Surgical stapler with discretely positionable distal tip

Abstract

An apparatus includes a first jaw (16) and a second jaw (618, 718, 900) that cooperate to grip and staple tissue (90). The second jaw includes a jaw body (620, 720, 902) and a distal tip (619, 719, 906) pivotable relative to the jaw body between a first discrete position and a second discrete position. Both the first and second openings (663, 784, 785, 932, 934) are defined by one of the distal tip or a structure (621, 920) located proximal to the distal tip. A protrusion (637, 781, 918) is defined by the other of the distal tip or the structure. The protrusion is positionable within a first opening (663, 785, 932) to releasably retain the distal tip in the first discrete position, and is positionable within a second opening (663, 784, 934) to releasably retain the distal tip in the second discrete position.

Description

[0001] Related Applications

[0002] This application claims the benefit of the filing dates of U.S. Provisional Application Serial No. 63 / 413,671, filed on October 6, 2022, and U.S. Provisional Application Serial No. 63 / 467,656, filed on May 19, 2023, under 35 U.S.C. §119(e), the entire contents of both provisional applications being incorporated herein by reference and relied upon. Background Art

[0003] In some environments, endoscopic surgical instruments may be preferred to minimize the size of the surgical incision and the postoperative recovery time and complications relative to traditional open surgical devices. Therefore, some endoscopic surgical instruments may be suitable for placing the distal end effector at the desired surgical site through the cannula of the trocar. These distal end effectors (e.g., internal cutters, graspers, cutters, staplers, clip appliers, access devices, drug / gene therapy delivery devices, and energy delivery devices using ultrasound, RF, lasers, etc.) can engage tissue in a variety of ways to achieve diagnostic or therapeutic effects. Endoscopic surgical instruments may include an axis that extends from the end effector toward the proximal side to a handle portion manipulated by a clinician, or alternatively to a manipulator. Such an axis can be inserted into the desired depth and rotated around the longitudinal axis of the axis, so as to facilitate positioning the end effector in the patient's body. It can also be further facilitated to position the end effector by including one or more articulation joints or features so that the end effector can selectively perform articulation or otherwise deflect relative to the longitudinal axis of the axis.

[0004] The example of endoscopic surgical instrument includes surgical stapler.Some such staplers can operate to clamp tissue layers, cut through the clamped tissue layers, and drive the nail through the tissue layers to substantially seal the cut tissue layers together near the cut ends of the tissue layers.Such endoscopic surgical staplers can also be used for laparotomy and / or other non-endoscopic surgeries.Only by way of example, in thoracic surgery, the surgical stapler can be inserted through thoracotomy and thus be located between the ribs of the patient to reach one or more organs, and the thoracic surgery does not use a trocar as a conduit for the stapler.Such surgery may include using a stapler to cut and close blood vessels leading to organs (such as lungs).For example, before removing an organ from the chest cavity, blood vessels leading to the organ can be cut and closed by a stapler.Of course, surgical staplers can be used in various other situations and surgeries.

[0005] In some surgeries, it may be necessary to fire along the tissue (i.e., cutting and / or suturing), where more than one firing is required to complete the surgery. In other words, it may be necessary to perform multiple firings in sequence along a continuous path, referred to as "marching". For surgeries involving marching, the surgical stapler end effector may be placed at the surgical site, actuated to cut and suturing, removed from the surgical site for installation of a new staple cartridge, and then placed back at the surgical site for the next firing along the same path. In some such procedures, the clinician may need or desire to adjust the position of the distal end of the end effector during the surgical procedure to better facilitate the manipulation of the tissue and the firing of the tissue. However, known surgical staplers have limited capabilities for such adjustments.

[0006] The surgical suturing feature of the present disclosure seeks to enable the clinician to quickly and accurately adjust the position of the distal end of the surgical stapler end effector during the surgical procedure. Although various surgical staplers and associated components have been manufactured and used, it is believed that no one has manufactured or used the invention described in the appended claims before the inventor. BRIEF DESCRIPTION OF THE DRAWINGS

[0007] The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments of the invention and, together with the general description of the invention given above and the detailed description of the embodiments given below, serve to explain the principles of the invention.

[0008] Figure 1 depicts a perspective view of an example of an articulating surgical stapling instrument;

[0009] Figure 2 Depicted Figure 1 A side view of the device;

[0010] Figure 3 Depicted Figure 1 A perspective view of an end effector opened in an instrument;

[0011] Figure 4A Depicted along Figure 3 The line 4-4 is intercepted Figure 3 A side cross-sectional view of an end effector of with the firing beam in a proximal position;

[0012] Figure 4B Depicted along Figure 3 The line 4-4 is intercepted Figure 3 A side cross-sectional view of an end effector of with the firing beam in a distal position;

[0013] Figure 5 Depicted along Figure 3 The line 5-5 is intercepted Figure 3 An end cross-sectional view of an end effector;

[0014] Figure 6 Depicted Figure 3 An exploded perspective view of an end effector;

[0015] Figure 7 Depicted Figure 3 A perspective view of an end effector positioned at tissue and having been actuated once in the tissue;

[0016] Figure 8 depicts a perspective view of an alternative version of an end effector having an angled anvil jaw and an angled cartridge;

[0017] Fig. 9 Depicted Figure 8 An enlarged side view of an end effector;

[0018] Fig.10 Depicted Figure 8 An enlarged top view of the end effector;

[0019] Fig.11 depicts a perspective view of an example of a surgical stapling instrument having an end effector with a bent, elastically deformable end section;

[0020] Fig. 12A Depicted Fig.11 An enlarged side view of a distal portion of an end effector;

[0021] Fig. 12B Describes something like Fig.11 An enlarged side view of a distal portion of an alternative end effector of the end effector;

[0022] Fig.13 depicts a perspective view of a distal portion of another anvil jaw configured for use with the surgical instruments described herein;

[0023] Fig.14 Depicted Fig.13 an upper exploded perspective view of a distal portion of an anvil jaw facing proximally, showing an anvil body, distal tip, connector, spring plate, pivot pin, and connector pin;

[0024] Fig.15 Depicted Fig.13 an upper exploded perspective view of a distally facing portion of a distal portion of an anvil jaw of , showing a distal tip, a connector, and a spring plate;

[0025] Fig.16 Depicted Fig.13a lower exploded perspective view of a distally facing portion of a distal portion of an anvil jaw of , showing a distal tip, a connector, a spring plate, and two spring plate pins;

[0026] Fig.17A Depicted along Fig.13 The line 17-17 is intercepted Fig.13 a side cross-sectional view of a distal portion of an anvil jaw of showing the tip in a first discrete position;

[0027] Fig. 17B Depicted along Fig.13 The line 17-17 is intercepted Fig.13 another side cross-sectional view of a distal portion of the anvil jaw showing the tip transitioning to a second discrete position;

[0028] Fig. 17C Depicted along Fig.13 The line 17-17 is intercepted Fig.13 another side cross-sectional view of a distal portion of the anvil jaw showing the tip in a second discrete position;

[0029] Fig.18 depicts a perspective view of a distal portion of another anvil jaw configured for use with the surgical instruments described herein;

[0030] Fig.19 Depicted Fig.18 An exploded upper perspective view of a distal portion of an anvil jaw facing proximally, showing an anvil body, a distal tip, a connector, two guide pins, a pivot pin, and two connector pins;

[0031] Fig. 20 Depicted Fig.18 a distally facing perspective view of the distal tip of the device;

[0032] Fig.21 Depicted Fig.18 a distally facing perspective view of the base of;

[0033] Fig.22A Depicted along Fig.18 The line 22-22 is intercepted Fig.18 a side cross-sectional view of a distal portion of an anvil jaw of , showing the distal tip in a first discrete position;

[0034] Fig. 22B Depicted along Fig.18 The line 22-22 is intercepted Fig.18 another side cross-sectional view of the distal portion of the anvil jaw of , showing the distal tip in a second discrete position;

[0035] Fig.23A Depicted along Fig.18 The line 23-23 is intercepted Fig.18 A distally facing cross-sectional view of the distal portion of the anvil jaws of Fig.22A a distal end of a first discrete position;

[0036] Fig. 23B Depicted along Fig.18 The line 23-23 is intercepted Fig.18 Another distally facing cross-sectional view of the distal portion of the anvil jaws, showing the Fig.22A The first discrete position of Fig. 22B a distal tip between a second discrete position of the

[0037] Fig.23C Depicted along Fig.18 The line 23-23 is intercepted Fig.18 Another distally facing cross-sectional view of the distal portion of the anvil jaws of Fig. 22B a distal end of a second discrete position;

[0038] Fig.24 depicts a perspective view of a distal portion of another anvil jaw configured for use with the surgical instruments described herein;

[0039] Fig.25 Depicted Fig.24 An exploded upper perspective view of a distal portion of an anvil jaw facing proximally, showing an anvil body, a distal tip, a connector, a slide, two locking pins, a pivot pin, and three connector pins;

[0040] Fig.26 Depicted Fig.24 a lower exploded perspective view of a distally facing portion of a distal portion of an anvil jaw of , showing a distal tip, a connector, a slide, and a pivot pin;

[0041] Fig.27A Depicted along Fig.24 The line 27-27 is intercepted Fig.24 a side cross-sectional view of a distal portion of an anvil jaw of , showing the distal tip in a first discrete position;

[0042] Fig.27B Depicted along Fig.24 The line 27-27 is intercepted Fig.24 a side cross-sectional view of a distal portion of an anvil jaw of , showing a distal tip between a first discrete position and a second discrete position;

[0043] Fig.27C Depicted along Fig.24 The line 27-27 is intercepted Fig.24a side cross-sectional view of a distal portion of an anvil jaw of , showing the distal tip in a second discrete position;

[0044] Fig.28A Depicted along Fig.24 The line 28-28 is intercepted Fig.24 a side cross-sectional view of a distal portion of an anvil jaw of , showing the distal tip in a first discrete position;

[0045] Fig.28B Depicted along Fig.24 The line 28-28 is intercepted Fig.24 a side cross-sectional view of a distal portion of an anvil jaw of , showing the distal tip in a second discrete position;

[0046] Fig.29 depicts a perspective view of a distal portion of another anvil jaw configured for use with the surgical instruments described herein, showing the distal tip of the anvil jaw in a first discrete position;

[0047] Fig.30 Depicted Fig.29 a perspective view of a distal portion of an anvil jaw of , showing the distal tip in a second discrete position;

[0048] Fig.31 Depicted Fig.29 an upper exploded perspective view of a distal portion of an anvil jaw facing proximally, showing an anvil body, distal tip, connector, and cap;

[0049] Fig.32 Depicted Fig.29 an upper exploded perspective view of a distally facing portion of a distal portion of an anvil jaw of , showing an anvil body, distal tip, connector, and cap;

[0050] Fig.33 Depicted Fig.29 a distally facing end view of a distal end of a distal end of an anvil jaw;

[0051] Fig.34A Depicted along Fig.29 The line 34A-34A is intercepted Fig.29 a side cross-sectional view of a distal portion of an anvil jaw of , showing the distal tip in a first discrete position;

[0052] Fig.34B Depicted along Fig.30 The line 34B-34B is intercepted Fig.30 another side cross-sectional view of the distal portion of the anvil jaw of , showing the distal tip in a second discrete position;

[0053] Fig.35 depicts a perspective view of a distal portion of another anvil jaw configured for use with the surgical instruments described herein;

[0054] Fig.36 Depicted Fig.35 An exploded perspective view of an anvil jaw;

[0055] Fig.37 Depicted Fig.35 a distally facing perspective view of a distal end of an anvil jaw;

[0056] Fig.38 Depicted Fig.35 a distally facing perspective view of an insert of an anvil jaw;

[0057] Fig.39A Depicted along Fig.35 The line 39-39 is intercepted Fig.35 a side cross-sectional view of a distal portion of an anvil jaw of , showing the distal tip in a first discrete position;

[0058] Fig.39B Depicted along Fig.35 The line 39-39 is intercepted Fig.35 a side cross-sectional view of a distal portion of an anvil jaw of , showing the distal tip in a second discrete position;

[0059] Fig.40A Depicted Fig.35 a distally facing cross-sectional view of a distal portion of an anvil jaw of , showing the distal tip in a first discrete position;

[0060] Fig.40B Depicted Fig.35 Another distally facing cross-sectional view of the distal portion of the anvil jaws, showing the Fig.39A The first discrete position of Fig.39B a distal tip between a second discrete position of the

[0061] Fig.40C Depicted Fig.35 Another distally facing cross-sectional view of the distal portion of the anvil jaws of Fig.39B a distal end of a second discrete position;

[0062] Fig.41 depicts a distally facing perspective view of a distal tip of another anvil jaw configured for use with the surgical instruments described herein;

[0063] Fig.42A Depicted is shown in a pre-assembled state Fig.41a top cross-sectional view of an anvil tip and a mating portion of a corresponding anvil jaw;

[0064] Fig.42B Depicted is shown in an assembled state Fig.42A Another top cross-sectional view of the anvil tip and mating portions of the anvil jaws;

[0065] Fig.43 depicts a perspective view of another exemplary end effector having an anvil jaw with a self-actuating distal tip;

[0066] Fig.44 Depicted Fig.43 an exploded perspective view of a distal portion of an anvil jaw;

[0067] Fig.45A Depicted Fig.43 A side elevation view of an end effector of showing the anvil jaw in a closed state and the distal tip in a corresponding first position relative to the body of the anvil jaw;

[0068] Fig.45B Depicted Fig.43 Another side elevation view of the end effector of , showing the anvil jaw in a partially open state and the distal tip in a corresponding second position relative to the anvil jaw body; and

[0069] Fig.45C Depicted Fig.43 Another side elevation view of the end effector of , showing the anvil jaw in a fully open state and the distal end in a corresponding third position relative to the anvil jaw body.

[0070] The drawings are not intended to be limiting in any way, and it is contemplated that various embodiments of the invention may be performed in a variety of other ways, including those not necessarily shown in the drawings. The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate several aspects of the invention and, together with the description, serve to explain the principles of the invention; however, it should be understood that the invention is not limited to the precise arrangements shown. DETAILED DESCRIPTION

[0071] The following description of certain examples of the present technology should not be used to limit the scope of the present technology. Other examples, features, aspects, embodiments and advantages of the present technology will become apparent to those skilled in the art from the following description, which is by way of example, one of the best ways contemplated for implementing the present technology. As will be appreciated, the technology described herein can have other different and obvious aspects, all of which do not depart from the present technology. Therefore, the drawings and descriptions should be regarded as illustrative in nature and not restrictive.

[0072] For clarity of the disclosure, the terms "proximal" and "distal" are defined herein relative to a human or robotic operator of a surgical instrument. The term "proximal" refers to a position of an element that is closer to a human or robotic operator of a surgical instrument and further away from a surgical end effector of the surgical instrument. The term "distal" refers to a position of an element that is closer to a surgical end effector of a surgical instrument and further away from a human or robotic operator of a surgical instrument. In addition, the terms "upper", "lower", "lateral", "transverse", "bottom", "top" are relative terms to provide additional clarity to the figure descriptions provided below. Therefore, the terms "upper", "lower", "lateral", "transverse", "bottom", "top" are not intended to unnecessarily limit the present invention described herein.

[0073] In addition, the terms "about," "approximately," "substantially," and the like, as used herein in connection with any numerical value, numerical range, and / or geometric / positional quantification, are intended to encompass the exact value or quantification referenced, as well as suitable tolerances to enable the referenced feature or combination of features to function for the intended purpose described herein. For example, "substantially parallel" encompasses nominally parallel structures.

[0074] As used herein in conjunction with various examples of end effector jaw tips, a tip described as "angled," "curved," or "bent" encompasses tip configurations in which the longitudinal path (e.g., linear or arcuate) along which the tip extends is non-coaxial and non-parallel to the longitudinal axis of the jaw body; in particular, configurations in which the longitudinal tip path extends distally toward the opposing jaws. Conversely, a tip described as "straight" encompasses tip configurations in which the longitudinal axis of the tip is substantially parallel or coaxial with the longitudinal axis of the jaw body.

[0075] I. Exemplary Surgical Stapler

[0076] Figures 1 to 7 An example of a surgical stapling and severing instrument (10) is depicted that is sized to be inserted into a surgical site of a patient through a trocar cannula or incision (e.g., thoracotomy, etc.) to perform a surgical procedure. The instrument (10) of this example includes a handle portion (20) connected to a shaft (22) that terminates distally in an articulation joint (11) that is further coupled to an end effector (12). Once the articulation joint (11) and the end effector (12) are inserted through the cannula channel of the trocar, the articulation joint (11) can be remotely articulated by an articulation control (13), such as Figure 1, so that the end effector (12) can be deflected from the longitudinal axis (LA) of the shaft (22) at a desired angle (α). The end effector (12) of this example includes a lower jaw (16) (also referred to herein as a cartridge jaw) and an upper jaw in the form of a pivotable anvil jaw (18), the lower jaw including a staple cartridge (37).

