Surgical instrument including a display
阅读说明:本技术 包括显示器的外科器械 (Surgical instrument including a display ) 是由 F·E·谢尔顿四世 G·G·斯科特 S·A·沃辛顿 J·L·哈里斯 D·C·耶茨 于 2018-12-13 设计创作,主要内容包括:本发明公开了一种外科器械,包括触摸屏显示器。(A surgical instrument includes a touch screen display.)
1. A surgical stapling instrument system comprising:
a handle, the handle comprising:
a touch sensitive display, the touch sensitive display comprising:
an insulating layer; and
a capacitance sensing mechanism;
a shaft;
an end effector comprising a staple cartridge;
An input device; and
a sterile barrier positioned on the touch-sensitive display, wherein the input device is configured to apply an input signal to the sterile barrier, wherein the sterile barrier comprises a plurality of conductive particles configured to transmit the input signal to the insulating layer, and wherein the capacitive sensing mechanism is configured to sense application of the input signal through the sterile barrier.
2. The surgical stapling instrument system of claim 1, wherein said touch-sensitive display is compatible with said input device when said input device is comprised of a human finger covered by a latex glove.
3. The surgical stapling instrument system of claim 1, wherein said input device comprises a stylus.
4. The surgical stapling instrument system of claim 1, wherein a gap is defined between said sterile barrier and said insulating layer of said touch-sensitive display.
5. The surgical stapling instrument system of claim 1, wherein said sterile barrier comprises plastic.
6. The surgical stapling instrument system of claim 1, wherein said staple cartridge is replaceable.
7. The surgical stapling instrument system of claim 1, wherein said staple cartridge comprises staples removably stored therein.
8. A surgical stapling instrument system comprising:
a handle, the handle comprising:
a touch sensitive display, the touch sensitive display comprising:
an insulating layer; and
a sensing device for sensing a capacitance;
a shaft;
an end effector comprising a staple cartridge; and
a sterile barrier, wherein the sterile barrier comprises a plurality of conductive particles configured to be capable of transmitting an input signal to the insulating layer, and wherein the sensing device is configured to be capable of sensing application of the input signal through the sterile barrier.
9. The surgical stapling instrument system of claim 8, wherein said sensing means is configured to sense said input signal when said input signal is derived from a human finger covered by a latex glove.
10. The surgical stapling instrument system of claim 8, wherein said sensing means is configured to sense said input signal when said input signal originates from a stylus.
11. The surgical stapling instrument system of claim 8, wherein a gap is defined between said sterile barrier and said insulating layer of said touch-sensitive display.
12. The surgical stapling instrument system of claim 8, wherein said sterile barrier comprises plastic.
13. The surgical stapling instrument system of claim 8, wherein said staple cartridge is replaceable.
14. The surgical stapling instrument system of claim 8, wherein said staple cartridge comprises staples removably stored therein.
15. A surgical stapling instrument system comprising:
a handle, the handle comprising:
a touch sensitive display, the touch sensitive display comprising:
an insulating layer; and
a sensing mechanism for sensing a capacitance;
a shaft;
an end effector comprising a staple cartridge; and
a sterile barrier, wherein the sterile barrier comprises a plurality of conductive particles configured to be capable of transmitting an input to the insulating layer, and wherein the sensing mechanism is configured to be capable of sensing application of the input through the sterile barrier.
16. The surgical stapling instrument system of claim 15, wherein said sensing mechanism is configured to sense said input when said input is derived from a human finger covered by a latex glove.
17. The surgical stapling instrument system of claim 15, wherein said sensing mechanism is configured to sense said input when said input is sourced from a stylus.
18. The surgical stapling instrument system of claim 15, wherein a gap is defined between said sterile barrier and said insulating layer of said touch-sensitive display.
19. The surgical stapling instrument system of claim 15, wherein said sterile barrier comprises plastic.
20. The surgical stapling instrument system of claim 15, wherein said staple cartridge comprises staples removably stored therein.
Background
The present invention relates to surgical instruments and, in various arrangements, to surgical stapling and cutting instruments designed to staple and cut tissue and staple cartridges for use therewith.
Drawings
Various features of the embodiments described herein, along with their advantages, may be understood from the following description in conjunction with the following drawings:
FIG. 1 is a perspective view of a surgical stapling instrument in accordance with at least one embodiment;
FIG. 2 is a cross-sectional view of the suturing apparatus of FIG. 1 taken along line 2-2 of FIG. 1;
FIG. 3 is a partial perspective view of the drive system of the stapling instrument of FIG. 1;
FIG. 4 is a plan view of the drive system of FIG. 3;
FIG. 5 is a front view of the drive system of FIG. 3 shown in a first operating configuration;
FIG. 6 is a side elevational view of the drive system of FIG. 3 shown in the first operating configuration of FIG. 5;
FIG. 7 is a side elevational view of the drive system of FIG. 3 shown in a second operating configuration;
FIG. 8 is a partial perspective view of a surgical stapling instrument in accordance with at least one embodiment;
FIG. 9 is a partial perspective view of a surgical stapling instrument in accordance with at least one embodiment;
FIG. 10 is a perspective view of a handle housing of the stapling instrument of FIG. 8;
FIG. 11 is a perspective view of a battery according to at least one embodiment;
FIG. 12 is a perspective view of the handle of the stapling instrument of FIG. 1;
FIG. 13 is a partial perspective view of a surgical stapling instrument including a display in accordance with at least one embodiment;
FIG. 14 illustrates a state control on the display of FIG. 13;
FIG. 15 illustrates a speed control on the display of FIG. 13;
FIG. 16 illustrates a failure threshold control on the display of FIG. 13;
FIG. 17 illustrates a directional control on the display of FIG. 13;
FIG. 18 illustrates the display of FIG. 13 and the speed control of FIG. 15;
FIG. 19 illustrates the display and speed control of FIG. 13;
FIG. 20 illustrates the display of FIG. 13 and a staple path control for altering the staple firing path of the stapling instrument;
FIG. 21 illustrates the display of FIG. 13 and the staple path control of FIG. 21 used to control the staple firing path of the stapling instrument;
FIG. 22 illustrates the display of FIG. 13 and controls for stopping the stapling instrument along a staple firing path;
FIG. 23 illustrates a surgical instrument system including an external or off-board display in accordance with at least one embodiment;
FIG. 24 illustrates a display of a surgical stapling instrument in accordance with at least one embodiment;
FIG. 25 shows the display of FIG. 24 being used to change staple firing paths as a gastric sleeve is formed during a gastric volume reduction procedure;
FIG. 26 illustrates a lever for changing the staple firing path on the display of FIG. 24;
FIG. 27 illustrates the stapling instrument being guided along the staple firing path;
FIG. 28 shows a patient's stomach;
FIG. 29 is a cross-sectional view of the patient's stomach;
FIG. 30 is a cross-sectional view of the target inserted into the stomach of FIG. 29;
FIG. 31 is a cross-sectional view of a patient's stomach, which is thinner than the stomach of FIG. 29;
FIG. 32 is a cross-sectional view of the target inserted into the stomach of FIG. 31;
FIG. 33 illustrates various anatomical features that may be referenced during a gastric sleeve procedure;
FIG. 34 is a partial front view of a surgical stapling instrument including a shaft, an end effector, and an articulation joint in accordance with at least one embodiment;
FIG. 35 is a partial front view of the stapling instrument of FIG. 34, showing the end effector in an articulated position;
FIG. 36 is a bottom cross-sectional view of an end effector of a surgical stapling instrument in accordance with at least one embodiment;
FIG. 37 is a partial cross-sectional view of a surgical stapling instrument including a tissue drive system in accordance with at least one embodiment;
FIG. 38 is a partial cross-sectional view of the stapling instrument of FIG. 37, showing the tissue drive system engaged with tissue of a patient;
FIG. 39 is a partial cross-sectional view of the stapling instrument of FIG. 37, showing the tissue drive system urging tissue of the patient in a first direction;
FIG. 40 is a partial cross-sectional view of the stapling instrument of FIG. 37, showing the tissue drive system urging tissue of the patient in a second direction;
FIG. 41 is a partial cross-sectional view of the stapling instrument of FIG. 37, showing the tissue drive system disengaged from patient tissue;
FIG. 42 is a partial front view of a drive system including a synchronization mechanism in accordance with at least one embodiment;
FIG. 43 shows the synchronization mechanism of FIG. 42 actuating the end effector drive system;
FIG. 44 illustrates a drive system configured to reciprocally drive a plurality of end effector drive systems;
FIG. 45 is a graph showing two synchronized end effector drives;
FIG. 46 is a table showing synchronization of four end effector drives;
FIGS. 47A-47G illustrate steps in operation of a surgical stapling instrument in accordance with at least one embodiment;
FIG. 48 is a table illustrating synchronization of end effectors of a surgical stapling instrument according to at least one embodiment;
FIG. 49 is a block diagram for operating a surgical stapling instrument, in accordance with at least one embodiment;
FIG. 50 is a partial perspective view of an end effector including a tissue drive system shown extended in accordance with at least one embodiment;
FIG. 51 is a partial perspective view of the tissue drive system of FIG. 50 retracted;
FIG. 52 is a partial cross-sectional view of the end effector of FIG. 50, showing the tissue drive system in a retracted configuration;
FIG. 53 is a partial cross-sectional view of the end effector of FIG. 50, showing the tissue drive system in a lowered configuration;
FIG. 54 is a partial cross-sectional view of the end effector of FIG. 50, showing the tissue drive system extended;
FIG. 55 is a partial cross-sectional view of the end effector of FIG. 50 showing the teeth of the tissue drive system in a protruding configuration;
FIG. 56 is a partial cross-sectional view of the end effector of FIG. 50, showing the drive system retracted;
FIG. 57 is a partial perspective view of a tissue drive system according to at least one embodiment;
FIG. 58 is a partial perspective view of the tissue drive system of FIG. 57 in an extended configuration;
FIGS. 59A-59D illustrate operational steps of a tissue drive system of a surgical stapling instrument, in accordance with at least one embodiment;
FIGS. 60A-60D further illustrate the operational steps of the tissue actuation system of FIGS. 59A-59D;
FIG. 61 is a partial perspective view of a surgical stapling instrument including a tissue drive system in accordance with at least one embodiment;
FIG. 62 is a partial perspective view of the tissue drive system of FIG. 61 in an extended configuration;
FIG. 63 is a perspective view, partially in section, of a surgical stapling instrument including a tissue drive system in accordance with at least one embodiment;
FIG. 64 is a bottom cross-sectional plan view of the suturing apparatus of FIG. 63;
FIG. 65 is a partial cross-sectional view of a surgical stapling instrument including a vacuum system in accordance with at least one embodiment;
FIG. 66 is a partial detail view of the tissue drive system of the stapling instrument of FIG. 65;
FIG. 67 is a partial cross-sectional view of the stapling instrument of FIG. 65 showing tissue being pulled into an end effector of the stapling instrument;
FIG. 68 is a partial detail view of the tissue drive system of FIG. 66;
FIG. 69 is a partial cross-sectional view of the stapling instrument of FIG. 65, showing tissue being released;
FIG. 70 is a partial cross-sectional view of a surgical stapling instrument including a vacuum system in accordance with at least one embodiment;
FIG. 71 is a partial cross-sectional view of the suturing apparatus of FIG. 70 showing the first and second feet of the suturing apparatus in a retracted configuration;
FIG. 72 is a partial cross-sectional view of the stapling instrument of FIG. 70, showing the first drive foot in an extended position;
FIG. 73 is a vacuum manifold of the stapling instrument of FIG. 70 in fluid communication with a first drive foot;
FIG. 74 is a partial perspective view of a surgical stapling instrument in accordance with at least one embodiment;
FIGS. 75A-75D illustrate operational steps of a surgical stapling instrument in accordance with at least one embodiment;
FIG. 76 is a perspective view, partially in section, of a surgical stapling instrument in accordance with at least one embodiment;
FIGS. 77A-77D illustrate the operative steps for manipulating the stapling instrument of FIG. 76;
FIG. 78 is a cross-sectional end view of a surgical stapling instrument in accordance with at least one embodiment;
FIG. 79 is a partial front view of a surgical stapling instrument including a tissue drive device in accordance with at least one embodiment;
FIG. 79A illustrates the position of a foot corresponding to the tissue driver of FIG. 79;
FIG. 80 is a partial front view of the suturing apparatus of FIG. 79 illustrating the foot extended;
FIG. 80A illustrates the position of a foot corresponding to the tissue driver of FIG. 80;
FIG. 81 is a partial front view of the stapling instrument of FIG. 79, showing the foot in an extended configuration;
FIG. 81A illustrates the position of a foot corresponding to the tissue driving device of FIG. 81;
FIG. 82 is a partial front view of the suturing apparatus of FIG. 79 illustrating the foot retracted;
FIG. 82A illustrates the position of a foot corresponding to the tissue driver of FIG. 82;
FIG. 83 is a partial cross-sectional view of the tissue driving device of the stapling instrument of FIG. 79;
FIG. 84 illustrates the kinematics of the tissue drive device of the stapling instrument of FIG. 79;
FIG. 85 shows a cam capable of producing the kinematics of FIG. 84;
FIG. 86 is a perspective view of a cam capable of producing the kinematics of FIG. 84;
FIG. 87 is a partial perspective view of a surgical stapling instrument that includes a tissue driving device in accordance with at least one embodiment;
FIG. 88 is a tissue driving device of a surgical stapling instrument according to at least one embodiment;
FIG. 89 shows the tissue driving device of FIG. 88 in an extended configuration;
FIGS. 90A-90D illustrate steps in operation of a surgical stapling instrument including a tissue driving device in accordance with at least one embodiment;
91A-91D illustrate steps in operation of a surgical stapling instrument that includes a tissue driving device in accordance with at least one embodiment;
FIG. 92 is a tissue driving device of a surgical stapling instrument according to at least one embodiment;
FIG. 93 illustrates the tissue driving device of FIG. 92 in an extended configuration;
FIG. 94 is a perspective view, partially in section, of a surgical stapling instrument in accordance with at least one embodiment;
FIG. 95 is a partial front view of a surgical stapling instrument including a tissue cutting member in accordance with at least one embodiment;
FIG. 96 shows the tissue cutting member of FIG. 95 moved through a tissue cutting stroke;
FIG. 97 is a partial perspective view of a surgical stapling instrument in accordance with at least one embodiment;
FIG. 98 is a perspective view of two connected staples according to at least one embodiment;
FIG. 99 is a partial perspective view of the staple of FIG. 98 in isolation;
FIG. 100 is a partial cross-sectional view of a staple firing system of the stapling instrument of FIG. 97 including a staple firing chamber in accordance with at least one embodiment;
FIG. 101 illustrates staples fired by the staple firing system of FIG. 100;
FIG. 102 illustrates another staple loaded into the staple firing chamber of FIG. 100;
FIG. 103 is a bottom cross-sectional end view of the suturing apparatus of FIG. 97;
FIG. 104 is a perspective view, partially in section, of a surgical stapling instrument in accordance with at least one embodiment;
105A-105D illustrate the operational steps of the suturing system of FIG. 104;
