Cooperative features between the underside of the driver and the underside of the cartridge platform

Abstract

The present disclosure provides surgical devices having at least one rotary input screw in an end effector. The rotary input screw can extend through a central longitudinal portion of the end effector. The end effector can include, for example, improved closure systems, firing systems, leverage and alignment features between a staple cartridge and the surgical device, staple cartridges with multi-staple drivers, single firing knives and lockout / safety features for same, and / or modified staple patterns. Certain components can be 3D printed components.

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: 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.

[0003] 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.

[0004] 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.

[0005] 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.

[0006] 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.

[0007] 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.

[0008] Figure 7 It is based on at least one aspect of this disclosure. Figure 6 Section lines 7,8-7,8 are used to cut the section. 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.

[0009] Figure 8 It is based on at least one aspect of this disclosure. Figure 6 Section lines 7,8-7,8 are used to cut the section. 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.

[0010] 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.

[0011] Figure 10 It is based on at least one aspect of this disclosure Figure 9 Exploded perspective view of the surgical suture assembly.

[0012] 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.

[0013] 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.

[0014] Figure 13 It is based on at least one aspect of this disclosure Figure 12 Exploded perspective view of the surgical suture assembly.

[0015] 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.

[0016] 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.

[0017] Figure 16 It is based on at least one aspect of this disclosure Figure 15 Exploded perspective view of the surgical suture assembly.

[0018] 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.

[0019] 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.

[0020] Figure 19 It is based on at least one aspect of this disclosure Figure 18 Exploded perspective view of the surgical suture assembly.

[0021] 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.

[0022] Figure 21 This is a perspective view of a robot controller according to at least one aspect of this disclosure.

[0023] 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.

[0024] 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.

[0025] Figure 24 This is a perspective view of the pinning pods based on various aspects of this disclosure.

[0026] Figure 25 Based on various aspects of this disclosure Figure 24 A perspective view of a portion of the stud magazine, showing the triple actuator in the stud magazine in firing configuration.

[0027] Figure 26 Based on various aspects of this disclosure Figure 25 A perspective view of the triple drive.

[0028] Figure 27 Based on various aspects of this disclosure Figure 26 A plan view of the triple drive.

[0029] Figure 28 Based on various aspects of this disclosure Figure 26 Bottom perspective view of the triple drive.

[0030] Figure 29 This is a front sectional view of a portion of an end effector according to various aspects of this disclosure, depicting the staple cartridge therein, wherein a portion of the staple cartridge is hidden for illustrative purposes.

[0031] Figure 30 Based on various aspects of this disclosure Figure 29 Detailed view of the end effector.

[0032] Figure 31 This is a front sectional view of a portion of an end actuator, including a staple cartridge, according to various aspects of this disclosure.

[0033] Figure 32 The diagram shows a triple actuator according to various aspects of this disclosure, with the modified geometry depicted in dashed lines and the relative positioning of the rotary drive screw shown in dashed lines.

[0034] Figure 33 This is a bottom perspective view of the container body according to various aspects of this disclosure, in which parts are hidden for illustrative purposes.

[0035] Figure 34 Based on various aspects of this disclosure Figure 33 A detailed view of a portion of the chamber, depicting the chamfer that defines the inner nail cavity into the chamber.

[0036] Figure 35 Based on various aspects of this disclosure Figure 33 A front sectional view of the inner support column and a portion of the chamber of the actuator, depicting the inner support column in a non-firing configuration relative to the inner nail cavity.

[0037] Figure 36 This is a perspective view of a portion of the support column of the drive according to various aspects of this disclosure.

[0038] Figure 37 Based on various aspects of this disclosure Figure 36 A front view of a portion of a support column, depicting a part of a nail supported on the support column.

[0039] Figure 38 This is a front view of the pinning device according to various aspects of this disclosure.

[0040] Figure 39 Based on various aspects of this disclosure Figure 38 The plane shown is cut off Figure 38 A front sectional view of the staple cartridge.

[0041] Figure 40 Based on various aspects of this disclosure Figure 38 The plane shown is cut off Figure 38 A perspective sectional view of a portion of the stud magazine, depicting the actuator in the fully fired position.

[0042] Figure 41 Based on various aspects of this disclosure Figure 40 A perspective view of the drive.

[0043] Figure 42 This is a perspective view of the various aspects of the driver according to this disclosure.

[0044] Figure 43 It is a perspective sectional view of a portion of the anvil according to various aspects of this disclosure.

[0045] Figure 44 It is a schematic diagram depicting the deformation process of a 4D printed matrix of a staple cartridge according to various aspects of this disclosure.

[0046] Figure 45 The present disclosure includes perspective views of staple cartridges and channels, depicting alignment and lever features for mounting staple cartridges into channels, and also depicting staple cartridges in an aligned and partially mounted configuration relative to the channels.

[0047] Figure 46 Based on various aspects of this disclosure Figure 45 The front view of the proximal portion and channel of the staple cartridge depicts the staple cartridge in an aligned and partially installed configuration.

[0048] Figure 47 Based on various aspects of this disclosure Figure 45 A perspective view of the distal portion of the staple cartridge and the channel, depicting the staple cartridge in an aligned and partially installed configuration.

[0049] Figure 48 Based on various aspects of this disclosure Figure 45 A perspective view of the distal portion of the staple cartridge and the channel, depicting the staple cartridge installed and fully positioned in the channel, and also depicting the anvil in a clamping configuration relative to the staple cartridge.

[0050] Figure 49 Based on various aspects of this disclosure Figure 48 A perspective view of the distal portion of the staple cartridge, the channel, and the anvil, depicting the staple cartridge installed and fully positioned in the channel, and also depicting the latch on the underside of the staple cartridge in the latched position relative to the channel.

[0051] Figure 50 The present disclosure is a perspective view of the distal portion of the staple cartridge, the channel, and the anvil, depicting a staple cartridge mounted in the channel and an anvil in a clamping configuration relative to the staple cartridge, and also depicting a flexible latch on the underside of the staple cartridge in a latching position relative to the channel.

[0052] Figure 51 The present disclosure includes perspective views of channels and staple cartridges, depicting alignment and lever features for mounting the staple cartridge into the channel, and also depicting a staple cartridge in an aligned and partially mounted configuration relative to the channel.

[0053] Figure 52This is a perspective view of a portion of the staple cartridge and the channel according to various aspects of this disclosure, depicting a lateral latching arm of the staple cartridge engaging with a lateral channel in the sidewall of the channel.

[0054] Figure 53 Based on various aspects of this disclosure Figure 52 A partial planar sectional view of the staple cartridge and the channel, depicting the lateral latch arm of the staple cartridge engaging with the lateral channel in the sidewall of the channel.

[0055] Figure 54 This is a perspective view of the staple cartridge and rotary drive screw according to various aspects of this disclosure.

[0056] Figure 55 Based on various aspects of this disclosure Figure 54 A perspective view of the distal portion of the pellet cartridge and the rotating drive screw, depicting the cartridge body and the actuator, wherein the actuator is in its non-firing position within the cartridge body.

[0057] Figure 56 Based on various aspects of this disclosure Figure 55 A perspective view of the distal portion of the staple cartridge and the rotary drive screw, with the drive screw in its non-firing position, and the hidden internal features are depicted in dashed lines for illustrative purposes.

[0058] Figure 57 Based on various aspects of this disclosure Figure 55 Another perspective view of the distal portion of the pellet magazine and the rotary drive screw, with the drive in its non-firing position and the hidden internal features depicted in dashed lines for illustrative purposes.

[0059] Figure 58 Based on various aspects of this disclosure Figure 54 A perspective view of the distal portion of the stud cartridge, showing the actuator moving within the cartridge to its firing position.

[0060] Figure 59 Based on various aspects of this disclosure Figure 58 A perspective view of the distal portion of the staple cartridge, with the actuator in its firing position, and the hidden internal features are depicted in dashed lines for illustrative purposes.

[0061] Figure 60 This is a perspective view of the proximal portion of a staple cartridge with a row of indentations, according to various aspects of this disclosure.

[0062] Figure 61 Based on various aspects of this disclosure Figure 60 A perspective sectional view of the staple cartridge, depicting the indentation in the cartridge body that engages with the lip on the side wall of the actuator.

[0063] Figure 62This is an exploded perspective view of a portion of the housing according to various aspects of this disclosure and a drive having interference features for engaging the housing.

[0064] Figure 63 This is a perspective breakdown diagram of the nailing silos based on various aspects of this disclosure.

[0065] Figure 64 This is a perspective view of a portion of the warehouse frame and its arm in an unformed configuration, according to various aspects of this disclosure.

[0066] Figure 65 Based on various aspects of this disclosure Figure 64 A perspective view of the frame and arms of the storage unit, depicting the arms in a shaped configuration.

[0067] Figure 66 The front sectional view of the container body and container frame according to various aspects of this disclosure depicts the heat-retaining features between them.

[0068] Figure 67 This is a front sectional view of the chamber body and chamber frame during the hot-melting process according to various aspects of this disclosure.

[0069] Figure 68 It is for use in various aspects of this disclosure Figure 67 A perspective view of the silo frame and insert supports used during the hot-melt process.

[0070] Figure 69 This is a perspective view of a composite chamber comprising a metal disc and a plastic composite material, according to various aspects of this disclosure, with the concealed metal disc depicted in dashed lines for illustrative purposes.

[0071] Figure 70 Based on various aspects of this disclosure Figure 69 The front view of the composite compartment, with the hidden metal disc depicted in dashed lines for illustrative purposes.

[0072] Figure 71 This is a perspective view of a portion of a surgical end effector, including a staple cartridge positioned therein, according to various aspects of this disclosure.

[0073] Figure 72 Based on various aspects of this disclosure Figure 71 A frontal sectional view of the surgical end effector and the staple cartridge.

[0074] Figure 73 This is a perspective view of the tamper-evident tear-open cover according to various aspects of this disclosure.

[0075] Figure 74 This is a perspective view of the main body of the slider assembly according to various aspects of this disclosure.

[0076] Figure 75 It is based on various aspects of this disclosure, including the body and the blade. Figure 74 A perspective anatomical view of the sliding component assembly.

[0077] Figure 76 Based on various aspects of this disclosure Figure 74 A perspective sectional view of the sliding component.

[0078] Figure 77 This is a partial sectional front view of an end effector according to various aspects of this disclosure, wherein portions have been removed for illustrative purposes, depicting... Figure 74 The firing mechanism, chamber, and sliding components.

[0079] Figure 78 This is a perspective view of a slider assembly aligned with a drive row according to various aspects of this disclosure.

[0080] Figure 79 Based on various aspects of this disclosure Figure 78 Exploded perspective view of the sliding component.

[0081] Figure 80 Based on various aspects of this disclosure Figure 78 A perspective sectional view of the sliding component.

[0082] Figure 81 It is based on various aspects of this disclosure and is integrated with the firing system. Figure 78 A perspective view of the sliding component assembly, the firing system including a rotary drive screw and a firing member threadedly connected to the rotary drive screw.

[0083] Figure 82 This is a perspective view of an end actuator including a locking member in a locking configuration, according to various aspects of this disclosure.

[0084] Figure 83 Based on various aspects of this disclosure Figure 82 A perspective view of a portion of the end effector, with parts removed for illustrative purposes, depicting the locking element in a locking configuration.

[0085] Figure 84 Based on various aspects of this disclosure Figure 82 A front sectional view of a portion of the end effector, depicting the locking element in a locking configuration.

[0086] Figure 85 Based on various aspects of this disclosure Figure 82 A perspective view of a portion of an end effector, with portions removed for illustrative purposes, depicting components mounted in the end effector including... Figure 78The pin magazine of the sliding component is also depicted, as well as the locking component in the unlocked configuration.

[0087] Figure 86 Based on various aspects of this disclosure Figure 85 A front view of a portion of the stud cartridge and the slider assembly, depicting the slider assembly in the non-firing position.

[0088] Figure 87 Based on various aspects of this disclosure Figure 85 A plan view of a portion of the lower side of the cartridge and the sliding assembly, with a portion of the firing assembly depicted in dashed lines for illustrative purposes.

[0089] Figure 88 Based on various aspects of this disclosure Figure 85 A front sectional view of the staple cartridge.

[0090] Figure 89 This is a front sectional view of the pinning device according to various aspects of this disclosure.

[0091] Figure 90 The present invention is a perspective view of the firing member and the sliding member assembly according to various aspects of the present disclosure, depicting the firing member in a non-firing configuration.

[0092] Figure 91 Based on various aspects of this disclosure Figure 90 An exploded view of the sliding component assembly.

[0093] Figure 92 Based on various aspects of this disclosure Figure 90 A perspective view of the firing member and sliding assembly relative to the housing, which is shown in dashed lines for illustrative purposes, depicting the firing member in a first propulsion configuration in which the firing member moves to engage with the sliding assembly, which in turn moves to engage with a drive in the housing.

[0094] Figure 93 Based on various aspects of this disclosure Figure 90 A front view of the firing member and sliding component assembly, wherein certain hidden features are shown in dashed lines for illustrative purposes, depicting the firing member in the first propulsion configuration.

[0095] Figure 94 It is based on various aspects of this disclosure along Figure 90 The plane intercepted by the middle indicator Figure 90 A front sectional view of the firing member and sliding component assembly, depicting the firing member in the first propulsion configuration.

[0096] Figure 95 It is based on various aspects of this disclosure along Figure 93The plane intercepted by the middle indicator Figure 90 A front sectional view of the firing member and sliding component assembly, depicting the firing member in the first propulsion configuration.

[0097] Figure 96A Based on various aspects of this disclosure Figure 90 A front view of the firing member and sliding component assembly, wherein certain hidden features are shown in dashed lines for illustrative purposes, depicting the firing member in the first retracted configuration.

[0098] Figure 96B Based on various aspects of this disclosure Figure 90 A front view of the firing member and sliding component assembly, in which certain hidden features are shown in dashed lines for illustrative purposes, depicting the firing member in the second retracted configuration.

[0099] Figure 96C Based on various aspects of this disclosure Figure 90 A front view of the firing member and sliding component assembly, in which certain hidden features are shown in dashed lines for illustrative purposes, depicting the firing member in the third retracted configuration.

[0100] Figure 96D Based on various aspects of this disclosure Figure 90 A front view of the firing member and sliding component assembly, in which certain hidden features are shown in dashed lines for illustrative purposes, depicting the firing member in the fourth retracted configuration.

[0101] Figure 97 Based on various aspects of this disclosure Figure 90 The firing mechanism and sliding component relative to Figure 92 The front view of the warehouse depicts... Figure 96D The firing mechanism is in the fourth retraction configuration, with the chamber shown in dashed lines for illustrative purposes.

[0102] Figure 98 Based on various aspects of this disclosure Figure 90 The firing mechanism and sliding component assembly and Figure 92 The plan of the warehouse depicts... Figure 96D The firing assembly is in the fourth retraction configuration.

[0103] Figure 99 This is a perspective view of a surgical end effector with a firing assembly according to various aspects of this disclosure, the firing assembly including a rotary drive screw and a reusable firing member with an integral double-track slider.

[0104] Figure 100A Based on various aspects of this disclosure Figure 99Exploded perspective view of the reusable firing mechanism and the single-use knife and firing indicator for use with the reusable firing mechanism.

[0105] Figure 100B It is assembled according to various aspects of this disclosure. Figure 99 Reusable firing mechanism Figure 100A A perspective view of the single-use knife and firing indicator, and also depicts the triple drive and pin deployed via an integrated double-track slider of the reusable firing component.

[0106] Figure 101 Based on various aspects of this disclosure Figure 100B A front view of the triple actuator, pin, and reusable firing mechanism.

[0107] Figure 102 Based on various aspects of this disclosure Figure 100B A perspective view of one of the three drives.

[0108] Figure 103 It is inclusive of various aspects of this disclosure. Figure 100B A plan view of a portion of the triple-drive housing, and also depicts... Figure 100A The firing mechanism.

[0109] Figure 104 Based on various aspects of this disclosure Figure 103 A perspective view of the lower part of the hull.

[0110] Figure 105 It is based on various aspects of this disclosure, including Figure 103 A front sectional view of the housing, firing mechanism, and end actuator of the triple drive.

[0111] Figure 106 Based on various aspects of this disclosure Figure 103 A perspective sectional view of the warehouse.

[0112] Figure 107 It is a perspective view of the warehouse body based on various aspects of this disclosure.

[0113] Figure 108 It is based on various aspects of this disclosure, including Figure 99 A perspective view of a portion of the end actuator of the drive assembly, depicting a locking arrangement including a locking nut mounted to the rotary drive screw, wherein the locking nut is in the locked position.

[0114] Figure 109A Based on various aspects of this disclosure Figure 108The front view of the end actuator, with some parts removed and others hidden, and shown in dashed lines, depicts the locking nut in the locked position.

[0115] Figure 109B Based on various aspects of this disclosure Figure 108 The front sectional view of the end actuator, with some parts removed and others hidden, and shown in dashed lines, depicts the locking nut in the unlocked position.

[0116] Figure 110 Based on various aspects of this disclosure Figure 103 A perspective view of a portion of the compartment, also depicting the locking key located near the side of the compartment.

[0117] Figure 111 Based on various aspects of this disclosure Figure 108 A perspective view of a portion of the end effector, in which Figure 110 The housing is mounted in the end effector and the locking key is in the proximal position, wherein the locking key is positioned to engage by moving the locking nut to the end effector. Figure 109B The unlocking position is used to overcome the locking arrangement.

[0118] Figure 112 Based on various aspects of this disclosure Figure 110 A perspective view of a portion of the lower side of the chamber, depicting the locking key in the non-firing position.

[0119] Figure 113 Based on various aspects of this disclosure Figure 108 A perspective partial sectional view of a portion of the end effector, in which Figure 110 The housing is mounted in the end effector and is partially cut out for illustrative purposes to expose the locking key that is advanced to the distal position.

[0120] Figure 114 Based on various aspects of this disclosure Figure 113 A perspective view of the end effector portion and the housing, with the locking key in the distal position.

[0121] Figure 115 Based on various aspects of this disclosure Figure 108 A perspective partial sectional view of a portion of the end effector, in which Figure 110 The housing is mounted in the end effector and is partially cut out for illustrative purposes to expose the locking nut in the locked position.

[0122] Figure 116This is a perspective view of a portion of an end effector according to various aspects of this disclosure, wherein some portions are removed and others are transparent and shown in dashed lines for illustrative purposes, depicting a locking arrangement in a locking configuration.

[0123] Figure 117 Based on various aspects of this disclosure Figure 116 A perspective view of a portion of the end effector, in which some parts are removed for illustrative purposes and others are transparent, depicting a locking arrangement in a locking configuration.

[0124] Figure 118 The pattern of the nail cavity is depicted based on the plan view of the nail chamber according to various aspects of this disclosure.

[0125] Figure 119 It is a schematic diagram depicting the nail cavity pattern of the nail cartridge according to various aspects of this disclosure.

[0126] Figure 120 It is a schematic diagram depicting the nail cavity pattern of the nail cartridge according to various aspects of this disclosure.

[0127] Figure 121 The pattern of the nail cavity is depicted based on the plan view of the nail chamber according to various aspects of this disclosure.

[0128] Figure 122 The plan view of the staple cartridge based on various aspects of this disclosure schematically depicts the organization stop.

[0129] 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

[0130] 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: - U.S. patent application entitled “METHOD OF USING A POWERED STAPLING DEVICE”, Agent’s File No. END9298USNP1 / 200859-1M; - U.S. patent application entitled “SURGICAL STAPLING ASSEMBLY COMPRISING NONPLANAR STAPLES ANDPLANAR STAPLE”, Agent’s File No. END9298USNP2 / 200859-2; - U.S. patent application entitled “SURGICAL STAPLE CARTRIDGE COMPRISING LONGITUDINAL SUPPORTBEAM”, Agent’s File No. END9298USNP3 / 200859-3; - U.S. patent application entitled “STAPLING ASSEMBLY COMPRISING ECCENTRICALLY DRIVEN FIRINGMEMBER”, Agent’s File No. END9298USNP4 / 200859-4; - U.S. patent application entitled “ROTARY-DRIVEN SURGICAL STAPLING ASSEMBLY COMPRISING AFLOATABLE COMPONENT”, Agent’s File No. END9298USNP5 / 200859-5; - U.S. patent application entitled "DRIVERS FOR FASTENER CARTRIDGE ASSEMBLIES HAVING ROTARYDRIVE SCREWS", Agent's File No. END9298USNP6 / 200859-6; - U.S. patent application entitled “LEVERAGING SURFACES FOR CARTRIDGE INSTALLATION”, Agent’s File No. END9298USNP8 / 200859-8; - U.S. patent application entitled "FASTENER CARTRIDGE WITH NON-REPEATING FASTENER ROWS", Agent's File No. END9298USNP9 / 200859-9; - U.S. patent application entitled "HAVING FLEXIBLE PORTIONS FOR ADAPTING TO A LOAD DURING ASURGICAL FIRING STROKE", Agent's File No. END9298USNP10 / 200859-10; - U.S. patent application entitled “STAPLING ASSEMBLY COMPONENTS HAVING METAL SUBSTRATES AND PLASTIC BODIES”, Agent’s File No. END9298USNP11 / 200859-11; - U.S. patent application entitled “MULTI-AXIS PIVOT JOINTS FOR SURGICAL INSTRUMENTS AND METHODSOF MANUFACTURING SAME”, Agent’s File No. END9298USNP12 / 200859-12; - U.S. patent application entitled "ARRANGEMENTS FOR MULTI-PLANAR ALIGNMENT AND SUPPORT OF OPERATIONAL DRIVE SHAFTS IN ARTICULATABLE SURGICAL INSTRUMENTS", Agent's File No. END9298USNP13 / 200859-13; and - U.S. patent application entitled “SURGICAL INSTRUMENT ARTICULATION JOINT ARRANGEMENTSCOMPRISING MULTIPLE MOVING LINKAGE FEATURES”, Agent’s File No. END9298USNP14 / 200859-14.

[0131] 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: - U.S. Patent No. 10,835,330 entitled “METHOD FOR DETERMINING THE POSITION OF A ROTATABLE JAW OF ASURGICAL INSTRUMENT ATTACHMENT ASSEMBLY”; - U.S. Patent No. 10,716,565 entitled “SURGICAL INSTRUMENTS WITH DUAL ARTICULATION DRIVERS”; - 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; - U.S. Patent No. 10,729,509 entitled “SURGICAL INSTRUMENT COMPRISING CLOSURE AND FIRING LOCKING MECHANISM”; - 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 - U.S. design patent D910,847 entitled “SURGICAL INSTRUMENT ASSEMBLY”.

