Surgical stapler having an individually positionable distal tip - Patent application

Abstract

The device includes a first jaw (16) and a second jaw (618, 718, 900) that cooperate to clamp 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 first and second discrete positions. Both the first and second openings (663, 784, 785, 932, 934) are defined by one of the distal tip or structures (621, 920) located proximal to the distal tip. A protrusion (637, 781, 918) is defined by the other of the distal tip or structure. The protrusion is positionable within the first opening (663, 785, 932) to releasably hold the distal tip in a first discrete position, and is positionable within the second opening (663, 784, 934) to releasably hold the distal tip in a second discrete position.

Description

[Technical Field]

[0001] (CROSS-REFERENCE TO RELATED APPLICATIONS) This application claims the benefit under 35 U.S.C. §119(e) of the filing date of U.S. Provisional Patent Application No. 63 / 413,671 (filed October 6, 2022) and U.S. Provisional Patent Application No. 63 / 467,656 (filed May 19, 2023), both of which are incorporated by reference in their entirety and relied upon herein. [Background technology]

[0002] In some situations, endoscopic surgical instruments may be preferred over traditional open surgical devices to minimize the size of surgical incisions and postoperative recovery time and complications. To this end, some endoscopic surgical instruments may be suitable for positioning a distal end effector at a desired surgical site through a trocar cannula. These distal end effectors can engage tissue in several ways to achieve diagnostic or therapeutic effects (e.g., endocutters, graspers, cutters, staplers, clip appliers, access devices, drug / gene therapy delivery devices, and energy delivery devices using ultrasound, RF, or lasers). Endoscopic surgical instruments may include a shaft extending proximally from the end effector to a handle portion manipulated by the clinician or, alternatively, to a robot. Such a shaft may allow insertion to a desired depth and rotation about the shaft's longitudinal axis, thereby facilitating positioning of the end effector within the patient. Positioning of the end effector can be further facilitated by including one or more articulation joints or features that allow the end effector to be selectively articulated or otherwise deflected relative to the longitudinal axis of the shaft.

[0003] Examples of endoscopic surgical instruments include surgical staplers. Some such staplers are operable to clamp tissue layers, cut the clamped tissue layers, and drive staples through the tissue layers to substantially seal the cut tissue layers together near the cut ends of the tissue layers. Such endoscopic surgical staplers may also be used in open procedures and / or other non-endoscopic procedures. By way of example only, in thoracic surgical procedures that do not use a trocar as a conduit for the stapler, a surgical stapler may be inserted through a thoracotomy, thereby between the patient's ribs, to access one or more organs. Such procedures may include the use of a stapler to cut and close blood vessels leading to an organ, such as the lungs. For example, blood vessels leading to an organ may be cut and closed with the stapler before the organ is removed from the chest cavity. Of course, surgical staplers may be used in a variety of other settings and procedures.

[0004] In some procedures, it may be necessary to fire (i.e., cut and / or staple) along tissue when more than one fire is required to complete the procedure. In other words, it may be necessary to perform multiple sequential fires along a continuous path known as "marching." In procedures involving marching, the surgical stapler end effector may be positioned at the surgical site, actuated to cut and staple, removed from the surgical site for installation of a new staple cartridge, and then returned to the surgical site again for the next fire along the same path. In some such procedures, a clinician may need or desire to adjust the position of the distal tip of the end effector during the surgical procedure to more easily manipulate and fire tissue on the tissue. However, known surgical staplers have limited capabilities for such adjustment.

[0005] The presently disclosed surgical stapling mechanism is intended to enable a clinician to quickly and accurately adjust the position of the distal tip of a surgical stapler end effector during a surgical procedure. While many different types of surgical staplers and related components have been made and used, it is believed that no one before the inventor(s) has made or used the invention described in the appended claims. [Brief explanation of the drawings]

[0006] The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate embodiments of the present 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. [Figure 1] 1 depicts a perspective view of an example of an articulating surgical stapling instrument; [Figure 2] 2 depicts a side view of the device of FIG. 1; [Figure 3] 2 depicts a perspective view of an open end effector of the instrument of FIG. 1; [Figure 4A] 4 depicts a side cross-sectional view of the end effector of FIG. 3 taken along line 4-4 of FIG. 3 with the firing beam in a proximal position. [Figure 4B] 4 depicts a side cross-sectional view of the end effector of FIG. 3 taken along line 4-4 of FIG. 3 with the firing beam in a distal position. [Figure 5] 5 depicts a cross-sectional end view of the end effector of FIG. 3 taken along line 5-5 of FIG. 3. [Figure 6] 4 depicts an exploded perspective view of the end effector of FIG. 3; [Figure 7] 4 depicts a perspective view of the end effector of FIG. 3 after being positioned in tissue and actuated once within the tissue. [Figure 8] 10 depicts a perspective view of an alternative variation of an end effector having an angled anvil jaw and an angled cartridge. [Figure 9] 9 depicts an enlarged side view of the end effector of FIG. 8; [Figure 10]9 depicts an enlarged top view of the end effector of FIG. 8; [Figure 11] 1 depicts a perspective view of an example of a surgical stapling instrument having an end effector with a curved, elastically deformable tip; [Figure 12A] 12 depicts an enlarged side view of a distal portion of the end effector of FIG. 11; [Figure 12B] 12 depicts an enlarged side view of a distal portion of an alternative end effector similar to that of FIG. 11; [Figure 13] FIG. 10 depicts a perspective view of a distal portion of another anvil jaw configured for use with a surgical instrument described herein; [Figure 14] 14 depicts a proximal-facing, top, exploded perspective view of the distal portion of the anvil jaw of FIG. 13, showing the anvil body, distal tip, connector, spring plate, pivot pin, and connector pin; [Figure 15] 14 depicts a distal-facing, top, exploded perspective view of the distal portion of the anvil jaw of FIG. 13, showing the distal tip, connector, and spring plate; [Figure 16] 14 depicts a distal-facing, bottom, exploded perspective view of the distal portion of the anvil jaw of FIG. 13 , showing the distal tip, connector, spring plate, and two spring plate pins. [Figure 17A] 17 depicts a side cross-sectional view of the distal portion of the anvil jaw of FIG. 13 taken along line 17-17 of FIG. 13 showing the tip in a first discrete position; [Figure 17B] 17 depicts another side cross-sectional view of the distal portion of the anvil jaw of FIG. 13 taken along line 17-17 of FIG. 13 showing the tip transitioning to a second, discrete position; [Figure 17C] 17 depicts another side cross-sectional view of the distal portion of the anvil jaw of FIG. 13 taken along line 17-17 of FIG. 13 showing the tip in a second discrete position; [Figure 18] FIG. 10 depicts a perspective view of a distal portion of another anvil jaw configured for use with a surgical instrument described herein; [Figure 19]19 depicts a proximal-facing, top, exploded perspective view of the distal portion of the anvil jaw of FIG. 18, showing the anvil body, distal tip, connector, two guide pins, pivot pin, and two connector pins. [Figure 20] 19 depicts a distal-facing perspective view of the distal tip of FIG. 18; [Figure 21] 19 depicts a distal-facing perspective view of the base of FIG. 18; [Figure 22A] 22 depicts a side cross-sectional view of the distal portion of the anvil jaw of FIG. 18 taken along line 22-22 of FIG. 18 showing the distal tip in a first discrete position; [Figure 22B] 22 depicts another side cross-sectional view of the distal portion of the anvil jaw of FIG. 18 taken along line 22-22 of FIG. 18 showing the distal tip in a second discrete position; [Figure 23A] 22A depicts a distal-facing cross-sectional view of the distal portion of the anvil jaw of FIG. 18 taken along line 23-23 of FIG. 18, showing the distal tip in a first discrete position of FIG. 22A. [Figure 23B] 23 depicts another distally facing cross-sectional view of the distal portion of the anvil jaw of FIG. 18 taken along line 23-23 of FIG. 18, showing the distal tip between the first discrete position of FIG. 22A and the second discrete position of FIG. 22B. [Figure 23C] 23B depicts another distally facing cross-sectional view of the distal portion of the anvil jaw of FIG. 18 taken along line 23-23 of FIG. 18, showing the distal tip in a second discrete position of FIG. 22B. [Figure 24] FIG. 10 depicts a perspective view of a distal portion of another anvil jaw configured for use with a surgical instrument described herein; [Figure 25] 25 depicts a proximal-facing, top, exploded perspective view of the distal portion of the anvil jaw of FIG. 24, showing the anvil body, distal tip, connector, slider, two locking pins, pivot pin, and three connector pins. [Figure 26] 25 depicts a distal-facing, bottom, exploded perspective view of the distal portion of the anvil jaw of FIG. 24, showing the distal tip, connector, slider, and pivot pin. [Figure 27A]27 depicts a side cross-sectional view of the distal portion of the anvil jaw of FIG. 24 taken along line 27-27 of FIG. 24 showing the distal tip in a first discrete position. [Figure 27B] 27 depicts a side cross-sectional view of the distal portion of the anvil jaw of FIG. 24 taken along line 27-27 of FIG. 24 showing the distal tip between a first discrete position and a second discrete position; [Figure 27C] 27 depicts a side cross-sectional view of the distal portion of the anvil jaw of FIG. 24 taken along line 27-27 of FIG. 24 showing the distal tip in a second discrete position. [Figure 28A] 28 depicts a side cross-sectional view of the distal portion of the anvil jaw of FIG. 24 taken along line 28-28 of FIG. 24 showing the distal tip in a first discrete position. [Figure 28B] 28 depicts a side cross-sectional view of the distal portion of the anvil jaw of FIG. 24 taken along line 28-28 of FIG. 24 showing the distal tip in a second discrete position. [Figure 29] FIG. 10 shows a perspective view of a distal portion of another anvil jaw configured for use with a surgical instrument described herein, depicting the distal tip of the anvil jaw in a first discrete position. [Figure 30] 30 depicts a perspective view of the distal portion of the anvil jaw of FIG. 29 showing the distal tip in a second discrete position; [Figure 31] 30 depicts a proximal-facing, top, exploded perspective view of the distal portion of the anvil jaw of FIG. 29 , showing the anvil body, distal tip, connector, and cap; [Figure 32] 30 depicts a distal-facing, top, exploded perspective view of the distal portion of the anvil jaw of FIG. 29, showing the anvil body, distal tip, connector, and cap; [Figure 33] 30 depicts a distal-facing end view of the distal tip of the anvil jaw of FIG. 29; [Figure 34A] 34A depicts a side cross-sectional view of the distal portion of the anvil jaw of FIG. 29 taken along line 34A-34A of FIG. 29 showing the distal tip in a first discrete position. [Figure 34B]34B depicts another side cross-sectional view of the distal portion of the anvil jaw of FIG. 30 taken along line 34B-34B of FIG. 30 showing the distal tip in a second discrete position. [Figure 35] FIG. 10 depicts a perspective view of a distal portion of another anvil jaw configured for use with a surgical instrument described herein; [Figure 36] 36 depicts an exploded perspective view of the anvil jaw of FIG. 35; [Figure 37] 36 depicts a distal-facing perspective view of the distal tip of the anvil jaw of FIG. 35; [Figure 38] 36 depicts a distal-facing perspective view of the anvil jaw insert of FIG. 35; [Figure 39A] 39 depicts a side cross-sectional view of the distal portion of the anvil jaw of FIG. 35 taken along line 39-39 of FIG. 35 showing the distal tip in a first discrete position. [Figure 39B] 39 depicts a side cross-sectional view of the distal portion of the anvil jaw of FIG. 35 taken along line 39-39 of FIG. 35 showing the distal tip in a second discrete position. [Figure 40A] 36 depicts a distal-facing cross-sectional view of the distal portion of the anvil jaw of FIG. 35 showing the distal tip in a first discrete position; [Figure 40B] 39B depicts another distal-facing cross-sectional view of the distal portion of the anvil jaw of FIG. 35 showing the distal tip between the first discrete position of FIG. 39A and the second discrete position of FIG. 39B. [Figure 40C] 39B depicts another distal-facing cross-sectional view of the distal portion of the anvil jaw of FIG. 35 showing the distal tip in a second discrete position; FIG. [Figure 41] FIG. 10 depicts a distal-facing perspective view of the distal tip of another anvil jaw configured for use with a surgical instrument described herein; [Figure 42A] 42 depicts a top cross-sectional view of the mating portion of the anvil tip and corresponding anvil jaw of FIG. 41 shown in a pre-assembled state. [Figure 42B] 42B depicts another top cross-sectional view of the mating portion of the anvil tip and anvil jaw of FIG. 42A shown in an assembled state. [Figure 43] 1 depicts a perspective view of another illustrative end effector having an anvil jaw with a self-actuating distal tip; [Figure 44] 44 depicts an exploded perspective view of a distal portion of the anvil jaw of FIG. 43; [Figure 45A] FIG. 44 illustrates a side view of the end effector of FIG. 43 depicting the anvil jaws in a closed state and the distal tips in their first positions relative to the body of the anvil jaws; [Figure 45B] 44 depicts another side view of the end effector of FIG. 43 showing the anvil jaws in a partially open state and the distal tips in their second positions relative to the anvil jaw body; [Figure 45C] 44 depicts another side view of the end effector of FIG. 43 showing the anvil jaws in a fully open position and the distal tips in their third positions relative to the anvil jaw body;

[0007] The drawings are not intended to be limiting in any manner, and it is contemplated that various embodiments of the invention may be embodied in a variety of other ways, including those not necessarily depicted in the drawings. The accompanying drawings, which are incorporated in and form a part of this specification, illustrate several aspects of the invention and, together with the specification, serve to explain the principles of the invention, it being understood, however, that the invention is not limited to the precise arrangements shown. DETAILED DESCRIPTION OF THE INVENTION

[0008] The following description of specific examples of the present technology should not be used for the purpose of limiting its scope. 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 modes contemplated for carrying out the present technology. As will be understood, the technology described herein is capable of other different and obvious modes, all without departing from the technology. Therefore, the drawings and descriptions should be regarded as illustrative in nature, and not as restrictive.

[0009] For clarity of this disclosure, the terms "proximal" and "distal" are defined herein relative to a human or robotic surgical instrument operator. The term "proximal" refers to the location of an element closer to a human or robotic surgical instrument operator and further from a surgical end effector of the surgical instrument. The term "distal" refers to the location of an element closer to a surgical end effector of the surgical instrument and further from a human or robotic surgical instrument operator. It should be noted that the terms "upper," "lower," "lateral," "transverse," "bottom," and "top" are relative terms used to provide additional clarity in the description of the figures provided below. The terms "upper," "lower," "lateral," "transverse," "bottom," and "top," therefore, are not intended to unnecessarily limit the invention(s) described herein.

[0010] Additionally, terms such as "about," "approximately," "substantially," and the like, as used herein in connection with any numerical value, range of values, and / or geometric / positional quantification, are intended to encompass the exact value(s) or quantification(s) referenced, as well as an appropriate tolerance that enables the referenced feature or combination of features to function for the intended purpose described herein. For example, "substantially parallel" encompasses nominally parallel structures.

[0011] As used herein in connection with various examples of end effector jaw tips, tips described as "angled," "bent," or "curved" encompass tip configurations in which the longitudinal path (e.g., straight or arcuate) along which the tip extends is non-coaxial and non-parallel to the longitudinal axis of the jaw body, and particularly encompasses configurations in which the longitudinal tip path extends distally toward the opposing jaw. Conversely, tips described as "straight" encompass tip configurations in which the longitudinal axis of the tip is substantially parallel or coaxial with the longitudinal axis of the jaw body.

