An articulatable surgical instrument having a joint with a flexible exoskeleton device

Abstract

A surgical instrument having an articulation joint and an axially movable firing member, wherein a constant speed drive shaft assembly spans the articulation joint and is configured to impart rotational drive motion to a flexible drive member associated with the firing member, the articulation joint comprising a movable exoskeleton comprising a series of movably associated annular rib members forming a passage therethrough for receiving the constant speed drive shaft assembly.

Description

Technical Field

[0001] (Cross - Reference to Related Applications) This non - provisional application claims the benefit of U.S. Provisional Application No. 63 / 057,430, filed on July 28, 2020, entitled "SURGICAL INSTRUMENTS WITH TORSION SPINE DRIVE ARRANGEMENTS" and U.S. Provisional Application No. 63 / 057,432, filed on July 28, 2020, entitled "ARTICULATION JOINT ARRANGEMENTS FOR SURGICAL INSTRUMENTS" under 35 U.S.C. § 119(e), and the disclosures of these provisional applications are hereby incorporated by reference in their entirety into this specification.

Background Art

[0002] The present invention relates to surgical instruments and, in various devices, to surgical stapling and cutting instruments designed to staple and cut tissue, and to staple cartridges for use therewith. Surgical instruments can be configured for use in open surgical procedures but have applications in other types of surgery such as laparoscopic, endoscopic, and robot - assisted procedures, and can include an end - effector that is articulable relative to the shaft portion of the instrument to facilitate accurate positioning within a patient.

Brief Description of the Drawings

[0003] The novel features of the various aspects are specifically set forth in the appended "Claims". However, the described forms, in regard to both structure and method of operation, may best be understood by reference to the following description taken in conjunction with the accompanying drawings.

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DETAILED DESCRIPTION OF THE INVENTION

[0004] The applicant of the present application owns the following US patent applications filed on the same day as the present application, each of which is hereby incorporated by reference in its entirety. - US Patent Application, titled "SURGICAL INSTRUMENTS WITH TORSION SPINE DRIVE ARRANGEMENTS", Attorney Docket No. END9248USNP1 / 200084-1, - US Patent Application, titled "SURGICAL INSTRUMENTS WITH FIRING MEMBER CLOSURE FEATURES", Attorney Docket No. END9248USNP2 / 200084-2, - US Patent Application, titled "SURGICAL INSTRUMENTS WITH SEGMENTED FLEXIBLE DRIVE ARRANGEMENTS", Attorney Docket No. END9248USNP3 / 200084-3, - US Patent Application, titled "SURGICAL INSTRUMENTS WITH FLEXIBLE BALL CHAIN DRIVE ARRANGEMENTS", Attorney Docket No. END9248USNP4 / 200084-4, - US Patent Application, titled "SURGICAL INSTRUMENTS WITH DOUBLE SPHERICAL ARTICULATION JOINTS WITH PIVOTABLE LINKS", Attorney Docket No. END9248USNP5 / 200084-5, - U.S. Patent Application, Invention Title "SURGICAL INSTRUMENTS WITH DOUBLE PIVOT ARTICULATION JOINT ARRANGEMENTS", Attorney Docket No. END9248USNP6 / 200084-6, - U.S. Patent Application, Invention Title "SURGICAL INSTRUMENTS WITH COMBINATION FUNCTION ARTICULATION JOINT ARRANGEMENTS", Attorney Docket No. END9248USNP7 / 200084-7, - U.S. Patent Application, Invention Title "METHOD OF OPERATING A SURGICAL INSTRUMENT", Attorney Docket No. END9248USNP8 / 200084-8M, - U.S. Patent Application, Invention Title "SURGICAL INSTRUMENTS WITH DUAL SPHERICAL ARTICULATION JOINT ARRANGEMENTS", Attorney Docket No. END9248USNP9 / 200084-9, - U.S. Patent Application, Invention Title "SURGICAL INSTRUMENTS WITH FLEXIBLE FIRING MEMBER ACTUATOR CONSTRAINT ARRANGEMENTS", Attorney Docket No. END9248USNP10 / 200084-10, and - U.S. Patent Application, Invention Title "SURGICAL INSTRUMENTS WITH DIFFERENTIAL ARTICULATION JOINT ARRANGEMENTS FOR ACCOMMODATING FLEXIBLE ACTUATORS", Attorney Docket No. END9248USNP12 / 200084-12.

[0005] Numerous specific details are set forth in order to provide a thorough understanding of the overall structure, function, manufacture, and use of the embodiments, as described in this specification and illustrated in the accompanying drawings. Well-known operations, components, and elements are not described in detail so as not to obscure the embodiments described in this specification. The reader will understand that the embodiments described and illustrated in this specification are non-limiting examples, and thus the specific structural and functional details disclosed in this specification may be representative and exemplary. Modifications and changes can be made thereto without departing from the scope of the "claims".

[0006] The terms "comprise", "have", "include", and "contain" (and any word forms of comprise such as "comprises" and "comprising", any word forms of have such as "has" and "having", any word forms of include such as "includes" and "including", and any word forms of contain such as "contains" and "containing") are open-ended conjunctive verbs. As a result, a surgical system, device, or instrument that "comprises", "has", "includes", or "contains" one or more elements has those one or more elements but is not limited to having only those one or more elements. Similarly, an element of a system, device, or instrument that "comprises", "has", "includes", or "contains" one or more features has those one or more features but is not limited to having only those one or more features.

[0007] The terms "proximal" and "distal" are used herein with reference to a clinician who operates the handle portion of a surgical instrument. The term "proximal" refers to the portion closest to the clinician, and the term "distal" refers to the portion located farther from the clinician. For convenience and clarity, it will be further understood that spatial terms such as "vertical", "horizontal", "up", and "down" may be used herein with respect to the drawings. However, surgical instruments are used in many orientations and positions, and these terms are not intended to be limiting and / or absolute.

[0008] References to items in the singular are to be understood to include items in the plural unless explicitly stated otherwise or otherwise apparent from the context, and vice versa. Grammatical conjunctions are intended to represent any and all disjunctive and conjunctive combinations of the joined clauses, sentences, words, etc., unless otherwise described or otherwise apparent from the context. Thus, the term "or" should generally be understood to mean "and / or" and the like.

[0009] Descriptions of ranges of values in the present invention are intended, unless otherwise stated herein, to refer individually to any and all values included within the range rather than to limit them, and each separate value within such a range is incorporated into the specification as if it were individually recited herein. Words such as "about" and "approximately", when associated with a numerical value, should be construed to indicate a deviation as would be understood by one of ordinary skill in the art to operate satisfactorily for the intended purpose. Similarly, approximate words such as "substantially" or "essentially", when used with respect to physical characteristics, should be construed to contemplate a range of deviations recognized by one of ordinary skill in the art to operate satisfactorily for the corresponding use, function, purpose, etc.

[0010] Any and all examples provided herein, i.e., the use of exemplary language (such as "for example", "such as", or the like), are merely intended to better illustrate each embodiment and do not impose a limitation on the scope of the embodiments. No language in the specification should be construed as indicating that any non-claimed element is essential to the practice of the embodiments.

[0011] Various exemplary devices and methods are provided for performing laparoscopic and minimally invasive surgical procedures. However, it will be readily understood by the reader that the various methods and devices disclosed herein can be used in many surgical procedures and applications, including, for example, those related to open surgical procedures. By reading the "DETAILED DESCRIPTION" of the present specification, the reader will further understand that the various instruments disclosed herein can be inserted into the body in any manner, such as through a pre-existing opening or through an incision or puncture formed in the tissue. The working portion, i.e., the end effector portion, of these instruments can be inserted directly into the patient's body or through an access device having a working passage through which the end effector and elongate shaft of the surgical instrument can be advanced.

[0012] During various laparoscopic surgical procedures, it is a common technique to insert the surgical end effector portion of a surgical instrument through a trocar placed in the patient's abdominal wall to access the surgical site located within the patient's abdomen. In its simplest form, a trocar is a pen-shaped instrument having a sharp triangular tip on one side and is typically used within a hollow tube known as a cannula or sleeve, creating an opening in the body through which the surgical end effector can be introduced. Such a device forms an access port within the body cavity through which the surgical end effector can be inserted. The inner diameter of the cannula of the trocar necessarily limits the size of the end effector and drive support shaft of the surgical instrument that can be inserted through the trocar.

[0013] Regardless of the specific type of surgical procedure being performed, when a surgical end effector is inserted into a patient through a trocar cannula, it is often necessary to move the surgical end effector relative to a shaft assembly positioned within the trocar cannula in order to properly position the surgical end effector with respect to the tissue or organ being treated. Movement or positioning of the surgical end effector relative to the portion of the shaft that remains within the trocar cannula is often referred to as "articulation" of the surgical end effector. To facilitate such articulation of the surgical end effector, various articulation joints have been developed for attaching the surgical end effector to an associated shaft. As is anticipated in many surgical procedures, it is desirable to use a surgical end effector having the largest possible range of articulation.

[0014] Due to the size constraints imposed by the size of the trocar cannula, the components of the articulation joint must be sized to be freely insertable through the trocar cannula. These size constraints also limit the size and configuration of the various drive members and components that are operably coupled to a motor and / or other control system supported within a housing, which may be hand-held or part of a larger automated system. In many cases, these drive members must operably pass through the articulation joint so as to be operably coupled to or in operable association with the surgical end effector. For example, one such drive member is commonly used to apply an articulation control motion to the surgical end effector. In use, the articulation drive member is deactivated to position the surgical end effector in a non-articulated position to facilitate insertion of the surgical end effector through the trocar, and can then be activated to articulate the surgical end effector to a desired position when the surgical end effector is within the patient.

[0015] Accordingly, the aforementioned size constraints are many challenges in the development of joint movement systems that achieve the desired range of joint movement and, furthermore, can accommodate the various different drive systems necessary to operate the various features of the surgical end effector. Further, when the surgical end effector is positioned at the desired joint movement position, the joint movement system and the joint must be able to hold the surgical end effector in that position during the operation of the end effector and the performance of the surgical procedure. Such a joint device must also be able to withstand the external forces that the end effector experiences during use.

[0016] There are various surgical end effectors configured to cut and staple tissue. Such surgical end effectors generally include a first jaw feature that supports a surgical staple cartridge and a second jaw that includes an anvil. The jaws are supported relative to each other so that they can move between an open position and a closed position to position and clamp target tissue therebetween. Many of these surgical end effectors employ a firing member that moves axially. In some end effector designs, the firing member is configured to engage the first and second jaws such that when the firing member is first advanced distally, the firing member moves the jaws to the closed position. Other end effector designs employ a separate closing system independent of the system that operates the firing member.

[0017] The staple cartridge comprises a cartridge body. The cartridge body includes a proximal end, a distal end, and a deck extending between the proximal end and the distal end. In use, the staple cartridge is positioned on a first side of the tissue to be stapled, and the anvil is positioned on a second side of the tissue. The anvil is moved toward the staple cartridge to press and clamp the tissue against the deck. Subsequently, staples removably stored within the cartridge body can be deployed into the tissue. The cartridge body includes a defined staple cavity therein, and the staples are removably stored within the staple cavity. The staple cavities are arranged in six longitudinal columns. Three columns of staple cavities are positioned on a first side of the longitudinal slot, and three columns of staple cavities are positioned on a second side of the longitudinal slot. Other devices for the staple cavities and staples are possible.

[0018] The staples are supported by a staple driver within the cartridge body. The driver is movable between a first, i.e., un-fired position and a second, i.e., fired position, for ejecting the staples from the staple cavity. The driver is held within the cartridge body by a retainer extending about a lower periphery of the cartridge body and includes an elastic member configured to grip the cartridge body and hold the retainer against the cartridge body. The driver is movable between their un-fired position and their fired position by a thread. The thread is movable between a proximal position adjacent the proximal end and a distal position adjacent the distal end. The thread includes a plurality of inclined surfaces configured to slide under the driver and lift the driver, upon which the staples are supported, toward the anvil.

[0019] In addition to the above, in these surgical end effectors, the thread is moved distally by a firing member. The firing member is configured to contact the thread and push the thread toward the distal end. The longitudinal slot defined within the cartridge body is configured to receive the firing member. The anvil also includes a slot configured to receive the firing member. The firing member further includes a first cam that engages a first jaw and a second cam that engages a second jaw. When advancing the firing member distally, the first cam and the second cam can control the distance between the deck of the staple cartridge and the anvil, i.e., the tissue gap. The firing member also includes a knife configured to excise tissue captured between the staple cartridge and the anvil. It is desirable for the knife to be positioned at least partially proximally relative to the inclined surface such that the staples are ejected in front of the knife.

[0020] Many surgical end effectors use an axially movable firing beam that is attached to a firing member and used to apply axial firing and retraction motion to the firing member. Many such firing beams have a laminated structure that provides some degree of flexure about the joint. When the firing beam crosses the joint, the firing beam can apply a joint-release force to the joint and can buckle the beam. To prevent the firing beam from buckling under pressure, the joint generally includes a lateral support or "blowout" plate feature for supporting the portion of the beam that crosses the joint. For example, to advance the firing beam over an angle greater than 60 degrees, a significant amount of axial force is required. This axial force must be applied to the firing member in a balanced manner to avoid the firing member engaging the jaw when the firing member moves distally. Any engagement of the firing member with the jaw can not only result in component damage and wear, but may also require an increased amount of axial driving force to drive the firing member through the clamped tissue.

[0021] In other end effector designs, a rotary powered firing member is employed. In many such designs, the rotary drive shaft extends through a joint and engages a rotatable firing member drive shaft that is rotatably supported within one of the jaws. The firing member is threadably engaged with the rotatable firing member drive shaft, and when the rotatable firing member drive shaft is rotated, the firing member is driven through the end effector. In such an apparatus, it is necessary to make the support jaws larger to accommodate the firing member drive shaft. In such a device, the lower end of the firing member is generally operably associated with the drive shaft, which can also result in forces being applied that tend to unbalance the firing member when driven distally.

[0022] Figures 1-4 illustrate one form of a surgical instrument 10 that can address many of the challenges faced by a surgical instrument having an articulatable end effector configured to cut and fasten tissue. In various embodiments, the surgical instrument 10 may comprise a handheld device. In other embodiments, the surgical instrument 10 may comprise an automated system, sometimes referred to as a robotic control system for example. In various forms, the surgical instrument 10 comprises a surgical end effector 1000 operably coupled to an elongate shaft assembly 2000. The elongate shaft assembly 2000 may be operably attached to a housing 2002. In one embodiment, the housing 2002 may comprise a handle configured to be grasped, manipulated, and actuated by a clinician. In other embodiments, the housing 2002 may house or otherwise operably support at least one drive system configured to generate and apply at least one control movement for operating the surgical end effectors disclosed herein and their respective equivalents. Additionally, various components may be “accommodated” or included within the housing, or various components may be “associated” with the housing. In such instances, the components may not be included with the housing or directly supported by the housing. For example, the surgical instruments disclosed herein may be used with various robotic systems, instruments, components, and methods disclosed in U.S. Patent No. 9,072,535, entitled “SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS,” which is hereby incorporated by reference in its entirety.

