Surgical instrument having a dual pivot articulation joint arrangement

Abstract

Surgical instruments having articulating joints comprising a proximal joint member having a proximal face defining an arcuate proximal tip and a distal joint member having a distal face defining an arcuate distal tip are provided. First and second links are coupled to the proximal and distal joint members such that they cross one another with the arcuate distal tip facing the arcuate proximal tip.

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, 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 end effectors that are articulatable 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 a partial 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 FIG. 1;

[0011] Figure 7 Figure 6 another exploded assembly view of the elongate shaft assembly of FIG. 1;

[0012] Figure 8 exploded assembly view of the firing system and rotary drive system according to at least one aspect of the present disclosure;

[0013] Figure 9 side view of the firing member, upper flexible spine assembly, and lower flexible spine assembly of the firing system engaged with the rotary drive screw of the rotary drive system of FIG. 1; Figure 8

[0014] Figure 10 cross-sectional view of the firing member and upper and lower flexible spine assemblies of FIG. 1; Figure 9

[0015] Figure 11 side elevational view of the firing member and upper and lower flexible spine assemblies engaged with the rotary drive screw of the rotary drive system of FIG. 1; Figure 9

[0016] Figure 12 cross-sectional end view of the surgical end effector of FIG. 1 taken along line 12-12 thereof; Figure 4 Figure 4

[0017] Figure 13 exploded perspective view of two adjacent upper vertebral members of the upper flexible spine assembly of FIG. 1; Figure 10

[0018] Figure 14 exploded perspective view of two adjacent lower vertebral members of the lower flexible spine assembly of FIG. 1; Figure 10

[0019] Figure 15 top view of the firing member and upper and lower flexible spine assemblies engaged with the rotary drive screw of the rotary drive system of FIG. 1; Figure 9

[0020] Figure 16 perspective view of the CV drive shaft assembly of the rotary drive system of FIG. 1 in an articulated orientation; Figure 8

[0021] Figure 17 perspective view of the firing system of FIG. 1 in driving engagement with the CV drive shaft assembly of FIG. 1 according to at least one aspect of the present disclosure; Figure 16 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 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 accordance with at least one aspect of the present disclosure articulated in a first direction relative to a portion of an elongate shaft assembly Figure 27 is a top view of the surgical end effector of FIG. 1;

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

[0035] Figure 31 is an articulating surgical end effector in accordance with at least one aspect of the present disclosure articulated in multiple planes relative to a portion of an elongate shaft assembly 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] is a partial cross-sectional view of a portion of the surgical instrument of FIG. 1; Figure 36 Figure 19 Figure 19 is a partial cross-sectional view of a portion of the surgical instrument of FIG. 1;

[0041] Figure 37 is a partial cross-sectional view of a portion of the surgical instrument of FIG. 1; Figure 19

[0042] is a partial cross-sectional view of a portion of the surgical instrument of FIG. 1; Figure 38 Figure 19 ​​​​​A side view of a portion of the surgical end effector of a surgical instrument, wherein the anvil of the surgical end effector is in the open position, and some parts of the surgical end effector are omitted for clarity;

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[0064] Figure 60 yes Figure 59another 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 a perspective view of a portion of theFigure 70 A cross-sectional side view of the rotating drive nut engaged with the drive component of a surgical instrument;

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

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

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

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

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

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

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

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

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

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

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

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

[0089] Figure 85 is a perspective view of a portion of another flexible firing drive assembly usable 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 usable 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 top view of the articulation joint of

[0095] Figure 91 is a perspective view of the articulation joint of Figure 89 as well as a cable-controlled closure pulley system for applying closure motions to an anvil of the surgical end effector of Figure 89

[0096] is a perspective view of a portion of the surgical end effector of Figure 92 articulated through the articulation joint of Figure 89 Figure 89 is another perspective view of the cable-controlled closure pulley system of

[0097] Figure 93 Figure 91 is an end view of a pulley unit of the cable-controlled pulley system of

[0098] Figure 94 is a side elevational view of a first transverse alpha wrap pulley of the pulley unit of Figure 93

[0099] is a side elevational view of a second transverse alpha wrap pulley of the pulley unit of Figure 95 Figure 94 is a side elevational view of a third transverse alpha wrap pulley of the pulley unit of

[0100] ​​​​​​​Figure 96 is a side cross-sectional view of a portion of the surgical end effector of Figure 89 , wherein the anvil 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 center 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 center joint member of the articulation joint and moves through a second articulation plane;

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

[0105] Figure 101 is another perspective view of the firing drive system of Figure 100 , wherein the upper link feature and the lower 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 link feature and the lower 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 perspective view of the first drive shaft segment and the second drive shaft segment of the rotary drive system of Figure 105 ;

[0111] Figure 107 is a perspective view of a surgical end effector of Figure 87 , wherein the rotary drive system is in an articulated orientation;

[0112] Figure 108 is a perspective view of a surgical end effector of Figure 87 , wherein the rotary drive system is in an articulated orientation;

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

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

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

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

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

[0118] Figure 114 is another partial elevational side view of a surgical instrument and cable tensioning system of Figure 113 , wherein the surgical end effector is in an articulated orientation;

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

[0120] Figure 116 is a perspective view of a portion of a surgical instrument of Figure 115 , wherein a surgical end effector portion of the portion of the surgical instrument is in an articulated position relative to an elongate shaft portion of the portion of the surgical instrument;

[0121] Figure 117 is a perspective view of a portion of a surgical instrument of Figure 116a side elevational view of the surgical end effector of

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

[0145] Figure 141 is a perspective view of an articulation joint of a surgical instrument of Figure 140 in a non-articulation orientation;

[0146] Figure 142 is another perspective view of an articulation joint of Figure 141 in another articulation orientation;

[0147] Figure 143 isFigure 141 exploded perspective view of the articulation joint of the

[0148] Figure 144 is a top view of the articulation joint of the Figure 141

[0149] Figure 145 is a cross-sectional view of the articulation joint of the Figure 144 Figure 144

[0150] Figure 146 is a side elevational view of the articulation joint of the Figure 144

[0151] Figure 147 is another side elevational view of the articulation joint of the Figure 146

[0152] Figure 148 is a perspective view of the articulation joint of the Figure 141

[0153] Figure 149 is another perspective view of the articulation joint of the Figure 141

[0154] Figure 150 is an end view of a proximal joint member of the articulation joint of the Figure 141

[0155] Figure 151 is an end view of a distal joint member of the articulation joint of the Figure 141

[0156] Figure 152 is a perspective view of a proximal cross pin assembly of the articulation joint of the Figure 141

[0157] Figure 153 is a perspective view of another articulation joint implementation;

[0158] Figure 154 is a perspective view of an articulation joint portion of another surgical instrument implementation;

[0159] Figure 155 is another perspective view of the articulation joint arrangement of the Figure 154

[0160] Figure 156 is an exploded perspective assembly view of the articulation joint arrangement and the firing drive system of the surgical instrument of the Figure 154 ​​​​​​​​​​​​

[0161] Figure 157 is Figure 156 a perspective view of the articulation joint and firing system arrangement of

[0162] Figure 158 is Figure 157 another perspective view of the articulation joint and firing system of

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

[0164] Figure 160 is Figure 154 a partial view of a proximal differential drive assembly of the surgical instrument embodiment of

[0165] Figure 161 is Figure 160 a cross-sectional end view through the proximal differential drive assembly of

[0166] Figure 162 is Figure 154 a side elevational view of the articulation joint and distal differential drive assembly of the surgical instrument of

[0167] Figure 163 is Figure 162 another side elevational view of the articulation joint and distal differential drive assembly of

[0168] Figure 164 is Figure 154 a partial graphical representation of the reaction forces acting on the push coil of the surgical instrument of when the articulation joint of the surgical instrument is in an articulated orientation and the firing member is being advanced distally;

[0169] Figure 165 is Figure 154 another partial graphical representation of the reaction forces acting on the flexible outer tube of the surgical instrument of when the articulation joint of the surgical instrument is in an articulated orientation;

[0170] Figure 166 is Figure 154 a perspective view of the center link member and flexible joint support assembly of the surgical instrument of

[0171] Figure 167 is Figure 154 a side elevational view of the articulation joint of the surgical instrument of in an unarticulated orientation;

[0172] Figure 168 is Figure 167articulation joint of the surgical instrument of FIG. 1 in a partially articulated orientation; Figure 167

[0173] Figure 169 is a perspective view of another articulation joint embodiment of a surgical instrument; Figure 154

[0174] Figure 170 is a perspective view of another articulation joint embodiment of a surgical instrument;

[0175] Figure 171 is a side view of the articulation joint of FIG. 1 in a non-articulated orientation; Figure 170

[0176] Figure 172 is another side view of the articulation joint of FIG. 1 partially articulated in a first articulation direction; Figure 170

[0177] Figure 173 is another side view of the articulation joint of FIG. 1 fully articulated in a first articulation direction; Figure 170

[0178] Figure 174 is another side view of the articulation joint of FIG. 1 showing a virtual pivot point when the articulation joint is in a non-articulated orientation and the position of the first pair of links; Figure 170

[0179] Figure 175 is another side view of the articulation joint and links of FIG. 1 partially articulated in a first articulation direction; Figure 170

[0180] Figure 176 is another side view of the articulation joint of FIG. 1 showing a virtual pivot point and wherein the links are omitted for clarity; Figure 174

[0181] Figure 177 is another side view of the articulation joint of FIG. 1 partially articulated in a first articulation direction; Figure 174

[0182] Figure 178 is a perspective view of another articulation joint embodiment of a surgical instrument;

[0183] Figure 179 is an exploded assembly view of the articulation joint of FIG. 1 ; and Figure 178

[0184] Figure 180 is an exploded assembly view of the articulation joint of FIG. 1 ; and Figure 178 ​​​​​​​​​​FIG. 7 is a perspective view of an articulation joint of the surgical instrument of FIG. 1, showing the cable control path. DETAILED DESCRIPTION

[0185] 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:

[0186] U.S. Patent Application entitled SURGICAL INSTRUMENTS WITH TORSION SPINE DRIVE ARRANGEMENTS, Attorney Docket No. END9248USNP1 / 200084-1 ;

[0187] U.S. Patent Application entitled SURGICAL INSTRUMENTS WITH FIRING MEMBER CLOSURE FEATURES, Attorney Docket No. END9248USNP2 / 200084-2;

[0188] U.S. Patent Application entitled SURGICAL INSTRUMENTS WITH SEGMENTED FLEXIBLE DRIVE ARRANGEMENTS, Attorney Docket No. END9248USNP3 / 200084-3;

[0189] U.S. Patent Application entitled SURGICAL INSTRUMENTS WITH FLEXIBLE BALL CHAIN DRIVE ARRANGEMENTS, Attorney Docket No. END9248USNP4 / 200084-4;

[0190] U.S. Patent Application entitled SURGICAL INSTRUMENTS WITH DOUBLE SPHERICAL ARTICULATION JOINTS WITH PIVOTABLE LINKS, Attorney Docket No. END9248USNP5 / 200084-5;

[0191] U.S. Patent Application entitled SURGICAL INSTRUMENTS WITH COMBINATION FUNCTION ARTICULATION JOINT ARRANGEMENTS, Attorney Docket No. END9248USNP7 / 200084-7;

[0192] U.S. Patent Application entitled METHOD OF OPERATING A SURGICAL INSTRUMENT, Attorney Docket No. END9248USNP8 / 200084-8M;

[0193] U.S. Patent Application entitled SURGICAL INSTRUMENTS WITH DUAL SPHERICAL ARTICULATION JOINT ARRANGEMENTS, Attorney Docket No. END9248USNP9 / 200084-9;

[0194] U.S. Patent Application entitled SURGICAL INSTRUMENTS WITH FLEXIBLE FIRING MEMBER ACTUATOR CONSTRAINT ARRANGEMENTS, Attorney Docket No. END9248USNP10 / 200084-10;

[0195] U.S. Patent Application entitled ARTICULATABLE SURGICAL INSTRUMENTS WITH ARTICULATION JOINTS COMPRISING FLEXIBLE EXOSKELETON ARRANGEMENTS, Attorney Docket No. END9248USNP11 / 200084-11; and

[0196] U.S. Patent Application entitled SURGICAL INSTRUMENTS WITH DIFFERENTIAL ARTICULATION JOINT ARRANGEMENTS FOR ACCOMMODATING FLEXIBLE ACTUATORS, Attorney Docket No. END9248USNP12 / 200084-12.

[0197] Numerous specific details are set forth herein to provide a thorough understanding of the overall structure, functioning, manufacture, and use of the embodiments described and shown in the specification. Well-known operations, components, and elements are not described in detail to avoid obscuring the embodiments described in the specification. The reader will understand that the embodiments described and shown herein are non-limiting examples, and thus can recognize that the particular structural and functional details disclosed herein are representative and illustrative. Variations and changes can be made to these embodiments without departing from the scope of the claims.

[0198] 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.

[0199] 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.

[0200] 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.

[0201] Unless otherwise indicated herein, the numerical values listed herein are not intended to be limited to the precise range expressed and are meant to be used in a generic sense. The word "about" when accompanying a numerical value, means that the value is intended to be approximate, not exact. Similarly, when used in reference to a physical feature, the approximate word such as "about" or "substantially" is to be interpreted to mean a range of deviation that a person of ordinary skill in the art would understand to be acceptable for the corresponding use, function, purpose, etc.

[0202] 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. No language in the specification should be construed as indicating any non-claimed element as essential.

[0203] 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.

[0204] 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 internal diameter of the cannula of the trocar needle inevitably limits the size of the end effector and drive support shaft of a surgical instrument that can be inserted through the trocar needle.

[0205] 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 is desirable to employ a surgical end effector having as large an articulation range as possible.

[0206] 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 are operably interfaced 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 be operably passed 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.

[0207] Accordingly, the aforementioned size constraints present a number of challenges to developing articulation systems that can achieve the desired articulation range, yet are also suitable for operating the various different drive systems required 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.

[0208] There are a variety of surgical end effectors that are 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.

[0209] 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.

[0210] 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 cavities. The drivers are retained in the cartridge body by a retainer that extends around the bottom of the cartridge body and includes resilient members that are configured to grasp the cartridge body and retain the retainer to the cartridge body. The drivers are movable between their 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 that are configured to slide under the drivers and lift the drivers toward the anvil, and the staples are supported on the drivers.

[0211] In addition to the above, in these surgical end effectors, the sled is moved distally by a firing member. The firing member is configured to contact the sled and push the sled toward the distal end. A longitudinal slot defined in the cartridge body is configured to receive the firing member. The anvil further includes a slot configured to receive the firing member. The firing member further includes a first cam that engages the first jaw and a second cam that engages the second jaw. As the firing member is advanced distally, the first and second cams can control the distance between the deck of the staple cartridge and the anvil or the tissue gap. The firing member further includes a knife configured to cut tissue captured intermediate the staple cartridge and the anvil. It is desirable for the knife to be positioned at least partially proximate the ramped surface such that staples are ejected prior to the knife.

[0212] Many surgical end effectors employ a firing beam that is axially movable that is attached to and used to apply axial firing and retraction motions to a 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.

[0213] 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 that 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.

[0214] Figures 1-4A form of 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 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.

[0215] 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".

[0216] In the illustrated arrangement, the second jaw 1200 includes an anvil 1210, which includes an elongated anvil body 1212, comprising a proximal end 1214 and a distal end 1216. In one arrangement, a pair of reinforcing bars or members 1213 may be supported in the anvil body 1212 to provide increased stiffness and rigidity to the anvil body 1212. The anvil body 1212 includes a staple-formed lower surface 1218 facing the first jaw 1100 and may include a series of staple-formed recesses (not shown) corresponding to each of the staples or fasteners in the surgical staple cartridge 1300. The anvil body 1212 may also include a pair of downwardly extending tissue stop features 1220 formed adjacent to the proximal end 1214 of the anvil body 1212. A tissue stop feature 1220 extends from each side of the anvil body 1212, such that the distal end 1222 of each tissue stop corresponds to the nearest side staple / fastener in the surgical cartridge 1300. When the anvil 1210 moves to the closed position toward the tissue positioned between the staple-forming lower surface 1218 of the anvil 1210 and the cartridge platform surface 1306 of the surgical cartridge 1300, the tissue contacts the distal end 1222 of the tissue stop feature 1220 to prevent proximal movement of the tissue past the nearest side staple / fastener, thereby ensuring that the cut tissue is also sutured. When the surgical cartridge is “fired,” as will be discussed in further detail below, the staple / fastener supported within each cavity is driven out of the cavity 1308, through the clamped tissue, and into contact with the staple-forming lower surface 1218 of the anvil 1210.

[0217] 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 2-5pivot about a pivot axis PA between an open position and a closed position. The pivot axis PA is translatable between the open and closed positions. The pivot axis PA is fixed in the sense that it does not translate or otherwise move when the anvil 1200 is pivoted from the open position to the closed position.

[0218] 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., hand-held unit, 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.

[0219] As discussed above, many surgical end effectors employ a firing member that is distally pushed 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.

[0220] As can be seen in Figures 5-11As can be seen, in at least one embodiment, the firing system 2300 includes a firing member 2310 that includes a vertically extending firing member body 2312 that includes a top firing member feature 2320 and a bottom firing member feature 2350. A tissue-cutting knife 2314 is attached to or formed in the vertically extending firing member body 2312. See Figure 9 and Figure 11 In at least one arrangement, it is desirable for the firing member 2310 to pass through the anvil body 1212 with low friction, high strength, and high stiffness. In the illustrated arrangement, the top firing member feature 2320 includes a top tubular body 2322 having a top axial conduit 2324 extending therethrough. See Figure 10 The bottom firing member feature 2350 includes a bottom tubular body 2352 having a bottom axial conduit 2354 extending therethrough. In at least one arrangement, the top firing member feature 2320 and the bottom firing member feature 2350 are integrally formed with the vertically extending firing member body 2312. As Figure 12 As can be seen, 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.

[0221] Conventional firing member arrangements employ long, flexible cantilevered wings that extend from the top and bottom portions of the firing member. These cantilevered wings slideably pass through slots in the anvil and channel that are typically cut with a rectangular t-shaped cutter, which tends to create a higher friction surface. Such long cantilevered wings have a minimum surface area in contact with the anvil and channel and can result in these components being scuffed. The keyhole shaped channel slot 1140 and keyhole shaped anvil slot 1240 can be cut with a circular t-shaped cutter and can be finished with a reamer / drill, which will result in a lower friction surface. Furthermore, 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.

[0222] 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.

[0223] 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.

[0224] 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.

[0225] As Figure 14 As can be seen in FIG. 27, 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.

[0226] Turning now to Figure 5 , Figure 7 and Figure 8In at least one arrangement, the firing drive system 2300 further includes a rotary drive screw 2700 that is configured to drivingly interface with the upper series 2410 of the upper vertebral members 2420 and the lower series 2510 of the lower vertebral members 2520. In the illustrated arrangement, the rotary drive screw 2700 is driven by a rotary drive system 2600 that includes a proximal rotary drive shaft 2610 that is rotatably supported within an axial channel 2126 within the proximal support shaft 2120. See Figure 7 . The proximal rotary drive shaft 2610 includes a proximal end 2612 and a distal end 2614. The proximal end 2612 is interfaceable with a gear box 2004 or other arrangement driven by a motor 2006 or other source of rotary motion housed in the housing of the surgical instrument. See Figure 2 . Such a source of rotary motion causes the proximal rotary drive shaft to rotate about a shaft axis SA within the axial channel 2126 in the proximal support shaft 2120.

