Liquid-immune trigger circuit for surgical instrument

Surgery in which a portion of the patient's gastrointestinal tract (e.g., gastrointestinal tract and/or esophagus, etc.) may be resected (e.g., colon surgery, bariatric surgery, etc.) to remove unwanted tissue or for other reasons. , thoracic surgery, etc.). After the tissue is removed, the remaining parts of the digestive tract can be joined together by anastomosing the ends. The end-to-end anastomosis provides a substantially unobstructed flow path from one portion of the digestive tract to another without leakage of any kind from the site where the anastomosis was made. can be provided.

One example of an instrument that can be used to achieve an end-to-end anastomosis is a circular stapler. Some such staplers include sandwiching layers of tissue, cutting the sandwiched layers of tissue, driving staples through the sandwiching layers of tissue, and severing the tissue adjacent the severed ends of the layers of tissue. and is operable to join two severed ends of an anatomical lumen. A circular stapler may be configured to cut tissue and substantially simultaneously seal the tissue. For example, circular staplers cut excess tissue inside an annular array of staples in an anastomosis to provide a substantially smooth transition between the cut surfaces of the anatomical lumens to be joined in the anastomosis. can provide. Circular staplers may be used in surgery such as open surgery, or in endoscopic surgery. In some cases, a portion of the circular stapler is inserted through a natural opening in the patient's body.

Examples of circular staplers are U.S. Pat. No. 5,205,459, issued Apr. 27, 1993 entitled "Surgical Anastomosis Stapling Instrument"; U.S. Pat. Title: "Surgical Anastomosis Stapling Instrument"; U.S. Patent No. 5,275,322, issued January 4, 1994; Title: "Surgical Anastomosis Stapling Instrument"; Title: "Surgical Anastomosis Stapling Instrument"; U.S. Patent No. 5,292,053, issued Mar. 8, 1994; Title: "Surgical Anastomosis Stapling Instrument"; No., title of the invention "Surgical Anastomosis Stapling Instrument"; U.S. Patent No. 5,350,104, issued September 27, 1994, entitled "Surgical Anastomosis Stapling Instrument"; and U.S. Patent No. 5,533,661, issued July 9, 1996, entitled " and in U.S. Patent No. 8,910,847, issued Dec. 16, 2014, entitled "Low Cost Anvil Assembly for a Circular Stapler." The disclosure of each of the US patents cited above is incorporated herein by reference.

Some circular staplers may include a motorized actuation mechanism. An example of a circular stapler with a motorized actuation mechanism is U.S. Patent Application Publication No. 2015/0083772, entitled "Surgical Stapler with Rotary Cam Drive and Return," published Mar. 26, 2015; U.S. Patent Application Publication No. 2015/0083773, published March 26, entitled "Surgical Stapling Instrument with Drive Assembly Having Toggle Features"; U.S. Patent Application Publication No. 2015/0083774, published March 26, 2015 , entitled "Control Features for Motorized Surgical Stapling Instrument"; Drive". The disclosure of each of the US patent application publications cited above is incorporated herein by reference.

Although various types of surgical stapling instruments and related components have been made and used, no one prior to the present inventors has made or used the invention recited in the appended claims. It is considered that there is no

While the specification concludes with claims that particularly point out and distinctly claim the technology, the technology is defined by the following description of specific embodiments taken in conjunction with the accompanying drawings. It will be better understood upon reading that like reference numerals identify the same elements in the drawings.

<figref num="1">1 is a perspective view of an exemplary circular stapler; FIG.</figref><figref num="2">2 is a perspective view depicting the circular stapler of FIG. 1 with the battery pack removed from the handle assembly and the anvil removed from the stapling head assembly; FIG.</figref><figref num="3">2 is a perspective view of an anvil of the circular stapler of FIG. 1; FIG.</figref><figref num="4">2 is a perspective view of a stapling head assembly of the circular stapler of FIG. 1; FIG.</figref><figref num="5">5 is an exploded perspective view of the stapling head assembly of FIG. 4; FIG.</figref><figref num="6">2 is an exploded perspective view of the circular stapler of FIG. 1 with portions of the shaft assembly shown separated from each other; FIG.</figref><figref num="7">2 is a perspective view of the handle assembly of the circular stapler of FIG. 1 with half of the housing omitted to show the internal components of the handle assembly; FIG.</figref><figref num="8">8 is a perspective view of the user interface of the handle assembly of FIG. 7; FIG.</figref><figref num="9A">2 shows a cross-sectional side view of the distal end of the circular stapler of FIG. 1 depicting the open contact switch of the circular stapler; FIG.</figref><figref num="9B">9B illustrates a cross-sectional side view of the distal end of the circular stapler of FIG. 1 depicting the contact switch of FIG. 9A being moved to a closed condition by proximal movement of the trocar and anvil of the circular stapler; FIG.</figref><figref num="10A">9B shows an enlarged cross-sectional side view of the contact switch of FIG. 9A in the open state of FIG. 9A; FIG.</figref><figref num="10B">9B shows an enlarged cross-sectional side view of the contact switch of FIG. 9A being moved to the closed state of FIG. 9B by proximal movement of the circular stapler trocar and anvil.</figref><figref num="11A">8 shows a perspective view of the firing trigger and motor activation module of the handle assembly of FIG. 7, with the firing trigger in an unactuated position; FIG.</figref><figref num="11B">11B shows a perspective view of the firing trigger and motor activation module of FIG. 11A with the firing trigger in the activated position; FIG.</figref><figref num="12A">8 shows a perspective view of the rotary cam, vibrating member and stop switch of the handle assembly of FIG. 7, with the rotary cam in the first angular position and the vibrating member in the first pivot position; FIG.</figref><figref num="12B">12B shows a perspective view of the rotary cam, vibrating member, and stop switch of FIG. 12A, with the rotary cam in the second angular position and the vibrating member in the second pivot position; FIG.</figref><figref num="13A">3 positioned within a first segment of the digestive tract and the stapling head assembly of FIG. 4 positioned within a second segment of the digestive tract, with the anvil separated from the stapling head assembly. shows a cross-sectional side view drawn in .</figref><figref num="13B">3 positioned within a first segment of the digestive tract and the stapling head assembly of FIG. 4 positioned within a second segment of the digestive tract, with the anvil secured to the stapling head assembly. shows a cross-sectional side view drawn in .</figref><figref num="13C">3 positioned within the first segment of the digestive tract and the stapling head assembly of FIG. 4 positioned within the second segment of the digestive tract, with the anvil retracted toward the stapling head assembly. 10A and 10B show side cross-sectional views thereby depicting tissue sandwiched between the anvil and stapling head assembly.</figref><figref num="13D">The anvil of FIG. 3 positioned within the first segment of the digestive tract and the stapling head assembly of FIG. FIG. 12C is a side cross-sectional view taken with the stapler actuated to stapling;</figref><figref num="13E">FIG. 13B shows a side cross-sectional view depicting the first and second segments of the digestive tract of FIG. 13A joined with an end-to-end anastomosis.</figref><figref num="14">2 shows a schematic diagram of an exemplary circuit that may be incorporated into the instrument of FIG. 1; FIG.</figref>

The drawings are not intended to be limiting in any way, and it is contemplated that various embodiments of the technology may be embodied in various other ways, including those not necessarily depicted in the drawings. . BRIEF DESCRIPTION OF THE DRAWINGS The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate several aspects of the technology and, together with the description, serve to explain the principles of the technology; , is understood not to be limited to the precise arrangements shown.

