Surgical instrument comprising a double ball joint with pivotable links

Abstract

1. A surgical instrument having an articulation joint including an articulation linkage assembly comprising a plurality of links configured to operatively associate with the proximal joint member for movably advancing relative to the proximal joint member in first and second proximal advancement paths that transverse one another, the plurality of links further configured to operatively associate with the distal joint member for movably advancing relative to the distal joint member in first and second distal advancement paths that transverse one another.

Description

[Technical Field]

[0001] (CROSS-REFERENCE TO RELATED APPLICATIONS) This non-provisional application claims the benefit under 35 U.S.C. § 119(e) of U.S. Provisional Patent Application No. 63 / 057,430, filed July 28, 2020, entitled "SURGICAL INSTRUMENTS WITH TORSION SPIN DRIVE ARRANGEMENTS," and U.S. Provisional Patent Application No. 63 / 057,432, filed July 28, 2020, entitled "ARTICULATION JOINT ARRANGEMENTS FOR SURGICAL INSTRUMENTS," the disclosures of which are incorporated herein by reference in their entireties. [Background technology]

[0002] The present invention relates to surgical instruments and to surgical stapling and severing instruments and staple cartridges for use therewith, designed for stapling and severing tissue in various configurations. The surgical instruments may be configured for use in open surgical procedures, but have application in other types of surgery, such as laparoscopic, endoscopic, and robotic-assisted procedures, and may include an end effector that is articulatable relative to a shaft portion of the instrument to facilitate precise positioning within a patient. [Brief explanation of the drawings]

[0003] The novel features of the various aspects are set forth with particularity in the appended claims. However, the described aspects, both as to organization and method of operation, can best be understood by reference to the following description taken in conjunction with the accompanying drawings.

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[0004] The applicant of the present application owns the following U.S. patent applications filed on the same day as the present application, each of which is hereby incorporated by reference in its entirety. - U.S. Patent Application, Invention Title "SURGICAL INSTRUMENTS WITH TORSION SPINE DRIVE ARRANGEMENTS", Attorney Docket No. END9248USNP1 / 200084-1, - U.S. Patent Application, Invention Title "SURGICAL INSTRUMENTS WITH FIRING MEMBER CLOSURE FEATURES", Attorney Docket No. END9248USNP2 / 200084-2, - U.S. Patent Application, Invention Title "SURGICAL INSTRUMENTS WITH SEGMENTED FLEXIBLE DRIVE ARRANGEMENTS", Attorney Docket No. END9248USNP3 / 200084-3, - U.S. Patent Application, Invention Title "SURGICAL INSTRUMENTS WITH FLEXIBLE BALL CHAIN DRIVE ARRANGEMENTS", Attorney Docket No. END9248USNP4 / 200084-4, - 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, - U.S. Patent Application, Invention Title "ARTICULATABLE SURGICAL INSTRUMENTS WITH ARTICULATION JOINTS COMPRISING FLEXIBLE EXOSKELETON ARRANGEMENTS", Attorney Docket No. END9248USNP11 / 200084-11, - U.S. Patent Application, Invention Title "SURGICAL INSTRUMENTS WITH DIFFERENTIAL ARTICULATION JOINT ARRANGEMENTS FOR ACCOMMODATING FLEXIBLE ACTUATORS", Attorney Docket No. END9248USNP12 / 200084-12.

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

[0006] The terms "comprise," "comprises," and any other forms of the word "comprising," "have," "has," and any other forms of the word "having," "include," "includes," and any other forms of the word "including," and "contain," "contains," and any other forms of the word "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. It will be further understood that, for convenience and clarity, spatial terms such as "vertical," "horizontal," "up," and "down" may be used herein with respect to the drawings. However, the surgical instrument is 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 should 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 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" or the like.

[0009] The description of a range of values in the present invention is intended to refer individually to any and all values included within that range, rather than to limit them, unless otherwise specified herein, and each separate value within such a range is incorporated into the specification as if individually recited herein. Words such as "about," "approximately," etc., 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 (e.g., "such as" or otherwise), 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 an element not claimed is essential to the practice of an embodiment.

[0011] A variety of 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 those related to, for example, open surgical procedures. By reading the "DETAILED DESCRIPTION" herein, 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 an operating passage through which the end effector and the elongate shaft of the surgical instrument can be advanced.

[0012] During various laparoscopic surgeries, 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 typically used within a hollow tube known as a cannula or sleeve, creating an opening in the body portion through which the surgical end effector can be introduced. Such a configuration 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 the 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 that has 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 operably interlocked with the surgical end effector. For example, one such drive member is commonly used to apply an articulation control movement 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 a joint motion system that can achieve the desired range of joint motion and further 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 motion position, the joint motion system and the joint coupling 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. The configuration of such a joint coupling 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 such 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 closure 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 configurations of the staple cavities and staples may be 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 its un-fired position and its 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 forward 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 articulation joint. When the firing beam crosses the articulation joint, the firing beam can apply an articulation release force to the articulation joint and can buckle the beam. To prevent the firing beam from buckling under pressure, the articulation joint generally includes a lateral support or "blowout" plate feature for supporting the portion of the beam that crosses the articulation 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 a configuration, it is necessary to make the support jaws larger to accommodate the firing member drive shaft. In such devices, 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 it is 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 articulable end effector configured to cut and fasten tissue. In various embodiments, the surgical instrument 10 may comprise a hand-held 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 "housed" or included within the housing, or alternatively, 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 employed with various robotic systems, instruments, components, and methods disclosed in U.S. Patent No. 9,072,535, the entire disclosure of which is incorporated herein by reference, entitled "SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS".

[0023] In one configuration, the surgical end effector 1000 includes a first jaw 1100 and a second jaw 1200. In the illustrated configuration, the first jaw 1100 includes a proximal end 1112 and a distal end 1114 and has an elongated channel 1110 configured to operably support a surgical staple cartridge 1300 therein. The surgical staple cartridge 1300 includes a cartridge body 1302 having an elongated 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 elongated slot 1304. Each driver is associated with a corresponding staple cavity 1308 that opens through the cartridge deck surface 1306. The surgical staple cartridge 1300 may be replaced after the staples / fasteners are discharged therefrom. Other embodiments are contemplated where, after the surgical staple cartridge 1300 has been used, the elongated channel 1110 and / or the entire surgical end effector 1000 may be discarded. Such an end effector configuration may be referred to as, for example, a "disposable loading unit".

[0024] In the illustrated configuration, 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 configuration, 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 that faces 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 to 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, preventing the tissue from moving proximally beyond the most proximal staple / fastener, thereby ensuring that the tissue being cut 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 forming 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 in a corresponding mounting cradle or pivot cradle 1120 formed at the proximal end portion 1112 of the elongated channel 1110. The mounting pins 1232 are pivotally held within the mounting cradle 1120 by an anvil cap 1260 that can be attached to the proximal end portion 1112 of the elongated channel 1110 by a mechanical snap mechanism 1261 configured to engage a retaining structure 1113 on the elongated channel 1110. See FIG. 5. In other configurations, the anvil cap 1260 may be attached to the elongated channel 1110 by welding, adhesive, or the like. Such a configuration facilitates pivotal movement of the anvil 1210 relative to the surgical staple cartridge 1300 mounted within the elongated 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 be referred to herein 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 configuration, the elongated shaft assembly 2000 defines a shaft axis SA and includes a proximal shaft portion 2100 that can be operably coupled to the housing of a control portion of the surgical instrument 10 (e.g., a handheld unit, a robotic tool driver, etc.). The elongated 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 can 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 can 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 through the interior from the proximal end 2122 to the distal end 2124.

[0027] As described above, many surgical end effectors use a firing member that is pushed distally through a surgical staple cartridge by an axially movable 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 occurrence of this additional friction may not only require applying a higher firing force to overcome such friction, but may also cause undesirable wear on each part 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 the firing beam crosses a joint. Such additional deflection can unlock the joint movement of the joint, particularly when the surgical end effector is jointed at a relatively high joint movement 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 that includes a vertically extending firing member body 2312, and the firing member body 2312 includes 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 configuration, 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 configuration, 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, and the lower tubular body 2352 has a lower axial passage 2354 extending therethrough. In at least one configuration, 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 a keyhole.

[0029] In a conventional launch member configuration, long flexible cantilever wings extending from the upper and lower portions of the launch member are employed. These cantilever wings slideably pass through an anvil and slots within a channel that are generally cut with a rectangular T-cutter that tends to produce a higher friction surface. Such long cantilever wings have a minimal 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 / drill, thereby creating a lower friction surface. Additionally, the upper tubular body 2322 and the lower tubular body 2352 are stiffer than a conventional cantilever wing configuration 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 a conventional rectangular slot, so their geometry and increased material can result in a stiffer anvil and channel compared to a conventional configuration.

[0030] Referring to FIGS. 9-11, in one configuration, the launch system 2300 further includes 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 includes 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 include 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 mating feature 2426 therein, and each distal end portion 2428 has an upper distal mating feature 2430 formed therein. In at least one embodiment, the upper proximal mating feature 2426 includes a concave recess 2427, and each upper distal mating 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 the 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 configuration, the firing drive system 2300 further includes a rotary drive screw 2700 configured to be drivingly coupled to an upper series 2410 of the upper vertebra member 2420 and a lower series 2510 of the lower vertebra member 2520. In the illustrated configuration, 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. See 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 configuration driven by a motor 2006 or other source of rotational motion housed within the housing of the surgical instrument. See 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 axially “extends” or extends through the articulation joint 2200. As seen in FIGS. 8, 16, and 17, in at least one configuration, 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 comprising 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 movably coupled drive joints 2650.

[0036] As can be seen from FIG. 18, in at least one configuration, each drive joint 2650 includes 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 includes a socket cavity 2662 configured to rotatably receive the proximal spherical portion 2652 of an adjacent drive joint 2650 therein. As can be seen from FIG. 16, each proximal spherical portion 2652 includes a pair of diametrically opposed joint pins 2654 configured to be movably received within corresponding pin slots 2664 within the distal spherical portion 2660 of an adjacent drive joint 2650. The proximal spherical portion 2652P of the most proximal drive joint 2650P is rotatably received within the distal socket portion 2636 of the proximal shaft segment 2632 as shown in FIG. 16. The joint 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 joint 2650D in the series 2640 of movably connected drive joints 2650 is movably connected to the distal CV drive shaft 2670.

[0037] In at least one configuration, the distal CV drive shaft 2670 includes a proximal spherical portion 2672 dimensioned to be movably received within the socket cavity 2662D within the most distal drive joint 2650D. The proximal spherical portion 2672 includes joint pins 2674 configured to be movably received within the pin slots 2664D within the most distal drive joint 2650D. The distal CV drive shaft 2670 further includes a distally extending shaft stem 2676 configured to be non-rotatably connected to a rotary drive screw 2700 positioned distally of the articulated 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 configuration, when the series 2640 of drive joints 2650 connected movably articulate, the joint pin 2674 remains within the corresponding pin slot 2664 of the 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 in the series is fully articulated 90 degrees in pitch and yaw, which results in an angle α of approximately 100.9 degrees. In such a configuration, the outer surface of each distal spherical portion 2660 has a clearance from the outer surface of the 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 connected movably to carry high loads in the torsional direction at overall large angles.