[0227] The proximal rotary drive shaft 2610 is operably supported within the elongate shaft assembly 2000 at a location proximal of 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.

[0228] 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 spherical 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, the distal-most drive joint 2650D of the series 2640 of movably coupled drive joints 2650 is movably coupled to a distal CV drive shaft 2670.

[0229] 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.

[0230] 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.

[0231] 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 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.

[0232] To prevent the drive joints 2650 from flexing during articulation, the series 2640 of movably coupled drive joints 2650 extend through at least one low-friction articulation joint spring 2730 that is supported within the outer elastomeric joint assembly 2210. See Figure 19 . The articulation joint spring 2730 is sized relative to the drive joints 2650 such that a slight radial clearance is provided between the articulation joint spring 2730 and the drive joints 2650. The articulation joint spring 2730 is designed to axially carry articulation joint loads, which 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 slack. 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.

[0233] 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 / bushing that is 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.

[0234] As Figure 9 and Figure 10 As can be seen in FIGS. 23A and 23B, the top firing member feature 2320 on the firing member 2310 includes a distal upper firing member tooth section 2330 that corresponds to half of the upper teeth 2450 on each upper vertebral member 2420. In addition, a proximal upper firing member tooth 2336, which is identical to the upper teeth 2450 on each upper vertebral member 2420, is spaced apart from the distal upper firing member tooth section 2330. The distal upper firing member tooth section 2330 and the proximal upper firing member tooth 2336 can be integrally formed with the top firing member feature 2320 of the firing member 2310. Likewise, the bottom firing member feature 2350 of the firing member 2310 includes a distal lower firing member tooth 2360 and a proximal lower firing member tooth 2366 integrally formed on the bottom firing member feature 2350. For example, in at least one arrangement, the firing member 2310 with rigidly attached teeth 2330, 2336, 2360, and 2366 can be manufactured as one integral component at a time using conventional metal injection molding techniques.

[0235] 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.

[0236] 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 onto 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 onto the lower cable 2504. The lower cable 2504 extends through a lower hypotube 2533 supported in the proximal support shaft.

[0237] 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.

[0238] As noted above, when the upper vertebral members 2420 are arranged in the upper series 2410 and the lower vertebral members 2520 are arranged in the lower series 2510, the male protuberances and the female recesses in each vertebral member, as well as the compression-limiter springs, serve to maintain the upper and lower vertebral members in relative linear alignment for driving engagement by the rotary drive screw 2700. As can be seen in Figure 9 and Figure 10 When the upper vertebral members 2420 are in linear alignment, the upper teeth 2450 are spaced apart from one another by open spaces generally designated 2460 that 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 that facilitate driving engagement with the helical drive threads 2170 of the rotary drive screw 2700.

[0239] 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.

[0240] As Figure 23 can be seen, the helical drive thread 2710 is disposed about the screw body 2702 and functions to form a proximal threaded pocket feature 2712. The proximal threaded pocket feature 2712 is formed with a first pitch 2713 and the remaining portion of the helical drive thread 2710 is formed with a second pitch 2715 that is different than the first pitch 2713. In Figure 22 and Figure 23 , the region 2718 illustrates where the first pitch 2713 and the second pitch 2715 converge. In at least one embodiment, the first pitch 2713 is greater than the second pitch 2715 to ensure that the rotationally driven screw 2700 captures and “pockets” or drivingly engages each of the upper vertebral member 2420 and each of the lower vertebral member 2520. As Figure 24 can be seen, the proximal end 2717 of the helical drive thread 2710 having the first pitch 2713 has been pocketed into the open space 2560 between two adjacent lower vertebral member teeth 2550A and 2550B, while the central portion 2719 of the helical drive thread 2710 having the second pitch 2715 is drivingly engaged with the helical 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.

[0241] A power screw is a screw with a complete 360-degree nut surrounding it. Rotation of the power screw causes the nut to advance or move longitudinally. However, in this arrangement, due to space constraints, the complete 360-degree nut cannot be fitted within the end effector. In a general sense, the upper flexible ridge assembly 2400 and the lower flexible ridge assembly 2500 include radially / longitudinally segmented "power screw nuts" rotatably driven by a rotary drive screw 2700. When the rotary drive screw rotates in a first rotational direction, the rotary drive screw 2700 longitudinally drives one or more vertebral members in each of the upper and lower series of vertebral members, while the vertebral members 2420, 2520 remain in the same position radially. The upper series 2410 and the lower series 2510 are constrained to rotate about the rotary drive screw 2700 and can only move longitudinally. In one arrangement, the upper vertebral member 2420 in the upper series 2410 and the lower vertebral member 2520 in the lower series 2510 each rotate around the drive screw 2700 at an angle of less than ten degrees.

[0242] Figure 25 The firing element 2310 is shown in its original or initial position. (Example) Figure 25 As can be seen, a portion of the helical drive thread 2710 on the rotary drive screw 2700 engages between the distal upper firing member tooth section 2330 and the proximal upper firing member tooth 2336, and another portion of the helical drive thread 2710 engages between the distal lower firing member tooth 2360 and the proximal lower firing member tooth 2366 on the firing member 2310. This arrangement allows the rotary drive screw 2700 to precisely control the distal and proximal movement of the firing member 2310, as will be discussed in further detail below, which results in precise movement of the anvil 1210. Once the firing member 2310 has been sufficiently advanced distally during the firing stroke, the helical drive thread 2710 operatively engages the teeth on the upper and lower vertebrae. See also Figure 26 .

[0243] The surgical instrument 10 also includes an articulation system 2240 configured to apply articulation to the surgical end effector 1000, causing the surgical end effector to articulate relative to the elongated shaft assembly 2000. In at least one arrangement, for example, the articulation system includes four articulation cables 2242, 2246, 2250, and 2254 extending through the elongated shaft assembly 2000. See also Figure 27In the illustrated arrangement, articulation cables 2242, 2246 pass through proximal mounting bushing 2750, the proximal end 2214 of the elastomeric joint assembly 2210, and a central rib segment 2216 to be fixed to the distal end 2212 of the elastomeric joint assembly 2210 or other portion of the surgical instrument. Likewise, articulation cables 2250 and 2254 extend through proximal mounting bushing 2750, the proximal end 2214 of the elastomeric joint assembly 2210, and a central rib segment 2218 to be fixed to the distal end 2212 of the elastomeric joint assembly 2210 or other portion of the surgical end effector. Cables 2242, 2246, 2250, and 2254 are operably interfaced with an articulation control system supported in the housing of the surgical instrument 10. For example, a proximal portion of each cable 2242, 2246, 2250, and 2254 can be wrapped around a corresponding rotary spool or cable management system 2007 Figure 2 ) in the housing portion of the surgical instrument 10 that is configured to pay out and retract each cable 2242, 2246, 2250, and 2254 in a desired manner. The spool / cable management system can be motor driven or manually driven (ratchet arrangement, etc.). Figure 29 Articulation of the surgical end effector 1000 relative to the elongated shaft assembly 2000 and movement through a first articulation plane is shown. Figure 30 Articulation of the surgical end effector 1000 relative to the elongated shaft assembly 2000 and movement through a second articulation plane is shown. Figure 31 Articulation of the surgical end effector 1000 relative to the elongated shaft assembly 2000 and movement through a plurality of articulation planes is shown.

[0244] Figures 32-34 An alternative articulation joint 2200' in the form of an elastomeric joint assembly 2210' is shown. As Figure 33As can be seen, each joint motion cable passes through a corresponding spring 2215' in the rib 2216' of the elastomer joint assembly 2210'. For example, cable 2242 extends through spring 2244. Cable 2246 extends through spring 2248. Cable 2250 extends through spring 2252 and cable 2254 extends through spring 2256. As described above, the end effector is jointed by pulling and releasing the appropriate cables 2242, 2246, 2250, and 2254. To achieve a higher joint motion angle with greater joint stability, each of the springs 2244, 2248, 2252, and 2256 is slidable through the rib of the elastomer joint to push the end effector and pull the cable extending through that spring. 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.

[0245] 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 bend with the outer elastomeric joint assembly 2210. The upper sleeve 2470 protects the upper vertebral member 2420 from contacting the outer elastomeric joint assembly 2210, which is made of an elastomeric material that can have a higher coefficient of friction than the coefficient of friction of the material of the upper sleeve 2470. In other words, the upper sleeve 2470 forms a low-friction, flexible, continuous, uninterrupted, and fully encapsulated path for the upper vertebral member 2420 as it traverses the articulating joint 2200.

[0246] Similarly, lower sleeves 2570 are used to support the lower vertebral members 2520 as they pass through the articulation joint 2200. Distal ends 2572 of the lower sleeves 2570 are supported in the proximal end of the elongated channel, and the proximal ends of the lower sleeves 2570 are supported in the distal end of the proximal support shaft 2120. Like the upper sleeves 2470, the lower sleeves 2570 are made of a polymer or plastic material that has a low coefficient of friction and is flexible, to enable the lower sleeves 2570 to bend with the outer elastomeric joint assembly 2210. The lower sleeves 2570 protect 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 sleeves 2570 form a low-friction, flexible, continuous, uninterrupted, and fully encapsulated path for the lower vertebral members 2520 as they traverse the articulation joint 2200. In various embodiments, the upper sleeves 2470 and the lower sleeves 2570 are configured to bend freely without kinking. To prevent kinking in the sleeves, in at least one arrangement, the sleeves 2470, 2570 are supported within the outer elastomeric joint assembly 2210, such that the sleeves can move axially. For example, as the articulation joint is angled upward, the lower sleeves 2570 can slide distally and have a large bend radius; in the same example, the upper sleeves 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, the 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, the 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.

[0247] 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 or pivot cradles 1120 formed in the proximal end 1112 of the elongated channel 1110. The mounting pins 1232 are pivotally held within the mounting cradles 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 lockhole-shaped vertebral conduit 1266 extending therethrough to accommodate passage of the top firing member feature 2320 and the upper vertebral members 2420 therethrough. Figure 36The vertebrae conduit 1266 in the anvil top cover 1260 is shown. When the rotary drive screw 2700 applies a load to the upper vertebra member 2420, the vertebra member 2420 will tend to tilt about Figure 37 Region A in the graph shows where the upper vertebra member 2420 is tilting, so the upper vertebra member teeth 2450 are no longer at a right angle to the rotary drive screw 2700, but can instead experience higher pressure line contact. Figure 37 Region B in the graph shows where the upper vertebra member 2420 stops tilting. To ensure that most of the load remains in the longitudinal direction to perform useful work, the amount that the upper vertebra member teeth 2450 are angled must be the same as the amount that the upper vertebra member 2420 is tilted. Thus, when the upper vertebra member 2420 is tilted, the upper vertebra member teeth 2450 will still maintain surface contact with the helical drive member 2710 on the rotary drive screw 2700, and all of the load will be directed longitudinally rather than vertically. The slightly angled upper vertebra member teeth 2450 can behave like a square thread when the vertebra member 2420 is tilted, and better distribute the load to reduce pressure contact. By directing most of the load in the longitudinal direction, vertical loads are avoided that can cause friction to build up that would counteract the longitudinal load. The upper vertebra member 2420 reacts similarly as it passes through the lock hole shaped anvil slot 1240 downward. Likewise, the lower vertebra member 2520 reacts similarly as it passes through the lock hole shaped axial extension slot 1140 in the elongated channel 1110.

[0248] 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 .

[0249] 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 .

[0250] 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.

[0251] 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.

[0252] 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 rotary spools or cable management systems 2009 Figure 2 ) within a housing portion of the surgical instrument 10 that are 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 systems 2009 can be motor driven or manually driven (ratchet arrangements, etc.) to apply 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.

[0253] 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):

[0254]

[0255] If the above equation holds, the rotary drive screw 2700 can be self-locking. To a great extent, in many cases, for an endo-cutter, the pitch diameter is mostly fixed, but the lead and the angle of the teeth are variable. Because the upper vertebra member teeth 2450 and the lower vertebra member teeth 2550 are mostly square, the rotary drive screw 2700 is more likely to be back drivable (cos(90) = 1). The lead of the upper vertebra member teeth 2450 and the lower vertebra member teeth 2550 can also be advantageous because the rolling friction between the vertebra members 2420, 2520 and the rotary drive screw 2700 is more likely to enable the rotary drive screw 2700 to be back driven. Thus, in an emergency, the surgeon can pull on the upper cable 2404 and the lower cable 2504 in the proximal direction to fully retract the firing member 2310 for a quick“panic” withdrawal.

[0256] As described above, the housing 2002 can support relative control motions of the rotary drive system 2600 and various cable management systems employed in connection with the firing system 2300 and the articulation control system 2240, which housing can be hand-held or part of a larger automated surgical system. The firing system 2300, the articulation control system 2240, and the rotary drive system 2600 can be, for example, motor-controlled and operated by one or more control circuits.

[0257] 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 apply a second rotary motion to the rotary drive screw 2700, causing 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 .

[0258] 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.

[0259] 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.

[0260] 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 patient's body by reversing the steps described above. The surgical end effector 1000 can then be replaced with a new surgical end effector or the surgical end effector 1000 can be reused. 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.

[0261] 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.

[0262] 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 or pivot cradles 23120 formed in the proximal end 23112 of the elongate channel 23110. The mounting pins 23232 are pivotally retained within the mounting cradles 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 an arrangement facilitates 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.

[0263] 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 .

[0264] 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 channel 24126 that extends therethrough from the proximal end 24122 to the distal end 24124.

[0265] As discussed above, many surgical end effectors employ a firing member that is distally pushed 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.

[0266] 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 through the T-shaped body. 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 through the T-shaped body. 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.

[0267] 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.

[0268] 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 curved shape, and each distal end 24428 has an arcuate or slightly convex curved shape. When arranged in the upper series 24410, the convex distal end 24428 on one upper vertebral member 24420 contacts and 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.

[0269] 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.

[0270] 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 curved shape, and the distal end 24528 has an arcuate or slightly convex curved shape. When arranged in the inferior series 24510, the convex distal end 24528 on one inferior vertebral member 24520 contacts and mates with the concave proximal end 24524 on an adjacent inferior vertebral member 24520 in the inferior series 24510 to hold the inferior vertebral members 24520 in general alignment so that the helical proximal inferior face portion 24552 and the helical distal inferior face portion 24554 on each respective inferior vertebral member tooth 24550 can be drivingly engaged by the rotary drive screw 2700 in the various methods disclosed herein. These curved mating surfaces on the inferior vertebral members 24520 allow the inferior vertebral members 24520 to better transfer loads between them even when they are tilted.

[0271] 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.

[0272] According to at least one aspect, the large surface area facilitates distributing the force between the vertebral members as they are pushed, thereby making it impossible for the vertebral members to 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 if the firing drive system 24300 fails during the firing stroke.

[0273] 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.

[0274] 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 Figure 49 As seen in FIG. 21, each ring-shaped rib member 24810 includes a first or proximal face 24820 that includes a convex or domed portion 24822. Each ring-shaped rib member 24810 also includes a second or distal face 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 Figure 58 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.

[0275] As Figure 49As can be seen, the movable exoskeleton assembly 24800 includes a proximal attachment rib 24870 configured to attach the movable exoskeleton assembly 24800 to the distal end 24124 of the proximal support shaft 24120 via a headed screw 24880 or other suitable fastener arrangement. The proximal attachment rib 24870 includes a first or distal side 24872, which is concave or disc-shaped to receive or movably engage with a convex or dome-shaped portion 24822 of the proximal side 24820 of the nearest annular rib member 24810P. Similarly, the movable exoskeleton assembly 24800 includes a distal attachment rib 24890 configured to attach the movable exoskeleton assembly 24800 to the proximal end 23112 of the elongated channel 23110 via a headed screw 24882 or other suitable fastener. The distal attachment rib 24890 includes a first or proximal side 24892 comprising a convex or dome-shaped portion 24894 configured to be received in or movably engaged with the concave or disc-shaped distal side 24832 of the distal annular rib member 24810D. In various embodiments, the annular rib members 24810, 24810P, and 24810D may be made of any suitable metal (e.g., stainless steel, titanium, etc.) or other suitable materials. Annular rib members 24810, 24810P, and 24810D can be formed by suitable stretching or forming operations, by machining, or by casting. The proximal side 24820 and the distal side 24830 can be polished or otherwise finished to a desired smooth surface to reduce friction and facilitate movement between the annular rib members 24810, 24810P, and 24810D. According to one aspect, all edges on each annular rib member 24810, 24810P, and 24810D are rounded to facilitate relative movement between the annular rib members. The proximal attachment rib 24870 and the distal attachment rib 24890 can be formed with similar properties.

[0276] The surgical instrument 22010 also includes an articulation system 24240 configured to apply articulation to the surgical end effector 23000, causing the surgical end effector 23000 to articulate relative to the elongated shaft assembly 24000. In at least one arrangement, for example as described above, the articulation system 24240 includes four articulation cables 24242, 24246, 24250, and 24254 extending through the elongated shaft assembly 24000. See also Figure 61In 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 Figure 63 and Figure 2 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.

[0277] 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( Figure 59 ) 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.). Figure 60 articulation joint 24200 is shown in an unarticulated position, and Figure 49 articulation joint is shown in an articulated configuration. This arrangement permits the surgical end effector 23000 to be articulated relative to the elongated shaft assembly 24000 and to move through a plurality of articulation planes.

[0278] AsFigure 58 , Figure 64 and Figure 58 As can be seen, the surgical instrument 22010 employs a constant velocity (CV) drive shaft assembly 2620, which spans or extends axially through the articular motion joint 24200. The operation and configuration of the CV drive shaft assembly 2620 have been described in detail above and will not be repeated here except where necessary for understanding the operation of the surgical instrument 22010. In short, as discussed above, the CV drive shaft assembly 2620 includes a proximal CV drive assembly 2630 and a distal CV drive shaft 2670. The proximal CV drive assembly 2630 includes a proximal shaft segment 2632 formed by an attachment shaft 2634 configured to be non-rotatably received within a similarly shaped connector cavity 2616 in the distal end 2614 of the proximal rotary drive shaft 2610. The proximal shaft segment 2632 is operatively engaged with a series 2640 of movably coupled drive joints 2650. Figure 58 As can be seen from the preceding description, in order to ensure that the drive joints 2650 engage with each other, a proximal drive spring 2740 is used to apply an axial biasing force to the series 2640 of the drive joints 2650. For example, as Figure 63 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.

[0279] To further prevent the drive joint 2650 from buckling during joint movement, a series 2640 of the movably coupled drive joints 2650 extend through at least one low-friction drive cover 24730, which extends through a central drive conduit 24860 in each of the annular rib members 24810. Figure 65 and Figure 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 Figure 66 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. Figure 58 An alternative drive cover 24730' is shown that includes an inner cut hypotube 24732'. Figure 67 Figure 68 Figure 69 Figures 70-73 An alternative drive cover 24730" is shown that includes a flexure tube 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.

