Multi-axis pivot joint for a surgical instrument and method of manufacturing the same

Abstract

The present disclosure provides polyaxial pivot joints and surgical instrument drive shafts formed using additive manufacturing methods.

Description

Background Technology

[0001] This invention relates to surgical instruments, and in various arrangements, to surgical suturing and cutting instruments, end effectors, and staple cartridges used with them, designed to suture and cut tissue. Attached Figure Description

[0002] The various features and advantages of the implementation scheme described herein can be understood in conjunction with the following figures and the following description:

[0003] Figure 1 This is a perspective view of a surgical suturing instrument including a handle, a shaft assembly, and an end effector according to at least one aspect of this disclosure.

[0004] Figure 2 It is based on at least one aspect of this disclosure Figure 1 A perspective view of a portion of the end effector and shaft assembly of a surgical suture instrument, wherein the end effector is shown in a straight or non-articular motion configuration.

[0005] Figure 3 It is based on at least one aspect of this disclosure Figure 1 A perspective view of a portion of the end effector and shaft assembly of a surgical suture instrument, wherein the end effector is shown in an articulated configuration.

[0006] Figure 4 It is based on at least one aspect of this disclosure Figure 1 An exploded perspective view of the end effector and a portion of the shaft assembly of a surgical suture instrument.

[0007] Figure 5 It is based on at least one aspect of this disclosure Figure 1 A cross-sectional front view of a portion of the end effector and shaft assembly of a surgical suture instrument, wherein the end effector is shown in a non-firing, clamping configuration.

[0008] Figure 6 It is based on at least one aspect of this disclosure Figure 1 A plan view of the end actuator and a portion of the shaft assembly of a surgical suture instrument.

[0009] Figure 7 It is based on at least one aspect of this disclosure. Figure 6 Section line 6-6 in the middle Figure 1 A cross-sectional front view of a portion of the end effector and shaft assembly, wherein the end effector is shown in an open configuration.

[0010] Figure 8 It is based on at least one aspect of this disclosure. Figure 6 Section line 7-7 in the middle Figure 1A cross-sectional front view of a portion of the end effector and shaft assembly, wherein the end effector is shown in a clamping configuration.

[0011] Figure 9 It is based on at least one aspect of this disclosure Figure 1 A perspective view of a surgical suture assembly including a shaft assembly and an end effector, wherein the end effector is attached to the shaft assembly via an articular joint.

[0012] Figure 10 It is based on at least one aspect of this disclosure Figure 9 Exploded perspective view of the surgical suture assembly.

[0013] Figure 11 It is based on at least one aspect of this disclosure Figure 9 A cross-sectional front view of a surgical suture assembly, in which the end effector is shown in a non-firing, clamping configuration.

[0014] Figure 12 It is based on at least one aspect of this disclosure Figure 1 A perspective view of a surgical suture assembly including a shaft assembly and an end effector, wherein the end effector is attached to the shaft assembly via an articular joint.

[0015] Figure 13 It is based on at least one aspect of this disclosure Figure 12 Exploded perspective view of the surgical suture assembly.

[0016] Figure 14 It is based on at least one aspect of this disclosure Figure 12 A cross-sectional front view of a surgical suture assembly, in which the end effector is shown in a non-firing, clamping configuration.

[0017] Figure 15 It is based on at least one aspect of this disclosure Figure 1 A perspective view of a surgical suture assembly including a shaft assembly and an end effector, wherein the end effector is attached to the shaft assembly via an articular joint.

[0018] Figure 16 It is based on at least one aspect of this disclosure Figure 15 Exploded perspective view of the surgical suture assembly.

[0019] Figure 17 It is based on at least one aspect of this disclosure Figure 15 A cross-sectional front view of a surgical suture assembly, in which the end effector is shown in a non-firing, clamping configuration.

[0020] Figure 18 It includes at least one aspect of this disclosure. Figure 1Perspective view of the surgical end effector assembly of the end effector and flexible firing drive system.

[0021] Figure 19 It is based on at least one aspect of this disclosure Figure 18 Exploded perspective view of the surgical suture assembly.

[0022] Figure 20 It is based on at least one aspect of this disclosure Figure 18 A cross-sectional front view of a surgical end effector assembly, wherein the surgical end effector assembly is shown in a non-firing, clamping configuration.

[0023] Figure 21 This is a perspective view of a robot controller according to at least one aspect of this disclosure.

[0024] Figure 22 This is a perspective view of a robotic arm carriage for a robotic surgical system according to at least one aspect of the present disclosure, showing manipulators on the robotic arm carriage that operatively support surgical tools.

[0025] Figure 23 It is based on at least one aspect of this disclosure Figure 22 Side view of the surgical armcart's manipulator and surgical gripper.

[0026] Figure 24 This is a schematic description of an example of an additive manufacturing system according to at least one aspect of this disclosure.

[0027] Figure 25 It is a description of at least one aspect of the present disclosure that can be made by Figure 24 A diagram in the form of a manufacturing process implemented by an additive manufacturing system.

[0028] Figure 26 It is available under at least one aspect of this disclosure. Figure 25 Manufacturing process and Figure 24 A perspective view of a form of universal movable joint formed by an additive manufacturing system.

[0029] Figure 27 It is based on at least one aspect of this disclosure Figure 26 A cross-sectional view of a universal movable joint.

[0030] Figure 28 It is based on at least one aspect of this disclosure Figure 26 Another perspective view of the universal movable joint.

[0031] Figure 29 It is based on at least one aspect of this disclosure Figure 26 A cross-sectional perspective view of a universal movable joint.

[0032] Figure 30 It is supported by at least one aspect of this disclosure. Figure 24 On the building board of the additive manufacturing system Figure 26 Another cross-sectional view of the universal movable joint.

[0033] Figure 30A It is in the form of a green blank according to at least one aspect of this disclosure. Figure 26 Another cross-sectional perspective view of the universal movable joint.

[0034] Figure 30B It is based on at least one aspect of this disclosure. Figure 30 An enlarged view of a portion of the second cap-shaped part and the bottom joint ring in the first state during the formation of the green universal movable joint, and the rounded space therebetween filled with a certain amount of building material.

[0035] Figure 30C It is based on at least one aspect of this disclosure Figure 30 An enlarged view of a portion of the second cap and a portion of the joint spine of a green universal movable joint, showing the amount of building material in the first state in the second horizontal joint space located between the second cap and the joint spine.

[0036] Figure 31 It is supported by a plurality of support members according to at least one aspect of this disclosure. Figure 24 A cross-sectional view of another universal movable joint in green form on the build plate of the additive manufacturing system.

[0037] Figure 32 It is supported by at least one aspect of this disclosure. Figure 24 A cross-sectional view of another green-formed universal joint on the build plate of the additive manufacturing system, in which build material and separate support material are used during the manufacturing process.

[0038] Figure 33 It is supported by at least one aspect of this disclosure. Figure 24 A cross-sectional view of another green-formed universal joint on the build plate of the additive manufacturing system, wherein the joint spine is formed of a first build material, and the vertical U-shaped joint member and the horizontal U-shaped joint member are formed of a second build material, and separate support materials are used during the manufacturing process.

[0039] Figure 34 This is a perspective view of another embodiment of a universal movable joint according to at least one aspect of this disclosure.

[0040] Figure 35 It is based on at least one aspect of this disclosure Figure 34A cross-sectional view of a universal movable joint.

[0041] Figure 36 It is based on at least one aspect of this disclosure Figure 34 Another cross-sectional view of the universal movable joint.

[0042] Figure 37 This is a perspective view of a universal movable drive shaft section according to at least one aspect of the present disclosure, the universal movable drive shaft section including a usable Figure 24 additive manufacturing systems and / or Figure 25 The manufacturing process produces multiple universal movable joints.

[0043] Figure 38 It is available under at least one aspect of this disclosure. Figure 24 additive manufacturing systems and / or Figure 25 An exploded perspective view of the joint motion joint assembly implementation scheme formed by the manufacturing process.

[0044] Figure 39 It is based on at least one aspect of this disclosure Figure 38 A perspective view of the joint motion joint assembly, which shows a portion of the shaft assembly and a portion of the end effector in dashed lines.

[0045] Figure 40 It is based on at least one aspect of this disclosure Figure 38 Another perspective view of the joint motion joint assembly.

[0046] Figure 41 It is available under at least one aspect of this disclosure. Figure 24 additive manufacturing systems and / or Figure 25 A perspective view of another joint motion joint assembly implementation scheme formed by the manufacturing process.

[0047] Figure 42 This is a perspective view of an installation component embodiment and a universal movable joint embodiment according to at least one aspect of this disclosure.

[0048] Figure 43 It is based on at least one aspect of this disclosure Figure 42 Another perspective view of the mounting components and universal joints, in which a portion of the shaft, conduit, or shaft guide extends through the central channel in the mounting components.

[0049] Figure 44 This is a perspective view of an embodiment of an articulated motion joint connecting an end effector to a shaft assembly, according to at least one aspect of this disclosure.

[0050] Figure 45 It is based on at least one aspect of this disclosure Figure 44 A cross-sectional view of the middle closed drive shaft portion of the joint motion joint.

[0051] Figure 46 It is based on at least one aspect of this disclosure Figure 44 A cross-sectional view of the middle firing drive shaft portion of the articulated joint.

[0052] Figure 47 It is based on at least one aspect of this disclosure Figure 44 A cross-sectional view of a portion of the end actuator, showing the connection between the distal closing drive shaft and the closing screw, and the connection between the distal firing drive shaft and the firing screw.

[0053] Figure 48 It is based on at least one aspect of this disclosure. Figure 47 Section line 48-48 was taken Figure 47 A cross-sectional end view of the closed connector.

[0054] Figure 49 This is a cross-sectional view of a portion of another end actuator according to at least one aspect of this disclosure, showing the connection between the distal closing drive shaft and the closing screw, and the connection between the distal firing drive shaft and the firing screw.

[0055] Figure 50 This is a cross-sectional view of the joint movement region of another surgical instrument according to at least one aspect of this disclosure.

[0056] Figure 51 It is a perspective view of another surgical instrument according to at least one aspect of this disclosure.

[0057] Figure 52 It is based on at least one aspect of this disclosure Figure 51 A breakdown view of a portion of a surgical instrument.

[0058] Figure 53 It is based on at least one aspect of this disclosure Figure 51 A cross-sectional view of a part of a surgical instrument.

[0059] Figure 54 This is a perspective view of an embodiment of a shaft guide according to at least one aspect of this disclosure.

[0060] Figure 55 It is based on at least one aspect of this disclosure Figure 54 A proximal end view of the implementation scheme of the shaft guide.

[0061] Figure 56 It is based on at least one aspect of this disclosure Figure 54 The distal end view of the shaft guide implementation scheme.

[0062] Figure 57 It is based on at least one aspect of this disclosure Figure 54 A side view of the implementation scheme of the shaft guide.

[0063] Figure 58 It is based on at least one aspect of this disclosure Figure 54 Another side view of the shaft guide implementation scheme.

[0064] Figure 59 It is in a fixed position according to at least one aspect of this disclosure. Figure 54 Another view of the implementation scheme of the shaft guide.

[0065] Figure 60 It is located in another fixed position according to at least one aspect of this disclosure. Figure 54 Another view of the implementation scheme of the shaft guide.

[0066] Figure 61 It is based on at least one aspect of this disclosure Figure 54 Another view of the implementation scheme of the shaft guide.

[0067] Figure 62 It is based on at least one aspect of this disclosure. Figure 56 Section line 62-62 is taken Figure 56 A cross-sectional view of the implementation scheme of the shaft guide.

[0068] Figure 63 It is a perspective view of another surgical instrument according to at least one aspect of this disclosure.

[0069] Figure 64 It is based on at least one aspect of this disclosure Figure 63 A breakdown view of a portion of a surgical instrument.

[0070] Figure 65 It is based on at least one aspect of this disclosure Figure 63 Side view of the joint motion joint assembly of a surgical instrument.

[0071] Figure 66 It is based on at least one aspect of this disclosure Figure 63 Another side view of the joint motion joint assembly of the surgical instrument.

[0072] Figure 67 It is in a joint motion configuration according to at least one aspect of this disclosure. Figure 63 Another view of the joint motion joint assembly of a surgical instrument.

[0073] Figure 68It is in another joint motion configuration according to at least one aspect of this disclosure. Figure 63 Another view of the joint motion joint assembly of a surgical instrument.

[0074] Figure 69 It is based on at least one aspect of this disclosure Figure 68 A perspective view of the articulated joint assembly, in which two articulated linkage components have been removed for clarity.

[0075] Figure 70 It is based on at least one aspect of this disclosure Figure 69 An end view of a portion of the joint motion connector assembly.

[0076] Figure 71 It is based on at least one aspect of this disclosure Figure 63 A perspective view of the shaft guide of the joint motion joint assembly of a surgical instrument.

[0077] Figure 72 It is based on at least one aspect of this disclosure Figure 63 A perspective view of the joint motion joint assembly of a surgical instrument.

[0078] Figure 73 It is based on at least one aspect of this disclosure Figure 63 A cross-sectional view of the joint motion joint assembly of a surgical instrument.

[0079] Figure 74 This is a partial perspective view of a joint motion system according to at least one aspect of this disclosure.

[0080] Figure 75 It is a top view of a portion of another end actuator in a non-joint motion position according to at least one aspect of this disclosure.

[0081] Figure 76 It is in a fully articulated position according to at least one aspect of this disclosure. Figure 75 Another top view of the end effector.

[0082] In several views, corresponding reference symbols indicate corresponding parts. The examples described herein illustrate various embodiments of the invention in one form, and such examples should not be construed as limiting the scope of the invention in any way. Detailed Implementation

[0083] The applicant of this application owns the following U.S. patent applications filed on the same date as this application, each of which is incorporated herein by reference in its entirety:

[0084] - U.S. patent application entitled “METHOD OF USING A POWERED STAPLING DEVICE”, Agent’s File No. END9298USNP1 / 200859-1M;

[0085] - U.S. patent application entitled “SURGICAL STAPLING ASSEMBLY COMPRISING NONPLANAR STAPLES AND PLANAR STAPLES”, Agent’s File No. END9298USNP2 / 200859-2;

[0086] - U.S. patent application entitled “SURGICAL STAPLE CARTRIDGE COMPRISING LONGITUDINAL SUPPORT BEAM”, Agent’s File No. END9298USNP3 / 200859-3;

[0087] - U.S. patent application entitled "ROTARY-DRIVEN SURGICAL STAPLING ASSEMBLYCOMPRISINGECENTRICALLY DRIVEN FIRING MEMBER", Agent's File No. END9298USNP4 / 200859-4;

[0088] - A U.S. patent application entitled "ROTARY-DRIVEN SURGICAL STAPLING ASSEMBLYCOMPRISING AFLOATABLE COMPONENT",

[0089] Agent's case file END9298USNP5 / 200859-5;

[0090] - U.S. patent application entitled "DRIVERS FOR FASTENER CARTRIDGE ASSEMBLIESHAVING ROTARY DRIVESCREWS", Agent's File No. END9298USNP6 / 200859-6;

[0091] - U.S. patent application entitled "MATING FEATURES BETWEEN DRIVERS ANDUNDERSIDE OF A CARTRIDGEDECK", Agent's File No. END9298USNP7 / 200859-7;

[0092] - U.S. patent application entitled "LEVERAGING SURFACES FOR CARTRIDGE INSTALLATION", Agent's File No. END9298USNP8 / 200859-8;

[0093] - U.S. patent application entitled "FASTENER CARTRIDGE WITH NON-REPEATING FASTENER ROWS", Agent's File No. END9298USNP9 / 200859-9;

[0094] - U.S. patent application entitled "FIRING MEMBERS HAVING FLEXIBLE PORTIONS FORADAPTING TO A LOADDURING A SURGICAL FIRING STROKE", Agent's File No. END9298USNP10 / 200859-10;

[0095] - U.S. patent application entitled “STAPLING ASSEMBLY COMPONENTS HAVING METAL SUBSTRATES AND PLASTIC BODIES”, Agent’s File No. END9298USNP11 / 200859-11;

[0096] - U.S. patent application entitled “Joint Arrangements for Multi-Planaral Lignanment and Support of Operative Drive Shafts in Artificial Streamical Instructions”, Agent’s File END9298USNP13 / 200859-13; and

[0097] - U.S. patent application entitled "SURGICAL INSTRUMENT ARTICULATION JOINTARRANGEMENTS COMPRISING MULTIPLE MOVING LINKAGEFEATURES", Agent's File No. END9298USNP14 / 200859-14.

[0098] The applicant of this application owns the following U.S. patent applications and U.S. patents, filed on December 19, 2017, each of which is incorporated herein by reference in its entirety:

[0099] - U.S. Patent No. 10,835,330 entitled “METHOD FOR DETERMINING THE POSITION OF AROTATABLE JAW OF ASURGICAL INSTRUMENTATTACHMENT ASSEMBLY”;

[0100] - U.S. Patent No. 10,716,565 entitled “SURGICAL INSTRUMENTS WITH DUALARTICULATION DRIVERS”;

[0101] - U.S. Patent Application Serial No. 15 / 847,325 entitled “SURGICAL TOOLS CONFIGURED FOR INTERCHANGEABLE USE WITH DIFFERENT CONTROLLER INTERFACES” is now published as U.S. Patent Application No. 2019 / 0183491;

[0102] - U.S. Patent No. 10,729,509 entitled "SURGICAL INSTRUMENT COMPRISING CLOSURE AND FIRING LOCKING MECHANISM";

[0103] - U.S. Patent Application Serial No. 15 / 847,315 entitled "ROBOTIC ATTACHMENT COMPRISING EXTERIOR DRIVE ACTUATOR", now published as U.S. Patent Application Publication No. 2019 / 0183594; and

[0104] - U.S. design patent number D910,847 entitled "SURGICAL INSTRUMENT ASSEMBLY".

[0105] The applicant of this application owns the following U.S. patent applications and U.S. patents, filed on June 28, 2017, each of which is incorporated herein by reference in its entirety:

[0106] - U.S. Patent Application Serial No. 15 / 635,693 entitled “SURGICAL INSTRUMENT COMPRISING AN OFFSET ARTICULATION JOINT” is now published as U.S. Patent Application No. 2019 / 0000466;

[0107] - U.S. Patent Application Serial No. 15 / 635,729 entitled “SURGICAL INSTRUMENT COMPRISING AN ARTICULATION SYSTEM RATIO” is now published as U.S. Patent Application No. 2019 / 0000467;

[0108] - U.S. Patent Application Serial No. 15 / 635,785 entitled “SURGICAL INSTRUMENT COMPRISING AN ARTICULATION SYSTEM RATIO” is now published as U.S. Patent Application No. 2019 / 0000469;

[0109] - U.S. Patent Application Serial No. 15 / 635,808 entitled “SURGICAL INSTRUMENT COMPRISING FIRING MEMBER SUPPORTS” is now published as U.S. Patent Application No. 2019 / 0000471;

[0110] - U.S. Patent Application Serial No. 15 / 635,837 entitled “SURGICAL INSTRUMENT COMPRISING AN ARTICULATION SYSTEMLOCKABLE TO A FRAME” is now published as U.S. Patent Application No. 2019 / 0000472;

[0111] - U.S. Patent No. 10,779,824 entitled “SURGICAL INSTRUMENT COMPRISING AN ARTICULATION SYSTEM LOCKABLE BY A CLOSURE SYSTEM”;

[0112] - U.S. Patent Application Serial No. 15 / 636,029 entitled “SURGICAL INSTRUMENT COMPRISING A SHAFT INCLUDING A HOUSING ARRANGEMENT” is now published as U.S. Patent Application Publication No. 2019 / 0000477;

[0113] - U.S. Patent Application Serial No. 15 / 635,958 entitled “SURGICAL INSTRUMENT COMPRISING SELECTIVELY ACTUATABLEROTATABLE COUPLERS” is now published as U.S. Patent Application No. 2019 / 0000474;

[0114] - U.S. Patent Application Serial No. 15 / 635,981 entitled “SURGICAL STAPLING INSTRUMENTS COMPRISINGSHORTENED STAPLECARTRIDGE NOSES” is now published as U.S. Patent Application No. 2019 / 0000475.

[0115] - U.S. Patent Application Serial No. 15 / 636,009 entitled “SURGICAL INSTRUMENT COMPRISING A SHAFTINCLUDING A CLOSURETUBE PROFILE” is now published as U.S. Patent Application No. 2019 / 0000476;

[0116] - U.S. Patent No. 10,765,427 entitled “METHOD FOR ARTICULATING A SURGICALINSTRUMENT”;

[0117] - U.S. Patent Application Serial No. 15 / 635,530 entitled “SURGICAL INSTRUMENTS WITH ARTICULATABLEEND EFFECTOR WITH AXIALLY SHORTENED ARTICULATION JOINT CONFIGURATIONS” is now published as U.S. Patent Application No. 2019 / 0000457;

[0118] - U.S. Patent No. 10,588,633 entitled “SURGICAL INSTRUMENTS WITH OPEN AND CLOSABLE JAWS AND AXIALLY MOVABLE FIRING MEMBERTHAT IS INITIALLY PARKED IN CLOSE PROXIMITY TO THE JAWSPRIOR TO FIRING”;

[0119] - U.S. Patent Application Serial No. 15 / 635,559 entitled “SURGICAL INSTRUMENTS WITH JAWSCONSTRAINED TO PIVOT ABOUT ANAXIS UPON CONTACT WITH A CLOSURE MEMBER THAT IS PARKED IN CLOSEPROXIMITY TOTHE PIVOT AXIS” is now published as U.S. Patent Application Publication No. 2019 / 0000459;

[0120] - U.S. Patent No. 10,786,253 entitled "SURGICAL END EFFECTORS WITH IMPROVED JAWAPERTURE ARRANGEMENTS";

[0121] - U.S. Patent Application Serial No. 15 / 635,594 entitled “SURGICAL CUTTING AND FASTENING DEVICES WITH PIVOTABLE ANVIL WITH A TISSUE LOCATING ARRANGEMENT IN CLOSE PROXIMITY TO AN ANVIL PIVOTAXIS” is now published as U.S. Patent Application No. 2019 / 0000461;

[0122] - U.S. Patent Application Serial No. 15 / 635,612 entitled “JAW RETAINER ARRANGEMENT FOR RETAINING APIVOTABLE SURGICALINSTRUMENT JAW IN PIVOTABLE RETAINING ENGAGEMENT WITH A SECONDSURGICALINSTRUMENT JAW” is now published as U.S. Patent Application No. 2019 / 0000462;

[0123] - U.S. Patent No. 10,758,232 entitled “SURGICAL INSTRUMENT WITH POSITIVE JAW OPENING FEATURES”;

[0124] - U.S. Patent No. 10,639,037 entitled "SURGICAL INSTRUMENT WITH AXIALLY MOVABLE CLOSURE MEMBER";

[0125] - U.S. Patent No. 10,695,057 entitled “SURGICAL INSTRUMENT LOCKOUT ARRANGEMENT”;

[0126] - U.S. design patent number D851,762 entitled "ANVIL";

[0127] - U.S. design patent D854,151 entitled "SURGICAL INSTRUMENT SHAFT"; and

[0128] - U.S. design patent number D869,655 entitled “SURGICAL FASTENER CARTRIDGE”.

[0129] The applicant of this application owns the following U.S. patent applications and U.S. patents, filed on June 27, 2017, each of which is incorporated herein by reference in its entirety:

[0130] - U.S. Patent Application Serial No. 15 / 634,024 entitled “SURGICAL ANVIL MANUFACTURING METHODS” is now published as U.S. Patent Application No. 2018 / 0368839.

[0131] - U.S. Patent No. 10,772,629 entitled “SURGICAL ANVIL ARRANGEMENTS”;

[0132] - U.S. Patent Application Serial No. 15 / 634,046 entitled “SURGICAL ANVIL ARRANGEMENTS” is now published as U.S. Patent Application No. 2018 / 0368841;

[0133] - U.S. Patent No. 10,856,869 entitled “SURGICAL ANVIL ARRANGEMENTS”;

[0134] - U.S. Patent Application Serial No. 15 / 634,068 entitled “SURGICAL FIRING MEMBER ARRANGEMENTS” is now published as U.S. Patent Application No. 2018 / 0368843;

[0135] - U.S. Patent Application Serial No. 15 / 634,076 entitled “STAPLE FORMING POCKET ARRANGEMENTS” is now published as U.S. Patent Application No. 2018 / 0368844;

[0136] - U.S. Patent Application Serial No. 15 / 634,090 entitled “STAPLE FORMING POCKET ARRANGEMENTS” is now published as U.S. Patent Application No. 2018 / 0368845;

[0137] - U.S. Patent Application Serial No. 15 / 634,099 entitled "SURGICAL END EFFECTORS AND ANVILS", now published as U.S. Patent Application Publication No. 2018 / 0368846; and

[0138] - U.S. Patent No. 10,631,859 entitled "ARTICULATION SYSTEMS FOR SURGICAL INSTRUMENTS".

[0139] The applicant of this application owns the following U.S. patent applications filed on June 2, 2020, each of which is incorporated herein by reference in its entirety:

[0140] - U.S. design patent application serial number 29 / 736,648 entitled "STAPLE CARTRIDGE";

[0141] - U.S. design patent application serial number 29 / 736,649 entitled "STAPLE CARTRIDGE";

[0142] - U.S. design patent application serial number 29 / 736,651 entitled "STAPLE CARTRIDGE";

[0143] - U.S. design patent application serial number 29 / 736,652 entitled "STAPLE CARTRIDGE";

[0144] - U.S. design patent application serial number 29 / 736,653 entitled "STAPLE CARTRIDGE";

[0145] - U.S. design patent application serial number 29 / 736,654 entitled "STAPLE CARTRIDGE"; and

[0146] - U.S. design patent application serial number 29 / 736,655 entitled "STAPLE CARTRIDGE".

[0147] The applicant of this application owns the following U.S. design patent applications and U.S. patents, filed on November 14, 2016, each of which is incorporated herein by reference in its entirety:

[0148] - U.S. Patent Application Serial No. 15 / 350,621 entitled “STAPLE FORMING POCKET CONFIGURATIONS FOR CIRCULAR STAPLERANVIL” is now published as U.S. Patent Application No. 2018 / 0132849;

[0149] - U.S. Patent Application Serial No. 15 / 350,624 entitled “CIRCULAR SURGICAL STAPLER WITH ANGULARLY ASYMMETRIC DECKFEATURES” is now published as U.S. Patent Application No. 2018 / 0132854;

[0150] - U.S. design patent D833,608 entitled "STAPLING HEAD FEATURE FOR SURGICAL STAPLER"; and

[0151] - U.S. design patent number D830,550 entitled "SURGICAL STAPLER".

[0152] This document sets forth numerous specific details to provide a thorough understanding of the overall structure, function, manufacture, and use of the embodiments described in the specification and illustrated in the figures. Well-known operations, components, and elements are not described in detail to avoid obscuring the embodiments described in the specification. The reader will understand that the embodiments described and illustrated herein are non-limiting examples, and thus will recognize that the specific structural and functional details disclosed herein are representative and illustrative. Variations and changes may be made to these embodiments without departing from the scope of the claims.

[0153] The terms “comprising,” “having,” “including,” and “accommodating” are open-ended linking verbs. Therefore, a surgical system, apparatus, or device that “comprising,” “having,” “including,” or “accommodating” one or more elements has, but is not limited to, having only those elements. Similarly, the elements of a system, apparatus, or device that “comprising,” “having,” “including,” or “accommodating” one or more features have, but are not limited to, those features.

[0154] The terms “proximal” and “distal” are used herein in relation to the clinician manipulating the handle portion of the surgical device. The term “proximal” refers to the portion closest to the clinician, and the term “distal” refers to the portion furthest from the clinician’s position. It should also be understood that, for the sake of brevity and clarity, spatial terms such as “vertical,” “horizontal,” “upper,” and “lower” may be used in conjunction with the accompanying drawings. However, surgical devices are used in many orientations and positions, and these terms are not intended to be restrictive and / or absolute. In the following description, terms such as “first,” “second,” “top,” “bottom,” “upper,” and “lower” are convenient expressions and should not be construed as restrictive.

[0155] References to singular items should be understood to include plural items, and vice versa, unless otherwise explicitly stated or clearly evident from the text. Grammatical conjunctions are intended to express any and all transitions and connecting combinations of clauses, sentences, words, etc., unless otherwise stated or clearly evident from the context. Therefore, the term "or" should generally be understood to mean "and / or," etc.

[0156] Unless otherwise specified herein, the numerical ranges listed herein are not intended to be limiting, but rather refer individually to any or all values ​​falling within that range, and each individual value within that range is incorporated into this disclosure as individually referenced herein. When used with numerical values, the terms “about,” “approximately,” etc., should be interpreted as indicating a deviation as would be understood by one of ordinary skill in the art for satisfactory use for the intended purpose. Similarly, when used with reference to physical characteristics, approximate terms such as “about” or “substantially” should be interpreted as envisioning a range of deviations as would be understood by one of ordinary skill in the art for satisfactory use for the corresponding application, function, purpose, etc.

