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not shown in the first gear passage formed in the ball member A first flexible worm gear cable is coupled to a first motor provided in the distal tube segment Similarly, in this non-limiting embodiment, the second flexible worm gear cable includes worm gear teeth, screws , etc. Second flexible worm gear cable proximal tube segment is coupled to a second motor provided on distal tube segment Although described herein as \”flexible worm gear cables\”, it is understood that this term includes all types of flexible drive cables or drive structures that do not need to have worm gear type teeth.

I want to be. 第1および第2のモータ2512、2522は、電気的に駆動させる(バッテリ234または別のバッテリ)、交流によって駆動させる、または作動液または空気によって駆動させることができる。一実施形態では、モータ2512、2522は、電気的に駆動され、ハンドル組立体200に設けられた1または複数のスイッチまたはボタン(不図示)によって操作する。第1および第2のウォームギヤケーブル2510、2520の回転の程度および回転の方向を制御して、ボール部材2462をソケット2458内で回転させ、これにより、遠位チューブセグメント2410(およびそこに取り付けられたエンドエフェクタ22)を近位チューブセグメント2450に対して関節動作させる。読者は、このような構造により、図17に示されているような左関節動作および右関節動作(不図示)を容易に行うことができることを理解できよう。しかしながら、同様に、読者は、2つの可撓性ウォームギヤケーブル/モータの構造を前記したが、本発明の他の実施形態が、1つのみの角度の関節動作が必要または望ましい場合には、1つのみの可撓性ウォームギヤケーブルの構造を用いることができることを理解できよう。また、ボール部材2462を近位チューブセグメント2450に移動しないように取り付けて、ソケット2458を遠位チューブセグメント2410に設けるとして説明したが、当業者であれば、限定目的ではない他の実施形態では、本発明の精神および範囲から逸脱することなく、ボール部材2462を遠位チューブセグメント2410に移動しないように取り付けて、ソケット2458を近位チューブセグメント2450に設けることができることを理解できよう。 The first and second motors , can be electrically driven battery or another battery , driven by alternating current, or driven by hydraulic fluid or air.

In one embodiment, the motors , are electrically driven and operated by one or more switches or buttons not shown provided on the handle assembly The degree and direction of rotation of the first and second worm gear cables , are controlled to rotate the ball member within the socket , thereby causing the distal tube segment and attached thereto.

End effector 22 is articulated relative to proximal tube segment The reader will understand that such a structure allows the left joint movement and the right joint movement not shown as shown in FIG. It will be appreciated that a structure of only one flexible worm gear cable can be used. Also, while ball member has been described as not being moved to proximal tube segment and socket is provided in distal tube segment , those skilled in the art will be aware that in other embodiments not limiting, It will be understood that the socket can be provided in the proximal tube segment with the ball member attached so as not to move to the distal tube segment without departing from the spirit and scope of the present invention.

The disk-like member \’is received in a socket \’ provided at the proximal end of the distal tube segment so that it can rotate freely within the socket \’. This embodiment typically uses motor driven flexible worm gear cables , as described above. 本発明の限定目的ではない様々な実施形態は、従来の関節動作外科器具よりも多くの利点を有する。具体的には、本発明の様々な実施形態により、外科実施部分をハンドルに取り付けるチューブ部材の各部を、トロカールまたは類似の装置を介して挿入し、患者の体内で選択的に関節動作させることが可能となっている。液圧式エンドカッターの使用に関連して様々な実施形態をここに開示してきたが、当業者であれば、本発明の様々な実施形態が、電気式または液圧式に関係なく、電気式エンドカッターおよび他のタイプの外科実施部分を用いることができることを理解できよう。 Various non-limiting embodiments of the present invention have many advantages over conventional articulating surgical instruments.

Specifically, according to various embodiments of the present invention, portions of the tube member that attach the surgical implement to the handle can be inserted through a trocar or similar device to selectively articulate within the patient\’s body.