[0132] 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: - 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; - 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; - 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; - 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; - 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; - U.S. Patent No. 10,779,824 entitled “SURGICAL INSTRUMENT COMPRISING AN ARTICULATION SYSTEM LOCKABLE BY A CLOSURE SYSTEM”; - U.S. Patent Application Serial No. 15 / 636,029 entitled “SURGICAL INSTRUMENT COMPRISING A SHAFT INCLUDING A HOUSING ARRANGEMENT”, now published as U.S. Patent Application No. 2019 / 0000477; - 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; - U.S. Patent Application Serial No. 15 / 635,981 entitled “SURGICAL STAPLING INSTRUMENTS COMPRISING SHORTENED STAPLECARTRIDGE NOSES” is now published as U.S. Patent Application No. 2019 / 0000475; - U.S. Patent Application Serial No. 15 / 636,009 entitled “SURGICAL INSTRUMENT COMPRISING A SHAFT INCLUDING A CLOSURETUBE PROFILE” is now published as U.S. Patent Application No. 2019 / 0000476; - U.S. Patent No. 10,765,427 entitled “METHOD FOR ARTICULATING A SURGICAL INSTRUMENT”; - U.S. Patent Application Serial No. 15 / 635,530 entitled “SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTOR WITH AXIALLY SHORTENED ARTICULATION JOINT CONFIGURATIONS”, now published as U.S. Patent Application No. 2019 / 0000457; - U.S. Patent No. 10,588,633 entitled “SURGICAL INSTRUMENTS WITH OPEN AND CLOSABLE JAWS AND AXIALLYMOVABLE FIRING MEMBER THAT IS INITIALLY PARKED IN CLOSE PROXIMITY TO THE JAWSPRIOR TO FIRING”; - U.S. Patent Application Serial No. 15 / 635,559 entitled “SURGICAL INSTRUMENTS WITH JAWS CONSTRAINED TO PIVOT ABOUT ANAXIS UPON CONTACT WITH A CLOSURE MEMBER THAT IS PARKED IN CLOSE PROXIMITY TOTHE PIVOT AXIS” is now published as U.S. Patent Application Publication No. 2019 / 0000459; - U.S. Patent No. 10,786,253 entitled “SURGICAL END EFFECTORS WITH IMPROVED JAW APERTURE ARRANGEMENTS”; - 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 PIVOT AXIS”, now published as U.S. Patent Application No. 2019 / 0000461; - U.S. Patent Application Serial No. 15 / 635,612 entitled “JAW RETAINER ARRANGEMENT FOR RETAINING A PIVOTABLE SURGICALINSTRUMENT JAW IN PIVOTABLE RETAINING ENGAGEMENT WITH A SECOND SURGICALINSTRUMENT JAW”, now published as U.S. Patent Application No. 2019 / 0000462; - U.S. Patent No. 10,758,232 entitled “SURGICAL INSTRUMENT WITH POSITIVE JAW OPENING FEATURES”; - U.S. Patent No. 10,639,037 entitled “SURGICAL INSTRUMENT WITH AXIALLY MOVABLE CLOSURE MEMBER”; - U.S. Patent No. 10,695,057 entitled “SURGICAL INSTRUMENT LOCKOUT ARRANGEMENT”; - U.S. design patent number D851,762 entitled "ANVIL"; - U.S. Design Patent No. D854,151 entitled "SURGICAL INSTRUMENT SHAFT"; and - U.S. design patent number D869,655 entitled “SURGICAL FASTENER CARTRIDGE”.

[0133] 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: - 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; - U.S. Patent No. 10,772,629 entitled “SURGICAL ANVIL ARRANGEMENTS”; - U.S. Patent Application Serial No. 15 / 634,046 entitled “SURGICAL ANVIL ARRANGEMENTS” is now published as U.S. Patent Application No. 2018 / 0368841; - U.S. Patent No. 10,856,869 entitled “SURGICAL ANVIL ARRANGEMENTS”; - 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; - 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; - 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; - 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 - U.S. Patent No. 10,631,859 entitled “ARTICULATION SYSTEMS FOR SURGICAL INSTRUMENTS”.

[0134] 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: - U.S. design patent application serial number 29 / 736,648 entitled “STAPLE CARTRIDGE”; - U.S. design patent application serial number 29 / 736,649 entitled "STAPLE CARTRIDGE"; - U.S. design patent application serial number 29 / 736,651 entitled “STAPLE CARTRIDGE”; - U.S. design patent application serial number 29 / 736,652 entitled “STAPLE CARTRIDGE”; - U.S. design patent application serial number 29 / 736,653 entitled “STAPLE CARTRIDGE”; - U.S. design patent application serial number 29 / 736,654 entitled "STAPLE CARTRIDGE"; and - U.S. design patent application serial number 29 / 736,655 entitled “STAPLE CARTRIDGE”.

[0135] 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: - 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; - 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; - U.S. design patent D833,608 entitled "STAPLING HEAD FEATURE FOR SURGICAL STAPLER"; and - U.S. design patent number D830,550 entitled "SURGICAL STAPLER".

[0136] 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.

[0137] The terms “comprising,” “having,” “including,” and “containing” are open-ended linking verbs. Therefore, a surgical system, apparatus, or device that “comprising,” “having,” “including,” or “containing” 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 “containing” one or more features have, but are not limited to, those features.

[0138] 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.

[0139] 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.

[0140] 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.

[0141] 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.

[0142] 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.

[0143] 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.

[0144] 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.

[0145] 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 hold the retainer to the cartridge. The actuator is movable between its non-firing position and its firing position by a slider. The slider is movable between a proximal position adjacent to the proximal end 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 and lift the actuator toward the anvil, and the nail is supported on the actuator.

[0146] 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 it.

[0147] Figures 1 to 8 A 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.

[0148] 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.

[0149] 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 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.

[0150] 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.

[0151] 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.

[0152] 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.

[0153] 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.

[0154] 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 handle 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 handle 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.

[0155] 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.

[0156] 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.

[0157] 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.

[0158] Currently, the main reference is... Figure 4 The 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.

[0159] 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 that includes 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.

[0160] 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.

[0161] 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 engages in 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.

[0162] 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 the 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.

[0163] 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.

[0164] 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.

[0165] 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.

[0166] The closing drive 250 is actuated by a flexible drive section 175, which includes a universal movable 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 kinematic 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.

[0167] 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 pin 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 pin 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.

[0168] In order to release the position ( Figure 7The clamping end actuator 200 closes the wedge 255, causing it to move proximally. As the closing 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 ).

[0169] In order 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 a 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 ).

[0170] 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.

[0171] 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.

[0172] Platform surface 221 includes a tissue-supporting surface with a lateral profile. In various aspects, 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 some 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.

[0173] 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.

[0174] 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 a support member 259 and a 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.

[0175] 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.

[0176] 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.

[0177] In various instances, the firing member 270 may be a hybrid construction of plastic and metal parts as further described herein. In various instances, the threaded part 273 may be, for example, a metal part, which is incorporated into the firing member body 271 by insert molding or overmolding.

[0178] 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.

[0179] 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.

[0180] 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.

[0181] 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 retain 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.

[0182] To enable the end effector 200 to articulate about the joint motion 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 protrusion 352 that extends eccentrically relative to the joint motion 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.

[0183] 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.

[0184] 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.

[0185] 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 includes 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.

[0186] 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 retain 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.

[0187] 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.

[0188] 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.

[0189] 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.

[0190] 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.

[0191] 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.

[0192] 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 retain 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.

[0193] 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.

[0194] 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 accommodate 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.

[0195] 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.

[0196] 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.

[0197] 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 retain the channel 630 to the shaft portion 610.

[0198] 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.

[0199] 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 pitch 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.

[0200] 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.

[0201] 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.

[0202] 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 640 facing the channel 630.

[0203] 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.

[0204] 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.

[0205] 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, for example... 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 “MECHANICALACTUATOR 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, which 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.).

[0206] 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.

[0207] In various forms, the robotic arm 800 includes a base 702, which, in an 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 FOROPTIMAL POSITIONING,” the entire disclosure of which is incorporated herein by reference.

[0208] 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.

[0209] 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.

[0210] Regardless of the specific type of surgical procedure performed, once a surgical end effector is inserted into the patient through a cannula, it is typically necessary to move the end effector relative to the shaft assembly positioned within the cannula in order to properly position the end effector relative to the tissue or organ being treated. This movement or positioning of the end effector relative to the shaft portion held within the cannula is generally referred to as the "articular movement" of the end effector. Various articulation joints have been developed to attach the end effector to the associated shaft to facilitate this articulation. It is anticipated that in many surgical procedures, the use of surgical end effectors with the largest possible range of articulation is desirable.

[0211] Due to the dimensional constraints imposed by the size of the cannula sheath, the dimensions of the articulation joint components must be configured to allow free insertion through the cannula sheath. These dimensional constraints also limit the size and composition of various drive members and components that operatively interact with a motor and / or other control system supported in a housing, which may be handheld or part of a larger automated system. In many cases, these drive members must operatively pass through the articulation joint to be operatively coupled to or operatively interact with a surgical end effector. For example, one such drive member is typically used to apply articulated motion control to a surgical end effector. During use, the articulation drive member may be deactivated to position the surgical end effector in a non-articular position to facilitate insertion of the surgical end effector through the cannula, and then actuated to articulate the surgical end effector to the desired position as it enters the patient's body.

[0212] Therefore, the aforementioned dimensional constraints pose numerous challenges to the development of articulation systems that can achieve the desired range of motion and are suitable for the various drive systems required to operate the different features of a surgical end effector. Furthermore, once the surgical end effector is positioned in the desired articulation location, the articulation system and articulation joint must be able to hold the surgical end effector in that locked position during actuation of the end effector and completion of the surgical procedure. Such an articulation joint arrangement must also be able to withstand the external forces experienced by the end effector during use.

[0213] 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.

[0214] 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.

[0215] 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.

[0216] The firing drive mechanism can be activated by a firing trigger, for example, 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 move the cutting member and / or the pin-firing slider during the rotation of the second rotary drive member.

[0217] 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 part properties, 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.

[0218] 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.

[0219] In various cases, surgical end effectors and / or suture assemblies for surgical devices may include a rotary drive screw or rotary drive member, as further described herein. The rotary drive screw may extend through a portion of the channel and / or cartridge to a distal position within the end effector. The rotary drive screw may facilitate clamping and / or firing of the cartridge, as further described herein. The rotary drive screw may extend along a longitudinal axis and may be aligned with a centerline of the cartridge extending from its proximal end to its distal end.

[0220] The rotary drive screw passing through the end effector can occupy a large portion of the limited fixed space along the longitudinal center of the end effector and its cartridge. In various cases, for example, the rotary drive screw may interfere with certain existing firing components, such as actuators and / or sliders. The small coverage area of ​​the cartridge and the significant firing forces applied to various components in the end effector and cartridge can pose various challenges to structural modifications and / or repositioning of certain components.

[0221] For example, modifications may be needed to the firing mechanism in a nail magazine with a rotary drive screw passing through it to avoid interference and to provide sufficient spacing around the rotary drive screw while bearing the firing force and balancing torque during the firing stroke to minimize damage to components and / or misfiring of nails. In various cases, the nail row may be compressed (i.e., a denser nail arrangement) and / or laterally displaced away from the rotary drive screw to increase lateral space around the centerline of the nail magazine. For example, repositioning and / or increasing the density of the nail row may require various adaptations to the firing mechanism, such as the actuator and / or slider.

[0222] In various cases, the actuator and / or slider may be modified to correspond to the repositioning and / or compression of the pin row, while minimizing the occurrence of jamming and / or misfiring. For example, modifications to the pin actuator may include changes in the structure and geometry of the pin support post and / or the bridging element between them. In some cases, the upper portion of the actuator (e.g., the width of the pin support post) may be asymmetrical relative to the centerline of the actuator. Additionally or alternatively, the lower portion of the actuator (e.g., the bridging element and / or base of the pin support post) may be asymmetrical relative to the centerline of the actuator.

[0223] For example, in one aspect of this disclosure, the staple cartridge may include a body extending along a longitudinal axis, a staple row, and a triple actuator configured to fire three staples simultaneously. The staple row may include an inner row located on a first side of the longitudinal axis, wherein the inner row includes inner staples. The staple row may also include an intermediate row located on the first side of the longitudinal axis, wherein the intermediate row includes intermediate staples. Furthermore, the staple row may include an outer row located on the first side of the longitudinal axis, wherein the outer row includes outer staples. The intermediate row may be equidistant from the inner and outer rows. The triple actuator may include an inner support post defining a first width, wherein the inner support is configured to support the inner staples. The triple actuator may also include an intermediate support post defining a second width, wherein the intermediate support post is configured to support the intermediate staples. Furthermore, the triple actuator may include an outer support post defining a third width, wherein the outer support post is configured to support the outer staples. The first width may be smaller than the second width and smaller than the third width. In some cases, the first width, second width, and third width may all be different.

[0224] In various aspects of this disclosure, the varying widths of the nail support columns of the multi-nail actuator are configured to provide wider space for the sliding track while optimizing the fixed space for the rotary drive screw along the central longitudinal portion of the nail cartridge. Various improvements to the nail cartridge (e.g., including the actuator and cartridge body) and their advantages are further described herein.

[0225] See now Figure 24 and Figure 25The staple cartridge 20100 includes a body 20102 extending along a longitudinal axis A. Staples are removably positioned in the body 20102. Staples can be ejected from the body 20102 and fired into tissue, for example, during a firing stroke. Staples are arranged in longitudinal rows on both sides of the longitudinal axis A. The cartridge 20102 also includes a platform 20104, which may be referred to as a tissue support surface, for example. The platform 20104 is a laterally curved tissue support surface and defines a curved surface or profile from a first lateral side of the body 20102 to a second lateral side of the body 20102. Peaks in the laterally curved tissue support platform 20104 are defined at the middle portion of the body 20102. For example, peaks may be positioned between longitudinal rows of staples and cover the longitudinal axis A. In various cases, for example, similar to the firing screw 261 ( Figure 4 and Figure 5 The rotary drive screw extends through a portion of the staple cartridge 20100, as further described herein.

[0226] The pins are positioned within cavities 20110 defined in the housing 20102. The pins are arranged in a longitudinal row on either side of the longitudinal axis A. For example, the cavity 20110 is arranged as a cavity row 20112. The cavity row includes an inner row 20112a, a middle row 20112b, and an outer row 20112c located on each side of the longitudinal axis A. The middle row 20112b is equidistantly spaced between the inner row 20112a and the outer row 20112c. For example, the inner cavity row 20112a may be spaced inwardly from the middle cavity row 20112b by a distance, and the outer cavity row 20112c may be spaced outwardly from the middle cavity row 20112b by the same distance. A rotary drive screw may be aligned with the longitudinal axis A and may extend through the housing 20102 adjacent to the inner cavity row 20112a. For example, the rotary drive screw may be located between and parallel to the inner cavity rows 20112a.

[0227] The inner row 20112a holds the inner nail, the middle row 20112b holds the middle nail, and the outer row 20112c holds the outer nail. In various cases, the inner nail, middle nail, and outer nail can be the same. In other cases, for example, the inner nail, middle nail, and / or outer nail can be different relative to the nail type (e.g., wire or stamped), material, and / or size (e.g., different heights). The reader will understand that this document describes various nails, nail cavities, nail drivers, and nail cartridges. However, in some cases, alternative fasteners may be used, and such fasteners may be incorporated into fastener cavities, driven by fastener drivers, and / or fired from fastener cartridges that may in many respects be similar to the nail cavities, nail drivers, and / or nail cartridges described herein.

[0228] The staple cartridge 20100 may have different staple arrangements. For example, the staple cartridge 20100 may have fewer than three staple rows on each side of the longitudinal axis A, and in one aspect, it may have only two staple rows on each side of the longitudinal axis A. In still other cases, the staple cartridge 20100 may include four or more staple rows on one or more sides of the longitudinal axis A. In various cases, the staple rows may be asymmetrical with respect to the longitudinal axis A. For example, the first side of the staple cartridge 20100 may have a different number of staple rows than the second side of the staple cartridge 20100.

[0229] Each nail cavity 20110 includes a proximal end, a distal end, and a lateral guide surface intermediate between the proximal and distal ends. The nail cavity 20110 is configured and sized to guide the actuator 20120 toward the platform 20104 through the nail cavity 20110. More specifically, the geometry of the nail cavity 20110 may be complementary to the geometry of the actuator 20120. For example, the lateral guide surface in each nail cavity 20110 is configured to guide the sidewall 20134 of the actuator 20120 (e.g., the sidewall of a nail support post) as the actuator 20120 moves through the nail cavity 20110. Additionally or alternatively, the proximal and / or distal end of each nail cavity 20110 may include an upright recess configured to slidably receive the end of the actuator 20120 and / or its tongue. Alternative tongue and groove arrangements are also envisioned, which can be configured to guide the driver 20120 through the nail chamber 20110 during nail firing from the nail cartridge 20100.

[0230] The actuator 20120 is configured to support and drive multiple staples from the cartridge 20102 during the firing stroke. The actuator 20120 can movably support two or more longitudinal rows of staples across the staple chamber 20112. For example, the actuator 20120 can movably support inner staples, intermediate staples, and outer staples on the same side of the staple cartridge 20100.

[0231] Now, please refer to Figures 26 to 28 The image shows actuator 20120. For example, multiple actuators (such as actuator 20120) are incorporated into staple cartridge 20100. Actuator 20120 is a triple actuator configured to simultaneously drive three staples. Actuator 20120 includes three support posts—an inner support post 20122a configured to support inner staples in an inner staple row; a middle support post 20122b, located laterally outside the inner support post 20122a and configured to support middle staples in a middle staple row; and an outer support post 20122c, located laterally outside the middle support post 20122b and configured to support outer staples in an outer staple row. In various cases, the support posts 20122a, 20122b, and 20122c of each actuator 20120 may be longitudinally staggered.

[0232] The actuator 20120 also includes bridging members 20126 extending between adjacent support posts 20122. For example, a first bridging member 20126a extends between an inner support post 20122a and an intermediate support post 20122b, and a second bridging member 20126b extends between an intermediate support post 20122b and an outer support post 20122c. Bridging members 20126a and 20126b each include a sloping underside 20128 configured to engage by a sliding member during the firing stroke. In other words, each actuator 20120 is configured to engage and lift by two parallel sliding member tracks along the sloping underside 20128 of the actuator 20120. For example, the sliding members may be configured to move along the firing path during the firing stroke. The slider may include a central portion aligned with a longitudinal axis A, a first track on a first side of the longitudinal axis A, and a second track on a second side of the longitudinal axis A. The first track is configured to drivably engage a lower inclined side 20128 of a first bridging member 20126a, and the second track is configured to drivably engage a lower inclined side 20128 of a second bridging member 20126b. The slider and its firing motion are further described herein.

[0233] Each support post 20122 includes a proximal end 20130, a distal end 20132, and a pair of opposing sidewalls 20134 extending longitudinally between the proximal end 20130 and the distal end 20132. The sidewalls 20134 are configured to slidably engage a lateral guide surface in the corresponding nail cavity 20110 during firing motion. Each support post 20122 includes a nail support bracket 20124. The base of the nail can be retained in the nail support bracket 20124.

[0234] Each of the nail support brackets 20124 is aligned with one of the inner axis A1, the intermediate axis A2, or the outer axis A3, which correspond to the axes defining the longitudinal rows of nails and the nail cavity 20110 on one side of the nail cartridge 20100. A first lateral distance D1 is defined between the inner axis A1 and the intermediate axis A2, and a second lateral distance D2 is defined between the outer axis A3 and the intermediate axis A2. The axes are equidistant; the first lateral distance D1 and the second lateral distance D2 are the same. Although the lateral distances D1 and D2 between the axes and adjacent rows of nail cavities 20110 are the same, the actuator 20120 is asymmetrical with respect to its centerline. For example, the centerline of the actuator 20120 corresponds to the intermediate axis A2, and the inner and outer nails are positioned equidistant from the intermediate axis A2; however, the actuator 20120 is not symmetrical about the intermediate axis A2.

[0235] See also Figure 27The inner support post 20122a defines a first width Wa between its sidewalls 20134, the intermediate support post 20122b defines a second width Wb between its sidewalls 20134, and the outer support post 20122c defines a third width Wc between its sidewalls 20134. The first width Wa differs from the second width Wb and the third width Wc. For example, the first width Wa may be reduced or narrowed to be less than the second width Wb and less than the third width Wc to accommodate a rotary drive screw passing through the central portion of the staple cartridge 20100. In some cases, one or more narrower support posts 20122 may effectively narrow and reduce the coverage area of ​​the actuator 20120 while maximizing the width of the bridging member 20126, and thus maximizing the width of the sliding track, for example, which engages the inclined lower side 20128 of the bridging member 20126 and delivers the firing force to the actuator 20120. In various cases, increasing the width of the bridging element 20126 and the slider rail can improve the stiffness of the slider rail and minimize deformation and / or damage to the slider during the firing stroke.

[0236] Widths Wa, Wb, and Wc are all different. For example, the width Wb of the intermediate support post 20122b is larger than the width Wa of the inner support post 20122a and the width Wc of the outer support post 20122c. The width Wc is smaller than the width Wb of the intermediate support post 20122b and larger than the width Wa of the inner support post 20122a. The different widths Wa, Wb, and Wc are configured to optimize the width of the actuator 20120 to accommodate the rotary drive screw along the longitudinal axis A, while effectively transmitting firing force and minimizing torque and misfiring, for example.

[0237] As provided herein, in some cases, the width of the pin support post on the actuator can be varied to accommodate a rotary drive screw positioned within the pin cartridge. Additionally or alternatively, in certain aspects of this disclosure, the lower portion of the actuator can also be laterally varied, and the lower portion (e.g., the lower portion of the support post and / or bridging member) can be asymmetrical relative to a centerline passing through the intermediate support post. For example, the lower portion of the actuator can be modified to increase the available fixing space in the longitudinal central portion of the pin cartridge. The asymmetrical geometry of the lower portion of the actuator can be selected to improve the strength and stiffness of the triple actuator while minimizing the height of the actuator. In various cases, although the support post thickness and / or bridging member geometry can be laterally varied, the support post can be equidistantly spaced from the centroid of the generally triangular triple actuator. For example, the intermediate support post can be longitudinally aligned with the centroid, and the inner and outer support posts can be longitudinally offset from the centroid. In various cases, inclined surfaces can be equidistantly spaced from the centroid of the triple actuator.

[0238] See Figure 29 and Figure 30The diagram shows an end effector 20240 including an staple cartridge 20200 and a triple actuator 20220. The staple cartridge 20200 is similar to the staple cartridge 20100 in many respects. Figure 24 ), and the Triple Drive 20220 is similar to the Triple Drive 20120 in many ways ( Figure 26 For example, the staple cartridge 20200 includes a cartridge body 20202 that includes three rows of staple chambers on each side of the rotary drive screw 20242, and the triple actuator 20220 includes three parallel staple support brackets 20224 configured to support staples, wherein the triple actuator 20220 is configured to fire staples from the inner row, the middle row and the outer row.

[0239] End effector 20240 includes a rotary drive screw 20242 and a firing member 20244, which are similar to the firing screw 261, respectively. Figure 4 and Figure 5 ) and firing component 270 ( Figure 4 and Figure 5 The firing member 20244 is configured to move through the staple cartridge 20200 during the firing stroke to advance the slider and elevate the actuator 20220. The actuator 20220 includes an inner support post 20222a, a middle support post 20222b, and an outer support post 20222c. The posts 20222 include different widths, as further described herein. In various aspects of this disclosure, one or more of the posts 20222 may also include a different height than the other posts. In various cases, the different heights are configured to enable the staples to be formed at different heights, which may correspond to, for example, the contours of a laterally curved tissue support surface or platform of the cartridge body.

[0240] The lower portion of the actuator 20220 includes a chamfered inner edge 20236. The chamfered inner edge 20236 is a cutout or fan-shaped edge sized to accommodate the lower portions of the drive screw 20242 and the firing member 20244. For example, the drive screw 20242 extends along a longitudinal axis A and is positioned between the actuators 20220 on opposite sides of the longitudinal axis A. In such a case, the drive screw 20242 may extend through the staple cartridge 20200 while minimizing the size of the staple cartridge 20200 and the end effector 20240. The chamfered inner edge 20236 includes a cutout into the base portion of the inner support post 20222a, which provides spacing for the firing member positioned along the longitudinal center portion of the end effector 20240. In addition, the chamfered inner edge 20236 is configured to provide space closer to the vertical centerline of the end effector, i.e., the equidistant distance between the upper and lower cams, which can improve and / or help balance the forces during the firing stroke.