[0023] In one configuration, a surgical end effector 1000 includes a first jaw 1100 and a second jaw 1200. In the illustrated apparatus, the first jaw 1100 includes a proximal end 1112 and a distal end 1114 and includes an elongate channel 1110 configured to operably support a surgical staple cartridge 1300 therein. The surgical staple cartridge 1300 includes a cartridge body 1302 having an elongate slot 1304 therein. A plurality of surgical staples or fasteners (not shown) are stored therein on drivers (not shown) arranged in rows on each side of the elongate slot 1304. Each driver is associated with a corresponding staple cavity 1308 that opens through a cartridge deck surface 1306. The surgical staple cartridge 1300 may be replaced after staples / fasteners are discharged therefrom. Other embodiments are contemplated where, after the surgical staple cartridge 1300 has been used, the elongate channel 1110 and / or the entire surgical end effector 1000 may be discarded. Such an end effector device may be referred to as, for example, a "disposable loading unit".

[0024] In the illustrated apparatus, the second jaw 1200 includes an anvil 1210 having an elongated anvil body 1212 with a proximal end 1214 and a distal end 1216. In one apparatus, a pair of reinforcing rods or members 1213 may be supported within the anvil body 1212 to provide additional stiffness and rigidity to the anvil body 1212. The anvil body 1212 includes a staple-forming lower surface 1218 facing the first jaw 1100 and may include a series of staple-forming pockets (not shown) corresponding to each of the staples or fasteners within the surgical staple cartridge 1300. The anvil body 1212 may further include a pair of downwardly extending tissue stop features 1220 formed adjacent the proximal end 1214 of the anvil body 1212. One tissue stop feature 1220 extends from each side of the anvil body 1212 such that the distal end 1222 of each tissue stop portion corresponds to the most proximal staple / fastener within the surgical staple cartridge 1300. When the anvil 1210 is moved to a tissue closing position positioned between the staple-forming lower surface 1218 of the anvil 1210 and the cartridge deck surface 1306 of the surgical staple cartridge 1300, the tissue contacts the distal end 1222 of the tissue stop feature 1220 to prevent the tissue from moving proximally beyond the most proximal staple / fastener, thereby ensuring that the tissue to be transected is also stapled. When the surgical staple cartridge is “fired” as discussed in more detail below, the staple / fastener supported within each staple cavity is driven out of the staple cavity 1308 through the clamped tissue and into form contact with the staple-forming lower surface 1218 of the anvil 1210.

[0025] As can be seen from FIGS. 5 and 6, the proximal end portion 1214 of the anvil body 1212 includes an anvil mounting portion 1230 that includes a pair of laterally extending mounting pins 1232 configured to be received within a corresponding mounting cradle or pivot cradle 1120 formed at the proximal end portion 1112 of the elongate channel 1110. The mounting pins 1232 are pivotally retained within the mounting cradle 1120 by an anvil cap 1260 that can be attached to the proximal end portion 1112 of the elongate channel 1110 by a mechanical snap feature 1261 configured to engage a retaining structure 1113 on the elongate channel 1110. See FIG. 5. In other devices, the anvil cap 1260 may be attached to the elongate channel 1110 by welding, adhesive, or the like. Such devices facilitate pivoting of the anvil 1210 relative to a surgical staple cartridge 1300 mounted within the elongate channel 1110 about a pivot axis PA between an open position (FIG. 1) and a closed position (FIGS. 2-5). Such a pivot axis PA may herein be referred to as "fixed" in that the pivot axis does not translate or otherwise move when the anvil 1200 is pivoted from the open position to the closed position.

[0026] In the illustrated apparatus, an elongate shaft assembly 2000 defines a shaft axis SA and includes a proximal shaft portion 2100 that may be operably coupled to a housing of a control portion of the surgical instrument 10 (e.g., a hand-held unit, a robotic tool driver, etc.). The elongate shaft assembly 2000 further includes a joint 2200 attached to the proximal shaft portion 2100 and the surgical end effector 1000. In various examples, the proximal shaft portion 2100 includes a hollow outer tube 2110 that may be operably coupled to the housing 2002. See FIG. 2. As can be seen from FIG. 6, the proximal shaft portion 2100 may further include a rigid proximal support shaft 2120 that is supported within the hollow outer tube 2110 and extends from the housing to the joint 2200. The proximal support shaft 2120 may include a first half 2120A and a second half 2120B that may be joined together, for example, by welding, an adhesive, etc. The proximal support member 2120 includes a proximal end 2122 and a distal end 2124 and includes an axial passage 2126 that extends therethrough from the proximal end 2122 to the distal end 2124.

[0027] As described above, many surgical end effectors use a firing member that is axially movable and is pushed distally through a surgical staple cartridge by a firing beam. The firing beam is generally attached to the firing member in a central region of the firing member body. This attachment location can introduce an imbalance in the firing member as the firing member is advanced through the end effector. Such an imbalance can lead to undesirable friction between the firing member and the end effector jaw. The generation of this additional friction may require the application of a higher firing force to overcome such friction and may also cause undesirable wear on parts of the jaw and / or the firing member. Applying a higher firing force to the firing beam can result in undesirable flexure in the firing beam as it crosses a joint. Such additional deflection can unlock the articulation of the joint, particularly when the surgical end effector is articulated at a relatively high articulation angle. Surgical instrument 10 uses a firing system 2300 that can address many of these problems, if not all of them.

[0028] As can be seen from FIGS. 5-11, in at least one embodiment, the firing system 2300 includes a firing member 2310 including a vertically extending firing member body 2312, the firing member body 2312 including an upper firing member feature 2320 and a lower firing member feature 2350. A tissue cutting blade 2314 is attached to or formed within the vertically extending firing member body 2312. See FIGS. 9 and 11. In at least one device, it is desirable for the firing member 2310 to pass through the anvil body 1212 with low friction, high strength, and high stiffness. In the illustrated device, the upper firing member feature 2320 includes an upper tubular body 2322 having an upper axial passage 2324 extending therethrough. See FIG. 10. The lower firing member feature 2350 includes a lower tubular body 2352, the lower tubular body 2352 having a lower axial passage 2354 extending therethrough. In at least one device, the upper firing member feature 2320 and the lower firing member feature 2350 are integrally formed with the vertically extending firing member body 2312. As can be seen from FIG. 12, the anvil body 1212 includes an axially extending anvil slot 1240 having a cross-sectional shape similar to a "keyhole". Similarly, the elongated channel 1110 includes an axially extending channel slot 1140 having a cross-sectional shape similar to that of a keyhole.

[0029] In conventional launch member devices, long flexible cantilever wings extending from the upper and lower portions of the launch member are employed. These cantilever wings slidably pass through an anvil and slots in a channel that are typically cut with a rectangular T-cutter that tends to produce a higher friction surface. Such long cantilever wings have a minimum surface area in contact with the anvil and channel, which can result in wear of these components. The keyhole-shaped channel slots 1140 and keyhole-shaped anvil slots 1240 may be cut with a round T-cutter or finished with a reamer / drilling machine, thereby creating a lower friction surface. Additionally, the upper tubular body 2322 and the lower tubular body 2352 are stiffer than conventional cantilever wing devices and tend to increase the surface area in contact with the anvil and channel, which can each result in reduced wear and a stronger sliding connection. Stated another way, the anvil slots 1240 and channel slots 1140 are keyhole-shaped and less material is removed than conventional rectangular slots, so their geometry and increased material can result in a stiffer anvil and channel compared to conventional devices.

[0030] Referring to FIGS. 9-11, in one apparatus, the launch system 2300 further comprises an upper flexible spine assembly 2400 operably coupled to an upper launch member feature 2320 and a lower flexible spine assembly 2500 operably coupled to a lower launch member feature 2350. In at least one embodiment, the upper flexible spine assembly 2400 comprises an upper series 2410 of upper vertebra members 2420 that are loosely coupled together by an upper flexible connector member 2402 attached to the upper launch member feature 2320. The upper flexible connector member 2402 may comprise an upper cable 2404 that extends through an upper axial passage 2324 within the upper launch member feature 2320, and a distal end 2406 of the upper cable 2404 is attached to a retainer ferrule 2408 fixed to the upper axial passage 2324.

[0031] As can be seen from FIG. 13, each upper vertebral member 2420 includes an upper vertebral body portion 2422 having a proximal end portion 2424 and a distal end portion 2428. An upper hollow passage 2429 extends through the upper vertebral body portion 2422 to accommodate the passage of the upper flexible connector member 2402. Each upper vertebral member 2420 further includes an upper drive feature or upper vertebral member tooth 2450 that projects from the upper vertebral body portion 2422 and extends downward. Each upper vertebral member tooth 2450 has a helical proximal upper surface portion 2452 and a helical distal upper surface portion 2454. Each proximal end portion 2424 of the upper vertebral body portion 2422 has an upper proximal fitting feature 2426 therein, and each distal end portion 2428 has an upper distal fitting feature 2430 formed therein. In at least one embodiment, the upper proximal fitting feature 2426 includes a concave recess 2427, and each upper distal fitting feature 2430 includes a convex mount 2431. When disposed in the upper series 2410, the convex mount 2431 on one upper vertebral member 2420 contacts and mates with the concave recess 2427 on an adjacent upper vertebral member 2420 within the upper series 2410 to maintain the upper vertebral members 2420 in a substantially aligned state, whereby the helical proximal upper surface portion 2452 and the helical distal upper surface portion 2454 on each corresponding upper tooth 2450 can be drivingly engaged by a rotary drive screw 2700, as will be described in more detail below.

[0032] Similarly, in at least one embodiment, the lower flexible spine assembly 2500 includes a lower series 2510 of lower vertebral members 2520 that are loosely coupled together by a lower flexible connector member 2502 attached to a lower emitter member feature 2350. The lower flexible connector member 2502 may include a lower cable 2504 that extends through a lower axial passage 2354 within the lower emitter member feature 2350, and the distal end portion 2506 of the lower cable 2504 is attached to a retainer ferrule 2508 fixed to the lower axial passage 2354.

[0033] As can be seen from FIG. 14, each lower vertebral member 2520 includes a lower vertebral body portion 2522 having a proximal end 2524 and a distal end 2528. A lower hollow passage 2529 extends through the lower vertebral body portion 2522 to receive the passage of the lower flexible connector member 2502. Each lower vertebral member 2520 further includes a downwardly extending lower drive feature or lower vertebral member tooth 2550 that projects from the lower vertebral body portion 2522. Each lower vertebral member tooth 2550 has a helical proximal lower surface portion 2552 and a helical distal lower surface portion 2554. Each proximal end 2524 of the lower vertebral body portion 2522 has a lower proximal mating feature 2526 therein, and each distal end 2528 has a lower distal mating feature 2530 formed therein. In at least one embodiment, the lower proximal mating feature 2526 comprises a concave recess 2527, and each lower distal mating feature 2530 comprises a convex mount 2531. When disposed in the lower series 2510, the convex mount 2531 on one lower vertebral member 2520 contacts and mates with the concave recess 2527 on an adjacent lower vertebral member 2520 within the lower series 2510 to maintain the lower vertebral members 2520 in a substantially aligned state, whereby the helical proximal lower surface portion 2552 and the helical distal lower surface portion 2554 on each corresponding lower tooth 2550 can be drivingly engaged by a rotary drive screw 2700, as will be described in more detail below.

[0034] Referring now to FIGS. 5, 7, and 8, in at least one device, the firing drive system 2300 further includes a rotary drive screw 2700 configured to be drivingly coupled with an upper series 2410 of the upper vertebra member 2420 and a lower series 2510 of the lower vertebra member 2520. In the illustrated device, the rotary drive screw 2700 is driven by a rotary drive system 2600 that includes a proximal rotary drive shaft 2610 rotatably supported within an axial passage 2126 in the proximal support shaft 2120. Refer to FIG. 7. The proximal rotary drive shaft 2610 includes a proximal end 2612 and a distal end 2614. The proximal end 2612 may be associated with a gearbox 2004 or other device driven by a motor 2006 or other source of rotational motion housed within the housing of the surgical instrument. Refer to FIG. 2. Such a source of rotational motion rotates the proximal rotary drive shaft about the shaft axis SA within the axial passage 2126 in the proximal support shaft 2120.

[0035] The proximal rotary drive shaft 2610 is operably supported within the elongate shaft assembly 2000 at a location proximal to the articulation joint 2200 and is operably associated with a constant velocity (CV) drive shaft assembly 2620 that extends or extends axially through the articulation joint 2200. As seen in FIGS. 8, 16, and 17, in at least one device, the CV drive shaft assembly 2620 includes a proximal CV drive assembly 2630 and a distal CV drive shaft 2670. The proximal CV drive assembly 2630 includes a proximal shaft segment 2632 consisting of a mounting shaft 2634 configured to be non-rotatably received within a similarly shaped connector cavity 2616 within the distal end 2614 of the proximal rotary drive shaft 2610. The proximal shaft segment 2632 is operably associated with a series 2640 of driving joints 2650 that are movably coupled.

[0036] As can be seen from FIG. 18, in at least one device, each drive coupling 2650 comprises a first or distal spherical portion 2660 and a second or proximal spherical portion 2652. The distal spherical portion 2660 is larger than the proximal spherical portion 2652. The distal spherical portion 2660 comprises a socket cavity 2662 configured to rotatably receive the proximal spherical portion 2652 of an adjacent drive coupling 2650 therein. Each proximal spherical portion 2652 comprises a pair of diametrically opposed coupling pins 2654 configured to be movably received within corresponding pin slots 2664 within the distal spherical portion 2660 of an adjacent drive coupling 2650, as can be seen from FIG. 16. The proximal spherical portion 2652P of the most proximal drive coupling 2650P is rotatably received within the distal socket portion 2636 of the proximal shaft segment 2632, as shown in FIG. 16. The coupling pins 2654P are received within corresponding pin slots 2637 within the distal socket portion 2636. As can be further seen from FIG. 16, the most distal drive coupling 2650D in the series 2640 of movably connected drive couplings 2650 is movably connected to the distal CV drive shaft 2670.

[0037] In at least one device, the distal CV drive shaft 2670 comprises a proximal spherical portion 2672 dimensioned to be movably received within the socket cavity 2662D within the most distal drive coupling 2650D. The proximal spherical portion 2672 includes coupling pins 2674 configured to be movably received within the pin slots 2664D within the most distal drive coupling 2650D. The distal CV drive shaft 2670 further comprises a shaft stem 2676 extending distally and configured to be non-rotatably connected to a rotary drive screw 2700 positioned distally of the articulation joint 2200. The distal CV drive shaft 2670 includes a flange 2677 and a mounting barrel portion 2678 for receiving a thrust bearing housing 2680 thereon.

