CN1911183A - 具有关节运动轴锁定机构的外科器械 - Google Patents

具有关节运动轴锁定机构的外科器械 Download PDF

Info

Publication number
CN1911183A
CN1911183A CNA2006101089982A CN200610108998A CN1911183A CN 1911183 A CN1911183 A CN 1911183A CN A2006101089982 A CNA2006101089982 A CN A2006101089982A CN 200610108998 A CN200610108998 A CN 200610108998A CN 1911183 A CN1911183 A CN 1911183A
Authority
CN
China
Prior art keywords
joint motions
end effector
surgical instruments
proximal
slide bar
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Granted
Application number
CNA2006101089982A
Other languages
English (en)
Other versions
CN1911183B (zh
Inventor
肯尼思·S·威尔士
查德·P·布杜克斯
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Ethicon Endo Surgery Inc
Original Assignee
Ethicon Endo Surgery Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Ethicon Endo Surgery Inc filed Critical Ethicon Endo Surgery Inc
Publication of CN1911183A publication Critical patent/CN1911183A/zh
Application granted granted Critical
Publication of CN1911183B publication Critical patent/CN1911183B/zh
Active legal-status Critical Current
Anticipated expiration legal-status Critical

Links

Images

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • A61B17/072—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously
    • A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/03—Automatic limiting or abutting means, e.g. for safety
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00535—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated
    • A61B2017/00557—Surgical instruments, devices or methods, e.g. tourniquets pneumatically or hydraulically operated inflatable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2926—Details of heads or jaws
    • A61B2017/2927—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft
    • A61B2017/2929—Details of heads or jaws the angular position of the head being adjustable with respect to the shaft with a head rotatable about the longitudinal axis of the shaft
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2946—Locking means

Abstract

一种特别适于以内窥方式使用的外科器械，通过包括位于轴的近侧部分中的横向滑动构件使端部执行器进行关节运动，所述轴将端部执行器枢转到所选的一侧。通过在横向滑动构件和轴的框架之间包括导向机构，有差别的相反致动力(例如液压的、流体的、机械的致动力)作用于该横向滑动构件而不会发生束缚。有利地，当关节运动由阻止反向驱动的机构控制时，锁定构件自动解除锁定。