[0241] Additionally or alternatively, the bridging element of the drive may vary laterally and / or be asymmetrical relative to the centerline of the intermediate support post passing through the drive. See now. Figure 31 The diagram shows an end effector 20340 including an staple cartridge 20300 and a triple actuator 20320. The staple cartridge 20300 is similar in many respects to the staple cartridge 20100 (see [link to documentation]). Figure 24 ), and the Triple Drive 20320 is similar to the Triple Drive 20120 in many ways (see Figure 26 For example, the staple cartridge 20300 includes a cartridge body 20302 and a platform 20304; three staple rows are positioned on each side of the rotary drive screw, and the triple actuator 20320 includes three parallel staple support brackets 20324 configured to support staples, wherein the triple actuator 20320 is configured to fire staples from the inner row, the middle row, and the outer row. The actuator 20320 in Figure 31 It is depicted in a firing configuration, in which the upper part of the nail support column extends through platform 20304 (i.e., nail overdrive).

[0242] The end effector 20340 may include a rotary drive screw and a firing member, which, as further described herein, moves through the pin cartridge 20300 during the firing stroke to advance a slider 20350 having a track 20352 to elevate the actuator 20320. The actuator 20320 includes an inner support post 20322a, an intermediate support post 20322b, and an outer support post 20322c. The posts 20322 include different widths, as further described herein. In various aspects of this disclosure, one or more of the posts 20322 may also include a different height than the other posts, as further described herein.

[0243] The lower portion of the driver 20320 includes a chamfered inner edge 20336, which is similar in many respects to chamfered edge 20236. Figure 29 The lower portion of the actuator 20320 also includes bridging members 20326 between adjacent nail support posts 20322. A first bridging member 20326a connects the inner support post 20322a to the intermediate support post 20322b, and a second bridging member 20326b connects the intermediate support post 20322b to the outer support post 20322c. The geometry of the first bridging member 20326a differs from that of the second bridging member 20326b. In other words, the bridging member 20326a is positioned relative to a vertical plane P passing through the actuator 20320. Figure 31 It is asymmetrical and aligned with the axis of the base / crown of the intermediate nail supported on it.

[0244] The first bridging member 20326a is higher than the second bridging member 20326b. In various cases, as further described herein, the central longitudinal portion of the staple cartridge 20300 may be higher and define a greater height at the peak of the laterally curved tissue support surface than along the side of the staple cartridge 20300. Therefore, the staple cartridge 20300 can accommodate additional material and / or the increased height / volume of the actuator 20320 between the inner support column 20322a and the intermediate support column 20322b compared to between the outer support column 20322c and the intermediate support column 20322b. For example, the increased height of the first bridging member 20326a from the base surface compared to the second bridging member 20326b can compensate for the loss of rigidity caused by the chamfered inner edge 20336. Additionally or alternatively, the greater height of the first bridging member 20326a compared to the second bridging member 20326b can improve the stiffness and strength of the triple actuator 20320, while minimizing size and maintaining the compact form factor of the staple cartridge 20300 and the end effector 20340.

[0245] In some cases, the upper portion of the first bridging member 20326a may be configured to guide the actuator 20320 through the nail cavity during the initial portion of the firing motion. For example, when the inner support post 20322a is in the non-firing position, due to a cut in the central portion of the housing assembly 20300 for receiving the rotary drive screw, the inner support post 20322a may be at least partially unsupported or unguided by lateral guide surfaces. Without some lateral support surface surrounding the inner support post 20322a, the actuator 20320 may be prone to twisting and / or misfiring. However, the increased height of the first bridging member 20326a may be configured to engage an upright support surface in the housing during the initial portion of the firing motion to improve the guidance and support of the actuator 20320.

[0246] See now Figure 32 This shows an alternative driver geometry for driver 20420. Driver 20420 is a triple driver and is similar to triple driver 20120 in many respects. Figure 26 For example, the triple actuator 20420 includes three parallel nail support brackets 20424 configured to support nails, and the triple actuator 20420 is configured to fire nails from the inner row, middle row, and outer row. The actuator 20420 can be incorporated into various nail cartridges disclosed herein. For example, the actuator 20420 can be used with a nail cartridge adapted to receive a rotary drive screw extending along a longitudinal axis and with a variable height platform.

[0247] The actuator 20420 includes an inner support column 20422a, a middle support column 20422b, and an outer support column 20422c. The columns 20422 include different widths, as further described herein. In various aspects of this disclosure, one or more of the support columns 20422 may also include a different height than the other support columns, as further described herein.

[0248] The lower portion of the driver 20420 includes a chamfered inner edge 20436, which is similar in many respects to chamfered edge 20236. Figure 29 The lower portion of the actuator 20420 also includes bridging members between adjacent nail support posts 20422. A first bridging member 20426a connects the inner support post 20422a to the intermediate support post 20422b, and a second bridging member 20426b connects the intermediate support post 20422b to the outer support post 20422c. The geometry of the lower portion of the actuator 20420 varies in... Figure 32 The schematic diagram is indicated by dashed lines. For example, the rotation drive screw 20442 (which in many respects resembles the firing screw 261) is located along the longitudinal portion of the center of the cartridge. Figure 4 and Figure 5 Providing sufficient space and spacing, the actuator 20420 includes a chamfered inner edge 20436 and an upper gusset plate 20438 between the first bridging member 20426a and the inner support post 20422a. In this case, the actuator 20420 can provide space and spacing for the rotary drive screw 20442 while maintaining sufficient structural integrity and rigidity to properly transmit the firing load.

[0249] In various cases, the maximum height of the variable height platform and the staple cartridge can be adjacent to the rotary drive screw 20442. In this case, a tighter tissue gap can be defined along the firing rod and the cutting edge. The maximum height can be defined by a portion of the inner support column 20422a and / or the first bridging member 20426a of the variable height platform, and therefore in some aspects, the raised first bridging member 20426a and / or the gusset plate 20438 can be fitted between the first bridging member 20426a and the inner support column 20422a.

[0250] In some cases, one or more gusset plates may extend between the upper edge of the first bridging member 20426a and the inner support post 20424. In some cases, the gusset plate 20438 may include longitudinal gusset ribs along at least a portion of the length of the inner support post 20422a and the first bridging member 20426a. The actuator 20420 is positioned relative to a vertical plane P passing through the intermediate support post 20422b. Figure 32The first bridging member 20426a is asymmetrical and aligned with the longitudinal axis of the nail base supported therein. For example, due to the gusset plate 20438 and / or the chamfered inner edge 20436, the first bridging member 20426a may define a different geometry and a different profile than the second bridging member 20426b.

[0251] In some cases, a portion of the cartridge body may be cut away to accommodate the rotary drive screw along the central portion of the cartridge. The cartridge body may include additional guides and support features configured to guide the drive through the nail cavity and toward the platform of the cartridge body. Even when a portion of the drive is not fully positioned in the nail cavity, the guides may be configured to engage and support the drive.

[0252] See Figure 33 and Figure 34 The diagram shows cargo hold 20502. In various cases, cargo hold 20502 can be similar to cargo hold 20102 in many respects. Figure 24 ), and can be integrated into the pin reservoir 20100 and used with driver 20120 ( Figure 26 The pins can be positioned in cavities 20510a, 20510b, and 20510c defined within the housing 20502. The pins are arranged in a longitudinal row on either side of the longitudinal axis A along the centerline of the housing 20502. For example, cavities 20510a, 20510b, and 20510c are arranged in a row. The row includes an inner row 20512a, a middle row 20512b, and an outer row 20512c located on a first side of the longitudinal axis. A rotary drive screw (e.g., Figure 4 and Figure 5 The firing screw 261 in the chamber can be aligned with the longitudinal axis A and can extend through the housing 20502 adjacent to the inner cavity row 20512a. For example, the rotary drive screw can be located between and parallel to the inner cavity row 20512a.

[0253] See also Figure 34The housing 20502 includes a guide surface 20514 extending around an inner cavity 20510a within the inner outlet 20512a. In various cases, the guide surface 20514 is configured to guide the actuator (e.g., the inner support column 20122a of a triple actuator 20120) into and through the inner cavity 20510a, even when the inner support column 20122a is not fully positioned within the inner cavity 20510a before firing. In various cases, the guide surface 20514 is a circumferential chamfer on a lower housing surface extending around the inner cavity 20510a. Such a circumferential chamfer is configured to prevent unintentional obstruction and hanging when the inner support column of the actuator is advanced into the inner cavity 20510a. In other cases, the guide surface 20514 may include, for example, a fillet. The guide surface 20514 may extend around the entire periphery of the inner cavity 20510a. In other cases, the guide surface 20514 may be positioned around a portion of the periphery, such as the first lateral side, the proximal end, and / or the distal end.

[0254] See also Figure 35 A portion of the cavity 20510a and the actuator 20120 are shown. The lower edge of the cavity 20510a includes a guide surface 20514 extending around the cavity 20510a. The top edge of the inner support post 20122a also includes a guide surface 20125, which is configured to guide the inner support post 20122a to be aligned with the cavity 20510a even when the inner support post 20122a is not fully positioned in the cavity 20510a before the firing stroke and the actuator 20120 is initially lifted by the slider. In such cases, the guide surfaces 20514 and 20125, located on the lower edge of the cavity 20510a and the top edge of the inner support post 20122a, respectively, are configured to interact to ensure that the inner support post 20122a moves smoothly into the cavity 20510a during the firing stroke. As further described herein, due to the space required for the rotation drive screw along the central longitudinal portion of the housing 20502, the inner support column 20122a may not be fully positioned in the inner cavity 20510a before the firing stroke.

[0255] See now Figure 36 and Figure 37 The image shows a portion of driver 20620. In various aspects of this disclosure, driver 20620 can be a triple driver and is similar in many respects to driver 20120. Figure 26 In various aspects of this disclosure, the driver 20620 may be incorporated into the pin reservoir 20100 ( ). Figure 24 In ), the driver 20620 includes components configured to support the pin 20680 ( Figure 37The support post 20622 includes a proximal end 20630, a distal end 20632, and a pair of opposing sidewalls 20634 extending longitudinally between the proximal end 20630 and the distal end 20632. The sidewalls 20634 are configured to slidably engage lateral guide surfaces in the respective nail cavities. The support post 20622 also includes a nail support bracket 20624, and the base of the nail 20860 can be held in the nail support bracket 20624.

[0256] The actuator 20630 also includes a proximal upright feature 20636 and a distal upright feature 20638, or extensions, extending away from the base of the actuator 20630 and away from the nail support bracket 20624. The proximal upright feature 20636 is the closest feature of the support post 20622 and extends from the proximal end 20630 of the support post 20622. The distal upright feature 20638 is the farthest feature of the support post 20622 and extends from the distal end 20636 of the support post 20622. In the non-firing position of the actuator, the proximal upright feature 20636 and the distal upright feature 20638 may be below and toward the platform of the nail cartridge. The proximal upright feature 20636 and the distal upright feature 20638 may be configured to support the nail 20680 and guide the nail leg, for example, during formation.

[0257] The proximal upright feature 20636 and the distal upright feature 20638 are the highest portions of the support post 20622. In some cases, when the actuator moves to the firing position, the proximal upright feature 20636 and the distal upright feature 20638 may extend above the platform and facilitate gripping and / or retaining tissue adjacent to the nail 20860. For example, the proximal upright feature 20636 and the distal upright feature 20638 may grip tissue at the proximal and distal ends of the nail cavity. Furthermore, the proximal upright feature 20636 and the distal upright feature 20638 may serve as guide surfaces for the actuator 20630 and, in some cases, guide the support post 20632 into the fastener cavity. For example, when the support post 20622 is not fully positioned in the nail cavity before firing, as further described herein, the proximal upright feature 20636 and the distal upright feature 20638 are configured to guide the support post 20622 to align with the nail cavity during the firing motion.

[0258] In some cases, the proximal upright feature 20636 and the distal upright feature 20638 may be incorporated into the inner support post (i.e., the support post adjacent to the firing path and / or the rotary drive screw). In such cases, the proximal upright feature 20636 and the distal upright feature 20638 may engage the nail cavity during the firing stroke and are configured to guide the inner support post, even if the inner support post is not fully positioned in the nail cavity before firing, as further described herein. In other cases, the intermediate support post and / or the outer support post may also include at least one of the proximal upright feature 20636 and / or the distal upright feature 20638.

[0259] In some aspects of this disclosure, when the actuator 20620 is in the fully advanced position, the proximal upright feature 20636 and the distal upright feature 20638 are configured to be received into recesses along the underside of the tissue support platform. As further described herein, the underside of the tissue support platform may include an array of recesses within a recess extender that engages on the anvil-facing side of the platform. The recess extender may surround or at least partially surround an opening in the tissue support platform to clamp tissue and / or guide screw legs during the firing stroke. The nesting of features on the actuator with the underside recesses in the tissue support platform is further described herein. The nesting of the proximal and distal upright features within the recess extenders or ridges of the platform can maintain desired tissue clearance and platform thickness in various cases.

[0260] In some cases, a replaceable cartridge may be used with each firing stroke and then replaced by another replaceable cartridge for subsequent firing strokes. A replaceable cartridge may include a cartridge body, a driver, a staple, and a slider, as further described herein. In some cases, a reusable multi-firing cutting edge may be incorporated into an end effector and advanced relative to the replaceable cartridge. For example, the end effector may include a firing member, such as an I-beam or E-beam, which, for example, has an upright cutting edge facing distally along its leading edge. Exemplary firing members with reusable cutting edges for use during multiple firing strokes are further described herein. In some cases, the reusable knife and one or more of its cutting edges may be hardened parts that may be expensive to manufacture. In some cases, the placement of a reusable knife in a surgical device may limit the number of times the surgical device can be reused. Furthermore, to prevent the knife from becoming dull through multiple firings, in some cases, a reusable knife may not be as sharp as a single-use knife.

[0261] In other cases, the firing mechanism, end effector, and / or surgical device may not include a multi-firing tissue transverse cutter. For example, the cutter may be integrated into a replaceable staple cartridge rather than into the surgical device itself. In such cases, a new cutting edge can be used with each firing stroke.

[0262] This article describes various replaceable cartridge assemblies with a tissue transverse cutter. In one example, the firing member may include an integral sliding component, and the cutter may be releasably attached to or mounted to the firing member when the cartridge is inserted into a surgical device or its end effector having a firing member.

[0263] See now Figure 99 An end effector 20840 with a firing member 20841 is shown, the firing member having an integral slider 20860 and an attachment feature (e.g., a recess 20846) for attachment to a single-use blade 20830. The end effector 20840 is similar in many respects to the end effector 200 (see [link]). Figure 4 and Figure 5 And is configured to cut and suture patient tissue. For example, the end effector 20840 includes a staple cartridge jaw 20850 having opposing sidewalls 20852, and the end effector 20840 also includes an anvil jaw 20854. For example, the jaw 20850 is configured to receive a staple cartridge, such as Figure 103 The replaceable staple cartridge 20800 is shown. The end effector 20840 also includes a firing drive system 20839, which includes a rotary drive screw 20842 ( Figure 105 ) and firing member 20841, which are respectively similar to firing screw 261 ( Figure 4 and Figure 5 ) and firing component 270 ( Figure 4 and Figure 5 During the firing stroke, as the rotary drive screw 20842 rotates, the firing member 20841 is driven through the end actuator 20840 to fire the nail from the nail magazine 20800. The rotary drive screw 20842 extends along the longitudinal axis A through the fastener magazine 20800.

[0264] See also Figure 100A The firing member 20841 includes an upright body portion 20843, upper cam members 20844 extending laterally from both sides of the upright body portion 20843, and lower cam members 20845 extending laterally from both sides of the upright body portion 20843. When the end effector 20840 is in the clamping configuration ( Figure 105In the firing stroke, the upper cam member 20844 is configured to engage the anvil jaws 20854 of the end effector 20840 in a cam manner, and the lower cam member 20845 is configured to engage the jaws 20850 of the end effector 20840 in a cam manner during the firing stroke. The upper cam member 20844 and the lower cam member 20845 are configured to clamp the jaws of the end effector 20840 and define the tissue clearance during the firing stroke, as further described herein with respect to various firing members (e.g., I-beams and E-beams). A threaded opening 20847 through the upright body portion 20843 is configured to receive a rotary drive screw 20842 passing therethrough. In other cases, a threaded nut may be threadedly connected to the rotary drive screw 20842 and mounted to the firing member 20841. Various threaded nuts and alternative firing members are further described herein.

[0265] See still Figure 100A The firing member 20841 also includes an integrated slider 20860. The slider 20860 has two tracks 20866. One of the tracks 20866 is configured to engage a row of staple drivers on each side of the surgical end effector 20800. In other words, the slider 20860 includes a row of staple drivers for each side of the surgical end effector 20800 (i.e., for the staple cartridge 20800). Figure 103 Each side of the surgical end effector 20840 has a single track 20866. A single track on each side saves lateral space in the surgical end effector 20840, which provides additional space to accommodate the rotary drive screw 20842 along the central portion of the surgical end effector 20840. In such cases, the slider 20860 can be a reusable component, for example, provided with the firing member 20841 and the surgical device.

[0266] See also Figure 103 The firing member 20841 is driven through the staple cartridge 20800, which includes a cartridge body 20802 and actuators 20820 and 20821 movably positioned therein. Actuator 20820 is a triple actuator, and actuator 20821 is a dual actuator. In various cases, the nearest-side actuator in the staple cartridge 20800 is the dual actuator 20821, and in other cases, one or more of the nearest-side actuators may be a single actuator. The dual actuator 20821 includes a lateral flange that includes an inclined surface for actuated engagement by a sliding track 20866, the inclined surface also engaging with an inclined groove 20818 on the triple actuator 20820. Figure 102 Alignment. In other words, both the dual actuator 20821 and the triple actuator 20820 are driven by a single sliding track 20866 on each side of the fastener housing 20800.

[0267] Parallel longitudinal slot 20803 passing through the compartment 20802 ( Figure 103 The dimensions of the firing member 20841 are set to receive the track 20866 during the firing stroke. In other words, as the upright body portion 20843 of the firing member 20841 moves through the central longitudinal slot 20808 in the housing 20802, the track 20866 moves along the parallel slot 20803 (along the underside of the housing 20802). The parallel longitudinal slot 20803 is also parallel to the longitudinal slot 20808, through which the upright body portion 20843 of the firing member 20841 protrudes.

[0268] In other cases, the integrated slider of the firing member 20841 may have more than one track on each side. For example, integrated sliders with four tracks and six tracks are also envisioned.

[0269] The firing member 20841 is adapted to be releasably connected to the blade 20830. The blade 20830 includes a opposing spring arm 20832 that extends proximally toward and resiliently engages the upright body portion 20843 of the firing member 20841. The spring arm 20832 snaps around the upright body portion 20843 and extends into a cavity 20846 defined in the upright body portion 20843. The blade 20830 also includes a longitudinal body 20834 configured to abut and / or nest on a complementary surface of the firing member 20841, for example, above a threaded opening 20847 for rotating the drive screw 20842. The blade 20830 also includes an upright cutting edge 20836 configured to be capable of cutting through a tissue support platform 20804 (…). Figure 105 The upper part extends to cut across the tissue during the firing stroke.

[0270] In various cases, the fastener cartridge 20800 and the jaws 20850 may include alignment and / or lever-action features to facilitate mounting the fastener cartridge 20800 into the jaws 20850. Various alignment and lever-action features are further described herein. These features may also align the blade 20830 with the firing member 20841 and, more specifically, the spring arm 20832 with the cavity 20846 to ensure that the blade 20830 is engaged with the firing member 20841 when the cartridge 20800 is inserted into the jaws 20850.

[0271] In the non-firing cartridge 20800, the blade 20830 is aligned with the indicator slider 20828, which is configured to be pushed distally by the blade 20830 during the firing stroke. As further described herein, when the firing stroke has passed through the window 20806 in the nose of the cartridge 20802 ( Figure 114When completed, indicator slider 20828 provides a visible indication to clinicians and / or users, as further described herein. Furthermore, indicator slider 20808 is configured to selectively overcome missing and / or used compartment closures in certain circumstances, as further described herein.

[0272] The indicator slider 20828 and the blade 20830 are components of the staple cartridge 20800. When the staple cartridge 20800 is installed in the surgical end effector 20840, the blade 20830 is aligned with the firing member 20841, causing the spring arm 20832 to elastically engage the opening 20846. The insertion angle of the staple cartridge 20800 is configured to ensure proper alignment of the spring arm 20832 and the opening 20846. In this configuration, a new blade can be supplied with each staple cartridge 20800 and for each firing stroke.

[0273] See also Figure 100B and Figure 101 The integral slider 20862 is configured to volutely engage the triple actuator 20820 during the firing stroke. The firing member 20841 and the slider 20862 move along a longitudinal path in the pin cartridge 20800 during the firing stroke to lift the actuator 20820 along the transverse axis.

[0274] The triple actuator 20820 is raised by a single sliding track 20862 on each side of the staple cartridge 20800. Each triple actuator 20820 includes a recessed ramp 20818. Figure 102 The position and dimensions of the recessed ramp are set to receive the slider track 20862. In other words, the slider 20860 has a single track 20862 on each side of the central portion, and the single track 20872 is configured to lift and drive the triple actuator 20820. In fact, the single track 20862 is configured to fire all the nails on one side of the nail magazine 20800 and is configured to fire nails across three rows (e.g., inner row, middle row, outer row) via the triple actuator 20820. See also: Figure 102 The triple drive 20820 includes a recessed ramp 20818 ( Figure 102 The recessed ramp is sized to receive the sliding track 20862. The recessed ramp 20818 extends along the central portion of the triple actuator 20820 (e.g., below the intermediate / middle support column), as further described herein.

[0275] The Triple Drive 20820 is similar to the Triple Drive 20120 in many respects. Figure 26 For example, the triple actuator 20820 is configured to support three pins 20890 (). Figure 100B and Figure 101It also simultaneously lifts three pins 20890. The triple actuator 20820 also includes three support posts—an inner support post 20822a configured to support the inner pins 20890 in the inner pin row; a middle support post 20822b located laterally outside the inner support post 20822a and configured to support the middle pins 20890 in the middle pin row; and an outer support post 20822b located laterally outside the middle support post 20822b and configured to support the outer pins 20890 in the outer pin row.

[0276] The triple actuator 20820 also includes bridging members 20826 extending between adjacent support posts 20822. For example, a first bridging member 20826a extends between the inner support post 20822a and the intermediate support post 20822b, and a second bridging member 20826b extends between the intermediate support post 20822b and the outer support post 20822c. A recessed ramp 20818 aligned with the drive track 20866 is positioned between the first bridging member 20826a and the second bridging member 20826b and close to the intermediate support post 20822b.

[0277] More specifically, the recessed ramp 20818 is longitudinally aligned with the intermediate support post 20822b. Therefore, the intermediate support post 20822b of the actuator 28020 is positioned in a parallel longitudinal slot 20803 passing through the chamber 20802, and is not supported by the chamber 20802, or at least not along its lower portion, when in the non-firing position within the chamber 20802. In this configuration, the nails 20890 in the intermediate nail rows on each side of the chamber are supported by the intermediate support post 20822b and guided primarily by the tissue support platform 20804 of the chamber 20802. In some cases, recessed extenders and / or ridges along the tissue support platform 20804 may further guide the nails 20890 during the firing stroke.