FIG. 106 is a partial perspective view of a surgical stapling instrument in accordance with at least one embodiment;
FIG. 107 is an exploded perspective view of a staple holder for use with the stapling instrument of FIG. 106;
FIG. 108 is a plan view of a staple holder according to at least one embodiment;
FIG. 109 is an end view of the staple clip of FIG. 108 positioned in a surgical stapling instrument;
FIG. 110 is a perspective view of the staple holder of FIG. 108;
FIG. 111 is an end view of a staple holder positioned in a surgical stapling instrument in accordance with at least one embodiment;
FIG. 112 is a perspective view of the staple holder of FIG. 111;
FIG. 113 is an end view of a staple holder positioned in a surgical stapling instrument in accordance with at least one embodiment;
FIG. 114 is a perspective view of the staple holder of FIG. 113;
FIG. 115 is a partial plan view of a nailing strip in a deployed configuration in accordance with at least one embodiment;
FIG. 116 is an end view of the nailing strip of FIG. 115 in its deployed configuration;
FIG. 117 is an end view of the nailing strip of FIG. 115 in its folded configuration;
FIG. 118 is a perspective view of the deployed nailing strip of FIG. 115;
FIG. 119 is a perspective view of a staple cluster in accordance with at least one embodiment;
FIG. 120 is a partial perspective view of the staple cluster of FIG. 119 loaded into a surgical stapling instrument;
FIG. 121 is a partial perspective view of a surgical stapling instrument including a deployable staple cluster in accordance with at least one embodiment;
FIG. 122 is a partial perspective view of a surgical stapling instrument that includes a tissue driving device in accordance with at least one embodiment;
FIG. 123 is a partial perspective view of the stapling instrument of FIG. 122, showing the tissue drive device in an extended configuration;
FIG. 124 illustrates a cross-sectional width of the distal head of the stapling instrument of FIG. 122;
FIG. 125 is a cross-sectional view of the tissue gripping surface of the tissue driver of FIG. 122;
FIG. 126 is a cross-sectional end view of a surgical stapling instrument including a tissue driving device shown in an extended configuration in accordance with at least one embodiment;
FIG. 127 is a cross-sectional end view of the stapling instrument of FIG. 126, showing the tissue driving device in a retracted configuration;
FIG. 128 illustrates a firing drive of the surgical stapling instrument shown in an unfired configuration in accordance with at least one embodiment;
FIG. 128A illustrates the tissue driving device of the stapling instrument of FIG. 128 shown in an extended configuration;
FIG. 129 illustrates the firing drive of FIG. 128 shown in a firing configuration;
FIG. 129A shows the tissue driving device of FIG. 128A in a retracted configuration;
FIG. 130 illustrates the firing drive of FIG. 128 shown in its unfired configuration;
FIG. 130A shows the tissue driving device of FIG. 128A in its retracted configuration;
FIG. 131 is a perspective view of a staple loading system of a surgical stapling instrument in accordance with at least one embodiment;
FIG. 132 is a plan view of the staple loading system of FIG. 131;
FIG. 133 is a partial front view of the staple loading system of FIG. 131;
FIG. 134 is a partial cross-sectional view of the stapling instrument of FIG. 131 shown in an unfired configuration;
FIG. 135 is a partial cross-sectional view of the stapling instrument of FIG. 131 shown in a fired configuration;
FIG. 136 is a partial cross-sectional view of the stapling instrument of FIG. 131 retracted to its unfired configuration;
FIG. 137 is a partial cross-sectional view of the stapling instrument of FIG. 131 shown in its unfired configuration;
FIG. 138 illustrates a staple pattern that may be produced by a surgical stapling instrument in accordance with at least one embodiment;
FIG. 139 illustrates a staple pattern that can be produced by a surgical stapling instrument in accordance with at least one embodiment;
FIG. 140 illustrates a surgical stapling instrument in accordance with at least one embodiment;
FIG. 141 illustrates the operational steps of the stapling instrument of FIG. 140 for making and deploying staples;
FIG. 142 shows a staple firing line in a patient's stomach;
FIG. 143 is a staple firing schedule in accordance with at least one embodiment;
144-146 illustrate the stapling instrument of FIG. 1 used during a surgical procedure;
fig. 147 illustrates a surgical stapling instrument for use during a surgical procedure in accordance with at least one embodiment;
FIG. 148 is a partial front elevational view of the surgical stapling instrument of FIG. 147;
FIG. 149 is a partial perspective view of the suturing apparatus of FIG. 147 in a first configuration;
FIG. 150 is a partial perspective view of the suturing apparatus of FIG. 147 in a second configuration;
FIG. 151 illustrates a potential result of a gastric sleeve procedure using the surgical stapling instrument disclosed herein;
figure 152 shows the guide inserted into a patient's stomach;
FIG. 153 shows a guide for defining a staple firing path in a patient's stomach;
fig. 154 shows the guide of fig. 153 used to form a gastric sleeve during a gastric bypass procedure;
FIG. 155 is a partial cross-sectional view of the guide of FIG. 153;
fig. 156 is a partial perspective view of a guide shown with some components removed, in accordance with at least one embodiment;
FIG. 157 is a schematic view of the guide of FIG. 153;
FIG. 158 is a perspective view of a surgical stapling system including a loadable staple cartridge in accordance with at least one embodiment;
FIG. 159 illustrates certain operative components of the suturing system of FIG. 158;
FIG. 160 is an end view of a surgical stapling instrument including a projection system including two lenses in accordance with at least one embodiment;
FIG. 161 shows the stapling instrument of FIG. 160 being used during a surgical procedure;
Fig. 162 illustrates a surgical stapling system including a projector according to at least one embodiment;
fig. 163 illustrates a surgical stapling system including a vision system and a projection system, in accordance with at least one embodiment;
FIG. 164 shows a projection system using the stitching system of FIG. 163;
FIG. 165 illustrates a projection image on tissue of a patient according to at least one embodiment;
FIG. 166 illustrates a staple firing path projected onto a patient's tissue in accordance with at least one embodiment;
FIG. 167 illustrates a surgical stapling instrument that includes a first projector configured to project a first portion of a staple firing path onto tissue of a patient and a second projector configured to project a second portion of the staple firing path onto tissue of a patient, in accordance with at least one embodiment;
FIG. 168 is a partial front view of a surgical stapling instrument including an articulatable end effector in accordance with at least one embodiment;
FIG. 169 is a partial front view of the surgical stapling instrument of FIG. 168;
FIG. 170 is a partial front view of a surgical stapling instrument including an articulatable end effector and a damper configured to reduce unintentional movement of the end effector in accordance with at least one embodiment;
FIG. 171 is a partial front view of a surgical stapling instrument including an end effector dampener in accordance with at least one embodiment;
FIG. 172 illustrates the suturing apparatus of FIG. 171 in use during a surgical procedure;
FIG. 173 illustrates the suturing apparatus of FIG. 171 being used in a surgical procedure;
FIG. 174 illustrates a staple firing path formed by a surgical stapling instrument that includes a longitudinal end effector;
FIG. 175 illustrates a staple firing path formed by the surgical stapling instrument disclosed herein;
FIG. 176 illustrates a staple firing path formed by a surgical stapling instrument that includes a longitudinal end effector;
FIG. 177 illustrates a staple firing path formed by the surgical stapling instrument disclosed herein;
FIG. 178 illustrates a staple firing path formed by a surgical stapling instrument that includes a longitudinal end effector;
FIG. 179 illustrates a staple firing path formed by the surgical stapling instrument disclosed herein;
FIG. 180 is a perspective view of a handle of a surgical instrument according to at least one embodiment;
FIG. 181 is a perspective view of the handle of the surgical instrument of FIG. 180 enclosed in a sterile barrier;
FIG. 182 is a partial cross-sectional view of the touch-sensitive display of the sterile barrier and handle of FIG. 181;
FIG. 183 is a plan view of the touch sensitive display of FIG. 182, showing a grid of electrodes in which a plurality of pixels are activated; and is
FIG. 184 is a graph illustrating the relationship between the position of the active pixel of FIG. 183 and the capacitance detected by the touch sensitive display of FIG. 182.
Corresponding reference characters indicate corresponding parts throughout the several views. The exemplifications set out herein illustrate various embodiments of the invention, in one form, and such exemplifications are not to be construed as limiting the scope of the invention in any manner.
Detailed Description
The applicant of the present application owns the following U.S. patent applications filed on 12/21 in 2017 and each incorporated herein by reference in its entirety:
U.S. patent application Ser. No. 15/850,431 entitled "CONTINUOUS USE SELF-PROPELLED STAPLING INDUSTRUMENT";
-U.S. patent application serial No. 15/850,461 entitled "SURGICAL INSTRUMENT COMPLEMENTING SPEEDCONTROL";
-U.S. patent application serial No. 15/850,433 entitled "SURGICAL INSTRUMENT COMPRISING APPARATUS";
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-U.S. patent application serial No. 15/850,562 entitled "minor incorporation into SYSTEMS";
-U.S. patent application serial No. 15/850,587 entitled "stable internal composition A STAPLEFEEDING SYSTEM";
-U.S. patent application Ser. No. 15/850,508 entitled "SURGICAL STAPLER COMPRISING STORABLECARTRIDGES HAVINGDIFFERENT STAPLE SIZES";
U.S. patent application Ser. No. 15/850,526 entitled "SURGICAL INSTRUMENT HAVING A DISPLAYCOMPRIVING IMAGE LAYERS";
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-U.S. patent application serial No. 15/850,518 entitled "SURGICAL INSTRUMENT COMPRISING APPIOTABLE DISTAL HEAD"; attorney docket number END8334 USNP/170234.
The applicant of the present application owns the following U.S. patent applications filed on 19.12.2017 and each incorporated herein by reference in its entirety:
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U.S. patent application Ser. No. 15/847,297 entitled "SURGICAL INSTRUMENTS WITH DUALARTICULATION DRIVERS";
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U.S. design patent application serial No. 29/630,115 entitled "minor inertia ASSEMBLY".
The applicant of the present application owns the following U.S. patent applications filed on 12/15/2017 and each incorporated herein by reference in its entirety:
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U.S. patent application Ser. No. 15/843,518 entitled "END EFFECTORS WITH POSITIVE JAW OPENNGFEATURES FOR USE WITH THADAPTERS FOR RELECTRICAL CHANNEL SURGICAL INSTRUMENTS";
U.S. patent application Ser. No. 15/843,535 entitled "SURGICAL END EFFECTORS WITH CLAMPING GASSEMBLIES CONFIGURED TOINCREASE JAWAPERTURE RANGES";
-U.S. patent application Ser. No. 15/843,558 entitled "SURGICAL END EFFECTORS WITH PIVOTALJAWS CONFIRED TO TOUCHAT THEIR RESPECTIVEDISTAL ENDS WHEN FULLY CLOSED";
-U.S. patent application Ser. No. 15/843,528 entitled "SURGICAL END EFFECTORS WITH JAWSTIFFENER ARRANGEMENTSCONFILED TO PERMITMONITORING OF FIRING MEMBER";
-U.S. patent application Ser. No. 15/843,567 entitled "ADAPTERS WITH END EFFECTOR POSITIONSENSING AND CONTROL TRANSGENTS FOR USE INCONNECTION WITH ELECTROMECHANICAL SUGARCONING SERUTS";
-U.S. patent application Ser. No. 15/843,556 entitled "DYNAMIC CLAMPING ASSEMBLIES WITHIMPROVED WEAR CHARACTERISTICS FOR USE IN CONNECTION WITH ELECTROMECHANICAL SUGACTIRUNTS";
-U.S. patent application Ser. No. 15/843,514 entitled "ADAPTERS WITH FIRING STROKE SENSIN GARRANGEMENTS FOR USE INCONNECTION WITH ELECTROMECHANICAL CHARACTERICAL SURGICALS";
-U.S. patent application Ser. No. 15/843,501 entitled "ADAPTERS WITH CONTROL SYSTEM FOR CONTROLLING MULTIPLE MOTORSOF ANELECTRICAL CHANICAL SURGICAL INSTRUMENT";
-U.S. patent application Ser. No. 15/843,508 entitled "HANDHELD ELECTRICAL SURGICALINITRUMERENTS WITH IMPROVEDMOTOR CONTROL MEANS FOR POSITIONING COMPONENTS OF OFAN ADAPTER COUPLEDTHERETO";
-U.S. patent application Ser. No. 15/843,682 entitled "SYSTEMS AND METHODS OF CONTROLLING ACLINING MEMBER FIRING OF A SURGICALINSTRUNT";
-U.S. patent application Ser. No. 15/843,689 entitled "SYSTEMS AND METHODS OF CONTROLLING ACLAmping Member";
and
U.S. patent application Ser. No. 15/843,704 entitled "METHODS OF OPERATING SURGICAL ENDEFECTORS".
The applicant of the present application owns the following U.S. patent applications filed 2017 on 29.6 and each incorporated herein by reference in its entirety:
-U.S. patent application Ser. No. 15/636,829 entitled "CLOSED LOOP located control products FOR rolling catalytic sizing";
-U.S. patent application serial No. 15/636,837 entitled "CLOSED LOOP cushion control detected received transmitted parameter device for the device for detecting and detecting" circular component injection ";
-U.S. patent application Ser. No. 15/636,844 entitled "CLOSED LOOP VELOCITY CONTROL OFCLOSURE MEMBER FOR ROBOTICSURGICALISTINGERUMENT";
U.S. patent application Ser. No. 15/636,854 entitled "Rolling minor INSTRUMENT WITH CLOSED LOOP FEEDBACCKENIQUES FOR RADDANEMENT OF CLOSURE MEMBER DURING"; and
U.S. patent application Ser. No. 15/636,858 entitled "SYSTEM FOR CONTROLLING ARTICULATED FORCES".
The applicant of the present application owns the following U.S. patent applications filed 2017 on 28/6 and each incorporated herein by reference in its entirety:
U.S. patent application Ser. No. 15/635,693 entitled "SURGICAL INSTRUMENT COMPRISING AND OFFSET ARTICULATION JOINT";
U.S. patent application Ser. No. 15/635,729 entitled "SURGICAL INSTRUMENT COMPLIMENTING ANARTICULATION SYSTEM RATIO";
U.S. patent application Ser. No. 15/635,785 entitled "SURGICAL INSTRUMENT COMPLIMENTING ANARTICULATION SYSTEM RATIO";
U.S. patent application Ser. No. 15/635,808 entitled "SURGICAL INSTRUMENT COMPRISING FIRING MEMBER SUPPORTS";
-U.S. patent application Ser. No. 15/635,837 entitled "SURGICAL INSTRUMENT COMPRISING AND ARTICULATION SYSTEM LOCKABLETO A FRAME";
U.S. patent application Ser. No. 15/635,941 entitled "SURGICAL INSTRUMENT COMPRISING AND ARTICULATION SYSTEM LOCKABLED BY A CLOSURESYSTEM";
U.S. patent application Ser. No. 15/636,029 entitled "SURGICAL INSTRUMENT COMPRISING A SHAFICTING A HOUSINGARRANGEMENT";
-U.S. patent application serial No. 15/635,958 entitled "minor ingredient ingredients" incorporated herein by reference;
U.S. patent application Ser. No. 15/635,981 entitled "SURGICAL STAPLING INSTRUMENTS SYSTEM STAPLETED STAPLETERIDGE NOSES";
U.S. patent application Ser. No. 15/636,009 entitled "SURGICAL INSTRUMENT COMPRISING A SHAFT COMPUTING A CLOSURE PROFILE";
-U.S. patent application serial No. 15/635,663 entitled "METHOD FOR organizing a SURGICALINSTRUMENT";
-U.S. patent application Ser. No. 15/635,530 entitled "SURGICAL INSTRUMENTS WITH ARTICULATED END EFFECTOR WITH THAXIALLY OPERATED ARTICULATED JOINT CONFIGURATIONS";
U.S. patent application Ser. No. 15/635,549 entitled "SURGICAL INSTRUMENTS WITH OPEN ANDCLOSABLE JAWS AND AXIALLYMOVABLE FIRING MEMBER THAT IS INITIALLY PARKED IN CLOSEP OXIMITY TO THE JAWSPRIOR TO FIRING";
U.S. patent application Ser. No. 15/635,559 entitled "SURGICAL INSTRUMENTS WITH JAWSCONSTRATIONATED TO PIVOT ABOUT ANAXIS UPONCONTACT WITH A CLOSURE MEMBER THAT IS PARKEDIN CLOSURE PROXIMITY TOTHEE PIVOT AXIS";
-U.S. patent application serial No. 15/635,578 entitled "SURGICAL END EFFECTORS WITH IMPROVEDJAW APERTURARRANGEMENTS";
-U.S. patent application Ser. No. 15/635,594 entitled "SURGICAL CUTTING AND FASTENING DEVICESWITH PIVOTABLE ANVILWITH A TISSUE LOCATINGARRANGEMENT IN CLOSE PROXIMITY TO AN ANVILPIVOT";
-U.S. patent application serial No. 15/635,612 entitled "JAW RETAINER ARRANGEMENT for converting a minor component IN minor component RETAINING ENGAGEMENT WITH for converted minor component JAW";
-U.S. patent application Ser. No. 15/635,621 entitled "SURGICAL INSTRUMENT WITH POSITIVE JAWOPENING FEATURES";
U.S. patent application Ser. No. 15/635,631 entitled "SURGICAL INSTRUMENT WITH AXIALLYMOVABLE CLOSURE MEMBER";
-U.S. patent application serial No. 15/635,521 entitled "SURGICAL INSTRUMENT LOCKOUTARRANGEMENT";
-U.S. design patent application serial No. 29/609,087 entitled "platform formulation and artificial";
-U.S. design patent application serial No. 29/609,083 entitled "SURGICAL INSTRUMENT SHAFT"; and
U.S. design patent application serial No. 29/609,093 entitled "SURGICAL FASTENER CARTRIDGE".
