Surgical stapling instrument with an articulatable end effector

[0001] The present invention relates generally to surgical stapling tools, and in particular surgical staplers having a closing system for closing the gripper, as well as a triggering system for applying staples.

2. Description of the Related Art [0002] As is known in the art, surgical staplers are often used to place staples in soft tissue to reduce or eliminate soft tissue bleeding, in particular when the tissue is, for example, dissected. Surgical staplers, such as an endo-knife, for example, may include a gripper that can be moved or bent relative to the longitudinal roller assembly. The grippers are often adapted to attach soft tissue between the first and second jaw elements, the first jaw element often including a staple cartridge which is adapted to be stapled and the second jaw element often includes an anvil. Such surgical staplers may include a closure system for rotating the anvil relative to the staple cartridge. However, these closing systems do not prevent the articulated gripper from moving relative to the shaft assembly after the jaw members have been closed. As a result, when the gripper is bent, the gripper may exert a shear force relative to the soft tissue gripped between the jaw elements.

[0003] As indicated above, surgical staplers can be adapted to rotate the gripper anvil relative to the staple cartridge to grip soft tissue between them. Under various circumstances, the anvil may be adapted to apply a clamping force to the soft tissue to keep the soft tissue tight between the anvil and the staple cartridge. If the surgeon does not accept the position of the gripper, he usually needs to activate the release mechanism on the surgical stapler to rotate the anvil to the open position, and then place the gripper in its proper place. Then the staples are usually applied from the staple cartridge through a drive element that moves in the channel in the staple cartridge and causes the staples to deform on the anvil and the layers of soft tissue are joined together. Often, as is known in the art, staples are arranged in several lines or rows of staples to more reliably connect tissue layers to each other. The gripper may also include a cutting element, such as, for example, a knife, which is advanced between two rows of staples to cut out soft tissue after the soft tissue layers have been stapled together.

[0004] Document US 2008/167670 A discloses an endoscopic surgical tool for cutting and clamping. The surgical tool includes a handle, shaft and articulated gripper pivotally connected to the shaft at the pivot axis. The gripper includes anvil and a channel for receiving the staple cartridge. Near the handle, articulation is provided to achieve gripper rotation about the articulation axis. The shaft includes a proximal closing tube and a distal closing tube pivotally connected by means of a joint axis connector. Further closing pipe. Inside the closing pipes there is a main rotary drive shaft that communicates with the secondary distal drive shaft via a bevel gear. The second drive shaft is connected to a drive gear which engages with the proximal drive wheel of the propeller shaft. The rotation of the helical shaft causes the cutting tool to move and retract it in the gripper. A locking mechanism is provided that includes a pair of hooks that, upon contact with the wedge sled of the unused staple cartridge, are pressed into the cavity, clearing the path where the cutting tool travels further through the staple cartridge. When the tool is fired, the cutting tool is retracted to the point of contact with the hooks. The cutting tool passes over the hooks, pushing them into the recess of the hook until it is behind the hooks, after which the hooks spring back to lock the cutting member. In this way, the cutting tool cannot move until the unused staple cartridge has been installed in the channel.

[0005] Document US 2007/73341 describes an endoscopic surgical stapling tool comprising support plates elastically or flexibly coupled to one side of the articulation mechanism to avoid buckling of the firing mechanism.

SUMMARY [0006] The tool according to the invention is defined in claim 1. Further embodiments are defined in the dependent claims.

BRIEF DESCRIPTION OF THE DRAWINGS [0007] The abovementioned and other features and benefits of using the present invention, as well as the method of achieving them, will become more obvious and the invention itself will become better understood by reference to the following description of an embodiment of the invention in connection with the accompanying drawings. In particular, the invention (as defined in claim 1) is described with reference to FIG. 144-146B.

FIG. 1 is a side view of a surgical instrument in accordance with an embodiment of the present invention;

FIG. 2 shows a side view of a portion of the surgical instrument holder of FIG. 1;

FIG. 3 is a side view of the surgical instrument gripper of FIG. 1;

FIG. 4 is a top view of the gripper of FIG. 3;

FIG. 5 is a perspective view of the articulation of the surgical instrument of FIG. 1 with some components of the surgical instrument removed;

FIG. 6 is a perspective view of the longitudinal shaft assembly and the articulation of the surgical instrument of FIG. 1 with some components of the surgical instrument removed;

FIG. 7 is a perspective view of a portion of the handle and shaft assembly of the surgical instrument of FIG. 1 with some components of the surgical instrument removed;

FIG. 8 shows a side view of the handle portion of FIG. 2 with some components of the surgical instrument removed;

FIG. 9 is a side view of the handle portion of FIG. 2 with additional components of the surgical instrument removed;

FIG. 10 is a side view of an actuating member of a joint locking mechanism and a closing system of a surgical instrument gripper in accordance with an alternative embodiment of the present invention with some surgical instrument components removed;

FIG. 11 shows a side view of the surgical instrument of FIG. 10, showing the actuator of the joint locking mechanism in the unlocked position and the gripper closing system in an open configuration;

FIG. 12 shows a side view of the surgical instrument of FIG. 10, showing the actuator of the joint locking mechanism in the unlocked position and the gripper closing system in a partially closed configuration;

FIG. 13 shows a side view of the surgical instrument of FIG. 10, showing the actuator of the joint locking mechanism in the locked position and the gripper closing system in a closed configuration;

FIG. 14 is a side view of the closing trigger of the closing system of the surgical device gripper of FIG. 1;

FIG. 15 is a partial perspective view of the closing trigger of FIG. 15;

FIG. 16 shows a partial side view of the closing trigger of FIG. 15;

FIG. 17 is a perspective view of the surgical instrument trigger lock of

FIG. 1;

FIG. 18 shows a side view of the trigger lock of FIG. 17;

FIG. 19 is a detailed view of the trigger drive of the surgical instrument of FIG. 1 with some components of the surgical instrument removed;

FIG. 20 is a perspective view of the firing drive of FIG. 19;

FIG. 21 is a partial detailed view of the trigger trigger, pawl, and tilt trigger mechanism of FIG. 19;

FIG. 22 shows a side view of the pawl, tilt mechanism, and also the spring of the trigger drive latch of FIG. 19;

FIG. 23 is a side view of the pawl of FIG. 22;

FIG. 24 is a detailed view of the trigger drive of FIG. 19, showing the pawl rotated into position to engage the trigger connector of the trigger drive;

FIG. 25 is a perspective view of the tilt mechanism of FIG. 22.

FIG. 26 is a perspective view of the frame of the surgical instrument of FIG. 1;

FIG. 27 is a detailed view of a triggering device for a surgical instrument in accordance with an alternative embodiment of the present invention with some components of the surgical instrument removed;

FIG. 28 is a detailed view of the trigger drive of FIG. 27, showing the trigger drive latch disconnected from the trigger switch;

FIG. 29 is a perspective view of the surgical device return mechanism according to claim 1, showing the trigger trigger in a non-actuated position with some surgical device components removed;

FIG. 30 is a partial perspective view of the return mechanism of FIG. 29, showing the firing trigger in the actuated position with some of the return mechanism components removed;

FIG. 31 is a side view of the return mechanism of FIG. 29 set in the configuration shown in FIG. thirty;

FIG. 32 is a side view of the return mechanism of FIG. 29, showing the return carriage of the return mechanism in the actuated position;

FIG. 33 is a partial perspective view of the return mechanism of FIG. 29 with some of the components of the return mechanism removed;

FIG. 34 is a perspective view of the pawl and the firing pin of the firing drive of FIG. 19.

FIG. 35 is a perspective view of the return mechanism of FIG. 29, showing the return carriage in the actuated position and the trigger trigger returned to its non-actuated position;

FIG. 36 is a partial perspective view of the return mechanism of FIG. 29 set in the configuration shown in FIG. 35, showing a return bolt of a return mechanism operatively connected to a triggering trigger;

FIG. 37 is a partial perspective view of the return mechanism of FIG.

29, showing the trigger trigger in the actuated position after the return pin has been rotated;

FIG. 38 is an additional perspective view of the return mechanism from

FIG. 29 set in the configuration shown in FIG. 37;

FIG. 39 is a partial perspective view of the return mechanism of FIG. 29, showing the firing trigger restored to its non-actuated position;

FIG. 40 is a perspective view of the return mechanism of FIG. 29, showing a return ambulance restored to its unarmed position;

FIG. 41 is a perspective view of the return mechanism of FIG. 29 set in the configuration of FIG. 40, showing the relative relationship between the biasing spring and the return bolt of the return mechanism with some of the return mechanism components removed;

FIG. 42 is a perspective view of the return mechanism of FIG. 29 set in the configuration of FIG. 40, showing a return carriage operatively coupled to the release pin of the release drive and a return pin of the return mechanism for resetting the trigger drive and the return mechanism in their initial configurations;

FIG. 43 is a detailed view of the retractor reel of FIG. 29, showing the relative relationship between the return band of the return mechanism and the stapler frame of FIG. 26;

FIG. 44 is a detailed view of the reel of FIG. 43, showing the relative relationship between the return band and an alternative embodiment of the stapler frame of FIG. 26;

FIG. 45 is a perspective view of a surgical device return mechanism in accordance with an alternative embodiment of the present invention, having a ratchet mechanism to prevent retraction;

FIG. 46 is a side view of the return mechanism of FIG. 45, having the return carriage in the unmanaged position;

FIG. 47 is a perspective view of the return mechanism of FIG. 45 with some components of the surgical instrument removed;

FIG. 48 is a perspective view of the return gear, return pin, and ratchet against retraction of the ratchet mechanism of FIG. 45;

FIG. 49 is another side view of the return mechanism of FIG. 45;

FIG. 50 is a perspective view of the articulation joint of FIG. 5.

FIG. 51 is a perspective view of the articulation joint of FIG. 5 with some components of the surgical instrument removed;

FIG. 52 is a perspective view of the articulation joint of FIG. 5 with additional components of the surgical instrument removed;

FIG. 53 is a perspective view of the gripper lock member of FIG. 3;

FIG. 54 is another perspective view of the gripper lock member of FIG.

53;

FIG. 55 is a bottom view of the gripper lock member of FIG. 53;

FIG. 56 is a side view of the gripper lock member of FIG. 53;

FIG. 57 is a partial perspective view of the articulation of an earlier surgical instrument;

FIG. 58 is a perspective view of the articulation joint of FIG. 5 with some components of the gripper and the longitudinal roller assembly removed;

FIG. 59 is another perspective view of the articulation joint of FIG. 5 with some components of the gripper and the longitudinal roller assembly removed;

FIG. 60 is a perspective view of the gripper blocking element of FIG. 53 operatively connected to the lock member of the longitudinal roller assembly;

FIG. 61 is a perspective view of the roller assembly lock member of FIG.

60;

FIG. 62 is a bottom view of the gripper lock member of FIG. 53 operatively coupled to the lock member of the roller assembly of FIG. 60;

FIG. 63 is a perspective view of an articulated surgical instrument in accordance with an alternative embodiment of the present invention with some of the surgical instrument components removed;

FIG. 64 is a top view of a gripper lock member operably coupled to the surgical device shaft assembly lock member of FIG. 63;

FIG. 65 is a perspective view of a gripper lock member operably coupled to the roller assembly lock member of FIG. 64;

FIG. 66 is a perspective view of the gripper lock member of FIG. 64;

FIG. 67 shows a side view of the gripper lock member of FIG. 64;

FIG. 68 is a side view of a surgical instrument in accordance with an embodiment of the present invention with some surgical instrument components removed;

FIG. 69 is a side view of the surgical instrument of FIG. 68, showing the closing trigger in the actuated position;

FIG. 70 is a side view of the surgical instrument of FIG. 68, showing the firing trigger in the actuated position after the first actuation of the firing trigger;

FIG. 71 is a perspective view of a gear transmission of the reversing mechanism of the surgical instrument of FIG. 68 for retracting the triggering element;

FIG. 72 shows a side view of the surgical instrument of FIG. 68, showing the trigger trigger in the non-actuated position after it has been released from its first actuation;

FIG. 73 is a side view of the surgical instrument of FIG. 68, showing the firing trigger in the actuated position after the second actuation of the firing trigger;

FIG. 74 is a side view of the surgical instrument of FIG. 68, showing the trigger trigger in the non-actuated position after it has been released from its second actuation;

FIG. 75 is a side view of the surgical instrument of FIG. 68, showing the firing trigger in the actuated position after the third actuation of the firing trigger;

FIG. 76 is another side view of the surgical instrument of FIG. 68, showing the return carriage of the reversing mechanism after it has been rotated downward to the actuated position;

FIG. 77 is a perspective view of the trigger gear, wedge gear, and also a gear return pin of the reversing mechanism of FIG. 71;

FIG. 78 is a cross-sectional view of the surgical instrument of FIG. 68, showing the return pin of FIG. 77 operably connected to the trigger gear and toothed wedge of the inverting mechanism of FIG. 71;

FIG. 79 is a perspective view of the return pin of FIG. 77.

FIG. 80 is another side view of the return carriage of FIG. 76 in the run position;

FIG. 81 is a perspective view of the firing pin connected to the latch of the firing drive of the surgical instrument of FIG. 68;

FIG. 82 is a side view of the return carriage of the surgical instrument of FIG. In the actuated position and the reversing mechanism operatively connected to the triggering element;

FIG. 83 is a side view of the surgical instrument of FIG. 68, showing the firing trigger in the actuated position after the fourth actuation that retracted the firing member;

FIG. 84 is a perspective view of the inverting mechanism of FIG. 76 with some components removed;

FIG. 85 is a side view of the surgical instrument of FIG. 68, showing the trigger trigger in the non-actuated position after it has been released from its fourth actuation;

FIG. 86 shows a side view of the surgical instrument of FIG. 68, showing the return carriage of FIG. 76 turned up to the unlatched position, and also presenting the closing trigger in its unlatched position;

FIG. 87 is a perspective view of a surgical instrument in accordance with an alternative embodiment of the present invention with some components of the surgical instrument removed;

FIG. 88 is a perspective view of the inverting mechanism of the surgical instrument of FIG. 87, including a gear transmission, showing directions in which the gears of the gear transmission can rotate when the trigger element of the surgical instrument is advanced;

FIG. 89 is a perspective view of the trigger gear and return bolt of the inverting mechanism of FIG. 88, showing the trigger gear in cross section;

FIG. 90 is another perspective view of the trigger gear and return pin of FIG. 89, showing a return pin without functional connection to the trigger gear;

FIG. 91 is a perspective view of the trigger gear and return pin of FIG. 89, showing a return pin again connected to the trigger gear;

FIG. 92 is a perspective view of the inverting mechanism of FIG. 88, showing directions in which the gears of the gears rotate when the trigger element is retracted;

FIG. 93 is another perspective view of the inverting mechanism of FIG.

88.

FIG. 94 is a perspective view of the surgical instrument of FIG. 87, showing a trigger lock that is adapted to connect to the gear of the reversing mechanism of FIG. 88 except the trigger;

FIG. 95 is a side view of a surgical instrument inverting mechanism in accordance with an alternative embodiment of the present invention, showing the return carriage in a non-actuated position with some surgical instrument components removed;

FIG. 96 is a perspective view of the inverting mechanism of FIG. 95, showing a trigger gear having a ratchet surface and an additional wedge gear having a ratchet surface with some of the additional components of the surgical instrument removed;

FIG. 97 is a cross-sectional view of the inverting mechanism of

FIG. 95 shown in the configuration of FIG. 96;

FIG. 98 is a perspective view of the return bolt of the inverting mechanism of FIG. 95.

FIG. 99 is a side view of the inverting mechanism of FIG. 95, showing the return carriage in the actuated position;

FIG. 100 is a perspective view of the inverting mechanism of FIG. 95, in which the surfaces of the trigger ratchet mechanism and the wedge gears mesh;

FIG. 101 is a side view of a surgical instrument in accordance with an alternative embodiment of the present invention, including a firing drive and an inverting drive of the surgical instrument of FIG. 68 in some of the surgical instrument components removed, wherein the trigger drive latch is as it may be when it is retracted relative to the trigger;

FIG. 102 shows a side view of the surgical instrument of FIG. 101, showing a pawl operatively connected to the triggering element;

FIG. 103 is a side view of the surgical instrument of FIG. 101, showing the lack of overlap of the pawl and recess in the firing element when the firing element accidentally retracts in relation to its intended position;

FIG. 104 is a side view of a surgical instrument in accordance with an alternative embodiment of the present invention, including a rollback safety mechanism with some of the surgical instrument components removed;

FIG. 105 is a perspective view of the retraction safety pin of the retraction mechanism of FIG. 104;

FIG. 106 is a detailed view of the wedge protruding from the return pin of FIG. 105;

FIG. 107 is a perspective view of the indexing element of the backoff mechanism of FIG. 104.

FIG. 108 is a perspective view of the return pin of FIG. 105 operably connected to the indexing element of FIG. 107;

FIG. 109 is a perspective view of the return pin and indexing element showing a return pin wedge located in a first hole in the indexing element;

FIG. 110a is another perspective view of the wedge of the return pin and indexing element of FIG. 109;

FIG. 110b is a perspective view of a wedge of the return pin pressing on the indexing member when the return pin wedge is moved from the first hole to the second opening of the indexing member;

FIG. 110c is a perspective view of a wedge portion of a return pin disposed in the second bore of the indexing element;

FIG. 110d is a perspective view of a wedge of the return pin pressing on the indexing member when the return pin wedge is moved from the second hole to the third opening of the indexing member;

FIG. 110e is a perspective view of a wedge portion of a return pin positioned in the third bore of the indexing element;

FIG. 110f is a perspective view of a wedge of the return pin pressing on the indexing member as the wedge of the return pin is moved from the third hole to the fourth hole of the indexing element;

FIG. 110g is a perspective view of a wedge portion of a return pin disposed within the fourth bore of the indexing element;

FIG. 111 is a cross-sectional view of the indexing element of FIG.

107.

FIG. 112 is a perspective view of an indexing element in accordance with an alternative embodiment of the present invention and a return spring operably connected to the indexing element;

FIG. 113 is a cross-sectional view of the indexing element of FIG.

112.