Description

具有关节运动轴锁定机构的外科器械
相关申请的交叉引用
本申请要求Kenneth Wales和Chad Boudreaux于2005年2月18日提交的申请号为11/061,908、题为“SURGICAL INSTRUMENTINCORPORATING A FLUID TRANSFER CONTROLLEDARTICULATION MECHANISM”的共有的美国专利申请的优先权，其内容通过引用而全部包含于本申请中。
技术领域
本发明总的涉及适合于将端部执行器(例如，内切割器、抓钳、切割器、缝合器、夹具施放器、接触装置、药物/基因治疗输送装置和使用超声波、RF、激光等的能量装置)以可内窥的方式插入到手术部位的外科器械，更具体地说，涉及具有关节连接轴的这种外科器械。
背景技术
内窥镜外科器械通常比传统的开放式外科装置更受到偏爱，这是因为较小的切口易于减少术后恢复时间和并发症。因此，在内窥镜外科器械的领域中已经有了显著发展，该内窥镜外科器械适合于将远端执行器通过套管针的套管精确地放置在所需的手术部位。这些远端执行器以多种方式接合组织以实现诊断或治疗作用(例如，内切割器、抓钳、切割器、缝合器、夹具施放器、接触装置、药物/基因治疗输送装置和使用超声波、RF、激光等的能量装置)。
通过套管针限制端部执行器的定位。通常，这些内窥镜外科器械包括在端部执行器和由医生操作的手柄部分之间的长轴。这个长轴能够插入到所需深度并围绕轴的纵向轴线转动，从而将端部执行器定位到一定程度。在正确定位套管针和例如通过另一套管针使用抓钳的条件下，通常这个定位量是足够的。诸如在美国专利No.5,465,895中描述的外科缝合和切割器械是通过插入和转动成功定位端部执行器的内窥镜外科器械的一个例子。
取决于操作的性质，可能希望进一步调整内窥镜外科器械的端部执行器的定位。特别是，通常希望在横切该器械的轴的纵向轴线的轴线上定向端部执行器。通常将端部执行器相对器械轴的横向运动称为“关节运动”。这典型地通过被放置在靠近钉施加组件的伸长的轴中的枢轴(或关节)接合来实现。这允许医生远程致动钉施加组件到任一侧，用于更好的手术放置钉线和更简单的组织操作和定向。这种关节连接定位允许医生在一些情况下更简单地接合组织，例如在器官后。另外，关节连接定位有利地允许将内窥镜定位在端部执行器后方，而不会被器械轴挡住。
由于将关节运动控制与在内窥镜器械的小直径的限制下闭合端部执行器以夹住组织和击发端部执行器(即，缝合和切割)的控制结合在一起，使外科缝合和切割器械进行关节运动的方法很复杂。通常，将三个控制动作都通过轴转换为纵向平移。例如美国专利No.5,673,840披露了手风琴状的关节运动机构(“柔性颈”)，该关节运动机构由有选择地通过执行轴拉回两个连接杆中的一个而进行关节运动，每个杆分别在轴中心线的相对侧处偏移。连接杆通过一系列不连续位置渐进运动。
关节运动机构的纵向控制的另一例子是美国专利No.5,865,361，该关节运动机构包括关节运动连接件，其与凸出枢轴偏置，从而推动或拉动关节运动连接件的纵向平移实现向相应侧的关节运动。同样，美国专利No.5,797,537公开了类似的穿过轴以实现关节运动的杆。
在美国专利US5,673,841中，已经认识到用于内镜外科缝合、切割、夹具施放以及抓取的关节运动外科器械的某些不足。特别地，当外科关节运动器械被加载时，器械上的关节连接头易于运动。这种运动通常是关节运动机构中零部件的偏转和松动(或后冲)的组合。器械远侧末端的高负荷(例如组织夹钳和击发钉)通过关节运动装置反应到位于手柄附近的关节运动控制器，并可使关节运动控制机构运动(或旋转)。过去，关节运动接头设计为具有能执行双重用途的关节运动装置，其用作定位和锁定器械的关节头的工具。对负载的施力点(器械的末端)和关节运动装置(关节运动接头附近)的检查表明关节运动装置具有机械学缺点。该缺点自身表现为放大了在关节运动装置中的偏差和间隙，因而导致头部的明显运动。
作为对认识到的不足的回应，提出了一些锁定机构。特别的是，除当需要使头部相对于轴进行关节运动的时候以外，锁定机构在所有时刻都将头部锁定在某一关节运动角度。在例如通过向着器械的近端拉动关节运动带致动关节运动装置时，锁定机构松开，从而使头部解锁并允许其进行关节运动。关节运动步骤例如由于中断关节运动带上的拉力而造成的不连续性导致锁定机构重新接合，从而将器械的头部锁定在新的关节运动角度。在另一方案中，位于两侧上的一对流体皮囊允许流体从一侧到另一侧的改变，从而允许头部枢转，并且由夹紧囊阻塞流体流来“锁定”关节运动枢转轴。
虽然关节运动带有效地实现了关节运动并同时锁定关节运动接头，但是可以理解，在一些应用中需要控制器和关节运动接头之间的直接连接。实现正确地确定带的尺寸而不滑动或断裂被认为很难。由关节运动控制器给出的松动程度的触觉响应还可能是不需要的。
因此，对于外科器械的关节接头存在这样的迫切需要，即：关节接头直接与关节运动控制器连接，该关节运动控制器有利地包括用于防止端部执行器的反向驱动的关节接头的自动锁定。
发明内容
通过提供其细长轴响应于关节运动连接机构进行枢转关节运动的外科器械，本发明克服了现有技术的上述和其它的缺点。通过防止端部执行器的反向负载的关节接头锁定来避免关节运动角度的因疏忽而导致的变化和/或对关节运动连接机构的损害。因此，关节运动连接机构可具有所需的小横截面。
在本发明的一个方面中，外科器械具有关节运动控制器，用户对其进行致动来引起端部执行器围绕细长轴的关节运动接头枢转。特别的，关节运动构件从细长轴伸出一个远端与端部执行器接合，该端部执行器响应于关节运动控制器而横向偏转，以便进行关节运动。与这种运动共同作用，将锁定致动器从关节运动接头向近侧拉动，从而使其与固定在端部执行器上的弧形制动表面脱离接合，并围绕关节运动接头的关节轴向近侧扩展(radiating)。因此，关节运动控制器的直接控制可通过关节运动锁定器来辅助，该关节运动锁定器将端部执行器保持在选定的关节运动角度，而且不需要为了防止所述反向负载而增加关节运动控制器的大小和强度。
在本发明的另一方面中，外科器械包括一个关节运动接头，该关节运动接头由细长轴中的滑杆的横向运动来控制。与端部执行器连接并围绕关节运动接头的关节轴布置的指向近侧的扇形齿轮与滑杆上的指向远侧的齿条接合。细长轴中的锁定构件还沿纵向向远侧平移成与扇形齿轮接合，从而将关节运动接头锁定就位。在利用关节运动锁定器来保持所需的关节运动角度的保证下实现通过诸如各种形式的动力使滑杆差分运动而提供的各种优点。
在本发明的又一方面中，外科器械具有进行关节运动的轴，其由容纳在细长轴中用于横向运动的滑杆控制。响应于端部执行器上的反向负载作用力使与滑杆连接的锁定机构有利地运动成与细长轴接合。
更具体地说，本发明还涉及如下内容：
(1)一种外科器械，包括：
构造为在患者体外进行操作的近侧部分；
连接到所述近侧部分的细长轴；
端部执行器；
将端部执行器以可枢转的方式连接到所述细长轴的关节运动接头；
弧形制动表面，其被连接到该端部执行器并围绕关节运动接头的关节运动轴线向近侧伸展；
连接到该近侧部分的关节运动控制器；
关节运动构件，其从所述细长轴的远端延伸成与该端部执行器接合，所述远端响应于关节运动控制器横向偏转，以便进行关节运动；
由所述细长轴导引的锁定致动器，其近端连接到关节运动控制器，远端终止于锁定表面，并且被定位成可选择地与该锁定表面接合。
(2)如第(1)项所述的外科器械，其中，所述关节运动控制器包括横向控制器，该横向控制器可操作地设置为在其运动期间向近侧推压锁定致动器，使该锁定致动器与端部执行器脱离接合。
(3)如第(2)项所述的外科器械，其中，所述锁定构件向远侧偏压，并且接合表面包括近侧销，横向扇形齿轮包括带齿的表面，该带齿的表面在致动期间使销向近侧伸出，允许该近侧销向远侧运动，当关节运动控制器停止时使该近侧销与带齿表面的相应齿根接合。
(4)如第(2)项所述的外科器械，其中，所述横向控制器包括差分流体控制器。
(5)如第(1)项所述的外科器械，还包括：
用于在细长轴中横向运动的受约束的滑杆；
定位在关节运动接头中的滑杆的远端；和
端部执行器的近侧表面，其与关节运动的远端接合，用于将滑杆的横向运动转化成端部执行器的枢转运动。
(6)如第(1)项所述的外科器械，其中，所述细长轴还包括关节运动驱动管，其将旋转运动传递到关节运动接头，使端部执行器进行枢转关节运动，并且所述锁定致动器包括介于关节运动驱动管和关节运动控制器之间的反向驱动锁定机构。
(7)如第(6)项所述的外科器械，其中，所述反向驱动锁定机构包括：
具有孔口的框架；
锁定构件，其与所述框架的孔口横向锁定就位并被连接到横向齿条；和
偏转构件，其被连接到关节运动控制器，并被定位成使锁定构件脱离接合和横向定位。
(8)如第(6)项所述的外科器械，其中，所述关节运动驱动管包括可旋转连接件，其与滑杆平行对准，并与所述细长轴的垂直中心线对准，该可旋转连接件与滑杆的近侧表面以可枢转的方式连接，当可旋转连接件旋转时引起滑杆的横向运动。
(9)如第(8)项所述的外科器械，其中，可旋转连接件包括沿着其纵向长度间隔开的与滑杆连接的多个枢转连接点，用于在致动期间保持对准。
(10)一种外科器械，包括：
构造为在患者体外进行操作的近侧部分；
连接到所述近侧部分的细长轴；
端部执行器；
将端部执行器以可枢转的方式连接到所述细长轴的关节运动接头；
扇形齿轮，其指向近侧并被连接到端部执行器，并且被布置成围绕关节运动接头的关节运动轴线旋转；
用于在细长轴中的横向运动的受限的滑杆；
指向远侧的齿条，其被连接到定位在关节运动接头中的滑杆，与端部执行器的扇形齿轮接合；
端部执行器的近侧表面，其与关节运动的远端接合，用于将滑杆的横向运动转化成端部执行器的枢转运动；以及
细长轴中的锁定构件，其可选择地向远侧纵向平移成与端部执行器的扇形齿轮接合，从而锁定关节运动接头。
(11)如第(10)项所述的外科器械，其中，所述锁定构件向远端偏压并具有近侧销，关节运动控制器包括带齿的表面，该带齿的表面定位成在致动期间使所述销向近侧伸出，并且当关节运动控制器停止时允许近侧销向远侧运动成与带齿表面的相应齿根接合。
(12)如第(10)项所述的外科器械，还包括定位在滑杆的各相对侧的差分关节运动致动器。
(13)如第(12)项所述的外科器械，其中，所述关节运动致动器包括流体致动器。
(14)如第(12)项所述的外科器械，其中，所述关节运动致动器包括电磁致动器。
(15)如第(12)项所述的外科器械，其中，所述关节运动致动器包括纵向平移凸轮致动器。
(16)如第(12)项所述的外科器械，其中，所述关节运动致动器包括具有可定位的近端的挠曲构件。
(17)一种外科器械，包括：
构造为在患者体外进行操作的近侧部分；
连接到所述近侧部分的细长轴；
端部执行器；
将端部执行器以可枢转的方式连接到所述细长轴的关节运动接头；
滑杆，其被容纳在细长轴中用于横向运动，并包括接合成使端部执行器围绕关节运动接头枢转的远端和响应于端部执行器上的反向驱动力运动成与细长轴束缚接合的锁定机构。
(18)如第(17)项所述的外科器械，还包括与端部执行器连接的扇形齿轮，滑杆还包括与扇形齿轮接合的在远端连接的齿条。
(19)如第(17)项所述的外科器械，其中，所述锁定机构包括沿横向形成于细长轴中的通道和与滑杆垂直连接并容纳于所述通道中的肋，滑杆还包括将肋与滑杆的远端连接的挠性纵向部分，其中端部执行器的反向驱动使该纵向部分弯曲，从而将肋旋塞成在所述通道中束缚接合。
(20)如第(17)项所述的外科器械，其中，所述锁定机构包括靠近与细长轴连接的横向接合表面沿横向平移的接合齿，该外科器械还包括偏压构件，该偏压构件向远侧推压滑杆和接合齿，使它们与横向接合表面脱离结合，直到端部执行器被反向驱动。
通过下面的附图和对附图的说明将清楚地了解本发明的这些和其它目的及优点。
附图说明
包括在该说明书中并构成该说明书的一部分的附图图示出本发明的实施例，并且与上述本发明的概述以及下述实施例的详细说明一起用来解释本发明的原理。
图1是外科缝合和切割器械的从前侧上部看的透视图，示出了打开的端部执行器或说钉施加组件，其中除去了钉仓。
图2是图1的外科缝合和切割器械的从前侧上部看的透视图，其中关节运动机构由流体致动控制器致动。
图3是图1的外科缝合和切割器械的细长轴和关节运动机构的分解透视图。
图4是图1的外科缝合和切割器械的执行部分的远侧部分的分解透视图，包括钉施加组件和关节运动机构。
图5是图1和图4中的钉施加组件的从前侧上部看的透视图，其中钉仓的侧半部被除去以暴露由击发运动驱动的元件。
图6是图1的外科器械的执行部分的从前侧看的透视图，其中除去了双枢轴闭合套管组件和端部执行器，暴露出通过流体关节运动机构进行关节运动的单枢轴框架底。
图7是用于图1的外科器械的替代的关节运动接头的详细透视图，示出了双枢轴闭合套管组件，在近侧位置带有单枢轴框架底。
图8是图7的替代的关节运动接头的从底部右侧看的分解透视图，包括双枢轴固定壁狗骨型连接件和具有用于横向运动构件(T型杆)的轨道的框架底。
图9是用于图1的外科器械的另一种替代关节运动接头的从上部左侧看的分解透视图，包括作为替代的实心壁支撑板机构，该实心壁支撑板机构被结合到下部双枢轴连接件中用于支撑击发杆并包括轨道导引的横向运动构件(T型杆)。
图10是用于图1的外科器械的作为替代的关节运动锁定机构的俯视示意图，其中除去了闭合套管组件，暴露出用于自动关节运动锁定接合和脱离接合的用反向载荷脱开的T型杆。
图11是用于图1的外科器械的另一种替代关节运动机构的俯视示意图，其中位于T型杆上的弹性偏压齿条带有由于来自端部执行器的反向载荷而接合的锁定零件。
图12是用于图1所示外科器械的作为替代的T型杆和具有横向导向件的框架底。
图13是用于图1所示外科器械的又一种作为替代的T型杆和具有横向导向件的框架底。
图14是用于图1的外科器械的作为替代的关节运动机构的左侧上部看的透视图，该关节运动机构包括双枢轴框架底组件和单枢轴闭合套管组件。
图15是作为图14的替代的关节运动机构的从左侧底部看的透视图。
图16是横向运动流体关节运动机构的示意图，其中枢转的齿条和扇形齿轮示出为未进行关节运动的状态。
图17是图16的流体关节运动机构沿着线17-17截取的主剖视图。
图18是横向运动流体关节运动机构的示意图，其中枢转的齿条和扇形齿轮示出为进行关节运动的状态。
图19是图18的流体关节运动机构沿着线19-19截取的主剖视图。
图20是由至少一个纵向运动构件使外科器械进行关节运动的俯视示意图，所述纵向运动构件将滑杆横向顶起，该滑杆又使端部执行器进行关节运动。
图21是图20的外科器械处于关节运动状态的俯视示意图。
图22是用于图16或20所示外科器械的作为选择的旋转连接机械控制系统的主剖视图，图示为未进行关节运动的状态，该旋转连接机械控制系统分别使T型杆或者滑杆横向平移。
图23是处于进行关节运动状态的图22的可旋转连接机械控制系统的一种替代的主剖视图。
图24示出了用于图22中的可选的旋转连接机构控制系统的替代横向关节运动控制机构的分解透视图。
图25示出了图24的横向关节运动控制机构的剖面的主视图。
图26示出了图24的横向关节运动控制机构的接合状态中的锁定块的详示图。
图27示出了处于脱离接合状态的图24所示横向关节运动控制机构的详示图。
具体实施方式
关节轴概述
参照附图，其中在所有附图中相同的附图标记代表相同的组成构件。图1示出了一种外科器械，更具体地，在示例性方案中为外科缝合和切割器械10，其能够实践本发明的独特优点。特别地，在图1中所示的未进行关节运动的状态下，该外科缝合和切割器械10的大小适于通过套管针的插管通道插入到患者(未显示)体内的手术部位，以进行外科手术。一旦执行部分12经过插管通道插入，该执行部分12的细长轴16的远侧部分中包含的关节运动机构14可通过关节运动控制器18远距离的进行关节运动，如图2所示。端部执行器(在示例性方案中示为钉施加组件20)从远侧与关节运动机构14连接。因此，远距离地使关节运动机构14进行关节运动由此使钉施加组件20相对于细长轴16的纵向轴线进行关节运动。这种带角度的位姿具有如下优点：以所需的角度接近组织以进行切割和缝合，接近那些否则受其它器官和组织阻挡的组织，和/或允许将内窥镜定位在钉施加组件20的后面并与其对准，以确认放置。
手柄
外科缝合和切割器械10包括与执行部分12从近侧连接的手柄部分22，用于向该执行部分提供定位、关节运动、闭合和击发运动。该手柄部分22具有手枪式把手24，医生朝着该把手24枢转地向近侧拉动闭合触发器26，导致钉施加组件20的夹紧和闭合。击发触发器28在所述闭合触发器26的外侧，医生以枢转的方式拉动该击发触发器28，使夹钳在钉施加组件20中的组织被缝合和切割。此后，按压闭合释放按钮30释放夹紧的闭合触发器26，并由此释放被夹钳的组织的切割和缝合端部。手柄部分22还包括与细长轴16一起运动的连接的旋钮32，以使轴16和关节连接的钉施加组件20围绕轴16的纵向轴线旋转。手柄部分22还包括击发回缩手柄34，用于在产生束缚时辅助缩回击发机构(在图1-2中未显示)，从而使钉施加组件20此后可以打开。
应当理解，这里使用的术语“近侧”和“远侧”是以握持器械手柄的医生为参照。因此，钉施加组件20相对于更近侧的手柄部分处于远侧。还应理解，为了方便和清楚起见，这里使用的空间术语，诸如“垂直”和“水平”均相对于附图而言。然而，外科器械可以多种方向和位置使用，这些术语并不是限制性的和绝对的。
在如下的未审结和共有的美国专利申请中更详细地描述了图1-2中用于外科缝合和切割器械10的示例性多冲程手柄部分22，该申请是Swayze和Shlton IV的序列号为10/674,026、名称为“SURGICALSTAPLING INSTRUMENT INCORPORATING A MULTISTROKEFIRING POSITION INDICATOR AND RETRACTION MECHANISM”的申请，上述申请公开的内容在此通过引用全部并入本文，附加特征和变化在此进行描述。虽然多冲程手柄部分22有利地支持在长距离上高击发力的应用，但是与本发明一致的应用可以采用单一击发冲程，例如在Frederick E.Shelton IV、Michael E.Setser和Brian J.Hemmelgarn的序列号为10/441,632、名称为“SURGICAL STAPLINGINSTRUMENT HAVING SEPARATE DISTINCT CLOSING ANDFIRING SYSTEMS”的未审结和共有的美国专利申请中所描述的，该申请的公开内容在此通过引用全部并入本文。
执行部分(进行关节运动的细长轴和钉施加组件)
在图1-5中，有利地，执行部分12包括在适于内窥镜和腹腔镜手术的较小直径内的纵向旋转、关节运动，闭合和击发的多种致动运动。钉施加组件20(“端部执行器”)具有一对可枢转地相对的钳口，图示为一个具有可枢转地连接的砧座42的细长通道40(图1-2，4-5)。砧座42相对于细长通道40的闭合和夹钳通过用可旋转地连接到手柄部分20的框架组件44(图3)、甚至用图2中所示的关节连接的钉施加组件20沿纵向支撑该细长通道40来实现，其中，一个双枢轴闭合套管组件46在所述框架组件44的上方沿纵向运动，以向砧座42施加分别对应于向远侧和近侧运动的闭合和打开。
特别参照图3，框架组件44包括一个单枢轴框架底48，其近端与旋钮32接合，并且如图3所示旋钮32上带有右侧半壳50。应当理解，闭合套管组件46的近端、特别是闭合直管52(其一端包围框架底48的近端，另一端进入手柄部分22内部)的近端与使闭合套管组件46纵向平移的闭合构件(未显示)接合。一个位于闭合直管52近端的圆形凸缘54提供了与所述元件的旋转接合。旋钮32的接合元件穿过闭合直管52的近侧部分上的纵向槽56与在框架底48上在近侧定位的孔口58接合。纵向槽56具有足够的长度，以允许闭合套管组件46以由闭合套管组件46和框架底48的旋钮32设定的各种旋转角度沿纵向闭合平移。
细长轴16通过容纳与手柄部分22(未显示)旋转接合的击发杆60来支持击发运动。击发杆60沿着框架底48的纵向中心线进入近侧开口62。框架底48的远侧部分包括一个沿着其与近侧开口62相通的底部的击发杆槽64。击发杆66在击发杆槽64中纵向平移，并包括一个向上突出的近侧销68，该近侧销与击发杆60的远端70接合。
细长轴16通过具有矩形容器腔72来支持关节运动，该容器腔72在旋钮32的远侧部分中描绘为横向部分。位于矩形容器腔72中的底部分隔室74具有横向间隔开的左和右挡板76、78。关节运动致动器80在底部分隔室74的上方横向滑动，该关节运动致动器的向下的横向间隔开的左和右凸缘82、84位于挡板76、78外侧，每个凸缘与分别从旋钮32的每个半壳向外伸出的左和右按钮86、88横向相通。抵抗流体关节运动系统94的左和右储存囊90、92而运转，关节运动致动器80的横向运动使左和右凸缘82、84分别更靠近或更远离左和右挡板76、78，每个囊90、92分别向远侧与左和右流体导管或通道96、98连通，该左和右流体导管或通道96、98又分别与左和右致动囊100、102连通。后者(也就是左和右致动囊100、102)相对并横向枢转关节运动机构14的T型杆104。
框架组件44通过包括框架底48的顶部和远侧带凹槽的板106来限制这些流体致动，流体通道96、98和致动囊100、102位于所述框架底的所述板106上面。T型杆104在致动囊100、102之间滑动地位于带凹槽的板106上面。在T型杆104的近侧，一个凸出的阻挡肋108与其对准，用于防止流体通道96、98向内膨胀。框架组件44具有一个圆形的顶部框架盖(隔离件)110，其在框架底48的上方滑动，从而防止流体通道96、98和致动囊100、102的垂直膨胀，同时限制T型杆104的任何垂直运动。特别地，框架盖110包括能使其还可提供关节运动的锁定构件111的零件，下面将作为关节运动锁定机构200的一部分进行详细描述。
T型杆104的远端(“齿条”)112用于使关节运动机构14的关节连接的远侧框架构件114的指向近侧的扇形齿轮115枢转。关节连接的闭合管116包围关节连接的框架构件114，并包括一个与砧座42接合的马蹄形孔口118。在闭合直管52和关节运动闭合环116之间关节运动机构14的上方形成一个双枢轴连接，从而允许即使当关节运动机构14进行关节运动时也可进行纵向闭合运动。特别地，带有销孔122、124的闭合直管52上的顶部和底部向远侧伸出的枢轴翼片119、120分别与具有销孔130、132的关节运动闭合环116上相应的顶部和底部向近侧伸出的枢轴翼片126、128沿纵向间隔开。一个上部双枢轴连接件134具有分别与销孔130、122接合的沿纵向间隔开的向上的远侧和后部销136、138，一个下部双枢轴连接件140具有分别与销孔132、124接合的沿纵向间隔开的向下伸出的远侧和后部销142、144。穿过框架底48在远侧定位的垂直销孔169用于容纳框架枢轴销171，该框架枢轴销171在远侧框架构件114的下面枢转。
特别参照图4，为了增强可制造性，关节运动闭合环116显示为包括一个短管146，该短管146与包括向近侧伸出的枢轴翼片126、128连接的关节连接卡圈148相连。类似地，闭合直管52由与后部连接卡圈152连接的长闭合管150组装而成，所述连接卡圈152包括向远侧伸出的枢轴翼片119、120。短闭合管146中的马蹄形孔口118与略微靠近横向枢轴销156的向上伸出的砧座零件154接合，所述枢轴销156与细长通道40中的枢轴槽158接合。
图4的可选方案包括狗骨型连接件160而不是框架枢轴销171，该狗骨型连接件160的近侧销157被可枢转地连接到框架底48的框架孔161中，并且其近侧销159与关节运动远侧框架构件114的近侧下表面162刚性连接，从而在各销之间提供可枢转地支撑。狗骨型连接件160的底部纵向刀槽163导引击发杆66的关节运动部分。关节运动远侧框架构件114还包括一个用于导引击发杆66的远侧部分的底部纵槽164。
钉施加器械(端部执行器)
参照图4-5，击发杆66在远侧终止于E-形梁165，所述E-形梁165包括上部导销166，该上部导销166插入砧座42中的砧座槽168中，以便在形成钉和切割期间检验并辅助将砧座42保持为闭合状态。细长通道40和砧座42之间的间隔还可通过如下方式来保持，即，E-形梁165具有沿着细长通道40的顶面滑动的中间销170，同时其底脚172由细长通道40中的纵向开口174导引沿着该细长通道40的下表面相对地滑动。位于上部导销166和中间销170之间的E形梁164的在远侧的切割表面176对夹钳的组织进行切割，同时E形梁通过向远侧运动楔形滑动件180致动可拆卸的钉仓178，该楔形滑动件180引起钉驱动器182向上凸出，以驱动钉184向上脱离钉仓体188中的钉孔186，从而抵靠砧座42的钉形成下表面190形成钉。钉仓座192从底部包围钉仓178的其它元件，将它们保持在适当的位置。钉仓座192包括一向后开口的槽194，该槽194覆盖在细长通道40中的纵向开口174上，从而使中间销170穿过钉仓座192的内部。
钉施加组件20由Frederick E.Shelton IV等共有的于2004年9月30日提交的申请号为10/955,042、名称为“ARTICULATINGSURGICAL STAPLING INSTRUMENT INCORPORATING ATWO-PIECE E-BEAM FIRING MECHANISM”的美国未审结专利申请中有详细描述，其公开的内容在此通过引用全部并入本文。
关节运动锁定机构
在图3-4和6-8中，有利地包括一个关节运动锁定机构200，以将钉施加组件20保持在预定的关节运动角度。关节运动锁定机构200减小了左和右致动100、102上的反向驱动负载。特别地，压缩弹簧202(图3)在近侧定位于关节锁定构件111的近端204和手柄部分22之间，向远侧偏压关节锁定构件111。特别参照图4，关节锁定构件111远端210上的两个平行的狭槽206、208分别容纳框架底48上的向上伸出的导向肋212、214。导向肋212、214的纵向长度比平行的狭槽206、208的长度短，使其具有相对纵向行程范围。特别参照图8，由此使远侧摩擦表面(示为从关节锁定构件111向远侧伸出的带齿的槽216)的可选抵接接合部分与容纳在关节运动框架构件114的顶部近侧凹槽220(图4)中的制动板218中的相应锁定扇形齿轮217接合。制动板218的远侧和近侧孔221、222容纳从顶部近侧凹槽220向上伸出的远侧和近侧销223、224。
特别参照图6，细长轴16示为处于进行关节运动的位置，其中闭合套管组件46被从框架组件44周围除去，而且没有细长通道40和砧座42。关节运动致动器80显示为横向运动到左侧，以压缩右侧近侧储存92，并使远侧右侧致动102膨胀，从而将T型杆104运动到所示位置。因此，当从上方看时，关节运动致动器80的横向运动使远侧框架114围绕单枢轴框架底48沿顺时针进行关节运动。有利地，关节运动致动器80还自动地与关节运动锁定机构200接合和脱离接合。特别地，沿着关节运动致动器80的近侧上表面的带齿止动表面225容纳从关节锁定构件111的近端204向下伸出的锁定销226(图6中未示出)。锁定销226在带齿止动表面225根部的接合为关节锁定构件111提供了足够的向远侧的运动，将锁定扇形齿轮217锁定接合于制动板218中。由操作人员造成的关节运动致动器80向近侧的横向运动向近侧推压锁定销226，由此使关节锁定构件111与制动板218脱离接合。当操作人员释放关节运动致动器80时，锁定销226被压缩弹簧202推压到止动表面225的相邻止动槽中，以使锁定机构111锁定，由此锁定钉施加组件20，从而通过限制和膨胀所述左和右侧近侧储存囊90、92的膨胀形状来将关节运动机构14限制在所需的关节运动位置。
作为替代或者附加，可在平行的流体导管96、98中提供开口，来控制远侧致动囊100、102和近侧储存囊90、92之间的流速。
在图10中，外科器械2004的关节运动机构2002的一种替代的锁定机构2000通常是未锁定的，并通过使横向运动的T型杆2006由于反向载荷而歪斜来启动。一个狭槽2008位于框架底2010中，以容纳并导引从T型杆2006向下伸出的肋2012。如果端部执行器2016受反向载荷，则一个与肋2012成直角连接的细长纵向部分2014偏斜。例如，当端部执行器2016受到如箭头2018所示向右的力，其近侧扇形齿轮2020作用在T型杆2006的齿条2022上，从而施加非垂直的反向驱动力，如箭头2114所示。因此，细长纵向部分2014偏斜，将肋2012旋塞到狭槽2008中。这种旋塞产生了相反的束缚力(如箭头2026、2028所示)，将T型杆2006锁定并阻止其继续进行关节运动。当关节运动囊的致动使横向运动T型杆2006释放时，则解除锁定。此后，肋2016可辅助导引T型杆2006。
在图11中，显示了外科器械2102的又一种关节运动锁定机构2100，其通常是未锁定的，并通过由端部执行器2106的齿轮齿2104和T型杆2110的齿条齿2108以20度压力角形成的近侧力向量来致动。当端部执行器2106受到反向载荷(如非垂直箭头2112所示)时，压力角的纵向向量(如箭头2114所示)使T型杆2110向近侧运动。该纵向力向量施加到位于T型杆2110的齿条2120后面的牵引弹簧2118上。当弹簧2118随着T型杆2110向近侧运动而偏斜时，从齿条2120向近侧伸出的锁定齿2126与在底部框架2124上向远侧伸出并横向对准的锁定元件2122接合。当通过除去端部执行器2106的反向载荷并且T型杆2110由于弹簧2118的推压向远侧运动使近侧力向量2014减小或消除时，锁定齿2126和锁定构件2122脱离接合。
双枢轴闭合套管和单枢轴框架底的组合
参照图3-4和7，有利地，执行部分12包括双枢轴闭合套管组件46，该双枢轴闭合套管组件46围绕一个单枢轴框架底48并在其上方纵向平移。下面将进一步详细描述这些机构和它们的操作。特别参照图7，关节运动机构14显示为处于进行关节运动的状态，其中闭合套管46向近侧回缩到砧座处于打开状态。在砧座42的打开的情况下(在图7中未示出)，关节运动控制器18的致动引起关节连接的闭合环116分别围绕上部和下部双枢轴闭合连接件134、140的向上的远侧销136和向下的远侧销142(在图7中未示出)枢转。框架底48围绕单个销(图示为连接框架底48与远侧框架构件114的框架枢轴销171(图3))枢转。随着砧座42的打开，框架底48的框架枢轴销171与闭合套管组件46的上部和下部双枢轴连接件134、140的最远位置对准。当砧座42打开时，这样定位很容易使钉施加组件20进行枢转和旋转。当闭合套管组件46向远侧运动来枢转闭合砧座42时，闭合直管52围绕框架底48向远侧运动，并且关节连接的闭合环116由于枢轴连接件134、140的促动沿着关节连接的远侧框架构件114的轴向远侧运动。当所述装置进行关节运动时(未显示)，随着它们向着远侧闭合位置的致动，连接件134、140上的双枢轴销136、138以及142、144有利于与闭合直管52和关节连接的闭合环116的接合。在远侧闭合位置，框架枢轴销171在进行完全关节运动时与近侧枢轴销138、144垂直对准，或者当有效运行时落在远侧销136、142和近侧销138、144之间的任一点上。
实心击发杆支撑件
在图8中，图7中的关节运动机构14被局部分解并从底部图示，显示图4中的实心壁击发杆支撑设计(狗骨型连接件160)，其提供了传统弹性支撑板所不具备的优点。支撑板用于间隙的桥接，并通过单框架底枢轴关节运动接头1801导引并支撑击发杆66。弹性击发杆是已知的，但是采用实心壁击发杆(例如图4、8、9中显示的那些)提供了独特的优点。下面参见图8，框架底48包括一个沿着框架底48的底部延伸的框架刀槽1802，和一个沿着进行关节运动的远侧框架构件114的底部延伸用于将击发杆66(未显示)滑动容纳于其中的远侧刀槽164。如上所述的框架底48还包括一个在框架枢轴销171处与远侧框架构件114的直接单枢轴连接。可旋转地连接于近侧销端部157并可动地连接在远侧销端部159上的固定壁狗骨型连接件160包括左和右横向导向件1818、1820，在这两个导向件之间限定了一个导槽1822，作为击发杆66的滑动通道(图4)。
因此，为了桥接框架底48和远侧框架构件114之间的间隔，将固定壁枢轴狗骨型连接件160可枢转地连接到框架底48，并与框架构件114滑动连接。枢转的狗骨型连接件160的近侧销157可枢转地容纳于框架底48的孔1824中，使枢转的狗骨型连接件160能够围绕孔1824枢转。远侧销159从枢轴狗骨型连接件160向上伸出，并滑动容纳于远侧框架构件114中的狭槽1826中。钉施加组件20与纵向轴线成例如45度角的关节运动使枢转狗骨型连接件116以其近侧销157为轴在孔1824中枢转，并且远侧销157滑进在远侧框架构件114中形成的狭槽1826中，使击发杆66弯曲成两个分开的角，它们的角度是钉施加组件20的角度的一半。与前面引用的将击发杆66弯曲成45度角的弹性支撑板不同，固定壁枢转狗骨型连接件160将击发杆66弯曲成两个分开的角，例如每个22.5度。将一个或多个弹性击发杆66弯曲成所述角度的一半可以在击发杆66中将弯曲应力减小到传统的关节运动支撑件中的一半。击发杆66中的弯曲应力的减小降低了击发杆中的永久弯曲或造成形变的可能性，降低了击发阻塞的可能性，确保了较小的击发杆回缩力，并为击发系统提供了更平稳的运行。
在图9中，外科器械1900包括双闭合枢轴。单框架枢轴关节运动接头1902给出了一种作为替代的实心壁支撑板机构1904，其可替代图8中的下部双枢轴连接件140和狗骨型连接件1812。左和右击发杆支撑件1906、1908从闭合套管组件1912的下部双枢轴连接件1904向上伸出。在框架底1916中提供间隙1914，当闭合套管组件1912向远侧运动闭合砧座42(在图9中未显示)以及向近侧运动打开砧座42时，使击发杆1906、1908能够在该间隙中运动。与上述的枢转狗骨型连接件160类似，作为替代的下部双枢轴连接件1910也可弯曲并支撑击发杆66(在图9中未显示)，从而形成两个分开的弯曲角，其中的每个达到钉施加组件20的弯曲角的一半。
横向构件导向机构
继续参照图9，框架底1916上的左和右向上凸缘1918、1920包括远侧和近侧横向销导向件1921、1922，它们横向穿过T型杆1926中的通孔1923、1924，从而辅助将关节运动机构1928中的束缚降到最低。这些销导向件1921、1922还结合到图7的框架底48中。作为另一个例子，在图7中，有利地，T型杆104包括一个燕尾状横向导向件1930，其可在框架底48中形成的燕尾状通道1932中横向滑动。作为另一个例子，在图12中，一个从框架底1936上的凸出的肋1934容纳于在T型杆1940中形成的矩形狭槽1938中。为了进一步有利于无束缚的横向平移，每个远侧和近侧横向支撑轨道都包括多个滚珠1946、1948。作为又一个例子，在图13中，与T型杆1964中的T型杆横向沟槽1958-1962相对应，在框架底1956中形成多个框架横向沟槽1950-1954。滑动滚柱1966-1970被捕获停留在每对横向沟槽1950/1958、1952/1960、1954/1962中。这些决不意味着对防止T型杆1964不期望的倾斜或旋转的横向导向构件的穷尽列举。
双枢轴框架底和单枢轴闭合件的组合
在图14-15中，外科器械2202包括一种替代的框架底和闭合机构2200，该框架底和闭合机构2200包括双枢轴框架组件2204。特别地，框架底2206通过双枢轴框架狗骨型件2210与远侧框架构件2208连接，所述双枢轴框架狗骨型件2210具有一个与框架底2206中的近侧孔2214枢转接合的近侧枢轴销2212和一个与远侧框架构件2208的远侧孔2218接合的远侧枢轴销2216。导向槽2220设置于狗骨型件2210的下侧，以在其中导引击发杆66(在图14-15中未显示)。刀槽2222设置在远侧框架构件2208中。如图所示，闭合套管组件2224的闭合环2230以四十五(45)度角进行关节运动，使远侧框架构件2208以四十五(45)度角相进行关节运动，并使框架狗骨型件2210以该角度的一半进行关节运动。因此，击发杆66仅受到分开的两个小的半弯曲，并能获得上述列举的优点。
最外层闭合套管组件2224的不同之处在于，框架组件2204的双枢轴设计中仅有一个枢轴适于纵向闭合运动。如图所示，闭合管轴2226在其远端具有一个叉形头(clevis)2228。叉形头2228与闭合环2230可枢转地接合。闭合环2230在其近端形成有近侧齿轮2232，并且销2234穿过近侧齿轮2232并与叉形头2228的上柄脚2236枢转接合。下臂2238通过定位销2241与叉形头2228的下柄脚2240可枢转地接合。叉形头2228中的孔2242容纳横向导销2243，并且T型杆2244可滑动地连接于其中，以接合闭合环2230的近侧齿轮2232。因此，这种替代机构2200使用与前面描述的机构相反的单/双枢轴替代构想。也就是说，这种作为替代的闭合机构2200具有单枢轴，而作为替代的框架底具有双枢轴，这与前面描述的具有单枢轴框架底的双枢轴闭合机构不同。
横向运动关节运动机构
在图16-19中示意性地描绘出了横向运动关节运动机构230，显示出用于执行端部执行器232的关节运动的横向运动。横向运动是至少一个元件向着或离开外科装置234的纵向轴线的运动。这种运动一般与纵向轴线(该纵向轴线是将机构230二等分的水平线)成直角，并不涉及旋转运动或者纵向运动。横向运动关节运动机构可以如图16-19所示地流体致动，也可以如图20-23所示地机械致动。
横向运动流体关节运动机构
在图16-19中示意性地显示了横向运动关节运动机构230，其包括流体控制系统235，该流体控制系统235具有流体填充的平行的左和右流体囊236、238，所述流体囊236、238在其间纵向延伸，通过流体242的运动使横向构件或者T型杆240横向运动。所有方向均以纵向轴线为参照。参见没有进行关节运动的图16、17，位于远侧的端部执行器232围绕销244枢转，并在其近端具有扇形齿轮246。枢轴销244与框架(未显示)连接。位于T型杆240远端的齿条248可操作地与扇形齿轮246接合。T型杆240和齿条248可沿着轴线A-A横向运动。长的左和右流体囊236、238的每个远侧部分位于可横向运动的T型杆240的侧部，并在横向上被限制于闭合套管250中，在垂直方向上由下面的框架252和上面的定位片254限制。特别地，左侧致动流体囊236具有左侧远侧致动囊256、左侧流体通道258以及左侧近侧储存囊260。右侧流体囊238具有右侧远侧致动囊262、右侧流体通道264以及右侧近侧储存囊266。固定的分隔器270从框架252伸出并隔开囊260、266以及流体通道258、264。固定分隔器270和闭合套管250限制该流体通道258、264，防止在囊236、238的流体通道258、264部分的膨胀。可横向运动的“C”形压缩构件272包括于关节运动控制机构273中，用于压缩近侧储存囊260、266中的一个，并用于端部执行器232的关节运动。另外，也可采用其它元件，诸如穿过框架252中的击发杆槽276的击发杆274(图17、19)。
如图18、19中所示，C形压缩构件272向左侧的横向运动压迫右侧近侧储存囊266，迫使流体242进入右侧流体通道264和右侧远侧致动囊262中。随着右侧远侧致动囊262使T型杆240横向运动到左侧，左侧远侧致动囊256被压缩，端部执行器232被致动到右侧(从图示的顶部顺时针方向观察)。左侧远侧致动囊256的压缩引起流体242经过左侧固定流体通道258向近侧流动，并进入左侧近侧储存囊260中。具体地，与C形压缩构件272相连的右侧壁280向左侧运动，引起右侧近侧储存囊266的压缩。当流体流进膨胀的左侧近侧储存囊260时，与C形压缩构件272相连的左侧壁278的相应的左向运动为来自受压缩的左侧制动器囊256的流体提供了空间。
该用于关节运动机构230的流体控制系统235提供了至少多个优点。首先，致动囊256、262靠近关节运动接头或者机构230的定向允许在外科装置234中使用长的囊236、238和更长的T型杆240。作为流体驱动系统，可以两种方式来实现流体控制系统235的输出力的增加。第一种，对于在T型杆240上的固定流体面积，可增大作用在固定面积上的流体压力。第二种，对于固定的流体压力，可增加T型杆240上的流体接触面积。第一种方法使设计更紧凑，系统压力更高。第二种方法导致设计更大，系统压力更小。为了降低成本，简化设置，降低系统应力，并减小囊破裂的风险，示例性方案示出了长的远侧致动囊256、262，它们处于外科装置234中靠近关节运动机构230的有利位置。正是囊256、262的这种设置使囊256、262可以很长，而且对较低的输入压力而言，关节运动的输出力可以很高。
因此，可以简单地通过增加T型杆240上的远侧致动囊(球囊)256、262的压力接触面积来增大关节运动机构230的输出力(对相同的输入压力而言)。压力接触面积的增大受到高度和长度的限制。由于传统内窥镜外科器械的直径是用于穿过注入口的固定直径，这限制了高度的变化。压力接触面积的长度变化具有最大效果，并使装置的横向输出力可(通过改变长度)有利地调节，以符合系统对各种输出力的需求。
在横向运动装置中使用的流体既可以是可压缩的，也可以是不可压缩的。如这里所指，术语“流体”包括液体、气体、凝胶、微粒和能够在压力梯度之间流动的任何其它材料。虽然可使用任何流体，但特别优选灭菌溶液，诸如盐水、矿物油或者硅氧烷。
横向运动机械关节运动机构
尽管上面描述了用流体机构引起横向运动和关节运动，但机械机构可实现与流体囊236、238产生的横向运动相同的横向运动。在图20-21中，作为替代的横向运动关节运动机构300采用机械控制系统(具体地说是纵向运动构件)为外科器械301施加横向运动和关节运动。在示例性方案中，特别参考图20，横向运动滑杆302具有至少一对倾斜的左和右凸出表面304、306，它们从滑杆302向细长纵轴308的相对侧横向伸出。在示例性方案中，还可包括另一对近侧左和右倾斜凸出表面310、312。右侧纵向运动连接件314包括对应的方向向内的远侧和近侧反向倾斜表面316、318，该远侧和近侧反向倾斜表面316、318与远侧和近侧的右侧凸出表面306、312对准并滑动接合，从而使运动连接件314的远侧纵向运动引起滑杆302的左向横向运动。应当理解，这种倾斜接触可颠倒，从而使远侧运动引起向右运动。
应当理解，在滑杆302上可包括弹性偏压件(未显示)，以用于促动滑杆302向右与右侧纵向运动连接件314接合，从而使右侧纵向运动连接件314的反向近侧运动允许滑杆302的向左运动。作为替代，在示例性方案中，左侧纵向运动连接件320包括相应的方向向内的远侧和近侧反向倾斜表面322、324，该远侧和近侧反向倾斜表面322、324与远侧和近侧的右侧凸出表面304、310对准并滑动接合，凸出表面304、310向远侧倾斜，反向倾斜表面322、324向近侧倾斜，从而使左侧纵向运动连接件320的远侧纵向运动引起滑杆302的向右横向运动。应当理解，这种倾斜接触可颠倒，使远侧运动引起向左运动。应当理解，右侧和左侧纵向运动连接件314、320和滑杆302支撑于细长轴308中，这允许纵向运动连接件314、320的这种纵向运动和滑杆302的横向运动。
图示为窝球(socket ball)328的滑杆302的远端容纳于V形凸轮槽330中，该V形凸轮槽330向近侧设置并靠近侧部执行器334的枢轴销332。因此，在图21中，右侧纵向运动连接件314的近侧运动和左侧纵向运动连接件320的远侧运动引起滑杆302的向右运动以及窝球328的相应的向右运动。这样V形凸轮槽330被向右驱动，其最远端336向左枢转。作为替代，滑杆302的横向运动可通过参见图16-19描述的齿条和扇形齿轮转化成端部执行器334的关节运动。因此，采用纵向运动的机械系统可用于为外科器械301提供横向关节运动。
可旋转连接件
在图22和23中，又一种作为替代的关节运动机构400采用可旋转连接件402使图示为横向运动滑杆404的横向构件运动，从而导致外科器械406进行关节运动。该横向运动滑杆404可操作地在端部执行器(未显示)的近端与上面图16和20中所示的旋转齿轮或者凸轮槽接合。可旋转连接件402可定位在滑杆404的下面，并具有至少一个臂408，所述臂408从该可旋转连接件402的纵向轴线横向地可旋转地伸出，以便接合到滑杆404中的插槽410内。滑杆404在顶部定位片412和底部框架414之间受到垂直限制，该底部框架414具有容纳可旋转连接件402并适于臂408旋转的纵向沟槽416。定位片412和框架414由管状套管418包围。可旋转连接件402的旋转使臂408沿着弧形运动，由此使滑杆404沿着旋转方向横向运动。
横向到旋转单向控制致动器
在图24到27中，提供一种防止可旋转连接件402反向驱动的自动锁定零件。为了达到这一目的，将可旋转连接件402连接到横向关节运动控制器500，在未审结的共有的美国专利申请No.10/615,972中描述了与各种关节运动接头一起使用的横向关节运动控制器500，该美国申请的题目为“SURGICAL INSTRUMENT WITH ALATERAL-MOVING ARTICULATION CONTROL”，其公开的内容在此通过引用全部并入本文。横向关节运动控制器500可适于在可选的关节运动外科器械502(与图1-6中描述的类似)的关节运动控制器18中使用。具体地说，横向关节运动控制器500将横向运动转化成由关节运动驱动管504传送到关节运动机构(在图24-27中未显示)的旋转运动。如将其应用到前述关节运动控制器18，其可用作在两个横向运动表面之间的单向离合器。仍参照图24-27，向下伸出的齿条506被连接到横向关节运动控制致动器510的下侧508，该下侧508用于与位于关节运动驱动管504的顶面上的纵向对准的槽512接合。
关节运动反向驱动锁定器516有利地包含于横向关节运动控制器500中，以防止施加到端部执行器(在图24-27中未显示)的作用力改变关节运动量。具体地说，介于关节运动控制致动器510和齿条506之间的是齿条板518，其包括能够容纳柔性的X形锁定构件522的中央开口520。关节运动控制器510包括两个偏转叶片524、526，它们向下伸入齿条板518的中央开口520中，并分别定位在由X形锁定构件522限定的远侧和近侧象限，以图26-27中所示的俯视图为参照。齿条506包括两个驱动叶片532、534，它们向上伸入齿条板518的中央开口520内，并分别定位在由X形锁定构件522限定的左侧和右侧象限中。所示的齿条板518的中央开口520大体上为矩形形状，但具有倾斜的齿540，每个齿形成朝内并纵向排列的抵接表面542。这些倾斜的齿540沿着远侧边缘548的右侧和左侧部分544、546设置，分别与X形锁定构件522的右和左远侧臂550、552以棘齿的方式接触。倾斜的齿540还沿着矩形孔口520的近侧边缘558的右侧和左侧部分554、556设置，分别与X形锁定构件522的右和左近侧臂560、562以棘齿的方式接触。
特别参照图25，齿条518显示为与旋钮564连接，因而不会与关节运动控制致动器510或者齿条506一起横向平移。关节运动控制致动器510的横向运动由形成于齿条框架518的矩形孔口520内的关节运动反向驱动锁定器516传递。相反，关节运动驱动管514和齿条506的反向驱动横向运动由进入齿条框架518和旋钮560的关节运动反向驱动锁定器516抵抗。因此阻止了关节运动驱动管504的运动。
在使用中，如图26所示，横向关节运动控制器500定位在中央。因而通过关节运动控制致动器510的等量延伸的右侧和左侧端部566、568为医生提供了视觉指示。偏转叶片524、526定位在X形锁定构件522的中央，因而没有在臂550、552、560、562上施加作用力，因而这允许所述臂向着它们未压缩的状态延伸成与倾斜的齿540抵靠接触，从而防止X形锁定构件522的横向运动。齿条506的驱动叶片532、534与X形锁定构件522的每一侧相对接触。通过驱动叶片532、534从关节运动驱动管504传递到齿条506中的任何横向力通过进入齿条506的X形锁定构件522抵抗，以便防止运动。
相反，如图27中所示，当医生将关节运动控制致动器510运动到一侧时，偏转叶片524、526与一对近侧和远侧臂(在图27中为左侧的一对552、562)接触，压缩这对臂与矩形孔口520脱离接触。由此允许X形锁定构件522沿着该方向运动，并且后面的一对臂(例如，图27中右侧的一对臂550、560)随着一起进行棘齿运动。这种横向运动可持续，直到前面的臂552、562碰到矩形孔口520的横边，如图所示。齿条506的驱动叶片532、534随着X形锁定构件522一起运动，并因而最终使端部执行器(在图27中未显示)对此响应也进行关节运动。
尽管已通过多个实施例的描述对本发明进行了解释，并且这些解释性的实施例描述得非常详细，但申请人并不是想将所附的权利要求书的范围限制或以任何方式限定得如此详细。其它优点和变化对本领域技术人员来说是可以想到的。
例如，可包括单流体传输方法，其中单个流体致动器扩张和压缩来进行关节运动(也许在不与手柄流体或者气动连通的弹性相对构件的辅助下)。与该设计一致的应用例如可包括仅仅一个与T型杆连接的囊，当通过将流体抽出而压缩时，所述囊拉动T型杆与其一起运动。