The applicant of the present application owns the following U.S. patent applications filed 2017 on 27/6 and each incorporated herein by reference in its entirety:
U.S. patent application Ser. No. 15/634,024 entitled "SURGICAL ANVIL MANUFACTURNMETHODS";
-U.S. patent application serial No. 15/634,035 entitled "SURGICAL ANVIL ARRANGEMENTS";
-U.S. patent application serial No. 15/634,046 entitled "SURGICAL ANVIL ARRANGEMENTS";
-U.S. patent application serial No. 15/634,054 entitled "SURGICAL ANVIL ARRANGEMENTS";
-U.S. patent application serial No. 15/634,068 entitled "SURGICAL FIRING MEMBER ARRANGEMENTS";
-U.S. patent application serial No. 15/634,076 entitled "stable formation POCKET arget argements";
-U.S. patent application serial No. 15/634,090 entitled "stable formation POCKET arget argements";
-U.S. patent application serial No. 15/634,099 entitled "SURGICAL END EFFECTORS AND ANVILS"; and
U.S. patent application Ser. No. 15/634,117 entitled "ARTICULATION SYSTEMS FOR SURGICALINSTRUMENTS".
The applicants of the present application own the following U.S. patent applications filed on 21/12/2016 and each of which is incorporated herein by reference in its entirety:
U.S. patent application Ser. No. 15/386,185 entitled "SURGICAL STAPLING INSTRUMENTS AND DREPLACEABLE TOOL ASSEMBLED BLIESTHEREOF";
-U.S. patent application serial No. 15/386,230 entitled "articulable minor filing systems";
-U.S. patent application serial No. 15/386,221 entitled "LOCKOUT arragements FOR surgicaled efficators";
-U.S. patent application serial No. 15/386,209 entitled "SURGICAL END EFFECTORS AND FIRING MEMBERS THEREOF";
-U.S. patent application serial No. 15/386,198 entitled "LOCKOUT arragements FOR minor and minor tools FOR tools" in the united states;
-U.S. patent application serial No. 15/386,240 entitled "SURGICAL END EFFECTORS AND ADAPTABLENING MEMBERS THEREFOR";
-U.S. patent application serial No. 15/385,939 entitled "STAPLE CARTRIDGES AND ARRANGEMENTS OFSTAPLES AND STAPLECAVITIES THEREIN";
U.S. patent application Ser. No. 15/385,941 entitled "SURGICAL TOOL ASSEMBLIES WITHCLUTCHING ARRANGEMENTS FOR THE SURGICAL BETWEENCLOSURE SYSTEMS WITH CLOSURE STROKEREDUCTION FEATURES ANDARTILATION ANDFIRING SYSTEMS";
-U.S. patent application Ser. No. 15/385,943 entitled "SURGICAL STAPLING INSTRUMENTS ANDSTAPLE-FORMING ANVILS";
-U.S. patent application serial No. 15/385,950 entitled "minor teeth WITH close teeth rolling piece reduction" and its use;
-U.S. patent application serial No. 15/385,945 entitled "STAPLE CARTRIDGES AND ARRANGEMENTS OFSTAPLES AND STAPLECAVITIES THEREIN";
-U.S. patent application Ser. No. 15/385,946 entitled "SURGICAL STAPLING INSTRUMENTS ANDSTAPLE-FORMING ANVILS";
U.S. patent application Ser. No. 15/385,951 entitled "SURGICAL INSTRUMENTS WITH JAW OPENNGFEATURES FOR INCREASING JAW OPENNINGDISTANCE";
U.S. patent application serial No. 15/385,953 entitled "METHODS OF marking TISSUE";
-U.S. patent application serial No. 15/385,954 entitled "fire MEMBERS WITH NON-para-wall j awengageent FEATURES for reasons of energy consumption;
-U.S. patent application serial No. 15/385,955 entitled "SURGICAL END EFFECTORS WITH EXPANDABLE ACTISSUE STOPARAMENTS";
-U.S. patent application Ser. No. 15/385,948 entitled "SURGICAL STAPLING INSTRUMENTS ANDSTAPLE-FORMING ANVILS";
-U.S. patent application Ser. No. 15/385,956 entitled "SURGICAL INSTRUMENTS WITH POSITIVE JAWOPENING FEATURES"; -U.S. patent application serial No. 15/385,958 entitled "SURGICAL INSTRUMENTS WITHLOCKOUTARRANGEMENTS FOR PREVENTING FIRING SYSTEM TUTION UNLESS AN UNSPENTSTAPLE CARTRIDGEIS PRESENT";
-U.S. patent application serial No. 15/385,947 entitled "STAPLE CARTRIDGES AND ARRANGEMENTS OFSTAPLES AND STAPLECAVITIES THEREIN";
-U.S. patent application Ser. No. 15/385,896 entitled "METHOD FOR RESETTING A FUSE OF ASURGICAL INSTRUMENT SHAFT";
-U.S. patent application Ser. No. 15/385,898 entitled "STAPLE FORMING POCKET ARRANGEMENT TOACCOMMODATE DIFFERENTYLES OF STAPLES";
-U.S. patent application serial No. 15/385,899 entitled "minor incorporation into mprovded JAW CONTROL";
-U.S. patent application serial No. 15/385,901 entitled "STAPLE CARTRIDGE AND STAPLE CARTRIDGECHANNEL compris ingwindows DEFINED THEREIN";
U.S. patent application Ser. No. 15/385,902 entitled "SURGICAL INSTRUMENT COMPRISING ACCUTTING MEMBER"; -U.S. patent application Ser. No. 15/385,904 entitled "STAPLE FIRING MEMBER COMPRISING AMISSING CARTRIDGEAND/OR SPECT CARTRIDGELOCKOUT";
-U.S. patent application serial No. 15/385,905 entitled "fixing ASSEMBLY assembling a LOCKOUT";
-U.S. patent application Ser. No. 15/385,907 entitled "SURGICAL INSTRUMENT SYSTEM COMPRISINGAN END EFFECTOR LOCKOUTAND A FIRING ASSEMBLY LOCKOUT"; -U.S. patent application serial No. 15/385,908 entitled "firingassbly composing a FUSE";
-U.S. patent application Ser. No. 15/385,909 entitled "FIRING ASSEMBLY COMPRISING A MULTIPLEFAILED-STATE FUSE"; -U.S. patent application serial No. 15/385,920 entitled "stable formation POCKET arget argements";
-U.S. patent application serial No. 15/385,913 entitled "ANVIL ARRANGEMENTS FOR SURGICAL TAPLE/FASTENERS";
U.S. patent application Ser. No. 15/385,914 entitled "METHOD OF DEFORMING STAPLES FROM TWO DIFFERENT TYPE OF STAPLECARTRIDGES WITH THESAME SURGICAL STAPLING INSTRUMENT";
-U.S. patent application serial No. 15/385,893 entitled "bilierally ASYMMETRIC STAPLE formulation key pair rs";
-U.S. patent application Ser. No. 15/385,929 entitled "CLOSURE MEMBERS WITH CAM SURFACERARRANGEMENTS FOR SURGICALINDEREMULMENTS WITHSEPARATE AND DISTINCT CLOSURE AND FIRINGSYSTEMS";
U.S. patent application Ser. No. 15/385,911 entitled "SURGICAL STAPLE/FASTENERS WITHINDEPENDENTLY ACTUATABLING CLOSING AND FIRINGSYSTEMS";
-U.S. patent application serial No. 15/385,927 entitled "SURGICAL STAPLING INSTRUMENTS WITHSMART STAPLE CARTRIDGES";
-U.S. patent application serial No. 15/385,917 entitled "STAPLE CARTRIDGE COMPRISING STAPLESWITH DIFFERENT clamingbudardhs";
-U.S. patent application Ser. No. 15/385,900 entitled "STAPLE FORMING POCKET ARRANGEMENTSCOMPRIMING PRIMARYSIDEWALLS AND POCKETSIDEWALLS";
-U.S. patent application serial No. 15/385,931 entitled "NO-CARTRIDGE AND SPENT cartriggelkout arragements for forsurgicalstatiple/FASTENERS"; -U.S. patent application serial No. 15/385,915 entitled "fixing MEMBERPIN ANGLE";
-U.S. patent application Ser. No. 15/385,897 entitled "STAPLE FORMING POCKET ARRANGEMENTSCOMPRIMING ZONED FORMING GSURFACE GROOVES";
U.S. patent application Ser. No. 15/385,922 entitled "SURGICAL INSTRUMENT WITH MULTIPLEFAILURE RESPONSE MODES";
-U.S. patent application serial No. 15/385,924 entitled "SURGICAL INSTRUMENT WITH PRIMARY ANDSAFETY PROCESSORS";
-U.S. patent application serial No. 15/385,912 entitled "minor appliances WITH JAWS movable anode active anode AND cathode AND DISTINCT closed anode AND FIRINGSYSTEMS";
-U.S. patent application serial No. 15/385,910 entitled "ANVIL HAVING A KNIFE SLOT WIDTH";
-U.S. patent application serial No. 15/385,906 entitled "fixing MEMBER PIN CONFIGURATIONS";
-U.S. patent application serial No. 15/386,188 entitled "STEPPED STAPLE CARTRIDGE WITHASYMMETRICAL STAPLES";
-U.S. patent application serial No. 15/386,192 entitled "STEPPED STAPLE CARTRIDGE WITH tissuesenterkind AND GAP setringfeitures";
-U.S. patent application serial No. 15/386,206 entitled "STAPLE CARTRIDGE WITH DEFORMABLEDRIVER RETENTION feats";
-U.S. patent application serial No. 15/386,226 entitled "dual utilities FOR END effects relating to filing associating systems FOR providing services;
-U.S. patent application Ser. No. 15/386,222 entitled "SURGICAL STAPLING INSTRUMENTS HAVANGING EFFECTORS WITH POSITIVE OPENING FEATURES";
-U.S. patent application serial No. 15/386,236 entitled "CONNECTION ports FOR dispiabeloading UNITS FOR surgicalstaltagingnstruments";
U.S. patent application Ser. No. 15/385,887 entitled "METHOD FOR ATTACHING A SHAFT ASSEMBLY A SURGICAL INSTRUMENTTAND, ALTERNATIVELY, TO A SURGICAL ROBOT";
-U.S. patent application Ser. No. 15/385,889 entitled "SHAFT ASSEMBLY COMPRISING AMANUALLY-OPERABLE RETRACTING SYSTEM FOR USE WITH A MOTORIZED SURGICAL INSTRUMENT SYSTEM";
-U.S. patent application Ser. No. 15/385,890 entitled "SHAFT ASSEMBLY COMPRISING SEPARATELYACTUATABLE ANDRETRACTABLE SYSTEMS";
-U.S. patent application Ser. No. 15/385,891 entitled "SHAFT ASSEMBLY COMPRISING A CLUTCHCONFIRED TO ADAPT THEUTPUT OF A ROTARYFIXING MEMBER TO TWO DIFFERENT SYSTEMS";
U.S. patent application Ser. No. 15/385,892 entitled "SURGICAL SYSTEM COMPRISING A FIRING MEMBER ROTATABLE INTO ANARTICULATE STATETTO ARTICULATE AN END EFFECTOR OF THE SURGICAL SYSTEMS";
-U.S. patent application serial No. 15/385,894 entitled "SHAFT association comprisinga locout";
-U.S. patent application Ser. No. 15/385,895 entitled "SHAFT ASSEMBLY COMPRISING FIRST ANDSECOND ARTICULATOLOCKOUTS";
-U.S. patent application serial No. 15/385,916 entitled "SURGICAL STAPLING SYSTEMS";
-U.S. patent application serial No. 15/385,918 entitled "SURGICAL STAPLING SYSTEMS";
-U.S. patent application serial No. 15/385,919 entitled "SURGICAL STAPLING SYSTEMS";
-U.S. patent application Ser. No. 15/385,921 entitled "SURGICAL STAPLE/FASTENER CARTRIDGEWITH Movable CAMMING MEMBERCONGURED TODISEANGAGE FIRING MEMBER LOCKOUT FEATURES";
-U.S. patent application serial No. 15/385,923 entitled "SURGICAL STAPLING SYSTEMS";
-U.S. patent application Ser. No. 15/385,925 entitled "JAW ACTITED LOCK ARRANGEMENTS FOR PREVENTING ADVANCEMENT OF AFIRING MEMBER INA SURGICAL END EFFECTOR UNLESS AN FIREDCARTRIDGE IS INSTALLEDIN THE END EFFECTOR";
-U.S. patent application Ser. No. 15/385,926 entitled "AXIALLY MOVABLE CLOSURE SYSTEM FOR APPLYING GCLOSURE MOTIONSTO JAWS OF SURGICAL INSTRUMENTS";
U.S. patent application Ser. No. 15/385,928 entitled "PROTECTIVE COVER ARRANGEMENTS FOR A JOINT INTERFACE BETWEEN AMOYABLE JAW ANDACTUATOR SHAFT OF A SURGICAL INSTRUMENT";
U.S. patent application Ser. No. 15/385,930 entitled "SURGICAL END EFFECTOR WITH TWOSEPARATE COOPERATING OPENING GFEATURES FOROPENING AND CLOSING END EFFECTOR JAWS";
-U.S. patent application serial No. 15/385,932 entitled "article subacable minor END effectore ASYMMETRIC SHAFTARRANGEMENT";
-U.S. patent application serial No. 15/385,933 entitled "article subaltern insert tube insert sheet column disc system access LOCK";
U.S. patent application Ser. No. 15/385,934 entitled "ARTICULATION LOCK ARRANGEMENTS FOR LOCKING AN END EFFECTOR IN ARTICULATED POSITION IN RESPONSE TO ACTION OF A JAWCLOSURE SYSTEM";
-U.S. patent application serial No. 15/385,935 entitled "LATERALLY ACTUATABLE ARTICULATIONLOCK ARRANGEMENTS FORLOCKING AN ENDEFFECTOR OF A SURGICAL INSTRUMENT IN ANARTICULATEDCONFIGURATION"; and
U.S. patent application Ser. No. 15/385,936 entitled "ARTICULATABLE SURGICAL INSTRUMENTS WITH ARTICULATION STROAMPLICATIONFEATURES";
the applicants of the present application have the following U.S. patent applications filed on 24/6/2016 and each of which is incorporated herein by reference in its entirety:
-U.S. patent application serial No. 15/191,775 entitled "STAPLE CARTRIDGE COMPRISING WIRESTAPLES AND STAMPED STAPLES";
-U.S. patent application serial No. 15/191,807 entitled "STAPLING SYSTEM FOR USE WITH WIRESTAPLES AND STAMPED STAPLES";
-U.S. patent application serial No. 15/191,834 entitled "STAMPED STAPLES AND STAPLE cartidesasing SAME" and;
-U.S. patent application serial No. 15/191,788 entitled "STAPLECARTRIDGE COMPRISING OVERDRIVENSTAPLES"; and
U.S. patent application Ser. No. 15/191,818 entitled "STAPLE CARTRIDGE composition OFFSETLONGITUDINAL STAPLE ROWS".
The applicants of the present application have the following U.S. patent applications filed on 24/6/2016 and each of which is incorporated herein by reference in its entirety:
-U.S. design patent application serial No. 29/569,218 entitled "SURGICAL FASTENER";
-U.S. design patent application serial No. 29/569,227 entitled "SURGICAL FASTENER";
-U.S. design patent application serial No. 29/569,259 entitled "SURGICAL FASTENER CARTRIDGE"; and
U.S. design patent application serial No. 29/569,264 entitled "SURGICAL FASTENER CARTRIDGE".
