Surgical instrument with flexible ball chain drive arrangement

Abstract

Surgical instruments are disclosed that include an axially movable firing member that is configured to be driven by an upper chain drive assembly and a lower chain drive assembly between a starting position and an ending position within a surgical end effector of the surgical instrument.

Description

[0001] Cross Reference to Related Applications

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[0040] Figure 36 Figure 19 Figure 19

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[0064] Figure 60 yes Figure 59another side view of the articulating joint of the surgical instrument of

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[0088] Figure 84 is a perspective view of a guide member of a rotary drive firing system and a rotary drive shaft; Figure 83

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[0113] Figure 109 is Figure 108 a cross-sectional view of an articulation joint and a rotary drive system of the surgical instrument of in an unarticulated orientation;

[0114] Figure 110 is Figure 109 another cross-sectional view of an articulation joint and a rotary drive system of the surgical instrument of in which a proximal joint member of the articulation joint is articulated relative to a central joint member of the articulation joint;

[0115] Figure 111 is Figure 87 a partial elevational side view of the surgical instrument of in a form of a cable tensioning system in which the surgical end effector is in an unarticulated orientation;

[0116] Figure 112 is Figure 111 another partial elevational side view of the surgical instrument and cable tensioning system of in which the surgical end effector is in an articulated orientation;

[0117] Figure 113 is Figure 87 a partial elevational side view of the surgical instrument of in another form of a cable tensioning system in which the surgical end effector is in an unarticulated orientation; and

[0118] Figure 114 is Figure 113 another partial elevational side view of the surgical instrument and cable tensioning system of in which the surgical end effector is in an articulated orientation. DETAILED DESCRIPTION

[0119] Applicant of the present application owns the following U.S. Patent Applications that were filed on even date herewith and which are each herein incorporated by reference in their respective entireties:

[0120] U.S. Patent Application entitled SURGICAL INSTRUMENTS WITH TORSION SPINE DRIVE ARRANGEMENTS, Attorney Docket No. END9248USNP1 / 200084-1;

[0121] U.S. Patent Application entitled SURGICAL INSTRUMENTS WITH FIRING MEMBER CLOSURE FEATURES, Attorney Docket No. END9248USNP2 / 200084-2;

[0122] U.S. Patent Application entitled SURGICAL INSTRUMENTS WITH SEGMENTED FLEXIBLE DRIVE ARRANGEMENTS, Attorney Docket No. END9248USNP3 / 200084-3;

[0123] U.S. Patent Application entitled SURGICAL INSTRUMENTS WITH DOUBLE SPHERICAL ARTICULATION JOINTS WITH PIVOTABLE LINKS, Attorney Docket No. END9248USNP5 / 200084-5;

[0124] U.S. Patent Application entitled SURGICAL INSTRUMENTS WITH DOUBLE PIVOT ARTICULATION JOINT ARRANGEMENTS, Attorney Docket No. END9248USNP6 / 200084-6;

[0125] U.S. Patent Application entitled SURGICAL INSTRUMENTS WITH COMBINATION FUNCTION ARTICULATION JOINT ARRANGEMENTS, Attorney Docket No. END9248USNP7 / 200084-7;

[0126] U.S. Patent Application entitled METHOD OF OPERATING A SURGICAL INSTRUMENT, Attorney Docket No. END9248USNP8 / 200084-8M;

[0127] U.S. Patent Application entitled SURGICAL INSTRUMENTS WITH DUAL SPHERICAL ARTICULATION JOINT ARRANGEMENTS, Attorney Docket No. END9248USNP9 / 200084-9;

[0128] U.S. Patent Application entitled SURGICAL INSTRUMENTS WITH FLEXIBLE FIRING MEMBER ACTUATOR CONSTRAINT ARRANGEMENTS, Attorney Docket No. END9248USNP10 / 200084-10;

[0129] U.S. Patent Application entitled ARTICULATABLE SURGICAL INSTRUMENTS WITH ARTICULATION JOINTS COMPRISING FLEXIBLE EXOSKELETON ARRANGEMENTS, Attorney Docket No. END9248USNP11 / 200084-11; and

[0130] U.S. Patent Application entitled SURGICAL INSTRUMENTS WITH DIFFERENTIAL ARTICULATION JOINT ARRANGEMENTS FOR ACCOMMODATING FLEXIBLE ACTUATORS, Attorney Docket No. END9248USNP12 / 200084-12.

[0131] Numerous specific details are set forth herein to provide a thorough understanding of the overall structure, functioning, manufacture, and use of the embodiments described and shown in the specification. Well-known operations, components, and elements are not described in detail to avoid obscuring the embodiments described in the specification. The reader will understand that the embodiments described and shown herein are non-limiting examples, and thus can recognize that the particular structural and functional details disclosed herein are representative and illustrative. Modifications and changes can be made without departing from the scope of the claims.

[0132] The terms "comprise" (and any form of comprise, such as "comprises" and "comprising"), "have" (and any form of have, such as "has" and "having"), "include" (and any form of include, such as "includes" and "including") and "contain" (and any form of contain, such as "contains" and "containing") are open-ended linking verbs. As a result, a surgical system, device, or apparatus that "comprises," "has," "includes" or "contains" one or more elements possesses those one or more elements, but is not limited to possessing only those one or more elements. Likewise, an element of a system, device, or apparatus that "comprises," "has," "includes" or "contains" one or more features possesses those one or more features, but is not limited to possessing only those one or more features.

[0133] The terms "proximal" and "distal" are used herein with respect to a clinician manipulating a handle portion of a surgical instrument. The term "proximal" refers to the portion closest to the clinician, and the term "distal" refers to the portion positioned away from the clinician. It will also be understood that, for the sake of brevity and clarity, spatial terms such as "vertical," "horizontal," "up," and "down," can be used herein with respect to the drawings. However, surgical instruments are used in many orientations and positions, and these terms are not limiting and / or absolute.

[0134] References to items in the singular should be understood to include items in the plural, and vice versa, unless explicitly stated otherwise or clear from context. Grammatical connections words are intended to express any and all transi tions and connections, commutative and non-commutative, implicit and explicit, between one or more sentences, clauses, phrases or words, unless otherwise indicated or clear from context. Thus, the term "or" should generally be understood to mean "and / or" unless otherwise stated or clear from context.

[0135] Unless otherwise indicated herein, the numerical values listed herein are not intended to be limited to the precise range expressed and are meant to be approximations that allow for significant figures to account for slightly different but related quantities. The word "about" means to the extent consistent with experimental error attributable to the measurement technique and / or instrumentation used to assess the quantity to which the term "about" refers. When used with respect to a physical property, the approximate words such as "about" or "substantially" are to be interpreted as contemplating a range of deviation that would be appreciated by a person of ordinary skill in the art to be satisfactory for the corresponding use, function, purpose, etc.

[0136] Any and all examples or exemplary language (e.g., "such as", "for instance", etc.) provided herein are intended merely to better illuminate embodiments and therefore does not indicate a limitation on the scope of embodiments otherwise claimed. No language in the specification should be construed as indicating any non-claimed element as essential to the practice of embodiments.

[0137] Various exemplary devices and methods are provided for performing laparoscopic and minimally invasive surgical procedures. However, as those skilled in the art will readily appreciate, the various methods and devices disclosed herein can be used in numerous surgical procedures and applications including, for example, in connection with open surgical procedures. As the present DETAILED DESCRIPTION proceeds, one will further appreciate that the various instruments disclosed herein can be inserted into a patient's body in any suitable manner, such as through a natural orifice, through an incision or puncture hole formed in tissue, etc. The working or end effector portion of the instrument can be inserted directly into a patient's body or can be inserted through an access device having a working channel, through which an end effector and elongated shaft of a surgical instrument can be advanced.

[0138] During various laparoscopic surgical procedures, it is common practice to insert the surgical end effector portion of a surgical instrument through a trocar needle that has been installed in the abdominal wall of a patient to access a surgical site located within the patient's abdomen. In its simplest form, a trocar needle is a pen-like instrument having a sharp triangular point at one end that is typically used inside a hollow tube known as a cannula to form an opening into the body through which the surgical end effector can be introduced. This arrangement forms an access port into a body cavity through which the surgical end effector can be inserted. The inner diameter of the cannula of the trocar needle inevitably limits the size of the end effector and drive support shaft of a surgical instrument that can be inserted through the trocar needle.

[0139] Regardless of the particular type of surgical procedure being performed, once the surgical end effector is inserted into the patient through the trocar cannula, it is often necessary to move the surgical end effector relative to the shaft assembly positioned within the trocar cannula in order to properly position the surgical end effector relative to the tissue or organ to be treated. This movement or positioning of the surgical end effector relative to the shaft portion held within the trocar cannula is commonly referred to as "articulation" of the surgical end effector. Various articulation joints have been developed to attach the surgical end effector to the associated shaft to facilitate such articulation of the surgical end effector. It is anticipated that in many surgical procedures it would be desirable to employ a surgical end effector having as large an articulation range as possible.

[0140] Due to the size constraints imposed by the size of the trocar cannula, the size of the articulation joint components must be set so as to freely pass through the trocar cannula. These size constraints also limit the size and composition of various drive members and components that operably interface with the motors and / or other control systems supported in a housing, which can be hand-held or part of a larger automated system. In many cases, these drive members must operably pass through the articulation joint to operably couple to or interface with the surgical end effector. For example, one such drive member is typically used to apply articulation control motions to the surgical end effector. During use, the articulation drive member can be unactuated to position the surgical end effector in a non-articulated position to facilitate insertion of the surgical end effector through the trocar, and then actuated to articulate the surgical end effector to a desired position as the surgical end effector enters the patient.

[0141] Accordingly, the aforementioned size constraints present a number of challenges to developing an articulation system that can achieve the desired articulation range, yet is also suitable for the various different drive systems needed to operate the various features of the surgical end effector. Moreover, once the surgical end effector has been positioned in the desired articulated position, the articulation system and articulation joint must be able to hold the surgical end effector in that locked position during actuation of the end effector and completion of the surgical procedure. Such articulation joint arrangements must also be able to withstand the external forces experienced by the end effector during use.

[0142] There are a variety of surgical end effectors configured to cut and staple tissue. Such surgical end effectors typically include a first jaw feature that supports a surgical staple cartridge and a second jaw that includes an anvil. The jaws are supported relative to one another such that they can be moved between open and closed positions to position and clamp target tissue therebetween. Many of these surgical end effectors employ an axial motion firing member. In some end effector designs, the firing member is configured to engage the first and second jaws such that when the firing member is initially advanced distally, the firing member moves the jaws to the closed position. Other end effector designs employ a separate closure system that is independent of and distinct from the system that operates the firing member.

[0143] The staple cartridge includes a cartridge body. The cartridge body includes a proximal end, a distal end, and a deck extending between the proximal end and the distal end. In use, the staple cartridge is positioned on a first side of tissue to be stapled and the anvil is positioned on a second side of the tissue. The anvil is moved toward the staple cartridge to compress and clamp the tissue against the deck. Staples that are removably stored in the cartridge body can then be deployed into the tissue. The cartridge body includes staple cavities defined therein, wherein the staples are removably stored in the staple cavities. The staple cavities are arranged in six longitudinal rows. Three rows of staple cavities are positioned on a first side of the longitudinal slot and three rows of staple cavities are positioned on a second side of the longitudinal slot. Other arrangements of staple cavities and staples are also possible.

[0144] The staples are supported by staple drivers in the cartridge body. The drivers are movable between a first or unfired position and a second or fired position to eject the staples from the staple cartridge. The drivers are retained in the cartridge body by a retainer that extends around the bottom of the cartridge body and includes resilient members configured to grasp the cartridge body and retain the retainer to the cartridge body. The drivers are movable between their unfired position and their fired position by a sled. The sled is movable between a proximal position adjacent the proximal end and a distal position adjacent the distal end. The sled includes a plurality of ramp surfaces configured to slide under the drivers and lift the drivers toward the anvil, and the staples are supported on the drivers.

[0145] In addition to the above, in these surgical end effectors, the sled is moved distally by a firing member. The firing member is configured to contact the sled and push the sled toward the distal end. A longitudinal slot defined in the cartridge body is configured to receive the firing member. The anvil further includes a slot configured to receive the firing member. The firing member further includes a first cam that engages the first jaw and a second cam that engages the second jaw. As the firing member is advanced distally, the first and second cams can control the distance between the deck of the staple cartridge and the anvil or the tissue gap. The firing member further includes a knife configured to cut tissue captured intermediate the staple cartridge and the anvil. It is desirable for the knife to be positioned at least partially proximate the ramped surface so that staples are ejected prior to the knife.

[0146] Many surgical end effectors employ an axially movable firing beam that is attached to a firing member and used to apply axial firing and retraction motions to the firing member. Many such firing beams include a laminate construction that causes the firing beam to have some degree of flexure about an articulation joint. As the firing beam traverses the articulation joint, it can apply a disarticulation force to the joint and can cause the beam to buckle. To prevent the firing beam from buckling under pressure, the articulation joint is often provided with a transverse support or "blowout" plate feature to support the portion of the beam that traverses the articulation joint. For example, to advance the firing beam through an angle greater than sixty degrees requires a substantial axial force. This axial force must be applied to the firing member in a balanced manner to avoid binding of the firing member with the jaws as the firing member is moved distally. Any binding of the firing member with the jaws can result in component damage and wear and requires an increased amount of axial drive force to drive the firing member through the clamped tissue.

[0147] Other end effector designs employ a firing member that is driven by a rotary power. In many such designs, a rotary drive shaft extends through an articulation joint and interfaces with a rotatable firing member drive shaft that is rotatably supported within one of the jaws. The firing member threadably engages the rotatable firing member drive shaft, which is driven through the end effector as the rotatable firing member drive shaft is rotated. Such arrangements require the support jaw to be larger to accommodate the firing member drive shaft. In such devices, the lower end of the firing member is often operably interfaced with the drive shaft, which can also result in forces being applied that tend to unbalance the firing member as it is driven distally.

[0148] Figures 1-4One form of a surgical instrument 10 is shown that can address many of the challenges faced by surgical instruments having articulatable end effectors configured to both cut and fasten tissue. In various embodiments, the surgical instrument 10 can comprise a hand-held device. In other embodiments, the surgical instrument 10 can comprise an automated system, such as sometimes referred to as a robotic control system. In various forms, the surgical instrument 10 includes a surgical end effector 1000 operably coupled to an elongated shaft assembly 2000. The elongated shaft assembly 2000 can be operably attached to a housing 2002. In one embodiment, the housing 2002 can comprise a handle configured to be grasped, manipulated, and actuated by a clinician. In other embodiments, the housing 2002 can comprise an accommodation or otherwise operable support of at least a portion of a robotic system configured to generate and apply at least one control motion that can be used to actuate the surgical end effectors disclosed herein and their respective equivalents. Moreover, various components can be "accommodated" or included in the housing, or various components can be "associated" with the housing. In such instances, the components can not be housed within or directly supported by the housing. For example, the surgical instruments disclosed herein can be used with various robotic systems, instruments, components, and methods disclosed in U.S. Patent No. 9,072,535 entitled SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS, which is hereby incorporated by reference in its entirety.

[0149] In one form, the surgical end effector 1000 includes a first jaw 1100 and a second jaw 1200. In the illustrated arrangement, the first jaw 1100 includes an elongated channel 1110 that includes a proximal end 1112 and a distal end 1114 and is configured to operably support a surgical staple cartridge 1300 therein. The surgical staple cartridge 1300 includes a cartridge body 1302 having an elongated slot 1304 therein. A plurality of surgical staples or fasteners (not shown) are stored in the cartridge body on drivers (not shown) arranged in rows on each side of the elongated slot 1304. The drivers are each associated with a corresponding staple cavity 1308 that is exposed through a cartridge deck surface 1306. The surgical staple cartridge 1300 can be replaced after the staples / fasteners have been expelled therefrom. Other embodiments can be envisioned wherein the elongated channel 1110 and / or the entire surgical end effector 1000 can be discarded after the surgical staple cartridge 1300 has been used. For example, such an end effector arrangement can be referred to as a "disposable loading unit".

[0150] In the illustrated arrangement, the second jaw 1200 includes an anvil 1210, which includes an elongated anvil body 1212, comprising a proximal end 1214 and a distal end 1216. In one arrangement, a pair of reinforcing bars or members 1213 may be supported in the anvil body 1212 to provide increased stiffness and rigidity to the anvil body 1212. The anvil body 1212 includes a staple-formed lower surface 1218 facing the first jaw 1100 and may include a series of staple-formed recesses (not shown) corresponding to each of the staples or fasteners in the surgical staple cartridge 1300. The anvil body 1212 may also include a pair of downwardly extending tissue stop features 1220 formed adjacent to the proximal end 1214 of the anvil body 1212. A tissue stop feature 1220 extends from each side of the anvil body 1212 such that the distal end 1222 of each tissue stop corresponds to the nearest side staple / fastener in the surgical cartridge 1300. When the anvil 1210 moves to the closed position toward the tissue positioned between the staple-forming lower surface 1218 of the anvil 1210 and the cartridge platform surface 1306 of the surgical cartridge 1300, the tissue contacts the distal end 1222 of the tissue stop feature 1220 to prevent proximal movement of the tissue past the nearest side staple / fastener, thereby ensuring that the cut tissue is also sutured. When the surgical cartridge is “fired” as will be discussed in further detail below, the staple / fastener supported in each cavity is driven out of the cavity 1308, through the clamped tissue, and into contact with the staple-forming lower surface 1218 of the anvil 1210.

[0151] like Figure 5 and Figure 6 As can be seen, the proximal end 1214 of the anvil body 1212 includes an anvil mounting portion 1230, which includes a pair of laterally extending mounting pins 1232 configured to be received in corresponding mounting brackets or pivot brackets 1120 formed in the proximal end 1112 of the elongated channel 1110. The mounting pins 1232 are pivotally held within the mounting brackets 1120 by an anvil top cover 1260, which is attached to the proximal end 1112 of the elongated channel 1110 via a mechanical snap-fit ​​feature 1261 configured to engage a retaining structure 1113 on the elongated channel 1110. See also Figure 5 In other arrangements, the anvil top cover 1260 can be attached to the elongated channel 1110 by welding, adhesive, etc. This arrangement facilitates the anvil 1210 in the open position relative to the surgical staple cartridge 1300 mounted in the elongated channel 1110 about the pivot axis PA. Figure 1 ) and closed position ( Figures 2-5pivotally travels between an open position and a closed position. Such a pivot axis PA can be referred to herein as being "fixed" in that the pivot axis does not translate or otherwise move when the anvil 1200 is pivoted from the open position to the closed position.

[0152] In the illustrated arrangement, the elongate shaft assembly 2000 defines a shaft axis SA and includes a proximal shaft portion 2100 that is operably interfaced with a housing of a control portion (e.g., a hand-held unit, a robotic tool driver, etc.) of the surgical instrument 10. The elongate shaft assembly 2000 further includes an articulation joint 2200 that is attached to the proximal shaft portion 2100 and the surgical end effector 1000. In various circumstances, the proximal shaft portion 2100 includes a hollow outer tube 2110 that can be operably coupled to the housing 2002. See Figure 2 . As can be seen in Figure 6 The proximal shaft portion 2100 can further include a rigid proximal support shaft 2120 that is supported within the hollow outer tube 2110 and that extends from the housing to the articulation joint 2200. The proximal support shaft 2120 can include first and second halves 2120A, 2120B that can be coupled together by, for example, welding, adhesive, etc. The proximal support member 2120 includes a proximal end 2122 and a distal end 2124 and includes an axial conduit 2126 that extends therethrough from the proximal end 2122 to the distal end 2124.