[0278] The triple actuator 20820 may be symmetrical about the longitudinal axis along the recessed ramp 20818. In various cases, the triple actuator 20820 may include wings 20824 that extend laterally outward on both sides of the intermediate support post 20822b. In some cases, the wings 20824 are configured to prevent the actuator from rolling and to reinforce the intermediate support post 20822b. For example, when the intermediate support post 20822b is not supported by the housing 20802 or is largely unsupported by it, the wings 20824 may help balance the intermediate support post 20822b during the firing stroke.

[0279] See also Figure 103 The wing 20824 extends into a complementary recess 20805 within the housing 20802. During the firing stroke, the wing 20824 moves upward within the recess 20805 toward the organization support platform 20804. See also... Figure 104 The groove 20805 is located on either side of the intermediate nail cavity and extends from the underside of the housing 20802 to the tissue support platform 20804. In some cases, the tissue support platform 20804 may catch, block, and / or stop further upward movement of the wing 20824 to hold the actuator 20820 in the housing 20800 when the firing stroke is complete.

[0280] See also Figure 103 The distal portion of the intermediate support post 20822b is also configured to nest within a portion of an adjacent triple actuator 20820. More specifically, the triple actuator 20820 includes a proximal recess 20817 ( Figure 102 The size of the proximal recess is set to receive the distal tip of the adjacent (e.g., directly behind / proximal) triple actuator 20820. The nested arrangement of the end-to-end triple actuators 20820 with nested features therebetween is configured to further facilitate the alignment and cooperative support of the triple actuators 20820 in the housing 20802.

[0281] In short, the staple cartridge 20800 may include a triple actuator 20820 configured to be lifted by a single sliding track 20866 that pushes the central portion and the inclined recess 20818 of the triple actuator 20820 during the firing stroke. The triple actuator 20820 may also include wings 20824 on both sides to prevent the triple actuator 20820 from rolling during the firing stroke. The wings 20824 are movable in corresponding slots in the cartridge body 20802. In some cases, the slider 20860 may be integrally formed with the firing member 20841 (e.g., an I-beam or an E-beam). In such cases, the slider 20860 may be a reusable component together with the firing member 20842; however, a new blade 20830 may be provided for each staple cartridge 20800. In other cases, the slider may be a separate component in the cartridge, and in some cases, the firing member 20841 may include an integral cutting edge.

[0282] In various cases, as described herein, a triple actuator and a firing member with an integrated dual-track slider allow for a narrower triple actuator, and thus more space in the housing for the rotary drive screw. For example, the rotary drive screw can be positioned further upward in the end effector closer to the upper cam of the firing member, rather than along the lowest part of the end effector. A narrower actuator, for example, provides a tighter pin line, which can also improve steady-state in some cases. Additionally, the inner pin row can be moved laterally outward to accommodate the rotary drive screw, which reduces the likelihood and / or incidence of pin tearing. Furthermore, the housing can provide a robust design without the need for thin sidewalls between narrower support posts, towers, and / or pin cavities, and / or longitudinal slots for the firing member. The slider track can also be wider in some cases, and therefore less prone to bending under heavy firing loads. In some cases, pin overdrive can be minimized when the bending and deflection of the slider track are limited.

[0283] See also Figure 106 The staple cartridge 20800 includes a robust support wall for bearing clamping loads, and the tissue support platform 20804 defines a thickness t1 along the inner edge of the intermediate staple cavity and a thickness t2 along the outer edge of the intermediate staple cavity. Conversely, referring now to the staple cartridge 20900 having a body 20902 and a tissue support platform 20904, the support wall of the body 20902 may be narrower than the wall in the body 20802. Furthermore, the tissue support platform 20904 has a thickness t3, which is smaller than the thicknesses t1 and t2 of the tissue support platform 20804. For example, the body 20902 is adapted to receive a four-track slider.

[0284] A firing stroke achieved when the staple cartridge is missing from the surgical end effector can result in the blade making a transverse cut into the clamped tissue without any means of sealing the cut. For example, without staples (such as pins), a suturing device cannot suture and seal the cut tissue. Similarly, if an empty or used staple cartridge (i.e., a cartridge without staples or without a complete set of staples) is loaded into the end effector, the tissue will not be completely sealed along the transverse cut. A missing staple cartridge closure prevents the firing stroke when the staple cartridge is missing from the end effector, and a used staple cartridge closure prevents the firing stroke when a used staple cartridge is loaded into the end effector. In some cases, the closure prevents the firing stroke when both the staple cartridge is missing and used. In cases where the rotating firing screw extends through the end effector, the closure can be configured to limit and / or prevent rotation of the rotating firing screw, and thus prevent the firing stroke.

[0285] In one aspect, a locking nut may be positioned on a rotary drive screw, and a locking key may engage with a movable feature in the cartridge. In the locking configuration, the locking nut rotates out of firing alignment and into a locking recess in the end effector. When a non-firing cartridge is installed in the end effector, the locking key engages the locking nut to rotate it into firing alignment and out of the locking recess. The locking nut moves distally along the rotary drive screw during the firing stroke, and the locking key is also pushed distally during the firing stroke. Upon completion of the firing stroke and / or retraction of the firing member, the locking key may remain in the distal position; however, the locking nut may return to the proximal position in the end effector. Because the cartridge has been fired (e.g., used), the locking nut rotates again out of firing alignment and into the locking recess to prevent subsequent firing strokes until a replacement non-firing cartridge is installed in the end effector. In other cases, the lock on the rotary drive screw may not engage with the rotary drive screw thread, and the spring may bias the lock into the locking recess to selectively prevent the firing stroke.

[0286] This locking arrangement can be configured to prevent firing stroke when the staple cartridge is missing and / or when the staple cartridge in the end effector has been used / fired. Furthermore, these arrangements occupy minimal space in the end effector. Additionally, the components can be simple and robust. With the locking nut threaded to the rotary drive screw, only a single additional component in the end effector is required for the locking configuration. In various cases, the locking key provides clinicians with a visual indication that the staple cartridge has been fired.

[0287] See now Figures 108 to 115 The locking arrangement 21868 and its various components are shown. The locking arrangement 21868 is incorporated into a surgical end effector 21840, which is similar in many respects to surgical end effector 20840 (see [link]). Figure 99 Furthermore, the end effector 21840 is adapted to receive the staple cartridge 20800 (see [link]). Figure 103 The end effector 21840 includes a jaw 20850 (see [link]). Figure 99 Similar to the jaw 21850. However, the jaw 21850 also includes a locking recess 21854 defined in the bottom side 21856.

[0288] More specifically, the jaw 21850 includes a bottom side 21856 and a sidewall 21852 forming a channel, the channel being sized and configured to receive the staple cartridge 20800 therein. The locking recess 21854 includes a lateral recess or opening located in the proximal portion of the bottom side 21856. When the rotary drive screw 20842 and the locking nut 21874 thereon are in the non-firing or proximal position, the locking recess 21854 aligns with the locking nut 21874, which is threadedly connected to the rotary drive screw 20842.

[0289] The locking nut 21870 includes a central threaded hole passing through the body portion, opposing flanges 21874, and lugs 21872. The flanges 21874 and lugs 21872 extend radially outward from the body portion. In the unlocked position ( Figure 109B and Figure 111 In the ), flange 21874 extends laterally outward to the inner surface of the bottom side 21856 of the chamber passage 21850 and is positioned to straddle along and / or adjacent to the inner surface. Furthermore, in the unlocked position, lug 21872 is aligned with the upright body portion 20843 of the firing member 20841. In the locked position (see...) Figure 108 , Figure 109A , Figure 115 In the locked position, flange 21874 is rotated to disalign with the inner surface of bottom side 21856, such that one of flanges 21874 rotates into locking recess 21854. Furthermore, in the locked position, lug 21872 is rotated to disalign with the firing alignment of the upright body portion 20843 of firing member 20841.

[0290] The locking nut 21870 is threadedly connected to the rotary drive screw 20842. Rotation of the rotary drive screw 20842 causes the locking nut 21870 to rotate with it, unless rotation of the locking nut 21870 is prevented or blocked. Initially, when the end actuator 21840 is not in use (… Figure 108 and Figure 109A The rotation of the rotary drive screw 20842 is configured to rotate the locking nut 21870, causing one of the flanges 21874 to rotate into its aligned locking recess 21854. When an unused staple cartridge 20800 is installed in the surgical end effector 21840, the locking nut 21854 rotates to the unlocked position. Figure 109B The unlocked position of locking nut 21854 is shown; however, the cartridge is hidden for illustrative purposes.

[0291] See also Figure 111 and Figure 112The locking key 20828 includes a foot 20827 that extends into a space within the housing 20802 above the rotary drive screw 20842. When the non-firing pin cartridge 20800 is mounted in the end effector 21840, the foot 20827 of the locking key 20828 rotates the locking nut 21870 to the unlocked position. More specifically, the foot 20827 includes an inclined surface configured to engage and abut a lug 21872 to bias and rotate the lug 21872 into alignment with the upright body portion 20843. See also: Figure 112 The cartridge 20802 includes a brake 20809 extending toward a longitudinal slot 20808 in the cartridge 20802. The brake 20809 is configured to hold the locking key 20828 in place when the staple cartridge 20800 is inserted into the end actuator 21840.

[0292] The locking key 20828 also defines a molding profile 20829 corresponding to a molding profile track 20807 in the housing 20802. The molding profile track 20807 is configured to prevent rotation of the locking key 20828 when it is pushed distally. In various cases, the foot 20827 forms a recess into which the lug 21872 is received. The foot 20827 rotates the lug 20872 into the unlocked position. Subsequently, during the firing stroke, the lug 21872 may remain engaged with the recess in the locking key 20828 and may push the locking key 20828 distally through the molding profile track 20807. The firing force is sufficient to overcome the brake 20809 to hold the foot 20827 in a proximal position in the housing 20802.

[0293] Additionally or alternatively, the blade 20830 can be pushed distally through the locking key 20828 via the housing 20802. The blade 20830 also includes a forming profile configured to travel through the forming profile track 20807 during the firing stroke without rotating out of firing alignment.

[0294] See now Figure 113 and Figure 114 Upon completion of the firing stroke, the locking key 20828 can be pushed to a distal position within the housing 20802. In the distal position, the locking key 20828 is visible through window 20806 in the housing 20802. For example, the distal nose of the housing 20802 may include window 20806, and the locking key 20828 may be positioned near window 20806 so that the locking key 20828 is visible. The foot 20827 of the locking key 20828 prevents it from falling out of the housing 20802 through window 20808.

[0295] The reverse rotational motion of the rotary drive screw 20842 is configured to retract the firing member 20841. As further described herein, in various cases, the blade 20830 may retract together with the firing member 20841. However, the locking key 21828 may be released from the blade 20830 and may be held in a distal position within the housing 20802. See also: Figure 115 When the firing member 20841 retracts to its proximal position within the housing 20802, the locking nut 21870 also retracts proximally along the rotary drive screw 20842. Due to the direction of rotation of the rotary drive screw 20840 during the retraction motion, the locking nut 21870 does not rotate into the locking recess 21854. In other words, the locking nut 21870 can remain in the unlocked position and move proximally through the locking recess 21854 during the retraction motion. However, if another firing motion is initiated and the direction of rotation of the rotary drive screw 20842 is reversed, the locking nut 21870 will again rotate out of alignment with the firing member 20841 during distal movement in the end effector 21840, and the flange 21874 of the locking nut 21870 can rotate into the locking recess 21854.

[0296] In the locked position, the locking nut 21870 cannot rotate relative to the rotary drive screw 20842 and cannot translate longitudinally through the end actuator 21840. Therefore, the rotational movement of the rotary drive screw 20842 is prevented and the firing stroke is prevented until the locking nut 21870 is in the unlocked position.

[0297] This article is relative to Figures 108 to 115 The described locking arrangement 21868 includes a threaded locking nut 21870 coupled to a rotary drive screw 20842. The displacement of the threaded locking nut 21870 is a function of the rotation of the rotary drive screw 20840. In other cases, the locking arrangement may include a non-threaded lock positioned around the rotary drive screw 20842. See now. Figure 116 and Figure 117 The image shows the locking arrangement 22868 and its various components. The locking arrangement 22868 is incorporated into a surgical end effector 22840, which is similar in many respects to surgical end effector 20840 (see [link to documentation]). Figure 99 End effector 22840 is adapted to receive staple cartridge 20800 (see...) Figure 103 The end effector 22840 includes a jaw 20850 (see [link]). Figure 99Similar to the jaw 22850. However, the jaw 22850 also includes a locking recess 22854 defined in the bottom side 21856. Furthermore, the end effector 22840 includes a firing member 22841 that is similar in many respects to the firing member 20841; however, the integral slider 20860 of the firing member 22841 includes a slider track 22868 having a hole 22868, as further described herein.

[0298] The locking arrangement 22868 includes a lock 22870, which is similar in many respects to the locking nut 21870; however, the lock 22870 is unthreadedly connected to the rotary drive screw 20842. The lock 22870 includes a central unthreaded hole through the body portion, opposing flanges 22874, and lugs 22872. The flanges 22874 and lugs 22872 extend radially outward from the body portion.

[0299] In the unlocked position, flange 22874 extends laterally outward to the inner surface of the bottom side 22856 of the compartment passage 22850 and is positioned to straddle along and / or adjacent to the inner surface. Flange 22874 is received in a hole 22868 in the slider 22860. For example, hole 22868 is a through hole in slider track 20866, sized and positioned to receive the opposing flange 22874 when lock 22870 is in the unlocked position. Therefore, firing member 22841 and its slider track 22868 are configured to pull lock 22870 along rotary drive screw 20842 during the firing stroke. Furthermore, in the unlocked position, lug 22872 aligns with the upright body portion of firing member 22841.

[0300] In the locked position ( Figure 116 and Figure 117 In the locked position, flange 22874 is rotated to disalign with the inner surface of bottom side 22856, such that one of flanges 22874 rotates into locking recess 22854. Furthermore, in the locked position, lug 22872 is rotated to disalign with the firing alignment of the upright body portion of firing member 22841.

[0301] The locking arrangement 22868 also includes a spring 22870 configured to bias the lock 22870 into the locking recess 22854. The locking arrangement 22868 can function like the locking arrangement 21868; however, the spring 22870 biases the lock 22870 into the locking recess 22854, such that the locking arrangement 22868 is always locked unless the non-firing cartridge 20800 is loaded into the end effector 22840 and its locking key 21828 temporarily overcomes the locking arrangement 22868 until the firing stroke is completed. As described above with respect to the locking arrangement 21868, the locking key 21828 is configured to move through the window 20806 in the cartridge 20802 upon completion of the firing stroke to convey the completion of the firing stroke and that the cartridge has been fired / used.

[0302] The shaping pin height is a function of the space between the pin support surface and the pin shaping surface. More specifically, the vertical space between (A) the pin support bracket on the actuator in the firing position and (B) the pin shaping recess surface in the anvil in the clamping position controls the pin shaping height. For example, different shaping pin heights are selected for different surgical procedures and / or different tissue types. When the cartridge includes a rotating firing screw passing through it, the arrangement of the pins, and the corresponding pin chambers and actuators, can be altered to accommodate the rotating firing screw. For example, the actuator may include at least one asymmetry, as further described herein. Additionally or alternatively, the actuator may be narrower, and therefore additional support and / or strength are required. Furthermore, in various cases, it is desirable to optimize tissue clearance while maintaining the desired shaping pin height. For example, when the end effector is in a closed configuration, the tissue clearance between the tissue support platform surface and the anvil can be maximized while maintaining the desired shaping pin height.

[0303] In various configurations, the underside of the tissue support platform may include a shaped and / or indented surface configured to receive one or more portions of the actuator when it is in its fully fired and / or over-driven position. Interlocking and / or nesting between the underside of the tissue support platform and the tissue-facing side of the actuator maximizes tissue clearance while still maintaining the desired shaped pin height. Furthermore, the interlocking feature can improve the actuator's strength in various configurations.

[0304] In one example, the staple cartridge may include a body comprising a tissue support platform, wherein a staple cavity is defined through the tissue support platform within the body, and wherein the tissue support platform includes a tissue-facing side, the tissue-facing side including an uneven or ridged surface. The tissue support platform also includes an underside opposite the tissue-facing side, wherein the underside includes an indentation surface. The staple may be removably positioned within the staple cavity. A driver may movably support the staple and is configured to move a portion through the staple cavity to a firing position to eject the staple from the cavity. Each driver may include a base received within the staple cartridge and includes a surface profile configured to engage with an indentation surface on the underside of the tissue support platform when moved to the firing position.

[0305] See now Figures 38 to 40 The image shows the staple cartridge 22100. The staple cartridge 22100 is similar to the staple cartridge 20100 in many ways. Figure 24 For example, staple cartridge 22100 includes a body 22102 extending along a longitudinal axis A. Staples are removably positioned in the body 22102. Staples can, for example, be ejected from the body 22102 and fired into tissue during the firing stroke. Staples are arranged in a longitudinal row on either side of the longitudinal axis A, which is connected to a rotary drive shaft 22242 extending therethrough. Figure 39 Alignment. For example, the housing 22102 also includes a platform 22104, which may be referred to as a tissue support platform. Platform 22104 is a laterally curved tissue support platform and defines a curved tissue-facing surface from a first lateral side 22101 of the body 22102 to a second lateral side 22103 of the body 22102. A peak 22105 in the laterally curved tissue support platform 22104 is defined at the middle portion of the body 22102. For example, peak 22105 may be positioned between longitudinal rows of pins and cover the longitudinal axis A. In various cases, the rotating firing screw 22242 ( Figure 39 () Extends through part of the staple cartridge 22100.

[0306] The cartridge 22102 also includes an array of recessed extenders or ridges 22114 extending from the tissue support platform 22104. The ridges 22114 extend around a periphery or opening formed in the tissue support platform 22104 for the staple cavity. The ridges 22114 may be configured to clamp and engage tissue positioned between the staple cartridge 22100 and the opposing anvil. For example, in various cases, the ridges 22114 may restrict and / or constrain tissue flow. Additionally or alternatively, the ridges 22114 may be configured to guide the staple legs as they enter the tissue and are guided to engage with corresponding shaped recesses on the staple forming surface of the anvil. For example, the ridges 22114 may extend around the proximal and distal ends of the staple cavity. The proximal and distally positioned protrusions or recessed extensions prevent outwardly biased staple legs (e.g., the legs of a V-shaped staple) from opening outward and missing their target position in the aligned shaped recess.

[0307] In some respects, adjacent ridges 22114 may be connected. For example, ridges 22114 may be interconnected relative to longitudinally offset cavities and / or laterally offset cavities.

[0308] In various cases, the array of laterally offset ridges 22114 can define different heights. In various cases, the ridges 22114 can laterally define different heights along the width of the housing 22102. For example, when the end effector is clamped, different heights can correspond to the lateral curve of the tissue support platform 22104 and / or different lengths and / or tissue gaps used to guide the staples beyond the tissue support platform 22104. Relative to the housing 22102, the ridges 22114 span three laterally spaced rows of staple cavities 22112a, 22112b, 22112c, and the ridge 22114 aligned with the outer row 22112c is higher than the inner rows 22112a, 22112b and will therefore guide the staple legs over a greater distance. However, due to the lateral bending of the tissue support platform 22104 and the non-stepped / non-shaped tissue clamping surface of the anvil, the tissue gap on the outer row 22112c is also larger than the tissue gap on the inner rows 22112a and 22112b.

[0309] The pin is positioned within the cavity defined in the chamber 22102, similar to cavity 20110. Figure 24 For example, the cavity rows 22112 are arranged longitudinally on either side of the longitudinal axis A. The cavity rows 22112 include inner rows 22112a, intermediate rows 22112b, and outer rows 22112c located on each side of the longitudinal axis A. The intermediate rows 22112b may be equidistantly spaced between the inner rows 22112a and the outer rows 22112c. A rotary drive screw 22242 may be aligned with the longitudinal axis A and may extend through the housing 22102 adjacent to the inner cavity rows 22112a. For example, the rotary drive screw 22242 may be located between and parallel to the inner cavity rows 22112a.

[0310] The inner row 22112a holds the inner nail, the middle row 22112b holds the middle nail, and the outer row 22112c holds the outer nail. In various cases, the inner nail, middle nail, and outer nail can be the same. In other cases, for example, the inner nail, middle nail, and / or outer nail can be different with respect to nail type (e.g., wire or stamped), material, and / or size (e.g., different heights).

[0311] In other cases, the staple cartridge 22100 may have different staple arrangements. For example, the staple cartridge 22100 may have fewer than three rows of staples on each side of the longitudinal axis A. In one aspect of this disclosure, the staple cartridge 22100 may have only two rows of staples on each side of the longitudinal axis A. In still other cases, the staple cartridge 22100 may include four or more rows of staples on one or more sides of the longitudinal axis A. In various cases, the rows of staples may be asymmetrical relative to the longitudinal axis A. For example, the first side of the staple cartridge 22100 may have a different number of rows of staples than the second side of the staple cartridge 22100.

[0312] The nail cavities in the housing 22102 may each include a proximal end, a distal end, and a lateral guide surface intermediate between the proximal and distal ends. The structure and dimensions of the nail cavities are configured to guide the actuator 22120 toward the platform 22104 through the nail cavities. See also: Figure 41 The driver 22120 is shown. Furthermore, in... Figure 41 and Figure 42 In the figure, a driver 22120 is shown in the staple cartridge 22100. Although a driver 22120 is depicted in these figures, the reader will understand that an additional driver (such as driver 22120) will be incorporated into the staple cartridge 22100 to fire staples from an additional staple cavity during the firing stroke.

[0313] The geometry of the nail cavity may be complementary to the geometry of the actuator 22120. For example, a lateral guide surface in each nail cavity is configured to guide the sidewall 22134 of the actuator 22120 as the actuator 22120 moves through the nail cavity. Additionally or alternatively, the proximal and / or distal ends of each nail cavity may include upright recesses configured to slidably receive the end of the actuator 22120 and / or its tongue. Alternative arrangements of tongues and recesses are also contemplated, which may be configured to guide the actuator 22120 through the nail cavity during nail firing from the nail cartridge 22100.

[0314] The actuator 22120 is configured to support and drive multiple staples from the cartridge 22102 during the firing stroke. The actuator 22120 can movably support staples spanning two or more longitudinal rows 22112. For example, the actuator 22120 can movably support inner staples, intermediate staples, and outer staples on the same side of the staple cartridge 22100.

[0315] The actuator 22120 is a triple actuator configured to simultaneously drive three pins. The actuator 22120 includes three support posts—an inner support post 22122a configured to support an inner pin in an inner pin row; a middle support post 22122b located laterally outside the inner support post 22122a and configured to support a middle pin in a middle pin row; and an outer support post 22122c located laterally outside the middle support post 22122b and configured to support an outer pin in an outer pin row.

[0316] The actuator 22120 also includes bridging members 22126 extending between adjacent support posts 22122. For example, a first bridging member 22126a extends between an inner support post 22122a and an intermediate support post 22122b, and a second bridging member 22126b extends between an intermediate support post 22122b and an outer support post 22122c. Bridging members 22126a and 22126b each include a sloped lower side 22128 configured to engage drivably by a slider during the firing stroke. For example, slider 22150 ( Figure 39 The slider 22150 may be configured to move along the firing path during the firing stroke. The slider 22150 may include a central portion aligned with the longitudinal axis A, a first track configured to drivably engage the inclined lower side 22128 of the first bridge 22126a, and a second track configured to drivably engage the inclined lower side 22128 of the second bridge 22126b. The slider and its firing motion are further described herein.