[0077] Unless otherwise described, the term "pivot" (and variations thereof) as used herein encompasses but is not necessarily limited to pivotal movement about a fixed axis. For example, in some versions, the anvil jaw (18) may pivot about an axis defined by a pin (or similar feature) that slidably translates along an elongated slot or channel as the anvil jaw (18) moves toward the lower jaw (16). Such translation may occur before, during, or after the pivotal motion. It should therefore be understood that such combinations of pivotal and translational movement are encompassed by the term "pivot" and variations thereof as used herein.

[0078] The handle portion (20) includes a pistol grip (24) and a closure trigger (26). The closure trigger (26) is capable of pivoting toward the pistol grip (24) to cause the anvil jaw (18) to clamp or close toward the lower jaw (16) of the end effector (12). Such closure of the anvil jaw (18) is provided by a closure tube (32) and a closure ring (33), both of which longitudinally translate relative to the handle portion (20) in response to pivoting of the closure trigger (26) relative to the pistol grip (24). The closure tube (32) extends along the length of the shaft (22); and the closure ring (33) is positioned distally of the articulation joint (11). The articulation joint (11) is operable to transmit / transmit longitudinal motion from the closure tube (32) to the closure ring (33).

[0079] like Figure 2 As shown in the figure, the handle portion (20) also includes a firing trigger (28). An elongated member (not shown) extends longitudinally through the shaft (22) and transmits a longitudinal firing motion from the handle portion (20) to the firing beam (14) in response to actuation of the firing trigger (28). This distal translation of the firing beam (14) causes the tissue clamped in the end effector (12) to be stapled and severed, as will be described in more detail below.

[0080] like Figures 3 to 6As shown in the figure, the end effector (12) adopts a firing beam (14) which includes a transversely oriented upper pin (38), a firing beam cap (44), a transversely oriented middle pin (46) and a distally located cutting edge (48). The upper pin (38) is positioned in the longitudinal anvil slot (42) of the anvil jaw (18) and is capable of translating in the longitudinal anvil slot. The firing beam cap (44) is formed by extending the firing beam (14) through the lower jaw slot (45) ( Figure 4B The middle pin (46) is slidably engaged with the lower surface of the lower jaw (16), and the lower jaw slot is formed through the lower jaw (16). The middle pin (46) is slidably engaged with the top surface of the lower jaw (16), thereby cooperating with the firing beam top cover (44).

[0081] Figure 3 The proximally positioned firing beam (14) of the present example is shown, as well as the anvil jaw (18) pivoted to an open configuration to allow an unspent staple cartridge (37) to be removably installed into the channel of the lower jaw (16). Figures 5 and 6 As best seen in the drawings, the staple cartridge (37) of the present example includes a cartridge body (70) that presents an upper deck (72) and is coupled to a lower cartridge tray (74). Figure 3 As best seen in FIG. 1 , the vertical slot (49) extends longitudinally through a portion of the staple cartridge body (70). Figure 3 As best seen in FIG. 1 , three rows of nail holes (51) are formed through the upper deck (72) on each lateral side of the vertical slot (49). FIG. 4A to FIG. 6 As shown in , a wedge-shaped slide (41) and a plurality of nail drivers (43) are captured between a magazine body (70) and a tray (74), wherein the wedge-shaped slide (41) is positioned proximate to the nail drivers (43). The wedge-shaped slide (41) is capable of moving longitudinally within the nail magazine (37); and the nail drivers (43) are capable of moving vertically within the nail magazine (37). The nails (47) are also positioned within the magazine body (70) above the corresponding nail drivers (43). Each nail (47) is driven vertically within the magazine body (70) by the nail driver (43) to drive the nail (47) outward through the associated nail hole (51). As shown in FIG. 4A to FIG. 4B and Figure 6 As best seen in the drawings, the wedge sled (41) presents an inclined cam surface which pushes the staple drivers (43) upwardly as the wedge sled (41) is driven distally through the staple cartridge (37).

[0082] By advancing the closure tube (32) and the closure ring (33) distally so that the end effector (12) is FIG. 4A to FIG. 4BIn the depicted closed position, a firing member in the form of a firing beam (14) is advanced distally into engagement with the anvil jaws (18) by allowing the upper pin (38) to enter the longitudinal anvil slot (42). Figure 5 ) is located at the distal end of the firing beam (14), and when the firing trigger (28) is actuated, the firing beam (14) pushes the wedge-shaped slide (41) distally as it advances distally through the staple cartridge (37). During such firing, the cutting edge (48) of the firing beam (14) enters the vertical slot (49) of the staple cartridge (37), thereby severing the tissue clamped between the staple cartridge (37) and the anvil jaw (18). FIG. 4A to FIG. 4B As shown, the intermediate pin (46) and the push block (80) together actuate the nail magazine (37) by entering the vertical slot (49) in the nail magazine (37), thereby driving the wedge-shaped slide (41) into upward push contact with the nail driver (43), which in turn drives the nail (47) outward through the nail hole (51) and causes the nail to engage with the nail forming recess (53) on the inner surface of the anvil jaw (18) ( Figure 3 ) to form contact. Figure 4B The firing beam (14) is shown fully translated distally after severing and stapling tissue. FIG. 4A to FIG. 4B The nail forming recess (53) is intentionally omitted in the view in FIG. Figure 3 From Figure 5 The anvil jaws (18) are intentionally omitted from the view.

[0083] Figure 7 The end effector (12) is shown having been actuated through tissue (90) via a single firing stroke. Figure 7 The end effector (12) is then retracted from the patient's body, the empty staple cartridge (37) is replaced with a new staple cartridge (37), and the end effector (12) is reinserted into the patient's body to reach the suturing site for further cutting and suturing. This process can be repeated until the desired number and pattern of firing strokes across the tissue (90) have been completed.

[0084] The instrument (10) may be further constructed and operated in accordance with any of the teachings of the following references, the disclosures of which are incorporated herein by reference: U.S. Patent No. 8,210,411, entitled “Motor-Driven Surgical Instrument,” issued on July 3, 2012; U.S. Patent No. 9,186,142, entitled “Surgical Instrument End Effector Articulation Drive with Pinion and Opposing Racks,” issued on November 17, 2015; U.S. Patent No. 9,517,065, entitled “Integrated Tissue Positioning and Jaw Alignment Features for Surgical Stapler,” issued on December 13, 2016; U.S. Patent No. 9,622,746, entitled “Distal Tip Features for End Effector of Surgical Instrument,” issued on April 18, 2017; U.S. Patent No. 9,622,746, entitled “Lockout Feature for Movable Cutting Member of Surgical Instrument,” issued on August 1, 2017 No. 9,717,497, entitled “Surgical Instrument”; No. 9,795,379, entitled “Surgical Instrument with Multi-Diameter Shaft”, issued on October 24, 2017; No. 9,808,248, entitled “Installation Features for Surgical Instrument End Effector Cartridge”, issued on November 7, 2017; No. 9,839,421, entitled “Jaw Closure Feature for End Effector of Surgical Instrument”, issued on December 12, 2017; and / or No. 10,092,292, entitled “Staple Forming Features for Surgical Stapling Instrument”, issued on October 9, 2018.

[0085] II. End Effector with Visualization, Introduction, and Collection Features

[0086] In some cases, it may be desirable to provide the user with a clearer view of the end effector (12). Specifically, after the user inserts the end effector (12) into the surgical site, the user may rotate the shaft (22) of the instrument (10) during the operation. The end effector (12) thereby also rotates. As the end effector (12) rotates, the user may wish to see the surgical site. For example, the user may want to see the contact surface or point of contact between the tissue (90) and the end effector (12). Because the end effector (12) can be rotated about the longitudinal axis (LA) relative to the handle portion (20), the user can see the lower jaw (16) of the end effector when observing the surgical site, rather than the anvil jaw (18). Alternatively, the end effector (12) can be rotated so that the anvil jaw (18) is visible to the user when the user is observing the end effector (12). The user may desire to be able to see more of the surgical site than when using a handle (12). Figure 1 The range of surgical sites that can be seen when using the instrument (10) is large.

[0087] For example, in the case of some surgical procedures in which a vessel containing body fluids is transected and sutured, it may be desirable to visually confirm that the anvil jaw (18) and the lower jaw (16) completely cover the vessel to be cut so that the vessel can be completely cut and sutured in a single action. In other words, the user may wish to avoid a situation in which only a portion of the vessel is cut and sutured. Therefore, some means of visual monitoring and / or feedback may be desired so that the user will know that the end effector (12) has been properly positioned within the surgical site so that the anvil jaw (18) and the lower jaw (16) fully clamp the vessel. A potential way to monitor the surgical site may include improving the visualization of an area adjacent to the distal ends of the lower jaw (16) and the anvil jaw (18). Furthermore, not only may visualization of the distal end of the end effector (12) be desired, but it may also be desirable to construct the end effector (12) so that the distal end of the anvil jaw (18) is configured to be capable of pushing tissue (e.g., a large vessel) proximally into the space between the anvil jaw (18) and the lower jaw (16) when the anvil jaw (18) is closed toward the lower jaw (16).

[0088] Figure 8 An example of an end effector (212) is depicted that includes an anvil jaw (218) and a lower jaw (216). It should be understood that the end effector (212) may be used in place of the end effector (12) of the instrument (10). The end effector (212) may be integrally formed with the instrument (10), or alternatively, may be interchangeable with the end effector (12) of the instrument (10).

[0089] The anvil jaw (218) is operable to pivot relative to the lower jaw (216). The anvil jaw (218) and the lower jaw (216) may be similar to those of Figure 1 The anvil jaw (18) and the lower jaw (16) are shown to clamp tissue (90). The end effector (212) also includes a cartridge (237) that is coupled to the end effector (212). Figure 3 The illustrated cartridge (37) is similarly operable to be placed within lower jaw (216).

[0090] If available Figures 8 to 10 The anvil jaw (218) seen in the drawing has an elongated shape, wherein the distal portion of the anvil jaw (218) approaches the cartridge (237) at an angle. The distal portion of the anvil jaw (218) approaches the cartridge (237) at an angle such that the distal-most end (219) of the anvil jaw (218) extends distally beyond the cartridge (237) in the longitudinal direction. However, in some versions, the distal end (219) may extend longitudinally to be flush with the cartridge (237) or to a position proximal to the distal-most point of the cartridge (237). In addition, the anvil jaw (218) approaches the cartridge (237) at an angle with a gentle slope. As shown in FIG. Fig.10 As best shown in FIG. 1 , the anvil jaw (218) includes a side surface (241) that tapers toward the distal-most end (219) of the anvil jaw (218). By way of example, the anvil jaw (218) may be tapered toward the distal-most end (219) of the anvil jaw (218). Figure 8 The anvil jaw (218) is shaped like an inverted ski top. An anvil jaw (218) having an angled shape can make it easier to insert the end effector (212) into the surgical site. For example, an anvil jaw (218) having a gentle slope or an inverted ski top shape can provide an atraumatic tissue deflection surface when contacting or moving through tissue. Such atraumatic tissue deflection may include pushing tissue (e.g., a large vessel) toward the proximal side when the anvil jaw (218) is closed toward the lower jaw (216) into the space between the anvil jaw (218) and the lower jaw (216). Once placed in the surgical site, the anvil jaw (218) having an angled shape can also provide better maneuverability of the end effector (212) and better visibility of the distal end of the end effector (212) relative to the anatomical structure at the surgical site. Other suitable configurations of anvil jaw (218) will be readily apparent to those of ordinary skill in the art in view of the teachings herein.

[0091] The bin (237) is operable to hold Figure 4A A staple similar to the staple (47) shown in FIG. 1 is used to drive into tissue. Fig. 9As shown, the distal end of the cartridge (237) has a triangular profile. Specifically, the distal end of the cartridge (237) includes an upper tapered surface (239) and a lower tapered surface (238). In addition, the distal end of the cartridge (237) includes a tapered side surface (243) on each side. In this example, each tapered side surface (243) of the cartridge (237) is generally aligned with the taper presented by the side (241) of the anvil jaw (218). Thus, as Fig.10 As shown, the side surface (243) of the cartridge (237) does not extend outward from the longitudinal axis (LA) of the end effector (212) beyond the side (241) of the anvil jaw (218). The upper tapered surface (239) and the lower tapered surface (238) are closed at the distal end of the cartridge (237). The lower tapered surface (238) defines a sight line (240) so that once the user inserts the end effector (212) into the surgical site, the sight line (240) can be observed. The sight line (240) extends along the edge of the lower tapered surface (238). It should be understood that the lower tapered surface (238) may be operated to have a planar shape to allow the user to see and / or roughly see the distal end (219) of the anvil jaw (218). In particular, sight line (240) intersects a longitudinal axis (LA) extending longitudinally through end effector (212) to form an angle of view (θ).

[0092] The viewing angle (θ) may determine a user's relative visibility of the distal tip (219). Specifically, the user may be in front of the distal tip (219) along any line of sight that passes through the intersection of the sight line (240) and the longitudinal axis (LA) within the viewing angle (θ). For example, as the viewing angle (θ) increases, the user may have greater visibility of the area directly in front of the distal tip (219) from a proximal vantage point; however, as the viewing angle (θ) decreases, the user may have less visibility of the area in front of the distal tip (219) from a proximal vantage point. In some embodiments, the viewing angle (θ) defines an angle greater than 90 degrees. Additionally, in some embodiments, the viewing angle (θ) defines an angle greater than 135 degrees. Other suitable angles for the viewing angle (θ) can be readily envisioned by a person of ordinary skill in the art based on the teachings herein. In the illustrated version, the user typically views along the sight line (240) or along some other line of sight within the viewing angle (θ), so the user can view not only the area along the sight line, but also any area within the viewing angle (θ). The underside of the distal tip (219) may also be slightly rounded to help the user see the intersection of the longitudinal axis (LA) and the sight line (240).

[0093] When tissue (90) is clamped between the closed chamber (237) and the anvil jaw (218), the user can observe along the sight line (240) or at other positions within the viewing angle (θ), for example, clearly see where the anvil jaw (218) clamps the tissue (90). In addition, the user will be able to determine whether the tissue is fully clamped between the anvil jaw (218) and the chamber (237), and only by determining that the tissue is fully clamped can the tissue be ensured not to overflow the end of the end effector (212). It is also possible to visually present to the user the degree to which the anvil jaw (218) and the chamber (237) clamp the tissue (90). It should be understood that in some cases, the end effector (212) can be rotated before, during, or after clamping the tissue (90). Therefore, the tapered shape of the anvil jaw (218) also allows the user to more easily observe the distal end (219), or the area generally adjacent to the distal end (219). The tapered anvil jaw (218) together with the lower tapered surface (238) of the cartridge (237) can further facilitate the easy insertion of the end effector (212) into the tissue in an atraumatic manner. In addition, because the end effector (212) has a tapered end, it is easier to push the end effector (212) through a trocar or other device operable to guide the end effector (212) into the surgical site. For example, once the user loads the distal end (219) into the trocar, the lower tapered surface (238) and the tapered anvil jaw (218) can be used as an introduction end to guide the rest of the end effector (212) into the trocar. According to the teachings of this article, a person of ordinary skill in the art will further understand that the tapered design of the two sides (241) of the anvil jaw (218) and each side (243) of the cartridge (237) can enhance visibility and maneuverability.

[0094] In addition to the foregoing, the end effector (212) and the type of instrument (10) incorporating the end effector (212) may be constructed and operated in accordance with at least some of the teachings of the following: U.S. Patent No. 9,186,142, entitled “Surgical Instrument End Effector Articulation Drive with Pinion and Opposing Racks,” issued on November 17, 2015, the disclosure of which is incorporated herein by reference; U.S. Patent No. 9,717,497, entitled “Lockout Feature for Movable Cutting Member of Surgical Instrument,” issued on August 1, 2017, the disclosure of which is incorporated herein by reference; U.S. Patent No. 9,717,497, entitled “Integrated Tissue Positioning and Jaw Alignment Features for Surgical No. 9,517,065, entitled “Jaw Closure Feature for End Effector of Surgical Instrument”, issued on December 12, 2017, the disclosure of which is incorporated herein by reference; No. 9,839,421, entitled “Jaw Closure Feature for End Effector of Surgical Instrument”, issued on December 12, 2017, the disclosure of which is incorporated herein by reference; No. 9,622,746, entitled “Distal Tip Features for End Effector of Surgical Instrument”, issued on April 18, 2017, the disclosure of which is incorporated herein by reference; No. 10,092,292, entitled “Staple Forming Features for Surgical Stapling Instrument”, issued on October 9, 2018, the disclosure of which is incorporated herein by reference; No. 10,092,292, entitled “Staple Forming Features for Surgical Stapling Instrument”, issued on October 24, 2017, the disclosure of which is incorporated herein by reference; Shaft”, the disclosure of which is incorporated herein by reference; and / or U.S. Patent No. 9,795,379, entitled “Installation Features for Surgical Instrument End Effector Cartridge”, issued on November 7, 2017, the disclosure of which is incorporated herein by reference.Additional modifications that may be incorporated into end effector (212) are described in greater detail below.

