JP7176017B2 - Surgical instrument with a system for bypassing operating steps of the surgical instrument - Google Patents

Description

The present invention relates to surgical instruments and, in various embodiments, to surgical stapling and cutting instruments and staple cartridges for use therewith.

The stapling instrument may include a pair of cooperating elongated jaw members, each adapted to be inserted into a patient and positioned against tissue to be stapled and/or incised. can. In various embodiments, one of the jaw members can support a staple cartridge having at least two laterally spaced rows of staples housed therein, and the other jaw member supports the staples in the staple cartridge. An anvil having staple-forming pockets aligned with the rows can be supported. Generally, the stapling instrument further includes a pusher bar and a knife blade that are slidable relative to the jaw members through camming surfaces on the pusher bar and/or camming surfaces on the wedge sled pushed by the pusher bar. , the staples can be continuously discharged from the staple cartridge. In at least one embodiment, the cartridge and the staples are retained by the cartridge for driving the staples against the anvil to form laterally spaced rows of deformed staples in the tissue grasped between the jaw members. The cam surface can be configured to actuate a plurality of staple drivers associated with. In at least one embodiment, the knife blade can follow the cam surface and cut tissue along the line between the staple rows.

The above discussion is intended only to describe various aspects of the relevant art in the field of the invention at the time, and should not be taken as denying the scope of the claims.

Various features of the embodiments described herein, together with their advantages, can be understood by the following description in conjunction with the accompanying drawings below.
FIG. 122 is a perspective view of a surgical stapling instrument in accordance with at least one embodiment; 2 is a perspective view of the surgical stapling instrument of FIG. 1 with components thereof removed for purposes of illustration; FIG. FIG. 100 is an exploded perspective view of a surgical stapling instrument including a handle, shaft, and end effector in accordance with at least one embodiment; 4 is a partial cross-sectional elevational view of the handle of FIG. 3 shown in an unclamped, unfired configuration; FIG. 4 is a partial cross-sectional elevational view of the handle of FIG. 3 shown in a clamped, unfired configuration; FIG. 4 is a partial cross-sectional elevational view of the handle of FIG. 3 shown in a clamped, partially fired configuration; FIG. 4 is a partial cross-sectional elevational view of the handle of FIG. 3 shown in a clamped, fully fired configuration; FIG. 4 is a partial cross-sectional elevational view of the handle of FIG. 3 prior to being returned to the unclamped configuration; FIG. FIG. 100 is an elevational view of a surgical stapling instrument including a handle, shaft, and end effector in accordance with at least one embodiment; 10 is an exploded perspective view of a staple cartridge for use with the surgical stapling instrument of FIG. 9; FIG. 11 is a perspective view showing the staple cartridge of FIG. 10 assembled to the surgical stapling instrument of FIG. 9; FIG. 11 is a cross-sectional view illustrating the staple cartridge of FIG. 10 positioned within the end effector of the surgical instrument of FIG. 9, showing the end effector in a clamped configuration; FIG. 11 is a cross-sectional view of the staple cartridge of FIG. 10 positioned within the end effector of the surgical instrument of FIG. 9 showing the staple driver of the end effector being moved to a firing configuration by the firing system; FIG. 11 is a cross-sectional view illustrating the staple cartridge of FIG. 10 positioned within the end effector of the surgical instrument of FIG. 9 showing the staple driver operably disengaged from the firing system; FIG. 11 is a cross-sectional view of the staple cartridge of FIG. 10 positioned within the end effector of the surgical instrument of FIG. 9 showing the cutting member being actuated by the firing system; FIG. FIG. 12 is an exploded view of a surgical stapling instrument in accordance with at least one embodiment, shown with components removed for purposes of illustration; 17 is a detailed view of the progress indicator of the surgical stapling instrument of FIG. 16; FIG. FIG. 14 is a cross-sectional view of an end effector of a surgical stapling instrument shown in a clamped but unfired configuration; 19 is a cross-sectional view of the end effector of FIG. 18 shown in staple firing mode; FIG. 19 is a cross-sectional view showing the shift between the staple firing mode and the tissue cutting mode of the end effector of FIG. 18; FIG. 19 is a cross-sectional view of the end effector of FIG. 18 shown in tissue cutting mode; FIG. FIG. 12 is an exploded view of a surgical stapling instrument in accordance with at least one embodiment, shown with components removed for purposes of illustration; 23 is a partial cross-sectional view of the surgical stapling instrument of FIG. 22 shown in an unclamped, unfired configuration; FIG. 23 is a detailed view of the transmission of the surgical stapling instrument of FIG. 22; FIG. 23 is a partial cross-sectional view of the surgical stapling instrument of FIG. 22 shown in a clamping configuration prior to the firing stroke; FIG. 23 is a partial cross-sectional view of the surgical stapling instrument of FIG. 22 shown in a clamped configuration after a firing stroke; FIG. 23 is a partial cross-sectional view of the surgical stapling instrument of FIG. 22 shown in a clamped and fired configuration prior to a transverse stroke; FIG. 23 is a partial cross-sectional view of the surgical stapling instrument of FIG. 22 shown in a clamped firing configuration after a transverse stroke; FIG. 23 is a perspective view of the transmission of the surgical stapling instrument of FIG. 22; FIG. 29 is another perspective view of the transmission of FIG. 28; FIG. FIG. 12 is an exploded view of a surgical stapling instrument in accordance with at least one embodiment, shown with components removed for purposes of illustration; FIG. 30 is a partial cross-sectional view of the surgical stapling instrument of FIG. 29 shown in an unclamped, unfired configuration; 31 is a detailed view of the transmission of the surgical stapling instrument of FIG. 29 shown in a configuration corresponding to the unclamped, unfired configuration depicted in FIG. 30; FIG. 30 is a partial cross-sectional view of the surgical stapling instrument of FIG. 29 shown in a clamped, unfired configuration; FIG. 32 is a detailed view of the transmission of the surgical stapling instrument of FIG. 29 shown in a configuration corresponding to the clamped, unfired configuration depicted in FIG. 31; FIG. 30 is a partial cross-sectional view of the surgical stapling instrument of FIG. 29 shown in a clamped configuration with staples deployed from the surgical instrument; FIG. 33 is a detailed view of the transmission of the surgical stapling instrument of FIG. 29 shown in a configuration corresponding to the clamped firing configuration depicted in FIG. 32; FIG. 30 is a partial cross-sectional view of the surgical stapling instrument of FIG. 29 shown in a clamped configuration with tissue traversed by the surgical instrument; FIG. 34 is a detailed view of the transmission of the surgical stapling instrument of FIG. 29 shown in a configuration corresponding to the clamped firing configuration depicted in FIG. 33; FIG. FIG. 12 is an exploded view of a surgical stapling instrument in accordance with at least one embodiment, shown with components removed for purposes of illustration; 35 is a partial cross-sectional view of the surgical stapling instrument of FIG. 34 in an unclamped, unfired configuration; FIG. 35 is a partial cross-sectional view of the surgical stapling instrument of FIG. 34 in a clamped configuration prior to the firing stroke; FIG. 35 is a partial cross-sectional view of the surgical stapling instrument of FIG. 34 in a clamped and fired configuration prior to a transverse stroke; FIG. 35 is a partial cross-sectional view of the surgical stapling instrument of FIG. 34 in a clamped firing configuration after a transverse stroke; FIG. FIG. 12 is an exploded view of a surgical stapling instrument in accordance with at least one embodiment, shown with components removed for purposes of illustration; 40 is a partial cross-sectional view of the handle of the surgical stapling instrument of FIG. 39 shown in an unclamped configuration; FIG. 41 is a partial cross-sectional view of the handle of FIG. 40 shown in a tissue stapling mode of operation; FIG. 41 is a partial cross-sectional view of the handle of FIG. 40 shown in a fired configuration; FIG. 41 is a partial cross-sectional view of the handle of FIG. 40 showing the handle being toggled between its tissue stapling mode of operation and its tissue traversing mode of operation; FIG. 41 is a partial cross-sectional view of the handle of FIG. 40 after a stroke across tissue; FIG. A portion of a surgical stapling instrument according to at least one embodiment, comprising a staple firing bar, a knife bar, and a lock configured to hold the firing bar in place while the knife bar is advanced relative to the firing bar. It is a sectional view. 46 shows the firing bar of FIG. 45 in a firing position and a lock positioned behind the staple firing bar; FIG. Figure 46 shows the knife bar of Figure 45 in the firing position; 46 shows the lock of FIG. 45 disengaged from the staple firing bar so that the firing bar can be retracted; FIG. 120 is a partial cross-sectional view of a surgical stapling instrument with a manually releasable lock in accordance with at least one alternative embodiment; FIG. 100 is a partial cross-sectional view of a surgical stapling instrument according to at least one embodiment shown in an unclamped configuration; 51 is a partial cross-sectional view of the surgical stapling instrument of FIG. 50 shown in a clamped configuration; FIG. 51 is a partial cross-sectional view of the surgical stapling instrument of FIG. 50 shown in a staple firing configuration; FIG. 51 is a partial cross-sectional view of the surgical stapling instrument of FIG. 50 shown in a tissue cutting configuration; FIG. FIG. 12 is an end effector configured to continuously fire staples and dissect tissue captured within the end effector, according to at least one embodiment, shown with components removed for purposes of illustration; FIG. It is a partial perspective view. 55 is a partial perspective view of the end effector of FIG. 54 shown in a staple firing mode of operation; FIG. 55 is a partial perspective view of the end effector of FIG. 54 shown in a tissue traversing mode of operation; FIG. FIG. 100 is a partial cross-sectional perspective view of an end effector in accordance with at least one embodiment; 58 is a perspective, partially sectioned view of the end effector of FIG. 57 shown in a staple firing mode of operation; FIG. 58 is a partial perspective view of the end effector of FIG. 57 shown in a tissue traversing mode of operation; FIG. FIG. 122 is a partial cross-sectional view of a surgical stapling instrument in accordance with at least one embodiment; 61 is a partial cross-sectional view of the surgical stapling instrument of FIG. 60 shown in a staple firing mode of operation; FIG. 61 is a partial cross-sectional view of the surgical stapling instrument of FIG. 60 transitioning between a staple firing mode of operation and a tissue traversing mode of operation; FIG. 61 is a partial cross-sectional view of the surgical stapling instrument of FIG. 60 in a tissue traversing mode of operation; FIG. FIG. 100 is a partial cross-sectional perspective view of a surgical stapling instrument in accordance with at least one embodiment shown in a partially fired condition; 65 is a partial cross-sectional elevational view of the surgical stapling instrument of FIG. 64 shown in a partially fired condition; FIG.

Corresponding reference characters indicate corresponding parts throughout the drawings. The exemplifications set forth herein are illustrative of various embodiments of the invention in one form and such exemplifications should not be construed as limiting the scope of the invention in any way. do not have.

The applicant of this application owns the following patent applications filed on the same date as this application, each of which is hereby incorporated by reference in its entirety:
- U.S. Patent Application No. ____________, entitled "SURGICAL INSTRUMENT COMPRISING SYSTEMS FOR ASSURING THE PROPER SEQUENTIAL OPERATION OF THE SURGICAL INSTRUMENT", Attorney Docket No. END7667USNP/150102,
－米国特許出願第＿＿＿＿＿＿＿＿＿＿号、発明の名称「ＳＵＲＧＩＣＡＬ ＩＮＳＴＲＵＭＥＮＴ ＣＯＭＰＲＩＳＩＮＧ ＳＥＰＡＲＡＴＥ ＴＩＳＳＵＥ ＳＥＣＵＲＩＮＧ ＡＮＤ ＴＩＳＳＵＥ ＣＵＴＴＩＮＧ ＳＹＳＴＥＭＳ」、代理人整理番号ＥＮＤ７６６８ＵＳＮＰ／１５０１０３、及び －米国特許出願第＿＿＿＿＿＿＿＿＿＿号、発明の名称「ＳＵＲＧＩＣＡＬ ＩＮＳＴＲＵＭＥＮＴ ＣＯＭＰＲＩＳＩＮＧ ＳＹＳＴＥＭＳ ＦＯＲ PERMITTING THE OPTIONAL TRANSSECTION OF TISSUE", Attorney Docket No. END7669USNP/150104.

Numerous specific details are set forth to provide a thorough understanding of the overall structure, function, manufacture, and use of the embodiments described herein and illustrated in the accompanying drawings. Well-known operations, components and elements have not been described in detail so as not to obscure the embodiments described herein. It is understood by the reader that the embodiments described and illustrated herein are non-limiting examples, and as such, specific structural and functional details disclosed herein are exemplary and exemplary. It will be understood to obtain Variations and modifications thereto may be made without departing from the scope of the claims.

The terms "comprise" (any form of comprise, such as "comprises" and "comprising"), "have" (any form of have, such as "has" and "having"), "comprise ( "include" (any form of include, such as "includes" and "including") and "contain" (any form of contain, such as "contains" and "containing") are open linkage is a verb. As a result, a surgical system, device, or apparatus that “comprises,” “has,” “includes,” or “contains” one or more elements may refer to those one or more While having elements, it is not limited to having only one or more of those elements. Similarly, an element of a system, device, or apparatus that "comprises," "has," "includes," or "contains" one or more features may refer to one or more of them. but is not limited to having only one or more of those features.

The terms "proximal" and "distal" are used herein with reference to the clinician manipulating the handle portion of the surgical instrument. The term "proximal" refers to the portion closest to the clinician and the term "distal" refers to the portion located away from the clinician. It is further understood that for convenience and clarity, spatial terms such as "vertical," "horizontal," "above," and "below" may be used with respect to the drawings herein. deaf. However, surgical instruments are used in many orientations and positions, and these terms are not intended to be limiting and/or absolute.