[0012] Exemplary Surgical Stapler 1-7 depict an example of a surgical stapling and severing instrument 10 sized for insertion into a surgical site in a patient through a trocar cannula or an incision (e.g., a thoracotomy) to perform a surgical procedure. The instrument 10 in this example includes a handle portion 20 connected to a shaft 22, which terminates distally in an articulation joint 11, which is further coupled to an end effector 12. Once the articulation joint 11 and end effector 12 are inserted through the cannula passage of the trocar, the articulation joint 11 can be remotely articulated, as depicted in phantom in FIG. 1, by an articulation control 13 so that the end effector 12 can be deflected at a desired angle α from the longitudinal axis (LA) of the shaft 22. The end effector (12) in this example includes a lower jaw (16) (also referred to herein as a cartridge jaw) that contains a staple cartridge (37), and an upper jaw in the form of a pivotable anvil jaw (18).

[0013] Unless otherwise noted, the term "pivot" (and variations thereof) as used herein encompasses, but is not necessarily limited to, pivoting about a fixed axis. For example, in some variations, the anvil jaw (18) may pivot about an axis defined by a pin (or similar mechanism) 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 pivoting movement. Thus, it should be understood that such combinations of pivoting and translational movement are encompassed by the term "pivot" and variations thereof as used herein.

[0014] The handle portion (20) includes a pistol grip (24) and a closure trigger (26). The closure trigger (26) is pivotable toward the pistol grip (24) to cause clamping or closure of the anvil jaw (18) toward the lower jaw (16) of the end effector (12). Such closure of the anvil jaw (18) is provided through a closure tube (32) and a closure ring (33), both of which translate longitudinally 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 distal to the articulation joint (11). The articulation joint (11) is operable to transmit / transmit longitudinal movement from the closure tube (32) to the closure ring (33).

[0015] As shown in FIGURE 2, handle portion (20) also includes a firing trigger (28). An elongate member (not shown) extends longitudinally through shaft (22) and, in response to actuation of firing trigger (28), transmits longitudinal firing motion from handle portion (20) to firing beam (14). As described in further detail below, this distal translation of firing beam (14) causes stapling and severing of tissue clamped within end effector (12).

[0016] As shown in Figures 3-6, the end effector (12) employs a firing beam (14) that includes a transversely oriented upper pin (38), a firing beam cap (44), a transversely oriented middle pin (46), and a distally presented cutting edge (48). The upper pin (38) is positioned and translatable within a longitudinal anvil slot (42) of the anvil jaw (18). The firing beam cap (44) slidably engages the underside of the lower jaw (16) by having the firing beam (14) extend through a lower jaw slot (45) (shown in Figure 4B) formed through the lower jaw (16). The middle pin (46) slidably engages the upper side of the lower jaw (16) in cooperation with the firing beam cap (44).

[0017] Figure 3 shows the present example firing beam (14) positioned proximally and the anvil jaw (18) pivoted to an open configuration, allowing an unused staple cartridge (37) to be removably mounted within a channel in the lower jaw (16). As best seen in Figures 5 and 6, the present example staple cartridge (37) includes a cartridge body (70) that presents an upper deck (72) and is coupled to a lower cartridge tray (74). As best seen in Figure 3, a vertical slot (49) extends longitudinally through a portion of the staple cartridge body (70). Also best seen in Figure 3, three rows of staple apertures (51) are formed through the upper deck (72) on each side of the vertical slot (49). As shown in FIGS. 4A-6, a wedge-shaped sled (41) and a plurality of staple drivers (43) are captured between a cartridge body (70) and a tray (74), with the wedge-shaped sled (41) positioned proximally relative to the staple drivers (43). The wedge-shaped sled (41) is longitudinally movable within the staple cartridge (37), while the staple drivers (43) are vertically movable within the staple cartridge (37). Staples (47) are also positioned within the cartridge body (70) above their corresponding staple drivers (43). Each staple (47) is driven vertically within the cartridge body (70) by the staple driver (43), and the staple (47) is driven out through an associated staple aperture (51). As best seen in Figures 4A and 4B, and Figure 6, wedge-shaped sled (41) presents an angled cam surface that urges staple driver (43) upward as wedge-shaped sled (41) is driven distally through staple cartridge (37).

[0018] As depicted in Figures 4A-4B, with the end effector 12 closed by distally advancing the closure tube 32 and closure ring 33, a firing member in the form of a firing beam 14 is then advanced distally into engagement with the anvil jaws 18 by entering the upper pin 38 into the longitudinal anvil slot 42. A pusher block 80 (shown in Figure 5) is located at the distal end of the firing beam 14 and, upon actuation of the firing trigger 28, pushes the wedge-shaped sled 41 distally as the firing beam 14 is advanced 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, severing the tissue clamped between the staple cartridge 37 and the anvil jaws 18. As shown in FIGS. 4A-4B, the middle pin (46) and pusher block (80) together actuate the staple cartridge (37) by entering a vertical slot (49) within the staple cartridge (37), driving the wedge-shaped sled (41) into upward camming contact with the staple driver (43), which in turn drives the staples (47) out through the staple apertures (51) and into forming contact with the staple-forming pockets (53) (shown in FIG. 3) on the inner surface of the anvil jaws (18). FIG. 4B depicts the firing beam (14) fully translated distally after tissue cutting and stapling are complete. The staple-forming pockets (53), shown in FIG. 3, are intentionally omitted from the views of FIGS. 4A-4B. The anvil jaws (18) are intentionally omitted from the view of FIG. 5.

[0019] Figure 7 shows the end effector 12 actuated through one stroke through tissue 90. The cutting edge 48 (obscured in Figure 7) cuts the tissue 90 while the staple driver 43 drives three alternating rows of staples 47 through the tissue 90 on either side of the cut line formed by the cutting edge 48. After the first stroke is completed, the end effector 12 is withdrawn from the patient, the spent staple cartridge 37 is replaced with a new staple cartridge 37, and the end effector 12 is then reinserted into the patient to reach the stapling site for additional cutting and stapling. This process can be repeated until the desired amount and pattern of firing strokes across the tissue 90 is completed.

[0020] Instrument (10) may further be configured and operable in accordance with any of the teachings of the following references, the disclosures of which are incorporated herein by reference: U.S. Pat. No. 8,210,411, entitled "Motor-Driven Surgical Instrument," issued July 3, 2012; U.S. Pat. No. 9,186,142, entitled "Surgical Instrument End Effector Articulation Drive with Pinion and Opposing Racks," issued November 17, 2015; U.S. Pat. No. 9,517,065, entitled "Integrated Tissue Positioning and Jaw Alignment Features for Surgical Stapler," issued December 13, 2016; U.S. Pat. No. 9,622,746, entitled "Distal Tip Features for End Effector of Surgical Instrument," issued April 18, 2017; U.S. Pat. No. 9,622,746, entitled "Lockout Feature for End Effector of Surgical Instrument," issued August 1, 2017; No. 9,717,497 entitled "For Movable Cutting Member of Surgical Instrument," issued on October 24, 2017; U.S. Patent No. 9,795,379 entitled "Surgical Instrument with Multi-Diameter Shaft," issued on October 24, 2017; U.S. Patent No. 9,808,248 entitled "Installation Features for Surgical Instrument End Effector Cartridge," issued on November 7, 2017; U.S. Patent No. 9,839,421 entitled "Jaw Closure Feature for End Effector of Surgical Instrument," issued on December 12, 2017; and / or U.S. Patent No. 10,092,292 entitled "Staple Forming Features for Surgical Stapling Instrument," issued on October 9, 2018.

[0021] II. End-effector with visualization, introduction, and collection capabilities In some instances, it may be desirable to provide the user with better visualization of the end effector 12. Specifically, when the end effector 12 is inserted into a surgical site, the user may rotate the shaft 22 of the instrument 10 during a procedure. As a result, the end effector 12 also rotates. As the end effector 12 rotates, it may be desirable for the user to have visual access to the surgical site. For example, the user may wish to view the interface or contact surface between the tissue 90 and the end effector 12. The end effector 12 may be rotated about the longitudinal axis LA relative to the handle portion 20 so that the user can view the surgical site such that the lower jaw 16 of the end effector is visible, rather than the anvil jaw 18. Alternatively, the end effector 12 may be rotated such that the anvil jaw 18 is visible to the user when the user views the end effector 12. It may be desirable to provide the user with greater visibility of the surgical site than is possible with the instrument (10) of FIG.

[0022] For example, in some surgical procedures in which fluid-carrying blood vessels are transected and stapled, it may be desirable to have visual confirmation that the anvil jaws 18 and lower jaw 16 completely cover the blood vessel to be severed, so that the blood vessel can be completely severed and stapled in one actuation. That is, the user may wish to avoid severing and stapling only a portion of the blood vessel. Therefore, some means of visual monitoring and / or feedback may be desirable so that the user knows when the end effector 12 is properly positioned within the surgical site so that the anvil jaws 18 and lower jaw 16 completely clamp the blood vessel. One potential method of monitoring the surgical site may include improved visualization of the area adjacent to the distal tips of the lower jaw 16 and anvil jaw 18. Furthermore, not only may visualization of the distal end of the end effector (12) be desirable, but it may also be desirable to construct the end effector (12) such that the distal end of the anvil jaw (18) is configured to urge tissue (e.g., a large blood vessel) proximally into the space between the anvil jaw (18) and the lower jaw (16) as the anvil jaw (18) closes toward the lower jaw (16).

[0023] 8 depicts one example of an end effector 212 including an anvil jaw 218 and a lower jaw 216. It will 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.

[0024] Anvil jaw 218 is operable to pivot relative to lower jaw 216. Anvil jaw 218 and lower jaw 216 are capable of clamping tissue 90 similar to the clamping performed by anvil jaw 18 and lower jaw 16 shown in Figure 1. End effector 212 further includes a cartridge 237 operable to be disposed within lower jaw 216, similar to cartridge 37 shown in Figure 3.

[0025] As can be seen in Figures 8-10, the anvil jaw (218) has an elongated shape with a distal portion of the anvil jaw (218) angled toward the cartridge (237). The distal portion of the anvil jaw (218) is angled toward the cartridge (237) such that the distal-most tip (219) of the anvil jaw (218) extends longitudinally further distally than the cartridge (237). However, in some variations, the distal tip (219) may extend longitudinally an equal distance to the cartridge (237) or proximally relative to the distal-most point on the cartridge (237). Furthermore, the anvil jaw (218) is angled toward the cartridge (237) by a gradual slope. As best seen in Figure 10, the anvil jaw (218) includes a side surface (241) that tapers as it approaches the distal-most tip (219) of the anvil jaw (218). As an example, the anvil jaw (218) is shaped similarly to an inverted ski tip in FIG. 8 . The angled shape of the anvil jaw (218) can provide easier insertion of the end effector (212) into the surgical site. For example, the gently sloping or inverted ski tip shape of the anvil jaw (218) can provide an atraumatic tissue deflection surface as the anvil jaw (218) contacts or moves through tissue. Such atraumatic tissue deflection can include urging tissue (e.g., a large blood vessel) proximally into the space between the anvil jaw (218) and the lower jaw (216) as the anvil jaw (218) closes toward the lower jaw (216). Once positioned at the surgical site, the angled shape of the anvil jaw (218) 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 structures at the surgical site. Other suitable variations of the anvil jaws (218) will be apparent to those skilled in the art in view of the teachings herein.

[0026] The cartridge (237) is operable to hold staples similar to the staples (47) shown in FIG. 4A for driving into tissue. As shown in FIG. 9, 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) generally aligns with the taper presented by the side surface (241) of the anvil jaw (218). Thus, as shown in FIG. 10, 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 surface (241) of the anvil jaw (218). The upper tapered surface (239) and the lower tapered surface (238) lead to the distal-most end of the cartridge (237). The lower tapered surface (238) defines a line of sight (240) such that a user can see along the line of sight (240) once the end effector (212) is inserted into a surgical site. The line of sight (240) extends along the edge of the lower tapered surface (238). It will be appreciated that the planar shape of the lower tapered surface (238) may be operable to allow a user to visualize and / or nearly visualize the distal tip (219) of the anvil jaw (218). In particular, the line of sight (240) intersects with a longitudinal axis (LA) extending longitudinally through the end effector (212) to form a viewing angle (θ).

[0027] The viewing angle (θ) may establish the relative visibility a user has of the distal tip (219). Specifically, the user can see in front of the distal tip (219) along any line of sight that passes through the intersection of the line of sight (240) and the longitudinal axis (LA) within the viewing angle (θ). For example, as the viewing angle (θ) increases, the user will have greater visibility of the area immediately in front of the distal tip (219) from a proximal viewing position. Conversely, as the viewing angle (θ) decreases, the user will have less visibility of the area in front of the distal tip (219) from a proximal viewing position. In some variations, the viewing angle (θ) defines an angle greater than 90 degrees. Additionally, in some variations, the viewing angle (θ) defines an angle greater than 135 degrees. Other suitable angles for the viewing angle (θ) will be apparent to those skilled in the art in light of the teachings herein. In the illustrated variation, the user generally looks along the line of sight (240) or along some other line of sight within the viewing angle (θ), and thus the user has visibility along the line of sight as well as along any region within the viewing angle (θ). The underside of the distal tip (219) is further slightly rounded to aid in visibility of the intersection of the longitudinal axis (LA) and the line of sight (240).

[0028] Once the tissue (90) is clamped between the closed cartridge (237) and anvil jaws (218), the user can look along the line of sight (240) or elsewhere within the viewing angle (θ) to, for example, see exactly where the anvil jaws (218) have clamped the tissue (90). Furthermore, the user can determine whether the tissue is fully clamped between the anvil jaws (218) and the cartridge (237) so that the tissue does not spill over the end of the end effector (212). The user may also be able to visualize the quality of the clamping between the anvil jaws (218) and the cartridge (237) relative to the tissue (90). It will be appreciated that in some instances, the end effector (212) may be rotated before, during, or after clamping the tissue (90). As a result, the tapered shape of the anvil jaws (218) can also provide a more accessible view of the distal tip (219) or a portion substantially adjacent the distal tip (219). The taper of the anvil jaw 218, along with the lower tapered surface 238 of the cartridge 237, may further facilitate easy atraumatic insertion of the end effector 212 into tissue. Additionally, the tapered end of the end effector 212 may make it easier to fit the end effector 212 through a trocar or other device operable to introduce the end effector 212 into a surgical site. For example, once the distal tip 219 is fitted within a trocar, the tapered shape of the lower tapered surface 238 and the anvil jaw 218 may provide a lead-in for guiding the remainder of the end effector 212 into the trocar. Given the teachings herein, those skilled in the art will further appreciate that the tapered design of both sides 241 of the anvil jaw 218 and each side 243 of the cartridge 237 may provide improved visibility and maneuverability.

[0029] In addition to the above, variations of the end effector (212) and instrument (10) incorporating the end effector (212) may be found in U.S. Pat. No. 9,186,142, entitled "Surgical Instrument End Effector Articulation Drive with Pinion and Opposing Racks," issued November 17, 2015, the disclosures of which are incorporated herein by reference; U.S. Pat. No. 9,717,497, entitled "Lockout Feature for Movable Cutting Member of Surgical Instrument," issued August 1, 2017, the disclosures of which are incorporated herein by reference; U.S. Pat. No. 9,517,065, entitled "Integrated Tissue Positioning and Jaw Alignment Features for Surgical Stapler," issued December 13, 2016, the disclosures of which are incorporated herein by reference; and U.S. Pat. No. 9,517,065, entitled "Jaw Closure Feature for End Effector," issued December 12, 2017, the disclosures of which are incorporated herein by reference. No. 9,839,421 entitled "Distal Tip Features for End Effector of Surgical Instrument," issued April 18, 2017, the disclosure of which is incorporated herein by reference; U.S. Pat. No. 9,622,746 entitled "Distal Tip Features for End Effector of Surgical Instrument," issued April 18, 2017, the disclosure of which is incorporated herein by reference; U.S. Pat. No. 10,092,292 entitled "Staple Forming Features for Surgical Stapling Instrument," issued October 9, 2018; U.S. Pat. No. 9,795 entitled "Surgical Instrument with Multi-Diameter Shaft," issued October 24, 2017, the disclosure of which is incorporated herein by reference;379, and / or U.S. Pat. No. 9,808,248, entitled "Installation Features for Surgical Instrument End Effector Cartridge," issued Nov. 7, 2017, the disclosure of which is incorporated herein by reference. Further modifications that may be incorporated into the end effector (212) are described in more detail below.

