Surgical instrument having a dual spherical articulation joint arrangement

Abstract

Surgical instruments having articulating joints are provided that include a proximal joint member defining a proximal face defining a proximal apex and a distal joint member defining a distal apex. A linkage assembly maintains the proximal apex and the distal apex in rolling interengagement. The linkage assembly includes first and second links coupled to the proximal joint member for pivotal travel relative to the proximal joint member about first and second proximal pivot axes. The first and second links are coupled to the distal joint member for pivotal travel relative to the distal joint member about first and second distal pivot axes.

Description

[0001] Cross-reference to related applications

[0002] This non-provisional application claims the benefit 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 ARRANGEMENTSFOR SURGICAL INSTRUMENTS”, filed July 28, 2020, the disclosures of which are incorporated herein by reference in their entirety. Background Technology

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

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

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

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

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

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

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

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

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

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

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

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

[0015] Figure 11 Is with Figure 9 A side front view of the firing component engaged by the rotary drive screw, as well as the upper flexible ridge assembly and the lower flexible ridge assembly;

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[0047] Figure 43 This occurs after the firing component has moved a short distance proximally to apply a rapid closing motion to the anvil in order to achieve a gripping effect. Figure 42 Another partial side view of the surgical end effector;

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

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

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

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

[0052] Figure 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 end view of a surgical end effector of a surgical instrument, wherein the jaws of the surgical end effector are in the closed position;

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[0082] Figure 78 It is a side view of a part of the rotary 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 instruments and end effector, wherein the anvil of the end effector is in the closed position;

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

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

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

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

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

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

[0092] Figure 88 yes Figure 87 Analyzed component view of surgical end effectors and surgical instruments;

[0093] Figure 89 yes Figure 87 A side front view of the joint motion joint of a surgical instrument;

[0094] Figure 90 yes Figure 89 A top view of the joint motion joint;

[0095] Figure 91 yes Figure 89 Joint kinematic joints and those used for... Figure 89 A perspective view of a cable-controlled closure pulley system that applies closing motion to the anvil of a surgical end effector;

[0096] Figure 92 Through Figure 89 The joint joint allows for joint movement. Figure 89 A perspective view of a portion of a surgical end effector;

[0097] Figure 93 yes Figure 91 Another perspective view of the cable-controlled closed pulley system;

[0098] Figure 94 yes Figure 93 An end view of the pulley unit of a cable-controlled pulley system;

[0099] Figure 95 yes Figure 94 A side front view of the first transverse α-wound pulley of the pulley unit;

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

[0101] Figure 97 yes Figure 96 The other side front view of the surgical end effector, with the anvil in the closed position;

[0102] Figure 98 yes Figure 87 A perspective view of a joint motion connector and cable-controlled closure system for a surgical instrument, wherein the central connector member and the distal connector member articulate relative to the proximal connector member of the joint motion connector.

[0103] Figure 99 yes Figure 87 Another perspective view of the articulation joint and cable-controlled closure system of a surgical instrument, wherein the distal joint member moves through the second articulation plane relative to the central joint member of the articulation joint.

[0104] Figure 100 yes Figure 87 A side front view of a portion of the firing drive system of a surgical instrument;

[0105] Figure 101 yes Figure 100 Another perspective view of the firing drive system, in which the upper link feature and the lower link feature are in the joint movement position;

[0106] Figure 102 yes Figure 100 Another side view of the firing drive system, wherein the upper link feature and the lower link feature are engaged with the rotary drive screw of the firing drive system;

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

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

[0109] Figure 105 yes Figure 87 An exploded view of the rotary drive system of a surgical instrument;

[0110] Figure 106 yes Figure 105 A perspective view of the first drive shaft section and the second drive shaft section of the rotary drive system;

[0111] Figure 107 yes Figure 87 A perspective view of a surgical end effector in which the rotary drive system is oriented for joint movement;

[0112] Figure 108 yes Figure 87 A disassembled component view of a part of the rotation drive system of a surgical instrument and a joint motion joint;

[0113] Figure 109 It is in a non-joint movement orientation. Figure 108 Cross-sectional view of the joint motion connector and rotary drive system;

[0114] Figure 110 yes Figure 109 Another cross-sectional view of the articulated joint and rotary drive system, wherein the proximal joint member of the articulated joint performs articulation relative to the central joint member of the articulated joint;

[0115] Figure 111 yes Figure 87 A partial side frontal view of a surgical instrument, which shows a form of cable tensioning system in which the surgical end effector is in a non-articular motion orientation;

[0116] Figure 112 yes Figure 111 Another partial side view of the surgical instruments and cable tensioning system, in which the surgical end effector is in the joint motion orientation;

[0117] Figure 113 yes Figure 87 A partial side frontal view of a surgical instrument, which shows another form of cable tensioning system in which the surgical end effector is in a non-articular motion orientation;

[0118] Figure 114 yes Figure 113 Another partial side view of the surgical instruments and cable tensioning system, in which the surgical end effector is in the joint motion orientation;

[0119] Figure 115 This is a perspective view of another surgical instrument implementation scheme;

[0120] Figure 116 yes Figure 115 A perspective view of a portion of a surgical instrument, wherein the surgical end actuator portion of the portion of the surgical instrument is in an articulated position relative to the elongated axial portion of the portion of the surgical instrument.

[0121] Figure 117 yes Figure 116A side front view of a surgical end effector, wherein the anvil of the surgical end effector is in the closed position;

[0122] Figure 118 yes Figure 117 A top view of the surgical end effector;

[0123] Figure 119 yes Figure 115 A perspective view of the disassembled components of a surgical instrument;

[0124] Figure 120 yes Figure 115 A cross-sectional view of the anvil portion and the bottom of the joint movement joint of a surgical instrument;

[0125] Figure 121 yes Figure 120 A breakdown view of the joint motion connector;

[0126] Figure 122 yes Figure 121 Side view of the annular disc component of the joint motion joint;

[0127] Figure 123 yes Figure 122 A perspective view of the annular disk component;

[0128] Figure 124 yes Figure 122 A view of the far side of the annular disk component;

[0129] Figure 125 yes Figure 122 A view of the near side of the annular disk component;

[0130] Figure 126 yes Figure 115 A top view of the pulley unit of a surgical instrument;

[0131] Figure 127 yes Figure 115 A perspective view of a portion of the joint joint and slender shaft assembly of a surgical instrument, wherein the outer shaft tube is omitted for clarity;

[0132] Figure 128 yes Figure 126 A side front view of the pulley unit;

[0133] Figure 129 yes Figure 126 The other side front view of the pulley unit;

[0134] Figure 130 yes Figure 115 The continuum axis of the joint motion joint of surgical instruments and Figure 126 A perspective view of the pulley unit;

[0135] Figure 131 yes Figure 115 A series of elastomeric annular spacer components for the joint motion joints of surgical instruments and Figure 126 Another perspective view of the pulley unit;

[0136] Figure 132 yes Figure 115 Another perspective view of the firing system, pulley unit, and articular joint of a surgical instrument;

[0137] Figure 133 yes Figure 115 A perspective view of a part of the firing system of a surgical instrument;

[0138] Figure 134 yes Figure 133 A partial cross-sectional view of the firing system;

[0139] Figure 135 yes Figure 115 Perspective view of the firing system, joint movement joint, and closure system of a surgical instrument;

[0140] Figure 136 yes Figure 115 A partial cross-sectional view of a surgical instrument, wherein the surgical end actuator of the surgical instrument is in a non-articular position;

[0141] Figure 137 yes Figure 115 A partial view of an implementation scheme for a differential drive assembly of a firing system for a surgical instrument;

[0142] Figure 138 yes Figure 115 Another partial cross-sectional view of a surgical instrument, wherein the surgical end actuator of the surgical instrument is in an articulated position;

[0143] Figure 139 yes Figure 115 Another partial cross-sectional view of the surgical instrument, wherein the surgical end actuator of the surgical instrument is in an articulated position;

[0144] Figure 140 This is a perspective view of another surgical instrument implementation scheme;

[0145] Figure 141 It is in a non-joint movement orientation. Figure 140 A perspective view of the joint motion joint of a surgical instrument;

[0146] Figure 142 It is in a different joint movement orientation. Figure 141 Another perspective view of the joint motion joint;

[0147] Figure 143 yes Figure 141 Exploded perspective view of the joint motion joint;

[0148] Figure 144 yes Figure 141 A top view of the joint motion joint;

[0149] Figure 145 It is along Figure 144 The line 145-145 is cut off. Figure 144 A cross-sectional view of the joint motion joint;

[0150] Figure 146 yes Figure 144 A side front view of the joint motion joint;

[0151] Figure 147 It is oriented towards joint movement. Figure 146 The other side front view of the joint motion joint;

[0152] Figure 148 It is in a different joint movement orientation. Figure 141 A perspective view of the joint motion joint;

[0153] Figure 149 It is in a different joint movement orientation. Figure 141 Another perspective view of the joint motion joint;

[0154] Figure 150 yes Figure 141 An end view of the proximal joint component of the articular motion joint;

[0155] Figure 151 yes Figure 141 An end view of the distal joint component of the articulated joint.

[0156] Figure 152 yes Figure 141 A perspective view of the proximal cross pin assembly of the joint motion joint;

[0157] Figure 153 This is a perspective view of another joint motion joint implementation scheme;

[0158] Figure 154 This is a perspective view of the joint motion joint portion of another surgical instrument implementation scheme;

[0159] Figure 155 yes Figure 154 Another perspective view of the joint motion joint arrangement, in which the outer shaft tube is omitted for clarity;

[0160] Figure 156 yes Figure 154 Exploded perspective view of the joint motion joint arrangement and firing drive system of surgical instruments.

[0161] Figure 157 yes Figure 156 A perspective view of the arrangement of the joint and firing system, wherein the outer shaft tube is omitted for clarity, and wherein the firing element is in the initial position;

[0162] Figure 158 This occurs after the firing mechanism has advanced to the far side position. Figure 157 Another perspective view of the joint motion joint and firing system;

[0163] Figure 159 yes Figure 154 A partial cross-sectional view of a portion of the firing system of a surgical instrument;

[0164] Figure 160 yes Figure 154 A partial view of the proximal differential drive assembly of a surgical instrument implementation scheme;

[0165] Figure 161 Is it through Figure 160 A cross-sectional end view of the proximal differential drive assembly;

[0166] Figure 162 yes Figure 154 Side front view of the joint motion joint and distal differential drive assembly of the surgical instrument;

[0167] Figure 163 It is oriented towards joint movement. Figure 162 A front view of the other side of the joint motion joint and the distal differential drive assembly;

[0168] Figure 164 When Figure 154 A partial graphical representation of the reaction force acting on the push coil of a surgical instrument when the joint joint of the surgical instrument is in the joint motion orientation and the firing component is being advanced distally;

[0169] Figure 165 When Figure 154 Another partial graphical representation of the reaction force acting on the flexible outer tube of a surgical instrument when the joint joint of the surgical instrument is in the joint motion orientation;

[0170] Figure 166 yes Figure 154 A perspective view of the central connecting rod component and flexible joint support assembly of a surgical instrument;

[0171] Figure 167 It is in a non-joint movement orientation. Figure 154 A side front view of the joint motion joint of a surgical instrument;

[0172] Figure 168 It is along Figure 167The line 168-168 is cut off. Figure 167 A cross-sectional view of the joint motion joint; and

[0173] Figure 169 It is oriented towards joint movement. Figure 154 A partial perspective view of the joint motion joint of a surgical instrument, in which the flexible joint support assembly is omitted for clarity. Detailed Implementation

[0174] The applicant of this application owns the following U.S. patent applications filed on the same date as this application, each of which is incorporated herein by reference in its entirety:

[0175] - A U.S. patent application entitled "SURGICAL INSTRUMENTS WITH TORSION SPINEDRIVE ARRANGEMENTS", agent file number END9248USNP1 / 200084-1;

[0176] - A U.S. patent application entitled "SURGICAL INSTRUMENTS WITH FIRING MEMBERCLOSURE FEATURES", agent file number END9248USNP2 / 200084-2;

[0177] - A U.S. patent application entitled "SURGICAL INSTRUMENTS WITH SEGMENTED FLEXIBLE DRIVEARRANGEMENTS", agent file number END9248USNP3 / 200084-3;

[0178] - A U.S. patent application entitled “SURGICAL INSTRUMENTS WITH FLEXIBLE BALL CHAIN ​​DRIVEARRANGEMENTS”, Agent’s File No. END9248USNP4 / 200084-4;

[0179] - A U.S. patent application entitled "SURGICAL INSTRUMENTS WITH DOUBLE SPHERICAL ARTICULATION JOINTS WITH PIVOTABLE LINKS", agent file number END9248USNP5 / 200084-5;

[0180] - A U.S. patent application entitled "SURGICAL INSTRUMENTS WITH DOUBLE PIVOT ARTICULATION JOINTARRANGEMENTS", agent file number END9248USNP6 / 200084-6;

[0181] - A U.S. patent application entitled "SURGICAL INSTRUMENTS WITH COMBINATION FUNCTION ARTICULATION JOINT ARRANGEMENTS", agent file number END9248USNP7 / 200084-7;

[0182] - A U.S. patent application entitled "METHOD OF OPERATING A SURGICAL INSTRUMENT", agent file number END9248USNP8 / 200084-8M;

[0183] - A U.S. patent application entitled "SURGICAL INSTRUMENTS WITH FLEXIBLE FIRING MEMBER ACTUATORCONSTRAINT ARRANGEMENTS", agent file number END9248USNP10 / 200084-10;

[0184] - U.S. patent application entitled "ARTICULATABLE SURGICAL INSTRUMENTS WITH ARTICULATION JOINTSCOMPRISING FLEXIBLE EXOSKELETON ARRANGEMENTS", Agent's File No. END9248USNP11 / 200084-11; and

[0185] - U.S. patent application entitled "SURGICAL INSTRUMENTS WITH DIFFERENTIAL ARTICULATION JOINTARRANGEMENTS FOR ACCOMMODATING FLEXIBLE ACTUATORS", Agent's File No. END9248USNP12 / 200084-12.

[0186] This document sets forth numerous specific details to provide a thorough understanding of the overall structure, function, manufacture, and use of the embodiments described in the specification and illustrated in the figures. Well-known operations, components, and elements are not described in detail to avoid obscuring the embodiments described in the specification. The reader will understand that the embodiments described and illustrated herein are non-limiting examples, and thus will recognize that the specific structural and functional details disclosed herein are representative and illustrative. Variations and changes may be made to these embodiments without departing from the scope of the claims.

[0187] The terms “comprise” (and any form of “comprise”, such as “comprises” and “comprising”), “have” (and any form of “have”, such as “has” and “having”), “include” (and any form of “include”, such as “includes” and “including”), and “contain” (and any form of “contain”, such as “contains” and “containing”) are open-ended linking verbs. Therefore, a surgical system, apparatus, or device that “comprises,” “haves,” “includes,” or “contains” one or more elements has, but is not limited to, having only those elements. Similarly, the elements of a system, apparatus, or device that “comprises,” “haves,” “includes,” or “contains” one or more features have, but are not limited to, having only those features.

[0188] The terms "proximal" and "distal" are used herein in relation to the clinician manipulating the handle portion of the surgical instrument. "Proximal" refers to the portion closest to the clinician, and "distal" refers to the portion furthest from the clinician's position. It should also be understood that, for brevity and clarity, spatial terms such as "vertical," "horizontal," "upper," and "lower" may be used in conjunction with accompanying drawings. However, surgical instruments are used in many orientations and locations, and these terms are not restrictive and / or absolute.

[0189] References to singular items should be understood to include plural items, and vice versa, unless otherwise explicitly stated or clearly evident from the text. Grammatical conjunctions are intended to express any and all transitions and connecting combinations of clauses, sentences, words, etc., unless otherwise stated or clearly evident from the context. Therefore, the term "or" should generally be understood to mean "and / or," etc.

[0190] Unless otherwise specified herein, the numerical ranges listed herein are not intended to be limiting, but rather refer individually to any or all values ​​falling within that range, and each individual value within that range is incorporated into this disclosure as individually referenced herein. When used with numerical values, the terms “about,” “approximately,” etc., should be interpreted as indicating a deviation as would be understood by one of ordinary skill in the art for satisfactory use for the intended purpose. Similarly, when used with reference to physical characteristics, approximate terms such as “about” or “substantially” should be interpreted as envisioning a range of deviations as would be understood by one of ordinary skill in the art for satisfactory use for the corresponding application, function, purpose, etc.

[0191] Any and all examples or exemplary language (“e.g.,” “such as,” etc.) provided herein are intended merely to better illustrate embodiments and are not intended to limit the scope of embodiments. No language in the specification should be construed as indicating that any element not protected by the claims is necessary for implementing the embodiments.

[0192] Various exemplary apparatuses and methods are provided for performing laparoscopic and minimally invasive surgical procedures. However, the reader will readily understand that the various methods and apparatuses disclosed herein can be used in a wide range of surgical procedures and applications, including, for example, in combination with open surgery. Continuing to refer to this specific embodiment, the reader will further understand that the various instruments disclosed herein can be inserted into the body in any manner, such as through natural cavities, through incisions or puncture holes formed in tissue, etc. The working portion or end effector portion of the instrument can be inserted directly into the patient's body or through an access device having a working channel through which the end effector and elongated shaft of the surgical instrument can be advanced.

[0193] During various laparoscopic surgical procedures, it is common practice to access surgical sites located within the patient's abdomen by inserting the surgical end-effector portion of a surgical instrument through a cannula already embedded in the patient's abdominal wall. In its simplest form, the cannula is a pen-shaped instrument with a sharp triangular dot at one end, typically used within a hollow tube called a cannula or trocar to form an opening into the body through which the surgical end-effector is introduced. This arrangement forms an entrance into the body cavity through which the surgical end-effector is inserted. The inner diameter of the cannula inevitably limits the size of the end-effector and drive support shaft of the surgical instrument that can be inserted through the cannula.

[0194] Regardless of the specific type of surgical procedure performed, once a surgical end effector is inserted into the patient through a cannula, it is typically necessary to move the end effector relative to the shaft assembly positioned within the cannula in order to properly position the end effector relative to the tissue or organ being treated. This movement or positioning of the end effector relative to the shaft portion held within the cannula is generally referred to as the "articular movement" of the end effector. Various articulation joints have been developed to attach the end effector to the associated shaft to facilitate this articulation. It is anticipated that in many surgical procedures, the use of surgical end effectors with the largest possible range of articulation is desirable.

[0195] Due to the dimensional constraints imposed by the size of the cannula sheath, the dimensions of the articulation joint components must be configured to allow free insertion through the cannula sheath. These dimensional constraints also limit the size and composition of various drive members and components that operatively interact with a motor and / or other control system supported in a housing, which may be handheld or part of a larger automated system. In many cases, these drive members must operatively pass through the articulation joint to be operatively coupled to or operatively interact with a surgical end effector. For example, one such drive member is typically used to apply articulated motion control to a surgical end effector. During use, the articulation drive member may be deactivated to position the surgical end effector in a non-articular position to facilitate insertion of the surgical end effector through the cannula, and then actuated to articulate the surgical end effector to the desired position as it enters the patient's body.

[0196] Therefore, the aforementioned dimensional constraints pose numerous challenges to the development of articulation systems that can achieve the desired range of motion and are suitable for the various drive systems required to manipulate the different features of a surgical end effector. Furthermore, once the surgical end effector is positioned in the desired articulation location, the articulation system and articulation joint must be able to hold the surgical end effector in that locked position during actuation of the end effector and completion of the surgical procedure. Such an articulation joint arrangement must also be able to withstand the external forces experienced by the end effector during use.

[0197] Various surgical end effectors exist that are configured to cut and suture tissue. Such surgical end effectors typically include a first jaw feature supporting a surgical cartridge and a second jaw including an anvil. The jaws are supported relative to each other, allowing them to move between an open and closed position to position and hold target tissue therebetween. Many of these surgical end effectors employ an axially moving firing member. In some end effector designs, the firing member is configured to engage the first and second jaws such that when the firing member is initially advanced distally, it moves the jaws to a closed position. Other end effector designs employ a separate closure system independent of and different from the system operating the firing member.

[0198] The staple cartridge includes a cartridge body. The cartridge body includes a proximal end, a distal end, and a platform extending between the proximal and distal ends. In use, the staple cartridge is positioned on a first side of the tissue to be sutured, and an anvil is positioned on a second side of the tissue. The anvil moves toward the staple cartridge to compress the tissue and clamp it against the platform. Staples, removably stored in the cartridge body, can then be deployed into the tissue. The cartridge body includes staple cavities defined within the cartridge body, in which staples are removably stored. The staple cavities are arranged in six longitudinal rows. Three rows of staple cavities are positioned on a first side of the longitudinal slots, and three rows of staple cavities are positioned on a second side of the longitudinal slots. Other arrangements of the staple cavities and staples are also possible.

[0199] The nail is supported by a nail actuator within the cartridge. The actuator is movable between a first or non-firing position and a second or firing position to eject the nail from the cartridge. The actuator is retained within the cartridge by a retainer extending around the bottom of the cartridge and including a resilient member configured to grip the cartridge and hold the retainer to the cartridge. The actuator is movable between its non-firing position and its firing position by a slider. The slider is movable between a proximal position adjacent to the proximal end and a distal position adjacent to the distal end. The slider includes multiple ramp surfaces configured to slide beneath the actuator toward the anvil and to lift the actuator, on which the nail is supported.

[0200] In addition to the above, in these surgical end effectors, a slider moves distally via a firing member. The firing member is configured to contact the slider and push it distally. A longitudinal slot defined in the cartridge is configured to receive the firing member. The anvil also includes a slot configured to receive the firing member. The firing member also includes a first cam engaging a first jaw and a second cam engaging a second jaw. As the firing member advances distally, the first and second cams control the distance or tissue gap between the cartridge platform and the anvil. The firing member also includes a blade configured to cut into tissue captured between the cartridge and the anvil. It is desirable that the blade be positioned at least partially close to the ramp surface so that the staples are fired before the blade.

[0201] Many surgical end effectors employ an axially movable firing beam attached to a firing member and used to apply axial firing and retraction motion to the firing member. Many such firing beams include a laminated construction that allows for a degree of deflection around the articulated joint. When the firing beam traverses the articulated joint, it can apply disjoint forces to the joint and cause beam buckling. To prevent buckling under pressure, the articulated joint typically features a transverse support or "blowout" plate feature to support the portion of the beam that traverses the articulated joint. For example, a significant axial force is required to advance the firing beam through angles greater than sixty degrees. This axial force must be applied in a balanced manner to the firing member to prevent engagement with the jaws as the firing member moves distally. Any engagement between the firing member and the jaws can lead to component damage and wear, and requires an increased amount of axial drive force to propel the firing member through the gripped tissue.

[0202] Other end effector designs employ a firing member driven by rotary power. In many of these designs, a rotary drive shaft extends through a joint and engages with a rotatable firing member drive shaft, which is rotatably supported within one jaw of the jaws. The firing member is threadedly engaged with the rotatable firing member drive shaft, and as the rotatable firing member drive shaft rotates, the firing member is driven through the end effector. This arrangement requires a larger support jaw to accommodate the firing member drive shaft. In such devices, the lower end of the firing member is typically operably engaged with the drive shaft, which can also result in the application of forces that tend to unbalance the firing member when it is driven distally.

[0203] Figures 1 to 4A surgical instrument 10 is illustrated that addresses many of the challenges faced by surgical instruments with articulated end effectors configured to cut and fasten tissue. In various embodiments, the surgical instrument 10 may include a handheld device. In other embodiments, the surgical instrument 10 may include 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 operatively coupled to an elongated shaft assembly 2000. The elongated shaft assembly 2000 may be operatively attached to a housing 2002. In one embodiment, the housing 2002 may include a handle configured to be grasped, manipulated, and actuated by a clinician. In other embodiments, the housing 2002 may include housing or otherwise operatively support a portion of a robotic system, the at least one drive system being configured to generate and apply at least one control motion that can be used to actuate the surgical end effector disclosed herein and its 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 the housing or may be directly supported by the housing. For example, the surgical instruments disclosed herein can be used with various robotic systems, instruments, components, and methods disclosed in U.S. Patent No. 9,072,535 entitled “SURGICAL STAPLING INSTRUMENTS WITHROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS,” the entire contents of which are incorporated herein by reference.

[0204] In one embodiment, the surgical end effector 1000 includes a first jaw 1100 and a second jaw 1200. In the illustrated arrangement, the first jaw 1100 includes an elongated channel 1110 comprising a proximal end 1112 and a distal end 1114 and is configured to operably support a surgical cartridge 1300 therein. The surgical cartridge 1300 includes a body 1302 having an elongated slot 1304 therein. A plurality of surgical staples or fasteners (not shown) are stored in the body on actuators (not shown) arranged in rows on each side of the elongated slot 1304. Each actuator is associated with a corresponding staple cavity 1308 exposed via a cartridge platform surface 1306. The surgical cartridge 1300 can be replaced after the staples / fasteners have been ejected therefrom. Other embodiments are contemplated in which the elongated channel 1110 and / or the entire surgical end effector 1000 can be discarded after the surgical cartridge 1300 has been used. For example, such an end effector arrangement can be referred to as a "one-time loading unit".

[0205] 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 within 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.

[0206] like Figure 5 and Figure 6 As can be seen, the proximal end 1214 of the anvil body 1212 includes an anvil mounting portion 1230, which includes a pair of laterally extending mounting pins 1232 configured to be received in corresponding mounting brackets or pivot brackets 1120 formed in the proximal end 1112 of the elongated channel 1110. The mounting pins 1232 are pivotally held within the mounting brackets 1120 by an anvil top cover 1260, which is attached to the proximal end 1112 of the elongated channel 1110 via a mechanical snap-fit ​​feature 1261 configured to engage a retaining structure 1113 on the elongated channel 1110. See also Figure 5 In other arrangements, the anvil top cover 1260 can be attached to the elongated channel 1110 by welding, adhesive, etc. This arrangement facilitates the anvil 1210 in the open position relative to the surgical staple cartridge 1300 mounted in the elongated channel 1110 about the pivot axis PA. Figure 1 ) and closed position ( Figures 2 to 5The pivot axis PA is referred to as "fixed" in this document because the pivot axis does not translate or otherwise move when the anvil 1200 pivots from the open position to the closed position.

[0207] In the illustrated arrangement, the elongated shaft assembly 2000 defines an axis SA and includes a proximal shaft portion 2100 operably engageable with the housing of a control portion of the surgical instrument 10 (e.g., a handheld unit, robotic tool actuator, etc.). The elongated shaft assembly 2000 also includes an articulated joint 2200 attached to the proximal shaft portion 2100 and the surgical end effector 1000. In various cases, the proximal shaft portion 2100 includes a hollow outer tube 2110 operably coupled to the housing 2002. See also Figure 2 .like Figure 6 As can be seen, the proximal shaft portion 2100 may further include a rigid proximal support shaft 2120, which is supported within the hollow outer tube 2110 and extends from the housing to the articulated joint 2200. The proximal support shaft 2120 may include a first half 2120A and a second half 2120B that can be joined together by, for example, welding, adhesive, etc. The proximal support member 2120 includes a proximal end 2122 and a distal end 2124, and includes an axial conduit 2126 extending from the proximal end 2122 through it to the distal end 2124.