[0039] In the illustrated configuration, 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 the distal mounting bushing 2720 to be 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 the proximal mounting bushing 2750 to be threadably received within 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 firing load. The joint spring(s) is / are longer than the series 2640 of drive joints 2650, and thus 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 firing load and the articulation load through the series 2640 of drive joints 2650. When the firing 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(s) 2730 is longer than the hard stack of the series 2640 of drive joints 2650, the firing load is contained within the end effector and the firing load does not relieve through the drive joint 2650 or through the spring(s) 2730.

[0041] To further ensure that the drive couplings 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 couplings 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 configuration, 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 couplings 2650 together to reduce any gaps that may occur during articulation. This ensures that the drive couplings 2650 reliably transmit torsional loads. However, it will be appreciated that in at least one configuration, 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 firing member feature 2320 on the firing member 2310 comprises a distal upper firing member tooth segment 2330 corresponding to half of the upper teeth 2450 on each upper vertebral member 2420. In addition, proximal upper firing member teeth 2336, which are identical to the upper teeth 2450 on each upper vertebral member 2420, are spaced apart from the distal upper firing member tooth segment 2330. The distal upper firing member tooth segment 2330 and the proximal upper firing member teeth 2336 may be integrally formed with the upper firing member feature 2320 of the firing member 2310. Similarly, the lower firing member feature 2350 of the firing member 2310 comprises distal lower firing member teeth 2360 and proximal lower firing member teeth 2366 integrally formed thereon. For example, in at least one configuration, the firing member 2310 having the firmly attached teeth 2330, 2336, 2360, and 2366 may be fabricated in one piece as a single integrated component using conventional metal injection molding techniques.

[0043] As described above, each of the upper vertebral member 2520 is movably received on an upper flexible connector member 2402 in the form of a top cable 2404. As described above, the distal end 2406 of the upper cable 2404 is fixed to the upper launch member feature 2320 of the launch member 2310. Similarly, each of the lower vertebral member 2520 is movably received on a lower flexible connector member 2502 in the form of a lower cable 2504. The distal end 2506 of the lower cable 2504 is fixed to the lower launch member mechanism 2350 of the launch member 2310. In at least one configuration, the upper cable 2404 and the lower cable 2504 extend through the proximal shaft portion 2100 and may be associated with a bailout configuration supported within the housing to retract the launch member 2310 to its fixed or starting position in the event of a failure of the launch 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 vertebral member 2420 u and the axial length AL of the lower series 2510 of the lower vertebral member 2520 lare equal, and must be of sufficient length to facilitate full distal advancement of the firing member 2310 from a fixed or starting position within the staple cartridge to a most distal end position while the most proximal upper vertebra member 2420 in the upper series 2410 of the upper vertebra member 2420 and the most proximal lower vertebra member 2520 in the lower series 2510 of the lower vertebra member 2520 remain drivingly engaged with the rotary drive screw 2700. As can be seen from FIG. 8, the upper compression limiting spring 2421 is configured to cooperate with the most proximal upper vertebra member 2420P in the upper series 2410 of the upper vertebra 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 vertebra 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 vertebra member 2520P in the lower series 2510 of the lower vertebra 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 vertebra 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 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 angles. If the cables 2404, 2504 are pulled too tightly, the spring holders 2423, 2523 will contact their respective most proximal vertebral members 2420P, 2520P. Such a compression limiting configuration ensures that the vertebral members 2420, 2520 in each series 2410, 2510 always remain sufficiently close together, such that the rotary drive screw 2700 will always drive-engage them in a 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 generally as 2460 that facilitates drive-engagement with the helical drive screw threads 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 generally as 2560 that facilitates drive-engagement with the helical drive screw threads 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 configuration, for example, twelve 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 a 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 first pitch 2713 is greater than the second pitch 2715 to ensure that the rotary drive screw 2700 captures all of the upper vertebra members 2420 and all of the lower vertebra members 2520 and "scoops up" or drives them into engagement. 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 launch 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 launch 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 completely 360 degrees around it. The rotation of the power screw advances or moves the nut longitudinally. However, in this configuration, 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 restricted from rotating around the rotary drive screw 2700 and can only move longitudinally. In one configuration, 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] Figure 25 shows the firing member 2310 in a fixed or starting position. As can be seen from Figure 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 configuration 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 Figure 26.

[0051] Surgical instrument 10 also includes an articulation system 2240 configured to articulate the surgical end effector 1000 in addition to joint movement, and to articulate the surgical end effector relative to the elongate shaft assembly 2000. In at least one configuration, for example, the articulation system includes four articulation cables 2242, 2246, 2250, and 2254 that extend through the elongate shaft assembly 2000. See FIG. 27. In the illustrated configuration, 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 that is 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 that is fixed to the distal end 2212 of the elastomeric joint assembly 2210 or other portion of the surgical end effector. The 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 of the cables 2242, 2246, 2250, and 2254 may be wound onto corresponding rotary 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 of the cables 2242, 2246, 2250, and 2254 in a desired manner. The spool / cable management system may be motor-driven or manual (such as a ratchet configuration). FIG. 29 shows the articulation of the surgical end effector 1000 through a first articulation plane relative to the elongate shaft assembly 2000. FIG. 30 shows the articulation of the surgical end effector 1000 through a second articulation plane relative to the elongate shaft assembly 2000. FIG. 31 shows the articulation of the surgical end effector 1000 through multiple articulation planes relative to the elongate shaft assembly 2000.

[0052] Figures 32 - 34 show an alternative joint 2200' in the form of an elastomeric joint assembly 2210'. As seen in Figure 33, each joint motion 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 the appropriate cables 2242, 2246, 2250, and 2254. To achieve a greater joint motion angle with a higher degree of joint stability, each of springs 2244, 2248, 2252, and 2256 can slide through the rib of the elastomeric joint to push the end effector and pull the cable extending therethrough. Springs 2244, 2248, 2252, 2256 also retract into the rib when cables 2242, 2246, 2250, 2254 are tightly pulled. Each of springs 2244, 2248, 2252, and 2256 seats loosely on the particular cable passing therethrough. Each cable and its 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 coupling between the cable and the spring can facilitate a higher joint motion angle, for example, approaching 90 degrees.

[0053] The radially / longitudinally segmented power screw nut configuration disclosed herein does not have the same constraints as a 360-degree nut, so the upper vertebra member 2420 of the upper series 2410 and the lower vertebra member 2520 of the lower series 2510 are constrained to ensure that their loads are transmitted to the firing member in the longitudinal direction. To maintain each of the upper vertebra members 2420 in the desired orientation and to prevent the upper vertebra members 2420 from catching or being misaligned when moving 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 elongated channel 1110, and the proximal end 2474 of the upper sleeve 2470 is supported within the distal end of the proximal support shaft 2120. To allow the upper sleeve 2470 to bend with the outer elastomeric joint assembly 2210, the upper sleeve 2470 is made of a polymer or plastic material having a low coefficient of friction and being flexible. The upper sleeve 2470 prevents the upper vertebra member 2420 from contacting the outer elastomeric joint assembly 2210 made of an elastomeric material that may have a coefficient of friction higher than that of the material of the upper sleeve 2470. In other words, the upper sleeve 2470 forms a low-friction, flexible, continuous, unbroken, and fully enclosed path for the upper vertebra member 2420 when the upper vertebra member 2420 traverses the articulation joint 2200.

[0054] Similarly, a lower sleeve 2570 is employed to support the lower vertebral member 210 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 an elongate 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 that has a low coefficient of friction and is 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 low friction, flexible, continuous, non-disruptive, and fully enclosed path for the lower vertebral member 2520 as 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. In at least one configuration, to prevent the formation of twist in the sleeves, 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 bend radius. The upper sleeve 2470 in the same example can slide proximally and have a tighter bend radius. By moving axially, the amount of material exposed outside the joint assembly 2210 that would otherwise be susceptible to kinking under a tight bend radius is reduced. In at least one configuration, 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 elongate 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 cradles or pivot cradles 1120 formed at the proximal end 1112 of the elongated channel 1110. The mounting pins 1232 are pivotally held 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 passages for the upper emitter member feature 2320 and the upper vertebral member 2420. FIG. 36 shows the vertebra passage 1266 within the anvil cap 1260. When the rotary drive screw 2700 loads the upper vertebral member 2420, the vertebral member 2420 tends to tilt about region A in FIG. 37, and thus the upper vertebral member teeth 2450 are no longer perpendicular to the rotary drive screw 2700 and may instead receive a higher pressure line contact. Region B in FIG. 37 shows where the upper vertebral member 2420 stops tilting. To ensure that most of the load remains longitudinal and performs useful work, the upper vertebral member teeth 2450 must be angled by the same amount that the upper vertebral member 2420 tilts. Thus, when the upper vertebral member 2420 tilts, the upper vertebral 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 teeth 2450 of the slightly tilted upper vertebral member can act like a square thread when the vertebral member 2420 is tilted, better dispersing the load and reducing the pressure contact. By directing most of the load longitudinally, a vertical load that could establish friction against the longitudinal load is avoided. The upper vertebral member 2420 reacts similarly when passing through the keyhole-shaped anvil slot 1240. Similarly, the lower vertebral member 2520 reacts similarly when passing through the keyhole-shaped axially extending channel slot 1140 within the elongated channel 1110.

[0056] In the illustrated configuration, anvil 1210 is moved to the 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 positioned to apply a pivotal biasing force to corresponding anvil control arms 1234 that may be integrally formed with and extend downwardly from anvil mounting portion 1230. See FIG. 38.

[0057] Figures 39 - 41 show various portions of the anvil 1210, the firing member 2310, and the 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 the 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 or some other reference point. Such a configuration allows the anvil 1210 to move radially without interfering with the anvil cap 1260 while maintaining a minimal 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 the 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 motion to the anvil 1210 as seen in Figure 40.During the firing stroke or firing sequence, further distal advancement of the firing member 2310 causes the upper firing member feature to enter the keyhole-shaped anvil slot 1240, fully closing the anvil 1210 and holding 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 be similarly high. In at least one configuration, 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 home or starting position to quickly close the anvil 1210 for grasping purposes. In at least one configuration, when the firing member 2310 is in a fixed or starting position, the firing member wings 2355 are located 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 bias of the anvil spring 1270. See FIG. 42. In one configuration, the firing member 2310 need only move a short distance D to pivot the anvil 1210 to a 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 a closed position. Thus, 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 a closed position.