FIG. 114 is a perspective view of an indexing element in accordance with another alternative embodiment of the present invention;

FIG. 115 is a partial perspective view of a surgical instrument, including a roll back safety mechanism in accordance with an alternative embodiment of the present invention, with some components of the surgical instrument removed;

FIG. 116 is a cross-sectional view of the roll back safety mechanism of FIG. 115;

FIG. 117 is a perspective view of the surgical instrument of FIG. 115, showing the return carriage of the inverting mechanism in the actuated position;

FIG. 118 is a cross-sectional view of the roll back safety mechanism of FIG. 115 when the return carriage of FIG. 117 is in its running position;

FIG. 119 is a perspective view of a surgical instrument in accordance with an alternative embodiment of the present invention with some surgical instrument components removed to provide a switch for actuating the inverting drive of the surgical instrument;

FIG. 120 is a partial side view of a surgical instrument in accordance with another alternative embodiment of the present invention with some surgical instrument components removed to provide a switch for actuating the inverting drive of the surgical instrument;

FIG. 121 shows a partial side view of the surgical instrument of FIG. 120, showing the first switch portion in the actuated position;

FIG. 122 shows a partial side view of the surgical instrument of FIG. 120, showing a second switch portion used to set the first switch portion in its actuated position;

FIG. 123 is a perspective view of an articulation pivotally connected to the gripper shaft of a surgical instrument;

FIG. 124 is a side view of the gripper of a surgical stapling apparatus showing the anvil in an open position;

FIG. 125 is a detailed view of the gripper closing tube of FIG. 124, holding the gripper anvil in a closed position;

FIG. 126 is a perspective view of a closing tube in accordance with an alternative embodiment;

FIG. 127 is a side view of the closure tube of FIG. 126 operatively connected to the anvil of FIG. 123 to set the anvil in a partially closed position;

FIG. 128 is a side view of the closure tube of FIG. 124 holding the anvil of FIG. 124 in the fully closed position;

FIG. 129 is a top view of the articulation between the shaft and the gripper of the surgical stapling apparatus illustrated with some components removed, the articulation connection further comprising a guide member that can move relative to the shaft and the gripper;

FIG. 130 is a top view of the distal portion of the articulation joint of FIG. 129;

FIG. 131 is a top view of the articulation between the shaft and the gripper of an alternative embodiment of the surgical stapling apparatus illustrated with some components removed, the articulation connection further comprising a guide element that can move relative to the shaft and the gripper;

FIG. 132 is a perspective view of the articulation joint of FIG. 131 with some components removed;

FIG. 133 shows a top view of the articulation joint of FIG. 131 with some components removed, showing the gripper in a rectilinear or centered position;

FIG. 134 is a top view of the articulation joint of FIG. 131, showing the gripper in an articulated position;

FIG. 135 is a side view of the articulation joint of FIG. 131 in the orientation shown in FIG. 133;

FIG. 136 is a side view of a drive rod including a cutting member adapted to cut tissue and a drive member adapted to apply staples from a staple cartridge;

FIG. 137 is a top view of the drive rod of FIG. 136.

FIG. 138 is a partial top view of the staple cartridge of a surgical stapler;

FIG. 139 is a side view of a cutting element and a knife rod attached to the knife rod, the knife rod comprising a restraining surface adapted to limit the extension of the cutting element within the surgical instrument gripper;

FIG. 140 is a cross-sectional view of the articulation joint of FIG. 131 of the knife shown in FIG. 139, wherein the gripper is in a straight or centered configuration and the bounding surface engages with the guide member of FIG. 131;

FIG. 141 is a cross-sectional view of the articulation joint of FIG. 131 of the knife shown in FIG. 139, the gripper being set in an articulated configuration and the restraining surface connected to the guide member of FIG. 131;

FIG. 142 schematically shows the trigger drive of a surgical stapling apparatus, the trigger drive comprising a motor, a rack and a motor-driven pinion system, and a trigger rod operably coupled to the rack, the motor operation extending and / or retracting the trigger rod;

FIG. 143 shows a side view of the cutting element in the staple cartridge of FIG. 138 located on the retraction stop;

FIG. 144 is a detailed view of the connection between the firing rod and the knife rod adapted to move the cutting element of FIG. 142 inside the staple cartridge of FIG. 138;

FIG. 145 is a graph showing an encoder error that can be generated in an encoder when the cutting element is retracted relative to the retraction stop as shown in FIG. 143;

FIG. 146a shows a detailed view of the connection of FIG. 144 after the cutting element has been placed on the retraction stop when the gripper is in a straight or centered configuration;

FIG. 146b shows a detailed view of the connection of FIG. 144 after the cutting element has been placed on the retraction stop when the gripper is in an articulated configuration;

FIG. 147 is a top view of the lock connected to the gripper lock element;

FIG. 148 is a cross-sectional view of the lock and lock element of FIG. 147.

[0008] Corresponding indications indicate the relevant parts in several views. The examples presented here illustrate preferred embodiments of the invention in one embodiment and such examples should not be construed as limiting the scope of the invention in any way.

DETAILED DESCRIPTION [0009] Certain exemplary embodiments will now be described to provide a complete understanding of the principles of design, functionality, manufacture, and use of the devices disclosed herein. One or more examples of these embodiments are shown in the accompanying drawings. Those skilled in the art will be aware that the devices described in detail herein and the accompanying drawings constitute the non-limiting scope of the invention, its exemplary embodiments, and 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 exemplary embodiment may be combined with those of other embodiments.

[0010] In various embodiments, the surgical instrument of the present invention may be adapted, for example, to introduce surgical staples into soft tissue. In at least one embodiment, with reference to FIG. 1-4, surgical instrument 100 may include handle portion 102, elongated roller assembly 104, and gripper 106. In various embodiments, with reference to FIG. 3 and 4, the gripper 106 may include a staple cartridge channel 108 and a staple cartridge 110, wherein the staple cartridge 110 may be adapted to store, with the option of removal, staples. In at least one embodiment, the gripper 106 may further include an anvil 112, which can be pivotally connected to the staple cartridge channel 108 and can be rotated between an open and closed position by the gripper closing system. To apply staples from the staple cartridge 110, the surgical instrument 100 may further include a staple drive element adapted to move the staple cartridge 110 and a firing drive adapted to extend the staple drive element within the staple cartridge. In various embodiments, the anvil 112 can be adapted to deform at least part of the staples when they are applied from the staple cartridge. Although various embodiments of the gripper closing system and the trigger drive are described in detail below, several embodiments of gripper closing systems and triggering drives have been disclosed in US Patent No. 6,905,057, entitled SURGICAL STAPLING INSTRUMENT INCORPORATING A FIRING MECHANISM HAVING A LINKED RACK TRANSMISSION, which was awarded on June 14, 2005, and also in US Patent No. 7,044,352, entitled SURGICAL STAPLING INSTRUMENT HAVING A SINGLE LOCKOUT MECHAMISN FOR PERVENTION OF FIRING, which was awarded on May 16, 2006.

[0011] In various embodiments, the surgical instrument of the present invention may include a system for moving or moving the articulated gripper relative to the longitudinal shaft assembly of the surgical instrument. In at least one embodiment, with reference to FIG. 3-7, the surgical instrument 100 may include articulation 114, which may be coupled to movement with the gripper 106 and the longitudinal roller assembly 104. In various embodiments, the articulation connection 114 may allow the gripper 106 to be moved relative to the shaft assembly 104 in one plane or, as an alternative, in multiple planes. In either case, the articulation 114 may include one or more rotation axes 116 (FIG. 5) around which the gripper 106 can articulate. In various embodiments, with reference to FIG. 5 and 6, the surgical instrument 100 may further include a locking mechanism 118 that can establish or block the relative relationship between the gripper 106 and the longitudinal roller assembly 104. In at least one embodiment, the locking mechanism 118 may include a lock member 120 that can be moved relative to the gripper 106 and engage with the gripper 106 to prevent or at least partially inhibit relative movement between the gripper 106 and the roller assembly 104. In at least one embodiment, the lock member 120 may be adapted to engage with at least one of the teeth 312 (FIG. 5 and 6) the gripper 106 in such a way that the interaction between the lock member 12 and the teeth 312 can prevent or at least partially inhibit the rotation of the gripper 106 about the axis 116, as described in detail below.

[0012] In various embodiments, with reference to FIG. 7-9, the locking mechanism 118 may further include an actuator 122 that can be operably connected to the lock member 120. In at least one embodiment, the actuator 122 may include a pin 124 that can be inserted into the slot 121 in the lock member 120 such that when the actuator 122 is moved relative to the handle portion 102, the pin 124 may abut against the side wall of the slot 121 and move the locking element 120 relative to the gripper 106. In at least one embodiment, the actuator 122 may be pulled away from the gripper 106, i.e. in a proximal direction, to detach the lock member 120 from the gripper 106. Although not shown, other embodiments are envisaged in which the actuator 122 may be moved further or even rotated to disengage the lock member 120 from the gripper 106. In any case, the locking mechanism 118 may further include a return spring 126 (FIG. 6), which can be adapted to move the lock element 120 towards the gripper 106, i.e. in a distal direction, to connect the lock element 120 to the gripper 106 after releasing the actuating element 122. Other blocking mechanisms have been disclosed in US Patent Application No. 2006/229665, entitled SURGICAL INSTRUMENT WITH ARTICULATING SHAFT WITH SINGLE PIVOT CLOSURE AND DOUBLE PIVOT FRAME GROUND, which was reported on April 7, 2005, U.S. Patent Application No. 2006/190031, entitled SURGICAL INSTRUMENT WITH ARTICULATING SHAFT WITH RIGID FIRING BAR SUPPORTS, which was reported on September 29, 2005, and also in US Patent Application No. 2007/027469, entitled SURGICAL STAPLING AND CUTTING DEVICE AND METHOD FOR USING THE DEVICE, which was reported on July 24, 2006.

[0013] In various embodiments, with reference to FIG. 1 and 2, the actuator 122 may be contoured in such a way that the surgeon can grip the outer surface of the actuator 122 and pull the actuator 122 in a proximal direction as described above. In at least one embodiment, to move the actuator 122, the surgeon may, for example, place one hand on the handle 127 and the other hand on the actuator 122 in such a way that the surgeon can move the actuator 122 relative to the handle 127. In various other embodiments, with reference to Figs. 10-13, the actuator 122 'may be adapted such that the surgeon may need only one hand to operate the surgical instrument. In particular, in at least one embodiment, the actuator 122 'may include hooks or projections 115, projecting therefrom, which may allow the surgeon to hold the handle 127 with one hand and extend at least one finger of this hand distally to grip at least one projection 115 and pulling actuator 122 'in a proximal direction as described above. Although the actuator 122 'described herein has projections 115, the actuator 122 or any other suitable actuator may also include projections 115 and / or any other suitable means that may assist the surgeon in operating the surgical instrument 100 using one hand. In at least one embodiment, the protrusions 115 may be at least partially made of and / or covered with a flexible or 'soft to the touch' material that may improve the surgeon's grip at the protrusions 115 and may provide the surgeon with other ergonomic benefits. In various embodiments, the actuator 122 'may, for example, be operably connected to the roller assembly 104 in such a way that the gripper 106 and the roller assembly 104 can be rotated about the longitudinal axis by the actuator 122'. In such embodiments, the surgeon can position the gripper 106 at the surgical site by articulating the gripper 106 in the manner described above and / or rotating the gripper 106 into position. In at least one embodiment, the surgeon can rotate the actuator 122 'by placing a finger on one of the projections 115 and applying force to it. In various embodiments, the surgeon may hold the actuator 122 'in position by placing a finger on the projection 115 and stopping any undesired movement of the actuator 122' and, respectively, the gripper 106.

[0014] In various embodiments, the surgical instrument of the present invention may, for example, comprise a system for closing or clamping the gripper on soft tissue. In at least one embodiment, with reference to FIG. 2, 5, 8 and 9, the surgical instrument 100 may include a closing trigger 128, a drive connector 130, a drive element 132, and a closing tube 134. In various embodiments, when the closing trigger 128 is actuated, the closing trigger 128 may be adapted to move the drive connector 130, the drive element 132, and also the closing tube 134 in a distal direction. In particular, in at least one embodiment, the drive coupler 130 may include a first end pivotally connected to the trigger 128, as well as a second end pivotally connected to the drive element 132 in such a way that the rotational movement of the trigger 128 toward the handle 127 can move the drive link 130 to forward and move the drive member 132 along the axis defined by the drive member guide 136 (FIG. 8). In various embodiments, the drive member 132 may include projections 133 protruding therefrom, which may be arranged slidably within the slots 135 in the drive member 136 in such a way that these slots 135 may define a path for the drive member 132 during its movement. In various embodiments, the closure tube 134 may be operably connected to the drive member 132 in such a way that when the drive member 132 moves further as described above, the closure tube 134 may engage with the anvil 112 and rotate the anvil 112 downwards. With reference mainly to FIG. 5, the closure tube 134 can be adapted to slide on the articulation 114 and rotate the anvil 112 relative to the staple cartridge 110. In at least one embodiment, according to FIG. 9, the closure tube 134 may include a proximal end having a projection 135 that can be located in the slot 131 in the drive member 132 in such a way that the displacement of the drive member 132 is transmitted to the closure tube 134.

[0015] In various embodiments, as described above, the locking mechanism 118 may prevent or at least partially inhibit relative movement between the gripper 106 and the roller assembly 104. In circumstances where, for example, soft tissue is clamped between the anvil 112 and the staple cartridge 110, the relative displacement between the gripper 106 and the roller assembly 104 may exert a shear force against the soft tissue clamped between them, which may cause damage. In various embodiments, with reference to FIG. 10-13, to prevent or at least reduce the relative displacement between the gripper 106 and the roller assembly 104 when the gripper 106 is closed, the gripper closing system may be adapted to engage the locking mechanism 118 to prevent the actuator 122 from moving to its unlocked position . As a result, in at least one embodiment, actuation of the closing trigger 128 may not only close the gripper 106, but may also prevent the locking mechanism 118 from being unlocked. In various embodiments, with reference to FIG. 10-13, the surgical instrument 100 'may include a drive member 132 that may be adapted to adhere or be positioned in close proximity to the actuator 122' when the drive member 132 is moved distally by the trigger 128, thereby preventing movement in the direction closer to the actuator 122 'as described above with respect to the actuator 122. In particular, before trigger 132 is activated, as shown in FIG. 10 and 11, the actuator 122 'may be moved further to move the lock member 120 relative to the gripper 106 and unlock the articulation 114. However, when the trigger 132 is actuated, referring to FIG. 13, the drive member 132 may be adapted to adhere or be positioned in close proximity to the actuator 122 'in such a way that the actuator 122' cannot move proximal to disengage the lock member 120 from the gripper 106. As a result, the gripper closing system may prevent the articulation of the gripper 106 after it is closed, thereby reducing the likelihood that the shear force will be transmitted to the soft tissue clamped therein.

[0016] Accordingly, the gripper closing system may provide the surgeon with feedback that the gripper has been closed and in order for the surgeon to unlock and articulate the gripper, the surgeon must first at least partially re-open the gripper before the gripper can move. articulated. In particular due to the interaction between the drive element 132 and the actuator 122 ', when the gripper 106 is closed, when the surgeon tries to pull the actuator 122 'proximal to unlock the articulation 114, the drive member 132 may substantially prevent the actuator 122 from moving, thus signaling to the surgeon that the gripper 106 is closed and that the gripper 106 should be first opened before the actuator 122 'can be moved and the articulation unblocked. In various embodiments, such a gripping closure system may prevent the surgeon from damaging the surgical instrument and / or tissue captured therein or surrounding the gripper. In particular, in at least one embodiment, when the closing tube 134 has been moved forward to close the anvil 112 in the manner described above, the closing tube 134 may exert a force on the anvil 112 to keep the anvil 112 in the closed position and in such circumstances such a force may generate frictional forces in articulation 114, which can prevent, if not prevent, rotation of the gripper 106 around articulation 114. In embodiments without the gripper closing system described above, when the surgeon attempts to overcome these frictional forces without first having at least partially opened the gripper, the surgeon may, for example, bend or break one or more components of the surgical instrument. However, in various embodiments of the present invention, the drive member 132 may, for example, prevent the surgeon from releasing the articulation lock 120 in the manner described above and as a result, the surgeon may not be able to unlock the articulation 114, let alone move the articulated gripper 106.

[0017] In various embodiments, the surgical instrument of the present invention may include a gripper closing system that can position the anvil 122, for example in an open position, in a closed position, as well as in a partially closed position. In at least one embodiment, the surgeon can move the anvil 112 to a partially closed position and assess whether the gripper should be repositioned or articulated before the anvil 112 is moved to its closed position. In such embodiments, the anvil 112 can be moved relative to the soft tissue sandwiched between the anvil 112 and the staple cartridge 110 without exerting a shear force or at least substantially a shear force on the soft tissue before the anvil 112 is completely closed. In at least one embodiment, the anvil 112 can be adapted in such a way that it does not clamp the soft tissue sandwiched between the anvil 112 and the staple cartridge 110 when it is in its partially closed position. Alternatively, the anvil 112 may be adapted to exert a small clamping force against the soft tissue when the anvil 112 is in its partially closed position before applying a greater clamping force when it is moved to its closed position. In at least one such embodiment, the surgical instrument may include a trigger that can be moved between the first position (FIG. 11), which corresponds to the open position of the anvil 112, the second position (FIG. 12) which corresponds to its partially closed position as well as the third position (FIG. 13) which corresponds to its closed position. In various embodiments, with reference to FIG. 8 and 9, the trigger 128 may be pivotally attached to the housing 103 of the handle part 102 in such a way that the trigger 128 can be rotated around the pin 129 between its first, second and third positions. In various embodiments, with reference to FIG. 8, 9, 17 and 18, surgical instrument 100 may further include trigger lock 148 that may be adapted to connect trigger 128 and selectively lock trigger 128 in at least one of the first, second and third positions described above. In at least one embodiment, the trigger 128 may include an articulated end 138 including a cam surface 140, a first notch 142, as well as a second notch 144, wherein the trigger lock 148 may be adapted to enter the first notch 142 and the second notch 144. In particular, with reference to FIG. 8 and 9, the surgical instrument 100 may further include a trigger lock spring 150, which may be adapted to deflect the trigger block portion 149 of the trigger block 148 against the cam surface 140 such that when the first notch 142 or second notch 144 coincides with the member 149 passive, trigger lock spring 150 may push part 149 of the passive member into first recess 142 or second recess 144 respectively. In at least one embodiment, with reference mainly to FIG. 8 and 9, trigger lock 148 can be pivotally attached to the housing 103 of the handle part 102 via a pin 151. In various embodiments, the trigger lock spring 150 may be compressed between the trigger lock button portion 152 and the housing 103 in such a way that the trigger lock spring 150 can rotate the trigger lock 148 about the pin 151 and pivot the trigger lock 148 down onto the trigger cam surface 140 128.