[0208] As discussed above, many surgical end effectors employ a firing member that is pushed distally through the surgical cartridge by a firing beam capable of axial movement. The firing beam is typically attached to the firing member in the central region of the firing member body. This attachment location can cause imbalance in the firing member as it is advanced through the end effector. This imbalance can induce undesirable friction between the firing member and the end effector jaws. This additional friction may require a higher firing force to overcome, and can cause undesirable wear on the jaws and / or portions of the firing member. Applying a higher firing force to the firing beam can cause undesirable deflection of the firing beam as it traverses the articulation joint. This additional deflection can cause the articulation joint to disengage from the joint, particularly when the surgical end effector performs joint movements at relatively high angles of articulation. Surgical instrument 10 employs a firing system 2300, which, while not solving all these problems, addresses many of them, as well as others.

[0209] like Figures 5 to 11As can be seen, in at least one embodiment, the firing system 2300 includes a firing member 2310, which includes a vertically extending firing member body 2312, the firing member body including a top firing member feature 2320 and a bottom firing member feature 2350. A tissue cutting blade 2314 is attached to or formed within the vertically extending firing member body 2312. See also... Figure 9 and Figure 11 In at least one arrangement, it is desirable for the firing member 2310 to pass through the anvil body 1212 with low friction, high strength, and high stiffness. In the illustrated arrangement, the top firing member feature 2320 includes a top tubular body 2322 having a top axial conduit 2324 extending therethrough. See also Figure 10 The bottom firing member feature 2350 includes a bottom tubular body 2352 having a bottom axial conduit 2354 extending therethrough. In at least one arrangement, the top firing member feature 2320 and the bottom firing member feature 2350 are integrally formed with a vertically extending firing member body 2312. Figure 12 As can be seen, the anvil body 1212 includes an axially extending anvil slot 1240 having a cross-sectional shape similar to a "keyhole". Similarly, the elongated channel 1110 includes an axially extending channel slot 1140 that also has a keyhole cross-sectional shape.

[0210] Traditional firing mechanism arrangements employ long, flexible cantilevered wings extending from the top and bottom portions of the firing mechanism. These cantilevered wings slide through slots in the anvil and channel, which are typically cut with a rectangular T-cutter, often resulting in high-friction surfaces. Such long cantilevered wings have minimal surface areas in contact with the anvil and channel, leading to abrasion of these components. The keyhole-shaped channel slot 1140 and the keyhole-shaped anvil slot 1240 can be cut with a circular T-cutter and can be finished with a reamer / drill, resulting in lower-friction surfaces. Furthermore, the top tubular body 2322 and 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, reducing abrasion and creating a stronger sliding connection. In other words, because the anvil slot 1240 and the channel slot 1140 are keyhole shaped and remove less material than conventional rectangular slots, the geometry and the added material allow for a more rigid anvil and channel compared to existing arrangements.

[0211] Go to Figures 9 to 11In one arrangement, the firing system 2300 further includes an upper flexible spine assembly 2400 operably coupled to a top firing member feature 2320 and a lower flexible spine assembly 2500 operably coupled to a bottom firing member feature 2350. In at least one embodiment, the upper flexible spine assembly 2400 includes an upper series 2410 of upper vertebral members 2420 loosely coupled together via an upper flexible connector member 2402 attached to the top firing member feature 2320. The upper flexible connector member 2402 may include a top cable 2404 extending through a top axial conduit 2324 in the top firing member feature 2320, and a distal end 2406 of the top cable 2404 is attached to a retainer collar 2408 fixed to the top axial conduit 2324.

[0212] like Figure 13 As can be seen, each upper vertebral component 2420 includes an upper vertebral body portion 2422 having a proximal end portion 2424 and a distal end portion 2428. An upper hollow conduit 2429 extends through the upper vertebral body portion 2422 to accommodate an upper flexible connector component 2402 passing therethrough. Each upper vertebral component 2420 also includes a downwardly extending upper drive feature or upper vertebral component tooth 2450 projecting from the upper vertebral body portion 2422. Each upper vertebral component tooth 2450 has a helical proximal upper face portion 2452 and a helical distal upper face portion 2454. Each proximal end portion 2424 of the upper vertebral body portion 2422 has an upper proximal mating feature 2426 therein, and each distal end portion 2428 has an upper distal mating feature 2430 therein. In at least one embodiment, the upper proximal mating feature 2426 includes a concave recess 2427, and each upper distal mating feature 2430 includes a convex protrusion 2431. When arranged in the upper series 2410, the convex protrusion 2431 on one upper vertebral member 2420 contacts and engages with the concave recess 2427 on an adjacent upper vertebral member 2420 in the upper series 2410 to maintain the upper vertebral members 2420 generally aligned, such that the helical proximal upper face portion 2452 and the helical distal upper face portion 2454 on each corresponding upper tooth 2450 can be induced to engage by a rotary drive screw 2700, as will be discussed in further detail below.

[0213] Similarly, in at least one embodiment, the lower flexible spine assembly 2500 includes a lower series 2510 of lower vertebral members 2520, which are loosely connected together by a lower flexible connector member 2502 attached to the bottom firing member feature 2350. The lower flexible connector member 2502 may include a lower cable 2504 extending through a bottom axial conduit 2354 in the bottom firing member feature 2350, and a distal end 2506 of the bottom cable 2504 is attached to a retainer collar 2508 fixed to the bottom axial conduit 2354.

[0214] like Figure 14 As can be seen, each lower vertebral component 2520 includes a lower vertebral body portion 2522 having a proximal end portion 2524 and a distal end portion 2528. A lower hollow conduit 2529 extends through the lower vertebral body portion 2522 to accommodate a lower flexible connector component 2502 passing therethrough. Each lower vertebral component 2520 also includes an upwardly extending lower drive feature or lower vertebral component tooth 2550 projecting upward from the lower vertebral body portion 2522. Each lower vertebral component tooth 2550 has a helical proximal lower face portion 2552 and a helical distal lower face portion 2554. Each proximal end portion 2524 of the lower vertebral body portion 2522 has a lower proximal mating feature 2526 therein, and each distal end portion 2528 has a lower distal mating feature 2530 therein. In at least one embodiment, the lower proximal mating feature 2526 includes a concave recess 2527, and each lower distal mating feature 2530 includes a convex protrusion 2531. When arranged in the lower series 2510, the convex protrusion 2531 on one lower vertebral member 2520 contacts and engages with the concave recess 2527 on an adjacent lower vertebral member 2520 in the lower series 2510 to maintain the lower vertebral members 2520 generally aligned, such that the helical proximal lower face portion 2552 and the helical distal lower face portion 2554 on each corresponding lower vertebral member tooth 2550 can be induced to engage by a rotary drive screw 2700, as will be discussed in further detail below.

[0215] Now go to Figure 5 , Figure 7 and Figure 8In at least one arrangement, the firing drive system 2300 further includes a rotary drive screw 2700 configured to be drivably engaged with the upper series 2410 of the upper vertebral member 2420 and the lower series 2510 of the lower vertebral member 2520. In the illustrated arrangement, the rotary drive screw 2700 is driven by a rotary drive system 2600 including a proximal rotary drive shaft 2610 rotatably supported within an axial conduit 2126 within a proximal support shaft 2120. See also Figure 7 The proximal rotary drive shaft 2610 includes a proximal end 2612 and a distal end 2614. The proximal end 2612 may engage with a gearbox 2004 or other arrangement driven by a motor 2006 or other rotary motion source housed in a surgical instrument housing. See also Figure 2 This rotational motion source causes the proximal rotational drive shaft to rotate about the axis SA within the axial conduit 2126 in the proximal support shaft 2120.

[0216] The proximal rotary drive shaft 2610 is operatively supported within the elongated shaft assembly 2000 at a location adjacent to the articulated joint 2200, and is operatively engaged with a constant velocity (CV) drive shaft assembly 2620 that "crosses" or extends axially through the articulated joint 2200. Figure 8 , Figure 16 and Figure 17 As can be seen, in at least one arrangement, the CV drive shaft assembly 2620 includes a proximal CV drive assembly 2630 and a distal CV drive shaft 2670. The proximal CV drive assembly 2630 includes a proximal shaft section 2632 formed by an attachment shaft 2634 configured to be non-rotatably received within a similarly shaped connector cavity 2616 in the distal end 2614 of the proximal rotary drive shaft 2610. The proximal shaft section 2632 is operatively engaged with a series 2640 of movably coupled drive joints 2650.

[0217] like Figure 18 As can be seen, in at least one arrangement, each drive connector 2650 includes a first or distal spherical portion 2660 and a second or proximal spherical portion 2652. The distal spherical portion 2660 is larger than the proximal spherical portion 2652. The distal spherical portion 2660 includes a socket 2662 configured to rotatably receive a proximal spherical portion 2652 of an adjacent drive connector 2650 therein. Each proximal spherical portion 2652 includes a pair of diametrically opposed engagement pins 2654 configured to movably receive in corresponding pin slots 2664 in the distal spherical portion 2660 of an adjacent drive connector 2650, such as... Figure 16As can be seen in the image. The proximal spherical portion 2652P of the nearest-side drive connector 2650P is rotatably received in the distal socket portion 2636 of the proximal shaft section 2632, as shown in the image. Figure 16 As shown. The engaging pin 2654P is received within the corresponding pin slot 2637 in the distal socket portion 2636. As... Figure 16 As can be further seen, the farthest drive connector 2650D in the series 2640 of the movably connected drive connector 2650 is movably connected to the far CV drive shaft 2670.

[0218] In at least one arrangement, the distal CV drive shaft 2670 includes a proximal spherical portion 2672, which is sized to be movably received in a socket 2662D in the distal drive joint 2650D. The proximal spherical portion 2672 includes an engagement pin 2674, which is movably received in a pin slot 2664D in the distal drive joint 2650D. The distal CV drive shaft 2670 also includes a distally extending shaft 2676 configured to be non-rotatably coupled to a rotary drive screw 2700 positioned distal to the articulated joint 2200. The distal CV drive shaft 2670 includes a flange 2677 and a mounting sleeve portion 2678 for receiving a thrust bearing housing 2680 thereon.

[0219] In the illustrated arrangement, when the series 2640 of the movably connected drive joints 2650 undergoes articulation, the engagement pin 2674 remains in the corresponding pin slot 2664 of the adjacent drive joint 2650. Figure 18 In the example shown, each drive joint may be able to make approximately 18 degrees of articulation in both the pitch and yaw directions. Figure 16 The angles of the series 2640 of drive joints 2650 are shown, where each drive joint 2650 in this series makes a full articulation of 90 degrees in both the pitch and yaw directions, resulting in an angle α of approximately 100.9 degrees. In this arrangement, the outer surface of each distal spherical portion 2660 extends over the outer surface of the adjacent or contiguous proximal spherical portion 2652, thus allowing unrestricted movement up to an 18-degree limit. The rigid design and limited small angles allow the series 2640 of movablely connected drive joints 2650 to bear high loads with a generally large angular torsion.

[0220] In the illustrated arrangement, the articulation joint 2200 includes an articulation joint spring 2230 supported within an external elastomer joint assembly 2210. The external elastomer joint assembly 2210 includes a distal end 2212 attached to the proximal end 1112 of the elongated channel 1110. For example, as... Figure 6As can be seen, the distal end 2212 of the external elastomeric connector assembly 2210 is attached to the proximal end 1112 of the elongated channel 1110 by a pair of headed screws 2722, which extend through the distal mounting bushing 2720 and are threadedly received in the proximal end 1112 of the elongated channel 1110. The proximal end 2214 of the elastomeric connector assembly 2210 is attached to the distal end 2124 of the proximal support shaft 2120 by a pair of headed screws 2732, which extend through the proximal mounting bushing 2750 and are threadedly received in a threaded insert 2125 mounted within the distal end 2124 of the proximal support member 2120.

[0221] To prevent the drive joint 2650 from buckling during joint movement, a series 2640 of the movably coupled drive joint 2650 extends through at least one low-friction joint movement joint spring 2730 supported within the external elastomeric joint assembly 2210. See also Figure 19 The articulated joint spring 2730 is sized relative to the drive joint 2650 to provide a small radial clearance between them. The articulated joint spring 2730 is designed to axially bear the joint load, which can be significantly lower than the torsional firing load. The joint spring is longer than the series 2640 of the drive joint 2650, making the drive joint axially relaxed. If the "hard stack" of the series 2640 of the drive joint 2650 is longer than the hard stack of the articulated joint spring 2730, the drive joint 2650 can act as a joint compression limiter, causing both the firing load and the joint load to be axially dissipated through the series 2640 of the drive joint 2650. When the firing load is axially dissipated through the series 2640 of the drive joint 2650, the load may attempt to straighten the articulated joint 2200, or in other words, cause disengagement from the joint. If the hard stack of the articulated joint spring 2730 is longer than the hard stack of the series 2640 of the drive joint 2730, the firing load will be contained within the end effector, and neither of the firing loads will be dissipated by the drive joint 2650 or by the spring 2650.

[0222] To further ensure that the drive joints 2650 are always engaged with each other, a proximal drive spring 2740 is used to apply an axial biasing force to the series 2640 of the drive joints 2650. For example, as Figure 8 , Figure 19 and Figure 20As can be seen, the proximal drive spring 2740 is positioned between the proximal mounting bushing 2734 and the support flange formed between the distal insertion portion 2636 and the proximal cylinder portion 2638 of the proximal shaft section 2632. In one arrangement, the proximal drive spring 2740 may include an elastomeric O-ring / bushing received on the proximal cylinder portion 2638 of the proximal shaft section 2632. The proximal drive spring 2740 slightly biases the drive joints 2650 together to reduce any play that may occur during joint movement. This ensures that the drive joints 2650 torsionally transmit the load. However, it should be understood that in at least one arrangement, the proximal drive spring 2740 does not apply a sufficiently high axial load such that the firing load translates through the joint movement joint 2200.

[0223] like Figure 9 and Figure 10 As can be seen, the top firing member feature 2320 on the firing member 2310 includes a distal upper firing member tooth segment 2330, which corresponds to half of the upper tooth 2450 on each upper vertebral member 2420. Furthermore, a proximal upper firing member tooth 2336, identical to the upper tooth 2450 on each upper vertebral member 2420, is spaced apart from the distal upper firing member tooth segment 2330. The distal upper firing member tooth segment 2330 and the proximal upper firing member tooth 2336 can be integrally formed with the top firing member feature 2320 of the firing member 2310. Similarly, the bottom firing member feature 2350 of the firing member 2310 includes a distal lower firing member tooth 2360 and a proximal lower firing member tooth 2366 integrally formed on the bottom firing member feature 2350. For example, in at least one arrangement, the firing member 2310 having rigidly attached teeth 2330, 2336, 2360 and 2366 can be manufactured as a single integral part using conventional metal injection molding technology.

[0224] As described above, each of the upper vertebral members 2520 is movably received on an upper flexible connector member 2402 in the form of a top cable 2404. As described above, the distal end 2406 of the top cable 2404 is fixed to the top firing member feature 2320 of the firing member 2310. Similarly, each of the lower vertebral members 2520 is movably received on a lower flexible connector member 2502 in the form of a lower cable 2504. The distal end 2506 of the lower cable 2504 is fixed to the bottom firing member feature 2350 of the firing member 2310. In at least one arrangement, the top cable 2404 and the bottom cable 2504 extend through the proximal shaft portion 2100 and, as will be discussed in further detail below, may engage with an emergency arrangement supported in the housing to retract the firing member 2310 to its original or initial position in the event of failure of the firing member drive system.

[0225] Turn to Figure 8 The axial length AL of the upper series 2410 of the upper vertebral component 2420 u The axial length AL of the lower series 2510 of the lower vertebral component 2520. l The lengths must be equal and sufficiently long to allow the firing member 2310 to be fully advanced distally from its original or initial position to the distal end position within the cartridge, while the nearest upper vertebral member 2420 of the upper series 2410 of the upper vertebral member 2420 and the nearest lower vertebral member 2520 of the lower series 2510 of the lower vertebral member 2520 remain engaged with the rotary drive screw 2700. Figure 8 As can be seen, the upper compression limiting spring 2421 is configured to engage with the nearest upper vertebral member 2420P in the upper series 2410 of the upper vertebral member 2420. The upper compression limiting spring 2421 is connected to the top cable 2404 via a journal and is held in bias engagement with the nearest upper vertebral member 2420P by an upper spring retainer 2423, which is held in place by an upper collar 2425 pressed onto the top cable 2404. The top cable 2404 extends through an upper hyaluronic acid tube 2433 supported in a proximal support shaft. Similarly, the lower compression limiting spring 2521 is configured to engage with the nearest lower vertebral member 2520P in the lower series 2510 of the lower vertebral member 2520. The lower compression spring 2521 is connected to the lower cable 2504 via a journal and is held in bias engagement with the nearest lower vertebral member 2520P by a lower spring retainer 2523, which is held in place by a lower collar 2525 pressed onto the lower cable 2504. The lower cable 2504 extends through the lower hyaluronic acid tube 2533, which is supported in the proximal support shaft.

[0226] When the upper vertebral member 2420 and the lower vertebral member 2520 are angled by the articulation joint (after the end effector has been positioned in the articulated position), in each series 2410, 2510, the gap between the corresponding vertebral members 2420, 2520 increases, causing the springs 2421, 2521 to become tighter. The compression limiting springs 2421, 2521 provide sufficient slack to the cables 2404, 2504 so that the angle formed by the vertebral members 2420, 2520 can pass through the most extreme articulation angle. If the cables 2404, 2504 are pulled too tight, the spring retainers 2423, 2523 will contact their respective nearest vertebral members 2420P, 2520P. This compression-limiting arrangement ensures that the vertebral components 2420, 2520 in their respective series 2410, 2510 always remain sufficiently close together, such that the rotary drive screw 2700 will always engage these vertebral components in a manner discussed in further detail below. When the vertebral components 2420, 2520 are aligned again, the compression-limiting springs 2421, 2521 can be partially relaxed while still maintaining some compression between the vertebral components.

[0227] As described above, when the upper vertebral member 2420 is arranged according to the upper series 2410 and the lower vertebral member 2520 is arranged according to the lower series 2510, the convex protrusions and concave recesses in each vertebral member, as well as the compression limiter spring, are used to maintain the upper and lower vertebral members in relative linear alignment so as to drive engagement by rotating the drive screw 2700. Figure 9 and Figure 10 As can be seen, when the upper vertebral member 2420 is linearly aligned, the upper teeth 2450 are spaced apart by an opening space generally designated 2460, which facilitates drive engagement with the helical drive thread 2170 on the rotary drive screw. Similarly, when the lower vertebral member 2520 is linearly aligned, the lower vertebral member teeth 2550 are spaced apart by an opening space generally designated 2560, which facilitates drive engagement with the helical drive thread 2170 of the rotary drive screw 2700.

[0228] Go to Figure 8 and Figure 22 The rotary drive screw 2700 includes a screw body 2702 having a socket 2704 therein for receiving a distally extending shaft 2676 of the distal CV drive shaft 2670. An internal radial groove 2714 ( Figure 10A plurality of ball bearings 2716 are formed in the screw body 2702 to support therein. In one arrangement, for example, 12 ball bearings 2716 are used. Radial grooves 2714 support the ball bearings 2716 between the screw body 2702 and the distal end of the thrust bearing housing 2680. The ball bearings 2716 are used to distribute the axial load of the rotary drive screw 2700 and significantly reduce friction through the rolling motion of the balls.

[0229] like Figure 23 As can be seen, a helical drive thread 2710 is arranged around the screw body 2702 and serves to form a proximal threaded chuck feature 2712. The proximal threaded chuck feature 2712 has a first pitch 2713, and the remaining portion of the helical drive thread 2710 has a second pitch 2715 different from the first pitch 2713. Figure 22 and Figure 23 In the diagram, region 2718 shows the location where the first pitch 2713 and the second pitch 2715 converge. In at least one embodiment, the first pitch 2713 is greater than the second pitch 2715 to ensure that the rotary drive screw 2700 captures and "hooks" or driveably engages each upper vertebral member 2420 and each lower vertebral member 2520. Figure 24 As can be seen, the proximal end 2717 of the helical drive thread 2710, having a first pitch 2713, is scooped into the opening space 2560 between two adjacent lower vertebral member teeth 2550A and 2550B. Simultaneously, the central portion 2719 of the helical drive thread 2710, having a second pitch 2715, engages with the helical distal lower face portion 2554 on the lower vertebral member tooth 2550B and the helical proximal lower face portion 2552 on the proximal lower firing member tooth 2366. It should also be understood that when the firing member 2310 is driven distally, the scooping feature 2712, when scooping the lower vertebral member tooth 2550B, may not contact the helical distal lower face portion 2554A of the lower vertebral member tooth 2550A. The helical drive thread 2710 interacts with the teeth 2450 of the upper vertebral member 2420 in a similar manner.

[0230] 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.

[0231] Figure 25 The firing element 2310 is shown in its original or initial position. (Example) Figure 25 As can be seen, a portion of the helical drive thread 2710 on the rotary drive screw 2700 engages between the distal upper firing member tooth section 2330 and the proximal upper firing member tooth 2336, and another portion of the helical drive thread 2710 engages between the distal lower firing member tooth 2360 and the proximal lower firing member tooth 2366 on the firing member 2310. This arrangement allows the rotary drive screw 2700 to precisely control the distal and proximal movement of the firing member 2310, as will be discussed in further detail below, which results in precise movement of the anvil 1210. Once the firing member 2310 has been sufficiently advanced distally during the firing stroke, the helical drive thread 2710 operatively engages the teeth on the upper and lower vertebrae. See also Figure 26 .

[0232] The surgical instrument 10 also includes an articulation system 2240 configured to apply articulation to the surgical end effector 1000, causing the surgical end effector to articulate relative to the elongated shaft assembly 2000. In at least one arrangement, for example, the articulation system includes four articulation cables 2242, 2246, 2250, and 2254 extending through the elongated shaft assembly 2000. See also Figure 27In the illustrated arrangement, articulation cables 2242 and 2246 pass through the proximal mounting bushing 2750, the proximal end 2214 of the elastomeric connector assembly 2210, and the central rib section 2216 to be secured to the distal end 2212 of the elastomeric connector assembly 2210 or other portions of the surgical instrument. Similarly, articulation cables 2250 and 2254 extend through the proximal mounting bushing 2750, the proximal end 2214 of the elastomeric connector assembly 2210, and the central rib section 2218 to be secured to the distal end 2212 of the elastomeric connector assembly 2210 or other portions of the surgical end effector. Cables 2242, 2246, 2250, and 2254 are operatively connected to an articulation control system supported within the housing of the surgical instrument 10. For example, the proximal portions of each cable 2242, 2246, 2250, and 2254 may be wound around a corresponding rotary reel or cable management system 2007 in the housing portion of the surgical instrument 10. Figure 2 On the reel or cable management system, each cable 2242, 2246, 2250, and 2254 is configured to be deployed and retracted in a desired manner. The reel / cable management system can be motor-driven or manually driven (ratchet arrangement, etc.). Figure 29 The surgical end effector 1000 is shown performing joint movements relative to the elongated shaft assembly 2000 through a first joint motion plane. Figure 30 The surgical end effector 1000 is shown performing joint movements relative to the elongated shaft assembly 2000 through a second joint motion plane. Figure 31 The surgical end effector 1000 is shown performing joint movements relative to the elongated shaft assembly 2000 through multiple joint motion planes.

[0233] Figures 32 to 34 An alternative articulated joint 2200' in the form of an elastomeric joint assembly 2210' is shown. For example... Figure 33As can be seen, each joint motion 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 jointed by pulling and releasing the appropriate cables 2242, 2246, 2250, and 2254. To achieve a higher joint motion 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.

[0234] Because the radial / longitudinal segmented power screw nut arrangement disclosed herein does not have the same limitations as the 360-degree nut, the upper vertebral member 2420 in the upper series 2410 and the lower vertebral member 2520 in the lower series 2510 are constrained to ensure that their load is transmitted to the firing member in the longitudinal direction. To maintain each upper vertebral member 2420 in the desired orientation, and to prevent the upper vertebral member 2420 from being obstructed or losing orientation when traversing the articulated joint 2200, the upper vertebral member 2420 is aligned to pass through the upper sleeve 2470, which extends through the upper portion of the external elastomeric joint assembly 2210 of the articulated joint 2200. See also Figure 27 , Figure 28 and Figure 35The distal end 2472 of the upper sleeve 2470 is supported in the proximal end 1112 of the elongated channel 1110, and the proximal end 2474 of the upper sleeve 2470 is supported in the distal end of the proximal support shaft 2120. The upper sleeve 2470 is made of a polymer or plastic material with a low coefficient of friction and is flexible, so that the upper sleeve 2470 can bend together with the external elastomeric joint assembly 2210. The upper sleeve 2470 protects the upper vertebral member 2420 from contact with the external elastomeric joint assembly 2210, which is made of an elastic material, which may have a higher coefficient of friction than the material of the upper sleeve 2470. In other words, when the upper vertebral member 2420 traverses the articular joint 2200, the upper sleeve 2470 forms a low-friction, flexible, continuous, uninterrupted, and fully enclosed path for the upper vertebral member.

[0235] Similarly, the lower sleeve 2570 is used to support the lower vertebral members 2520 as they pass through the articulation joint 2200. The distal end 2572 of the lower sleeve 2570 is supported in the proximal end of the elongated channel, and the proximal end of the lower sleeve 2570 is supported in the distal end of the proximal support shaft 2120. Similar to the upper sleeve 2470, the lower sleeve 2570 is made of a polymer or plastic material with a low coefficient of friction and is flexible, so that the lower sleeve 2570 can bend together with the external elastomeric joint assembly 2210. The lower sleeve 2570 protects the lower vertebral members 2520 from contacting the external elastomeric joint assembly 2210 as they pass through the articulation joint 2200. In other words, as the lower vertebral member 2520 traverses the articulation joint 2200, the lower sleeve 2570 forms a low-friction, flexible, continuous, uninterrupted, and fully enclosed path for the lower vertebral member. In various embodiments, the upper sleeve 2470 and the lower sleeve 2570 are configured to bend freely without kinking. To prevent kinking within the sleeves, in at least one arrangement, the sleeves 2470, 2570 are supported within the external elastomeric joint assembly 2210, allowing axial movement of the sleeves. For example, when the articulation joint is angled upwards, the lower sleeve 2570 can slide distally with a large bending radius; in the same example, the upper sleeve 2470 can slide proximally with a tighter bending radius. Axial movement reduces the amount of material exposed outside the joint assembly 2210, which would otherwise be prone to kinking at the tighter bending radius. In at least one arrangement, the distal end 2472 of the upper sleeve 2470 is formed with an upper sling 2476, which is configured to convey the upper vertebral member 2420 into the anvil cap 1260. Similarly, the distal end of the lower sleeve 2570 may be formed with a lower sling, which is configured to convey the lower vertebral member 2520 into the channel slot 1140 in the elongated channel 1110.

