Source: http://www.google.ca/patents/CN101327137B
Timestamp: 2017-11-17 19:40:30
Document Index: 431078921

Matched Legal Cases: ['art 805', 'art 5', 'art 825', 'art 1310', 'Application No. 11', 'Application No. 11']

Patent CN101327137B - Surgical stapling and cutting instrument with improved closure system - Google Patents
本发明涉及带有改进的闭合系统的外科缝合和切割器械，所述闭合系统用于将闭合动作施加到外科器械上。 The present invention relates to a closed system with an improved surgical stapling and severing instrument, the closure system for closing motion applied to the...http://www.google.ca/patents/CN101327137B?cl=en&utm_source=gb-gplus-sharePatent CN101327137B - Surgical stapling and cutting instrument with improved closure system
Publication number CN101327137 B
Also published as CN101327132A, CN101327132B, CN101327133A, CN101327133B, CN101327134A, CN101327134B, CN101327135A, CN101327135B, CN101327136A, CN101327136B, CN101327137A, DE602008002854D1, DE602008004590D1, DE602008005672D1, EP2005896A2, EP2005896A3, EP2005896B1, EP2005897A2, EP2005897A3, EP2005898A2, EP2005898A3, EP2005898B1, EP2005899A2, EP2005899A3, EP2005900A2, EP2005900A3, EP2005900B1, EP2005901A1, EP2005901B1, EP2382928A1, US7510107, US7588175, US7588176, US7731072, US20080308601, US20080308602, US20080308603, US20080308604, US20080308606, US20080308607
Publication number 200810109779.5, CN 101327137 B, CN 101327137B, CN 200810109779, CN-B-101327137, CN101327137 B, CN101327137B, CN200810109779, CN200810109779.5
Inventors R·W·蒂姆, F·E·谢尔顿四世, E·L·蒂姆珀曼, L·M·富吉卡瓦
CN 101327137 B
本发明涉及带有改进的闭合系统的外科缝合和切割器械，所述闭合系统用于将闭合动作施加到外科器械上。 The present invention relates to a closed system with an improved surgical stapling and severing instrument, the closure system for closing motion applied to the surgical instrument. 在各种实施方式中，所述外科器械包括索驱动刀组件，并且当由具有施加到其上的推力的闭合管组件接触时，其砧座组件被运动到闭合位置。 In various embodiments, the surgical instrument includes a cable drive knife assembly, and when having applied thereto to thrust the closure tube assembly of the contact, which the anvil assembly is moved to the closed position. 其他实施方式包括可通过旋转动作致动的闭合系统。 Other embodiments include the rotation operation can be actuated closure system. 本发明还公开了各种可锁定关节运动接头。 The present invention also discloses various lockable articulation joint.
1.ー种外科器械，包括: 细长通道组件，其被构造成将钉仓组件可操作地支撑在其中； 刀组件，其被定向以便在所述细长通道组件中行进； 至少ー根索，其与所述刀组件以及索驱动系统可操作地接合以便在所述细长通道组件中驱动所述刀组件； 砧座组件，其可动地连接到所述细长通道组件上并能够在打开位置和闭合位置之间运动； 闭合管组件，其靠近所述细长通道组件可操作地受到支撑以便选择性地将闭合动作施加到所述砧座组件；和闭合管驱动系统，其与所述闭合管组件的一部分可操作地接合， 其特征在于，所述闭合管驱动系统能够选择性地将推动动作施加到所述闭合管组件上，使得随着所述闭合管驱动系统将所述推动动作施加到所述闭合管组件上，所述闭合管组件将所述闭合动作施加到所述站座组件上，其中所述闭合管组件包括: 近侧闭合管段，其与所述闭合管驱动系统接合；和远侧闭合管段，其与所述近侧闭合管段枢转地连接，用于选择性地围绕彼此垂直的至少两根轴线相对于所述近侧闭合管段枢转行迸，并被定向成选择性地与所述砧座组件接触，以将所述闭合运动传递到所述砧座组件上。 1. ー kinds of surgical instrument, comprising: an elongate channel assembly that is configured to operably support a staple cartridge assembly therein; knife assembly, which is oriented to travel in said elongate channel assembly; Morgenthau least ーwith said knife assembly and a cable drive system operably engaged so as to drive the blade assembly in said elongate channel assembly; anvil assembly movably coupled to said elongate channel assembly and is capable of moved between the open and closed positions; closure tube assembly proximate the elongate channel assembly operatively supported to be selectively applied to the closing action of the anvil assembly; and a closure tube drive system with the a portion of said closure tube assembly operably engaged with, characterized in that said closure tube drive system capable of selectively applying a pushing action to said closure tube assembly such that as said closure tube drive system of the push action is applied to the closed tube assembly, said closure tube assembly to the closing motion is applied to said seat assembly station, wherein said closure tube assembly comprises: a proximal closure tube segment with said closure tube drive system bonding; and a distal closure tube segment with said proximal closure tube segment is pivotally connected, for selectively around at least two axes perpendicular to each other with respect to the proximal closure tube segment pivotally switch 迸, and are oriented selectively in contact with said anvil assembly to transfer said closing motion to said anvil assembly.
2.如权利要求1所述的外科器械，其中所述远侧闭合管段枢转地与中央闭合管段连接，以便选择性地围绕至少ー根枢转轴线相对于所述中央闭合管段枢转行进，其中所述中央闭合管段与所述近侧闭合管段枢转连接，以便选择性地围绕至少ー根其他枢转轴线相对于所述近侧闭合管段枢转行进，其中所述至少一根枢转轴线与所述至少一根其他枢转轴线垂直。 2. The surgical instrument of claim 1, wherein said distal closure tube segment pivotally connected to the central closure tube segment for selectively surrounding at least ー root pivot axis relative to the central closure tube segment to pivot travel, wherein said central closure tube segment with said proximal closure tube segment pivotally attached to selectively surround at least ー root other pivot axis relative to the proximal closure tube segment pivotally traveling, wherein the at least one pivot axis with the at least one other pivot axis perpendicular.
带有改进的闭合系统的外科缝合和切割器械 Surgical stapling and severing instrument with the improved closure system
[0001] 本发明总体涉及内窥镜外科器械，包括但不限于适于将成排缝钉施加到组织上同时切割那些缝钉排之间的组织的外科縫合器械，更具体涉及有关其击发和驱动系统的改迸。 [0001] The present invention generally relates to endoscopic surgical instruments including, but not limited to, the rows of staples adapted to be applied to tissue while cutting the tissue between those staple rows surgical stapling apparatus, and more particularly relates to firing and drive related to its system change Beng.
[0002] 本申请涉及如下在同一天申请的共有美国专利申请，它们的公开内容通过引用而整体包含在本申请中: [0002] The present application relates to commonly owned U.S. Patent Application on the same day of application, the disclosures of which are included in its entirety by reference herein:
[0003] (I)题为“Surgical Stapling and Cutting Instrument WithImproved FiringSystem” 的美国专利申请，发明人为Richard ff.Timm, Frederick E.Shelton, IV, EugeneL.Timperman 和Leslie M.Fugikawa，(案卷号END6094USNP/KLG N0.070064)； "Surgical Stapling and Cutting Instrument WithImproved FiringSystem" U.S. Patent Application [0003] (I), entitled, artificial invention Richard ff.Timm, Frederick E.Shelton, IV, EugeneL.Timperman and Leslie M.Fugikawa, (Docket No. END6094USNP / KLG N0.070064);
[0004] (2)题为“Cable Driven Surgical Stapling and Cutting InstrumentffithApparatus For Preventing Inadvertent Cable Disengagement”的美国专利申请，发明人为Richard ff.Timm 和Frederick E.Shelton, IV,(案卷号END6096USNP/KLG.N0.070066)； [0004] (2), entitled "Cable Driven Surgical Stapling and Cutting InstrumentffithApparatus For Preventing Inadvertent Cable Disengagement" U.S. Patent Application, inventors Richard ff.Timm and Frederick E.Shelton, IV, (Docket No. END6096USNP / KLG.N0. 070 066);
[0005] (3)题为“Cable Driven Surgical Stapling and Cutting InstrumentffithImproved Cable Attachment Arrangements” 的美国专利申请，发明人为FrederickE.Shelton, IV 和Richard ff.Timm,(案卷号END6097USNP/KLG.N0.070067)； [0005] (3), entitled "Cable Driven Surgical Stapling and Cutting InstrumentffithImproved Cable Attachment Arrangements" US patent application, inventors FrederickE.Shelton, IV and Richard ff.Timm, (Docket No. END6097USNP / KLG.N0.070067);
[0006] (4)题为“Surgical Stapling and Cutting Instrument WithImproved AnvilOpening Features” 的美国专利申请,发明人为RichardW.Timm, Frederick E.Shelton, IV和Jeffrey S.Swayze， (案卷号END6098USNP/KLG N0.070068);和 [0006] (4), entitled "Surgical Stapling and Cutting Instrument WithImproved AnvilOpening Features" US Patent Application, human invention RichardW.Timm, Frederick E.Shelton, IV and Jeffrey S.Swayze, (Docket No. END6098USNP / KLG N0.070068 ); and
[0007] (5)题为“Surgical Stapling and Cutting Instruments” 的美国专利申请，发明人为Richard ff.Timm, Frederick E.Shelton, IV, CharlesJ.Scheib, ChristopherJ.SchalI, Glen A.Armstrong, Eugene L.Timperman,和Leslie M.Fugikawa,(案卷号END6102USNP/KLG.N0.070071)。 [0007] (5), entitled "Surgical Stapling and Cutting Instruments" U.S. Patent Application, inventors Richard ff.Timm, Frederick E.Shelton, IV, CharlesJ.Scheib, ChristopherJ.SchalI, Glen A.Armstrong, Eugene L. Timperman, and Leslie M.Fugikawa, (Docket No. END6102USNP / KLG.N0.070071).
[0008] 与传统的开放式外科器械相比，内窥镜外科器械通常更受青睐，这是因为较小的切ロ易于减少术后恢复时间和并发症。 [0008] Compared with the traditional open surgical instruments, endoscopic surgical instruments are often more popular, it is because the smaller cut ro easy to reduce postoperative recovery time and complications. 因此，适于通过套管针的插管将远端执行器精确放置在需要进行外科手术部位上的内窥镜器械领域已经有了显著的发展。 Thus the field of endoscopic instruments, is adapted through the trocar cannula to the distal end of the actuator needs to be accurately placed on the surgical site has been significantly developed. 这些远端执行器(例如，内镜切割器、抓钳、切割器、縫合器、夹具施放器、进入装置、药物/基因治疗输送装置、以及使用超声波、RF、或激光等的能量装置)以各种方式与组织接合，以达到诊断或治疗的效果。 These distal end effectors (e.g., endoscopic cutter, grasper, cutter, staplers, clip applier, access device, drug / gene therapy delivery device, and energy device using ultrasound, RF, or laser, etc.) to engaging tissue in various ways to achieve a diagnostic or therapeutic effect.
[0009] 已知的外科縫合器包括端部执行器，该端部执行器在组织中形成纵向切ロ的同时在切ロ的相对两侧上施加多排缝钉。 While [0009] Known surgical staplers include an end effector, the end effector is formed ro longitudinal cut in tissue rows of staples on opposite sides of the cut is applied ro a. 所述端部执行器包括ー对相配合的钳ロ构件，如果器械用于内窥镜或者腹腔镜应用，这对钳ロ构件能够穿过插管通道。 The end effector includes ー ro clamp member for mating, if instruments for endoscopic or laparoscopic applications, which can pass through the tube clamp member ro channel. 钳ロ构件中的一个容纳有具有至少两个横向间隔的缝钉排的钉仓。 Ro clamp member accommodated in a staple having at least two laterally spaced rows of staple cartridge. 另ー个钳ロ构件限定了具有缝钉成形凹槽的砧座，所述凹ロ与钉仓中的缝钉排对准。 Another ー ro member defines a jaw having a staple forming anvil recess, said recess ro and staple cartridge aligned with the rows of staples. 该器械通常包括多个往复运动的楔形件，这些楔形件在被向远侧驱动时穿过钉仓中的开ロ并与支承缝钉的驱动器接合，向着砧座击发缝钉。 The device generally includes a plurality of reciprocating wedges which wedge member extends through the opening ro staple cartridge is driven distally in engagement with the support and drive the staples, firing the staples towards the anvil. [0010] 所述外科縫合器的一个例子在申请人为Olson等人的美国专利申请US2006/001699A1中公开，其公开的内容通过引用而包含在本申请中。 [0010] An example of the surgical stapling device of Olson et al., In the applicant's U.S. Patent Application US2006 / 001699A1 disclosed, the disclosure of which incorporated by reference herein. 其中公开的缝合装置采用ー根或多根索，所述索围绕定位在远侧的销或者滑轮定位并固定到刀上。 Stapling apparatus disclosed therein adopts ー or a plurality of cable, the cable is positioned distally around pin or pulley is positioned and fixed to the knife. 索的端部沿着近侧方向被拉动。 Ends of the cable is pulled in the proximal direction. 但是，这种系统的机械优势较低并趋向于在冲程中需要相对较大的力来拉动刀。 However, the mechanical advantage of this system is lower stroke and tends to require a relatively large force to pull the knife. 这种系统常常采用ー根或多根索来闭合和夹钳端部执行器，该端部执行器螺纹连接并围绕砧座中的表面并终止于闭合环。 Such systems often employ ー or a plurality of cable to close and clamp the end effector, the end effector and screwed around the anvil surface and terminating in a closed loop. 当索的近端或者自由端被拉动吋，闭合环被向着远侧拉动并且使砧座闭合。 When the proximal or the free end of the cable is pulled inch, closed loop is pulled toward the distal and the anvil is closed. 但是，这种系统产生夹钳カ的能力受到限制。 However, the ability of such a system is limited clamp ka.
[0011] 因此，需要用于索驱动的外科器械的改进的闭合系统，其能避免在使用由一根或多根索驱动的闭合系统时的缺点。 [0011] Thus, the need for an improved closure system cable driven surgical instrument, which can avoid the disadvantages in the use of one or more cord drive by a closed system.
[0012] 还需要具有上述能够与可进行关节运动的端部执行器/工具组件一起使用的特征的改进闭合系统。 [0012] and may also need to be capable of having an articulatable end effector / tool assembly for use with the above improved closure system features.
[0013] 在本发明的ー个方面，提供了ー种包括具有远端和近端的细长通道组件的外科器械。 [0013] In ー aspect of the present invention, there is provided ー species may include elongate channel assembly having a distal end and a proximal end of the surgical instrument. 细长通道组件可被构造成将钉仓组件可操作地支撑在其中。 Elongate channel assembly may be configured to staple cartridge assembly operatively supported therein. 刀组件可被定向以便在细长通道组件中行迸。 Knife assembly may be directed to the Bank 迸 elongate channel assembly. 至少ー根索可操作地与刀组件和索驱动系统接合以便在细长通道组件中驱动刀组件。 At least ー Morgenthau operatively associated with the knife assembly and cable drive system engages to drive the blade assembly in the elongate channel assembly. 砧座组件可动地连接到细长通道组件并可在打开和闭合位置之间运动。 An anvil assembly movably coupled to the elongate channel assembly and movable between open and closed positions. 闭合管组件在细长通道组件附近可操作地受到支撑，以便在将推动动作施加到闭合管组件上时选择性地将闭合云力作施加到站座组件上。 In the vicinity of the elongate closure tube assembly operably channel assembly is supported, so that when the pushing action applied to the closure tube assembly for selectively applying the closing force on the cloud base station components.
[0014] 在本发明的各种实施方式的另ー个总的方面，提供了ー种包括具有远端和近端的细长通道组件的外科器械。 [0014] In another ー various embodiments of the present invention is a general aspect, there is provided ー species may include elongate channel assembly having a distal end and a proximal end of the surgical instrument. 细长通道组件可被构造成将钉仓组件可操作地支撑在其中。 Elongate channel assembly may be configured to staple cartridge assembly operatively supported therein. 刀组件可通过可操作地与其接合的驱动系统在细长通道组件中被驱动。 Knife assembly by a drive system operably engaged therewith in the elongate channel assembly is driven. 砧座组件可动地连接到细长通道组件并可在打开和闭合位置之间运动。 An anvil assembly movably coupled to the elongate channel assembly and movable between open and closed positions. 闭合环在细长通道组件附近可操作地受到支撑以便选择性地将闭合动作施加到砧座组件上。 A closed loop in the vicinity of the elongate channel assembly operably supported to be selectively applied to the closing action of the anvil assembly. 闭合管段可操作地与闭合环接合，当将致动动作施加到闭合管段上时闭合管段驱动闭合环与砧座组件接触，导致砧座组件闭 Closure tube segment operably engaged with a closed loop, the closed loop closure tube segment driver in contact with the anvil assembly when the actuation motions applied to the closed line segment, resulting in closing the anvil assembly
合。 Co. [0015] 在本发明的各种实施方式的又一个总的方面，提供了ー种包括具有远端和近端的细长通道组件的外科器械。 [0015] In yet another general aspect of various embodiments of the present invention, there is provided ー species may include elongate channel assembly having a distal end and a proximal end of the surgical instrument. 细长通道组件可被构造成可操作地将钉仓组件支撑在其中。 Elongate channel assembly may be configured to operably support a staple cartridge assembly therein. 脊组件可与细长通道组件连接并且刀组件可被定向以便当对其施加驱动动作时使其在细长通道组件中行迸。 Ridge component can be connected with the elongate channel assembly and the knife assembly may be oriented so that it is in the elongate channel assembly BOC 迸 when the driving operation is applied thereto. 砧座组件可动地连接到细长通道组件并可在打开和闭合位置之间运动。 An anvil assembly movably coupled to the elongate channel assembly and movable between open and closed positions. 闭合环靠近细长通道组件可操作地支撑在脊组件上以便选择性地与砧座组件轴向接触。 Closed loop near the elongate channel assembly operatively supported on the spine assembly for selective axial contact with the anvil assembly. 至少ー个第一索过渡支架可操作地安装在闭合环上，并且至少ー个第二索过渡支架可操作地连接到脊组件。 At least one first cable transition support ー operatively mounted on a closed loop, and at least one second cable transition support ー operatively connected to the ridge assembly. 闭合索可操作地围绕第一和第二索过渡支架延伸并与索驱动系统接合，以将致动动作施加到闭合环上以将闭合环驱动成与砧座组件闭合接触。 Cable operatively closed around the first and second cable transition support and engagement with the extension cable drive system to be applied to the actuator action on a closed loop to closed loop drive into contact with the anvil assembly is closed.
[0016] 在本发明的各种实施方式的另ー个总的方面，提供了ー种包括具有远端和近端的细长通道组件的外科器械。 [0016] In another ー various embodiments of the present invention is a general aspect, there is provided ー species may include elongate channel assembly having a distal end and a proximal end of the surgical instrument. 细长通道组件可被构造成可操作地将钉仓组件支撑在其中。 Elongate channel assembly may be configured to operably support a staple cartridge assembly therein. 器械还包括脊段和连接在细长通道组件和脊段之间的关节运动接头。 Instrument also includes a ridge segment and the articulation joint coupled between the elongate channel assembly and spine segment. 在各种实施方式中，关节运动接头可包括插座元件和球形元件，该球形元件从细长通道组件和脊段中之一突出并被容纳在插座中，以利于细长通道组件相对于脊段选择性地运动。 In various embodiments, the articulation joint may comprise a socket member and the spherical elements, the spherical elements from one of the elongate channel assembly and the spine segment and is received in the socket protrusion, in order to facilitate the elongate channel assembly relative to the ridge segments selectively movable. 球形元件可具有至少ー个可径向延伸的部分，用于与插座选择性地锁定接触，以便当将锁定动作施加到至少ー个可径向延伸的部分时选择性地防止球形元件在插座中运动。ー spherical element may have at least one radially extending portion may, for selectively locking contact with the socket, so that when the locking action is applied to selectively prevent ー a radially extending at least partially spherical member in the socket movement.
[0017] 在本发明的各种实施方式的另ー个总的方面，提供了ー种包括具有远端和近端的细长通道组件的外科器械。 [0017] In another ー various embodiments of the present invention is a general aspect, there is provided ー species may include elongate channel assembly having a distal end and a proximal end of the surgical instrument. 细长通道组件可被构造成可操作地将钉仓组件支撑在其中。 Elongate channel assembly may be configured to operably support a staple cartridge assembly therein. 器械还包括脊段和连接在细长通道组件和脊段之间的关节运动接头。 Instrument also includes a ridge segment and the articulation joint coupled between the elongate channel assembly and spine segment. 在各种实施方式中，关节运动接头可包括在细长通道组件和脊段中之一上的插座元件。 In various embodiments, the articulation joint may comprise one of the elongate channel assembly and spine segment socket element. 球形元件可动地容纳在插座元件中，并从细长通道组件和脊段中的另ー个突出。 Spherical element is movably received in the socket element, and the elongate channel assembly and spine segment another ー projections. 至少ー个锁定部分可选择性地与球形元件接合，以防止球形元件在插座中运动。 At least ー locking portion may be selectively engaged with the spherical element, the spherical element in order to prevent movement in the socket.
[0018] 具体而言，本发明公开了: [0018] More specifically, the present invention discloses:
[0019] (I)、一种外科器械,包括: [0019] (I), A surgical instrument, comprising:
[0020]细长通道组件，其被构造成将钉仓组件可操作地支撑在其中； [0020] an elongate channel assembly that is configured to operably support a staple cartridge assembly therein;
[0021] 刀组件，其被定向以便在所述细长通道组件中行进； [0021] knife assembly, which is oriented so as to travel in said elongate channel assembly;
[0022] 至少ー根索，其与所述刀组件以及索驱动系统可操作地接合以便在所述细长通道组件中驱动所述刀组件； [0022] at least ー root cable, with the knife assembly and the cable drive system operably engaged so as to drive the blade assembly in said elongate channel assembly;
[0023] 砧座组件，其可动地连接到所述细长通道组件上并能够在打开位置和闭合位置之间运动；和 [0023] an anvil assembly movably coupled to said elongate channel assembly and movable between an open position and a closed position; and
[0024] 闭合管组件，其靠近所述细长通道组件可操作地受到支撑以便在将推动动作施加到所述闭合管组件上时选择性地将闭合动作施加到所述站座组件。 [0024] The closure tube assembly adjacent said elongate channel assembly operably supported by the action so that when the push is applied to said closure tube assembly is selectively applied to the closing action of the seat assembly station.
[0025] (2)、如第(I)项所述的外科器械，还包括闭合管驱动系统，其与所述闭合管组件的一部分可操作地接合，以便选择性地将所述推动动作施加到所述闭合管组件上，使得随着所述闭合管驱动系统将所述推动动作施加到所述闭合管组件上，所述闭合管组件将所述闭合动作施加到所述站座组件上。 [0025] (2), as described in Section (I) wherein the surgical instrument further comprising a closure tube drive system is applied, with a portion of the closure tube assembly operably engaged to selectively couple the pushing action onto said closure tube assembly such that as said closure tube drive system of the pushing action applied to said closure tube assembly, said closure tube assembly of the closing motion is applied to said seat assembly station.
[0026] (3)、如第⑴项所述的外科器械，其中所述闭合管组件包括: [0026] (3), such as a surgical instrument according to the first ⑴ item, wherein said closure tube assembly comprises:
[0027] 近侧闭合管段，其与所述闭合管驱动系统接合；和 [0027] the proximal closure tube segment with said closure tube drive system engaged; and
[0028] 远侧闭合管段，其与所述近侧闭合管段枢转地连接，用于选择性地围绕彼此垂直的至少两根轴线相对于所述近侧闭合管段枢转行迸，并被定向成选择性地与所述砧座组件接触，以将所述闭合运动传递到所述砧座组件上。 [0028] The distal closure tube segment with said proximal closure tube segment is pivotally connected, for selectively around at least two axes perpendicular to each other with respect to the proximal closure tube segment pivotally switch 迸, and are oriented selectively in contact with said anvil assembly to transfer said closing motion to said anvil assembly.
[0029] (4)、如第(3)项所述的外科器械，其中所述远侧闭合管段枢转地与中央闭合管段连接，以便选择性地围绕至少ー根枢转轴线相对于所述中央闭合管段枢转行进，其中所述中央闭合管段与所述近侧闭合管段枢转连接，以便选择性地围绕至少ー根其他枢转轴线相对于所述近侧闭合管段枢转行进，其中所述至少一根枢转轴线与所述至少一根其他枢转轴 According to [0029] (4), as described in Section (3) of the surgical instrument, wherein the distal closure tube segment pivotally connected to the central closure tube segment for selectively surrounding at least ー root with respect to the pivot axis the central closure tube segment pivotally traveling, wherein said central closure tube segment with said proximal closure tube segment pivotally attached to selectively surround at least ー root other pivot axis relative to the proximal closure tube segment pivotally traveling, wherein said at least one pivot axis and the pivot axis of said at least one other
线垂直。 Vertical line.
[0030] (5)、ー种用于处理外科器械的方法,所述方法包括: [0030] (5), ー method processing an instrument for surgery, the method comprising:
[0031] 获得如第(I)项所述的器械； [0031] obtained as described in Section (I) of the instrument items;
[0032] 对所述外科器械进行灭菌；和 [0032] For sterilizing the surgical instrument; and
[0033] 将所述器械存储在灭菌容器中。 [0033] the device is stored in the sterile container.
[0034] (6)、一种外科器械,包括: [0034] (6) A surgical instrument, comprising:
[0035]细长通道组件，其被构造成将钉仓组件可操作地支撑在其中； [0035] The elongate channel assembly that is configured to operably support a staple cartridge assembly therein;
[0036] 刀组件，其被定向成在所述细长通道组件中行进；[0037] 驱动系统，用于将驱动动作施加到所述刀组件上； [0036] knife assembly, which is oriented to travel in said elongate channel assembly; [0037] The drive system for the drive operation is applied to the knife assembly;
[0038] 砧座组件，其可动地连接到所述细长通道组件并能够在打开和闭合位置之间运动； [0038] an anvil assembly movably coupled to said elongate channel assembly and movable between open and closed position;
[0039] 闭合环，其靠近所述细长通道组件的端部可操作地受到支撑，用于选择性地将闭合动作施加到所述站座组件上；和 [0039] a closed loop, which is close to the end portion of the elongate channel assembly operably supported by, for selectively applying the closing motion to said seat assembly station; and
[0040] 闭合管段，其与所述闭合环可操作地接合，当将致动动作施加到所述闭合管段上时，驱动所述闭合环与所述砧座组件闭合接触。 [0040] closure tube segment operably engaged with the closed loop, when the operation of the actuator when the closure is applied to the upper pipe section, and the closed loop drive the anvil assembly to close the contactor.
[0041] (7)、如第(6)项所述的外科器械，还包括从所述闭合环突出的至少ー个销，所述至少ー个销被容纳在所述闭合管段中的相应槽中，当所述致动动作施加到所述闭合管段上时，使所述闭合环沿着远侧方向运动成与所述砧座组件闭合接触。 [0041] (7), as described in section (6) of the surgical instrument, further comprising a closed loop from the at least one pin projecting ー, ー corresponding groove of said at least one pin being received in said closure tube segment when the actuation motions applied to said closure tube segment, so that the closed loop in the distal direction movement with said anvil assembly to close the contactor.
[0042] (8)、如第(6)项所述的外科器械，其中所述致动动作是旋转动作。 [0042] (8), as described in Section (6) of the surgical instrument, wherein the actuation motion is a rotary motion.
[0043] (9)、如第(6)项所述的外科器械，还包括从所述闭合管段突出的至少ー个销，所述至少ー个销被容纳在所述闭合环中的相应槽中，当所述致动动作施加到所述闭合管段时，使所述闭合环沿着远侧方向运动成与所述砧座组件闭合接触。 [0043] (9), as described in section (6) of the surgical instrument, further comprising a tube section projecting from the closure of at least ー pins, at least one of said ー pins are received in respective grooves in the closed loop , when applied to the operation of said actuator when said closure tube segment, so that the closed loop in the distal direction movement with said anvil assembly to close the contactor.
[0044] (10)、如第(6)项所述的外科器械，还包括制动系统，其与所述闭合管段可操作地相互作用，以便选择性地将所述闭合管段锁定在需要的位置中。 [0044] (10), as described in Section (6) of the surgical instrument, further comprising a brake system operably interacting with said closure tube segment to selectively lock said closure tube segment in a desired position.
[0045] (11)、如第(6)项所述的外科器械，其中当第二致动动作施加到所述闭合管组件上时，所述闭合环被构造成将拉动动作施加到所述站座组件上，引起所述站座组件运动到打开位置。 [0045] (11), as described in section (6) of the surgical instrument, wherein when a second actuating operation is applied to the closed tube assembly, the closed loop is configured to convert the pulling action is applied to the the seat assembly station, causing the base station component to the open position.
[0046] (12)、如第(11)项所述的外科器械，其中所述致动动作是第一旋转动作，其中所述第二致动动作是另ー个旋转动作。 The surgical instrument of [0046] (12), as described in item (11), wherein said actuator is a first rotational movement operation, wherein said second actuating operation is another ー rotary motion.
[0047] (13)、如第(6)项所述的外科器械，其中所述闭合管段与所述闭合环螺纹连接。 [0047] (13), surgical instrument according to paragraph (6) above, wherein said closure tube segment connected to the closed loop thread.
[0048] (14)、ー种用于处理外科器械的方法,所述方法包括: [0048] (14), ー method processing an instrument for surgery, the method comprising:
[0049] 获得如第(6)项所述的外科器械； [0049] obtained as described in Section (6) of the surgical instrument;
[0050] 对所述外科器械进行灭菌；和[0051 ] 将所述器械存储在灭菌容器中。 [0050] For sterilizing the surgical instrument; and [0051] the device is stored in the sterile container.
[0052] (15)、一种外科器械；包括: [0052] (15) A surgical instrument; comprising:
[0053]细长通道组件，其被构造成将钉仓组件可操作地支撑在其中； [0053] The elongate channel assembly that is configured to operably support a staple cartridge assembly therein;
[0054] 脊组件，其与所述细长通道组件连接； [0054] ridge assembly, which is connected to said elongate channel assembly;
[0055] 刀组件，其被定向以便在对其施加驱动动作时在所述细长通道组件中行进； [0055] The knife assembly is oriented so that the driving operation is applied thereto when traveling in the elongate channel assembly;
[0056] 砧座组件，其可动地连接到所述细长通道组件上，并能够在打开和闭合位置之间运动； [0056] an anvil assembly movably coupled to said elongate channel assembly, and movable between open and closed position;
[0057] 闭合环，其靠近所述细长通道组件可操作地支撑在所述脊组件上以便与所述砧座组件选择性地轴向接触； [0057] a closed loop, which is close to the elongate channel assembly operably supported on said spine assembly for selective axial contact with said anvil assembly;
[0058] 至少ー个第一索过渡支架，其可操作地安装在所述闭合环上； [0058] at least ー a first cable transition support operably mounted to said closure ring;
[0059] 至少ー个第二索过渡支架，其可操作地连接到所述脊组件上；和 [0059] ー a second cable transition support operably connected at least to said ridge assembly; and
[0060] 闭合索，其可操作地围绕所述第一索过渡支架和第二索过渡支架延伸并与索驱动系统接合，以将致动动作施加到所述闭合环以驱动闭合环与所述砧座组件闭合接触。 [0060] closure cable operably surrounds the first cable transition support and the second cable transition support extends and engages the cable drive system to apply actuation motions to be applied to the closed loop and the closed loop drive anvil assembly closed contact.
[0061] (16)、如第(15)项所述的外科器械，其中所述第一和第二索过渡支架选自包括滑轮、杆和绞盘的组中的索过渡支架。 [0061] (16), as described (15) of said surgical instrument, wherein said first and second cable transition support selected from the group comprising a pulley, rod, and the group of the winch cable transition support.