[0038] In the illustrated apparatus, when a series 2640 of drive joints 2650 that are movably coupled articulate, the joint pin 2674 remains within the corresponding pin slot 2664 of an adjacent drive joint 2650. In the example shown in FIG. 18, each drive joint may be capable of articulating approximately 18 degrees in the pitch and yaw directions. FIG. 16 shows the angles of the series 2640 of drive joints 2650 when each drive joint 2650 within the series is fully articulated 90 degrees in pitch and yaw, which results in an angle α of approximately 100.9 degrees. In such an apparatus, the outer surface of each distal spherical portion 2660 has a clearance from the outer surface of an adjacent or proximate proximal spherical portion 2652 to allow unrestricted movement until the 18-degree limit is reached. The rigid design and limited small angles allow the series 2640 of drive joints 2650 that are movably coupled to collectively carry high loads at large angles in the torsional direction.

[0039] In the illustrated apparatus, the articulation joint 2200 includes an articulation joint spring 2230 supported within an outer elastomeric joint assembly 2210. The outer elastomeric joint assembly 2210 includes a distal end 2212 attached to the proximal end 1112 of the elongated channel 1110. For example, as can be seen from FIG. 6, the distal end 2212 of the outer elastomeric joint assembly 2210 is attached to the proximal end 1112 of the elongated channel 1110 by a pair of cap screws 2722 that extend through a distal mounting bushing 2720 and are threadably received by the proximal end 1112 of the elongated channel 1110. The proximal end 2214 of the elastomeric joint assembly 2210 is attached to the distal end 2124 of the proximal support shaft 2120. The proximal end 2214 of the elastomeric joint assembly 2210 is attached to the distal end 2124 of the proximal support member 2120 by a pair of cap screws 2732 that extend through a proximal mounting bushing 2750 and are threadably received by a threaded insert 2125 mounted within the distal end 2124 of the proximal support shaft 2120.

[0040] To prevent the drive joint 2650 from buckling during articulation, a series 2640 of movably coupled drive joints 2650 extends through at least one low friction articulation joint spring 2730 that is supported within the outer elastomer joint assembly 2210. See FIG. 19. The articulation joint spring 2730 is sized relative to the drive joint 2650 such that a slight radial clearance is provided between the articulation joint spring 2730 and the drive joint 2650. The articulation joint spring 2730 is designed to carry an articulation load that can be significantly lower than the torsional launch load. The joint spring is longer than the series 2640 of drive joints 2650, such that the drive joint is axially free to float. If the "hard stack" of the series 2640 of drive joints 2650 is longer than the hard stack of the articulation joint spring 2730, the drive joint 2650 can function as an articulation compression limiter that axially relieves the launch load and the articulation load through the series 2640 of drive joints 2650. When the launch load axially relieves through the series 2640 of drive joints 2650, the load can attempt to straighten the articulation joint 2200, or in other words, attempt to cause an articulation release. If the hard stack of the articulation joint spring 2730 is longer than the hard stack of the series 2640 of drive joints 2650, the launch load is contained within the end effector and the launch load does not relieve through the drive joint 2650 or through the spring 2730.

[0041] To further ensure that the drive joints 2650 are always engaged with each other, a proximal drive spring 2740 is used to apply an axial biasing force to the series 2640 of drive joints 2650. For example, as can be seen from FIGS. 8, 19, and 20, the proximal drive spring 2740 is disposed between the proximal mounting bushing 2734 and a support flange formed between the distal socket portion 2636 of the proximal shaft segment 2632 and the proximal barrel portion 2638. In one device, the proximal drive spring 2740 may comprise an elastomeric O-ring / bushing received on the proximal barrel portion 2638 of the proximal shaft segment 2632. The proximal drive spring 2740 lightly biases the drive joints 2650 together to reduce any gaps that may occur during articulation. This ensures that the drive joint 2650 reliably transmits torsional loads. However, it will be appreciated that in at least one device, the proximal drive spring 2740 does not apply an axial load high enough to create a firing load for translation through the articulation joint 2200.

[0042] As can be seen from FIGS. 9 and 10, the upper launch member feature 2320 on the launch member 2310 comprises a distal upper launch member tooth segment 2330 corresponding to half of the upper teeth 2450 on each upper vertebral member 2420. In addition, proximal upper launch member teeth 2336, which are identical to the upper teeth 2450 on each upper vertebral member 2420, are spaced apart from the distal upper launch member tooth segment 2330. The distal upper launch member tooth segment 2330 and the proximal upper launch member teeth 2336 may be integrally formed with the upper launch member feature 2320 of the launch member 2310. Similarly, the lower launch member feature 2350 of the launch member 2310 comprises distal lower launch member teeth 2360 and proximal lower launch member teeth 2366 integrally formed thereon. For example, in at least one device, the launch member 2310 having the firmly attached teeth 2330, 2336, 2360, and 2366 may be fabricated as one integral component at once using conventional metal injection molding techniques.

[0043] As described above, each of the upper vertebra member 2520 is movably received on the upper flexible connector member 2402 in the form of the upper cable 2404. As described above, the distal end 2406 of the upper cable 2404 is fixed to the upper emitter member feature 2320 of the emitter member 2310. Similarly, each of the lower vertebra member 2520 is movably received on the lower flexible connector member 2502 in the form of the lower cable 2504. The distal end 2506 of the lower cable 2504 is fixed to the lower emitter member feature 2350 of the emitter member 2310. In at least one device, the upper cable 2404 and the lower cable 2504 extend through the proximal shaft portion 2100 and may cooperate with a bailout device supported within the housing to retract the emitter member 2310 to its fixed or starting position in the event of a failure of the emitter member drive system, as will be described in more detail below.

[0044] Referring again to FIG. 8, the axial length AL of the upper series 2410 of the upper vertebra member 2420 u and the axial length AL of the lower series 2510 of the lower vertebra member 2520 lThey are equal, and while the most proximal upper vertebral member 2420 in the upper series 2410 of the upper vertebral member 2420 and the most proximal lower vertebral member 2520 in the lower series 2510 of the lower vertebral member 2520 remain drivingly engaged with the rotary drive screw 2700, it must be of sufficient length to facilitate the complete distal advancement of the firing member 2310 from the fixed or starting position within the staple cartridge to the most distal end position. As can be seen from FIG. 8, the upper compression limiting spring 2421 is configured to cooperate with the most proximal upper vertebral member 2420P in the upper series 2410 of the upper vertebral member 2420. The upper compression limiting spring 2421 is pivotally supported on the upper cable 2404 and is held in position by an upper spring holder 2423 held in position by an upper ferrule 2425 crimped onto the upper cable 2404, and is biased and engaged with the most proximal upper vertebral member 2420P to be held. The upper cable 2404 extends through an upper hypo tube 2433 supported within the proximal support shaft. Similarly, the lower compression limiting spring 2521 is configured to cooperate with the most proximal lower vertebral member 2520P in the lower series 2510 of the lower vertebral member 2520. The lower compression spring 2521 is pivotally supported on the lower cable 2504 and is held in position by a lower spring holder 2523 held in position by a lower ferrule 2525 crimped onto the lower cable 2504, and is biased and engaged with the most proximal lower vertebral member 2520P to be held. The lower cable 2504 extends through a lower hypo tube 2533 supported within the proximal support shaft.

[0045] After the end effector is positioned at the articulation movement position, when the upper vertebral member 2420 and the lower vertebral member 2520 form an angle via the articulation joint, the gap between the respective vertebral members 2420, 2520 increases in each series 2410, 2510, whereby the springs 2421, 2521 become tighter. The compression limiting springs 2421, 2521 respectively provide sufficient slack to the cables 2404, 2504 to enable the vertebral members 2420, 2520 to form an angle over the most extreme articulation movement angles. When the cables 2404, 2504 are pulled too tightly, the spring holders 2423, 2523 will contact their respective most proximal vertebral members 2420P, 2520P. Such compression limiting devices ensure that the vertebral members 2420, 2520 in each series 2410, 2510 always remain sufficiently close together, so that the rotary drive screw 2700 will always drive-engage them in the manner discussed in more detail below. When the vertebral members 2420, 2520 are realigned linearly again, the compression limiting springs 2421, 2521 can relax partially while still maintaining some compression between the vertebral members.

[0046] As described above, when the upper vertebral member 2420 is disposed in the upper series 2410 and the lower vertebral member 2520 is disposed in the lower series 2510, the convex mounts and concave grooves of each vertebral member and the compression limiter springs function to maintain the upper and lower vertebral members in a relatively linear alignment for drive engagement by the rotary drive screw 2700. As can be seen from FIGS. 9 and 10, when the upper vertebral member 2420 is linearly aligned, the upper teeth 2450 are separated from each other by an opening space designated as 2460 as a whole, which facilitates drive engagement with the helical drive screw ridges 2170 on the rotary drive screw. Similarly, when the lower vertebral member 2520 is linearly aligned, the lower vertebral member teeth 2550 are separated from each other by an opening space designated as 2560 as a whole, which facilitates drive engagement with the helical drive screw ridges 2170 of the rotary drive screw 2700.

[0047] Referring to FIGS. 8 and 22, the rotary drive screw 2700 includes a screw body 2702 having therein a socket 2704 for receiving a shaft stem 2676 that extends distally of the distal CV drive shaft 2670. An internal radially extending groove 2714 (FIG. 10) for supporting a plurality of ball bearings 2716 therein is formed in the screw body 2702. In one device, for example, 12 ball bearings 2716 are employed. The radially extending groove 2714 supports the ball bearings 2716 between the screw body 2702 and the distal end of the thrust bearing housing 2680. The ball bearings 2716 function to distribute the axial load of the rotary drive screw 2700 and to significantly reduce friction by the rolling movement of the balls.

[0048] As can be seen from FIG. 23, the helical drive thread 2710 is provided around the screw body 2702 and functions to form the proximal thread scoop feature 2712. The proximal thread scoop feature 2712 is formed with a first pitch 2713, and the remainder of the helical drive thread 2710 is formed with a second pitch 2715 that is different from the first pitch 2713. In FIGS. 22 and 23, region 2718 indicates where the first pitch 2713 and the second pitch 2715 converge. In at least one embodiment, the rotational drive screw 2700 captures all of the upper vertebra member 2420 and all of the lower vertebra member 2520, and to ensure that it "scoops up" or drive engages, the first pitch 2713 is larger than the second pitch 2715. As can be seen from FIG. 24, the proximal end 2717 of the helical drive thread 2710 having the first pitch 2713 is scooped into the opening space 2560 between the teeth 2550A and 2550B of two adjacent lower vertebra members, while the central portion 2719 of the helical drive thread 2710 having the second pitch 2715 is in driving engagement with the helical distal lower surface portion 2554 on the lower vertebra member tooth 2550B and the helical proximal lower surface portion 2552 on the proximal lower firing member tooth 2366. Also as can be understood, the scoop feature 2712 may not contact the helical distal lower surface portion 2554A of the lower vertebra member tooth 2550A when scooping up the lower vertebra member tooth 2550B when driving the firing member 2310 distally. The helical drive thread 2710 engages with the teeth 2450 of the upper vertebra member 2420 in a similar manner.

[0049] The power screw is a threaded rod having a nut that is fully 360 degrees around. Rotation of the power screw advances or moves the nut longitudinally. However, in this device, due to spatial constraints, a full 360-degree nut cannot fit inside the end effector. In a general sense, the upper flexible spine assembly 2400 and the lower flexible spine assembly 2500 comprise a radially / longitudinally segmented "power screw nut" that is rotatably driven by a rotary drive screw 2700. When the rotary drive screw is rotated in a first rotational direction, the rotary drive screw 2700 drives one or more vertebra members in each of the upper series and the lower series of vertebra members longitudinally, while the vertebra members 2420, 2520 remain in the same place radially. The upper series 2410 and the lower series 2510 are constrained to rotate around the rotary drive screw 2700 and can only move longitudinally. In one device, the upper vertebra member 2420 of the upper series 2410 and the lower vertebra member 2520 of the lower series 2510 each surround the rotary drive screw 2700 by less than 10 degrees.

[0050] FIG. 25 shows the firing member 2310 in a fixed or starting position. As can be seen from FIG. 25, a portion of the helical drive thread 2710 on the rotary drive screw 2700 is engaged between the distal upper firing member tooth segment 2330 and the proximal upper firing member tooth 2336, and another portion of the helical drive thread 2710 is engaged between the distal lower firing member tooth 2360 and the proximal lower firing member tooth 2366 on the firing member 2310. Such a device allows the rotary drive screw 2700 to accurately control the distal and proximal movement of the firing member 2310, which can result in the accurate movement of the anvil 1210, as will be discussed in more detail below. When the firing member 2310 is advanced sufficiently distally during the firing stroke, the helical drive thread 2710 operably engages the teeth on the upper and lower vertebrae. See FIG. 26.

[0051] Surgical instrument 10 also includes an articulation system 2240 configured to articulate the surgical end effector 1000 relative to the elongated shaft assembly 2000 in addition to the articulation of the joint movement. In at least one device, for example, the articulation system includes four articulation cables 2242, 2246, 2250, and 2254 that extend through the elongated shaft assembly 2000. See FIG. 27. In the illustrated device, the articulation cables 2242, 2246 pass through the proximal mounting bushing 2750, the proximal end 2214 of the elastomeric joint assembly 2210, and the central rib segment 2216 fixed to the distal end 2212 of the elastomeric joint assembly 2210 or other portion of the surgical instrument. Similarly, the articulation cables 2250 and 2254 pass through the proximal mounting bushing 2750, the proximal end 2214 of the elastomeric joint assembly 2210, and the central rib segment 2218 fixed to the distal end 2212 of the elastomeric joint assembly 2210 or other portion of the surgical end effector. Cables 2242, 2246, 2250, and 2254 are operatively coupled to an articulation control system supported within the housing of the surgical instrument 10. For example, the proximal portions of each cable 2242, 2246, 2250, and 2254 may be wound onto corresponding rotating spools or cable management systems 2007 (FIG. 2) within a housing portion of the surgical instrument 10 configured to pay out and also retract each cable 2242, 2246, 2250, and 2254 in a desired manner. The spool / cable management system may be motor-driven or manual (such as a ratchet device). FIG. 29 shows the articulation of the surgical end effector 1000 through a first articulation plane relative to the elongated shaft assembly 2000. FIG. 30 shows the articulation of the surgical end effector 1000 through a second articulation plane relative to the elongated shaft assembly 2000. FIG. 31 shows the articulation of the surgical end effector 1000 through a plurality of articulation planes relative to the elongated shaft assembly 2000.