The following descriptions of specific examples of the technology should not be used to limit its scope. Other examples, features, aspects, embodiments, and advantages of the present technology will be apparent to those skilled in the art from the following description, which is, by way of illustration, one of the best modes contemplated for carrying out the present technology. will be As will be realized, the technology described herein is capable of other different and obvious aspects, all without departing from the technology. Accordingly, the drawings and description are to be regarded as illustrative rather than restrictive in nature.

I. Overview of an Exemplary Circular Stapling Surgical Instrument FIGS. 1-2 provide an end-to-end anastomosis between two cross-sections of an anatomical lumen, such as a section of a patient's gastrointestinal tract. 1 depicts an exemplary circular surgical stapling instrument (10) that may be used to. The instrument (10) of this example includes a handle assembly (100), a shaft assembly (200), a stapling head assembly (300), an anvil (400), and a removable battery pack (120). Each of these components is described in more detail below. It is understood that instrument (10) may additionally or alternatively be further constructed and operable in accordance with at least some of the teachings of the following patent documents, the disclosures of which are incorporated herein by reference: want to be U.S. Patent Application Publication No. 2016/0374672, entitled "Method of Applying an Annular Array of Staples to 5,205,459; 5,271,544; 5,275,322; 5,285,945; 5,292,053; 5,333,773; 8,910,847. Still other suitable configurations will be apparent to those of ordinary skill in the art in view of the teachings herein.

A. Exemplary Tissue Engaging Mechanism for Circular Stapling Instrument As best seen in FIG. 3, anvil (400) of the present example includes a head (410) and a shank (420). Head (410) includes a proximal surface (412) that defines a plurality of staple forming pockets (414). Staple forming pockets (414) are arranged in two concentric rows of annular arrays in this example. Staple forming pockets (414) are configured to deform the staples as they are driven into staple forming pockets (414) (e.g., generally "U-shaped" as is known in the art). shape staples into a "B-shaped" shape). The shank (420) has a bore or defines a lumen (422) and has a pair of pivoting latch members (430) positioned within the bore (422). Each latch member (430) includes a mechanism that allows the anvil (400) to be removably secured to the trocar (330) of the stapling head assembly (300), as described in greater detail below. However, it should be understood that anvil (400) may be removably secured to trocar (330) using any other suitable component, mechanism, or technique.

A stapling head assembly (300) is positioned at the distal end of the shaft assembly (200). As shown in FIGS. 1-2, anvil (400) is configured to removably couple with shaft assembly (200) adjacent stapling head assembly (300). As will be described in greater detail below, the anvil (400) and stapling head assembly (300) cooperate to manipulate tissue in three ways: pinch tissue, cut tissue, and staple tissue. is configured to As best seen in FIGS. 4-5, stapling head assembly (300) of the present example comprises a tubular casing (310) that houses a slidable staple driver member (350). A cylindrical inner core member (312) extends distally within tubular casing (310). Tubular casing (310) is fixedly attached to outer sheath (210) of shaft assembly (200) such that tubular casing (310) serves as a mechanical base for stapling head assembly (300).

The trocar (330) is coaxially positioned on the inner core member (312) of the tubular casing (310). Trocar (330) is operable to move distally and proximally relative to tubular casing (310) in response to rotation of knob (130) located at the proximal end of handle assembly (100). is. Trocar (330) comprises a shaft (332) and a head (334). Head (334) includes a pointed tip (336) and an inwardly extending proximal surface (338). Head (334) and the distal portion of shaft (332) are configured to be inserted into bore (422) of anvil (420). Proximal surface (338) is configured to complement the features of latch member (430) to provide a snap fit between anvil (400) and trocar (330).

Staple driver member (350) is operable to move longitudinally within tubular casing (310) in response to actuation of motor (160), as will be described in greater detail below. Staple driver member (350) includes two concentric annular arrays of distally directed staple drivers (352). Staple drivers (352) are arranged to correspond to the arrangement of staple forming pockets (414) described above. Accordingly, each staple driver (352) is configured to drive a corresponding staple into a corresponding staple forming pocket (414) when stapling head assembly (300) is actuated. Staple driver member (350) also defines a bore (354) configured to coaxially receive core member (312) of tubular casing (310).

A cylindrical knife member (340) is coaxially positioned within the staple driver member (350). Knife member (340) includes a distally directed, sharp, circular cutting edge (342). Knife member (340) is sized such that knife member (340) defines an outer diameter that is less than the diameter defined by the inner annular array of staple drivers (352). Knife member (340) also defines an opening (344) configured to coaxially receive core member (312) of tubular casing (310).

A deck member (320) is fixedly attached to the tubular casing (310). Deck member (320) includes a distally directed deck surface (322) that defines two concentric annular arrays of staple openings (324). Staple openings (324) are arranged to correspond to the arrangement of staple drivers (352) and staple forming pockets (414) described above. Thus, each staple opening (324) allows a corresponding staple driver (352) to drive a corresponding staple through deck member (320) and anvil when stapling head assembly (300) is actuated. It is configured to provide a pathway for driving into corresponding staple forming pockets (414) of (400). As noted above, the placement of staple openings (322) can be modified just as the placement of staple forming pockets (414). It should also be appreciated that various structures and techniques may be used to load staples into stapling head assembly (300) before stapling head assembly (300) is actuated.

Deck member (320) defines an inner diameter that is only slightly larger than the outer diameter defined by knife member (340). Deck member (320) is thus configured to allow knife member (340) to move distally to a point where cutting edge (342) is distal to deck surface (322). there is Solely by way of example, the deck member (320) is disclosed in U.S. Patent Application Serial No. 15/350,513, entitled "Circular Surgical Stapler," filed November 14, 2016, the disclosure of which is incorporated herein by reference. with Recessed Deck" and can be further constructed and operationalized in accordance with at least some of the teachings of Other suitable configurations that may be used for deck member (320) will be apparent to those skilled in the art in view of the teachings herein.

FIG. 6 shows various components of shaft assembly (200) extending distally from handle assembly (100) to connect components of stapling head assembly (300) to components of handle assembly (100). indicates Specifically, and as described above, shaft assembly (200) includes an outer sheath (210) that extends between handle assembly (100) and tubular casing (310). In the present example, outer sheath (210) is rigid and includes a preformed curved portion (212) configured to facilitate positioning of stapling head assembly (300) within a patient's colon as described below. have. Curved portion (212) includes an inner curve (216) and an outer curve (214).

Shaft assembly (200) further includes a trocar actuation rod (220) and a trocar actuation band assembly (230). The distal end of trocar actuation band assembly (230) is fixedly attached to the proximal end of trocar shaft (332). The proximal end of the trocar actuation band assembly (230) is fixedly attached to the distal end of the trocar actuation rod (220), thus allowing the trocar actuation band assembly (230) and the trocar actuation rod to the outer sheath (210). In response to movement of (220), trocar (330) moves longitudinally relative to outer sheath (210). Trocar actuation band assembly (230) moves within shaft assembly (200) as trocar actuation band assembly (230) is moved longitudinally relative to outer sheath (210). is configured to bend so that it can move along a pre-formed curve of the . However, the trocar actuation band assembly (230) has sufficient column strength and tensile strength to transmit distal and proximal forces from the trocar actuation rod (220) to the trocar shaft (332). The trocar actuation rod (220) is rigid. A clip (222) is fixedly attached to the trocar actuation rod (220), and the clip (222) prevents longitudinal movement of the trocar actuation rod (220) within the handle assembly (100). configured to prevent the trocar actuation rod (220) from rotating within the handle assembly (100) in cooperation with a complementary mechanism within the handle assembly (100) while still allowing there is Trocar actuation rod (220) has a coarse helical thread (224) and a fine helical thread (224) configured to interact with nut (132) and knob (130), as described in greater detail below. (226) is further included.