[0062] (17)、如第(15)项所述的外科器械，其中所述脊组件包括: [0062] (17), as described (15) of said surgical instrument, wherein said ridge assembly comprises:
[0063] 与所述细长通道组件连接的远侧脊段；和 [0063] with the elongate channel assembly connected to a distal spine segment; and
[0064] 可动地与所述远侧脊段连接的近侧脊段。 [0064] The movable with said distal spine segment connected to the proximal spine segment.
[0065] (18)、如第(17)项所述的外科器械，其中所述近侧脊段通过球接头组件与所述远侧脊段可动地连接。 According to [0065] (18), as described (17) of the surgical instrument, wherein the proximal spine segments are connected by a ball joint assembly and the distal spine segment movably.
[0066] (19)、ー种用于处理外科器械的方法,所述方法包括: [0066] (19), ー method processing an instrument for surgery, the method comprising:
[0067] 获得如第(15)项所述的器械； [0067] As described in the instrument to get the first item (15);
[0068] 对所述外科器械进行灭菌；和 [0068] For sterilizing the surgical instrument; and
[0069] 将所述器械存储在灭菌容器中。 [0069] the device is stored in the sterile container.
[0070] (20)、一种外科器械；包括: [0070] (20) A surgical instrument; comprising:
[0071]细长通道组件，其被构造成将所述钉仓组件可操作地支撑在其中； [0071] an elongate channel assembly configured to move the cartridge assembly operatively supported therein;
[0072]脊段； [0072] ridge segment;
[0073] 关节运动接头，连接在所述细长通道组件和所述脊段之间，所述关节运动接头包括: [0073] articulation joint coupled between the elongate channel assembly and said spine segment, said articulation joint comprising:
[0074] 插座元件；和 [0074] socket element; and
[0075] 球形元件，其从所述细长通道组件和所述脊段中之一突出并被容纳在所述插座中，以利于所述细长通道组件相对于所述脊段的选择性运动，所述球形元件具有至少ー个可径向延伸部分，用于选择性地与所述插座元件锁定接触，以在将锁定动作施加到所述至少ー个可径向延伸部分上时选择性地防止所述球形元件在所述插座元件中运动。 [0075] the spherical element and is housed in the projecting receptacle, said elongate channel assembly relative to facilitate selective movement of the ridge segment from one of said elongate channel assembly and said spine segment , said spherical member having at least one radially extending portion ー, used for selectively locking contact with said socket member, the locking action is applied to at least to the last ー radially extending portions selectively preventing movement of said spherical member in said socket element.
[0076] (21)、如第(20)项所述的外科器械，还包括与所述可径向延伸部分连接的至少ー根索，使得当张カ被施加到所述索上时，所述可径向延伸部分在所述插座元件中径向延伸。 [0076] (21), such as a surgical instrument section (20) above, further comprising a radially extending portion connected to said at least ー root cable, such that when the sheet is applied to the cord grades on the said radially extending portion extending radially in the receptacle element.
[0077] (22)、如第(20)项所述的外科器械，还包括致动元件，其穿过所述球形元件的中央部分延伸，并被构造成当轴向致动动作施加到所述致动元件时将径向运动施加到所述可径向延伸部分上。 [0077] (22), such as a surgical instrument section (20) above, further comprising an actuator member, which central portion extends through the spherical element, and is configured such that when axial movement is applied to the actuator when said actuator element is applied to the radial movement of said radially extending portion.
[0078] (23)、ー种用于处理外科器械的方法，所述方法包括: [0078] (23), ー method processing an instrument for surgery, the method comprising:
[0079] 获得如第(20)项所述的器械； [0079] obtained as described in the instrument section (20) entries;
[0080] 对所述外科器械进行灭菌；和[0081 ] 将所述器械存储在灭菌容器中。 [0080] For sterilizing the surgical instrument; and [0081] the device is stored in the sterile container.
[0082] (24)、一种外科器械,包括: [0082] (24) A surgical instrument, comprising:
[0083]细长通道组件，其被构造成将钉仓组件可操作地支撑在其中； [0083] an elongate channel assembly that is configured to operably support a staple cartridge assembly therein;
[0084] 脊段；和 [0084] ridge segment; and
[0085] 连接在所述细长通道组件和所述脊段之间的关节运动接头，所述关节运动接头包括: [0085] connected between said elongate channel assembly and said spine segment of the articulation joint, the articulation joint comprises:
[0086] 插座元件，位于所述细长通道组件和所述脊段之一中； [0086] socket element, in one of the elongate channel assembly and said spine segment;
[0087] 球形元件，其可动地容纳在所述插座元件中，并从所述细长通道组件和所述脊段中的另ー个突出；和 [0087] spherical element, which is movably received in said socket element, and from the elongate channel assembly and said spine segment another ー projections; and
[0088] 至少ー个锁定部分，其选择性地与所述球形元件接合， [0088] At least ー locking portion, which is selectively engageable with said spherical element,
[0089] 以防止所述球形元件在所述插座中运动。 [0089] in order to prevent the movement of the spherical member in said socket. [0090] (25)、如第(24)项所述的外科器械，其中所述至少一个锁定部分包括所述插座元件的至少ー个可径向收缩部分。 The surgical instrument of [0090] (25), as described in item (24), wherein said at least one locking portion comprises a socket element at least ー radially constricted portion.
[0091] (26)、如第(25)项所述的外科器械，还包括与所述插座元件的所述至少一个可径向收缩部分可操作地接合的至少ー根索，当将张カ施加到所述索上时，使所述插座元件的所述至少一个可径向收缩部分径向收缩成与所述球形元件锁定接触。 [0091] (26), such as the section (25) of said surgical instrument, and further comprising at least one of the socket member is contracted radially at least partially ー root cable operably engaged, when the sheets ka When applied to the cord on the socket element so that the at least one radial contraction of the radial contraction part into contact with the spherical locking element.
[0092] (27)、如第(24)项所述的外科器械，其中所述锁定部分包括被支撑的闭合环，用于选择性地在所述插座元件的至少一部分上滑动行进，当所述闭合环在其上滑动时，使所述插座元件的至少ー些所述可径向收缩部分运动成与所述球形元件锁定接触。 The surgical instrument of [0092] (27), as described in item (24), wherein the locking portion comprises a closed ring supported, for selectively at least a portion of said socket element of the sliding travel, when the said closed loop when sliding thereon, so that the socket element, at least some of said radial contraction ー portion movement into locking contact with said spherical element.
[0093] (28)、如第(24)项所述的外科器械，其中所述至少一个锁定部分包括被支撑的锁定销，用干与所述球形元件的一部分和所述插座元件的一部分之一选择性锁定结合。 [0093] (28), as said first (24) of the surgical instrument, wherein the at least one locking portion comprises a locking pin is supported by a portion of the stem portion of the spherical element and said socket element of a selective combination lock.
[0094] (29)、如第(28)项所述的外科器械，其中所述锁定销被定向用干与所述球形元件的其中形成有至少ー个定位槽的部分选择性接合。 Wherein [0094] (29), such as a surgical instrument according to paragraph (28) above, wherein the locking pin is oriented with a dry and said spherical member partially formed with at least ー selectively positioning groove engagement.
[0095] (30)、如第(28)项所述的外科器械，其中所述锁定销被容纳在所述球形元件中，并被定向以便与所述插座的其中具有至少ー个定位槽的部分选择性接合。 [0095] (30), such as a section (28) of said surgical instrument, wherein the locking pin which is accommodated in the spherical element and is oriented so said socket having at least one positioning groove ーPart selective engagement.
[0096] (31)、ー种用于处理外科器械的方法,所述方法包括: [0096] (31), ー method processing an instrument for surgery, the method comprising:
[0097] 获得如第(24)项所述的器械； [0097] As described in the instrument to get the first item (24);
[0098] 对所述外科器械进行灭菌；和 [0098] For sterilizing the surgical instrument; and
[0099] 将所述器械存储在灭菌容器中。 [0099] the device is stored in the sterile container.
[0100] 通过附图及其描述，本发明的这些和其它目的和优点将是可以想到的。 [0100] The drawings and the description, these and other objects and advantages of the invention will be conceivable.
[0101 ] 包含在本说明书中并构成其一部分、示出本发明的实施方式的附图与上面给出的本发明的一般描述以及下面给出的实施方式的详细描述一道，用于解释本发明的各种原理。 [0101] included in the present specification and constitute a part, illustrating the general description given above and the accompanying drawings an embodiment of the present invention of the present invention and the detailed description of the embodiments given below, together, serve to explain the present invention The various principles.
[0102] 图1是本发明的各种实施方式的外科缝合和切割器械的透视图。 [0102] FIG. 1 is a perspective view of the surgical stapling and severing instrument of various embodiments of the present invention.
[0103] 图2是图1中示出的工具组件的分解透视图。 [0103] FIG. 2 is an exploded perspective view of FIG. 1 shows the tool assembly.
[0104] 图3是图1的工具组件的从右侧看的透视图，其中该工具组件的一些元件以剖面显不。 [0104] FIG. 3 is a perspective view viewed from the right tool assembly of Figure 1, wherein some of the elements of the tool assembly in cross-section substantially not.
[0105] 图4是图2和3中示出的工具组件的左侧部分剖视图。 [0105] FIG. 4 is a sectional view of a left side portion 2 3 shown in FIG. And the tool assembly.
[0106] 图5是其中ー些部分与本发明的各种实施方式的仓组件分离的仰视透视图。 [0106] FIG. 5 is a bottom perspective view in which the various embodiments of the present invention ー some portion of the cartridge assembly and separation.
[0107] 图6是本发明的各种实施方式的滑车、缝钉和缝钉推出器的分解组装图。 [0107] FIG. 6 is a block of various embodiments of the present invention, staples and staple ejector exploded assembly view.
[0108] 图7是本发明的各种实施方式的砧座组件的透视图。 [0108] FIG. 7 is a perspective view of various embodiments of the present invention of the anvil assembly.
[0109] 图8是本发明的各种实施方式的动カ夹钳元件的透视图。 [0109] FIG. 8 is a perspective view of the movable jaw member ka various embodiments of the present invention.
[0110] 图9是图1-4中示出的工具组件的侧剖视图，其中组织被夹钳在工具组件中。 [0110] FIG. 9 is a sectional side view 1-4 shown in FIG tool assembly, wherein the tissue is clamped in the tool assembly.
[0111] 图10是本发明的各种实施方式的细长通道组件的仰视透视图。 [0111] FIG. 10 is a bottom perspective view of the various embodiments of the elongate channel assembly of the present invention.
[0112] 图11是图10的细长通道组件的近侧部分的透视图。 [0112] FIG. 11 is a perspective view of the proximal portion of the elongate channel assembly 10 of FIG.
[0113] 图12是图10和11的细长通道组件的远侧部分的透视图。 [0113] FIG. 12 is a perspective view of the distal portion of the elongate channel assembly 10 and 11.
[0114] 图13是图10-12的细长通道组件的远侧部分的剖面图，其中动カ夹钳元件支撑在其中。 [0114] FIG. 13 is a sectional view of the distal portion of the elongate channel assembly of FIG. 10 to 12, wherein the movable jaw member supported therein ka. [0115] 图14是图10-13的细长通道组件的另ー仰视图。 [0115] FIG. 14 is a diagram of the elongate channel assembly of 10-13 Another ー bottom view.
[0116] 图15是本发明的各种实施方式的击发系统的示意性侧视图。 [0116] FIG. 15 is a schematic side view of a firing system of various embodiments of the present invention.
[0117] 图15A是本发明的各种实施方式的另ー种击发系统的示意性侧视图。 [0117] FIG 15A is another kind ー schematic side view of a firing system of various embodiments of the present invention.
[0118] 图16是图15的击发系统的示意性俯视图。 [0118] FIG. 16 is a diagram of a firing system 15 a schematic plan view.
[0119] 图16A是图15A的击发系统的示意图。 [0119] FIG. 16A is a schematic view of a firing system of Figure 15A.
[0120] 图17是本发明的各种实施方式的绞盘组件的主透视图。 [0120] FIG. 17 is a front perspective view of a winch assembly of various embodiments of the present invention.
[0121] 图18是图17的绞盘组件实施方式的后透视图。 [0121] FIG. 18 is a rear perspective view of the winch assembly 17 of the embodiment of FIG.
[0122] 图19是图17和18的绞盘组件实施方式的右侧图。 [0122] FIG. 19 is a right side in FIG. 17 and FIG. 18 winch assembly embodiment.
[0123] 图20是处于空闲位置的图17-19的绞盘组件实施方式的剖视图。 [0123] FIG. 20 is a sectional view of the rest position of FIGS. 17-19 in the winch assembly embodiment.
[0124] 图21是本发明的驱动系统实施方式的透视图。 [0124] FIG. 21 is a perspective view of a drive system of an embodiment of the present invention.
[0125] 图22是采用关节运动接头的本发明的另ー种实施方式的局部剖视图。 [0125] FIG. 22 is a partial cross-sectional view of another embodiment of the seed ー articulation joint of the present invention employs.
[0126] 图23是在图22中示出的关节运动接头的局部放大剖视图。 [0126] FIG. 23 is a cross-sectional view in FIG. 22, partially shown in an enlarged articulation joint.
[0127] 图24是图22中示出的器械的一部分的放大剖视图。 [0127] FIG. 24 is an enlarged sectional view showing a portion of the instrument in FIG. 22.
[0128] 图25是本发明的另ー细长通道组件的仰视图。 [0128] Figure 25 is another ー bottom view of the elongate channel assembly of the present invention.
[0129] 图26是图25的细长通道组件的远端部分的放大图。 [0129] FIG. 26 is an enlarged view of the distal portion of the elongate channel assembly 25.
[0130] 图27是沿着图26中的线27-27的图26中的细长通道组件远端的一部分的剖视图。 [0130] FIG. 27 is a sectional view of a portion along the line 26 in Figure 27-27 of Figure 26, the distal end of the elongate channel assembly.
[0131] 图28是本发明的另ー细长通道组件实施方式的远端的一部分的仰视图，其中一些元件以剖面显示。 [0131] Figure 28 is a distal end of the elongate channel assembly ー another embodiment of a bottom view of a portion of the present invention, wherein some of the elements in a cross-sectional display.
[0132] 图29是沿着图28中的线29-29的图28中示出的细长通道组件的一部分的剖视图。 [0132] FIG. 29 is a sectional view of a portion along the line 28 in Figure 29-29 of Figure 28 shown in the elongate channel assembly.
[0133] 图30是本发明的各种实施方式的采用索张紧接头的另一索设置的示意性俯视图。 [0133] FIG. 30 is a various embodiments of the present invention employs a cable tensioning joint schematic top view of another cable set.
[0134] 图31是图30的索设置的另ー示意性俯视图，其中索张紧接头处于完全张开位置。 [0134] Figure 31 is a set 30 of another cable ー schematic plan view, wherein the cable tensioning joint in a fully open position.
[0135] 图32是处于进行关节运动位置的图30和31的索设置的另ー示意性俯视图。 [0135] FIG. 32 is in the articulated position of Fig. 30 and 31 of the cable set another ー schematic plan view.
[0136] 图33是图30-32中示出的索张紧接头的局部放大图。 [0136] FIG. 33 is a partially enlarged diagram shown in FIG. 30-32 cable tensioning joint.
[0137] 图34是本发明的索实施方式的透视图。 [0137] FIG. 34 is a perspective view of a cable embodiment of the present invention.
[0138] 图35是本发明的索连接接头实施方式的放大图。 [0138] FIG. 35 is a cable attachment joint embodiment of the present invention is an enlarged view.
[0139] 图36是与动力夹钳组件连接的本发明的索锚定接头实施方式的剖视图。 [0139] FIG. 36 is given a cross-sectional view of an embodiment of the connector cable anchor and dynamic clamping assembly connected to the present invention.
[0140] 图37是图36的索锚定接头的透视图。 [0140] FIG. 37 is a perspective view of the cable anchor joint of FIG 36 is given.
[0141] 图38是与动力夹钳组件连接的本发明的另一索锚定接头实施方式的剖视图。 [0141] FIG. 38 is a sectional view of another dynamic clamping assembly of the present invention, the cable connected to the anchor joint embodiment.
[0142] 图39是本发明的另一索连接实施方式的局部视图。 [0142] FIG. 39 is a partial view of another cable attachment embodiment of the present invention.
[0143] 图40是本发明的另一索连接实施方式的局部视图。 [0143] FIG. 40 is a partial view of another cable attachment embodiment of the present invention.
[0144] 图41是关节运动接头设置的局部透视图。 [0144] FIG. 41 is a partial perspective view of the articulation joint set.
[0145] 图42是本发明的闭合管接头组件实施方式的透视图。 [0145] FIG. 42 is a perspective view of a closure tube joint assembly embodiment of the present invention.
[0146] 图43是沿着线43-43的图42的闭合管接头组件实施方式的剖视图。 [0146] FIG. 43 is a sectional view of an embodiment of the connector assembly along line 43-43 of the closure tube 42 of FIG.
[0147] 图44是安装在图41中示出的关节运动接头上方的图42和43的闭合管接头组件的透视图。 [0147] FIG. 44 is mounted in Figure 41 the articulation joint shown in Fig. 42 and 43 above the closure tube joint assembly perspective view of FIG.
[0148] 图44A是安装在图41的关节运动接头上方的本发明的另ー闭合管接头组件实施方式的透视图。 [0148] FIG. 44A is mounted in a perspective view of another ー closure tube joint assembly embodiment of the articulation joint of Fig. 41 above the present invention.
[0149] 图45是本发明的另ー砧座组件实施方式的透视图。 [0149] Figure 45 is another ー anvil assembly perspective view of an embodiment of the present invention.
[0150] 图46是本发明的手柄组件和闭合管致动设置实施方式的分解透视图。 [0150] FIG. 46 is a handle assembly of the present invention and a closure tube actuation setting exploded perspective view of the embodiment.
[0151] 图47是本发明的手柄组件和工具组件实施方式的局部剖视图，其中ー些元件以立体方式显示，并且砧座组件处于闭合或者夹钳位置。 [0151] FIG. 47 is a partial cross-sectional view of the handle assembly and tool assembly of an embodiment of the present invention, wherein ー elements so as to display the three-dimensional manner, and the anvil assembly is in the closed position or clamp.
[0152] 图48是本发明的闭合管组件和工具组件实施方式的局部剖视图，其中砧座组件处于闭合或夹钳位置。 [0152] FIG. 48 is a partial sectional view of a closure tube assembly and tool assembly of an embodiment of the present invention, wherein the anvil assembly in a closed position or clamp.
[0153] 图49是图47的手柄组件和砧座组件的另一局部剖视图，其中其砧座组件处于打开位置。 [0153] Figure 49 is another partial cross-sectional view of the handle assembly and the anvil assembly of Figure 47, wherein the anvil assembly is in its open position.
[0154] 图50是图48的闭合管组件和工具组件的另一局部剖视图，其中其砧座组件处于打开位置。 [0154] Figure 50 is another partial cross-sectional view of the closure tube assembly and tool assembly of Figure 48, wherein the anvil assembly is in its open position.
[0155] 图51是本发明的另ー种实施方式的闭合管和闭合环的局部剖视图。 [0155] FIG. 51 is a partial cross-sectional view of another ー present invention embodiments as the closure tube and the closed loop.
[0156] 图52是本发明的另ー种实施方式的万向关节运动接头的局部剖切透视图。 [0156] FIG. 52 is a species of the present invention further ー partially cutaway perspective view of an embodiment of a universal articulation joint of FIG.
[0157] 图53是图52的工具组件和关节运动接头的剖视图。 [0157] FIG. 53 is a sectional view of the tool assembly and articulation joint of FIG. 52.
[0158] 图54是图53的工具组件和关节运动接头的俯视图。 [0158] FIG. 54 is a view of the tool assembly and articulation joint 53 is a plan view of FIG.
[0159] 图55是本发明的另ー种实施方式的另一万向关节运动接头的剖视图。 [0159] FIG. 55 is the present invention further ー embodiments as described cross-sectional view of another universal articulation joint.
[0160] 图56是本发明的索控可锁定关节运动接头实施方式的透视图。 [0160] FIG. 56 is a control cable of the present invention is a perspective view of the lockable articulation joint embodiment.
[0161] 图57是图56的索控可锁定关节运动接头实施方式的端视图。 [0161] FIG. 57 is a diagram of the control cable 56 is an end view of the lockable articulation joint embodiment.
[0162] 图58是本发明的另ー种实施方式的另一索控可锁定关节运动接头的剖视图。 [0162] Figure 58 is the present invention further ー embodiments as described further sectional view of the cable controlled lockable articulation joint.
[0163] 图59是图58的索控可锁定关节运动接头的近侧脊段的局部透视端视图。 [0163] FIG. 59 is a diagram of the control cable 58 may be a partial perspective end view of the proximal locking ridge segment articulation joint.
[0164] 图60是图59的近侧脊段的端视图。 [0164] FIG. 60 is an end view of the ridge 59 of the proximal segment.
[0165] 图61是图59和60的近侧脊段的局部侧视图。 [0165] FIG. 61 is a partial side view of the ridge 59 and proximal segment 60.
[0166] 图62是本发明的另ー种实施方式的另一可锁定关节运动接头的剖视图。 [0166] FIG. 62 is a species of the present invention further ー embodiment cross-sectional view of another lockable articulation joint.
[0167] 图63是图62的可锁定关节运动接头的近侧脊段的局部透视端视图。 [0167] FIG. 63 is a partial perspective view of FIG lockable end view of a proximal spine segment of the articulation joint 62.
[0168] 图64是图63的近侧脊段的端视图。 [0168] Figure 64 is an end view of the proximal spine segment of FIG. 63.
[0169] 图65是本发明的另ー种实施方式的另一可锁定关节运动接头的剖视图。 [0169] Figure 65 is the present invention further ー embodiments as described cross-sectional view of another lockable articulation joint.
[0170] 图66是图65的可锁定关节运动接头的近侧脊段的局部透视端视图。 [0170] FIG. 66 is a partial perspective view of FIG lockable end view of a proximal spine segment of the articulation joint 65.
[0171] 图67是图66的近侧脊段的端视图。 [0171] Figure 67 is an end view of the proximal section 66 of the ridge.
[0172] 图68是本发明的另ー种实施方式的另一可锁定关节运动接头的剖视图。 [0172] FIG. 68 is the present invention further ー embodiments as described cross-sectional view of another lockable articulation joint.
[0173] 图69是图68的可锁定关节运动接头的近侧脊段的局部透视端视图。 [0173] FIG. 69 is a partial perspective view of FIG lockable proximal end view of the ridge segment 68 of the articulation joint.
[0174] 图70是图69的近侧脊段的端视图。 [0174] Figure 70 is an end view of the proximal section 69 of the ridge.
[0175] 图71是本发明的另ー种实施方式的另一可锁定关节运动接头的剖视图。 [0175] FIG. 71 is the present invention further ー embodiments as described cross-sectional view of another lockable articulation joint.
[0176] 图72是本发明的另ー种实施方式的另一可锁定关节运动接头的剖视图。 [0176] FIG. 72 is the present invention further ー embodiments as described cross-sectional view of another lockable articulation joint.
[0177] 图73A是本发明的另ー种外科器械实施方式的工具组件和关节运动接头的局部首1J视图。 [0177] FIG. 73A is a partial view of another ー 1J first species surgical instrument embodiment tool assembly and articulation joint of the present invention.
[0178] 图73B是图73A的外科器械的闭合管组件的局部剖视图。 [0178] FIG. 73B is a partial cross-sectional view of the surgical instrument of FIG. 73A closure tube assembly.
[0179] 图74A是图73A和73B的外科器械的工具组件和关节运动接头的另ー种局部剖视图。 [0179] FIG. 74A is a partial sectional view of a tool assembly and articulation surgical instrument of FIG. 73A and 73B another ー linker species.
[0180] 图74B是图73A和73B的外科器械的闭合管组件的另一局部剖视图。 [0180] FIG. 74B is another partial cross-sectional view of the closure tube assembly of the surgical instrument of FIG. 73A and 73B are. [0181] 图75是沿着图74A中的线75-75的图74A中示出的闭合管组件的剖视图。 [0181] FIG. 75 is a sectional view taken along line 74A in FIG. 74A 75-75 are shown in the closed tube assembly.
[0182] 图76是沿着图74B中的线76_76的图74B中示出的闭合管组件的另ー剖视图。 [0182] FIG. 76 is taken along the line 74B 74B in Fig 76_76 FIG closure tube assembly illustrated in cross-sectional view of another ー.
[0183] 图77是沿着图74B中的线77_77的图74B中示出的闭合管组件的另ー剖视图。 [0183] FIG. 77 is taken along the line 74B 74B in Fig 77_77 FIG closure tube assembly illustrated in cross-sectional view of another ー.
[0184] 图78是本发明实施方式的快速断开接头的局部分解组装视图，其中其元件以剖面显示。 [0184] FIG. 78 is an embodiment of the present invention is a partial exploded assembly view of the quick-disconnect connector, in cross-section display in which the elements thereof.
[0185] 图79是图78的快速断开接头的另一局部分解组装视图。 [0185] FIG. 78 FIG. 79 is another partial exploded assembly view of the quick disconnect fitting.
[0186] 图80是图78和79的快速断开接头的另一局部分解组装视图。 [0186] Figure 80 is another partial exploded assembly view of the quick disconnect fittings 78 and 79 of the.
[0187] 图81是图78-80的快速断开接头的另一局部分解组装视图。 [0187] Figure 81 is an exploded view of another partial view of the quick-disconnect connector 78-80.
[0188] 图82是本发明的另一手柄组件实施方式的剖视图。 [0188] FIG. 82 is a sectional view of another handle assembly embodiment of the present invention.
[0189] 图83是本发明的各种实施方式的驱动系统的示意性端视图。 [0189] FIG. 83 is a schematic end views of various embodiments of the drive system of the present invention.
[0190] 图84是本发明的各种实施方式的制动释放机构的局部透视图。 [0190] FIG. 84 is a partial perspective view of the various embodiments of the brake release mechanism of the present invention.
[0191] 图85是本发明的各种实施方式的另ー关节运动接头实施方式的局部透视图。 [0191] Figure 85 is another embodiment of the articulation joint ー partial perspective view of various embodiments of the present invention.
[0192] 图86是图85的关节运动接头的分解组装视图。 [0192] FIG. 86 is an exploded assembly view of the articulation joint 85.
[0193] 图87是图85和86的关节运动接头的局部侧视图。 [0193] FIG. 87 is a partial side view of FIG. 85 and 86 of the articulation joint.
[0194] 图88是图87的关节运动接头的俯视图。 [0194] FIG. 88 is articulation joint of FIG 87 a plan view of FIG.
[0195] 图89是处于进行关节运动位置的图87和88的关节运动接头的另ー种俯视图。 [0195] FIG. 89 is in the articulated position of Fig. 87 and 88 ー articulation joint of another species plan view.
[0196] 图90是本发明的各种实施方式的另ー工具组件和闭合管设置的局部透视图，其中一部分闭合管以剖面显示。 [0196] Figure 90 is another ー partial perspective view of the tool assembly and closure tube disposed in various embodiments of the present invention, wherein a portion of closure tube in cross-section display.
[0197] 图91是图90的工具组件和闭合管组件设置的剖面图，其中耳轴锁定杆处于将耳轴保持在它们各自的槽中的锁定位置。 [0197] FIG. 91 is a sectional view of the tool assembly and closure tube assembly of Figure 90 is provided, wherein the trunnion in the trunnion lock lever held in their respective grooves of the locked position.
[0198] 图92是图91的工具组件和闭合管设置的局部俯视图，其中其部分以剖面显示。 [0198] FIG. 92 is a view of the tool assembly 91 and a partial top view of the closed pipe is provided, wherein its portions in cross-section display.
[0199] 图93是图90-92的工具组件和闭合管设置的剖面图，其中耳轴锁定杆处于未锁定位置。 [0199] FIG. 93 is a sectional view of the tool assembly and closure tube set of Fig. 90-92, wherein the trunnion lock lever is in the unlocked position.
[0200] 图94是图93的工具组件和闭合管设置的局部俯视图，其中其一部分以剖面显示。 [0200] FIG. 94 is a view of the tool assembly 93 and a partial plan view of the closed pipe is provided, wherein a portion of its cross-section is displayed.
[0201] 图95是图90-92的工具组件和闭合管组件设置的剖面图，其中耳轴锁定杆处于未锁定位置并且耳轴从细长通道组件的耳轴槽中运动出来。 [0201] FIG. 95 is a view of the tool assembly and closure tube cross-sectional view of the assembly set 90-92, wherein the trunnion lock lever is in the unlocked position and out of the trunnion slots trunnion movement of the elongate channel assembly.
[0202] 图96是本发明的各种实施方式的另ー动力夹钳组件的侧视图。 [0202] Figure 96 is another side view ー dynamic clamping assembly of various embodiments of the present invention.
[0203] 图97是本发明的各种实施方式的另ー动力夹钳组件的侧视图。 [0203] Figure 97 is another side view ー dynamic clamping assembly of various embodiments of the present invention.
[0204] 图98是本发明的各种实施方式的另ー动力夹钳组件的侧视图。 [0204] Figure 98 is another side view ー dynamic clamping assembly of various embodiments of the present invention.
[0205] 图99是本发明的各种实施方式的另ー动力夹钳组件的侧视图。 [0205] Figure 99 is another side view ー dynamic clamping assembly of various embodiments of the present invention.
[0206] 图100是在槽已经被打开并且销已经被除去后图99的动カ夹钳组件的另ー侧视图。 [0206] FIG. 100 is a groove has been opened and the pin has been fixed another ー ka clamping assembly 99 after removal of a side view of FIG.
[0207] 图101是本发明的各种实施方式的另ー动力夹钳组件的侧视图。 [0207] Figure 101 is another side view ー dynamic clamping assembly of various embodiments of the present invention.
[0208] 图102是本发明的各种实施方式的另ー动力夹钳组件的侧视图。 [0208] Figure 102 is another side view ー dynamic clamping assembly of various embodiments of the present invention.
[0209] 图103是沿着图102中的线103-103的图102的动カ夹钳组件的局部剖视图。 [0209] FIG. 103 is a partial cross-sectional view taken along line 103-103 in FIG 102. FIG dynamic clamping assembly 102 ka.
[0210] 图104是本发明的另ー种外科器械实施方式的一部分的侧视图，其中闭合环运动到其最远侧位置并且其中其ー些元件以剖面显示。 [0210] Figure 104 is another embodiment of a surgical instrument ー kind of side view of a part of the present invention, wherein the closed loop is moved to its distal-most position and wherein the cross-sectional view thereof ー elements so as to display.
[0211] 图105是图104的外科器械实施方式的侧视图，其中闭合环运动到其最近侧位置并且其ー些元件以剖面显示。 [0211] Figure 105 is a side view of the surgical instrument embodiment of FIG. 104, wherein the closed loop is moved to its proximal-most position and which ー elements so as to display the cross-section. 具体实施方式 DETAILED DESCRIPTION
[0212] 现在将描述ー些典型实施方式，提供对本文中公开的装置和方法的结构、功能、制造和使用的原理的总体理解。 [0212] will now be described ー some exemplary embodiments, provides apparatus and methods disclosed herein of the structure, an overall understanding of the function, manufacture, and use principles. 这些实施方式的一个或多个例子在附图中示出。 One or more examples of these embodiments are illustrated in the accompanying drawings. 本领域普通技术人员将会理解，在本文中特别描述和在附图中示出的装置和方法是非限制性的典型实施方式，本发明的各种实施方式的范围仅由权利要求书来限定。 One of ordinary skill in the art will appreciate that specifically described and illustrated in the drawings herein of exemplary embodiments of apparatus and methods are non-limiting, the scope of various embodiments of the present invention is only defined by the claims. 结合一种典型实施方式不出和描述的特征可与其他实施方式的特征组合。 Not in connection with one exemplary embodiment may be characterized and described with a combination of the features of other embodiments. 这样的修改和变化也包括在本发明的范围内。 Such modifications and variations are also included within the scope of the invention.