Various exemplary devices and methods are provided for performing laparoscopic and minimally invasive surgical procedures. However, the reader will readily appreciate that the various methods and devices disclosed herein can be used in many surgical procedures and applications, including, for example, those associated with open surgical procedures. will be done. By proceeding with the Detailed Description of the Invention herein, the reader will understand that the various instruments disclosed herein can be used to perform an incision or puncture made in tissue, for example, through a natural orifice. It will further be appreciated that it can be inserted into the body in any manner, such as through a hole. The working or end effector portion of these instruments can be inserted directly into the patient's body or through an access device having a working channel through which the end effector and elongated shaft of the surgical instrument can be advanced. can also

Certain prior art surgical stapling instruments include:
European Patent Application No. EP 795298 filed 12 March 1997 entitled "LINEAR STAPLER WITH IMPROVED FIRING STROKE";
U.S. Pat. No. 5,605,272, issued Feb. 25, 1997, entitled "TRIGGER MECHANISM FOR SURGICAL INSTRUMENTS";
U.S. Pat. No. 5,697,543, issued Dec. 16, 1997, entitled "LINEAR STAPLER WITH IMPROVED FIRING STROKE";
U.S. Patent Application Publication No. 2005/0246881, published Nov. 10, 2005, entitled "METHOD FOR MAKING A SURGICAL STAPLER";
U.S. Patent Application Publication No. 2007/0208359, published September 6, 2007, entitled "METHOD FOR STAPLING TISSUE";
U.S. Pat. No. 4,527,724, issued July 9, 1985, entitled "DISPOSABLE LINEAR SURGICAL STAPLING INSTRUMENT";
U.S. Pat. No. 5,137,198, issued Aug. 11, 1992, entitled "FAST CLOSURE DEVICE FOR LINEAR SURGICAL STAPLING INSTRUMENT," and U.S. Pat. No. 5, issued Apr. 11, 1995; 405,073, entitled "FLEXIBLE SUPPORT SHAFT ASSEMBLY," the entire disclosures of which are incorporated herein by reference.

Japanese Patent Application Laid-Open No. 2006-218296 Japanese translation of PCT publication No. 2013-534159 Japanese Patent Publication No. 2015-513960

1 and 2, a surgical stapling instrument 100 is disclosed. Instrument 100 includes handle 110 , shaft 140 extending from handle 110 , and end effector 150 . Handle 110 includes housing 111 , frame 114 extending through shaft 140 , closure trigger 120 and firing trigger 130 . Actuation of the closure trigger 120 moves the end effector 150 between an open configuration (FIG. 1) and a closed configuration. Referring primarily to FIG. 2, closure trigger 120 is pivotally mounted to handle housing 111 about pivot 121 to move closure trigger 120 between an open position (FIG. 1) and a closed position. It includes a drive portion 122 that sometimes rotates distally. Closure trigger 120 is part of a closure drive that also includes link 123 and closure bar 126 . Link 123 is rotatably pinned to drive portion 122 of closure trigger 120 about pin 124 and link 123 is rotatably pinned to closure bar 126 about pin 125 . As drive portion 122 of closure trigger 120 rotates distally, drive portion 122 engages closure bar 126 to clamp tissue between staple cartridge 160 and anvil 170 during the closure stroke of the closure drive. Actuated to move staple cartridge 160 of end effector 150 toward anvil 170 of end effector 150 . Drive portion 122 includes a locking slot 127 defined therein for receiving distal end 117 of closure lock 112 when closure trigger 120 reaches its fully clamped position. It is configured. Closure lock 112 is rotatably mounted to handle housing 111 about pivot pin 113 and is biased against drive portion 122 of closure trigger 120 by a biasing member, such as a spring.

Actuation of firing trigger 130 fires staples removably stored within staple cartridge 160 toward anvil 170 . Referring primarily to FIG. 2, firing trigger 130 is pivotally mounted to handle housing 111 about pivot 131 to move firing trigger 130 between a non-actuated position (FIG. 1) and an actuated position. It includes a drive portion that rotates distally as it engages. Firing trigger 130 is part of a firing drive that further includes a firing bar 136 that is driven distally as firing trigger 130 moves toward its actuated position. The firing drive also includes a staple driver and cutting member advanced distally by firing bar 136 during the firing stroke of the firing drive. Frame 114 , closure bar 126 , and firing bar 136 are surrounded, or at least substantially surrounded, by shaft housing 144 .

Handle 110 further includes a firing return spring configured to return firing trigger 130 to its unactuated position to reset the firing system after the firing stroke is completed and firing trigger 130 is released by the clinician. It's okay. Similarly, handle 110 is configured to return closure trigger 120 to its open position to reset the closure system after closure lock 112 is depressed by the clinician to disengage closure lock 112 from lock slot 127. A configured closure return spring may also be included.
With respect to the embodiment disclosed in FIGS. 1 and 2, firing trigger 130 is actuated to staple and incise tissue clamped within end effector 150 with a single stroke of firing trigger 130 . Further, the embodiments disclosed in FIGS. 1 and 2 do not provide the clinician operating the instrument with the ability to pause between the staple firing and tissue cutting functions of the firing system. Additionally, the instrument does not provide any feedback to the clinician as to whether the instrument is performing a staple forming function or a tissue cutting function. Various improvements to this instrument are presented below.

A surgical stapling instrument 200 is shown in FIGS. 3-8 and is similar in many respects to instrument 100 and/or other surgical instruments disclosed herein. For example, referring primarily to FIG. 4, instrument 200 includes closure trigger 120 that, when actuated, drives closure bar 126 distally to close the end effectors of instrument 200 . Actuation of the closure trigger 120 also advances the firing bar 236 of the firing system at least partially distally to a pre-staged position, at which point the firing trigger 130 is then actuated to close the end. Staples can be fired from a staple cartridge positioned within the effector. Firing trigger 130 includes a drive portion 132 that aligns with proximal end 133 of firing bar 236 when firing bar 236 moves to its primed position. Referring now to FIG. 5, at this point the firing trigger 130 can be actuated to move the firing bar 236 distally to fire staples from the staple cartridge. However, actuation of firing trigger 130 and distal advancement of firing bar 236 is limited by a stop or switch 280 . Switch 280 stops distal advancement of firing bar 236 before firing bar 236 traverses tissue captured within the end effector. To traverse tissue, switch 280 is actuated to release firing bar 236, as shown in FIG. 6, thereby completing the firing stroke of firing actuator 130, as shown in FIG. be able to. In this manner, firing staples and traversing tissue may comprise separate and distinct operational steps of instrument 200 . In such cases, the clinician can choose when and/or whether to cut the tissue.

As described above, and referring primarily to FIG. 5, firing bar 236 is stopped by switch 280 during distal advancement of firing bar 236 . Firing bar 236 includes a slot 285 defined therein, and switch 280 is removably positioned within slot 285 . Switch 280 is pivotally mounted to handle housing 111 about pivot pin 281 and includes locking arm 282 positioned within slot 285 . Firing bar 236 can be advanced distally by firing trigger 130 until the proximal end of slot 285 contacts locking arm 282 . At this point, further distal movement of firing bar 236 is prevented by locking arm 282 . As shown in FIG. 6, a spring 284 is positioned between locking arm 282 and handle housing 111 and biases locking arm 282 into slot 285 to hold locking arm 282 in place until switch 280 is actuated. Hold in position. As shown in FIG. 7, when switch 280 is actuated, locking arm 282 rotates out of slot 285, allowing firing bar 236 to again be advanced distally. As firing bar 236 advances toward the end of its firing stroke, locking arm 282 is misaligned with slot 285 and spring 284 biases locking arm 282 against the bottom surface of firing bar 236 . After cutting tissue, firing bar 236 may be retracted toward its unfired position to realign locking arm 282 with slot 285 and spring 284 biases locking arm 282 into slot 285. can do.

In addition to the above, staples are fully formed when firing bar 236 is stopped by switch 280 . In such instances, the tissue may be fully secured by the staples before the cutting portion of firing bar 236 advances to cut the tissue. Alternative embodiments are also envisioned in which staples are only partially formed when firing bar 236 is stopped by switch 280 . In such embodiments, the tissue is cut at the same time staple formation is completed. In either case, a pause in operation of instrument 200 after the first step is provided that performs the second step even though both steps are performed by a single actuation of the trigger. Requires intervention by the clinician to selectively determine whether Stated another way, switch 280 deactivates firing trigger 130 during the actuation stroke of firing trigger 130, and the deactivation function of switch 280 must be defeated before the actuation stroke can be completed. Switch 280 can be activated when the clinician deems it appropriate. In certain instances, switch 280 may be activated immediately after switch 280 stops firing bar 236, or may be activated after a period of time. In some instances, switch 280 may be operated prior to stopping firing bar 236, thereby selectively combining the first and second steps.

In addition to the above, the clinician may or may not release the firing trigger 130 during the pause provided by switch 280 . In either case, it is desirable to prevent sudden and/or unintentional retraction of firing bar 236 . To this end, instrument 200 further comprises lock 290 configured to releasably hold firing bar 236 in place. Lock 290 includes a ratchet system, but any suitable lock can be utilized. Lock 290 is rotatably mounted to housing 111 about pivot pin 291 and includes a pawl 292 extending therefrom for engaging ratchet teeth 295 defined within firing bar 236 . It is configured. Lock 290 further includes a proximal arm 293 and a spring 294 positioned intermediate proximal arm 293 and housing 111 and configured to bias pawl 292 into engagement with tooth 295 . When pawl 292 engages tooth 295, lock 290 is configured to allow firing bar 236 to move distally, but prevent firing bar 236 from moving proximally. . Handle 210 of instrument 200 is a switch configured to engage proximal arm 293 of lock 290, rotate pawl 292 away from firing bar 236, and disengage pawl 292 from tooth 295. 296 is further included. At this point, firing bar 236 can be retracted.

To retract firing bar 236, the clinician may press closure lock 112 to disengage closure lock 112 from closure trigger 120 and move closure trigger 120 to its unactuated position (FIG. 4). and/or handle 210 may include a return spring configured to bias closure trigger 120 toward its unactuated position. In either case, moving closure trigger 120 toward its unactuated position can pull link 123 proximally, which in turn causes closure bar 126 and firing bar 236 to move proximally. can be pulled to More specifically, pins 125 connecting links 123 also pass through longitudinal openings defined in closure bar 126 and firing bar 236, such as longitudinal opening 129 defined in firing bar 236. and when link 123 is pulled proximally by closure trigger 120 , pin 125 engages the proximal end of opening 129 and the proximal end of the longitudinal opening defined in closure bar 126 . Contact can be made and the firing bar 236 and closing bar 126 can be pulled proximally. Also, proximal movement of firing bar 236 may push firing actuator 120 back into its unactuated position and/or firing actuator 120 may be returned to its unactuated position by a return spring. good. In either case, resetting lock 290 by pushing switch 296 distally so that pawl 292 can re-engage tooth 295 once firing bar 236 has been returned to its non-actuated position. can do.

In addition to the above, pawl 292 may be configured to produce an audible sound, such as a click, as teeth 295 of firing bar 236 slide under pawl 292, for example. Such audible sounds can provide feedback to the surgeon that firing bar 236 is moving distally. Also, because a fast-paced sound indicates that the firing bar 236 is moving at a fast speed, while a slow-paced sound indicates that the firing bar 236 is moving at a slow speed, Such audible sounds can also provide feedback to the surgeon regarding the velocity of firing bar 236 .

A surgical stapling instrument 300 is shown in FIGS. 9-15 and is similar in many respects to instruments 100, 200, and/or other surgical instruments disclosed herein. Instrument 300 includes an end effector 350 that includes staple cartridge 360 and anvil 170 . In use, tissue is positioned between staple cartridge 360 and anvil 170 and then captured within end effector 350 by deployable tissue pin 379 . Tissue pins 379 are housed within pin cavities 378 within staple cartridge 360 and travel distally toward anvil 170 . As discussed in greater detail below, tissue pin 379 can be pushed distally as staple cartridge 360 is moved to the closed position. Tissue pin 379 includes lateral gripping members 377 configured to allow a clinician to push pin 379 toward anvil 170 and/or retract pin into 379 staple cartridge 360 . Staple cartridge 360 includes transverse slots 375 configured to guide longitudinal movement of grasping members 377 and tissue pins 379 defined therein. Movement of tissue pin 379 is limited by anvil 170 and proximal end plate 376 .

Referring primarily to FIG. 9, instrument 300 further includes a closure trigger 120 which, when actuated, drives closure bar 126 distally to close end effector 350 of instrument 300 and staple cartridge. Tissue is clamped between 360 and anvil 170 . Instrument 300 also includes a firing trigger 130 that, when actuated, pushes firing bar 336 distally to eject staples from staple cartridge 360 positioned within end effector 350 . 10-15, staple cartridge 360 includes cartridge body 361 including a plurality of staple cavities 361a, 361b and knife slot 366 defined therein. Staple cavities 361 a are positioned on a first side of knife slot 366 and staple cavities 361 b are positioned on a second side of knife slot 366 . Although not shown, staples are stored within staple cavities 361 a , 361 b and ejected from staple cavities 361 a , 361 b when staple driver 362 is moved toward anvil 170 by firing bar 336 . Staple driver 362 is configured to drive a plurality of staple supports or cradles 362a configured to drive staples stored within staple cavities 361a and staples stored within staple cavities 361b. A plurality of staple supports or cradles 362b. Staple driver 362 further includes longitudinal guides 368a and 368b configured to control and/or limit travel of staple driver 362 to a longitudinal path.

In addition to the above, staple cartridge 360 includes a cutting member or knife 367 slidably positioned within knife slot 366 . Staple driver 362 includes a first knife latch 364a and a second knife latch 364b that releasably retain knife 366 and staple driver 362 together, as described in more detail below. is configured to Staple driver 362 includes a first pivot joint 363a and a second pivot joint 363b. A first knife latch 364a is rotatably positioned within a first pivot joint 363a and a second knife latch 364b is rotatably positioned within a second pivot joint 363b. The first knife latch 364a and the second knife latch 364b have a clamped position (FIGS. 12 and 13) in which they are engaged with the knife 367 and an unclamped position (FIG. 14) in which they are disengaged from the knife 367. and 15). Staple driver 362 and knife 367 move together when first knife latch 364a and second knife latch 364b are in the clamped position. In use, staple driver 362 and knife 367 are pushed distally by firing bar 336 to move staples between an unfired position (FIG. 12) and a fired position (FIG. 13). As can be seen from FIG. 13, when staple driver 362 is moved to its firing position, the cutting edge of knife 367 exits cartridge body 361 and cuts tissue captured between cartridge body 361 and anvil 170 . It never cuts. Instead, knife 367 is in a ready position below the deck surface of cartridge body 361 .

12 and 13, firing bar 336 contacts first knife latch 364a and second knife latch 364b to push staple driver 362 distally. 11-13, first knife latch 364a is releasably engaged with knife support 369 such that motion of staple driver 362 can be transferred to knife 367. Referring to FIGS. More specifically, the first knife latch 364a includes a ridge 365a positioned within a recess 369a defined within the knife support 369; It includes a ridge 365b positioned within a recess 369b defined in support 369. As shown in FIG. Protuberances 365a, 365b are recessed within respective recesses 369a, 369b such that the driving force delivered by firing bar 336 is transmitted to staple driver 362 and knife 367 to deform the staples against anvil 170. firmly received. The ridges 365a, 365b and the recesses 369a, 369b are configured such that the ridges 365a, 365b remain engaged with the recesses 369a, 369b until a threshold force is reached, at which point , knife latches 364a, 364b are offset outwardly away from knife support 369, as shown in FIGS. A threshold force can include, for example, the force required to fully form a staple. At this point, firing bar 336 is out of operative engagement with staple driver 362 and firing bar 336 is allowed to move distally relative to staple driver 362 . Firing bar 336 can now directly contact knife support 369 and drive knife 367 toward anvil 170 to traverse tissue. After staple driver 362 is separated from knife 367, knife 367 moves relative to staple driver 362, as can be seen in FIG.