Shaft assembly (200) further includes a stapling head assembly driver (240) slidably received within outer sheath (210). The distal end of stapling head assembly driver (240) is fixedly attached to the proximal end of staple driver member (350). The proximal end of stapling head assembly driver (240) is attached to drive bracket (250) via pin (242). Thus, in response to movement of stapling head assembly driver (240) and drive bracket (250) relative to outer sheath (210), staple driver member (350) moves longitudinally toward outer sheath (210). It should be understood that moving relative to As the stapling head assembly driver (240) moves longitudinally relative to the outer sheath (210), the stapling head assembly driver (240) moves the shaft assembly (200). It is bent and configured to move along a pre-formed curve within. However, stapling head assembly driver (240) has sufficient column strength to transmit distal force from drive bracket (250) to staple driver member (350).

As shown in FIG. 7, motor (160) is coupled to drive bracket (250) via cam member (162) and pivot arm (164). Pivot arm (164) is pivotally coupled to housing (166) of handle assembly (100) via pin (116). Motor (160) is operable to rotate cam member (162). Cam member (162) is configured to drive pivotal movement of pivot arm (164) when cam member (162) rotates in response to motor activation. Pivot arm (164) is adapted to drive movement of drive bracket (250) as pivot arm (164) pivots about pin (116) in response to rotation of cam member (162). is configured to Thus, motor (160) is operable to drive stapling head assembly driver (240) via cam member (162), pivot arm (164), and drive bracket (250). Merely by way of example, these components are described in U.S. Patent Application Publication No. 2014/0166717, entitled "Circular Stapler with Selectable Motorized and Manual Control, Including a Control Ring".

In this embodiment, as best seen in FIGS. 12A-12B, the cam member (162) of this embodiment includes a first cam mechanism (650), a second cam mechanism (652), and a third cam mechanism (650). and a cam mechanism (654). First cam mechanism (650) and pivot arm (164) cooperatively direct distal movement of stapling head assembly driver (240) when cam member (162) is rotated by motor (160). is configured to drive to Second cam mechanism (652) and pivot arm (164) engage stapling head assembly driver (240) via cam member (162) when cam member (162) is rotated by motor (160). and configured to cooperatively drive distal movement of the . In the present example, such distal and proximal actuation is performed by one single angularly rotating cam member (162), so that motor (160) drives stapling head assembly driver (240). ) need not be reversed to effect distal and proximal movement. Further, such distal and proximal actuation is performed by a cam member (162) that rotates less than 360 degrees. Third cam mechanism (654) interacts with vibrating member (670) to actuate a pair of switch buttons (192) at the end of the actuation stroke of stapling head assembly (300), as will be described in greater detail below. can operate as Likewise, the cam mechanisms (650, 652, 654) may be constructed and operable in accordance with at least some of the teachings of US Patent Publication No. 2014/0166717, the disclosure of which is incorporated herein by reference.

B. Exemplary User Interface Features of a Circular Stapling Instrument As shown in FIGS. 1 and 7, handle assembly (100) includes pistol grip (112), anvil (400) and stapling head assembly (300). and a number of components operable to operate. Specifically, handle assembly (100) includes knob (130), safety trigger (140), firing trigger (150), motor (160), and motor activation module (180). Knob (130) is coupled to trocar actuation rod (220) via nut (132) (shown in FIG. 7) such that coarse helical thread (224) is threaded inside the nut. In selective engagement with mating features, fine helical threads (226) selectively engage threaded engagement features inside knob (130). These complementary structures are such that trocar actuation rod (220) initially moves proximally at a relatively slow rate and then moves proximally at a relatively fast rate in response to rotation of knob (130). is configured to

Battery pack (120) is operable to power motor (160) as described above. Battery pack (120) may be removably coupled with handle assembly (100) by a snap fit or any other suitable method. Battery pack (120) and handle assembly (100) may have complementary electrical contacts, pins and sockets and/or battery pack (120) contacts when battery pack (120) is mated with handle assembly (100). ) to the motorized components within the handle assembly (100). It is also understood that in some variations, battery pack (120) is integrally integrated with handle assembly (100) such that battery pack (120) is not removable from handle assembly (100). want to be

When anvil (400) is coupled with trocar (330), rotation of knob (130) causes the anvil to correspondingly move relative to stapling head assembly (300). Knob (130) is rotated in a first angular direction (e.g., clockwise) to retract anvil (400) toward stapling head assembly (300) and a second angular direction (e.g., counterclockwise). to advance anvil (400) away from stapling head assembly (300). Thus, using knob (130), adjust the gap distance between opposing surfaces (412, 322) of anvil (400) and stapling head assembly (300) until a suitable gap distance is obtained. can be done.

In the present example, handle assembly (100) includes a user feedback mechanism (114) configured to provide visual feedback to the operator indicating placement of anvil (400) relative to stapling assembly (300). Specifically, as best seen in FIG. 10, the user feedback mechanism (114) of the present embodiment includes fixed linear indicia (552, 554, 556), graphical representations of staples (560, 562), and check Includes graphical indicators (550), including mark graphics (564). User feedback mechanism (114) further defines a window (570) through which indicator needle (522) can be viewed. In some variations, the user feedback mechanism (114) provides feedback on the size of the staples in the stapling head assembly (300), the size of the gap defined between the anvil (400) and the stapling head assembly (300). , and/or other information.

Indicator needle (522) is a feature of indicator member (520) shown in FIG. Indicator member (520) is coupled to bracket (500), and bracket (500) is configured to move longitudinally based on longitudinal movement of trocar actuation rod (220). As bracket (500) moves longitudinally, indicator member (520) pivots within handle assembly (100). The corresponding movement of indicator needle (522) is visible through window (570) so that the operator can see this pivotal movement of indicator member (520). Merely by way of example, indicator member (520) and bracket (500) are described in U.S. patent application filed on even date herewith [Attorney Docket No. END8219USNP.0646592], entitled " Hysteresis Removal Feature in Surgical Stapling Instrument, and may be constructed and operable in accordance with at least some of the teachings. Other suitable methods of constructing and operable indicator member (520) and bracket (500) will be apparent to those skilled in the art in view of the teachings herein.

As the operator rotates knob (130) to adjust the longitudinal position of anvil (400) relative to stapling head assembly (300), the operator observes the position of indicator needle (522) through window (570). can do. Initially, indicator needle (522) may be positioned at or near the distal end of window (570). As anvil (400) continues to move proximally, indicator needle (522) eventually moves proximally relative to window (570). The operator can see the position of indicator needle (522) relative to fixed linear indicia (552, 554, 556). Distal-most and proximal-most indicia (552, 556) indicate the allowable distance range between anvil (400) and stapling head assembly (300) for successful actuation of stapling head assembly (300). , may represent the boundaries of the "green zone". Thus, when indicator needle (522) is distal to distal-most indicia (552), the distance between anvil (400) and stapling head assembly (300) is too great and indicator needle (522) 522) is proximal to proximal-most indicia (556), the distance between anvil (400) and stapling head assembly (300) is too small. Indicia (554) is longitudinally positioned between indicia (552, 556). Graphical representation (560) represents relatively high formed staples (e.g., suitable for use with relatively thick tissue), and graphic representation (562) represents relatively low formed staples (e.g., relatively thin). suitable for tissue use). Thus, the graphical representations (560, 562) select appropriate corresponding spatial relationships between the indicator needles (522) and the indicia (552, 554, 556) based on tissue observations or otherwise. This may facilitate operator decision-making as to whether and how to obtain the desired formed staple height.