[0052] Figures 32-34 show an alternative joint 2200' in the form of an elastomeric joint assembly 2210'. As seen in FIG. 33, each joint movement cable passes through a corresponding spring 2215' attached to a rib 2216' of the elastomeric joint assembly 2210'. For example, cable 2242 extends through spring 2244. Cable 2246 extends through spring 2248. Cable 2250 extends through spring 2252, and cable 2254 extends through spring 2256. As described above, the end effector is joint actuated by pulling or releasing appropriate cables 2242, 2246, 2250, and 2254. To achieve a greater joint movement angle with a higher degree of joint stability, each of springs 2244, 2248, 2252, and 2256 can slide through a rib of the elastomeric joint to push the end effector and pull the cable extending therethrough. Springs 2244, 2248, 2252, and 2256 also retract into the rib when cables 2242, 2246, 2250, and 2254 are pulled tightly. Each of springs 2244, 2248, 2252, and 2256 seats loosely on the particular cable passing therethrough. Each cable and corresponding spring can be supported within an elongate shaft assembly 2000 and terminated with a corresponding solid rod that can be pushed and pulled from its proximal end, or otherwise connected thereto. When the cable is pulled, the corresponding spring bears little or no load. When the spring is pushed, the cable bears little load but serves to limit the movement of the end effector. This interaction between the cable and spring can facilitate a higher joint movement angle, for example, approaching 90 degrees.

[0053] Because the radially / longitudinal segmented power screw nut arrangement disclosed herein does not have the same constraints as a 360-degree nut, the upper vertebra members 2420 of the upper series 2410 and the lower vertebra members 2520 of the lower series 2510 are constrained to ensure that their loads are transferred to the firing member in the longitudinal direction. To maintain each of the upper vertebra members 2420 in a desired orientation and to prevent the upper vertebra members 2420 from binding or losing orientation as they move through the articulation joint 2200, the upper vertebra members 2420 are aligned to pass through an upper sleeve 2470 that extends through the upper portion of the outer elastomeric joint assembly 2210 of the articulation joint 2200. See FIGS. 27, 28, and 35. The distal end 2472 of the upper sleeve 2470 is supported within the proximal end 1112 of the elongate channel 1110, and the proximal end 2474 of the upper sleeve 2470 is supported within the distal end of the proximal support shaft 2120. The upper sleeve 2470 is fabricated from a polymer or plastic material that has a low coefficient of friction and is flexible to allow the upper sleeve 2470 to flex with the outer elastomeric coupling assembly 2210. The upper sleeve 2470 prevents the upper vertebra member 2420 from contacting the outer elastomeric coupling assembly 2210, which is fabricated from an elastomeric material that may have a higher coefficient of friction than the coefficient of friction of the material of the upper sleeve 2470. In other words, the upper sleeve 2470 forms a low-friction, flexible, continuous, uninterrupted, and completely enclosed path for the upper vertebra member 2420 as it traverses the articulation joint 2200.

[0054] Similarly, a lower sleeve 2570 is employed to support the lower vertebral member 2520 as the lower vertebral member 2520 passes through the articulation joint 2200. The distal end 2572 of the lower sleeve 2570 is supported within the proximal end of the elongated channel, and the proximal end of the lower sleeve 2570 is supported within the distal end of the proximal support shaft 2120. Similar to the upper sleeve 2470, the lower sleeve 2570 is manufactured from a polymer or plastic material having a low coefficient of friction and being flexible to allow the lower sleeve 2570 to bend with the outer elastomeric joint assembly 2210. The lower sleeve 2570 prevents the lower vertebral member 2520 from contacting the outer elastomeric joint assembly 2210 as the lower vertebral member 2520 passes through the articulation joint 2200. In other words, the lower sleeve 2570 forms a path for the lower vertebral member 2520 that is low friction, flexible, continuous, unbroken, and fully enclosed when the lower vertebral member 2520 traverses the articulation joint 2200. In various embodiments, the upper sleeve 2470 and the lower sleeve 2570 are configured to bend freely without kinking. To prevent the formation of kinks in the sleeves, in at least one device, the sleeves 2470, 2570 are supported within the outer elastomeric joint assembly 2210 such that the sleeves can move axially. For example, when the articulation joint angles upward, the lower sleeve 2570 can slide distally and have a large bending radius. The upper sleeve 2470 in the same example can slide proximally and have a tighter bending radius. By moving axially, the amount of material exposed outside the joint assembly 2210 that would otherwise be susceptible to kinking under a tight bending radius is reduced. In at least one device, the distal end 2472 of the upper sleeve 2470 is formed with an upper scoop 2476 configured to feed the upper vertebral member 2420 into the anvil cap 1260. Similarly, the distal end of the lower sleeve 2570 can be formed with a lower scoop configured to feed the lower vertebral member 2520 into the channel slot 1140 within the elongated channel 1110.

[0055] As described above, the anvil mounting portion 1230 may include a pair of laterally extending mounting pins 1232 configured to be received in corresponding mounting or pivot cradles 1120 formed in the proximal end 1112 of the elongated channel 1110. The mounting pins 1232 are pivotally retained within the mounting cradle 1120 by an anvil cap 1260 attached to the proximal end 1112 of the elongated channel 1110 in the manner described above. The anvil cap 1260 includes a proximal end 1262 and a distal end 1264 and has a keyhole-shaped vertebra passage 1266 extending therethrough to accommodate passage therethrough of the upper firing member feature 2320 and the upper vertebra member 2420. FIG. 36 illustrates the vertebra passage 1266 within the anvil cap 1260. As the rotary drive screw 2700 applies a load to the upper vertebra member 2420, the vertebra member 2420 tends to tilt around region A in FIG. 37, so the upper vertebra member teeth 2450 are no longer perpendicular to the rotary drive screw 2700 and may instead experience higher pressure line contact. Region B in FIG. 37 indicates where the upper vertebra member 2420 stops tilting. To ensure that the majority of the load remains longitudinal and performs useful work, the upper vertebra member teeth 2450 must be angled the same amount as the upper vertebra member 2420 tilts. Thus, as the upper vertebra member 2420 tilts, the upper vertebra member teeth 2450 still maintain surface contact with the helical drive member 2710 on the rotary drive screw 2700 and all of the load is directed longitudinally and not vertically. The slightly angled teeth 2450 of the upper vertebra member allow the vertebra member 2420 to behave like a square thread when tilted, better distributing the load and reducing pressure contact. By directing the majority of the load longitudinally, normal loads are avoided, which can result in the establishment of friction that opposes the longitudinal load. The upper vertebra member 2420 reacts similarly as it passes through the keyhole-shaped anvil slot 1240. Similarly, the lower vertebra member 2520 reacts similarly as it passes through the keyhole-shaped, axially extending channel slot 1140 in the elongated channel 1110.

[0056] In the illustrated apparatus, anvil 1210 is moved to an open position by a pair of anvil springs 1270 supported within the proximal end of the elongated channel. See FIGS. 38, 42, and 43. Springs 1270 are formed integrally with anvil mounting portion 1230 and are positioned to apply a pivotal biasing force to corresponding anvil control arms 1234 that may extend downwardly therefrom. See FIG. 38.

[0057] Figures 39-41 show various portions of anvil 1210, firing member 2310, and anvil cap 1260 when the anvil 1210 is open (Figure 39), when the anvil 1210 is partially closed (Figure 40), and after the firing member has advanced distally from a fixed or starting position (Figure 41). As seen in Figure 39, when the firing member 2310 is in its fixed or starting position, the upper firing member feature 2320 is fully received within the vertebra passage 1266 in the anvil cap 1260. During the firing stroke, the upper firing member feature 2320 and the upper vertebra member 2420 within the upper series 2410 must transition from the vertebra passage 1266 in the anvil cap 1260 to the keyhole-shaped anvil slot 1240. Accordingly, it is desirable to minimize any gap "G" between the anvil mounting portion 1230 and the distal end 1264 of the anvil cap 1260. To minimize this gap G while facilitating unobstructed pivotal movement of the anvil 1210, the distal end 1264 of the anvil cap 1260 is formed with a curved cap surface 1265 that conforms to the curved mating surface 1231 on the anvil mounting portion 1230. Both surfaces 1265, 1231 are curved and concentric about the pivot axis PA. Such an arrangement allows the anvil 1210 to move radially without interfering with the anvil cap 1260 while maintaining a minimum gap G therebetween. The gap G between the anvil mounting portion 1230 and the distal end 1264 of the anvil cap 1260 is significantly shorter than the length of the upper vertebra member 2420, which facilitates the easy transition of each upper vertebra member 2420 from the vertebra passage 1266 in the anvil cap 1260 to the keyhole-shaped anvil slot 1240. Additionally, an inclined surface 1241 is formed adjacent to the curved mating surface 1231 on the anvil mounting portion 1230 to further assist the transition of the upper firing member feature 2320 into the keyhole-shaped anvil slot 1240. When the firing member 2310 is first advanced distally from its fixed or starting position, the distal end of the upper firing member feature 2320 contacts the inclined surface 1241 and begins to apply a closing movement to the anvil 1210 as seen in Figure 40.Further distal advancement of the firing member 2310 during the firing stroke or firing sequence will cause the upper firing member feature to enter the keyhole-shaped anvil slot 1240, fully close the anvil 1210, and hold the anvil 1210 in the closed position during the firing sequence. See Figure 41.

[0058] Generally, the highest firing forces established in an end cutter are associated with tissue cutting and stapling. If these same forces can be used to close the anvil, the forces generated during pre-clamping and grasping of tissue can likewise be high. In at least one device, the firing member body 2312 further comprises firing member wings or tabs 2355 that extend laterally from each side surface of the firing member body 2312. See FIGS. 15 and 36. The firing member wings 2355 are positioned to contact corresponding anvil control arms 1234 when the firing member 2310 is driven in the proximal direction PD from a fixed or starting position to quickly close the anvil 1210 for grasping purposes. In at least one device, when the firing member 2310 is in a fixed or starting position, the firing member wings 2355 are positioned on the distal side of the anvil control arm 1234 as shown in FIG. 42. When the firing member 3210 is moved proximally, the firing member wings 2355 push (in the pivotal direction C) the anvil control arm 1234 against the biasing of the anvil spring 1270. See FIG. 42. In one device, the firing member 2310 need only be moved a short distance D to pivot the anvil 1210 to the closed position. In one embodiment, the distance D may be, for example, approximately 0.070 inches in length. This short movement allows for a rapid response. Since the anvil pivot point or pivot axis PA is relatively far from the firing member wings 2355 that create a substantial moment arm, the proximal movement of the firing member 2310 (and the firing member wings 2355) results in a high preload torque being applied to the anvil 1210, moving the anvil 1210 to the closed position. Accordingly, the firing member wings 2355 may be referred to herein as “preload features”. See FIG. 43. Thus, a clinician can use the surgical end effector 1000 to grasp and manipulate tissue between the anvil 1210 and the surgical staple cartridge 1300 without cutting the tissue or forming staples by advancing the firing member 2310 proximally a short distance D to quickly pivot the anvil 1210 to the closed position.

[0059] The firing member 2310 can be moved in the proximal direction PD by rotating the rotary drive screw 2700 in a second rotational direction. Thus, when the firing member 2310 is in a "home" or starting position, the anvil 1210 can be biased to a fully open position by the anvil spring 1270. Actuating the rotary drive system 2600 to impart rotational motion to the rotary drive screw 2700 in a first rotational direction advances the firing member 2310 distally from the home or starting position and imparts an anvil closing motion to the anvil 1210, closing and moving the anvil to clamp the target tissue between the anvil 1210 and the surgical staple cartridge 1300. Continued rotation of the rotary drive screw in the first rotational direction continues to advance the firing member 2310 distally through the surgical end effector 1000. As the firing member 2310 moves distally, it contacts a sled 1312 ( FIG. 19 ) supported within the surgical staple cartridge 1300, driving the sled 1312 distally through the staple cartridge body 1302. When the firing member 2310 is in a home or starting position, the surgeon may desire to grasp and manipulate tissue using the surgical end effector. To do so, the rotational drive system is actuated to impart a second rotational drive motion to the rotary drive screw 2700 in a second rotational direction opposite the first rotational direction. Such rotational motion of the rotary drive screw 2700 in the second rotational direction will drive the firing member 2310 proximally from the starting position and rapidly pivot the anvil 1210 to the closed position. Thus, according to at least one embodiment, the “home or starting position” of the firing member 2310 is not its proximal-most position.

[0060] If the rotational drive system 2600 stops rotating during the firing process, the firing member 2310 may become immobile within the surgical end effector. In such an example, the upper firing member feature 2320 may remain engaged with the anvil 1210, and the lower firing member feature 2350 may remain engaged with the elongate channel 1110, thereby preventing the surgeon from moving the anvil 1210 to the open position and releasing the tissue clamped between the anvil 1210 and the surgical staple cartridge 1300. This can occur, for example, if the motor or other control device that supplies rotational drive motion to the rotational drive shaft 2610 fails or otherwise becomes inoperable. In such a case, the firing member 2310 may be retracted to a fixed or starting position within the surgical end effector 1000 by pulling the upper cable 2404 and the lower cable 2504 in the proximal direction. For example, the proximal portions of the upper cable 2404 and the lower cable 2505 may be wound onto a rotational spool or cable management system 2009 (FIG. 2) within the housing portion of the surgical instrument 10, and this rotational spool or cable management system is configured to pay out the upper cable 2404 and the lower cable 2504 during the firing stroke and to retract the cables 2404, 2504 in the proximal direction when it is necessary to retract the firing member 2310. The cable management system 2009 may be motor-driven or manual (such as a ratchet device) to apply a retraction motion to the cables 2404, 2504. When the cables 2404, 2504 are retracted, the upper vertebra member 2420 and the lower vertebra member 2520 rotate the rotational drive screw 2700 in the reverse direction.

[0061] The following equation can be used to determine whether the rotational drive screw 2700 rotates in the reverse direction based on the lead (L), pitch diameter (d p ), tooth angle (α), and friction (μ).

[0062]

Equation

[0063] The rotary drive screw 2700 can self-lock when the above equation is true. In most cases, in many examples, the pitch circle diameter is mostly fixed for the end cutter, but the lead angle and tooth angle are variable. Since the upper vertebral member teeth 2450 and the lower vertebral member teeth 2550 are mostly square, the rotary drive screw 2700 is likely to be reversibly drivable (cos(90)=1). The leads of the upper vertebral member teeth 2450 and the lower vertebral member teeth 2550 can also be advantageous in that the rolling friction between the vertebral members 2420, 2520 and the rotary drive screw 2700 makes it more likely that the rotary drive screw 2700 can be reversibly driven. Thus, in an emergency, the surgeon can pull the upper cable 2404 and the lower cable 2504 in the proximal direction and fully retract the firing member 2310 to perform a quick "bailout".

[0064] As described above, the relative control movements for the rotary drive system 2600 and the various cable management systems used in connection with the firing system 2300 and the articulation control system 2240 may be supported within the housing 2002, which may be handheld or part of a larger automated surgical system. The firing system 2300, the articulation control system 2240, and the rotary drive system 2600 may be motor-controlled and operated, for example, by one or more control circuits.