[0153] As discussed above, many surgical end effectors employ a firing member that is pushed distally through a surgical staple cartridge by an axially movable firing beam. The firing beam is typically attached to the firing member in a central region of the firing member body. This attachment location can cause the firing member to be unbalanced as it is advanced through the end effector. This imbalance can cause undesirable friction between the firing member and the end effector jaw. The creation of this additional friction can require a higher firing force to be applied to overcome this friction and can cause undesirable wear to portions of the jaw and / or firing member. The application of a higher firing force to the firing beam can cause undesirable flexing of the firing beam as it traverses the articulation joint. This additional flexing can cause the articulation joint to disarticulate, particularly when the surgical end effector is articulated at relatively high articulation angles. The surgical instrument 10 employs a firing system 2300 that addresses many of these issues, if not all of them, as well as other issues.

[0154] As Figures 5-11As can be seen, in at least one embodiment, the firing system 2300 includes a firing member 2310 that includes a vertically extending firing member body 2312 that includes a top firing member feature 2320 and a bottom firing member feature 2350. A tissue-cutting knife 2314 is attached to or formed in the vertically extending firing member body 2312. See Figure 9 and Figure 11 In at least one arrangement, it is desirable for the firing member 2310 to pass through the anvil body 1212 with low friction, high strength, and high stiffness. In the illustrated arrangement, the top firing member feature 2320 includes a top tubular body 2322 having a top axial conduit 2324 extending therethrough. See Figure 10 The bottom firing member feature 2350 includes a bottom tubular body 2352 having a bottom axial conduit 2354 extending therethrough. In at least one arrangement, the top firing member feature 2320 and the bottom firing member feature 2350 are integrally formed with the vertically extending firing member body 2312. As shown, Figure 12 The anvil body 1212 includes an axially extending anvil slot 1240 that has a keyhole-like cross-sectional shape. Similarly, the elongate channel 1110 includes an axially extending channel slot 1140 that also has a keyhole cross-sectional shape.

[0155] Conventional firing member arrangements employ long, flexible cantilevered wings that extend from the top and bottom portions of the firing member. These cantilevered wings slideably pass through slots in the anvil and channel that are typically cut with a rectangular t-shaped cutter, which tends to create a higher friction surface. Such long cantilevered wings have a minimum surface area in contact with the anvil and channel and can result in these components being scuffed. The keyhole-shaped channel slot 1140 and keyhole-shaped anvil slot 1240 can be cut with a round t-shaped cutter and can be finished with a reamer / drill, which will result in a lower friction surface. Additionally, the top tubular body 2322 and the bottom tubular body 2352 tend to be stiffer than existing cantilevered wing arrangements and have an increased surface area in contact with the anvil and channel, respectively, which can reduce scuffing and create a stronger sliding connection. In other words, because the anvil slot 1240 and channel slot 1140 are keyhole-shaped and remove less material than conventional rectangular slots, this geometry and increased material can make the anvil and channel stiffer when compared to existing arrangements.

[0156] Turning to Figures 9-11In one arrangement, the firing system 2300 further includes an upper flexible spine assembly 2400 operably coupled to the top firing member feature 2320 and a lower flexible spine assembly 2500 operably coupled to the bottom firing member feature 2350. In at least one embodiment, the upper flexible spine assembly 2400 includes an upper series 2410 of upper vertebra members 2420 that are loosely coupled together by an upper flexible coupler member 2402 that is attached to the top firing member feature 2320. The upper flexible coupler member 2402 can include a top cable 2404 that extends through a top axial conduit 2324 in the top firing member feature 2320, and a distal end 2406 of the top cable 2404 is attached to a retainer ferrule 2408 that is fixed with the top axial conduit 2324.

[0157] As Figure 13 As can be seen in FIGS. 27-29, each upper vertebra member 2420 includes an upper vertebra body portion 2422 having a proximal end 2424 and a distal end 2428. An upper hollow conduit 2429 extends through the upper vertebra body portion 2422 to accommodate the upper flexible coupler member 2402 therethrough. Each upper vertebra member 2420 further includes a downwardly extending upper drive feature or upper vertebra member tooth 2450 that protrudes from the upper vertebra body portion 2422. Each upper vertebra member tooth 2450 has a helical proximal upper face portion 2452 and a helical distal upper face portion 2454. Each proximal end 2424 of the upper vertebra body portion 2422 has an upper proximal mating feature 2426 therein, and each distal end 2428 has an upper distal mating feature 2430 formed therein. In at least one embodiment, the upper proximal mating feature 2426 includes a concave recess 2427, and each upper distal mating feature 2430 includes a convex bump 2431. When arranged in the upper series 2410, the convex bump 2431 on one upper vertebra member 2420 contacts and mates with the concave recess 2427 on an adjacent upper vertebra member 2420 in the upper series 2410 to hold the upper vertebra members 2420 in general alignment so that the helical proximal upper face portion 2452 and the helical distal upper face portion 2454 on each respective upper tooth 2450 can be drivingly engaged by the rotary drive screw 2700, as will be discussed in further detail below.

[0158] Similarly, in at least one embodiment, the lower flexible spine assembly 2500 includes a lower series 2510 of lower vertebral members 2520 that are loosely coupled together by lower flexible coupler members 2502 that are attached to the bottom firing member features 2350. The lower flexible coupler members 2502 can include lower cables 2504 that extend through bottom axial conduits 2354 in the bottom firing member features 2350, and distal ends 2506 of the bottom cables 2504 are attached to retainer collars 2508 that are fixed with the bottom axial conduits 2354.

[0159] As Figure 14 can be seen, each lower vertebral member 2520 includes a lower vertebral body portion 2522 having a proximal end 2524 and a distal end 2528. A lower hollow conduit 2529 extends through the lower vertebral body portion 2522 to accommodate the lower flexible coupler members 2502 therethrough. Each lower vertebral member 2520 also includes an upwardly extending lower drive feature or lower vertebral member tooth 2550 that projects upwardly from the lower vertebral body portion 2522. Each lower vertebral member tooth 2550 has a helical proximal lower face portion 2552 and a helical distal lower face portion 2554. Each proximal end 2524 of the lower vertebral body portion 2522 has a lower proximal mating feature 2526 therein, and each distal end 2528 has a lower distal mating feature 2530 formed therein. In at least one embodiment, the lower proximal mating feature 2526 includes a concave recess 2527, and each lower distal mating feature 2530 includes a convex protrusion 2531. When arranged in the lower series 2510, the convex protrusion 2531 on one lower vertebral member 2520 contacts and mates with the concave recess 2527 on an adjacent lower vertebral member 2520 in the lower series 2510 to hold the lower vertebral members 2520 in general alignment so that the helical proximal lower face portion 2552 and the helical distal lower face portion 2554 on each respective lower vertebral member tooth 2550 can be drivingly engaged by the rotary drive screw 2700, as will be discussed in further detail below.

[0160] Turning now to Figure 5 , Figure 7 and Figure 8In at least one arrangement, the firing drive system 2300 further includes a rotary drive screw 2700 that is configured to drivingly interface with the upper series 2410 of the upper vertebral members 2420 and the lower series 2510 of the lower vertebral members 2520. In the illustrated arrangement, the rotary drive screw 2700 is driven by a rotary drive system 2600 that includes a proximal rotary drive shaft 2610 that is rotatably supported within an axial channel 2126 within the proximal support shaft 2120. See Figure 7 . The proximal rotary drive shaft 2610 includes a proximal end 2612 and a distal end 2614. The proximal end 2612 can interface with a gear box 2004 or other arrangement driven by a motor 2006 or other source of rotary motion housed in the housing of the surgical instrument. See Figure 2 . Such a source of rotary motion causes the proximal rotary drive shaft to rotate about a shaft axis SA within the axial channel 2126 in the proximal support shaft 2120.

[0161] The proximal rotary drive shaft 2610 is operably supported within the elongate shaft assembly 2000 adjacent the articulation joint 2200 and operably interfaces with a constant velocity (CV) drive shaft assembly 2620 that "straddles" or extends axially through the articulation joint 2200. As can be seen in Figure 8 , Figure 16 and Figure 17 , in at least one arrangement, the CV drive shaft assembly 2620 includes a proximal CV drive assembly 2630 and a distal CV drive shaft 2670. The proximal CV drive assembly 2630 includes a proximal shaft segment 2632 that is comprised of an attachment shaft 2634 that is configured to be non-rotatably received within a similarly shaped coupler cavity 2616 in the distal end 2614 of the proximal rotary drive shaft 2610. The proximal shaft segment 2632 operably interfaces with a series 2640 of movable coupled drive joints 2650.

[0162] As can be seen in Figure 18 , in at least one arrangement, each drive joint 2650 includes a first or distal spherical portion 2660 and a second or proximal spherical portion 2652. The distal spherical portion 2660 is larger than the proximal spherical portion 2652. The distal spherical portion 2660 includes a socket cavity 2662 that is configured to rotatably receive the proximal spherical portion 2652 of an adjacent drive joint 2650 therein. Each proximal spherical portion 2652 includes a pair of diametrically opposed engagement pins 2654 that are configured to movably receive in a corresponding pin slot 2664 in the distal spherical portion 2660 of an adjacent drive joint 2650, as can be seen in Figure 16The proximal ball portion 2652P of the proximal-most drive joint 2650P is rotatably received in a distal socket portion 2636 of the proximal shaft segment 2632, as Figure 16 shown. An engagement pin 2654P is received within a corresponding pin slot 2637 in the distal socket portion 2636. As Figure 16 further shown in the series 2640 of movably coupled drive joints 2650, the distal-most drive joint 2650D is movably coupled to a distal CV drive shaft 2670.

[0163] In at least one arrangement, the distal CV drive shaft 2670 includes a proximal spherical portion 2672 sized to be movably received in a socket cavity 2662D in the distal-most drive joint 2650D. The proximal spherical portion 2672 includes an engagement pin 2674 movably received in a pin slot 2664D in the distal-most drive joint 2650D. The distal CV drive shaft 2670 further includes a shaft stem 2676 extending distally configured to be non-rotatably coupled to a rotary drive screw 2700 positioned distal to the articulation joint 2200. The distal CV drive shaft 2670 includes a flange 2677 and a mounting cylinder portion 2678 for receiving a thrust bearing housing 2680 thereon.

[0164] In the illustrated arrangement, as the series 2640 of movably coupled drive joints 2650 articulate, the engagement pin 2674 remains in the corresponding pin slot 2664 of the adjacent drive joint 2650. In Figure 18 the illustrated example, each drive joint is capable of articulating approximately 18 degrees in the pitch direction and yaw direction. Figure 16 The angle of the series 2640 of drive joints 2650 is shown at a time when each drive joint 2650 in the series has been fully articulated ninety degrees in the pitch direction and yaw direction, which results in an angle a of approximately 100.9 degrees. In this arrangement, the outer surface of each distal spherical portion 2660 passes over the outer surface of the adjacent or abutting proximal spherical portion 2652, allowing unrestricted movement until the 18 degree limit is reached. The rigid design and limited small angle allows the series 2640 of movably coupled drive joints 2650 to torsionally carry high loads at a generally large angle.

[0165] In the illustrated arrangement, the articulation joint 2200 includes an articulation joint spring 2230 supported within an outer elastomeric joint assembly 2210. The outer elastomeric joint assembly 2210 includes a distal end 2212 attached to the proximal end 1112 of the elongated channel 1110. For example, as Figure 6As can be seen, the distal end 2212 of the outer elastomeric joint assembly 2210 is attached to the proximal end 1112 of the elongated channel 1110 by a pair of headed screws 2722 that extend through a distal mounting bushing 2720 to be threadably received in the proximal end 1112 of the elongated channel 1110. The proximal end 2214 of the elastomeric joint assembly 2210 is attached to the distal end 2124 of the proximal end support shaft 2120. The proximal end 2214 of the elastomeric joint assembly 2210 is attached to the distal end 2124 of the proximal support member 2120 by a pair of headed screws 2732 that extend through a proximal mounting bushing 2750 to be threadably received in a threaded insert 2125 that is mounted within the distal end 2124 of the proximal support shaft 2120.

[0166] To prevent the drive joints 2650 from buckling during articulation, the series 2640 of movably coupled drive joints 2650 extend through at least one low-friction articulation joint spring 2730 that is supported within the outer elastomeric joint assembly 2210. See Figure 19 . The articulation joint spring 2730 is sized relative to the drive joints 2650 such that a slight radial clearance is provided between the articulation joint spring 2730 and the drive joints 2650. The articulation joint spring 2730 is designed to axially carry articulation joint loads that can be significantly lower than the torsional firing loads. The joint spring is longer than the series 2640 of drive joints 2650 such that the drive joints are axially loose. If the "hard stack" of the series 2640 of drive joints 2650 is longer than the hard stack of the articulation joint spring 2730, the drive joints 2650 can act as an articulation compression limiter, resulting in the firing loads and the articulation loads being axially resolved through the series 2640 of drive joints 2650. When the firing loads are axially resolved through the series 2640 of drive joints 2650, the loads can attempt to straighten the articulation joint 2200, or in other words, cause disarticulation. If the hard stack of the articulation joint spring 2730 is longer than the hard stack of the series 2640 of drive joints 2730, the firing loads will be contained within the end effector and neither the firing loads will be resolved through the drive joints 2650 or through the spring 2650.

[0167] To further ensure that the drive joints 2650 are always engaged with one another, a proximal drive spring 2740 is employed to apply an axial biasing force to the series 2640 of drive joints 2650. For example, as Figure 8 , Figure 19 and Figure 20As can be seen in FIGS. 27A and 27B, the proximal drive spring 2740 is positioned between the proximal mounting bushing 2734 and a support flange formed between the distal socket portion 2636 and the proximal barrel portion 2638 of the proximal shaft section 2632. In one arrangement, the proximal drive spring 2740 can comprise an elastomeric O-ring / bush received on the proximal barrel portion 2638 of the proximal shaft section 2632. The proximal drive spring 2740 biases the drive joints 2650 slightly together to reduce any play that can occur during articulation. This ensures that the drive joints 2650 transmit loads torsionally. It will be appreciated, however, that in at least one arrangement, the proximal drive spring 2740 does not exert a high enough axial load such that the firing load translates through the articulation joint 2200.

[0168] As Figure 9 and Figure 10 As can be seen in FIGS. 27A and 27B, the proximal drive spring 2740 is positioned between the proximal mounting bushing 2734 and a support flange formed between the distal socket portion 2636 and the proximal barrel portion 2638 of the proximal shaft section 2632. In one arrangement, the proximal drive spring 2740 can comprise an elastomeric O-ring / bush received on the proximal barrel portion 2638 of the proximal shaft section 2632. The proximal drive spring 2740 biases the drive joints 2650 slightly together to reduce any play that can occur during articulation. This ensures that the drive joints 2650 transmit loads torsionally. It will be appreciated, however, that in at least one arrangement, the proximal drive spring 2740 does not exert a high enough axial load such that the firing load translates through the articulation joint 2200.

[0169] As noted above, each of the upper vertebra members 2520 is movably received on an upper flexible coupler member 2402 in the form of a top cable 2404. As noted above, the distal end 2406 of the top cable 2404 is fixed to the top firing member feature 2320 of the firing member 2310. Similarly, each of the lower vertebra members 2520 is movably received on a lower flexible coupler member 2502 in the form of a lower cable 2504. The distal end 2506 of the lower cable 2504 is fixed to the bottom firing member feature 2350 of the firing member 2310. In at least one arrangement, the top cable 2404 and the bottom cable 2504 extend through the proximal shaft portion 2100 and, as will be discussed in further detail below, can interface with an emergency arrangement supported in the housing to retract the firing member 2310 to its original or home position in the event of a firing member drive system failure.

[0170] Turning again to Figure 8 the axial length AL of the upper series 2410 of the upper vertebra members 2420 u and the axial length AL of the lower series 2510 of the lower vertebra members 2520 l are equal and must be long enough to facilitate full distal advancement of the firing member 2310 from the original or home position to the distal-most end position within the cartridge while the proximal-most upper vertebra member 2420 of the upper series 2410 of the upper vertebra members 2420 and the proximal-most lower vertebra member 2520 of the lower series 2510 of the lower vertebra members 2520 remain in driving engagement with the rotary drive screw 2700. As Figure 8 can be seen, the upper compression limiting spring 2421 is configured to interface with the proximal-most upper vertebra member 2420P of the upper series 2410 of the upper vertebra members 2420. The upper compression limiting spring 2421 is journaled on the top cable 2404 and held in biasing engagement with the proximal-most upper vertebra member 2420P by an upper spring retainer 2423 which is held in place by an upper collar 2425 crimped on the top cable 2404. The top cable 2404 extends through an upper hypotube 2433 supported in the proximal support shaft. Likewise, the lower compression limiting spring 2521 is configured to interface with the proximal-most lower vertebra member 2520P of the lower series 2510 of the lower vertebra members 2520. The lower compression spring 2521 is journaled on the lower cable 2504 and held in biasing engagement with the proximal-most lower vertebra member 2520P by a lower spring retainer 2523 which is held in place by a lower collar 2525 crimped on the lower cable 2504. The lower cable 2504 extends through a lower hypotube 2533 supported in the proximal support shaft.

[0171] When the upper vertebral members 2420 and the lower vertebral members 2520 are angled by the articulation joints (after the end effector has been positioned in an articulated position), in each series 2410, 2510, the gap between the respective vertebral members 2420, 2520 increases, which causes the springs 2421, 2521 to become tighter. The compression-limiting springs 2421, 2521 provide enough slack to the cables 2404, 2504, respectively, to enable the angle of the vertebral members 2420, 2520 to pass through the most extreme articulation angles. If the cables 2404, 2504 are pulled too tight, the spring retainers 2423, 2523 will contact their respective proximal-most vertebral members 2420P, 2520P. This compression-limiting arrangement ensures that the vertebral members 2420, 2520 always remain close enough together in their respective series 2410, 2510 so that the rotary drive screw 2700 will always drivingly engage these vertebral members in the manner discussed in further detail below. When the vertebral members 2420, 2520 are again in straight alignment, the compression-limiting springs 2421, 2521 can partially relax while still maintaining some compression between the vertebral members.

[0172] As noted above, when the upper vertebral members 2420 are arranged in the upper series 2410 and the lower vertebral members 2520 are arranged in the lower series 2510, the convex bulges and concave recesses in each vertebral member, as well as the compression-limiter springs, serve to hold the upper and lower vertebral members in relatively linear alignment for driving engagement by the rotary drive screw 2700. As can be seen in Figure 9 and Figure 10 When the upper vertebral members 2420 are in linear alignment, the upper teeth 2450 are spaced apart from one another by open spaces generally designated 2460, which facilitate driving engagement with the helical drive threads 2170 on the rotary drive screw 2700. Similarly, when the lower vertebral members 2520 are in linear alignment, the lower vertebral member teeth 2550 are spaced apart from one another by open spaces generally designated 2560, which facilitate driving engagement with the helical drive threads 2170 of the rotary drive screw 2700.

[0173] Turning to Figure 8 and Figure 22 , the rotary drive screw 2700 includes a screw body 2702 having a socket 2704 therein for receiving the distally extending shaft 2676 of the distal CV drive shaft 2670. An internal radial groove 2714( Figure 10formed in the screw body 2702 for supporting a plurality of ball bearings 2716 therein. In one arrangement, for example, twelve ball bearings 2716 are employed. The radial grooves 2714 support the ball bearings 2716 between the screw body 2702 and the distal end of the thrust bearing housing 2680. The ball bearings 2716 function to distribute the axial load of the rotationally driven screw 2700 and significantly reduce friction through the rolling motion of the balls.

[0174] As can be seen in Figure 23 , the helical drive thread 2710 is disposed about the screw body 2702 and functions to form a proximal threaded pocket feature 2712. The proximal threaded pocket feature 2712 is formed with a first pitch 2713 and the remaining portion of the helical drive thread 2710 is formed with a second pitch 2715 that is different than the first pitch 2713. In Figure 22 and Figure 23 , the region 2718 illustrates where the first pitch 2713 and the second pitch 2715 converge. In at least one embodiment, the first pitch 2713 is greater than the second pitch 2715 to ensure that the rotationally driven screw 2700 captures and “pockets” or drivingly engages each of the upper vertebral member 2420 and each of the lower vertebral member 2520. As can be seen in Figure 24 , the proximal end 2717 of the helical drive thread 2710 having the first pitch 2713 has been pocketed into the open space 2560 between two adjacent lower vertebral member teeth 2550A and 2550B, while the central portion 2719 of the helical drive thread 2710 having the second pitch 2715 is drivingly engaged with the helical distal lower face portion 2554 on the lower vertebral member tooth 2550B and the helical proximal lower face portion 2552 on the proximal lower firing member tooth 2366. It should also be appreciated that as the firing member 2310 is driven distally, the pocketed feature 2712 can not contact the helical distal lower face portion 2554A of the lower vertebral member tooth 2550A as it pockets the lower vertebral member tooth 2550B. The helical drive thread 2710 interacts with the teeth 2450 of the upper vertebral member 2420 in a similar manner.

