Surgical stapling instruments with rotatable staple deployment arrangements

[0001] A number of minimally invasive robotic (or "telefunctional") systems have been developed in recent years to increase surgical dexterity and to enable the surgeon to operate the patient in an intuitive manner. Many of these systems have been disclosed in the following US patents: US Patent No. 5,792,135, entitled "Articulated Surgical Instrument For Performing Minimally Invasive Surgery With Enhanced Dexterity and Sensitivity", US Patent No. 6,231,565, entitled "Robotic Arm DLUS For Performing Surgical Tasks", US Patent No. 6,783,524, entitled 'Robotic Surgical Tool With Ultrasound Cauterizing and Cutting Instrument', US Patent No. 6,364,888, entitled "Alignment of Master and Slave In a Minimally Invasive Surgical Apparatus", US Patent No. 7,524,320, entitled "Mechanical Actuator Interface System For Robotic Surgical Tools", US Patent No. 7,691,098, entitled "Platform Link Wrist Mechanism", US Patent No. 7,806,891, entitled "Repositioning and Reorientation of Master / Slave Relationship in Minimally Invasive Telesurgery" and US Patent No. 7,824,401, entitled "Surgical Tool With Writed Monopolar Electrosurgical End Effectors". However, many of these systems in the past have not been able to generate the forces needed to effectively cut and attach tissue. [0002] US 6,488,196 discloses a surgical stapler using plastic staples and ultrasonic welding to secure the staples in body tissue. The stapler includes a pair of movable jaws between open and closed positions, a handle and trigger assembly for controlling the operation of the jaws and an elongated tubular structure connecting the handle and the trigger assembly with the jaws. The stapler also includes a ejection assembly for ejecting at least one staple from one of the jaws to the other jaw, which includes cams for moving the platform toward the upper jaw after rotation and a ejection rod for rotating the cams after longitudinal movement. The anvil and corner are placed in the other of the jaws and are arranged to receive the ends of the ejected staple so that the ends overlap between the anvil and the corner. The horn is used to melt and connect at least some of the overlapping staple tips after being excited by a predetermined form of energy, and one of the anvils and horn is movable from within the welded staple to allow the jaws to move to the open position.

[0003] EP 1 935 351 A2 discloses a movable surgical tool that includes a handle, an articulation portion extending further from the handle, and a gripper located at the distal end of the articulation. The flexible drive belt is designed to move through the articulated part and the gripper. The flexible drive belt includes a first portion having a first height and a second portion having a second height greater than the first height, the height difference being sufficient to eject staples from the gripper body portion into the gripper anvil member. The actuating mechanism is provided for pulling the flexible drive belt through an articulated surgical tool.

SUMMARY [0004] The present invention provides a surgical stapling tool comprising:

an actuation system for selectively generating multiple control motions;

a surgical gripper operably connected to the indicated actuation system, wherein the surgical gripper comprises:

the anvil which can move between the open position and the closed position in response to the closing movements applied to it by the indicated actuator;

surgical staple cartridge functionally supporting many linearly arranged pusher members, each indicated pusher member operatively supporting at least one unformed surgical staple thereon; and the actuating member operably coupled to the indicated actuating system such that that after applying the indicated steering movements to it, said actuating member is axially driven within said surgical staple cartridge between an initial position and an end position; and cam means coupled to the indicated actuator in such a way that when the indicated actuator is driven from the indicated start position to the indicated end position, the indicated cam means are moved for rotary cam engagement with each indicated surgical pusher, to propel at least one surgical staple supported on it for contacting molding with the indicated anvil, when the indicated anvil is in the indicated closed position.

FIGURES [0005] Various embodiments of the present invention are described herein by way of example in connection with the following figures, in which:

FIG. 1 is a perspective view of an embodiment of one controller;

FIG. 2 is a perspective view of one robotic arm trolley / robotic system manipulator supporting multiple embodiments of the surgical tool of the present invention;

FIG. 3 is a side view of the robotic surgical arm trolley / manipulator shown in FIG. 2;

FIG. 4 is a perspective view of an exemplary carriage structure with positioning mechanisms for operating robotic manipulators that can be used with various embodiments of surgical instruments according to the present invention;

FIG. 5 is a perspective view of a surgical tool;

FIG. 6 is an exploded view of the adapter system and the tool holder for attaching various embodiments of the surgical tool to the robotic system; FIG. 7 is a side view of the adapter shown in FIG. 6;

FIG. 8 is a bottom view of the adapter shown in FIG. 6;

FIG. 9 shows a top view of the adapter of FIG. 6 and 7;

FIG. 10 is a partial perspective view from below of the surgical tool of FIG. 5;

FIG. 1 is a partial exploded view of an articulated gripper;

FIG. 12 is a perspective view of the embodiment of the surgical tool of FIG. 10 with tool holder housing removed;

FIG. 13 is a rear perspective view of the surgical tool embodiment of FIG. 10 with tool holder housing removed;

FIG. 14 is a front perspective view of the surgical tool of FIG. 10 with tool holder housing removed;

FIG. 15 is an exploded partial perspective view of the surgical tool of FIG. 10;

FIG. 16 is a partial cross-sectional view of the embodiment of the surgical tool of FIG. 10;

FIG. 17 is an enlarged cross-sectional view of a portion of the surgical tool shown in FIG. 16;

FIG. 18 is an exploded view of an exploded portion of the tool attachment for the surgical tool shown in FIG. 10;

FIG. 19 is an enlarged exploded view of a portion of the tool attachment assembly of FIG. 18;

FIG. 20 is a partial cross-sectional view of a portion of the surgical tool longitudinal shaft assembly of FIG. 10;

FIG. 21 is a side view of the surgical instrument cap half;

FIG. 22 is a perspective view of another surgical tool;

FIG. 23 is a cross-sectional side view of a portion of the surgical gripper and an elongated roller assembly of the surgical tool embodiment of FIG. 22 with the anvil in the open position and the closing clutch assembly in the neutral position;

FIG. 24 is another cross-sectional side view of the surgical gripper and the longitudinal roller assembly of FIG. 23 with the clutch assembly engaged in the closed position;

FIG. 25 is another side cross-sectional view of the surgical gripper and roller longitudinal assembly of FIG. 23 with the clutch assembly engaged in the released position;

FIG. 26 is a top view of a tool attachment portion;

FIG. 27 is a perspective view of another surgical tool;

FIG. 28 is a cross-sectional view of a portion of the surgical gripper and the longitudinal roller assembly of the surgical tool of FIG. 27 with the anvil in the open position;

FIG. 29 is another cross-sectional view of a portion of the surgical gripper and the longitudinal roller assembly of the surgical tool of FIG. 27 with the anvil in the closed position;

FIG. 30 is a perspective view of the closing drive nut and part of the knife rod;

FIG. 31 is a top view of another part of the tool attachment;

FIG. 32 is a perspective view of another surgical tool;

FIG. 33 is a cross-sectional view of a portion of the surgical gripper and the longitudinal roller assembly of the surgical tool of FIG. 32 with the anvil in the open position;

FIG. 34 is another cross-sectional view of a portion of the surgical gripper and the longitudinal roller assembly of the surgical tool of FIG. 33 with the anvil in the closed position;

FIG. 35 is a cross-sectional view of an embodiment of the surgical tool mounting flange showing a knife rod and part of a distal closing end of a drive shaft;

FIG. 36 is a cross-sectional view of the mounting flange of FIG. 35;

FIG. 37 is a top view of another tool attachment portion of another surgical tool;

FIG. 37A is a perspective view of a portion of the transmission system of another surgical tool;

FIG. 37B is a perspective cross-sectional view of the gear system shown in FIG. 37A;

FIG. 38 is a cross-sectional view of a portion of the surgical gripper and a longitudinal shaft assembly of another surgical tool utilizing an pressure sensor system with an anvil in an open position;

FIG. 39 is another cross-sectional view of a portion of the surgical gripper and the longitudinal roller assembly of the surgical tool of FIG. 38 with the anvil in the closed position;

FIG. 40 is a side view of a portion of another surgical tool in association with a tool holder part of a robotic system with some components shown in cross section;

FIG. 41 is a side view of a portion of another surgical tool in association with a tool holder part of a robotic system with some components shown in cross section;

FIG. 42 is a side view of a portion of another surgical tool with some components shown in cross section;

FIG. 43 is a side view of a portion of another surgical gripper of a portion of a surgical tool with some components shown in cross section;

FIG. 44 is a side view of a portion of another surgical gripper of a surgical tool portion with some components shown in cross section;

FIG. 45 is a side view of a portion of another surgical gripper of a portion of a surgical tool with some components shown in cross section;

FIG. 46 is a cross-sectional side view of the gripper portion of FIG. 45;

FIG. 47 is another cross-sectional view of the gripper portion of FIG. 45 and 46;

FIG. 48 is a cross-sectional side view of a portion of the surgical gripper and an elongated shaft assembly of another surgical tool with the anvil in the open position; FIG. 49 is an enlarged cross-sectional side view of a portion of the surgical gripper and the longitudinal roller assembly of the surgical tool of FIG. 48;

FIG. 50 is another side view in cross section of the surgical gripper and the longitudinal roller assembly of FIG. 48 and 49 with the anvil in the closed position;

FIG. 51 shows an enlarged cross-sectional view of a portion of the surgical gripper and the longitudinal roller assembly of the surgical tool of FIG. 48-50;

FIG. 52 is a top view of a tool attachment portion for a surgical tool;

FIG. 53 is a perspective view of a further surgical instrument assembly;

FIG. 54 is a front perspective view of a disposable loading unit that can be used in various embodiments of the surgical tool of the present invention;

FIG. 55 is a rear perspective view of the disposable loading unit of FIG. 54;

FIG. 56 is a bottom perspective view of the disposable loading unit of FIG. 54 and 55;

FIG. 57 is a bottom perspective view of another embodiment of a disposable loading unit that can be used in various embodiments of the surgical tool of the present invention;

FIG. 58 is an exploded view of the disposable loading unit attachment assembly of FIG. 54-56;

FIG. 59 is a perspective view of a portion of a disposable loading unit and a longitudinal surgical instrument shaft assembly with the disposable loading unit in a first position;

FIG. 60 is another perspective view of a disposable loading unit portion and shaft longitudinal assembly of FIG. 59 with the disposable loading unit in the second position;

FIG. 61 shows a cross-sectional view of a portion of the disposable loading unit and the embodiment of the longitudinal roller assembly shown in FIG. 59 and 60;

FIG. 62 is another cross-sectional view of the disposable loading unit and longitudinal roller assembly shown in FIG. 59-61;

FIG. 63 is a partial exploded view of a portion of another embodiment of a disposable loading unit and a surgical longitudinal roller assembly;

FIG. 64 is a partial exploded view of a portion of another embodiment of a disposable loading unit and a surgical longitudinal roller assembly;

FIG. 65 is another partial perspective exploded view of the disposable loading unit and roller longitudinal assembly of FIG. 64;

FIG. 66 is a top view of another part of the tool attachment of another surgical tool;

FIG. 67 is a side view of another surgical instrument with some components depicted in cross section and in connection with a robotic tool holder of a robotic system;

FIG. 68 is an exploded view of a surgical gripper that can be used in conjunction with various embodiments of the surgical tool of the present invention;

FIG. 69 is a side view of a portion of a cable driven system for driving a cutting tool used in various embodiments of the surgical gripper of the present invention;

FIG. 70 is a top view of the cable driven system and cutting tool of FIG. 69; FIG. 71 is a top view of the cable driven gear in the closed position;

FIG. 72 is another top view of the cable driven transmission of FIG. 71 in the neutral position;

FIG. 73 is another top view of the cable driven transmission of FIG. 71 and 72 in the firing position;

FIG. 74 is a perspective view of a cable driven transmission in the position shown in FIG. 71;

FIG. 75 is a perspective view of a cable driven transmission in the position shown in FIG. 72;

FIG. 76 is a perspective view of the cable driven transmission in the position shown in FIG. 73;

FIG. 77 is a perspective view of another surgical tool;

FIG. 78 is a side view of a portion of another cable driven system for driving a cutting tool used in various embodiments of the surgical gripper of the present invention;

FIG. 79 is a top view of the embodiment of the cable driven system of FIG. 78;

FIG. 80 is a top view of a tool attachment portion of another surgical tool;

FIG. 81 is a top view in cross section of another surgical tool;

FIG. 82 is a cross-sectional view of a portion of a surgical gripper of a surgical tool;

FIG. 83 is a cross-sectional view of the surgical gripper of FIG. 82 along lines 83-83 in FIG. 82; FIG. 84 is a perspective view of the surgical gripper of FIG. 82 and 83 with parts shown in cross section;

FIG. 85 is a side view of a portion of the surgical gripper of FIG. 82-84;

FIG. 86 is a perspective view of an embodiment of a sled assembly of various surgical instruments;

FIG. 87 is a cross-sectional view of the sled assembly of FIG. 86 and parts of the longitudinal channel of FIG. 85;

FIG. 88-93 schematically illustrate the sequential firing of staples in an embodiment of the surgical tool of the present invention;

FIG. 94 is a partial perspective view of the surgical gripper according to the present invention;

FIG. 95 is a partial cross-sectional view of a surgical tool gripper portion;

FIG. 1 is another perspective partial view in section of the surgical gripper of FIG. 95 with the sled assembly axially extended;

FIG. 97 is a perspective view of another embodiment of the sled assembly of another surgical tool;

FIG. 98 is a partial top view of a portion of the surgical gripper embodiment shown in FIG. 95 and 1 with the sled assembly extended axially;

FIG. 99 is another partial top view of the surgical gripper embodiment of FIG. 98 with the upper surface of the surgical staple cartridge omitted for clarity;

FIG. 100 is a partial cross-sectional side view of the embodiment of the rotary drive member and the staple pusher embodiment of the surgical gripper shown in FIG. 95 and 97;

FIG. 101 is a perspective view of an automated reloading system with a surgical gripper in an extraction attachment with an extraction system;

FIG. 102 is another perspective view of the embodiment of the automated reload system shown in FIG. 101;

FIG. 102 is a cross-sectional side view of the automated reloading system shown in FIG. 101 and 102;

FIG. 104 is another cross-sectional view of the automated reloading system shown in FIG. 101-103 with an extraction system that removes the used surgical staple cartridge from the surgical gripper;

FIG. 105 is another cross-sectional view of the automated reloading system shown in FIG. 101-104, showing loading a new surgical staple cartridge into a surgical gripper;

FIG. 106 is a perspective view of another automated reload system with some components depicted in cross section;

FIG. 107 is an exploded view of the automated reload system of FIG. 106;

FIG. 108 is another exploded view of a portion of the automated reload system shown in FIG. 107;

FIG. 109 is a cross-sectional side view of the automated reloading system shown in FIG. 106-108;

FIG. 10 is a cross-sectional view of an embodiment of a directional tube holding a disposable loading unit in its interior;

FIG. 11 is a perspective view of another surgical tool;

FIG. 12 is a partial perspective view of an embodiment of the articulation of a surgical tool;

FIG. 13 is a perspective view of an embodiment of a surgical instrument closing tube;

FIG. 14 is a perspective view of the closure tube of FIG. 13 mounted on the embodiment of the articulation joint of FIG. 12;

FIG. 15 is a top view of the part for the tool attachment part for the surgical tool;

FIG. 16 is a perspective view of an embodiment of the articulated drive assembly used in the embodiment of the tool mounting portion of FIG. 15;

FIG. 17 is a perspective view of another surgical tool;

FIG. 18 is a perspective view of another surgical tool.

DETAILED DESCRIPTION [0006] Certain embodiments will now be described to provide a complete understanding of the principles of design, functionality, manufacture and use of the devices and methods disclosed herein. One or more of these embodiments are shown in the accompanying drawings. Those skilled in the art will recognize that the devices and methods described in detail herein and in the accompanying drawings are non-limiting embodiments and that the scope of the various embodiments of the present invention is determined solely by the claims. The properties shown or described in connection with one embodiment may be combined with the properties in other embodiments. Such modifications and variations are within the scope of the present invention.

[0007] The use of the expressions "in different embodiments", "in certain embodiments", "in one embodiment" or "in an embodiment" or the like throughout the description does not necessarily apply to the same embodiment. In addition, the specific features, constructions or properties of one or more embodiments may be combined in any suitable manner in one or more other embodiments. Such modifications and variations are within the scope of the present invention.

[0008] FIG. 1 shows one version of the main controller 1001 that can be used in conjunction with a slave robot arm carriage 1100 of the type shown in FIG. 1. The main controller 1001 and the slave trolley 1100 of the robot arm, as well as their respective components and control systems are collectively referred to herein as the robotic system 1000. Examples of such systems and devices are disclosed in US Patent 7,524,320, which is incorporated herein by reference. Accordingly, various details of such devices will not be described in detail herein except as may be necessary to understand the various embodiments and forms of the present invention. As known, master controller 1001 typically includes master controllers (typically referred to as 1003 in FIG. 1) that are captured by the surgeon and operated in space when the surgeon observes the procedure through the 1002 stereoscopic display. Main controllers 1001 typically include manual input devices that preferably move with multiple degrees of freedom and which often also have a movable handle for moving tools (e.g., for closing gripping saws, applying electrical potential to the electrode, and the like).

[0009] As can be seen in FIG. 2, in one embodiment the robot arm carriage 1100 is adapted to move a plurality of surgical instruments, generally designated 1200. Various surgical systems and robotic methods utilizing master controller configurations and a robotic arm trolley are disclosed in US Patent No. 6,132,368, entitled "Multi-Component Telepresence System and Method". In various embodiments, the robot arm carriage 1100 includes a base 1002 from which three surgical instruments 1200 are supported in the embodiment shown. In various embodiments, the surgical tools 1200 are operated by a series of manually operated mechanisms, usually referred to as adjustable connections 1104, as well as robotic manipulator 1106. These constructions are shown in this document with protective covers extending over a large portion of the robotic mechanism. These protective covers may be optional and may be limited in size or eliminated completely in some embodiments to minimize the inertia that is encountered by the servos used to operate such devices to limit the volume of moving components to avoid collisions and to limit the total weight of the trolley 1100. The trolley 1100 will usually have dimensions suitable for transporting the trolley 1100 between functional rooms. The 1100 trolley can be adapted to fit into standard functional room doors and standard hospital elevators. In various embodiments, the trolley 1100 may advantageously have a weight and include a wheel system (or other means of transport) that allows the trolley 100 to be positioned adjacent to the functional table with the help of one employee.

[0010] In FIG. 13 in at least one embodiment, the robotic manipulators 1106 may include a mechanism 1108 that limits the movement of the surgical tool 1200. In various embodiments, mechanism 1108 includes rigid connectors connected to each other by means of rotary joints in a parallelogram configuration in such a way that the surgical tool 1200 rotates around a point in space 1110, which is described in more detail in issued US patent No. 5,817,084, the full disclosure of which is incorporated herein by reference. The parallelogram configuration limits the rotation to rotation around axis 1112a, sometimes referred to as the tilting axis. The connectors holding the parallelogram mechanism are pivotally attached to the adjustable connections 1104 (FIG. 2) in such a way that the surgical tool 1200 rotates further around axis 1112b, sometimes referred to as the direction axis. The tilting axis and the directional axis 1112a, 1112b intersect at a distal center 1114 that is aligned along the shaft 1208 of the surgical tool 1200. Surgical tool 1200 may have additional degrees of freedom being supported by manipulator 1106, including sliding movement of the surgical tool 1200 along the longitudinal axis of the "LT-LT" tool. As the surgical tool 1200 moves along the LT-LT axis relative to the manipulator 1106 (arrow 1112c), the remote center 1114 remains stationary relative to the base 1116 of the manipulator 1106. Thus, the entire manipulator usually moves to position the distant center 1114 in its proper place. Mechanism 1108 of manipulator 1106 is driven by a series of engines 1120. These motors actively move mechanism 1108 in response to commands from the control system processor. As detailed below, motors 1120 are also used to manipulate surgical instruments 1200.

[0011] An alternative design of the adjustable connection is shown in FIG. 4. In this embodiment, the surgical tool 1200 is held by an alternative manipulator design 1106 'between two tissue manipulation tools. Those skilled in the art will be aware that various embodiments of the present invention may include a variety of different alternative robotic constructions, including those described in US Patent No. 5,878,193, entitled "Automated Endoscope System For Optimal Positioning." Also, despite the, that the data transmission between the robotic element and the processor of the robotic surgical system is generally described in this document with respect to the transmission between the surgical tool 1200 and the main controller 1001, it should be assumed that, that a similar transmission may occur between the manipulator circuitry, adjustable connection, endoscope or other image capture device or the like and a processor of a robotic surgical system to verify component compatibility, identification of the type of elements, gears for the purposes of calibrating components (such as offset or the like), confirmation of the connection of the element to a robotic surgical system or the like. [0012] An exemplary non-limiting surgical tool 1200 that is well suited for use with a robotic system 1000 having a tool drive assembly 1010 (FIG. 6), which is functionally connected to the main controller 1001, operated by input signals from an operator (e.g. a surgeon), is shown in FIG. 5. As can be seen in this figure, the surgical tool 1200 includes a surgical gripper 12012 that includes an endo-knife. In at least one embodiment, the surgical tool 1200 typically includes an elongated shaft assembly 12008 that has a proximal closing tube 12040 and a distal closing tube 12042 that are connected to each other by means of articulation 12011. The surgical instrument 1200 is operably connected to the manipulator by means of a tool attachment portion, typically designated 1300. The surgical tool 1200 further includes a connector 1230 that mechanically and electrically connects the tool attachment portion 1300 to the manipulator. One form of connector 1230 is shown in FIG. 6-10. In various embodiments, the tool attachment portion 1300 includes a tool attachment plate 1302 that operatively retains many of (in FIG. 10 four) rotating body parts, disks or driven elements 1304 are shown, each of which includes a pair of pins 1306 that extend from the surface of the driven element 1304. One pin 1306 is closer to the axis of rotation of each driven element 1304 than the other pin 1306 on the same driven element 1304, which helps to ensure positive angular orientation of the driven element 1304. The adapter 1230 includes an adapter portion 1240 that is adapted to engage the mounting attachment plate 1302, as will be described in detail below. The adapter portion 1240 may include an arrangement of electrical connection terminals 1242 (FIG. 8) which can be connected to the memory structure by means of a printed circuit board inside the tool attachment part 1300. Although the 1230 has been described herein with respect to mechanical, electrical and magnetic connecting elements, it should be assumed that a variety of telemetry procedures can be used, including infrared, induction and the like.

[0013] As can be seen in FIG. 6-9, the adapter part 1240 usually includes tool side 1244 and handle side 1246. In various embodiments, many of the rotatable bodies 1250 are mounted to the movable plate 1248, which has a limited range of motion relative to the surrounding adapter structure perpendicular to the main surfaces of the 1240 adapter. The axial movement of the movable plate 1248 helps detach the rotary bodies 1250 from the tool attachment parts 1300 when the levers 1303 along the sides of the housing 1301 the tool attachment parts move (see FIG. 100). Other mechanisms / configurations can be used to detachably connect the 1300 tool attachment part to the 1240 adapter. In at least one embodiment, the rotary bodies 1250 are resiliently attached to the movable plate 1248 by means of radial spring members that extend into a circumferential notch around the rotary bodies 1250. Rotary bodies 1250 can move axially with respect to plate 1248 by deflecting these elastic constructions. When arranged in the first axial position (towards the tool side 1244), the rotary bodies 1250 rotate freely without any angle constraint. However, when the rotary bodies 1250 move axially towards the side of the tool 1244, flaps 1252 (running radially from the rotary bodies 1250) laterally engage the pawls on the movable plates to limit the angular rotation of the rotary bodies 1250 about their axis. This limited rotational motion can be used to assist the drive engagement of rotary bodies 1250 with drive pins 1272 of the corresponding part of the tool holder 1270 of the robotic system 1000, when drive pins 1272 push the rotary bodies 1250 to a limited rotation position until pins 1234 are aligned with (and pushed into ) through holes 1256 '. The holes 1256 in the tool portion 1244 and the holes 1256 'in the portion 1246 of the handle of the rotary bodies 1250 are adapted to precisely align the driven elements 1304 (FIG. 10) parts 1300 for tool attachment with drive components 1271 for tool holder 1270. As described above regarding the inner and outer pins 1306 of the driven elements 1304, the holes 1256, 1256 'are at different distances from the axis of rotation on their respective rotary bodies 1250 to ensure that the alignment is not 180 degrees from the intended position. In addition, each of the holes 1256 is slightly extended radially to accommodate pins 1306 in a circumferential arrangement. This allows the pins 1306 to move radially inside the holes 1256, 1256 'and assume some axial misalignment between tool 1200 and tool holder 1270, while minimizing any misalignment and play between the driven and driving elements. Holes 1256 on the tool side 1244 are offset about 90 degrees from the holes 1256 '(shown in dashed lines) on the handle side 1246, as best seen in FIG. 9.

[0014] Various embodiments may further include an arrangement of electrical connection terminals 1242 located on side 1246 of the adapter holder 1240, and page 1244 of the adapter tool 1240 may include slots 1258 (FIG. 9) for placing a bit pattern (not shown) from tool attachment portion 1300. In addition to transmitting electrical signals between the surgical tool 1200 and the tool holder 1270, at least some of these electrical connections may be connected to the adapter storage device 1260 (FIG. 8) using the 1240 adapter printed circuit board.

[0015] The detachable latch system 1239 can be used to attach the adapter 1240 to the tool holder 1270 with the option of removal. The term "tool drive assembly" as used herein in the context of robotic system 1000 includes at least various embodiments of the adapter 1240 and tool holder 1270 and is generally referred to as 1010 in FIG. 6. As can be seen in FIG. 6, tool holder 1270 may include a first arrangement of latch pins 1274 that is sized such that it can be inserted into respective stirrup slots 1241 in adapter 1240. In addition, tool holder 1270 may further have second latch pins 1276 that are sized so that they can be held in respective latch stirrups 1243 in adapter 1240. See FIG. 9. In at least one embodiment, the latch assembly 1245 is retained with displacement on the adapter 1240 and may diverge between the first latched position in which the latch pins 1276 are held in their respective latch stirrup 1243 and the non-latched position in which the second latch pins 1276 can be introduced into or removed from latch stirrups 1243. A spring or springs (not shown) are used to pivot the latch assembly into the latched position. The lip on the side 1244 of the adapter tool 1240 can slidably receive the laterally extending tabs 301 of the tool mounting housing.

[0016] In FIG. 10-17 in at least one embodiment, the surgical tool 1200 includes a surgical gripper 2012, which includes, in this example, at least one component 2024 that can move selectively between a first and second position relative to the at least one other component 2022 in response to various control movements applied to it as detailed below. In various embodiments, component 2022 includes an elongate channel 2022 adapted to operatively hold the surgical staple cartridge 2034 therein and component 2024 includes a rotatably movable clamping element, such as anvil 2024. Various embodiments of the 2012 surgical gripper are adapted to hold the anvil 2024 and the longitudinal channel 2022 at a distance that guarantees effective stapling and cutting of tissue clamped in the 2012 surgical gripper. As can be seen in FIG. 16, the 2012 surgical gripper further includes a cutting tool 2032 and a sled 2033. The cutting tool 2032 may be, for example, a knife. The surgical staple cartridge 2034 operably houses a plurality of surgical staples (not shown) that are held on the movable staple drive elements (not shown). When the cutting tool 2032 is driven distally through a centrally located slot (not shown) in the surgical staple cartridge 2034, it also pushes the sled 2033 further. When the sled 2033 is driven further, their wedge-shaped arrangement contacts the movable staple drive members and directs them vertically towards the closed anvil 2024. Surgical staples are formed when they are directed to the forming surface on the bottom side of anvil 2024. The sled 2033 may form part of the surgical staple cartridge 2034 in such a way that when the cutting tool 2032 is retracted as a result of the cutting operation, the sled 2033 is not retracted. Anvil 2024 can be rotatably opened and closed at the pivot point 2025 located at the proximal end of the longitudinal channel 2022. Anvil 2024 may also include a flap 2027 at its proximal end that cooperates with a component of the mechanical locking system (described in detail below) to facilitate opening of the anvil 2024. The longitudinal channel 2022 and the anvil 2024 can be made of electrically conductive material (such as metal), which means that they can act as part of the antenna that communicates with the sensor (s) in the gripper, as described above. The surgical staple cartridge 2034 may be made of non-conductive material (such as plastic), and the sensor may be connected to or disposed in the surgical staple cartridge 2034, as also described above.