[0280] Various embodiments of the present disclosure provide advantages over prior surgical endoscopic cutter configurations that are capable of articulation. For example, pushing a firing member forward in an articulating end effector typically requires a significant amount of force and that force must be balanced. For example, when firing a firing member at an angle greater than sixty degrees, it becomes very difficult to push the beam through the articulation joint. The joint also experiences significant loading, which can cause the articulation joint to come out of articulation. By employing an upper flexible drive arrangement and a lower flexible drive arrangement (each of which is flexible as it passes through the articulation joint, but then becomes rigid as they are distal of the articulation joint), a large degree of articulation (e.g., articulation angles of more than seventy degrees) can be allowed while applying balanced loads to the firing member that are constrained to the firing member and not to the articulation joint. In other words, torsional loads are applied proximal of the articulation joint rather than longitudinal loads that can cause the end effector to come out of articulation. The torsional loads are converted to longitudinal loads at a location distal of the articulation joint. Thus, the rotary drive screw is used to effectively convert torsional motion or loads to longitudinal loads that are applied to the firing member at a location distal of the articulation joint.

[0281] ​​​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.

[0282] Figure 70 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.

[0283] 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.

[0284] 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. Figure 72The 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.

[0285] 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. 6 and 7. Figure 70 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. 6 and 7. Figure 72 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.

[0286] The rotary drive nut 4400 includes a proximal section 4410 and a distal section 4420. The threaded distal section 4420 is distal of the articulation joint 5200 and is configured to threadably engage a series 4600 of drive components 4610 that are slackly connected together by flexible tethers 4640. In at least one arrangement, for example, each drive component 4610 includes a vertically extending plate member 4612 that includes a top end 4614 and a bottom end 4618. The top end 4614 includes a top threaded section 4616 and the bottom end 4418 includes a bottom threaded section 4620. The top threaded section 4616 and the bottom threaded section 4620 are configured to threadably engage the threads 4430 of the rotary drive nut 4400. The series 4600 of drive components 4610 are configured to flexibly pass through the articulation joint 5200 and into a vertical conduit 5012 in the distal spine assembly 5010. Rotation of the rotary drive nut 4400 in a first rotational direction causes the series 4600 of drive components 4610 to move axially in a distal direction and rotation of the rotary drive nut 4400 in a second rotational direction will cause the series 4600 of drive components 4610 to move axially in a proximal direction.

[0287] Turning to Figure 72 In at least one arrangement, each drive component 4610 further includes a distally projecting latch feature 4630. Each latch feature 4360 is configured to be releasably received in a latching engagement within a latch cavity 4364 formed in an adjacent drive component 4610 immediately distal of the latch feature. When the drive components 4610 are latched together, they form an axially rigid series 4600AR of drive components for applying axial drive motions to the firing member 5310 to drive the firing member 5310 through the surgical end effector 4000 from a starting position to an ending position and back from the ending position to the starting position. As can be seen in Figures 73-76 As can be seen in FIGS. 27 and 28, when 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.

[0288] In the illustrated example, the drive components 4610 in the series 4600 of drive components are flexibly connected together, enabling them to move relative to one another to accommodate the articulation joint and obviate the need for reinforcing support plates that are typically needed when pushing a firing beam through an articulation joint. When the series of drive components 4610 enters and is 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.

[0289] Figure 74 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 the articulation joint 6200 and rigidly advance a firing member 6130 through the surgical end effector 6000 is shown. The surgical end effector 6000 can include a channel 6010 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.

[0290] Turning to Figure 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 further 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 when the spherical latch head 6634 is inserted through the tapered conduit 6338 and into the latch cavity 6636 as shown in FIG. 63. The spherical latch head 6634 is configured to be movable within the latch cavity 6636 to enable the series 6600 of drive components 6610 to be assembled in the movable continuous arrangement. The spherical latch head 6634 is further configured to be movable within the latch cavity 6636 to enable the series 6600 of drive components 6610 to be disassembled from the movable continuous arrangement. Figure 73The illustrated arrangement permits relative movement between the drive members 6610. However, when the drive members are axially aligned such that the distal face 6616 of one drive member 6610 is in abutting engagement with the proximal face 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.

[0291] As Figure 77 As can be seen in FIG. 27, 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.

[0292] Torsional loads applied to the firing system components as they traverse the articulation joint are less likely to disarticulate 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, disarticulation is prevented. Figure 78One 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 as 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.

[0293] Figure 79 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 as 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 flexible cables 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.

[0294] Figures 80-84 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 distally 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.

[0295] It is often difficult to push a firing beam forward in an articulating end effector and such force must be balanced. For example, it is often difficult to push a firing beam through an articulation joint that has been articulated to an angle greater than sixty degrees. When the firing beam traverses the articulation joint, the firing beam can place significant loads on the articulation joint components which can cause the articulation joint to unarticulate. Figures 80-82 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 can be seen in FIG. 73, Figure 84 As can be seen in FIG. 73, 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.

[0296] 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 Figure 80 .

[0297] 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 Figure 81 and Figure 82 . 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 Figures 80-83 , 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.

[0298] In the illustrated example, the firing drive system 7300 can also be used to apply opening and closing motions to the anvil 7032. As Figure 80 visible in FIGS. 73 and 74, 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 Figure 81 and Figure 85 . 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.

[0299] Figure 86 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. Figures 87-89 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.

[0300] 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. Moreover, 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.

[0301] Figure 88 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 large articulation angles and end effectors 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 herein in its entirety.

[0302] 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.

[0303] 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 within 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.

[0304] As Figure 87As can be seen, the proximal end 10214 of the anvil body 10212 includes an anvil mounting portion 10230 that includes a pair of laterally extending mounting pins 10232 that are configured to be received in corresponding mounting inserts 10130 that are configured to be held in receiving in mounting cradles 10120 formed in the proximal end 10112 of the elongate channel 10110. The mounting pins 10232 are pivotally received within pivot holes 10132 in the mounting inserts 10130 which are then inserted into their corresponding cradles 10120 and affixed to the elongate channel 10110 by welding, adhesive, snap engagement, etc. This arrangement facilitates pivotal travel of the anvil 10210 about a fixed (i.e., non-translating, non-moving) pivot axis PA relative to the elongate channel 10110. See Figure 89 .

[0305] In the illustrated arrangement, the elongate shaft assembly 12000 defines a shaft axis SA and includes a hollow outer tube (omitted for clarity) that is operably interfaced with a housing of a control portion (e.g., hand unit, robotic tool driver, etc.) of the surgical instrument 9010. The elongate shaft assembly 12000 further includes an articulation joint 12200 that is attachable to the hollow outer tube and the surgical end effector 10000 to facilitate selective articulation of the surgical end effector 10000 in multiple articulation planes about multiple articulation axes relative to the elongate shaft assembly 12000. In at least one arrangement, for example, the articulation joint 12200 includes a proximal joint member 12210, a central joint member 12230, and a distal joint member 12250. In one example, the central joint member 12230 is operably interfaced with the proximal joint member 12210 to enable the central joint member 12230 to be selectively articulated through a first or proximal articulation plane that is defined by a first or proximal articulation axis AA1 that is transverse to the shaft axis SA. Also in one example, the distal joint member 12250 is operably interfaced with the central joint member 12230 to enable the distal joint member 12250 to be selectively articulated through a second or distal articulation plane that is defined by a second or distal articulation axis AA2 that is transverse to the shaft axis SA and transverse to the first or proximal articulation axis AA1.

[0306] As Figure 90 and Figure 90As can be seen, the proximal joint member 12210 includes a proximal joint distal face 12212 that defines two spaced-apart lateral top end portions 12214, 12216. The top end portion 12214 defines a radial surface 12215, and the top end portion 12216 defines a radial surface 12217 Figure 89 The central joint member 12230 includes a proximal face 12232 that defines two spaced-apart lateral proximal top end portions 12234, 12236. The proximal top end portion 12234 defines a radial surface 12235, and the top end portion 12236 defines a radial surface 12237. As can be seen, Figure 88 As can be seen, the proximal face 12232 of the central joint member 12230 confronts the proximal joint distal face 12212 of the proximal joint member 12210, thereby enabling the central joint member 12230 to articulate and move through a first plane of articulation defined by a first or proximal articulation axis AA1 that extends between a point at which the lateral top end portion 12214 on the proximal joint member contacts the proximal top end portion 12234 on the central joint member 12230 and a point at which the lateral top end portion 12216 on the proximal joint member 12210 contacts the proximal top end portion 12236 on the central joint member 12230. In one arrangement, the radial surfaces 12215, 12217 on the lateral top end portions 12214, 12216, respectively, and the radial surfaces 12235 and 12237 on the proximal top end portions 12234, 12236, respectively, can act as rock- about points / surfaces about which the central joint member 12230 can articulate relative to the proximal joint member 12210. In addition, the central joint member 12230 includes a proximal first gear tooth segment that is configured to be rotatably engaged with the distal gear segments 12218, 12220 on the proximal joint member 12210. See Fig. 34. Figure 89 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.

[0307] The central joint member 12230 also includes a central joint distal face 12240 that defines a centrally disposed upper top end portion 12242 that forms an upper radial surface 12244 and a lower top end portion 12246 that forms a lower radial surface 12248. See Fig. 34. Figure 89The 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 12251 that confronts or confronts a central joint distal face 12240 on the central joint member 12230. See Figure 92 and Figure 89 As can be seen in Figure 92 and Figure 89 , the proximal face 12251 defines a centrally disposed upper tip portion 12252 that forms an upper radial surface 12254 that is configured to confront or abut an upper radial surface 12244 on the central joint member 12230. The proximal face 12251 also defines a centrally disposed lower tip portion 12256 that forms a lower radial surface 12258 that is configured to confront or abut a lower radial surface 12248 on the central joint member 12230. See Figure 92 The distal joint member 12250 also includes an upper gear tooth segment 12253 that is configured to rotatably mesh with an 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 a lower gear tooth segment 12245 on the central joint member 12230. See Figure 89 .

[0308] The distal joint member 12250 is configured for articulation and movement 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 confronts 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 confronts the lower tip portion 12246 on the central joint member 12230. See Figure 92 and Figure 88In one arrangement, radial surfaces 12254, 12258 on upper and lower tip portions 12252, 12256, respectively, of distal joint member 12250 and radial surfaces 12244 and 12248 on upper and lower tip portions 12242 and 12246, respectively, of central joint member 12230 can act as swing arm points / surfaces about which distal joint member 12250 can articulate relative to central joint member 12230. In an alternative arrangement, however, radial surface 12254 on distal joint member 12250 is spaced from radial surface 12244 on central joint member 12230 and radial surface 12258 on distal joint member 12250 is spaced from radial surface 12248 on central joint member 12230.

[0309] Returning to Figure 88 In 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 elongated 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 / driving 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.

[0310] As Figure 93 As can be seen, cables 12510, 12520, 12530, and 12540 are configured to operably interface with a closure system 12600 that is rotatably mounted in a proximal end 10112 of elongated 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 Figure 94 and Figure 88 Pulley unit 12610 is rotatably supported within proximal end 10112 of elongated channel 10110 by mounting brackets 12710 and 12720. See Figure 94More specifically, the proximal end 10112 of the elongated channel 10110 defines a firing member parking area 10140, which is proximal to the mounting bracket 10120 and configured to operably support the firing member 12310 when in the initial position. Each mounting bracket 12710, 12720 is mounted within the firing member parking area 10140 on each side of the axis SA, such that the firing member 12310 can be received in the parking area 10140 when in the initial position. The mounting brackets 12710, 12720 can be attached to the proximal end 10112 of the elongated channel 10110 by welding, adhesive, snap-fit ​​features, etc. Mounting bracket 12710 includes a first shaft bracket 12712 configured to rotatably support a first pivot shaft 12621 protruding from a first transverse α-winding pulley 12620, and a second mounting bracket 12720 includes a second shaft bracket 12722 configured to rotatably support a second pivot shaft 12644 protruding from a second transverse α-winding pulley 12630. Furthermore, each mounting bracket 12710, 12720 includes a release region 12732 shaped to receive the corresponding first α-winding pulley 12620 and second α-winding pulley 12630 therein.

[0311] like Figure 94 As can be seen, the first α-winding pulley 12620 includes a first circumferential groove 12622 and a second circumferential groove 12624. In the illustrated example, a first cable 12510 is received in and attached to the first circumferential groove 12622, and a second cable 12520 is received in and attached to the second circumferential groove 12624. Pulling the first cable 12510 will cause the first transverse α-winding pulley 12620 to rotate in a first direction, and pulling the second cable 12520 will cause the first transverse α-winding pulley 12620 to rotate in a second opposite direction. Similarly, the second transverse α-winding pulley 12630 includes a first circumferential groove 12632 and a second circumferential groove 12634. In the illustrated arrangement, a first cable 12540 is received in and attached to a first circumferential groove 12632, and a second cable 12520 is received in and attached to a second circumferential groove 12634. Pulling the fourth cable 12540 will cause the first and second α-winding pulleys 12630 to rotate in a first direction, and pulling the third cable 12530 will cause the second transverse α-winding pulley 12630 to rotate in a second opposite direction. The transverse α-winding pulleys 12620 and 12630 can rotate approximately 330 degrees. This range of rotation is significantly different from that of normal pulleys, which can have a range of rotation of less than 180 degrees.

[0312] 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 can be seen in Figure 96 FIG. 8, 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 thereto. Figure 97 The position of the screw closure cam 12626 on the first lateral alpha wrap pulley 12620 is shown when the anvil 10210 is biased to 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 to the Figure 96 closed position shown. To open the anvil 10210, the pulley unit 12610 is rotated in the opposite direction back to the Figure 91 position shown.

[0313] Referring now to Figure 93 and Figure 92 , 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 around two redirecting pulleys 12650, 12660 which are supported on shafts 12602, 12612 which are mounted in the center joint member 12230. The first cable 12510 exits the center 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 thereto. 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 loop around the redirecting pulleys 12650, 12660 in the center joint member 12230. The second cable 12520 exits the center joint member 12230 through a corresponding 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 thereto.

[0314] In the illustrated example, a third cable 12530 extends from the cable control system 9030 through the elongated shaft assembly 12000 and through corresponding conduits in the proximal connector member 12210, the central connector member 12230, and the distal connector member 12250, to be received in a corresponding circumferential groove in the second transverse α-winding pulley 12630, where the third cable is attached to the corresponding circumferential groove. Furthermore, a fourth cable 12540 extends from the cable control system 9030 through the elongated shaft assembly 12000 and through corresponding conduits in the proximal connector member 12210, the central connector member 12230, and the distal connector member 12250, to be received in a corresponding circumferential groove in the second transverse α-winding pulley 12630, where the fourth cable is attached to the corresponding circumferential groove.

[0315] In at least one example, to articulate the surgical end effector 10000 relative to the elongated shaft assembly 12000 and through a first articulation plane defined by a first articulation axis AA1, the cable control system 9030 is actuated to simultaneously pull the second cable 12520 and the fourth cable 12540, wherein equal amounts of tension are applied to each cable 12520 and 12540. Because equal amounts of tension are applied to both sides of the pulley unit 12610, the pulley unit 12610 does not rotate. However, the pulling action of the cables 12520 and 12540 is transferred to the surgical end effector 10000 via the articulation joint 12200, which causes the central joint member 12230 to articulate relative to the proximal joint member 12210 about the first articulation axis AA1. See also Figure 98 and Figure 92 To enable the surgical end effector 10000 to articulate and move through a second joint motion plane defined by the second joint motion axis AA2 and transverse to the first joint motion plane, the cable control system 9030 is actuated to simultaneously pull the third cable 12530 and the fourth cable 12540, wherein equal tension is applied to each cable 12530 and 12540. Because cables 12530 and 12540 apply equal tension on both sides of the second transverse α-wound pulley 12630 of the pulley unit 12610, the pulley unit 12610 does not rotate. However, the pulling action of cables 12530 and 12540 is transferred to the surgical end effector 10000 through the articulation joint 12200, which causes the distal joint member 12250 to articulate relative to the central joint member 12230 about the second joint motion axis AA2. See also Figure 99 and Figure 96 .

[0316] 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 Figure 97 To close the anvil 10210 from this position, the cable control system 9030 is actuated to simultaneously pull the first cable 12510 and the fourth cable 12540, with the same amount of tension being 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, which causes the closure cams 10626 to cammably contact the anvil closure arms 10234 to cause the anvil 10210 to pivot to the closed position. It will be appreciated that by applying an equal amount of tension into the cables 12510 and 12540, no moment is applied to the center joint member 12230 and / or the distal joint member 12250 because an equal amount of tension is applied on each side of the articulation joint 12200. See Figure 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 closure mechanism for clamping onto tissue. The cable control system 9030 of the present application can also not produce a recoil that typically occurs with other cable control systems and can therefore 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 center axis or shaft axis of the articulation joint that provides the critical space for the firing drive system 13000. Figures 100-103 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 keeping the center region of the articulation joint 12200 available for other control systems, as will be discussed in further detail below. The articulation joint 12200 uses the last degree of freedom to actuate the jaw closure of the surgical end effector. In one aspect, the articulation joint 12200 comprises an N+1 joint, which means that for N degrees of freedom, the joint requires N+1 cables to actuate it. Thus, in the example described above, the articulation joint 12200 employs four actuation cables.

[0317] As

[0318] Figure 103 ​As can be seen, the firing drive system 13000 includes a firing member 13310, which includes a vertically extending firing member body 13312 having two laterally extending tabs 13314 projecting from a bottom portion 13313 of the firing member body 13312. The tabs 13314 are configured to slidably engage a flange 10113 in an elongated channel 10110 when the firing member 13310 is axially driven in the elongated channel 10110. Furthermore, a pair of upper tabs 13316 project from a top portion 13315 of the firing member body 13312. The upper tabs 13316 are configured to engage a flange 10213 in anvil body 10212 when the firing member 13310 is driven distally through a closed anvil body 10210. Figures 100-102 During the firing stroke, tabs 13314 and 13316 can be used to space the anvil 10210 relative to the surgical cartridge supported in the elongated channel 10110. The firing member body 13312 also includes a tissue cutting feature 13318 and a proximal notch 13319 configured to receive the central axis 12640 of the pulley unit 12610 when the firing member 13310 is in its proximal starting position within the firing member parking area 10140 in the proximal end 10112 of the elongated channel 10110.

[0319] like Figure 100 As shown, the firing drive system 13000 also includes an upper flexible chain drive assembly 13400 operably coupled to a top portion 13315 of the firing member 13310 and a lower flexible chain drive assembly 13500 operably coupled to a bottom portion 13313 of the firing member 13310. In at least one embodiment, the upper flexible chain drive assembly 13400 includes an upper series 13410 of upper link features 13420, which are loosely coupled together by an upper flexible coupler member 13402 attached to the top portion 13315 of the firing member 13310. In at least one example, each upper link feature 13420 includes an upper ball or sphere 13422 having an upper hollow conduit 13424 therein, the upper hollow conduit being configured to allow the upper flexible coupler member 13402 to pass through it. Figure 104As 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 onto 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 link features 13420.

[0320] Similarly, in at least one embodiment, the lower flexible chain drive assembly 13500 includes a lower series 13510 of lower 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 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 onto 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 link features 13520.