[0065] One way to use the surgical instrument 10 may include using laparoscopic techniques to cut and staple target tissue within a patient's body. For example, one or more trocars may be placed through the patient's abdominal wall to provide access to the target tissue within the patient. The surgical end effector 1000 may be inserted through one trocar, and one or more cameras or other surgical instruments may be inserted through other trocars. To enable the surgical end effector 1000 to pass through the trocar cannula, the surgical end effector 1000 is positioned in a non-articulated orientation, and jaws 1100 and 1200 must be closed. For example, to hold jaws 1100 and 1200 in the closed position for insertion purposes, the rotary drive system 2600 can be actuated to apply a second rotational movement to the rotary drive screw 2700 to move the firing member 2310 proximally from the starting position and move the anvil 1210 (jaw 1200) to the closed position. See FIG. 44. The rotary drive system 2600 is deactivated to hold the firing member 2310 in that position. Once the surgical end effector has entered the abdomen through the trocar, the rotary drive system 2600 can be actuated to drive the rotary drive screw 2700 to drive the firing member 2310 distally back to the starting position, where the anvil spring 1270 pivots the anvil 1210 to the open position. See FIG. 38.

[0066] Once inside the abdomen, before engaging the target tissue, the surgeon may need to articulate the surgical end effector 1000 to an advantageous position. The articulation control system 2240 is then actuated to articulate the surgical end effector in one or more planes with respect to a portion of the elongate shaft assembly 2000 received within the cannula of the trocar. When the surgeon aims the surgical end effector 1000 at the desired location, the articulation control system 2240 is deactivated to hold the surgical end effector 1000 in the articulated orientation. Next, the surgeon may use the surgical end effector to actuate the rotational drive system to rotate the rotational drive screw in a second rotational direction to move the firing member proximally and rapidly close the anvil 1210 to grasp tissue between the anvil 1210 and the surgical staple cartridge 1300, thereby grasping the target tissue or adjacent tissue. The anvil 1210 may be opened by reversing the rotation of the rotational drive screw 2700. This process may be repeated as necessary until the target tissue is properly positioned between the anvil 1210 and the surgical staple cartridge 1300.

[0067] Once the target tissue is positioned between the anvil 1210 and the surgical staple cartridge, the surgeon can initiate the closure and firing process by actuating the rotational drive system 2600 to drive the firing member 2310 distally from a start position. As the firing member 2310 moves distally from the start position, it imparts a closing motion to the anvil 1210, moving the anvil 1210 from the open position to the closed position in the manner described above. As the firing member 2310 moves distally, it holds the anvil 1210 in the closed position, thereby clamping the target tissue between the anvil 1210 and the surgical staple cartridge 1300. As the firing member 2310 moves distally, it contacts a sled 1312 supported within the surgical staple cartridge 1300 and drives the sled 1312 distally through the staple cartridge body 1302. The sled 1312 sequentially drives an array of drivers supported within the staple cartridge toward the clamped target tissue. Each driver has one or more surgical staples or fasteners supported thereon, which are then driven through the target tissue and into forming contact with the underside of the anvil 1210. As the firing member 2310 moves distally, a tissue-cutting edge 2314 thereon cuts the stapled tissue.

[0068] After the firing member 2310 is driven distally to its end position within the surgical end effector 1000 (FIG. 45), the rotary drive system 2600 is reversed, whereby the firing member 2310 retracts proximally back to its home or starting position. When the firing member 2310 returns to its starting position, the anvil spring 1270 pivots the anvil 1210 to its open position, enabling the surgeon to release the stapled tissue from the surgical end effector 1000. Once the stapled tissue is released, the surgical end effector can be withdrawn from the patient through the trocar cannula. To do so, the surgeon first actuates the articulation control system 2240 to return the surgical end effector 1000 to its non-articulated position and also actuates the rotary drive system to drive the firing member 2310 proximally from its home or starting position to close the jaws. Thereafter, the surgical end effector 1000 can be withdrawn from the trocar cannula. If the firing system becomes inoperable during or after the firing process, the surgeon may retract the firing member 2310 to its starting position by applying a tensile movement to the cables 2404, 2505 in the proximal direction in various manners described herein.

[0069] FIGS. 46-68 depict another surgical instrument 22010 that is identical or very similar in many respects to the surgical instrument 10 described above, except for the various differences discussed below. Similar to the surgical instrument 10, the surgical instrument 22010 can address many of the challenges faced by surgical instruments having an articulable end effector configured to cut and fasten tissue. In various embodiments, the surgical instrument 22010 may comprise a handheld device. In other embodiments, the surgical instrument 22010 may comprise an automated system, sometimes referred to as a robotic control system, for example. In various forms, the surgical instrument 22010 comprises a surgical end effector 23000 operably coupled to an elongate shaft assembly 24000. The elongate shaft assembly 24000 may be operably attached to a handheld housing or, alternatively, may include a portion of a robotic system as described above.

[0070] As seen in FIG. 49 , in one form, the surgical end effector 23000 includes a first jaw 23100 and a second jaw 23200. In the illustrated device, the first jaw 23100 includes an elongated channel 23110 having a proximal end 23112 and a distal end 23114 and configured to operably support a surgical staple cartridge 1300 therein. The elongated channel 23110 has an open bottom to facilitate ease of assembly and includes a channel cover 23113 configured to be attached (e.g., welded) thereto to cover the opening and add rigidity to the elongated channel 23110. In the illustrated device, the second jaw 23200 includes an anvil 23210 including an elongated anvil body 23212 having a proximal end 23214 and a distal end 23216. In one arrangement, an anvil cover 23213 is provided to facilitate assembly of the device and to add rigidity to the anvil 23210 when the anvil 23210 is attached (e.g., welded) to the anvil body 23212. The anvil body 23212 includes a staple-forming lower surface 23218 facing the first jaw 23100 and may include a series of staple-forming pockets (not shown) corresponding to each of the staples or fasteners in the surgical staple cartridge 1300. The proximal end 23214 of the anvil body 23212 includes an anvil mounting portion 23230 including a pair of laterally extending mounting pins 23232 configured to be received in corresponding mounting or pivot cradles 23120 formed in the proximal end 23112 of the elongated channel 23110. The mounting pin 23232 is pivotally retained within the mounting cradle 23120 by an anvil cap 23260, which may be attached to the proximal end 23112 of the elongated channel 23110 by screws 23261. In other arrangements, the anvil cap 23260 may be attached to the elongated channel 23110 by welding, adhesive, or the like. Such arrangements facilitate pivotal advancement of the anvil 23210 relative to the surgical staple cartridge 1300 mounted within the elongated channel 23110 about a pivot axis PA between an open position ( FIG. 47 ) and a closed position ( FIG. 48 ).Such a pivot axis PA may be referred to herein as "fixed" in that the pivot axis does not translate or otherwise move when the anvil 23210 is pivoted from the open position to the closed position.

[0071] In the illustrated arrangement, the anvil 23210 is moved to the open position by a pair of anvil springs 23270 supported within the proximal end 23112 of the elongate channel 23110. See FIGS. 49 and 62. The springs 23270 are positioned to apply a pivotal biasing force to a corresponding portion of the anvil 23210 to apply an opening force. See FIG. 47.

[0072] In the illustrated device, the elongate shaft assembly 24000 defines a shaft axis SA and comprises a proximal shaft portion 24100 that may be operatively associated with a housing of a control portion of the surgical instrument 22010 (e.g., a handheld unit, a robotic tool driver, etc.). The elongate shaft assembly 24000 further comprises an articulation joint 24200 attached to the proximal shaft portion 24100 and the surgical end effector 23000. In various examples, the proximal shaft portion 24100 comprises a hollow outer tube 24110 that may be operatively coupled to the housing in various manners as described above. As can be seen in FIG. 49 , the proximal shaft portion 24100 may further comprise a rigid proximal support shaft 24120 that is supported within the hollow outer tube 24110 and extends from the housing to the articulation joint 24200. The rigid proximal support shaft 24120 may comprise a first half 24120A and a second half 24120B that may be coupled together by, for example, welding, adhesive, etc. The rigid proximal support shaft 24120 comprises a proximal end 24122 and a distal end 24124 and includes an axial passage 24126 extending therethrough from the proximal end 24122 to the distal end 24124.

[0073] As described above, many surgical end effectors use a firing member that is axially movable and is pushed distally through a surgical staple cartridge by a firing beam. The firing beam is generally attached to the firing member in a central region of the firing member body. This attachment location can introduce an imbalance in the firing member as it is advanced through the end effector. Such an imbalance can lead to undesirable friction between the firing member and the end effector jaw. The generation of this additional friction may require the application of a higher firing force to overcome such friction, and may also cause undesirable wear on parts of the jaw and / or the firing member. Applying a higher firing force by the firing beam can result in undesirable flexure in the firing beam as it crosses the articulation joint. Such additional deflection can unlock the articulation of the articulation joint, particularly when the surgical end effector is articulated at a relatively high articulation angle. Surgical instrument 22010 employs a firing system 24300 that is identical or very similar in many respects to the firing system 2300 described above. Accordingly, only those aspects of the firing system 24300 that are necessary to understand the operation of the surgical instrument 22010 are discussed below.

[0074] As can be seen in FIGS. 50-54 , in at least one embodiment, the firing system 24300 comprises a firing member 24310 including a vertically extending firing member body 24312 comprising an upper firing member feature 24320 and a lower firing member feature 24350. A tissue-cutting blade 24314 is attached to or formed within the vertically extending firing member body 24312. See FIGS. 50 and 51 . In at least one device, it is desirable for the firing member 24310 to pass through the anvil body 23212 with low friction, high strength, and high stiffness. In the illustrated device, the upper firing member feature 24320 comprises a T-shaped body 24322 having two laterally extending tabs 24323 projecting therefrom and an upper axial passage 24324 extending therethrough. See FIG. 53 . The lower firing member feature 24350 comprises a T-shaped body 24352 having two laterally extending tabs 24353 projecting therefrom and a lower axial passage 24354 extending therethrough. See FIG. 50 . In at least one device, the upper firing member feature 24320 and the lower firing member feature 24350 are integrally formed with the vertically extending firing member body 24312. As seen in FIG. 54 , the anvil body 23212 comprises an axially extending anvil slot 23240 defining two opposed ledges 23241 for slidably receiving the laterally extending tabs 24323 thereon. Similarly, the elongated channel 23110 comprises an axially extending channel slot 23140 defining an axially extending channel ledge 23141 configured to slidably receive the laterally extending tabs 24353 thereon.

[0075] In the illustrated apparatus, the launch system 24300 includes an upper flexible spine assembly 24400 operably coupled to an upper launch member feature 24320 of a launch member 24310. In at least one embodiment, the upper flexible spine assembly 24400 includes an upper series 24410 of upper vertebra members 24420 that extend through each of the upper vertebra members 24420 and are loosely coupled together by upper flexible connector members 24440 attached to the upper launch member feature 24320.

[0076] As seen in FIG. 52, each upper vertebra member 24420 is substantially T-shaped when viewed from its end. In one aspect, each upper vertebra member 24420 includes an upper vertebra body portion 24422 having a proximal end 24424 and a distal end 24428. Each upper vertebra member 24420 further includes an upper drive feature or upper vertebra member tooth 24450 that extends downwardly and projects from the upper vertebra body portion 24422. Each upper vertebra member tooth 24450 has a helical proximal upper surface portion 24452 and a helical distal upper surface portion 24454. Each proximal end 24424 of the upper vertebra body portion 24422 has an arcuate or slightly concave curved shape, and each distal end 24428 has an arcuate or slightly convex curved shape. When disposed in the upper series 24410, the convex distal end 24428 on one upper vertebra member 24420 contacts and mates with the concave proximal end 24424 on an adjacent upper vertebra member 24420 within the upper series 24410 to maintain the upper vertebra members 24420 in a substantially aligned state, such that the helical proximal upper surface portion 24452 and the helical distal upper surface portion 24454 on each respective upper vertebra member tooth 24450 can be drivingly engaged by a rotary drive screw 2700 in various manners disclosed herein. These curved mating surfaces on the upper vertebra members 24420 allow for better load transfer therebetween even when the upper vertebra members 24420 are tilted.

[0077] In at least one embodiment, the upper alignment member 24480 is used to assist in aligning the upper vertebral member 24420 in the upper series 24410. In one device, the alignment member 24480 can include a spring member or a metal cable that can be made from nitinol wire, spring steel, etc., and is formed with a distal upper loop end 24482 and two upper leg portions 24484 that extend through corresponding upper passages 24425 within each upper vertebral body portion 24422. The upper flexible connector member 24440 extends through each upper passage 24429 of the upper vertebral member 24420 so as to be attached to the firing member 24310. In particular, the distal end portion 24442 extends through an upper axial passage 24324 within the upper firing member feature 24320 and is secured therein by an upper retaining lug 24444. The proximal portion of the upper flexible connector member 24440 may cooperate with corresponding rotary spools or cable management systems of various types and designs disclosed herein that function to pay out and take up the upper flexible connector member 24440 and maintain a desired amount of tension therein during operation and articulation of the surgical end effector 23000. The cable management system may be motor-powered or manual (such as a ratchet device) to maintain a desired amount of tension in the upper flexible connector member 24440. The amount of tension in each flexible connector member can vary depending on the relative positioning of the surgical end effector 23000 with respect to the elongate shaft assembly 24000.

[0078] The launch system 24300 further includes a lower flexible spine assembly 24500 operably coupled to a lower launch member feature 24350. The lower flexible spine assembly 24500 includes a lower series 24510 of lower vertebra members 24520 that extend through each of the lower vertebra members 24520 and are loosely coupled together by lower flexible connector members 24540 attached to the lower launch member feature 24350. As can be seen from FIG. 52, each lower vertebra member 24520 is substantially T-shaped when viewed from its end. In one aspect, each lower vertebra member 24520 includes a lower vertebra body portion 24522 having a proximal end 24524 and a distal end 24528. Each lower vertebra member 24520 further includes a downwardly extending lower drive feature or lower vertebra member tooth 24550 that projects from the lower vertebra body portion 24522. Each lower vertebra member tooth 24550 has a helical proximal lower surface portion 24552 and a helical distal lower surface portion 24554. The proximal end 24524 of the lower vertebra body portion 24522 has an arcuate or slightly concave curved shape, and each distal end 24528 has an arcuate or slightly convex curved shape. When disposed in the lower series 24510, the convex distal end 24528 on one lower vertebra member 24520 contacts and mates with the concave proximal end 24524 on an adjacent lower vertebra member 24520 within the lower series 24510 to maintain the lower vertebra members 24520 in a substantially aligned state, such that the helical proximal lower surface portion 24552 and the helical distal lower surface portion 24554 on each respective lower vertebra member tooth 24550 can be drivingly engaged by a rotary drive screw 2700 in various manners disclosed herein. These curved mating surfaces on the lower vertebra members 24520 allow for better load transfer therebetween even when the lower vertebra members 24520 are tilted.