[0018] Accordingly, in at least one embodiment, the first notch 142 may coincide with the passive portion 149 when the trigger 132 is moved to its second position and the anvil 112 is moved to its partially closed position. In various embodiments, the passive portion 149 may be securely held in the first notch 142 in such a way that trigger lock 148 may require manual disconnection from trigger 132 before the trigger 132 can be moved to its third position and / or returned to its first position. In at least one embodiment, with reference to FIG. 8 and 9, the surgeon may press the button portion 152 of the lock member 148 in such a way that the lock member 148 is rotated around the pin 151 and the passive portion 149 is raised up and out of connection with the trigger 128. In various other embodiments, the first notch 142 may be adapted such that the passive portion 149 may extend beyond the first notch 142 when force is applied to the trigger 132. In any case, after the passive portion 149 is detached from the first notch 142, the surgeon can selectively move the trigger 132 to its third position or release the trigger 132 and allow, for example, the trigger spring to return the trigger 132 to its first position. In at least one alternative embodiment, the first notch 142 and the passive portion 149 may be adapted such that after the trigger 132 is moved to its second position, the trigger 132 should be moved to its third position before it can be returned to first position. In any case, in at least one embodiment, the second cutout 144 of the trigger 132 may coincide with the passive portion 149 when the trigger 132 is moved to its third position and the anvil 112 is moved to its closed position. Like the first notch 142, the second notch 144 may be adapted to hold the passive portion 149 therein until the lock member 148 is disengaged from the trigger 132 and / or the appropriate force is applied to the trigger 132 to remove the passive portion 149 from the second notch 144. Then, in various embodiments, the trigger spring may move the trigger 132 from its third position to its second position, it may be necessary, as above, for the surgeon to disconnect the passive portion 149 from the first cutout 142. In at least one alternative embodiment, the first notch 142 may be adapted so that the passive portion 149 can slide through the first notch 142 and allow the trigger 132 to move from its third position to its first position without the surgeon having to remove the passive part 149 from first cut out 142.

[0019] Accordingly, although not shown, the button 152 of the lock member 148 can be recessed into, for example, the surgical instrument housing 103 when the closing trigger 128 is in its first position. In an alternative embodiment, the button portion 152 may be flush with the housing 103, or it may protrude slightly from the housing 103. In any case, in at least one embodiment, the button portion 152 may move outward with respect to the housing 103 when the closing trigger 128 is moved to its second position. Such displacement can provide the surgeon with visual feedback that the anvil of the surgical instrument is in its partially closed position. In addition, the movement of the button portion 152 may also be accompanied by audible and / or tactile feedback. In any case, the surgeon can access the button portion 152 after it has been moved out such that the lock member 148 can be detached from the trigger 128 in the manner described above. In various embodiments, the button portion 152 can move outward even more when the trigger 128 is moved from its second position to its third position. As above, such displacement may provide the surgeon with a visual hint that the anvil is just in its closed position and may be accompanied by audible and / or tactile feedback as described above. Although the button 152 has been described above as moving outward when the trigger 128 advances between its first and third positions, the invention is not limited to this form. On the contrary, button 152 or any other suitable indicator may provide the surgeon with feedback in any suitable manner.

[0020] In alternative embodiments, although not shown, the anvil 112 can be held in more than the three positions described above, i.e. in the open, closed, and partially closed positions. In at least one embodiment, the anvil 112 can be held in an open, closed position, and two or more intermediate positions. In such embodiments, the anvil 112 can advance through these intermediate positions and exert an increasing force on the soft tissue captured in the gripper 106 when the anvil 112 is moved toward its closed position. As above, in at least one embodiment, the trigger 132 may include a plurality of notches that may correspond to different intermediate positions of the anvil 112. In various alternative embodiments, although not shown, the gripper closing system may include a ratchet assembly that can allow the trigger 132 and the anvil 112 to be held in multiple positions, respectively. In such embodiments, the anvil 112 and trigger 132 may be held in place by a pawl pivotally connected to a ratchet wheel operatively connected to the trigger 132.

[0021] In various embodiments, with reference to FIG. 10-13, the relative displacement between the actuating member 122 'and the handle portion 102' as described above can be limited to control the extent to which the lock member 120 can be moved. In particular, with reference to FIG. 10 and 11, the distal portion of the actuator 122 'may include a projection 123 therefrom, which may be located in the cavity 125, wherein the displacement of the actuator 122' may be limited by the proximal wall 117 and the distal wall 119 of the cavity 125. In at least one embodiment, when the trigger 128 is in its first position, as shown in FIG. 10 and 11, the actuator 122 may be moved from a distal position in which the projection 123 may abut the distal wall 119, as shown in FIG. 10, to an even closer position in which the projection 123 does not adjoin the distal wall 119, as shown in FIG. 11. In this still further position, as described above, the lock member 120 may be detached from the gripper 106 and the gripper 106 may be rotated relative to the roller assembly 104. When the trigger 128 is in its second position, referring to FIG. 12, the drive member 132 may limit the range of motion of the actuator 122 'in such a way that the projection 123 cannot be positioned opposite the proximal wall 117. However, in at least one embodiment, the actuator 122 'may be moved proximal to a sufficient distance to detach the lock member 120 from the gripper 106. In such circumstances, the surgeon may change the position of the gripper 106, although the anvil 112 may, for example, be partially closed on soft tissue. When the trigger 128 is in its third position, as shown in FIG. 13, the drive member 132 can push the actuator 122 'away such that the projection 132 is adjacent or adjacent the distal wall 119 and the actuator 122' cannot be moved sufficiently to unlock the articulation 114.

[0022] In various embodiments, the surgical instrument of the present invention may include a firing drive adapted to extend the cutting element and / or the staple driver within the gripper as described above. In at least one embodiment, with reference to FIG. 8, 9 and 19-25, the trigger drive of the surgical instrument 100 may include trigger trigger 160, first trigger connector 162, second trigger connector 164, and trigger member 166. In various embodiments, the trigger trigger 160 may be operably connected to at least one of the trigger member 166 and the trigger connectors 162 and 164 to extend the knife rod 168 within the longitudinal roller assembly 104. In at least one embodiment, the knife rod 168 may be operably connected to a cutting element (not shown) and a staple drive element (not shown) in the gripper 106, wherein the cutting element may be adapted, for example, to cut tissue, and the staple drive element be adapted to apply staples from a 110 staple cartridge. Cutting elements and staple driving elements are disclosed in US Patent Nos. 6,905,057 and 7,044,352, which were already cited in this application, and therefore these devices are not described in more detail in this document. Other cutting elements and staple driving elements have been disclosed in US Patent Application No. 2008/082124, entitled SURGICAL STAPLES HAVING COMPRESSIBLE OR CRUSHABLE MEMBERS FOR SECURING TISSUE THEREIN AND STAPLING INSTRUMENTS FOR DEPLOYING THE SAME, which was also filed on September 29, 2006 Patent Application No. 2008/169332, entitled SURGICAL STAPLING DEVICE WITH A CURVED CUTTING MEMBER, which was filed on January 11, 2007.

[0023] In various embodiments, with reference mainly to FIG. 19 and 20, the trigger trigger 160 may be pivotally connected to the surgical instrument housing 103 (FIG. 8 and 9) using the bolt 161. When used in at least one embodiment, the trigger trigger 160 may be rotated about the pin 161 to extend the trigger member 166 and the trigger connectors 162 and 164 further away. In various embodiments, the trigger trigger 160 may include slots 159, the slots 159 may be adapted to accommodate the firing pin 172. In various embodiments, when the trigger trigger 160 is actuated or rotated from its first position shown in FIG. 2 to a position adjacent to the handle 127, the side walls of the slots 159 may be adapted to connect and extend the firing pin 172 in a distal direction. In at least one embodiment, with reference to FIG. 23, the trigger drive may further include a latch 170, the latch 170 may include an opening 171. In various embodiments, the aperture 171 may be adapted to accommodate at least a portion of the firing pin 172 in such a way that when the firing pin 172 is extended distally by the trigger 160, the firing pin 172 may also extend the latch 170 further. In various embodiments, with reference to FIG. 24, pawl 170 may include tooth 174, and trigger member 166 may include cavity 167, the cavity 167 being adapted to receive tooth 174. In use, when the pawl 170 is extended distally by the firing pin 172 and the tooth 174 engages with the side wall of the recess 167, the pawl 170 may also extend the firing member 166 in the distal direction. In various embodiments, the pawl 170 can be extended distally by the release pin 172 along a substantially linear path. In such embodiments, the slots 159 may include arcuate profiles that can, in cooperation with the firing pin 172, convert the rotational movement of the firing trigger 160 into the translational movement of the latch 170. In at least one embodiment, the force exerted on the latch 170 can be substantially, if not all, directed away. As a result, in such embodiments, the likelihood that the pawl 170 will be stuck or locked on the stapler frame 184 is reduced.

[0024] In various embodiments, the pawl 170 can be rotated between a first position in which the pawl 170 is operatively disengaged from the trigger member 166 and a second position, with reference to FIG. 19 and 20, wherein the pawl 170 engages operatively against the trigger member 166. With reference to FIG. 2125, the firing drive may further include a tilt mechanism 178 that may be adapted to rotate the pawl 170 between its first and second positions. In use, when the trigger trigger 160 is actuated, the pawl 170 can be moved, at least initially, relative to the tilt mechanism 178 in such a way that at least a portion of the pawl 170 can adhere to the tilt mechanism 178 and rotate the pawl 170 upward and for functional connection with trigger 166. In at least one embodiment, the pawl 170 may include, with reference mainly to FIG. 23, groove 175 that can be adapted to receive projection 179 (FIG. 25), protruding from the central part of the tilting mechanism 178. In at least one embodiment, when the pawl 170 is extended farther, the proximal wall 176 of the groove 175 may contact the cam surface on the projection 179 and, due to the force exerted on the pawl 170 by the pivot pin 172, the pawl 170 may be rotated upwards such that the tooth 174 can be placed in the recess 167 of the firing element 166 in the manner described above. After the pawl 170 has been rotated, the pawl 170 may drag the tilt mechanism 178 distally when the pawl 170 is extended toward the gripper 106. In particular, in at least one embodiment, the tilt mechanism 178 may include deformable members 180 that can be placed in slots 182 in the stapler frame 184 in such a way that the interaction between the deformable members 180 and the stapler frame 184 at least partially inhibits movement of the tilt mechanism 178 to the stapler frame 184. In other words, due to the static frictional forces between the deformed members 180 and the side walls of the slots 182, a force appropriate to overcome these frictional forces should be applied to the tilt mechanism 178 before the tilt mechanism 178 can be "stretched" relative to the stapler frame 184.

[0025] After the trigger 160 has been actuated and the trigger member 166 has been extended, the trigger 160 can be released and returned to its non-actuated position shown in FIG. 2, and the pawl 170 can be detached from the firing member 166 and retracted to its initial position shown in FIG. 19. In particular, in at least one embodiment, the surgical instrument 100 may include a trigger spring (not shown) operably connected to, for example, trigger 160 and housing 103, the trigger spring may be adapted to rotate trigger 160 around pin 161 and drive the firing pin 172 into closer after the pawl 170 is disengaged from the trigger 166. In various embodiments, the pawl 170 may be disengaged from the trigger member 166 when it is rotated from its second position, as shown in FIG. 24, to its first position, as described above, by the tilt mechanism 178. In such embodiments, the pawl 170 can be moved, at least initially, relative to the tilt mechanism 178 in such a way that the distal wall 177 of the groove 175 can contact the second cam surfaces on the projection 179 and can, due to the force exerted on the firing pin 172 by trigger 160 or return spring 186, rotate pawl 170 downward so that paw tooth 174 can be detached from recess 167 in firing member 166. Then trigger 160 and / or return spring 186 may pull or retract pawl 170 relative to trigger 166. In various embodiments, as above, the pawl 170 may be adapted to pull the tilt mechanism 178 proximal inside the slot 182. Therefore, pawl 170 does not need to be deflected to its first or second position. In various circumstances, pawl 170 can rotate freely between its first and second positions without having to overcome the force exerted on it by the bias spring. As a result, in various embodiments, the displacement force of the pawl 170 between its first and second positions requires only overcoming the gravitational weight of the pawl 170 and any friction forces between the pawl 170 and the surrounding components of the surgical instrument.

[0026] When the pawl 170 is restored to its original position, in at least one embodiment, the pawl tooth 174 of the pawl 170 may no longer be aligned with the recess 167 in the firing member 166. On the contrary, essentially with

FIG. 19 and 20, ratchet tooth 174 may be aligned with recess 163 in the first trigger fastener 162. In particular, the first trigger connector 162 may be pivotally connected to the trigger member 166 in such a way that when the trigger member 166 is extended further, as described above, the trigger member 166 may pull the first trigger connector 162 to a position that was previously occupied through trigger element 166. As a result, for the second actuation of the trigger 160, the pawl 170 may be rotated from its first position to its second position in such a way that the tooth 174 is operatively connected to the cavity 163, and the pawl 170 may extend the trigger connector 162 further. In at least one embodiment, the trigger connector 162 may push the trigger member 166 and the knife rod 168 distally and accordingly extend the cutting element and the staple drive member distally inside the gripper 106. Then, pawl 170 can be pivoted again from its second position to its first position and can be retracted relative to first trigger switch 162. After the pawl 170 has been rotated to its original position a second time, the paw 174 of the pawl 170 may no longer be aligned with the recess 163 of the first trigger connector 162. On the contrary, like above, the tooth 174 can be aligned with the recess 165 in the second trigger connector 164, and the process described above can be repeated.

[0027] Although not shown, the surgical instrument of the present invention may include more than two or less than two triggering connectors to extend the cutting element and the staple driver to their required positions within the gripper 106. In various embodiments, as detailed below, the firing member 166 may include more than one recess 167 in such a way that the pawl 170 may directly extend the firing member 166 toward the gripper 106 more than once. In at least one such embodiment, the pawl 170 can be retracted after the trigger member 166 is extended farther, as described above, such that when the pawl 170 is pivoted up again, the pawl 170 may enter another recess 167 in the element. trigger 166 and slide the trigger member 166 back toward the gripper 106. As a result, in at least one embodiment, triggering switches 162 and 164 may not be necessary.

[0028] In various embodiments, the surgical instrument may include one or more spring elements adapted to move the pawl 170 to at least one of its first and second positions. In at least one embodiment, with reference to FIG. 27 and 28, the trigger drive may include a pawl 170 ', a trigger pin 172, as well as a tilt mechanism 178', wherein, like above, the tilt mechanism 178 'may be adapted to rotate the pawl 170' upward when the pawl 170 'is extended further away. The firing drive may further include a rotational spring 188 that can be operably connected to the pawl 170 'in such a way that when the pawl 170' is rotated upward to its second position, as shown in FIG. 27, pawl 170 'may tension or resiliently bend rotation spring 188. After the pawl 170 'is extended, the pawl 170' can be rotated downward to its first position by the rotational spring 188, as shown in FIG. 28. In particular, due to the potential energy stored in the rotational spring 188 when it is bent, the spring 188 can move the pawl 170 'downwards when the pawl 170' is no longer held in its second position by the tilting mechanism 178 'and spring pin 172 . Then, as described above, pawl 170 'may be retracted relative to trigger member 166 and / or trigger connectors 162 and 164. In various embodiments, the tilt mechanism 178 'may not include a second cam surface for rotating the pawl 170 to its first position. In such embodiments, the pawl 170 'may be retracted by the force exerted on the firing pin 172 as described above. In various alternative embodiments, although not shown, the tilt mechanism 178 'and pawl 170' may also include mating means for rotating the pawl 170 'downward to its first position.

[0029] In various embodiments, with reference to FIG. 19 and 20, the surgical instrument 100 may further include a band 190 that can be adapted to move the trigger member 166 and the trigger connectors 162 and 164 relative to the gripper 106. In at least one embodiment, the first end of the strand 190 can be connected, for example, to the firing member 166 in such a way that when the firing member 166 is extended in the distal direction, the band 190 can also be pulled in the distal direction. In various alternative embodiments, the band 190 may be connected to the first trigger connector 162 and / or the second trigger connector 164. In at least one embodiment, the strand 190 may be positioned around at least a portion of the reel or spool 192 such that when the strand 190 is pulled out by the firing member 166, the strand 190 may be deployed or unwound from the reel 192. In at least one embodiment, the second end of the band 190 may be connected to the retractor 192 in such a way that the band 190 cannot be easily detached from the reel 192 under normal operating conditions of the surgical instrument 100. Whenever the strand 190 is pulled out by the firing member 166, the reel 192 may be rotated clockwise or counterclockwise depending on how the strand 190 is positioned around the reel 192. In order to retract the trigger element 166, the coiler 192 can be rotated in the opposite direction to move the trigger element

166, as well as trigger fasteners 162 and 164 in the proximal direction, and winding of band 190 around the reel 192.

[0030] In various embodiments, the strand 190 may be wound on the coiler 192 such that the strand 190 is wound around a substantially cylindrical surface on the coiler 192. In at least one embodiment, the distance between the axis of rotation of the coiler 192 and the cylindrical surface may be substantially uniform around the perimeter of the coiler 192. In these embodiments, the force ratio of the reel 192 can remain substantially constant when the strand 190 is pulled proximal as described above, and the ability of the reel 192 to exert a pulling force on the strand 190 can remain substantially the same. However, in alternative embodiments, the coiler 192 may be adapted to provide a variable power ratio. In at least one embodiment, the reel 192 may include a non-cylindrical surface on which the band 190 may be wound such that the distance between the axis of rotation of the reel 192 and the non-cylindrical surface is not uniform around the perimeter of the reel 192. As a result, in these embodiments, the ability of the reel 192 to exert tensile force on the strand 190 may change when the strand 190 is wound onto the coil 192. In at least one embodiment, the reel 192 may act as a cam and may include a shape that can be optimized to provide additional force to the band 190 when it is initially retracted, i.e., for example, when the force for retracting the cutting element can be highest.

[0031] In various embodiments, with reference to FIG. 29-42, trigger trigger 160 can be selectively combined with the retraction mechanism of the surgical instrument 100. In at least one embodiment, when the trigger trigger 160 is operably connected to the trigger member 166 via the pawl 170, as described above, actuation of the trigger trigger 160 may extend the trigger member 166 further and when the trigger trigger 160 is operatively connected to the trigger member 166 via the band 190, actuation of the trigger trigger 160 may cause the trigger member 166 to retract in a proximal direction. In various embodiments, the return mechanism may be manually activated to disengage the trigger trigger 160 from the trigger member 166 and to operatively connect the trigger trigger 160 to the retractor 192. In at least one embodiment, the return mechanism may include a return carriage 194, which can be pivotally mounted in the housing of the surgical instrument in such a way that the return carriage 194 can be pivoted between a first or non-actuated position as shown in FIG. 29 and the second or actuated position, as shown in FIG. 32. In at least one such embodiment, the return carriage 194 may include a button portion 195 that, if force applied to it, may be adapted to move the return carriage 194 from its non-activated position to its activated position.