It is possible. While various embodiments have been disclosed herein in connection with the use of a hydraulic end cutter, those skilled in the art will recognize that various embodiments of the present invention may be an electric end cutter, whether electrical or hydraulic. It will be appreciated that and other types of surgical implementations may be used. 様々な実施形態によって本発明を例示し、例示的な実施形態をかなり詳細に説明してきたが、出願者は、このような詳細な事項に、添付の特許請求の範囲を制限またはいかなる意味においても限定することを意図していない。当業者であれば、さらなる利点および改良に容易に想到するであろう。したがって、本発明は、内視鏡処置および装置に関連して説明してきた。しかしながら、ここで使用した「内視鏡下(endoscopic)」などの用語は、本発明を、内視鏡チューブ(すなわちトロカール)だけに使用する外科ステープル止め/切断器具に限定すると解釈すべきではない。むしろ、本発明は、限定するものではないが、腹腔鏡処置並びに開腹処置を含むアクセスが小さな切開部に限定されるあらゆる処置に用いることができると考えられる。さらに、本発明の様々な実施形態は、液圧式または空気式外科実施部分を備えた外科器具に関しての使用だけに限定されるべきものではない。本発明の様々な実施形態は、電気式外科実施部分を備えた外科器具および類似の器具にも有効に利用することができる。 While the invention has been illustrated by various embodiments and exemplary embodiments have been described in considerable detail, the applicant has limited such claims in any way to limit or limit the scope of the appended claims.

It is not intended to be limiting. One skilled in the art will readily appreciate further advantages and improvements.

Thus, the present invention has been described in relation to endoscopic procedures and devices. Rather, it is contemplated that the present invention can be used for any procedure where access is limited to small incisions, including but not limited to laparoscopic procedures as well as open procedures. Further, the various embodiments of the present invention should not be limited solely to use with surgical instruments with hydraulic or pneumatic surgical implementations.

Various embodiments of the present invention can also be used effectively with surgical instruments and similar instruments that include an electrosurgical implementation. An actuator assembly for selectively rotating a portion of the ball member in the socket to articulate the distal tube segment relative to the proximal tube segment; An articulation assembly, A handle assembly, A surgical implement attached to the distal tube segment; Including surgical instruments.

第1の実質的に同軸的に整合した位置にあるチューブセグメントを備えた液圧式エンドカッターに用いるモーメントアーム伸長構造の限定目的ではない一実施形態の部分斜視図である。 FIG. チューブセグメントが互いに対して所定角度関節動作している、図1のエンドカッターおよびモーメントアーム伸長構造の別の斜視図である。 FIG. 見やすくするために一部の構成要素を省略し、アンビルが開位置、すなわちクランプしていない位置にある、図1および図2に示されているエンドカッターに用いられるエンドエフェクタの部分断面図である。 FIG. 切断バーが伸長した位置にあり、アンビルが閉位置、すなわちクランプした位置にある、図3のエンドエフェクタの別の断面図である。 FIG. 切断されてステープル止めされた後の組織を示す、図3および図4のエンドエフェクタの別の断面図である。 FIG.

エンドエフェクタおよびステープルカートリッジの別の組立分解図である。 FIG. 図6および図7に示されているエンドエフェクタに取り付けられたステープルカートリッジの平面図である。 FIG. トロカール通路内に挿入されたエンドエフェクタを例示する端部断面図である。 FIG. アンビルが開位置、すなわちクランプしていない位置にある、エンドエフェクタに取り付けられたカートリッジの斜視図である。 FIG. 本発明の1つの液圧システムの実施形態の概略図である。 1 is a schematic diagram of one hydraulic system embodiment of the present invention.

関節動作していない位置にある本発明の関節接合部の限定目的ではない一実施形態の部分斜視図である。 FIG. 関節動作した位置にある図12に示されている関節接合部の別の部分斜視図である。 FIG. 関節動作した位置にある図12および図13に示されている関節接合部の実施形態の別の部分斜視図である。 14 is another partial perspective view of the embodiment of the articulation joint shown in FIGS. 関節動作した位置にある本発明の関節接合部の限定目的ではない別の実施形態の部分断面図である。 FIG. 関節動作した位置にある本発明の別の関節接合部の部分断面図である。 It is a fragmentary sectional view of another joint joint part of this invention in the position which carried out the joint operation movement.