[0017] As can be seen in FIG. 10-17, the 2012 surgical gripper is attached to the tool attachment portion 1300 by means of a longitudinal roller assembly 2008 in accordance with various embodiments. As shown in the illustrated embodiment, the shaft assembly 2008 includes an articulation generally designated 2011, which allows the surgical gripper 2012 to selectively rotate about the AA-AA articulation axis, which is substantially transverse to the longitudinal axis of the LT-LT tool. See FIG. 11. In other embodiments, the articulation has been omitted. In various embodiments, the shaft assembly 2008 may include a closure tube assembly 2009 that includes a proximal closure tube 2040 and a distal closure tube 2042 that are pivotally connected by means of articulated couplings 2044 and are operatively mounted on a spine assembly generally designated 2049. In the embodiment shown, the dorsal assembly 2049 includes a distal dorsal portion 2050 that is attached to the longitudinal channel 2022 and is pivotally connected to the proximal dorsal portion 2052. The closure tube assembly 2009 is adapted to axially slide on the dorsal assembly 2049 in response to actuating movements applied to it. The distal closing tube 2042 has an opening 2045 into which a flap 2027 on the anvil 2024 is inserted to facilitate the opening of the anvil 2024 when the distal closing tube 2042 moves axially in a proximal "PD" direction. The closing tubes 2040, 2042 may be made of electrically conductive material (such as metal) in such a way that they can act as part of the antenna, as described above. The components of the main drive shaft assembly (e.g., drive shafts 2048, 2050) can be made of non-conductive material (such as plastic).

[0018] In use, it may be necessary to rotate the surgical gripper 2012 about the longitudinal axis of the LT-LT tool. In at least one embodiment, the tool attachment portion 1300 includes a rotary drive assembly 2069 that is adapted to receive a corresponding output rotation movement from the tool drive assembly 1010 of the robot system 1000 and to convert that output rotation movement to a control rotation movement for rotating the longitudinal shaft assembly (and surgical gripper 2012) around the longitudinal axis of the LT-LT tool. For example, in various embodiments, the proximal end 2060 of the proximal closure tube 2040 is pivotally supported on the tool attachment plate 1302 of the tool attachment portion 1300 by means of the front retaining cradle 1309 and closing shoe 2100, which are also supported with the ability to be moved on the tool attachment plate 1302. In at least one embodiment, the rotary drive assembly 2069 includes a tubular toothed section 2062 that is formed (or attached to) the proximal end 2060 of the proximal closure tube 2040 for functional engagement with the rotary gear assembly 2070 that is operably supported on the tool mounting plate 1302. As can be seen in FIG. 13, the rotary gear assembly 2070 in at least one embodiment includes a rotatable driving gear 2072 that is connected to the corresponding first of the drives or driven elements 1304 on the adapter side 1307 of the tool mounting plate 1302 when the tool mounting portion 1300 is connected to the drive assembly 1010 tools. See FIG. 10. The rotary gear assembly 2070 further includes a rotary gear assembly 2074 that is supported rotatably on the tool mounting plate 1302 in meshing with the tubular toothed section 2062 and the driving gear 2072. Applying the first output rotation from the tool drive unit 1010 of the robotic system 1000 to the respective driven element 1304 will cause the rotation of the rotating drive gear 2072. The rotational movement of the rotating drive gear 2072 ultimately results in the rotational movement of the longitudinal shaft assembly 2008 (and surgical gripper 2012) about the longitudinal axis of the LT-LT tool (indicated by the "R" arrow in FIG. 13). It should be noted that the application of the output rotation of the tool drive assembly 1010 in one direction will result in the rotation of the longitudinal shaft assembly 2008 and the surgical gripper 2012 about the longitudinal axis of the LTLT tool in the first direction, and the use of the output rotation of the opposite direction will result in the rotation of the assembly 2008 longitudinal roller and surgical gripper 2012 in a second direction that is opposite to the first direction. [0019] In at least one embodiment, the anvil 2024 is closed to the staple cartridge 2034 by axially displacing the closure tube assembly 2009 in the distal "DD" direction on the dorsal assembly 2049. As indicated above, in various embodiments, the proximal end 2060 of the proximal closing tube 2040 is supported by the closing sled 2100, which includes a portion of the closing gear, generally designated 2099. In at least one embodiment, the closing sled 2100 is adapted to support the closing tube 2009 on the tool mounting plate 1320 in such a way that the proximal closing tube 2040 can rotate relative to the closing sled 2100, however, moves axially with the closing sled 2100. In particular, as can be seen in FIG. 18, closing sled 2100 has a vertical flap 2101 that extends into a radial groove 2063 in the proximal end portion of the proximal closing tube 2040. In addition, as can be seen in FIG. 15 and 18, the closing sled 2100 has a flap portion 2102 that extends through the slot 1305 in the tool mounting plate 1302. Flap portion 2102 is adapted to hold closing sled 2100 in sliding engagement with the tool mounting plate 1302. In various embodiments, closing sled 2100 has a vertical portion 2104 that has a closing rack 2106 formed thereon. The closing toothed rack 2106 is adapted to engage the drive gear on the closing gear assembly 2110. See FIG. 15.

[0020] In various embodiments, the closing gear assembly 2110 includes a closing face gear 2112 that is connected to the corresponding second of the drives or driven elements 1304 on the adapter side 1307 of the tool attachment plate 1302. See FIG. 10. Thus, applying a second output rotation from the tool drive unit 1010 of the robotic system 1000 to the corresponding second driven element 1304 will cause the closing face gear 2112 to rotate when the tool attachment portion 1300 is connected to the tool drive unit 1010. The closing gear assembly 2110 further includes a closing reduction gear set 2114 that is in mesh with the closing face gear 2112. As can be seen in FIG. 14 and 15, the closing reduction gear assembly 2114 includes a driven gear 2116 that is rotatably engaged in engagement with the closing face gear 2112. The closing gear set 2114 further includes a first closing driving gear 2118 which is in meshing with a second closing driving gear 2120 which is pivotally supported on the tool attachment plate 1302 in the meshing with closing gear rack 2106. Therefore, applying a second output rotation from the tool drive assembly 1010 of the robotic system 1000 to the corresponding second driven element 1304 will cause the closing gear of the front gear 2112 and the closing drive 2110 to rotate and ultimately drive axially the closing slide 2100 and the closing tube assembly 2009. The axial direction in which the closure tube assembly 2009 moves ultimately depends on the direction in which the second driven element 1304 rotates. For example, in response to one output rotational motion from tool drive assembly 1010 of robotic system 1000, closing sled 2100 will be driven downstream "DD" and will eventually drive closing tube assembly 1009 downstream. When the distal closing tube 2042 is driven distally, the end of the closing tube section 2042 will engage part of the anvil 2024 and cause the anvil 2024 to rotate to the closed position. When using the "opening" exit motion from the tool drive unit

1010 robotic system 1000 closing sled 2100 and roller assembly 2008 will be driven closer to "PD". When the distal closing tube 2042 is driven proximal, the opening 2045 therein cooperates with the flap 2027 on the anvil 2024 to facilitate its opening. In various embodiments, the spring (not shown) can be used to bias the anvil to the open position when the distal closing tube 2042 is moved to its initial position. In various embodiments, the different gears of the closing gear assembly 2110 are sized to generate the required closing forces needed to successfully close the anvil 2024 on tissue for cutting and suturing with a 2012 surgical gripper. For example, closing drive gears 2110 may be sized to generate approximately 70-120 pounds (31.75-54.43 kg).

[0021] In various embodiments, the cutting tool 2032 is driven by the surgical gripper 2012 by a knife rod 2200. See FIG. 16 and 18. In at least one embodiment, the knife bar 2200 may be made of, for example, stainless steel or other similar material, and has a substantially rectangular cross-section. This knife rod configuration is rigid enough to push the cutting tool 2032 through the tissue clamped in the surgical gripper 2012, while remaining flexible enough to allow articulation of the surgical gripper 2012 relative to the proximal closing tube 2040 and the proximal dorsal portion 2052 around the articulated axis AA -AA, as discussed in detail below. As can be seen in FIG. 14 and 15, the proximal ridge 2052 has a rectangular corridor 2054 running through it to provide support for the knife rod 2200 when it is pushed axially through it. The proximal dorsal portion 2052 has a proximal end 2056 that is pivotally attached to the dorsal mounting bracket 2057 attached to the tool mounting plate 1032. See FIG. 18. This configuration allows rotation of the proximal dorsal portion 2052 but not axial displacement within the proximal closing tube 2040.

[0022] As seen in FIG. 16, the distal end 2202 of the knife rod 2200 is attached to cutting tool 2032. The proximal end 2204 of the knife rod 2200 is rotatably attached to the knife rack 2206 in such a way that the knife rod 2200 will rotate freely relative to the knife rack 2206. See FIG. 18. As can be seen in FIG. 217, knife blade 2206 is slidably mounted inside the blade housing 2210, which is attached to tool attachment plate 1302 in such a manner that knife blade 2206 is in meshing with the knife gear assembly 2220. In particular and with reference to FIG. 15 in at least one embodiment, the knife gear assembly 2220 includes a knife face gear 2222 that is connected to the corresponding third of driven discs or elements 1304 on the adapter side 1307 of the tool attachment plate 1302. See FIG. 105. Therefore, the use of a different output rotation from the robot system 1000 via the tool drive assembly

1010 against the corresponding third driven element 1304 will cause the knife spur gear 2222 to rotate. The knife gear assembly 2220 further includes a knife reduction gear assembly 2224 that includes a first driven knife gear 2226 and a second driving gear of the knife 2228. The knife reduction gear assembly 2224 is rotatably mounted on the tool mounting plate 1302 in such a way that the first driven gear of the knife 2226 is in meshing with the blade front gear 2222. Similarly, the second driving gear of the knife 2228 is in meshing with the third driving gear of the knife 2230, which is rotatably retained on the tool mounting plate 1302 in meshing with the knife toothed rack 2206. In various embodiments, the gears of the knife gear assembly 2220 are sized to generate the forces required to drive the cutting element 2032 through tissue clamped in the surgical gripper 2012 and actuate the staples. For example, the gears of the knife drive assembly 2230 may be sized to generate approximately 40-100 pounds (18.14-55.36 kg). It should be noted that the application of the output rotation of the tool drive assembly 1010 in one direction will result in the axial displacement of the cutting tool 2032 in a distal direction, and the use of the output rotation of the opposite direction will result in the axial displacement of the cutting tool 2032 in the proximal direction.

[0023] In various embodiments, the surgical tool 1200 uses and the articulation system 2007, which includes articulation joint 2011, which allows the surgical gripper 2012 to rotate about an AA-AA articulation axis, which is substantially and relative to the longitudinal axis of the LT-LT tool. In at least one embodiment, the surgical tool 1200 includes first and second articulated rod 2250a, 2250b that are slidably mounted within respective passages 2053 provided in the proximal dorsal portion 2052. See FIG. 18 and 20. In at least one embodiment, the first and second articulated rod 2250a, 2250b are moved by means of an articulated drive generally designated 2249, which is functionally mounted on the tool mounting plate 1032. Each of the articulated rods 2250a, 2250b has a proximal end 2252, which has a guide rod protruding therefrom, which runs transversely through a respective gap in the proximal end portion of the proximal ridge 2052 and into the corresponding arcuate slot in the articulated nut 2260, which includes the articulation portion. FIG. 19 shows the articulated rod 2250a. It should be noted that the articulated rod 2250b is constructed in a similar manner. As can be seen in FIG. 19, the articulated rod 2250a has a guide rod 2254 that runs transversely through the respective slot 2058 in the proximal end portion 2056 of the distal dorsal portion 2050 and into the corresponding arcuate slot 2262 in the articulated nut 2260. In addition, articulated rod 2250a has a distal end 2251a that is pivotally connected to the distal dorsal portion 2050, for example, by means of a pin 2253a, and articulated rod 2250b has a distal end 2251b, which is pivotally connected to the distal ridge 2050, for example by means of a pin

2253b. In particular, the articulated rod 2250a is offset laterally in the first transverse direction from the longitudinal axis of the LT-LT tool, and the articulated rod 2250b is offset laterally in the second transverse direction from the longitudinal axis of the LT-LT tool. Thus, the axial displacement of articulated rods 2250a and 2250b in opposite directions will result in articulation of the distal dorsal portion 2050 and the surgical gripper 2012 attached thereto around the AA-AA articulated axis, which will be discussed in detail below.

[0024] The articulation movement of the surgical gripper 2012 is controlled by the rotational movement of articulated nut 2260 about the longitudinal axis of the LT-LT tool. The articulated nut 2260 is pivotally attached to the proximal end portion 2056 of the distal dorsal portion 2050 and is pivotally driven by the articulated gear assembly 2270. In particular and with reference to FIG. in at least one embodiment, the articulated gear assembly 2270 includes an articulated spur gear 2272 that is connected to the corresponding fourth of the driven disks or components 1304 on the adapter side 1307 of the tool attachment plate 1302. See FIG. 10. Thus, applying a different input rotation from the robotic system 1000 via the tool drive assembly 1010 to the corresponding fourth driven element 1304 will cause the articulated spur gear 2272 to rotate when the link 230 is connected to the tool holder 270. The articulated gear 2274 is rotatably retained on the tool mounting plate 1302 in meshing engagement with the articulated spur gear 2272 and the portion 2264 of the articulated nut 2260 as shown. As can be seen in FIG. 18 and 19, the articulated nut 2260 has a projection 2266 formed thereon that defines an annular groove 2267 for receiving retaining posts 2268. The retaining posts 2268 are attached to the tool attachment plate 1302 and serve to prevent the axial displacement of the articulated nut 2260 on the proximal dorsal portion 2052 while maintaining rotation about it. Thus, the rotational movement of the articulated nut 2260 in the first direction will result in the axial displacement of the articulated rod 2250a in the distal "DD" direction and the axial displacement of the articulated rod 2250b in the proximal "PD" direction due to the interaction of the guide rods 2254 with the spiral slots 2262 in the articulated gear 2260. Similarly, the rotational movement of articulated nut 2260 in a second direction that is opposite to the first direction will result in the axial displacement of articulated rod 2250a in a proximal "PD" direction and will cause axial displacement of articulated rod 2250b in a distal "DD" direction. Thus, the surgical gripper 2012 can be selectively rotated about the "AA-AA" articulated axis in the first "FD" direction by simultaneously moving the articulated rod 2250a in the distal "DD" direction and the articulated rod 2250b in the proximal "PD" direction. Similarly, the 2012 surgical gripper can be selectively rotated about the "AA-AA" articulated axis in the second "SD" direction by simultaneously moving the articulated rod 2250a proximal "PD" and the articulated rod 2250b in the distal "DD" direction. See FIG. 11.

[0025] The embodiment of the tool described above uses a connector configuration that is particularly well suited for attaching a robot-controlled surgical tool to at least one form of the robot arm configuration that generates at least four different rotational control motions. Persons skilled in the art will be aware that such output rotational motions may be selectively controlled by programmable control systems used by the system / controller. For example, the tool configuration described above may be particularly suitable for use with these robotic systems manufactured by Intuitive Surgical, Inc. Sunnyvale, California, United States, many of which can be described in detail in various patents. Aspects of the various embodiments disclosed herein are for using the starting rotational motions provided by the robotic system to generate specific control motions of appropriate sizes that allow the grippers to cut and staple the tissue. Thus, the configurations and principles of various embodiments of the present disclosure may allow the effective use of a number of different forms of the tool systems disclosed and claimed herein in conjunction with other types and forms of robotic systems that provide programmable rotational or other output motions. Furthermore, as will become more apparent when reading the detailed description, various embodiments of the gripper of the present invention that require other forms of actuating motions may also be effectively activated using one or more of the motions generated by the robotic system.

[0026] FIG. 22-26 show another 2300 surgical tool, which can be effectively used in conjunction with the robotic system 1000, which has a tool drive assembly, which is connected functionally to the robot controller, which is supported by input from the operator and which is adapted to provide at least one rotational output motion for at least one rotational body portion held on the tool drive assembly. In various embodiments, the surgical tool 2300 includes a surgical gripper 2312 that includes an elongated channel 2322 and a rotatably movable clamping member, such as anvil 2324, which are held apart from each other, which ensures efficient sewing and cutting of tissue clamped in the surgical gripper 2312. As shown in the embodiment shown, the surgical gripper 2312 may include, in addition to the previously indicated elongated channel 2322 and anvil 2324, a cutting tool 2332 that has a sled portion 2333 formed thereon, a surgical staple cartridge 2334 that is disposed in the elongated channel 2322, and rotary drive shaft 2336 of the gripper, which has a screw thread formed on it. The cutting tool 2332 can be, for example, a knife. As described in the following detailed description, the rotational movement of the gripper drive shaft 2336 will cause axial displacement of the cutting tool 2332 and sled portion 2333 in the surgical staple cartridge 2334 for movement between the initial position and the end position. The axial displacement direction of the cutting tool 2332 depends on the direction in which the gripper drive shaft 2336 rotates. Anvil 2324 can be articulated open and close at pivot point 2325 connected to the proximal end of longitudinal channel 2322. Anvil 2324 may also include at its proximal end a flap 2327 that engages with the ability to operate with a component of the mechanical closing system (described in detail below) to open and close the anvil 2324. As the gripper drive shaft 2336 rotates, the cutting tool 2332 and the sled 2333 will move longitudinally along the surgical staple cartridge 2334 from the initial position to the final position, thereby cutting tissue clamped inside the surgical gripper 2312. The movement of the sled 2333 along the surgical staple cartridge 2334 causes the staples contained therein to be directed through the cut tissue and the closed anvil 2324, which in turn causes the staples to secure the cut tissue. In one embodiment, the elongate channel 2322 and the anvil 2324 can be made of electrically conductive material (such as metal), which means that they can act as part of the antenna that communicates with the sensor (s) in the gripper, as described above. The surgical staple cartridge 2334 may be made of non-conductive material (such as plastic), and the sensor may be connected to or positioned in the surgical staple cartridge 2334, as described above.

[0027] It should be noted that although the embodiments of the surgical tool 2300 described herein use a surgical gripper 2312 that sutures the incisioned tissue, other techniques for attaching or sealing the incisioned tissue may be used in other embodiments. For example, it is possible to use grippers that use radio frequency energy or a binder to fix the cut tissue. US Patent No. 5,709,680, entitled "Electrosurgical Hemostatic Device", Yates et al., as well as US Patent No. 5,688,270, entitled "Electrosurgical Hemostatic Device With Recessed And / Or Offset Electrodes", Yates et al., which disclose cutting tools that use radio frequency energy to attach the dissected tissue. US Patent Application No. 1 / 267,811, Morgan et al., as well as US Patent Application No. 1 / 267,363, Shelton et al. disclose cutting tools that use binders to attach the dissected tissue. In this regard, although the present description relates to cutting / stapling operations and the like, it should be noted that this is only an embodiment and that it is not limiting. You can use other tissue attachment techniques.

[0028] In the embodiment shown, the surgical gripper 2312 is connected to the longitudinal roller assembly 2308 which is connected to the tool attachment portion 2460 and defines the longitudinal axis of the LT-LT tool. In this embodiment, the longitudinal shaft assembly 2308 does not include an articulation. Persons skilled in the art will be aware that other embodiments may have articulated joints. In at least one embodiment, the elongated shaft assembly 2308 includes a hollow outer tube 2340 that is pivotally mounted on the tool mounting plate 2462 of the tool attachment parts 2460, as will be discussed in detail below. In various embodiments, the elongated shaft assembly 2308 further includes a distal dorsal shaft 2350. The distal dorsal roller 2350 has a distal end portion 2354 that is connected to or formed in an integral manner with the distal portion 2360 of the fixed base that is connected to the passage 2322 without being moved. See FIG. 23-25.

[0029] As seen in FIG. 23, the distal dorsal roller 2350 has a portion of the proximal end 2351 that is slidably disposed in a slit 2355 in the proximal dorsal roller 2353 that is retained without being able to move within the hollow outer tube 2340 by means of at least one supporting flange 2357. As can be seen in FIG. 23 and 24, the surgical tool 2300 includes a closure tube 2370 that is limited to axial displacement only relative to the distal portion 2360 of the stationary base. The closure tube 2370 has a proximal end 2372 with an internal thread 2374 formed therein that threadedly engages the drive system, generally designated 2375, which is functionally mounted on the tool mounting plate 2462. In various embodiments, the drive system 2375 includes a rotary drive shaft assembly, generally designated 2381. During rotation, the rotary drive shaft assembly 2381 will cause the axial tube 2370 to move axially, as will be described in detail below. In at least one embodiment, the rotatable drive shaft assembly 2381 includes a drive closure nut 2382 of the clutch assembly, generally designated 2380. In particular, the closing drive nut 2382 has a proximal end portion 2384 that is pivotally mounted relative to the outer tube 2340 and threaded to the closing tube 2370. For assembly purposes, the proximal end portion 2384 may be threaded to the retaining ring 2386. The retaining ring 2386 in cooperation with the end 2387 of the closing drive nut 2382 defines an annular gap 2388 into which the projection 2392 of the locking flange 2390 extends. The locking collar 2390 is attached without moving (e.g. welded, glued, etc.) to the end of the outer tube 2340. This configuration serves to attach the closing drive nut 2382 to the outer tube 2340 while allowing the closing drive nut 2382 to rotate relative to the outer tube 2340. The closing drive nut 2382 further has a distal end 2383 that has a threaded portion 2385 that threadedly engages with the internal thread 2374 of the closing tube 2370. Thus, the rotational movement of the closing drive nut 2382 will cause the axial displacement of the closing tube 2370 indicated by the arrow "D" in FIG. 24.

[0030] The closing of the anvil 2324 and the activation of the cutting tool 2332 are accomplished by means of control movements that are transmitted through the hollow drive sleeve 2400. As can be seen in FIG. 23 and 24, the hollow drive sleeve 2400 is rotatably and slidably positioned on the distal shaft 2350. The drive sleeve 2400 has a proximal end portion 2401 that is pivotally attached to the proximal ridge shaft 2353 that protrudes from the tool attachment portion 2460 in such a way that the drive sleeve 2400 can rotate relative to it. See FIG. 23. As can be seen in FIG. 23-25, the drive sleeve 2400 rotates around the longitudinal axis of the "LT-LT" tool using a 2440 drive shaft. The drive shaft 2440 has a drive gear 2444 that is attached to its distal end 2442 and is in meshing with the drive gear 2450 that is attached to the drive sleeve 2400.

[0031] The drive sleeve 2400 further has a distal end portion 2402 that is connected to the closing clutch assembly portion 2480 2380 that has a proximal side 2412 and a distal side 2414. The proximal side 2412 has a number of proximal teeth 2416 formed thereon, which are adapted to be selectively connected to respective cavities 2418 of the proximal teeth formed in the proximal end portion 2384 of the closing drive nut 2382. Thus, when the proximal teeth 2416 are in mesh with the cavities 2418 of the proximal teeth in the closing drive nut 2382, the rotational movement of the drive sleeve 2400 will result in the rotational movement of the closing drive nut 2382 and ultimately cause the axial displacement of the closing tube 2370, as described in detail below.

[0032] As can be seen in particular in FIG. 23 and 24, distal side 2414 of the drive clutch parts 2410 has a number of distal teeth 2415 formed thereon, which are adapted to be selectively connected to respective cavities 2426 of the distal teeth formed on the face plate 2424 of the knife drive shaft assembly 2420. In various embodiments, the knife drive shaft assembly 2420 includes a hollow section of the knife shaft 2430 that is rotatably disposed on a respective portion of the distal dorsal shaft 2350 that is attached to or protrudes from the stationary base 2360. When the distal teeth 2415 of the closing clutch parts 2410 are in mesh with the cavities 2426 of the distal teeth in the face plate part 2424, the rotational movement of the drive sleeve 2400 will result in the rotational movement of the drive shaft section 2430 around the stationary shaft 2350. As can be seen in FIG. 18-120, the drive gear 2432 of the knife is attached to the drive shaft section 2430 and is in meshing with the drive gear 2434 of the knife that is attached to the gripper drive shaft 2336. Thus, the rotational movement of the drive shaft section 2430 will result in the rotational movement of the gripper drive shaft 2336 to drive the cutting tool 2332 and the sled 2333 in a distal direction through the surgical staple cartridge 2334 to cut and staple tissue clamped within the surgical gripper 2312. The sledge 2333 can be made of, for example, plastic and can have a sloped distal surface. As the sled 2333 moves along the channel 2322, the sloped front surface 2333 of the sled pushes or "directs" the staples in the staple cartridge 2334 through the clamped tissue and onto the anvil 2324. Anvil 2324 bends or "forms" staples, thereby stapling the cut tissue. The term "trigger" as used herein refers to the initiation of the action required to drive the cutting tool and part of the sledge further down through the surgical staple cartridge to cut the tissue clamped in the surgical gripper and drive the staples through the cut tissue.

[0033] In use, it may be necessary to rotate the surgical gripper 2312 about the longitudinal axis of the LT-LT tool. In at least one embodiment, the drive system 2375 includes a rotary drive assembly 2465 that is adapted to receive a corresponding rotational output motion from the tool drive assembly 1010 of the robotic system 1000 and to convert this rotational output motion to a rotational control movement for rotating the longitudinal shaft assembly 2308 ( and a surgical gripper 2312) around the longitudinal axis of the LT-LT tool. As can be seen in FIG. 26, the proximal end 2341 of the outer tube 2340 is pivotally supported inside the cradle configuration 2343 attached to the tool attachment plate 2462 of the part 2460. Rotary gear 2345 is formed on or attached to the proximal end 2341 of outer tube 2340 of longitudinal shaft assembly 2308 for meshing with rotary gear assembly 2470 operatively mounted on tool mounting plate 2462. In at least one embodiment, rotary gear 2472 is connected to the corresponding first of the driven discs or components 304 on the adapter side of the tool attachment plate 2462 when the tool attachment portion 2460 is connected to the tool drive assembly 1010. See FIG. 10 and 26. The rotary gear assembly 2470 further includes a rotatable driven gear 2474 that is rotatably supported on a tool mounting plate 2462 in engagement with a rotatable gear wheel 2345 and a rotatable drive gear 2472. The application of the first rotational output motion from the robotic system 1000 via the tool drive assembly 1010 to the respective driven element 304 will cause the rotational drive gear 2472 to rotate due to the fact that it is operably connected to it. The rotational movement of the rotating drive gear 2472 ultimately results in the rotational movement of the shaft longitudinal assembly 2308 (and the gripper 2312) about the longitudinal axis of the LT-LT tool (main rotational movement).