In the present example, window 570 is illuminated via light emitting diodes (LEDs) 702 to further facilitate viewing of indicator hands 522 within window 570 . Additionally, when stapling head assembly (300) completes a stapling and cutting cycle, checkmark graphic (564) is illuminated via another LED (704). In the present example, illumination of LEDs 704 is triggered by actuation of switch button 192, which will be described in detail below as being actuated at the end of a stapling and cutting cycle. Thus, the operator further relies on the illumination of checkmark graphic 564 to advance anvil 400 distally away from anastomosis 70 and remove instrument 10 from the patient. is safe. Merely by way of example, LED (702) may be configured to emit white visible light and LED (704) may be configured to emit green visible light. Exemplary ways in which the LEDs (702, 704) may be incorporated into the control circuit (700) are described in detail below with reference to FIG. Other implementations will be apparent to those skilled in the art in view of the teachings herein.

C. Some variations of the exemplary anvil connection sensor instrument (10) provide for proper and/or improper connection of the anvil (400) to the trocar (330) of the stapling head assembly (300). It may be desirable to provide the instrument (10) with a mechanism configured to point. For example, a mechanism may be configured to prevent firing of stapling head assembly (300) unless anvil (400) is properly coupled to trocar (300). When anvil (400) is properly coupled to trocar (330), firing of stapling head assembly (300) may be possible. 9A-10B show an exemplary switch assembly (600) incorporated into stapling head assembly (300) of the present example. The switch assembly (600) includes a dome switch (610) and a resilient actuator spring (602). An actuator spring (602) is secured within a cavity (606) formed within the tubular casing (310). Dome switch (610) is positioned between a pair of flanges (612, 614) of actuator spring (602) such that when flange (614) moves toward flange (612), dome switch (610) works.

When anvil (400) is properly secured to trocar (330) as described herein and is retracted proximally, anvil (400) moves flange (612) toward flange (614). Move to activate the dome switch (610). Actuation of dome switch (610) may provide the operator with audible, tactile, and/or visual feedback indicating proper engagement. Various suitable mechanisms that may be used to provide such responses to dome switch (610) actuation will be apparent to those skilled in the art in view of the teachings herein. Additionally, in the present example, actuation of dome switch (610) may enable firing of stapling head assembly (300). In other words, stapling head assembly (300) cannot be fired in the present example unless dome switch (610) is activated.

After anvil (400) is secured to trocar (330), the operator then rotates knob (130) to retract trocar (330) and anvil (400) proximally, as described above. 13A-13E, when trocar (330) and anvil (400) are properly secured together, this proximal retraction of trocar (330) and anvil (400) can Tissue of tubular anatomical structure (20, 40) is compressed between surfaces (412, 322) of (400) and stapling head assembly (300). If trocar (330) and anvil (400) are not properly secured together, trocar (330) will retract proximally without anvil (400) and tissue of tubular anatomy (20, 40) will It remains uncompressed. When trocar (330) and anvil (400) are properly secured to one another, retraction of trocar (330) and anvil (400) proximally will cause the proximal end of shank (420) of anvil (400) to move. , engages the upstanding portion (604) of the flange (612) of the actuator spring (602) to drive the flange (612) toward the flange (614), thereby causing a Dome switch (610) is activated. As noted above, such actuation of dome switch (610) may provide audible, tactile, and/or visual feedback to the operator indicating proper engagement. Further, such actuation of dome switch (610) enables firing of stapling head assembly (300). In other words, stapling head assembly (300) cannot be fired unless dome switch (610) is activated. Exemplary ways in which dome switch 610 may be incorporated into control circuit 700 are described in greater detail below with reference to FIG. Other embodiments will be apparent to those skilled in the art in view of the teachings herein.

D. Exemplary Firing Circuit Activation and Deactivation Mechanism Firing trigger (150) is operable to activate stapling head assembly (300) by activating motor (160). Safety trigger (140) is operable to selectively block actuation of firing trigger (150) based on the longitudinal position of anvil (400) relative to stapling head assembly (300). Thus, firing trigger 150 cannot be actuated until after safety trigger 140 has been actuated. The handle assembly (100) also includes components operable to selectively lock out both of the triggers (140, 150) based on the position of the anvil (400) relative to the stapling head assembly (300). ing. When the triggers (140, 150) are locked out, the safety trigger (140) is prevented from moving to allow actuation of the firing trigger (150), which in turn allows the stapling head to move. It is prevented from starting operation of the assembly (300). Thus, trigger (150) is operable to initiate actuation of stapling head assembly (300) only when the position of anvil (400) relative to stapling head assembly (300) is within a predetermined range. be. Solely by way of example, such a lockout mechanism is described in U.S. Patent Application Publication No. 2016/0374667, entitled "Surgical Stapler with Anvil Seating Detection".

As best seen in FIGS. 11A-11B, firing trigger (150) of the present example includes an integral actuation paddle (158). In scenarios in which safety trigger (140) is activated to allow activation of firing trigger (150), firing trigger (150) moves from the position shown in FIG. 11A to the position shown in FIG. 11B. , the paddle (158) pivots forward. Paddle (158) switches switch (182) (FIG. 14) of motor activation module (180) when firing trigger (150) pivots from the position shown in FIG. 11A to the position shown in FIG. 11B. (see ). Switch (182) of motor start module (180) communicates with battery pack (120) and motor (160), and motor start module (180) allows paddle (158) to switch on motor start module (180). In response to actuating (182), power from the battery pack (120) is configured to effect activation of the motor (160). Thus, motor (160) is activated when firing trigger (150) is pivoted from the position shown in FIG. 11A to the position shown in FIG. 11B. This activation of motor (160) actuates stapling head assembly (300) as described herein. Merely by way of example, this actuation is described in U.S. Patent Application Publication No. 2016/0374666, entitled "Surgical Stapler with Reversible Motor," published Dec. 29, 2016, the disclosure of which is incorporated herein by reference. can be performed in accordance with at least some of the teachings of Exemplary ways in which motor startup module 180 may be incorporated into control circuit 700 are described in greater detail below with reference to FIG. Other implementations will be apparent to those skilled in the art in view of the teachings herein.

As mentioned above, third cam mechanism (654) of cam member (162) interacts with vibrating member (670) to cause a pair of switch buttons to be activated at the end of the working stroke of stapling head assembly (300). (192) is configured to operate. Figure 12A shows the cam member (162) at the beginning of the working stroke and Figure 12B shows the cam member (162) at the end of the working stroke. As shown in FIG. 12B, vibrating member (670) includes bearing member (672), integral pin (674), and paddle (676). At the stage shown in FIG. 12A, vibrating member (670) is in a first angular position, so switch button (192) is in an inactive state. At the stage shown in FIG. 12B, the third cam mechanism (654) engages the bearing member (672) thereby driving the vibrating member (670) to pivot about the axis of the pin (674). Let When vibrating member (670) pivots to the position shown in FIG. 12B, paddle (676) actuates switch button (192). Switch button 192 is a feature of motor stop module 190 that is configured to prevent further activation of motor 160 when switch button 192 is actuated. An exemplary manner in which motor stop module 190 may be incorporated into control circuit 700 is described in detail below with reference to FIG. Other implementations will be apparent to those skilled in the art in view of the teachings herein.