[0079] In at least one embodiment, the lower alignment member 24580 is used to assist in aligning the lower vertebral member 24520 in the lower series 24510. In one device, the lower alignment member 24580 can include a spring member or a metal cable that can be made from nitinol wire, spring steel, etc., and includes a distal lower loop end 24582 and two lower leg portions 24584 that extend through corresponding lower passages 24525 within each lower vertebral body portion 24522. The lower flexible connector member 24540 extends through each lower passage 24529 of the lower vertebral member 24520 so as to be attached to the firing member 24310. In particular, the distal end portion 24542 of the lower flexible connector member 24540 extends through a lower axial passage 24354 within the lower firing member feature 24350 and is fixed therein by a lower retaining lug 24544. The proximal portion of the lower flexible connector member 24540 may be associated with corresponding rotary spools or cable management systems of various types and designs disclosed herein that function to pay out and retract the lower flexible connector member 24540 and maintain a desired amount of tension therein during the operation and articulation of the surgical end effector 23000. The cable management system may be motor-powered or manual (such as a ratchet device) to maintain a desired amount of tension in the lower flexible connector member 24540. The amount of tension in each flexible connector member can vary depending on the relative positioning of the surgical end effector 23000 with respect to the elongate shaft assembly 24000.

[0080] According to at least one embodiment, a large surface area is advantageous for distributing forces between the vertebra members as they push so that they cannot twist relative to one another. The available area within the anvil and channel is limited, and the anvil and channel must remain rigid. The T-shaped upper vertebra member 24420 and the T-shaped lower vertebra member 24520 are designed to fit within the limited space available within the anvil 23210 and elongated channel 23110 while ensuring that there is a large area for distributing firing loads. The curved surfaces on each upper vertebra member 24420 and each lower vertebra member 24520 allow each of these vertebrae to better transfer loads between themselves, even when they are angled. The upper alignment member 24480 and the lower alignment member 24580 may also function to prevent the upper vertebra member 24420 and the lower vertebra member 24520 from twisting relative to one another. The large surface area may also help prevent wear on the vertebra members and / or the anvil and channel. The upper flexible spine assembly 24400 and the lower flexible spine assembly 24500 are otherwise operatively associated with the rotary drive screw 2700 apparatus as disclosed herein. The upper flexible coupler member 24440 and the lower flexible coupler member 24540 may also be used in the manner described above to retract the firing member 24310 to its starting position in the event of a failure of the firing drive system 24300 during the firing stroke.

[0081] As can be seen from FIG. 51, the upper launch member feature 24320 on the launch member 24310 includes a distal upper launch member tooth segment 24330 that corresponds to half of the upper vertebra member teeth 24450 on each upper vertebra member 24420. In addition, two proximal upper launch member teeth 24336 that are identical to the upper vertebra member teeth 24450 on each upper vertebra member 24420 are spaced apart from the distal upper launch member tooth segment 24330. The distal upper launch member tooth segment 24330 and the proximal upper launch member teeth 24336 may each be integrally formed with the upper launch member feature 24320 of the launch member 24310. Similarly, the lower launch member feature 24350 of the launch member 24310 includes a distal lower launch member tooth 24360 and two proximal lower launch member teeth 24366 that are integrally formed on the lower launch member feature 24350. For example, in at least one device, the launch member 24310 having the securely attached teeth 24330, 24336, 24360, and 24366 may be fabricated as one integral component at once using conventional metal injection molding techniques. One of ordinary skill in the art will recognize that the launch member 24310 operates in essentially the same manner as the launch member 2310 described in detail herein.

[0082] Referring now to FIGS. 55-58, according to at least one aspect, the articulation joint 24200 includes a movable exoskeleton assembly 24800. In one form, the movable exoskeleton assembly 24800 includes a series 24802 of annular rib members 24810 that are movably interconnected. As seen in FIGS. 55-57, each annular rib member 24810 includes a first or proximal surface 24820 that includes a convex or domed portion 24822. Each annular rib member 24810 further includes a second or distal surface 24830 that is concave or dish-shaped. Each annular rib member 24810 further includes an upper spine passage 24840 configured to accommodate passage of the upper flexible spine assembly 24400 therethrough and a lower spine passage 24842 configured to accommodate passage of the lower flexible spine assembly 24500 therethrough. Additionally, each annular rib member 24810 further includes four articulation movement passages 24850, 24852, 24854, and 24856 for accommodating passage of articulation movement actuators in the form of articulation movement cables 24242, 22446, 24250, and 24254. See FIG. 49. Each annular rib member 24810 further includes a central drive passage 24860 configured to accommodate passage of a constant velocity (CV) drive shaft assembly 2620 therethrough.

[0083] 58 , the mobile exoskeleton assembly 24800 comprises a proximal attachment rib 24870 configured to attach the mobile exoskeleton assembly 24800 to the distal end 24124 of the proximal support shaft 24120 by cap screws 24880 or other suitable fastener devices. The proximal attachment rib 24870 comprises a first or distal surface 24872 that is concave or dished to receive or otherwise movably cooperate with the convex or dome-shaped portion 24822 of the proximal surface 24820 of the proximal-most annular rib member 24810P. Similarly, the mobile exoskeleton assembly 24800 comprises a distal attachment rib 24890 configured to attach the mobile exoskeleton assembly 24800 to the proximal end 23112 of the elongate channel 23110 by cap screws 24882 or other suitable fastener devices. The distal mounting rib 24890 includes a first or proximal surface 24892 including a convex or dome-shaped portion 24894 configured to be received within or movably engage the concave or dished distal surface 24832 of the distal-most annular rib member 24810D. In various embodiments, the annular rib members 24810, 24810P, and 24810D may be fabricated from any suitable metal (e.g., stainless steel, titanium, etc.) or other suitable material. The annular rib members 24810, 24810P, and 24810D may be formed by machining or casting, by a suitable drawing or forming operation. The proximal and distal surfaces 24820, 24830 may be polished or otherwise finished to a desired smooth finish to reduce friction and facilitate movement between the annular rib members 24810, 24810P, and 24810D. According to one aspect, all edges on each annular rib member 24810, 24810P, 24810D are rounded to facilitate relative movement between the annular rib members. The proximal attachment rib 24870 and distal attachment rib 24890 may be formed with similar attributes.

[0084] Surgical instrument 22010 also includes an articulation system 24240 configured to articulate the surgical end effector 23000 relative to the elongate shaft assembly 24000 in addition to articulating joint movement to the surgical end effector 23000. In at least one device, for example, as described above, the articulation system 24240 includes four articulation cables 24242, 24246, 24250, and 24254 that extend through the elongate shaft assembly 2400. See FIG. 49. In the illustrated device, the articulation cables 24242, 24246 pass through the proximal attachment rib 24870 and through each of the annular rib members 24810P, 24810, and 24810D and are fixed to the distal attachment rib 24890. For example, in one device, each of the articulation cables 24242, 24246 is fixed to the distal attachment rib 24890 by a corresponding attachment lug 24243. See FIGS. 61 and 63. Similarly, the articulation cables 24250 and 24254 pass through the proximal attachment rib 24870, extend through each of the annular rib members 24810P, 24810, and 24810D, and are fixed to the distal attachment rib 24890 by corresponding attachment lugs 24243.

[0085] In one device, each of the articulation cables 24242, 24246, 24250, and 24254 extends through a corresponding coil spring 24896 supported within a cavity 24125 in the distal end 24124 of the rigid proximal support shaft 24120. Additionally, each coil spring 24896 is associated with a tension lug 24897 which is also pivotally supported and fixed on each respective articulation cable 24242, 24246, 24250, and 24524 to achieve a desired amount of compression in each spring 24896 that serves to hold the annular rib members 24810P, 24810, and 24810D movably engaged with each other and with the proximal attachment rib 24870 and the distal attachment rib 24890. The cables 24242, 24246, 24250, and 24254 are operably coupled with an articulation control system supported within the housing of the surgical instrument 22010. For example, as described above, the proximal portions of each cable 24242, 24246, 24250, and 24254 may be wound onto corresponding rotary spools or cable management systems 2007 (FIG. 2) within a housing portion of the surgical instrument 22010 configured to payout and retract each cable 24242, 24246, 24250, and 24254 in a desired pattern. The spool / cable management system may be motor-powered or manually-powered (such as a ratchet device). FIG. 59 illustrates the joint 24200 in a non-articulated position and FIG. 60 illustrates the joint in one articulated configuration. With such a device, the surgical end effector 23000 can articulate through multiple articulation planes with respect to the elongate shaft assembly 24000.

[0086] As seen in FIGS. 49, 58, and 64, the surgical instrument 22010 employs a constant velocity (CV) drive shaft assembly 2620 that spans or extends axially through the articulation joint 24200. The operation and construction of the CV drive shaft assembly 2620 have been described in detail above and will not be repeated here beyond the extent necessary to understand the operation of the surgical instrument 22010. Briefly, as noted above, the CV drive shaft assembly 2620 comprises a proximal CV drive assembly 2630 and a distal CV drive shaft 2670. The proximal CV drive assembly 2630 comprises a proximal shaft segment 2632 comprised of a mounting shaft 2634 configured to be non-rotatably received within a similarly shaped coupler cavity 2616 in the distal end 2614 of the proximal rotational drive shaft 2610. The proximal shaft segment 2632 is in operative association with a series 2640 of movably coupled drive couplings 2650. As seen in FIG. 58 and described above, to ensure that the drive couplings 2650 are engaged with one another, a proximal drive spring 2740 is used to apply an axial biasing force to the series 2640 of drive couplings 2650. For example, as can be seen in FIG. 58 , the proximal drive spring 2740 is disposed between the proximal mounting bushing 2734 and a support flange formed between the distal socket portion 2636 and the proximal barrel portion 2638 of the proximal shaft segment 2632. In one arrangement, the proximal drive spring 2740 may comprise an elastomeric O-ring received on the proximal barrel portion 2638 of the proximal shaft segment 2632. The proximal drive spring 2740 lightly biases the drive couplings 2650 together to reduce any clearance that occurs during articulation. This ensures that the drive couplings 2650 transmit loads torsionally. However, it will be appreciated that in at least one device, the proximal drive spring 2740 does not apply a sufficiently high axial load to create a firing load to translate through the articulation joint 2200.

[0087] To further prevent the drive joint 2650 from buckling during articulation, a series 2640 of movably coupled drive joints 2650 extends through at least one low friction drive portion cover 24730 that extends through each central drive passage 24860 of the annular rib member 24810. In the apparatus shown in FIGS. 63 and 65, the drive portion cover 24730 includes outer and inner cut hypo tubes 24732. Such hypo tubes 24732 may be made of metal (e.g., stainless steel, etc.) and may have a plurality of series of cut portions or slits made using a laser cutter device therein. In the illustrated apparatus, the hypo tube 24732 may be fabricated with an upper relief passage 24734 that provides clearance for the upper flexible spine assembly 24400 to pass over it during operation while the surgical end effector 23000 is in the articulated position. Additionally, the hypo tube 24732 may have a lower relief passage 24736 to provide similar clearance for the lower flexible spine assembly 24500. Also, as seen in FIG. 65, the hypo tube 24732 may be shaped with diametrically opposed lateral tab portions 24738 to provide lateral stability during articulation. FIG. 66 shows an alternative drive portion cover 24730' that includes an inner cut hypo tube 24732'. FIGS. 58, 67, 68, and 69 illustrate alternative drive portion covers 24730'' that include a flexible heat shrink tube 24732'' applied over the constant velocity (CV) drive shaft assembly 2620. In still other apparatuses, the drive portion cover may also include a coil spring or coil member.

[0088] Various embodiments of the present disclosure provide advantages over previous surgical end cutter configurations that allow for articulation. For example, pushing a firing member forward in an articulating end effector generally requires a lot of force, which must be balanced. For example, when firing the firing member at an angle greater than 60 degrees, it becomes very difficult to push the beam through the articulation joint. The joint also receives a significant load that can disarticulate the articulation joint. By employing an upper flexible drive and a lower flexible drive that are each flexible through the articulation joint but become rigid when distal to the articulation joint, a large range of articulation (e.g., an articulation angle greater than 70 degrees) can be achieved while applying a balanced load that is constrained by the firing member rather than the articulation joint. In other words, instead of a longitudinal load that can cause disarticulation of the end effector, a torsional load is applied proximal to the articulation joint. The torsional load is converted to a longitudinal load at a location distal to the articulation joint. Thus, the rotary drive screw functions to actually convert the torsional motion or load to a longitudinal load applied to the firing member at a location distal to the articulation joint.

[0089] Furthermore, by longitudinally disassembling the threaded drive, the threaded drive can pass through the articulation joint while effectively reducing the length of the surgical end effector. For example, each single vertebra tooth is significantly shorter than a plurality of pitches that are rigidly connected. The vertebra can be angled as it passes through the articulation joint. This flexible interconnect allows the rotary drive screw to be positioned closer to the articulation joint compared to being significantly spaced from the articulation joint if all of the pitches were rigidly connected.

[0090] Example 1 - A surgical instrument comprising an elongate shaft having a surgical end effector coupled to the elongate shaft by an articulation joint configured to facilitate selective articulation of the surgical end effector relative to the elongate shaft. A constant speed drive shaft assembly spans the articulation joint and is configured to impart rotational motion to a portion of the surgical end effector. The constant speed drive shaft assembly comprises a series of movable drive joints. Each movable drive joint is capable of moving relative to one another in multiple planes. A movable exoskeleton spans the articulation joints and comprises a series of movably coupled annular rib members. Each annular rib member has a first end and a second end. The first end of one annular rib member is configured to movably couple with the second end of an adjacent annular rib member to facilitate relative movement therebetween in multiple directions. Each annular rib member includes a central opening such that the central openings of each annular rib member cooperate to form a passageway through the series of movably associated annular rib members for receiving a constant speed drive shaft assembly therethrough.

[0091] Example 2 - The surgical instrument of Example 1, further comprising a flexible drive cover configured to movably support the series of movable drive joints, the flexible drive cover configured to maintain each movable drive joint in the series of movable drive joints in movably engagement with one another and sized to pass through the passages in the series of movably associated annular rib members.

[0092] Example 3 - The surgical instrument of Example 2, wherein the flexible drive cover comprises heat shrink tubing.

[0093] Example 4 - The surgical instrument of Example 2, wherein the flexible drive cover comprises a coiled member.

[0094] Example 5 - The surgical instrument of Example 2, wherein the flexible drive cover comprises a tube with a series of offset slits therein.

