvil is in an open position and the firing member is in a home or starting position; Figure 38

[0044] Figure 40 is another cross-sectional side view of a surgical end effector of a surgical instrument in accordance with at least one aspect of the present disclosure, wherein the anvil is in a closed position; Figure 39

[0045] Figure 41 is another partial cross-sectional side view of a surgical end effector of a surgical instrument in accordance with at least one aspect of the present disclosure, wherein the anvil is in a fully closed position and the firing member is advanced distally through the surgical end effector; Figure 39

[0046] Figure 42 is a partial side elevational view of a surgical end effector of a surgical instrument in accordance with at least one aspect of the present disclosure, wherein portions of the surgical end effector are omitted for clarity to show an anvil opening spring applying an opening motion to the anvil, and wherein the firing member is in a home or starting position; Figure 19

[0047] is another partial side view of a surgical end effector of a surgical instrument in accordance with at least one aspect of the present disclosure, after the firing member has been moved proximally a short distance to apply a quick closure motion to the anvil for grasping purposes; Figure 43 Figure 42 is another cross-sectional view of a surgical end effector of a surgical instrument in accordance with at least one aspect of the present disclosure, after the firing member has been advanced distally to an end position within the surgical end effector;

[0048] Figure 44 Figure 19 is a perspective view of a portion of another surgical instrument;

[0049] Figure 45 is a side elevational view of a surgical end effector of a surgical instrument in accordance with at least one aspect of the present disclosure, wherein the jaw of the end effector is in an open position; Figure 44

[0050] Figure 46 is a side elevational view of a surgical end effector of a surgical instrument in accordance with at least one aspect of the present disclosure, wherein the jaw of the end effector is in an open position;

[0051] Figure 47 is a perspective view of a portion of another surgical instrument; Figure 46

[0052] Figure 48 ​​​​​​​yes 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 view of the proximal side 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 articulating joint of the surgical instrument of

[0065] Figure 61 is Figure 46 a partial perspective view of a portion of the surgical instrument of

[0066] Figure 62 is Figure 46 another partial perspective view of a portion of the surgical instrument of

[0067] Figure 63 is Figure 46 another partial perspective view of a portion of the surgical instrument of

[0068] Figure 64 is Figure 46 a perspective view of a portion of the elongated shaft assembly and CV drive shaft assembly of the surgical instrument of

[0069] Figure 65 is Figure 64 another perspective view of the CV drive shaft assembly and elongated shaft assembly of

[0070] Figure 66 is Figure 64 another perspective view of the CV drive shaft assembly and elongated shaft assembly of

[0071] Figure 67 is Figure 64 another perspective view of the CV drive shaft assembly and elongated shaft assembly of

[0072] Figure 68 is Figure 46 a side view of a portion of the firing system of the surgical instrument of Figure 67 the drive cover of

[0073] Figure 69 is Figure 68 another side view of a portion of the firing system and drive cover of

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

[0075] Figure 71 is Figure 70 a cross-sectional end view of the surgical end effector of the surgical instrument of

[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 is a perspective view of a guide member of a rotary drive firing system and a rotary drive shaft; Figure 83

[0089] Figure 85 is a perspective view of a portion of another flexible firing drive assembly that can be used with the firing drive system of Figure 83

[0090] Figure 86 is another perspective view of a portion of another flexible firing drive assembly implementation that can be used with the firing drive system of Figure 83

[0091] Figure 87 is a perspective view of a surgical end effector of another surgical instrument, wherein the anvil of the surgical end effector is in an open position and the surgical end effector is in an unarticulated orientation;

[0092] Figure 88 is an exploded assembly view of the surgical end effector and surgical instrument of Figure 87

[0093] is a side elevational view of an articulation joint of the surgical instrument of Figure 89 Figure 87 is a top view of the articulation joint of

[0094] Figure 90 Figure 89 is a perspective view of a portion of the surgical end effector of

[0095] Figure 91 is a perspective view of the articulation joint of Figure 89 Figure 89 is another perspective view of the cable-controlled closure pulley system of

[0096] Figure 92 Figure 89 is a perspective view of a portion of the surgical end effector of Figure 89

[0097] Figure 93 is another perspective view of the cable-controlled closure pulley system of Figure 91

[0098] is an end view of a pulley unit of the cable-controlled pulley system of Figure 94 Figure 93 is a side elevational view of a first transverse alpha wrap pulley of the pulley unit of

[0099] Figure 95 Figure 94 ​​​​​​​​​​​

[0100] Figure 96 is a side cross-sectional view of a portion of the surgical end effector of Figure 89 , wherein the anvil assembly of the surgical end effector is in an open position;

[0101] Figure 97 is another side elevational view of the surgical end effector of Figure 96 , wherein the anvil is in a closed position;

[0102] Figure 98 is a perspective view of the articulation joint and cable-controlled closure system of the surgical instrument of Figure 87 , wherein the central joint member and the distal joint member are articulated relative to the proximal joint member of the articulation joint;

[0103] Figure 99 is another perspective view of the articulation joint and cable-controlled closure system of the surgical instrument of Figure 87 , wherein the distal joint member is articulated relative to the central joint member of the articulation joint through a second articulation plane;

[0104] Figure 100 is a side elevational view of a portion of the firing drive system of the surgical instrument of Figure 87 ;

[0105] Figure 101 is another perspective view of the firing drive system of Figure 100 , wherein the upper chain connection feature and the lower chain connection feature are in an articulated position;

[0106] Figure 102 is another side view of the firing drive system of Figure 100 , wherein the upper chain connection feature and the lower chain connection feature are in driving engagement with the rotary drive screw of the firing drive system;

[0107] Figure 103 is a cross-sectional end view of the surgical end effector of Figure 87 , wherein the anvil of the surgical end effector is in a closed position;

[0108] Figure 104 is a cross-sectional side view of a portion of the surgical instrument of Figure 87 , wherein the firing member is in a starting position and the anvil is in a closed position;

[0109] Figure 105 is an exploded assembly view of the rotary drive system of the surgical instrument of Figure 87 ;

[0110] Figure 106 is a cross-sectional side view of a portion of the surgical instrument of Figure 105a perspective view of a first drive shaft segment and a second drive shaft segment of a rotary drive system of the surgical instrument of

[0111] Figure 107 is Figure 87 a perspective view of a surgical end effector of the surgical instrument of

[0112] Figure 108 is Figure 87 an exploded assembly view of a portion of a rotary drive system and an articulation joint of the surgical instrument of

[0113] Figure 109 is a cross-sectional view of the articulation joint and the rotary drive system of Figure 108

[0114] Figure 110 is another cross-sectional view of the articulation joint and the rotary drive system of Figure 109

[0115] Figure 111 is a partial elevational side view of the surgical instrument of Figure 87

[0116] Figure 112 is another partial elevational side view of the surgical instrument and the cable tensioning system of Figure 111

[0117] Figure 113 is a partial elevational side view of the surgical instrument of Figure 87

[0118] Figure 114 is another partial elevational side view of the surgical instrument and the cable tensioning system of Figure 113

[0119] is a perspective view of a portion of another surgical instrument embodiment Figure 115

[0120] is a perspective view of a portion of the surgical instrument of Figure 116 Figure 115 is a perspective view of a portion of the surgical instrument of

[0121] Figure 117 Figure 116 ​​​​​​​a side elevational view of the surgical end effector of

[0122] Figure 118 is Figure 117 a top view of the surgical end effector of

[0123] Figure 119 is Figure 115 an exploded assembly perspective view of a portion of the surgical instrument of

[0124] Figure 120 is Figure 115 a bottom cross-sectional view of a portion of the anvil and the articulation joint of the surgical instrument of

[0125] Figure 121 is Figure 120 an exploded assembly view of the articulation joint of

[0126] Figure 122 is Figure 121 a side view of the ring disk member of the articulation joint of

[0127] Figure 123 is Figure 122 a perspective view of the ring disk member of

[0128] Figure 124 is Figure 122 a view of the distal face of the ring disk member of

[0129] Figure 125 is Figure 122 a view of the proximal face of the ring disk member of

[0130] Figure 126 is Figure 115 a top view of the pulley unit of the surgical instrument of

[0131] Figure 127 is Figure 115 a perspective view of a portion of the articulation joint and the elongate shaft assembly of the surgical instrument of

[0132] Figure 128 is Figure 126 a side elevational view of the pulley unit of

[0133] Figure 129 is Figure 126 another side elevational view of the pulley unit of

[0134] Figure 130 is Figure 126 a perspective view of the pulley unit and Figure 115 a perspective view of the continuous body shaft of the articulation joint of the surgical instrument of

[0135] Figure 131 is Figure 126 a pulley unit and Figure 115 another perspective view of a series of elastomeric ring spacer members of an articulation joint of a surgical instrument of

[0136] Figure 132 is Figure 115 another perspective view of a pulley unit, part of a firing system, and an articulation joint of a surgical instrument of

[0137] Figure 133 is Figure 115 a perspective view of a portion of a firing system of a surgical instrument of

[0138] Figure 134 is Figure 133 a partial cross-sectional view of a firing system

[0139] Figure 135 is Figure 115 a perspective view of a firing system, an articulation joint, and a closure system of a surgical instrument of

[0140] Figure 136 is Figure 115 a partial cross-sectional view of a surgical instrument of

[0141] Figure 137 is Figure 115 a partial view of a differential drive assembly implementation of a firing system of a surgical instrument of

[0142] Figure 138 is Figure 115 another partial cross-sectional view of a surgical instrument of

[0143] Figure 139 is Figure 115 another partial cross-sectional view of a surgical instrument of DETAILED DESCRIPTION

[0144] Applicant of the present application owns the following U.S. Patent Applications that were filed on even date herewith and which are each herein incorporated by reference in their respective entireties:

[0145] U.S. Patent Application entitled SURGICAL INSTRUMENTS WITH TORSION SPINE DRIVE ARRANGEMENTS, Attorney Docket No. END9248USNP1 / 200084-1 ;

[0146] U.S. Patent Application entitled SURGICAL INSTRUMENTS WITH FIRING MEMBER CLOSURE FEATURES, Attorney Docket No. END9248USNP2 / 200084-2;

[0147] U.S. Patent Application entitled SURGICAL INSTRUMENTS WITH SEGMENTED FLEXIBLE DRIVE ARRANGEMENTS, Attorney Docket No. END9248USNP3 / 200084-3;

[0148] U.S. Patent Application entitled SURGICAL INSTRUMENTS WITH FLEXIBLE BALL CHAIN DRIVE ARRANGEMENTS, Attorney Docket No. END9248USNP4 / 200084-4;

[0149] U.S. Patent Application entitled SURGICAL INSTRUMENTS WITH DOUBLE SPHERICAL ARTICULATION JOINTS WITH PIVOTABLE LINKS, Attorney Docket No. END9248USNP5 / 200084-5;

[0150] U.S. Patent Application entitled SURGICAL INSTRUMENTS WITH DOUBLE PIVOT ARTICULATION JOINT ARRANGEMENTS, Attorney Docket No. END9248USNP6 / 200084-6;

[0151] U.S. Patent Application entitled SURGICAL INSTRUMENTS WITH COMBINATION FUNCTION ARTICULATION JOINT ARRANGEMENTS, Attorney Docket No. END9248USNP7 / 200084-7;

[0152] U.S. Patent Application entitled METHOD OF OPERATING A SURGICAL INSTRUMENT, Attorney Docket No. END9248USNP8 / 200084-8M;

[0153] U.S. Patent Application entitled SURGICAL INSTRUMENTS WITH DUAL SPHERICAL ARTICULATION JOINT ARRANGEMENTS, Attorney Docket No. END9248USNP9 / 200084-9;

[0154] U.S. Patent Application entitled SURGICAL INSTRUMENTS WITH FLEXIBLE FIRING MEMBER ACTUATOR CONSTRAINT ARRANGEMENTS, Attorney Docket No. END9248USNP10 / 200084-10; and

[0155] U.S. Patent Application entitled ARTICULATABLE SURGICAL INSTRUMENTS WITH ARTICULATION JOINTS COMPRISING FLEXIBLE EXOSKELETON ARRANGEMENTS, Attorney Docket No. END9248USNP11 / 200084-11.

[0156] Numerous specific details are set forth herein to provide a thorough understanding of the overall structure, functioning, manufacture, and use of the embodiments described and shown in the specification. 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 shown herein are non-limiting examples, and thus can recognize that the particular structural and functional details disclosed herein are representative and illustrative. Variations and changes can be made to these embodiments without departing from the scope of the claims.

[0157] 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. As a result, a surgical system, device, or apparatus that "comprises," "has," "includes" or "contains" one or more elements possesses those one or more elements, but is not limited to possessing only those one or more elements. Likewise, an element of a system, device, or apparatus that "comprises," "has," "includes" or "contains" one or more features possesses those one or more features, but is not limited to possessing only those one or more features.

[0158] The terms "proximal" and "distal" are used herein with respect to a clinician manipulating a handle portion of a surgical instrument. The term "proximal" refers to the portion closest to the clinician, and the term "distal" refers to the portion positioned away from the clinician. It will also be understood that, for the sake of brevity and clarity, spatial terms such as "vertical," "horizontal," "up," and "down," can be used herein with respect to the drawings. However, surgical instruments are used in many orientations and positions, and these terms are not limiting and / or absolute.

[0159] References to items in the singular should be understood to include items in the plural, and vice versa, unless explicitly stated otherwise or clear from context. Grammatical connections words are intended to express any and all transi tions and connections, commutative and non-commutative, implicit and explicit, between one or more sentences, clauses, phrases or words, unless otherwise indicated or clear from context. Thus, the term "or" should generally be understood to mean "and / or" unless otherwise stated or clear from context.

[0160] Unless otherwise indicated herein, the numerical values listed herein are not intended to be limited to the precise range expressed and are meant to be used in a generic sense. For example, numerical values are often expressed in a range format. It is to be understood that such a range format is used only for convenience and generally covers every value and / or sub-range of the values of the range. Unless otherwise indicated, the use of

[0161] Any and all examples or exemplary language (e.g., "such as", "for instance", etc.) provided herein are intended merely to better illuminate embodiments and do not indicate a limitation on the scope of embodiments otherwise claimed. No language in the specification should be construed as indicating any non-claimed element as essential to the practice of embodiments.

[0162] Various exemplary devices and methods are provided for performing laparoscopic and minimally invasive surgical procedures. However, as those skilled in the art will readily appreciate, the various methods and devices disclosed herein can be used in numerous surgical procedures and applications including, for example, in connection with open surgical procedures. As the present DETAILED DESCRIPTION proceeds, one will further appreciate that the various instruments disclosed herein can be inserted into a patient's body in any suitable manner, such as through a natural orifice, through an incision or puncture hole formed in tissue, etc. The working portions or end effector portions of the instruments can be inserted directly into a patient's body or can be inserted through an access device having a working channel, through which an end effector and elongated shaft of a surgical instrument can be advanced.

[0163] During various laparoscopic surgical procedures, it is common practice to insert the surgical end effector portion of a surgical instrument through a trocar needle that has been installed in the abdominal wall of a patient to access a surgical site located within the patient's abdomen. In its simplest form, a trocar needle is a pen-like instrument having a sharp triangular point at one end that is typically used inside a hollow tube known as a cannula or trocar to form an opening into the body through which the surgical end effector can be introduced. This arrangement forms an access port into a body cavity through which the surgical end effector can be inserted. The internal diameter of the cannula of the trocar needle inevitably limits the size of the end effector and drive support shaft of a surgical instrument that can be inserted through the trocar needle.

[0164] Regardless of the specific type of surgical procedure being performed, once the surgical end effector is inserted into the patient through the trocar cannula, it is often necessary to move the surgical end effector relative to the shaft assembly positioned within the trocar cannula in order to properly position the surgical end effector relative to the tissue or organ to be treated. This movement or positioning of the surgical end effector relative to the shaft portion held within the trocar cannula is commonly referred to as "articulation" of the surgical end effector. Various articulation joints have been developed to attach the surgical end effector to the associated shaft to facilitate such articulation of the surgical end effector. It is anticipated that in many surgical procedures it would be desirable to employ a surgical end effector having as large an articulation range as possible.

[0165] Due to the size constraints imposed by the size of the trocar cannula, the size of the articulation joint components must be set so as to freely pass through the trocar cannula. These size constraints also limit the size and composition of various drive members and components that operably interface with the motors and / or other control systems supported in a housing, which can be hand-held or part of a larger automated system. In many cases, these drive members must operably pass through the articulation joint to operably couple to or interface with the surgical end effector. For example, one such drive member is typically used to apply articulation control motions to the surgical end effector. During use, the articulation drive member can be unactuated to position the surgical end effector in a non-articulated position to facilitate insertion of the surgical end effector through the trocar, and then actuated to articulate the surgical end effector to a desired position as the surgical end effector enters the patient.

[0166] Accordingly, the aforementioned size constraints present a number of challenges to developing articulation systems that can achieve the desired articulation range, yet are also suitable for the various different drive systems needed to operate the various features of the surgical end effector. Moreover, once the surgical end effector has been positioned in the desired articulated position, the articulation system and articulation joint must be able to hold the surgical end effector in that locked position during actuation of the end effector and completion of the surgical procedure. Such articulation joint arrangements must also be able to withstand the external forces experienced by the end effector during use.

[0167] There are a variety of surgical end effectors configured to cut and staple tissue. Such surgical end effectors typically include a first jaw feature that supports a surgical staple cartridge and a second jaw that includes an anvil. The jaws are supported relative to one another such that they can be moved between open and closed positions to position and clamp target tissue therebetween. Many of these surgical end effectors employ an axial motion firing member. In some end effector designs, the firing member is configured to engage the first and second jaws such that when the firing member is initially advanced distally, the firing member moves the jaws to the closed position. Other end effector designs employ a separate closure system that is independent of and distinct from the system that operates the firing member.

[0168] The staple cartridge includes a cartridge body. The cartridge body includes a proximal end, a distal end, and a deck extending between the proximal end and the distal end. In use, the staple cartridge is positioned on a first side of tissue to be stapled and the anvil is positioned on a second side of the tissue. The anvil is moved toward the staple cartridge to compress and clamp the tissue against the deck. Staples that are removably stored in the cartridge body can then be deployed into the tissue. The cartridge body includes staple cavities defined therein, wherein the staples are removably stored in the staple cavities. The staple cavities are arranged in six longitudinal rows. Three rows of staple cavities are positioned on a first side of the longitudinal slot and three rows of staple cavities are positioned on a second side of the longitudinal slot. Other arrangements of staple cavities and staples are also possible.

[0169] The staples are supported by staple drivers in the cartridge body. The drivers are movable between a first or unfired position and a second or fired position to eject the staples from the staple cartridge. The drivers are retained in the cartridge body by a retainer that extends around the bottom of the cartridge body and includes resilient members configured to grasp the cartridge body and retain the retainer to the cartridge body. The drivers are movable between their unfired position and their fired position by a sled. The sled is movable between a proximal position adjacent the proximal end and a distal position adjacent the distal end. The sled includes a plurality of ramp surfaces configured to slide under the drivers and lift the drivers toward the anvil, and the staples are supported on the drivers.

[0170] In addition to the above, in these surgical end effectors, the sled is moved distally by a firing member. The firing member is configured to contact the sled and push the sled toward the distal end. A longitudinal slot defined in the cartridge body is configured to receive the firing member. The anvil further includes a slot configured to receive the firing member. The firing member further includes a first cam that engages the first jaw and a second cam that engages the second jaw. As the firing member is advanced distally, the first and second cams can control the distance between the deck of the staple cartridge and the anvil or the tissue gap. The firing member further includes a knife configured to cut tissue captured intermediate the staple cartridge and the anvil. It is desirable for the knife to be positioned at least partially proximate the ramped surface such that staples are ejected prior to the knife.

[0171] Many surgical end effectors employ an axially movable firing beam that is attached to a firing member and used to apply axial firing and retraction motions to the firing member. Many such firing beams include a laminate construction that causes the firing beam to have some degree of flexure about an articulation joint. As the firing beam traverses the articulation joint, it can apply a disarticulation force to the joint and can cause the beam to buckle. To prevent the firing beam from buckling under pressure, the articulation joint is often provided with a transverse support or "blowout" plate feature to support the portion of the beam that traverses the articulation joint. For example, to advance the firing beam through an angle greater than sixty degrees requires a substantial axial force. This axial force must be applied to the firing member in a balanced manner to avoid binding of the firing member with the jaws as the firing member is moved distally. Any binding of the firing member with the jaws can result in component damage and wear and requires an increased amount of axial drive force to drive the firing member through the clamped tissue.

[0172] Other end effector designs employ a firing member that is driven by a rotary power. In many such designs, a rotary drive shaft extends through an articulation joint and interfaces with a rotatable firing member drive shaft that is rotatably supported within one of the jaws. The firing member threadably engages the rotatable firing member drive shaft, which is driven through the end effector as the rotatable firing member drive shaft is rotated. Such arrangements require the support jaw to be larger to accommodate the firing member drive shaft. In such devices, the lower end of the firing member is often operably interfaced with the drive shaft, which can also result in forces being applied that tend to unbalance the firing member as it is driven distally.

[0173] Figures 1-4One form of a surgical instrument 10 is shown that can address many of the challenges faced by surgical instruments having articulatable end effectors configured to both cut and fasten tissue. In various embodiments, the surgical instrument 10 can comprise a hand-held device. In other embodiments, the surgical instrument 10 can comprise an automated system, such as sometimes referred to as a robotic control system. In various forms, the surgical instrument 10 includes a surgical end effector 1000 operably coupled to an elongated shaft assembly 2000. The elongated shaft assembly 2000 can be operably attached to a housing 2002. In one embodiment, the housing 2002 can comprise a handle configured to be grasped, manipulated, and actuated by a clinician. In other embodiments, the housing 2002 can comprise an accommodation or otherwise operable support of at least a portion of a robotic system configured to generate and apply at least one control motion that can be used to actuate the surgical end effectors disclosed herein and their respective equivalents. Moreover, various components can be "accommodated" or included in the housing, or various components can be "associated" with the housing. In such instances, the components can not be housed within or directly supported by the housing. For example, the surgical instruments disclosed herein can be used with various robotic systems, instruments, components, and methods disclosed in U.S. Patent No. 9,072,535 entitled SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS, which is hereby incorporated by reference in its entirety.

[0174] In one form, the surgical end effector 1000 includes a first jaw 1100 and a second jaw 1200. In the illustrated arrangement, the first jaw 1100 includes an elongated channel 1110 that includes a proximal end 1112 and a distal end 1114 and is configured to operably support a surgical staple cartridge 1300 therein. The surgical staple cartridge 1300 includes a cartridge body 1302 having an elongated slot 1304 therein. A plurality of surgical staples or fasteners (not shown) are stored in the cartridge body on drivers (not shown) arranged in rows on each side of the elongated slot 1304. The drivers are each associated with a corresponding staple cavity 1308 that is exposed through a cartridge deck surface 1306. The surgical staple cartridge 1300 can be replaced after the staples / fasteners have been expelled therefrom. Other embodiments can be envisioned wherein the elongated channel 1110 and / or the entire surgical end effector 1000 can be discarded after the surgical staple cartridge 1300 has been used. For example, such an end effector arrangement can be referred to as a "disposable loading unit".

[0175] 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.

[0176] 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 2-5pivotally travels between an open position and a closed position. Such a pivot axis PA can be referred to herein as being "fixed" in that the pivot axis does not translate or otherwise move when the anvil 1200 is pivoted from the open position to the closed position.

[0177] In the illustrated arrangement, the elongate shaft assembly 2000 defines a shaft axis SA and includes a proximal shaft portion 2100 that is operably interfaced with a housing of a control portion (e.g., a hand-held unit, a robotic tool driver, etc.) of the surgical instrument 10. The elongate shaft assembly 2000 further includes an articulation joint 2200 that is attached to the proximal shaft portion 2100 and the surgical end effector 1000. In various circumstances, the proximal shaft portion 2100 includes a hollow outer tube 2110 that can be operably coupled to the housing 2002. See Figure 2 . As can be seen in Figure 6 The proximal shaft portion 2100 can further include a rigid proximal support shaft 2120 that is supported within the hollow outer tube 2110 and that extends from the housing to the articulation joint 2200. The proximal support shaft 2120 can include first and second halves 2120A, 2120B that can be coupled together by, for example, welding, adhesive, etc. The proximal support member 2120 includes a proximal end 2122 and a distal end 2124 and includes an axial conduit 2126 that extends therethrough from the proximal end 2122 to the distal end 2124.

