Jointly moving surgical instruments

Abstract

To provide an articulating surgical instrument.SOLUTION: In one embodiment, a surgical instrument may include an elongated shaft assembly including an articulable portion moveable between a non-articulated configuration and an articulated configuration. First and second articulating shafts of the elongated shaft assembly may be coaxially arranged and axially fixed at an attachment point located distally from the articulable portion. Proximal portions of the first and second articulating shafts may be displaceable in opposing directions to articulate the articulable portion from the non-articulated configuration to the articulated configuration. In another embodiment, an articulation control part may be movable from a first position to a second position to move an articulation lock from a locked configuration to an unlocked configuration to selectively permit articulation of a surgical instrument. The articulation lock also may be movable from the second position to a third position to articulate the surgical instrument.SELECTED DRAWING: Figure 5

Description

Technical Field

[0001]

[0001] The disclosed embodiments relate to a surgical instrument that articulates.

Background Art

[0002]

[0002] To surgically repair a hernia, a surgical mesh fabric or other prosthetic repair fabric may be used. The prosthetic repair fabric is generally placed via an open procedure or laparoscopically. Often, a surgical instrument is used to secure the repair fabric in place by deploying one or more fasteners from the distal end of the surgical instrument through the prosthetic repair fabric into the underlying tissue. However, surgical instruments that include a rigid elongate shaft assembly for deploying the fasteners may have a limited range of motion within the surgical field. Accordingly, many surgical instruments include at least one articulable portion, i.e., an articulating portion, along the elongate shaft assembly to facilitate the orientation and placement of the fasteners within the surgical field.

Summary of the Invention

[0003]

[0003] In one embodiment, a surgical instrument includes a handle and an elongate shaft assembly that extends distally from the handle. The elongate shaft assembly includes an articulating portion that is movable between a non-articulated state, i.e., a state in which the joint is non-operating, and an articulated state, i.e., a state in which the joint is operating. The elongate shaft assembly includes a first articulating shaft and a second articulating shaft that is coaxially disposed with respect to and axially fixed with respect to the first articulating shaft at a location distal to the articulating portion of the elongate shaft assembly. The proximal portion of the first articulating shaft is displaceable in a distal direction, and the proximal portion of the second articulating shaft is displaceable in a proximal direction to move the articulating portion of the elongate shaft assembly from the non-articulated state to the articulated state.

[0004]

[0004] In another embodiment, the method of operating the surgical instrument includes displacing the proximal portion of the first articulated shaft of the elongated shaft assembly of the surgical instrument in the proximal direction. The elongated shaft assembly includes an articulated portion that is movable between a non-articulated configuration and an articulated configuration. The method also includes displacing the proximal portion of the second articulated shaft of the elongated shaft assembly in the distal direction. The second articulated shaft is located distal to the articulated portion of the elongated shaft assembly, is coaxially positioned with respect to the first articulated shaft, and is axially fixed with respect to the first articulated shaft. The method further includes, at least in part, articulating the elongated shaft assembly from a non-articulated configuration to an articulated configuration due to the displacement of the proximal portions of the first and second articulated shafts.

[0005]

[0005] In a further embodiment, the surgical instrument includes a handle and an articulated cam that is movable relative to the handle between at least a first position and a second position. The articulated cam includes a first cam profile and a second cam profile. The surgical instrument further includes an elongated shaft assembly extending distally from the handle, and the elongated shaft assembly includes a first shaft including a proximal portion coupled to the first cam profile and a second shaft including a proximal portion coupled to the second cam profile, the second shaft being coaxially positioned with respect to the first shaft. Moving the articulated cam from the first position to the second position displaces the proximal portion of the first shaft in the first direction and the proximal portion of the second shaft in the second direction.

[0006]

[0006] In yet another embodiment, the method of operating a surgical instrument includes moving an articulated cam relative to the handle of the surgical instrument from a first position to a second position. The surgical instrument includes an elongated shaft assembly extending distally from the handle. The elongated shaft assembly includes a first shaft and a second shaft arranged coaxially with respect to the first shaft. The articulated cam includes a first cam profile coupled to the proximal portion of the first shaft and a second cam profile coupled to the proximal portion of the second shaft. The method further includes, at least in part, displacing the proximal portion of the first shaft in a first direction due to the movement of the articulated cam from a first position to a second position, and at least in part, displacing the proximal portion of the second shaft in a second direction opposite to the first direction due to the movement of the articulated cam from a first position to a second position.

[0007]

[0007] In another embodiment, the surgical instrument includes a handle and an elongated shaft assembly extending distally from the handle. The elongated shaft assembly includes an articulated portion that is movable between a non-articulated position and an articulated position. The surgical instrument further includes an articulated lock, which, when the articulated lock is in a first locked position, selectively prevents articulation of the articulated portion of the elongated shaft assembly, and when the articulated lock is in a second unlocked position, allows articulation of the articulated portion of the elongated shaft assembly. The surgical instrument also includes an articulated control unit that controls the articulation of the articulated portion of the elongated shaft assembly. Moving the articulated control unit from a first position to a second position moves the articulated lock from a first locked position to a second unlocked position, thereby allowing articulation of the articulated portion of the elongated shaft assembly, and moving the articulated control unit from a second position to a third position causes the articulated portion of the elongated shaft assembly to articulate from a non-articulated position to an articulated position.

[0008]

[0008] In yet another embodiment, the method of operating a surgical instrument includes moving the joint control unit of the surgical instrument from a first position to a second position. The surgical instrument includes an elongated shaft assembly extending distally from a handle, and the elongated shaft assembly includes an articulated portion that is movable between a non-articulated position and an articulated position. The method further includes moving the articulation lock of the surgical instrument from a first locked state to a second unlocked state while the joint control unit moves from the first position to the second position. The articulation lock selectively prevents articulation of the articulated portion when the articulation lock is in the first locked state, and allows articulation of the articulated portion when the articulation lock is in the second unlocked state. The method also includes moving the joint control unit from a second position to a third position, and articulating the articulated portion of the elongated shaft assembly from a non-articulated position to an articulated position while the joint control unit moves from the second position to the third position.

[0009]

[0009] In another embodiment, the surgical instrument includes a handle and an elongated shaft assembly extending distally from the handle. The elongated shaft assembly includes an articulated portion which is movable between a non-articulated form and an articulated form. The elongated shaft assembly includes a first shaft which includes an articulated portion having a first plurality of spaced-apart cuts along a first length of at least the distal portion of the first shaft. Each of the first plurality of cuts partially extends around the circumference of the first shaft to define a first vertebral portion extending along the first length of the first shaft, and the first vertebral portion has a first width at the distal end of the first vertebral portion and a second width greater than the first width at the proximal end of the first vertebral portion. The elongated shaft assembly further includes a second shaft which is coaxially positioned with respect to the first shaft, and the second shaft which includes an articulated portion having a second plurality of spaced-apart cuts along a second length of at least the distal portion of the second shaft. Each of the second plurality of cuts partially extends along the circumference of the second shaft and defines a second vertebral portion extending along the second length of the second shaft, and the second vertebral portion has a third width at the distal end of the second vertebral portion and a fourth width greater than the third width at the proximal end of the fourth vertebral portion. The first vertebral portion is located on the first side of the elongated shaft assembly, and the second vertebral portion is located on the second opposing side of the elongated shaft assembly.

[0010]

[0010] Naturally, this disclosure is not limited in this respect, and the concepts described above, and the additional concepts described below, may be composed of any preferred combination. Furthermore, other advantages and novel features of this disclosure will become apparent from the following detailed description of various non-limiting embodiments when considered in conjunction with the accompanying drawings.

[0011]

[0011] If this specification and any references referred to herein contain conflicting and / or contradictory disclosures, this specification shall prevail. If two or more references referred to herein contain conflicting and / or contradictory disclosures, the reference with the later effective date shall prevail.

[0012]

[0012] The attached drawings are not intended to be to scale. In the drawings, each identical or nearly identical component shown in different drawings may be represented by the same reference numeral. For clarity, not all components are referenced in all drawings. [Brief explanation of the drawing]

[0013] [Figure 1]

[0013] This is a schematic diagram of one embodiment of an articulated surgical instrument. [Figure 2]

[0014] Figure 1 is a side view of the internal part of an articulated surgical instrument. [Figure 3]

[0015] Figure 1 is an exploded view of the elongated shaft assembly of a surgical instrument. [Figure 4]

[0016] Figure 3 is an exploded view of a portion of the elongated shaft assembly. [Figure 5]

[0017] Figure 1 is a side view of the first and second joint motion shafts of the surgical instrument. [Figure 6]

[0018] This is an enlarged side view of the surgical instrument of Figure 1, which includes a joint control system according to one embodiment, with the joint control system in a first position. [Figure 7]

[0019] This is a side view of one embodiment of a joint motion cam. [Figure 8]

[0020] Figure 7 is a perspective view of the joint motion cam. [Figure 9]

[0021] This is a perspective view of one embodiment of a locking cam. [Figure 10]

[0022] Figure 6 is an exploded view of a portion of the joint control system. [Figure 11]

[0023] This is a perspective view of a portion of the joint control system in Figure 6, located in the first position. [Figure 12]

[0024] This is a side view of the joint control system in the second position, as shown in Figure 6. [Figure 13]

[0025] A side view of the joint control system of FIG. 6 at the third position. [Figure 14]

[0026] A perspective view of a portion of the joint operation system of FIG. 11 in a state where the joint control system is at the third position. [Figure 15]

[0027] A schematic plot showing the movement of components of the joint control system according to one embodiment. [Figure 16]

[0028] A side view of the locking shaft of the surgical instrument of FIG. 1. [Figure 17]

[0029] A side view of the first joint operation shaft of the surgical instrument of FIG. 1. [Figure 18]

[0030] A side view of the second joint operation shaft of the surgical instrument of FIG. 1. [Figure 19]

[0031] A perspective view of the drive shaft of the surgical instrument of FIG. 1. [Figure 20]

[0032] A side view of the drive shaft of FIG. 19. [Figure 21]

[0033] A perspective rear view of a part of the surgical instrument. [Figure 22]

[0034] A perspective view of one embodiment of the fastener level indicator system. [Figure 23]

[0035] A perspective bottom view of the fastener level indicator system of FIG. 22.