[0030] III. End effector with angled elastically deformable distal tip As seen in Figures 4A-4B and 7, 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 marching by providing an atraumatic space for tissue to enter the distal end of the end effector 12 at the start of each marching stroke.

[0031] As described above, the distal end configuration of the end effector (212) differs from the distal end configuration of the end effector (12), and different configurations of the end effector (212) offer different potential advantages. Specifically, the distal end configuration of the end effector (212) can provide improved maneuverability and improved 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 gathering effect by urging tissue proximally into the space between the anvil jaw (218) and the lower jaw (216) as the anvil jaw (218) closes toward the lower jaw (216). However, in variations in which the entire structure of the end effector 212 is rigid, the bent configuration of the distal tip 219 of the anvil jaw 218 may not be fully conducive to marching actions 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 as the anvil jaw 218 closes toward the lower jaw 216. Thus, in variations in which the entire structure of the end effector 212 is rigid, the end effector 212 may be best suited for cutting and stapling actions (e.g., vessel transection), where all of the tissue to be cut and stapled is collected proximal to the distal tip 219.

[0032] In view of the above, it may be desirable to provide variations of the end effector 12, 212 that provide the marching capabilities of the end effector 12, improved visibility associated with the end effector 212, and tissue gathering capabilities of the end effector 212 without increasing the risk of trauma that may otherwise be associated with completely rigid variations of the end effector 212. The following describes merely illustrative examples of some such variations of the end effector 12, 212. In the examples below, the anvil jaws have distal tips that are resiliently biased to assume a bent or angled configuration, such as distal tip 219. Furthermore, the resiliently biased distal tips are deflectable away from the lower jaw in response to a sufficient load on the distal tips. Given the teachings herein, it will be appreciated that providing anvil jaws with resiliently deformable angled distal tips can provide an additional level of maneuverability benefit with respect to navigating through tissue to a surgical site. In this manner, the deformable distal tip may flex or deform to facilitate smooth, atraumatic movement of the end effector through tissue, particularly during marching motions. Additionally, improved visualization during tissue capture and cutting can be achieved with anvil jaws having a bias to an angled position when not under load or contacted by surrounding tissue, compared to using an end effector with straight or non-angled anvil jaws. Furthermore, anvil jaws with distal tips biased to an angled position can provide some tissue gathering effect until a load point associated with marching is reached, rather than simply being associated with gathering relatively small tissue structures between the anvil jaw and the lower jaw.

[0033] FIG. 11 illustrates another example of an instrument 310 configured as a surgical stapler. The instrument 310 includes a handle portion 320 and a shaft 322. The instrument 310 has a modular configuration such that the shaft 322 is selectively detachable from and attachable to the handle portion 320. The instrument 310 is configured similarly to the instrument 10, and the operability and use of the instrument 310 are the same as those described above for the instrument 10, except for the additional feature of the instrument 310 being its modular configuration. Due to its modular configuration, the instrument 310 provides a way to change the end effector. Such changes in the end effector can be made to replace a differently fitted end effector or to provide different end effector configurations based on procedure or user preference. Additionally or alternatively, mechanisms operable to provide a modular configuration of instrument 310 may be configured in accordance with at least a portion of the teachings of U.S. Patent No. 10,182,813, entitled "Surgical Stapling Instrument with Shaft Release, Powered Firing, and Powered Articulation," issued January 22, 2019, the disclosure of which is incorporated herein by reference. Other suitable components, features, and configurations for providing instrument 310 with a modular configuration will be apparent to those skilled in the art in view of the teachings herein. Furthermore, those skilled in the art will understand in view of the teachings herein that instrument 10 may be modified to incorporate the modular configurations shown and described with respect to instrument 310 or the other instruments incorporated herein by reference.

[0034] In the illustrated example of FIG. 11 , the instrument (310) includes an end effector (312) having an anvil jaw (318) with an angled distal tip (319). Furthermore, the distal tip (319) of the anvil jaw (318) is elastically deformable. In this manner, as best shown in FIGS. 12A and 12B , 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 variations, while in other variations it may be angled to some degree (e.g., slightly above or slightly below the longitudinal axis (A1)). 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 this example, the end effector (312) is provided on a shaft (322) that is removable from the handle portion (320). By way of example only, the shaft (322) may be removable from the 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 March 13, 2018, the disclosure of which is incorporated herein by reference. In some other variations, the shaft (322) is not removable from the handle portion (320).

[0035] It will be understood that the end effector 312 may be used in place of the end effector 12 shown in FIG. 1 . In some variations, the end effector 312 may be integrally formed with the shaft 22, or alternatively, may be formed separately and then combined. In some variations, the end effector 312 may be provided for use with a robotic system. In such a robotic system, the modular shaft 322 having the end effector 312 may be attachable to a portion of the robotic system for use such that the handle portion 320 is interchangeable with a component of the robotic system. In yet other examples, the end effector 312 may be adapted for use with a robotic system in a manner in which the end effector 312 connects to the robotic system without necessarily connecting the entire modular shaft 322. In light of the teachings herein, other methods for incorporating an end effector having an angled, resiliently deformable anvil tip into a user-operated or robotically operated instrument will be apparent to those skilled in the art.

[0036] Figure 12A shows an enlarged side view of the distal end of end effector (312). End effector (312) includes an anvil jaw (318) and a lower jaw (16) that receives cartridge (37), as described above with respect to instrument (10). Anvil jaw (318) pivotally rotates toward lower jaw (16) in the same manner as anvil jaw (18) as described above with respect to instrument (10). In this configuration, end effector (312) is similar to end effector (12), except that anvil jaw (318) includes a resiliently deformable angled distal tip (319). As shown in Figure 12A, distal tip (319) is biased toward the angled position shown in Figure 11 and in phantom in Figure 12A. The distal tip 319 assumes this angled position when the end effector 312 is not clamping tissue and is open, as shown in Figure 11, or when it is closed and not clamping tissue, as shown in phantom in Figure 12A. When the end effector 312 is in this angled state or position, the end effector 312 may be considered to be in an unloaded or unloaded state or position. Conversely, when the end effector 312 is clamping tissue, the end effector 312 may be considered to be in a loaded or loaded state or position.

[0037] When closed and no tissue is clamped between the anvil jaws (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 with the longitudinal axis (A1) defined by the shaft (322) to form an angle (θ1). When closed and tissue (90) is clamped between the anvil jaws (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 with the longitudinal axis (A1) to form an angle (θ2). In the illustrated example of FIG. 12A , 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 and not limitation, in some examples, the angle (θ1) is about 20 to about 70 degrees, or more specifically, about 30 to about 50 degrees, downward from the longitudinal axis (A1) toward the cartridge (37). By way of example and not limitation, in some examples, the angle (θ2) is about 0 to about 90 degrees upward from the longitudinal axis (A1) away from the cartridge (37). By way of example and not limitation, in some examples, the range of motion experienced by the distal tip (319) is about 20 to about 110 degrees. The angles (θ1, θ2) described are by way of example only and are not intended to be limiting. Other suitable angles will be apparent to those skilled in the art in light of the teachings herein.

[0038] Additionally, in some instances, the longitudinal axis (A1) represents a zero-degree reference, and angles relative thereto can be positive or negative. For example, if the angle is in a downward direction from the longitudinal axis (A1) toward the cartridge (37), the angle may be characterized as a negative angle. Similarly, if the angle is in an upward direction from the longitudinal axis (A1) away from the cartridge (37), the angle may be characterized as a positive angle. Using these conventions, the range of motion of the distal tip (319) due to deformation can be understood as the sum of the absolute values ​​of the angle when the distal tip (319) is in contact with the cartridge (37) and the angle when the distal tip (319) is in a deformed state in which it clamps tissue.

[0039] Figure 12B shows another side view of an alternative end effector (412) similar to the end effector (312) of Figure 12A. In the end effector (312), when the anvil jaw (318) is in its angled, undeformed state (as seen in phantom in the view of Figure 12A), the anvil jaw (318) extends to a point at or proximal to the distal-most end of the cartridge (37). When the anvil jaw (318) is deformed to bend upward, the end of the distal tip (319) extends to a point just distal to the distal-most end of the cartridge (37). In the end effector (412), as shown in Figure 12B, when the anvil jaw (318) is in its angled, undeformed state (as seen in phantom in the view of Figure 12B), the anvil jaw (318) extends to a point at or proximal to the distal-most end of the cartridge (37). When the anvil jaw (318) is deformed to deflect upward, the end of the distal tip (319) of the anvil jaw (318) extends to a point flush with or proximal to the distal-most end of the cartridge (37). In this manner, the anvil jaw (318) of the end effector (412) remains flush with or proximal to the distal-most end of the cartridge (37) when the anvil jaw (318) is in its angled or deformed state, so that the anvil jaw (318) does not extend beyond the distal-most end of the cartridge (37) regardless of whether the anvil jaw (318) is in its angled and undeformed state or its deformed state. In some instances, this can be achieved by modifying the anvil jaw (318) to shorten the length of the anvil jaw's distal tip (319). In other instances, the instrument (10, 310) may be modified to provide slight proximal retraction of the anvil jaw (318) when clamping. Other methods of modifying the end effector (412) in relation to controlling the position of the anvil jaw (318) will be apparent to those skilled in the art in view of the teachings herein.

[0040] IV. End effector jaws with individually positionable distal tips In some instances, it may be desirable to provide a clinician with a versatile end effector jaw having a distal tip that can assume multiple distinct positions relative to the jaw body to accommodate various needs during a surgical procedure. In that regard, it may be desirable for a user to have an end effector with an angled (or “bent”) distal tip that provides visualization and positioning benefits as described above or that more effectively biases tissue (e.g., large blood vessels) proximally within the space between the anvil jaw and cartridge jaw as the end effector closes. In other situations, it may be desirable for a user to use an end effector with a substantially straight distal tip to facilitate easier marching as described above or to reduce pressure exerted on tissue positioned below the distal tip.

[0041] Each of the exemplary end effector jaws described below in connection with Figures 13-42B is configured for use with any of the surgical stapling instruments described herein and includes a distal tip configured to move (e.g., pivot or rotate) relative to the jaw body between first and second discrete positions to adjust and maintain the orientation of the longitudinal distal tip axis relative to the longitudinal jaw body axis. The transition between such discrete positions occurs in response to an external input force intentionally applied to the distal tip by a clinician, directly or indirectly, via a patient's anatomical structure in contact with the distal tip. Additionally, each end effector jaw is preferably configured to maintain its current discrete position until its distal tip is acted upon by an external input intentionally applied to the distal tip, directly or indirectly, by a clinician.

[0042] While such end effector jaws in this variation are shown in the form of anvil jaws each having anvil jaw bodies with a plurality of staple-forming pockets, in other variations, such individually positionable distal tips may be applied to cartridge jaws configured to receive a replaceable staple cartridge or to support a stapling assembly containing a plurality of staples. Additionally, while the first individual position of each end effector jaw described below is presented in the form of a straight position in which the distal tip axis extends substantially parallel to the jaw body axis, in other variations, the first individual position may include an angled position in which the distal tip axis is angled relative to the jaw body axis, for example, in a direction away from the opposing end effector jaw. Additionally, in other variations, the end effector jaws may include more than two individual positions for their distal tips.

[0043] The term "individual" and variations thereof, as used herein in connection with the individually positionable distal tips shown in Figures 13-42B, means predefined, and each individual position of the distal tip relative to its respective jaw body is predefined by particular structural features of the distal tip (519) and / or other portions of the respective end effector jaw. As used herein, "individual" and variations thereof are not intended to encompass configurations in which the distal tip is configured to transition between various positions relative to its respective jaw body solely by elastic or plastic deformation of the distal tip.

[0044] Anvil jaw with toggle tip with spring plate and pinned hinge Figures 13-17C depict the distal portion of an exemplary anvil jaw (518) having an individually positionable distal tip (519) and configured for use with an endoscopic surgical stapler end effector, such as any of the end effectors (12, 212, 312, 412) described above.

[0045] The anvil jaw (518) includes an elongated jaw body (520) having a stapling surface with a plurality of staple-forming pockets similar to the pockets (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 fixed to the distal end of the jaw body (520), and the distal tip (519) is pivotally coupled to the connector (521) and configured to pivot relative to the jaw body (520) between a first discrete position having a straight tip orientation (see FIG. 17A) and a second discrete position having an angled tip orientation (see FIG. 17C). In this variation, the connector (521) is configured to be press-fit into the jaw body (520). Specifically, connector (521) includes a proximal protrusion (541) that is inserted into a slot (542) formed in the distal end of jaw body (520), and the connection is then pinned using pin (536). Other methods of attaching connector (521) to jaw body (520) of anvil jaw (518) will be apparent to those skilled in the art. In other variations of anvil jaw (518), features of connector (521) may be integrally formed with jaw body (520) to define an integral connector portion at the distal end of jaw body (520), as described below.

[0046] Connector (521) includes a pair of distally extending arms (529). Arms (529) include a bore (531) configured to coaxially align with a corresponding bore formed in a proximal end portion of distal tip (519) to receive pivot pin (508) and thereby pivotally couple distal tip (519) to connector (521). In this manner, bore (531) and pivot pin (508) define a longitudinally fixed pivot or rotation axis about which distal tip (519) is configured to pivot (or "toggle") between first and second discrete positions and that extends transversely to the longitudinal axis of jaw body (520). In some alternative variations, the pivot shaft may be permitted to slidably translate longitudinally a minimal distance before, during, or after pivoting about the pivot shaft, for example, by providing the bore (531) of the connector (521) or the bore of the distal tip (519) with an elongated cross-sectional shape rather than a circular cross-sectional shape. It will be understood that similar modifications may be applied to the anvil jaws (618, 718) described below. As seen in FIGS. 17A and 17C , the distal tip (519) may be restrained from pivoting beyond a certain angle due to interference between the connector (521) and a tapered detent protrusion (537) extending proximally from the body of the distal tip (519). The pivot pin (508) may be press-fit, threaded, or glued to either the connector (521) or the distal tip (519), for example, and in some variations may be removable.

[0047] The connector (521) further includes a longitudinally extending slot (527) (which may also be referred to as a cavity) that receives and restrains a 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, that may apply a biasing force to a detent protrusion (537) on the distal tip (519), thereby pivotably biasing the distal tip (519) toward one of a first or second discrete position. More specifically, the spring (535) may include a distal bend (538) configured to contact and apply a force to the detent protrusion (537) on the distal tip (519). Spring plate 560 may be made of a material that can flex to apply a spring force, such as metal or plastic. Additionally, spring plate 560 may be removably or permanently attached to connector 521. Spring plate 560 may be coupled to connector 521 using a pair of spring plate pins 567 that extend through a pair of connector pin holes 569 and spring plate holes 564. Spring plate pins 567 may be secured to connector 521 by, for example, threads, adhesive, or a press fit.