In the present example, motor stop module 190 reverses the polarity of power provided to motor 160 when switch button 192 is actuated. As a result, once the stapling head assembly (300) has completed its working stroke, the motor (160) is deactivated. Solely by way of example, the motor stop module (190) may be constructed and operable in accordance with at least some of the teachings of US Patent Publication No. 2015/0083774, the disclosure of which is incorporated herein by reference. Other suitable configurations will become apparent to those skilled in the art in view of the teachings herein.

E. Exemplary Anastomosis Procedure Using a Circular Stapling Instrument Figures 13A-13E show an instrument (10) used to form an anastomosis (70) between two tubular anatomical structures (20, 40). ). By way of example only, the tubular anatomical structures (20, 40) may be a section of the patient's esophagus, a section of the patient's large intestine, other sections of the patient's digestive tract, or any other tubular anatomical structure. can contain. In some variations, one or more diseased portions of the patient's colon are removed and the tubular anatomy (20, 40) in Figures 13A-13E shows the remaining amputated portion of the colon.

As shown in FIG. 13A, the anvil (400) is positioned within one tubular anatomical structure (20) and the stapling head assembly (300) is positioned within the other tubular anatomical structure (40). positioned within. In variations where the tubular anatomy (20, 40) includes a segment of the patient's large intestine, the stapling head assembly (300) may be inserted through the patient's rectum. It should also be understood that while the procedure shown in FIGS. 13A-13E is an open surgery, the procedure can also be performed as a laparoscopic surgery. Solely by way of example, surgery is disclosed in U.S. Patent Publication No. 2016/0100837, entitled "Staple Cartridge," published Apr. 14, 2016, the disclosure of which is incorporated herein by reference, and/or or U.S. Patent Application Publication No. 2017/0086848, entitled "Apparatus and Method for Forming a Staple Line with Trocar It may also be performed as a laparoscopic procedure in accordance with at least some of the teachings of Passageway. Various other suitable methods in which instrument (10) may be used to laparoscopically create anastomosis (70) will be apparent to those skilled in the art in view of the teachings herein.

As shown in FIG. 13A, anvil (400) is positioned within tubular anatomy (20) such that shank (420) protrudes from open cut end (22) of tubular anatomy (20). be done. A purse string suture (30) is provided around the central region of the shank (420) to loosely secure the position of the anvil (400) within the tubular anatomy (20). Similarly, stapling head assembly (300) is positioned within tubular anatomy (40) such that trocar (330) protrudes from the open cut end (42) of tubular anatomy (20). be done. A purse string suture (50) is provided around a central region of shaft (332) to loosely secure the position of stapling head assembly (300) within tubular anatomy (40).

Anvil (400) is then secured to trocar (330) by inserting trocar (330) into hole (422), as shown in FIG. 13B. A latch member (430) engages head (334) of trocar (330), thereby providing a secure fit between anvil (400) and trocar (330). The operator then rotates knob (130) via pistol grip (112) while holding handle assembly (100) stationary. This rotation of knob (130) retracts trocar (330) and anvil (400) proximally as described above. This proximal retraction of trocar (330) and anvil (400) causes the tissue of tubular anatomy (20, 40) to move between anvil (400) and stapling head assembly (300), as shown in FIG. 13C. are compressed between the surfaces (412, 322) of the The operator observes user feedback mechanism (114) to determine if the gap distance (d) between opposing surfaces (412, 322) of anvil (400) and stapling head assembly (300) is appropriate. If so, adjust via knob (130).

After the operator has appropriately set the gap distance (d) via knob (130), the operator activates safety trigger (140) to allow activation of firing trigger (150). The operator then actuates the firing trigger (150). This actuation of firing trigger (150) in turn activates switch (182) of motor activation module (180), which activates motor (160), thereby causing knife member (340) and knife member (340), as shown in FIG. 13D. Stapling head assembly (300) is actuated by driving staple driver member (350) distally. As knife member (340) moves distally, cutting edge (342) of knife member (340) cooperates with inner edge (416) of anvil (400), thereby causing an annular recess in anvil (400). Excess tissue positioned within (418) and within knife member (340) is cut.

As shown in FIG. 3, anvil (400) of the present example includes breakaway washer (417) within annular recess (418). When knife member (340) moves the full distal range from the position shown in FIG. 13C to the position shown in FIG. Destroyed by (340). The drive mechanism of knife member (340) provides increasing mechanical advantage as knife member (340) reaches the end of its distal motion, thereby destroying washer (417). can be provided with the greater force required for Of course, in some variations the breakaway washer (417) may be omitted entirely. In variations where washer (417) is included, washer (417) may also serve as a cutting board for assisting knife member (340) in cutting tissue. Such cutting techniques may be employed in addition to or instead of the cutting action between inner edge (416) and cutting edge (342) already described.

As staple driver member (350) moves distally from the position shown in FIG. 13C to the position shown in FIG. The tissue of the anatomy (20, 40) is pierced and driven into the staple forming pockets (414) of the anvil (400). Staple forming pockets (414) deform the driven staples (90) into a B-shape, as is known in the art. The staples (90) thus formed secure the tissue ends together, thereby connecting the tubular anatomy (20) with the tubular anatomy (40).

After the operator actuates stapling head assembly (300), the operator rotates knob (130) to move anvil (400) far away from stapling head assembly (300), as shown in FIG. 13D. The posterior drive increases the gap distance (d) to facilitate tissue release between surfaces (412, 322). The operator then removes instrument (10) from the patient, with anvil (400) still attached to trocar (330). Referring again to the example where tubular anatomy (20, 40) includes a segment of the patient's large intestine, instrument (10) may be removed through the patient's rectum. When the instrument (10) is removed, the tubular anatomy (20, 40) is held securely by a two-row annular arrangement of staples (90) at the anastomosis (70), as shown in Figure 13E. Remain closed. The inner diameter of the anastomosis (70) is defined by the severed edge (60) left by the knife member (340).

II. Exemplary Trigger Circuit Resistant to Fluid Ingression It will be appreciated by those skilled in the art that during normal use of instrument (10), at least certain portions of instrument (10) may experience, but are not limited to, patient body fluids. , saline, and the like. By way of example only, areas of instrument (10) that may be most susceptible to liquid intrusion may include stapling head assembly (300) and features at or near the underside of handle assembly (100), Liquid may tend to collect there after flowing down the shaft assembly (200). Those skilled in the art will also recognize that some electrical circuitry may experience performance degradation when such electrical circuitry is exposed to liquids. For example, liquids can impair the functionality of some electrical circuits and circuit components. In the context of a surgical instrument such as instrument 10, a compromised circuit can prematurely activate a mechanism, such as motor 160 and thus stapling head assembly 300, with undesirable consequences. can bring Therefore, the device (10) shall not suffer from premature start-up or other undesired effects, impairing the performance of such electrical circuits and circuit components. It may be desirable to provide variations.