[0236] As described above, the anvil mounting portion 1230 includes a pair of laterally extending mounting pins 1232 configured to be received in corresponding mounting brackets or pivot brackets 1120 formed in the proximal end 1112 of the elongated channel 1110. The mounting pins 1232 are pivotally held within the mounting brackets 1120 by an anvil top cover 1260, which is attached to the proximal end 1112 of the elongated channel 1110 in the manner described above. The anvil top cover 1260 includes a proximal end 1262 and a distal end 1264, and has a keyhole-shaped vertebral conduit 1266 extending therethrough to accommodate the passage of the top firing member feature 2320 and the upper vertebral member 2420. Figure 36The vertebral conduit 1266 in the anvil top cover 1260 is shown. When the rotary drive screw 2700 applies a load to the upper vertebral member 2420, the vertebral member 2420 will tend to rotate around... Figure 37 Region A is tilted, so the upper vertebral component tooth 2450 is no longer perpendicular to the rotary drive screw 2700, but may experience line contact with higher pressure. Figure 37 Region B in the diagram shows where the upper vertebral member 2420 stops tilting. To ensure that most of the load remains in the longitudinal direction to perform useful work, the angle of the upper vertebral member teeth 2450 must be the same as the amount of tilt of the upper vertebral member 2420. Therefore, when the upper vertebral member 2420 tilts, the upper vertebral member teeth 2450 will still maintain surface contact with the helical drive member 2710 on the rotary drive screw 2700, and all the load will be guided longitudinally rather than vertically. When the vertebral member 2420 tilts, the slightly angled upper vertebral member teeth 2450 can behave like a square thread and better distribute the load to reduce pressure contact. By guiding most of the load in the longitudinal direction, vertical loads that could cause friction to build up and counteract the longitudinal load are avoided. The upper vertebral member 2420 reacts similarly as it passes downward through the keyhole-shaped anvil slot 1240. Similarly, the lower vertebral component 2520 reacts in a similar manner when passing through the keyhole-shaped axially extending channel slot 1140 in the elongated channel 1110.

[0237] In the arrangement shown, the anvil 1210 is moved to the open position by a pair of anvil springs 1270 supported within the proximal end of the elongated channel. See also Figure 38 , Figure 42 and Figure 43 Spring 1270 is positioned to apply a pivoting bias force to corresponding anvil control arms 1234, which are integrally formed with and extend downward from the anvil mounting portion 1230. See also Figure 38 .

[0238] Figures 39 to 41 This shows what happens when the anvil 1210 is open ( Figure 39 When the anvil 2310 is partially closed ( Figure 40 ) and after the firing component has advanced distally from its original or initial position ( Figure 41 The anvil 1210, firing member 1210, and anvil top cover 1260 of the anvil. For example... Figure 39As can be seen, when the firing member 2310 is in the original or initial position, the top firing member feature 2320 is fully received within the vertebral channel 1266 in the anvil top cover 1260. During the firing stroke, the top firing member feature 2320 and the upper vertebral member 2420 in the upper series 2410 must transition from the vertebral channel 1266 in the anvil top cover 1260 to the keyhole-shaped anvil slot 1240. Therefore, it is desirable to minimize any gap “G” between the anvil mounting portion 1230 and the distal end 1264 of the anvil top cover 1260. To minimize this gap G while facilitating unobstructed pivoting travel of the anvil 1210, the distal end 1264 of the anvil top cover 1260 is formed with a curved top cover surface 1265 that matches the curved mating surface 1231 on the anvil mounting portion 1230. The two surfaces 1265 and 1231 are curved and concentric about the pivot axis PA or some other reference point. This arrangement allows radial movement of the anvil 1210 without interfering with the anvil top cover 1260, while maintaining a minimum clearance G between them. The clearance G between the anvil mounting portion 1230 and the distal end 1264 of the anvil top cover 1260 is significantly shorter than the length of the upper vertebral member 2420, which facilitates the easy transition of each upper vertebral member 2420 from the vertebral canal 1266 in the anvil top cover 1260 to the keyhole-shaped anvil slot 1240. Furthermore, to further aid the transition of the top firing member feature 2320 into the keyhole-shaped anvil slot 1240, the curved mating surface 1231 adjacent to the anvil mounting portion 1230 forms an inclined surface 1241. When the firing member 2310 is initially advanced distally from its original or starting position, the distal end of the top firing member feature 2320 contacts the inclined surface 1241 and begins to apply a closing motion to the anvil 1210, such as Figure 40 As can be seen, further distal advancement of the firing member 2310 during the firing stroke or firing sequence causes the top firing member feature to enter the keyhole-shaped anvil slot 1240, completely closing the anvil 1210 and holding the anvil 1210 in the closed position during the firing sequence. See also Figure 41 .

[0239] Typically, the highest firing force established in an endoscopic cutter is associated with cutting and suturing tissue. If those same forces are available for closing the anvil, the forces generated during pre-clamping and gripping of the tissue can also be high. In at least one arrangement, the firing member body 2312 also includes firing member wings or tabs 2355 extending from each lateral side of the firing member body 2312. See also Figure 15 and Figure 36The firing member wing 2355 is positioned to contact the corresponding anvil control arm 1234 when the firing member 2310 is driven from its original or initial position in the proximal direction PD to rapidly close the anvil 1210 for gripping purposes. In at least one arrangement, when the firing member 2310 is in its original or initial position, the firing member wing 2355 is located distal to the anvil control arm 1234, such as... Figure 42 As shown. When the firing member 3210 moves proximally, the firing member wing 2355 resists the bias of the anvil spring 1270 and pushes the anvil control arm 1234 (in the pivoting direction C). See also Figure 42 In one arrangement, the firing member 2310 only needs to move a short distance D to pivot the anvil 1210 to the closed position. For example, in one embodiment, the distance D may be approximately 0.070 inches. This short movement allows for rapid response. Because the anvil pivot point or pivot axis PA is relatively far from the firing member wing 2355, this generates a considerable moment arm, so the proximal movement of the firing member 2310 (and the firing member wing 2355) results in a high pre-compression torque being applied to the anvil 1210 to move it to the closed position. Therefore, the firing member wing 2355 may be referred to herein as the "pre-compression feature". See also Figure 43 Therefore, by advancing the firing member 2310 proximally a short distance D to rapidly pivot the anvil 1210 to the closed position, the clinician can use the surgical end effector 1000 to grasp and manipulate tissue between the anvil 1210 and the surgical cartridge 1300 without cutting the tissue and forming staples.

[0240] The firing member 2310 can be moved in the proximal direction PD by rotating the rotary drive screw 2700 in the second rotational direction. Therefore, when the firing member 2310 is in the "original" or initial position, the anvil 1210 can be biased to the fully open position by the anvil spring 1270. Activating the rotary drive system 2600 to apply rotational motion to the rotary drive screw 2700 in the first rotational direction will cause the firing member 2310 to be advanced distally from the original or initial position to apply anvil closing motion to the anvil 1210 to move the anvil into a closed position, thereby clamping the target tissue between the anvil 1210 and the surgical cartridge 1300. Continued rotation of the rotary drive screw in the first rotational direction will cause the firing member 2310 to continue to be advanced distally through the surgical end effector 1000. As the firing member 2310 moves distally, it contacts the slide 1312 supported in the surgical cartridge 1300. Figure 19The slider 1312 is driven distally through the staple cartridge body 1302. When the firing member 2310 is in the initial or starting position, the surgeon may wish to use a surgical end effector to grasp and manipulate tissue. For this purpose, the rotary drive system is actuated to apply a second rotary drive motion to the rotary drive screw 2700 in a second rotational direction opposite to the first rotational direction. This rotational motion of the rotary drive screw 2700 in the second rotational direction will drive the firing member 2310 proximally from the starting position and cause the anvil 1210 to pivot rapidly to the closed position. Therefore, according to at least one embodiment, the "initial or starting position" of the firing member 2310 is not its proximal position.

[0241] If the rotary drive system 2600 stops rotating during firing, the firing member 2310 may become stuck within the surgical end effector. In this case, the top firing member feature 2320 may remain engaged with the anvil 1210, and the bottom firing member feature 2350 may remain engaged with the elongated channel 1110, thereby preventing the surgeon from moving the anvil 1210 to the open position to release tissue clamped between the anvil 1210 and the surgical cartridge 1300. This may occur, for example, if the motor or other control arrangement providing rotary drive motion to the rotary drive shaft 2610 fails or otherwise becomes inoperable. In this case, the firing member 2310 can be retracted to its original or initial position within the surgical end effector 1000 by pulling the top cable 2404 and the lower cable 2504 in a proximal direction. For example, the proximal portions of the top cable 2404 and the lower cable 2505 may be wound around a rotating reel or cable management system 2009 in the housing portion of the surgical instrument 10. Figure 2 On the rotating reel or cable management system, the top cable 2404 and the lower cable 2504 are configured to be released during the firing stroke, and to retract the cables 2404 and 2504 in a proximal direction if the firing member 2310 needs to be retracted. The cable management system 2009 can be motor-driven or manually driven (ratchet arrangement, etc.) to apply a retraction motion to the cables 2404 and 2504. When the cables 2404 and 2504 are retracted, the upper vertebral member 2420 and the lower vertebral member 2520 will cause the rotary drive screw 2700 to rotate in the opposite direction.

[0242] It can be used depending on the lead (L) and pitch circle diameter (d) p The following equations, using tooth angle (α) and friction (μ), determine whether the rotary drive screw 2700 will rotate in the opposite direction:

[0243] If the above equation holds, the rotary drive screw 2700 can be self-locking. To a large extent, in many cases, for endoscopic cutters, the pitch circle diameter is mostly fixed, but the lead and tooth angle are variable. Because the upper vertebral component teeth 2450 and the lower vertebral component teeth 2550 are mostly square, the rotary drive screw 2700 is more likely to be reversibly driven (cos(90) = 1). The lead of the upper vertebral component teeth 2450 and the lower vertebral component teeth 2550 can also be advantageous, because the rolling friction between the vertebral components 2420, 2520 and the rotary drive screw 2700 is more likely to enable the rotary drive screw 2700 to be reversibly driven. Therefore, in an emergency, the surgeon can pull the upper cable 2404 and the lower cable 2504 in the proximal direction to fully retract the firing member 2310 for a quick "emergency" maneuver.

[0244] As described above, the housing 2002 can support the relative controlled movement of the rotary drive system 2600 and various cable management systems employed in conjunction with the firing system 2300 and the joint motion control system 2240. This housing can be handheld or included as part of a larger automated surgical system. The firing system 2300, the joint motion control system 2240, and the rotary drive system 2600 can, for example, be motor-controlled and operated by one or more control circuits.

[0245] One method of using surgical instrument 10 may involve using surgical instrument 10 to cut and suture target tissue within a patient using laparoscopic techniques. For example, one or more trocars may have been placed through the abdominal wall of the patient to provide access to target tissue within the patient. A surgical end effector 1000 may be inserted through one trocar, and one or more cameras or other surgical instruments may be inserted through other trocars. In order for surgical end effector 1000 to be able to insert through the trocar, surgical end effector 1000 is positioned in a non-articular motion orientation, and jaws 1100 and 1200 must be closed. In order to hold jaws 1100 and 1200 in the closed position for insertion purposes, for example, a rotary drive system 2600 may be actuated to apply a second rotational motion to rotary drive screw 2700, thereby causing firing member 2310 to move proximally from an initial position to move anvil 1210 (jaws 1200) to the closed position. See also Figure 44 The rotary drive system 2600 is deactivated to hold the firing member 2310 in this position. Once the surgical end effector has been inserted into the abdomen through the cannula, the rotary drive system 2600 can be activated to cause the rotary drive screw 2700 to drive the firing member 2310 distally back to the starting position, where the anvil spring 1270 will pivot the anvil 1210 to the open position. See also Figure 38 .

[0246] Once inside the abdomen and before engaging the target tissue, the surgeon may need to articulate the surgical end effector 1000 into a favorable position. The articulation control system 2240 is then actuated to articulate the surgical end effector in one or more planes relative to the portion of the elongated shaft assembly 2000 received within the cannula. Once the surgeon has oriented the surgical end effector 1000 to the desired position, the articulation control system 2240 is deactivated to hold the surgical end effector 1000 in the articulated orientation. The surgeon can then use the surgical end effector to grasp the target or adjacent tissue by activating the rotary drive system to rotate the rotary drive screw in a second rotational direction to move the firing member proximally, thereby rapidly closing the anvil 1210 to grasp tissue between the anvil 1210 and the surgical cartridge 1300. The anvil 1210 can be opened by reversing the rotation of the rotary drive screw 2700. This process can be repeated as needed until the target tissue is properly positioned between the anvil 1210 and the surgical cartridge 1300.

[0247] Once the target tissue has been positioned between the anvil 1210 and the surgical cartridge, the surgeon can initiate the closing and firing process by activating the rotary drive system 2600 to drive the firing member 2310 distally from the starting position. As the firing member 2310 moves distally from the starting position, it applies a closing motion to the anvil 1210 and moves it from the open position to the closed position in the manner discussed above. As the firing member 2310 moves distally, it holds the anvil 1210 in the closed position, thereby clamping the target tissue between the anvil 1210 and the surgical cartridge 1300. As the firing member 2310 moves distally, it contacts the slider 1312 supported in the surgical cartridge 1300 and also drives the slider 1312 distally through the cartridge body 1302. The slider 1312 continuously drives a row of actuators supported in the staple cartridge toward the target tissue being held. Each actuator has one or more surgical staples or fasteners supported thereon, which are then driven through the target tissue and make contact with the underside of the anvil 1210. As the firing member 2310 moves distally, its tissue cutting blade 2314 cuts through the sutured tissue.

[0248] The firing member 2310 has been driven distally to the end position within the surgical end effector 1000. Figure 45Subsequently, the rotary drive system 2600 is reversed, causing the firing member 2310 to retract proximally to its original or starting position. Once the firing member 2310 has returned to its starting position, the anvil spring 1270 will pivot the anvil 1210 to the open position, allowing the surgeon to release the sutured tissue from the surgical end effector 1000. Once the sutured tissue has been released, the surgical end effector can be withdrawn from the patient through a cannula. To do this, the surgeon must first actuate the joint motion control system 2240 to return the surgical end effector 1000 to a non-joint position and actuate the rotary drive system to drive the firing member 2310 proximally from its original or starting position to close the jaws. Afterward, the surgical end effector 1000 can be withdrawn through a cannula. If the firing system becomes inoperable during the firing process or during the retraction process, the surgeon can retract the firing member 2310 to the starting position by applying a pulling motion to the cables 2404, 2505 in the proximal direction in various manners described herein.

[0249] Figures 46 to 68 Another surgical instrument 22010 is shown, which is identical or very similar in many respects to the surgical instrument 10 described above, except for the various differences discussed below. Similar to surgical instrument 10, surgical instrument 22010 addresses many of the challenges faced by surgical instruments having articulated end effectors configured to cut and fasten tissue. In various embodiments, surgical instrument 22010 may include a handheld device. In other embodiments, surgical instrument 22010 may include an automated system, such as sometimes referred to as a robot control system. In various forms, surgical instrument 22010 includes a surgical end effector 23000 operatively coupled to an elongated shaft assembly 24000. The elongated shaft assembly 24000 may be operatively attached to a housing that is handheld or otherwise incorporates part of a robotic system, as discussed above.

[0250] like Figure 49As can be seen, in one embodiment, the surgical end effector 23000 includes a first jaw 23100 and a second jaw 23200. In the illustrated arrangement, the first jaw 23100 includes an elongated channel 23110, which includes a proximal end 23112 and a distal end 23114 and is configured to operably support the surgical cartridge 1300 therein. The elongated channel 23110 has an open bottom for easy assembly and a channel cover 23113 configured to be attached (welded, etc.) to the elongated channel to cover the opening and increase the rigidity of the elongated channel 23110. In the illustrated arrangement, the second jaw 23200 includes an anvil 23210, which includes an elongated anvil body 23212, which includes a proximal end 23214 and a distal end 23216. In one arrangement, an anvil cover 23213 is provided to facilitate assembly of the device and to increase the rigidity of the anvil when the anvil 23210 is attached (welded, etc.) to the anvil body 23212. The anvil body 23212 includes a nail-shaped lower surface 23218 facing the first jaw 23100 and may include a series of nail-shaped recesses (not shown) corresponding to each of the nails or fasteners in the surgical staple cartridge 1300. The proximal end 23214 of the anvil body 23212 includes an anvil mounting portion 23230, which includes a pair of laterally extending mounting pins 23232 configured to be received in corresponding mounting brackets or pivot brackets 23120 formed in the proximal end 23112 of the elongated channel 23110. Mounting pin 23232 is pivotally held within mounting bracket 23120 via an anvil top cover 23260, which can be attached to the proximal end 23112 of elongated channel 23110 by screw 23261. In other arrangements, anvil top cover 23260 can be attached to elongated channel 23110 by welding, adhesive, etc. This arrangement facilitates the anvil 23210 in the open position relative to surgical staple cartridge 1300 mounted in elongated channel 23110 about pivot axis PA. Figure 47 ) and closed position ( Figure 48 The pivot axis PA is referred to as "fixed" in this document because the pivot axis does not translate or otherwise move when the anvil 23210 pivots from the open position to the closed position.

[0251] In the arrangement shown, the anvil 23210 is moved to the open position by a pair of anvil springs 23270 supported within the proximal end 23112 of the elongated channel 23110. See also Figure 49 and Figure 62 Spring 23270 is positioned to apply a pivoting bias force to the corresponding portion of anvil 23210 to apply an opening force thereto. See also Figure 47 .

[0252] In the illustrated arrangement, the elongated shaft assembly 24000 defines an axis SA and includes a proximal shaft portion 24100 operatively connectable to the housing of a control portion (e.g., a handheld unit, robotic tool actuator, etc.) of the surgical instrument 22010. The elongated shaft assembly 24000 also includes an articulated joint 24200 attached to the proximal shaft portion 24100 and the surgical end effector 23000. In various cases, the proximal shaft portion 24100 includes components operatively connectable to the hollow outer tube 24110 within the housing in various manners discussed above. Figure 49 As can be seen, the proximal shaft portion 24100 may further include a rigid proximal support shaft 24120, which is supported within the hollow outer tube 24110 and extends from the housing to the articulated joint 24200. The rigid proximal support shaft 24120 may include a first half 24120A and a second half 24120B that can be joined together by, for example, welding, adhesive, etc. The rigid proximal support shaft 24120 includes a proximal end 24122 and a distal end 24124, and includes an axial conduit 24126 extending from the proximal end 24122 through it to the distal end 24124.

[0253] As discussed above, many surgical end effectors employ a firing member that is pushed distally through the surgical cartridge by a firing beam capable of axial movement. The firing beam is typically attached to the firing member in the central region of the firing member body. This attachment location can cause imbalance in the firing member as it is advanced through the end effector. This imbalance can induce undesirable friction between the firing member and the end effector jaws. This additional friction may require a higher firing force to overcome, and can cause undesirable wear on the jaws and / or portions of the firing member. Applying a higher firing force to the firing beam can cause undesirable deflection of the firing beam as it traverses the articulation joint. This additional deflection can cause the articulation joint to disengage from the joint motion, particularly when the surgical end effector performs articulation at a relatively high angle of articulation. Surgical instrument 22010 employs a firing system 24300 that is identical or very similar in many respects to the firing system 2300 discussed above. Therefore, the following discussion will only cover those aspects of the firing system 24300 required for understanding the operation of the surgical instrument 22010.

[0254] like Figures 50 to 54As can be seen, in at least one embodiment, the firing system 24300 includes a firing member 24310, which includes a vertically extending firing member body 24312, the firing member body including a top firing member feature 24320 and a bottom firing member feature 24350. A tissue cutting blade 24314 is attached to or formed within the vertically extending firing member body 24312. See also... Figure 50 and Figure 51 In at least one arrangement, it is desirable for the firing member 24310 to pass through the anvil body 23212 with low friction, high strength, and high stiffness. In the illustrated arrangement, the top firing member feature 24320 includes a T-shaped body 24322 having two laterally extending tabs 24323 projecting therefrom and a top axial conduit 24324 extending therethrough. See also Figure 53 The bottom firing member feature 24350 includes a T-shaped body 24352 having two laterally extending tabs 24353 protruding from it and a bottom axial channel 24354 extending through it. See also Figure 50 In at least one arrangement, the top firing member feature 24320 and the bottom firing member feature 24350 are integrally formed with the vertically extending firing member body 24312. For example... Figure 54 As can be seen, the anvil body 23212 includes an axially extending anvil slot 23240 that defines two opposing flanges 23241 for slidably receiving laterally extending tabs 24323 thereon. Similarly, the elongated channel 23110 includes an axially extending channel slot 23140 that defines an axially extending channel flange 23141 that is configured to slidably receive laterally extending tabs 24353 thereon.

[0255] In the illustrated arrangement, the firing system 24300 includes an upper flexible spine assembly 24400 operatively coupled to a top firing member feature 24320 of the firing member 24310. In at least one embodiment, the upper flexible spine assembly 24400 includes an upper series 24410 of upper vertebral members 24420, which are loosely coupled together by an upper flexible connector member 24440 extending through each of the upper vertebral members 24420 and attached to the top firing member feature 24320.

[0256] like Figure 52As can be seen, each upper vertebral component 24420 is substantially T-shaped when viewed from one end of each upper vertebral component. In one aspect, each upper vertebral component 24420 includes an upper vertebral body portion 24422 having a proximal end portion 24424 and a distal end portion 24428. Each upper vertebral component 24420 also includes a downwardly extending upper drive feature portion or upper vertebral component tooth 24450 projecting from the upper vertebral body portion 24422. Each upper vertebral component tooth 24450 has a helical proximal upper face portion 24452 and a helical distal upper face portion 24454. Each proximal end portion 24424 of the upper vertebral body portion 24422 has an arcuate or slightly concave curved shape, and each distal end portion 24428 has an arcuate or slightly convex curved shape. When arranged in the upper series 24410, the convex distal end 24428 on one upper vertebral member 24420 contacts and engages with the concave proximal end 24424 on the adjacent upper vertebral member 24420 in the upper series 24410 to maintain general alignment of the upper vertebral members 24420 such that the helical proximal upper face portion 24452 and helical distal upper face portion 24454 on each corresponding upper vertebral member tooth 24450 can be engaged by a rotary drive screw 2700 in a driven manner using the various methods disclosed herein. These curved mating surfaces on the upper vertebral members 24420 allow for better load transfer between them, even when they are tilted.

[0257] In at least one embodiment, an upper alignment member 24480 is used to assist in the alignment of the upper vertebral members 24420 in the upper series 24410. In one arrangement, the alignment member 24480 includes a spring member or metal cable that may be made of nitinol wire, spring steel, etc., and is formed with a distal upper annular end 24482 and two upper support portions 24484 that extend through corresponding upper conduits 24425 in each upper vertebral body portion 24422. An upper flexible connector member 24440 extends through an upper conduit 24429 in each upper vertebral member of the upper vertebral members 24420 to attach to the firing member 24310. Specifically, the distal end portion 24442 extends through a top axial conduit 24324 in the top firing member feature portion 24320 and is secured therein by an upper retaining lug 24444. The proximal portion of the upper flexible connector member 24440 can be engaged with a corresponding rotary reel or cable management system of various types and designs disclosed herein, which is used to release and tighten the upper flexible connector member 24440 during operation and joint movement of the surgical end effector 23000 to maintain a desired amount of tension therein. The cable management system can be motor-driven or manually driven (ratchet arrangement, etc.) to maintain the desired amount of tension in the upper flexible connector member 24440. The amount of tension in each flexible connector member can be varied according to the relative positioning of the surgical end effector 23000 and the elongated shaft assembly 24000.

[0258] The firing system 24300 also includes a lower flexible spine assembly 24500 operatively coupled to the bottom firing member feature 24350. The lower flexible spine assembly 24500 includes a lower series 24510 of lower vertebral members 24520, which are loosely coupled together by a lower flexible connector member 24540 extending through each of the lower vertebral members 24520 and attached to the bottom firing member feature 24350. Figure 52As can be seen, each upper vertebral component 24520 is substantially T-shaped when viewed from one end of each lower vertebral component. In one aspect, each lower vertebral component 24520 includes a lower vertebral body portion 24522 having a proximal end portion 24524 and a distal end portion 24528. Each lower vertebral component 24520 also includes an upwardly extending lower drive feature portion or lower vertebral component tooth 24550 projecting from the lower vertebral body portion 24522. Each lower vertebral component tooth 24550 has a helical proximal lower face portion 24552 and a helical distal lower face portion 24554. The proximal end portion 24524 of each lower vertebral body portion 24522 has an arcuate or slightly concave curved shape, and each distal end portion 24528 has an arcuate or slightly convex curved shape. When arranged in the lower series 24510, the convex distal end 24528 on the upper vertebral member 24520 contacts and engages with the concave proximal end 24524 on the adjacent lower vertebral member 24520 in the lower series 24510 to maintain the lower vertebral members 24520 generally aligned, such that the helical proximal lower face portion 24552 and helical distal lower face portion 24554 on each corresponding lower vertebral member tooth 24550 can be driven to engage by the rotary drive screw 2700 in various methods disclosed herein. These curved mating surfaces on the lower vertebral members 24520 allow the lower vertebral members 24520 to better transmit loads between them, even when they are tilted.

[0259] In at least one embodiment, a lower alignment member 24580 is used to assist in the alignment of the lower vertebral members 24520 in the lower series 24510. In one arrangement, the lower alignment member 24580 includes a spring member or metal cable that may be made of nitinol wire, spring steel, etc., and is formed with a distal lower annular end 24582 and two lower support portions 24584 that extend through corresponding lower conduits 24525 in each lower vertebral body portion 24522. A lower flexible connector member 24540 extends through a bottom axial conduit 24529 in each lower vertebral member 24520 to attach to the firing member 24310. Specifically, the distal end portion 24542 of the lower flexible connector member 24540 extends through the bottom axial conduit 24354 in the bottom firing member feature portion 24350 and is secured therein by a lower retaining lug 24544. The proximal portion of the lower flexible connector member 24540 can be engaged with a corresponding rotary reel or cable management system of various types and designs disclosed herein, which is used to release and tighten the lower flexible connector member 24540 during operation and joint movement of the surgical end effector 23000 to maintain a desired amount of tension therein. The cable management system can be motor-driven or manually driven (ratchet arrangement, etc.) to maintain the desired amount of tension in the lower flexible connector member 24540. The amount of tension in each flexible connector member can be varied according to the relative positioning of the surgical end effector 23000 and the elongated shaft assembly 24000.

[0260] According to at least one aspect, a large surface area facilitates the distribution of force between vertebral members when they are pushed, preventing them from twisting relative to each other. The available area in the anvil and channel is limited, and the anvil and channel must remain rigid. The T-shaped upper vertebral member 24420 and the T-shaped lower vertebral member 24520 are designed to fit within the limited space available in the anvil 23210 and the elongated channel 23110, while ensuring ample area for distributing the firing load. The curved surfaces on each upper vertebral member 24420 and each lower vertebral member 24520 allow each of those vertebrae to better transmit the load between them, even when they are tilted. The upper alignment member 24480 and the lower alignment member 24580 also serve to prevent the upper vertebral member 24420 and the lower vertebral member 24520 from twisting relative to each other. The large surface area also helps prevent abrasion of the vertebral members and / or the anvil and channel. The upper flexible ridge assembly 24400 and the lower flexible ridge assembly 24500 are otherwise operably connected to the rotary drive screw 2700 as disclosed herein. If the firing drive system 24300 fails during the firing stroke, the upper flexible connector member 24440 and the lower flexible connector member 24540 can also be used, as discussed above, to retract the firing member 24310 to its initial position.