[0213] 转向附图，其中相同的附图标记在ー些附图中表示相同的元件，图1示出了能够实践本发明的ー些独特优点的外科器械，在典型方案中其具体为外科縫合和切割器械I。 [0213] Turning to the drawings, wherein like reference numerals refer to like elements in ー these drawings, FIG 1 shows a to practice the present invention ー some unique advantages of a surgical instrument, in a typical scenario for specific surgical stapling and severing instrument I. 器械I可主要包括外科缝合器，其形式和构造在前面引证的美国专利公开US2006/0011699A1中公开，在此通过全文引用而包含在本申请中，其中一个或多个改进在下面描述。 Instrument I may include surgical stapler, its form and structure in the U.S. Patent cited above is disclosed US2006 / 0011699A1 is disclosed herein and incorporated herein by reference in its entirety, wherein one or more improvements in the following description. 但是，如前面本具体实施方式所说的那样，本领域普通技术人员可以理解，与其他外科縫合器构造有关的在本文中描述的各种实施方式和改进都可被包括，也不脱离本发明的精神和范围。 However, in this particular embodiment, as previously stated, one of ordinary skill will appreciate, other related surgical stapler constructed in various embodiments and improvements described herein can be included, not departing from the present invention The spirit and scope.
[0214] 如图1所示，器械I可包括分别具有远端4和近端6的外壳3、安装在外壳3上(优选安装在其远端4上)的细长轴20以及总体标记为5的手柄组件。 [0214] 1, the instrument I may include a housing 4, respectively, having a distal end and a proximal end 6 of 3, the elongate shaft 3 is mounted on the housing (4 preferably mounted on the distal end thereof) is generally designated 20 and 5 of the handle assembly. 轴20可具有远端20a，可通过连接机构20b可操作地将一次性加载单元10与其连接。 Shaft 20 may have a distal end 20a, 20b can be operably disposable loading unit 10 connected thereto through the connection mechanism. 同样如图1所示，一次性加载单元(DLU) 10可包括可枢转并可操作地通过连接器机构C彼此连接的工具组件100和轴连接器部分20c。 Also shown in Figure 1, the disposable loading unit (DLU) 10 may comprise a pivotally and operatively mechanism C via the connector tool assembly 100 connected to each other and the shaft connector portion 20c.
[0215] 在本发明公开的范围内，工具组件100例如通过连接机构诸如连接器机构C可枢转、可操作或者整体地永久并直接连接到一次性外科縫合器的轴20的远端20a。 The distal end [0215] within the scope of the present disclosure, tool assembly 100 such as by connection means such as a connector means C pivotally, operatively, or integrally permanently and directly connected to a disposable surgical stapling instrument shaft 20 20a. 如同已知的那样，已使用或者用过的一次性加载单元10可从可重新使用或者一次性的开放式内窥镜或者腹腔镜外科縫合器的轴20上除去，并更换成未使用过的一次性単元。 20 is removed as is known, used or spent disposable loading unit 10 may be reusable or disposable from open endoscopic or laparoscopic surgical stapler shaft, and replaced with an unused Disposable radiolabeling yuan. 在各种实施方式中，可以想到具有或不具有整体或可拆卸连接的一次性加载单元的轴20可选择性地从外壳3拆卸。 In various embodiments, it is contemplated that the shaft with or without a disposable loading unit 20 connected integrally or selectively removable from the housing 3 disassembly.
[0216] 轴连接器部分20c包括近端24和远端22。 [0216] shaft connector portion 20c includes a proximal end 24 and a distal end 22. 如前所述，近端24可永久或者可拆卸地与手柄或者手动(或者其他，例如机器人或计算机)操作的开放式或者内窥镜外科縫合器I的其他致动组件连接。 As mentioned earlier, the other proximal actuator assembly 24 may be permanently or removably or manually with the handle (or others, such as robots or computer) operated open or endoscopic surgical stapler I connection. 轴连接器部分20c的远端22可操作地连接到工具组件100。 Shaft connector portion 20c of the distal end 22 operatively connected to the tool assembly 100. エ具组件100通常可包括细长通道组件120、砧座组件110和钉仓组件200。 Eito tool assembly 100 may generally include an elongate channel assembly 120, an anvil assembly 110 and cartridge assembly 200. 一旦未用尽或未用过的仓200安装在细长通道组件120上,工具组件100还可优选包括致动器(优选为动力夹钳元件150)、滑车160以及缝钉推出器228和缝钉350，參见图2、5和6。 Once the non-exhaustion or unused cartridge 200 is mounted on the elongate channel assembly 120, the tool assembly 100 further preferably includes an actuator (preferably a dynamic clamping jaw member 150), block 160, and a staple ejector 228 and the seam nail 350, see Fig. 2, 5 and 6.
[0217] 应当理解，术语“近端”和“远端”在本文中以临床医生握持器械的手柄为參照。 [0217] It should be understood that the terms "proximal" and "distal" is used herein in the clinician gripping the handle of the instrument as a reference. 因此，工具组件100相对于更近侧的手柄组件5为远侧。 Thus, the tool assembly 100 with respect to the more proximal handle assembly 5 is distally. 还应理解，为了方便和清楚起见，空间术语“垂直”和“水平”在本文中以附图为參考来使用。 It should also be understood that, for convenience and clarity, spatial terms "vertical" and "horizontal" herein used with reference to the accompanying drawings. 但是，外科器械可以许多朝向和位置来使用，这些术语并不是限制和绝对化。 However, the surgical instrument can be used in many orientations and positions, that these terms are not limiting and absolute.
[0218] 轴连接器部分20c可以是圆柱形形状并限定了尺寸可设置为容纳管适配器40的内部通道25，见图2。 [0218] shaft connector portion 20c may be cylindrical shape and defines the size of the tube may be provided to accommodate internal passage 40 of the adapter 25, shown in Figure 2. 轴连接器部分20c还可接收或容纳用于致动工具组件100的致动器。 Shaft connector portion 20c may also receive or accommodate a tool assembly for actuating the actuator 100. 工具组件100可安装到轴连接器20c的远端22 (或者轴20的远端20a)上。 Tool assembly 100 may be mounted to shaft distal end 22 connector 20c (or the distal end of the shaft 20 20a) on. 在各种实施方式中，工具组件100可被安装在具有外部圆柱表面47的管适配器40上，该外部圆柱表面47可与轴连接器20c (再次地，也可与轴20)的内部通道25摩擦配合接合而被滑动容纳。 In various embodiments, tool assembly 100 may be mounted on the adapter tube 47 having an outer cylindrical surface 40, the outer cylindrical surface 47 with a shaft connector 20c (Again, the shaft 20 may be) of the internal passage 25 friction fit engagement is slidably accommodated. 这里，工具组件100与轴连接器20c的近端连接或附接还可应用到其与轴20的连接。 Here, the tool assembly 100 is connected to the proximal end of shaft connector 20c may also be applied or attached to shaft 20 which is connected to. 管适配器40的外表面47还可还包括至少ー个机械界面，例如切ロ或者凹ロ45，其被定向为与设置在内部通道25的内周上的相应的机械界面例如径向向内延伸的凸起或定位槽(未显示)配合，以便将管适配器40锁定到轴连接器20c。 The outer surface 47 of tube adapter 40 may further include at least ー mechanical interface, e.g., cut or recess ro ro 45, which is oriented with the internal passage provided in the inner periphery 25 of the respective mechanical interface extending radially inwardly e.g. The projection or locating slot (not shown) with, in order to lock the tube adapter 40 to the shaft connector 20c.
[0219] 在各种实施方式中，管适配器40的远端可包括一对相对的翼缘42a和42b，它们限定了用于枢转地容纳枢轴块50的腔41。 [0219] In various embodiments, the distal end of tube adapter 40 may include a pair of opposing flanges 42a and 42b, which define a cavity for pivotally receiving the pivot block 50 41. 每个翼缘42a和42b可包括被定向为容纳枢轴销57的孔44a和44b，所述枢轴销延伸通过枢轴块50中的孔，允许枢轴块50围绕与工具组件100的纵向轴线“X”垂直限定的“Z”轴可枢转地运动，见图3。 Each flange 42a and 42b may be oriented to receive comprise a pivot pin 44a of the hole 57 and 44b, the pivot pin extending through the pivot block 50 holes, allowing the pivot block 50 and the tool assembly 100 about the longitudinal axis "X" defined by the vertical "Z" axis pivotally movement, shown in Figure 3. 如同将在下面详细描述的那样，通道组件可形成有两个向上延伸的翼缘121a、121b，它们分别具有孔122a、122b，孔的尺寸设置成可容纳枢轴销59。 As will be as described in detail below, the channel assembly may be formed with two upwardly extending flanges 121a, 121b, respectively having holes 122a, 122b, the size of the hole is arranged to accommodate a pivot pin 59. 枢轴销59通过枢轴块50的孔53a、53b安装，以便在给定外科手术过程中当需要时允许工具组件100围绕“Y”轴旋转。 Pivot pin 59 through hole 50 of the pivot block 53a, 53b installed to allow the tool assembly in a given surgical procedure when the time required around 100 "Y" axis. 枢轴块50沿着“Z”轴围绕销57的旋转使工具组件100围绕“Z”轴旋转。 Pivot block 50 along the "Z" axis about the rotation pin 57 of the tool assembly 100 about the "Z" axis. 在不背离本发明的精神和范围的条件下也可有效采用将通道120紧固到枢轴块和将砧座紧固到通道的其他方法。 Without departing from the spirit and scope of the present invention the conditions can be effectively used other methods to channel 120 is fastened to the pivot block and is fastened to the anvil channel.
[0220] 在各种实施方式中，一个或多个致动器(未显示)优选穿过轴连接器部分20c、管适配器40和枢轴块50，并可操作地与工具组件100连接，以便在外科手术过程中当需要时允许外科医生使工具组件100围绕“Y”轴和“Z”轴进行关节运动。 [0220] In various embodiments, one or more actuators (not shown) preferably pass through shaft connector portion 20c, tube adapter 40 and pivot block 50, and operatively connected to tool assembly 100 to Allow when required during the surgical process the surgeon so that the tool assembly 100 about the "Y" axis and "Z" axis articulation. 另外，可通过旋钮“K”的旋转使外科缝合器I的轴20能够360°旋转。 Also, I can make the surgical stapler shaft 20 can be rotated 360 ° by turning the knob of "K". 结果，工具组件100可在所有方向上关节运动至少90°。 As a result, tool assembly 100 may be articulatable at least 90 ° in all directions. 可被用于完成该任务的各种致动器、手柄组件和枢轴块都是可以想到的，其中一些与美国专利US 6250532和US 6330965中的相同，这两分专利的内容通过引用而包含在本申请中。 Can be used to accomplish this task various actuator handle assembly and pivot blocks are conceivable, some of which are the same as the US Patent US 6250532 and US 6330965 the contents of the two sub-patent incorporated by reference in the present application.
[0221] 如上所述，在各种实施方式中，工具组件100可包括砧座组件110和细长通道组件120，见图2。 [0221] As described above, in various embodiments, tool assembly 100 may include anvil assembly 110 and elongate channel assembly 120, shown in Figure 2. 细长通道组件120可支撑钉仓组件200、致动器(例如动カ夹钳元件150)和滑车160。 The elongate channel assembly 120 may support the staple cartridge assembly 200, an actuator (e.g., the movable jaw member 150 ka) and winches 160. 这样，当组装时，这些不同组件和它们各自的内部元件在给定外科手术过程中(将在下面解释)协作，允许工具组件操作、夹持、夹钳、紧固并优选切割组织。 Thus, when assembled, the various components and their respective internal components in a given surgical procedure (explained below) collaboration, allowing tool assembly operation, gripping, clamp, fasten and preferably cutting tissue. 细长通道组件120可包括具有向上延伸的侧壁或翼缘121a和121b的底表面128，所述侧壁或翼缘限定了细长支撑通道125，该支撑通道的尺寸又设置成可将钉仓组件200可安装地容纳在其中。 The elongate channel assembly 120 may include upwardly extending side walls having flanges 121a and 121b or the bottom surface 128, the side walls or flanges defining an elongated support channel 125, the size of the support channel and arranged to be nailed cartridge assembly 200 may be installed therein. 细长通道组件120还可包括多个机械界面127a、127b、127c、127d，它们被定向成容纳设置在钉仓组件200的朝向外面的表面中的相应的多个机械界面235a、235b、235c和235d。 The elongate channel assembly 120 may also include a plurality of mechanical interfaces 127a, 127b, 127c, 127d, which are oriented to receive the cartridge assembly disposed in the outer surface 200 facing a corresponding plurality of mechanical interfaces 235a, 235b, 235c and 235d. 见图2和6。 See Figure 2 and 6.
[0222] 钉仓组件200安装在细长通道组件120中并包括上部组织接触或者朝向表面231，如同在本具体实施方式中进ー步变得清楚的那样，所述表面231与砧座组件110的组织接触或朝向底部的砧座表面114b相対。 [0222] cartridge assembly 200 is mounted in elongate channel assembly 120 and includes an upper tissue contacting or facing surface 231, as in the present embodiment further into ー become clear as the surface 231 of anvil assembly 110 The organization contact or towards the bottom of the anvil surface 114b Dui phase. 在制造或组装工程中钉仓组件200可被组装并安装在细长通道组件120中，并作为整体工具组件100的一部分出售，或者在需要时钉仓组件200可被设计成选择性安装到通道组件120上，并单独出售，例如作为单独使用的替换、可替换或者一次性的钉仓组件200。 Cartridge assembly 200 may be assembled in a manufacturing or assembly process and is mounted in elongate channel assembly 120, and sold as part of overall tool assembly 100, or when the cartridge assembly 200 may need to be designed to be selectively mounted to the channel assembly 120, and sold separately, e.g., as a single use replacement, replaceable or disposable staple cartridge assembly 200. 例如,钉仓组件200可被制造成包括滑车160和动カ夹钳元件150。 For example, cartridge assembly 200 may be manufactured to include sled 160 and the movable clamp member 150 ka. 作为替代，具有刀155的动カ夹钳元件150可作为不具有刀片155a的可替换钉仓组件200的一部分出售(但优选具有刀片155a)，以增强和/或确保缝钉成形后精确地切割组织。 Alternatively, a knife 155 having a movable jaw member 150 may ka as a replaceable cartridge assembly 155a does not have a blade portion 200 of the sale (but preferably having a blade 155a), to enhance and / or to ensure accurate cutting after staple forming organization. 工具组件100还可作为套件出售，该套件包括各种含有不同尺寸和/或设置成以不同模式射出外科紧固件350的钉仓200，其中任何一种钉仓可与细长通道组件120选择性地接合以便在在特定手术过程中在需要时使用。 Tool assembly 100 may also sold as a kit, the kit includes a variety of containing different sizes and / or arranged in a different mode exit 350 of the surgical fastener cartridge 200, which may be any one of a staple cartridge and the elongate channel assembly 120 selects engageable such that in use when needed in a particular procedure.
[0223] 如图6最清楚显示的，滑车160可包括ー对向上延伸的凸轮楔161a和161b，当由用户致动以运动时，其使一系列外科紧固件350或者缝钉进入并穿过组织并且抵靠砧座组件110的缝钉成形凹槽111 (在图9中显示)，以便成形紧固件350并紧固组织。 [0223] Figure 6 shows most clearly, block 160 may include ー pair of upwardly extending cam wedges 161a and 161b, when actuated by the user to the movement, which causes a series of surgical fasteners 350 or staples into and wear through tissue and against the anvil assembly 110 of the staple forming pockets 111 (shown in FIG. 9), to be shaped fasteners 350 and fasten tissue. 动カ夹钳元件150与滑车160连接，例如安装并骑设在其上，或者与其相连或者集成在一起和/或骑设在其后面。 Ka movable clamp member 150 is connected with the pulley 160, such as installation and riding disposed thereon or connected thereto or integrated with and / or rides located behind. 可以想到，动カ夹钳元件150可具有与其连接或者一体形成的凸轮楔或者凸轮表面，或者由凸轮楔或者凸轮表面的远侧前表面推动。 You can think of, moving ka jaw member 150 may have attached thereto or integrally formed cam wedge or cam surface, or pushed by the front surface of the distal cam wedges or cam surface.
[0224] 在各种实施方式中，动カ夹钳元件150可包括具有横向孔154(销159可安装或者安装在其中)的上部157、中央支架或者向上的延伸部分151和大体上为T形的底部翼缘152，所述各部分协同动作以在滑车160的纵向向远侧运动过程中沿着理想切割路径滑动保持动カ夹钳元件150。 [0224] In various embodiments, the movable Carbopol 150 may include an upper clamp member having a transverse bore 154 (pin 159 mountable or mounted therein) 157, or the center bracket upwardly extending portion 151 and a substantially T-shaped The bottom of the flange 152, the respective portions cooperating to slide block 160 is moved distally longitudinally along an ideal cutting path during holding the movable jaw member 150 ka. 见图8。 See Figure 8. 前切割边缘155 (这里为刀片155a)的尺寸设置成倚靠在钉仓组件200的槽282中，并且一旦缝合就使组织400分离。 Before cutting edge 155 (where the blade 155a) sized to rely on the cartridge assembly slots 282 200, and 400 once the suture on the tissue separation. 可以想到，动カ夹钳元件150的前缘153a可以是锯齿状的、倾斜的或者带缺ロ的，以利于组织切割。 It is contemplated that the movable clamp member 150 ka leading edge 153a may be serrated, or with missing ro inclined in order to facilitate tissue cutting. 在一些实施方式中，例如，上部凸轮运动元件不必是销，而可以是任何一体的或可拆卸的适当向上突出的凸轮表面。 In some embodiments, for example, the upper camming member need not be a pin, but may be any one of the upwardly projecting appropriate or removable cam surface. 同样对于底部翼缘152来说，其可以是任何合适的凸轮运动表面，包括销或者可拆卸的销、按钮，以利于将动カ夹钳元件安装到滑车160中或者细长通道组件120中。 Also for the bottom flange 152, it may be any suitable camming surface, including a pin or a removable pin, a button to facilitate mounting the movable jaw member to block Carbopol 160 or elongate channel assembly 120. 在本文中使用的术语“刀组件” 170可包括前述动カ夹钳元件150、刀155和滑车160或者其他刀/梁/滑车驱动设置。 The terminology used in this article, "knife assembly" 170 may include the aforementioned movable jaw member 150 ka, knife block 155 and 160, or other knife / beam / pulley drive settings. 另外，本发明的各种实施方式可采用刀组件设置，刀组件设置可完全支撑在钉仓中或者部分支撑在钉仓和细长通道组件中或者完全支撑在细长通道组件中。 Further, various embodiments of the present invention may be provided knife assemblies, the knife assembly may be provided entirely supported in the staple cartridge or partially supported in the staple cartridge and elongate channel assembly or entirely supported within the elongate channel assembly.
[0225] 如图10最清楚地显示的，细长通道组件120具有远端123和近端123'。 [0225] best shown in FIG. 10, the elongate channel assembly 120 has a distal end 123 and proximal end 123 '. 细长通道组件120的底表面128还包括细长的纵向槽126，该纵向槽包括切ロ或者槽ロ129并以近端与其连通。 The bottom surface 128 of the elongate channel assembly 120 also includes an elongated longitudinal slot 126 which includes a longitudinal groove or slot cut ro ro 129 and a proximal end in communication therewith. 槽ロ129的尺寸设置成允许动カ夹钳元件150的底部翼缘152穿过其间。 Ro groove 129 sized to allow the movable clamp member bottom flange 150 Carbopol 152 therethrough. 槽126的狭窄部分的尺寸设置成滑动容纳向上的支架或者延伸部分151并允许其从其中穿过。 Dimensions of the narrow part of the groove 126 is disposed to be slidably received upwardly extending portion 151 and the stent or allow it to pass therethrough. 见图13。 See Figure 13. 其他动カ夹钳元件150、通道槽和滑车构造也可采用。 Other moving ka clamp element 150, channel slots and block structure can also be used.
[0226] 当组装工具组件100时，滑车160可滑动定位在钉仓组件200和细长通道组件120之间(參见图3)。 [0226] When assembling tool assembly 100, pulley 160 is slidably positioned between the elongate channel assembly 200 and cartridge assembly 120 (see FIG. 3). 滑车160和上面详细描述的钉仓组件200的内部工作元件可操作地协同动作以使缝钉350变形。 Internal working element block 160 and cartridge assembly 200 detailed above operatively cooperating to deform the staples 350. 更具体地，如上所述，滑车160可包括向上延伸的分叉凸轮楔161a和161b，它们与一系列缝钉推出器288接合并协同动作，以便从钉仓组件200驱动缝钉350通过槽225，并基于砧座组件100的缝钉成形凹槽11使缝钉变形。 More specifically, as described above, block 160 may include upwardly extending bifurcated cam wedges 161a and 161b, which with a series of staple ejector 288 engages and cooperates, in order from the staple cartridge assembly 200 drives the staples 350 through slots 225 and based on the anvil assembly 100 staple forming grooves 11 deform the staples. 各种实施方式的滑车160、动カ夹钳元件150和钉仓组件200的进ー步的细节在美国专利公开US2006/0011699A1中有描述。 Various embodiments of pulley 160, Carbopol 150 and the movable clamp member into the staple cartridge assembly ー 200 further detail in U.S. Patent Publication US2006 / 0011699A1 are described.
[0227] 如图2和7所示，砧座组件110可以是细长的并分别包括近端116、远端118、顶表面114a和底表面114b。 [0227] Figures 2 and 7, anvil assembly 110 may be elongated and include a proximal end 116, respectively, a distal end 118, a top surface 114a and bottom surface 114b. 一对耳轴119a和119b可设置在近端116附近并被设计成用于可枢转接合对应的一对槽ロ123a和123b，槽ロ123a和123b设置在细长通道组件120的近端附近的侧壁121a和121b中。 A pair of trunnions 119a and 119b may be disposed near the proximal end 116 and is designed to be pivotally coupled to a corresponding pair of grooves ro 123a and 123b, 123a and 123b slots ro disposed near the proximal end 120 of the elongate channel assembly The side walls 121a and 121b,. 可以想到，通过常规方式(例如远程致动，例如通过手柄组件5)致动可引起夹钳卡圈140沿着远侧方向运动并接合砧座组件110的前向凸轮表面115。 It is contemplated by conventional means (e.g., a remote actuator, e.g., by the handle assembly 5) causes actuation of the clamp collar 140 and the distal direction prior to movement of the anvil assembly 110 engages the cam surface 115. 这可引起砧座组件110从打开的第一位置枢转到闭合的第二位置，在所述第一位置中细长通道组件120以彼此间隔设置的关系设置，在所述第二位置中砧座组件110和钉仓组件200协同动作将组织夹钳在其间，即将组织预先夹钳在砧座组件110的组织接合表面114b和钉仓组件200的相対的组织接合表面231之间。 This can cause the anvil assembly 110 pivot from a first position to open a second closed position, the elongate channel assembly 120 disposed in spaced relation to each other is provided in said first position, the anvil in said second position seat assembly 110 and cartridge assembly 200 cooperating to clamp tissue therebetween, i.e. pre-clamp tissue between anvil assembly surface 231 engaging surface 114b of the tissue 110 and cartridge assembly 200 relative to the tissue engaging Dui. 但是，其他砧座组件设置也可成功地被采用。 However, other anvil assembly settings can also be successfully adopted.
[0228] 在各种实施方式中，砧座组件110可包括细长的十字形或者T形通道或者槽，其总体标记为112,具有悬垂中央部分(dependingcentral portion)或者腿112a和横向上部112b。 [0228] In various embodiments, anvil assembly 110 may include an elongated cross or T-shaped channel or groove, which is generally designated 112, having a central portion overhang (dependingcentral portion) or leg 112a and a transverse upper portion 112b. 见图7。 Figure 7. 槽112优选从砧座组件110的上部114a的近端113纵向延伸到其远端118。 The groove 112 preferably extends from the upper portion of the proximal end of the anvil assembly 110 114a 113 to its distal end 118 longitudinally. 腿112a从砧座组件110的近端113开始或者进入其中并延伸到远端118，横向上部112b从近侧凸轮115开始并延伸到远端118。 Legs 112a from the proximal end 110 of anvil assembly 113 to start or enter therein and extending to a distal end 118, laterally from the upper portion 112b starts proximal cam 115 and extends to a distal end 118. 见图7。 Figure 7. 优选地，上部112b的尺寸设置成滑动容纳横向销159，该横向销159在动カ夹钳元件150的中央支架或者延伸部分157的上部157中的孔154内延伸(见图9)。 Preferably, the size of the upper portion 112b is arranged to slidably receive transverse pin 159, the transverse pin 159 in the movable jaw member 150 grades or center bracket 157 extending upper portion 157 extending within the aperture 154 (see FIG. 9). 销159的尺寸设置成将动カ夹钳元件150的上部157滑动锁定在T形槽112中，使动カ夹钳元件150可在槽112中纵向往复运动。 Pin 159 sized to the upper portion of the movable jaw member 157 ka locking slide 150 in T-shaped slot 112, so that the movable clamp member 150 ka reciprocate longitudinally in the groove 112.
[0229] 在各种实施方式中，在组织紧固之前，预夹钳卡圈140可被设置成围绕通道组件120和砧座组件110，并将它们夹紧或者预夹紧在接近的夹钳位置中。 [0229] In various embodiments, prior to tissue fastening, pre-clamp collar 140 may be provided around the channel assembly 120 and anvil assembly 110, and the clamp or pre-clamp them in close clamp position. 通过向远侧运动预夹钳卡圈140，用户可从打开的第一位置向着通道组件120致动/运动砧座组件110使钳ロ即砧座组件110和钉仓200靠近到闭合的第二位置，将组织夹持在其间。 Pre-clamp is moved distally through collar 140, the user can open from the first position toward channel assembly 120 actuation / movement of anvil assembly 110 causes jaw ro i.e., the anvil assembly 110 and staple cartridge 200 is close to the closed second position, the tissue held therebetween. 滑车160可由用户致动以缝合井随后切断组织。 Block 160 may be actuated by the user to cut and then stitched well organized.
[0230] 最好见图4、8和9所示，在动カ夹钳元件150通过组织400向远侧移动过程中，砧座组件110的大尺寸材料以及大致垂直对准的翼缘152、刀片155和凸轮运动销159的组合进行操作，使位于刀155a的前缘155远侧的运动点处的相対的组织接合表面(即砧座底表面114b和钉仓组件200的朝上表面231)进ー步靠近(即进ー步夹钳)。 [0230] best shown in Figure 4, 8 and 9, the movable jaw member 150 ka distally through the tissue 400 during movement of anvil assembly 110 of the oversize material and the flange 152 is substantially vertically aligned, blade 155 and camming pin 159 of the combination is operated, so that the leading edge is located relative to the knife 155a Dui tissue motion at the point of engaging the distal surface 155 (i.e., the upper surface of the bottom surface 114b of anvil assembly 200 and staple cartridge 231) Step into ー close (ie, step into ー tongs). 相对于移动的动力夹钳元件150向远侧进ー步夹钳组织400用来保持相対的表面114b和231之间的最大可接受间隙并从组织400压迫出流体，该流体可增强缝合并降低在变形过程中缝钉350的液压位移的可能性。 With respect to the movement of the power clamp element 150 further distally into ー tissue clamp 400 for holding Dui phase surface 114b and a gap 231 between the maximum acceptable from the tissue 400 and forced out of the fluid, the fluid may enhance stapling and reduce during deformation displacement hydraulic possibility staples 350. 可以想到，由于砧座组件110的大尺寸材料和上述动カ夹钳元件150一起产生的增强的闭合力的组合，当前缘155行进穿过组织400时增强的闭合力的组合允许组织400的相对精确的切割。 You can think of, as a result of a combination of large size material anvil assembly 110 and above grades jaw member 150 move together to produce enhanced closing force, the current travels through a combination of organizational edge 155 400 Enhanced 400 allows organizations closing force relative precise cutting.
[0231] 通过前面的描述部并參照各个附图，本领域技术人员将会理解，也可对本发明公开的内容进行ー些改变，也不脱离本发明公开的范围。 [0231] From the foregoing description and with reference to the accompanying drawings section, those skilled in the art will appreciate that the present invention may be carried ー disclosure some changes, not departing from the scope of the present disclosure. 例如，上述工具组件100可以是一次性加载单元(DLU)诸如在美国专利IS6330965中公开的那些的一部分或者结合到其中，或者直接与任何已知的外科縫合装置的远端连接。 For example, the above-described tool assembly 100 may be disposable loading unit (DLU) such as disclosed in U.S. Patent No. IS6330965 those wherein a part of or incorporated in, or directly connected to the distal end of any known surgical stapling device. 用于致动接近元件的手柄组件可选自各种致动机构，包括拉钳、可旋转和滑动的旋钮、可枢转的杆或扳机以及它们的任何组合。 Close element for actuating a handle assembly may be selected from a variety of actuating mechanism comprises pull clamp, rotatable and slidable knobs, pivotable lever or trigger and any combination thereof. 上述工具组件100作为机械系统的一部分的使用也是可以想到的。 Using the above-described tool assembly 100 as part of a mechanical system is conceivable.
[0232] 图10-18示出了単一用途的工具组件设置。 [0232] Figure 10-18 shows a tool assembly set radiolabeling purposes. 如同从这些图中可以看到的那样，一对索、绳线、丝线、窄带或者带800、820可由通道组件120支撑。 As can be seen from these figures as a pair of cable, wire rope, wire, or with 800,820 narrowband channel component 120 may be supported. 如同从图11和12中看到的那样，第一索800包括锚定段802、致动部分804和运动部分805，锚定段802固定到细长通道组件120的远端123处的底部128上的第一连接点803上，致动部分804延伸到定位在外壳部分5中的驱动系统(未示出)。 As from the bottom as seen in Figures 11 and 12, the cable 800 includes a first anchoring section 802, actuating portion 804 and the moving part 805, the anchoring section 802 is fixed to the distal end of the elongate channel assembly 123 120 128 a first connection point 803 on the actuating portion 804 extends into the housing part 5 is positioned in the drive system (not shown). 如同特别从图12中看到的那样，第一索800可操作地支撑在远侧第一索过渡支架830上，该远侧第一索过渡支架830例如包括安装到细长通道组件120的远端123的底部128上的滑轮、杆、绞盘等。 As particularly seen from FIG. 12 as a first cable 800 is operably supported on a first distal cable transition support 830, the first distal cable transition support 830, for example comprising an elongate channel assembly 120 mounted to the distal end pulley 123 on the bottom 128, rod, capstan and so on. 第一索800还可操作地支撑在第二索过渡支架840上，该第二索过渡支架例如可包括安装到刀组件170的双滑轮840。 The first cable 800 may also operably supported on the second cable transition support 840, the second cable transition support may include, for example, mounted to the knife assembly 840 double pulley 170. 在一种实施方式中，例如，第二索过渡支架安装到动カ夹钳元件150的底部翼缘部分152上。 In one embodiment, for example, the second cable transition support is mounted to the movable jaw member ka 150 of the bottom flange portion 152. 见图12和13。 Figure 12 and 13. 第一索800可经过设置在细长通道组件120的底部128中的纵向延伸的第ー槽806。 The first cable 800 may be disposed through the bottom 128 in the elongate channel assembly 120 in the first ー grooves 806 extending longitudinally. 运动部分805可邻近槽126来回自由地轴向运动。 Sports section 805 may be disposed adjacent the slot 126 axial movement back and forth freely. 致动部分804可经过细长通道组件120的底部128中的第一过渡通道808，见图11。 Actuating portion 804 may pass through the elongate channel assembly 128 at the bottom 120 of the first transition passage 808, see Figure 11.