[0178] As discussed above, many surgical end effectors employ a firing member that is pushed distally through a surgical staple cartridge by an axially movable firing beam. The firing beam is typically attached to the firing member in a central region of the firing member body. This attachment location can cause the firing member to be unbalanced as it is advanced through the end effector. This imbalance can cause undesirable friction between the firing member and the end effector jaw. The creation of this additional friction can require a higher firing force to be applied to overcome this friction and can cause undesirable wear to portions of the jaw and / or firing member. The application of a higher firing force to the firing beam can cause undesirable flexing of the firing beam as it traverses the articulation joint. This additional flexing can cause the articulation joint to disarticulate, particularly when the surgical end effector is articulated at relatively high articulation angles. The surgical instrument 10 employs a firing system 2300 that addresses many of these issues, if not all of them, as well as other issues.

[0179] As can be seen in Figures 5-11As can be seen, in at least one embodiment, the firing system 2300 includes a firing member 2310 that includes a vertically extending firing member body 2312 that includes a top firing member feature 2320 and a bottom firing member feature 2350. A tissue-cutting knife 2314 is attached to or formed in the vertically extending firing member body 2312. See Figure 9 and Figure 11 In at least one arrangement, it is desirable for the firing member 2310 to pass through the anvil body 1212 with low friction, high strength, and high stiffness. In the illustrated arrangement, the top firing member feature 2320 includes a top tubular body 2322 having a top axial conduit 2324 extending therethrough. See Figure 10 The bottom firing member feature 2350 includes a bottom tubular body 2352 having a bottom axial conduit 2354 extending therethrough. In at least one arrangement, the top firing member feature 2320 and the bottom firing member feature 2350 are integrally formed with the vertically extending firing member body 2312. As shown, Figure 12 the anvil body 1212 includes an axially extending anvil slot 1240 having a keyhole-like cross-sectional shape. Similarly, the elongate channel 1110 includes an axially extending channel slot 1140 that also has a keyhole cross-sectional shape.

[0180] Conventional firing member arrangements employ long, flexible cantilevered wings that extend from the top and bottom portions of the firing member. These cantilevered wings slideably pass through slots in the anvil and channel that are typically cut with a rectangular t-shaped cutter, which tends to create a higher friction surface. Such long cantilevered wings have a minimum surface area in contact with the anvil and channel and can result in these components being scuffed. The keyhole-shaped channel slot 1140 and keyhole-shaped anvil slot 1240 can be cut with a round t-shaped cutter and can be finished with a reamer / drill, which will result in a lower friction surface. Additionally, the top tubular body 2322 and the 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 can reduce scuffing and create a stronger sliding connection. In other words, because the anvil slot 1240 and channel slot 1140 are keyhole-shaped and remove less material than conventional rectangular slots, this geometry and increased material can make the anvil and channel stiffer when compared to existing arrangements.

[0181] Turning to Figures 9-11In one arrangement, the firing system 2300 further includes an upper flexible spine assembly 2400 operably coupled to the top firing member feature 2320 and a lower flexible spine assembly 2500 operably coupled to the bottom firing member feature 2350. In at least one embodiment, the upper flexible spine assembly 2400 includes an upper series 2410 of upper vertebra members 2420 that are loosely coupled together by an upper flexible coupler member 2402 that is attached to the top firing member feature 2320. The upper flexible coupler member 2402 can include a top cable 2404 that extends through a top axial conduit 2324 in the top firing member feature 2320, and a distal end 2406 of the top cable 2404 is attached to a retainer ferrule 2408 that is fixed with the top axial conduit 2324.

[0182] As Figure 13 As can be seen in FIGS. 27-29, each upper vertebra member 2420 includes an upper vertebra body portion 2422 having a proximal end 2424 and a distal end 2428. An upper hollow conduit 2429 extends through the upper vertebra body portion 2422 to accommodate the upper flexible coupler member 2402 therethrough. Each upper vertebra member 2420 further includes a downwardly extending upper drive feature or upper vertebra member tooth 2450 that protrudes from the upper vertebra body portion 2422. Each upper vertebra member tooth 2450 has a helical proximal upper face portion 2452 and a helical distal upper face portion 2454. Each proximal end 2424 of the upper vertebra body portion 2422 has an upper proximal mating feature 2426 therein, and each distal end 2428 has an upper distal mating feature 2430 formed therein. In at least one embodiment, the upper proximal mating feature 2426 includes a concave recess 2427, and each upper distal mating feature 2430 includes a convex bump 2431. When arranged in the upper series 2410, the convex bump 2431 on one upper vertebra member 2420 contacts and mates with the concave recess 2427 on an adjacent upper vertebra member 2420 in the upper series 2410 to hold the upper vertebra members 2420 in general alignment so that the helical proximal upper face portion 2452 and the helical distal upper face portion 2454 on each respective upper tooth 2450 can be drivingly engaged by the rotary drive screw 2700, as will be discussed in further detail below.

[0183] Similarly, in at least one embodiment, the lower flexible spine assembly 2500 includes a lower series 2510 of lower vertebral members 2520 that are loosely coupled together by lower flexible coupler members 2502 that are attached to the bottom firing member features 2350. The lower flexible coupler members 2502 can include lower cables 2504 that extend through bottom axial conduits 2354 in the bottom firing member features 2350, and distal ends 2506 of the bottom cables 2504 are attached to retainer collars 2508 that are fixed with the bottom axial conduits 2354.

[0184] As Figure 14 can be seen, each lower vertebral member 2520 includes a lower vertebral body portion 2522 having a proximal end 2524 and a distal end 2528. A lower hollow conduit 2529 extends through the lower vertebral body portion 2522 to accommodate the lower flexible coupler members 2502 therethrough. Each lower vertebral member 2520 also includes an upwardly extending lower drive feature or lower vertebral member tooth 2550 that projects upwardly from the lower vertebral body portion 2522. Each lower vertebral member tooth 2550 has a helical proximal lower face portion 2552 and a helical distal lower face portion 2554. Each proximal end 2524 of the lower vertebral body portion 2522 has a lower proximal mating feature 2526 therein, and each distal end 2528 has a lower distal mating feature 2530 formed therein. In at least one embodiment, the lower proximal mating feature 2526 includes a concave recess 2527, and each lower distal mating feature 2530 includes a convex protrusion 2531. When arranged in the lower series 2510, the convex protrusion 2531 on one lower vertebral member 2520 contacts and mates with the concave recess 2527 on an adjacent lower vertebral member 2520 in the lower series 2510 to hold the lower vertebral members 2520 in general alignment so that the helical proximal lower face portion 2552 and the helical distal lower face portion 2554 on each respective lower vertebral member tooth 2550 can be drivingly engaged by the rotary drive screw 2700, as will be discussed in further detail below.

[0185] Turning now to Figure 5 , Figure 7 and Figure 8In at least one arrangement, the firing drive system 2300 further includes a rotary drive screw 2700 that is configured to drivingly interface with the upper series 2410 of the upper vertebral members 2420 and the lower series 2510 of the lower vertebral members 2520. In the illustrated arrangement, the rotary drive screw 2700 is driven by a rotary drive system 2600 that includes a proximal rotary drive shaft 2610 that is rotatably supported within an axial channel 2126 within the proximal support shaft 2120. See Figure 7 . The proximal rotary drive shaft 2610 includes a proximal end 2612 and a distal end 2614. The proximal end 2612 can interface with a gear box 2004 or other arrangement driven by a motor 2006 or other source of rotary motion housed in the housing of the surgical instrument. See Figure 2 . Such a source of rotary motion causes the proximal rotary drive shaft to rotate within the axial channel 2126 in the proximal support shaft 2120 about a shaft axis SA.

[0186] The proximal rotary drive shaft 2610 is operably supported within the elongate shaft assembly 2000 adjacent the articulation joint 2200 and operably interfaces with a constant velocity (CV) drive shaft assembly 2620 that "straddles" or extends axially through the articulation joint 2200. As can be seen in Figure 8 , Figure 16 and Figure 17 , in at least one arrangement, the CV drive shaft assembly 2620 includes a proximal CV drive assembly 2630 and a distal CV drive shaft 2670. The proximal CV drive assembly 2630 includes a proximal shaft segment 2632 that is comprised of an attachment shaft 2634 that is configured to be non-rotatably received within a similarly shaped coupler cavity 2616 in the distal end 2614 of the proximal rotary drive shaft 2610. The proximal shaft segment 2632 operably interfaces with a series 2640 of movable coupled drive joints 2650.

[0187] As can be seen in Figure 18 , in at least one arrangement, each drive joint 2650 includes a first or distal spherical portion 2660 and a second or proximal spherical portion 2652. The distal spherical portion 2660 is larger than the proximal spherical portion 2652. The distal spherical portion 2660 includes a socket cavity 2662 that is configured to rotatably receive the proximal spherical portion 2652 of an adjacent drive joint 2650 therein. Each proximal spherical portion 2652 includes a pair of diametrically opposed engagement pins 2654 that are configured to movably receive in a corresponding pin slot 2664 in the distal spherical portion 2660 of an adjacent drive joint 2650, as can be seen in Figure 16The proximal ball portion 2652P of the proximal-most drive joint 2650P is rotatably received in a distal socket portion 2636 of the proximal shaft segment 2632, as Figure 16 shown. An engagement pin 2654P is received within a corresponding pin slot 2637 in the distal socket portion 2636. As Figure 16 further shown in the series 2640 of movably coupled drive joints 2650, the distal-most drive joint 2650D is movably coupled to a distal CV drive shaft 2670.

[0188] In at least one arrangement, the distal CV drive shaft 2670 includes a proximal spherical portion 2672 sized to be movably received in a socket cavity 2662D in the distal-most drive joint 2650D. The proximal spherical portion 2672 includes an engagement pin 2674 movably received in a pin slot 2664D in the distal-most drive joint 2650D. The distal CV drive shaft 2670 further includes a shaft stem 2676 extending distally configured to be non-rotatably coupled to a rotary drive screw 2700 positioned distal to the articulation joint 2200. The distal CV drive shaft 2670 includes a flange 2677 and a mounting cylinder portion 2678 for receiving a thrust bearing housing 2680 thereon.

[0189] In the illustrated arrangement, as the series 2640 of movably coupled drive joints 2650 articulate, the engagement pin 2674 remains in the corresponding pin slot 2664 of the adjacent drive joint 2650. In Figure 18 the illustrated example, each drive joint is capable of articulating approximately 18 degrees in the pitch direction and yaw direction. Figure 16 The angle of the series 2640 of drive joints 2650 is shown at a time when each drive joint 2650 in the series has been fully articulated ninety degrees in the pitch direction and yaw direction, which results in an angle a of approximately 100.9 degrees. In this arrangement, the outer surface of each distal spherical portion 2660 passes over the outer surface of the adjacent or abutting proximal spherical portion 2652, allowing unrestricted movement until the 18 degree limit is reached. The rigid design and limited small angle allows the series 2640 of movably coupled drive joints 2650 to torsionally carry high loads at a generally large angle.

[0190] In the illustrated arrangement, the articulation joint 2200 includes an articulation joint spring 2230 supported within an outer elastomeric joint assembly 2210. The outer elastomeric joint assembly 2210 includes a distal end 2212 attached to the proximal end 1112 of the elongated channel 1110. For example, as Figure 6As can be seen, the distal end 2212 of the outer elastomeric joint assembly 2210 is attached to the proximal end 1112 of the elongated channel 1110 by a pair of headed screws 2722 that extend through a distal mounting bushing 2720 to be threadably received in the proximal end 1112 of the elongated channel 1110. The proximal end 2214 of the elastomeric joint assembly 2210 is attached to the distal end 2124 of the proximal end support shaft 2120. The proximal end 2214 of the elastomeric joint assembly 2210 is attached to the distal end 2124 of the proximal support member 2120 by a pair of headed screws 2732 that extend through a proximal mounting bushing 2750 to be threadably received in a threaded insert 2125 that is mounted within the distal end 2124 of the proximal support shaft 2120.

[0191] To prevent the drive joints 2650 from flexing during articulation, the series 2640 of movably coupled drive joints 2650 extend through at least one low-friction articulation joint spring 2730 that is supported within the outer elastomeric joint assembly 2210. See Figure 19 . The articulation joint spring 2730 is sized relative to the drive joints 2650 such that a slight radial clearance is provided between the articulation joint spring 2730 and the drive joints 2650. The articulation joint spring 2730 is designed to axially carry articulation joint loads that can be significantly lower than the torsional firing loads. The joint spring is longer than the series 2640 of drive joints 2650 such that the drive joints are axially loose. If the "hard stack" of the series 2640 of drive joints 2650 is longer than the hard stack of the articulation joint spring 2730, the drive joints 2650 can act as an articulation compression limiter, resulting in the firing loads and the articulation loads being axially resolved through the series 2640 of drive joints 2650. When the firing loads are axially resolved through the series 2640 of drive joints 2650, the loads can attempt to straighten the articulation joint 2200, or in other words, cause disarticulation. If the hard stack of the articulation joint spring 2730 is longer than the hard stack of the series 2640 of drive joints 2730, the firing loads will be contained within the end effector and neither the firing loads will be resolved through the drive joints 2650 or through the spring 2650.

[0192] To further ensure that the drive joints 2650 are always engaged with one another, a proximal drive spring 2740 is employed to apply an axial biasing force to the series 2640 of drive joints 2650. For example, as Figure 8 , Figure 19 and Figure 20As can be seen in FIGS. 27A and 27B, the proximal drive spring 2740 is positioned between the proximal mounting bushing 2734 and a support flange formed between the distal socket portion 2636 and the proximal barrel portion 2638 of the proximal shaft section 2632. In one arrangement, the proximal drive spring 2740 can comprise an elastomeric O-ring / bush received on the proximal barrel portion 2638 of the proximal shaft section 2632. The proximal drive spring 2740 biases the drive joints 2650 slightly together to reduce any play that can occur during articulation. This ensures that the drive joints 2650 transmit loads torsionally. It will be appreciated, however, that in at least one arrangement, the proximal drive spring 2740 does not exert a high enough axial load such that the firing load translates through the articulation joint 2200.

[0193] As Figure 9 and Figure 10 As can be seen in FIGS. 27A and 27B, the proximal drive spring 2740 is positioned between the proximal mounting bushing 2734 and a support flange formed between the distal socket portion 2636 and the proximal barrel portion 2638 of the proximal shaft section 2632. In one arrangement, the proximal drive spring 2740 can comprise an elastomeric O-ring / bush received on the proximal barrel portion 2638 of the proximal shaft section 2632. The proximal drive spring 2740 biases the drive joints 2650 slightly together to reduce any play that can occur during articulation. This ensures that the drive joints 2650 transmit loads torsionally. It will be appreciated, however, that in at least one arrangement, the proximal drive spring 2740 does not exert a high enough axial load such that the firing load translates through the articulation joint 2200.

[0194] As noted above, each of the upper vertebra members 2520 is movably received on an upper flexible coupler member 2402 in the form of a top cable 2404. As noted above, the distal end 2406 of the top cable 2404 is fixed to the top firing member feature 2320 of the firing member 2310. Similarly, each of the lower vertebra members 2520 is movably received on a lower flexible coupler member 2502 in the form of a lower cable 2504. The distal end 2506 of the lower cable 2504 is fixed to the bottom firing member feature 2350 of the firing member 2310. In at least one arrangement, the top cable 2404 and the bottom cable 2504 extend through the proximal shaft portion 2100 and, as will be discussed in further detail below, can interface with an emergency arrangement supported in the housing to retract the firing member 2310 to its original or home position in the event of a firing member drive system failure.

[0195] Turning again to Figure 8 the axial length AL of the upper series 2410 of the upper vertebra members 2420 u and the axial length AL of the lower series 2510 of the lower vertebra members 2520 l are equal and must be long enough to facilitate full distal advancement of the firing member 2310 from the original or home position to the distal-most end position within the cartridge while the proximal-most upper vertebra member 2420 of the upper series 2410 of the upper vertebra members 2420 and the proximal-most lower vertebra member 2520 of the lower series 2510 of the lower vertebra members 2520 remain in driving engagement with the rotary drive screw 2700. As Figure 8 can be seen, the upper compression limiting spring 2421 is configured to interface with the proximal-most upper vertebra member 2420P of the upper series 2410 of the upper vertebra members 2420. The upper compression limiting spring 2421 is journaled on the top cable 2404 and held in biasing engagement with the proximal-most upper vertebra member 2420P by an upper spring retainer 2423 which is held in place by an upper collar 2425 crimped on the top cable 2404. The top cable 2404 extends through an upper hypotube 2433 supported in the proximal support shaft. Likewise, the lower compression limiting spring 2521 is configured to interface with the proximal-most lower vertebra member 2520P of the lower series 2510 of the lower vertebra members 2520. The lower compression spring 2521 is journaled on the lower cable 2504 and held in biasing engagement with the proximal-most lower vertebra member 2520P by a lower spring retainer 2523 which is held in place by a lower collar 2525 crimped on the lower cable 2504. The lower cable 2504 extends through a lower hypotube 2533 supported in the proximal support shaft.

[0196] When the upper vertebral members 2420 and the lower vertebral members 2520 are angled by the articulation joints (after the end effector has been positioned in an articulated position), in each series 2410, 2510, the gap between the respective vertebral members 2420, 2520 increases, which causes the compression limiting springs 2421, 2521 to become tighter. The compression limiting springs 2421, 2521 provide enough slack to the cables 2404, 2504, respectively, to enable the angle of the vertebral members 2420, 2520 to pass through the most extreme articulation angles. If the cables 2404, 2504 are pulled too tight, the spring retainers 2423, 2523 will contact their respective proximal-most vertebral members 2420P, 2520P. This compression limiting arrangement ensures that the vertebral members 2420, 2520 always remain close enough together in their respective series 2410, 2510 so that the rotary drive screw 2700 will always drivingly engage these vertebral members in the manner discussed in further detail below. When the vertebral members 2420, 2520 are again in straight alignment, the compression limiting springs 2421, 2521 can partially relax while still maintaining some compression between the vertebral members.

[0197] As noted above, when the upper vertebral members 2420 are arranged in the upper series 2410 and the lower vertebral members 2520 are arranged in the lower series 2510, the male protuberances and the female recesses in each vertebral member, as well as the compression limiter springs, serve to hold the upper and lower vertebral members in relatively linear alignment for driving engagement by the rotary drive screw 2700. As can be seen in Figure 9 and Figure 10 When the upper vertebral members 2420 are in linear alignment, the upper teeth 2450 are spaced apart from one another by open spaces generally designated 2460, which facilitate driving engagement with the helical drive threads 2170 on the rotary drive screw 2700. Similarly, when the lower vertebral members 2520 are in linear alignment, the lower vertebral member teeth 2550 are spaced apart from one another by open spaces generally designated 2560, which facilitate driving engagement with the helical drive threads 2170 of the rotary drive screw 2700.

[0198] Turning to Figure 8 and FIG. 22 , the rotary drive screw 2700 includes a screw body 2702 having a socket 2704 therein for receiving the distally extending shaft 2676 of the distal CV drive shaft 2670. An internal radial groove 2714( FIG. 10formed in the screw body 2702 for supporting a plurality of ball bearings 2716 therein. In one arrangement, for example, twelve ball bearings 2716 are employed. The radial grooves 2714 support the ball bearings 2716 between the screw body 2702 and the distal end of the thrust bearing housing 2680. The ball bearings 2716 function to distribute the axial load of the rotationally driven screw 2700 and significantly reduce friction through the rolling motion of the balls.

[0199] As FIG. 23 can be seen, the helical drive thread 2710 is disposed about the screw body 2702 and functions to form a proximal threaded pocket feature 2712. The proximal threaded pocket feature 2712 is formed with a first pitch 2713 and the remaining portion of the helical drive thread 2710 is formed with a second pitch 2715 that is different than the first pitch 2713. In FIG. 22 and FIG. 23 , the region 2718 illustrates where the first pitch 2713 and the second pitch 2715 converge. In at least one embodiment, the first pitch 2713 is greater than the second pitch 2715 to ensure that the rotationally driven screw 2700 captures and “pockets” or drivingly engages each of the upper vertebral member 2420 and each of the lower vertebral member 2520. As FIG. 24 can be seen, the proximal end 2717 of the helical drive thread 2710 having the first pitch 2713 has been pocketed into the open space 2560 between two adjacent lower vertebral member teeth 2550A and 2550B, while the central portion 2719 of the helical drive thread 2710 having the second pitch 2715 is drivingly engaged with the helical 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 appreciated that as the firing member 2310 is driven distally, the pocketed feature 2712 can not contact the helical distal lower face portion 2554A of the lower vertebral member tooth 2550A as it pockets the lower vertebral member tooth 2550B. The helical drive thread 2710 interacts with the teeth 2450 of the upper vertebral member 2420 in a similar manner.

[0200] 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.

[0201] FIG. 25 The firing element 2310 is shown in its original or initial position. (Example) FIG. 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 FIG. 26 .

[0202] 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 FIG. 27In the illustrated arrangement, articulation cables 2242, 2246 pass through proximal mounting bushing 2750, the proximal end 2214 of the elastomeric joint assembly 2210, and a central rib segment 2216 to be fixed to the distal end 2212 of the elastomeric joint assembly 2210 or other portion of the surgical instrument. Likewise, articulation cables 2250 and 2254 extend through proximal mounting bushing 2750, the proximal end 2214 of the elastomeric joint assembly 2210, and a central rib segment 2218 to be fixed to the distal end 2212 of the elastomeric joint assembly 2210 or other portion of the surgical end effector. Cables 2242, 2246, 2250, and 2254 are operably interfaced with an articulation control system supported in the housing of the surgical instrument 10. For example, a proximal portion of each cable 2242, 2246, 2250, and 2254 can be wrapped around a corresponding rotary spool or cable management system 2007 FIG. 2 ) in a housing portion of the surgical instrument 10 that is configured to pay out and retract each cable 2242, 2246, 2250, and 2254 in a desired manner. The spool / cable management system can be motor driven or manually driven (ratchet arrangement, etc.). FIG. 29 Articulation of the surgical end effector 1000 relative to the elongated shaft assembly 2000 through a first articulation plane is shown. FIG. 30 Articulation of the surgical end effector 1000 relative to the elongated shaft assembly 2000 through a second articulation plane is shown. FIG. 31 Articulation of the surgical end effector 1000 relative to the elongated shaft assembly 2000 through a plurality of articulation planes is shown.

[0203] FIG. 32 to FIG. 34 An alternative articulation joint 2200' in the form of an elastomeric joint assembly 2210' is shown. As FIG. 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 movement angles approaching ninety degrees.

[0204] 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 FIG. 27 , FIG. 28 and FIG. 35The distal end 2472 of the upper sleeve 2470 is supported in the proximal end 1112 of the elongated channel 1110 and the proximal end 2474 of the upper sleeve 2470 is supported in the distal end of the proximal support shaft 2120. The upper sleeve 2470 is made of a polymer or plastic material that has a low coefficient of friction and is flexible to enable the upper sleeve 2470 to flex with the outer elastomeric joint assembly 2210. The upper sleeve 2470 protects the upper vertebral member 2420 from contacting the outer elastomeric joint assembly 2210, which is made of an elastomeric material that can have a higher coefficient of friction than the coefficient of friction of the material of the upper sleeve 2470. In other words, the upper sleeve 2470 forms a low-friction, flexible, continuous, uninterrupted, and fully encapsulated path for the upper vertebral member 2420 as it traverses the articulating joint 2200.

[0205] Similarly, a lower sleeve 2570 is used to support the lower vertebral members 2520 as they pass through the articulation joint 2200. A distal end 2572 of the lower sleeve 2570 is supported in the proximal end of the elongated channel, and the proximal end of the lower sleeve 2570 is supported in the distal end of the proximal support shaft 2120. Like the upper sleeve 2470, the lower sleeve 2570 is made of a polymer or plastic material that has a low coefficient of friction and is flexible, to enable the lower sleeve 2570 to flex with the outer elastomeric joint assembly 2210. The lower sleeve 2570 protects the lower vertebral members 2520 from contacting the outer elastomeric joint assembly 2210 as they pass through the articulation joint 2200. In other words, the lower sleeve 2570 forms a low-friction, flexible, continuous, uninterrupted, and fully encapsulated path for the lower vertebral members as they traverse the articulation joint 2200. In various embodiments, the upper sleeve 2470 and the lower sleeve 2570 are configured to freely bend without kinking. To prevent kinking in the sleeves, in at least one arrangement, the sleeves 2470, 2570 are supported within the outer elastomeric joint assembly 2210 so that the sleeves can move axially. For example, as the articulation joint is angled upward, the lower sleeve 2570 can slide distally and have a large bend radius; in the same example, the upper sleeve 2470 can slide proximally and have a tighter bend radius. With the axial movement, the amount of material that is exposed outside the joint assembly 2210 is reduced, which material can otherwise be prone to kinking under a tight bend radius. In at least one arrangement, a distal end 2472 of the upper sleeve 2470 is formed with an upper pocket 2476 that is configured to deliver the upper vertebral members 2420 into the anvil top cover 1260. Similarly, a distal end of the lower sleeve 2570 can be formed with a lower pocket that is configured to deliver the lower vertebral members 2520 into the channel slots 1140 in the elongated channel 1110.