[0095] III. End Effector with Angled Elastically Deformable Distal Tip

[0096] like FIG. 4A to FIG. 4B and Figure 7 As can be seen in the figure, the distal end configuration of the end effector (12) provides a gap between the distal end of the anvil jaw (18) and the distal end of the cartridge (37). This gap can facilitate advancement by providing tissue with an atraumatic space for access to the distal end of the end effector (12) at the beginning of each advancement step.

[0097] As described above, the distal end configuration of the end effector (212) is different from the distal end configuration of the end effector (12); wherein the different configurations of the end effector (212) provide different potential advantages. Specifically, the distal end configuration of the end effector (212) can improve maneuverability and improve visibility of the relationship between the distal end of the end effector (212) and adjacent anatomical structures. In addition, the distal end configuration of the end effector (212) can provide a tissue acquisition effect by pushing tissue proximally into the space between the anvil jaw (218) and the lower jaw (216) when the anvil jaw (218) is closed toward the lower jaw (216). However, in a version in which all structures of the end effector (212) are rigid, the curved configuration of the distal tip (219) of the anvil jaw (218) may not be suitable for advancing operations because the distal tip (219) may traumatize tissue that is not collected in the space between the anvil jaw (218) and the lower jaw (216) when the anvil jaw (218) is closed toward the lower jaw (216). Therefore, in a version in which all structures of the end effector (212) are rigid, the end effector (212) may be most suitable for cutting and stapling operations (e.g., vessel transection) in which all tissue to be cut and stapled is collected proximal to the distal tip (219).

[0098] In view of the foregoing, it may be desirable to provide a variation of an end effector (12, 212) that provides travel capabilities of the end effector (12), improved visibility associated with the end effector (212), and tissue acquisition capabilities of the end effector (212) without increasing the risk of trauma that may otherwise be associated with a completely rigid version of the end effector (212). Several merely illustrative examples of such variations of the end effector (12, 212) are described below. In the following examples, the anvil jaw has a distal tip that is resiliently biased to present a curved or angled configuration similar to the distal tip (219); however, the resiliently biased distal tip can deflect away from the lower jaw in response to a sufficient load on the distal tip. Based on the teachings herein, it should be understood that providing an anvil jaw having an angled distal tip portion that is resiliently deformable can provide an additional level of maneuverability benefit in navigating through tissue to a surgical site. In this manner, the deformable distal tip portion can be deflected or deformed to facilitate smooth and atraumatic movement of the end effector through tissue, particularly during advancement operations. Additionally, with the anvil jaw having a bias to an angled position when not in a loaded state or in contact with surrounding tissue, enhanced visualization during tissue capture and cutting can be achieved compared to using an end effector with a straight or non-angled anvil jaw. Furthermore, an anvil jaw having a distal tip biased to an angled position can provide a degree of tissue acquisition effect until a load point associated with advancement is reached, rather than being associated with simply acquiring relatively small tissue structures between the anvil jaw and the lower jaw.

[0099] Fig.11Another example of an instrument (310) configured to be capable of being a surgical stapler is shown. The instrument (310) includes a handle portion (320) and a shaft (322). The instrument (310) has a modular configuration so that the shaft (322) can be selectively removed from the handle portion (320) and can be attached to the handle portion. The instrument (310) is constructed similarly to the instrument (10) so that the operability and use of the instrument (310) are the same as those described above for the instrument (10), wherein an additional feature of the instrument (310) is the modular configuration. Through its modular configuration, the instrument (310) provides a method for replacing an end effector. Such changes can be made in the end effector to replace an otherwise worn end effector, or to provide different end effector configurations based on the procedure or user preference. In addition to or in lieu of the foregoing, features operable to provide a modular configuration of the apparatus (310) may be constructed in accordance with at least some of the teachings of the following U.S. Patent No. 10,182,813, entitled "Surgical Stapling Instrument with Shaft Release, Powered Firing, and Powered Articulation," issued on January 22, 2019, the disclosure of which is incorporated herein by reference. Other suitable components, features, and configurations for providing an apparatus (310) having a modular configuration will be apparent to one of ordinary skill in the art in light of the teachings herein. Furthermore, one of ordinary skill in the art will appreciate that the apparatus (10) may be modified to incorporate a modular configuration, as shown and described with respect to the apparatus (310) or other apparatus incorporated herein by reference, in light of the teachings herein.

[0100] exist Fig.11 In the example shown in FIG. 1 , the instrument ( 310 ) includes an end effector ( 312 ) having an anvil jaw ( 318 ) having an angled distal tip ( 319 ). In addition, the distal tip ( 319 ) of the anvil jaw ( 318 ) is elastically deformable. In this manner, and as Fig. 12A and Fig. 12BAs best shown in , the angled distal tip (319) is operable to elastically deform from a first angled position to a second position. The second position of the angled distal tip (319) may be substantially straight in some versions, but may be angled to a certain degree (e.g., slightly above or slightly below the longitudinal axis (A1)) in other versions. It should be understood that the second position of the angled distal tip (319) may be defined by the characteristics (e.g., thickness, density, etc.) of the tissue captured between the anvil jaw (318) and the lower jaw (16). In the present example, the end effector (312) is disposed on a shaft (322) that is removable from the handle portion (320). By way of example only, shaft (322) may be detachable from handle portion (320) in accordance with at least some of the teachings of U.S. Patent No. 9,913,642, entitled “Surgical Instrument Comprising a Sensor System,” issued on Mar. 13, 2018, the disclosure of which is incorporated herein by reference. In some other versions, shaft (322) is not detachable from handle portion (320).

[0101] It should be understood that the end effector (312) may be used instead of Figure 1 . In some versions, the end effector (312) may be integrally formed with the shaft (22), or alternatively, the end effector may be formed separately and then assembled. In some versions, the end effector (312) may be provided for use in a robotic system. In such a robotic system, a modular shaft (322) having an end effector (312) can be attached to a portion of the robotic system for use, so that the handle portion (320) is replaced by a component of the robotic system. Still in other examples, the end effector (312) may be adapted for use with a robotic system in a manner in which the end effector (312) is connected to the robotic system without having to connect the entire modular shaft (322). In accordance with the teachings herein, other ways of incorporating an end effector having an angled, elastically deformable anvil tip into a user-operated or robot-operated instrument will be apparent to one of ordinary skill in the art.

[0102] Fig. 12AAn enlarged side view of the distal end of the end effector (312) is shown. The end effector (312) includes an anvil jaw (318) and a lower jaw (16) that receives a cartridge (37) as described above with respect to the instrument (10). As described above with respect to the instrument (10), the anvil jaw (318) is pivotally rotatable toward the lower jaw (16) in the same manner as the anvil jaw (18). In this configuration, the end effector (312) is similar to the end effector (12), however, the anvil jaw (318) includes an angled distal tip (319) that is resiliently deformable. As Fig. 12A As shown, the distal tip (319) is biased to an angled position that is Fig.11 is shown in and Fig. 12A When the end effector (312) is not clamping tissue and is open, the distal end (319) assumes this angled position, as shown in dashed lines. Fig.11 as shown; or closed without clamping the tissue, as Fig. 12A . When end effector (312) is in this angled state or position, end effector (312) may be considered unloaded or in an unloaded state or position. Conversely, when end effector (312) is clamping tissue, end effector (312) may be considered loaded or in a loaded state or position.

[0103] When closed and not clamping tissue between the anvil jaw (318) and the lower jaw (16), the distal tip (319) contacts the cartridge (37). In this position, the lower surface (324) of the distal tip (319) defines a plane that intersects the longitudinal axis (A1) defined by the shaft (322) to form an angle (θ1). When closed and clamping tissue (90) between the anvil jaw (318) and the lower jaw (16), the lower surface (324) of the distal tip (319) contacts the tissue (90). In this position, the lower surface (324) of the distal tip (319) defines a plane that intersects the longitudinal axis (A1) to form an angle (θ2). Fig. 12AIn the illustrated example, the angles (θ1, θ2) are relative to the longitudinal axis (A1), and the sum of the angles (θ1, θ2) represents the range of motion experienced by the distal tip (319). By way of example only and not limitation, in some examples, in the downward direction from the longitudinal axis (A1) toward the bin (37), the angle (θ1) is between about 20 and about 70 degrees, or more specifically between about 30 and about 50 degrees. By way of example only and not limitation, in some examples, in the upward direction away from the longitudinal axis (A1) from the bin (37), the angle (θ2) is between about 0 and about 90 degrees. By way of example only and not limitation, in some examples, the range of motion experienced by the distal tip (319) is between about 20 and about 110 degrees. The angles described for angles (θ1, θ2) are examples only and are not limiting. Other suitable angles will be apparent to one of ordinary skill in the art based on the teachings herein.

[0104] Additionally, in some cases, the longitudinal axis (A1) represents a zero degree reference and the angle relative to it can be positive or negative. For example, in the case where the angle is in a downward direction from the longitudinal axis (A1) toward the bin (37), the angle can be characterized as a negative angle. Similarly, in the case where the angle is in an upward direction away from the longitudinal axis (A1) away from the bin (37), the angle can be characterized as a positive angle. When using these provisions, the range of movement of the distal tip (319) due to deformation can be understood as the sum of the absolute value of the angle when the distal tip (319) is in a position to contact the bin (37) and the angle when the distal tip (319) is in a deformed state (when clamping tissue).

[0105] Fig. 12B Shown with Fig. 12A 4. With respect to the end effector (312), when the anvil jaws (318) are in their angled and undeformed state (e.g., in the Fig. 12A When the anvil jaw (318) is deformed so that it deflects upward, the end of the distal tip (319) extends to the far side of the far end of the cartridge (37). Fig. 12B As shown, when the anvil jaws (318) are in their angled and undeformed state (e.g., in Fig. 12BWhen the anvil jaw (318) is deformed so that it is deflected upward, the end of the distal tip (319) of the anvil jaw (318) extends to a point that is flush with or close to the distal end of the cartridge (37). In this way, when the anvil jaw (318) is in its angled state or deformed state, the anvil jaw (318) of the end effector (412) is flush with or close to the distal end of the cartridge (37), so that whether the anvil jaw (318) is in an angled and undeformed state or in a deformed state, the anvil jaw (318) does not extend beyond the distal end of the cartridge (37). In some cases, this can be achieved by modifying the anvil jaw (318) so that the length of the distal tip (319) of the anvil jaw is shortened. In other cases, instrument (10, 310) may be modified to provide slight proximal retraction of anvil jaw (318) when clamping.Other ways to modify end effector (412) as it relates to controlling the position of anvil jaw (318) will be apparent to those of ordinary skill in the art in view of the teachings herein.

[0106] IV. End Effector Jaws with Discretely Positionable Distal Tips

[0107] In some cases, it may be desirable to provide clinicians with a universal end effector jaw with a distal tip that can present multiple discrete positions relative to the jaw body to accommodate various needs during surgical procedures. In this regard, a user may desire an end effector with an angled (or "bent") distal tip that provides visualization and placement benefits as described above, or more effectively pushes tissue (e.g., large vessels) proximally into the space between the anvil jaw and the cartridge jaw when the end effector is closed. In other cases, a user may desire to use an end effector with a substantially straight distal tip to better facilitate advancement as described above, or to reduce pressure applied to tissue positioned below the distal tip.

[0108] Combined with the following Figures 13 to 42BEach of the exemplary end effector jaws described is configured to be used with any of the surgical stapling instruments described herein, and includes a distal tip that is configured to move (e.g., pivot or rotate) between a first discrete position and a second discrete position relative to the jaw body to adjust the orientation of the longitudinal distal tip axis relative to the longitudinal jaw body axis and maintain the discrete. Such transitions between discrete positions occur in response to an external input force intentionally applied to the distal tip by a clinician directly or indirectly via an anatomical structure of a patient in contact with the distal tip. In addition, each end effector jaw is appropriately configured to enable its distal tip to maintain its current discrete position until an external input force intentionally applied to the distal tip by a clinician directly or indirectly acts on it.

[0109] Although such end effector jaws of the present type are shown in the form of anvil jaws, each of which has an anvil jaw body with a plurality of nail forming recesses, in other types, such discretely positionable distal ends may be applied to a magazine jaw that is configured to receive a replaceable nail magazine or otherwise support a suturing assembly that accommodates a plurality of nails. In addition, although the first discrete position of each end effector jaw described below is presented in the form of a straight position in which the distal end axis extends substantially parallel to the jaw body axis, in other types, the first discrete position may include an angled position in which the distal end axis is angled relative to the jaw body axis, for example, in a direction away from the opposite end effector jaw. In addition, in other types, the end effector jaw may include more than two discrete positions for its distal end.

[0110] As this article combines Figures 13 to 42B The term "discrete" and variations thereof used with the illustrated discretely positionable distal tip means predetermined, wherein each discrete position of the distal tip relative to its respective jaw body is predetermined by specific structural features of the distal tip (519) and / or other portions of the respective end effector jaws. As used herein, "discrete" and variations thereof are not intended to encompass configurations in which the distal tip is configured to be able to transition between various positions relative to the respective jaw body solely by elastic or plastic deformation of the distal tip.

[0111] A. Anvil jaws with spring plate and toggle end with pin hinge

[0112] Figures 13 to 17C A distal portion of an exemplary anvil jaw (518) is depicted having a discretely positionable distal tip (519) and configured to be used with an endoscopic surgical stapler end effector, such as any of the end effectors (12, 212, 312, 412) described above.

[0113] The anvil jaw (518) includes: an elongated jaw body (520) having a suturing surface having a plurality of staple forming dimples similar to dimples (53); a distal tip (519) located distal to the jaw body (520); a connector (521) interconnecting the distal tip (519) with the jaw body (520); and a spring plate (560) housed within the connector (521). As described in more detail below, the connector (521) is attached to the distal end of the jaw body (520), and the distal tip (519) is pivotally coupled to the connector (521) and is configured to be capable of being moved relative to the jaw body (520) in a first discrete position presenting a straight tip orientation (see Fig.17A ) and a second discrete position presenting an angled distal orientation (see Fig. 17C ) are pivoted between the jaw body (520). In this version, the connector (521) is configured to be press-fit into the jaw body (520). Specifically, the connector (521) includes a proximal protrusion (541) that is inserted into a slot (542) formed in the distal end of the jaw body (520), and the connection is then secured using a pin (536). Other ways of attaching the connector (521) to the jaw body (520) of the anvil jaw (518) will be apparent to one of ordinary skill in the art. In other versions of the anvil jaw (518), the features of the connector (521) may be integrally formed with the jaw body (520) so as to define an integral connector portion at the distal end of the jaw body (520), as described below.

[0114] The connector (521) includes a pair of arms (529) extending distally. The arms (529) include apertures (531) that are configured to coaxially align with corresponding apertures formed in the proximal end portion of the distal tip (519) to receive the pivot pin (508) and thereby pivotably couple the distal tip (519) to the connector (521). In this manner, the apertures (531) and the pivot pin (508) define a longitudinally fixed pivot axis or rotation axis about which the distal tip (519) is configured to pivot (or "switch") between a first discrete position and a second discrete position, and which extends transversely relative to the longitudinal axis of the jaw body (520). In some alternative versions, the pivot axis may be permitted to slidably translate longitudinally a minimum distance before, during, or after pivotal movement about the pivot axis, such as by providing the aperture (531) of the connector (521) or the aperture of the distal tip (519) with an elongated cross-sectional shape rather than a circular cross-sectional shape. It should be understood that similar modifications may also be applied to the anvil jaws (618, 718) described below. Fig.17A and Fig. 17C As shown, the distal tip (519) may be constrained from pivoting beyond a certain angle due to interference between the connector (521) and a tapered detent projection (537) extending proximally from the body of the distal tip (519). The pivot pin (508) may be press-fit, threaded, or glued to, for example, the connector (521) or the distal tip (519), and in some versions may be removable.