[0157] Any and all examples or exemplary language (“e.g.,” “such as,” etc.) provided herein are intended merely to better illustrate embodiments and are not intended to limit the scope of embodiments. No language in the specification should be construed as indicating that any element not protected by the claims is necessary for implementing the embodiments.

[0158] Various exemplary devices and methods are provided for performing laparoscopic and minimally invasive surgical procedures. However, the reader will readily understand that the various methods and devices disclosed herein can be used in a wide range of surgical procedures and applications, including, for example, in combination with open surgery. Continuing to refer to this specific embodiment, the reader will further understand that the various surgical devices disclosed herein can be inserted into the body in any manner, such as through natural cavities, through incisions or puncture holes formed in tissue, etc. The working portion or end effector portion of the surgical device can be inserted directly into the patient's body or through an access device having a working channel through which the end effector and elongated shaft of the surgical device can be advanced.

[0159] The surgical suturing system may include an axis and an end effector extending from the axis. The end effector includes a first jaw and a second jaw. The first jaw includes a staple cartridge. The staple cartridge is insertable into and can be removed from the first jaw; however, other embodiments are contemplated in which the staple cartridge cannot be removed from the first jaw or at least can be easily replaced from the first jaw. The second jaw includes an anvil configured to deform staples ejected from the staple cartridge. The second jaw is pivotable relative to the first jaw about a closed axis; however, other embodiments are contemplated in which the first jaw is pivotable relative to the second jaw. The surgical suturing system also includes an articulation joint configured to allow the end effector to rotate or perform articulation relative to the axis. The end effector is rotatable about an articulation axis extending through the articulation joint. Other embodiments without an articulation joint are contemplated.

[0160] The staple cartridge includes a cartridge body. The cartridge body includes a proximal end, a distal end, and a platform extending between the proximal and distal ends. In use, the staple cartridge is positioned on a first side of the tissue to be sutured, and an anvil is positioned on a second side of the tissue to be sutured. The anvil moves toward the staple cartridge to compress the tissue and clamp it against the platform. Staples, removably stored in the cartridge body, can then be deployed into the tissue. The cartridge body includes staple cavities defined within the cartridge body, in which staples are removably stored. The staple cavities are arranged in six longitudinal rows. Three rows of staple cavities are positioned on a first side of the longitudinal slots, and three rows of staple cavities are positioned on a second side of the longitudinal slots. Other arrangements of staple cavities and staples are contemplated.

[0161] The nail is supported by a nail actuator within a cartridge. The actuator is movable between a first or non-firing position and a second or firing position to eject the nail from the nail chamber. The actuator is retained within the cartridge by a retainer extending around the bottom of the cartridge and including a resilient member configured to grip the cartridge and secure the retainer to the cartridge. The actuator is movable between its non-firing position and its firing position by a slider. The slider is movable between a proximal position adjacent to the proximal end of the cartridge and a distal position adjacent to the distal end of the cartridge. The slider includes multiple ramp surfaces configured to slide beneath the actuator toward the anvil and to lift the actuator, on which the nail is supported.

[0162] In addition to the above, the slider can also move distally via the firing member. The firing member is configured to contact the slider and push it distally. A longitudinal slot defined in the cartridge is configured to receive the firing member. The anvil also includes a slot configured to receive the firing member. The firing member also includes a first cam engaging a first jaw and a second cam engaging a second jaw. As the firing member advances distally, the first and second cams control the distance or tissue gap between the platform of the cartridge and the anvil. The firing member also includes a blade configured to cut into tissue captured between the cartridge and the anvil. It is desirable that the blade be positioned at least partially close to the ramp surface so that the staples are ejected into the tissue before the blade cuts through the tissue.

[0163] Figures 1 to 8A surgical suturing instrument 10 configured to clamp, suture, and cut patient tissue is shown. The surgical suturing instrument 10 includes a handle 20, a shaft assembly 100 attached to the handle 20, and an end effector 200. For cutting and suturing patient tissue, the end effector 200 includes a jaw 201 and an anvil jaw 203. The anvil jaw 203 is pivotable relative to the jaw 203 to clamp tissue between the anvil jaw 203 and the jaw 203. Once the tissue is clamped between the jaws 201, 203, the surgical suturing instrument 10 can be actuated to advance a firing member through the jaws 201, 203 to suture and cut the tissue via the end effector 200, as discussed in more detail below.

[0164] As discussed in more detail below, the end effector 200 can be articulated via the articulated motion region 110 of the shaft assembly 100. Such articulation provides the user of the surgical suture instrument 10 with the ability to more accurately position and / or manipulate the end effector 200 near the target tissue.

[0165] The handle 20 includes a housing 21 configured to accommodate various mechanical and electrical components and a handle portion 22 extending from the housing 21. The handle portion 22 is configured to fit in the user's palm and / or be grasped and / or held by the user when using the surgical suturing instrument 10. The handle 20 also includes various actuators and / or triggers configured to be actuated by the user to operate one or more functions of the surgical suturing instrument 10. The handle 20 includes a closing trigger 24, a firing trigger 25, and at least one articulation actuator 26. When actuated by the user, the closing trigger 24 is configured to grip tissue with the end effector 200 by moving the anvil jaws 203 toward the jaws 201. When actuated by the user, the firing trigger 25 is configured to cut and suture tissue with the end effector 200 by advancing the firing member to eject a nail and cutting tissue with a scalpel. When actuated by a user, the articulation actuator 26 is configured to articulate the end effector 200 relative to the shaft assembly 100 via the articulation region 110. The trigger and actuator of the surgical suture instrument 10 can trigger one or more motors within the handle 20 to actuate various functions of the surgical suture instrument 10 and / or manually drive various drive shafts and components to actuate various functions of the surgical suture instrument 10.

[0166] The handle 20 also includes a nozzle assembly 30 configured to support the shaft assembly 100 therein. The nozzle assembly 30 includes an actuating wheel 31 configured to be rotated by a user to rotate the shaft assembly 100 and the end effector 200 about a longitudinal axis LA relative to the handle 20. This mechanism allows the user of the surgical suture instrument 10 to rotate only the shaft assembly 100 and / or the end effector 200 without having to rotate the entire handle 20.

[0167] The handle 20 also includes a battery 23 configured to provide power to various electronic components, sensors, and / or motors of the surgical suturing instrument 10. Embodiments in which the surgical suturing instrument 10 is directly connected to a power source are envisioned. Embodiments in which the surgical suturing instrument 10 is entirely manual or, for example, non-powered are also envisioned. Embodiments in which the articulation of the end effector, the clamping and loosening of the jaws, the firing of end effector studs to suture and cut tissue, and the rotation of the shaft and / or end effector are all powered systems are also envisioned.

[0168] In at least one instance, the shaft assembly 100 and the end effector 200 may be modular and removable from the handle 20. In at least one instance, the end effector 200 may be modular because it can be removed from the shaft assembly 100 and replaced with a different end effector. In at least one instance, the shaft assembly 100 and / or the end effector 200 may be used in a surgical robotic environment. Such embodiments will provide power input from a surgical robot interface to actuate each function of the end effector 200. Examples of such surgical robots and surgical tools are further described in U.S. Patent Application Publication 2020 / 0138534, entitled “ROBOTIC SURGICAL SYSTEM,” published May 7, 2020, the entire contents of which are incorporated herein by reference.

[0169] In at least one instance, the shaft assembly 100 and the end effector 200 are configured to be used with a surgical robot. In such instances, the shaft assembly 100 and the end effector 200 are configured to be coupled to a surgical robot comprising multiple output drives. The multiple output drives of the surgical robot are configured to cooperate with the drive system of the shaft assembly 100 and the end effector 200. In such instances, the surgical robot can actuate the end effector 200 for various functions, such as jointing the end effector about multiple different articulation joints, rotating the shaft assembly 100 and / or the end effector 200 about its longitudinal axis, clamping the end effector 200 to clamp tissue between the jaws of the end effector 200, and / or firing the end effector 200 to cut and / or suture tissue.

[0170] The shaft assembly 100 is configured to accommodate various drive system components and / or electronic components of the surgical suture instrument 10, such that the end effector 200 and the shaft assembly 100 can be inserted through a cannula for laparoscopic surgery. The various drive system components are configured to be actuated by various triggers and actuators of the shank 20. Such components may include drive shafts for articulation, drive shafts for clamping and releasing the end effector 200, and / or drive shafts for firing the end effector 200. In instances where the shaft assembly 100 is connected to a drive system in the shank 20 or a surgical robot interface, such drive shafts may be rotatable by that drive system. In various aspects, the suture end effector may include two independently rotatable drive members—for example, one drive member for gripping tissue and one drive member for firing a staple. The suture end effector may also include an articulation joint, through which rotational motion can be transmitted. In various aspects, the suture end effector may include one or more 3D-printed components that can be incorporated into an articulation system, a gripping system, or a firing system.

[0171] In instances where the shaft assembly 100 is connected to a drive system in the shank 20 or surgical robot interface, such a drive shaft can be actuated by that drive system. Such a drive shaft can include linear actuation, rotary actuation, or a combination thereof. For example, a combination of rotary and linear actuation can employ a series of rack and pinion gears and / or drive screws.

[0172] In at least one instance, for example, the shaft assembly 100 is also configured to accommodate electrical leads for, for example, positioning within the shaft assembly 100 and / or the end effector 200 of various sensors and / or motors.

[0173] The shaft assembly 100 includes an outer shaft 101 extending from the nozzle assembly 30 to the articulated motion region 110, which includes a dual articulated joint, which will be discussed in more detail below. The articulated motion region 110 allows the end effector 200 to articulate relative to the outer shaft 101 in two different planes about two separate axes AA1, AA2.

[0174] Currently, the main reference is... Figure 4The articulation of the end effector 200 will now be described. The articulation region 110 includes two distinct articulation joints and two articulation actuators 150 and 160. This allows the end effector 200 to articulate about two independent axes AA1 and AA2 in two different planes. The articulation region 110 includes a proximal joint shaft component 120, an intermediate joint shaft component 130, and a distal joint shaft component 140. The proximal joint shaft component 120 is attached to the distal end of the shaft assembly 100, the intermediate joint shaft component 130 is pivotally connected to the proximal joint shaft component 120 and the distal joint shaft component 140, and the distal joint shaft component 140 is fixedly attached to the end effector 200 by a retaining ring 146. This arrangement provides the end effector 200 with articulation about independent axes AA1 and AA2 relative to the shaft assembly 100, as discussed in more detail below.

[0175] The proximal connector shaft assembly 120 includes a proximal annular portion 121 that is fixedly fitted within the outer shaft 101. The proximal connector shaft assembly 120 also includes a hollow channel 122 to allow various drive system components to pass through, and includes an articulated tab 123 including a pin hole 124 configured to receive an articulated pin 125. The articulated pin 125 is pivotally connected to the proximal articulated tab 131 of the intermediate connector shaft assembly 130. To enable articulation of the end effector 200 about axis AA1, the articulated actuator 150 is linearly actuated in a distal or proximal direction. For example, such an actuator may comprise a rod or bar made of any suitable material, such as metal and / or plastic. The articulated actuator 150 is pivotally mounted to the articulated linkage 151. The articulation link 151 is pivotally mounted off-axis relative to the articulation pin 125 to the intermediate joint shaft assembly 130, such that when the articulation actuator 150 is actuated, torque is applied off-axis by the articulation link 151 to the intermediate joint shaft assembly 130 relative to the articulation pin 125, causing the intermediate joint shaft assembly 130 and thus the end effector 200 to pivot about axis AA1 relative to the proximal joint shaft assembly 120.

[0176] Intermediate joint shaft component 130 is pivotally connected to proximal joint shaft component 120 via articulated pin 125 defining axis AA1. Specifically, intermediate joint shaft component 130 includes a proximal articulated tab 131 pivotally connected to proximal joint shaft component 120 via articulated pin 125. Intermediate joint shaft component 130 also includes a hollow channel 132 and a distal articulated tab 133, the hollow channel being configured to allow various drive system components to pass through it. Distal articulated tab 133 includes a pin hole 134 and a distal projecting key 135, the pin hole being configured to receive another articulated pin 136 defining axis AA2.

[0177] To enable the end effector 200 to articulate about axis AA2, articulation cable 160 is actuated to apply articulation torque to the proximal tab 141 of the distal connector shaft assembly 140 via key 135. Articulation cable 160 is secured to key 135 such that key 135 pivots relative to intermediate connector shaft assembly 130 as cable 160 rotates. Key 135 is fitted within keyhole 144 of distal connector shaft assembly 140. Clearly, key 135 is not secured to intermediate connector shaft assembly 130 and is rotatable relative to intermediate connector shaft assembly 130. Articulation cable 160 also contacts the proximal tab 141 surrounding pin hole 142. This provides additional torque from articulation cable 160 to distal connector shaft assembly 140. Articulation pin 136 is received within pin hole 142 to pivotally connect intermediate connector shaft assembly 130 and distal connector shaft assembly 140.

[0178] In at least one instance, the articulation cable 160 can only be pulled in the proximal direction. In such instances, only one side of the articulation cable 160 is pulled proximally to cause the end effector 200 to articulate in the desired direction. In at least one instance, the articulation cable 160 is pushed and pulled in opposition. In other words, the cable 160 may include a rigid configuration such that one side of the articulation cable 160 is pushed distally while the other side is pulled proximally. Such an arrangement allows the articulation force to be distributed between the half pushed and half pulled of the cable 160. In at least one instance, a push-pull arrangement allows a larger articulation force to be transmitted to the corresponding articulation joint. Such a force may be necessary in an arrangement with two articulation joints. For example, if the proximal articulation joint is to be fully articulated, a larger force may be required from the articulation actuator designed to articulate the distal articulation joint due to the stretching and / or extension distance that the articulation actuator for the distal articulation joint must travel.

[0179] The distal connector shaft assembly 140 also includes a cutout 143 to allow various drive components to pass through. A retaining ring 146 secures the channel 210 of the jaw 201 to the distal connector shaft assembly 140, thereby securing the end effector assembly 200 to the distal end of the articulated motion region 110.

[0180] As discussed above, the anvil jaws 201 are movable relative to the magazine jaws 203 to clamp and release tissue via the end effector 200. The operation of this function of the end effector 200 will now be described. The magazine jaws 201 include a channel 210 and a staple cartridge 220 configured to be received within a cavity 214 of the channel 210. The channel 210 also includes an annular groove 211 configured to receive a retaining ring 146 and a pair of pivot holes 213 configured to receive a jaw coupling pin 233. The jaw coupling pin 233 allows the anvil jaws 203 to pivot relative to the magazine jaws 201.

[0181] The anvil jaws 203 include anvil body 230 and a pair of pivot holes 231. The pivot holes 231 in the proximal portion of the anvil jaws 203 are configured to receive jaw connecting pins 233, thereby pivotally connecting the anvil jaws 203 to the jaw 201. A closing drive 250 is provided for opening and closing the anvil jaws 203 relative to the jaw 201.

[0182] The closing drive 250 is actuated by a flexible drive section 175, which includes a universal joint arranged or formed end-to-end. In various instances, the flexible drive section 175 may include tandem 3D-printed universal joints printed together as a single continuous system. Discussed in more detail below, the flexible drive section 175 is driven by an input shaft passing through the shaft assembly 100. The flexible drive section 175 transmits rotational actuation motion via a double-articular joint. The closing drive 250 includes a closing screw 251 and a closing wedge 255 threadedly connected to the closing screw 251. The closing wedge 255 is configured to explicitly open and close the anvil jaws 203 by a cam. The closing screw 251 is supported by a first support body 258 and a second support body 259 fixed within the channel 210.

[0183] In order to be in the clamping position ( Figure 8 ) and release position ( Figure 7 The anvil jaws 203 move between the closing screw and the cartridge 220, actuating the closing drive shaft to actuate the flexible drive section 175. The flexible drive section 175 is configured to rotate the closing screw 251, which displaces the closing wedge 255. For example, the closing wedge 255 is threaded to the closing screw 251, and the rotational travel of the closing wedge 255 with respect to the cartridge 220 is restricted. The closing screw 251 drives the closing wedge 255 proximally or distally depending on the direction of rotation of the closing screw 251.

[0184] In order to release the position ( Figure 7 The clamping end actuator 200 closes the wedge 255, causing it to move proximally. As the wedge 255 moves proximally, its proximal cam surface 256 contacts the corresponding cam surface 234 defined in the proximal end 235 of the anvil body 230. When the cam surface 256 contacts the cam surface 234, a force is applied to the proximal end 235 of the anvil body 230, causing the anvil body 230 to rotate about the pin 233 into the clamping position. Figure 8 ).

[0185] To open or release the end actuator 200 from the clamped position ( Figure 8 The closing wedge 255 is moved distally by rotating the closing screw 251 in the direction opposite to the direction that causes the closing wedge 255 to move proximally. As the closing wedge 255 moves distally, a pair of protrusions 257 extending from the distal end of the closing wedge 255 contact the cam surface 234 near the downwardly extending tab 237 of the anvil body 230. When the protrusions 257 contact the cam surface 234 near the tab 237, a force is applied to the anvil body 230 to rotate the anvil body 230 about the pin 233 into the open position. Figure 7 ).

[0186] In at least one instance, the profile of cam surface 234 corresponds to the profile of cam surface 256. For example, cam surface 234 and cam surface 256 may be matched such that a maximum cam force is applied to the anvil body 230 to cause a desired rotation of the anvil body 230. Figure 8 As can be seen, for example, the cam surface 234 defined by the proximal end 235 of the anvil body 230 includes a ramp section similar to the upper ramp section of the cam surface 256.

[0187] As discussed above, the surgical suturing instrument 10 can be actuated to advance the firing member through jaws 201, 203 to suture and cut tissue via the end effector 200. The function of deploying staples 226 from the cartridge 220 and cutting tissue with a blade 283 will now be described. The cartridge 220 includes a cartridge body 221, a plurality of staple drivers 225, and a plurality of staples 226 removably stored within the cartridge body 221. The cartridge body 221 includes a platform surface 222, a plurality of staple cavities 223 arranged in a longitudinal row defined within the cartridge body 221, and a longitudinal slot 224 that bifurcates the cartridge body 221. The blade 283 is configured to be driven through the longitudinal slot 224 to cut tissue clamped between the anvil body 230 and the platform surface 221.

[0188] Platform surface 221 includes a tissue-supporting surface with a lateral profile. In various respects, the profile of platform surface 221 may form a peak along the central portion of chamber 221. Such a peak may cover a longitudinally extending firing screw 261 that extends through the central portion of chamber 221, as will be further described herein. In various instances, the increased height along the peak may be associated with a smaller tissue gap along the firing path of blade 283. In certain aspects of this disclosure, the drive height, the formed pin height, the pin recess extension height, and / or the pin overdrive distance may also vary laterally along platform surface 221. Laterally variable pin forming (e.g., a combination of 2D and 3D pins) is also contemplated and further described herein.

[0189] The nail actuator 225 is configured to be lifted by the slider 280 when the slider 280 is pushed distally through the nail magazine 220 to eject the nail 226 supported by the nail actuator 225 in the nail cavity 223. The slider 280 includes a ramp 281 to contact the nail actuator 225. The slider 280 also includes a blade 283. The slider 280 is configured to be actuated by the firing member 270.

[0190] For deploying the nail 226 and cutting tissue with the blade 283, the end effector 200 includes a firing drive 260. The firing drive 260 is actuated by a flexible drive shaft 176. Discussed in more detail below, the flexible drive shaft 176 is driven by an input shaft passing through the shaft assembly 100. The flexible drive shaft 176 transmits rotational actuation motion via a double-joint kinematic joint. The firing drive 260 includes a firing screw 261 configured to be rotatable by the flexible drive shaft 176. The firing screw 261 includes a journal supported within bearings in the support member 259 and the channel 210. In various instances, the firing screw 261 may float relative to the channel 210, as further described herein. The firing screw 261 includes a proximal end 262 supported within the support member 259 and the channel 210, a distal end 263 supported within the channel 210, and a thread 265 extending along a portion of the length of the firing screw 261.

[0191] The firing member 270 is threadedly connected to the firing screw 261 such that, as the firing screw 261 rotates, the firing member 270 advances distally or retracts proximally along the firing screw 261. Specifically, the firing member 270 includes a body portion 271, which includes a hollow channel 272 defined therein. The firing screw 261 is configured to be received within the hollow channel 272 and is configured to be threadedly connected to a threaded portion 273 of the firing member 270. Thus, as the firing screw 261 rotates, the threaded portion 273 applies a linear force to the body portion 271 to advance the firing member 270 distally or retract it proximally. When the firing member 270 advances distally, it pushes a slider 280. The distal movement of the slider 280 through engaging a plurality of pin actuators 225 causes the ejection of pins 223, as further described herein. The actuator 225 is a triple actuator configured to fire multiple pins 223 simultaneously. The actuator 225 may include lateral asymmetry, as further described herein, to maximize the width of the slider track in various instances and to receive the firing screw 261 downward along the center of the pin magazine 220.

[0192] At some point during the firing of the end effector 200, the user can retract the firing member 270 to allow the jaws 201, 203 to open. In at least one instance, full retraction of the firing member 270 is required to open the jaws 201, 203, wherein the upper cam actuating member and the lower cam actuating member are disposed on the body portion 271, and once the firing member 270 is fully retracted, it can only disengage from the jaws 201, 203.

[0193] In various instances, the firing member 270 may be a hybrid construction of plastic and metallic portions as further described herein. In various instances, the threaded component 273 may be, for example, a metallic component, which is incorporated into the firing member body 271 by insert molding or overmolding.

[0194] In some instances, the firing member 270 may also be referred to as an I-beam. The firing member 270 may include a complex 3D-printed geometry that includes a grid pattern space. In various instances, 3D printing may allow the firing member or a portion thereof to act as a spring and allow a portion to be more easily flexed, which may improve, for example, force distribution and / or tolerances during the firing stroke.

[0195] Figures 9 to 11 A surgical suture assembly 300 is shown, which includes a shaft assembly 310 and an attachment to the shaft assembly 310. Figures 1 to 8The end effector 200. The shaft assembly 310 may be similar in many respects to various other shaft assemblies discussed herein; however, the shaft assembly 310 includes a single articulation joint and an articulation rod configured to enable articulation of the end effector 200 about the single articulation joint. The surgical suture assembly 300 is configured to cut and suture tissue. The surgical suture assembly 300 may be attached to a surgical instrument handle and / or a surgical robot interface. The surgical instrument handle and / or the surgical robot interface may be configured to actuate various functions of the surgical suture assembly 300. The shaft assembly 310 includes an articulation joint 320. As discussed in more detail below, the end effector 200 is configured to articulate about axis AA relative to the outer axis 311 of the shaft assembly 310.

[0196] The shaft assembly 310 includes an outer shaft 311, a first shaft connector 330, and a second shaft connector 350 pivotally coupled to the first shaft connector 330 via an articulated pin 354. The first shaft connector 330 includes a proximal tube portion 331 configured to engage within the inner diameter of the outer shaft 311. Such engagement may include a press fit, for example. However, any suitable attachment device may be used. The first shaft connector 330 also includes a distal portion 332. The distal portion 332 includes an articulated tab 333 including a pin hole 334 defined therein, and a hollow channel 335 through which various actuation components of the surgical suture assembly 300 can pass. Such actuation components may include, for example, articulation actuators, closure actuators, and / or firing actuators.

[0197] The first axial connector component 330 is pivotally connected to the second axial connector component 350 via an articulation pin 354. The articulation pin 354 is also received within a pin hole 353 of a proximal articulation tab 351 of the second axial connector component 350. The pin hole 353 is axially aligned with the pin hole 334. The articulation pin 354 allows the second axial connector component 350 to articulate about the articulation axis AA relative to the first axial connector component 330. The second axial connector component 350 also includes a pin projection 352 extending from the proximal articulation tab 351. Discussed in more detail below, the pin projection 352 is configured to be pivotally coupled to an articulation drive system. The second axial connector component 350 also includes a distal portion 355, which includes an annular groove 356 configured to receive a retaining ring 358. The distal portion 355 also includes a hollow channel 357 through which various drive components of the surgical suture assembly 300 can pass. The retaining ring 358 is configured to secure the first jaw 201 to the second shaft connector 350 by engaging within the annular groove 211 of the compartment channel 210 and the annular groove 356 of the second shaft connector component 350.

[0198] To enable the end effector 200 to articulate about the articulation axis AA, an articulation lever 360 is provided. The articulation lever 360 can be actuated by any suitable means, such as by a robot or motor input and / or a manual handle trigger. For example, the articulation lever 360 can be actuated in both proximal and distal directions. Embodiments in which, in addition to or instead of linear actuation, the articulation system includes rotary actuation are contemplated. The articulation lever 360 extends through an outer shaft 311. The articulation lever 360 includes a distal end 361 pivotally coupled to an articulation link 362. The articulation link 362 is pivotally coupled to a pin projection 352 that extends eccentrically relative to the articulation axis AA from a proximal articulation tab 351. This eccentric connection of the articulated link 362 allows the articulated link 360 to apply force to the second joint shaft member 350, causing the second joint shaft member 350 and thus the end effector 200 to rotate relative to the first joint shaft member 330. The articulated link 360 can be advanced distally to rotate the end effector 200 about the articulation axis AA in a first direction, and can be retracted proximally to rotate the end effector 200 about the articulation axis AA in a second direction opposite to the first direction.

[0199] The shaft assembly 310 also includes a joint motion component support structure 340 located within the joint motion joint 320. This support structure provides support to various drive components configured to reach the end effector 200 through the joint motion joint 320 during joint motion. The support structure 340 also serves to isolate the drive components from tissue residue during use.

[0200] Figures 12 to 14 A surgical suture assembly 400 is shown, which includes a shaft assembly 410 and an attachment to the shaft assembly 410. Figures 1 to 8 The end effector 200. The shaft assembly 410 may be similar in many respects to various other shaft assemblies discussed herein; however, the shaft assembly 410 includes a single articulation joint and an articulation cable configured to enable the end effector 200 to articulate about the single articulation joint. The surgical suture assembly 400 is configured to cut and suture tissue. The surgical suture assembly 400 may be attached to a surgical instrument handle and / or a surgical robot interface. The surgical instrument handle and / or the surgical robot interface may be configured to actuate various functions of the surgical suture assembly 400. The shaft assembly 410 includes an articulation joint 420. As discussed in more detail below, the end effector 200 is configured to articulate about axis AA relative to the outer axis 411 of the shaft assembly 310.

[0201] The shaft assembly 410 includes an outer shaft 411, a first shaft connector 430, and a second shaft connector 450 pivotally coupled to the first shaft connector 430 via an articulated pin 454. The first shaft connector 430 includes a proximal tube portion 431 configured to engage within the inner diameter of the outer shaft 411. Such engagement may include, for example, a press fit. However, any suitable attachment device may be used. The first shaft connector 430 also includes a distal portion 432 comprising an articulated tab 433 including a pin hole 434 defined therein. The distal portion 432 also defines a hollow channel 435 through which various actuation components of the surgical suture assembly 400 can pass. Such actuation components may include, for example, articulation actuators, closure actuators, and / or firing actuators.

[0202] The first axial connector component 430 is pivotally connected to the second axial connector component 450 via an articulation pin 454. The articulation pin 454 is also received within a pin hole 453 of a proximal articulation tab 451 of the second axial connector component 450. The articulation pin 454 allows the second axial connector component 450 to articulate about an articulation axis AA relative to the first axial connector component 430. The second axial connector component 450 also includes a drive ring structure 452. The drive ring structure 452 extends from the proximal articulation tab 451 and also defines a portion of the pin hole 453. Discussed in more detail below, the drive ring structure 452 is configured to be engaged by an articulation drive system. The second axial connector component 450 also includes a distal portion 455, which includes an annular groove 456 configured to receive a retaining ring 458. A hollow channel 457 through the distal portion 455 is configured to receive various drive components of a surgical suture assembly 400 passing therethrough. The retaining ring 458 is configured to secure the first jaw 201 to the second shaft connector 450 by engaging within the annular groove 211 of the compartment channel 210 and the annular groove 456 of the second shaft connector component 450.

[0203] To enable the end effector 200 to articulate about the articulation axis AA, an articulation cable 460 is provided. The articulation cable 460 can be actuated by any suitable means, such as a manual trigger actuation, for example, on the handle of a robot input and / or handheld surgical instrument. The articulation cable 460 may include an anti-application profile. In other words, when a first side of the articulation cable 460 is pulled proximally, a second side of the articulation cable 460 is allowed to advance distally, like a pulley system. Similarly, when the second side is pulled proximally, the first side is allowed to advance distally. The articulation cable 460 extends through the outer shaft 411. The articulation cable 460 is positioned around and frictionally held on the drive ring structure 452 to allow the second shaft connector component 450 to rotate when the articulation cable 460 is actuated. When the articulation cable 460 is actuated, the articulation cable 460 is configured to apply rotational torque to the drive ring structure 452 of the second connector shaft component 450 and thus to the end effector 200. This torque is configured to cause the second connector shaft component 450 to rotate or pivot relative to the first connector shaft component 430, thereby causing the end effector 200 to articulate relative to the outer shaft 411. A first side of the articulation cable 460 can be pulled to rotate the end effector 200 about the articulation axis AA in a first direction, and a second side of the articulation cable 460 can be pulled to rotate the end effector 200 about the articulation axis AA in a second direction opposite to the first direction.