[0321] Turning now to Figure 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 link features 13420 and the lower series 13510 of lower link features 13520. As can be seen, the rotary drive screw 13700 includes a threaded shaft 13702 that is received within 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 supported by 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 advance the upper series 13410 of upper link features 13420 distally and in a second direction to retract the upper series 13410 of upper link features 13420 proximally. 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 advance the lower series 13510 of lower link features 13520 distally and in a second direction to retract the lower series 13510 of lower link features 13520 proximally. Figure 105As can be seen, in the illustrated arrangement, the rotary drive screw 13700 is rotatably supported in a mounting bushing 10150, which is attached to the proximal end 10112 of the elongated channel 10110. For example, the rotary drive screw 13700 includes a body portion 13702 having a central shaft 13704 projecting therefrom, which is rotatably mounted in a mounting hole 10152 in the mounting bushing 10150. This arrangement allows the rotary drive screw 13700 to rotate about an axis SA.

[0322] In the illustrated example, the rotary drive screw 13700 is driven by a rotary drive system 13600, which includes a proximal rotary drive shaft 13610 rotatably supported within an axial conduit 12225 within a proximal connector member 12210. Figure 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 be engaged with a gearbox / motor arrangement 9050 or other rotary motion source housed in the housing 9020 of the surgical instrument 9010. This rotary motion source causes the proximal rotary drive shaft 13610 to rotate about the axial axis SA within an axial conduit 12225 in the proximal connector member 12210. See also... Figure 105 .like Figure 106 As can be seen, the distal end 13614 of the proximal rotary drive shaft 13610 is movably connected to the first drive shaft segment 13620. In the illustrated example, the first drive shaft segment 13620 resembles a "dog bone" having a first spherical proximal end 13622 and a first spherical distal end 13624. See also Figure 105 The first spherical proximal end 13622 is movably pinned to a first distal socket 13616 formed in the distal end 13614 of the proximal end rotary drive shaft 13610 via a first proximal pin 13618. The first proximal pin 13618 extends through an arcuate transverse slot 13623 in the first spherical proximal end 13622. This arrangement allows the first spherical proximal end 13622 to move in multiple directions within the first distal socket 13616 while remaining attached to the first distal socket. The first spherical distal end 13624 is received within a first proximal socket 13632 in a central bearing housing 13630 mounted within a central joint member 12230. The first spherical distal end 13624 is movably pinned to the first proximal socket 13632 via a first distal pin 13634. The first distal pin 13634 extends through an arcuate transverse slot 13625 in the first spherical distal end 13624. This arrangement allows the first spherical distal end 13624 to move in multiple directions within the first proximal socket 13632 while remaining attached to the central bearing housing 13630.

[0323] like Figure 102 As can be seen, the rotary drive system 13600 also includes a second drive shaft section 13640, which is similar to the first drive shaft section 13620 and includes a second spherical proximal end 13642 and a second spherical distal end 13644. The second spherical proximal end 13642 is movably pinned to a second distal socket 13636 formed in the central bearing housing 13630 by a second proximal pin 13637. The second proximal pin 13637 extends through an arcuate transverse slot 13643 in the second spherical proximal end 13642. This arrangement allows the second spherical proximal end 13642 to move in multiple directions within the second distal socket 13636 while remaining attached to the second distal socket. The second spherical distal end 13644 is received within a second proximal socket 13706 in the rotary drive screw 13700 and is movably pinned within the second proximal socket 13706 by a second distal pin 13647. The second distal pin 13647 extends through a transverse slot 13646 in the second spherical distal end 13644. This arrangement allows the second spherical distal end 13644 to move relative to the rotary drive screw 13700 in multiple directions.

[0324] The dual-joint rotary drive maintains linear velocity output by using angular constraints on the joint members of the joint motion joints. This universal joint arrangement itself can have a sinusoidal output based on the joint angles. If the angles are equal and the phases are correctly aligned, the sinusoidal output of the first universal joint is canceled out by the second universal joint, resulting in a linear rotational speed. This is advantageous for imposing constraints in a rotary drive because it reduces component complexity and avoids the need to remove material from components to achieve the required clearance. Therefore, the components of this embodiment are more robust and stronger than existing arrangements. Furthermore, the constant speed of the rotary drive system allows for smoother firing and reduces wear that could otherwise be caused by vibration.

[0325] return Figure 104The rotary drive screw 13700 includes helical grooves or drive features 13708 formed on its circumference that are configured to engage and drive the upper balls or spheres 13422 in the upper series 13410 of the upper link features 13420 and the lower balls or spheres 13522 in the lower series 13510 of the lower link features 13520. Thus, to drive the firing member 13310 from a starting position in the surgical end effector 10000 to an ending position within the end effector, the rotary drive system 13600 is actuated to apply rotary drive 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 link features 13420 and the lower balls or spheres 13522 in the lower series 13510 of the lower 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 under 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 under compression, they are constrained by the slots in the anvil 10210 and elongated channel 10110, respectively. This arrangement ensures that the upper flexible chain drive assembly 13400 and the lower flexible chain drive assembly 13500 do not buckle as they are compressed.

[0326] This arrangement enables two degrees of articulation freedom for several reasons. For example, the upper and lower flexible chain drive assemblies 13400, 13500 are free to bend both in the pitch axis and in the yaw axis. Thus, the upper and lower flexible chain drive assemblies 13400, 13500 can assume a variety of configurations that are capable of accommodating a variety of articulation positions that are achievable through 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 cause the rotary drive screw 13700 to rotate about the shaft axis in a second rotary direction. As the rotary drive screw 13700 rotates in the second rotary direction, the upper and lower flexible chain drive assemblies 13400, 13500 serve to retract the firing member 13310 in the proximal direction back to the starting position. As the upper and lower flexible chain drive assemblies 13400, 13500 proximally retract the firing member 13310, a portion of the upper and lower flexible chain drive assemblies 13400, 13500 are returned across the articulation joint 12200 and into the elongate shaft. This arrangement allows the firing member 13310 to translate a long distance without having to increase the length of the end effector joint. In addition, because the rotary drive screw 13700 drivingly engages the upper and lower flexible chain drive assemblies 13400, 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 Figure 111 .

[0327] 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 and lower flexible chain drive assemblies 13400, 13500 as the assemblies bend through the articulation joint 12200. Maintaining the upper and lower flexible chain drive assemblies 13400, 13500 at a desired amount of tension as they traverse the articulation joint 12200 can prevent slack from forming in the flexible chain drive assemblies 13400, 13500 that can otherwise cause the assemblies to undesirably bunch up in the articulation joint 12200. Figure 112 and Figure 113One 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 the length of the flexible chain drive assemblies 13400, 13500 to be preserved.

[0328] Another cable management system 13800 is shown as Figure 114 and Figure 63 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 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 to articulate the surgical end effector.

[0329] One method of using the surgical instrument 9010 can involve using the surgical instrument to cut and staple target tissue within a patient's body using laparoscopic techniques. For example, one or more trocars can have been placed through the patient's abdominal wall to provide access to target tissue within the patient's body. The surgical end effector 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 Figure 97 ) 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 simultaneously pull the first cable 12510 and the fourth cable 12540, which causes the pulley unit 12610 to rotate and causes the closure cams 10626, 10636 to contact the anvil closure arm 10234 to pivot the anvil 10210 into the closed position. See Figure 96 The cable control system 9030 is deactivated to hold the anvil 10210 in the closed position. Once the surgical end effector 10000 has passed through the trocar into the abdomen, the cable control system 9030 is activated to rotate the pulley unit 12610 in the opposite direction to the position shown in Figures 115-139 to allow the anvil 10210 to be biased open by the anvil spring 10240.

[0330] 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.

[0331] 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 the starting position. As the firing member 13310 moves distally, it contacts and also drives the sled distally through the cartridge body, which is supported in the surgical staple cartridge 10300. The sled successively drives rows of drivers supported in the cartridge toward the clamped target tissue. Each driver has one or more surgical staples or fasteners supported thereon which 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.

[0332] After the firing member 13310 has been driven distally to the end position within the surgical end effector 10000, the rotary drive system 13600 is reversed, which causes the firing member 13310 to retract proximally to the starting position. Once the firing member 13310 has returned to the starting position, the cable control system 9030 can be activated to rotate the pulley unit 12610 back to the open position, wherein the anvil spring 10240 can pivot the anvil 10210 to the 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.

[0333] 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 it 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 the starting position within the end effector to the end position as the end effector is articulated. Furthermore, as the flexible beam traverses the articulation joint, it can impart a disarticulation motion to the articulation joint components. As a result, the articulation joint components must be sufficiently robust so as to resist such disarticulation motions.

[0334] Other forms of surgical endoscopic cutters employ a rotary force to drive the firing member through the end effector. Such arrangements typically employ a rotary drive screw housed within a channel that supports a staple cartridge. During use, the sled and tissue place a large moment on the firing member, which decreases the efficiency of the system and ultimately requires a higher rotary force to actuate the firing member. Due to the location of the cartridge and tissue, it is difficult to move the rotary drive screw closer to the center of such moments. It is also 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.

[0335] Figure 119Another form of surgical instrument 25010 is shown that can address many of the challenges faced by surgical instruments that include an end effector that can articulate to large articulation angles and end effectors that are configured to both cut and fasten tissue. In various embodiments, the surgical instrument 25010 can comprise a hand-held device. In other embodiments, the surgical instrument 25010 can comprise an automated system, such as sometimes referred to as a robotic control system. In various forms, the surgical instrument 25010 comprises a surgical end effector 26000 operably coupled to an elongated shaft assembly 28000. The elongated shaft assembly 28000 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.

[0336] In one form, the surgical end effector 26000 comprises a first jaw 26100 and a second jaw 26200. In the illustrated arrangement, the first jaw 26100 comprises an elongate channel 26110 that includes a proximal end 26112 and a distal end 26114 and is configured to operably support a surgical staple cartridge 10300 therein. Examples of surgical staple cartridges 10300 are described in detail above. The second jaw 26200 comprises an anvil 26210 that includes an elongate anvil body 26212 having a proximal end 26214 and a distal end 26216. The anvil body 26212 includes a staple-forming, lower surface 26218 facing the first jaw 26100 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. As is described in detail above, the surgical staple cartridge 10300 can be configured to support a plurality of staples 10410 in at least two rows or tiers 10412, 10414. In various forms, the surgical staple cartridge 10300 can be configured to support at least two rows or tiers of staples 10410 on the staple-forming, lower surface 26218 of the anvil 26210. Figure 115As can be seen, the proximal end 26214 of the anvil body 26212 includes an anvil mounting portion 26230 that includes a pair of laterally extending mounting pins 26232 that are configured to be received in corresponding mounting inserts 26130 that are configured to be received in a retaining manner within mounting cradles 26120 formed in the proximal end 26112 of the elongate channel 26110. The mounting pins 26232 are pivotally received within pivot holes 26132 in the mounting inserts 26130 which are then inserted into their corresponding cradles 26120 and affixed to the elongate channel 26110 by welding, adhesive, snap engagement, etc. This arrangement facilitates pivotal travel of the anvil 26210 about a fixed pivot axis PA relative to the elongate channel 26110. See Figure 119 As noted above, as used herein, the term "fixed" means that the pivot axis PA does not translate or move relative to the elongate channel 26110.

[0337] In the illustrated arrangement, the elongate shaft assembly 28000 defines a shaft axis SA and includes a shaft spine assembly 28100 that is received within a hollow outer shaft tube 28102. See Figures 120-125 The shaft spine assembly 28100 is operably interfaced with a housing of a control portion (e.g., hand-held unit, robotic tool driver, etc.) of the surgical instrument 25010 and, in one arrangement, includes a proximal spine segment 28120 and a distal spine segment 28140.

[0338] The elongate shaft assembly 28000 further includes an articulation joint 28200 that is attachable to the distal spine segment 28140 and the surgical end effector 26000 to facilitate selective articulation of the surgical end effector 26000 relative to the elongate shaft assembly 28000 in a plurality of articulation planes. Turning now to Figure 122 The articulation joint 28200 includes a series 28202 of movably interfaced annular disk members 28210. As Figure 123 , Figure 125 and Figure 122 As can be seen in Figs. 1 1-13, each annular disk member 28210 includes a "first" or proximal face 28220 that includes a centrally disposed spherical feature or nub 28222. Each annular disk member 28210 further includes a second or distal face 28230 that includes an annular hub portion 28232 that defines a female socket 28234 therein. See Figure 124 and Figure 120 Each annular disk member 28210 further has a central axial conduit 28236 therethrough. As Figure 121 and Figure 120As can be seen, the articulation joint 28200 further includes a proximal attachment disk assembly 28240 that is configured to be attached to the distal end of the distal spine segment 28140 by welding, adhesive, or other suitable fastener arrangement. The proximal attachment disk assembly 28240 includes a distal face 28242 that includes an annular hub portion 28244 that defines a female socket 28246 therein. The proximal attachment disk 28240 also has a central shaft conduit 28248 therethrough. Also in the illustrated arrangement, an anvil mounting bracket 26240 is configured to operably interface with the articulation joint 28200. The anvil mounting bracket 26240 is attached to the proximal end 26112 of the elongate channel 26110 of the surgical end effector 26000 by welding, adhesive, or other suitable fastener arrangement, and includes a proximal face 26244 that has a centrally disposed spherical feature or nub 26246 protruding therefrom. See Figure 120 The anvil mounting bracket 26240 also has a central shaft conduit 26248 therethrough.

[0339] In at least one embodiment, the articulation joint further includes a series 28270 of elastomeric annular spacer members 28280 that function to space each of the annular disk members 28210 apart and provide elastomeric support therebetween. The elastomeric annular spacer members 28280 define spacer openings 28282 such that each elastomeric spacer member 28280 is journaled on the annular hub portion 28232 of a corresponding annular disk member 28210. Each annular disk member 28210 is journaled on a central elastomeric support or continuum shaft 28300 that is mounted to the proximal attachment disk assembly 28240 and the anvil mounting bracket 26240. In one arrangement, the central continuum shaft 28300 is made of an elastomeric material (e.g., rubber, polymer, etc.) and includes a flanged proximal end 28302 and a cylindrical body portion 28304. The cylindrical body portion 28304 includes a series of annular grooves 28306 therein. Each annular groove 28306 corresponds to one of the annular disk members 28210. The annular disk members 28210 and annular spacer members 28280 are journaled on the central continuum shaft 28300 as Figure 120The flanged proximal end 28302 of the central continuum shaft 28300 is supported in a proximal conduit 28249 in the proximal attachment disk 28240. The cylindrical body portion 28304 of the central continuum shaft 28300 extends through the central conduit 28236 in each of the series 28202 of movably interfacing annular disk members 28210. Each centrally disposed spherical feature or protrusion 28222 includes an annular key member 28224 configured to be received in a corresponding annular groove 28306 in the central continuum shaft 28300. Such an arrangement can be used, for example, to orient each annular disk member 28210 in a desired spaced orientation on the central continuum shaft 28300.

[0340] Still referring to Figure 120 The proximal-most elastomeric spacer member 28280P is journaled on the annular hub portion 28244 of the proximal attachment disk assembly 28240, thereby positioned between the proximal-most annular disk member 28210P and the proximal attachment disk 28240. The annular key member 28224 of the proximal-most annular disk member 28210P is received within a corresponding annular groove 28306 in the central continuum shaft 28300 to position the centrally disposed spherical feature or protrusion 28222 of the proximal-most annular disk member 28210P within the recessed socket 28246 in the annular hub portion 28244 of the proximal attachment disk 28240. As further seen in Figure 120 Another elastomeric spacer member 28280A is journaled on the annular hub portion 28232 of the proximal-most annular disk member 28210P, thereby positioned between the next annular disk member 28210A in the series 28202 of movably interfacing annular disk members 28202 and the proximal-most annular disk member 28210P. The annular key member 28224 of the annular disk member 28210A is received within a corresponding annular groove 28306 in the central continuum shaft 28300 to position the centrally disposed spherical feature or protrusion 28222 of the annular disk member 28210A within the recessed socket 28246 in the annular hub portion 28244 of the proximal attachment disk 28210P. Still referring to Figure 120, another elastomeric spacer member 28280B is journaled on the annular hub portion 28232 of the annular disk member 28210A, thereby being positioned between the next annular disk member 28210B in the series 28202 of movably interfacing annular disk members. The annular key member 28224 of the annular disk member 28210B is received within a corresponding annular groove 28306 in the central continuum shaft 28300 to position the centrally disposed spherical feature or protrusion 28222 of the annular disk member 28210B within the recessed socket 28246 in the annular hub portion 28244 of the annular disk member 28210A. Also in this arrangement, another elastomeric spacer member 28280C is journaled on the annular hub portion 28232 of the annular disk member 28210B, thereby being positioned between the distal-most annular disk member 28210C in the series 28202 of movably interfacing annular disk members. The annular key member 28224 of the distal-most annular disk member 28210C is received within a corresponding annular groove 28306 in the central continuum shaft 28300 to position the centrally disposed spherical feature or protrusion 28222 of the distal-most annular disk member 28210C within the recessed socket 28246 in the annular hub portion 28244 of the annular disk member 28210B. Finally, another elastomeric spacer member 28280D is journaled on the annular hub portion 28232 of the distal-most annular disk member 28210C, thereby being positioned between the anvil mounting bracket 26240 and the distal-most annular disk member 28210C. The annular key member 28224 of the centrally disposed spherical feature or protrusion 26246 of the anvil mounting bracket 26240 is received within a corresponding annular groove 28306 in the central continuum shaft 28300 to position the centrally disposed spherical feature or protrusion 226246 of the anvil mounting bracket 26240 within the recessed socket 28246 in the annular hub portion 28244 of the distal-most annular disk member 28210C.

[0341] In at least one arrangement, to limit the pivotal travel of the annular disk members to a range of relative pivotal travel and to prevent full relative rotation of the annular disk members 28210 relative to one another, the centrally disposed spherical feature or protrusion 28222 of each annular disk member 28210P, 28210A, 28210B, 28210C and the distal spherical feature or protrusion 26246 of the anvil mounting bracket 26240 include a pair of arcuate pin slots 28226 therein. As can be seen in Figure 119 the corresponding travel limiting pin member 28227 is pressed into or otherwise attached to each annular hub portion 28232 and is received within the corresponding pin slot 28226 in the centrally disposed spherical feature or protrusion 28222, 26246.

[0342] ReturningFigure 126 In the illustrated example, articulation joint 28200 is operably controlled by an articulation system 28400 that includes four cable assemblies 28410, 28420, 28430, and 28440 that extend through elongated shaft assembly 28000. In one arrangement, cable assembly 28410 includes a proximal cable portion 28412 that is attached to an articulation bar 28414 that is supported in a corresponding axial groove in shaft spine assembly 28100 for axial travel therein. A distal cable portion 28416 is attached to articulation bar 28414. Cable assembly 28420 includes a proximal cable portion 28422 that is attached to an articulation bar 28424 that is supported in a corresponding axial groove in shaft spine assembly 28100 for axial travel therein. A distal cable portion 28426 is attached to articulation bar 28414. Cable assembly 28430 includes a proximal cable portion 28432 that is attached to an articulation bar 28434 that is supported in a corresponding axial groove in shaft spine assembly 28100 for axial travel therein. A distal cable portion 28436 is attached to articulation bar 28434. Cable assembly 28440 includes a proximal cable portion 28442 that is attached to an articulation bar 28444 that is supported in a corresponding axial groove in shaft spine assembly 28100 for axial travel therein. A distal cable portion 28446 is attached to articulation bar 28444.