[0115] The connector (521) also includes a longitudinally extending slot (527) (which may also be referred to as a cavity) that accommodates and constrains the spring plate (560). The spring plate (560) may include a spring plate hole (564) for removably securing the spring plate (560) to the connector (521). The spring plate (560) may include a spring (535), shown as a leaf spring tab, which may apply a biasing force to the pawl protrusion (537) of the distal end (519) and thereby pivotably bias the distal end (519) toward one of the first discrete position or the second discrete position. More specifically, the spring (535) may include a distal bend (538) that is configured to contact the pawl protrusion (537) of the distal end (519) and apply a force thereto. The spring plate (560) may be made of a material that is capable of deflecting and applying a spring force, such as metal or plastic. Additionally, the spring plate (560) may be removably or non-removably attached to the connector (521). The spring plate (560) may be coupled to the connector (521) using a pair of spring plate pins (567) extending through a pair of connector pin holes (569) and spring plate holes (564). The spring plate pins (567) may be secured to the connector (521) by, for example, threads, adhesive, or press fit.

[0116] like 17A to 17C As shown, and as described above, the distal tip (519) is configured to pivot relative to the jaw body (520) and the connector (521) via the pivot pin (508) between first and second discrete positions defining respective first and second orientations of the distal tip (519). Fig.17A , which illustrates the distal tip (519) in a first discrete position, in which the distal tip (519) is in a straight orientation in which the longitudinal axis of the distal tip (519) is substantially parallel to the longitudinal axis of the jaw body (520). In the illustrated version, this corresponds to when the detent projection (537) of the distal tip (519) is located below the distal bend (538) of the spring tab (535). Fig. 17C, which illustrates the distal tip (519) in a second discrete position, the distal tip (519) being in a bent or angled orientation in which the longitudinal axis of the distal tip (519) is angled relative to the longitudinal axis of the jaw body (520). In the illustrated version, this corresponds to when the detent projection (537) of the distal tip (519) is located above the distal bend (538) of the spring (535). Fig. 17B The distal tip (519) is illustrated in transition from a first discrete position to a second discrete position such that the detent projection (537) contacts the distal bend (538) of the spring (535) of the spring plate (560).

[0117] The detent projection (537) of the distal tip (519) may maintain continuous contact with the spring (535) within the connector slot (527), such that the spring (535) is continuously in a state of at least slight proximal deflection. This interaction may cause the spring (535) to continuously apply a distally directed biasing force on the detent projection (537), and when the distal tip (519) rotates, the distally directed biasing force may reach a peak as the detent projection (537) approaches the distal bend (538). When the detent projection (537) is located at or below the distal bend (538), the spring (535) may be able to rotationally bias the detent projection (537) downwardly, so that the distal tip (519) presents a proximal position. Fig.17A When the detent projection (537) is located at or above the distal bend (538), the spring (535) can be configured to rotationally bias the detent projection (537) upwardly so that the distal tip (519) presents a first discrete position and a corresponding straight tip orientation. Fig. 17C The second discrete position and corresponding angled tip orientation of the distal tip (519) can be selected. In this regard, the distal bend (538) can serve as a fulcrum feature. The size and shape of the spring (535) and the detent protrusion (537) can be selected to achieve a desired biasing effect on the distal tip (519).

[0118] In the present example, the detent projection (537) acts together with the spring (535) to hold the distal tip (519) in its current discrete position until sufficient force is applied to the distal tip (519) to overcome the biasing force applied between the detent projection (537) and the spring (535). For example, when the distal tip (519) is in an angled orientation and sufficient upward force is applied to the distal tip (519), the detent projection (537) of the distal tip (519) will rotate downward and snap past the spring bend (538), thereby allowing the distal tip (519) to assume another discrete position. Similarly, when the distal tip (519) is in a straight orientation and sufficient downward force is applied to the distal tip (519), the detent projection (537) of the distal tip (519) will rotate upward and snap past the spring bend (538), thereby allowing the distal tip (519) to assume another discrete position.

[0119] Also like Figures 15 to 17C As can be seen, the proximal end of the distal tip (519) includes stop surfaces that are configured to engage corresponding distal end surfaces of the connector (521) to constrain the distal tip (519) to a predetermined angular range of motion relative to the jaw body (720). Specifically, as Fig.17A As shown, when the distal tip (519) is in the first discrete position, the upper stop surface at the upper end of the base of the pawl protrusion (537) is configured to engage the upper distal end surface of the connecting member (521) to inhibit the distal tip (519) from further pivoting beyond the first discrete position. Fig. 17C As shown, when the distal tip (519) is in the second discrete position, the lower stop surface at the lower end of the base of the pawl protrusion is configured to engage the lower distal end surface of the connecting member (521) to inhibit the distal tip (519) from further pivoting beyond the second discrete position.

[0120] B. Anvil jaws with toggle tips and resilient pawl connections

[0121] Figures 18 to 23C A distal portion of another exemplary anvil jaw (618) is depicted having a discretely positionable distal tip (619) and configured to be used with an endoscopic surgical stapler end effector, such as any of the end effectors (12, 212, 312, 412) described above.

[0122] The anvil jaw (618) includes: an elongated jaw body (620) having a suturing surface having a plurality of staple forming recesses similar to recesses (53); a distal tip (619) located distal to the jaw body (620); and a connector (621) interconnecting the distal tip (619) and the jaw body (620). Similar to the distal tip (519), the distal tip (619) and the connector (621) are pivotally coupled and are configured to be able to be positioned relative to the jaw body (620) in a first discrete position presenting a straight tip orientation (see Fig.22A ) and a second discrete position presenting an angled distal orientation (see Fig. 22B ) pivots between the jaw bodies (620). The connector (621) is attached to the distal end of the jaw body (620), for example, using a plurality of pins. In this version, the connector (621) is attached using a pair of pins (646) positioned in corresponding pin holes (647) to maintain the connector (621) in lateral alignment with the jaw body (620), and is attached using a pair of pins (636) to longitudinally secure the connector (621) relative to the jaw body (620). For example, the pins (636, 646) can be secured by a press fit or a threaded connection. Fig.19 As shown, the proximal end of the connecting member (621) includes a vertically extending narrow slot (627), the size and shape of which are set to receive a pair of protrusions extending distally from the distal end of the jaw body (620) when the connecting member (621) is assembled with the jaw body (620).

[0123] The distal end of the connector (621) includes a pair of arms (629) extending distally and including respective apertures (631) configured to receive a pivot pin (608) to pivotally couple the distal tip (619) to the connector (621). In this manner, the aperture (631) and the pivot pin (608) define a longitudinally fixed pivot axis or rotation axis about which the distal tip (619) is configured to pivot (or "switch") between a first discrete position and a second discrete position, and which extends transversely relative to the longitudinal axis of the jaw body (620). In some alternative versions, the pivot axis may be permitted to slidably translate longitudinally a minimum distance before, during, or after pivotal movement about the pivot axis. The proximal end of distal tip (619) includes a terminal hole (633) that is coaxially aligned with aperture (631) and similarly receives pivot pin (608). Pivot pin (608) may be press-fit, threaded, or glued, for example, to connector (621) or distal tip (619), and in some versions may be removable.

[0124] The central body portion of the connector (621) includes a pawl cavity (663) that extends longitudinally through the central body portion and is located proximal to the arm opening (631). As described below, the connector (621) as a whole or at least the central body portion of the connector (621) including the pawl cavity (663) is formed of an elastically deformable material that is configured to releasably retain the distal end (619) in each of its first discrete position and second discrete position. The pawl cavity (663) is defined by two interconnected vertically adjacent openings, which respectively define an upper cavity portion and a lower cavity portion, each of which extends longitudinally along a corresponding longitudinal axis. As FIG. 22A to FIG. 22B As shown, these longitudinal axes are angled relative to each other so as to define a proximal opening angle. The opening of each cavity portion defining the pawl cavity (663) is sized to receive a pin-shaped pawl projection (637) extending proximally from the proximal end of the distal tip (619). The intermediate cavity portion of the pawl cavity (663) interconnects the upper cavity portion and the lower cavity portion and has a maximum lateral width that is narrower than the maximum lateral width of each of the upper cavity portion, the lower cavity portion, and the pawl projection (637) of the distal tip (619). In this version, the pawl projection (637) is substantially cylindrical, and each opening defining the upper and lower portions of the pawl cavity (663) has a stadium shape, wherein the length is aligned with the length of the pawl cavity (663) along the vertical thickness of the connector (621).

[0125] The detent projection (637) can be positioned within a lower cavity portion (i.e., a lower opening) of the detent cavity (663) to releasably retain the distal end (619) in a first discrete position and a corresponding straight end orientation. Conversely, the detent projection (637) can be positioned within an upper cavity portion (i.e., an upper opening) to releasably retain the distal end (619) in a second discrete position and a corresponding angled end orientation. In addition, at least a central body portion of the connector (621) is formed of a polymer that is configured to resiliently deflect in response to an external input force applied to the distal end (619) and thereby permit the detent projection (637) of the distal end (619) to pass between the upper cavity portion and the lower cavity portion. The reduced lateral width of the intermediate cavity portion provides an interference fit with the pawl protrusion (637) and is therefore used to inhibit the pawl protrusion (637) from transitioning between the upper cavity portion and the lower cavity portion in the absence of an external input force. In addition, the pawl cavity (663) includes tapered edges at the intermediate cavity portion that bias the pawl protrusion (637) toward the closer of the upper cavity portion or the lower cavity portion, thereby biasing the distal end (619) toward the closer of the first discrete position or the second discrete position. The connector (621) also includes a release groove (661) extending vertically along each lateral side of the pawl cavity (663). When the pawl protrusion (637) transitions between the upper cavity portion and the lower cavity portion, each release groove (661) enables the corresponding wall of the material separating the release groove (661) from the pawl cavity (663) to be elastically deflected laterally outward. Each release groove (661) is shown in the form of an elongated through hole, but may be configured in various other ways in other versions of the connector (621).

[0126] The distal tip (619) is configured to pivot about its pivot axis between discrete positions relative to the jaw body (620), wherein the discrete positions are defined by the lower and upper portions of the pawl cavity (663). Specifically, Fig.22A and Fig.23A The distal tip (619) is shown in a first discrete position in which the distal tip (619) assumes a straight orientation relative to the jaw body (620) such that the distal tip axis is substantially parallel to the jaw body axis. This distal position is achieved by positioning the detent projection (637) of the distal tip (619) within the lower cavity portion of the detent cavity (663). Fig. 22B and Fig.23CThe distal tip (619) is shown in a second discrete position in which the distal tip (619) is oriented at an angle relative to the jaw body (620) such that the distal tip axis is angled relative to the jaw body axis. This end position is achieved by positioning the pawl projection (637) within the upper cavity portion of the pawl cavity (663). Fig. 23B The detent projection (637) of the distal tip (619) is shown transitioning between the lower and upper cavity portions of the detent cavity (663), which causes the wall of the material to deflect laterally outward into the release groove (661). Once the detent projection (637) has been driven into the lower or upper cavity portion of the detent cavity (663) to provide the distal tip (619) in the corresponding first discrete position or second discrete position, the detent projection (637) remains there until an external input force is applied to the distal tip (619) by a user or an external structure to drive the distal tip (619) to the opposite discrete position.

[0127] C. Anvil jaws with pin locking ends

[0128] Figures 24 to 28B Depicted is a distal portion of another exemplary anvil jaw (718) having a discretely positionable distal tip (719) and configured to be used with an endoscopic surgical stapler end effector, such as any of the end effectors (12, 212, 312, 412) described above.

[0129] The anvil jaw (718) includes: an elongated jaw body (720) having a suturing surface having a plurality of staple forming dimples similar to dimples (53); a distal tip (719) located distal to the jaw body (720); a connector (721) interconnecting the distal tip (719) with the jaw body (720); and a movable latch, which is illustrated as a slide (768) movably coupled to the jaw body (720) and the connector (721). The connector (721) is coupled to the jaw body (720) using a pin (746) positioned within a corresponding pin hole (747). The pin (746) may be secured via, for example, a press fit or threaded fixation, but various other ways of attaching the connector (721) to the jaw body (720) will be apparent to one of ordinary skill in the art.

[0130] The jaw body (720) further includes a slider slot (724) that can slidably accommodate a slider (768) and permit the slider (768) to translate relative to the jaw body (720) between a distal locking position and a proximal release position. The slider (768) can be resiliently biased toward the distal locking position and can be selectively retracted to the proximal release position by a user grasping an exposed side portion of the slider (768). The slider (768) includes a pair of latch projections, shown as pins (781), that are configured to extend distally through a corresponding pair of transverse holes (789) of the connector (721) and into a pair of first latch pin apertures (785) or a pair of second latch pin apertures (784) formed in the proximal end (737) of the distal tip (719). The slide (768) is laterally positioned relative to the jaw body (720) and the connector (721) by a pair of laterally opposed guide rails that are capable of slidably tracking within corresponding longitudinal channels defined by the distal end of the jaw body (720) in conjunction with the connector (721).

[0131] The connector (721) includes a pair of arms (729) extending distally and including apertures (731) configured to receive a pivot pin (708) to pivotally couple the distal tip (719) to the connector (721). In this manner, the aperture (731) provides a longitudinally fixed pivot axis or axis of rotation for the distal tip (719). In some alternative versions, the pivot axis may be permitted to slidably translate longitudinally a minimum distance before, during, or after pivotal movement about the pivot axis. The pivot pin (708) may be press-fit, threaded, or glued to, for example, the connector (721) or the distal tip (719), and may be removable in some versions.

[0132] The first latch pin aperture (785) and the second latch pin aperture (784) open through the convexly curved proximal end surface of the distal tip (719). FIG. 27A to FIG. 27C As shown, each first latch pin aperture (785) is angled relative to the corresponding second latch pin aperture (784) such that each vertically adjacent pair of first and second latch pin apertures (785, 784) define a proximal opening angle and communicate at their distal ends. In other versions of the distal tip (719), various alternative numbers and configurations of latch apertures may be provided, wherein each pair of latch apertures defines a respective discrete position of the distal tip (719) when engaged by the latch pin (781).

[0133] With the above-described configuration for anvil jaw (718), distal tip (719) is configured to be pivotable about a pivot axis defined by aperture (731) to assume at least first and second discrete positions relative to jaw body (720). Fig.27A The distal tip (719) is shown in a first discrete position in which the longitudinal axis of the distal tip (719) is substantially parallel to the longitudinal axis of the jaw body (720), wherein the first discrete position is maintained by inserting the latch pin (781) distally into the first latch pin orifice (785). Fig.27B and 27C The distal tip (719) is shown in a second discrete position in which the longitudinal axis of the distal tip (719) is angled relative to the longitudinal axis of the jaw body (720), wherein the second discrete position is maintained by inserting the latch pin (781) distally into the second latch pin aperture (784). FIG. 27B to FIG. 27C As shown, the sliding member (768) is capable of being actuated in the proximal direction (790) to retract the latch pin (781) from the latch pin orifices (784, 785) and thereby permitting the distal end (719) to freely pivot relative to the connecting member (721) and the jaw body (720); and actuated in the distal direction (791) to insert the latch pin (781) into one of the first latch pin orifice (785) or the second latch pin orifice (784), thereby releasably locking the distal end (719) in one of the first discrete position or the second discrete position.

[0134] like Figure 25 to Figure 26 As shown, the distal end of the connector (721) includes a fixed range pin (783) positioned between the arms (729) and extending distally toward the distal tip (719). In addition, the proximal end (737) of the distal tip (719) includes a range pin slot (786) sized to slidably receive the distal end of the range pin (783) when the distal tip (719) pivots between the first discrete position and the second discrete position. Thus, the range pin (783) and the range pin slot (786) are configured to cooperate to inhibit the distal tip (719) from pivoting beyond each of the first discrete position and the second discrete position, and thereby constrain the distal tip (719) to a predetermined range of angular motion relative to the jaw body (720), wherein the predetermined range has endpoints that coincide with the first discrete position and the second discrete position of the distal tip (719).

[0135] D. Anvil jaws with pivoting ends and cantilever springs

[0136] Figures 29 to 34BDepicted is a distal portion of another exemplary anvil jaw (818) having a discretely positionable distal tip (819) and configured to be used with an endoscopic surgical stapler end effector, such as any of the end effectors (12, 212, 312, 412) described above.