Claims (9)

1.一种外科器械，包括：
构造为在患者体外进行操作的近侧部分；
连接到所述近侧部分的细长轴；
端部执行器；
将端部执行器以可枢转的方式连接到所述细长轴的关节运动接头；
弧形制动表面，其被连接到该端部执行器并围绕关节运动接头的关节运动轴线向近侧伸展；
连接到该近侧部分的关节运动控制器；
关节运动构件，其从所述细长轴的远端延伸成与该端部执行器接合，所述远端响应于关节运动控制器横向偏转，以便进行关节运动；
由所述细长轴导引的锁定致动器，其近端连接到关节运动控制器，远端终止于锁定表面，并且被定位成可选择地与该锁定表面接合。
2.如权利要求1所述的外科器械，其中，所述关节运动控制器包括横向控制器，该横向控制器可操作地设置为在其运动期间向近侧推压锁定致动器，使该锁定致动器与端部执行器脱离接合。
3.如权利要求2所述的外科器械，其中，所述锁定构件向远侧偏压，并且接合表面包括近侧销，横向扇形齿轮包括带齿的表面，该带齿的表面在致动期间使销向近侧伸出，允许该近侧销向远侧运动，当关节运动控制器停止时使该近侧销与带齿表面的相应齿根接合。
4.如权利要求2所述的外科器械，其中，所述横向控制器包括差分流体控制器。
5.如权利要求1所述的外科器械，还包括：
用于在细长轴中横向运动的受约束的滑杆；
定位在关节运动接头中的滑杆的远端；和
端部执行器的近侧表面，其与关节运动的远端接合，用于将滑杆的横向运动转化成端部执行器的枢转运动。
6.如权利要求1所述的外科器械，其中，所述细长轴还包括关节运动驱动管，其将旋转运动传递到关节运动接头，使端部执行器进行枢转关节运动，并且所述锁定致动器包括介于关节运动驱动管和关节运动控制器之间的反向驱动锁定机构。
7.如权利要求6所述的外科器械，其中，所述反向驱动锁定机构包括：
具有孔口的框架；
锁定构件，其与所述框架的孔口横向锁定就位并被连接到横向齿条；和
偏转构件，其被连接到关节运动控制器，并被定位成使锁定构件脱离接合和横向定位。
8.如权利要求6所述的外科器械，其中，所述关节运动驱动管包括可旋转连接件，其与滑杆平行对准，并与所述细长轴的垂直中心线对准，该可旋转连接件与滑杆的近侧表面以可枢转的方式连接，当可旋转连接件旋转时引起滑杆的横向运动。
9.如权利要求8所述的外科器械，其中，可旋转连接件包括沿着其纵向长度间隔开的与滑杆连接的多个枢转连接点，用于在致动期间保持对准。
CN2006101089982A 2005-08-01 2006-07-31 具有关节运动轴锁定机构的外科器械 Active CN1911183B (zh)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US11/194,437 2005-08-01
US11/194,437 US20070027468A1 (en) 2005-08-01 2005-08-01 Surgical instrument with an articulating shaft locking mechanism

Publications (2)

Publication Number Publication Date
CN1911183A true CN1911183A (zh) 2007-02-14
CN1911183B CN1911183B (zh) 2011-04-06

Family

ID=37309366

Family Applications (1)

Application Number Title Priority Date Filing Date
CN2006101089982A Active CN1911183B (zh) 2005-08-01 2006-07-31 具有关节运动轴锁定机构的外科器械

Country Status (7)

Country Link
US (1) US20070027468A1 (zh)
EP (1) EP1749485A1 (zh)
JP (1) JP5073240B2 (zh)
CN (1) CN1911183B (zh)
AU (1) AU2006202972B2 (zh)
BR (1) BRPI0603089A (zh)
CA (1) CA2553499C (zh)

Cited By (18)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN102366955A (zh) * 2011-10-21 2012-03-07 奇瑞汽车股份有限公司 一种用于机械臂的齿轮齿条式锁止装置
CN102711629A (zh) * 2009-05-06 2012-10-03 坎布里奇内窥镜设备有限公司 外科器械的导引设备
CN103110456A (zh) * 2011-11-16 2013-05-22 柯惠Lp公司 动力关节式运动和腕式旋转的手术装置
CN103315789A (zh) * 2013-06-27 2013-09-25 常州市康迪医用吻合器有限公司 适用于微创手术的切割吻合器执行组件
CN103908320A (zh) * 2014-04-25 2014-07-09 王舒怡 一种腹腔镜手术抓钳
CN104042286A (zh) * 2013-03-14 2014-09-17 伊西康内外科公司 模块化外科器械的驱动系控制结构
CN104306053A (zh) * 2014-10-22 2015-01-28 广州新诚生物科技有限公司 可控向穿刺鞘
CN105025825A (zh) * 2013-02-28 2015-11-04 伊西康内外科公司 具有小齿轮和反向齿条的外科器械端部执行器关节运动驱动器
CN105324086A (zh) * 2013-04-16 2016-02-10 伊西康内外科公司 动力外科缝合器
CN106456177A (zh) * 2014-06-25 2017-02-22 伊西康内外科有限责任公司 用于外科缝合器的可枢转关节运动接头解锁特征结构
CN107049397A (zh) * 2016-02-11 2017-08-18 柯惠Lp公司 带有小直径内窥镜部的手术吻合器
CN107920832A (zh) * 2015-08-26 2018-04-17 伊西康有限责任公司 具有稳定特征的关节运动的外科装置和装载器
CN110099628A (zh) * 2016-12-21 2019-08-06 爱惜康有限责任公司 用于在关节运动构型中锁定外科器械的端部执行器的能够侧向致动的关节运动锁定布置
CN110114005A (zh) * 2016-12-21 2019-08-09 爱惜康有限责任公司 包括第一和第二关节运动闭锁件的轴组件
CN113197628A (zh) * 2014-11-12 2021-08-03 思科医疗器械有限公司 一种成像换能器及超声波探头外壳
US11234696B2 (en) 2014-06-25 2022-02-01 Cilag Gmbh International Articulation drive features for surgical stapler
CN114305558A (zh) * 2021-05-27 2022-04-12 天津瑞奇外科器械股份有限公司 一种外科器械及其操作方法
WO2022236770A1 (en) * 2021-05-13 2022-11-17 Covidien Lp Articulation mechanism for a surgical device