In addition to the above, the firing system of instrument 300 includes two separate and distinct stages, a first or staple firing stage and a second or tissue cutting stage. The action of knife latches 364a, 364b defines the boundary between the two stages. When knife latches 364a, 364b are clamped to knife 367, the firing system is in its staple firing state. When knife latches 364a, 364b are unclamped from knife 367, the firing system is in its tissue cutting phase. Although these two stages are distinct and distinct and there is no overlap between them, embodiments are also envisioned in which there may be at least some overlap between the two stages.

A surgical stapling instrument 400 is shown in FIGS. 16 and 17 and is similar in many respects to instruments 100, 200, 300, and/or other surgical instruments disclosed herein. . For example, instrument 400 includes handle 410 that includes housing 411 that is similar in many respects to housing 111 . Instrument 400 further includes a closure bar 126 which, in addition to the above, moves the staple cartridge toward the anvil to clamp tissue therebetween. As described above, closure trigger 120 operates to move closure bar 126 distally. As also described above, the closure trigger 120 also advances the firing bar 136 to a primed position when the closure trigger 120 is actuated. Firing trigger 130 can now be actuated to move firing bar 136 distally to fire staples from the staple cartridge and subsequently cut tissue. Thus, it can be said that the firing bar 136 moves distally during all three operating states: the closing operating state, the staple firing operating state, and the tissue dissecting operating state. Instrument 400 further comprises a progress indicator that identifies the operational status of instrument 400, as discussed in more detail below.

Further to the above, referring primarily to FIG. 17, progress indicator includes segmented portion 418 on firing bar 136 . Although compartments 418 include projections extending laterally from firing bar 136 , in various other instances compartments 418 may include indicia printed on firing bar 136 , for example. The progress indicator further includes a progress bar 415 positioned within a window 414 defined within handle housing 411 . Progress bar 415 includes indicators 416 corresponding to three operational states of instrument 400 . For example, the display 416 may include a first display “Clamp” corresponding to a tissue clamping operational state, a second display “STAPLE” corresponding to a staple firing operational state, and a third display corresponding to a tissue cutting operational state. Includes display "Cut". Progress bar 415 further includes three lines 417 corresponding to completion of the operating state. In use, the segmented portion 418 on the firing bar 136 is aligned with the first line 417 when the closing stroke is completed and the second line 417 when the staples are fully fired, as shown in FIG. line 417, and a third line 417 when the cutting stroke is completed. Stated another way, segmented portion 418 moves distally along progress bar 415 as firing bar 136 advances distally to indicate the progress of firing bar 136 . Such movement of segment 418 is observable by an operator of surgical instrument 400 through window 414 defined within handle housing 411 . In at least one embodiment, the portion of the progress bar 415 associated with the clamping operating state can be a first color, such as green, and the portion of the progress bar 415 associated with the staple firing operating state can be It may be a second color, eg, yellow, and the portion of the progress bar 415 associated with the tissue cutting motion state may be a third color, eg, red. In an alternative embodiment, advancement bar 415 may be attached to firing bar 136 and compartment 418 may extend from handle housing 411 .

A surgical stapling instrument 500 is shown in FIGS. 18-21. Instrument 500 is similar in many respects to instruments 100 , 200 , 300 and/or 400 . Instrument 500 includes an end effector 550 that includes staple cartridge 560 and anvil 170 . Staple cartridge 560 includes a cartridge body 561 including staple cavities 561a defined therein. A staple is detachably stored in the staple cavity 561a. Staple cartridge 560 further includes a staple driver 562 including a pusher 562a configured to move staples toward anvil 170 and eject staples from staple cavities 561a. Instrument 500 further comprises firing bar 536 configured to push staple driver 562 distally toward anvil 170 . Staple driver 562 includes a proximally extending flange 564 that is engaged by firing bar 536 as firing bar 536 is advanced distally. When end effector 550 is in the unclamped but unfired configuration as shown in FIG. 18, flange 564 is positioned within channel 568 defined within cartridge 561 . In effect, flange 564 is flexed or urged inwardly by the sidewalls of channel 568 to slide along the sidewalls as staple driver 562 moves distally. Flange 564 engages and is retained in its inwardly bent portion by the channel sidewalls throughout the staple firing stroke. The end of the staple firing stroke is depicted in FIG.

Staple cartridge 560 further includes a cutting member 567 movably positioned within knife slot 566 defined within cartridge body 561 . Cutting member 567 includes a base 569 that is captured between flanges 564 such that cutting member 567 moves with staple driver 562 as staple driver 562 is driven distally by firing bar 563 . Referring again to FIG. 19, which depicts the end of the staple firing stroke, it will be appreciated that cutting member 567 has not yet emerged from cartridge body 561 . Thus, the staple firing action of instrument 500 is separate and distinct from the tissue cutting action of instrument 500 . Instrument 500 transitions between its staple firing motion and its tissue cutting motion when flange 564 releases cutting member 567 . By comparing FIGS. 19 and 20, it will be appreciated that flange 564 springs outward when the proximal end of flange 564 is no longer urged inwardly by the sidewalls of channel 568 . More particularly, flange 564 flexes outwardly upon clearing distal end 565 of channel 568 . At this point, flange 564 no longer engages cutting member 567 . Further, at this point, flange 564 no longer engages firing bar 536 and as a result firing bar 536 is unable to push staple driver 562 distally. Instead, firing bar 536 directly contacts base 569 of cutting member 567, as shown in FIG. 21, to advance cutting member 567 distally as firing bar 536 advances distally, Tissue captured between anvil 170 and staple cartridge 560 can be traversed.

In addition to the above, the point at which instrument 500 shifts between staple-firing and tissue-cutting modes of operation is a function of the distance that firing bar 536 travels. Other instruments disclosed herein shift between a staple firing mode of operation and a tissue cutting mode of operation, for example, in response to the force transmitted by the firing bar of the instrument. Certain embodiments may use a combination of both shifting techniques.

A surgical stapling instrument 600 is shown in FIGS. 22-28A. Instrument 600 is similar in many respects to instruments 100, 200, 300, 400, 500, and/or other surgical instruments disclosed herein. Instrument 600 includes a handle 610 that includes a closure trigger 620 configured to operate a closure or tissue clamping system and a firing trigger 630 configured to operate a firing system. Closure trigger 620 is rotatable between an unactuated position (Fig. 24) and an actuated position (Fig. 25). The closure system of instrument 600 is similar in many respects to the closure system of instrument 100 and will not be repeated here for the sake of brevity. In various instances, instrument 600 includes a lockout system that prevents activation of firing trigger 630 prior to activation of closing trigger 620 .

In addition to the above, closure trigger 620 includes a drive portion 622 that pushes link 123 distally to clamp the end effector of surgical instrument 600 on tissue. Drive portion 622 includes a clearance slot 628 defined therein such that drive portion 622 can move relative to shaft 634 extending through clearance slot 628 .

The launch system of instrument 600 is separate and distinct from the closure system. The firing system has two separate and distinct operational functions: staple firing and tissue cutting. A staple firing function is performed during a first actuation of firing trigger 630 and a tissue cutting function is performed during a second actuation of firing trigger 630 . Similar to above, firing trigger 630 is rotatably coupled to housing 111 about pivot 131 . Referring primarily to FIGS. 23, 23A, 28 and 28A, firing trigger 630 includes gear portion 632 in meshing engagement with pinion gear 633 . Pinion gear 633 is mounted on shaft 634 that is rotatably mounted on handle housing 111 . More specifically, pinion gear 633 is mounted on first portion 634a of shaft 634 such that pinion gear 633 and shaft portion 634a rotate together. Accordingly, actuation or rotation of firing trigger 630 causes pinion gear 633 and first shaft portion 634a to rotate.

Referring again to FIGS. 28 and 28A, shaft 634 further includes a second portion 634b selectively engageable with first portion 634a at ratchet interface 639. As shown in FIG. When the second shaft portion 634b is operably engaged with the first portion 634a, rotation of the first portion 634a is transferred to the second portion 634b, causing the first and second shaft portions 634a, 634b rotates together. An output pinion gear 635 is mounted on the second shaft portion 634b such that the pinion gear 635 rotates with the second shaft portion 634b. Pinion gear 635 is in meshing engagement with rack 637 defined on the proximal end of firing bar 636 . 25, in use, ratchet interface 639 imparts rotational motion of firing trigger 630 to firing bar 636 when firing trigger 630 is actuated, causing firing bar 636 to move distally (in FIG. 28). D direction).

In addition to the above and referring back to FIG. 25, a first actuation of firing trigger 630 pushes firing bar 636 distally to fire staples. As shown in FIG. 26, after the first actuation, the surgeon releases firing trigger 630 and a return spring operably coupled with firing trigger 630 allows firing trigger 630 to return to its unfired position. can. Alternatively, the surgeon may manually return firing trigger 630 to its unactuated position. In either case, ratchet interface 639 permits first shaft portion 634a to rotate relative to second shaft portion 634b when firing trigger 630 is returned to its unfired position. It is configured. More specifically, first shaft portion 634a slides against corresponding ratchet teeth defined on second shaft portion 634b when firing trigger 630 is returned to its unactuated position. , including ratchet teeth. To accommodate such relative motion, the first shaft portion 634a can be offset away from the second shaft portion 634b. Handle 610 provides a biasing member, such as a spring, configured to reengage first shaft portion 634a with second shaft portion 634b once firing trigger 630 is returned to its unactuated position. Including further.

Referring again to FIG. 26, the reader will appreciate that firing bar 636 is only partially advanced during the first stroke of firing trigger 630 . This partial advancement of firing bar 630 during the first stroke of firing trigger 630 fires or fully forms the staples stored within the end effector of instrument 600, but not within the end effector. It does not traverse trapped tissue. Referring now to FIG. 27, firing trigger 630 can fully advance firing bar 630 and traverse tissue on a second actuation. As outlined above, actuation or rotation of firing trigger 630 drives pinion gear 633, shaft 634, and output pinion gear 635 to advance firing bar 636 distally. In various instances, the surgeon may choose not to traverse the tissue and instead may unclamp the tissue after firing the staples. In such instances, the surgeon does not actuate firing trigger 630 a second time. In various instances, the teachings described above in connection with instrument 600 can be used in connection with instruments 400 and/or 500, for example.

A surgical stapling instrument 700 is shown in FIGS. 29-33A. Instrument 700 is similar in many respects to instruments 100, 200, 300, 400, 500, 600, and/or other surgical instruments disclosed herein. Instrument 700 includes a handle 710 that includes a closure trigger 620 configured to operate a closure or tissue clamping system and a firing trigger 630 configured to operate a firing system. Closure trigger 620 is rotatable between an unactuated position (Fig. 30) and an actuated position (Fig. 31). The closure system of instrument 700 is similar in many respects to the closure system of instrument 100 and will not be repeated here for the sake of brevity. In various instances, instrument 700 includes a lockout system that prevents actuation of firing trigger 630 prior to actuation of closing trigger 620 .

The firing system of instrument 700 is separate and distinct from the closure system. The firing system has two separate and distinct operational functions: staple firing and tissue cutting. Actuation of firing trigger 630 performs both functions, as will be described in further detail below. Firing trigger 630 is rotatably mounted to handle 710 about pivot 131 and includes gear portion 632 . The teeth of gear portion 632 are in meshing engagement with pinion gear 733 , which is rotatably mounted on handle 710 about shaft 734 . Shaft 734 further includes two cam lobes attached thereto, a first cam lobe 735a and a second cam lobe 735b. A first cam lobe 735a is configured to engage and advance staple firing bar 736a and a second cam lobe 735b is configured to engage and advance tissue cutting bar 736b. there is Cam lobes 735a, 735b are mounted on shaft 734 so that they rotate therewith.

Referring to FIG. 31, before the firing trigger 630 is actuated, the first cam lobe 735a is aligned with the first cam surface 737a defined on the proximal end of the staple firing bar 736a and the second cam surface 737a. cam lobe 735b is aligned with a second cam surface 737b defined on the proximal end of tissue cutting bar 736b. A first cam lobe 735a and a second cam lobe 735b are mounted on shaft 734 in a staggered relationship. As shown in FIG. 31, when the firing trigger 630 is in its unactuated position, the first cam lobe 735a is positioned adjacent the first cam surface 737a and the second cam lobe 735b is positioned adjacent to the second cam surface 737a. It is separated from the cam surface 737b.

In addition to the above, firing trigger 630 operates to drive staple firing bar 736 a and tissue cutting bar 736 b during a single stroke of firing trigger 630 . A first portion of the firing trigger actuation drives staple firing bar 736a distally and a second portion of the firing trigger actuation drives tissue cutting bar 736b distally. The first portion does not overlap the second portion of the firing trigger actuation. Stated another way, the staple firing process is completed before the tissue cutting process begins. In use, the angled surface 738a of the first cam lobe 735a displaces the staple firing bar 736a distally until the angled surface 738a passes the first cam surface 737a. At this point, dowel 739a of first cam lobe 735a is aligned with first cam surface 737a and staple firing bar 736a is no longer advanced distally by first cam lobe 735a. In various other embodiments, a dwell 739a of the first cam lobe 735a may complete the staple forming process. In such instances, ramp 738a of first cam lobe 735a initiates the staple forming process and dwell 739a terminates the staple forming process. In at least one instance, ramp 738a can complete more of the staple forming process than dwell 739a. In such instances, the staple quickly grasps the tissue and then slowly closes to fully secure the tissue therein. Alternatively, the dowel 739a may complete more of the staple forming process than the ramp 738a. In such cases, the compressive pressure applied by the staples may be applied over a longer period of time, which may better allow fluid to flow out of the tissue during the staple forming process. In either case, the second cam lobe 735b is spaced from ramp 738a by dowel 739a. As shaft 734 is rotated by firing actuator 630, as shown in Figures 32 and 32A, second cam lobe 735b rotates into contact with second cam surface 737b, as shown in Figures 33 and 33A. , the staple cutting process is completed.

Further to the above, in various instances, instrument 700 may include a stop that demarcates the transition between the staple firing process and the tissue cutting process. This stop can, for example, impede or prevent movement of firing actuator 630 after staple firing bar 736a has been fully advanced and before tissue cutting bar 736b has been advanced. Handle 710 may include a stop release that, when actuated, may allow the surgeon to complete the firing stroke of firing actuator 630 . Such embodiments may allow the surgeon to choose whether or not to continue the tissue cutting function of instrument 700 . In certain instances, instrument 700 generates tactile feedback, such as audible and/or tactile feedback, as firing actuator 630 passes the transition between staple firing and tissue cutting functions. can be done.