[0175] A power screw is a screw with a full 360 degree nut around it. Rotation of the power screw causes the nut to longitudinally advance or move. In the present arrangement, however, due to space constraints, a full 360 degree nut cannot fit within the end effector. In a general sense, the upper and lower flexible spine assemblies 2400, 2500 comprise a radially / longitudinally segmented "power screw nut" that is rotatably driven by a rotary drive screw 2700. When the rotary drive screw is rotated in a first rotational direction, the rotary drive screw 2700 longitudinally drives one or more vertebral members in each of the upper and lower series of vertebral members, while the vertebral members 2420, 2520 remain in the same position radially. The upper and lower series 2410, 2510 are constrained to rotate around the rotary drive screw 2700 and can only move longitudinally. In one arrangement, the upper vertebral members 2420 in the upper series 2410 and the lower vertebral members 2520 in the lower series 2510 each rotate around the rotary drive screw 2700 at an angle of less than ten degrees.

[0176] Figure 25 The firing member 2310 is shown in a home or starting position. As can be seen in Figure 25 A portion of the helical drive threads 2710 on the rotary drive screw 2700 are engaged between the distal upper firing member tooth segment 2330 and the proximal upper firing member tooth 2336, and another portion of the helical drive threads 2710 are engaged between the distal lower firing member tooth 2360 and the proximal lower firing member tooth 2366 on the firing member 2310. This arrangement enables the rotary drive screw 2700 to precisely control the distal and proximal movement of the firing member 2310, which, as will be discussed in further detail below, can result in precise movement of the anvil 1210. Once the firing member 2310 has been advanced distally sufficiently during a firing stroke, the helical drive threads 2710 operably engage the teeth on the upper and lower vertebrae. See Figure 26 .

[0177] The surgical instrument 10 further includes an articulation system 2240 that is configured to apply articulation motions to the surgical end effector 1000 to articulate the surgical end effector 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 that extend through the elongated shaft assembly 2000. See Figure 27In the illustrated arrangement, articulation cables 2242, 2246 pass through proximal mounting bushing 2750, the proximal end 2214 of elastomeric joint assembly 2210, and a central rib segment 2216 to be fixed to the distal end 2212 of elastomeric joint assembly 2210 or other portion of the surgical instrument. Likewise, articulation cables 2250 and 2254 extend through proximal mounting bushing 2750, the proximal end 2214 of elastomeric joint assembly 2210, and a central rib segment 2218 to be fixed to the distal end 2212 of elastomeric joint assembly 2210 or other portion of the surgical end effector. Cables 2242, 2246, 2250, and 2254 are operably interfaced with an articulation control system supported in the housing of surgical instrument 10. For example, a proximal portion of each cable 2242, 2246, 2250, and 2254 can be wrapped around a corresponding rotary spool or cable management system 2007 Figure 2 ) in the housing portion of surgical instrument 10 that is configured to pay out and retract each cable 2242, 2246, 2250, and 2254 in a desired manner. The spool / cable management system can be motor driven or manually driven (ratchet arrangement, etc.). Figure 29 Articulation of surgical end effector 1000 relative to elongated shaft assembly 2000 through a first articulation plane is illustrated. Figure 30 Articulation of surgical end effector 1000 relative to elongated shaft assembly 2000 through a second articulation plane is illustrated. Figure 31 Articulation of surgical end effector 1000 relative to elongated shaft assembly 2000 through a plurality of articulation planes is illustrated.

[0178] Figures 32-34 An alternative articulation joint 2200' in the form of an elastomeric joint assembly 2210' is illustrated. As Figure 33As shown, each articulation cable passes through a corresponding spring 2215' in the rib 2216' of the elastomer joint assembly 2210'. For example, cable 2242 extends through spring 2244. Cable 2246 extends through spring 2248. Cable 2250 extends through spring 2252 and cable 2254 extends through spring 2256. As described above, the end effector is articulated by pulling and releasing the appropriate cables 2242, 2246, 2250, and 2254. To achieve a higher articulation angle with greater joint stability, each of the springs 2244, 2248, 2252, and 2256 is slidable through the rib of the elastomer joint to push the end effector and pull the cable extending therethrough. When cables 2242, 2246, 2250, and 2254 are tensioned, springs 2244, 2248, 2252, and 2256 also retract into the ribs. Each of springs 2244, 2248, 2252, and 2256 is loosely positioned on a specific cable passing through it. Each cable and its corresponding spring may terminate at or otherwise connect to a corresponding solid rod supported in the elongated shaft assembly 2000 and may be pushed and pulled from its proximal end. When the cable is pulled, the corresponding spring will bear a small load or no load. When the spring is pushed, the cable will bear a small load but will help limit the movement of the end effector. This interaction between the cable and the spring can, for example, facilitate the generation of higher joint movement angles approaching ninety degrees.

[0179] 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 that has a low coefficient of friction and is flexible to enable the upper sleeve 2470 to flex with the outer elastomeric joint assembly 2210. The upper sleeve 2470 protects the upper vertebral member 2420 from contacting the outer elastomeric joint assembly 2210, which is made of an elastomeric material that can have a higher coefficient of friction than the coefficient of friction of the material of the upper sleeve 2470. In other words, the upper sleeve 2470 forms a low-friction, flexible, continuous, uninterrupted, and fully encapsulated path for the upper vertebral member 2420 as it traverses the articulating joint 2200.

[0180] Similarly, a lower sleeve 2570 is used to support the lower vertebral members 2520 as they pass through the articulation joint 2200. A distal end 2572 of the lower sleeve 2570 is supported in the proximal end of the elongated channel, and the proximal end of the lower sleeve 2570 is supported in the distal end of the proximal support shaft 2120. Like the upper sleeve 2470, the lower sleeve 2570 is made of a polymer or plastic material that has a low coefficient of friction and is flexible, to enable the lower sleeve 2570 to flex with the outer elastomeric joint assembly 2210. The lower sleeve 2570 protects the lower vertebral members 2520 from contacting the outer elastomeric joint assembly 2210 as they pass through the articulation joint 2200. In other words, the lower sleeve 2570 forms a low-friction, flexible, continuous, uninterrupted, and fully encapsulated path for the lower vertebral members as they traverse the articulation joint 2200. In various embodiments, the upper sleeve 2470 and the lower sleeve 2570 are configured to freely bend without kinking. To prevent kinking in the sleeves, in at least one arrangement, the sleeves 2470, 2570 are supported within the outer elastomeric joint assembly 2210 so that the sleeves can move axially. For example, as the articulation joint is angled upward, the lower sleeve 2570 can slide distally and have a large bend radius; in the same example, the upper sleeve 2470 can slide proximally and have a tighter bend radius. With the axial movement, the amount of material that is exposed outside the joint assembly 2210 is reduced, which material can otherwise be prone to kinking under a tight bend radius. In at least one arrangement, a distal end 2472 of the upper sleeve 2470 is formed with an upper pocket 2476 that is configured to deliver the upper vertebral members 2420 into the anvil top cover 1260. Similarly, a distal end of the lower sleeve 2570 can be formed with a lower pocket that is configured to deliver the lower vertebral members 2520 into the channel slots 1140 in the elongated channel 1110.

[0181] As described above, the anvil mounting portion 1230 includes a pair of laterally extending mounting pins 1232 that are configured to be received in corresponding mounting brackets or pivot brackets 1120 formed in the proximal end 1112 of the elongated channel 1110. The mounting pins 1232 are pivotally held within the mounting brackets 1120 by an anvil top cover 1260 that is attached to the proximal end 1112 of the elongated channel 1110 in the manner described above. The anvil top cover 1260 includes a proximal end 1262 and a distal end 1264, and has a keyhole-shaped vertebral conduit 1266 extending therethrough to accommodate the passage of the top firing member feature 2320 and the upper vertebral members 2420 therethrough. Figure 36The vertebrae conduit 1266 in the anvil top cover 1260 is shown. When the rotary drive screw 2700 applies a load to the upper vertebra member 2420, the vertebra member 2420 will tend to tilt about the Figure 37 Region A in the above drawing shows where the upper vertebra member 2420 is tilted, so the upper vertebra member teeth 2450 are no longer at a right angle to the rotary drive screw 2700, but can experience higher pressure line contact. Figure 37 Region B in the above drawing shows where the upper vertebra member 2420 stops tilting. To ensure that most of the load remains in the longitudinal direction to perform useful work, the amount that the upper vertebra member teeth 2450 are angled must be the same as the amount that the upper vertebra member 2420 is tilted. Thus, when the upper vertebra member 2420 is tilted, the upper vertebra member teeth 2450 will still maintain surface contact with the helical drive member 2710 on the rotary drive screw 2700, and all load will be directed longitudinally, not vertically. The slightly angled upper vertebra member teeth 2450 can behave like a square thread when the vertebra member 2420 is tilted, and better distribute the load to reduce pressure contact. By directing most of the load in the longitudinal direction, vertical loads are avoided that can cause friction to build up that would counteract the longitudinal load. The upper vertebra member 2420 reacts similarly as it passes through the lock hole shaped anvil slot 1240 downward. Likewise, the lower vertebra member 2520 reacts similarly as it passes through the lock hole shaped axial extension slot 1140 in the elongated channel 1110.

[0182] In the illustrated arrangement, the anvil 1210 is moved to an open position by a pair of anvil springs 1270 that are supported within the proximal end of the elongated channel. See Figure 38 , Figure 42 and Figure 43 . The springs 1270 are positioned to apply a pivotal biasing force to corresponding anvil control arms 1234 that can be integrally formed with and extend downward from the anvil mounting portion 1230. See Figure 38 .

[0183] Figures 39-41 Portions of the anvil 1210, the firing member 1210, and the anvil top cover 1260 are shown when the anvil 1210 is open ( Figure 39 ), when the anvil 2310 is partially closed ( Figure 40 ), and after the firing member has been advanced distally from an original or starting position ( Figure 41 ). As Figure 39As can be seen, when the firing member 2310 is in the home or starting position, the top firing member feature 2320 is fully received within the vertebrae channel 1266 in the anvil top cover 1260. During the firing stroke, the top firing member feature 2320 and the superior vertebrae members 2420 in the superior series 2410 must transition from the vertebrae channel 1266 in the anvil top cover 1260 to the keyhole-shaped anvil slot 1240. Accordingly, it is desirable to minimize any gap "G" between the anvil mounting portion 1230 and the distal end 1264 of the anvil top cover 1260. To minimize this gap G while facilitating unimpeded pivotal travel of the anvil 1210, the distal end 1264 of the anvil top cover 1260 is formed with a curved top cover surface 1265 that matches a curved mating surface 1231 on the anvil mounting portion 1230. Both surfaces 1265, 1231 are curved and concentric about the pivot axis PA or some other reference point. This arrangement allows radial movement of the anvil 1210 and does not interfere with the anvil top cover 1260 while maintaining a minimal gap G therebetween. The gap G between the anvil mounting portion 1230 and the distal end 1264 of the anvil top cover 1260 is significantly shorter than the length of the superior vertebrae members 2420, which facilitates easy transition of each superior vertebrae member 2420 from the vertebrae channel 1266 in the anvil top cover 1260 to the keyhole-shaped anvil slot 1240. Moreover, to further assist the top firing member feature 2320 in transitioning into the keyhole-shaped anvil slot 1240, a ramped surface 1241 is formed adjacent the curved mating surface 1231 on the anvil mounting portion 1230. When the firing member 2310 is initially advanced distally from the home or starting position, the distal end of the top firing member feature 2320 contacts the ramped surface 1241 and begins to impart closure motions to the anvil 1210, as will be discussed in more detail below. 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 to fully close the anvil 1210 and maintain the anvil 1210 in the closed position during the firing sequence. See Figure 41 .

[0184] Generally, the highest firing forces established in an endocutter are associated with cutting and stapling tissue. If those same forces were available to close the anvil, the forces generated during pre-clamping and grasping of the tissue could also be higher. In at least one arrangement, the firing member body 2312 further includes a firing member wing or tab 2355 extending from each lateral side of the firing member body 2312. See Figure 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.

[0185] 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 19) and drive the sled 1312 distally through the staple cartridge body 1302. When the firing member 2310 is in the original or starting position, the surgeon can wish to use the surgical end effector to grasp and manipulate tissue. To do so, the rotary drive system is actuated to apply a second rotary drive motion to the rotary drive screw 2700 in a second rotary direction opposite to the first rotary direction. This rotary motion of the rotary drive screw 2700 in the second rotary direction will drive the firing member 2310 proximally from the starting position and cause the anvil 1210 to quickly pivot to the closed position. Thus, according to at least one embodiment, the "original or starting position" of the firing member 2310 is not its most proximal position.

[0186] If during the firing process, the rotary drive system 2600 stops rotating, the firing member 2310 can become stuck within the surgical end effector. In such circumstances, the top firing member feature 2320 can remain engaged with the anvil 1210 and the bottom firing member feature 2350 can remain engaged with the elongate channel 1110, thereby preventing the surgeon from moving the anvil 1210 to the open position to release tissue clamped between the anvil 1210 and the surgical staple cartridge 1300. This can occur, for example, if the motor or other control arrangement that provides rotary drive motions to the rotary drive shaft 2610 fails or otherwise becomes inoperative. In such circumstances, the firing member 2310 can be retracted to the original or starting position within the surgical end effector 1000 by pulling the top cable 2404 and the lower cable 2504 in the proximal direction. For example, the proximal portions of the top cable 2404 and the lower cable 2505 can be wound onto a rotary spool or cable management system 2009 Figure 2 ) within a housing portion of the surgical instrument 10 that is configured to pay out the top cable 2404 and the lower cable 2504 during the firing stroke and also retract the cables 2404, 2504 in the proximal direction if the firing member 2310 needs to be retracted. The cable management system 2009 can be motor driven or manually driven (ratchet arrangement, etc.) to apply the retraction motions to the cables 2404, 2504. As the cables 2404, 2504 are retracted, the upper vertebra member 2420 and the lower vertebra member 2520 will cause the rotary drive screw 2700 to rotate in reverse.

[0187] Whether the rotary drive screw 2700 will rotate in reverse can be determined using the following equation that depends on the lead (L), the pitch diameter (d p ), the tooth angle (a), and the friction (m):

[0188]

[0189] If the above equation holds, the rotary drive screw 2700 can be self-locking. To a great extent, in many cases, for an endoscopic cutter, the pitch diameter is mostly fixed, but the lead and the angle of the teeth are variable. Because the upper vertebra member teeth 2450 and the lower vertebra member teeth 2550 are mostly square, the rotary drive screw 2700 is more likely to be back drivable (cos(90) = 1). The lead of the upper vertebra member teeth 2450 and the lower vertebra member teeth 2550 can also be advantageous because the rolling friction between the vertebra members 2420, 2520 and the rotary drive screw 2700 is more likely to enable the rotary drive screw 2700 to be back driven. Thus, in an emergency, the surgeon can pull the upper cable 2404 and the lower cable 2504 in the proximal direction to fully retract the firing member 2310 for a quick "panic" withdrawal.

[0190] As discussed above, the housing 2002, which can be hand-held or part of a larger automated surgical system, can support relative control motions of the rotary drive system 2600 and various cable management systems employed in connection with the firing system 2300 and the articulation control system 2240. The firing system 2300, the articulation control system 2240, and the rotary drive system 2600 may, for example, be motor controlled and operated by one or more control circuits.

[0191] One method of using the surgical instrument 10 can involve using the surgical instrument 10 to cut and staple target tissue within a patient using laparoscopic techniques. For example, one or more trocars can have been placed through the abdominal wall of a patient to provide access to target tissue within the patient. The surgical end effector 1000 can be inserted through one trocar and one or more cameras or other surgical instruments can be inserted through the other trocars. In order for the surgical end effector 1000 to be inserted through the trocar cannula, the surgical end effector 1000 is positioned in an unarticulated orientation and the jaws 1100 and 1200 must be closed. In order to maintain the jaws 1100 and 1200 in the closed position for insertion purposes, for example, the rotary drive system 2600 can be actuated to impart a second rotary motion to the rotary drive screw 2700, which causes the firing member 2310 to move proximally from the starting position to move the anvil 1210 (jaw 1200) to the closed position. See Figure 44 . The rotary drive system 2600 is deactivated to maintain the firing member 2310 in that position. Once the surgical end effector has been passed through the trocar into the abdomen, the rotary drive system 2600 can be activated to drive the rotary drive screw 2700 distally to move the firing member 2310 back to the starting position, where the anvil spring 1270 will pivot the anvil 1210 to the open position. See Figure 38 .

[0192] Once inside the abdomen and prior to engaging the target tissue, the surgeon can need to articulate the surgical end effector 1000 into a favorable position. The articulation control system 2240 is then actuated to articulate the surgical end effector in one or more planes relative to the portion of the elongate shaft assembly 2000 that is received within the cannula of the trocar. Once the surgeon has oriented the surgical end effector 1000 in the desired position, the articulation control system 2240 is deactivated to hold the surgical end effector 1000 in the articulated orientation. The surgeon can then use the surgical end effector to grasp the target tissue or adjacent tissue by activating the rotary drive system to rotate the rotary drive screw in the second rotational direction to move the firing member proximally to cause the anvil 1210 to rapidly close to grasp tissue between the anvil 1210 and the surgical staple cartridge 1300. The anvil 1210 can be opened by reversing the rotation of the rotary drive screw 2700. This process can be repeated as desired until the target tissue has been properly positioned between the anvil 1210 and the surgical staple cartridge 1300.

[0193] Once the target tissue has been positioned between the anvil 1210 and the surgical staple cartridge, the surgeon can begin the closure and firing process by activating the rotary drive system 2600 to drive the firing member 2310 distally from the starting position. As the firing member 2310 moves distally from the starting position, the firing member 2310 applies closure motions to the anvil 1210 and moves the anvil 1210 from the open position to the closed position in the manner discussed above. As the firing member 2310 moves distally, the firing member 2310 holds the anvil 1210 in the closed position to clamp the target tissue between the anvil 1210 and the surgical staple cartridge 1300. As the firing member 2310 moves distally, the firing member 2310 contacts the sled 1312 supported in the surgical staple cartridge 1300 and also drives the sled 1312 distally through the cartridge body 1302. The sled 1312 continuously drives the rows of drivers supported in the cartridge as it moves toward the clamped target tissue. Each driver has one or more surgical staples or fasteners supported thereon that are subsequently driven through the target tissue and into contact with the underside of the anvil 1210. As the firing member 2310 moves distally, the tissue-cutting knife 2314 thereon cuts through the stapled tissue.

[0194] Once the firing member 2310 has been driven to the end position within the surgical end effector 1000, the surgeon can release the trigger 2610 to deactivate the rotary drive system 2600. The surgeon can then remove the surgical end effector 1000 from the trocar and replace it with a new surgical end effector 1000. The trocar can then be reinserted into the patient and the new surgical end effector 1000 can be attached to the trocar. The surgeon can then repeat the process of articulating the surgical end effector 1000 into a favorable position, grasping the target tissue between the anvil 1210 and the surgical staple cartridge 1300, and firing the surgical end effector 1000 to staple and / or incise the target tissue. Figures 45-68) After the firing stroke is complete, the rotation drive system 2600 is reversed, which causes the firing member 2310 to retract proximally to the original or starting position. Once the firing member 2310 has returned to the starting position, the anvil spring 1270 will pivot the anvil 1210 to the open position to enable the surgeon to release the stapled tissue from the surgical end effector 1000. Once the stapled tissue has been released, the surgical end effector can be withdrawn from the patient through the trocar cannula. To do so, the surgeon must first actuate the articulation control system 2240 to return the surgical end effector 1000 to the unarticulated position and actuate the rotation drive system to drive the firing member 2310 proximally from the original or starting position to close the jaws. Thereafter, the surgical end effector 1000 can be withdrawn through the trocar cannula. If the firing system becomes inoperative during the firing stroke or during the retraction stroke, the surgeon can retract the firing member 2310 to the starting position by applying a pulling motion to the cables 2404, 2505 in the proximal direction in various manners described herein.