[0034] The closure of the anvil 2324 with respect to the staple cartridge 12034 is accomplished by axial displacement of the closing tube 2370 in the distal "DD" direction. The axial movement of the closing tube 2370 in the distal direction "DD" is accomplished by applying a rotational control movement to the closing drive nut 2382. In order to apply a rotational control movement to the closing drive nut 2382, the closing clutch 2410 should first engage with a portion of the proximal end 2384 of the closing drive nut 2382. In various embodiments, the drive system 2375 further includes a slide drive unit 2480 that is functionally mounted on the tool mounting plate 2462. In particular and with reference to FIG. 21 it can be seen that a portion of the proximal end 2359 of the proximal dorsal portion 2353 runs through the rotary gear 2345 and is pivotally connected to the gear rack of the shifter 2481, which is slidably attached to the tool mounting plate 2462 through slots 2482. The shifter drive assembly 2480 further includes a shifter driving gear 2483 that is connected to the corresponding second of the driven disks or elements 304 on the adapter side of the tool attachment plate 2462 when the tool attachment portion 2460 is connected to the tool holder 1270. See FIG. 10 and 26. The shifter drive assembly 2480 further includes a shifted driven gear 2478 that is pivotally supported on the tool mounting plate 2462 in meshing with the shifter driving gear 2483 and the shifter rack 2482. Applying a second rotational output motion from the robotic system 1000 via the tool drive assembly 1010 to the respective driven element 304 will cause the rotating drive gear 2483 to rotate due to the fact that it is operably connected to it. The rotational movement of the drive gear 2483 of the shifter ultimately results in the axial movement of the gear rack 2482 of the shifter and the proximal ridge 2353, as well as the drive sleeve 2400 and the closing clutch 2410 attached thereto. The axial displacement direction of the closing clutch 2410 depends on the direction in which the drive gear 2483 of the shifter is rotated by the robotic system 1000. Thus, the rotational movement of the drive gear 2483 of the shifter in the first rotational direction will result in the axial movement of the closing clutch 2410 in the proximal "PD" direction to bring the proximal teeth 2416 into engagement with the cavities 2418 of the proximal teeth in the closing drive nut 2382. In turn, the rotational movement of the drive gear 2483 of the shifter in the second direction of rotation (opposite to the first direction of rotation) will result in the axial movement of the closing clutch 2410 in the "DD" distal direction to drive further teeth 2415 into meshing with respective cavities 2426 of further teeth formed in part 2424 front plate of the knife drive shaft assembly 2420.

[0035] After bringing the closing clutch 2410 into engagement with the closing drive nut 2382, the closing drive nut 2382 rotates due to the rotational movement of the closing clutch 2410. The rotational movement of the closing clutch 2410 is controlled by applying rotational output movements to the drive portion 2490 of the rotary drive system 2375 that is functionally mounted on the tool mounting plate 2462, as shown in FIG. 26. In at least one embodiment, the rotary drive transmission 2490 includes a rotary drive assembly 2490 'that includes a gear 2491 that is connected to the corresponding third of the driven discs or components 304 on the adapter side of the tool attachment plate 2462 when the tool attachment portion 2460 is connected. with tool holder 1270. See FIG. 10 and 26. The rotary drive gear 2490 further includes a first rotatable driven gear 2492 which is rotatably supported on a tool mounting plate 2462 in meshing with a second rotatable drive gear 2493 and a rotatable drive gear 2491. A second rotary driven gear 2493 is connected to the portion 2443 of the proximal end of the drive shaft 2440.

[0036] The rotational movement of the rotatable driving gear 2491 in the first rotational direction will result in the rotational movement of the drive shaft 2440 in the first direction. In turn, the rotational movement of the rotating drive gear 2491 in a second rotation direction (opposite to the first rotation direction) will cause the rotation shaft 2440 to rotate in a second direction. As indicated above, the drive shaft 2440 has a driving gear 2444 that is attached to its distal end 2442 and is in meshing with a driven gear 2450 that is attached to the drive sleeve 2400. Thus, the rotational movement of the drive shaft 2440 results in the rotational movement of the drive sleeve 2400.

[0037] The method of operating the surgical tool 2300 will be described below. After functional engagement of the tool attachment part 2462 with the tool holder 1270 of the robotic system 1000 and positioned adjacent to the target tissue for cutting and stitching, if the anvil 2334 is no longer in the open position (FIG. 18), the robotic system 1000 can apply the first rotary output motion to the drive gear 2483 of the shifter, which results in the axial displacement of the closing clutch 2410 into engagement with the closing drive nut 2382 (if it is no longer in engagement with it). See FIG. 24. When robot controller 1001 1000 confirms that the closing clutch 2410 is in mesh with the closing drive nut 2382 (e.g., using a sensor (s) in the surgical gripper 2312, which communicates with the robotic control system), controller 1001 may then apply a second rotary output motion to rotary drive gear 2492, What, as described above, ultimately results in the rotational movement of the 2382 rotary nut in the first direction, which results in the axial displacement of the closing tube 2370 in the distal "DD" direction. As the closure tube 2370 moves distally, it contacts the anvil portion 2323 and causes the anvil 2324 to rotate to the closed position to clamp the target tissue between the anvil 2324 and the surgical staple cartridge 2334. When the controller 1001 determines, by means of a suitable sensor (s) in the surgical gripper 2312 in communication with it that the anvil 2334 has been rotated to the closed position, the robotic system 1000 interrupts the application of the second rotary output motion to the rotating drive gear 2491. Controller 1001 may also provide the surgeon with an indication that the anvil 2334 has been completely closed. The surgeon can then start the launch procedure. In alternative embodiments, the firing procedure may be started automatically by controller 1001. The controller 1001 then applies the main rotary control movement 2483 to the drive gear 2483, which results in the axial displacement of the closing clutch 2410 to engage with a portion of the front plate 2424 of the knife drive shaft assembly 2420. See FIG. 25. When robot controller 1001 1000 confirms that the closing clutch 2410 is in mesh with the face plate part 2424 (using the sensor (s)) in the gripper 2312, which communicates with the controller 1001), controller 1001 may then apply a second rotary output motion to rotary drive gear 2492, What, as described above, ultimately results in the axial displacement of the cutting tool 2332 and the sled portion 2333 in the distal "DD" direction via the surgical staple cartridge 2334. As the cutting tool 2332 moves distally through the surgical staple cartridge 2334, the tissue clamped in it is cut. When the sled portion 2333 is driven distally, the staples inside the surgical staple cartridge are driven by the cut tissue to contact the forming with the anvil 2324. When the controller 1001 determines that the cutting tool 2324 has reached its final position within the surgical staple cartridge 2334 (using a sensor (s) in the gripper 2312 that communicates with the controller 1001), the controller 1001 interrupts the use of a second rotational output motion against the rotating drive gear 2491 . The controller 1001 then applies a secondary rotational output motion to the rotating drive gear 2491, which ultimately results in axial displacement of the cutting tool 2332 and the sled portion 2333 proximal "PD" to the initial position. When the controller 1001 determines that the cutting tool 2324 has reached its initial position by means of the sensor (s) in the surgical gripper 2312 that communicates with the controller 1001, the controller 1001 interrupts the application of the secondary rotational output motion to the rotating drive gear 2491. Then controller 1001 applies the main rotational output motion to the drive gear 2483 of the shifter to displace the closing clutch 2410 to engage with the rotational drive nut 2382. When the closing clutch 2410 is in meshing with the rotary drive nut 2382, the controller 1001 then applies a second output motion to the rotating drive gear 2491, which ultimately results in the rotational movement of the rotary drive nut 2382 in a second direction to move the closing tube 2370 closer to the "PD ". As can be seen in FIG. 23-25, the closing tube 2370 has an opening 2345 that connects to the flap 2327 on the anvil 2324 to rotate the anvil 2324 to the open position. In alternative embodiments, it is possible to use the spring to rotate the anvil 2324 to the open position when the closing tube 2370 has been returned to its initial position (FIG. 23).

[0038] FIG. 27-31 show another 2500 surgical tool that can be effectively used in conjunction with the 1000 robotic system. In various embodiments, the surgical tool 2500 includes a surgical gripper 2512 that includes a "first portion" in the form of an elongate channel 2522 and a "second movable portion" in the form of a rotatably movable clamping member, such as anvil 2524, which are held at a distance that guarantees effective stapling and cutting the tissue clamped in the surgical gripper 2512. As seen in the embodiment shown, the surgical gripper 2512 may include, in addition to the previously indicated elongate channel 2522 and anvil 2524, a "third movable portion" in the form of a cutting tool 2532, a sled (not shown), as well as a surgical staple cartridge 2534 that is placed with can be removed in the longitudinal channel 2522. The cutting tool 2532 may be, for example, a knife. Anvil 2524 can be articulated open and close at a pivot point 2525 connected to the proximal end of the longitudinal channel 2522. Anvil 2524 may also include a flap 2527 at its proximal end, which is adapted to be operable with a component of the mechanical locking system (described in detail below). When activated, the knife 2532 and the sled move along the longitudinal channel 2522, thereby cutting tissue clamped inside the surgical gripper 2512. The movement of the sled along the elongated channel 2522 causes the staples of the surgical staple cartridge 2534 to be guided through the cut tissue and the closed anvil 2524, which in turn causes the staples to secure the cut tissue. In one embodiment, the elongate channel 2522 and the anvil 2524 can be made of electrically conductive material (such as metal), which means that they can act as part of the antenna that communicates with the sensor (s) in the gripper, as described above. The surgical staple cartridge 2534 may be made of non-conductive material (such as plastic), and the sensor may be connected to or positioned in the surgical staple cartridge 2534, as described above.

[0039] It should be noted that although the embodiments of the surgical tool described herein use the surgical gripper 2512 that sutures the cut tissue, other techniques for attaching or sealing the cut tissue can be used in other embodiments. For example, grippers that use radio frequency energy or binders can also be used to secure the cut tissue. US Patent No. 5,709,680, entitled "Electrosurgical hemostatic device", Yates et al., as well as US Patent No. 5,688,270, entitled "Electrosurgical hemostatic device with recessed and / or offset electrodes", Yates et al. disclose cutting tools that use radio frequency energy to attach the cut tissue. US Patent Application No. 1 / 267,811, Morgan et al., and US Patent Application No. 1 / 267,363, Shelton et al. disclose endoscopic cutting tools that use binders to attach the cut tissue. In this regard, although the present description relates to cutting / stapling operations and the like, it should be noted that this is only an embodiment and that it is not limiting. You can use other tissue attachment techniques.

[0040] In the embodiment shown, the elongate channel 2522 of the surgical gripper 2512 is connected to the elongated roller assembly 2508 that is connected to the tool attachment portion 2600. As shown in FIG. 27, the elongated shaft assembly 2508 may include the articulated connection 2511 of the type and structure described herein to allow selective connection of the articulated gripper 2512 about an axis that is substantially transverse to the LT-LT axis of the tool. In other embodiments, however, articulation may be missing. In at least one embodiment, the elongated shaft assembly 2508 includes a hollow dorsal tube 2540 that is connected to a non-movable plate 2602 of tool attachment part 2600 of attachment tool. As can be seen in FIG. 28 and 29, the proximal end 2523 of the elongate channel 2522 includes a hollow tubular structure adapted to be attached to the distal end 2541 of the dorsal tube 2540. For example, in one embodiment, the proximal end 2523 of the longitudinal channel 2522 is welded or glued to the distal end of the dorsal tube 2540.

[0041] As can further be seen in FIG. 28 and 29, in at least one non-limiting embodiment, the surgical tool 2500 further includes an axially displaced actuator in the form of a closing tube 2550 that is limited to axial displacement with respect to the longitudinal channel 2522 and the dorsal tube 2540. The closing tube 2550 has a proximal end 2552, which has an inner thread 2554 formed therein, which is in a threaded connection with a rotatably displaceable portion in the form of a closing drive nut 2560. In particular, the closing drive nut 2560 has a proximal end portion 2562 that is pivotally mounted relative to the longitudinal channel 2522 and the dorsal tube 2540. For assembly purposes, a portion of the proximal end 2562 is threaded to the retaining ring 2570. Retaining ring 2570 is placed in groove 2529 formed between projection 2527 at proximal end 2523 of longitudinal channel 2522 and distal end 2541 of dorsal tube 2540. This configuration serves to rotatably support the closing drive nut 2560 within the elongated channel 2522. The rotational movement of the closing drive nut 2560 will cause the axial displacement of the closing tube 2550 indicated by the arrow "D" in FIG. 28.

[0042] A drive member passing through the dorsal tube 2540 and the closing drive nut 2560, which in at least one embodiment includes a knife rod 2580, has a distal end portion 2582 that is pivotally connected to the cutting tool 2532 in such a way that the knife rod 2580 can rotate relative to cutting tool 2582. As can be seen in FIG. 49-51, the closing drive nut 2560 has a slot 2564 through which the knife rod 2580 can slide slidably. This configuration allows axial displacement of the knife rod 2580 relative to the closing drive nut 2560. However, the rotational movement of the knife rod 2580 about the longitudinal axis of the LT-LT tool will also result in the rotational movement of the closing drive nut 2560. The axial direction in which the closing tube 2550 moves ultimately depends on the direction in which the knife rod 2580 and the closing drive nut 2560 rotate. When the closing tube 2550 is driven distally, its distal end will contact the anvil 2524 and cause the anvil 2524 to rotate to the closed position. If an opening rotational exit from the robotic system 1000 is used, the closing tube 2550 will be driven proximal "PD" and the anvil 2524 will be rotated to the open position by connecting the cap 2527 to the opening 2555 in the closing tube 2550. [0043] In use, it may be necessary to rotate the surgical gripper 2512 about the longitudinal axis of the LT-LT tool. In at least one embodiment, the tool attachment portion 2600 is adapted to receive a corresponding first rotational output motion from the robotic system 1000 and to convert this first rotational output motion to a rotational control movement for rotating the longitudinal shaft assembly 2508 about the longitudinal axis of the LT-LT tool. As can be seen in FIG. 26, the proximal end 2542 of the hollow dorsal tube 2540 is pivotably supported inside the cradle configuration 2603 attached to the plate 2602 of the tool attachment portion 2600. Various embodiments of the surgical tool 2500 further include a transmission system, generally designated 2605, which is functionally mounted on the tool mounting plate 2602. In various embodiments, the gear system 2605 includes a rotary gear 2544 that is formed on or attached to the proximal end 2542 of the dorsal tube 2540 for meshing with the rotary drive assembly 2610 that is functionally mounted on the tool mounting plate 2602. In at least one embodiment, rotary gear 2612 is connected to the respective first of the rotary bodies, driven discs or components 304 on the adapter mounting plate 2602 side of the tool when the tool mounting portion 2600 is connected to the tool holder 1270. See FIG. 105 and 26. The rotary drive assembly 2610 further includes a rotatable driven gear 2614 that is pivotally mounted on a tool mounting plate 2602 in engagement with a rotatable gear 2544 and a rotatable drive gear 2612. Applying the first rotational output motion from the robotic system 1000 via the tool drive assembly 1010 to the respective driven rotary body 304 will cause the rotational drive gear 2612 to rotate because it is connected to it. The rotational movement of the rotating drive gear 2612 ultimately results in the rotational movement of the longitudinal shaft assembly 2508 (and gripper 2512) about the longitudinal axis of the LT-LT tool.

[0044] The closure of the anvil 2524 with respect to the surgical staple cartridge 2534 is accomplished by axial displacement of the closing tube 2550 in the distal "DD" direction.

The axial displacement of the closing tube 2550 in the distal direction "DD" is accomplished by applying a rotational control movement to the closing drive nut 2382. In various embodiments, the closing drive nut 2560 is rotated by applying a rotational output motion to the knife rod 2580. The rotational movement of the knife rod 2580 is controlled by applying rotational exit motions to the rotary locking system 2620 which is operably mounted on the tool mounting plate 2602 as shown in FIG. 31. In at least one embodiment, the rotary locking system 2620 includes a locking driving gear 2622 that is connected to the corresponding second of the rotatable rotatable body parts, discs or elements 304 on the adapter side of the tool attachment plate 2462 when the tool attachment portion 2600 is connected to the handle 1270 tools. See FIG. 10 and 31. The closing driving gear 2622 in at least one embodiment is in the driving gear with the closing gear, generally designated 2623. The closing gear 2623 includes a first driven closing gear 2624 that is pivotally mounted on the tool mounting plate 2602. The first driven closing gear 2624 is attached to the second driven closing gear 2626 by means of a drive shaft 2628. The second driven closing gear 2626 is in mesh with the third driven closing gear 2630 which is pivotally mounted on the tool mounting plate 2602. The rotational movement of the drive closing gear 2622 in the second rotation direction will result in the rotation of the third driven closing gear 2630 in the second direction. In turn, the rotational movement of the drive closing gear 2483 in the secondary rotation direction (opposite to the second rotation direction) will cause the rotation of the driven closing gear 2630 in the second direction. [0045] As can be seen in FIG. 31, the drive shaft assembly 2640 is connected to the proximal end of the knife rod 2580. In various embodiments, the drive shaft assembly 2640 includes a proximal portion 2642 that has a square cross section. The proximal part 2642 is adapted to be slidably connected to a suitably shaped hole in the third driven gear 2630. This configuration results in a rotational movement of the drive shaft assembly 2640 (and knife rod 2580) as the third driven gear 2630 rotates. The drive shaft assembly 2640 is extended axially in a distal and proximal direction by a knife drive assembly 2650. One form of the knife drive assembly 2650 includes a closing rotary gear 2652 that is connected to a respective third of the rotatable rotatable body parts, discs or components 304 on the adapter side of the tool attachment plate 2462 when the tool attachment portion 2600 is connected to the tool holder 1270. See FIG. 10 and 31. Rotary driven gear 2652 is in the toothing with the gear wheel, generally designated 2653. In at least one embodiment, the gear 2653 further includes a first rotatable driven gear assembly 2654 that is rotatably mounted on a tool mounting plate 2602. The first rotary driven gear assembly 2654 is in meshing with the third rotary driven gear assembly 2656, which is pivotally mounted on the tool mounting plate 2602 and which is in meshing with the fourth rotating driving gear assembly 2658 that is in meshing with the threaded part 2644 of the drive shaft assembly 2640. The rotational movement of the rotatable driven gear wheel 2652 in the third direction of rotation will result in the axial extension of the drive shaft assembly 2640 and knife bar 2580 in the distal direction "DD". In turn, the rotational movement of the rotating drive gear 2652 in a tertiary rotational direction (opposite to the third rotational direction) will cause the drive shaft assembly 2640 and the knife rod 2580 to move closer.

[0046] The method of operating the surgical tool 2500 will be described below. When the tool attachment portion 2600 is operably connected to the tool holder 1270 of the robotic system 1000, the robotic system 1000 can position the surgical gripper 2512 in a position adjacent to the target tissue for cutting and suturing. If the anvil 2524 is no longer in the open position (FIG. 49), the robotic system 1000 may apply a second rotational output motion to the closing drive gear 2622, which results in the rotational movement of the knife rod 2580 in the second direction. The rotational movement of the knife rod 2580 in the second direction results in the rotational movement of the closing drive nut 2560 in the second direction. When the closing drive nut 2560 rotates in a second direction, the closing tube 2550 moves in a proximal direction "PD". As the closing tube 2550 moves proximal "PD", the flap 2527 on the anvil 2524 connects to the opening 2555 in the closing tube 2550 and causes the anvil 2524 to rotate to the open position. In addition or in alternative embodiments, it is possible to use a spring (not shown) to rotate the anvil 2354 to the open position when the closing tube 2550 has returned to its original position (FIG. 28). The open surgical gripper 2512 can then be operated by the robotic system 1000 to position the target tissue between the open anvil 2524 and the surgical staple cartridge 2534. The surgeon may then begin the closing process by activating the robotic control system 1000 to apply a second rotary output movement to the closing drive gear 2622 which, as described above, ultimately results in the rotational movement of the closing drive nut 2382 in a second direction, resulting in axial displacement of the closing tube 2250 towards the "DD". As the closure tube 2550 moves distally, it contacts the anvil portion 2524 and causes the anvil 2524 to rotate to the closed position to clamp the target tissue between the anvil 2524 and the staple cartridge 2534. When the controller 1001 determines that the anvil 2524 has been turned to the closed position by means of a suitable sensor (s) in the gripper 2512 that communicates with it, the controller 1001 interrupts the application of the second rotary output motion to the closing drive gear 2622. Controller 1001 may also provide the surgeon with an indication that the anvil 2524 has been completely closed. The surgeon can then start the launch procedure. In alternative embodiments, the firing procedure may be started automatically by controller 1001.

[0047] When the controller 1001 determines that the anvil 2524 is in the closed position, the controller 1001 then applies a third rotational output movement to the rotating drive gear 2652, which results in the axial displacement of the drive shaft assembly 2640 and the knife rod 2580 toward the distal "DD" . As the cutting tool 2532 moves distally through the surgical staple cartridge 2534, the tissue clamped in it is cut. When part of the sled (not shown) is driven in distal direction, the staples inside the surgical staple cartridge 2534 are driven by the cut tissue to contact the forming anvil with the anvil 2524. When the controller 1001 determines that the cutting tool 2532 has reached the end position within the surgical staple cartridge 2534 by means of a sensor (s) in the surgical gripper 2512 that communicates with the controller 1001, the controller 1001 interrupts the use of a second ego rotational output motion against the rotating drive gear 2652 . The controller 1001 then applies a secondary rotational control movement to the rotating drive gear 2652, which ultimately results in the axial displacement of the cutting tool 2532 and parts of the sled in a proximal "PD" direction to the initial position. When controller 1001 determines that that the cutting tool 2524 has reached its initial position by means of the sensor (s) in the gripper 2512, which communicates with the 1001 controller, controller 1001 interrupts the application of the secondary rotational output motion to the rotating drive gear 2652. Then controller 1001 can apply the secondary rotational output motion to the closing drive gear 2622, which results in rotation of the knife rod 2580 in a secondary direction. The rotational movement of the knife rod 2580 in the secondary direction results in the rotation of the closing drive nut 2560 in the secondary direction. As the closing drive nut 2560 rotates in the secondary direction, the closing tube 2550 moves in a proximal "PD" direction to the open position.

[0048] FIG. 32-37B show another 2700 surgical tool that can be effectively used in conjunction with the 1000 robotic system. In various embodiments, the surgical tool 2700 includes a surgical gripper 2712 that includes a "first portion" in the form of an elongate channel 2722 and a "second movable portion" in a form comprising a rotatably movable clamping member, such as anvil 2724, which is held at a distance that guarantees effective suturing and cutting the tissue clamped in the surgical gripper 2712. As seen in the embodiment shown, the surgical gripper 2712 may include, in addition to the previously indicated longitudinal channel 2722 and the anvil 2724, a "third movable portion" in the form of a cutting tool 2732, a sled (not shown), and a surgical staple cartridge 2734 that is placed with can be removed in the longitudinal channel 2722. The cutting tool 2732 may for example be a knife. Anvil 2724 can be articulated open and close at pivot point 2725 connected to the proximal end of longitudinal channel 2722. Anvil 2724 may also include a flap 2727 at its proximal end that engages with a component of the mechanical closing system (described in detail below) to open and close the anvil 2724. When activated, the knife 2732 and the sled move along the longitudinal channel 2722, thereby cutting the tissue clamped inside the surgical gripper 2712. The movement of the sled along the elongated channel 2722 causes the staples of the surgical staple cartridge 2734 to be directed through the cut tissue and the closed anvil 2724, which in turn causes the staples to fix the cut tissue. In one embodiment, the longitudinal channel 2722 and the anvil 2724 can be made of electrically conductive material (such as metal), which means that they can act as part of the antenna that communicates with the sensor (s) in the gripper, as described above. The surgical staple cartridge 2734 may be made of non-conductive material (such as plastic), and the sensor may be connected to or disposed in the surgical staple cartridge 2734, as described above.

[0049] It should be noted that although the embodiments of the surgical tool described herein utilize the surgical gripper 2712 that sutures the cut tissue, other techniques for attaching or sealing the cut tissue can be used in other embodiments. For example, grippers that use radio frequency energy or binders can also be used to secure the cut tissue. US Patent No. 5,709,680, entitled "Electrosurgical hemostatic device", Yates et al., as well as US Patent No. 5,688,270, entitled "Electrosurgical hemostatic device with recessed and / or offset electrodes", Yates et al. disclose cutting tools that use radio frequency energy to attach the cut tissue. US Patent Application No. 1 / 267,811, Morgan et al. and US patent application No. 1 / 267,363, Shelton et al. disclose cutting tools that use binders to fix the cut tissue. In this regard, although the present description relates to cutting / stapling operations and the like, it should be noted that this is only an embodiment and that it is not limiting. You can use other tissue attachment techniques.

[0050] In the embodiment shown, the elongate channel 2722 of the surgical gripper 2712 is connected to the elongated roller assembly 2708 which is connected to the tool attachment portion 2900. Although not shown, the longitudinal shaft assembly 2708 may include articulation to allow selective articulation of the surgical gripper 2712 about an axis that is substantially and relative to the axis of the LT35 tool

LT. In at least one embodiment, the longitudinal shaft assembly 2708 includes a hollow dorsal tube 2740 that is connected without being able to move with the plate 2902 of the tool attachment portion 2900. As can be seen in FIG. 28 and 29, the proximal end 2723 of the elongate channel 2722 includes a hollow tubular structure that is attached to the dorsal tube 2740 by means of a mounting flange 2790. A cross-sectional view of the mounting flange 2790 is shown in FIG. 35. In various embodiments, the mounting flange 2790 has a proximal flange end 2791 that is adapted to be connected to the distal end of the dorsal tube 2740. For example, in at least one embodiment, the proximal flange end 2791 of the mounting flange 2790 is welded or glued to the distal end of the dorsal tube 2740. As can further be seen in FIG. 28 and 29, mounting flange 2790 further has a mounting hub portion 2792 that is sized to accommodate the proximal end 2723 of elongated channel 2722. The proximal end 2723 of the longitudinal channel 2722 is attached without being able to be moved to the mounting hub portion 2792, for example by welding, adhesive and the like.

[0051] As can further be seen in FIG. 33 and 34, the surgical tool 2700 further includes an axially displaced actuator in the form of a closing tube 2750 that is limited to axial displacement relative to the longitudinal channel 2722. The closing tube 2750 has a proximal end 2752, which has an internal thread 2754 formed therein, which is in a threaded connection with a rotatably displaceable portion in the form of a closing drive nut 2760. In particular, the closing drive nut 2760 has a portion of the proximal end 2762 that is pivotally mounted relative to the longitudinal channel 2722 and the dorsal tube 2740. For assembly purposes, a portion of the proximal end 2762 is threaded to the retaining ring 2770. The retaining ring 2770 is placed in the groove 2729 formed between the projection 2727 at the proximal end 2723 of the channel 2722 and the mounting hub 2729 of the mounting flange 2790. This configuration is used to rotatably mount the closing drive nut 2760 inside channel 2722. The rotational movement of the closing drive nut 2760 will cause the axial displacement of the closing tube 2750 indicated by the arrow "D" in FIG. 33.

[0052] Through the dorsal tube 2740, mounting flange 2790 and the closing drive nut 2560, a drive element passes which in at least one embodiment includes a knife rod 2780 which has a distal end portion 2782 which is connected to the cutting tool 2732. As can be seen in FIG. 33 and 34, the mounting flange 2790 has a through passage 2793 that allows the knife rod 2780 to slide through it. Similarly, the closing drive nut 2760 has a slot 2764 through which the knife rod 2780 may slide through. This configuration allows axial displacement of the knife rod 2780 relative to the closing drive nut 2760.

[0053] The movement of the anvil 2724 is controlled by the driven rotary closing roller 2800. As can be seen in FIG. 33 and 34, portion 2802 of the distal end of the closing drive shaft 2800 runs through the passage 2794 in the mounting flange 2790, and the closing gear 2804 is attached thereto. The closing gear 2804 is adapted for a drive connection with the inner surface 2761 of the closing drive nut 2760. Thus, the rotational movement of the closing shaft 2800 will also result in the rotational movement of the closing drive nut 2760. The axial direction in which the closing tube 2750 moves ultimately depends on the direction in which the closing shaft 2800 and the closing drive nut 2760 rotate. For example, in response to one rotary closing motion received from the robotic system 1000, the closing tube 2750 will be driven in the "DD" downstream direction. When the closing tube 2750 is driven distally, the opening 2745 will engage with the flap 2727 on the anvil 2724 and cause the anvil 2724 to rotate to the closed position. If a rotational opening movement is used from the robotic system 1000, the closing tube 2750 will be driven closer to "PD" and the anvil 2724 will rotate to the open position. In various embodiments, it is possible to use a spring (not shown) to swing the anvil 2724 into the open position (FIG. 33).