[0032] When the return carriage 194 is in its unlatched position shown in FIG. 29-31, the trigger trigger 160 may be adapted to extend the trigger member 166 as described above, and the trigger gear portion 158 may be operably connected to the trigger gear 196. In various embodiments, the gear portion 158 and the trigger gear 196 may be operably connected in such a way that the rotational movement of the trigger 160 about the pin 161 can drive the trigger gear 196 about the axis defined by the return pin 198. In at least one embodiment, when the return carriage 194 is in its non-actuated position, the trigger gear 196 may be adapted to rotate freely about the return pin 198 in such a way that the rotational movement of the trigger gear 196 is not transmitted or substantially at least is not passed to return bolt 198. In particular, with reference to FIG. 30, the wedge 199 of the return pin 198 may be deflected past the connection to the trigger gear 196 in such a way that the rotational movement of the trigger gear 196 is not transmitted to the wedge gear 206 and the reel 192. As a result, actuation of the trigger gear 196 does not cause rotation or at least substantially rotate the reel 192 when the return carriage 194 is in its non-actuated position.

[0033] After the cutting element and the staple driver are extended in the gripper 106, the return carriage 194 can be moved to its activated position. In various embodiments, with reference to FIG. 30, the coiler 192 may include a cam element 202 protruding therefrom, which may contact the return carriage 194 and rotate the return carriage 194 downwards. In at least one embodiment, the cam element 202 may contact the return carriage 194 during final actuation of the trigger 160, which extends the cutting element and the staple driver in the gripper 106. In at least one such embodiment, the cam member 202 may contact the return carriage 194 after the third actuation of the trigger trigger 160. In various embodiments, with reference to FIG. 32-35, when the gear carriage 194 is moved to its activated position, the return carriage 194 may be adapted to functionally engage the gear wheel 196 with the coiler 192. In at least one embodiment, with reference to FIG. 33 and 35, the return carriage 194 may include a biasing spring 200, wherein, when the return carriage 194 is in its non-actuated position, the spring 200 may be in the position shown in FIG. 33, and when the return carriage 194 is moved to its activated position shown in FIG. 35, the spring 200 may contact the return pin 198 and deflect the return pin 198 towards the trigger gear 196. In at least one embodiment, with reference to FIG. 31, the trigger gear 196 may include a D-shaped cavity 197, which may, under certain circumstances explained below, accommodate a wedge 199 protruding from the return pin 198 and operatively connect the trigger gear 196 to the wedge gear 206 and the retractor 192. In various embodiments, the movement of the return carriage 194 to its actuated position may be accompanied by audible and / or tactile feedback to inform the surgeon that the return mechanism of the surgical instrument has been connected to the trigger 160.

[0034] Accordingly, when the return pin 198 is moved toward the trigger gear 196, the D-shaped cavity 197 can be positioned such that the wedge 199 does not directly enter the cavity 197. On the contrary, with reference to FIG. 31, the spring 200 may deflect the return pin 198 in such a way that the wedge 199 initially adheres to the surface 204 of the trigger gear 196. However, after the trigger 160 is released and returned to its non-actuated position, the D-shaped cavity 197 can be rotated and aligned with the wedge 199 so that the spring 200 can deflect the wedge 199 into the cavity 197, as shown in FIG. . 36. In at least one embodiment, with reference to FIG. 31, when the return pin 198 is moved toward the trigger gear 196, the end of the return pin 198 may be located in the slot 193 in the return carriage 194, as shown in FIG. 32. After the wedge 199 is introduced into the cavity 197, further actuation of the trigger 160 may cause the surface 210 of the D-shaped cavity 197 to adhere to the wedge 199 and rotate the pivot pin 198 to the position shown in FIG. 37 and 38. As a result, actuation of the trigger 160 in at least one embodiment can cause the wedge 199 to be rotated approximately half a turn in such a way that the wedge 199, which initially runs substantially downward (FIG. 36), it can be rotated so that the wedge 199 extends substantially upward (FIG. 37). The trigger 160 may then be released and the trigger gear 194 may be rotated relative to the wedge 199, wherein the wedge 199 may remain in a substantially upward orientation, as shown in FIG. 39-41.

[0035] In various embodiments, mainly referring to FIG. 38, the wedge gear 206 can be operably connected to the return pin 198 in such a way that the rotational movement of the return pin 198 can be transmitted to the wedge gear 206. In at least one embodiment, the wedge gear 206 may include a wedge-shaped hole 212 that can be adapted to slidably insert the wedge 199 of the return pin 198. In at least one such embodiment, the wedge 199 may be operably connected to the recess 197 of the trigger gear 196 and with the hole 212 of the wedge gear 206 when the return pin 198 is connected to the trigger gear 196. In various alternative embodiments, the wedge gear 206 may be permanently attached to return bolt 198. In such embodiments, when the return pin 198 is moved relative to the trigger gear 196, the wedge gear 206 may also be moved relative to the trigger gear 196. In various embodiments, with reference to substantially FIG. 38, the reel 192 may include a spur gear 216 attached thereto, wherein the spur gear 216 can engage with the wedge gear 206 in such a way that the rotational movement of the wedge gear 206 can be transmitted to the reel 192. In at least one embodiment, the wedge gear 206, when it is moved toward the trigger gear 196 in the manner described above, may be shifted to functional connection with the coiler 192. In alternative embodiments, the spur gear 216 can be adapted in such a way that the wedge gear 206 is in functional engagement with it, regardless of whether the wedge gear 206 has been deflected toward the trigger gear 196.

[0036] Accordingly, when the return carriage 194 is in its actuated position shown in FIG. 32, actuation of the trigger 160 may cause the reel 192 to rotate and wind the band 190 at least on a portion thereof. In the event that the wedge 199 cannot be operably connected to the trigger gear 196, when the return carriage 194 is activated, the reel 192 may be rotated manually to retract the strand 190. In at least one such embodiment, with reference to FIG. 33 and 37, the screw or fastener 218 may be operably connected to the reel 192 in such a way that the rotational movement of the screw 218 can cause the rotational movement of the reel 192. In various embodiments, the surgeon may insert the screw 218 through the opening in the surgical instrument housing 103 and connect the screw 218 to the retractor 192. In at least one embodiment, the surgical instrument 100 may further include a counting mechanism (not shown) that can count the trigger actuations 160 and in at least one embodiment, the screw 218 may, for example, be operably connected to a counting mechanism to rotate the retractor 192. As a result, in various embodiments, the surgical instrument may include a first or main actuator for winding the reel 192 and a second actuator that can be adapted to wind the reel 192 instead of the first actuator.

As described above, in various embodiments, the coiler 192 may be adapted to pull the strand 190 and retract the firing member 166 and the firing connectors 162 and 164 in the proximal direction. In particular, as described above, the trigger member 166 and the trigger connectors 162 and 164 may be retracted relative to the latch 170 to change the position of the trigger member 166 and the trigger connectors 162 and 164 in their initial positions. In such embodiments, especially in embodiments where the pawl 170 can rotate in the manner described above, the return mechanism of the surgical instrument 100 may further be adapted to hold the pawl 170 out of functional connection with trigger member 166 and trigger connectors 162 and 164, when they are displaced relative to pawl 170. In particular, when the return carriage 194 is moved to its activated position shown in FIG. 35, the return carriage 194 may be adapted to contact the end of the firing pin 172 and slide the firing pin 172 toward the pawl 170 in such a way that the firing pin 172 engages the pawl 170 and prevents the pawl 170 from turning upward. In particular, with reference to FIG. 34, the firing pin 172 may include a first end 220, which may e.g. include an oblique and / or rounded surface, wherein, when the return carriage 194 contacts the first end 220, the return carriage 194 may push the firing pin 172 toward the pawl 170. In at least one embodiment, the pawl 170 may include a recess 173 that can be adapted to accommodate a wedge 222 protruding from the firing pin 172 when the firing pin 172 is moved toward the pawl 170. When the wedge 222 and the recess 173 are operatively connected, the firing pin 172 may prevent the pawl 170 from rotating upwardly to engage the firing member 166 and the firing connectors 162 and 164.

[0038] After the firing member 166 and firing connectors 162 and 164 are retracted, the new staple cartridge 110 can be secured in the gripper 106 and the surgical instrument 100 can be re-positioned so that it can be reused and stitching soft tissue. In various embodiments, with reference to FIG. 39-42, the return carriage 194 can be moved from its actuated position shown in FIG. 32 to its unrestrained position shown in FIG. 40. In at least one embodiment, the return carriage 194 can be rotated or articulated upwards when force is exerted on the portion 195 of the button. Alternatively, the return carriage 194 can be moved up when, with reference to FIG. 29, trigger lock 148 is rotated upward to disengage passive portion 149 from closing trigger 128 to re-open gripper 106 as described above. In particular, when force is exerted on the trigger lock button portion 152, the trigger lock 148 may be rotated up such that the projection 147 protruding therefrom may contact the return carriage 194 and also move the return carriage 194 upwards. In each case, with reference to FIG. 42, when the return carriage 194 is moved up to its non-actuated position, the return carriage 194 may detach the release pin 172 from the pawl 170, and further detach the return pin 198 from the trigger gear 196. In particular, the return carriage 194 may be adapted to adhere to the oblique or rounded end 221 of the release pin 172 in such a way that when the return carriage 194 is rotated upward, the return carriage 194 may move the return pin 172 beyond the latch 170 and detach the wedge 222 from the recess 173. Similarly, when the return carriage 194 is moved upward, the side wall of the slot 193 may be adapted to contact the end of the return pin 198 and move the return pin 198 away from the trigger gear 196 to disengage the wedge 199 from the D-shaped recess 197. Briefly, in at least one embodiment shown, when the button portion 152 of the lock member 148 is pressed and the return carriage 194 is moved upwards, the surgical instrument can be re-positioned and can be reused.

[0039] Although the surgical instruments described above can be re-positioned after the cutting element and the staple drive element are fully inserted into the gripper 106, part 195 of the return carriage button 194, for example, can be pressed after the cutting element and the drive element the staples will only be partially inserted into the gripper 106. In various embodiments, the return carriage 194 may further include a guide pin 191 between opposing sides of the return carriage 194. In at least one such embodiment, the guide pin 191 can be slidably inserted into the guide slot 185 (FIG. 31) in frame 184 in such a way that the gap 185 and the pin 191 can define a path for the return carriage 194. In various embodiments, the guide pin 191 and the guide slot 185 can be adapted to ensure that the return carriage 194 engages with the release pin 172 and the return pin 198 and resets the surgical instrument when the return carriage 194 is moved from its actuated position to its position not activated, as described above.

[0040] In various embodiments, the surgical instrument 100 may further include a brake for preventing or at least partially preventing the cutting drive from retracting and / or retracting from the cutting member and the staple driver in the gripper 106. In at least one embodiment, with reference to FIG. 43, frame 184 may include brake surface 187, wherein brake surface 187 may be adapted to exert a braking force on band 190. In particular, when the strand 190 is pulled in the distal and / or proximal direction as described above, the frame 184 can be adapted in such a way that the strand 190 slides over the brake surface 187 and a frictional force arises between them. In various embodiments, with reference to FIG. 44, the brake surface 187 'may be adapted such that the path of the band 190 between the trigger member 166 and the coiler 192 is interrupted by the brake surface 187' and a significant normal force can be applied to the band 190.

In at least one embodiment, the band 190 may be connected to the brake surface 187 'when the band 190 is at rest in such a way that the static frictional force between the band 190 and the brake surface 187' may prevent, at least initially, displacement strands 190 relative to brake surface 187 'when pulling force is exerted on strand 190. When the pulling force exerted on the strand 190 is greater than the static friction force, the strand 190 may be displaced relative to the surface

187 'brake. Such embodiments can be particularly useful when the trigger 160 is actuated more than once to extend the cutting element and / or the staple driver in the gripper 106. In particular, upon actuation of trigger 160, pawl 170 may be retracted relative to trigger member 166 as described above and in various embodiments, the friction force between band 190 and brake surface 187 'may prevent or at least partially inhibit proximal and / or distal displacement trigger member 166 and / or trigger connectors 162 and 164 when the pawl 170 is retracted. Accordingly, the alignment between the tooth 174 of the pawl 170 and the recess in the trigger member 166 and the trigger connectors 162 and 164 can be maintained when the pawl 170 is moved relative to them.

[0042] Similarly, in at least one embodiment, the stiffness of the band 190 may also assist in keeping the trigger member 166 and the trigger connectors 162 and 164 in position. In particular, in order to 'retract' the trigger member 166 or move it closer, the trigger member 166 should push the strand 190 proximal and, as a result, wind the strand 190 onto the coiler 192. In various embodiments, the stiffness of the strand 190 may be such that a significant force is required to wind the strand 190 onto the coiler 192, and as a result, the trigger element 166 may be held in place. In order to further increase the force required to wind the strand 190 on the coiler 192, with reference to FIG. 44, the path of the band 190 may be controlled such that it is not wound onto the coiler 192 in a tangential direction. In particular, when the path of the strand 190 is such that it is wound onto the winder 192 in a non-tangential direction, some of the force transmitted through the strand 190 will be lost, which will result in a poor force ratio for winding on the winder 192.

[0043] In various embodiments, the surgical instrument 100 may include a brake that can be connected to the reel 192 or any other component of the firing drive to prevent, for example, accidental retraction of the firing member 166 and / or the firing connectors 162 and 164. In at least one embodiment, although not shown, the brake may be moved between the first position and the second position, wherein when the brake is in the first position, the brake may exert a first braking force on the 190 band. In at least one such embodiment, the brake may, for example, exert on the band 190 when in the second position, a second braking force which may be greater or less than the first braking force. In various alternative embodiments, the brake may not connect to band 190 or any other part of the triggering drive when the brake is in the second position. In various embodiments, although not shown, the surgical instrument 100 may include a hooking mechanism that can exert braking force on the reel 192 and / or band 190. In at least one such embodiment, the hooking mechanism may include a ball hook and a spring member for pivotally hooking the ball hook on the coil 192 and / or the band 190.

[0044] In various embodiments, the surgical instrument 100 may include a ratchet mechanism that may allow the retractor 192 to be rotated in the first direction, but may in different circumstances prevent the retractor 192 from being rotated in the opposite direction to the first direction. In at least one embodiment, with reference to FIG. 45-49, the surgical instrument 100 may include a ratchet mechanism assembly 230, wherein the ratchet mechanism assembly 230 may include a ratchet wheel 232 and a ratchet 234. In various embodiments, the ratchet wheel 232 may operate in substantially the same way as the wedge gear 206 described above except that, with reference mainly to FIG. 47 and 48, the ratchet wheel 232 may have ratchet teeth 236, which may, due to the ratchet connection on the pawl 234, prevent the ratchet wheel 232 from rotating, e.g. clockwise, when the return carriage 194 'is in its non-actuated position (FIG. 47). In particular, each ratchet tooth 236 may include a flat surface 240, with reference to FIG. 48, at least one of the flat surfaces 240 may adhere to the edge 235 of the pawl 234 and thereby prevent the ratchet wheel 232 from turning clockwise.

[0045] Each ratchet tooth 235 may further include an inclined surface 238, wherein the inclined surfaces 238 may be adapted to slide below the ratchet 234 when the ratchet wheel 232 rotates counterclockwise. Accordingly, the ratchet assembly 230 may allow the strand 190 to be pulled, for example, distally through the trigger member 166, but prevents or at least substantially prevents the strand 190 from moving closer, at least when the return carriage 194 'is in the in its non-activated position. When the return carriage 194 'is rotated downward to its activated position, as described above with respect to the return carriage 194, the ratchet wheel 232 can be moved toward the trigger gear 196' and beyond the functional connection with the pawl 234. Then the ratchet wheel 232 can be turned clockwise or counterclockwise without interference or at least substantially no interference from pawl 234. In various alternative embodiments, in which the ratchet wheel 232 is not moved toward the trigger gear 196 ', the pawl 234 can be moved downward and out of functional engagement with the teeth of the pawl 236 when the return carriage 194' is moved to its actuated position. Whenever the return carriage 194 'is in its actuated position, the trigger gear 196' and the return pin 198 'can rotate the ratchet wheel 232 and cam 192' to withdraw the band 190 and the trigger member 166.

[0046] In various embodiments, with reference to FIG. 68-86, the surgical instrument 400 may include a closing system for closing the gripper anvil, a trigger drive for extending the trigger rod, a cutting element and / or a staple drive element in the gripper, as well as a reverse drive driven by a gear to retract at least one of the trigger rod, cutting element and / or staple driving element relative to the gripper. In at least one embodiment, with reference to FIG. 68, the closing system may include a closing trigger 428, drive coupler 130 as well as a drive member 132, wherein, like above, the closing trigger 428 may be adapted to move the drive coupler 130 and drive member 132 when the closing trigger 428 is moved from its unrestrained position shown in FIG. 68 to its actuated position shown in FIG. 69. In various embodiments, actuation of the closing trigger 428 may unlock the trigger drive. In at least one embodiment, the firing drive may include a firing trigger 460, which, when the closing trigger 428 is rotated toward the handle 427, may be moved between the locked position shown in FIG. 68 and the unlocked position shown in FIG. 69. In at least one such embodiment, the closing trigger 428 may include a slit or groove 128a, in which the pin or projection 160a may be placed, protruding from the trigger trigger 460, the sidewall of the slot 128a may be adapted to prevent displacement or at least substantially displacement of the pin 160a and the trigger trigger 460 relative to the closing trigger 428, when the closing trigger 428 is in its non-actuated position (FIG. 68). When the closing trigger 428 is activated or closed, the side wall of the slot 128a may abut the pin 160a and move the trigger trigger 460 between its locked position shown in FIG. 68 and its unlocked position shown in FIG. 69. In this unlocked position, the slot 128a may be positioned to allow movement of the pin 160a in the slot 128a, thereby enabling the trigger trigger 460 to move relative to the closing trigger 428 and extend the trigger drive as detailed below.