Although the following examples are provided in the context of variations of instrument 10, the same teachings can be readily incorporated into various other types of surgical instruments. Other types of instruments to which the teachings below may be applied will be apparent to those skilled in the art.

FIG. 14 shows an exemplary control circuit (700) that may be incorporated within the instrument (10). Circuit (700) ensures that liquid intrusion into dome switch (610) and motor start module (180) does not compromise performance of dome switch (610), motor start module (180), or motor stop module (190). configured as Thus, dome switch (610) and motor activation module (180) are within liquid tolerant region (750) of circuit (700). As shown, the circuit (700) of this example includes several transistors (710, 712, 714, 716, 718), several resistors (720, 722, 724, 726, 728, 730, 732 , 734, 736), several Schottky diodes (740, 742, 744, 746), Zener diodes (748), and capacitors (749). Also shown are battery pack (120), motor (160), motor starter module (180), switch button (192), dome switch (610), and LEDs (702, 704) in circuit (700). incorporated.

In the present example, transistor (710), motor start module (180), and resistors (720, 722) are all located within liquid resistant region (750) of circuit (700). Transistor (710) of the present example has a relatively low voltage threshold and communicates with dome switch (610), motor starter module (180), and other components that are ultimately coupled to motor (160). do. In the present example, switch (182) of motor start module (180) is configured such that switch (182) is held closed by default. Thus, when paddle (158) engages motor starter module (180) in response to an operator pivoting firing trigger (150), paddle (158) engages a switch on motor starter module (180). (182) transitions from the closed state to the open state.

Transistor 710 and related components of circuit 700 are activated when motor start module 180 switch is in an open state (indicating firing trigger 150 is fully actuated) and dome Only when switch (610) is in the closed state (indicating that anvil (400) is properly coupled with trocar (330)) is it configured to effect activation of motor (160). Thus, when the motor activation module 180 switch is in the closed state (indicating that the firing trigger 150 is not fully actuated), even if the dome switch 610 is in the closed state, Motor (160) is not started. Similarly, when the dome switch (610) is in the open state (indicating that the anvil (400) is not properly coupled with the trocar (330)), the motor starter module (180) switch is in the open state. However, motor 160 is not started.

Those skilled in the art will recognize that a switch immersed in liquid may be prone to failure and may prematurely result in a closed switch. Thus, in an alternative variation of the circuit (700) in which the motor (160) is activated upon the transition of the switch of the motor activation module (180) from the open state to the closed state, liquid ingress will damage the switch, thereby , may effectively bring the closed state before the firing trigger (150) is actuated. In other words, in an alternative variation of the circuit (700) in which the motor (160) is activated upon transition of the switch of the motor activation module (180) from the open state to the closed state, liquid ingress ), and thus premature activation of the stapling head assembly (300). However, because the switch of motor start module 180 is required to be in an open state to effect start of motor 160, circuit 700 of the present example provides motor 160, This in turn prevents premature activation of the stapling head assembly (300) due to liquid intrusion.

When dome switch 610 is in an open state (i.e., when anvil 400 is not actuating dome switch 610 as described above), transistor 710 acts as a closing switch ("on"). do. When dome switch 610 is in the closed state (i.e., when anvil 400 actuates dome switch 610 as described above), transistor 710 behaves as an open switch ("off"). do. Those skilled in the art will recognize that the voltage threshold of transistor 714 is greater than or equal to 0.7V because the emitter (the point where transistors 714, 716 are connected) is connected to the 0V battery. deaf. When the point where capacitor (749), resistors (728, 726) and transistor (714) connect exceeds this threshold, transistor (714) acts as a closed switch ("on"), thereby turning motor (160) on. ) can be started.

Transistor 714 has a relatively low voltage threshold in this example. Transistor 714 is thus regulated by the fact that even if motor starter module 180 is immersed in a conductive liquid, the liquid presents a sufficient resistivity that does not equate to a closed switch. , it is possible to recognize the open state of the switch (182) of the motor starting module (180). The inherent resistance of the liquid will reduce the voltage, but not to a level below the low voltage threshold of transistor 710, so transistor 710 can recognize that switch 182 has been opened.

In addition to or as an alternative to providing the circuit (700) configuration described above, the various electrical components may be coated with a liquid impermeable coating to provide at least some resistance to liquid intrusion. good too. For example, in some variations, one or more printed circuit boards of circuit (700) (eg, the circuit board on which LEDs (702, 704) are mounted) may be coated with a liquid impermeable coating. . Additionally or alternatively, either or both of the LEDs (702, 704) may be coated with a liquid impermeable coating. Other features of circuitry (700) that may be coated with a liquid impermeable coating will be apparent to those skilled in the art in view of the teachings herein.

In some variations where a liquid impermeable coating is used on one or more components of circuit (700), the liquid impermeable coating may include a UV curable urethane coating. In some variations the liquid impermeable coating is transparent. By making the coating transparent, this may preserve the legibility of coated features that are intended to be seen (eg, either or both LEDs (702, 704)). Furthermore, in variations where one or both of the LEDs (702, 704) are coated, the use of a transparent coating ensures that light emitted from the coated LEDs (702, 704) is conducted along the coating ( That is, "bleeding" can be prevented. Various other suitable materials that can be used to provide such coatings, and various methods that can be used to apply such coatings, will occur to those of ordinary skill in the art in view of the teachings herein. would be clear.

III. Exemplary Combinations The following examples relate to various non-exhaustive ways in which the teachings herein can be combined or applied. The following examples are not intended to limit the scope of any claims, which may be presented at any time in this application or in any subsequent application after this application. No waiver is intended. The following examples are given for illustrative purposes only. It is believed that the various teachings herein can be arranged and applied in many other ways. It is also contemplated that in some variations certain features referred to in the examples below may be omitted. Accordingly, none of the aspects or features referred to below should be viewed as essential, unless expressly indicated to the contrary at a later date by the inventors or persons succeeding to the interests of the inventors. . If claims containing further features other than those mentioned below appear in this application, or in a subsequent application related to this application, then those further features are for any reason relevant to patentability. It should not be assumed as added.

<p>(a) a body; (b) a shaft assembly extending distally from the body and having a distal end; and (c) an end effector at the distal end of the shaft assembly, the end effector being positioned on tissue. and (d) an activation circuit, the activation circuit being (i) an end effector driver, the end effector driver driving the end effector to create an organizational and (ii) a driver activation switch, the driver activation switch configured to transition between an open state and a closed state, the end effector driver The driver is configured to activate in response to the driver activation switch transitioning to the open state and the end effector driver is configured to not activate in response to the driver activation switch being in the closed state. , a driver-activated switch; and (e) a user input mechanism operable to transition between a deactivated state and an activated state, wherein the driver-activated switch activates the user input mechanism when the user input mechanism is deactivated. Configured to remain in the closed state when in the activated state, the driver-activated switch is configured to transition from the closed state to the open state in response to the user input mechanism transitioning from the deactivated state to the activated state. and a user input mechanism.</p>

<p>2. The apparatus of example 1, wherein the end effector includes a stapling head assembly, the stapling head assembly operable to apply staples to tissue.</p>

<p>3. The apparatus of example 2, wherein the end effector further comprises a knife member operable to cut tissue.</p>

<p>The apparatus of any one or more of Examples 2-3, wherein the stapling head assembly is operable to apply at least one annular row of staples to tissue.</p>