The applicants of the present application have the following patent applications filed on 1/4/2016 and each of which is incorporated herein by reference in its entirety:
U.S. patent application Ser. No. 15/089,325 entitled "METHOD FOR OPERATING A SURGICAL TAPLING SYSTEM", now U.S. patent application publication 2017/0281171;
U.S. patent application Ser. No. 15/089,321 entitled "MODULAR SURGICAL STAPLING SYSTEM OMPRISING A DISPLAY", now U.S. patent application publication 2017/0281163;
-U.S. patent application serial No. 15/089,326 entitled "SURGICAL STAPLING SYSTEM COMPRISING ADISPLAY INCLUDING A RE-ORIENTABLE DISPLAYFLE", now U.S. patent application publication 2017/0281172;
U.S. patent application Ser. No. 15/089,263 entitled "SURGICAL INSTRUMENT HANDLE ASSEMBLED WITH RECONFIGURABLE GRIPPORTION", now U.S. patent application publication 2017/0281165;
U.S. patent application Ser. No. 15/089,262 entitled "ROTARY POWER SURGICAL INSTRUMENTTURING MANUALLY ACTUATABLEILUROUT SYSTEM," now U.S. patent application publication 2017/0281161;
U.S. patent application Ser. No. 15/089,277 entitled "SURGICAL CUTTING AND STAPLING ENDEFECTOR WITH ANVILCONCENTRIC DRIVE MEMBER", now U.S. patent application publication 2017/0281166;
-U.S. patent application Ser. No. 15/089,296 entitled "INTERCHANGEABLE SURGICAL TOOLS WITH A SURGICAL ENDEFECTOR THAT ISSELECTIVELY ROTATABLE ABOUT A SHAFT AXIS", now U.S. patent application publication 2017/0281168;
U.S. patent application Ser. No. 15/089,258 entitled "SURGICAL STAPLING SYSTEM COMPRISING ASHIFTABLE TRANSMISSION," now U.S. patent application publication 2017/0281178;
U.S. patent application Ser. No. 15/089,278 entitled "SURGICAL STAPLING SYSTEM CONFIGURED ended TOPROVIDE SELECTIVECUTING OF TISSUE", now U.S. patent application publication 2017/0281162;
U.S. patent application Ser. No. 15/089,284 entitled "SURGICAL STAPLING SYSTEM COMPRISING ACONOURABLE SHAFT," now U.S. patent application publication 2017/0281186;
U.S. patent application Ser. No. 15/089,295 entitled "SURGICAL STAPLING SYSTEM COMPRISING ATISSUE COMPRESSION LOCKOUT", now U.S. patent application publication 2017/0281187;
U.S. patent application Ser. No. 15/089,300 entitled "SURGICAL STAPLING SYSTEM COMPRISING AND CLAMPING LOCKOUT," now U.S. patent application publication 2017/0281179;
U.S. patent application Ser. No. 15/089,196 entitled "SURGICAL STAPLING SYSTEM COMPRISING AJAW CLOSURE LOCKOUT," now U.S. patent application publication 2017/0281183;
U.S. patent application Ser. No. 15/089,203 entitled "SURGICAL STAPLING SYSTEM COMPRISING AJAW ATTACHMENT LOCKOUT", now U.S. patent application publication 2017/0281184;
-U.S. patent application serial No. 15/089,210 entitled "SURGICAL STAPLING SYSTEM COMPRISING ASPENT CARTRIDGE LOCKOUT," now U.S. patent application publication 2017/0281185;
U.S. patent application Ser. No. 15/089,324 entitled "SURGICAL INSTRUMENT COMPRISING ASHIFTING MECHANISM," now U.S. patent application publication 2017/0281170;
U.S. patent application Ser. No. 15/089,335 entitled "SURGICAL STAPLING INSTRUMENTCUMENT COPERING MULTIPLE LOCKOUTS", now U.S. patent application publication 2017/0281155;
U.S. patent application Ser. No. 15/089,339 entitled "SURGICAL STAPLING INSTRUMENT," now U.S. patent application publication 2017/0281173;
U.S. patent application Ser. No. 15/089,253 entitled "SURGICAL STAPLING SYSTEM CONFIGURED TOAPPLY ANNULAR ROWS OFSTAPLES HAVINGDIFFERENT HEIGHTS," now U.S. patent application publication 2017/0281177;
U.S. patent application Ser. No. 15/089,304 entitled "SURGICAL STAPLING SYSTEM COMPRISING AGROOVED FORMING POCKET", now U.S. patent application publication 2017/0281188;
U.S. patent application Ser. No. 15/089,331 entitled "ANVIL MODIFICATION MEMBERS FORSURGICAL STAPLE/FASTENERS," now U.S. patent application publication 2017/0281180;
-U.S. patent application serial No. 15/089,336 entitled "STAPLE CARTRIDGES WITH atraumaticfeature", now U.S. patent application publication 2017/0281164;
-U.S. patent application serial No. 15/089,312 entitled "CIRCULAR STAPLING SYSTEM comprisingning and available tisssue support", now U.S. patent application publication 2017/0281189;
-U.S. patent application serial No. 15/089,309 entitled "CIRCULAR STAPLING SYSTEM comprisinggrotary FIRING SYSTEM," now U.S. patent application publication 2017/0281169; and
U.S. patent application Ser. No. 15/089,349 entitled "CIRCULAR STAPLING SYSTEM COMPRISING GLOAD CONTROL", now U.S. patent application publication 2017/0281174.
The applicant of the present application also owns the following identified U.S. patent applications filed on 30/12/2015 and each incorporated herein by reference in its entirety:
-U.S. patent application serial No. 14/984,488 entitled "MECHANISMS FOR COMPENSATING FORBATTERY PACK FAILURE INPOWERED SURGICALINSTRUMENTS," now U.S. patent application publication 2017/0189018;
-U.S. patent application serial No. 14/984,525 entitled "MECHANISMS FOR COMPENSATING FORDRIVETRAIN FAILURE IN POWEREDSURGICALINSTRUMENTS," now U.S. patent application publication 2017/0189019; and
U.S. patent application Ser. No. 14/984,552 entitled "SURGICAL INSTRUMENTS WITH SEPARALLEMOTORS AND MOTOR CONTROL IRCUITS", now U.S. patent application publication 2017/0189020.
The applicant of the present application also owns the following identified U.S. patent applications filed on 9/2/2016 and each incorporated herein by reference in its entirety:
U.S. patent application Ser. No. 15/019,220 entitled "SURGICAL INSTRUMENT WITH ARTICULATED AND AXIALLY TRANSLATIONED EFFECTOR", now U.S. patent application publication 2017/0224333;
U.S. patent application Ser. No. 15/019,228 entitled "SURGICAL INSTRUMENTS WITH MULTIPLE LELINK ARTICULATOR GEMENTS", now U.S. patent application publication 2017/0224342;
U.S. patent application Ser. No. 15/019,196 entitled "SURGICAL INSTRUMENT ARTICULATONMENT MECHANISM WITH SLOTTEDSONDARYCONSTRAINT", now U.S. patent application publication 2017/0224330;
U.S. patent application Ser. No. 15/019,206 entitled "SURGICAL INSTRUMENTS WITH AN ENDEFECTOR THAT IS HIGHLYCRYLATIC ABLELATIVE TO AN ELONGGATE SHAFT ASSEMBLY", now U.S. patent application publication 2017/0224331;
U.S. patent application Ser. No. 15/019,215 entitled "SURGICAL INSTRUMENTS WITHNON-SYMMETRICAL ARTICULATIONARRANGEMENTS," now U.S. patent application publication 2017/0224332;
U.S. patent application Ser. No. 15/019,227 entitled "ARTICULATABLE SURGICAL INSTRUMENTS WITH SINGLE ARTICULATOLINK ARRANGEMENTS," now U.S. patent application publication 2017/0224334;
U.S. patent application Ser. No. 15/019,235 entitled "SURGICAL INSTRUMENTS WITH TESNIONIONAL ARRANGEMENTS FOR CABLE DRIVEN ARTICULATION SYSTEMS", now U.S. patent application publication 2017/0224336;
U.S. patent application Ser. No. 15/019,230 entitled "ARTICULATABLE SURGICAL INSTRUMENTS WITH OFF-AXIS FIRING BEAMARRANGEMENTS", now U.S. patent application publication 2017/0224335; and
U.S. patent application Ser. No. 15/019,245 entitled "SURGICAL INSTRUMENTS WITH CLOSURES TROROKE REDUCTION ARRANGEMENTS", now U.S. patent application publication 2017/0224343.
The applicant of the present application also owns the following identified U.S. patent applications filed on 12.2.2016, each of which is incorporated herein by reference in its entirety:
-U.S. patent application serial No. 15/043,254 entitled "MECHANISMS FOR COMPENSATING FORDRIVETRAIN FAILURE IN POWEREDSURGICALINSTRUMENTS";
-U.S. patent application serial No. 15/043,259 entitled "MECHANISMS FOR COMPENSATING FORDRIVETRAIN FAILURE IN POWEREDSURGICALINSTRUMENTS";
-U.S. patent application serial No. 15/043,275 entitled "MECHANISMS FOR COMPENSATING FORDRIVETRAIN FAILURE IN POWEREDSURGICALINSTRUMENTS"; and
U.S. patent application Ser. No. 15/043,289 entitled "MECHANISMS FOR COMPENSATING FORDRIVETRAIN FAILURE IN POWEREDSURGICALINSTRUMENTS".
The applicants of the present application have the following patent applications filed on 18/6/2015 and each incorporated herein by reference in its entirety:
U.S. patent application Ser. No. 14/742,925 entitled "SURGICAL END EFFECTORS WITH POSITIVEEJAW OPENING ARRANGEMENTS", now U.S. patent application publication 2016/0367256;
U.S. patent application Ser. No. 14/742,941 entitled "SURGICAL END EFFECTORS WITH DUAL CAMACTUTED JAW CLOSINGFATURES", now U.S. patent application publication 2016/0367248;
U.S. patent application Ser. No. 14/742,914 entitled "Movable filing bed supporting machinery FOR achieving adhesion and lining services", now U.S. patent application publication 2016/0367255;
U.S. patent application Ser. No. 14/742,900 entitled "ARTICULATABLE SURGICAL INSTRUMENTS WITH COMPOSITE FIRING BEAMS STRUCTURES WITHCENTER FIRING SUPPORT MEMBER FOR CURATITION SUPPORT", now U.S. patent application publication 2016/0367254;
-U.S. patent application Ser. No. 14/742,885 entitled "DUAL ARTICULATION DRIVE SYSTEMARRANGEMENTS FOR ARTICULATED SULERGICALINSTRUMENTS", now U.S. patent application publication 2016/0367246; and
U.S. patent application Ser. No. 14/742,876 entitled "PUSH/PULL ARTICULATION DRIVE SYSTEM FOR ARTICULATABLE SURGICAL INSTRUMENTS," now U.S. patent application publication 2016/0367245.
The applicants of the present application have the following patent applications filed 3/6/2015 and each incorporated herein by reference in its entirety:
-U.S. patent application serial No. 14/640,746 entitled "POWERED minor instroment", now U.S. patent 9,808,246;
U.S. patent application Ser. No. 14/640,795 entitled "MULTIPLE LEVEL THRESHOLDS TO MODIFY OPERATION OF POWER REDSURGICAL INSTRUMENTS," now U.S. patent application publication 2016/02561185;
U.S. patent application Ser. No. 14/640,832 entitled "ADAPTIVE time Equipment complete detection method ADAPTIVE close circuit raw material, now U.S. patent application publication 2016/0256154;
U.S. patent application Ser. No. 14/640,935 entitled "OVERAID MULTI SENSOR RADIO FREQUENCY (RF) ELECTRODE SYSTEM TOMEASURE TISSUECOMPRESSION," now U.S. patent application publication 2016/0256071;
U.S. patent application Ser. No. 14/640,831 entitled "MONITORING SPEED CONTROL AND PRECISION INFORMATION OF MOTORFOR POWER SURGICAL STRUCTURENTS", now U.S. patent application publication 2016/0256153;
-U.S. patent application Ser. No. 14/640,859 entitled "TIME DEPENDENT EVALUATION OF SENSORDATA TO DETERMINEMITABILITY, CREPE, ANDVISOELASTIC ELEMENTS OF MEASURES", now U.S. patent application publication 2016/0256187;
-U.S. patent application serial No. 14/640,817 entitled "INTERACTIVE FEEDBACK SYSTEM FORPOWERED SURGICAL INSTRUMENTS," now U.S. patent application publication 2016/0256186;
U.S. patent application Ser. No. 14/640,844 entitled "CONTROL TECHNIQUES AND SUB-PROCESSORCONNECTED WITH MODULAR SHAFT WITH SELECTCONTROL PROCESSING FROM HANDLE", now U.S. patent application publication 2016/0256155;
U.S. patent application Ser. No. 14/640,837 entitled "SMART SENSORS WITH LOCAL SIGNAPROCESESSING", now U.S. patent application publication 2016/0256163;
U.S. patent application Ser. No. 14/640,765 entitled "SYSTEM FOR DETECTING THE MIS-INSERTION OF A STAPLE CARTRIDGEINTO A SURGICAL TAPLE/FASTENER," now U.S. patent application publication 2016/0256160;
-U.S. patent application serial No. 14/640,799 entitled "SIGNAL AND POWER communiation system POSITIONED ON available shift short", now U.S. patent application publication 2016/0256162; and
U.S. patent application Ser. No. 14/640,780 entitled "SURGICAL INSTRUMENT COMPRISING ALOCKABLE BATTERY HOUSING", now U.S. patent application publication 2016/0256161.
The applicants of the present application have the following patent applications filed on day 27 of
U.S. patent application Ser. No. 14/633,576 entitled "SURGICAL INSTRUMENT SYSTEM COMPRISINGAN INSPECTION STATION", now U.S. patent application publication 2016/0249919;
U.S. patent application Ser. No. 14/633,546 entitled "SURGICAL APPATUS CONFIRED TOASSESS WHETHER A PERFORMALMANCETATER OFTHEE SURGICAL APPATUS IS WITHIN ANACEPTABLE PERFORMANCE BAND", now U.S. patent application publication 2016/0249915;
U.S. patent application Ser. No. 14/633,560 entitled "SURGICAL CHARGING SYSTEM THAT CHARGESAND/OR CONDITIONS ONE ORMORE BATTERIES," now U.S. patent application publication 2016/0249910;
-U.S. patent application serial No. 14/633,566 entitled "CHARGING SYSTEM THAT enablesecure systems for assisting ABATTERY", now U.S. patent application publication 2016/0249918;
U.S. patent application Ser. No. 14/633,555 entitled "SYSTEM FOR MONITORING WHETHER ASURGICAL INSTRUMENTS NEEDS TOBE SERVICED," now U.S. patent application publication 2016/0249916;
U.S. patent application Ser. No. 14/633,542 entitled "REINFORCED BATTERY FOR A SURGICALINDERMENT," now U.S. patent application publication 2016/0249908;
U.S. patent application Ser. No. 14/633,548 entitled "POWER ADAPTER FOR A SURGICALINSTRUCOMENT," now U.S. patent application publication 2016/0249909;
-U.S. patent application serial No. 14/633,526 entitled "adaptive minor insert HANDLE", now U.S. patent application publication 2016/0249945;
U.S. patent application serial No. 14/633,541 entitled "MODULAR station association" and now U.S. patent application publication 2016/0249927; and
U.S. patent application Ser. No. 14/633,562 entitled "SURGICAL APPATUS CONFIGURED TOTRACK AN END-OF-LIFEPARAMETER," now U.S. patent application publication 2016/0249917.