[0054] In use, it may be necessary to rotate the surgical gripper 2712 about the longitudinal axis of the LT-LT tool. In at least one embodiment, the tool attachment portion 2900 is adapted to receive a corresponding first rotational output motion from the robotic system 1000 to rotate the shaft longitudinal assembly 2708 about the LT-LT tool axis. As can be seen in FIG. 132, the proximal end 2742 of the hollow dorsal tube 2740 is pivotably mounted inside the cradle configuration 2903 and bearing assembly 2904, which are attached to the plate 2902 of the tool attachment part 2900. Rotary gear 2744 is formed on or attached to the proximal end 2742 of the dorsal tube 2740 for meshing with the rotary drive assembly 2910 which is functionally mounted on the tool mounting plate 2902. In at least one embodiment, the rotatable driving gear 2912 is connected to the corresponding first of the driven discs or elements 304 on the side 2602 of the tool mounting plate adapter when the tool mounting portion 2600 is connected to the tool holder 270. See FIG. 105 and 132. The rotary drive assembly 2910 further includes a rotatable driven gear 2914 that is rotatably mounted on a tool mounting plate 2902 in meshing engagement with the rotatable gear 2744 and the rotatable drive gear 2912. The application of the first rotational control motion from the robotic system 1000 via the tool holder and adapter 240 to the respective driven element 304 will cause the rotational drive gear 2912 to rotate due to the fact that it is connected to it. The rotational movement of the rotating drive gear 2912 ultimately results in the rotational movement of the longitudinal shaft assembly 2708 (and the gripper 2712) about the longitudinal axis of the LT-LT tool (main rotational motion).

[0055] The closure of the anvil 2724 with respect to the staple cartridge 2734 is accomplished by axial displacement of the closing tube 2750 in the distal "DD" direction. The axial displacement of the closing tube 2750 in the distal direction "DD" is accomplished by applying a rotational control movement to the closing drive nut 2760. In various embodiments, the closing drive nut 2760 rotates by applying a rotational output motion to the closing drive shaft 2800. As can be seen in FIG. 37 the portion 2806 of the proximal end of the closing drive shaft 2800 has a driven gear 2808 which is in engagement with the closing drive assembly 2920. In various embodiments, the closing drive system 2920 includes a closing drive gear 2922 that is connected to the corresponding second of the driven bodies or rotating elements 304 on the adapter side of the tool attachment plate 2462 when the tool attachment portion 2900 is connected to the tool holder 270. See FIG. 10 and 37. The closing driving gear 2922 is held in meshing with the closing gear, generally designated 2923. In at least one embodiment, the closing gear rack 2923 includes a first driven closing gear 2924 that is rotatably mounted on a tool mounting plate 2902. The first driven closing gear 2924 is attached to the second driven closing gear 2926 by means of a drive shaft 2928. A second driven closing gear 2926 is in mesh with the planetary gear assembly 2930. In various embodiments, the planetary gear assembly 2930 includes a driven closing planetary gear 2932 that is rotatably mounted within a bearing assembly 2904 that is mounted on a tool mounting plate 2902. As can be seen in FIG. 37 and 37B, a portion of the proximal end 2806 of the closing drive shaft 2800 is rotatably mounted within the proximal end portion 2742 of the dorsal tube 2740 in such a way that the driven gear 2808 is in meshing with central gear teeth 2934 formed on planetary gear 2932. As can also be seen in FIG. 37A, two additional support gears 2936 are attached to or rotatably mounted relative to portion 2742 of the proximal end of the dorsal tube 2740 to provide a support support for it. This configuration with planetary gear assembly 2930 serves to receive the rotary motion of the spindle shaft 2740 by the rotary drive assembly 2910 while allowing the driven closing gear 2808 to remain in engagement with the closing drive system 2920. Furthermore, the rotational movement of the closing drive gear 2922 in the first direction will ultimately result in the rotation of the closing drive shaft 2800 and the closing drive nut 2760, which ultimately results in the closing of the anvil 2724 as described above. In turn, the rotational movement of the closing drive gear 2922 in a second opposite direction will ultimately result in the rotational movement of the closing drive nut 2760 in the opposite direction, which results in the opening of the anvil 2724.

[0056] As can be seen in FIG. 31, the proximal end 2784 of the knife rod 2780 has a threaded shaft portion 2786 attached thereto which is in drive connection with the knife drive assembly 2940. In various embodiments, the threaded shaft portion 2786 is rotatably supported by a bearing 2906 attached to the tool mounting plate 2902. This configuration allows rotational movement of the threaded shaft portion 2786 and axial displacement with respect to the tool mounting plate 2902. The knife rod 2780 is extended axially in a distal and proximal direction by means of the knife drive assembly 2940. One form of the knife drive assembly 2940 includes a rotatable drive gear 2942 that is connected to the corresponding third of the rotatable rotatable bodies, discs or components 304 on the side 2902 of the tool attachment plate when the tool attachment portion 2900 is connected to the tool holder 270. See FIG. 10 and 37. The rotating drive gear 2942 is in mesh with the knife gear, generally designated 2943. In various embodiments, the blade gear 2943 includes an assembly 2944 of a first rotatable drive gear that is rotatably mounted on a tool mounting plate 2902. The first rotary driven gear assembly 2944 is in meshing with the third rotary driven gear assembly 2946 that is pivotally mounted on the tool mounting plate 29 and which is in meshing with the fourth rotary driving gear assembly 2948 that is in meshing with the threaded part 2786 knife rod 2780. The rotational movement of the rotating gear wheel 2942 in one direction will result in the axial extension of the knife rod 2780 in the distal "DD" direction. In turn, the rotational movement of the rotating drive gear 2942 in the opposite direction will result in the knife rod 2780 being moved closer. The 2700 tool may be used in a different way as described above.

[0057] FIG. 38 and 39 show an embodiment of the surgical tool 2700 'that is substantially the same as the 2700 tool that has been described in detail above. However, tool 2700 'includes a pressure sensor 2950 that is adapted to provide feedback to controller 1001 regarding the amount of crimping pressure experienced by the anvil 2724. For example, in various embodiments, the pressure sensor may include a spring-biased contact switch. For a continuous signal, you can use a cantilever beam with a load cell located on it or a dome button with a load cell on the inside. Another version may include a switch that only contacts when the required load is known. Such a configuration may include a dome on the base, the dome being one electric pole and the base being the second electric pole. This configuration allows the controller 1001 to adjust the amount of clamping pressure applied to the tissue within the surgical gripper 2712 by adjusting the amount of closing pressure applied to the anvil 2724. Those skilled in the art will be aware that such a pressure sensor configuration can be effectively used with the various embodiments of the surgical tool described herein and their equivalent designs.

[0058] FIG. 40 shows part of another 3000 surgical instrument that can be effectively used in conjunction with the 1000 robot system. The 3003 surgical tool uses a built-in motor (s) to drive various components of the surgical gripper's cutting tool. For example, in at least one non-limiting embodiment, the surgical tool 3000 includes a surgical end-knife gripper (not shown) which has an anvil (not shown) and a surgical staple cartridge (not shown), the types and designs of which have been described above. The surgical instrument 3000 also includes an elongated shaft (not shown) and anvil closing system (not shown), types of which are described above. Therefore, in this part of the detailed description, the description of these components will not be repeated, except for those that are necessary to understand the features of the various embodiments of the surgical tool 3000.

[0059] In the embodiment shown, the gripper comprises a cutting tool 3002 that is connected to the knife rod 3003. As can be seen in FIG. 40, surgical tool 3000 includes a tool attachment portion 3010 that includes a tool attachment plate 3012 that is adapted to be mounted to the adapter portion 1240 'that is connected to the robotic system 1000 in the various ways described above. The tool attachment portion 3010 is adapted to support the gear system 3013 thereon. In at least one embodiment, the adapter portion 1240 'may be the same as the adapter portion 1240 described in detail above without the powered rotary bodies and disk components used by the 1240 adapter. In other embodiments, the adapter portion 1240 'may be the same as the adapter portion 1240. Further other modifications that are considered to be in accordance with the concept and scope of the various embodiments of the present invention may utilize one or more mechanical movements (i.e., rotary movements) originating from tool holder parts 1270 (as described above) to power / run the transmission system 3013 using the simultaneous use of one or more motors in the tool attachment portion 3010 to power one or more other components of the surgical gripper. Furthermore, although the gripper of the illustrated embodiment includes an endo-knife, those skilled in the art will be aware that the features of the illustrated embodiment can be effectively used in conjunction with other types of surgical grippers without departing from the concept and scope of the various forms of disclosure.

[0060] In various embodiments, the tool attachment plate 3012 is adapted to at least accommodate the first firing motor 3011 to provide firing and retracting motions to the knife rod 3003 that is connected or operable with the cutting tool 3002. The tool mounting plate 3012 has an arrangement of electrical connection terminals 3014 that are adapted to be connected to slots 1258 (FIG. 9) in the 1240 'adapter. This configuration allows the controller 1001 of the robotic system 1000 to provide control signals to the electronic control circuit 3020 of the surgical tool 3000. Although the connector has been described in this document with respect to mechanical, electrical and magnetic connecting elements, it should be assumed that many different telemetry procedures can be used, including infrared, inductive and the like.

[0061] The control circuit 3020 is schematically shown in FIG. 40. In one embodiment or embodiment, the control circuit 3020 includes a power source in the form of a battery 3022, which is connected to an on / off switch powered by an electromagnet 3024. Control circuit 3020 further includes on / off firing solenoid 3026 that is connected to a bipolar switch 3028 for controlling the rotation direction of motor 3011. Thus, when the robot controller 1000 1001 provides the appropriate control signal, switch 3024 will allow battery 3022 to power bipolar switch 3028. The controller 1001 of the robot system 1000 will also provide the appropriate signal to the 3028 bipolar switch to power the 3011 motor. When triggering of the surgical gripper is required (i.e., driving the cutting tool 3002 distally by tissue clamped in the surgical gripper, the bipolar switch 3028 will be in the first position. When retraction of cutting tool 3002 is required to the initial position, the bipolar switch 3028 will be moved to the second position by means of controller 1001.

[0062] Various embodiments of the surgical tool 3000 also use a 3030 gearbox, which is so big in cooperation with the launching 3031 gear, that in at least one non-limiting embodiment, includes a firing propelling 3032 gear, which is in engagement with a 3034 driven gear to generate the required amount of motive force to drive the cutting tool 3002 through the tissue and to drive and form staples in various ways described herein. In the embodiment shown in FIG. 135 the driven gear 3034 is connected to a screw shaft 3036, which is threaded connected to a screw nut arrangement 3038, which is limited to axial displacement (indicated by the arrow "D"). The screw nut arrangement 3038 is attached to the firing rod 3003. Thus, the rotational movement of the helical roller 3036 in the first direction will cause the cutting tool 3002 to be driven in the distal "DD" direction, and the rotational movement of the helical shaft in the second opposite direction will cause the cutting tool 3002 to be retracted in the proximal "PD" direction.

[0063] FIG. 41 shows a portion of another surgical tool 3000 'that is substantially the same as the tool 3000 described above except that the driven gear 3034 is attached to the drive shaft 3040. The drive shaft 3040 is attached to the second driven gear 3042 which is located in mesh with the third driven gear 3044, which is in mesh with the screw 3046 connected to the firing rod 3003.

[0064] FIG. 42 presents another 3200 surgical tool that can be effectively used in conjunction with the 1000 robotic system. In this embodiment, the surgical tool 3200 includes a surgical gripper 3212, which in one non-limiting embodiment includes a component portion that can move selectively between the first and second positions relative to the at least one other portion of the gripper component. As detailed below, the 3200 surgical tool uses built-in motors to power various components of the 3305 transmission system. The surgical gripper 3212 includes an elongated channel 3222 that operatively supports the surgical staple cartridge 3234. The elongate channel 3222 has a proximal end 3223 which slides to the hollow elongated shaft assembly 3208 which is connected to the tool attachment portion 3300. In addition, the surgical gripper 3212 includes an anvil 3224, which is pivotally connected to the elongate channel 3222 by means of a pair of plugs 3225, which are placed within respective holes 3229 in the elongated channel 3222. The distal end portion 3209 of the roller assembly 3208 includes an opening 3245 into which a flap 3227 on the anvil 3224 is inserted to open the anvil 3224 when the longitudinal channel 3222 moves axially proximal "PD" relative to the distal end portion 3209 of the roller assembly 3208. In various embodiments, it is possible to use a spring (not shown) to bias the anvil 3224 to the open position.

[0065] As indicated above, the surgical tool 3200 includes a tool attachment portion 3300 that includes a tool attachment plate 3302 that is adapted to support a functional transmission system 3305 and to be assembled with an adapter portion 1240 'that is connected to a 1000 robotic system various methods described above. In at least one embodiment, the adapter portion 1240 'may be the same as the adapter portion 1240 described in detail above without the powered disk components used by the 1240 adapter. In other embodiments, the adapter portion 1240 'may be the same as the adapter portion 1240. However, in such embodiments, since the various components of the surgical gripper 3212 are entirely powered by the motor (s) in the tool attachment part 3300, the 3200 surgical tool will not use or require any mechanical (i.e. non-electric) actuating movements from the tool holder part 1270 to supply the components of the 3200 surgical gripper. Further other modifications, which are considered to be in accordance with the concept and scope of the various forms of this disclosure, can utilize one or more mechanical movements originating from tool holder parts 1270 (as described above) to power / actuate one or more components of the surgical gripper, while using one or more motors in a tool attachment portion to power one or more other components of the surgical gripper.

[0066] In various embodiments, the tool attachment plate 3302 is adapted to support the first firing motor 3310 to provide firing and retracting motions to the transmission system 3305 to drive a knife rod 3335 which is connected to a cutting tool 3332, the type of which has been described above. As can be seen in FIG. 42, tool attachment plate 3212 has an arrangement 3014 of electrical connection terminals that are adapted to interface with slots 258 (FIG. 9) in the adapter 240 '. This configuration allows the robot controller 1000 1001 to provide control signals to the 3320, 3340 electronic control circuits of the 3200 surgical tool. Although the connector has been described in this document with respect to mechanical, electrical and magnetic connecting elements, it should be assumed that many different telemetry procedures can be used, including infrared, inductive and the like.

[0067] In one embodiment or embodiment, the first control circuit 3320 includes a first power source in the form of a first battery 3322 that is connected to the first on / off switch powered by electromagnet 3324. The first firing control circuit 3320 further includes a first on / off switch powered by a solenoid 3326 that is connected to the first bipolar switch 3328 to control the rotation direction of the first firing motor 3310. Thus, when the controller 1001 provides the appropriate control signal, the first switch 3324 will allow the first battery 3322 to power the first bipolar switch 3328. Controller 1001 will also provide the appropriate signal to the first bipolar switch 3328 to power the first fire engine 3310. When triggering of the surgical gripper (i.e., driving the cutting tool 3232 in distal direction by tissue clamped in the surgical gripper 3212) is required, the first switch 3328 will be set to the first position by the controller 1001. When it is required to retract the cutting tool 3232 to its initial position, controller 1001 will send a corresponding control signal to move the first switch 3328 to the second position.

[0068] Various embodiments of the surgical tool 3200 also use the 3330 gear box, which is of such a size, in cooperation with the firing gear 3332 which is connected thereto, which combines with the possibility of operation with the 3333 firing gear. In at least one non-limiting embodiment, the firing gear 3333 includes a firing driven gear 3334 that is in mesh with the driving gear 3332 to generate the required amount of driving force necessary to drive the cutting tool 3232 through the tissue, and to drive and form staples into various methods described in this document. In the embodiment shown in FIG. 41 the driven gear 3334 is connected to the drive shaft 3335, which has a second driven gear 3336 connected to it. The second driven gear 3336 is in meshing with the third driven gear 3337, which is in meshing with the fourth driven gear 3338. The fourth driven gear 3338 is in meshing with the proximal part 3339 of the knife rod 3235, which is limited to axial displacement. Thus, the rotational movement of the drive shaft 3335 in the first direction will cause the cutting tool 3232 to be driven in the distal "DD" direction, and the rotational movement of the drive shaft 3335 in the second opposite direction will cause the cutting tool 3232 to be retracted in the proximal "PD" direction.

[0069] As indicated above, the opening and closing of the anvil 3224 is controlled by axial displacement of the longitudinal channel 3222 relative to the longitudinal shaft assembly 3208. The axial displacement of the longitudinal channel 3222 is controlled by the 3339 closing control system. In various embodiments, the closing control system 3339 includes a closing shaft 3340, which has a portion 3341 of a hollow threaded end that engages threaded with the threaded closing rod 3342. A portion of the threaded end 3341 is pivotably mounted on the dorsal shaft 3343, which engages with the possibility of operation with the tool mounting portion 3300 and extends through the shaft assembly portion 3208. The closing system 3339 further includes a closing control circuit 3350 that includes a second power source in the form of a second battery 3352 which is connected to a second on / off switch powered by a solenoid 3354. The closing control circuit 3350 further includes a second on / off firing solenoid 3356 that is connected to a bipolar switch 3358 to control the rotation of the second closing motor 3360. Thus, when the controller 1001 provides the appropriate control signal, the second switch 3354 will allow the second battery 3352 to power the second bipolar switch 3354. Controller 1001 will also provide the appropriate signal to the second 3358 bipolar switch to power the second 3360 motor. When closing the anvil 3224 is required, the second switch 3348 will be in the first position. When it is required to open the anvil 3224, the second switch 3348 will be moved to the second position.

[0070] Various embodiments of the tool attachment portion 3300 also use a second gearbox 3362 that is connected to the closing drive gear 3364. The closing drive gear 3364 is in meshing with the closing gear 3363. In various non-limiting embodiments, the closing gear 3363 includes a driven closing gear 3365 that is attached to the closing drive shaft 3366. To the closing drive shaft 3366 there is also attached a closing drive gear 3367 which is in meshing with the closing gear of the shaft 3368 attached to the closing shaft 3340. FIG. 42 shows the gripper 3212 in the open position. As indicated above, when the threaded closing rod 3342 is in the position shown in FIG. 42, the spring (not shown) deflects the anvil 3224 to the open position. When the anvil 3224 is required to close, controller 1001 activates a second motor 3360 to cause the closing shaft 3340 to rotate to attract the threaded closing rod 3342 and channel 3222 proximal 'PD'. When the anvil 3224 contacts the distal end portion 3209 of the shaft 3208, the anvil 3224 rotates to the closed position.

[0071] In the following, the method of operation of the surgical tool 3200 will be described. When the tool attachment portion 3302 is operably connected to the tool holder 1270 of the robot system 1000, the robot system 1000 can position the gripper 3212 adjacent to the target tissue for cutting and stitching. If the anvil 3224 is no longer in the open position, the controller 1001 may activate the second closing motor 3360 to drive the channel 3222 further to the position shown in FIG. 42. When the controller 1001 determines that the surgical gripper 3212 is in the open position by means of the sensor (s) in the gripper and / or the attachment part of the tool 3300, the controller 1001 may provide a signal to the surgeon to inform the surgeon that the anvil 3224 can then be closed. When the target tissue is placed between the open anvil 3224 and the surgical staple cartridge 3234, the surgeon can begin the closing process by activating controller 1001 to apply a closing control signal to the second closing motor 3360. The second closing motor 3360 applies a rotational movement to the closing shaft 3340 to pull channel 3222 proximal "PD" until the anvil 3224 is turned to the closed position. When the controller 1001 determines that the anvil 3224 has been moved to the closed position by means of a sensor (s) in the surgical gripper 3212 and / or in the attachment part of the 3300 tool that communicates with the robotic control system, the 3360 engine can be deactivated. Then the firing process can be started manually by the surgeon activating the trigger, button and the like on controller 1001 or controller 1001 can automatically start the firing process.

[0072] To initiate the firing process, controller 1001 activates the firing motor 3310 to drive the firing rod 3235 and cutting tool 3232 in the "DD" downstream direction. When the controller 1001 determines that the cutting tool 3232 has been moved to an end position within the surgical staple cartridge 3234 by means of sensors in the surgical gripper 3212 and / or in the drive part of the motor 3300, the controller 1001 may provide the surgeon with an indication signal. Then, the surgeon may manually activate the first motor 3310 to retract the cutting tool 3232 to the initial position, or the controller 1001 may automatically activate the first motor 3310 to retract the cutting element 3232.

[0073] The embodiment shown in FIG. 42 does not include articulation. FIG. 64-65 show surgical instruments 3200 'and 3200 ", which have grippers 3212', 3212", respectively, which can be used in the form of an elongated shaft that has an articulated joint, various types of which are disclosed herein. For example, as can be seen in FIG. 64, the threaded closing shaft 3342 is connected to the proximal end 3223 of the longitudinal channel 3222 by a flexible cable or other flexible element 3345. The location of the articulation (not shown) inside the longitudinal shaft assembly 3208 will coincide with the elastic 3345 to allow the elastic 3345 to receive such articulation. In addition, in the above-mentioned embodiment, the flexible element 3345 is pivotally attached to a portion of the proximal end 3223 of the longitudinal channel 3222 to allow the flexible element 3345 to rotate relative thereto to prevent winding of the flexible element 3229 relative to the channel 3222. Although not shown, the cutting element can be driven in one of the ways described above by a knife rod, which can also take on the articulation of the shaft longitudinal assembly. FIG. 44 shows the surgical gripper 3212 ", which is essentially the same as the surgical gripper 3212 described above except that the threaded locking rod 3342 is attached to the locking nut 3347, which is limited only to axial movement within the longitudinal roller assembly 3208. Flexible element 3345 is attached to closing nut 3347. This configuration also prevents the threaded closing rod 3342 from winding the flexible element 3345. The flexible knife bar 3235 'can be used to facilitate the articulated movement of the surgical gripper 3212 ".

[0074] The surgical instruments 3200, 3200 'and 3200 "described above may also use any of the cutting tool embodiments described herein. As described above, the anvil of each of these tool grippers is closed by attracting the elongate channel to contact the distal end of the elongated shaft assembly. Thus, when the target tissue is placed between the staple cartridge 3234 and the anvil 3224, the controller 1001 may begin to pull the channel 3222 inward into the roller assembly 3208. However, in various embodiments, to prevent the gripper 3212, 3212 ', 3212 "from moving the target tissue along with the gripper during this closing process, the controller 1001 can simultaneously move the tool holder and ultimately the tool in such a way as to compensate for the movement of the longitudinal channel 3222 into such a way that as a result the target tissue is clamped between the anvil and the elongated channel without being displaced otherwise.

[0075] FIG. 45-47 illustrate another embodiment of surgical tool 3201 that is substantially the same as the 3200 "surgical tool described above except for the differences discussed below. In this embodiment, the threaded closing rod 3342 'has variable pitch grooves. In particular, as can be seen in FIG. 46, the closing rod 3342 'has a distal groove section 3380 and a proximal groove section 3382. The distal and proximal sections of the groove 3380, 3382 are adapted to be connected to a projection 3390 mounted inside the portion 3341 'of the hollow threaded end. As can be seen in FIG. 41, distal section 3380 of the groove has a smaller pitch than section 3382 of the groove. Thus, such a variable pitch configuration allows the elongated channel 3222 to be drawn into the shaft 3208 at the first speed due to the connection between the projection 3390 and the proximal section 3382 of the groove. When projection 3390 connects to the distal groove section, channel 3222 will be attracted to shaft 3208 at a second speed. Because the proximal groove 3382 is more rough than the distal groove 3380, the first speed will be greater than the second speed. This configuration is used to accelerate the initial closure of the gripper to manipulate the tissue, and then, after the tissue has been correctly positioned in it, generate closing forces to properly tighten the tissue for cutting and sealing. Thus, the anvil 3234 initially closes quickly with less force, and then a greater closing force is applied when the anvil closes more slowly.

[0076] Opening and closing movements of the surgical gripper are used to allow the user to use the gripper to grip and manipulate tissue before fully clamping it in the required position to perform cutting and sealing. For example, the user can open and close the surgical gripper multiple times during this process to bring the gripper into position that allows the tissue to be held in the desired location. Thus, in at least some embodiments, to generate a high load for firing, a fine thread may require as much as 5-10 full turns to generate the required load. For example, in some cases, this may take 2-5 seconds. If it takes the same amount of time to open and close the gripper each time during the tissue setting / manipulation process, it may take too long to set up the gripper. In this case, it is possible that the user may refrain from using the gripper in favor of using a conventional gripping device. The use of grippers and the like may undesirably increase the costs associated with performing a surgical procedure.

[0077] The above described embodiments use a battery or batteries to power the motors used to drive the gripper components. The activation of the motors is controlled by a 1000 robot system. In alternative embodiments, the power source may include "AC" which is supplied to the motors by the robotic system 1000. This means that AC power can be supplied from the system powering the 1000 robotic system through the tool holder and adapter. In further embodiments, the power cord may be attached to the tool attachment portion 3300 to provide the required power from a separate AC or DC source.

[0078] In use, the controller 1001 may apply an initial rotational movement to the closing shaft 3340 (FIG. 42) to pull the longitudinal channel 3222 in an axial direction inwardly into the longitudinal shaft assembly 3208 and to move the anvil from the first position to the intermediate position at the first speed that corresponds to the point where the distal section 3380 of the groove passes to the proximal section 3382 of the groove. Further application of the rotational movement to the closing shaft 3340 will result in the anvil being moved from an intermediate position to a closed position relative to the surgical staple cartridge. In the closed position, the tissue for incision and suturing is properly clamped between the anvil and the surgical staple cartridge.

[0079] FIG. 48-52 show another embodiment of a surgical tool 3400 according to the present invention. This embodiment includes an elongated shaft assembly 3408 that extends from the tool attachment portion 3500. The longitudinal shaft assembly 3408 includes a rotatable proximal section 3410 of the closure tube that is rotatably disposed on the proximal ridge member 3420 that is rigidly connected to the plate 3502 of the tool mounting portion 3500. The proximal dorsal member 3420 has a distal end 3422 that is connected to a portion of the longitudinal channel 3522 of the surgical gripper 3412. For example, in at least one embodiment, the portion of the elongate channel 3522 has a distal end portion 3523 that "engages" the distal end 3422 of the dorsal member 3420. The elongated channel 3522 is adapted to hold a surgical staple cartridge 3534 therein. This embodiment may use one of the various embodiments of the cutting tool disclosed herein to incision the tissue that is clamped in the surgical gripper 3412 and to fire the staples in the staple cartridge 3534 for the dissected tissue.

[0080] The surgical gripper 3412 has an anvil 3524 which is pivotally connected to the elongate channel 3522 by means of a pair of plugs 3525 which are placed in respective holes 3529 in the elongated channel 3522. Anvil 3524 moves between the open position (FIG. 48) and the closed position (FIG. 49-51) using a distal section 3430 of the closing tube. The distal end portion 3432 of the closure tube section 3430 includes an opening 3445 into which a flap 3527 on the anvil 3524 is inserted to open and close the anvil 3524 when the distal closure tube section 3430 moves axially relative thereto. In various embodiments, the opening 3445 has a shape such that when the closing tube section 3430 moves in the proximal direction, the closing tube section 3430 causes the anvil 3524 to rotate to the open position. In addition or as an alternative, it is possible to use a spring (not shown) to swing the anvil 3524 into the open position.

[0081] As can be seen in FIG. 48-51, the distal section 3430 of the closure tube includes a projection 3442 that extends from its distal end 3440 to a threaded threaded / groove connection 3414 with a variable pitch formed at the distal end 3412 of the rotary proximal section of the closing tube 3410. The 3414 variable pitch thread / groove has a distal section 3416 and a proximal section 3418. The pitch of the distal thread / groove 3416 is smaller than the pitch of the proximal thread / groove 3418. As can also be seen in FIG. 48-51, the distal section 3430 of the closing tube is limited to axial displacement relative to the dorsal member 3420 by means of an axial retaining pin 3450 which is placed in the axial gap 3424 at the distal end of the dorsal member 3420.