[0048] 17A-17C, and as described above, the distal tip (519) is configured to pivot relative to the jaw body (520) and connector (521) via the pivot pin (508) between first and second discrete positions that define respective first and second orientations of the distal tip (519). For example, as shown in FIG. 17A, which shows the distal tip (519) in the first discrete position, the distal tip (519) is in a linear 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 variation, this corresponds to when the detent protrusion (537) of the distal tip (519) is located below the distal bend (538) of the spring tab (535). As shown in Figure 17C, which shows the distal tip (519) in a second discrete position, the distal tip (519) is 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 variation, this corresponds to when the detent protrusion (537) of the distal tip (519) is located above the distal bend (538) of the spring (535). Figure 17B shows the distal tip (519) transitioning from the first discrete position to the second discrete position such that the detent protrusion (537) contacts the distal bend (538) of the spring (535) of the spring plate (560).

[0049] The detent protrusion (537) of the distal tip (519) may remain in continuous contact with the spring (535) in the connector slot (527) such that the spring (535) is continuously in at least a slight proximally deflected state. This interaction may cause the spring (535) to continuously exert a distal biasing force on the detent protrusion (537), which may reach a peak as the detent protrusion (537) approaches the distal bend (538) as the distal tip (519) rotates. When the detent protrusion (537) is located at or below the distal bend (538), the spring (535) may rotatably bias the detent protrusion (537) downward such that the distal tip (519) assumes the first discrete position of FIG. 17A and the corresponding straight tip orientation. When the detent protrusion (537) is located at or above the distal bend (538), the spring (535) can rotatably bias the detent protrusion (537) upward such that the distal tip (519) assumes the second discrete position and corresponding angled tip orientation of FIG. 17C. In this regard, the distal bend (538) can function as a fulcrum mechanism. 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).

[0050] In this example, detent protrusion (537) acts in conjunction with spring (535) to hold distal tip (519) in its current discrete position until sufficient force is applied to distal tip (519) to overcome the biasing force exerted between detent protrusion (537) and spring (535). For example, if distal tip (519) is in an angled orientation and sufficient upward force is applied to distal tip (519), detent protrusion (537) on distal tip (519) will rotate downward and click past spring flexure (538), allowing 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 protrusion (537) on the distal tip (519) rotates upward and clicks past the spring flexure (538), allowing the distal tip (519) to assume other discrete positions.

[0051] As can also be seen in Figures 15-17C, the proximal end of the distal tip (519) includes stop surfaces configured to engage with respective distal end faces of the connectors (521) to constrain the distal tip (519) within a predetermined range of angular movement relative to the jaw body (720). Specifically, as shown in Figure 17A, an upper stop surface at the upper end of the base of the detent protrusion (537) is configured to engage with the upper distal end face of the connectors (521) when the distal tip (519) is in a first discrete position to prevent the distal tip (519) from further pivoting beyond the first discrete position. Additionally, as shown in Figure 17C, a lower stop surface at the lower end of the base of the detent protrusion is configured to engage with the lower distal end face of the connectors (521) when the distal tip (519) is in a second discrete position to prevent the distal tip (519) from further pivoting beyond the second discrete position.

[0052] Anvil jaw with toggle tip and resilient detent connector Figures 18-23C depict the distal portion of another exemplary anvil jaw (618) having an individually positionable distal tip (619) and configured for use with an endoscopic surgical stapler end effector, such as any of the end effectors (12, 212, 312, 412) described above.

[0053] The anvil jaw (618) includes an elongated jaw body (620) having a stapling surface with a plurality of staple-forming pockets similar to the pockets (53), a distal tip (619) located distally of the jaw body (620), and a connector (621) interconnecting the distal tip (619) with the jaw body (620). Like the distal tip (519), the distal tip (619) is pivotally coupled to the connector (621) and configured to pivot relative to the jaw body (620) between a first discrete position for a straight tip orientation (see FIG. 22A) and a second discrete position for an angled tip orientation (see FIG. 22B). The connector (621) is attached to the distal end of the jaw body (620) using, for example, a plurality of pins. In this variation, the connector 621 is attached to a pair of pins 646 positioned within corresponding pin holes 647 to hold the connector 621 in lateral alignment with the jaw body 620 and to a pair of pins 636 to longitudinally secure the connector 621 relative to the jaw body 620. The pins 636, 646 may be secured by, for example, a press fit or threaded engagement. As shown in FIG. 19 , the proximal end of the connector 621 includes a vertically extending slot 627 sized and shaped to receive a pair of protrusions extending distally from the distal end of the jaw body 620 when the connector 621 is assembled with the jaw body 620.

[0054] The distal end of the connector (621) includes a pair of distally extending arms (629) with respective bores (631) configured to receive a pivot pin (608) for pivotally coupling the distal tip (619) with the connector (621). The bores (631) and pivot pin (608) thus define a longitudinally fixed pivot or rotation axis about which the distal tip (619) is configured to pivot (or "toggle") between first and second discrete positions and that extends transversely to the longitudinal axis of the jaw body (620). In some alternative variations, the pivot axis may be allowed to longitudinally slidably translate a minimum distance before, during, or after pivoting about the pivot axis. The proximal end of distal tip 619 includes tip bore 633 that is coaxially aligned with bore 631 and also receives pivot pin 608. Pivot pin 608 may be press-fit, threaded, or glued to either connector 621 or distal tip 619, for example, and in some variations may be removable.

[0055] The central body portion of the connector (621) includes a detent cavity (663) extending longitudinally therethrough and located proximal to the arm bore (631). As described below, the connector (621) as a whole, or at least the central body portion of the connector (621) including the detent cavity (663), is formed of a resiliently deformable material configured to releasably retain the distal tip (619) in each of its first and second discrete positions. The detent cavity (663) is defined by two interconnected, vertically adjacent openings that respectively define upper and lower cavity portions that extend longitudinally along their respective longitudinal axes. As shown in Figures 22A-22B, these longitudinal axes are angled relative to one another to define a proximal opening angle. The openings defining each cavity portion of the detent cavity 663 are sized to receive a pin-like detent protrusion 637 extending proximally from the proximal end of the distal tip 619. The inner cavity portion of the detent cavity 663 interconnects the upper and lower cavity portions and has a maximum lateral width that is narrower than the maximum lateral widths of each of the upper and lower cavity portions and the detent protrusion 637 of the distal tip 619. In this variation, the detent protrusion 637 is substantially cylindrical, and each opening defining the upper and lower portions of the detent cavity 663 has a stadium shape with a length aligned with the length of the detent cavity 663 along the vertical thickness of the connector 621.

[0056] The detent protrusion 637 is positionable within the lower cavity portion (i.e., the lower opening) of the detent cavity 663 to releasably retain the distal tip 619 in a first discrete position and corresponding straight tip orientation. Conversely, the detent protrusion 637 is positionable within the upper cavity portion (i.e., the upper opening) to releasably retain the distal tip 619 in a second discrete position and corresponding angled tip orientation. Additionally, at least the central body portion of the connector 621 is formed of a polymer configured to resiliently deflect, thereby permitting passage of the detent protrusion 637 of the distal tip 619 between the upper and lower cavity portions in response to an external input force applied to the distal tip 619. The reduced lateral width of the inner cavity portion provides an interference fit with the detent protrusion (637), thus functioning to prevent the detent protrusion (637) from transitioning between the upper and lower cavity portions in the absence of an external input force. Additionally, the detent cavity (663) includes a tapered edge in the inner cavity portion that biases the detent protrusion (637) toward the closer of either the upper or lower cavity portion, thereby biasing the distal tip (619) toward the closer of either the first or second discrete position. The connector (621) further includes a relief groove (661) extending vertically along each side of the detent cavity (663). Each relief groove (661) allows a corresponding wall of material separating the relief groove (661) from the detent cavity (663) to resiliently flex laterally outward as the detent protrusion (637) transitions between the upper and lower cavity portions. Although each relief groove (661) is shown in the form of an elongated through-hole, it may be configured in a variety of other ways in other variations of connector (621).

[0057] The distal tip (619) is configured to pivot about its pivot axis relative to the jaw body (620) between discrete positions, the discrete positions being defined by the lower and upper portions of the detent cavity (663). Specifically, FIGS. 22A and 23A show the distal tip (619) 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 tip position is achieved by positioning the detent protrusion (637) of the distal tip (619) within the lower hollow portion of the detent cavity (663). FIGS. 22B and 23C show the distal tip (619) in a second discrete position, in which the distal tip (619) assumes an angled orientation relative to the jaw body (620) such that the distal tip axis is angled relative to the jaw body axis. This tip position is achieved by positioning the detent protrusion (637) within the upper cavity portion of the detent cavity (663). Figure 23B shows the detent protrusion (637) of the distal tip (619) transitioning between the lower and upper cavity portions of the detent cavity (663), which causes the wall of the material to deflect laterally outward toward the relief groove (661). Once the detent protrusion (637) is driven into the lower or upper cavity portion of the detent cavity (663) to provide the distal tip (619) with a corresponding first or second discrete position, the detent protrusion (637) remains there until an external input force is applied to the distal tip (619) by a user or external structure to drive the distal tip (619) to the opposite discrete position.

[0058] C. Anvil jaw with pin-locking tip Figures 24-28B depict the distal portion of another exemplary anvil jaw (718) having an individually positionable distal tip (719) and configured for use with an endoscopic surgical stapler end effector, such as any of the end effectors (12, 212, 312, 412) described above.

[0059] The anvil jaw 718 includes an elongated jaw body 720 having a stapling surface with a plurality of staple-forming pockets similar to pockets 53, a distal tip 719 located distally of the jaw body 720, a connector 721 interconnecting the distal tip 719 with the jaw body 720, and a movable latch, illustrated as a slider 768, movably coupled to the jaw body 720 and the connector 721. The connector 721 is coupled to the jaw body 720 using pins 746 positioned within respective pin holes 747. The pins 746 may be secured, for example, via a press fit or threads, although various other methods of attaching the connector 721 to the jaw body 720 will be apparent to those skilled in the art.

[0060] The jaw body (720) further includes a slider slot (724) that slidably receives a slider (768) and allows the slider (768) to translate relative to the jaw body (720) between a distal locked position and a proximal released position. The slider (768) is resiliently biased toward the distal locked position and can be selectably retracted to a proximal released position by a user grasping the exposed sides of the slider (768). The slider (768) includes a pair of latch protrusions, shown as pins (781), that are configured to extend distally through a corresponding pair of transverse holes (789) in the connector (721) and into either a pair of first latch pin bores (785) or a pair of second latch pin bores (784) formed in the proximal end (737) of the distal tip (719). The slider (768) is laterally disposed relative to the jaw body (720) and connector (721) by a pair of laterally opposed guide rails that slidably track within respective longitudinal channels defined by the distal end of the jaw body (720) in combination with the connector (721).

[0061] The connector 721 includes a pair of distally extending arms 729 and a bore 731 configured to receive a pivot pin 708 for pivotally coupling the distal tip 719 to the connector 721. In this manner, the bore 731 provides a longitudinally fixed pivot or rotation axis for the distal tip 719. In some alternative variations, the pivot axis may be allowed to longitudinally slidably translate a minimal distance before, during, or after pivoting about the pivot axis. The pivot pin 708 may be press-fit, threaded, or glued to either the connector 721 or the distal tip 719, for example, and in some variations may be removable.

[0062] The first latch pin bore (785) and the second latch pin bore (784) open through the convexly curved proximal end surface of the distal tip (719). As shown in Figures 27A-27C, each first latch pin bore (785) is angled relative to the corresponding second latch pin bore (784), such that each vertically adjacent pair of first and second latch pin bores (785, 784) defines a proximal opening angle and communicates at their distal ends. In other variations of the distal tip (719), various alternative quantities and configurations of latch bores may be provided, with each pair of latch bores defining a respective distinct position of the distal tip (719) when engaged by the latch pin (781).

[0063] Due to the above-described configuration of the anvil jaws 718, the distal tip 719 is configured to pivot about a pivot axis defined by the bore 731 to assume at least first and second distinct positions relative to the jaw body 720. Figure 27A shows the distal tip 719 in a first distinct position, in which the longitudinal axis of the distal tip 719 is substantially parallel to the longitudinal axis of the jaw body 720, and this first distinct position is maintained by distal insertion of the latch pin 781 into the first latch pin bore 785. Figures 27B and 27C show the distal tip 719 in a second distinct position, in which the longitudinal axis of the distal tip 719 is angled relative to the longitudinal axis of the jaw body 720, and this second distinct position is maintained by distal insertion of the latch pin 781 into the second latch pin bore 784. As shown in Figures 27B-27C, the slider 768 is actuatable in a proximal direction 790 to retract the latch pin 781 from the latch pin bores 784, 785, thereby allowing the distal tip 719 to pivot freely relative to the connector 721 and jaw body 720. The slider 768 is configured to insert the latch pin 781 in a distal direction 791 into one of the first latch pin bore 785 or the second latch pin bore 784 to releasably lock the distal tip 719 in one of the first or second discrete positions.

[0064] As shown in Figures 25-26, 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. Additionally, 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 as the distal tip 719 pivots between a first discrete position and a second discrete position. Thus, the range pin 783 and the range pin slot 786 cooperate to prevent the distal tip 719 from pivoting beyond each of the first discrete position and the second discrete position, thereby constraining the distal tip 719 to a predetermined range of angular movement relative to the jaw body 720, the predetermined range having endpoints coinciding with the first and second discrete positions of the distal tip 719.

[0065] D. Anvil jaw with swivel tip and cantilever spring Figures 29-34B depict the distal portion of another exemplary anvil jaw (818) having an individually positionable distal tip (819) and configured for use with an endoscopic surgical stapler end effector, such as any of the end effectors (12, 212, 312, 412) described above.

[0066] The anvil jaw (818) includes an elongated jaw body (820) having a plurality of staple-forming pockets (not shown) disposed along its length, similar to the pockets (53) of the anvil (18). A cantilever spring in the form of a connector (821) and a cap plate (890) is coupled to a distal portion of the anvil jaw body (820) such that the cap plate (890) is cantilevered at its fixed proximal end above the anvil jaw body (820) and connector (821). The connector (821) and cap 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 cap plate (890) each include curved features that cooperate to define an opening shaped as an oval or circle to form an opening in which the proximal end shaft (837) of the distal tip (819) can be rotatably captured when the connector (821) and the cap plate (890) are coupled to the anvil jaw body (820).

[0067] The distal tip (819) is rotatably coupled between the opposing distal end of the connector (821) and the cap plate (890) and is selectively rotatable relative to the anvil jaw body (820), the connector (821), and the cap plate (890) between a first discrete position and a second discrete position about an axis (A1) defined by the proximal end shaft (837) (see Figures 34A-34B) in response to an external rotational force applied to the distal tip (819) by a user or by adjacent anatomical structures. 29 , the distal tip (819) in the first discrete position is oriented straight relative to the anvil jaw body (820) such that when the end effector is in a closed condition, the distal tip (819) extends generally parallel to the lower jaw (16) and the staple cartridge (37), and thus the distal end of the distal tip (819) is spaced apart from and defines a gap with the distal end of the staple cartridge (37). Thus, the distal tip (819) in the straight position is configured to provide the end effector with a larger distally opening aperture throughout its clamping range than the corresponding aperture exhibited by the end effector when the distal tip (819) is in an angled position. Thus, similar to the other exemplary variations described above, the distal tip (819) in the angled position is preferably oriented to draw tissue proximally between the anvil jaws (818) and the staple cartridge (37) and facilitate visualization of the target tissue during closure of the end effector. Additionally, the distal tip (819) in the straight position is preferably oriented to facilitate marching during the stapling procedure, as also described above. As shown in FIG. 30 , 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 jaws (818) are closed to clamp tissue therebetween. Thus, a user can select the angled or straight position of the distal tip (819) as desired to best facilitate the particular procedure being performed.