The applicants of the present application own the following patent applications filed on 12/18/2014 and each incorporated herein by reference in its entirety:
U.S. patent application Ser. No. 14/574,478 entitled "SURGICAL INSTRUMENT SYSTEM COMPLEMENTS COMPLEMENTATION ENDEFECTOR AND MEANS FOR RADDY USE THE FIRING STROKE OF A FIRING MEMBER", now U.S. patent 9,844,374;
U.S. patent application Ser. No. 14/574,483 entitled "SURGICAL INSTRUMENT ASSEMBLED LOCKABLE SYSTEMS", now U.S. patent application publication 2016/0174969;
-U.S. patent application serial No. 14/575,139 entitled "DRIVE ARRANGEMENTS FOR articulalsuerganical INSTRUMENTS", now U.S. patent 9,844,375;
-U.S. patent application serial No. 14/575,148 entitled "LOCKING argements FOR detachhableshaft association with movable surface FOR effects", now U.S. patent application publication 2016/0174976;
U.S. patent application Ser. No. 14/575,130 entitled "SURGICAL INSTRUMENT WITH AN ANVIL THATIS SELECTIVELY MOVABLE ABOUT A DISCRETEN-MOVABLE AXIS RELATIVE TO A STAPLECARTRIDGE, now U.S. patent application publication 2016/0174972;
U.S. patent application Ser. No. 14/575,143 entitled "SURGICAL INSTRUMENTS WITH IMPROVEDCLOSURE ARRANGEMENTS", now U.S. patent application publication 2016/0174983;
U.S. patent application Ser. No. 14/575,117 entitled "SURGICAL INSTRUMENTS WITHARTICULATED END EFFECTORS ANDMOVABLEFIRING BEAM SUPPORT ARRANGEMENTS", now U.S. patent application publication 2016/0174975;
U.S. patent application Ser. No. 14/575,154 entitled "SURGICAL INSTRUMENTS WITHARTICULATED END EFFECTORS ANDIMPROVEDINING BEAM SUPPORT ARRANGEMENTS", now U.S. patent application publication 2016/0174973;
-U.S. patent application serial No. 14/574,493 entitled "minor assembly a flexile interaction SYSTEM"; now U.S. patent application publication 2016/0174970; and
U.S. patent application Ser. No. 14/574,500 entitled "SURGICAL INSTRUMENT ASSEMBLY BLOCKOMPRISING A LOCKABLEARTICULATION SYSTEM," now U.S. patent application publication 2016/0174971.
The applicant of the present application owns the following patent applications filed on 3/1 of 2013 and each incorporated herein by reference in its entirety:
U.S. patent application Ser. No. 13/782,295 entitled "Integrated Surgical Instruments With reduced Path for Signal Communication", now U.S. Pat. No. 9,700,309;
U.S. patent application Ser. No. 13/782,323 entitled "Rotary Power engineering Joints For scientific instruments," now U.S. Pat. No. 9,782,169;
U.S. patent application Ser. No. 13/782,338 entitled "thumb Switch arrays For surgical instruments," now U.S.
U.S. patent application Ser. No. 13/782,499 entitled "Electrical scientific Device with Signal Relay arrangement", now U.S. patent application publication 9,358,003;
U.S. patent application Ser. No. 13/782,460 entitled "Multiple Processor Motor Control for Modular surgical instruments," now U.S. Pat. No. 9,554,794;
U.S. patent application Ser. No. 13/782,358 entitled "journal Switch Assemblies For Surgical Instruments," now U.S. patent application publication 9,326,767;
U.S. patent application Ser. No. 13/782,481 entitled "Sensor straight End Effect or During removalThroughright", now U.S. patent application publication 9,468,438;
U.S. patent application Ser. No. 13/782,518 entitled "Control Methods for scientific Instruments with RemovableImplements", now U.S.
U.S. patent application serial No. 13/782,375 entitled "road Powered Surgical Instruments With multiple details of freedom", now U.S. patent application publication 9,398,911; and
U.S. patent application Ser. No. 13/782,536 entitled "Surgical Instrument Soft Stop", now U.S. patent application publication 9,307,986.
The applicant of the present application also owns the following patent applications filed on 3/14 of 2013 and each incorporated herein by reference in its entirety:
-U.S. patent application serial No. 13/803,097 entitled "articulable minor incorporation in united states patent No. A FIRING DRIVE," now U.S. patent No. 9,687,230;
U.S. patent application Ser. No. 13/803,193 entitled "CONTROL ARRANGEMENTS FOR A DRIVEMEMBER OF A SURGICALINSTRUNT", now U.S. patent application publication 9,332,987;
U.S. patent application Ser. No. 13/803,053 entitled "INTERCHANGEABLE SHAFT ASSEMBLIES FOR WITH A SURGICALINSTRUNT", now U.S.
U.S. patent application Ser. No. 13/803,086 entitled "ARTICULATABLE SURGICAL INSTRUMENTC OMPRIMING AN ARTICULATOLOCK", now U.S.
-U.S. patent application serial No. 13/803,210 entitled "SENSOR arrays FOR absolute position SYSTEM FOR detecting INSTRUMENTS", now U.S. patent 9,808,244;
U.S. patent application Ser. No. 13/803,148 entitled "Multi-functional Motor FOR A SURGICALINSTRUCOMENT," now U.S.
-U.S. patent application Ser. No. 13/803,066 entitled "DRIVE SYSTEM LOCKOUT ARRANGEMENTSFOR MODULAR SURGICALINSTRUMENTS", now U.S. patent 9,629,623;
U.S. patent application Ser. No. 13/803,117 entitled "ARTICULATION CONTROL SYSTEM FOR SURGICAL LINESTRUTMENTS", now U.S. patent application publication 9,351,726;
-U.S. patent application serial No. 13/803,130 entitled "DRIVE TRAIN CONTROL argemenets format modular patent applications," now U.S. patent application publication 9,351,727; and
U.S. patent application Ser. No. 13/803,159 entitled "METHOD AND SYSTEM FOR OPERATING ASURGICAL INSTRUMENT," now U.S.
The applicant of the present application also owns the following patent applications filed on 3/7/2014 and incorporated herein by reference in their entirety:
U.S. patent application Ser. No. 14/200,111 entitled "CONTROL SYSTEMS FOR SURGICALINGURUMENTS", now U.S. Pat. No. 9,629,629.
The applicant of the present application also owns the following patent applications filed on 26/3/2014 and each incorporated herein by reference in its entirety:
U.S. patent application Ser. No. 14/226,106 entitled "POWER MANAGEMENT CONTROL SYSTEM FOR URGICAL INSTRUMENTS", now U.S. patent application publication 2015/0272582;
-U.S. patent application serial No. 14/226,099 entitled "serilization version CIRCUIT", now U.S. patent 9,826,977;
U.S. patent application Ser. No. 14/226,094 entitled "VERIFICATION OF NUMBER OF BATTERYEXCHANGES/PROCEDURE COUNT", now U.S. patent application publication 2015/0272580;
U.S. patent application Ser. No. 14/226,117 entitled "POWER MANAGEMENT THROUGH SLEEPTIONS OF SEGMENTED CICUITAND WAKE UPCONTROL," now U.S. patent application publication 2015/0272574;
U.S. patent application serial No. 14/226,075 entitled "MODULAR POWERED minor energy stabilized machinery stabilized energy storage systems," now U.S. patent 9,743,929;
U.S. patent application Ser. No. 14/226,093 entitled "FEEDBACK ALGORITHMS FOR MANUALBAILOUT SYSTEMS FOR SURGICALINSTRUMENTS", now U.S. patent application publication 2015/0272569;
U.S. patent application Ser. No. 14/226,116 entitled "SURGICAL INSTRUMENT UTILIZING SENSOR RADARAPTATION", now U.S. patent application publication 2015/0272571;
U.S. patent application Ser. No. 14/226,071 entitled "SURGICAL INSTRUMENT CONTROL A SAFETY PROCESSOR", now U.S. patent 9,690,362;
-U.S. patent application serial No. 14/226,097 entitled "minor ingredient compositions SYSTEMS," now U.S. patent 9,820,738;
-U.S. patent application Ser. No. 14/226,126 entitled "INTERFACE SYSTEMS FOR USE WITH SURGICALINSTRUCOMETS", now U.S. patent application publication 2015/0272572;
U.S. patent application Ser. No. 14/226,133 entitled "MODULAR SURGICAL INSTRUMENTS SYSTEM," now U.S. patent application publication 2015/0272557;
-U.S. patent application serial No. 14/226,081 entitled "SYSTEMS AND METHODS FOR CONTROLLING evaluated circui", now U.S. patent 9,804,618;
U.S. patent application Ser. No. 14/226,076 entitled "POWER MANAGEMENT THROUGH SEGMENTEDCIRCUIT AND VARIABLEVOLTAGE PROTECTION", now U.S. Pat. No. 9,733,663;
U.S. patent application Ser. No. 14/226,111 entitled "SURGICAL STAPLING INSTRUMENTT SYSTEM", now U.S. Pat. No. 9,750,499;
and
U.S. patent application Ser. No. 14/226,125 entitled "SURGICAL INSTRUMENT COMPRISING AROTATABLE SHAFT," now U.S. patent application publication 2015/0280384.
The applicant of the present application also owns the following patent applications filed on 5/9/2014 and each incorporated herein by reference in its entirety:
U.S. patent application serial No. 14/479,103 entitled "CIRCUITRY AND SENSORS FOR power DEVICE," now U.S. patent application publication 2016/0066912;
-U.S. patent application serial No. 14/479,119 entitled "ADJUNCT WITH INTEGRATED SENSORS torque determination time compensation", now U.S. patent 9,724,094;
U.S. patent application serial No. 14/478,908 entitled "MONITORING DEVICE classification based EVALUATION" and now U.S. patent 9,737,301;
-U.S. patent application serial No. 14/478,895 entitled "MULTIPLE SENSORS WITH ONE SENSOR sensing a SECOND SENSOR' detecting or detecting", now U.S. patent 9,757,128;
-U.S. patent application Ser. No. 14/479,110 entitled "POLARITY OF HALL MAGNET TO DETECTINCISLOADED CARTRIDGE", now U.S. patent application publication 2016/0066915;
-U.S. patent application serial No. 14/479,098 entitled "SMART CARTRIDGE WAKE UP OPERATION and data RETENTION," now U.S. patent application publication 2016/0066911;
U.S. patent application Ser. No. 14/479,115 entitled "MULTIPLE MOTOR CONTROL FOR POWER DMEDICAL DEVICE", now U.S. Pat. No. 9,788,836; and
U.S. patent application Ser. No. 14/479,108 entitled "LOCAL DISPLAY OF TIMSSUE PARAMETERSTABILIZATION", now U.S. patent application publication 2016/0066913.
The applicant of the present application also owns the following patent applications filed on 9/4/2014 and each incorporated herein by reference in its entirety:
-U.S. patent application serial No. 14/248,590 entitled "MOTOR driver minor actuation with locked DUAL drivers", now U.S. patent 9,826,976;
-U.S. patent application serial No. 14/248,581 entitled "minor constituent synthesizing acid DRIVE AND A FIRINGDRIVE operator loop product OUTPUT", now U.S. patent 9,649,110;
U.S. patent application Ser. No. 14/248,595 entitled "SURGICAL INSTRUMENT SHAFT INCLUDING SIGGSWITCHES FOR CONTROLLING OPERATION OF THESURGICAL INSTRUMENT", now U.S. patent 9,844,368;
U.S. patent application Ser. No. 14/248,588 entitled "POWER LINEAR SURGICALTAPPLE/FASTENER," now U.S.
U.S. patent application Ser. No. 14/248,591 entitled "TRANSMISSION ARRANGEMENT FOR ASURGICAL INSTRUMENT", now U.S.
-U.S. patent application Ser. No. 14/248,584 entitled "MODULAR MOTOR DRIVEN SURGICALINT MEANS WITH ALIGNMENTFEATURES FOR CURATIVE ROUTERING DRIVE SHAFTS WITH SURGICALEND EFFECTOR SHAFTTS", now U.S. patent 9,801,626;
U.S. patent application Ser. No. 14/248,587 entitled "POWER SURGICAL STAPLE/FASTENER," now U.S.
-U.S. patent application Ser. No. 14/248,586 entitled "DRIVE SYSTEM DECOUPLING ARRANGEMENTFOR A SURGICAL INSTRUMENT", now U.S.
U.S. patent application Ser. No. 14/248,607 entitled "MODULAR MOTOR DRIVEN SURGICALINUSTRUMENTS WITH STATIONIC ARRANGEMENTS", now U.S. patent 9,814,460.
The applicant of the present application also owns the following patent applications filed on 16.4.2013 and each incorporated herein by reference in its entirety:
U.S. provisional patent application serial No. 61/812,365 entitled "minor entering WITH multiple properties BY entering MOTOR";
-U.S. provisional patent application serial No. 61/812,376 entitled "LINEAR CUTTER WITH POWER";
-U.S. provisional patent application serial No. 61/812,382 entitled "LINEAR CUTTER WITH MOTOR AND pisorlgrip";
-U.S. provisional patent application serial No. 61/812,385 entitled "minor entering portable with ACTUATION motor and dispenser control"; and
U.S. provisional patent application serial No. 61/812,372 entitled "minor ignition WITH multiple properties BY entering MOTOR".
Numerous specific details are set forth herein to provide a thorough understanding of the overall structure, function, manufacture, and use of the embodiments described in the specification and illustrated in the accompanying drawings. Well-known operations, components and elements have not been described in detail so as not to obscure the embodiments described in the specification. The reader will understand that the embodiments described and illustrated herein are non-limiting examples and that specific structural and functional details disclosed herein are representative and illustrative. Variations and changes may be made to these embodiments without departing from the scope of the claims.
The term "comprises" (and any form of "comprising", such as "comprises" and "comprising)", "has" (and "has)", such as "has" and "has)", "contains" (and any form of "containing", such as "comprises" and "containing)", and "containing" (and any form of "containing", such as "containing" and "containing", are open-ended verbs. Thus, a surgical system, device, or apparatus that "comprises," "has," "contains," or "contains" one or more elements possesses those one or more elements, but is not limited to possessing only those one or more elements. Likewise, an element of a system, apparatus, or device that "comprises," "has," "includes," or "contains" one or more features has those one or more features, but is not limited to having only those one or more features.
The terms "proximal" and "distal" are used herein with respect to a clinician manipulating a handle portion of a surgical instrument. The term "proximal" refers to the portion closest to the clinician and the term "distal" refers to the portion located away from the clinician. It will be further appreciated that for simplicity and clarity, spatial terms such as "vertical," "horizontal," "up," and "down" may be used herein with respect to the drawings. However, surgical instruments are used in many orientations and positions, and these terms are not intended to be limiting and/or absolute.
Various exemplary devices and methods are provided for performing laparoscopic and minimally invasive surgical procedures. However, the reader will readily appreciate that the various methods and devices disclosed herein may be used in a variety of surgical procedures and applications, including, for example, in conjunction with open surgery. With continued reference to this detailed description, the reader will further appreciate that the various instruments disclosed herein can be inserted into the body in any manner, such as through a natural orifice, through an incision or puncture formed in tissue, and the like. The working portion or end effector portion of the instrument may be inserted directly into a patient or may be inserted through an access device having a working channel through which the end effector and elongate shaft of the surgical instrument may be advanced.
Various surgical instruments configured to secure tissue of a patient are disclosed herein. As discussed in more detail below, such surgical instruments include an end effector and a plurality of drive systems configured to perform various end effector functions. Such drive systems can include, for example, an anvil drive system configured to clamp tissue within the end effector, a staple firing system configured to deploy staples into tissue, and/or a tissue cutting system configured to cut tissue. Such drive systems may also include, for example, an articulation drive system configured to articulate the end effector, a tissue drive system configured to move the end effector relative to tissue, and/or a staple loading system configured to reload an end effector having staples. As also discussed in more detail below, two or more of the drive systems can be operably coupled to a common drive system such that the drive systems are operated in synchronization.