[0195] Figure 49 Another surgical instrument 22010 is shown that is identical or very similar in many respects to the surgical instrument 10 described above except for various differences discussed below. Like the surgical instrument 10, the surgical instrument 22010 can address many of the challenges faced by surgical instruments having articulatable end effectors that are configured to cut and fasten tissue. In various embodiments, the surgical instrument 22010 can comprise a hand-held device. In other embodiments, the surgical instrument 22010 can comprise an automated system, such as sometimes referred to as a robotic control system. In various forms, the surgical instrument 22010 comprises a surgical end effector 23000 operably coupled to an elongated shaft assembly 24000. The elongated shaft assembly 24000 can be operably attached to a housing that is hand-held or otherwise comprises part of a robotic system, as discussed above.

[0196] As Figure 47As can be seen, in one form, the surgical end effector 23000 comprises a first jaw 23100 and a second jaw 23200. In the illustrated arrangement, the first jaw 23100 comprises an elongate channel 23110 that comprises a proximal end 23112 and a distal end 23114 and is configured to operably support a surgical staple cartridge 1300 therein. The elongate channel 23110 has an open bottom to facilitate ease of assembly and has a channel cover 23113 that is configured to attach (welded, etc.) to the elongate channel to cover the opening and increase the rigidity of the elongate channel 23110. In the illustrated arrangement, the second jaw 23200 comprises an anvil 23210 that comprises an elongate anvil body 23212 that comprises a proximal end 23214 and a distal end 23216. In one arrangement, an anvil cover 23213 is provided to facilitate assembly of the device and increase the rigidity of the anvil when the anvil 23210 is attached (welded, etc.) to the anvil body 23212. The anvil body 23212 includes a staple-forming, lower surface 23218 facing the first jaw 23100 and can include a series of staple-forming pockets (not shown) corresponding to each of the staples or fasteners in the surgical staple cartridge 1300. The proximal end 23214 of the anvil body 23212 includes an anvil mounting portion 23230 that includes a pair of laterally extending mounting pins 23232 that are configured to be received in corresponding mounting brackets or pivot brackets 23120 formed in the proximal end 23112 of the elongate channel 23110. The mounting pins 23232 are pivotally retained within the mounting brackets 23120 by an anvil top cap 23260 that can be attached to the proximal end 23112 of the elongate channel 23110 by a screw 23261. In other arrangements, the anvil top cap 23260 can be attached to the elongate channel 23110 by welding, adhesive, etc. Such arrangements facilitate pivotal travel of the anvil 23210 about a pivot axis PA between an open position Figure 48 ) and a closed position Figure 49 ) relative to the surgical staple cartridge 1300 mounted in the elongate channel 23110. Such a pivot axis PA can be referred to herein as being "fixed" in that the pivot axis does not translate or otherwise move when the anvil 23210 is pivoted from the open position to the closed position.

[0197] In the illustrated arrangement, the anvil 23210 is moved to the open position by a pair of anvil springs 23270 that are supported within the proximal end 23112 of the elongate channel 23110. See Figure 62 and Figure 47 . The springs 23270 are positioned to apply a pivotal biasing force to corresponding portions of the anvil 23210 to apply an opening force thereto. See Figure 49 .

[0198] In the illustrated arrangement, the elongate shaft assembly 24000 defines a shaft axis SA and includes a proximal shaft portion 24100 that is operably interfaced with a housing of a control portion (e.g., hand-held unit, robotic tool driver, etc.) of the surgical instrument 22010. The elongate shaft assembly 24000 further includes an articulation joint 24200 that is attached to the proximal shaft portion 24100 and the surgical end effector 23000. In various circumstances, the proximal shaft portion 24100 includes a hollow outer tube 24110 that is operably coupled to the housing in various manners as discussed above. As Figures 50-54 As can be seen in FIG. 22, the proximal shaft portion 24100 can further include a rigid proximal support shaft 24120 that is supported within the hollow outer tube 24110 and that extends from the housing to the articulation joint 24200. The rigid proximal support shaft 24120 can include first and second halves 24120A, 24120B that can be coupled together by, for example, welding, adhesive, etc. The rigid proximal support shaft 24120 includes a proximal end 24122 and a distal end 24124 and includes an axial conduit 24126 that extends therethrough from the proximal end 24122 to the distal end 24124.

[0199] As discussed above, many surgical end effectors employ a firing member that is pushed distally through a surgical staple cartridge by an axially movable firing beam. The firing beam is typically attached to the firing member in a central region of the firing member body. This attachment location can cause the firing member to be unbalanced as it is advanced through the end effector. This imbalance can cause undesirable friction between the firing member and the end effector jaw. The creation of this additional friction can require a higher firing force to be applied to overcome this friction and can cause undesirable wear to portions of the jaw and / or firing member. The application of a higher firing force to the firing beam can cause undesirable flexing of the firing beam as it traverses the articulation joint. This additional flexing can cause the articulation joint to disarticulate, particularly when the surgical end effector is articulated at relatively high articulation angles. The surgical instrument 22010 employs a firing system 24300 that is the same or very similar in many respects to the firing system 2300 discussed above. Accordingly, only those aspects of the firing system 24300 that are needed to understand the operation of the surgical instrument 22010 will be discussed below.

[0200] As Figure 50As can be seen in at least one embodiment, the firing system 24300 comprises a firing member 24310 that comprises a vertically extending firing member body 24312 that comprises a top firing member feature 24320 and a bottom firing member feature 24350. A tissue cutting blade 24314 is attached to or formed in the vertically extending firing member body 24312. See Figure 51 and Figure 53 In at least one arrangement, it is desirable for the firing member 24310 to pass through the anvil body 23212 with low friction, high strength, and high stiffness. In the illustrated arrangement, the top firing member feature 24320 comprises a T-shaped body 24322 having two laterally extending tabs 24323 protruding therefrom and a top axial conduit 24324 extending therethrough. See Figure 50 The bottom firing member feature 24350 comprises a T-shaped body 24352 having two laterally extending tabs 24353 protruding therefrom and a bottom axial conduit 24354 extending therethrough. See Figure 54 In at least one arrangement, the top firing member feature 24320 and the bottom firing member feature 24350 are integrally formed with the vertically extending firing member body 24312. As Figure 52 As can be seen, the anvil body 23212 comprises an axially extending anvil slot 23240 that defines two opposing flanges 23241 for slidably receiving the laterally extending tabs 24323 thereon. Similarly, the elongate channel 23110 comprises an axially extending channel slot 23140 that defines an axially extending channel flange 23141 that is configured to slidably receive the laterally extending tabs 24353 thereon.

[0201] In the illustrated arrangement, the firing system 24300 comprises an upper flexible spine assembly 24400 operably coupled to the top firing member feature 24320 of the firing member 24310. In at least one embodiment, the upper flexible spine assembly 24400 comprises an upper series 24410 of upper vertebral members 24420 that are loosely coupled together by an upper flexible coupler member 24440 that extends through each of the upper vertebral members 24420 and is attached to the top firing member feature 24320.

[0202] As Figure 52As can be seen, each upper vertebral member 24420 is substantially T-shaped when viewed from one end of each upper vertebral member. In one aspect, each upper vertebral member 24420 includes an upper vertebral body portion 24422 having a proximal end 24424 and a distal end 24428. Each upper vertebral member 24420 also includes a downwardly extending upper drive feature or upper vertebral member tooth 24450 protruding from the upper vertebral body portion 24422. Each upper vertebral member tooth 24450 has a helical proximal upper face portion 24452 and a helical distal upper face portion 24454. Each proximal end 24424 of the upper vertebral body portion 24422 has an arcuate or slightly concave curvature shape, and each distal end 24428 has an arcuate or slightly convex curvature shape. When arranged in the upper series 24410, the convex distal end 24428 on one upper vertebral member 24420 contacts and mates with the concave proximal end 24424 on an adjacent upper vertebral member 24420 in the upper series 24410 to hold the upper vertebral members 24420 generally aligned so that the helical proximal upper face portion 24452 and the helical distal upper face portion 24454 on each respective upper vertebral member tooth 24450 can be drivingly engaged by the rotary drive screw 2700 in the various methods disclosed herein. These curved mating surfaces on the upper vertebral members 24420 allow the upper vertebral members 24420 to better transfer loads between them even when they are tilted.

[0203] In at least one embodiment, upper alignment members 24480 are employed to help align the upper vertebral members 24420 in the upper series 24410. In one arrangement, the alignment members 24480 comprise spring members or metal cables that can be made from Nitinol wire, spring steel, etc., and are formed with a distal upper looped end 24482 and two upper strut portions 24484 that extend through corresponding upper conduits 24425 in each of the upper vertebral body portions 24422. An upper flexible coupler member 24440 extends through the upper conduit 24429 in each of the upper vertebral members 24420 to attach to the firing member 24310. Specifically, a distal end portion 24442 extends through a top axial conduit 24324 in the top firing member feature 24320 and is secured therein by an upper retention lug 24444. A proximal portion of the upper flexible coupler member 24440 can interface with various types and designs of corresponding rotational spool or cable management systems disclosed herein for paying out and taking up the upper flexible coupler member 24440 during operation and articulation of the surgical end effector 23000 to maintain a desired amount of tension therein. The cable management system can be motor driven or manually driven (ratchet arrangement, etc.) to maintain a desired amount of tension in the upper flexible coupler member 24440. The amount of tension in each flexible coupler member can vary depending on the relative positioning of the surgical end effector 23000 with the elongate shaft assembly 24000.

[0204] The firing system 24300 further includes a lower flexible spine assembly 24500 operably coupled to the bottom firing member feature 24350. The lower flexible spine assembly 24500 includes a lower series 24510 of lower vertebral members 24520 that are loosely coupled together by a lower flexible coupler member 24540 that extends through each of the lower vertebral members 24520 and is attached to the bottom firing member feature 24350. As Figure 51As can be seen, each superior vertebral member 24520 is substantially T-shaped when viewed from one end of each inferior vertebral member. In one aspect, each inferior vertebral member 24520 includes an inferior vertebral body portion 24522 having a proximal end 24524 and a distal end 24528. Each inferior vertebral member 24520 also includes an inferior driving feature or inferior vertebral member tooth 24550 extending upwardly from the inferior vertebral body portion 24522. Each inferior vertebral member tooth 24550 has a helical proximal inferior face portion 24552 and a helical distal inferior face portion 24554. The proximal end 24524 of each inferior vertebral body portion 24522 has an arcuate or slightly concave curvature, and the distal end 24528 has an arcuate or slightly convex curvature. When arranged in the inferior series 24510, the convex distal end 24528 on one inferior vertebral member 24520 contacts and mates with the concave proximal end 24524 on an adjacent inferior vertebral member 24520 in the inferior series 24510 to hold the inferior vertebral members 24520 generally aligned so that the helical proximal inferior face portion 24552 and the helical distal inferior face portion 24554 on each respective inferior vertebral member tooth 24550 can be drivingly engaged by the rotary drive screw 2700 in the various methods disclosed herein. These curved mating surfaces on the inferior vertebral members 24520 allow the inferior vertebral members 24520 to better transfer loads between them even when they are tilted.

[0205] In at least one embodiment, lower alignment member 24580 is employed to help align the lower vertebral members 24520 in the lower series 24510. In one arrangement, lower alignment member 24580 comprises a spring member or metal cable that can be made from Nitinol wire, spring steel, or the like, and is formed with a distal lower looped end 24582 and two lower strut portions 24584 that extend through corresponding lower tunnels 24525 in each of the lower vertebral body portions 24522. A lower flexible coupler member 24540 extends through a bottom axial tunnel 24529 in each of the lower vertebral members 24520 to attach to the firing member 24310. Specifically, a distal end portion 24542 of the lower flexible coupler member 24540 extends through a bottom axial tunnel 24354 in the bottom firing member feature 24350 and is secured therein by a lower retention lug 24544. A proximal portion of the lower flexible coupler member 24540 can interface with various types and designs of corresponding rotational spool or cable management systems disclosed herein for paying out and taking up the lower flexible coupler member 24540 during operation and articulation of the surgical end effector 23000 to maintain a desired amount of tension therein. The cable management system can be motor driven or manually driven (ratchet arrangement, etc.) to maintain a desired amount of tension in the lower flexible coupler member 24540. The amount of tension in each flexible coupler member can vary depending on the relative positioning of the surgical end effector 23000 with the elongate shaft assembly 24000.

[0206] According to at least one aspect, the large surface area facilitates distributing the force between the vertebral members as they are pushed, so that the vertebral members cannot twist relative to one another. The available area in the anvil and channel is limited, and the anvil and channel must remain rigid. The T-shaped upper vertebral members 24420 and the T-shaped lower vertebral members 24520 are designed to fit in the limited space available in the anvil 23210 and the elongated channel 23110, while ensuring that there is a large amount of area to distribute the firing load. The curved surfaces on each upper vertebral member 24420 and each lower vertebral member 24520 allow each of those vertebrae to better transfer the load between them, even when they are tilted. The upper alignment members 24480 and the lower alignment members 24580 can also be used to prevent the upper vertebral members 24420 and the lower vertebral members 24520 from twisting relative to one another. The large surface area can also help prevent galling of the vertebral members and / or the anvil and channel. The upper flexible spine assembly 24400 and the lower flexible spine assembly 24500 are otherwise operably interfaced with the rotary drive screw 2700 arrangement as disclosed herein. The upper flexible coupler members 24440 and the lower flexible coupler members 24540 can also be used to retract the firing member 24310 to its starting position in the manner discussed above, should the firing drive system 24300 fail during the firing stroke.

[0207] As Figure 55 As can be seen in FIG. 27, the top firing member feature 24320 on the firing member 24310 includes a distal upper firing member tooth segment 24330 that corresponds to half of the upper vertebral member teeth 24450 on each upper vertebral member 24420. In addition, two proximal upper firing member teeth 24336, identical to the upper vertebral member teeth 24450 on each upper vertebral member 24420, are spaced apart from the distal upper firing member tooth segment 24330. The distal upper firing member tooth segment 24330 and the proximal upper firing member teeth 24336 can each be integrally formed with the top firing member feature 24320 of the firing member 24310. Likewise, the bottom firing member feature 24350 of the firing member 24310 includes a distal lower firing member tooth 24360 and two proximal lower firing member teeth 24366 integrally formed on the bottom firing member feature 24350. In at least one arrangement, for example, the firing member 24310 with rigidly attached teeth 24330, 24336, 24360, and 24366 can be manufactured as one integral piece at a time using conventional metal injection molding techniques. Those of ordinary skill in the art will recognize that the firing member 24310 operates in substantially the same manner as the firing member 2310 as described in detail herein.

[0208] Turning now to Figures 55-57To 58, according to at least one aspect, the articulation joint 24200 includes a movable exoskeleton assembly 24800. In one form, the movable exoskeleton assembly 24800 includes a series 24802 of ring-shaped rib members 24810 movably interfaced. As ​ As seen in FIG. 49 , each ring-shaped rib member 24810 includes a first or proximal face portion 24820 that includes a convex or domed portion 24822. Each ring-shaped rib member 24810 also includes a second or distal face portion 24830 that is concave or disc-shaped. Each ring-shaped rib member 24810 also includes an upper spine channel 24840 configured to accommodate the upper flexible spine assembly 24400 therethrough and a lower spine channel 24842 configured to accommodate the lower flexible spine assembly 24500 therethrough. In addition, each ring-shaped rib member 24810 also includes four articulation channels 24850, 24852, 24854, and 24856 to accommodate articulation actuators in the form of articulation cables 24242, 24246, 24250, and 24254 therethrough. See FIG. 49 . Each ring-shaped rib member 24810 also includes a central drive channel 24860 configured to accommodate a constant velocity (CV) drive shaft assembly 2620 therethrough.

[0209] As FIG. 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 facet 24872, which is concave or disc-shaped to receive or movably engage with a convex or dome-shaped portion 24822 of the proximal facet 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 portion 24892, which includes a convex or domed portion 24894 configured to be received in or movably engaged with the concave or disc-shaped distal side portion 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.

[0210] 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 FIG. 49In the illustrated arrangement, articulation cables 24242, 24246 pass through proximal attachment rib 24870 and through each of annular rib members 24810P, 24810 and 24810D to be secured to distal attachment rib 24890. In one arrangement, for example, each of articulation cables 24242, 24246 is secured to distal attachment rib 24890 by a corresponding attachment lug 24243. See FIG. 61 and FIG. 63 Likewise, articulation cables 24250 and 24254 extend through proximal attachment rib 24870 and through each of annular rib members 24810P, 24810 and 24810D to be secured to distal attachment rib 24890 by a corresponding attachment lug 24243.

[0211] In one arrangement, each of articulation cables 24242, 24246, 24250 and 24254 extends through a corresponding coil spring 24896 which is supported in a cavity 24125 in the distal end 24124 of rigid proximal support shaft 24120. In addition, each coil spring 24896 is associated with a tensioning lug 24897 which is also journaled to and secured on each respective articulation cable 24242, 24246, 24250 and 24524 to achieve a desired amount of compression in each spring 24896 which serves to maintain annular rib members 24810P, 24810 and 24810D in movable engagement with one another and with proximal attachment rib 24870 and distal attachment rib 24890. Cables 24242, 24246, 24250 and 24254 are operably interfaced with an articulation control system supported in the housing of surgical instrument 22010. For example, as discussed above, a proximal portion of each cable 24242, 24246, 24250 and 24254 can be wound on a corresponding rotational spool or cable management system 2007( FIG. 2 ) in the housing portion of surgical instrument 22010 which is configured to pay out and retract each cable 24242, 24246, 24250 and 24254 in a desired manner. The spool / cable management system can be motor driven or manually driven (ratchet arrangement, etc.). FIG. 59 articulation joint 24200 is shown in a non-articulated position, and FIG. 60 articulation joint is shown in an articulated configuration. This arrangement permits surgical end effector 23000 to articulate through a plurality of articulation planes relative to elongated shaft assembly 24000.

[0212] AsFIG. 49 , FIG. 58 and FIG. 64 As can be seen, the surgical instrument 22010 employs a constant velocity (CV) drive shaft assembly 2620, which spans or extends axially through the articular motion joint 24200. The operation and configuration of the CV drive shaft assembly 2620 have been described in detail above and will not be repeated here except where necessary for understanding the operation of the surgical instrument 22010. In short, as discussed above, the CV drive shaft assembly 2620 includes a proximal CV drive assembly 2630 and a distal CV drive shaft 2670. The proximal CV drive assembly 2630 includes a proximal shaft segment 2632 formed by an attachment shaft 2634 configured to be non-rotatably received within a similarly shaped connector cavity 2616 in the distal end 2614 of the proximal rotary drive shaft 2610. The proximal shaft segment 2632 is operatively engaged with a series 2640 of movably coupled drive joints 2650. FIG. 58 As can be seen from the preceding description, to ensure that the drive joints 2650 engage with each other, a proximal drive spring 2740 is used to apply an axial biasing force to the series 2640 of the drive joints 2650. For example, as FIG. 58 As can be seen, the proximal drive spring 2740 is positioned between the proximal mounting bushing 2734 and the support flange formed between the distal insertion portion 2636 and the proximal cylinder portion 2638 of the proximal shaft section 2632. In one arrangement, the proximal drive spring 2740 may include an elastomeric O-ring received on the proximal cylinder portion 2638 of the proximal shaft section 2632. The proximal drive spring 2740 slightly biases the drive joints 2650 together to reduce any play that occurs during joint movement. This ensures that the drive joints 2650 torsionally transmit the load. However, it should be understood that in at least one arrangement, the proximal drive spring 2740 does not apply a sufficiently high axial load such that the firing load translates through the joint movement joint 2200.