Further to the above, in various alternative embodiments, the tissue cutting process may overlap at least partially with the staple forming process. In such embodiments, the first cam lobe 735a and the second cam lobe 735b may drive the staple firing bar 736a simultaneously with the second cam lobe 735b driving the tissue cutting bar 736b. It is positioned and arranged on shaft 734 as such.

In addition to the above, firing actuator 630 may be returned to its unactuated position after being actuated to fire staples and/or cut tissue. Handle 710 may include a return spring engaged with firing actuator 630 biased to return firing actuator 630 to its unactuated position. Additionally or alternatively, instrument 700 includes one or more biasing elements engaged with bars 736a, 736b configured to return bars 736a, 736b to their unfired positions. A member may be included. As firing actuator 630 is returned to its inoperative position, gear portion 632 rotates pinion gear 733, shaft 734, and cam lobes 735a, 735b in opposite directions to engage cam lobes 735a, 735b from bars 736a, 736b, respectively. Release.

A surgical stapling instrument 800 is shown in FIGS. 34-38. Instrument 800 is similar in many respects to instruments 100, 200, 300, 400, 500, 600, and/or 700 and/or other surgical instruments disclosed herein. Instrument 800 includes a handle 810 that includes a closure trigger 620 configured to operate a closure or tissue clamping system. Instrument 800 further comprises a firing trigger 830a configured to operate the staple firing system and a cutting trigger 830b configured to operate the tissue cutting system. Closure trigger 620 is rotatable between a non-actuated position (Fig. 35) and an actuated position (Fig. 36). The closure system of instrument 800 is similar in many respects to the closure system of instrument 100 and will not be repeated here for the sake of brevity. In various instances, instrument 800 includes a lockout system that prevents actuation of firing trigger 830a and/or cutting trigger 830b prior to actuation of closure trigger 620. FIG.

The firing system of instrument 800 is separate and distinct from the closure system. Actuation of firing trigger 830 a operates the staple firing system to deform staples removably stored within the end effector of instrument 800 . Firing trigger 830a is rotatably mounted on handle 810 about pivot 131 between an unfired position (FIG. 36) and a fired position (FIG. 37). As shown in FIG. 36, firing trigger 830a includes a curved cam member 832a extending therefrom that moves distally when firing trigger 830a is actuated. Cam member 832a contacts proximal end 837a of staple firing bar 836a as cam member 832a is advanced distally to drive and deform staples removably stored within the end effector of instrument 800. .

The cutting system of instrument 800 is separate and distinct from the firing and closing systems. Actuation of cutting trigger 830 b operates the tissue cutting system to cut tissue captured within the end effector of instrument 800 . Cutting trigger 830b is rotatably mounted on handle 810 about pivot 131 between a non-actuated position (FIG. 37) and an actuated position (FIG. 38). As shown in FIG. 38, cutting trigger 830b includes a curved cam member 832b extending therefrom that moves distally when cutting trigger 830b is actuated. Cam member 832b contacts proximal end 837b of tissue cutting bar 836b as cam member 832b is advanced distally to cut tissue.

Rotation of firing actuator 830a through a first range of motion completes the firing stroke of firing bar 836a, and rotation of cutting actuator 830b through a second range of motion completes the cutting stroke of cutting bar 836b. Other embodiments are envisioned in which the firing stroke is the same length, or at least substantially the same length, as the cutting stroke, but the length of the firing stroke differs from the length of the cutting stroke. Further, the first range of motion of firing actuator 830a is the same as, or at least substantially the same as, the second range of motion of cutting actuator 830b, except that the first range of motion is different from the second range of motion. Embodiments of are also envisioned.

Referring again to FIGS. 37 and 38, firing actuator 830a includes a recess 839 defined therein. Recess 839 is configured to receive, or at least partially receive, cutting actuator 830b therein. As shown in FIG. 36, when firing actuator 830a and cutting actuator 830b are in their unactuated positions, cutting actuator 830b is nested with firing actuator 830a. As shown in FIG. 37, when firing actuator 830a is moved to its actuated position, cutting actuator 830b can remain in its non-actuated position, thus de-nesting actuators 830a, 830b. can be done. Thereafter, as shown in FIG. 38, actuation of cutting actuator 830b may re-nest actuator 830b with firing actuator 830a.

In addition to the above, separate and distinct actuators 830a, 830b may allow the staple firing system and tissue cutting system of instrument 800 to selectively operate in separate and distinct manners. However, the surgeon has the option of activating actuators 830a, 830b of instrument 800 simultaneously. In such instances, instrument 800 simultaneously staples and cuts tissue captured within the end effector. Alternatively, in at least one embodiment, instrument 800 may include a lockout configured to prevent actuation of cutting actuator 830b prior to full actuation of firing actuator 830a. In such embodiments, the surgeon does not have the option of activating actuators 830a and 830b simultaneously, but still has the option of selectively activating cutting actuator 830b. In a further alternative embodiment, cutting actuator 830b may be unlocked at some point during activation of firing actuator 830a so that actuators 830a, 830b may then be activated simultaneously if desired by the surgeon. . Such embodiments may ensure that the staples are at least partially fired, or at least fully fired, prior to cutting tissue.

A surgical stapling instrument 900 is shown in FIGS. 39-44. Instrument 900 is similar in many respects to instruments 100, 200, 300, 400, 500, 600, 700, 800, and/or other surgical instruments disclosed herein. Instrument 900 includes a housing 911, a closure trigger 620 configured to operate a closure system or tissue clamping system, and a first staple firing system and secondly a tissue cutting system. A handle 910 is provided which includes a firing trigger 930a. Closure trigger 620 is rotatable between an unactuated position (Fig. 40) and an actuated position (Fig. 41). The closure system of instrument 900 is similar in many respects to the closure system of instrument 100 and will not be repeated here for the sake of brevity. In various instances, instrument 900 includes a lockout system that prevents actuation of firing trigger 930 prior to actuation of closing trigger 620 .

In addition to the above, firing trigger 930 is rotatably mounted on handle housing 911 about pivot 131 between a non-actuated position (Fig. 41) and an actuated position (Fig. 42). Firing trigger 930 operates the staple firing system during a first actuation of firing trigger 930 (FIG. 42) and during a second actuation of firing trigger 930 (FIG. 43), as described in more detail below. Operate the tissue cutting system. Firing trigger 930 includes a curved cam portion 932 that moves distally when firing trigger 930 is actuated. Cam portion 932 contacts cam plate 985 as cam portion 932 rotates distally. Cam plate 985 is slidably mounted within handle housing 911 . Cam plate 985 is longitudinally slidable when pushed distally by cam portion 932 . Cam plate 985 includes a drive slot defined between arms 986 and 987 extending from the distal end of cam plate 985 . The drive slot is configured to receive the proximal end of staple firing bar 936a such that when cam plate 985 is pushed distally, cam plate 985 drives firing bar 936a distally. to fire staples removably stored within the end effector of instrument 900 . More specifically, distally extending arm 986 contacts proximal end 987a of staple firing bar 936a and pushes firing bar 936a distally.

In addition to the above, the cam plate 985 is also laterally slidable. More specifically, cam plate 985 is positioned in a first position (FIGS. 41 and 42) in which cam plate 985 is operably engageable with staple firing bar 936a and in which cam plate 985 is positioned with tissue cutting bar 936b. It is slidable between a second position (FIGS. 43 and 44) in which it is operatively engageable. Handle 910 further includes pusher block 980 engaged with cam plate 985 . Pusher block 980 includes a push pin 981 extending therefrom that extends through handle housing 911 . Pusher block 980 may include another push pin 981 extending through handle housing 911 in the opposite direction. In any event, the user of surgical instrument 900 shifts pusher block 980 between its first position and its second position by applying force to one of push pins 981. be able to. Tissue cutting bar 936b is positioned within the drive slot defined between arms 986 and 987 when pusher block 980 is in its second position. At this point, cam plate 985 is operatively coupled with tissue cutting bar 936b and subsequent actuation of firing trigger 930 activates the tissue cutting system.

In use, instrument 900 is positioned within a patient and the end effector of instrument 900 is positioned against tissue to be treated. The closure trigger 620 is then actuated to clamp the end effector onto tissue. At this point, pusher block 980 is positioned in its first position and operatively engaged with staple firing bar 936a. Activation of firing trigger 930 then advances staple firing bar 936a distally, but because cam slide 985 is not engaged with tissue cutting bar 936b, this activation of firing trigger 930 also advances tissue cutting bar 936b. do not advance After actuating the firing trigger 930, the firing trigger 930 can be released and returned to its unactuated position as shown in FIG. Similar to the above, handle 910 may include a return spring configured to return firing trigger 930 to its unactuated position. As also shown in FIG. 43, firing bar 936a remains in its firing position when firing trigger 930 is returned to its unactuated position. 44, pusher block 980 can be moved to its second position to disengage pusher block 980 from staple firing bar 936a and engage pusher block 980 with tissue cutting bar 936b. can. Activation of firing trigger 930 may then advance tissue cutting bar 936b distally to cut tissue, but the surgeon has the option of not cutting tissue and a second actuation of firing trigger 930 Tissue may be released from the end effector without Handle 910 may include a release mechanism configured to return closure trigger 620 and closure system to their unfired positions. In any event, instrument 900 can include one or more return springs and/or return mechanisms for resetting bars 936a, 936b to their unactuated positions. In at least one instance, bars 936a, 936b can reset when re-opening the end effector.

As described above, staple firing bar 936a remains in its distal firing position while firing trigger 930 is reactivated to drive tissue cutting bar 936b distally. In various instances, firing bar 936a may remain in its firing position due, for example, to frictional forces between firing bar 936a and the frame of instrument 900, but such frictional forces can be overcome and Firing bar 936a can be pushed proximally. Referring now to FIG. 45, in certain instances, the staple firing bar and/or the tissue cutting bar has an actuated, or at least partially actuated, position for affirmatively retaining the bar. may include means.

In addition to the above, in at least one exemplary embodiment, surgical instrument 1000 includes handle 1010 including handle housing 1011 . Instrument 1000 further comprises staple firing bar 1036a configured to eject and deform staples removably stored within an end effector of instrument 1000 when firing bar 1036a is pushed distally. Instrument 1000 also includes a tissue cutting bar 1036b configured to cut tissue captured within the end effector of instrument 1000 . Handle 1010 includes a lock 1090 configured, for example, to hold firing bar 1036a in place while actuating cutting bar 1036b. Lock 1090 includes a first end attached to handle housing 1011 and a second or cantilevered end 1092 engaged with rack 1093a of firing bar 1036a. Rack 1093a allows firing bar 1036a to move distally relative to lock 1090, and until lock 1090 is released from firing bar 1036a, as shown in FIG. a longitudinal array of teeth configured to prevent proximal movement relative to the .

In addition to the above, lock 1090 continuously positions itself behind each tooth of rack 1093a as firing bar 1036a passes lock 1090. FIG. If the surgeon pauses the advancement of firing bar 1036a at any point during the firing stroke of firing bar 1036a, lock 1090 can hold firing bar 1036a in place until the firing stroke is restarted. After the staple firing stroke is completed, lock 1090 is positioned behind the most proximal tooth of firing bar 1036a. At this point, lock 1090 is held in engagement with firing bar 1036a by tissue cutting bar 1036b. Cutting bar 1036b includes a rack 1093b defined thereon which, in a manner similar to that described above, supports distal movement of cutting bar 1036b relative to lock 1090, as shown in FIG. 48, configured to allow and prevent cutting bar 1036b from moving proximally relative to lock 1090 until cutting bar 1036b completes its cutting stroke, as shown in FIG. Contains directional array teeth. At this point, lock 1090 can slide off the ends of firing bar 1036a and cutting bar 1036b and disengage from bars 1036a and 1036b.

In addition to the above, the lock 1090 is configured such that after the racks 1093a and 1093b have passed the lock 1090, the lock 1090 can elastically deploy and disengage itself from the bars 1036a and 1036b. It is held in the bent configuration by 1036a and 1036b. Rack 1093a is defined on flexible cantilever 1094a extending proximally from firing bar 1036a, and rack 1093b is defined on flexible cantilever 1094b extending proximally from cutting bar 1036b. Racks 1093 a and 1093 b are configured to flex in cooperation with lock 1090 . In any event, bars 1036a and 1036b can return to their inoperative positions after lock 1090 is disengaged from racks 1093a and 1093b, respectively. In various instances, one or more return springs can be associated with bars 1036a and 1036b to return bars 1036a and 1036b to their unactuated positions.

49, instrument 1000 may, for example, disengage lock 1090 from firing bar 1036a and/or cutting bar 1036b prior to completion of the firing stroke and/or cutting stroke of instrument 1000. Actuator A reset actuator such as 1190 may be included. Actuator 1190 includes a first end 1191 rotatably mounted to the handle housing via pivot pin 1193 and, in addition, a second end 1192 configured to engage lock 1090 . . A push button 1194 is operatively engaged with a first end 1191 of the actuator 1190 such that depression of the push button 1194 causes a second end 1192 of the actuator 1190 to rotate as shown in FIG. is configured to engage lock 1090 by In such instances, actuator 1190 flexes second end 1092 of lock 1090 away from bars 1036a and 1036b to disengage lock 1090 from racks 1093a and 1093b. At this point, bars 1036a and 1036b can be retracted to their inoperative positions. Such a release actuation system may allow instrument 1000 to be quickly released and unclamped from tissue at any suitable time during operation of instrument 1000 . Push button 1194 can be depressed to release lock 1090 during, after the firing stroke, during the cutting stroke, and/or after the cutting stroke.

Referring to FIGS. 50-53, surgical instrument 1200 comprises an end effector 1250 and a closure system configured to close end effector 1250 . End effector 1250 includes staple cartridge 1260 and anvil 170 . Staple cartridge 1260 includes a cartridge body 161, a plurality of staple cavities defined within the cartridge body, and staples removably stored within the staple cavities. Staple cartridge 1260 is movable toward anvil 170 between an open position (FIG. 50) and a closed position (FIG. 51) to compress tissue between cartridge body 161 and anvil 170 . Instrument 1200 further comprises closure bar 126 attached to cartridge body 161 . Closure bar 126 can be advanced distally to move staple cartridge 1260 distally and retracted proximally to move staple cartridge 1260 proximally. End effector 1250 further includes guide rails 168 configured to guide staple cartridge 1260 along the longitudinal axis in moving staple cartridge 1260 proximally and distally.