[0317] See also Figure 38 and Figure 39 The tissue support platform 22104 includes a tissue-facing side 22115 with an array of ridges 22114, which form an uneven tissue gripping surface. The tissue support surface 22104 also includes a lower side 22116 opposite the tissue-facing side 22115. The lower side 22116 includes an indentation surface having an array of indentations 22118 therein. The indentations 22118 may define a pattern of recesses and / or cavities in the lower side 22116. The tissue support platform 22104 defines a platform height between the uneven tissue-facing side 22115 and the indentation lower side 22116. The platform height varies; however, a certain minimum height around the opening in the platform 22104 provides a minimum amount of guide length for the nail during the firing stroke. For example, if the platform is too thin around the nail cavity, the nail may not be adequately supported during deployment into the tissue and toward the shaped recess.

[0318] When the actuator 22120 moves to the firing position, the actuator 22120 is configured to engage or nest with the underside of the indentation 22116. See again for further details. Figure 41 The bridging members 22126a and 22126b of the actuator 22120 include a protrusion 22130. The protrusion 22130 is a surface profile and protrusion on the upper tissue surface of the bridging members 22126a and 22126b, which faces the inclined lower side 22128 of the bridging members 22126a and 22126b. The protrusion 22130 is configured to be received in an indentation 22118 on the lower side 22116 of the tissue support platform 22104 when the actuator 22120 is moved to its firing position. In the firing position, see primarily [reference needed]. Figure 40 The actuator 22120 is overdriven relative to the platform 22104, such that a portion of the actuator 22120 extends beyond the side 22115 facing the organization and extends out of the compartment 22102.

[0319] The top surfaces of bridging members 22126a and 22126b are symmetrical with respect to the longitudinal center lines of the respective bridging members 22126a and 22126b. The center lines of each bridging member 22126a and 22126b are equidistant from the longitudinal axis defined by the nail support bracket 22124 of the adjacent support column 22122. The protrusion 22130 is symmetrical with respect to the longitudinal center lines of the respective bridging members 22126a and 22126b.

[0320] In other cases, the driver, its bridging components, and / or its top surface may be laterally asymmetrical, as further described herein. See also Figure 42 The drives 22220 and 22200 are similar to drive 22120 in many ways. Figure 41 However, the actuator 22200 defines a lateral asymmetry relative to the interconnecting bridges 22226a, 22226b and their respective top surfaces 22230. The actuator 22220 includes three support posts 22222a, 22222b, 22222c, each having a nail support bracket 22222. Bridges 22226a, 22226b connect laterally adjacent support posts 22222a, 22222b, 22222c. Bridges 22226a, 22226b include a sloping lower side 22228, which is driven by a slider during the firing stroke, as further described herein. The top surface 22230 of bridges 22226a, 22226b includes a diagonal surface and is asymmetric relative to the centerline passing through bridges 22226a, 22226b and is aligned with the firing path of the slider track during the firing stroke. The centerlines of each bridging element 22226a, 22226b are equidistant from the axis aligned with the adjacent nail support bracket 22224 and the base / crown of the nail therein.

[0321] The top surface 22230 of each bridging member 22226a, 22226b includes a laterally inclined top surface that is configured to complement a portion of the molded underside of the tissue support platform, such as the indentation underside 22116. Figure 39 and Figure 40 This type of bridging configuration provides improved post-to-post support, which allows the entire bridging 22226a, 22226b to be thinner while adequately supporting nails across multiple rows.

[0322] exist Figure 43 An anvil 22370 for a surgical end effector is shown. The anvil 22370 includes a tissue compression surface 22374 and a pair of pin-forming recesses 22372 formed in the tissue compression surface 22374. Each pair of pin-forming recesses 22372 includes a proximal recess 22372a and a distal recess 22372b. The recesses can be aligned with the legs of a pin (e.g., the line leg of the pin). During the firing stroke, the tip of the pin leg can be received within the pin-forming recess 22372 and formed, for example, a B-shaped pin. In some aspects of this disclosure, the length of the pin-forming recess 22372 can be configured to match the line diameter of the pin aligned with it. For example, the proximal recess 22372a and distal recess 22372b of the first pair of nail-forming recesses 22372 in the anvil 22370 may have a first recess length, while the proximal recess 22372a and distal recess 22372b of the second pair of nail-forming recesses 22372 in the anvil 22370 may have different recess lengths. The first recess length may correspond to a nail wire diameter different from the second recess length. In various respects, a larger wire diameter nail may correspond to a shorter recess length.

[0323] The space d between the proximal recess 22372a and the distal recess 22372b in a pair of nail forming recesses 22372 can be minimized in certain situations to maximize the longitudinal forming length of the nail. Typically, the nail excessively bends during the forming process to compensate for springback. However, when the forming recess is shorter and therefore, in some cases, steeper, excessive bending of the nail can be reduced. Shorter and steeper nail recesses that define a larger space or gap d between the proximal recess 22372a and the distal recess 22372b in a pair of nail forming recesses 22372 can reduce springback. For example, shorter and steeper nail recesses allow for greater bending of the nail legs and greater plastic deformation of the nail to reduce springback. Furthermore, in some cases, shorter and steeper nail recesses can improve continuous nail leg bending. See also Figure 43 In the space d, the proximal recess 22372a and the distal recess 22372b in a pair of nail-shaped recesses 22372 can be shortened and the entire pair can maintain the same length L, so that a larger space d is defined between the proximal recess 22372a and the distal recess 22372b.

[0324] For example, in end effectors, the pins and / or actuators can vary between rows. In some cases, the pins can be shorter, including different wire diameters, lifted by actuators with different heights and / or different overdrive amounts. In some cases, as described above, shorter pin forming recesses can be utilized with a pin row in the same anvil and with non-adjacent pin rows. For example, shorter pins can utilize shortened recesses to improve the bending of consecutive pin legs, such as two consecutive bends on each pin leg to present a B-shape. In still other cases, pins along the inner pin row (i.e., adjacent to the longitudinal tool path) can utilize shortened recesses to allow the pin to bend more plastically and reduce springback to form a tighter row. In these cases, Figure 43 The distance d in the middle can vary between rows.

[0325] For example, pinning (such as pinning 20100 ( Figure 24 ) and pinning 22100 ( Figure 39 This includes components with minimum size constraints to ensure appropriate strength, stiffness, support, and / or manufacturing requirements are met. These minimum size constraints can make optimization and / or increase tissue clearance difficult, considering other constraints on surgical end effectors. For example, in some cases, the minimum height of the tissue support platform is 0.01 inches due to molding constraints. As another example, in some cases, the minimum height of the bridging between support posts on the actuator is 0.022 inches due to actuator strength constraints. As another example, in some cases, the minimum height of the actuator (e.g., its support posts) is 0.066 inches due to actuator rolling constraints. As another example, the minimum height of the staple leg is 0.166 inches in some cases, 0.160 inches in others, 0.150 inches in others, 0.102 inches in others, and 0.085 inches in still others, depending on the type of staple cartridge and target tissue. As another example, the minimum thickness of the anvil is 0.134 inches, and in some cases, 0.154 inches due to anvil stiffness and strength constraints. Given such minimum size constraints, it may be advantageous in some cases to reduce the minimum size limit and / or to repeatedly count certain size limits or portions thereof in the component stack.

[0326] For example, in some cases, portions of the actuator may be nested within a recess in the underside of the tissue support platform to reduce certain minimum size constraints. In various cases, to ensure the tissue support platform maintains an appropriate height, the recess may be aligned, for example, with a localized area along the tissue support platform that provides increased height, such as below the recessed extender / tissue gripper ridge. In other cases, one or more additional recesses in the underside of the tissue support platform may be configured to receive portions of the actuator and / or its bridging elements. For example, in Figure 39The diagram illustrates an exemplary interlocking feature between the inner surface of the staple cartridge and the actuator. Other actuator features may similarly be received within corresponding recesses on the underside of the tissue support platform.

[0327] To reduce the vertical stacking size of multiple components, staple cartridges (such as staple cartridge 20100) Figure 24 ) and pinning 22100 ( Figure 39 The tissue support platform may, for example, have predefined spacing holes through it, which may be separate from and distinct from the staple cartridge. Predefined holes along the length and / or width of the staple cartridge may receive features of the actuator (e.g., portions of a bridging member) in the fully fired position of the actuator and in over-driven positions in various cases. Additionally or alternatively, the tissue support platform may include a brittle position or “breakable position” configured to physically break by the actuator when moved to its fully fired position.

[0328] Additionally, for example, pinned storage (such as pinned storage 20100 ( Figure 24 ) and pinning 22100 ( Figure 39 It may also include features that can be selectively compressed and expanded to reduce the vertical stacking size. Drives and / or housings may include such features.

[0329] For example, a vertically expandable actuator can be configured to reduce the actuator's resting or non-firing height within the cartridge. The actuator can be telescopic and, when in the non-firing position, limited to approximately 50% of its final height. In such cases, the nail can be positioned at a lower position within the cartridge before firing. In some cases, a first portion of the sliding track activates the actuator by overcoming a significant snap-fit ​​feature with the actuator body and expanding it to its final height. A second portion of the sliding track then completes the firing of the actuator to eject the nail supported thereon from the cartridge. The first portion of the sliding track may be narrower than the second portion of the sliding track.

[0330] Additionally or alternatively, the tissue support platform may include a height-variable injection-molded platform that is compressible when a predefined tissue load is applied to increase tissue clearance. When the slider fires the actuator and pins, the slider and / or actuator can momentarily push the platform back into the tissue to the increased height to temporarily reduce tissue clearance. The tissue support platform can then relax or otherwise return to a compressed state, corresponding to the increased tissue clearance after the slider has passed.

[0331] For example, the chamber or its tissue support platform may include selectively positioned wall segments that may be thin and configured to buckle under predefined tissue loads while still maintaining proper alignment between the pin and the pin-forming recess in the anvil. In some cases, an electro-actuating material (e.g., an electroactive polymer) may be incorporated into the tissue support platform. When an electric current is applied thereto, a component or feature formed by such a material may become flexible and / or more compressible, and when no current is applied, the component or feature may become rigid and / or less compressible. In some cases, portions of the actuator may be received within the tissue support platform when the material is excited and thus deformable to accommodate additional structures therein.

[0332] In some cases, for example, 4D printed materials can be beneficial for staple cartridges (such as staple cartridge 20100). Figure 24 ) and pinning 22100 ( Figure 39 Selective collapse of the tissue support platform. For example, the cartridge may include 4D-printed material printed on its top or upper portion. The 4D-printed material may be heat-sensitive. In some cases, the material may have a glass transition point between room temperature and body temperature. For example, when the cartridge is clamped onto tissue, the material may become soft and deflectable, thereby increasing tissue gaps. In such cases, increased heat from the patient may increase the heat of the 4D-printed material to achieve a shape change. When the cartridge subsequently cools (e.g., removed from heat transfer contact with tissue), the 4D-printed material may return to its original shape and / or height. For example, the tissue support platform may be higher in the original and restored states than in the heated and collapsed states. For example, the increased height in the original and restored states may ensure that the staples stored in the cartridge remain protected and do not protrude from the cartridge before being fired.

[0333] See now Figure 44 The deformation and recovery process 22400 of a 4D-printed matrix 22402 for use on a silo is described. During the shape programming phase 22490, the 4D-printed matrix 22402 is heated, deformed from its original configuration to a deformed configuration 22402', and then cooled. During the shape recovery phase 22492, the 4D-printed matrix 22402' is heated and returned to its original configuration 22402, and then cooled. The shape programming and recovery of 4D printing materials are further described in the article "4D Printing Reconfigurable, Deployable and Mechanically Tunable Metamaterials" by Chen Yang et al., published in Materials Horizon, Vol. 6, 2019.

[0334] In some cases, the 4D-printed matrix can be used in combination with, for example, foldable or collapseable actuators as further described herein. For instance, a 4D-printed matrix on a staple cartridge can be configured to selectively fold interference actuator features to merge and / or compress the covering area and stack within the staple cartridge at a specific temperature. The interference features can then unfold upon extraction from the interference state, such as when the cartridge returns to its original undeformed state. In various respects, the actuator can fully expand when the staple is actively lifted and fired. In some cases, the actuator may encounter an interference surface near its fully fired position, and the upper portion of the actuator may be configured to fold into itself. In some cases, the 4D matrix may form the interference surface.

[0335] Users may want to quickly and easily install the cartridge into the channel of the end effector or disposable loading unit during surgical procedures. A secure connection may also be desired. Some secure connections may require clinicians to overcome significant resistance and / or friction between interfering components. Additionally or alternatively, a secure connection may have minimal spacing and require precise alignment of the components by the clinician. While a secure connection between the cartridge and the channel may be desired, it may be helpful to make cartridge installation faster, easier, and / or require less force and / or effort from the clinician's perspective.

[0336] In some cases, the suture assembly may include levering features that facilitate mounting the staple cartridge into the channel. For example, the channel and the staple cartridge may include complementary geometric alignment features. When the alignment feature of the staple cartridge is placed against the alignment feature of the channel, the alignment feature of the channel provides a fulcrum or abutment surface around which the staple cartridge leverages to properly align the staple cartridge with the channel. Once the staple cartridge is properly aligned due to the abutment relationship between the alignment features, additional alignment features (e.g., distal lugs and notches) may facilitate further connection between the staple cartridge and the channel.

[0337] In some cases, the spring may distally bias the cartridge along a longitudinal axis perpendicular to the insertion axis to fully and securely position the cartridge in the channel. Additionally or alternatively, the distal firing force during the firing stroke may further distally displace the cartridge to interconnect the inclined surfaces on the alignment features (e.g., the distal edges of the distal lugs and notches). Alternative spring-loaded and / or resilient features are envisioned to further secure the cartridge to the channel when it is properly positioned relative to the channel. In some cases, a user-actuated release may be configured to release one or more resilient attachment features between the cartridge and the channel. In other cases, the firing stroke may result in the release and / or breakage of one or more resilient attachment features.

[0338] In one example, the suture assembly may include a staple cartridge comprising a body defining a longitudinal axis, wherein the body includes a proximal cartridge alignment feature and a distal cartridge alignment feature. The suture assembly may also include a channel sized to receive the staple cartridge, wherein the channel includes sidewalls comprising a proximal channel alignment feature and a distal channel alignment feature, positioned to receive the distal cartridge alignment feature when the proximal cartridge alignment feature is positioned abutting against the proximal channel alignment feature and the staple cartridge is moved along the insertion axis to a first position within the channel. The insertion axis may be perpendicular to the longitudinal axis. A spring may be configured to bias the staple cartridge distally along the longitudinal axis within the channel from the first position to a fully seated position. The proximal alignment feature may include a shaped abutment surface. The distal alignment feature may include a notch and a lug having complementary wedge-shaped distal ends.

[0339] In various situations, improved cartridge retention and release features can increase engagement retention force while allowing the user to release the cartridge from the channel with significantly less force. For example, the user can quickly and easily remove the cartridge from the channel by sliding it proximally against minimal spring force. In some cases, the force required to remove a used or fired cartridge may be less than the force required to remove a new, non-fired cartridge. For example, the firing stroke, or even a portion thereof, can be configured to disengage and / or release certain resilient attachment features that connect the cartridge to the channel.

[0340] See now Figure 45 The diagram illustrates a suture assembly 24000. The suture assembly 24000 includes a channel 24050 and a staple cartridge 24100 removably positioned within the channel 24050. The staple cartridge 24100 is a disposable, single-use component configured to be removed from the channel 24050 after the firing stroke and associated surgical procedure. The channel 24050 may be reusable and configured to receive a replacement staple cartridge assembly therein. In other cases, the staple cartridge 24100 may be removed from the channel 24050, loaded with additional staples, and reinstalled in the channel 24050. In some cases, the channel 24050 may be a component of a disposable loading unit and / or a modular suture assembly including an anvil and / or shaft portions.

[0341] Ding Container 24100 is similar to Ding Container 20100 in some respects. Figure 24For example, staple cartridge 24100 includes a cartridge body 24102 having a tissue support platform 24104, staples 24160 removably positioned in the cartridge body 24102, and an actuator 24120 movably supporting the staples 24160. The staples 24160 include end-to-end bases, and the bases of the staples 24160 are oriented at an angle relative to a longitudinal axis A along the length of the staple cartridge 24100. The staples 24160 may be configured to form flexible staple threads that allow for a degree of torsion and / or stretching while minimizing damage to tissue. In some cases, the cartridge body 24102 may include a plurality of longitudinal rows of staples having longitudinally aligned staples arranged parallel to the longitudinal axis A, as further described herein.

[0342] The housing 24102 includes at least one alignment bump 24162 having a proximal alignment surface 24164. In various cases, the alignment bump 24162 may project laterally from each side of the housing 24102. The proximal alignment surface 24164 defines a curved proximal edge of the alignment bump 24162. In various cases, the alignment bump 24162 on either side of the housing 24102 may be symmetrical about the longitudinal axis A.

[0343] The chamber 24102 also includes an alignment lug 24166 having a proximal end 24168 and a distal end 24170. An alignment lug 24166 is positioned on each side of the chamber 24102. The proximal end 24168 defines an upright or vertical surface relative to the tissue support platform 24104. The distal end 24170 of the alignment lug 24166 defines a wedge shape with an inclined distal surface. The inclined distal surface may form a narrower dimension along the platform 24104 and a wider dimension at the opposite ends of the alignment lug 24166. In various cases, the alignment lug 24166 may be positioned on each side of the chamber 24102, and the alignment lug 24166 may be symmetrical about the longitudinal axis A. The alignment lug 24166 is closer to the distal end of the chamber 24102 than the alignment bump 24162.

[0344] Channel 24050 includes lateral sidewalls 24052 forming a U-shaped channel. The staple cartridge 24100 can be releasably secured within the U-shaped channel between the sidewalls 24052. Other portions of the sidewalls 24052 and / or channel 24050 may include resilient snap-fit ​​features for engaging the staple cartridge 24100. Each sidewall 24052 includes an alignment feature 24054 that includes a proximal alignment profile 24056. The proximal alignment profile 24056 includes an edge configured to engage the proximal alignment surface 24164 of the alignment protrusion 24162. The proximal alignment profile 24056 resists longitudinal displacement of the alignment protrusion 24162 in the proximal direction beyond the proximal alignment profile 24056. As further described herein, the alignment feature 24054 can be used as a fulcrum or support, around which the staple cartridge 24100 acts as a lever during insertion and installation into the channel 24050.

[0345] Channel 24050 also includes an alignment notch 24058 having a proximal end 24060 and a distal end 24062. The alignment notch 24058 is positioned on each side of channel 24050. The proximal end 24060 defines an upright or vertical surface in sidewall 24052, and the distal end 24062 defines another upright surface in sidewall 24052 that is not parallel to the vertical surface at the proximal end 24060. The upright surface defining the distal end 24062 of alignment notch 24058 may define a skewed or inclined distal surface that may form a wedge shape having a narrower dimension along the upper edge of sidewall 24052 and a wider dimension at the opposite end of notch 24058. In various cases, alignment notch 24058 may be positioned symmetrically about longitudinal axis A. The alignment notch 24058 is closer to the distal end of the housing 24102 than the alignment protrusion 24162. As further described herein, the position and size of each alignment notch 24058 are configured to receive one of the alignment lugs 24166 therein.

[0346] The alignment features between channel 24050 and staple cartridge 24100 are configured to interact to facilitate quick and easy installation of staple cartridge 24100 into channel 24050. For example, to quickly align alignment lug 24166 with alignment notch 24058, a clinician can pull alignment lug 24162 proximally to engage with the corresponding alignment feature 24054 on channel 24050. The proximal alignment contour 24056 on the proximal alignment feature 24054 acts as a longitudinal stop, preventing further proximal displacement of staple cartridge 24100 relative to channel 24050. The shaped proximal edge 24164 of alignment lug 24162 can match or complement the shaped contour of proximal alignment contour 24056. When the complementary contours engage, the alignment lug 24166 also aligns with its corresponding alignment notch 24058.

[0347] Spring 24172 is positioned between the upright surface of the alignment lug 24166 and the upright surface of the alignment recess 24060. More specifically, spring 24172 is positioned between the proximal end 24168 of the alignment lug 24166 and the proximal end 24060 of the alignment recess 24060. Spring 24172 is configured to distally bias the angled distal end 24170 of the alignment lug 24166 into mating contact with the angled distal end 24062 of the channel 24050 when the staple cartridge 24100 is inserted into the channel 24050. When the alignment protrusion 24162 abuts against the proximal alignment profile 24056 and the staple cartridge 24100 and its alignment lug 24166 move into the channel 24050 along the mounting direction 24101 parallel to the mounting axis I, the spring 24172 can be compressed between the upright proximal end 24060 of the alignment recess 24060 and the upright proximal end 24168 of the lug 24166. The mounting axis I is perpendicular to the longitudinal axis A.

[0348] In use, when the staple cartridge 24100 moves into the channel along the mounting axis I, the cartridge body 24102 and its protrusion 24162 can act as levers against the proximal alignment profile 24056 of the channel 24050. The proximal lever position of the alignment profile 24056 improves the mechanical advantages of mounting the staple cartridge 24100 and its distal lug 24166 into the channel 24050. When the staple cartridge 24100 moves into the first position or insertion position along the mounting direction 24101, the protrusion 24164 can slide downward into the channel 24050. After the staple cartridge 24100 has moved to the first position (where the staple cartridge 24100 is inserted but not fully seated in the channel 24050), the spring 24172 is configured to displace the staple cartridge 24100 distally in a direction parallel to the longitudinal axis L to the second position (where the staple cartridge 24100 is fully seated in the channel 24050).

[0349] See also Figure 47 Spring 24172 is a leaf spring. Spring 24172 is a cantilever spring having a first end attached to the alignment lug 24166, a second end opposite the first end, and a curved portion between the first and second ends. The curved portion defines an S-shaped curve that can be compressed by the clinician with minimal force and / or effort when the proximal alignment profiles 24056, 24164 are aligned and the staple cartridge 24100 is proximally abutted against the alignment feature 24054. Upon release of the leverage and compressive force on spring 24172, spring 24172 is configured to cause the staple cartridge 24100 to recoil distally relative to the channel 24050 and biased to a fully seated position. Figure 48 )middle.

[0350] In the fully relocated location ( Figure 48 In the alignment lug 24166 and the distal inclined ends 24062 and 24170 of the alignment notch 24058 are respectively engaged. The undercut geometry of the distal ends 24062 and 24170 is configured to secure the staple cartridge 24100 in the channel 24050 until the spring 24172 is compressed by the force applied by the user to pull the staple cartridge 24100 proximally along the longitudinal axis A and then pull the staple cartridge upward in a direction 24103 parallel to the mounting axis I and opposite to the mounting direction 24101 to remove the staple cartridge 24100 from the channel 24050.

[0351] In some cases, the firing element is configured to apply a distal force to the staple cartridge 24100 during the firing stroke to further secure the staple cartridge 24100 within the channel 24050. For example, when the staple cartridge 24100 is pushed distally, the tilting distal ends 24062, 24170 can create an interlock between the staple cartridge 24100 and the channel 24050. In some cases, even without the distal biasing force of the spring 24172, the distal firing force of the tilting distal ends 24062, 24170 and the undercut geometry can secure the staple cartridge 24100 to the channel 24050. For example, the suture assembly 24000 may not include a spring configured to bias the staple cartridge 24100 relative to the channel 24050 in the direction of the firing stroke. The reader will understand that in a suture assembly utilizing a distal-to-proximal firing stroke, for example, the undercut interlock between the staple cartridge 24100 and the channel 24050 can be located at the proximal ends 24168 and 24060 of the alignment lug 24166 and the alignment notch 24058, respectively.