[0137] The anvil jaw (818) includes an elongated jaw body (820) having a plurality of staple forming recesses (not shown) similar to the recesses (53) of the anvil (18) arranged along its length. A connector (821) and a cantilever spring in the form of a top cover plate (890) are coupled to a distal portion of the anvil jaw body (820) such that the top cover plate (890) is cantilevered above the anvil jaw body (820) and the connector (821) at its fixed proximal end. The connector (821) and the top cover plate (890) may be removably or fixedly coupled to the anvil jaw body (820) by, for example, adhesive, welding, or fasteners. The distal end of the connector (821) and the distal end of the top cover plate (890) each include a curved feature that cooperates to define an opening shaped as an ellipse or a circle, such that when the connector (821) and the top cover plate (890) are coupled to the anvil jaw body (820), they form an opening through which the proximal end axis (837) of the distal end (819) can be rotatably captured.

[0138] The distal tip (819) is rotatably coupled between the facing distal ends of the connector (821) and the top cover plate (890) and is capable of rotating relative to the anvil jaw body (820), the connector (821) and the top cover plate (890) about an axis (A1) defined by the proximal end axis (837) in response to an external rotational force applied to the distal tip (819) by a user or by an adjacent anatomical structure (see FIG. 34A to FIG. 34B ) is selectively rotatable between a first discrete position and a second discrete position. Fig.29As shown, the distal tip (819) in the first discrete position is oriented straight relative to the anvil jaw body (820) so that when the end effector is in a closed state, the distal tip (819) extends generally parallel to the lower jaw (16) and the staple cartridge (37), and the distal end of the distal tip (819) is thus spaced apart from the distal end of the staple cartridge (37) to define a gap therebetween. Thus, the distal tip (819) in the straight position is configured to provide the end effector with a distal opening aperture throughout its clamping range that is larger than a corresponding aperture presented by the end effector when the distal tip (819) is in an angled position. Thus, similar to the other exemplary embodiments described above, the distal tip (819) in the angled position is appropriately oriented to pull tissue proximally between the anvil jaw (818) and the staple cartridge (37) and facilitate visualization of target tissue during closure of the end effector. Additionally, the distal tip (819) in the straight position is appropriately oriented to facilitate advancement during the suture procedure, also as described above. Fig.30 As shown, the distal tip (819) in the second position is angled relative to the anvil jaw body (820) so that the distal end of the distal tip (819) extends toward the staple cartridge (37) and is configured to contact the distal end of the staple cartridge (37) when the anvil jaw (818) is closed to clamp tissue therebetween. Thus, the user can select the angled position or the straight position of the distal tip (819) as desired to best facilitate the particular procedure being performed.

[0139] like Figure 31 to Figure 32 As shown, the connector (821) and the top cover plate (890) are fixed to the jaw body (820) so that the top cover plate (890) is placed on the connector (821) and cooperates with the recessed portion formed in the upper side of the connector (821) to define an elongated cavity. The connector (821) and the top cover plate (890) cooperate to rotatably accommodate the proximal end shaft (837) of the distal tip (819) in the elongated cavity.

[0140] The anvil jaw (818) includes an angled joint (830) defined by an angled distal side (832) of the connector (821) and an angled proximal side (834) of the distal tip (819). The angled surfaces (832, 834) are configured to engage with each other in a first mating configuration and a second mating configuration to define a first discrete position and a second discrete position of the distal tip (819). Fig.31 and Fig.32 As shown, the angled surfaces (832, 834) are obliquely angled relative to the longitudinal axis of the anvil jaw body (820) and the distal tip (819). Fig.34BAs shown, when the distal tip (819) is in a second rotational orientation relative to the anvil jaw body (820), the inclination angles of the angled joint (830) are accumulated, thereby obliquely orienting the longitudinal axis of the distal tip (819) relative to the longitudinal axis of the anvil jaw body (820) to provide the distal tip (819) in an angled position.

[0141] The first rotational orientation may be achieved by rotating the distal tip (819) 180 degrees relative to the second rotational orientation. Fig.34A As shown, the angled angles of the angled joint (830) are configured to offset each other when the distal tip (819) is in a first rotational orientation relative to the anvil jaw body (820), thereby coaxially aligning the longitudinal axes of the anvil jaw body (820) and the distal tip (819) so that the distal tip (819) extends substantially straight from the anvil jaw body (820). In other words, the angled surfaces (832, 834) are arranged in a first rotational orientation relative to the anvil jaw body (820). Fig.34A The first discrete positions shown are oriented relative to each other so that the angled surfaces (832, 834) define supplementary angles that together define a 180 degree angle. In other versions, the angled surfaces (832, 834) may alternatively be configured to define an angle greater than 180 degrees when the distal tip (819) is in the first position. In this type of version, the distal tip (819) in the first position will expand upward away from the distal end of the staple cartridge (37) and the anvil body axis.

[0142] Although not shown, the anvil jaw (818) may also include a tip locking mechanism operable to releasably retain the distal tip (819) in a first discrete position and a second discrete position, thereby preventing the distal tip (819) from being inadvertently rotated away from a selected position. Such a tip locking mechanism may include various types of one or more detent features, protrusions, recesses, resilient members, interference features, etc., as would be apparent to one of ordinary skill in the art in view of the teachings herein. For example, the anvil jaw (818) may include any one or more detent protrusions and / or detent recesses.

[0143] like Fig.34A and Fig.34B As shown, the distal tip (819) is configured to be rotatable about an axis of rotation (A1) while still extending in a generally proximal-to-distal direction. The axis of rotation (A1) of the distal tip (819) is defined by a proximal end shaft (837), as described below. In this version, the proximal end shaft (837) is suitably configured such that the axis of rotation (A1) extends obliquely relative to the longitudinal axis of the distal tip (819).

[0144] like Figures 33 to 34BAs shown, the proximal end shaft (837) of the distal tip (819) includes a tapered proximal end feature in the form of a spherical tip that is captured between the connector (821) and the distal facing end of the top cover plate (890), thereby longitudinally constraining the distal tip (819) relative to the jaw body (820). The spherical tip includes an angled cam surface and a proximal end surface, each of which has a proximal end surface such as Fig.33 The generally elliptical profile shown. Specifically, the elliptical shape includes a major diameter (D1) along the width of the distal end (819) and a minor diameter (D2) along the thickness of the distal end (819). The tapered proximal end feature of the proximal end shaft (837) is captured in an elongated cavity defined between the top cover plate (890) and the connector (821), while the distal cylindrical shaft portion of the proximal end shaft (837) extends through the distal opening defined between the top cover plate (890) and the connector (821). Therefore, the distal end (819) is able to rotate about the proximal end shaft (837) relative to the connector (821) while also being longitudinally constrained by the tapered proximal end feature.

[0145] The top cover plate (890) acts as a cantilever leaf spring and is configured to be slightly laterally offset from the distal end of the jaw body (820) to exert a spring force on the tapered proximal end feature of the proximal end shaft (837) and thereby rotationally bias the distal tip (819) toward the closest of the first discrete position or the second discrete position. Specifically, when the distal tip (819) is in Fig.34A The first discrete position and Fig.34B In each of the second discrete positions shown, the underside of the top cover plate (890) directly contacts the angled cam surface of the tapered proximal end feature and exerts a spring force thereon, thereby maintaining the distal end (819) in the current discrete position. Rotation of the distal end (819) away from the discrete position causes the angled cam surface of the proximal end shaft (837) to push the distal end of the top cover plate (890) away from the connector (921), and thus causes the top cover plate (890) to deflect along the large diameter (D1) of the tapered proximal end feature. In turn, this causes the underside of the top cover plate (890) to exert an increased spring force on the angled cam surface. This rotatably pushes the distal end (819) toward the closer of the first discrete position or the second discrete position, so that as long as the external rotational input force applied to the distal end (819) (e.g., by an operator) is removed, the distal end (819) can automatically snap into one of these discrete positions.

[0146] E. Anvil jaws with toggle tips and resilient detent inserts

[0147] Figures 35 to 40CA distal portion of another exemplary anvil jaw (900) is depicted, the anvil jaw having a discretely positionable distal tip (906) and configured to be used with an endoscopic surgical stapler end effector, such as any of the end effectors (12, 212, 312, 412) described above. Anvil jaw (900) is similar to anvil jaw (518) described above, except as further described below.

[0148] The anvil jaw (900) includes an elongated jaw body (902) having a suturing surface having a plurality of staple forming dimples similar to dimples (53); and a distal tip (519) movably disposed distally of the jaw body (902). The distal end of the jaw body (902) defines a connector portion (904) to which the distal tip (906) is pivotally coupled via a pivot pin (908) extending transversely to a longitudinal axis of the jaw body (902) and the distal tip (906) along a lateral width of the jaw body (902) and the distal tip (906). In the present version, the connector portion (904) is integrally formed with the remaining proximal portion of the jaw body (902), but in other versions, similar to the connector (621) described above, the connector portion (904) may be separately formed and attached to the distal end of the jaw body (902). Similarly, it should be understood that the other connectors (521, 621, 721, 821) disclosed herein may be integrally formed with their respective jaw bodies (520, 620, 720, 820) so as to define an integral connector portion at the distal end of the jaw bodies (520, 620, 720, 820). The distal tip (906) is configured to be movable about a pivot pin (908) relative to the jaw body (902) in a first discrete position presenting a straight tip orientation (see Fig.22A ) and a second discrete position presenting an angled distal orientation (see Fig. 22B ) in a first discrete position where the longitudinal axis of the distal tip is substantially parallel to the longitudinal axis of the jaw body (902) and in a second discrete position where the longitudinal axis of the distal tip (906) is angled relative to the longitudinal axis of the jaw body (902).

[0149] like Fig.37As best shown in FIG. 1 , the distal tip (906) includes a tip body (910) that tapers to a rounded distal end. The proximal end of the tip body (910) includes a central pivot support protrusion (912) that projects proximally and is configured to be received between side pivot support protrusions (914) that project distally from the connector portion (904), wherein the protrusions (912, 914) include pivot pin apertures (916) that are coaxially aligned to receive a pivot pin (908) therethrough laterally. A pin-shaped pawl protrusion (918) extends proximally from a lower portion of the central pivot support protrusion (912) and has a stadium-shaped cross-section with a length extending parallel to the lateral width of the tip body (910). The proximal end of the distal tip (906) also includes stop surfaces that are configured to engage corresponding distal end surfaces of the connector portion (904) to constrain the distal tip (906) to a predetermined range of angular motion relative to the jaw body (902), wherein such surfaces and their functions are similar to those surfaces and their functions described above in conjunction with the anvil jaw (518).

[0150] Similar to the distal end (619) of the anvil jaw (618), the distal end (906) is resiliently biased toward the closer of the first discrete position or the second discrete position by a resilient structure supported by the connector portion (904). Unlike the anvil jaw (618), the resilient structure of the anvil jaw (900) is in the form of an insert (920) that is received and longitudinally fixed within a channel (922) that extends within the distal end of the jaw body (902) and opens distally through the connector portion (904) between the side pivot support projections (914). Fig.38As best shown in , the insert (920) includes an upper flange (924), a lower flange (926), and a pair of laterally opposed side walls (928) extending vertically between the upper and lower flanges (924, 926) and recessed laterally inward from opposite ends of the flanges (924, 926). The underside of the lower flange (926) may include a downwardly extending protrusion that is configured to be received within a corresponding lower recess of the channel (922) to facilitate proper orientation of the insert (920) relative to the jaw body (902) during assembly of the anvil jaws (618). The detent cavity (930) is defined between the flanges (924, 926) and the sidewall (928) and includes a lower cavity portion (932), an upper cavity portion (934), and an intermediate passage (936) interconnecting the cavity portions (932, 934). Each cavity portion (932, 934) is formed with a stadium-shaped profile similar to the profile of the detent protrusion (918) of the distal end (906), and is oriented so that the length of the cavity portion (932, 934) extends parallel to the lateral width of the insert (920). The intermediate passage (936) interconnects the lower cavity portion and the upper cavity portion (932, 934) along their lengths and is formed with a lateral width that is smaller than the lateral width of each cavity portion (932, 934) and the detent protrusion (918). The cavity portions (932, 934) extend longitudinally along respective longitudinal axes that are angled relative to each other to define a proximal opening angle, such as FIG. 39A to FIG. 39B shown.

[0151] like Fig.39A and Fig.40A As shown, lower cavity portion (932) is configured to receive and releasably retain detent projection (918) to maintain distal tip (906) in a first discrete position relative to jaw body (902). Fig.39B and Fig.40C As shown, upper cavity portion (934) is configured to receive and releasably retain detent projection (918) to maintain distal tip (906) in a second discrete position relative to jaw body (902). Fig.40BAs shown, the insert sidewall (928) is configured to be elastically deflected laterally outward into the channel (922) as the pawl projection (918) is vertically advanced through the intermediate passage (936) when transitioning between the lower cavity portion and the upper cavity portion (932, 934). Therefore, the sidewall (928) exerts a laterally inward elastic force on the pawl projection (918) to bias the pawl projection (918) toward the closer of the lower cavity portion (932) or the upper cavity portion (934), thereby biasing the distal end (906) toward the closer of the first discrete position or the second discrete position. In this regard, the insert (920) is formed of an elastomeric polymer that is configured to repeatedly elastically expand and contract when the distal end (906) transitions between the first discrete position and the second discrete position. In contrast, jaw body (902) and distal tip (906) may be formed from a more rigid material, such as metal.

[0152] In other versions of anvil jaw (900), the detent projection (918) of the distal tip (906) and each detent cavity portion (932, 934) of the insert (920) may have a cross-sectional profile of various shapes other than the illustrated gymnasium shape, such as, for example, an elongated hexagonal shape. Such shapes may be selected to optimize the shear strength of the detent projection (918) relative to the tip body (910) and the external input force required to transition the distal tip (906) between the first discrete position and the second discrete position.

[0153] The above-described configuration of anvil jaw (900) minimizes the tissue clamping area and provides a resilient detent structure, while otherwise maximizing the stiffness of the components of anvil jaw (900) to promote product durability and precise manipulation of tissue.

[0154] F. Alternative Switching Ends Configured for Pinless Pivoting

[0155] Figures 41 to 42B An exemplary alternative distal tip (950) is shown that is configured for use with anvil jaws (900) in place of distal tip (906). The proximal end of distal tip (950) includes a central pivot support protrusion (952) that omits pivot aperture (916) and instead includes a pair of pivot nubs (954) extending laterally outward from opposite lateral sides of central pivot support protrusion (952). Each pivot nub (954) is generally cylindrical and includes a lead-in chamfer on a proximally facing edge of its free end. FIG. 42A to FIG. 42BAs shown, these lead-in ramps facilitate proximal insertion of pivot nub (954) into pivot aperture (916) of connector portion (904) of jaw body (902) when distal tip (950) is assembled with jaw body (902). Pivot nub (954) cooperates with pivot aperture (916) to enable distal tip (950) to pivot relative to jaw body (902) without the need for pivot pin (908).

[0156] V. End Effector Having Anvil Jaw With Self-Actuated Distal Tip

[0157] As above combined Figures 13 to 42B As described, the anvil jaws (518, 618, 718, 818, 900) include distal tips (519, 619, 719, 819, 906) that are configured to actuate between a plurality of predetermined discrete positions in response to an external input force intentionally applied directly or indirectly to the distal tips (519, 619, 719, 819, 906) by a clinician. Figures 43 to 45C The described end effector (1000) includes an anvil jaw (1004) having a distal end (1008) that is configured to be self-actuated in response to actuation of the anvil jaw (1004) relative to the cartridge jaw (1002) between an open state and a closed state.

[0158] like Fig.43As shown, the end effector (1000) includes a cartridge jaw (1002) configured to removably receive a replaceable staple cartridge similar to the staple cartridge (37), the replaceable staple cartridge defining a first suturing surface. The end effector (1000) also includes an anvil jaw (1004) configured to pivot between an open position and a closed position relative to the cartridge jaw (1002) in response to a user input (such as actuation of a closure trigger (26)). The anvil jaw (1004) includes: an elongated anvil jaw body (1006) having a second suturing surface, the second suturing surface having a plurality of staple forming dimples similar to the dimples (53); a distal tip (1008) located distal to the anvil jaw body (1006); and a connector (1010) disposed between the distal tip (1008) and the anvil jaw body (1006). The connector (1010) may be attached to or integrally formed with the distal end of the anvil jaw body (1006). The proximal end of the distal tip (1008) includes a pivot support protrusion (1012) pivotally coupled to the connector (1010) via a laterally extending pivot pin (1014). As discussed further below, the distal tip (1008) is configured to pivot between infinite positions relative to the connector (1010) and the anvil jaw body (1006) in response to actuation of the anvil jaw (1004) relative to the cartridge jaw (1002) without requiring a user input force to be applied to the distal tip (1008).