[0206] As described above, the anvil mounting portion 1230 includes a pair of laterally extending mounting pins 1232 that are configured to be received in corresponding mounting brackets or pivot brackets 1120 formed in the proximal end 1112 of the elongated channel 1110. The mounting pins 1232 are pivotally held within the mounting brackets 1120 by an anvil top cover 1260 that is attached to the proximal end 1112 of the elongated channel 1110 in the manner described above. The anvil top cover 1260 includes a proximal end 1262 and a distal end 1264, and has a keyhole-shaped vertebral conduit 1266 extending therethrough to accommodate the passage of the top firing member feature 2320 and the upper vertebral members 2420 therethrough. FIG. 36The vertebrae conduit 1266 in the anvil top cover 1260 is shown. When the rotary drive screw 2700 applies a load to the upper vertebra member 2420, the vertebra member 2420 will tend to tilt about FIG. 37 Region A in the above drawing shows where the upper vertebra member 2420 is tilted, so the upper vertebra member teeth 2450 are no longer at a right angle to the rotary drive screw 2700, but can experience higher pressure line contact. FIG. 37 Region B in the above drawing shows where the upper vertebra member 2420 stops tilting. To ensure that most of the load remains in the longitudinal direction to perform useful work, the amount that the upper vertebra member teeth 2450 are angled must be the same as the amount that the upper vertebra member 2420 is tilted. Thus, when the upper vertebra member 2420 is tilted, the upper vertebra member teeth 2450 will still maintain surface contact with the helical drive member 2710 on the rotary drive screw 2700, and all of the load will be directed longitudinally rather than vertically. The slightly angled upper vertebra member teeth 2450 can behave like a square thread when the vertebra member 2420 is tilted, and better distribute the load to reduce pressure contact. By directing most of the load in the longitudinal direction, vertical loads are avoided that can cause friction to build up that would counteract the longitudinal load. The upper vertebra member 2420 reacts similarly as it passes through the lock hole shaped anvil slot 1240 downward. Likewise, the lower vertebra member 2520 reacts similarly as it passes through the lock hole shaped axial extension slot 1140 in the elongated channel 1110.

[0207] In the illustrated arrangement, the anvil 1210 is moved to an open position by a pair of anvil springs 1270 that are supported within the proximal end of the elongated channel. See FIG. 38 , FIG. 42 and FIG. 43 The springs 1270 are positioned to apply a pivotal biasing force to corresponding anvil control arms 1234 that can be integrally formed with and extend downward from the anvil mounting portion 1230. See FIG. 38 .

[0208] FIG. 39 to FIG. 41 Portions of the anvil 1210, the firing member 1210, and the anvil top cover 1260 are shown when the anvil 1210 is open ( FIG. 39 ), when the anvil 2310 is partially closed ( FIG. 40 ), and after the firing member has been advanced distally from an original or starting position ( FIG. 41 ). As FIG. 39As can be seen, when the firing member 2310 is in the home or starting position, the top firing member feature 2320 is fully received within the vertebrae channel 1266 in the anvil top cover 1260. During the firing stroke, the top firing member feature 2320 and the superior vertebrae members 2420 in the superior series 2410 must transition from the vertebrae channel 1266 in the anvil top cover 1260 to the keyhole-shaped anvil slot 1240. Accordingly, it is desirable to minimize any gap "G" between the anvil mounting portion 1230 and the distal end 1264 of the anvil top cover 1260. To minimize this gap G while facilitating unimpeded pivotal travel of the anvil 1210, the distal end 1264 of the anvil top cover 1260 is formed with a curved top cover surface 1265 that matches a curved mating surface 1231 on the anvil mounting portion 1230. Both surfaces 1265, 1231 are curved and concentric about the pivot axis PA or some other reference point. This arrangement allows radial movement of the anvil 1210 and does not interfere with the anvil top cover 1260 while maintaining a minimal gap G therebetween. The gap G between the anvil mounting portion 1230 and the distal end 1264 of the anvil top cover 1260 is significantly shorter than the length of the superior vertebrae members 2420, which facilitates easy transition of each superior vertebrae member 2420 from the vertebrae channel 1266 in the anvil top cover 1260 to the keyhole-shaped anvil slot 1240. Moreover, to further assist the top firing member feature 2320 in transitioning into the keyhole-shaped anvil slot 1240, a ramped surface 1241 is formed adjacent the curved mating surface 1231 on the anvil mounting portion 1230. When the firing member 2310 is initially advanced distally from the home or starting position, the distal end of the top firing member feature 2320 contacts the ramped surface 1241 and begins to impart closure motions to the anvil 1210, as will be discussed in more detail below. FIG. 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 to fully close the anvil 1210 and maintain the anvil 1210 in the closed position during the firing sequence. See FIG. 41 .

[0209] Generally, the highest firing forces established in an endocutter are associated with cutting and stapling tissue. If those same forces were available to close the anvil, the forces generated during pre-clamping and grasping of the tissue could also be higher. In at least one arrangement, the firing member body 2312 further includes a firing member wing or tab 2355 extending from each lateral side of the firing member body 2312. See FIG. 15 and FIG. 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... FIG. 42 As shown. When the firing member 3210 moves proximally, the firing member wing 2355 resists the bias of the anvil spring 1270 and pushes the anvil control arm 1234 (in the pivoting direction C). See also FIG. 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 FIG. 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.

[0210] 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. FIG. 19) and drive the sled 1312 distally through the staple cartridge body 1302. When the firing member 2310 is in the original or starting position, the surgeon can wish to use the surgical end effector to grasp and manipulate tissue. To do so, the rotary drive system is actuated to apply a second rotary drive motion to the rotary drive screw 2700 in a second rotary direction opposite to the first rotary direction. This rotary motion of the rotary drive screw 2700 in the second rotary direction will drive the firing member 2310 proximally from the starting position and cause the anvil 1210 to quickly pivot to the closed position. Thus, according to at least one embodiment, the "original or starting position" of the firing member 2310 is not its most proximal position.

[0211] If during the firing process, the rotary drive system 2600 stops rotating, the firing member 2310 can become stuck within the surgical end effector. In such circumstances, the top firing member feature 2320 can remain engaged with the anvil 1210 and the bottom firing member feature 2350 can remain engaged with the elongate channel 1110, thereby preventing the surgeon from moving the anvil 1210 to the open position to release tissue clamped between the anvil 1210 and the surgical staple cartridge 1300. This can occur, for example, if the motor or other control arrangement that provides rotary drive motions to the rotary drive shaft 2610 fails or otherwise becomes inoperative. In such circumstances, the firing member 2310 can be retracted to the original or starting position within the surgical end effector 1000 by pulling the top cable 2404 and the lower cable 2504 in the proximal direction. For example, the proximal portions of the top cable 2404 and the lower cable 2505 can be wound onto a rotary spool or cable management system 2009 FIG. 2 ) within a housing portion of the surgical instrument 10 that is configured to pay out the top cable 2404 and the lower cable 2504 during the firing stroke and also retract the cables 2404, 2504 in the proximal direction if the firing member 2310 needs to be retracted. The cable management system 2009 can be motor driven or manually driven (ratchet arrangement, etc.) to apply the retraction motions to the cables 2404, 2504. As the cables 2404, 2504 are retracted, the upper vertebra member 2420 and the lower vertebra member 2520 will cause the rotary drive screw 2700 to rotate in reverse.

[0212] Whether the rotary drive screw 2700 will rotate in reverse can be determined using the following equation that depends on the lead (L), the pitch diameter (d p ), the tooth angle (a), and the friction (m):

[0213]

[0214] If the above equation holds, the rotary drive screw 2700 can be self-locking. To a great extent, in many cases, for an endo-cutter, the pitch diameter is mostly fixed, but the lead and the angle of the teeth are variable. Because the upper vertebra member teeth 2450 and the lower vertebra member teeth 2550 are mostly square, the rotary drive screw 2700 is more likely to be back drivable (cos(90) = 1). The lead of the upper vertebra member teeth 2450 and the lower vertebra member teeth 2550 can also be advantageous because the rolling friction between the vertebra members 2420, 2520 and the rotary drive screw 2700 is more likely to enable the rotary drive screw 2700 to be back driven. Thus, in an emergency, the surgeon can pull on the upper cable 2404 and the lower cable 2504 in the proximal direction to fully retract the firing member 2310 for a quick "panic" withdrawal.

[0215] As discussed above, the housing 2002, which can be hand-held or part of a larger automated surgical system, can support relative control motions of the rotary drive system 2600 and various cable management systems employed in connection with the firing system 2300 and the articulation control system 2240. The firing system 2300, the articulation control system 2240, and the rotary drive system 2600 may, for example, be motor controlled and operated by one or more control circuits.

[0216] One method of using the surgical instrument 10 can involve using the surgical instrument 10 to cut and staple target tissue within a patient's body using laparoscopic techniques. For example, one or more trocars can have been placed through the patient's abdominal wall to provide access to the target tissue within the patient's body. The surgical end effector 1000 can be inserted through one trocar and one or more cameras or other surgical instruments can be inserted through the other trocars. In order for the surgical end effector 1000 to be inserted through the trocar cannula, the surgical end effector 1000 is positioned in an unarticulated orientation and the jaws 1100 and 1200 must be closed. In order to maintain the jaws 1100 and 1200 in the closed position for insertion purposes, for example, the rotary drive system 2600 can be actuated to impart a second rotary motion to the rotary drive screw 2700, which causes the firing member 2310 to move proximally from the starting position to move the anvil 1210 (jaw 1200) to the closed position. See FIG. 44 . The rotary drive system 2600 is deactivated to maintain the firing member 2310 in that position. Once the surgical end effector has been passed through the trocar into the abdomen, the rotary drive system 2600 can be activated to drive the rotary drive screw 2700 distally to move the firing member 2310 back to the starting position, where the anvil spring 1270 will pivot the anvil 1210 to the open position. See FIG. 38 .

[0217] Once inside the abdomen and prior to engaging the target tissue, the surgeon can need to articulate the surgical end effector 1000 into a favorable position. The articulation control system 2240 is then actuated to articulate the surgical end effector in one or more planes relative to the portion of the elongate shaft assembly 2000 that is received within the cannula of the trocar. Once the surgeon has oriented the surgical end effector 1000 in the desired position, the articulation control system 2240 is deactivated to hold the surgical end effector 1000 in the articulated orientation. The surgeon can then use the surgical end effector to grasp the target tissue or adjacent tissue by activating the rotary drive system to rotate the rotary drive screw in the second rotational direction to move the firing member proximally to cause the anvil 1210 to rapidly close to grasp tissue between the anvil 1210 and the surgical staple cartridge 1300. The anvil 1210 can be opened by reversing the rotation of the rotary drive screw 2700. This process can be repeated as desired until the target tissue has been properly positioned between the anvil 1210 and the surgical staple cartridge 1300.

[0218] Once the target tissue has been positioned between the anvil 1210 and the surgical staple cartridge, the surgeon can begin the closure and firing process by activating the rotary drive system 2600 to drive the firing member 2310 distally from the starting position. As the firing member 2310 moves distally from the starting position, the firing member 2310 applies closure motions to the anvil 1210 and moves the anvil 1210 from the open position to the closed position in the manner discussed above. As the firing member 2310 moves distally, the firing member 2310 holds the anvil 1210 in the closed position to clamp the target tissue between the anvil 1210 and the surgical staple cartridge 1300. As the firing member 2310 moves distally, the firing member 2310 contacts and also drives the sled 1312 supported in the surgical staple cartridge 1300 distally through the cartridge body 1302. The sled 1312 continuously drives the rows of drivers supported in the cartridge distally toward the clamped target tissue. Each driver has one or more surgical staples or fasteners supported thereon that are subsequently driven through the target tissue and into contact with the underside of the anvil 1210. As the firing member 2310 moves distally, the tissue-cutting knife 2314 thereon cuts through the stapled tissue.

[0219] Once the firing member 2310 has been driven to the end position within the surgical end effector 1000, the surgeon can remove the surgical end effector 1000 from the trocar and the patient's body. The surgical end effector 1000 can then be removed from the trocar and the patient's body. The surgical end effector 1000 can then be removed from the trocar and the patient's body. FIG. 45) After the firing stroke is complete, the rotation drive system 2600 is reversed, which causes the firing member 2310 to retract proximally to the starting position. Once the firing member 2310 has returned to the home or starting position, the anvil spring 1270 will pivot the anvil 1210 to the open position to enable the surgeon to release the stapled tissue from the surgical end effector 1000. Once the stapled tissue has been released, the surgical end effector can be withdrawn from the patient through the trocar cannula. To do so, the surgeon must first actuate the articulation control system 2240 to return the surgical end effector 1000 to the unarticulated position and actuate the rotation drive system to drive the firing member 2310 proximally from the home or starting position to close the jaws. Thereafter, the surgical end effector 1000 can be withdrawn through the trocar cannula. If the firing system becomes inoperative during the firing stroke or during the retraction stroke, the surgeon can retract the firing member 2310 to the starting position by applying a pulling motion to the cables 2404, 2505 in the proximal direction in various manners described herein.

[0220] FIG. 46 to FIG. 68 Another surgical instrument 22010 is shown that is identical or very similar in many respects to the surgical instrument 10 described above except for various differences discussed below. Like the surgical instrument 10, the surgical instrument 22010 can address many of the challenges faced by surgical instruments having articulatable end effectors that are configured to cut and fasten tissue. In various embodiments, the surgical instrument 22010 can comprise a hand-held device. In other embodiments, the surgical instrument 22010 can comprise an automated system, such as sometimes referred to as a robotic control system. In various forms, the surgical instrument 22010 comprises a surgical end effector 23000 operably coupled to an elongated shaft assembly 24000. The elongated shaft assembly 24000 can be operably attached to a housing that is hand-held or otherwise comprises part of a robotic system, as discussed above.

[0221] As FIG. 49As can be seen, in one form, the surgical end effector 23000 comprises a first jaw 23100 and a second jaw 23200. In the illustrated arrangement, the first jaw 23100 comprises an elongate channel 23110 that comprises a proximal end 23112 and a distal end 23114 and is configured to operably support a surgical staple cartridge 1300 therein. The elongate channel 23110 has an open bottom to facilitate ease of assembly and has a channel cover 23113 that is configured to attach (welded, etc.) to the elongate channel to cover the opening and increase the rigidity of the elongate channel 23110. In the illustrated arrangement, the second jaw 23200 comprises an anvil 23210 that comprises an elongate anvil body 23212 that comprises 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 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 staple-forming, lower surface 23218 facing the first jaw 23100 and can include a series of staple-forming pockets (not shown) corresponding to each of the staples or fasteners in the surgical staple cartridge 1300. The proximal end 23214 of the anvil body 23212 includes an anvil mounting portion 23230 that includes a pair of laterally extending mounting pins 23232 that are configured to be received in corresponding mounting brackets or pivot brackets 23120 formed in the proximal end 23112 of the elongate channel 23110. The mounting pins 23232 are pivotally retained within the mounting brackets 23120 by an anvil top cap 23260 that can be attached to the proximal end 23112 of the elongate channel 23110 by a screw 23261. In other arrangements, the anvil top cap 23260 can be attached to the elongate channel 23110 by welding, adhesive, etc. Such arrangements facilitate pivotal travel of the anvil 23210 about a pivot axis PA between an open position FIG. 47 ) and a closed position FIG. 48 .

[0222] In the illustrated arrangement, the anvil 23210 is moved to the open position by a pair of anvil springs 23270 that are supported within the proximal end 23112 of the elongate channel 23110. See FIG. 49 and FIG. 62 . The springs 23270 are positioned to apply a pivotal biasing force to corresponding portions of the anvil 23210 to apply an opening force thereto. See FIG. 47 .

[0223] In the illustrated arrangement, the elongate shaft assembly 24000 defines a shaft axis SA and includes a proximal shaft portion 24100 that is operably interfaced with a housing of a control portion (e.g., hand-held unit, robotic tool driver, etc.) of the surgical instrument 22010. The elongate shaft assembly 24000 further includes an articulation joint 24200 that is attached to the proximal shaft portion 24100 and the surgical end effector 23000. In various circumstances, the proximal shaft portion 24100 includes a hollow outer tube 24110 that is operably coupled to the housing in various manners as discussed above. As FIG. 49 As can be seen in FIG. 22, the proximal shaft portion 24100 can further include a rigid proximal support shaft 24120 that is supported within the hollow outer tube 24110 and that extends from the housing to the articulation joint 24200. The rigid proximal support shaft 24120 can include first and second halves 24120A, 24120B that can be coupled 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 that extends therethrough from the proximal end 24122 to the distal end 24124.

[0224] As discussed above, many surgical end effectors employ a firing member that is pushed distally through a surgical staple cartridge by an axially movable firing beam. The firing beam is typically attached to the firing member in a central region of the firing member body. This attachment location can cause the firing member to be unbalanced as it is advanced through the end effector. This imbalance can cause undesirable friction between the firing member and the end effector jaw. The creation of this additional friction can require a higher firing force to be applied to overcome this friction and can cause undesirable wear to portions of the jaw and / or firing member. The application of a higher firing force to the firing beam can cause undesirable flexing of the firing beam as it traverses the articulation joint. This additional flexing can cause the articulation joint to disarticulate, particularly when the surgical end effector is articulated at relatively high articulation angles. The surgical instrument 22010 employs a firing system 24300 that is the same or very similar in many respects to the firing system 2300 discussed above. Accordingly, only those aspects of the firing system 24300 that are needed to understand the operation of the surgical instrument 22010 will be discussed below.

[0225] As FIG. 50 to FIG. 54As can be seen in at least one embodiment, the firing system 24300 comprises a firing member 24310 that comprises a vertically extending firing member body 24312 that comprises a top firing member feature 24320 and a bottom firing member feature 24350. A tissue cutting blade 24314 is attached to or formed in the vertically extending firing member body 24312. See FIG. 50 and FIG. 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 comprises a T-shaped body 24322 having two laterally extending tabs 24323 protruding therefrom and a top axial conduit 24324 extending therethrough. See FIG. 53 The bottom firing member feature 24350 comprises a T-shaped body 24352 having two laterally extending tabs 24353 protruding therefrom and a bottom axial conduit 24354 extending therethrough. See FIG. 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. As FIG. 54 As can be seen, the anvil body 23212 comprises an axially extending anvil slot 23240 that defines two opposing flanges 23241 for slidably receiving the laterally extending tabs 24323 thereon. Similarly, the elongate channel 23110 comprises an axially extending channel slot 23140 that defines an axially extending channel flange 23141 that is configured to slidably receive the laterally extending tabs 24353 thereon.

[0226] In the illustrated arrangement, the firing system 24300 comprises an upper flexible spine assembly 24400 that is operably coupled to the top firing member feature 24320 of the firing member 24310. In at least one embodiment, the upper flexible spine assembly 24400 comprises an upper series 24410 of upper vertebral members 24420 that are loosely coupled together by an upper flexible coupler member 24440 that extends through each of the upper vertebral members 24420 and is attached to the top firing member feature 24320.

[0227] As FIG. 52As can be seen, each upper vertebral member 24420 is substantially T-shaped when viewed from one end of each upper vertebral member. In one aspect, each upper vertebral member 24420 includes an upper vertebral body portion 24422 having a proximal end 24424 and a distal end 24428. Each upper vertebral member 24420 also includes a downwardly extending upper drive feature or upper vertebral member tooth 24450 protruding from the upper vertebral body portion 24422. Each upper vertebral member tooth 24450 has a helical proximal upper face portion 24452 and a helical distal upper face portion 24454. Each proximal end 24424 of the upper vertebral body portion 24422 has an arcuate or slightly concave curvature shape, and each distal end 24428 has an arcuate or slightly convex curvature shape. When arranged in the upper series 24410, the convex distal end 24428 on one upper vertebral member 24420 contacts and mates with the concave proximal end 24424 on an adjacent upper vertebral member 24420 in the upper series 24410 to hold the upper vertebral members 24420 generally aligned so that the helical proximal upper face portion 24452 and the helical distal upper face portion 24454 on each respective upper vertebral member tooth 24450 can be drivingly engaged by the rotary drive screw 2700 in the various methods disclosed herein. These curved mating surfaces on the upper vertebral members 24420 allow the upper vertebral members 24420 to better transfer loads between them even when they are tilted.

[0228] In at least one embodiment, upper alignment members 24480 are employed to help align the upper vertebral members 24420 in the upper series 24410. In one arrangement, the alignment members 24480 comprise spring members or metal cables that can be made from Nitinol wire, spring steel, etc., and are formed with a distal upper looped end 24482 and two upper strut portions 24484 that extend through corresponding upper conduits 24425 in each of the upper vertebral body portions 24422. An upper flexible coupler member 24440 extends through the upper conduit 24429 in each of the upper vertebral members 24420 to attach to the firing member 24310. Specifically, a distal end portion 24442 extends through a top axial conduit 24324 in the top firing member feature 24320 and is secured therein by an upper retention lug 24444. A proximal portion of the upper flexible coupler member 24440 can interface with various types and designs of corresponding rotational spool or cable management systems disclosed herein for paying out and taking up the upper flexible coupler member 24440 during operation and articulation 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 a desired amount of tension in the upper flexible coupler member 24440. The amount of tension in each flexible coupler member can vary depending on the relative positioning of the surgical end effector 23000 with the elongate shaft assembly 24000.

[0229] The firing system 24300 further includes a lower flexible spine assembly 24500 operably coupled to the bottom firing member feature 24350. The lower flexible spine assembly 24500 includes a lower series 24510 of lower vertebral members 24520 that are loosely coupled together by a lower flexible coupler member 24540 that extends through each of the lower vertebral members 24520 and is attached to the bottom firing member feature 24350. As FIG. 52As can be seen, each superior vertebral member 24520 is substantially T-shaped when viewed from one end of each inferior vertebral member. In one aspect, each inferior vertebral member 24520 includes an inferior vertebral body portion 24522 having a proximal end 24524 and a distal end 24528. Each inferior vertebral member 24520 also includes an inferior driving feature or inferior vertebral member tooth 24550 extending upwardly from the inferior vertebral body portion 24522. Each inferior vertebral member tooth 24550 has a helical proximal inferior face portion 24552 and a helical distal inferior face portion 24554. The proximal end 24524 of each inferior vertebral body portion 24522 has an arcuate or slightly concave curvature, and the distal end 24528 has an arcuate or slightly convex curvature. When arranged in the inferior series 24510, the convex distal end 24528 on one inferior vertebral member 24520 contacts and mates with the concave proximal end 24524 on an adjacent inferior vertebral member 24520 in the inferior series 24510 to hold the inferior vertebral members 24520 in general alignment so that the helical proximal inferior face portion 24552 and the helical distal inferior face portion 24554 on each respective inferior vertebral member tooth 24550 can be drivingly engaged by the rotary drive screw 2700 in the various methods disclosed herein. These curved mating surfaces on the inferior vertebral members 24520 allow the inferior vertebral members 24520 to better transfer loads between them even when they are tilted.

[0230] In at least one embodiment, lower alignment member 24580 is employed to help align the lower vertebral members 24520 in the lower series 24510. In one arrangement, lower alignment member 24580 comprises a spring member or metal cable that can be made from Nitinol wire, spring steel, or the like, and is formed with a distal lower looped end 24582 and two lower strut portions 24584 that extend through corresponding lower tunnels 24525 in each of the lower vertebral body portions 24522. A lower flexible coupler member 24540 extends through a bottom axial tunnel 24529 in each of the lower vertebral members 24520 to attach to the firing member 24310. Specifically, a distal end portion 24542 of the lower flexible coupler member 24540 extends through a bottom axial tunnel 24354 in the bottom firing member feature 24350 and is secured therein by a lower retention lug 24544. A proximal portion of the lower flexible coupler member 24540 can interface with various types and designs of corresponding rotational spool or cable management systems disclosed herein for paying out and taking up the lower flexible coupler member 24540 during operation and articulation 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 a desired amount of tension in the lower flexible coupler member 24540. The amount of tension in each flexible coupler member can vary depending on the relative positioning of the surgical end effector 23000 with the elongate shaft assembly 24000.