[0068] 31-32, connector 821 and cap plate 890 are secured to jaw body 820 such that cap plate 890 overlies connector 821 and cooperates with a recess formed in the upper side of connector 821 to define an elongated cavity. Connector 821 and cap plate 890 cooperate to rotatably receive proximal end shaft 837 of distal tip 819 within the elongated cavity.

[0069] The anvil jaw (818) includes an angled interface (830) defined by an angled distal surface (832) of the connector (821) and an angled proximal surface (834) of the distal tip (819). The angled surfaces (832, 834) are configured to engage with one another in first and second mating configurations to define first and second discrete positions of the distal tip (819). As shown in Figures 31 and 32, the angled surfaces (832, 834) are angled obliquely relative to the longitudinal axes of the anvil jaw body (820) and the distal tip (819). As shown in FIG. 34B, the oblique angle of the angled interface (830) is summed when the distal tip (819) is in a second rotational orientation relative to the anvil jaw body (820), thus orienting the longitudinal axis of the distal tip (819) obliquely relative to the longitudinal axis of the anvil jaw body (820) to provide the distal tip (819) in an angled position.

[0070] The first rotational orientation can be obtained by rotating the distal tip (819) 180 degrees relative to the second rotational orientation. As shown in FIG. 34A , the bevel angles of the angled interface surfaces (830) are configured to cancel each other when the distal tip (819) is in the first rotational orientation relative to the anvil jaw body (820), thus 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 oriented relative to each other in the first discrete position shown in FIG. 34A , such that the angled surfaces (832, 834) define supplementary angles that together define a 180-degree angle. In other variations, the angled surfaces (832, 834) can alternatively be configured to define an angle greater than 180 degrees when the distal tip (819) is in the first position. In such variations, the distal tip (819) in the first position flares upwardly, away from the distal end of the staple cartridge (37) and the anvil body shaft.

[0071] Although not shown, the anvil jaw (818) may further include a tip locking mechanism operable to releasably retain the distal tip (819) in first and second discrete positions, thus preventing inadvertent rotation of the distal tip (819) away from the selected position. Such tip locking mechanism may comprise one or more detent features, protrusions, recesses, resilient members, interference features, etc. of various types that will be readily apparent to those skilled 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.

[0072] As shown in Figures 34A and 34B, the distal tip (819) is configured to rotate about an axis of rotation (A1) while still extending generally in a proximal-to-distal direction. The axis of rotation (A1) of the distal tip (819) is defined by the proximal end shaft (837), described below. In this variation, the proximal end shaft (837) is preferably configured so that the axis of rotation (A1) extends obliquely relative to the longitudinal axis of the distal tip (819).

[0073] As shown in Figures 33-34B, 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 opposing distal ends of the connector (821) and the cap plate (890), thereby longitudinally constraining the distal tip (819) relative to the jaw body (820). The spherical tip comprises angled camming surfaces and a proximal end surface, each of which has a generally elliptical profile, as shown in Figure 33. Specifically, the elliptical shape includes a major diameter (D1) along the width of the distal tip (819) and a minor diameter (D2) along the thickness of the distal tip (819). The tapered proximal end feature of the proximal end shaft (837) is captured within an elongated cavity defined between the cap plate (890) and the connector (821), and the distal cylindrical shaft portion of the proximal end shaft (837) extends through a distal opening defined between the cap plate (890) and the connector (821). Thus, the distal tip (819) is rotatable about the proximal end shaft (837) relative to the connector (821) while being longitudinally constrained by the tapered proximal end feature.

[0074] The cap plate (890) functions as a cantilever leaf spring and is configured to flex slightly transversely away from the distal end of the jaw body (820) to exert a resilient force on the tapered proximal end feature of the proximal end shaft (837), thereby rotatably biasing the distal tip (819) toward the closest of the first or second discrete positions. Specifically, when the distal tip (819) is in each of the first discrete position shown in FIG. 34A and the second discrete position shown in FIG. 34B, the underside of the cap plate (890) directly contacts and exerts a resilient force on the angled cam surface of the tapered proximal end feature, thereby retaining the distal tip (819) in its current discrete position. Rotation of the distal tip (819) away from the discrete positions causes the angled camming surface of the proximal end shaft (837) to push the distal end of the cap plate (890) away from the connector (921), thus deflecting the cap plate (890) along the larger diameter (D1) of the tapered proximal end feature. This, in turn, causes the underside of the cap plate (890) to exert an increased resilient force against the angled camming surface. This rotatably biases the distal tip (819) toward the closer of the first or second discrete positions, such that the distal tip (819) can automatically snap into one of these discrete positions as soon as an external rotational input applied to the distal tip (819) (e.g., by an operator) is removed.

[0075] E. Anvil jaw with toggle tip and resilient detent insert 35-40C depict the distal portion of another exemplary anvil jaw (900) having an independently positionable distal tip (906) and configured for use with an endoscopic surgical stapler end effector, such as any of the above-described end effectors (12, 212, 312, 412). The anvil jaw (900) is similar to the anvil jaw (518) described above, except as otherwise described below.

[0076] The anvil jaw 900 includes an elongated jaw body 902 having a stapling surface with a plurality of staple-forming pockets similar to pockets 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 that extends transversely to the longitudinal axes of the jaw body 902 and the distal tip 906 and along the lateral width of the jaw body 902 and the distal tip 906. In this variation, the connector portion 904 is integrally formed with the remaining proximal portion of the jaw body 902, although in other variations the connector portion 904 may be separately formed and attached to the distal end of the jaw body 902, similar to connector 621 described above. Similarly, it will 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 body (520, 620, 720, 820). The distal tip (906) is configured to pivot relative to the jaw body (902) about a pivot pin (908) between a first discrete position in a straight tip orientation (see FIG. 22A ), in which the longitudinal axis of the distal tip is substantially parallel to the longitudinal axis of the jaw body (902), and a second discrete position in an angled tip orientation (see FIG. 22B ), in which the longitudinal axis of the distal tip (906) is angled relative to the longitudinal axis of the jaw body (902).

[0077] As best shown in FIG. 37 , 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), the protrusions (912, 914) including a coaxially aligned pivot pin bore (916) for laterally receiving a pivot pin (908) therethrough. A pin-like detent 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) further includes stop surfaces configured to engage with the distal end faces of each of the connector portions (904) to constrain the distal tip (906) within a predetermined range of angular movement relative to the jaw body (902), such surfaces and their functions being similar to those described above in connection with the anvil jaw (518).

[0078] Like the distal tip (619) of the anvil jaw (618), the distal tip (906) is resiliently biased toward the closer of the first or second discrete positions 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 a longitudinally fixed insert (920) that extends into the distal end of the jaw body (902) and is housed in a channel (922) that opens distally through the connector portion (904) between the side pivot support projections (914). As best shown in FIG. 38 , the insert (920) includes an upper flange (924), a lower flange (926), and a pair of laterally opposed side walls (928) extending perpendicularly between the upper and lower flanges (924, 926) and recessed laterally inward from opposite ends of the flanges (924, 926). The lower surface of the lower flange (926) includes a downwardly extending protrusion configured to be received within a corresponding lower recess in the channel (922), thereby facilitating proper orientation of the insert (920) relative to the jaw body (902) during assembly of the anvil jaw (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 projection 918 on the distal tip 906 and is oriented such 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 932 and the upper cavity portion 934 along their lengths and is formed with a lateral width that is smaller than the lateral widths of the cavity portions 932, 934 and the detent projection 918. The cavity portions (932, 934) extend longitudinally along respective longitudinal axes that are angled relative to one another to define a proximal opening angle, as seen in Figures 39A-39B.

[0079] As shown in Figures 39A and 40A, the lower cavity portion (932) is configured to receive and releasably retain the detent protrusion (918) to maintain the distal tip (906) at a first discrete position relative to the jaw body (902). As shown in Figures 39B and 40C, the upper cavity portion (934) is configured to receive and releasably retain the detent protrusion (918) to maintain the distal tip (906) at a second discrete position relative to the jaw body (902). As shown in Figure 40B, the insert sidewalls (928) are configured to resiliently flex laterally outward into the channel (922) as the detent protrusion (918) advances vertically through the intermediate passage (936) when transitioning between the lower cavity portion (932) and the upper cavity portion (934). As a result, the sidewalls (928) exert a resilient force laterally inward on the detent protrusions (918) to bias the detent protrusions (918) toward the closer of the lower cavity portion (932) or the upper cavity portion (934), thereby biasing the distal tip (906) toward the closer of the first or second discrete position. In this regard, the insert (920) is formed of an elastomeric polymer configured to repeatedly elastically expand and contract as the distal tip (906) transitions between the first and second discrete positions. In contrast, the jaw body (902) and the distal tip (906) may be formed of a more rigid material, such as a metal.

[0080] In other variations of the anvil jaw 900, the detent projection 918 of the distal tip 906 and the respective detent cavity portions 932, 934 of the insert 920 may have cross-sectional profiles of various shapes other than the illustrated stadium shape, such as, for example, an elongated hexagon. Such shapes may be selected to optimize the shear strength of the detent projection 918 relative to the tip body 910 and the external force required to transition the distal tip 906 between a first discrete position and a second discrete position.

[0081] The above-described structure of the anvil jaw (900) minimizes the tissue clamping area and provides a resilient detent structure while otherwise maximizing the stiffness of the anvil jaw (900) components to promote product durability and accurate manipulation of tissue.

[0082] F. Alternative toggle tip configured for pinless pivot 41-42B illustrate an exemplary alternative distal tip (950) configured for use with the anvil jaw (900) in place of the distal tip (906). The proximal end of the distal tip (950) includes a central pivot support protrusion (952) that omits the pivot bore (916) and instead includes a pair of pivot nubs (954) extending laterally outward from opposite sides of the central pivot support protrusion (952). Each pivot nub (954) is generally cylindrical and includes a lead-in chamfer on the proximally-facing edge of its free end. As shown in FIGS. 42A-42B, these lead-in chamfers facilitate proximal insertion of the pivot nubs (954) into the pivot bore (916) of the connector portion (904) of the jaw body (902) when the distal tip (950) is assembled with the jaw body (902). The pivot nub (954) cooperates with the pivot bore (916) to allow the distal tip (950) to pivot relative to the jaw body (902) without the need for a pivot pin (908).

[0083] V. End effector with anvil jaws having self-actuating distal tips As described above in connection with Figures 13-42B, the anvil jaws (518, 618, 718, 818, 900) include distal tips (519, 619, 719, 819, 906) configured to actuate between a plurality of predetermined discrete positions in response to an external input force intentionally applied to the distal tips (519, 619, 719, 819, 906) directly or indirectly by a clinician. The end effector (1000), described below in connection with Figures 43-45C, includes an anvil jaw (1004) having a distal tip (1008) configured to self-actuate in response to actuation of the anvil jaw (1004) relative to the cartridge jaws (1002) between an open state and a closed state.

[0084] As shown in FIG. 43 , the end effector (1000) includes a cartridge jaw (1002) configured to removably receive a replaceable staple cartridge similar to staple cartridge (37), the cartridge jaw (1002) defining a first stapling surface. The end effector (1000) further includes an anvil jaw (1004) configured to pivot relative to the cartridge jaw (1002) between an open position and a closed position 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 stapling surface with a plurality of staple-forming pockets similar to pockets (53), a distal tip (1008) located distally of 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 a user input force applied to the distal tip (1008).

[0085] The end effector (1000) further includes an elongated linkage arm (1016) operable to actuate the distal tip (1008) relative to the anvil jaw body (1006) to manipulate the angular orientation of the distal tip (1008) and its longitudinal axis relative to the anvil jaw body (1006) and its longitudinal axis. The linkage arm (1016) is slidably received within an elongated channel (1018) extending longitudinally through the anvil jaw body (1006) and the connector (1010). As can be seen in FIG. 44, the proximal end of the linkage arm (1016) is pivotally connected to the proximal end of the side wall of the cartridge jaw (1002) via a pivot connection in the form of a short link (1020), and the distal end of the linkage arm (1016) is pivotally connected to the pivot support protrusion (1012) of the distal tip (1008) via a pivot pin (1014).

[0086] The connector (1010) includes a pin slot (1022) extending laterally through the connector (1010) and opening laterally to an internal cavity of the connector (1010), the distal end of the linkage arm (1016) configured to translate longitudinally through the internal cavity, and the pivot support protrusion (1012) of the distal tip (1008) configured to pivot within the internal cavity. The pin slot (1022) has an elongated, stadium-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 an upper end of the profile is oriented distally and a lower end of the profile is oriented proximally. This elongated profile of the pin slot (1022) allows the pivot pin (1014) to translate within the pin slot (1022) such that the pivot pin (1014) translates transversely to its own longitudinal axis when the distal tip (1008) pivots relative to the connector (1010) and the anvil jaw body (1006).

[0087] As shown in Figures 45A-45C, actuation of the anvil jaw (1004) relative to the cartridge jaw (1002) drives longitudinal translation of the anvil jaw body (1006) and a linkage arm (1016) within 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 progressively decreasing angle with respect 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.

[0088] Figure 45A shows the anvil jaw (1004) in a fully closed position relative to the cartridge jaw (1002) for clamping tissue between the anvil jaw (1004) and a staple cartridge (not shown) seated within the cartridge jaw (1002). 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). Figure 45B shows the anvil jaw (1004) in an exemplary partially open position relative to the cartridge jaw (1002), with the distal tip (1008) oriented at an angle relative to the anvil jaw body (1006) such that the longitudinal axis of the distal tip (1008) defines a first angle (α1) with respect to the longitudinal axis of the anvil jaw body (1006). 45C shows the anvil jaw (1004) in a fully open position relative to the cartridge jaw (1002), with the distal tip (1008) oriented at a more angular angle relative to the anvil jaw body (1006) such that the longitudinal axis of the distal tip (1008) defines a second angle (α2) with respect to the longitudinal axis of the anvil jaw body (1006), the second angle (α2) being less than the first angle (α1). It will be understood that the distal tip (1008) assumes angles that vary progressively between those shown as the anvil jaw (1004) is actuated between the positions shown in FIGS. 45A-45C.

[0089] The angled position of the distal tip 1008 relative to the anvil jaw body 1006 when the anvil jaws 1004 are at least partially open relative to the cartridge jaws 1002 allows the distal tip 1008 to effectively collect and manipulate tissue while facilitating visualization distally down the length of the anvil jaws 1004. The straight position of the distal tip 1008 relative to the anvil jaw body 1006 when the anvil jaws 1004 are closed ensures that tissue positioned within the end effector 1000 is not over-clamped by the distal tip 1008, while also facilitating marching of the end effector 1000 along tissue structures.