[0343] Proximal cable portions 28412, 28422, 28432, 28442 are operably interfaced with portions of cable control system 25030 that are supported within or otherwise associated with a housing of surgical instrument 25010. Cable control system 25030 can include a number of cable support members / drive wheels, pulleys, or the like that are controlled by one or more corresponding motors that are controlled by control circuit portions of surgical instrument 25010. In various embodiments, cable control system 25030 is configured to manage tensioning (pulling) and pay-out of the cables at precise times during the articulation process. Moreover, in at least one arrangement, cable control system 25030 can be employed to control the opening and closing of anvil 26210, as will be discussed in further detail below.

[0344] Turning now to Figure 126 Distal cable portions 28416, 28426, 28436, 28446 are configured to operably interface with a closure system 28500 that is rotatably mounted in a proximal end 26112 of elongated channel 26110. As Figure 119As can be seen, the closure system 28500 includes a pulley unit 28510 that includes a first lateral alpha wrap pulley 28520 and a second lateral alpha wrap pulley 28530 that are interconnected by a central shaft 28540. The pulley unit 28510 is rotatably supported within the proximal end 26112 of the elongate channel 26110 and retained therein by an anvil mounting bracket 26240 that is attached to the proximal end 26112 of the elongate channel 26110. See Figure 126 The anvil mounting bracket 26240 can be attached to the proximal end 26112 of the elongate channel 26110 by welding, adhesive, snap features, etc. The anvil mounting bracket 26240 includes a shaft cradle 26242 that is configured to rotatably support the central shaft 28540 within the elongate channel 26110. In the illustrated arrangement, a first pivot shaft 28521 protrudes from the first lateral alpha wrap pulley 28520 and is pivotally supported in a pivot hole 26113 in the proximal end of the elongate channel. Similarly, a second pivot shaft 28531 protrudes from the second lateral alpha wrap pulley 28530 and is pivotally supported in a pivot hole 26115 in the proximal end 26112 of the elongate channel 26110.

[0345] As Figure 126 As can be seen, the first alpha wrap pulley 28520 includes a first circumferential groove 28522 and a second circumferential groove 28524. In the illustrated example, the first distal cable portion 28416 is received in and attached to the first circumferential groove 28522 and the second distal cable portion 28426 is received in and attached to the second circumferential groove 28524. Pulling on the first distal cable portion 28416 will cause the first lateral alpha wrap pulley 28520 to rotate in a first direction and pulling on the second distal cable portion 28426 will cause the first lateral alpha wrap pulley 28520 to rotate in a second, opposite direction. Similarly, the second lateral alpha wrap pulley 28530 includes a first circumferential groove 28532 and a second circumferential groove 28534. In the illustrated arrangement, the distal cable portion 28446 is received in and attached to the first circumferential groove 28532 and the third distal cable portion 28436 is received in and attached to the second circumferential groove 28534. Pulling on the fourth distal cable portion 28446 will cause the second alpha wrap pulley 28530 to rotate in a first direction and pulling on the third distal cable portion 28436 will cause the second lateral alpha wrap pulley 28530 to rotate in a second, opposite direction. According to one aspect, the lateral alpha wrap pulleys 28520, 28530 are rotatable about 330 degrees. This range of rotational travel is in stark contrast to a normal pulley that can have a range of rotational travel of less than 180 degrees of rotational angle.

[0346] Each of the first lateral alpha wrap pulley 28520 and the second lateral alpha wrap pulley 28530 further includes a corresponding screw closure cam configured to apply closure motions to the anvil 26210. As can be seen in Figure 119 FIG. 16, the first lateral alpha wrap pulley 28520 includes a first screw closure cam 28526 and the second lateral alpha wrap pulley 28530 has a second screw closure cam 28536 thereon. The screw closure cams 28526, 28536 are configured to cam interact with corresponding anvil closure arms 26234 on the anvil mounting portion 26230 of the anvil 26210 to apply closure motions thereto. See Figure 127 Rotation of the pulley unit 28510 in a first rotational direction will cause the screw closure cams 28526, 28536 to cam the anvil 26210 into a closed position. To open the anvil 26210, the pulley unit 28510 is rotated in an opposite direction to position the screw closure cams 28526, 28536 in a position in which the anvil 26210 can be pivoted open by an anvil spring (not shown).

[0347] In the illustrated arrangement, the proximal attachment disc 28240, the proximal-most annular disc member 28210P, the annular proximal disc members 28210A, 28210B, 28210C, and the anvil mounting bracket 26240 all include fourth articulation cable conduits 28214 configured to allow each of the distal cable portions 28416, 28426, 28436, and 28446 to pass therethrough. Figure 119 An articulation bar 28424 is shown slidably supported in a corresponding axial groove 28146 in the distal spine segment 28140 for axial travel therein. Each of the other articulation bars 28414, 28434, 28444 are similarly supported in axial grooves in the distal spine segment 28140 and corresponding grooves in the proximal spine segment 28120.

[0348] Referring now to Figures 128-130 and ​The distal cable portion 28416 extends from the articulation bar 28414 through the articulation joint 28200 and around two re-direction pulleys 28550, 28560 supported on shafts 28502, 28512 rotatably mounted in the proximal end 26112 of the elongate channel 26110. The distal cable portion 28416 exits the articulation joint 28200 to be received within a first circumferential groove 28522 in a first transverse alpha wrap pulley 28520 where it is secured therein. The distal cable portion 28426 extends from the articulation bar 28424 through the articulation joint 28200 to wrap around the re-direction pulleys 28560, 28550 to be received within a second circumferential groove 28524 in the first transverse alpha wrap pulley 28520 where it is secured therein.

[0349] In the illustrated example, the distal cable portion 28436 extends from the articulation bar 28434 through the articulation joint 28200 to be received within a corresponding circumferential groove 28534 in a second transverse alpha wrap pulley 28530 where it is secured therein. Further, the distal cable portion 28446 extends from the articulation bar 28444 through the articulation joint 28200 to be received within a corresponding circumferential groove 28532 in the second transverse alpha wrap pulley 28530 where it is secured therein.

[0350] In at least one example, to articulate and move the surgical end effector 26000 relative to the elongate shaft assembly 28000 through a first articulation plane, the cable control system 25030 is actuated to simultaneously pull the distal cable portion 28426 and the distal cable portion 28446 with the same amount of tension applied to each distal cable portion 28426, 28446. Because the distal cable portions 28426, 28446 apply equal amounts of tension on both sides of the pulley unit 28510, the pulley unit 28510 does not rotate. However, the pulling action of the distal cable portions 28426, 28446 is translated through the articulation joint 28200 to the surgical end effector 26000, which causes the articulation joint 28200 to articulate and move through the first articulation plane. To articulate and move the surgical end effector 26000 relative to the elongate shaft assembly 28000 through a second articulation plane that is transverse to the first articulation plane, the cable control system 25030 is actuated to simultaneously pull the distal cable portion 28436 and the distal cable portion 28446 with the same amount of tension applied to each distal cable portion 28436, 28446. Because the distal cable portions 28436, 28446 apply equal amounts of tension on both sides of the pulley unit 28510, which is transverse to the second transverse alpha wrap pulley 25830, the pulley unit 28510 does not rotate. However, the pulling action of the distal cable portions 28436, 28446 is translated through the articulation joint 28200 to the surgical end effector 26000, which causes the articulation joint 28200 to articulate in the second articulation plane.

[0351] The cable control system 25030 can also be used to control the opening and closing of the anvil 26210 in the following manner. As described above, when the spiral closure cams 28526 on the first lateral alpha wrap pulley 28520 and the second lateral alpha wrap pulley 28530 are in the first position, the anvil 26210 can be pivoted to an open position by one or more anvil springs (not shown) positioned in the proximal end 26112 of the elongated channel 26110 and positioned to contact the anvil mounting portion 26230 or the anvil closure arm 26234 to pivot the anvil 26210 to the open position. To close the anvil 26210 from this position, the cable control system 25030 is actuated to simultaneously pull the distal cable portion 28416 and the distal cable portion 28446 with the same amount of tension applied to each distal cable portion 28416 and 28446. These distal cable portions 28416, 28446 will cause the pulley unit 28510 to rotate, causing the spiral closure cams 28526, 28536 to contact the anvil closure arm 26234 and cam the anvil 26210 to the closed position. It will be appreciated that by applying equal amounts of tension into the distal cable portions 28416, 28446, no moment is applied to the articulation joint 28200 because equal amounts of tension are applied on each side of the shaft axis SA. This arrangement allows the jaw closure to be shaped as desired. This cable control system 25030 can allow for faster closure when the anvil 26210 is fully open. The cable control system 25030 can also be used as a lower speed / higher force closure mechanism for clamping onto tissue. The cable control system 25030 of the present application can not generate the recoil that typically occurs with other cable control systems and can therefore also be used to control the articulation position of the end effector. The articulation joint 28200 and the cable control system 25030 described above can facilitate multi-plane articulation while also providing additional actuation motions to the surgical end effector 26000.

[0352] As discussed above, many surgical end effectors employ a firing member that is pushed distally through a surgical staple cartridge by an axially movable firing beam. The firing beam is typically attached to the firing member in a central region of the firing member body. This attachment location can cause the firing member to be unbalanced as it is advanced through the end effector. This imbalance can cause undesirable friction between the firing member and the end effector jaw. The creation of this additional friction can require a higher firing force to be applied to overcome this friction and can cause undesirable wear to portions of the jaw and / or firing member. The application of a higher firing force to the firing beam can cause undesirable flexing of the firing beam as it traverses the articulation joint. This additional flexing can cause the articulation joint to disarticulate, particularly when the surgical end effector is articulated at a relatively high articulation angle. The surgical instrument 25010 employs a firing system 27000 that addresses, if not solves, many of these issues.

[0353] Referring now to Figures 133-134 In at least one embodiment, the firing system 27000 includes a firing member 27100 that includes a vertically extending firing member body 27112 that includes a top firing member feature 27120 and a bottom firing member feature 27130. A tissue-cutting knife 27114 is attached to or formed in the vertically extending firing member body 27112. In at least one arrangement, the top firing member feature 27120 includes a top tubular body 27122 having a top axial conduit 27124 extending therethrough. See Figure 134 The bottom firing member feature 27130 includes a bottom tubular body 27132 having a bottom axial conduit 27134 extending therethrough. In at least one arrangement, the top firing member feature 27120 and the bottom firing member feature 27130 are integrally formed with the vertically extending firing member body 27112. In at least one example, the anvil body 26212 includes an axially extending anvil slot that has a cross-sectional shape similar to a "keyhole" to accommodate passage of the top firing member feature 27120 in various manners described herein. Similarly, the elongate channel 26110 includes an axially extending channel slot that also has a keyhole cross-sectional shape for accommodating the conduit of the bottom firing member feature 27130 as described above.

[0354] In the illustrated arrangement, the firing system 27000 includes an upper firing assembly 27200 that operably interfaces with the top firing member feature 27120. The upper firing assembly 27200 includes an upper flexible outer tube or conduit 27210 having a proximal end 27212 that is fixed to an upper insert 27214 that is immovably attached to the shaft spine assembly 28100. For example, the upper insert 27214 can be welded to the shaft spine assembly 28100, or otherwise attached thereto by an adhesive or other suitable fastener means. The flexible outer tube or conduit 27210 extends through upper tubes 28216 that are disposed through the proximal attachment disk assembly 28240, the proximal annular disk member 28210P, the annular disk members 28210A, 28210B, 28210C, and the anvil mounting bracket 26240. A distal end 27216 of the flexible outer tube or conduit 27210 can be attached to the anvil mounting bracket 26240.

[0355] In the illustrated embodiment, the upper firing assembly 27200 further includes an upper push rod 27220 that is slidably supported in a corresponding axial tube in the shaft spine assembly 28100. The upper firing assembly 27200 further includes an upper push coil 27230 that is supported in an inner flexible upper sleeve 27240 that extends through the upper flexible outer tube or conduit 27210. A proximal end 27232 of the upper push coil 27230 and a proximal end 27242 of the inner flexible upper sleeve 27240 abut a distal end 27222 of the upper push rod 27220. The upper push coil 27230 is hollow and can comprise a helical spring made of Nitinol, Titanium, Stainless Steel, or the like. In other arrangements, the upper push coil 27230 comprises a laser cut "hypo tube" that essentially comprises a hollow tubular member having biased laser cuts therein that enable the hypo tube to flex and bend while also being able to transmit axial forces or motions. The inner flexible upper sleeve 27240 can be made of a polymer or similar material and prevents tissue, fluids, and / or debris from penetrating into the upper push coil 27230 that can interfere with the ability of the upper push coil to flex and bend during articulation of the surgical end effector relative to the elongate shaft assembly.

[0356] As Figure 134As can be seen, the distal end 27234 of the upper push coil 27230 and the distal end 27244 of the inner flexible upper sleeve 27240 are adjacent to the proximal end 27123 of the top tubular body 27122 or the top firing member feature 27120. Also in the illustrated arrangement, the upper firing assembly includes an upper push coil cable 27250 extending through the hollow upper push coil 27230. The upper push coil cable 27250 includes a proximal end 27252 and a distal end 27254. The proximal end is fixed to the distal end 27222 of the upper push rod 27220, and the distal end is fixed within the top axial conduit 27124 of the top tubular body 27122 of the top firing member feature 27120 via an upper attachment lug 27256. The upper push coil cable 27250 is kept taut between the top firing member feature 27120 and the upper push rod 27220. This is to keep the distal end 27234 of the upper push coil 27230 and the distal end 27244 of the inner flexible upper sleeve 27240 in abutment with the proximal end 27123 of the top tubular body 27122 of the top firing member feature 27120, and to keep the proximal end 27232 of the upper push coil 27230 and the proximal end 27242 of the inner flexible upper sleeve 27240 in abutment with the distal end 27222 of the upper push rod 27220.

[0357] In the illustrated example, the firing system 27000 also includes a lower firing assembly 27300 operatively connected to a bottom firing member feature 27130. The lower firing assembly 27300 includes a lower flexible outer tube or conduit 27310 having a proximal end 27312 fixed to a lower insert 27314, which is immovably attached to the spine assembly 28100. For example, the lower insert 27314 may be welded to the spine assembly 28100 or otherwise attached thereto by adhesive or other suitable fastening means. A lower flexible outer tube or conduit 27310 extends through a lower conduit 28218, which is disposed in each of the proximal attachment disc assembly 28240, the nearest annular disc member 28210P, annular disc members 28210A, 28210B, 28210C, and the anvil mounting bracket 26240. The distal end 27316 of the flexible outer tube or conduit 27310 is attached to the anvil mounting bracket 26240.

[0358] In the illustrated implementation, the lower firing assembly 27300 further includes a lower push rod 27320 that is slidably supported in a corresponding axial channel in the shaft spine assembly 28100. The lower firing assembly 27300 further includes a lower push coil 27330 that is supported in an inner flexible lower sleeve 27340 that extends through the lower flexible outer tube or conduit 27310. A proximal end 27332 of the lower push coil 27330 and a proximal end 27342 of the inner flexible lower sleeve 27340 abut a distal end 27322 of the lower push rod 27320. The lower push coil 27330 is hollow and can comprise a helical spring made of Nitinol, Titanium, Stainless Steel, or the like. In other arrangements, the lower push coil 27330 comprises a laser cut hypotube that essentially comprises a hollow tubular member with biased laser cuts therein that enable the hypotube to flex and bend. The inner flexible lower sleeve 27340 can be made of a polymer or similar material and prevents tissue, fluid, and / or debris from permeating into the lower push coil 27330 that can impede the ability of the lower push coil to flex during articulation.

[0359] As Figure 134 As can be seen in the middle, a distal end 27334 of the lower push coil 27330 and a distal end 27344 of the inner flexible lower sleeve 27340 abut a proximal end 27133 of the bottom tubular body 27132 of the bottom firing member feature 27130. Also in the illustrated arrangement, the lower firing assembly 27300 further includes a lower push coil cable 27350 that extends through the hollow lower push coil 27330. The lower push coil cable 27350 includes a lower cable proximal end 27352 that is fixed to the distal end 27322 of the lower push rod 27320 and a lower cable distal end 27354 that is fixed within a bottom axial channel 27134 in the bottom tubular body 27132 of the bottom firing member feature 27130 by a bottom attachment lug 27356. The lower push coil cable 27350 remains tensioned between the bottom firing member feature 27130 and the lower push rod 27320, which serves to maintain the distal end 27334 of the lower push coil 27330 and the distal end 27344 of the inner flexible lower sleeve 27340 in abutting contact with the proximal end 27133 of the bottom tubular body 27132 of the bottom firing member feature 27130, and the proximal end 27332 of the lower push coil 27330 and the proximal end 27342 of the inner flexible lower sleeve 27340 in abutting contact with the distal end 27322 of the lower push rod 27320.

[0360] In the illustrated arrangement, the firing system 27000 also includes a differential drive assembly 27400, which is configured to axially drive the upper firing assembly 27200 and the lower firing assembly 27300. (Go to...) Figures 136-139 In at least one arrangement, the proximal end 27224 of the upper push rod 27220 is connected to the first or upper rack 27410 of the differential drive assembly 27400. For example... Figure 136 As can be seen, the first or upper rack 27410 is slidably supported in the upper proximal axial cavity 28122 within the proximal ridge section 28120. Similarly, the proximal end 27324 of the lower push rod 27320 is coupled to the second or lower rack 27420, which is supported to travel axially within the lower proximal axial cavity 28124 within the proximal ridge section 28120. The differential drive assembly 27400 also includes an axially movable carrier member 27430, centrally disposed between the first or upper rack 27410 and the second or lower rack 27420, and supported to travel axially within the proximal axial cavity 28126 within the proximal ridge section 28120. See also Figure 136 See still Figures 136-139 The pinion 27432 is pivotally pinned to an axially movable load-bearing member 27430, thereby engaging with a first or upper rack 27410 and a second or lower rack 27420. The axially movable load-bearing member 27430 is axially driven by a firing actuator 27440 within a proximal axial cavity 28126 in the proximal ridge section 28120. See also... Figure 137 In one arrangement, the firing actuator 27440 includes a firing drive rack 27442 dextrinsically engaged with a drive gear 27444, which is driven by a firing motor 27446 operatively supported in or otherwise associated with the housing of the surgical instrument 25010. In other arrangements, the firing actuator 27440 may be axially driven distally and proximally by an associated cylinder arrangement or other suitable actuator. Figures 137-139As can be seen, the firing drive actuator 27440 can be attached to the axially movable carrier member 27430 by a pair of spaced apart coupling pins 27448 that attach to the firing drive actuator 27440 and are received within corresponding axial slots 27434 in the axially movable carrier member 27430. This arrangement allows for some relative axial movement between the firing drive actuator 27440 and the axially movable carrier member 27430. For example, when the firing drive actuator 27440 is driven proximally in the proximal direction PD, the axially movable carrier member 27430 will not move proximally until the coupling pins 27448 reach the proximal end of their corresponding axial slots 27434, at which point the axially movable carrier member 27430 will move proximally. Similarly, when the firing drive actuator 27440 is driven distally in the distal direction DD, the axially movable carrier member 27430 will not move distally until the coupling pins 27448 reach the distal end of their corresponding axial slots 27434, at which point the axially movable carrier member 27430 will move distally.