[0231] According to at least one aspect, the large surface area facilitates distributing the force between the vertebral members as they are pushed, so that the vertebral members cannot twist relative to one another. The available area in the anvil and channel is limited, and the anvil and channel must remain rigid. The T-shaped upper vertebral members 24420 and the T-shaped lower vertebral members 24520 are designed to fit in the limited space available in the anvil 23210 and the elongated channel 23110, while ensuring that there is a large amount of area to distribute 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 transfer the load between them, even when they are tilted. The upper alignment members 24480 and the lower alignment members 24580 can also be used to prevent the upper vertebral members 24420 and the lower vertebral members 24520 from twisting relative to one another. The large surface area can also help prevent galling of the vertebral members and / or the anvil and channel. The upper flexible spine assembly 24400 and the lower flexible spine assembly 24500 are otherwise operably interfaced with the rotary drive screw 2700 arrangement as disclosed herein. The upper flexible coupler members 24440 and the lower flexible coupler members 24540 can also be used to retract the firing member 24310 to its starting position in the manner discussed above, should the firing drive system 24300 fail during the firing stroke.

[0232] As FIG. 51 As can be seen in FIG. 48, the top firing member feature 24320 on the firing member 24310 includes a distal upper firing member tooth segment 24330 that corresponds to half of the upper vertebral member teeth 24450 on each upper vertebral member 24420. In addition, 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. Likewise, 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. In at least one arrangement, for example, the firing member 24310 with rigidly attached teeth 24330, 24336, 24360, and 24366 can be manufactured as one integral piece at a time using conventional metal injection molding techniques. Those of ordinary skill 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.

[0233] Turning now to FIG. 55To 58, according to at least one aspect, the articulation joint 24200 includes a movable exoskeleton assembly 24800. In one form, the movable exoskeleton assembly 24800 includes a series 24802 of ring-shaped rib members 24810 movably interfaced. As FIG. 55 to FIG. 57 As seen in FIG. 54, each ring-shaped rib member 24810 includes a first or proximal face portion 24820 that includes a convex or domed portion 24822. Each ring-shaped rib member 24810 also includes a second or distal face portion 24830 that is concave or disc-shaped. Each ring-shaped rib member 24810 also includes an upper spine channel 24840 configured to accommodate the upper flexible spine assembly 24400 therethrough and a lower spine channel 24842 configured to accommodate the lower flexible spine assembly 24500 therethrough. In addition, each ring-shaped rib member 24810 also includes four articulation channels 24850, 24852, 24854, and 24856 to accommodate articulation actuators in the form of articulation cables 24242, 24246, 24250, and 24254 therethrough. See FIG. 49 Each ring-shaped rib member 24810 also includes a central drive channel 24860 configured to accommodate a constant velocity (CV) drive shaft assembly 2620 therethrough.

[0234] As FIG. 58As can be seen, the movable exoskeleton assembly 24800 includes a proximal attachment rib 24870 that is configured to be attached to the distal end 24124 of the proximal support shaft 24120 by means of a set screw 24880 or other suitable fastener arrangement. The proximal attachment rib 24870 includes a first or distal face 24872 that is concave or dish-shaped to receive or movably interface with a convex or domed portion 24822 of a proximal face 24820 of the proximal annular rib member 24810P. Similarly, the movable exoskeleton assembly 24800 includes a distal attachment rib 24890 that is configured to be attached to the proximal end 23112 of the elongate channel 23110 by means of a set screw 24882 or other suitable fastener. The distal attachment rib 24890 includes a first or proximal face 24892 that includes a convex or domed portion 24894 that is configured to be received in or movably interface with a concave or dish-shaped distal face 24832 of the distal annular rib member 24810D. In various embodiments, the annular rib members 24810, 24810P and 24810D can be fabricated from any suitable metal (e.g., stainless steel, titanium, etc.) or other suitable material. The annular rib members 24810, 24810P and 24810D can be formed by suitable stretching or shaping operations, by machining or casting. The proximal and distal faces 24820 and 24830 can be polished or otherwise finished to a desired smooth finish to reduce friction and facilitate movement between the annular rib members 24810, 24810P and 24810D. According to one aspect, all edges on each of the annular rib members 24810, 24810P, 24810D are rounded to facilitate relative movement between the annular rib members. The proximal and distal attachment ribs 24870 and 24890 can be formed with similar attributes.

[0235] The surgical instrument 22010 also includes an articulation system 24240 that is configured to apply articulation motions to the surgical end effector 23000 to articulate the surgical end effector 23000 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 that extend through the elongated shaft assembly 24000. See FIG. 49In the illustrated arrangement, articulation cables 24242, 24246 pass through proximal attachment rib 24870 and through each of annular rib members 24810P, 24810 and 24810D to be secured to distal attachment rib 24890. In one arrangement, for example, each of articulation cables 24242, 24246 is secured to distal attachment rib 24890 by a corresponding attachment lug 24243. See FIG. 61 and FIG. 63 Likewise, articulation cables 24250 and 24254 extend through proximal attachment rib 24870 and through each of annular rib members 24810P, 24810 and 24810D to be secured to distal attachment rib 24890 by a corresponding attachment lug 24243.

[0236] In one arrangement, each of articulation cables 24242, 24246, 24250 and 24254 extends through a corresponding coil spring 24896 that is supported in a cavity 24125 in the distal end 24124 of rigid proximal support shaft 24120. In addition, each coil spring 24896 is associated with a tensioning lug 24897 that is also journaled to and secured on each respective articulation cable 24242, 24246, 24250 and 24524 to achieve a desired amount of compression in each spring 24896 that serves to maintain annular rib members 24810P, 24810 and 24810D in movable engagement with one another and with proximal attachment rib 24870 and distal attachment rib 24890. Cables 24242, 24246, 24250 and 24254 are operably interfaced with an articulation control system supported in the housing of surgical instrument 22010. For example, as discussed above, a proximal portion of each cable 24242, 24246, 24250 and 24254 can be wound on a corresponding rotational spool or cable management system 2007( FIG. 2 ) in the housing portion of surgical instrument 22010 that is configured to pay out and retract each cable 24242, 24246, 24250 and 24254 in a desired manner. The spool / cable management system can be motor driven or manually driven (ratchet arrangement, etc.). FIG. 59 The articulation joint 24200 is shown in an unarticulated position, and FIG. 60 The articulation joint is shown in an articulated configuration. This arrangement permits the surgical end effector 23000 to be articulated through a plurality of articulation planes relative to the elongated shaft assembly 24000.

[0237] AsFIG. 49 , FIG. 58 and FIG. 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. FIG. 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 FIG. 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.

[0238] 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. FIG. 63 and FIG. 65In the depicted arrangement, the drive cover 24730 includes an outer cut hypotube and an inner cut hypotube 24732. Such a hypotube 24732 can be made of metal (e.g., stainless steel or the like) and have a plurality of series of cuts or slits made therein using a laser cutter arrangement. In the illustrated arrangement, the hypotube 24732 can be made to have an upper release conduit 24734 that provides a gap for the upper flexible spine assembly 24400 to pass thereover when the surgical end effector 23000 is in one or more articulated positions during a procedure. In addition, the hypotube 24732 can have a lower release conduit 24736 to provide a similar gap for the lower flexible spine assembly 24500. As FIG. 65 As can also be seen, the hypotube 24732 can be shaped to have diametrically opposed lateral tab portions 24738 to provide lateral stability during articulation. FIG. 66 An alternative drive cover 24730' is shown that includes an inner cut hypotube 24732'. FIG. 58 FIG. 67 FIG. 68 FIG. 69 An alternative drive cover 24730" is shown that includes a flexible heat shrink tubing 24732" applied over a constant velocity (CV) drive shaft assembly 2620. In other arrangements, the drive cover can also include a coil spring or helical member.

[0239] Various embodiments of the present disclosure provide advantages over prior surgical endoscopic cutter configurations that are capable of articulation. For example, pushing a firing member forward in an articulating end effector typically requires a significant amount of force and that force must be balanced. For example, when firing a firing member at an angle greater than sixty degrees, it becomes very difficult to push the beam through the articulation joint. The joint also experiences significant loading, which can cause the articulation joint to come out of articulation. By employing an upper flexible drive arrangement and a lower flexible drive arrangement (each of which is flexible as it passes through the articulation joint, but then becomes rigid as they are distal of the articulation joint), a large degree of articulation (e.g., articulation angles of more than seventy degrees) can be allowed while balancing loads applied to the firing member that are constrained to the firing member and not to the articulation joint. In other words, torsional loads rather than longitudinal loads, which can cause the end effector to come out of articulation, are applied proximal of the articulation joint. The torsional loads are converted to longitudinal loads at a location distal of the articulation joint. Thus, the rotary drive screw is used to effectively convert torsional motion or loads to longitudinal loads that are applied to the firing member at a location distal of the articulation joint.

[0240] ​​​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.

[0241] FIG. 70 to FIG. 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.

[0242] 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.

[0243] 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 FIG. 70The distal spine assembly 5010 is non-movably supported in a distal outer tube segment 5020 which operably interfaces with the surgical end effector 4000. The elongate shaft assembly 5000 further comprises a proximal spine member (not shown) which operably interfaces with a proximal end of the articulation joint 5200 and which is attachable to or otherwise operably interfaces with a housing of the surgical instrument 3010. A proximal outer tube segment 5030 extends from the articulation joint 5200 back to the housing to operably interface therewith.

[0244] The surgical instrument 3010 employs a firing drive system 4300 which includes a firing member 4310 which comprises a vertically extending firing member body 4312 which includes a top firing member feature and a bottom firing member feature. A tissue cutting blade 4314 is attached to or formed in the vertically extending firing member body 4312. The firing drive system 4300 includes a rotary drive nut 4400 which is configured to rotatably drive a series 4600 of drive components 4610 which operably interface with the firing member 4310. The rotary drive nut 4400 includes a flexible proximal segment 4410 which spans the articulation joint 5200 and a threaded distal segment 4420 distal of the articulation joint 5200. The threaded distal segment 4420 includes a series of variable pitch threads 4430 with a coarse pitch 4432 at the proximal end and a narrower pitch 4434 at the distal or exit end. See FIGS. 19 and 20. FIG. 72 The threaded rotary drive nut 4400 includes a proximal drive gear 4440 which meshingly interfaces with a distal drive gear 4510 attached to a rotary drive shaft 4500. See FIGS. 19 and 20. FIG. 70 The rotary drive shaft 4500 can interface with a gear box / 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.

[0245] The rotary drive nut 4400 includes a proximal section 4410 and a distal section 4420. The threaded distal section 4420 is distal of the articulation joint 5200 and is configured to threadably engage a series 4600 of drive components 4610 that are slackly connected together by flexible tethers 4640. In at least one arrangement, for example, each drive component 4610 includes a vertically extending plate member 4612 that includes 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 the threads 4430 of the rotary drive nut 4400. The series 4600 of drive components 4610 are configured to flexibly pass through the articulation joint 5200 and into a vertical conduit 5012 in the distal spine assembly 5010. Rotation of the rotary drive nut 4400 in a first rotational direction causes the series 4600 of drive components 4610 to move axially in a distal direction and rotation of the rotary drive nut 4400 in a second rotational direction will cause the series 4600 of drive components 4610 to move axially in a proximal direction.

[0246] Turning to FIG. 72 In at least one arrangement, each drive component 4610 further includes a distally projecting latch feature 4630. Each latch feature 4360 is configured to be releasably received in a latching engagement within a latch cavity 4364 formed in an adjacent drive component 4610 immediately distal of the latch feature. When the drive components 4610 are latched together, they form an axially rigid series 4600AR of drive components for applying axial drive motions 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 back to the starting position. As can be seen in FIG. 72 As the drive components 4610 enter the threaded distal section 4420 of the rotary drive nut 4400, they are slackly connected together. When the drive components 4610 threadably engage the fine pitch threads 4430 in the threaded distal section 4420 of the rotary drive nut 4400, the latch features 4630 are latchingly received within the corresponding latch cavities 4364 in the distally adjacent drive components 4610 to form an axially rigid series 4600AR of drive components 4610. In one arrangement, the distal most drive component 4610 can be configured to latchingly engage the firing member 4310 in a similar manner or, in an alternative arrangement, the distal most drive component can be removably attached to the firing member 4310.

[0247] 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, eliminating the need for the reinforcing support plates 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.

[0248] FIG. 73 to FIG. 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 articulated 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.

[0249] Go to FIG. 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 FIG. 74The illustrated arrangement permits relative movement between the drive members 6610. However, when the drive members are axially aligned such that the distal face portion 6616 of one drive member 6610 is in abutting engagement with the proximal face portion 6614 of the drive member immediately distal thereto, the drive members 6610 form an axially rigid series 6600AR of drive members that can drive the firing member 6130 through the surgical end effector 6000.

[0250] As FIG. 73 As can be seen in FIG. 22, a flexible rotary drive system 6700 is employed to drive the series 6600 of drive members 6610. In one arrangement, the flexible rotary drive system 6700 includes a flexible rotary drive shaft 6710 that can pass through the articulation joint 6210 and includes a rotary drive gear 6720 that is configured to threadably engage the threaded segment 6620 on each drive member 6610. The flexible rotary drive shaft 6710 can be rotated by a motor / gear arrangement supported in the housing of the surgical instrument. The portion 6600F of the series 6600 of drive members 6610 proximal of the rotary drive gear 6720 remains flexibly connected or "loose". As the drive members 6610 are threadably engaged by the rotary drive gear 6720, these drive members are driven through the tubing in the channel 6010 which causes the drive members to form an axially rigid series 6600AR of drive members for driving the firing member 6130 through the surgical end effector 6000.

[0251] Torsional loads applied to the firing system components as they traverse the articulation joint are less likely to un-articulate the articulation joint than axial loads. The various embodiments disclosed herein transfer the torsional loads to longitudinal loads in locations distal of the articulation joint. Because the longitudinal loads are contained in the end effector, un- articulation is prevented. FIG. 77One firing system 6800 example that can provide such advantages is shown. Firing system 6800 includes a firing member 6810 that is configured to be operably supported in a surgical end effector in various manners described herein. A flexible spring-like follower member 6820 is attached to firing member 6810. This flexible spring-like follower member 6820 can span an articulation joint region 6840 that can achieve a relatively large range of articulation. The flexible spring-like follower member 6820 is configured to be axially driven by a rotatably supported flexible spring-like torsional drive member 6830 to span the articulation joint region 6840. The flexible spring-like torsional drive member 6830 includes a threaded insert 6832 that is configured to threadably engage the spring-like follower member 6820 at a location 6841 distal of the articulation joint region 6840. The flexible spring-like torsional drive member 6830 can be rotated by a motor / gear arrangement supported in a housing of the surgical instrument. When the flexible spring-like torsional drive member 6830 is rotated in a first direction, the flexible spring-like follower member 6820 translates longitudinally to drive the firing member 6810. Rotation of the flexible torsional drive member 6830 in a second direction will cause the flexible spring-like follower member to move proximally.

[0252] FIG. 78 Another firing system 6850 is shown that includes a firing member 6860 that is 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 that includes a series 6862 of spherical ball members 6870 that are coupled together by a flexible cable 6872. Such a series 6862 of flexible spherical ball members 6870 can span an articulation joint region 6840 that can achieve a relatively large range of articulation. The series 6862 of flexible spherical ball members 6870 is configured to be axially driven by a rotatably supported flexible torsional drive member 6880 to span the articulation joint region 6890. The flexible torsional drive member 6880 includes an insert 6882 that is configured to drivingly engage the spherical ball members 6870 at a location 6892 distal of the articulation joint region 6890. The flexible torsional drive member 6880 can be rotated by a motor / gear arrangement supported in a housing of the surgical instrument. When the flexible torsional drive member 6880 is rotated in a first direction, the spherical ball members 6870 are driven distally into contact with one another 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 ball members 6870 to move proximally.

[0253] FIG. 79 Another firing system 6950 is shown that includes a firing member 6960 that is configured to be operably supported in a surgical end effector in various manners described herein. A laser cut hypotube slave member 6970 is attached to the firing member 6960. This flexible slave member 6970 can span an articulation joint region 6940 that can achieve a relatively large range of articulation. The flexible slave member 6970 is configured to be axially driven by a flexible torsion drive member 6980 that is rotatably supported to span the articulation joint region 6940. The flexible torsion drive member 6980 includes a threaded insert 6982 that is configured to threadably engage a laser cut 6972 on the flexible slave member 6970 at a location 6942 distal of the articulation joint region 6940. The flexible torsion drive member 6980 can be rotated by a motor / gear arrangement supported in a housing of the surgical instrument. When the flexible torsion drive member 6980 is rotated in a first direction, the flexible slave member 6970 is translated longitudinally to drive the firing member 6960. Rotation of the flexible torsion drive member 6980 in a second direction will cause the flexible slave member 6970 to move proximally.

[0254] It is often difficult to push a firing beam forward in an articulating end effector and such force must be balanced. For example, it is often difficult to push a firing beam through an articulation joint that has been articulated to an angle greater than sixty degrees. When the firing beam traverses the articulation joint, the firing beam can place significant loads on the articulation joint components which can cause the articulation joint to unarticulate. FIG. 80 to FIG. 84 A firing drive system 7300 is shown that includes a flexible upper drive band 7320 and a flexible lower drive band 7330 that are attached to a firing member 7310 that is configured to move within a surgical end effector 7000 between a starting position and an ending position. As FIG. 80 to FIG. 82 As can be seen in FIG. 39, the flexible upper drive band 7320 includes a plurality of spaced apart upper drive teeth 7322 that are configured to threadably engage helical threads 7342 on a rotary drive nut 7340. Similarly, the flexible lower drive band 7330 includes a plurality of spaced apart lower drive teeth 7332 that are configured to threadably engage the helical threads 7342 on the rotary drive nut 7340. In at least one arrangement, the flexible upper drive band 7320 and the flexible lower drive band 7330 are formed from a metallic material and are welded or otherwise attached to the firing member 7310. Such an arrangement serves to balance the firing loads applied to the firing member 7310.

[0255] A rotary drive nut 7340 is received on a flexible rotary drive shaft 7350 that is centrally disposed between the flexible upper drive belt 7320 and the flexible lower drive belt 7330 and traverses the articulation joint area designated generally as 7200. The flexible rotary drive shaft 7350 can be rotated by a motor / gear arrangement supported in the housing of the surgical instrument. When the flexible rotary drive shaft 7350 is rotated in a first direction, the flexible upper drive belt 7320 and the flexible lower drive belt 7330 will drive the firing member 7310 distally. Rotation of the flexible rotary drive shaft 7350 in a second direction will cause 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 that surrounds 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 FIG. 84 .

[0256] In the illustrated arrangement, the firing member 7310 is configured to move through a surgical end effector 7000 that includes a first jaw 7010 and a second jaw 7030 that is configured to move relative to the first jaw 7010. In one embodiment, the first jaw 7010 includes an elongate channel 7012 that is configured to operably support a surgical staple cartridge therein. See FIG. 80 and FIG. 81 . The second jaw 7030 includes an anvil 7032 that is pivotally supported on the elongate channel 7012 and is movable relative thereto between open and closed positions. As can be seen in FIG. 82 , in at least one form, the firing member 7310 includes a shape that is commonly referred to as an "E-beam". The firing member 7310 includes an upright extending firing member body 7312 that has a lower base feature 7314 that includes two laterally extending tabs 7315 that are configured to slidably engage the elongate channel 7012 when the firing member is axially driven therein. In addition, a pair of upper tabs 7316 protrude from an upper portion of the firing member body 7312 to engage the anvil 7032 when the firing member 7310 is driven distally therethrough. During the firing stroke, the tabs 7315 and 7316 can serve to space the anvil 7032 apart relative to a surgical staple cartridge supported in the elongate channel 7012. The firing member body 7312 also includes a tissue cutting feature 7318. The tabs 7316 can also serve to apply a closure motion to the anvil 7032 as the firing member 7310 is moved distally from a starting position.

[0257] In the illustrated example, the firing drive system 7300 can also be used to apply opening and closing motions to the anvil 7032. As FIG. 80 to FIG. 83 can be seen, the closure nut 7370 is threadably received on the flexible rotary drive shaft 7350. The closure nut 7370 includes cam pins 7372 that extend laterally from each side of the closure nut 7370 to be received in corresponding cam slots 7036 in the anvil mounting portion 7034 of the anvil 7032. See FIG. 80 and FIG. 81 . Such cam pins 7372 prevent the closure nut 7370 from rotating with the flexible rotary drive shaft 7350, such that rotation of the flexible rotary drive shaft 7350 causes axial motion of the closure nut 7370. Thus, rotation of the flexible rotary drive shaft 7350 in a first direction causes the closure nut 7370 to move distally and cam the anvil 7032 from an open position to a closed position. Rotation of the flexible rotary drive shaft 7350 in a second rotational direction will cause the closure nut 7370 to move proximally and cam the anvil 7032 back to the open position. Thus, for example, alternating rotation of the flexible rotary drive shaft 7350 can allow a surgeon to quickly open and close the anvil 7032 for grasping purposes.

[0258] FIG. 85 An alternative firing drive assembly 7302 is shown that includes a flexible upper drive belt 7320' having upper drive teeth 7322' and a flexible lower drive belt 7330' having lower drive teeth 7332' that are formed from a single piece of material, such as metal. The flexible upper drive belt 7320' also includes an upper reinforcement tab 7324' disposed through the anvil 7032 similar to the upper tab 7316 on the firing member 7310 and a lower reinforcement tab 7334 disposed through the channel 7012 similar to the tab 7315 on the firing member 7310. FIG. 86 An alternative firing drive assembly 7302' is shown that is made from two belt assemblies 7302A and 7302B that are laminated together to form a flexible upper drive belt 7320" having upper drive teeth 7322" and a flexible lower drive belt 7330" having lower drive teeth 7332". Each belt assembly 7302A, 7302B also includes an upper reinforcement tab 7324A", 7324B" and a lower reinforcement tab 7334A", 7334B" disposed through the anvil 7032 and the elongate channel 7012, respectively.

[0259] For example, the firing drive system 7300 functions to apply uniform drive motion to the firing member 7310 and can accommodate articulation angles that can be greater than seventy degrees. Additionally, because the rotary drive nut 7340 engages the flexible upper drive band 7320 and the flexible lower drive band 7330 at a location distal to the articulation joint region 7200, linear firing loads are constrained to the end effector and are not passed through the articulation joint.

[0260] FIG. 87 to FIG. 89 Another form of a surgical instrument 9010 is shown that can address many of the challenges faced by surgical instruments having end effectors that are capable of articulating to a maximum articulation angle and that are configured to both cut and fasten tissue. In various embodiments, the surgical instrument 9010 can comprise a hand-held device. In other embodiments, the surgical instrument 9010 can comprise an automated system, such as sometimes referred to as a robotic control system. In various forms, the surgical instrument 9010 comprises a surgical end effector 10000 operably coupled to an elongated shaft assembly 12000. The elongated shaft assembly 12000 can be operably attached to a housing. In one embodiment, the housing can comprise a handle configured to be grasped, manipulated, and actuated by a clinician. In other embodiments, the housing can comprise a robotic system that houses or otherwise operably supports at least 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 respective equivalents. Moreover, various components can be "housed" or contained in the housing, or various components can be "associated with" the housing. In such instances, the components can not be housed within or directly supported by the housing. For example, the surgical instruments disclosed herein can be used with various robotic systems, instruments, components, and methods disclosed in U.S. Patent No. 9,072,535, entitled SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS, which is hereby incorporated by reference in its entirety.

[0261] In one form, the surgical end effector 10000 includes a first jaw 10100 and a second jaw 10200. In the illustrated arrangement, the first jaw 10100 includes an elongate channel 10110 that includes a proximal end 10112 and a distal end 10114 and is configured to operably support a surgical staple cartridge 10300 therein. The surgical staple cartridge 10300 includes a cartridge body 10302 having an elongate slot 10304 therein. A plurality of surgical staples or fasteners (not shown) are stored in the cartridge body on drivers (not shown) arranged in rows on each side of the elongate slot 10304. The drivers are each associated with a corresponding staple cavity 10308 that is exposed through a cartridge deck surface 10306. The surgical staple cartridge 10300 can be replaced after the staples / fasteners have been expelled therefrom. Other embodiments are envisioned in which the elongate channel 10110 and / or the entire surgical end effector 10000 is discarded after the surgical staple cartridge 10300 has been used.