[0059] The firing member 2310 can be moved in the proximal direction PD by rotating the rotary drive screw 2700 in the second rotational direction. Thus, when the firing member 2310 is in the "fixed" or starting position, the anvil 1210 can be biased to the fully open position by the anvil spring 1270. Actuating the rotary drive system 2600 to apply a rotational movement to the rotary drive screw 2700 in the first rotational direction advances the firing member 2310 distally from the fixed or starting position, applies an anvil closing movement to the anvil 1210, closes and moves the anvil, and clamps the target tissue between the anvil 1210 and the surgical staple cartridge 1300. Continuing to rotate the rotary drive screw in the first rotational direction will continue to advance the firing member 2310 distally through the surgical end effector 1000. As the firing member 2310 moves distally, the firing member 2310 contacts a thread 1312 (FIG. 19) supported within the surgical staple cartridge 1300 and drives the thread 1312 distally through the staple cartridge body 1302. When the firing member 2310 is in the fixed or starting position, the surgeon may wish to grasp and manipulate tissue using the surgical end effector. To do so, the rotary drive system is actuated to apply a second rotational drive movement to the rotary drive screw 2700 in a second rotational direction opposite the first rotational direction. Such a rotational movement of the rotary drive screw 27,00 in the second rotational direction drives the firing member 2310 proximally from the starting position and rapidly pivots the anvil 1210 to the closed position. Thus, according to at least one embodiment, the "fixed or starting position" of the firing member 2310 is not its most proximal 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 a motor or other control component 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 configuration) to apply a retraction motion to the cables 2404, 2504. When the cables 2404, 2504 are retracted, the upper vertebral member 2420 and the lower vertebral 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 vertibra member teeth 2450 and the lower vertibra 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 vertibra member teeth 2450 and the lower vertibra member teeth 2550 can also be advantageous in that the rolling friction between the vertibra 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 effect a rapid "escape".

[0064] As described above, the relative control motions 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 a housing 2002 that may be hand-held or may be 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 of using the surgical instrument 10 can 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. In order 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 rotational drive system 2600 can be actuated to apply a second rotational movement to the rotational 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 rotational 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 rotational drive system 2600 can be actuated to drive the rotational 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 has oriented the surgical end effector 1000 to the desired position, 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 grip tissue between the anvil 1210 and the surgical staple cartridge 1300, thereby gripping 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] When the target tissue is positioned between the anvil 1210 and the surgical staple cartridge, the surgeon may initiate the closing and firing process by activating the rotary drive system 2600 to drive the firing member 2310 distally from the starting position. As the firing member 2310 moves distally from the starting position, the firing member 2310 applies 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, the firing member 2310 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, the firing member 2310 contacts the thread 1312 supported within the surgical staple cartridge 1300 and drives the thread 1312 distally through the staple cartridge body 1302. The thread 1312 continuously drives a row 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 to make a form-fit contact under the anvil 1210 through the target tissue. As the firing member 2310 moves distally, the 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 retreats proximally back to its set 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 inoperative 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] Figures 46-48 illustrate another form of the articulating joint 18200 that includes a proximal joint member 18210 and a distal joint member 18250. The proximal joint member 18210 is configured to be attached to the distal end of an elongated shaft assembly 18100 (FIG. 47) that is coupled to the housing or other portion of the surgical instrument in various manners disclosed herein. The distal joint member 18250 may be attached to a closure tube configuration 18110 (FIG. 47) that is configured to apply a closing and / or opening movement to the movable jaw of the end effector 18000. In an alternative configuration, the distal joint member 18250 may be attached to one of the end effector jaws or other attachment portion of the end effector 18000. For example, the distal joint member 18250 may be attached to the elongated channel of an end cutter configuration in various manners disclosed herein. In at least one configuration, for example, the shaft assembly 18100 defines a shaft axis SA and the end effector 18000 defines an end effector axis EA. The articulating joint facilitates selectively articulating the end effector 18000 relative to the shaft assembly 18100 in an articulation plane between a non-articulated position where the end effector axis EA is axially aligned with the shaft axis SA and an articulated position where the end effector axis EA is not aligned with the shaft axis SA.

[0070] As can be seen in FIGS. 46-48, the proximal coupling member 18210 includes a proximal mounting hub 18212. The proximal mounting hub may be configured to be inserted, for example, into the hollow outer shaft or tube portion 18102 of the elongate shaft assembly 18100 and attached thereto by welding, an adhesive, or the like. The illustrated example further includes a distal-facing collar portion 18214 that defines a distal-facing mounting region, designated generally as 18220. See FIG. 48. To accommodate the passage of various control shafts / drive members through the articulation joint 18200, the proximal coupling member 18210 further includes a proximal central passage 18216 that extends through the proximal mounting hub 18212 to the distal-facing mounting region 18220. In the illustrated example, the proximal central passage 18216 is configured to receive the proximal drive shaft 18310, which is part of the rotary drive system 18300. In other configurations, a flexible drive shaft (not shown) may extend through the proximal central passage 18216.

[0071] The distal coupling member 18250 includes a distal mounting hub 18252 that is configured to be inserted into the hollow outer shaft 18114 or closure tube or mounting hub of the surgical end effector 18000 and attached thereto by welding, an adhesive, or the like. The surgical end effector 18000 may include any of the examples of surgical end effectors disclosed herein. The illustrated embodiment further includes a proximal-facing collar portion 18254 that defines a proximal-facing mounting region, designated generally as 18260. Additionally, the distal coupling member 18250 further includes a distal central passage 18256 that extends from the distal-facing mounting region 18220 through the distal mounting hub 18252. In the illustrated example, the distal central passage 18256 is configured to receive the distal drive shaft 18330, which is part of the rotary drive system 18300, or in other embodiments, the distal central passage 18256 may support another portion of a flexible drive shaft configuration.

[0072] The illustrated embodiment further includes a kinematic linkage assembly 19000 that extends between a proximal joint member 18210 and a distal joint member 18250 and is configured to operably couple therewith to facilitate articulation of the distal joint member 18250 (and the surgical end effector coupled thereto) relative to the proximal joint member 18210 (and the elongate shaft assembly 18100 coupled thereto). As can be seen in FIG. 48, the kinematic linkage assembly 19000 includes a first link 19010, a second link 19030, and a third link 19050. Each of the links 19010, 19030, and 19050 is movably captured between the proximal joint member 18210 and the distal joint member 18250, but none of the links 19010, 19030, 19050 is directly attached to either the proximal joint member 18210 or the distal joint member 18250, as will be discussed in more detail below.

[0073] In one example, the first link 19010 includes a rigid first link body 19012 that defines a first proximal end 19014 and a first distal end 19018. The first proximal end 19104 has a first proximal saddle 19016 configured to be pivotally received in a corresponding first proximal mounting lug 18222 formed in a proximally facing mounting region 18220. The first proximal mounting lug 18222 has an arcuate proximal pivot surface 18223 thereon that defines a first proximal pivot axis FPPA. See FIG. 49. The first proximal saddle 19016 includes a U-shaped proximal pivot surface 19017 configured to rotatably or movably couple with the arcuate proximal pivot surface 18223 on the first proximal mounting lug 18222 such that the first link 19010 is movable relative to the proximal joint member 18210 about the first proximal pivot axis FPPA in a plurality of directions or a plurality of proximal travel paths. For example, the first proximal saddle 19016 can move relative to the first proximal pivot axis FPPA in a first proximal travel path FPTP and a second proximal travel path SPTP. In at least one configuration, the first proximal travel path FPTP intersects the second proximal travel path SPTP. See FIGS. 49, and 51-54.

[0074] The first distal end portion 19108 includes a first distal saddle 19020 configured to be pivotally received in a corresponding first distal mounting lug 18262 formed in a proximally facing mounting region 18260. The first distal mounting lug 18262 has an arcuate pivot surface 18263 that defines a first distal pivot axis FDPA. See FIG. 50. The first distal saddle 19020 includes a U-shaped pivot surface 19022 configured to be rotatably or movably associated with the arcuate proximal pivot surface 18263 on the first distal mounting lug 18262 such that the first link 19010 is movable relative to the distal-proximal joint member 18250 about the first distal pivot axis FDPA in a plurality of directions or a plurality of distal travel paths. For example, the first distal saddle 19020 can move relative to the first distal pivot axis FDPA in a first distal travel path FDTP and a second distal travel path SDTP. In at least one configuration, the first distal travel path FDTP intersects the second distal travel path SDTP. See FIG. 50.

[0075] The second link 19030 includes a rigid second link body 19032 that defines a second proximal end 19034 and a second distal end 19038. The second proximal end 19034 has a second proximal saddle 19036 configured to be pivotally received in a corresponding second proximal mounting lug 18224 formed in a mounting area 18220 facing distally. The second proximal mounting lug 18224 has a second arcuate proximal pivot surface 18225 thereon that defines a second proximal pivot axis SPPA. See FIG. 49. The second proximal saddle 19036 includes a second U-shaped proximal pivot surface 19037 configured to be rotatably or movably associated with the arcuate proximal pivot surface 18225 on the second proximal mounting lug 18224 such that the second link 19030 is movable relative to the proximal joint member 18210 about the second proximal pivot axis SPPA in a plurality of directions or a plurality of proximal travel paths. For example, the second proximal saddle 19036 can move relative to the second proximal pivot axis SPPA in a first proximal travel path FPTP and a second proximal travel path SPTP. In at least one configuration, the first proximal travel path FPTP intersects the second proximal travel path SPTP. See FIG. 49.

[0076] The second distal end portion 19038 includes a second distal saddle 19040 configured to be pivotally received on a corresponding second distal mounting lug 18264 formed on a proximally facing mounting region 18260. See FIG. 50. The second distal mounting lug 18264 has a second arcuate distal pivot surface 18265 that defines a second distal pivot axis SDPA. The second proximal saddle 19040 has a second U-shaped distal pivot surface 19042 configured to rotatably engage with the second arcuate distal pivot surface 18265 on the second distal mounting lug 18264 such that the second link 19030 is movable relative to the distal joint member 18250 about the second proximal pivot axis SDPA in a plurality of directions or a plurality of distal paths. For example, the second distal saddle 19040 can move relative to the second distal pivot axis SDPA in a first distal travel path FDTP and a second distal travel path SDTP. In at least one configuration, the first distal travel path FDTP intersects the second distal travel path SDTP. See FIG. 50.

[0077] The third link 19050 includes a rigid third link body 19052 that defines a third proximal end portion 19054 and a third distal end portion 19058. The third proximal end portion 19054 has a third proximal saddle 19056 configured to be pivotally received in a corresponding third proximal mounting lug 18226 formed in a distally facing mounting region 18220. The third proximal mounting lug 18226 has a third arcuate proximal pivot surface 18227 that defines a third proximal pivot axis TPPA. See FIG. 49. The third proximal saddle 19056 includes a third U-shaped proximal pivot surface 19057 configured to be rotatably or movably coupled with the third arcuate proximal pivot surface 18227 on the third proximal mounting lug 18226 such that the third link 19050 is movable relative to the proximal joint member 18210 about the third proximal pivot axis TPPA in a plurality of directions or a plurality of proximal movement paths. For example, the third proximal saddle 19056 can move relative to the third proximal pivot axis TPPA in a first proximal travel path FPTP and a second proximal travel path SPTP. In at least one configuration, the first proximal travel path FPTP intersects the second proximal travel path SPTP. See FIG. 49.