[0361] Surgical stapling devices require a great deal of force to be exerted on the firing member to form the staples and cut the tissue as the firing member is translated through a long displacement. Transferring this force through an articulation joint is particularly challenging because it is difficult to redirect the force in the desired direction and it is difficult to bear the load exerted on it. The differential drive assembly 27400 described herein addresses and deals with many of these challenges by employing two flexible outer tubes or conduits 27210, 27310 to constrain the paths of the flexible push coil 27230, 27330, respectively. As described herein, the upper flexible outer tube or conduit 27210 surrounds a portion of the upper push coil 27230 and the upper flexible outer tube or conduit 27310 surrounds a portion of the lower push coil 27330. Each of the outer tubes or conduits 27210, 27310 can bend, but they can also resolve axial tensile loads. The ability to bend allows the firing member force to be redirected through the articulation joint and the ability to resolve tension allows it to change the direction in which the push coil travels. When the push coils 27230, 27330 are in a compressed state, the flexible outer tubes or conduits 27210, 27310 are in a tensioned state. The outer tubes or conduits 27210, 27310 prevent the push coils 27230, 27330 from buckling. The outer tubes 27210, 27310 terminate in a manner that resolves tensile loads. As described above, the distal end 27216 of the flexible outer tube or conduit 27210 and the distal end 27316 of the flexible outer tube or conduit 27310 are both attached to the anvil mounting bracket 26240. The proximal end 27212 of the flexible outer tube or conduit 27210 and the proximal end 27312 of the flexible outer tube or conduit 27310 are both attached to the shaft spine assembly 28100. The pinion gear 27432 is in meshing engagement with the first or upper rack 27410 and the second or lower rack 27420 such that when one of the racks 27410, 27420 is moved in one axial direction, the other of the racks 27410, 27420 moves axially in the opposite direction. As Figure 138 and Figure 139 As can be seen in FIGS. 27-29, during articulation, the pinion gear 27432 rotates, thus the flexible outer tubes or conduits 27210, 27310 can move to account for the change in path length. However, when the firing drive actuator 27440 is driven in the distal direction DD, the axially movable carrier member 27430 is actuated to push the push coils 27230, 27330 distally through the outer tubes or conduits 27210, 27310 to fire (i.e., drive the firing member 27100 distally), the tensile loads in the two flexible outer tubes or conduits 27210, 27310 react with each other while the pinion gear 27432 is not moving at all.

[0362] According to one general aspect, the upper tube 28216 forms an upper path 28221 through the articulation joint 28200 (Figure 117 ). Similarly, the lower tube 28218 forms a lower path 28223 through the articulation joint 28200. When the surgical end effector 26000 is in an unarticulated position (i.e., the surgical end effector is axially aligned with the elongate shaft assembly 28000 on the shaft axis SA Figure 115 、 Figure 117 、 Figure 118 ) on the shaft axis SA Figure 117 . When the surgical end effector 26000 is in an articulated position relative to the elongate shaft assembly 28000, the upper path 28221 and the lower path 28223 are concentric with each other. See FIGS. 28 and 29. Figure 116 .

[0363] When the surgical end effector 26000 is in the unarticulated position, the firing system 27000 can be actuated to drive the firing member 27100 from a starting position within the proximal end 26112 of the elongated channel 26110 to an ending position within the distal end 26114 of the elongated channel 26110. When the surgical end effector 26000 is in the unarticulated position and the firing system 27000 is actuated, the differential drive assembly 27400 drives the upper firing assembly 27200 and the lower firing assembly 27300 equal axial distances in the same axial direction (i.e., the distal direction DD) to impart an upper axial drive motion and a lower axial drive motion to the firing member 27100. The upper axial drive motion and the lower axial drive motion are substantially equal in magnitude, which serves to advance the firing member 27100 distally through the surgical end effector 26000 without constraint, which can otherwise occur if the upper axial drive motion and the lower axial drive motion were different in magnitude. Similarly, when the surgical end effector 26000 is in an articulated position relative to the elongated shaft assembly 28000, the firing system 27000 can be actuated to drive the firing member 27100 from the starting position to the ending position. In this case, the differential drive assembly 27400 is configured to permit the upper firing assembly 27200 and the lower firing assembly 27300 to move in opposite axial directions equal distances to accommodate the articulated position. The differential drive assembly 27400 can then impart an upper axial drive motion and a lower axial drive motion to the firing member 27100 that are equal to one another. For example, depending on the articulated position of the surgical end effector 26000 relative to the elongated shaft assembly 28000, the upper firing assembly 27200 can be moved proximally a first distance and the lower firing assembly 27300 can be positioned distally relative thereto by the pinion gear 27432 to a second distance that is substantially equal to the first distance as the surgical end effector 26000 is articulated. Thereafter, distal actuation of the firing drive actuator 27440 will cause the upper firing assembly 27200 and the lower firing assembly 27300 to impart an upper axial drive motion and a lower axial drive motion to the firing member 27100 that are equal to one another. As used herein, a carrier can impart an "axial control motion" to the upper firing assembly 27200 and the lower firing assembly 27300 as the carrier is moved distally.Therefore, when the surgical end effector 26000 is in a non-articular motion configuration, the carrier can apply equal amounts of axial control movement to the upper firing member 27200 and the lower firing member 27300 in the same axial direction (distal direction DD), and when the surgical end effector 26000 is in an articulated motion configuration, the carrier can apply "other equal amounts" of axial control movement to the upper firing member 27200 and the lower firing member 27300 in the same axial direction (distal direction DD) to move the firing member 27100 from the starting position to the ending position.

[0364] Figures 140-152 Another surgical instrument 30010 is shown, which employs a different form of articulated joint 30200 to connect the surgical end effector 31000 to the elongated shaft assembly 32000. The elongated shaft assembly 32000 may be identical or very similar to various other elongated shaft assemblies described herein. Figures 140-143 As can be seen, the articulation joint 30200 includes a proximal joint member 30210 and a distal joint member 30250. The proximal joint member 30210 is configured to attach to the distal end of an elongated shaft assembly 32000, which is coupled to a housing or other portion of a surgical instrument. The distal joint member 30250 is configured to attach to a surgical end effector 31000. For example, the distal joint member 30250 may attach to an elongated channel 31200 of the surgical end effector 31000. The end effector 31000 may be the same as or very similar to the various surgical end effectors disclosed herein.

[0365] like Figure 143 and Figure 150 As can be seen, the proximal connector member 30210 includes a proximal side 30212 defining a proximal tip 30218. Similarly, the distal connector member 30250 includes a distal side 30252 defining a distal tip 30254. See also Figure 151 The proximal joint member 30210 and the distal joint member 30250 are pivotally held together with their respective end portions 30218 and 30254 via a link assembly 30300 in a "rolling engagement" manner. Figures 141-143 As can be seen, the linkage assembly 30300 includes a first link 30310 and a second link 30320. In the illustrated example, the first link 30310 and the second link 30320 are connected to the proximal joint member 30210 via a proximal crosspin assembly 30330. According to one aspect, the proximal crosspin assembly 30330 includes a first proximal crosspin 30332 defining a first proximal pivot axis FPPA. See also Figure 152The proximal end 30312 of the first link 30310 is configured to receive a first proximal threaded fastener 30314 therethrough that is configured to be threadably received in a first threaded hole 30334 in a first proximal cross pin 30332. See FIGS. 27 and 28. The first proximal cross pin 30332 is configured to be received in a proximal joint member 30210 of the articulating joint assembly 30000. The proximal joint member 30210 is configured to be coupled to a handle assembly 31000 of the surgical instrument 30000. The proximal joint member 30210 is configured to be coupled to a distal joint member 30250 of the articulating joint assembly 30000. The proximal joint member 30210 is configured to be coupled to a first articulation member 30230 of the articulating joint assembly 30000. The proximal joint member 30210 is configured to be coupled to a second articulation member 30240 of the articulating joint assembly 30000. Figure 143 Likewise, the proximal end 30322 of the second link 30320 is configured to receive a second proximal threaded fastener 30324 therethrough that is configured to be threadably received in a second threaded hole 30336 in the first proximal cross pin 30332.

[0366] In at least one embodiment, the first proximal cross pin assembly 30330 further includes a second proximal cross pin 30340 rotatably journaled on the first proximal cross pin 30332. In one arrangement, the first proximal cross pin 30332 can include a first proximal bushing or low friction sleeve 30338 that is configured to facilitate free rotation between the first proximal cross pin 30332 and the second proximal cross pin 30340. The second proximal cross pin 30340 defines a second proximal pivot axis SPPA that is transverse to the first proximal pivot axis FPPA and a shaft axis SA defined by the elongated shaft assembly 32000. As can be seen in FIGS. 27 and 28, the second proximal cross pin 30340 is received within a laterally aligned proximal pin opening 30220 in the proximal joint member 30210 to attach the link assembly 30300 to the proximal joint member 30210 such that the link assembly 30300 can be pivoted relative to the proximal joint member 30210 about the first proximal pivot axis FPPA and the second proximal pivot axis SPPA. Figure 143 Likewise, the proximal end 30322 of the second link 30320 is configured to receive a second proximal threaded fastener 30324 therethrough that is configured to be threadably received in a second threaded hole 30336 in the first proximal cross pin 30332.

[0367] In the illustrated example, the first link 30310 and the second link 30320 are coupled to the distal joint member 30250 by a distal cross pin assembly 30350. According to one aspect, the distal cross pin assembly 30350 includes a first distal cross pin 30352 that defines a first distal pivot axis FDPA. The distal end 30316 of the first link 30310 is configured to receive a first distal threaded fastener 30318 therethrough that is configured to be threadably received in a third threaded hole 30354 in the first distal cross pin 30352. Likewise, the distal end 30326 of the second link 30320 is configured to receive a second distal threaded fastener 30328 therethrough that is configured to be threadably received in a fourth threaded hole 30356 in the first distal cross pin 30352.

[0368] In at least one embodiment, the first distal cross pin assembly 30350 further comprises a second distal cross pin 30360 rotatably journaled on the first distal cross pin 30352. In one arrangement, the first distal cross pin 30352 can comprise a first proximal bushing or low friction sleeve 30358 which is configured to facilitate free rotation between the first distal cross pin 30352 and the second distal cross pin 30360. The second distal cross pin 30360 defines a second distal pivot axis SDPA transverse to the first distal pivot axis FDPA and a shaft axis SA. As can be seen in Figure 142 the second distal cross pin 30360 is received within a laterally aligned distal pin opening 30256 in the distal joint member 30250 to attach the linkage assembly 30300 to the distal joint member 30250 such that the linkage assembly 30300 can pivot relative to the distal joint member 30250 about the first distal pivot axis FDPA and the second distal pivot axis SDPA.

[0369] Turning now to Figure 150 the proximal face 30212 of the proximal joint member 30210 defines a proximal tip 30218 which includes a plurality of radially spaced apart recessed regions 30222 formed therein. In the illustrated arrangement, a total of six recessed regions 30222 are equally spaced about the center 30219 of the proximal tip 30218. As can be seen in Figure 151 the distal face 30252 of the distal joint member 30250 includes a total of six distal fins or projections 30262 equally spaced about the center 30255 of the distal tip 30254 such that each fin 30262 corresponds to one of the recessed regions 30222 when the surgical end effector is in an unarticulated position. For example, angle B can be about sixty degrees. See Figure 151 Each of the fins 30262 and each of the recessed regions 30222 include rounded edges which are configured to facilitate rolling interengagement between the proximal tip 30218 and the distal tip 30254 during articulation of the surgical end effector 31000 relative to the elongate shaft assembly 32000. Such rolling interengagement can be somewhat analogous to the rolling interengagement between the teeth of intermeshing bevel gears, for example, such that the proximal tip 30218 and the distal tip 30254 remain engaged with one another during articulation of the surgical end effector 31000.

[0370] See Figure 141surgical end effector 31000 relative to the elongated shaft assembly 32000. In at least one arrangement, the articulation system 30500 includes four articulation cables 30510, 30520, 30530, and 30540 that extend through the elongated shaft assembly 32000. In the illustrated arrangement, the articulation cables 30510, 30520, 30530, and 30540 pass through the proximal joint member 30210 and the distal joint member 30250 and are secured to the surgical end effector 31000 in various manners as disclosed herein. The articulation cables 30510, 30520, 30530, and 30540 are operably interfaced with an articulation control system supported in or otherwise associated with the housing of the surgical instrument 30010. For example, as discussed above, the proximal portion of each cable 30510, 30520, 30530, and 30540 can be wrapped around a corresponding rotary spool or cable management system 2007 Figure 2 ) in the housing portion of the surgical instrument 30010 that is configured to pay out and retract each cable 30510, 30520, 30530, and 30540 in a desired manner. The spool / cable management system can be motor driven or manually driven (ratcheting arrangement, etc.). Figure 140 、 Figure 141 and Figures 144-146 illustrates the position of the articulation joint 30200 when the surgical end effector is in an articulated position, and Figure 142 and Figures 147-149Various positions of the articulation joint 30200 are shown as the surgical end effector has been articulated relative to the elongate shaft assembly 32000 in various positions. The surgical instrument 30010 can also employ various types and configurations of firing systems 30600 as disclosed in detail herein to drive a firing member (not shown) within the surgical end effector 31000. For example, the proximal joint member 30210 can be provided with an upper proximal firing member conduit 30214 that is configured to accommodate an upper flexible firing assembly 30610 therethrough. The upper flexible firing assembly 30610 can span the area designated generally as 30700 between the proximal face 30212 of the proximal joint member 30210 and the distal face 30252 of the distal joint member 30250 and can slideably pass through an upper distal firing member conduit 30257 in the distal joint member 30250. Similarly, the proximal joint member 30210 is provided with a lower proximal firing member conduit 30216 that is configured to accommodate a lower flexible firing assembly 30620 member therethrough. The lower flexible firing assembly 30620 spans the area 30700 and is received in a lower distal firing member conduit 30259 in the distal joint member 30250. The upper and lower flexible firing assemblies 30610, 30620 are operably interfaced with a firing member in the surgical end effector 31000. The upper and lower flexible firing assemblies 30610, 30620 can be identical or very similar in construction to various flexible firing member drive arrangements disclosed herein.

[0371] Figure 153 Another form of articulation joint 30200' is shown that is identical in construction and operation to the articulation joint 30200 described above except that the first link 30310 and the second link 30320 are connected together by an annular ring 30380 that is located in the area 30700 between the proximal face 30212 of the proximal joint member 30210 and the distal face 30252 of the distal joint member 30250. In at least one arrangement, the annular ring 30380 comprises an outer diameter that is equal to or less than the outer diameter of the proximal joint member 30210 and the outer diameter of the distal joint member 30250. In one arrangement, for example, the outer diameter of the distal joint member 30250 is equal to the outer diameter of the proximal joint member 30210 that is equal to or less than the maximum outer diameter of the elongate shaft assembly 32000. Thus, this arrangement permits the surgical instrument 30010 to be inserted into a patient through a trocar cannula that can accommodate the maximum outer diameter of the elongate shaft assembly 32000. The annular ring 30380 can be particularly advantageous in that it can prevent tissue or a flexible outer joint cover (not shown) from potentially getting caught between the joint components.

[0372] The articulation joints 30200, 30200' utilize an external linkage assembly 30300 that connects the proximal cross pin assembly 30330 and the distal cross pin assembly 30350 together and resolves torsional loads and axial loads applied to the joint, an arrangement that can be particularly important in addressing loads in the instrument during firing of the firing member. This joint arrangement also leaves space between the proximal and distal joint members to accommodate additional components / features. As can be seen in the various figures, the proximal and distal joint members are each provided with a clearance pocket / feature / profile to accommodate the linkage assembly as the joint is articulated.

[0373] Figures 154-156 Another form of articulation joint 33000 is shown that can be employed to couple various types of surgical end effector disclosed herein to an elongated shaft assembly 34000 of a surgical instrument 33010. The elongated shaft assembly 34000 includes a central spine member 34100 Figure 155 that can be coupled to or otherwise operably interfaced with a housing (not shown) of the surgical instrument 33010. The elongated shaft assembly 34000 further includes an outer tube member 34110 that extends over the central spine member 34100. In at least one form, the articulation joint 33000 includes a proximal joint member 33100 that is attached to the central spine member 34100 and a distal joint member 33300 that is attached to a surgical end effector (not shown). For example, the distal joint member 33300 can be attached to an elongated channel of an endoscopic cutter arrangement in various manners disclosed herein.

[0374] In the illustrated arrangement, the proximal joint member 33100 includes a first or right half segment 33100A and a second or left half segment 33100B that are attached to a distal end of the central spine member 34100. The first and second half segments 33100A, 33100B can be attached to the central spine member 34100 or other similar components of the elongated shaft assembly 34000 by welding, adhesive, mechanical fastener, pin, etc. According to one aspect, the surgical instrument 33010 includes a firing system 35000 that includes a distal differential drive assembly 35100 and a proximal differential drive assembly 35500.

[0375] As can be seen in Figure 156 , the proximal joint member 33100 operably supports the distal differential drive assembly 35100. In one arrangement, the distal differential drive assembly 35100 includes an upper distal rack assembly 35110 that is supported for axial travel within the proximal joint member 33100. As can be seen in Figure 156 , Figure 157 and Figure 158As can be seen in FIGS. 33 and 34, the upper distal rack assembly 35110 is supported in meshing engagement with a distal differential gear 35130 that is rotatably supported on a pivot shaft 35132 that is supported in the proximal joint member 33100. The upper distal rack assembly 35110 is supported for axial travel within the proximal joint member 33100. The distal differential drive assembly 35100 further includes a lower distal rack assembly 35120 that is supported in meshing engagement with the distal differential gear 35130 and is configured for axial travel within the proximal joint member 33100.

[0376] According to one aspect, the firing system 35000 further comprises an upper flexible firing assembly 35300 and a lower flexible firing assembly 35400 that are configured to operably interface with the firing member 35200. As can be seen in FIGS. 33 and 34, Figure 156 and Figure 159 As can be seen in FIGS. 33 and 34, the firing member 35200 comprises a vertically extending firing member body 35212 that comprises a top firing member feature 35220 and a bottom firing member feature 35230. A tissue cutting blade 35214 is attached to or formed in the vertically extending firing member body 35212. In at least one arrangement, the top firing member feature 35220 comprises a top fin-like portion 35222 having a top axial conduit 35224 extending therethrough. The bottom firing member feature 35230 comprises a bottom fin-like portion 35232 having a bottom axial conduit 35234 extending therethrough. In at least one arrangement, the top firing member feature 35220 and the bottom firing member feature 35230 are integrally formed with the vertically extending firing member body 35212. In at least one example, the anvil body comprises an axially extending anvil slot that is configured to accommodate passage of the top firing member feature 35220 in various manners as described herein. Similarly, the elongate channel comprises an axially extending channel slot that is configured to accommodate passage of the bottom firing member feature 35230 as described herein.

[0377] In one example, the upper flexible firing assembly 35300 includes an upper flexible tube or conduit 35310 having a proximal end 35312 supported in a distal socket 3512 in an upper distal rack assembly 35110 and secured to the distal socket by welding, adhesive, or the like. The upper flexible tube or conduit 35310 extends through an upper opening 33218 in a proximal connector member 33100 and across an articulated joint 33000. The upper flexible tube or conduit 35310 includes a distal end 35314 received in an opening 33330 in the distal connector member 33300 and terminated or secured therein by welding, adhesive, or the like. The upper flexible firing assembly 35300 also includes an upper actuation coil 35320. The upper actuation coil 35320 is hollow and may include a helical spring made of nitinol, titanium, stainless steel, or the like. In other arrangements, the upper actuation coil 35320 includes a laser-cut thiopanel tube, which essentially comprises a hollow tubular member with offset laser cutouts or helical cutouts, enabling the thiopanel tube to flex and bend. The upper actuation coil 35320 may also be received within an internal flexible upper sleeve 35330, which may be made of a polymer or similar material and prevents tissue, fluid, and / or debris from penetrating into the upper actuation coil 35320, which could impede the upper actuation coil's ability to flex and bend during joint movement.