[0047] In various embodiments, with reference to FIG. 68, the trigger drive may include a trigger trigger 460, a trigger pin 172, as well as a pawl 170, wherein the trigger trigger 460 may be operably connected to the trigger rod or member 466 via the pawl 170 and the trigger pin 172 to extend the cutting element and the drive member staples inside the gripper. In at least one such embodiment, as above, the pawl 170 may be pivoted upward to engage with the trigger member 466 in such a way that when the trigger member 460 is actuated, referring to FIG. 70, the trigger trigger 460 may extend the trigger pin 172, the latch 170, and the trigger member 466 further away. Then, with reference to FIG. 101, pawl 170 can be rotated downwardly beyond the connection with trigger 466 in such a way that pawl 170 can be retracted in a proximal direction relative to trigger 466 when trigger trigger 460 is released or returned to its non-actuated or unlocked position shown on FIG. 72. In the case of comparison FIG. 69 and 72 it is clear that the first trigger drive cycle has caused the trigger member 466 to move further, as well as changing the position of the latch 170, trigger pin 172, and trigger trigger 460 in such a way that trigger trigger 460 can be actuated a second time further extending the trigger 466. In such circumstances, referring to FIG. 102, pawl 170 can be pivoted up for functional engagement with the trigger member 466 and extended further by releasing the trigger trigger 460.

[0048] In various embodiments, with reference to FIG. 101 and 102, the trigger member 466 may include a plurality of recesses 467, at least a portion of the pawl 170 may be arranged in each of them such that the pawl 170 may sequentially fall into the recesses 467 to extend the trigger member 466 multiple times as described above. In particular, in at least one embodiment, the triggering element 466 may include three recesses 467 that may allow the triggering element 466 to extend at least three times through trigger 460. For example, FIG. 73 shows the trigger drive after the second trigger actuation 460, FIG. 74 shows the trigger drive after the trigger 460 is restored to its non-actuated position after the second actuation, FIG. 75 shows the trigger drive after the third actuation of the trigger 460, and FIG. 82 shows the trip drive after the trigger 460 is restored to a non-actuated position after its third actuation. At this point, as detailed below, the trigger drive may be disengaged from the trigger 466 and the reverse drive may be operably connected to the trigger 466 in such a way that in various embodiments, the trigger 466 may be retracted relative to the gripper, and the surgical instrument can be re-positioned. Although the trigger trigger 460 is triggered three times to fully extend the trigger member 466 in the exemplary embodiment shown, other embodiments are envisaged that may use more or less than three strokes or trigger trigger.

[0049] As indicated above, in various embodiments, the surgical instrument 400 may further include a gear-driven inverting drive or mechanism that may be adapted to retract the trigger member 466, the cutting member and / or the staple driver relative to the surgical instrument gripper. In at least one embodiment, the reversing mechanism may be operably connected to the trigger member 466 or any other suitable part of the trigger drive to move the trigger member 466 closer. In at least one such embodiment, with reference to FIG. 71, the reverse drive may include a gearing, including, for example, trigger gear 496, wedge gear 406, pinion 401, idler 403, and end gear 416. In various embodiments, with reference to FIG. 84, the reversing drive may further include a gear portion 158 protruding from the trigger trigger 460 that can be adapted such that when the trigger trigger 460 rotates around the pin 161, as above, the gear portion 158 may rotate the gear wheel 496 drain around the axis defined by return pin 498. In at least one embodiment, gear portion 158 and trigger gear 496 may include teeth and / or cavities that can be adapted to cooperate and transfer rotational movement therebetween.

[0050] With reference to FIG. 77, as above, trigger gear 496 and return pin 498 can be adapted in such a way that they can be selectively connected and disconnected from each other. In at least one such embodiment, the trigger gear 496 may be operably connected to the return pin 498 when the trigger member 466 is extended by the trigger drive. In other words, the trigger gear 496 may be adapted in such a way that it does not or at least substantially does not transmit rotational motion to the return pin 498 when the trigger member 466 is extended by the trigger drive as described above. In addition, in at least one such embodiment, with reference to FIG. 77 and 79, return pin 498 may include a wedge 499 projecting therefrom, wherein the wedge 499 may be held beyond the functional connection with the D-shaped recess 497 in the trigger gear 496 until the reversing drive is operably connected to the trigger 466, as described in detail below. To keep the wedge 499 out of functional engagement with the trigger gear 496, with reference to FIG. 84, return pin 498 may include an end 498a that can be moved and / or held in position by the return carriage 494 in such a way that the wedge 499 is positioned outside the D-shaped cavity 497.

[0051] Before the trigger gear 496 and return pin 498 are operably connected as indicated above, the inverting drive pinion 401, with reference to FIG. 71, can be operably connected to the rack portion 405 of the firing member 466 in such a way that when the firing member 466 is extended in the distal direction by the firing drive as described above, the rack portion 405 may rotate the pinion 401 about the axis defined by axis 407. In various embodiments, the rack 405 may include a plurality of teeth and / or grooves that can be adapted to convert the translational movement of the trigger 466 into the rotation of the pinion 401. In various embodiments, the idler 403 may be attached to or formed integral with the pinion 401 in such a way that the translational movement of the trigger 466 may also cause the idler 403 to rotate. In at least one embodiment, the idler 403 and the wedge gear 406 may include teeth and / or cavities that can be adapted to cooperate and transfer rotational movement between them. Similarly, spur gear 416 may include teeth and / or cavities that can be adapted to cooperate with the teeth and / or cavities of the wedge gear 406 and to transmit rotational motion therebetween. Thus, as a result, the extension of the trigger member 466 may cause gears 401, 403, 406 and 416 to rotate the gearing.

[0052] In at least one embodiment, with reference to FIG. 71 and 84, spur gear 416 may be attached to or formed integrally with the index gear 492 in such a manner that when the spur gear 416 is rotated by the wedge gear 406 in the manner described above, the index gear 492 may be rotated by the wheel toothed front 416. As a result, in at least one such embodiment, advancing the firing member 466 may cause the indicator gear 492 to rotate about an axis defined by the opening 407. In various embodiments, the indicator gear 492 may, for example, include at least one designation, such as letters, numbers, and / or any other suitable symbols for displaying the number of trigger trigger actuations 460. In at least one such embodiment, the housing of the surgical instrument may include a window or opening, wherein, for example, the number "1" on the index gear 492 may coincide with the window after the first trigger trigger 460 has been actuated. Similarly, for example, the number "2" on the toothed wheel 492 of the indicator may coincide with the window after the second actuation of the trigger and the corresponding number "3" may coincide with the window after the third actuation. Alternatively, in at least one embodiment, the indicator gear 492 may include markings that may correspond to the number of remaining actuations that are required to fully extend the release member 466, cutting element, and / or staple driver relative to the gripper.

[0053] After the release member 466 has been fully extended relative to the gripper or at least appropriately extended, the return carriage 494 can be rotated downward, with reference to FIG. 76 and 82 to connect a functional reverse drive, trigger trigger 460, and trigger element 466. In various embodiments, the return carriage 494 can be rotated around the pin 494a in such a way that the return carriage 494 will no longer be in contact or at least substantially no contact with the return pin 498. Then, with reference to FIG. 77 and 78, the spring 400 may move or displace the return pin 498 towards the trigger gear 496 and place at least a portion of the wedge 499 in the cavity 497. In at least one such embodiment, with reference to FIG. 78, spring 400 may be located between the frame 484 and the wedge 499 of the return pin 498 in such a way that when the return carriage 494 is no longer in contact with the end 498a, the spring 400 may extend and move the wedge 499 into the recess 497. In various embodiments, with reference to FIG. 80, the return carriage 494 may also operatively disconnect the firing drive from the trigger member 466 when the return carriage 494 is rotated downward as described above. In particular, with reference to FIG. 81, the return carriage 494 may contact the end 220 of the firing pin 172 in such a way that the firing pin 172 can be moved toward the pawl 170 and, as described above, the firing pin 172 may include a wedge 222 protruding therefrom which may enter into recess 173 in pawl 170 to prevent pawl 170 from rotating upwardly to engage with trigger 466. As a result, when the pawl 170 cannot functionally connect to the trigger 466, the trigger drive can no longer engage the trigger 466 and the reversing drive can retract the trigger 466 without interference from the trigger drive.

[0054] Accordingly, in various embodiments, the return carriage 494 may, for example, be manually rotated downwards by a surgeon or by another physician. In various embodiments, with reference to substantially FIG. 68 and 82, the surgeon may apply force to the button portion 495 such that the return carriage 494 can be rotated downward about the axis defined by the pin 494a. Such force may be applied after reaching a predefined number of trigger trigger operations, although in various embodiments, such force may be applied before a predefined number of trigger trigger actuations is reached. In addition to or instead of the above, at least one of the reversing gears may be adapted to contact the return carriage 494 after a predefined number of trigger trigger actuations 460. In various embodiments, with reference to FIG. 76, the indicator gear 492 may include a cam 402 that may be adapted to contact a portion of the return carriage 494 and exert force thereon upon the third actuation of the trigger trigger 460. In at least one such embodiment, extending the trigger 466 may cause the indicator gear 492 to rotate by a predefined angle each time trigger 460 is actuated such that cam 402 may contact carriage 494 after the third or final trigger stroke 460 that extends trigger 466. As a result, the indicator gear 492 or any other suitable gear of the reversing mechanism may be adapted to rotate by a predefined angle before switching the surgical instrument from the "forward" mode of operation to the "reverse" mode of operation.

[0055] When the return pin 498 is operably connected to the trigger gear 496 and the trigger pin 172 is connected to the pawl 170 to prevent the pawl 170 from being operatively connected to the trigger member 466 as described above, the trigger trigger 460 can be restarted to retracting trigger 466. In at least one such embodiment, a further actuation of the trigger trigger 466 may cause the trigger gear 492 to rotate and because of the functional connection between trigger gear 492 and the return pin 498, trigger gear 492 may rotate the wedge gear 406. In particular, with reference to FIG. 71, 77, and 78, the wedge 499 of the return pin may be operably connected to the drive surface 410 of the trigger gear 492 in addition to the sidewall of the cavity 406a inside the gear 406 of the wedge in such a way that the rotational movement of the trigger gear 496 is transmitted to the gear 406 wedge via return bolt 498. In various embodiments, with reference to FIG. 71, the rotational motion of the gear wheel 406 the wedge may rotate the idler 403 and pinion 401 to drive or retract the trigger 466 in a proximal direction. As a result, when the trigger 460 is operably connected to the reversing drive, the pinion 401 can be rotated in a direction that is opposite to the direction in which it is rotated when the trigger trigger 460 is operably connected to the trigger drive. In various embodiments, the size or pitch radius of gears 401, 403, 406, 492, 496, and trigger gear parts 158 can be selected in such a way that trigger 466 can be restored by one actuation of trigger 460, although other embodiments in which more or less than one trigger actuation 460 can be used.

[0056] After the trigger element 466 has been retracted, the return carriage 494 can be pivoted up to its non-actuated position to re-position the surgical instrument. In various embodiments, with reference to FIG. 85 and 86, the surgeon or physician may apply force to portion 452 of the trigger lock button 448 in such a way that the trigger lock 448 can rotate up and adhere to the return carriage 494. Under these circumstances, trigger lock 448 may rotate the return carriage 494 up and set the carriage 494 to its non-actuated position. In this way, the return carriage 494 can engage with the end 221 of the trigger pin 172 to move the trigger pin 172 away from the latch 170 and remove the wedge 222 from the recess 173 in the latch 170, thereby enabling the pawl 170 to be re-connected to the trigger member 466 after another actuation trigger trigger 460. Return carriage 494 can also reconnect to end 498a of return bolt 498 when it is turned upward to move wedge 499 far from trigger gear 496, thereby functionally disconnecting return pin 498 from trigger gear 496 and properly disconnecting drive reversing from trigger 466. Then the used staple cartridge can be detached from the surgical instrument and replaced with a new staple cartridge in such a way that the surgical instrument can be reused.

[0057] In various alternative embodiments, the surgical instrument may include a coupling mechanism adapted to operably connect and disengage the reversing drive from the triggering element. In at least one embodiment, with reference to FIG. 87-94, the surgical instrument 500, like the surgical instrument 400, may include a trigger trigger 560, which may be adapted to drive the trigger pin and the trigger drive latch to extend the trigger element 566, cutting element, and / or staple driver relative to the gripper. In various embodiments, also as above, the surgical instrument may further include an inverting drive, including pinion 501, idler 503, wedge toothed wheel 506, and end wheel 516. In at least one such embodiment, due to the functional connection between the trigger portion 505 of the trigger element 496 and the pinion 501, extending the trigger member 466 may cause the gears 501, 503, 506 and 516 to rotate as described in detail below. In various embodiments, the return pin or wedge 598 may be attached to or integrally formed with the wedge gear 506 in such a way that rotational motion is transmitted between them. In at least one such embodiment, with reference to FIG. 89, at least a portion of the return pin 598 may include a non-circular cross section, including, for example, a flat portion, which may, with respect to FIG. 92, be positioned slidably within the appropriately shaped hole 506b in the key gear 506. Also, as above, the trigger trigger 560 may include a gear portion 558 that can be operably connected to the trigger gear 596 in such a way that the gear portion 558 can rotate the trigger gear 596 about an axis defined by the wedge pin 598, as described in detail below.

In use, when the trigger trigger 560 is actuated for the first time, trigger trigger 560 may, as above, rotate the trigger gear 596 around the wedge pin 598 without directly transmitting rotational motion to the wedge pin 598 via the trigger gear 596. With reference to FIG. 88, the first actuation of the trigger trigger 560 may cause the trigger gear 596 to rotate in the direction of the arrow "A", i.e. clockwise for the purposes of this discussion. Also, the first time the trigger trigger 560 is actuated, the trigger trigger 560 can cause the pinion 501 and the idler 503 to rotate in the direction of arrow B, key 506 in direction of arrow C, and 516 front gear and pinion indicator 592 in the direction of the arrow 'D'. In various embodiments, according to FIG. 88, the trigger gear 596 and the wedge gear 506 may be rotated in opposite directions during the first actuation of the trigger 560 and may not be operably connected to each other until the first actuation of the trigger 560 as described in detail below. When the trigger 560 is released or returned to its non-actuated position after its first actuation, the trigger drive latch may e.g. be disengaged from the trigger 566 such that, for example, pinion 501 and key wheel 506 are not rotated or at least substantially rotated when trigger 560 is returned to its original or unlatched position. However, the trigger gear 596 can be rotated by the trigger trigger 560 when the trigger 560 is rotated to its non-actuated position and as a result, the trigger gear 596 can be rotated relative to the wedge gear 506 as shown in FIG. 89. When the trigger 560 is returned to its non-actuated position as described above, the sloped surface 509 of the trigger gear 596 may contact the coupling hook 599 of the wedge pin 598 and move the wedge pin 598 away from the trigger gear 596, as shown in FIG . 90. Subsequently, the trigger gear 596 can be further rotated by the trigger trigger 560 until the inclined surface 509 completely passes through the coupling hook 599, and the spring 500 can deflect the coupling hook 599 to a position behind the drive surface 510, as shown in FIG. 91. At this time, trigger trigger 560 may be in its non-actuated position.

[0059] For the second trigger trigger 560, the trigger drive pawl may remain disconnected from the trigger 566, although the second trigger trigger 560 may again cause the trigger gear 596 to rotate in the direction of arrow A in FIG. 92. Due to the position of the hook 599 behind the drive surface 510 of the trigger gear 596, the rotational movement of the trigger gear 596 may also cause the wedge pin 598 and the wedge gear 506 to rotate clockwise marked by arrow A, i.e. in the counterclockwise direction arrow C. Accordingly, the gear 506 of the wedge can rotate the pinion 501 and the intermediate gear 503 in the direction of arrow E, i.e. in the opposite direction of arrow B, and also rotate the gear 592 of the indicator in the direction of arrow F, i.e. in the opposite direction marked with an arrow D. Due to the rotational movement of the pinion 501 in the opposite direction during the second actuation of the trigger 560, the pinion 501 may retract the firing member 566 relative to the gripper and change or at least substantially change the position of the firing member 566 in its initial or immobilized position. Thereafter, trigger trigger 566 may be released and returned to its non-actuated position. In such circumstances, the drive surface 510 of the trigger gear 596 can be rotated far from the coupling hook 599, and because the release drive pawl can still be functionally disengaged from the trigger 566, the wedge pin 598 and the wedge gear 596 can remain in position . To re-position the surgical instrument, the trigger drive pawl can be released so that it can re-engage the trigger 566 the next time trigger 560 is actuated. In such embodiments, the used staple cartridge may be indicated in such a way that the surgical instrument can be reused.

[0060] In various embodiments, with reference to FIG. 94, the surgical instrument 500 may further include a trigger lock 548 that, like the trigger lock 148 described above, can be used to hold the closing trigger in position. In at least one embodiment, the trigger lock 548 can be rotated between the actuated and non-actuated positions to lock and unlock the closing trigger, such as, for example, the closing trigger 428 (FIG. 68). In at least one such embodiment, when the trigger lock 548 is in its non-actuated position, the trigger lock portion 548a 548a may be located in the recess 592a of indicator 592 to prevent or at least substantially prevent accidental actuation of the gear transmission and the trigger 566. In other words, when the portion 548a is placed in the recess 592a, the trigger and reversing drive described above may be rendered inoperative and as a result the trigger element 566 cannot be substantially displaced. When the trigger lock 548 is moved to its actuated position to hold or lock the closing trigger in place, the trigger lock portion 548a 548 can be moved or rotated beyond the cavity 592a in such a way that the triggering and reversing drive described above can operate.

[0061] In various alternative embodiments, the surgical instrument may include a pawl adapted to operably connect and disengage the reversing drive from the triggering element. In at least one embodiment, with reference to FIG. 95-100, the surgical instrument 600 may include a trigger trigger 660, which may be adapted to drive, for example, the trigger pin and the trigger drive latch to extend the trigger 666, cutting element, and / or staple drive relative to the gripper, as above. In various embodiments, as above, the surgical instrument may further include a reversing mechanism, including pinion 601, wedge gear 606, as well as spur gear 616, wherein extending of trigger 666 may rotate gear 601, 606 and 616 with due to functional connection between the rack portion 605 of the release member 696 and pinion 601. In various embodiments, the pin

698 The return or wedge may be attached to or formed integrally with the wedge gear 606 in such a way that rotational movement can be transmitted between them. Also, as above, the trigger trigger 660 may include a gear portion 658 that may be operably connected to the trigger gear 696 in such a way that the gear portion 658 can rotate the trigger gear 696 about an axis defined by the wedge pin 698.