[0078] The third distal end portion 19058 includes a third distal saddle 19060 configured to be pivotally received on a corresponding third distal mounting lug 18266 formed in a proximally facing mounting region 18260. See FIG. 50. The third distal mounting lug 18266 has a third arcuate distal pivot surface 18267 that defines a third distal pivot axis TDPA. The third distal saddle 19060 is configured to be rotatably or movably coupled with the third arcuate distal pivot surface 18267 on the third distal mounting lug 18266 such that the third link 19050 is movable relative to the distal joint member 18250 about the third distal pivot axis TDPA in a plurality of directions or a plurality of distal travel paths. For example, the third distal saddle 19060 can move relative to the third distal pivot axis TDPA in a first distal travel path FDTP and a second distal travel path SDTP. In at least one configuration, the first distal travel path FDTP intersects the second distal travel path SDTP. See FIG. 50.

[0079] In the illustrated configuration, none of the links 19010, 19030, and 19050 are directly attached to either the proximal joint member 18210 or the distal joint member 18250. Instead, the link assembly 19000 is movably pivotally engaged and supported by a cable-based articulation system 18400 with the proximal joint member 18210 and the distal joint member 18250. In the illustrated example, the articulation joint 18200 is operably controlled by a cable control system 18400 comprising four flexible actuator members in the form of cables 18410, 18420, 18430, and 18440, which extend through an elongated shaft assembly and are operably coupled with a cable control system that may be supported within the housing of the surgical instrument. The cable control system may comprise a plurality of cable support members / capstans, pulleys, etc. controlled by one or more corresponding motors controlled by a control circuit portion of the surgical instrument. The cable control system is configured to manage the tension (pull) and payout of the cables at precise times during the articulation process. As can be seen in FIG. 46, the cable 18410 extends through a corresponding passage 18412 in the proximal joint member 18210 into a corresponding passage 18414 in the distal joint member 18250 and has a retainer lug (not shown) thereon to prevent it from being pulled through the distal joint member 18250. The cable 18420 extends through a corresponding passage 18422 in the proximal joint member 18210, enters a corresponding passage in the distal joint member 18250, and has a retainer lug (not shown) thereon to prevent it from being pulled through the distal joint member 18250. The cable 18430 extends through a corresponding passage 18432 in the proximal joint member 18210 into a corresponding passage 18434 in the distal joint member 18250 and has a retainer lug (not shown) thereon to prevent it from being pulled through the distal joint member 18250. The cable 18440 extends through a corresponding passage 18442 in the proximal joint member 18210 into a corresponding passage 18444 in the distal joint member 18250 and has a retainer lug (not shown) thereon to prevent it from being pulled through the distal joint member 18250.Thus, in a sense, cables 18410, 18420, 18430, and 18440 span joint 18200 so as to apply articulation movement to distal joint member 18250.

[0080] The distal joint member 18250 is selectively articulable in multiple directions with respect to the proximal joint member 18210 by applying tension to the various cables while allowing the remaining cables to slack. As can be seen in FIGS. 55 and 56, the link assembly 19000 facilitates an articulation that essentially approximates a distal virtual sphere VDS that rotates with respect to a virtual proximal sphere VPS. In the illustrated configuration, the rotary drive system 18300 further includes a central "dogbone" drive shaft 18310 having a spherical proximal end 18322 that is received within a proximal socket 18312 within the proximal drive shaft 18320 and is movably retained therein by a corresponding pin 18324. The central drive shaft 18320 is further received within a distal socket 18332 within the distal drive shaft 18330 and further has a spherical distal end 18326 that is movably retained therein by a corresponding pin 18328. Other flexible drive shaft configurations (rotary and / or non-rotary) may be employed. Also, as seen in FIG. 55, the three links 19010, 19030, and 19050 are configured with a geometry that positions the distal ends of each link 180 degrees (about the longitudinal axis) from the proximal ends of the links. Each respective link 19010, 19030, and 19050 "reaches around" the central drive shaft 18320. In other words, the first link 19010 defines a first link axis FLA. The second link 19030 defines a second link axis SLA, and the third link 19050 defines a third link axis TLA. In one configuration, the links 19010, 19030, and 19050 are supported relative to each other such that the first link axis FLA, the second link axis SLA, and the third link axis TLA cross each other. See FIG. 48. The particular geometric positions of the lug and saddle configurations define a linkage 19000 that moves the distal joint member 18250 relative to the proximal joint member 18210 as if it were a ball rolling on another ball. The cables hold the links in a compressed state, such that the saddle is movably engaged and held in a state where it is not directly connected otherwise (e.g., without pins or other configurations) to their corresponding lugs within the proximal joint member 18210 and the distal joint member 18250.

[0081] To close the anvil, a system that meets many requirements is needed. The closing system needs to respond quickly to the movement of the surgeon's hand, which is operating either a robotic system or a hand-held system to which the end effector is attached. The closing system must also be able to apply sufficient load to the tissue to ensure proper staple formation. Also, it should be easy to disengage in case of failure during closing. All of these features should be achievable within the smallest possible footprint to ensure proper operability inside the patient's body.

[0082] Figures 57-59 illustrate a surgical end effector 20000 having a closure system 20400 that addresses many, if not all, of the aforementioned problems. In the illustrated example, the surgical end effector 20000 includes an elongate channel 20100 configured to operably support a surgical staple cartridge 20300 therein. The surgical end effector 20000 further includes an anvil 20200 configured to move between an open position and a closed position relative to the surgical staple cartridge 20300 to clamp tissue therebetween. As can be seen in FIGS. 59 and 60, the closure system 20400 includes a rotary drive closure cam member 20410 configured to apply a closing motion to the anvil 20200. In one configuration, the closure cam member 20410 is supported on a rotatable cam shaft 20420 having a driven gear 20422 formed thereon. The driven gear 20422 is supported in meshing engagement with a rotary closure gear 20660 that can be driven by a motor / gearbox configuration supported within a housing of a surgical instrument to which the surgical end effector is operably attached. As can be seen from FIGS. 61 and 62, the cam shaft 20420 includes a helical drive groove 20424 configured to receive a drive pin 20412 on the closure cam member 20410. Rotation of the cam shaft 20420 in a first rotational direction will move the closure cam member 20410 in a distal direction DD from a starting position (FIGS. 59 and 61) to an ending position (FIGS. 50 and 62).

[0083] In one configuration, the anvil 20200 includes an anvil mounting portion 20210 having two mounting arms 20212 each having a slot configured to receive a corresponding pivot pin 20216 projecting from the proximal end of the elongate channel 20100. See FIG. 58. The closure cam member 20410 further includes two closure cams 20414 corresponding to the anvil mounting arms 20212 of the anvil 20200. In one configuration, the anvil 20200 may be biased to the open position shown in FIGS. 58 and 59 by a spring (not shown). The anvil 20200 is moved to the closed position by actuating the rotary closure gear 20660 to drive the closure cam member 20410 distally from the starting position to the ending position. When the closure cam member 20410 is driven distally, the closure cams 20414 contact the corresponding mounting arms 20212 and pivot the anvil 20200 to the closed position shown in FIG. 60.

[0084] FIG. 63 shows a surgical end effector 20000 attached to a joint 20500 that employs a rotary drive assembly 20600 for transmitting a rotary drive motion across the joint 20500. In the illustrated example, the rotary drive assembly 20600 includes a nested universal joint that may allow the surgical end effector 20000 to roll distally relative to the joint 20500. For example, a two-plane joint configuration may be employed where each joint may form an angle of about 70 degrees (140 degrees total).

[0085] In one configuration, the articulation joint 20500 includes a proximal joint member 20510 that can be coupled to the housing of the surgical instrument or attached to an outer tube member of an elongate shaft assembly that is operably associated therewith. In an alternative configuration, the proximal joint member 20510 may be integrally formed at the distal end of the outer tube member of the elongate shaft. As can be seen in FIGS. 63-65, the proximal joint member 20510 includes a distal projecting upper pivot tang 20520 and a distal projecting lower pivot tang 20530. The articulation joint 20500 further includes a distal joint member 20540 attached to the surgical end effector 20000. In one example, the distal joint member 20540 is attached to the proximal end of the elongate channel 20100 and includes a proximal projecting upper pivot tang 20550 and a proximal projecting lower pivot tang 20560. In the illustrated example, a series of proximal articulation movement gear teeth 20522 are formed on the distal projecting upper pivot tang 20520, and a series of distal articulation movement gear teeth 20552 are formed on the proximal projecting upper pivot tang 20550. An arcuate proximal surface 20532 is formed on the distal projecting lower pivot tang 20530, and an arcuate distal surface 20562 is formed on the proximal projecting lower pivot tang 20560. In one example, the rotary drive assembly 20600 extends through the articulation joint 20500 and functions to engage and hold the proximal articulation movement gear teeth 20522 in meshing engagement with the distal articulation movement gear teeth 20552 and facilitate pivotal movement therebetween. Additionally, in at least one configuration, the arcuate distal surface 20562 and the arcuate proximal surface 20532 may be supported in a rocking engagement with each other. With such a configuration, the surgical end effector 20000 can articulate through a single articulation plane with respect to the elongate shaft assembly when an articulation control movement is applied to the surgical end effector 20000. Such an articulation control movement may be applied to the surgical end effector by a cable or other articulation member (not shown), and the cable or other articulation member extends from a control system within the surgical instrument housing, spans the articulation joint 20500, and is operably associated with the surgical end effector.

[0086] Referring to FIG. 65, the rotational drive system 20600 includes a series of nested shaft systems 20610, 20710, and 20810. As can be seen in FIG. 65, the middle “first” shaft system 20610 includes a corresponding first proximal shaft member 20620 that is attached to a corresponding first rotational drive system supported by the housing of the surgical instrument or is otherwise operably coupled. For example, the first rotational drive system may include a corresponding motor / gear configuration configured to rotate the first proximal shaft member 20620. The first shaft system 20610 further includes a first central shaft 20630 having a shaft body 20632 with a first spherical proximal end 20634 rotatably supported within a first spherical proximal cup 20622 on the first proximal shaft member 20620. The first central shaft 20630 is movably pinned within a cavity 20624 within the first spherical proximal cup 20622 by a first proximal pin 20636 extending through an arcuate slot 20635 within the first spherical proximal end 20634. The first central shaft 20630 further includes a first spherical distal end 20640 rotatably supported within a first spherical distal cup 20652 attached to the first distal shaft member 20650. The first central shaft 20630 is movably pinned within a cavity 20654 within the first spherical distal cup 20652 by a first distal pin 20644 extending through an arcuate slot 20642 within the first spherical distal end 20640. In one configuration, for example, the first distal shaft member 20650 may be configured to apply rotational movement to a closure gear 20660 to apply a rotational closing motion to the rotatable camshaft 20420 in the manner described above. See FIGS. 59 and 60. Thus, in at least one configuration, the operation of the first rotational drive system to cause rotation of the first proximal shaft member 20620 results in the operation of the closure system 20400 to move the anvil 20200 from the open position to the closed position.