Referring primarily to FIGS. 50 and 51 , distal advancement of closure bar 126 also distally advances tissue pin 379 to capture tissue within end effector 1250 . More specifically, closure bar 126 includes a drive pin 128a extending laterally therefrom that actuates one or more tissue pins as closure bar 126 moves distally. It is configured to engage actuator 372 . Tissue pin actuator 372 is rotatably mounted to shaft frame 114 about pivot pin 118 and is movable between a non-actuated position (Fig. 50) and an actuated position (Fig. 51). Each tissue pin actuator 372 includes a drive portion 373 configured to engage and push against a base 374 of tissue pin 379 . Tissue pin 379 is slidably retained within cavity 378 defined within end effector 1250 such that movement of tissue pin 379 is restricted to a longitudinal path. Anvil 170 includes a pin opening 179 defined therein configured to receive tissue pin 379 when tissue pin 379 reaches its fully deployed position. .

In addition to the above, staple cartridge 1260 moves toward anvil 170 before tissue pins 379 are deployed. In such instances, the tissue is clamped sequentially and then captured within the end effector 1250, but an alternative is where the tissue is simultaneously clamped by the cartridge 1260 and captured within the end effector 1250 by the tissue pin 379. Embodiments are also envisioned. Other embodiments are also envisioned in which tissue pins 379 are deployed before staple cartridge 1260 moves distally to compress tissue.

In addition to the above, staple cartridge 1260 further includes staple driver 162 configured to drive staples toward anvil 170 . Anvil 170 includes forming pockets 171 defined therein, which are configured to deform staples. Staple driver 162 is pushed distally by firing bar 1236, as described in more detail below. 50 and 51, closure bar 126 further includes a second drive pin 128b extending laterally therefrom which engages firing bar 1236 to allow cartridge 1260 to penetrate tissue. Firing bar 1236 is configured to move distally with cartridge 1260 as it moves distally to clamp the . In this manner, the relative position of firing bar 1236 and staple cartridge 1260 can be maintained, or at least substantially maintained, during closure of end effector 1250 .

Firing bar 1236 does not push staple driver 162 directly; rather, firing bar 1236 directly pushes intermediate driver 1263 that transmits movement of firing bar 1236 to staple driver 162 . More specifically, intermediate driver 1263 includes a plurality of drive arms 1264 extending distally therefrom that contact drive surfaces 1265 defined on the proximal side of staple driver 162 . ing. As shown in FIG. 52, as firing bar 1236 is advanced distally to deform staples against anvil 170, drive arm 1264 exerts force between firing bar 1236 and staple driver 162. to communicate.

Each of drive arms 1264 is rotatably connected to intermediate driver 1263 about pivot pin 1266 . Each drive arm 1264 is constructed and arranged to transmit a certain amount of force to staple driver 162 such that when the force transmitted by drive arm 1264 exceeds a threshold force, drive arm 1264 will It can be rotated into a folded position as shown in . The threshold force is selected to match the force required to deform the staples to their formed or fired configuration, but a range of forces may be required to deform the staples to their preferred post-form height. may be suitable, and that the threshold force may be anywhere within or beyond this preferred range. In any event, folding of drive arm 1264 allows intermediate driver 1263 to move toward or toward staple driver 162 , at which point staple driver 162 moves toward anvil 170 . You can stop doing it. Further, at this point, the staple firing process is complete and the now enabled relative motion between intermediate driver 1263 and staple driver 162 is utilized to deploy the cutting member or knife toward anvil 170. and the tissue is cut. The cutting stroke of the knife begins when drive arm 1264 begins to fold and ends when drive arm 1264 contacts bearing surface 1239 defined on intermediate driver 1263 . As a result of the above, the tissue cutting motion is separate and distinct from the staple firing motion. Further, the staple firing motion and the tissue cutting motion are performed sequentially and without overlapping. Such placement prevents traversing of tissue before the staples are fully formed.

The reader will appreciate that the operator of surgical instrument 1200 may retract firing bar 1236 to its unfired position at any time during the staple firing operation of instrument 1200 . More specifically, firing bar 1236 can be returned proximally until it contacts second drive pin 128b of closure bar 126 . The reader will also appreciate that the surgical instrument operator may open end effector 1250 and move staple cartridge 1260 away from anvil 170 at any time during the staple firing operation of instrument 1200 . Nevertheless, instrument 1200 includes a lockout system configured to prevent end effector 1250 from being released during a tissue cutting operation. Further, the knife member must be fully retracted by firing bar 1236 before tissue pin 379 can be retracted and/or before end effector 1250 can be released. Such a lockout system is depicted in Figures 51-53.

Referring to FIG. 51, each drive arm 1264 of the staple firing system includes a locking pin 1267 extending therefrom. Each locking pin 1267 is positioned within a locking slot defined within cartridge body 161 , each locking slot including a first portion 1268 and a second portion 1269 . As discussed in more detail below, locking pin 1267 is positioned within first portion 1268 during staple forming operations and within second portion 1269 during tissue cutting operations. During the staple forming operation of instrument 1200, locking pin 1267 slides distally within locking slot first portion 1268 as shown in FIG. In effect, locking pin 1267 is moved proximally and distally within first portion 1268 to selectively advance and retract firing bar 1236 during the staple forming operation, as described above. can make it possible. Further, such movement of pin 1267 within first portion 1268 proximally moves staple cartridge 1261 away from anvil 170 of instrument 1200 to open end effector 1250, also as described above. Allows selective movement to the side. However, during a tissue cutting operation, locking pin 1267 enters second portion 1269 of locking slot. At this point, sidewalls of second portion 1269 prevent cartridge body 161 from retracting relative to firing bar 1236 . In this manner, staple cartridge 1260 is locked in place when the cutting members are or may be exposed. In such instances, the end effector 1250 cannot be released until the cutting member is retracted, or at least fully retracted. The cutting member retracts when firing bar 1236 is pulled proximally. As firing member 1236 is pulled proximally, locking pin 1267 moves from locking slot second portion 1269 to locking slot first portion 1268 , unlocking cartridge body 161 . At this point, locking pin 379 can be retracted and/or end effector 1250 can be released.

An alternative embodiment of the tissue stapling and cutting mechanism of surgical instrument 1300 is shown in FIGS. 54-56. Instrument 1300 includes staple cartridge jaws 1360 that first include a plurality of staple drivers 1362 configured to eject staples from staple cartridge 1360 to staple tissue; Second, a knife member 1367 configured to cut tissue. Staple driver 1362 and knife member 1367 are deployed by firing member 1336, although the deployment of staple driver 1362 and knife member 1367 is staggered, as described below. Firing member 1336 includes a rack of teeth 1369 that moves or translates distally in direction D to deploy staple driver 1362 and knife member 1367 . Instrument 1300 further comprises gear train 1366 including a plurality of rotatable gears operatively engaged or meshed with rack 1369 . Rack 1369 and gear train 1366 are configured to convert translational motion of firing member 1336 to rotational motion of gear train 1366 .

Gear train 1366 includes first and second output gears 1368 . Each output gear 1368 is mounted on shaft 1363 such that shaft 1363 and gear 1368 rotate together. Gear train 1366 further includes staple firing output cams 1364 a , 1364 b mounted on each of shafts 1363 . In the embodiment shown, each shaft 1363 includes first and second staple deploying cams 1364a mounted thereon that rotate with shaft 1383. As shown in FIG. Each cam 1364 a includes an indented surface configured to engage a drive surface 1365 a defined on the bottom of staple driver 1362 . As cam 1364a is rotated by shaft 1363, the cam profile changes between a first orientation (FIG. 54) associated with the unfired position of staple driver 1362 and a second orientation (FIG. 54) associated with the fired position of staple driver 1362. 55). The first orientation and the second orientation are, for example, approximately 180 degrees apart. Such movement of cam 1364a and staple driver 1362 constitutes the firing stroke of instrument 1300, with the apex of cam 1364a being driven when staple driver 1362 reaches the end of the firing stroke, as shown in FIG. It is in contact with surface 1365a.

In addition to the above, although instrument 1300 includes four staple firing cams 1364a, any suitable number of cams 1364a may be utilized. Four staple firing cams 1364a are positioned and arranged with respect to drive surface 1365a to provide a balanced or symmetrical firing load to staple driver 1362 . 54 and 55, the reader will appreciate that staple firing cam 1364a moves staple driver 1362 relative to knife member 1367. FIG. Knife member 1367 is deployed independently of staple driver 1362, as described below.

Gear train 1366 further includes tissue-cutting output cams 1364 b mounted on each of shafts 1363 . Cam 1364 b is configured to deploy knife member 1367 . Similar to above, cam 1364b rotates between a first orientation (FIG. 54) and a second orientation (FIG. 55) during the staple firing process described above, but cam 1364b rotates staples during this rotation. Do not push the driver 1362 or knife member 1367 distally. Referring now to FIG. 56, subsequent rotation of shaft 1363 and cam 1364b causes cam 1364b to engage drive surface 1365b of knife member 1367, which pushes knife member 1367 distally, causing the stapled tissue to collapse. is disconnected. Such subsequent rotation also rotates the apex of staple firing cam 1364a out of engagement with drive surface 1365a. In such instances, staple driver 1362 can float or retract back to staple cartridge 1360 as tissue is being cut.

As discussed above, cams 1364a and 1364b are positioned and arranged on shaft 1363 such that staple firing motions and tissue cutting motions do not occur simultaneously. In some cases, cams 1364a and 1364b may be positioned such that there is a pause between staple firing and tissue cutting motion. In at least one such instance, cams 1364a and/or cams 1364b can include dwells that provide a pause between the staple firing motion and the tissue cutting motion. Such a pause can give the surgeon the opportunity to stop motion of instrument 1300 between the staple firing stroke and the tissue cutting stroke. In alternative embodiments, cams 1364a and 1365b may be positioned and arranged on shaft 1363 such that there is overlap between the staple firing motion and the tissue cutting motion. Such overlap allows for high speed actuation of the instrument.

An alternative embodiment of the tissue stapling and cutting mechanism of surgical instrument 1400 is shown in FIGS. 57-59. Instrument 1400 includes a cartridge body 1461, a plurality of staple drivers 1462 configured to eject staples from cartridge body 1461 to staple tissue, and a knife member 1467 configured to incise tissue. staple cartridge jaws 1460 including; Staple driver 1462 and knife member 1467 are deployed by firing member 1436, although the deployment of staple driver 1462 and knife member 1467 is staggered, as described below. Staple driver 1462 and knife member 1467 move distally between a first or non-actuated position (FIG. 57) and a second position (FIG. 58) corresponding to the end of the staple firing process. . Knife member 1467 is then movable relative to staple driver 1462 to a third position shown in FIG.

In addition to the above, firing member 1436 includes an angled drive surface 1464 defined thereon. In use, staple driver 1462 and knife member 1467 are pushed distally by drive surface 1464 to fire staples from cartridge body 1461 . More specifically, drive surface 1464 pushes knife member 1467 distally, which in turn pushes staple driver 1462 distally, at least during the staple firing process. Knife member 1467 includes rollers 1465 a and 1465 b in contact with ramp surface 1464 . Rollers 1465a and 1465b are rotatably mounted to knife member 1467 about drive pins 1469a and 1469b, respectively. Drive pins 1469a and 1469b are positioned within drive slots 1463a and 1463b, respectively, defined in frame 1468 that connects staple driver 1462. FIG. Drive pins 1469 a , 1469 b are configured to bear against distal sidewalls of drive slots 1463 a , 1463 b , respectively, when knife member 1467 is pushed distally by firing member 1436 . In this manner, staple firing force is transferred from firing bar 1436 to staple driver 1462 via drive ramp 1464, rollers 1465a, 1465b, drive pins 1469a, 1469b, and drive slots 1463a, 1463b. Distal travel of staple driver 1462 is limited, for example, by stop surface 1466 defined within cartridge body 1461 . When staple driver frame 1468 contacts stop surface 1466 (see FIG. 58), the firing stroke of instrument 1400 is completed. At this point, only a portion of the cutting surface of knife member 1467 is out of cartridge body 1461, but tissue is not yet exposed to the cutting surface. More specifically, the opposing jaw or anvil of staple cartridge 1460 may include cavities configured to receive the emerging portion of the cut surface, resulting in a severance at this point in the operation of instrument 1400. The likelihood of knife member 1467 cutting tissue is reduced.

As described above, distal travel of staple driver 1462 and knife member 1467 is limited by stop surface 1466 at the end of the firing stroke, so that further distal or longitudinal motion of firing bar 1436 is restricted to staple driver 1462 and knife member 1467. Distal or longitudinal motion of 1462 and knife member 1467 is no longer translated. Alternatively, referring to FIG. 59, further distal movement of firing bar 1436 translates into lateral movement of knife member 1467 . More specifically, further distal movement of ramp surface 1464 generates a reaction force between knife member 1467 and the now static driver frame 1468, which causes knife member 1467 to tilt downward. Lateral displacement along surface 1464 . Lateral movement of knife member 1467 is facilitated by rollers 1465a, 1465b, but knife member 1467 undergoes continued distal movement of firing member 1436 without the assistance of rollers 1465a, 1465b to drive tilt. It may slide along surface 1464 .

In addition to the above, knife member 1467 cuts stapled tissue as it moves laterally through staple cartridge 1460 . Knife member 1467 is offset along a cutting axis that is transverse to the longitudinal firing axis defined by the motion of firing member 1436 . The cutting axis is orthogonal, or at least substantially orthogonal, to the firing axis, although any suitable arrangement can be utilized. Further to the above, the cutting stroke of knife member 1467 begins at the end of the firing stroke of driver 1462, but it is recalled that a delay may be provided between the cutting stroke and the firing stroke.

Many of the surgical instruments disclosed herein utilize a single firing bar to actuate the staple deployment system and tissue cutting system. Such instruments may benefit from the use of audible and/or tactile feedback that can inform the user of the surgical instrument of specific information regarding the current operational state of the surgical instrument. be. In at least one example, the firing bar of the surgical instrument includes a first array of teeth and a second array of teeth slidable relative to one or more click elements within the handle of the surgical instrument. It may contain an array of teeth. During a staple firing operation of the surgical instrument, the interaction of the teeth of the first array with the click element may generate a clicking sound and/or vibration. The teeth of the first array can be positioned on the firing bar such that feedback occurs near the end of the firing stroke, for example. With such feedback, the surgeon slows the advancement of the firing bar, e.g., when intending to at least pause operation of the surgical instrument between staple firing and tissue cutting modes of operation. be able to. Alternatively, the surgeon may choose not to cut tissue. A second array of teeth can be positioned on the cutting bar such that feedback occurs near the end of the cutting stroke, for example. In certain embodiments, an array of teeth may be positioned on the firing bar such that feedback occurs between staple firing and tissue cutting modes of operation. The feedback described above can also be utilized with instruments that include a staple firing bar and a separate tissue cutting bar.