Families Citing this family (620)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US11134978B2 (en) 2016-01-15 2021-10-05 Cilag Gmbh International Modular battery powered handheld surgical instrument with self-diagnosing control switches for reusable handle assembly
US10835307B2 (en) 2001-06-12 2020-11-17 Ethicon Llc Modular battery powered handheld surgical instrument containing elongated multi-layered shaft
US9060770B2 (en) 2003-05-20 2015-06-23 Ethicon Endo-Surgery, Inc. Robotically-driven surgical instrument with E-beam driver
US20070084897A1 (en) 2003-05-20 2007-04-19 Shelton Frederick E Iv Articulating surgical stapling instrument incorporating a two-piece e-beam firing mechanism
US7410494B2 (en) * 2003-06-20 2008-08-12 International And Surgical Innovations, Llc Device for grasping and/or severing
US11896225B2 (en) 2004-07-28 2024-02-13 Cilag Gmbh International Staple cartridge comprising a pan
US8905977B2 (en) 2004-07-28 2014-12-09 Ethicon Endo-Surgery, Inc. Surgical stapling instrument having an electroactive polymer actuated medical substance dispenser
US8215531B2 (en) 2004-07-28 2012-07-10 Ethicon Endo-Surgery, Inc. Surgical stapling instrument having a medical substance dispenser
US7559450B2 (en) * 2005-02-18 2009-07-14 Ethicon Endo-Surgery, Inc. Surgical instrument incorporating a fluid transfer controlled articulation mechanism
US7654431B2 (en) * 2005-02-18 2010-02-02 Ethicon Endo-Surgery, Inc. Surgical instrument with guided laterally moving articulation member
US7784662B2 (en) * 2005-02-18 2010-08-31 Ethicon Endo-Surgery, Inc. Surgical instrument with articulating shaft with single pivot closure and double pivot frame ground
US7780054B2 (en) * 2005-02-18 2010-08-24 Ethicon Endo-Surgery, Inc. Surgical instrument with laterally moved shaft actuator coupled to pivoting articulation joint
US7559452B2 (en) * 2005-02-18 2009-07-14 Ethicon Endo-Surgery, Inc. Surgical instrument having fluid actuated opposing jaws
US20060289602A1 (en) * 2005-06-23 2006-12-28 Ethicon Endo-Surgery, Inc. Surgical instrument with articulating shaft with double pivot closure and single pivot frame ground
US8800838B2 (en) 2005-08-31 2014-08-12 Ethicon Endo-Surgery, Inc. Robotically-controlled cable-based surgical end effectors
US10159482B2 (en) 2005-08-31 2018-12-25 Ethicon Llc Fastener cartridge assembly comprising a fixed anvil and different staple heights
US11484312B2 (en) 2005-08-31 2022-11-01 Cilag Gmbh International Staple cartridge comprising a staple driver arrangement
US7669746B2 (en) 2005-08-31 2010-03-02 Ethicon Endo-Surgery, Inc. Staple cartridges for forming staples having differing formed staple heights
US9237891B2 (en) 2005-08-31 2016-01-19 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical stapling devices that produce formed staples having different lengths
US11246590B2 (en) 2005-08-31 2022-02-15 Cilag Gmbh International Staple cartridge including staple drivers having different unfired heights
US7673781B2 (en) 2005-08-31 2010-03-09 Ethicon Endo-Surgery, Inc. Surgical stapling device with staple driver that supports multiple wire diameter staples
US7934630B2 (en) 2005-08-31 2011-05-03 Ethicon Endo-Surgery, Inc. Staple cartridges for forming staples having differing formed staple heights
US20070106317A1 (en) 2005-11-09 2007-05-10 Shelton Frederick E Iv Hydraulically and electrically actuated articulation joints for surgical instruments
US8161977B2 (en) 2006-01-31 2012-04-24 Ethicon Endo-Surgery, Inc. Accessing data stored in a memory of a surgical instrument
US7753904B2 (en) 2006-01-31 2010-07-13 Ethicon Endo-Surgery, Inc. Endoscopic surgical instrument with a handle that can articulate with respect to the shaft
US8708213B2 (en) 2006-01-31 2014-04-29 Ethicon Endo-Surgery, Inc. Surgical instrument having a feedback system
US11278279B2 (en) 2006-01-31 2022-03-22 Cilag Gmbh International Surgical instrument assembly
US11224427B2 (en) 2006-01-31 2022-01-18 Cilag Gmbh International Surgical stapling system including a console and retraction assembly
US11793518B2 (en) 2006-01-31 2023-10-24 Cilag Gmbh International Powered surgical instruments with firing system lockout arrangements
US20110290856A1 (en) 2006-01-31 2011-12-01 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical instrument with force-feedback capabilities
US7845537B2 (en) 2006-01-31 2010-12-07 Ethicon Endo-Surgery, Inc. Surgical instrument having recording capabilities
US20120292367A1 (en) 2006-01-31 2012-11-22 Ethicon Endo-Surgery, Inc. Robotically-controlled end effector
US8763879B2 (en) 2006-01-31 2014-07-01 Ethicon Endo-Surgery, Inc. Accessing data stored in a memory of surgical instrument
US20110024477A1 (en) 2009-02-06 2011-02-03 Hall Steven G Driven Surgical Stapler Improvements
US8186555B2 (en) 2006-01-31 2012-05-29 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting and fastening instrument with mechanical closure system
US20110006101A1 (en) 2009-02-06 2011-01-13 EthiconEndo-Surgery, Inc. Motor driven surgical fastener device with cutting member lockout arrangements
US8820603B2 (en) 2006-01-31 2014-09-02 Ethicon Endo-Surgery, Inc. Accessing data stored in a memory of a surgical instrument
US9861359B2 (en) 2006-01-31 2018-01-09 Ethicon Llc Powered surgical instruments with firing system lockout arrangements
US20070225562A1 (en) 2006-03-23 2007-09-27 Ethicon Endo-Surgery, Inc. Articulating endoscopic accessory channel
US8992422B2 (en) 2006-03-23 2015-03-31 Ethicon Endo-Surgery, Inc. Robotically-controlled endoscopic accessory channel
US8322455B2 (en) 2006-06-27 2012-12-04 Ethicon Endo-Surgery, Inc. Manually driven surgical cutting and fastening instrument
US10568652B2 (en) 2006-09-29 2020-02-25 Ethicon Llc Surgical staples having attached drivers of different heights and stapling instruments for deploying the same
US8348131B2 (en) 2006-09-29 2013-01-08 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with mechanical indicator to show levels of tissue compression
US10130359B2 (en) 2006-09-29 2018-11-20 Ethicon Llc Method for forming a staple
US7481348B2 (en) * 2006-10-06 2009-01-27 Tyco Healthcare Group Lp Surgical instrument with articulating tool assembly
US8652120B2 (en) 2007-01-10 2014-02-18 Ethicon Endo-Surgery, Inc. Surgical instrument with wireless communication between control unit and sensor transponders
US8684253B2 (en) 2007-01-10 2014-04-01 Ethicon Endo-Surgery, Inc. Surgical instrument with wireless communication between a control unit of a robotic system and remote sensor
US8459520B2 (en) 2007-01-10 2013-06-11 Ethicon Endo-Surgery, Inc. Surgical instrument with wireless communication between control unit and remote sensor
US11291441B2 (en) 2007-01-10 2022-04-05 Cilag Gmbh International Surgical instrument with wireless communication between control unit and remote sensor
US11039836B2 (en) 2007-01-11 2021-06-22 Cilag Gmbh International Staple cartridge for use with a surgical stapling instrument
US8540128B2 (en) 2007-01-11 2013-09-24 Ethicon Endo-Surgery, Inc. Surgical stapling device with a curved end effector
US8727197B2 (en) 2007-03-15 2014-05-20 Ethicon Endo-Surgery, Inc. Staple cartridge cavity configuration with cooperative surgical staple
US8893946B2 (en) 2007-03-28 2014-11-25 Ethicon Endo-Surgery, Inc. Laparoscopic tissue thickness and clamp load measuring devices
US8800837B2 (en) * 2007-04-13 2014-08-12 Covidien Lp Powered surgical instrument
US7549564B2 (en) * 2007-06-22 2009-06-23 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with an articulating end effector
US7832408B2 (en) 2007-06-04 2010-11-16 Ethicon Endo-Surgery, Inc. Surgical instrument having a directional switching mechanism
US8931682B2 (en) 2007-06-04 2015-01-13 Ethicon Endo-Surgery, Inc. Robotically-controlled shaft based rotary drive systems for surgical instruments
US8534528B2 (en) 2007-06-04 2013-09-17 Ethicon Endo-Surgery, Inc. Surgical instrument having a multiple rate directional switching mechanism
US7905380B2 (en) 2007-06-04 2011-03-15 Ethicon Endo-Surgery, Inc. Surgical instrument having a multiple rate directional switching mechanism
US11564682B2 (en) 2007-06-04 2023-01-31 Cilag Gmbh International Surgical stapler device
US7753245B2 (en) 2007-06-22 2010-07-13 Ethicon Endo-Surgery, Inc. Surgical stapling instruments
US8308040B2 (en) 2007-06-22 2012-11-13 Ethicon Endo-Surgery, Inc. Surgical stapling instrument with an articulatable end effector
US11849941B2 (en) 2007-06-29 2023-12-26 Cilag Gmbh International Staple cartridge having staple cavities extending at a transverse angle relative to a longitudinal cartridge axis
US7624902B2 (en) * 2007-08-31 2009-12-01 Tyco Healthcare Group Lp Surgical stapling apparatus
US7703653B2 (en) 2007-09-28 2010-04-27 Tyco Healthcare Group Lp Articulation mechanism for surgical instrument
US8561870B2 (en) 2008-02-13 2013-10-22 Ethicon Endo-Surgery, Inc. Surgical stapling instrument
US7866527B2 (en) 2008-02-14 2011-01-11 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with interlockable firing system
US8459525B2 (en) 2008-02-14 2013-06-11 Ethicon Endo-Sugery, Inc. Motorized surgical cutting and fastening instrument having a magnetic drive train torque limiting device
US8758391B2 (en) 2008-02-14 2014-06-24 Ethicon Endo-Surgery, Inc. Interchangeable tools for surgical instruments
US8636736B2 (en) 2008-02-14 2014-01-28 Ethicon Endo-Surgery, Inc. Motorized surgical cutting and fastening instrument
US8752749B2 (en) 2008-02-14 2014-06-17 Ethicon Endo-Surgery, Inc. Robotically-controlled disposable motor-driven loading unit
US8622274B2 (en) 2008-02-14 2014-01-07 Ethicon Endo-Surgery, Inc. Motorized cutting and fastening instrument having control circuit for optimizing battery usage
US7819298B2 (en) 2008-02-14 2010-10-26 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with control features operable with one hand
US8584919B2 (en) 2008-02-14 2013-11-19 Ethicon Endo-Sugery, Inc. Surgical stapling apparatus with load-sensitive firing mechanism
US8657174B2 (en) 2008-02-14 2014-02-25 Ethicon Endo-Surgery, Inc. Motorized surgical cutting and fastening instrument having handle based power source
US8573465B2 (en) 2008-02-14 2013-11-05 Ethicon Endo-Surgery, Inc. Robotically-controlled surgical end effector system with rotary actuated closure systems
US7793812B2 (en) 2008-02-14 2010-09-14 Ethicon Endo-Surgery, Inc. Disposable motor-driven loading unit for use with a surgical cutting and stapling apparatus
US7861906B2 (en) * 2008-02-14 2011-01-04 Ethicon Endo-Surgery, Inc. Surgical stapling apparatus with articulatable components
US9179912B2 (en) 2008-02-14 2015-11-10 Ethicon Endo-Surgery, Inc. Robotically-controlled motorized surgical cutting and fastening instrument
RU2493788C2 (ru) 2008-02-14 2013-09-27 Этикон Эндо-Серджери, Инк. Хирургический режущий и крепежный инструмент, имеющий радиочастотные электроды
WO2009105158A2 (en) 2008-02-15 2009-08-27 Interventional & Surgical Innovations, Llc. Surgical instrument for grasping and cutting tissue
US20090206131A1 (en) 2008-02-15 2009-08-20 Ethicon Endo-Surgery, Inc. End effector coupling arrangements for a surgical cutting and stapling instrument
US20130153641A1 (en) 2008-02-15 2013-06-20 Ethicon Endo-Surgery, Inc. Releasable layer of material and surgical end effector having the same
US11272927B2 (en) 2008-02-15 2022-03-15 Cilag Gmbh International Layer arrangements for surgical staple cartridges
EP2288296B1 (en) * 2008-06-19 2013-04-03 Boston Scientific Scimed, Inc. Hemostatic clipping devices and methods
US9089360B2 (en) 2008-08-06 2015-07-28 Ethicon Endo-Surgery, Inc. Devices and techniques for cutting and coagulating tissue
PL3476312T3 (pl) 2008-09-19 2024-03-11 Ethicon Llc Stapler chirurgiczny z urządzeniem do dopasowania wysokości zszywek
US7954686B2 (en) 2008-09-19 2011-06-07 Ethicon Endo-Surgery, Inc. Surgical stapler with apparatus for adjusting staple height
US9005230B2 (en) 2008-09-23 2015-04-14 Ethicon Endo-Surgery, Inc. Motorized surgical instrument
US9050083B2 (en) 2008-09-23 2015-06-09 Ethicon Endo-Surgery, Inc. Motorized surgical instrument
US11648005B2 (en) 2008-09-23 2023-05-16 Cilag Gmbh International Robotically-controlled motorized surgical instrument with an end effector
US8210411B2 (en) 2008-09-23 2012-07-03 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting instrument
US9386983B2 (en) 2008-09-23 2016-07-12 Ethicon Endo-Surgery, Llc Robotically-controlled motorized surgical instrument
US8142473B2 (en) 2008-10-03 2012-03-27 Tyco Healthcare Group Lp Method of transferring rotational motion in an articulating surgical instrument
US8608045B2 (en) 2008-10-10 2013-12-17 Ethicon Endo-Sugery, Inc. Powered surgical cutting and stapling apparatus with manually retractable firing system
US8517239B2 (en) 2009-02-05 2013-08-27 Ethicon Endo-Surgery, Inc. Surgical stapling instrument comprising a magnetic element driver
US8414577B2 (en) 2009-02-05 2013-04-09 Ethicon Endo-Surgery, Inc. Surgical instruments and components for use in sterile environments
US8485413B2 (en) * 2009-02-05 2013-07-16 Ethicon Endo-Surgery, Inc. Surgical stapling instrument comprising an articulation joint
US8397971B2 (en) 2009-02-05 2013-03-19 Ethicon Endo-Surgery, Inc. Sterilizable surgical instrument
US8444036B2 (en) 2009-02-06 2013-05-21 Ethicon Endo-Surgery, Inc. Motor driven surgical fastener device with mechanisms for adjusting a tissue gap within the end effector
CA2751664A1 (en) 2009-02-06 2010-08-12 Ethicon Endo-Surgery, Inc. Driven surgical stapler improvements
US9131985B2 (en) 2009-03-27 2015-09-15 Micron Shiga, Inc. Medical treatment device
US8663220B2 (en) 2009-07-15 2014-03-04 Ethicon Endo-Surgery, Inc. Ultrasonic surgical instruments
US20110295260A1 (en) * 2009-08-20 2011-12-01 T.A.G. Medical Devices - Agriculture Cooperative Ltd. Knee reconstruction procedure and surgical implement particularly useful for such knee reconstruction procedure
US9474540B2 (en) * 2009-10-08 2016-10-25 Ethicon-Endo-Surgery, Inc. Laparoscopic device with compound angulation
US11090104B2 (en) 2009-10-09 2021-08-17 Cilag Gmbh International Surgical generator for ultrasonic and electrosurgical devices
US10441345B2 (en) 2009-10-09 2019-10-15 Ethicon Llc Surgical generator for ultrasonic and electrosurgical devices
US8986302B2 (en) 2009-10-09 2015-03-24 Ethicon Endo-Surgery, Inc. Surgical generator for ultrasonic and electrosurgical devices
CN113967039A (zh) 2009-11-13 2022-01-25 直观外科手术操作公司 具有紧凑腕部的手术工具
WO2011060311A2 (en) 2009-11-13 2011-05-19 Intuitive Surgical Operations, Inc. End effector with redundant closing mechanisms
EP2498710B1 (en) 2009-11-13 2018-05-16 Intuitive Surgical Operations, Inc. Motor interface for parallel drive shafts within an independently rotating member
US20110118708A1 (en) 2009-11-13 2011-05-19 Intuitive Surgical Operations, Inc. Double universal joint
US8851354B2 (en) 2009-12-24 2014-10-07 Ethicon Endo-Surgery, Inc. Surgical cutting instrument that analyzes tissue thickness
US8220688B2 (en) 2009-12-24 2012-07-17 Ethicon Endo-Surgery, Inc. Motor-driven surgical cutting instrument with electric actuator directional control assembly
US8608046B2 (en) 2010-01-07 2013-12-17 Ethicon Endo-Surgery, Inc. Test device for a surgical tool
US8469981B2 (en) 2010-02-11 2013-06-25 Ethicon Endo-Surgery, Inc. Rotatable cutting implement arrangements for ultrasonic surgical instruments
US9226760B2 (en) 2010-05-07 2016-01-05 Ethicon Endo-Surgery, Inc. Laparoscopic devices with flexible actuation mechanisms
US8562592B2 (en) 2010-05-07 2013-10-22 Ethicon Endo-Surgery, Inc. Compound angle laparoscopic methods and devices
US20110275901A1 (en) * 2010-05-07 2011-11-10 Ethicon Endo-Surgery, Inc. Laparoscopic devices with articulating end effectors
WO2011151828A2 (en) * 2010-06-01 2011-12-08 T.A.G. Medical Devices - Agriculture Cooperative Ltd. Surgical implement particularly useful for knee reconstruction surgery
US8795327B2 (en) 2010-07-22 2014-08-05 Ethicon Endo-Surgery, Inc. Electrosurgical instrument with separate closure and cutting members
US9192431B2 (en) 2010-07-23 2015-11-24 Ethicon Endo-Surgery, Inc. Electrosurgical cutting and sealing instrument
US8783543B2 (en) 2010-07-30 2014-07-22 Ethicon Endo-Surgery, Inc. Tissue acquisition arrangements and methods for surgical stapling devices
US8360296B2 (en) 2010-09-09 2013-01-29 Ethicon Endo-Surgery, Inc. Surgical stapling head assembly with firing lockout for a surgical stapler
US8632525B2 (en) 2010-09-17 2014-01-21 Ethicon Endo-Surgery, Inc. Power control arrangements for surgical instruments and batteries
US9289212B2 (en) 2010-09-17 2016-03-22 Ethicon Endo-Surgery, Inc. Surgical instruments and batteries for surgical instruments
US20120078244A1 (en) 2010-09-24 2012-03-29 Worrell Barry C Control features for articulating surgical device
US8733613B2 (en) 2010-09-29 2014-05-27 Ethicon Endo-Surgery, Inc. Staple cartridge
US9364233B2 (en) 2010-09-30 2016-06-14 Ethicon Endo-Surgery, Llc Tissue thickness compensators for circular surgical staplers
US20120080498A1 (en) 2010-09-30 2012-04-05 Ethicon Endo-Surgery, Inc. Curved end effector for a stapling instrument
US11298125B2 (en) 2010-09-30 2022-04-12 Cilag Gmbh International Tissue stapler having a thickness compensator
JP5931072B2 (ja) * 2010-09-30 2016-06-08 エシコン・エンド−サージェリィ・インコーポレイテッドＥｔｈｉｃｏｎ Ｅｎｄｏ−Ｓｕｒｇｅｒｙ，Ｉｎｃ． 外科用器具のためのジョークロージャ構成
US10945731B2 (en) 2010-09-30 2021-03-16 Ethicon Llc Tissue thickness compensator comprising controlled release and expansion
US9414838B2 (en) 2012-03-28 2016-08-16 Ethicon Endo-Surgery, Llc Tissue thickness compensator comprised of a plurality of materials
US11812965B2 (en) 2010-09-30 2023-11-14 Cilag Gmbh International Layer of material for a surgical end effector
US9629814B2 (en) 2010-09-30 2017-04-25 Ethicon Endo-Surgery, Llc Tissue thickness compensator configured to redistribute compressive forces
US9320523B2 (en) 2012-03-28 2016-04-26 Ethicon Endo-Surgery, Llc Tissue thickness compensator comprising tissue ingrowth features
US9861361B2 (en) 2010-09-30 2018-01-09 Ethicon Llc Releasable tissue thickness compensator and fastener cartridge having the same
US9307989B2 (en) 2012-03-28 2016-04-12 Ethicon Endo-Surgery, Llc Tissue stapler having a thickness compensator incorportating a hydrophobic agent
CN103140178B (zh) 2010-09-30 2015-09-23 伊西康内外科公司 包括保持矩阵和对齐矩阵的紧固件系统
US9314246B2 (en) 2010-09-30 2016-04-19 Ethicon Endo-Surgery, Llc Tissue stapler having a thickness compensator incorporating an anti-inflammatory agent
US8893949B2 (en) 2010-09-30 2014-11-25 Ethicon Endo-Surgery, Inc. Surgical stapler with floating anvil
US9301753B2 (en) 2010-09-30 2016-04-05 Ethicon Endo-Surgery, Llc Expandable tissue thickness compensator
US9295464B2 (en) 2010-09-30 2016-03-29 Ethicon Endo-Surgery, Inc. Surgical stapler anvil comprising a plurality of forming pockets
US9332974B2 (en) 2010-09-30 2016-05-10 Ethicon Endo-Surgery, Llc Layered tissue thickness compensator
US11925354B2 (en) 2010-09-30 2024-03-12 Cilag Gmbh International Staple cartridge comprising staples positioned within a compressible portion thereof
US9220501B2 (en) 2010-09-30 2015-12-29 Ethicon Endo-Surgery, Inc. Tissue thickness compensators
US9839420B2 (en) 2010-09-30 2017-12-12 Ethicon Llc Tissue thickness compensator comprising at least one medicament
US9517063B2 (en) 2012-03-28 2016-12-13 Ethicon Endo-Surgery, Llc Movable member for use with a tissue thickness compensator
US9277919B2 (en) 2010-09-30 2016-03-08 Ethicon Endo-Surgery, Llc Tissue thickness compensator comprising fibers to produce a resilient load
USD650074S1 (en) 2010-10-01 2011-12-06 Ethicon Endo-Surgery, Inc. Surgical instrument
US8695866B2 (en) 2010-10-01 2014-04-15 Ethicon Endo-Surgery, Inc. Surgical instrument having a power control circuit
US8906019B2 (en) 2011-01-07 2014-12-09 Covidien Lp Ferrofluidic lock
US8827903B2 (en) 2011-03-14 2014-09-09 Ethicon Endo-Surgery, Inc. Modular tool heads for use with circular surgical instruments
US8926598B2 (en) 2011-03-15 2015-01-06 Ethicon Endo-Surgery, Inc. Surgical instruments with articulatable and rotatable end effector
US8857693B2 (en) * 2011-03-15 2014-10-14 Ethicon Endo-Surgery, Inc. Surgical instruments with lockable articulating end effector
RU2606493C2 (ru) 2011-04-29 2017-01-10 Этикон Эндо-Серджери, Инк. Кассета со скобками, содержащая скобки, расположенные внутри ее сжимаемой части
US8444664B2 (en) * 2011-05-16 2013-05-21 Covidien Lp Medical ultrasound instrument with articulated jaws
US9072535B2 (en) 2011-05-27 2015-07-07 Ethicon Endo-Surgery, Inc. Surgical stapling instruments with rotatable staple deployment arrangements
US11207064B2 (en) 2011-05-27 2021-12-28 Cilag Gmbh International Automated end effector component reloading system for use with a robotic system
US8574263B2 (en) 2011-07-20 2013-11-05 Covidien Lp Coaxial coil lock
US8568390B2 (en) 2011-07-20 2013-10-29 Covidien Lp Articulating surgical apparatus
US8603135B2 (en) 2011-07-20 2013-12-10 Covidien Lp Articulating surgical apparatus
US9028478B2 (en) 2011-07-20 2015-05-12 Covidien Lp Articulating surgical apparatus
US9259265B2 (en) 2011-07-22 2016-02-16 Ethicon Endo-Surgery, Llc Surgical instruments for tensioning tissue
US9050084B2 (en) 2011-09-23 2015-06-09 Ethicon Endo-Surgery, Inc. Staple cartridge including collapsible deck arrangement
US9271749B2 (en) 2011-12-20 2016-03-01 Specialty Surgical Instrumentation Inc. System and method for an articulating grasper end-effector
WO2013119545A1 (en) 2012-02-10 2013-08-15 Ethicon-Endo Surgery, Inc. Robotically controlled surgical instrument
US9044230B2 (en) 2012-02-13 2015-06-02 Ethicon Endo-Surgery, Inc. Surgical cutting and fastening instrument with apparatus for determining cartridge and firing motion status
US9078653B2 (en) 2012-03-26 2015-07-14 Ethicon Endo-Surgery, Inc. Surgical stapling device with lockout system for preventing actuation in the absence of an installed staple cartridge
US9198662B2 (en) 2012-03-28 2015-12-01 Ethicon Endo-Surgery, Inc. Tissue thickness compensator having improved visibility
CN104321024B (zh) 2012-03-28 2017-05-24 伊西康内外科公司 包括多个层的组织厚度补偿件
MX353040B (es) 2012-03-28 2017-12-18 Ethicon Endo Surgery Inc Unidad retenedora que incluye un compensador de grosor de tejido.
CN104334098B (zh) 2012-03-28 2017-03-22 伊西康内外科公司 包括限定低压强环境的胶囊剂的组织厚度补偿件
US9439668B2 (en) 2012-04-09 2016-09-13 Ethicon Endo-Surgery, Llc Switch arrangements for ultrasonic surgical instruments
US9101358B2 (en) 2012-06-15 2015-08-11 Ethicon Endo-Surgery, Inc. Articulatable surgical instrument comprising a firing drive
US9101385B2 (en) 2012-06-28 2015-08-11 Ethicon Endo-Surgery, Inc. Electrode connections for rotary driven surgical tools
US20140005718A1 (en) 2012-06-28 2014-01-02 Ethicon Endo-Surgery, Inc. Multi-functional powered surgical device with external dissection features
US9125662B2 (en) 2012-06-28 2015-09-08 Ethicon Endo-Surgery, Inc. Multi-axis articulating and rotating surgical tools
US20140001231A1 (en) 2012-06-28 2014-01-02 Ethicon Endo-Surgery, Inc. Firing system lockout arrangements for surgical instruments
US8747238B2 (en) 2012-06-28 2014-06-10 Ethicon Endo-Surgery, Inc. Rotary drive shaft assemblies for surgical instruments with articulatable end effectors
BR112014032776B1 (pt) 2012-06-28 2021-09-08 Ethicon Endo-Surgery, Inc Sistema de instrumento cirúrgico e kit cirúrgico para uso com um sistema de instrumento cirúrgico
US9028494B2 (en) 2012-06-28 2015-05-12 Ethicon Endo-Surgery, Inc. Interchangeable end effector coupling arrangement
US9119657B2 (en) 2012-06-28 2015-09-01 Ethicon Endo-Surgery, Inc. Rotary actuatable closure arrangement for surgical end effector
US9072536B2 (en) 2012-06-28 2015-07-07 Ethicon Endo-Surgery, Inc. Differential locking arrangements for rotary powered surgical instruments
US9649111B2 (en) 2012-06-28 2017-05-16 Ethicon Endo-Surgery, Llc Replaceable clip cartridge for a clip applier
US9408606B2 (en) 2012-06-28 2016-08-09 Ethicon Endo-Surgery, Llc Robotically powered surgical device with manually-actuatable reversing system
US11202631B2 (en) 2012-06-28 2021-12-21 Cilag Gmbh International Stapling assembly comprising a firing lockout
US20140005705A1 (en) 2012-06-29 2014-01-02 Ethicon Endo-Surgery, Inc. Surgical instruments with articulating shafts
US9289256B2 (en) 2012-06-28 2016-03-22 Ethicon Endo-Surgery, Llc Surgical end effectors having angled tissue-contacting surfaces
US9561038B2 (en) 2012-06-28 2017-02-07 Ethicon Endo-Surgery, Llc Interchangeable clip applier
RU2636861C2 (ru) 2012-06-28 2017-11-28 Этикон Эндо-Серджери, Инк. Блокировка пустой кассеты с клипсами
US9198714B2 (en) 2012-06-29 2015-12-01 Ethicon Endo-Surgery, Inc. Haptic feedback devices for surgical robot
US20140005702A1 (en) 2012-06-29 2014-01-02 Ethicon Endo-Surgery, Inc. Ultrasonic surgical instruments with distally positioned transducers
US9408622B2 (en) 2012-06-29 2016-08-09 Ethicon Endo-Surgery, Llc Surgical instruments with articulating shafts
US9226767B2 (en) 2012-06-29 2016-01-05 Ethicon Endo-Surgery, Inc. Closed feedback control for electrosurgical device
US9326788B2 (en) 2012-06-29 2016-05-03 Ethicon Endo-Surgery, Llc Lockout mechanism for use with robotic electrosurgical device
US9393037B2 (en) 2012-06-29 2016-07-19 Ethicon Endo-Surgery, Llc Surgical instruments with articulating shafts
US9351754B2 (en) 2012-06-29 2016-05-31 Ethicon Endo-Surgery, Llc Ultrasonic surgical instruments with distally positioned jaw assemblies
KR102174907B1 (ko) * 2012-09-26 2020-11-05 아에스쿨랍 아게 조직을 커팅 및 봉합하기 위한 장치
BR112015007010B1 (pt) 2012-09-28 2022-05-31 Ethicon Endo-Surgery, Inc Atuador de extremidade
US9386985B2 (en) 2012-10-15 2016-07-12 Ethicon Endo-Surgery, Llc Surgical cutting instrument
US9095367B2 (en) 2012-10-22 2015-08-04 Ethicon Endo-Surgery, Inc. Flexible harmonic waveguides/blades for surgical instruments
US20140135804A1 (en) 2012-11-15 2014-05-15 Ethicon Endo-Surgery, Inc. Ultrasonic and electrosurgical devices
US9386984B2 (en) 2013-02-08 2016-07-12 Ethicon Endo-Surgery, Llc Staple cartridge comprising a releasable cover
US10092292B2 (en) 2013-02-28 2018-10-09 Ethicon Llc Staple forming features for surgical stapling instrument
US9867615B2 (en) * 2013-02-28 2018-01-16 Ethicon Llc Surgical instrument with articulation lock having a detenting binary spring
RU2672520C2 (ru) 2013-03-01 2018-11-15 Этикон Эндо-Серджери, Инк. Шарнирно поворачиваемые хирургические инструменты с проводящими путями для передачи сигналов
US9554794B2 (en) 2013-03-01 2017-01-31 Ethicon Endo-Surgery, Llc Multiple processor motor control for modular surgical instruments
MX364729B (es) 2013-03-01 2019-05-06 Ethicon Endo Surgery Inc Instrumento quirúrgico con una parada suave.
US20140263552A1 (en) 2013-03-13 2014-09-18 Ethicon Endo-Surgery, Inc. Staple cartridge tissue thickness sensor system
US9629629B2 (en) 2013-03-14 2017-04-25 Ethicon Endo-Surgey, LLC Control systems for surgical instruments
US9572577B2 (en) 2013-03-27 2017-02-21 Ethicon Endo-Surgery, Llc Fastener cartridge comprising a tissue thickness compensator including openings therein
US9795384B2 (en) 2013-03-27 2017-10-24 Ethicon Llc Fastener cartridge comprising a tissue thickness compensator and a gap setting element
US9332984B2 (en) 2013-03-27 2016-05-10 Ethicon Endo-Surgery, Llc Fastener cartridge assemblies
BR112015026109B1 (pt) 2013-04-16 2022-02-22 Ethicon Endo-Surgery, Inc Instrumento cirúrgico
US9574644B2 (en) 2013-05-30 2017-02-21 Ethicon Endo-Surgery, Llc Power module for use with a surgical instrument
US9254161B2 (en) 2013-06-10 2016-02-09 Keith A. Easter Radiolucent handle system
US9402659B2 (en) 2013-08-06 2016-08-02 Warsaw Orthopedic, Inc. Spinal implant system
RU2678363C2 (ru) 2013-08-23 2019-01-28 ЭТИКОН ЭНДО-СЕРДЖЕРИ, ЭлЭлСи Устройства втягивания пускового элемента для хирургических инструментов с электропитанием
US9510828B2 (en) 2013-08-23 2016-12-06 Ethicon Endo-Surgery, Llc Conductor arrangements for electrically powered surgical instruments with rotatable end effectors
US9814514B2 (en) 2013-09-13 2017-11-14 Ethicon Llc Electrosurgical (RF) medical instruments for cutting and coagulating tissue
US9265926B2 (en) 2013-11-08 2016-02-23 Ethicon Endo-Surgery, Llc Electrosurgical devices
US9918713B2 (en) 2013-12-09 2018-03-20 Covidien Lp Adapter assembly for interconnecting electromechanical surgical devices and surgical loading units, and surgical systems thereof
ES2755485T3 (es) 2013-12-09 2020-04-22 Covidien Lp Conjunto de adaptador para la interconexión de dispositivos quirúrgicos electromecánicos y unidades de carga quirúrgica, y sistemas quirúrgicos de los mismos
GB2521228A (en) 2013-12-16 2015-06-17 Ethicon Endo Surgery Inc Medical device
US9724092B2 (en) 2013-12-23 2017-08-08 Ethicon Llc Modular surgical instruments
US9681870B2 (en) 2013-12-23 2017-06-20 Ethicon Llc Articulatable surgical instruments with separate and distinct closing and firing systems
US20150173756A1 (en) * 2013-12-23 2015-06-25 Ethicon Endo-Surgery, Inc. Surgical cutting and stapling methods
US9763662B2 (en) 2013-12-23 2017-09-19 Ethicon Llc Fastener cartridge comprising a firing member configured to directly engage and eject fasteners from the fastener cartridge
US9839428B2 (en) 2013-12-23 2017-12-12 Ethicon Llc Surgical cutting and stapling instruments with independent jaw control features
US9795436B2 (en) 2014-01-07 2017-10-24 Ethicon Llc Harvesting energy from a surgical generator
US9839424B2 (en) 2014-01-17 2017-12-12 Covidien Lp Electromechanical surgical assembly
CN104783868B (zh) * 2014-01-20 2018-08-10 北京安和加利尔科技有限公司 一种具有可换刀头的超声手术刀刀杆
US9962161B2 (en) 2014-02-12 2018-05-08 Ethicon Llc Deliverable surgical instrument
US9707005B2 (en) 2014-02-14 2017-07-18 Ethicon Llc Lockout mechanisms for surgical devices
US9884456B2 (en) 2014-02-24 2018-02-06 Ethicon Llc Implantable layers and methods for altering one or more properties of implantable layers for use with fastening instruments
JP6462004B2 (ja) 2014-02-24 2019-01-30 エシコン エルエルシー 発射部材ロックアウトを備える締結システム
US9554854B2 (en) 2014-03-18 2017-01-31 Ethicon Endo-Surgery, Llc Detecting short circuits in electrosurgical medical devices
US9913642B2 (en) 2014-03-26 2018-03-13 Ethicon Llc Surgical instrument comprising a sensor system
US10013049B2 (en) 2014-03-26 2018-07-03 Ethicon Llc Power management through sleep options of segmented circuit and wake up control
US9820738B2 (en) 2014-03-26 2017-11-21 Ethicon Llc Surgical instrument comprising interactive systems
BR112016021943B1 (pt) 2014-03-26 2022-06-14 Ethicon Endo-Surgery, Llc Instrumento cirúrgico para uso por um operador em um procedimento cirúrgico
US20150272582A1 (en) 2014-03-26 2015-10-01 Ethicon Endo-Surgery, Inc. Power management control systems for surgical instruments
US10463421B2 (en) 2014-03-27 2019-11-05 Ethicon Llc Two stage trigger, clamp and cut bipolar vessel sealer
US10092310B2 (en) 2014-03-27 2018-10-09 Ethicon Llc Electrosurgical devices
US9737355B2 (en) 2014-03-31 2017-08-22 Ethicon Llc Controlling impedance rise in electrosurgical medical devices
US9913680B2 (en) 2014-04-15 2018-03-13 Ethicon Llc Software algorithms for electrosurgical instruments
BR112016023807B1 (pt) 2014-04-16 2022-07-12 Ethicon Endo-Surgery, Llc Conjunto de cartucho de prendedores para uso com um instrumento cirúrgico
US10561422B2 (en) 2014-04-16 2020-02-18 Ethicon Llc Fastener cartridge comprising deployable tissue engaging members
US20150297223A1 (en) 2014-04-16 2015-10-22 Ethicon Endo-Surgery, Inc. Fastener cartridges including extensions having different configurations
US10426476B2 (en) 2014-09-26 2019-10-01 Ethicon Llc Circular fastener cartridges for applying radially expandable fastener lines
BR112016023825B1 (pt) 2014-04-16 2022-08-02 Ethicon Endo-Surgery, Llc Cartucho de grampos para uso com um grampeador cirúrgico e cartucho de grampos para uso com um instrumento cirúrgico
CN106456176B (zh) 2014-04-16 2019-06-28 伊西康内外科有限责任公司 包括具有不同构型的延伸部的紧固件仓
US10045781B2 (en) 2014-06-13 2018-08-14 Ethicon Llc Closure lockout systems for surgical instruments
JP6625569B2 (ja) * 2014-06-25 2019-12-25 エシコン エルエルシーＥｔｈｉｃｏｎ ＬＬＣ 外科用ステープラ用の枢動可能な関節動作ジョイントの係止解除特徴部
US10285724B2 (en) 2014-07-31 2019-05-14 Ethicon Llc Actuation mechanisms and load adjustment assemblies for surgical instruments
US9788836B2 (en) 2014-09-05 2017-10-17 Ethicon Llc Multiple motor control for powered medical device
US11311294B2 (en) 2014-09-05 2022-04-26 Cilag Gmbh International Powered medical device including measurement of closure state of jaws
BR112017004361B1 (pt) 2014-09-05 2023-04-11 Ethicon Llc Sistema eletrônico para um instrumento cirúrgico
US10105142B2 (en) 2014-09-18 2018-10-23 Ethicon Llc Surgical stapler with plurality of cutting elements
CN105496483B (zh) * 2014-09-25 2017-06-23 瑞奇外科器械(中国)有限公司 外科手术器械的驱动装置及外科手术器械
BR112017005981B1 (pt) 2014-09-26 2022-09-06 Ethicon, Llc Material de escora para uso com um cartucho de grampos cirúrgicos e cartucho de grampos cirúrgicos para uso com um instrumento cirúrgico
US11523821B2 (en) 2014-09-26 2022-12-13 Cilag Gmbh International Method for creating a flexible staple line
US10076325B2 (en) 2014-10-13 2018-09-18 Ethicon Llc Surgical stapling apparatus comprising a tissue stop
US9924944B2 (en) 2014-10-16 2018-03-27 Ethicon Llc Staple cartridge comprising an adjunct material
US10517594B2 (en) 2014-10-29 2019-12-31 Ethicon Llc Cartridge assemblies for surgical staplers
US11141153B2 (en) 2014-10-29 2021-10-12 Cilag Gmbh International Staple cartridges comprising driver arrangements
US9844376B2 (en) 2014-11-06 2017-12-19 Ethicon Llc Staple cartridge comprising a releasable adjunct material
US10639092B2 (en) 2014-12-08 2020-05-05 Ethicon Llc Electrode configurations for surgical instruments
US10736636B2 (en) 2014-12-10 2020-08-11 Ethicon Llc Articulatable surgical instrument system
US10117649B2 (en) * 2014-12-18 2018-11-06 Ethicon Llc Surgical instrument assembly comprising a lockable articulation system
US10188385B2 (en) 2014-12-18 2019-01-29 Ethicon Llc Surgical instrument system comprising lockable systems
US10004501B2 (en) 2014-12-18 2018-06-26 Ethicon Llc Surgical instruments with improved closure arrangements
BR112017012996B1 (pt) 2014-12-18 2022-11-08 Ethicon Llc Instrumento cirúrgico com uma bigorna que é seletivamente móvel sobre um eixo geométrico imóvel distinto em relação a um cartucho de grampos
US9844375B2 (en) 2014-12-18 2017-12-19 Ethicon Llc Drive arrangements for articulatable surgical instruments
US9844374B2 (en) 2014-12-18 2017-12-19 Ethicon Llc Surgical instrument systems comprising an articulatable end effector and means for adjusting the firing stroke of a firing member
US10085748B2 (en) 2014-12-18 2018-10-02 Ethicon Llc Locking arrangements for detachable shaft assemblies with articulatable surgical end effectors
US9987000B2 (en) 2014-12-18 2018-06-05 Ethicon Llc Surgical instrument assembly comprising a flexible articulation system
US10245095B2 (en) 2015-02-06 2019-04-02 Ethicon Llc Electrosurgical instrument with rotation and articulation mechanisms
US10182816B2 (en) 2015-02-27 2019-01-22 Ethicon Llc Charging system that enables emergency resolutions for charging a battery
US11154301B2 (en) 2015-02-27 2021-10-26 Cilag Gmbh International Modular stapling assembly
US9993258B2 (en) 2015-02-27 2018-06-12 Ethicon Llc Adaptable surgical instrument handle
US10180463B2 (en) 2015-02-27 2019-01-15 Ethicon Llc Surgical apparatus configured to assess whether a performance parameter of the surgical apparatus is within an acceptable performance band
US9895148B2 (en) 2015-03-06 2018-02-20 Ethicon Endo-Surgery, Llc Monitoring speed control and precision incrementing of motor for powered surgical instruments
US10687806B2 (en) 2015-03-06 2020-06-23 Ethicon Llc Adaptive tissue compression techniques to adjust closure rates for multiple tissue types
US9993248B2 (en) 2015-03-06 2018-06-12 Ethicon Endo-Surgery, Llc Smart sensors with local signal processing
US10548504B2 (en) 2015-03-06 2020-02-04 Ethicon Llc Overlaid multi sensor radio frequency (RF) electrode system to measure tissue compression
US10045776B2 (en) 2015-03-06 2018-08-14 Ethicon Llc Control techniques and sub-processor contained within modular shaft with select control processing from handle
US9901342B2 (en) 2015-03-06 2018-02-27 Ethicon Endo-Surgery, Llc Signal and power communication system positioned on a rotatable shaft
US10441279B2 (en) 2015-03-06 2019-10-15 Ethicon Llc Multiple level thresholds to modify operation of powered surgical instruments
US10245033B2 (en) 2015-03-06 2019-04-02 Ethicon Llc Surgical instrument comprising a lockable battery housing
JP2020121162A (ja) 2015-03-06 2020-08-13 エシコン エルエルシーＥｔｈｉｃｏｎ ＬＬＣ 測定の安定性要素、クリープ要素、及び粘弾性要素を決定するためのセンサデータの時間依存性評価
US10617412B2 (en) 2015-03-06 2020-04-14 Ethicon Llc System for detecting the mis-insertion of a staple cartridge into a surgical stapler
US9924961B2 (en) 2015-03-06 2018-03-27 Ethicon Endo-Surgery, Llc Interactive feedback system for powered surgical instruments
US9808246B2 (en) 2015-03-06 2017-11-07 Ethicon Endo-Surgery, Llc Method of operating a powered surgical instrument
US10321950B2 (en) 2015-03-17 2019-06-18 Ethicon Llc Managing tissue treatment
US10342602B2 (en) 2015-03-17 2019-07-09 Ethicon Llc Managing tissue treatment
US10595929B2 (en) 2015-03-24 2020-03-24 Ethicon Llc Surgical instruments with firing system overload protection mechanisms
US10213201B2 (en) 2015-03-31 2019-02-26 Ethicon Llc Stapling end effector configured to compensate for an uneven gap between a first jaw and a second jaw
RU2717936C2 (ru) 2015-06-18 2020-03-26 ЭТИКОН ЭлЭлСи Конструкции системы двухшарнирного привода для хирургических инструментов с возможностью шарнирного поворота
US10182818B2 (en) 2015-06-18 2019-01-22 Ethicon Llc Surgical end effectors with positive jaw opening arrangements
US10034704B2 (en) 2015-06-30 2018-07-31 Ethicon Llc Surgical instrument with user adaptable algorithms
US11129669B2 (en) 2015-06-30 2021-09-28 Cilag Gmbh International Surgical system with user adaptable techniques based on tissue type
US10898256B2 (en) 2015-06-30 2021-01-26 Ethicon Llc Surgical system with user adaptable techniques based on tissue impedance
US10765470B2 (en) 2015-06-30 2020-09-08 Ethicon Llc Surgical system with user adaptable techniques employing simultaneous energy modalities based on tissue parameters
US11051873B2 (en) 2015-06-30 2021-07-06 Cilag Gmbh International Surgical system with user adaptable techniques employing multiple energy modalities based on tissue parameters
KR102639672B1 (ko) * 2015-08-06 2024-02-23 어플라이드 메디컬 리소시스 코포레이션 로킹 관절 조인트를 갖는 수술용 스테이플러
US11058425B2 (en) 2015-08-17 2021-07-13 Ethicon Llc Implantable layers for a surgical instrument
CN108348233B (zh) 2015-08-26 2021-05-07 伊西康有限责任公司 用于允许改变钉特性并实现轻松仓加载的外科钉条
US10213203B2 (en) 2015-08-26 2019-02-26 Ethicon Llc Staple cartridge assembly without a bottom cover
MX2022006191A (es) 2015-09-02 2022-06-16 Ethicon Llc Configuraciones de grapas quirurgicas con superficies de leva situadas entre porciones que soportan grapas quirurgicas.