[0090] VI. Combination Examples 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 scope of any claims that may be presented at any time in this application or any subsequent application related to this application. No disclaimer is intended. The following examples are provided merely for illustrative purposes. It is contemplated that the various teachings herein may be configured and applied in many other ways. It is also contemplated that certain features referred to in the following examples may be omitted in some variations. Accordingly, none of the aspects or features referred to below should be considered critical unless later expressly indicated otherwise by the inventors or their successors. If a claim presented in this application or a subsequent application related to this application includes additional features other than those referred to below, those additional features should not be considered added for any reasons of patentability. [Example]

[0091] (a) a first jaw (16); and (b) a second jaw (618, 718, 900) configured to cooperate with the first jaw to clamp and staple tissue (90) with a plurality of staples (47), the second jaw including: (i) a jaw body (620, 720, 902) extending longitudinally along a jaw body axis; and (ii) a distal tip (619, 719, 906) movably disposed distally of the jaw body and extending longitudinally along a distal tip axis, the distal tip being pivotable about a pivot axis extending transversely to the jaw body axis between a first discrete position and a second discrete position, wherein at the first discrete position, the distal tip axis assumes a first orientation relative to the jaw body axis and a second discrete position, the distal tip axis assumes a second orientation relative to the jaw body axis. a distal tip, wherein at the first 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 defined by one of the distal tip or a structure (621, 920) located proximal to the distal tip; and (iv) a protrusion (637, 781, 918) defined by the other of the distal tip or the structure, wherein the protrusion is positionable within the first opening (663, 785, 932) to releasably retain the distal tip in the first discrete position and the protrusion is positionable within the second opening (663, 784, 934) to releasably retain the distal tip in the second discrete position. [Example]

[0092] The device of Example 1, wherein when the distal tip (619, 719, 906) is in a first discrete position, the distal tip axis is substantially parallel to the jaw body axis, and when the distal tip is in a second discrete position, the distal tip axis is angled relative to the jaw body axis. [Example]

[0093] A device as described in any one of Examples 1-2, wherein the distal tip (619, 719, 906) is constrained to a predetermined range of angular motion having first and second endpoints defined by first and second discrete positions, respectively. [Example]

[0094] 4. The device of any one of Examples 1 to 3, wherein the protrusion (637, 918) is defined by a distal tip (619, 906). [Example]

[0095] The device of Example 4, wherein the second jaw (618,900) further includes an elastic structure (621,970) defining the first opening and the second opening (663,932,934), and the elastic structure is configured to elastically deflect when the protrusion (637,918) transitions between the first opening and the second opening. [Example]

[0096] 6. The device 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). [Example]

[0097] 7. The apparatus of any one of Examples 5-6, wherein the first opening and the second opening (663, 932, 934) are interconnected. [Example]

[0098] A device described in any one of Examples 5 to 7, wherein the first opening and second opening (663, 932, 934) define respective longitudinal axes that are perpendicularly arranged and intersect to define a proximal opening angle. [Example]

[0099] The device of any one of Examples 5 to 8, wherein the resilient structure (970) comprises an insert housed within a channel (922) in the distal end of the jaw body (902). [Example]

[0100] 10. The apparatus of example 9, wherein the jaw body (902) comprises a metal and the insert (970) comprises a polymer. [Example]

[0101] 2. The device of example 1, wherein the first and second openings (784, 785) are defined on a proximal end of the distal tip (719). [Example]

[0102] The device of Example 11, wherein the second jaw (718) further includes a latch (768) defining a protrusion (781) and is actuatable by a user relative to the jaw body (720) between a locked position in which the latch prevents movement of the distal tip relative to the jaw body and a released position in which the latch allows movement of the distal tip relative to the jaw body. [Example]

[0103] 13. The device of example 12, wherein the latch (768) is biased toward the locked position. [Example]

[0104] 14. The device of any one of Examples 12-13, wherein the latch (768) is translatable relative to the jaw body (720) between a locked position and a released position. [Example]

[0105] The device of any one of Examples 1 to 14, wherein the first jaw (16) is configured to support a stapling assembly (37) operable to deploy staples (47), and the second jaw (618, 718, 900) comprises an anvil jaw having a plurality of staple forming pockets (53) configured to form staples. [Example]

[0106] (a) a first jaw (16); and (b) a second jaw (618, 900) configured to cooperate with the first jaw to clamp and staple tissue (90) with a plurality of staples (47), the second jaw including: (i) a jaw body (620) extending longitudinally along a jaw body axis; and (ii) a distal tip (619, 906) movably disposed distally of the jaw body and extending longitudinally along a distal tip axis, the distal tip including a detent protrusion (637, 918) and pivotable about a 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 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. a distal tip that assumes a second orientation; and (iii) an elastic structure (621, 970) fixed relative to the jaw body proximal to the distal tip, the elastic structure including a detent cavity (663, 930) having a first cavity portion (663, 932) and a second cavity portion (663, 934) configured to receive a detent protrusion of the distal tip, the detent protrusion being positionable within the first cavity portion (663, 932) to releasably retain the distal tip in a first discrete position, and the detent protrusion being positionable within the second cavity portion (663, 934) to releasably retain the distal tip in a second discrete position, the elastic structure configured to elastically deflect when the detent protrusion moves between the first cavity portion and the second cavity portion. [Example]

[0107] 17. The device of example 16, wherein the elastic structure (621,970) is longitudinally fixed relative to the jaw body (620,902) and the distal tip (619,906). [Example]

[0108] A device described in any one of Examples 16 to 17, wherein the elastic structure (621,970) is configured to bias the detent protrusion (637,918) toward the closer of the first hollow portion (663,932) or the second hollow portion (934), thereby biasing the distal tip (619,906) toward the closer of the first discrete position or the second discrete position. [Example]

[0109] 19. The device of any one of Examples 16 to 18, wherein the first cavity portion and the second cavity portion (663, 932, 934) are vertically arranged such that the first cavity portion comprises a lower cavity portion (663, 932) and the second cavity portion comprises an upper cavity portion (663, 934). [Example]

[0110] A device described in any one of Examples 16 to 19, wherein the first cavity portion and the second cavity portion are defined by respective first openings and second openings (663, 932, 934) that are interconnected and extend along respective longitudinal axes that define a proximal opening angle. [Example]

[0111] 21. The device of any one of Examples 16 to 20, wherein the resilient structure comprises an insert (970) housed within a channel (922) at the distal end of the jaw body (902). [Example]

[0112] 22. The apparatus of example embodiment 21, wherein the jaw body (902) comprises a metal and the insert (970) comprises a polymer. [Example]

[0113] An apparatus as described in any one of Examples 21 to 22, wherein the insert (970) has a pair of insert side walls (928) laterally opposed to each other, each insert side wall spaced inward from the respective inner surface of the jaw body (902), such that the insert side walls are configured to elastically flex laterally outward into the channel (922) when the detent protrusion (918) transitions between the first hollow portion (932) and the second hollow portion (934). [Example]

[0114] An apparatus as described in any one of Examples 16 to 23, wherein when the distal tip (619,906) is in a first discrete position, the distal tip axis is substantially parallel to the jaw body axis, and when the distal tip (619,906) is in a second discrete position, the distal tip axis is angled relative to the jaw body axis. [Example]

[0115] A device described in any one of Examples 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 first and second discrete positions, respectively. [Example]

[0116] (a) a first jaw (16); and (b) a second jaw (718) configured to cooperate with the first jaw to clamp and staple tissue (90) with a plurality of staples (47), the second jaw including: (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 distal to the jaw body and the latch and extending longitudinally along a distal tip axis, the distal tip being movable relative to the jaw body between a first discrete position and a second discrete position. a distal tip that is movable, wherein in a first discrete position the distal tip axis has a first orientation relative to the jaw body axis and, in a second discrete position, the distal tip axis has a second orientation relative to the jaw body axis; and a latch that is actuatable 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 tip in one of the first discrete position or the second discrete position and the latch in the released position is configured to allow the distal tip to transition between the first discrete position and the second discrete position. [Example]

[0117] 27. The device of embodiment 26, wherein the latch (768) is translatable relative to the jaw body (720) between a locked position and a released position. [Example]

[0118] 28. The device of any one of Examples 26-27, wherein the latch (768) is positioned distally in the locked position and proximally in the released position, the latch being biased toward the locked position. [Example]

[0119] The device described in any one of Examples 26 to 28, wherein the second jaw (718) further includes a protrusion (781) defined by one of the latch (768) or the distal tip (719), and a first opening and a second opening (784, 785) defined by the other of the latch or the distal tip, wherein the first opening (785) is configured to receive the protrusion when the distal tip is in a first individual position and the latch is in a locked position, and the second opening (784) is configured to receive the protrusion when the distal tip is in a second individual position and the latch is in a locked position. [Example]

[0120] The device of Example 29, wherein the protrusion (781) is longitudinally insertable into one of the first opening (785) or the second opening (784) when the latch transitions from the released position to the locked position. [Example]

[0121] A device described in any one of Examples 29 to 30, wherein the latch (768) includes a protrusion (781) and the distal tip (719) includes a first opening and a second opening (785, 784). [Example]

[0122] An apparatus as described in any one of Examples 29 to 31, wherein the protrusion comprises a pin (781), and the first opening and the second opening comprise first and second bores (785, 784), respectively, configured to slidably receive the pin. [Example]

[0123] The device described in any one of Examples 29 to 32, wherein the protrusion (781) comprises a first protrusion (781), and the second jaw (718) further comprises a second protrusion (781), a third opening (785) configured to receive the second protrusion when the distal tip is in a first individual position, and a fourth opening (784) configured to receive the second protrusion when the distal tip is in a second individual position. [Example]

[0124] An apparatus as described in any one of Examples 26 to 33, further comprising a connector (721) fixed to the distal end of the jaw body (720), the distal tip (719) being pivotally connected to the distal end of the connector, and the latch (768) being operable within a slot (724) defined between the jaw body and the connector. [Example]

[0125] A device described in any one of Examples 26 to 34, wherein the distal tip (719) is constrained to a predetermined range of angular motion having first and second endpoints defined by first and second discrete positions, respectively. [Example]

[0126] (a) a first jaw (16); and (b) a second jaw (818) configured to cooperate with the first jaw to clamp and staple tissue (90) with a plurality of staples (47), the second jaw including: (i) a jaw body (820) extending longitudinally along a jaw body axis; and (ii) a distal tip (819) movably disposed distally of the jaw body and extending longitudinally along a distal tip axis, the distal tip being movable relative to the jaw body between a first discrete position and a second discrete position. a distal tip that is rotatable 180 degrees, wherein in a first discrete position, the distal tip axis is in a first orientation relative to the jaw body axis, and in a second discrete position, the distal tip axis is in a second orientation relative to the jaw body axis; and (iii) a cantilever spring (890) configured to exert a resilient force on a proximal end of the distal tip when the distal tip is positioned between the first and second discrete positions, rotatably biasing the distal tip toward the closer of the first or second discrete position. [Example]

[0127] The device described in Example 36, wherein the second jaw (818) includes an angled distal surface (834) defined by the proximal end of the distal tip (819) and an angled proximal surface (832) located proximal to the angled distal surface, and the first and second angled surfaces are configured to engage with each other in a first mating configuration to define a first discrete position of the distal tip and to engage with each other in a second mating configuration to define a second discrete position of the distal tip. [Example]

[0128] 38. The device of Example 37, wherein the angled distal surface (834) and the angled proximal surface (832) each define an oblique angle relative to the jaw body axis. [Example]

[0129] An apparatus as described in any one of Examples 36 to 38, wherein the cantilever spring (890) includes a fixed proximal end and a free distal end, the fixed proximal end being fixed to the distal end of the jaw body (820), and the free proximal end being configured to exert an elastic force on the proximal end of the distal tip (819). [Example]

[0130] A device described in any one of Examples 36 to 39, wherein the cantilever spring comprises a plate (890) that cooperates with an opposing portion of the second jaw (818) to define a cavity therebetween, and the proximal end (837) of the distal tip (819) is rotatable within the cavity. [Example]

[0131] The device of any one of Examples 36 to 40, wherein the proximal end of the distal tip comprises a shaft (837). [Example]

[0132] 42. The device of Example 41, wherein the shaft (837) comprises a bulbous tip configured to longitudinally constrain the distal tip (819) relative to the jaw body (820). [Example]

[0133] 43. The device of Example 42, wherein the bulbous tip is rotatable within a cavity in the second jaw (818) proximal to the distal tip (819). [Example]

[0134] A device described in any one of Examples 42 to 43, wherein the spherical tip includes an angled cam surface having an elliptical cross-sectional profile, and the free distal end of the cantilever spring (890) is configured to exert an elastic force on the angled cam surface to rotatably bias the distal tip (819) toward the closer of the first discrete position or the second discrete position. [Example]

[0135] 45. The device of example 44, wherein the cross-sectional profile of the bulbous tip has a major diameter along the width of the distal tip (819) and a minor diameter along the thickness of the distal tip. [Example]

[0136] 1. A device comprising: (a) a first jaw (1002); and (b) a second jaw (1004) configured to cooperate with the first jaw to clamp and staple tissue (90) with a plurality of staples (47), the second jaw including: (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 in response to actuation of the second jaw relative to the first jaw, thereby manipulating the orientation of the distal tip axis relative to the jaw body axis. [Example]

[0137] The device of Example 46, wherein the linkage arm (1016) is configured to position the distal tip (1008) so that the distal tip 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), and the linkage arm is configured to position the distal tip so that the distal tip axis is angled relative to the jaw body axis when the second jaw is in an open state relative to the first jaw. [Example]

[0138] An apparatus described in any one of Examples 46 to 47, wherein the linkage arm (1016) is configured to actuate the distal tip (1008) relative to the jaw body (1006) so that the distal tip axis defines a gradually decreasing angle (α) relative to the jaw body axis as the second jaw (1004) moves from a closed state toward an open state. [Example]

[0139] An apparatus described in any one of Examples 46 to 48, wherein the distal end of the linkage arm (1016) is pivotally connected to the distal tip (1008) and the proximal end of the linkage arm is operably connected to the first jaw (1002). [Example]

[0140] The device described in Example 49, wherein the distal end of the linkage arm (1016) is pivotally connected to the distal tip (1008) using a pin (1014), and the distal portion of the second jaw (1004) includes a slot (1022) configured to allow the pin to translate when the second jaw acts relative to the first jaw (1002). [Example]

[0141] 51. The device of Example 50, wherein the pin (1014) is translatable within the slot (1022) transversely to its longitudinal axis. [Example]

[0142] An apparatus as described in any one of Examples 49 to 51, further comprising a connector (1010) connecting the distal tip (1008) to the distal end of the jaw body (1006), the connector defining a slot (1022). [Example]

[0143] An apparatus described in any one of Examples 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). [Example]

[0144] An apparatus according to any one of Examples 46 to 53, wherein the jaw body (1006) comprises an elongated channel (1018) that slidably accommodates the linkage arm (1016). [Example]

[0145] An apparatus as described in any one of Examples 46 to 54, wherein the first jaw (1002) is configured to support a staple fastening assembly (37) operable to deploy staples (47), and the second jaw comprises an anvil jaw (1004) having a plurality of staple forming pockets (53) configured to form staples. [Example]

[0146] The device of any one of Examples 1 to 55, wherein the device is a surgical end effector, a surgical instrument, or a surgical stapling instrument.