[0233] 同样在该实施方式中，第二索820可具有锚定部分822、延伸到定位在手柄外壳5中的驱动系统的致动部分824和运动部分825，所述锚定部分822在第二连接点803'处固定到细长通道组件120的远端123的底部128上。 [0233] Also in this embodiment, a second cable 820 may have an anchor portion 822, extends to the handle housing 5 positioned in a drive system actuating portion 824 and the moving part 825, the anchor portion 822 in the first second connection point 803 'at the distal end secured to the elongate channel assembly 120 at the bottom of 128 123. 第二索820可操作地支撑在远侧第二索过渡支架850上，该过渡支架例如可以包括与细长通道组件120的远端123连接并且还可操作地支撑在远侧第二索过渡支架850上的第二滑轮、杆、绞盘等。 The second cable 820 is operably supported on a second distal cable transition support 850, which may include, for example, the transition bracket connected to the elongate channel assembly 120 and the distal end 123 may also operably supported on a second distal cable transition support a second pulley 850 on the rod, capstan, etc. 第二索820可通过设置在细长通道组件120的底部128中的纵向延伸的第二槽826。 The second cable 820 extends longitudinally through the elongate channel assembly disposed in the bottom 120 of the 128 second groove 826. 运动部分825可靠近槽126前后自由地轴向运动。 Sports section 825 may be close to 126 slots axial movement back and forth freely. 致动部分824可经过细长通道组件120的底部128中的第二过渡通道828。 Actuating portion 824 may pass through the elongate channel assembly 128 at the bottom 120 of the second transition passage 828. 见图11。 See Figure 11. 本领域普通技术人员将会理解，所述设置可提供优于现有的索设置的改进的机械优点，由此降低了必须产生使动カ夹钳元件150、刀155和滑车160形式的刀组件170行进以击发缝钉350的击发カ的大小。 One of ordinary skill in the art will appreciate that the setting provides better improvement of existing cable set of mechanical advantage, thereby reducing the need to produce to make the movable jaw member 150 ka, knife 155, and sled 160 in the form of knife assembly 170 traveling to fire staples 350 firing ka size.
[0234] 如上所述，刀组件170 (即动カ夹钳元件150、刀155和滑车160)的前进和回缩由索800、820控制，每个索都具有例如可与索驱动系统连接的近端，所述索驱动系统例如可包括可旋转的卷绕鼓轮(ー个或多个)(未显示)，其可操作地支撑在手柄5上。 [0234] As described above, the knife assembly 170 (i.e., the movable jaw member 150 ka, knife 155, and sled 160) advancing and retracting the cable 800,820 is controlled by, for example, each cable has a cable connected to the drive system a proximal end, the cable drive system may comprise for example a rotatable winding drum (ー or more) (not shown) operably supported in the handle 5. 一个或多个卷绕鼓轮可机械或手动地旋转或者通过马达提供动力，使索800、820在其上旋转。 One or more of the winding drum can be mechanically or manually rotated or powered by a motor, so that rotation of the cable 800,820 thereon. 当索800、820被卷绕在那些鼓轮上吋，刀组件170 (动カ夹钳组件150/滑车160)从细长通道120的近端向其远端驱动，完成切割及縫合操作。 When the cable is wound on those 800,820 drum inches, knife assembly 170 (dynamic clamping assembly 150 ka / pulley 160) driven from the proximal end to its distal end 120 of the elongate channel, cutting and stapling operation is completed. 在各种实施方式中没有提供装置用于将刀组件170回缩到通道120的近端，因而工具组件不能被重新使用。 In various embodiments no means are provided for the knife assembly 170 retracted to the proximal end 120 of the channel, and thus tool assembly can not be re-used.
[0235] 替代的击发系统1300的实施方式在图15-20中公开。 [0235] alternative firing system 1300 embodiment is disclosed in Figs 15-20. 如图15_17中可以看到的那样，该实施方式采用了行进索13 02和以示意图形式示出的回缩索1330，该行进索1302分叉形成一对行进索部分1310、1320。 Figure 15_17 can be seen, this embodiment uses a traveling cable 1302 and shown in schematic form retract cable 1330, 1302 cable that travels the road bifurcated to form a pair of cable section 1310, 1320. 如同更尤其从图16中可以看到的那样，第一行进索部分1310可操作地支撑在远侧第一索过渡支架1340上，该远侧第一索过渡支架例如可包括与细长通道组件120的远端123连接的滑轮、杆、绞盘等，见上述。 As more in particular from Figure 16, can be seen, the first part 1310 traveling cable operably supported on a first distal cable transition support 1340, the first distal cable transition support may include, for example, with the elongate channel assembly pulley 120 is connected to the distal end 123, rod, capstan, etc., see above. 第一行进索部分1310的远端1312可固定到刀组件170 (动カ夹钳组件150)上。 The distal portion of the first travel cable 1310 1312 can be fixed to the knife assembly 170 (dynamic grades clamp assembly 150). 第二行进索部分1320可操作地支撑在例如可包括安装到细长通道元件120的远端123上的滑轮、杆、绞盘等的远侧第二索过渡支架1360上。 Second travel cable portion 1320 may be operably supported in, for example comprise a pulley mounted on the distal end 123 of elongated channel member 120 on the rod, capstan, etc. The second cable transition support 1360 distally. 第二行进索部分1320的远端1322与刀组件170 (动カ夹钳组件150)连接。 The distal portion of the second traveling cable 1320 1322 and knife assembly 170 (dynamic clamping assembly 150 ka) connection. 同样在这些实施方式中，采用回缩索1330。 Also in these embodiments, a retract cable 1330 using. 在一种实施方式中，回缩索1330可形成环，使远侧成环末端1332固定连接到动カ夹钳组件150上。 In one embodiment, the retract cable 1330 may form a ring, a ring formed so that the distal end 1332 is fixedly connected to the movable clamp assembly 150 ka.
[0236] 在各种实施方式中，行进索1302和回缩索1330例如可由索驱动系统1000驱动，所述索驱动系统例如可包括安装在手柄组件5中或者由其支撑的手动致动的绞盘组件1001。 [0236] In various embodiments, the traveling cable 1302 and 1330, for example by the retract cable drive system 1000 drive cable, the cable drive system may comprise, for example mounted on the handle assembly 5 or by manual actuation of the support of the winch Components 1001. 见图17-20。 Figure 17-20. 绞盘组件1001例如可包括由手柄组件5枢转支撑的击发扳机1004形式的致动器1002。 Winch assembly 1001 may include, for example, by the handle assembly 5 is pivotally supported the firing trigger 1004 in the form of an actuator 1002. 虽然该实施方式采用可握持扳机1004，本领域普通技术人员将会理解，在不背离本发明的精神和范围的条件下，致动器1002可包括按钮、杆、滑块等。 Although this embodiment employs grippable trigger 1004, those of ordinary skill in the art will appreciate that without departing from the spirit and scope of the present invention the conditions, the actuator 1002 can include buttons, levers, sliders and the like. 在图17-20所示的实施方式中，绞盘组件1001可分别包括支撑在机架组件1012上的传动装置1010、可旋转第一线轴1250和可旋转第二线轴1260。 In the embodiment shown in Figure 17-20, the winch assembly 1001 may include, respectively, supported on the frame assembly 1012 of the actuator 1010, the first rotatable spool 1250 and the second rotatable spool 1260.
[0237] 在各种实施方式中，手柄齿轮部分1006可形成或者以其他方式设置在击发扳机1004上。 [0237] In various embodiments, a handle gear segment 1006 may be formed or otherwise provided on the firing trigger 1004. 手柄齿轮部分1006与安装到与离合器组件1050的第一棘齿离合器盘1052连接的轴1042上的初级传动齿轮1040啮合地安装。 Gear portion 1006 and a handle attached to the primary drive gear shaft and the clutch assembly 1042 first ratchet clutch plate 1052 1050 1040 connection on engagement mounted. 见图18。 See Figure 18. 第二棘齿离合器盘1060支撑在旋转支撑在手柄组件5中的离合器轴1062上。 Second ratchet clutch plate 1060 is supported on the handle assembly 5 rotatably supported in the clutch shaft 1062. 离合器轴1062可设置有肩部1064并具有通过轴颈连接于其上并与一部分外壳3接触的离合器弹簧1066,将第二棘齿离合器盘1060偏压成与第一棘齿离合器盘1052啮合。 Clutch shaft 1062 may be provided with a shoulder portion 1064 and have a spigot thereon and connected by contact with a portion of the housing 3 of the clutch spring 1066, the second ratchet clutch plate 1060 biased into engagement with the first ratchet clutch plate 1052. 通过图18还可以看出，第二传动齿轮1070可通过轴颈连接在离合器轴1062上并与第三传动齿轮1080啮合，所述第三传动齿轮1080连接到第一传动轴1090上，第一传动轴1090由与由安装在机架组件1012中的第一传动轴承或者套筒1092可旋转支撑。 Figure 18 can also be seen through the second drive gear 1070 may be connected to the clutch shaft 1062 and is journalled meshing with the third drive gear 1080, the third drive gear 1080 is connected to the first transmission shaft 1090, a first 1090 by the drive shaft by the first drive frame assembly 1012 mounted in a bearing or sleeve 1092 rotatably supported. 见图18。 See Figure 18. 第一传动轴1090可具有第一小齿轮部分1100和在其上形成的ー组第一齿轮齿1102，用于选择性地与轴向地并可旋转运动的轴卷筒1110上的一组初级齿轮齿1112啮合。 The first transmission shaft 1090 may have a first pinion gear portion 1100 and a set of first gear teeth 1102 ー formed thereon for a set of primary selectively axially and rotatably moving on the shaft spool 1110 1112 meshing gear teeth. 从图20中可以看出，轴卷筒1110容纳在花键轴1120上，该花键轴可旋转地容纳在第一传动轴1090和第二小齿轮1130中。 As can be seen from Figure 20, the shaft spool 1110 is accommodated in the spline shaft 1120, the spline shaft is rotatably received in the first transmission shaft 1090 and a second pinion gear 1130. 第二小齿轮1130具有第二小齿轮部分1132和ー组第二齿轮齿1134，以便选择性地与轴卷筒1110上的次级齿轮齿1114啮合。 The second pinion gear 1130 has a second pinion gear portion 1132 and a second set of gear teeth ー 1134 to selectively engage the spool shaft and the secondary gear teeth 1110 on 1114. 第二小齿轮1130由安装在机架组件1012中第二轴承1136可旋转地支撑，如图所示。 The second pinion gear 1130 of the second bearing 1136 is rotatably supported by the frame assembly 1012 is mounted, as shown in FIG. 从图18和20中可以看出，反向锥齿轮1140由分别与第一和第二小齿轮1100、1130啮合的机架组件1012支撑。 As can be seen from Figures 18 and 20, the reverse bevel gear 1140 by the frame assembly with the first and second pinion meshing 1100,1130 1012 support.
[0238] 从图18和20中还可以看出，轴卷筒1110还具有在其上形成的卡圈部分1150，以便容纳从在切换杆1166的底部上形成的轭形件1160延伸的两个相对的销1162。 [0238] can also be seen from Figures 18 and 20, the shaft spool 1110 also has a collar portion 1150 formed thereon to accommodate extending from the yoke 1160 in the bottom 1166 of the selection lever is formed of two 1162 relative to the pin. 切换杆1166可具有轴部分1168，其可枢转地销接到机架组件1012的横杆部分1014上。 Switching lever 1166 may have a shaft portion 1168 that is pivotally pinned to a crossbar portion 1014 of the frame assembly 1012. 轴1168的一部分经过手柄壳体(未显示)中的开ロ向外突出，并且切换钮1170可与轴1168的端部连接，使用户能够来回轴向移动轴1168，以便使传动装置1010换向(将在下面进ー步探讨)。 A portion of the shaft 1168 through the handle housing (not shown) protruding outwardly opening ro, and switching button 1170 may be connected to the shaft end portion 1168, enables the user to move the shaft 1168 axially back and forth, so that the actuator 1010 commutation (will be further explored in the following into ー). 本领域普通技术人员将会理解，轭形件1160的设置使轴卷筒1110能够相对于轭形件1160自由旋转，同时使轭形件1160能够在花键轴1120上轴向移动轴卷筒1110。 One of ordinary skill in the art will appreciate that the yoke of the shaft spool 1160 disposed 1110 with respect to the yoke member 1160 is free to rotate, while the yoke shaft spool 1160 axially movable on the spline shaft 1110 1120 .
[0239] 如图20所示，切换器输出齿轮1180通过键或其他方式连接到花键轴1120上，以便与花键轴1120 —起旋转。 [0239] As shown, the switch 1180 is connected to the output gear spline shaft 1120 through a key or other means, so that the spline shaft 1120 20 - from rotating. 该切换器输出齿轮1180被设置成与第一卷筒齿轮1190啮合，该第一卷筒齿轮1190被连接到可旋转第一卷筒1250的轴1200上。 The switching output gear 1180 is arranged to mesh with the first spool gear 1190, the first spool gear 1190 is attached to the shaft 1200 of the first rotatable spool 1250. 第一卷筒传动齿轮1220连接到可旋转第一卷筒轴1200的另一端部上。 First spool drive gear 1220 is rotatably connected to the other end portion of the first drum shaft 1200. 第一卷筒传动齿轮1220与反向齿轮1230啮合，该反向齿轮1230与连接到可旋转第二卷筒1260的轴1252上的第二卷筒传动齿轮1240啮合。 First spool drive gear 1220 meshes with the reverse gear 1230, which meshes with reverse gear 1230 1240 connected to the second drum rotatable second drive spool shaft 1252 of the gear 1260. 见图17。 See Figure 17. 在各种实施方式中，行进索1302可被接收在可旋转第二(底部)卷筒1260上并且回缩索1330被接收在可旋转第一卷筒1250上。 In various embodiments, the traveling cable 1302 may be received on a rotatable second (bottom) of the spool 1260 and the retraction cable 1330 is received on a first rotatable spool 1250. [0240] 现在将參照图17-20描述绞盘1000的操作方法。 [0240] Referring now to Figures 17-20 describe a method 1000 of operation of the winch. 首先转到图20，在该图中，轴卷筒1110处于空闲位置。 Turning first to FIG. 20, in this figure, the shaft spool 1110 is in the idle position. 因此,击发扳机1004的致动不会导致动力夹钳元件150、刀155或者滑车160的任何运动。 Thus, actuation of the firing trigger 1004 will not result in any movement of the power clamp member 150, knife 155 or sled 160. 为了击发装置(使动カ夹钳元件150、刀155和滑车160从细长通道组件120的近端运动到细长通道组件120的远端)，临床医生将切换器钮1170切换到图18中显示的位置。 To a firing mechanism (ka clamp element 150 so that the movable knife 155, and sled 160 from the proximal end of the movement of the elongate channel assembly 120 to the distal end of the elongate channel assembly 120), the clinician will be switched to the switch button 1170 in FIG. 18 display position. 在这样做时,轴卷筒1110的初级齿轮齿1112与第一小齿轮1100的第一齿轮齿1102啮合。 In doing so, the primary gear teeth 1112 of the shaft spool 1110 with the first gear teeth 1100 of the first pinion gear 1102 engages. 在轴卷筒1110已经运动到该位置之后，临床医生可开始拉动/枢转击发扳机1004，引起手柄齿轮部分1006沿着由图18中的箭头“A”表示的方向运动。 After the shaft spool 1110 has been moved to that position, the clinician may begin to pull / pivot the firing trigger 1004 to cause the handle gear segment 1006 along the direction indicated by the arrow in FIG. 18 "A" represents the movement. 当击发扳机1004继续枢转时，齿轮部分1006使初级传动齿轮1040和离合器组件1050以及第二传动齿轮1070沿着“B”方向旋转。 When the firing trigger 1004 continues to pivot, the gear portion 1006 so that the primary drive gear 1050 as well as the clutch assembly 1040 and the second drive gear 1070 rotates in the "B" direction. 当第二传动齿轮1070沿着该方向旋转时，第三传动齿轮1080沿着相反的“A”方向旋转，这又引起第一小齿轮1100沿着该方向旋转。 When the second drive gear 1070 is rotated in the direction, the third drive gear 1080 in the opposite "A" direction of rotation, which in turn causes the first pinion gear 1100 to rotate in that direction. 由于第一小齿轮1100的第一齿1102与轴卷筒1110的初级齿1112啮合，轴卷筒1110也沿着“A”方向旋转。 Because the first teeth 1102 of the first pinion gear and the spool shaft 1100 is engaged with the primary teeth 1110 of 1112, the shaft spool 1110 also rotates in the "A" direction. 当轴卷筒1110沿着“A”方向旋转时，花键轴1120和切换器输出齿轮1180也沿着该方向旋转。 When the shaft spool 1110 rotates in the "A" direction, the splined shaft 1120 and the switch output gear 1180 also rotate in that direction. 切换器输出齿轮1180与连接到第一卷筒1250的轴1200连接的第一卷筒齿轮1190啮合。 Switching output gear connected to the first spool 1180 with a first gear connected to the spool shaft 1200 1250 1190 engages. 当切换器输出齿轮沿着“A”方向旋转时，第一卷筒齿轮1190沿着“B”方向旋转。 When switching output gear is rotated in the "A" direction, the first spool gear 1190 rotates in the "B" direction. 第一卷筒传动齿轮1220与轴1200连接并且也沿着“B”方向旋转。 First spool drive gear 1220 is connected to the shaft 1200 and also rotates in the "B" direction. 当第一卷筒1250沿着“B”方向旋转时，回缩索1330被第一卷筒1250放出。 When the first spool 1250 rotates in the "B" direction, the retract cable 1330 is a first spool 1250 release. 当第一卷筒1250旋转时，第一卷筒传动齿轮1220沿着相同方向旋转。 When the first spool 1250 rotates the first drum drive gear 1220 rotates in the same direction. 第一卷筒传动齿轮1220、反向齿轮1230和第二卷筒传动齿轮1240引起第二卷筒1260将行进索1302卷绕于其上。 First spool drive gear 1220, gear 1230 and a second reverse drive gear 1240 cause the second spool 1260 to the traveling spool cable 1302 wound thereon.
[0241] 在击发扳机1004已经被下压到其最大可能压缩程度时(到其冲程末端)，临床医生释放击发扳机1004，并且由手柄组件5支撑的弹簧(未显示)或者其他合适设置偏压击发扳机1004回到开始位置(未击发位置)。 [0241] In the firing trigger 1004 has been depressed to its maximum possible degree of compression (to the end of its stroke), the clinician releases the firing trigger 1004, and is supported by the handle assembly 5 a spring (not shown) or other suitable bias settings 1004 back to the starting position of the firing trigger (not firing position). 当击发扳机1004恢复到开始位置时，第一离合器盘1052相对于第二离合器盘1060向后旋转(“A”方向)，同时第二离合器盘1060保持静止而不运动。 When the firing trigger 1004 returns to the starting position, the first clutch plate 1052 with respect to the second clutch plate 1060 rotates backward ("A" direction), while the second clutch plate 1060 remains stationary without movement. 用户然后可再次压下击发扳机1004，直到动カ夹钳元件150、刀155和滑车160通过行进索1302已经完全行进到通道组件120中的远端位置。 The user may then depressing the firing trigger 1004 again until the dynamic clamping jaw member 150 ka, knife 155, and sled 160 have been completely via the traveling cable 1302 travels to the channel assembly 120 in the distal position.
[0242] 为了回缩(使刀组件170沿着近侧方向“H)”运动到开始位置)动カ夹钳元件150、刀155和滑车160，临床医生移动切换器钮1170，使轴卷筒1110的次级齿轮齿1114与第二小齿轮1130上的第二齿轮齿1134啮合。 [0242] To retract (the cutter assembly 170 in the proximal direction "H)" is moved to the starting position) the movable jaw member Carbopol 150, knife 155, and sled 160, the clinician to move the switch button 1170, the shaft spool secondary gear teeth 1110 of the second gear 1114 and 1130 on the second pinion gear 1134 engages. 在轴卷筒1110已经运动到该位置之后，临床医生可以上述方式开始拉动/枢转击发扳机1004。 In 1110, after the roll axis has moved to that location, the clinician can begin pulling the manner described above / pivoting firing trigger 1004. 当击发扳机1004继续枢转时，齿轮部分1006沿着“B”方向旋转初级传动齿轮1040以及离合器组件1050和第二传动齿轮1070。 When the firing trigger 1004 continues to pivot, the gear portion rotating the primary drive gear 1006 as well as the clutch assembly 1040 along the "B" direction 1050 and the second transmission gear 1070. 当第二传动齿轮1070沿着该方向旋转时，第三传动齿轮1080沿着相反的“A”方向旋转，也引起第一小齿轮1110沿着该方向旋转。 When the second drive gear 1070 is rotated in the direction, the third drive gear 1080 in the opposite "A" direction of rotation, but also causes the first pinion gear 1110 to rotate in that direction. 当第一小齿轮1100旋转时，其引起反向锥齿轮1140旋转并引起第二小齿轮1130沿着“B”方向旋转。 When the first pinion gear 1100 rotates, it causes the reverse bevel gear 1140 to rotate and cause the second pinion gear 1130 rotates in the "B" direction. 由于轴卷筒1110的次级齿1114与第二小齿轮1130的第二齿1134啮合，轴卷筒1110和花键轴1120沿着“B”方向旋转。 Because the secondary teeth 1114 of the shaft spool 1110 and the second pinion gear 1134 engaged with the second teeth 1130 of the shaft spool 1110 and the splined shaft 1120 along the "B" direction. 切换器输出齿轮1180引起第一卷筒传动齿轮1220沿着“A”方向旋转。 Switching output gear 1180 causes the first spool drive gear 1220 rotates in the "A" direction. 当第一卷筒传动齿轮1220沿着“A”方向旋转时，回缩索1330卷绕到第一卷筒1250上。 When the first spool drive gear 1220 rotates in the "A" direction, the retract cable 1330 is wound onto the first spool 1250. 当第一卷筒1250旋转时，第一卷筒传动齿轮1220沿着相同的方向旋转。 When the first spool 1250 rotates the first drum drive gear 1220 is rotated in the same direction. 第一卷筒传动齿轮1220、反向齿轮1230和第二卷筒传动齿轮1240引起第二卷筒1260旋转以从第二卷筒1260松开行进索1302。 The first reel drive gear 1220, 1230, and the second reel reverse gear transmission gear 1240 cause the second spool 1260 rotates to release the road from the second cable reel 1260 1302.
[0243] 在击发扳机1004已经被压下到其最大可能压缩程度时(到其冲程末端)，临床医生释放击发扳机1004，并且由手柄组件5支撑的弹簧(未显示)或者其他合适设置偏压击发扳机1004回到开始位置(未击发位置)。 [0243] In the firing trigger 1004 has been depressed to its maximum possible degree of compression (to the end of its stroke), the clinician releases the firing trigger 1004, and is supported by the handle assembly 5 a spring (not shown) or other suitable bias settings 1004 back to the starting position of the firing trigger (not firing position). 当击发扳机1004恢复到开始位置时，第一离合器盘1052相对于第二离合器盘1060向后旋转，同时第二离合器盘1060保持静止而不运动。 When the firing trigger 1004 returns to the starting position, the first clutch plate 1052 with respect to the second clutch plate 1060 rotating backwards, while the second clutch plate 1060 remains stationary without movement. 用户然后可再次压下击发扳机1004，直到动カ夹钳元件150、刀155和滑车160通过回缩索1330已经完全回缩到细长通道组件120中的开始位置。 The user may then depressing the firing trigger 1004 again until the dynamic clamping jaw member 150 ka, knife 155, and sled 160 through the retract cable 1330 has been completely retracted to the start position of the elongate channel assembly 120.
[0244] 在图18和20中示出的实施方式中，可旋转第一卷筒1250和可旋转第二卷筒1260逐渐变细。 [0244] In Figures 18 and 20 in the embodiment illustrated, the first rotatable spool 1250 and the second rotatable spool 1260 are tapered. 也就是说，它们沿着各自的轴向方向具有逐渐减小的直径。 That is, they have a gradually decreasing diameter along their respective axial directions. 因此，当绞盘组件1001张紧索吋，绞盘组件1001具有改变机械优点的能力。 Thus, when the winch assembly 1001 tension cords inches, the winch assembly 1001 has the ability to change the mechanical advantage. 在该实施方式中，行进索1302与卷筒1260连接并且回缩索1330与卷筒1250连接，使最大张紧カ在击发过程开始时产生。 In this embodiment, the traveling cable 1302 connected to the spool 1260 and 1330 and the retract cable 1250 connected to the spool, so that the maximum tension generated at ka firing process starts. 在绞盘组件1001以恒定扭矩转动时，索在卷筒上张紧并且卷筒直径的变化将改变传递到索上的力。 In 1001 when the winch assembly rotates at a constant torque, cable tension on the roll and roll diameter change will change the force transmitted to the cable on. 当击发过程中必须克服的最大摩擦或者阻力在击发程序开始发生吋，这种设置特别有利。 When the maximum firing process must overcome the friction or drag inches beginning at the firing sequence occurs, such an arrangement is particularly advantageous. 但是，如果最大摩擦和阻力预期在接近击发过程结束时遇到，则索1302、1330可与它们各自的卷筒1260、1250的另一端(较小的一端)连接。 However, if the maximum expected friction and resistance at the time of the end face close to the firing process, the cable 1302,1330 may be connected with their respective ends 1260,1250 of the other roll (smaller end). 在又ー种其他实施方式中，如果最大阻力和摩擦力在击发过程的中间遇到时，则每个卷筒1250、1260可具有带有比卷筒的端部更大的直径的中央部分。 In yet other embodiments ー species, if the maximum resistance and friction encountered in the middle of the firing process, each end portion of the spool 1250,1260 may have a larger diameter with a central portion than the spool. 这种独特新颖的卷筒构造与上面描述的独特新颖的滑轮一道，使装置能够被设计成解决在击发顺序中遇到的不同摩擦和阻力，并代表了对与外科縫合器械结合采用的驱动系统有关的现有索的巨大改进。 This unique and novel pulley unique and novel structure described above roll together, enables the device to be designed to address different frictional and resistance encountered during the firing sequence and represent a combination of the drive system used with the surgical stapling instrument dramatic improvements related to existing cord.
[0245] 虽然上述索驱动系统1000包括了可手动致动的驱动系统，但本发明的其他构思实施方式也可采用电池供电的ー个或多个马达，交流电供电的一个或多个马达或者气动马达，以便为索驱动系统供电。 [0245] While the cable drive system 1000 described above comprises a manually actuatable drive system, but other embodiments of the idea of invention can also employ one or more motors ー battery-powered, AC-powered or a plurality of motors or pneumatic motor drive cable in order to power the system. 因此，对本发明的各种实施方式给予的保护不应当仅仅限制为可手动致动的外科器械。 Accordingly, the various embodiments of the present invention should not only give protection limit for manually actuated surgical instrument.
[0246] 图15A、16A和21示出了本发明的另ー种改进实施方式的击发系统1300'。 [0246] FIG. 15A, 16A and 21 show the present invention further ー species improved firing system embodiment 1300 '. 从图15A和16A中可以看出，该实施方式采用了一对行进索1310'、1320'和回缩索1330。 As can be seen from Figures 15A and 16A, this embodiment employs a pair of traveling cable 1310 ', 1320' and a retract cable 1330. 图15A和16A以示意形式示出了索1310'、1320'和回缩索1330。 Figures 15A and 16A is shown in schematic form a cable 1310 ', 1320' and the retract cable 1330. 从这些附图中可以看出，第一行进索1310'可操作地支撑在远侧第一索过渡支架1340和近侧第一索过渡支架1350上，如同上面描述的那样，所述远侧第一索过渡支架例如可包括与细长通道组件120的远端123连接的滑轮、杆、绞盘等，所述近侧第一索过渡支架例如可包括可操作地由细长通道组件120支撑的滑轮、杆、绞盘等。 As can be seen from these figures, the first traveling cable 1310 'is operably supported on a first distal cable transition support 1340 and the first proximal cable transition support 1350, as described above, as the distal section A distal cable transition support may comprise for example a pulley assembly 120 and the elongate channel 123 is connected, rod, capstan, etc., the first proximal cable transition support operably 120 may include, for example, supported by the elongate channel assembly of pulleys , bar, winch, etc. 第一行进索1310'的远端1312'固定到刀组件170(动カ夹钳组件150)并且第一行进索1310'的近端1314'连接到与可往复运动驱动元件1390连接的连接器1380。 First traveling cable 1310 'distal end 1312' is fixed to the knife assembly 170 (dynamic clamping assembly 150 ka) and the first traveling cable 1310 'proximal end 1314' is connected to a reciprocable drive element connected to the connector 1380 1390 . 如同从图15A和16A中看到的那样，远侧第一索过渡支架1340可被定向成使其旋转轴线大体上与近侧第一索过渡支架1350的旋转轴线垂直。 As seen from Figures 15A and 16A, as the first distal cable transition support 1340 may be oriented so that an axis of rotation perpendicular to the axis of rotation is substantially a first proximal cable transition support 1350. 第二行进索1320'可操作地支撑在远侧第二索过渡支架1360和近侧第二索过渡支架1370上，所述远侧第二索过渡支架例如可包括与细长通道组件120的远端123连接的滑轮、杆、绞盘等，所述近侧第二索过渡支架例如可包括例如安装在细长通道组件120的近端的滑轮、杆、绞盘等。 Second travel cable 1320 'is operably supported on a second distal cable transition support 1360 and a second proximal cable transition support 1370, the second distal cable transition support may for example comprise an elongate channel assembly 120 and the distal terminal 123 connected to the pulley, rod, capstan, etc., the second proximal cable transition support may include, for example, for example, mounted on the proximal end of the elongate channel assembly 120 of the pulley, rod, capstan and so on. 第二行进索1320的远端1322'连接刀组件170 (动カ夹钳组件150)并且近端1324'与连接器1380'连接。 Advancing the distal end of the second cable 1320 1322 'is connected knife assembly 170 (dynamic clamping assembly 150 ka) and the proximal end 1324' and the connector 1380 'is connected. 同样在这些实施方式中，采用回缩索1330。 Also in these embodiments, a retract cable 1330 using. 在一种实施方式中，回缩索1330可形成环，使远侧环状末端1332固定连接(模压等)到动カ夹钳组件150上并且两个近端1334、1336每个都固定连接(模压等)到连接器1380上。 In one embodiment, the retract cable 1330 may form a ring, so that the annular distal end 1332 is fixedly connected (molded, etc.) to the dynamic clamping assembly 150 ka and two proximal 1334,1336 are each fixedly connected ( molded, etc.) to the connector 1380.