US10172619B2 (en) 2015-09-02 2019-01-08 Ethicon Llc Surgical staple driver arrays
US10363036B2 (en) 2015-09-23 2019-07-30 Ethicon Llc Surgical stapler having force-based motor control
US10105139B2 (en) 2015-09-23 2018-10-23 Ethicon Llc Surgical stapler having downstream current-based motor control
US10085751B2 (en) 2015-09-23 2018-10-02 Ethicon Llc Surgical stapler having temperature-based motor control
US10076326B2 (en) 2015-09-23 2018-09-18 Ethicon Llc Surgical stapler having current mirror-based motor control
US10327769B2 (en) 2015-09-23 2019-06-25 Ethicon Llc Surgical stapler having motor control based on a drive system component
US10238386B2 (en) 2015-09-23 2019-03-26 Ethicon Llc Surgical stapler having motor control based on an electrical parameter related to a motor current
US10299878B2 (en) 2015-09-25 2019-05-28 Ethicon Llc Implantable adjunct systems for determining adjunct skew
US20170086829A1 (en) 2015-09-30 2017-03-30 Ethicon Endo-Surgery, Llc Compressible adjunct with intermediate supporting structures
US10751108B2 (en) 2015-09-30 2020-08-25 Ethicon Llc Protection techniques for generator for digitally generating electrosurgical and ultrasonic electrical signal waveforms
US10980539B2 (en) 2015-09-30 2021-04-20 Ethicon Llc Implantable adjunct comprising bonded layers
US10603039B2 (en) 2015-09-30 2020-03-31 Ethicon Llc Progressively releasable implantable adjunct for use with a surgical stapling instrument
US11890015B2 (en) 2015-09-30 2024-02-06 Cilag Gmbh International Compressible adjunct with crossing spacer fibers
US10595930B2 (en) 2015-10-16 2020-03-24 Ethicon Llc Electrode wiping surgical device
US10368865B2 (en) 2015-12-30 2019-08-06 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10265068B2 (en) 2015-12-30 2019-04-23 Ethicon Llc Surgical instruments with separable motors and motor control circuits
US10292704B2 (en) 2015-12-30 2019-05-21 Ethicon Llc Mechanisms for compensating for battery pack failure in powered surgical instruments
US10179022B2 (en) 2015-12-30 2019-01-15 Ethicon Llc Jaw position impedance limiter for electrosurgical instrument
US10575892B2 (en) 2015-12-31 2020-03-03 Ethicon Llc Adapter for electrical surgical instruments
US10716615B2 (en) 2016-01-15 2020-07-21 Ethicon Llc Modular battery powered handheld surgical instrument with curved end effectors having asymmetric engagement between jaw and blade
US11129670B2 (en) 2016-01-15 2021-09-28 Cilag Gmbh International Modular battery powered handheld surgical instrument with selective application of energy based on button displacement, intensity, or local tissue characterization
US11229471B2 (en) 2016-01-15 2022-01-25 Cilag Gmbh International Modular battery powered handheld surgical instrument with selective application of energy based on tissue characterization
US10245029B2 (en) 2016-02-09 2019-04-02 Ethicon Llc Surgical instrument with articulating and axially translatable end effector
US11213293B2 (en) 2016-02-09 2022-01-04 Cilag Gmbh International Articulatable surgical instruments with single articulation link arrangements
CN108882932B (zh) 2016-02-09 2021-07-23 伊西康有限责任公司 具有非对称关节运动构造的外科器械
US10349937B2 (en) * 2016-02-10 2019-07-16 Covidien Lp Surgical stapler with articulation locking mechanism
US10258331B2 (en) 2016-02-12 2019-04-16 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10448948B2 (en) 2016-02-12 2019-10-22 Ethicon Llc Mechanisms for compensating for drivetrain failure in powered surgical instruments
US11224426B2 (en) 2016-02-12 2022-01-18 Cilag Gmbh International Mechanisms for compensating for drivetrain failure in powered surgical instruments
US10555769B2 (en) 2016-02-22 2020-02-11 Ethicon Llc Flexible circuits for electrosurgical instrument
US10675021B2 (en) 2016-04-01 2020-06-09 Ethicon Llc Circular stapling system comprising rotary firing system
US10376263B2 (en) 2016-04-01 2019-08-13 Ethicon Llc Anvil modification members for surgical staplers
US10307159B2 (en) 2016-04-01 2019-06-04 Ethicon Llc Surgical instrument handle assembly with reconfigurable grip portion
US11284890B2 (en) 2016-04-01 2022-03-29 Cilag Gmbh International Circular stapling system comprising an incisable tissue support
US10617413B2 (en) 2016-04-01 2020-04-14 Ethicon Llc Closure system arrangements for surgical cutting and stapling devices with separate and distinct firing shafts
US11179150B2 (en) 2016-04-15 2021-11-23 Cilag Gmbh International Systems and methods for controlling a surgical stapling and cutting instrument
US10426467B2 (en) 2016-04-15 2019-10-01 Ethicon Llc Surgical instrument with detection sensors
US10357247B2 (en) 2016-04-15 2019-07-23 Ethicon Llc Surgical instrument with multiple program responses during a firing motion
US10828028B2 (en) 2016-04-15 2020-11-10 Ethicon Llc Surgical instrument with multiple program responses during a firing motion
US10335145B2 (en) 2016-04-15 2019-07-02 Ethicon Llc Modular surgical instrument with configurable operating mode
US10456137B2 (en) 2016-04-15 2019-10-29 Ethicon Llc Staple formation detection mechanisms
US10405859B2 (en) 2016-04-15 2019-09-10 Ethicon Llc Surgical instrument with adjustable stop/start control during a firing motion
US11607239B2 (en) 2016-04-15 2023-03-21 Cilag Gmbh International Systems and methods for controlling a surgical stapling and cutting instrument
US10492783B2 (en) 2016-04-15 2019-12-03 Ethicon, Llc Surgical instrument with improved stop/start control during a firing motion
US20170296173A1 (en) 2016-04-18 2017-10-19 Ethicon Endo-Surgery, Llc Method for operating a surgical instrument
US11317917B2 (en) 2016-04-18 2022-05-03 Cilag Gmbh International Surgical stapling system comprising a lockable firing assembly
US10368867B2 (en) 2016-04-18 2019-08-06 Ethicon Llc Surgical instrument comprising a lockout
US10646269B2 (en) 2016-04-29 2020-05-12 Ethicon Llc Non-linear jaw gap for electrosurgical instruments
US10485607B2 (en) 2016-04-29 2019-11-26 Ethicon Llc Jaw structure with distal closure for electrosurgical instruments
US10702329B2 (en) 2016-04-29 2020-07-07 Ethicon Llc Jaw structure with distal post for electrosurgical instruments
US10456193B2 (en) 2016-05-03 2019-10-29 Ethicon Llc Medical device with a bilateral jaw configuration for nerve stimulation
USD850617S1 (en) 2016-06-24 2019-06-04 Ethicon Llc Surgical fastener cartridge
JP6957532B2 (ja) 2016-06-24 2021-11-02 エシコン エルエルシーＥｔｈｉｃｏｎ ＬＬＣ ワイヤステープル及び打ち抜き加工ステープルを含むステープルカートリッジ
USD826405S1 (en) 2016-06-24 2018-08-21 Ethicon Llc Surgical fastener
USD847989S1 (en) 2016-06-24 2019-05-07 Ethicon Llc Surgical fastener cartridge
US10893863B2 (en) 2016-06-24 2021-01-19 Ethicon Llc Staple cartridge comprising offset longitudinal staple rows
US10376305B2 (en) 2016-08-05 2019-08-13 Ethicon Llc Methods and systems for advanced harmonic energy
US11266430B2 (en) 2016-11-29 2022-03-08 Cilag Gmbh International End effector control and calibration
US20180168633A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Surgical stapling instruments and staple-forming anvils
US10758230B2 (en) 2016-12-21 2020-09-01 Ethicon Llc Surgical instrument with primary and safety processors
US10898186B2 (en) 2016-12-21 2021-01-26 Ethicon Llc Staple forming pocket arrangements comprising primary sidewalls and pocket sidewalls
US10993715B2 (en) 2016-12-21 2021-05-04 Ethicon Llc Staple cartridge comprising staples with different clamping breadths
US10945727B2 (en) 2016-12-21 2021-03-16 Ethicon Llc Staple cartridge with deformable driver retention features
US10426471B2 (en) 2016-12-21 2019-10-01 Ethicon Llc Surgical instrument with multiple failure response modes
US10736629B2 (en) 2016-12-21 2020-08-11 Ethicon Llc Surgical tool assemblies with clutching arrangements for shifting between closure systems with closure stroke reduction features and articulation and firing systems
BR112019011947A2 (pt) 2016-12-21 2019-10-29 Ethicon Llc sistemas de grampeamento cirúrgico
US20180168577A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Axially movable closure system arrangements for applying closure motions to jaws of surgical instruments
US11419606B2 (en) 2016-12-21 2022-08-23 Cilag Gmbh International Shaft assembly comprising a clutch configured to adapt the output of a rotary firing member to two different systems
US10695055B2 (en) 2016-12-21 2020-06-30 Ethicon Llc Firing assembly comprising a lockout
US11684367B2 (en) 2016-12-21 2023-06-27 Cilag Gmbh International Stepped assembly having and end-of-life indicator
US10856868B2 (en) 2016-12-21 2020-12-08 Ethicon Llc Firing member pin configurations
US11179155B2 (en) 2016-12-21 2021-11-23 Cilag Gmbh International Anvil arrangements for surgical staplers
US10835247B2 (en) 2016-12-21 2020-11-17 Ethicon Llc Lockout arrangements for surgical end effectors
JP7010956B2 (ja) 2016-12-21 2022-01-26 エシコン エルエルシー 組織をステープル留めする方法
US10537325B2 (en) 2016-12-21 2020-01-21 Ethicon Llc Staple forming pocket arrangement to accommodate different types of staples
CN110099619B (zh) 2016-12-21 2022-07-15 爱惜康有限责任公司 用于外科端部执行器和可替换工具组件的闭锁装置
US10835245B2 (en) 2016-12-21 2020-11-17 Ethicon Llc Method for attaching a shaft assembly to a surgical instrument and, alternatively, to a surgical robot
US20180168615A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Method of deforming staples from two different types of staple cartridges with the same surgical stapling instrument
US11134942B2 (en) 2016-12-21 2021-10-05 Cilag Gmbh International Surgical stapling instruments and staple-forming anvils
BR112019012528A2 (pt) * 2016-12-21 2019-11-19 Ethicon Llc disposições de bloqueio de articulação para travamento de um atuador de extremidade em uma posição articulada em resposta à atuação de um sistema de fechamento de garra
US10687810B2 (en) 2016-12-21 2020-06-23 Ethicon Llc Stepped staple cartridge with tissue retention and gap setting features
US10888322B2 (en) 2016-12-21 2021-01-12 Ethicon Llc Surgical instrument comprising a cutting member
US20180168650A1 (en) 2016-12-21 2018-06-21 Ethicon Endo-Surgery, Llc Connection portions for disposable loading units for surgical stapling instruments
US10624633B2 (en) 2017-06-20 2020-04-21 Ethicon Llc Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument
US11071554B2 (en) 2017-06-20 2021-07-27 Cilag Gmbh International Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on magnitude of velocity error measurements
US10646220B2 (en) 2017-06-20 2020-05-12 Ethicon Llc Systems and methods for controlling displacement member velocity for a surgical instrument
US10881399B2 (en) 2017-06-20 2021-01-05 Ethicon Llc Techniques for adaptive control of motor velocity of a surgical stapling and cutting instrument
US10368864B2 (en) 2017-06-20 2019-08-06 Ethicon Llc Systems and methods for controlling displaying motor velocity for a surgical instrument
US11653914B2 (en) 2017-06-20 2023-05-23 Cilag Gmbh International Systems and methods for controlling motor velocity of a surgical stapling and cutting instrument according to articulation angle of end effector
US10980537B2 (en) 2017-06-20 2021-04-20 Ethicon Llc Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified number of shaft rotations
US10813639B2 (en) 2017-06-20 2020-10-27 Ethicon Llc Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on system conditions
USD890784S1 (en) 2017-06-20 2020-07-21 Ethicon Llc Display panel with changeable graphical user interface
US11382638B2 (en) 2017-06-20 2022-07-12 Cilag Gmbh International Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured time over a specified displacement distance
US10779820B2 (en) 2017-06-20 2020-09-22 Ethicon Llc Systems and methods for controlling motor speed according to user input for a surgical instrument
US11090046B2 (en) 2017-06-20 2021-08-17 Cilag Gmbh International Systems and methods for controlling displacement member motion of a surgical stapling and cutting instrument
US10327767B2 (en) 2017-06-20 2019-06-25 Ethicon Llc Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation
US10888321B2 (en) 2017-06-20 2021-01-12 Ethicon Llc Systems and methods for controlling velocity of a displacement member of a surgical stapling and cutting instrument
US11517325B2 (en) 2017-06-20 2022-12-06 Cilag Gmbh International Closed loop feedback control of motor velocity of a surgical stapling and cutting instrument based on measured displacement distance traveled over a specified time interval
US10307170B2 (en) 2017-06-20 2019-06-04 Ethicon Llc Method for closed loop control of motor velocity of a surgical stapling and cutting instrument
US10390841B2 (en) 2017-06-20 2019-08-27 Ethicon Llc Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation
USD879809S1 (en) 2017-06-20 2020-03-31 Ethicon Llc Display panel with changeable graphical user interface
USD879808S1 (en) 2017-06-20 2020-03-31 Ethicon Llc Display panel with graphical user interface
US10881396B2 (en) 2017-06-20 2021-01-05 Ethicon Llc Surgical instrument with variable duration trigger arrangement
US11266405B2 (en) 2017-06-27 2022-03-08 Cilag Gmbh International Surgical anvil manufacturing methods
US11324503B2 (en) 2017-06-27 2022-05-10 Cilag Gmbh International Surgical firing member arrangements
US10631859B2 (en) 2017-06-27 2020-04-28 Ethicon Llc Articulation systems for surgical instruments
US10993716B2 (en) 2017-06-27 2021-05-04 Ethicon Llc Surgical anvil arrangements
US10772629B2 (en) 2017-06-27 2020-09-15 Ethicon Llc Surgical anvil arrangements
US10856869B2 (en) 2017-06-27 2020-12-08 Ethicon Llc Surgical anvil arrangements
USD906355S1 (en) 2017-06-28 2020-12-29 Ethicon Llc Display screen or portion thereof with a graphical user interface for a surgical instrument
US10903685B2 (en) 2017-06-28 2021-01-26 Ethicon Llc Surgical shaft assemblies with slip ring assemblies forming capacitive channels
USD854151S1 (en) 2017-06-28 2019-07-16 Ethicon Llc Surgical instrument shaft
US11564686B2 (en) 2017-06-28 2023-01-31 Cilag Gmbh International Surgical shaft assemblies with flexible interfaces
EP4070740A1 (en) 2017-06-28 2022-10-12 Cilag GmbH International Surgical instrument comprising selectively actuatable rotatable couplers
US10765427B2 (en) 2017-06-28 2020-09-08 Ethicon Llc Method for articulating a surgical instrument
JP7341902B2 (ja) * 2017-06-28 2023-09-11 エシコン エルエルシー 枢動軸に近接して停止された閉鎖部材との接触時に軸を中心として枢動するように拘束されたジョーを備えた外科用器具
US11389161B2 (en) 2017-06-28 2022-07-19 Cilag Gmbh International Surgical instrument comprising selectively actuatable rotatable couplers
US11259805B2 (en) 2017-06-28 2022-03-01 Cilag Gmbh International Surgical instrument comprising firing member supports
USD869655S1 (en) 2017-06-28 2019-12-10 Ethicon Llc Surgical fastener cartridge
US10211586B2 (en) 2017-06-28 2019-02-19 Ethicon Llc Surgical shaft assemblies with watertight housings
USD851762S1 (en) 2017-06-28 2019-06-18 Ethicon Llc Anvil
US11246592B2 (en) 2017-06-28 2022-02-15 Cilag Gmbh International Surgical instrument comprising an articulation system lockable to a frame
US10758232B2 (en) 2017-06-28 2020-09-01 Ethicon Llc Surgical instrument with positive jaw opening features
US10716614B2 (en) 2017-06-28 2020-07-21 Ethicon Llc Surgical shaft assemblies with slip ring assemblies with increased contact pressure
US10398434B2 (en) 2017-06-29 2019-09-03 Ethicon Llc Closed loop velocity control of closure member for robotic surgical instrument
US10258418B2 (en) 2017-06-29 2019-04-16 Ethicon Llc System for controlling articulation forces
US10898183B2 (en) 2017-06-29 2021-01-26 Ethicon Llc Robotic surgical instrument with closed loop feedback techniques for advancement of closure member during firing
US10932772B2 (en) 2017-06-29 2021-03-02 Ethicon Llc Methods for closed loop velocity control for robotic surgical instrument
US11007022B2 (en) 2017-06-29 2021-05-18 Ethicon Llc Closed loop velocity control techniques based on sensed tissue parameters for robotic surgical instrument
US11304695B2 (en) 2017-08-03 2022-04-19 Cilag Gmbh International Surgical system shaft interconnection
US11471155B2 (en) 2017-08-03 2022-10-18 Cilag Gmbh International Surgical system bailout
US11944300B2 (en) 2017-08-03 2024-04-02 Cilag Gmbh International Method for operating a surgical system bailout
USD907647S1 (en) 2017-09-29 2021-01-12 Ethicon Llc Display screen or portion thereof with animated graphical user interface
USD917500S1 (en) 2017-09-29 2021-04-27 Ethicon Llc Display screen or portion thereof with graphical user interface
US11399829B2 (en) 2017-09-29 2022-08-02 Cilag Gmbh International Systems and methods of initiating a power shutdown mode for a surgical instrument
US10796471B2 (en) 2017-09-29 2020-10-06 Ethicon Llc Systems and methods of displaying a knife position for a surgical instrument
USD907648S1 (en) 2017-09-29 2021-01-12 Ethicon Llc Display screen or portion thereof with animated graphical user interface
US10743872B2 (en) 2017-09-29 2020-08-18 Ethicon Llc System and methods for controlling a display of a surgical instrument
US10765429B2 (en) 2017-09-29 2020-09-08 Ethicon Llc Systems and methods for providing alerts according to the operational state of a surgical instrument
US11090075B2 (en) * 2017-10-30 2021-08-17 Cilag Gmbh International Articulation features for surgical end effector
US11134944B2 (en) 2017-10-30 2021-10-05 Cilag Gmbh International Surgical stapler knife motion controls
US10842490B2 (en) 2017-10-31 2020-11-24 Ethicon Llc Cartridge body design with force reduction based on firing completion
US10779903B2 (en) 2017-10-31 2020-09-22 Ethicon Llc Positive shaft rotation lock activated by jaw closure
US10743875B2 (en) 2017-12-15 2020-08-18 Ethicon Llc Surgical end effectors with jaw stiffener arrangements configured to permit monitoring of firing member
US11197670B2 (en) 2017-12-15 2021-12-14 Cilag Gmbh International Surgical end effectors with pivotal jaws configured to touch at their respective distal ends when fully closed
US11033267B2 (en) 2017-12-15 2021-06-15 Ethicon Llc Systems and methods of controlling a clamping member firing rate of a surgical instrument
US10966718B2 (en) 2017-12-15 2021-04-06 Ethicon Llc Dynamic clamping assemblies with improved wear characteristics for use in connection with electromechanical surgical instruments
US10687813B2 (en) 2017-12-15 2020-06-23 Ethicon Llc Adapters with firing stroke sensing arrangements for use in connection with electromechanical surgical instruments
US11071543B2 (en) 2017-12-15 2021-07-27 Cilag Gmbh International Surgical end effectors with clamping assemblies configured to increase jaw aperture ranges
US10743874B2 (en) 2017-12-15 2020-08-18 Ethicon Llc Sealed adapters for use with electromechanical surgical instruments
US10779826B2 (en) 2017-12-15 2020-09-22 Ethicon Llc Methods of operating surgical end effectors
US10779825B2 (en) 2017-12-15 2020-09-22 Ethicon Llc Adapters with end effector position sensing and control arrangements for use in connection with electromechanical surgical instruments
US10828033B2 (en) 2017-12-15 2020-11-10 Ethicon Llc Handheld electromechanical surgical instruments with improved motor control arrangements for positioning components of an adapter coupled thereto
US11006955B2 (en) 2017-12-15 2021-05-18 Ethicon Llc End effectors with positive jaw opening features for use with adapters for electromechanical surgical instruments
US10869666B2 (en) 2017-12-15 2020-12-22 Ethicon Llc Adapters with control systems for controlling multiple motors of an electromechanical surgical instrument
US10716565B2 (en) 2017-12-19 2020-07-21 Ethicon Llc Surgical instruments with dual articulation drivers
US10729509B2 (en) 2017-12-19 2020-08-04 Ethicon Llc Surgical instrument comprising closure and firing locking mechanism
USD910847S1 (en) 2017-12-19 2021-02-16 Ethicon Llc Surgical instrument assembly
US11020112B2 (en) 2017-12-19 2021-06-01 Ethicon Llc Surgical tools configured for interchangeable use with different controller interfaces
US10835330B2 (en) 2017-12-19 2020-11-17 Ethicon Llc Method for determining the position of a rotatable jaw of a surgical instrument attachment assembly
US11045270B2 (en) 2017-12-19 2021-06-29 Cilag Gmbh International Robotic attachment comprising exterior drive actuator
US20190192147A1 (en) 2017-12-21 2019-06-27 Ethicon Llc Surgical instrument comprising an articulatable distal head
US11311290B2 (en) 2017-12-21 2022-04-26 Cilag Gmbh International Surgical instrument comprising an end effector dampener
US11129680B2 (en) 2017-12-21 2021-09-28 Cilag Gmbh International Surgical instrument comprising a projector
US11076853B2 (en) 2017-12-21 2021-08-03 Cilag Gmbh International Systems and methods of displaying a knife position during transection for a surgical instrument
US11051841B2 (en) * 2018-04-12 2021-07-06 Ethicon Llc Mechanical lockout for ultrasonic surgical instrument
US11291440B2 (en) 2018-08-20 2022-04-05 Cilag Gmbh International Method for operating a powered articulatable surgical instrument
US10842492B2 (en) 2018-08-20 2020-11-24 Ethicon Llc Powered articulatable surgical instruments with clutching and locking arrangements for linking an articulation drive system to a firing drive system
US11253256B2 (en) 2018-08-20 2022-02-22 Cilag Gmbh International Articulatable motor powered surgical instruments with dedicated articulation motor arrangements
US11039834B2 (en) 2018-08-20 2021-06-22 Cilag Gmbh International Surgical stapler anvils with staple directing protrusions and tissue stability features
US11083458B2 (en) 2018-08-20 2021-08-10 Cilag Gmbh International Powered surgical instruments with clutching arrangements to convert linear drive motions to rotary drive motions
US11045192B2 (en) 2018-08-20 2021-06-29 Cilag Gmbh International Fabricating techniques for surgical stapler anvils
US10779821B2 (en) 2018-08-20 2020-09-22 Ethicon Llc Surgical stapler anvils with tissue stop features configured to avoid tissue pinch
US10856870B2 (en) 2018-08-20 2020-12-08 Ethicon Llc Switching arrangements for motor powered articulatable surgical instruments
US10912559B2 (en) 2018-08-20 2021-02-09 Ethicon Llc Reinforced deformable anvil tip for surgical stapler anvil
USD914878S1 (en) 2018-08-20 2021-03-30 Ethicon Llc Surgical instrument anvil
US11207065B2 (en) 2018-08-20 2021-12-28 Cilag Gmbh International Method for fabricating surgical stapler anvils
US11324501B2 (en) 2018-08-20 2022-05-10 Cilag Gmbh International Surgical stapling devices with improved closure members
CN111134751A (zh) * 2018-11-02 2020-05-12 上海逸思医疗科技有限公司 一种执行器可弯转的外科器械
US11147551B2 (en) 2019-03-25 2021-10-19 Cilag Gmbh International Firing drive arrangements for surgical systems
US11696761B2 (en) 2019-03-25 2023-07-11 Cilag Gmbh International Firing drive arrangements for surgical systems
US11147553B2 (en) 2019-03-25 2021-10-19 Cilag Gmbh International Firing drive arrangements for surgical systems
US11172929B2 (en) 2019-03-25 2021-11-16 Cilag Gmbh International Articulation drive arrangements for surgical systems
US11432816B2 (en) 2019-04-30 2022-09-06 Cilag Gmbh International Articulation pin for a surgical instrument
US11471157B2 (en) 2019-04-30 2022-10-18 Cilag Gmbh International Articulation control mapping for a surgical instrument
US11253254B2 (en) 2019-04-30 2022-02-22 Cilag Gmbh International Shaft rotation actuator on a surgical instrument
US11426251B2 (en) 2019-04-30 2022-08-30 Cilag Gmbh International Articulation directional lights on a surgical instrument
US11648009B2 (en) 2019-04-30 2023-05-16 Cilag Gmbh International Rotatable jaw tip for a surgical instrument
US11452528B2 (en) 2019-04-30 2022-09-27 Cilag Gmbh International Articulation actuators for a surgical instrument
US11903581B2 (en) 2019-04-30 2024-02-20 Cilag Gmbh International Methods for stapling tissue using a surgical instrument
US11399837B2 (en) 2019-06-28 2022-08-02 Cilag Gmbh International Mechanisms for motor control adjustments of a motorized surgical instrument
US11376098B2 (en) 2019-06-28 2022-07-05 Cilag Gmbh International Surgical instrument system comprising an RFID system
US11246678B2 (en) 2019-06-28 2022-02-15 Cilag Gmbh International Surgical stapling system having a frangible RFID tag
US11426167B2 (en) 2019-06-28 2022-08-30 Cilag Gmbh International Mechanisms for proper anvil attachment surgical stapling head assembly
US11497492B2 (en) 2019-06-28 2022-11-15 Cilag Gmbh International Surgical instrument including an articulation lock
US11259803B2 (en) 2019-06-28 2022-03-01 Cilag Gmbh International Surgical stapling system having an information encryption protocol
US11298132B2 (en) 2019-06-28 2022-04-12 Cilag GmbH Inlernational Staple cartridge including a honeycomb extension
US11298127B2 (en) 2019-06-28 2022-04-12 Cilag GmbH Interational Surgical stapling system having a lockout mechanism for an incompatible cartridge
US11051807B2 (en) 2019-06-28 2021-07-06 Cilag Gmbh International Packaging assembly including a particulate trap
US11291451B2 (en) 2019-06-28 2022-04-05 Cilag Gmbh International Surgical instrument with battery compatibility verification functionality
US11684434B2 (en) 2019-06-28 2023-06-27 Cilag Gmbh International Surgical RFID assemblies for instrument operational setting control
US11627959B2 (en) 2019-06-28 2023-04-18 Cilag Gmbh International Surgical instruments including manual and powered system lockouts
US11638587B2 (en) 2019-06-28 2023-05-02 Cilag Gmbh International RFID identification systems for surgical instruments
US11478241B2 (en) 2019-06-28 2022-10-25 Cilag Gmbh International Staple cartridge including projections
US11464601B2 (en) 2019-06-28 2022-10-11 Cilag Gmbh International Surgical instrument comprising an RFID system for tracking a movable component
US11771419B2 (en) 2019-06-28 2023-10-03 Cilag Gmbh International Packaging for a replaceable component of a surgical stapling system
US11660163B2 (en) 2019-06-28 2023-05-30 Cilag Gmbh International Surgical system with RFID tags for updating motor assembly parameters
US11224497B2 (en) 2019-06-28 2022-01-18 Cilag Gmbh International Surgical systems with multiple RFID tags
US11219455B2 (en) 2019-06-28 2022-01-11 Cilag Gmbh International Surgical instrument including a lockout key
US11523822B2 (en) 2019-06-28 2022-12-13 Cilag Gmbh International Battery pack including a circuit interrupter
US11553971B2 (en) 2019-06-28 2023-01-17 Cilag Gmbh International Surgical RFID assemblies for display and communication
US11241235B2 (en) 2019-06-28 2022-02-08 Cilag Gmbh International Method of using multiple RFID chips with a surgical assembly
US11076850B2 (en) 2019-11-26 2021-08-03 Covidien Lp Surgical instrument including an adapter assembly and an articulating surgical loading unit
US11291446B2 (en) 2019-12-18 2022-04-05 Covidien Lp Surgical instrument including an adapter assembly and an articulating surgical loading unit
US11911032B2 (en) 2019-12-19 2024-02-27 Cilag Gmbh International Staple cartridge comprising a seating cam
US11701111B2 (en) 2019-12-19 2023-07-18 Cilag Gmbh International Method for operating a surgical stapling instrument
US11607219B2 (en) 2019-12-19 2023-03-21 Cilag Gmbh International Staple cartridge comprising a detachable tissue cutting knife
US11464512B2 (en) 2019-12-19 2022-10-11 Cilag Gmbh International Staple cartridge comprising a curved deck surface
US11931033B2 (en) 2019-12-19 2024-03-19 Cilag Gmbh International Staple cartridge comprising a latch lockout
US11559304B2 (en) 2019-12-19 2023-01-24 Cilag Gmbh International Surgical instrument comprising a rapid closure mechanism
US11234698B2 (en) 2019-12-19 2022-02-01 Cilag Gmbh International Stapling system comprising a clamp lockout and a firing lockout
US11304696B2 (en) 2019-12-19 2022-04-19 Cilag Gmbh International Surgical instrument comprising a powered articulation system
US11529139B2 (en) 2019-12-19 2022-12-20 Cilag Gmbh International Motor driven surgical instrument
US11504122B2 (en) 2019-12-19 2022-11-22 Cilag Gmbh International Surgical instrument comprising a nested firing member
US11529137B2 (en) 2019-12-19 2022-12-20 Cilag Gmbh International Staple cartridge comprising driver retention members
US11576672B2 (en) 2019-12-19 2023-02-14 Cilag Gmbh International Surgical instrument comprising a closure system including a closure member and an opening member driven by a drive screw
US11291447B2 (en) 2019-12-19 2022-04-05 Cilag Gmbh International Stapling instrument comprising independent jaw closing and staple firing systems
US11446029B2 (en) 2019-12-19 2022-09-20 Cilag Gmbh International Staple cartridge comprising projections extending from a curved deck surface
US11844520B2 (en) 2019-12-19 2023-12-19 Cilag Gmbh International Staple cartridge comprising driver retention members
US11950797B2 (en) 2019-12-30 2024-04-09 Cilag Gmbh International Deflectable electrode with higher distal bias relative to proximal bias
US11779329B2 (en) 2019-12-30 2023-10-10 Cilag Gmbh International Surgical instrument comprising a flex circuit including a sensor system
US20210196363A1 (en) 2019-12-30 2021-07-01 Ethicon Llc Electrosurgical instrument with electrodes operable in bipolar and monopolar modes
US11937863B2 (en) 2019-12-30 2024-03-26 Cilag Gmbh International Deflectable electrode with variable compression bias along the length of the deflectable electrode
US11911063B2 (en) 2019-12-30 2024-02-27 Cilag Gmbh International Techniques for detecting ultrasonic blade to electrode contact and reducing power to ultrasonic blade
US11812957B2 (en) 2019-12-30 2023-11-14 Cilag Gmbh International Surgical instrument comprising a signal interference resolution system
US11759251B2 (en) 2019-12-30 2023-09-19 Cilag Gmbh International Control program adaptation based on device status and user input
US20210196357A1 (en) 2019-12-30 2021-07-01 Ethicon Llc Electrosurgical instrument with asynchronous energizing electrodes
US11684412B2 (en) 2019-12-30 2023-06-27 Cilag Gmbh International Surgical instrument with rotatable and articulatable surgical end effector
US11779387B2 (en) 2019-12-30 2023-10-10 Cilag Gmbh International Clamp arm jaw to minimize tissue sticking and improve tissue control
US11696776B2 (en) 2019-12-30 2023-07-11 Cilag Gmbh International Articulatable surgical instrument
US20210196362A1 (en) 2019-12-30 2021-07-01 Ethicon Llc Electrosurgical end effectors with thermally insulative and thermally conductive portions
US11660089B2 (en) 2019-12-30 2023-05-30 Cilag Gmbh International Surgical instrument comprising a sensing system
US11452525B2 (en) 2019-12-30 2022-09-27 Cilag Gmbh International Surgical instrument comprising an adjustment system
US11944366B2 (en) 2019-12-30 2024-04-02 Cilag Gmbh International Asymmetric segmented ultrasonic support pad for cooperative engagement with a movable RF electrode
US11786291B2 (en) 2019-12-30 2023-10-17 Cilag Gmbh International Deflectable support of RF energy electrode with respect to opposing ultrasonic blade
USD975278S1 (en) 2020-06-02 2023-01-10 Cilag Gmbh International Staple cartridge
USD974560S1 (en) 2020-06-02 2023-01-03 Cilag Gmbh International Staple cartridge
USD975851S1 (en) 2020-06-02 2023-01-17 Cilag Gmbh International Staple cartridge
USD976401S1 (en) 2020-06-02 2023-01-24 Cilag Gmbh International Staple cartridge
USD967421S1 (en) 2020-06-02 2022-10-18 Cilag Gmbh International Staple cartridge
USD975850S1 (en) 2020-06-02 2023-01-17 Cilag Gmbh International Staple cartridge
USD966512S1 (en) 2020-06-02 2022-10-11 Cilag Gmbh International Staple cartridge
US11737748B2 (en) * 2020-07-28 2023-08-29 Cilag Gmbh International Surgical instruments with double spherical articulation joints with pivotable links
US11452526B2 (en) 2020-10-29 2022-09-27 Cilag Gmbh International Surgical instrument comprising a staged voltage regulation start-up system
US11931025B2 (en) 2020-10-29 2024-03-19 Cilag Gmbh International Surgical instrument comprising a releasable closure drive lock
US11534259B2 (en) 2020-10-29 2022-12-27 Cilag Gmbh International Surgical instrument comprising an articulation indicator
USD1013170S1 (en) 2020-10-29 2024-01-30 Cilag Gmbh International Surgical instrument assembly
USD980425S1 (en) 2020-10-29 2023-03-07 Cilag Gmbh International Surgical instrument assembly
US11779330B2 (en) 2020-10-29 2023-10-10 Cilag Gmbh International Surgical instrument comprising a jaw alignment system
US11617577B2 (en) 2020-10-29 2023-04-04 Cilag Gmbh International Surgical instrument comprising a sensor configured to sense whether an articulation drive of the surgical instrument is actuatable
US11896217B2 (en) 2020-10-29 2024-02-13 Cilag Gmbh International Surgical instrument comprising an articulation lock
US11844518B2 (en) 2020-10-29 2023-12-19 Cilag Gmbh International Method for operating a surgical instrument
US11717289B2 (en) 2020-10-29 2023-08-08 Cilag Gmbh International Surgical instrument comprising an indicator which indicates that an articulation drive is actuatable
US11517390B2 (en) 2020-10-29 2022-12-06 Cilag Gmbh International Surgical instrument comprising a limited travel switch
US11737751B2 (en) 2020-12-02 2023-08-29 Cilag Gmbh International Devices and methods of managing energy dissipated within sterile barriers of surgical instrument housings
US11744581B2 (en) 2020-12-02 2023-09-05 Cilag Gmbh International Powered surgical instruments with multi-phase tissue treatment
US11627960B2 (en) 2020-12-02 2023-04-18 Cilag Gmbh International Powered surgical instruments with smart reload with separately attachable exteriorly mounted wiring connections
US11653920B2 (en) 2020-12-02 2023-05-23 Cilag Gmbh International Powered surgical instruments with communication interfaces through sterile barrier
US11678882B2 (en) 2020-12-02 2023-06-20 Cilag Gmbh International Surgical instruments with interactive features to remedy incidental sled movements
US11944296B2 (en) 2020-12-02 2024-04-02 Cilag Gmbh International Powered surgical instruments with external connectors
US11849943B2 (en) 2020-12-02 2023-12-26 Cilag Gmbh International Surgical instrument with cartridge release mechanisms
US11890010B2 (en) 2020-12-02 2024-02-06 Cllag GmbH International Dual-sided reinforced reload for surgical instruments
US11653915B2 (en) 2020-12-02 2023-05-23 Cilag Gmbh International Surgical instruments with sled location detection and adjustment features
US11696757B2 (en) 2021-02-26 2023-07-11 Cilag Gmbh International Monitoring of internal systems to detect and track cartridge motion status
US11751869B2 (en) 2021-02-26 2023-09-12 Cilag Gmbh International Monitoring of multiple sensors over time to detect moving characteristics of tissue
US11749877B2 (en) 2021-02-26 2023-09-05 Cilag Gmbh International Stapling instrument comprising a signal antenna
US11950779B2 (en) 2021-02-26 2024-04-09 Cilag Gmbh International Method of powering and communicating with a staple cartridge
US11793514B2 (en) 2021-02-26 2023-10-24 Cilag Gmbh International Staple cartridge comprising sensor array which may be embedded in cartridge body
US11950777B2 (en) 2021-02-26 2024-04-09 Cilag Gmbh International Staple cartridge comprising an information access control system
US11701113B2 (en) 2021-02-26 2023-07-18 Cilag Gmbh International Stapling instrument comprising a separate power antenna and a data transfer antenna
US11925349B2 (en) 2021-02-26 2024-03-12 Cilag Gmbh International Adjustment to transfer parameters to improve available power
US11730473B2 (en) 2021-02-26 2023-08-22 Cilag Gmbh International Monitoring of manufacturing life-cycle
US11744583B2 (en) 2021-02-26 2023-09-05 Cilag Gmbh International Distal communication array to tune frequency of RF systems
US11812964B2 (en) 2021-02-26 2023-11-14 Cilag Gmbh International Staple cartridge comprising a power management circuit
US11723657B2 (en) 2021-02-26 2023-08-15 Cilag Gmbh International Adjustable communication based on available bandwidth and power capacity
US11759202B2 (en) 2021-03-22 2023-09-19 Cilag Gmbh International Staple cartridge comprising an implantable layer
US11717291B2 (en) 2021-03-22 2023-08-08 Cilag Gmbh International Staple cartridge comprising staples configured to apply different tissue compression
US11806011B2 (en) 2021-03-22 2023-11-07 Cilag Gmbh International Stapling instrument comprising tissue compression systems
US11737749B2 (en) 2021-03-22 2023-08-29 Cilag Gmbh International Surgical stapling instrument comprising a retraction system
US11723658B2 (en) 2021-03-22 2023-08-15 Cilag Gmbh International Staple cartridge comprising a firing lockout
US11826012B2 (en) 2021-03-22 2023-11-28 Cilag Gmbh International Stapling instrument comprising a pulsed motor-driven firing rack
US11826042B2 (en) 2021-03-22 2023-11-28 Cilag Gmbh International Surgical instrument comprising a firing drive including a selectable leverage mechanism
US11786243B2 (en) 2021-03-24 2023-10-17 Cilag Gmbh International Firing members having flexible portions for adapting to a load during a surgical firing stroke
US11786239B2 (en) 2021-03-24 2023-10-17 Cilag Gmbh International Surgical instrument articulation joint arrangements comprising multiple moving linkage features
US11832816B2 (en) 2021-03-24 2023-12-05 Cilag Gmbh International Surgical stapling assembly comprising nonplanar staples and planar staples
US11793516B2 (en) 2021-03-24 2023-10-24 Cilag Gmbh International Surgical staple cartridge comprising longitudinal support beam
US11849945B2 (en) 2021-03-24 2023-12-26 Cilag Gmbh International Rotary-driven surgical stapling assembly comprising eccentrically driven firing member
US11857183B2 (en) 2021-03-24 2024-01-02 Cilag Gmbh International Stapling assembly components having metal substrates and plastic bodies
US11896219B2 (en) 2021-03-24 2024-02-13 Cilag Gmbh International Mating features between drivers and underside of a cartridge deck
US11903582B2 (en) 2021-03-24 2024-02-20 Cilag Gmbh International Leveraging surfaces for cartridge installation
US11849944B2 (en) 2021-03-24 2023-12-26 Cilag Gmbh International Drivers for fastener cartridge assemblies having rotary drive screws
US11744603B2 (en) 2021-03-24 2023-09-05 Cilag Gmbh International Multi-axis pivot joints for surgical instruments and methods for manufacturing same
US11896218B2 (en) 2021-03-24 2024-02-13 Cilag Gmbh International Method of using a powered stapling device
US11944336B2 (en) 2021-03-24 2024-04-02 Cilag Gmbh International Joint arrangements for multi-planar alignment and support of operational drive shafts in articulatable surgical instruments
US11826047B2 (en) 2021-05-28 2023-11-28 Cilag Gmbh International Stapling instrument comprising jaw mounts
US11877745B2 (en) 2021-10-18 2024-01-23 Cilag Gmbh International Surgical stapling assembly having longitudinally-repeating staple leg clusters
US11957337B2 (en) 2021-10-18 2024-04-16 Cilag Gmbh International Surgical stapling assembly with offset ramped drive surfaces
US11937816B2 (en) 2021-10-28 2024-03-26 Cilag Gmbh International Electrical lead arrangements for surgical instruments