A surgical instrument 1500 is disclosed in FIGS. 61-64. Instrument 1500 includes a shaft 1540 and a circular end effector 1550 that is utilized, for example, for stapling and traversing lumens. [Incorporated by reference. ] End effector 1550 includes a staple cartridge 1560 that includes a circular cartridge body 1561 and a plurality of staples removably stored in the cartridge body 1561 in a circular array. Staple cartridge 1560 further includes staple driver 1562 configured to eject staples from cartridge body 1561 . Staple drivers 1562 are also arranged in a circular array and connected to a common drive frame, although any suitable arrangement can be utilized. For example, staple drivers 1562 may not be connected to each other. End effector 1550 further includes circular anvil 1570 configured to compress a portion of the lumen against cartridge body 1561 . Anvil 1570 is attached to closure actuator 1526 that extends through shaft 1540 . Closure actuator 1526 is configured to move anvil 1570 toward and away from staple cartridge 1560 between a clamped position and a clamped release position. Figures 61-64 all show the anvil 1570 in the clamped position. Anvil 1570 further includes a circular array of forming pockets 1571 configured to deform the staples as they are ejected from staple cartridge 1560 .

Surgical instrument 1500 further comprises a cutting member 1567 configured to dissect tissue captured between anvil 1570 and staple cartridge 1560 . In use, staple driver 1562 drives staples against anvil 1570 during the staple forming process (FIG. 61) and cutting member 1567 cuts tissue during the tissue cutting process (FIG. 63). Embodiments in which the staple forming process and the tissue cutting process occur sequentially, with no overlap between them, but the staple forming process and the tissue cutting process can occur simultaneously, or at least partially simultaneously, as described below. is also assumed.

In addition to the above, and referring primarily to FIG. 60, when anvil 1570 is moved to its clamped position, staple driver 1562 and cutting member 1567 are retracted within end staple cartridge 1560 in an inoperative position. be done. 61, staple driver 1562 and cutting member 1567 are then moved distally by firing member 1536 during the staple forming process to deform the staples. More specifically, distal end 1538 of firing member 1536 engages washer 1539 positioned intermediate firing member 1536 and driver 1562 and cutting member 1567 , which in turn engages driver 1562 . and cutting member 1567 . The firing stroke of staple driver 1562 ends when driver 1562 contacts the proximal side of cartridge body 1561 . Notably, cutting member 1567 does not come out of cartridge body 1561 during the staple forming process. Rather, cutting member 1567 remains positioned within cartridge body 1561 during the staple forming process even as it is moved toward anvil 1570 .

Once the staple driver 1562 is bottomed-out with respect to the cartridge body 1561, the surgeon can understand that the staple forming process is complete. At this point, the surgeon may then, at his option, retract firing member 1536 and skip the tissue cutting step. Alternatively, the surgeon may apply a force on firing member 1536 to break washer 1539, as shown in FIG. This pushing force exceeds the force required to fire the staples. As a result, the surgeon will notice a significant increase in the force required to advance firing member 1536 beyond the end of the staple firing stroke. When firing member 1536 is driven by a manually operated actuator, the surgeon is forced to voluntarily choose to increase the force applied to firing member 1536 to initiate a tissue cutting stroke. be. Washer 1539 may be constructed to withstand forces up to a threshold force, and distal end 1538 of firing member 1536 may be pushed through washer 1539 once the threshold force is met or exceeded.

In addition to the above, in certain instances, washer 1539 may be constructed to break or fail suddenly when a threshold force applied to washer 1539 is met. In at least one such instance, washer 1539 can include weakened portions, such as annular groove 1537, that facilitate failure of washer 1539 in defined areas. In some cases, distal end 1538 of firing member 1536 may include a cut across washer 1539 . In any event, washer 1539 can act as a fuse that must fail before the cutting stroke can begin.

Once washer 1539 has been broken, traversed, or otherwise broken (see FIG. 63), washer 1539 is divided into two separate parts, namely a second cleaver that can be pushed distally by firing member 1536 . It will include one portion 1539a and a remaining second portion 1539b. The groove 1537 is intermediate the first portion 1539a and the second portion 1539b of the washer 1539 . Groove 1537 makes washer 1539 brittle enough that washer 1539 breaks if a suitable level of force is applied to washer 1539 . In at least one instance, washer 1539 is made of plastic, for example. First washer portion 1539a is urged distally by firing member 1536 to move cutting member 1567 distally to complete the cutting stroke of instrument 1500 .

In addition to or in place of a manually operated actuator, instrument 1500 may include an electric motor configured to drive firing member 1536 . Such a system includes at least one sensor configured to detect the load experienced by the firing member; A controller in communication with the sensor and electric motor may also be utilized. Such a system can recognize that the staple driver 1562 has run out and pause the electric motor in response. Such a pause may allow the surgeon to choose whether to open the anvil 1570 after the staple firing process or instruct the controller to perform the tissue cutting process. Instrument 1500 may include a first button that can be actuated, for example, by a surgeon to open anvil 1570, and a second button that can be actuated, for example, by a surgeon to perform a tissue cutting process. good.

In addition to the foregoing, each surgical instrument disclosed herein includes one or more manually operated triggers and/or one or more motorized triggers for operating the instrument. It can include or be modified to include a motor. Surgical instruments 100, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1200, 1300, 1400, and 1500 transmit force between a closure trigger and an end effector of the surgical instrument. A manually operated closure system may be included. For example, instrument 100 includes a manually operated closure system configured to transmit rotation of closure trigger 120 to end effector 150 . In alternative embodiments, any of the instruments disclosed herein may include an electric motor configured to operate the closure system of the instrument. Similar to the above, the instrument is configured to operate the electric motor in response to one or more inputs from the surgeon and/or data received from one or more sensors of the instrument. It may further include a controlled control system.

Additionally or alternatively, surgical instruments 100, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1200, 1300, 1400, and 1500 may include a firing trigger and end of the surgical instrument. A manually operated firing system may be included to transmit force to and from the effector. For example, instrument 100 includes a manually operated firing system configured to transmit rotation of firing trigger 130 to end effector 150 . In alternative embodiments, any of the instruments disclosed herein may include an electric motor configured to operate the instrument's firing system. Similar to the above, the instrument is configured to operate the electric motor in response to one or more inputs from the surgeon and/or data received from one or more sensors of the instrument. It may further include a controlled control system.

Surgical instruments 100, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1200, 1300, and 1400 make one or more large incisions to access a surgical site within a patient. The reader will understand that is often used during surgical procedures performed on patients. Such surgical procedures are often referred to as "open" surgical procedures. The teachings provided herein are adaptable, for example, to surgical procedures in which instruments are inserted through one or more trocars or cannulas that provide access into the patient's body through smaller incisions. Open surgical procedures often provide the surgeon with a better view of the surgical site, and laparoscopic surgical procedures often leave smaller scars on the patient's body. Instrument 1500 is insertable through a natural orifice such as, for example, the patient's anus. The teachings provided herein are adaptable to surgical procedures in which instruments are inserted through one or more natural orifices of a patient.

The staples of surgical instruments 100, 200, 300, 400, 500, 600, 700, 800, 900, 1000, 1200, 1300, 1400, and 1500 are defined longitudinally, i.e., by the shaft of the surgical instrument. It will be understood by the reader to be deployed along, parallel to, or substantially parallel to the longitudinal axis. Other embodiments are envisioned in which staples are deployed along one or more axes transverse to the longitudinal axis. 64 and 65 disclose one such exemplary surgical instrument, namely surgical instrument 1600. FIG. Surgical instrument 1600 includes staple cartridge jaws 1660 and anvil jaws 1670 . Staple cartridge jaws 1660 and/or anvil jaws 1670 are movable to clamp tissue therebetween. Staple cartridge jaw 1660 includes a cartridge body 1661 that includes a plurality of staple cavities defined therein. Cartridge jaw 1660 further includes a plurality of staples 1669 removably stored within staple cavities and a plurality of staple drivers 1662 configured to eject staples 1669 from the staple cavities. Instrument 1600 further comprises firing bar 1636 that is distally moveable to lift staple driver 1662 and staples 1669 toward anvil jaws 1670 . Anvil jaw 1670 includes staple forming pockets 1671 configured to deform staples 1669, as shown in FIGS. The teachings provided herein are adaptable to surgical instrument 1600 and the like.

A surgical stapling system can comprise a shaft and an end effector extending from the shaft. The end effector has a first jaw and a second jaw. The first jaw includes a staple cartridge. the staple cartridge is insertable into and removable from the first jaw, but the staple cartridge is not removable from the first jaw, or at least not easily replaceable; Other embodiments are also envisioned. The second jaw includes an anvil configured to deform staples ejected from the staple cartridge. The second jaw is pivotable relative to the first jaw about the closure axis, while the first jaw is pivotable or movable relative to the second jaw. , other embodiments are also envisioned. The surgical stapling system further includes an articulation joint configured to allow the end effector to rotate or articulate with respect to the shaft. The end effector is rotatable about an articulation axis that extends through the articulation joint. Other embodiments are envisioned that do not include articulated joints.

The staple cartridge has a cartridge body. The cartridge body includes a proximal end, a distal end, and a deck extending between the proximal and distal ends. In use, the staple cartridge is positioned on a first side of the tissue to be stapled and the anvil is positioned on a second side of the tissue. The anvil is moved toward the staple cartridge to compress and clamp tissue against the deck. Staples removably stored within the cartridge body can then be deployed into tissue. The cartridge body includes a staple cavity defined therein, and staples are removably stored within the staple cavities. The staple cavities are arranged in six longitudinal rows. Three rows of staple cavities are positioned on a first side of the longitudinal slot and three rows of staple cavities are positioned on a second side of the longitudinal slot. Other arrangements of staple cavities and staples may also be possible.

The staples are supported by staple drivers within the cartridge body. The driver is movable between a first or unfired position and a second or fired position that ejects staples from the staple cavities. The driver is retained within the cartridge body by a retainer extending around the bottom of the cartridge body and includes a resilient member configured to grip the cartridge body and retain the retainer against the cartridge body. . The drivers are moveable between their unfired position and their fired position by a sled. The sled is movable between a proximal position adjacent the proximal end and a distal position adjacent the distal end. The sled slides under the driver and includes a plurality of ramps configured to lift the driver, with staples supported thereon, toward the anvil.

In addition to the above, the sled is moved distally by the firing member. A firing member is configured to contact the sled and push the sled toward the distal end. A longitudinal slot defined within the cartridge body is configured to receive the firing member. The anvil also includes a slot configured to receive the firing member. The firing member further comprises a first cam engaging the first jaw and a second cam engaging the second jaw. In advancing the firing member distally, the first cam and the second cam can control the distance between the deck of the staple cartridge and the anvil, ie, the tissue gap. The firing member also includes a knife configured to cut tissue captured intermediate the staple cartridge and the anvil. Desirably, the knife is positioned at least partially proximal to the ramp so that the staples are ejected forward of the knife.

Although the surgical instrument systems described herein are described in connection with the deployment and deformation of staples, the embodiments described herein are not so limited. Various embodiments are also envisioned that deploy fasteners other than staples, such as clamps or tacks. Further, various embodiments are envisioned utilizing any suitable means for sealing tissue. For example, an end effector according to various embodiments may include electrodes configured to heat and seal tissue. Also for example, an end effector according to certain embodiments can apply vibrational energy to seal tissue.

Example 1 - A surgical stapler for treating tissue of a patient comprising a handle, a shaft extending from the handle, and an end effector extending from the shaft, the end effector being configurable in an open configuration and a closed configuration . The end effector has a first jaw, a second jaw movable toward the first jaw to place the end effector in a closed configuration, and a staple. A cartridge body including a cavity, staples removably stored within the staple cavities, and an anvil configured to deform the staples. The surgical stapler includes a closure system configured to move the second jaw toward the first jaw, and a firing system to move the staples from the staple cavities toward the anvil during the firing stroke. a firing driver configured to eject; and a cutting member configured to cut tissue during a cutting stroke and retract the cutting member during a retraction stroke. The system and means for preventing the end effector from being returned to the open configuration until the retraction stroke is completed.

[0033] Example 2 - The surgical stapler of Example 1, wherein the means allows the end effector to be returned to the open configuration during the firing stroke.

[0036] Example 3 - The surgical stapler of Examples 1 or 2, wherein the means allows the end effector to be returned to the open configuration after the firing stroke is completed and before the cutting stroke is initiated.

Example 4 - A tissue pin movable between an undeployed position and a deployed position, wherein the tissue pin is configured to capture tissue within an end effector; a tissue pin actuator extending between the deployed position and the deployed position and configured to withdraw the tissue pin toward the undeployed position during the withdrawal stroke; 4. The surgical stapler of example 1, 2, or 3, wherein the surgical stapler prevents withdrawal toward an undeployed position.

Example 5 - A tissue pin movable between an undeployed position and a deployed position, wherein the tissue pin is configured to capture tissue within the end effector and the tissue pin is undeployed during the deployment stroke. a tissue pin actuator extending between the deployed position and the deployed position and configured to withdraw the tissue pin toward the undeployed position during the withdrawal stroke; The surgical stapler of example 1, 2, or 3, wherein the surgical stapler is prevented from being withdrawn toward the undeployed position.

Example 6 - A surgical stapler for treating tissue of a patient, comprising a handle, a shaft extending from the handle, and an end effector extending from the shaft, the end effector being configurable in an open configuration and a closed configuration is a surgical stapler. The end effector has a first jaw and a second jaw movable toward the first jaw to place the end effector in a closed configuration and a staple. A cartridge body including a cavity, staples removably stored within the staple cavities, and an anvil configured to deform the staples. The surgical stapler includes a closure system configured to move the second jaw toward the first jaw, and a firing system to move the staples from the staple cavities toward the anvil during the firing stroke. a driver configured to eject; and a cutting member configured to cut tissue during the cutting stroke, the cutting member including a cutting edge exposed from the cartridge body during the cutting stroke. , a firing system, and means for preventing the closure system from being returned to the open configuration while the cutting member is exposed.

[00100] Example 7 - The surgical stapler of Example 6, wherein the means allows the end effector to be returned to the open configuration during the firing stroke.

[00100] Example 8 - The surgical stapler of Example 6 or 7, wherein the means allows the end effector to be returned to the open configuration after the firing stroke is completed and before the cutting stroke is initiated.

[00103] Example 9 - The surgical stapler of Example 6, 7, or 8, wherein the means allows the end effector to be returned to the open configuration after the firing stroke is completed and before the cutting member is exposed.