A
The handle 1100' is shown in fig. 8 and 10. The handle 1100' is similar in many respects to the
Referring again to fig. 1, the
In addition to the above, the
In various instances, the
Referring again to fig. 1, the
Referring primarily to fig. 3, the
Referring to fig. 4-6, the tissue drive system includes a
In addition to the above, the tissue drive system includes a first gear train configured to transmit rotation of the
The second gear train is similar in many respects to the first gear train, except that the second gear train does not include a transfer gear intermediate two spur gears, as described below. The second gear train includes a spur gear 1381b operatively intermeshed with
The presence of the
Once the
Notably, the
Referring again to fig. 3, there is a longitudinal gap between the
Referring again to fig. 1, the
Referring again to fig. 1, each
As described above, the
In addition to the above, the
FIG. 44 illustrates another exemplary embodiment of a reciprocating drive system. The drive system 2900 includes an electric motor 2930, a first drive system 2940 operatively coupled with the electric motor 2930, and a second drive system 2950 operatively coupled with the electric motor 2930. The electric motor 2930 includes a rotatable output shaft 2931 and a drive gear 2932 fixedly mounted to the output shaft 2931. First drive system 2940 includes an input gear 2942 that operably intermeshes with drive gear 2932. Input gear 2942 is fixedly mounted to drive shaft 2943 such that drive shaft 2943 rotates with input gear 2942. The first drive system 2940 also includes a barrel cam 2944 that is slidably mounted to the drive shaft 2943 and rotates with the drive shaft 2943. The barrel cam 2944 includes an aperture 2945 defined therein that includes a non-circular profile configured to transmit rotation between the drive shaft 2943 and the barrel cam 2944, but allow relative translation therebetween, for example. The barrel cam 2944 also includes a cam slot 2949 defined therearound that interacts with a cam pin 2919 mounted to the frame 2910 such that as the barrel cam 2944 rotates, the barrel cam 2944 also translates. The barrel cam 2944 translates distally when the barrel cam 2944 is rotated in a first direction and proximally when the barrel cam 2944 is rotated in a second or opposite direction. The first drive system 2940 further includes a drive shaft 2946 extending from a barrel cam 2944 configured to drive the first end effector function.
Second drive system 2950 includes an input gear 2952 that operatively intermeshes with drive gear 2932. The input gear 2952 is fixedly mounted to the drive shaft 2953 such that the drive shaft 2953 rotates with the input gear 2952. The second drive system 2950 also includes a barrel cam 2954 that is slidably mounted to the drive shaft 2953 and rotates with the drive shaft 2953. The barrel cam 2954 includes an aperture 2955 defined therein that includes a non-circular profile configured to transmit rotation between the drive shaft 2953 and the barrel cam 2954, but allow relative translation therebetween, for example. The barrel cam 2954 further includes a cam slot 2959 defined therearound that interacts with a cam pin 2919 mounted to the frame 2910 such that as the barrel cam 2954 rotates, the barrel cam 2944 also translates. The barrel cam 2954 translates distally when the barrel cam 2954 is rotated in a first direction and proximally when the barrel cam 2954 is rotated in a second or opposite direction. The second drive system 2950 also includes a drive shaft 2956 extending from a barrel cam 2954 configured to drive a second end effector function.
When the electric motor 2930 of the drive system 2900 is rotated in a first direction, the first drive shaft 2946 is advanced distally and the second drive shaft 2956 is retracted proximally. Accordingly, when the electric motor 2930 is operated in a second or opposite direction, the first drive shaft 2946 is retracted proximally and the second drive shaft 2956 is advanced distally. Other embodiments are contemplated in which the drive shaft 2946 and the drive shaft 2956 are advanced distally simultaneously.
Referring to fig. 92 and 93, a
As described above, the
As described above, the
As mentioned above, the stapling instruments disclosed herein, including the tissue drive systems, are configured to drive or advance themselves across patient tissue as they staple and cut the patient tissue along the staple firing path. In various circumstances, the thickness of the tissue can vary along the length of the staple firing path. In other words, the thickness of the tissue may increase and/or decrease in the anterior-posterior direction and/or the lateral left-right direction. Referring again to fig. 88 and 89, the degrees of freedom provided by
Referring now to fig. 87, the stapling instrument 4100 includes a distal stapling head 4120 that is similar to the
Referring now to fig. 37-41, a
Referring to fig. 38-40, the
Referring now to fig. 78-85, the
In addition to the above, referring to fig. 79-82,
In addition to the above, the
Fig. 86 illustrates an alternative embodiment of the cam path 4099 that includes a shoulder that prevents reverse movement of the
Referring to fig. 50-56, the
Referring to fig. 52-56, the
When the
Referring to fig. 57-59D, the
Referring primarily to fig. 57 and 58,
Referring to fig. 61 and 62, the surgical instrument 3300 includes a distal head 3320 and a laterally extendable drive foot 3380. The drive foot 3380 is coupled to the distal head 3320 via a flexible connector 3375 and an actuator 3370. When a compressive force is applied to actuator 3370, actuator 3370 is displaced and/or compressed, which causes connector 3375 to extend laterally and push corresponding drive foot 3380 laterally. When the compressive force is removed from the actuator 3370, the connector 3375 resiliently contracts and pulls the drive foot 3380 inward. The drive foot 3380 can include tissue gripping features defined thereon that are configured to push and/or pull on patient tissue as the drive foot 3380 moves laterally. Thus, the drive foot 3380 may produce relative motion between the distal head 3320 and the patient's tissue.
Referring to fig. 91A-91D, the stapling instrument 4400 includes a distal head 4420 which includes a tissue cutting drive 4440, a staple firing drive 4450 and a tissue drive including feet 4480. Each foot 4480 is rotatably mounted to the distal head 4420 about a pivot pin 4481 and is rotatable to drive the distal head 4420 relative to the patient tissue. FIG. 91 illustrates the foot 4480 in a retracted position. Fig. 91B shows the extended foot 4480. Fig. 91C shows the foot 4480 in a fully extended position. Fig. 91D shows the foot 4480 retracted. As the feet 4480 extend, the feet 4480 drive the distal head 4420 relative to the patient tissue. Notably, the feet 4480 are synchronized such that the feet extend and retract together, and in such instances, the feet 4480 can drive the distal head 4420 along a straight line, or at least substantially straight line. That is, one of the feet 4480 may extend while the other foot 4480 retracts. In such cases, the foot 4480 may rotate the distal head 4420 along a curved path.
Referring to fig. 76 and 77A-77D, the
As described above, the tissue drive system is configured to rotate the
Referring to fig. 63 and 64, the
Referring to fig. 94, the stapling instrument 4600 includes a distal head 4620 that includes a staple firing system 4650, an anvil 4660 and a tissue drive system. The tissue drive system includes a drive two drive wheels 4680, each rotatably supported by a separate pin extending through its center. Thus, the drive wheels 4680 may rotate independently. Each drive wheel 4680 includes an array of teeth extending therearound in meshing engagement with a drive shaft of the electric motor. In other words, the tissue drive system includes two electric motors configured to individually rotate the drive wheels 4680. Similar to the above, the teeth extending around the drive wheel 4680 are also suitably configured to engage and grip patient tissue. In use, the electric motor may be operated to rotate the drive wheel 4680 to create relative motion between the distal head 4620 and the patient tissue and to move the distal head 4620 along the staple firing path, as described in more detail below.
In addition to the above, the tissue drive system is configured to rotate the drive wheels 4680 in the same direction and at the same speed to move the distal head 4620 along a straight staple firing path. The tissue drive system is further configured to rotate the wheels 4680 in the same direction but at different speeds to rotate the distal head 4620 along a curved staple firing path. In such cases, the distal head 4620 may be gradually rotated. The tissue drive system is further configured to rotate only one of the drive wheels 4680 without rotating the other drive wheel 4680 to rotate the distal head 4620 along the curved staple firing path. In addition, the tissue drive system is further configured to rotate the drive wheel 4680 in the opposite direction to rotate the distal head 4620 along a curved staple firing path having a small or small radius of curvature.
The tissue drive system also includes a lateral drive wheel 4670 positioned laterally relative to the drive wheel 4680. Similar to the above, each lateral drive wheel 4670 is operably coupled to a different electric motor. Thus, the tissue drive system of the stapling instrument 4600 includes four electric motors that can be operated simultaneously or non-simultaneously. The lateral drive wheels 4670 can operate independently of the drive wheels 4680, but these lateral drive wheels can operate simultaneously with one or both of the drive wheels 4680. Further, the lateral drive wheels 4670 can be operated independently with respect to each other. Similar to the drive wheel 4680, the tissue drive system is configured to rotate the lateral drive wheels 4670 together at the same speed, at different speeds, and/or in different directions to move the distal head 4620 along the staple firing path. Further, the tissue drive system can be configured to rotate any suitable combination of the drive wheel 4670 and the drive wheel 4680 in any suitable direction and at any suitable speed to move the stapling instrument 4600 along a desired staple firing path.
Referring to fig. 36, the
Referring now to fig. 75A-75D, the stapling instrument 3700 includes a distal head 3720 that includes an anvil 3760 and a tissue drive system that includes a tissue drive foot 3780. The stapling instrument 3700 is similar in many respects to the
Referring now to fig. 65-69, the stapling instrument 3500 includes a distal head 3520 that includes an anvil 3560 and a tissue drive system that includes a vacuum supply line 3570, two
As described above, extension of the
Once the patient tissue is positioned within tissue chamber 3525, the tissue can be sutured and/or incised. The supply line 3570 does not supply a vacuum pressure differential during the stapling and/or cutting operation, as doing so may extend the
Referring to fig. 70-73, the
An alternative embodiment of a stapling instrument 3600' is shown in fig. 74. The stapling instrument 3600' is similar in many respects to the
Referring now to fig. 47A-47G, the stapling instrument 3000 includes a distal head 3020 that includes a staple firing system, an anvil closure system that includes an anvil 3060, a tissue drive device that includes at least one drive foot 3080, and a tissue holder 3070 that is configured to releasably hold tissue. Referring to fig. 47A, the anvil 3060 is movable from a clamped position to an undamped position to unclamp the patient tissue T. Referring to fig. 47B, the tissue holder 3070 can engage the patient tissue T to hold the tissue in place as the drive feet 3080 are extended, as shown in fig. 47C and 47D. The tissue holder 3070 can engage tissue when the anvil 3060 is opened and/or after the anvil 3060 has been opened. In either case, referring to fig. 47E, the tissue holder 3070 is disengaged from the tissue before the drive foot 3080 is retracted to draw the distal head 3020 relative to the tissue and position the distal head 3020 at a new position along the staple firing path, as shown in fig. 47F. At this point, referring to FIG. 47G, the patient tissue is clamped by the anvil 3060 and the staple firing system is operated to staple the tissue. At this point, the cycle can be repeated.
As shown in fig. 47D-47F, the drive foot 3080 is in fluid communication with a vacuum source 3090. Similar to the above, the drive foot 3080 can utilize a vacuum pressure differential from the vacuum source 3090 to grip the patient tissue. Also similar to the above, a vacuum pressure differential from the vacuum source 3090 can be used to extend the drive foot 3080. That is, the drive foot 3080 can be extended using any suitable mechanism.
Referring again to fig. 78, the
For example, fig. 45, 46, 48, and 49 illustrate operational sequences of a stapling instrument that may be used with the stapling instruments disclosed herein (such as stapling instrument 4000 and/or
Referring again to fig. 49, operation 4001 comprises loading a staple cartridge into the stapling instrument 4000 and/or pushing the staple cartridge into position within the stapling instrument 4000. Operation 4002 comprises removing staples from the staple cartridge and operation 4003 comprises placing the staples in place within a staple firing drive 4050. If desired, operation 4004 comprises articulating an end effector of the stapling instrument 4000. That is, operation step 4004 may also occur before and/or during steps 4001, 4002, and/or 4003. Operation 4005 comprises positioning the end effector on tissue of a patient, and
In addition to the above, operation 4007 comprises forming staples against an anvil, and operation 4008 comprises deploying a knife of the tissue cutting system 4040. Operation 4007 occurs before operation 4008, but step 4007 and step 4008 may occur simultaneously or with some amount of overlap. Operation 4009 comprises retracting the knife using the tissue cutting system 4040, and this step follows operation 4008. Operation 4010 comprises using tissue gripping system 4090 to grip and hold patient tissue positioned within an end effector of stapling instrument 4000.
In addition to the above, FIG. 46 shows that certain operational steps may occur simultaneously or with some amount of overlap. For example, the
In addition to the above, fig. 45 illustrates an actuation cycle of
As described above, it may be desirable to perform certain operational steps of the stapling instrument 4000 sequentially while performing other operational steps simultaneously. However, in some cases, it may not be desirable to perform certain operational steps at this time. Thus, the stapling instrument 4000 is configured to latch certain drive systems and prevent those drive systems from being operated while other drive systems of the stapling instrument 4000 are being operated. The latch may comprise, for example, a mechanical latch and/or an electrical latch. All of the drive systems of the stapling instrument 4000 are motorized and in communication with the controller of the stapling instrument 4000, and thus the controller can be used to lock the drive systems. The controller includes a microprocessor, for example, configured to enable electrical latching of one or more drive systems during operation of one or more other drive systems. FIG. 48 is a chart showing which operational steps are prevented from being performed during the performance of other operational steps. For example, during step 4001, in which the staple cartridge is loaded into position, all other operational steps are locked out or prevented from occurring except for step 4004, which articulates the end effector of the stapling instrument 4000, step 4005, which positions the stapling instrument 4000 relative to the tissue, and
Referring to fig. 90A-90D, the
As described above,
As noted above, the stapling instruments disclosed herein are configured to staple tissue of a patient. These stapling instruments are also configured to cut the tissue. Referring to fig. 95 and 96, the
In addition to the above, the
Referring to fig. 98, the
As described above, the
Referring primarily to fig. 97, 100, and 102, the staple advancement system 5190 includes a
The
Referring to fig. 104-105D, the stapling instrument 5200 includes a
Referring to fig. 104 and 105A, the staple firing drive 5250 further comprises longitudinal staple drivers 5257 that are driven along a longitudinal staple firing path by the lateral staple drivers 5254. Each lateral staple driver 5254 includes a drive cavity 5256 defined therein that receives a portion of the longitudinal staple drivers 5257 therein. More specifically, each longitudinal staple driver 5257 includes a cam portion positioned in the drive cavity 5256 that is longitudinally driven by a cam surface 5258 defined in the drive cavity 5256 as the lateral staple drivers 5254 are laterally moved, as shown in fig. 105B. As a result of the above, rotational movement of the rotatable actuator 5252 is converted into lateral translation of the lateral staple drivers 5254, which is converted into longitudinal translation of the longitudinal staple drivers 5257. The longitudinal movement of the staple drivers 5257 drives the staples 5230 against the anvil 5260 to deform the staples 5230 as illustrated in FIG. 105B. The longitudinal staple drivers 5257 comprise staple supports 5251 defined therein that are configured to support the staples 5230 as the staples 5230 are deformed.
In addition to the above, referring to fig. 105C, the return lateral movement of the staple drivers 5254 retracts the longitudinal staple drivers 5257 to their unactuated position. More specifically, the drive cavity 5256 further comprises camming surfaces 5258' configured to drive the longitudinal staple drivers 5257 in opposite directions until the staple drivers 5257 are reset in their unactuated or unfired positions, as illustrated in fig. 105D. Notably, when the longitudinal staple drivers 5257 are retracted, the anvil 5260 is moved to an open position. At this point, the
As described above, the connected rows of staples can be used to feed and re-feed the staple firing system of the stapling instrument. In other instances, the entire staple cartridge can be used to feed and re-feed the staple firing system. Referring to fig. 106, the
In addition to the above, referring to fig. 107, a
In addition to the above, the
Referring to fig. 109 and 110, the stapling instrument 5400 includes a shaft 5410, a distal head, a staple loading system, a staple firing system, a tissue cutting system, an anvil closure system, and a system configured to move the distal head relative to tissue of a patient. Stapling instrument 5400 also includes
Referring to fig. 111 and 112, the stapling instrument 5500 includes a shaft 5510, a distal head, a staple loading system, a staple firing system, a tissue cutting system, an anvil closure system, and a system configured to move the distal head relative to the tissue of a patient. The stapling instrument 5500 also includes a first strip of staples 5530a "and a second strip of staples 5530 b" stored in a shaft 5510. Strip staples 5530a "and 5530 b" are comprised of
Referring to fig. 113 and 114, the stapling instrument 5600 includes a shaft 5610, a distal head, a staple loading system, a staple firing system, a tissue cutting system, an anvil closure system, and a system configured to move the distal head relative to the patient's tissue. Stapling instrument 5600 also includes a first staple bar 5630a "and a second staple bar 5630 b" stored in shaft 5610. Staple strips 5630a "and 5630 b" are comprised of
Referring again to fig. 106, the
Staple strips 5730' are stored in the shaft of the stapling instrument 5700. In the stored condition of spike 5730', the spike is planar or at least substantially planar. More specifically, referring to fig. 115 and 116,
Referring to fig. 115 and 118, nailing
In addition to the above, stapling instrument 5700 is configured to separate a staple cluster from
Referring to fig. 119, a staple cluster 5830' includes four
In addition to the above, the staple cluster 5830' includes two
Referring to fig. 120, the
In addition to the above, each staple cluster 5930' includes one or more guides 5935.