[0095] Example 6 - The surgical instrument of Examples 1, 2, 3, 4, or 5, wherein each movable drive joint comprises a first spherical portion including a socket cavity. The second spherical portion is sized to be rotatably received within the socket cavity in the first spherical portion of an adjacent movable drive joint in the series of movable drive joints. A pair of diametrically opposed pins protrude from the second spherical portion. Each pin is configured to be movably received within a corresponding pin slot in the first spherical portion of the adjacent drive joint, and is configured to rotate and move axially therein.

[0096] Example 7 - The surgical instrument of Examples 1, 2, 3, 4, 5, or 6, further comprising a proximal rotary drive shaft configured to impart a rotary drive motion to the constant speed drive shaft assembly.

[0097] Example 8 - The surgical instrument of Example 7, further comprising a proximal mounting shaft comprising a proximal mounting portion configured to operatively communicate with the proximal rotational drive shaft, the mounting shaft socket portion configured to rotatably receive therein the second spherical portion of the proximal-most movable drive coupling.

[0098] Example 9 - The surgical instrument of Examples 1, 2, 3, 4, 5, 6, 7, or 8, further comprising a distal drive shaft configured to operatively couple with the movable distal-most drive joint.

[0099] Example 10 - The surgical instrument of Example 9, further comprising a firing member supported for axial advancement within the surgical end effector between a start position and an end position. An upper flexible spine assembly is attached to an upper portion of the firing member. A lower flexible spine assembly is attached to a lower portion of the firing member. A distal drive shaft is configured to impart a rotational drive motion to the upper and lower flexible spine assemblies.

[0100] Example 11 - The surgical instrument according to Example 10, wherein each annular rib member includes an upper spine passage configured to accommodate the passage of the upper flexible spine assembly. The lower spine passage is configured to accommodate the passage of the lower flexible spine assembly.

[0101] Example 12 - The surgical instrument according to any one of Examples 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11, further comprising a plurality of flexible articulation actuating members configured to span a joint and apply an articulating motion to the surgical end effector. Each annular rib member includes therein an articulation passage corresponding to each flexible articulation actuating member, allowing for a movable passage therethrough.

[0102] Example 13 - A movable outer skeleton assembly for a surgical instrument. The movable outer skeleton assembly includes a series of annular rib members movably interconnected and configured to span the joint of the surgical instrument. Each movably interconnected annular rib member includes a cup-shaped end and a dome-shaped end. The cup-shaped end of one movably interconnected annular rib member is movably interconnected with the dome-shaped end of an adjacent movably interconnected annular rib member and is configured to facilitate relative movement in a plurality of directions therebetween. Each movably interconnected annular rib member includes a central opening, such that the central openings of each interconnected annular rib member cooperate to form a passage through the series of movably interconnected annular rib members, allowing a drive component to pass therethrough.

[0103] Example 14 - The movable outer skeleton assembly according to Example 13, further comprising a flexible hollow support member received within the passage and configured to operably support a drive component therethrough.

[0104] Example 15 - The movable outer skeleton assembly according to Example 14, wherein the flexible hollow support member includes a heat shrinkable tube.

[0105] Example 16 - The mobile exoskeleton assembly of Example 14, wherein the flexible hollow support member comprises heat shrink tubing.

[0106] Example 17 - The ambulatory exoskeleton assembly of Example 14, wherein the flexible cover comprises a tube with a series of offset slits therein.

[0107] Example 18 - A surgical instrument comprising an elongate shaft having a surgical end effector coupled to the elongate shaft by an articulation joint configured to facilitate selective articulation of the surgical end effector relative to the elongate shaft. The surgical end effector comprises a first jaw and a second jaw configured to move relative to the first jaw between an open position and a closed position. A firing member is supported for axial advancement within the surgical end effector between a start position and an end position. The surgical instrument further comprises an upper flexible spine assembly attached to an upper portion of the firing member. A lower flexible spine assembly is attached to a lower portion of the firing member. A rotational drive is configured to move the firing member between the start position and the end position. The movable exoskeleton comprises a series of annular rib members spanning and movably associated with the articulation joint. Each annular rib member has a proximal end and a distal end. The proximal end of one of the annular rib members is configured to movably associate with the distal end of an adjacent annular rib member to facilitate relative movement therebetween in multiple directions, and each annular rib member includes a central opening that cooperates to form a passageway through the series of annular rib members for receiving a portion of the rotary drive therethrough.

[0108] Example 19 - The surgical instrument of Example 18, wherein each annular rib member includes a proximal cup-shaped end and a distal dome-shaped end, wherein the proximal cup-shaped end of one annular rib member is configured to movably associate with the distal dome-shaped end of an adjacent annular rib member to facilitate relative movement therebetween in multiple directions.

[0109] The surgical instrument according to Example 18 or 19, further comprising a flexible hollow support member received in the passageway and configured to allow a portion of the rotational drive unit to pass through the passageway.

[0110] When used in any aspect of this specification, the term "control circuit" can refer to, for example, a hardwired circuit, a programmable circuit (e.g., a computer processor, processing unit, processor, microcontroller, microcontroller unit, controller, digital signal processor (DSP), programmable logic device (PLD), programmable logic array (PLA), or field programmable gate array (FPGA) that includes one or more individual instruction processing cores), a state machine circuit, firmware that stores instructions executed by a programmable circuit, and any combination thereof. The control circuit can be embodied, collectively or individually, as a circuit that forms part of a larger system, such as an integrated circuit (IC), an application specific integrated circuit (ASIC), a system on chip (SoC), a desktop computer, a laptop computer, a tablet computer, a server, a smartphone, etc. Thus, as used herein, "control circuit" refers to an electrical circuit having at least one individual electrical circuit, an electrical circuit having at least one integrated circuit, an electrical circuit having at least one application specific integrated circuit, an electrical circuit forming a general purpose computing device configured by a computer program (e.g., a general purpose computer configured by a computer program that at least partially executes the processes and / or devices described herein, or a microprocessor configured by a computer program that at least partially executes the processes and / or devices described herein), an electrical circuit forming a memory device (e.g., in the form of a random access memory), and / or an electrical circuit forming a communication device (e.g., a modem, a communication switch, or an optical-electrical facility), but is not limited thereto. Those skilled in the art will recognize that the subject matter described herein may be implemented in analog form, digital form, or some combination thereof.

[0111] Although several forms have been shown and described, it is not the intention of the applicant to limit or restrict the appended claims in such detail. Many modifications, variations, changes, substitutions, combinations, and equivalents of these forms can be implemented and would be envisioned by those skilled in the art without departing from the scope of the present disclosure. Further, the structure of each element related to the forms described can alternatively be described as a means for providing the function implemented by that element. Also, although materials are disclosed with respect to specific components, other materials may be used. Accordingly, it should be understood that the foregoing description and the appended claims are intended to cover all such modifications, combinations, and variations as being within the scope of the disclosed forms. The appended claims are intended to cover all such modifications, variations, changes, substitutions, modifications, and equivalents.

[0112] One or more components may be referred to in this specification as "configured to", "configurable to", "operable / operative to", "adapted / adaptable", "able to", "conformable / conformed to", and the like. Those skilled in the art will understand that "configured to" generally can include components in an active state and / or components in a non-active state and / or components in a standby state, except where the context dictates otherwise.

[0113] Those skilled in the art will understand that the terms used herein generally, and in the appended claims in particular (e.g., the body of the appended claims), are generally intended as “open” terms (e.g., the term “including” should be interpreted as “including but not limited to,” the term “having” should be interpreted as “having at least,” the term “includes” should be interpreted as “includes but is not limited to,” etc.). Furthermore, those skilled in the art will understand that where a specific number is intended in an introduced claim recitation, such intention will be clearly recited in the claim; and, in the absence of such recitation, no such intention exists. For example, as an aid to understanding, the appended claims below may include the introductory phrases “at least one” and “one or more” to introduce the claim recitation. However, the use of such phrases should not be construed as suggesting that when a claim is introduced by the indefinite article "a" or "an," any particular claim containing such introduced claim language is limited to claims containing only one such recitation, even if the same claim contains an introductory phrase such as "one or more" or "at least one" and the indefinite article "a" or "an" (e.g., "a" and / or "an" should normally be construed to mean "at least one" or "one or more"). The same applies when a definite article is used to introduce a claim.

[0114] In addition, even if a specific number is specified in the introduced claim description, those skilled in the art will recognize that such description should typically be construed to mean at least the recited number (e.g., in the case of a mere recitation of "two items" without other modifiers, generally it means at least two items, or two or more items). Further, when an expression such as "at least one of A, B, and C" is used, generally such syntax is intended in the sense that those skilled in the art will understand the expression (e.g., "a system having at least one of A, B, and C" includes, but is not limited to, a system having only A, only B, only C, both A and B, both A and C, both B and C, and / or all of A, B, and C). When an expression such as "at least one of A, B, or C" is used, generally such syntax is intended in the sense that those skilled in the art will understand the expression (e.g., "a system having at least one of A, B, or C" includes, but is not limited to, a system having only A, only B, only C, both A and B, both A and C, both B and C, and / or all of A, B, and C). Further, typically, any disjunctive word and / or phrase representing two or more alternative terms should be understood to be intended to include one of those terms, any of those terms, or both of those terms, whether in the specification, in the claims, or in the drawings, unless the context requires otherwise. For example, the phrase "A or B" will typically be understood to include the possibilities of "A" or "B" or "A and B".

[0115] Regarding the appended claims, those skilled in the art will understand that the recited operations herein can generally be performed in any order. Also, although the flowcharts of various operations are shown in sequence, it should be understood that the various operations may be performed in an order other than that shown, or may be performed simultaneously. Examples of such alternative orderings may include repetition, interleaving, interruption, reordering, incremental, preparatory, additional, simultaneous, reverse, or other different orderings, except where the context dictates otherwise. Further, terms such as "responsive to", "associated with", or other past tense adjectives are generally not intended to exclude such variations, except where the context dictates otherwise.

[0116] It is worth noting that any reference to "one aspect", "aspect", "exemplification", "an exemplification", etc. means that the specific feature, structure, or characteristic described in relation to that aspect is included in at least one aspect. Thus, the phrases "in one aspect", "in an aspect", "in an exemplification", and "in an exemplification" that appear in various places throughout this specification do not necessarily all refer to the same aspect. Further, the specific features, structures, or characteristics can be combined in any suitable manner in one or more aspects.

[0117] Any patent application, patent, non-patent publication, or other disclosure material referred to herein and / or listed in any application data sheet is incorporated herein by reference to the extent that the incorporated material is not inconsistent with this specification. In itself, and to the extent necessary, the disclosure clearly set forth herein shall supersede any conflicting description incorporated herein by reference. Although it is stated to be incorporated herein by reference, any content, or portions thereof, that conflict with the current definitions, views, or other disclosure content set forth herein shall be incorporated only to the extent that no conflict arises between the incorporated content and the current disclosure content.

[0118] In summary, many benefits resulting from using the concepts described herein have been described. The above description in one or more forms is presented for purposes of illustration and explanation. It is not intended to be exhaustive or to limit the disclosure to the precise forms disclosed. Modifications or variations are possible in light of the above teachings. One or more forms are selected and described to illustrate principles and practical applications and thereby enable one of ordinary skill in the art to utilize the various forms, with various modifications, as suitable for the particular uses contemplated. The claims presented along with this specification are intended to define the overall scope.

[0119] The surgical instrument system described herein has been described in relation to staple deployment and deformation. However, the embodiments described herein are not limited thereto. For example, various embodiments are envisioned that deploy fasteners other than staples, such as clamps or tacks. Further, various embodiments are envisioned that utilize any suitable means for sealing tissue. For example, end effectors according to various embodiments may comprise electrodes configured to heat and seal tissue. Also for example, an end effector according to a particular embodiment may be capable of applying vibrational energy to seal tissue.

[0120] Many of the surgical instrument systems described herein are driven by an electric motor. However, the surgical instrument systems described herein can be driven in any suitable manner. In various instances, the surgical instrument systems described herein can be driven, for example, by a manually operated trigger. In a particular example, the motors disclosed herein can comprise one or more portions of a robotic control system. Further, any of the end effectors and / or tool assemblies disclosed herein can be utilized with a robotic surgical instrument system. For example, U.S. Patent Application No. 13 / 118,241, entitled "SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS" (U.S. Patent No. 9,072,535), discloses some examples of robotic surgical instrument systems in more detail.

[0121] The entire contents of the following disclosure are incorporated herein by reference. U.S. Patent No. 5,403,312, entitled "ELECTROSURGICAL HEMOSTATIC DEVICE", issued on April 4, 1995, U.S. Patent No. 7,000,818, entitled "SURGICAL STAPLING INSTRUMENT HAVING SEPARATE DISTINCT CLOSING AND FIRING SYSTEMS", issued on February 21, 2006, U.S. Patent No. 7,422,139, entitled "MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING INSTRUMENT WITH TACTILE POSITION FEEDBACK", issued on September 9, 2008, U.S. Patent No. 7,464,849, entitled "ELECTRO-MECHANICAL SURGICAL INSTRUMENT WITH CLOSURE SYSTEM AND ANVIL ALIGNMENT COMPONENTS", issued on December 16, 2008, U.S. Patent No. 7,670,334, issued on March 2, 2010, titled "SURGICAL INSTRUMENT HAVING AN ARTICULATING END EFFECTOR", U.S. Patent No. 7,753,245, issued on July 13, 2010, titled "SURGICAL STAPLING INSTRUMENTS", U.S. Patent No. 8,393,514, issued on March 12, 2013, titled "SELECTIVELY ORIENTABLE IMPLANTABLE FASTENER CARTRIDGE", U.S. Patent Application No. 11 / 343,803, titled "SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES", now U.S. Patent No. 7,845,537, U.S. Patent Application No. 12 / 031,573, filed on February 14, 2008, titled "SURGICAL CUTTING AND FASTENING INSTRUMENT HAVING RF ELECTRODES", U.S. Patent Application No. 12 / 031,873, filed on February 15, 2008, titled "END EFFECTORS FOR A SURGICAL CUTTING AND STAPLING INSTRUMENT", now U.S. Patent No. 7,980,443, U.S. Patent Application No. 12 / 235,782, titled "MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT", now U.S. Patent No. 8,210,411, U.S. Patent Application No. 12 / 235,972, titled "MOTORIZED SURGICAL INSTRUMENT", now U.S. Patent No. 9,050,083, U.S. Patent Application No. 12 / 249,117, titled "POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY RETRACTABLE FIRING SYSTEM", now U.S. Patent No. 8,608,045, U.S. Patent Application No. 12 / 647,100, filed December 24, 2009, entitled "MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT WITH ELECTRIC ACTUATOR DIRECTIONAL CONTROL ASSEMBLY," now U.S. Patent No. 8,220,688; U.S. Patent Application No. 12 / 893,461, filed September 29, 2012, now U.S. Patent No. 8,733,613, entitled "STAPLE CARTRIDGE"; U.S. Patent Application No. 13 / 036647, filed February 28, 2011, now U.S. Patent No. 8,561,870, entitled "SURGICAL STAPLING INSTRUMENT"; U.S. Patent Application No. 13 / 118,241, entitled "SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS," now U.S. Patent No. 9,072,535; U.S. Patent Application No. 13 / 524,049, filed June 15, 2012, entitled "ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE," now U.S. Patent No. 9,101,358; U.S. Patent Application No. 13 / 800,025, filed March 13, 2013, entitled "STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM," now U.S. Patent No. 9,345,481; U.S. Patent Application No. 13 / 800,067, filed March 13, 2013, entitled "STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM" (now U.S. Patent Application Publication No. 2014 / 0263552); U.S. Patent Application Publication No. 2007 / 0175955, filed January 31, 2006, entitled "SURGICAL CUTTING AND FASTENING INSTRUMENT WITH CLOSURE TRIGGER LOCKING MECHANISM"; and U.S. Patent Application Publication No. 2010 / 0264194, filed April 22, 2010, entitled "SURGICAL STAPLING INSTRUMENT WITH AN ARTICULATABLE END EFFECTOR," now U.S. Patent No. 8,308,040.