[0213] To further prevent the drive joint 2650 from buckling during joint movement, a series 2640 of the movably coupled drive joints 2650 extend through at least one low-friction drive cover 24730, which extends through a central drive conduit 24860 in each of the annular rib members 24810. FIG. 63 and FIG. 65In the depicted arrangement, the drive cover 24730 includes an outer cut hypotube and an inner cut hypotube 24732. Such a hypotube 24732 can be made of metal (e.g., stainless steel or the like) and have a plurality of series of cuts or slits made therein using a laser cutter arrangement. In the illustrated arrangement, the hypotube 24732 can be made to have an upper release conduit 24734 that provides a gap for the upper flexible spine assembly 24400 to pass thereover when the surgical end effector 23000 is in one or more articulated positions during a procedure. In addition, the hypotube 24732 can have a lower release conduit 24736 to provide a similar gap for the lower flexible spine assembly 24500. As FIG. 65 As can also be seen, the hypotube 24732 can be shaped to have diametrically opposed lateral tab portions 24738 to provide lateral stability during articulation. FIG. 66 An alternative drive cover 24730' is shown that includes an inner cut hypotube 24732'. FIG. 58 FIG. 67 FIG. 68 FIG. 69 An alternative drive cover 24730" is shown that includes a flexible heat shrink tubing 24732" applied over a constant velocity (CV) drive shaft assembly 2620. In other arrangements, the drive cover can also include a coil spring or helical member.

[0214] Various embodiments of the present disclosure provide advantages over prior surgical endoscopic cutter configurations that are capable of articulation. For example, pushing a firing member forward in an articulating end effector typically requires a significant amount of force and that force must be balanced. For example, when firing a firing member at an angle greater than sixty degrees, it becomes very difficult to push the beam through the articulation joint. The joint also experiences significant loading, which can cause the articulation joint to come out of articulation. By employing an upper flexible drive arrangement and a lower flexible drive arrangement (each of which is flexible as it passes through the articulation joint, but then becomes rigid as they are located distal to the articulation joint), a large degree of articulation (e.g., articulation angles in excess of seventy degrees) can be allowed while balancing loads applied to the firing member that are constrained to the firing member and not to the articulation joint. In other words, torsional loads rather than longitudinal loads, which can cause the end effector to come out of articulation, are applied proximal to the articulation joint. The torsional loads are converted to longitudinal loads at locations distal to the articulation joint. Thus, the rotary drive screw is used to effectively convert torsional motion or loads to longitudinal loads that are applied to the firing member at locations distal to the articulation joint.

[0215] ​​​Furthermore, by longitudinally decomposing the threaded drive arrangements, the threaded drive arrangements pass through the articulation joint while also effectively reducing the length of the surgical end effector. For example, each individual vertebra tooth is significantly shorter than the plurality of rigidly connected thread pitches. The vertebrae can angle as they pass through the articulation joint. This flexible interconnection enables the rotary drive screw to be closely positioned to the articulation joint, whereas the rotary drive screw is significantly spaced apart from the articulation joint if all of the thread pitches are rigidly connected.

[0216] FIG. 70 to FIG. 73 Another surgical end effector 4000 that can be used with a surgical instrument 3010 that can be similar in many respects to surgical instrument 10 is shown. The surgical end effector 4000 can be similar to surgical end effector 1000 except for the differences discussed below. The surgical end effector 4000 is operably coupled to an elongated shaft assembly 5000. The elongated shaft assembly 5000 can be operably attached to a housing portion of the surgical instrument 3010. The housing can comprise a handle configured to be grasped, manipulated, and actuated by a clinician. In other embodiments, the housing can comprise a robotic system that houses or otherwise operably supports at least a portion of at least one drive system configured to generate and apply at least one control motion that can be used to actuate the surgical end effectors disclosed herein and their respective equivalents.

[0217] In at least one form, the surgical end effector 4000 comprises a first jaw 4100 and a second jaw 4200. In the illustrated arrangement, the first jaw 4100 comprises an elongated channel 4110 that includes a proximal end 4112 and a distal end 4114 and is configured to operably support a surgical staple cartridge 1300 therein. In the illustrated arrangement, the second jaw 4200 comprises an anvil 4210 that can be similar to the anvil 1210 described above. In the illustrated arrangement, the elongated shaft assembly 5000 defines a shaft axis SA and comprises a proximal shaft portion that operably interfaces with a housing of a control portion (e.g., hand unit, robotic tool driver, etc.) of the surgical instrument 3010. The elongated shaft assembly 5000 further comprises an articulation joint 5200 that is attached to the proximal shaft portion and the surgical end effector 4000.

[0218] The elongated shaft assembly 5000 can comprise a distal spine assembly 5010 that is attached to the proximal end 4112 of the elongated channel 4110 and the articulation joint 5200. See FIGS. 48 and 49. The distal spine assembly 5010 can comprise a proximal spine portion 5012 that is attached to the proximal end 4112 of the elongated channel 4110. The proximal spine portion 5012 can be configured to operably interface with the articulation joint 5200. In the illustrated arrangement, the proximal spine portion 5012 comprises a first proximal spine portion 5014 and a second proximal spine portion 5016 that are configured to operably interface with the articulation joint 5200. In the illustrated arrangement, the first proximal spine portion 5014 comprises a first proximal spine portion 5014 that is configured to operably interface with a first articulation joint portion 5202 of the articulation joint 5200. In the illustrated arrangement, the second proximal spine portion 5016 comprises a second proximal spine portion 5016 that is configured to operably interface with a second articulation joint portion 5204 of the articulation joint 5200. FIG. 70The distal spine assembly 5010 is non-movably supported in a distal outer tube segment 5020 which operably interfaces with the surgical end effector 4000. The elongate shaft assembly 5000 further comprises a proximal spine member (not shown) which operably interfaces with a proximal end of the articulation joint 5200 and which is attachable to or otherwise operably interfaces with a housing of the surgical instrument 3010. A proximal outer tube segment 5030 extends from the articulation joint 5200 back to the housing to operably interface therewith.

[0219] The surgical instrument 3010 employs a firing drive system 4300 which includes a firing member 4310 which comprises a vertically extending firing member body 4312 which includes a top firing member feature and a bottom firing member feature. A tissue cutting blade 4314 is attached to or formed in the vertically extending firing member body 4312. The firing drive system 4300 includes a rotary drive nut 4400 which is configured to rotatably drive a series 4600 of drive components 4610 which operably interface with the firing member 4310. The rotary drive nut 4400 includes a flexible proximal segment 4410 which spans the articulation joint 5200 and a threaded distal segment 4420 distal of the articulation joint 5200. The threaded distal segment 4420 includes a series of variable pitch threads 4430 with a coarse pitch 4432 at the proximal end and a narrower pitch 4434 at the distal or exit end. See FIGS. 19 and 20. FIG. 72 The threaded rotary drive nut 4400 includes a proximal drive gear 4440 which meshingly interfaces with a distal drive gear 4510 attached to a rotary drive shaft 4500. See FIGS. 19 and 20. FIG. 70 The rotary drive shaft 4500 can interface with a gear box / motor arrangement supported in the housing of the surgical instrument 3010. Rotation of the rotary drive shaft 4500 causes the drive nut 4400 to rotate about the shaft axis SA.

[0220] The rotary drive nut 4400 includes a proximal section 4410 and a distal section 4420. The threaded distal section 4420 is distal to the articulation joint 5200 and is configured to threadably engage a series 4600 of drive components 4610 that are slackly connected together by flexible tethers 4640. In at least one arrangement, for example, each drive component 4610 includes a vertically extending plate member 4612 that includes a top end 4614 and a bottom end 4618. The top end 4614 includes a top threaded section 4616 and the bottom end 4418 includes a bottom threaded section 4620. The top threaded section 4616 and the bottom threaded section 4620 are configured to threadably engage the threads 4430 of the rotary drive nut 4400. The series 4600 of drive components 4610 are configured to flexibly pass through the articulation joint 5200 and into a vertical conduit 5012 in the distal spine assembly 5010. Rotation of the rotary drive nut 4400 in a first rotational direction causes the series 4600 of drive components 4610 to move axially in a distal direction and rotation of the rotary drive nut 4400 in a second rotational direction will cause the series 4600 of drive components 4610 to move axially in a proximal direction.

[0221] Turning to FIG. 72 In at least one arrangement, each drive component 4610 further includes a distally projecting latch feature 4630. Each latch feature 4360 is configured to be releasably received in a latching engagement within a latch cavity 4364 formed in an adjacent drive component 4610 immediately distal to the latch feature. When the drive components 4610 are latched together, they form an axially rigid series 4600AR of drive components for applying axial drive motions to the firing member 5310 to drive the firing member 5310 through the surgical end effector 4000 from a starting position to an ending position and back to the starting position. As can be seen in FIG. 72 As the drive components 4610 enter the threaded distal section 4420 of the rotary drive nut 4400, they are slackly connected together. When the drive components 4610 threadably engage the fine pitch threads 4430 in the threaded distal section 4420 of the rotary drive nut 4400, the latch features 4630 are latchingly received within the corresponding latch cavities 4364 in the distally adjacent drive components 4610 to form an axially rigid series 4600AR of drive components 4610. In one arrangement, the distal most drive component 4610 can be configured to latchingly engage the firing member 4310 in a similar manner or, in an alternative arrangement, the distal most drive component can be removably attached to the firing member 4310.

[0222] In the illustrated example, the drive components 4610 in the series 4600 of drive components are flexibly connected together such that they can move relative to one another to accommodate the articulation joint and do not require the reinforcing support plates that are typically needed when pushing a firing beam through an articulation joint. When the series of drive components 4610 enter and are drivingly engaged by the threaded distal section 4420 distal to the articulation 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 into an open position by a spring or other arrangement in various manners disclosed herein and then closed by the firing member 4310 as the firing member 4310 is driven distally from a starting position to an ending position in various manners discussed herein. Other jaw control arrangements can also be employed to control the opening and closing of the jaws.

[0223] FIG. 73 to FIG. 76 Another surgical end effector 6000 employing a drive system 6300 including a series 6600 of flexibly connected drive components 6610 that can be used to traverse an articulation joint 6200 and rigidly advance a firing member 6130 through the surgical end effector 6000 is illustrated. The surgical end effector 6000 can include a channel 6010 that is configured to operably support a surgical staple cartridge (not shown) therein. An anvil 6020 can be pivotally coupled to the channel 6010 and movable between open and closed positions by the firing member 6130 or other closure system arrangement. The anvil 6020 can be moved to the open position by a spring or other arrangement in various manners disclosed herein.

[0224] Turning to FIG. 74 In at least one arrangement, each drive component 6610 includes a drive component body 6612 having a proximal face 6614, a distal face 6616, and a threaded section 6620 formed on a bottom surface 6618. Each drive component 6610 also includes a latch feature 6630 that projects proximally. Each latch feature 6630 includes a neck feature 6632 having a spherical latch head 6634 formed on an end thereof. The latch feature 6630 is configured to be movably received within a latch cavity 6636 formed in an adjacent drive component 6610 immediately distal thereto. To facilitate the movable attachment of the drive components 6610 in the movable continuous arrangement, the spherical latch head 6634 is inserted through a tapered conduit 6338 in the drive component body 6612 and into the latch cavity 6636. The spherical latch head 6634 is sized and shaped relative to the latch cavity 6636 to be movably retained therein as the series 6600 of drive components 6610 is advanced distally through the surgical end effector 6000. The spherical latch head 6634 is configured to be removed from the latch cavity 6636 when the series 6600 of drive components 6610 is advanced distally through the surgical end effector 6000 and the drive component 6610 is drivingly engaged by the threaded distal section 6420 of the threaded shaft 6420. FIG. 74The illustrated arrangement permits relative movement between the drive members 6610. However, when the drive members are axially aligned such that the distal face portion 6616 of one drive member 6610 is in abutting engagement with the proximal face portion 6614 of the drive member immediately distal thereto, the drive members 6610 form an axially rigid series 6600AR of drive members that can drive the firing member 6130 through the surgical end effector 6000.

[0225] As FIG. 73 As can be seen in FIG. 22, a flexible rotary drive system 6700 is employed to drive the series 6600 of drive members 6610. In one arrangement, the flexible rotary drive system 6700 includes a flexible rotary drive shaft 6710 that can pass through the articulation joint 6210 and includes a rotary drive gear 6720 that is configured to threadably engage the threaded segment 6620 on each drive member 6610. The flexible rotary drive shaft 6710 can be rotated by a motor / gear arrangement supported in the housing of the surgical instrument. The portion 6600F of the series 6600 of drive members 6610 proximal of the rotary drive gear 6720 remains flexibly connected or "loose". As the drive members 6610 are threadably engaged by the rotary drive gear 6720, these drive members are driven through the tubing in the channel 6010 which causes the drive members to form an axially rigid series 6600AR for driving the firing member 6130 through the surgical end effector 6000.

[0226] Torsional loads applied to the firing system components as they traverse the articulation joint are less likely to un-articulate the articulation joint than axial loads. The various embodiments disclosed herein transfer the torsional loads to longitudinal loads in locations distal of the articulation joint. Because the longitudinal loads are contained in the end effector, un- articulation is prevented. FIG. 77One firing system 6800 example that can provide such advantages is shown. Firing system 6800 includes a firing member 6810 that is configured to be operably supported in a surgical end effector in various manners described herein. A flexible spring-like follower member 6820 is attached to firing member 6810. This flexible spring-like follower member 6820 can span an articulation joint region 6840 that can achieve a relatively large range of articulation. The flexible spring-like follower member 6820 is configured to be axially driven by a rotatably supported flexible spring-like torsional drive member 6830 to span the articulation joint region 6840. The flexible spring-like torsional drive member 6830 includes a threaded insert 6832 that is configured to threadably engage the spring-like follower member 6820 at a location 6841 distal of the articulation joint region 6840. The flexible spring-like torsional drive member 6830 can be rotated by a motor / gear arrangement supported in a housing of the surgical instrument. When the flexible spring-like torsional drive member 6830 is rotated in a first direction, the flexible spring-like follower member 6820 translates longitudinally to drive the firing member 6810. Rotation of the flexible torsional drive member 6830 in a second direction will cause the flexible spring-like follower member to move proximally.

[0227] FIG. 78 Another firing system 6850 is shown that includes a firing member 6860 that is configured to be operably supported in a surgical end effector in various manners described herein. The firing member 6860 is driven by a firing member drive assembly 6861 that includes a series 6862 of spherical ball members 6870 that are coupled together by a flexible cable 6872. Such a series 6862 of flexible spherical ball members 6870 can span an articulation joint region 6840 that can achieve a relatively large range of articulation. The series 6862 of flexible spherical ball members 6870 is configured to be axially driven by a rotatably supported flexible torsional drive member 6880 to span the articulation joint region 6890. The flexible torsional drive member 6880 includes an insert 6882 that is configured to drivingly engage the spherical ball members 6870 at a location 6892 distal of the articulation joint region 6890. The flexible torsional drive member 6880 can be rotated by a motor / gear arrangement supported in a housing of the surgical instrument. When the flexible torsional drive member 6880 is rotated in a first direction, the spherical ball members 6870 are driven distally into contact with one another forming an axially rigid series 6862AR that translates longitudinally to drive the firing member 6860 distally. Rotation of the flexible torsional drive member 6880 in a second direction will cause the series of spherical ball members 6870 to move proximally.

[0228] FIG. 79 Another firing system 6950 is shown that includes a firing member 6960 that is configured to be operably supported in a surgical end effector in various manners described herein. A laser cut hypotube slave member 6970 is attached to the firing member 6960. This flexible slave member 6970 can span an articulation joint region 6940 that can achieve a relatively large range of articulation. The flexible slave member 6970 is configured to be axially driven by a flexible torsion drive member 6980 that is rotatably supported to span the articulation joint region 6940. The flexible torsion drive member 6980 includes a threaded insert 6982 that is configured to threadably engage a laser cut 6972 on the flexible slave member 6970 at a location 6942 distal of the articulation joint region 6940. The flexible torsion drive member 6980 can be rotated by a motor / gear arrangement supported in a housing of the surgical instrument. When the flexible torsion drive member 6980 is rotated in a first direction, the flexible slave member 6970 is translated longitudinally to drive the firing member 6960. Rotation of the flexible torsion drive member 6980 in a second direction will cause the flexible slave member 6970 to move proximally.

[0229] It is often difficult to push a firing beam forward in an articulating end effector and such force must be balanced. For example, it is often difficult to push a firing beam through an articulation joint that has been articulated to an angle greater than sixty degrees. When the firing beam traverses the articulation joint, the firing beam can place significant loads on the articulation joint components which can cause the articulation joint to disarticulate. FIG. 80 to FIG. 84 A firing drive system 7300 is shown that includes a flexible upper drive band 7320 and a flexible lower drive band 7330 that are attached to a firing member 7310 that is configured to move within a surgical end effector 7000 between a starting position and an ending position. As FIG. 80 to FIG. 82 As can be seen in FIG. 63, the flexible upper drive band 7320 includes a plurality of spaced apart upper drive teeth 7322 that are configured to threadably engage helical threads 7342 on a rotary drive nut 7340. Similarly, the flexible lower drive band 7330 includes a plurality of spaced apart lower drive teeth 7332 that are configured to threadably engage the helical threads 7342 on the rotary drive nut 7340. In at least one arrangement, the flexible upper drive band 7320 and the flexible lower drive band 7330 are formed from a metallic material and are welded or otherwise attached to the firing member 7310. Such an arrangement serves to balance the firing loads applied to the firing member 7310.

[0230] A rotary drive nut 7340 is received on a flexible rotary drive shaft 7350 that is centrally disposed between the flexible upper drive belt 7320 and the flexible lower drive belt 7330 and traverses the articulation joint area designated generally as 7200. The flexible rotary drive shaft 7350 can be rotated by a motor / gear arrangement supported in the housing of the surgical instrument. When the flexible rotary drive shaft 7350 is rotated in a first direction, the flexible upper drive belt 7320 and the flexible lower drive belt 7330 will drive the firing member 7310 distally. Rotation of the flexible rotary drive shaft 7350 in a second direction will cause the flexible upper drive belt 7320 and the flexible lower drive belt 7330 to pull the firing member 7310 proximally. In at least one arrangement, the flexible upper drive belt 7320 and the flexible lower drive belt 7330 pass through a guide member 7360 that surrounds the rotary drive nut 7340 to prevent the flexible upper drive belt 7320 and the flexible lower drive belt 7330 from bypassing the rotary drive nut 7340 during actuation of the flexible rotary drive shaft 7350. See FIG. 84 .

[0231] In the illustrated arrangement, the firing member 7310 is configured to move through a surgical end effector 7000 that includes a first jaw 7010 and a second jaw 7030 that is configured to move relative to the first jaw 7010. In one embodiment, the first jaw 7010 includes an elongate channel 7012 that is configured to operably support a surgical staple cartridge therein. See FIG. 80 and FIG. 81 . The second jaw 7030 includes an anvil 7032 that is pivotally supported on the elongate channel 7012 and movable relative thereto between open and closed positions. As can be seen in FIG. 82 , in at least one form, the firing member 7310 includes a shape commonly referred to as an "E-beam". The firing member 7310 includes an upright extending firing member body 7312 that has a lower base feature 7314 that includes two laterally extending tabs 7315 that are configured to slidably engage the elongate channel 7012 when the firing member is axially driven therein. In addition, a pair of upper tabs 7316 protrude from an upper portion of the firing member body 7312 to engage the anvil 7032 when the firing member 7310 is driven distally therethrough. During the firing stroke, the tabs 7315 and 7316 can serve to space the anvil 7032 apart relative to a surgical staple cartridge supported in the elongate channel 7012. The firing member body 7312 also includes a tissue cutting feature 7318. The tabs 7316 can also serve to apply a closing motion to the anvil 7032 as the firing member 7310 is moved distally from a starting position.