Family Cites Families (90)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3506005A (en) * 1967-02-23 1970-04-14 Arthur S Gilio Pressure infusion device for medical use
US3726134A (en) * 1971-02-22 1973-04-10 B Grabovac Dial torque wrench
US4331277A (en) * 1980-05-23 1982-05-25 United States Surgical Corporation Self-contained gas powered surgical stapler
US4794912A (en) * 1987-08-17 1989-01-03 Welch Allyn, Inc. Borescope or endoscope with fluid dynamic muscle
GB8800909D0 (en) * 1988-01-15 1988-02-17 Ethicon Inc Gas powered surgical stapler
US4921482A (en) * 1989-01-09 1990-05-01 Hammerslag Julius G Steerable angioplasty device
US5632746A (en) * 1989-08-16 1997-05-27 Medtronic, Inc. Device or apparatus for manipulating matter
US5478320A (en) * 1989-11-29 1995-12-26 Cordis Corporation Puncture resistant balloon catheter and method of manufacturing
US5179934A (en) * 1990-02-20 1993-01-19 Olympus Optical Co., Ltd. Endoscope
US5005754A (en) * 1990-04-04 1991-04-09 Ethicon, Inc. Bladder and mandrel for use with surgical stapler
US5219111A (en) * 1991-03-11 1993-06-15 Ethicon, Inc. Pneumatically actuated linear stapling device
US5275608A (en) * 1991-10-16 1994-01-04 Implemed, Inc. Generic endoscopic instrument
US5289963A (en) * 1991-10-18 1994-03-01 United States Surgical Corporation Apparatus and method for applying surgical staples to attach an object to body tissue
US5326013A (en) * 1991-10-18 1994-07-05 United States Surgical Corporation Self contained gas powered surgical apparatus
US5312023A (en) * 1991-10-18 1994-05-17 United States Surgical Corporation Self contained gas powered surgical apparatus
US5356064A (en) * 1991-10-18 1994-10-18 United States Surgical Corporation Apparatus and method for applying surgical staples to attach an object to body tissue
US6250532B1 (en) * 1991-10-18 2001-06-26 United States Surgical Corporation Surgical stapling apparatus
US5197649A (en) * 1991-10-29 1993-03-30 The Trustees Of Columbia University In The City Of New York Gastrointestinal endoscoptic stapler
US5383880A (en) * 1992-01-17 1995-01-24 Ethicon, Inc. Endoscopic surgical system with sensing means
US5250056A (en) * 1992-02-04 1993-10-05 Hasson Harrith M Forceps-type surgical instrument
US5271543A (en) * 1992-02-07 1993-12-21 Ethicon, Inc. Surgical anastomosis stapling instrument with flexible support shaft and anvil adjusting mechanism
US5514157A (en) * 1992-02-12 1996-05-07 United States Surgical Corporation Articulating endoscopic surgical apparatus
US5314466A (en) * 1992-04-13 1994-05-24 Ep Technologies, Inc. Articulated unidirectional microwave antenna systems for cardiac ablation
US5250074A (en) * 1992-07-14 1993-10-05 Wilk Peter J Surgical instrument assembly and associated technique
US5411519A (en) * 1992-09-23 1995-05-02 United States Surgical Corporation Surgical apparatus having hinged jaw structure
US5485952A (en) * 1992-09-23 1996-01-23 United States Surgical Corporation Apparatus for applying surgical fasteners
US5381943A (en) * 1992-10-09 1995-01-17 Ethicon, Inc. Endoscopic surgical stapling instrument with pivotable and rotatable staple cartridge
US5330502A (en) * 1992-10-09 1994-07-19 Ethicon, Inc. Rotational endoscopic mechanism with jointed drive mechanism
US5431323A (en) * 1992-10-09 1995-07-11 Ethicon, Inc. Endoscopic surgical instrument with pivotable and rotatable staple cartridge
US5662662A (en) * 1992-10-09 1997-09-02 Ethicon Endo-Surgery, Inc. Surgical instrument and method
US5409498A (en) * 1992-11-05 1995-04-25 Ethicon, Inc. Rotatable articulating endoscopic fastening instrument
US5792165A (en) * 1993-07-21 1998-08-11 Charles H. Klieman Endoscopic instrument with detachable end effector
US5441494A (en) * 1993-07-29 1995-08-15 Ethicon, Inc. Manipulable hand for laparoscopy
US5405344A (en) * 1993-09-30 1995-04-11 Ethicon, Inc. Articulable socket joint assembly for an endoscopic instrument for surgical fastner track therefor
US5339723A (en) * 1993-09-30 1994-08-23 Ethicon, Inc. Pressurized fluid actuation system for amplifying operator input force in a surgical instrument
US5487499A (en) * 1993-10-08 1996-01-30 United States Surgical Corporation Surgical apparatus for applying surgical fasteners including a counter
DE4340707C2 (de) * 1993-11-30 1997-03-27 Wolf Gmbh Richard Manipulator
US5743456A (en) * 1993-12-16 1998-04-28 Stryker Corporation Hand actuable surgical handpiece
US5465895A (en) 1994-02-03 1995-11-14 Ethicon Endo-Surgery, Inc. Surgical stapler instrument
CA2145723A1 (en) * 1994-03-30 1995-10-01 Steven W. Hamblin Surgical stapling instrument with remotely articulated stapling head assembly on rotatable support shaft
US5901895A (en) * 1994-10-05 1999-05-11 United States Surgical Corporation Articulating apparatus for applying surgical fasteners to body tissue
US5752973A (en) * 1994-10-18 1998-05-19 Archimedes Surgical, Inc. Endoscopic surgical gripping instrument with universal joint jaw coupler
US5632432A (en) * 1994-12-19 1997-05-27 Ethicon Endo-Surgery, Inc. Surgical instrument
US5530502A (en) * 1995-03-13 1996-06-25 Eastman Kodak Company Camera autowind gear mechanism
US5860995A (en) * 1995-09-22 1999-01-19 Misener Medical Co. Inc. Laparoscopic endoscopic surgical instrument
US5725536A (en) * 1996-02-20 1998-03-10 Richard-Allen Medical Industries, Inc. Articulated surgical instrument with improved articulation control mechanism
US6010054A (en) * 1996-02-20 2000-01-04 Imagyn Medical Technologies Linear stapling instrument with improved staple cartridge
US5797537A (en) * 1996-02-20 1998-08-25 Richard-Allan Medical Industries, Inc. Articulated surgical instrument with improved firing mechanism
US5762255A (en) * 1996-02-20 1998-06-09 Richard-Allan Medical Industries, Inc. Surgical instrument with improvement safety lockout mechanisms
US5779727A (en) * 1997-02-18 1998-07-14 Orejola; Wilmo C. Hydraulically operated surgical scissors
TW473600B (en) * 1997-04-15 2002-01-21 Swagelok Co Tube fitting, rear ferrule for a two ferrule tube fitting and ferrule for a tube fitting and a non-flared tube fitting
US5865361A (en) * 1997-09-23 1999-02-02 United States Surgical Corporation Surgical stapling apparatus
US6756094B1 (en) * 2000-02-28 2004-06-29 Scimed Life Systems, Inc. Balloon structure with PTFE component
WO2001093766A1 (en) * 2000-06-07 2001-12-13 Stereotaxis, Inc. Guide for medical devices
US6506202B1 (en) * 2000-07-10 2003-01-14 Advanced Cardiovascular Systems, Inc. Expandable stent dimensional retention system and method
US6357490B1 (en) * 2000-08-22 2002-03-19 Advanced Inhalation Research, Inc. System, method and apparatus for filling containers
AU2001288462A1 (en) * 2000-08-30 2002-03-13 Cerebral Vascular Applications Inc. Medical instrument
US6773438B1 (en) * 2000-10-19 2004-08-10 Ethicon Endo-Surgery Surgical instrument having a rotary lockout mechanism
EP1357842B1 (en) * 2001-01-16 2010-11-03 Cytyc Surgical Products Apparatus and method for treating venous reflux
JP2003090877A (ja) * 2001-07-12 2003-03-28 Murata Mfg Co Ltd レーダ装置
US6755338B2 (en) * 2001-08-29 2004-06-29 Cerebral Vascular Applications, Inc. Medical instrument
US20030111507A1 (en) * 2001-12-14 2003-06-19 George Nunez Balloon actuator for use in a resectioning device
US7112357B2 (en) * 2002-01-23 2006-09-26 Boston Scientific Scimed, Inc. Medical devices comprising a multilayer construction
US8287561B2 (en) * 2002-06-28 2012-10-16 Boston Scientific Scimed, Inc. Balloon-type actuator for surgical applications
AU2003237588A1 (en) * 2002-07-11 2004-02-02 Sightline Technologies Ltd. Piston-actuated endoscopic steering system
WO2004032762A1 (en) * 2002-10-04 2004-04-22 Tyco Healthcare Group, Lp Tool assembly for a surgical stapling device
EP1915955B1 (en) * 2002-10-04 2011-09-21 Tyco Healthcare Group, LP Surgical stapler with universal articulation and tissue pre-clamp
TW566349U (en) * 2003-03-11 2003-12-11 Lite On Technology Corp Multi-functional office appliance
US7380696B2 (en) 2003-05-20 2008-06-03 Ethicon Endo-Surgery, Inc. Articulating surgical stapling instrument incorporating a two-piece E-beam firing mechanism
EP2474272B1 (en) * 2003-06-17 2020-11-04 Covidien LP Surgical stapling device
US6981628B2 (en) * 2003-07-09 2006-01-03 Ethicon Endo-Surgery, Inc. Surgical instrument with a lateral-moving articulation control
US7213736B2 (en) * 2003-07-09 2007-05-08 Ethicon Endo-Surgery, Inc. Surgical stapling instrument incorporating an electroactive polymer actuated firing bar track through an articulation joint
US7111769B2 (en) * 2003-07-09 2006-09-26 Ethicon Endo-Surgery, Inc. Surgical instrument incorporating an articulation mechanism having rotation about the longitudinal axis
US6964363B2 (en) * 2003-07-09 2005-11-15 Ethicon Endo-Surgery, Inc. Surgical stapling instrument having articulation joint support plates for supporting a firing bar
US6786382B1 (en) * 2003-07-09 2004-09-07 Ethicon Endo-Surgery, Inc. Surgical stapling instrument incorporating an articulation joint for a firing bar track
US7259750B2 (en) * 2003-09-15 2007-08-21 Intel Corporation Extended stand computer system with non-retractable carrying handle
US7364061B2 (en) * 2003-09-29 2008-04-29 Ethicon Endo-Surgery, Inc. Surgical stapling instrument incorporating a multistroke firing position indicator and retraction mechanism
US6905057B2 (en) * 2003-09-29 2005-06-14 Ethicon Endo-Surgery, Inc. Surgical stapling instrument incorporating a firing mechanism having a linked rack transmission
US7166077B2 (en) * 2004-02-03 2007-01-23 Pharma-Smart, Llc Cuff for measurement of blood pressure
US7407077B2 (en) * 2004-07-28 2008-08-05 Ethicon Endo-Surgery, Inc. Electroactive polymer-based actuation mechanism for linear surgical stapler
US7487899B2 (en) * 2004-07-28 2009-02-10 Ethicon Endo-Surgery, Inc. Surgical instrument incorporating EAP complete firing system lockout mechanism
US8057508B2 (en) * 2004-07-28 2011-11-15 Ethicon Endo-Surgery, Inc. Surgical instrument incorporating an electrically actuated articulation locking mechanism
US7410086B2 (en) * 2004-07-28 2008-08-12 Ethicon Endo-Surgery, Inc. Electroactive polymer-based actuation mechanism for circular stapler
US7407074B2 (en) * 2004-07-28 2008-08-05 Ethicon Endo-Surgery, Inc. Electroactive polymer-based actuation mechanism for multi-fire surgical fastening instrument
US8905977B2 (en) * 2004-07-28 2014-12-09 Ethicon Endo-Surgery, Inc. Surgical stapling instrument having an electroactive polymer actuated medical substance dispenser
US7857183B2 (en) * 2004-07-28 2010-12-28 Ethicon Endo-Surgery, Inc. Surgical instrument incorporating an electrically actuated articulation mechanism
US7143925B2 (en) * 2004-07-28 2006-12-05 Ethicon Endo-Surgery, Inc. Surgical instrument incorporating EAP blocking lockout mechanism
JP2006073171A (ja) * 2004-08-06 2006-03-16 Konica Minolta Opto Inc モニタ用光学素子およびその製造方法ならびに光ピックアップ
US7559450B2 (en) * 2005-02-18 2009-07-14 Ethicon Endo-Surgery, Inc. Surgical instrument incorporating a fluid transfer controlled articulation mechanism
US7481824B2 (en) * 2005-12-30 2009-01-27 Ethicon Endo-Surgery, Inc. Surgical instrument with bending articulation controlled articulation pivot joint