[0082] As indicated above, the anvil 2524 is opened and closed by rotational movement of the proximal section of the closing tube 3410. The variable pitch configuration of the thread enables the distal portion 3430 of the closure tube to be driven in the distal "DD" direction at the first speed due to the connection between the protrusion 3442 and the proximal groove / thread 3418. When the projection 3442 connects to the distal groove / thread section 3416, the distal section 3430 of the closing tube will be driven in the distal direction at a second speed. As the proximal groove / thread section 3418 is more rough than the distal groove / thread section 3416, the first speed will be greater than the second speed.

[0083] In at least one embodiment, the tool attachment portion 3500 is adapted to receive a corresponding first rotation movement from the robotic system 1001 and to convert this first rotation movement into a main rotation movement to rotate the rotary proximal section 3410 of the closure tube about the longitudinal axis of the LT-LT tool . As can be seen in FIG. 52, proximal end 3460 of the proximal end of the closure tube 3410 is pivotally supported within the cradle configuration 3504 attached to the tool mounting plate 3502 of the tool mounting portion 3500. The rotary gear 3462 is formed on or attached to the proximal end 3460 of the closure tube section 3410 for meshing with the rotary drive assembly 3470 which is operatively mounted on the tool mounting plate 3502. In at least one embodiment, the rotatable drive gear 3472 is connected to the respective first of the driven discs or elements 304 on the adapter mounting plate side 3502 when the tool mounting portion 3500 is connected to the tool holder 1270. See FIG. 10 and 52. The rotary drive assembly 3470 further includes a rotatable driven gear 3474 that is rotatably mounted on a tool mounting plate 3502 in meshing engagement with a rotatable gear 3462 and a rotatable drive gear 3472. The application of the first rotational control motion from the robot system 1001 via the tool holder 1270 and the adapter 1240 to the respective driven element 1304 will cause the rotational drive gear 3472 to rotate due to the fact that it is connected to it. The rotational movement of the rotating drive gear 3472 ultimately results in the rotational movement of the closing tube section 3410 to open and close the anvil 3524 in the manner described above.

[0084] As indicated above, surgical gripper 3412 uses a cutting tool, the type and construction of which has been described above. FIG. 52 shows one embodiment of a knife drive assembly 3480 for axially extending a knife rod 3492 that is attached to such a cutting tool. One form of the knife drive assembly 3480 includes a rotatable drive gear 3482 that is connected to the corresponding third of the driven disks or components 1304 on the adapter side of the tool attachment plate 3502 when the tool drive portion 3500 is connected to the tool holder 270. See FIG. 10 and 52. The knife drive assembly 3480 further includes a first rotatable driven gear assembly 3484 that is rotatably mounted on a tool mounting plate 5200. The first rotary driven gear assembly 3484 is in meshing with the third rotary driven gear assembly 3486 that is pivotally mounted on the tool mounting plate 3502 and which is in meshing with the fourth rotary driven gear assembly 3488 which is in meshing with the the threaded portion 3494 of the drive shaft assembly 3490 that is connected to the knife rod 3492. The rotational movement of the rotating drive gear 3482 in the second direction of rotation will result in the axial extension of the drive shaft assembly 3490 and the knife bar 3492 in the distal "DD" direction. In turn, the rotational movement of the rotating drive gear 3482 in a secondary rotational direction (opposite to the second rotational direction) will cause the drive shaft assembly 34 and the knife rod 3492 to move closer.

[0085] FIG. 53-62 show another embodiment of a 3600 surgical tool according to the present invention that can be used in conjunction with the robotic system 1000. As can be seen in FIG. 53, tool 3600 includes a gripper in the form of a disposable loading unit 3612. Various forms of disposable loading units that can be used in conjunction with the 3600 tool have been disclosed, for example, in US Patent Application No. 2009/0206131 A1, entitled "End Effector Arrangements For a Surgical Cutting and Stapling Instrument".

[0086] In at least one embodiment, the disposable loading unit 3612 includes an anvil assembly 3620 that is held to articulate relative to the carrier 3630 that operably holds the staple cartridge 3640. The attachment assembly 3650 is pivotally connected to the cartridge carrier 3630 to allow the carrier 3630 to rotate about the AA-AA articulated axis relative to the longitudinal axis of the LT-LT tool. In FIG. 58 mounting assembly 3650 includes upper and lower mounting parts 3652 and 3654. Each attachment part has a threaded hole 3656 on each side, which is sized to screw in threaded bolts (not shown) for attaching the proximal end of carrier 3630 to them. A pair of centrally located rotary elements 3658 runs between the upper and lower fastening parts via a pair of connecting elements 3660 that connect the distal end of the housing part 3662. The connecting members 3660 include a proximal connecting portion 3664 adapted to be inserted into the grooves 3666 formed at the proximal end of the housing portion 3662 to hold the mounting assembly 3650 and housing portion 3662 in a longitudinally fixed position.

[0087] In various embodiments, the housing portion 3662 of the disposable loading unit 3614 includes an upper housing half 3670 and a lower housing half 3672 located inside the outer shell 3674. The proximal end of the housing half 3670 includes hooking protrusions 3676 for attachment with the option of removing the longitudinal shaft 3700 and insertion tip 3678. The protrusions 3676 form a bayonet type connection with the distal end of the 3700 longitudinal shaft, which will be discussed in detail below. The housing halves 3670, 3672 define a channel 3674 for slidingly positioning the axial drive assembly 3680. The second articulation joint 3690 is sized to be slidably positioned inside the gap 3679 formed between the housing halves 3670, 3672. A pair of blown plates 3691 are adjacent the distal end of the housing portion 3662 adjacent the distal end of the axial drive assembly 3680 to prevent pushing out of the drive assembly 3680 during articulation of the carrier 3630.

[0088] In various embodiments, the second articulation joint 3690 includes at least one longitudinal metal plate. Preferably, two or more metal plates are stacked to form connector 3690. The proximal end of the articulated joint 3690 includes a 3692 hook portion adapted to be connected to the first articulated joint 3710 running through the 3700 longitudinal shaft. The distal end of the second articulation joint 3690 includes a 3694 loop that is sized to engage the projection formed on the mounting assembly 3650. The projection is offset laterally from the pivot pin 3658 in such a way that the linear displacement of the second articulation joint 3690 causes the mounting assembly 3650 to pivot around the pivot pins 3658 to cause articulation of the carrier 3630.

[0089] In various embodiments, the axial drive assembly 3680 includes a longitudinal drive beam 3682, including a distal operating head 3684 and a proximal engagement region 3685. The 3682 drive beam can be made of one sheet of material or preferably of multiple stacked sheets. The hooking area 3685 includes a pair of hooking fingers that can be of this size and can be adapted such that they hooked to a pair of respective retaining slots formed in the drive element 3686. The drive element 3686 includes a proximal opening 3687 adapted to receive the distal end 3722 of the control rod 2720 (see FIG. 62) when the proximal end of the disposable loading unit 3614 attaches to the longitudinal body 3700 of the 3600 surgical tool.

[0090] In FIG. 53 and 60-62 to use the 3600 surgical tool, the disposable loading unit 3612 is first attached to the distal end of the 3700 longitudinal shaft. It should be noted that the 3600 surgical tool may include an articulated or non-articulated disposable loading unit. To attach the disposable loading unit 3612 to the longitudinal shaft 3700, the distal end 3722 of the control rod 3720 is inserted into the insertion terminal 3678 of the disposable loading unit 3612, and the insertion tip 3678 is inserted longitudinally to the distal end of the longitudinal shaft 3700 in the direction of the arrow "A" on FIG. 60 in such a way that the hook portion 3692 of the second articulation joint 3690 slides inside the channel 3702 in the elongated shaft 3700. The protrusions 3676 will be aligned in the appropriate channel (not shown) in the longitudinal shaft 3700. When the hook portion 3692 connects to the proximal wall 3704 of channel 3702, the disposable loading unit 3612 is rotated in the direction of the arrow "B" in FIG. 59 and 62 to displace the hook portion 3692 of the second articulation link 3690 to engage with the finger 3712 of the first articulation link 3710. The protrusions 3676 also form a bayonet type connection inside the annular channel 3703 in the elongated shaft 3700. During the rotational movement of the loading unit 3612, protrusions 3676 engage the cam surface 3732 (FIG. 60) a locking plate 3730 to initially displace the plate 3730 in the direction of the arrow "C" in FIG. 55 to lock the hooking element 3734 in the recess 3721 of the control rod 3720 to prevent the longitudinal movement of the control rod 3720 when connecting the disposable loading unit 3612. During the final degree of rotation, the protrusions 3676 detach from the cam surface 3732 to allow the locking plate 3730 to move in the direction of the "D" arrow in FIG. 59 and 62 from the rear of the hooking element 3734 to again allow longitudinal displacement of the control rod 3720. Although the method of attachment described above assumes that the disposable loading unit 3612 is operated relative to the 3700 longitudinal roller, one skilled in the art will be aware that the disposable loading unit 3612 can be kept stationary and the robotic system 1000 can handle part of the longitudinal roller 3700 in relation to the disposable loading unit 3612 in order to carry out the connection procedure described above.

[0091] FIG. 63 shows another disposable loading unit 3612 'that can be attached in a bayonet type configuration to a 3700' longitudinal shaft which is substantially the same as the 3700 shaft except for the differences described below. As can be seen in FIG. 158, the elongated shaft 3700 'has slots 3705 that extend at least over a portion thereof and which are adapted to receive protuberances 3676 therein. In various embodiments, the disposable loading unit 3612 'includes arms 3677 extending therefrom which, prior to the rotational movement of the disposable loading unit 3612', may be aligned or at least substantially aligned with the protrusions 3676 extending from housing portion 3662. In at least one embodiment, arms 3677 and protrusions 3676 may be inserted into slots 3705 in the longitudinal roller 3700 ', for example, when the disposable loading unit 3612' is inserted into the longitudinal roller 3700 '. When the disposable loading unit 3612 'is rotated, the arms 3677 may be sufficiently enclosed within the slots 3705 in such a way that the slots 3705 can hold them in place, while the protrusions 3676 can be arranged in such a way that they are not closed inside slots 3705 and can be rotated relative to arms 3677. During rotation, the hook portion 3692 of the articulated joint 3690 is connected to the first articulated joint 3710, extending through the 3700 'longitudinal shaft.

[0092] It is possible to use other methods for connecting disposable loading units to the end of an elongated roller. For example according to FIG. 64 and a disposable loading unit 3612 "may include a connector portion 3613 that may be adapted to be connected to the connector portion 3740 of the 3700" elongated shaft. In at least one embodiment, the connector portion 3613 may include at least one projection and / or a groove that can mate with the at least one projection and / or groove of the connector portion 3740. In at least one such embodiment, the connector parts may include mating parts with a dovetail connection. In various embodiments, portions of the connector may be adapted to connect with each other and prevent or at least inhibit movement in the distal and / or proximal direction of the disposable loading unit 3612 "along axis 3741. In at least one embodiment, the distal end of the axial drive assembly 3680 'may include an aperture 3681 that may be adapted to receive a projection 3721 extending from the control rod 3720'. In various embodiments, this configuration may allow a one-time load unit 3612 "to be connected to the longitudinal shaft 3700 in a direction that is not collinear or parallel to the 3741 axis. Although not shown, the axial drive assembly 3680 'and control rod 3720 may include any other suitable configuration of the projections and apertures for their functional joining together. Also in this embodiment, the first articulation link 3710, which can be operably connected to the second articulation link 3690.

[0093] As can be seen in FIG. 53 and 66, the 3600 surgical tool includes a tool attachment portion 3750. The tool attachment portion 3750 includes a tool attachment plate 3751 that is adapted to attach to the tool drive assembly 1010. The tool attachment part functionally supports the 3752 transmission system. During use, it may be necessary to rotate the disposable loading unit 3612 about the longitudinal axis of the tool defined by the longitudinal roller 3700. In at least one embodiment, the transmission system 3752 includes a rotary drive assembly 3753 that is adapted to receive a corresponding rotational output motion from the drive tool assembly 1010 of the robotic system 1000 and to convert this rotational output motion to a rotational control motion for rotating the 3700 longitudinal shaft (and a disposable one) loading unit 3612) around the longitudinal axis of the LT-LT tool. As can be seen in FIG. 61, the proximal end 3701 of the longitudinal shaft 3700 is rotatably mounted inside the cradle configuration 3754, which is attached to the tool mounting plate 3751 3750. The rotary gear 3755 is formed on or attached to the proximal end 3701 of the longitudinal shaft 3700 for meshing with the rotary gear assembly 3756 operatively mounted on the tool mounting plate 3751. In at least one embodiment, the rotatable drive gear 3757 connected to the respective first of the driven drives or components 304 on the adapter mounting plate 3751 side when the tool attachment portion 3750 is connected to the tool drive assembly 1010. The rotary drive assembly 3753 further includes a rotatable driven gear 3758 which is rotatably mounted on a tool mounting plate 3751 in engagement with a rotatable gear wheel 3755 and a rotatable drive gear 3757. Applying the first rotational output motion from the robotic system 1000 via the tool drive assembly 1010 to the respective driven element 304 will cause the rotational drive gear 3757 to rotate due to the fact that it is connected to it. The rotational movement of the rotating drive gear 3757 ultimately results in the rotational movement of the longitudinal shaft 3700 (and the disposable loading unit 3612) about the longitudinal axis of the LT-LT tool (main rotational motion).

[0094] As can be seen in FIG. 66, the drive shaft assembly 3760 is connected to the proximal end of the control rod 2720. In various embodiments, the control rod 2720 is extended axially in a distal and proximal direction by means of a drive closing gear / knife 3762. One form of the 3762 drive closing gear / knife includes a 3763 rotatable driving gear that is connected to the corresponding second of the rotatable rotatable body parts, disks or 304 elements on the adapter mounting plate 3751 side when the tool mounting portion 3750 is connected to the handle

1270 tool. The 3763 rotatable driven gear is located in the toothing with the gearing, generally designated 3764. In at least one embodiment, the gear train 3764 further includes a first rotatable driven gear assembly 3765 that is rotatably mounted on a tool mounting plate 3751. The first rotary driven gear assembly 3765 is in meshing with the second rotary driven gear assembly 3766 that is pivotally mounted on the tool mounting plate 3751 and which is in meshing with the third rotatable driven gear assembly 3767 which is in engagement with the threaded part 3768 of the 3760 drive shaft assembly. The rotational movement of the rotating drive gear 3760 in the second direction of rotation will result in the axial extension of the drive shaft assembly 3760 and control rod 2720 in the "DD" direction. In turn, the rotational movement of the rotating drive gear 3763 in a secondary rotation direction that is opposite to the second rotation direction will cause the drive shaft assembly 3760 and control rod 2720 to move closer. As the control rod 2720 moves further, it drives the drive beam 3682 and its working head 3684 further through the surgical staple cartridge 3640. When the work head 3684 is driven in the distal direction, it operatively engages with the anvil 3620 to rotate it to the closed position.

[0095] The cartridge carrier 3630 can be selectively rotated about the AA-AA articulation axis by applying axial articulation to the first and second articulation joints 3710 and 3690. In various embodiments, the transmission system 3752 further includes an articulated drive 3770 that is functionally mounted on the tool mounting plate 3751. In particular and with reference to FIG. 61 it can be seen that the portion 3772 of the proximal end 3771 of the articulated shaft adapted for functional connection with the first articulation link 3710, extends through the rotary gear 3755 and is pivotally connected to the gear rack 3774 of the shifter which is slidably attached to the tool mounting plate 3751 by means of slots 3775. The 3770 articulated drive further includes a shifter 3776 toothed bar that is connected to the corresponding third of driven discs or elements 304 on the adapter mounting plate 3751 side of the tool attachment when the tool attachment portion 3750 is connected to tool holder 270. The articulated drive assembly 3770 further includes a shifted driven gear 3778 which is pivotally mounted on a tool mounting plate 3751 in meshing with the shifting drive gear 3776 and the shifter rack 3774. Applying a third rotational output motion from the robotic system 1000 via the tool drive assembly 1010 to the respective driven element 304 will cause the rotational drive gear 3776 of the shifter to rotate due to the fact that it is operably connected to it. The rotational movement of the driving gear of the 3776 shifter ultimately results in the axial displacement of the rack

3774 shifter and shaft 3771 of articulated drive. The direction of axial displacement of the articulated drive shaft 3771 depends on the direction in which the driving gear 3776 of the shifter is rotated by the robotic system 1000. Thus, the rotational movement of the drive gear 3776 of the shifter in the first rotational direction will result in the axial displacement of the articulated shaft 3771 in the proximal "PD" direction and cause the insert carrier 3630 to rotate in the first direction about the articulated axis AAAA. In turn, the rotational movement of the drive gear 3776 of the shifter in the second direction of rotation (opposite to the first direction of rotation) will result in the axial displacement of the articulated shaft 3771 in the distal "DD" direction, thereby causing the insert carrier 3630 to rotate around the AA-AA articulated axis in the direction of the opposite.

[0096] FIG. 67 shows another embodiment of a 3800 surgical tool according to the present invention that can be used with a robotic system 1000. As can be seen in FIG. 67, surgical tool 3800 includes a surgical gripper 3812 in the form of an endo-knife 3814 that utilizes various cord-driven components. Various forms of cord-driven endo-knives have been disclosed, for example, in US Patent No. 7,726,537, entitled "Surgical Stapler With Universal Articulation and Tissue Pre-Clamp" and US Patent Application No. US 2008 / 0308603A1, entitled "Cable Driven Surgical Stapling and Cutting Instrument With Improved Cable Attachment Arrangements". Such 3814 endo knives may be referred to as "disposable loading unit" because they are intended to be discarded after a single use. However, various configurations of various embodiments of the present invention can also be used in conjunction with cord driven grippers that can be reused.

[0097] As can be seen in FIG. 67, in at least one embodiment, the endo-knife 3814 includes an elongated channel 3822 that operatively holds the surgical staple cartridge 3834 in its interior. Anvil 3824 is rotatably supported for displacement relative to the surgical staple cartridge 3834. Anvil 3824 has a cam surface 3825 that is adapted to interact with a pre-clamping flange 3840 that is supported for axial displacement with respect to it. The gripper 3814 is connected to the longitudinal shaft assembly 3808, which is attached to the tool mounted portion 3900. In various embodiments, the closing cord 3850 is used to move the pre-clamping collar 3840 distally to and above the cam surface 3825 to close the anvil 3824 with the surgical staple cartridge 3834 and compress the tissue between them. Preferably, the closure cable 3850 is attached to the pre-clamping flange 3840 at or near point 3841 and is fed through the passageway in the anvil 3824 (or below the proximal part of the anvil 3824) and fed proximal through the shaft 3808. Movement of the closing cable

3850 proximal "PD" pushes the pre-clamping collar 3840 distally to the cam surface 3825 to close the anvil 3824 relative to the staple cartridge 3834 assembly. A return mechanism, e.g., a spring, cable system or the like can be used to restore the pre-clamping collar 3840 to the pre-clamping setting which reopens the anvil 3824.

[0098] The elongated shaft assembly 3808 may have a cylindrical shape and define a channel 3811 that may be sized to receive a 3870 tubular adapter. See FIG. 68. In various embodiments, the 3870 tube adapter can be slidably mounted in friction connection with the internal channel of the longitudinal shaft 3808. The outer surface of the 3870 tubular adapter may further include at least one mechanical connection, e.g., a notch or notch 3871, arranged to mate with a suitable mechanical connection, e.g., a radially inwardly extending protrusion or latch (not shown) disposed on the inner periphery of the internal passage 3811 to lock the 3870 tubular adapter against the longitudinal shaft 3808. In various embodiments, the distal end of the tubular adapter 3870 may include a pair of opposed flanges 3872a and 3872b that define a cavity for rotatably receiving the rotary block 3873. Each collar 3872a and 3872b may include a bore 3874a and 3874b that is used to receive a 3875 pivot pin passing through the hole in the 3873 pivot block to allow the pivot block 3873 to rotate about an axis that is perpendicular to the longitudinal axis of the "LT-LT" tool . Channel 3822 may be formed using two upwardly extending flanges 3823a, 3823b that have holes that are large enough to receive a rotary pin 3827. In turn, the rotary pin 3875 seats through holes in the rotatable block 3873 to allow the surgical gripper 3814 to rotate about the "Y" axis as needed during a given surgical procedure. The rotational movement of the 3873 rotatable block around pin 3875 along the "Z" axis causes the surgical gripper 3814 to rotate about the "Z" axis. See FIG. 63. Other methods of attaching the longitudinal channel 3822 to the rotary block 3873 can be effectively used without departing from the concept and scope of the present invention.

[0099] The surgical staple cartridge 3834 may be assembled and mounted inside the elongated channel 3822 during the manufacturing or assembly process and sold as part of the surgical gripper 3812 or the surgical staple cartridge 3834 may be designed to be selectively mounted within the elongated channel 3822 as needed and sold separately , for example, as a disposable spare part, replaceable or disposable staple cartridge assembly. It is within the scope of the present disclosure that the surgical gripper 3812 can be rotatably, functionally or integrally attached to, for example, the distal end 3809 of the disposable surgical stapler channel 3808. As is known, a used or used disposable loading unit 3814 can be removed from a roller elongated assembly 3808 and replaced with an unused disposable unit. The endonion 3814 may also advantageously comprise an actuator, preferably a dynamic clamping element 3860, a sled 3862, as well as staple pushers (not shown) and staples (not shown) when unused or unused 3834 insert is mounted in the longitudinal channel 3822. See FIG. 68.

[0100] In various embodiments, the dynamic clamping member 3860 is associated with, e.g., attached to and moving on or with, or connected to or integrated with and / or following the sled 3862. It is anticipated that the dynamic clamping element 3860 may have cam wedges or cam surfaces attached or formed in an integrated manner, or may be pushed through their distal leading surface. In various embodiments, the dynamic clamping element 3860 may include a top portion 3863 with a 3864 hole with a bolt 3865 mountable or secured inside, a central support or upward extension 3866, and a bottom flange 3867 having a substantially T-shape that mates for sliding maintaining dynamic clamping member 3860 along the ideal cutting path during longitudinal displacement toward the distant sled 3862. The leading cutting edge 3868, in this case the knife blade 3869, is sized to move within the gap 3835 of the staple cartridge assembly 3834 and separate the tissue after suturing. As used herein, the term "knife assembly" may include the 3860 clamping member indicated above, knife 3869, as well as sled 3862 or other knife / beam / sled drive configurations and cutting tool configurations. In addition, various embodiments of the present invention may be used with the knife assembly / cutting tool configurations that can be wholly retained in the staple cartridge 3834 or partially retained in the staple cartridge 3834 and elongated channel 3822 or fully retained within the elongated channel 3822.

[0101] In various embodiments, the dynamic clamping member 3860 can be driven in the proximal and distal direction by means of the 3870 cable drive assembly. In one non-limiting embodiment, the cable drive assembly includes a pair of extendable cables 3880, 3882 and a firing cable 3884. FIG. 90 and 91 show links 3880, 3882, 3884 in schematic form. As can be seen in these figures, the first extendable cable 3880 is operatively mounted on the first distal support of the 3885 cable passage, which may e.g. include a pulley, rod, puller and the like that are attached to the distal end of the longitudinal channel 3822 and on the first proximal 3886 cable passage support, which may, for example, include a pulley, rod, puller, and the like that are functionally supported by an elongated channel 3822. A distal end 3881 of the first extendable cable 3880 is attached to dynamic clamping assembly 3860. A second extendable cable 3882 is operatively mounted on a second distal support 3887 of the cable passage, which may e.g. include a pulley, rod, puller and the like which are mounted at the distal end of the longitudinal channel 3822 and on the second closer support 3888 of the cable passage, which may for example, include a pulley, rod, puller, and the like mounted on the proximal end of the longitudinal channel 3822. The proximal end 3883 of the second extendable cable 3882 can be attached to dynamic clamping assembly 3860. Also in these embodiments, a 3884 continuous firing cord is utilized and placed on a support 3889, which may include a pulley, rod, puller, and the like mounted within a longitudinal shaft 3808. In one embodiment, the retractable cord 3884 may be formed as a loop and connected to a connector 3889 'that is permanently attached to the first and second extendable cord 3880, 3882.

[0102] Various non-limiting embodiments of the present invention include a cable driven transmission 3920 that is operatively mounted on a plate 3902 of the tool mounting portion 3900. The tool mounting portion 3900 has an arrangement of electrical connection terminals 3904 that are adapted to be connected to slots 1258 (FIG. 9) in the 1240 'adapter. This configuration allows the robotic system 1000 to provide control signals to the 3810 control circuit 3910. Although the connector has been described in this document with respect to mechanical, electrical and magnetic connecting elements, it should be assumed that many different telemetry procedures can be used, including infrared, inductive and the like.

[0103] The control circuit 3910 is schematically shown in FIG. 67. In one embodiment or embodiment, the control circuit 3910 includes a power source in the form of a battery 3912, which is connected to an on / off switch powered by a solenoid 3914. However, in other embodiments, the power source may include an AC source. The control circuit 3910 further includes an on / off solenoid 3916 that is connected to a double pole switch 3918 to control the direction of rotation of the motor. Thus, when the robotic system 1000 provides the appropriate control signal, switch 3914 will allow battery 3912 to supply energy to the 3918 bipolar switch. The robotic system 1000 will also provide the appropriate signal to the 3918 bipolar switch to supply energy to the 3922 shift motor.

[0104] With reference to FIG. 71-76 at least one embodiment of the corded 3920 transmission includes a driving pulley 3930 that is functionally attached to the 3932 drive shaft which is attached to the 304 driven element, the type and construction of which have been described above, which is intended to be connected to a suitable driving element 250 of the adapter 240. See FIG. 49 and 74. Thus, when the tool attachment portion 3900 is operably connected to the tool holder 270, the robotic system 1000 can apply rotational motion to the drive pulley 3930 in the required direction. The first drive element or belt 3934 drives drive with the 3930 pulley and with the second drive shaft 3936 which is rotatably mounted on the shifter 3940. The shifter yoke 3940 is operably connected to the shifter 3922 motor in such a way that the rotational movement of the 3939 shaft of the shifter motor 3922 in the first direction will cause the shifter yoke to shift in the first direction "FD" and the rotational movement of the 3939 shifter motor shaft in the second direction will cause the displacement 3940 shifter shifter in second direction "SD". Other embodiments may use the shifter solenoid configuration to move the shifter yoke in the first and second directions.

[0105] As can be seen in FIG. 71-74, the closing drive gear 3950 is attached to the second drive shaft 3936 and is adapted to selectively engage with the closing drive assembly, generally designated 3951. Similarly, the firing drive gear 3960 is also attached to the second drive shaft 3936 and is adapted to selectively engage with firing the drive assembly, generally designated 3961. The rotational movement of the second drive shaft 3936 causes the rotational movement of the closing drive gear 3950 and the firing of the drive gear 3960. In one non-limiting embodiment, the closing drive assembly 3951 includes a driven closing gear 3952 that is connected to the first closing pulley 3954, which is rotatably mounted on the third drive shaft 3956. The closing cable 3850 is driven to be positioned on the first closing pulley 3954 in such a way that the rotational movement of the driven closing gear 3952 will drive the closing cable 3850. Similarly, the firing drive assembly 3961 includes a firing driven gear 3962 which is connected to the first firing pulley 3964 which is pivotally mounted on the third drive shaft 3956. The first and second driving pulleys 3954 and 3964 rotate independently on the third drive shaft 3956. The 3884 firing cord is propelled placed on the first firing of the 3964 pulley in such a way that the rotational motion of firing the driven gear 3962 will drive the 3884 firing cord.

[0106] Also in various embodiments, the cable-driven transmission 3920 further includes a brake assembly 3970. For example, in at least one embodiment, brake assembly 3970 includes a closing brake 3972 that includes a spring arm 3973 that is attached to the transmission housing portion 3971. The closing brake 3972 has a toothed projection 3974 that is sized to mesh with the teeth of the driven closing gear 3952, which will be described in detail below. Brake assembly 3970 further includes a firing brake 3976 that includes a spring arm 3977 that is attached to the second portion 3971 of the transmission housing. The 3976 firing brake has a 3978 toothing that is sized to mesh with the teeth of the 3962 driven firing of the gear.