In use, the first time the trigger trigger 660 is actuated, the trigger trigger 660 can rotate the trigger gear 696 around the wedge bolt 698 without directly transmitting rotation to the wedge pin 698 and the wedge gear 606. In particular, with reference to FIG. 97, the trigger gear 696 may include a bore 696a that may be adapted such that there is a loose fit between the wedge pin 698 and the side walls of the bore 696a and as a result the wedge pin 698 may rotate in the bore. In addition, referring to FIG. 96, the key gear 606 may include a ratchet mechanism surface 606c, and the trigger gear 696 may include a ratchet mechanism surface 696c that, when the trigger member 666 is extended by the trigger drive, can be detached or separated from each other in such a way that movement rotary is not transferred between them. After the trigger member 666 has been properly extended, as above, the return carriage 694 may be rotated downwardly around the pin 694a, such that the return carriage 694, with reference to FIG. 99, may be detached from end 698a of return bolt 698. In such circumstances, as described in detail below, the return pin 698 may be operably coupled to the trigger gear 696 and the trigger 666 may be retracted.

[0063] Accordingly, in various embodiments, the return carriage 694 can be manually moved between its non-actuated position shown in FIG. 95 to the actuated position shown in FIG. 99, similar to 494 return ambulance. In addition to or instead of the above, at least one of the gears in a gear, such as, for example, indicator gear 692, may include a cam, such as, for example, cam 602, which may contact the return carriage 694 and rotate it downward when it occurs predefined number of trigger trigger actuations 660. Then, in each case, the wedge gear 606 may be moved toward the trigger gear 696 by the spring 600. In particular, with reference to FIG. 100, spring 600, which may be, for example, positioned or compressed between the wedge gear 606 and the surgical instrument frame such that when the return carriage 694 is detached from the end pin 698a of the return pin 698, the spring 600 may be stretched to move the gear 606 wedge towards the trigger gear 696. In addition, in at least one embodiment, the return pin 698 may be attached to or integrally formed with the wedge gear 606 in such a way that the return pin 698 can be moved toward the trigger gear 696 with the wedge gear 606. In at least one embodiment, with reference to FIG. 97, return bolt 698 may include a flange 698b on which the wedge gear 606 may abut and push the return bolt 698 toward the trigger gear 696.

[0064] Accordingly, in various embodiments, the surfaces 606c and 696c of the ratchet mechanism can be positioned opposite each other by the spring 600 when the return carriage 694 is rotated downward to its actuated position, as shown in FIG. 100. In at least one embodiment, with reference to FIG. 97, surfaces 606c and 696c of the ratchet mechanism may include teeth projecting therefrom that may cooperate to impart rotational movement between them. In use, the next time the trigger trigger 660 is actuated, the trigger trigger 660 can rotate the trigger gear 696, as well as the wedge gear 606, clockwise indicated by arrow A, with reference to FIG. 99, wherein the toothed wheel 606 can rotate the pinion 601 in the direction of arrow E. As a result of the functional connection between the pinion 601 and the trigger portion 605 of the trigger member 666, pinion 601 may retract the trigger member 666, cutting element, and / or staple driver relative to the gripper, as above. In at least one embodiment, gears 601, 606 and 696, as well as gear portion 658 can be adapted in such a way that trigger 666 can be completely retracted using one trigger actuation 460.

[0065] Then, the trigger trigger 460 may be released and / or returned to its non-actuated position. In at least one such embodiment, surfaces 606c and 696c of the ratchet mechanism may include oblique surfaces that may allow the surfaces 606c and 696c to rotate relative to them when the trigger 660 is returned to its non-actuated position. Under such circumstances, the trigger gear 696 may be turned counterclockwise, i.e. counterclockwise. In at least one embodiment, the surfaces 606c and 696c of the ratchet mechanism can rotate relative to each other, even if the surfaces of the ratchet mechanism are in contact with each other. Then, the return carriage 694 can be rotated up so that it can contact the end of the return pin 698a 698 and move the return pin 698 and the wedge gear 606 away from the trigger gear 696. As a result, in such circumstances, the ratchet surface 606c may be detached from the ratchet surface 696c in such a way that they will no longer be operably connected to each other. In at least one such embodiment, the return carriage 694 may exert a force at the end 698a of the return pin 698, wherein the force may be transmitted to the wedge gear 606 via flange 698b to move the gear 606 wedge away from the trigger gear 696.

[0066] As described above, the surgical instruments of the present invention may include a firing drive having a latch that can be adapted to extend the firing member relative to the gripper. In various embodiments, as described above, the pawl 170 can be rotated upward to engage a recess 467 in the trigger member 466 and to extend the trigger member 466 away. Then, referring again to FIG. 101 and 102, pawl 170 can be rotated downward and retracted closer to the trigger member 466 to reset the pawl 170 so that pawl 170 can be rotated up again to enter the next recess 467 and further extend the trigger member 466 . However, in various circumstances, the pawl 170 may not be able to enter the recess 467 when it is turned upward as shown in FIG. 103. Such circumstances may occur, for example, when the trigger element 466 is accidentally displaced by forces or energy transmitted by and / or stored in various mechanisms of the surgical instrument. If the pawl is unable to reconnect to the trigger, the surgical instrument may become unusable and, as a result, it may be necessary to manually re-position the surgical instrument. To alleviate this condition, surgical instruments according to various embodiments of the present invention may include a retraction safety mechanism that can hold or at least substantially hold the trigger member in position.

[0067] In various embodiments, with reference to FIG. 104, the retraction safety mechanism may be adapted to hold at least a portion of the trigger drive and / or the reversing drive in position, e.g. In at least one embodiment, the roll back safety mechanism may include an indexing mechanism or plate 711, which can be adapted to allow turning of the return bolt 798 counterclockwise indicated by arrow B, when trigger 466 is extended, as described above, but preventing or at least substantially preventing the rotation of the return bolt 798 clockwise, i.e. in the opposite direction to the direction of arrow B. As a result, when the return pin 798 is pivotally connected to the wedge gear 406 and the wedge gear 406 is operably connected to the release member 466 via the intermediate gear 403 and pinion 401, the indexing mechanism 711 may also prevent or at least substantially prevent retraction in closer to trigger 466. Furthermore, as detailed below, the indexing mechanism 711 can also prevent the trigger element 466 from accidentally sliding further away.

[0068] To prevent accidental rotation of the return bolt 798 as described above, the indexing member 711 may include one or more depressions and / or holes for retaining the return bolt 798 in position. In various embodiments, with reference to FIG. 104, 107 and 111, the indexing mechanism 711 may include a leaf spring including a clamp end 711a that can be held in the recess 784a of the frame 784 in such a way that the indexing mechanism 711 can bend and / or rotate relative to the support point 784b of the frame 784. In at least one embodiment, with reference to FIG. 105 and 106, return pin 798 may include a wedge 799 projecting therefrom, wherein the wedge 799 may be adapted to engage with the indexing mechanism 711. In particular, in at least one such embodiment, the indexing mechanism 711 may include a plurality of pits or holes 713a-d, with reference to FIG. 107 and 108, each of which may be adapted to hold a projection 799a protruding from a wedge 799, and thereby hold the return pin 798 in position, as will be described in detail below.

[0069] In use, the gripper of the surgical instrument may, for example, be enclosed on the soft tissue of a patient, and then, as described above, the trigger element of the surgical instrument may be extended by the trigger drive. Before the trigger member is extended, projection 799a of the return pin 798 may be positioned in the first hole 713a of the indexing member 711 as shown in FIG. 110a. In various embodiments, with reference to FIG. 106 and 109, the wedge 799 may further include an inclined or oblique surface 799b, which can be adapted in such a way that when the return pin 798 is rotated in the direction of the arrow B by the trigger 466, pinion 401, the intermediate gear 403, and a 406 wedge gear, the first time the trigger 460 is actuated, the oblique surface 799b may contact the edge of the opening 713a and pivot and / or rotate the indexing mechanism 711 downwards, as shown in FIG. 110b. In particular, some force may be required to deflect and / or rotate the indexing mechanism 711 and thereby reduce the likelihood of accidentally displacing the return pin 798 from the recesses 713. In particular, due to the lack of a large pulling force exerted on the trigger element 766, for example, the indentations in the indexing element are able to hold the wedge 799 of the return pin 798 and accordingly the likelihood that the trigger element 466 will be accidentally extended can be reduced.

[0070] At the end of the first actuation of the trigger trigger 460, the wedge 799 may be inserted into the second opening 713b of the indexing mechanism 711, as shown in FIG. 110c. In this position, the wedge 799 can be prevented from moving backwards into the hole 713a due to the restraining surface 799c. In particular, with reference to FIG. 108, the wedge 799 may further include a stop surface 799c, which may be adapted to, for example, adhere to the perimeter of the opening 713b, and because of the configuration of the stop surface 799c, the hole 713b and the stop surface 799c may be adapted to prevent wedge 799 from pivoting or turning the mechanism indexing 711 downwards in recess 715 (FIG. 111) and allow the return pin 798 to be rotated in the opposite direction to that marked with arrow B. In at least one such embodiment, the bounding surface 799c and perimeter of the opening 713b may include surfaces that are parallel to each other. In various other embodiments, the contact surfaces may include at least partially oblique portions that can be adapted in such a way that when the bounding surface 799c is pushed out to the edge of the opening 713b, the wedge 799 can further be attracted to the opening 713b as opposed to being pulled out. In any case, due to the functional relationship between the return pin 798, the gears of the gear and the trigger, as described above, the trigger 466 cannot or at least essentially cannot be accidentally retracted by indexing element 711. As a result, in such embodiments, the likelihood that the pawl 170 will not be aligned with the recesses 467 in the trigger element 466 when the pawl 170 is retracted relative to the trigger element 466, can be reduced.

[0071] For the second actuation of the trigger trigger 460, the trigger member 466 may rotate the gears 401, 403 and 406 again such that the return pin 798 is rotated in the direction of arrow B. As a result, in various embodiments, the oblique surface 799b may contact the edge of the second opening 713b and deflect and / or rotate the indexing mechanism 711 downwards as shown in FIG. 110d. At the end of the second trigger trigger actuation 460, the wedge 799 may be inserted into the third hole 713c of the indexing mechanism 711, as shown in FIG. 110e. In this position, the wedge 799 can be prevented from moving backwards to the second hole 713b due to the restraining surface 799c, as above. In addition, when the trigger trigger is triggered for the third time 460, trigger 466 may again rotate the return pin 798 in the direction of arrow B and as a result the oblique surface 799b may contact the edge of the third hole 713c and deflect and / or rotate the indexing mechanism 711 downwards as shown in FIG. 110f. At the end of the third actuation of the trigger trigger 460, the wedge 799 may be inserted into the fourth hole 713d of the indexing mechanism 711, as shown in FIG. 110g. In this position, as above, the wedge 799 may be secured to prevent rearward movement to the third opening 713c due to the restraining surface 799c.

[0072] At this point, in order to functionally connect the reversing drive to the triggering element, as above, the return pin 798 and the wedge 799 may be displaced towards the trigger gear 496 to engage the wedge gear 406 with the trigger gear 496. As a result, in various embodiments, the projection 799a may be moved far from the indexing element 711 and beyond the fourth opening 713d. Then, in the event of a return trigger trigger stroke 460, the trigger member 466 may be retracted, and the return pin 798 may be rotated clockwise, i.e. counterclockwise. At this point, trigger 466 and pawl 170 will be returned to their original positions, pin 798 will be rotated so that it aligns with first hole 713a, and pin 798 may be detached from trigger gear 496 in such a way that wedge 499 is moved to enter the first opening 713a. As a result, the surgical instrument can then be reused.

[0073] In various embodiments, with reference to FIG. 112 and 113, the rollback safety mechanism may include an indexing element or plate 811 that can be pivotally mounted in the recess 884a of the frame 884 in such a manner that the hinge end 811a can be pivotally attached to the pin portion 884b. In at least one embodiment, as above, the index element 811 may be rotated and / or deflected relative to the pin 811b. In various embodiments, the retraction safety mechanism may further include at least one spring element or return spring 811b in the recess 815, which may be adapted to deflect indexing element 811 to the position shown in FIG. 112 and 113. Similarly, the return spring 811b may further be adapted to return the indexing element to such a position after it has been deflected by the wedge 799 as shown above. In various embodiments, at least one return spring may, for example, be positioned between the indexing element 811 and the side wall of the recess 815. In various alternative embodiments, with reference to FIG. 114, the rollback safety mechanism may include an indexing element 911, which, like above, may be secured in the recess 984a of the frame 984. In at least one such embodiment, the frame 984 may further include mounting projections 984b, which may be adapted to be positioned by interference fit in the holes 911a in the indexing element 911 in such a way that the indexing element 911 can be flexed and / or rotated relative to frame 984.

[0074] In various alternative embodiments, the retraction safety mechanism according to at least one embodiment of the present invention may include a ratchet mechanism to prevent or at least limit the undesirable movement of the triggering element and / or the gearing. In various embodiments, with reference to FIG. 115-118, the ratchet mechanism may include a ratchet, which can be adapted to allow the gears to rotate the gears, such as, for example, indicator gear 492 and end gear 416, in the first direction when they are driven by the trigger element, such as triggering element 466, but prevent or at least restrict the rotation of the gears in the opposite direction, when the trigger drive latch, such as, for example, pawl 170 is retracted relative to the firing element. In at least one embodiment, with reference to FIG. 116, the ratchet mechanism may include a leaf spring or pawl 1011 that can limit the rotational movement of the front gear 416 as described in detail below.

[0075] Accordingly, when, for example, the trigger member 466 is extended by the trigger trigger 460, the trigger member 466 can rotate the spur gear 416 in the direction of arrow D (FIG. 116) due to functional connection with pinion 401, idler 403, wedge pinion 406, as well as spur gear 416 as described above. When the spur gear 416 is rotated in direction D, in at least one embodiment, the gear teeth 416a may be adapted to engage with and deflect the pawl 1011 in such a way that the gear teeth 416a can pass through it. However, in the event that the trigger element 466 is accidentally retracted and / or the spur gear 416 is rotated in the direction of arrow H, pawl 1011 can be adapted such that at least a portion of it can be positioned between two adjacent teeth 416a gear and prevent or at least restrict the rotation of the front gear 416 in the H direction. In various embodiments, with reference to FIG. 116, at least a portion of the pawl 1011 may be wedged between the teeth 416a of the gear or "clamped" in the gear 416 in such a way that the gear 416 generally cannot rotate in the H direction, at least until the reversing drive of the surgical instrument functionally a trigger element as detailed below.

[0076] In various embodiments, the surgical instrument may include a return carriage that can be moved between a non-actuated position as shown in FIG. 115 and 116 and the actuated position as shown in FIG. 117 and 118 to position the surgical instrument in its reversing or retracting mode of operation. As with the return carriage 494, in at least one embodiment, the return carriage 1094 can be pivoted relative to the frame 484 around the pin 1094a. In various embodiments, with reference to FIG. 118, pawl 1011 may be attached to the return carriage 1094 in such a way that when the return carriage 1094 is rotated downward to its actuated position, the pawl 1011 may be moved beyond the functional connection with the front gear 416. In such circumstances, the rotation of the front gear 416 in the direction of the arrow H is allowed when the surgical instrument is positioned in its inverting mode. When the spur gear 416 is allowed to rotate in the H direction, it is allowed to rotate the gear without interference or at least substantially without interference from the retraction protection mechanism in such a way that the trigger element can be retracted as described above. After the triggering element is properly retracted, the return carriage 1094 can be pivoted up to its non-actuated position, and the pawl 1011 can be re-engaged with the front gear 416.

[0077] In various circumstances, the reversing drive of the surgical instrument may be secured against proper engagement with the triggering element of the surgical instrument. In at least one embodiment, the reversing drive return carriage, such as, for example, return carriage 494 and 1094, may not be able to properly contact and actuate the release pin 172 and / or return bolt 498. In particular, the return carriage may not be able to properly move the release pin 172 and / or return bolt 498 in such a way that the wedge gear 406 will be operatively connected to the trigger 496, and in such a way that the pawl 170 will not be able to engage functionally with trigger element 466. As described above, in various embodiments, the return carriage may include a portion of a button that may be adapted to manually rotate the return carriage downwards when force is exerted on it. However, in various circumstances, such force may not be sufficient when the lever is moved to move the return carriage, especially when the return carriage and / or one of the pins 172 and 498 are locked in position.

[0078] In various embodiments of the present invention, the surgical instrument may include a switch that may be better adapted to manually connect the inverting mechanism of the surgical instrument to the triggering element. In at least one embodiment, with reference to FIG. 119, the switch may include a first and a second portion, the first portion 1194 may, for example, be movable with frame 1184 and the second portion 1118 may also be movable with frame 1184. In various embodiments, the first switch portion 1194 can be pivotally connected to the frame 1184 in such a way that when the first switch portion 1194 is rotated downwardly by a cam, similar to cam 402, for example, the first portion 1194 can be adapted to disengage the return pin 498 and allowing the wedge portion 499 of the return pin 498 to be connected to the trigger gear 496 as described above. In various embodiments, although not shown in FIG. 119, the return carriage 1194 may include an arm 1194d protruding therefrom, which may be moved far from the return pin 498a end 498 in such a way that, for example, the spring can deflect the return pin 498 for functional connection with the trigger gear 496.

[0079] Accordingly, the first portion 1194 of the switch, when turned downward, can be adapted to contact the return pin 172 and operatively connect the wedge 222 of the return pin 172 to the pawl 170 in such a way that the pawl 170 cannot be rotated toward top, as described above. As a result, in at least one such embodiment, the first switch portion 1194 may include a cam that can be actuated to operably disengage the triggering member from and operatively couple to the inverting drive with the firing member. In various circumstances, only the operation of the first portion 1194 may be required to switch the surgical instrument between its forward and reverse modes of operation. However, in the event that the reversing drive cam, such as cam 402, for example, cannot properly position or actuate the first switch portion 1194, the second switch portion 1118 may be used to actuate the first switch portion 1194, as described in detail below.

[0080] Accordingly, the second switch portion 1118 may be actuated to actuate the first switch portion 1194. In various embodiments, referring again to FIG. 119, the second switch portion 1118 may include a handle 1118b, which may for example be adapted to be gripped by a surgeon in such a way that the surgeon can apply force to it and rotate the switch portion 1118 about the pivot axis 1118a. In at least one embodiment, the second switch portion 1118 may be adapted to contact the first switch portion 1184 and move the first portion 1184 between its non-actuated position shown in FIG. 119 and its position activated as described above. As a result, in various embodiments, the second switch portion 1118 may include a cam that can contact the first portion 1194 and direct the first portion 1194 down such that the first portion 1194 contacts the release pin 172 and the return pin 498. In at least one such embodiment, with reference to FIG. 119, the second switch portion 1118 may include a contact surface 1118c that may be adapted to contact the surface 1194c of the first switch portion 1194. In various embodiments, the contact surface 1118c may be directly above the contact surface 1194c in such a way that the surfaces 1118c and 1194c can be leveled, and the likelihood of non-contact of the second switch portion 1118 with the first switch portion 1194 may be reduced.