<p>The apparatus of any one or more of Examples 2-4, wherein the end effector further comprises an anvil, the anvil operable to retract proximally relative to the stapling head assembly.</p>

<p>6. The apparatus of example 5, further comprising an anvil sensor, the anvil sensor configured to sense the position of the anvil relative to the stapling head assembly.</p>

<p>The activation circuit is further configured to prevent activation of the end effector driver unless the anvil sensor senses that the anvil is at or proximal to a predetermined longitudinal position relative to the stapling head assembly. , the apparatus as described in Example 6.</p>

<p>8. The apparatus of any one or more of examples 1-7, wherein the end effector driver comprises a motor.</p>

<p>9. The apparatus of any one or more of Examples 1-8, wherein the user input mechanism comprises a trigger, the trigger being movable from an inactivated state to an activated state.</p>

<p>An embodiment wherein the trigger comprises a paddle, the paddle configured to contact the driver-activated switch when the trigger is moved to the actuated state, thereby transitioning the driver-activated switch from the closed state to the open state. 9. Apparatus according to 9.</p>

<p>11. The apparatus of any one or more of examples 1-10, wherein the activation circuit further comprises a low voltage threshold transistor in communication with the driver activation switch, the low voltage threshold transistor further in communication with the end effector driver.</p>

<p>12. The apparatus of example 11, wherein the low voltage threshold transistor is operable to recognize an open state of the driver activation switch when the driver activation switch is submerged in liquid.</p>

<p>13. The apparatus of any one or more of Examples 1-12, further comprising at least one electronic component coated with a liquid impermeable coating.</p>

<p>14. The apparatus of example 13, wherein the at least one electronic component comprises a printed circuit board.</p>

<p>15. The apparatus according to any one or more of Examples 13-14, wherein at least one electronic component comprises an LED.</p>

<p>The device of any one or more of Examples 13-15, wherein the liquid impermeable coating comprises UV curable urethane.</p>

<p>The device of any one or more of Examples 13-16, wherein the liquid-impermeable coating is transparent.</p>

<p>(a) a body, (b) a shaft assembly extending distally from the body and having a distal end, and (c) a stapling head assembly at the distal end of the shaft assembly, the stapling head assembly comprising: is a stapling head assembly operable to apply staples to tissue and cut tissue; and (d) an activation circuit, the activation circuit being (i) a motor, the motor comprising: a motor operable to drive the stapling head assembly to apply staples to tissue and cut tissue; and (ii) a motor activation switch, the motor activation switch having an open state and a closed state. and the motor is configured to start in response to the motor start switch transitioning from the closed state to the open state, and the motor is configured to transition between the closed state of the motor start switch and the closed state of the motor start switch. a motor activation switch configured not to activate in response to; and (e) a firing trigger operable to transition between an inactivated state and an activated state, wherein , the motor activation switch is configured to remain in a closed state when the firing trigger is in the deactivated state, the motor activation switch responsive to the firing trigger transitioning from the deactivated state to the activated state; a firing trigger configured to transition from a closed state to an open state.</p>

<p>(a) an anvil, the anvil being operable to retract the anvil proximally relative to the stapling head assembly; and (b) an anvil sensor, the anvil sensor being the anvil sensor to the stapling head assembly. an anvil sensor configured to sense the position of the anvil relative to the anvil, the activation circuit further comprising a transistor coupled with the anvil sensor and the motor activation switch, the transistor: (i) the anvil in response to the combination of the anvil sensor sensing being positioned at or proximal to a predetermined longitudinal position with respect to the stapling head assembly and (ii) the motor activation switch being in an open state. and the transistor is configured to: (i) prevent the anvil sensor from sensing that the anvil is positioned at or proximal to a predetermined longitudinal position relative to the stapling head assembly; 19. An apparatus as recited in embodiment 18, further configured to prevent activation of the motor in response to either that, or (ii) the motor activation switch being in a closed state.</p>