[0087] Referring to FIGS. 65-67, a second shaft system 20710 includes a second proximal shaft member 20720 that is attached to a corresponding second rotational drive system supported by a housing of a surgical instrument or is otherwise operably linked. For example, the second rotational drive system may include a corresponding motor / gear configuration configured to rotate the second proximal shaft member 20720. The second shaft system 20710 further includes a second hollow central shaft 20730 having a hollow shaft body 20732 with a second spherical proximal end 20734. In one configuration, the second hollow central shaft 20730 may be fabricated as two segments that are welded or otherwise connected to each other. The second spherical proximal end 20734 defines a second central proximal cavity 20735 configured to movably receive the first spherical proximal cup 20622 of the first proximal shaft member 20620 therein. The second spherical proximal end 20734 is configured to be rotatably supported within a second spherical proximal cup 20722 on the second proximal shaft member 20720. The second hollow central shaft 20730 is movably pinned within a cavity 20724 within the second spherical proximal cup 20722 by a second proximal pin segment 20736 extending from the second spherical proximal end 20734 such that it is movably received within a corresponding arcuate slot 20726 within the second spherical proximal cup 20722 on the second proximal shaft member 20720. The second hollow central shaft 20730 further includes a second spherical distal end 20740. The second spherical distal end 20740 defines a second central distal cavity 20742 configured to movably receive the first spherical distal cup 20652 of the first distal shaft member 20650 therein. The second hollow central shaft 20730 is movably pinned within a cavity 20754 within the second spherical distal cup 20752 by a second distal pin segment 20746 extending from the second spherical distal end 20740 such that it is movably received within a corresponding arcuate slot 20756 within the second spherical distal cup 20752 on the second distal shaft member 20750.

[0088] In one configuration, the second distal shaft member 20750 can be configured to apply a rotational movement to a first rotary drive gear 20760 that meshes with a driven gear 20762 attached to a rotary drive shaft 20770 rotatably supported within an elongate channel 20100. See FIGS. 59, 60, and 68. As can be seen from FIGS. 59, 60, and 68, the surgical end effector 20000 further includes a firing member 20310 that threadedly engages the rotary drive shaft 20770. Rotation of the rotary drive shaft 20770 in a first rotational direction will move the firing member 20310 distally through the surgical end effector 20000 from a starting position (FIG. 59) to an end position. Rotation of the rotary drive shaft 20770 in the opposite rotational movement will drive the firing member 20310 from the end position to the starting position. Thus, in at least one configuration, when the second rotary drive system is actuated to rotate the second proximal shaft member 20720, the firing member 20310 will be actuated to cut and staple tissue clamped between the anvil 20200 and the surgical staple cartridge 20300.

[0089] Referring to FIGS. 65 - 67, a third shaft system 20810 includes a third proximal shaft member 20820 that is attached to or otherwise operably coupled to a corresponding third rotational drive system supported by a housing of a surgical instrument. For example, the third rotational drive system may include a corresponding motor / gear configuration configured to rotate the third proximal shaft member 20820. The third shaft system 20810 further includes a third hollow central shaft 20830 having a hollow shaft body 20832 with a third spherical proximal end 20834. In one configuration, the third hollow central shaft 20830 may be fabricated as two segments that are welded or otherwise connected to each other. The third spherical proximal end 20834 defines a third central proximal cavity 20835 configured to movably receive the second spherical proximal cup 20722 of the second proximal shaft member 20720 therein. The third spherical proximal end 20834 is configured to be rotatably supported within a third spherical proximal socket 20824 within the third proximal shaft member 20820. The third spherical proximal end 20834 is axially movable within the third proximal socket 20824 and is attached to the third proximal socket by a third proximal pin segment 20836 extending from the third spherical proximal end 20834 and being movably received within a corresponding axial slot 20824 within the third proximal socket 20824 on the third proximal shaft member 20820. The third hollow central shaft 20830 further includes a third spherical distal end 20840. The third spherical distal end 20840 defines a third central distal cavity 20842 configured to movably receive the second spherical distal cup 20752 of the second distal shaft member 20750 therein. The third spherical distal end 20840 is movably pinned within a third distal socket 20852 on the third distal shaft 20850.The third spherical distal end 20840 is axially movable within a third distal socket 20852 and is attached to the third distal socket 20852 by a third distal pin segment 20846 extending from the third spherical distal end 20840 so as to be movably received within a corresponding axial slot 20854 within the third distal socket 20850.

[0090] In one configuration, the third distal shaft member 20850 can be configured to rotate the surgical end effector 20000 about the shaft axis SA in addition to applying a rotational movement to the surgical end effector 20000. In one configuration, for example, the third distal shaft member 20850 may be directly attached (welded) to the elongate channel 20100. Thus, in at least one configuration, the actuation of the third rotational drive system to cause rotation of the third proximal shaft member 20820 will result in rotation of the third distal shaft member 20850 and the surgical end effector 20000. In the illustrated configuration, the mating gear teeth 20522 and 20552 on the upper proximal pivoting tang 20520 and the upper distal pivoting tang 20550 keep the center of the shaft system at the same center distance when undergoing articulating movement. Such a shaft system is very strong and robust while maintaining a tight articulation joint and also facilitates the distal roll of the surgical end effector.

[0091] Articulated robotic and hand-held end mechanical staplers must generate a lot of force to clamp thick tissue. It is difficult to transfer force through highly articulated joints (e.g., 60 degrees or more). Many robotic and hand-held motors are slow and have limited ability to generate sufficient torque. Figures 69-75 show a surgical end effector 21000 that can address many, if not all, of these challenges. As can be seen from Figure 69, the surgical end effector 21000 includes a first jaw 21100, which comprises an elongated channel 21110 configured to operably support a surgical staple cartridge 21300 therein. The surgical end effector 21000 further comprises a second jaw 21200 having an anvil 21210 pivotally coupled to the elongated channel 21110 about a fixed pivot axis PA. The anvil 21210 is pivotable between an open position (Figure 71) and a closed position (Figure 70) by a rotary drive closure system 21400.

[0092] In one configuration, the closure system 21400 includes a closure drive shaft 21410 configured to be rotated by a corresponding rotational motion source (such as a motor) within the housing of the surgical instrument to which the surgical end effector is attached. The closure drive shaft 21410 may comprise a flexible shaft configuration that can bend while transmitting torque through a joint. The closure drive shaft 21410 is attached to a rotary cam shaft 21420 having a closure cam lobe 21422 formed thereon. In one configuration, the opening bushing 21430 is pivotally supported for movement on the rotary cam shaft 21420 and is configured to engage an opening tab 21222 on the anvil mounting portion 21220 of the anvil 21210. The opening spring 21440 is positioned on the rotary cam shaft 21420 and biases the opening bushing 21430 distally into contact with the opening tab 21222 on the anvil 21210. As can be seen in FIG. 70, when the opening bushing 21430 moves distally, it contacts the opening tab 21222, thereby pivoting the anvil 21210 about the pivot axis PA to the open position (FIG. 71).

[0093] In one example, the anvil 21210 is pivoted from the open position to the closed position by rotating the rotary camshaft 21420 from the first rotational position shown in FIG. 72 to the final rotational position shown in FIG. 74. As can be seen in FIGS. 69 and 70, the closure system 21400 further includes a cam follower 21450 that is movably supported within the anvil mounting portion 21220 and configured to movably engage a closure cam lobe 21422 on the rotary camshaft 21420. FIGS. 71 and 72 show the position of the closure cam lobe 21422 when the anvil 21210 is in the open position. In that position, the anvil mounting portion 21220 pivots beyond the closure cam lobe 21422 such that the cam follower 21450 is not contacted by the closure cam lobe 21422. When the rotary camshaft 21420 begins to rotate, the closure cam lobe 21422 contacts the cam follower 21450 (FIG. 73) and cam drives the cam follower 21450 into contact with a pivot cradle 12224 within the anvil mounting portion 21220 (upward in FIG. 73), and the cam follower 21452 pivots the anvil 21210 to the closed position (FIG. 75). When the anvil 21210 pivots to the closed position, the release tab 21222 biases the release bushing 21430 proximally on the rotary camshaft 21420 against the biasing of the release spring 21440. Thus, when the rotary camshaft 21420 is rotated in the opposite direction, the anvil release spring 21440 biases the release bushing 21430 distally into contact with the release tab 21222 and pivots the anvil 21210 back to the open position.

[0094] FIG. 76 shows another rotary camshaft 21420' that is identical to the rotary camshaft 21420, except that the distal end 21426 of the rotary camshaft 21420' includes an opening cam 21426 configured to engage an opening tab 21222 on an anvil 21210 and move the anvil 21210 to an open position. Thus, when the rotary camshaft 21420' is in the first rotational position, the opening cam 21426 cam drives the anvil opening tab 21222 to pivot the anvil 21210 to the open position. Refer to FIG. 77. To close the anvil, the rotary camshaft 21420' is rotated in the closing direction such that the cam lobe 21422 cam drives the cam follower 21450 upward to pivot the anvil 21210 to the closed position. Next, the anvil 21210 can be returned to the open position by rotating the rotary camshaft 21420' back to the first rotational position. In an alternative configuration, an opening bushing 21430 and an opening spring 21440 may be used with the rotary camshaft 21420'.

[0095] It will be appreciated that the foregoing embodiments of the closing system 21400 facilitate applying relatively rapid closing and opening motions to the anvil 21210. In various configurations, the cam profile may be formed to establish a first low mechanical advantage and finally a relatively high mechanical advantage when the anvil 21210 begins to compress tissue. Such a closing system configuration employs fewer components than many other closing system designs. This configuration also provides additional space at the proximal end of the end effector to accommodate electronics and other mechanisms within the end effector.

[0096] Example 1 - A surgical instrument comprising a shaft assembly that defines a shaft axis. The surgical instrument further comprises a surgical end effector coupled to the shaft assembly by a joint that is configured to facilitate articulation of the surgical end effector relative to the shaft assembly in an articulation plane between a non-articulated position where the end effector axis is axially aligned with the shaft axis and an articulated position where the end effector axis is not axially aligned with the shaft axis. The joint comprises a proximal joint member coupled to the shaft assembly and a distal joint member coupled to the surgical end effector. The joint further comprises an articulation linkage assembly comprising a plurality of links. Each link is configured to moveably travel relative to the proximal joint member in a first proximal travel path and a second proximal travel path that traverses the first proximal travel path, and is thereby operably coupled to the proximal joint member. Each link is further configured to moveably travel relative to the distal joint member in a first distal travel path and a second distal travel path that traverses the first distal travel path, and is thereby operably coupled to the distal joint member. The articulation linkage assembly defines a central passageway that extends between the plurality of links. The surgical instrument further comprises a drive member that extends through the proximal joint member, the central passageway, and the distal joint member and is operably coupled to the surgical end effector. At least two flexible actuator members span the joint and are operably coupled to the distal joint member to apply articulation movement to the distal joint member.