Cited By (28)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN102711629A (zh) * 2009-05-06 2012-10-03 坎布里奇内窥镜设备有限公司 外科器械的导引设备
CN102366955A (zh) * 2011-10-21 2012-03-07 奇瑞汽车股份有限公司 一种用于机械臂的齿轮齿条式锁止装置
CN103110456A (zh) * 2011-11-16 2013-05-22 柯惠Lp公司 动力关节式运动和腕式旋转的手术装置
CN105025825B (zh) * 2013-02-28 2018-02-02 伊西康内外科公司 具有小齿轮和反向齿条的外科器械端部执行器关节运动驱动器
CN105025825A (zh) * 2013-02-28 2015-11-04 伊西康内外科公司 具有小齿轮和反向齿条的外科器械端部执行器关节运动驱动器
CN104042286B (zh) * 2013-03-14 2018-03-30 伊西康内外科公司 模块化外科器械的驱动系控制结构
CN104042286A (zh) * 2013-03-14 2014-09-17 伊西康内外科公司 模块化外科器械的驱动系控制结构
CN105324086A (zh) * 2013-04-16 2016-02-10 伊西康内外科公司 动力外科缝合器
CN105324086B (zh) * 2013-04-16 2018-02-02 伊西康内外科公司 动力外科缝合器
CN103315789B (zh) * 2013-06-27 2015-04-15 常州市康迪医用吻合器有限公司 适用于微创手术的切割吻合器执行组件
CN103315789A (zh) * 2013-06-27 2013-09-25 常州市康迪医用吻合器有限公司 适用于微创手术的切割吻合器执行组件
CN103908320A (zh) * 2014-04-25 2014-07-09 王舒怡 一种腹腔镜手术抓钳
CN103908320B (zh) * 2014-04-25 2016-08-24 张世君 一种腹腔镜手术抓钳
US11234696B2 (en) 2014-06-25 2022-02-01 Cilag Gmbh International Articulation drive features for surgical stapler
CN106456177A (zh) * 2014-06-25 2017-02-22 伊西康内外科有限责任公司 用于外科缝合器的可枢转关节运动接头解锁特征结构
CN104306053A (zh) * 2014-10-22 2015-01-28 广州新诚生物科技有限公司 可控向穿刺鞘
CN113197628A (zh) * 2014-11-12 2021-08-03 思科医疗器械有限公司 一种成像换能器及超声波探头外壳
CN107920832A (zh) * 2015-08-26 2018-04-17 伊西康有限责任公司 具有稳定特征的关节运动的外科装置和装载器
CN107920832B (zh) * 2015-08-26 2020-08-04 伊西康有限责任公司 具有稳定特征的关节运动的外科装置和装载器
CN107049397A (zh) * 2016-02-11 2017-08-18 柯惠Lp公司 带有小直径内窥镜部的手术吻合器
CN107049397B (zh) * 2016-02-11 2021-03-05 柯惠Lp公司 带有小直径内窥镜部的手术吻合器
CN110099628A (zh) * 2016-12-21 2019-08-06 爱惜康有限责任公司 用于在关节运动构型中锁定外科器械的端部执行器的能够侧向致动的关节运动锁定布置
CN110114005A (zh) * 2016-12-21 2019-08-09 爱惜康有限责任公司 包括第一和第二关节运动闭锁件的轴组件
CN110114005B (zh) * 2016-12-21 2022-08-09 爱惜康有限责任公司 包括第一和第二关节运动闭锁件的轴组件
CN110099628B (zh) * 2016-12-21 2022-10-25 爱惜康有限责任公司 用于在关节运动构型中锁定外科器械的端部执行器的能够侧向致动的关节运动锁定布置
WO2022236770A1 (en) * 2021-05-13 2022-11-17 Covidien Lp Articulation mechanism for a surgical device
CN114305558A (zh) * 2021-05-27 2022-04-12 天津瑞奇外科器械股份有限公司 一种外科器械及其操作方法
CN114305558B (zh) * 2021-05-27 2024-02-23 天津瑞奇外科器械股份有限公司 一种外科器械及其操作方法