BEST MODE FOR CARRYING OUT THE INVENTION

[0014]

[0036] The inventors recognize numerous advantages associated with surgical instruments that include an elongated shaft assembly having an articulated portion to allow at least a portion of the surgical instrument to be positioned in one or more desired shapes and / or orientations. For example, the articulation of the articulated portion may allow the distal end of the elongated shaft assembly to be easily positioned in one or more desired positions and / or orientations for performing surgical procedures such as deploying a surgical fastener into tissue. In some cases, it may be desirable to selectively allow or prevent the articulation of the elongated shaft assembly by an articulation lock. For example, it may be desirable to prevent articulation during insertion and withdrawal of a surgical instrument into and out of the surgical field, as may occur during laparoscopic surgery, and / or when it is desirable to deploy a fastener with the joint disengaged, i.e., in a disengaged state. Therefore, in some embodiments, the inventors have recognized that it may be desirable to provide a single integrated articulation control unit that allows the user to selectively lock and unlock the articulation lock and to control the articulation of the articulated portion. Such an integrated joint control unit can eliminate the use of separate control units for joint locking, thereby avoiding additional steps and complications in the typical operation of such surgical devices.

[0015]

[0037] In some embodiments, the inventors also recognize the advantages associated with articulated surgical instruments, i.e., articulated surgical instruments, in that when the articulated portion of the articulated shaft assembly is moved between a non-articulated and articulated configuration, the axial movement of the distal end of the articulated shaft assembly is minimized. For example, maintaining the axial position of the distal end during articulation can assist in the precise positioning of the end when deploying a fastener or performing another suitable surgical procedure.

[0016]

[0038] In addition, in yet another embodiment, the inventors recognize that it may be desirable to provide an articulated elongated shaft assembly with sufficient rigidity, i.e., an articulated elongated shaft assembly, to avoid excessive deflection of the elongated shaft assembly when the elongated shaft assembly is in an articulated configuration during the operation of the device. Such rigidity may help to maintain the distal end of the elongated shaft assembly in a desired position and / or orientation during a surgical procedure and / or to avoid excessive deflection of the shaft assembly when a force is applied to the distal end. For example, the distal end may be pressed against a surface when deploying a fastener into tissue, and the rigidity of the elongated shaft assembly may limit the deflection of the end to below a desired threshold deflection for a predetermined force applied to the distal end.

[0017]

[0039] In this specification, the term “distal direction” within a surgical instrument may refer to the direction extending along the longitudinal central axis of the surgical instrument toward the distal end of the surgical instrument where the desired operation is performed. Correspondingly, the “proximal direction” may refer to the direction opposite to the distal direction, which may be directed away from the distal end of the surgical instrument where the desired operation is performed, along the longitudinal central axis of the surgical instrument.

[0018]

[0040] According to some embodiments, the elongated shaft assembly extends distally from the handle of a surgical instrument. The elongated shaft assembly includes an articulated portion that can articulate in at least one direction between a first position and a second position, the first position may correspond to a non-articulated form, and the second position may correspond to a fully articulated form, i.e., a fully articulated form, in which the distal end is oriented at a certain angle (e.g., an articulation angle) relative to the portion of the elongated shaft assembly located proximal to the articulated portion. When in the non-articulated, i.e., straight form, the longitudinal axis passing through the articulated portion may be aligned with the longitudinal axis of the proximal portion of the elongated shaft assembly. Correspondingly, when in the fully articulated form, the distal end of the elongated shaft assembly and the longitudinal axis of the articulated portion are oriented at a certain articulation angle relative to the longitudinal axis of the proximal portion. In one embodiment, the articulation angles of the fully articulated form may be -30° to 30°, -45° to 45°, -90° to 90°, -180° to 180°, 15° to 90°, or 45° to 90°, but it should be understood that this disclosure is not limited to any specific range of articulation angles. Furthermore, in some embodiments, the articulated portion may be movable to one or more additional articulated positions between the non-articulated (i.e., straight) form and the fully articulated form.

[0019]

[0041] The surgical instruments described herein may be made from any desired material or combination of materials. In some cases, the surgical instruments described herein may be made from sterilized and / or sterilizable materials using any suitable method, including, but not limited to, heat, radiation, and / or pressure. Furthermore, the materials may be sterilized before, during, or after assembly and packaging in order to maintain sterility.

[0020]

[0042] In one embodiment, the surgical instrument may include a slender shaft assembly comprising a first articulated shaft and a second articulated shaft coaxially positioned with respect to the first articulated shaft. The first and second articulated shafts may include flexible portions that form an articulated section of the slender shaft assembly, and the first and second articulated shafts are axially fixed to each other at a location distal to the articulated section. The proximal portions of the first and second articulated shafts are displaceable relative to each other, allowing the articulated section of the slender shaft assembly to move between a first and a second position. For example, the proximal portions of the first and second articulated shafts can be displaced relative to each other to selectively place the first and second articulated shafts in opposite tensioned and / or compressed states. As will be described in more detail below, such tensile and / or compressive forces are transmitted through a suitable structure within the articulated section to apply and / or release bending moments to the first and second articulated shafts, thereby moving the articulated section between a non-articulated and articulated state. In some embodiments, a bending moment moves the articulated portion from a non-articulated state, which can correspond to a relaxed state of the elongated shaft assembly, to an articulated state. However, it should be understood that this disclosure is not limited to embodiments in which a bending moment causes movement toward the articulated state. For example, in some embodiments, a sufficient articulated state may correspond to a relaxed (i.e., stress-free) state of the elongated shaft assembly, and the elongated shaft assembly may be moved toward a non-articulated (i.e., straight) state by applying a bending moment (or other suitable stress).

[0021]

[0043] According to some aspects of this disclosure, undesirable movement of the distal end of an elongated shaft assembly can be reduced by displacing the first and second articulated shafts of the elongated shaft assembly in opposite directions, thereby moving the articulated portion of the elongated shaft assembly between a non-articulated and articulated configuration. As described above, the first and second articulated shafts may be fixed axially at a location distal to the articulated portion, and such opposite displacements of the proximal portions of the first and second articulated shafts may generate opposite tensile and compressive forces on the articulated shafts when moving the articulated portion between a non-articulated and articulated configuration. While not limited to theory, these opposite displacements of the shafts may help reduce axial displacement of the distal end that would be greater than what would be expected from simply articulating the elongated shaft assembly.

[0022]

[0044] In one embodiment, a surgical instrument may include a user-operable joint control unit to selectively move an articulated portion of an elongated shaft assembly of the instrument between a non-articulated state and a fully articulated state. Furthermore, the surgical instrument may include an articulation lock, which is movable between a first locked state in which the articulation lock prevents articulation of the articulated portion and a second unlocked state in which the articulation lock allows articulation. In some embodiments, the joint control unit may also be associated with the articulation lock, and the movement of the joint control unit causes the articulation lock to move between a locked position and an unlocked position. For example, in one embodiment, the joint control unit may be movable from a first position corresponding to a state in which the articulated portion is in a non-articulated state and the articulation lock is in a locked state, to a second position corresponding to a state in which the articulation lock is moved to the unlocked position and the articulated portion remains in a non-articulated state. The joint control unit may further be movable from the second position to a third position corresponding to a state in which the articulated portion is fully articulated. In this way, a single joint control unit can be used to both unlock and control the joint movement of the articulated part.

[0023]

[0045] The embodiments described herein may include a single joint control unit that controls both the articulation and the movement of the joint lock of the articulated portion of an elongated shaft assembly, but other configurations may be preferred. For example, in some embodiments, a surgical instrument may include a separate lock control unit that moves the joint lock between a locked position and an unlocked position. Therefore, it should be understood that this disclosure is not limited to any particular configuration of the joint and / or lock control unit for moving the articulated portion and / or joint lock of an elongated shaft assembly.

[0024]

[0046] Depending on the embodiment, the articulated portion of an elongated shaft assembly may be formed by one or more flexible portions of the associated shaft that allow for articulation. For example, the flexible portion of the shaft may include a plurality of cuts that extend transversely across the width of the shaft and are positioned along at least a portion of the length of various shafts, including the elongated shaft assembly, in order to produce desired flexibility. In some embodiments, the cuts may define a preferred bending direction of the articulated portion, and the articulation of the articulated portion may include bending the articulated portion along the preferred bending direction. While articulated portions including cuts are described herein, other structures that allow for articulation are also conceivable. For example, since the disclosure is not limited in this respect, the articulated portion may include one or more weakened sections, interconnected flexible segments, interconnected segments connected by hinges, one or more flexible shafts, or any other suitable structure, all positioned to produce desired flexibility and / or a preferred bending direction.

[0025]

[0047] As described above, while the desired rigidity of the elongated shaft assembly is provided, it may still be beneficial to allow articulation of the articulated portion of the elongated shaft assembly. Therefore, in some embodiments, the specific dimensions and configuration arrangement of at least the first and second articulated shafts, spine-like portions, and / or other preferred features of the elongated shaft assembly may be selected to provide the desired rigidity. In one embodiment, the first and second spine-like portions may have a tapered shape in which the distal portions of the first and second spine-like portions are narrower than their proximal portions. This can increase the bending rigidity of the elongated shaft assembly at the proximal end of the spine-like portion and increase the flexibility of the assembly at the distal end. Such an embodiment may allow the distal end of the articulated shaft assembly to be flexible enough to articulate to the desired articulated position, as well as to gradually become rigid towards the proximal end of the articulated portion. While not bound by theory, such a form may help avoid unwanted bending of the elongated shaft assembly during use, for example, when the user presses the distal end of the shaft assembly against a surface to deploy the fastener into the tissue.

[0026]

[0048] In addition to the above, the inventors recognize that the number, size, and / or spacing of the notches in the shaft of the articulated portion of an elongated shaft assembly can affect the resulting stiffness of the elongated shaft assembly in both the non-articulated and / or articulated configurations. For example, the inventors have found that an articulated shaft with a large number of notches and small notches in the articulated portion has increased stiffness but can still allow a desired amount of articulation of the articulated portion. Therefore, in some embodiments, the number, size, and / or spacing of the notches can be selected to give the elongated shaft assembly a desired stiffness. Specific sizing and spacing of the notches will be described in more detail below with respect to specific embodiments. Furthermore, in some embodiments, at least a portion of the notches may include stress relief sections at the opposing ends of each notch to help reduce stress concentration along the notches. The stress relief sections may have any preferred shape, including, for example, elliptical, circular, or any other suitable shape.

[0027]

[0049] As described above, the elongated shaft assembly may include first and second articulated shafts that are in opposite tension and compression states when the articulated portion of the elongated shaft assembly is in articulated configuration. In some embodiments, the articulated shaft in compression configuration may include a plurality of notches that are sized and shaped such that the opposing sides of each notch contact each other when the articulated portion is fully articulated. For example, we have found that such a configuration may provide additional stability and / or rigidity to the distal portion of the elongated shaft assembly when in articulated configuration.