[0097] Example 2 - The surgical instrument of Example 1, wherein the plurality of links includes three links.

[0098] Example 3 - The three links are configured to operably associate with a proximal joint member so as to be movable relative to the proximal joint member in a first proximal travel path and another first proximal travel path that crosses the first proximal travel path, and include a first link. The first link is further configured to operably associate with a distal joint member so as to be movable relative to the distal joint member in a first distal travel path and another first distal travel path that crosses the first distal travel path. The three links further include a second link configured to operably associate with the proximal joint member so as to be movable relative to the proximal joint member in a second proximal travel path and another second proximal travel path that crosses the second proximal travel path. The second link is configured to operably associate with the distal joint member so as to be movable relative to the distal joint member in a second distal travel path and another second distal travel path that crosses the second distal travel path. The three links further include a third link configured to operably associate with the proximal joint member so as to be movable relative to the proximal joint member in a third proximal travel path and another third travel path that crosses the third proximal travel path. The third link is further configured to operably associate with the distal joint member so as to be movable relative to the distal joint member in a third distal travel path and another third distal travel path that crosses the third distal travel path.

[0099] Example 4 - The surgical instrument according to Example 1, 2, or 3, wherein each link comprises a proximal saddle configured to be movably associated with a corresponding proximal mounting lug on the proximal joint member and a distal saddle configured to be movably associated with a corresponding distal mounting lug on the distal joint member.

[0100] Example 5 - The surgical instrument according to Example 4, wherein each proximal mounting lug defines an arcuate proximal pivoting surface. Each proximal saddle is movably coupled to the arcuate proximal pivoting surface on the proximal mounting lug and is configured to facilitate movement of the link in the first proximal travel path and the second proximal travel path on the proximal mounting lug, and includes a U-shaped proximal pivoting surface. Each distal mounting lug defines an arcuate distal pivoting surface. Each distal saddle is movably coupled to the arcuate distal pivoting surface on the distal mounting lug and is configured to facilitate movement of the link in the first distal travel path and the second distal travel path on the distal mounting lug, and includes a U-shaped distal pivoting surface.

[0101] Example 6 - The surgical instrument according to Example 5, wherein each proximal mounting lug defines a proximal lug axis, and the first proximal travel path includes a first arcuate proximal travel path along the proximal lug axis. The second proximal travel path includes a second arcuate proximal travel path around the proximal lug axis. Each distal mounting lug defines a distal lug axis, and the first distal travel path includes a first arcuate distal travel path along the distal lug axis. The second distal travel path includes a second arcuate distal travel path around the distal lug axis.

[0102] Example 7 - The surgical instrument according to Example 1, 2, 3, 4 or 6, wherein the portion of the drive member extending through the articulation joint is flexible.

[0103] Example 8 - The surgical instrument according to Example 1, 2, 3, 4, 5, 6, or 7, wherein the drive member includes a proximal drive shaft including a distal end operably supported within a proximal coupling member. The distal drive shaft includes a proximal end operably supported within a distal coupling member. The central drive shaft spans between the proximal coupling member and the distal coupling member on the distal side and includes a proximal end configured to be operably coupled to the distal end of the proximal drive shaft. The central drive shaft further includes a distal end configured to be operably coupled to the proximal end of the distal drive shaft.

[0104] Example 9 - The surgical instrument according to Example 8, wherein the proximal drive shaft is configured to apply a rotational driving motion to the central drive shaft.

[0105] Example 10 - The surgical instrument according to any one of Examples 1, 2, 3, 4, 5, 6, 7, 8, or 9, wherein at least two flexible actuator members span a joint and include four cables operably coupled to a distal joint member to apply articulating movement to the distal joint member.

[0106] Example 11 - The surgical instrument according to any one of Examples 1, 2, 3, 4, 5, 6, 7, 8, 9, or 10, wherein each link is not attached to a proximal joint member and a distal joint member.

[0107] Example 12 - The surgical instrument according to any one of Examples 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11, wherein each link is movably in contact with and held by a proximal joint member and a distal joint member.

[0108] Surgical instrument comprising a shaft assembly defining a shaft axis and a surgical end effector defining an end effector axis. The surgical end effector is connected to the shaft assembly by a joint configured to facilitate articulation of the surgical end effector relative to the shaft assembly in an articulation plane between a non-articulated position where the end effector axis is axially aligned with the shaft axis in the articulation plane and an articulated position where the end effector axis is not axially aligned with the shaft axis. The joint includes a proximal member connected to the shaft assembly and a distal member connected to the surgical end effector. The joint further includes an articulation linkage assembly having a first link configured to operably engage the proximal member to travel movably relative to the proximal member in a first proximal travel path and another first proximal travel path traversing the first proximal travel path. The first link is further configured to operably engage the distal member to travel movably relative to the distal member in a first distal travel path and another first distal travel path traversing the first distal travel path. The articulation linkage assembly further includes a second link configured to operably engage the proximal member to travel movably relative to the proximal member in a second proximal travel path and another second proximal travel path traversing the second proximal travel path. The second link is further configured to operably engage the distal member to travel movably relative to the distal member in a second distal travel path and another second distal travel path traversing the second distal travel path. The articulation linkage assembly further includes a third link configured to operably engage the proximal member to travel movably relative to the proximal member in a third proximal travel path and another third travel path traversing the third proximal travel path. The third link is further configured to operably engage the distal member to travel movably relative to the distal member in a third distal travel path and another third distal travel path traversing the third distal travel path.The surgical instrument further comprises at least two flexible actuator members that span a joint and are operably coupled to a distal member to apply joint movement to the distal member.

[0109] Example 14 - The surgical instrument according to Example 13, wherein the first link defines a first link axis. The second link defines a second link axis. The third link defines a third link axis. The first link axis, the second link axis, and the third link axis are transverse to each other.

[0110] Example 15 - The first link, the second link, and the third link are arranged relative to each other to define a central passage extending between the first link, the second link, and the third link, and the central passage is configured to operably support a drive member therein. The surgical instrument according to Example 13 or 14.

[0111] Example 16 - The first link includes a first proximal saddle configured to be movably coupled to a corresponding first proximal attachment lug on the proximal member and a first distal saddle configured to be movably coupled to a corresponding first distal attachment lug on the distal member. The surgical instrument according to Example 13, 14, or 15. The second link includes a second proximal saddle configured to be movably coupled to a corresponding second proximal attachment lug on the proximal member and a second distal saddle configured to be movably coupled to a corresponding second distal attachment lug on the distal member. The third link includes a third proximal saddle configured to be movably coupled to a corresponding third proximal attachment lug on the proximal member and a third distal saddle configured to be movably coupled to a corresponding third distal attachment lug on the distal member.

[0112] Example 17 - The surgical instrument described in Example 16, wherein the first proximal mounting lug defines a first arcuate proximal pivoting surface. The first proximal saddle is movably associated with the first arcuate proximal pivoting surface on the first proximal mounting lug and is configured to facilitate movement of the first link in a first proximal travel path and another first proximal travel path on the first proximal mounting lug, and includes a first U-shaped proximal pivoting surface. The second proximal mounting lug defines a second arcuate proximal pivoting surface. The second proximal saddle is movably associated with the second arcuate proximal pivoting surface on the second proximal mounting lug and is configured to facilitate movement of the second link in a second proximal travel path and another second proximal travel path on the second proximal mounting lug, and includes a second U-shaped proximal pivoting surface. The third proximal mounting lug defines a third arcuate proximal pivoting surface. The third proximal saddle is movably associated with the third arcuate proximal pivoting surface on the third proximal mounting lug and is configured to facilitate movement of the third link in a third proximal travel path and another third proximal travel path on the third proximal mounting lug, and includes a third U-shaped proximal pivoting surface.

[0113] Example 18 - The surgical instrument described in Example 17, wherein the first distal mounting lug defines a first arcuate distal pivoting surface. The first distal saddle is movably associated with the first arcuate distal pivoting surface on the first distal mounting lug and is configured to facilitate movement of the first link in a first distal travel path and another first distal travel path on the first distal mounting lug, and includes a first U-shaped distal pivoting surface. The second distal mounting lug defines a second arcuate pivoting surface. The second distal saddle is movably associated with the second arcuate distal pivoting surface on the second distal mounting lug and is configured to facilitate movement of the second link in a second distal travel path and another second distal travel path on the second distal mounting lug, and includes a second U-shaped distal pivoting surface. The third distal mounting lug defines a third arcuate distal pivoting surface. The third distal saddle is movably associated with the third arcuate distal pivoting surface on the third distal mounting lug and is configured to facilitate travel of the third link in a third distal travel path and another third distal travel path on the third distal mounting lug, and includes a third U-shaped distal pivoting surface.

[0114] Example 19 - The surgical instrument described in Example 18, wherein the first proximal attachment lug defines a first proximal lug axis. The first proximal travel path includes a first arcuate proximal travel path along the first proximal lug axis, and another first proximal travel path includes another first arcuate proximal travel path extending around the first proximal lug axis. The second proximal attachment lug defines a second proximal lug axis. The second proximal travel path includes a second arcuate proximal travel path along the second proximal lug axis, and another second proximal travel path includes another second arcuate proximal travel path extending around the second proximal lug axis. The third proximal attachment lug defines a third proximal lug axis. The third proximal travel path includes a third arcuate proximal travel path extending along the third proximal lug axis. Another third proximal travel path includes another third arcuate proximal travel path extending along the third proximal lug axis. The first distal attachment lug defines a first distal lug axis. The first distal travel path includes a first arcuate distal travel path extending along the first distal lug axis. Another first distal travel path includes another first arcuate distal travel path extending around the first distal lug axis. The second distal attachment lug defines a second distal lug axis. The second distal travel path includes a second arcuate distal travel path extending along the second distal lug axis. Another second distal travel path includes another second arcuate distal travel path extending around the second distal lug axis. The third distal attachment lug defines a third distal lug axis. The third distal travel path includes a third arcuate distal travel path extending along the third distal lug axis. Another third distal travel path includes another third arcuate distal travel path extending around the third distal lug axis.

[0115] Example 20 - The surgical instrument described in Example 19, wherein the first proximal lug axis, the second proximal lug axis, and the third proximal lug axis are transverse to each other, and the first distal lug axis, the second distal lug axis, and the third distal lug axis are transverse to each other.