[0081] Accordingly, in various embodiments, the contact surfaces 1118c and 1194c can be arranged and arranged in such a way that the force F2 exerted on the handle 1198b has sufficient force transmission to move the first portion 1194 of the switch to its actuated position. In at least one embodiment, the force F2 exerted on the handle can be transmitted through the body of the second switch portion 1118 and to the first switch portion 1194 via the contact surfaces 1118c and 1194c as the transfer force F3. In particular, in various embodiments, the transfer force F3 may be different from the force F2 exerted on the handle. In addition, referring to FIG. 119, the torques associated with the force F2 exerted on the handle and the transfer force F3 to initially displace the first part 1194 of the switch may be substantially the same, that is, the product of distance Da and force F2 can be substantially equal to the product of distance Db and force F3, wherein the distance Da can be the distance between the axis of joint 1118a and the application of force F2, and wherein the distance Db may be the distance between the axis of joint 1118a and the transmission of force F3. Thus, when the distance Da is less than the distance Db, as shown in FIG. 119, force F2 may be greater than force F3. Therefore, for force F3 to be substantially equal to force F2, handle 1118b should be positioned substantially above surfaces 1118c and 1194c when force F2 is applied to handle 1118b.

[0082] Accordingly, in various embodiments, the transfer force F3 can be transmitted through the body of the first switch portion 1194 to the firing pin 172 as the displacement force F1. As above, the displacement force F1 may be different than the transfer force F3. In addition, referring again to FIG. 119, Torques associated with the displacement force F1 and the transmission force F3 for the initial displacement of the firing pin 172 towards the latch 170, as described above, can be basically the same that is, the product of the distance Dc and the force F1 can be substantially equal to the product of the distance Dd and the force F3, wherein the distance Dc may mean the distance between the axis of joint 1194a and the application of force F3, and wherein the distance Dd may be the distance between the axis of joint 1194a and the transmission of force F3. Thus, when the distance Dc is smaller than the distance Dd, as shown in FIG. 119, force F1 may be greater than force F3. As a result, a lower transfer force F3 can be used to exert a larger displacement force F1 on the trigger pin 172, depending on the choice of the distances Da, Db, Dc and Dd. As a result, in different embodiments, the first and second parts of the switch can be adapted in such a way that the force F2 supplied by, for example, a surgeon, can be suitable to manually set the first part of the switch in its position actuated via the second part of the switch, and thus to pass a surgical instrument from a progressive mode of operation to a reverse mode of operation, as detailed above. To return the surgical instrument to its progressive mode of operation, the first switch portion 1194 may be rotated upward such that the second switch portion 1118 may also be rotated upward, which will re-position the switch assembly.

[0083] In another exemplary embodiment, with reference to FIG. 120-122, the surgical instrument may include a switch assembly including a first portion 1294 that can be pivotally attached to the frame 1284 around the pin 1294a, and further a second portion 1218 that can be pivotally attached to the frame 1284 about the pivot axis 1218a. Although the first and second switch parts can be pivotally attached to frame 1284, the switch parts can be pivotally attached to any suitable part of the surgical instrument. In various embodiments, as above, the first switch portion 1294 may be operated to switch the surgical instrument between the forward and reverse modes of operation. In at least one embodiment, the first switch portion 1294 can be rotated between its non-actuated position shown in FIG. 120 and its actuated position shown in FIG. 121. As above, the second switch portion 1218 may be moved downward by the force exerted on the handle 1218b to move the first portion 1294 downwardly to its actuated position.

[0084] In various embodiments, for example, the second switch portion 1218 and the trigger of the surgical instrument, such as, for example, trigger trigger 460, can be adapted in such a way that the second portion 1218 can be secured or at least essentially secured against rotation, down unless the trigger is in its unlatched position. Due to the requirement that the trigger trigger be in its non-actuated position prior to enabling the switch to operate, the first flipping switch switch portion 1294 can be properly aligned with the firing drive trigger pin, such as the trigger pin 172 when the first portion 1294 is rotated toward down. In various embodiments, the surgical instrument may be adapted in such a way that the firing pin is positioned within a predefined area in such a way that the firing pin can contact the first portion of the switch 1294 and move to connect to the trigger drive latch, such as example latch 170.

[0085] In various embodiments, with reference to FIG. 50, the surgical instrument 100 may include a gripper 106 and an elongated roller assembly 104, wherein the gripper 106 and roller assembly 104 may be pivotally connected via articulation 114. As described above, the articulation connection 114 can allow articulation 105 or movement of the gripper 105 relative to the shaft assembly 104 about the axis 116. In various circumstances, the surgeon may articulate the gripper 106 for easier access to the site of the procedure within the patient's body. In particular, the surgeon may insert the gripper 106 and the roller assembly 104 through the cannula at least partially inserted into the patient's body and after the gripper 106 passes through the cannula, the gripper 106 may be rotated or articulated to position the gripper 106 relative to soft tissue, e.g. the surgical site that should be stapled and / or cut. Once the gripper 106 is set, the relative relationship between the gripper 106 and the roller assembly 104 can be fixed or locked by the locking mechanism as described in detail below.

[0086] In at least one embodiment, with reference to FIG. 51 and 52, the articulation 114 may include a gripper lock member 300 and a pivot axis 302. In various embodiments, with reference to FIG. 53-56, the gripper lock member 300 may include a connector portion 320 that may secure the lock member 300 to the gripper 106, and with reference to FIG. 52, shaft assembly 104 may include a rotary union 342, the rotary union 342 may include a joint axis 302 extending therefrom. In various embodiments, the lock member 300 may include an opening 301, which may be of this size and may be adapted to receive at least a portion of the pivot axis 302. In at least one embodiment, the pivot axis 302 and the hole 301 can be adapted in such a way that the gripper 106 can rotate freely about the axis 116. In various other embodiments, the pivot axis 302 and the aperture 301 may be adapted such that the friction between the pivot axis 302 and the aperture 301 may inhibit, but allow, relative movement between the gripper 106 and the roller assembly 104. Although not shown, the articulation connection 114 may include more than one axis or axis of articulation about which the gripper 106 may rotate.

[0087] In various embodiments, the surgeon can articulate the gripper 106 relative to the roller assembly 104, for example, by pressing the gripper 106 against the side wall of the body cavity surrounding the procedure and exerting force on the roller assembly 104 in such a way that the gripper 106 rotates about axis 116 . Then, when the surgeon wants to re-center the gripper 106, i.e. align the gripper 106 and the roller assembly 104 along the line, the surgeon can, for example, re-position the gripper 106 on the side wall of the body cavity and apply force to the roller assembly 104 as described above. In various embodiments, with reference to FIG. 51 and 52, the surgical instrument 100 may include a re-centering mechanism that can automatically re-center or at least substantially re-center the gripper 106 relative to the roller assembly 104. In various embodiments, the gripper lock member 300 may include centering surfaces 316, and the elongated shaft assembly 104 may include centering rollers 328 and biasing members 330, wherein the biasing members 330 may be adapted to bias the centering rollers 328 relative to the centering surfaces 316. In at least one such embodiment, the centering surfaces 316 can be arranged on substantially opposite sides of the axis 116 in such a way that the centering rollers 328 can generate a substantially equal torque or torque to the lock member 300 and in the absence of additional actuating force keep the gripper 106 in substantially centered position. When the gripper 106 is bent by such an actuating force as described above, the lock member 300 may be adapted to move one of the centering rollers 328 in a proximal direction and to compress the biasing member 330 operably connected to the shaft. In particular, the biasing member 330 may be disposed between the guide 331 and at least one projection 329 protruding from the centering shaft 328 in such a way that when the projection 329 is moved proximal by the roller 328, the biasing member 330 is compressed between them. After removing the actuating force, the compressed biasing member 330 may expand and rotate the lock member 300 to its centered position through the centering shaft 328 or to a position where the torque applied by the biasing members 330 will be substantially balanced. Although the biasing element 330 is shown as a helical spring, the biasing element 330 may include any suitable elastic element.

[0088] In various embodiments, the locking mechanism may be used to hold the gripper 106 in its articulated position, even after the actuation force has been removed. In at least one embodiment, with reference to FIG. 53-56, the gripper lock member 300 may include a first portion having a first surface 308, a second portion having a second surface 304, teeth 312, and cavities 314 defined between teeth 312, wherein, as detailed below, teeth 312 and the recesses 314 may be adapted to functionally engage with the locking element of the roller assembly to establish or lock the relative relationship between the gripper 106 and the roller assembly 104. In various embodiments, teeth 312 and depressions 314 may be located between first surface 308 and second surface 304. In at least one embodiment, the first surface 308 may extend from the opening 301 to the first circumference 310, and the second surface 304 may extend from the opening 301 to the second circumference 306. In various embodiments, the first circumference 310 may define a first plane and the second circumference 306 may define a second plane, wherein the teeth 312 and depressions 314 may be located between the first and second planes. In embodiments in which the first circumference 310 is different from the second circumference 306, teeth 312 may protrude at an angle or bevel between them. In various embodiments, tooth 312 may intersect the first circumference 310 at a point farther from axis 116 than the point at which tooth 312 intersects the second circumference 306. In at least one embodiment, at least one of the teeth 312 may define a first axis 313 that may extend between the first surface 308 and the second surface 304 in a direction that is not perpendicular to the first surface 308 and / or the rotation axis 116. In such embodiments, teeth 312 may, for example, slide over soft tissue that is adjacent to articulation 114. In other words, due to the sloping or oblique surfaces of the teeth 112, the likelihood that teeth 112 will attach or damage the soft tissue surrounding the articulation 114 when the gripper 106 is bent can be reduced. In at least one embodiment, teeth 312 may not protrude beyond the first circumference 310 in such a way that when at least a portion of the first circumference 310 comes into contact with, for example, soft tissue, the first circumference 310 and the teeth 312 may, as above, easily move relative to soft tissue.

[0089] Accordingly, embodiments of the present invention may provide significant advantages over prior surgical instruments. In particular, with reference to FIG. 57, the articulated joints of the previous end grippers had lock members, such as, for example, lock member 299, which included teeth 298 that protruded outside the perimeter of the lock member. As a result, when the gripper is bent relative to the surgical instrument shaft assembly, teeth 298 may engage or violate surrounding soft tissue and potentially cause injury. Under various circumstances, the tissue can be caught between adjacent teeth 298 in such a way that when the gripper is bent, soft tissue can be pulled into the articulation and can be clamped by the moving or moving components of the articulation axis. In embodiments of the present invention in which the teeth of the lock member are inclined or oblique, as described above and shown in FIG. 58, soft tissue can move more easily over the teeth, and soft tissue is less likely to be drawn into the articulation.

[0090] As described above, referring to FIG. 59-62, the surgical instrument 100 may further include a locking element 120 that can be moved relative to the gripper 106 and can be operably connected to the gripper 106 to prevent or at least limit the relative movement between the roller assembly 104 and the gripper 106. In at least one embodiment, the lock member 120 may be adapted to engage with at least one of the teeth 312 in such a way that the gripper 106 cannot move relative to the lock member 120. In particular, the lock member 120 may include an end portion 338 and a roller portion 340, the end portion 338 may include a recess 336 that may be adapted to position the tooth 312 of the lock member 300 depending on a tight fit or even an interference fit. In various alternative embodiments, the locking portion 338 may be placed within at least one of the recesses 314 in a tight fit or interference fit, as above. In any case, a surgical instrument

100 it may further include a spring 126 that can be adapted to pivot the lock member 120 in connection with the gripper lock member 300. In case the recess 336 is not aligned with the tooth 312, in at least one embodiment, the biasing force exerted on the lock member 120 by the spring 126 may contact the lock member 120 and rotate the gripper lock member 300 about the axis 116 until the teeth 312 coincide. with recess 336. In various embodiments, the spring 126 may include any suitable biasing element, including a coil spring, leaf spring, or other biasing material.

[0091] In various alternative embodiments, with reference to FIG. 63-67, the surgical instrument may include a gripper lock member 350 including an opening 301, a first portion including a first surface 358, a second portion including a second surface 354 (FIG. 67), as well as part 320 of the connector. The gripper lock member 350 may further include teeth 362 and depressions 364 defined between teeth 362, wherein in at least one embodiment, teeth 362 and depressions 364 may be located between first surface 358 and second surface 354. In various embodiments, with reference to FIG. 65-67, teeth 362 may not protrude beyond the first circumference 357 of the first surface 358 and / or the second circumference 353 of the second surface 354. In at least one such embodiment, the teeth 362 may be completely positioned or comprised between the first surface 358 and the second surface 354. In at least one alternative embodiment, teeth 362 may partially protrude past first circumference 357 and / or second circumference 353. In various embodiments, the first circumference 357 and the second circumference 353 may define an outer surface between them, wherein the depressions 364 may be defined in the outer surface. Due to the functions described above, the gripper lock member 350 may slide relative to the soft tissue adjacent the articulation without disturbing the soft tissue. In various embodiments, teeth 362 may be blunted or rounded to further facilitate the relative displacement described above. In at least one embodiment, with reference to FIG. 63-65, the locking mechanism may be adapted to engage with at least one of teeth 362 and cavities 364, and may include a lock member 382 including an end portion 388 and a roller portion 390. In at least one embodiment, as above, the end portion 388 may include a recess 394, which may for example be adapted to engage with at least one of the teeth 362.

[0092] In various embodiments, with reference to FIG. 123, the surgical instrument 1300 may include, as above, a gripper 1306 pivotally connected to the shaft 1304 about articulation 1315. Also, as above, the surgical instrument 1300 may include means for opening and closing the anvil 1312 relative to the staple cartridge channel 1308, and in addition to means for allowing articulation of the gripper 1306 about axis 1316 of articulation 1315. With respect to the means for opening and closing the anvil 1312, the surgical instrument 1300 may include a closing tube, including another tube component 1334a and a proximal tube component 1334b that, when extended in the distant direction, i.e. in the direction of arrow Z, may combine with anvil 1312 and cam or rotate the anvil 1312 down toward channel 1308 of the staple cartridge. Accordingly, when the closure tube is retracted in the opposite direction to the arrow Z, the distal tube member 1334a may displace the anvil 1312 up away from the staple insert channel 1308 and / or allow the anvil 1312 to deflect open by the spring.

[0093] In various embodiments, with reference to FIG. 124 and 125, the distal tube member 1334a may be extended further such that it at least partially includes the anvil 1312 and the staple cartridge channel 1308. In at least one embodiment, the distal portion 1334a of the tube may include a cam portion 1335 that may be adapted to contact the anvil 1312 and slide over the outer surface 1337 of the anvil 1312. Furthermore, cam portion 1335 may be adapted to slide over the outer surface 1319 of the staple cartridge channel 1318 in such a way that the distal portion 1334a of the tube may include the entire circumference or at least a significant portion of the anvil 1312. In at least one embodiment, the cam portion 1335 may include a continuous circular or at least substantially circular material ring defining an opening adapted to control the position of the anvil 1312 relative to the staple cartridge channel 1318 and the space, if any, between the anvil 1312 and the staple cartridge located inside channel 1318 of the staple cartridge.

In some embodiments, at least one spring or biasing element may be located between the anvil 1312 and the staple cartridge channel 1318, the spring being adapted to bias the anvil 1312 and / or staple cartridge channel 1318 on the inner circumference of the distal portion 1334a of the opening tube.

[0094] In various embodiments, referring again to FIG. 125, the distal portion 1334a of the tube may include a distal edge 1333 that may define the distal portion of the cam portion 1335 in contact with the anvil 1312 and the staple cartridge channel 1318. In some embodiments, the staple cartridge channel 1318 may, for example, include a front stop such as, for example, a stop 1331 adapted to limit displacement towards the distal portion 1334a of the tube. In at least one such embodiment, the distal edge 1333 may contact the stop 1331 and as a result limit the distance at which the cam portion 1335 can slide over the anvil 1312. However, under certain circumstances, limiting the distance at which the cam portion 1335 can slide over the anvil 1312 may limit the amount of clamping force or leverage that the anvil 1312 can apply to the tissue placed between the anvil 1312 and the staple cartridge positioned within the staple cartridge channel 1318.

[0095] In various alternative embodiments, with reference to FIG. 126128, the distal portion 1334a 'of the tube may include a first cam portion 1335a' adapted to engage with the anvil 1312, and further a second cam portion 1335b 'adapted to engage with the staple cartridge channel 1318. As with the distal portion 1334a of the tube, the distal portion 1334a 'of the tube may include or at least substantially include a portion or circumference of the gripper 1306 defined by the anvil 1312 and the staple cartridge channel 1318. However, in various embodiments, the cam portion 1335a 'may extend further away than the cam portion 1335b'. As a result, in at least one such embodiment, the cam portion 1335a 'may extend a greater distance above or around the anvil 1312 than the cam portion 1335b' may extend under or around the staple cartridge channel 1308. According to FIG. 127 the distal portion 1334a 'of the tube may include a distal edge 1333a' that is positioned distally to the distal edge 1333b 'in such a way that with reference to FIG. 128, cam portion 1335a 'may extend a greater distance from the anvil 1312 and provide greater clamping force or leverage compared to cam portion 1335 of distal portion 1334a of the tube. As a result, in various circumstances, the cam portion 1335a 'may extend a greater distance over the anvil 1312 before the cam portion 1335b' contacts the stop 1331.

[0096] In various embodiments, referring again to FIG. 126, the inner circumference of the cam portion 1335a 'may include an arcuate or at least substantially arcuate internal profile that corresponds to or at least substantially corresponds to the arcuate or at least substantially arcuate profile of the anvil 1312. In at least one such embodiment, the inner profile of the cam portion 1335a 'may be adapted to provide a tight fit with the outer profile of the anvil 11312 in such a way that there is a slight, if any relative lateral or radial displacement between them, but adapted to allow slipping cam portion 1335a 'relative to the anvil 1312 when the distal portion 1334a' of the tube is moved in the distal direction indicated by arrow Z. As above, the inner circumference of the cam portion 1335b 'may include an arcuate or at least substantially arcuate inner profile that corresponds to or at least substantially corresponds to the arcuate or at least substantially arcuate outer profile of staple cartridge channel 1308. In at least one such embodiment, the internal profile of the cam portion 1335b 'may be adapted to provide a tight fit with the external profile of the staple insert channel 1308 in such a way that there is a small, if any relative transverse or radial displacement, but adapted, to allow the cam portion 1335b 'to move relative to the anvil 1312 when the distal portion 1334a' of the tube is moved in the distal direction indicated by arrow Z.