[0204] The shaft assembly 410 also includes a joint motion component support structure 440 located within the joint motion joint 420. This support structure 440 provides support to various drive components configured to reach the end effector 200 through the joint motion joint 420 during joint motion. The support structure 440 also serves to isolate the drive components from tissue residue during use.

[0205] The surgical suture assembly 400 also includes a closing drive shaft section 475 and a firing drive shaft section 476, each configured to transmit rotational motion to the end effector 200 via an articulation joint 420. Drive shaft sections 475 and 476 are configured to passively expand and contract longitudinally during articulation of the end effector 200. For example, articulation can cause expansion and contraction of drive shaft sections 475 and 476 to account for a corresponding longitudinal stretching or contraction of the drive shaft length due to articulation of the end effector 200 relative to the shaft assembly 410. During expansion and contraction of drive shaft sections 475 and 476, drive shaft sections 475 and 476 maintain rotational drive engagement with corresponding input and output shafts extending through the outer shaft 411 in the end effector 200. In at least one instance, the output shaft includes a closing screw 251 and a firing screw 261, the closing screw being configured to perform gripping, closing, or organization manipulation via jaws 201, 203, and the firing screw being configured to perform clamping of jaws 201, 203 and firing of the firing member 270.

[0206] Figures 15 to 17 A surgical suture assembly 500 is shown, which includes a shaft assembly 510 and an attachment to the shaft assembly 510. Figures 1 to 8 The end effector 200. The shaft assembly 510 may resemble in many respects the various other shaft assemblies discussed herein; however, the shaft assembly 510 includes a single articulated joint and a drive shaft segment configured to passively expand and contract. The surgical suture assembly 500 is configured to cut and suture tissue. The surgical suture assembly 500 may be attached to a surgical instrument handle and / or a surgical robot interface. The surgical instrument handle and / or surgical robot interface may be configured to actuate various functions of the surgical suture assembly 500. The shaft assembly 510 includes an articulated joint 520. As discussed in more detail below, the end effector 200 is configured to articulate about axis AA.

[0207] The shaft assembly 510 includes a first shaft connector portion 530 and a second shaft connector portion 540 pivotally coupled to the first shaft connector portion 530 via an articulated pin 543. The first shaft connector portion 530 is configured to attach to a shaft of a surgical instrument assembly and / or a surgical robot interface. The first shaft connector portion 530 includes a proximal portion 531 and an articulated tab 533 including a pin hole 534 defined therein. In at least one embodiment, the first shaft connector portion 530 includes a hollow channel through which various drive components of the surgical suture assembly 400 can pass. Such drive components may include, for example, articulated actuators, closure actuators, and / or firing actuators.

[0208] The first axial connector component 530 is pivotally connected to the second axial connector component 540 via an articulation pin 543. The articulation pin 543 is also received within a pin hole 542 of an articulation tab 541 extending proximally in the second axial connector component 540. The articulation pin 543 allows the second axial connector component 540 to articulate relative to the first axial connector component 530 about an articulation axis AA. The second axial connector component 540 also includes a distal portion 545 comprising an annular groove 547 configured to receive a retaining ring 548 and a hollow channel 546 through which various drive components of the surgical suture assembly 500 can pass. The retaining ring 548 is configured to secure the first jaw 201 to the second axial connector component 540 by engaging within the annular groove 211 of the compartment channel 210 and the annular groove 547 of the second axial connector component 540.

[0209] Any suitable articulation drive system can be used to articulate the end effector 200 about axis AA. In at least one instance, the end effector 200 passively articulates. In such instances, the end effector 200 may be pressed against tissue, for example, to apply a force to the end effector 200 and cause it to articulate about the articulation axis. In at least one instance, the end effector 200 also includes a spring configured to apply a neutral biasing force to the second shaft joint section 540, for example, to bias the end effector 200 toward a non-articulated configuration.

[0210] The surgical suture assembly 500 also includes a closing drive shaft section 575 and a firing drive shaft section 576, each configured to transmit rotational motion to the end effector 200 via an articulation joint 520. Drive shaft sections 575 and 576 are configured to passively expand and contract longitudinally during articulation of the end effector 200. Articulation causes drive shaft sections 575 and 576 to expand and contract to compensate for longitudinal stretching or contraction of the drive shaft length due to articulation of the end effector 200. During expansion and contraction, drive shaft sections 575 and 576 maintain rotational drive engagement with corresponding input and output shafts in the end effector 200. In at least one example, the output shaft includes a closing screw 251 and a firing screw 261, which will be further described herein.

[0211] Figures 18 to 20A surgical suturing end effector assembly 600 is shown, comprising a shaft portion 610 and an end effector 600. The end effector assembly 600 is similar in many respects to various other end effector assemblies disclosed herein; however, the end effector assembly 600 includes a multi-part firing member driven by a flexible firing shaft. The end effector assembly 600 is configured to cut and suture tissue. The end effector assembly 600 can be attached to a surgical instrument handle and / or a surgical robot interface via a proximal tab 611 of the shaft portion 610. The surgical instrument handle and / or the surgical robot interface can be configured to actuate various functions of the end effector assembly 600. The end effector assembly 600 includes a pouch passage jaw 620 and an anvil jaw 660, the anvil jaw being pivotally mounted to the pouch passage jaw 620 to clamp tissue between the pouch passage jaw 620 and the anvil jaw 660.

[0212] The cartridge channel jaw 620 includes: a channel 630 including a proximal end 631; a cartridge 640 configured to store a plurality of cartridges and configured to be received within the channel 630; and a support bracket 650 mating within the cartridge 640. The cartridge 640 and the support bracket 650 are configured to be assembled together prior to installing the cartridge 640 into the channel 630. Discussed in more detail below, the support bracket 650 is configured to further support the firing member assembly as it is advanced through the end effector assembly 600.

[0213] The anvil jaws 660 are configured to shape nails ejected from the nail cartridge 640. The anvil jaws 660 include a proximal end 661 with a pair of pin holes 662 defined therein, configured to receive a connecting pin 663. The anvil jaws 660 are pivotable about the connecting pin 663 between an open position and a fully clamped position. The connecting pin 663 is also received within a pair of pin holes 633 defined in the proximal end 631 of the channel 630. The connecting pin 663 is used to pivotally mount the anvil jaws 660 to the channel 630. In at least one embodiment, the channel 630 is mounted to the shaft portion 610 by a retaining ring or band engaging an annular groove 632 around the channel 630 and an annular groove 615 of the shaft portion 610. The retaining ring or band is configured to secure the channel 630 to the shaft portion 610.

[0214] The end effector assembly 600 includes a closing drive 670 configured to clamp tissue between the anvil jaws 660 and the cartridge channel jaws 620 by pivoting the anvil jaws 660 relative to the channel 630. The end effector assembly 600 also includes a firing drive 680 configured to clamp, suture, and cut tissue by deploying a plurality of staples from the staple cartridge 640. The closing drive 670 includes a closing screw 671 positioned within the channel 630 and a closing wedge 675 threaded to the closing screw 671. When the closing screw 671 rotates, the closing wedge 675 advances distally or retracts proximally to open or close the anvil jaws 660, respectively. The closing drive 670 can be actuated by any suitable means. For example, a rotary drive shaft can extend from the actuation interface through the shaft portion 610, for example, to rotate the closing screw 671. Other examples of suitable rotary drive shafts are further described herein.

[0215] The firing actuator 680 includes a flexible drive shaft 681 configured to move linearly through the end effector assembly 600. For example, the flexible drive shaft 681 may be actuated by a manually actuated drive shaft of the robot input and / or the handle assembly. The flexible drive shaft 681 is configured to extend through a hollow channel 614 through the distal end 613 of the shaft portion 610 and is flexible, allowing the end effector assembly 600 to articulate relative to the end effector 600 from its extending shaft. The flexible drive shaft 681 extends through a gap slot 676 defined in a closing wedge 675 and is fixedly attached to the lower firing member 682. The lower firing member 682 is configured to be reusable with different cartridges.

[0216] The staple cartridge 640 includes a disposable upper firing member 683 configured to engage or latch onto a lower firing member 682 in a hook-like manner, such that the lower firing member 682 can push or drive the upper firing member 683 through the staple cartridge 640 and the support bracket 650. In other words, firing actuation involves a two-part firing member—the disposable upper firing member 683 incorporated into the cartridge 640 and the reusable lower firing member 682 incorporated into the firing drive mechanism 680—which can be coupled together when the staple cartridge 640 is located in the elongated channel 630. The two-part firing member is further described herein.

[0217] The upper firing member 683 includes an upper flange configured to engage and position the anvil jaws 660, a cutting edge configured to cut tissue, and a latch portion configured to engage the lower firing member 682 in a hook-like manner. The staple cartridge 640 also includes a slide 684 configured to engage a staple driver positioned within the cartridge 640 to eject staples from the cartridge 640. Because the blade and cutting edge are integrated into the disposable upper firing member 683 of the staple cartridge 640, new and / or brand-new cutting edges can be supplied with each staple cartridge loaded into the end effector assembly 600.

[0218] The lower firing member 682 and the upper firing member 683 are configured to move through the support bracket 650, such that the vertical load associated with the firing sequence is configured to be distributed through the support bracket 650, the cartridge 640, the channel 630, and the anvil jaws 660. The support bracket 650 may be made of, for example, a metal material to be inserted into the cartridge 640. The support bracket 650 includes a keyway 655 configured to engage within a corresponding keyway defined in a longitudinal slot of the cartridge 640. The support bracket 650 also includes a longitudinal slot 653 configured to receive the blade of the upper firing member 683, a cylindrical channel 657 configured to receive a portion of the upper firing member 683, a portion of the lower firing member 682, and a flexible drive shaft 681. The support bracket 650 also includes a vertical key extension 656 configured to be received within a corresponding keyhole in the cartridge platform. When the support bracket 650 is installed within the staple cartridge 640, such an extension is visible through the cartridge platform. In at least one instance, the support bracket 650 is configured to be inserted into the staple cartridge 640 from the bottom of the staple cartridge facing the channel 630.

[0219] The support bracket 650 also includes a proximal tab 651 and a distal tab 653, both configured to engage with the channel 630. Tabs 651 and 653 are configured to distribute at least some of the forces transmitted by the firing actuator 680 and corresponding components through the assembly 600. The distal tab 651 can be used to prevent the upper firing member 683 and the lower firing member 682 from being pushed through the distal end of the support bracket 650 by sharing and / or redistributing the load applied to the support bracket 650 by the firing actuator 680 with the channel 630.

[0220] When replacing the cartridge 640 to make the end effector assembly 600 reusable, the cartridge 640 is removed from the channel jaws 630. Removing the cartridge 640 from the channel jaws 630 removes the upper firing member 683, the slider 684, the support bracket 650, and the cartridge 640. A new blade can then be configured with a replacement cartridge.

[0221] The various implementation schemes disclosed herein can be used in conjunction with the robot system 700. For example, in Figures 21 to 23 An exemplary robotic system is shown in the figure. Figure 21 The main controller 701 is shown, which can be used in conjunction with a surgical robot, such as Figure 22 The slave robotic arm 800 is shown in the diagram. The master controller 701 and the slave robotic arm 800, along with their respective components and control systems, are collectively referred to herein as the robotic system 700. Examples of such systems and devices are disclosed in U.S. Patent No. 7,524,320, entitled “MECHANICAL ACTUATOR INTERFACE SYSTEM FOR ROBOTIC SURGICAL TOOLS,” and U.S. Patent No. 9,072,535, entitled “SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS,” the entire contents of which are incorporated herein by reference. As is well known, the master controller 701 typically includes a controller (in... Figure 21 The controller (generally referred to as 703) is held and manipulated in mid-air by the surgeon while the surgeon observes the surgery via a stereoscopic display 702. The controller 701 typically includes manual input devices that preferably move in multiple degrees of freedom and generally also have actuable handles, triggers, or actuators for actuating tools (e.g., for closing gripping jaws, applying potential to electrodes, etc.).

[0222] like Figure 22 As can be seen, in one form, the robotic arm 800 can be configured to actuate one or more surgical instruments, commonly referred to as 900. Various robotic surgical systems and methods employing a master controller and robotic arm arrangement are disclosed in U.S. Patent No. 6,132,368 entitled “MULTI-COMPONENT TELEPRESENCE SYSTEM AND METHOD,” the entire disclosure of which is incorporated herein by reference.

[0223] In various forms, the robotic arm 800 includes a base 702, which, in the illustrated embodiment, supports a surgical instrument 900. In various forms, the surgical instrument 900 may be supported by a series of manually articulated links (commonly referred to as device connector 804) and a robotic manipulator 806. In various embodiments, the link and connector arrangement may facilitate rotation of the surgical instrument about a point in space, as described more fully in U.S. Patent No. 5,817,084 entitled “REMOTE CENTER POSITIONING DEVICE WITH FLEXIBLE DRIVE,” the entire disclosure of which is hereby incorporated by reference. The parallelogram arrangement constrains rotation for pivoting about axis 812a (sometimes referred to as the pitch axis). Connectors supporting the parallelogram links are pivotally mounted to device connector 804. Figure 22 This allows the surgical instrument to also rotate about axis 812b (sometimes referred to as the yaw axis). The pitch axis 812a and yaw axis 812b intersect at a remote center 814, which is aligned along the slender axis of the surgical instrument 900. When supported by the manipulator 806, the surgical instrument 900 may have additional driven degrees of freedom, including sliding motion of the surgical instrument 900 along the longitudinal axis “LT-LT”. When the surgical instrument 900 moves relative to the manipulator 806 (arrow 812c) along the tool axis LT-LT, the remote center 814 remains fixed relative to the base 816 of the manipulator 806. Therefore, the entire manipulator is typically moved to reposition the remote center 814. The linkage 808 of the manipulator 806 may be driven by a series of motors 820. These motors actively move the linkage 808 in response to commands from the processor of the control system. Motors 820 may also be used to manipulate the surgical instrument 900. Alternative joint structures and device arrangements are also envisioned. Examples of other joint and device arrangements are disclosed, for example, in U.S. Patent No. 5,878,193 entitled “AUTOMATED ENDOSCOPE SYSTEM FOR OPTIMALPOSITIONING,” the entire disclosure of which is incorporated herein by reference.

[0224] While the communication between the surgical instruments and the main controller 701 is initially described herein, the data communication between the robotic components and the processor of the robotic surgical system should be understood. However, similar communication can occur between the circuitry of manipulators, device connectors, endoscopes, or other image-capturing devices and the processor of the robotic surgical system, which is used for component compatibility verification, component type identification, component correction (such as offset) communication, and component-to-system connection verification. According to at least one aspect, the various surgical instruments disclosed herein can be used in conjunction with other robot-controlled or automated surgical systems, and are not necessarily limited to those... Figures 21 to 23 Used together with the specific robot system components shown and described in the above references.

[0225] During various laparoscopic surgical procedures, it is common practice to access surgical sites located within the patient's abdomen by inserting the surgical end-effector portion of a surgical instrument through a cannula already embedded in the patient's abdominal wall. In its simplest form, the cannula is a pen-shaped instrument with a sharp triangular dot at one end, typically used within a hollow tube called a cannula or trocar to form an opening into the body through which the surgical end-effector is introduced. This arrangement forms an entrance into the body cavity through which the surgical end-effector is inserted. The inner diameter of the cannula inevitably limits the size of the end-effector and drive support shaft of the surgical instrument that can be inserted through the cannula.

[0226] Regardless of the specific type of surgical procedure performed, once a surgical end effector is inserted into the patient through a cannula, it is typically necessary to move the end effector relative to the shaft assembly positioned within the cannula to properly position it relative to the tissue or organ being treated. This movement or positioning of the end effector relative to the shaft portion held within the cannula is generally referred to as the "articular movement" of the end effector. Various articulation joints have been developed to attach the end effector to an associated shaft to facilitate this articulation. It is anticipated that in many surgical procedures, the use of surgical end effectors with the largest possible range of articulation is desirable.

[0227] Due to the dimensional constraints imposed by the size of the cannula sheath, the dimensions of the articulation joint components must be configured to allow free insertion through the cannula sheath. These dimensional constraints also limit the size and composition of various drive members and components that operatively intersect with a motor and / or other control system supported in a housing, which may be handheld or part of a larger automated system. In many instances, these drive members must operatively pass through the articulation joint to be operatively coupled to or operatively intersect with a surgical end effector. For example, one such drive member is typically used to apply articulated motion control to a surgical end effector. During use, the articulation drive member may be unacted to position the surgical end effector in a non-articular position to facilitate insertion of the surgical end effector through the cannula, and then actuated to articulate the surgical end effector to the desired position as it enters the patient's body.

[0228] Therefore, the aforementioned dimensional constraints pose numerous challenges to the development of articulation systems that can achieve the desired range of motion and accommodate a variety of different drive systems required to operate the various features of a surgical end effector. Furthermore, once the surgical end effector is positioned in the desired articulation location, the articulation system and articulation joint must be able to hold the surgical end effector in that locked position during actuation of the end effector and completion of the surgical procedure. Such an articulation joint arrangement must also be able to withstand the external forces experienced by the end effector during use.

[0229] Various surgical instruments employ diverse drive shaft arrangements to transmit drive motion from corresponding drive motion sources supported in the handle of the surgical instrument or in other parts of an automated or robotic control system. These drive shaft arrangements must accommodate the significant articulation orientation of the end effector while efficiently transmitting such drive motion across the articulation joints of the surgical instrument. Furthermore, due to the aforementioned dimensional constraints imposed by the size of the cannula through which the instrument shaft must be inserted, these drive shaft components must occupy as little space as possible within the shaft. To accommodate these requirements, many drive shaft arrangements comprise several movable elements connected in series. The small size (e.g., 4 mm diameter) and number of components result in difficult and lengthy assembly procedures, increasing the cost and complexity of the device.

[0230] As further described herein, a powered suture device may include two independently rotatable drive members: a first rotary drive member configured to close the jaws of an end effector and a second rotary drive member configured to fire a staple cartridge mounted in the end effector. The first and second rotary drive members are flexible and configured to extend through at least one articulated joint. In such examples, the first and second rotary drive members can transmit rotational actuation motion via the articulated joint in both a non-flexible and a flexible configuration. Exemplary rotary drive members are further described herein.

[0231] The powered suture assembly also includes a first jaw, a second jaw, a closing drive, and a firing drive. The closing drive includes a first rotary drive member extending through a joint joint, and the firing drive includes a second rotary drive member extending through the joint joint. The second rotary drive member can rotate independently of the first rotary drive member. For example, the closing drive can be activated by a closing trigger, which actuates the closing drive to cause rotation of the first rotary drive member, which transmits the rotational motion to the closing screw via the joint joint. The closing drive also includes a closing wedge threaded to the closing screw, wherein the closing wedge is configured to engage the first jaw to move it from an open position to a closed position as the first rotary drive member rotates.

[0232] The firing drive mechanism can be activated by, for example, a firing trigger separate from the closing trigger. The rotation of the second rotary drive member is separate from the rotation of the first rotary drive member, and the closing motion is separate from and different from the firing motion. Actuation of the firing drive mechanism enables the rotation of the second rotary drive member, which transmits the rotational motion to the firing screw via a joint. The firing drive mechanism also includes a firing member threadedly connected to the firing screw, wherein the firing member is configured to engage the first and second jaws in a cam-like manner and to move the cutting member and / or the pin-firing slider during the rotation of the second rotary drive member.

[0233] In various instances, at least one component of a powered suture device can be a 3D-printed part. 3D-printed parts can be incorporated into articulated motion systems, closure / gripping systems, and / or firing systems, as further described herein. In some instances, 3D printing technology can be utilized to improve part capabilities. For example, 3D printing can allow printed parts to exhibit metamaterial properties, resulting in greater structural strength and stiffness, while allowing for precise formation of small detail features and optimizing other properties of the part, such as selective flexibility and / or lubrication. Exemplary 3D-printed parts of powered suture devices are further described herein and include flexible rotatable drive components, such as tandem 3D-printed universal joints, firing components or I-beams, and / or staple cartridges and / or their sub-components. In one instance, the staple cartridge can be a composite plastic-metal 3D-printed part. 3D printing of various parts and considerations thereof are further described herein.

[0234] Methods for suturing using such surgical suture assemblies are also envisioned. The methods may include obtaining the surgical suture assembly and a closing drive mechanism actuated by a closing trigger, wherein a closing wedge is configured to engage a first jaw to move the first jaw from an open position to a closed position as the first rotary drive member rotates. The methods may also include activating a firing drive mechanism by a firing trigger, wherein a firing member is configured to engage the first and second jaws in a cam-like manner and advance a cutting member and a nail firing slider during the firing motion as the second rotary drive member rotates. Various applications of 3D-printed parts in such assemblies are further described herein.

[0235] Figures 26 to 29 One form of the universal joint 60200 is shown, which can be manufactured by various additive manufacturing processes that typically fall under the general term "3D printing". As this disclosure progresses, it will become more apparent that using such processes to produce the universal joint 60200 (which can be used to form the various drive shaft arrangements disclosed herein) solves many, if not all, of the dimensional and assembly challenges discussed above.

[0236] Various forms of additive manufacturing systems are known for manufacturing parts from, for example, sinterable building materials. Figure 24 An additive manufacturing system 60100 according to at least one aspect of this disclosure is shown in general form, which can implement a manufacturing process 60000 for forming a universal movable joint 60200. As used herein, the term "additive manufacturing" may include, but is not limited to, "selective laser melting (SLM)," "direct laser melting (DMLM)," "laser powder bed melting (LPBF)," and various other known systems, as well as those disclosed, for example, in U.S. Patent No. 9,815,118 entitled "FABRICATING MULTI-PART ASSEMBLIES," the entire disclosure of which is incorporated herein by reference.

[0237] As a non-limiting example, the additive manufacturing system 60100 includes a printer 60120, which may include a filament fabrication system, a binder jetting system, a stereolithography system, a selective laser sintering system, or any other system effectively adapted or used to form the universal joint 60200 described herein from or from a build material 60130 under computer control. In at least one form, the build material 60130 may include a sinterable material commonly used in such printers. For example, according to various aspects of this disclosure, the build material 60130 may include 316 stainless steel, 17-4 stainless steel, Ti-64 titanium, etc. Various other forms of build materials (metals and nonmetals) may also be employed, as will be discussed in further detail below.

[0238] In one aspect, the additive manufacturing system 60100 may include a computer system 60125 configured to generate a computer-aided design (CAD) three-dimensional file of the universal joint 60200. The CAD file data can then be segmented into multiple layers to form a two-dimensional image of each layer. This file can then be loaded into a file preparation software package, which assigns parameters, values, and physical support allowing the file to be interpreted by the printer 60120. In a general form, the printer 60120 may include a build chamber 60122 comprising a build plate or platform 60124 and a laser 60126. According to a non-limiting aspect, the build chamber 60122 may also include a material dispensing platform (not shown) and a recoating mechanism (not shown) for moving new build material 60130 onto the build plate 60124. In at least one arrangement, the building material 60130 is typically in powder form (“first state”), and the laser 60126 melts the powdered building material 60130 into a solid portion by using a focused laser beam to locally melt the powdered building material 60130 (“second state”). For example, components of the universal joint 60200 can be additionally built layer by layer.

[0239] Many additive manufacturing processes may require support structures to dissipate heat from the printed part into the build plate and to support the part throughout the manufacturing process. Overhanging features of the printed part typically lack an underlying solid layer to support them at any point. Therefore, such overhanging features may be more susceptible to deformation during manufacturing due to gravity, internal heat, and residual stress. In such cases, support structures may be employed during the additive manufacturing process to support those overhanging features to avoid this deformation. While such support structures are useful for these reasons, they must be removed from the formed part or component after the process is complete. This results in material waste and can potentially increase manufacturing costs.

[0240] In a non-limiting example, the additive manufacturing system 60100 may include a conveying device 60140 for transporting the printed “green” universal joint 60200G to a post-processing station 60150. As used herein, the term “green” may refer to a condition of the universal joint 60200 in which one or more components of the universal joint lack one or more of the following properties: for example, (i) the final desired composition, (ii) the final desired strength, (iii) the final desired dimensions, (iv) the final desired shape, (v) the final desired density, and / or (vi) the final desired surface finish. The conveying device 60140 may be any suitable mechanism or combination of devices suitable for the physical transport of the green universal joint 60200G. This could include, for example, robots and machine vision systems on the printer side for separating the green universal joint 60200G from the build plate 60124, and robots and machine vision systems on the post-processing side for accurately placing the green universal joint 60200G within the post-processing station 60150. Alternatively, the green universal joint 60200G can be manually transported between the two corresponding stations.

[0241] The post-processing station 60150 can be any system or combination of systems for transforming the green universal joint 60200G into, for example, a desired net final shape, net final dimensions, net final density, net final strength, and / or net final finish. For example, the post-processing station 60150 may also include, or alternatively include, a debonding station, such as a chemical debonding station for dissolving adhesive materials in solvents, or more generally, any debonding station configured to remove at least a portion of the adhesive system from various forms of building material 60130. For example, the post-processing station 60150 may also include, or alternatively include, a thermal sintering station for applying a thermal sintering cycle at the sintering temperature of the building material 60130 or the powdered material in the building material 60130, such as a sintering furnace configured to sinter the powdered material into a dense object. The post-processing station may also include, or alternatively include, a heat treatment station. The post-processing station may also include, or alternatively include, a system for removing unformed building materials and / or support materials using a variety of different media (including but not limited to liquids, solvents, air pressure, gravity, etc.).

[0242] Furthermore, the post-processing station 60150 can effectively employ a wide range of sintering techniques. In one aspect, the green movable joint 60200G can be solidified in a furnace to a higher theoretical density using, for example, vacuum sintering. In another aspect, the furnace can use a combination of flowing gas (e.g., at below atmospheric pressure, slightly above atmospheric pressure, or some other suitable pressure) and vacuum sintering. More generally, any sintering or other process suitable for increasing the density of the material can be used, preferably wherein the process produces parts with a near-theoretical density having very low or no porosity. Hot isostatic pressing (“HIP”) can also be used, or alternatively, to increase the density of the final part, for example by applying elevated temperature and pressure as a post-sintering step. In another aspect, the movable green joint 60200G can be processed using any of the aforementioned processes, followed by moderate overpressure (above the sintering pressure, but below the HIP pressure). More generally, the post-processing station 60150 may use any technique or combination of techniques suitable for removing adhesive systems and driving powdered materials to become solidified and densified to process the manufactured universal joint 60200 as envisioned herein.

[0243] Post-processing station 60150 may also include, or alternatively include, machining operations configured to remove support structures (if any) and / or machine components of the green universal joint 60200G that have been printed within “near-net” dimensions to provide a joint component with the final desired dimensions and shape. Post-processing station 60150 may also include, or alternatively include, a directional energy deposition (DED) process, which in one form may include a three-dimensional (3D) printing method that uses a focused energy source (such as a plasma arc, laser, or electron beam) to melt material simultaneously deposited by a nozzle. Such DED processes can be used, for example, to repair or add additional material to the green universal joint 60200G or the finished universal joint 60200. Post-processing station 60150 may also include, or alternatively include, various sandblasting and / or polishing operations to obtain the desired final surface finish of the universal joint 60200.

[0244] Figure 25A non-limiting example of a manufacturing process 60000 for forming a universal joint 60200 is shown. In one general aspect, the manufacturing process 60000 includes an action 60010 that develops a computer-aided design (CAD) file for the universal joint 60200 in a format usable by a printer 60120. The manufacturing process 60000 also includes an action 60020 that implements the computer-aided design file, causing the printer 60120 to form a green universal joint 60200G from build material 60130 supplied to the build chamber 60122 of the printer 60120. In at least one non-limiting form, the manufacturing process 60000 may also include an action 60030 that post-processes the green universal joint 60200G to form the final universal joint 60200 as described and envisioned herein. Action 60030 may include one or more actions described herein, which are designed to provide the green universal movable joint 60200G and its components with, for example, the final desired composition, strength, shape, size, density and / or finish.

[0245] Figures 26 to 29 A complete or finished universal movable joint 60200 formed using an additive manufacturing system 60100 is shown. (Example) Figures 26 to 29 As shown, one form of the universal joint 60200 includes a cross-shaped joint spine 60300, a vertical U-shaped joint 60400, and a horizontal U-shaped joint 60500. In at least one embodiment, for example, the joint spine 60300 defines a vertical axis VA-VA and a horizontal axis HA-HA transverse to the vertical axis VA-VA. In one arrangement, the horizontal axis HA-HA is orthogonal to the vertical axis VA-VA. For example, as... Figure 27 and Figure 29 As can be seen, the connector spine 60300 includes a bottom axis segment 60310 axially aligned on the vertical axis VA-VA, and includes a flared bottom end 60312. The flared bottom end 60312 defines an arcuate bottom surface 60314. The connector spine 60300 also includes a top axis segment 60320 axially aligned on the vertical axis VA-VA, and includes a flared top end 60322, which defines an arcuate top surface 60324. The connector spine 60300 also includes a first or right horizontal axis segment 60330 axially aligned on the horizontal axis HA-HA and terminating in a first tapered end portion 60334. The connector spine 60300 also includes a second or left horizontal axis segment 60340 axially aligned on the horizontal axis HA-HA and terminating in a second tapered end portion 60344.