[0378] The upper push coil 35320 extends through the upper flexible tube 35310 and through an axial conduit in the upper distal rack 35110. The upper support beam 35140 is supported by the central ridge member 34100 and has an upper conduit 35142 to constrain and allow the upper push coil 35320 to pass through it. Figure 159 As can be seen, the distal end 35322 of the upper push coil 35320 and the distal end 35332 of the inner flexible upper sleeve 35330 are adjacent to the proximal end 35223 of the top fin-shaped portion 35222 of the top firing member feature 35220. Also in the illustrated arrangement, the upper firing assembly 35300 includes an upper cable 35340 extending through the hollow upper push coil 35320. The upper cable 35340 includes a distal end 35342, which is secured within a top axial conduit 35224 in the top fin-shaped portion 35222 of the top firing member feature 35220 by an upper attachment lug 35343.

[0379] Turn Figures 156-161The proximal differential drive assembly 35500 includes an upper rack 35510 that is slidably supported within the central spine member 34100. The proximal differential drive assembly 35500 also includes a lower proximal rack 35520 that is supported for axial travel within the central spine member 34100. The proximal differential drive assembly 35500 also includes an axially movable carrier member 35530 that is centrally disposed between the upper proximal rack 35510 and the lower proximal rack 35520 and is supported for axial travel within the central spine member 34100. A proximal pinion gear 35532 is pivotally supported on a pin 35533 that is mounted to the axially movable carrier member 35530 such that the proximal pinion gear 35532 is in meshing engagement with the upper proximal rack 35510 and the lower proximal rack 35520. The axially movable carrier member 35530 is axially driven within an axial cavity in the central spine member 34100 by a firing drive actuator 35540. As can be seen in Figure 160 the firing drive actuator 35540 includes a firing drive rack 35542 that is in driving engagement with a drive gear 35544 that is driven by a firing motor 35546 that is operably supported in a housing of the surgical instrument 33010. In other arrangements, the firing drive actuator 35540 can be driven axially distally and proximally by a cylinder arrangement or other suitable actuator that interfaces therewith. As can be seen in Figure 156 and Figure 160 the firing drive actuator 35540 can be attached to the axially movable carrier member 35530 by a pair of spaced apart coupling pins 35548.

[0380] In the illustrated arrangement, the upper proximal rack 35510 also includes an upper cable attachment feature 35512 that protrudes from the upper proximal rack and is configured to slide within an upper conduit 35142 in the upper support beam 35140. According to one aspect, the upper cable 35340 extends through the hollow upper push coil 35320 and the proximal end of the upper cable 35340 is fixed to the upper cable attachment feature 35512. The upper cable 35340 is held taut between the top firing member feature 35220 and the upper cable attachment feature 35512 which serves to maintain the distal end 35322 of the upper push coil 35320 and the distal end 35332 of the inner flexible upper sleeve 35330 in abutting contact with the proximal end 35323 of the top fin portion 35222 of the top firing member feature 35220 and the proximal end of the upper push coil 35320 and the proximal end of the inner flexible upper sleeve 35330 in abutting contact with the distal end of the upper cable attachment feature 35512.

[0381] In one example, the lower flexible firing assembly 35400 includes a lower flexible tube or conduit 35410 having a proximal end 35412 that is supported in and secured to a distal socket 35122 in the lower distal rack 35120 by welding, adhesive, etc. The lower flexible tube or conduit 35410 extends through a lower opening 33219 in the proximal joint member 33100 and across the articulation joint 33000. The lower flexible tube or conduit 35410 includes a distal end 35414 that is received in and terminated or secured in an opening 33340 in the distal joint member 33300 by welding, adhesive, etc. The lower flexible firing assembly 35400 also includes a lower push coil 35420. The lower push coil 35420 is hollow and can comprise a helical spring made of nitinol, titanium, stainless steel, etc. In other arrangements, the lower push coil 35420 comprises a laser cut hypotube that essentially comprises a hollow tubular member having offset laser or helical cuts therein that enable the hypotube to flex and bend. The lower push coil 35420 can additionally be received within an inner flexible lower sleeve 35430 that can be made of a polymer or similar material and prevents tissue, fluids, and / or debris from penetrating into the lower push coil 35420 that can interfere with the ability of the lower push coil to flex and bend during articulation.

[0382] The lower push coil 35420 extends through the lower flexible tube 35410 and through an axial conduit in the lower distal rack 35120. A lower support beam 35150 is supported by the central spine member 34100 and has a lower conduit 35152 to constrain and allow the lower push coil 35420 therethrough. As Figure 159As can be seen, the distal end 35422 of the lower push coil 35420 and the distal end 35432 of the inner flexible lower sleeve 35430 abut the proximal end 35233 of the bottom fin portion 35232 of the bottom firing member feature 35230. Also in the illustrated arrangement, the lower flexible firing assembly 35400 further comprises a lower cable 35440 that extends through the hollow lower push coil 35420. The lower cable 35440 comprises a lower cable distal end 35442 that is secured within a bottom axial channel 35234 in the bottom fin portion 35232 of the bottom firing member feature 35230 by a lower attachment lug 35443. According to one aspect, the lower cable 35440 extends through the hollow lower push coil 35420 and the distal end of the lower cable 35440 is secured to a lower cable attachment feature 35522 on the lower proximal rack 35520. The lower cable 35440 is held taut between the bottom firing member feature 35230 and the lower cable attachment feature 35522 which serves to maintain the distal end 35422 of the lower push coil 35420 and the distal end 35332 of the inner flexible upper sleeve 35330 in abutting contact with the proximal end 35233 of the bottom fin portion 35232 of the bottom firing member feature 35230 and the proximal end of the lower push coil 35420 and the proximal end of the inner flexible lower sleeve 35430 in abutting contact with the distal end of the lower cable attachment feature 35522.

[0383] Surgical stapling devices require a great deal of force to be exerted on the firing member to form the staples and cut the tissue as the device is passed through long displacements. Transferring this force through an articulation joint is particularly challenging as it is difficult to redirect the force in the desired direction and it is difficult to withstand the loads exerted on it. The firing system 35000 described herein addresses and deals with many of these challenges by employing two flexible tubes 35310, 35410 to constrain the paths of the push coils 35320, 35420, respectively, even if it does not address and deal with all of them. As described herein, the upper flexible tube 35310 surrounds the upper push coil 35320 and the lower flexible tube 35410 surrounds the lower push coil 35420. Each of the tubes 35310, 35410 can bend, but they can also resolve axial tensile loads. See Figure 164 and Figure 165The ability to bend allows the firing member force to be redirected through the articulation joint, and the ability to untension allows it to change the direction in which the push coil travels. When the push coil 35320, 35420 is in a compressed state, the flexible tube 35310, 35410 is in a tensioned state. The tube 35310, 35410 prevents the push coil 35320, 35420 from buckling. To untension the tensile load, the tube 35310, 35410 needs to terminate in a manner that untensions the load. In the illustrated example, the respective distal end 35314, 35414 of the flexible tube 35310, 35410 is fixed to the distal joint member 33300. The proximal end 35312, 35412 of the flexible tube 35310, 35410 is fixed to the upper distal rack assembly 35110 and the lower distal rack 35120, respectively. The distal differential gear 35130 is in meshing engagement with each of the upper distal rack assembly 35110 and the lower distal rack 35120, such that when one of the rack assemblies 35110, 35120 moves in one axial direction, the other of the rack assemblies 35110, 35120 will move axially in the opposite axial direction. As can be seen in FIG. 33, Figures 163-165 During articulation, the distal differential gear 35130 rotates, so the flexible tubes 35310, 35410 can move to account for the change in path length. However, when the firing drive system is actuated to push the push coil 35320, 35420 distally through the tubes 35310, 35410 to fire (i.e., drive the firing member distally), the tensile load in both flexible tubes 35310, 35410 react against each other, and the distal differential gear 35130 does not have any motion.

[0384] According to one aspect, the upper flexible tube or conduit 35310 forms an upper path across the articulation joint 33000, and the lower flexible tube or conduit 35410 forms a lower path across the articulation joint 33000. The upper path supports axial travel of the upper push coil 35320 therethrough, and supports axial travel of the lower push coil 35420 therethrough. When the surgical end effector to which the articulation joint 33000 is attached is in an unarticulated position (i.e., the surgical end effector is articulated with the elongate shaft assembly axially aligned along the shaft axis), the upper and lower paths are parallel. In other words, when the surgical end effector is in the unarticulated position, the end effector axis is axially aligned with the shaft axis, and the upper and lower paths are parallel. When the surgical end effector is in the unarticulated position (i.e., the end effector axis is not axially aligned with the shaft axis), the upper and lower paths are concentric with one another. When the surgical end effector is in the unarticulated position, the proximal differential drive assembly is configured to drive the upper push coil 35320 and the lower push coil 35420 equal distances in the same axial direction (distal direction DD) to impart an upper axial drive motion and a lower axial drive motion to the firing member. The upper and lower axial drive motions are substantially equal in magnitude, which serves to advance the firing member distally through the surgical end effector without constraint, which can otherwise occur if the upper and lower axial drive motions were different in magnitude. Similarly, when the surgical end effector is in an articulated position relative to the elongate shaft assembly, the proximal differential drive assembly is configured to allow the upper push coil 35320 and the lower push coil 35420 to move approximately equal distances in opposite axial directions, and thereafter impart upper and lower axial drive motions to the firing member that are equal to one another.

[0385] As Figure 156As can be seen, the proximal joint member 33100 defines a proximal face 33200 that is configured to receive a spherical proximal end 33410 of the central link member 33400. In the illustrated arrangement, the spherical proximal end 33410 is configured to be pivotally received in a proximal socket 33210 in the proximal face 33200 of the proximal joint member 33100. The spherical proximal end 33410 of the central link member 33400 is retained within the proximal socket 33210 by a proximal cross pin assembly 33500. According to one aspect, the proximal cross pin assembly 33500 includes a first proximal cross pin 33510 that defines a first proximal pivot axis FPPA. The first proximal cross pin 33510 is pivotally supported in a pair of attachment lugs 33220 formed on the proximal face 33200 of the proximal joint member 33100 and extends through two opposing arcuate slots 33412 to allow the first proximal cross pin 33510 to pivot within the spherical proximal end 33410 of the central link member 33400 as well as rotational travel. In other words, the spherical proximal end 33410 of the central link member 33400 is rotatable about the first proximal cross pin 33510 and is pivotable through a proximal pivot angle PPA defined by the arcuate slots 33412.

[0386] The proximal cross pin assembly 33500 also includes a second proximal cross pin 33520 that is rotatably journaled on the first proximal cross pin 33510 to allow relative pivotal rotation between the first proximal cross pin 33510 and the second proximal cross pin 33520. The second proximal cross pin 33520 is pivotally supported within the spherical proximal end 33410 of the central link member 33400 and defines a second proximal pivot axis SPPA. The first proximal pivot axis FPPA is transverse to the shaft axis SA. The second proximal pivot axis SPPA is transverse to the shaft axis SA and the first proximal pivot axis FPPA. The proximal cross pin assembly 33500 facilitates pivotal travel of the spherical proximal end 33410 of the central link member 33400 relative to the proximal joint member 33100 about the first proximal pivot axis FPPA and the second proximal pivot axis SPPA.

[0387] In the illustrated arrangement, the distal joint member 33100 defines a distal face 33310 that is configured to receive a spherical distal end 33420 of the central link member 33400. In the illustrated arrangement, the spherical distal end 33420 is configured to be pivotally received in a distal socket 33312 in the distal face 33310 of the distal joint member 33300. The spherical distal end 33420 of the central link member 33400 is retained within the distal socket 33312 by a distal cross pin assembly 33600. According to one aspect, the distal cross pin assembly 33600 includes a first distal cross pin 33610 that defines a first distal pivot axis FDPA. The first distal cross pin 33610 is pivotally supported in a pair of attachment lugs 33314 formed on the distal face 33312 of the distal joint member 33300 and extends through two opposing arcuate slots 33422 to permit pivotal and rotational travel of the first distal cross pin 33610 within the spherical distal end 33420 of the central link member 33400. In other words, the spherical distal end 33420 of the central link member 33400 is rotatable about the first distal cross pin 33610 and is pivotable through a distal pivot angle DPA defined by the arcuate slots 33412.

[0388] The distal cross pin assembly 33600 also includes a second distal cross pin 33620 that is rotatably journaled on the first distal cross pin 33610 to permit relative pivotal rotation between the first distal cross pin 33610 and the second distal cross pin 33620. The second distal cross pin 33620 is pivotally supported within the spherical distal end 33420 of the central link member 33400 and defines a second distal pivot axis SDPA. The first distal pivot axis FDPA is transverse to the shaft axis SA. The second distal pivot axis SDPA is transverse to the shaft axis SA and the first distal pivot axis FDPA. The distal cross pin assembly 33600 facilitates pivotal travel of the spherical distal end 33420 of the central link member 33400 relative to the distal joint member 33300 about the first distal pivot axis FDPA and the second distal pivot axis SDPA.

[0389] According to at least one aspect, the articulation joint 33000 also includes a flexible joint support assembly, generally designated 33700, that provides flexible support between the proximal joint member 33100 and the distal joint member 33200 during articulation and helps return the articulation joint 33000 to the non-articulated position Figures 155-158In at least one arrangement, the flexible joint support assembly 33700 includes a series of flexible members 33710, 33720, 33730, and 33740 that pass through and extend between a hollow central link portion 33430 attached to and extending between the spherical proximal end 33410 and the spherical distal end 33420. The flexible members 33710, 33720, 33730, and 33740 may comprise cables or spring members made of, for example, spring steel, stainless steel, nitinol, titanium, etc. More specifically and referring to… Figure 166 The first flexible member 33710 includes a central portion 33712 and a proximal end portion 33714, the proximal end portion being configured to be received in a corresponding attachment hole 33212 in the first or right half-section 33100A of the proximal connector member 33100. Figure 156 The first flexible member 33710 also includes a distal end portion 33716, which is configured to be received in and attached to a corresponding slot 33320 in the distal connector member 33300. In this arrangement, the central portion 33712 of the first flexible member 33710 extends diagonally through the hollow central link portion 33430. The second flexible member 33720 includes a central portion 33722 and a proximal end portion 33724, which is configured to be received in a corresponding attachment hole 33214 in the second or left segment 33100B of the proximal connector member 33100. Figure 156The second flexible member 33720 includes a central portion 33722 and a proximal end portion (not shown) that is configured to be inserted into a corresponding attachment hole (not shown) in the first or right segment 33100A of the proximal joint member 33100 and secured therein. The second flexible member 33720 also includes a distal end portion 33726 that is configured to be received in a corresponding slotted hole 33322 in the distal joint member 33300 and secured therein. In this arrangement, the central portion 33722 of the second flexible member 33720 extends diagonally through the hollow central link portion 33430. The third flexible member 33730 includes a central portion 33732 and a proximal end portion (not shown) that is configured to be inserted into a corresponding attachment hole (not shown) in the first or right segment 33100A of the proximal joint member 33100 and secured therein. The third flexible member 33730 also includes a distal end portion 33736 that is configured to be received in a corresponding slotted hole 33324 in the distal joint member 33300 and secured therein. In this arrangement, the central portion 33732 of the third flexible member 33730 extends diagonally through the hollow central link portion 33430. The fourth flexible member 33740 includes a central portion 33742 and a proximal end portion 33744 that is configured to be inserted into a corresponding attachment hole 33216 in the second or left segment 33100B of the proximal joint member 33100 and secured therein. The fourth flexible member 33740 also includes a distal end portion 33746 that is configured to be received in a corresponding slotted hole 33326 in the distal joint member 33300 and secured therein. In this arrangement, the central portion 33742 of the fourth flexible member 33740 extends diagonally through the hollow central link portion 33430.

[0390] The surgical instrument 33010 also includes an articulation system 33800 that is configured to apply articulation motions to the surgical end effector to cause the surgical end effector to articulate relative to the elongate shaft assembly 34000. In at least one arrangement, the articulation system 33800 includes four articulation cables 33810, 33820, 33830, and 33840 that extend through the elongate shaft assembly 34000. In the illustrated arrangement, the articulation cables 33810, 33820, 33830, and 33840 pass through the proximal articulation joint member 33100 and the distal articulation joint member 33300 and are secured to the surgical end effector in various manners disclosed herein. The articulation cables 33810, 33820, 33830, and 33840 are operably interfaced with an articulation control system that is supported in or otherwise associated with the housing of the surgical instrument 33010. For example, as discussed above, a proximal portion of each cable 33810, 33820, 33830, and 33840 can be wrapped around a corresponding rotary spool or cable management system 2007 Figure 2 444) in the housing portion of the surgical instrument 33010 that is configured to pay out and retract each cable 33810, 33820, 33830, and 33840 in a desired manner. The spool / cable management system can be motor driven or manually driven (ratchet arrangement, etc.). Figure 154 、 Figure 155 、 Figure 157 、 Figure 158 、 Figure 162 and Figure 167 illustrates the position of the articulation joint 33000 when the surgical end effector is in an unarticulated position, and Figure 163 and Figures 169-177 illustrate various positions of the articulation joint 33000 as the surgical end effector has been articulated in various positions relative to the elongate shaft assembly.

[0391] 444The articulation joint 33000 includes ball joints for pitch and deflection, which are cable-controlled and used for joint movement of a surgical end effector. The articulation joint includes a double ball joint, meaning it has a pair of joints, each capable of both pitch and deflection. This arrangement creates redundancy in the joint, as there are now two joints capable of both pitch and deflection. A flexible joint support assembly 33700 is used to constrain how each joint moves during joint movement, thus allowing four degrees of freedom to function as two. The flexible joint support assembly 33700 connects the two ball joints together such that if one rotates, the other rotates by the same amount. When one joint rotates, it applies tension in the cable, which also forces the other joint to rotate. This joint arrangement offers a very compact form factor and very little recoil in wrist designs.

[0392] Figures 170-173 Another form of articulated joint 14200 is shown, comprising a proximal joint member 14210 and a distal joint member 14250. The proximal joint member 14210 is configured to attach to the distal end of an elongated shaft assembly coupled to a housing or other portion of a surgical instrument. The distal joint member 14250 is configured to attach to a surgical end effector. For example, the distal joint member 14250 can be attached to an elongated channel of an endoscopic cutter arrangement in various manners disclosed herein. Figures 171-175 As can be seen, the proximal connector member 14210 includes a proximal side 14212 that defines two face segments 14214 and 14216 that are angled away from the arcuate proximal tip 14218. Similarly, the distal connector member 14250 includes a distal side 14252 that defines two face segments 14254 and 14256 that are angled away from the arcuate distal tip 14258. The proximal connector member 14210 and the distal connector member 14250 are pivotally held together by at least one and preferably two link assemblies 15000 and 15002 arranged face-to-face with their respective arcuate tip portions 14218 and 14258.