[0159] The end effector (1000) further includes an elongated link arm (1016) operable to actuate the distal end (1008) relative to the anvil jaw body (1006) to manipulate the angular orientation of the distal end (1008) and its longitudinal axis relative to the anvil jaw body (1006) and its longitudinal axis. The link arm (1016) is slidably received within an elongated channel (1018) extending longitudinally through the anvil jaw body (1006) and the connector (1010). Fig.44 As shown, the proximal end of the link arm (1016) is pivotally connected to the proximal end of the side wall of the bin jaw (1002) via a pivot connection in the form of a short link (1020), and the distal end of the link arm (1016) is pivotally connected to the pivot support protrusion (1012) of the distal end (1008) via a pivot pin (1014).

[0160] The connector (1010) includes a pin slot (1022) extending laterally through the connector (1010) and opening laterally into an inner cavity of the connector (1010) through which the distal end of the link arm (1016) is configured to be able to longitudinally translate and in which the pivot support protrusion (1012) of the distal tip (1008) is configured to be able to pivot. The pin slot (1022) has an elongated gymnasium-shaped profile in a plane parallel to the longitudinal axis of the anvil jaw body (1006), and the pin slot (1022) is angled so that the upper end of the profile is oriented distally and the lower end of the profile is oriented proximally. This elongated profile of the pin slot (1022) permits the pivot pin (1014) to translate within the pin slot (1022) such that the pivot pin (1014) is transverse to its own longitudinal axis when the distal tip (1008) pivots relative to the connector (1010) and the anvil jaw body (1006).

[0161] like FIG. 45A to FIG. 45C As shown, actuation of the anvil jaw (1004) relative to the cartridge jaw (1002) drives the linkage arm (1016) to longitudinally translate within the anvil jaw body (1006) and the connector (1010), thereby automatically actuating the distal tip (1008) relative to the anvil jaw body (1006). More specifically, the linkage arm (1016) is configured to actuate the distal tip (1008) relative to the anvil jaw body (1006) such that the longitudinal axis of the distal tip (1008) defines a gradually decreasing angle relative to the longitudinal axis of the anvil jaw body (1006) as the anvil jaw (1004) moves from a closed state for clamping tissue toward an open state for releasing or receiving tissue.

[0162] Fig.45A The anvil jaw (1004) is shown in a fully closed position relative to the cartridge jaw (1002) for clamping tissue between the anvil jaw (1002) and a staple cartridge (not shown) seated within the cartridge jaw (1004). In this position, the distal tip (1008) is oriented substantially straight relative to the anvil jaw body (1006) such that the longitudinal axis of the distal tip (1008) is substantially parallel to the longitudinal axis of the anvil jaw body (1006). Fig.45B An anvil jaw (1004) is shown in an exemplary partially open position relative to a cartridge jaw (1002), wherein a distal tip (1008) is oriented at an angle relative to an anvil jaw body (1006) such that a longitudinal axis of the distal tip (1008) defines a first angle (α1) relative to a longitudinal axis of the anvil jaw body (1006). Fig.45CAnvil jaw (1004) is shown in a fully open position relative to cartridge jaw (1002), wherein distal tip (1008) is oriented at a greater angle relative to anvil jaw body (1006) such that a longitudinal axis of distal tip (1008) defines a second angle (α2) relative to a longitudinal axis of anvil jaw body (1006), wherein second angle (α2) is less than first angle (α1). It should be understood that when anvil jaw (1004) is in a fully open position, distal tip (1008) is oriented at a greater angle relative to anvil jaw body (1006). FIG. 45A to FIG. 45C Upon actuation between the illustrated positions, distal tip (1008) assumes angles that gradually change between the illustrated angles.

[0163] When the anvil jaw (1004) is at least partially open relative to the cartridge jaw (1002), the angled position of the distal tip (1008) relative to the anvil jaw body (1006) enables the distal tip (1008) to effectively harvest and manipulate tissue while also facilitating visualization distally and downwardly along the length of the anvil jaw (1004). The straight position of the distal tip (1008) relative to the anvil jaw body (1006) when the anvil jaw (1004) is closed ensures that tissue positioned within the end effector (1000) is not improperly gripped by the distal tip (1008), while also facilitating advancement of the end effector (1000) along tissue structures.

[0164] VI. Combination Examples

[0165] The following examples relate to various non-exhaustive ways in which the teachings herein may be combined or applied. It should be understood that the following examples are not intended to limit the coverage of any claims that may be provided at any time in this patent application or in the subsequent submissions of this patent application. It is not intended to make a disclaimer. The following examples are provided only for illustrative purposes. It is envisioned that the various teachings herein may be arranged and applied in a variety of other ways. It is also envisioned that some variations may omit certain features mentioned in the following examples. Therefore, any of the aspects or features mentioned below should not be considered decisive unless otherwise explicitly indicated by the inventor or the successor with an interest in the inventor at a later date. If any claim proposed in this patent application or in the subsequent submissions related to this patent application includes additional features other than those mentioned below, these additional features should not be assumed to be added for any reason related to patentability.

[0166] Example 1

[0167] A device comprising: (a) a first jaw (16); and (b) a second jaw (618, 718, 900), the second jaw being configured to cooperate with the first jaw to clamp tissue (90) and suturing the tissue using a plurality of staples (47), wherein the second jaw comprises: (i) a jaw body (620, 720, 902), the jaw body extending longitudinally along a jaw body axis, and (ii) a distal tip (619, 719, 906), the distal tip being movably disposed distally of the jaw body and extending longitudinally along the distal tip axis, wherein the distal tip is capable of pivoting between a first discrete position and a second discrete position about a pivot axis extending transversely to the jaw body axis, wherein in the first discrete position, the distal tip axis is relative to the distal tip axis. The jaw body axis presents a first orientation and, in the second discrete position, the distal tip axis presents a second orientation relative to the jaw body axis, (iii) a first opening and a second opening (663, 784, 785, 932, 934), both of which are defined by the distal tip or one of the structures (621, 920) located proximal to the distal tip, and (iv) a protrusion (637, 781, 918), which is capable of being positioned in the first opening (663, 785, 932) to releasably retain the distal tip in the first discrete position, wherein the protrusion is capable of being positioned in the second opening (663, 784, 934) to releasably retain the distal tip in the second discrete position.

[0168] Example 2

[0169] A device according to Example 1, wherein when the distal tip (619, 719, 906) is in the first discrete position, the distal tip axis is substantially parallel to the jaw body axis, and wherein when the distal tip is in the second discrete position, the distal tip axis is angled relative to the jaw body axis.

[0170] Example 3

[0171] The device of any of the preceding embodiments, wherein the distal tip (619, 719, 906) is constrained to a predetermined range of angular motion having first and second endpoints defined by the first and second discrete positions, respectively.

[0172] Example 4

[0173] The device of any of the preceding embodiments, wherein the projection (637, 918) is defined by the distal tip (619, 906).

[0174] Example 5

[0175] According to the device of embodiment 4, the second jaw (618, 900) also includes a resilient structure (621, 970) defining the first opening and the second opening (663, 932, 934), wherein the resilient structure is configured to be able to elastically deflect when the protrusion (637, 918) transitions between the first opening and the second opening.

[0176] Example 6

[0177]

[0066] The apparatus of Example 5, wherein the resilient structure (621, 970) is longitudinally fixed relative to the jaw body (620, 902) and the distal tip (619, 906).

[0178] Example 7

[0179] The device according to any one of embodiments 5 to 6, wherein the first opening and the second opening (663, 932, 934) are interconnected.

[0180] Example 8

[0181] A device as in any one of Examples 5 to 7, wherein the first and second openings (663, 932, 934) are vertically arranged and define respective longitudinal axes that intersect to define a proximal opening angle.

[0182] Example 9

[0183] A device according to any one of Examples 5 to 8, wherein the resilient structure (970) includes an insert received within a channel (922) in the distal end of the jaw body (902).

[0184] Example 10

[0185]

[0096] The apparatus of Example 9, wherein the jaw body (902) comprises metal and the insert (970) comprises a polymer.

[0186] Embodiment 11

[0187] A device as in Example 1, wherein the first and second openings (784, 785) are defined on a proximal end of the distal tip (719).

[0188] Example 12

[0189] A device according to embodiment 11, wherein the second jaw (718) also includes a latch (768), which defines a protrusion (781) and is capable of being actuated by a user between a locked position and a released position relative to the jaw body (720), wherein in the locked position, the latch inhibits movement of the distal end relative to the jaw body, and in the released position, the latch permits movement of the distal end relative to the jaw body.

[0190] Example 13

[0191] A device as in any one of Embodiment 12, wherein the latch (768) is biased toward the locked position.

[0192] Embodiment 14

[0193] A device according to any of Examples 12 to 13, wherein the latch (768) is capable of translating relative to the jaw body (720) between the locked position and the released position.

[0194] Embodiment 15

[0195] An apparatus according to any of the foregoing embodiments, wherein the first jaw (16) is configured to support a suturing assembly (37) operable to deploy staples (47), wherein the second jaw (618, 718, 900) comprises an anvil jaw having a plurality of staple forming recesses (53) configured to form the staples.

[0196] Example 16

[0197] A device comprising: (a) a first jaw (16); and (b) a second jaw (618, 900), the second jaw being configured to cooperate with the first jaw to clamp tissue (90) and suture the tissue using a plurality of staples (47), wherein the second jaw comprises: (i) a jaw body (620), the jaw body extending longitudinally along a jaw body axis; and (ii) a distal tip (619, 906), the distal tip being movably disposed distally of the jaw body and extending longitudinally along the distal tip axis, wherein the distal tip comprises a pawl protrusion (637, 918) and is pivotable about a pivot axis, the pivot axis extending transversely to the jaw body axis between a first discrete position and a second discrete position, wherein in the first discrete position, the distal tip axis presents a first orientation relative to the jaw body axis, and in the second discrete position, the distal tip axis is in a first orientation relative to the jaw body axis. The line presents a second orientation relative to the axis of the jaw body; and (iii) a resilient structure (621, 970) fixed relative to the jaw body proximal to the distal end, wherein the resilient structure includes a pawl cavity (663, 930) having a first cavity portion and a second cavity portion (663, 932, 934) configured to receive the pawl protrusion of the distal end, wherein the pawl protrusion is positionable in the first cavity portion (663, 932) to releasably hold the distal end in the second discrete position, wherein the pawl protrusion is positionable in the second cavity portion (663, 934) to releasably hold the distal end in the second discrete position, and wherein the resilient structure is configured to be resiliently deflected when the pawl protrusion moves between the first cavity portion and the second cavity portion.

[0198] Embodiment 17

[0199]

[00136] The apparatus of Example 16, wherein the resilient structure (621, 970) is longitudinally fixed relative to the jaw body (620, 902) and the distal tip (619, 906).

[0200] Embodiment 18

[0201] A device according to any one of Examples 16 to 17, wherein the resilient structure (621, 970) is configured to bias the pawl protrusion (637, 918) toward the closer of the first cavity portion (663, 932) or the second cavity portion (934), and thereby bias the distal end (619, 906) toward the closer of the first discrete position or the second discrete position.

[0202] Embodiment 19

[0203] An apparatus according to any one of embodiments 16 to 18, wherein the first cavity portion and the second cavity portion (663, 932, 934) are arranged vertically so that the first cavity portion includes a lower cavity portion (663, 932) and the second cavity portion includes an upper cavity portion (663, 934).

[0204] Embodiment 20

[0205] A device according to any one of embodiments 16 to 19, wherein the first cavity portion and the second cavity portion are defined by respective first and second openings (663, 932, 934), the respective first and second openings being interconnected and extending along respective longitudinal axes defining a proximal opening angle.

[0206] Embodiment 21

[0207] A device according to any one of Examples 16 to 20, wherein the resilient structure includes an insert (970) received within a channel (922) in the distal end of the jaw body (902).

[0208] Embodiment 22

[0209]

[00136] The apparatus of Example 21, wherein the jaw body (902) comprises metal, and wherein the insert (970) comprises a polymer.

[0210] Embodiment 23

[0211] A device according to any one of embodiments 21 to 22, wherein the insert (970) includes a pair of insert side walls (928) laterally opposed to each other, wherein each insert side wall is spaced inwardly from a corresponding inner surface of the jaw body (902) so that the insert side walls are configured to be able to elastically deflect laterally outward into the channel (922) when the pawl protrusion (918) transitions between the first cavity portion and the second cavity portion (932, 934).

[0212] Embodiment 24

[0213] According to a device described in any of Examples 16 to 23, wherein when the distal tip (619, 906) is in the first discrete position, the distal tip axis is substantially parallel to the jaw body axis, and wherein when the distal tip (619, 906) is in the second discrete position, the distal tip axis is angled relative to the jaw body axis.

[0214] Embodiment 25

[0215] A device according to any one of embodiments 16 to 24, wherein the distal tip (619, 906) is constrained to a predetermined range of angular motion having first and second endpoints defined by the first and second discrete positions, respectively.

[0216] Embodiment 26

[0217] A device comprising: (a) a first jaw (16); and (b) a second jaw (718), the second jaw being configured to cooperate with the first jaw to clamp tissue (90) and suturing the tissue using a plurality of staples (47), wherein the second jaw comprises: (i) a jaw body (720), the jaw body extending longitudinally along a jaw body axis; (ii) a latch (768), the latch being movably coupled to the jaw body; and (iii) a distal tip (719), the distal tip being movably disposed distally of the jaw body and the latch and extending longitudinally along the distal tip axis, wherein the distal tip is capable of being moved relative to the jaw body at a first discrete position. The invention relates to a method for moving a distal end of a jaw jaw from a first discrete position to a second discrete position, wherein in the first discrete position, the distal end axis presents a first orientation relative to the jaw body axis, and in the second discrete position, the distal end axis presents a second orientation relative to the jaw body axis, wherein the latch is actuable by a user relative to the jaw body between a locked position and a released position, wherein the latch in the locked position is configured to releasably lock the distal end in one of the first discrete position or the second discrete position, and wherein the latch in the released position is configured to permit the distal end to transition between the first discrete position and the second discrete position.

[0218] Embodiment 27

[0219]

[00136] The apparatus of Example 26, wherein the latch (768) is capable of translating relative to the jaw body (720) between the locked position and the released position.

[0220] Embodiment 28

[0221] A device according to any of Examples 26 to 27, wherein the latch (768) is positioned distally in the locked position and proximally in the released position, wherein the latch is biased toward the locked position.

[0222] Embodiment 29

[0223] According to a device described in any of Examples 26 to 28, the second jaw (718) also includes a protrusion (781) defined by one of the latch (768) or the distal end (719), and a first opening and a second opening (784, 785) defined by the other of the latch or the distal end, wherein the first opening (785) is configured to receive the protrusion when the distal end is in the first discrete position and the latch is in the locked position, and wherein the second opening (784) is configured to receive the protrusion when the distal end is in the second discrete position and the latch is in the locked position.

[0224] Embodiment 30

[0225] A device as described in Example 29, wherein the protrusion (781) is capable of being longitudinally inserted into one of the first opening (785) or the second opening (784) when the latch is transitioned from the release position to the lock position.

[0226] Embodiment 31

[0227] A device according to any one of Examples 29 to 30, wherein the latch (768) includes the protrusion (781), wherein the distal tip (719) includes the first opening and the second opening (785, 784).

[0228] Embodiment 32

[0229] An apparatus according to any one of embodiments 29 to 31, wherein the protrusion includes a pin (781), wherein the first opening and the second opening include a first orifice and a second orifice (785, 784), and the first orifice and the second orifice are each configured to be able to slidably receive the pin.

[0230] Embodiment 33

[0231] A device according to any one of embodiments 29 to 32, wherein the protrusion (781) includes a first protrusion (781), wherein the second jaw (718) also includes a second protrusion (781), a third opening (785) configured to receive the second protrusion when the distal end is in the first discrete position, and a fourth opening (784) configured to receive the second protrusion when the distal end is in the second discrete position.

[0232] Embodiment 34

[0233] The device according to any one of Examples 26 to 33 further includes a connector (721) which is fixed to the distal end of the jaw body (720), wherein the distal tip (719) is pivotally connected to the distal end of the connector, and wherein the latch (768) is capable of being actuated within a narrow slot (724) defined between the jaw body and the connector.

[0234] Embodiment 35

[0235] A device according to any one of embodiments 26 to 34, wherein the distal tip (719) is constrained to a predetermined range of angular motion having first and second endpoints defined by the first and second discrete positions, respectively.