[0246] Still refer to Figure 28 and 29The vertical U-shaped connector 60400, in at least one form, includes a bottom "wishbone" or bottom connector ring 60410, which is journal-connected to a bottom shaft section 60310 for rotation about the bottom shaft section. The bottom end 60312 of the flared portion of the connector spine 60300 permanently retains the bottom connector ring 60410 on the bottom shaft section 60310. In a non-limiting example, the vertical U-shaped connector 60400 also includes a top "wishbone" or top connector ring 60420, which is journal-connected to a top shaft section 60320 for rotation about the top shaft section. The top end 60322 of the flared portion of the connector spine 60300 permanently retains the top connector ring 60420 on the top shaft section 60320. The vertical U-shaped connector 60400 also includes a U-shaped vertical bridge 60430 that protrudes from and extends between a bottom connector ring 60410 and a top connector ring 60420. The U-shaped vertical bridge 60430 includes an arcuate outer surface 60431 designed to facilitate pivoting and movement of the vertical U-shaped connector 60400 within the tight confinement of the hollow outer shaft portion of a surgical instrument and / or surgical cannula. The vertical U-shaped connector 60400 includes an integrally formed component of a universal movable connector 60200 that is rotatable about the vertical axis VA-VA of the connector spine 60300 and permanently held on the connector spine by a flared bottom end 60312 and a flared top end 60322, as well as the U-shaped vertical bridge 60430. In other words, the vertical U-shaped connector 60400 cannot be separated from the connector spine 60300 without damage to one or both of these components.

[0247] According to another aspect of this disclosure, the horizontal U-joint 60500 includes, in at least one form, a first horizontal "fork" or joint cap 60510 and a second horizontal "fork" or joint cap 60520, the first horizontal "fork" or joint cap being rotatably journaled onto a first horizontal shaft segment 60330, and the second horizontal "fork" or joint cap being rotatably journaled onto a second horizontal shaft segment 60340. The horizontal U-joint 60500 also includes a U-shaped horizontal bridge 60530 (…). Figure 26The U-shaped horizontal bridge protrudes from and extends between the first horizontal connector cap 60510 and the second horizontal connector cap 60520. The U-shaped horizontal bridge 60530 includes an arcuate (opposite to the flat portion) outer surface 60531, which facilitates pivoting and movement of the horizontal U-shaped connector 60500 under the tight constraint of the hollow outer shaft portion of surgical instruments and / or surgical cannulas. The horizontal U-shaped connector 60500 includes an integrally formed component of a universal movable connector 60200, which is rotatable about the horizontal axis HA-HA of the connector spine 60300 and permanently held on the connector spine by the U-shaped horizontal bridge 60530. See also Figure 26 In other words, the horizontal U-shaped connector 60500 cannot be separated from the connector spine 60300 without damaging one or both of these components.

[0248] Go to Figure 29 In at least one non-limiting example, the bottom connector ring 60410 includes a bottom ring inner surface 60412 spaced apart from the outer surface 60316 of the bottom shaft section 60310 to define a bottom connector space 60318 extending between the bottom connector ring 60410 and the bottom shaft section 60310 and opening around the flared bottom end 60312 to the bottom of the universal joint 60200. Similarly, the top connector ring 60420 includes a top ring inner surface 60422 spaced apart from the outer surface 60323 of the top shaft section 60320 to define a top connector space 60326.

[0249] Still refer to Figure 29 According to another non-limiting example, the first horizontal connector cap 60510 includes a first hub portion 60512 and a first cap portion 60516, the first hub portion including a first inner hub surface 60514, the first cap portion defining a first wedge-shaped end surface 60518. The first inner hub surface 60514 is spaced apart from an outer surface 60332 of the first horizontal shaft segment 60330, and the first wedge-shaped end surface 60518 is spaced apart from a first tapered end portion 60334 to define a first horizontal connector space 60336 extending between the first horizontal connector cap 60510 and the first horizontal shaft segment 60330 and the first tapered end portion 60334. The first horizontal connector space 60336 opens through a first hole 60519 in the first cap portion 60516.

[0250] Similarly, the second horizontal connector cap 60520 includes a second hub portion 60522 and a second cap portion 60526, the second hub portion including a second inner hub surface 60524, the second cap portion defining a second wedge-shaped end surface 60528. The second inner hub surface 60524 is spaced apart from the outer surface 60342 of the second horizontal shaft segment 60340, and the second wedge-shaped end surface 60528 is spaced apart from the second tapered end portion 60344 to define a second horizontal connector space 60346 extending between the second horizontal connector cap 60520 and the first horizontal shaft segment 60340 and the first tapered end portion 60344. The second horizontal connector space 60346 opens through a second hole 60529 in the second cap portion 60526.

[0251] like Figure 27 As can also be seen, in a non-limiting example, the bottom connector ring 60410 includes a bottom connector ring outer surface 60414. The top connector ring 60420 includes a top connector ring outer surface 60424. The first horizontal connector cap 60510 includes a first cap outer surface 60517, and the second horizontal connector cap 60520 includes a second outer cap surface 60527. In the illustrated example, the bottom connector ring outer surface 60414 is spaced apart from the first cap outer surface 60517 to define a first lower gap space or "rounded corner" 60416 therebetween. Similarly, the bottom connector ring outer surface 60414 is spaced apart from the second cap outer surface 60527 to define a second lower gap space or "rounded corner" 60418 therebetween. The top connector ring outer surface 60424 is spaced apart from the first cap outer surface 60517 to define a first upper gap space or "rounded corner" 60426 therebetween. Similarly, the outer surface 60424 of the top connector ring is spaced apart from the outer surface 60527 of the second cap to define a second upper gap space or "rounded corner" 60428 therebetween.

[0252] Figure 30 A green preform universal joint 60200G is shown still supported on the build plate 60124. In this example, one form of build material 60130 is employed. In the “first state,” build material 60130 includes various types of powdered materials disclosed and contemplated herein. For example, once converted by a laser or other component / system, build material 60130 includes a “second” state. Figure 30 As shown, various amounts of the building material 60130 in powder form (e.g., "first state") are present. Figure 30The unformed build material 60130U (referred to as "60130U") is located in the top joint space 60326, the first upper gap space 60426, the second upper gap space 60428, the first horizontal joint space 60336, the second horizontal joint space 60346, the first lower gap space 60416, the second lower gap space 60418, and the bottom joint space 60318. This amount of unformed build material 60130U is used to support the vertical U-joint 60400 and the horizontal U-joint 60500 on the joint spine 60300 during the printing process and to prevent these parts from fusing or becoming immovably formed together. After the green universal movable joint 60200G has been formed, this amount of unformed build material 60130U must be removed from between the vertical U-joint 60400 and the joint spine 60300 and between the horizontal U-joint 60500 and the joint spine 60300. In various instances, a certain amount of unformed build material 60130U can be removed during post-processing under the influence of gravity, and / or can be removed using a removal medium (air, liquid, solvent, etc.). In one aspect, the first lower gap or fillet 60416, the second lower gap or fillet 60418, the first upper gap space or fillet 60426, the second upper gap space or fillet 60428, and the holes 60519 in the first horizontal joint cap 60510 and the second hole 60529 in the second horizontal joint cap 60520 are used to facilitate the easy removal of a certain amount of build material 60130U from the green universal movable joint 60200G. See also Figures 30A to 30C .

[0253] During the printing or forming process, the connector spine 60300 extends from and is vertically formed outside the build plate 60124. A flared bottom end 60312 is formed outside the build plate 60124 and is attached to the build plate during forming. The flared bottom end 60312 serves to support the connector spine 60300 during the printing process. In one aspect, a certain amount of unformed building material 60130U surrounding the bottom end 60312 of the flare, the bottom connector ring 40410, the first horizontal connector cap 60510 and the second horizontal connector cap 60520, and in the space between the vertical U-shaped connector 60400, the horizontal U-shaped connector 60500 and the connector spine 60300, can further help maintain the vertical orientation of the connector spine 60300 (and the universal joint 60200G) during the forming process without using a support member between the connector component and the building plate 60124. In such an arrangement, the bottom end 60312 of the flare facilitates heat dissipation into the building plate 60124. The bottom connector ring 60410 is formed without being attached to the building plate 60124. According to at least one aspect, the universal joint 60200 with a total diameter of about 4 mm can be formed in this way. Joints with a larger diameter (e.g., about 10 mm or more) may require one or more support members to support the joint components along a vertical orientation during the printing process. In any case, once a certain amount of unformed (i.e., still in a first state, in powder form, or uncured) build material 60130U is removed from between the joint components, the vertical U-joint 60400 can rotate freely about the vertical axis VA-VA on the joint spine 60300, and the horizontal U-joint 60500 can rotate freely about the horizontal axis HA-HA near the joint spine 60300. Additionally, the vertical U-joint 60400 and the horizontal U-joint 60500 cannot be removed from the joint spine 60300 without damaging the universal movable joint 60200.

[0254] Figure 31 A non-limiting example is shown, wherein a support member 60600 is formed between the flared bottom end 60312 and the building plate 60124, and / or between the bottom joint ring 60410 and the building plate 60124, and / or between the first horizontal joint cap 60510 and the building plate 60124, and / or between the second horizontal joint cap 60520 and the building plate 60124. The shape, number, and composition of such support members can vary, and they are configured to be removable from the universal movable joint 60200G during post-processing. In such an arrangement, various amounts 60130U of unformed building material can be received in the aforementioned spaces between the joint components and then removed during post-processing.

[0255] Figure 32 A green universal joint 60200G formed from a construction material 60130 of the type disclosed and contemplated herein is shown. However, during this manufacturing process, a support material SM is introduced into the process to separate parts 60300, 60400, and 60500 during printing. Such support material SM may include a powdered support material that can be removed from the space between parts under the influence of gravity, air pressure, liquid, etc. Other support materials SM that can be dissolved upon contact with a solvent medium are contemplated.

[0256] Other non-limiting systems and processes are envisioned, in which the universal movable joint 60200 is formed from different building materials and different support materials. For example, Figure 33 A universal joint 60200' is shown, which is identical to the universal joint 60200 except for the differences in its composition and forming noted below. For example, the joint spine 60300' may be formed from a first build material FBM, and the vertical U-joint 60400' and / or the horizontal U-joint member 60500' may be manufactured from a second build material SBM different from the first build material FBM. For example, the first build material FBM may include a polymer and the second build material may include a metallic build material, or vice versa. The first build material FBM and the second build material SBM may be introduced into precise locations on the build plate 60124 at predetermined times and locations, thereby facilitating the printing of parts from the desired material. In other arrangements, one of these parts may be printed from the first build material FBM and then introduced into the second build material SBM to form a second part. For example, in one envisioned arrangement, the joint spine 60300' may be printed from a softer material than the material used to form the vertical U-joint 60400' and / or the horizontal U-joint member 60500'. For example, in one arrangement, the joint spine 60300' may be printed from a polymer material or a softer material (such as brass or bronze), and the vertical U-joint 60400' and horizontal U-joint 60500' may be printed from stainless steel, titanium, or other metallic materials. Such a combination of materials may result in reduced friction between these components. In yet another arrangement, the joint spine 60300' may be made of stainless steel, titanium, etc., and the vertical U-joint 60400' and horizontal U-joint 60500' may be formed from softer materials such as brass, bronze, polymers, etc. Such arrangements may also employ a support material SM of the type envisioned herein to separate the component parts, which can then be removed from between these component parts during post-processing operations.

[0257] Figures 34 to 36Another form of the universal joint 60200” is shown, which is identical to the universal joint 60200 except that the bottom end 60312” and the top end 60322” are not extended. The vertical U-shaped joint 60400 is held on the joint spine by a U-shaped vertical bridge 60430.

[0258] The various forms of the universal joints 60200, 60200', and 60200" represent a significant improvement over existing joint arrangements used in various drive shafts and / or articulation joints of surgical instruments. The universal joints 60200, 60200', and 60200" incorporate a compact, "one-piece" design, avoiding many of the challenges and increased costs associated with other multi-part shaft / joint arrangements that might be used in assembling numerous surgical devices. Each of the universal joints 60200, 60200', and 60200" is designed to minimize / eliminate unsupported horizontal surfaces that could otherwise lead to increased surface roughness and component warping. The universal joints 60200, 60200', and 60200" can be printed from metallic construction materials and exhibit strength characteristics comparable to or exceeding those of multi-part joints machined from similar metallic materials and assembled together using pins, screws, welding, etc. The connectors of the present invention are designed to be further minimized, and in many cases eliminate the need for numerous delicate support components during the printing process, and also reduce post-processing operations and / or costs.

[0259] Figure 37 A universal movable drive shaft section 60700 is shown, comprising a plurality of movable universal movable joints 60200A, 60200B, and 60200C, which are continuously printed in a single continuous manufacturing system of the type contemplated herein. In a non-limiting example, universal movable joint 60200A is substantially identical to universal movable joint 60200 described herein, except that the U-shaped vertical bridge 60430A is formed together with the U-shaped horizontal bridge 60530B of universal movable joint 60200B. The U-shaped vertical bridge 60430B of universal movable joint 60200B is formed together with the U-shaped horizontal bridge 60530C of universal movable joint 60200C. In the non-limiting example shown, universal movable joints 60200B and 60200C may otherwise be identical in construction, manufacture, and operation to universal movable joint 60200. The universal movable drive shaft section 60700 may include additional universal movable joints formed in series, but is not limited to three joints formed in series. The universal movable drive shaft section 60700 may include two universal movable joints, three or more universal movable joints, which are formed together in series using the methods and processes contemplated herein.

[0260] Figures 38 to 40 One form of the articular motion joint assembly 61000 is shown, which can be used in various surgical instruments disclosed and envisioned herein, as well as other surgical instrument arrangements, devices, and configurations. In a non-limiting example, the articular motion joint assembly 61000 includes a proximal mounting member 61100 configured to engage with a shaft assembly 61010 of the surgical instrument. For example, the proximal mounting member 61100 can be welded or attached to the distal portion of the shaft assembly 61010 by any suitable means. See also Figure 39 In other arrangements, the proximal mounting member 61100 may include a portion of the shaft assembly 61010. Also in a non-limiting example, the articular joint assembly 61000 includes a distal mounting member 61200 configured to engage with the surgical end effector 61020. The surgical end effector 61020 may include any of the surgical end effectors disclosed or contemplated herein, and may include, but is not limited to, end effectors configured to manipulate tissue (grippers), end effectors configured to cut and suture tissue (endoscopic cutters), clamps, and end effectors configured to cut and fasten tissue using ultrasound, harmonics, radio frequency energy, etc. The distal mounting member 61200 may be welded or attached to the proximal portion of the surgical end effector 61020 by any suitable means. In other arrangements, the distal mounting member 61200 may include a portion of the surgical end effector 61020.

[0261] exist Figures 38 to 40 In the non-limiting example shown, the proximal mounting member 61100 includes a proximal shaft bore 61110 axially aligned with the shaft axis SA-SA defined by the shaft assembly 61010. Similarly, the distal mounting member 61200 includes a distal shaft bore 61210. The distal shaft bore 61210 may have the same or similar diameter as the proximal shaft bore 61110. The dimensions and configuration of the proximal and distal shaft bores 61110 and 61210 are configured to accommodate various flexible or otherwise movable drive shafts, actuator components, conductors, cables, shaft support structures, etc., extending from the shaft assembly 61010 to the surgical end effector 61020. In various instances, such drive shafts, actuators, conductors, etc., can be operatively supported in one or more flexible hollow conduits or support members that span, for example, between the proximal mounting member 61100 and the distal mounting member 61200. In other arrangements, the drive shaft is supported in one of the shaft guides described below and envisioned herein. When the surgical end effector 61020 is aligned with the shaft assembly 61010 on the shaft axis SA-SA, the distal shaft bore 61210 is aligned with the proximal shaft bore 61110.

[0262] Still refer to Figures 38 to 40 In at least one non-limiting example, the articulated joint assembly 61000 also includes a plurality of articulated linkage assemblies attached to and extending therebetween the proximal mounting member 61100 and the distal mounting member 61200. The non-limiting example shown includes three articulated linkage assemblies 61300A, 61300B, and 61300C. Other numbers of articulated linkage assemblies are contemplated. Unless otherwise stated herein, the articulated linkage assemblies 61300A, 61300B, and 61300C are similar in construction, and in at least one instance, these articulated linkage assemblies can each be formed or printed using a manufacturing system of the type contemplated herein. The articulated linkage assembly 61300A includes a proximal movable joint 62200A and a distal movable joint 63200A, which are structurally and designally very similar to the universal joint 60200 described herein. For example, the proximal movable joint 62200A includes a proximal joint spine 62300A, a proximal first joint member 62400A, and a proximal second joint member 62500A. Similarly, each distal movable joint 63200A includes a distal joint spine 63300A, a distal first joint member 63400A, and a distal second joint member 63500A. In the non-limiting example shown, the vertical U-shaped joint 62400A of the proximal first joint member 62400A and the vertical U-shaped joint 63400A of the distal first joint member 63400A may be designed similarly to the vertical U-shaped joint 60400 described above, except that the connecting member 62600A protrudes from and extends therebetween the proximal first bridging member 62430A of the proximal first joint member 62400A and the distal first bridging member 63430A of the distal first joint member 63400A. In one example, link member 62600A includes a circular cross-sectional shape. The circular cross-sectional shape facilitates the passage of the operating axis and control members within the region defined between link members 62600A, 62600B, and 62600C, as will be discussed further below. The proximal first joint member 62400A is configured to pivot relative to the proximal joint spine 62300A about a first proximal axis FPA-FPA, and the distal first joint member 63400A is configured to pivot relative to the distal joint spine 63300A about a first distal axis FDA-FDA.

[0263] like Figures 38 to 40As can be further seen, the proximal second connector member 62500A can be designed similarly to the aforementioned horizontal U-shaped connector 60500, except that the mounting feature 62700A protrudes from the proximal second bridging member 62530A of the proximal second connector member 62500A. In a non-limiting example, the mounting feature 62700A is configured to be received in a corresponding proximal axial mounting slot 61120A provided in the proximal mounting member 61100. For ease of assembly, the proximal mounting feature 62700A includes a hook portion 62702A configured to hook onto a retaining ear 61122A formed in the proximal axial mounting slot 61120A. In one arrangement, the hook portion 62702A is spaced apart from the proximal second bridging member 62530A by a wedge-shaped opening 62704A and is configured to engage with a wedge-shaped retaining lug 61122A to immovably wedge the proximal movable joint 62200A into the proximal mounting member 61100. In one aspect, the wedge-shaped interface may be sufficient to immovably engage the proximal movable joint 62200A into the proximal mounting member 61100. In other arrangements, in addition to the wedge-shaped interface, alternatively or additionally, the mounting feature 62700A may be attached to the proximal mounting member 61100 by welding, adhesive, or other suitable mounting means. In one example, the mounting feature 62700A may be simply maintained in hook engagement with the proximal mounting member 61100 and the distal mounting member 61200 by a conduit or shaft guide extending through the proximal shaft bore 61110 and the distal shaft bore 61210. In some other arrangements, the proximal mounting feature 62700A may include a rod feature (not shown) configured to be movably inserted into a corresponding axial slot (not shown) in the proximal mounting member 61100 to facilitate axial movement of the proximal movable connector 62200A relative to the proximal mounting member 61100. In at least one non-limiting example, the distal movable connector 63200A may be similarly configured and coupled to the distal mounting member 61200, and will not be repeated in detail herein. In various instances, when a shaft guide or hollow conduit extends between the proximal mounting member 61100 and the distal mounting member 61200, the conduit or shaft guide serves to prevent the proximal mounting feature 62700A from disengaging from the proximal mounting member 61100 and to prevent the distal mounting feature from disengaging from the distal mounting member 61200.

[0264] The articulated linkage assemblies 61300B and 61300C are similar in design to the articulated linkage assembly 61300A described in detail above. For example... Figures 38 to 40As can be seen, the proximal movable joint 62200A of the articulation linkage assembly 61300A is attached to the proximal mounting member 61100 at a first proximal attachment position FPA defined by the axial mounting slot 61120A. Similarly, the distal movable joint 63200A of the articulation assembly 61300A is formed with a distal mounting feature (not shown), which is similar to the proximal mounting feature 62700A, for attachment to the distal mounting member 61200. The distal movable joint 63200A is attached to the distal mounting member 61200 at a first distal attachment position FDA defined by the distal axial mounting slot 61220A in the distal mounting member 61200.

[0265] Still refer to Figures 38 to 40The proximal movable joint 62200B of the articulated linkage assembly 61300B is attached to the proximal mounting member 61100 at a second proximal attachment position SPA defined by a proximal axial mounting slot 61120B, and the proximal movable joint 62200C of the articulated linkage assembly 61300C is attached to the proximal mounting member 61100 at a third proximal attachment position TPA defined by a proximal axial mounting slot 61120C. In a non-limiting example, the first proximal attachment position FPA, the second proximal attachment position SPA, and the third proximal attachment position TPA are equidistantly spaced about the axis SA-SA. In other words, angles A, B, and C are each approximately 120°. Similarly, the distal movable joint 63200B of the articulated link assembly 61300B is attached to the distal mounting member 61200 at a second distal attachment position SDA defined by the distal axial mounting slot 61220B, and the distal movable joint 63200C of the articulated link assembly 61300C is attached to the distal mounting member 61200 at a third distal attachment position TDA defined by the distal axial mounting slot 61220C. In a non-limiting example, the first distal attachment position FDA, the second distal attachment position SDA, and the third distal attachment position TDA are equidistantly spaced around the axis SA-SA, with angles D, E, and F each approximately 120°. In one arrangement, when the surgical end effector 61020 is in a non-articular position, or in other words, axially aligned with the shaft assembly 61010 along the axis SA-SA, the first distal attachment position FDA and the first proximal attachment position FPA are diametrically opposed; the second distal attachment position SDA and the second proximal attachment position SPA are diametrically opposed; and the third distal attachment position TDA and the third proximal attachment position TPA are diametrically opposed. In such an arrangement, each of the link members 62600A, 62600B, and 62600C can be slightly twisted about an open central tunnel region 62800 defined by the shaft bore to accommodate unobstructed passage and operation of various drive shafts and other components from the shaft assembly 61010 to the surgical end effector 61020. In other words, in at least one arrangement, the axes of each of the link members 62600A and 62600B are not parallel to each other and are not parallel to the axis SA-SA. In one example, the distal mounting member 61200 can rotate relative to the proximal mounting member 61100 during joint movement to maintain the inner drive radius of the open central tunnel or open area 62800. In this arrangement, the axial distance AD ​​between the proximal mounting member 61100 and the distal mounting member 61200 remains constant throughout the joint movement / orientation of the articulated joint assembly 61000. See also Figure 40 .

[0266] To facilitate joint movement of the end effector, at least two, and preferably four, flexible joint motion actuators (not shown) are attached to the distal mounting member and movably extend through an opening in the proximal mounting member to communicate with a joint motion control system supported in or by the housing or robotic system. For example, the flexible joint motion actuators may comprise flexible cables constructed in various ways contemplated herein and described in further detail below. Other suitable joint motion drive systems may be employed.

[0267] Figure 41 Another form of the articulation joint assembly 64000 is shown, which is somewhat similar in design and use to the articulation joint assembly 61000 described above. In a non-limiting example, the articulation joint assembly 64000 includes a proximal mounting member 64100 configured to engage with a shaft assembly 64010 of a surgical instrument. For example, the proximal mounting member 64100 can be welded or attached to a distal portion of the shaft assembly 64010 by any suitable means. In other arrangements, the proximal mounting member 64100 may comprise a portion of the shaft assembly 64010. Also in a non-limiting example, the articulation joint assembly 64000 includes a distal mounting member 64200 configured to engage with a surgical end effector 64020. The surgical end effector 64020 may include any of the surgical end effectors disclosed or contemplated herein, and may include, but is not limited to, end effectors configured to manipulate tissue (grippers), end effectors configured to cut and suture tissue (endoscopic cutters), applicators, and end effectors configured to cut and fasten tissue using ultrasound, harmonics, radiofrequency energy, etc. The distal mounting member 64200 may be welded or attached to the proximal portion of the surgical end effector 64020 by any suitable means. In other arrangements, the distal mounting member 64200 may include a portion of the surgical end effector 64020.

[0268] exist Figure 41In the non-limiting example shown, the proximal mounting member 64100 includes a proximal shaft bore 64110 axially aligned with the shaft axis SA-SA defined by the shaft assembly 64010. Similarly, the distal mounting member 64200 includes a distal shaft bore 64210. The distal shaft bore 64210 may have the same or similar diameter as the proximal shaft bore 64110. The dimensions and configuration of the proximal and distal shaft bores 64110 and 64210 are set to accommodate various flexible or otherwise movable drive shafts, actuator components, conductors, cables, shaft support structures, etc., extending from the shaft assembly 64010 to the surgical end effector 64020. When the surgical end effector 64020 is aligned with the shaft assembly 64010 along the shaft axis SA-SA, the distal shaft bore 64210 is aligned with the proximal shaft bore 64110.

[0269] Still refer to Figure 41In at least one non-limiting example, the articulation joint assembly 64000 also includes a plurality of articulation link assemblies extending between and attached to the proximal mounting member 64100 and the distal mounting member 64200. The non-limiting examples shown include three articulation link assemblies 64300A, 64300B, and 64300C, which, in at least one instance, can each be formed or printed using a manufacturing system of the type contemplated herein. Other numbers of articulation link assemblies are contemplated. For example, an articulation joint assembly comprising only two articulation link assemblies would function, but such an assembly might only be advantageous for articulation via a single plane. Unless otherwise stated herein, the articulation link assemblies 64300A, 64300B, and 64300C are similar in construction. The articulated linkage assembly 64300A includes a proximal movable joint 65200A and a distal movable joint 66200A, which are structurally and designally very similar to the universal joint 60200 described herein. For example, the proximal movable joint 65200A includes a proximal joint spine 65300A, a proximal first joint member 65400A, and a proximal second joint member 65500A. Similarly, each distal movable joint 66200A includes a distal joint spine 66300A, a distal first joint member 66400A, and a distal second joint member 66500A. In the non-limiting example shown, the U-shaped connector 65400A of the proximal movable connector 65200A and the U-shaped connector 65400B of the distal movable connector 66200A may be designed similarly to the U-shaped connector 60400 described above, except that the connecting member 65600A protrudes from and extends therebetween the proximal first bridging member 65430A of the proximal first connector member 65400A and the distal first bridging member 66420A of the distal first connector member 66400A. The proximal first connector member 65400A is configured to pivot about a first proximal axis relative to the proximal connector spine 65300A, and the distal first connector member 66400A is configured to pivot about a first distal axis relative to the distal connector spine 66300 in the manner disclosed herein. In other embodiments, the mounting feature 65700A may include the hook-shaped feature disclosed herein.

[0270] like Figure 41As can be further seen, the proximal second connector member 65500A can be designed similarly to the aforementioned horizontal U-joint 60500, except that the mounting feature 65700A protrudes from the proximal second bridging member 65530A of the proximal second connector member 65500A. In a non-limiting example, the mounting feature 65700A is configured to be received in a corresponding proximal axial mounting hole 64120A provided in the proximal mounting member 64100. Such an arrangement facilitates easy assembly and, in at least one alternative arrangement, allows axial movement of the articulated link 64300A relative to the proximal mounting member 64100.

[0271] The articulated linkage assemblies 64300B and 64300C are similar in design to the articulated linkage assembly 64300A described in detail above. For example... Figure 41 As can be seen, the proximal movable joint 65200A of the articulated linkage assembly 64300A is attached to the proximal mounting member 64100 at a first proximal attachment position FPA defined by the axial mounting slot 64120A. Similarly, the distal movable joint 66200A of the articulated linkage assembly 64300A is formed with a distal mounting feature 66700A, which is similar to the proximal mounting feature 62700A, for axially movable attachment to the distal mounting member 64200. The distal movable joint 65200A is attached to the distal mounting member 64200 at a first distal attachment position FDA defined by the distal axial mounting slot 64220A in the distal mounting member 64200. In one example, the linkage assemblies 64300A, 64300B, and 64300C can be compressed between the proximal mounting member 64100 and the distal mounting member 64200 during assembly. In this arrangement, the axial distance between the proximal mounting member 64100 and the distal mounting member 64200 remains constant throughout the joint motion / orientation of the articulated joint assembly 64000. In other instances, the proximal mounting member 64100 and the distal mounting member 64200 may be spaced apart from each other by a desired distance to allow some limited axial movement of the link assemblies 64300A, 64300B, and 64300C.