[0116] 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 including one or more individual instruction processing cores, a processing unit, a processor, a microcontroller, a microcontroller unit, a controller, a digital signal processor (DSP), a programmable logic device (PLD), a programmable logic array (PLA), or a field programmable gate array (FPGA)), 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" includes, but is not limited 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).Those skilled in the art will recognize that the subject matter described herein may be implemented in analog or digital form, or some combination thereof.

[0117] 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 disclosure. Further, the structure of each element associated with 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, revisions, and equivalents.

[0118] One or more components may be referred to herein as "configured to", "configurable to", "operable / operative to", "adapted / adaptable", "able to", "conformable / conformed to", etc. 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, unless the context dictates otherwise.

[0119] Those skilled in the art will generally understand that the terms used herein, and particularly those used in the appended claims (e.g., the body of the appended claims), are generally intended to be "open" terms (e.g., the term "including" should be construed as "including but not limited to", the term "having" should be construed as "having at least", the term "includes" should be construed as "includes but is not limited to", etc.). Further, where a specific number is intended in an introduced claim recitation, such intent will be clearly recited in the claim, and those skilled in the art will understand that where there is no such recitation, there is no such intent. For example, for purposes of illustration, the following appended claims may include introductory phrases such as "at least one" and "one or more" to introduce claim recitations. However, the use of such phrases should not be construed as suggesting that any particular claim that includes such an introduced claim recitation, even where the introductory phrase and the indefinite article "a" or "an" are included in the same claim, is limited to a claim that includes only one such recited item (e.g., "a" and / or "an" should generally be construed as meaning "at least one" or "one or more"). The same holds true when introducing a claim recitation using a definite article.

[0120] In addition, even if a specific number is specified in the introduced claim description, it will be recognized by those skilled in the art that such description should typically be construed to mean at least the recited number (for example, in the case of a mere description of "two items" without other modifiers, generally it means at least two items, or two or more items). Further, when a notation similar to "at least one of A, B, and C, etc." is used, generally such syntax is intended in the sense that those skilled in the art will understand the notation (for example, "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 a notation similar to "at least one of A, B, or C, etc." is used, generally such syntax is intended in the sense that those skilled in the art will understand the notation (for example, "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 by those skilled in the art 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".

[0121] 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, unless the context dictates otherwise, repetition, interleaving, interruption, reordering, incremental, preparatory, additional, simultaneous, reverse, or other different orderings. Further, terms such as "responsive to", "associated with", or other past tense adjectives are generally not intended to exclude such variations, unless the context dictates otherwise.

[0122] It is worth noting that any reference to "one aspect", "aspect", "exemplification", "an exemplification", etc. means that the particular mechanism, 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, a particular feature, structure, or characteristic can be combined in any suitable manner in one or more aspects.

[0123] 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. As such, 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 are inconsistent 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.

[0124] 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 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, thereby enabling one of ordinary skill in the art to utilize various forms, with various modifications, as suitable for the particular uses contemplated. The claims presented with this specification are intended to define the overall scope.

[0125] The surgical instrument system described herein has been described in connection with the deployment and deformation of staples; 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 can include electrodes configured to heat and seal tissue. Also for example, an end effector according to a particular embodiment can apply vibrational energy to seal tissue.

[0126] 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. Additionally, 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.

[0127] The entire contents of the following disclosure are incorporated herein by reference. U.S. Patent No. 5,403,312, issued April 4, 1995, entitled "ELECTROSURGICAL HEMOSTATIC DEVICE", U.S. Patent No. 7,000,818, issued February 21, 2006, entitled "SURGICAL STAPLING INSTRUMENT HAVING SEPARATE DISTINCT CLOSING AND FIRING SYSTEMS", U.S. Patent No. 7,422,139, issued September 9, 2008, entitled "MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING INSTRUMENT WITH TACTILE POSITION FEEDBACK", U.S. Patent No. 7,464,849, issued December 16, 2008, entitled "ELECTRO-MECHANICAL SURGICAL INSTRUMENT WITH CLOSURE SYSTEM AND ANVIL ALIGNMENT COMPONENTS", 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 on 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 on September 29, 2012, now U.S. Patent No. 8,733,613, entitled "STAPLE CARTRIDGE", U.S. Patent Application No. 13 / 036,647, filed on 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 on 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 on 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 on 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 on January 31, 2006, titled "SURGICAL CUTTING AND FASTENING INSTRUMENT WITH CLOSURE TRIGGER LOCKING MECHANISM", and U.S. Patent Application Publication No. 2010 / 0264194, filed on April 22, 2010, titled "SURGICAL STAPLING INSTRUMENT WITH AN ARTICULATABLE END EFFECTOR", now U.S. Patent No. 8,308,040.

[0128] Although various devices have been described herein in connection with specific embodiments, modifications and changes may be made to those embodiments. Specific features, structures, or characteristics may be combined in any suitable manner in one or more embodiments. Thus, specific features, structures, or characteristics illustrated or described with respect to one embodiment may be combined, without limitation, in whole or in part with the features, structures, or characteristics of one or more other embodiments. Also, although materials are disclosed with respect to specific components, other materials may be used. Further, in accordance with various embodiments, a single component may be replaced by a plurality of components, or a plurality of components may be replaced by a single component, to perform a given function. The foregoing description and the following claims are intended to embrace all such modifications and variations.

[0129] The devices disclosed herein can be designed to be discarded after a single use or to 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 a disassembly step of the device, followed by a cleaning step or replacement step of certain parts of the device, and then a reassembly step of the device. Specifically, the 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 skilled in the art will understand that various techniques for disassembly, cleaning / replacement, and reassembly can be utilized for the reconditioning of the device. The use of such techniques, and the resulting reconditioned device, are all within the scope of this application.

[0130] 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 a TYVEK bag. The container and the 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 sterilized container. The sealed container can keep the instrument in a sterilized 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.

[0131] 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.

[0132] 〔Embodiments〕 (1) A surgical instrument, comprising a shaft assembly defining a shaft axis, and a surgical end effector, wherein the surgical end effector defines an end effector axis, and the surgical end effector is connected to the shaft assembly by a joint configured to facilitate articulation of the surgical end effector relative to the shaft assembly in an articulation plane between a non-articulated position where the end effector axis is axially aligned with the shaft axis and an articulated position where the end effector axis is not axially aligned with the shaft axis, and the joint includes a proximal joint member connected to the shaft assembly, a distal joint member connected to the surgical end effector, an articulation linkage assembly including a plurality of links, each link being configured to move relative to the proximal joint member in a first proximal travel path and a second proximal travel path that crosses the first proximal travel path, and each link being configured to move relative to the distal joint member in a first distal travel path and a second distal travel path that crosses the first distal travel path, and the articulation linkage assembly defining a central passage extending between the plurality of links, and the surgical instrument further includes a drive member extending through the proximal joint member, the central passage, and the distal joint member to be operably associated with the surgical end effector, and at least two flexible actuator members spanning the joint and operably associated with the distal joint member to apply articulation movement to the distal joint member. (2) The surgical instrument according to embodiment 1, wherein the plurality of links includes three links. (3) The three links are In a first proximal travel path and another first proximal travel path that crosses the first proximal travel path, a first link configured to be operably associated with the proximal joint member to travel movably with respect to the proximal joint member, and in a first distal travel path and another first distal travel path that crosses the first distal travel path, a first link configured to be operably associated with the distal joint member to travel movably with respect to the distal joint member. In a second proximal travel path and another second proximal travel path that crosses the second proximal travel path, a second link configured to be operably associated with the proximal joint member to travel movably with respect to the proximal joint member, and in a second distal travel path and another second distal travel path that crosses the second distal travel path, a second link configured to be operably associated with the distal joint member to travel movably with respect to the distal joint member. In a third proximal travel path and another third travel path that crosses the third proximal travel path, a third link configured to be operably associated with the proximal joint member to travel movably with respect to the proximal joint member, and in a third distal travel path and another third distal travel path that crosses the third distal travel path, a third link configured to be operably associated with the distal joint member to travel movably with respect to the distal joint member. The surgical instrument according to Embodiment 2 includes the third link. (4) Each of the links A proximal saddle configured to be movably associated with a corresponding proximal mounting lug on the proximal joint member. A distal saddle configured to be movably associated with a corresponding distal mounting lug on the distal joint member. The surgical instrument according to Embodiment 1 includes the distal saddle. (5) Each of the proximal mounting lugs defines an arcuate proximal pivoting surface, and each of the proximal saddles is movably coupled with the arcuate proximal pivoting surface on the proximal mounting lug and includes a U-shaped proximal pivoting surface configured to facilitate the advancement of the link in the first proximal advancement path and the second proximal advancement path on the proximal mounting lug. Each of the distal mounting lugs defines an arcuate distal pivoting surface, and each of the distal saddles is movably coupled with the arcuate distal pivoting surface on the distal mounting lug and includes a U-shaped distal pivoting surface configured to facilitate the advancement of the link in the first distal advancement path and the second distal advancement path on the distal mounting lug. The surgical instrument according to Embodiment 4.

[0133] (6) Each of the proximal mounting lugs defines a proximal lug axis, the first proximal advancement path includes a first arcuate proximal advancement path along the proximal lug axis, the second proximal advancement path includes a second arcuate proximal advancement path around the proximal lug axis, each of the distal mounting lugs defines a distal lug axis, the first distal advancement path includes a first arcuate distal advancement path along the distal lug axis, and the second distal advancement path includes a second arcuate distal advancement path around the distal lug axis. The surgical instrument according to Embodiment 5. (7) A portion of the drive member extending through the articulation joint is flexible. The surgical instrument according to Embodiment 1. (8) The drive member includes a proximal drive shaft having a distal end operably supported within the proximal joint member, a distal drive shaft having a proximal end operably supported within the distal joint member, and a central drive shaft spanning between the proximal joint member and the distal end of the distal joint member. The central drive shaft includes a proximal end configured to be operably coupled with the distal end of the proximal drive shaft, and the central drive shaft further includes a distal end configured to be operably coupled with the proximal end of the distal drive shaft. The surgical instrument according to Embodiment 1. (9) The proximal drive shaft is configured to apply a rotational drive motion to the central drive shaft, the surgical instrument according to Embodiment 8. (10) The at least two flexible actuator members include four cables, the four cables spanning the articulation joint and operably coupled to the distal articulation member to apply an articulation motion to the distal articulation member, the surgical instrument according to Embodiment 1.