Referring to fig. 121, in addition, the stapling instrument 6000 includes a shaft, a distal head 6020 that includes an anvil 6060, and a staple firing system. In this embodiment, the staple firing system loads the staples 6030 into the distal head 6020 and fires the staples by pushing the staples against the anvil 6060. The distal head 6020 includes staple cavities 6021 defined therein that are configured to store and guide the staples 6030 as they are pushed toward the anvil 6060.
Referring to fig. 122-125, the
Referring to fig. 126-137, the
Similar to fig. 127, fig. 129A shows the
Referring again to fig. 134, the sides of the
The stapling instruments disclosed herein can be configured to deploy staples in a suitable staple pattern. Fig. 138 illustrates one exemplary staple
Referring to fig. 140 and 141, the
Referring to fig. 141, the
Referring to fig. 158 and 159, the suturing apparatus 7300 includes a shaft 7310, a distal head 7320, and an articulation joint 7370 that rotatably connects the distal head 7320 to the shaft 7310. In use, the suturing apparatus 7300 is inserted into the body of patient P through trocar TC. Trocar TC includes a passageway extending therethrough that allows distal head 7320 and a portion of shaft 7310 to be inserted into a patient. In other instances, the distal head 7320 may be inserted into the patient through an open incision without a trocar. In either case, the stapling instrument 7300 is configured to deploy staples from a staple cartridge inserted therein. The shaft 7310 includes a loading port 7312 that communicates with a cartridge passageway or passage extending through the shaft 7310, the articulation joint 7370, and the distal head 7320. In use, a staple cartridge (such as staple cartridge 7330') is inserted into shaft 7310, e.g., through loading port 7312, and then pushed into distal head 7320. The stapling instrument 7300 further includes a cartridge pusher system configured to push the staple cartridge 7330' into the end effector 7300.
In various instances, in addition to the above, the staple cartridge 7330' may be fed into the stapling instrument 7300 such that the stapling instrument 7300 may be continuously operated without being removed from the patient for reloading. Each staple cartridge 7330' has stored therein staples having a first size (such as a first unfired height). In some instances, it is desirable to form staple lines having staples all of the same size or unfired height. Such a situation may occur when the tissue being stapled has a substantially uniform thickness. In other instances, it may be desirable to form staple lines having staples of different sizes or unfired heights. Such a situation may occur when the tissue being stapled does not have a uniform thickness. For example, stomach tissue transected during a gastric volume reduction procedure typically does not have a consistent thickness. In such instances, a first staple cartridge 7330' having staples of a first unfired height may be loaded into the stapling instrument 7300, and a second staple cartridge 7330 "having staples of a second unfired height may be loaded into the stapling instrument 7300. The first unfired height is higher than the second unfired height, but the first unfired height may be lower than the second unfired height. Similarly, a third staple cartridge 7330 "' having staples with a third unfired height that is different from the first unfired height and the second unfired height may be loaded into the stapling instrument 7300.
In addition to the above, more than one staple cartridge may be loaded into the stapling instrument 7300. The staple cartridges may be inserted into the stapling instrument 7300 such that the staple cartridges are used in a particular order. For example, a staple cartridge having a lower unfired height may be fired prior to firing a staple cartridge having a higher unfired height. Alternatively, a staple cartridge having a higher unfired height may be fired prior to firing a staple cartridge having a lower unfired height. In any event, the most distal staple cartridge is used first, and the most proximal staple cartridge is used last. This arrangement allows for pre-planning of the surgical procedure, thereby wasting little time (if any) to load the stapling instrument 7300 during the surgical procedure. Alternatively, the staple cartridges may be fed into the stapling instrument 7300 one at a time. Such an arrangement provides the clinician with an opportunity to change the order of end-use of the staple cartridges.
The loading port 7312 includes an opening accessible from the exterior of the shaft 7310, but the loading port 7312 may be defined in the handle of the stapling instrument 7300 or in any other suitable location. In various instances, the suturing apparatus 7300 can also include a door configured to cover the loading port 7312. In at least one instance, the door can be sealed when closed to prevent or inhibit the ingress of fluids and/or contaminants into the stapling apparatus 7300. In such cases, the door and/or housing of shaft 7310 may include one or more seals.
Referring primarily to fig. 159, a stapling instrument 7300 includes a system for stripping a cluster of staples (such as staples 7330), for example, from a distal-most staple cartridge. The stapling instrument 7300 further comprises a staple firing system 7350 configured to deploy the staples 7330 and deform the staples 7330 against the anvil 7360 during a staple firing stroke. The stapling instrument 7300 further includes a tissue drive system 7380 configured to move the distal head 7320 relative to the patient tissue after a staple firing stroke.
Referring to fig. 168 and 169, the
In addition to the above, referring again to fig. 168 and 169, the
Referring to fig. 169, the
In various embodiments, the
In addition to the above, the articulation joint 7970 of the
Referring to fig. 170, the stapling instrument 8000 includes a damping system 8080 that is configured to control or slow the articulation of the
Referring to fig. 171, the
Referring to fig. 172, a
Referring to fig. 34 and 35, the stapling instrument 2500 includes a shaft 2510, a distal head 2520, and an articulation joint 2570 rotatably connecting the distal head 2520 to the shaft 2510. The shaft 2510 extends along a longitudinal shaft axis LA, and the distal head 2520 extends along a longitudinal head axis HA. When the distal head 2520 is not articulated, the shaft axis LA and the head axis HA are aligned, as shown in fig. 34. Referring to fig. 35, when the distal head 2520 is articulated, the head axis HA is transverse to the shaft axis LA. The stapling instrument 2500 further comprises a damping system 2580 configured to control or slow the articulation of the distal head 2520. Damping system 2580 includes a first connection 2581, a second connection 2582, and a damper 2585. First link 2581 is pinned to distal head 2520 at pivot 2584. First link 2581 is also pinned to second link 2582 at pivot 2583. The pivots 2583 and 2584 allow the damping system 2580 to accommodate various articulation of the distal head 2520. Referring to fig. 34, when distal head 2520 is not articulated, first connector 2581 is aligned with second connector 2582 along the longitudinal axis. Referring to fig. 35, as distal head 2520 is articulated, first connector 2581 is transverse to second connector 2582.
The dampener 2585 includes a housing mounted to the shaft 2510 and a dampening medium 2586 contained in a chamber defined in the housing. Second connector 2582 includes a piston defined on a proximal end thereof that is positioned in the housing bore and is configured to move through damping medium 2586 as distal head 2520 is articulated. Damping medium 2586 flows through and/or around the piston, allowing but slowing relative movement between the piston and the housing. Accordingly, the damping medium 2586 allows but slows the movement of the distal head 2520 relative to the shaft 2510. For example, damping medium 2586 may include any suitable medium, such as damping foam.
The
In addition to the above, the
Referring to fig. 14,
Referring to fig. 17, the
Referring to fig. 15, the
Referring to fig. 16, the
Turning now to fig. 18, the
In addition to the above, referring again to fig. 18, the
As described above, the speed at which the staple firing system and/or the tissue drive system of the
Referring to fig. 20, the stapling instrument 2200 includes a display 2230. The stapling instrument 2200 is similar in many respects to the
In addition to the above, the display 2230 can be configured to display one or more alternative staple firing paths. For example, the display 2230 is configured to display an alternative staple firing path 2243' in the central image window 2235. Similar to staple firing path 2243, staple firing path 2243 'is shown as a series of actuations or staple firings 2244'. Each projected actuation 2244' shows the path along which the tissue T is to be cut and the location at which the staple cluster 2245 is to be deployed in the tissue T. The
As described above, the staple firing path 2243 can be modified to an alternative staple firing path 2243'. The staple firing path 2243 and an alternative staple firing path 2243' are displayed in an image that overlays the video image from the camera. The staple firing path 2243 and the alternative staple firing path 2243' are shown in the same image stack or layer, but may be shown in different image stacks or layers. In at least one such instance, staple firing paths 2243 are displayed in a first image stack or layer, and alternative staple firing paths 2243 are displayed in a second image stack or layer that is different from the first image stack. The screen of the display 2230 is configured to receive input commands from the central image window 2235 that can drag a staple firing path 2243 and/or an alternative staple firing path 2243' within one or more image stacks. The screen of the display 2230 is configured to be responsive to the user's fingers such that the staple firing path can be modified by the user dragging his or her fingers. Referring to fig. 21, the screen of the display 2230 is further configured to be responsive to, for example, a stylus 2220.
As described above, the display 2230 can be configured to display a current or expected staple firing path and one or more alternative staple firing paths. The controller of the stapling instrument 2200 is configured to generate one or more alternative staple firing paths and display these alternative staple firing paths on the display 2230. In various circumstances, the controller can determine an alternative staple firing path based on one or more properties of the tissue T being stapled. For example, a controller that manipulates the stapling instrument 2200 around blood vessels within the tissue T may identify those blood vessels and provide or suggest an alternative staple firing path.
Referring to fig. 22, the display 2230 includes a menu including a plurality of controls configured to modify the staple firing path as the stapling instrument 2200 deploys the staple path and/or after the stapling instrument 2200 has stopped. The display 2230 includes a
In addition to the above, the shaft assembly attached to the handle of the stapling instrument 2200 may be rotatable relative to the handle. The shaft assembly includes a rotatable slip joint configured to allow the distal head of the shaft assembly to rotate relative to the handle, although any suitable arrangement may be used. Due to this sliding joint, a user of the stapling instrument 2200 may selectively orient the display 2230 relative to the distal head of the stapling instrument 2200. In such cases, the user may, for example, maintain the orientation of the display 2230 relative to the patient even though the distal head is rotating to follow the staple firing path. Similarly, fig. 144-146 illustrate the
Referring to fig. 147-150, the
Fig. 180 illustrates a handle 1500 of the surgical instrument 100 for use by a clinician during a surgical procedure. The handle 1500 includes a central portion 110 that abuts one or more ergonomic grips 120 to facilitate manipulation of the surgical instrument 100 by a clinician. Each ergonomic grip 120 is configured to fit a clinician's hand to enhance control and comfort. The handle 1500 includes one or more interactive controls 180 configured to provide navigation commands to the end effector of the surgical instrument 100. In various instances, the one or more interactive controls 180 are configured to be capable of providing user commands corresponding to selection of one or more items. Interactive control 180 is positioned on handle 1500 at a location that allows the clinician to easily perform operations, such as a location within the reach of the clinician's thumb. In various instances, the controls 180 are comprised of, for example, various types of switches and/or buttons. In various instances, interactive controls 180 include, for example, a toggle switch, a simulated lever, a rocker, a cross key, and/or any other suitable interactive controls capable of facilitating communication of user commands to the controller of surgical instrument 100.
The handle 1500 also includes a touch
To create a sterile environment for the surgical instrument 100, a
Fig. 182 illustrates a touch
The
The touch
Fig. 183 shows the touch-
FIG. 184 illustrates the location and arrangement of active pixel clusters within the x electrode 1542 of a touch-sensitive display 1510A graphical representation 1550 of the relationship between capacitances detected by
Returning to fig. 182, touch
Referring to fig. 24, the
Referring again to fig. 24, the image of the tissue T may be a substantially two-dimensional image of the top of the tissue T. In such cases, the controller is configured to map a two-dimensional staple firing path on the tissue T. Referring to fig. 25, the image of the tissue T may be a three-dimensional image viewed on the surface of the tissue T. In such cases, the controller is configured to map the three-dimensional staple firing path on the tissue T. In either case, stylus 2220 and/or the patient's finger may be used to establish and/or modify the staple firing path. Referring to fig. 26 and 27, the
Referring again to fig. 26 and 27, the
As mentioned above, referring now to FIG. 23, the
In addition to the above, the on-
When modifying a first laminate or layer on one of
While the staple firing paths and/or other images projected into the above-described on-board and off-board displays are highly conducive to producing a desired staple firing path, the stapling instrument can include one or more projectors configured to display images onto patient tissue that can assist a user of the stapling instrument in producing a desired staple firing path. Referring to fig. 160 and 161, the
Referring to fig. 162, the stapling instrument 7500 includes a shaft 7510, a distal head 7520, and an articulation joint 7570 that rotatably couples the distal head 7520 to the shaft 7510. The stapling instrument 7500 also includes a projector 7590 that extends along an edge of the shaft 7510. The projector 7590 includes a flexible tube mounted to a shaft 7510 and a distal head 7520 and is configured to bend as the distal head 7520 articulates. Thus, the image I projected by the projector 7590 tracks the orientation of the distal head 7520 and may be projected distally relative to the anvil 7560 of the stapling instrument 7500. Projector 7590 includes a lens and is configured to project an image I; however, various alternative embodiments are contemplated in which the projector includes more than one lens and/or may project more than one image onto the patient tissue.
Referring again to fig. 160, the
In some cases, in addition to the above, the
Referring to fig. 165, the stapling instrument 7700 includes a distal head 7720 positioned on a first side of the patient tissue T and an anvil 7760 positioned on a second side of the patient tissue T. Similar to the other stapling instruments disclosed herein, the stapling instrument 7700 is configured to deploy staples 7730 into tissue T and cut into tissue T along an incision 7740 during a series of staple firing strokes. The stapling instrument 7700 further includes a projector 7770 configured to project the image I onto the tissue T. Image I in fig. 165 represents the position of the next firing stroke, which includes the two lateral regions in which the staple cluster will be applied. Referring to fig. 166, the image projected by the projector 7770 includes lines designating staple firing paths FP and/or lines designating alternative staple firing paths FP'. These lines may be, for example, solid and/or dashed lines. The lines may be of the same color or different colors.
In addition to the above, the controller of the stapling instrument 7700 is configured to modify the images projected by the projector 7770 as the stapling instrument 7700 is moved or advanced along the staple firing path. The controller may continuously evaluate and determine where the next firing stroke should occur, and also continuously adjust the images projected by the stapling instrument 7700. In various circumstances, the controller may update the projected image after each firing stroke, for example. In some cases, the controller may use projector 7770 to continuously project an image or series of images, while in other cases, the controller may use projector 7770 to intermittently project an image or series of images. In at least one instance, the controller can display an image using the projector 7770 before the stapling instrument 7700 grips tissue. In such instances, the user of the stapling instrument 7700 has the opportunity to pause or stop the stapling instrument 7700 before it makes another staple firing stroke.
Referring to fig. 167, the stapling instrument 7800 includes a distal head 7820 positioned on a first side of a patient's tissue T and an anvil 7860 positioned on a second side of the patient's tissue T. Similar to the other stapling instruments disclosed herein, the stapling instrument 7800 is configured to deploy staples 7830 into tissue T and incise the tissue T along an incision 7840 during a series of staple firing strokes. The stapling instrument 7800 also includes a projector 7870 that includes a first lens 7872 and a second lens 7874. First of allThe lens 7872 is configured to enable the first image I1Projected onto patient tissue T, and a second lens 7874 is configured to enable a second image I2Projected onto the patient tissue T. Image I1The position of the next staple cluster is shown, and image I2The cutting path of the stapling instrument 7800 is shown, but any suitable image may be projected. Image I1And I2May be, for example, solid and/or dashed lines. Image I1May be associated with image I2The same color or a different color.
As described above, the stapling instrument disclosed herein can include at least one projector for projecting an image onto patient tissue and at least one camera for viewing the patient tissue. Referring to fig. 163 and 164, the stapling instrument 7600 includes a shaft, a distal head, and a video system. The video system includes at least one image projector 7690 and a camera system 7670 that includes at least one camera, such as a first camera 7672 and a second camera 7674, for example, in communication with the controller. The first camera 7672 points in a first direction and focuses on a first region F1 of the patient's tissue, and the second camera 7674 points in a second direction and focuses on a second or different region F2 of the patient's tissue. In various instances, the controller is configured to present two images on the surgical instrument display at the same time or at different times so that the user can toggle back and forth between the images. In some cases, the controller is configured to generate and present a composite image on the surgical instrument display using images from the first camera 7672 and the second camera 7674.