Also Published As

Publication number Publication date
CA2553499C (en) 2016-01-19
AU2006202972A1 (en) 2007-02-15
CA2553499A1 (en) 2007-02-01
JP2007038003A (ja) 2007-02-15
AU2006202972B2 (en) 2012-05-24
CN1911183B (zh) 2011-04-06
JP5073240B2 (ja) 2012-11-14
US20070027468A1 (en) 2007-02-01
EP1749485A1 (en) 2007-02-07
BRPI0603089A (pt) 2007-03-13

Similar Documents

Publication Publication Date Title
CN1911183A (zh) 具有关节运动轴锁定机构的外科器械
CN1843302A (zh) 具有导向横向运动的关节运动构件的外科器械
CN1903138A (zh) 具有与枢转关节接头连接的横向运动轴致动器的外科器械
CN1883411A (zh) 具有带双枢轴闭合器和单枢轴框架底的关节运动轴的外科器械
CN1843301A (zh) 具有单枢轴闭合和双枢轴框架底的关节运动轴的外科器械
US11304697B2 (en) Surgical stapler with deflectable distal tip
US11439391B2 (en) Surgical stapler with toggling distal tip
CN1957854B (zh) 锁定机构和具有该锁定机构的外科器械
CN101292888B (zh) 具有两件式e形梁击发机构的可关节运动的外科缝合器械
CN101584596B (zh) 用于外科缝合设备的一次性装载单元
JP4642395B2 (ja) 長軸に対して回動させる関節動作機構を備えた外科器具
JP5436754B2 (ja) 関節運動式エンドエフェクタを有する外科用器械
EP2522282B1 (en) Surgical stapling and cutting instrument with articulatable end effector
CN1732859A (zh) 具有两件式e形梁发射机构的铰接手术缝合器
US20060190031A1 (en) Surgical instrument with articulating shaft with rigid firing bar supports
CN1939228A (zh) 具有预加载击发辅助机构的外科缝合器械
CN101028205A (zh) 具有力控制间距的端部执行器的外科缝合器械
CN1596833A (zh) 具有横向移动铰接控制装置的外科器械
CN1827052A (zh) 自动结束冲程退回的多冲程机构
CN108784769A (zh) 包括铰接末端执行器的外科手术装载单元
JP2021529629A (ja) 空隙を有する変形可能な先端部を備えた手術用ステープル留めエンドエフェクタ構成要素
JP2021530304A (ja) 様々な屈曲角度を有する先端部を有する外科用ステープル留めエンドエフェクタ構成要素
JP2010193971A (ja) 医療用縫合装置

Legal Events

Date Code Title Description
C06 Publication
PB01 Publication
C10 Entry into substantive examination
SE01 Entry into force of request for substantive examination
C14 Grant of patent or utility model
GR01 Patent grant