[0247] 本领域普通技术人员将会理解，当驱动杆1390沿着远侧方向“DD”行进时，动カ夹钳元件150、刀155和滑车160也可沿着远侧方向(“DD”)行进。 [0247] Those of ordinary skill in the art will appreciate that when the drive bar 1390 in the distal direction "DD" travel, the movable jaw member 150 ka, knife 155, and sled 160 in the distal direction may be ("DD" ) travels. 为了沿着近侧方向“PD”回缩刀，驱动杆1390沿着近侧方向“H)”运动。 To the proximal direction "PD" knife retraction, the drive rod 1390 in the proximal direction "H)" movement. 在各种实施方式中，驱动杆1390可选择性地通过驱动系统1400行进和回缩，所述驱动系统1400在操作上有些类似于绞盘组件1001的操作，但下面描述的不同除外。 In various embodiments, the drive rod 1390 may be selectively driven by advancing and retracting system 1400, the drive system 1400 is similar to the operation in the operation of the winch assembly 1001, except for different but described below. 特别是，从图21中可以看出，手柄齿轮部分1006可在击发扳机(未显示)上形成或者设置。 In particular, it can be seen from Fig. 21, a handle gear segment 1006 may be in the firing trigger (not shown) formed or disposed on. 手柄齿轮部分1006可安装成与初级传动齿轮1040啮合，所述初级传动齿轮安装在与离合器组件1050的第一棘齿离合器盘1052连接的轴(未显示)上。 Handle gear portion 1006 may be mounted with the primary drive gear 1040 engaging the drive gear mounted on the primary shaft and the clutch assembly 1052 first ratchet clutch plate 1050 is connected (not shown). 第二棘齿离合器盘1060支撑在可旋转支撑在手柄组件5中的离合器轴1062上。 Second ratchet clutch plate 1060 is supported rotatably supported on the handle assembly 5 on the clutch shaft 1062. 离合器轴1062可设置有肩部(未显示)并具有通过轴颈连接于其上的离合器弹簧1066，以便将第二棘齿离合器盘1060偏压成与第一棘齿离合器盘1050哨合。 Clutch shaft 1062 may be provided with a shoulder (not shown) connected thereto and having a clutch spring 1066 journaled, so that the second ratchet clutch plate 1060 biased into the first ratchet clutch plate 1050 post together.
[0248] 第二传动齿轮1070可通过轴颈连接到离合器轴1062上并与第三传动齿轮1080啮合，所述第三传动齿轮1080与由安装在机架组件1012'中的第一传动轴承或套筒(未显示)可旋转支撑的第一传动轴1090连接。 [0248] The second drive gear 1070 may be connected to the clutch shaft journalled through 1062 and 1080 meshes with the third transmission gear, the third drive gear 1080 is mounted by the first drive frame assembly 1012 'in the bearing or a sleeve (not shown) rotatably supported drive shaft 1090 connected to a first. 第一传动轴1090具有第一小齿轮部分1100和一组在其上形成的第一齿轮齿1102，以便选择性地与轴向可旋转运动的轴卷筒1110上的一组初级齿轮齿1112啮合。 The first transmission shaft 1090 has a first pinion gear portion 1100 and a set of first gear teeth 1102 formed thereon for selectively axially rotatable movement of a set of the primary gear shaft spool 1110 engages the teeth 1112 . 轴卷筒1110容纳在可旋转容纳在第一传动轴1090和第二小齿轮1130中的花键轴1120(未显示)上。 Spline shaft 1120 spool shaft 1110 is rotatably accommodated in the first transmission shaft 1090 and received in the second pinion gear 1130 (not shown). 第二小齿轮1130具有第二小齿轮部分1132和一组第二齿轮齿1134，用于选择性地与轴卷筒1110上的次级齿轮齿1114啮合。 The second pinion gear 1130 has a second pinion gear portion 1132 and a set of second gear teeth 1134 for selective engagement with secondary gear teeth on the shaft spool 1110 1114. 第二小齿轮1130由安装在机架组件1012'中的第二轴承(未显示)可旋转支撑，如图所示。 The second pinion gear 1130 mounted on the chassis unit by 1012 'of the second bearing (not shown) is rotatably supported, as shown in FIG. [0249] 反向锥齿轮1140由分别与第一和第二小齿轮1100、1130啮合的机架组件1012'支撑。 [0249] reverse bevel gear rack components by 1140 with the first and second pinion meshing 1100,1130 1012 'support. 轴卷筒1110具有在其上形成的卡圈部分1150，以便容纳从切换杆1166的底部上形成的轭形件1160延伸的两个相对的销1162。 Shaft spool 1110 has a collar portion 1150 formed thereon for receiving the yoke 1160 extend from the bottom of the switch lever 1166 is formed of two opposing pins 1162. 切换杆1166具有枢转地销接到机架组件1012'上的横杆部分1014'的轴1168部分。 1166 has a switching lever is pivotally connected to the frame assembly pins 'on the bar section 1014' 1012 1168 shaft portion. 一部分轴1168经过手柄壳体(未显示)中的开口向外突出，并且切换钮1170可与轴1168的端部连接，使用户可来回轴向移动轴1168，使驱动器1140反向(将在下面进一步探讨)。 Part of the shaft 1168 through the handle housing (not shown) outwardly projecting in the opening, and switch button 1170 may be connected with the end portion of the shaft 1168, so that the user can move the shaft 1168 axially back and forth, so that the reverse drive 1140 (in the following further study). 本领域普通技术人员将会理解，轭形件1160的设置使轴卷筒1110相对于轭形件1160自由旋转，同时使轭形件1160在花键轴1120上轴向移动卷筒1110。 One of ordinary skill in the art will appreciate that the yoke member 1160 is provided so that the shaft spool 1110 relative to the yoke member 1160 is free to rotate, while the yoke 1160 in the axial direction of the spline shaft 1120 to move the spool 1110. [0250] 切换器输出齿轮1180锁定到花键轴1120上或者与其连接以便与其一起旋转。 [0250] 1180 switcher output gear is locked to the spline shaft 1120 or connected thereto for rotation therewith. 切换器输出齿轮1180被设置成与连接到传动轴1200'的传动齿轮1190'啮合。 Switching output gear 1180 is arranged and connected to the drive shaft 1200 'of drive gear 1190' engagement. 与传动轴1200'连接的是传动齿轮1410，其与被限制成在机架1012'中形成的两个凸耳1422、1424之间沿着远侧和近侧方向轴向运动的齿条1420啮合。 And the drive shaft 1200 'is connected to the transmission gear 1410, which is constrained to the frame 1012 and' 1420 the engagement between the two lugs 1422,1424 formed in the axial direction along the distal and proximal movement of the rack . 为了将驱动杆1390的近端固定到齿条1420上，可在齿条1420的远端1425中形成T形槽1426。 To the proximal end of the drive rod 1390 is fixed to the rack 1420, a T-slot 1426 may be formed in the distal end 1425 of the rack 1420. 但是，也可采用其他连接方法。 However, other connection methods can also be used. [0251] 现在将描述操作驱动系统1400的方法。 [0251] Now the method of operating the drive system 1400 is described. 从图21中可以看出，轴卷筒1110处于空闲位置。 As can be seen from Figure 21, the shaft spool 1110 is in the idle position. 因此，击发扳机1004的致动不会导致动力夹钳元件150、刀155或者滑车160的任何运动。 Thus, actuation of the firing trigger 1004 will not result in any movement of the power clamp member 150, knife 155 or sled 160. 为了击发装置(使动力夹钳元件150、刀155或者滑车160沿着远侧方向DD运动)，临床医生移动切换器钮1170，使第一小齿轮1100的第一齿轮齿1102与轴卷筒1110的初级齿轮齿1112啮合。 To a firing mechanism (element 150 of the power clamp, knife 155 or sled 160 in the distal direction DD movement), the clinician to move the switch button 1170, a first small gear of the first gear teeth 1100 of the shaft spool 1102 and 1110 1112 primary gear teeth meshing. 在轴卷筒1110已经运动到该位置时，临床医生可开始拉动/枢转击发扳机1004，引起手柄齿轮部分1006运动。 In 1110 when the roll axis has moved to that location, the clinician may begin to pull / pivoting firing trigger 1004, causing the handle part of the 1006 campaign gear. 当击发扳机1004继续枢转时，齿轮部分1006使离合器组件1050的初级传动齿轮和第二传动齿轮1070旋转。 When the firing trigger 1004 continues to pivot, the gear portion 1006 of the clutch assembly 1050 of the primary drive gear and the second drive gear 1070 to rotate. 当第二传动齿轮1070沿着一个方向旋转时，第三传动齿轮10 80沿着相反的方向旋转，并且还引起第一小齿轮1100也沿着该方向旋转。 When the second drive gear 1070 is rotated in one direction, the third drive gear 1080 in the opposite direction of rotation, and also causes the first pinion gear 1100 also rotate in that direction. 由于第一小齿轮1100的第一齿1102与轴卷筒1110的初级齿1112啮合，轴卷筒1110也沿着该方向旋转。 Because the first teeth 1102 of the first pinion gear and the spool shaft 1100 is engaged with the primary teeth 1110 of 1112, the shaft spool 1110 also rotates in that direction. 当轴卷筒1110沿着该方向旋转时，花键轴和切换器输出齿轮1180也沿着该方向旋转。 When the shaft is rotated in the direction of the roll 1110, splined shaft and switching output gear 1180 also rotate in that direction. 切换器输出齿轮1180引起传动齿轮1190'、传动轴1200'和传动齿轮1410沿着“B”方向旋转，从而沿着远侧方向DD驱动齿条。 Switching output gear 1180 causes the drive gear 1190 ', drive shaft 1200', and drive gear 1410 to rotate in the "B" direction thereby driving the rack in the distal direction DD. [0252] 在击发扳机1004已经被下压到其最大可能压缩的程度(到其冲程末端)时，临床医生释放击发扳机1004并且弹簧(未显示)或者由手柄组件5支撑的其他合适设置偏压击发扳机1004回到开始位置(未击发位置)。 [0252] In the firing trigger 1004 has been depressed to the maximum possible extent its compressed (to the end of its stroke), the clinician releases the firing trigger 1004 and a spring (not shown) or supported by the handle assembly 5 other suitable bias settings 1004 back to the starting position of the firing trigger (not firing position). 当击发扳机1004返回到开始位置时，第一离合器盘1052相对于第二离合器盘1060向后旋转(A方向)，同时第二离合器盘1060保持静止而不运动。 When the firing trigger 1004 returns to the starting position, the first clutch plate 1052 with respect to the second clutch plate 1060 rotates backward (A direction), while the second clutch plate 1060 remains stationary without movement. 临床医生然后可再次压下击发扳机1004，直到刀组件170(动力夹钳元件150、刀155和滑车160)通过齿条1420和驱动杆1390已经完全行进到通道组件120中的远侧末端位置。 Clinician may then be depressed the firing trigger 1004 again until the knife assembly 170 (dynamic clamping jaw member 150, knife 155, and sled 160) by the rack 1420 and the drive rod 1390 has completely traveled to the channel assembly 120 in the distal end position. [0253] 为了回缩(沿着近侧方向“PD”运动到开始位置)动力夹钳元件150、刀155和滑车160，临床医生移动切换器钮1170，使轴卷筒1110的次级齿轮齿1114与第二小齿轮1130上的第二齿轮齿1134啮合。 [0253] In order to retract (in the proximal direction "PD" movement to the start position) power clamp member 150, knife 155, and sled 160, the clinician to move the switch button 1170, the shaft spool secondary gear teeth 1110 1114 and second gear 1130 on the second pinion gear 1134 engages. 在轴卷筒1110已经运动到该位置之后，临床医生可以上述方式开始拉动/枢转击发扳机1004。 In 1110, after the roll axis has moved to that location, the clinician can begin pulling the manner described above / pivoting firing trigger 1004. 当击发扳机1004继续枢转时，齿轮部分1006沿着“B”方向旋转初级传动齿轮1040以及离合器组件1050和第二传动齿轮1070。 When the firing trigger 1004 continues to pivot, the gear portion rotating the primary drive gear 1006 as well as the clutch assembly 1040 along the "B" direction 1050 and the second transmission gear 1070. 当第二传动齿轮1070沿着该方向旋转时，第三传动齿轮1080沿着相反的“A”方向旋转，也引起第一小齿轮1110沿着该方向旋转。 When the second drive gear 1070 is rotated in the direction, the third drive gear 1080 in the opposite "A" direction of rotation, but also causes the first pinion gear 1110 to rotate in that direction. 当第一小齿轮1100旋转时，其引起反向锥齿轮1140旋转并引起第二小齿轮1130沿着“B”方向旋转。 When the first pinion gear 1100 rotates, it causes the reverse bevel gear 1140 to rotate and cause the second pinion gear 1130 rotates in the "B" direction. 由于轴卷筒1110的次级齿1114与第二小齿轮1130的第二齿1134啮合，轴卷筒1110和花键轴1120沿着“B”方向旋转。 Because the secondary teeth 1114 of the shaft spool 1110 and the second pinion gear 1134 engaged with the second teeth 1130 of the shaft spool 1110 and the splined shaft 1120 along the "B" direction. 切换器输出齿轮1180引起传动齿轮1190'、传动轴1220'和传动齿轮1410沿着“A”方向旋转，这引起齿条1424沿着近侧方向“PD”运动。 Switching output gear 1180 causes the drive gear 1190 ', drive shaft 1220', and drive gear 1410 to rotate in the "A" direction which causes the rack 1424 in the proximal direction "PD" movement. [0254] 在击发扳机1004已经被下压到其最大可能压缩程度时(到其冲程末端)，用户释放击发扳机1004，并且由手柄组件5支撑的弹簧(未显示)或者其他合适设置偏压击发扳机1004回到开始(未击发位置)位置。 [0254] In the firing trigger 1004 has been depressed to its maximum possible degree of compression (to the end of its stroke), the user releases the firing trigger 1004, and is supported by the handle assembly 5 a spring (not shown) or other suitable firing bias settings 1004 Back to the start trigger (not firing position) position. 当击发扳机1004返回到开始位置时，第一离合器盘1052相对于第二离合器盘1060向后旋转(A方向)，同时第二离合器盘1060保持静止而不运动。 When the firing trigger 1004 returns to the starting position, the first clutch plate 1052 with respect to the second clutch plate 1060 rotates backward (A direction), while the second clutch plate 1060 remains stationary without movement. 用户然后可再次下压击发扳机1004，直到动力夹钳元件150、刀155和滑车160通过驱动杆1390和导轨1424已经完全回缩到细长通道组件120中的开始位置。 The user may then press the firing trigger 1004 again at the start position until the dynamic clamping jaw member 150, knife 155, and sled 160 by the drive rod 1390 and the rail 1424 has been completely retracted into the elongate channel assembly 120. 本领域技术人员将会理解，传动装置或导轨和小齿轮的传动比的变化可被用于得到改进的机械优点，以便在细长通道组件120中驱动刀组件170 (动力夹钳元件150、刀155和滑车160)。 Those skilled in the art will appreciate that the rails and the drive gear or pinion of ratio change may be used to obtain improved mechanical advantages for driving the knife assembly 120 in the elongate channel assembly 170 (dynamic clamping jaw member 150, knife pulley 155 and 160). [0255] 虽然上述索驱动系统1400包括了可手动致动的驱动系统，但本发明的其他构思实施方式也可采用电池供电的一个或多个马达，交流电供电的一个或多个马达或者气动马达，以便为索驱动系统供电。 [0255] While the cable drive system 1400 described above comprises a manually actuatable drive system, but other embodiments of the idea of the invention also may employ one or more battery-powered motor, an alternating current powered motor or a pneumatic motor or a plurality of in order to drive the system power supply cable. 因此，对本发明的各种实施方式给予的保护不应当仅仅限制为可手动致动的外科器械。 Accordingly, the various embodiments of the present invention should not only give protection limit for manually actuated surgical instrument. [0256] 图22-24示出了可采用本发明的一些零件的另一种外科缝合器械1500的一部分。 [0256] Figures 22-24 illustrate a portion of another surgical stapling apparatus of the present invention may be used with parts of 1500. 该实施方式采用了从手柄(未显示)延伸到通道组件(未显示)的中空脊或者管1510。 This embodiment uses extending from a handle (not shown) to the channel assembly (not shown) of a hollow tube or a ridge 1510. 在图22-24示出的实施方式中，中空脊1510与Racenet等人的美国专利公开US2005/0006432中公开的类型和构造的关节运动接头1512连接，该文献的内容通过引用而包含在本申请中。 In the embodiment shown in Figure 22-24, the hollow spine 1510 and Racenet et al., U.S. Patent Publication US2005 / articulation joint 1512 of the type and construction disclosed in connection 0,006,432, the disclosure of which is incorporated by reference in the present application in. 在不背离本发明的精神和范围的条件下也可采用其他关节运动接头设置。 Without departing from the spirit and scope of the present invention may also be other conditions articulation joint set. 从图22-24中可以看出，驱动杆1520延伸穿过中空管1510并具有近端1522，该近端1522可与上述类型的驱动设置的导轨连接并由手柄支撑。 As can be seen from Figures 22-24, a drive rod 1520 extends through the hollow tube 1510 and has a proximal end 1522, a proximal end 1522 of the handle support may be connected by a drive provided with guide rails of the type described above. 过渡块1530可与驱动杆1520的远端1524连接或者在其上形成以便连接从动杆1540。 Distal transition block 1530 may drive rod 1520 1524 formed thereon or connected to the driven connecting rods 1540. 近侧滑轮、杆、绞盘等1560安装在中空管1510中，如图22和24中所示。 Proximal pulley, rod, capstan, etc. 1560 is mounted in the hollow tube 1510, shown in Figures 22 and 24. [0257] 索、丝线、窄带、带等1570可操作地支撑在通道组件(未显示)上形成的一个或多个滑轮、杆、绞盘等上，并延伸穿过关节运动接头1512并可操作地支撑在如图22-24中显示的远侧滑轮1560上。 [0257] cord, wire, narrow band, belt, etc. 1570 is operably supported in the channel assembly (not shown) formed on one or more of the pulleys, rods, capstans, etc., and extend through the articulation joint 1512 and operably supported on the distal pulley 1560 shown in FIG. 22-24. 索1570可具有行进部分1572和回缩部分1574。 Cable 1570 and 1572 may have retracted part of the road section 1574. 回缩部分1574的端部1576可固定连接到从动杆1540的远端1542，如图22中所示。 Retraction portion 1574 of the end portion 1576 may be fixedly connected to the distal end 1540 of the driven rod 1542, shown in Figure 22. 同样的，索1570的另一端部1578与从动杆1540的远端1542连接。 Similarly, the other end portion 1578 of cable 1570 is connected to the distal end 1542 of the driven rod 1540. 图22示出了当动力夹钳元件(未显示)、刀(未显示)和滑车(未显示)处于细长通道组件(未显示)的远端时从动杆1540的位置。 Figure 22 shows the position when the power clamp element (not shown), knife (not shown) and a pulley (not shown) in the elongate channel assembly (not shown) of the distal end 1540 of the driven rod. 动力夹钳元件、刀和滑车可通过上述驱动系统(图21)以可引起驱动杆1520和从动杆1540沿着近侧方向“PD”运动的上述回缩模式操作运动到回缩位置。 Dynamic clamp member, knife, and sled may be (Fig. 21) can cause the drive rod 1520 and the driven rod 1540 is retracted in the proximal direction of the operation of the moving mode "PD" to a retracted position by the movement of the drive system. 本领域普通技术人员将会理解，所述设置代表了优于现有索设置的机械优点的巨大改进。 One of ordinary skill in the art will appreciate that the settings represent superior mechanical advantages over prior cable set huge improvements. 还应当理解，当器械进行关节运动时索1570可挠曲。 It should also be understood that when the instrument is articulated cable 1570 may flex. 在其他实施方式中，索的端部可与将在下面进一步描述类型的弹簧连接设置连接在一起。 In other embodiments, the ends of the cable may be described further below with the type of spring connection settings are connected together. [0258] 如上所述，当使用索驱动的外科切割和缝合器械时可能遇到的一个问题是一根或多根索可与一个或多个索过渡支架诸如滑轮、杆、绞盘等脱离接合或者可使装置丧失能力的类似问题。 [0258] As described above, a problem when using the cable-driven surgical cutting and stapling instrument is likely to encounter one or more cable can be used with one or more cable transition support such as pulleys, levers, winches and other disengaged or Similar problems can device incapacitated. 例如，所述索脱离可由装置的使用过程中的机械振动引起，或者可通过在使用或者运输过程中装置受到震动引起。 For example, the use of the cable out of the process by means of mechanical vibration caused by, or can be obtained by using the device during transport or caused by vibrations. 图25-27示出了采用索止动元件1600的本发明的其他实施方式，该索止动元件例如可包括细长通道组件120上靠近索过渡支架830、850以将索800、820分别保持于其上的索保持块1601。 Figures 25-27 illustrates another embodiment of the use of cable stop member 1600 of the present invention, the cable stop element may for example comprise an elongate channel assembly close to the cable transition support 120 to 830,850, respectively, to maintain the cable 800,820 Cable thereon holding block 1601. 在各种实施方式中，索过渡支架830、850例如可包括滑轮、杆、绞盘等。 In various embodiments, the cable transition support 830,850 may for example comprise a pulley, rod, capstan and so on. 虽然在各种实施方式中索保持块1610可以各种形状和构造设置，但每个索保持块1601可具有与索800、820弧形形状互补的弧形表面1602，使索800、820不会与索过渡支架800、820脱离。 Although the various embodiments of cable retention block 1610 may set a variety of shapes and configurations, but each cable retention block 1601 may have an arcuate shape complementary to the cable 800,820 arcuate surface 1602, so that the cable will not be 800,820 bracket with cable transition from 800,820. [0259] 图28和29示出了另一种索止动元件1700，例如其可包括本发明的其他实施方式的索保持块1701。 [0259] Figures 28 and 29 illustrates another cable stop member 1700, for example, it may include other embodiments of the invention the cable retention block 1701. 从这些附图中可以看出，块1701具有穿过其中的通道1702，其形成索800、820可通过的弧形支撑表面1704。 As can be seen from these figures, the block 1701 has a passage 1702 therethrough, cable 800,820 through the arcuate support surface 1704 which is formed. 在该实施方式中，在安装过程中索可穿入弧形通道1702并从其中通过。 In this embodiment, the cable during installation can penetrate and from which a curved path through 1702. 所述设置避免了索从一个或多个滑轮、杆、绞盘等脱开的问题。 Avoiding the cable from the set of one or more pulleys, rods, capstans, etc. disengaged problems. [0260] 图30-33以示意形式示出了本发明的另一种实施方式。 [0260] Figure 30-33 illustrates in schematic form another embodiment of the present invention. 该实施方式采用具有由索1800驱动的动力夹钳元件150、刀155和滑车组件160 (在本文中统称为“刀组件170”)的细长通道组件120。 This embodiment uses the cable 1800 having a driving power clamp element 150, knife 155, and sled assembly 160 (collectively referred to herein as "knife assembly 170") of the elongate channel assembly 120. 特别是，索1800可操作地支撑在一对索过渡支架1802、1804和位于刀组件170上的第三索过渡支架1806上，所述索过渡支架1802、1804例如可包括安装在细长通道组件120的远端123底部的滑轮、柱、绞盘等，所述第三索过渡支架1806例如可包括滑轮、柱、绞盘等。 On particular, the cable 1800 is operably supported on a pair of cable transition support 1802, 1804 and knife assembly 170 is located in a third cable transition support 1806, the cable transition support 1802, 1804 may include, for example, installed in the elongate channel assembly 123 at the bottom of the distal pulley 120, columns, winches, etc., and the third cable transition support 1806 may include, for example, pulleys, columns, winches, etc. 另外，索1800可操作地支撑在由手柄组件5可运动支撑的驱动滑轮1808上。 In addition, the cable 1800 is operably supported by the handle assembly 5 on the movable support of the drive pulley 1808. 驱动滑轮1808可通过手柄组件5中的扳机(未显示)或者其它致动器设置(未显示)选择性地沿着远侧方向“DD”和近侧方向“PD”运动。 Drive pulley 1808 by the handle assembly 5 in a trigger (not shown) or other actuator is provided (not shown) selectively in the distal direction "DD" and proximal direction "PD" movement. [0261] 如图30-33中示出的本发明的其他实施方式采用独特新颖的用于连接索1800的端部的索张紧接头1801，以便保持索1800的张紧，防止索1800从滑轮1802、1804、1806、1808脱落。 [0261] 30-33 in other embodiments of the present invention shown in FIG using a unique and novel cable 1800 for connecting the ends of the cable tensioning joint 1801 in order to maintain the tension cable 1800 to prevent the cable from the pulley 1800 1802,1804,1806,1808 off. 特别是，该设置采用弹簧1810形式的张紧元件，其大体上沿着与索加载路径平行的路径定向。 In particular, the use of the spring 1810 provided in the form of the tension element, which is substantially along a path parallel to the load path Mississauga orientation. 