[0028]

[0050] For clarity, the embodiments of the present disclosure described below with respect to the drawings relate to a laparoscopic device for deploying one or more fasteners. However, the present disclosure is not limited to a laparoscopic device for deploying one or more fasteners. Rather, the articulated system, locking mechanism, control unit, and surgical fastener of the disclosure may be used in any suitable surgical instrument including an articulated portion. For example, suitable surgical instruments may include endoscopes, borescopes, catheters, surgical instruments used in "open" procedures, or any other suitable surgical instruments. Furthermore, the surgical instruments of the disclosure may include any suitable end effectors and are not limited to the deployment of fasteners. However, in embodiments including fasteners, the instrument including the articulated locking mechanism may have one or more fasteners loaded, or may be configured to allow a user to load one or more fasteners into the instrument. Furthermore, the embodiments of the disclosure including fasteners are described with respect to general fasteners. It should be understood that any suitable fastener may be used with the articulated locking mechanism of the present disclosure, including tacks, clips, staples, pins, tissue anchors, bone anchors, or any other suitable type of fastener.

[0029]

[0051] Specific, non-limiting embodiments will be described in further detail with reference to the drawings. Since this disclosure is not limited to the specific embodiments described herein, it should be understood that the various systems, components, features, and methods described in relation to these embodiments may be used individually and / or in any desired combination.

[0030]

[0052] Figure 1 shows one embodiment of the surgical instrument 2. The surgical instrument includes a handle 4 and an elongated shaft assembly 6 extending distally from the handle toward a distal end 20 from which a fastener can be deployed. The elongated shaft assembly 6 includes an articulated portion 8 that is movable between a non-articulated (i.e., straight) position and one or more articulated (i.e., curved or bent) positions. The articulation of the articulated portion 8 may be controlled by an articulated control unit 10, which is, for example, a rotatable and / or axially displaceable knob, handle, lever, or other feature that moves between one or more positions relative to the handle 4 to move the articulated portion 8 between a non-articulated form and one or more articulated forms. The surgical instrument 2 also includes a trigger 12 for activating the fastener deployment system to deploy the fastener, but other suitable types of actuation systems for other types of operation are also conceivable.

[0031]

[0053] The articulated portion 8 of the elongated shaft assembly can be moved using the articulation control unit 10 between a first position, such as at least a disjointed (i.e., straight) position, and a second position, such as a fully articulated position. Depending on the embodiment, the articulated portion 8 can be moved to one or more pre-selected articulation angles, or the articulated portion 8 can be adjusted to one or more arbitrary (i.e., unselected) articulation angles. The articulated portion 8 can articulate in at least a first direction, but embodiments in which the articulated portion articulates in at least a second direction are also conceivable. For example, the articulated portion 8 can articulate in a first direction corresponding to an articulation angle greater than about 0°, and in an opposing second direction corresponding to an articulation angle less than about 0°. Alternatively, or in addition to the above, the articulated portion 8 may be articulated around two different axes (e.g., articulation in the horizontal and vertical directions) to articulate in at least two directions.

[0032]

[0054] In some embodiments, it may be desirable to rotate the elongated shaft assembly 6 to facilitate positioning of the distal tip. For example, the elongated shaft assembly 6 may simply be adapted to be rotatable with respect to at least a portion of the handle 4. Alternatively, the portion of the handle 4 including the elongated shaft assembly 6 may be rotatable with respect to another portion of the handle 4, such as the portion including the grip. One such embodiment is shown in Figure 1. In the illustrated embodiment, the surgical instrument 2 includes a first handle portion 14 and a second handle portion 16, from which the elongated shaft assembly 6 extends. The first and second handle portions 14 and 16 may be configured and arranged to be rotatable with respect to each other in any suitable manner. The surgical instrument may include a rotation lock 18 that is movable to selectively allow and prevent rotation of the second handle portion 16 relative to the first handle portion 14. While the drawings show surgical instruments including a rotatable elongated shaft assembly 6 or a handle 4, it should be understood that the disclosure is not limited to this method, and surgical instruments including a unitary handle and / or an elongated shaft assembly 6 stationary to the handle are also possible.

[0033]

[0055] In some applications, it may be advantageous to include a distal rigid linear section 20 located distal to the articulated portion 8 of the elongated shaft assembly. The rigid linear section 20 may include several features to assist in the deployment of the fastener from the distal end of the elongated shaft assembly 6. For example, the distal rigid linear section 20 may include fastener retaining elements, such as tabs, to hold the furthest distal fastener in the deployed position before the surgical instrument is activated. Furthermore, although not theoretically bound, when the drive shaft of the fastener deployment system applies force to the fastener, the force passes around the articulated portion of the elongated shaft assembly, so the force applied by the drive shaft to the fastener head may not be perfectly aligned with the deployment direction of the fastener in question. For example, the furthest distal fastener may be located distal to the distal end of the drive shaft, and accordingly, the fastener may be located within a portion of the elongated shaft assembly that is oriented at a larger angle than the portion of the elongated shaft assembly that includes the distal end of the drive shaft. Therefore, when the drive shaft applies force to the fastener (for example, through the reciprocating motion of the drive shaft), the force applied to the fastener may be misaligned with the longitudinal axis of the fastener.

[0034]

[0056] Considering the above, it may be desirable to include a distal rigid linear section 20 to provide a linear section of a long shaft assembly of sufficient length to accommodate the fastener and to allow the operating force to be applied to the fastener from the fastener deployment system in the same direction as the fastener deployment direction. Although not bound by theory, this may result in a reduction of the operating force required to deploy the fastener from a surgical instrument. In some embodiments, the length of the distal rigid linear section may be greater than the length of the fastener so that the distal end of the drive shaft can be aligned in the deployment direction. For example, as shown in Figure 3, the distal rigid linear section 20 is longer than the length of the fastener 202. In this way, both the most distal fastener and the distal end of the drive shaft can be housed in the distal rigid linear section to assist in the deployment force from the drive shaft and the alignment of the fastener's orientation. Although surgical instruments 2 including a distal rigid straight portion 20 have been described and shown in the drawings herein, it should be understood that embodiments are also conceivable in which the articulated portion 8 extends all the way to the distal end of the elongated shaft assembly 6 so that the surgical instrument does not include a distal rigid straight portion.

[0035]

[0057] Figure 2 shows a schematic side view of the surgical instrument of Figure 1, illustrating various components and systems that may be provided within the handle 4. As shown, the trigger 12 may be coupled to a return spring 22 that can provide a restoring force that drives the trigger back to the deactivated position following the activation of the trigger to deploy the fastener. The trigger may be coupled to a drive system 24 configured and positioned to apply a deploying force to the fastener when the trigger 12 is activated to deploy the fastener from the distal end of the elongated shaft assembly 6. Furthermore, in some embodiments, the surgical instrument may include an actuation lockout system 26 that can selectively prevent the activation of the drive system 24 until the force applied to the trigger exceeds a threshold force. Specific drive systems and actuation lockout systems are shown in the drawings, but it should be understood that this disclosure is not limited to surgical instruments including any particular drive system and / or actuation lockout system. For example, any suitable configuration and arrangement of cams, linkages, gears, clutches, and other suitable components may be used as part of a drive system in any suitable combination.

[0036]

[0058] In some embodiments, the surgical instrument may include multiple fasteners within a long shaft assembly 6, and the fasteners may be deployed sequentially when a trigger 12 is subsequently activated. In some such embodiments, it may be desirable to monitor the number of fasteners remaining in the long shaft assembly that have not yet been deployed. Therefore, the surgical instrument 2 may include a fastener level indicator system 28 configured and positioned to display the number of fasteners available for deployment. For example, the fastener level indicator system 28 may be coupled to a trigger 12, and when the trigger is activated (and the fasteners are deployed), the fastener level indicator system may move a corresponding indicator to indicate that the number of remaining fasteners has decreased by one (see, for example, Figures 21-23, which are further detailed below). However, it should be understood that the disclosure is not limited in this respect, other systems for monitoring the number of remaining fasteners may also be used, and in some embodiments, the surgical instrument may not include a fastener level monitoring system.

[0037]

[0059] In addition to the above, Figure 2 shows a joint control system 100 according to several embodiments. As will be described in more detail below, the joint control system is coupled to a joint control unit 10 and one or more shafts of the elongated shaft assembly 6, and the movement of the joint control unit 10 applies a suitable joint force to one or more shafts, or other components of the elongated shaft assembly, to selectively move the articulated portion 8 of the elongated shaft assembly between at least a joint release position and a joint operation position.

[0038]

[0060] Figure 3 shows an exploded view of the elongated shaft assembly 6 of the surgical instrument 2 extending distally from the handle 4. The elongated shaft assembly includes a drive shaft 30, which is driven by a suitable drive system (such as the drive system 24 described above) to apply a distal force to the fastener, thereby deploying the fastener from the distal end of the elongated shaft assembly. The elongated shaft assembly further includes an articulated lock in the form of an internal, articulated first articulated shaft 32, an external, articulated second articulated shaft 34, and a locking shaft 36. As will be described in more detail below, the first and second articulated shafts are configured and arranged to apply articulated force to the elongated shaft assembly, moving the articulated portion 8 between a non-articulated position and one or more articulated positions.

[0039]

[0061] As shown in Figure 3, various shafts in an elongated shaft assembly can be arranged coaxially with respect to one another. For example, in the illustrated embodiment, the fastener carrier and follower assembly 38 is housed on the drive shaft, and the drive shaft is housed on the first and second articulated shafts 32, 34 and the locking shaft 36. While a specific configuration of shafts is shown in the drawings, it should be understood that other configurations are also preferable. For example, in one embodiment, the locking shaft 36 may be located within the first and second articulated shafts 32, 34. Therefore, this disclosure is not limited to any specific configuration of shafts including an elongated shaft assembly.

[0040]

[0062] In some embodiments, the fastener carrier and follower assembly 38 are provided within a long shaft assembly. For example, a stack of fasteners 200 may be slidably positioned on the fastener carrier. The follower may be located proximal to the fastener stack 200 and can apply a distal force to one or more surgical fasteners in the stack, thereby driving the stack of fasteners distally. Suitable types of followers include, but are not limited to, compression springs, ratchet-pole mechanisms, walking beam assemblies, and / or any other suitable types of mechanisms that can move the stack of fasteners distally toward the distal end of the device.