[0272] Still refer to Figure 41The proximal movable joint 65200B of the articulated linkage assembly 64300B is attached to the proximal mounting member 64100 at a second proximal attachment position SPA defined by a proximal axial mounting slot 64120B, and the proximal movable joint 65200C of the articulated linkage assembly 64300C is attached to the proximal mounting member 64100 at a third proximal attachment position TPA defined by a proximal axial mounting slot 64120C. In a non-limiting example, the first proximal attachment position FPA, the second proximal attachment position SPA, and the third proximal attachment position TPA are equidistantly spaced around the axis SA-SA. Similarly, the distal movable joint 66200B of the articulated link assembly 64300B is attached to the distal mounting member 64200 at a second distal attachment position SDA defined by the distal axial mounting slot 64220B, and the distal movable joint 66200C of the articulated link assembly 64300C is attached to the distal mounting member 64200 at a third distal attachment position TDA defined by the distal axial mounting slot 64220C. In a non-limiting example, the first distal attachment position FDA, the second distal attachment position SDA, and the third distal attachment position TDA are equidistantly spaced around the axis SA-SA. In one arrangement, when the surgical end effector 64020 is in a non-articular position, or in other words, when axially aligned with the shaft assembly 64010 along the axis SA-SA, the first distal attachment position FDA and the first proximal attachment position FPA are diametrically opposed; the second distal attachment position SDA and the second proximal attachment position SPA are diametrically opposed; and the third distal attachment position TDA and the third proximal attachment position TPA are diametrically opposed. In such an arrangement, each of the link members 65600A, 65600B, and 65600C is slightly twisted about an open central tunnel or open area 65800 defined by shaft holes 64110 and 64210 to accommodate unobstructed passage and operation of various drive shafts and other components from the shaft assembly 64010 to the surgical end effector 64020. In other words, in at least one arrangement, the axes of each of the link members 62600A and 62600B are not parallel to each other and are not parallel to the axis SA-SA. In one instance, the distal mount 64200 can rotate relative to the proximal mount 64100 during joint movement to maintain the inner drive radius of the open central tunnel or open area 65800.

[0273] To facilitate joint movement of the end effector, at least two, and preferably four, flexible joint motion actuators (not shown) are attached to the distal mounting member 64200 and movably extend through an opening in the proximal mounting member 64100 to communicate with a joint motion control system supported in or by a housing or robotic system. For example, the flexible joint motion actuators may comprise flexible cables constructed in various ways contemplated herein and described in further detail below. Other suitable joint motion drive systems may also be employed.

[0274] Figure 42 and Figure 43 Another non-limiting arrangement for attaching one of the movable joint components disclosed herein to a mounting member 67100, which can be attached to a portion of a shaft assembly or a portion of a surgical end effector in various ways disclosed herein. In the example shown, the mounting member 67100 includes an axial slot 67120 corresponding to each universal joint 60200” to which it is to be attached. Each slot 67120 has a stop 67122 formed therein to limit axial travel in one direction. The universal joint 60200” is substantially the same as the universal joints 60200, 60200’ described herein, except that a mounting rod or mounting feature 67700 protrudes from the U-shaped vertical bridge 60430 of the vertical U-joint 60400. A stop block 67702 is formed on the end of the mounting rod 67700 to engage the stop 67122 formed in the axial slot 67120, thereby restricting the axial movement of the universal movable joint 60200” in the direction PD.

[0275] Mounting member 67100 includes shaft bore 67110, which is configured to allow various drive shafts and / or other instrument components to pass through. In a non-limiting arrangement, each slot 67120 opens into shaft bore 67110. Figure 43 A portion of a shaft or conduit 67200 extending through a shaft bore 67110 is shown. In this arrangement, the shaft or conduit 67200 holds the mounting member 67700 and the stop block 67702 in corresponding axial slots 67120. Depending on the axial length of the mounting rod or feature 67700, the mounting rod 67700 and the stop block 67702 can move axially within the axial slots 67120, which facilitates the axial movement of the universal joint 60200 relative to the mounting member 67100. In other arrangements, the mounting rod 67700 and the stop block 67702 are immovably held within their corresponding axial slots 67120 by welding, adhesive, or other suitable fastening methods. Such arrangements facilitate easy assembly of the articulated joint components.

[0276] Now back Figures 12 to 14 The surgical suture assembly 400 shown, as discussed above, includes, in at least one form, an end effector 200 operatively coupled to the shaft assembly 410 via an articulated joint 420. The end effector 200 includes an anvil jaw 203 pivotally coupled to a magazine jaw 201 and movable relative to the magazine jaw between an open and closed position via a closing drive mechanism configured to operatively engage with a closing drive shaft section 475. Alternatively, the end effector 200 further includes a firing member 270 operatively engaged with a firing screw 261 such that, as the firing screw 261 rotates, the firing member 270 advances distally or retracts proximally along the firing screw 261. The firing screw 261 is operatively engaged with a firing drive shaft section 476, which transmits rotary drive motion from the firing drive device to the firing drive shaft section. The firing drive device may, for example, include any suitable source of rotary firing motion. For example, the firing drive device may include a firing drive motor operatively supported in a surgical instrument housing or part of a robotic system.

[0277] For example, in a non-limiting arrangement, the closing drive includes a proximal closing drive shaft portion 68002 that extends through the outer shaft 411 of the shaft assembly 410 and operatively engages with a rotary closing motion source supported in or by the housing or robotic system. The closing drive may also include an intermediate closing drive shaft portion bridging a joint motion joint and a distal closing drive shaft portion supported in the end effector 200. In one arrangement, the proximal portion may include, for example, a rigid shaft segment, a flexible shaft segment, or a combination of rigid and flexible segments. In a non-limiting arrangement, the intermediate closing drive shaft portion may include a universal joint (60200) or a series of movable joints or a universally movable drive shaft segment (60700) spanning the joint motion joint. The distal closing drive shaft portion may include a closing drive shaft arrangement supported in the end effector to apply opening and closing motions to the anvil in various manners disclosed herein.

[0278] Similarly, the firing drive may include a proximal firing shaft portion extending through the outer shaft 411 of the shaft assembly 410 and operatively engaging with a rotary firing motion source supported in or by a housing or robotic system. The firing drive may also include an intermediate firing drive shaft portion bridging a joint joint and a distal firing drive shaft portion supported in the end effector 200. In one arrangement, the proximal firing drive shaft portion may include, for example, a rigid shaft section, a flexible shaft section, or a combination of rigid and flexible sections. In a non-limiting arrangement, the intermediate firing drive shaft portion may include a universal joint (60200) or a series of movable joints or a universal drive shaft section (60700) spanning a joint joint. The distal firing drive shaft portion may include a firing drive shaft arrangement supported in the end effector to apply drive motion to the firing member 270 in various manners disclosed herein.

[0279] Figure 44 The proximal closure drive shaft portion 68002, intermediate closure drive shaft portion 68100, and distal closure drive shaft portion 68300 used in the surgical suture assembly 400 described above are shown. Figure 44 Also shown are the proximal firing drive shaft portion 68004, the intermediate firing shaft portion 68500, and the distal firing shaft portion 68600.

[0280] Figure 45 An example of an intermediate closed drive shaft portion 68100 according to at least one aspect of this disclosure is shown. Figure 45 As can be seen, the proximal closing drive shaft 68010 is attached to the closing coupling member 68110 for movement relative to the closing coupling member. In at least one non-limiting arrangement, the closing coupling member 68110 is made of a flexible material (polymer, rubber, etc.) that facilitates some torsional and axial flexure while maintaining sufficient rigidity to effectively transmit rotational closing motion. For example, the closing coupling member 68110 includes an elongated body 68112 comprising a proximal end 68114 and a distal end 68116, and a central portion 68118 extending therebetween. The central outer diameter of the central portion 68118 is smaller than the outer diameter of each of the proximal end 68114 and the distal end 68116 to facilitate axial flexure (arrow F).

[0281] For example, the proximal closing drive shaft 68010 may include a rigid shaft section, a flexible shaft section (e.g., a twisted cable, etc.), or a combination of rigid and flexible sections. The proximal closing drive shaft 68010 may be operatively coupled to a rotary closing motion source (e.g., a motor, etc.) operatively supported, for example, by or operatively supported within a housing or part of a robotic system. In the illustrated arrangement, the proximal closing drive shaft 68010 includes a bulbous distal end 68012 received in a proximal receptacle 68120 within the proximal end 68114 of the closing connector member 68110. The bulbous distal end 68012 of the proximal closing drive shaft 68010 is pivotally connected to the proximal end 68114 of the closing connector member 68110 via a proximal closing pin 68130, the proximal closing pin being received in an X-shaped channel 68014 within the bulbous distal end 68012 of the proximal closing drive shaft 68010. It should be understood that the X-shaped channel 68014 facilitates some pivoting travel between the proximal closing drive shaft 68010 and the closing connector member 68110.

[0282] The closure coupling member 68110 is operatively coupled to a distal closure drive shaft 68300, the distal closure drive shaft including... Figure 13 The closed drive shaft section 475 depicted includes a closed coupling shaft 68310 operably intersecting with a closed screw 251, as will be discussed in further detail below. In at least one arrangement, the closed coupling shaft 68310 includes a bulbous proximal end 68312 received in a distal receptacle 68122 of the closed coupling member 68110. The bulbous proximal end 68312 of the closed coupling shaft 68310 is pivotally connected to the distal end 68116 of the closed coupling member 68110 via a distal closing pin 68132 received in an X-shaped channel 68314 in the bulbous proximal end 68312 of the closed coupling shaft 68310. It should be understood that the X-shaped channel 68314 facilitates some pivoting travel between the closed coupling shaft 68310 and the closed coupling member 68110.

[0283] like Figure 45 As can be seen, the intermediate closed drive shaft portion 68100 is housed within the joint motion component support structure 440. In at least one arrangement, the joint motion component support structure 440 is made of a flexible material (such as polymer, rubber, etc.) and has an accordion-like shape to facilitate axial and flexural flexure.

[0284] Figure 46 An example of an intermediate firing drive shaft portion 68500 according to at least one aspect of this disclosure is shown. Figure 46As can be seen, the proximal firing drive shaft 68020 is attached to the firing coupler member 68510 for movement relative to the firing coupler member. In at least one non-limiting arrangement, the firing coupler member 68510 is made of a flexible material (polymer, rubber, etc.) that facilitates some torsional flexural ...

[0285] For example, the proximal firing drive shaft 68020 may include a rigid shaft section, a flexible shaft section (e.g., a twisted cable, etc.), or a combination of rigid and flexible sections. The proximal firing drive shaft 68020 may be operatively coupled to a rotary firing motion source (e.g., a motor, etc.), which may be operatively supported, for example, by or within a housing or part of a robotic system. In the illustrated arrangement, the proximal firing drive shaft 68020 includes a bulbous distal end 68022 received in a proximal receptacle 68520 within a proximal end 68514 of the firing coupler member 68510. The bulbous distal end 68022 of the proximal firing drive shaft 68020 is pivotally connected to the proximal end 68514 of the firing coupler member 68510 via a proximal firing pin 68630, the proximal firing pin being received in an X-shaped channel 68024 within the bulbous distal end 68022 of the proximal firing drive shaft 68020. It should be understood that the X-shaped channel 68024 facilitates some pivoting travel between the proximal firing drive shaft 68020 and the firing coupler member 68510.

[0286] The firing coupler component 68510 is operatively coupled to the distal firing drive shaft portion 68600, which includes... Figure 13 The firing drive shaft section 476 depicted includes a firing coupler shaft 68610 operably coupled to the firing screw 261, as will be discussed in further detail below. In at least one arrangement, the firing coupler shaft 68610 includes a bulbous proximal end 68612 received in a distal receptacle 68522 of the firing coupler member 68510. The bulbous proximal end 68612 of the firing coupler shaft 68610 is pivotally coupled to the distal end 68516 of the firing coupler member 68510 via a distal firing pin 68532 received in an X-shaped channel 68614 in the bulbous proximal end 68612 of the firing coupler shaft 68610. Figure 46 As can be seen, the intermediate firing drive shaft portion 68500 is housed within the joint motion component support structure 440. It should be understood that the X-shaped channel 68614 facilitates some pivotal travel between the firing coupler shaft 68610 and the firing coupler component 68510.

[0287] Figure 47 A longitudinally extended sectional view including the proximal end portion of the end effector 200 shows the distal closing drive shaft portion 68300 and the distal firing drive shaft portion 68600. In the illustrated arrangement, the distal closing drive shaft portion 68300 includes a closing screw 251 that rotatably supports the chamber channel 210 via a channel mounting fastener 68700 mounted within the proximal end of the chamber channel 210. The channel mounting fastener 68700 facilitates rotation of the closing screw 251 while preventing its axial movement. The closing screw 251 includes a series of closing drive threads that intersect with threaded channels in the closing wedge 255. Rotation of the closing screw 251 in a first rotational direction will cause axial movement of the closing wedge 255 in a first axial direction, and rotation of the closing screw 251 in a second rotational direction opposite to the first rotational direction will cause axial movement of the closing wedge 255 in the second axial direction. For example, rotation of the closing screw 251 in the first rotational direction can cause the closing wedge 255 to move axially in the distal direction DD to apply a closing motion to the anvil 203. Rotation of the closing screw 251 in the second rotational direction can cause the closing wedge 255 to move axially in the proximal direction to apply an opening motion to the anvil 203.

[0288] Still refer to Figure 47 The closing screw 251 defines the distal closing shaft axis DC-DC and includes a proximal mounting flange 68712 and a closing connector rod 68710, which projects proximally from the proximal mounting flange 68712 and is axially aligned on the distal closing shaft axis DC-DC. The closing connector rod 68710 has a non-circular cross-sectional shape and is adapted to be movably and non-rotatably received in a connector housing 68316 in the distal end of the closing connector shaft 68310. In a non-limiting arrangement, such as Figure 48As can be seen, the closing connector rod 68710 has a square cross-sectional shape. Other arrangements may, for example, have a hexagonal cross-sectional shape. The connector housing 68316 has a similar square shape and is configured to facilitate axial movement of the closing connector shaft 68310 relative to the closing screw 251 while transmitting rotational closing motion (torque) to it. This type of slidable connection arrangement also avoids adhesion and buildup between the drive parts of the connection. The proximal mounting flange 68712 and the connector housing 68316 are freely rotatable within the opening 68714 in the second shaft joint component 450. A housing flange 68318 is provided on the distal end of the connector housing 68316, which serves to limit the proximal travel of the connector housing 68316 when the housing flange 68318 contacts the end of the opening 68714. The closing connector rod 68710 is sized relative to the connector housing 68316 such that when the connector housing 68316 has reached its proximal travel limit, the closing connector rod 68710 remains operably engaged with the connector housing 68316 to prevent the closing screw 251 from disengaging from the closing connector shaft 68310.

[0289] In the illustrated arrangement, the distal firing drive shaft portion 68600 includes a firing screw 261 that rotatably supports the chamber channel 210 via a channel mounting fastener 68700. The channel mounting fastener 68700 facilitates rotation of the firing screw 261 while preventing its axial movement. The firing screw 261 includes a series of closed drive threads that engage with threaded channels in a threaded drive nut, which is configured to operably engage with threaded channels in the firing member 270 or the firing member 270 itself. Rotation of the firing screw 261 in a first rotational direction will cause axial movement of the firing member 270 in a first axial direction, and rotation of the firing screw 261 in a second rotational direction opposite to the first rotational direction will cause axial movement of the firing member 270 in the second axial direction. For example, rotation of the firing screw 261 in the first rotation direction can cause the firing member 270 to move axially in the distal direction DD, and rotation of the firing screw 261 in the second rotation direction can cause the firing member 270 to move axially in the proximal direction PD.

[0290] Still refer to Figure 47The firing screw 261 defines a distal firing shaft axis DF-DF and includes a proximal mounting flange 68722 and a firing coupler rod 68720, which projects proximally from the proximal mounting flange 68722 and is axially aligned on the distal firing shaft axis DF-DF. The firing coupler rod 68720 has a non-circular cross-sectional shape and is adapted to be movably and non-rotatably received in a coupler housing 68616 in the distal end of the firing coupler shaft 68610. In a non-limiting arrangement, the firing coupler rod 68720 has a square cross-sectional shape. Other arrangements may, for example, have a hexagonal cross-sectional shape. The coupler housing 68616 has a similar square shape and is configured to facilitate axial movement of the firing coupler shaft 68610 relative to the firing screw 261 while transmitting rotational (torque) firing motion to it. Such a slidable connection arrangement also avoids adhesion and buildup between the drive parts of the connection.

[0291] The proximal mounting flange 68722 and the connector housing 68616 are rotatable within the opening 68724 defined in the compartment channel 210 and the channel mounting fastener 68700. A housing flange 68618 is disposed on the distal end of the connector housing 68616, which restricts the proximal travel of the connector housing 68616 when the housing flange 68618 contacts the end of the opening 68724. The firing connector rod 68720 is sized relative to the connector housing 68616 such that when the connector housing 68616 has reached its proximal travel limit, the firing connector rod 68720 remains operably engaged with the connector housing 68616 to prevent the firing screw 261 from disengaging from the firing connector shaft 68610.

[0292] Figure 49 The intermediate closure drive shaft portion 69100 and the intermediate firing drive shaft portion 69500 ​​used in the surgical suture assembly 500 described above are shown. The intermediate closure drive shaft portion 69100 is configured to be operatively attached to the distal closure drive shaft portion 68300', which may include... Figure 16The closed drive shaft section 575 depicted is substantially similar to the distal closed drive shaft portion 68300 described above. In this embodiment, the intermediate closed drive shaft portion 69100 includes a closed coupling member 69110 comprising a solid cylindrical body connected to the proximal closed drive shaft portion 68002 and the distal closed drive shaft portion 68300' in the manner described above. In at least one non-limiting arrangement, the closed coupling member 69110 is made of a flexible material (polymer, rubber, etc.) that facilitates some torsional and axial flexural deflection while maintaining sufficient rigidity to effectively transmit rotational closing motion through it. Similarly, the intermediate firing drive shaft portion 69500 ​​is configured to be operably attached to the distal firing drive shaft portion 68600', which includes... Figure 16 The firing drive shaft 576 depicted is substantially similar to the distal firing drive shaft portion 68600 described above. In this embodiment, the intermediate firing drive shaft portion 69500 ​​includes a firing coupler member 69510 comprising a solid cylindrical body connected to the proximal firing drive shaft portion 68004 in the manner described above. In at least one non-limiting arrangement, the firing coupler member 69510 is made of a flexible material (polymer, rubber, etc.) that facilitates some torsional and axial deflection while maintaining sufficient rigidity to effectively transmit rotational closing motion.

[0293] Figures 44 to 49The closed and drive shaft arrangement depicted includes a dual rotary drive system, wherein a first (distal) portion is prevented from axial movement, and a second (intermediate) portion is slidably coupled thereto. Each rotary drive includes three parts: a proximal portion located in the shaft assembly, a distal portion located in the end effector, and an intermediate portion bridging the articulated joint. The intermediate portion may include one or more universal joints or torsion cable couplings. The distal portion is longitudinally fixed to the end effector, and the proximal portion is fixed to a retainer in the shaft to, for example, prevent longitudinal or axial movement of either of these portions. The intermediate portion may be slidably coupled to either or both of the proximal and distal portions. The sliding coupling may be coupled to either or both ends of the distal and proximal portions, or it may include a separate sliding aspect. These arrangements allow the intermediate portion to effectively become longer or shorter as the articulated joint moves through its range of motion. The sliding coupling between the intermediate portion and the distal and / or proximal portions may be fixed within a chamber that allows the distal end / or proximal portion to slide but limits the maximum sliding distance. This prevents the drive unit from separating if the articulated joint becomes overstretched. The sliding coupling has a square or hexagonal geometry, which facilitates torque transmission but allows longitudinal sliding of the coupled drive unit. The double intermediate sections are also supported by an articulated joint support structure bridging the articulated joint. The articulated joint coupling structure allows for fixed-floating, fixed-fixed (but flexible), fixed-sliding, and / or sliding-sliding connections of the components.

[0294] Figure 50 The above is shown in cross-section. Figures 1 to 6 End effector 200 and articulated motion region 110. As described above, the flexible drive sections 175 and 176 are each composed of universal joints arranged or formed in an "end-to-end" manner. For example, drive sections 175 and 176 may each include a plurality of universal joints 60200 arranged end-to-end, or drive sections 175 and 176 may include a universal drive shaft section 60700 manufactured using the additive manufacturing systems and processes described and envisioned herein. For example, in a non-limiting arrangement, the closing drive device 250 includes a proximal closing drive shaft portion 69200 that extends through the outer shaft 411 of the shaft assembly 410 and operatively engages with a rotary closing motion source supported in or by a housing or robot system (not shown). The proximal closing drive shaft portion 69200 may include, for example, a twisted cable 69202, a laser-cut flexible shaft or other flexible rotary drive member, a rigid rotary drive member, or a combination of a rigid rotary drive member and a flexible rotary drive member. like Figure 50As can be seen, the proximal closing drive shaft portion 69200 is coupled to the intermediate closing drive shaft portion 69300, which bridges the two articulation joints in the articulation joint region 110, including the flexible drive shaft section 175. The flexible drive shaft section 175 is coupled to the distal closing drive shaft portion 69400, which includes a closing drive shaft arrangement supported in the end effector to apply opening and closing movements to the anvil in various manners disclosed herein.

[0295] Still refer to Figure 50 In one non-limiting form, the distal closed drive shaft portion 69400 includes a closed connector shaft 69410 that is operatively engaged with the closed screw 251 in a manner described herein. In at least one arrangement, the closed connector shaft 69410 is integrally formed with the flexible drive shaft segment, such that the closed connector shaft 69410 is printed together with the flexible drive shaft segment 175 using the additive manufacturing systems and processes described and envisioned herein. In other arrangements, the closed connector shaft 69410 is otherwise attached to the distal universal joint member 60200D in the flexible drive shaft segment 175 by welding, adhesive, threading, or other means.

[0296] As discussed above, the closing screw 251 includes a proximal mounting flange 68712 and a closing connector rod 68710 projecting proximally from the proximal mounting flange 68712. The closing connector rod 68710 has a non-circular cross-sectional shape and is adapted to be movably and non-rotatably received in a connector housing 69416 in the distal end of the closing connector shaft 69410. The closing connector rod 68710 has a square cross-sectional shape. Other arrangements may, for example, have a hexagonal cross-sectional shape. The connector housing 68316 has a similar square shape and is configured to facilitate axial movement of the closing connector shaft 69410 relative to the closing screw 251 while transmitting rotational closing motion (torque) to it. Such a slidable connection arrangement also avoids adhesion and buildup between the drive parts of the connection. The proximal mounting flange 68712 and the connector housing 69416 are freely rotatable in the opening 68714 in the second shaft joint member 450.

[0297] In one aspect, the firing actuator includes a proximal firing drive shaft portion 69500 ​​that extends through the outer shaft 411 of the shaft assembly 410 and operatively engages with a rotary firing motion source supported in or by a housing or robotic system. The proximal firing drive shaft portion 69500 ​​may include, for example, another twisted cable 69502, a laser-cut flexible shaft, or another flexible rotary drive member, another rigid rotary drive member, or a combination of another rigid rotary drive member and another flexible rotary drive member. Figure 50 As can be seen, the proximal firing drive shaft portion 69500 ​​is coupled to the intermediate firing drive shaft portion 69600, which bridges the two articulated joints in the articulated joint region 110, including the flexible drive shaft section 176. The flexible drive shaft section 176 is coupled to the distal firing drive shaft portion 69700, which includes a firing drive shaft arrangement supported in the end effector to apply firing drive motion to the firing member 270 in various manners disclosed herein.

[0298] Still refer to Figure 50 In one non-limiting form, the distal firing drive shaft portion 69700 includes a flexible drive shaft section 176 and a firing coupler shaft 69710 that is operatively coupled to the firing screw 261 as described above. In at least one arrangement, the firing coupler shaft 69710 is integrally formed with the flexible drive shaft section 176, such that the firing coupler shaft 69710 is printed together with the flexible drive shaft section 176 using the additive manufacturing systems and processes described and envisioned herein. In other arrangements, the firing coupler shaft 69710 is otherwise attached to the distal universal joint member 60200DF in the flexible drive shaft section 176 by welding, adhesive, threading, or other means.

[0299] In the illustrated arrangement, the distal firing drive shaft portion 69700 includes a firing screw 261 that rotatably supports the chamber channel 210 via a channel mounting fastener 68700. The channel mounting fastener 68700 facilitates rotation of the firing screw 261 while preventing its axial movement. The firing screw 261 includes a series of closed drive threads that engage with threaded channels in a threaded drive nut, which is configured to operably engage with threaded channels in the firing member 270 or the firing member 270 itself. Rotation of the firing screw 261 in a first rotational direction will cause axial movement of the firing member 270 in a first axial direction, and rotation of the firing screw 261 in a second rotational direction opposite to the first rotational direction will cause axial movement of the firing member 270 in the second axial direction.

[0300] Still refer to Figure 50The firing screw 261 includes a firing coupler rod 68720 projecting proximally. The firing coupler rod 68720 has a non-circular cross-sectional shape and is adapted to be movably and non-rotatably received in a coupler housing 69716 in the distal end of the firing coupler shaft 69710. In a non-limiting arrangement, the firing coupler rod 68720 has a square cross-sectional shape. Other arrangements may, for example, have a hexagonal cross-sectional shape. The coupler housing 69716 has a similar square shape and is configured to facilitate axial movement of the firing coupler shaft 69710 relative to the firing screw 261 while transmitting rotational (torque) firing motion to it. Such a slidable connection arrangement also avoids adhesion and buildup between the driving portions of the connection. Therefore, rotation of the proximally closed shaft portion 69200 in the first rotational direction will drive the distally closed wedge 255 to move the anvil jaws 203, causing the anvil jaws to pivot. Figure 50 The closed position is shown. Rotation of the proximal closing axis portion 69200 in the opposite rotational direction will drive the closing wedge 255 proximally, causing the anvil jaws 203 to pivot to the open position. After the anvil jaws 203 has moved to the closed position to clamp the target tissue between the anvil jaws 203 and the staple cartridge 220, rotation of the proximal firing axis portion 69500 ​​in the first direction will cause the firing member 270 to move distally within the staple cartridge 220 to drive the staples from there and cut through the clamped tissue in the manner described herein. Rotation of the proximal firing axis portion 69500 ​​in the opposite rotational direction will cause the firing member 270 to move proximally back to the initial position, in which the anvil jaws 203 can move to the open position to release the cut and sutured tissue.

[0301] Figures 51 to 53 A portion of a surgical suturing instrument 10' is shown, which is substantially similar to the surgical suturing instrument 10 described above, except for the differences detailed below. Specifically, instead of the flexible drive shaft sections 175, 176 formed by universal joints, the surgical suturing instrument employs a closing drive device 250' including a flexible closing drive shaft 69210 that extends through the outer shaft 101 of the shaft assembly 100 and operatively engages with a rotary closing motion source supported in or by a housing or robotic system (not shown). The flexible closing drive shaft 69210 may include, for example, a twisted cable, a laser-cut flexible shaft or other flexible rotary drive member, a rigid rotary drive member, or a combination of a rigid rotary drive member (the portion inside the outer shaft 101) and a flexible rotary drive member (the portion spanning the joint motion region 110). Figure 53 As can be seen, the flexible closing drive shaft 69210 is connected to the closing screw 251 to apply a rotational closing motion thereto, thereby opening and closing the anvil jaws 203 in the manner described herein.

[0302] like Figure 52 and Figure 53 As can be further seen, the firing drive device 260' includes a flexible firing drive shaft 69520 that extends through the outer shaft 101 of the shaft assembly 100 and operatively engages with a rotary firing motion source supported in or by a housing or robotic system (not shown). The flexible firing drive shaft 69520 may include, for example, a twisted cable, a laser-cut flexible shaft, or other flexible rotary drive member, a rigid rotary drive member, or a combination of a rigid rotary drive member (the portion inside the outer shaft 101) and a flexible rotary drive member (the portion spanning the joint motion region 110). Figure 53 As can be seen, the flexible firing drive shaft 69520 is coupled to the firing screw 261 to apply a rotational firing motion thereto, thereby moving the firing member 270 through the end effector 200 in the manner described herein. In this arrangement, portions of the transverse joint movement region 110 of the flexible closed drive shaft 69210 and the flexible firing drive shaft 69520 are supported in the flexible shaft guide 69000.

[0303] Figures 54 to 62 One form of a shaft guide 69000 that can be incorporated into a shaft assembly 100 is shown. In the example shown, the shaft guide 69000 includes a shaft guide body 69010, which is sized to span a joint movement region 110. The shaft guide body 69010 includes a proximal shaft guide end 69020 and a distal shaft guide end 69030, and defines a shaft guide axis SGA extending between the proximal shaft guide end 69020 and the distal shaft guide end 69030. The shaft guide body 69010 also includes a first channel 69022 that extends from the proximal shaft guide end 69020 through the shaft guide body 69010 to the distal shaft guide end 69030. In the example shown, the first channel 69022 opens through the proximal shaft guide end 69020 on the first side FRP1 of the first reference plane FRP-FRP. Figure 55 And it opens on the first side SRP1 of the second reference plane SRP through the distal end 69030 of the shaft guide. Figure 56 In the arrangement shown, the central portion 69024 of the first channel 69022 passes at least partially through one or both of the first reference plane FRP and the second reference plane SRP.