从那些附图中可以看出，第一止动元件或者块1820固定(模制、粘合、焊接等)连接到索1800的第一端部1803。 As can be seen from those figures, the first stop member or block 1820 is fixed (molding, bonding, welding, etc.) is connected to the first end 1800 of the cable 1803. 索1800的第二端部1805也与第二止动元件或者块1830固定连接(模制、焊接、粘合等)。 The second end portion 1800 of cable 1805 and the second stopper member has or block 1830 is fixedly connected (molding, welding, bonding, etc.). 从图33中可以看出，第二止动元件1830具有穿过其中的通道1832，一部分索1800可滑动通过其中，如该图中的箭头所示。 As can be seen from Figure 33, the second stop member 1830 has a passage 1832 therethrough, a portion of the cable 1800 may slidably pass therethrough, as shown by the arrows in Fig. 第三止动元件或者块1840与索1800固定连接并且弹簧1810的端部与其连接。 Mover third stop or block 1840 with a fixed connection cable 1800 and spring 1810 ends connected thereto. 弹簧1810的另一端与第二止动元件1830连接。 The other end of the spring 1810 is connected with the second stopper member 1830. 本领域普通技术人员可以理解，当可操作地支撑在例如滑轮、绞盘、保持块等形式的索过渡支架上时，当张紧弹簧1810未扩张时所述设置允许索1800使距离“L”(第一和第二止动元件1820、1830之间的距离)变长。 Those of ordinary skill will be appreciated, when operably supported on e.g. pulleys, capstans, holding block form of cable transition support, when the tension spring 1810 unexpanded setting allows cable 1800 so that the distance "L" ( The first and the second stopper member 1820, 1830 between the distance) becomes long. 还应当理解，当采用如图32中所示的进行关节运动的器械时所述设置特别有利。 It should also be understood that when using an articulatable instrument as shown in FIG 32 the arrangement is particularly advantageous. 特别是，索张紧接头1801的使用使索能够延伸或者围绕关节运动接头弯曲，同时保持围绕各种索过渡支架张紧。 In particular, the use of the cable tensioning joint 1801 enables the cable to extend or bend around the articulation joint while maintaining tension around various cable transition support. [0262] 如上所述，当采用索驱动系统时通常遇到的另一种挑战涉及以确保索有效地将需要的力传递到刀/动力夹钳元件或者其他外科器械元件的方式连接索(驱动元件)的端部。 [0262] As described above, when a cable drive system generally encountered another challenge relates to ensure that the cable effectively transmitted to the force required manner the knife / dynamic clamping jaw member or other surgical instrument component connected to the cable (drive element) of the end portion. 图34和35示出了本发明的各种实施方式的环形索1900。 Figures 34 and 35 illustrate various embodiments of the present invention an annular cable 1900. 在该实施方式中，例如，环形索1900可包括编织的金属线或者编织的塑性材料元件。 In this embodiment, for example, the cable 1900 may comprise a ring of braided metal wire or woven plastic material element. 为了形成环形索，端部1902的纤维1903可与端部1904的纤维1905交织形成索环。 In order to form a ring rope, the ends of the fibers can be 1903 1902 1905 1904 and ends of the fibers interwoven to form a grommet. 另一种实施方式是中国式指套(Chinesefinger cuff)(图35)方法，其中一个端部插入中空编织索的另一端部形成张得更紧的连接。 Another embodiment is a Chinese finger formula (Chinesefinger cuff) (Fig. 35), wherein one end portion inserted into the other end portion of the hollow braided cord formed sheets tighter connection. 在各种实施方式中，在组装过程中可采用一些紧固剂/粘接剂以便于所述接头的预张紧。 In various embodiments, some fastening agent may be employed / adhesive during assembly to facilitate the joint pretensioning. 例如，当沿着纵向施加张力时所述设置可允许索1900稍微围绕其纵向轴线“LL”压缩。 For example, when tension is applied along a longitudinal direction of the cable 1900 disposed may allow slightly about its longitudinal axis "LL" compression. 所述编织模式的一个例子在Olsen的美国专利US4817643中公开，其内容通过引用而包含在本申请中。 An example of the weave pattern in Olsen U.S. Patent No. US4817643 discloses, the contents of which incorporated by reference herein. 在端部1902、1904如图所示编织在一起之后，索1900形成封闭的环1906。 After 1902, 1904 as shown in Figure ends woven together to form a closed loop of cable 1900 1906. 当端部1902、1904编制或者交织在一起时，索可围绕驱动滑轮或者其他元件以及外科器械元件的可运动元件诸如销、滑轮、绞盘或者其他部分成环。 When the end portions 1902, 1904 prepared or intertwined, cable rotatable about a drive pulley or other member and a surgical instrument element movable member such as pins, pulleys, capstans or other portions to form a ring. [0263] 图36-38示出了本发明的用于将索与外科器械元件连接的另一种索连接设置2000。 [0263] Figure 36-38 illustrates another cable for the cable element is connected with the surgical instrument of the present invention, connection setting 2000. 从这些附图中可以看出，索2002可具有大体上为楔形或者大体上为圆锥形的嵌块(slug) 2010，该嵌块具有在其中延伸的孔2012，用于容纳索2002的端部2004，如图36中所示。 As can be seen from these figures, the cable 2002 may have a substantially wedge-shaped or substantially conical slug (slug) 2010, the slug having a bore therein extending 2012, 2002 for receiving the end portion of Naço 2004, 36 as shown in FIG. 嵌块2010可卷曲、模制、粘合、包覆成型、超声焊接等到索端部2012上，如图所示。 Slug 2010 may be crimped, molding, adhesive, overmolding, ultrasonic welding until the upper end portion of the cable 2012, as shown in FIG. 在各种实施方式中，例如，嵌块2010可由略软的材料诸如铅、铜、黄铜、不锈钢、钛等或者例如热塑性材料诸如尼龙或者聚碳酸酯制成。 In various embodiments, for example, the slug 2010 may be slightly soft material such as lead, copper, brass, stainless steel, titanium, etc. or, for example a thermoplastic material such as nylon or polycarbonate. 嵌块2010的尺寸设置成使其能被容纳在例如与动力夹钳元件150连接的外科器械元件中的形状互补的凹口2020中。 Size slug 2010 is set to be that it can be accommodated in for example surgical instrument jaw member 150 is connected to the power element in the complementary shaped recess 2020. 凹口2020的尺寸可设置成当沿着“T”方向向索2002施加张力时使连接变得更紧。 Recess dimension 2020 may be arranged so that the connection becomes even tighter when viewed along the "T" direction of the applied tension to the cable 2002. 也就是说，当索张力增大时，嵌块2010进一步压缩在索2020的端部2004上。 That is, when the cable tension increases, embedded block 2010 further compression on the cable ends 2004 2020. 在各种实施方式中，凹口2020可以至少在其一侧上是开口的，以允许嵌块2010被安装在其中。 In various embodiments, the recess 2020 may, at least on one side thereof is open to permit the slug 2010 to be installed therein. [0264] 图39示出了本发明的各种实施方式的另一种索连接设置2100。 [0264] Figure 39 shows various embodiments of the present invention of another cable connection settings 2100. 从该图中可以看出，索2110的端部2112可围绕销2120卷绕，并通过一个或多个夹具2130与索2110的其他部分2114连接，所述夹具可卷绕或者夹紧于其上，以便形成环2140，该环2140用于容纳至少一部分外科器械元件例如诸如滑轮、销、绞盘等。 As can be seen from this figure, the end portion 2110 of the cable 2112 is wound about the pin 2120, and through one or more clamps 2130 and 2110 of the other part of the cable 2114 is connected, the jig clamping can be wound thereon, or , 2140 to form a ring, the ring 2140 for receiving at least a portion of the surgical instrument components such as pulleys, pins, winches, etc. [0265] 图40示出了本发明的各种实施方式的另一种索连接设置2200。 [0265] Figure 40 shows various embodiments of the present invention of another cable connection settings 2200. 从该图中可以看出，索2210的端部2212可卷绕在销2220上并可焊接或者粘合在索2210的另一相邻部分2214上以形成环2240，以便容纳至少一部分外科器械元件，例如滑轮、销、绞盘等。 As can be seen from this figure, the end portion 2210 of the cable 2212 may be wound around the pin 2220 can be soldered or glued to another adjacent portion 2210 of cable 2214 to form a loop 2240 for receiving at least a portion of a surgical instrument element such as pulleys, pins, winches, etc. [0266] 在美国专利公开US2006/0011699A1中公开的内镜切割器采用了两个索系统:一个用于闭合砧座，并且另一个拉动动力夹钳组件、刀和滑车，以切割组织并成形缝钉。 [0266] in U.S. Patent Publication US2006 / 0011699A1 disclosed endoscopic cutter uses two cable systems: one for closing the anvil, and the other pulling power clamping assembly, knife, and sled to cut tissue and shaped slit nail. 在一种设置中，索与夹钳卡圈连接以便在凸轮表面上和上方向远侧拉动夹钳卡圈，以便相对于钉仓组件闭合砧座并压缩组织。 In one arrangement, the cable with the clamp collar connected to the cam surface and the direction of pulling the clamp collar distal to relative to the staple cartridge assembly and compress the tissue close the anvil. 该闭合索必须通过关节运动接头回穿到手柄中。 The closure cable must pass back through the articulation joint to handle. 当该索的近端被拉动时，与夹钳卡圈连接的索的远端引起夹钳卡圈向远侧运动并闭合砧座。 When the proximal end of the cord is pulled, the distal end of the cable with clamp collar collar clamp connection caused to move distally and close the anvil. 但是，所述设置受到产生夹钳力的能力的限制。 However, the setting is limited ability to produce the clamp force. [0267] 图41示出了在上述公开中公开类型的关节运动接头1512。 [0267] Figure 41 shows the type disclosed in the above publication of the articulation joint 1512. 图42和43示出了本发明的各种实施方式的闭合管组件2300的关节运动接头组件2302，这些实施方式可与关节运动接头1512结合使用并不需要用索来闭合砧座110。 Figures 42 and 43 illustrate various embodiments of the closure tube assembly of the present invention the articulation joint assembly 2300 of 2302, 1512 of these embodiments may be used in combination with the cable does not need to close the anvil 110 and the articulation joint. 图44示出了安装在关节运动接头1512上方的闭合管组件2300。 Figure 44 shows a closure tube assembly mounted above the articulation joint 1512 2300. 如同将在下面进一步详细讨论的那样，在各种实施方式中，闭合管组件2300可操作地靠近细长通道组件120受到支撑，以便当与闭合管组件2300闭合接触时选择性地将闭合动作施加到站座组件110。 As will be discussed in further detail below, in various embodiments, closure tube assembly 2300 is operably close to the elongate channel assembly 120 by the support, so that when the contact 2300 is closed with the closure tube assembly selectively applying a closing motion 110 seat assembly station. [0268] 从图42中可以看出，闭合管组件2300的实施方式可包括具有近端2312和远端2314的远侧闭合管段2310、具有远端2322和近端2324的中央闭合管段2320和具有近端2332和远端2334的近侧闭合管段2330。 [0268] As can be seen from Figure 42, the closure tube assembly 2300 may include an embodiment having a proximal end 2312 and a distal end 2314 of the distal closure tube segment 2310, having a distal end and a proximal end 2322 of the central closure tube segment 2320 and 2324 have 2332 proximal and distal proximal closure tube segment 2334 2330. 近侧闭合管段2330的近端2332可以不可旋转地连接到闭合管段2340的远端2342。 A proximal closure tube segment 2330 of the proximal end 2332 may be non-rotatably connected to the distal closure tube segment 2340 of 2342. 从图43中可以看出，中空闭合管段2340的远端2342中可设置有用于容纳从近侧闭合管段2330的远端2334向近侧突出的翼片2336的凹口2344。 As can be seen from Figure 43, the distal end of the hollow closure tube segment 2340 of 2342 may be provided with means for receiving from the distal end 2330 of the proximal closure tube segment 2334 proximally projecting fins 2336 of the recess 2344. 从图43中还可以看出，近端2332可容纳在中空闭合管段2340的中空远端2342中。 Can also be seen from Figure 43, the proximal end 2332 may be received in the hollow closure tube segment 2340 distal end 2342 of the hollow. 近侧闭合管段2330可通过粘接剂、胶水等与闭合管段2340保持连接。 A proximal closure tube segment 2330 may remain connected to the closure tube 2340 segment by an adhesive, such as glue. 本领域普通技术人员应当理解，所述独特新颖的构造帮助促进装置的组装。 Ordinary skill in the art should appreciate that the unique and novel configuration helps to promote assembly of the device. 但是，例如在其他实施方式中，近侧闭合管段2330可与闭合管段2340 —体形成。 However, for example, in other embodiments, the proximal closure tube segment 2330 with closure tube segment 2340-- formed body. [0269] 在各种实施方式中，闭合管组件2300可还包括从近侧闭合管段2330的远端2334突出的第一上部翼片2350和与第一上部翼片2350成间隔关系的从近侧闭合管段2330的远端2334突出的第一下部翼片2352。 [0269] In various embodiments, the closure tube assembly 2300 may further include a distal end from the proximal closure tube segment 2330 of 2334 and 2350 projecting first upper flap 2350 in a spaced relationship with the first upper flap from the proximal 2330 of the distal closure tube segment 2334 protruding first lower flap 2352. 第一上部翼片2350具有穿过其中的第一上部枢轴孔2354并且第一下部翼片2352具有穿过其中的第一下部枢轴孔2356,在各种实施方式中该第一下部枢轴孔与第一上部枢轴孔2354共轴对准。 First upper flap 2350 has a first upper pivot hole 2354 therethrough and the first lower flap 2352 with 2356, in various embodiments of the first lower therethrough a first lower pivot hole pivot hole and the first upper pivot hole 2354 coaxial alignment. 中央闭合管段2320的近端2324具有从其上突出的第二上部翼片2326和从其上突出并与第二上部翼片2326成间隔关系的第二下部翼片2328。 The central closure tube segment 2320 has a proximal end 2324 of the second upper projecting therefrom and a second lower flap 2326 and 2326 projecting tabs spaced relationship with the second upper flap on from 2328. 第二上部翼片2326具有穿过其中的第二上部枢轴孔2327并且第二下部翼片2328具有穿过其中的第二下部枢轴孔2329，该第二下部枢轴孔大体上与第二上部枢轴孔2327共轴对准。 The second upper flap 2326 has a second upper pivot hole 2327 therethrough and the second lower flap 2328 having therethrough a second lower pivot hole 2329, the second lower pivot hole and a second substantially upper pivot hole 2327 coaxial alignment. [0270] 从图44中可以看出，中央闭合管段2320的远端2322具有从其上突出的第一侧向翼片2321和第二侧向翼片2323。 [0270] As can be seen from Figure 44, the distal end 2320 of the central closure tube segment 2322 has projecting therefrom a first lateral flap and a second lateral flap 2321 2323. 第一侧向翼片具有穿过其中的第一侧孔(未显示)，第二侧向翼片2323具有穿过其中的第二侧孔2325，该第二侧孔与第一侧孔2325共轴对准。 First lateral flaps having a first side holes therethrough (not shown), a second lateral flap 2323 having a second side hole 2325 therethrough, the second side holes and a first side hole 2325 Total axis alignment. 另夕卜，远侧闭合管段2310的近端2312具有从其上突出的第三侧向翼片2316和从其上突出并与第三侧向翼片2316成间隔关系的第四侧向翼片2318。 Another Xi Bu, the distal closure tube segment 2310 has a proximal end 2312 of the third projecting therefrom laterally protruding tabs 2316 and 2316 and in spaced relation to the third lateral flap on its fourth side flaps 2318. 第三侧向翼片2316具有穿过其中的第三侧向枢轴孔(未显示)，第四侧向翼片2318具有穿过其中的第四侧向枢轴孔2319，其与第三侧向枢轴孔大体上共轴对准。 Third side flap 2316 having therethrough a third lateral pivot hole (not shown), the fourth side flap 2318 therethrough having a fourth lateral pivot hole 2319, with the third side substantially coaxially aligned with the pivot hole. [0271] 在各种实施方式中，闭合管接头组件2302还包括具有从其中突出的第一上部销2362和第二上部销2364的上部双枢轴连接件2360。 [0271] In various embodiments, the closure tube joint assembly 2302 further includes a connection from which the first upper pin 2362 protruding upper pin 2364 and the second upper double pivot member 2360. 第一上部销2362的尺寸设置成可枢转地容纳在第一上部枢轴孔2354中，第二上部销2364的尺寸设置成可枢转地容纳在第二上部枢轴孔2327中。 The first upper pin 2362 is sized to be pivotally received in the first upper pivot hole 2354, a second upper pin 2364 is sized to be pivotally received in upper pivot hole 2327 in the second. 上部双枢轴连接件2360可通过关节运动接头组件1512保持在中央闭合管段2320的近端2324和近侧闭合管段2330的远端2334之间的位置中。 An upper double pivot link 2360 may be held in the 1512 central closure tube segment 2320 and the proximal end of the distal end 2324 of the proximal closure tube segment 2330 between the positions 2334 by the articulation joint assembly. 闭合管接头组件2300可还包括下部双枢轴连接件2370，其具有从其上突出的第一下部销2372和第二下部销2374。 Closure tube joint assembly 2300 may further include a lower double pivot link 2370 that has a first lower projecting therefrom pin 2372 and a second lower pin 2374. 见图43。 See Figure 43. 第一下部销2372的尺寸设置成可枢转地容纳在第一下部枢轴孔2356中，第二下部销2374的尺寸可枢转地容纳在第二下部枢轴孔2329中。 First lower pin 2372 is sized to be pivotally received within the first lower pivot hole 2356, the dimensions of the second lower pin 2374 is pivotally received in the second lower pivot hole 2329 in. 下部双枢轴连接件2370可通过关节运动接头组件1512保持在中央闭合管段2320的近端2324和中央闭合管段2320的远端2322之间的位置中。 The lower part of the double pivot link 2370 by the articulation joint assembly 1512 is maintained at the central closure tube segment 2320 and proximal end 2324 distal end of the central closure tube segment 2320 between the 2322 position. [0272] 当上部双枢轴连接件2360和下部双枢轴连接件2370连接到中央闭合管段2320的近端2324和近侧闭合管段2330的远端2334时，第一上部销2362和第一下部销2372沿着第一枢转轴线DD共轴对准，在各种实施方式中，该第一枢转轴线DD可大体上与延伸穿过细长闭合管组件1000的细长轴轴线CC垂直。 [0272] connected to the central closure tube segment when the upper double pivot link 2360 and lower double pivot link 2370 2320 2324 proximal distal and proximal closure tube segment 2330 of 2334, the first upper pin 2362 and the first under the pin 2372 coaxially aligned along a first pivot axis DD, in various embodiments, the first pivot axis DD can substantially extend through the elongate axis of the elongate closure tube assembly 1000. CC vertical. 见图43。 See Figure 43. 同样的，第二上部枢轴销2364和第二下部枢轴销2374沿着第二枢转轴线EE共轴对准。 Similarly, the second upper pivot pin 2364 and the second lower pivot pin 2374 coaxially aligned along a second pivot axis EE. 在各种实施方式中，第二枢转轴线EE大体上与细长轴轴线CC垂直并大体上与第一枢转轴线DD平行。 In various embodiments, the second pivot axis EE CC axis substantially perpendicular to the elongate axis and substantially parallel to the first pivot axis DD. 读者可以理解，这种设置允许中央闭合管段2320围绕枢转轴线DD和EE相对于近侧闭合管段2330枢转。 Readers will be appreciated, this arrangement allows the central closure tube segment 2320 about pivot axis DD and EE relative to the proximal closure tube segment 2330 to pivot. [0273] 在各种实施方式中，闭合管接头组件2302可还包括第一侧向双枢轴连接件2380，其具有从其上突出的第一上部销(未显示)和第二上部销(未显示)。 [0273] In various embodiments, the closure tube joint assembly 2302 may further include a first lateral double pivot link 2380 that has a first upper projecting therefrom a pin (not shown) and a second upper pin ( not shown). 第一侧销的尺寸设置成可枢转地容纳在第一侧向翼片2321中的第一侧向枢轴孔(未显示)中，第二侧销的尺寸设置成可枢转地容纳在第三侧向翼片2316中的第二侧向枢轴孔(未显示)中。 Size of the first side of the pin is set to a first lateral pivot hole pivotally received in the first lateral flap 2321 (not shown), the size of the second side of the pin is arranged to be pivotally received in the third side flap 2316 in the second lateral pivot hole (not shown). 第一侧向双枢轴连接件2380可通过关节运动接头组件1512保持在远侧闭合管段2310的近端2312和中央闭合管段2320的远端2322之间的位置中。 The first lateral double pivot link 2380 by the articulation joint assembly 1512 is maintained at the distal closure tube segment 2310 and proximal end 2312 distal end of the central closure tube segment 2320 between the 2322 position. 闭合管接头组件2300可还包括第二侧向双枢轴连接件2390，其具有从其上突出的第三侧销2392和第四侧销2394。 Closure tube joint assembly 2300 may further include a second lateral double pivot link 2390, which has a pin 2392 protruding therefrom and a fourth lateral pin 2394 of the third side. 第三侧销2392的尺寸设置成可枢转地容纳在第二侧向翼片2323中的第二侧孔2325中，第四侧销2394的尺寸设置成可枢转地容纳在第四侧向翼片2318中的第四侧向枢轴孔2319中。 The third side of the pin 2392 is sized to a second side of the hole may be pivotally received in the second side flap 2323 in 2325, the fourth side of the pin 2394 is sized to be pivotally received in the fourth lateral fins 2318 in the fourth lateral pivot hole 2319. 第二侧向双枢轴孔连接件2390可通过关节运动接头组件1512保持在远侧闭合管段2310的近端2312和中央闭合管段2320的远端2322之间的位置中。 The second lateral double pivot hole connecting member 2390 may be 1512 by the articulation joint assembly 2322 between a holding position in the distal end 2310 of the distal closure tube segment 2312 and the proximal end of the central closure tube segment 2320 in. [0274] 当第一侧向双枢轴连接件2380和第二双枢轴连接件2390连接到远侧闭合管段2310的近端2312和中央闭合管段2310的远端2322上时，第一侧销和第三侧销2392沿着第三枢转轴线FF共轴对准，在各种实施方式中，该第三枢转轴线FF可大体上横过细长轴轴线CC或与其垂直。 [0274] When the first lateral double pivot link 2380 and the second double pivot link 2390 is connected to the distal closure tube segment 2310 and proximal end 2312 distal end of the central closure tube segment 2310 on the 2322, the first side pin and third lateral pin 2392 coaxially aligned along a third pivot axis FF, in various embodiments, the third pivot axis may be substantially transverse to the elongate axis FF CC axis or perpendicular thereto. 同样的，第二侧向枢轴销和第四侧向枢轴销2394沿着第四枢转轴线GG共轴对准。 Similarly, the second lateral pivot pin and the fourth lateral pivot pin 2394 coaxially aligned along a fourth pivot axis GG. 在各种实施方式中，第三枢转轴线FF大体上横过细长轴轴线CC、第一轴线DD和第二轴线EE或者与其垂直，并且大体上与第四枢转轴线GG平行。 In various embodiments, the third pivot axis substantially transverse to the elongated shaft axis FF CC, DD the first axis and a second axis perpendicular thereto, or EE, and substantially parallel to the fourth pivot axis GG. 读者可以理解，这种设置允许远侧闭合管段2310围绕枢转轴线GG和FF相对于中央闭合管段2320枢转。 Readers will be appreciated, this arrangement allows the distal closure tube segment 2310 about pivot axis GG and FF segment relative to the central closure tube 2320 to pivot. 因此，所述设置提供了可在接头组件1512上方轴向运动并仍提供了围绕四个轴线进行多个关节运动的闭合管组件。 Thus, the arrangement provides an axially movable in the upper joint assembly 1512 and still provide a plurality of around four articulation axis of the closure tube assembly. [0275] 本领域普通技术人员将会理解，当闭合管组件2300沿着远侧方向DD运动(推动)时，远侧闭合管段2310的远端2314通过与砧座组件110的凸轮表面115 (见图2、4和7)接触而将闭合动作施加到砧座组件110上，将砧座组件110相对于钉仓组件200闭合。 [0275] Those of ordinary skill in the art will appreciate that when the closure tube assembly 2300 in the distal direction DD motion (push), the distal end of the distal closure tube segment 2310 and 2314 by the cam surface 115 of anvil assembly 110 (see Figures 2, 4 and 7) contact the closing motion is applied to the anvil assembly 110, anvil assembly 110 relative to the staple cartridge assembly 200 is closed. 在各种实施方式中，可采用复位机构例如弹簧、索系统或者类似物(未显示)，将闭合管组件2300回复成预夹钳朝向，当闭合管段2310与砧座组件110近端上的反向凸轮表面117接触时引起砧座组件Iio重新打开。 