[0147] The following clauses also relate to various non-exhaustive ways in which the teachings herein may be combined or applied. 1. An apparatus comprising: (a) a first jaw; (b) a second jaw configured to cooperate with the first jaw to clamp and staple tissue with a plurality of staples, the second jaw comprising: (i) a jaw body extending longitudinally along a jaw body axis; (ii) a distal tip movably disposed distal to the jaw body and extending longitudinally along a distal tip axis, the distal tip being pivotable about a 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 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; (iii) a first opening and a second opening, both defined by one of the structures located at the distal tip or proximal to the distal tip; (iv) a protrusion defined by the other of the distal tip or the structure; the protrusion is positionable within the first opening to releasably retain the distal tip in a first discrete position; The protrusion is positionable within the second opening to releasably retain the distal tip in a second discrete position, the device. 2. The device of claim 1, wherein when the distal tip is in a first discrete position, the distal tip axis is substantially parallel to the jaw body axis, and when the distal tip is in a second discrete position, the distal tip axis is angled relative to the jaw body axis. 3. The device of claim 1, wherein the distal tip is constrained to a predetermined range of angular motion having first and second endpoints defined by first and second discrete locations, respectively. 4. The device of claim 1, wherein the protrusion is defined by a distal tip. 5. The device of claim 4, wherein the second jaw further includes a resilient structure defining the first opening and the second opening, the resilient structure configured to resiliently deflect as the protrusion transitions between the first opening and the second opening. 6. The device of claim 5, wherein the resilient structure is longitudinally fixed relative to the jaw body and distal tip. 7. The apparatus of claim 5, wherein the first opening and the second opening are interconnected. 8. The device of claim 5, wherein the first opening and the second opening define respective longitudinal axes that are perpendicularly disposed and intersect to define a proximal opening angle. 9. The device of claim 5, wherein the resilient structure comprises an insert housed within a channel in the distal end of the jaw body. 10. The apparatus of claim 9, wherein the jaw body comprises a metal and the insert comprises a polymer. 11. The device of claim 1, wherein the first opening and the second opening are defined on a proximal end of the distal tip. 12. The device of claim 11, wherein the second jaw further includes a latch defining a protrusion and is actuatable by a user relative to the jaw body between a locked position in which the latch prevents movement of the distal tip relative to the jaw body and a released position in which the latch allows movement of the distal tip relative to the jaw body. 13. The device of claim 12, wherein the latch is biased toward the locked position. 14. The apparatus of claim 12, wherein the latch is translatable relative to the jaw body between a locked position and a released position. 15. The apparatus of claim 1, wherein the first jaw is configured to support a stapling assembly operable to deploy staples, and the second jaw comprises an anvil jaw having a plurality of staple-forming pockets configured to form staples. 16. An apparatus comprising: (a) a first jaw; (b) a second jaw configured to cooperate with the first jaw to clamp and staple tissue with a plurality of staples, the second jaw comprising: (i) a jaw body extending longitudinally along a jaw body axis; (ii) a distal tip movably disposed distal to the jaw body and extending longitudinally along a distal tip axis, the distal tip being rotatable 180° 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 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; (iii) a cantilever spring configured to exert a resilient force on a proximal end of the distal tip when the distal tip is positioned between the first and second discrete positions to rotatably bias the distal tip toward the closer of the first or second discrete positions. 37. The device of claim 36, wherein the second jaw includes an angled distal surface defined by a proximal end of the distal tip and an angled proximal surface located proximal to the angled distal surface, the first and second angled surfaces configured to engage with each other in a first mating configuration to define a first discrete position of the distal tip and to engage with each other in a second mating configuration to define a second discrete position of the distal tip. 38. The device of claim 36, wherein the cantilever spring includes a fixed proximal end and a free distal end, the fixed proximal end being fixed to the distal end of the jaw body and the free proximal end being configured to exert a resilient force on the proximal end of the distal tip. 39. An apparatus comprising: (a) a first jaw; (b) a second jaw configured to cooperate with the first jaw to clamp and staple tissue with a plurality of staples, the second jaw comprising: (i) a jaw body extending longitudinally along a jaw body axis; (ii) a distal tip movably disposed distally of the jaw body and extending longitudinally along a distal tip axis; (iii) a linkage arm operable to actuate the distal tip relative to the jaw body in response to actuation of the second jaw relative to the first jaw, thereby manipulating the orientation of the distal tip axis relative to the jaw body axis. 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 progressively decreasing angle with respect to the jaw body axis as the second jaw moves from the closed state toward the open state.

[0148] VII. Other It should be understood that any one or more of the teachings, expressions, embodiments, examples, etc. described herein can be combined with any one or more of the other teachings, expressions, embodiments, examples, etc. described herein. Thus, the above teachings, expressions, embodiments, examples, etc. should not be considered in isolation from one another. Various suitable ways in which the teachings herein can be combined will be readily apparent to those skilled in the art in light of the teachings herein. Such modifications and variations are intended to be within the scope of the claims.

[0149] Additionally, any one or more of the teachings herein may be incorporated into U.S. patent application Ser. No. 63 / 467,622, filed May 19, 2023, entitled "Surgical Stapler Cartridge Having Intermediate Raised Tissue Engagement Protrusions," U.S. patent application Ser. No. 63 / 467,623, filed May 19, 2023, entitled "Surgical Stapler Cartridge Having Tissue Engagement Protrusions with Enlarged Engagement Surface," U.S. patent application Ser. No. 63 / 467,648, filed May 19, 2023, entitled "Surgical Stapler Cartridge Having Raised Surface to Promote Buttress Adhesion," U.S. patent application Ser. No. 63 / 467,648, filed May 19, 2023, entitled "Surgical Stapler Cartridge Having Cartridge Retention," U.S. patent application Ser. No. 63 / 467,648, filed May 19, 2023, No. 63 / 467,469, filed May 19, 2023, entitled "Surgical Staple Anvil Having Staple Forming Pockets with Laterally Varying Orientations," U.S. Patent Application No. 63 / 459,739, filed May 19, 2023, entitled "Surgical Staple Anvil With Discretely Positionable Distal Tip," U.S. Patent Application No. 63 / 467,656, filed May 19, 2023, and / or U.S. Patent Application No. 63 / 467,615, filed May 19, 2023, entitled "Incompatible Staple Cartridge Use Prevention Features for Surgical Staple."

[0150] Additionally, any one or more of the teachings herein may be combined with any one or more of the teachings disclosed in U.S. Patent Application No. 63 / 459,739, entitled "Surgical Staple Anvil Having Staple Forming Pockets with Laterally Varying Orientations," filed April 17, 2023. The disclosure of each of these U.S. patent applications is incorporated herein by reference in its entirety.

[0151] Additionally, any one or more of the teachings herein may be combined with any one or more of the teachings disclosed in U.S. Patent No. 11,304,697, entitled "Surgical Stapler with Deflectable Distal Tip," issued April 19, 2022, the disclosure of which is incorporated herein by reference; U.S. Patent No. 11,317,912, entitled "Surgical Stapler with Rotatable Distal Tip," issued May 3, 2022, the disclosure of which is incorporated herein by reference; and / or U.S. Patent No. 11,439,391, entitled "Surgical Stapler with Toggling Distal Tip," issued September 13, 2022, the disclosure of which is incorporated herein by reference.

[0152] It should be understood that all or part of any patent, publication, or other disclosure referred to as being incorporated herein by reference is incorporated herein only to the extent that the incorporated material does not contradict existing definitions, opinions, or other disclosures set forth in this disclosure. As such, and to the extent necessary, the disclosure explicitly set forth herein shall prevail over any conflicting statements incorporated herein by reference. Any material, or portions thereof, that is referred to as being incorporated herein by reference but that contradicts current definitions, opinions, or other disclosures set forth herein shall be incorporated only to the extent that no conflict arises between the incorporated material and the current disclosures.

[0153] Variations of the above devices may be applied not only to traditional medical procedures and surgeries performed by medical professionals, but also to robotic-assisted medical procedures and surgeries. By way of example only, the various teachings herein may be readily incorporated into robotic surgical systems such as those offered by Auris Health, Inc., Redwood City, CA, or Intuitive Surgical, Inc., Sunnyvale, California.

[0154] Variations of the devices described above may be designed to be disposed of after a single use, or they may be designed to be used multiple times. Variations, in either or both cases, may be reconditioned for reuse after at least one use. Reconditioning may include any combination of the steps of disassembly of the device, followed by cleaning or replacement of particular parts, and subsequent reassembly. Specifically, some device variations may be disassembled and any number of particular portions or parts of the device may be selectively replaced or removed in any combination. Upon cleaning and / or replacement of particular parts, some device variations may be reassembled for subsequent use at a reconditioning facility or by a user immediately prior to a procedure. Those skilled in the art will appreciate that reconditioning of a device can utilize a variety of techniques for disassembly, cleaning / replacement, and reassembly. Use of such techniques, and the resulting reconditioned device, are all within the scope of the present application.

[0155] By way of example only, the variations described herein may be sterilized before and / or after treatment. In one sterilization technique, the device is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and device may then be placed in a radiation field that can penetrate the container, such as gamma radiation, X-rays, or a high-energy electron beam. The radiation may kill bacteria on the device and in the container. The sterilized device may then be stored in the 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.

[0156] While various embodiments of the present invention have been shown and described, further adaptations of the methods and systems described herein may be achieved by appropriate modifications by those skilled in the art without departing from the scope of the present invention. While some of such possible modifications have been mentioned, other modifications will be apparent to those skilled in the art. For example, the examples, embodiments, geometries, materials, dimensions, proportions, steps, etc. discussed above are illustrative and not required. Accordingly, it will be understood that the scope of the present invention should be considered in terms of the following claims, and is not limited to the details of structure and operation shown and described in this specification and drawings.

[0157] [Embodiment] (1) A device comprising: (a) the first jaw (16); (b) a second jaw (618, 718, 900) configured to cooperate with the first jaw to clamp and staple tissue (90) with a plurality of staples (47), the second jaw comprising: (i) a jaw body (620, 720, 902) extending longitudinally along a jaw body axis; (ii) a distal tip (619, 719, 906) movably disposed distal to the jaw body and extending longitudinally along a distal tip axis, the distal tip pivotable about a pivot axis extending transversely to the jaw body axis between a first discrete position and a second discrete position, wherein at the first discrete position, the distal tip axis has a first orientation relative to the jaw body axis, and at the second discrete position, the distal tip axis has a second orientation relative to the jaw body axis; (iii) a first opening and a second opening (663, 784, 785, 932, 934) both defined by one of the structures (621, 920) located at or proximal to the distal tip; (iv) a protrusion (637, 781, 918) defined by the other of the distal tip or the structure; the protrusion is positionable within the first opening (663, 785, 932) to releasably retain the distal tip in the first discrete position; The device, wherein the protrusion is positionable within the second opening (663, 784, 934) to releasably retain the distal tip in the second discrete position. (2) The device of embodiment 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 when the distal tip is in the second discrete position, the distal tip axis is angled relative to the jaw body axis. (3) A device described in any of embodiments 1 to 2, 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) A device according to any one of embodiments 1 to 3, wherein the protrusion (637, 918) is defined by the distal tip (619, 906). (5) The device of embodiment 4, wherein the second jaw (618, 900) further includes an elastic structure (621, 970) defining the first opening and the second opening (663, 932, 934), and the elastic structure is configured to elastically deflect when the protrusion (637, 918) transitions between the first opening and the second opening.

[0158] (6) The device of claim 5, wherein the elastic structure (621,970) is longitudinally fixed relative to the jaw body (620,902) and the distal tip (619,906). (7) An apparatus according to any one of embodiments 1 to 6, wherein the first opening and the second opening (663, 932, 934) are interconnected. (8) A device described in any one of embodiments 1 to 7, wherein the first opening and the second opening (663, 932, 934) define respective longitudinal axes that are arranged perpendicularly and intersect to define a proximal opening angle. (9) The device according to any one of embodiments 5 to 8, wherein the elastic structure (970) comprises an insert housed within a channel (922) at the distal end of the jaw body (902). (10) The apparatus of embodiment 9, wherein the jaw body (902) comprises a metal and the insert (970) comprises a polymer.

[0159] (11) A device described in any one of embodiments 1 to 3, wherein the first opening and the second opening (784, 785) are defined on the proximal end of the distal tip (719). (12) The device of embodiment 11, wherein the second jaw (718) further includes a latch (768) defining the protrusion (781), and the latch is actuatable relative to the jaw body (720) by a user between a locked position in which the latch prevents movement of the distal tip relative to the jaw body and a released position in which the latch allows movement of the distal tip relative to the jaw body. (13) The device of claim 12, wherein the latch (768) is biased toward the locked position. (14) The device according to any one of embodiments 12 to 13, wherein the latch (768) is translatable relative to the jaw body (720) between the locked position and the released position. (15) An apparatus according to any one of embodiments 1 to 14, wherein the first jaw (16) is configured to support a staple fastening assembly (37) operable to deploy staples (47), and the second jaw (618, 718, 900) comprises an anvil jaw having a plurality of staple forming pockets (53) configured to form the staples.

[0160] (16) An apparatus comprising: (a) the first jaw (16); (b) a second jaw (618, 900) configured to cooperate with the first jaw to clamp and staple tissue (90) with a plurality of staples (47), the second jaw comprising: (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, the distal tip including a detent protrusion (637, 918) and pivotable about a 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 has a first orientation relative to the jaw body axis and wherein in the second discrete position, the distal tip axis has a second orientation relative to the jaw body axis; (iii) a resilient structure (621, 970) secured to the jaw body proximal to the distal tip, the resilient structure including a detent cavity (663, 930) having a first cavity portion and a second cavity portion (663, 932, 934) configured to receive the detent protrusion of the distal tip; the detent protrusion is positionable within the first hollow portion (663, 932) to releasably retain the distal tip in the first discrete position; the detent protrusion is positionable within the second cavity portion to releasably retain the distal tip in the second discrete position; The resilient structure is configured to resiliently deflect when the detent protrusion moves between the first cavity portion and the second cavity portion. (17) The device of embodiment 16, wherein the elastic structure (621,970) is longitudinally fixed relative to the jaw body (620,902) and the distal tip (619,906). (18) A device described in any of embodiments 16 to 17, wherein the elastic structure (621, 970) is configured to bias the detent protrusion (637, 918) toward the closer of the first hollow portion (663, 932) or the second hollow portion (934), thereby biasing the distal tip (619, 906) toward the closer of the first discrete position or the second discrete position. (19) The device according to any one of embodiments 16 to 18, wherein the first cavity portion and the second cavity portion (663, 932, 934) are vertically arranged such that the first cavity portion comprises a lower cavity portion (663, 932) and the second cavity portion comprises an upper cavity portion (663, 934). (20) A device described in any 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) that are interconnected and extend along respective longitudinal axes that define a proximal opening angle.

[0161] (21) The device according to any one of embodiments 16 to 20, wherein the elastic structure comprises an insert (970) housed within a channel (922) at the distal end of the jaw body (902). (22) The apparatus of embodiment 21, wherein the jaw body (902) comprises a metal and the insert (970) comprises a polymer. (23) The device of any one of embodiments 21-22, wherein the insert (970) includes a pair of insert side walls (928) laterally opposed to each other, each insert side wall spaced inward from a respective inner surface of the jaw body (902), such that the insert side walls are configured to resiliently flex laterally outward into the channel (922) when the detent protrusion (918) transitions between the first cavity portion (932) and the second cavity portion (934). (24) A device according to any one of embodiments 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 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) A device described in any 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.

[0162] (26) An apparatus comprising: (a) the first jaw (16); (b) a second jaw (718) configured to cooperate with the first jaw to clamp and staple tissue (90) with a plurality of staples (47), the second jaw comprising: (i) a jaw body (720) extending longitudinally along a jaw body axis; (ii) a latch (768) movably coupled to the jaw body; (iii) a distal tip (719) movably disposed distally of the jaw body and the latch and extending longitudinally along a distal tip axis, the distal tip being 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 has a first orientation relative to the jaw body axis, and wherein in the second discrete position, the distal tip axis has a second orientation relative to the jaw body axis; the latch is actuatable by a user relative to the jaw body between a locked position and a released position, the latch in the locked position configured to releasably lock the distal tip in one of the first discrete position or the second discrete position, and the latch in the released position configured to allow the distal tip 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) A device described in any of embodiments 26 to 27, wherein the latch (768) is located distally in the locked position and proximally in the released position, and the latch is biased toward the locked position. (29) The device according to any one of embodiments 26 to 28, wherein the second jaw (718) further includes a protrusion (781) defined by one of the latch (768) or the distal tip (719), and a first opening (785) and a second opening (784, 785) defined by the other of the latch or the distal tip, wherein the first opening (785) is configured to receive the protrusion when the distal tip is in the first individual position and the latch is in the locked position, and the second opening (784) is configured to receive the protrusion when the distal tip is in the second individual position and the latch is in the locked position. (30) The device of embodiment 29, wherein the protrusion (781) is longitudinally insertable into one of the first opening (785) or the second opening (784) when the latch transitions from the released position to the locked position.