[0041]

[0063] Figure 4 shows exploded perspective views of the first articulated shaft 32, the second articulated shaft 34, and the locking shaft 36. Each of these shafts may include a flexible portion located in the articulated section 8 of the elongated shaft assembly. As shown, the flexible portion includes a plurality of cuts that define one or more spine-like portions extending along the length of the shaft in the articulated section. In particular, the first articulated shaft 32 includes a first plurality of cuts 40, which partially extend transversely along the circumference of the first articulated shaft and are spaced apart from each other along the length of the shaft to define a first spine-like portion 44 that extends along the length of the flexible portion of the first articulated shaft. Similarly, the second articulated shaft 34 includes a second plurality of cuts 42, which partially extend transversely along the circumference of the second articulated shaft and are spaced apart from each other along the length of the shaft to define a second spine-like portion 46. The cuts 40, 42 and the spine-like portions 44, 46 can define preferred bending directions for the first and second articulated shafts 32 and 34, which are oriented perpendicular to the direction in which the spine-like portions extend. For example, the first articulated shaft 32 has a preferred bending direction 48, and the second articulated shaft 34 has a preferred bending direction 50. In the illustrated embodiment, the bending directions 48 and 50 are parallel, but the first and second spine-like portions 44, 46 are located on opposite sides of the elongated shaft assembly. As will be described in more detail below, such an embodiment can cause the first and second articulated shafts to bend in the same direction when the first and second articulated shafts are placed in opposite tension and compression states.

[0042]

[0064] Depending on the particular embodiment, the first and second articulated shafts may include any preferred structure to provide a desired preferred bending direction. For example, as described above, the first and second articulated shafts may include spine-like portions positioned opposite each other to define a preferred bending direction parallel to the first and second articulated shafts. In some embodiments, the first and second spine-like portions may be parallel to the longitudinal axis of the elongated shaft assembly, but other configurations are also possible. For example, the first and second spine-like portions may extend helically around the opposing sides of the first and second articulated shafts, respectively. Therefore, it should be understood that the first and second spine-like portions may be arranged in any preferred manner.

[0043]

[0065] In addition to the joint shafts and spine-like portions, the locking shaft 36 includes two sets of joints 54, which may define opposing spine-like portions 56 extending along at least a portion of the length of the locking shaft and along the length of the flexible portion. In this way, the joints 54 and spine-like portions 56 define a preferred bending direction 58 perpendicular to a plane passing between the opposing spine-like portions and a bending resistance direction 60 in the direction extending between the opposing spine-like portions. In some embodiments, the locking shaft 36 is rotatable in a direction 52 about the longitudinal axis of the elongated shaft assembly and with respect to the first and second joint shafts 32, 34. For example, the locking shaft may be rotated to an unlocked position in which the preferred bending direction 58 of the locking shaft aligns with the preferred bending directions 48, 50 of the first and second joint shafts, allowing articulation of the articulated portion 8 of the elongated shaft assembly 6. Similarly, the locking shaft can be rotated to a locked position where the bending resistance direction 60 is aligned with the preferred bending direction of the articulated shaft, thereby suppressing or preventing articulation. Furthermore, similar to the spine-like portions of the first and second articulated shafts, the spine-like portion 56 can be arranged on the locking shaft in any preferred manner, for example, parallel to the longitudinal axis of the elongated shaft assembly, at an angle to the longitudinal axis, or spirally around the opposing sides of the locking shaft.

[0044]

[0066] Several possible embodiments of articulation locks, including those in the form of locking shafts rotatable with respect to first and second articulation shafts, are described herein, but other configurations of articulation locks are possible. For example, an articulation lock may include a locking shaft, which is axially movable with respect to the articulation shafts, causing the locking shaft to move between a locked and unlocked state. The locking shaft may include a flexible portion, and the axial movement may selectively align or overlap the flexible portion of the locking shaft with the articulated portion of the elongated shaft assembly to allow articulation. When the flexible portion is not aligned with the articulated portion, the locking shaft may suppress articulation of the articulated portion. Therefore, it should be understood that this disclosure is not limited to any particular structure relating to articulation locks, but rather to selectively allow and prevent articulation of elongated shaft assemblies.

[0045]

[0067] As shown in Figure 5, the first and second articulated shafts 32 and 34 can be attached to each other at a mounting point 62 located distal to the articulated portion of the elongated shaft assembly. This attachment allows the first and second articulated shafts to be fixed axially to each other at the mounting point. In the illustrated embodiment, the mounting point is located at the distal end of the second articulated shaft 34, but other configurations are also preferable. For example, the second articulated shaft may extend beyond the mounting point so that the mounting point is spaced apart from the distal end of the second articulated shaft. Furthermore, it should be understood that the first and second articulated shafts can be attached in any preferred manner, such as by adhesive, one or more fasteners, one or more pins, one or more welds, and / or any other suitable connection method.

[0046]

[0068] The mounting of the first and second articulated shafts 32 and 34 at the distal mounting point 62 allows for the application of axial forces and / or displacements to the corresponding proximal portions of the first and second shafts, thereby placing them under tension and / or compression. For example, a proximal force and displacement 64 applied to the proximal portion of the first articulated shaft 32 can generate tensile stress in the first articulated shaft. Similarly, applying a corresponding distal force and displacement to the proximal portion of the second articulated shaft 34 can generate compressive stress in the second articulated shaft. These opposing tensile and compressive stresses are transmitted through the opposing spine-like portions 44 and 46 of the first and second articulated shafts, which are offset from the neutral bending axis of the entire elongated shaft assembly. This generates a bending moment in the articulated shafts, which bends the articulated shafts along direction 68, moving the elongated shaft assembly toward the articulated position. As will be explained in more detail below, it should be understood that proximal and distal forces and displacements can be applied to the first and second shafts, respectively, via any suitable joint control system.

[0047]

[0069] While specific configurations for applying force and / or displacement to the first and second articulated shafts to move the elongated shaft assembly toward the articulated position are shown in the drawings and described above, other configurations may also be preferred. For example, in some embodiments, articulating the elongated shaft assembly may involve applying distal force and / or displacement to the proximal portion of the first articulated shaft 32 and proximal force and / or displacement to the proximal portion of the second articulated shaft 34, thereby articulating the elongated shaft assembly in the opposite direction to that shown in Figure 5. Alternatively, in some embodiments, the first and second articulated shafts may form an elongated shaft assembly having a curved (e.g., along the direction corresponding to the articulated form) stationary shape (i.e., when no stress is applied), and the first and second articulated shafts may be placed in opposite tension and compression states to move the elongated shaft assembly toward a non-articulated (i.e., straight) shape. Therefore, it should be understood that the articulated shaft assemblies of this disclosure are not limited with respect to their articulated directions and / or final form when placed in a compressed and / or tensioned state.

[0048]

[0070] While several possible embodiments relating to the configuration of articulated elongated shaft assemblies are described herein, it should be understood that this disclosure is not limited to the embodiments described herein. For example, the articulated portion of the elongated shaft assembly may be configured and arranged in any suitable manner to bring articulation in a desired direction. Furthermore, while specific types of articulation mechanisms using articulated shafts comprising opposing spine-like portions are described, other mechanisms for articulating the elongated shaft assembly may be preferred. For example, the articulated portion of the elongated shaft assembly may be articulated using: one or more control wires, ribbons, or slats associated with the articulated portion; a prestressed member and a retractable sheath, a rigid link mechanism associated with an axle joint; or any other suitable structure that can articulate the articulated portion.

[0049]

[0071] As described above, surgical instruments may include a joint control unit to selectively move the articulated portion of an elongated shaft assembly between a non-articular position and an articular position. Depending on the particular embodiment, the joint control unit may be coupled to the articular shaft of the elongated shaft assembly via any suitable structure to control the articular movement. Embodiments of the joint control system 100 will be described in more detail with reference to Figures 6 to 14.

[0050]

[0072] Figure 6 is a schematic side view of a joint motion system 100 in a first position, which may correspond to a long shaft assembly in a non-articular (straight) configuration. The joint motion system includes a joint motion cam 102 coupled to a joint control unit 10, such that the movement of the joint control unit 10 causes associated movement of the joint motion cam 102. In the illustrated embodiment, the rotational movement of the joint control unit rotates the joint motion cam relative to an associated part of a handle, for example, including a rotatable handle portion 16 of a surgical instrument. Although rotation is shown, it should be understood that this disclosure is not limited to a rotatable joint motion cam, and other types of movement, such as translational movement of the joint control unit and the joint motion cam, are also conceivable.

[0051]

[0073] In the illustrated embodiment, the articulated cam 102 includes first and second cam profiles 104 and 106 which may be located on opposite sides of the cam's axis of rotation. The cam profiles may be configured and arranged to accommodate first and second articulated pins 108 and 110, respectively. The first and second articulated pins may be coupled to the respective proximal portions of the first and second articulated shafts, and the movement of the articulated pins within the cam profiles displaces the proximal portions of the articulated shafts. For example, as will be described in more detail below, each of the cam profiles 104 and 106 may include one or more profile portions located at different radial distances from the axis of rotation of the articulated cam 102. Thus, rotation of the articulated cam may move the pins between the profile portions located at different radial distances, thereby displacing the corresponding proximal portions of the articulated shafts. While embodiments including articulated pins coupled to cam profiles are described herein, this disclosure is not limited thereto, and it should be understood that other structures for coupling the articulated shafts to the articulated cams may also be suitable.

[0052]

[0074] In addition to controlling the joint motion of the articulated shaft assembly, the articulation control system 100 may also be used to selectively suppress or allow the joint motion of the elongated shaft assembly by moving the associated locking shaft 36 between a locked position and an unlocked position. In the illustrated embodiment, the articulated cam 102 is coupled to the locking cam 112, which is similarly coupled to the locking shaft 36 via a gear 114. As will be described in more detail below, the movement of the articulated cam (e.g., rotational motion) can correspondingly displace the locking cam, thereby rotating the gear 114. The rotation of the gear 114 then rotates the locking shaft 36, moving the locking shaft between a locked and unlocked position as described above.

[0053]

[0075] In some embodiments, the joint control system may preferably include one or more features to help maintain the elongated shaft assembly in a non-articular position or in one or more articular positions. For example, one or more detent mechanisms or other suitable locking mechanisms may help prevent unwanted movement of the joint control system and / or unwanted movement of the elongated shaft assembly toward or away from the articular positions. In the illustrated embodiment, the joint control system may include first and second cam locks 116 and 118 corresponding to elastic arms extending from the articular cam 102. The corresponding features, for example, recesses 120 and 122, are provided on the inner surface of the rotatable handle portion 16, and the engagement of the cam locks 116 and 118 with the recesses 120 and 122 may function as a detent mechanism to maintain the articular cam 102 in a desired orientation. For example, as shown in Figure 6, the engagement of the first cam lock 116 with the recess 120 maintains the joint control system in a first position, thereby maintaining the elongated shaft assembly in a non-articular position. Similarly, as shown in Figure 12, the engagement of the second cam lock 118 with the second recess 122 can help maintain the elongated shaft assembly in a fully articulated position. When movement of the articulated control unit is desired, the elastic arm can deform to disengage the cam lock from the corresponding recess.