[0261] like Figure 51 As can be seen, the top firing member feature 24320 on the firing member 24310 includes a distal upper firing member tooth segment 24330, which corresponds to half of the upper vertebral member tooth 24450 on each upper vertebral member 24420. Furthermore, two proximal upper firing member teeth 24336, identical to the upper vertebral member teeth 24450 on each upper vertebral member 24420, are spaced apart from the distal upper firing member tooth segment 24330. The distal upper firing member tooth segment 24330 and the proximal upper firing member teeth 24336 can each be integrally formed with the top firing member feature 24320 of the firing member 24310. Similarly, the bottom firing member feature 24350 of the firing member 24310 includes a distal lower firing member tooth 24360 and two proximal lower firing member teeth 24366 integrally formed on the bottom firing member feature 24350. For example, in at least one arrangement, the firing member 24310 having rigidly attached teeth 24330, 24336, 24360 and 24366 can be manufactured as a single integral part using conventional metal injection molding techniques. Those skilled in the art will recognize that the firing member 24310 operates in substantially the same manner as the firing member 2310 as described in detail herein.

[0262] Now go to Figure 55Regarding 58, according to at least one aspect, the articular joint 24200 includes a movable exoskeleton assembly 24800. In one form, the movable exoskeleton assembly 24800 includes a series 24802 of movably connected annular rib members 24810. Figures 55 to 57 As can be seen, each annular rib member 24810 includes a first or proximal side 24820, which includes a convex or dome-shaped portion 24822. Each annular rib member 24810 also includes a concave or disc-shaped second or distal side 24830. Each annular rib member 24810 also includes an upper ridge conduit 24840 and a lower ridge conduit 24842, the upper ridge conduit being configured to accommodate an upper flexible ridge assembly 24400 passing through it, and the lower ridge conduit being configured to accommodate a lower flexible ridge assembly 24500 passing through it. Furthermore, each annular rib member 24810 includes four articulation conduits 24850, 24852, 24854, and 24856 to accommodate articulation actuators in the form of articulation cables 24242, 2446, 24250, and 24254 passing through them. See also Figure 49 Each annular rib member 24810 also includes a central drive conduit 24860, which is configured to accommodate a constant speed (CV) drive shaft assembly 2620 passing through it.

[0263] like Figure 58As can be seen, the movable exoskeleton assembly 24800 includes a proximal attachment rib 24870 configured to attach the movable exoskeleton assembly 24800 to the distal end 24124 of the proximal support shaft 24120 via a headed screw 24880 or other suitable fastener arrangement. The proximal attachment rib 24870 includes a first or distal side 24872, which is concave or disc-shaped to receive or movably engage with a convex or dome-shaped portion 24822 of the proximal side 24820 of the nearest annular rib member 24810P. Similarly, the movable exoskeleton assembly 24800 includes a distal attachment rib 24890 configured to attach the movable exoskeleton assembly 24800 to the proximal end 23112 of the elongated channel 23110 via a headed screw 24882 or other suitable fastener. The distal attachment rib 24890 includes a first or proximal side 24892 comprising a convex or dome-shaped portion 24894 configured to be received in or movably engaged with the concave or disc-shaped distal side 24832 of the distal annular rib member 24810D. In various embodiments, the annular rib members 24810, 24810P, and 24810D may be made of any suitable metal (e.g., stainless steel, titanium, etc.) or other suitable materials. Annular rib members 24810, 24810P, and 24810D can be formed by suitable stretching or forming operations, by machining, or by casting. The proximal side 24820 and the distal side 24830 can be polished or otherwise finished to a desired smooth surface to reduce friction and facilitate movement between the annular rib members 24810, 24810P, and 24810D. According to one aspect, all edges on each annular rib member 24810, 24810P, and 24810D are rounded to facilitate relative movement between the annular rib members. The proximal attachment rib 24870 and the distal attachment rib 24890 can be formed with similar properties.

[0264] The surgical instrument 22010 also includes an articulation system 24240 configured to apply articulation to the surgical end effector 23000, causing the surgical end effector 23000 to articulate relative to the elongated shaft assembly 24000. In at least one arrangement, for example as described above, the articulation system 24240 includes four articulation cables 24242, 24246, 24250, and 24254 extending through the elongated shaft assembly 24000. See also Figure 49In the illustrated arrangement, articulation cables 24242, 24246 pass through the proximal attachment rib 24870 and through each of the annular ribs 24810P, 24810, and 24810D to be secured to the distal attachment rib 24890. In one arrangement, for example, each of the articulation cables 24242, 24246 is secured to the distal attachment rib 24890 by a corresponding attachment lug 24243. See also Figure 61 and Figure 63 Similarly, joint motion cables 24250 and 24254 extend through the proximal attachment rib 24870 and through each of the annular rib members 24810P, 24810 and 24810D to be secured to the distal attachment rib 24890 by the corresponding attachment lug 24243.

[0265] In one arrangement, each of the articular motion cables 24242, 24246, 24250, and 24254 extends through a corresponding helical spring 24896, which is supported in a cavity 24125 in the distal end 24124 of a rigid proximal support shaft 24120. Furthermore, each helical spring 24896 is associated with a tension lug 24897, which is also connected via a journal to and secured to each of the respective articular motion cables 24242, 24246, 24250, and 24524 to achieve a desired amount of compression in each spring 24896. This compression serves to hold the annular rib members 24810P, 24810, and 24810D to each other and to movably engage with the proximal attachment rib 24870 and the distal attachment rib 24890. Cables 24242, 24246, 24250, and 24254 are operatively connected to a joint motion control system supported within the housing of surgical instrument 22010. For example, as discussed above, the proximal portion of each cable 24242, 24246, 24250, and 24254 can be wound around a corresponding rotary reel or cable management system 2007 within the housing portion of surgical instrument 22010. Figure 2 On the reel or cable management system, each cable 24242, 24246, 24250, and 24254 is configured to be extended and retracted in a desired manner. The reel / cable management system can be motor-driven or manually driven (ratchet arrangement, etc.). Figure 59 The articulation joint 24200 in a non-articular motion position is shown, and Figure 60 A joint motion connector in a joint motion configuration is shown. This arrangement allows the surgical end effector 23000 to perform joint motion relative to the elongated shaft assembly 24000 through multiple joint motion planes.

[0266] like Figure 49 , Figure 58 and Figure 64 As can be seen, the surgical instrument 22010 employs a constant velocity (CV) drive shaft assembly 2620, which spans or extends axially through the articular motion joint 24200. The operation and configuration of the CV drive shaft assembly 2620 have been described in detail above and will not be repeated here except where necessary for understanding the operation of the surgical instrument 22010. In short, as discussed above, the CV drive shaft assembly 2620 includes a proximal CV drive assembly 2630 and a distal CV drive shaft 2670. The proximal CV drive assembly 2630 includes a proximal shaft segment 2632 formed by an attachment shaft 2634 configured to be non-rotatably received within a similarly shaped connector cavity 2616 in the distal end 2614 of the proximal rotary drive shaft 2610. The proximal shaft segment 2632 is operatively engaged with a series 2640 of movably coupled drive joints 2650. Figure 58 As can be seen from the preceding description, in order to ensure that the drive joints 2650 engage with each other, a proximal drive spring 2740 is used to apply an axial biasing force to the series 2640 of the drive joints 2650. For example, as Figure 58 As can be seen, the proximal drive spring 2740 is positioned between the proximal mounting bushing 2734 and the support flange formed between the distal insertion portion 2636 and the proximal cylinder portion 2638 of the proximal shaft section 2632. In one arrangement, the proximal drive spring 2740 may include an elastomeric O-ring received on the proximal cylinder portion 2638 of the proximal shaft section 2632. The proximal drive spring 2740 slightly biases the drive joints 2650 together to reduce any play that occurs during joint movement. This ensures that the drive joints 2650 torsionally transmit the load. However, it should be understood that in at least one arrangement, the proximal drive spring 2740 does not apply a sufficiently high axial load such that the firing load translates through the joint movement joint 2200.

[0267] To further prevent the drive joint 2650 from buckling during joint movement, a series 2640 of the movably coupled drive joints 2650 extend through at least one low-friction drive cover 24730, which extends through a central drive conduit 24860 in each of the annular rib members 24810. Figure 63 and Figure 65In the depicted arrangement, the drive cover 24730 includes an externally cut hypotube and an internally cut hypotube 24732. This hypotube 24732 may be made of metal (e.g., stainless steel) and has multiple series of incisions or slits therein that can be made using a laser cutter. In the illustrated arrangement, the hypotube 24732 may be manufactured with an upper release conduit 24734 that provides a clearance for the upper flexible spine assembly 24400 to pass over it during surgery when the surgical end effector 23000 is in one or more joint movement positions. Furthermore, the hypotube 24732 may have a lower release conduit 24736 to provide a similar clearance for the lower flexible spine assembly 24500. Figure 65 It can also be seen that the hysteresis tube 24732 can be shaped to have lateral tab portions 24738 opposite in diameter to provide lateral stability during joint movement. Figure 66 An alternative drive cover 24730' including an internally cut submersible tube 24732' is shown. Figure 58 , Figure 67 , Figure 68 and Figure 69 An alternative drive cover 24730” is shown, comprising a flexible heat-shrinkable tube 24732” applied to a constant speed (CV) drive shaft assembly 2620. In other arrangements, the drive cover may also include a helical spring or a helical member.

[0268] Various embodiments of this disclosure offer advantages over previous surgical endoscopic cutter configurations capable of articulation. For example, pushing the firing member forward in an articulated end effector typically requires a large force, and this force must be balanced. For instance, when firing the firing member at an angle greater than sixty degrees, it becomes very difficult to push the beam through the articulated joint. The joint also experiences significant loads, which can cause the articulated joint to disengage from the articulation. By employing an upper flexible drive arrangement and a lower flexible drive arrangement (each flexible as it passes through the articulated joint, but then becoming rigid as it is distal to the articulated joint), a large degree of articulation (e.g., articulation angles exceeding seventy degrees) is allowed while balancing loads are applied to the firing member, which are constrained to the firing member but not to the articulated joint. In other words, torsional loads, rather than longitudinal loads, are applied proximally to the articulated joint, and these longitudinal loads can cause the end effector to disengage from the articulation. The torsional load is converted into a longitudinal load at a location distal to the articulated joint. Therefore, the rotary drive screw is used to effectively convert torsional motion or load into longitudinal load, which is applied to the firing member at a location distal to the articulated joint.

[0269] 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.

[0270] Figures 70 to 73 Another surgical end effector 4000 is shown that can be used with surgical instrument 3010, which is similar in many respects to surgical instrument 10. Except for the differences discussed below, surgical end effector 4000 may be similar to surgical end effector 1000. Surgical end effector 4000 is operatively coupled to an elongated shaft assembly 5000. Elongated shaft assembly 5000 may be operatively attached to a housing portion of surgical instrument 3010. The housing may include a handle configured to be grasped, manipulated, and actuated by a clinician. In other embodiments, the housing may include housing of a robotic system or otherwise operatively supporting a portion of at least one drive system configured to generate and apply at least one control motion that can be used to actuate the surgical end effectors disclosed herein and their corresponding equivalents.

[0271] 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.

[0272] The elongated shaft assembly 5000 may include a proximal end 4112 attached to the elongated channel 4110 and a distal spine assembly 5010 of the articular joint 5200. See also Figure 70The distal spinal assembly 5010 is immovably supported in the distal external cannula section 5020, which is operatively engaged with the surgical end effector 4000. The elongated shaft assembly 5000 also includes a proximal spinal member (not shown) operatively engaged with the proximal end of the articulation joint 5200 and operatively attached to or otherwise operatively engaged with the housing of the surgical instrument 3010. The proximal external cannula section 5030 extends from the articulation joint 5200 back to the housing for operative engagement therewith.

[0273] Surgical instrument 3010 employs a firing drive system 4300, which includes a firing member 4310 comprising a vertically extending firing member body 4312, the firing member body including a top firing member feature and a bottom firing member feature. A tissue cutting blade 4314 is attached to or formed within the vertically extending firing member body 4312. The firing drive system 4300 includes a rotary drive nut 4400 configured to rotatably drive a series 4600 of drive components 4610 operably engaged with the firing member 4310. The rotary drive nut 4400 includes a flexible proximal section 4410 spanning a joint joint 5200 and a threaded distal section 4420 distal to the joint joint 5200. The distal section 4420 includes a series of variable pitch threads 4430, with a coarser pitch 4432 at the proximal end and a narrower pitch 4434 at the distal end or exit end. See also Figure 72 The threaded rotary drive nut 4400 includes a proximal drive gear 4440 that meshes with a distal drive gear 4510 attached to the rotary drive shaft 4500. See also Figure 70 The rotary drive shaft 4500 can be connected to a gearbox / motor arrangement supported in the housing of the surgical instrument 3010. Rotation of the rotary drive shaft 4500 causes the drive nut 4400 to rotate about the shaft axis SA.

[0274] The rotary drive nut 4400 includes a proximal section 4410 and a distal section 4420. The threaded distal section 4420 is located distal to the articulated joint 5200 and is configured to threadably engage a series 4600 of drive components 4610, which are loosely connected together by a flexible chain 4640. In at least one arrangement, for example, each drive component 4610 includes a vertically extending plate member 4612, each vertically extending plate member including a top end 4614 and a bottom end 4618. The top end 4614 includes a top threaded section 4616, and the bottom end 4418 includes a bottom threaded section 4620. The top threaded section 4616 and the bottom threaded section 4620 are configured to threadably engage with the threads 4430 of the rotary drive nut 4400. The series 4600 of the drive components 4610 are configured to flexibly pass through the articulated joint 5200 and enter the vertical conduit 5012 in the distal ridge assembly 5010. Rotation of the drive nut 4400 in a first rotational direction causes the series 4600 of the drive components 4610 to move axially in the distal direction, and rotation of the drive nut 4400 in a second rotational direction causes the series 4600 of the drive components 4610 to move axially in the proximal direction.

[0275] Go to Figure 72 In at least one arrangement, each drive member 4610 further includes a distally projecting latching feature 4630. Each latching feature 4360 is configured to be releasably received in a latching cavity 4364 formed in an adjacent drive member 4610 immediately adjacent to the latching feature distal to it. When the drive members 4610 are latched together, these drive members form an axial rigidity series 4600AR for applying axial drive movement to the firing member 5310 to drive the firing member 5310 through the surgical end effector 4000 from a starting position to an ending position and then back from the ending position to the starting position. Figure 72 As can be seen, when the drive component 4610 enters the threaded distal section 4420 of the rotary drive nut 4400, these drive components are loosely connected together. When the drive component 4610 is threadedly engaged with the fine-pitch thread 4430 in the threaded distal section 4420 of the rotary drive nut 4400, the latching feature 4630 is received in a latching manner within a corresponding latching cavity 4364 in the distal adjacent drive component 4610 to form an axial rigidity series 4600AR of the drive component 4610. In one arrangement, the distal drive component 4610 may be configured to engage the firing member 4310 in a similar latching manner, or in another arrangement, the distal drive component may be non-removably attached to the firing member 4310.

[0276] In the illustrated example, the drive components 4610 in the series 4600 of drive components are flexibly connected together, allowing them to move relative to each other to accommodate the articulated joint, and eliminating the need for the reinforcing support 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.

[0277] Figures 73 to 76 Another surgical end effector 6000 employing a drive system 6300 is shown, which includes a series 6600 of flexible connecting drive components 6610 that can be used to traverse the 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.

[0278] Go to Figure 74 In at least one arrangement, each drive member 6610 includes a drive member body 6612 having a proximal side 6614, a distal side 6616, and a threaded section 6620 formed on a bottom surface 6618. Each drive member 6610 also includes a latching feature 6630 projecting proximally. Each latching feature 6630 includes a neck feature 6632 having a spherical latching head 6634 formed at its end. The latching feature 6630 is configured to be movably received within a latching cavity 6336 formed in an adjacent drive member 6610 immediately adjacent to the distal side of the latching feature. To facilitate movable attachment of the drive members 6610 in a movably continuous arrangement, the spherical latching head 6634 is inserted through a tapered conduit 6338 in the drive member body 6612 and into the latching cavity 6636. The size and shape of the spherical latch head 6634 relative to the latch cavity 6636 are set such that when Figure 74The arrangement shown allows relative movement between the drive components 6610. However, when the drive components are axially aligned such that the distal side 6616 of one drive component 6610 abuts against the proximal side 6614 of the drive component immediately adjacent to the distal side of the drive component, the drive components 6610 form an axially rigid series 6600AR of the drive components that can drive the firing member 6130 through the surgical end effector 6000.

[0279] like Figure 73 As can be seen, a series 6600 of drive components 6610 are driven by a flexible rotary drive system 6700. In one arrangement, the flexible rotary drive system 6700 includes a flexible rotary drive shaft 6710 that passes through an articulated joint 6210 and includes a rotary drive gear 6720 configured to threadedly engage threaded sections 6620 on each drive component 6610. The flexible rotary drive shaft 6710 can be rotated by a motor / gear arrangement supported in the housing of a surgical instrument. The portion 6600F of the series 6600 of drive components 6610 proximal to the rotary drive gear 6720 remains flexibly connected or “loose.” When the drive components 6610 are threadedly engaged by the rotary drive gear 6720, these drive components are driven through a conduit in a channel 6010, which causes the drive components to form an axially rigid series 6600AR for driving the firing member 6130 through the surgical end effector 6000.

[0280] When firing system components traverse the articulated joint, the torsional load applied to these components is less likely than the axial load to disengage the articulated joint from its articulation. The various embodiments disclosed herein transfer the torsional load to a longitudinal load located distal to the articulated joint. Because the longitudinal load is contained within the end effector, disengagement from the articulation is prevented. Figure 77An example of a firing system 6800 that can provide such advantages is shown. The firing system 6800 includes a firing member 6810 configured to be operably supported in a surgical end effector in various ways described herein. A flexible spring-like follower 6820 is attached to the firing member 6810. This flexible spring-like follower 6820 can span an articulation joint region 6840, which allows for a relatively large range of articulation. The flexible spring-like follower 6820 is configured to be axially driven across the articulation joint region 6840 by a rotatably supported flexible spring-like torsional drive member 6830. The flexible spring-like torsional drive member 6830 includes a threaded insert 6832 configured to thread-engage the spring-like follower 6820 at a location 6841 distal to the articulation joint region 6840. The flexible spring-like torsional drive member 6830 can be rotated by a motor / gear arrangement supported within the housing of a surgical instrument. When the flexible spring-shaped torsion drive member 6830 rotates in the first direction, the flexible spring-shaped follower member 6820 translates longitudinally to drive the firing member 6810. The rotation of the flexible torsion drive member 6830 in the second direction will cause the flexible spring-shaped follower member to move proximally.

[0281] Figure 78 Another firing system 6850 is shown, which includes a firing member 6860 configured to be operably supported in a surgical end effector in various manners described herein. The firing member 6860 is driven by a firing member drive assembly 6861, which includes a series 6862 of spherical ball members 6870 connected together by a flexible cable 6872. This series 6862 of the flexible spherical ball members 6870 spans an articulation joint region 6840, which allows for a relatively large range of articulation. The series 6862 of the flexible spherical ball members 6870 is configured to be axially driven by a rotatably supported flexible torsional drive member 6880 to span an articulation joint region 6890. The flexible torsional drive member 6880 includes an insert 6882 configured to operatively engage at a position 6892 distal to the articulation joint region 6890 of the spherical ball member 6870. The flexible torsional drive member 6880 can be rotated by a motor / gear arrangement supported within the housing of the surgical instrument. When the flexible torsional drive member 6880 rotates in a first direction, the spherical members 6870 are driven distally into contact with each other, forming an axially rigid series 6862AR that translates longitudinally to drive the firing member 6860 distally. Rotation of the flexible torsional drive member 6880 in a second direction will cause the series of spherical members 6870 to move proximally.

[0282] Figure 79 Another firing system 6950 is shown, which includes a firing member 6960 configured to be operably supported in a surgical end effector in various ways described herein. A laser-cut hypotube follower 6970 is attached to the firing member 6960. This flexible follower 6970 can span an articulation joint region 6940, which allows for a relatively large range of articulation. The flexible follower 6970 is configured to be axially driven across the articulation joint region 6940 by a rotatably supported flexible torsional drive member 6980. The flexible torsional drive member 6980 includes a threaded insert 6982 configured to threadably engage a laser incision 6972 on the flexible follower 6970 at a location 6942 distal to the articulation joint region 6940. The flexible torsional drive member 6980 can be rotated by a motor / gear arrangement supported in the housing of a surgical instrument. When the flexible torsional drive member 6980 rotates in the first direction, the flexible follower member 6970 translates longitudinally to drive the firing member 6960. The rotation of the flexible torsional drive member 6980 in the second direction will cause the flexible follower member 6970 to move proximally.

[0283] Pushing the firing beam forward in an articulated end effector typically requires a significant amount of force, and this force must be balanced. For example, it is often difficult to push the firing beam through an articulated joint that has been articulated to an angle greater than sixty degrees. When the firing beam crosses the articulated joint, it can apply a significant load to the articulated joint components, which can cause the articulated joint to disengage from the articulation. Figures 80 to 84 A firing drive system 7300 is shown, comprising a flexible upper drive belt 7320 and a flexible lower drive belt 7330 attached to a firing member 7310, the firing member being configured to move between a starting position and an ending position within a surgical end effector 7000. Figures 80 to 82 As can be seen, the flexible upper drive belt 7320 includes a plurality of spaced-apart upper drive teeth 7322, which are configured to thread-engage helical threads 7342 on the rotary drive nut 7340. Similarly, the flexible lower drive belt 7330 includes a plurality of spaced-apart lower drive teeth 7332, which are configured to thread-engage helical threads 7342 on the rotary drive nut 7340. In at least one arrangement, the flexible upper drive belt 7320 and the flexible lower drive belt 7330 are formed of a metallic material and are welded to or otherwise attached to the firing member 7310. This arrangement is used to balance the firing load applied to the firing member 7310.

[0284] A rotary drive nut 7340 is received on a flexible rotary drive shaft 7350, which is centrally located between a flexible upper drive belt 7320 and a flexible lower drive belt 7330 and traverses the articulated joint region generally designated 7200. The flexible rotary drive shaft 7350 is rotatable by a motor / gear arrangement supported within the housing of the surgical instrument. When the flexible rotary drive shaft 7350 rotates in a first direction, the flexible upper drive belt 7320 and the flexible lower drive belt 7330 drive the firing member 7310 distally. Rotation of the flexible rotary drive shaft 7350 in a second direction causes the flexible upper drive belt 7320 and the flexible lower drive belt 7330 to pull the firing member 7310 proximally. In at least one arrangement, the flexible upper drive belt 7320 and the flexible lower drive belt 7330 pass through a guide member 7360 surrounding the rotary drive nut 7340 to prevent the flexible upper drive belt 7320 and the flexible lower drive belt 7330 from bypassing the rotary drive nut 7340 during actuation of the flexible rotary drive shaft 7350. See also Figure 84 .

[0285] In the illustrated arrangement, the firing member 7310 is configured to move through a surgical end effector 7000, which includes a first jaw 7010 and a second jaw 7030, the second jaw being configured to move relative to the first jaw 7010. In one embodiment, the first jaw 7010 includes an elongated channel 7012 configured to operably support a surgical staple cartridge therein. See also Figure 80 and Figure 81 The second jaw 7030 includes an anvil 7032, which is pivotally supported on the elongated channel 7012 and movable relative to the elongated channel 7012 between an open position and a closed position. Figure 82 As can be seen, in at least one form, the firing member 7310 includes a shape commonly referred to as an "E-beam". The firing member 7310 includes a vertically extending firing member body 7312 having a lower base feature 7314 including two laterally extending tabs 7315 configured to slidably engage the elongated channel 7012 when the firing member is axially driven within it. Furthermore, a pair of upper tabs 7316 protrude from the upper portion of the firing member body 7312 to engage the anvil 7032 when the firing member 7310 is driven distally through a closed anvil 7032. During the firing stroke, the tabs 7315 and 7316 can be used to space the anvil 7032 relative to the surgical cartridge supported in the elongated channel 7012. The firing member body 7312 also includes a tissue cutting feature 7318. The tab 7316 can also be used to apply a closing motion to the anvil 7032 when the firing member 7310 moves from the starting position to the distal side.

[0286] In the illustrated example, the firing drive system 7300 can also be used to apply opening and closing movements to the anvil 7032. For example... Figures 80 to 83 As can be seen, the closing nut 7370 is threadedly received on the flexible rotary drive shaft 7350. The closing nut 7370 includes a cam pin 7372 that extends laterally from each side of the closing nut 7370 to be received in a corresponding cam slot 7036 in the anvil mounting portion 7034 of the anvil 7032. See also... Figure 80 and Figure 81 This cam pin 7372 prevents the closing nut 7370 from rotating together with the flexible rotary drive shaft 7350, such that rotation of the flexible rotary drive shaft 7350 causes axial movement of the closing nut 7370. Therefore, rotation of the flexible rotary drive shaft 7350 in the first direction causes the closing nut 7370 to move distally and moves the anvil 7032 from the open position to the closed position via a cam. Rotation of the flexible rotary drive shaft 7350 in the second rotational direction causes the closing nut 7370 to move proximally and moves the anvil 7032 via a cam back to the open position. Thus, for example, alternating rotation of the flexible rotary drive shaft 7350 allows the surgeon to quickly open and close the anvil 7032 for gripping purposes.

[0287] Figure 85 An alternative firing drive assembly 7302 is shown, which includes a flexible upper drive belt 7320' having upper drive teeth 7322' and a flexible lower drive belt 7330' having lower drive teeth 7332', the flexible lower drive belt being formed from a single piece of material such as metal. The flexible upper drive belt 7320' also includes an upper reinforcing tab 7324' similar to an upper tab 7316 on the firing member 7310, which is configured to pass through an anvil 7032, and a lower reinforcing tab 7334 similar to a tab 7315 on the firing member 7310, which is configured to pass through a channel 7012. Figure 86 An alternative firing drive assembly 7302' is shown, which is made of two belt assemblies 7302A and 7302B laminated together to form a flexible upper drive belt 7320" with upper drive teeth 7322" and a flexible lower drive belt 7330" with lower drive teeth 7332". Each belt assembly 7302A, 7302B also includes upper reinforcing tabs 7324A" and 7324B" and lower reinforcing tabs 7334A" and 7334B" respectively configured to pass through the anvil 7032 and the elongated channel 7012.

[0288] For example, the firing drive system 7300 is used to apply a uniform drive motion to the firing member 7310 and can accommodate articulation angles greater than seventy degrees. Furthermore, because the rotary drive nut 7340 engages the flexible upper drive belt 7320 and the flexible lower drive belt 7330 at a position distal to the articulation joint region 7200, the linear firing load is limited to the end effector and does not pass through the articulation joint.