In various embodiments, the return mechanism may be employed such as a spring, cable system or the like (not shown), the closure tube assembly 2300 returned to the pre-clamp faces, when closure tube segment 2310 and the proximal end of the anti-assembly 110 on the anvil cause the anvil assembly Iio reopened to the cam surface 117 contacts. 见图2和7。 See Figures 2 and 7. 在图45中所示的其他实施方式中，砧座组件110'可形成直立的致动翼片111'，其尺寸设置成延伸到远侧闭合管段2310的远端2314中的马蹄形开口2315中。 In other embodiments shown in Fig. 45, the anvil assembly 110 'may be formed upstanding actuating flap 111', which is sized to extend into the distal closure tube segment 2310 distal end 2314 of the horseshoe aperture 2315. 见图44A。 Figure 44A. 因此，当闭合管组件2300沿着远侧方向DD运动时，马蹄形开口2315接触斜面115并促使砧座组件110'进入闭合位置。 Thus, when the closure tube assembly 2300 in the distal direction DD movement, horseshoe opening 2315 contacts ramp 115 and cause the anvil assembly 110 'into the closed position. 当闭合管组件2300沿着近侧方向H)运动时，马蹄形开口2315拉动翼片111'并引起砧座组件110'枢转到打开位置。 When the closure tube assembly 2300 in the proximal direction H) movement, opening 2315 horseshoe pull tab 111 'and causes the anvil assembly 110' to pivot to an open position. [0276] 本发明的一种闭合管驱动系统在图46中简要图示。 A closure tube drive system [0276] The present invention is briefly illustrated in Fig. 46. 但是，其他系统也可被有效地采用，也不脱离本发明的精神和范围。 However, other systems may also be effectively adopted, not departing from the spirit and scope of the invention. 从图46中可以看出，一种形式的闭合管驱动系统2400包括与闭合扳机18连接的轭形件2402。 As can be seen from Figure 46, one form of closure tube drive system 2400 includes a yoke-shaped member 18 is connected with the closure trigger 2402. 枢轴销2404经过闭合扳机18和轭形件2402两者中对准的开口插入。 2404 through the closure trigger pivot pin 18 and the yoke member 2402 aligned openings in both the insert. 轭形件2402的远端经销2406与闭合托架2410的第一部分2408连接。 The distal end of the yoke 2406 and 2402 distribution closure bracket 2410. The first portion 2408 is connected. 第一闭合托架部分2408与第二闭合托架部分2412连接。 The first closure bracket portion 2408 2412 connected to the second closure bracket portion. 整体上，闭合托架2410限定了开口，闭合管段2340的近端2346可安放并保持在其中，使闭合托架2410的纵向运动基本上沿着远侧方向DD推动或驱动闭合管段2340(并最终驱动细长闭合管组件2300)。 Overall, the closure bracket 2410 defines an opening, the proximal closure tube segment 2340 2346 can be placed and held therein, the longitudinal movement of the closure bracket 2410 essentially DD pushed or driven closure tube segment 2340 (and ultimately the distal direction Driver elongated closure tube assembly 2300). [0277] 在操作中，当轭形件2402由于闭合扳机18的回缩而旋转时，闭合托架2410引起近侧闭合管段2340沿着近侧方向H)运动，这引起远侧闭合管段2310向近侧运动。 [0277] In operation, when the yoke 2402 due to retraction of the closure trigger 18 is rotated, the closure bracket 2410 causes the proximal closure tube segment 2340 in the proximal direction H) movement, which causes the distal closure tube segment 2310 to proximal movement. 如果采用砧座组件110 '，当远侧闭合管段2310向近侧运动时则翼片111'引起砧座组件110 '打开。 If the anvil assembly 110 ', when the distal closure tube segment 2310 to move proximally the flap 111' causes the anvil assembly 110 'to open. 当闭合扳机18从锁定位置打开时，近侧闭合管段2340沿着远侧方向DD被推动或者驱动，引起远侧闭合管段2310向远侧滑动。 When the closure trigger 18 from the locked open position, the proximal closure tube segment 2340 DD is pushed or driven in the distal direction, which causes the distal closure tube segment 2310 to slide distally. 远侧闭合管段2310通过驱动砧座组件110'向远侧进入斜面115而迫使其闭合。 The distal closure tube segment 2310 by driving the anvil assembly 110 'distally into the inclined surface 115 forcing its closure. 这种闭合系统2400在共同拥有的申请号为11/343547的美国专利申请中进一步描述，该申请的题目为“Endoscopic SurgicalInstrument With a HandleThat Can Ariculate With Respect to theShaft”，申请人为Frederick E.Shelton, IV等，其内容通过全文引用而包含在本申请中。 Such closure system 2400 is further described in commonly owned U.S. Application No. 11/343547 patent application, the subject of this application as "Endoscopic SurgicalInstrument With a HandleThat Can Ariculate With Respect to theShaft", the applicant is Frederick E.Shelton, IV et al., which is incorporated by reference in its entirety is included in this application. 但是，也可采用其他闭合系统使闭合管组件2300沿着近侧和远侧方向轴向运动。 However, the other closed systems can also be used to make a closed tube assembly 2300 along the axial direction of the proximal and distal movement. [0278] 图47-50示出了本发明的各种实施方式的另一种独特新颖的闭合系统2500。 [0278] Figure 47-50 illustrates another unique and novel closure system of various embodiments of the present invention is 2,500. 在这些附图中示出的实施方式中，采用了可手动致动的驱动系统2600。 In these embodiments shown in the drawings, the use of a manually actuatable drive system 2600. 这样的驱动系统设置在共同拥有的申请号为11/475412的美国专利申请中公开，其申请日为2006年6月27日，申请人为Frederick Ε.Shelton 等，题目为“Manually Driven Surgical Cutting andFasteningInstrument ”,该专利申请的全部内容通过引用而包含在本申请中。 Such a drive system settings in commonly owned US Patent Application No. 11/475412 disclosed in its filing date of June 27, 2006, an applicant for Frederick Ε.Shelton etc., entitled "Manually Driven Surgical Cutting andFasteningInstrument" , the entire contents of this patent application is incorporated by reference herein. 如前面所进行的详细描述，本领域技术人员将会理解，本发明的闭合系统2500还可有效地与采用一根或多根索来驱动动力夹钳元件、刀和滑车的外科缝合器械结合使用。 As described in detail previously carried out, those skilled in the art will appreciate that the closure system 2500 of the present invention is also effective with the use of one or more drive power cable to the clamp member, knife and sled surgical stapling apparatus in combination . 另外，闭合系统2500还可有效地与采用马达来驱动动力夹钳元件、刀、滑车等的其他外科缝合器械结合使用。 In addition, the closure system 2500 may also be effectively used to drive the motor with the use of surgical stapling instrument powering other jaw member, knife, sled, etc. in combination. 因此，对本文中描述的闭合系统2500所提供的保护不应当仅限于其与图47-50所示出的可手动致动的驱动系统结合使用。 Therefore, the protection of the closure system described herein, provided only that it can not be 2500 in Fig. 47-50 illustrated manual actuation of the drive system used in combination. [0279] 如这些附图中所示，击发扳机2610由手柄组件5可操作地支撑并在其上具有与可操作地连接旋转驱动轴2614的传动齿轮设置(未显示)啮合连接的齿轮齿2612。 [0279] As shown in these drawings, the firing trigger 2610 5 operably supported by the handle assembly and having thereon and operatively connected to the rotary drive shaft 2614 of the transmission gear set (not shown) connected to the ring gear teeth 2612 . 旋转传动轴2614可旋转地支撑在延伸穿过细长中空闭合管2510的脊2616中。 The rotary drive shaft 2614 is rotatably supported in the hollow extending through the elongated closure tube 2510 of ridge 2616. 旋转传动轴2614可与由脊2617可操作地支撑的其他传动元件连接，以便将旋转驱动运动传递到工具组件100'。 The rotary drive shaft 2614 may be connected with other transmission components operably supported by the spine 2617 to the rotary drive motion is transmitted to the tool assembly 100 '. 而且在各种实施方式中，切换器组件2620与传动齿轮设置连接。 Also in various embodiments, the switch assembly 2620 is connected with the drive gear set. 切换器组件可包括选择器开关2622，当开关处于一个位置中并`且击发扳机2610在棘轮运动中枢转时，使旋转传动轴2614沿着第一方向旋转，并最终将旋转运动施加到工具组件100'上，引起动力夹钳元件或者刀组件沿着远侧方向DD运动，并且当选择器开关2622运动到第二位置时，击发扳机2610的棘轮运动引起旋转传动轴2614沿着相反方向旋转,从而将相反的旋转运动施加到工具组件100'，并引起动力夹钳组件或者刀组件沿着近侧方向F1D运动。 Switch assembly may include a selector switch 2622, when the switch is in one position and the firing trigger 2610 and `during pivoting movement of the ratchet wheel, the rotary drive shaft 2614 to rotate in a first direction, and finally applying a rotary motion to the tool assembly 100 ', causing the power clamp member or knife assembly movement in the distal direction DD, and when the selector switch 2622 is moved to the second position, movement of the firing trigger 2610 causes the ratchet drive shaft 2614 is rotated in the opposite rotational direction, whereby the opposite rotational movement is applied to the tool assembly 100 'and cause the dynamic clamping assembly or knife assembly in a proximal direction F1D movement. [0280] 从这些附图中还可以看出，闭合管组件2500可还包括闭合旋钮2520和用于工具组件旋转的旋转组件2550。 [0280] From these figures it can be seen, closure tube assembly 2500 may further include a closure knob 2520 and a rotation assembly for rotation of the tool assembly 2550. 从图48中更特别能够看出，闭合旋钮2520可支撑在闭合管2510的近端2512和脊连接管2618上。 More particularly, it can be seen from Figure 48, the closure knob 2520 may be supported on the proximal end 2510 of the closure tube 2512 and a spine connecting the tube 2618. 出于组装的目的，闭合旋钮2520可设置成通过机械紧固件或者粘接剂互连的半部。 For assembly purposes, the closure knob 2520 may be provided by mechanical fasteners or adhesive interconnected halves. 在一种实施方式中，脊连接管2618是中空的并具有带凸缘的近端2619。 In one embodiment, the ridge connecting tube 2618 is hollow and has a flanged proximal end 2619. 带凸缘近端2619可旋转支撑在设置在闭合旋钮2520中的径向槽2522中，使闭合旋钮2520可围绕脊连接管2618自由旋转。 Flanged proximal end 2619 is rotatably supported in the knob 2520 provided at the closed radial slots 2522 in the closure knob 2520 can freely rotate about the spine connection tube 2618. 从图48中还可以看出，脊2616可具有尺寸设置成延伸到脊连接管2618中的近端2617。 Can also be seen from Figure 48, the ridges 2616 can have a ridge dimensioned to extend into the proximal end of the connection tube 2618 2617. 但是，也可采用其他设置。 However, other settings can also be used. 从图48中还可以看出，闭合管2510的近端2512可以带凸缘并可被定向成不旋转地保持在闭合旋钮2520中形成的第二径向槽2524中，使闭合旋钮2520的旋转引起闭合管2510的旋转。 Can also be seen from Figure 48, the proximal end 2510 of the closure tube 2512 may be flanged and may be oriented so as not to rotatably held in the second radial slot 2524 formed in the closure knob 2520 in the closure knob 2520 causes rotation of the closure tube 2510. [0281] 各种实施方式还可包括旋转组件2550。 [0281] Various embodiments may also include a rotation assembly 2550. 从图47、49和50中可以看出，旋转组件2550可包括可旋转地容纳在手柄组件5中的旋转旋钮2552。 As can be seen from Fig. 47, 49 and 50, the rotation assembly 2550 may include a rotation knob rotatably housed in the handle assembly 5 in 2552. 如闭合旋钮2520和外科组件5 一样，旋转旋钮2552可设置成两部分，为了组装它们可通过机械紧固件-螺钉、按扣等或者粘接剂互连。 As closure knob 2520 and the same surgical assembly 5, the rotation knob 2552 may be provided in two parts, in order to assemble them by mechanical fasteners - screws, snaps, etc. or adhesive interconnection. 在各种实施方式中，旋转旋钮2552的远端2554具有在其中延伸的孔2556，其适于将脊管2560容纳在其中，所述脊管具有与旋转旋钮2552的远端2554轴向接合的带键部分2562，使旋转旋钮2550可相对于脊管2560轴向运动，但总是与其带键部分2562接合。 In various embodiments, the distal end 2552 of the rotation knob 2554 has a hole 2556 extending therein, which is adapted to the ridge 2560 is accommodated in the tube wherein the tube has a ridge distal end 2552 of the rotation knob 2554 engages axially with a key part of 2562, the rotary knob 2550 with respect to the axial movement of the spinal canal 2560, but always with a key part of its 2562 engagement. 从图48中可以看出，脊管2560具有延伸到闭合旋钮2520中并且通过粘接剂或者其他合适的紧固件设置与脊连接管2618不旋转地连接的远端2564。 As can be seen from Figure 48, the ridge extending into the closure tube 2560 has a knob 2520 and is provided with a ridge 2618 is not connected to the distal tube 2564 is rotatably connected via an adhesive or other suitable fastener. 脊管2560的近端2566带有凸缘并适于被容纳在设置在手柄组件5中的环形槽2570中，使带凸缘的近端2566可在其中旋转。 Ridge tube 2560 and the proximal end 2566 with a flange adapted to be received in the handle assembly 5 is provided in the annular groove 2570, and 2566 so that the proximal end of the flanged rotatable therein. [0282] 从图47和49中还可以看出，外壳组件的远端2580带有凸缘并具有在其上形成的第一径向齿轮2582。 [0282] can also be seen from FIG. 47 and 49, the distal end of the housing assembly 2580 and having a flange having a first radial gear 2582 formed thereon. 外壳组件的带凸缘的远端2580延伸到在旋转旋钮2552中形成的环形腔2567中。 Flanged distal end 2580 of the housing assembly extends into an annular cavity 2552 formed in the rotation knob 2567 in. 环形腔2567通过向内延伸的环形凸缘2568形成，所述环形凸缘2568具有在其上形成的第二径向齿轮2569以便选择性地与第一径向齿轮2582啮合。 The annular chamber 2567 through the annular inwardly extending flange 2568 is formed, the annular flange 2568 having a second radial gear 2569 formed thereon for selectively engaging with the first radial gear 2582. 环形凸缘2568还延伸到在外科组件5中形成的环形弹簧腔2584中。 Annular flange 2568 also extends into an annular spring cavity 2584 formed in the surgical assembly 5 in. 在弹簧腔2584中设置锁定弹簧2590。 Set lock spring 2590 spring 2584 in the chamber. 将第二径向齿轮2569偏压成与第一径向齿轮2582哨合。 The second bias voltage radial gear 2569 with the first radial gear 2582 post together. 如同将在下面详细讨论的那样，临床医生可解锁脊2616，从而通过向近侧拉动旋转旋钮2552使第二径向齿轮2569从第一径向齿轮2582脱离，使临床医生能够旋转脊2616并最终将工具组件100'旋转到将工具组件100'沿着所需的朝向定位，使旋转旋钮2550、脊管2560和脊2616能够旋转。 As will be discussed in detail below, the clinician can unlock the ridge 2616, thus turning the knob pulled proximally through the second radial gear 2552 2569 2582 off from the first radial gear, so that the clinician can rotate the ridge 2616 and eventually The tool assembly 100 'is rotated to the tool assembly 100' positioned along the desired orientation, so that rotation of the knob 2550, 2560 and ridge 2616 ridge tube can be rotated. [0283] 如图47和48中所示，闭合管2510的远端2514可形成有直径减小部分2515，以便将不能旋转的闭合环2594滑动容纳于其上。 [0283] 47 and shown in FIG. 48, the distal end 2514 of the closure tube 2510 may be formed with a reduced diameter portion 2515, so as to not rotate the closure ring 2594 slidably received thereon. 在各种实施方式中，一对槽2516设置在其中，被定向成容纳从闭合环2594的壁上向内突出的相应的销2596。 In various embodiments, a pair of grooves 2516 disposed therein, is oriented to accommodate the walls of the closed loop from 2594 respective inwardly projecting pins 2596. 在各种实施方式中，采用至少一个销和槽设置。 In various embodiments, the use of at least one pin and a groove is provided. 在替代实施方式中，销2596可以在闭合管2510中并且槽2516可设置在闭合环中。 In alternative embodiments, the pin 2596 may be 2510 and closure tube 2516 may be disposed in the groove in a closed loop. 图50示出了处于打开位置中的工具组件100'的砧座110'中。 'Of the anvil 110' in FIG. 50 shows the open position of the tool assembly 100. 为了闭合砧座110'，临床医生简单地沿着第一方向旋转闭合旋钮2520，并同样沿着该方向旋转闭合管2510。 To close the anvil 110 ', the clinician simply closing the first direction of rotation knob 2520, and also along the direction of the rotational closure tube 2510. 闭合管2510借助销2596和槽2516之间的相互作用的旋转引起闭合环2594向远侧运动，与砧座110'的一部分接触，将砧座110'枢转到图47和48中所示的闭合位置。 Closure tube 2510 by the rotation of the interaction between the pins 2596 and slots 2516 causes a closed loop 2594 is moved distally, 'of the contact portion, the anvil 110' to pivot the anvil 110 as shown in FIG. 47 and 48 closed position. 如图48所示，在闭合环2594的近端2598和闭合管2510的直径减小部分2515的突出部分2517之间存在距离2599。 As shown, the proximal end 2594 of the closure ring 2598 and closure tube 2510 of the reduced diameter portion 2515 of the projecting portion 48 exists between the distance 2599 2517. 所述距离2599代表了闭合环2594可利用的轴向行进量。 The 2599 represents the axial distance closed loop 2594 the amount of travel available.本领域普通技术人员将会理解，通过以相对较低的角度提供槽2516，销2596将易于保持在位置中，由此也将砧座110'保持在闭合位置中。但是，也可采用其他锁定设置。 [0284] 为了打开砧座110'，临床医生再次沿着近侧方向H)运动制动旋钮2552，然后沿着如图49和50所示的第二方向运动闭合旋钮2520(和闭合管2510)。在各种实施方式中，被夹甜在工具组件100'中的组织引起站'座110'运动到打开位直。在另外的实施方式中，当闭合环2594已经运动到图49和50所示的位置时，可采用弹簧或者其他偏压元件(未显示)将砧座110'偏压到打开位置。在其他实施方式中，闭合环2594可设置有上述马蹄形开口，并且砧座110'可被构造成具有如图45中所示的翼片111'。因此，在该实施方式中，当闭合环2594被向近侧拉动时，其将砧座110'拉到打开位置，一旦处于打开位置中，临床医生可释放制动旋钮2552并且定位槽2550将闭合管2510(和砧座110')锁定在打开位置中。本领域普通技术人员将会理解，闭合系统2500可有效地与上述闭合管接头组件2302结合使用。在所述实施方式中，槽2516可设置在远侧闭合管段2310中。所述设置将可以上述相同的方式操作，但是，器械还可围绕多个轴进行关节运动。 [0285] 图51示出了本发明的另一种实施方式，其中闭合管2510的远端2515'上具有螺纹2513，以便与闭合环2594'上的螺纹2597螺纹接合。在该实施方式中，闭合环2594'可被构造成与通道组件120和或脊2616相互作用，使闭合环2594'可相对于其纵向运动，但不旋转。螺纹2597在闭合环2594'的近端2595中形成，当闭合管2510沿着一个方向旋转时，使闭合环2594'沿着远侧方向DD轴向运动，与砧座110'接触并将砧座110'枢转到夹钳位置。闭合环2594'沿着相反方向的旋转引起闭合环2594'沿着近侧方向H)运动，使待枢转的砧座110'通过夹钳在其中的组织或者通过弹簧或者其他偏压元件打开。多圈螺纹的使用可提供比其他闭合环设置更多的闭合动力。在替代实施方式中，闭合环2594'可设置有马蹄形开口以便与砧座上的闭合翼片相互作用。见图45。闭合管2510'的旋转和锁定可通过闭合系统2500和上述闭合管制动组件2550来控制。该实施方式还可与上述各种关节运动接头结合使用，也不脱离本发明的精神和范围。还应当理解，所述实施方式可有效地用于图47和49所示的手动驱动系统或者其他驱动设置，诸如索驱动设置等。 [0286] 图52-54示出了本发明的另一种索致动闭合系统2700的实施方式。从这些附图中可以看出，各种实施方式包括轴向支撑近侧脊段2720的近侧覆盖管2710。近侧脊段2720从手柄组件(未显示)延伸并可由此以一些已知设置中任何一种被支撑，也不脱离本发明的精神和范围。 [0287] 在各种实施方式中，近侧脊段2720具有远端2722，所述远端2722具有从其上突出并具有与其连接或者与其一起形成的球形元件2730的颈部2724。从这些图中可以看出，球形元件2730的尺寸设置成可容纳在通道形远侧脊段2740的近端2742中形成的插座2750中。球形元件2730和插座2750共同形成球形接头，总体标记为2760，为远侧脊段2740提供相对于近侧脊段2720沿着多个方向进行关节运动的能力。在远侧脊段2740的近端2742和近侧脊段2720的远端2722之间提供足够大小的间隙2748，使远侧脊段2740相对于近侧脊段2720在所需的运动范围中进行关节运动。在各种实施方式中，远侧脊段2740和与砧座110”枢转连接的细长通道组件120”连接。从图52-54中可进一步看出，闭合环2770支撑在远侧脊段2740上以便在其上轴向行进。 [0288] 在各种实施方式中，砧座110'的打开和闭合可通过从手柄组件(未显示)穿过近侧脊段2720和颈部2724中的中空通道2726的闭合索2780来完成。闭合索2780的近端(未显示)可与在本文中描述的一个索驱动系统或者其他索控制系统连接以便选择性地将张力施加到索2780。本领域普通技术人员还会理解，也可采用上面描述的各种类型的驱动索系统来驱动动力夹钳元件、刀和滑车。 [0289] 从图52-54中可以看出，闭合环2770可具有安装于其上的第一索过渡支架2790，其延伸到通道形远侧脊段2740的开口上端，当闭合环2770在其上运动时，使第一索过渡支架2790可在远侧脊段2740中向远侧和轴向来回运动。在各种实施方式中，第一索过渡支架2790可包括选自包括滑轮、杆、绞盘等的支架组的支架。另外，第二索过渡支架2792可沿着图示的朝向安装在远侧脊段2740中，使闭合索2780可操作地支撑在第一和第二索过渡支架2790、2792上。类似地，第二索过渡支架2792可包括选自包括滑轮、杆、绞盘等的支架组的支架。 [0290] 闭合索2780的远端2782可在连接点2744处固定到远侧脊段2740。因此，将张力施加到闭合索2780 (沿着近侧方向H)拉动闭合索2780)引起闭合环2770沿着远侧方向DD运动与砧座110'接触并以上述方式将其枢转到闭合位置。在各种实施方式中，被夹钳在工具组件100”中的组织引起砧座110'运动到打开位置。在其他实施方式中，当闭合环2770已经轴向运动到其近侧未夹钳位置时，可采用弹簧或者其他偏压元件(未显示)将砧座110'偏压到打开位置中。这种独特新颖的索致动闭合系统相对于现有技术的索提供动力的闭合系统具有显著的机械优点，同时还提供了相对于器械的其他部分致动工具组件100”的能力。其他实施方式也可被预期，其中球形元件在远侧脊段2740中形成并且插座在近侧脊段2720中形成。在还有一些其他实施方式中，不采用关节运动接头。也就是说，近侧脊段和远侧脊段包括单个元件。 [0291] 图55-57示出了本发明的各种实施方式的索控可锁定关节运动接头2800，其可连接在细长通道组件120”和近侧脊段2820之间。在各种实施方式中，近侧脊段2820可从手柄组件(未显示)延伸从而可由一些已知设置中的任何一种支撑，都不脱离本发明的精神和范围。近侧脊段2780可具有远端2822，其具有从其上突出并具有与其连接或者与其一起形成的大致球形元件2822的颈部2824。从这些附图中还可以看出，球形元件2830的尺寸可设置成容纳于在远侧脊段2840的近端2842中形成的插座2850中。球形元件2830和插座2850共同形成球接头，总体标记为2800，其为远侧脊段2840提供了相对于近侧脊段2820沿着多个方向进行关节运动的能力。在远侧脊段2840的近端2842和近侧脊段2820的远端2822之间提供足够大小的间隙2848，使远侧脊段2840相对于近侧脊段2820在所需的运动范围中进行关节运动。在各种实施方式中，远侧脊段2840与细长通道组件120”连接，砧座与细长通道组件120”枢转连接。[0292] 在各种实施方式中，一个或多个可径向延伸部分2880可设置在球形元件2830中。在图55-57中所示的实施方式中，例如设置三个可径向延伸指2880。在各种实施方式中，可径向延伸指2880可围绕球形元件2830等间距(例如以120°为间隔)设置。其他数目的可径向延伸指2880也可成功地被采用。在各种实施方式中，球形元件2830例如可由塑性材料、金属等制成，使可径向延伸指可被拉动或者径向向外驱动一距离，以便以所需的方向将球形元件2830锁定在插座2850中。[0293] 在各种实施方式中，每个可径向延伸指2880可具有与其连接的索2882，该索2882延伸到近侧脊段2820的颈部2824附近并穿过近侧脊段2820的远端2822中相应的通道2826。索2826可延伸穿过中空近侧脊段2820并到达由手柄(未显示)支撑的控制系统，以便选择性地将张力施加到索2882。例如，索2882可与锁定扳机或者支撑在手柄中的其他机构连接，所述其他机构可将张力施加到索并可选择性地保持在该位置中，直到需要释放接头，由此所述机构可被打开以释放索2882中的张力。从图55中可以看出，可采用如图所示的中空索环2890将索2882保持在颈部2824附近。[0294] 为了使用这种实施方式，临床医生将工具组件100定位在患者体内然后通过另一种外科器械将关节运动力施加到工具组件上，或者在将张力施加到锁定索2882之前通过将工具组件100与患者的一部分接触而使工具组件进行关节运动到所需位置。在工具组件100已经进行关节运动到所需位置后，临床医生将张力施加到锁定索2882，引起可径向延伸指2880沿径向向外延伸并将球形元件2830在插座2850中锁定在该朝向，从而将远侧脊段2840(以及与其连接的工具组件100)保持在该关节运动位置。所述系统采用“被动”关节运动技术。 [0295] 图58-61示出了本发明的各种实施方式的索控可锁定关节运动接头2900。从这些图中可以看出，各种实施方式可包括近侧脊段2920，所述近侧脊段2920可从手柄组件(未显示)延伸从而可由一些已知设置中的任何一种支撑，都不脱离本发明的精神和范围。从图58中可以看出，球形元件2936可在远侧脊段2930的近端2932上形成。球形元件2930的尺寸可设置成容纳于在近侧脊段2920的远端2922中形成的插座2924中。球形元件2936和插座2924共同形成球接头，整体标记为2910，其为远侧脊段2930提供了相对于近侧脊段2920沿着多个方向进行关节运动的能力。在远侧脊段2930的近端2932和近侧脊段2920的远端2922之间提供足够大小的间隙2948，使远侧脊段2930相对于近侧脊段2920在所需的运动范围中进行关节运动。在各种实施方式中，远侧脊段2930可以连接到与砧座(未显示)枢转连接的细长通道组件(未显示)上。 [0296] 在各种实施方式中，近侧脊段2920的远端2922可具有柔性部分2950和束带部分2960。近侧脊部分例如可由塑性材料、金属等制成。柔性部分2950可由设置在近侧脊段2920的远端2922中的一组等间距的槽2952限定，形成多个可径向收缩的锁定部分，例如柔性部分2954的形式，用于将插座2924限定在其间。另外，在周围延伸的槽2956可围绕近侧脊段2920的远端2922的圆周设置。锁定索2970可延伸穿过中空近侧脊段2920并围绕在周向延伸的槽2956中的束带部分2960形成环，如图59和61所示。从这些附图中可以看出，索2970可穿过两个通道2957、2958，使其末端可延伸穿过近侧脊段2920到达支撑在手柄组件(未显示)中的索控制系统(未显示)，可用于选择性地将张力施加到索2970。 [0297] 为了使用该实施方式，临床医生将工具组件100定位在患者体内然后使用另一种外科器械将关节运动力施加到工具组件上，或者在将张力施加到锁定索2970之前通过将工具组件100与患者的一部分接触而使工具组件关节运动到所需位置。在工具组件100已经进行关节运动到所需位置后，临床医生将张力施加到锁定索2970，引起柔性部分2954围绕球形元件2970锁定并防止其相对于近侧脊段2920运动，从而将远侧脊段2840 (以及与其连接的工具组件100)保持在该关节运动位置。所述系统采用“被动”关节运动技术。为了释放球形元件以便允许工具组件进一步进行关节运动，张力从索2970释放。 [0298] 图62-64示出了本发明的各种实施方式的可锁定关节运动接头3000。从这些图中可以看出，各种实施方式可包括近侧脊段3010，所述近侧脊段3010可从手柄组件(未显示)延伸从而可由一些已知设置中的任何一种支撑，都不脱离本发明的精神和范围。近侧脊段3010具有远端3012，其具有从其上突出并具有在其上形成的大体球形元件3016的颈部3014。从图63和64中可以看出，球形元件3016中具有一组槽3018，用于限定一组球形分部3020。如图62中所示，球形元件3016的尺寸可设置成容纳于在远侧脊段3030的近端3032中形成的插座3034中。球形元件3016和插座3034共同形成球接头，整体标记为3040，其为远侧脊段3030提供了相对于近侧脊段3010沿着多个方向进行关节运动的能力。在远侧脊段3030的近端3032和近侧脊段3010的远端3012之间提供足够大小的间隙3042，使远侧脊段3030相对于近侧脊段3010在所需的运动范围中关节运动。在各种实施方式中，远侧脊段3030可以连接到与砧座(未显示)枢转连接的细长通道组件(未显示)上。 [0299] 从图62中可以看出，致动元件3050可被用于选择性地径向延伸球形分部3020以便在插座3034中膨胀并锁定球形元件3016。在一种实施方式中(图62-64)，致动元件具有中空轴部分3052，其延伸通过近侧脊段3010的颈部3014中的通道3015并且还通过球形元件3016中的通道3017。致动元件3050的远端3054具有大体锥形部分3056，其被容纳在球形元件3016中的锥形关节运动插座3050中，如图所示。当致动元件3050沿着近侧方向H)被拉动时，锥形部分3056引起球形分部3020径向向外延伸并将球形元件3016锁定在插座3034中。也可采用手柄中的各种扳机和锁定设置(未显示)，以便选择性地沿着近侧方向H)和远侧方向DD运动致动元件并将致动元件3050锁定在位置中，将球形元件3016保持为膨胀/锁定状态。 [0300] 为了使用该实施方式，临床医生将工具组件100定位在患者体内然后使用另一种外科器械将关节运动力施加到工具组件上，或者在沿着近侧方向F1D拉动致动元件3050之前将工具组件100与患者的一部分接触，使工具组件关节运动到所需位置。在工具组件100已经进行关节运动到所需位置后，临床医生沿着近侧方向拉动致动元件3050，引起球形分部3020径向向外扩张并沿着该朝向将球形元件3016锁定在插座3034中，从而将远侧脊段3030(以及与其连接的工具组件100)保持在该关节运动位置。