[0262] In the illustrated arrangement, the second jaw 10200 includes an anvil 10210 that includes an elongate anvil body 10212 having a proximal end 10214 and a distal end 10216. The anvil body 10212 includes a staple-forming undersurface 10218 that faces the first jaw 10100 and can include a series of staple-forming pockets (not shown) corresponding to each of the staples or fasteners in the surgical staple cartridge 10300. The anvil body 10212 can also include a pair of downwardly extending tissue stop features 10220 formed adjacent the proximal end 10214 of the anvil body 10212. One tissue stop feature 10220 extends from each side of the anvil body 10212 such that a distal end 10222 on each tissue stop 10220 corresponds to the proximal-most staple / fastener in the surgical staple cartridge 10300. When the anvil 10200 is moved into the closed position toward tissue positioned between the staple-forming undersurface 10218 of the anvil 10200 and the cartridge deck surface 10306 of the surgical staple cartridge 10300, the tissue contacts the distal end 10222 of the tissue stop 10220 to prevent the tissue from moving proximally past the proximal-most staple / fastener, thereby ensuring that the cut tissue is also stapled. When the surgical staple cartridge is "fired" as will be discussed in further detail below, the staples / fasteners supported in each staple cavity 10308 are driven out of the staple cavities 10308, through the clamped tissue, and into contact with the staple-forming undersurface 10218 of the anvil 10200.

[0263] As FIG. 88As can be seen in FIG. 1, the proximal end 10214 of the anvil body 10212 includes an anvil mounting portion 10230 that includes a pair of laterally extending mounting pins 10232 that are configured to be received in corresponding mounting inserts 10130 that are configured to be held in place within mounting brackets 10120 formed in the proximal end 10112 of the elongate channel 10110. The mounting pins 10232 are pivotally received within pivot holes 10132 in the mounting inserts 10130, which are then inserted into their corresponding brackets 10120 and affixed to the elongate channel 10110 by welding, adhesive, snap fit, etc. This arrangement facilitates pivotal travel of the anvil 10210 about a fixed (i.e., non-translational, non-motive) pivot axis PA relative to the elongate channel 10110. See FIG. 1. FIG. 87 .

[0264] In the illustrated arrangement, the elongate shaft assembly 12000 defines a shaft axis SA and includes a hollow outer tube (omitted for clarity) that is operably interfaced with a housing of a control portion (e.g., hand-held unit, robotic tool driver, etc.) of the surgical instrument 9010. The elongate shaft assembly 12000 further includes an articulation joint 12200 that is attachable to the hollow outer tube and the surgical end effector 10000 to facilitate selective articulation of the surgical end effector 10000 about a plurality of articulation axes in a plurality of articulation planes relative to the elongate shaft assembly 12000. In at least one arrangement, for example, the articulation joint 12200 includes a proximal joint member 12210, a central joint member 12230, and a distal joint member 12250. In one example, the central joint member 12230 is operably interfaced with the proximal joint member 12210 such that the central joint member 12230 is selectively articulatable through a first or proximal articulation plane defined by a first or proximal articulation axis AA1 that is transverse to the shaft axis SA. Likewise, in one example, the distal joint member 12250 is operably interfaced with the central joint member 12230 such that the distal joint member 12250 is selectively articulatable through a second or distal articulation plane defined by a second or distal articulation axis AA2 that is transverse to the shaft axis SA and transverse to the first or proximal articulation axis AA1.

[0265] As FIG. 89 and FIG. 90 can be seen, the proximal joint member 12210 includes a proximal joint distal face portion 12212 that defines two spaced apart lateral top end portions 12214, 12216. The top end portion 12214 defines a radial surface 12215 and the top end portion 12216 defines a radial surface 12217 (FIG. 90 ). The central joint member 12230 includes a proximal face portion 12232 that defines two spaced-apart transverse proximal tip portions 12234, 12236. The proximal tip portion 12234 defines a radial surface 12235, and the tip portion 12236 defines a radial surface 12237. As can be seen in FIG. 89 the proximal face portion 12232 of the central joint member 12230 faces the proximal joint distal face portion 12212 of the proximal joint member 12210 such that the central joint member 12230 is articulatable through a first articulation plane defined by a first or proximal articulation axis AA1 that extends between a point where the transverse tip portion 12214 on the proximal joint member contacts the proximal tip portion 12234 on the central joint member 12210 and a point where the transverse tip portion 12216 on the proximal joint member 12230 contacts the proximal tip portion 12236 on the central joint member 12230. In one arrangement, the radial surfaces 12215, 12217 on the transverse tip portions 12214, 12216, respectively, and the radial surfaces 12235 and 12237 on the proximal tip portions 12234, 12236, respectively, can act as rocker points / surfaces about which the central joint member 12230 can articulate relative to the proximal joint member 12210. In addition, the central joint member 12230 includes proximal first gear teeth segments that are configured to be rotatably engaged with the distal gear segments 12218, 12220 on the proximal joint member 12210. See FIG. 88 In various arrangements, the radial surface 12235 on the central joint member 12230 can be spaced apart from the radial surface 12215 on the proximal joint member 12210, and the radial surface 12237 on the central joint member 12230 can be spaced apart from the radial surface 12217 on the proximal joint member 12210.

[0266] The central joint member 12230 also includes a central joint distal face portion 12240 that defines a centrally disposed upper tip portion 12242 that forms an upper radial surface 12244 and a lower tip portion 12246 that forms a lower radial surface 12248. See FIG. 89 The distal joint member 12250 is attached to the proximal end 10112 of the elongate channel 10110 by a mounting bushing 10150 and includes a proximal face portion 12251 that faces or confronts the central joint distal face portion 12240 on the central joint member 12230. See FIG. 89 and FIG. 92 As can be seen in FIG. 89 and FIG. 92As can be seen, the proximal face portion 12251 defines a centrally disposed upper tip portion 12252 that forms an upper radial surface 12254 that is configured to face or abut the upper radial surface 12244 on the central joint member 12230. The proximal face portion 12251 also defines a centrally disposed lower tip portion 12256 that forms a lower radial surface 12258 that is configured to face or abut the lower radial surface 12248 on the central joint member 12230. See FIG. 89 The distal joint member 12250 also includes an upper gear tooth segment 12253 that is configured to rotatably mesh with the upper gear tooth segment 12243 on the central joint member 12230. In addition, the distal joint member 12250 includes a lower gear tooth segment 12255 that is configured to rotatably mesh with the lower gear tooth segment 12245 on the central joint member 12230. See FIG. 92 .

[0267] The distal joint member 12250 is configured to articulate through a second or distal articulation plane defined by a second or distal articulation axis AA2 that extends between a point on the distal joint member 12250 where the upper tip portion 12252 contacts or faces the upper tip portion 12242 on the central joint member 12230 and a point on the distal joint member 12250 where the lower tip portion 12256 contacts or faces the lower tip portion 12246 on the central joint member 12230. See FIG. 89 and FIG. 92 In one arrangement, the radial surfaces 12254, 12258 on the upper and lower tip portions 12242, 12246, respectively, of the distal joint member 12250 and the radial surfaces 12244, 12248 on the upper and lower tip portions 12252, 12256, respectively, of the central joint member 12230 can act as rocker points / surfaces about which the distal joint member 12250 can articulate relative to the central joint member 12230. In an alternative arrangement, however, the radial surface 12254 on the distal joint member 12250 is spaced from the radial surface 12244 on the central joint member 12230 and the radial surface 12258 on the distal joint member 12250 is spaced from the radial surface 12248 on the central joint member 12230.

[0268] Returning to FIG. 88In the illustrated example, articulation joint 12200 is operably controlled by a cable control system 9030 that includes four cables 12510, 12520, 12530, and 12540 that extend through the elongate shaft assembly 12000. Cable control system 9030 can be supported within a housing 9020 of surgical instrument 9010. Cable control system 9030 can include a plurality of cable support members / drive wheels, pulleys, or the like that are controlled by one or more corresponding motors that are controlled by a control circuit portion of surgical instrument 9010. In various embodiments, cable control system 9030 is configured to manage tensioning (pulling) and pay-out of the cables at precise times during the articulation process. Moreover, in at least one arrangement, cable control system 9030 is employed to control the opening and closing of anvil 10210 as will be discussed in further detail below.

[0269] As FIG. 88 can be seen, cables 12510, 12520, 12530, and 12540 are configured to operably interface with a closure system 12600 that is rotatably mounted in the proximal end 10112 of the elongate channel 10110. In at least one arrangement, closure system 12600 includes a pulley unit 12610 that includes a first lateral alpha wrap pulley 12620 and a second lateral alpha wrap pulley 12630 that are interconnected by a central shaft 12640. See FIG. 93 and FIG. 94 . Pulley unit 12610 is rotatably supported within the proximal end 10112 of the elongate channel 10110 by mounting brackets 12710 and 12720. See FIG. 88More specifically, the proximal end 10112 of the elongated channel 10110 defines a firing member park region 10140 proximal of the mounting bracket 10120 and configured to operably support the firing member 12310 when in the starting position. Each mounting bracket 12710, 12720 is mounted within the firing member park region 10140 on each side of the shaft axis SA such that the firing member 12310 can be received in the park region 10140 when the firing member 12310 is in the starting position. The mounting brackets 12710, 12720 can be attached to the proximal end 10112 of the elongated channel 10110 by welding, adhesive, snap features, etc. The first mounting bracket 12710 includes a first shaft support 12712 configured to rotatably support a first pivot shaft 12621 protruding from the first transverse alpha wrap pulley 12620, and the second mounting bracket 12720 includes a second shaft support 12722 configured to rotatably support a second pivot shaft 12644 protruding from the second transverse alpha wrap pulley 12630. In addition, each mounting bracket 12710, 12720 further includes a release region 12732 shaped to receive the corresponding first and second alpha wrap pulleys 12620, 12630 therein.

[0270] As FIG. 94 As can be seen in FIG. 12, the first alpha wrap pulley 12620 includes a first circumferential groove 12622 and a second circumferential groove 12624. In the illustrated example, the first cable 12510 is received in and attached to the first circumferential groove 12622, and the second cable 12520 is received in and attached to the second circumferential groove 12624. Pulling on the first cable 12510 will cause the first transverse alpha wrap pulley 12620 to rotate in a first direction, and pulling on the second cable 12520 will cause the first transverse alpha wrap pulley 12620 to rotate in a second, opposite direction. Similarly, the second transverse alpha wrap pulley 12630 includes a first circumferential groove 12632 and a second circumferential groove 12634. In the illustrated arrangement, the fourth cable 12540 is received in and attached to the first circumferential groove 12632, and the third cable 12530 is received in and attached to the second circumferential groove 12634. Pulling on the fourth cable 12540 will cause the first second alpha wrap pulley 12630 to rotate in a first direction, and pulling on the third cable 12530 will cause the second transverse alpha wrap pulley 12630 to rotate in a second, opposite direction. The transverse alpha wrap pulleys 12620, 12630 can rotate approximately 330 degrees. This range of rotational travel is in contrast to a normal pulley, which can have a range of rotational travel of less than 180 degrees of rotation.

[0271] Each of the first lateral alpha wrap pulley 12620 and the second lateral alpha wrap pulley 12630 further includes a corresponding screw closure cam configured to apply closure motions to the anvil 10210. As FIG. 94 visible in FIG. 12, the first lateral alpha wrap pulley 12620 includes a first screw closure cam 12626 and the second lateral alpha wrap pulley 12630 has a second screw closure cam 12636 thereon. The screw closure cams 12626, 12636 are configured to cam interact with corresponding anvil closure arms 10234 on the anvil mounting portion 10230 of the anvil 10210 to apply closure motions to the anvil. FIG. 96 The position of the screw closure cam 12626 on the first lateral alpha wrap pulley 12620 is shown when the anvil 10210 is biased into an open position by the anvil spring 10240. Rotation of the pulley unit 12610 in a first rotational direction will cause the screw closure cam 12626 to cam the anvil 1210 into the FIG. 97 closed position shown. To open the anvil 10210, the pulley unit 12610 is rotated in the opposite direction back to the FIG. 96 position shown.

[0272] Referring now to FIG. 91 and FIG. 93 , the first cable 12510 extends from the cable control system through the elongate shaft assembly and through a conduit in the proximal joint member 12210 and is looped around two redirecting pulleys 12650, 12660 supported on shafts 12602, 12612 that are mounted in the central joint member 12230. The first cable 12510 exits the central joint member 12230 through a conduit 12231 and extends through a conduit 12257 in the distal joint member 12250 to be received within a first circumferential groove 12622 in the first lateral alpha wrap pulley 12620 where it is attached to the first lateral alpha wrap pulley. The second cable 12520 extends from the cable control system through the elongate shaft assembly and through a conduit 12213 in the proximal joint member 12210 to be looped around the redirecting pulleys 12650, 12660 in the central joint member 12230. The second cable 12520 exits the central joint member 12230 through a respective conduit 12241 and extends through a conduit 12259 in the distal joint member 12250 to be received within a second circumferential groove 12624 in the first lateral alpha wrap pulley 12620 where it is attached to the first lateral alpha wrap pulley.

[0273] In the illustrated example, a third cable 12530 extends from the cable control system 9030 through the elongated shaft assembly 12000 and through corresponding conduits in the proximal joint member 12210, the central joint member 12230, and the distal joint member 12250 to be received within a corresponding circumferential groove in the second transverse alpha wrap pulley 12630 where it is attached to the second transverse alpha wrap pulley. Further, a fourth cable 12540 extends from the cable control system 9030 through the elongated shaft assembly 12000 and through corresponding conduits in the proximal joint member 12210, the central joint member 12230, and the distal joint member 12250 to be received within a corresponding circumferential groove in the second transverse alpha wrap pulley 12630 where it is attached to the second transverse alpha wrap pulley.

[0274] In at least one example, to articulate the surgical end effector 10000 relative to the elongated shaft assembly 12000 through a first articulation plane defined by the first articulation axis AA1, the cable control system 9030 is actuated to simultaneously pull the second cable 12520 and the fourth cable 12540, with the same amount of tension being applied to each cable 12520 and 12540. Because the cables 12520, 12540 apply equal amounts of tension on either side of the pulley unit 12610, the pulley unit 12610 does not rotate. However, the pulling action of the cables 12520 and 12540 is translated through the articulation joint 12200 to the surgical end effector 10000, which causes the central joint member 12230 to articulate relative to the proximal joint member 12210 about the first articulation axis AA1. See FIG. 92 and FIG. 98 To articulate the surgical end effector 10000 through a second articulation plane defined by the second articulation axis AA2 and transverse to the first articulation plane, the cable control system 9030 is actuated to simultaneously pull the third cable 12530 and the fourth cable 12540, with the same amount of tension being applied to each cable 12530 and 12540. Because the cables 12530, 12540 apply equal amounts of tension on either side of the second transverse alpha wrap pulley 12630 of the pulley unit 12610, the pulley unit 12610 does not rotate. However, the pulling action of the cables 12530 and 12540 is translated through the articulation joint 12200 to the surgical end effector 10000, which causes the distal joint member 12250 to articulate relative to the central joint member 12230 about the second articulation axis AA2. See FIG. 92 and FIG. 99 .

[0275] The cable control system 9030 can also be used to control the opening and closing of the anvil 10210 in the following manner. As described above, when the helical cams 10626 on the first lateral alpha wrap pulley 10620 and the second lateral alpha wrap pulley 10630 are in the positions shown FIG. 96 To close the anvil 10210 from this position, the cable control system 9030 is actuated to pull both the first cable 12510 and the fourth cable 12540 simultaneously, with the same amount of tension applied to each cable 12510 and 12540. These cables 12510 and 12540 will cause the pulley unit 12610 to rotate to the closed position shown FIG. 97 which causes the closure cams 10626 to cammingly contact the anvil closure arms 10234 to pivot the anvil 10210 into the closed position. It will be appreciated that by applying equal amounts of tension to the cables 12510 and 12540, no moment is applied to the central joint member 12230 and / or the distal joint member 12250 because equal amounts of tension are applied on each side of the articulation joint 12200. See FIG. 91 This arrangement allows the jaw closure to be shaped as desired. This cable control system 9030 allows for faster closure when the anvil is fully open. The cable control system 9030 can also be used as a lower speed / higher force generation for the closure mechanism used to clamp onto tissue. This cable control system 9030 can also not produce the recoil that other cable control systems typically occur and thus can also be used to control the articulation position of the end effector. As will be discussed further below, this cable actuated closure and articulation system does not cross the central axis or shaft axis of the articulation joint that provides the critical space for the firing drive system 13000.

[0276] The articulation joint 12200 and cable control system 9030 described above can facilitate two-plane articulation while also providing additional actuation motions to the surgical end effector 10000 while leaving the central region of the articulation joint 12200 open for other control systems, as will be discussed in further detail below. The articulation joint 12200 uses the last degree of freedom to actuate the jaw closure of the surgical end effector. In one aspect, the articulation joint 12200 comprises an N+1 joint, which means that for N degrees of freedom, the joint requires N+1 cables to actuate. Thus, in the example described above, the articulation joint 12200 employs four actuation cables.

[0277] As FIG. 100 to FIG. 103As can be seen, the firing drive system 13000 includes a firing member 13310 that includes a vertically extending firing member body 13312 having two laterally extending tabs 13314 that protrude from a bottom portion 13313 of the firing member body 13312. The tabs 13314 are configured to slidably engage the flanges 10113 in the elongated channel 10110 as the firing member 13310 is axially driven therein. In addition, a pair of upper tabs 13316 protrude from a top portion 13315 of the firing member body 13312. The upper tabs 13316 are configured to engage the flanges 10213 in the anvil body 10212 as the firing member 13310 is driven distally through the closed anvil 10210 FIG. 103 ). During the firing stroke, the tabs 13314 and 13316 can serve to space the anvil 10210 relative to a surgical staple cartridge supported in the elongated channel 10110. The firing member body 13312 further includes a tissue-cutting feature 13318 and a proximally facing notch 13319 that is configured to accommodate the central shaft 12640 of the pulley unit 12610 when the firing member 13310 is in a proximal-most starting position within a firing member parking area 10140 in the proximal end 10112 of the elongated channel 10110.

[0278] As FIG. 100 to FIG. 102 shown, the firing drive system 13000 further includes an upper flexible chain drive assembly 13400 that is operably coupled to the top portion 13315 of the firing member 13310 and a lower flexible chain drive assembly 13500 that is operably coupled to the bottom portion 13313 of the firing member 13310. In at least one embodiment, the upper flexible chain drive assembly 13400 includes an upper series 13410 of upper chain connection features 13420 that are loosely coupled together by an upper flexible coupler member 13402 that is attached to the top portion 13315 of the firing member 13310. In at least one example, each upper chain connection feature 13420 includes an upper ball or bulb 13422 having an upper hollow conduit 13424 therein that is configured to allow the upper flexible coupler member 13402 to pass therethrough. As FIG. 100As can be seen, the upper flexible chain drive assembly 13400 further includes an upper compression assembly 13430 for compressing the upper balls 13422 in the upper series 13410 together. In one arrangement, the upper compression assembly 13430 includes a hollow flexible compression tube 13432 received over the upper flexible coupler member 13402. An upper collar 13440 is crimped over the upper flexible coupler member 13402 and an upper compression spring 13442 is journaled between the upper collar 13440 and the upper flexible compression tube 13432 to bias the upper flexible compression tube 13432 distally into contact with the proximal-most upper ball 13422P in the upper series 13410 of upper chain link features 13420.

[0279] Similarly, in at least one embodiment, the lower flexible chain drive assembly 13500 includes a lower series 13510 of lower chain link features 13520 that are loosely coupled together by a lower flexible coupler member 13502 that is attached to the bottom portion 13313 of the firing member 13310. In at least one example, each lower chain link feature 13520 includes a lower ball or spheroid 13522 having a lower hollow conduit 13524 therein that is configured to allow the lower flexible coupler member 13502 to pass therethrough. The lower flexible chain drive assembly 13500 further includes an upper compression assembly 13530 for compressing the lower balls 13522 in the lower series 13510 together. In one arrangement, the lower compression assembly 13530 includes a hollow flexible compression tube 13532 received over the lower flexible coupler member 13502. A lower collar 13540 is crimped over the lower flexible coupler member 13502 and a lower compression spring 13542 is journaled between the lower collar 13540 and the lower flexible compression tube 13532 to bias the lower flexible compression tube 13532 distally into contact with the proximal-most lower ball 13522P in the lower series 13510 of lower chain link features 13520.

[0280] Turning now to FIG. 104 In at least one arrangement, the firing drive system 13000 further includes a rotary drive screw 13700 that is configured to drivingly interface with the upper series 13410 of upper chain link features 13420 and the lower series 13510 of lower chain link features 13520. As can be seen, the rotary drive screw 13700 includes a threaded shaft 13702 that is received in a threaded bore 13704 in the upper collar 13440 of the upper compression assembly 13430. The threaded shaft 13702 is further received in a threaded bore 13706 in the lower collar 13540 of the lower compression assembly 13530. The threaded shaft 13702 is configured to be driven by a motor 13708 that is mounted to the housing 13010. In at least one example, the motor 13708 is a rotary motor that is configured to drive the threaded shaft 13702 in a first direction to drive the upper series 13410 of upper chain link features 13420 and the lower series 13510 of lower chain link features 13520 distally to fire the firing member 13310. The motor 13708 is further configured to drive the threaded shaft 13702 in a second direction to drive the upper series 13410 of upper chain link features 13420 and the lower series 13510 of lower chain link features 13520 proximally to retract the firing member 13310. FIG. 104As can be seen in the illustrated arrangement, the rotary drive screw 13700 is rotatably supported in a mounting bushing 10150 that is attached to the proximal end 10112 of the elongate channel 10110. For example, the rotary drive screw 13700 includes a body portion 13702 having a central shaft 13704 protruding therefrom that is rotatably mounted in a mounting hole 10152 in the mounting bushing 10150. This arrangement allows the rotary drive screw 13700 to rotate about the shaft axis SA.

[0281] In the illustrated example, the rotary drive screw 13700 is driven by a rotary drive system 13600 that includes a proximal rotary drive shaft 13610 that is rotatably supported within an axial conduit 12225 within the proximal joint member 12210. As FIG. 105 As can be seen, the proximal rotary drive shaft 13610 includes a proximal end 13612 and a distal end 13614. The proximal end 13612 can interface with the gear box / motor arrangement 9050 or other source of rotary motion housed in the housing 9020 of the surgical instrument 9010. This source of rotary motion causes the proximal rotary drive shaft 13610 to rotate within the axial conduit 12225 in the proximal joint member 12210 about the shaft axis SA. See FIG. 104 As can be seen, the proximal rotary drive shaft 13610 includes a proximal end 13612 and a distal end 13614. The proximal end 13612 can interface with the gear box / motor arrangement 9050 or other source of rotary motion housed in the housing 9020 of the surgical instrument 9010. This source of rotary motion causes the proximal rotary drive shaft 13610 to rotate within the axial conduit 12225 in the proximal joint member 12210 about the shaft axis SA. See FIG. 105 As can be seen, the distal end 13614 of the proximal rotary drive shaft 13610 is movably coupled to a first drive shaft segment 13620. In the illustrated example, the first drive shaft segment 13620 resembles a "dog bone" having a first spherical proximal end 13622 and a first spherical distal end 13624. See FIG. 106 The first spherical proximal end 13622 is movably pinned within a first distal socket 13616 formed in the distal end 13614 of the proximal rotary drive shaft 13610 by a first proximal pin 13618. The first proximal pin 13618 extends through an arcuate transverse slot 13623 in the first spherical proximal end 13622. This arrangement allows the first spherical proximal end 13622 to move in multiple directions within the first distal socket 13616 while remaining attached thereto. The first spherical distal end 13624 is received within a first proximal socket 13632 in a central bearing housing 13630 that is mounted within the central joint member 12230. The first spherical distal end 13624 is movably pinned within the first proximal socket 13632 by a first distal pin 13634. The first distal pin 13634 extends through an arcuate transverse slot 13625 in the first spherical distal end 13624. This arrangement allows the first spherical distal end 13624 to move in multiple directions within the first proximal socket 13632 while remaining attached to the central bearing housing 13630.