[0236] Embodiment 36

[0237] A device, comprising: (a) a first jaw (16); and (b) a second jaw (818), the second jaw being configured to cooperate with the first jaw to clamp tissue (90) and suturing the tissue using a plurality of staples (47), wherein the second jaw comprises: (i) a jaw body (820), the jaw body extending longitudinally along a jaw body axis; and (ii) a distal tip (819), the distal tip being movably disposed distal to the jaw body and extending longitudinally along the distal tip axis, wherein the distal tip is capable of being movably engaged with a second jaw body at a first discrete position relative to the jaw body. The distal tip of the present invention is configured to rotate 180 degrees between two discrete positions, wherein in the first discrete position, the distal tip axis has a first orientation relative to the jaw body axis, and in the second discrete position, the distal tip axis has a second orientation relative to the jaw body axis; and (iii) a cantilever spring (890) configured to apply a spring force on the proximal end of the distal tip when the distal tip is positioned between the first discrete position and the second discrete position to rotationally bias the distal tip toward the closer of the first discrete position or the second discrete position.

[0238] Embodiment 37

[0239] A device according to embodiment 36, wherein the second jaw (818) includes an angled distal side (834) defined by the proximal end of the distal tip (819) and an angled proximal side (832) located proximal to the angled distal side, wherein the first angled surface and the second angled surface are configured to be able to engage with each other in a first mating configuration to define the first discrete position of the distal tip, and to engage with each other in a second mating configuration to define the second discrete position of the distal tip.

[0240] Embodiment 38

[0241]

[00136] The apparatus of Example 37, wherein each of the angled distal side (834) and the angled proximal side (832) defines an angle of inclination relative to the jaw body axis.

[0242] Embodiment 39

[0243] A device according to any one of embodiments 36 to 38, wherein the cantilever spring (890) includes a fixed proximal end and a free distal end, wherein the fixed proximal end is fixed to the distal end of the jaw body (820), and wherein the free proximal end is configured to be able to apply the elastic force on the proximal end of the distal tip (819).

[0244] Embodiment 40

[0245] A device according to any one of embodiments 36 to 39, wherein the cantilever spring includes a plate (890) that cooperates with a relative portion of the second jaw (818) to define a cavity therebetween, wherein the proximal end (837) of the distal tip (819) is capable of rotating within the cavity.

[0246] Embodiment 41

[0247] A device according to any one of Examples 36 to 40, wherein the proximal end of the distal tip comprises a shaft (837).

[0248] Embodiment 42

[0249] A device according to Example 41, wherein the shaft (837) includes a spherical end, and the spherical end is configured to longitudinally constrain the distal end (819) relative to the jaw body (820).

[0250] Embodiment 43

[0251] A device according to Example 42, wherein the ball-shaped tip is capable of rotating within a cavity of the second jaw (818) proximal to the distal tip (819).

[0252] Embodiment 44

[0253] A device according to any one of embodiments 42 to 43, wherein the spherical end includes an angled cam surface having an elliptical cross-sectional profile, and wherein the free distal end of the cantilever spring (890) is configured to apply the spring force on the angled cam surface to rotationally bias the distal end (819) toward the closer of the first discrete position or the second discrete position.

[0254] Embodiment 45

[0255] A device as described in Example 44, wherein the cross-sectional profile of the spherical tip has a major diameter along the width of the distal tip (819) and a minor diameter along the thickness of the distal tip.

[0256] Embodiment 46

[0257] A device comprising: (a) a first jaw (1002); and (b) a second jaw (1004), the second jaw being configured to cooperate with the first jaw to clamp tissue (90) and suturing the tissue using a plurality of staples (47), wherein the second jaw comprises: (i) a jaw body (1006), the jaw body extending longitudinally along a jaw body axis, (ii) a distal tip (1008), the distal tip being movably disposed distally of the jaw body and extending longitudinally along the distal tip axis, and (iii) a linkage arm (1016), the linkage arm being operable to actuate the distal tip relative to the jaw body and thereby manipulate the orientation of the distal tip axis relative to the jaw body axis in response to actuation of the second jaw relative to the first jaw.

[0258] Embodiment 47

[0259] A device according to Example 46, wherein the link arm (1016) is configured to position the distal end (1008) so that when the second jaw (1004) is in a closed state relative to the first jaw (1002), the distal end axis is substantially parallel to the jaw body axis, and wherein the link arm is configured to position the distal end so that when the second jaw is in an open state relative to the first jaw, the distal end axis is angled relative to the jaw body axis.

[0260] Embodiment 48

[0261] According to the device described in any one of Examples 46 to 47, the link arm (1016) is configured to actuate the distal end (1008) relative to the jaw body (1004) so ​​that when the second jaw (1006) moves from the closed state toward the open state, the distal end axis defines a gradually decreasing angle (α) relative to the jaw body axis.

[0262] Embodiment 49

[0263] A device according to any one of embodiments 46 to 48, wherein the distal end of the linkage arm (1016) is pivotally connected to the distal tip (1008), wherein the proximal end of the linkage arm is operably connected to the first jaw (1002).

[0264] Embodiment 50

[0265] According to the device of Example 49, the distal end of the linkage arm (1016) is pivotally connected to the distal tip (1008) using a pin (1014), wherein the distal portion of the second jaw (1004) includes a narrow slot (1022), and the pin is configured to be able to translate in the narrow slot when the second jaw (1002) is actuated relative to the first jaw (1002).

[0266] Embodiment 51

[0267] A device according to embodiment 50, wherein the pin (1014) is capable of translating within the narrow slot (1022) transversely to its own longitudinal axis.

[0268] Embodiment 52

[0269] The device according to any one of Examples 49 to 51 further includes a connector (1010) that connects the distal tip (1008) to the distal end of the jaw body (1006), wherein the connector defines the narrow slot (1022).

[0270] Embodiment 53

[0271] The apparatus of any one of embodiments 46 to 52 further comprises a pivot connection (1020) connecting the proximal end of the linkage arm (1016) to the proximal end of the first jaw (1002).

[0272] Embodiment 54

[0273] A device according to any one of embodiments 46 to 53, wherein the jaw body (1006) includes an elongated channel (1018) capable of slidably accommodating the linkage arm (1016).

[0274] Embodiment 55

[0275] A device according to any one of embodiments 46 to 54, wherein the first jaw (1002) is configured to support a suturing assembly (37) operable to deploy staples (47), wherein the second jaw (1004) includes an anvil jaw having a plurality of staple forming recesses (53) configured to form the staples.

[0276] Embodiment 56

[0277] A device according to any one of embodiments 1 to 55, wherein the device is a surgical end effector, a surgical instrument or a surgical suturing instrument.

[0278] The following clauses also refer to the various non-exhaustive ways in which the teachings herein may be combined or applied.

[0279] 1. A device, comprising:

[0280] (a) a first jaw; and

[0281] (b) a second jaw configured to cooperate with the first jaw to clamp tissue and suturing the tissue with a plurality of staples, wherein the second jaw comprises:

[0282] (i) a jaw body extending longitudinally along a jaw body axis,

[0283] (ii) a distal tip movably disposed distally of the jaw body and extending longitudinally along a distal tip axis, wherein the distal tip is pivotable between a first discrete position and a second discrete position about a pivot axis extending transverse to the jaw body axis, wherein in the first discrete position the distal tip axis assumes a first orientation relative to the jaw body axis and in the second discrete position the distal tip axis assumes a second orientation relative to the jaw body axis,

[0284] (iii) a first opening and a second opening, both of which are defined by one of the distal tip or a structure located proximal to the distal tip, and (iv) a protrusion, which is defined by the other of the distal tip or the structure,

[0285] wherein the projection is positionable within the first opening to releasably retain the distal tip in the first discrete position,

[0286] wherein the projection is positionable within the second opening to releasably retain the distal tip in the second discrete position.

[0287] 2. The apparatus of claim 1 , wherein the distal tip axis is substantially parallel to the jaw body axis when the distal tip is in the first discrete position, and wherein the distal tip axis is angled relative to the jaw body axis when the distal tip is in the second discrete position.

[0288] 3. The apparatus of claim 1, wherein the distal tip is constrained to a predetermined range of angular motion having first and second endpoints defined by the first and second discrete positions, respectively.

[0289] 4. The device of claim 1, wherein the projection is defined by the distal tip.

[0290] 5. The apparatus of claim 4, wherein the second jaw further comprises a resilient structure defining the first opening and the second opening, wherein the resilient structure is configured to be resiliently deflected when the protrusion transitions between the first opening and the second opening.

[0291] 6. The apparatus of claim 5, wherein the resilient structure is longitudinally fixed relative to the jaw body and the distal tip.

[0292] The apparatus of claim 5 , wherein the first opening and the second opening are interconnected.

[0293] 8. The apparatus of claim 5, wherein the first opening and the second opening are vertically arranged and define respective longitudinal axes that intersect to define a proximal opening angle.

[0294] 9. The apparatus of claim 5, wherein the resilient structure comprises an insert received within a channel in the distal end of the jaw body.

[0295] 10. The apparatus of claim 9, wherein the jaw body comprises metal, and

[0296] The insert comprises a polymer.

[0297] 11. The apparatus of claim 1, wherein the first opening and the second opening are defined on a proximal end of the distal tip.

[0298] 12. An apparatus according to claim 11, wherein the second jaw further comprises a latch defining a protrusion and capable of being actuated by a user relative to the jaw body between a locked position and a released position, wherein in the locked position, the latch inhibits movement of the distal end relative to the jaw body, and in the released position, the latch permits movement of the distal end relative to the jaw body.

[0299] 13. The apparatus of claim 12, wherein the latch is biased toward the locked position.

[0300] 14. The apparatus of claim 12, wherein the latch is translatable relative to the jaw body between the locked position and the released position.

[0301] 15. The apparatus of claim 1, wherein the first jaw is configured to support a suturing assembly operable to deploy staples, wherein the second jaw comprises an anvil jaw having a plurality of staple forming recesses configured to form the staples.

[0302] 16. A device, comprising:

[0303] (a) a first jaw; and

[0304] (b) a second jaw configured to cooperate with the first jaw to clamp tissue and suturing the tissue with a plurality of staples, wherein the second jaw comprises:

[0305] (i) a jaw body extending longitudinally along a jaw body axis,

[0306] (ii) a distal tip movably disposed distally of the jaw body and extending longitudinally along a distal tip axis, wherein the distal tip is capable of rotating 180 degrees relative to the jaw body between a first discrete position and a second discrete position, wherein in the first discrete position the distal tip axis assumes a first orientation relative to the jaw body axis and in the second discrete position the distal tip axis assumes a second orientation relative to the jaw body axis, and

[0307] (iii) a cantilever spring configured to apply a spring force on a proximal end of the distal tip when the distal tip is positioned between the first discrete position and the second discrete position so as to rotationally bias the distal tip toward the closer of the first discrete position or the second discrete position.

[0308] 37. The device of claim 36, wherein the second jaw comprises an angled distal side surface defined by a proximal end of the distal tip and an angled proximal side surface located proximal to the angled distal side surface, wherein the first angled surface and the second angled surface are configured to engage with each other in a first mating configuration to define the first discrete position of the distal tip, and to engage with each other in a second mating configuration to define the second discrete position of the distal tip.

[0309] 38. The device of claim 36, wherein the cantilever spring comprises a fixed proximal end and a free distal end, wherein the fixed proximal end is fixed to the distal end of the jaw body, and wherein the free proximal end is configured to be capable of exerting the elastic force on the proximal end of the distal tip.

[0310] 39. A device, comprising:

[0311] (a) a first jaw; and

[0312] (b) a second jaw configured to cooperate with the first jaw to clamp tissue and suturing the tissue with a plurality of staples, wherein the second jaw comprises:

[0313] (i) a jaw body extending longitudinally along a jaw body axis,

[0314] (ii) a distal tip movably disposed distally of the jaw body and extending longitudinally along a distal tip axis, and

[0315] (iii) a linkage arm operable to actuate the distal tip relative to the jaw body and thereby manipulate the orientation of the distal tip axis relative to the jaw body axis in response to actuation of the second jaw relative to the first jaw.

[0316] 40. The apparatus of claim 39, wherein the linkage arm is configured to actuate the distal tip relative to the jaw body such that the distal tip axis defines a gradually decreasing angle relative to the jaw body axis as the second jaw moves from the closed state toward the open state.

[0317] VII. Miscellaneous

[0318] It should be understood that any one or more of the teachings, expressions, embodiments, examples, etc. described herein may be combined with any one or more of the other teachings, expressions, embodiments, examples, etc. described herein. Therefore, the above teachings, expressions, embodiments, examples, etc. should not be considered isolated from each other. Various suitable ways in which the teachings herein can be combined will be apparent to those of ordinary skill in the art based on the teachings herein. Such modifications and variations are intended to be included within the scope of the claims.

[0319] In addition, any one or more of the teachings of this document may be combined with any one or more of the teachings disclosed in the following patent applications: U.S. patent application No. 63 / 467,622, filed on May 19, 2023, entitled “Surgical Stapler Cartridge Having Intermediate Raised Tissue Engagement Protrusions”; U.S. patent application No. 63 / 467,623, filed on May 19, 2023, entitled “Surgical Stapler Cartridge Having Raised Surface to Promote Buttress Adhesion”; U.S. patent application No. 63 / 467,648, filed on May 19, 2023, entitled “Surgical Stapler Cartridge Having Cartridge Retention No. 63 / 467,469, filed on May 19, 2023, and entitled “Surgical Stapler Anvil Having Staple Forming Pockets with Laterally Varying Orientations”; No. 63 / 459,739, filed on May 19, 2023, and entitled “Surgical Stapler With Discretely Positionable Distal Tip”; No. 63 / 467,656, filed on May 19, 2023, and entitled “Surgical Stapler With Discretely Positionable Distal Tip”; and / or No. 63 / 467,615, filed on May 19, 2023, and entitled “Incompatible Staple Cartridge Use Prevention Features for Surgical Stapler”.

[0320] In addition, any one or more of the teachings herein may be combined with any one or more of the teachings disclosed in the following patent application: U.S. Patent Application No. 63 / 459,739, entitled "Surgical Stapler Anvil Having Staple Forming Pockets with Laterally Varying Orientations," filed on April 17, 2023. The disclosures of each of these U.S. patent applications are incorporated herein by reference in their entirety.

[0321] In addition, any one or more of the teachings of this document may be combined with any one or more of the teachings disclosed in the following patent applications: U.S. Patent No. 11,304,697, entitled “Surgical Stapler with Deflectable Distal Tip,” published on April 19, 2022, the disclosure of which is incorporated herein by reference in its entirety; U.S. Patent No. 11,317,912, entitled “Surgical Stapler with Rotatable Distal Tip,” published on May 3, 2022, the disclosure of which is incorporated herein by reference in its entirety; and / or U.S. Patent No. 11,439,391, entitled “Surgical Stapler with Toggling Distal Tip,” published on September 13, 2022, the disclosure of which is incorporated herein by reference in its entirety.

[0322] It should be understood that any patent, patent publication, or other public material, whether in whole or in part, allegedly incorporated herein by reference is incorporated herein only to the extent that the incorporated material does not conflict with existing definitions, statements, or other public materials listed in the present disclosure. Therefore, and to the extent necessary, the disclosure explicitly listed herein supersedes any conflicting material incorporated herein by reference. Any material or portion thereof allegedly incorporated herein by reference but conflicting with existing definitions, statements, or other public materials listed herein will be incorporated only to the extent that there is no conflict between the incorporated material and the existing public materials.

[0323] Versions of the above-described devices may be applied to traditional medical treatments and surgeries performed by medical professionals, as well as robotic-assisted medical treatments and surgeries. By way of example only, the various teachings herein may be readily incorporated into robotic surgical systems, such as those provided by Auris Health, Inc. (Redwood City, CA) or by Intuitive Surgical, Inc. (Sunnyvale, California).

[0324] The devices of the types described above can be designed to be discarded after a single use, or they can be designed to be reusable. In either case or both, these types can be repaired to be reused after at least one use. Repair can include any combination of the following steps: disassembling the device, then cleaning or replacing specific parts and subsequently reassembling. Specifically, some types of devices can be disassembled, and any number of specific parts or parts of the device can be selectively replaced or removed in any combination. When cleaning and / or replacing specific parts, some types of the device can be reassembled at a repair facility or reassembled by the user before surgery is about to be performed for subsequent use. Those skilled in the art will appreciate that the repair of the device can be disassembled, cleaned / replaced, and reassembled using a variety of techniques. The use of such technology and the resulting repair device are all within the scope of the present application.