[0054]

[0076] While embodiments have been described that include two cam locks and two associated recesses corresponding to a non-articulated position and a fully articulated position for a long shaft assembly, it should be understood that the joint control system may include any preferred number and / or type of cam locks. For example, in some embodiments, one or more additional cam locks and recesses may be provided to maintain the joint control system in one or more intermediate positions, i.e., positions corresponding to a partially articulated position of the long shaft assembly. In other embodiments, the joint control system may not include any cam locks at all. For example, frictional engagement between the various components of the joint control system may be sufficient to maintain the joint control unit in a desired position, or the joint control system may be held in a desired position by user input to the joint control unit 10.

[0055]

[0077] As described above, in some embodiments, it may be desirable for the joint control system to apply displacements in opposite directions to the proximal portions of the first and second articular shafts. For example, such opposite displacements may place the first and second articular shafts in opposite tension and / or compression states (e.g., due to shafts fixed axially at a distal mounting point), thereby reducing the movement of the distal end of the elongated shaft assembly while the articulated portion of the surgical instrument articulates. Therefore, various cam profiles of the articular cam can be shaped to produce this desired movement in the proximal portion of the articular shaft, as described below.

[0056]

[0078] For example, Figure 7 shows a schematic side view of the joint motion cam 102 of the joint control system 100. As shown, the first cam profile 104 includes a first profile portion 124 and a second profile portion 126. Similarly, the second cam profile 106 includes a third profile portion 128 and a fourth profile portion 130. The first and third profile portions may follow a curved path that is at a constant radial distance from the axis of rotation of the joint motion cam. In some embodiments, the first and third profile portions may be located at a constant first radial distance from the axis of rotation. Correspondingly, the second and fourth profile portions follow a curved path that is at a radial distance different from the radial distance of the corresponding first and third profile portions. For example, the second and fourth profile portions may extend to a longer second radial distance from the axis of rotation. In this way, when the first and second articulation pins 108 and 110 (not shown in Figure 7), which are associated with the proximal portions of the first and second articulation shafts, are moved within the first and second cam profiles 104 and 106, respectively, the articulation pins are displaced relative to the axis of rotation of the articulation cam. Since the articulation pins and articulation shafts are constrained to move axially, this results in axial displacements of the pins and shafts toward and / or away from the axis of rotation of the articulation cam, depending on the direction of rotation.

[0057]

[0079] Embodiments of the articulated cam including a cam profile comprising multiple profile portions are described herein, but the disclosure is not limited thereto, and it should be understood that the cam profile may have any preferred form such that the cam profile may produce a desired movement of the proximal portion of the articulated shaft in opposite directions.

[0058]

[0080] In the illustrated embodiment, the first and second cam profiles 104 and 106 are arranged symmetrically around the axis of rotation of the articulated cam 102. Therefore, as the articulated cam rotates, the first and second articulated pins 108 and 110, and the associated articulated shafts 32 and 34 are displaced in opposite directions (see Figures 11 to 14). Furthermore, various parts of the first and second cam profiles 104 and 106 may be located at the same radial distance from the axis of rotation of the articulated cam 102, thereby displacing the first and second articulated pins 108 and 110, and the associated articulated shafts 32 and 34 by equal magnitude in opposite directions.

[0059]

[0081] While specific configurations of the cam profile have been shown, it should be understood that other configurations may be preferable. For example, the cam profile does not have to be symmetrically arranged around the rotation axis of the cam. In such embodiments, the first profile portion 124, the second profile portion 126, the third profile portion 128, and the fourth profile portion 130 may each be spaced at different radial distances from the rotation axis of the articulated cam 102. In other embodiments, one or both of the cam profiles may have only a single profile portion, where the distance of the profile portion from the rotation axis may vary along the length of the profile, or, as the disclosure is not limited in this way, the cam profile may have three or more profile portions. Furthermore, depending on the particular embodiment, the first, second, third, and / or fourth path portions of the first and second cam profiles may each be located at a constant radial distance from the rotation axis of the articulated cam, or the radial distance may not be constant and may vary within each path portion.

[0060]

[0082] As best illustrated in Figure 8, the articulated cam may be configured and positioned to adapt to various other components of a surgical instrument. For example, the articulated cam may include one or more channels, openings, or other features extending from the proximal portion of the device toward the distal end of an elongated shaft assembly for housing into a component of a transmission system or fastener deployment system. In the illustrated embodiment, the articulated cam 102 includes a pair of end pieces 134 attached to each other by a cross piece 136, which define a channel 138 extending through the articulated cam. Each of the end pieces may include identical cam profiles 104 and 106. Furthermore, the articulated cam may include a rotating shaft 140 extending from the end pieces, which may include a joint control unit 10, such as a key-shaped coupling 142 for attaching a handle to the articulated cam. However, other forms of attaching the joint control unit to the cam are also conceivable, including welding, fasteners, snap-fits, adhesives, and / or other suitable attachment methods, although the disclosure is not so limited.

[0061]

[0083] In some embodiments, the articulated cam may be formed as a single monolithic component, for example, by a suitable molding or casting method. However, embodiments in which the articulated cam is formed from separate elements are also conceivable. For example, since the disclosure is not so limited, various components, such as end pieces and cross pieces, may be formed separately and attached to each other by welding, fasteners, snap-fits, adhesives, and / or other suitable attachment methods.

[0062]

[0084] Figure 9 shows a schematic side view of a locking cam 112 that can be coupled to the articulated cam 102 and the locking shaft 36, as shown in Figure 6. The locking cam includes a locking cam profile 144 configured and positioned to receive a locking pin 152 (see Figure 10) which is received in a through hole 132 (see Figures 7-8) of the corresponding articulated cam 102. Thus, the locking pin 152 rotates at a constant radial distance from the axis of rotation of the articulated cam when the articulated cam 102 is rotated. The locking cam 112 is constrained to move in a desired direction, for example, in a direction traversing the longitudinal axis of the elongated shaft assembly, thereby moving the articulated lock to an unlocked state. Furthermore, the locking cam profile 144 may include a fifth profile portion 146, which is configured and arranged such that the rotational movement of the locking pin within the fifth profile portion causes the locking cam to move in a desired direction, displacing the locking cam from a first position corresponding to a locking shaft 36 in a locked state to a second position corresponding to a locking shaft in an unlocked state (see Figures 6 and 12). For example, in the illustrated embodiment, the fifth profile portion is linear, but other configurations may be preferred.

[0063]

[0085] The locking cam profile 144 of the locking cam 112 may further include a sixth profile portion 148 that can be configured and positioned so as not to cause any displacement of the locking cam by the movement of the locking pin 152 within the sixth profile portion. For example, the sixth profile portion may have a curved shape so that when the locking cam 112 is moved to a second position, the sixth profile portion 148 is located at a certain radial distance from the axis of rotation of the articulated cam 102, corresponding to the distance of the locking pin from the axis of rotation. In this way, the first part of the movement of the articulated cam may cause movement of the locking cam, but the locking cam may remain stationary during the second part of the movement of the articulated cam.

[0064]

[0086] In addition to the locking cam profile 144, the locking cam 112 may include a rack 150 configured and positioned to engage with a gear 114 which can be coupled to the locking shaft 36 of the elongated shaft assembly. The rack may extend in a direction parallel to the direction of movement of the locking cam. In this way, the displacement of the locking cam between the first and second positions causes the gear and the locking shaft to rotate accordingly, thereby moving the locking shaft between the locked and unlocked states as described above.

[0065]

[0087] Figure 10 is a schematic exploded view of the joint control system 100 and shows how the various components of the joint control system can be coupled to one another. As shown in the drawing, the first articular action pin 108 is coupled to the proximal portion and / or end of the first articular action shaft 32 via a first shuttle 154 connected to the first pin, and the second articular action pin 110 is coupled to the proximal portion and / or end of the second articular action shaft 34 via a second shuttle 156 connected to the second pin. The first and second shuttles are housed within the channel 138 of the articular action cam 102, and the opposing ends of the articular action pins extend from the shuttles into the first and second cam profiles 104 and 106 located on either side of the articular action cam. Furthermore, the end of the locking pin 152 of the articulated cam may extend from and, in some embodiments, through the articulated cam so that the locking pin is housed in the locking cam profile 144 of the locking cam 112, thereby coupling the articulated cam to the locking cam.

[0066]

[0088] Figures 6 and 11-14 illustrate various modes of operation of the joint control system 100. As described above, Figure 6 shows the joint control system 100 in a first position corresponding to a long shaft assembly in a non-articular position and a locking shaft in a locked position. Figure 11 shows a perspective view of the joint control system in the first position, although the joint action cam 102 is not shown in Figure 11 for clarity. As shown, when the joint control unit is in the first position, the first and second shuttles 154 and 156 may be adjacent to each other, and the locking pin 152 is housed in the first end of the locking cam profile 144. Furthermore, when the locking cam is in the first position, the upper part of the locking cam rack 150 may engage with the gear 114.

[0067]

[0089] Figures 12 and 13 show schematic side views of the joint control system in the second and third positions, respectively. For example, the second position is rotated to the unlocked position, but since it is before the joint movement of the elongated shaft assembly, it can be an intermediate position corresponding to the locking shaft 36, which is still in the non-jointed position. As shown in the drawings, the joint cam is rotated compared to the configuration shown in Figure 6, resulting in the movement of the locking pin 152 within the locking cam profile 144 toward the end of the fifth path section 146 (and toward the beginning of the sixth path section 148). As described above, the movement of the locking pin within the fifth path section can displace the locking cam 112 from the first position (shown in Figure 6) to the second position shown in Figure 12. This movement of the locking cam displaces the locking cam rack 150, thereby rotating the gear 114 and associated locking shaft 36 in direction 160 (Figure 14). In the illustrated embodiment, the displacement of the locking cam is in a direction 158 (Figure 14) that transverses the longitudinal axis of the elongated shaft assembly, but the disclosure is not limited in this respect, and other directions and / or types of motion (e.g., rotational motion) are also suitable.

[0068]

[0090] As shown in Figure 12, when the joint control system 100 is in the second configuration, the first and second joint action pins 108 and 112 are moved within the first and third path portions 124 and 128 of the first and second cam profiles 104 and 106, respectively. However, in some embodiments, the first and third path portions are located at a constant radial distance from the axis of rotation of the joint action cam. Therefore, the joint action pins, and correspondingly the elongated shaft assembly 6, remain stationary relative to the handle while the joint control system moves from the first position shown in Figure 6 to the second position shown in Figure 12. In this way, the movement of the joint control system from the first position to the second position can move the locking shaft 36 from the locked configuration to the unlocked configuration, but without applying any force to the joint action shaft and / or displacing it, leaving it in the non-articular configuration.