[0304] Still refer to Figure 55 and Figure 56The shaft guide body 69010 also includes a second channel that extends from the proximal end 69020 of the shaft guide through the shaft guide body 69010 to the distal end 69030 of the shaft guide. The second channel 69026 opens across the proximal end 69020 of the shaft guide on the second side FRP2 of the first reference plane FRP. Figure 55 And it opens on the second side SRP2 of the second reference plane SRP through the distal end 69030 of the shaft guide. Figure 56 In the arrangement shown, the central portion 69028 of the second channel 69026 at least partially passes through one or both of the first reference plane FRP and the second reference plane SRP. Figure 55 As can be seen, the proximal end 69023 of the first channel 69022 is bisected by the second reference plane SRP, and the proximal end 69027 of the second channel 69026 is also bisected by the second reference plane SRP. Figure 56 As can be seen, the distal end 69025 of the first channel 69022 is bisected by the first reference plane FRP, and the distal end 69029 of the second channel 69026 is bisected by the first reference plane FRP.

[0305] In at least one arrangement, the shaft guide 69000 is made of a flexible, elastic, or ductile material (e.g., polypropylene, low-density polyethylene, liquid crystal polymer (LCP), nylon, etc.) that facilitates torsional flexure of the shaft guide 69000 when the end effector 200 performs articulation about at least one of a first joint motion axis AA1-AA1 and a second joint motion axis AA2-AA2. The shaft guide body 69010 includes a central body portion 69012 extending between the proximal end 69020 and the distal end 69030 of the shaft guide. In at least one non-limiting example, the central body portion 69012 includes a central bulbous portion 69014 that may further facilitate such flexure during joint movement. Furthermore, in at least one arrangement, the shaft guide body 69010 includes a proximal necking portion 69016 located between the central bulbous portion 69014 and the proximal end 69020 of the shaft guide, and substantially coinciding with the first joint motion axis AA1-AA1. The proximal necking portion 69016 may be formed by a first pair of opposing proximal fan-shaped notches 69017 corresponding to the first joint motion axis AA1-AA1. See also Figure 54The shaft guide body 69010 may also include a distal necking portion 69018 located between the central bulbous portion 69014 and the distal end 69030 of the shaft guide and substantially coinciding with the second joint motion axis AA2-AA2. The distal necking portion 69018 may be formed by a second pair of opposing distal fan-shaped notches 69019 corresponding to the second joint motion axis AA2-AA2. Such a “necked” or “diameter-reduced” section further facilitates the flexure of the shaft guide 69000 during joint movement of the end effector 200.

[0306] like Figure 55 As can be seen, in at least one arrangement, the proximal end 69020 of the shaft guide includes an elliptical or egg-shaped portion aligned on the proximal long axis PLA, which is aligned with the second reference plane SRP. Similarly, as... Figure 56 As can be seen, the distal end 69030 of the shaft guide includes an elliptical or egg-shaped part aligned on the distal long axis DLA-DLA aligned with the first reference plane FRP.

[0307] like Figure 53As can be seen, the shaft guide 69000 spans the joint movement region 110, and the distal end 69030 of the shaft guide is supported in and / or coupled to the distal shaft feature 140, while the proximal end 69020 of the shaft guide is supported in and / or attached to the proximal shaft feature 120. In the illustrated arrangement, the flexible drive shaft segment 175 is received within the first channel 69022, and the flexible drive shaft segment 176 is received within the second channel 69026. The proximal end 69020 of the shaft guide is coupled to a portion of the proximal shaft feature 120, and the distal end 69030 of the shaft guide is coupled to the distal shaft feature 140. The flexible drive shaft segment 175 operatively extends through the first channel 69022, and the flexible drive shaft segment 176 extends through the second channel 69026. In the example shown, the proximal closed drive shaft portion 69200 extends through the outer shaft 101 of the shaft assembly 100 and is located on one side of the shaft guide axis SGA to engage with the intermediate closed drive shaft portion 69300 (flexible drive shaft segment 175) supported in the first channel 69022 within the shaft guide 69000. Similarly, the proximal firing drive shaft portion 69500 ​​extends through the outer shaft 101 of the shaft assembly 100 and is located on the other side of the shaft guide axis SGA to engage with the intermediate firing drive shaft portion 69600 (flexible drive shaft segment 176) supported in the second channel 69026 within the shaft guide 69000. Thus, when the intermediate closed drive shaft portion 69300 and the intermediate firing drive shaft portion 69600 enter the proximal end 69020 of the shaft guide, the intermediate closed drive shaft portion 69300 and the intermediate firing drive shaft portion 69600 are in a side-by-side relationship or configuration (one on each side of the shaft guide axis SGA). When the intermediate closed drive shaft portion 69300 and the intermediate firing drive shaft portion 69600 are separated from the distal end of the shaft guide in a vertically stacked relationship, the intermediate closed drive shaft portion 69300 is located above the intermediate firing drive shaft portion 69600.

[0308] In one example, the first channel 69022 and the second channel 69026 twist as they travel from the proximal end 69020 of the shaft guide to the distal end 69030 of the shaft guide. The shaft guide 69000 includes supports for the intermediate closing drive shaft portion 69300 and the intermediate firing drive shaft portion 69600, which prevent the formation of a preferred bending plane. The shaft guide 69000 spans two tandem articulated joints of a multi-axis joint arrangement without forming a preferred bending orientation. In at least one arrangement, the multi-axis joint arrangement facilitates articulation of the end effector about articulated motion axes AA1-AA1, AA2-AA2 through two articulated motion angles, each of which is at least approximately 75 degrees in magnitude. The external contours of the shaft guide 69000 and each of the first channel 69022 and the second channel 69026 are torsion-compatible to minimize bending resistance by aligning its plane of minimum moment of inertia with the plane of moment of inertia of the articulated motion axes. In an alternative arrangement, each of the first channel 69022 and the second channel 69026 may be twisted multiple times between the proximal end 69020 and the distal end 69030 of the shaft guide. For example, in such an instance, each of the first channel 69022 and the second channel 69026 may pass through each of the first reference plane FRP and the second reference plane SRP multiple times.

[0309] According to at least one aspect of this disclosure, the proximal end 69027 of the second channel 69026 opens relative to the proximal end 69023 of the first channel 69022 through the proximal end 69020 of the shaft guide in a "first orientation". Figure 55 In the example shown, the proximal end 69027 of the second channel 69026 is horizontally spaced apart from or "horizontally aligned" with the proximal end 69023 of the first channel 69022. Other first orientations are contemplated. Also, according to at least one aspect of this disclosure, the distal end 69029 of the second channel 69026 is oriented in a "second orientation" relative to the distal end 69025 of the first channel 69022, different from the first orientation. For example, as Figure 56 As can be seen, the distal end 69029 of the second channel is located below the distal end 69025 of the first channel. In other words, the distal ends 69025 and 69029 of the first and second channels are either "vertically stacked" or "vertically aligned" with each other. Other second orientations are contemplated. In yet another few applications, the shaft guide 69000 may be mounted in opposite orientations between the surgical end effector and the shaft assembly, such that the proximal end 69020 of the shaft guide will be effectively distal to the distal end 69030 of the shaft guide. Thus, in such an arrangement, drive shafts entering the shaft guide 69000 will be vertically stacked relative to each other, and they will exit the shaft guide 69000, for example, in a horizontally spaced orientation.

[0310] Figure 63 A portion of another surgical suturing instrument 70010 is shown, including an elongated shaft assembly 100, which can be operatively coupled to a housing or part of a robotic system of various types and forms of surgical instruments described and envisioned herein. The elongated shaft assembly 100 is operatively coupled to an end effector 200 via an articulated joint assembly 71000. The end effector 200 may include various different end effectors configured to perform specific surgical functions. In the illustrated arrangement, the end effector 200 is configured to clamp, suture, and cut patient tissue. However, other forms of end effectors may be employed. In this example, the end effector 200 includes a clamp jaw 201 and an anvil jaw 203. The anvil jaw 203 is pivotable relative to the clamp jaw 203 to clamp tissue between the anvil jaw 203 and the clamp jaw 201. Once the tissue is clamped between jaws 201 and 203, the surgical suturing instrument 70010 can be actuated to advance the firing member through jaws 201 and 203 to suture and cut the tissue via the end effector 200, as discussed in more detail below.

[0311] A closing drive device 250 is provided for opening and closing the anvil jaws 203 relative to the jaw 201. See also Figure 64 The closure drive 250 is actuated by a flexible closure drive shaft 72000, which may include flexible shaft segments (e.g., twisting cable, laser cutting shaft, etc.) or a combination of rigid and flexible segments, operatively engaging, for example, a rotary closure motion source supported in or by a housing or robotic system. Discussed in more detail below, the flexible closure drive shaft 72000 is driven by a closure input shaft 72010, which extends through the shaft assembly 100 and operatively engages with a rotary closure motion source (e.g., a motor) supported in the housing of a surgical instrument or part of a robotic system. The flexible closure drive shaft 72000 transmits rotary actuation motion via an articulated joint assembly 71000. The closure drive 250 includes a closure screw 251 and a closure wedge 255 threadedly connected to the closure screw 251. The closure wedge 255 is configured to explicitly open and close the anvil jaws 203 by a cam in various manners described herein. The closing screw 251 is supported by a first support body 258 and a second support body 259 fixed within the channel 210. (See also...) Figure 64 .

[0312] To move the anvil jaws 203 between the clamping and releasing positions, the closing input shaft 72010 is actuated (rotated) to actuate (rotate) the flexible closing drive shaft 72000. The flexible closing drive shaft 72000 is connected to the closing screw 251 via a coupling 72012 and is configured to rotate the closing screw 251, thereby displacing the closing wedge 255. For example, the closing wedge 255 is threaded to the closing screw 251, and the rotational travel of the closing wedge 255 with respect to the staple cartridge 220 is restricted. The closing screw 251 drives the closing wedge 255 proximally or distally depending on the direction of rotation of the closing screw 251.

[0313] As discussed above, the surgical suturing instrument 70010 can be actuated to advance the firing member through the jaws 201, 203 to suture and cut tissue via the end effector 200. As discussed above, when the sliding member ( Figure 64 When a needle (not shown) is driven distally through the staple cartridge 220, staples stored in the cartridge 220 are deployed. A blade (not shown) is operatively supported on a slider, and when the slider is driven distally through the staple cartridge 220 by the firing member 270, the blade is used to cut tissue clamped between the anvil 203 and the cartridge 220. The firing member 270 is driven distally through the end effector 200 by the firing drive 260. The firing drive 260 is actuated by a flexible firing drive shaft 72100. The flexible firing drive shaft 72100 includes a flexible shaft section (e.g., a twisted cable, a laser-cutting flexible shaft, etc.) or a combination of rigid and flexible sections, which operatively engages, for example, a rotary firing motion source (e.g., a firing drive motor) supported in or by the housing of a surgical instrument or a robotic system. The flexible firing drive shaft 72100 is driven by a firing input shaft 72110 extending through the shaft assembly 100. The flexible firing drive shaft 72100 transmits rotational actuation motion to the firing screw 261, which includes a portion of the firing drive device 260, via the articulated joint assembly 71000. The firing screw 261 includes a journal supported within a bearing in a support member 259 and a channel 210. The firing screw 261 includes a proximal end 262 supported within the support member 259 and the channel 210, a distal end 263 supported within the channel 210, and a thread 265 extending along a portion of the length of the firing screw 261.

[0314] The firing member 270 is threadedly connected to the firing screw 261 such that, as the firing screw 261 rotates, the firing member 270 advances distally or retracts proximally along the firing screw 261. Specifically, the firing member 270 includes a body portion 271, which includes a hollow channel 272 defined therein. The firing screw 261 is configured to be received within the hollow channel 272 and is configured to be threadedly connected to a threaded component 273 of the firing member 270. Thus, as the firing screw 261 rotates, the threaded component 273 applies a linear force to the body portion 271 to advance the firing member 270 distally or retract it proximally. As the firing member 270 advances distally, it actuates a slider (not shown) movably supported in the nail cartridge 220. The distal movement of the slider causes nail ejection by engaging a plurality of nail actuators, as described above. The flexible firing drive shaft 72100 is connected to the firing screw 261 via a connector 72112 and is configured to rotate the firing screw 251, which causes the firing member 270 to be displaced.

[0315] Still refer to Figure 64 One form of the articulation joint assembly 71000 includes a proximal mounting member 71100 configured to engage with the shaft assembly 100 of the surgical suture instrument 70010. For example, the proximal mounting member 71100 may be welded or attached to the distal portion of the shaft assembly 100 by any suitable means. In other arrangements, the proximal mounting member 71100 may comprise a portion of the shaft assembly 100. The articulation joint assembly 71000 also includes a distal joint shaft component or a distal mounting member 71300. The distal mounting member 71300 may be welded or attached to the proximal portion of the surgical end effector 200 by any suitable means. For example, in the illustrated arrangement, the distal mounting member 71300 is attached to the proximal end of the jaw 201 via a retaining ring 146. In other arrangements, the distal mounting member 71300 may comprise a portion of the surgical end effector 200.

[0316] exist Figure 63 and Figure 64 In the non-limiting example shown, the proximal mounting member 71100 includes a proximal shaft hole 71110 axially aligned on the shaft axis SA-SA defined by the shaft assembly 100. See also Figure 69 Similarly, the distal mounting member 71300 includes a distal shaft bore 71310. The distal shaft bore 71310 may have the same or similar diameter as the proximal shaft bore 71110. When the surgical end effector 200 is aligned with the shaft assembly 100 on the shaft axis SA-SA, the distal shaft bore 71310 is aligned with the proximal shaft bore 71110.

[0317] Now refer to Figures 65 to 69In at least one non-limiting example, the articulation joint assembly 71000 further includes a linkage assembly 71400 that is coupled to and extends between the proximal mounting member 71100 and the distal mounting member 71300. In at least one form, the linkage assembly 71400 includes a plurality of articulation linkage members extending between and attached to the proximal mounting member 71100 and the distal mounting member 71300. The non-limiting examples shown include three articulation linkage members 71500A, 71500B, and 71500C. Other numbers of articulation linkage members are contemplated. For example, a linkage assembly including only two linkage members would be functional, but such a linkage assembly might only be advantageous for articulation through a single plane.

[0318] In one non-limiting arrangement, the articulated linkage member 71500A includes a proximal linkage end 71510A, a distal linkage end 71520A, and a linkage body 71530A. The proximal linkage end 71510A is coupled to the proximal mounting member 71100 at a first proximal attachment position 71120A via a first proximal joint assembly 71130A. In the illustrated example, the first proximal joint assembly 71130A includes a pair of first proximal attachment lugs 71132A projecting from the proximal mounting member 71100. A first proximal attachment link 71134A is pivotally coupled to the first proximal attachment lugs 71132A via a first proximal joint pin 71136A defining a first proximal joint axis FPJA1. The first proximal attachment link 71134A is pivotally attached to the proximal link end 71510A via a second proximal connector pin 71138A that defines the second proximal connector axis SPJA2. The second proximal connector axis is transverse to the first proximal connector axis FPJA1 and the axis SA-SA.

[0319] In the example shown, the distal link end 71520A is connected to the distal mounting member 71300 at the first distal attachment position 71320A via a first distal connector assembly 71330A. In the example shown, the first distal connector assembly 71330A includes a pair of first distal attachment lugs 71332A projecting from the distal mounting member 71300. A first distal attachment link 71334A is pivotally connected to the first distal attachment lugs 71332A via a first distal connector pin 71336A defining a first distal connector axis FDJA1. The first distal attachment link 711334A is pivotally attached to the distal link end 71520A via a second distal connector pin 71338A defining a second distal connector axis SDJA2 transverse to the first distal connector axis FDJA1 and the axis SA-SA.

[0320] In one non-limiting arrangement, the articulated linkage member 71500B includes a proximal linkage end 71510B, a distal linkage end 71520B, and a linkage body 71530B. The proximal linkage end 71510B is coupled to the proximal mounting member 71100 at a second proximal attachment position 71120B via a second proximal joint assembly 71130B. In the illustrated example, the second proximal joint assembly 71130B includes a pair of second proximal attachment lugs 71132B projecting from the proximal mounting member 71100. A second proximal attachment link 71134B is pivotally coupled to the second proximal attachment lugs 71132B via a first proximal joint pin 71136B defining a third proximal joint axis TPJA3. The second proximal attachment link 71134B is pivotally attached to the proximal link end 71510B via the second proximal connector pin 71138B that defines the fourth proximal connector axis FPJA4. The fourth proximal connector axis is transverse to the third proximal connector axis TPJA3 and the axis SA-SA.

[0321] In the example shown, the distal link end 71520B is connected to the distal mounting member 71300 at the second distal attachment position 71320B via a second distal connector assembly 71330B. In the example shown, the second distal connector assembly 71330B includes a pair of second distal attachment lugs 71332B projecting from the distal mounting member 71300. The second distal attachment link 71334B is pivotally connected to the second distal attachment lugs 71332B via a first distal connector pin 71336B defining a third distal connector axis TDJA3. The second distal attachment link 71334B is pivotally attached to the distal link end 71520B via a second distal connector pin 71338B defining a fourth distal connector axis FDJA4 transverse to the third distal connector axis TDJA3 and the axis SA-SA.

[0322] In one non-limiting arrangement, the articulated link member 71500C includes a proximal link end 71510C, a distal link end 71520C, and a link body 71530C. The proximal link end 71510C is coupled to the proximal mounting member 71100 at a third proximal attachment position 71120C via a third proximal joint assembly 71130C. In the illustrated example, the third proximal joint assembly 71130C includes a pair of third proximal attachment lugs 71132C projecting from the proximal mounting member 71100. The third proximal attachment link 71134C is pivotally coupled to the third proximal attachment lugs 71132C via a first proximal joint pin 71136C defining a fifth proximal joint axis FPJA5. The third proximal attachment link 71134C is pivotally attached to the proximal link end 71510C via a second proximal connector pin 71138C defining the sixth proximal connector axis SPJA6, which is transverse to the fifth proximal connector axis TPJA5 and the axis SA-SA. In a non-limiting example, the first proximal attachment position 71120A, the second proximal attachment position 71120B, and the third proximal attachment position 71120C are equidistantly spaced around the axis SA-SA. In other words, the angle between the first proximal attachment position 71120A, the second proximal attachment position 71120B, and the third proximal attachment position 71120C is approximately 120°.

[0323] In the example shown, the distal link end 71520C is connected to the distal mounting member 71300 at the third distal attachment position 71320C via a third distal connector assembly 71330C. In the example shown, the third distal connector assembly 71330C includes a pair of third distal attachment lugs 71332C projecting from the distal mounting member 71300. The third distal attachment link 71334C is pivotally connected to the third distal attachment lugs 71332C via a first distal connector pin 71336C defining a fifth distal connector axis FDJA3. The third distal attachment link 71334C is pivotally attached to the distal link end 71520C via a second distal connector pin 71338C defining a sixth distal connector axis SDJA6 transverse to the fifth distal connector axis FDJA5 and the axis SA-SA. In a non-limiting example, the first distal attachment position 71320A, the second distal attachment position 71320B, and the third distal attachment position 71320C are equidistantly spaced around the axis SA-SA. In other words, the angle between the first distal attachment position 71320A, the second distal attachment position 71320B, and the third distal attachment position 71320C is approximately 120°. In one arrangement, when the surgical end effector 200 is in a non-articular position, or in other words, when axially aligned with the shaft assembly 100 along the axis SA-SA, the first distal attachment position 71320A is diametrically opposed to the first proximal attachment position 71120A; the second distal attachment position 71320B is diametrically opposed to the second proximal attachment position 71120B; and the third distal attachment position 71320C is diametrically opposed to the third proximal attachment position 71120C.

[0324] In one aspect, the proximal shaft hole 71110 and the distal shaft hole 71310 in the proximal mounting member 71100 are used to define the central open passage area 72900. Figure 70 An end view of the joint motion linkage component 71500A is shown. (See attached image.) Figure 70 As can be seen, the link body 71530A includes a curved surface 71532A that bends around a central open channel region 79200. The link body 72530B similarly has a curved surface 71532B, and the link body 71530C has a curved surface 71532C. The curved surfaces 71532A, 71532B, and 71532C cooperate to maintain the central open channel region 72900 regardless of the joint position of the articulated joint assembly 71000. See, for example... Figures 66 to 67It should also be understood that the length of the articulation joint assembly 71000 remains relatively constant during such joint movements / positions. In other words, the distance DA between the proximal mounting member 71100 and the distal mounting member 71300 remains the same, regardless of the joint angle of motion. For example, this range of motion is advantageous because each of the link members 71500A, 71500B, and 71500C can move (rotate) through a link path LP of approximately 180 degrees. See also Figure 70 .

[0325] Figure 71 One form of shaft guide 73000 is shown, which is configured to extend between a proximal mounting member 71100 and a distal mounting member 71300, while supporting a flexible closing drive shaft 72000 and a flexible firing drive shaft 72100 therein. In one aspect, shaft guide 73000 includes a proximal end portion 73010, a distal end portion 73020, and a central body portion 73030. The proximal end portion 73010 includes a proximal mounting collar 73012 configured to be rotatably supported within a proximal shaft bore 71110 in the proximal mounting member 71100. Similarly, the distal end portion 73020 includes a distal mounting collar 73022 configured to be rotatably supported within a distal shaft bore 71310 in the distal mounting member 71300. This arrangement facilitates rotation of the shaft guide 73000 relative to the proximal mounting member 71100 and the distal mounting member 71300 while maintaining it fixed thereto. In another arrangement, the proximal mounting collar 73012 may additionally be configured relative to the proximal mounting member 71100, thereby also facilitating some axial movement relative to the proximal mounting member. Alternatively, the distal mounting collar 73022 may be configured to facilitate some axial movement relative to the distal mounting member 71300.

[0326] In one arrangement, the entire central body portion 73030 is flexible and may be made of a malleable material (e.g., polypropylene, low-density polyethylene, liquid crystal polymer (LCP), nylon, etc.) configured to facilitate torsional flexure during articulation of the end effector. For example, in another arrangement, the central body portion 73030 includes a relatively rigid hollow central segment, which may include a polymer, metal, etc., and is connected to a proximal flexible segment and a distal flexible segment. The proximal flexible segment is connected to a proximal mounting collar 73012, and the distal flexible segment is connected to a distal mounting collar 73022. The proximal and distal flexible segments may be made of a polymer, rubber, etc., which are more flexible than the central segment. Figure 71 and Figure 72In the illustrated embodiment, the shaft guide 73000 is made of a single flexible material (polymer, rubber, etc.) and additionally includes proximal flexible ribs 73032 and distal flexible ribs 73034 formed therein to facilitate additional flexibility.

[0327] In the example shown, shaft guide 73000 defines a central shaft guide axis SGA extending from the proximal end 73010 to the distal end 73020 of the shaft guide. Shaft guide 73000 also includes a first channel 73040 that opens on a first side RP1 of a reference plane RP through a proximal mounting collar 73012, the reference plane RP extending laterally through the shaft guide axis SGA. In the illustrated arrangement, the first channel 73040 is configured to operably support a portion of the flexible closed drive shaft 72000 spanning between the proximal mounting member 71100 and the distal mounting member 71300. Figure 71 As can be seen, in at least one arrangement, the first channel 73040 passes through the reference plane RP at least twice and opens through the distal mounting collar 73022 on the first side RP1 of the reference plane RP.

[0328] In the example shown, the shaft guide 73000 also includes a second channel 73050 that opens through the proximal mounting collar 73012 on the second side RP2 of the reference plane RP. In the arrangement shown, the second channel 73050 is configured to operably support the portion of the flexible firing drive shaft 72100 spanning between the proximal mounting member 71100 and the distal mounting member 71300. Figure 71 As can be seen, in at least one arrangement, the second channel 73050 passes through the reference plane RP at least twice and opens through the distal mounting collar 73022 on the second side RP2 of the reference plane RP. Such arrangements are used to operatively support the flexible closing drive shaft 72000 and the flexible firing drive shaft 72100, regardless of the articulated position of the end effector 200. Furthermore, this “twisted” arrangement of the first channel 73040 and the second channel 73050 forms a non-preferred bending plane through the shaft guide. In other arrangements, the shaft guide 73000 may be coupled to the proximal mounting member 71100 and the distal mounting member 71300 to facilitate relative rotation between them.

[0329] Now refer to Figure 64 and Figure 74In at least one arrangement, the surgical instrument includes an articulation system 74000, which includes a horizontal articulation drive 74100 and a vertical articulation drive 74200. In one aspect, the horizontal articulation drive 74100 includes a horizontal articulation cable 74110 journal-connected to a horizontal drive pulley 74120, which may be supported in or by a housing or robotic system. In other arrangements, the horizontal drive pulley 74120 may be supported in a portion of a shaft assembly 100. In at least one embodiment, the horizontal drive pulley 74120 includes a horizontal drive gear 74122 meshing with a horizontal drive rack 74124. The horizontal drive rack 74124 is configured to be axially driven by a corresponding motor drive unit (not shown) supported in or by a housing or robotic system.

[0330] like Figure 64 As can be seen, the horizontal articulation cable 74110 includes a first horizontal cable end portion 74112 that extends through a corresponding channel in the proximal mounting member 71100 and is attached to the distal mounting member 71300. The horizontal articulation cable 74110 also includes a second horizontal cable end portion 74114 that extends through a corresponding channel in the proximal mounting member 71100 and is attached to the distal mounting member 71300. Rotation of the horizontal drive pulley 71420 in a first direction will cause the end effector 200 to perform articulation in the first horizontal direction, and rotation of the horizontal drive pulley 71420 in a second direction will cause the end effector 200 to perform articulation in the second horizontal direction. Figure 63 (The arrow in the image is HD).

[0331] Still refer to Figure 64 and Figure 74 The vertical joint motion drive device 74200 includes a vertical joint motion cable 74210, which is journal-connected to a vertical drive pulley 74220, which may be supported in or by a housing or robot system. In other arrangements, the vertical drive pulley 74220 may be supported in a portion of a shaft assembly 100. In at least one embodiment, the vertical drive pulley 74220 includes a vertical drive gear (not shown) that meshes with a vertical drive rack 74224. The vertical drive rack 74224 is configured to be axially driven by a corresponding motor drive unit supported in or by a housing or robot system.

[0332] like Figure 64As can be seen, the vertical articulation cable 74210 includes a first vertical cable end portion 74212 that extends through a corresponding channel in the proximal mounting member 71100 and is attached to the distal mounting member 71300. The vertical articulation cable 74210 also includes a second horizontal cable end portion 74214 that extends through a corresponding channel in the proximal mounting member 71100 and is attached to the distal mounting member 71300. Rotation of the vertical drive pulley 74220 in a first direction will cause the end effector 200 to articulate in the first vertical direction, and rotation of the vertical drive pulley 74220 in a second direction will cause the end effector 200 to articulate in the second vertical direction. Figure 63 (See arrow VD in the diagram). When the horizontal joint motion drive 74100 and the vertical joint motion drive 74200 operate in concert, they enable the end effector to perform articulated movements in any combination of planes, thereby producing a three-dimensional cone of articulated motion. In various arrangements, springs may be used in conjunction with cables and / or drive pulleys to reduce / minimize backlash during operation.

[0333] Figure 75 and Figure 76 Another articulated surgical end effector 75000 is shown, configured to perform articulation in a single plane through an angle of motion AAG of approximately sixty-five degrees or greater. For example, such an articulated end effector may be particularly useful when performing a lower anterior colectomy (LAR). In one example, the surgical end effector 75000 includes a surgical suturing device capable of cutting and suturing tissue. Other applications may employ surgical end effectors configured to cut and fasten tissue using ultrasound, harmonics, radiofrequency energy, etc. In the example shown, the surgical end effector 75000 is substantially similar to the end effector 200 described above, except for the differences discussed herein.

[0334] For example, the surgical end effector 75000 shown includes a first jaw 201 and anvil jaw 203, the various details of which have been provided above. The surgical end effector also includes a distal connector 75450 similar to the connector 450 discussed above. In at least one arrangement, the distal connector 75450 is attached to the first jaw 201 via a retaining ring 358 in various ways described herein. According to one aspect, a distal articulation cam 75500 is coupled to the distal connector 75450. The distal articulation cam 75500 is configured to engage in a cam-like manner with a proximal articulation cam 75600, which is operatively engaged with a shaft assembly 75410.