[0282] As FIG. 105 As can be seen in FIG. 136, the rotary drive system 13600 further includes a second drive shaft segment 13640 that is similar to the first drive shaft segment 13620 and includes a second spherical proximal end 13642 and a second spherical distal end 13644. The second spherical proximal end 13642 is movably pinned within a second distal socket 13636 formed in the central bearing housing 13630 by a second proximal pin 13637. The second proximal pin 13637 extends through an arcuate transverse slot 13643 in the second spherical proximal end 13642. This arrangement allows the second spherical proximal end 13642 to move in multiple directions within the second distal socket 13636 while remaining attached thereto. The second spherical distal end 13644 is received within a second proximal socket 13706 in the rotary drive screw 13700 and is movably pinned within the second proximal socket 13706 by a second distal pin 13647. The second distal pin 13647 extends through a transverse slot 13646 in the second spherical distal end 13644. This arrangement allows the second spherical distal end 13644 to move in multiple directions relative to the rotary drive screw 13700.

[0283] The dual-joint rotary drive maintains a linear velocity output by using the angular constraint of the joint members of the articulation joints. This universal rotary joint arrangement can have a sine output based on the joint angle by itself. If the angles are equal and the phases are properly aligned, the sine output of the first universal joint will be canceled out by the second universal joint, resulting in a linear rotational velocity. This is advantageous to impose in a rotary drive because it reduces the complexity of the components and avoids the need to remove material from the components to obtain the necessary clearance. As a result, the components of this embodiment are more robust and stronger than existing arrangements. Furthermore, the constant velocity of the rotary drive system will allow for a smoother firing and reduce wear that might otherwise be caused by vibrations.

[0284] Returning to FIG. 102To drive the firing member 13310 from the starting position in the surgical end effector 10000 to the ending position within the end effector, the actuation rotary drive system 13600 is actuated to apply rotary drive motions to the rotary drive screw 13700. As the rotary drive screw 13700 is rotated in a first rotary direction, the helical drive features 13708 engage the upper balls or spheres 13422 in the upper series 13410 of the upper chain link features 13420 and the lower balls or spheres 13522 in the lower series 13510 of the lower chain link features 13520 and drive the upper flexible chain drive assembly 13400 and the lower flexible chain drive assembly 13500 distally. As each upper ball 13422 and lower ball 13522 engages the rotary drive screw 13700, the upper balls 13422 in the upper series 13410 distal of the rotary drive screw 13700 (and the articulation joint 12200) and the lower balls 13522 in the lower series 13510 distal of the rotary drive screw 13700 (and the articulation joint 12200) are placed into compression to apply a balanced axial drive force to the firing member 13310. As the upper flexible chain drive assembly 13400 and the lower flexible chain drive assembly 13500 are placed into compression, they are constrained by the slots in the anvil 10210 and the elongate channel 10110, respectively. This arrangement ensures that the upper flexible chain drive assembly 13400 and the lower flexible chain drive assembly 13500 do not buckle as they are compressed.

[0285] For a number of reasons, this arrangement enables two degrees of articulation freedom. For example, the upper flexible chain drive assembly 13400 and the lower flexible chain drive assembly 13500 can freely bend in both the pitch and yaw axes. Thus, the upper flexible chain drive assembly 13400 and the lower flexible chain drive assembly 13500 can assume a variety of configurations that can adapt to the various articulation positions available to the articulation joint 12200. Once the firing member 13310 has been advanced distally through the surgical end effector 10000 to the end position therein, the rotary drive system 13600 is actuated to apply a second rotary drive motion to the rotary drive screw 13700 to thereby rotate the rotary drive screw 13700 in a second rotary direction about the shaft axis. As the rotary drive screw 13700 is rotated in the second rotary direction, the upper flexible chain drive assembly 13400 and the lower flexible chain drive assembly 13500 serve to retract the firing member 13310 in the proximal direction back to the starting position. As the upper flexible chain drive assembly 13400 and the lower flexible chain drive assembly 13500 proximally retract the firing member 13310, a portion of the upper flexible chain drive assembly 13400 and the lower flexible chain drive assembly 13500 is traversed back through the articulation joint 12200 and into the elongate shaft. This arrangement allows the firing member 13310 to translate a longer distance without increasing the length of the end effector joint. In addition, because the rotary drive screw 13700 drivingly engages the upper flexible chain drive assembly 13400 and the lower flexible chain drive assembly 13500 at a location distal of the articulation joint 12200, high compressive loads are contained within the surgical end effector 10000 and do not create a moment on the articulation joint 12200. This arrangement can greatly reduce the strength requirements of the articulation joint. See FIG. 104 .

[0286] In at least one arrangement, the surgical instrument 9010 can further include a cable tensioning system 13800 that is configured to maintain a desired amount of tension on the upper flexible chain drive assembly 13400 and the lower flexible chain drive assembly 13500 as they are bent through the articulation joint 12200. Maintaining the upper flexible chain drive assembly 13400 and the lower flexible chain drive assembly 13500 at a desired amount of tension as they are traversed through the articulation joint 12200 can prevent slack portions from forming in those flexible chain drive assemblies 13400, 13500 that might otherwise cause them to undesirably bunch up in the articulation joint 12200. FIG. 111 and FIG. 112One form of cable tensioning system 13800 is shown that includes constant force spring arrangements 13810 and 13820. This solution has the benefit of not requiring length conservation of the flexible chain drive assemblies 13400, 13500.

[0287] Another cable arrangement system 13800' is shown in FIG. 113 and FIG. 114 . In this arrangement, the proximal ends of the flexible chain drive assemblies 13400, 13500 are coupled together and articulated about a cable management pulley 13840 that is configured to translate with the firing member 13310. As the firing member 13310 advances distally during the firing stroke, the cable management pulley 13840 also translates distally, thereby maintaining tension in the flexible chain drive assemblies 13400, 13500. During articulation, the length of one of the flexible chain drive assemblies 13400, 13500 will increase while the length of the other flexible chain drive assembly will decrease. This arrangement serves to minimize the length of the flexible chain drive assemblies 13400, 13500 required to fully actuate the surgical end effector 10000 and articulate it.

[0288] One method of using the surgical instrument 9010 can involve using the surgical instrument to cut and staple target tissue within a patient using laparoscopic techniques. For example, one or more trocars can have been placed through the abdominal wall of a patient to provide access to target tissue within the patient. The surgical end effector 10000 can be inserted through one trocar and one or more cameras or other surgical instruments can be inserted through the other trocars. In order for the surgical end effector 10000 to be inserted through the trocar cannula, the surgical end effector 10000 is positioned in a non-articulated orientation FIG. 63 ) and the jaws 10100 and 10200 must be closed. In order to hold the jaws 10100 in the closed position for insertion purposes, for example, the cable control system 9030 is actuated to pull the first cable 12510 and the fourth cable 12540 simultaneously, which causes the pulley unit 12610 to rotate and cause the closure cams 10626, 10636 to contact the anvil closure arms 10234 to pivot the anvil 10210 into the closed position. See FIG. 97 . The cable control system 9030 is deactivated to hold the anvil 10210 in the closed position. Once the surgical end effector 10000 has entered the abdomen through the trocar, the cable control system 9030 is activated to rotate the pulley unit 12610 in the opposite direction to the position shown in FIG. 96 , thereby allowing the anvil 10210 to be biased open by the anvil spring 10240.

[0289] Once inside the abdomen and prior to engaging the target tissue, the surgeon can need to articulate the surgical end effector 10000 into a favorable position. The cable control system 9030 can then be actuated to articulate the surgical end effector 10000 in one or more planes relative to the portion of the elongate shaft assembly 12000 that is received within the cannula of the trocar. Once the surgeon has oriented the surgical end effector 10000 in the desired position, the cable control system 9030 is deactivated to hold the surgical end effector 10000 in the articulated orientation. Thereafter, the surgeon can activate the cable control system 9030 in the manner described above to rapidly close the anvil 10210 to grasp the tissue between the anvil 10210 and the surgical staple cartridge 10300. This process can be repeated as desired until the target tissue has been suitably positioned between the anvil 10210 and the surgical staple cartridge 10300.

[0290] Once the target tissue has been positioned between the anvil 10210 and the surgical staple cartridge 10300, the surgeon can activate the cable control system 9030 to close the anvil 10210 to clamp the target tissue in place. Thereafter, the firing process can be initiated by activating the rotary drive system 13600 to drive the firing member 13310 distally from a starting position. As the firing member 13310 moves distally, it contacts a sled that is supported in the surgical staple cartridge 10300 and also drives the sled distally through the cartridge body. The sled successively drives rows of drivers that are supported in the cartridge toward the clamped target tissue. Each driver has one or more surgical staples or fasteners supported thereon that are subsequently driven through the target tissue and into forming contact with the underside of the anvil 10210. As the firing member 13310 moves distally, the tissue-cutting edge 13318 thereon cuts through the stapled tissue.

[0291] After the firing member 13310 has been driven distally to an end position within the surgical end effector 10000, the rotary drive system 13600 is reversed, which causes the firing member 13310 to retract proximally to a starting position. Once the firing member 13310 has returned to the starting position, the cable control system 9030 can be activated to rotate the pulley unit 12610 back to an open position wherein the anvil spring 10240 can pivot the anvil 10210 to an open position to enable the surgeon to release the stapled tissue from the surgical end effector 10000. Once the stapled tissue has been released, the surgical end effector 10000 can be withdrawn from the patient through the trocar cannula. To do so, the surgeon must first actuate the cable control system 9030 to return the surgical end effector 10000 to the unarticulated position and actuate the cable control system 9030 to pivot the anvil 10210 to the closed position. Thereafter, the surgical end effector 10000 can be withdrawn through the trocar cannula.

[0292] In prior endoscopic cutter arrangements, the firing member is pushed by a flexible beam. In such arrangements, the articulation joint must redirect the linear motion of the flexible beam as it enters the articulation joint back to linear motion as the flexible beam exits the articulation joint and enters the end effector. Due to the high loads required to push the flexible beam and firing member, the flexible beam typically experiences a significant amount of friction as it exits the articulation joint and is redirected linearly into the end effector. This increased amount of friction increases the amount of drive force required to drive the firing member from a starting position within the end effector to an end position when the end effector is articulated. Furthermore, as the flexible beam traverses the articulation joint, it can impart a disarticulation to the articulation joint components. As a result, the articulation joint components must be strong enough to resist such disarticulation.

[0293] Other forms of surgical endoscopic cutters employ a rotational force to drive the firing member through the end effector. Such arrangements typically employ a rotary drive screw housed within a channel that supports a staple cartridge. During use, the sled and tissue place a large moment on the firing member, which decreases the efficiency of the system and ultimately requires a higher rotational force to actuate the firing member. Due to the location of the cartridge and tissue, it is difficult to move the rotary drive screw closer to the center of this force. It is difficult to package the screw on the top and bottom of the firing member without increasing the overall diameter of the surgical end effector. The various embodiments discussed above can address many, if not all, of these problems and challenges.

[0294] FIG. 115 to FIG. 139Another form of surgical instrument 25010 is shown, which addresses many of the challenges faced by surgical instruments including end effectors capable of articulating to maximum joint angles and configured to cut and fasten tissue. In various embodiments, surgical instrument 25010 may include a handheld device. In other embodiments, surgical instrument 25010 may include an automated system, such as sometimes referred to as a robotic control system. In various forms, surgical instrument 25010 includes a surgical end effector 26000 operatively coupled to an elongated shaft assembly 28000. The elongated shaft assembly 28000 may be operatively attached to a housing. In one embodiment, 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. 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 housed within a housing or may be directly supported by the housing. For example, the surgical instruments disclosed herein can be used in conjunction with various robotic systems, instruments, components, and methods disclosed in U.S. Patent No. 9,072,535 entitled “SURGICALSTAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS,” the entire contents of which are incorporated herein by reference.

[0295] In one embodiment, the surgical end effector 26000 includes a first jaw 26100 and a second jaw 26200. In the illustrated arrangement, the first jaw 26100 includes an elongated channel 26110 comprising a proximal end 26112 and a distal end 26114 and is configured to operably support a surgical cartridge 10300 therein. An example of the surgical cartridge 10300 has been described in detail above. The second jaw 26200 includes an anvil 26210 comprising an elongated anvil body 26212 having a proximal end 26214 and a distal end 26216. The anvil body 26212 includes a nail-forming lower surface 26218 facing the first jaw 26100 and may include a series of nail-forming recesses (not shown) corresponding to each of the nails or fasteners in the surgical cartridge 10300. FIG. 119As can be seen, the proximal end 26214 of the anvil body 26212 includes an anvil mounting portion 26230 that includes a pair of laterally extending mounting pins 26232 that are configured to be received in corresponding mounting inserts 26130 that are configured to be heldingly received within mounting brackets 26120 formed in the proximal end 26112 of the elongate channel 26110. The mounting pins 26232 are pivotally received within pivot holes 26132 in the mounting inserts 26130 which are then inserted into their corresponding brackets 26120 and affixed to the elongate channel 26110 by welding, adhesive, snap fit, etc. This arrangement facilitates pivotal travel of the anvil 26210 about a fixed pivot axis PA relative to the elongate channel 26110. See FIG. 115 . As noted above, the term "fixed" as used in this context means that the pivot axis PA does not translate or move relative to the elongate channel 26110.

[0296] In the illustrated arrangement, the elongate shaft assembly 28000 defines a shaft axis SA and includes a shaft spine assembly 28100 that is received within a hollow outer shaft tube 28102. See FIG. 119 . The shaft spine assembly 28100 is operably engageable with a housing of a control portion (e.g., hand-held unit, robotic tool driver, etc.) of the surgical instrument 25010 and, in one example, includes a proximal spine segment 28120 and a distal spine segment 28140.

[0297] The elongate shaft assembly 28000 further includes an articulation joint 28200 that is attachable to the distal spine segment 28140 and the surgical end effector 26000 to facilitate selective articulation of the surgical end effector 26000 relative to the elongate shaft assembly 28000 in a plurality of articulation planes. Turning now to FIG. 120 to FIG. 125 , the articulation joint 28200 includes a series 28202 of annular disc members 28210 that are movably interfaced. As FIG. 122 、 FIG. 123 and FIG. 125 can be seen, each annular disc member 28210 includes a "first" or proximal face portion 28220 that includes a centrally disposed spherical feature or nub 28222. Each annular disc member 28210 further includes a second or distal face portion 28230 that includes an annular hub portion 28232 that defines a female socket 28234 therein. See FIG. 122 and FIG. 124 . Each annular disc member 28210 further has a central shaft conduit 28236 therethrough. As FIG. 120 and FIG. 121As can be seen, the articulation joint 28200 further includes a proximal attachment disk assembly 28240 that is configured to be attached to the distal end of the distal spine segment 28140 by welding, adhesive, or other suitable fastener arrangement. The proximal attachment disk assembly 28240 includes a distal face portion 28242 that includes an annular hub portion 28244 that defines a female socket 28246 therein. The proximal attachment disk 28240 also has a central shaft conduit 28248 therethrough. Also in the illustrated arrangement, the anvil mounting bracket 26240 is configured to operably interface with the articulation joint 28200. The anvil mounting bracket 26240 is attached to the proximal end 26112 of the elongated channel 26110 of the surgical end effector 26000 by welding, adhesive, or other suitable fastener arrangement, and includes a proximal face portion 26244 that has a centrally disposed spherical feature or nub 26246 protruding therefrom. See FIG. 120 . The anvil mounting bracket 26240 also has a central shaft conduit 26248 therethrough.

[0298] In at least one embodiment, the articulation joint further includes a series 28270 of elastomeric annular spacer members 28280 that function to space each of the annular disk members 28210 apart and provide elastomeric support therebetween. The elastomeric annular spacer members 28280 define spacer openings 28282 such that each elastomeric spacer member 28280 can be journaled on the annular hub portion 28232 of a corresponding annular disk member 28210. Each annular disk member 28210 is journaled on a central elastomeric support or continuum shaft 28300 that is mounted to the proximal attachment disk assembly 28240 and the anvil mounting bracket 26240. In one arrangement, the central continuum shaft 28300 is made of an elastomeric material (e.g., rubber, polymer, etc.) and includes a flanged proximal end 28302 and a cylindrical body portion 28304. The cylindrical body portion 28304 includes a series of annular grooves 28306 therein. Each annular groove 28306 corresponds to one of the annular disk members 28210. The annular disk members 28210 and annular spacer members 28280 are journaled on the central continuum shaft 28300 as FIG. 120The flanged proximal end 28302 of the central continuum shaft 28300 is supported in a proximal channel 28249 in the proximal attachment disc 28240. The cylindrical body portion 28304 of the central continuum shaft 28300 extends through the central channel 28236 in each of the series 28202 of movably interfacing annular disc members 28210. Each centrally disposed spherical feature or protrusion 28222 includes an annular key member 28224 configured to be received in a corresponding annular groove 28306 in the central continuum shaft 28300. Such an arrangement can be used, for example, to orient each annular disc member 28210 at a desired spaced orientation on the central continuum shaft 28300.

[0299] Still referring to FIG. 120 The proximal elastomeric spacer member 28280P is journaled on the annular hub portion 28244 of the proximal attachment disc assembly 28240 such that it is positioned between the proximal annular disc member 28210P and the proximal attachment disc 28240. The annular key member 28224 of the proximal annular disc member 28210P is received within a corresponding annular groove 28306 in the central continuum shaft 28300 to position the centrally disposed spherical feature or protrusion 28222 of the proximal annular disc member 28210P within the recessed socket 28246 in the annular hub portion 28244 of the proximal attachment disc 28240. As further seen in FIG. 120 The other elastomeric spacer member 28280A is journaled on the annular hub portion 28232 of the proximal annular disc member 28210P such that it is positioned between the next annular disc member 28210A in the series 28202 of movably interfacing annular disc members 28202 and the proximal annular disc member 28210P. The annular key member 28224 of the annular disc member 28210A is received within a corresponding annular groove 28306 in the central continuum shaft 28300 to position the centrally disposed spherical feature or protrusion 28222 of the annular disc member 28210A within the recessed socket 28246 in the annular hub portion 28244 of the proximal attachment disc 28210P. Still referring to FIG. 120In this arrangement, another elastomeric spacer member 28280B is journaled on the annular hub portion 28232 of the annular disc member 28210A such that it is positioned between the next annular disc member 28210B in the series 28202 of movably interfacing annular disc members. The annular key member 28224 of the annular disc member 28210B is received within a corresponding annular groove 28306 in the central continuum shaft 28300 to position the centrally disposed spherical feature or protrusion 28222 of the annular disc member 28210B within the recessed socket 28246 in the annular hub portion 28244 of the annular disc member 28210A. Likewise, in this arrangement, another elastomeric spacer member 28280C is journaled on the annular hub portion 28232 of the annular disc member 28210B such that it is positioned between the distal-most annular disc member 28210C in the series 28202 of movably interfacing annular disc members. The annular key member 28224 of the distal-most annular disc member 28210C is received within a corresponding annular groove 28306 in the central continuum shaft 28300 to position the centrally disposed spherical feature or protrusion 28222 of the distal-most annular disc member 28210C within the recessed socket 28246 in the annular hub portion 28244 of the annular disc member 28210B. Finally, another elastomeric spacer member 28280D is journaled on the annular hub portion 28232 of the distal-most annular disc member 28210C such that it is positioned between the anvil mounting cradle 26240 and the distal-most annular disc member 28210C. The annular key member 28224 of the centrally disposed spherical feature or protrusion 26246 of the anvil mounting cradle 26240 is received within a corresponding annular groove 28306 in the central continuum shaft 28300 to position the centrally disposed spherical feature or protrusion 226246 of the anvil mounting cradle 26240 within the recessed socket 28246 in the annular hub portion 28244 of the distal-most annular disc member 28210C.

[0300] In at least one arrangement, to limit the pivotal travel of the annular disc members to a range of relative pivotal travel and to prevent the annular disc members 28210 from undergoing full relative rotation with respect to one another, the centrally disposed spherical feature or protrusion 28222 of each of the annular disc members 28210P, 28210A, 28210B, 28210C and the distal spherical feature or protrusion 26246 of the anvil mounting cradle 26240 include a pair of arcuate pin recesses 28226 therein. As can be seen in FIG. 120 corresponding travel limiting pin members 28227 are pressed into or otherwise attached to each annular hub portion 28232 and are received within the corresponding pin recesses 28226 in the centrally disposed spherical feature or protrusion 28222, 26246.

[0301] Returning to FIG. 119 In the illustrated example, articulation joint 28200 is operably controlled by articulation system 28400, which includes four cable assemblies 28410, 28420, 28430, and 28440 that extend through elongate shaft assembly 28000. In one arrangement, cable assembly 28410 includes a proximal cable portion 28412 that is attached to an articulation bar 28414 that is supported in a corresponding axial groove in shaft spine assembly 28100 for axial travel therein. A distal cable portion 28416 is attached to articulation bar 28414. Cable assembly 28420 includes a proximal cable portion 28422 that is attached to an articulation bar 28424 that is supported in a corresponding axial groove in shaft spine assembly 28100 for axial travel therein. A distal cable portion 28426 is attached to articulation bar 28414. Cable assembly 28430 includes a proximal cable portion 28432 that is attached to an articulation bar 28434 that is supported in a corresponding axial groove in shaft spine assembly 28100 for axial travel therein. A distal cable portion 28436 is attached to articulation bar 28434. Cable assembly 28440 includes a proximal cable portion 28442 that is attached to an articulation bar 28444 that is supported in a corresponding axial groove in shaft spine assembly 28100 for axial travel therein. A distal cable portion 28446 is attached to articulation bar 28444.

[0302] Proximal cable portions 28412, 28422, 28432, 28442 can be operably interfaced with portions of cable control system 25030 that are supported within or otherwise associated with a housing of surgical instrument 25010. Cable control system 25030 can include a number of cable support members / drive wheels, pulleys, or the like that are controlled by one or more corresponding motors that are controlled by control circuit portions of surgical instrument 25010. In various embodiments, cable control system 25030 is configured to manage tensioning (pulling) and pay-out of the cables at precise times during the articulation process. Moreover, in at least one arrangement, cable control system 25030 can be employed to control the opening and closing of anvil 26210, as will be discussed in further detail below.

[0303] Turning now to FIG. 126 Distal cable portions 28416, 28426, 28436, 28446 are configured to be operably interfaced with closure system 28500, which is rotatably mounted in a proximal end 26112 of elongate channel 26110. As FIG. 126As can be seen, the closure system 28500 includes a pulley unit 28510 that includes a first lateral alpha wrap pulley 28520 and a second lateral alpha wrap pulley 28530 that are interconnected by a central shaft 28540. The pulley unit 28510 is rotatably supported within the proximal end 26112 of the elongate channel 26110 and retained therein by an anvil mounting cradle 26240 that is attached to the proximal end 26112 of the elongate channel 26110. See FIG. 119 The anvil mounting cradle 26240 can be attached to the proximal end 26112 of the elongate channel 26110 by welding, adhesive, snap features, etc. The anvil mounting cradle 26240 includes a shaft holder 26242 that is configured to rotatably support the central shaft 28540 within the elongate channel 26110. In the illustrated arrangement, a first pivot shaft 28521 protrudes from the first lateral alpha wrap pulley 28520 and is pivotally supported in a pivot hole 26113 in the proximal end of the elongate channel. Similarly, a second pivot shaft 28531 protrudes from the second lateral alpha wrap pulley 28530 and is pivotally supported in a pivot hole 26115 in the proximal end 26112 of the elongate channel 26110.

[0304] As FIG. 126 As can be seen, the first alpha wrap pulley 28520 includes a first circumferential groove 28522 and a second circumferential groove 28524. In the illustrated example, the first distal cable portion 28416 is received in and attached to the first circumferential groove 28522 and the second distal cable portion 28426 is received in and attached to the second circumferential groove 28524. Pulling on the first distal cable portion 28416 will cause the first lateral alpha wrap pulley 28520 to rotate in a first direction and pulling on the second distal cable portion 28426 will cause the first lateral alpha wrap pulley 28520 to rotate in a second, opposite direction. Similarly, the second lateral alpha wrap pulley 28530 includes a first circumferential groove 28532 and a second circumferential groove 28534. In the illustrated arrangement, the distal cable portion 28446 is received in and attached to the first circumferential groove 28532 and the third distal cable portion 28436 is received in and attached to the second circumferential groove 28534. Pulling on the fourth distal cable portion 28446 will cause the second alpha wrap pulley 28530 to rotate in a first direction and pulling on the third distal cable portion 28436 will cause the second lateral alpha wrap pulley 28530 to rotate in a second, opposite direction. According to one aspect, the lateral alpha wrap pulleys 28520, 28530 can rotate approximately 330 degrees. This range of rotational travel is in contrast to a normal pulley that can have a range of rotational travel of less than 180 degrees of rotation.