[0069]

[0091] Figures 13 and 14 show the articulation control system 100 in a third position where the locking shaft 36 is in the unlocked position and the elongated shaft assembly is fully articulated. As shown in Figure 13, the articulation cam 102 is further rotated relative to the second position shown in Figure 12. This rotation moves the first and second articulation pins 108 and 110 to the second and fourth profile portions 126 and 130 within the first and second cam profiles 104 and 106, respectively. Because the second and fourth profile portions are located at different radial distances from the axis of rotation of the articulation cam 102 compared to the first and third profile portions, the first and second articulation pins 108 and 110 are displaced in either opposite directions, either away from or toward the axis of rotation of the articulation cam. In particular, as shown in Figure 14, the second and fourth profile portions are located at a longer radial distance from the axis of rotation of the articulation cam compared to the first and third profile portions. Therefore, the first and second articulated pins 108 and 110, which can be constrained to move only in the axial direction as described below, are displaced in opposing axial directions. Specifically, the first articulated pin 108 is displaced proximal 162, and the second articulated pin is displaced distal 164. In some embodiments, the first and second cam profiles 104 and 106 may be arranged to cause displacement of the first and second articulated pins 108 and 110, and this displacement may be of equal magnitude and may help avoid movement of the distal end of the elongated shaft assembly as described above. However, in other embodiments, the displacement may not be of equal magnitude, as the present disclosure is not limited in this respect.

[0070]

[0092] The first and second articulation pins 108 and 110 are connected to the proximal portions and / or ends of the first and second articulation shafts 32 and 34, respectively, via the first and second shuttles 154 and 156, so that displacement of the articulation pins causes corresponding displacement of the proximal ends of the articulation shafts. In particular, the proximal end of the first articulation shaft 32 is displaced proximal along direction 162, and the proximal end of the second articulation shaft 34 is displaced distally along direction 164 (see Figure 14). Furthermore, the mounting of the first and second shafts at the distal mounting point 62 (see Figure 5) results in the displacement of the first and second articulation shafts in opposite directions, placing the shafts in opposite tension and compression states, respectively. As described above, these tension and compression states generate bending moments in the articulation shafts, thereby articulating the elongated shaft assembly toward the articulation position.

[0071]

[0093] In addition to the movement of the articulation pins 108 and 110 within the second and fourth path portions 126 and 130, when the articulation control unit 100 is moved from the second position (Figure 12) to the third position, the locking pin 152 is moved within the sixth path portion 148 (see Figure 13). However, as described above in relation to Figure 9, when the locking cam is in the second position, which can correspond to the unlocked locking shaft, the sixth profile portion 148 of the locking cam may be located at a certain radial distance from the axis of rotation of the articulation cam 102. Therefore, the movement of the locking pin within the sixth path portion may not cause any further movement of the locking cam or any associated movement (e.g., rotation) of the locking shaft. In this way, the locking shaft remains in the unlocked position, while the articulation control unit is moved between the second and third positions to articulate the elongated shaft assembly.

[0072]

[0094] While joint control systems including various pins that accept corresponding cam profiles have been described above and shown in the drawings, other embodiments are also possible. For example, the joint cam may include a suitably shaped engagement surface that engages with corresponding surfaces of the joint shaft and / or locking shaft, thereby producing a desired movement of one or more shafts. Furthermore, while a rotatable joint cam has been described above, other types of movement of the joint cam may be preferred, as this disclosure is not limited to surgical instruments in which the joint cam is rotated to control joint movement. For example, in some embodiments, the movement of the joint control unit may displace the joint cam relative to the handle of the surgical instrument, and the joint movement may include a suitably shaped camming structure to cause a desired displacement of the proximal portion of the joint shaft.

[0073]

[0095] Furthermore, since the joint control system is not limited to the specific joint motion and locking systems described herein, it should be understood that the joint control systems described herein, which control both the joint motion and joint motion locking movements of an elongated shaft assembly, can be used in conjunction with any suitable joint motion system and / or locking system. For example, a joint motion and joint motion locking combined control system can be used in conjunction with a joint motion system that includes an elastically biased system, a flexible tube and / or shaft, a connecting segment biased in one or more directions by one or more flexible members, or a cable placed under tension.

[0074]

[0096] Referring now to Figure 15, the operation of one embodiment of the joint control system 100 and joint lock described above will be explained in more detail in relation to Figures 6 to 14. In particular, Figure 15 is a schematic plot of the angular position of the locking shaft 36 relative to the proximal linear portion of the elongated shaft assembly and the joint movement angle of the articulated portion of the elongated shaft assembly 6, depending on the position of the joint control unit 10. For example, position A may correspond to the first position of the joint control system, as shown in Figure 6, i.e., the joint release position where the locking shaft is in the locked state and the elongated shaft assembly is in the non-articular state. Correspondingly, position B may correspond to the second position of the joint control system shown in Figure 12, where the elongated shaft assembly is unlocked and just before the elongated shaft assembly articulates. Position C may correspond to the third position of the joint control system shown in Figure 13, once the device has been fully articulated.

[0075]

[0097] As shown in Figure 15, when the joint control unit is moved from position A to position B, the locking shaft moves from a locked state to an unlocked state. For example, in the embodiments described above in relation to Figures 6-14, the movement of the locking shaft can be rotational. In particular, the locked state at position A may correspond to a 0° rotation, and the bending resistance direction of the locking shaft is aligned with the preferred bending direction of the joint shaft to prevent joint movement of the elongated shaft assembly. By moving the joint control unit from position A to position B, the locking shaft is rotated relative to the joint shaft as described above. This rotation aligns the joint shaft with one or more of the preferred bending directions of the locking shaft, placing the locking shaft and the elongated shaft assembly in an unlocked state. This rotation may correspond to any suitable angle, but in some embodiments, the unlocked state at position B may correspond to a locking shaft rotated 90° relative to the locked state at position A.

[0076]

[0098] While the joint control unit moves from position A to position B, the locking shaft moves from the locked position to the unlocked position, but the elongated shaft assembly does not articulate and remains in the non-articulated position. Specifically, the articulation angle is an angle θ that can correspond to an articulation angle of 0°. 関節不動作 It remains so. Depending on the embodiment, this may be achieved via one or more suitably shaped cam profiles associated with the articulated shaft, such as those described above, depending on the type of cam movement, and these cam profiles include at least one path portion located at a constant radial distance from the axis of rotation, i.e., a constant linear distance with respect to the translation axis of the articulated cam. Therefore, when the articulated control unit is moved from position A to position B, the pin, and therefore the associated articulated shaft, remains stationary.

[0077]

[0099] When the joint control unit is moved from position B to position C, the locking shaft may remain stationary in the unlocked position. For example, in the embodiment described above in relation to Figures 6 to 14, moving the joint control handle from position B to position C may correspond to the movement of the locking pin within the sixth path portion of the locking cam. As described above, this portion of the locking cam may be located at a certain radial distance from the rotation axis of the joint motion cam when the locking cam is in the second position. As a result, moving the locking pin within this path portion may not cause any associated movement of the locking cam, and the locking shaft may be kept in the locked position.

[0078]

[0100] In addition to the above, by moving the joint control unit from position B to position C, the elongated shaft assembly is moved to θ 関節不動作 Therefore, in some embodiments, an angle θ can correspond to a long shaft assembly that is moved to a sufficient jointed position. 関節動作The joint can be moved. The specific joint angle can correspond to any suitable angle as described above. In some embodiments, as described above in relation to Figures 6 to 14, this joint movement of the elongated shaft assembly can be caused by the movement of the articulating pin in the respective second and fourth path portions of the articulating cam, which are spaced at a longer radial distance from the axis of rotation of the articulating cam compared to the first and third path portions. Thus, the articulating pin, and the corresponding proximal portions of the first and second articulating shafts, are displaced in opposite directions, placing the articulating shafts in opposite tension and compression states, thereby generating a bending moment and moving the elongated shaft assembly to the articulated position. However, as described above, other articulating mechanisms may be preferred, and accordingly, any preferred method can be brought about in the elongated shaft assembly by moving the joint control unit from position B to position C.

[0079]

[0101] Joint movement angle θ 関節動作 Figure 15 shows that the joint is smaller than the angle corresponding to the locking shaft in the unlocked position (e.g., 90°), but other configurations are possible. For example, in some embodiments, the joint motion angle of the elongated shaft assembly may be larger than the rotation angle required to move the locking shaft from the locked position to the unlocked position. Furthermore, while the rotation of the locking shaft and the joint motion of the elongated shaft assembly are shown to change linearly with the movement of the joint control unit, in some embodiments, the response may have any preferred functional form and may not be linear. In addition to the above, in Figure 15, the movement of the locking shaft and the joint motion of the elongated shaft assembly do not overlap, but other configurations may be preferred. For example, in some embodiments, the present disclosure is not so limited, and the elongated shaft assembly may begin its joint motion before the locking shaft is in a fully unlocked position.

[0080]

[0102] Various embodiments of the locking shaft 36 and the first and second joint motion shafts 32 and 34 are described in more detail here with reference to Figures 16 to 18.

[0081]

[0103] Figure 16 shows a schematic side view of the distal portion of the locking shaft 36. The locking shaft includes a pair of spine-like portions 56 located on opposing sides of the locking shaft (only one spine-like portion is shown in Figure 16), and the spine-like portions extend along the length of the flexible portion 70 of the locking shaft. The spine-like portions 56 may correspond to the continuous portion of the locking shaft 36 and may be able to transmit axial forces along their length to adjacent portions of the locking shaft. As described above, the spine-like portions may be defined by a plurality of notches 54 formed on opposing sides of the locking shaft within the flexible portion 70. For example, the notches may partially extend along the circumference of the locking shaft 36 and may be axially spaced along the length of the flexible portion 70 with the spine-like portions positioned between the two opposing pairs of notches. The spine-like portions 56 and the notches 54 may interact to form a plurality of flexible segments 72 joined together by a plurality of integral hinges 74. Adjacent flexible segments 72 can pivot relative to each other around the intervening integral hinge 74. This relative pivoting of the flexible segments can impart flexibility to the locking shaft within the flexible portion 70. Furthermore, the orientation of the spine-like portion 56 and the cut 54 determines the preferred bending direction 58 around the axis of rotation of the integral hinge 74. Although not bound by theory, the integral hinge 74 may have increased bending resistance in directions other than those corresponding to the pivoting of the integral hinge 74 around the axis of rotation of the integral hinge. Therefore, the direction in which the integral hinge 74 increases rigidity can be considered to correspond to the bending resistance direction (see Figure 4). In the illustrated embodiment, the bending resistance direction 60 (Figure 4) may correspond to a direction perpendicular to the preferred bending direction 58 and parallel to the axis of rotation of the integral hinge 74 of the locking shaft 36.