[0352] See also Figures 47 to 48The diagram illustrates a suture assembly 24000, wherein an anvil 24090 is in a clamping configuration relative to a channel 24050 and the staple cartridge 24100 is fully housed therein. The cartridge body 24102 includes a distal nose 24103 having a lock 24180. The lock 24180 includes a latch arm 24182 located on the underside of the cartridge body 24102. The latch arm 24182 is configured to overlap a portion of the channel 24050 when the staple cartridge 24100 is fully housed in the channel 24050. For example, the channel 24050 includes a lug or shelf 24082 located on its underside facing the latch arm 24182. The lock 24180 can be in a first position ( Figure 49 The device moves between a first position and a second position, in which the latch arm 24182 secures the distal nose 24103 of the cartridge 24102 to the distal end of the channel 24050 via the overhanging shelf 24082, and in the second position, the latch arm 24182 releases the shelf 24082, thereby facilitating the release of the staple cartridge 24100 from the channel 24050.

[0353] Lock 24180 also includes a release button 24184 facing the anvil, opposite the latch arm 24182. The release button 24184 facing the anvil may be flush or substantially flush with the top surface of the distal nose 24103. The release button 24184 facing the anvil may be pressed by a clinician to drive lock 24180 downward and / or distally, thereby releasing latch 24182 from engagement with shelf 24082. In some cases, lock 24180 may be made of a resilient and / or deformable material that can flex to move latch arm 24182 to a second position upon receiving user input on the release button 24184 facing the anvil. In other cases, lock 24180 may pivot relative to the housing 24102 to move latch arm 24812 to the second position.

[0354] In other cases, the distal nose of the compartment can be deflected to releasably engage the retaining feature along the distal edge of the elongated channel. For example, see now. Figure 50 The diagram shows a suture assembly 24200, in which anvil 24190 is in a clamping configuration relative to channel 24050 and staple cartridge 24300 is fully housed therein. Staple cartridge 24300 is identical to staple cartridge 24100; however, the distal nose 24301 is constructed of a flexible material or a flexible portion, or the flexible portion forms a lock 24380 with a latching arm configured to flex to engage and disengage with a shelf 24082 on the underside of channel 24050. In some cases, the entire distal nose 24301 may be flexible to facilitate the flexing of the latching arm 24382 to disengage from the lug 24082. In other cases, only the lock 24380 and / or its latching arm 24382 are sufficiently flexible to disengage from the lug 24082.

[0355] In various cases, the housing 24302 can be a composite housing composed of different materials in different regions, such that the flexibility of the integral composite housing can vary between regions. For example, the housing 24302 can be 3D printed and includes flexible and / or elastic materials for the lock 24380 and / or latch arm 24382, as well as lower flexible and / or lower elastic materials for adjacent regions within the housing. Additionally or alternatively, in some cases, adjacent portions may be printed with a material having the same or similar relatively low stiffness as the lock 24380 and / or latch arm 24382; however, embedded metal within the housing (such as a metal frame and / or longitudinal supports) can increase the overall strength and stiffness of the housing.

[0356] Additional alignment and retention features are envisioned between the staple cartridge and the channel, which improve the retention and release of the staple cartridge relative to the channel. These features improve the ease of alignment and the force required to remove the staple cartridge from the channel, while maintaining sufficient retention force between the staple cartridge and the channel. These additional alignment and retention features can be combined with the proximal alignment features between the staple cartridge and the channel, as further described herein.

[0357] Figure 51 The suture assembly 25000 is shown. The suture assembly 25000 is similar in many respects to the suture assembly 24000 and includes a staple cartridge 25100 and a channel 25050; however, the suture assembly includes an alternative proximal alignment and retention feature between the staple cartridge 25100 and the channel 25050. Additionally, the staple cartridge 25100 includes a longitudinal row of staple cavities located within its cartridge body 25102 and longitudinal alignment staples positioned within the cavities. The staple cavities are oriented parallel to the longitudinal axis A along the longitudinal slot and centerline of the cartridge body 25102.

[0358] The compartment 25102 includes an alignment lug 25166, which includes a proximal end 25168 and a distal end 25170. The alignment lug 25166 can be positioned on each side of the compartment 25102. The proximal end 25168 can define an upright or vertical surface, and the distal end 25170 can also include an upright or vertical surface. The upright surfaces defining the proximal end 25168 and the distal end 25170, respectively, can be parallel or substantially parallel. In various cases, the alignment lug 25166 can be positioned on each side of the compartment 25102, and the alignment lug 25166 can be symmetrical about a centerline passing through the compartment 25102.

[0359] The staple cartridge 25100 also includes a lateral pin 25180 that protrudes outward from the cartridge body 25102. Another symmetrically positioned lateral pin 25180 may protrude laterally outward on the other side of the cartridge body 25102.

[0360] Channel 25050 includes lateral sidewalls 25052 forming a U-shaped channel. A staple cartridge 25100 can be releasably secured within the U-shaped channel between the sidewalls 25052. Channel 25050 also includes an alignment notch 25058 comprising a proximal end 25060 and a distal end 25062. The alignment notch 25058 can be positioned on each side of channel 24050 to receive a corresponding alignment lug 25166. The proximal end 24060 defines an upright or vertical surface in the sidewall 24052, and the distal end 24062 defines another upright surface in the sidewall 24052. The upright surfaces can be parallel or substantially parallel.

[0361] In other cases, the distal ends 25062 and 25170 of the aligned notches 25058 and 25166 may be undercut, as further described herein, to further secure the staple cartridge 25100 to the channel 25050 when the staple cartridge 25100 is fully positioned in the channel 25050.

[0362] Channel 25050 also includes a slot 25084 defining an internal track for the lateral pin 25180. Slot 25080 includes a V-shaped or tapered inlet portion 25082 extending parallel to the insertion direction of the cartridge 25100 and an end portion 25084 extending parallel to the longitudinal axis of the cartridge body. The V-shaped inlet portion 25082 provides a wider inlet area 25083 for the lateral pin 25180 to enter the slot 25084, ensuring that clinicians do not need to align the cartridge 25100 with the channel 25050 with strict accuracy. Furthermore, the wider inlet area 25083 of the slot 25084 defines a greater range of longitudinal positions for aligning the alignment lug 25166 with the inlet area 25063 of the alignment notch 25058 compared to the permissible range of longitudinal positions.

[0363] The alignment features between channel 25050 and staple cartridge 25100 are configured to interact to facilitate quick and easy insertion of staple cartridge 25100 into channel 25050. For example, to quickly align alignment lug 25166 with alignment notch 25058, a clinician can position staple cartridge 25100 at any location within a wide range of longitudinal positions to position lateral pin 25180 in the inlet portion 25083 of slot 25080. As lateral pin 25180 moves along the narrowing track of V-shaped portion 25082 of slot 25080, lug 25166 can converge to align with alignment notch 25058.

[0364] In various situations, the cartridge 25100 can fall into the channel 25050 with minimal interference or frictional resistance. For example, the cartridge 25100 may not be secured to the channel 25050 by a robust frictional fit feature between the cartridge 25100 and the channel 25050. Instead of such a frictional fit feature or otherwise, the geometry of the slot 25080 can secure the cartridge 25100 in the channel 25050. For example, the frictional force applied to the cartridge 25100 during the proximal to distal firing stroke can cause the lateral pin 25180 to move distally along the end portion 25084 of the slot 25080 and displace the cartridge 25100 distally in the channel 25050. In such cases, the firing force can move the lug 25166 to its furthest position, flush with the distal end 25062 of the alignment notch 25058.

[0365] In all cases, to remove the used staple cartridge 25100 from channel 25050, the clinician can pull the staple cartridge 25100 proximally to remove the lateral pin 25180 from the end portion 25084 of slot 25080. As the staple cartridge 25100 is moved proximally by the clinician (requiring minimal force and effort), the clinician can quickly and easily lift the staple cartridge 25100 out of channel 25050.

[0366] exist Figure 52 and Figure 53 An alternative latching mechanism between the staple cartridge 26100 and the channel 26050 for the suture assembly 26000 is shown. The staple cartridge 26100 is similar in many respects to the various staple cartridges described herein and may include a cartridge body 26102 having staples and staple support actuators movably positioned within the cartridge body 26102. The channel 26050 includes opposing sidewalls 26052 forming a U-shaped channel profile, which are configured to receive the staple cartridge 26100 therebetween or at least substantially therein. For example, the staple cartridge 26100 includes a lateral latching arm 26180 configured to releasably engage a lateral recess 26080 along the outer surface of the sidewall 26052.

[0367] The latch arm 26180 extends along the lateral side of the staple cartridge 26000 and may be integrally formed (e.g., molded) with the cartridge body 26102. For example, the cartridge body 26102 and the latch arm 26180 may be a single, integral component. In various cases, the latch arm 26180 may be deflectable. The latch arm 26180 includes a user-actuated button 26182 and a latching member 26184. The latching member 26184 is longitudinally offset from the user-actuated button 26182. A lever arm extends between the user-actuated button 26182 and the latching member 26184 such that actuation of the button 26182 is configured to deflect the latching member 26184. For example, an inward actuation of the button 26182 is configured to deflect the latching member 26184 outward, disengaging it from engagement with the lateral recess 26080. In some cases, the deflection of the latch 26184 when the clinician actuates button 26182 is configured to remove the latch 26184 from the recess 26080. In other cases, the latch 26184 can be moved to a position with less engagement relative to the recess 26080 and thus easier to overcome. The clinician can apply a pinching motion to button 26182 to actuate both buttons 26182 simultaneously and deflect both latches 26184 out of engagement with the recess 26080.

[0368] In various configurations, to install the staple cartridge 26100 in the channel 26050, the staple cartridge 26100 can be moved upright in the insertion direction until a portion of the cartridge body 26102 rests in the channel 26050. In this position, the latching arm 26180 can be aligned with the longitudinal guide along the outer surface of the sidewall 26052. As the cartridge body 26102 slides proximally toward the fully positioned location in the channel 26050, the latching arm 26180 moves along the longitudinal guide and the latching member 26184 engages in the recess 26080 to secure the staple cartridge 26100 in the fully positioned location. When the staple cartridge 26100 is fully positioned in the channel 26050 and the latching member 26184 engages or locks in the recess 26080, the width of the suture assembly remains within conventionally sized trocars (e.g., a 12mm profile). In order to release the staple cartridge 26100 from the channel 26050, the clinician pinches the button 26182 to offset the latch 26184 outward from the recess 26080, so that the clinician can remove the staple cartridge 26100 by pulling it distally along the longitudinal axis A and / or pulling it vertically away from the channel 26050.

[0369] In some cases, the housing 26102 is made of plastic and the latch arm 26180 is also made of plastic. For example, the housing 26102 and the latch arm 26180 may be molded composite plastic parts.

[0370] In other cases, the latch body can be a composite component of plastic and metal. For example, the latch arm can be a metal spring formed together with the latch body. The latch arm can be an insert-molded metal arm. In some cases, metal latch arms can provide a larger spring constant and a more snap-fit ​​latch feature compared to plastic arms.

[0371] In some cases, the suture assembly may include a fragile cartridge retaining feature configured to hold the cartridge in place within the channel until intentionally destroyed by the user. For example, a clinician may intentionally destroy the cartridge retaining feature and / or the feature may be destroyed during the firing stroke, such as at or near completion of the firing stroke. Destruction of the fragile cartridge retaining feature reduces the retaining force between the cartridge and the channel, allowing the clinician to remove the cartridge with less force. In various cases, when the fragile feature is destroyed, it remains attached to the cartridge body. For example, see again... Figure 50 The lock 24380 may include a fragile portion that is configured to break but not fall off when a user applies an intentional action to the staple cartridge to remove it from the channel.

[0372] In some cases, the cartridge may include a brake that engages with the channel and releases from the channel upon completion of the firing stroke. See now. Figures 54 to 59 The image shows the staple cartridge 26200, which is similar in many ways to the staple cartridge 20100. Figure 24 For example, staple cartridge 26200 includes a cartridge body 26202, which includes a tissue support platform 26204 having staple cavities defined therein; the staple cavities are arranged in three longitudinal rows 26212a, 26212b, 26212c on each side of a rotary drive screw 26242, which is similar in many respects to a firing screw 261 (see...). Figure 4 and Figure 5 The staples in the staple cartridge 26200 are supported by the actuator 26220, which is similar in many ways to the triple actuator 20120. Figure 26 For example, the actuator 26220 includes three parallel nail support brackets configured to support nails, such that the actuator 26220 is configured to fire nails simultaneously from the inner row 26212a, the middle row 26212b, and the outer row 26212c.

[0373] The staple cartridge 26200 includes a releasably engaging brake 26280 that engages the channel. The brake 26280 can be configured in a locking configuration ( Figures 54 to 57 ) and unlock configuration ( Figure 58 and Figure 59The passage 20852 can move between these components. In some cases, the inward-facing side of the passageway sidewall adjacent to the compartment 26202 may include a recess sized and configured to receive the brake 26280 in a locked configuration. For example, passageway 20852 ( Figure 99 This includes a distal recess 20853. The recess is configured to retain the brake 26280 relative to the channel and thus retain the staple cartridge 26200 until the brake 26280 moves to the unlocked configuration. In other cases, the outward bias of the brake 26280 against the channel sidewall is configured to frictionally engage the channel without placing the brake 26280 in the recess. Opposite brakes 26280 on opposite sides of the staple cartridge 26000 are configured to frictionally engage the channel to retain the staple cartridge 26000 therein.

[0374] The brake element 26280 is housed in the farthest nail cavity 26210 within the outer outlet 26212c. A through-hole 26205 is defined in the outer wall 26203 of the housing 26202, extending into the farthest nail cavity 26210 within the outer outlet 26212c. When the brake element 26280 is in the locked configuration (… Figures 54 to 57 When activated, the brake 26280 aligns with the through hole 26205 and protrudes from the housing 26202 at the through hole 26205. The rod 26282 extends from the brake 26280 and is operatively engaged with the actuator 26220 in the distal nail cavity 26210.

[0375] When the farthest driver 26220 is in the non-firing position ( Figures 54 to 57 When the farthest actuator 26200 is in this position, it can bias the brake 26280 into the locked position. See now. Figure 58 and Figure 59 Upon completion of the firing stroke, as the distal actuator 26200 is lifted by the slider through the nail cavity and toward the tissue support platform 26204, the distal actuator 26220 can move away from the brake 26280 and engage the lever 26282. As the distal actuator 26220 moves along the lever 26282, the actuator 26220 is configured to laterally bias the lever outward, causing the brake 26280 to pivot inward into and / or through the through-hole 26205 and disengage from the channel. In this case, upon completion of the firing stroke, the distal actuator 26220 releases the latching feature, i.e., the brake 26280.

[0376] In some cases, multiple actuator-releasable brake elements may be positioned along the length of the housing 26202. In other cases, longitudinally staggered and / or longitudinally symmetrical brake elements may be positioned along both sides of the housing 26202. In addition to actuating the releasable brake element 26280, in some aspects of this disclosure, the slider may be configured to release the snap-fit ​​or brake element feature. Furthermore, in some cases, the actuator may be configured to engage or disengage the brake element 26280 and / or its lever 26282 during the firing stroke to release the attachment feature.

[0377] In various cases, the staple cartridge assembly described herein may include a actuator retaining feature configured to prevent the actuator from being released from the cartridge body. For example, some staple cartridges include a metal disc that is thermoformed or thermo-molded to the cartridge body after the actuator is installed in the fastener cavity. The metal disc may wrap around the underside of the cartridge body and retain the actuator therein. In some cases, the actuator may be retained without a separate metal disc to create additional space in a cartridge assembly with a small form factor. For example, as further described herein, a thermoformed joint between the cartridge body and the actuator may retain the actuator. Additionally or alternatively, the cartridge body may be molded with a metal disc overlay. For example, the actuator retaining feature may include a thermoformed interference feature between the actuator and the cartridge body and / or an insert-molded part within the cartridge body.

[0378] exist Figure 60 and Figure 61 The image shows the staple pod 26300. The staple pod 26300 is similar to the staple pod 20100 in many ways. Figure 24 For example, staple cartridge 26300 includes a cartridge body 26302, which includes a tissue support platform 26304 having staple cavities defined therein; the staple cavities are arranged in three longitudinal rows 26312a, 26312b, 26312c on either side of the cartridge body 26302. The staples in staple cartridge 26300 are driven by actuator 26320 (…). Figure 61 Supported by this drive, the drive is similar in many ways to the triple drive 20120 ( Figure 26 For example, the actuator 26320 includes three parallel nail support brackets configured to support nails, such that the actuator 26320 is configured to fire nails from the inner row 26312a, the middle row 26312b, and the outer row 26312c.

[0379] The housing 26302 includes a row of recesses 26330 or pits along the lower portion of the housing 26302. This row of recesses 26330 can be positioned to engage and retain the actuator 26320 when it is in its non-firing position. Figure 60In this configuration, each indentation 26330 is configured to engage the actuator 26320. For example, each actuator 26320 may be held in place by an indentation 26330 on the outer surface of its adjacent nail support post. When the actuators 26320 are in their non-firing and lowest positions, the indentations 26330 in the housing 26302 prevent the actuators from falling out of the housing 26302.

[0380] The recess 26330 in the housing 26302 is configured to engage with the recess 26321 in the outer surface of the actuator 26320. The recess 26321 may include an upper lip or boundary that prevents vertical displacement of the actuator 26320 relative to the housing 26302. In various cases, the recess 26330 and the corresponding recess 26320 may be joined by thermoforming, melting, or otherwise via a hot-melt process. Hot-melt processes are further described herein.

[0381] Because actuator 26320 is a triple actuator, the thermoweled connection between the outer wall of actuator 26320 and housing 26302 holds the entire actuator 26320 (including the intermediate support column and the inner support column) in place within housing 26302. The interference connection between recesses 26330 and recesses 26321 can be overcome by a slider during the firing stroke to sequentially release and elevate actuators 26320 as the slider moves along the row of recesses 26330. In some cases, a series of thermoweled connections along the inner surface of housing 26302 can engage each actuator 26320 during firing. In such cases, actuator 26320 can capture multiple vertical latches or pits during firing.

[0382] In some cases, the drive and housing may include interference features molded into the drive and / or housing. See also Figure 62 DingSink 26400 is similar to DingSink 20100 in many ways. Figure 24 For example, staple cartridge 26400 includes a cartridge body 26402, which includes a tissue support platform 26404 having staple cavities 26410 defined therein; the staple cavities 26410 are arranged in three longitudinal rows on either side of the cartridge body 26402. The staples in staple cartridge 26400 are driven by actuator 26420 (…). Figure 62 Supported by this drive, the drive is similar in many ways to the triple drive 20120 ( Figure 26 However, driver 26420 is a dual driver. In other cases, the retaining features described herein with respect to driver 26420 may be incorporated into a single driver and / or a triple driver.

[0383] The actuator 26420 includes an integrally formed wedge 26421, which is narrower along its top edge 26423 and thicker along its bottom edge 26425. The wedge 26421 is positioned on the sidewall of the nail support post and is configured to abut the sidewall of the nail cavity 26410. For example, the nail cavity 26410 includes a vertical groove 26405 aligned with the wedge 26421. The wedge 26421 is configured to move along the vertical groove 26405 when the actuator 26420 is lifted upward by the slider during the firing stroke. To accommodate the wedge 26421, the chamber wall is configured to flex outward when the actuator 26420 is inserted into the chamber 26402. In use, the firing force of the slider is sufficient to overcome interference and lift the actuator 26420. In other words, in the depicted embodiment, the wedge 26421 is configured to travel through the vertical groove 26405; however, the depth of the groove 26405 is insufficient to allow the wedge 26421 to pass freely and unobstructed therethrough. The narrow top edge 26423 can fit into the groove without interference; however, between the narrow top edge 26423 and the thicker bottom edge 26425, the wedge 26421 can still interfere with the housing 26402 despite the vertical groove 26405. The interference connection between the wedge 26421 and the vertical groove 26405 is configured to hold the actuator 26420 in the proper position within the nail cavity 26410 and resist downward movement during the firing motion; the slider can overcome the interference during the firing stroke to sequentially release and lift the actuator 26420 as the wedge 26421 passes through the housing 26402 along the row of grooves 26330. The chamber 26402 can continue to bend as its actuator 26420 and wedge 26421 move through the cavity 26410.

[0384] See now Figure 63 The image shows a staple cartridge 26500. The staple cartridge 26500 includes a body 26502 having staple cavities defined therein; the staple cavities are arranged in three longitudinal rows on either side of the body 26502. Staps 26580 in the staple cartridge 26500 are supported by an actuator 26520, which is similar in many respects to a triple actuator 20120 (…). Figure 26 DingSink 26500 is similar to DingSink 20100 in many ways. Figure 24However, the staple cartridge 26500 also includes an insert-molded metal frame 26503 located within the cartridge body 26502. The insert-molded metal frame 26503 is a two-part assembly comprising a first disc 26503a and a second disc 26503b, extending laterally from the cartridge body 26502. The discs 26503a and 26503b can be insert-molded together with the cartridge body 26502, snapped into the cartridge body 26502 by frictional engagement between bosses 26505 along the length of the cartridge body 26502 and openings 26507 in the discs 26503a and 26503b, and / or heat-fused to the cartridge body 26502 by deforming the bosses 26505 along the length of the cartridge body 26502 within the openings 26507 in the discs 26503a and 26503b.

[0385] In one aspect, a flat, non-curved disc may be insert-molded together with the housing 26502 (e.g., discs 26503a, 26503b may initially define a linear profile rather than an L-shaped profile). For example, the housing 26502 may be formed from an overmolded metal sheet along its lateral sides. The exposed length of the overmolded metal sheet may then be bent around a portion of the underside of the housing 26502 to at least partially overlap some of the nail cavities, thereby retaining the actuator 26520 from its underside within the housing 26502. In some cases, the actuator may be a triple actuator spanning the outer nail cavity, the intermediate nail cavity, and the inner nail cavity. The bent portion of the metal sheet may overlap or substantially overlap with the lower portion of the outer nail cavity to retain the actuator within the housing.

[0386] Alternatively, L-shaped disks (such as disks 26503a and 26503b) can be snapped onto the side of the housing 26502 to hold the drive from below within the housing 26502, without molding disks 26503a and 26503b inserts into the housing 26502.

[0387] In one aspect, discs 26503a and 26503b may be molded with the insert of housing 26502 and may include exposed, flexible metal flanges or arms that bend around housing 26502 after actuator 26520 has been installed in the nail cavity. For example, see now. Figure 64 and Figure 65 This shows the use of warehouse bodies (such as warehouse body 26502). Figure 63 ) or warehouse body 20102 ( Figure 24 The metal frame or part of disk 26603. Disk 26603 may be molded with a housing insert. For example, disk 26603 includes a frame portion 26605 on which the housing has been molded. Disk 26603 also includes an arm 26609. Arm 26609 may utilize along direction F ( Figure 65 The deformation force of ) from the initial configuration ( Figure 64) transforms into a curved arm 26609' configuration ( Figure 65 This is to wrap the arm 26609 around the lower part of the nail cavity and hold the actuator therein.

[0388] In various aspects of this disclosure, in certain cases, various techniques for forming a metal element on the outer nail cavity to retain the actuator therein may be applied to the inner nail cavity. For example, in various aspects of this disclosure, the nail cartridge may include a support bracket, such as a support bracket 650 that fits within the nail cartridge 640 (see [link to relevant documentation]). Figure 19 and Figure 20 As further described herein, the staple cartridge 640 and the support bracket 650 may be assembled together prior to mounting the staple cartridge 640 into the channel 630. In some cases, such support bracket 650 or other insert-molded longitudinal frame members within the cartridge may include sheet, disc, or arm that may be bent around the underside of the cartridge to retain the actuator in the inner staple cavity row.