Example 10 - A tissue pin movable between an undeployed position and a deployed position, the tissue pin configured to capture tissue within an end effector; a tissue pin actuator extending between the deployed position and the deployed position and configured to withdraw the tissue pin toward the undeployed position during the withdrawal stroke, the means wherein the cutting member is exposed; The surgical stapler of example 6, 7, 8, or 9, wherein the tissue pin is prevented from being withdrawn toward the undeployed position in the meantime.

Example 11 - A tissue pin movable between an undeployed position and a deployed position, the tissue pin being configured to capture tissue within an end effector; a tissue pin actuator extending between the deployed position and the deployed position and configured to withdraw the tissue pin toward the undeployed position during the withdrawal stroke; The surgical stapler of example 6, 7, 8, or 9, wherein the surgical stapler is prevented from being withdrawn toward the undeployed position.

Example 12 - A surgical stapler for treating tissue of a patient, comprising a handle, a shaft extending from the handle, and an end effector extending from the shaft, the end effector being configurable in an open configuration and a closed configuration is a surgical stapler. The end effector has a first jaw, a second jaw movable toward the first jaw to place the end effector in a closed configuration, and a staple. A cartridge body including a cavity, staples removably stored within the staple cavities, and an anvil configured to deform the staples. The surgical stapler includes a closure system configured to move the second jaw toward the first jaw and a firing system, the staple driver, wherein the firing system comprises: a staple driver configured to push the staple driver toward the anvil immediately and to retract the staple driver during the retraction stroke; and a cutting member configured to cut tissue during the cutting stroke, wherein a cutting member including a cutting edge exposed from the cartridge body during the cutting stroke; and means for preventing retraction of the staple driver while the cutting member is exposed. Prepare more.

[00130] Example 13 - The surgical stapler of Example 12, wherein the means allows the end effector to be returned to the open configuration during the firing stroke.

[00140] Embodiment 14 - The surgical stapler of embodiment 12 or 13, wherein the means allows the end effector to be returned to the open configuration after the firing stroke is completed and before the cutting stroke is initiated.

[00133] Example 15 - The surgical stapler of Example 12, 13, or 14, wherein the means allows the end effector to be returned to the open configuration after the firing stroke is completed and before the cutting member is exposed.

Example 16 - A tissue pin movable between an undeployed position and a deployed position, the tissue pin configured to capture tissue within an end effector; a tissue pin actuator extending between the deployed position and the deployed position and configured to withdraw the tissue pin toward the undeployed position during the withdrawal stroke; 16. The surgical stapler of example 12, 13, 14, or 15, wherein the surgical stapler is prevented from being withdrawn toward the undeployed position.

Example 17 - A tissue pin movable between an undeployed position and a deployed position, the tissue pin configured to capture tissue within an end effector; a tissue pin actuator extending between the deployed position and the deployed position and configured to withdraw the tissue pin toward the undeployed position during the withdrawal stroke; 16. The surgical stapler of example 12, 13, 14, or 15, wherein the surgical stapler is prevented from being withdrawn toward the undeployed position.

Example 18 - A surgical stapler for treating tissue of a patient, comprising a handle, a shaft extending from the handle, and an end effector extending from the shaft, the end effector being configurable in an open configuration and a closed configuration is a surgical stapler. The end effector has a first jaw, a second jaw movable toward the first jaw to place the end effector in a closed configuration, and a staple. a cartridge body including a cavity; staples removably stored within the staple cavities; an anvil configured to deform the staples; and a tissue pin movable between an undeployed position and a deployed position. and a tissue pin configured to capture tissue within the end effector. The surgical stapler includes a closure system configured to move the second jaw toward the first jaw and a tissue pin to move between an undeployed position and a deployed position during the deployment stroke. and a tissue pin actuator configured to retract the tissue pin toward the undeployed position during the retraction stroke; and a firing system, the staple driver, wherein the firing system drives the staple driver during the firing stroke. a staple driver configured to push toward the anvil; and a cutting member configured to cut tissue during the cutting stroke, the cutting member including a cutting edge exposed from the cartridge body during the cutting stroke; and means for preventing retraction of the tissue pin while the cutting member is exposed.

[00190] Example 19 - The surgical stapler of Example 18, wherein the means allows the end effector to be returned to the open configuration during the firing stroke.

[0040] 20 - The surgical stapler of embodiment 18 or 19, wherein the means allows the end effector to be returned to the open configuration after the firing stroke is completed and before the cutting stroke is initiated.

[00333] Example 21 - The surgical stapler of Example 18, 19, or 20, wherein the means allows the end effector to be returned to the open configuration after the firing stroke is completed and before the cutting member is exposed.

Example 22 - A surgical stapler for treating tissue of a patient, comprising a handle, a shaft extending from the handle, and an end effector extending from the shaft, the end effector having a first jaw and a first jaw. A cartridge comprising: two jaws, one of the first jaw and the second jaw being movable with respect to the other of the first jaw; and a staple cavity A surgical stapler including a body, a staple removably stored within a staple cavity, and an anvil configured to deform the staple. The surgical stapler further comprises a firing system configured to eject staples from the staple cavities toward the anvil during the firing stroke and to cut tissue during the cutting stroke after the firing stroke is completed.

[00130] Example 23 - The surgical stapler of Example 22, wherein the firing system includes a firing bar, the firing bar being movable toward the end effector to perform a firing stroke and a cutting stroke.

[0043] 24 - The surgical stapler of 22 or 23, further comprising a stop configured to stop the firing bar after the firing stroke.

[00133] Example 25 - The surgical stapler of Example 24, wherein the stop is manually operable to release the firing member so that the firing member can perform a cutting stroke.

Example 26 - A firing system comprising a staple driver configured to eject staples from a staple cavity and a cutting member configured to cut tissue that travels with the staple driver during the firing stroke to fire 26. The surgical stapler of example 22, 23, 24, or 25, further comprising a cutting member that does not cut tissue during the stroke.

[00103] Example 27 - The surgical stapler of Example 26, wherein the cutting member is coupled to the staple driver during the firing stroke and the cutting member is not coupled to the staple driver during the cutting stroke.

Embodiment 28 - Further comprising a clamp releasably holding the cutting member to the staple driver during the firing stroke of the firing member, the clamp releasing the cutting member from the staple driver when the force transmitted through the firing member exceeds a threshold force 28. The surgical stapler of embodiment 26 or 27, wherein the surgical stapler is configured to:

Example 29 - A Clamp Releasably Holding a Staple Driver to a Cutting Member During the Firing Stroke of the Firing Member, Releasably Holding the Clamp in a Clamped Condition During the Firing Stroke, and Biasing the Clamp Open During the Cutting Stroke 28. The surgical stapler of embodiment 26 or 27, further comprising a clamp limiter configured to disengage the firing member from the firing bar.

Embodiment 30 - The handle includes a firing trigger operably coupled to the firing member, the firing trigger rotatable through a first range of motion and a second range of motion, and the firing trigger having a second range of motion. Examples 22, 23, wherein when moving through one range of motion the firing member moves through a firing stroke and when the trigger moves through a second range of motion the trigger moves the firing member through a cutting stroke; , 24, 25, 26, 27, 28, or 29.

[00313] Example 31 - The surgical stapler of Example 30, wherein the first range of motion is separated with respect to the second range of motion.

[00333] Example 32 - The surgical stapler of Example 30 or 31, wherein the first range of motion and the second range of motion occur during a single actuation of the firing trigger.

Embodiment 33 - Further comprising an indicator configured to provide a first indication when the firing stroke is completed and a second indication when the cutting stroke is completed, the first indication being: The surgical stapler of example 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, or 32, wherein the second indicator is different.

Example 34 - The first indicator comprises one of a visual indicator, an auditory indicator, and a tactile indicator, and the second indicator comprises one of a visual indicator, an auditory indicator, and a tactile indicator 34. The surgical stapler of Example 33, comprising one of:

[00430] Example 35 - The surgical stapler of example 30, wherein the first range of motion occurs during one actuation of the firing trigger and the second range of motion occurs during another actuation of the firing trigger.

Example 36 - An indicator configured to provide a first indication when one actuation of the firing trigger is completed and a second indication when another actuation of the firing trigger is completed 31. The surgical stapler of example 30, further comprising: the first indicator is different than the second indicator.

Example 37 - Example 22 wherein the firing system includes a firing bar configured to eject staples from staple cavities during a firing stroke and a knife bar configured to cut tissue during a cutting stroke , 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, or 36.

Example 38 - A firing system further comprising a firing trigger, wherein a firing bar is driven toward the end effector during activation of the firing trigger, and a knife bar is driven toward the end effector during activation of the firing trigger , Example 37.

Example 39 - The firing trigger shifts between a first position in which the firing trigger is operatively engaged with the firing bar and a second position in which the firing trigger is operatively engaged with the knife bar The surgical stapler of Example 38, which is possible.

[0040] Embodiment 40 - According to embodiment 38 or 39, further comprising a switching mechanism configured to automatically shift the firing trigger out of engagement with the firing bar and into engagement with the knife bar after the firing stroke surgical stapler.

Example 41 - Further comprising a switching mechanism configured to allow the firing trigger to be manually shifted out of engagement with the firing bar and into engagement with the knife bar after the firing stroke, Example 38, A surgical stapler according to 39 or 40.

Example 42 - The firing system further includes a firing trigger, wherein the firing bar is driven toward the end effector during a first actuation of the firing trigger, and the knife bar is driven toward the end effector during a second actuation of the firing trigger. 38. The surgical stapler of example 37 being driven toward.

Example 43 - The firing system is a firing trigger operatively engaged with the firing bar, wherein actuation of the firing trigger moves the firing bar through the firing stroke, and the knife bar is operatively engaged. 38. The surgical stapler of embodiment 37, further comprising a cutting trigger, wherein actuation of the cutting trigger moves the knife bar through the cutting stroke.

Example 44 - A firing system is provided that activates a surgical stapler after a firing stroke is completed so that a user of the surgical stapler can optionally choose whether or not to perform a cutting stroke with the surgical stapler. Examples 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40 further configured to pause , 41, 42, or 43.

Embodiment 45 - A surgical stapler for treating tissue of a patient, comprising a handle, a shaft extending from the handle, and an end effector extending from the shaft, the end effector having a first jaw and a first jaw. A cartridge comprising: two jaws, one of the first jaw and the second jaw being movable with respect to the other of the first jaw; and a staple cavity A surgical stapler including a body, a staple removably stored within a staple cavity, and an anvil configured to deform the staple. The surgical stapler includes a firing bar configured to eject staples from staple cavities during a firing stroke, a knife bar configured to cut tissue during a cutting stroke, and operatively engaged with the firing bar. a firing trigger, wherein actuation of the firing trigger moves the firing bar through the firing stroke; and a cutting trigger operably engaged with the knife bar, wherein actuation of the cutting trigger moves the knife bar through the cutting stroke. and a disconnect trigger for moving across.

Example 46 - A surgical stapler for treating tissue of a patient, comprising a handle, a shaft extending from the handle, and an end effector extending from the shaft, the end effector having a first jaw and a first jaw. A cartridge comprising: two jaws, one of the first jaw and the second jaw being movable with respect to the other of the first jaw; and a staple cavity A surgical stapler including a body, a staple removably stored within a staple cavity, and an anvil configured to deform the staple. The surgical stapler includes a firing system configured to eject staples from the staple cavities toward the anvil during the firing stroke, a cutting system configured to cut tissue during the cutting stroke, and a firing system comprising: and means for preventing the cutting system from making a cutting stroke until the firing stroke is completed.

Example 47 - A surgical stapler for treating tissue of a patient comprising a handle, a shaft extending from the handle, and an end effector extending from the shaft. the end effector has a first jaw and a second jaw, one of the first jaw and the second jaw being movable relative to the other of the first jaw; A second jaw, a cartridge body including a staple cavity, staples removably stored in the staple cavities, and an anvil configured to deform the staples. The surgical stapler comprises a firing system configured to eject staples from staple cavities toward an anvil during a firing stroke and cut tissue during a cutting stroke after the firing stroke is completed; means for allowing the user of the surgical stapler to select whether or not to perform a cutting stroke with the surgical stapler after the firing stroke.

[00400] Embodiment 48 - The surgical stapler of embodiment 47, further comprising feedback means for indicating when the firing stroke is complete.

[00400] Embodiment 49 - The surgical stapler of embodiment 47 or 48, further comprising feedback means for indicating when the firing system is nearing the end of the firing stroke.

[0054] Embodiment 50 - The surgical stapler of embodiment 47, 48, or 49, further comprising feedback means for indicating when the cutting stroke has been completed.

[0051] Embodiment 51 - The surgical stapler of embodiment 47, 48, 49, or 50, further comprising feedback means for indicating when the firing system is nearing the end of the cutting stroke.

Embodiment 52 - Further comprising a visual indicator bar including a first range and a second range, the first range displaying the progress of the firing stroke and the second range displaying the progress of the cutting stroke , Example 47, 48, 49, 50, or 51.

Example 53 - The means includes a stop configured to stop the firing system after the firing stroke, the stop being selectively releasable by a user of the surgical stapler, Examples 47, 48, 53. A surgical stapler according to 49, 50, 51 or 52.

Embodiment 54 - A surgical stapler for treating tissue of a patient, comprising a handle, a shaft extending from the handle, and an end effector extending from the shaft, the end effector having a first jaw and a first jaw. A cartridge comprising: two jaws, one of the first jaw and the second jaw being movable with respect to the other of the first jaw; and a staple cavity A surgical stapler including a body, a staple removably stored within a staple cavity, and an anvil configured to deform the staple. The surgical stapler has a firing system configured to eject staples from the staple cavities toward the anvil during the firing stroke and to cut tissue during the cutting stroke after the firing stroke is completed. A cutting system and means for pausing the surgical stapler so that a user of the surgical stapler can choose whether or not to perform a cutting stroke with the surgical stapler.

[00103] Embodiment 55 - The surgical stapler of embodiment 54, further comprising feedback means for indicating when the firing stroke is complete.

[00103] Embodiment 56 - The surgical stapler of embodiment 54 or 55, further comprising feedback means for indicating when the firing system is nearing the end of the firing stroke.

[00100] Embodiment 57 - The surgical stapler of embodiment 54, 55, or 56, further comprising feedback means for indicating when the cutting stroke is complete.

[0058] Embodiment 58 - The surgical stapler of embodiment 54, 55, 56, or 57, further comprising feedback means for indicating when the cutting system is nearing the end of the cutting stroke.

Embodiment 59 - Further comprising a visual indicator bar including a first range and a second range, the first range displaying the progress of the firing stroke and the second range displaying the progress of the cutting stroke , embodiment 54, 55, 56, 57, or 58.