[0082]

[0104] Figure 17 shows a schematic side view of the distal end of the first articulated shaft 32, which may be the inner articulated shaft when positioned coaxially with the second articulated shaft 34 shown in Figure 18. As described above, the first articulated shaft includes a spine-like portion 44 extending along the length of the flexible portion 80 of the first articulated shaft. As before, the spine-like portion 44 may correspond to the continuous portion of the first articulated shaft 32 and transmit axial forces along its length to adjacent portions of the first articulated shaft, but unlike the locking shaft 36, the first articulated shaft has only a single spine-like portion 44. Furthermore, the spine-like portion may be defined by a plurality of cuts 40 formed in a portion of the circumference of the first articulated shaft within the flexible portion 80, and the cuts may be spaced axially along the length of the flexible portion 80. As before, the spine-like portion 44 and the cuts 40 may interact to form a plurality of flexible segments 82 joined by a plurality of integral hinges 84. Adjacent flexible segments 82 can pivot relative to each other around the intervening integral hinge 84. Although not bound by theory, the integral hinge 84 increases bending resistance in directions other than those corresponding to the pivoting of the integral hinge 74 around the pivot axis of the integral hinge. This relative pivoting of the flexible segments imparts flexibility to the first articulated shaft 32 within the flexible portion 80. Furthermore, the orientation of the spine-like portion 44 and the cut 40 defines a preferred bending direction 48 of the first articulated shaft 32 parallel to the pivot axis of the integral hinge 84.

[0083]

[0105] Furthermore, the first joint action shaft 32 may include one or more fastener retaining features, such as tabs 76, at its distal end. While not theoretically bound, such tabs may help maintain one or more fasteners in a desired position before or during deployment from a surgical instrument.

[0084]

[0106] Similar to Figure 17, Figure 18 shows a schematic side view of the distal end of the second articulated shaft 34, which may be the outer articulated shaft when positioned coaxially with the first articulated shaft 32. As before, the second articulated shaft includes a spine-like portion 46 along the length of the flexible portion 90 of the second articulated shaft, and the spine-like portion 44 corresponds to a continuous portion of the second articulated shaft 34, which may be capable of transmitting axial forces along its length to adjacent portions of the second articulated shaft. The spine-like portion may be defined by a plurality of notches 42 formed in a portion of the circumference of the second articulated shaft within the flexible portion 90, and the notches may be spaced axially along the length of the flexible portion 90. As before, the spine-like portion 46 and the notches 42 may interact to form a plurality of flexible segments 92 joined together by a plurality of integral hinges 94. Adjacent flexible segments 92 may pivot relative to each other around the intervening integral hinges 94. This relative rotation of the flexible segment imparts flexibility to the second joint shaft 34 within the flexible portion 90. Furthermore, the orientation of the spine-like portion 46 and the cut 42 defines a preferred bending direction 50 parallel to the axis of rotation of the integrated hinge 94.

[0085]

[0107] Once the first articulated shaft 32 and the second articulated shaft 34 are assembled (for example, arranged coaxially with respect to each other as shown in Figures 4 and 5), the second articulated shaft can be rotated 180 degrees relative to the configuration shown in Figure 18 so that the spine-like portion 46 of the second articulated shaft is positioned on the side of the elongated shaft assembly opposite the spine-like portion 44 of the first articulated shaft 32. The inventors have recognized that positioning the spine-like portion on the opposite side of the elongated shaft assembly can increase the rigidity of the elongated shaft assembly. As mentioned above, such increased rigidity can be advantageous, for example, in avoiding unwanted bending or movement of the elongated shaft assembly during the operation of a surgical instrument for deploying a fastener into tissue.

[0086]

[0108] As shown in Figures 17 and 18, the spine-like portions 44 and 46 of the first and second joint motion shafts 32 and 34 may each have a tapered shape. For example, in the spine-like portion 44 of the first joint motion shaft, the distal end of the spine-like portion may have a first width d1 that is narrower than the second width d2 of the proximal end of the spine-like portion 44. In some embodiments, the first width d1 may be about 1.5 mm to about 2.2 mm, and the second width d2 may be about 3.5 mm to about 4.0 mm. Similarly, in the second spine-like portion 46 of the second joint motion shaft, the distal end of the spine-like portion may have a third width d3 that is narrower than the fourth width d4 of the proximal end of the spine-like portion 46. In some embodiments, the third width d3 may be about 2.6 mm to about 3.0 mm, and the fourth width d4 may be about 4.3 mm to about 4.8 mm. Depending on the particular embodiment, various cuts in the first and second articular shafts may extend about 240 to 300 degrees around the circumference of the articular shaft to define the morphology of a tapered spine-like portion. However, while specific dimensional ranges are given herein with respect to the cuts, spine-like portions, and other features, it should be noted that this disclosure is not so limited, and other ranges, both larger and smaller than those disclosed herein, may be used.

[0087]

[0109] While not bound by theory, such a tapered form of the spine-like portion may increase the flexibility of the flexible portions 80 and 90 at its distal end, while gradually increasing rigidity towards the proximal end. In this way, the tapered spine-like portion can increase the overall rigidity of the articulated shaft while remaining sufficiently flexible to allow articulation of the elongated shaft assembly. Furthermore, in some embodiments, the tapered spine-like portion may provide more uniform rigidity along the length of the spine-like portion compared to a spine-like portion of constant width. In particular, the increase in width of the tapered spine-like portion at its proximal end may correspond to areas along the elongated shaft assembly that experience larger bending moments than areas closer to the distal end (for example, due to larger moment arms further away from the distal end). Correspondingly, increasing the rigidity of the tapered spine-like portion at these proximal points can offset larger bending moments, at least partially, thus resulting in more uniform bending rigidity along the length of the elongated shaft assembly.

[0088]

[0110] Depending on the particular embodiment, various cuts, spine-like portions, and flexible segments of the articulated shaft and / or locking shaft may have dimensions selected to provide the desired rigidity and / or flexibility to the elongated shaft assembly. For example, the first and / or second articulated shaft may have a diameter of about 3.5 mm to about 5.5 mm and a wall thickness of about 0.13 mm to about 0.30 mm, and the locking shaft may have a diameter of about 5.5 mm to 6.4 mm and a wall thickness of about 0.07 mm to about 0.15 mm. In one exemplary embodiment, the first articulated shaft has a diameter of about 4.8 mm and a wall thickness of about 0.025 mm, the second articulated shaft has a diameter of about 5 mm and a wall thickness of about 0.18 mm, and the locking shaft has a diameter of about 5.6 mm and a wall thickness of about 0.13 mm. In this embodiment, the first and second articulated shafts and the locking shaft have different wall thicknesses, but it should be understood that the disclosure is not limited thereto. For example, in other embodiments, the wall thickness of the first articulated shaft may be thinner than that of the second articulated shaft and / or the locking shaft, or the articulated shafts and the locking shaft may have substantially the same wall thickness.

[0089]

[0111] Furthermore, in some embodiments, the spacing between adjacent cuts on the articulated shafts and locking shafts may be about 0.6 mm to about 2.2 mm. In an exemplary embodiment, the spacing between adjacent cuts may be about 1 mm on the first and second articulated shafts and about 1.5 mm on the locking shaft. In addition, each of the first articulated shaft, the second articulated shaft, and the locking shaft may include cuts of different widths. For example, in an exemplary embodiment, the first articulated shaft may have cuts with a width of about 0.007 mm to 0.03 mm (e.g., about 0.02 mm), the second articulated shaft may have cuts with a width of about 0.07 mm to about 0.18 mm (e.g., about 0.09 mm), and the locking shaft may have cuts with a width of about 0.10 mm to about 0.18 mm (e.g., about 0.14 mm). In some embodiments, the width of the notches on the locking shaft may be selected such that opposing sides of the notches do not come into contact when the elongated shaft assembly is in a fully articulated configuration. For example, we have found that such a configuration can help allow movement of the drive shaft when the elongated shaft assembly is articulated (e.g., while deploying a fastener). However, it should be understood that in some embodiments, other dimensions of the spacing and width of the notches, including both smaller and larger ranges than those described above, may be preferred to provide the desired rigidity and / or flexibility of the elongated shaft assembly.

[0090]

[0112] Depending on the embodiment, the slits formed in the articulated shafts and / or locking shafts may extend along the length of the flexible portion of each shaft in the articulated part of the elongated shaft assembly. For example, in some embodiments, the length of the flexible portion of each shaft may be about 26 mm to about 42 mm. In some embodiments, the first and second articulated shafts may have flexible portions of the same or different lengths. For example, the first articulated shaft may have a flexible portion of about 26 mm to about 42 mm in length, and the second articulated shaft may have a flexible portion of about 26 mm to about 38 mm in length. In some embodiments, the lengths of the flexible portions of the first and second articulated shafts may be selected such that the length of the flexible portion of the first shaft is greater than or equal to the length of the flexible portion of the second shaft.

[0091]

[0113] In addition to the above, in some embodiments, and as shown in Figures 16 to 18, the cuts formed in various shafts may terminate in a stress relief section integrated with a hinge. The stress relief section may be shaped to help avoid fatigue and / or failure of the hinge due to repeated bending of the flexible portion, for example, when a long shaft assembly is moved back and forth between a non-articulated position and an articulated position. In some embodiments, the stress relief section may have an elliptical shape, but other shapes such as circular may also be preferred.

[0092]

[0114] In addition to the above, several patterns of cuts and spine-like portions are disclosed with respect to the flexible portions of locking shafts and articulated shafts, but it should be understood that other patterns of cuts and spine-like portions are also possible. For example, the flexible portion of a shaft corresponding to the articulated portion of a long shaft assembly can be configured and arranged in any suitable way so that the flexible portion bends preferentially in at least one direction. Furthermore, although a linearly tapered spine-like portion has been illustrated, embodiments of the spine-like portion with a nonlinear taper are also conceivable.

[0093]

[0115] Figures 19-20 show one embodiment of a drive shaft 30 that may be used in a surgical instrument to deploy a fastener from the surgical instrument by applying a distal force through, for example, reciprocating axial displacement of the drive shaft. As shown in Figure 3, the drive shaft may be coaxially arranged within the articulating shaft and the locking shaft, but other configurations may also be preferred. In the illustrated embodiment, as will be described in more detail below, the drive shaft includes a flat surface 302 which may be configured and arranged to engage with a corresponding plane of the fastener head. The engagement of the planes may maintain the fastener in a desired orientation within the drive shaft, including when the elongated shaft assembly is articulated. Furthermore, the drive shaft may include a flexible portion 310, in which a pair of spine-like portions 304 are defined by two or more notches 306 that partially extend around the circumference of the drive shaft and are located on opposite sides of the drive shaft. The notches may be spaced apart along the length of the flexible portion, similar to the locking shaft described above. Similar to a locking shaft, the spine-like portion 304 and the slit 306 can interact to form a plurality of flexible segments 308 joined by a plurality of integral hinges 312, and adjacent flexible segments 308 can pivot relative to each other around the intervening integral hinges 312.