[0389] As described herein, the actuator retaining and / or interlocking features with the housing can be heat-fused to retain the actuator within the housing. In at least one aspect of this disclosure, each actuator may include a heat-fused feature corresponding to the housing. It may be important to ensure that the heat-fused depth is sufficient to keep the actuator from disengaging without causing interference with the actuator in its non-firing or downward position. Heat-fused and track-forming techniques can be controlled to ensure adequate engagement.

[0390] See now Figure 67 The image shows several parts of the staple cartridge 26700, including a cartridge body 26702 in which a actuator 26720 is located. The staple cartridge 26700 is similar to the staple cartridge 20100 in many respects. Figure 24 The device includes a longitudinal support frame 26703 and a heat-fused retaining feature 26705 between the cartridge 26702 and the longitudinal support frame 26703. In various cases, heat fusion can be performed against a solid metal sheet to secure the cartridge 26702 to the longitudinal support frame 26703. The actuator 26720 can then be installed in the nail cavity. For example, the actuator 26720 and the nail can be installed in the nail cavity 26710. After the actuator 26720 has been installed, the longitudinal support frame 26703 can be bent over the underside of the cartridge 26702 to retain the actuator 26720 therein. For example, a portion 26709 of the longitudinal support frame 26703 can cover the opening in the underside of the nail cartridge 26702 associated with the outer nail support post on the actuator 26720 and the outer nail cavity 26710.

[0391] In certain hot melt operations, insert supports can be used to reduce the amount of pressure and improve consistency. For example, removable insert supports or gaskets can be positioned after each hot melt. Furthermore, insert supports can push the actuator into an upward position during solidification to protect it from deformation or other effects during the hot melt operation.

[0392] See Figure 67 The image illustrates the heat-fusion operation of the staple cartridge 26800, where the cartridge body 26802 is secured to the longitudinal support frame 26803 using a heat-fused component 26805. The staple cartridge 26800 is similar in many respects to the staple cartridge 20100. Figure 24 The system includes a longitudinal support frame 26803 and a thermoplastic member 26805. The longitudinal support frame 26803 includes an upright piece 26808 and an orthogonal flange 26809 extending therefrom to form an L-shaped profile. The upright piece 26808 includes an opening 26807 through which it is aligned with the thermoplastic member 26805. The orthogonal flange 26809 also includes an opening 26806 through which it is configured to receive a finger 26892 into which a support member 26890 is inserted.

[0393] During the thermofusion operation, the L-shaped support frame 26803 is positioned along the length of the cartridge 26802, and the insert support 26890 is positioned relative to the support frame 26803 and the cartridge 26802 such that the finger 26892 extends through the opening 26806 in the orthogonal flange 26809 and into the staple cavity 26810. The finger 26892 is configured to push the actuator 26820 upward toward the tissue support platform 26804 of the cartridge 26802. After the thermofusion element 26805 has been formed between the cartridge 26802 and the L-shaped support frame 26803, the insert support 26890 can be removed from the staple cartridge 26800, thereby allowing the actuator 26820 to move downward and present its non-firing position in the staple cavity 26810. The orthogonal flange 26809 is configured to cover a portion of the underside of the housing 26802 and to cover multiple nail support posts (e.g., outer posts and intermediate posts) and / or bridging between two adjacent nail support posts to retain the actuator 26820 spanning multiple nail cavity rows 26810 within the housing 26802.

[0394] As further described herein, certain end effector components can be constructed using 3D printing technology to improve component capabilities. In some cases, for example, 3D printing can allow the printed components to exhibit metamaterial properties. A metamaterial is a synthetic composite material whose structure allows it to exhibit properties not typically found in natural materials. 3D printing is a technique used to produce metamaterials by forming components therein having two or more materials and / or structures. In other cases, insert molding and overmolding can produce composite components that, in certain circumstances, may possess metamaterial properties.

[0395] Composite end effector components can exhibit greater structural strength and stiffness while allowing for the precise fabrication of small, detailed features and, in some cases, improved frictional properties. For example, metal-plastic composite housings can exhibit certain metamaterial properties because they can be stronger and stiffer than similar injection-molded, all-plastic, or composite housings, while still allowing for precision relative to small, detailed features. In some cases, metal-plastic composite housings can exhibit improved frictional properties relative to actuators movably positioned in each nail cavity. Some composite metal-plastic components can be formed via insert molding or overmolding. In other cases, 3D printing allows for the creation of complex geometries and / or material combinations that would otherwise be too expensive and time-consuming to manufacture using conventional mass production techniques, or in some cases, even impossible to manufacture without 3D printing technology.

[0396] For example, see Figure 69 The image shows a composite metal-plastic housing 30002. In some cases, the composite metal-plastic housing 30002 can provide metamaterial properties. Additionally or alternatively, the composite metal-plastic housing can allow for improved integration of electronic components such as electronic sensors and flexible circuits.

[0397] In one aspect, the housing 30002 is formed with a stamped metal frame 30001 or two or more discs, which are stamped and otherwise formed into a skeletal shape for the housing 30002. A plastic material 30003 is then molded over the metal frame 30001. In such cases, the metal frame 30001 may be insert-molded into the plastic material 30003. Compared to a completely plastic housing (i.e., an injection-molded housing without a metal frame), the metal-plastic composite housing 30002 can exhibit increased strength and collapse stiffness. The plastic material 30003 on the metal or composite frame can provide a structurally functional frame with complex actuator guide features molded into the plastic material 30003.

[0398] In some cases, the metal frame 30001 may comprise a thin metal frame, and the plastic material may be injection molded together with the structural members. In one aspect, the metal frame may form one or more integrated discs, as further described herein, which can save space in the cartridge and / or increase tissue clearance. Additionally, metal may be used for certain components related to the locking mechanism, cartridge identification, and reset. In some cases, the metal may be less prone to breakage or fracture and can withstand significant forces, which can help the locking mechanism and / or mechanical keys (e.g., extension tabs or posts) prevent the cartridge from inserting into incompatible channels and / or devices. Certain metal components may be resilient during firing stroke reset, i.e., retracting the slide during manufacturing to test the cartridge and ensure all components have been installed. Furthermore, composite metal-plastic cartridge bodies can facilitate smart cartridge technologies, integrated wiring, and / or flexible circuitry.

[0399] In some cases, the metal frame 30001 may have flanges that interconnect or span multiple walls and / or columns within the chamber. For example, some walls within the chamber may be thinner than others, and the flanges can connect thinner walls to thicker walls to better distribute torque loads, rather than torsional supports. In some cases, the main upright support wall within the chamber can be connected to an adjacent, thicker support wall via the metal frame. For example, a thinner inner chamber wall can be coupled to a thicker outer chamber wall to improve force distribution during clamping and / or firing.

[0400] In other cases, the composite plastic-metal housing can be 3D printed. The orientation of the 3D construct forming the composite plastic-metal housing can be optimized to ensure smooth actuator movement during the firing stroke. For example, see again... Figure 69 The chamber 30002 includes staple cavities 30010 arranged in a plurality of longitudinal rows 30012. The staple cavities 30010 are defined to pass through the tissue support platform 30004 and enter the chamber 30002. Actuators (such as actuator 20120) further described herein... Figure 26 The nails can be supported in the chamber 30002.

[0401] The composite plastic-metal housing 30002 can be printed layer by layer along the longitudinal axis A of the housing 30002. In other words, the orientation of the 3D build-up can be orthogonal to the longitudinal axis A and / or orthogonal to the tissue support platform 30004. When the orientation 3D printing of the housing 30002 is perpendicular to the longitudinal axis A (e.g., proximal to distal), the build-up layers can be aligned with the direction of the actuator movement during the firing stroke. See again Figure 69Each nail cavity 30010 extends along axis D, which is perpendicular to the longitudinal axis A. As the slider moves along the longitudinal axis A through the chamber 30002, each actuator is lifted upwards along its corresponding axis D toward the tissue support platform 30004. The build direction is parallel to the axis D of the nail cavity, along which the actuator moves during the firing stroke. In some cases, aligning the 3D build layer with the direction of actuator movement can prevent actuator entrapment and suspension when the actuator is lifted by the slider during the firing stroke.

[0402] In some cases, the 3D construction for composite plastic-metal housings is from proximal to distal. In other cases, for example, the 3D construction can be from distal to proximal. In some cases, the support structure used for certain 3D constructions can be minimized when constructing a narrower body section on top of the wider distal nose of the housing.

[0403] In various cases, 3D-printed composite hopper bodies may include different filler percentages and / or different materials to obtain metamaterial properties related to improving the strength of the hopper body while minimizing friction during the firing stroke. Furthermore, the support walls of such hopper bodies may define open spaces, voids, and / or chambers therebetween. In various cases, the spaces between the support walls (such as thin walls between nail cavities) may be configured to allow for improved bending resistance during clamping loads. For example, the spaces between the support walls of the hopper body may include 3D-printed internal fillets, chamfers, and / or struts configured to improve the strength of the openings in the support walls.

[0404] Some of the chambers described herein may include smaller cross-sectional geometries, less material, and / or thinner support walls due to a central firing screw passing through them (e.g., Figure 4 and Figure 5 The firing screw (261) covers the area of ​​the chamber, which occupies a fixed space within the compact shape factor of the chamber. During the firing stroke, high loads on the chamber can exert deforming forces, which can cause deformation of the chamber or parts thereof. For example, the thin walls separating the pin chambers may, in some cases, tend to bend or buckle, which could lead to the driver and the pins supported thereon becoming disaligned with the forming recesses in the anvil. In any case, connecting the lateral sides of the chamber via bridging members strengthens the chamber and helps maintain alignment between the pins in the pin chambers and their associated forming recesses in the anvil, even under high loads.

[0405] See now Figure 71 and Figure 72 This shows a portion of the surgical end effector 30140. The surgical end effector 30140 is similar in many respects to the surgical end effector 20240 (…). Figure 29For example, end effector 30140 includes staple cartridge 30100, which is similar in many respects to staple cartridge 20100 (…). Figure 24 ), and includes housing 30102 and rotary drive screw 30142 ( Figure 72 The rotary drive screw has three rows of pin cavities on each side, and in many respects is similar to, for example, drive screw 261 (see Figure 4 and Figure 5 ) and rotary drive screw 20242 ( Figure 29 The staple cartridge 30100 is installed in the channel 30150. The firing member 30144, having an upright cutting edge 30146, is configured to move along the rotary drive screw 30142 through the staple cartridge 30100 during the firing stroke to advance the slider and lift the driver and staple thereon to form contact with the forming recess in the anvil.

[0406] For example, warehouse body 30102 is similar to warehouse body 20102 in many ways ( Figure 24 However, the housing 30102 also includes a bridging member 30106 extending between the two lateral sides 30102a, 30102b of the housing 30102. The bridging member 30106 covers a longitudinal blade receiving slot 30108 defined in the housing 30102, along which a portion of the firing member 30144 moves during the firing stroke. The bridging member 30106 forms a continuous tissue support platform 30104 between the two lateral sides 30102a, 30102b of the housing 30102. In various cases, the bridging member 30106 can, for example, improve the strength of the housing 30102 and help maintain alignment of the pin with the shaped recess on the anvil, especially when firing under high loads, for example. In such cases, the bridging member 30106 can mitigate lateral pin misalignment, for example, caused by high clamping loads.

[0407] The bridging element 30106 is a fragile component configured to be cut or transversely sliced ​​by the upright cutting edge 30146 of the firing member 30144 during the firing stroke. In various cases, the geometry of the bridging element 30106 is configured to mitigate the risk of breakage. For example, the geometry may allow for a predictable geometry and orientation of the breakage of the bridging element 30106. In the case where the chamber 30102 is 3D printed, for example, the chamber 30102 may include different materials, different infill percentages, and / or different infill geometries along the bridging element 30106 or portions thereof compared to adjacent portions of the chamber 30102. This can further facilitate transverse slicing of the bridging element 30106 during the firing stroke without damaging the firing member 30144 and / or causing the chamber 30102 to break under firing load.

[0408] In some cases, as further described herein, the staple cartridge 30100 may include, for example, a single-use blade that can traverse the bridging member 30106 during the firing stroke. When using a single-use blade, there is no risk of the blade becoming dull for subsequent firing strokes when traversing the fragile portion of the bridging member 30106. The bridging member 30106 may include, for example, a molded and / or 3D-printed plastic part that can be easily traversed by the upright cutting edge 30146 without significant resistance. In other cases, a reusable blade may be used to cut the bridging member 30106.

[0409] In some cases, the bridging member 30106 may include perforated and / or disconnect / tear lines, and the bridging member 30106 is configured to be detachable from the housing 30202 along the perforated and / or disconnect / tear lines. See also Figure 73 For example, the thief's hatch 30200 includes a fragile portion 30206 having a tear-off tab 30202 and defined by a break line 30204 between the fragile portion and the remainder of the hatch 30200. The fragile portion 30206 can be removed or separated from the thief's hatch 30200 along the break line 30204. Similarly, a bridging member 30106 can be removed from the housing 30102 along the break line, which facilitates separation of the bridging member 30106 from the housing 30102. In some cases, the bridging member 30106 can be interrupted by a recess along the sidewall of the blade receiving slot 30108. The deflection and / or separation portion of the bridging member 30106 can be configured to move into the recess during the firing stroke, rather than being pushed out of the housing 30102 and into the tissue clamped between them.

[0410] In some cases, as further described herein, a replaceable cartridge may include a single-use blade that provides a new cutting edge for each firing stroke. However, in order to cut tissue clamped between the jaws of the end effector, in various cases, the blade should extend beyond the tissue support platform of the cartridge. This protruding blade and cutting edge pose a risk of unintentional and / or accidental contact outside the firing stroke, which could damage tissue and / or dull the cutting edge. For example, before the firing stroke, such as when the cartridge is being loaded into the end effector, the cutting edge may unintentionally contact and / or cut the patient's and / or clinician's tissue. In other cases, after the firing stroke is completed, the cutting edge may remain in a distally protruding position and may unintentionally contact and / or cut the patient's and / or clinician's tissue as the end effector releases the tissue and is being withdrawn from the surgical site. Additional unintentional tissue contact scenarios are envisioned.

[0411] In various cases, the tissue cutter can be mounted on a slider in the staple cartridge. As the slider moves through the firing stroke, the cutter also moves through the cartridge. Furthermore, the slider can interact with a firing member (e.g., an I-beam or E-beam) in the end effector. For example, the slider and the cutter thereon can be releasably coupled to the firing member, allowing the slider and cutter to advance distally during the firing stroke. In some cases, when the firing stroke is completed or terminated, the slider and cutter can retract proximally together with the firing member. In this case, the cutter can be reset and / or returned to a proximal position in the cartridge before the firing member allows the jaws to open. In such cases, the protruding cutter and its cutting edge can return to a predictable and / or at least partially obscured position at the proximal end of the cartridge. In other cases, the slider may include multiple separable parts (e.g., a two-part slider), with one part of the slider retracting proximally while the other part remains in a distal position. In some aspects, the retractable portion of the slider may include the cutter. In other cases, the non-retractable portion of the slider may include a blade, which can be guided downward into the chamber as the retractable portion of the slider moves past the blade. In some cases, a portion of the slider may interact with a locking feature to prevent damage when the chamber is missing and / or using an outdated firing stroke.

[0412] In one aspect of this disclosure, the firing member may include a distally extending hook, and the slider may include a proximal cavity sized to receive the distally extending hook. Furthermore, the blade can be pivotally coupled to the slider and positioned to selectively engage the distally extending hook and retain it within the slider. For example, the distally extending hook may hook around a portion of the blade. In various cases, the interconnection of the distally extending hook and the blade is configured to hold the blade in a protruding position relative to the housing.

[0413] In such cases, when the firing member advances to engage with the slider, the blade can move to a protruding position, in which the cutting edge is positioned to transversely cut the tissue clamped between the jaws. Before the firing stroke, the blade can pivot to a concealed position, in which at least a portion of the cutting edge is concealed by the slider and / or the chamber. Furthermore, upon completion of the firing stroke, the firing member can return, together with the slider, to a proximal position within the chamber and back to its concealed position. In various cases, the aforementioned arrangement prevents certain unintentional tissue contact outside the firing stroke.

[0414] See now Figures 74 to 77 This shows an end effector 30340 ( Figure 77 The sliding component assembly 30320. The end effector 30340 is similar in many respects to the end effector 200 (see [link]). Figure 4 and Figure 5And is configured to cut and suture patient tissue. The end effector 30340 may include, for example, a clamp jaw and anvil jaw, and the clamp jaw may be configured to receive a staple cartridge 30300 having a tissue support platform 30304, which is similar in many respects to, for example, a staple cartridge 220 (see...). Figure 4 and Figure 5 The end effector 30340 also includes a rotary drive screw and a firing member 30342, which are similar to the firing screw 261 (see [link]). Figure 4 and Figure 5 ) and firing mechanism 270 (see Figure 4 and Figure 5 The jaws are configured to receive a staple cartridge 30300, which includes staples that can be ejected when the firing member 30342 is advanced within the staple cartridge 30300. For example, during the firing stroke, as the firing screw rotates, the firing member 30342 is driven through the end effector 30340 to advance the slider assembly 30320.

[0415] The firing member 30342 includes a main body portion 30343, upper cam members 30344 extending laterally from both sides of the main body portion 30343, and lower cam members 30345 extending laterally from both sides of the main body portion 30343. The upper cam members 30344 are configured to engage the upper jaw or anvil of the end effector 30340 in a cam manner during the firing stroke, and the lower cam members 30345 are configured to engage the lower jaw or elongated channel of the end effector 30340 in a cam manner during the firing stroke.

[0416] In addition to the above, a longitudinal opening extends through the main body portion 30343. The longitudinal opening is configured to receive the aforementioned rotary drive screw. The main body portion 30343 also includes a cutout region 30349 configured to receive a firing drive nut 30350. The firing drive nut 30350 is configured to thread-engage the rotary drive screw to convert the rotational motion of the rotary drive screw into translation of the firing member 30342. The firing drive nut 30350 also includes lateral extension members 30351 extending from both sides of the firing drive nut 30350. The lateral extension members 30351 are aligned with the lower cam member 30345. Therefore, the cam members 30345 and 30351 cooperate to engage the lower jaw of the end effector 30340 in a cam manner during the firing stroke.

[0417] The main body portion 30343 of the firing member 30342 also includes a distal nose portion 30346 that extends distally and forms a distal slider abutment surface 30352. A distal extension 30347 extends from the distal slider abutment surface 30352 in a generally distal direction and is configured to selectively interlock with the slider assembly 30320. More specifically, the distal extension 30347 includes a lateral portion or latching member 30348 extending in a direction transverse to the distal direction. The distal extension 30347 and the latching member 30347 form a hook geometry that selectively engages a portion of the slider assembly 30320, as further described herein.

[0418] For example, slider assembly 30320 includes slider body 30321 and blade 30338, the blade having a position for engaging a actuator (such as actuator 20120). Figure 26 The track 30322 is configured to lift the actuator toward the tissue support platform 30304 of the staple cartridge 30300. The central portion 30333 of the slider body 30321 moves along a central longitudinal path in the staple cartridge 30300 during the firing stroke. In various aspects, the central portion 30333 includes an upright hub 30334 with sidewalls 30335, sized and configured to move along a longitudinal slot in the staple cartridge 30300. The central portion 30333 also includes an arcuate lower profile 30334, sized and positioned to accommodate the rotary drive screw without interference.

[0419] The upright hub 30334 includes a recess or space 30328 between sidewalls 30335 and a shaft or pin 30336 extending between the sidewalls 30335. A stop 30337 also extends between the sidewalls 30334 and is further described herein. A cutter 30338 of the sliding member assembly 30320 is pivotally mounted to the pin 30336 at the hub 30339. In various aspects, the hub 30339 may define a hub diameter that allows the cutter 30338 to rotate about the pin 30336. Furthermore, the cutter 30338 includes a mounting slot 30329 having a width narrower than the hub diameter, and the pin 30336 passes into this mounting slot to secure the hub 30339 to the pin 30336. In various cases, the cutter 30338 may, for example, snap-fit ​​or press-fit to the pin 30336. See also Figure 75 An exploded view of the slider assembly 30320, wherein the cutter 30338 is movable along the assembly axis A to rotatably mount the cutter 30338 to the slider body 30321.

[0420] In various situations, the blade 30338 can pivot relative to the sliding body 30321 to a downward or recessed position. For example, when the blade 30338 is in the recessed position, the blade 30338 and its cutting edge may, for example, face generally downward and / or be obscured by the sidewall 30335. In some cases, a biasing element is configured to bias the blade 30338 toward the recessed position.

[0421] Now, please refer to Figure 77 During the firing stroke, the firing member 30340 is advanced distally into the pin magazine 30300, which drives the distal extension 30347 and the locking member 30348 into the space 30328 between the sidewalls 30335 of the upright hub 30334. When inserted into the space 30348, the locking member 30348 hooks around the end portion 30328 of the blade 30338. The end portion 30328 of the blade 30338 defines a planar abutment surface 30327, and the spherical end 30327 extends around the locking member 30348 to securely retain the locking member 30348 against the planar abutment surface 30327. In this configuration, the locking member 30348 is held in the space 30328 at a position away from the end portion 30328 of the blade 30338. Furthermore, the blade 30338 is rotated to a protruding position, in which the cutting edge protrudes from the housing 30302 and enters the tissue gap defined between the tissue support surface 30304 and the anvil. In various cases, the distal extension 30347 and / or the end portion 30328 are configured to flex under a defined load during the distal firing motion to elastically engage the distal extension 30347 in the space 30328 of the slider assembly 30320.

[0422] Subsequently, the firing member 30340 can propel the sliding member assembly 30320 distally. As the sliding member assembly 30320 moves distally, from... Figure 77 The indicated orientation pushes the blade 30338 clockwise. Resistance to the firing motion (e.g., tissue) can be configured to allow the blade 30338 to rotate clockwise. The blade 30338 can rotate clockwise from... Figure 77 The orientation of the blade 30038 is rotated to engage with the stop 30337, which is configured to prevent further clockwise rotation of the blade 30038. In this case, during the distal movement of the firing stroke, the blade 30338 remains in an upright or protruding position relative to the tissue support platform 30304. For example, the abutment surface 30327 may be flush or substantially flush with the inner surface of the latching member 30348.

[0423] The proximal retraction motion of the firing component 30320 in Figure 77As shown, the firing member 30320 is withdrawn in the proximal direction P. The retraction of the firing member 30320 in the proximal direction B is configured to pull the distal extension 30347 and the latching member 30348 proximally, which also applies a force to the end portion 30328 in the proximal direction. This force on the end portion 30328 is then configured to rotate the blade 30338 counterclockwise while simultaneously retracting the sliding member assembly 30320 together with the firing member 30320. For example, in various cases, a slight clockwise rotation of the blade 30338 is configured to pivot the cutting edge of the blade 30338 downwards to an orientation unlikely to contact and / or cut tissue.

[0424] In various configurations, the interconnection between the firing member 30340 and the sliding assembly 30320 is configured to ensure that the sliding assembly 30320 and its blade 30338 are reset in a proximal position within the staple cartridge 30300 before the jaws are released from engagement with the cam members 30344, 30345, 30351 of the firing member 30340 and permitted to open. As the firing member 30340 retracts further and is withdrawn from the staple cartridge 30300, the distal extension 30347, the latching member 30348, and / or the end portion 30328 can be configured to deflect to release the distal extension 30347 from the sliding body 30321 and allow the blade 30338 to further withdraw from the cartridge. Figure 77 The orientation in the middle pivots counterclockwise to the shielding orientation.