関節動作した位置にある本発明の別の関節接合部の実施形態の部分断面図である。 FIG. Various embodiments of the articulation joint include at least one fluid-actuated cylinder or flexible driven member to articulate a surgical implement relative to the handle assembly of the instrument.

請求項1に記載の外科器具において、 前記アクチュエータ組立体は、少なくとも1つの流体作動式シリンダを含む、外科器具。 The surgical instrument of claim 1, wherein The surgical instrument includes the actuator assembly including at least one fluid operated cylinder. 請求項3に記載の外科器具において、 前記第1の作動ロッドおよび前記第2の作動ロッドは、可撓性材料から形成されている、外科器具。 The surgical instrument of claim 3, wherein The surgical instrument, wherein the first actuation rod and the second actuation rod are formed from a flexible material. 請求項1に記載の外科器具において、 前記ボール部材は、前記遠位チューブセグメントおよび前記近位チューブセグメントに設けられている開口と連通するように構成された、前記ボール部材の内部を通る少なくとも1つの中空通路を有する、外科器具。 The surgical instrument of claim 1, wherein The surgical instrument having at least one hollow passage through the interior of the ball member configured to communicate with openings provided in the distal tube segment and the proximal tube segment.

請求項2に記載の外科器具において、 少なくとも1つの前記流体作動式シリンダの少なくとも一部にクリアランスを付与するべく、前記ボール部材の外面に形成された少なくとも1つの凹部、 をさらに含む、外科器具。 The surgical instrument of claim 2, wherein At least one recess formed in the outer surface of the ball member to provide clearance to at least a portion of the at least one fluid-operated cylinder; A surgical instrument further comprising: 請求項1に記載の外科器具において、 前記アクチュエータ組立体は、前記遠位チューブセグメントと前記近位チューブセグメントとの間に延在する少なくとも1つの可撓性駆動部材を含む、外科器具。 The surgical instrument of claim 1, wherein The actuator assembly includes at least one flexible drive member extending between the distal tube segment and the proximal tube segment.

請求項7に記載の外科器具において、 前記少なくとも1つの可撓性駆動部材は、前記ボール部材に形成された対応する通路にねじ込み可能な、モータに取り付けられた可撓性ウォームギヤケーブルを含む、外科器具。 The surgical instrument of claim 7, wherein The surgical instrument, wherein the at least one flexible drive member includes a flexible worm gear cable attached to a motor that can be screwed into a corresponding passage formed in the ball member. 請求項8に記載の外科器具において、 前記ボール部材は、前記遠位チューブセグメントおよび前記近位チューブセグメントに設けられている開口に連通するように構成された、前記ボール部材の内部を通る少なくとも1つの中空通路を有する、外科器具。 The surgical instrument of claim 8, wherein The surgical instrument having at least one hollow passage through the interior of the ball member configured to communicate with openings provided in the distal tube segment and the proximal tube segment.

請求項1に記載の外科器具において、 前記ボール部材は、前記遠位チューブセグメントの前記端部に移動しないように結合され、かつ、前記近位チューブセグメントの前記端部のソケット内に回転可能に受容されている、外科器具。 The surgical instrument of claim 1, wherein The surgical instrument, wherein the ball member is non-movably coupled to the end of the distal tube segment and is rotatably received in a socket at the end of the proximal tube segment.

Hydraulically and electrically actuated articulation joints for surgical instruments. JPA true JPA en. JPB2 JPB2 en. JPA Active JPB2 en.

USA1 en. EPB1 en. JPB2 en. CNB en. AUB2 en. BRPIA en. CAC en. MXPAA en. Pneumatically powered surgical cutting and fastening instrument with electrical control and recording mechanisms.

USB2 en. Robotically-controlled shaft based rotary drive systems for surgical instruments. Surgical cutting and fastening instrument with apparatus for determining cartridge and firing motion status. Surgical stapling device with lockout system for preventing actuation in the absence of an installed staple cartridge.

Rotating support joint assembly for connecting a first portion of a surgical instrument to a second portion of the surgical instrument. Tissue thickness compensator comprising capsules defining a low pressure environment. Robotically-controlled surgical stapling devices that produce formed staples having different lengths.