[0094]

[0116] As shown in Figures 19-20, the cuts may be positioned at an angle not perpendicular to the longitudinal axis of the drive shaft. In some embodiments, the cuts may be positioned to follow a helical path around the drive shaft. While not theoretically bound, this configuration may allow the cuts on the drive shaft 30 to be positioned at an angle to the cuts on the articulated shafts 32 and 34, thereby helping to avoid the cuts on the drive shaft binding together with the cuts on the articulated shafts. For example, a cut 306 positioned at any single angle on the drive shaft may contact only an adjacent cut on the first locking shaft 32 at one point, thereby reducing the possibility of the cuts binding together when the drive shaft is displaced relative to the articulated shafts while the fasteners are deployed.

[0095]

[0117] Depending on the specific embodiment, the width of the cuts on the drive shaft may be approximately 0.07 mm to approximately 0.13 mm, and the spacing between adjacent cuts may be approximately 0.8 mm to approximately 1.4 mm. In some embodiments, the cuts may define a spine-like portion along the length of the drive shaft, and the width of the spine-like portion may range from approximately 0.5 mm to approximately 1.3 mm. Furthermore, the cuts may extend along a flexible portion of the drive shaft, and the length of the flexible portion may be approximately 38 mm to approximately 54 mm. In some embodiments, the length of the flexible portion of the drive shaft may be greater than or equal to the length of the flexible portion of the outer articulated shaft plus the travel distance of the drive shaft. Such a configuration may help allow sliding of the drive shaft while the elongated shaft assembly is in an articulated configuration (e.g., while deploying a fastener).

[0096]

[0118] In addition to the above, the drive shaft 30 may include fastener engagement features such as a tab 314 extending distally and oriented radially inward at the distal end of the drive shaft. Therefore, when the trigger of the surgical fastener is activated, the tab engages with the most distal fastener, applying a distal force to the fastener and deploying it from the distal end of the elongated shaft assembly. However, the disclosure is not so limited, and other forms for applying force to the most distal fastener can also be envisioned.

[0097]

[0119] Hereinafter, an embodiment of the fastener level indicator system 28 will be described in more detail with reference to Figures 21 to 23. As described above, the fastener level indicator system may be configured and arranged to display the number of fasteners available for deployment from the surgical instrument. For example, Figure 21 shows a perspective rear view of the surgical instrument, which includes a window 502 through which the indicator can be seen. As shown in Figure 22, the fastener level indicator system 28 may include an indicator 504 in the form of a gear cylinder. For example, the top surface of the indicator may be visible through the window 502. The indicator is coupled to a reciprocating arm 506, which may be coupled to a trigger 12 of the surgical instrument in any preferred manner, and when the trigger is activated (and the fastener is deployed), the reciprocating arm is moved, causing the indicator to rotate to a new position. For example, the new position indicates that one less fastener remains available for deployment from the surgical instrument.

[0098]

[0120] As shown in Figures 22-23, the reciprocating arm can be coupled to the indicator by an actuator 508 positioned within the gear cylinder of the indicator 504. As shown in Figure 23, which shows a perspective bottom view of the fastener level indicator system 28, the actuator 508 includes an elastic arm 508 having teeth 512 at the end of the arm. The teeth 512 are configured and positioned to engage with corresponding gear teeth 514 located inside the indicator gear cylinder 504. In this way, the elastic arm and teeth 512 and 514 form a clutch-type interface between the actuator 508 and the indicator 504, so that rotation of the actuator in a first direction produces associated rotation of the indicator (for example, to move the indicator to a new position), while rotation of the actuator in the opposite direction flexes the elastic arm 510 inward, preventing the indicator from rotating. Therefore, the reciprocating motion of the reciprocating arm 506, which can cause associated rotation of the actuator in the first and second directions, does not cause backward movement of the indicator. Furthermore, in some embodiments, the fastener level indicator system includes a fixed arm 516 formed on the outside of the indicator gear cylinder, which includes teeth 518 configured and positioned to engage with corresponding teeth 520. The engagement of teeth 516 and 520 may be arranged to prevent the indicator from rotating backward.

[0099]

[0121] Although this instruction has been described in conjunction with various embodiments and examples, it is not intended to limit this instruction to such embodiments or examples. Rather, as will be understood by those skilled in the art, this instruction includes various alternatives, modifications, and equivalents. Therefore, the above description and drawings are illustrative only.

Claims

1. The handlebars and A long shaft assembly having an articulated portion extending distally from the handle and movable between a non-articulated state and an articulated state, a first articulated shaft, and a second articulated shaft, wherein the second articulated shaft is located distal to the articulated portion of the long shaft assembly, is arranged coaxially with respect to the first articulated shaft, and is fixed axially with respect to the first articulated shaft, and each of the first articulated shaft and the second articulated shaft has a flexible portion located in the articulated portion, and the proximal portion of the first articulated shaft is displaceable distally relative to the second articulated shaft, and the proximal portion of the second articulated shaft is displaceable proximally relative to the first articulated shaft, thereby moving the articulated portion of the long shaft assembly from the non-articulated state to the articulated state, A joint control unit that controls the displacement of the proximal portions of the first and second joint motion shafts, A locking shaft that selectively prevents joint movement of the articulated portion of the elongated shaft assembly when in a first locked state, and allows joint movement of the articulated portion of the elongated shaft assembly when in a second unlocked state, wherein the locking shaft is moved from the first locked state to the second unlocked state by the movement of the joint control unit from a first position to a second position, A surgical instrument equipped with [a specific feature / feature].

2. The joint control unit and the first shuttle coupled to the proximal portion of the first joint motion shaft, The present invention further includes the joint control unit and a second shuttle coupled to the proximal portion of the second joint motion shaft, The surgical instrument according to claim 1, wherein the first and second shuttles are axially movable with respect to the elongated shaft assembly.

3. The surgical instrument according to claim 2, wherein the joint control unit is moved from the second position to the third position, thereby displacing the first shuttle in the distal direction and the second shuttle in the proximal direction.

4. The proximal portion of the first joint motion shaft is displaceable relative to the second joint motion shaft in the proximal direction. The surgical instrument according to any one of claims 1 to 3, wherein the second joint-moving shaft is displaceable in the distal direction relative to the first joint-moving shaft, and the relative displacement of the proximal portions of the first and second joint-moving shafts moves the articulated portion of the elongated shaft assembly from the articulated form to the non-articulated form.

5. The displacement of the proximal portion of the first joint motion shaft in the distal direction applies a compressive stress to the first joint motion shaft. A surgical instrument according to any one of claims 1 to 4, wherein tensile stress is applied to the second joint motion shaft by displacement of the proximal portion of the second joint motion shaft in the proximal direction.

6. The joint motion cam further includes a first cam profile operably connected to the proximal portion of the first joint motion shaft, and a second cam profile operably connected to the proximal portion of the second joint motion shaft, The surgical instrument according to claim 1, wherein the rotation of the joint motion cam in a first direction displaces the first joint motion shaft in the distal direction and the second joint motion shaft in the proximal direction, thereby moving the articulated portion into the articulated form, and the proximal portion of the first joint motion shaft and the proximal portion of the second joint motion shaft are partially positioned within the joint motion cam.

7. The first cam profile and the first shuttle coupled to the proximal portion of the first joint motion shaft, The invention further includes the second cam profile and a second shuttle coupled to the proximal portion of the second joint motion shaft, The first and second shuttles are movable in the axial direction relative to the elongated shaft assembly. The articulated cam includes a pair of end pieces on opposite sides of the longitudinal axis of the elongated shaft assembly, The first cam profile is formed on both end pieces, The second cam profile is formed on both end pieces, The surgical instrument according to claim 6, wherein the first and second shuttles are located between the end pieces of the joint cam.

8. The first articular shaft includes a first plurality of notches spaced apart along a first length of at least the distal portion of the first flexible portion on the first articular shaft, each of the first plurality of notches partially extending along the circumference of the first articular shaft and defining a first spine-like portion extending along the first length of the first articular shaft, the first spine-like portion having a first width at its distal end and a second width at its proximal end that exceeds the first width. The second articular shaft includes a second plurality of notches spaced apart along a second length of at least the distal portion of the second flexible portion on the second articular shaft, each of the second plurality of notches partially extending along the circumference of the second articular shaft and defining a second spine-like portion extending along the second length of the second articular shaft, the second spine-like portion having a third width at the distal end of the second spine-like portion and a fourth width exceeding the third width at the proximal end of the fourth spine-like portion. The first spine-like portion is located on the first side of the elongated shaft assembly, The surgical instrument according to claim 1, wherein the second spine-like portion is located on the opposing second side of the elongated shaft assembly.

9. The surgical instrument according to claim 8, wherein the first and second spine-like portions are parallel to the longitudinal axis of the elongated shaft assembly.

10. The surgical instrument according to claim 8, wherein the first and second spine-like portions are curved along the length of the first and second joint motion shafts.

11. The width of each of the second plurality of notches is selected such that when the elongated shaft assembly is in the articulated position, the opposing edges of each of the second plurality of notches are in contact with each other, according to any one of claims 8 to 10.

12. The system further includes drive shafts disposed within the first and second joint motion shafts, The drive shaft includes a third plurality of spaced-apart cuts along at least a portion of the length of the drive shaft, The surgical instrument according to any one of claims 8 to 11, wherein each of the third plurality of cuts forms at most one contact point with the cuts of the first or second plurality of cuts.

13. The surgical instrument according to claim 12, wherein when the elongated shaft assembly is in the articulated position, the width of each of the third plurality of notches is selected such that the opposing edges of each of the third plurality of notches do not come into contact with each other.

14. The surgical instrument according to claim 12 or 13, wherein the width of each of the first and second plurality of cuts is approximately 0.007 mm to approximately 0.018 mm.

15. The surgical instrument according to any one of claims 12 to 14, wherein the spacing between each of the first and second plurality of slits is approximately 0.6 mm to approximately 1.4 mm.

16. The first width is 1.5 mm to approximately 2.2 mm. The surgical instrument according to any one of claims 12 to 15, wherein the second width is approximately 3.5 mm to approximately 4.0 mm.

17. The third width is approximately 2.6 mm to approximately 3.0 mm. The surgical instrument according to any one of claims 12 to 16, wherein the fourth width is approximately 4.3 mm to approximately 4.8 mm.

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