[0107] At least one embodiment of the surgical tool 3800 can be used in the following manner. The tool attachment part 3900 is operatively connected to connector 1240 of the robotics system 1000. The robot controller or control unit functions to locate the tissue for incision and suturing between the anvil 3824 and the staple cartridge 3834. In the initial position, the brake assembly 3970 has a locked driven closing gear 3952 and a driven firing gear 3962 in such a way that they cannot rotate. This means that as seen in FIG. 71, toothed projection 3974 is in the locking engagement with the driven closing gear 3952, and toothed projection 3978 is in the locking engagement with the driven firing gear 3962. When the surgical gripper 3814 is correctly positioned, the robot controller 1000 1001 will provide a control signal to the shifter 3922 motor (or shifter solenoid) to move the shifter yoke 3940 in the first direction. When the shifter 3940 is displaced in the first direction, the closing drive gear 3950 moves the toothed projection 3974 out of engagement with the driven closing gear 3952 as it moves into the engagement engagement with the driven closing gear 3952. As can be seen in FIG. 166, in such a position, the toothed projection 3978 remains in the locking engagement with the driven firing of the toothed wheel 3962 to prevent firing of the firing system. The controller 1001 then provides a first rotary actuation motion to the drive pulley 3930 via a link between the driven element 1304 and the corresponding components of the tool holder 240. When the driving pulley 3930 is rotated in the first direction, the closing cord 3850 is rotated to drive the pre-clamping flange 3840 to the closing engagement with the cam surface 3825 of the anvil 3824 to move it to the closed position and thereby clamp the target tissue between the anvil 3824 and the insert 3834 staples. See FIG. 67. When the anvil 3824 is moved to the closed position, the controller 1001 stops applying the first rotation to the driving pulley 3930. Then controller 1001 may start the firing process by sending another control signal to the shifter 3922 motor (or shifter solenoid) to cause the shifter yoke to move in the second "SD" direction as shown in FIG. 94. When the shifter 3940 is moved in the other direction, the firing drive gear 3960 displaces the toothed projection 3978 out of engagement with the driven firing gear 3952 as it moves into the engagement engagement with the driven firing gear 3962. As can be seen in FIG. 73, in such a position, the toothed projection 3974 remains in the locking engagement with the driven closing gear 3952 to prevent the closing system from starting. Then the controller 1001 is actuated to provide the first rotary actuation motion to the drive pulley 3930 through a connector between the driven element 1304 and the corresponding components of the tool holder 1240. When the drive pulley 3930 is rotated in the first direction, the firing cord 3884 is rotated to drive the dynamic clamping member 3860 in the distal "DD" direction, thereby firing staples and cutting the tissue clamped in the gripper 3814. Once the 1000 robotic system has established, that the dynamic clamping element 3860 has reached its extreme position, using sensors, or by monitoring the amount of rotation applied to the driving pulley 3930, the controller 1001 may then apply a second rotational motion to the driving pulley 3930 to cause the closing cable 3850 to rotate in the opposite direction to cause the dynamic clamping element 3860 to retract in the proximal "PD" direction. When the dynamic clamping element is retracted to the initial position, the application of the second rotation movement to the driving pulley 3930 is discontinued. Then, the shifter motor 3922 (or shifter solenoid) is powered to move the shifter yoke 3940 to the closed position (FIG. 71). When the closing drive gear 3950 is in an engagement engagement with the driven closing gear 3952, the controller 1001 may reapplicate a second rotational motion to the drive pulley 3930. The rotational movement of the drive pulley 3930 in the other direction causes the closing cable 3850 to withdraw the pre-clamping flange beyond the engagement with the cam surface 3825 of the anvil 3824 to allow the anvil 3824 to move to the open position (by spring or other means) to release the sutured tissue from the surgical gripper 3814.

[0108] FIG. 77 shows a surgical tool 4000 that uses a gear-driven firing rod 4092, shown in FIG. 78-80. This embodiment includes an elongated shaft assembly 4008 that extends from the tool attachment portion 4100. The tool attachment portion 4100 includes a tool attachment plate 4102 that operatively supports the transmission system 4103. The elongate shaft assembly 4008 includes a rotatable proximal closing tube 4010 that is rotatably disposed on the proximal ridge element 4020 that is rigidly connected to the tool mounting plate 4102. The proximal dorsal element 4020 has a distal end that is connected to a portion of the elongated channel 4022 of the surgical gripper 4012. The surgical gripper 4012 may be substantially similar to the surgical gripper 3412 described above. In addition, the anvil 4024 of the surgical gripper 4012 can be opened and closed by means of a distal closing tube 4030 that operably connects to the proximal closing tube 4010. The distal closing tube 4030 is the same as the distal closing tube 3430 described above. Similarly, the proximal closing tube 4010 is the same as the proximal section of the closing tube 3410 described above. [0109] Anvil 4024 is opened and closed by rotational movement of the proximal closing tube 4010 as described above with respect to the distal closing tube 13410. In at least one embodiment, the gear system includes a closing gear, generally designated 4011. As described in the following detailed description, the closing drive

4011 it is adapted to receive a corresponding first rotational movement from the robotic system 1000 and to convert this first rotational movement into a main rotational movement for rotating a rotary proximal closing tube 4010 about the longitudinal axis of the LT-LT tool. As can be seen in FIG. 80, the proximal end 4060 of the proximal closure tube 4010 is pivotally supported within the cradle configuration 4104, which is attached to the tool attachment plate 4102 of the attachment portion 4100. A rotary gear 4062 is formed on or attached to the proximal end 4060 of a section of the closing tube 4010 for meshing with the rotary drive assembly 4070 that is operatively mounted on the tool mounting plate 4102. In at least one embodiment, the rotatable drive gear 4072 is connected to the respective first of the driven discs or elements 304 on the adapter side of the tool attachment plate 4102 when the tool attachment portion 4100 is connected to the tool holder 1270. See FIG. 10 and 80. The rotary drive assembly 4070 further includes a rotatable driven gear 4074 that is rotatably supported on the tool mounting plate 4072 in meshing with the rotatable gear 4062 and the rotatable drive gear 4072. The application of the first rotational control motion from the robotic system 1000 via the tool holder and adapter 240 to the respective driven element 304 will cause the rotational drive gear 4072 to rotate due to the fact that it is connected to it. The rotational movement of the rotating drive gear 4072 ultimately results in the rotational movement of the section of the closing tube 4010 to open and close the anvil 4024 as described above.

[0110] As indicated above, the gripper 4012 uses a cutting element 3860 as shown in FIG. 78 and 79. In at least one non-limiting embodiment, the transmission system 4103 further includes a knife drive system that includes a knife drive assembly 4080. FIG. 80 illustrates one embodiment of a knife drive assembly 4080 for axially extending a knife rod 4092 that is attached to such a cutting element using cords as described above with respect to a 3800 surgical tool. In particular, the knife rod 4092 replaces the 3884 firing cord used as the 3800 surgical tool. One form of knife drive assembly 4080 includes a rotatable drive gear 4082 that is connected to the corresponding second of the driven discs or components 1304 on the adapter side of the tool attachment plate 4102 when the tool attachment portion 4100 is connected to the tool holder 1270. See FIG. 10 and 80. The knife drive assembly 4080 further includes a assembly 4084 of a first rotatable driven gear that is rotatably mounted on a tool mounting plate 4102. The first rotary driven gear assembly 4084 is in meshing with the third rotary driven gear assembly 4086 that is pivotally mounted on the tool mounting plate 4102 and which is in meshing with the fourth rotary driven gear assembly 4088 that is in meshing with the the 4094 threaded portion of the drive shaft assembly 4090, which is connected to the knife rod 4092. The rotational movement of the rotating drive gear 4082 in the second direction of rotation will result in the axial extension of the drive shaft assembly 4090 and the knife rod 4092 in the "DD" direction. In turn, the rotational movement of the rotating drive gear 4082 in a secondary rotational direction (opposite to the second rotational direction) will cause the drive shaft assembly 4090 and the knife rod 4092 to move closer. The movement of the firing rod 4092 in the proximal direction "PD" will drive the cutting element 31860 in the distal direction "DD". In turn, the movement of the firing rod 4092 in the distal direction "DD" will result in the movement of the cutting element 3860 in the proximal direction "PD".

[0111] FIG. 81-87 show another 5000 surgical tool that can be effectively used in conjunction with the 1000 robotic system. In various embodiments, the surgical tool 5000 includes a surgical gripper 5012 in the form of a surgical stapling tool that includes an elongated channel 5020 and a rotatably movable clamping member, such as anvil 5070, which are held at a distance that guarantees effective stapling and cutting of the clamped tissue in the surgical gripper 5012 . As can be seen in FIG. 83, the longitudinal channel 5020 may have a substantially U-shaped cross section and may be made of, for example, titanium, stainless steel 203, stainless steel 304, stainless steel 416, stainless steel 17-4, stainless steel 17-7, aluminum 6061 or 7075, chrome steel, ceramics and the like. The metal bushing of the channel 5022, which is generally U-shaped, can be held at the bottom of the elongated channel 5020 as shown.

[0112] Various embodiments include an actuator in the form of a sled assembly 5030 that is operably mounted within the surgical gripper 5012 and can move axially within it between the initial position and the end position in response to control movements applied thereto. In some embodiments, the metal channel shell 5022 has a centrally located slot 5024 for movably placing the base portion 5032 of the sled assembly 5030. The base portion 5032 includes a foot portion 5034 that is sized so that it can be slidably inserted into the slot 5021 in the longitudinal channel 5020. See FIG. 104. As can be seen in FIG. 82, 83, 86 and 87, part 5032 of the base 5030 of the sled assembly includes an axially extending threaded hole 5036 that is adapted to be threaded onto a threaded drive shaft 5130 as discussed in detail below. In addition, the sled assembly 5030 includes a vertical support portion 5038 that supports the tissue cutting blade or tissue cutting tool 5040. The vertical portion 5038 of the support ends in the upper portion 5042, which has a pair of laterally extending 5044 retaining ribs. As seen in FIG. 83, ribs 5044 are positioned so that they are placed within respective slots 5072 in anvil 5070. Ribs 5044 and foot 5034 serve to hold the anvil 5070 in the required further closed position when the sled assembly 5030 is driven in distal direction by tissue clamped inside surgical gripper 5014. As can also be seen in FIG. 85 and 87, the sled assembly 5030 further includes a reciprocating or sequential actuator 5050 to drive the staple pushers toward the closed anvil 5070.

[0113] In particular and with reference to FIG. 83 and 84, the elongate channel 5020 is adapted to operatively hold a surgical staple cartridge 5080 within it. In at least one embodiment, the surgical staple cartridge 5080 includes a body portion 5082 that may be made of, for example, Vectra, Nylon (6/6 or 6/12) material and include a centrally located slot 5084 to receive the vertical portion 5038 of the support 5058 of the sled assembly. See FIG. 83. These materials can also be filled with glass, carbon or mineral filler in 10% -40%. The surgical staple cartridge 5080 further includes a plurality of retaining cavities 5086 with the ability to move lines or rows of staples 5088 staple holders. Recess 5086 may be arranged in longitudinally spaced apart lines or rows 5090, 5092, 5094, 5096. For example, rows 5090 may be referred to herein as the first outer rows. Rows 5092 may be referred to herein as the first internal rows. Rows 5094 may be referred to as second inner rows and 5096 rows may be referred to as second outer rows. The first inner row 5090 and the first outer row 5092 are on the first side of the longitudinal slot 5084, and the second inner row 5094 and the second outer row 5096 are on the second side of the longitudinal slot 5084. The first 5088 staple pushers in the first inner row 5092 are staggered relative to the first 5088 staple pushers in the first outer row 5090. Similarly, the second staple pushers 5088 in the second outer row 5096 are staggered relative to the second 5088 pushers in the second inner row 5094. Each 5088 pusher functionally supports the 5098 surgical staple.

[0114] In various embodiments, the sequentially activated or reciprocally activated drive assembly 5050 includes a pair of external drive members 5052 and a pair of internal drive members 5054 that are attached to a common shaft 5056 that is pivotally mounted inside the base 5032 of the sled assembly 5030. The outer drive elements 5052 are arranged to engage in a sequential manner or using reciprocating movement of a plurality of the outer activation cavities 5026 provided in the channel shell 5022. Similarly, internal drive elements 5054 are arranged to engage in a sequential manner or using reciprocating movement of a plurality of the internal activation cavities 5028 provided in channel shell 5022. The internal activation recesses 5028 are staggered relative to the adjacent external activation recesses

5026. See FIG. 179. As can be seen in FIG. 84 and 86, in at least one embodiment, the sled assembly 5030 further includes further wedge segments 5060 and intermediate wedge segments 5062 disposed on each side of the opening 5036 to engage with the tappets 5088 when the sled assembly 5030 is driven in the distal "DD" direction. As indicated above, the sled assembly 5030 is threaded on a threaded portion 5132 of the drive shaft 5130 that is rotatably mounted inside the gripper 5012. For example, in various embodiments, the drive shaft 5130 has a distal end 5134, which is mounted in a distal bearing 5136 mounted in the surgical gripper 5012. See FIG. 83 and 84.

[0115] In various embodiments, the surgical gripper 5012 is connected to the tool attachment portion 5200 by a longitudinal roller assembly 5108. In at least one embodiment, the tool attachment portion 5200 operably supports the gear system generally designated 5204, which is adapted to receive rotational output movements from the robotic system. The longitudinal shaft assembly 5108 includes an outer closure tube 5110 that can be rotatably and axially displaceable on the dorsal member 5120 which is rigidly connected to the tool mounting plate 5201, tool mounting parts 5200. The dorsal member 5120 also has a distal end 5122 that is connected to the portion 5020 of the elongated surgical channel of the gripper 5012.

[0116] In use, it may be required to rotate the surgical gripper 5012 about the longitudinal axis of the LT-LT tool defined by the longitudinal roller assembly 5008. In various embodiments, the outer closure tube 5110 has a proximal end 5112 that is pivotably mounted on the tool attachment plate 5201 of the tool drive portion 5200 by means of the front retaining cradle 5203. The proximal end 5112 of the outer closing tube 5110 is adapted to be operably connected to part 5206 of the rotary gear of the gear system 5204. In various embodiments, the proximal end 5112 of the outer closure tube 5110 is also mounted on the closing shoe 5140, which is also mounted with the possibility of moving the tool attachment plate 5201. A closing tubular section 5114 is formed at the proximal end 5112 of the outer closing tube 5110 for meshing with the rotary drive assembly 5150 of the rotary gear 5206. As can be seen in FIG. 176, the rotary drive assembly 5150 in at least one embodiment includes a rotatable drive gear 5152 that is connected to the corresponding first of the driven drives or elements 304 on the side 307 of the adapter mounting plate 5201 when the drive portion 5200 of the tool is connected to the handle 270 tool. The rotary drive assembly 5150 further includes a rotatable driven gear 5154 which is rotatably mounted on a tool mounting plate 5201 in engagement with a closing tubular gear 5114 and a rotatable drive gear 5152. The application of the first rotational control motion from the robot system 1000 via the tool holder 1270 and the adapter 240 to the respective driven element 1304 will thus cause the rotational motion of the rotating drive gear 5152. The rotational movement of the rotating drive gear 5152 ultimately results in the rotational movement of the longitudinal assembly 5108 (and gripper 5012) about the longitudinal axis of the LT-LT tool (arrow "R" in FIG. 81).

[0117] The closure of the anvil 5070 with respect to the surgical staple cartridge 5080 is accomplished by axial displacement of the outer closure tube 5110 in the distal "DD" direction. Such axial displacement of the outer closing tube 5110 can be accomplished by means of the closing gear portion 5144 of the transmission system 5204. As indicated above, in various embodiments, the proximal end 5112 of the outer closure tube 5110 is supported by the closing sledge 5140, which allows rotational movement of the proximal end 5112 relative thereto, and axial movement with the closing sled 5140. In particular, as can be seen in FIG. 81, closing sled 5140 have a vertical flap 5141 that extends into a radial groove 5115 in a portion of the proximal end 5112 of the outer closing tube 5110. In addition, as described above, closing sled 5140 are slidably attached to the tool attachment plate 5201. In various embodiments, closing sled 5140 has a vertical portion 5142, which has a closing rack 5143 formed thereon. The closing rack 5143 is adapted to drive toothing with the closing drive 5144.

[0118] In various embodiments, the closing drive 5144 includes a closing front gear 5145 that is connected to the corresponding second of the driven disks or elements 1304 on the side 1307 of the tool attachment plate 5201. Thus, applying a second rotational control motion from the robotic system 1000 via the tool holder 270 and the adapter 1240 to the corresponding second driven element 304 will cause the closing face gear 5145 to rotate when the connector 1230 is connected to the tool attachment portion 5200. The closing gear 5144 further includes a set of driven closing gear 5146, which is mounted in engagement with the closing front gear 5145 and the closing gear 5143. Thus, the application of a second rotational control motion from the robotic system 1000 via the tool holder 1270 and the adapter 1240 to the respective second driven element 1304 will cause the closing gear of the front gear 5145 to rotate and ultimately axial drive of the closing shoe 5140 and the outer closing tube 5110. The axial direction in which the closing tube 5110 travels ultimately depends on the direction in which the second driven element 304 is rotating. For example, in response to one rotary closing motion received from the robotic system 1000, the closing sled 5140 will be driven in the distal direction "DD" and eventually the outer closing tube 5110 will also be driven in the distal direction. The outer closure tube 5110 has an opening 5117 at a distal end 5116 that is adapted to be connected to the flap 5071 on the anvil 5070 using the methods described above. When the outer closing flap 5110 is driven distally, the proximal end 5116 of the closing tube 5110 will contact the anvil 5070 and the anvil will close. When using the "opening" rotation of the robotic system 1000, the closing sled 5140 and the outer closing tube 5110 will be driven proximal "PD" and the anvil 5070 will rotate to the open position using the methods described above.

[0119] In at least one embodiment, the drive shaft 5130 has a proximal end 5137 that has a proximal shaft gear 5138 attached thereto. The proximal shaft gear 5138 is in meshing engagement with the distal drive gear 5162 attached to the rotary drive rod 5160 which is rotatably mounted in the dorsal member 5120. The rotational motion of the rotary drive rod 5160 and ultimately the rotary drive shaft 5130 is controlled by a knife rotary gear 5207 which includes a portion of the gear system 5204 mounted on the tool mounting plate 5210. In various embodiments, the rotary knife gear 5207 includes a rotary knife drive system 5170 that is functionally mounted on the tool mounting plate 5201. In various embodiments, the knife drive system 5170 includes a rotatable drive gear 5172 that is connected to a respective third of the driven drives or components 304 on the adapter attachment plate 5201 side of the tool when the drive portion 5200 of the tool is connected to the tool holder 270. The knife drive system 5170 further includes a first rotatable driven gear 5174, which is rotatably supported on a tool mounting plate 5201 in meshing with a second rotatable driven gear 5176 and a rotatable drive gear 5172. A second rotary driven gear 5176 is connected to the portion 5164 of the proximal end of the rotational drive rod 5160.

[0120] The rotational movement of the rotating drive gear 5172 in the first rotational direction will result in the rotational movement of the rotational drive rod 5160 and the rotational drive shaft 5130 in the first direction. In turn, the rotational movement of the rotating drive gear 5172 in a second rotational direction (opposite to the first rotational direction) will cause the rotational drive rod 5160 and rotational drive shaft 5130 to rotate in a second direction. Thus, rotation of drive shaft 2440 causes rotation of guide sleeve 2400.

[0121] In the following, the method of operation of the surgical tool 5000 will be described. The 5200 tool drive is operably connected to connector 240 of the 1000 robot system. The robotic system controller 1001 operates to locate the tissue for incision and suturing between the open anvil 5070 and the surgical staple cartridge 5080. When the 5012 surgical gripper is positioned by the robotic system 1000 in such a way, that the target tissue will be between the 5070 anvil and the 5080 surgical staple cartridge, robotic system controller 1001 can be activated to apply a second rotational output motion to a second driven element 304 connected to the closing gear 5145 to drive the closing sledge 5140 and the outer closing tube 5110 axially in a distal direction to rotate the closed anvil 5070 as described above. When the controller 1001 determines that the anvil 5070 has been closed, for example by means of sensors in the surgical gripper 5012 and / or the drive part 5200 of the tool, the controller system 1001 may provide the surgeon with an indication that signals the anvil closing. Such indication may for example be a light and / or sound signal, tactile feedback on the controls and the like. Then the surgeon can start the firing process. However, in alternative embodiments, controller 1001 may automatically start the firing process.

[0122] To initiate the firing process, the controller applies a third rotary output motion to the third driven disk or element 1304 connected to the rotary drive gear 5172. The rotational movement of the rotating drive gear 5172 results in the rotational movement of the rotational drive rod 5160 and the rotary drive shaft 5130 as described above. The firing and forming of surgical staples 5098 can best be understood by reference to FIG. 82, 84 and 85. When the sled assembly 5030 is driven in the distal "DD" direction by the surgical staple cartridge 5080, the distal wedge segments 5060 first contact the staple push rods 5088 and begin moving them toward the closed anvil 5070. As the sled assembly 5030 continues to move farther, the external drive members 5052 will fall into the corresponding activation cavity 5026 in the channel pan 5022. The opposite end of each outer drive element 5052 will contact the respective outer follower 5088, which has moved further and intermediate wedge segments 5060, 5062. Further displacement toward the sled assembly 5030 causes the external drive members 5052 to rotate and drives respective pushers 5088 toward anvil 5070 to form staples 5098 mounted thereon when they are directed to anvil 5070. It should be assumed that as the sled assembly 5030 moves further down, the knife blade 5040 cuts through the tissue that is clamped between the anvil and the staple cartridge. Since the internal drive components 5054 and the external drive components 5052 are attached to the same shaft 5056, and the inner drive elements 5054 are radially offset from the outer drive elements 5052 on shaft 5056, when the external drive elements 5052 drive their respective tappets 5088 towards the anvil 5070, internal drive elements 5054 fall into their respective activation cavity 5028 to cause rotary or reciprocating drive of respective internal pushers 5088 towards the closed anvil 5070 in the same manner. Thus, the respective outer staples 5098 on each side of the centered slot 5084 are formed simultaneously, and the corresponding inner staples 5098 on each side of the slot 5084 are formed simultaneously when the sled assembly 5030 is driven in the distal direction. When controller 1001 determines that that the 5030 sled team got its farthest location, using sensors, by monitoring the amount of rotation applied to the 5130 drive shaft and / or the 5160 rotary drive rod, controller 1001 may then apply a third output rotation to drive shaft 5130 to cause rotation of drive shaft 5130 to rotate in the opposite direction to withdraw the sled assembly 5030 back to its initial position. When the sled assembly 5030 is retracted to its original position (which is indicated by sensors in the gripper 5012 and / or the drive portion of tool 5200), the application of a second rotational motion to the shaft 5130 is discontinued. Then the surgeon can manually activate the anvil opening process or it can be started automatically via the 1001 controller. In order to open the anvil 5070, a second output rotation is applied to the closing front gear 5145 to axially drive the closing sledge 5140 and the outer closing tube 5110 in the proximal direction. As the closing tube 5110 moves proximal, the opening 5117 at the distal end 5116 of the closing tube 5110 contacts the flap 5071 on the anvil 5070 to rotate the anvil 5070 to the open position. It is also possible to use the spring to deflect the anvil 5070 to the open position when the closing tube 5116 has been returned to its original position. Again, the sensors in the surgical gripper 5012 and / or in the tool attachment portion 5200 may provide a signal to the controller 1001 indicating that the anvil 5070 is now open. Then the surgical gripper 5012 can be withdrawn from the functional field.

[0123] FIG. 88-93 schematically depict the sequential firing of staples in the 5000 'surgical tool assembly, which is substantially similar to the 5000 surgical tool assembly described above. In this embodiment, the inner and outer drive members 5052 ', 5054' have a cam-like shape 5053 and a cutout 5055 of the actuator, as shown in FIG. 88-94. The drive elements 5052 ', 5054' are placed on the same shaft 5056 'which is rotatably mounted by a sled assembly 5030'. In this embodiment, the sled assembly 5030 'has further wedge segments 5060' for attachment to 5088 push rods. FIG. 88 shows the initial position of the two inner or outer drive members 5052 ', 5054' when the sled assembly 5030 'is driven in the distal "DD" direction. As can be seen in this figure, the pusher 5088a has moved up using the wedge segment 5060 'and is in contact with the drive element 5052', 5054 '. Further moving the sled assembly 5030 'in a distal direction causes the drive element 5052', 5054 'to rotate in the "P" direction (FIG. 89) until part of the actuator 5055 contacts the end wall 5029a of the activation cavity 5026, 5028, as shown in FIG. 185. Further moving the sled assembly 5030 'in the distal direction "DD" causes the drive member 5052', 5054 'to rotate in the direction "D" as shown in FIG. 91. As the drive element 5052 ', 5054' rotates, the pusher 5088a moves the cam surface 5053 to the final vertical position shown in FIG. 113. When the pusher 5088a reaches the final vertical position shown in FIG. 92 and 93, the staple (not shown) mounted thereon is directed to the anvil staple forming surface to form the staple.

[0124] FIG. 95-100 show a surgical gripper 5312 that can be used, for example, in conjunction with the tool attachment portion 300 and shaft 1208 described in detail above. In various embodiments, the surgical gripper 5312 includes an elongated channel 5322 that is constructed as described above to hold a surgical staple cartridge 5330 inside. The surgical staple cartridge 5330 includes a body portion 5332 that includes a central slot 5334 for receiving the vertical portion 5386 of the support of the sled assembly 5380. See FIG. 95-97. The surgical body portion 5332 of the staple cartridge further includes a plurality of retaining recesses 5336 with the possibility of displacing staples retaining 5350. Recess 5336 can be arranged in longitudinally spaced rows 5340, 5342, 5344, 5346. Rows 5340, 5342 are on one side of the longitudinal slot 5334, and rows 5344, 5346 are on the other side of the longitudinal slot 5334. In at least one embodiment, the 5350 tappets are adapted to support two surgical staples 5352. In particular, each pusher 5350 on one side of the longitudinal slot 5334 supports one staple 5352 in row 5340 and one staple 5352 in row 5342 in an alternating position. Similarly, each pusher 5350 on the other side of the longitudinal slot 5334 supports one surgical staple 5352 in row 5344 and the other surgical staple 5352 in row 5346 in an alternating position. Thus, each 5350 pusher supports two 5352 surgical staples.

[0125] As can further be seen in FIG. 95, 96, the surgical staple cartridge 5330 includes a plurality of 5360 rotary drive members. In particular, the rotatable driving elements 5360 on each side of the longitudinal slot 5334 are arranged in one line 5370 corresponding to the push rods 5350 in lines 5340, 5342. In addition, the rotatable driving elements 5360 on the other side of the longitudinal slot 5334 are arranged in one line 5372 corresponding to the push rods 5350 in lines 5344, 5346. As can be seen in FIG. 95, each rotatable drive element 5360 is rotatably mounted within the staple cartridge body 5332. In particular, each rotatable drive element 5360 is rotatably placed on a respective drive shaft 5362. Each drive element 5360 has an arched portion of ramp 5364 formed thereon, which is adapted to be connected to an arcuate lower surface 5354 formed on each pusher 5350. See FIG. 100. In addition, each drive element 5360 has a lower support portion extending therefrom 5366 to slidably support the pusher 5360 on channel 5322. Each drive element 5360 has a downwardly actuating rod 5368 that is adapted to be connected to a 5380 sled assembly.