[0232] In the illustrated example, the firing drive system 7300 can also be used to apply opening and closing motions to the anvil 7032. As FIG. 80 to FIG. 83 can be seen, the closure nut 7370 is threadably received on the flexible rotary drive shaft 7350. The closure nut 7370 includes cam pins 7372 that extend laterally from each side of the closure nut 7370 to be received in corresponding cam slots 7036 in the anvil mounting portion 7034 of the anvil 7032. See FIG. 80 and FIG. 81 . Such cam pins 7372 prevent the closure nut 7370 from rotating with the flexible rotary drive shaft 7350, such that rotation of the flexible rotary drive shaft 7350 causes axial motion of the closure nut 7370. Thus, rotation of the flexible rotary drive shaft 7350 in a first direction causes the closure nut 7370 to move distally and cam the anvil 7032 from an open position to a closed position. Rotation of the flexible rotary drive shaft 7350 in a second rotational direction will cause the closure nut 7370 to move proximally and cam the anvil 7032 back to the open position. Thus, for example, alternating rotation of the flexible rotary drive shaft 7350 can allow a surgeon to quickly open and close the anvil 7032 for grasping purposes.

[0233] FIG. 85 An alternative firing drive assembly 7302 is shown that includes a flexible upper drive belt 7320' having upper drive teeth 7322' and a flexible lower drive belt 7330' having lower drive teeth 7332' that are formed from a single piece of material, such as metal. The flexible upper drive belt 7320' also includes an upper reinforcement tab 7324' disposed through the anvil 7032 similar to the upper tab 7316 on the firing member 7310 and a lower reinforcement tab 7334 disposed through the channel 7012 similar to the tab 7315 on the firing member 7310. FIG. 86 An alternative firing drive assembly 7302' is shown that is made from two belt assemblies 7302A and 7302B that are laminated together to form a flexible upper drive belt 7320" having upper drive teeth 7322" and a flexible lower drive belt 7330" having lower drive teeth 7332". Each belt assembly 7302A, 7302B also includes an upper reinforcement tab 7324A", 7324B" and a lower reinforcement tab 7334A", 7334B" disposed through the anvil 7032 and the elongate channel 7012, respectively.

[0234] For example, the firing drive system 7300 functions to apply uniform drive motion to the firing member 7310 and can accommodate articulation angles that can be greater than seventy degrees. Additionally, because the rotary drive nut 7340 engages the flexible upper drive band 7320 and the flexible lower drive band 7330 at a location distal to the articulation joint region 7200, linear firing loads are constrained to the end effector and are not passed through the articulation joint.

[0235] FIG. 87 to FIG. 89 Another form of a surgical instrument 9010 is shown that can address many of the challenges faced by surgical instruments having end effectors that are capable of articulating to a maximum articulation angle and that are configured to both cut and fasten tissue. In various embodiments, the surgical instrument 9010 can comprise a hand-held device. In other embodiments, the surgical instrument 9010 can comprise an automated system, such as sometimes referred to as a robotic control system. In various forms, the surgical instrument 9010 comprises a surgical end effector 10000 operably coupled to an elongated shaft assembly 12000. The elongated shaft assembly 12000 can be operably attached to a housing. In one embodiment, the housing can comprise a handle configured to be grasped, manipulated, and actuated by a clinician. In other embodiments, the housing can comprise a robotic system that houses or otherwise operably supports at least a portion of at least one drive system configured to generate and apply at least one control motion that can be used to actuate the surgical end effectors disclosed herein and their respective equivalents. Moreover, various components can be "housed" or contained in the housing, or various components can be "associated with" the housing. In such instances, the components can not be housed within or directly supported by the housing. For example, the surgical instruments disclosed herein can be used with various robotic systems, instruments, components, and methods disclosed in U.S. Patent No. 9,072,535, entitled SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS, which is hereby incorporated by reference in its entirety.

[0236] In one form, the surgical end effector 10000 includes a first jaw 10100 and a second jaw 10200. In the illustrated arrangement, the first jaw 10100 includes an elongate channel 10110 that includes a proximal end 10112 and a distal end 10114 and is configured to operably support a surgical staple cartridge 10300 therein. The surgical staple cartridge 10300 includes a cartridge body 10302 having an elongate slot 10304 therein. A plurality of surgical staples or fasteners (not shown) are stored in the cartridge body on drivers (not shown) arranged in rows on each side of the elongate slot 10304. The drivers are each associated with a corresponding staple cavity 10308 that is exposed through a cartridge deck surface 10306. The surgical staple cartridge 10300 can be replaced after the staples / fasteners have been expelled therefrom. Other embodiments are envisioned in which the elongate channel 10110 and / or the entire surgical end effector 10000 is discarded after the surgical staple cartridge 10300 has been used.

[0237] In the illustrated arrangement, the second jaw 10200 includes an anvil 10210 that includes an elongate anvil body 10212 having a proximal end 10214 and a distal end 10216. The anvil body 10212 includes a staple-forming undersurface 10218 that faces the first jaw 10100 and can include a series of staple-forming pockets (not shown) corresponding to each of the staples or fasteners in the surgical staple cartridge 10300. The anvil body 10212 can also include a pair of downwardly extending tissue stop features 10220 formed adjacent the proximal end 10214 of the anvil body 10212. One tissue stop feature 10220 extends from each side of the anvil body 10212 such that a distal end 10222 on each tissue stop 10220 corresponds to the proximal-most staple / fastener in the surgical staple cartridge 10300. When the anvil 10200 is moved into the closed position toward tissue positioned between the staple-forming undersurface 10218 of the anvil 10200 and the cartridge deck surface 10306 of the surgical staple cartridge 10300, the tissue contacts the distal end 10222 of the tissue stop 10220 to prevent the tissue from moving proximally past the proximal-most staple / fastener, thereby ensuring that the cut tissue is also stapled. When the surgical staple cartridge is "fired" as will be discussed in further detail below, the staples / fasteners supported in each staple cavity 10308 are driven out of the staple cavities 10308, through the clamped tissue, and into contact with the staple-forming undersurface 10218 of the anvil 10200.

[0238] As FIG. 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. These pins are configured to be received in corresponding mounting inserts 10130, which 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-translational, non-motion) pivot axis PA. See also... FIG. 87 .

[0239] 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 (e.g., a handheld unit, robotic tool actuator, etc.) of the surgical instrument 9010. 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 articulate through a first or proximal joint motion plane defined by a first or proximal joint motion axis AA1 transverse to the axial axis SA. Similarly, in one example, the distal joint member 12250 is operatively connected to the central joint member 12230 such that the distal joint member 12250 can selectively articulate through a second or distal joint motion plane defined by a second or distal joint motion axis AA2 transverse to both the axial axis SA and the first or proximal joint motion axis AA1.

[0240] like FIG. 89 and FIG. 90 As can be seen, the proximal connector member 12210 includes a distal proximal connector portion 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.FIG. 90 ). The central joint member 12230 includes a proximal face portion 12232 that defines two spaced-apart transverse proximal tip portions 12234, 12236. The proximal tip portion 12234 defines a radial surface 12235, and the tip portion 12236 defines a radial surface 12237. As can be seen in FIG. 89 , the proximal face portion 12232 of the central joint member 12230 faces the proximal joint distal face portion 12212 of the proximal joint member 12210 such that the central joint member 12230 is articulatable through a first articulation plane defined by a first or proximal articulation axis AA1 that extends between a point where the transverse tip portion 12214 on the proximal joint member contacts the proximal tip portion 12234 on the central joint member 12210 and a point where the transverse tip portion 12216 on the proximal joint member 12230 contacts the proximal tip portion 12236 on the central joint member 12230. In one arrangement, the radial surfaces 12215, 12217 on the transverse tip portions 12214, 12216, respectively, and the radial surfaces 12235 and 12237 on the proximal tip portions 12234, 12236, respectively, can act as rocker points / surfaces about which the central joint member 12230 is articulatable relative to the proximal joint member 12210. In addition, the central joint member 12230 includes proximal first gear teeth segments that are configured to be rotatably meshable with the distal gear segments 12218, 12220 on the proximal joint member 12210. See FIG. 88 . In various arrangements, the radial surface 12235 on the central joint member 12230 can be spaced apart from the radial surface 12215 on the proximal joint member 12210, and the radial surface 12237 on the central joint member 12230 can be spaced apart from the radial surface 12217 on the proximal joint member 12210.

[0241] The central joint member 12230 also includes a central joint distal face portion 12240 that defines a centrally disposed upper tip portion 12242 that forms an upper radial surface 12244 and a lower tip portion 12246 that forms a lower radial surface 12248. See FIG. 89 . The distal joint member 12250 is attached to the proximal end 10112 of the elongate channel 10110 by a mounting bushing 10150 and includes a proximal face portion 12251 that faces or confronts the central joint distal face portion 12240 on the central joint member 12230. See FIG. 89 and FIG. 92 . As can be seen in FIG. 89 and FIG. 92As can be seen, the proximal face portion 12251 defines a centrally disposed upper tip portion 12252 that forms an upper radial surface 12254 that is configured to face or abut the upper radial surface 12244 on the central joint member 12230. The proximal face portion 12251 also defines a centrally disposed lower tip portion 12256 that forms a lower radial surface 12258 that is configured to face or abut the lower radial surface 12248 on the central joint member 12230. See FIG. 89 The distal joint member 12250 also includes an upper gear tooth segment 12253 that is configured to rotatably mesh with the upper gear tooth segment 12243 on the central joint member 12230. In addition, the distal joint member 12250 includes a lower gear tooth segment 12255 that is configured to rotatably mesh with the lower gear tooth segment 12245 on the central joint member 12230. See FIG. 92 .

[0242] The distal joint member 12250 is configured to articulate through a second or distal articulation plane defined by a second or distal articulation axis AA2 that extends between a point on the distal joint member 12250 where the upper tip portion 12252 contacts or faces the upper tip portion 12242 on the central joint member 12230 and a point on the distal joint member 12250 where the lower tip portion 12256 contacts or faces the lower tip portion 12246 on the central joint member 12230. See FIG. 89 and FIG. 92 In one arrangement, the radial surfaces 12254, 12258 on the upper and lower tip portions 12242, 12246, respectively, of the distal joint member 12250 and the radial surfaces 12244, 12248 on the upper and lower tip portions 12252, 12256, respectively, of the central joint member 12230 can act as rocker points / surfaces about which the distal joint member 12250 can articulate relative to the central joint member 12230. In an alternative arrangement, however, the radial surface 12254 on the distal joint member 12250 is spaced from the radial surface 12244 on the central joint member 12230 and the radial surface 12258 on the distal joint member 12250 is spaced from the radial surface 12248 on the central joint member 12230.

[0243] Returning to FIG. 88In the illustrated example, articulation joint 12200 is operably controlled by a cable control system 9030 that includes four cables 12510, 12520, 12530, and 12540 that extend through the elongate shaft assembly 12000. Cable control system 9030 can be supported within a housing 9020 of surgical instrument 9010. Cable control system 9030 can include a plurality of cable support members / drive wheels, pulleys, or the like that are controlled by one or more corresponding motors that are controlled by a control circuit portion of surgical instrument 9010. In various embodiments, cable control system 9030 is configured to manage tensioning (pulling) and pay-out of the cables at precise times during the articulation process. Moreover, in at least one arrangement, cable control system 9030 is employed to control the opening and closing of anvil 10210 as will be discussed in further detail below.

[0244] As FIG. 88 can be seen, cables 12510, 12520, 12530, and 12540 are configured to operably interface with a closure system 12600 that is rotatably mounted in the proximal end 10112 of the elongate channel 10110. In at least one arrangement, closure system 12600 includes a pulley unit 12610 that includes a first lateral alpha wrap pulley 12620 and a second lateral alpha wrap pulley 12630 that are interconnected by a central shaft 12640. See FIG. 93 and FIG. 94 . Pulley unit 12610 is rotatably supported within the proximal end 10112 of the elongate channel 10110 by mounting brackets 12710 and 12720. See FIG. 88More specifically, the proximal end 10112 of the elongated channel 10110 defines a firing member 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 on each side of the axis SA within the firing member parking area 10140 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 support 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 support 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 area 12732 shaped to receive the corresponding first α-winding pulley 12620 and second α-winding pulley 12630 therein.

[0245] like FIG. 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, cable 12540 is received in and attached to a first circumferential groove 12632, and 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 contrasts with that of a normal pulley, which can have a range of rotation of less than 180 degrees.

[0246] Each of the first lateral alpha wrap pulley 12620 and the second lateral alpha wrap pulley 12630 further includes a corresponding screw closure cam configured to apply closure motions to the anvil 10210. As FIG. 94 can be seen, the first lateral alpha wrap pulley 12620 includes a first screw closure cam 12626 and the second lateral alpha wrap pulley 12630 has a second screw closure cam 12636 thereon. The screw closure cams 12626, 12636 are configured to cam interact with corresponding anvil closure arms 10234 on the anvil mounting portion 10230 of the anvil 10210 to apply closure motions to the anvil. FIG. 96 The position of the screw closure cam 12626 on the first lateral alpha wrap pulley 12620 is shown when the anvil 10210 is biased into an open position by the anvil spring 10240. Rotation of the pulley unit 12610 in a first rotational direction will cause the screw closure cam 12626 to cam the anvil 1210 into the FIG. 97 closed position shown. To open the anvil 10210, the pulley unit 12610 is rotated in the opposite direction back to the FIG. 96 position shown.

[0247] Referring now to FIG. 91 and FIG. 93 , the first cable 12510 extends from the cable control system through the elongate shaft assembly and through a conduit in the proximal joint member 12210 and is looped around two redirecting pulleys 12650, 12660 supported on shafts 12602, 12612 that are mounted in the central joint member 12230. The first cable 12510 exits the central joint member 12230 through a conduit 12231 and extends through a conduit 12257 in the distal joint member 12250 to be received within a first circumferential groove 12622 in the first lateral alpha wrap pulley 12620 where it is attached to the first lateral alpha wrap pulley. The second cable 12520 extends from the cable control system through the elongate shaft assembly and through a conduit 12213 in the proximal joint member 12210 to be looped around the redirecting pulleys 12650, 12660 in the central joint member 12230. The second cable 12520 exits the central joint member 12230 through a respective conduit 12241 and extends through a conduit 12259 in the distal joint member 12250 to be received within a second circumferential groove 12624 in the first lateral alpha wrap pulley 12620 where it is attached to the first lateral alpha wrap pulley.

[0248] In the illustrated example, a third cable 12530 extends from the cable control system 9030 through the elongated shaft assembly 12000 and through corresponding conduits in the proximal joint member 12210, the central joint member 12230, and the distal joint member 12250 to be received within a corresponding circumferential groove in the second transverse alpha wrap pulley 12630 where it is attached to the second transverse alpha wrap pulley. In addition, a fourth cable 12540 extends from the cable control system 9030 through the elongated shaft assembly 12000 and through corresponding conduits in the proximal joint member 12210, the central joint member 12230, and the distal joint member 12250 to be received within a corresponding circumferential groove in the second transverse alpha wrap pulley 12630 where it is attached to the second transverse alpha wrap pulley.

[0249] In at least one example, to articulate the surgical end effector 10000 relative to the elongated shaft assembly 12000 through a first articulation plane defined by the first articulation axis AA1, the cable control system 9030 is actuated to simultaneously pull the second cable 12520 and the fourth cable 12540, with the same amount of tension being applied to each cable 12520 and 12540. Because the cables 12520, 12540 apply equal amounts of tension on either side of the pulley unit 12610, the pulley unit 12610 does not rotate. However, the pulling action of the cables 12520 and 12540 is translated through the articulation joint 12200 to the surgical end effector 10000, which causes the central joint member 12230 to articulate relative to the proximal joint member 12210 about the first articulation axis AA1. See FIG. 92 and FIG. 98 To articulate the surgical end effector 10000 through a second articulation plane defined by the second articulation axis AA2 and transverse to the first articulation plane, the cable control system 9030 is actuated to simultaneously pull the third cable 12530 and the fourth cable 12540, with the same amount of tension being applied to each cable 12530 and 12540. Because the cables 12530, 12540 apply equal amounts of tension on either side of the second transverse alpha wrap pulley 12630 of the pulley unit 12610, the pulley unit 12610 does not rotate. However, the pulling action of the cables 12530 and 12540 is translated through the articulation joint 12200 to the surgical end effector 10000, which causes the distal joint member 12250 to articulate relative to the central joint member 12230 about the second articulation axis AA2. See FIG. 92 and FIG. 99 .

[0250] The cable control system 9030 can also be used to control the opening and closing of the anvil 10210 in the following manner. As described above, when the helical cams 10626 on the first lateral alpha wrap pulley 10620 and the second lateral alpha wrap pulley 10630 are in the positions shown FIG. 96 To close the anvil 10210 from this position, the cable control system 9030 is actuated to pull both the first cable 12510 and the fourth cable 12540 simultaneously, with the same amount of tension applied to each cable 12510 and 12540. These cables 12510 and 12540 will cause the pulley unit 12610 to rotate to the closed position shown FIG. 97 which causes the closure cams 10626 to cammingly contact the anvil closure arms 10234 to pivot the anvil 10210 into the closed position. It will be appreciated that by applying equal amounts of tension to the cables 12510 and 12540, no moment is applied to the central joint member 12230 and / or the distal joint member 12250 because equal amounts of tension are applied on each side of the articulation joint 12200. See FIG. 91 This arrangement allows the jaw closure to be shaped as desired. This cable control system 9030 allows for faster closure when the anvil is fully open. The cable control system 9030 can also be used as a lower speed / higher force generation for the closure mechanism used to clamp onto tissue. This cable control system 9030 can also not produce the recoil that other cable control systems typically occur and thus can also be used to control the articulation position of the end effector. As will be discussed further below, this cable actuated closure and articulation system does not cross the central axis or shaft axis of the articulation joint that provides the critical space for the firing drive system 13000.

[0251] The articulation joint 12200 and cable control system 9030 described above can facilitate two-plane articulation while also providing additional actuation motions to the surgical end effector 10000 while leaving the central region of the articulation joint 12200 open for other control systems, as will be discussed in further detail below. The articulation joint 12200 uses the last degree of freedom to actuate the jaw closure of the surgical end effector. In one aspect, the articulation joint 12200 comprises an N+1 joint, which means that for N degrees of freedom, the joint requires N+1 cables to actuate. Thus, in the example described above, the articulation joint 12200 employs four actuation cables.

[0252] As FIG. 100 to FIG. 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 10210. FIG. 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 shaft 12640 of the pulley unit 12610 when the firing member 13310 is in the proximal starting position within the firing member parking area 10140 in the proximal end 10112 of the elongated channel 10110.

[0253] like FIG. 100 to FIG. 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 chain 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 chain 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. FIG. 100As can be seen, the upper flexible chain drive assembly 13400 further includes an upper compression assembly 13430 for compressing the upper balls 13422 in the upper series 13410 together. In one arrangement, the upper compression assembly 13430 includes a hollow flexible compression tube 13432 received over the upper flexible coupler member 13402. An upper collar 13440 is crimped over the upper flexible coupler member 13402 and an upper compression spring 13442 is journaled between the upper collar 13440 and the upper flexible compression tube 13432 to bias the upper flexible compression tube 13432 distally into contact with the proximal-most upper ball 13422P in the upper series 13410 of upper chain link features 13420.

[0254] Similarly, in at least one embodiment, the lower flexible chain drive assembly 13500 includes a lower series 13510 of lower chain link features 13520 that are loosely coupled together by a lower flexible coupler member 13502 that is attached to the bottom portion 13313 of the firing member 13310. In at least one example, each lower chain link feature 13520 includes a lower ball or spheroid 13522 having a lower hollow conduit 13524 therein that is configured to allow the lower flexible coupler member 13502 to pass therethrough. The lower flexible chain drive assembly 13500 further includes an upper compression assembly 13530 for compressing the lower balls 13522 in the lower series 13510 together. In one arrangement, the lower compression assembly 13530 includes a hollow flexible compression tube 13532 received over the lower flexible coupler member 13502. A lower collar 13540 is crimped over the lower flexible coupler member 13502 and a lower compression spring 13542 is journaled between the lower collar 13540 and the lower flexible compression tube 13532 to bias the lower flexible compression tube 13532 distally into contact with the proximal-most lower ball 13522P in the lower series 13510 of lower chain link features 13520.