[0393] like Figures 171-175 As can be seen, the first link assembly 15000 includes a first link 15101 and a second link 15020 located on a lateral side of the axis SA. The second link assembly 15002 includes a first link 15010 and a second link 15020 located on a lateral side of the axis SA opposite to that of the first link assembly 15000. Figure 174As can be seen, the first link 15010 of each link assembly 15000, 15002 includes a rigid body 15012 that defines a proximal end 15014 and a distal end 15016. The proximal end 15014 is pivotally coupled or pinned to the proximal joint 14210 on one side (the A-side - see Figure 170 ) of a first reference plane RP1 defined by the shaft axis SA. The proximal end 15014 pivots about a first pivot axis FPA that is transverse to the shaft axis SA. See Figure 174 . The distal end 15016 is pivotally coupled or pinned to the distal joint member 14250 on an opposite side (the B-side - see Figure 176 ) of the first reference plane RP1 such that the first link 15010 passes through the first reference plane RP1. The distal end 15016 pivots about a second pivot axis SPA that is also transverse to the shaft axis SA.

[0394] The second link 15020 of each link assembly 15000, 15002 includes a rigid body 15022 that defines a proximal end 15024 and a distal end 15026. The proximal end 15024 is pivotally coupled or pinned to the proximal joint member 14210 on the B-side of the first reference plane RP1 and the distal end 15016 is pivotally coupled or pinned to the distal joint member 14250 on the A-side of the first reference plane RP1 such that the second link 15020 crosses the first link 15010 and passes through the first reference plane RP1. The proximal end 15024 pivots about a third pivot axis TPA that is transverse to the shaft axis SA and the distal end 15026 pivots about a fourth pivot axis FTPA that is transverse to the shaft axis. In at least one example, all of the pivot axes FPA, SPA, TPA, FTPA are parallel to one another and transverse to the shaft axis SA.

[0395] Turning now to Figure 177 and Figure 176 , the link assemblies 15000, 15002 of the links 15010, 15020 function to position the proximal joint member 14210 and the distal joint member 14250 relative to one another to pivot about two virtual pivot points VPP P and VPP D . In at least one arrangement, the proximal joint member 14210 defines a proximal virtual pivot point VPP P that lies on the shaft axis SA at a proximal radius PR from the arcuate proximal tip 14218. The distal joint member 14250 defines a distal virtual pivot point VPP D that lies on the end effector axis EA at a distal radius DR from the arcuate distal tip 14228. The virtual pivot points VPP P and VPP DLocated on the common joint axis JA, which has a length PR+DR that is held constant by the linkage assemblies 15000, 15002. Figure 177 The articulation joint 14200 is shown in an unarticulated orientation, with the end effector axis EA, joint axis JA, and shaft axis SA axially aligned. Figure 177 The articulation joint 14200 is shown in an articulated orientation. During articulation, the linkage assemblies 15000, 15002 facilitate rotation of the distal joint member 14250 relative to the proximal joint member 14210, such that the angle Θ1 between the shaft axis SA and the joint axis JA is equal to the angle Θ2 between the end effector axis EA and the joint axis JA. See Figure 170 .

[0396] Returning Figure 170 In the illustrated example, the articulation joint 14200 is operably controlled by a cable control system that includes four cables 15040, 15050, 15060, and 15070 that extend through the elongate shaft assembly to be operably interfaced with a cable control system 9030 that can be supported within a housing of the surgical instrument. The cable control system 9030 can include a number of cable support members / active wheels, pulleys, etc. that are controlled by one or more corresponding motors that are controlled by a control circuit portion of the surgical instrument. The cable control system 9030 is configured to manage the tensioning (pulling) and pay-out of the cables at precise times during the articulation process. As Figure 171 As can be seen, the cables 15040, 15050 extend through conduits in the proximal joint member 14210 on the A-side of the first reference plane RP1 and into corresponding conduits in the distal joint member 14250. The cable 15040 has a retainer lug 15042 thereon to prevent it from being pulled through the distal joint member 14250. The cable 15050 also has a retainer lug 15052 to prevent the cable 15050 from being pulled through the distal joint member 14250. The cables 15060, 15070 extend through conduits in the proximal joint member 14210 on the B-side of the first reference plane RP1 and into corresponding conduits in the distal joint member 14250. The cable 15060 has a retainer lug 15062 thereon to prevent it from being pulled through the distal joint member 14250. The cable 15070 also has a retainer lug 15072 to prevent the cable 15050 from being pulled through the distal joint member 14250.

[0397] Figure 172 The articulation joint 14200 is shown in an unarticulated orientation. Figure 173Articulation of distal joint member 14250 on one side of the shaft axis SA in the first articulation direction is shown by applying tension to cables 15040, 15050 and allowing cables 15060, 15070 to relax. Figure 170 Distal joint member 14250 is shown articulated in a maximum articulation orientation having an articulation angle of about ninety degrees relative to the shaft axis SA. Distal joint member 14250 can be articulated in the opposite direction by applying tension to cables 15060 and 15070 and allowing cables 15040, 15050 to relax. In this arrangement, links 15010, 15020 hold proximal joint member 14210 and distal joint member 14250 together without reliance on maintaining tension in cables 15040, 15050, 15060, and 15070. The virtual pivot point arrangement also allows pairs 15000, 15002 of links 15010, 15020 to attach to proximal joint member 14210 and distal joint member 14250 away from those virtual pivot points. This arrangement provides maximum clearance in the central region of articulation joint 14200 to accommodate various actuation members / shafts. As Figures 178-180 As can be seen in the middle, proximal joint member 41210 includes a central proximal opening 14211 and distal joint member 14250 includes a central distal opening 14251. In various embodiments, various control members / drive members 14300 can extend through openings 14211, 14251 to provide drive / control motions to an end effector. Such drive members 14300 must be flexible to accommodate articulation of the articulation joint components. In one arrangement, tip regions 14218, 14528 can be in contact with each other and in other embodiments, tip regions 14218, 14258 are spaced apart from each other. This arrangement also enables distal joint member 14250 to pivotally travel relative to proximal joint member 14210 without using intermeshing gear segments employed in other embodiments.

[0398] Figure 179Another form of articulation joint 16200 is shown that can facilitate articulation of a surgical end effector in multiple articulation planes. In one arrangement, the articulation joint 16200 includes a proximal link member 16210, a central link member 16230, and a distal link member 16250. The proximal link member 16210 is configured for attachment to a distal end of an elongated shaft assembly that is coupled to a housing or other portion of a surgical instrument. The distal link member 16250 is configured for attachment to a surgical end effector. For example, the distal link member 16250 can be attached to an elongated channel of an endoscopic cutter arrangement in various manners disclosed herein. The proximal link member 16210 includes a proximal link distal face 16212 that defines two face segments 16214, 16216 that are angled away from an arcuate proximal apex 16218.

[0399] The central link member 16230 includes a proximal face 16232 that defines two face segments 16234, 16236 that are angled away from a first arcuate central apex 16238. The central link member 16230 further includes a central link distal face 16240 that defines two face segments 16244, 16246 that are angled away from a second arcuate central apex 16248. The distal link member 16250 includes a distal link proximal face 16252 that defines two face segments 16254, 16256 that are angled away from an arcuate distal apex 16258. In the illustrated example, the proximal link member 16210 and the central link member 14230 are pivotally held together with their respective arcuate apex portions 16218, 16238 in a face-to-face arrangement by a first proximal link assembly 17000 that includes proximal links 17010, 17020 on one side (the A-side) of a first reference plane RP1 that extends through the shaft axis SA and a second proximal link assembly 17002 that includes proximal links 17030, 17040 on the B-side of the first reference plane RP1. The first proximal link 17010 includes a rigid body 17012 that defines a proximal end 17014 and a distal end 17016. The proximal end 17014 is pivotally coupled or pinned to the proximal link member 16210 on the C-side of a second reference plane RP2 that is defined by the shaft axis SA and that is orthogonal to the first reference plane RF1. The proximal end 17014 pivots about a first pivot axis FPA that is transverse to the shaft axis SA. See Figure 178The distal end 17016 is pivotally connected or pinned to the central joint member 16230 on the opposite side (D side) of the second reference plane RP2, thereby allowing the first proximal link 17010 to pass through the second reference plane RP2. The distal end 17016 pivots about a second pivot axis SPA, which is also transverse to the axis SA.

[0400] The second proximal link 17020 of the proximal link assembly 17000 includes a rigid body 17022 defining a proximal end 17024 and a distal end 17026. The proximal end 17024 is pivotally coupled or pinned to a proximal joint member 16210 on the D side of the second reference plane RP2, and the distal end 17026 is pivotally coupled or pinned to a center joint member 16230 on the C side of the second reference plane RP2, such that the second proximal link 17020 intersects the first proximal link 17010 and passes through the second reference plane RP2. The proximal end 17024 pivots about a third pivot axis TPA transverse to the axis SA, and the distal end 17026 pivots about a fourth pivot axis FTPA transverse to the axis SA. In at least one example, all pivot axes FPA, SPA, TPA, and FTPA are parallel to eac...

Claims

1. A surgical instrument, comprising: Shaft assembly, wherein the shaft assembly defines a shaft axis; A surgical end effector, wherein the surgical end effector defines an end effector axis, wherein the surgical end effector is coupled to the axis assembly via an articulated joint, the articulated joint being configured to facilitate articulation of the surgical end effector relative to the axis assembly in an articulation plane between a non-articulated position and an articulated position, wherein in the non-articulated position the end effector axis is axially aligned with the axis axis in the articulation plane, and in the articulated position the end effector axis is not axially aligned with the axis axis, wherein the articulated joint includes: A proximal connector member coupled to the shaft assembly, wherein the proximal connector member includes a proximal side defining an arcuate proximal apex; A distal connector member, the distal connector member being coupled to the surgical end effector, wherein the distal connector member includes a distal surface defining an arcuate distal apex; and At least one linkage assembly, including: A first link, the first link being connected to the proximal joint member and the distal joint member; and A second link, connecting the proximal connector member and the distal connector member, wherein the second link intersects the first link, wherein the first link and the second link pivotally connect the proximal connector member to the distal connector member such that the arcuate distal apex faces the arcuate proximal apex, wherein the surgical instrument further includes at least two flexible actuator members, wherein the at least two flexible actuator members span the articulation joint and are operatively engaged with the distal connector member to apply articulation to the distal connector member.

2. The surgical instrument according to claim 1, wherein, The at least one link assembly movably attaches the proximal connector member to the distal connector member, thereby spacing the arcuate distal tip from the arcuate proximal tip.

3. The surgical instrument according to claim 1, wherein, The at least one linkage assembly movably attaches the proximal connector member to the distal connector member, thereby supporting the arcuate distal tip in rolling contact with the arcuate proximal tip.

4. The surgical instrument according to claim 1, wherein, The at least one linkage assembly includes: A first linkage assembly, comprising a first link and a second link, wherein the first link and the second link are located on one side of the axis; and The second link assembly includes: Another first link, which is connected to the proximal joint member and the distal joint member; and Another second link, which is connected to the proximal connector member and the distal connector member, wherein the other second link intersects the other first link, and wherein the second link assembly is located on the other side of the axis.

5. The surgical instrument according to claim 1, wherein, The surgical end effector is capable of articulating relative to the shaft assembly and moving through joint motion angles on each side of the shaft axis, wherein each joint motion angle ranges from zero to ninety degrees.

6. The surgical instrument according to claim 1, wherein, The arcuate distal tip is defined by a distal radius extending between the distal virtual pivot point and the arcuate distal tip, wherein the arcuate proximal tip is defined by a proximal radius extending between the proximal virtual pivot point and the arcuate proximal side, wherein the distal virtual pivot point and the proximal virtual pivot point are located on a common joint axis extending between the distal virtual pivot point and the proximal virtual pivot point.

7. The surgical instrument according to claim 6, wherein, When the surgical end effector articulates relative to the shaft assembly, the proximal angle between the shaft axis and the connector axis is equal to the distal angle between the end effector axis and the connector axis.

8. The surgical instrument according to claim 6, wherein, The first link of each of the at least one link assembly is attached to the proximal joint member at a corresponding proximal position, the corresponding proximal position being offset relative to a proximal virtual pivot axis perpendicular to the axis and extending through the proximal virtual pivot point, and wherein the first link of each of the at least one link assembly is attached to the distal joint member at a corresponding distal position, the distal position being offset relative to a distal virtual pivot axis perpendicular to the end effector axis and extending through the distal virtual pivot point.

9. The surgical instrument according to claim 8, wherein, The second link of each of the at least one link assembly is attached to the proximal joint member at another corresponding proximal position, the other corresponding proximal position being offset relative to the proximal virtual pivot axis, and wherein the second link of each of the at least one link assembly is attached to the distal joint member at another corresponding distal position, the other corresponding distal position being offset relative to the distal virtual pivot axis.

10. The surgical instrument according to claim 1, wherein, The proximal connector member includes a proximal central conduit, and the distal connector member includes a distal central conduit, and the surgical instrument includes a flexible drive member extending through the proximal central conduit and the distal central conduit.

11. A surgical instrument, comprising: Shaft assembly, wherein the shaft assembly defines a shaft axis; A surgical end effector, wherein the surgical end effector defines an end effector axis, wherein the surgical end effector is coupled to the axis assembly via an articulated joint, the articulated joint being configured to facilitate articulation of the surgical end effector relative to the axis assembly in an articulation plane between a non-articulated position and an articulated position, wherein in the non-articulated position the end effector axis is axially aligned with the axis axis in the articulation plane, and in the articulated position the end effector axis is not axially aligned with the axis axis, wherein the articulated joint includes: A proximal connector member, the proximal connector member being coupled to the shaft assembly, wherein the proximal connector member includes a proximal arcuate tip; A central connector component, the central connector component including a first arcuate apex facing the proximal side and a second arcuate apex facing the distal side; A distal connector member, coupled to the surgical end effector, wherein the distal connector member defines a distal arcuate connector apex; and At least one proximal link assembly, the at least one proximal link assembly comprising: A first proximal link, the first proximal link being connected to the proximal joint member and the central joint member; and A second proximal link is connected to the proximal connector member and the central connector member, wherein the second proximal link intersects the first proximal link, and wherein the first and second proximal links pivotally connect the proximal connector member to the central connector member such that the first arcuate apex facing proximally faces the proximal arcuate apex, so that the central connector member can articulate relative to the proximal connector member and move through a first articulation plane, and wherein the surgical instrument further includes at least one distal link assembly, the at least one distal link assembly comprising: A first distal link, the first distal link being connected to the central joint member and the distal joint member; and A second distal link is connected to the central connector member and the distal connector member, wherein the second distal link intersects with the first distal link, and wherein the first distal link and the second distal link pivotally connect the central connector member to the distal connector member such that the distal arcuate connector tip faces the arcuate, distally facing second arcuate tip, so that the distal connector member can articulate relative to the central connector member and move through a second articulation plane different from the first articulation plane, wherein the surgical instrument further includes four flexible actuator members, and wherein the four flexible actuator members span the articulation connector and are operatively engaged with the distal connector member to apply articulation to the distal connector member.

12. The surgical instrument according to claim 11, wherein, The at least one proximal link assembly movably attaches the central connector member to the proximal connector member, such that the first arcuate tip facing proximal is spaced apart from the proximal arcuate tip, and wherein the at least one distal link assembly movably attaches the distal connector member to the central connector member, such that the distal arcuate tip is spaced apart from the second arcuate tip facing distal.

13. The surgical instrument according to claim 11, wherein, The at least one proximal link assembly movably attaches the central joint member to the proximal joint member such that the first arcuate tip facing proximal side rolls into contact with the proximal arcuate tip, and wherein the at least one distal link assembly movably attaches the distal joint member to the central joint member such that the distal arcuate tip rolls into contact with the second arcuate tip facing distal side.

14. The surgical instrument according to claim 11, wherein, The at least one proximal link assembly includes: A first proximal link assembly, comprising a first proximal link and a second proximal link, wherein the first proximal link and the second proximal link are located on one side of the axis; and The second proximal link assembly includes: Another proximal first link, which is connected to the proximal joint member and the central joint member; and Another proximal second link, which is connected to the proximal joint member and the center joint member, wherein the other proximal second link intersects the other proximal first link, and wherein the second proximal link assembly is located on the other side of the axis.

15. The surgical instrument according to claim 14, wherein, The at least one distal link assembly includes: A first distal link assembly, comprising a first distal link and a second distal link, wherein the first distal link and the second distal link are located on one side of the axis; and The second distal link assembly includes: Another first distal link, the other first distal link being connected to the central joint member and the distal joint member; and Another second distal link is connected to the center joint member and the distal joint member, wherein the other second distal link intersects with the other first distal link, and wherein the second distal link assembly is located on the other side of the axis.

16. The surgical instrument according to claim 11, wherein, The second joint motion plane is perpendicular to the first joint motion plane.

17. The surgical instrument according to claim 11, wherein, The proximal connector member includes a proximal conduit passing through the proximal connector member, the central connector member includes a central conduit passing through the central connector member, the distal connector member includes a distal conduit passing through the distal connector member, and the surgical instrument further includes at least one drive member extending through the proximal conduit, the central conduit, and the distal conduit to transmit drive motion to the end effector.

18. The surgical instrument of claim 11, further comprising a first reference plane extending through the axis and a second reference plane extending perpendicularly through the axis relative to the first reference plane, wherein a first cable of the cable passes through the proximal connector member on a first side of the first reference plane and the first side of the second reference plane, and extends through the first reference plane and into the central connector member on a second side of the first reference plane, and extends through the second reference plane and into the distal connector member on a second side of the first reference plane, and wherein a second cable of the cable extends through the proximal connector member on a second side of the first reference plane and the first side of the second reference plane, and extends through the second reference plane and into the central connector member on a first side of the first reference plane, and passes through the second reference plane to extend into the distal connector member on a first side of the first reference plane and the second side of the second reference plane.

19. A surgical instrument comprising: Shaft assembly, wherein the shaft assembly defines a shaft axis; A surgical end effector, the surgical end effector being coupled to the shaft assembly via a joint joint, wherein the joint joint includes: A proximal connector member, which is connected to the shaft assembly; A distal connector assembly, the distal connector assembly being coupled to the surgical end effector; A first link assembly, the first link assembly comprising: A first link, the first link being connected on a first side of the axis to the proximal joint member and the distal joint member; and A second link, connected to the proximal joint member on the first side of the axis, wherein the second link intersects the first link and is attached to the distal joint member on the first side of the axis, and wherein the articulation joint further includes: The second link assembly includes: A third link, which connects on a second side of the axis to the proximal connector and the distal connector; and A fourth link is connected to the proximal connector member on the second side of the axis, wherein the fourth link intersects the third link on the second side of the axis and is attached to the distal connector member on the second side of the axis, wherein the first and second link assemblies facilitate articulation of the surgical end effector relative to the axis assembly and the movement passes through the articulation plane, wherein the surgical instrument further includes at least two flexible actuator members, and wherein the at least two flexible actuator members span the articulation connector and are operatively engaged with the distal connector member to apply articulation to the distal connector member.

20. The surgical instrument according to claim 19, wherein, The proximal connector member defines a proximal central canal extending through the proximal connector member, and the distal connector member defines a distal central canal extending through the distal connector member, and the surgical instrument includes a flexible drive member extending through the proximal central canal and the distal central canal to apply drive motion to the surgical end effector.

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