[0126] As can be seen in FIG. 97, in at least one embodiment, the sled assembly 5380 includes a base portion 5382 that has a foot portion 5384 that is sized such that it can be slidably inserted into slot 5333 in channel 5322. See FIG. 95. The sled assembly 5380 includes a vertical support portion 5386 that supports the tissue cutting blade or tissue cutting tool 5388. The vertical portion 5386 of the end support ends in the upper portion 5390, which has a pair of retaining ribs 5392 protruding therefrom. Ribs 5392 are positioned in such a way that they are placed within appropriate slots (not shown) in the anvil (not shown). As in the above-described embodiments, ribs 5392 and foot portion 5384 are used to hold the anvil (not shown) in the required remote closed position when the sled assembly 5380 is driven distally by tissue clamped within surgical gripper 5312. The vertical portion 5386 of the support is adapted to be attached to the knife bar 2200 (FIG. 16). The sled assembly 5380 further has a horizontally extending actuator plate 5394 that has a shape suitable for engaging the actuator with each of the actuator rods 5368 on the 5360 tappets.

[0127] Operation of the surgical gripper 5312 will now be described with reference to FIG. 95 and 96. When the sled assembly 5380 is driven downstream by the staple cartridge 5330, the actuator plate 5394 sequentially contacts the actuator rods 5368 on the 5360 pushers. As the sled assembly 5380 continues to move further, the actuator plate 5394 sequentially contacts the rods 5368 of the actuator 5360 on each side of the longitudinal slot 5334. This action causes the drive members 5360 to rotate from the first non-actuated position to the actuated position in which the tappets 5350 are driven toward the closed anvil. When the 5350 pushers are driven toward the anvil, the 5352 surgical staples are driven to contact the forming side with the bottom of the anvil. When the robotic system 1000 determines that the 5080 sled assembly has reached its furthest position by sensors or other means, the robotic system 1000 control system can retract the knife rod and 5380 sled assembly back to their original position. The robotic control system can then activate the procedure to return the anvil to the open position to release the stapled tissue.

[0128] FIG. 101-105 show an example of an automated reload system, generally designated 5500. In one embodiment, the 5500 automated reloading system is adapted to replace the "used" surgical gripper component in the manipulation portion of the surgical surgical tool with the "new" surgical gripper component. The term "surgical gripper component" as used herein may include, for example, a surgical staple cartridge, a disposable loading unit, or other gripper components that, as a result of use, are subject to wear and should be replaced with new components. In addition, the term "worn" means that the gripper component has been activated and is no longer usable for its intended purpose in its current state. For example, in the context of a surgical staple cartridge or disposable loading unit, the term "used" means that at least some of the unformed staples that were previously bearing in it were "released" from it. The term "new" component of a surgical gripper as used herein refers to a gripper component that is in the state intended for its intended use. For example, in the context of a surgical staple cartridge or disposable loading unit, the term "new" means a component that has unformed staples inside and that is otherwise ready for use.

[0237] In various embodiments, the automated reloading system 5500 includes a base portion 5502 that can be conveniently located within the work space 1109 of the robotic arm carriage 1100 (FIG. 2) the 1000 robotic system. The term "manipulative part of a surgical tool" as used herein refers collectively to a surgical tool of the various types disclosed herein and other forms of surgical instruments moved by robots that are functionally attached to, for example, a robotic arm carriage 1100 or a similar device that is adapted for automatic operation and moving the surgical tool. The term "workspace" used in this document refers to the extent of displacement of the manipulation portion of a surgical tool of a robotic system. FIG. 2 generally shows an area that may include the working space of the robotic arm carriage 1100. Experts in this field will be aware that the shape and size of the workspace presented in this document is illustrative only. The final size, shape and location of the work surface will ultimately depend on the construction, extent of movement restrictions, and the location of the surgical part of the surgical tool. Thus, the term "workspace" as used herein is intended to include a number of different sizes and shapes of workspaces and should not be limited to the specific size and shape of the exemplary workspace shown in FIG. 2.

[0130] As can be seen in FIG. 101, base portion 5502 includes a new component segment or arrangement 5510 that is adapted to functionally support at least one new surgical gripper component in the "loading setting". As used herein, the term "charging setting" means that the new gripper component is supported in such a way to enable snapping of the corresponding support portion of the surgical tool manipulator component to engage loading with (i.e., functional seating or functional attachment to) a new gripper component (or a new gripper component to attract the loading attachment with a corresponding support portion of the tool manipulator component surgical) without human intervention other than which is necessary to run the robotic system. As will be seen from the following detailed description, in at least one embodiment, the preparing nurse will load a new portion of the component support prior to surgery with the appropriate length and color of the cartridges (some surgical staple cartridges may hold staples of a certain size, which is indicated by the color cartridge body) required to complete the surgery. However, no human interaction is necessary during surgery to reload the robotic endonath. In one embodiment, the surgical gripper component includes a staple cartridge 1234 that is adapted to functionally embed within the support portion of the component (elongated channel) any of the various other gripper configurations described above. For description, new (unused) cartridges will be labeled "12034a" and used cartridges will be labeled "12034b". The figures show cartridges 1234a, 1234b intended for use with the surgical gripper 1212, which includes channel 1222 and anvil 1224, the structure and operation of which have been discussed in detail above. The cartridges 1234a, 1234b are the same as the cartridges 1234 described above. In various embodiments, the cartridges 1234a, 1234b are adapted to latch (i.e. engage charging) within the surgical gripper 1212 channel 1222. However, as the remainder of the detailed description, those skilled in the art will be aware that the features of the 5500 automated cartridge reloading system can be effectively used in conjunction with the automated removal and installation of other cartridge configurations.

[0131] In the embodiment shown, the expression "charging setting" means that the distal tip portion 1235a of the new surgical staple cartridge 1234a is inserted into the respective support cavity 5512 in the support section 5510 of the new cartridge in such a manner, that the proximal end portion 1237a of the new surgical staple cartridge 1234a is in a convenient position to allow the arm carriage 1100 to direct the surgical gripper 1212 into position, wherein the new cartridge 1234a may be automatically loaded into channel 1222 of the surgical gripper 1212. In various embodiments, the base 5502 includes at least one sensor 5504, which communicates with the control system 1003 of the controller 1001 to provide the control system 1003 with the location of the base 5502 and / or the length of reloading and the color of each used or new cartridge 1234a.

[0132] As can be seen in these figures, the base 5502 further includes a container 5520 that is adapted to collect used cartridges 1234b that have been removed or disconnected from the surgical gripper 1212 that is operatively attached to the robotic system 1000. Furthermore, in one embodiment, the automated reloading system 5500 includes an extraction system 5530 for automatically removing a used gripper component from a respective gripper support portion or surgical tool handling portion without human intervention beyond what may be required to activate the robotic system. In various embodiments, the extraction system 5530 includes an extraction element 5532 of a hook. For example, in one embodiment, the extractive hook element 5532 is rigidly mounted on base portion 5502. In one embodiment, the extraction hook element has at least one hook 5534 formed thereon, which is adapted to engage the distal end 1235 of the used cartridge 1234b when it is held in the longitudinal channel 1222 of the surgical gripper 1212. In various embodiments, the extractive hook element 5532 is conveniently located within the container portion 5520 in such a way that when the used gripper component (insert 1234b) is brought into engagement with the extraction hook 5532, the used gripper component (insert 1234b) is removed from the corresponding support part of the component (elongated channel 1222) and falls into the container 5020. Thus, in order to use this embodiment, the manipulation part of the surgical tool is directed by a gripper attached thereto to pull the distal end 1235 of the used cartridge 1234b into hook with the hook 5534, and then moves the gripper in such a way as to remove the used cartridge 1234b from the longitudinal channel 1222.

[0133] In other configurations, the extractive hook element 5532 includes a rotatable wheel configuration that has a pair of opposing hooks 5334 protruding therefrom. See FIG. 101 and 104. The extraction element 5532 of the hook is rotatably mounted inside the container 5520 and is connected to the extraction motor 5540, which is controlled by the robot controller 1001. This form of the 5500 automated reloading system can be used as follows. FIG. 103 shows the introduction of a surgical gripper 1212 that is operatively attached to the handling portion of the surgical tool 1200. As can be seen in this figure, the robotic arm carriage 1100 places the surgical gripper 2012 in the position shown, in which the hook end 5534 of the extraction element 5532 engages the distal end 1235 of the used cartridge 1234b in the surgical gripper 1212. The anvil 1224 of the surgical gripper 1212 is in the open position. After connecting the distal end 1235 of the used cartridge 1234b to the end of the hook 5532, the extraction motor 5540 is started to induce rotation of the extraction wheel 5532 to disconnect the used cartridge 1234b from channel 1222. To assist detachment of the used cartridge 1234b from channel 1222 (or if the extraction member 5530 is stationary), the robotic system 1000 may move the surgical gripper 2012 in an upward direction (arrow "U" in FIG. 104). When used cartridge 1234b is removed from channel 1222, used cartridge 1234b falls into container 5520. When the used cartridge 1234b is removed from the surgical gripper 1212, the robotic system 1000 moves the surgical gripper 2012 to the position shown in FIG. 105.

[0134] In various embodiments, the sensor system 5533 is located adjacent to the extraction element 5532 that communicates with the controller 1001 of the robot system 1000. The sensor system 5533 may include a sensor that is adapted to detect the presence of the surgical gripper 1212, and in particular the tip 1235b of the used surgical staple cartridge 1234b when part of the distal tip 1235b is connected to the extraction element 5532. In some embodiments, the sensor system 5533 may, for example, include a light curtain system. However, it is possible to use other forms of proximity sensors. In this configuration, when the surgical gripper 2012 with the used surgical staple cartridge 1234b is brought to the removal hook with the extraction element 5532, the sensor detects the distal tip 1235b of the surgical staple cartridge 1234b (e.g., the light curtain has been interrupted). When the extraction element 5532 rotates and pulls out, the surgical staple cartridge 1234b is loosened and falls into the container 5520, the light curtain is uninterrupted again. As the 2012 surgical gripper was not moved during this procedure, the controller 1001 is confident that the used surgical staple cartridge 1234b has been removed from it. Other sensor systems may also be successfully used to provide the controller 1001 with an indication that the used surgical staple cartridge 1234b has been removed from the surgical gripper 1212.

[0135] As can be seen in FIG. 105, the surgical gripper 2012 is set to grip the new surgical staple cartridge 2034a between the channel 2022 and the anvil 1224. In particular, according to FIG. 102 and 105, each recess 5512 has a corresponding vertical clamp 5514 associated therewith. The 2012 surgical gripper is positioned such that the clamp 5514 is located between the new cartridge 2034a and the anvil 2024. In this position, the robotic system 1000 closes the anvil 1224 on the presser 5514, which serves to push the new insert 2034a into the snap connection with the surgical gripper channel 2022. When the new cartridge 1234a snaps into position within the longitudinal channel 1222, the robotic system 1000 withdraws the surgical gripper 2012 from the 5500 automated cartridge recharge system for use in conjunction with the preparation of another surgical procedure.

[0136] FIG. 106-110 show another automated reload system 5600 that can be used to remove a used disposable loading unit 3612 from a surgical tool handling system 3600 (FIG. 53-66), which is attached to the trolley 1100 arm or other part of the robot system 1000 and to reload the new disposable loading unit 3612. As can be seen in FIG. 106 and 107, one form of the automated reloading system 5600 includes a housing 5610 that has a movable support assembly in the form of an upper plate 5620 of a rotary carousel mounted thereon that cooperates with the housing 5610 to form a hollow enclosed area 5612. The automated 5600 reloading system is adapted to functionally support within the working space of the manipulation portion of the surgical tool of the robotic system, as described above. In various embodiments, the rotary carousel plate 5620 has a plurality of holes 5622 to hold a plurality of direction tubes 5660 therein. As can be seen in FIG. 107 and 108, the rotary carousel plate 5620 is attached to the spindle shaft 5624. The spindle shaft 5624 is centrally located within the enclosed area 5612 and has a spindle gear 5626 attached to it. The spindle gear 5626 is in meshing with the carousel driving gear 5628, which is connected to the carousel drive motor 5630, which communicates with the controller 1001 of the 1000 robot system.

[0137] Various embodiments of the automated reload system 5600 may also include a carousel locking assembly, generally designated 5640. In various embodiments, the carousel locking assembly 5640 includes a cam disk 5642 that is attached to the spindle shaft 5624. The spindle gear 5626 may be attached to the underside of the cam disk 5642 and the cam disk 5642 may be mounted on the spindle shaft 5624. In alternative configurations, the spindle gear 5626 and cam disk 5642 can be independently rotatedly attached to the spindle shaft 5624. As can be seen in FIG. 107 and 108, multiple cutouts 5644 are disposed around the perimeter of the cam disk 5642. The locking arm 5648 is pivotally mounted inside the housing 5610 and is pivoted to connect to the cam disk 5642 by the locking spring 5649. As can be seen in FIG. 106, the outer circumference of cam disk 5642 is rounded to facilitate rotation of cam disk 5642 relative to the locking arm 5648. The edges of each cutout 5644 are also rounded in such a way that when the cam disk 5642 rotates, the locking arm 5648 is pushed past the connection with the notches 5644 through the circumference of cam disk 5642.

[0138] Various forms of the automated reloading system 5600 are adapted to support the portable / removable tray assembly 5650, which is adapted to support multiple disposable loading units 3612 in separate direction tubes 5660. In particular and with reference to FIG. 107 and 108, the replaceable tray assembly 5650 includes a tray 5652 that has a centrally positioned spindle retainer 5654 protruding from its bottom side. The retainer spindle 5654 is sized such that it can be positioned inside the hollow end 5625 of the spindle shaft 5624. Tray 5652 has a plurality of holes 5656 that are adapted to hold a directional tube 5660 therein. Each directional tube 5660 is positioned within the respective opening 5656 in the replaceable tray assembly 5650 in the required orientation by means of a retaining rib 5666 on the directional tube 5660 which is intended to be placed within the corresponding retaining slot 5658 in the tray assembly 5650. In at least one embodiment, the retaining rib 5666 has a substantially V-shaped cross-section that is sized to fit into the V-shaped retaining slot 5658. This configuration is used to position the directional tube 5660 in the desired initial position while allowing it to rotate within opening 5656 when a rotational motion is applied to it. This means that when rotational motion is applied to the directional tube 5660, a V-shaped retaining fin 5666 will pop out of its respective retaining slot, allowing tube 5660 to rotate relative to tray 5652, which will be discussed in detail below. As can be seen in FIG. 106-108, the replaceable tray 5652 may be equipped with one or more handle parts 5653 to facilitate the transport of the tray assembly 5652 when it is loaded with direction tubes 5660.

[0139] As can be seen in FIG. 110, each directional tube 5660 includes a body portion 5662 that has a flanged open end 5664. The body portion 5662 defines a cavity 5668 that is sized to accommodate a portion of the disposable loading unit 3612. To properly position the disposable loading unit 3612 inside the 5660 directional tube, cavity 5668 has a flat retaining surface 5670 formed therein. As can be seen in FIG. 110, the flat retaining surface 5670 is adapted to facilitate the insertion of the disposable loading unit into the cavity 5668 in the required or predefined non-rotatable arrangement. In addition, the end 5669 of cavity 5668 may include foam or cushioning material 5672 that serves to cushion the distal end of the disposable loading unit 3612 inside the cavity 5668. In addition, the length of the retaining surface may correspond to the sliding support member 3689 of the axial drive unit 3680 of the disposable loading unit 3612 to further position the disposable loading unit 3612 in the desired position within the directional tube 5660.

[0140] The directional tubes 5660 can be made of Nylon material, polycarbonate, polyethylene, liquid crystal polymer, 6061 or 7075 aluminum, titanium 300 or 400 stainless steel, coated or varnished steel, clad steel and the like, and when placed in a removable tray 5662, and the retainer spindle 5654 is inserted into the hollow end 5625 of the spindle shaft 5624, directional tubes 5660 pass through respective holes 5662 in the top carousel plate 5620. Each replaceable tray 5662 is equipped with a position sensor 5663 that communicates with the control system 1003 of the controller 1001 of the robotic system 1000. The 5663 sensor is used to identify the location of the reload system, as well as the number, length and trigger status of each reload on the tray.

In addition, the 5665 optical sensor or sensors that communicate with the 1001 controller can be used to detect the type / size / length of disposable loading units that are located inside tray 5662.

[0141] Various embodiments of the automated reloading system 5600 further include a drive assembly 5680 for applying rotational motion to a directional tube 5660 holding a disposable loading unit 3612 to attach to the shaft 3700 of the surgical tool 3600 (collectively the "manipulative part of the surgical tool") that is connected functional with the robotic system. The drive assembly 5680 includes a yoke 5682 support that is attached to the locking arm 5648. Thus, the support yoke 5682 rotates with the locking arm 5648. The yoke 5682 of the support rotatably supports the idler tube 5684 and the tubular drive wheel 5686, which is driven by the tubular motor 5688 attached thereto. The 5688 tubular motor communicates with and is controlled by the 1003 control system. The idler tube 5684 and the tubular drive wheel 5686 are made of, for example, natural rubber, sanoprene, isoplast and the like in such a way that their outer surfaces generate enough friction to cause the direction tube 5660 to rotate in contact with it in contact with it. 5688 tubular motor activation. The intermediate gear 5684 and the tubular drive wheel 5686 are positioned relative to each other to form a cradle area 5687 between them for placing the direction tube 5060 in the driving meshing.

[0142] In use, one or more direction tubes 5660 placed in the automated reloading system 5600 are left empty, while other direction tubes 5660 can functionally hold the corresponding new disposable loading unit 3612. As described in the detailed description below, the empty direction tubes 5660 are used for placing used disposable loading units 3612 in them.

[0143] The automated reload system 5600 can be used as follows after the 5600 system has been located within the working space of the handling part of the surgical tool of the robotic system. If the handling part of the surgical tool has a used disposable loading unit 3612 operatively connected to it, one of the direction tubes 5660 that are held on the removable tray 5662 is left empty to accommodate the used disposable loading unit 3612. However, if the handling part of the surgical instrument does not have a disposable 3612 loading unit operatively connected to it, each of the directional tubes 5660 may be equipped with a correctly positioned new disposable 3612 loading unit.

[0144] As described above, the disposable loading unit 3612 uses the bayonet type swivel connection configuration to operably connect the disposable loading unit 3612 to the appropriate portion of the surgical tool handling portion. This means that to attach the disposable loading unit 3612 to the appropriate part (3700 - see FIG. 59.60), rotational installation movement should be applied to the disposable loading unit 3612 and / or the corresponding handling part of the surgical tool when these components have been moved to engage the loading relative to each other. Such installation movements are collectively referred to herein as "loading movements". Similarly, to disconnect a used disposable loading unit 3612 from the appropriate surgical instrument handling part, a detachment movement should be applied to the used disposable loading unit 3612 and / or the appropriate surgical instrument handling part, while moving the used disposable loading unit and the appropriate part of the surgical instrument handling from myself. Such disconnection movements are collectively referred to herein as "extraction movements".

[0145] To initiate the loading process, the robotic system 1000 is activated to direct the handling part of the surgical tool and / or the automated reloading system 5600 to bring the surgical part of the surgical tool to engage loading with a new disposable loading unit 3612 that is held in the direction tube 5660 , which is in the drive teeth with the 5680 drive unit. When controller 1001 (FIG. 1) the robotic control system 1000 will place the handling part of the surgical tool in the loading hook with the new disposable loading unit 3612, the controller 1001 activates the drive assembly 5680 to apply rotary loading movement to the directional tube 5660 in which the new disposable loading unit 3612 is maintained and / or uses another rotating loading movement relative to the respective handling portion of the surgical tool. When such a rotational loading movement (s) is used, the controller 1001 also displaces the appropriate handling portion of the surgical tool toward the new disposable loading unit 3612 to engage the loading. When the disposable loading unit 3612 finds itself in the loading hook with the appropriate part of the handling part of the tool, the loading movements are interrupted and the handling part of the surgical tool can be removed from the automated reloading system 5600 by replacing it with a new disposable loading unit 3612, which is joined to it .

[0146] To disconnect the used disposable loading unit 3612 from the appropriate surgical tool handling portion, the robotic system controller 1001 directs the surgical handling portion of the surgical tool to insert the distal end of the used disposable loading unit 3612 into the empty directional tube 5660 that remains in the drive meshing with the drive assembly 5680. The controller 1001 then activates the drive assembly 5680 to apply a rotational extraction movement to the directional tube 5660 in which the used disposable loading unit 3612 is maintained and / or applies the rotational extraction movement to the respective manipulating portion of the surgical tool. The controller 1001 also causes the handling part of the surgical tool to be withdrawn from the used rotary disposable loading unit 3612. Then the rotational extraction movement (s) is interrupted.

[0147] After removing the used disposable loading unit 3612 from the handling part of the surgical tool, controller 1001 can activate the motor 5630 driving the carousel to index the top plate 5620 of the carousel to feed another directional tube 5660 that holds the new disposable loading unit 3612 to the drive meshing with drive assembly 5680 . Then the loading process can be repeated to attach a new disposable loading unit 3612 to the handling part of the surgical tool. The controller 1001 can record the number of disposable loading units that have been used from a specific 5652 removable tray. When controller 1001 determines that new disposable loading units 3612 have been used from this tray, controller 1001 may provide the surgeon with a signal (visual and / or audible) indicating that tray 5652 holding all used disposable loading units 3612 should be replaced with a new tray 5652 containing new disposable loading units 3612.

[0148] FIG. 111-116 show another non-limiting embodiment of a surgical tool 6000 according to the present invention, which is well adapted for use with a robotic system 1000 that has a tool drive assembly 1010 (FIG. 6), which is connected to the main controller 1001, which is operated by input signals from the operator (i.e. surgeon). As can be seen in FIG. 206, surgical tool 6000 includes a surgical gripper 6012 that includes an end knife. In at least one embodiment, the surgical tool 6000 typically includes an elongated shaft assembly 6008 that has a proximal closure tube 6040 and a distal closure tube 6042 that are connected to each other by articulation 6100. The 6000 surgical tool is operably connected to the manipulator by means of the tool attachment portion, generally designated 6200. The surgical tool 6000 further includes a connector 6030 that can mechanically and electrically connect the attachment part of the tool 6200 to the manipulator in various ways described in detail below.

[0149] In at least one embodiment, the surgical tool 6000 includes a surgical gripper 6012 that includes, inter alia, at least one component 6024 that can move selectively between the first and second positions relative to the at least one other component 6022 in response to different control movements applied to component 6024, which will be discussed in detail below, to perform surgery. In various embodiments, component 6022 includes an elongate channel 6022 adapted to functionally hold the surgical staple cartridge 6034, and component 6024 includes a rotatably movable clamping element, such as anvil 6024. Various embodiments of the surgical gripper 6012 are adapted to hold the anvil 6024 and the elongated channel 6022 at a distance that guarantees effective stapling and cutting of the tissue clamped in the surgical gripper 6012. Unless otherwise stated, the gripper 6012 is similar to the surgical gripper 2012 described above and includes a cutting tool (not shown) and a sled (not shown). Anvil 6024 may include a flap 6027 at its proximal end that interacts with a component of the mechanical locking system (described in detail below) to facilitate opening of the anvil 6024. The longitudinal channel 6022 and the anvil 6024 can be made of electrically conductive material (such as metal), which means that they can act as part of the antenna that communicates with the sensor (s) in the gripper, as described above. The surgical staple cartridge 6034 may be made of a non-conductive material (such as plastic), and the sensor may be connected to or positioned in the surgical staple cartridge 6034, as also described above.

[0150] As can be seen in FIG. 111, surgical gripper 6012 is attached to the tool attachment portion 6200 by means of a longitudinal roller assembly 6008 in accordance with various embodiments. According to the illustrated embodiment, the longitudinal shaft assembly 6008 includes a pivot joint generally designated 6100 that allows the surgical gripper 6012 to be selectively rotated about the first articulated axis of the AA1-AA1 tool, which is substantially transverse to the longitudinal axis of the LT-LT tool and the second articulated axis of the AA2 tool -AA2, which is essentially up to the longitudinal axis of the LT-LT tool and the first articulated axis AA1-AA1. See FIG. 207. In various embodiments, the elongate shaft assembly 6008 includes a closing tube assembly 6009 that includes a proximal closing tube 6040 and a distal closing tube 6042 that are pivotally connected by means of articulated joints 6044 and 6046. The closure tube assembly 6009 is movable on a dorsal assembly, generally designated 6102.

[0151] As can be seen in FIG. 113, the proximal closing tube 6040 is pivotally connected to the intermediate closing tube 6043 by means of the upper articulation coupling 6044U and the lower articulation coupling 6044L in such a way that the intermediate coupling 6043 of the closing tube pivots relative to the proximal closing tube 6040 about the first closing axis CA1CA1 and the second closing axis CA2-CA2. In various embodiments, the first closing axis CA1-CA1 is substantially parallel to the second closing axis CA2-CA2, and both closing axes CA1-CA1, CA2-CA2 are substantially transverse to the longitudinal axis of the LT-LT tool. As can be seen in FIG. 134, the intermediate closing tube 6043 is pivotally connected to the distal closing tube 6042 by means of the left articulation coupling 6046L and the right articulation coupling 6046R in such a way that the intermediate coupling 6043 of the closing tube pivots relative to the distal closing tube 6042 about the third closing axis CA3 -CA3 and the fourth closing axis CA4CA4. In various embodiments, the third closing axis CA3-CA3 is substantially parallel to the fourth closing axis CA4-CA4, and both closing axes CA3-CA3, CA4-CA4 are essentially e to the first and second closing axis CA1CA1, CA2-CA2 and to the longitudinal axis LT-LT tools.

[0152] The closure tube assembly 6009 is adapted to axially slide on the dorsal assembly 12102 in response to actuating movements applied thereto. Another closure tube 6042 includes an opening 6045 that connects to the flap 6027 on the anvil 6024 to facilitate the opening of the anvil 6024 as the subsequent closure tube 6042 moves axially in a proximal "PD" direction. The closing tubes 6040, 6042 can be made of electrically conductive material (such as metal) in such a way that they can act as part of the antenna, as described above. The components of ridge assembly 6102 may be made of non-conductive material (such as plastic).

[0153] As indicated above, the surgical tool 6000 includes a tool attachment portion 6200 that is adapted to be operably attached to the tool attachment assembly 1010 of the robot system 1000 in the various ways described in detail above. As can be seen in FIG. 115, tool attachment portion 6200 includes a tool attachment plate 6202 that operably supports the transmission system 6204. In various embodiments, the transmission system 6204 includes a transmission 6142 that includes articulation portion 6140 for moving the surgical gripper 6012 about the first articulated axis of the TA1-TA1 tool and the second articulated axis of the TA2TA2 tool. The first articulated axis of the TA1-TA1 tool is essentially up to the second articulated axis of the TA2TA2 tool, and the first and second articulated axis of the tool are generally e to the longitudinal axis of the LT-LT tool. See FIG. 112.

[0154] To facilitate the selective movement of the surgical gripper 6012 around the first and second articulated axes of the TA1-TA1, TA2-TA2 tool, the dorsal assembly 6102 includes a proximal dorsal portion 6110 that is pivotally connected to the subsequent dorsal portion 6120 by means of rotary pins 6122 in for selective rotation about the axis TA1-TA1. Similarly, the distal dorsal portion 6120 is pivotally attached to the longitudinal channel 6022 of the surgical gripper 6012 by means of pivot pins 6124 to allow selective rotation of the surgical gripper 6012 about the second axis of the TA2-TA2 tool relative to the distal dorsal portion 6120.

[0155] In various embodiments, the articulation system 6140 further includes a plurality of articulation elements that operably engage in the surgical gripper 6012 and an articulated control system 6160 that is operatively mounted on the attachment member of the tool 6200, as will be described in detail below. In at least one embodiment, the articulated elements comprise a first pair of first articulated lines 6144 and 6146. The first articulated links are located on the first right side of the longitudinal axis of the tool. Thus, the first articulated links are referred to in this document as right upper cable 6144 and right lower cable 6146. The right upper cable 6144 and the right lower cable 6146 run through the respective corridors 6147, 6148 along the right side of the proximal ridge 6110, respectively. See FIG. 137. The articulated system 6140 further includes a second pair of second articulated cords 6150, 6152. The other articulated links are located on the other left side of the longitudinal axis of the tool. Thus, the second articulated links are referred to as top left articulated cable 6150 and left articulated cable 6152. The upper left articulated cable 6150 and the lower left articulated cable 6152 run through corridors 6153, 6154, in the proximal ridge 6110, respectively.