[0305] Each of the first lateral alpha winding pulley 28520 and the second lateral alpha winding pulley 28530 further includes a corresponding screw closure cam configured to apply closure motions to the anvil 26210. As can be seen in FIG. 126 the first lateral alpha winding pulley 28520 includes a first screw closure cam 28526 and the second lateral alpha winding pulley 28530 has a second screw closure cam 28536 thereon. The screw closure cams 28526, 28536 are configured to cam interact with corresponding anvil closure arms 26234 on the anvil mounting portion 26230 of the anvil 26210 to apply closure motions to the anvil. See FIG. 119 Rotation of the pulley unit 28510 in a first rotational direction will cause the screw closure cams 28526, 28536 to cam the anvil 26210 into a closed position. To open the anvil 26210, the pulley unit 28510 is rotated in an opposite direction to position the screw closure cams 28526, 28536 in a position in which the anvil 26210 can be pivoted open by an anvil spring (not shown).

[0306] In the illustrated arrangement, the proximal attachment disc 28240, the proximal-most annular disc member 28210P, the annular proximal disc members 28210A, 28210B, 28210C, and the anvil mounting carriage 26240 all include fourth articulation cable conduits 28214 configured to allow each of the distal cable portions 28416, 28426, 28436, and 28446 to pass therethrough. FIG. 127 An articulation bar 28424 is shown that is slidably supported in a corresponding axial groove 28146 in the distal spine segment 28140 for axial travel therein. Each of the other articulation bars 28414, 28434, 28444 are similarly supported in axial grooves in the distal spine segment 28140 and corresponding grooves in the proximal spine segment 28120.

[0307] Reference is now made to FIG. 119 and FIG. 128 to FIG. 130The distal cable portion 28416 extends from the articulation bar 28414 through the articulation joint 28200 and around two redirecting pulleys 28550, 28560 supported on shafts 28502, 28512 rotatably mounted in the proximal end 26112 of the elongate channel 26110. The distal cable portion 28416 exits the articulation joint 28200 to be received within a first circumferential groove 28522 in a first transverse alpha wrap pulley 28520 in which it is secured. The distal cable portion 28426 extends from the articulation bar 28424 through the articulation joint 28200 to be received within a second circumferential groove 28524 in the first transverse alpha wrap pulley 28520 in which it is secured around the redirecting pulleys 28560, 28550.

[0308] In the illustrated example, the distal cable portion 28436 extends from the articulation bar 28434 through the articulation joint 28200 to be received within a corresponding circumferential groove 28534 in a second transverse alpha wrap pulley 28530 in which it is secured. In addition, the distal cable portion 28446 extends from the articulation bar 28444 through the articulation joint 28200 to be received within a corresponding circumferential groove 28532 in the second transverse alpha wrap pulley 28530 in which it is secured.

[0309] In at least one example, to articulate the surgical end effector 26000 relative to the elongate shaft assembly 28000 through a first articulation plane, the actuation cable control system 25030 is actuated to simultaneously pull the distal cable portion 28426 and the distal cable portion 28446, with each distal cable portion 28426, 28446 being applied with the same amount of tension. Because the distal cable portions 28426, 28446 apply equal amounts of tension on either side of the pulley unit 28510, the pulley unit 28510 does not rotate. However, the pulling action of the distal cable portions 28426, 28446 is translated through the articulation joint 28200 to the surgical end effector 26000, which causes the articulation joint 28200 to articulate through the first articulation plane. To articulate the surgical end effector 26000 through a second articulation plane that is transverse to the first articulation plane, the actuation cable control system 25030 is actuated to simultaneously pull the distal cable portion 28436 and the distal cable portion 28446, with each distal cable portion 28436 and 28446 being applied with the same amount of tension. Because the distal cable portions 28436, 28446 apply equal amounts of tension on either side of the pulley unit 28510, the second transverse alpha wrap pulley 25830, the pulley unit 28510 does not rotate. However, the pulling action of the distal cable portions 28436, 28446 is translated through the articulation joint 28200 to the surgical end effector 26000, which causes the articulation joint 28200 to articulate in the second articulation plane.

[0310] The cable control system 25030 can also be used to control the opening and closing of the anvil 26210 in the following manner. As described above, when the helical closure cams 28526 on the first lateral alpha wrap pulley 28520 and the second lateral alpha wrap pulley 28530 are in the first position, the anvil 26210 can be pivoted to an open position by one or more anvil springs (not shown) positioned in the proximal end 26112 of the elongated channel 26110 and positioned to contact the anvil mounting portion 26230 or the anvil closure arm 26234 to pivot the anvil 26210 to the open position. To close the anvil 26210 from this position, the cable control system 25030 is actuated to simultaneously pull the distal cable portion 28416 and the distal cable portion 28446, with each distal cable portion 28416 and 28446 being applied with the same amount of tension. These distal cable portions 28416, 28446 will cause the pulley unit 28510 to rotate, causing the helical closure cams 28526, 28536 to contact the anvil closure arm 26234 and cam the anvil 26210 to the closed position. It will be appreciated that by applying equal amounts of tension to the distal cable portions 28416, 28446, no moment is applied to the articulation joint 28200 because equal amounts of tension are applied on each side of the shaft axis SA. This arrangement allows the jaw closure to be shaped as desired. This cable control system 25030 can allow for faster closure when the anvil 26210 is fully open. The cable control system 25030 can also be used as a lower speed / higher force generation for the closure mechanism used to clamp onto tissue. This cable control system 25030 can not generate the recoil that other cable control systems typically occur and can therefore also be used to control the articulation position of the end effector. The articulation joint 28200 and the cable control system 25030 described above can facilitate multi-plane articulation while also providing additional actuation motions to the surgical end effector 26000.

[0311] As discussed above, many surgical end effectors employ a firing member that is pushed distally through a surgical staple cartridge by an axially movable firing beam. The firing beam is typically attached to the firing member in a central region of the firing member body. This attachment location can cause the firing member to be unbalanced as it is advanced through the end effector. This imbalance can cause undesirable friction between the firing member and the end effector jaw. The creation of this additional friction can require a higher firing force to be applied to overcome this friction and can cause undesirable wear to portions of the jaw and / or firing member. The application of a higher firing force to the firing beam can cause undesirable flexing of the firing beam as it traverses the articulation joint. This additional flexing can cause the articulation joint to disarticulate, particularly when the surgical end effector is articulated at a relatively high articulation angle. The surgical instrument 25010 employs a firing system 27000 that addresses, if not solves, many of these issues.

[0312] Referring now to FIG. 133 and FIG. 134 In at least one embodiment, the firing system 27000 includes a firing member 27100 that includes a vertically extending firing member body 27112 that includes a top firing member feature 27120 and a bottom firing member feature 27130. A tissue-cutting knife 27114 is attached to or formed in the vertically extending firing member body 27112. In at least one arrangement, the top firing member feature 27120 includes a top tubular body 27122 having a top axial conduit 27124 extending therethrough. See FIG. 134 The bottom firing member feature 27130 includes a bottom tubular body 27132 having a bottom axial conduit 27134 extending therethrough. In at least one arrangement, the top firing member feature 27120 and the bottom firing member feature 27130 are integrally formed with the vertically extending firing member body 27112. In at least one example, the anvil body 26212 includes an axially extending anvil slot that has a cross-sectional shape similar to a “keyhole” to accommodate the top firing member feature 27120 passing therethrough in various manners described herein. Similarly, the elongate channel 26110 includes an axially extending channel slot that also has a keyhole cross-sectional shape to accommodate the bottom firing member feature 27130 passing therethrough as described above.

[0313] In the illustrated arrangement, the firing system 27000 includes an upper firing assembly 27200 that operably interfaces with a top firing member feature 27120. The upper firing assembly 27200 includes an upper flexible outer tube or conduit 27210 that has a proximal end 27212 that is fixed to an upper insert 27214 that is immovably attached to a shaft spine assembly 28100. For example, the upper insert 27214 can be welded to the shaft spine assembly 28100, or otherwise attached thereto by an adhesive or other suitable fastener device. The flexible outer tube or conduit 27210 extends through an upper tube 28216 that is disposed through a proximal attachment disk assembly 28240, a proximal annular disk member 28210P, annular disk members 28210A, 28210B, 28210C, and an anvil mounting carriage 26240. A distal end 27216 of the flexible outer tube or conduit 27210 can be attached to the anvil mounting carriage 26240.

[0314] In the illustrated embodiment, the upper firing assembly 27200 further includes an upper push rod 27220 that is slidably supported in a corresponding axial tube in the shaft spine assembly 28100. The upper firing assembly 27200 further includes an upper push coil 27230 that is supported in an inner flexible upper sleeve 27240 that extends through the upper flexible outer tube or conduit 27210. A proximal end 27232 of the upper push coil 27230 and a proximal end 27242 of the inner flexible upper sleeve 27240 abut a distal end 27222 of the upper push rod 27220. The upper push coil 27230 is hollow and can comprise a helical spring made of Nitinol, Titanium, Stainless Steel, or the like. In other arrangements, the upper push coil 27230 comprises a laser cut "hypo tube" that essentially comprises a hollow tubular member with offset laser cuts therein that enable the hypo tube to flex and bend while being able to transmit axial forces or motions. The inner flexible upper sleeve 27240 can be made of a polymer or similar material and prevents tissue, fluids, and / or debris from seeping into the upper push coil 27230, which can compromise the ability of the upper push coil to flex and bend during articulation of the surgical end effector relative to the elongate shaft assembly.

[0315] As FIG. 134As can be seen, the distal end 27234 of the upper push coil 27230 and the distal end 27244 of the inner flexible upper sleeve 27240 abut the proximal end 27123 of the top tubular body 27122 or the top firing member feature 27120. Also in the illustrated arrangement, the upper firing assembly further includes an upper push coil cable 27250 that extends through the hollow upper push coil 27230. The upper push coil cable 27250 includes an upper cable proximal end 27252 that is fixed to the distal end 27222 of the upper push rod 27220 and an upper cable distal end 27254 that is fixed within a top axial conduit 27124 in the top tubular body 27122 of the top firing member feature 27120 by an upper attachment lug 27256. The upper push coil cable 27250 maintains tension between the top firing member feature 27120 and the upper push rod 27220 for maintaining the distal end 27234 of the upper push coil 27230 and the distal end 27244 of the inner flexible upper sleeve 27240 in abutting contact with the proximal end 27123 of the top tubular body 27122 of the top firing member feature 27120 and the proximal end 27232 of the upper push coil 27230, and the proximal end 27242 of the inner flexible upper sleeve 27240 in abutting contact with the distal end 27222 of the upper push rod 27220.

[0316] In the illustrated example, the firing system 27000 further includes a lower firing assembly 27300 that operably interfaces with the bottom firing member feature 27130. The lower firing assembly 27300 includes a lower flexible outer tube or conduit 27310 that has a proximal end 27312 that is fixed to a lower insert 27314 that is immovably attached to the shaft spine assembly 28100. For example, the lower insert 27314 can be welded to the shaft spine assembly 28100 or otherwise attached to the shaft spine assembly by adhesive or other suitable fastening means. The lower flexible outer tube or conduit 27310 extends through a lower conduit 28218 that is disposed in the proximal attachment disk assembly 28240, the proximal-most annular disk member 28210P, the annular disk members 28210A, 28210B, 28210C, and the anvil mounting bracket 26240. A distal end 27316 of the flexible outer tube or conduit 27310 is affixed to the anvil mounting bracket 26240.

[0317] In the illustrated embodiment, the lower firing assembly 27300 further includes a lower push rod 27320 that is slidably supported in a corresponding axial channel in the shaft spine assembly 28100. The lower firing assembly 27300 further includes a lower push coil 27330 that is supported in an inner flexible lower sleeve 27340 that extends through the lower flexible outer tube or conduit 27310. A proximal end 27332 of the lower push coil 27330 and a proximal end 27342 of the inner flexible lower sleeve 27340 abut a distal end 27322 of the lower push rod 27320. The lower push coil 27330 is hollow and can comprise a helical spring made of Nitinol, Titanium, Stainless Steel, or the like. In other arrangements, the lower push coil 27330 comprises a laser cut "hypo tube" that essentially comprises a hollow tubular member with offset laser cuts therein that enable the hypo tube to flex and bend. The inner flexible lower sleeve 27340 can be made of a polymer or similar material and prevents tissue, fluids, and / or debris from seeping into the lower push coil 27330, which can impair the ability of the upper push coil to flex during articulation.

[0318] As FIG. 134 As can be seen in the middle, a distal end 27334 of the lower push coil 27330 and a distal end 27344 of the inner flexible lower sleeve 27340 abut a proximal end 27133 of the bottom tubular body 27132 of the bottom firing member feature 27130. Also in the illustrated arrangement, the lower firing assembly 27300 further includes a lower push coil cable 27350 that extends through the hollow lower push coil 27330. The lower push coil cable 27350 includes a lower cable proximal end 27352 that is fixed to the distal end 27322 of the lower push rod 27320 and a lower cable distal end 27354 that is fixed within a lower axial channel 27134 in the bottom tubular body 27132 of the bottom firing member feature 27130 by a lower attachment lug 27356. The lower push coil cable 27350 maintains tension between the bottom firing member feature 27130 and the bottom push rod 27320 for maintaining the distal end 27334 of the lower push coil 27330 and the distal end 27344 of the inner flexible lower sleeve 27340 in abutting contact with the proximal end 27133 of the bottom tubular body 27132 of the bottom firing member feature 27130 and the proximal end 27332 of the lower push coil 27330, and the proximal end 27342 of the inner flexible lower sleeve 27340 in abutting contact with the distal end 27322 of the lower push rod 27320.

[0319] In the illustrated arrangement, the firing system 27000 further comprises a differential drive assembly 27400 that is configured to axially drive the upper firing assembly 27200 and the lower firing assembly 27300. Turning now to FIG. 136 to FIG. 139 In at least one arrangement, the proximal end 27224 of the upper push rod 27220 is coupled to a first or upper rack 27410 of the differential drive assembly 27400. As FIG. 136 As can be seen in FIG. 27, the first or upper rack 27410 is slidably supported in an upper proximal axial cavity 28122 in the proximal spine segment 28120. Similarly, the proximal end 27324 of the lower push rod 27320 is coupled to a second or lower rack 27420 that is supported for axial travel within a lower proximal axial cavity 28124 in the proximal spine segment 28120. The differential drive assembly 27400 further comprises an axially movable carrier member 27430 that is centrally disposed between the first or upper rack 27410 and the second or lower rack 27420 and is supported for axial travel within a proximal axial cavity 28126 in the proximal spine segment 28120. See FIG. 136 Still referring to FIG. 136 to FIG. 139 The pinion gear 27432 is pivotally pinned to the axially movable carrier member 27430 such that the pinion gear 27432 is in meshing engagement with the first or upper rack 27410 and the second or lower rack 27420. The axially movable carrier member 27430 is axially driven within the proximal axial cavity 28126 in the proximal spine segment 28120 by a firing drive actuator 27440. See FIG. 137 In one arrangement, the firing drive actuator 27440 comprises a firing drive rack 27442 that is drivingly interfaced with a drive gear 27444 that is driven by a firing motor 27446 that can be operably supported in or otherwise associated with a housing of the surgical instrument 25010. In other arrangements, the firing drive actuator 27440 can be axially driven distally and proximally by a cylinder arrangement or other suitable actuator interfaced therewith. As FIG. 137 to FIG. 139As can be seen, the firing drive actuator 27440 can be attached to the axially movable carrier member 27430 by a pair of spaced apart coupling pins 27448 that attach to the firing drive actuator 27440 and are received within corresponding axial slots 27434 in the axially movable carrier member 27430. This arrangement allows for some relative axial movement between the firing drive actuator 27440 and the axially movable carrier member 27430. For example, when the firing drive actuator 27440 is driven distally in the distal direction DD, the axially movable carrier member 27430 will not move distally until the coupling pins 27448 reach the distal end of their corresponding axial slots 27434, at which point the axially movable carrier member 27430 will move distally. Similarly, when the firing drive actuator 27440 is driven in the proximal direction PD, the axially movable carrier member 27430 will not move proximally until the coupling pins 27448 reach the distal end of their corresponding axial slots 27434, at which point the axially movable carrier member 27430 will move proximally.

[0320] Surgical stapling devices require a great deal of force to be exerted on the firing member to form the staples and cut the tissue as the device is passed through a long displacement. Transferring this force through an articulation joint is particularly challenging as it is difficult to redirect the force in the desired direction and it is difficult to bear the load exerted on it. The differential drive assembly 27400 described herein addresses and deals with many of these challenges by employing two flexible outer tubes or conduits 27210, 27310 to constrain the paths of the flexible push coils 27230, 27330, respectively. As described herein, the upper flexible outer tube or conduit 27210 surrounds a portion of the upper push coil 27230 and the upper flexible outer tube or conduit 27310 surrounds a portion of the lower push coil 27330. Each of the outer tubes or conduits 27210, 27310 can be bent, but they can also resolve axial tensile loads. The ability to bend allows the firing member force to be redirected through the articulation joint and the ability to resolve tension allows it to change the direction in which the push coils travel. When the push coils 27230, 27330 are in a compressed state, the flexible outer tubes or conduits 27210, 27310 are in tension. The outer tubes or conduits 27210, 27310 prevent the push coils 27230, 27330 from buckling. The outer tubes 27210, 27310 terminate in a manner that resolves tensile loads. As described above, the distal end 27216 of the flexible outer tube or conduit 27310 and the distal end 27316 of the flexible outer tube or conduit 27210 are both attached to the anvil mounting carriage 26240. The proximal end 27212 of the flexible outer tube or conduit 27210 and the proximal end 27312 of the flexible outer tube or conduit 27310 are both attached to the shaft spine assembly 28100. The pinion gear 27432 is in meshing engagement with the first or upper rack 27410 and the second or lower rack 27420 such that when one of the racks 27410, 27420 is moved in one axial direction, the other of the racks 27410, 27420 moves axially in the opposite direction. As FIG. 138 and FIG. 139 As can be seen in FIGS. 27-29, during articulation, the pinion gear 27432 rotates, thus the flexible outer tubes or conduits 27210, 27310 can move to account for changes in path length. However, when the firing drive actuator 27440 is driven in the distal direction DD, the axially movable carrier member 27430 is actuated, pushing the push coils 27230, 27330 distally through the outer tubes or conduits 27210, 27310, thus firing (i.e., driving the firing member 27100 distally) the two flexible outer tubes or conduits 27210, 27310. The tensile loads in the two flexible outer tubes or conduits 27210, 27310 react against each other while the pinion gear 27432 is not moved at all.

[0321] According to one general aspect, the upper tube 28216 forms an upper passageway 28221 through the articulation joint 28200 FIG. 117 ). Similarly, the lower tube 28218 forms a lower passageway 28223 through the articulation joint 28200. When the surgical end effector 26000 is in an unarticulated position (i.e., the surgical end effector is axially aligned with the elongate shaft assembly 28000 on the shaft axis SA FIG. 115 , FIG. 117 , FIG. 118 ) the upper passageway 28221 and the lower passageway 28223 are parallel to each other. See FIG. 22. FIG. 117 When the surgical end effector 26000 is in an articulated position relative to the elongate shaft assembly 28000, the upper passageway 28221 and the lower passageway 28223 are concentric with each other. See FIG. 23. FIG. 116 .

[0322] When the surgical end effector 26000 is in the non-articular position, the firing system 27000 can be actuated to drive the firing member 27100 from a starting position within the proximal end 26112 of the elongated channel 26110 to an ending position within the distal end 26114 of the elongated channel 26100. When the surgical end effector 26000 is in the non-articular position and the firing system 27000 is actuated, the differential drive assembly 27400 drives the upper firing assembly 27200 and the lower firing assembly 27300 by an equal axial distance in the same axial direction (i.e., distal direction DD) to apply upper and lower axial drive motions to the firing member 27100. The upper and lower axial drive movements are substantially equal in magnitude to propel the firing member 27100 distally through the surgical end effector 26000 without constraint, which would normally occur if the upper and lower axial drive movements were different in magnitude. Similarly, when the surgical end effector 26000 is in an articulated position relative to the elongated shaft assembly 28000, the firing system 27000 can be actuated to drive the firing member 27100 from a starting position to an ending position. In this case, the differential drive assembly 27400 is configured to allow the upper firing member 27200 and the lower firing member 27300 to move by substantially equal distances in opposite axial directions, thereby adapting to the articulated position. The differential drive assembly 27400 can then apply equal upper and lower axial drive movements to the firing member 27100. For example, depending on the articulated position of the surgical end effector 26000 relative to the elongated shaft assembly 28000, during articulation of the surgical end effector 26000, the upper firing assembly 27200 can move proximally a first distance, and the lower firing assembly 27300 can be positioned distally relative to the surgical end effector by means of the pinion 27432 a second distance, which is substantially equal to the first distance. Subsequently, distal actuation of the firing drive actuator 27440 will cause the upper firing assembly 27200 and the lower firing assembly 27300 to apply equal upper and lower axial drive movements to the firing member 27100. As used herein, when the carrier moves distally, the carrier can apply “axial control movement” to the upper firing assembly 27200 and the lower firing assembly 27300.Accordingly, the carrier can apply an equal amount of axial control motion to the upper and lower firing members in the same axial direction (distal direction DD) when the surgical end effector 26000 is in the unarticulated configuration, and the carrier can apply "other equal amounts" of axial control motion to the upper and lower firing members in the same axial direction (distal direction DD) when the surgical end effector 26000 is in the articulated configuration to move the firing member 27100 from the starting position to the ending position.

[0323] Example 1 - A surgical instrument comprising a surgical end effector comprising a firing member supported for axial travel within the surgical end effector between a starting position and an ending position. The surgical instrument further comprises an elongate shaft coupled to the surgical end effector by an articulation joint configured to facilitate selective articulation of the surgical end effector relative to the elongate shaft. The articulation joint is configured to establish an upper passage and a lower passage through the articulation joint. The upper and lower passages are parallel to each other when the surgical end effector is in an unarticulated position and concentric with each other when the surgical end effector is articulated relative to the elongate shaft assembly. The surgical instrument further comprises a firing system configured to selectively move the firing member between the starting position and the ending position. The firing system comprises an upper flexible firing assembly slidably extending through the upper passage and operably interfacing with a top portion of the firing member. A lower flexible firing assembly slidably extends through the lower passage and operably interfaces with a bottom portion of the firing member. The firing system further comprises a differential drive assembly supported proximal of the articulation joint and operably interfacing with the upper and lower firing assemblies such that when the surgical end effector is in the unarticulated position, the differential drive assembly is configured to drive the upper and lower flexible firing assemblies equal axial distances in the same axial direction to apply upper and lower axial drive motions to the firing member that are equal to each other. When the surgical end effector is in the articulated position, the differential drive assembly is configured to allow the upper and lower firing assemblies to move equal but opposite axial distances while applying upper and lower axial drive motions to the firing member.

[0324] Example 2 - The surgical instrument of Example 1, wherein the differential drive assembly comprises an axially movable carrier assembly in operable communication with the upper and lower flexible firing assemblies such that when the surgical end effector is in an unarticulated position relative to the elongate shaft assembly, the axially movable carrier assembly simultaneously applies equal amounts of axial control motion to the upper and lower flexible firing assemblies in the same axial direction to move the firing member from a starting position to an ending position. When the surgical end effector is in an articulated position relative to the elongate shaft assembly, the axially movable carrier assembly applies other equal amounts of axial control motion to the upper and lower flexible firing assemblies in the same axial direction to move the firing member from the starting position to the ending position.

[0325] Example 3 - The surgical instrument of Example 2, wherein the upper firing assembly proximal end portion comprises a first rack gear and the lower firing assembly proximal end portion comprises a second rack gear. The axially movable carrier assembly comprises an axially movable carrier member supported for axial travel relative to the first and second rack gears and comprising a rotatable pinion gear in meshing engagement with the first and second rack gears.

[0326] Example 4 - The surgical instrument of Example 3, wherein the axially movable carrier member comprises a carrier rack gear in meshing engagement with a motor-driven drive gear.