[0289] Figures 87 to 89 Another form of surgical instrument 9010 is shown, which addresses many of the challenges faced by surgical instruments with end effectors capable of joint movement to large joint angles and end effectors configured to cut and fasten tissue. In various embodiments, surgical instrument 9010 may include a handheld device. In other embodiments, surgical instrument 9010 may include an automated system, such as sometimes referred to as a robot control system. In various forms, surgical instrument 9010 includes a surgical end effector 10000 operatively coupled to an elongated shaft assembly 12000. The elongated shaft assembly 12000 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.

[0290] In one embodiment, 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 elongated channel 10110 comprising a proximal end 10112 and a distal end 10114 and is configured to operably support a surgical cartridge 10300 therein. The surgical cartridge 10300 includes a cartridge body 10302 having an elongated slot 10304 therein. A plurality of surgical staples or fasteners (not shown) are stored in the cartridge body on actuators (not shown) arranged in rows on each side of the elongated slot 10304. Each actuator is associated with a corresponding staple cavity 10308 exposed through a cartridge platform surface 10306. The surgical cartridge 10300 can be replaced after the staples / fasteners have been ejected therefrom. Other implementations are conceivable in which the elongated channel 10110 and / or the entire surgical end effector 10000 are discarded after the surgical cartridge 10300 has been used.

[0291] In the illustrated arrangement, the second jaw 10200 includes an anvil 10210, which includes an elongated anvil body 10212 having a proximal end 10214 and a distal end 10216. The anvil body 10212 includes a staple-shaped lower surface 10218 facing the first jaw 10100 and may include a series of staple-shaped recesses (not shown) corresponding to each of the staples or fasteners in the surgical cartridge 10300. The anvil body 10212 may also include a pair of downwardly extending tissue stop features 10220 formed adjacent to the proximal end 10214 of the anvil body 10212. A tissue stop feature 10220 extends from each side of the anvil body 10212 such that the distal end 10222 on each tissue stop 10220 corresponds to the nearest side staple / fastener in the surgical cartridge 10300. When the anvil 10200 moves to the closed position toward the tissue positioned between the staple-forming lower surface 10218 of the anvil 10200 and the staple cartridge platform surface 10306 of the surgical staple cartridge 10300, the distal end 10222 of the tissue contact tissue stop 10220 prevents the tissue from moving proximally past the nearest side staple / fastener, thereby ensuring that the cut tissue is also sutured. When the surgical staple cartridge is “fired” as will be discussed in further detail below, the staples / fasteners supported in each staple cavity are driven out of the staple cavity 10308, through the clamped tissue, and into contact with the staple-forming lower surface 10218 of the anvil 10200.

[0292] like Figure 88As can be seen, the proximal end 10214 of the anvil body 10212 includes an anvil mounting portion 10230, which includes a pair of laterally extending mounting pins 10232 configured to be received in corresponding mounting inserts 10130. These corresponding mounting inserts are configured to be held securely received within mounting brackets 10120 formed in the proximal end 10112 of the elongated 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 attached to the elongated channel 10110 by welding, adhesive, snap-fit, or the like. This arrangement facilitates the pivoting of the anvil 10210 relative to the elongated channel 10110 about a fixed (i.e., non-translating, non-moving) pivot axis PA. See also Figure 87 .

[0293] In the illustrated arrangement, the elongated shaft assembly 12000 defines an axis SA and includes a hollow outer tube (omitted for clarity) operatively connected to the housing of a control portion of the surgical instrument 9010 (e.g., a handheld unit, robotic tool actuator, etc.). The elongated shaft assembly 12000 also includes an articulation joint 12200 attachable to the hollow outer tube and the surgical end effector 10000 to allow selective articulation of the surgical end effector 10000 relative to the elongated shaft assembly 12000 about multiple articulation axes in multiple articulation planes. 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 operatively connected to the proximal joint member 12210 such that the central joint member 12230 can selectively perform joint movements through a first or proximal joint movement plane defined by a first or proximal joint movement axis AA1 transverse to the axial axis SA. Similarly, in another example, the distal joint member 12250 is operatively connected to the central joint member 12230 such that the distal joint member 12250 can selectively perform joint movements through a second or distal joint movement plane defined by a second or distal joint movement axis AA2 transverse to both the axial axis SA and the first or proximal joint movement axis AA1.

[0294] like Figure 89 and Figure 90As can be seen, the proximal connector member 12210 includes a proximal connector distal side 12212, which defines two spaced-apart laterally oriented tip portions 12214 and 12216. Tip portion 12214 defines a radial surface 12215, and tip portion 12216 defines a radial surface 12217. Figure 90 The center joint member 12230 includes a proximal side 12232 that defines two spaced-apart transverse proximal end portions 12234 and 12236. The proximal end portion 12234 defines a radial surface 12235, and the end portion 12236 defines a radial surface 12237. Figure 89 As can be seen, the proximal side 12232 of the central connector member 12230 faces the distal side 12212 of the proximal connector member 12210, allowing the central connector member 12230 to move through the first joint motion plane defined by the first or proximal joint motion axis AA1, which extends between the point where the transverse apex portion 12214 on the proximal connector member contacts the proximal apex portion 12234 on the central connector member 12230 and the point where the transverse apex portion 12216 on the proximal connector member 12210 contacts the proximal apex portion 12236 on the central connector member 12230. In one arrangement, radial surfaces 12215 and 12217 on the lateral end portions 12214 and 12216, respectively, and radial surfaces 12235 and 12237 on the proximal end portions 12234 and 12236, respectively, can serve as rocker arm points / surfaces, and the central joint member 12230 can articulate relative to the proximal joint member 12210 about these rocker arm points / surfaces. Additionally, the central joint member 12230 includes a proximal first gear tooth section configured to rotatably mesh with distal gear sections 12218 and 12220 on the proximal joint member 12210. See also Figure 88 In various arrangements, the radial surface 12235 on the central joint member 12230 may 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 may be spaced apart from the radial surface 12217 on the proximal joint member 12210.

[0295] The center connector member 12230 also includes a center connector distal side 12240, which defines a centrally located upper tip portion 12242 forming an upper radial surface 12244 and a lower tip portion 12246 forming a lower radial surface 12248. See also Figure 89The distal connector member 12250 is attached to the proximal end 10112 of the elongated channel 10110 via a mounting bushing 10150, and includes a proximal side 12251 facing or confronting the distal side 12240 of the central connector member 12230. See also Figure 89 and Figure 92 .like Figure 89 and Figure 92 As can be seen, the proximal side 12251 defines a centrally located upper tip portion 12252 forming an upper radial surface 12254, which is configured to face or abut against the upper radial surface 12244 on the center joint member 12230. The proximal side 12251 also defines a centrally located lower tip portion 12256 forming a lower radial surface 12258, which is configured to face or abut against the lower radial surface 12248 on the center joint member 12230. See also... Figure 89 The distal connector member 12250 also includes an upper gear tooth section 12253 configured to rotatably mesh with an upper gear tooth section 12243 on the central connector member 12230. Furthermore, the distal connector member 12250 includes a lower gear tooth section 12255 configured to rotatably mesh with a lower gear tooth section 12245 on the central connector member 12230. See also Figure 92 .

[0296] The distal joint member 12250 is configured to move through a second or distal joint motion plane defined by a second or distal joint motion axis AA2, which extends between the 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 the 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 also Figure 89 and Figure 92In one arrangement, radial surfaces 12254 and 12258 on the upper end portion 12252 and lower end portion 12256 of the distal joint member 12250, and radial surfaces 12244 and 12248 on the upper end portion 12242 and lower end portion 12246 of the central joint member 12230, respectively, can serve as rocker arm points / surfaces, around which the distal joint member 12250 can articulate relative to the central joint member 12230. However, in an alternative arrangement, the radial surface 12254 on the distal joint member 12250 is spaced apart from the radial surface 12244 on the central joint member 12230, and the radial surface 12258 on the distal joint member 12250 is spaced apart from the radial surface 12248 on the central joint member 12230.

[0297] return Figure 88 In the illustrated example, the articular joint 12200 is operatively controlled by a cable control system 9030, which includes four cables 12510, 12520, 12530, and 12540 extending through the elongated shaft assembly 12000. The cable control system 9030 may be supported within the housing 9020 of the surgical instrument 9010. The cable control system 9030 may include multiple cable support members / drive wheels, pulleys, etc., controlled by one or more corresponding motors controlled by a control circuit portion of the surgical instrument 9010. In various embodiments, the cable control system 9030 is configured to manage cable tension (pulling) and release at precise times during joint movement. Furthermore, in at least one arrangement, the cable control system 9030 is used to control the opening and closing of the anvil 10210, as will be discussed in further detail below.

[0298] like Figure 88 As can be seen, cables 12510, 12520, 12530, and 12540 are configured to be operatively connected to a closure system 12600, which is rotatably mounted in the proximal end 10112 of the elongated channel 10110. In at least one arrangement, the closure system 12600 includes a pulley unit 12610, which includes a first transverse α-winding pulley 12620 and a second transverse α-winding pulley 12630 interconnected by a central shaft 12640. See also Figure 93 and Figure 94 The pulley unit 12610 is rotatably supported within the proximal end 10112 of the elongated channel 10110 by mounting brackets 12710 and 12720. See also Figure 88More specifically, the proximal end 10112 of the elongated channel 10110 defines a firing member parking area 10140, which is proximal to the mounting bracket 10120 and configured to operably support the firing member 12310 when in the initial position. Each mounting bracket 12710, 12720 is mounted within the firing member parking area 10140 on each side of the axis SA, such that the firing member 12310 can be received in the parking area 10140 when in the initial position. The mounting brackets 12710, 12720 can be attached to the proximal end 10112 of the elongated channel 10110 by welding, adhesive, snap-fit ​​features, etc. Mounting bracket 12710 includes a first shaft bracket 12712 configured to rotatably support a first pivot shaft 12621 protruding from a first transverse α-winding pulley 12620, and a second mounting bracket 12720 includes a second shaft bracket 12722 configured to rotatably support a second pivot shaft 12644 protruding from a second transverse α-winding pulley 12630. Furthermore, each mounting bracket 12710, 12720 includes a release region 12732 shaped to receive the corresponding first α-winding pulley 12620 and second α-winding pulley 12630 therein.

[0299] like Figure 94 As can be seen, the first α-winding pulley 12620 includes a first circumferential groove 12622 and a second circumferential groove 12624. In the illustrated example, a first cable 12510 is received in and attached to the first circumferential groove 12622, and a second cable 12520 is received in and attached to the second circumferential groove 12624. Pulling the first cable 12510 will cause the first transverse α-winding pulley 12620 to rotate in a first direction, and pulling the second cable 12520 will cause the first transverse α-winding pulley 12620 to rotate in a second opposite direction. Similarly, the second transverse α-winding pulley 12630 includes a first circumferential groove 12632 and a second circumferential groove 12634. In the illustrated arrangement, a first cable 12540 is received in and attached to a first circumferential groove 12632, and a second cable 12520 is received in and attached to a second circumferential groove 12634. Pulling the fourth cable 12540 will cause the first and second α-winding pulleys 12630 to rotate in a first direction, and pulling the third cable 12530 will cause the second transverse α-winding pulley 12630 to rotate in a second opposite direction. The transverse α-winding pulleys 12620 and 12630 can rotate approximately 330 degrees. This range of rotation is significantly different from that of normal pulleys, which can have a range of rotation of less than 180 degrees.

[0300] Each of the first transverse α-winding pulley 12620 and the second transverse α-winding pulley 12630 further includes a corresponding helical closing cam, which is configured to apply a closing motion to the anvil 10210. Figure 94 As can be seen, the first transverse α-winding pulley 12620 includes a first helical closing cam 12626, and the second transverse α-winding pulley 12630 has a second helical closing cam 12636 thereon. The helical closing cams 12626 and 12636 are configured to interact in a cam manner with the corresponding anvil closing arm 10234 on the anvil mounting portion 10230 of the anvil 10210 to apply a closing motion thereto. Figure 96 This diagram illustrates the position of the helical closing cam 12626 on the first transverse α-winding pulley 12620 when the anvil 10210 is biased to the open position by the anvil spring 10240. Rotation of the pulley unit 12610 in the first rotational direction will cause the helical closing cam 12626 to move the anvil 1210 cam to... Figure 97 The closed position is shown. To open the anvil 10210, the pulley unit 12610 rotates back in the opposite direction. Figure 96 The location shown.

[0301] See now Figure 91 and Figure 93 A first cable 12510 extends from the cable control system through an elongated shaft assembly and through a conduit in the proximal connector member 12210, and surrounds two redirecting pulleys 12650 and 12660, which are supported on shafts 12602 and 12612 mounted in the central connector member 12230. The first cable 12510 exits the central connector member 12230 through conduit 12231 and extends through conduit 12257 in the distal connector member 12250 to be received in a first circumferential groove 12622 in a first transverse α-winding pulley 12620, where the first cable is attached to the first circumferential groove. A second cable 12520 extends from the cable control system through an elongated shaft assembly and through a conduit 12213 in the proximal connector member 12210 to surround the redirecting pulleys 12650 and 12660 in the central connector member 12230. The second cable 12520 passes through the corresponding conduit 12241, exits the central connector member 12230, and extends through the conduit 12259 in the distal connector member 12250 to be received in the second circumferential groove 12624 in the first transverse α winding pulley 12620, where the second cable is attached to the second circumferential groove.

[0302] 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 connector member 12210, the central connector member 12230, and the distal connector member 12250, to be received in a corresponding circumferential groove in the second transverse α-winding pulley 12630, where the third cable is attached to the corresponding circumferential groove. Furthermore, a fourth cable 12540 extends from the cable control system 9030 through the elongated shaft assembly 12000 and through corresponding conduits in the proximal connector member 12210, the central connector member 12230, and the distal connector member 12250, to be received in a corresponding circumferential groove in the second transverse α-winding pulley 12630, where the fourth cable is attached to the corresponding circumferential groove.

[0303] In at least one example, to enable the surgical end effector 10000 to articulate relative to the elongated shaft assembly 12000 through a first articulation plane defined by a first articulation axis AA1, the cable control system 9030 is actuated to simultaneously pull the second cable 12520 and the fourth cable 12540, wherein equal amounts of tension are applied to each cable 12520 and 12540. Because equal amounts of tension are applied to both sides of the pulley unit 12610, the pulley unit 12610 does not rotate. However, the pulling action of the cables 12520 and 12540 is transferred to the surgical end effector 10000 via the articulation joint 12200, which causes the central joint member 12230 to articulate relative to the proximal joint member 12210 about the first articulation axis AA1. See also Figure 92 and Figure 98 To enable the surgical end effector 10000 to articulate through a second joint motion plane defined by the second joint motion axis AA2 and transverse to the first joint motion plane, the cable control system 9030 is actuated to simultaneously pull the third cable 12530 and the fourth cable 12540, with equal tension applied to each cable 12530 and 12540. Because cables 12530 and 12540 apply equal tension on both sides of the second transverse α-wound pulley 12630 of the pulley unit 12610, the pulley unit 12610 does not rotate. However, the pulling action of cables 12530 and 12540 is transferred to the surgical end effector 10000 via the articulation joint 12200, causing the distal joint member 12250 to articulate relative to the central joint member 12230 about the second joint motion axis AA2. See also Figure 92 and Figure 99 .

[0304] 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 cam 10626 on the first transverse α-winding pulley 10620 and the second transverse α-winding pulley 10630 is in... Figure 96 In the indicated position, the anvil 10210 is biased to the open position by the anvil spring 10240. To close the anvil 10210 from this position, the cable control system 9030 is actuated to simultaneously pull the first cable 12510 and the fourth cable 12540, wherein the same amount of tension is applied to each cable 12510 and 12540. These cables 12510 and 12540 will cause the pulley unit 12610 to rotate to... Figure 97 The closed position shown causes the closing cam 10626 to engage the anvil closing arm 10234 in a cam-like manner, causing the anvil 10210 to pivot to the closed position. It should be understood that by applying equal tension to cables 12510 and 12540, no torque is applied to the central joint member 12230 and / or the distal joint member 12250, because equal tension is applied to each side of the articulated joint 12200. See also... Figure 91 This arrangement allows the jaw closure to be shaped as needed. The 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 closure mechanism that generates a lower speed / greater force for clamping onto tissue. The cable control system 9030 of the present invention also does not produce the recoil typically found in other cable control systems, and therefore can also be used to control the articulated position of the end effector. As will be discussed further below, the cable-actuated closure and articulated system do not cross the central axis or shaft axis of the articulated joint that provides critical space for the firing drive system 13000.

[0305] The aforementioned articulation joint 12200 and cable control system 9030 facilitate the movement of two planar joints while also providing additional actuation motion to the surgical end effector 10000, thus keeping the central area of ​​the articulation joint 12200 available 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 includes an N+1 connector, meaning that for N degrees of freedom, the connector requires N+1 cables to actuate it. Therefore, in the example above, the articulation joint 12200 employs four actuation cables.

[0306] like Figures 100 to 103As can be seen, the firing drive system 13000 includes a firing member 13310, which includes a vertically extending firing member body 13312 having two laterally extending tabs 13314 projecting from a bottom portion 13313 of the firing member body 13312. The tabs 13314 are configured to slidably engage a flange 10113 in an elongated channel 10110 when the firing member 13310 is axially driven in the elongated channel 10110. Furthermore, a pair of upper tabs 13316 project from a top portion 13315 of the firing member body 13312. The upper tabs 13316 are configured to engage a flange 10213 in anvil body 10212 when the firing member 13310 is driven distally through a closed anvil body 10210. Figure 103 During the firing stroke, tabs 13314 and 13316 can be used to space the anvil 10210 relative to the surgical cartridge supported in the elongated channel 10110. The firing member body 13312 also includes a tissue cutting feature 13318 and a proximal notch 13319 configured to receive the central axis 12640 of the pulley unit 12610 when the firing member 13310 is in its proximal starting position within the firing member parking area 10140 in the proximal end 10112 of the elongated channel 10110.

[0307] like Figures 100 to 102 As shown, the firing drive system 13000 also includes an upper flexible chain drive assembly 13400 operably coupled to a top portion 13315 of the firing member 13310 and a lower flexible chain drive assembly 13500 operably coupled to a 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 link features 13420, which are loosely coupled together by an upper flexible coupler member 13402 attached to the top portion 13315 of the firing member 13310. In at least one example, each upper link feature 13420 includes an upper ball or sphere 13422 having an upper hollow conduit 13424 therein, the upper hollow conduit being configured to allow the upper flexible coupler member 13402 to pass through it. Figure 100As can be seen, the upper flexible chain drive assembly 13400 also 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 on the upper flexible connector member 13402. An upper collar 13440 is pressed onto the upper flexible connector member 13402, and an upper compression spring 13442 is connected via a journal between the upper collar 13440 and the upper flexible compression tube 13432, such that the upper flexible compression tube 13432 is distally biased to contact the nearest upper ball 13422P in the upper series 13410 of the upper link feature 13420.

[0308] Similarly, in at least one embodiment, the lower flexible chain drive assembly 13500 includes a lower series 13510 of lower link features 13520, which are loosely coupled together by a lower flexible connector member 13502 attached to the bottom portion 13313 of the firing member 13310. In at least one example, each lower link feature 13520 includes a lower ball or sphere 13522 having a lower hollow conduit 13524 therein, which is configured to allow the lower flexible connector member 13502 to pass through it. The lower flexible chain drive assembly 13500 also 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 on the lower flexible connector member 13502. The lower collar 13540 is pressed onto the lower flexible connector member 13502, and the lower compression spring 13542 is connected between the lower collar 13540 and the lower flexible compression tube 13532 via a journal, so that the lower flexible compression tube 13532 is biased distally to contact the nearest lower ball 13522P in the lower series 13510 of the lower link feature 13520.

[0309] Now go to Figure 104 In at least one arrangement, the firing drive system 13000 further includes a rotary drive screw 13700 configured to be drivably engaged with the upper series 13410 of the upper link feature 13420 and the lower series 13510 of the lower link feature 13520. Figure 104As can be seen, in the illustrated arrangement, the rotary drive screw 13700 is rotatably supported in a mounting bushing 10150, which is attached to the proximal end 10112 of the elongated channel 10110. For example, the rotary drive screw 13700 includes a body portion 13702 having a central shaft 13704 projecting therefrom, which is rotatably mounted in a mounting hole 10152 in the mounting bushing 10150. This arrangement allows the rotary drive screw 13700 to rotate about an axis SA.

[0310] In the illustrated example, the rotary drive screw 13700 is driven by a rotary drive system 13600, which includes a proximal rotary drive shaft 13610 rotatably supported within an axial conduit 12225 within a proximal connector member 12210. Figure 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 be engaged with a gearbox / motor arrangement 9050 or other rotary motion source housed in the housing 9020 of the surgical instrument 9010. This rotary motion source causes the proximal rotary drive shaft 13610 to rotate about the axial axis SA within an axial conduit 12225 in the proximal connector member 12210. See also... Figure 104 .like Figure 105 As can be seen, the distal end 13614 of the proximal rotary drive shaft 13610 is movably connected to the 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 also Figure 106 The first spherical proximal end 13622 is movably pinned to a first distal socket 13616 formed in the distal end 13614 of the proximal end rotary drive shaft 13610 via 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 to the first distal socket. The first spherical distal end 13624 is received within a first proximal socket 13632 in a central bearing housing 13630 mounted within a central joint member 12230. The first spherical distal end 13624 is movably pinned to the first proximal socket 13632 via 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.

[0311] like Figure 105 As can be seen, the rotary drive system 13600 also includes a second drive shaft section 13640, which is similar to the first drive shaft section 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 to 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 to the second distal socket. 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 relative to the rotary drive screw 13700 in multiple directions.

[0312] The dual-joint rotary drive maintains linear velocity output by using angular constraints on the joint members of the joint motion joints. This universal joint arrangement itself can have a sinusoidal output based on the joint angles. If the angles are equal and the phases are correctly aligned, the sinusoidal output of the first universal joint is canceled out by the second universal joint, resulting in a linear rotational speed. This is advantageous for imposing constraints in a rotary drive because it reduces component complexity and avoids the need to remove material from components to achieve the required clearance. Therefore, the components of this embodiment are more robust and stronger than existing arrangements. Furthermore, the constant speed of the rotary drive system allows for smoother firing and reduces wear that could otherwise be caused by vibration.

[0313] return Figure 102The rotary drive screw 13700 includes helical grooves or drive features 13708 formed on its circumference. These helical grooves or drive features are configured to engage and drive upper balls or spheres 13422 in the upper series 13410 of the upper link features 13420 and lower balls or spheres 13522 in the lower series 13510 of the lower link features 13520. Therefore, in order to drive the firing member 13310 from a starting position in the surgical end effector 10000 to an ending position within the end effector, the rotary drive system 13600 is actuated to apply rotary drive motion to the rotary drive screw 13700. When the rotary drive screw 13700 rotates in the first rotation direction, the helical drive feature 13708 engages the upper ball or sphere 13422 in the upper series 13410 of the upper link feature 13420 and the lower ball or sphere 13522 in the lower series 13510 of the lower link feature 13520, and drives the upper flexible chain drive assembly 13400 and the lower flexible chain drive assembly 13500 to the distal side. When each upper ball 13422 and lower ball 13522 engages the rotary drive screw 13700, the upper ball 13422 in the upper series 13410 distal to the rotary drive screw 13700 (and the articulated joint 12200) and the lower ball 13522 in the lower series 13510 distal to the rotary drive screw 13700 (and the articulated joint 12200) are placed under compression to apply a balanced axial driving force to the firing member 13310. When the upper flexible chain drive assembly 13400 and the lower flexible chain drive assembly 13500 are in a compressed state, they are constrained by the anvil 10210 and the slots in the elongated channel 10110, respectively. This arrangement ensures that the upper flexible chain drive assembly 13400 and the lower flexible chain drive assembly 13500 do not bend when compressed.

[0314] This arrangement enables two degrees of freedom of joint movement for several reasons. For example, the upper flexible chain drive assembly 13400 and the lower flexible chain drive assembly 13500 can bend freely on both the pitch and yaw axes. Therefore, the upper flexible chain drive assembly 13400 and the lower flexible chain drive assembly 13500 can be configured in various ways to accommodate a variety of joint positions achievable via the articulation joint 12200. Once the firing member 13310 has traveled distally through the surgical end effector 10000 to its final position, the rotary drive system 13600 is actuated to apply a second rotary drive motion to the rotary drive screw 13700, causing the rotary drive screw 13700 to rotate about its axis in a second rotational direction. When the rotary drive screw 13700 rotates in the second rotational direction, the upper flexible chain drive assembly 13400 and the lower flexible chain drive assembly 13500 are used to retract the firing member 13310 proximally back to its starting position. As the upper and lower flexible chain drive assemblies 13400 and 13500 retract the firing member 13310 proximally, a portion of each assembly returns across the articulated joint 12200 and into the elongated shaft. This arrangement allows the firing member 13310 to translate a long distance without increasing the length of the end effector joint. Furthermore, because the rotary drive screw 13700 operatively engages the upper flexible chain drive assembly 13400 and the lower flexible chain drive assembly 13500 at a position distal to the articulated joint 12200, high compressive loads are contained within the surgical end effector 10000 and no torque is generated on the articulated joint 12200. This arrangement significantly reduces the strength requirements of the articulated joint. See also Figure 104 .

[0315] In at least one arrangement, the surgical instrument 9010 may further include a cable tensioning system 13800 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 bend through the articulation joint 12200. Maintaining the upper and lower flexible chain drive assemblies under the desired tension as they traverse the articulation joint 12200 prevents the formation of slack in the flexible chain drive assemblies 13400, 13500, which could otherwise cause undesirable bundled aggregation of the flexible chain drive assemblies in the articulation joint 12200. Figure 111 and Figure 112One form of cable tensioning system 13800 is shown, which includes constant force spring arrangements 13810 and 13820. This solution has the advantage of not requiring the length retention of the flexible chain drive assemblies 13400 and 13500.

[0316] Another cable management system, such as 13800 Figure 113 and Figure 114 As shown. In this arrangement, the proximal ends of the flexible chain drive assemblies 13400 and 13500 are joined together and journal-connected around a cable management pulley 13840, which is configured to translate together with the firing member 13310. As the firing member 13310 advances distally during its firing stroke, the cable management pulley 13840 also translates distally, thereby maintaining tension in the flexible chain drive assemblies 13400 and 13500. During joint movement, the length of one of the flexible chain drive assemblies 13400 and 13500 increases, while the length of the other decreases. This arrangement is intended to minimize the length of the fully actuated surgical end effector 10000 and the flexible chain drive assemblies 13400 and 13500 required to perform joint movement of the surgical end effector.

[0317] One method of using surgical instrument 9010 may involve using the surgical instrument to cut and suture target tissue within a patient using laparoscopic techniques. For example, one or more trocars may have been placed through the abdominal wall of the patient to provide access to target tissue within the patient. Surgical end effector 10000 may be inserted through one trocar, and one or more cameras or other surgical instruments may be inserted through other trocars. In order for surgical end effector 10000 to be able to insert through the trocars, surgical end effector 10000 is in a non-articular orientation ( Figure 63 Positioning is required, and jaws 10100 and 10200 must be closed. To hold jaws 10100 in the closed position for insertion purposes, for example, cable control system 9030 is actuated to simultaneously pull the first cable 12510 and the fourth cable 12540. This causes pulley unit 12610 to rotate and causes closing cams 10626, 10636 to contact anvil closing arm 10234, causing anvil 10210 to pivot in the closed position. See also Figure 97 The cable control system 9030 is deactivated to hold the anvil 10210 in the closed position. Once the surgical end effector 10000 has been inserted into the abdomen through the cannula, the cable control system 9030 is activated to rotate the pulley unit 12610 in the opposite direction. Figure 96 The position shown allows the anvil 10210 to be biased open by the anvil spring 10240.