[0163] (31) A device described in any of embodiments 29 to 30, wherein the latch (768) includes the protrusion (781) and the distal tip (719) includes the first opening and the second opening (785, 784). (32) The device described in any one of embodiments 29 to 31, wherein the protrusion comprises a pin (781), and the first opening and the second opening comprise first and second bores (785, 784), respectively, configured to slidably receive the pin. (33) The device described in any of embodiments 29 to 32, wherein the protrusion (781) comprises a first protrusion (781), and the second jaw (718) further comprises a second protrusion (781), a third opening (785) configured to receive the second protrusion when the distal tip is in the first individual position, and a fourth opening (784) configured to receive the second protrusion when the distal tip is in the second individual position. (34) A device as described in any of embodiments 26 to 33, further comprising a connector (721) fixed to the distal end of the jaw body (720), the distal tip (719) being pivotally connected to the distal end of the connector, and the latch (768) being operable within a slot (724) defined between the jaw body and the connector. (35) A device described in any 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.

[0164] (36) An apparatus comprising: (a) the first jaw (16); (b) a second jaw (818) configured to cooperate with the first jaw to clamp and staple tissue (90) with a plurality of staples (47), the second jaw comprising: (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, the distal tip being rotatable 180° 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 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; (iii) a cantilever spring (890) configured to exert a resilient force on a proximal end of the distal tip when the distal tip is positioned between the first and second discrete positions to rotatably bias the distal tip toward the closer of the first or second discrete positions. (37) The device of embodiment 36, wherein the second jaw (818) includes an angled distal surface (834) defined by a proximal end of the distal tip (819) and an angled proximal surface (832) located proximal to the angled distal surface, the first angled surface and the second angled surface 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 device of embodiment 37, wherein the angled distal surface (834) and the angled proximal surface (832) each define an oblique angle relative to the jaw body axis. (39) A device described in any of embodiments 36 to 38, wherein the cantilever spring (890) includes a fixed proximal end and a free distal end, the fixed proximal end being fixed to the distal end of the jaw body (820), and the free proximal end being configured to exert the elastic force on the proximal end of the distal tip (819). (40) A device described in any of embodiments 36 to 39, wherein the cantilever spring comprises a plate (890) that cooperates with an opposing portion of the second jaw (818) to define a cavity therebetween, and the proximal end (837) of the distal tip (819) is rotatable within the cavity.

[0165] (41) A device described in any one of embodiments 36 to 40, wherein the proximal end of the distal tip comprises a shaft (837). (42) The device of embodiment 41, wherein the shaft (837) includes a bulbous tip configured to longitudinally constrain the distal tip (819) relative to the jaw body (820). (43) The device of embodiment 42, wherein the spherical tip is rotatable within a cavity in the second jaw (818) proximal to the distal tip (819). (44) A device described in any of embodiments 42 to 43, wherein the spherical tip includes an angled cam surface having an elliptical cross-sectional profile, and the free distal end of the cantilever spring (890) is configured to exert the elastic force on the angled cam surface and rotatably bias the distal tip (819) toward the closer of the first discrete position or the second discrete position. (45) The device of embodiment 44, wherein the cross-sectional profile of the bulbous tip has a major diameter along the width of the distal tip (819) and a minor diameter along the thickness of the distal tip.

[0166] (46) An apparatus comprising: (a) The first Joe (1002) and (b) a second jaw (1004) configured to cooperate with the first jaw to clamp and staple tissue (90) with a plurality of staples (47), the second jaw comprising: (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; (iii) a linkage arm (1016) operable to actuate the distal tip relative to the jaw body in response to actuation of the second jaw relative to the first jaw, thereby manipulating the orientation of the distal tip axis relative to the jaw body axis. (47) The device of embodiment 46, wherein the linkage arm (1016) is configured to position the distal tip (1008) so that the distal tip 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), and the linkage arm is configured to position the distal tip so that the distal tip axis is angled relative to the jaw body axis when the second jaw is in an open state relative to the first jaw. (48) An apparatus according to any one of embodiments 46 to 47, wherein the linkage arm (1016) is configured to actuate the distal tip (1008) relative to the jaw body (1006) such that the distal tip axis defines a gradually decreasing angle (α) with respect to the jaw body axis as the second jaw (1004) moves from the closed state toward the open state. (49) A device described in any of embodiments 46 to 48, wherein the distal end of the linkage arm (1016) is pivotally connected to the distal tip (1008) and the proximal end of the linkage arm is operably connected to the first jaw (1002). (50) An apparatus as described in any of embodiments 46 to 49, wherein the distal end of the linkage arm (1016) is pivotally connected to the distal tip (1008) using a pin (1014), and the distal portion of the second jaw (1004) includes a slot (1022) configured to allow the pin to translate when the second jaw is actuated relative to the first jaw (1002).

[0167] (51) The device of embodiment 50, wherein the pin (1014) is translatable within the slot (1022) transversely to its longitudinal axis. (52) A device described in any of embodiments 50 to 51, further comprising a connector (1010) connecting the distal tip (1008) to the distal end of the jaw body (1006), the connector defining the slot (1022). (53) An apparatus described in any one of embodiments 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) The device according to any one of embodiments 46 to 53, wherein the jaw body (1006) includes an elongated channel (1018) that slidably accommodates the linkage arm (1016). (55) An apparatus according to any of embodiments 46 to 54, wherein the first jaw (1002) is configured to support a staple fastening assembly (37) operable to deploy staples (47), and the second jaw comprises an anvil jaw (1004) having a plurality of staple forming pockets (53) configured to form the staples.

Claims

1. 1. An apparatus comprising: (a) a first jaw (16); (b) a second jaw (618, 718, 900) configured to cooperate with said first jaw to clamp and staple tissue (90) with a plurality of staples (47), said second jaw comprising: (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, the distal tip pivotable about a pivot axis extending transversely to the jaw body axis between a first discrete position and a second discrete position, wherein at the first discrete position, the distal tip axis has a first orientation relative to the jaw body axis, and at the second discrete position, the distal tip axis has a second orientation relative to the jaw body axis; (iii) a first opening and a second opening (663, 784, 785, 932, 934) both defined by one of the distal tip or a structure (621, 920) located proximal to the distal tip; (iv) a protrusion (637, 781, 918) defined by the other of the distal tip or the structure; the protrusion is positionable within the first opening (663, 785, 932) to releasably retain the distal tip in the first discrete position; The protrusion is positionable within the second opening (663, 784, 934) to releasably retain the distal tip in the second discrete position.

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

3. 3. The device of claim 1, 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 of claim 1 , wherein the protrusion (637, 918) is defined by the distal tip (619, 906).

5. 5. The apparatus of claim 4, wherein the second jaw further includes a resilient structure that defines the first opening and the second opening, the resilient structure configured to resiliently deflect as the protrusion transitions between the first opening and the second opening.

6. 6. The device of 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 apparatus of claim 1 , wherein the first opening and the second opening (663, 932, 934) are interconnected.

8. 2. The device of claim 1, wherein the first opening and the second opening define respective longitudinal axes that are perpendicularly disposed and intersect to define a proximal opening angle.

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

10. The apparatus of claim 9, wherein the jaw body (902) comprises a metal and the insert (970) comprises a polymer.

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

12. 12. The device of claim 11, wherein the second jaw (718) further includes a latch (768) defining the protrusion (781), and wherein the second jaw (718) is actuatable relative to the jaw body (720) by a user between a locked position in which the latch prevents movement of the distal tip relative to the jaw body and a released position in which the latch allows movement of the distal tip relative to the jaw body.

13. 13. The apparatus of claim 12, wherein the latch (768) is biased toward the locked position.

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

15. 2. The device of claim 1, wherein the first jaw (16) is configured to support a staple fastening assembly (37) operable to deploy staples (47), and the second jaw (618, 718, 900) comprises an anvil jaw having a plurality of staple forming pockets (53) configured to form the staples.

16. 1. An apparatus comprising: (a) a first jaw (16); (b) a second jaw (618, 900) configured to cooperate with said first jaw to clamp and staple tissue (90) with a plurality of staples (47), said second jaw comprising: (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, the distal tip including a detent protrusion (637, 918) and pivotable about a 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 assumes a first orientation relative to the jaw body axis and wherein in the second discrete position the distal tip axis assumes a second orientation relative to the jaw body axis; (iii) a resilient structure (621, 970) secured to the jaw body proximal to the distal tip, the resilient structure including a detent cavity (663, 930) having first and second cavity portions (663, 932, 934) configured to receive the detent protrusion of the distal tip; the detent protrusion is positionable within the first hollow portion (663, 932) to releasably retain the distal tip in the first discrete position; the detent protrusion is positionable within the second cavity portion to releasably retain the distal tip in the second discrete position; The resilient structure is configured to resiliently deflect when the detent projection moves between the first cavity portion and the second cavity portion.

17. 17. The device of 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. 18. The device of claim 16, wherein the elastic structure (621, 970) is configured to bias the detent protrusion (637, 918) toward the closer of the first hollow portion (663, 932) or the second hollow portion (934), thereby biasing the distal tip (619, 906) toward the closer of the first discrete position or the second discrete position.

19. 17. The apparatus of claim 16, wherein the first cavity portion and the second cavity portion (663, 932, 934) are vertically arranged such that the first cavity portion comprises a lower cavity portion (663, 932) and the second cavity portion comprises an upper cavity portion (663, 934).

20. 17. The device of claim 16, wherein the first cavity portion and the second cavity portion are defined by respective first and second openings (663, 932, 934) that are interconnected and extend along respective longitudinal axes that define a proximal opening angle.

21. 17. The apparatus of claim 16, wherein the resilient structure comprises an insert (970) housed within a channel (922) in the distal end of the jaw body (902).

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

23. 23. The apparatus of claim 21, wherein the insert (970) comprises a pair of laterally opposed insert sidewalls (928), each spaced inwardly from a respective inner surface of the jaw body (902), such that the insert sidewalls are configured to resiliently flex laterally outwardly into the channel (922) when the detent protrusion (918) transitions between the first cavity portion (932) and the second cavity portion (934).

24. 17. The device of claim 16, 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 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. 17. The device of claim 16, 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 locations, respectively.

26. 1. An apparatus comprising: (a) a first jaw (16); (b) a second jaw (718) configured to cooperate with said first jaw to clamp and staple tissue (90) with a plurality of staples (47), said second jaw comprising: (i) a jaw body (720) extending longitudinally along a jaw body axis; (ii) a latch (768) movably coupled to said jaw body; (iii) a distal tip (719) movably disposed distally of the jaw body and the latch and extending longitudinally along a distal tip axis, the distal tip being 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 has a first orientation relative to the jaw body axis, and wherein in the second discrete position, the distal tip axis has a second orientation relative to the jaw body axis; the latch is actuatable by a user relative to the jaw body between a locked position and a released position, the latch in the locked position configured to releasably lock the distal tip in one of the first discrete position or the second discrete position, and the latch in the released position configured to allow the distal tip to transition between the first discrete position and the second discrete position.

27. 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. 28. The device of any one of claims 26-27, wherein the latch (768) is located distally in the locked position and proximally in the released position, the latch being biased towards the locked position.

29. 27. The device of claim 26, wherein the second jaw (718) further includes a protrusion (781) defined by one of the latch (768) or the distal tip (719) and first and second openings (784, 785) defined by the other of the latch or the distal tip, the first opening (785) configured to receive the protrusion when the distal tip is in the first discrete position and the latch is in the locked position, and the second opening (784) configured to receive the protrusion when the distal tip is in the second discrete position and the latch is in the locked position.

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

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

32. 30. The apparatus of claim 29, wherein the protrusion comprises a pin (781), and the first opening and the second opening comprise first and second bores (785, 784), respectively, configured to slidably receive the pin.

33. 30. The device of claim 29, wherein the protrusion (781) comprises a first protrusion (781), and the second jaw (718) further comprises a second protrusion (781), a third opening (785) configured to receive the second protrusion when the distal tip is in the first discrete position, and a fourth opening (784) configured to receive the second protrusion when the distal tip is in the second discrete position.

34. 27. The device of claim 26, further comprising a connector (721) secured to a distal end of the jaw body (720), the distal tip (719) pivotally coupled to the distal end of the connector, and the latch (768) actuable within a slot (724) defined between the jaw body and the connector.

35. 27. The device of claim 26, 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 locations, respectively.

36. 1. An apparatus comprising: (a) a first jaw (16); (b) a second jaw (818) configured to cooperate with said first jaw to clamp and staple tissue (90) with a plurality of staples (47), said second jaw comprising: (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, the distal tip being rotatable 180° 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 has a first orientation relative to the jaw body axis, and wherein in the second discrete position, the distal tip axis has a second orientation relative to the jaw body axis; (iii) a cantilever spring (890) configured to exert a resilient force on a proximal end of the distal tip when the distal tip is positioned between the first and second discrete positions to rotatably bias the distal tip toward the closer of the first or second discrete positions.

37. 37. The device of claim 36, wherein the second jaw (818) includes an angled distal surface (834) defined by a proximal end of the distal tip (819) and an angled proximal surface (832) located proximal to the angled distal surface, the first angled surface and the second angled surface 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. 38. The apparatus of claim 37, wherein the angled distal surface (834) and the angled proximal surface (832) each define an oblique angle relative to the jaw body axis.

39. 39. The device of any one of claims 36 to 38, wherein the cantilever spring (890) includes a fixed proximal end and a free distal end, the fixed proximal end being fixed to a distal end of the jaw body (820), and the free proximal end being configured to exert the elastic force on the proximal end of the distal tip (819).

40. 37. The device of claim 36, wherein the cantilever spring comprises a plate (890) that cooperates with an opposing portion of the second jaw (818) to define a cavity therebetween, and wherein a proximal end (837) of the distal tip (819) is rotatable within the cavity.

41. 37. The device of claim 36, wherein the proximal end of the distal tip comprises a shaft (837).

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

43. 43. The device of claim 42, wherein the spherical tip is rotatable within a cavity in the second jaw (818) proximal to the distal tip (819).

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

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

46. 1. An apparatus comprising: (a) a first jaw (1002); (b) a second jaw (1004) configured to cooperate with said first jaw to clamp and staple tissue (90) with a plurality of staples (47), said second jaw comprising: (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; (iii) a linkage arm (1016) operable to actuate the distal tip relative to the jaw body in response to actuation of the second jaw relative to the first jaw, thereby manipulating the orientation of the distal tip axis relative to the jaw body axis.

47. 47. The device of claim 46, wherein the linkage arm (1016) is configured to position the distal tip (1008) so that the distal tip 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), and the linkage arm is configured to position the distal tip so that the distal tip axis is angled relative to the jaw body axis when the second jaw is in an open state relative to the first jaw.

48. 48. The apparatus of claim 46, wherein the linkage arm is configured to actuate the distal tip relative to the jaw body such that the distal tip axis defines a progressively decreasing angle with respect to the jaw body axis as the second jaw moves from the closed state toward the open state.

49. 47. The device of claim 46, wherein a distal end of the linkage arm (1016) is pivotally connected to the distal tip (1008) and a proximal end of the linkage arm is operably connected to the first jaw (1002).

50. 47. The device of claim 46, wherein the distal end of the linkage arm (1016) is pivotally connected to the distal tip (1008) using a pin (1014), and the distal portion of the second jaw (1004) includes a slot (1022) configured to allow the pin to translate when the second jaw is actuated relative to the first jaw (1002).

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

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

53. 47. The apparatus of claim 46, further comprising a pivot connection (1020) connecting a proximal end of the linkage arm (1016) to a proximal end of the first jaw (1002).

54. 47. The apparatus of claim 46, wherein the jaw body (1006) includes an elongated channel (1018) that slidably receives the linkage arm (1016).

55. 47. The apparatus of claim 46, wherein the first jaw (1002) is configured to support a staple fastening assembly (37) operable to deploy staples (47), and the second jaw comprises an anvil jaw (1004) having a plurality of staple forming pockets (53) configured to form the staples.

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