<p>A method of operating a surgical instrument comprising: (a) positioning an end effector of the surgical instrument within a patient; and (b) transitioning a user input mechanism from a deactivated state to an activated state, the method comprising: activating the user input mechanism; (c) transitioning the driver activated switch from the closed state to the open state in response to the user input mechanism being activated to the activated state; activating the end effector driver in response to transitioning from the closed state to the open state; and (e) activating the end effector to operate on the tissue of the patient in response to activating the end effector driver. A method, including:</p><p>IV. Miscellaneous Any one or more of the teachings, expressions, embodiments, examples, etc. described herein may be used in conjunction with any one of the other teachings, expressions, embodiments, examples, etc. described herein. It should also be understood that the above can be combined. Accordingly, the above teachings, expressions, embodiments, examples, etc. should not be considered independently of each other. Various suitable ways in which the teachings herein can be combined will be readily apparent to those skilled in the art in light of the teachings herein. Such modifications and variations are intended to be included within the scope of the claims.</p><p>At least some of the teachings of this specification are based on U.S. Pat. (the disclosure of which is incorporated herein by reference); U.S. Patent Application Publication No. 2014/0151429, published Jun. 5, 2014, entitled "Trans-Oral Circular Anvil Introduction System with Dilation Feature." (the disclosure of which is incorporated herein by reference); U.S. Patent Application Publication No. 2014/0144968, published May 29, 2014, entitled "Surgical Staple with Integral Pledget for Tip"; Deflection" (the disclosure of which is incorporated herein by reference); U.S. Patent Application Publication No. 2014/0158747, published June 12, 2014, entitled "Surgical Stapler with Varying Staple Widths along Different Circumferences"; U.S. Patent Application Publication No. 2014/0144969, published May 29, 2014, entitled "Pivoting Anvil for Surgical Circular Stapler" (this disclosure is incorporated herein by reference); U.S. Patent Application Publication No. 2014/0151430, entitled "Circular Anvil Introduction System with Alignment Feature," published Jun. 5, 2014 (the contents of which are incorporated herein by reference); incorporated herein by ); U.S. Patent Application Publication No. 2014/0166717, published Jun. 19, 2014, entitled "Circular Stapler with Selectable Motorized and Manual Control, Including a Control Ring" (the disclosure of which is incorporated herein by reference); U.S. Patent Application Publication No. 2014/0166728, published June 19, 2014, entitled " Motor Driven Rotary Input Circular Stapler with Modular End Effector, the disclosure of which is incorporated herein by reference; and/or U.S. Patent Application Publication No. 2014/0166718, published June 19, 2014, Invention entitled "Motor Driven Rotary Input Circular Stapler with Lockable Flexible Shaft" (the disclosure of which is incorporated herein by reference); Various suitable ways in which such teachings can be combined will be apparent to those skilled in the art.</p><p>Any patents, publications, or other disclosures referred to herein as incorporated by reference may be incorporated, in whole or in part, by the current definitions, opinions, or other statements of any kind set forth in this disclosure. should be understood to be incorporated herein only to the extent not inconsistent with the disclosure of . As such, and to the extent necessary, the disclosure as explicitly set forth herein supersedes any conflicting statements incorporated herein by reference. Any content, or portion thereof, that is inconsistent with the current definitions, opinions, or other disclosures set forth herein, is hereby incorporated by reference, but the reference content and the current disclosure are hereby incorporated by reference. References shall be made only to the extent that there is no inconsistency between</p><p>Versions of the device described above may have application not only in conventional medical procedures and surgeries performed by medical professionals, but also in robot-assisted medical procedures and surgeries. By way of example only, various teachings herein can be readily incorporated into robotic surgical systems such as the DAVINCI system by Intuitive Surgical, Inc. (Sunnyvale, Calif.).</p><p>The variants described above can be designed to be discarded after a single use, or they can be designed to be used multiple times. The variant may be reconditioned for reuse after at least one use in either or both cases. Reconditioning may involve any combination of the steps of disassembly of the device, followed by cleaning or replacement of particular parts, and subsequent reassembly. In particular, several variations of the device may be disassembled, and any number of the particular parts or parts of the device may be selectively replaced or removed in any combination. After cleaning and/or replacement of certain parts, some variations of the device are reassembled for subsequent use, either at a reconditioning facility or by the user immediately prior to the procedure. can be done. Those skilled in the art will appreciate that reconditioning of the device can utilize a variety of techniques for disassembly, cleaning/replacement, and reassembly. Use of such techniques, and the resulting reconditioned device, are all within the scope of the present application.</p><p>By way of example only, the variations described herein may be sterilized before and/or after treatment. In one sterilization technique, the device is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and device may then be placed in a radiation field that can penetrate the container, such as gamma rays, X-rays, or high energy electron beams. Radiation can kill bacteria on the device and in the container. The sterilized device may then be stored in the sterile container for later use. Any other technique known in the art may be used to sterilize the device including, but not limited to, beta or gamma radiation, ethylene oxide, or steam.</p><p>While various embodiments of this invention have been shown and described above, suitable modifications by those skilled in the art will enable further adaptations of the methods and systems described herein without departing from the scope of this invention. can do. While some of such possible modifications have been mentioned, others will become apparent to those skilled in the art. For example, the examples, embodiments, shapes, materials, dimensions, ratios, steps, etc. described above are illustrative and not essential. Accordingly, the scope of the present invention should be considered in light of the following claims and understood not to be limited to the details of construction and operation shown and described in the specification and drawings.</p><p>[Embodiment] (1) An apparatus comprising: (a) a body; (b) a shaft assembly extending distally from said body having a distal end; and (c) an end effector at said distal end of said shaft assembly. an end effector operable to operate on tissue; and (d) an activation circuit, said activation circuit being (i) an end effector driver, wherein said an end effector driver operable to drive the end effector to perform an action on tissue; and (ii) a driver activation switch, wherein the driver activation switch is in an open state. and a closed state, the end effector driver configured to activate in response to the driver activation switch transitioning to the open state, the end effector driver configured to transition between the a driver-activated switch configured not to activate in response to the driver-activated switch being in said closed state; and (e) transitioning between an inactivated state and an activated state. wherein the driver-activated switch is configured to remain in the closed state when the user-input mechanism is in the non-activated state, the driver-activated switch operable to actuate the user a user input mechanism configured to transition from the closed state to the open state in response to the input mechanism transitioning from the inactivated state to the activated state.</p><p>(2) The apparatus of embodiment 1, wherein the end effector includes a stapling head assembly, the stapling head assembly operable to apply staples to tissue.</p><p>(3) The apparatus of embodiment 2, wherein the end effector further comprises a knife member operable to cut tissue.</p><p>(4) The apparatus of embodiment 2, wherein said stapling head assembly is operable to apply at least one annular row of staples to tissue.</p><p>(5) The apparatus of embodiment 2, wherein the end effector further comprises an anvil, the anvil operable to retract proximally relative to the stapling head assembly.</p><p>(6) The apparatus of embodiment 5, further comprising an anvil sensor, said anvil sensor configured to sense the position of said anvil relative to said stapling head assembly.</p><p>(7) the activation circuit prevents activation of the end effector driver unless the anvil sensor senses that the anvil is at or proximal to a predetermined longitudinal position relative to the stapling head assembly; 7. An apparatus according to embodiment 6, further configured to.</p><p>(8) The apparatus of embodiment 1, wherein the end effector driver includes a motor.</p><p>(9) The apparatus of embodiment 1, wherein the user input mechanism comprises a trigger, the trigger being movable from the inactivated state to the activated state.</p><p>(10) said trigger includes a paddle, said paddle contacting said driver-activated switch when said trigger is moved to said actuated state, thereby transitioning said driver-activated switch from said closed state to said open state; 10. An apparatus according to embodiment 9, configured to allow the</p><p>(11) The apparatus of embodiment 1, wherein the activation circuit further comprises a low voltage threshold transistor in communication with the driver activation switch, the low voltage threshold transistor further in communication with the end effector driver.</p><p>12. The apparatus of claim 11, wherein the low voltage threshold transistor is operable to recognize an open state of the driver activation switch when the driver activation switch is submerged in liquid.</p><p>(13) The apparatus of embodiment 1, further comprising at least one electronic component coated with a liquid impermeable coating.</p><p>(14) The apparatus of embodiment 13, wherein the at least one electronic component comprises a printed circuit board.</p><p>(15) The apparatus of embodiment 13, wherein the at least one electronic component comprises an LED.</p><p>(16) The apparatus of embodiment 13, wherein said liquid impermeable coating comprises UV curable urethane.</p><p>(17) The device of embodiment 13, wherein said liquid-impermeable coating is transparent.</p><p>(18) An apparatus comprising: (a) a body; (b) a shaft assembly extending distally from said body having a distal end; and (c) stapling at said distal end of said shaft assembly. a stapling head assembly, said stapling head assembly being operable to apply staples to tissue and cut tissue; and (d) an activation circuit, said activation circuit comprising: , (i) a motor operable to drive the stapling head assembly to apply staples to tissue and cut tissue; and (ii) a motor activation switch. wherein the motor start switch is configured to transition between an open state and a closed state, and the motor is responsive to transition of the motor start switch from the closed state to the open state. a motor start switch configured to start, wherein the motor is configured not to start in response to the motor start switch being in the closed state; (e) A firing trigger operable to transition between a deactivated state and an activated state, wherein the motor activated switch is configured to remain in the closed state when the firing trigger is in the deactivated state. and the motor activation switch is configured to transition from the closed state to the open state in response to the firing trigger transitioning from the inactivated state to the activated state. A device comprising a.</p><p>(19) (a) an anvil, said anvil operable to retract proximally relative to said stapling head assembly; and (b) an anvil sensor, said anvil sensor comprising: an anvil sensor configured to sense the position of the anvil relative to the stapling head assembly, the activation circuit further comprising a transistor coupled to the anvil sensor and the motor activation switch; wherein the transistor causes (i) the anvil sensor to sense that the anvil is at or proximal to a predetermined longitudinal position relative to the stapling head assembly; and (ii) the motor activating. a switch being in the open state, the transistor being configured to effect activation of the motor in response to a combination of: (i) the anvil being in a predetermined longitudinal position relative to the stapling head assembly; or (ii) the motor activation switch is in the closed state to prevent activation of the motor. 19. An apparatus according to embodiment 18, further configured to:</p><p>(20) A method of operating a surgical instrument, the method comprising: (a) positioning an end effector of the surgical instrument within a patient; and (b) activating a user input mechanism. (c) transitioning a driver activation switch from a closed state to an open state in response to said user input mechanism being actuated to said activated state; (d) ) activating an end effector driver in response to said driver activation switch transitioning from said closed state to said open state; and (e) activating said end effector in response to activation of said end effector driver. to operate on tissue of the patient.</p>