[0318] Once inside the abdomen and before engaging the target tissue, the surgeon may 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 elongated shaft assembly 12000 received within the cannula of the trocar. Once the surgeon has oriented the surgical end effector 10000 to 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, thereby grasping the tissue between the anvil 10210 and the surgical cartridge 10300. This process can be repeated as needed until the target tissue has been properly positioned between the anvil 10210 and the surgical cartridge 10300.

[0319] Once the target tissue has been positioned between the anvil 10210 and the surgical cartridge 10300, the surgeon can activate the cable control system 9030 to close the anvil 10210, thereby clamping the target tissue in place. The firing process can then be initiated by activating the rotary drive system 13600 to drive the firing member 13310 distally from its starting position. As the firing member 13310 moves distally, it contacts a slider supported in the surgical cartridge 10300 and also drives the slider distally through the cartridge body. The slider continuously drives rows of actuators supported in the cartridge toward the clamped target tissue. Each actuator has one or more surgical staples or fasteners supported thereon, which are then driven through the target tissue and make contact with the underside of the anvil 10210. As the firing member 13310 moves distally, its tissue cutting blade 13318 cuts through the sutured tissue.

[0320] After the firing member 13310 has been driven distally to the end position within the surgical end effector 10000, the rotary drive system 13600 is reversed, causing the firing member 13310 to retract proximally to the 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 the open position, where the anvil spring 10240 pivots the anvil 10210 to the open position, allowing the surgeon to release sutured tissue from the surgical end effector 10000. Once the sutured tissue has been released, the surgical end effector 10000 can be withdrawn from the patient through a cannula. To do this, the surgeon must first actuate the cable control system 9030 to return the surgical end effector 10000 to a non-articular position and actuate the cable control system 9030 to pivot the anvil 10210 to the closed position. Afterward, the surgical end effector 10000 can be withdrawn through a cannula.

[0321] In previous endoscopic cutter arrangements, the firing element was actuated by a flexible beam. In such arrangements, the articulated joint must redirect the linear motion of the flexible beam as it enters the articulated joint back to its linear motion as it leaves the articulated joint and enters the end effector. Due to the high load required to actuate the flexible beam and the firing element, the flexible beam typically experiences significant friction as it leaves the articulated joint and is linearly redirected into the end effector. This increased friction increases the amount of driving force required to move the firing element from a starting position to an ending position within the end effector during articulation. Furthermore, as the flexible beam traverses the articulated joint, it can exert disarticulation motion on the articulated joint components. Therefore, the articulated joint components must be sufficiently robust to resist such disarticulation motion.

[0322] Other forms of surgical endoscopic cutters use rotational force to drive the firing member through the end effector. Such arrangements typically employ a rotary drive screw housed within a channel supporting the cartridge. During use, the sliding elements and tissue exert large torques on the firing member, reducing system efficiency and ultimately requiring higher rotational forces to actuate it. Due to the location of the cartridge and tissue, it is difficult to move the rotary drive screw closer to the center of such forces. Encapsulating the screw at the top and bottom of the firing member without increasing the overall diameter of the surgical end effector is also challenging. While the various embodiments discussed above do not solve all of these problems and challenges, they address many of them.

[0323] Figures 115 to 139Another form of surgical instrument 25010 is shown, which addresses many challenges faced by surgical instruments including end effectors capable of articulating to large joint angles and end effectors 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 robot 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 support 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 “SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS,” the entire contents of which are incorporated herein by reference.

[0324] 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. Figure 119As can be seen, the proximal end 26214 of the anvil body 26212 includes an anvil mounting portion 26230, which includes a pair of laterally extending mounting pins 26232. These laterally extending mounting pins are configured to be received in corresponding mounting inserts 26130, which are configured to be held securely received within mounting brackets 26120 formed in the proximal end 26112 of the elongated 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 attached to the elongated channel 26110 by welding, adhesive, snap-fit, or the like. This arrangement facilitates the pivoting movement of the anvil 26210 relative to the elongated channel 26110 about a fixed pivot axis PA. See also... Figure 115 As stated above, and as used herein, the term "fixed" means that the pivot axis PA does not translate or move relative to the elongated channel 26110.

[0325] In the illustrated arrangement, the elongated shaft assembly 28000 defines the shaft axis SA and includes a shaft ridge assembly 28100 received in a hollow outer shaft tube 28102. See also Figure 119 The axial spine assembly 28100 is operatively connected to the housing of the control portion of the surgical instrument 25010 (e.g., handheld unit, robot tool actuator, etc.), and in one example, the axial spine assembly includes a proximal spine segment 28120 and a distal spine segment 28140.

[0326] The elongated shaft assembly 28000 also includes an articulation joint 28200, which can be attached to the distal spinal segment 28140 and the surgical end effector 26000 to allow selective articulation of the surgical end effector 26000 relative to the elongated shaft assembly 28000 in multiple articulation planes. Now turn to Figures 120 to 125 The articulated joint 28200 includes a series 28202 of annular disc members 28210 that are movably connected. For example... Figure 122 , Figure 123 and Figure 125 As can be seen, each annular disk component 28210 includes a "first" or proximal side portion 28220, which includes a centrally located spherical feature or protrusion 28222. Each annular disk component 28210 also includes a second or distal side portion 28230, which includes an annular hub portion 28232, wherein the annular hub portion defines a concave socket 28234. See also Figure 122 and Figure 124 Each annular disk component 28210 also has a central axis conduit 28236 passing through it. (See also...) Figure 120 and Figure 121As can be seen, the articulation joint 28200 also includes a proximal attachment plate assembly 28240, which is configured to be attached to the distal end of the distal ridge segment 28140 by welding, adhesive, or other suitable fastener arrangement. The proximal attachment plate assembly 28240 includes a distal side 28242, which includes an annular hub portion 28244 defining a recessed socket 28246 therein. The proximal attachment plate 28240 also has a central axis conduit 28248 passing through it. Also in the illustrated arrangement, the anvil mounting bracket 26240 is configured to be operably engaged with the articulation joint 28200. Anvil mount 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 fasteners, and the anvil mount includes a proximal side 26244 having a centrally located spherical feature or protrusion 26246 projecting therefrom. See also Figure 120 The anvil mounting bracket 26240 also has a central shaft tube 26248 passing through it.

[0327] In at least one embodiment, the articulated joint further includes a series 28270 of elastomeric annular spacer members 28280 for spaced apart and providing elastic support between each annular disc member 28210. The elastomeric annular spacer members 28280 define spacer openings 28282 such that each elastomeric spacer member 28280 can be journal-connected to the annular hub portion 28232 of the corresponding annular disc member 28210. Each annular disc member 28210 is journal-connected to a central elastomeric support or continuous shaft 28300, which is mounted to a proximal attachment disc assembly 28240 and anvil mounting bracket 26240. In one arrangement, the central continuous shaft 28300 is made of an elastomeric material (e.g., rubber, polymer, etc.) and includes a flange proximal end 28302 and a cylindrical body portion 28304. The cylindrical main body portion 28304 includes a series of annular grooves 28306. Each annular groove 28306 corresponds to one of the annular disk members 28210. The annular disk members 28210 and the annular spacer members 28280 are connected to the central continuous shaft 28300 via journals, as shown. Figure 120As shown. The proximal end 28302 of the flange of the central continuum shaft 28300 is supported in a proximal conduit 28249 in a proximal attachment disc 28240. The cylindrical body portion 28304 of the central continuum shaft 28300 extends through a central conduit 28236 in each of a series 28202 of movably connected annular disc members 28210. Each centrally located 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. For example, this arrangement can be used to orient each annular disc member 28210 on the central continuum shaft 28300 at a desired spacing orientation.

[0328] See still Figure 120 The nearest-side elastomeric spacer member 28280P is connected via a journal to the annular hub portion 28244 of the nearest-side attachment disk assembly 28240, thereby being positioned between the nearest-side annular disk member 28210P and the near-side attachment disk 28240. The annular key member 28224 of the nearest-side annular disk member 28210P is received within a corresponding annular groove 28306 in the central continuum shaft 28300, so as to position the centrally located spherical feature or protrusion 28222 of the nearest-side annular disk member 28210P within the concave insertion port 28246 in the annular hub portion 28244 of the near-side attachment disk 28240. For example... Figure 120 As can be further seen, another elastomeric spacer member 28280A is connected via a journal to the annular hub portion 28232 of the nearest annular disk member 28210P, thereby being positioned between the next annular disk member 28210A in a series of movably connected annular disk members 28202 and the nearest annular disk member 28210P. The annular key member 28224 of the annular disk member 28210A is received in a corresponding annular groove 28306 in the central continuum shaft 28300 to position the centrally located spherical feature or protrusion 28222 of the annular disk member 28210A within a concave insertion port 28246 in the annular hub portion 28244 of the near-side attachment disk 28210P. See still... Figure 120Another elastomeric spacer member 28280B is connected via a journal to the annular hub portion 28232 of the annular disk member 28210A, thereby being positioned between the next annular disk member 28210B in the series 28202 of the movably connected annular disk members 28210. The annular key member 28224 of the annular disk member 28210B is received in a corresponding annular groove 28306 in the central continuous shaft 28300 to position the centrally located spherical feature or protrusion 28222 of the annular disk member 28210B within the concave insertion port 28246 in the annular hub portion 28244 of the annular disk member 28210A. In the same arrangement, another elastomeric spacer member 28280C is connected via a journal to the annular hub portion 28232 of the annular disk member 28210B, thereby being positioned between the farthest annular disk members 28210C in the series 28202 of movably connected annular disk members. The annular key member 28224 of the farthest annular disk member 28210C is received in a corresponding annular groove 28306 in the central continuum shaft 28300, so as to position the centrally located spherical feature or protrusion 28222 of the farthest annular disk member 28210C in the concave insertion 28246 in the annular hub portion 28244 of the annular disk member 28210B. Finally, another elastomeric spacer member 28280D is connected via a journal to the annular hub portion 28232 of the farthest annular disk member 28210C, thereby being positioned between the anvil mounting bracket 26240 and the farthest annular disk member 28210C. The annular key member 28224 of the centrally located spherical feature or protrusion 26246 of the anvil mounting bracket 26240 is received in a corresponding annular groove 28306 in the central continuous shaft 28300, so as to position the centrally located spherical feature or protrusion 226246 of the anvil mounting bracket 26240 in the concave insertion 28246 in the annular hub portion 28244 of the farthest annular disk member 28210C.

[0329] In at least one arrangement, in order to limit the pivoting travel of the annular disk members to the range of relative pivoting travel and to prevent complete relative rotation of the annular disk members 28210 with respect to each other, the centrally located spherical feature or protrusion 28222 of each annular disk member 28210P, 28210A, 28210B, 28210C and the distal spherical feature or protrusion 26246 of the anvil mounting bracket 26240 include a pair of arcuate pin grooves 28226. Figure 120 As can be seen, the corresponding travel restriction pin member 28227 is pressed into or otherwise attached to each annular hub portion 28232 and received in the corresponding pin groove 28226 in the centrally located spherical feature or protrusion 28222, 26246.

[0330] return Figure 119 In the illustrated example, the articulation joint 28200 is operably controllable by an articulation system 28400, which includes four cable assemblies 28410, 28420, 28430, and 28440 extending through an elongated shaft assembly 28000. In one arrangement, cable assembly 28410 includes a proximal cable portion 28412 attached to an articulation rod 28414, which is supported in a corresponding axial recess in the spine assembly 28100 for axial travel therein. A distal cable portion 28416 is attached to the articulation rod 28414. Cable assembly 28420 includes a proximal cable portion 28422 attached to an articulation rod 28424, which is supported in a corresponding axial recess in the spine assembly 28100 for axial travel therein. A distal cable portion 28426 is attached to the articulation rod 28414. Cable assembly 28430 includes a proximal cable portion 28432 attached to articulated rod 28434, which is supported in a corresponding axial groove in the spine assembly 28100 for axial travel therein. A distal cable portion 28436 is attached to the articulated rod 28434. Cable assembly 28440 includes a proximal cable portion 28442 attached to articulated rod 28444, which is supported in a corresponding axial groove in the spine assembly 28100 for axial travel therein. A distal cable portion 28446 is attached to the articulated rod 28444.

[0331] Proximal cable portions 28412, 28422, 28432, and 28442 are operatively connected to portions of the cable control system 25030 supported within or otherwise associated with the housing of the surgical instrument 25010. The cable control system 25030 may include multiple cable support members / drive wheels, pulleys, etc., controlled by one or more corresponding motors controlled by a control circuit portion of the surgical instrument 25010. In various embodiments, the cable control system 25030 is configured to manage cable tension (pulling) and release at precise times during joint movement. Furthermore, in at least one arrangement, the cable control system 25030 may be used to control the opening and closing of the anvil 26210, as will be discussed in further detail below.

[0332] Now go to Figure 126 The distal cable portions 28416, 28426, 28436, and 28446 are configured to be operably connected to a closure system 28500, which is rotatably mounted in the proximal end 26112 of the elongated channel 26110. For example... Figure 126As can be seen, the closure system 28500 includes a pulley unit 28510, which includes a first transverse α-winding pulley 28520 and a second transverse α-winding pulley 28530 interconnected by a central shaft 28540. The pulley unit 28510 is rotatably supported within the proximal end 26112 of the elongated channel 26112 and held therein by an anvil mounting bracket 26240 attached to the proximal end 26112 of the elongated channel 26110. See also... Figure 119 The anvil mounting bracket 26240 can be attached to the proximal end 26112 of the elongated channel 26110 by welding, adhesive, snap-fit ​​features, etc. The anvil mounting bracket 26240 includes a shaft bracket 26242 configured to rotatably support the central shaft 28540 within the elongated channel 26110. In the illustrated arrangement, a first pivot shaft 28521 protrudes from a first transverse α-winding pulley 28520 and is pivotally supported in a pivot hole 26113 in the proximal end of the elongated channel. Similarly, a second pivot shaft 28531 protrudes from a second transverse α-winding pulley 28530 and is pivotally supported in a pivot hole 26115 in the proximal end 26112 of the elongated channel 26110.

[0333] like Figure 126 As can be seen, the first α-winding pulley 28520 includes a first circumferential groove 28522 and a second circumferential groove 28524. In the illustrated example, a first distal cable portion 28416 is received in and attached to the first circumferential groove 28522, and a second distal cable portion 28426 is received in and attached to the second circumferential groove 28524. Pulling the first distal cable portion 28416 will cause the first transverse α-winding pulley 28520 to rotate in a first direction, and pulling the second distal cable portion 28426 will cause the first transverse α-winding pulley 28520 to rotate in a second opposite direction. Similarly, the second transverse α-winding 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 the fourth distal cable portion 28446 will cause the second α-winding pulley 28530 to rotate in a first direction, and pulling the third distal cable portion 28436 will cause the second transverse α-winding pulley 28530 to rotate in a second opposite direction. According to one aspect, the transverse α-winding pulleys 28520 and 28530 can rotate approximately 330 degrees. This range of rotation is significantly different from that of a normal pulley, which can have a range of rotation of less than 180 degrees.

[0334] Each of the first transverse α-winding pulley 28520 and the second transverse α-winding pulley 28530 further includes a corresponding helical closing cam, which is configured to apply a closing motion to the anvil 26210. Figure 126 As can be seen, the first transverse α-winding pulley 28520 includes a first helical closing cam 28526, and the second transverse α-winding pulley 28530 has a second helical closing cam 28536 thereon. The helical closing cams 28526 and 28536 are configured to interact in a cam-like manner with a corresponding anvil closing arm 26234 on the anvil mounting portion 26230 of the anvil 26210 to apply a closing motion thereto. See also Figure 119 Rotation of pulley unit 28510 in the first rotational direction will cause helical closing cams 28526, 28536 to move anvil 26210 cam to the closed position. To open anvil 26210, pulley unit 28510 rotates in the opposite direction to position helical closing cams 28526, 28536 in a position where anvil 26210 can be pivotally opened by anvil spring (not shown).

[0335] In the arrangement shown, the proximal attachment plate 28240, the nearest annular disc member 28210P, the annular proximal disc members 28210A, 28210B, 28210C, and the anvil mounting bracket 26240 all include fourth joint motion cable conduits 28214, which are configured to allow each of the distal cable portions 28416, 28426, 28436, and 28446 to pass through them. Figure 127 Articulated rod 28424 is shown, which is slidably supported in a corresponding axial groove 28146 in the distal vertebral segment 28140 for axial travel therein. Each of the other articulated rods 28414, 28434, and 28444 is similarly supported in an axial groove in the distal vertebral segment 28140 and a corresponding groove in the proximal vertebral segment 28120.

[0336] See now Figure 119 and Figures 128 to 130The distal cable portion 28416 extends from the articulated rod 28414 through the articulated joint 28200 and surrounds two redirecting pulleys 28550 and 28560, which are supported on shafts 28502 and 28512, which are rotatably mounted in the proximal end 26112 of the elongated channel 26110. The distal cable portion 28416 exits the articulated joint 28200 to be received in a first circumferential groove 28522 in a first transverse α-winding pulley 28520, where the distal cable portion is secured in the first circumferential groove. The distal cable portion 28426 extends from the articulated rod 28424 through the articulated joint 28200 to surround the redirection pulleys 28560, 28550, and is thus received in the second circumferential groove 28524 in the first transverse α winding pulley 28520, where the distal cable portion is fixed in the second circumferential groove.

[0337] In the illustrated example, the distal cable portion 28436 extends from the articulated rod 28434 through the articulated joint 28200 to be received in a corresponding circumferential groove 28534 in the second transverse α-winding pulley 28530, where the distal cable portion is secured in the corresponding circumferential groove. Furthermore, the distal cable portion 28446 extends from the articulated rod 28444 through the articulated joint 28200 to be received in a corresponding circumferential groove 28532 in the second transverse α-winding pulley 28530, where the distal cable portion is secured in the corresponding circumferential groove.

[0338] In at least one example, to enable the surgical end effector 26000 to articulate relative to the elongated shaft assembly 28000 through the first articulation plane, the cable control system 25030 is actuated to simultaneously pull distal cable portions 28426 and 28446, wherein equal amounts of tension are applied to each of the distal cable portions 28426, 28446. Because equal amounts of tension are applied to both sides of the pulley unit 28510, the pulley unit 28510 does not rotate. However, the pulling action of the distal cable portions 28426, 28446 is transferred to the surgical end effector 26000 via the articulation joint 28200, which causes the articulation joint 28200 to articulate through the first articulation plane. To enable the surgical end effector 26000 to articulate across a second articulation plane transverse to the first articulation plane, the cable control system 25030 is actuated to simultaneously pull distal cable portions 28436 and 28446, with equal tension applied to each distal cable portion 28436, 28446. Because the distal cable portions 28436, 28446 apply equal tension on both sides of the second transverse α-winding pulley 25830 of the pulley unit 28510, the pulley unit 28510 does not rotate. However, the pulling action of the distal cable portions 28436, 28446 is transferred to the surgical end effector 26000 via the articulation joint 28200, causing the articulation joint 28200 to articulate in the second articulation plane.

[0339] The cable control system 25030 can also be used to control the opening and closing of the anvil 26210 in such a manner as described above. When the helical closing cam 28526 on the first transverse α-winding pulley 28520 and the second transverse α-winding pulley 28530 is in the first position, the anvil 26210 can be pivoted to the open position by one or more anvil springs (not shown), which are positioned in the proximal end 26112 of the elongated channel 26110 and positioned to contact the anvil mounting portion 26230 or the anvil closing 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, wherein the same amount of tension is applied to each of the distal cable portions 28416 and 28446. These distal cable portions 28416, 28446 will cause the pulley unit 28510 to rotate, thereby causing the helical closing cams 28526, 28536 to contact the anvil closing arm 26234 and move the anvil 26210 cam to the closed position. It should be understood that by applying equal tension to the distal cable portions 28416, 28446, no torque is applied to the articulated joint 28200 because equal tension is applied on each side of the axis SA. This arrangement allows the jaw closure to be shaped as needed. The cable control system 25030 allows for faster closure when the anvil 26210 is fully open. The cable control system 25030 can also be used as a closure mechanism that generates a lower speed / higher force for clamping onto tissue. The cable control system 25030 of the present invention does not produce the recoil that typically occurs with other cable control systems, and therefore can also be used to control the articulated position of the end effector. The aforementioned joint motion connector 28200 and cable control system 25030 facilitate multi-plane joint movement while also providing additional actuation motion to the surgical end effector 26000.

[0340] As discussed above, many surgical end effectors employ a firing member that is pushed distally through the surgical cartridge by a firing beam capable of axial movement. The firing beam is typically attached to the firing member in the central region of the firing member body. This attachment location can cause imbalance in the firing member as it is advanced through the end effector. This imbalance can induce undesirable friction between the firing member and the end effector jaws. This additional friction may require a higher firing force to overcome, and can cause undesirable wear on the jaws and / or portions of the firing member. Applying a higher firing force to the firing beam can cause undesirable deflection of the firing beam as it traverses the articulation joint. This additional deflection can cause the articulation joint to disengage from the joint, particularly when the surgical end effector performs articulation at a relatively high angle of articulation. Surgical Instrument 25010 employs a firing system 27000, which, while not solving all such problems, addresses many of them.

[0341] See now Figures 133 to 134 In at least one embodiment, the firing system 27000 includes a firing member 27100, which includes a vertically extending firing member body 27112, the firing member body including a top firing member feature 27120 and a bottom firing member feature 27130. A tissue cutting blade 27114 is attached to or formed within 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 also Figure 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 a vertically extending firing member body 27112. In at least one example, the anvil body 26212 includes an axially extending anvil slot having a cross-sectional shape similar to a "keyhole" to accommodate the passage of the top firing member feature 27120 in various ways described herein. Similarly, the elongated channel 26110 includes an axially extending channel slot, which also has a keyhole cross-sectional shape for receiving the conduit of the bottom firing member feature 27130 as described above.

[0342] In the illustrated arrangement, the firing system 27000 includes an upper firing assembly 27200 operatively connected to a top firing member feature 27120. The upper firing assembly 27200 includes an upper flexible outer tube or conduit 27210 having a proximal end 27212 fixed to an upper insert 27214, which is immovably attached to the spine assembly 28100. For example, the upper insert 27214 may be welded to the spine assembly 28100 or otherwise attached thereto by adhesive or other suitable fastening means. Flexible outer tubes or conduits 27210 extend through upper conduits 28216, which are configured to pass through proximal attachment disc assemblies 28240, proximal annular disc members 28210P, annular disc members 28210A, 28210B, 28210C, and anvil mounting brackets 26240. The distal end 27216 of the flexible outer tube or conduit 27210 may be attached to the anvil mounting bracket 26240.

[0343] In the illustrated embodiment, the upper firing assembly 27200 further includes an upper push rod 27220 slidably supported in a corresponding axial conduit within the spine assembly 28100. The upper firing assembly 27200 also includes an upper push coil 27230 supported within an inner flexible upper sleeve 27240 extending through an upper flexible outer tube or conduit 27210. The proximal end 27232 of the upper push coil 27230 and the proximal end 27242 of the inner flexible upper sleeve 27240 abut the distal end 27222 of the upper push rod 27220. The upper push coil 27230 is hollow and may include a helical spring made of nitinol, titanium, stainless steel, or the like. In other arrangements, the upper actuation coil 27230 includes a laser-cut "hypo tube," which essentially comprises a hollow tubular member with offset laser cutouts, enabling the hypo tube to flex and bend while also transmitting axial force or motion. An internal flexible upper sleeve 27240 may be made of a polymer or similar material and prevents tissue, fluid, and / or debris from penetrating into the upper actuation coil 27230, which could impede the upper actuation coil's ability to flex and bend during articulated movement of the surgical end effector relative to the elongated shaft assembly.

[0344] like Figure 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 are adjacent to 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 includes an upper push coil cable 27250 extending through the hollow upper push coil 27230. The upper push coil cable 27250 includes a proximal end 27252 and a distal end 27254. The proximal end is fixed to the distal end 27222 of the upper push rod 27220, and the distal end is fixed within the top axial conduit 27124 of the top tubular body 27122 of the top firing member feature 27120 via an upper attachment lug 27256. The upper push coil cable 27250 is kept taut between the top firing member feature 27120 and the upper push rod 27220. This is to keep the distal end 27234 of the upper push coil 27230 and the distal end 27244 of the inner flexible upper sleeve 27240 in abutment with the proximal end 27123 of the top tubular body 27122 of the top firing member feature 27120, and to keep the proximal end 27232 of the upper push coil 27230 and the proximal end 27242 of the inner flexible upper sleeve 27240 in abutment with the distal end 27222 of the upper push rod 27220.

[0345] In the illustrated example, the firing system 27000 also includes a lower firing assembly 27300 operatively connected to a bottom firing member feature 27130. The lower firing assembly 27300 includes a lower flexible outer tube or conduit 27310 having a proximal end 27312 fixed to a lower insert 27314, which is immovably attached to the spine assembly 28100. For example, the lower insert 27314 may be welded to the spine assembly 28100 or otherwise attached thereto by adhesive or other suitable fastening means. A lower flexible outer tube or conduit 27310 extends through a lower conduit 28218, which is disposed in each of the proximal attachment disc assembly 28240, the nearest annular disc member 28210P, annular disc members 28210A, 28210B, 28210C, and the anvil mounting bracket 26240. The distal end 27316 of the flexible outer tube or conduit 27310 is attached to the anvil mounting bracket 26240.

[0346] In the illustrated embodiment, the lower firing assembly 27300 further includes a lower push rod 27320 slidably supported in a corresponding axial conduit within the spine assembly 28100. The lower firing assembly 27300 also includes a lower push coil 27330 supported within an inner flexible lower sleeve 27340 extending through a lower flexible outer tube or conduit 27310. The proximal end 27332 of the lower push coil 27330 and the proximal end 27342 of the inner flexible lower sleeve 27340 abut the distal end 27322 of the lower push rod 27320. The lower push coil 27330 is hollow and may include a helical spring made of nitinol, titanium, stainless steel, or the like. In other arrangements, the lower actuation coil 27330 includes a laser-cut thiopanel tube, which essentially comprises a hollow tubular member with offset laser cutouts, allowing the thiopanel tube to flex and bend. An internal flexible lower sleeve 27340 may be made of a polymer or similar material and prevents tissue, fluid, and / or debris from penetrating into the lower actuation coil 27330, which could impede the lower actuation coil's ability to flex during joint movement.