[0325] By way of example only, the types described herein may be sterilized before and / or after a procedure. In one sterilization technique, the device is placed in a closed and sealed container such as a plastic bag or a TYVEK bag. The container and device may then be placed in a field of radiation that can penetrate the container, such as gamma radiation, x-rays, or high-energy electrons. The radiation may kill bacteria on the device and in the container. The sterilized device may then be stored in a sterile container for later use. The device may also be sterilized using any other technique known in the art, including but not limited to beta or gamma radiation, ethylene oxide, or steam.

[0326] Various embodiments of the present invention have been shown and described, and further improvements of the methods and systems described herein may be achieved by appropriate modifications by those of ordinary skill in the art without departing from the scope of the present invention. Several such possible modifications have been mentioned, and other modifications will be apparent to those of skill in the art. For example, the embodiments, embodiments, geometries, materials, dimensions, ratios, steps, etc. discussed above are illustrative and not required. Therefore, the scope of the present invention should be considered in light of the following claims, and should be understood not to be limited to the details of the structure and operation shown and described in the specification and drawings.

Claims

1. A device, comprising: (a) a first jaw (16); and (b) a second jaw (618, 718, 900) configured to cooperate with the first jaw to clamp tissue (90) and suturing the tissue using a plurality of staples (47), wherein the second jaw comprises: (i) a jaw body (620, 720, 902) extending longitudinally along a jaw body axis, (ii) a distal tip (619, 719, 906) movably disposed distally of the jaw body and extending longitudinally along a distal tip axis, wherein the distal tip is pivotable between a first discrete position and a second discrete position about a pivot axis extending transversely to the jaw body axis, wherein in the first discrete position the distal tip axis assumes a first orientation relative to the jaw body axis and in the second discrete position the distal tip axis assumes a second orientation relative to the jaw body axis, (iii) a first opening and a second opening (663, 784, 785, 932, 934), both of which are defined by one of the distal tip or a structure (621, 920) located proximal to the distal tip, and (iv) a projection (637, 781, 918) defined by the other of the distal tip or the structure, wherein the projection is positionable within the first opening (663, 785, 932) to releasably retain the distal tip in the first discrete position, wherein the projection is positionable within the second opening (663, 784, 934) to releasably retain the distal tip in the second discrete position.

2. The device according to claim 1, wherein: When the distal tip (619, 719, 906) is in the first discrete position, the distal tip axis is substantially parallel to the jaw body axis, wherein when the distal tip is in the second discrete position, the distal tip axis is angled relative to the jaw body axis.

3. The device according to any one of the preceding claims, wherein: The distal tip (619, 719, 906) is constrained to a predetermined range of angular motion having first and second endpoints defined by the first and second discrete positions, respectively.

4. The device according to any one of the preceding claims, wherein: The projection (637, 918) is defined by the distal tip (619, 906).

5. The device according to claim 4, wherein: The second jaw (618, 900) also includes a resilient structure (621, 970) defining the first opening and the second opening (663, 932, 934), wherein the resilient structure is configured to be resiliently deflected when the protrusion (637, 918) transitions between the first opening and the second opening.

6. The device according to claim 5, wherein: The resilient structure (621, 970) is longitudinally fixed relative to the jaw body (620, 902) and the distal tip (619, 906).

7. The device according to any one of claims 1 to 6, wherein: The first opening and the second opening (663, 932, 934) are interconnected.

8. The apparatus according to any one of claims 1 to 7, wherein: The first and second openings (663, 932, 934) are vertically arranged and define respective longitudinal axes that intersect to define a proximal opening angle.

9. The apparatus according to any one of claims 5 to 8, wherein: The resilient structure (970) includes an insert received within a channel (922) in the distal end of the jaw body (902).

10. The device according to claim 9, wherein: The jaw body (902) comprises metal and the insert (970) comprises a polymer.

11. The apparatus according to any one of claims 1 to 3, wherein: The first and second openings (784, 785) are defined on a proximal end of the distal tip (719).

12. The device according to claim 11, wherein The second jaw (718) also includes a latch (768), which defines a protrusion (781) and is capable of being actuated by a user between a locked position and a released position relative to the jaw body (720), wherein in the locked position, the latch inhibits movement of the distal end relative to the jaw body; and in the released position, the latch permits movement of the distal end relative to the jaw body.

13. The device according to any one of claims 12, wherein: The latch (768) is biased toward the locked position.

14. The apparatus according to any one of claims 12 to 13, wherein: The latch (768) is translatable relative to the jaw body (720) between the locked position and the released position.

15. Apparatus according to any one of the preceding claims, wherein: The first jaw (16) is configured to support a suturing assembly (37) operable to deploy staples (47), wherein the second jaw (618, 718, 900) comprises an anvil jaw having a plurality of staple forming pockets (53) configured to form the staples.

16. A device, comprising: (a) a first jaw (16); and (b) a second jaw (618, 900) configured to cooperate with the first jaw to clamp tissue (90) and suturing the tissue using a plurality of staples (47), wherein the second jaw comprises: (i) a jaw body (620) extending longitudinally along a jaw body axis, (ii) a distal tip (619, 906) movably disposed distally of the jaw body and extending longitudinally along a distal tip axis, wherein the distal tip includes a detent projection (637, 918) and is pivotable between a first discrete position and a second discrete position about a pivot axis extending transversely to the jaw body axis, wherein: In the first discrete position, the distal tip axis assumes a first orientation relative to the jaw body axis, and in the second discrete position, the distal tip axis assumes a second orientation relative to the jaw body axis, and (iii) a resilient structure (621, 970) fixed relative to the jaw body proximal to the distal end, wherein the resilient structure includes a detent cavity (663, 930) having a first cavity portion and a second cavity portion (663, 932, 934), the first cavity portion and the second cavity portion being configured to receive the detent projection of the distal end, wherein the detent projection is positionable within the first cavity portion (663, 932) to releasably retain the distal tip in the first discrete position, wherein the detent projection is positionable within the second cavity (663, 934) portion to releasably retain the distal tip in the second discrete position, Wherein, the elastic structure is configured to be able to elastically deflect when the pawl protrusion moves between the first cavity portion and the second cavity portion.

17. The device according to claim 16, wherein: The resilient structure (621, 970) is longitudinally fixed relative to the jaw body (620, 902) and the distal tip (619, 906).

18. The apparatus according to any one of claims 16 to 17, wherein: The resilient structure (621, 970) is configured to bias the pawl protrusion (637, 918) toward the closer of the first cavity portion (663, 932) or the second cavity portion (934), and thereby bias the distal end (619, 906) toward the closer of the first discrete position or the second discrete position.

19. The apparatus according to any one of claims 16 to 18, wherein: The first cavity portion and the second cavity portion (663, 932, 934) are arranged vertically such that the first cavity portion includes a lower cavity portion (663, 932) and the second cavity portion includes an upper cavity portion (663, 934).

20. Apparatus according to any one of claims 16 to 19, wherein: The first and second cavity portions are defined by respective first and second openings (663, 932, 934) that are interconnected and extend along respective longitudinal axes defining a proximal opening angle.

21. Apparatus according to any one of claims 16 to 20, wherein: The resilient structure includes an insert (970) received within a channel (922) in the distal end of the jaw body (902).

22. The apparatus according to claim 21, wherein The jaw body (902) comprises metal, wherein the insert (970) comprises a polymer.

23. Apparatus according to any one of claims 21 to 22, wherein: The insert (970) includes a pair of insert side walls (928) that are laterally opposed to each other, wherein each insert side wall is spaced inwardly from a corresponding inner surface of the jaw body (902) so that the insert side walls are configured to be elastically deflected laterally outward into the channel (922) when the pawl protrusion (918) transitions between the first cavity portion and the second cavity portion (932, 934).

24. Apparatus according to any one of claims 16 to 23, wherein: When the distal tip (619, 906) is in the first discrete position, the distal tip axis is substantially parallel to the jaw body axis, wherein when the distal tip (619, 906) is in the second discrete position, the distal tip axis is angled relative to the jaw body axis.

25. Apparatus according to any one of claims 16 to 24, wherein: The distal tip (619, 906) is constrained to a predetermined range of angular motion having first and second endpoints defined by the first and second discrete positions, respectively.

26. A device, comprising: (a) a first jaw (16); and (b) a second jaw (718) configured to cooperate with the first jaw to clamp tissue (90) and suturing the tissue using a plurality of staples (47), wherein the second jaw comprises: (i) a jaw body (720) extending longitudinally along a jaw body axis, (ii) a latch (768) movably coupled to the jaw body, and (iii) a distal tip (719) movably disposed distally of the jaw body and the latch and extending longitudinally along a distal tip axis, wherein the distal tip is movable relative to the jaw body between a first discrete position and a second discrete position, wherein in the first discrete position the distal tip axis assumes a first orientation relative to the jaw body axis and in the second discrete position the distal tip axis assumes a second orientation relative to the jaw body axis, wherein the latch is actuable by a user between a locked position and a released position relative to the jaw body, wherein the latch in the locked position is configured to releasably lock the distal end in one of the first discrete position or the second discrete position, and wherein the latch in the released position is configured to permit the distal end to transition between the first discrete position and the second discrete position.

27. The apparatus of claim 26, wherein: The latch (768) is translatable relative to the jaw body (720) between the locked position and the released position.

28. Apparatus according to any one of claims 26 to 27, wherein The latch (768) is positioned distally in the locked position and proximally in the released position, wherein the latch is biased toward the locked position.

29. Apparatus according to any one of claims 26 to 28, wherein The second jaw (718) also includes a protrusion (781) defined by one of the latch (768) or the distal end (719), and a first opening and a second opening (784, 785) defined by the other of the latch or the distal end, wherein the first opening (785) is configured to receive the protrusion when the distal end is in the first discrete position and the latch is in the locked position, and wherein the second opening (784) is configured to receive the protrusion when the distal end is in the second discrete position and the latch is in the locked position.

30. The apparatus of claim 29, wherein: The protrusion (781) is insertable longitudinally into one of the first opening (785) or the second opening (784) when the latch transitions from the release position to the lock position.

31. Apparatus according to any one of claims 29 to 30, wherein: The latch (768) includes the protrusion (781), wherein the distal tip (719) includes the first opening and the second opening (785, 784).

32. Apparatus according to any one of claims 29 to 31, wherein: The protrusion includes a pin (781), wherein the first opening and the second opening include first and second apertures (785, 784), the first aperture and the second aperture each being configured to slidably receive the pin.

33. Apparatus according to any one of claims 29 to 32, wherein: The protrusion (781) includes a first protrusion (781), wherein the second jaw (718) further includes a second protrusion (781), a third opening (785) configured to receive the second protrusion when the distal end is in the first discrete position, and a fourth opening (784) configured to receive the second protrusion when the distal end is in the second discrete position.

34. The device according to any one of claims 26 to 33, further comprising a connecting member (721) fixed to the distal end of the jaw body (720), wherein The distal tip (719) is pivotally coupled to a distal end of the connector, wherein the latch (768) is actuatable within a slot (724) defined between the jaw body and the connector.

35. Apparatus according to any one of claims 26 to 34, wherein: The distal tip (719) is constrained to a predetermined range of angular motion having first and second endpoints defined by the first and second discrete positions, respectively.

36. A device, comprising: (a) a first jaw (16); and (b) a second jaw (818) configured to cooperate with the first jaw to clamp tissue (90) and suturing the tissue using a plurality of staples (47), wherein the second jaw comprises: (i) a jaw body (820) extending longitudinally along a jaw body axis, (ii) a distal tip (819) movably disposed distally of the jaw body and extending longitudinally along a distal tip axis, wherein the distal tip is capable of rotating 180 degrees relative to the jaw body between a first discrete position and a second discrete position, wherein in the first discrete position the distal tip axis assumes a first orientation relative to the jaw body axis and in the second discrete position the distal tip axis assumes a second orientation relative to the jaw body axis, and (iii) a cantilever spring (890) configured to apply a spring force on a proximal end of the distal tip when the distal tip is positioned between the first discrete position and the second discrete position so as to rotationally bias the distal tip toward the closer of the first discrete position or the second discrete position.

37. The apparatus of claim 36, wherein: The second jaw (818) includes an angled distal side (834) defined by a proximal end of the distal tip (819) and an angled proximal side (832) located proximal to the angled distal side, wherein the first angled surface and the second angled surface are configured to engage with each other in a first mating configuration to define the first discrete position of the distal tip, and to engage with each other in a second mating configuration to define the second discrete position of the distal tip.

38. The apparatus of claim 37, wherein: Each of the angled distal side (834) and the angled proximal side (832) defines an angle of inclination relative to the jaw body axis.

39. Apparatus according to any one of claims 36 to 38, wherein: The cantilever spring (890) includes a fixed proximal end and a free distal end, wherein the fixed proximal end is fixed to the distal end of the jaw body (820), and wherein the free proximal end is configured to be able to apply the elastic force on the proximal end of the distal tip (819).

40. Apparatus according to any one of claims 36 to 39, wherein: The cantilever spring includes a plate (890) that cooperates with an opposing portion of the second jaw (818) to define a cavity therebetween, wherein a proximal end (837) of the distal tip (819) is rotatable within the cavity.

41. Apparatus according to any one of claims 36 to 40, wherein: The proximal end of the distal tip includes a shaft (837).

42. The apparatus of claim 41, wherein: The shaft (837) includes a spherical tip configured to longitudinally constrain the distal tip (819) relative to the jaw body (820).

43. The apparatus of claim 42, wherein: The ball tip is capable of rotating within a cavity of the second jaw (818) proximal to the distal tip (819).

44. Apparatus according to any one of claims 42 to 43, wherein The spherical tip includes an angled cam surface having an elliptical cross-sectional profile, wherein the free distal end of the cantilever spring (890) is configured to apply the spring force on the angled cam surface to rotationally bias the distal tip (819) toward the closer of the first discrete position or the second discrete position.

45. The apparatus of claim 44, wherein: The cross-sectional profile of the ball tip has a major diameter along the width of the distal tip (819) and a minor diameter along the thickness of the distal tip.

46. ​​A device, comprising: (a) a first jaw (1002); and (b) a second jaw (1004) configured to cooperate with the first jaw to clamp tissue (90) and suturing the tissue using a plurality of staples (47), wherein the second jaw comprises: (i) a jaw body (1006) extending longitudinally along a jaw body axis, (ii) a distal tip (1008) movably disposed distally of the jaw body and extending longitudinally along a distal tip axis, and (iii) a linkage arm (1016) operable to actuate the distal tip relative to the jaw body and thereby manipulate the orientation of the distal tip axis relative to the jaw body axis in response to actuation of the second jaw relative to the first jaw.

47. The apparatus of claim 46, wherein: The link arm (1016) is configured to position the distal end (1008) such that the distal end axis is substantially parallel to the jaw body axis when the second jaw (1004) is in a closed state relative to the first jaw (1002), wherein the link arm is configured to position the distal end such that the distal end axis is angled relative to the jaw body axis when the second jaw is in an open state relative to the first jaw.

48. Apparatus according to any one of claims 46 to 47, wherein The linkage arm (1016) is configured to actuate the distal tip (1008) relative to the jaw body (1004) such that the distal tip axis defines a gradually decreasing angle (α) relative to the jaw body axis as the second jaw (1006) moves from the closed state toward the open state.

49. Apparatus according to any one of claims 46 to 48, wherein The distal end of the linkage arm (1016) is pivotally coupled to the distal tip (1008), wherein the proximal end of the linkage arm is operatively coupled to the first jaw (1002).

50. Apparatus according to any one of claims 46 to 49, wherein: The distal end of the linkage arm (1016) is pivotally connected to the distal tip (1008) by a pin (1014), wherein the distal portion of the second jaw (1004) includes a slot (1022), and the pin is configured to translate in the slot when the second jaw (1002) is actuated relative to the first jaw (1002).

51. The apparatus of claim 50, wherein: The pin (1014) is capable of translating within the slot (1022) transversely to its own longitudinal axis.

52. The device according to any one of claims 50 to 51, further comprising a connector (1010) connecting the distal tip (1008) to the distal end of the jaw body (1006), wherein: The connector defines the slot (1022).

53. The apparatus according to any one of claims 46 to 52, further comprising a pivot connection (1020) connecting the proximal end of the linkage arm (1016) to the proximal end of the first jaw (1002).

54. Apparatus according to any one of claims 46 to 53, wherein: The jaw body (1006) includes an elongated channel (1018) configured to slidably receive the linkage arm (1016).

55. Apparatus according to any one of claims 46 to 54, wherein The first jaw (1002) is configured to support a suturing assembly (37) operable to deploy staples (47), wherein the second jaw (1004) comprises an anvil jaw having a plurality of staple forming pockets (53) configured to form the staples.

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