Example 60 - Firing, wherein the firing system is a firing trigger and a firing bar operatively engaged with the firing trigger, wherein actuation of the firing trigger advances the firing member toward the end effector during the firing stroke 60. The surgical stapler of example 54, 55, 56, 57, 58, or 59, comprising a bar and a tactile feedback generator engaged with the firing bar.

[00103] Example 61 - The surgical stapler of example 60, wherein the tactile feedback generator is configured to generate a series of sounds that progressively increase in intensity as the firing stroke progresses.

Example 62 - The surgical stapler of Example 60 or 61, wherein the tactile feedback generator is silent during the first portion of the firing stroke and audible during the second portion of the firing stroke .

[00103] Example 63 - The surgical stapler of example 60, 61, or 62, wherein the tactile feedback generator is configured to emit a series of sounds at increasing rates as the firing stroke progresses.

Example 64 - The surgical stapler of example 60, 61, 62, or 63, wherein the tactile feedback generator produces tactile feedback when the firing bar reaches the end of its firing stroke.

Example 65 - The means includes a stop configured to stop the firing system after the firing stroke, the stop being selectively releasable by a user of the surgical stapler, Examples 54, 55, 56, 57, 58, 59, 60, 61, 62, 63, or 64. The surgical stapler.

Embodiment 66 - A surgical stapler for treating tissue of a patient, comprising a handle, a shaft extending from the handle, and an end effector extending from the shaft, the end effector having a first jaw and a first jaw. A cartridge comprising: two jaws, one of the first jaw and the second jaw being movable with respect to the other of the first jaw; and a staple cavity A surgical stapler including a body, a staple removably stored within a staple cavity, and an anvil configured to deform the staple. The surgical stapler has a firing system configured to eject staples from the staple cavities toward the anvil during the firing stroke and to cut tissue during the cutting stroke after the firing stroke is completed. Further comprising a cutting system and a feedback generator configured to indicate a shift between the firing stroke and the cutting stroke.

Example 67 - A surgical stapler for treating tissue of a patient, comprising a handle, a shaft extending from the handle, and an end effector extending from the shaft, the end effector configurable in an open configuration and a closed configuration is a surgical stapler. The end effector has a first jaw, a second jaw movable toward the first jaw to place the end effector in a closed configuration, and a staple. A cartridge body including a cavity, staples removably stored within the staple cavities, and an anvil configured to deform the staples. The surgical stapler includes a closure system configured to move the second jaw toward the first jaw and a firing system, the staple driver, wherein the firing system comprises: a staple driver configured to push the staple driver toward the anvil immediately and to retract the staple driver during the retraction stroke; and a cutting member configured to cut tissue during the cutting stroke, wherein a cutting member including a cutting edge exposed from the cartridge body during the cutting stroke. The surgical stapler is configured to overcome a lockout configured to prevent retraction of the staple driver during the firing stroke and to overcome the lockout to allow retraction of the staple driver during the firing stroke. and a bypass.

Example 68 - A surgical stapler for treating tissue of a patient, comprising a handle, a shaft extending from the handle, and an end effector extending from the shaft, the end effector configurable in an open configuration and a closed configuration is a surgical stapler. The end effector has a first jaw, a second jaw movable toward the first jaw to place the end effector in a closed configuration, and a staple. A cartridge body including a cavity, staples removably stored within the staple cavities, and an anvil configured to deform the staples. The surgical stapler includes a closure system configured to move the second jaw toward the first jaw and a firing system, the staple driver, wherein the firing system comprises: a staple driver configured to push the staple driver toward the anvil immediately and to retract the staple driver during the retraction stroke; and a cutting member configured to cut tissue during the cutting stroke, wherein a cutting member including a cutting edge exposed from the cartridge body during the cutting stroke. The surgical stapler includes a lock configured to prevent retraction of the staple driver prior to completion of the cutting stroke and a lock configured to overcome the lock so that the staple driver may be retracted prior to completion of the cutting stroke. a configured bypass.

Example 69 - A surgical stapler for treating tissue of a patient, comprising a handle, a shaft extending from the handle, and an end effector extending from the shaft, the end effector configurable in an open configuration and a closed configuration is a surgical stapler. The end effector has a first jaw, a second jaw movable toward the first jaw to place the end effector in a closed configuration, and a staple. A cartridge body including a cavity, staples removably stored within the staple cavities, and an anvil configured to deform the staples. The surgical stapler includes a closure system configured to move the second jaw toward the first jaw and a firing system, the staple driver, wherein the firing system comprises: a staple driver configured to push the staple driver toward the anvil immediately and to retract the staple driver during the retraction stroke; and a cutting member configured to cut tissue during the cutting stroke, wherein a cutting member including a cutting edge exposed from the cartridge body during the cutting stroke. The surgical stapler is configured to overcome a lockout configured to prevent retraction of the cutting member during the cutting stroke and to overcome the lockout to allow retraction of the cutting member during the cutting stroke. and a bypass.

The entire disclosure of the following is incorporated herein by reference. i.e.
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U.S. Patent No. 7,000,818, issued Feb. 21, 2006, entitled "SURGICAL STAPLING INSTRUMENT HAVING SEPARATE DISTINCT CLOSING AND FIRING SYSTEMS";
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Although various embodiments of devices have been described herein in connection with specific disclosed embodiments, many modifications and variations are possible. Also, although materials are disclosed for particular components, other materials may be used. Further, according to various embodiments, single components may be replaced with multiple components, and multiple components may be replaced with a single component to perform a given function. . The foregoing description and the following claims are intended to cover all such modifications and changes.

The devices disclosed herein can be designed to be discarded after a single use, or can be designed to be used multiple times. In either case, however, the device can be reconditioned for reuse after at least one use. Reconditioning can include any combination of the steps of disassembly of the device, followed by cleaning or replacement of particular parts, and subsequent reassembly. In particular, the device can be disassembled and any number of the particular parts or portions of the device can be selectively replaced or removed in any combination. After cleaning and/or replacing particular parts, the device can be reassembled for later use at a reconditioning facility or by a surgical team immediately prior to a surgical procedure. Those skilled in the art will appreciate that reconditioning of the device can utilize a variety of techniques for disassembly, cleaning/replacement, and reassembly. Use of such techniques, and the resulting reconditioned device, are all within the scope of the present invention.

Merely by way of example, the aspects described herein may be processed pre-operatively. Initially, a new or used instrument may be obtained and cleaned as necessary. The instruments can then be sterilized. In one sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic bag or TYVEK bag. The container and instrument can then be placed in a radiation field that can penetrate the container, such as gamma rays, X-rays, or high-energy electrons. Radiation can kill bacteria on the device and in the container. After this, the sterilized instrument can be stored in the sterile container. The sealed container can keep the instrument sterile until it is opened in the medical facility. The device may also be sterilized using any other technique known in the art including, but not limited to, beta or gamma radiation, ethylene oxide, hydrogen peroxide plasma, or water vapor.

While this invention has been described as having an exemplary design, the present invention may be further modified within the spirit and scope of this disclosure. This application is therefore intended to cover any variations, uses, or adaptations of the invention using its general principles.

Any patent, publication, or other disclosure referred to as being incorporated herein by reference, in whole or in part, is not subject to any preexisting definitions, statements, or disclosures for which the incorporated subject matter is set forth. It is incorporated herein only to the extent not inconsistent with other disclosures herein. As such, and to the extent necessary, the disclosure as explicitly set forth herein supersedes any conflicting statements incorporated herein by reference. Although incorporated herein by reference, any document, or portion thereof, that contradicts existing definitions, statements, or other disclosure documents set forth herein, shall It shall be incorporated only to the extent that there is no contradiction with the disclosed content.

[Mode of implementation]
(1) A surgical stapler for treating patient tissue, comprising:
a handle;
a shaft extending from the handle;
an end effector extending from the shaft, configurable in an open configuration and a closed configuration;
a first jaw;
a second jaw movable toward the first jaw to place the end effector in the closed configuration;
a cartridge body including a staple cavity;
staples removably stored in the staple cavities;
an anvil configured to deform the staple;
an end effector comprising
a closure system configured to move the second jaw toward the first jaw;
a launch system,
a staple driver, wherein the firing system is configured to push the staple driver toward the anvil during a firing stroke and retract the staple driver during a retraction stroke;
a cutting member configured to cut tissue during a cutting stroke, the cutting member including a cutting edge exposed from the cartridge body during the cutting stroke;
a launch system comprising
a lockout configured to prevent retraction of the staple driver during the firing stroke;
a bypass configured to overcome the lockout so that the staple driver may be retracted during the firing stroke;
A surgical stapler comprising:
(2) a surgical stapler for treating patient tissue, comprising:
a handle;
a shaft extending from the handle;
an end effector extending from the shaft, configurable in an open configuration and a closed configuration;
a first jaw;
a second jaw movable toward the first jaw to place the end effector in the closed configuration;
a cartridge body including a staple cavity;
staples removably stored in the staple cavities;
an anvil configured to deform the staple;
an end effector comprising
a closure system configured to move the second jaw toward the first jaw;
a launch system,
a staple driver, wherein the firing system is configured to push the staple driver toward the anvil during a firing stroke and retract the staple driver during a retraction stroke;
a cutting member configured to cut tissue during a cutting stroke, the cutting member including a cutting edge exposed from the cartridge body during the cutting stroke;
a launch system comprising
a lock configured to prevent retraction of the staple driver prior to completion of the cutting stroke;
a bypass configured to overcome the lock so that the staple driver may be retracted prior to completion of the cutting stroke;
A surgical stapler comprising:
(3) A surgical stapler for treating patient tissue, comprising:
a handle;
a shaft extending from the handle;
an end effector extending from the shaft, configurable in an open configuration and a closed configuration;
a first jaw;
a second jaw movable toward the first jaw to place the end effector in the closed configuration;
a cartridge body including a staple cavity;
staples removably stored in the staple cavities;
an anvil configured to deform the staple;
an end effector comprising
a closure system configured to move the second jaw toward the first jaw;
a launch system,
a staple driver, wherein the firing system is configured to push the staple driver toward the anvil during a firing stroke and retract the staple driver during a retraction stroke;
a cutting member configured to cut tissue during a cutting stroke, the cutting member including a cutting edge exposed from the cartridge body during the cutting stroke;
a launch system comprising
a lockout configured to prevent retraction of the cutting member during the cutting stroke;
a bypass configured to overcome the lockout such that the cutting member may retract during the cutting stroke;
A surgical stapler comprising:

Claims (7)

A surgical stapler for treating tissue of a patient, comprising:
a handle;
a shaft extending from the handle;
an end effector extending from the shaft, configurable in an open configuration and a closed configuration;
a first jaw;
a second jaw movable toward the first jaw to place the end effector in the closed configuration;
a cartridge body including a staple cavity;
staples removably stored in the staple cavities;
an anvil configured to deform the staple;
an end effector comprising
a closure system configured to move the second jaw toward the first jaw;
a launch system,
a staple driver, wherein the firing system is configured to push the staple driver toward the anvil during a firing stroke and retract the staple driver during a retraction stroke;
a cutting member configured to cut the tissue during a cutting stroke, the cutting member including a cutting edge exposed from the cartridge body during the cutting stroke;
a launch system comprising
a lock configured to prevent retraction of the staple driver during the firing stroke;
a bypass configured to overcome the lock so that the staple driver may be retracted during the firing stroke;
with
the cutting member is operable after actuation of the staple driver;
the lock is further configured to prevent retraction of the cutting member during the firing stroke;
A surgical stapler, wherein the cutting member extends along the staple driver and is movable relative to the staple driver. A surgical stapler for treating tissue of a patient, comprising:
a handle;
a shaft extending from the handle;
an end effector extending from the shaft, configurable in an open configuration and a closed configuration;
a first jaw;
a second jaw movable toward the first jaw to place the end effector in the closed configuration;
a cartridge body including a staple cavity;
staples removably stored in the staple cavities;
an anvil configured to deform the staple;
an end effector comprising
a closure system configured to move the second jaw toward the first jaw;
a launch system,
a staple driver, wherein the firing system is configured to push the staple driver toward the anvil during a firing stroke and retract the staple driver during a retraction stroke;
a cutting member configured to cut the tissue during a cutting stroke, the cutting member including a cutting edge exposed from the cartridge body during the cutting stroke;
a launch system comprising
a lock configured to prevent retraction of the staple driver prior to completion of the cutting stroke;
a bypass configured to overcome the lock so that the staple driver may be retracted prior to completion of the cutting stroke;
with
the cutting member is operable after actuation of the staple driver;
the lock is further configured to prevent retraction of the cutting member prior to completion of the cutting stroke;
the cutting member extends along the staple driver and is movable relative to the staple driver;
A surgical stapler, wherein the bypass is configured to overcome the lock such that the staple driver and the cutting member can be retracted prior to completion of the cutting stroke. A surgical stapler for treating tissue of a patient, comprising:
a handle;
a shaft extending from the handle;
an end effector extending from the shaft, configurable in an open configuration and a closed configuration;
a first jaw;
a second jaw movable toward the first jaw to place the end effector in the closed configuration;
a cartridge body including a staple cavity;
staples removably stored in the staple cavities;
an anvil configured to deform the staple;
an end effector comprising
a closure system configured to move the second jaw toward the first jaw;
a launch system,
a staple driver, wherein the firing system is configured to push the staple driver toward the anvil during a firing stroke and retract the staple driver during a retraction stroke;
a cutting member configured to cut the tissue during a cutting stroke, the cutting member including a cutting edge exposed from the cartridge body during the cutting stroke;
a launch system comprising
a lock configured to prevent retraction of the cutting member during the cutting stroke;
a bypass configured to overcome the lock so that the cutting member can be retracted during the cutting stroke;
with
said firing system is operable independently of said closure system;
the lock is further configured to prevent retraction of the staple driver during the cutting stroke;
A surgical stapler, wherein the cutting member extends along the staple driver and is movable relative to the staple driver. The surgical stapler of any one of claims 1-3, wherein the lock is configured to prevent actuation of the cutting member prior to full actuation of the staple driver. The staple driver comprises a firing bar, the cutting member comprises a cutting bar, and the lock is configured to hold the firing bar in place while actuating the cutting bar. Item 5. The surgical stapler according to any one of Items 1-4. Claim 1- wherein the lock is configured to automatically move to an unlocked position such that the staple driver and the cutting member can be retracted after completion of the firing stroke and the cutting stroke. 6. The surgical stapler according to any one of clause 5 . The surgical stapler of Claim 6 , wherein the lock is further configured to hold the staple driver in a fully actuated position while the cutting member moves through the cutting stroke.

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