[0335] According to at least one aspect, shaft assembly 75410 is substantially similar to shaft assembly 410 described herein, except for the aforementioned differences. In one example, the shaft assembly includes an outer shaft 75411 operably interacting with a proximal shaft joint member 75330. According to one aspect, a proximal articulation cam 75600 is supported by the proximal shaft joint member 75330 to rotate about an axis SA. For example, in one embodiment, the proximal articulation cam 75600 includes an annular gear 75610 configured to engage with an articulation drive gear 75710 attached to an articulation drive shaft 75700 rotatably supported in the shaft assembly 75410. The articulation drive shaft 75700 operably interacts with a rotary motion source (e.g., a motor, etc.) supported in or by a housing or robotic system. Rotation of the joint motion drive shaft 75700 in the first rotational direction will cause the proximal cam surface 75620 on the proximal joint motion cam 75600 to intersect the distal cam surface 75520 on the distal joint motion cam 75500 in a cam manner, so that the surgical end effector 75000 performs joint motion through the joint motion angle AAG. Continued rotation of the joint motion drive shaft 75700 in the first direction will cause the surgical end effector to perform joint motion through a single joint motion plane until the surgical end effector 75000 reaches, for example... Figure 76 The maximum joint motion position is shown (joint motion angle AAG is approximately 65°). Rotation of the joint motion drive shaft 75700 in the second rotational direction will cause the proximal joint motion cam 75600 and the distal joint motion cam 75500 to drive the surgical end effector 75000 back in a cam-like manner. Figure 75 The non-joint movement positions are shown.

[0336] According to one aspect of this disclosure, Figure 75 and Figure 76 The implementation scheme described above can adopt the one detailed in the text. Figures 44 to 48 The closed-loop drive system and firing drive system are depicted in the figure. It should be understood that the closed-loop drive system and firing drive system are used to maintain the distal cam surface 75520 and the proximal cam surface 75620 in a cam-like engagement. Figure 75 and Figure 76 This is only a "plan view" or "top view" showing the closed-loop drive arrangement; it should be understood that the firing drive arrangement is located directly below the closed-loop drive arrangement in the manner described herein. For example, as... Figure 75 and Figure 76As can be seen, the closing drive arrangement includes a proximal closing drive shaft portion 68002, an intermediate closing drive shaft portion 68100, and a distal closing drive shaft portion 68300, the distal closing drive shaft portion being operatively engaged with the closing member described herein to open and close the anvil 203. Also as described above, the proximal closing drive shaft 68010 and the distal closing drive shaft 68300 are attached to the closing coupling member 68110 for movement relative to the closing coupling member. The proximal closing drive shaft 68010 is operatively engaged with a rotary closing motion source (e.g., a motor, etc.) operatively supported, for example, by or operatively supported within a housing or part of a robot system. Rotation of the proximal closing drive shaft 68010 in a first direction results in the closing of the anvil 203, and rotation of the proximal closing drive shaft 68010 in a second rotational direction results in the anvil 203 moving from a closed position to an open position in the manner described herein. The firing drive system that can be used in this implementation scheme has been described in detail above and will not be repeated here for the sake of brevity.

[0337] Other embodiments may employ shaft embodiments including the universal movable joint 60200 in various manners and arrangements disclosed herein. The distal joint motion cam 75500 and the proximal joint motion cam 75500 define the joint motion region 75100 and utilize the rotary cam torsion joint to facilitate uniplane, unidirectional, and high-degree joint motion.

[0338] Many of the surgical instrument systems described herein are actuated by electric motors; however, they can be actuated in any suitable manner. In various instances, for example, the surgical instrument systems described herein may be actuated by manually operated triggers. In some instances, the motors disclosed herein may comprise one or more parts of a robot control system. Furthermore, any end effector and / or tooling assembly disclosed herein may be used with a robotic surgical instrument system. For example, U.S. Patent Application Serial No. 13 / 118,241 (now U.S. Patent No. 9,072,535), entitled “SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENTARRANGEMENTS,” discloses several examples of robotic surgical instrument systems in more detail.

[0339] The surgical instrument system described herein has been described in conjunction with the deployment and variations of the staples; however, the embodiments described herein are not limited thereto. For example, various embodiments are contemplated for deploying fasteners other than staples, such as clamps or pins. Furthermore, various embodiments utilizing any suitable means for sealing tissue are contemplated. For example, the end effector according to various embodiments may include electrodes configured to heat and seal tissue. Additionally, for example, the end effector according to some embodiments may apply vibrational energy to seal tissue.

[0340] Example Set 1

[0341] Example 1—A universal movable drive shaft for a surgical instrument, wherein the universal movable drive shaft includes a first movable joint, the first movable joint including a first joint spine defining a first axis and a second axis transverse to the first axis. The first movable joint further includes a first U-shaped bridge movably and nonremovably journal-connected to the first joint spine for pivoting about the first axis relative to the first joint spine. The first movable joint further includes a second U-shaped bridge movably and nonremovably journal-connected to the first joint spine for pivoting about the second axis relative to the first joint spine. The second U-shaped bridge further includes a third U-shaped bridge of the second movable joint. The second movable joint includes a second joint spine defining a third axis and a fourth axis transverse to the third axis. The third U-shaped bridge movably and nonremovably journal-connected to the second joint spine for pivoting about the fourth axis relative to the second joint spine. The second movable joint also includes a fourth U-shaped bridge, which is movably and non-removably journal-connected to the spine of the second joint for pivoting relative to the spine of the second joint about the third axis.

[0342] Example 2—According to the universal movable drive shaft of Example 1, wherein the fourth U-bridge further includes a fifth U-bridge of a third movable joint. The third movable joint includes a third joint spine defining a fifth axis and a sixth axis transverse to the fifth axis. The fifth U-bridge is movably and non-removably journal-connected to the third joint spine for pivoting relative to the third joint spine about the sixth axis. The third movable joint also includes a sixth U-bridge, which is movably and non-removably journal-connected to the third joint spine for pivoting relative to the third joint spine about the fifth axis.

[0343] Example 3—A universal movable drive shaft according to Example 1 or 2, wherein the first U-shaped bridge includes a first connector cap rotatably supported on a first conical portion of the first connector spine to rotatably travel about the first axis around the first conical portion, and the first connector cap is spaced apart from the first conical portion by a first connector space. A second connector cap rotatably supported on a second conical portion of the first connector spine to rotatably travel about the first axis around the second conical portion, wherein the second connector cap is spaced apart from the second conical portion by a second connector space. The second U-shaped bridge includes a first connector ring journaled on a portion of the first connector spine to rotate about the second axis around the portion of the first connector spine, wherein the first connector ring is held on the first connector spine by an end of a first flared opening of the first connector spine, and wherein the first connector ring is spaced apart from the portion of the first connector spine by a third connector space. The second connector ring is journal-connected to another portion of the first connector spine to rotate about the second axis around the other portion of the first connector spine, wherein the second connector ring is spaced apart from the other portion of the first connector spine by a fourth connector space.

[0344] Example 4—A universal movable drive shaft according to Example 1, 2 or 3, wherein the universal movable drive shaft is made of a building material that is transformed from a first state to a second state through a manufacturing process.

[0345] Example 5—The universal movable drive shaft according to Example 4, wherein the manufacturing process includes a three-dimensional printing process.

[0346] Example 6—A universal movable drive shaft according to Example 4 or 5, wherein the first joint space is configured to accommodate a first amount of the building material in the first state during the formation of the first universal movable drive shaft and to exit from the first joint space after the formation. The second joint space is configured to accommodate a second amount of the building material in the first state during the formation and to exit from the second joint space after the formation. The third joint space is configured to accommodate a third amount of the building material in the first state during the formation and to exit from the third joint space after the formation. The fourth joint space is configured to accommodate a fourth amount of the building material in the first state during the formation and to exit from the fourth joint space after the formation.

[0347] Example 7—A universal joint for a shaft of a surgical instrument. The universal joint includes a joint spine defining a first axis and a second axis transverse to the first axis. The joint spine includes a first shaft segment and a second shaft segment, each aligned on the first axis. The first shaft segment includes a first end with a flare, and the second shaft segment includes a second end with a flare. The joint spine also includes a third shaft segment and a fourth shaft segment, each aligned on the second axis. The universal joint further includes a first U-shaped connector, which is pivotally journaled on the joint spine to pivot about the first axis relative to the joint spine. The first U-shaped connector includes a first joint ring, which is journaled on the first shaft segment to rotate about the first shaft segment and held on the first shaft segment by the first end with the flare. The first U-shaped connector also includes a second joint ring, which is journaled on the second shaft segment to rotate about the second shaft segment and held on the second shaft segment by the second end with the flare. The first U-shaped connector further includes a first bridge extending between the first connector ring and the second connector ring. The universal joint also includes a second U-shaped connector pivotally journaled on the connector spine to pivot about a second axis relative to the connector spine. The second U-shaped connector includes a third connector cap rotatably journaled on the third axis segment to rotate about the second axis about the third axis segment. The second U-shaped connector also includes a fourth connector cap rotatably journaled on the fourth axis segment to rotate about the second axis about the fourth axis segment. The second U-shaped connector further includes a second bridge extending between the third and fourth connector caps to retain the third connector cap on the third axis segment and the fourth connector cap on the fourth axis segment.

[0348] Example 8—The universal movable joint according to Example 7, wherein the third shaft section terminates at the third conical end, and wherein the fourth shaft section terminates at the fourth conical end.

[0349] Example 9—A universal movable joint according to Example 8, wherein the first joint ring includes a first joint ring inner surface, wherein the first joint ring inner surface is spaced apart from the first shaft segment and the first end of the flared opening to define a first joint space. The second joint ring includes a second joint ring inner surface, wherein the second joint ring inner surface is spaced apart from the second shaft segment and the second end of the flared opening to define a second joint space. The third joint cap includes a third shaft surface, the third shaft surface being spaced apart from the third shaft segment to define a third shaft joint space. A third tapered surface is spaced apart from the third tapered end to define a third wedge joint space, the third wedge joint space communicating with the third shaft joint space to form a third joint space. A third outlet hole extends through the third joint cap and communicates with the third joint space. The fourth joint cap includes a fourth shaft surface, the fourth shaft surface being spaced apart from the fourth shaft segment to define a fourth shaft joint space. A fourth tapered surface is spaced apart from the fourth tapered end to define a fourth wedge joint space, the fourth wedge joint space communicating with the fourth shaft joint space to form a fourth joint space. The fourth outlet hole extends through the fourth connector cap and communicates with the fourth connector space.

[0350] Example 10—A universal movable joint according to Example 7 or 8, wherein the universal movable joint further includes a first joint space located between the first ring and the first shaft. A second joint space is located between the second ring and the second shaft. A third joint space is located between the third joint cap and the third shaft segment, and a fourth joint space is located between the fourth joint cap and the fourth shaft segment.

[0351] Example 11—A universal movable joint according to Examples 7, 8, 9 or 10, wherein the universal movable joint is made of a building material that has been transformed from a first state to a second state through a manufacturing process.

[0352] Example 12—The universal movable joint according to Example 11, wherein the manufacturing process includes a three-dimensional printing process.

[0353] Example 13—A universal movable joint according to Example 11 or 12, wherein the first joint space is configured to accommodate a first amount of the building material in the first state during the formation of the multi-planar movable joint. The second joint space is configured to accommodate a second amount of the building material in the first state during the formation. The third joint space is configured to accommodate a third amount of the building material in the first state during the formation, and the fourth joint space is configured to accommodate a fourth amount of the building material in the first state during the formation.

[0354] Example 14—A universal movable joint according to Example 13, wherein the first joint space is configured such that at least some of the first amount of the building material in the first state can exit from the first joint space after the formation of the universal movable joint. The second joint space is configured such that at least some of the second amount of the building material in the first state can exit from the second joint space after the formation. The third joint cap includes a third outlet hole, the size of which is set to allow at least some of the third amount of the building material in the first state to exit through the third outlet hole after the formation. The fourth joint cap includes a fourth outlet hole, the size of which is set to allow at least some of the fourth amount of the building material in the first state to exit through the fourth outlet hole after the formation.

[0355] Example 15—A universal movable connector according to Example 14, wherein the first connector ring includes a first connector ring outer surface. The third connector cap includes a third connector cap outer surface, and the fourth connector cap includes a fourth connector cap outer surface. The outer surface of the first connector ring and the outer surface of the third connector cap are spaced apart by a first rounded corner space. The outer surface of the first connector ring and the outer surface of the fourth connector cap are spaced apart by a second rounded corner space. The second connector ring includes a second connector ring outer surface, and the outer surface of the second connector ring and the outer surface of the third connector cap are spaced apart by a third rounded corner space. The outer surface of the second connector ring and the outer surface of the fourth connector cap are spaced apart by a fourth rounded corner space.

[0356] Example 16—According to the universal movable joint of Example 15, wherein the first rounded corner space is configured to allow at least some of the other building materials of the third amount of building materials in the first state to exit through the first rounded corner space after formation. The second rounded corner space is configured to allow at least some of the other building materials of the fourth amount of building materials in the first state to exit through the second rounded corner space after formation. The third rounded corner space and the fourth rounded corner space are each configured to allow at least some of the other building materials of the second amount of building materials in the first state to exit through the third rounded corner space and the fourth rounded corner space.

[0357] Example 17—A universal movable joint according to Examples 7, 8, 9, 10, 11, 12, 13, 14, 15 or 16, wherein the universal movable joint further includes a mounting member protruding from one of the first bridge and the second bridge.

[0358] Example 18—A universal movable joint according to Examples 11, 12, 13, 14, 15, 16 or 17, wherein, during the formation, a support material different from the building material is accommodated in the first joint space, the second joint space, the third joint space and the fourth joint space.

[0359] Example 19—A universal movable joint according to Examples 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17 or 18, wherein the joint spine is formed of a first building material, and wherein the first U-shaped joint and the second U-shaped joint are each formed of a second building material different from the first building material.

[0360] Example 20—An articulation joint assembly for facilitating multi-axis articulation of a surgical end effector relative to a shaft assembly of a surgical instrument, wherein the shaft assembly defines an axis, and wherein the articulation joint assembly includes a proximal mounting member configured to engage with the shaft assembly. The articulation joint assembly also includes a distal mounting member configured to engage with the surgical end effector. The articulation joint assembly further includes a plurality of articulation linkage assemblies attached to and extending between the proximal and distal mounting members. Each articulation linkage assembly includes a pair of universal joints. Each universal joint includes a joint spine defining a first axis and a second axis transverse to the first axis. The first and second axes are transverse to the axis. A first bridge is movably and non-removably journal-connected to the joint spine for pivoting about the first axis relative to the joint spine. The second bridge is movably and non-removably journal-connected to the joint spine for pivoting about the second axis relative to the joint spine. An attachment member projects from the second bridge and is configured to movably attach the universal joint to a corresponding one of the proximal mounting member and the distal mounting member. The articulated linkage assembly also includes an elongated link that projects from and extends between the first bridge on one of the universal joints of the pair of universal joints and the first bridge on the other universal joint of the pair of universal joints.

[0361] Example 21—A joint motion joint assembly according to Example 20, wherein the elongated link defines a link axis that is curved about the axis and is not parallel to the axis.

[0362] Example 22—A joint motion joint assembly according to Example 20 or 21, wherein the attachment member of one of the universal joints is configured to movably attach one of the universal joints to the proximal mounting member, such that the universal joint is axially movable relative to the proximal mounting member. The attachment member of the other universal joint is configured to movably attach the other universal joint to the distal mounting member, such that the other universal joint is axially movable relative to the distal mounting member.

[0363] Example 23—A joint motion joint assembly according to Example 20, 21 or 22, wherein each attachment member defines an attachment member axis parallel to the axis.

[0364] Example 24—A joint motion joint assembly according to Examples 20, 21, 22, or 23, wherein the second bridge includes a first joint cap rotatably supported on a first conical portion of the joint spine for rotatable travel about a first axis around the first conical portion, and spaced apart from the first conical portion by a first joint space. The second bridge also includes a second joint cap rotatably supported on a second conical portion of the joint spine for rotatable travel about the first axis around the second conical portion, and spaced apart from the second conical portion by a second joint space. The first bridge includes a first joint ring journaled on a first axial portion of the joint spine for rotatable travel about a second axis around the first axial portion, and spaced apart from the first axial portion of the joint spine by a third joint space. The first bridge also includes a second joint ring journaled on a second axial portion of the joint spine for rotatable travel about the second axis around the second axial portion, and spaced apart from the second axial portion of the joint spine by a fourth joint space.

[0365] Example 25—A joint motion joint assembly according to Examples 20, 21, 22, 23 or 24, wherein each joint motion link assembly is made of a building material that is transformed from a first state to a second state through a manufacturing process.

[0366] Example 26—The joint motion joint assembly according to Example 25, wherein the manufacturing process includes a three-dimensional printing process.

[0367] Example 27—A joint motion joint assembly according to Example 25 or 26, wherein the first joint space is configured to accommodate a first amount of the building material in the first state during the formation of the joint motion link assembly and to leave the first joint space after the formation; wherein the second joint space is configured to accommodate a second amount of the building material in the first state during the formation and to leave the second joint space after the formation; wherein the third joint space is configured to accommodate a third amount of the building material in the first state during the formation and to leave the third joint space after the formation; and wherein the fourth joint space is configured to accommodate a fourth amount of the building material in the first state during the formation and to leave the fourth joint space after the formation.

[0368] Example 28—A method comprising providing a building material that can be transformed from a first powder state to a second solid state. The method further comprises transforming a first amount of the building material from the first powder state to the second solid state to form a first cruciform joint spine, wherein the first cruciform joint spine defines a first vertical axis and a first horizontal axis transverse to the first vertical axis. The method further comprises transforming a second amount of the building material from the first powder state to the second solid state to form a first vertical head member, the first vertical head member being configured to non-removably pivot about the first vertical axis on the first cruciform joint spine. The method further comprises transforming a third amount of the building material from the first powder state to the second solid state to form a first horizontal joint member, the first horizontal joint member being configured to non-removably pivot about the first horizontal axis on the first cruciform joint spine. The method further comprises discharging all remaining amounts of the building material in the first powder state between the first cruciform joint spine, the vertical head member, and the horizontal joint member.

[0369] Example 29—According to the method of Example 28, the method of transforming a first amount of the building material from the first powder state to the second solid state further includes forming a second cruciform joint spine, wherein the second cruciform joint spine defines a second vertical axis and a second horizontal axis transverse to the second vertical axis. Transforming a second amount of the building material from the first powder state to the second solid state to form a first vertical joint member further includes forming a second vertical joint member configured to be nonremovably pivotable about the second vertical axis on the second cruciform joint spine. Transforming a third amount of the building material from the first powder state to the second solid state to form a first horizontal joint member further includes forming a second horizontal joint member protruding from the first vertical joint member and configured to be nonremovably pivotable about the second horizontal axis on the second cruciform joint spine.

[0370] Example 30—According to the method of Example 29, wherein changing a first amount of the building material from the first powder state to the second solid state further includes forming a third cruciform joint spine, the third cruciform joint spine defining a third vertical axis and a third horizontal axis transverse to the third vertical axis. Changing a second amount of the building material from the first powder state to the second solid state to form a first vertical head member further includes forming a third vertical head member, the third vertical head member being configured to be nonremovably pivotable about the third vertical axis on the third cruciform joint spine. Changing a third amount of the building material from the first powder state to the second solid state to form a first horizontal joint member further includes forming a third horizontal joint member, the third horizontal joint member protruding from the second vertical head member and being configured to be nonremovably pivotable about the third horizontal axis on the third cruciform joint spine.

[0371] Example Set 2

[0372] Example 1—A shaft guide for a surgical instrument, the surgical instrument comprising a shaft assembly defining a shaft axis and a surgical end effector operably coupled to the shaft assembly via an articulated joint. The articulated joint facilitates articulation of the surgical end effector about a first articulated axis and a second articulated axis, the first articulated axis being transverse to the shaft axis, and the second articulated axis being transverse to both the shaft axis and the first articulated axis. The shaft guide includes a shaft guide body sized to span the articulated joint and the first and second articulated axes. The shaft guide body includes a proximal shaft guide end and a distal shaft guide end. A first channel extends through the shaft guide body and includes a first channel proximal opening in the proximal shaft guide end and a first channel distal opening in the distal shaft guide end. A second channel extends through the shaft guide body and includes a second channel proximal opening in the proximal shaft guide end and a second channel distal opening in the distal shaft guide end. The proximal opening of the second channel is oriented in a first orientation relative to the proximal opening of the first channel, and the distal opening of the second channel is oriented in a second orientation relative to the distal opening of the first channel, wherein the second orientation is different from the first orientation.

[0373] Example 2—The shaft guide according to Example 1, wherein the proximal opening of the second channel is horizontally aligned with the proximal opening of the first channel, and wherein the distal opening of the second channel is vertically aligned with the distal opening of the first channel.

[0374] Example 3—The shaft guide according to Example 1 or 2, wherein the first proximal center of the first channel proximal opening and the second proximal center of the second channel proximal opening are located on a first reference plane. The first distal center of the first channel distal opening and the second distal center of the second channel distal opening are located on a second reference plane, the second reference plane being transverse to the first reference plane.

[0375] Example 4—The shaft guide according to Example 1 or 3, wherein the proximal opening of the second channel is vertically aligned with the proximal opening of the first channel, and the distal opening of the second channel is horizontally aligned with the distal opening of the first channel.

[0376] Example 5—A shaft guide according to Example 1 or 2, wherein the proximal opening of the first channel is located on a first side of a first reference plane, and the distal opening of the first channel is located on a first side of a second reference plane, the second reference plane being transverse to the first reference plane. The proximal opening of the second channel is located on a second side of the first reference plane, and the distal opening of the second channel is located on a second side of the second reference plane.

[0377] Example 6—A shaft guide according to Example 3, 4 or 5, wherein a first central portion of the first channel passes through at least one of the first reference plane and the second reference plane, and wherein a second central portion of the second channel passes through at least one of the first reference plane and the second reference plane.

[0378] Example 7—A shaft guide according to Examples 1, 2, 3, 4, 5 or 6, wherein the shaft guide is made of a ductile material configured to facilitate torsional flexure of the shaft guide when the surgical end effector performs joint movements about at least one of the first joint axis of motion and the second joint axis of motion.

[0379] Example 8—A shaft guide according to Example 1, 2, 3, 4, 5, 6 or 7, wherein the proximal end of the shaft guide includes a proximal elliptical shape and the distal end of the shaft guide includes a distal elliptical shape.

[0380] Example 9—A shaft guide according to Examples 1, 2, 3, 4, 5, 6, 7 or 8, wherein the shaft guide body includes a central body portion and includes a centrally located bulbous section, the central body portion extending between the proximal end and the distal end of the shaft guide.

[0381] Example 10—According to the shaft guide of Example 9, the central body portion further includes a proximal body portion located between the centrally located bulbous section and the proximal end of the shaft guide. The proximal body portion includes a proximal diameter smaller than the diameter of the centrally located bulbous section and corresponds to the first joint movement axis. The central body portion further includes a distal body portion located between the centrally located bulbous section and the distal end of the shaft guide. The distal body portion includes a proximal diameter smaller than the diameter of the centrally located bulbous section and corresponds to the second joint movement axis.

[0382] Example 11—The shaft guide according to Example 10, wherein the proximal body portion further includes a first pair of opposing proximal fan-shaped regions on the proximal side of the centrally located bulbous section and a second pair of opposing distal fan-shaped regions on the distal side of the centrally located bulbous section.

[0383] Example 12—A shaft guide for a surgical instrument, the surgical instrument comprising a shaft assembly defining a shaft axis and a surgical end effector operably coupled to the shaft assembly via an articulated joint facilitating articulated movement of the surgical end effector relative to the shaft axis through a plurality of articulated planes. The shaft guide includes a shaft guide body and includes a proximal end and a distal end of the shaft guide, the shaft guide body being sized to span the articulated joint. The shaft guide also includes a first channel extending from the proximal end of the shaft guide through the shaft guide body to the distal end of the shaft guide, and is configured to operably support a portion of a first drive shaft passing therethrough. The first channel opens on a first side of a reference plane through the proximal end of the shaft guide and opens on the first side of the reference plane through the distal end of the shaft guide, the reference plane extending through the shaft axis. A first central portion of the first channel passes through the reference plane at at least two locations. The shaft guide also includes a second channel extending from a proximal end of the shaft guide through the shaft guide body to a distal end of the shaft guide, and configured to operably support a portion of a second drive shaft passing therethrough. The second channel opens on a second side of the reference plane through the proximal end of the shaft guide and also opens on the second side of the reference plane through the distal end of the shaft guide. A second central portion of the second channel passes through the reference plane at at least two other locations.

[0384] Example 13—A shaft guide according to Example 12, wherein the shaft guide is made of a ductile material configured to facilitate torsional flexure of the shaft guide when the surgical end effector performs articulation relative to the shaft assembly.

[0385] Example 14—A shaft guide according to Example 12 or 13, wherein the proximal end of the shaft guide is coupled to the shaft assembly and configured to rotate relative to the shaft assembly, and wherein the distal end of the shaft guide is coupled to the surgical end effector and configured to rotate relative to the surgical end effector.

[0386] Example 15—A surgical instrument comprising a shaft assembly defining an axis. A surgical end effector is operatively coupled to the shaft assembly via an articulated joint defining a first articulated axis about which the surgical end effector is articulated relative to the shaft assembly. The first articulated axis is transverse to the shaft axis. The articulated joint further defines a second articulated axis about which the surgical end effector is articulated relative to the shaft assembly. The second articulated axis is transverse to both the shaft axis and the first articulated axis. The articulated joint includes a shaft guide comprising a proximal end of the shaft guide adjacent to the shaft assembly and a distal end of the shaft guide adjacent to the surgical end effector. The shaft guide also includes a shaft guide body that spans the articulated joint and the first and second articulated axes. The shaft guide body defines a shaft guide axis and includes a first channel extending from a proximal end of the shaft guide through the shaft guide body to a distal end of the shaft guide, and configured to operatively support a portion of a first drive shaft. The first channel opens on a first side of a first reference plane passing through the proximal end of the shaft guide and on a first side of a second reference plane passing through the distal end of the shaft guide, the first reference plane extending through the shaft guide axis and the second reference plane extending through the shaft guide axis and transverse to the first reference plane. A first central portion of the first channel passes through at least one of the first reference plane and the second reference plane. The shaft guide body also includes a second channel extending from the proximal end of the shaft guide through the shaft guide body to the distal end of the shaft guide, and configured to operatively support a portion of a second drive shaft passing therethrough. The second channel opens on a second side of the first reference plane passing through the proximal end of the shaft guide and on a second side of the second reference plane passing through the distal end of the shaft guide. A second central portion of the second channel passes through at least one of the first reference plane and the second reference plane.

[0387] Example 16—A surgical instrument according to Example 15, wherein the shaft guide is made of a malleable material configured to facilitate flexure of the shaft guide when the surgical end effector performs joint movements about at least one of the first joint axis of motion and the second joint axis of motion.

[0388] Example 17—A surgical instrument according to Example 15 or 16, wherein the first channel includes a proximal end and a distal end, the proximal end of the first channel opening through the proximal end of the shaft guide, and the distal end of the first channel opening through the distal end of the shaft guide. The second channel includes a proximal end and a distal end, the proximal end of the second channel opening through the proximal end of the shaft guide, and the distal end of the second channel opening through the distal end of the shaft guide. The proximal end of the first channel is bisected by a second reference plane, and the distal end of the first channel is bisected by the first reference plane. The proximal end of the second channel is bisected by the second reference plane, and the distal end of the second channel is bisected by the first reference plane.

[0389] Example 18—A surgical instrument according to Example 15, 16 or 17, wherein the proximal end of the shaft guide includes a proximal elliptical shape, and wherein the distal end of the shaft guide includes a distal elliptical shape.

[0390] Example 19—A surgical instrument according to Example 18, wherein the proximal elliptical shape includes a proximal long axis aligned on the first reference plane, and wherein the distal elliptical shape includes a distal long axis aligned on the second reference plane.

[0391] Example 20—A surgical instrument according to Example 19, wherein the first channel includes a proximal end and a distal end, the proximal end of the first channel opening through the proximal end of the shaft guide, and the distal end of the first channel opening through the distal end of the shaft guide. The second channel includes a proximal end and a distal end, the proximal end of the second channel opening through the proximal end of the shaft guide, and the distal end of the second channel opening through the distal end of the shaft guide. The proximal ends of the first and second channels are laterally spaced apart from each other on the proximal long axis. The distal ends of the first and second channels are vertically spaced apart from each other on the distal long axis.

[0392] Set of 3 Examples

[0393] Example 1—A surgical instrument comprising a shaft assembly defining an axis. The surgical instrument further comprises an end effector and an articulation joint. The articulation joint includes a proximal mounting member attached to the shaft assembly and a distal mounting member attached to the surgical end effector. The articulation joint further comprises a linkage assembly including a first linkage member comprising a proximal end of a first linkage, a distal end of a first linkage, and a first linkage body extending between the proximal and distal ends of the first linkage. During articulation of the surgical end effector, the proximal end of the first linkage is coupled to the proximal mounting member such that the proximal end of the first linkage is pivotable relative to the proximal mounting member and the first linkage body is rotatable about the axis. The distal end of the first linkage is coupled to the distal mounting member such that the distal end of the first linkage is pivotable relative to the distal mounting member and the first linkage body is rotatable about the axis. The linkage assembly further includes a second linkage member, which includes a proximal end of a second link, a distal end of a second link, and a second link body extending between the proximal end and the distal end of the second link. The proximal end of the second link is coupled to the proximal mounting member such that the proximal end of the second link is pivotable relative to the proximal mounting member, and the second link body is rotatable about the axis. The distal end of the second link is coupled to the distal mounting member such that the distal end of the second link is pivotable relative to the distal mounting member, and the second link body is rotatable about the axis.