[0134] (11) Each of the plurality of links is not attached to the proximal member and the distal member, the surgical instrument according to Embodiment 10. (12) Each of the plurality of links is movably in contact with and held by the proximal member and the distal member, the surgical instrument according to Embodiment 11. (13) A surgical instrument, A shaft assembly defining a shaft axis, A surgical end effector, and the surgical end effector defines an end effector axis, the surgical end effector being coupled to the shaft assembly by an articulation joint configured to facilitate articulation of the surgical end effector relative to the shaft assembly in the articulation plane between a non-articulation position where the end effector axis is axially aligned with the shaft axis in the articulation plane and an articulation position where the end effector axis is not axially aligned with the shaft axis, the articulation joint including A proximal member coupled to the shaft assembly, A distal member coupled to the surgical end effector, An articulation linkage assembly, In a first proximal travel path and another first proximal travel path that crosses the first proximal travel path, a first link configured to be operably coupled with the proximal joint member so as to travel movably relative to the proximal joint member, and in a first distal travel path and another first distal travel path that crosses the first distal travel path, the first link configured to be operably coupled with the distal joint member so as to travel movably relative to the distal joint member, In a second proximal travel path and another second proximal travel path that crosses the second proximal travel path, a second link configured to be operably coupled with the proximal joint member so as to travel movably relative to the proximal joint member, and in a second distal travel path and another second distal travel path that crosses the second distal travel path, the second link configured to be operably coupled with the distal joint member so as to travel movably relative to the distal joint member, In a third proximal travel path and another third travel path that crosses the third proximal travel path, a third link configured to be operably coupled with the proximal joint member so as to travel movably relative to the proximal joint member, and in a third distal travel path and another third distal travel path that crosses the third distal travel path, the third link configured to be operably coupled with the distal joint member so as to travel movably relative to the distal joint member, and an articulating linkage assembly comprising the third link, and the surgical instrument further comprises at least two flexible actuator members, the at least two flexible actuator members spanning the articulation joint and operably coupled with the distal joint member to apply articulating movement to the distal joint member. (14) The first link defines a first link axis, the second link defines a second link axis, the third link defines a third link axis, and the first link axis, the second link axis, and the third link axis cross each other. The surgical instrument according to Embodiment 13. (15) The first link, the second link, and the third link are arranged relative to each other so as to define a central passage extending between the first link, the second link, and the third link, and the central passage is configured to operably support a drive member therein. The surgical instrument according to Embodiment 14.

[0135] (16) The first link a first proximal saddle configured to movably cooperate with a corresponding first proximal mounting lug on the proximal joint; a first distal saddle configured to movably cooperate with a corresponding first distal mounting lug on the distal joint. The second link a second proximal saddle configured to movably cooperate with a corresponding second proximal mounting lug on the proximal joint; a second distal saddle configured to movably cooperate with a corresponding second distal mounting lug on the distal joint. The third link a third proximal saddle configured to movably cooperate with a corresponding third proximal mounting lug on the proximal joint; a third distal saddle configured to movably cooperate with a corresponding third distal mounting lug on the distal joint. The surgical instrument according to Embodiment 13. (17) The first proximal mounting lug defines a first arcuate proximal pivoting surface, and the first proximal saddle is movably coupled with the first arcuate proximal pivoting surface on the first proximal mounting lug and is configured to facilitate the advancement of the first link in the first proximal advancement path and the other first proximal advancement path on the first proximal mounting lug, and includes a first U-shaped proximal pivoting surface; the second proximal mounting lug defines a second arcuate proximal pivoting surface, and the second proximal saddle is movably coupled with the second arcuate proximal pivoting surface on the second proximal mounting lug and is configured to facilitate the advancement of the second link in the second proximal advancement path and the other second proximal advancement path on the second proximal mounting lug, and includes a second U-shaped proximal pivoting surface; the third proximal mounting lug defines a third arcuate proximal pivoting surface, and the third proximal saddle is movably coupled with the third arcuate proximal pivoting surface on the third proximal mounting lug and is configured to facilitate the advancement of the third link in the third proximal advancement path and the other third proximal advancement path on the third proximal mounting lug, and includes a third U-shaped proximal pivoting surface. The surgical instrument according to Embodiment 16. (18) The first distal mounting lug defines a first arcuate distal pivot surface, and the first distal saddle is movably coupled with the first arcuate distal pivot surface on the first distal mounting lug and is configured to facilitate the travel of the first link in the first distal travel path and the other first distal travel path on the first distal mounting lug, and includes a first U-shaped distal pivot surface; the second distal mounting lug defines a second arcuate distal pivot surface, and the second distal saddle is movably coupled with the second arcuate distal pivot surface on the second distal mounting lug and is configured to facilitate the travel of the second link in the second distal travel path and the other second distal travel path on the second distal mounting lug, and includes a second U-shaped distal pivot surface; the third distal mounting lug defines a third arcuate distal pivot surface, and the third distal saddle is movably coupled with the third arcuate distal pivot surface on the third distal mounting lug and is configured to facilitate the travel of the third link in the third distal travel path and the other third distal travel path on the third distal mounting lug, and includes a third U-shaped distal pivot surface, the surgical instrument according to Embodiment 17. (19) The first proximal mounting lug defines a first proximal lug axis, the first proximal travel path includes a first arcuate proximal travel path along the first proximal lug axis, the another first proximal travel path includes another first arcuate proximal travel path around the first proximal lug axis, the second proximal mounting lug defines a second proximal lug axis, the second proximal travel path includes a second arcuate proximal travel path along the second proximal lug axis, the another second proximal travel path includes another second arcuate proximal travel path extending around the second proximal lug axis, the third proximal mounting lug defines a third proximal lug axis, the third proximal travel path includes a third arcuate proximal travel path along the third proximal lug axis, the another third proximal travel path includes another third arcuate proximal travel path extending around the third proximal lug axis, the first distal mounting lug defines a first distal lug axis, the first distal travel path includes a first arcuate distal travel path along the first distal lug axis, the another first distal travel path includes another first arcuate distal travel path extending around the first distal lug axis, the second distal mounting lug defines a second distal lug axis, the second distal travel path includes a second arcuate distal travel path along the second distal lug axis, the another second distal travel path includes another second arcuate distal travel path extending along the second distal lug axis, the third distal mounting lug defines a third distal lug axis, the third distal travel path includes a third arcuate distal travel path along the third distal lug axis, the another third distal travel path includes another third arcuate distal travel path extending around the third distal lug axis, the surgical instrument according to embodiment 18. (20) The first proximal lug axis, the second proximal lug axis, and the third proximal lug axis are transverse to each other, and the first distal lug axis, the second distal lug axis, and the third distal lug axis are transverse to each other, the surgical instrument according to embodiment 19.

Claims

**Claim 1** A surgical instrument, comprising: a shaft assembly defining a shaft axis; and a surgical end effector defining an end effector axis, the surgical end effector being connected to the shaft assembly by a joint configured to facilitate articulation of the surgical end effector relative to the shaft assembly in an articulation plane between a non-articulated position where the end effector axis is axially aligned with the shaft axis and an articulated position where the end effector axis is not axially aligned with the shaft axis, the joint including: a proximal joint member connected to the shaft assembly; a distal joint member connected to the surgical end effector; and an articulation linkage assembly including a plurality of links, each link being configured to move relative to the proximal joint member along a first proximal travel path and a second proximal travel path that crosses the first proximal travel path, and each link being configured to move relative to the distal joint member along a first distal travel path and a second distal travel path that crosses the first distal travel path, the articulation linkage assembly defining a central passage extending between the plurality of links, the surgical instrument further comprising: a drive member extending through the proximal joint member, the central passage, and the distal joint member and being operably associated with the surgical end effector; and at least two flexible actuator members spanning the joint and being operably associated with the distal joint member to apply articulation movement to the distal joint member. **Claim 2** The surgical instrument according to claim 1, wherein the plurality of links includes three links. **Claim 3** The three links are: In a first proximal travel path and another first proximal travel path that crosses the first proximal travel path, a first link configured to be operably coupled with the proximal joint member so as to travel movably with respect to the proximal joint member, and in a first distal travel path and another first distal travel path that crosses the first distal travel path, a first link configured to be operably coupled with the distal joint member so as to travel movably with respect to the distal joint member, In a second proximal travel path and another second proximal travel path that crosses the second proximal travel path, a second link configured to be operably coupled with the proximal joint member so as to travel movably with respect to the proximal joint member, and in a second distal travel path and another second distal travel path that crosses the second distal travel path, a second link configured to be operably coupled with the distal joint member so as to travel movably with respect to the distal joint member, In a third proximal travel path and another third travel path that crosses the third proximal travel path, a third link configured to be operably coupled with the proximal joint member so as to travel movably with respect to the proximal joint member, and in a third distal travel path and another third distal travel path that crosses the third distal travel path, a third link configured to be operably coupled with the distal joint member so as to travel movably with respect to the distal joint member, the surgical instrument according to claim 2, comprising:

4. Each said link is a proximal saddle configured to be movably coupled with a corresponding proximal mounting lug on the proximal joint member, a distal saddle configured to be movably coupled with a corresponding distal mounting lug on the distal joint member, the surgical instrument according to claim 1, comprising:

5. 5. The surgical instrument of claim 4, wherein each proximal mounting lug defines an arcuate proximal pivot surface, each proximal saddle includes a U-shaped proximal pivot surface configured in movably association with the arcuate proximal pivot surface on the proximal mounting lug to facilitate advancement of the link in the first proximal advancement path and the second proximal advancement path on the proximal mounting lug, and each distal mounting lug defines an arcuate distal pivot surface, each distal saddle includes a U-shaped distal pivot surface configured in movably association with the arcuate distal pivot surface on the distal mounting lug to facilitate advancement of the link in the first distal advancement path and the second distal advancement path on the distal mounting lug.

6. 6. The surgical instrument of claim 5, wherein each proximal attachment lug defines a proximal lug axis, the first proximal progression path comprises a first arcuate proximal progression path along the proximal lug axis, the second proximal progression path comprises a second arcuate proximal progression path about the proximal lug axis, and each distal attachment lug defines a distal lug axis, the first distal progression path comprises a first arcuate distal progression path along the distal lug axis, and the second distal progression path comprises a second arcuate distal progression path about the distal lug axis.

7. The surgical instrument of claim 1 , wherein the portion of the drive member extending through the articulation joint is flexible.

8. The driving member is a proximal drive shaft having a distal end operably supported within the proximal coupling member; a distal drive shaft having a proximal end operably supported within the distal coupling member; 2. The surgical instrument of claim 1, comprising: a central drive shaft spanning between the proximal joint member and the distal joint member, the central drive shaft comprising a proximal end configured to operatively couple with the distal end of the proximal drive shaft; and the central drive shaft further comprising a distal end configured to operatively couple with the proximal end of the distal drive shaft.

9. The surgical instrument of claim 8, wherein the proximal drive shaft is configured to impart a rotational drive motion to the central drive shaft.

10. 10. The surgical instrument of claim 1, wherein the at least two flexible actuator members comprise four cables that span the articulation joint and are in operative association with the distal joint member to impart articulation motion to the distal joint member.

11. The surgical instrument of claim 10, wherein each link of the plurality of links is unattached to the proximal joint member and the distal joint member.

12. The surgical instrument of claim 11 , wherein each link of the plurality of links is held in moveable contact with the proximal joint member and the distal joint member.

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