[0156] As can be seen in FIG. 112, the right upper cable 6144 runs around the upper articulation 6123 and is attached to the upper left of the longitudinal channel 6022 at the left articulated 6125. The right lower cable 6146 runs around the lower articulated joint 6126 and is attached to the lower left side of the longitudinal channel 6022 at the left articulated joint 6125. The left upper cable 6150 runs around the top articulated joint 6123 and is attached to the upper right side of the longitudinal channel 6022 at the right articulated joint 6127. The left bottom cable 6152 runs around the bottom articulated joint 6126 and is attached to the bottom right side of the longitudinal channel 6022 at the right articulated joint 6127. Thus, to rotate the surgical gripper 6012 around the first articulated axis of the TA1-TA1 tool to the left (arrow "L"), the right upper cable 6144 and the right lower cable 6146 should be pulled closer to "PD". To rotate the surgical gripper 6012 clockwise (arrow 'R') around the first articulated axis of the TA1-TA1 tool, left upper cable 6150 and right lower cable 6152 should be pulled closer to 'PD'. To rotate the surgical gripper 6012 around the second articulated axis of the TA2-TA2 tool in the up direction (arrow "U"), the right upper cable 6144 and the left upper cable 6150 should be pulled closer to "PD". In order to rotate the surgical gripper 6146 downwards (arrow "DW") around the second articulated axis of the TA2-TA2 tool, the lower right cable 6146 and the left lower cable 6152 should be pulled closer to "PD".

[0157] The proximal ends of the articulated ropes 6144, 6146, 6150, 6152 are connected to the articulated control system 6160, which includes a ball coupling that is part of the articulated drive 6142. In particular and with reference to FIG. 211 the ball joint assembly 6160 includes a ball-shaped element 6162 that is formed on the proximal part of the proximal ridge 6110. The articulated steering ring 6164 is mounted and can be moved on a ball-shaped element 6162. As can be seen in FIG. 211, proximal ends of the articulated cables 6144, 6146, 6150, 6152 are connected to the articulated control ring 6164 by means of appropriate ball joint systems 6166. The articulated control ring 6164 is controlled by the articulated drive assembly 6170.

As can be seen in particular in FIG. 211, proximal ends of the first articulated ropes 6144, 6146 are attached to the articulated control ring 6164 at the respectively spaced first points 6149, 6151, which are on plane 6159. Similarly, the proximal ends of the second articulated cables 6150, 6152 are attached to the articulated control ring 6164 at the correspondingly spaced second points 6153, 6155, which are also arranged along the plane 6159. As the remainder of the detailed description, those skilled in the art will be aware that such a cable attachment configuration on articulated control ring 6164 facilitates the required articulation range when articulated control ring 6164 is operated by articulated drive assembly 6170.

[0158] In various embodiments, the articulated drive assembly 6170 includes a horizontal articulated assembly, generally designated 6171. In at least one embodiment, the horizontal articulation assembly 6171 includes a horizontal pushing cable 6172 that is attached to the horizontal gear system 6180. The articulated drive assembly 6170 further includes a vertical articulated assembly, generally designated 6173. In at least one embodiment, the vertical articulation assembly 6173 includes a vertical push cord 6174 that is attached to the vertical gear system 6190. As can be seen in FIG. 115 and 116, the horizontal ejection cable 6172 runs through the support plate 6167, which is attached to the proximal dorsal portion 6110. The distal end of the horizontal push cord 6174 is attached to the articulated control ring 6164 by means of a suitable ball / articulated joint 6168. The vertical ejection cable 6174 runs through the support plate 6167 and its distal end is attached to the articulated steering ring 6164 by means of a suitable ball / articulated joint 6169. [0159] The horizontal gear system 6180 includes a horizontal driven gear 6182 that is pivotally mounted on a horizontal shaft 6181 that is attached to the proximal part of the proximal ridge 6110. The proximal end of the horizontal push cord 6172 is pivotally attached to the horizontal drive gear 6182 in such a way that when the horizontal drive gear 6172 rotates about the horizontal rotary axis HA, the horizontal push cable 6172 applies a first rotational movement to the articulated control ring 6164. Similarly, the vertical gear system 6190 includes a vertical driven gear 6192 that is pivotally mounted on a vertical shaft 6191 attached to the proximal part of the proximal ridge 6110 for rotational displacement around the vertical rotary axis VA. The proximal end of the vertical ejection cable 6174 is pivotally attached to the vertical driving gear 6192 in such a way that when the vertical driven gear 6192 rotates about the vertical rotational axis VA, the vertical ejection cable 6174 applies a second rotational movement to the articulated control ring 6164.

[0160] The horizontal driven gear 6182 and the vertical driven gear 6192 are driven by an articulated gear 6300 that operably connects to the articulated shifter assembly 6320. In at least one embodiment, the articulated shifter assembly includes an articulated driving gear 6322 that is connected to a respective of driven drives or elements 304 on the 307 side of the tool attachment plate 6202. See FIG. 10. Thus, the application of the rotary input motion from the robot system 1000 via the tool drive assembly 1010 to the respective driven element 304 will cause the rotational motion of the drive gear 6322 to rotate when the connector 1230 is connected to the tool holder 270. The articulated driving gear 6324 is attached to the spline shifter 6330 of the shifter which is pivotally mounted on the tool mounting plate 6202. The articulated driven gear 6324 is in mesh with the articulated driving gear 6322, as shown. Thus, the rotational movement of the articulated gear 6322 will result in the rotational movement of the shaft 6330. In various embodiments, the shifter driven gear assembly 6340 is mounted with the ability to move over the spline portion 6332 of the shifter shaft 6330.

[0161] In various embodiments, the shifter driven gear assembly 6340 includes the shifter driven gear 6342 that is attached to the shifter plate 6344. The shifter plate 6344 is operably connected to the shifter solenoid 6350 assembly. The shift solenoid 6350 assembly is connected to the corresponding terminals 6352 by wires 6351. See FIG. 115. Terminals 6352 are positioned for electrical connection with slots 258 (FIG. 9) on the tool side 1244 of adapter 240. This configuration is used to electrically connect the shift solenoid 6350 assembly to the 1001 controller. Thus, activation of the shifter solenoid 6350 will move the shifter driven gear assembly 6340 on the spline portion 6332 of the shaft shifter 6330 in the direction of the arrow "S" in FIG. 115 and 211. Various embodiments of the articulated gear transmission further include a horizontal gear assembly 6300 6360 which includes a first horizontal driving gear 6362 which is mounted on a shaft 6361 which is pivotally attached to a tool mounting plate 6202. The first horizontal driving gear 6362 is meshed with the second horizontal driving gear 6364. As can be seen in FIG. 116, horizontal driven gear 6182 is in mesh with distal portion 6365 of the second horizontal driven gear 6364.

[0162] Various embodiments of the articulated gear 6300 further include a vertical gear assembly 6370 which includes a first vertical driving gear 6372 which is mounted on a shaft 6371 which is rotatably mounted on a tool mounting plate 6202. The first vertical driving gear 6372 is maintained in mesh with the second vertical driving gear 6374, which is coaxially maintained with the second horizontal driving gear 6364. A second vertical drive gear 6374 is pivotably mounted on the proximal ridge 6110 for movement around it. A second horizontal drive gear 6364 is rotatably mounted on parts of a second vertical gear 6374 for independent rotational movement on it. As can be seen in FIG. 116, vertical driven gear 6192 is in mesh with the distal side 6375 of the second vertical driven gear 6374.

[0163] In various embodiments, the first horizontal drive gear 6362 has a first diameter and the first vertical drive gear 6372 has a second diameter. As can be seen in FIG. 115 and 116, shaft 6361 is not in line with shaft 6371. This means that the first horizontal driven gear 6362 and the first vertical driven gear 6372 do not rotate around a common axis. Thus, when the gear 6342 is in the central "locking" position in such a way that the gear 6342 is in mesh with the first horizontal driven gear 6362 and the first vertical driving gear 6372, components of the articulated system 6140 in the locked position. Thus, the sliding gear 6342 and the first horizontal and vertical driving gear 6362, 6372 and the articulated shifter assembly 6320 together may be referred to as an articulated locking system, generally designated 6380.

[0164] In use, the controller 1001 of the robotic system 1000 may control the articulation system 6140 as follows. To rotate the gripper 6012 counterclockwise around the first articulated axis of the TA1-TA1 tool, controller 1001 activates the shift solenoid assembly 6350 to bring the shift gear 6342 into meshing with the first horizontal drive gear 6362. Then controller 1001 causes the first rotational output motion to be applied to the articulated driving gear 6322 to drive the shifter gear in the first direction to ultimately drive the horizontal driven gear 6182 in the other first direction. The horizontal driven gear 6182 is driven to rotate the articulation ring 6164 on the ball-shaped portion 6162 to thereby pull the right upper cable 6144 and right bottom cable 6146 closer to "PD". To rotate the gripper 6012 clockwise around the first articulated axis of the TA1-TA1 tool, controller 1001 activates the shift solenoid assembly 6350 to bring the shift gear 6342 into meshing with the first horizontal drive gear 6362. The controller 1001 then causes the first rotational output motion in the opposite direction to be applied to the articulated gear 6322 to drive the gear 6342 in the second direction to ultimately drive the horizontal driven gear 6182 in a different second direction. Such actions result in the articulated steering ring 6164 moving in such a way that it pulls out the left upper cable 6150 and the left lower cable 6152 in a proximal direction "PD". In various embodiments, the gear ratio and friction forces generated between the gears of the vertical gear assembly 6370 serve to prevent rotation of the vertical driven gear 6192 when the horizontal gear assembly 6360 is moved.

[0165] To rotate the gripper 6012 in an upward direction around the second articulated axis of the TA2-TA2 tool, controller 1001 activates the shift solenoid assembly 6350 to bring the shift gear 6342 into meshing with the first vertical drive gear 6372. Then controller 1001 causes the first rotational output motion to be applied to the articulated driving gear 6322 to drive the gear 6342 in the first direction to ultimately drive the vertical driven gear 6192 in the other first direction. The vertical driven gear 6192 is driven to rotate the articulated ring 6164 on the ball-shaped portion 6162 closer to the ridge 6110 to thereby pull the right upper cable 6144 and the left upper cable 6150 closer to "PD". To rotate gripper 6012 in an upward direction around the second articulated axis of tool TA2-TA2, controller 1001 activates the shift solenoid assembly 6350 to bring the shift gear 6342 into meshing with the first vertical drive gear 6372. The controller 1001 then causes the first rotational output motion to be applied in the opposite direction to the articulated drive gear 6322 to drive the shift gear 6342 in a second direction to ultimately drive the horizontal driven gear 6192 in another second direction. Such actions cause the articulated control ring 6164 to pull out the lower right cable 6146 and the lower left cable 6152 proximal "PD". In various embodiments, the gear ratio and friction forces generated between the gears of the horizontal gear wheel assembly 6360 are used to prevent the horizontal drive of the gear wheel 6182 to rotate when the vertical gear assembly 6370 is moved.

[0166] In various embodiments, a series of sensors may communicate with the controller 1001 to determine the position of the articulated gripper 6012. Such sensors can connect to, for example, articulation 6100 or can be located inside the tool attachment portion 6200. Sensors can, for example, be used to detect the position of the articulated control ring 6164 on the ball-shaped portion 6162 closer to the dorsal portion 6110. Such feedback from sensors to controller 1001 allows controller 1001 to adjust the amount of rotation and the direction of rotation of the output articulated driving gear 6322. Furthermore, as described above, when the drive gear 6342 of the shifter is centrally located in engagement with the first horizontal drive gear 6362 and the first vertical drive gear 6372, the gripper 6012 is locked in an articulated position. Thus, after achieving the required amount of articulation, controller 1001 can activate the shifter solenoid assembly 6350 to drive the shifter gear 6342 into meshing with the first horizontal drive gear 6362 and the first vertical drive gear 6372. In alternative embodiments, the shift solenoid 6350 assembly can be activated by a spring to a central locked position.

[0167] In use, it may be necessary to rotate the surgical gripper 6012 about the longitudinal axis of the LT-LT tool. In at least one embodiment, the gear arrangement 6204 for the tool attachment portions includes a rotatable assembly 6400 of the gear that is adapted to receive the corresponding output rotational movement from the drive assembly 1010 of the tool of the robotic system 1000 and to convert this output rotational movement into a control rotational movement for rotating the assembly longitudinal shaft 6008 (and surgical gripper 6012) around the longitudinal axis of the LT-LT tool. For example, in various embodiments, a portion of the proximal end 6041 of the proximal closure tube 6040 is pivotably mounted on the tool attachment plate 6202 of the tool attachment portion 6200 by means of the front retaining cradle 6205 and closing shoe 6510, which are also supported with the possibility of moving the attachment attachment plate 6202. In at least one embodiment, the rotary gear assembly 6400 includes a tubular toothed section 6402 that is formed (or attached to) the proximal end 6041 of the proximal closing tube 6040 for functional engagement with the rotary gear assembly 6410 that is operably supported on the tool mounting plate 6202. As can be seen in FIG. 115, the rotary gear assembly 6410 in at least one embodiment includes a rotatable drive gear 6412 that is connected to the corresponding second of the driven drives or components 304 on the adapter side 307 of the tool mounting plate 6202 when the tool mounting portion 6200 is connected to the drive assembly tools 1010. See FIG. 10. The rotary gear assembly 6410 further includes a first rotatable driven gear 6414 that is rotatably mounted on a tool mounting plate 6202 in meshing with a rotatable drive gear 6412. The first rotary driven gear 6414 is attached to the drive shaft 6416 which is rotatably mounted on a tool mounting plate 6202. A second rotary driven gear 6418 is attached to the drive shaft 6416 and is in meshing with the tubular gear segment 6402 on the proximal closing tube 6040. The application of the second rotational output motion from the drive assembly 1010 of the robotic system tool 1000 to the respective driven element 304 will thus cause the rotational movement of the rotating drive gear 6412. The rotational movement of the rotating drive gear 6412 ultimately results in the rotational movement of the longitudinal shaft assembly 6008 (and surgical gripper 6012) about the longitudinal axis of the LTLT tool. It should be noted that the application of the output rotation from the tool drive assembly 1010 in one direction will result in the rotation of the longitudinal shaft assembly 6008 and the surgical gripper 6012 about the longitudinal axis of the LT-LT tool in the first direction, and the use of the output rotation in the opposite direction will result in the movement rotary shaft assembly 6008 and surgical gripper 6012 in a second direction that is opposite to the first direction.

[0168] In at least one embodiment, the anvil 12024 is closed to the staple cartridge 12034 by axially displacing the closing portion of the longitudinal roller assembly 12008 toward the distal "DD" on the dorsal assembly 12049. As described above, in various embodiments, the proximal end portion 6041 of the proximal closing tube 6040 is mounted by closing sleds 6510, which include a portion of the closing gear, generally designated 6512. As can be seen in FIG. 115, part 6041 of the proximal end part of the proximal closure tube 6040 has a flange 6048 formed thereon. The closing sled 6510 is connected to the 6048 flange by a yoke 6514 that connects the annular groove 6049 in the 6048 flange. This configuration is intended to allow the collar 6048 to rotate around the longitudinal axis of the LT-LT tool while it is still connected to the closing gear 6512. In various embodiments, closing sled 6510 has a vertical portion 6516 which has a closing gear rack 6518 formed thereon. The closing rack 6518 is adapted for driving engagement with the closing gear assembly 6520. See FIG. 115.

[0169] In various embodiments, the closing gear assembly 6520 includes a closing face gear 6522 that is connected to the corresponding second of the driven disks or elements 304 on the 307 side of the tool attachment plate 6202. See FIG. 10. Thus, the use of a third rotational output motion from the tool drive assembly 1010 of the robotic system 1000 to the corresponding second driven element 304 will cause the closing face gear 6522 to rotate when the tool attachment portion 6202 is connected to the tool drive assembly 1010. The closing gear assembly 6520 further includes a kit 6524 of the closing reduction gear which is in mesh with the closing face gear 6522 and the closing gear 2106. Thus, applying a third rotational output motion from the drive assembly 1010 of the robotic system tool 1000 to the corresponding second driven element 304 will cause the closing gear of the front gearing 6522 and the closing gear 6512 to rotate and ultimately driving the closing sledge 6510 and the proximal closing tube 6040 axially on the proximal ridge 6110. The axial direction in which the proximal closing tube 6040 moves, ultimately depends on the direction in which the third driven element 304 rotates. For example, in response to one rotary output motion originating from the drive unit 1010 of the robotic system 1000, the closing sledge 6510 will be driven in the distal "DD" direction and will eventually drive the proximal closing tube 6040 in the distal "DD" direction. When the proximal closing tube 6040 is driven distally, the distal closing tube

6042 it is also driven in distal direction due to its connection to the proximal closing tube 6040. When distal closure tube 6042 is driven distally, the end of closure tube 6042 will engage part of the anvil 6024 and cause the anvil 6024 to rotate to the closed position. When using the "opening" exit motion from drive unit 1010, tools of the robot system 1000, the closing sledge 6510 and the proximal closing tube 6040 will be driven proximal "PD" on the proximal ridge 16110. When the proximal closing tube 6040 is driven proximal " PD ", distal closing tube 6042 will also be driven in a proximal direction" PD ". When distal closure tube 6042 is driven proximal "PD", the opening 6045 therein mates with the flap 6027 on the anvil 6024 to facilitate its opening. In various embodiments, the spring (not shown) can be used to pivot the anvil 6024 into the open position when the distal closing tube 6042 is moved to its initial position. In various embodiments, the different gears of the closing gear assembly 6520 are sized to generate the required closing forces needed to successfully close the anvil 6024 on tissue for cutting and suturing with a surgical gripper 6012. For example, gears of the closing gear 6520 may be sized to generate closing forces of approximately 70-120 pounds (31.75-54.43 kg).

[0170] In various embodiments, the cutting tool is driven by the surgical gripper 6012 by the knife rod 6530. See FIG. 115. In at least one embodiment, the knife rod 6530 is made with a connection configuration (not shown) and / or is made of a material that can take the articulation movement of the surgical gripper 6102 around the first and second articulated axis of the tool, while remaining rigid enough to push the tool out cutting through tissue clamped in surgical gripper 6012. The knife rod 6530 runs through the empty corridor 6532 in the proximal ridge 6110.

[0171] In various embodiments, the proximal end 6534 of the knife rod 6530 is pivotally attached to the knife rack 6540 in such a way that the knife rod 6530 can rotate freely relative to the knife rack 6540. The distal end of the knife rod 6530 is attached to the cutting tool in the various ways described above. As can be seen in FIG. 115, the blade rack 6540 is slidably mounted inside the blade housing 6542, which is attached to the tool attachment plate 6202 in such a way that the knife rack 6540 is in meshing with a portion of the transmission gear 6550 of the knife assembly 6204. In various embodiments, the blade drive portion 6550 includes the knife gear assembly 6560. In particular and with reference to FIG. 115 in at least one embodiment, the knife gear assembly 6560 includes a knife gear unit 6562 that is connected to the corresponding fourth of the driven discs or elements 304 on the 307 side of the tool attachment plate 6202. See FIG. 105. Thus, applying a different rotational output from the robotic system 1000 via the tool drive assembly 1010 to the corresponding fourth driven element 304 will cause the rotational movement of the cutter 6562 of the knife. The knife gear assembly 6560 further includes a knife reduction gear assembly 6564 that includes a first knife driven gear 6566 and a second driving gear 6568 of the knife. The knife reduction gear assembly 6564 is pivotally attached to the tool attachment plate 6202 in such a way that the first driven gear of the knife 6566 is in meshing with the front gear 6562 of the knife. Similarly, the second knife driving gear 6568 is in meshing with the third knife driving gear assembly 6570. As seen in FIG. 115, the second driven gear 6568 of the knife is in meshing with the fourth driven gear 6572 of the knife of the third drive assembly 6570 of the knife gear. The fourth driven gear 6572 of the knife is in meshing with the fifth driven gear 6574 of the knife, which is in the meshing with the gear rack 6540 of the knife. In various embodiments, the gears of the knife gear assembly 6560 are sized to generate the forces required to drive the cutting tool through tissue clamped in the surgical gripper 6012 and actuate the staples. For example, the gears of the knife gear assembly 6560 may be sized to generate a driving force of approximately 40-100 pounds (18.14-55.36 kg). It should be noted that the application of the rotational output movement from the tool drive assembly 1010 in one direction will result in the axial displacement of the cutting tool in the distal direction, and the use of the rotational output movement in the opposite direction will result in the axial displacement of the cutting tool in the proximal direction.

[0172] As can be seen from the above description, the surgical tool 6000 is a significant improvement over previous robotic tool systems. The unique and innovative gear system used by the 6000 surgical tool enables functional connection of the tool with a part of the tool holder 1010 of the robotic system, which has only four rotary output bodies, and yet obtaining rotational output motions to: (i) move the gripper around two different articulated axes, which are substantially e relative to each other and to the longitudinal axis of the tool; (ii) rotating the gripper 6012 about the longitudinal axis of the tool; (iii) the closure of the anvil 6024 to the surgical staple cartridge 6034 to varying degrees, to enable the use of gripper 6012 to manipulate tissue, and then clamping it in the cutting and stapling position and (iv) releasing the cutting tool to cut the tissue clamped inside the gripper 6012. The unique and novel shifter systems according to the various embodiments of the present invention described above enable the feeding of two different articulated mechanisms from one part of the rotary body of the robot system.

[0173] Various embodiments have been described above in connection with surgical instruments intended for cutting. It should be noted, however, that in other embodiments, the surgical tool disclosed herein need not be a surgical cutting tool, but can be used in any type of surgical tool, including remote sensor transponders. For example, it could be an endoscopic tool not intended for cutting, a gripper, a stapler, a clamp applicator, an access device, a dosing device for drug / gene therapy, an energy device using ultrasound, a radio frequency, a laser, etc. The present invention can be used, for example, in laparoscopic instruments. The present invention is also used in traditional endoscopic surgical instruments and for open surgery as well as in robotic assisted surgery.

[0174] FIG. 117 illustrates the use of various aspects of certain embodiments of the present invention in combination with a surgical tool 7000 that has an ultrasound-powered gripper 7012. The gripper 7012 is functionally attached to the tool attachment portion 17100 by means of a longitudinal shaft assembly 7008. The tool attachment portion 17100 may be substantially similar to the various tool attachment parts described above. In one embodiment, the gripper 7012 includes an ultrasound-powered jaw portion 7014 that is powered by alternating current or direct current in a known manner. Such ultrasound powered devices have been disclosed in US Patent No. 6,783,524, entitled "Robotic Surgical Tool With Ultrasound Cauterizing and Cutting Instrument." In the embodiment shown, a separate 7020 power cord is shown. However, it should be noted that power can be supplied from controller 1001 through the tool attachment portion 17100. The surgical gripper 7012 further includes a movable jaw 7016 that can be used to clamp the tissue on the ultrasonic jaw portion 7014. The movable jaw portion 7016 may be selectively moved by the controller 1001 via the tool attachment portion 17100 using any of the various methods described herein.

[0175] FIG. 118 illustrates the use of various aspects of certain embodiments of the present invention in combination with a surgical tool 8000 that has a gripper 8012 that includes a linear stapling device. The gripper 8012 is functionally attached to the tool attachment portion 8100 by means of a 3700 longitudinal roller assembly, the type and construction of which have been described above. However, the gripper 8012 can be attached to the tool attachment portion 8100 by the series of longitudinal shaft assemblies described herein. In one embodiment, the tool attachment portion 8100 may be substantially similar to the tool attachment portion 3750. However, various other tool attachment parts and their respective transmission systems described in detail herein may also be used. Such linear parts of the stapling head have also been disclosed in, for example, US Patent No. 7,673,781, entitled "Surgical Stapling Device With Staple Driver That Supports Multiple Wire Diameter Staples".

[0176] Various embodiments of the sensor described in US Patent Publication No. 2011/0062212 A1, Shelton IV et al. May be used together with many of the embodiments of the surgical tool disclosed herein. As described above, the master controller 1001 generally includes master controllers (generally designated 1003) that are captured by the surgeon and moved in space as the surgeon observes the procedure through the 1002 stereoscopic display. See FIG. 1. Main controllers 1001 are manual input devices that preferably move with many degrees of freedom and which, moreover, often have a movable handle to move surgical instruments. Some of the embodiments of the surgical tool disclosed herein utilize a motor or motors in the drive part of the tool to provide various control movements for the tool gripper. Such embodiments may also obtain additional control motion (s) from the motor system used in the components of the robotic system. Other embodiments disclosed herein obtain all of the control motions from the motor systems in a robotic system.

[0177] Such motor-powered systems may use various sensor systems that have been disclosed in the published US Patent Application referenced above to provide the surgeon with a variety of feedback forms. For example, those master controller systems 1003 that use a manually actuated firing trigger may use a sensor (s) of a running engine to provide the surgeon with feedback regarding the amount of force applied to or experienced by the cutting element. The sensor (s) of the running engine may be adapted to communicate with a portion of the firing trigger to detect when a portion of the firing trigger has been moved to initiate cutting / stapling operations by the gripper. The running motor sensor may be a proportional sensor, such as a rheostat or a variable resistor, for example. When the trigger is pulled, the sensor detects movement and sends an electrical signal indicating the voltage (or energy) to be delivered to the appropriate engine. When the sensor is an adjustable resistor or the like, the rotary motion of the motor can generally be proportional to the amount of displacement of the firing trigger. This means that if the operator only slightly pulls or closes the firing trigger, the motor's rotation is generally low. When the firing trigger is fully extended (or fully closed), the motor's rotational movement is maximum. In other words, the stronger the surgeon pulls the firing trigger, the more voltage is applied to the engine, resulting in higher rotational speed. Other configurations may provide the surgeon with a feedback meter 1005 that can be viewed through the display 1002 and which provides the surgeon with a visual indication of the amount of force applied to the cutting tool or dynamic clamping element. It is possible to use other sensor systems to provide the main controller 1001 with an indication of whether the staple cartridge has been loaded into the gripper, or the anvil has been moved to a closed position prior to release and the like.

[0178] In alternative embodiments, the motor-controlled connector may be used in conjunction with controller 1001 that limits the maximum trigger pull based on the amount of load (e.g. clamping force, shear force and the like) experienced by the surgical gripper. For example, the more strongly the cutting tool is driven by the tissue clamped inside the gripper, the more strongly the activating trigger should be pulled / activated. In other embodiments, the trigger on the controller 1001 is arranged in such a way that the position of the trigger pull is proportional to the position / state of the gripper. For example, the trigger is fully depressed only when the gripper is fully triggered.

[0179] The devices disclosed herein may be designed to be disposed of after a single use, or may be designed for multiple use. In both cases, however, the device can be regenerated for reuse after at least one use. Regeneration can include any combination of steps to disassemble the device, then clean or replace individual components, and then reassemble. In particular, the device can be dismantled, and any number of individual parts or parts of the device can be selectively replaced or removed in any combination. After cleaning and / or replacing individual parts, the device can be re-assembled for subsequent use at the regeneration plant or by the surgical team immediately prior to surgery. Professionals in the field will appreciate that device regeneration can utilize a variety of techniques for disassembly, cleaning / replacement, and reassembly. The use of such techniques and the resulting refurbished device is within the scope of this application.

[0180] Although the present invention has been described herein in connection with certain disclosed embodiments, many modifications and changes to these embodiments can be made. For example, different types of grippers can be used. In addition, if materials have been disclosed for certain components, other materials may be used. The above description and the following reservations are intended to cover any such modifications or changes.

Ethicon LLC, Puerto Rico Representative:

Z-16808/18