Fastener cartridge comprising a cutting member for releasing a tissue thickness compensator. Robotically-controlled surgical instrument with selectively articulatable end effector. Motor-driven surgical cutting and fastening instrument with tactile position feedback.

Powered surgical cutting and stapling apparatus with manually retractable firing system. Motor driven surgical fastener device with switching system configured to prevent firing initiation until activated. Motorized surgical cutting and fastening instrument having handle based power source.

Fastener cartridge comprising a firing member including fastener transfer surfaces. Fastener cartridge comprising a tissue thickness compensator including openings therein. Surgical instrument comprising a closing drive and a firing drive operated from the same rotatable output. Articulatable surgical instruments with separate and distinct closing and firing systems.

Motor interface for parallel drive shafts within an independently rotating member. Fastener cartridge comprising a tissue thickness compensator and a gap setting element. Fastener cartridge assembly comprising a fixed anvil and a staple driver arrangement. Surgical cutting and stapling instruments with independent jaw control features. Surgical instrument systems comprising an articulatable end effector and means for adjusting the firing stroke of a firing member.

Monitoring speed control and precision incrementing of motor for powered surgical instruments. Surgical instruments with articulatable end effectors and movable firing beam support arrangements. Control techniques and sub-processor contained within modular shaft with select control processing from handle. Time dependent evaluation of sensor data to determine stability, creep, and viscoelastic elements of measures. Automated end effector component reloading system for use with a robotic system.

Locking arrangements for detachable shaft assemblies with articulatable surgical end effectors. Surgical apparatus configured to assess whether a performance parameter of the surgical apparatus is within an acceptable performance band. Stapling end effector configured to compensate for an uneven gap between a first jaw and a second jaw.

Articulatable surgical instruments with conductive pathways for signal communication. Surgical stapler having motor control based on an electrical parameter related to a motor current. Surgical instruments with tensioning arrangements for cable driven articulation systems. Mechanisms for compensating for drivetrain failure in powered surgical instruments. USDS1 en. Mechanisms for compensating for battery pack failure in powered surgical instruments. Method for closed loop control of motor velocity of a surgical stapling and cutting instrument.

Control of motor velocity of a surgical stapling and cutting instrument based on angle of articulation. Systems and methods for controlling displaying motor velocity for a surgical instrument. Endoscopic surgical instrument with a handle that can articulate with respect to the shaft. Articulatable surgical instruments with articulation stroke amplification features.

Surgical staples having attached drivers of different heights and stapling instruments for deploying the same. System for detecting the mis-insertion of a staple cartridge into a surgical stapler. Adaptive tissue compression techniques to adjust closure rates for multiple tissue types.

Surgical shaft assemblies with slip ring assemblies with increased contact pressure. Systems and methods for providing alerts according to the operational state of a surgical instrument. Percussion safety mechanism and percussion device of cutting anastomat and anastomat. USA en. Modular battery powered handheld surgical instrument with multiple magnetic position sensors. Compressible jaw configuration with bipolar RF output electrodes for soft tissue fusion.

Surgical adapter assemblies for use between surgical handle assembly and surgical end effectors. Surgical stapling instrument having an electroactive polymer actuated medical substance dispenser. EST3 en. Flexible endoscopic catheter with an end effector for coagulating and transfecting tissue. Articulation joint with improved moment arm extension for articulating an end effector of a surgical instrument. Motor-driven surgical cutting and fastening instrument with adaptive user feedback.

Motor-driven surgical cutting and fastening instrument with user feedback system. Motor-driven surgical cutting and fastening instrument with articulatable end effector. Pneumatically powered surgical cutting and fastening instrument with mechanical linkage coupling end effector and trigger motion. Pneumatically powered surgical cutting and fastening instrument with a variable control of the actuating rate of firing with mechanical power assist.

Surgical instrument with elements to communicate between control unit and end effector. Surgical instrument with wireless communication between control unit and remote sensor. Surgical stapling and cutting instrument with travel-indicating retraction member. Pneumatically powered surgical cutting and fastening instrument with electrical feedback.

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