[0255] Turning now to FIG. 104 In at least one arrangement, the firing drive system 13000 further includes a rotary drive screw 13700 that is configured to drivingly interface with the upper series 13410 of upper chain link features 13420 and the lower series 13510 of lower chain link features 13520. As can be seen, the rotary drive screw 13700 includes a threaded shaft 13702 that is received in a threaded bore 13704 in the upper collar 13440 of the upper compression assembly 13430. The threaded shaft 13702 is configured to be driven by a motor 13706 that is mounted to the handle 13100. In at least one example, the motor 13706 is a rotary motor that is configured to drive the threaded shaft 13702 in a first direction to drive the upper series 13410 of upper chain link features 13420 and the lower series 13510 of lower chain link features 13520 distally to fire the staple cartridge 13200 and in a second direction to retract the staple cartridge 13200. FIG. 104As can be seen in the illustrated arrangement, the rotary drive screw 13700 is rotatably supported in a mounting bushing 10150 that is attached to the proximal end 10112 of the elongate channel 10110. For example, the rotary drive screw 13700 includes a body portion 13702 having a central shaft 13704 protruding therefrom that is rotatably mounted in a mounting hole 10152 in the mounting bushing 10150. This arrangement allows the rotary drive screw 13700 to rotate about the shaft axis SA.

[0256] In the illustrated example, the rotary drive screw 13700 is driven by a rotary drive system 13600 that includes a proximal rotary drive shaft 13610 that is rotatably supported within an axial conduit 12225 within the proximal joint member 12210. As FIG. 105 As can be seen, the proximal rotary drive shaft 13610 includes a proximal end 13612 and a distal end 13614. The proximal end 13612 can interface with the gear box / motor arrangement 9050 or other source of rotary motion housed in the housing 9020 of the surgical instrument 9010. This source of rotary motion causes the proximal rotary drive shaft 13610 to rotate within the axial conduit 12225 in the proximal joint member 12210 about the shaft axis SA. See FIG. 104 As can be seen, the proximal rotary drive shaft 13610 includes a proximal end 13612 and a distal end 13614. The proximal end 13612 can interface with the gear box / motor arrangement 9050 or other source of rotary motion housed in the housing 9020 of the surgical instrument 9010. This source of rotary motion causes the proximal rotary drive shaft 13610 to rotate within the axial conduit 12225 in the proximal joint member 12210 about the shaft axis SA. See FIG. 105 As can be seen, the distal end 13614 of the proximal rotary drive shaft 13610 is movably coupled to a first drive shaft segment 13620. In the illustrated example, the first drive shaft segment 13620 resembles a "dog bone" having a first spherical proximal end 13622 and a first spherical distal end 13624. See FIG. 106 The first spherical proximal end 13622 is movably pinned within a first distal socket 13616 formed in the distal end 13614 of the proximal rotary drive shaft 13610 by a first proximal pin 13618. The first proximal pin 13618 extends through an arcuate transverse slot 13623 in the first spherical proximal end 13622. This arrangement allows the first spherical proximal end 13622 to move in multiple directions within the first distal socket 13616 while remaining attached thereto. The first spherical distal end 13624 is received within a first proximal socket 13632 in a central bearing housing 13630 that is mounted within the central joint member 12230. The first spherical distal end 13624 is movably pinned within the first proximal socket 13632 by a first distal pin 13634. The first distal pin 13634 extends through an arcuate transverse slot 13625 in the first spherical distal end 13624. This arrangement allows the first spherical distal end 13624 to move in multiple directions within the first proximal socket 13632 while remaining attached to the central bearing housing 13630.

[0257] As FIG. 105 As can be seen in FIG. 136, the rotary drive system 13600 further includes a second drive shaft segment 13640 that is similar to the first drive shaft segment 13620 and includes a second spherical proximal end 13642 and a second spherical distal end 13644. The second spherical proximal end 13642 is movably pinned within a second distal socket 13636 formed in the central bearing housing 13630 by a second proximal pin 13637. The second proximal pin 13637 extends through an arcuate transverse slot 13643 in the second spherical proximal end 13642. This arrangement allows the second spherical proximal end 13642 to move in multiple directions within the second distal socket 13636 while remaining attached thereto. The second spherical distal end 13644 is received within a second proximal socket 13706 in the rotary drive screw 13700 and is movably pinned within the second proximal socket 13706 by a second distal pin 13647. The second distal pin 13647 extends through a transverse slot 13646 in the second spherical distal end 13644. This arrangement allows the second spherical distal end 13644 to move in multiple directions relative to the rotary drive screw 13700.

[0258] The dual-joint rotary drive maintains a linear velocity output by using the angular constraint of the joint members of the articulation joints. This universal rotary joint arrangement can have a sine output based on the joint angle by itself. If the angles are equal and the phases are properly aligned, the sine output of the first universal joint will be canceled out by the second universal joint, resulting in a linear rotational velocity. This is advantageous to impose in a rotary drive because it reduces the complexity of the components and avoids the need to remove material from the components to obtain the necessary clearance. As a result, the components of this embodiment are more robust and stronger than existing arrangements. Furthermore, the constant velocity of the rotary drive system will allow for a smoother firing and reduce wear that might otherwise be caused by vibrations.

[0259] Returning to FIG. 102To drive the firing member 13310 from the starting position in the surgical end effector 10000 to the ending position within the end effector, the actuation rotary drive system 13600 is actuated to apply rotary drive motions to the rotary drive screw 13700. As the rotary drive screw 13700 is rotated in a first rotary direction, the helical drive features 13708 engage the upper balls or spheres 13422 in the upper series 13410 of the upper chain link features 13420 and the lower balls or spheres 13522 in the lower series 13510 of the lower chain link features 13520 and drive the upper flexible chain drive assembly 13400 and the lower flexible chain drive assembly 13500 distally. As each upper ball 13422 and lower ball 13522 engages the rotary drive screw 13700, the upper balls 13422 in the upper series 13410 distal of the rotary drive screw 13700 (and articulation joint 12200) and the lower balls 13522 in the lower series 13510 distal of the rotary drive screw 13700 (and articulation joint 12200) are placed into compression to apply a balanced axial drive force to the firing member 13310. As the upper flexible chain drive assembly 13400 and the lower flexible chain drive assembly 13500 are placed into compression, they are constrained by the slots in the anvil 10210 and the elongate channel 10110, respectively. This arrangement ensures that the upper flexible chain drive assembly 13400 and the lower flexible chain drive assembly 13500 do not buckle as they are compressed.

[0260] For a number of reasons, this arrangement enables two degrees of articulation freedom. For example, the upper flexible chain drive assembly 13400 and the lower flexible chain drive assembly 13500 can freely bend in both the pitch and yaw axes. Thus, the upper flexible chain drive assembly 13400 and the lower flexible chain drive assembly 13500 can assume a variety of configurations that can adapt to the various articulation positions available to the articulation joint 12200. Once the firing member 13310 has been advanced distally through the surgical end effector 10000 to the end position therein, the rotary drive system 13600 is actuated to apply a second rotary drive motion to the rotary drive screw 13700 to thereby rotate the rotary drive screw 13700 in a second rotary direction about the shaft axis. As the rotary drive screw 13700 is rotated in the second rotary direction, the upper flexible chain drive assembly 13400 and the lower flexible chain drive assembly 13500 serve to retract the firing member 13310 in the proximal direction back to the starting position. As the upper flexible chain drive assembly 13400 and the lower flexible chain drive assembly 13500 proximally retract the firing member 13310, a portion of the upper flexible chain drive assembly 13400 and the lower flexible chain drive assembly 13500 is traversed back through the articulation joint 12200 and into the elongate shaft. This arrangement allows the firing member 13310 to translate a longer distance without increasing the length of the end effector joint. In addition, because the rotary drive screw 13700 drivingly engages the upper flexible chain drive assembly 13400 and the lower flexible chain drive assembly 13500 at a location distal to the articulation joint 12200, high compressive loads are contained within the surgical end effector 10000 and do not create a moment on the articulation joint 12200. This arrangement can greatly reduce the strength requirements of the articulation joint. See FIG. 104 .

[0261] In at least one arrangement, the surgical instrument 9010 can further include a cable tensioning system 13800 that is configured to maintain a desired amount of tension on the upper flexible chain drive assembly 13400 and the lower flexible chain drive assembly 13500 as they are bent through the articulation joint 12200. Maintaining the upper flexible chain drive assembly 13400 and the lower flexible chain drive assembly 13500 at a desired amount of tension as they are traversed through the articulation joint 12200 can prevent slack portions from forming in those flexible chain drive assemblies 13400, 13500 that might otherwise cause them to undesirably bunch up in the articulation joint 12200. FIG. 111 and FIG. 112One form of cable tensioning system 13800 is shown that includes constant force spring arrangements 13810 and 13820. This solution has the benefit of not requiring length conservation of the flexible chain drive assemblies 13400, 13500.

[0262] Another cable arrangement system 13800' is shown in FIG. 113 and FIG. 114 In this arrangement, the proximal ends of the flexible chain drive assemblies 13400, 13500 are coupled together and articulated about a cable management pulley 13840 that is configured to translate with the firing member 13310. As the firing member 13310 advances distally during the firing stroke, the cable management pulley 13840 also translates distally, thereby maintaining tension in the flexible chain drive assemblies 13400, 13500. During articulation, the length of one of the flexible chain drive assemblies 13400, 13500 will increase while the length of the other flexible chain drive assembly will decrease. This arrangement serves to minimize the length of the flexible chain drive assemblies 13400, 13500 required to fully actuate the surgical end effector 10000 and articulate it.

[0263] One method of using the surgical instrument 9010 can involve using the surgical instrument to cut and staple target tissue within a patient using laparoscopic techniques. For example, one or more trocars can have been placed through the abdominal wall of a patient to provide access to target tissue within the patient. The surgical end effector 10000 can be inserted through one trocar and one or more cameras or other surgical instruments can be inserted through the other trocars. In order for the surgical end effector 10000 to be inserted through the trocar cannula, the surgical end effector 10000 is positioned in a non-articulated orientation FIG. 63 ) and the jaws 10100 and 10200 must be closed. In order to hold the jaws 10100 in the closed position for insertion purposes, for example, the cable control system 9030 is actuated to pull the first cable 12510 and the fourth cable 12540 simultaneously, which causes the pulley unit 12610 to rotate and cause the closure cams 10626, 10636 to contact the anvil closure arms 10234 to pivot the anvil 10210 into the closed position. See FIG. 97 . The cable control system 9030 is deactivated to hold the anvil 10210 in the closed position. Once the surgical end effector 10000 has entered the abdomen through the trocar, the cable control system 9030 is activated to rotate the pulley unit 12610 in the opposite direction to the position shown in FIG. 96 , thereby allowing the anvil 10210 to be biased open by the anvil spring 10240.

[0264] Once inside the abdomen and prior to engaging the target tissue, the surgeon can need to articulate the surgical end effector 10000 into a favorable position. The cable control system 9030 can then be actuated to articulate the surgical end effector 10000 in one or more planes relative to the portion of the elongate shaft assembly 12000 that is received within the cannula of the trocar. Once the surgeon has oriented the surgical end effector 10000 in the desired position, the cable control system 9030 is deactivated to hold the surgical end effector 10000 in the articulated orientation. Thereafter, the surgeon can activate the cable control system 9030 in the manner described above to rapidly close the anvil 10210 to grasp the tissue between the anvil 10210 and the surgical staple cartridge 10300. This process can be repeated as desired until the target tissue has been suitably positioned between the anvil 10210 and the surgical staple cartridge 10300.

[0265] Once the target tissue has been positioned between the anvil 10210 and the surgical staple cartridge 10300, the surgeon can activate the cable control system 9030 to close the anvil 10210 to clamp the target tissue in place. Thereafter, the firing process can be initiated by activating the rotary drive system 13600 to drive the firing member 13310 distally from a starting position. As the firing member 13310 moves distally, it contacts a sled that is supported in the surgical staple cartridge 10300 and also drives the sled distally through the cartridge body. The sled successively drives rows of drivers that are supported in the cartridge toward the clamped target tissue. Each driver has one or more surgical staples or fasteners supported thereon that are subsequently driven through the target tissue and into forming contact with the underside of the anvil 10210. As the firing member 13310 moves distally, the tissue-cutting edge 13318 thereon cuts through the stapled tissue.

[0266] After the firing member 13310 has been driven distally to an end position within the surgical end effector 10000, the rotary drive system 13600 is reversed, which causes the firing member 13310 to retract proximally to a starting position. Once the firing member 13310 has returned to the starting position, the cable control system 9030 can be activated to rotate the pulley unit 12610 back to an open position wherein the anvil spring 10240 can pivot the anvil 10210 to an open position to enable the surgeon to release the stapled tissue from the surgical end effector 10000. Once the stapled tissue has been released, the surgical end effector 10000 can be withdrawn from the patient through the trocar cannula. To do so, the surgeon must first actuate the cable control system 9030 to return the surgical end effector 10000 to the unarticulated position and actuate the cable control system 9030 to pivot the anvil 10210 to the closed position. Thereafter, the surgical end effector 10000 can be withdrawn through the trocar cannula.

[0267] In prior endoscopic cutter arrangements, the firing member is pushed by a flexible beam. In such arrangements, the articulation joint must redirect the linear motion of the flexible beam as it enters the articulation joint back to linear motion as the flexible beam exits the articulation joint and enters the end effector. Due to the high loads required to push the flexible beam and firing member, the flexible beam typically experiences a significant amount of friction as it exits the articulation joint and is redirected linearly into the end effector. This increased amount of friction increases the amount of drive force required to drive the firing member from a starting position within the end effector to an end position when the end effector is articulated. Furthermore, as the flexible beam traverses the articulation joint, it can impart a disarticulation to the articulation joint components. As a result, the articulation joint components must be strong enough to resist such disarticulation.

[0268] Other forms of surgical endoscopic cutters employ a rotational force to drive the firing member through the end effector. Such arrangements typically employ a rotating drive screw housed within a channel that supports a staple cartridge. During use, the sled and tissue place a large moment on the firing member, which decreases the efficiency of the system and ultimately requires a higher rotational force to actuate the firing member. Due to the location of the cartridge and tissue, it is difficult to move the rotating drive screw closer to the center of this force. It is difficult to package the screw on the top and bottom of the firing member without increasing the overall diameter of the surgical end effector. The various embodiments discussed above can address many, if not all, of these problems and challenges.

[0269] Example 1 - a surgical instrument comprising a surgical end effector comprising a firing member supported for axial travel within the surgical end effector. An upper chain drive assembly operably interfaces with a top portion of the firing member and a lower chain drive assembly operably interfaces with a bottom portion of the firing member. A drive member operably interfaces with the upper chain drive assembly and the lower chain drive assembly to cause the upper chain drive assembly and the lower chain drive assembly to apply axial drive motions to the firing member to cause the firing member to move within the surgical end effector between a starting position and an ending position.

[0270] Example 2 - the surgical instrument of Example 1, wherein the upper chain drive assembly comprises a plurality of upper chain link features movably interconnected by an upper flexible member, and wherein the lower chain drive assembly comprises a plurality of lower chain link features movably interconnected by a lower flexible member.

[0271] Example 3 - the surgical instrument of Example 2, further comprising an upper tensioner attached to a proximal end of the upper flexible member to maintain a variable tension in the upper chain drive assembly and a lower tensioner attached to a proximal end of the lower flexible member to maintain a variable tension in the lower chain drive assembly.

[0272] Example 4 - the surgical instrument of Examples 2 or 3, wherein each upper chain link feature comprises an upper sphere, and wherein each lower chain link feature comprises a lower sphere.

[0273] Example 5 - the surgical instrument of Examples 1, 2, 3, or 4, further comprising an elongate shaft coupled to the surgical end effector by an articulation joint configured to facilitate selective articulation of the surgical end effector relative to the elongate shaft. The drive member operably interfaces with the upper chain drive assembly at an upper location and the drive member operably interfaces with the lower chain drive assembly at a lower location. The upper location and the lower location are distal to the articulation joint.

[0274] Example 6 - the surgical instrument of Example 5, wherein the articulation joint comprises a poly-axial articulation joint.

[0275] Example 7 - The surgical instrument of Examples 1, 2, 3, 4, or 6, wherein a proximal upper portion of the upper chain drive assembly, located proximal to the drive member, is loosely coupled together and a distal upper portion of the upper chain drive assembly, located distal to the drive member, is compressed into a substantially rigid upper state configured to enable application of an upper axial drive motion to the firing member. A proximal lower portion of the lower chain drive assembly, located proximal to the drive member, is loosely coupled together and a distal lower portion of the lower chain drive assembly, located distal to the drive member, is compressed into a substantially rigid lower state configured to enable application of a lower axial drive motion to the firing member.

[0276] Example 8 - The surgical instrument of Examples 1, 2, 3, 4, 5, 6, or 7, wherein the upper chain drive assembly includes an upper proximal end and an upper distal end operably interfacing with a top portion of the firing member. The lower chain drive assembly includes a lower proximal end and a lower distal end operably interfacing with a bottom portion of the firing member. The upper proximal end is coupled to the lower proximal end by a coupler member supported in operable engagement with a proximal support member that facilitates movement of the coupler member and the upper chain drive assembly and the lower chain drive assembly. The proximal support member is configured to axially translate with axial translation of the upper chain drive assembly and the lower chain drive assembly.

[0277] Example 9 - The surgical instrument of Examples 5 or 6, wherein the drive member is located between the upper chain drive assembly and the lower chain drive assembly and is supported in a position distal to the articulation joint.

[0278] Example 10 - A surgical instrument comprising an elongate shaft having a surgical end effector coupled thereto by an articulation joint configured to facilitate selective articulation of the surgical end effector relative to the elongate shaft. The surgical end effector comprises a first jaw and a second jaw configured to move relative to the first jaw between an open position and a closed position. A firing member is supported for axial travel within the surgical end effector between a starting position and an ending position. The surgical instrument further comprises an upper chain drive assembly attached to a top portion of the firing member and a lower chain drive assembly attached to a bottom portion of the firing member. A rotary drive member operably interfaces with the upper chain drive assembly at an upper location and operably interfaces with the lower chain drive assembly at a lower location. The upper location and the lower location are located distal to the articulation joint. The rotary drive member applies axial drive motions to the upper chain drive assembly and the lower chain drive assembly to the firing member to move the firing member between the starting position and the ending position.

[0279] Example 11 - The surgical instrument of Example 10, wherein the upper chain drive assembly includes a plurality of upper chain link features movably interconnected by an upper flexible member, and the lower chain drive assembly includes a plurality of lower chain link features movably interconnected by a lower flexible member.

[0280] Example 12 - The surgical instrument of Example 11, further comprising an upper tensioner attached to a proximal end of the upper flexible member to maintain a variable tension in the upper chain drive assembly, and a lower tensioner attached to a proximal end of the lower flexible member to maintain a variable tension in the lower chain drive assembly.

[0281] Example 13 - The surgical instrument of Example 10, 11, or 12, wherein each upper chain link feature includes an upper sphere, and each lower chain link feature includes a lower sphere.

[0282] Example 14 - The surgical instrument of Example 10, 11, 12, or 13, wherein the first jaw includes a bottom conduit configured to slidably house a bottom portion of the firing member and a distal portion of the lower chain drive assembly, and the second jaw includes a top conduit configured to slidably house a top portion of the firing member and a distal portion of the upper chain drive assembly as the firing member moves between the starting position and the ending position.