[0347] like Figure 134 As can be seen, the distal end 27334 of the lower push coil 27330 and the distal end 27344 of the internal flexible lower sleeve 27340 are adjacent to the proximal end 27133 of the bottom tubular body 27132 of the bottom firing member feature 27130. Also in the arrangement shown, the lower firing assembly 27300 includes a lower push coil cable 27350 that extends through the hollow lower push coil 27330. The lower push coil cable 27350 includes a proximal end 27352 and a distal end 27354. The proximal end of the lower cable is fixed to the distal end 27322 of the lower push rod 27320. The distal end of the lower cable is fixed to the bottom axial conduit 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 is kept taut between the bottom firing member feature 27130 and the lower push rod 27320. This is to keep the distal end 27334 of the lower push coil 27330 and the distal end 27344 of the inner flexible lower sleeve 27340 in abutment with the proximal end 27133 of the bottom tubular body 27132 of the bottom firing member feature 27130, and to keep the proximal end 27332 of the lower push coil 27330 and the proximal end 27342 of the inner flexible lower sleeve 27340 in abutment with the distal end 27322 of the lower push rod 27320.

[0348] In the illustrated arrangement, the firing system 27000 also includes a differential drive assembly 27400, which is configured to axially drive the upper firing assembly 27200 and the lower firing assembly 27300. (Go to...) Figures 136 to 139 In at least one arrangement, the proximal end 27224 of the upper push rod 27220 is connected to the first or upper rack 27410 of the differential drive assembly 27400. For example... Figure 136 As can be seen, the first or upper rack 27410 is slidably supported in the upper proximal axial cavity 28122 within the proximal ridge section 28120. Similarly, the proximal end 27324 of the lower push rod 27320 is coupled to the second or lower rack 27420, which is supported to travel axially within the lower proximal axial cavity 28124 within the proximal ridge section 28120. The differential drive assembly 27400 also includes an axially movable carrier member 27430, centrally disposed between the first or upper rack 27410 and the second or lower rack 27420, and supported to travel axially within the proximal axial cavity 28126 within the proximal ridge section 28120. See also Figure 136 See still Figures 136 to 139 The pinion 27432 is pivotally pinned to an axially movable load-bearing member 27430, such that the pinion 27432 meshes with a first or upper rack 27410 and a second or lower rack 27420. The axially movable load-bearing member 27430 is axially driven by a firing actuator 27440 within a proximal axial cavity 28126 in the proximal ridge section 28120. See also... Figure 137 In one arrangement, the firing actuator 27440 includes a firing drive rack 27442 dextrinsically engaged with a drive gear 27444, which is driven by a firing motor 27446 operatively supported in or otherwise associated with the housing of the surgical instrument 25010. In other arrangements, the firing actuator 27440 may be axially driven distally and proximally by an associated cylinder arrangement or other suitable actuator. Figures 137 to 139As can be seen, the firing actuator 27440 is attached to an axially movable support member 27430 via a pair of spaced-apart connecting pins 27448. These spaced-apart connecting pins are attached to the firing actuator 27440 and received within corresponding axial slots 27434 in the axially movable support member 27430. This arrangement allows for some relative axial movement between the firing actuator 27440 and the axially movable support member 27430. For example, when the firing actuator 27440 is driven distally in the distal direction DD, the axially movable support member 27430 will not move distally until the connecting pins 27448 reach the distal ends of their corresponding axial slots 27434, at which point the axially movable support member 27430 will move distally. Similarly, when the firing actuator 27440 is driven in the proximal direction PD, the axially movable bearing member 27430 will not move proximally until the connecting pins 27448 reach the proximal end of their corresponding axial slots 27434, at which point the axially movable bearing member 27430 will move proximally.

[0349] Surgical suturing devices require significant force to be applied to the firing member during long displacements to form a staple and cut tissue. Transmitting this force via an articulated joint is particularly challenging due to the difficulty in redirecting the force in the desired direction and the strain on the applied load. While the differential drive assembly 27400 described herein does not solve all of these challenges, it addresses and resolves many of them by employing two flexible outer tubes or conduits 27210, 27310 to respectively constrain the paths of the flexible actuation coils 27230, 27330. As described herein, the upper flexible outer tube or conduit 27210 surrounds a portion of the upper actuation coil 27230, and the upper flexible outer tube or conduit 27310 surrounds a portion of the lower actuation coil 27330. Each of the outer tubes or conduits 27210, 27310 is flexible, but they also dissipate axial tensile loads. The flexibility allows the firing member force to be redirected via the articulated joint, and the ability to dissipate tension allows it to change the direction of travel of the actuation coil. When the actuating coils 27230 and 27330 are in a compressed state, the flexible outer tubes or conduits 27210 and 27310 are in a tensioned state. The outer tubes or conduits 27210 and 27310 prevent the actuating coils 27230 and 27330 from buckling. The outer tubes 27210 and 27310 terminate in a manner that relieves tensile load. As described above, the distal ends 27216 and 27316 of the flexible outer tubes or conduits 27210 and 27310 are both attached to the anvil mounting bracket 26240. The proximal ends 27212 and 27312 of the flexible outer tubes or conduits 27210 and 27310 are both attached to the shaft spine assembly 28100. The pinion 27432 meshes with the first or upper rack 27410 and the second or lower rack 27420, such that when one of the racks 27410 and 27420 moves in one axial direction, the other of the racks 27410 and 27420 moves axially in the opposite direction. Figure 138 and Figure 139 As can be seen, during joint movement, the pinion 27432 rotates, thus allowing the flexible outer tubes or conduits 27210, 27310 to move to accommodate changes in path length. However, when the firing actuator 27440 is driven in the distal direction DD, the axially movable load-bearing member 27430 is actuated to push the push coils 27230, 27330 distally through the outer tubes or conduits 27210, 27310, thereby firing (i.e., driving the firing member 27100 distally). At this point, the tensile loads in the two flexible outer tubes or conduits 27210, 27310 act counteract each other, while the pinion 27432 does not move at all.

[0350] According to a general aspect, the upper conduit 28216 forms an upper path 28221 passing through the articulated joint 28200. Figure 117 Similarly, the lower conduit 28218 forms a lower path 28223 through the articulated joint 28200. When the surgical end effector 26000 is in a non-articular position (i.e., the surgical end effector and the elongated shaft assembly 28000 are aligned on axis SA), Figure 115 , Figure 117 , Figure 118 When aligned axially, the upper path 28221 and the lower path 28223 are parallel to each other. See also Figure 117 When the surgical end effector 26000 is in an articulated position relative to the elongated shaft assembly 28000, the upper path 28221 and the lower path 28223 are concentric. See also Figure 116 .

[0351] 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 26100 to an ending position within the distal end 26114 of the elongated channel 26110. 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. This allows the firing member 27100 to be advanced distally through the surgical end effector 26000 without constraint; otherwise, constraint might occur if the upper and lower axial drive movements were of different magnitudes. Similarly, when the surgical end effector 26000 is in a jointed 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 assembly 27200 and the lower firing assembly 27300 to move by substantially equal distances in opposite axial directions to accommodate the jointed position. The differential drive assembly 27400 can then apply upper and lower axial drive movements of equal magnitude 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 upper firing assembly at a second distance, substantially equal to the first distance, via the pinion 27432. 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.Therefore, when the surgical end effector 26000 is in a non-articular motion configuration, the carrier can apply equal amounts of axial control movement to the upper firing member 27200 and the lower firing member 27300 in the same axial direction (distal direction DD), and when the surgical end effector 26000 is in an articulated motion configuration, the carrier can apply "other equal amounts" of axial control movement to the upper firing member 27200 and the lower firing member 27300 in the same axial direction (distal direction DD) to move the firing member 27100 from the starting position to the ending position.

[0352] Figures 140 to 152 Another surgical instrument 30010 is shown, which employs a different form of articulated joint 30200 to connect the surgical end effector 31000 to the elongated shaft assembly 32000. The elongated shaft assembly 32000 may be identical or very similar to various other elongated shaft assemblies described herein. Figures 140 to 143 As can be seen, the articulation joint 30200 includes a proximal joint member 30210 and a distal joint member 30250. The proximal joint member 30210 is configured to attach to the distal end of an elongated shaft assembly 32000, which is coupled to a housing or other portion of a surgical instrument. The distal joint member 30250 is configured to attach to a surgical end effector 31000. For example, the distal joint member 30250 may attach to an elongated channel 31200 of the surgical end effector 31000. The end effector 31000 may be the same as or very similar to the various surgical end effectors disclosed herein.

[0353] like Figure 143 and Figure 150 As can be seen, the proximal connector member 30210 includes a proximal side 30212 defining a proximal tip 30218. Similarly, the distal connector member 30250 includes a distal side 30252 defining a distal tip 30254. See also Figure 151 The proximal joint member 30210 and the distal joint member 30250 are pivotally held together with their respective end portions 30218 and 30254 via a link assembly 30300 in a "rolling engagement" manner. Figures 141 to 143 As can be seen, the linkage assembly 30300 includes a first link 30310 and a second link 30320. In the illustrated example, the first link 30310 and the second link 30320 are connected to the proximal joint member 30210 via a proximal crosspin assembly 30330. According to one aspect, the proximal crosspin assembly 30330 includes a first proximal crosspin 30332 defining a first proximal pivot axis FPPA. See also Figure 152The proximal end 30312 of the first link 30310 is configured to receive a first proximal threaded fastener 30314 passing through it, the first proximal threaded fastener being configured to be threadedly received in a first threaded hole 30334 in a first proximal cross pin 30332. See also Figure 143 Similarly, the proximal end 30322 of the second link 30320 is configured to receive a second proximal threaded fastener 30324 passing through it, which is configured to be threadedly received in a second threaded hole 30336 in the first proximal cross pin 30332.

[0354] In at least one embodiment, the first proximal crosspin assembly 30330 further includes a second proximal crosspin 30340 rotatably connected via a journal to the first proximal crosspin 30332. In one arrangement, the first proximal crosspin 30332 may include a first proximal bushing or low-friction sleeve 30338 configured to facilitate free rotation between the first proximal crosspin 30332 and the second proximal crosspin 30340. The second proximal crosspin 30340 defines a second proximal pivot axis SPPA transverse to the first proximal pivot axis FPPA and a shaft axis SA defined by the elongated shaft assembly 32000. Figure 143 As can be seen, the second proximal cross pin 30340 is received in a laterally aligned proximal pin opening 30220 in the proximal joint member 30210 to attach the link assembly 30300 to the proximal joint member 30210, such that the link assembly 30300 is pivotable relative to the proximal joint member 30210 about a first proximal pivot axis FPPA and a second proximal pivot axis SPPA.

[0355] In the illustrated example, the first link 30310 and the second link 30320 are connected to the distal connector member 30250 via a distal crosspin assembly 30350. According to one aspect, the distal crosspin assembly 30350 includes a first distal crosspin 30352 defining a first distal pivot axis FDPA. The distal end 30316 of the first link 30310 is configured to receive a first distal threaded fastener 30318 passing through it, the first distal threaded fastener being configured to be threadedly received in a third threaded hole 30354 in the first distal crosspin 30352. Similarly, the distal end 30326 of the second link 30320 is configured to receive a second distal threaded fastener 30328 passing through it, the second distal threaded fastener being configured to be threadedly received in a fourth threaded hole 30356 in the first distal crosspin 30352.

[0356] In at least one embodiment, the first distal crosspin assembly 30350 further includes a second distal crosspin 30360 rotatably connected via a journal to the first distal crosspin 30352. In one arrangement, the first distal crosspin 30352 may include a first proximal bushing or low-friction sleeve 30358 configured to facilitate free rotation between the first distal crosspin 30352 and the second distal crosspin 30360. The second distal crosspin 30360 defines a second distal pivot axis SDPA and a shaft axis SA transverse to the first distal pivot axis FDPA. Figure 142 As can be seen, the second distal cross pin 30360 is received within a laterally aligned distal pin opening 30256 in the distal connector member 30250 to attach the link assembly 30300 to the distal connector member 30250, such that the link assembly 30300 is pivotable relative to the distal connector member 30250 about a first distal pivot axis FDPA and a second distal pivot axis SDPA.

[0357] Now go to Figure 150 The proximal side 30212 of the proximal connector member 30210 defines a proximal tip 30218, which includes a plurality of radially spaced recessed regions 30222 formed thereon. In the illustrated arrangement, a total of six recessed regions 30222 are equidistantly spaced around the center 30219 of the proximal tip 30218. Figure 151 As can be seen, the distal surface 30252 of the distal connector member 30250 includes a total of six distal fins or protrusions 30262 equidistantly spaced around the center 30255 of the distal tip 30254, such that when the surgical end effector is in a non-articular position, each fin 30262 corresponds to one of the recessed regions 30222. For example, angle B could be approximately sixty degrees. See also Figure 151 Each fin in fin 30262 and each recessed region in recessed region 30222 includes rounded edges configured to facilitate rolling engagement between the proximal tip 30218 and the distal tip 30254 during articulation of the surgical end effector 31000 relative to the elongated shaft assembly 32000. This rolling engagement can be analogous in some way to the rolling engagement between the teeth of meshing bevel gears, for example, causing the proximal tip 30218 and the distal tip 30254 to remain engaged with each other during articulation of the surgical end effector 31000.

[0358] See Figure 141The surgical instrument 30010 also includes an articulation system 30500 configured to apply articulation to the surgical end effector 31000, causing the surgical end effector 31000 to articulate relative to the elongated shaft assembly 32000. In at least one arrangement, the articulation system 30500 includes four articulation cables 30510, 30520, 30530, and 30540 extending through the elongated shaft assembly 32000. In the illustrated arrangement, the articulation cables 30510, 30520, 30530, and 30540 pass through the proximal connector member 30210 and the distal connector member 30250 and are secured to the surgical end effector 31000 in various manners disclosed herein. Joint motion cables 30510, 30520, 30530, and 30540 are operatively connected to a joint motion control system supported within or otherwise associated with the housing of the surgical instrument 300010. For example, as discussed above, the proximal portion of each cable 30510, 30520, 30530, and 30540 may be wound around a corresponding rotary reel or cable management system 2007 within the housing portion of the surgical instrument 30010. Figure 2 On the reel or cable management system, each cable 30510, 30520, 30530, and 30540 is configured to be extended and retracted in a desired manner. The reel / cable management system can be motor-driven or manually driven (ratchet arrangement, etc.). Figure 140 , Figure 141 and Figures 144 to 146 The position of the articulation joint 30200 is shown when the surgical end effector is in a non-articular motion position, and Figure 142 and Figures 147 to 149Various positions of the articulation joint 30200 are shown when the surgical end effector has been articulated relative to the elongated shaft assembly 32000 in various positions. The surgical instrument 30010 may also employ firing systems 30600 of various types and configurations disclosed in detail herein to drive a firing member (not shown) within the surgical end effector 31000. For example, the proximal joint member 30210 may be provided with an upper proximal firing member conduit 30214 configured to accommodate an upper flexible firing member 30610 passing through it. The upper flexible firing member 30610 may span the region generally designated 30700 between the proximal side 30212 of the proximal joint member 30210 and the distal side 30252 of the distal joint member 30250, and slidably pass through the upper distal firing member conduit 30257 in the distal joint member 30250. Similarly, the proximal connector member 30210 is provided with a lower proximal firing member conduit 30216, which is configured to accommodate a lower flexible firing assembly 30620 passing through it. The lower flexible firing assembly 30620 spans region 30700 and is received in a lower distal firing member conduit 30259 in the distal connector member 30250. The upper flexible firing assembly 30610 and the lower flexible firing assembly 30620 are operatively connected to the firing member in the surgical end effector 31000. The upper flexible firing assembly 30610 and the lower flexible firing assembly 30620 may be constructed in the same or very similar manner to the various flexible firing member drive arrangements disclosed herein.

[0359] Figure 153 Another form of articular joint 30200' is shown, which is identical in construction and operation to the articular joint 30200 described above, except that the first link 30310 and the second link 30320 are connected together by an annular ring 30380 located in region 30700 between the proximal side 30212 of the proximal joint member 30210 and the distal side 30252 of the distal joint member 30250. In at least one arrangement, the annular ring 30380 includes an outer diameter equal to or smaller than the outer diameters of the proximal joint member 30210 and the distal joint member 30250. In one arrangement, for example, the outer diameter of the distal joint member 30250 is equal to the outer diameter of the proximal joint member 30210, which is equal to or smaller than the maximum outer diameter of the elongated shaft assembly 32000. Therefore, this arrangement allows surgical instruments 30010 to be inserted into the patient through a cannula accommodating the maximum outer diameter of the elongated shaft assembly 32000. The annular ring 30380 can be particularly advantageous because it prevents tissue or flexible external connector cover (not shown) from potentially getting stuck between connector components.

[0360] The articulated joints 30200 and 30200' are arranged with an external link assembly 30300 that connects the proximal crosspin assembly 30330 and the distal crosspin assembly 30350 to dissipate torsional and axial loads applied to the joint. This arrangement may be particularly important for handling the loads in the instrument during firing of the firing element. This joint arrangement also leaves space between the proximal and distal joint members to accommodate additional components / features. As can be seen in several figures, the proximal and distal joint members each have clearance recesses / features / contours to accommodate the link assembly during articulated joint movement.

[0361] Figures 154 to 156 Another form of articulated joint 33000 is shown, which can be used to connect various types of surgical end effectors disclosed herein to an elongated shaft assembly 34000 of surgical instrument 33010. The elongated shaft assembly 34000 includes a central spine member 34100 (…). Figure 155 The central spinal member can be coupled to or otherwise operably engaged with the housing of the surgical instrument 33010. The elongated shaft assembly 34000 also includes an outer tube member 34110 extending on the central spinal member 34100. In at least one form, the articular joint 33000 includes a proximal joint member 33100 attached to the central spinal member 34100 and a distal joint member 33300 attached to a surgical end effector (not shown). For example, the distal joint member 33300 can be attached to an elongated channel of an endoscopic cutter arrangement in various manners disclosed herein.

[0362] In the illustrated arrangement, the proximal connector member 33100 includes a first or right half-segment 33100A and a second or left half-segment 33100B attached to the distal end of the central spine member 34100. The first half-segment 33100A and the second half-segment 33100B can be attached to the central spine member 34100 or other similar components of the elongated shaft assembly 34000 by welding, adhesives, mechanical fasteners, pins, etc. According to one aspect, the surgical instrument 33010 includes a firing system 35000, which includes a distal differential drive assembly 35100 and a proximal differential drive assembly 35500.

[0363] like Figure 156 As can be seen, the proximal connector member 33100 operatively supports the distal differential drive assembly 35100. In one arrangement, the distal differential drive assembly 35100 includes an upper distal rack assembly 35110, which is supported to travel axially within the proximal connector member 33100. Figure 156 , Figure 157 and Figure 158As can be seen, the upper distal rack assembly 35110 is supported to mesh with a distal differential gear 35130, which is rotatably supported on a pivot shaft 35132, which is supported within the proximal joint member 33100. The upper distal rack assembly 35110 is supported to travel axially within the proximal joint member 33100. The distal differential drive assembly 35100 also includes a lower distal rack assembly 35120, which is supported to mesh with the distal differential gear 35130 and configured to travel axially within the proximal joint member 33100.

[0364] According to one aspect, the firing system 35000 also includes an upper flexible firing assembly 35300 and a lower flexible firing assembly 35400, which are configured to be operatively connected to the firing member 35200. Figure 156 and Figure 159 As can be seen, the firing member 35200 includes a vertically extending firing member body 35212, which includes a top firing member feature 35220 and a bottom firing member feature 35230. A tissue cutting blade 35214 is attached to or formed within the vertically extending firing member body 35212. In at least one arrangement, the top firing member feature 35220 includes a top fin-like portion 35222 having a top axial conduit 35224 extending therethrough. The bottom firing member feature 35230 includes a bottom fin-like portion 35232 having a bottom axial conduit 35234 extending therethrough. In at least one arrangement, the top firing member feature 35220 and the bottom firing member feature 35230 are integrally formed with the vertically extending firing member body 35212. In at least one example, the anvil body includes an axially extending anvil slot configured to accommodate the passage of the top firing member feature 35220 in various manners described herein. Similarly, the elongated channel includes an axially extending channel slot configured to accommodate the passage of the bottom firing member feature 35230 as described herein.

[0365] In one example, the upper flexible firing assembly 35300 includes an upper flexible tube or conduit 35310 having a proximal end 35312 supported in a distal socket 3512 in an upper distal rack assembly 35110 and secured to the distal socket by welding, adhesive, or the like. The upper flexible tube or conduit 35310 extends through an upper opening 33218 in a proximal connector member 33100 and across an articulated joint 33000. The upper flexible tube or conduit 35310 includes a distal end 35314 received in an opening 33330 in the distal connector member 33300 and terminated or secured therein by welding, adhesive, or the like. The upper flexible firing assembly 35300 also includes an upper actuation coil 35320. The upper actuation coil 35320 is hollow and may include a helical spring made of nitinol, titanium, stainless steel, or the like. In other arrangements, the upper actuation coil 35320 includes a laser-cut thiopanel tube, which essentially comprises a hollow tubular member with offset laser cutouts or helical cutouts, enabling the thiopanel tube to flex and bend. The upper actuation coil 35320 may also be received within an internal flexible upper sleeve 35330, which may be made of a polymer or similar material and prevents tissue, fluid, and / or debris from penetrating into the upper actuation coil 35320, which could impede the upper actuation coil's ability to flex and bend during joint movement.

[0366] The upper push coil 35320 extends through the upper flexible tube 35310 and through an axial conduit in the upper distal rack 35110. The upper support beam 35140 is supported by the central ridge member 34100 and has an upper conduit 35142 to constrain and allow the upper push coil 35320 to pass through it. Figure 159 As can be seen, the distal end 35322 of the upper push coil 35320 and the distal end 35332 of the inner flexible upper sleeve 35330 are adjacent to the proximal end 35223 of the top fin-shaped portion 35222 of the top firing member feature 35220. Also in the illustrated arrangement, the upper firing assembly 35300 includes an upper cable 35340 extending through the hollow upper push coil 35320. The upper cable 35340 includes a distal end 35342, which is secured within a top axial conduit 35224 in the top fin-shaped portion 35222 of the top firing member feature 35220 by an upper attachment lug 35343.

[0367] Turn Figures 156 to 161The proximal differential drive assembly 35500 includes an upper rack 35510 slidably supported within a central ridge member 34100. The proximal differential drive assembly 35500 also includes a lower proximal rack 35520 supported for axial travel within the central ridge member 34100. The proximal differential drive assembly 35500 further includes an axially movable carrier member 35530 centrally disposed between the upper proximal rack 35510 and the lower proximal rack 35520 and supported for axial travel within the central ridge member 34100. A proximal pinion 35532 is pivotally supported on a pin 35533 mounted to the axially movable carrier member 35530, such that the proximal pinion 35532 engages with both the upper proximal rack 35510 and the lower proximal rack 35520. The axially movable load-bearing member 35530 is axially driven by a firing actuator 35540 within the axial cavity of the central ridge member 34100. For example... Figure 160 As can be seen, the firing actuator 35540 includes a firing rack 35542, which is operatively engaged with a drive gear 35544, which is driven by a firing motor 35546, operatively supported within the housing of the surgical instrument 33010. In other arrangements, the firing actuator 35540 can be axially driven distally and proximally by an associated cylinder arrangement or other suitable actuator. Figure 156 and Figure 160 As can be seen, the firing actuator 35540 can be attached to the axially movable load-bearing member 35530 via a pair of spaced-apart connecting pins 35548.

[0368] In the illustrated arrangement, the upper proximal rack 35510 also includes an upper cable attachment feature 35512 that protrudes from the upper proximal rack and is configured to slide within an upper conduit 35142 in the upper support beam 35140. According to one aspect, an upper cable 35340 extends through a hollow upper actuating coil 35320, and the proximal end of the upper cable 35340 is secured to the upper cable attachment feature 35512. The upper cable 35340 is kept taut between the top firing member feature 35220 and the upper cable attachment feature 35512. This is to keep the distal end 35322 of the upper push coil 35320 and the distal end 35332 of the inner flexible upper sleeve 35330 in abutment contact with the proximal end 35323 of the top fin-shaped portion 35222 of the top firing member feature 35220, and to keep the proximal end of the upper push coil 35320 and the proximal end of the inner flexible upper sleeve 35330 in abutment contact with the distal end of the upper cable attachment feature 35512.

[0369] In one example, the lower flexible firing assembly 35400 includes a lower flexible tube or conduit 35410 having a proximal end 35412 supported in a distal socket 35122 of a lower distal rack 35120 and secured to the distal socket by welding, adhesive, or the like. The lower flexible tube or conduit 35410 extends through a lower opening 33219 in a proximal connector member 33100 and across an articulated joint 33000. The lower flexible tube or conduit 35410 includes a distal end 35414 received in an opening 33340 in the distal connector member 33300 and terminated or secured therein by welding, adhesive, or the like. The lower flexible firing assembly 35400 also includes a lower actuation coil 35420. The lower actuation coil 35420 is hollow and may include a helical spring made of nitinol, titanium, stainless steel, or the like. In other arrangements, the lower actuation coil 35420 includes a laser-cut thiopanel tube, which essentially comprises a hollow tubular member with offset laser cutouts or helical cutouts, enabling the thiopanel tube to flex and bend. The lower actuation coil 35420 may also be received within an internal flexible lower sleeve 35430, which may be made of a polymer or similar material and prevents tissue, fluid, and / or debris from penetrating into the lower actuation coil 35420, which could impede the lower actuation coil's ability to flex and bend during joint movement.

[0370] The lower push coil 35420 extends through the lower flexible tube 35410 and through an axial conduit in the lower distal rack 35120. The lower support beam 35150 is supported by a central ridge member 34100 and has a lower conduit 35152 to constrain and allow the lower push coil 35420 to pass through it. Figure 159As can be seen, the distal end 35422 of the lower push coil 35420 and the distal end 35432 of the internal flexible lower sleeve 35430 are adjacent to the proximal end 35233 of the bottom finned portion 35232 of the bottom firing member feature 35230. Also in the illustrated arrangement, the lower flexible firing assembly 35400 includes a lower cable 35440 extending through the hollow lower push coil 35420. The lower cable 35440 includes a distal end 35442, which is secured within a bottom axial conduit 35234 in the bottom finned portion 35232 of the bottom firing member feature 35230 by a lower attachment lug 35443. According to one aspect, a lower cable 35440 extends through a hollow lower push coil 35420, and the distal end of the lower cable 35440 is fixed to a lower cable attachment feature 35522 on a lower proximal rack 35520. The lower cable 35440 is kept taut between the bottom firing member feature 35230 and the lower cable attachment feature 35522, which serves to maintain the distal end 35422 of the lower push coil 35420 and the distal end 35332 of the inner flexible upper sleeve 35330 in abutment contact with the proximal end 35233 of the bottom finned portion 35232 of the bottom firing member feature 35230, and to maintain the proximal end of the lower push coil 35420 and the proximal end of the inner flexible lower sleeve 35430 in abutment contact with the distal end of the lower cable attachment feature 35522.