[0122] Although various devices are described herein in conjunction with specific embodiments, modifications and variations may be made to those embodiments. Particular features, structures, or characteristics may be combined in any suitable manner in one or more embodiments. Thus, a particular feature, structure, or characteristic illustrated or described with respect to one embodiment may be combined in whole or in part with the feature, structure, or characteristic of one or more other embodiments, without limitation. Also, although materials are disclosed with respect to particular components, other materials may be used. Furthermore, multiple components may be substituted for a single component, and multiple components may be substituted for a single component, to perform a given function, according to various embodiments. The foregoing description and the following claims are intended to cover all such modifications and variations.

[0123] The devices disclosed herein can be designed to be discarded after a single use or can be designed for multiple uses. However, in either case, the device can be reconditioned for reuse after at least one use. Reconditioning can include, but is not limited to, any combination of disassembling the device, followed by cleaning or replacing certain parts of the device, and then reassembling the device. Specifically, a reconditioning facility and / or surgical team can disassemble the device, clean and / or replace certain parts of the device, and then reassemble the device for subsequent use. One of ordinary skill in the art will understand that various techniques for disassembly, cleaning / replacement, and reassembly can be utilized for reconditioning the device. The use of such techniques, and the resulting reconditioned device, are all within the scope of this application.

[0124] The devices disclosed herein can be processed prior to surgery. First, a new or used instrument can be obtained and optionally cleaned. The instrument can then be sterilized. In one sterilization technique, the instrument is placed in a closed and sealed container such as a plastic bag or TYVEK bag. The container and instrument can then be placed in a radiation field that can penetrate the container, such as gamma rays, x-rays, and / or high-energy electrons. The radiation can kill bacteria on the instrument and within the container. After this, the sterilized instrument can be stored within the sterilization container. The sealed container can keep the instrument in a sterile state until it is opened at a medical facility. The device can also be sterilized using any other technique known in the art, including but not limited to beta rays, gamma rays, ethylene oxide, hydrogen peroxide plasma, and / or steam.

[0125] Although the invention has been described as having representative designs, the invention may be further modified within the spirit and scope of this disclosure. Accordingly, this application is intended to cover any variations, uses, or adaptations of the invention using its general principles.

[0126] 〔Embodiments〕 (1) A surgical instrument, an elongated shaft, and a surgical end effector coupled to the elongated shaft by a joint, the joint being configured to facilitate selective articulation of the surgical end effector relative to the elongated shaft, a surgical end effector, a constant speed drive shaft assembly spanning the joint, the constant speed drive shaft assembly being configured to apply rotational movement to a portion of the surgical end effector, the constant speed drive shaft assembly comprising a series of movable drive joints, each of the movable drive joints being capable of moving relative to one another in a plurality of planes, a constant speed drive shaft assembly, a movable outer skeleton spanning the joint, the movable outer skeleton comprising a series of annular rib members that are movably interconnected, each of the annular rib members having a first end and a second end, the first end of one of the annular rib members being movably interconnected with the second end of an adjacent annular rib member to facilitate relative movement in a plurality of directions between the first end and the second end, each of the annular rib members having a central opening, the central openings of each of the annular rib members within the series of movably interconnected annular rib members cooperating to form a passage through the series of movably interconnected annular rib members for receiving the constant speed drive shaft assembly therethrough, a movable outer skeleton, a surgical instrument comprising. (2) Further comprising a flexible drive cover configured to movably support the series of movable drive joints therein, the flexible drive cover being configured to movably engage and maintain each of the movable drive joints within the series of movable drive joints relative to one another, the flexible drive cover being sized to pass through the passage within the series of movably interconnected annular rib members, the surgical instrument according to embodiment 1. (3) The flexible drive cover includes a heat shrinkable tube, the surgical instrument according to embodiment 2. (4) The flexible drive cover is a surgical instrument according to Embodiment 2, including a coiled member. (5) The flexible cover is a surgical instrument according to Embodiment 2, including a tube having a series of offset slits therein.

[0127] (6) Each of the movable drive joints comprises a first spherical portion having a socket cavity, and a second spherical portion sized to be rotatably received within the socket cavity of the first spherical portion of an adjacent one of the movable drive joints within the series of the movable drive joints, the second spherical portion comprising a pair of diametrically opposed pins projecting from the second spherical portion, each of the diametrically opposed pins being configured to be movably received within a corresponding pin slot within the first spherical portion of the adjacent drive joint, each of the diametrically opposed pins being configured to rotate and axially move within the corresponding pin slot. The surgical instrument according to Embodiment 1. (7) The surgical instrument according to Embodiment 6 further comprises a proximal rotary drive shaft configured to apply a rotary drive motion to the constant speed drive shaft assembly. (8) The surgical instrument further comprises a proximal attachment shaft, and the proximal attachment shaft comprises a proximal attachment portion configured to be operably coupled with the proximal rotary drive shaft, and an attachment shaft socket portion configured to rotatably receive therein the second spherical portion of the most proximal one of the movable drive joints. The surgical instrument according to Embodiment 7. (9) The surgical instrument according to Embodiment 8 further comprises a distal drive shaft configured to be operably coupled with the movable most distal drive joint. (10) A firing member supported to axially travel within the surgical end effector between a starting position and an ending position, and an upper flexible spine assembly attached to an upper portion of the firing member. The surgical instrument according to embodiment 9, further comprising a lower flexible spine assembly attached to a lower portion of the firing member, wherein the distal drive shaft is configured to apply a rotational driving motion to the upper flexible spine assembly and the lower flexible spine assembly.

[0128] (11) Each of the annular rib members includes an upper spine passage configured to accommodate passage of the upper flexible spine assembly therethrough, and a lower spine passage configured to accommodate passage of the lower flexible spine assembly therethrough, the surgical instrument according to embodiment 10. (12) The surgical instrument according to embodiment 11, further comprising a plurality of flexible articulation actuating members spanning the articulation joint and configured to apply an articulation motion to the surgical end effector, each of the annular rib members including an articulation passage therein, the articulation passage corresponding to each of the flexible articulation actuating members to permit movement therethrough. (13) A movable outer skeleton assembly for a surgical instrument, the movable outer skeleton assembly comprising a series of annular rib members movably coupled and configured to span the articulation joint of the surgical instrument, each of the movably coupled annular rib members including a cup-shaped surface, and a dome-shaped surface, wherein the cup-shaped surface of one of the movably coupled annular rib members is movably coupled to the dome-shaped surface of an adjacent movably coupled annular rib member to facilitate relative movement in a plurality of directions between the cup-shaped surface and the dome-shaped surface, each of the movably coupled annular rib members including a central opening, and the central openings of each of the movably coupled annular rib members within the series of movably coupled annular rib members cooperate to form a passage through the series of movably coupled annular rib members for permitting passage of a drive component therethrough, the movable outer skeleton assembly. (14) The movable exoskeleton assembly according to embodiment 13, further comprising a flexible hollow support member configured to be received within the passageway and operably support the drive component passing therethrough. (15) The movable exoskeleton assembly according to embodiment 14, wherein the flexible hollow support member includes a heat shrinkable tube.

[0129] (16) The movable exoskeleton assembly according to embodiment 14, wherein the flexible hollow support member includes a heat shrinkable tube. (17) The movable exoskeleton assembly according to embodiment 14, wherein the flexible cover includes a tube having a series of offset slits therein. (18) A surgical instrument, an elongate shaft, a surgical end effector coupled to the elongate shaft by a joint, the joint being configured to facilitate selective articulation of the surgical end effector relative to the elongate shaft, the surgical end effector including a first jaw, a second jaw, the second jaw being configured to move relative to the first jaw between an open position and a closed position, a firing member supported to travel axially within the surgical end effector between a start position and an end position, the surgical instrument including an upper flexible spine assembly attached to an upper portion of the firing member, a lower flexible spine assembly attached to a lower portion of the firing member, a rotary drive device configured to move the firing member between the start position and the end position, A movable exoskeleton spanning the joint prosthesis, the movable exoskeleton comprising a series of annular rib members movably interconnected, each of the movably interconnected annular rib members having a proximal end and a distal end, the proximal end of one of the movably interconnected annular rib members being movably interconnected with the distal end of an adjacent movably interconnected annular rib member to facilitate relative movement in a plurality of directions between the proximal end and the distal end, each of the movably interconnected annular rib members having a central opening, the central openings of each of the movably interconnected annular rib members within the series of movably interconnected annular rib members cooperating to form a passage through the series of movably interconnected annular rib members for receiving a portion of the rotary drive device therethrough, and a surgical instrument further comprising a movable exoskeleton. (19) Each of the movably interconnected annular rib members has a proximal cup-shaped end, and a distal dome-shaped end, the proximal cup-shaped end of one of the movably interconnected annular rib members being movably interconnected with the distal dome-shaped end of an adjacent movably interconnected annular rib member to facilitate relative movement in a plurality of directions between the proximal cup-shaped end and the distal dome-shaped end, the surgical instrument according to embodiment 18. (20) The surgical instrument according to embodiment 19, further comprising a flexible hollow support member configured to be received within the passage and to permit passage of the portion of the rotary drive device therethrough.

Claims

Claim 1 A surgical instrument comprising: an elongated shaft; a surgical end effector coupled to the elongated shaft by a joint, the joint configured to facilitate selective articulation of the surgical end effector relative to the elongated shaft; a drive shaft assembly spanning the joint, the drive shaft assembly configured to apply rotational movement to a portion of the surgical end effector, the drive shaft assembly comprising a series of movable drive joints, each of the movable drive joints being movable relative to one another in a plurality of planes; a movable outer skeleton forming the joint, the movable outer skeleton comprising a series of annular members movably interconnected, each annular member having a first end in the axial direction with a convex or domed portion and a second end in the axial direction that is concave or dish-shaped, the first end of one annular member being movably interconnected with the second end of an adjacent annular member to facilitate relative movement between the first and second ends in a plurality of directions, each annular member having a central opening extending therethrough in the axial direction, the central openings of the annular members in the series of movably interconnected annular members cooperating to form a passage through the series of movably interconnected annular members for receiving the drive shaft assembly therethrough; a distal drive shaft configured to operably couple with the most distal drive joint in the series of drive joints, and a firing system; the firing system having a firing member body extending in a vertical direction, an upper flexible spine assembly integrally formed with an upper end of the firing member body, and a lower flexible spine assembly integrally formed with a lower end of the firing member body; the firing member body advancing axially within the surgical end effector between a starting position and an end position; The upper flexible spine assembly includes an upper series of upper vertebral members connected by an upper flexible coupler member, and one upper vertebral member is movable relative to an adjacent upper vertebral member in the axial direction. The lower flexible spine assembly includes a lower series of lower vertebral members connected by a lower flexible coupler member, and one lower vertebral member is movable relative to an adjacent lower vertebral member in the axial direction. Each upper vertebral member includes an upper vertebral body portion and a downward engaging portion formed integrally with the upper vertebral body portion, and each lower vertebral member includes a lower vertebral body portion and an upward engaging portion formed integrally with the lower vertebral body portion. Each downward engaging portion is engageable with an upward engaged portion of the distal drive shaft, and each upward engaging portion is engageable with a downward engaged portion of the distal drive shaft. When the distal drive shaft rotates due to the rotation of the most distal drive joint, after one downward engaging portion engages with the upward engaged portion, a downward engaging portion adjacent to the one downward engaging portion in the axial direction engages with the upward engaged portion, and after one upward engaging portion engages with the downward engaged portion, an upward engaging portion adjacent to the one upward engaging portion in the axial direction engages with the downward engaged portion. Thus, when the distal drive shaft rotates, the upper flexible spine assembly, the lower flexible spine assembly, and the firing member body move in the axial direction without rotating, a surgical instrument.

2. The surgical instrument according to claim 1, further comprising a flexible drive cover configured to movably support the series of movable drive joints therein, the flexible drive cover being configured to movably engage and maintain each of the movable drive joints within the series of movable drive joints with each other, and sized to pass through the passage within the series of movably associated annular members.

3. The surgical instrument according to claim 2, wherein the flexible drive cover includes a heat shrinkable tube.

4. The flexible drive cover is the surgical instrument according to claim 2, including a coiled member.

5. The flexible drive cover is the surgical instrument according to claim 2, including a tube having a series of offset slits therein.

6. Each of the movable drive joints has a first spherical portion with a socket cavity, and a second spherical portion sized to be rotatably received within the socket cavity of the first spherical portion of an adjacent one of the movable drive joints within the series of the movable drive joints, the second spherical portion having a pair of diametrically opposed pins projecting from the second spherical portion, each of the diametrically opposed pins being configured to be movably received within a corresponding pin slot within the first spherical portion of the adjacent drive joint, each of the diametrically opposed pins being configured to rotate and axially move within the corresponding pin slot, the surgical instrument according to claim 1, comprising the second spherical portion.

7. The surgical instrument according to claim 6, further comprising a proximal rotary drive shaft located proximal to the drive shaft assembly and configured to apply a rotary drive motion to the drive shaft assembly.

8. The surgical instrument further comprises a proximal attachment shaft, the proximal attachment shaft being configured to be operably coupled to the distal end of the proximal rotary drive shaft and having a proximal attachment portion located at the proximal end of the proximal attachment shaft, and an attachment shaft socket portion located at the distal end of the proximal attachment shaft and configured to rotatably receive the second spherical portion of the most proximal one of the movable drive joints therein, wherein the proximal attachment shaft is located distal to the proximal rotary drive shaft and the drive shaft assembly is located distal to the proximal attachment shaft, the surgical instrument according to claim 7.

9. Each of the annular members has an upper spine passage configured to accommodate passage of the upper flexible spine assembly therethrough, and a lower spine passage configured to accommodate passage of the lower flexible spine assembly therethrough, the surgical instrument according to claim 1.

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