[0394] Example 2—The surgical instrument according to Example 1, wherein the connecting assembly further includes a third link member, the third link member including a proximal end of the third link, a distal end of the third link, and a third link body. The proximal end of the third link is coupled to the proximal mounting member, such that the proximal end of the third link is pivotable relative to the proximal mounting member, and the third link body is rotatable about the axis. The distal end of the third link is coupled to the distal mounting member, such that the distal end of the third link is pivotable relative to the distal mounting member, and the third link body is rotatable about the axis.

[0395] Example 3—The surgical instrument according to Example 1 or 2 further includes a flexible shaft guide that spans between the proximal mounting member and the distal mounting member, thereby operatively supporting at least a portion of at least one drive shaft passing through it.

[0396] Example 4—A surgical instrument according to Example 1, 2 or 3, wherein the connecting assembly is configured to maintain the axial distance between the proximal mounting member and the distal mounting member during articulation of the surgical end effector relative to the shaft assembly.

[0397] Example 5—A surgical instrument according to Examples 1, 2, 3, or 4, wherein the proximal end of the first link is attached to the proximal mounting member at a first proximal attachment position via a first proximal connector assembly, the first proximal connector assembly being configured to facilitate pivoting of the proximal end of the first link relative to the proximal mounting member about two mutually transverse first proximal connector axes. The distal end of the first link is attached to the distal mounting member at a first distal attachment position on the distal mounting member via a first distal connector assembly, the first distal connector assembly being configured to facilitate pivoting of the distal end of the first link relative to the distal mounting member about two mutually transverse first distal connector axes. The proximal end of the second link is attached to the proximal mounting member at a second proximal attachment position via a second proximal connector assembly, the second proximal connector assembly being configured to facilitate pivoting of the proximal end of the second link relative to the proximal mounting member about two mutually transverse second proximal connector axes. The distal end of the second link is attached to the distal mounting member via a second distal joint assembly at a second distal attachment position on the distal mounting member. The second distal joint assembly is configured to facilitate pivoting of the distal end of the second link relative to the distal mounting member about two second distal joint axes that are transverse to each other.

[0398] Example 6—A surgical instrument according to Examples 2, 3, or 5, wherein the proximal end of the third link is attached to the proximal mounting member at a third proximal attachment position via a third proximal connector assembly, the third proximal connector assembly being configured to facilitate pivoting of the proximal end of the third link relative to the proximal mounting member about two mutually transverse third proximal connector axes. The distal end of the third link is attached to the distal mounting member at a third distal attachment position on the distal mounting member via a third distal connector assembly, the third distal connector assembly being configured to facilitate pivoting of the distal end of the third link relative to the distal mounting member about two mutually transverse third distal connector axes.

[0399] Example 7—A surgical instrument according to Example 6, wherein the proximal end of a first link is attached to the proximal mounting member at a first proximal attachment position via a first proximal connector assembly, the first proximal connector assembly being configured to facilitate pivoting of the proximal end of the first link relative to the proximal mounting member about two mutually transverse first proximal connector axes. The distal end of the first link is attached to the distal mounting member at a first distal attachment position on the distal mounting member via a first distal connector assembly, the first distal connector assembly being configured to facilitate pivoting of the distal end of the first link relative to the distal mounting member about two mutually transverse first distal connector axes. The proximal end of a second link is attached to the proximal mounting member at a second proximal attachment position via a second proximal connector assembly, the second proximal connector assembly being configured to facilitate pivoting of the proximal end of the second link relative to the proximal mounting member about two mutually transverse second proximal connector axes. The distal end of the second link is attached to the distal mounting member via a second distal joint assembly at a second distal attachment position on the distal mounting member. The second distal joint assembly is configured to facilitate pivoting of the distal end of the second link relative to the distal mounting member about two second distal joint axes that are transverse to each other.

[0400] Example 8—A surgical instrument according to Examples 2, 3, 6 or 7, wherein, when the distal mounting member is axially aligned with the proximal mounting member on the axis, the first distal attachment position on the distal mounting member is diametrically opposite to the first proximal attachment position on the proximal mounting member, the second distal attachment position on the distal mounting member is diametrically opposite to the second proximal attachment position on the proximal mounting member, and the third distal attachment position on the distal mounting member is diametrically opposite to the third proximal attachment position on the proximal mounting member.

[0401] Example 9—A surgical instrument according to Example 3, wherein the first link body includes at least one first link bending surface configured to accommodate passage of the flexible shaft guide between the proximal mounting member and the distal mounting member. The second link body includes at least one second link bending surface configured to accommodate passage of the flexible shaft guide between the proximal mounting member and the distal mounting member. The third link body includes at least one third link bending surface configured to accommodate passage of the flexible shaft guide between the proximal mounting member and the distal mounting member.

[0402] Example 10—A surgical instrument according to Example 3 or 9, wherein the flexible shaft guide is rotatably movable relative to at least one of the proximal mounting member and the distal mounting member.

[0403] Example 11—A surgical instrument according to Examples 3, 9, or 10, wherein the flexible shaft guide includes a shaft guide body sized to extend between the proximal mounting member and the distal mounting member. The shaft guide body includes a proximal end portion configured to be retained in and rotated within a proximal shaft bore in the proximal mounting member. The shaft guide body further includes a proximal flexible rib positioned adjacent to the proximal end portion of the shaft guide. The shaft guide body also includes a distal end portion configured to be retained in and rotated within a distal shaft bore in the distal mounting member. The distal flexible rib is positioned adjacent to the distal end portion of the shaft guide.

[0404] Example 12—A surgical instrument according to Example 11, wherein the flexible shaft guide further includes a first channel extending from a proximal end of the shaft guide through the shaft guide body to a distal end of the shaft guide, and configured to operatively support a portion of a first drive shaft passing therethrough. The first channel opens on a first side of a reference plane extending through the shaft axis. The first channel opens on the first side of the reference plane extending through the distal end of the shaft guide, and a first central portion of the first channel passes through the reference plane at at least two first locations. The flexible shaft guide further includes a second channel extending from the proximal end of the shaft guide through the shaft guide body to a distal end of the shaft guide, and configured to operatively support a portion of a second drive shaft passing therethrough. The second channel opens on a second side of the reference plane extending through the proximal end of the shaft guide. The second channel opens on the second side of the reference plane extending through the distal end of the shaft guide, and a second central portion of the second channel passes through the reference plane at at least two second locations.

[0405] Example 13—A surgical instrument according to Example 7, wherein the first proximal connector assembly includes a first proximal attachment link pivotally connected to a proximal end of a first link to facilitate pivoting of the proximal end of the first link relative to the first proximal attachment link about one of the first proximal connector axes. The first proximal attachment link is pivotally connected to the proximal mounting member to facilitate pivoting of the proximal end of the first link relative to the proximal mounting member about another of the first proximal connector axes. The second proximal connector assembly includes a second proximal attachment link pivotally connected to a proximal end of a second link to facilitate pivoting of the proximal end of the second link relative to the second proximal attachment link about one of the second proximal connector axes. The second proximal attachment link is pivotally connected to the proximal mounting member to facilitate pivoting of the proximal end of the second link relative to the proximal mounting member about another of the second proximal connector axes. The third proximal connector assembly includes a third proximal attachment link pivotally connected to the proximal end of the third link to facilitate pivoting of the proximal end of the third link relative to the third proximal attachment link about one of the third proximal connector axes. The third proximal attachment link is pivotally connected to the proximal mounting member to facilitate pivoting relative to the proximal mounting member about the other of the third proximal connector axes.

[0406] Example 14—A surgical instrument according to Example 7 or 13, wherein the first distal connector assembly includes a first distal attachment link pivotally connected to a distal end of a first link to facilitate pivoting of the distal end of the first link relative to the first distal attachment link about one of the first distal connector axes. The first distal attachment link is pivotally connected to the distal mounting member to facilitate pivoting of the distal end of the first link relative to the distal mounting member about another of the first distal connector axes. The second distal connector assembly includes a second distal attachment link pivotally connected to a distal end of a second link to facilitate pivoting of the distal end of the second link relative to the second distal attachment link about one of the second distal connector axes. The second distal attachment link is pivotally connected to the distal mounting member to facilitate pivoting of the distal end of the second link relative to the distal mounting member about another of the second distal connector axes. The third distal connector assembly includes a third distal attachment link pivotally connected to the distal end of the third link to facilitate pivoting of the distal end of the third link relative to the third distal attachment link about one of the third distal connector axes. The third distal attachment link is pivotally connected to the distal mounting member to facilitate pivoting relative to the distal mounting member about the other of the third distal connector axes.

[0407] Example 15—A surgical instrument according to Examples 7, 13, or 14, wherein the first link member, the first proximal connector assembly, and the first distal connector assembly are formed into a single first link assembly by a 3D printing process. The second link member, the second proximal connector assembly, and the second distal connector assembly are formed into a single second link assembly by the same 3D printing process. The third link member, the third proximal connector assembly, and the third distal connector assembly are formed into a single third link assembly by the same 3D printing process.

[0408] Example 16—A surgical instrument according to Examples 7, 13, 14, or 15, wherein the first proximal connector assembly intersects with the proximal mounting member to facilitate axial movement of the first proximal connector assembly relative to the proximal mounting member. The second proximal connector assembly intersects with the proximal mounting member to facilitate axial movement of the second proximal connector assembly relative to the proximal mounting member. The third proximal connector assembly intersects with the proximal mounting member to facilitate axial movement of the third proximal connector assembly relative to the proximal mounting member.

[0409] Example 17—A surgical instrument according to Examples 7, 13, 14, 15, or 16, wherein the first distal connector assembly intersects with the distal mounting member to facilitate axial movement of the first distal connector assembly relative to the distal mounting member. The second distal connector assembly intersects with the distal mounting member to facilitate axial movement of the second distal connector assembly relative to the distal mounting member. The third distal connector assembly intersects with the distal mounting member to facilitate axial movement of the third distal connector assembly relative to the distal mounting member.

[0410] Example 18 - A surgical instrument according to Examples 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16 or 17, wherein the first link member includes a first circular cross-sectional shape. The second link member includes a second circular cross-sectional shape. The third link member includes a third circular cross-sectional shape.

[0411] Example 19 - A surgical instrument according to Examples 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17 or 18, wherein the first link body is partially twisted about the axis. The second link body is partially twisted about the axis. The third link body is partially twisted about the axis.

[0412] Example 20—An articulation joint assembly for facilitating multi-axis articulation of a surgical end effector relative to a shaft assembly of a surgical instrument. The articulation joint assembly includes a proximal mounting member and a distal mounting member, the proximal mounting member being configured to engage with the shaft assembly, and the distal mounting member being configured to engage with the surgical end effector. The articulation joint assembly further includes a connecting assembly comprising a first link member having a proximal end of a first link operably engaged with the proximal mounting member such that the proximal end of the first link is axially movable relative to the proximal mounting member and pivotable about two first proximal joint axes laterally adjacent to each other. The first link member also includes a distal end of a first link operably engaged with the distal mounting member such that the distal end of the first link is axially movable relative to the distal mounting member and pivotable about two first distal joint axes laterally adjacent to each other. The connecting assembly further includes a second link member, the second link member including a proximal end of a second link, the proximal end of the second link being operably engaged with the proximal mounting member such that the proximal end of the second link is axially movable relative to the proximal mounting member and pivotable about two mutually transverse second proximal joint axes. The second link member also includes a distal end of a second link, the distal end of the second link being operably engaged with the distal mounting member such that the distal end of the second link is axially movable relative to the distal mounting member and pivotable about two mutually transverse second distal joint axes. The connecting assembly includes a third link member, the third link member including a proximal end of a third link, the proximal end of the third link being operably engaged with the proximal mounting member such that the proximal end of the third link is axially movable relative to the proximal mounting member and pivotable about two mutually transverse third proximal joint axes. The third link component also includes a distal end of a third link, which is operably engaged with the distal mounting component such that the distal end of the third link is axially movable relative to the distal mounting component and pivotable about two third distal joint axes that are transverse to each other.

[0413] Example 21—According to the articulation joint assembly of Example 20, the articulation joint assembly further includes a flexible shaft guide that spans between the proximal mounting member and the distal mounting member to flexibly support two drive shafts extending between the proximal mounting member and the distal mounting member.

[0414] Many of the surgical instrument systems described herein are actuated by electric motors; however, they can be actuated in any suitable manner. In various instances, for example, the surgical instrument systems described herein may be actuated by manually operated triggers. In some instances, the motors disclosed herein may comprise one or more parts of a robot control system. Furthermore, any end effector and / or tooling assembly disclosed herein may be used with a robotic surgical instrument system. For example, U.S. Patent Application Serial No. 13 / 118,241 (now U.S. Patent No. 9,072,535), entitled “SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENTARRANGEMENTS,” discloses several examples of robotic surgical instrument systems in more detail.

[0415] The surgical instrument system described herein has been described in conjunction with the deployment and variations of the staples; however, the embodiments described herein are not limited thereto. For example, various embodiments are contemplated for deploying fasteners other than staples, such as clamps or pins. Furthermore, various embodiments utilizing any suitable means for sealing tissue are contemplated. For example, the end effector according to various embodiments may include electrodes configured to heat and seal tissue. Additionally, for example, the end effector according to some embodiments may apply vibrational energy to seal tissue.

[0416] The following patent disclosures are incorporated herein by reference in their entirety:

[0417] - U.S. Patent No. 5,403,312, entitled "ELECTROSURGICAL HEMOSTATIC DEVICE", published on April 4, 1995;

[0418] - U.S. Patent No. 7,000,818, published on February 21, 2006, entitled "SURGICAL STAPLING INSTRUMENT HAVINGSEPARATE DISTINCT CLOSING AND FIRING SYSTEMS";

[0419] - U.S. Patent No. 7,422,139, published on September 9, 2008, entitled "MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING INSTRUMENT WITH TACTILE POSITION FEEDBACK";

[0420] - U.S. Patent No. 7,464,849, published on December 16, 2008, entitled "ELECTRO-MECHANICAL SURGICAL INSTRUMENT WITH CLOSURE SYSTEM AND ANVIL ALIGNMENT COMPONENTS";

[0421] - U.S. Patent No. 7,670,334, published on March 2, 2010, entitled "SURGICAL INSTRUMENT HAVING ANARTICULATING END EFFECTOR";

[0422] - U.S. Patent No. 7,753,245, entitled “SURGICAL STAPLING INSTRUMENTS”, published on July 13, 2010;

[0423] - U.S. Patent No. 8,393,514, published on March 12, 2013, entitled "SELECTIVELY ORIENTABLE IMPLANTABLE FASTENER CARTRIDGE";

[0424] - U.S. Patent Application Serial No. 11 / 343,803 entitled “SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES”, now U.S. Patent No. 7,845,537;

[0425] - U.S. Patent Application Serial No. 12 / 031,573, filed on February 14, 2008, entitled “SURGICAL CUTTING AND FASTENING INSTRUMENT HAVING RF ELECTRODES”;

[0426] - U.S. Patent Application Serial No. 12 / 031,873, entitled “END EFFECTORS FOR A SURGICAL CUTTING AND STAPLING INSTRUMENT”, filed on February 15, 2008, is now U.S. Patent No. 7,980,443;

[0427] - U.S. Patent Application Serial No. 12 / 235,782 entitled “MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT”, now U.S. Patent No. 8,210,411;

[0428] - U.S. Patent Application Serial No. 12 / 249,117 entitled “POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY RETRACTABLE FIRING SYSTEM”, now U.S. Patent No. 8,608,045;

[0429] - U.S. Patent Application Serial No. 12 / 647,100, filed on December 24, 2009, entitled “MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT WITH ELECTRIC ACTUATOR DIRECTIONAL CONTROL ASSEMBLY”, now U.S. Patent No. 8,220,688;

[0430] - U.S. Patent Application Serial No. 12 / 893,461, entitled “STAPLE CARTRIDGE”, filed on September 29, 2012, is now U.S. Patent No. 8,733,613;

[0431] - U.S. Patent Application Serial No. 13 / 036,647, entitled “SURGICAL STAPLING INSTRUMENT”, filed on February 28, 2011, is now U.S. Patent No. 8,561,870;

[0432] - U.S. Patent Application Serial No. 13 / 118,241 entitled “SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLEDEPLOYMENT ARRANGEMENTS”, now U.S. Patent No. 9,072,535;

[0433] - U.S. Patent Application Serial No. 13 / 524,049, entitled “ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE”, filed on June 15, 2012, is now U.S. Patent No. 9,101,358;

[0434] - U.S. Patent Application Serial No. 13 / 800,025, entitled “STAPLE CARTRIDGE TISSUE THICKNESS SENSORSYSTEM”, filed on March 13, 2013, is now U.S. Patent No. 9,345,481;

[0435] - U.S. Patent Application Serial No. 13 / 800,067, entitled “STAPLE CARTRIDGE TISSUE THICKNESS SENSORSYSTEM”, filed on March 13, 2013, is now published as U.S. Patent Application No. 2014 / 0263552.

[0436] - U.S. Patent Application Publication No. 2007 / 0175955, filed January 31, 2006, entitled "SURGICAL CUTTING AND FASTENING INSTRUMENT WITH CLOSURE TRIGGER LOCKING MECHANISM"; and

[0437] - U.S. Patent Application No. 2010 / 0264194, entitled "SURGICAL STAPLING INSTRUMENT WITH ANARTICULATABLE END EFFECTOR", filed on April 22, 2010, is now U.S. Patent No. 8,308,040.

[0438] While various apparatuses have been described herein in conjunction with certain embodiments, numerous modifications and variations of these embodiments are also possible. In one or more embodiments, specific features, structures, or characteristics can be combined in any suitable manner. Therefore, without limitation, specific features, structures, or characteristics shown or described in conjunction with one embodiment may be combined wholly or partially with features, structures, or characteristics of one or more other embodiments. Additionally, where materials for certain components are disclosed, other materials may also be used. Furthermore, according to various embodiments, a single component may be replaced by multiple components, and multiple components may be replaced by a single component to perform a given one or more functions. The above detailed description and the following claims are intended to cover all such modifications and variations.

[0439] The device disclosed herein may be designed for single-use disposal or for multiple-use applications. However, in either case, the device can be refurbished and reused after at least one use. Refurbishment may include any combination of the following steps, including but not limited to disassembling the device, subsequently cleaning or replacing specific components of the device, and subsequently reassembling the device. Specifically, refurbishment facilities and / or surgical teams may disassemble the device and, after cleaning and / or replacing specific parts of the device, reassemble the device for subsequent use. Those skilled in the art will understand that various techniques can be used to refurbish the device for disassembly, cleaning / replacement, and reassembly. The use of such techniques and the resulting repaired device are within the scope of this application.

[0440] The device disclosed herein can be processed prior to surgery. First, new or used instruments are obtained and cleaned as needed. Then, the instruments can be sterilized. In one sterilization technique, the instrument is placed in a closed and sealed container (such as a plastic or TYVEK bag). The container and instrument can then be placed in a radiation field that can penetrate the container, such as gamma radiation, X-rays, and / or high-energy electrons. The radiation kills bacteria on the instrument and in the container. The sterilized instrument can then be stored in a sterile container. Sealing the container keeps the instrument sterile until it is opened in a medical facility. The device can also be sterilized using any other techniques known in the art, including but not limited to beta radiation, gamma radiation, ethylene oxide, plasma peroxide, and / or vapor.

[0441] Although the invention has been described as having an exemplary design, further modifications can be made to the invention within the spirit and scope of this disclosure. Therefore, this application is intended to cover any variations, uses, or alterations of the invention using the general principles of the invention.

[0442] Any patent, publication, or other disclosure incorporated herein by reference, in whole or in part, is incorporated only to the extent that the incorporated material does not conflict with any prior art definitions, statements, or other disclosures set forth herein. Therefore, and to the extent necessary, the disclosures expressly listed herein replace any conflicting material incorporated herein by reference. Any material, or portions thereof, allegedly incorporated herein by reference but conflicting with any prior art definitions, statements, or other disclosures listed herein, will be incorporated only to the extent that the incorporated material does not conflict with any existing disclosures.

Claims

1. A universal movable drive shaft for surgical instruments, wherein, The universal movable drive shaft includes: A first movable connector, comprising: A first connector spine, the first connector spine defining a first axis and a second axis transverse to the first axis; A first U-shaped bridge, movably and non-removably hinged to the first connector spine for pivoting about the first axis relative to the first connector spine; and A second U-shaped bridge, movably and non-removably journal-connected to the first connector spine for pivoting about a second axis relative to the first connector spine, wherein the second U-shaped bridge further includes a third U-shaped bridge of a second movable connector, wherein the second movable connector includes: A second connector spine, defining a third axis and a fourth axis transverse to the third axis, wherein the third U-shaped bridge is movably and non-removably journal-connected to the second connector spine for pivoting relative to the second connector spine about the fourth axis; and A fourth U-shaped bridge is movably and non-removably journal-connected to the second connector spine to pivot about the third axis relative to the second connector spine.

2. The universal movable drive shaft according to claim 1, wherein, The fourth U-shaped bridge further includes a fifth U-shaped bridge with a third movable joint, wherein the third movable joint includes: A third connector spine, defining a fifth axis and a sixth axis transverse to the fifth axis, wherein the fifth U-shaped bridge is movably and non-removably journal-connected to the third connector spine for pivoting relative to the third connector spine about the sixth axis; and A sixth U-shaped bridge is movably and non-removably journal-connected to the third joint spine to pivot about the fifth axis relative to the third joint spine.

3. The universal movable drive shaft according to claim 1, wherein, The first U-shaped bridge includes: A first connector cap-like member, rotatably supported on a first conical portion of the spine of the first connector for rotatable travel about the first axis around the first conical portion, wherein the first connector cap-like member is spaced apart from the first conical portion by a first connector space; and A second connector cap-like member, rotatably supported on a second conical portion of the first connector spine for rotatable travel about the first axis around the second conical portion, wherein the second connector cap-like member is spaced apart from the second conical portion by a second connector space, and wherein the second U-shaped bridge includes: A first connector ring, the first connector ring journal being connected to a portion of the first connector spine for rotation about a second axis about the portion of the first connector spine, wherein the first connector ring is held on the first connector spine by an end of a first flared opening of the first connector spine, and wherein the first connector ring is spaced apart from said portion of the first connector spine by a third connector space; and A second connector ring, the second connector ring journal being connected to another portion of the first connector spine to rotate about the second axis around the other portion of the first connector spine, wherein the second connector ring is spaced apart from the other portion of the first connector spine by a fourth connector space.

4. The universal movable drive shaft according to any one of claims 1-3, wherein, The universal movable drive shaft is made of a building material that is transformed from a first state to a second state through a manufacturing process.

5. The universal movable drive shaft according to claim 4, wherein, The manufacturing process includes 3D printing.

6. The universal movable drive shaft according to claim 4 or 5 when claim 3 is referenced, wherein, The first joint space is configured to accommodate a first amount of the building material in the first state during the formation of the first universal movable drive shaft and to exit from the first joint space after the formation, wherein the second joint space is configured to accommodate a second amount of the building material in the first state during the formation and to exit from the second joint space after the formation, wherein the third joint space is configured to accommodate a third amount of the building material in the first state during the formation and to exit from the third joint space after the formation, wherein the fourth joint space is configured to accommodate a fourth amount of the building material in the first state during the formation and to exit from the fourth joint space after the formation.

7. A joint motion joint assembly for facilitating multi-axis articulated movement of a surgical end effector relative to a axial assembly of a surgical instrument, wherein, The shaft assembly defines a shaft axis, and wherein the joint motion joint assembly includes: A proximal mounting member, the proximal mounting member being configured to engage with the shaft assembly; A distal mounting member, configured to intersect with the surgical end effector; and A plurality of articulated linkage assemblies are attached to and extend between the proximal and distal mounting members, wherein each articulated linkage assembly includes: A pair of universal joints, wherein each of the universal joints includes: A connector spine, the connector spine defining a first axis and a second axis transverse to the first axis, wherein both the first axis and the second axis are transverse to the axis; A first bridge is movably and non-removably journal-connected to the connector spine to pivot about the first axis relative to the connector spine. A second bridge, movably and non-removably journal-connected to the connector spine for pivoting about the second axis relative to the connector spine; and An attachment member protruding from the second bridge, wherein the attachment member is configured to movably attach the universal joint to one of the proximal mounting member and the distal mounting member, and wherein the articulated linkage assembly further includes an elongated link that protrudes from the first bridge at one of the universal joints of the pair of universal joints and extends between the first bridge at the other universal joint of the pair of universal joints.

8. The joint motion joint assembly according to claim 7, wherein, The elongated link defines a link axis, wherein the link axis is curved about the axis and is not parallel to the axis.

9. The joint motion joint assembly according to claim 7, wherein, The attachment member of one of the universal joints is configured to movably attach the one universal joint to the proximal mounting member, such that the one universal joint is axially movable relative to the proximal mounting member, and wherein the attachment member of the other universal joint is configured to movably attach the other universal joint to the distal mounting member, such that the other universal joint is axially movable relative to the distal mounting member.

10. The joint motion joint assembly according to any one of claims 7-9, wherein, Each of the attachment members defines an attachment member axis parallel to the axis.

11. The joint motion joint assembly according to any one of claims 7-9, wherein, The second bridge includes: A first connector cap, rotatably supported on a first conical portion of the connector spine to rotatably travel about the first axis around the first conical portion, wherein the first connector cap is spaced apart from the first conical portion by a first connector space; A second connector cap-like member, rotatably supported on a second conical portion of the connector spine for rotatable travel about the first axis around the second conical portion, wherein the second connector cap-like member is spaced apart from the second conical portion by a second connector space, and wherein the first bridge includes: A first connector ring, the first connector ring journal being connected to a first axial portion of the connector spine for rotation about a second axis around the first axial portion, wherein the first connector ring is spaced apart from the first axial portion of the connector spine by a third connector space; and A second connector ring, the second connector ring journal being connected to a second axial portion of the connector spine for rotation about a second axis, wherein the second connector ring is spaced apart from the second axial portion of the connector spine by a fourth connector space.

12. The joint motion joint assembly according to claim 11, wherein, Each of the joint motion link assemblies is made of a building material that is transformed from a first state to a second state through a manufacturing process.

13. The joint motion joint assembly according to claim 12, wherein, The manufacturing process includes 3D printing.

14. The joint motion joint assembly according to claim 12, wherein, The first joint space is configured to accommodate a first amount of the building material in the first state during the formation of the articulated linkage assembly and to exit from the first joint space after the formation. The second joint space is configured to accommodate a second amount of the building material in the first state during the formation and to exit from the second joint space after the formation. The third joint space is configured to accommodate a third amount of the building material in the first state during the formation and to exit from the third joint space after the formation. The fourth joint space is configured to accommodate a fourth amount of the building material in the first state during the formation and to exit from the fourth joint space after the formation.

15. A method, the method comprising: Provides building materials that can be transformed from a first powder state to a second solid state; The first amount of the building material is transformed from the first powder state to the second solid state to form a first cruciform joint spine, wherein the first cruciform joint spine defines a first vertical axis and a first horizontal axis transverse to the first vertical axis; The second amount of the building material is transformed from the first powder state to the second solid state to form a first vertical head member, the first vertical head member being configured to pivot non-removably on the first cross-shaped joint spine about the first vertical axis; A third amount of the building material is transformed from the first powder state to the second solid state to form a first horizontal joint member, the first horizontal joint member being configured to pivot non-removably about the first horizontal axis on the first cruciform joint spine; and All amounts of the building material remaining in the first powder state are discharged from between the first cruciform joint spine, the vertical head member, and the horizontal joint member.

16. The method according to claim 15, wherein, The step of transforming a first amount of the building material from the first powder state to the second solid state further includes forming a second cruciform joint spine, wherein the second cruciform joint spine defines a second vertical axis and a second horizontal axis transverse to the second vertical axis, wherein the step of transforming a second amount of the building material from the first powder state to the second solid state to form a first vertical head member further includes forming a second vertical head member configured to be nonremovably pivotable about the second vertical axis on the second cruciform joint spine, and wherein the step of transforming a third amount of the building material from the first powder state to the second solid state to form a first horizontal joint member further includes forming a second horizontal joint member protruding from the first vertical head member and configured to be nonremovably pivotable about the second horizontal axis on the second cruciform joint spine.

17. The method according to claim 16, wherein, The step of transforming a first amount of the building material from the first powder state to the second solid state further includes forming a third cruciform joint spine, wherein the third cruciform joint spine defines a third vertical axis and a third horizontal axis transverse to the third vertical axis; wherein the step of transforming a second amount of the building material from the first powder state to the second solid state to form a first vertical head member further includes forming a third vertical head member, the third vertical head member being configured to be nonremovably pivotable about the third vertical axis on the third cruciform joint spine; and wherein the step of transforming a third amount of the building material from the first powder state to the second solid state to form a first horizontal joint member further includes forming a third horizontal joint member, the third horizontal joint member protruding from the second vertical head member and being configured to be nonremovably pivotable about the third horizontal axis on the third cruciform joint spine.

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