[0371] Surgical suturing devices require the application of significant forces on the firing member to form a staple and cut tissue during long displacements. Transmitting this force through articulated joints is particularly challenging due to the difficulty in redirecting the force in the desired direction and the strain on the applied load. While the firing system 35000 described herein cannot solve or address all of these challenges, it can address and handle many of them by employing two flexible tubes 35310 and 35410 to constrain the paths of the actuation coils 35320 and 35420, respectively. As described herein, the upper flexible tube 35310 surrounds the upper actuation coil 35320, and the lower flexible tube 35410 surrounds the lower actuation coil 35420. Each of the tubes 35310 and 35410 is flexible, but they also absorb axial tensile loads. See also Figure 164 and Figure 165The ability to bend allows the firing force to be redirected through the articulated joint, and the ability to dissipate tension allows it to change the direction of travel of the actuating coil. When the actuating coils 35320 and 35420 are compressed, the flexible tubes 35310 and 35410 are tensioned. The tubes 35310 and 35410 prevent the actuating coils 35320 and 35420 from buckling. To dissipate the tensile load, the tubes 35310 and 35410 need to terminate in a load-dissipating manner. In the illustrated example, the respective distal ends 35314 and 35414 of the flexible tubes 35310 and 35410 are fixed to the distal joint member 33300, respectively. The proximal ends 35312 and 35412 of the flexible tubes 35310 and 35410 are fixed to the upper distal rack assembly 35110 and the lower distal rack 35120, respectively. The distal differential gear 35130 meshes with each of the upper distal rack assembly 35110 and the lower distal rack 35120, such that when one of the rack assemblies 35110 and 35120 moves in one axial direction, the other rack assembly 35110 and 35120 will move axially in the opposite axial direction. Figures 163 to 165 As can be seen, during joint movement, the distal differential gear 35130 rotates, thus allowing the flexible tubes 35310 and 35410 to move to accommodate changes in path length. However, when the firing drive system is actuated to push the push coils 35320 and 35420 distally through the tubes 35310 and 35410 to fire (i.e., drive the firing member distally), the tensile loads in the two flexible tubes 35310 and 35410 act counteract each other, while the distal differential gear 35130 does not move at all.

[0372] According to one aspect, the upper flexible tube or conduit 35310 forms an upper path across the articulation joint 33000, and the lower flexible tube or conduit 35410 forms a lower path across the articulation joint 33000. The upper path supports the upper push coil 35320 traveling through it axially, and supports the lower push coil 35420 traveling through it axially. When the surgical end effector to which the articulation joint 33000 is attached is in a non-articular position (i.e., the surgical end effector is articulated with the elongated shaft assembly along the axis of the shaft), the upper and lower paths are parallel. In other words, when the surgical end effector is in a non-articular position, the end effector axis is axially aligned with the axis of the shaft, and the upper and lower paths are parallel. When the surgical end effector is in a non-articular position (i.e., the end effector axis is not axially aligned with the axis of the shaft), the upper and lower paths are concentric. When the surgical end effector is in a non-articular position, the proximal differential drive assembly is configured to drive the upper push coil 35320 and the lower push coil 35420 by equal distances in the same axial direction (distal direction DD) to apply upper and lower axial drive motions to the firing member. The magnitudes of the upper and lower axial drive motions are substantially equal, which allows the firing member to be advanced distally through the surgical end effector without constraint; otherwise, constraint might occur if the magnitudes of the upper and lower axial drive motions were different. Similarly, when the surgical end effector is in an articulated position relative to the elongated shaft assembly, the proximal differential drive assembly is configured to allow the upper push coil 35320 and the lower push coil 35420 to move by approximately equal distances in opposite axial directions, and subsequently apply equal upper and lower axial drive motions to the firing member.

[0373] like Figure 156As can be seen, the proximal connector member 33100 defines a proximal side 33200, which is configured to receive a spherical proximal end 33410 of the central link member 33400. In the illustrated arrangement, the spherical proximal end 33410 is configured to be pivotally received in a proximal socket 33210 within the proximal side 33200 of the proximal connector member 33100. The spherical proximal end 33410 of the central link member 33400 is held within the proximal socket 33210 by a proximal crosspin assembly 33500. According to one aspect, the proximal crosspin assembly 33500 includes a first proximal crosspin 33510 defining a first proximal pivot axis FPPA. The first proximal cross pin 33510 is pivotally supported in a pair of attachment lugs 33220 formed on the proximal side 33200 of the proximal connector member 33100, and extends through two opposing arcuate slots 33412 to allow the first proximal cross pin 33510 to pivot and rotate within the spherical proximal end 33410 of the central link member 33400. In other words, the spherical proximal end 33410 of the central link member 33400 is rotatable about the first proximal cross pin 33510 and is pivotable through a proximal pivot angle PPA defined by the arcuate slots 33412.

[0374] The proximal crosspin assembly 33500 also includes a second proximal crosspin 33520, which is rotatably connected via a journal to the first proximal crosspin 33510 to allow relative pivoting rotation between the first and second proximal crosspins 33510 and 33520. The second proximal crosspin 33520 is pivotally supported within a spherical proximal end 33410 of the central link member 33400 and defines a second proximal pivot axis SPPA. The first proximal pivot axis FPPA is transverse to the axis SA. The second proximal pivot axis SPPA is transverse to both the axis SA and the first proximal pivot axis FPPA. The proximal crosspin assembly 33500 facilitates pivoting of the spherical proximal end 33410 of the central link member 33400 relative to the proximal joint member 33100 about the first and second proximal pivot axes FPPA.

[0375] In the illustrated arrangement, the distal connector member 33100 defines a distal surface 33310 configured to receive a spherical distal end 33420 of the central link member 33400. In the illustrated arrangement, the spherical distal end 33420 is configured to be pivotally received in a distal socket 33312 within the distal surface 33310 of the distal connector member 33300. The spherical distal end 33420 of the central link member 33400 is held within the distal socket 33312 by a distal crosspin assembly 33600. According to one aspect, the distal crosspin assembly 33600 includes a first distal crosspin 33610 defining a first distal pivot axis FDPA. The first distal cross pin 33610 is pivotally supported in a pair of attachment lugs 33314 formed on the distal side 33312 of the distal connector member 33300, and extends through two opposing arcuate slots 33422 to allow the first distal cross pin 33610 to pivot and rotate within the spherical distal end 33420 of the central link member 33400. In other words, the spherical distal end 33420 of the central link member 33400 is rotatable about the first distal cross pin 33610 and is pivotable through a distal pivot angle DPA defined by the arcuate slots 33412.

[0376] The distal crosspin assembly 33600 also includes a second distal crosspin 33620 rotatably connected via a journal to the first distal crosspin 33610 to allow relative pivoting rotation between the first distal crosspin 33610 and the second distal crosspin 33620. The second distal crosspin 33620 is pivotally supported within a spherical distal end 33420 of the central link member 33400 and defines a second distal pivot axis SDPA. The first distal pivot axis FDPA is transverse to the axis SA. The second distal pivot axis SDPA is transverse to both the axis SA and the first distal pivot axis FDPA. The distal crosspin assembly 33600 facilitates pivoting of the spherical distal end 33420 of the central link member 33400 relative to the distal joint member 33300 about the first distal pivot axis FDPA and the second distal pivot axis SDPA.

[0377] According to at least one aspect, the articular joint 33000 also includes a flexible joint support assembly, generally designated 33700, which provides flexible support between the proximal joint member 33100 and the distal joint member 33200 during joint movement and helps the articular joint 33000 return to a non-articular position. Figures 155 to 158In at least one arrangement, the flexible joint support assembly 33700 includes a series of flexible members 33710, 33720, 33730, and 33740 that pass through and extend between a hollow central link portion 33430 attached to and extending between the spherical proximal end 33410 and the spherical distal end 33420. The flexible members 33710, 33720, 33730, and 33740 may comprise cables or spring members made of, for example, spring steel, stainless steel, nitinol, titanium, etc. More specifically and referring to… Figure 166 The first flexible member 33710 includes a central portion 33712 and a proximal end portion 33714, the proximal end portion being configured to be received in a corresponding attachment hole 33212 in the first or right half-section 33100A of the proximal connector member 33100. Figure 156 The first flexible member 33710 also includes a distal end portion 33716, which is configured to be received in and attached to a corresponding slot 33320 in the distal connector member 33300. In this arrangement, the central portion 33712 of the first flexible member 33710 extends diagonally through the hollow central link portion 33430. The second flexible member 33720 includes a central portion 33722 and a proximal end portion 33724, which is configured to be received in a corresponding attachment hole 33214 in the second or left segment 33100B of the proximal connector member 33100. Figure 156The second flexible member 33720 also includes a distal end portion 33726, which is configured to be received in and fixed therein in a corresponding slotted hole 33322 in the distal connector member 33300. In this arrangement, the central portion 33722 of the second flexible member 33720 extends diagonally through the hollow central link portion 33430. The third flexible member 33730 includes a central portion 33732 and a proximal end portion (not shown), which is configured to be inserted into and fixed therein in a corresponding attachment hole (not shown) in the first or right segment 33100A of the proximal connector member 33100. The third flexible member 33730 also includes a distal end portion 33736, which is configured to be received in and fixed therein in a corresponding slotted hole 33324 in the distal connector member 33300. In this arrangement, the central portion 33732 of the third flexible member 33730 extends diagonally through the hollow central link portion 33430. The fourth flexible member 33740 includes a central portion 33742 and a proximal end portion 33744, which is configured to be inserted into and secured in a corresponding attachment hole 33216 in the second or left segment 33100B of the proximal connector member 33100. The fourth flexible member 33740 also includes a distal end portion 33746, which is configured to be received in and secured in a corresponding slotted hole 33326 in the distal connector member 33300. In this arrangement, the central portion 33742 of the fourth flexible member 33740 extends diagonally through the hollow central link portion 33430.

[0378] The surgical instrument 33010 also includes an articulation system 33800 configured to apply articulation to a surgical end effector, causing the surgical end effector to articulate relative to an elongated shaft assembly 34000. In at least one arrangement, the articulation system 33800 includes four articulation cables 33810, 33820, 33830, and 33840 extending through the elongated shaft assembly 34000. In the illustrated arrangement, the articulation cables 33810, 33820, 33830, and 33840 pass through a proximal articulation joint member 33100 and a distal articulation joint member 33300, and are secured to the surgical end effector in various manners disclosed herein. The articulation cables 33810, 33820, 33830, and 33840 are operatively connected to an articulation control system supported within or otherwise associated with the housing of the surgical instrument 33010. For example, as discussed above, the proximal portion of each cable 33810, 33820, 33830, and 33840 can be wound around a corresponding rotary reel or cable management system 2007 in the housing portion of the surgical instrument 330010. Figure 2 On the reel or cable management system, each cable 33810, 33820, 33830, and 33840 is configured to be deployed and retracted in a desired manner. The reel / cable management system can be motor-driven or manually driven (ratchet arrangement, etc.). Figure 154 , Figure 155 , Figure 157 , Figure 158 , Figure 162 and Figure 167 The position of the articulation joint 33000 is shown when the surgical end effector is in a non-articular motion position, and Figure 163 and Figure 169 The various positions of the articulation joint 33000 are shown when the surgical end effector has been articulated relative to the elongated shaft assembly in various positions.

[0379] The articulation joint 33000 includes ball joints for pitch and deflection, which are cable-controlled and used for joint movement of a surgical end effector. The articulation joint includes a double ball joint, meaning it has a pair of joints, each capable of performing pitch and deflection. This arrangement creates redundancy in the joint, as there are now two joints capable of performing pitch and deflection. A flexible joint support assembly 33700 is used to constrain how each joint moves during joint movement, such that four degrees of freedom act as two. The flexible joint support assembly 33700 connects the two ball joints together such that if one rotates, the other rotates by the same amount. When one joint rotates, it applies tension in the cable, which also forces the other joint to rotate. This joint arrangement has a very compact form factor and very little recoil in wrist designs.

[0380] Example 1—A surgical instrument includes a shaft assembly defining an axis and having a surgical end effector coupled thereto via an articulated joint. The articulated joint includes a proximal joint member coupled to the shaft assembly and including a proximal side defining a proximal tip. The articulated joint further includes a distal joint member coupled to the surgical end effector and including a distal side defining a distal tip. A linkage assembly is configured to maintain the proximal tip and the distal tip in roll-like engagement. The linkage assembly includes a first link coupled to the proximal joint member for pivoting relative to the proximal joint member about a first proximal pivot axis transverse to the axis and a second proximal pivot axis transverse to the first pivot axis and the axis. The first link is also coupled to the distal joint member for pivoting relative to the distal joint member about a first distal pivot axis transverse to the axis and a second distal pivot axis transverse to the axis and the first distal pivot axis. The linkage assembly also includes a second link connected to the proximal joint member for pivoting relative to the proximal joint member about the first and second proximal pivot axes. The second link is also connected to the distal joint member for pivoting relative to the distal joint member about the first and second distal pivot axes.

[0381] Example 2—A surgical instrument according to Example 1, wherein the first link is attached to the second link.

[0382] Example 3—A surgical instrument according to Example 2, wherein the first link is attached to the second link by an annular ring extending between the first link and the second link.

[0383] Example 4—A surgical instrument according to Example 3, wherein the proximal connector member includes a proximal outer diameter, and wherein the distal connector member includes a distal outer diameter equal to the proximal outer diameter. The annular ring includes an outer diameter equal to or smaller than the proximal and distal outer diameters.

[0384] Example 5—The surgical instrument according to Examples 1, 2, 3, or 4 further includes a proximal crosspin assembly defining the first proximal pivot axis and the second proximal pivot axis. The surgical instrument also includes a distal crosspin assembly defining the first distal pivot axis and the second distal pivot axis.

[0385] Example 6—A surgical instrument according to Example 5, wherein the proximal crosspin assembly includes a first proximal crosspin and a second proximal crosspin. The second proximal crosspin is rotatably connected to the first proximal crosspin via a journal to facilitate rotation of the first proximal crosspin relative to the second proximal crosspin. The distal crosspin assembly includes a first distal crosspin and a second distal crosspin. The second distal crosspin is rotatably connected to the first distal crosspin via a journal to facilitate rotation of the first distal crosspin relative to the second distal crosspin.

[0386] Example 7—A surgical instrument according to Example 6, wherein the first link is removably connected to the first proximal cross pin and the first distal cross pin. The second link is removably connected to the first proximal cross pin and the first distal cross pin.

[0387] Example 8—A surgical instrument according to Examples 1, 2, 3, 4, 5, 6 or 7, wherein the proximal tip includes a plurality of proximal engagement features, and the distal tip includes a plurality of distal engagement features that are rolled into engagement with the proximal engagement features.

[0388] Example 9—A surgical instrument according to Example 8, wherein the plurality of proximal engagement features include a plurality of radially protruding fin members, and wherein the distal engagement feature includes a plurality of radially recessed portions spaced apart between the plurality of radially protruding fin members.

[0389] Example 10—A surgical instrument according to Examples 1, 2, 3, 4, 5, 6, 7, 8, or 9 further includes a plurality of flexible articulation actuators extending through the proximal connector member and the distal connector member. Each flexible articulation actuator is coupled to the surgical end effector and configured to apply articulation to the surgical end effector.

[0390] Example 11—A surgical instrument includes a shaft assembly defining a shaft axis and having a surgical end effector operably coupled thereto via an articulated joint defining an end effector axis. The articulated joint is configured to facilitate articulation of the surgical end effector relative to the shaft assembly between a non-articulated position and an articulated position, in which the end effector axis is axially aligned with the shaft axis, and in the articulated position, the end effector axis is not axially aligned with the shaft axis. The articulated joint includes a proximal joint member coupled to the shaft assembly and a distal joint member coupled to the surgical end effector. The articulated joint also includes a central link member including a proximal end coupled to the proximal joint member for pivoting relative to the proximal joint member about a first proximal pivot axis transverse to the shaft axis and a second proximal pivot axis transverse to the first proximal pivot axis and the shaft axis. The central link also includes a distal end that is coupled to the distal joint member to pivot relative to the distal joint member about a first distal pivot axis transverse to the axis and a second distal pivot axis transverse to the first distal pivot axis and the axis.

[0391] Example 12—A surgical instrument according to Example 11, wherein the proximal end of the central link member is connected to the proximal connector member via a proximal crosspin assembly defining the first proximal pivot axis and the second proximal pivot axis. The distal end of the central link member is connected to the distal connector member via a distal crosspin assembly defining the first distal pivot axis and the second distal pivot axis.

[0392] Example 13—A surgical instrument according to Example 11 or 12, wherein the proximal end of the central link member includes a proximal spherical member that is rollably retained in a proximal socket in the proximal connector member, and wherein the distal end of the central link member includes a distal spherical member that is rollably retained in a distal socket in the distal connector member.

[0393] Example 14—A surgical instrument according to Example 12 or 13, wherein the proximal crosspin assembly includes a first proximal crosspin and a second proximal crosspin. The second proximal crosspin is rotatably connected to the first proximal crosspin via a journal to facilitate rotation of the first proximal crosspin relative to the second proximal crosspin. The distal crosspin assembly includes a first distal crosspin and a second distal crosspin. The second distal crosspin is rotatably connected to the first distal crosspin via a journal to facilitate rotation of the first distal crosspin relative to the second distal crosspin.

[0394] Example 15—A surgical instrument according to Example 14, wherein the first proximal cross pin is rotatably supported in the proximal connector member and the second proximal cross pin is rotatably supported in the proximal spherical member. The first distal cross pin is rotatably supported in the distal connector member and the second distal cross pin is rotatably supported in the distal spherical member.

[0395] Example 16—The surgical instrument according to Examples 11, 12, 13, 14 or 15 further includes a plurality of flexible articulation actuators extending through the proximal connector member and the distal connector member. Each flexible articulation actuator is coupled to the surgical end effector and configured to apply articulation to the surgical end effector.

[0396] Example 17—A surgical instrument according to Examples 11, 12, 13, 14, 15 or 16, wherein the central link member includes a central link portion connected to the proximal spherical member and the distal spherical member and extending between the proximal spherical member and the distal spherical member.

[0397] Example 18—The surgical instrument according to Example 17 further includes a flexible joint support that surrounds the central link member and is connected to the proximal joint member and the distal joint member.

[0398] Example 19—A surgical instrument according to Example 18, wherein the flexible connector support includes a first flexible member connected to the proximal connector member and the distal connector member. A second flexible member is connected to the proximal connector member and the distal connector member. A third flexible member is connected to the proximal connector member and the distal connector member, and a fourth flexible member is connected to the proximal connector member and the distal connector member.

[0399] Example 20—A surgical instrument according to Example 19, wherein each of the first flexible member, the second flexible member, the third flexible member, and the fourth flexible member passes through the central portion of the central link member.

[0400] As used in any aspect of this document, the term "control circuitry" may refer to, for example, hardwired circuitry systems, programmable circuitry systems (e.g., computer processors including one or more individual instruction processing cores, processing units, processors, microcontrollers, microcontroller units, controllers, digital signal processors (DSPs), programmable logic devices (PLDs), programmable logic arrays (PLAs), field-programmable gate arrays (FPGAs)), state machine circuitry systems, firmware storing instructions executed by the programmable circuitry system, and any combination thereof. Control circuitry can be implemented collectively or individually as part of a larger system, such as integrated circuits (ICs), application-specific integrated circuits (ASICs), system-on-a-chip (SoCs), desktop computers, laptop computers, tablet computers, servers, smartphones, etc. Therefore, as used herein, "control circuit" includes, but is not limited to, electronic circuits having at least one discrete circuit, electronic circuits having at least one integrated circuit, electronic circuits having at least one application-specific integrated circuit, electronic circuits forming a general-purpose computing device configured by a computer program (e.g., a general-purpose computer configured by a computer program that at least partially implements the methods and / or devices described herein, or a microprocessor configured by a computer program that at least partially implements the methods and / or devices described herein), electronic circuits forming a memory device (e.g., forming a random access memory), and / or electronic circuits forming a communication device (e.g., a modem, a communication switch, or an optoelectronic device). Those skilled in the art will recognize that the subject matter described herein can be implemented in analog or digital modes, or some combination thereof.

[0401] Although several forms have been illustrated and described, the applicant does not intend to limit or restrict the scope of the appended claims to such details. Many modifications, variations, alterations, substitutions, combinations, and equivalents of these forms can be made without departing from the scope of this disclosure, and those skilled in the art will recognize such modifications, variations, alterations, substitutions, combinations, and equivalents. Furthermore, alternatively, the structure of each element associated with a described form can be described as a device for providing the function performed by said element. Additionally, where materials for certain components are disclosed, other materials may also be used. Therefore, it should be understood that the foregoing detailed descriptions and the appended claims are intended to cover all such modifications, combinations, and variations falling within the scope of the forms disclosed in this invention. The appended claims are intended to cover all such modifications, variations, alterations, substitutions, modifications, and equivalents.

[0402] 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.

[0403] 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.

[0404] 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".

[0405] 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. Furth...

Claims

1. A surgical instrument, comprising: Shaft assembly, the shaft assembly defining a shaft axis; A surgical end effector, the surgical end effector being coupled to the shaft assembly via an articulated joint, the articulated joint being configured to facilitate articulation of the surgical end effector relative to the shaft assembly between a non-articular position and an articulated position, wherein the articulated joint includes: A proximal connector member coupled to the shaft assembly, wherein the proximal connector member includes a proximal side surface defining a proximal tip; A distal connector member, the distal connector member being coupled to the surgical end effector, wherein the distal connector member includes a distal surface defining a distal tip; A linkage assembly configured to maintain the proximal tip and the distal tip in rollwise engagement, wherein the linkage assembly includes: A first link, connected to the proximal joint member, pivots relative to the proximal joint member about a first proximal pivot axis transverse to the axis and a second proximal pivot axis transverse to the first pivot axis and the axis; and wherein the first link is connected to the distal joint member, pivots relative to the distal joint member about a first distal pivot axis transverse to the axis and a second distal pivot axis transverse to the axis and the first distal pivot axis; and A second link is connected to the proximal joint member to pivot relative to the proximal joint member about a first proximal pivot axis and a second proximal pivot axis, and wherein the second link is connected to the distal joint member to pivot relative to the distal joint member about a first distal pivot axis and a second distal pivot axis. A proximal cross pin assembly, wherein the proximal cross pin assembly defines a first proximal pivot axis and a second proximal pivot axis; and A distal cross pin assembly, wherein the distal cross pin assembly defines a first distal pivot axis and a second distal pivot axis.

2. The surgical instrument according to claim 1, wherein, The first link is attached to the second link.

3. The surgical instrument according to claim 2, wherein, The first link is attached to the second link via an annular ring extending between the first link and the second link.

4. The surgical instrument according to claim 3, wherein, The proximal connector component includes a proximal outer diameter, wherein the distal connector component includes a distal outer diameter equal to the proximal outer diameter, and wherein the annular ring includes an outer diameter equal to or smaller than the proximal outer diameter and the distal outer diameter.

5. The surgical instrument according to claim 1, wherein, The proximal cross pin assembly includes: First proximal cross pin; and A second proximal cross pin, rotatably connected via a journal to the first proximal cross pin to facilitate rotation of the first proximal cross pin relative to the second proximal cross pin, and wherein the distal cross pin assembly includes: First distal cross pin; and A second distal cross pin is rotatably connected to the first distal cross pin via a journal to facilitate rotation of the first distal cross pin relative to the second distal cross pin.

6. The surgical instrument according to claim 5, wherein, The first link is removably connected to the first proximal cross pin and the first distal cross pin, and wherein the second link is removably connected to the first proximal cross pin and the first distal cross pin.

7. The surgical instrument according to claim 1, wherein, The proximal tip includes a plurality of proximal engagement features, and the distal tip includes a plurality of distal engagement features that are rolled into engagement with the proximal engagement features.

8. The surgical instrument according to claim 7, wherein, The plurality of proximal engagement features include a plurality of radially protruding fin members, and wherein the distal engagement features include a plurality of radially recessed portions spaced apart between the plurality of radially protruding fin members.

9. The surgical instrument of claim 1, further comprising a plurality of flexible joint motion actuators extending through the proximal connector member and the distal connector member, wherein, Each of the flexible joint motion components is coupled to the surgical end effector and is configured to apply joint motion to the surgical end effector.

10. A surgical instrument comprising: A shaft assembly, wherein the shaft assembly defines a shaft axis; A surgical end effector, wherein the surgical end effector defines an end effector axis, wherein the surgical end effector is coupled to the shaft assembly via an articulated joint, the articulated joint being configured to facilitate articulation of the surgical end effector relative to the shaft assembly between a non-articulated position and an articulated position, wherein in the non-articulated position the end effector axis is axially aligned with the shaft axis, and in the articulated position the end effector axis is not axially aligned with the shaft axis, and wherein the articulated joint includes: A proximal connector member, which is connected to the shaft assembly; Distal connector member, the distal connector member being coupled to the surgical end effector; and The central connecting rod component includes: The proximal end portion is coupled to the proximal connector member to pivot relative to the proximal connector member about a first proximal pivot axis transverse to the axis and a second proximal pivot axis transverse to the first proximal pivot axis and the axis; and The distal end is connected to the distal connector member to pivot relative to the distal connector member about a first distal pivot axis transverse to the axis and a second distal pivot axis transverse to the first distal pivot axis and the axis. The proximal end of the central link member is connected to the proximal connector member via a proximal crosspin assembly, wherein the proximal crosspin assembly defines a first proximal pivot axis and a second proximal pivot axis, and wherein the distal end of the central link member is connected to the distal connector member via a distal crosspin assembly, wherein the distal crosspin assembly defines a first distal pivot axis and a second distal pivot axis.

11. The surgical instrument according to claim 10, wherein, The proximal end of the central link member includes a proximal spherical member that is rollably retained in a proximal socket in the proximal connector member, and wherein the distal end of the central link member includes a distal spherical member that is rollably retained in a distal socket in the distal connector member.

12. The surgical instrument according to claim 11, wherein, The proximal cross pin assembly includes: First proximal cross pin; and A second proximal cross pin, rotatably connected via a journal to the first proximal cross pin to facilitate rotation of the first proximal cross pin relative to the second proximal cross pin, and wherein the distal cross pin assembly includes: First distal cross pin; and A second distal cross pin is rotatably connected to the first distal cross pin via a journal to facilitate rotation of the first distal cross pin relative to the second distal cross pin.

13. The surgical instrument according to claim 12, wherein, The first proximal cross pin is rotatably supported in the proximal connector member, and the second proximal cross pin is rotatably supported in the proximal spherical member, wherein the first distal cross pin is rotatably supported in the distal connector member and the second distal cross pin is rotatably supported in the distal spherical member.

14. The surgical instrument of claim 10, further comprising a plurality of flexible articular motion actuators extending through the proximal connector member and the distal connector member, wherein, Each of the flexible joint motion components is coupled to the surgical end effector and is configured to apply joint motion to the surgical end effector.

15. The surgical instrument according to claim 11, wherein, The central link member includes a central link portion that is connected to the proximal spherical member and the distal spherical member and extends between the proximal spherical member and the distal spherical member.

16. The surgical instrument of claim 15, further comprising a flexible connector support surrounding the central link member and connected to the proximal connector member and the distal connector member.

17. The surgical instrument according to claim 16, wherein, The plurality of flexible joint support members include: A first flexible member is connected to the proximal connector member and the distal connector member; A second flexible member is connected to the proximal connector member and the distal connector member; A third flexible member, the third flexible member being connected to the proximal connector member and the distal connector member; and A fourth flexible member is connected to the proximal connector member and the distal connector member.

18. The surgical instrument according to claim 17, wherein, Each of the first flexible member, the second flexible member, the third flexible member, and the fourth flexible member passes through the central portion of the central link member.

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