所述系统采用“被动”关节运动技术。 [0301] 图65-67示出了本发明的各种实施方式的另一种可锁定关节运动接头3100，其基本上与上述关节运动接头3000的操作相同，但致动元件3150和球形元件3116除外。从这些图中可以看出，球形元件3116具有在其中形成的至少一个并优选三个可径向延伸部分3120。致动元件3150具有中空轴部分3152，其延伸穿过近侧脊段3010的颈部3014中的通道3015并且还通过球形元件3116中的通道3017。致动元件3150的远端3154具有大体锥形楔部3156，其与球形元件3116中的每个可径向延伸部分3120对应，延伸到球形元件3116中的锥形致动插座3118中，如图所示。当致动元件3150沿着近侧方向F1D被拉动时，锥形楔部3156引起对应的可径向延伸部分3120径向向外膨胀并将球形元件3116锁定在插座3034中。也可采用手柄中各种扳机和锁定设置(未显示)，以便选择性地沿着近侧方向H)和远侧方向DD运动致动元件并将元件锁定在位置中，将球形元件3116保持为膨胀/锁定状态。 [0302] 为了使用该实施方式，临床医生将工具组件100定位在患者体内使用另一种外科器械将关节运动力施加到工具组件上，或者将工具组件100与患者的一部分接触，在沿着近侧方向F1D拉动致动元件3150之前使工具组件沿着近侧方向F1D进行关节运动到所需位置。在工具组件100已经进行关节运动到所需位置后，临床医生沿着近侧方向拉动致动元件3150，引起可径向延伸的部分3120径向向外膨胀并沿着该朝向将球形元件3116锁定在插座3034中，从而将远侧脊段3030(以及与其连接的工具组件100)保持在该关节运动位置。所述系统采用“被动”关节运动技术。 [0303] 图68-70示出了本发明的各种实施方式的另一种可锁定关节运动接头3200。从这些图中可以看出，各种实施方式可包括近侧脊段3210，所述近侧脊段3210可从手柄组件(未显示)延伸从而可由一些已知设置中的任何一种支撑，都不脱离本发明的精神和范围。近侧脊段3210具有远端3212，其具有多个可径向收缩部分，例如其中限定插座3216的柔性插座指3214的形式。从图68中可以看出，球形元件3310可在远侧脊段3300的近端3312上形成。球形元件3310可在颈部3308的端部上形成，其尺寸可设置成容纳于在由插座指3214形成的插座3216中。球形元件3310和插座3216共同形成球接头，整体标记为3320，其为远侧脊段3300提供了相对于近侧脊段3210沿着多个方向进行关节运动的能力。在远侧脊段3300的近端3304和近侧脊段3210的远端3212之间提供足够大小的间隙3002，使远侧脊段3300相对于近侧脊段3210在所需的运动范围中进行关节运动。在各种实施方式中，远侧脊段3300可以连接到与砧座(未显示)枢转连接的细长通道组件(未显示)上。另外，中空通道3306可经过球形元件3310和颈部3308设置，以便于索或其他致动器械/元件从其中穿过。 [0304] 从图68-70中还可以看出，该实施方式还可包括闭合环3400，其选择性地沿着近侧和远侧方向在近侧脊段3210上滑动并可轴向运动。上述各种系统和元件都可被采用，以便选择性地沿着近侧和远侧方向运动闭合环3400。特别是从图68中可以看出，插座指3214具有倾斜或者逐渐变细的端表面3215，使闭合环3400的远侧部分3402在其上滑动，并引起插座指3214闭合在球形元件3310上并将其锁定在位置中。 [0305] 为了使用该实施方式，临床医生将工具组件100定位在患者体内使用另一种外科器械将关节运动力施加到工具组件上，或者在向远侧行进闭合环3400之前通过将工具组件100与患者的一部分接触而使工具组件关节运动到所需位置。在工具组件100已经进行关节运动到所需位置后，临床医生向远侧行进闭合环3400，引起插座指3214闭合在球形元件3310上并将球形元件3310沿着该朝向锁定在插座3216中，从而将远侧脊段3300 (以及与其连接的工具组件100)保持在该关节运动位置。所述系统采用“被动”关节运动技术。 [0306] 图71示出了本发明的各种实施方式的另一种被动关节运动接头3500。从该图中可以看出，各种实施方式可包括近侧脊段3510，所述近侧脊段3510可从手柄组件(未显示)延伸从而可由一些已知设置中的任何一种支撑，都不脱离本发明的精神和范围。近侧脊段3510具有远端3512，其中具有插座3514。从图71中还可以看出，球形元件3530可在远侧脊段3520的近端3522 上的颈部3532上形成。球形元件3530和插座3514共同形成球接头，整体标记为3540，其为远侧脊段3520提供了相对于近侧脊段3510沿着多个方向进行关节运动的能力。在替代实施方式中，插座可在远侧脊段中形成并且球形元件可在近侧脊段中形成。在远侧脊段3520的近端3522和近侧脊段3510的远端3512之间提供足够大小的间隙3542，使远侧脊段3520相对于近侧脊段3510在所需的运动范围中进行关节运动。在各种实施方式中，远侧脊段3520可以连接到与砧座(未显示)枢转连接的细长通道组件(未显示)上。 [0307] 从图71中还可以看出，球形元件3530的近侧朝向面3532具有多个在其中形成的定位槽3534。锁定销3550可操作地支撑在近侧脊段3510中并被定向成与定位槽3534接合。锁定销3550可被弹簧偏置成向着球形元件3530的近侧朝向面3532，当远侧脊段3520相对于近侧脊段3510进行关节运动时，使锁定销扣合到相应的一个定位槽3534中，将远侧脊段3520保持在该位置中。 [0308] 为了使用该实施方式，临床医生将工具组件100定位在患者体内使用另一种外科器械将关节运动力施加到工具组件上，或者将工具组件100与患者的一部分接触，使工具组件关节运动到所需位置，或者另一个外科工具可被用于将关节运动力施加到工具组件，引起工具组件100向着所需方向运动。当工具组件进行关节运动时，锁定销的远端3552将扣合到定位槽3534中，直到到达所需的关节运动位置再从其中脱离。所述系统采用“被动”关节运动技术。 [0309] 图72示出了本发明的各种实施方式的另一种被动关节运动接头3600，其有些类似于上述关节运动接头3500，下面讨论其不同。例如在该实施方式中，球形元件3630可在从近侧脊段3610向远侧突出的颈部3632上形成。近侧脊段3610可从手柄组件(未显示)延伸从而可由一些已知设置中的任何一种支撑，都不脱离本发明的精神和范围。远侧脊段3620中具有插座3624。球形元件3630和插座3624共同形成球接头，整体标记为3650，其为远侧脊段3620提供了相对于近侧脊段3610沿着多个方向进行关节运动的能力。在远侧脊段3620的近端3622和近侧脊段3610的远端3612之间提供足够大小的间隙3642，使远侧脊段3620相对于近侧脊段3610在所需的运动范围中进行关节运动。在各种实施方式中，远侧脊段3620连接到与砧座(未显示)枢转连接的细长通道组件(未显示)。 [0310] 从图72中还可以看出，插座面3636的一部分3638具有多个在其中形成的定位槽3639。锁定销3660可操作地支撑在近侧脊段3610中并被定向成与定位槽3639结合。锁定销3660可被弹簧偏压成向着球形元件3530的面3636，当远侧脊段3620相对于近侧脊段3610进行关节运动时，使锁定销3660扣合到相应的一个定位槽3639中，将远侧脊段3620保持在该位直中。 [0311] 为了使用该实施方式，临床医生将工具组件100定位在患者体内然后使用另一种外科器械将关节运动力施加到工具组件上，或者通过将工具组件100与患者的一部分接触而使工具组件进行关节运动到所需位置，或者另一个外科工具可被用于将关节运动力施加到工具组件而引起工具组件100向着所需方向运动。当工具组件进行关节运动时，锁定销3660的远端3662将扣合到定位槽3639中，直到到达所需的关节运动位置再从其中脱离。所述系统采用“被动”关节运动技术。 [0312] 本发明的各种外科缝合器械可被设计成适用被设计成单次使用后被抛弃的工具组件。在缝合操作完成后，工具组件被抛弃并且器械可在准备用于另一次手术时重新灭菌。在所述应用中，因此通常希望采用接头设置，方便将工具组件与器械快速地连接和拆卸。图73-83示出了外科器械4000，其被构造成与可进行外科手术动作的外科工具组件100”结合使用。在各种实施方式中，工具组件100”被构造成通过上述索提供动力的动力夹钳元件/刀设置来切割并缝合组织。在其他实施方式中，可采用不同的驱动设置来驱动动力夹钳元件/刀穿过工具组件100”的细长通道部分。[0313] 在一些实施方式中，工具组件100”包括一次性重新加载单元4002的一部分。在其他实施方式中，工具组件100”可与器械4000的其他部分永久连接并能够与钉仓组件结合重新使用。一次性重新加载单元4002可还包括用于将一次性重新加载单元4002与器械4000连接的连接器部分4004。在各种实施方式中，工具组件100”可通过关节运动接头4006相对于连接器部分4004进行关节运动。 [0314] 特别是从图73A中可以看出，一种实施方式的工具组件100”可包括具有与其枢转连接的砧座组件4020的细长通道组件4012。例如，在一种实施方式中，砧座组件4020可具有一对耳轴4022，它们适于被容纳在细长通道组件4012的壁中相应的槽4014中，如图所示。砧座组件4020可被形成为在其近端4024上具有砧座闭合翼片4026，以便选择性地由闭合环4030接触。不旋转的闭合环4030键接到细长通道组件4012和/或砧座组件4020，使闭合环4030不能相对于细长通道4012旋转。翼片间隙开口4032可经过闭合环4030设置，当砧座组件4020处于闭合(夹钳)位置时容纳砧座闭合翼片4026。一组内螺纹4036可设置在不旋转的闭合环4030的近端4034，用于螺纹接收远侧闭合管段4040的带螺纹远端4042。如同将在下面进一步详细讨论的那样，当远侧闭合管段4040旋转时，闭合环4030沿着远侧方向DD轴向驱动。当闭合环4030沿着远侧方向DD运动时，其上到砧座组件4020的近端的斜面4021上，引起砧座组件4020枢转到闭合位置。这种设置代表了优于其中闭合环由索沿着远侧方向拉动的现有设置的巨大改进。[0315] 外科器械4000可还包括细长闭合管组件5000，其容纳各种元件并可操作地与手柄组件连接(将在下面进一步详细讨论)。在本发明的各种实施方式中，闭合管组件5000可包括中间闭合管段5001和近侧闭合管段5020。在一些实施方式中，工具组件100”可通过关节运动接头4006与闭合管组件5000的中间闭合管段5001连接，方便工具组件100”相对于闭合管组件5000围绕大体上彼此垂直的两个轴线UA-UA和OA-OA的行进(将在下面进一步详细讨论)。而且，各种实施方式可包括用于主动控制工具组件100”、具有被动关节运动能力、同时还具有将工具组件锁定在所需的关节运动位置中的能力的部件。当详细描述本发明时这些独特新颖的特征和优点将进一步变得清楚。 [0316] 例如，在各种实施方式中，远侧闭合管段4040可形成为具有从其上沿着近侧方向突出的一对相对的通用枢转臂4046。中间闭合管段5001的远端5002可形成为具有两个从其上向远侧突出的相对的紧固件臂5004、5006，见图73A和74B。紧固件臂5004具有穿过其中的枢轴孔5008，并且紧固件臂5006具有大体上与枢轴孔5008共轴对准的枢轴孔5010，限定通用枢转轴线UA-UA。定位在紧固件臂5004和5006之间的是通用环4070，其具有从其上突出的两对销4072、4074，其中每个销可围绕通用环4070的圆周彼此间隔90度(一个销4074如图73A和74B中虚线所示)。如图73A所示，一个销4072可枢转地容纳在紧固件臂4006的下部枢轴孔5010中。这种设置使通用环4070能够相对于闭合管组件5000围绕通用轴线UA-UA枢转。从远侧闭合管4040突出的每个相对的通用枢转臂4046中具有可枢转地将一个对应的销容纳在其中的孔4047，使远侧闭合管4040能够围绕垂直轴线OA-OA (在图75中显示)沿着由图73A中的箭头FD所示的第一枢转方向和由图73A中的箭头SD所示的第二枢转方向相对于通用环4070和闭合管组件5000枢转。轴线UA-UA和OA-OA可大体上彼此垂直。 [0317] 因此，本领域普通技术人员将会理解，上述通用环4070设置利于远侧闭合管4040的关节运动，并最终利于与其连接的工具组件100”相对于闭合管组件5000围绕多个轴线UA-UA和OA-OA进行关节运动。另外，如同将在下面进一步描述的那样，在各种实施方式中，闭合管组件5000可由手柄组件旋转地支撑，使其可围绕轴的轴线CC旋转。由于工具组件100 ”固定到闭合管组件5000 (通过关节运动接头4006)，工具组件100 ”也可与其一起旋转。因此，这种设置提供了工具组件100”，其中可具有索驱动刀组件和具有围绕多个轴被致动的能力的非索驱动的砧座闭合设置。 [0318] 从图73A和74A中还可以看到，该实施方式可还包括远侧脊段4050，其可具有在其上形成的容纳在远侧闭合管4040中的定位槽4044中的环状保持凸缘4052。在各种实施方式中，关节运动接头4006还可包括关节运动锁定组件，整体标记为4007，其利于在工具组件100”已经进行关节运动到所需朝向后关节运动接头4006的锁定。所述锁定组件4007 可包括在远侧脊段4050的颈部4054上形成的球形元件4060。锁定组件4007可还包括带齿插座元件5030，其在定位在连接器部分4004中的中间脊段5020的远端5022上形成。带齿插座元件5030可包括多个可径向收缩指5032，将插座5034限定在它们之间，球形元件4060可沿着多个方向在其中进行关节运动。带齿插座元件5030安装在通用环4070中。[0319] 在各种实施方式中，插座锁定管5080可共轴容纳在一次性脊段5020上，使其可相对于脊段5020轴向运动(将在下面进一步详细讨论)。锁定管5080的远端5082可逐渐变细，以便当锁定管5080沿着远侧方向DD轴向运动时选择性地与带齿插座元件5030轴向接触，引起带齿指5032径向收缩并围绕球形元件4060闭合，将远侧脊段4050(以及工具组件100”)相对于细长闭合管组件5000锁定在位置中。 [0320] 本发明的各种实施方式的外科器械4000可还包括主动关节运动系统，整体标记为5090，用于将关节运动主动施加到远侧脊段4050。例如在各种实施方式中，主动关节运动系统5090可包括四个进行关节运动的丝5092，它们可由弹簧钢或者类似物制成，并具有足够的硬度，以便将施加的压缩力传递到其近侧部分而不皱缩。丝5092可围绕带齿插座5030彼此以90度为间隔设置，并可容纳在可径向收缩指5032的外表面中的对应槽5033 中。每根丝5092的远端5094可与远侧脊段4050的颈部4054连接，并且每根丝5092的近端5096可与容纳在闭合管5000中的远侧丝固定架5100的套节部分5102连接，如图73B 中所示。如同将在下面进一步详细讨论的那样，远侧脊段4050(以及与其连接的工具组件100”)可通过拉动和推动丝5092主动进行关节运动。[0321] 而且在各种实施方式中，球形元件4060的近侧朝向部分中可具有大体锥形腔4062，以容纳一个或多个刀致动索5040，该刀致动索5040与安装在一次性工具组件100”中的动力夹钳元件(未显示)和/或刀(未显示)连接。索5040的近端5042(图73A)可与刀螺母5050连接，该刀螺母5050可螺纹连接在刀螺钉5060上。从图73A和75中可以看出，刀螺母5050具有一对侧向突出的翼片5052，它们轴向容纳在一次性脊段5020中的相应的轴向延伸槽5024中。本领域普通技术人员将会理解，当刀螺钉5060旋转时这种设置允许刀螺母5050沿着近侧方向H)或远侧方向DD轴向运动。 [0322] 如上所述，各种实施方式中一次性重新加载单元4002可被构造成一次使用后丢弃。为了便于重新加载单元4002的快速拆卸和新的重新加载单元4002的重新连接而无需工具，可采用快速断开接头4008。在本文中，术语“快速断开”指的是不使用工具将一个元件从另一个元件上拆下的能力。快速断开接头4008的各种实施方式的操作和构造可通过图73B、74B和76来理解。从图73B和74B可以看出，闭合管组件5000包括中间闭合管段5001和近侧闭合管段5120。从图73B和76中可以看出，中间闭合管段5001的近端具有一组在其上形成的径向齿轮齿5003，当一次性重新加载单元4002与近侧闭合管段5120连接时用于与近侧闭合管段5120(在图76中未显示)的远端5122上的齿轮齿5124(在图76 中未显不)B齿合。 [0323] 为了支持一次性重新加载单元4002和近侧闭合管段5120之间的可拆卸互连，可采用连接星轮5150。连接星轮5150可部分容纳在中间闭合管段5001的近端中并从其中突出，当中间闭合管段5001与近侧闭合管段5120连接时，使连接星轮5150的一部分突出到近侧闭合管段5120的远端5122中。在各种实施方式中，连接星轮可通过销钉在或者通过粘接剂或者其他合适的紧固件设置连接在中间闭合管段5001的近端中。见图76。 [0324] 在各种实施方式中，连接星轮5150还可通过轴颈连接在一次性脊段5020上并被构造成容纳从远侧丝固定架5100突出的相应的致动器杆5104。每个致动器杆5104的近端5106可包括锥形的定位槽，以利于多个近侧丝连接器元件5160之间的互连。例如在一种实施方式中，可采用四个近侧丝连接器元件。多个致动器杆5104可设置有定位槽5108， 用于容纳安装在每个近侧丝连接器5160中的锥形孔定位槽5162中的相应连接器球5164。见图73B和77。因此，采用四个连接器球5164，每个近侧丝连接器5160—个。从图73B、78 和79中还可以看出，一次性脊段5020的近端5021具有向近侧延伸的连接部分5023，其可具有在其中形成的内卡圈部分5025，以支撑刀螺钉5060的近侧部分5062。另外，向近侧延伸的连接部分5023可具有在其上形成的外部花键5026，用于容纳在近侧脊段5200的远端5202中形成的键槽5206中。刀螺钉5060的近端5062可支撑在轴承5064中，并具有带键驱动部分5066，以便不旋转容纳在刀驱动轴5220的远端5222中的带键驱动腔5224中，见图78。 [0325] 接着转到图74A和74B，锁定管5080的连接可被理解。从图74A中可以看出，锁定管5080具有从其上向近侧突出的一对致动器制动臂5084。图74B是从图73B中显示的剖面旋转大约45度的剖视图。从图74B中可以看出，每个致动器制动臂5084具有在其中形成的定位槽5085，用于将安装在锥形孔定位槽5166中的连接器球5168容纳在相应近侧致动器制动臂5300中，见图74B和77。为了为致动器制动臂5084提供滑动横向支撑，每个致动器制动臂5084可滑动容纳在一次性脊段5020中的对应槽5027中。见图75和76。 [0326] 从图73B中还可以看出，外部近侧脊段5400可容纳在近侧闭合管5120中并与其协作来限定用于将闭合管弹簧5410容纳在其中的弹簧腔5402。近侧闭合管段5120的近端5126上可具有加大的旋钮部分5128，以便于由临床医生将控制运动施加到其上。插座5130可在旋钮部分5128中形成，用于将固定到外部近侧脊段5400的弹簧挡圈5132容纳在其中。因此，闭合管弹簧5410用于将近侧闭合管段5120偏压成与一次性闭合管段5000 啮合。从图73B和78中可以看出，近侧闭合管段5120的远端122具有更大的内径5123，其具有倾斜的表面5125。为了将工具组件100”从器械4000上拆下，临床医生依靠弹簧5410 的力沿着近侧方向H)拉动旋钮5128，直到更大的内径部分5123与连接器球5164对准，当用户将除去力施加到工具组件100 ”、沿着远侧方向DD对其进行拉动时，使连接器球5164能够沿着远侧丝固定架5100的致动器杆5104的近端5106与定位槽5108脱离结合。 [0327] 图78-81示出了将一次性重新加载单元4002连接到器械部分4000。特别参见图78，临床医生定向单元4002，使刀螺钉5060的带键部分5066与刀驱动轴5220中的内部带键腔5224对准并将带键驱动部分5066的近端插入其中。见图79。此后，临床医生将一次性脊段的近端5021上的花键5026与近侧脊段5200中的键槽5206对准。见图79和80。临床医生然后继续将近端5106插入到四个近侧丝连接器5160和近侧脊段5200之间的区域5161中。见图80。临床医生然后可沿着近侧方向运动闭合旋钮5128，当致动器杆5104 的近端5106向近侧被推动到位置中时，使连接器球5164能够径向向外运动。临床医生染后释放旋钮5128，允许近侧闭合管5120向远侧运动，将连接器球5164锁定在远侧丝固定架5100的致动器杆5104中的定位槽5108中，将四个近侧丝连接器5160固定到远侧丝固定架5100，并且还将连接器球5168锁定在致动器制动臂5084中的定位槽5085中。另外， 径向齿轮5003、5124被保持为彼此啮合。 [0328] 图82-84示出了可用于使工具组件100”相对于连接器部分4004进行关节运动并为其提供致动的一种实施方式。从图82中可以看出，器械4000可还包括手柄组件5500，其可由可通过螺钉、扣件、粘接剂等连接在一起的两个外壳部分5510(在图82中仅仅显示一个外壳部分5510)形成。在各种实施方式中，手柄组件5500可米取具有手柄抓持部分5512 的“手枪把手”形外壳。从图82中可以看出，连接凸缘5404可在外部近侧脊段5400的近端上形成，用于将外部近侧脊段5400固定到手柄组件5500上。凸缘5404可通过粘接剂或者其他机械紧固件设置、螺钉、扣件、槽等与手柄外壳5500连接。同样地，近侧脊段5200的近端5204可具有用于将近侧脊段5200固定到手柄组件5500的凸缘5210。凸缘5210可通过粘接剂或者其他机械紧固件设置、螺钉、扣件、槽等与手柄外壳5500连接。[0329] 在各种实施方式中，主动关节运动系统5090可还包括关节运动控制系统，整体标记为5600，其由手柄组件5500可操作地支撑并与关节运动丝5092连接。从图82中可以看出，关节运动控制系统5600可包括操纵杆组件5602，每个近侧丝连接器5160的近端与其可枢转连接。例如在一种实施方式中，操纵杆组件5602可包括可旋转地支撑在手柄组件5500 中的插座5520中的关节运动球5610。在各种实施方式中，近侧丝连接器5160的每个近端5170可具有支撑在其上的球形支架5172，以便容纳支架安装销5612，将近侧丝连接器5160 与关节运动球5610连接。但是，也可采用其他紧固件设置。另外，关节运动旋钮5620可与关节运动球5610连接。[0330] 因此，为了使工具组件100”相对于连接器部分4004进行关节运动，临床医生可用一只手握持手柄部分5512并用另一只手握持关节运动旋钮5620。通过操纵关节运动旋钮5620，临床医生可将关节运动施加到远侧丝固定架5100，并最终将关节运动施加到与其连接的四根关节运动丝5092，进而将关节运动施加到将引起工具组件100”相对于一次性重新加载单元4002进行关节运动的远侧脊段4050。因此临床医生可通过使用操纵杆组件5602有效地调整工具组件100”。 [0331] 工具组件100”的位置可通过整体标记为5640的制动控制系统锁定在位置中。从图82和84中可以看出，制动控制系统5640可包括通过轴颈可动地连接在刀驱动轴5220 上的驱动器盘5642，用于选择性地与其一道运动而不妨碍刀驱动轴5220的旋转。从图84 中可以看出，每个近侧致动器制动臂5300具有固定到驱动盘5642的近端5302。制动轭形件5650可通过突出到在驱动器盘5642中形成的沿着圆周延伸的槽5644中的一对销5643 与驱动器盘5642连接。制动轭形件5650由制动轭形件枢轴销5652上的外壳组件5500可枢转支撑。从图84中可以看出，在各种实施方式中，制动扳机5654在制动轭形件5650的下部形成。制动扳机5654可具有从其上突出到外壳组件5500中的开口5506中的锁定臂5656。锁定臂5656的下部可具有在其上形成的锁定齿5658，以便与外壳组件5500的锁定壁部分5508接合。[0332] 本发明的各种实施方式还可采`用制动释放机构5660来锁定和解锁制动扳机5654。从图84中可以看出，一种形式的释放机构5660可包括锁定按钮5662，其具有释放按钮部分5664并可由图84中示出的位置中的手柄组件5500可动地支撑。从该图中可以看出，锁定按钮5664可具有锥形末端部分5666，该锥形末端部分5666具有延伸到释放按钮部分5664的锥形部分(未显示)的颈部。当临床医生沿着第一方向推动释放按钮部分5664 时，锥形部分5666与锁定臂5656接触并将其升高，使其与锁定壁部分5508脱离结合，从而使扳机5654能够枢转。弹簧(未显不)可被用于将锁定按钮5662保持在锁定位置中。一旦扳机5654枢转到所需位置，用户可简单地沿着相反方向推动释放部分5664，使锥形部分5666运动，与锁定臂5656脱离结合，允许其再次与锁定壁部分5508接合。因此，一旦临床医生已经使工具组件100”运动到所需位置，临床医生可向着手柄组件5500挤压制动扳机5654。该动作引起制动轭形件5650和驱动器盘5642沿远侧方向DD运动制动臂5300，这沿着远侧方向DD驱动锁定管5080，将指5032锁定在球形元件4060周围。一旦指5032已经被锁定在球形元件4060周围，临床医生就可沿着允许锁定臂5656上的一个齿5658与锁定壁部分5508接合的方向推动锁定按钮，并将制动释放机构保持在锁定位置中。当临床医生需要解锁工具组件100”或许使其再次进行关节运动时，临床医生可简单地推动锁定扳机释放按钮部分，允许扳机5654枢转远离手柄组件5500，由此使致动器臂5300向近侧运动。[0333] 在本发明的各种实施方式中，可通过整体标记为5700的驱动系统将旋转运动施加到刀驱动轴5220上。从图82和83可以看出，在一种实施方式中，驱动系统5700可包括可枢转或者可致动连接到手柄组件5500的击发手柄5702。例如在一种实施方式中，击发手柄5702通过枢轴销5704可枢转地连接到手柄组件5500。与击发手柄连接的是击发齿轮5706，其被定向成随着击发手柄5702枢转。击发齿轮5706可与安装在棘轮传动轴5710的棘轮传动齿轮5708啮合。棘轮传动轴5710可与棘轮离合器组件5720连接。[0334] 在各种实施方式中，棘轮离合器组件5720可包括第一离合器盘5722,其与棘轮轴5710连接并与安装在输出轴5726的第二棘轮离合器盘5724啮合。第二离合器盘5724可被偏压成通过棘轮弹簧5730与第一离合器盘5722啮合。棘轮输出齿轮5740可与设置成与安装到锥齿传动轴5752上的传动齿轮5750啮合的棘轮输出轴5726连接。输入锥齿轮5760可被安装到锥齿传动轴5752上并与安装到输出轴5780上的输出锥齿轮5770啮合。 输出齿轮5782被安装到输出轴5780并与连接到刀驱动轴5220的近端5226的刀驱动齿轮5790啮合。[0335] 因此，为了旋转刀驱动轴5220并沿着近侧方向H)驱动刀螺母5050，并通过刀致动索5040致动动力夹钳组件(未显示)和刀设置(未显示)，临床医生握持手柄组件并向着握持部分5512使手柄组件5702来回棘轮运动。击发手柄5512以该方式的运动将引起驱动系统5700将旋转运动施加到刀驱动轴5220，并最终将旋转运动施加到刀螺钉5060，弓丨起刀螺母5050沿着近侧方向运动。在击发顺序已经完成时，临床医生可拆下重新加载单元4002并重新连接另一个重新加载单元并重复该过程。在替代实施方式中，刀驱动轴可通过马达和行星齿轮驱动旋转。马达可以由电池供电或者由交流电供电。其他设置也可被采用。[0336] 图85-89示出了采用主动或者可控关节运动接头设置6010的另一种实施方式的外科器械6000。从图85和86中可以看出，一种实施方式可采用上面描述的类型和构造的闭合管6020。闭合管6020具有可与由手柄组件支撑的各种闭合管控制机构连接的近端(未显示)，用于为手柄组件提供致动力。闭合管6020还可与各种上述工具组件之一连接，将打开或者打开与闭合力施加到其砧座组件。而且在该实施方式中，脊元件6030可从手柄组件(未显示)延伸穿过闭合管6020。再次地，脊元件6030的近端(未显示)可操作地由手柄组件(未显示)以上面描述的各种方式或者其他已知方式支撑。在各种实施方式中，脊元件6030的远端6032可形成有顶部脊臂6034和底部脊臂6036，它们从脊元件6030的远端6032沿着远侧方向DD突出。顶部脊臂6034具有穿过其中的枢轴孔6037，底部脊臂6036 具有大体上沿着垂直轴线VA-VA与枢轴孔6037共轴对准的枢轴孔6039。 [0337] 各种实施方式还包括延伸穿过脊元件6030的水平锁定管6040。水平锁定管6040 具有近端(未显示)，其由手柄组件(未显示)支撑并可与致动设置(未显示)连接以便在脊元件6030中轴向沿着近侧方向H)和远侧方向DD轴向行进水平锁定管6040，并选择性地将水平锁定管6040保持或者锁定在所需轴向位置。另外，用于水平锁定管6040的致动设置还可采用弹簧或者其他设置，以便在水平锁定管6040被解锁之后沿着近侧方向H)偏压水平锁定管6040。从图86中可以看出，水平锁定管6040具有顶部或者第一锁定杆6042， 其具有在其中形成的一组顶部或者第一齿6044。水平锁定杆6040进一步具有底部或者第二锁定杆6046，其具有在其远端形成的底部或者第二齿6048。 [0338] 同样在这些实施方式中，垂直锁定管6050可延伸穿过水平锁定管6040。垂直锁定管6050具有近端(未显示)，其由手柄组件(未显示)支撑并可与致动设置(未显示) 连接以便在水平锁定管6040中轴向沿着近侧方向H)和远侧方向DD轴向行进垂直锁定管6050，并选择性地将垂直锁定管6050保持或者锁定在所需轴向位置。另外，用于垂直锁定管6050的致动设置还可采用弹簧或者其他设置，以便在垂直锁定管6050被解锁之后沿着近侧方向H)偏压垂直锁定管6050。例如在各种实施方式中，所采用的致动设置可被构造成同时致动、锁定和释放水平锁定管6040和垂直锁定管6050。 [0339] 从图86中可以看出，例如在各种实施方式中，垂直锁定管6050具有第一垂直锁定尖端6052和第二垂直锁定尖端6054。各种实施方式可采用上面描述类型的使用索驱动动力夹钳元件和/或刀设置的工具组件。垂直锁定管可具有从其中穿过的索通道6056，以容纳穿过工具组件到达手柄组件的驱动索(未显示)。 [0340] 在各种实施方式中，第一和第二垂直锁定尖端6052、6054被定向成与垂直锁定块6060接合。例如在一种实施方式中，垂直锁定块6060可具有第一侧向锁定柱6062和第二侧向锁定柱6066，第一侧向锁定柱上具有一组第一侧齿6064，第二侧向锁定柱上具有一组第二侧齿6068。第一侧向锁定柱6062和第二侧向锁定柱6066通过上部或者第一侧向横杆6070和底部或者第二侧向横杆6072彼此间隔地设置，两个横杆彼此成间隔设置关系以便在它们之间限定致动器容纳通道6074。在各种实施方式中，垂直锁定块6060可被构造成响应于来自垂直锁定管6050的致动动作相对于关节运动元件或者块6080沿着近侧方向PD和远侧方向DD轴向行进。垂直锁定块6060可被支撑，以便通过一对延伸到垂直锁定块6060中的孔6077、6079和关节运动块6080中的孔(未显示)向着和远离致动块6080轴向行进。 [0341] 从图85和86中可以看出，关节运动块6080可具有穿过其中的纵向通道6082，用于容纳驱动索(未显示)。另外，第一垂直销6084容纳在关节运动块中的孔6083中并从其上突出到被容纳在脊元件6030的顶部或者第一上臂6037中的第一枢轴孔6037中。同样地，下部销6089从关节运动块6080的底表面突出成可枢转容纳在脊元件6030的底部或者第二臂6036中的底部或者第二枢轴孔中，使关节运动块6080可选择性地围绕垂直轴线VA-VA枢转。同样在该实施方式中，可包括一部分工具组件的细长通道组件6090的近端可具有从其上沿着近侧方向延伸的第一夹板部分或者臂6092和第二夹板部分或者臂6094。第一夹板臂6092的近侧朝向面6096具有在其上形成的第一组水平锁定齿6068，用于选择性地与第一侧向锁定柱6062上相应组的第二水平锁定齿6064结合。同样的，第二夹板臂6094的近侧朝向面6100具有在其上形成的另一组第一水平锁定齿6102，用于选择性地与垂直锁定块6060上的第二侧向锁定柱6062上另一相应组的第二水平锁定齿6068哨合。第一夹板臂6092可具有穿过其中的第一枢轴孔6093，其适于枢转容纳从关节运动块6080突出的枢轴销6110，第二夹板臂6094可具有穿过其中的第二枢轴孔6095，用于可枢转地容纳从关节运动块6080突出的第二枢轴孔6112，使得通道组件6090可选择性地围绕水平轴线HA-HA相对于关节运动块6080枢转。 [0342] 从图86中还可以看出，第一水平锁定片6120可与关节运动块6080的上表面6081 连接或者与其一体形成，并具有一组在其中形成的第一垂直锁定齿6122，用于与在顶部或者第一水平锁定杆6042中形成的相应组的第二垂直锁定齿6044接合。同样地，第二水平锁定片6130可与关节运动块6080的底表面6083连接或者与其一体形成，并具有另一组在其中形成的第一垂直锁定齿6132，用于与在第二或者底部锁定杆6046上的相应组的第二垂直锁定齿6048结合。 [0343] 为了使用户能够使工具组件(通道组件6090)主动进行关节运动，关节运动接头6010可设置有水平致动器杆6140和垂直致动器杆6150。水平致动器杆6140例如可由塑性材料、弹簧钢等制成。水平致动器杆6140的远端6142可形成有上面描述的球形轴承设置，并可被销接在关节运动块6080上或者通过其他方式与关节运动块6080连接。水平致动器杆6140的近端(未显示)可以可操作地与上面描述的类型的操纵杆组件连接，该操纵杆组件可支撑在手柄组件中或者其他致动设置中，用于将推拉运动施加到水平致动器杆6140。从图85和86还可以看出，垂直致动器杆6150的远端6152可与第二夹板臂6094上形成的延伸块6097连接。远端6152可固定连接到延伸块6097，或者具有在其上形成的球形轴承，以便可枢转地与其连接。垂直致动器杆6150的近端(未显示)可以可操作地与上面描述的类型的操纵杆组件连接，该操纵杆组件可支撑在手柄组件中或者其他致动设置中，用于将推拉运动施加到水平致动器杆6140。垂直致动器杆6150的近端(未显示)可以可操作地与上面描述的类型的操纵杆组件连接，该操纵杆组件可支撑在手柄组件中或者其他致动设置中，用于将推拉运动施加到垂直致动器杆6150。在替代实施方式中，垂直致动器杆6150或者水平致动器杆6140可被省略。在那些实施方式中，例如，如果水平致动器杆6140被省略，则可采用垂直致动器杆6150使通道组件6090 (和工具组件)围绕水平轴线HA-HA进行关节运动，并且临床医生可通过释放(解锁)水平锁定管6040并将工具组件与患者身体的一部分或者另一种外科器械接触，将枢转力施加到通道组件(和工具组件)， 使通道组件6090(以及工具组件)围绕垂直轴线HA-HA进行关节运动，引起它们围绕垂直轴线VA- VA枢转，直到它们被锁定在所需位置中(在该时刻水平锁定管6040可被行进到与水平锁定元件6120、6130锁定结合)。类似地，如果垂直致动器杆被省略，则可采用水平致动器杆来使通道组件6090 (和工具组件)围绕垂直轴线VA-VA进行关节运动，并且临床医生可通过释放(解锁)垂直锁定管6050并将工具组件与患者身体的一部分或者另一种外科器械接触，将枢转力施加到通道组件6090 (和工具组件)，使通道组件6090 (以及工具组件)围绕水平轴线HA-HA进行关节运动，引起它们围绕水平轴线HA-HA枢转，直到它们被定位在所需位置中(在该时刻垂直锁定管6050可被行进到分别与通道夹板臂6092、6094上的水平锁定齿6068、6102锁定结合)。 [0344] 图90-105示出了本发明的另一种实施方式的外科器械7000，其可在使用后被抛弃。但是，这些实施方式的独特新颖的特征可与上面描述的多个实施方式结合采用，也不脱离本发明的精神和范围。从图90中可以看出，工具组件7002包括砧座组件7010，其可枢转地连接到上面描述的类型和构造的通道组件7020，以便可操作地将钉仓7021容纳在其中。砧座组件7020具有近端7012，该近端7012具有两个从其上突出砧座耳轴7014，它们适于被容纳在通道组件7020的近端7021的壁7022中的相应的端部开口的槽7024中。从图90-95中还可以看出，器械7000还可包括脊元件7030，该脊元件具有可与通道组件7020 的近端7021连接的远端7032。 [0345] 这些实施方式还可采用按照上面描述的方式构建并操作的闭合管7040。例如，远端7042可被构造成用于选择性地与在砧座组件7010中形成的近侧朝向壁架7016轴向接触，使得当闭合管7040沿着远侧方向DD运动时，远端7042与壁架7016接触并引起砧座组件7010枢转到闭合位置(图90-92)，同时耳轴7014通过将在下面进一步描述的耳轴锁定杆7050被限制成在它们各自的槽7024中枢转。闭合管7040的近端(未显示)可由手柄组件(未显示)中的上面描述的类型和构造的致动元件支撑，以便选择性地控制闭合管7040 沿着远侧方向DD和近侧方向H)轴向运动。 [0346] 从图90中可以看出，耳轴锁定杆7050可滑动支撑在设置于脊7030中的轴向槽7034中。耳轴锁定杆7050的近端(未显示)可与手柄组件中的致动元件相互作用，使耳轴锁定杆7050沿着远侧方向DD和近侧方向H)进行运动，并选择性地将杆7050保持在那些位置中。从图92和94中还可以看出，耳轴锁定杆7050的远端7052可具有两个从其上突出的耳轴保持臂7054。 [0347] 图90-92示出了处于锁定位置中的耳轴锁定杆7050，其中耳轴保持臂7054将耳轴保持在通道组件7020中各自的端部开口的槽7024中。从这些附图中可以看出，当处于该位置中时，砧座组件7010可处于闭合(夹钳)位置。在缝合手术已经完成后(例如动力夹钳元件/刀组件已经从工具组件7002的近端7004驱动到工具组件7002的远端7006之后)， 临床医生可沿近侧方向回缩闭合管和耳轴锁定杆7050，允许耳轴7014通过每个槽7024的开口端7025弹出，如图95中所示。当砧座组件7010的近端7012处于图95中所示的位置中时，本领域普通技术人员将会理解，被夹钳在砧座组件7010和钉仓7021之间的组织现在就可以从其中被释放。 [0348] 图104和105示出了作为替代实施方式的外科器械4000'，其可具有大体上与上面描述的外科器械4000相同的构造和操作。但是，在图104和105所示的实施方式中，槽4014'具有开口端，允许耳轴4022'变得与其脱离接合。从图104中可以看出，当闭合环4030 已经行进到其最远侧位置中以闭合砧座组件4020时，闭合环4030可用于通过其在砧座组件4020'的近端部分4024'上的轴承将砧座组件4020'保持在夹钳位置中。当闭合环4030 被行进到其最近侧位置时，如图105中所示，耳轴4022'自由运动，从细长通道组件4012' 中的端部开口的槽4014'中运动脱离。外科器械400'还可以在上面详细描述的外科器械4000相同的方式操作。 [0349] 同样在各种实施方式中，为了完全释放砧座组件7010，砧座组件7010可设置有与砧座组件7010的下侧7011连接的弹簧元件7100，如图95所示。从该图还可以看出，被构造成由一个或多个驱动索7110、7112在细长通道组件7020中驱动的动力夹钳元件150可设置有销159，其被定向成可滑动容纳在砧座组件7010中的槽7018中。当动力夹钳组件150沿着远侧方向DD被驱动经过细长通道组件7010时，销159用于向着细长通道组件7020 拉动砧座组件7010。从图95中可以看出，弹簧元件7120的远端7102向下延伸，以便当动力夹钳组件150已经到达图95中所示的其最远侧位置时与销159接合。此后，沿着近侧方向拉动或者运动动力夹钳组件150可导致弹簧7102将销159从槽7018中释放出来。 [0350] 动力夹钳元件150的各种实施方式在图96-103中示出。从这些附图中可以看出， 动力夹钳元件150可包括上部157、中央支架或者向上的延伸部分151和底部152，在动力夹钳元件150在细长通道组件7020中向远侧纵向运动过程中，这些部分协同动作以沿着理想切割路径滑动保持动力夹钳元件150。前切割边缘155 (这里为刀片155a)的尺寸设置成倚靠在钉仓7021中形成的槽中，并且一旦缝合则将组织分开。可以想到动力夹钳元件150 的前缘可以为齿状、带斜边或者切口，以利于组织切割。动力夹钳元件150可由一根或多根驱动索7100、7112驱动。为了便于所述驱动索7110、7112的连接，动力夹钳元件150可设置有连接孔7130和壁架7132。但是，也可采用其他连接设置和驱动构造。 [0351] 转向图96，动力夹钳元件的上部157设置有端部开口的槽7140，用于将销159容纳在其中。一旦销159与弹簧7100接触，则销159可被迫使脱离端部开口的槽7140。图97的动力夹钳元件实施方式大体上与图96的相同，但上部157具有在其上形成的加强元件7150。在图98的实施方式中，底切部分7160设置在上部中并且槽7162最初被卷曲闭合。当销159与弹簧7100接触时，形成槽的底部7164允许向下弯曲以释放销159。在图99所示的实施方式中，支撑销159的槽7170由可弯曲的挡板7172限定，该挡板可弯曲或者变形以便打开槽7170，允许销从其上被除去，如图100所示。图101中示出的实施方式具有与第一销槽7180连通的第二槽7190，使第一销槽7180能够被打开到其中销可从其上被释放的位置。在图96-101所示的实施方式中，销159具有大体为圆形的截面形状。在图102和103所示的实施方式中，销159'可设置有侧翼或者角板7200，为销159'提供另外的支撑并将当动力夹钳元件150被驱动经过细长通道组件7020时使销弯曲的任何可能最小化。 [0352] 虽然已经描述了本发明的一些实施方式，但可想到的是，本领域技术人员为获得本发明的一些或者所有优点，可对这些实施方式进行各种修改、变化和改变。例如，根据各种实施方式，单个元件可被多个元件代替，多个元件也可被单个元件代替，来执行给定的一种或多种功能。本申请因此覆盖了所有这些修改、改变和变化，都不脱离由所附的权利要求书所限定的本发明的精神和范围。 [0353] 在本文中公开的装置可被设计成在单次使用后可抛弃的，或者它们可被设计成可多次使用的。但在任何一种情况下，在至少一次使用后装置可再生以便重新使用。再生可包括下列步骤的任何组合:装置拆卸，然后清洁并替换特定部件，随后重新组装。特别是， 装置可被拆卸，任意数目的特定部件或者装置的部分可选择性地以任意组合被替换或者除去。当清洁和/或替换特定部分时，装置可在再生工厂或者由外科团队在外科手术前立即重新组装以便后续使用。本领域普通技术人员将会理解，装置的再生可利用用于拆卸、清洁/替换和重新装配的各种不同技术。所述技术的使用以及产生的再生装置都属于本申请的范围。 [0354] 优选地，在这里所描述的本发明在外科手术前处理。首先得到新的或者使用过的器械，如果可能的话，对其进行清洁。 器械然后可被灭菌。 Instrument can then be sterilized.在一种灭菌技术中，器械被放置在密闭并密封的容器中，诸如塑料袋或者TYVEK ®袋。容器和器械然后放置在可穿透容器的辐射场所中，诸如Y射线、X-射线或者高能电子。辐射杀死器械上和容器中的细菌。灭菌的器械然后可存在在灭菌容器中。密封容器保持器械无菌，直到其在医疗场合被打开。 [0355] 声称通过引用而包含在本申请中的任何专利、出版物或者其他形式的公开材料， 全部或部分，在本文中仅仅包含到所包含的材料不与在本申请中阐明的现有定义、陈述或者其他公开材料相矛盾的程度。这样，并且在需要的程度，在本文中明确阐明的公开内容代替了任何通过引用而包含在本申请中的相矛盾的材料。声称通过引用而包含在本申请中但与现有定义、陈述或者其他公开材料相矛盾的的任何材料或者其部分仅仅包含到不引起所包含的材料与现有公开材料不相矛盾的程度。
[0356] 试图保护的本发明不被解释为由所公开的特定实施方式所限定或限制的内容。 [0356] The present invention seeks to protect not be construed particular embodiment disclosed as limit or restrict the content of the grounds. 因此这些实施方式被认为是示意性的而不是限制性的。 Therefore, these embodiments are considered illustrative and not restrictive. 可在不脱离本发明的精神和范围的情况下对其进行变化和改变。 May be made without departing from the spirit and scope of the present invention changes and modifications made thereto. 因此，清楚的是落入由权利要求书所限定的本发明的精神和范围内的所有这些等同物、变化和改变由此而被包括。 Thus, it is clear that all such equivalents, variations and changes therefrom which are included as falling within the spirit and scope defined by the claims of the present invention.
CN1961839A 9 Nov 2006 16 May 2007 伊西康内外科公司 Hydraulically and electrically actuated articulation joints for surgical instruments
International Classification A61B17/072, A61B17/94, A61B17/138
Cooperative Classification A61B2017/320052, A61B2017/07214, A61B2017/0069, A61B17/07207, A61B2017/2937, A61B2017/2927, A61B2017/2933, A61B2017/294, A61B2017/2934, A61B2017/2936, A61B2017/292, A61B2017/07285, A61B2017/07278, A61B2017/2939, A61B2017/2946, A61B2017/00473, A61B2017/2916, A61B2034/715