In addition to the above, the first camera 7672 comprises a digital camera configured to be capable of providing a first digital video stream to the controller, and the second camera 7674 comprises a digital camera configured to be capable of providing a second digital video stream. The camera system 7670 also includes a first actuator system configured to enable movement of the first camera 7672 and/or a second actuator system configured to enable movement of the second camera 7674. In other embodiments, one or more of the orientations of the camera 7672 and the camera 7674 are fixed. In any case, the image I projected onto the patient tissue by the projector 7690 can be captured by the first camera 7672 and/or the second camera 7674 and can be viewed by a user of the surgical instrument 7600 through the surgical instrument display.
In addition to the above, projector 7690 and/or any of the projectors disclosed herein are configured to emit light of any suitable wavelength. In various instances, the projector 7690 emits, for example, visible light, infrared light, and/or ultraviolet light. In addition, when visible light is reflected off of the tissue, the visible light is useful for the clinician to view the color of the tissue. Red or pink tissue indicates healthy vascularized tissue, while dark or black tissue may indicate unhealthy tissue. Also in addition to the above, the camera system 7670 is configured to capture, for example, visible light, infrared light, and/or ultraviolet light. Infrared light indicates, for example, the presence of heat, such as from a large blood vessel. Ultraviolet light indicates the presence of blood or bleeding, for example. In addition to or in lieu of the above, the projector may be configured to emit acoustic, infrasonic, and/or ultrasonic waves, and the surgical instrument may include one or more acoustic sensors configured to detect waves reflected off patient tissue and generate data that may be used by the controller to generate a three-dimensional profile of the patient tissue.
Referring to fig. 142, the stapling instruments described herein are configured to repeatedly fire staples into tissue of a patient, such as a patient' S stomach S. Many of the stapling instruments disclosed herein are self-driven, self-advancing, and/or self-steering in that they are sufficiently electrically powered so that they can follow and advance themselves along an intended or modified staple firing path FP as staples, such as
In addition to the above, many of the stapling instruments disclosed herein can be at least partially rotated between staple firings. Accordingly, such stapling instruments may follow complex and/or non-linear staple firing paths. Referring to fig. 174, prior stapling instruments have been configured to deploy linear staple line portions 8230', such as
The stapling instruments disclosed herein may be used to perform any suitable surgical procedure. For example, referring to fig. 179, the stapling instrument disclosed herein can be used to create a gastric pouch SP during a gastric bypass procedure and thus effectively reduce the size of a patient' S stomach S. Because these stapling instruments may form a curved staple path 7930', the curved staple path forms a curved gastric pouch SP. Referring to fig. 178, previous stapling instruments will generate a staple path including linear portions 8230' that form a square stomach pouch SP or a stomach pouch SP with right angle corners. It is believed that the extent of a leak in the curved gastric pouch SP produced by the stapling instrument disclosed herein will be less than the extent of a leak in the linear gastric pouch SP produced by a prior stapling instrument.
As described in greater detail herein, referring to fig. 177, the stapling instrument disclosed herein can be used to create a gastric sleeve SS during a gastric reduction procedure and thus effectively reduce the size of a patient' S stomach S. Due to the system of stapling instruments disclosed herein, these stapling instruments can form a curved staple path 7930 ', which curved staple path 7930' forms a curved gastric sleeve SS. Referring to fig. 176, the prior stapling instrument will generate a staple path that includes linear portions 8230 'that form a linear gastric sleeve SS or a gastric sleeve SS having a right angle corner 8235'. It is believed that the degree of leakage of curved gastric sleeve SS produced by the stapling instrument disclosed herein is less than the degree of leakage of linear gastric sleeve SS produced by prior stapling instruments. Additional details for forming the gastric sleeve SS are shown in fig. 151, wherein a staple firing path FP is used to cut the gastric sleeve SS from the patient' S stomach S.
In addition to the above, gastric bypass surgery and gastric sleeve surgery help to reduce weight and are used to treat severe obesity. Both procedures are used to greatly reduce the size of the stomach in order to limit food intake. Gastric bypass surgery involves creating a small section of stomach for receiving food and obstructing the rest of the stomach. In addition, limiting the size of the stomach serves to limit the amount of fat and calories absorbed into the patient. Gastric bypass surgery creates a direct path from the small stomach segment to the lower intestine. Thus, in such cases, this direct route eliminates the use of the upper intestine during digestion.
Gastric sleeve surgery involves creating a sleeve-like path from the esophagus, through the stomach, and to the upper intestine. Laparoscopic Sleeve Gastrectomy (LSG) is a type of gastric sleeve procedure that involves transecting and sealing a substantial portion of the stomach to form a small gastric reservoir or pouch. Unlike gastric bypass surgery, it has been found that LSG surgery does not cause reduced absorption of nutrients and/or does not eliminate the use of any portion of the intestine. However, LSG surgery still serves to significantly reduce the size of the patient's stomach. In such LSG procedures, a long and thin flexible member, i.e., bougie, may be used as a measurement tool. More specifically, the bougie may be used to determine or define the size and shape of the stomach that becomes the gastric sleeve at the completion of the LSG procedure. Bougies B are shown in fig. 30 and 32. Bougies are manufactured in a variety of sizes to accommodate different stomach sizes. The appropriate size of bougie is typically determined based on the stomach size and the expected gastric sleeve size. During the initial steps of the LSG procedure, the surgeon inserts a bougie through the patient's mouth, down the esophagus, and through the esophageal sphincter to finally reach the patient's stomach. Once the bougie reaches the patient's stomach, the bougie is placed so that the end of the bougie reaches the pyloric canal, which is the lower region of the stomach that connects to the pylorus.
Fig. 28 illustrates various portions of the stomach anatomy involved during various steps of the LSG procedure. In particular, fig. 28 shows the stomach prior to insertion of the bougie B into the stomach S during the LSG procedure. As shown in fig. 28, omentum O, which is a double layer of adipose tissue, is attached to the outer layer of stomach S. Omentum O includes two portions, the greater omentum and the lesser omentum. The greater omentum serves to store fatty deposits, and the smaller omentum connects the stomach S and intestine to the liver. The stomach S includes a plurality of regions shaded based on the tissue thickness of the stomach S. The tissue thickness of the stomach S forms a first shadow S1aAnd a second shadow S1a. Shadow S1aAnd S1bVaries according to the thickness of the stomach S. As further shown in FIG. 28, a first shadow S1aAlong the greater curvature GC of the stomach S, and a second shade S1bAlong the lesser curvature LC of the stomach S. As discussed in more detail below, the shading S1aAnd S1bFor determining or estimating the thickness of the stomach S along the major and minor curves GC and LC, respectively. Once the thickness of the stomach S is determined or estimated, the thickness is used to determine the bougie B relative to the calculated hatching S as shown in FIG. 28LTo the appropriate size and location.
Fig. 33 illustrates another view of the stomach anatomy according to various embodiments. The stomach is as shown in fig. 28 The anatomical structure is similar, and the tissue thickness of the stomach S forms a first shadow S1And a second shadow S2. Similar to that discussed above, the first shade S1Appears along the major bend GC and is shaded with a second shade S2Along the small bend LC. First shade S1And the second shadow S2At point S3Where they intersect. During gastric sleeve surgery, the pylorus PxAnd point S3Is used for determining the position of the pylorus PxThe position of the cut line C1 offset by a distance a. As shown in fig. 33 and described in more detail below, the sleeve diameter D is determined based on the estimated tissue thickness.
Fig. 152 shows various portions of the stomach involved in various steps of the LSG procedure. In particular, fig. 152 shows an early step of the LSG procedure, wherein a bougie B is inserted into the stomach S. At the beginning of the LSG procedure, the surgeon inserts a bougie through the patient's mouth, down the esophagus E and through the esophageal sphincter to finally reach the patient's stomach. Once the bougie B reaches the patient's stomach, the bougie B is positioned such that the end of the bougie B rests in the pyloric canal PC and stops at the pyloric sphincter PS. As also shown in FIG. 152, bougie B is configured to be positioned along the shape and length of stomach S and along the angular notch AN of lesser curvature LC. As will be described in greater detail below with reference to fig. 153, a bougie 7210 can be used that includes magnetic properties configured to interact with a
Referring again to fig. 152, once the bougie is placed in its final position, the distance D1 is measured along the pyloric antrum PA of the greater curvature GC. Distance D1 is used to determine pylorus PxAnd is used to determine the location of cut line C1. The
In some cases, a clinician may estimate the appropriate staple firing path in the patient's stomach by observing certain anatomical landmarks on the stomach and/or at other locations within the surgical site. Referring to fig. 152, a stapling instrument (such as stapling instrument 7100) disclosed herein, for example, is configured to sense anatomical landmarks within a patient to determine an appropriate staple firing path. In addition to the above, the stapling instruments disclosed herein can include one or more cameras configured to sense or detect one or more anatomical landmarks, and further include a controller configured to calculate a staple firing path based on the detected anatomical landmarks. In at least one instance, the stapling instrument is configured to detect the lesser curvature of the stomach and calculate a staple firing path in the stomach tissue that is parallel, or at least substantially parallel, to the lesser curvature. Other anatomical landmarks of the patient's stomach that may be detected and used to determine the staple firing path include, for example, the angular notch, esophageal sphincter, angle of His, pyloric sphincter, and/or the pyloric antrum.
As described above, the lesser curvature of the stomach may be used to determine the staple firing path. In each case, however, the lesser curvature is at least partially obscured by fat and/or connective tissue. That is, the lesser curvature, the lesser omentum, and any overlap between the lesser curvature and the lesser omentum, for example, may be visually distinguished. More specifically, the uncovered stomach tissue has a first color, the omentum has a second color different from the first color, and the overlap between the uncovered stomach and the omentum has a third color different from the first color and the second color. These colors can be detected by the stapling instrument to determine the appropriate staple firing path. In some cases, the color of the stomach tissue under the omentum produces a shadow that can be detected by the stapling instrument. Other methods may be used to determine the appropriate position of the staple firing path.
In addition to the above, the gastric sleeve SS formed during gastric bypass surgery must have a sufficiently large digestive pathway defined therein for food to pass therethrough. Thus, referring now to fig. 29, the staple firing path through the patient' S stomach S must be sufficiently spaced from the lesser curvature of the stomach to form an adequate digestive tract D. The stapling instruments disclosed herein can be configured to detect the lesser curvature of the stomach and calculate a staple firing path, such as staple firing path SP 1E.g., it is at a distance X from the edge of the stomach S. In other instances, the stapling instruments disclosed herein can be configured to detect the lesser omentum LO adjacent to the lesser curvature of the stomach and fire the staples along the path SP1Calculated, for example, as a preset or predetermined distance X from the periphery of the stomach S.
As described above, detecting the margins of the stomach S can be difficult. In certain instances, the stapling instrument disclosed herein can include a camera system configured to be able to observe the color of the stomach tissue and/or changes in the color of the stomach tissue in order to determine the margins of the stomach S. In various instances, the stapling instruments disclosed herein can be configured to detect the margins of the stomach by evaluating the thickness of the stomach tissue and/or changes in the thickness of the stomach tissue. The tissue of a patient's stomach is generally thinner around the periphery or edges of the stomach than in the middle of the stomach, and it has been observed that the color of stomach tissue generally depends on its thickness. In other words, the tissue surrounding the periphery of the stomach appears to have a shade or darker color due to its thinner thickness. In fig. 29, the shaded area S1By a distance Z1And (4) defining. Distance Z1Also defined is a region T from the thinner tissue of the stomach S to the entire tissue thickness 1The transition of (2). In various instances, the surgical instruments disclosed herein can be configured to be capable of being deployed, for example, by establishing a shadow region S1Staple firing path SP at a distance1To determine the staple firing path SP1. In at least one instance, the surgical instrument can establish a location, such as with the retina LO and shadow region S1Is spaced from the midpoint of the edge of the nailRouting path SP1。
In addition to the above, the controller of the stapling instrument disclosed herein can include an edge detection algorithm. The edge detection algorithm is configured to sense a first light intensity at a first location and a second light intensity at a second location on the stomach tissue. The edge detection algorithm is further configured to calculate a first light intensity value for the first light intensity and a second light intensity value for the second light intensity, and then compare the first light intensity value to the second light intensity value. For example, the light intensity value may range between 1 and 100, with lower values indicating darker tissue and higher values indicating brighter tissue. The first and second locations establish a sample line along which additional samples may be taken to establish an intensity gradient. To this end, the edge detection algorithm is further configured to sense a third light intensity at a third location along the sample line, determine a third light intensity value at the third location, and compare the third light intensity value to the first light intensity value and the second light intensity value. The first, second and third locations are located sequentially along the sample line, and if the algorithm determines that the first light intensity value is greater than the second light intensity value and the second light intensity value is greater than the third light intensity value, then the algorithm may, for example, determine that a shadow gradient exists between the first and third locations, and the third location is closer to the edge of the stomach tissue than the first location. The method can be applied on a very large scale to map shadow gradients and/or color gradients of the entire stomach tissue or at least a portion of the stomach tissue.
As described above, the thickness of the stomach tissue may affect the color or shade of the stomach tissue. Thus, a stomach with thicker tissue (fig. 29) will generally have a different color and/or shade than a stomach with thinner tissue (fig. 31). The thinner tissue in FIG. 31 has a distance of Z2Defined shaded area S2. Distance Z2Also defining a secondary stomach S2To the whole tissue thickness region T2The transition of (2). In various instances, the surgical instruments disclosed herein can be configured to be capable of being deployed, for example, by establishing a shadow region S2Staple firing path SP at a distance2To determine the staple firing path SP2. At least oneIn such a case, the surgical instrument may be established, for example, with the retina LO2And a shaded area S2Has a certain distance of the middle point between the edges2。
Nail firing path SP1Establishing a first sleeve profile and staple firing path SP2A second sleeve profile different from the first sleeve profile is established. The first sleeve profile includes a first width X and the second sleeve profile includes a second width Y different from the width X. Regardless of the sleeve profile generated by the stapling instrument disclosed herein, the tissue drive system of the stapling instrument is configured to advance the stapling instrument along the staple firing path, which forms the desired gastric sleeve. Such a stapling instrument may be configured to recognize anatomical landmarks and orient itself toward, away from, and/or parallel to one or more anatomical landmarks.
In addition to the above, referring to fig. 153, the
Referring to fig. 154, the
Referring to fig. 155 and 157, the
In use, a voltage source is applied to winding
As described above, the
Referring to fig. 156, the bougie 7310 includes an inner flexible core 7312 and a plurality of conductor windings configured to emit the magnetic fields SMF and WMF described above. The flexible core 7312 is constructed of, for example, a non-conductive material or an at least substantially non-conductive material such as rubber. The conductor winding includes winding circuitry 7314 configured to emit a weak magnetic field WMF and winding circuitry 7316 configured to emit a strong magnetic field SMF. Winding circuit 7314 has fewer windings than winding circuit 7316 and will produce a weaker magnetic field for a given current than winding circuit 7316. Each winding circuit 7314 includes conductive wires that are wound around the inner flexible core 7312 and communicate with the controller of the bougie 7310. The windings of circuit 7314 are more compact or denser than the windings of
The surgical instrument systems described herein are actuated by an electric motor; the surgical instrument systems described herein may be actuated in any suitable manner. In certain instances, the motors disclosed herein may comprise a portion or portions of a robotic control system. For example, U.S. patent application serial No. 13/118,241 (now U.S. patent 9,072,535), entitled "SURGICAL INSTRUMENTS WITH robotic SURGICAL INSTRUMENTS," discloses several examples of robotic SURGICAL instrument systems in more detail.
The surgical instrument systems described herein have been described in connection with the deployment and deformation of staples; however, the embodiments described herein are not so limited. For example, various embodiments are contemplated in which fasteners other than staples, such as clamps or tacks, are deployed. Moreover, various embodiments are also contemplated that utilize any suitable means for sealing tissue. For example, an end effector according to various embodiments may include an electrode configured to heat and seal tissue. In addition, for example, an end effector according to certain embodiments may apply vibrational energy to seal tissue.