[0327] Example 5 - The surgical instrument of Example 4, wherein the upper flexible firing assembly further comprises an upper flexible coil member comprising an upper coil distal end and an upper coil proximal end. The upper coil distal end is in operable communication with the top portion of the firing member and the upper coil proximal end is coupled to the upper rack gear. The lower flexible firing assembly further comprises a lower flexible coil member comprising a lower coil distal end and a lower coil proximal end. The lower coil distal end is in operable communication with the bottom portion of the firing member and the lower coil proximal end is coupled to the lower rack gear.

[0328] Example 6 - The surgical instrument of Example 5, further comprising an upper cable extending through the upper flexible coil member and comprising an upper cable distal end and an upper cable proximal end. The upper cable distal end is coupled to the top portion of the firing member and the upper cable proximal end is in operable communication with the articulation source. The surgical instrument further comprises a lower cable extending through the lower flexible coil member and comprising a lower cable distal end and a lower cable proximal end. The lower cable distal end is coupled to the bottom portion of the firing member. The lower cable proximal end is in operable communication with the articulation source.

[0329] Example 7 - The surgical instrument of Examples 1, 2, 3, 4, 5, or 6, wherein the articulation joint comprises a series of movably interfacing annular disc members. Each annular disc member comprises a first face and a second face. The first face of one annular disc member is configured to movably interface with the second face of an adjacent annular disc member to facilitate relative movement between the annular disc member and the adjacent annular disc member in a plurality of directions. Each annular disc member has an upper opening extending therethrough such that the upper openings in each of the series of movably interfacing annular disc members cooperate to form an upper passageway for receiving an upper flexible firing assembly therethrough. Each annular disc member has a lower opening extending therethrough such that the lower openings in each of the series of movably interfacing annular disc members cooperate to form a lower passageway for receiving a lower flexible firing assembly therethrough.

[0330] Example 8 - The surgical instrument of Example 7, wherein the first face of each annular disc member comprises a centrally disposed spherical feature. The second face of each annular disc member comprises a centrally disposed spherical socket configured to movably receive the centrally disposed spherical feature of an adjacent annular disc member therein.

[0331] Example 9 - The surgical instrument of Example 8, further comprising means for limiting pivotal travel of the centrally disposed spherical feature within the centrally disposed spherical socket of an adjacent annular disc member to a predetermined range of pivotal travel.

[0332] Example 10 - The surgical instrument of Examples 7, 8, or 9, further comprising a resilient spacer member between each annular disc member.

[0333] Example 11 - The surgical instrument of Examples 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10, wherein the surgical end effector comprises a first jaw and a second jaw supported for movable travel relative to the first jaw between an open position and a closed position.

[0334] Example 12 - The surgical instrument of Examples 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11, further comprising a plurality of actuation cables configured to apply articulation motions to the surgical end effector to articulate the surgical end effector relative to the elongate shaft assembly.

[0335] Example 13 - The surgical instrument of Example 12, wherein the plurality of actuation cables are configured to apply opening motions to the surgical end effector to move the second jaw between the open position and the closed position.

[0336] Example 14 - A surgical instrument comprising a surgical end effector comprising a channel configured to operably support a surgical staple cartridge therein. The surgical end effector further comprises an anvil pivotally supported on the channel for movement relative to the surgical staple cartridge supported in the channel between open and closed positions. A tissue cuting member is supported for axial travel within the surgical end effector between a starting position and an ending position. The surgical instrument further comprises an elongated shaft assembly coupled to the channel by an articulation joint configured to facilitate selective articulation of the surgical end effector relative to the elongated shaft. The articulation joint is configured to establish an upper passageway and a lower passageway therethrough. The upper and lower passageways are parallel to each other when the surgical end effector is in an unarticulated position and concentric with each other when the surgical end effector is articulated relative to the elongated shaft assembly. A firing system is configured to selectively move the tissue cutting member between the starting position and the ending position. The firing system comprises an upper flexible coil member extending through the upper passageway and comprising an upper coil proximal end and an upper coil distal end. The upper coil distal end is coupled to a top portion of the tissue cutting member. The firing system further comprises a lower flexible coil member extending through the lower passageway and comprising a lower coil proximal end and a lower coil distal end. The lower coil distal end is coupled to a bottom portion of the tissue cutting member. A differential drive assembly is supported proximal to the articulation joint and operably interfaced with the upper and lower flexible coil members such that when the surgical end effector is in the unarticulated position, the differential drive assembly is configured to drive the upper and lower flexible coil members equal axial distances in the same axial direction to impart equal upper and lower axial drive motions to the tissue cutting member. When the surgical end effector is in an articulated position, the differential drive assembly is configured to allow the upper and lower flexible coil members to move equal but opposite axial distances while imparting equal upper and lower axial drive motions to the tissue cutting member.

[0337] Example 15 - The surgical instrument of Example 14, further comprising an upper axial push rod having an upper push rod proximal end operably interfacing with the differential drive assembly and an upper push rod distal end operably interfacing with the upper coil proximal end. An upper push coil cable extends through the upper flexible coil member and includes an upper cable distal end coupled to a top portion of the tissue cutting member and an upper cable proximal end coupled to the upper push rod distal end. The surgical instrument further comprises a lower axial push rod having a lower push rod proximal end operably interfacing with the differential drive assembly and a lower push rod distal end operably interfacing with the lower coil proximal end. A lower push coil cable extends through the lower flexible coil member and includes a lower cable distal end coupled to a bottom portion of the tissue cutting member and a lower cable proximal end coupled to the lower push rod distal end.

[0338] Example 16 - The surgical instrument of Example 15, wherein the upper flexible coil member and a portion of the upper axial push rod are constrained for axial movement within an upper outer tube member supported within an upper passage and including an upper tube member distal end supported within the surgical end effector and an upper tube member proximal end fixed within the elongate shaft assembly. The lower flexible coil member and a portion of the lower axial push rod are constrained for axial movement within a lower outer tube member supported within a lower passage and including a lower tube member distal end supported within the surgical end effector and a lower tube member proximal end fixed within the elongate shaft assembly.

[0339] Example 17 - The surgical instrument of Examples 15 or 16, wherein the differential drive assembly comprises an upper rack coupled to the upper push rod proximal end and a lower rack coupled to the lower push rod proximal end. A carrier is supported for axial movement relative to the upper and lower racks. The carrier includes a rotatable pinion gear in meshing engagement with the upper and lower racks.

[0340] Example 18 - The surgical instrument of Example 17, wherein the carrier further includes a carrier rack in meshing engagement with a motor-driven drive gear.

[0341] Example 19 - The surgical instrument of Examples 14, 15, 16, 17, or 18, further comprising a plurality of actuation cables extending through the elongate shaft assembly and the articulation joint to provide actuation motions to the surgical end effector.

[0342] Example 20 - A surgical instrument as described in Example 19, wherein the plurality of actuation cables are configured to apply articulation to the surgical end effector to articulate the surgical end effector relative to the elongate shaft assembly and to apply opening and closing motions to the anvil.

[0343] As used herein with respect to any aspect, the term "control circuitry" can refer to, for example, hardwired circuitry, programmable circuitry (e.g., a computer processor including one or more individual instruction processing cores, processing units, processors, microcontrollers, microcontroller units, controllers, digital signal processors (DSPs), programmable logic devices (PLD), programmable logic arrays (PLA), field programmable gate arrays (FPGA)), state machine circuitry, firmware that stores instructions executed by programmable circuitry, and any combination thereof. The control circuitry can be implemented in collective or individual pieces of circuitry forming a part of a larger system, such as an integrated circuit (IC), an application-specific integrated circuit (ASIC), a system-on-chip (SoC), a desktop computer, a laptop computer, a tablet computer, a server, a smart phone, and the like. As such, "control circuitry," as used herein, includes, but is not limited to, electronic circuitry having at least one discrete electrical circuit, electronic circuitry having at least one integrated circuit, electronic circuitry having at least one application specific integrated circuit (ASIC), electronic circuitry forming a general purpose computing device configured by a computer program (e.g., a general purpose computer configured by a computer program that at least partially embodies the methods described herein, or a microprocessor configured by a computer program that at least partially embodies the methods described herein), electronic circuitry forming a memory device (e.g., forms of random access memory), and / or electronic circuitry forming a communications device (e.g., a modem, a communications switch, or an optical-electrical device). Those skilled in the art will recognize that the subject matter described herein can be implemented in an analog or digital form, or a combination thereof, as some embodiments of the subject matter described herein can be implemented in one of these forms or combinations.

[0344] Although a number of forms have been illustrated and described, it is the applicant's intent that none of the claims below be limited to the details of any form described, but that the scope be given such breadth as would be accorded under the patent laws. Many modifications, variations, alterations, substitutions, combinations and equivalents will occur to those skilled in the art upon reading this disclosure. Further, it is intended that each element of each form described herein is implemented by equivalent structures as would be recognized by those skilled in the art. Additionally, where materials are disclosed, other materials of equivalent technical characteristics are intended to be included. Therefore, it is to be understood that the foregoing specific embodiments and the following claims are intended to cover all such modifications, combinations and variations as falling within the scope of the forms disclosed. It is intended that each claim cover all such modifications and variations as falling within the scope of the forms described herein. The claims are intended to cover all modifications and alterations of this form or their equivalents.

[0345] One or more components may be referred to herein as “configured to be,” “configurable to be,” “operable / operationally,” “suitable / adaptable,” “capable,” “adaptable / fittable,” etc. Those skilled in the art will recognize that, unless the context otherwise requires, “configured to be” generally encompasses components in an active state and / or in an inactive state and / or in a standby state.

[0346] 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.

[0347] 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".

[0348] 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.

[0349] 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.

[0350] Any patent application, patent, non-patent publication, or other disclosure material referred to in this specification, in any application data sheet, or in any correspondence, such as catalogs, brochures, or the like, is hereby incorporated by reference herein, only to the extent that the incorporated material is not inconsistent with the explicit teachings of this specification. Thus, and to the extent necessary, the disclosure herein supersedes any contradictory or inconsistent teachings of the incorporated material. Any material, or portion thereof, that is said to be incorporated by reference herein, but which contradicts the present definition, statement, or other disclosure material set forth herein, is only incorporated to the extent that the material is consistent with the explicit teachings of the present specification.

[0351] In general, an overall description of many of the advantageous effects resulting from the use of the concepts described herein has been presented. The foregoing detailed description has set forth various embodiments of the application via one or more forms. These embodiments are not intended to be exhaustive or to limit the application to the precise forms disclosed. Alterations, modifications, and variations will become apparent to those skilled in the art upon reading the foregoing detailed description. The one or more forms selected and described are for purposes of illustration and description and are not intended to limit the scope of the application to the precise form disclosed. The claims set forth below are what is intended as the complete scope of the application.

[0352] The surgical instrument systems described herein have been described in connection with the deployment and deformation of staples; however, the embodiments described herein are not so limited. For example, various embodiments are envisioned that deploy fasteners other than staples, such as clips or tacks. Further, various embodiments are also envisioned that utilize any suitable means for sealing tissue. For example, an end effector according to various embodiments can include electrodes configured to heat and seal tissue. Additionally, for example, an end effector according to certain embodiments can apply vibratory energy to seal tissue.

[0353] Many of the surgical instrument systems described herein are actuated by electric motors; however, the surgical instrument systems described herein can be actuated in any suitable manner. In various instances, for example, the surgical instrument systems described herein can be actuated by manually operated triggers. In certain instances, the motors disclosed herein can comprise part or parts of a robotic control system. Further, any of the end effector and / or tool assemblies disclosed herein can be used with a robotic surgical instrument system. For example, U.S. Patent Application Serial No. 13 / 118,241, entitled SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS, now U.S. Patent No. 9,072,535, discloses several examples of robotic surgical instrument systems in greater detail.

[0354] The entire disclosure of the following patents is hereby incorporated by reference herein:

[0355] U.S. Patent No. 5,403,312, entitled ELECTROSURGICAL HEMOSTATIC DEVICE, which issued on April 4, 1995;

[0356] U.S. Patent No. 7,000,818, entitled SURGICAL STAPLING INSTRUMENT HAVING SEPARATE DISTINCT CLOSING AND FIRING SYSTEMS, which issued on February 21, 2006;

[0357] U.S. Patent No. 7,422,139, entitled MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING INSTRUMENT WITH TACTILE POSITION FEEDBACK, which issued on September 9, 2008;

[0358] U.S. Patent No. 7,464,849, entitled ELECTRO-MECHANICAL SURGICAL INSTRUMENT WITH CLOSURE SYSTEM AND ANVIL ALIGNMENT COMPONENTS, which issued on December 16, 2008;

[0359] U.S. Patent No. 7,670,334, entitled SURGICAL INSTRUMENT HAVING AN ARTICULATING END EFFECTOR, which issued on March 2, 2010;

[0360] U.S. Patent No. 7,753,245, entitled SURGICAL STAPLING INSTRUMENTS, which issued on July 13, 2010;

[0361] U.S. Patent No. 8,393,514, entitled SELECTIVELY ORIENTABLE IMPLANTABLE FASTENER CARTRIDGE, which issued on March 12, 2013;

[0362] U.S. Patent Application Serial No. 11 / 343,803, entitled SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES, now U.S. Patent No. 7,845,537;

[0363] U.S. Patent Application Serial No. 12 / 031,573, entitled “SURGICAL CUTTING AND FASTENING INSTRUMENTHAVING RF ELECTRODES”, filed on February 14, 2008;

[0364] 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 ASURGICAL CUTTING AND STAPLING INSTRUMENT”.

[0365] The U.S. patent application serial number 12 / 235,782 entitled “MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT” is now U.S. Patent 8,210,411;

[0366] U.S. Patent Application Serial No. 12 / 235,972 entitled “MOTORIZED SURGICAL INSTRUMENT” is now U.S. Patent No. 9,050,083.

[0367] 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.

[0368] 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.

[0369] 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.

[0370] 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.

[0371] 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.

[0372] 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.

[0373] 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.

[0374] 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.

[0375] U.S. Patent Application No. 2007 / 0175955, filed January 31, 2006, entitled “SURGICAL CUTTING AND FASTENING INSTRUMENT WITH CLOSURE TRIGGER LOCKING MECHANISM”; and

[0376] 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.

[0377] While various devices have been described herein with regard to certain embodiments, many modifications and variations to these embodiments can be implemented. In one or more embodiments, specific structural and functional details disclosed herein are not to be interpreted as limiting, but merely as a basis for the claims and as a representative basis for teaching. Accordingly, the terms of a claim should not be construed as limiting the scope of the disclosure or of a claim. Features relating to one embodiment are, where applicable, combinable with features relating to other embodiments. In addition, where materials are disclosed for certain components, other materials can be used. Furthermore, in various embodiments, a single component can be replaced by multiple components, and multiple components can be replaced by a single component to perform the same function or functions. The foregoing detailed description and the following claims are intended to cover all such modifications and variations.

[0378] The devices disclosed herein can be designed to be disposed of after a single use, or they can be designed to be used multiple times. In either case, however, a device can be reconditioned for reuse after at least one use. Reconditioning can include any combination of the steps including, but not limited to, disassembly of the device, followed by cleaning and / or replacement of particular pieces, and subsequent reassembly of the device. In particular, a reconditioning facility and / or surgical team can disassemble a device and, after cleaning and / or replacing particular parts of the device, can reassemble the device for subsequent use. Those skilled in the art will appreciate that reconditioning of a device can utilize a variety of techniques for disassembly, cleaning / replacement, and reassembly. Use of such techniques, and the resulting reconditioned device, are all within the scope of the present application.

[0379] The devices disclosed herein can be processed before surgery. First, a new or used instrument can be obtained and, if necessary, cleaned. The instrument can then be sterilized. In one sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and instrument can then be placed in a field of radiation that can penetrate the container, such as gamma radiation, x-rays, and / or high-energy electrons. The radiation can kill bacteria on the instrument and in the container. The sterilized instrument can then be stored in the sterile container. The sealed container can keep the instrument sterile until it is opened in the medical facility. Sterilization can also be done using any other technique known in the art, including but not limited to beta radiation, gamma radiation, ethylene oxide, plasma, and / or steam.

[0380] While this application has been described as taking an exemplary design, the present application can be further modified within the spirit and scope of the disclosure. This application is therefore intended to cover any variations, uses, or adaptations of the application using its general principles.

Claims

1. A surgical instrument, comprising: A surgical end effector, the surgical end effector including a firing member supported for axial travel within the surgical end effector between a start position and an end position; Slender shaft assembly; An articulated joint is coupled to the surgical end effector and the elongated shaft assembly, wherein the articulated joint is configured to establish an upper passage and a lower passage through the articulated joint, wherein the upper passage and the lower passage are parallel to each other when the surgical end effector is in a non-articular position, and wherein the upper passage and the lower passage are concentric with each other when the surgical end effector is articulated relative to the elongated shaft assembly; and A firing system configured to selectively move the firing member between the starting position and the ending position, wherein the firing system includes: An upper flexible firing assembly, the upper flexible firing assembly being slidably extended through the upper passage and operably engaged with the top portion of the firing member; A lower flexible firing assembly, the lower flexible firing assembly slidably extending through the lower passage and operably engaging with the bottom portion of the firing member; and A differential drive assembly, supported proximal to the articulated joint and operably engaged with the upper and lower flexible firing assemblies, is provided such that when the surgical end effector is in the non-articular position, the differential drive assembly is configured to drive the upper and lower flexible firing assemblies by equal axial distances in the same axial direction to apply equal upper and lower axial drive movements to the firing member. Furthermore, when the surgical end effector is in the articulated position, the differential drive assembly is configured to allow the upper and lower flexible firing assemblies to move in equal but opposite axial directions while simultaneously applying the upper and lower axial drive movements to the firing member. The differential drive assembly includes an axially movable carrier component operably connected to each of the upper flexible firing assembly and the lower flexible firing assembly. This carrier component, when the surgical end effector is in the non-jointed position relative to the elongated shaft assembly, simultaneously applies equal amounts of axial control movement to both the upper and lower flexible firing assemblies in the same axial direction to move the firing member from the starting position to the ending position. Furthermore, when the surgical end effector is in the jointed position relative to the elongated shaft assembly, the axially movable carrier component applies other equal amounts of axial control movement to both the upper and lower flexible firing assemblies in the same axial direction to move the firing member from the starting position to the ending position. The upper flexible firing assembly includes an upper rack, the lower flexible firing assembly includes a lower rack, the axially movable load-bearing assembly includes an axially movable load-bearing member supported for axial travel relative to the upper rack and the lower rack, and the axially movable load-bearing member includes a rotatable pinion meshing with the upper rack and the lower rack.

2. The surgical instrument according to claim 1, wherein, The upper flexible firing assembly further includes an upper flexible coil member, the upper flexible coil member including a distal end of an upper coil and a proximal end of an upper coil, wherein the distal end of the upper coil is operatively connected to the top portion of the firing member, wherein the proximal end of the upper coil is connected to the upper rack, and wherein the lower flexible firing assembly further includes a lower flexible coil member, the lower flexible coil member including a distal end of a lower coil and a proximal end of a lower coil, wherein the distal end of the lower coil is operatively connected to the bottom portion of the firing member, and the proximal end of the lower coil is connected to the lower rack.

3. The surgical instrument of claim 2, further comprising an upper cable extending through the upper flexible coil member and including a distal end and a proximal end, wherein the distal end of the upper cable is coupled to the top portion of the firing member, and wherein the proximal end of the upper cable is operatively connected to a joint motion source, wherein the surgical instrument further comprises a lower cable extending through the lower flexible coil member and including a distal end and a proximal end, wherein the distal end of the lower cable is coupled to the bottom portion of the firing member, and wherein the proximal end of the lower cable is operatively connected to the joint motion source.

4. The surgical instrument according to claim 3, wherein, The articulated joint includes a series of movably connected annular disk members, each of the movably connected annular disk members including a first face and a second face. The first face of each movably connected annular disk member is configured to movably engage with the second face of an adjacent movably connected annular disk member to facilitate relative movement between the movably connected annular disk members and adjacent movably connected annular disk members in multiple directions. Each movably connected annular disk member includes an upper opening therethrough, allowing the series of movably connected annular disk members to... The upper opening in each of the movably connected annular disk members cooperates to form a series of upper passages through the movably connected annular disk members, the upper passages being for receiving the upper flexible firing assembly passing through them, wherein each of the movably connected annular disk members also includes a lower opening through it, such that the lower opening in each of the movably connected annular disk members cooperates to form a series of lower passages through the movably connected annular disk members, the lower passages being for receiving the lower flexible firing assembly passing through them.

5. The surgical instrument according to claim 4, wherein, The first face of each of the movably connected annular disk members includes a centrally located spherical feature, wherein the second face of each of the movably connected annular disk members includes a centrally located spherical recess, and wherein the centrally located spherical recess in each of the movably connected annular disk members is configured to movably receive the centrally located spherical feature of an adjacent movably connected annular disk member.

6. The surgical instrument according to claim 5, further comprising means for limiting the pivoting movement of the centrally located spherical feature within a centrally located spherical recess of an adjacent movably connected annular disc member to a predetermined pivoting range.

7. The surgical instrument of claim 5, further comprising an elastic spacer member between each of the movably connected annular disk members.

8. The surgical instrument according to claim 1, wherein, The surgical end effector includes: First jaws; and The second jaw is supported for movable movement relative to the first jaw between an open position and a closed position.

9. The surgical instrument of claim 8 further comprises a plurality of actuation cables configured to apply articulation to the surgical end effector to cause the surgical end effector to articulate relative to the elongated shaft assembly.

10. The surgical instrument according to claim 1, wherein, The surgical end effector further includes: A first jaw, the first jaw including a channel configured to operably support a surgical staple cartridge therein; The second jaw includes an anvil that is pivotally supported on the channel for movement between an open and closed position relative to a surgical cartridge supported in the channel. The firing component includes a tissue cutting component; The articular joint is connected to the channel of the surgical end effector; The upper flexible firing assembly includes an upper flexible coil component, which includes a proximal end and a distal end, wherein the distal end of the upper coil is connected to the top portion of the tissue cutting component; and The lower flexible firing assembly includes a lower flexible coil component, which includes a proximal end and a distal end of the lower coil, wherein the distal end of the lower coil is connected to the bottom portion of the tissue cutting component.

11. The surgical instrument of claim 10, further comprising: An upper axial push rod, the upper axial push rod including a proximal end and a distal end, the proximal end of the upper push rod being operably connected to the differential drive assembly, and the distal end of the upper push rod being operably connected to the proximal end of the upper coil; An upper push coil cable extends through the upper flexible coil member and includes a distal end and a proximal end of the upper cable. The distal end of the upper cable is connected to the top portion of the tissue cutting member, and the proximal end of the upper cable is connected to the distal end of the upper push rod. The lower axial push rod includes a proximal end and a distal end, the proximal end of which is operably connected to the differential drive assembly, and the distal end of which is operably connected to the proximal end of the lower coil. and A lower push coil cable extends through the lower flexible coil member and includes a distal end and a proximal end, the distal end of the lower cable being connected to the bottom portion of the tissue cutting member, and the proximal end of the lower cable being connected to the distal end of the lower push rod.

12. The surgical instrument according to claim 11, wherein, The upper flexible coil member and a portion of the upper axial push rod are constrained to move axially within the upper outer tube member, the upper outer tube member being supported within the upper passage and including a distal end of the upper tube member supported in the surgical end effector and a proximal end of the upper tube member fixed within the elongated shaft assembly, and wherein the lower flexible coil member and a portion of the lower axial push rod are constrained to move axially within the lower outer tube member, the lower outer tube member being supported within the lower passage and including a distal end of the lower tube member supported in the surgical end effector and a proximal end of the lower tube member fixed within the elongated shaft assembly.

13. The surgical instrument according to claim 12, wherein, The upper rack is connected to the proximal end of the upper push rod; and The lower rack is connected to the proximal end of the lower push rod.

14. The surgical instrument according to claim 1 or 13, wherein, The axially movable load-bearing component includes a load-bearing rack that meshes with a drive gear driven by a motor.

15. The surgical instrument of claim 10, further comprising a plurality of actuation cables extending through the elongated shaft assembly and the articular joint to provide actuation motion to the surgical end effector.

16. The surgical instrument according to claim 9 or 15, wherein, The plurality of actuation cables are configured to apply articulation to the surgical end effector, causing the surgical end effector to articulate relative to the elongated shaft assembly, and also to apply opening and closing motions to the second jaw.

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