[0425] In some aspects of this disclosure, the slider may be stamped from a sheet of metal. In some cases, the slider may be a two-part slider formed by two stamped sheets. In some cases, the stamped slider may have a substantially W-shaped profile. For example, a blade may be integral with one of the stamped sheets. In some cases, the two-part slider may include a first stamped member and a second stamped member, the first stamped member retracting with the firing member and the second stamped member not retracting with the firing member. In the proximal non-firing position, the second stamped member is configured to interact with and overcome the missing and used magazine locking member. In the distal firing position, where the firing member does not cause the second stamped member to retract from its position, the missing and used magazine locking member is configured to engage the firing member and prevent firing stroke.

[0426] When the staple cartridge is missing from the end effector and / or when a depleted or empty staple cartridge is installed in the end effector, the two-part sliding and locking arrangement prevents the firing stroke. Furthermore, in some cases, a lower-cost sliding element formed from two stamped metal sheets can be provided, featuring integrated blades and cutting edges, a connecting feature for the firing element, and a locking engagement feature. Such stamped metal sliding elements prevent the sliding track from bending or mushrooming under high staple forming loads and, in some cases, prevent the sliding element from breaking or cracking. Additionally, the stamped metal sliding element can define a thin track that allows for more plastic (or other material) in the cartridge body, improving the strength of the cartridge body, including the strength of the support walls between the staple cavities. In some cases, the thin profile of the stamped metal sliding element allows the actuators to be positioned closer together and, in some cases, better accommodates the rotary drive screw.

[0427] See now Figures 74 to 89 This shows an end effector 30440 (see [reference]). Figure 82 The sliding component assembly 30420. The end effector 30440 is similar in many respects to the end effector 200 (see [link]). Figure 4 and Figure 5 And is configured to cut and suture patient tissue. The end effector 30440 includes, for example, a cartridge jaw 30450 and an anvil jaw 30454, and the cartridge jaw 30450 is configured to receive a staple cartridge 30400 having a cartridge body 30402 and a tissue support platform 30404, which is similar in many respects to, for example, a staple cartridge 220 (see...). Figure 4 and Figure 5 The end effector 30440 also includes a firing drive system 30339, which includes a rotary drive screw 30442 and a firing member 30441, which are similar to the firing screw 261 (see [link]). Figure 4 and Figure 5 ) and firing mechanism 270 (see Figure 4 and Figure 5 The jaw 30450 defines a channel having opposing sidewalls 30452, configured to receive a staple cartridge 30400 containing staples that can be ejected when the firing member 30441 is advanced through the staple cartridge 30400. For example, during the firing stroke, as the rotary drive screw 30442 rotates, the firing member 30341 is driven through the end effector 30340 to advance the slider assembly 30420.

[0428] See also Figure 81The firing member 30441 includes a main body portion 30443, upper cam members 30444 extending laterally from both sides of the main body portion 30443, and lower cam members 30445 extending laterally from both sides of the main body portion 30443. The upper cam members 30444 are configured to engage the anvil jaws 30454 of the end effector 30440 in a cam manner during the firing stroke, and the lower cam members 30445 are configured to engage the jaws 30450 of the end effector 30400 in a cam manner during the firing stroke.

[0429] In addition to the above, a longitudinal opening extends through the body portion 30343. The longitudinal opening is configured to receive the aforementioned rotary drive screw 30442. In some cases, the rotary drive screw 30442 may be threaded to the body portion 30343, and in other cases, it may be threaded to a firing drive nut housed therein, as further described herein.

[0430] See also Figures 78 to 81 The slider assembly 30420 includes two separate sliders, namely a proximal slider 30422 and a distal slider 30424. Each slider 30422, 30424 is a separate and independent stamped part. For example, each slider 30422, 30424 can be formed by separate stamping. Slider 30422, 30424 is formed from a stamped sheet of material (such as a metal sheet). In at least one aspect, slider 30422, 30424 is formed from a steel sheet; however, other materials are also contemplated. The proximal slider 30422 and the distal slider 30422 cooperate to engage a actuator 30416 housed in a housing 30402. For example, the actuator 30416 may be a triple actuator in various cases and may be similar to actuator 20120 in many respects. Figure 26 ).

[0431] The proximal slider 30422 and the distal slider 30424 can be connected by a push connection. In other words, when the proximal slider 30422 applies a push force to the distal slider 30424, the sliders 30422 and 30424 can remain connected. In the absence of a push force, the sliders 30422 and 30424 are separable components that can be selectively moved and repositioned in certain situations.

[0432] Each slider 30422, 30424 includes a pair of stamped wedges forming a track. The proximal slider 30422 includes an outer track 30423 for the slider assembly 30420, and the distal slider 30424 includes an inner track 30425 for the slider assembly 30420. The outer track 30423 and inner track 30425 are configured to move along each side of the cartridge during the firing stroke and are alignable with a row of actuators 30416. Between the tracks 30423, 30425, the proximal slider 30422 and distal slider 30424 each include a central upright portion 30426, 30428, which defines lower arcuate profiles 30426a, 30428a to accommodate a rotary drive screw 30442 passing through it. Figure 81 The central upright portions 30426 and 30428 also include keys 30426b and 30428b, respectively, which are configured to align and guide the sliders 30422 and 30424 through the housing 30402. Keys 30426b and 30428 are arc-shaped rings, but other geometries are also envisioned. For example, orthogonal flanges connect the central upright portions 30426 and 30428 to their respective tracks 30423 and 30425. The orthogonal flanges, due to their stamping process, have the same thickness as the associated tracks 30423 and 30425.

[0433] Slider assembly 30420 in Figure 88 The inner track 30423 is shown as being in the staple cartridge. The thickness of the metal sheet may be related to the thickness of the tracks 30423 and 30425. In this case, the inner track 30423 must have the same thickness, and the outer track 30423 must have the same thickness. In at least one aspect, the inner track 30423 and the outer track 30423 may have the same thickness, but are stamped separately. In any case, formed from a thin metal sheet, the sliding assembly 30420 may have a reduced thickness while still withstanding high loads without bending and / or breaking. For example, the tracks 30423 and 30425 may be narrower than the cartridge walls between the staple cavities in adjacent longitudinal rows. See, in contrast. Figure 89 The staple cartridge 30500 has the same overall width and staple geometry. The inner rails 30523 and outer rails 30525 of the slider 30530 (e.g., a molded plastic slider) in the cartridge body 30502 may be wider than rails 30423 and 30425. In such cases, for example, the cartridge body 30502 may have a smaller space and therefore less material and associated strength to support the inner drive row.

[0434] The proximal slider 30422 and the distal slider 30424 can be aligned and assembled along the assembly axis A. Figure 79During assembly, the central upright portions 30426 and 30428 can be longitudinally staggered, and the proximal portion of the inner track 30425 can rest on the orthogonal flange of the proximal slider 30422 (see...). Figure 80 Furthermore, the orthogonal flanges of the two sliders 30422 and 30424 are configured to run along the lower support surface (such as the inner surface of the jaw 30450 (see...)). Figure 82 Slide or move in other ways.

[0435] See still Figures 78 to 81 The proximal slider 30422 also includes an integral blade 30430 having a distally facing cutting edge 30432. For example, when the proximal slider 30422 is stamped, the blade 30430 can cut into the sheet of material. The proximal slider 30422 also includes a proximal tail or extension 30434, which is configured to be able to engage when the staple cartridge 30400 and its actuator assembly 30420 are mounted on the jaws 30450. Figure 82 ) and firing mechanism 30441 ( Figure 81 The proximal extension 30434 is T-shaped and includes a lateral bias configured to facilitate engagement with the T-shaped recess 30448 in the firing member 30441. Figure 81 (Connection). For example, see [link / reference]. Figure 87 The proximal extension 30434 can initially reside in a recess in the housing 30402, which holds the proximal slider 30422 in place relative to the housing 30402. Then, as the firing member 30442 moves distally, the proximal extension 30434 bends into a T-shaped recess 30448 to lock the proximal slider 30422 to the firing member 30442. Alternative complementary profiles are also envisioned for connecting the proximal extension 30434 and the firing member 30441.

[0436] In various cases, when the staple cartridge 30400 is installed in the jaws 30450, the firing member 30441 can be aligned with the actuator assembly 30420 and can be configured to move into drive engagement with the actuator assembly 30420 when the firing member 30441 has moved an initial distance distally during the firing stroke, such as... Figure 81 As shown. See also Figure 87 For example, when the firing member 30441 begins to move proximally, the proximally extended portion 30434 is allowed to deflect into the recess 30448.

[0437] The proximal extension 30434 can be biased to engage with the recess 30448 in the body 30443 of the firing member 30441, and can remain engaged with the recess 30448 during proximal and distal displacement of the firing member 30441 until the firing member 30441 is finally withdrawn proximally from or nearly withdrawn from the magazine 30400 at the completion of the firing stroke. When the firing member 30441 is releasably attached to the proximal slider 30422, the upright body portion 30443 of the firing member 30441 is aligned with the blade 30430. Figure 81 As shown, the body portion 30443 supports the blade 30430 as it is advanced through the tissue. In various cases, additional supports from the body portion are configured to prevent the blade 30430 from deflecting away from the firing path and longitudinal axis of the end effector 30440.

[0438] The distal slider 30424 is pushed distally by the proximal slider 30422 during the firing stroke. The distal slider 30424 also includes a foot 30429 extending downward from the track 30245 and / or the orthogonal flange. Figure 86 The foot 30429 may be configured to move through a slot in the jaws 30450 during the firing stroke as the firing member 30441 pushes the proximal slider 30422, which pushes the distal slider 30424 distally during the firing stroke. In various cases, the foot 30429 is configured to engage the locking element in the end effector 30440 when the distal slider 30424 is in the proximal non-firing position. The distal slider 30424 and its locking features are further described herein.

[0439] See also Figures 82 to 84 The end effector 30440 includes a locking arm 30460 selectively engaged by a distal slider 30424. The locking arm 30460 is available in a locked position (…). Figures 82 to 84 ) and unlock location ( Figure 85 The locking arm 30460 moves between the locking position and the unlocking position, preventing the firing stroke. In some cases, the locking arm 30460 is flexibly positioned in the longitudinal recess 30453 in the channel portion of the jaw 30450 and is configured to pivot about the central pivot portion 40646.

[0440] The locking arm 30460 includes a proximal end 30466 biased into a locking recess 30449 in the firing member 30341. For example, a spring 30470 positioned in the jaws 30450 is configured to push the proximal end 30466 into the locking recess 30449 of the firing member 30341 when the firing member 30341 is in the proximal, pre-firing stroke position. When the proximal end 30466 of the locking arm 30460 is received in the locking recess 30449, the locking arm 30460 is configured to resist translation of the firing member 30441 and thus prevent firing stroke.

[0441] The slider assembly 30420 is configured to overcome the locking arm 30460 by removing its proximal end 30466 from the locking recess 30449. More specifically, when the distal slider 30424 is positioned in the proximal non-firing position in the pin cartridge 30400, the foot 30429 of the distal slider 30424 is positioned to engage the distal end 30462 of the locking arm 30460 (see [link]). Figure 85 The pivot portion 30464 of the locking arm 30400, located between the proximal end 30466 and the distal end 30462, is held in an arcuate support 30451 within the jaws 30450. In some cases, the pivot portion 30464, and thus the entire locking arm 20468, is configured to pivot about the arcuate support 30451.

[0442] For example, when the staple cartridge 30400 is installed in the end effector 30440 and the distal slider 30424 is in the proximal non-firing position (indicating that the staple cartridge is unused or empty), the locking arm 30460 pivots from the locked position to the unlocked position. When the firing member 30441 pushes the proximal slider 30422 distally (which pushes the distal slider 30422 distally), the locking arm 30460 pivots from the unlocked position to the locked position. When the foot 30429 on the bottom of the distal slider 30422 moves out of engagement with the distal end 30462 of the locking arm 30460, the locking arm 30460 pivots due to the biasing force of the spring 30470. When the firing member returns to its proximal position after the firing stroke and attempts to move the locking recess 30449 past the locking arm 30460, the spring 30470 pushes the proximal end 30466 of the locking arm 30460 into the locking recess 30449 to prevent the firing stroke. The foot 30429 moves along the longitudinal recess 30453 in the channel 30450 during the firing stroke.

[0443] As described herein, the two-part slider assembly 30420 is configured to selectively overcome the locking arm 30460 to allow the firing stroke. Furthermore, the slider assembly 30420 includes an integral blade 30430, which is a single-use blade 30420 with a suitably sharp cutting edge 30432 for transversely cutting tissue clamped by the end effector 30440. Upon completion of the firing stroke, the single-use blade 30420 retracts proximally together with the firing member 30441. Moreover, because the firing beam 30441 includes opposing cams 30445, 30446, the firing member 30441 ensures that the jaws 30450, 30542 remain closed until the blade 30420 returns to a proximal position in the staple cartridge 30400.

[0444] As described herein, for example, certain surgical devices may include a reusable blade incorporated into the surgical device, such as a distally facing blade on the firing member. Upon completion of the firing stroke, the reusable blade may retract from the cartridge and subsequently be refired with another cartridge. In such applications, the surgical device, including its reusable blade, may be cleaned and sterilized between surgical procedures.

[0445] In other cases, a single-use knife may be used in conjunction with a surgical device. For example, a staple cartridge may include a single-use knife for use only with that specific staple cartridge. When the staple cartridge is removed from the surgical device, the single-use knife is also removed. When a replacement staple cartridge is installed in the surgical device, a new single-use knife is provided. In some cases, the single-use knife may remain in the staple cartridge during the firing stroke and even after the firing stroke when the staple cartridge is removed from the surgical device. In some cases, the cutting edge of the single-use knife may be at least partially obscured by a feature of the staple cartridge after the firing stroke and / or when the staple cartridge is removed from the surgical device. In some cases, the knife or a portion thereof may be folded or otherwise deformed and / or pushed downwards into the staple cartridge from a protruding orientation.

[0446] For example, the cartridge may include a two-part sliding assembly comprising a proximal slide and a distal slide. When the two-part sliding assembly is inserted into the surgical device, the proximal slide may be connected to the firing member. The distal slide may include an upright cutting blade. During the firing stroke, the firing member is configured to push the proximal slide distally, which in turn pushes the distal slide distally to transcribe tissue. Upon completion of the firing stroke, the proximal slide may retract proximally through the firing member and may disengage from the distal slide. As the proximal slide retracts proximally, a central lug of the proximal slide is configured to move over the upright cutting blade to fold the cutting blade downward into the cartridge body. In various cases, the proximal slide may also include a support feature for supporting the upright cutting blade during the firing stroke.

[0447] In some cases, the two-part sliding assembly can be manufactured from stamped sheet metal, which can be a low-cost alternative to other manufacturing techniques. In some cases, for the same size cartridge, the stamped metal sliding assembly can have a thinner track but is more robust than a plastic slide. Furthermore, in some cases, the stamped metal sliding assembly can form a nail with less springback and / or allow the nails to be positioned closer together in the nail line. In some cases, the blade can be configured to extend and / or deform into the cartridge at any point along the length of the firing stroke, and only the proximal stamped sliding component can return with the firing member. The folding and / or deformation of the blade during the proximal retraction of the firing member and the proximal stamped sliding component ensures that the blade is not reused during subsequent surgical procedures. In some cases, the proximal stamped sliding component and the firing member can be positioned to support the distal stamped sliding component and its blade during the distal firing stroke.

[0448] Now for reference Figures 90 to 98 The image depicts a two-part slider assembly 30620. The slider assembly 30620 includes two separate sliders, namely a proximal slider 30622 and a distal slider 30624. Each slider 30622, 30624 is a separate and independent stamped part. For example, each slider 30622, 30624 can be formed by separate stamping. Slider 30622, 30624 is formed from a stamped sheet of material (such as a metal sheet). In at least one aspect, slider 30622, 30624 is formed from a steel sheet; however, other materials are also contemplated. The proximal slider 30622 and the distal slider 30622 cooperate to engage a actuator 30616 housed in a housing 30602. Figure 92 For example, drive 30616 can be a triple drive in various cases and can be similar to drive 20120 in many ways ( ). Figure 26 ).

[0449] The proximal slider 30622 and the distal slider 30624 can be connected by a push connection. In other words, when the proximal slider 30622 applies a push force to the distal slider 30624, the sliders 30622 and 30624 can remain connected. In the absence of a push force, the sliders 30622 and 30624 are separable components that can be selectively moved and repositioned in certain situations.

[0450] Each slider 30622, 30624 includes a pair of stamped wedges forming a track. The proximal slider 30622 includes an outer track 30623 for slider assembly 30620, and the distal slider 30624 includes an inner track 30625 for slider assembly 30620. The outer track 30623 and inner track 30625 are configured to move along each side of the cartridge during the firing stroke and to align with a row of actuators 30616. The proximal slider 30622 includes a central upright portion 30626 and an orthogonal flange 30621 connecting the central upright portion 30426 to each outer track 30623. The orthogonal flange 30621 is configured to straddle a lower support surface (e.g., along the inner surface of the cartridge jaws) during the firing stroke and has the same thickness as the outer track 30423 due to the stamping formation of the proximal slider 30622. The dimensions of the central upright portion 20426 are set to fit around a portion of the distal slider 20624 and define the lug 30627.

[0451] The distal slider 30624 includes a central upright portion 30628 and an orthogonal flange 30619 connecting the central upright portion 30626 to each inner rail 30625. The orthogonal flange 30619 is configured to ride along a lower support surface (e.g., along the inner surface of the pin cartridge jaws) during the firing stroke and has the same thickness as the inner rail 30625 due to the stamping formation of the distal slider 30624. The central upright portion 30628 defines a lower arcuate profile 30626a, which is sized to accommodate a rotary drive screw 30642 passing through it. Figure 92 The rotary drive screw 30642 is similar in many respects to the firing screw 261 (see...). Figure 4 and Figure 5 The central upright portion 30628 also includes an extended blade 30629 having a distally facing cutting edge 30630. The central upright portion 30626 of the proximal slider 30622 is configured to engage around the central upright portion 30628 of the distal slider 30622, except for the extended blade 30629 extending beyond the lug 30627 and the upper edge of the central upright portion 30626. The distal slider 30624 also includes an anti-retraction arm 30632, which can be laterally biased to engage with the housing 30602 to prevent proximal retraction of the distal slider 30624 after the firing stroke. In some cases, the anti-retraction arm 30632 may be positioned on each lateral side of the distal slider 30624.

[0452] See also Figure 92The sliding assembly 30620 is a component of the staple cartridge 30600, which also includes a cartridge body 30602, an actuator 30616, and staples removably positioned within the cartridge body 30602. In various cases, the staple cartridge 30600 (including its sliding assembly 30620) can be releasably mounted in a surgical device or its end effector having a jaw, anvil jaw, and firing member, as further described herein. After suturing motions are completed, the staple cartridge 30600 (including its sliding assembly 30620) can be removed from the end effector. When the staple cartridge 30600 is mounted in the surgical end effector, the sliding assembly 30620 can be aligned with the firing member in the surgical end effector, and when the staple cartridge 30600 is mounted in the surgical end effector, the distal sliding member 30622 can be releasably engaged with the firing member.

[0453] See now Figure 90 The diagram illustrates a firing member 30641 for use with a slider assembly 30620. When assembled, the firing member 30641 and the slider assembly 30620 form a firing assembly 30639, which is configured to advance along a rotary drive screw 30642 during the firing stroke. The firing member 30641 includes an upright body portion 30643, upper cam members 30644 extending laterally from both sides of the body portion 30643, and lower cam members 30645 extending laterally from both sides of the body portion 30643. The upper cam members 30644 are configured to engage the upper jaw or anvil of the end effector in a cam manner during the firing stroke, and the lower cam members 30645 are configured to engage the lower jaw or elongated channel of the end effector in a cam manner during the firing stroke. Cam members 30644 and 30645 are configured to clamp the jaws of end effector 30640 and define the tissue gap during the firing stroke, as further described herein with respect to various firing members (e.g., I-beams and E-beams).

[0454] like Figure 90As shown, when the staple cartridge 30600, including the slider assembly 30620, is mounted in the surgical end effector, the slider assembly 30620 is releasably engaged with the firing member 30641. More specifically, the proximal slider 30622 includes proximal fingers 30638 that extend laterally inward along each inner edge of the orthogonal portion 30621 into the longitudinal track 30637. Furthermore, the firing member 30641 includes a ridge 30648 positioned within a corresponding slot 30646 in the access body portion 30645. Due to the insertion angle of the staple cartridge 30600 relative to the firing member 30641, the proximal fingers 30641 are raised above the ridge 30648 and positioned in the slot 30646 in the firing member 30641 to releasably retain the proximal slider 30622 to the firing member 30641. See also: Figure 95 The engagement feature between the proximal slider 30622 and the firing member 30641 is sy...

Claims

1. A fastener compartment, comprising: A body comprising a tissue support platform, wherein a fastener cavity is defined through the tissue support platform within the body, wherein the fastener cavity includes a first cavity, and wherein the tissue support platform includes: The organizational aspect; and The lower side is opposite to the side facing the tissue, wherein the lower side includes a lower surface profile adjacent to the first cavity; Fasteners, the fasteners being removably positioned within the fastener cavity; and A driver, the driver movably supporting the fastener and configured to move through a portion of the fastener cavity to a firing position to eject the fastener from the fastener cavity, wherein the driver includes a first driver comprising: A first support column, the first support column including a fastener bracket; Base, the base extending from the first support column side toward the ground; and The second support column is offset laterally from the first support column. The base forms a bridging member between the first support column and the second support column; The top portion of the bridging member includes a top surface profile configured to engage with the lower surface profile when the first driver is in the firing position.

2. The fastener compartment according to claim 1, wherein, The lower surface profile includes a recess, and the top surface profile includes a protrusion configured to be nested in the recess when the first driver is in the firing position.

3. The fastener compartment according to claim 1, wherein, The fastener cavity includes an opening located in the tissue-facing side, and wherein the tissue-facing side includes a ridge extending around at least a portion of the opening.

4. The fastener compartment according to claim 3, wherein, The ridge includes a first ridge, which has a laterally varying height.

5. The fastener compartment according to claim 3, wherein, The ridge spans at least two openings across adjacent fastener cavity rows.

6. The fastener magazine of claim 1, further comprising a slider including a slider track configured to move along a firing path during the firing stroke to drively engage the first actuator, wherein, The top portion of the bridging member is asymmetrical relative to the firing path.

7. The fastener housing according to claim 6, wherein, The first actuator is overdriven by the slider to the firing position, in which the fastener bracket extends beyond the tissue support platform to the outside of the fastener compartment.

8. The fastener housing according to claim 1, wherein, The bridging member includes a first bridging member, wherein the fastener cavity further includes a second cavity, wherein the lower side further includes a second lower side surface profile adjacent to the first cavity, and wherein the first driver further includes: A third support column, which is laterally offset from the first and second support columns; and A second bridging member is located between the second support post and the third support post, wherein the top surface of the second bridging member includes a second top surface profile configured to engage with a second lower surface profile when the first driver is in the firing position.

9. The fastener housing according to claim 8, further comprising a slider, the slider comprising: A first sliding rail is configured to move along a first firing path during the firing stroke to drively engage the first bridging member. as well as A second sliding track is configured to move along a second firing path during the firing stroke to drively engage the second bridge, wherein the top portion of the bridge is asymmetrical relative to the firing path.

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