[0283] Example 15 - The surgical instrument of Example 14, wherein the bottom conduit is sized and shaped relative to each lower sphere in the distal portion of the lower chain drive assembly to prevent the distal portion of the lower chain drive assembly from buckling as the firing member is driven from the starting position to the ending position. The top conduit is sized and shaped relative to each upper sphere in the distal portion of the upper chain drive assembly to prevent the distal portion of the upper chain drive assembly from buckling as the firing member is driven from the starting position to the ending position.

[0284] Example 16 - The surgical instrument of Example 14 or 15, wherein the bottom conduit includes a bottom lockhole shape, and the top conduit includes a top lockhole shape.

[0285] Example 17 - The surgical instrument of Example 10, 11, 12, 13, 14, 15, or 16, wherein the firing member is movable from a position distal to the starting position to the starting position without actuating the rotary drive member by applying an axial emergency motion to each of the upper chain drive assembly and the lower chain drive assembly.

[0286] Example 18 - a surgical instrument comprising an elongated shaft having a surgical end effector coupled thereto by an articulation joint configured to facilitate selective articulation of said surgical end effector relative to the elongated shaft. The surgical end effector comprises a firing member supported for axial travel within the surgical end effector between a starting position and an ending position. An upper slackly connected chain drive assembly is supported by the elongated shaft and traverses the articulation joint to operably interface with a top portion of the firing member. A lower slackly connected chain drive assembly is supported by the elongated shaft and traverses the articulation joint to operably interface with a bottom portion of the firing member. The surgical instrument further comprises means for converting an upper portion of the upper slackly connected chain drive assembly distal of the articulation joint into a rigid drive member configured to apply axial drive motions to the firing member to drive the firing member between the starting position and the ending position.

[0287] Example 19 - the surgical instrument of Example 18 wherein the upper slackly connected chain drive assembly comprises a plurality of upper chain link features movably interconnected by an upper flexible member and the lower slackly connected chain drive assembly comprises a plurality of lower chain link features movably interconnected by a lower flexible member.

[0288] Example 20 - the surgical instrument of Example 19 wherein each upper chain link feature comprises an upper sphere and wherein each lower chain link feature comprises a lower sphere.

[0289] As used in any aspect herein, the term “control circuitry” can refer to, for example, hardwired circuitry, programmable circuitry (for example, a computer processor including one or more individual instruction processing cores, processing units, processors, microcontrollers, microcontroller units, controllers, digital signal processors (DSPs), programmable logic devices (PLD), programmable logic arrays (PLA), field programmable gate arrays (FPGA)), state machine circuitry, firmware that stores instructions executed by programmable circuitry, and any combination thereof. The control circuitry can be implemented in collective or individual components of an electronic system, for example, an integrated circuit (IC), an application-specific integrated circuit (ASIC), a system on chip (SoC), a desktop computer, a laptop computer, a tablet computer, a server, a smart phone, and the like. As used herein, “control circuitry” includes, but is not limited to, electronic circuitry with at least one discrete electrical circuit, electronic circuitry having at least one integrated circuit, electronic circuitry having at least one application specific integrated circuit (ASIC), electronic circuitry forming a general purpose computing device configured by a computer program (e.g., a general purpose computer configured by a computer program that at least partially carries out the processes and / or devices described herein, or a microprocessor configured by a computer program that at least partially carries out the processes and / or devices described herein), electronic circuitry forming a memory device (e.g., forms of random access memory), and / or electronic circuitry forming a communications device (e.g., a modem, communications switch, or optical-electrical equipment). Those skilled in the art will recognize that the subject matter described herein can be implemented in an analog or digital form, or a combination thereof, as some embodiments of the subject matter described herein can be implemented to include both analog and digital aspects.

[0290] Although a number of forms have been exemplified and described, it is the intent of the applicant that the scope of the appended claims not be limited to the forms described herein. Many modifications, variations, alterations, substitutions, combinations and equivalents of the forms described herein will occur to those skilled in the art upon reading the description of the forms. Also, alternative structures for each element associated with the forms described can be described as means to provide the function that the element performs. Further, where materials are disclosed for certain components, other materials can be used. Thus, it is intended that the above description and the appended claims be construed to embrace all such modifications, combinations and variations as falling within the scope of the forms disclosed. It is intended that the appended claims cover all such modifications, variations, alterations, substitutions, modifications and equivalents.

[0291] One or more components can be referred to herein as being“configured to,”“configurable to,”“operable to,”“adapted to,”“capable of,”“adapted for,”“operable for,”“apt for,”“capable of,”“apt to,” etc. Those skilled in the art will recognize that, in general, a component being“configured to” can encompass active states of the component and / or inactive states of the component and / or pending states of the component.

[0292] Those skilled in the art will recognize that, in general, the terms used herein, and especially in the appended claims (e.g., in the body of the appended claims), are generally intended as“open” terms (e.g., the term“including” should be interpreted as“including but not limited to,” the term“having” should be interpreted as“having at least,” the term“includes” should be interpreted as“includes but is not limited to,” etc.). Those skilled in the art will also recognize that, unless otherwise specified, the use of particular numbers or language in the specification should not be construed as limiting the scope of the claims. For example, although the use of the terms“at least one” and“one or more” in the specification can be construed as introducing a specific number of elements, the use of such terms in the claims should not be so construed. For example, the use of the term“at least one” in the claims should not be construed as limiting the claims to only those claims that contain a specific number of elements, even though the use of such terms in the specification can so be construed. This is because the use of such terms in the claims is intended to be a recitation of a specific number of elements, and the use of such terms in the specification is intended to be a recitation of an open-ended range of elements. This is also true for the use of the terms“one or more” in the claims and the specification. For example, the use of the term“one or more” in the claims should not be construed as limiting the claims to only those claims that contain a specific number of elements, even though the use of such terms in the specification can so be construed. This is because the use of such terms in the claims is intended to be a recitation of a specific number of elements, and the use of such terms in the specification is intended to be a recitation of an open-ended range of elements. This is also true for the use of the terms“one or more” in the claims and the specification.

[0293] 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".

[0294] With respect to the appended claims, those skilled in the art will understand that the operations described herein can generally be performed in any order. Furthermore, although various operation flowcharts are shown in one or more sequences, it should be understood that the various operations may be performed in other orders than those shown, or may be performed simultaneously. Unless the context otherwise requires, examples of such alternative orderings may include overlapping, interleaving, interruption, reordering, incremental, preparatory, supplementary, simultaneous, reverse, or other altered orderings. Moreover, unless the context otherwise requires, terms such as “in response to,” “related,” or other past tense adjectives are generally not intended to exclude such variations.

[0295] It is worth noting that any reference to "one aspect," "one aspect," "one example," or "one example" means that the specific feature, structure, or characteristic described in connection with said aspect is included in at least one aspect. Therefore, the phrases "in one aspect," "in one aspect," "in one example," and "in one example" appearing in various places throughout the specification do not necessarily refer to the same aspect. Furthermore, specific features, structures, or characteristics may be combined in one or more aspects in any suitable manner.

[0296] Any patent application, patent, non-patent publication, or other disclosure material referred to in this specification, in any application data sheet, or in any correspondence, such as catalogs, brochures, or the like, is hereby incorporated by reference herein, only to the extent that the incorporated material is not inconsistent with the explicit teachings of this specification. Thus, and to the extent necessary, the disclosure herein supersedes any contradictory or inconsistent teachings of the incorporated material. Any material, or portion thereof, that is said to be incorporated by reference herein, but which contradicts the present definition, statement, or other disclosure material set forth herein, is only incorporated to the extent that the material is consistent with the explicit teachings of the present specification.

[0297] In general, an overall description of many of the advantageous effects resulting from the use of the concepts described herein has been presented. The foregoing detailed description has set forth various embodiments of the application via one or more forms. These embodiments are not intended to be exhaustive or to limit the application to the precise forms disclosed. Alterations, modifications, and variations will become apparent to those skilled in the art upon reading the foregoing detailed description. The one or more forms selected and described are for purposes of illustration and description and are not intended to limit the scope of the application to the precise form disclosed. The claims set forth below are what is intended as the complete scope of the application. The disclosure set forth in the specification is to be considered in all respects as illustrative and not restrictive, with the scope of the application indicated by the appended claims.

[0298] The surgical instrument systems described herein have been described in connection with the deployment and deformation of staples; however, the embodiments described herein are not so limited. For example, various embodiments are envisioned that deploy fasteners other than staples, such as clips or tacks. Further, various embodiments are also envisioned that utilize any suitable device for sealing tissue. For example, an end effector according to various embodiments can include electrodes configured to heat and seal tissue. Additionally, for example, an end effector according to certain embodiments can apply vibrational energy to seal tissue.

[0299] Many of the surgical instrument systems described herein are actuated by electric motors; however, the surgical instrument systems described herein can be actuated in any suitable manner. In various instances, for example, the surgical instrument systems described herein can be actuated by manually operated triggers. In certain instances, the motors disclosed herein can comprise part or parts of a robotic control system. Further, any of the end effector and / or tool assemblies disclosed herein can be used with a robotic surgical instrument system. For example, U.S. Patent Application Serial No. 13 / 118,241, entitled SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS, now U.S. Patent No. 9,072,535, discloses several examples of robotic surgical instrument systems in greater detail.

[0300] The entire disclosure of the following patents is hereby incorporated by reference herein:

[0301] U.S. Patent 5,403,312, entitled “ELECTROSURGICAL HEMOSTATIC DEVICE”, published on April 4, 1995;

[0302] U.S. Patent 7,000,818, published on February 21, 2006, entitled “SURGICAL STAPLING INSTRUMENT HAVINGSEPARATE DISTINCT CLOSING AND FIRING SYSTEMS”;

[0303] U.S. Patent 7,422,139, published on September 9, 2008, entitled “MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING INSTRUMENT WITH TACTILE POSITION FEEDBACK”;

[0304] U.S. Patent 7,464,849, entitled “ELECTRO-MECHANICAL SURGICAL INSTRUMENT WITH CLOSURE SYSTEM AND ANVIL ALIGNMENT COMPONENTS”, published on December 16, 2008;

[0305] U.S. Patent 7,670,334, published on March 2, 2010, entitled “SURGICAL INSTRUMENT HAVING AN ARTICULATINGEND EFFECTOR”;

[0306] U.S. Patent 7,753,245, entitled “SURGICAL STAPLING INSTRUMENTS”, published on July 13, 2010;

[0307] U.S. Patent 8,393,514, entitled “SELECTIVELY ORIENTABLE IMPLANTABLE FASTENER CARTRIDGE”, published on March 12, 2013;

[0308] U.S. Patent Application Serial No. 11 / 343,803 entitled “SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES” is now U.S. Patent No. 7,845,537.

[0309] U.S. Patent Application Serial No. 12 / 031,573, entitled SURGICAL CUTTING AND FASTENING INSTRUMENT HAVING RF ELECTRODES, filed February 14, 2008;

[0310] U.S. Patent Application Serial No. 12 / 031,873, entitled END EFFECTORS FOR A SURGICAL CUTTING AND STAPLING INSTRUMENT, filed February 15, 2008, now U.S. Patent No. 7,980,443;

[0311] U.S. Patent Application Serial No. 12 / 235,782, entitled MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT, now U.S. Patent No. 8,210,411;

[0312] U.S. Patent Application Serial No. 12 / 235,972, entitled MOTORIZED SURGICAL INSTRUMENT, now U.S. Patent No. 9,050,083;

[0313] U.S. Patent Application Serial No. 12 / 249,117, entitled POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY RETRACTABLE FIRING SYSTEM, now U.S. Patent No. 8,608,045;

[0314] U.S. Patent Application Serial No. 12 / 647,100, entitled MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT WITH ELECTRIC ACTUATOR DIRECTIONAL CONTROL ASSEMBLY, filed December 24, 2009, now U.S. Patent No. 8,220,688;

[0315] U.S. Patent Application Serial No. 12 / 893,461, entitled STAPLE CARTRIDGE, filed September 29, 2012, now U.S. Patent No. 8,733,613;

[0316] U.S. Patent Application Serial No. 13 / 036,647, entitled SURGICAL STAPLING INSTRUMENT, filed February 28, 2011, now U.S. Patent No. 8,561,870;

[0317] U.S. Patent Application Serial No. 13 / 118,241 entitled “SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS” is now U.S. Patent No. 9,072,535.

[0318] U.S. Patent Application Serial No. 13 / 524,049, entitled “ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE”, filed on June 15, 2012, is now U.S. Patent No. 9,101,358.

[0319] U.S. Patent Application Serial No. 13 / 800,025, entitled “STAPLE CARTRIDGE TISSUE THICKNESS SENSORSYSTEM”, filed on March 13, 2013, is now U.S. Patent No. 9,345,481.

[0320] U.S. Patent Application Serial No. 13 / 800,067, entitled “STAPLE CARTRIDGE TISSUE THICKNESS SENSORSYSTEM”, filed on March 13, 2013, is now published as U.S. Patent Application 2014 / 0263552.

[0321] U.S. Patent Application No. 2007 / 0175955, filed January 31, 2006, entitled “SURGICAL CUTTING AND FASTENING INSTRUMENT WITH CLOSURE TRIGGER LOCKING MECHANISM”; and

[0322] U.S. Patent Application No. 2010 / 0264194, entitled “SURGICAL STAPLING INSTRUMENT WITH ANARTICULATABLE END EFFECTOR”, filed on April 22, 2010, is now U.S. Patent No. 8,308,040.

[0323] While various devices have been described herein with regard to certain embodiments, many modifications and variations to these embodiments can be implemented. In one or more embodiments, specific features, structures, or characteristics described herein can be combined in any suitable manner. Thus, the specific features, structures, or characteristics described herein in connection with one embodiment can be combined in any suitable manner with the features, structures, or characteristics of one or more other embodiments. Also, where materials are disclosed for certain components, other materials can be used. Moreover, according to various embodiments, a single component can be replaced with multiple components, and multiple components can be replaced with a single component to perform the same functions. The foregoing description and the following claims are intended to cover all such modifications and variations.

[0324] The devices disclosed herein can be designed to be disposed of after a single use, or they can be designed to be used multiple times. In either case, however, a device can be reconditioned for reuse after at least one use. Reconditioning can include any combination of the steps including, but not limited to, disassembly of the device, followed by cleaning and / or replacement of particular pieces, and subsequent reassembly of the device. In particular, a reconditioning facility and / or surgical team can disassemble a device and, after cleaning and / or replacing particular parts of the device, can reassemble the device for subsequent use. Those skilled in the art will appreciate that reconditioning of a device can utilize a variety of techniques for disassembly, cleaning / replacement, and reassembly. Use of such techniques, and the resulting reconditioned device, are all within the scope of the present application.

[0325] The devices disclosed herein can be processed before surgery. First, a new or used instrument can be obtained and, if necessary, cleaned. The instrument can then be sterilized. In one sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and instrument can then be placed in a field of radiation that can penetrate the container, such as gamma radiation, x-rays, and / or high-energy electrons. The radiation can kill bacteria on the instrument and in the container. The sterilized instrument can then be stored in the sterile container. The sealed container can keep the instrument sterile until it is opened in the medical facility. Any other techniques known in the art to sterilize instruments can also be utilized, including but not limited to beta radiation, gamma radiation, ethylene oxide, plasma, and / or steam.

[0326] While this application has been described as taking an exemplary design, the present application can be further modified within the spirit and scope of the disclosure. This application is therefore intended to cover any variations, uses, or adaptations of the application using its general principles.

Claims

1. A surgical instrument, comprising: a surgical end effector comprising a firing member supported for axial travel within said surgical end effector; an upper chain drive assembly operably interfacing with a top portion of said firing member and having an upper proximal end and an upper distal end; a lower chain drive assembly operably interfacing with a bottom portion of said firing member and having a lower proximal end and a lower distal end; and a drive member, wherein said drive member operably interfaces with said upper chain drive assembly and said lower chain drive assembly to cause said upper chain drive assembly and said lower chain drive assembly to apply axial drive motions to said firing member to thereby move said firing member within said surgical end effector between a starting position and an ending position; and a coupler, wherein said upper proximal end is coupled to said lower proximal end by said coupler, wherein said coupler is supported in operable engagement with a proximal support member that facilitates movement of said coupler and said upper chain drive assembly and said lower chain drive assembly, and wherein said proximal support member is configured to axially translate with axial translation of said upper chain drive assembly and said lower chain drive assembly. said upper chain drive assembly comprises a plurality of upper chain link features movably interconnected by an upper flexible member, and wherein said lower chain drive assembly comprises a plurality of lower chain link features movably interconnected by a lower flexible member.

2. The surgical instrument of Claim 1, wherein, 3. The surgical instrument of Claim 2, further comprising: an upper tensioner attached to a proximal end of said upper flexible member to maintain variable tension in said upper chain drive assembly; and a lower tensioner attached to a proximal end of said lower flexible member to maintain variable tension in said lower chain drive assembly. each said upper chain link feature comprises an upper sphere, and wherein each said lower chain link feature comprises a lower sphere. said articulation joint is configured to facilitate selective articulation of said surgical end effector relative to said elongate shaft, wherein said drive member operably interfaces with said upper chain drive assembly at an upper position, wherein said drive member operably interfaces with said lower chain drive assembly at a lower position, and wherein said upper position and said lower position are distal to said articulation joint.

4. The surgical instrument of claim 2, wherein, said articulation joint comprises a poly-axial articulation joint.

5. The surgical instrument of Claim 1, further comprising an elongate shaft coupled to said surgical end effector by an articulation joint, wherein, said drive member comprises a drive tube, wherein said drive tube is supported for axial travel within said elongate shaft, wherein said drive tube is configured to operably interface with said upper chain drive assembly and said lower chain drive assembly to cause said upper chain drive assembly and said lower chain drive assembly to apply axial drive motions to said firing member to thereby move said firing member within said surgical end effector between a starting position and an ending position.

6. The surgical instrument of claim 5, wherein, said drive tube comprises a proximal end and a distal end, wherein said proximal end is supported for axial travel within said elongate shaft, wherein said distal end is supported for axial travel within said surgical end effector, and wherein said proximal end is configured to operably interface with said upper chain drive assembly and said lower chain drive assembly to cause said upper chain drive assembly and said lower chain drive assembly to apply axial drive motions to said firing member to thereby move said firing member within said surgical end effector between a starting position and an ending position. said proximal support member comprises a proximal end and a distal end, wherein said proximal end is supported for axial travel within said elongate shaft, wherein said distal end is supported for axial travel within said surgical end effector, and wherein said proximal support member is configured to axially translate with axial translation of said upper chain drive assembly and said lower chain drive assembly. said proximal support member comprises a proximal end and a distal end, wherein said proximal end is supported for axial travel within said elongate shaft, wherein said distal end is supported for axial travel within said surgical end effector, and wherein said proximal support member is configured to axially translate with axial translation of said upper chain drive assembly and said lower chain drive assembly. said proximal support member comprises a proximal end and a distal end, wherein said proximal end is supported for axial travel within said elongate shaft, wherein said distal end is supported for axial travel within said surgical end effector, and wherein said proximal support member is configured to axially translate with axial translation of said upper chain drive assembly and said lower chain drive assembly.

7. The surgical instrument of Claim 1, wherein, a proximal upper portion of the upper chain drive assembly proximal of the drive member is loosely coupled together, wherein an upper distal portion of the upper chain drive assembly distal of the drive member is compressed into a substantially rigid upper state configured to be capable of imparting an upper axial drive motion to the firing member, wherein a lower proximal portion of the lower chain drive assembly proximal of the drive member is loosely coupled together, wherein a lower distal portion of the lower chain drive assembly distal of the drive member is compressed into a substantially rigid lower state configured to be capable of imparting a lower axial drive motion to the firing member.

8. The surgical instrument of Claim 1, wherein, the upper distal end operably interfaces with the top portion of the firing member, wherein the lower distal end operably interfaces with the bottom portion of the firing member.

9. The surgical instrument of claim 5, wherein, the drive member is positioned between the upper chain drive assembly and the lower chain drive assembly, and wherein the drive member is supported in a position distal of the articulation joint.

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