[0097] As described above, referring again to FIG. 123, gripper 1306 can be rotated relative to shaft 1304 about articulation 1315. In various embodiments, the closure tube including the distal portion 1334a of the tube and the proximal portion 1334b of the tube may include one or more articulation joints, such as, for example, fittings 1301a and 1301b, which may allow rotation of the distal portion 1334a of the tube relative to the proximal portion 1334b of the tube when gripper 1306 is rotated relative to shaft 1304. In at least one embodiment, the connector 1301a and / or the connector 1301b may, for example, include protrusions 1303, which may be positioned, for example, in the holes 1334a and 1334b in the parts of the tube such that the connectors 1301a and 1301b can rotate relative to the proximal part 1334b the tube and in such a way that the distal portion 1334a of the tube can rotate relative to the connectors 1301a and 1301b. In various other embodiments, fittings 1301a, 1301b and portions of closure tubes 1334a, 1334b may include any suitable combination of projections and holes to permit articulation between them. In either case, fittings 1301a and 1301b may provide more than a degree of freedom between the distal portion 1334a of the tube and the proximal portion 1334b of the tube. In particular, fittings 1301a and 1301b may provide at least two degrees of freedom, i.e. a first degree of freedom between the proximal portion 1334b of the tube and fittings 1301a, 1301b and a second degree of freedom between the fittings 1301a, 1301b and the distal portion 1334a of the tube.

In use, as described above, the gripper 1306 can be pivoted relative to the shaft 1304 about axis 1316 and then locked in position by means of a lock. With reference now to FIG. 129, the pivot axis 1316 of the articulation joint 1315 may be defined by the pivot axis 1302 extending from the shaft channel portion 1342, wherein the pivot axis 1302 may be located within a hole in the staple channel lock portion 1308 of the staple cartridge 1308. When the lock is detached from the lock portion 1305, the gripper 1306 can be rotated about the axis 1316 to the desired position and then locked in place by reconnecting the lock to the lock portion 1305. In various embodiments, the gripper 1306 may rotate in the first and second, or left and right directions about the axis of the joint 1302. Similar to the embodiments described above, the lock may engage at least one of the lock teeth 1312 and / or at least one of the indentations 1314 sandwiched between the lock teeth 1312. Regardless of whether the gripper 1306 is in the centered or articulated position, the closing tube 1334 of the shaft 1304 can be extended further to close the anvil 1312 as described above. When the closing tube 1334 is extended in the distal direction, fittings 1301a and 1301b may slide relative to axis 1316 and articulation 1315 in various circumstances due to the many degrees of freedom provided by fittings 1301 a and 1301 b in the manner described above, although gripper 1306 may example, move articulated relative to shaft 1304.

[0099] When the closing tube 1334 is extended and the anvil 1312 is closed, a drive rod, such as, for example, drive rod 1390 (FIG. 136), it can be extended inside the shaft 1304 and the gripper 1306. In various embodiments, with reference to FIG. 136 and 137, the drive rod 1390 may include a rod portion 1391 adapted to transmit force from the trigger of the surgical instrument holder (FIG. 1) to the cutting element 1392 and / or the staple driver 1393 in such a way that the cutting element 1392 can cut the tissue located inside the gripper 1306 and / or in such a way that the staple drive 1393 can eject staples, such as staples 1381 (represented by the dashed line in FIG. 136), from a staple cartridge, such as, for example, a staple cartridge 1380 (FIG. 138) in staple cartridge 1308. With reference to FIG. 129, the gripper block portion 1305 1306 may include a guide slot 1321 adapted to receive and guide portion 1391 of the drive rod 1390. Furthermore, shaft 1304 may further include a frame or ridge 1345 (FIG. 131 and 132), including a guide slot 1341 also adapted to receive a portion 1391 of the guide rod of the drive rod 1390, wherein the drive rod 1390 may slide within the guide slots 1321 and 1341 when the drive 1390 is extended in the distal direction and / or retracted in the proximal direction. .

[0100] In various embodiments, now referring to FIG. 129 and 130, the surgical instrument 1300 may further include a guide member 1370, which may include a guide slot adapted to receive at least a portion of the drive rod 1390. In at least one embodiment, the guide gap inside the guide member 1370 may include a first sidewall 1371 and a second sidewall 1372 that may be adapted to support a portion 1391 of the rod (shown in dashed lines in FIG. 129) when the drive rod 1390 is moved relative to the articulation 1315. In particular, when the gripper 1306 is moved articulated in the first or left direction, as shown in FIG. 129, the first side wall 1371 may be adapted to support a portion 1391 of the drive rod 1390 when the portion 1391 of the rod is moved relative thereto. In various embodiments, the rod portion 1391 may be sufficiently flexible to accommodate the geometry change so that it fits and moves within the guide slot 1341 and the guide slot 1321. Under certain circumstances, the guide member 1970 may be adapted to assist in preventing bending of the 1391 rod as a result of the load applied to it. As above, the second side wall 1372 may be adapted to support the rod portion 1391 when the gripper 1306 is bent in the second or right direction.

[0101] In various embodiments, referring again to FIG. 129-130, the guide member 1370 can move independently of the shaft 1304 and / or the gripper 1306. In particular, in at least one embodiment, the guide member 1370 may be adapted to displace or adjust its own position relative to the grip portion 1305 of the gripper block 1306 and the frame 1341 (FIG. 131 and 132) the shaft 1304, including when the gripper 1306 is moved articulated relative to the shaft 1304. In some embodiments, the guide member 1370 may include members that allow, but are not limited to, relative movement between the guide member 1370. In at least one such embodiment, the guide member 1370 may include a first protrusion or bead 1376 protruding therefrom, which may be positioned inside the first bead gap 1343 in the shaft channel portion 1342, the side walls of the bead gap 1343 being appropriately spaced apart, to allow movement of the end 1378 of the guide member 1370 relative to the shaft 1304, but with a limited range of motion between them. Similarly, the guide member 1370 may further include a second protrusion or bead 1377 protruding therefrom, which may be positioned inside the second bead 1322 of the bead portion 1305 of the lock, the side walls of the bead slit 1345 being appropriately spaced apart to allow the end member 1379 to be moved 1370 relative to shaft 1304, but with a limited range of motion between them. In various alternative embodiments, the guide member 1370 may include first and second bead slots and a shaft channel portion 1342, and the lock portion 1305 may include beads protruding therefrom.

[0102] Accordingly, in various embodiments, the first slot 1343 of the bead portion 1342 of the shaft channel and the first bead 1376 of the guide member 1370 may be adapted to maintain an aligned or at least substantially aligned proximal end 1378 of the guide member slot 1370 with the guide slot 1341 in the shaft 1304. Similarly, the second bead 1377 of the guide member 1370 and the second slot 1322 of the bead portion 1305 of the lock may be adapted to maintain an aligned or at least substantially aligned distal end 1379 of the guide slot in the guide element 1370 with the guide slot 1321 in the gripper 1306. Accordingly, in various embodiments, the lock portion 1305 may, for example, include recesses 1323a and 1323b adapted to accommodate and store distal corners or end of the guide member 1370 when the gripper 1306 and the lock portion 1305 are, for example, articulated relative to the shaft 1304. In at least one embodiment, with reference mainly to FIG. 130, recesses 1323a and 1323b may be adapted to provide a clearance between the side walls of recesses 1323a and 1323b and the end of the guide member 1370.

[0103] In various alternative embodiments, with reference to FIG. 133 and 134, gripper 1306 may include an alternative embodiment of the lock portion 1305, i.e., the lock portion 1305 '. The lock portion 1305 may include recesses 1323a 'and 1323b' which may be adapted to place and support a distal end of the guide member 1370, as described in detail below. With reference to FIG. 133, gripper 1306 is shown in straight or at least substantially straight alignment with the shaft 1304, the space 1329 being between the guide element 1370 and the lock portion 1305, and further the space 1349 being between the guide element 1370 and the frame or ridge 1345. In this position, the guide slot 1341, the guide slot in the guide member 1370, and the guide slot 1321 in the lock portion 1305 can be aligned or at least substantially aligned with each other along a common axis. In such circumstances, the knife rod 1390 may be subjected to an axial load along the 1394 axis during use, although it may be subjected to small, if any, lateral loads that are transverse to the 1394 axis and, as a result, it may be necessary for the sidewalls to provide small guide gaps, if at all, the lateral support of the sides of the drive member 191.

[0104] With reference to FIG. 134, the gripper 1306 is articulated with the shaft 1304, as illustrated by the rotational movement of the lock portion 1305 '. As can also be seen in FIG. 134, the guide member 1370 has also been displaced in response to the articulation movement of the gripper 1306. In various embodiments, the movement of the gripper 1306 and the lock portion 1305 'may cause the lock portion 1305' to contact the guide member 1370 and at least one of the rotation of the guide member 1370 in the same direction as the gripper 1306 rotates, and the guide member 1370 being pushed out. closer to the frame 1345 of shaft 1304. As can be seen in FIG. 134, the space 1329 between the distal end of the guide member 1370 and the lock portion 1305 has been eliminated or substantially reduced. As can also be seen in FIG. 134, at least a portion of the guide member 1370 may be disposed within the first recess 1323a 'in such a manner that relative movement between the distal end of the guide member 1370 and the lock portion 1305 may be impossible or at least substantially inhibited. In particular, in at least one embodiment, the latch 1373a protruding from the guide member 1370 can be located in the first recess 1323 in such a way that relative movement between the latch 1373a and the lock portion 1305 is impossible or at least limited and in such a way that the required alignment between the first side wall 1371 and the first side wall 1321a of the guide slot 1321 can be substantially maintained. Due to the elimination or reduction of space 1329 and the alignment or at least a substantial alignment of the first side wall 1371 and the first side wall 1321a, the drive rod 1391 may be supported to eliminate or at least reduce the likelihood of bending the drive rod 1391, e.g. in lateral direction.

[0105] Accordingly, in various circumstances, the gripper 1306 can, for example, be rotated in a second direction or in a direction opposite to the first direction. In such circumstances, as above, the guide member 1370 may move in response to the articulation movement of the gripper 1306. In various embodiments, the movement of the gripper 1306 and lock portion 1305 'may cause the lock portion 1305' to contact the guide member 1370 and at least one of the rotation of the guide member 1370 in the same direction as the gripper 1306 rotates, and the guide member 1370 being pushed out. closer to frame 1345 of roller 1304. In such circumstances, also like above, the space 1329 between the distal end of the guide member 1370 and the lock portion 1305 may be eliminated or substantially reduced, and at least a portion of the guide member 1370 may be located in the second recess 1323b 'in such a way that the relative movement between the distal end of the guide member 1370 and the lock portion 1305 may be impossible or at least substantially inhibited. In particular, in at least one embodiment, the latch 1373b protruding from the guide member 1370 can be located in the second recess 1323 in such a way that relative movement between the latch 1373a and the lock portion 1305 is impossible or at least limited and in such a way that the required alignment between the second side wall 1372 and the second side wall 1321a of the guide slot 1321 can be substantially maintained. Due to the elimination or reduction of space 1329 and the alignment or at least a substantial alignment of the second side wall 1372 and the second side wall 1321b, the drive rod 1391 may be supported to eliminate or at least reduce the likelihood of bending the drive rod 1391, e.g. in lateral direction.

[0106] Accordingly, in various embodiments, the second bead 1377, protruding from the guide member 1370, may be adapted to interact with catches 1373a or 1373b to prevent or at least substantially inhibit relative movement between the distal end of the guide member 1370 and part 1305 'locks. In particular, in at least one embodiment, the second bead 1377 and the second bead 1322 may be adapted such that the second bead 1377 contacts the side wall of the second bead 1322 when the first hook 1373a is located in the first cavity 1323a '. Accordingly, the translational and / or rotational movement of the distal end of the guide member 1370 relative to the lock portion 1305 'may be blocked or at least stopped. In various circumstances, the first hook 1373a may be located in the first recess 1323a 'without contacting the second bead 1377 with the side wall of the second bead 1322. In at least one such case, displacement of the drive rod 1390 may cause the guide member 1370 to rotate relative to the lock portion 1305 'and to position the second bead 1377 against the side wall of the second bead 1322.

[0107] When the gripper 1306 is rotated in its second direction, as above, the second bead 1377 and the second bead 1322 may be adapted so that the second bead 1377 contacts the side wall of the second bead 1322 when the second hook 1373b is located in the second recess 1323b '. Accordingly, the translational and / or rotational movement of the distal end of the guide member 1370 relative to the lock portion 1305 'may be blocked or at least stopped. Under various circumstances, the second hook 1373b may be located in the second recess 1323b 'without contacting the second bead 1377 with the side wall of the second bead 1322. In at least one such case, displacement of the drive rod 1390 may cause the guide member 1370 to rotate relative to the lock portion 1305 'and to position the second bead 1377 against the side wall of the second bead 1322.

[0108] As described above, the gripper 1306 can be rotated within a range of bending angles relative to the shaft 1304. For example, the gripper 1306 can be rotated between rectilinear or centered alignment, as shown in FIG. 133 and the articulation, as shown in FIG. 134. In the articulated alignment of FIG. 134 The gripper 1306 may, for example, be rotated approximately 45 degrees from the straight or centered alignment. In various embodiments, with reference to FIG. 131 and 132, gripper 1306 may, for example, be rotated approximately 75 degrees from the straight or centered alignment. When the gripper 1306 is rotated, as indicated above, the lock portion 1305 'can, in various embodiments, rotate the guide member 1370 because of the functional connection between the first hook 1373a of the guide member 1370 and the first recess 1323a' of the lock portion 1305 '. Also, as described above, the rotational movement of the lock portion 1305 'can push the guide member 1370 closer to the frame 1345. In various embodiments, the guide member 1370 may include a proximal projection or tab 1375 that may be adapted to slide within a cavity in the shaft 1304 when the guide member 1370 is pushed in the proximal direction. In at least one such embodiment, the proximal latch 1375 may be inserted into the recess 1349 defined between the frame 1345 and the proximal roller portion 1341. In such circumstances, raising the proximal end 1375 of the guide member 1370 relative to the frame 1345 may be blocked or at least restrained. In addition, in at least one embodiment, the first bead 1376 and the first bead 1343 may interact with the proximal tab 1375 and the recess 1349 of the shaft 1304 to prevent or at least limit relative translational and / or rotational movement between the proximal end of guide 1370 relative to shaft 1304.

[0109] As described above, the gripper 1306 can be pivoted relative to the shaft 1304 about axis 1316 in a range of positions or settings. When the gripper 1306 is in a straight or centered orientation, as shown in FIG. 133, the distance between the distal end of the guide slot 1341, i.e. reference point 1330, and the proximal end of the guide slot 1321, i.e. reference point 1331, can be determined by the first distance 1332a. When the gripper 1306 is in the articulated orientation, as shown in FIG. 134, the distance between reference point 1330 and reference point 1331 may be determined by a second distance 1332b. Due to the articulation movement of the gripper 1306 and the movement of reference point 1331 towards reference point 1330, the second distance 1332b is smaller than the first distance 1332a. Similarly, when the gripper 1306 is further articulated to the orientation shown in FIG. 131, the distance between reference point 1330 and reference point 1331 may be determined by a third distance 1332c that is smaller than the first distance 1332a and the second distance 1332b. In any case, the reader will be aware that the various degrees of articulation of the gripper 1306 shown in FIG. 131, 133 and 134 are exemplary and that gripper 1306 can be pivoted to any other suitable setting in which, for such other settings, the distance between reference points 1330 and 1331 can be different.

[0110] Under various circumstances, cutting element 1392 may be placed inside the staple cartridge 1380 (FIG. 138) when the gripper 1306 is in a straight and / or articulated position. When the gripper 1306 is in a rectilinear position, the cutting element 1392 may be located in a first position relative to the distal end 1382 of the staple cartridge 1380 and / or the distal end 1384 of the cutting knife slot 1383. When the gripper 1306 is articulated relative to the shaft 1304, as discussed above, one of the cutting element 1392 and the staple cartridge 1380 can move relative to the other, leaving the cutting element 1392 in a second position relative to the distal end 1382 of the 1380 staple cartridge and the distal end 1380 of the slit 1383 cutting knife. In various circumstances, this second position may be closer to the distal end 1382 and the distal end 1384 than the first position. In such circumstances, depending on the degree of bending, the cutting element 1392 may have an initial position that is closer to the distal end 1382 and a distal end 1384 when the cutting element 1392 is extended distally by the drive rod 1390. Such different initial positions may result from, first, holding the cutting element 1392 in position or at least partially holding in position by the rigidity of the drive rod 1390 in such a way that the cutting element 1392 slides inside the staple cartridge 1380 when the gripper 1306 is bent. and, secondly, the distances (1332a, 1332b and 1332c) between reference points 1330 and 1331 varying when the gripper 1306 is bent as discussed above.

[0111] Accordingly, under certain circumstances, the distance between the start position of the cutting element 1392 and the distal ends 1382, 1384 may be the same or at least substantially the same in the mirror settings of the gripper 1306. In particular, the distance between the start position of the cutting element 1392 and the distal ends 1382, 1384 can be the same when the gripper is bent 45 degrees to the left from the center position compared to 45 degrees to the right from the center position. In various embodiments, the start position of the cutting element 1392 may be closer to the distal ends 1382, 1384 when the gripper is at the maximum articulation angle in each direction, left or right. In some embodiments, the start position of the cutting element 1392 may be furthest from the ends 1382, 1384 when the gripper 1306 is in its rectilinear or centered position.

[0112] As described above, in use, the drive rod 1390 may be extended farther to cut the tissue placed in the gripper 1306 and / or to eject the staples contained in the staple cartridge 1380 (FIG. 138). In some embodiments, the surgical stapling instrument can be adapted in such a way that the drive rod 1390 is extended a predefined or predetermined distance by a trigger mechanism or a trigger mechanism of the surgical instrument during use. In other words, in various embodiments such a surgical instrument may be adapted to extend the cutting element 1392 a predefined or predetermined distance regardless of whether the gripper 1306 is bent and / or regardless of the degree of bending of the gripper 1306. However, in various embodiments, the cutting element 1392 may stop at different distal positions in the staple cartridge 1380 due to the different initial positions of the cutting element 1392. In particular, with reference to FIG. 137 and 138, cutting edge 1396 of cutting element 1392 can be extended to position 1389a when gripper 1306 is in its straight alignment (FIG. 133) and to another distal position 1389c when the gripper is completely bent or almost fully bent (FIG. 131), although the cutting element 1392 has been extended to the same predefined or fixed distance.

[0113] In different circumstances different end positions of the cutting element 1392 and cutting edge 1396 may result from different initial positions of the cutting element 1392 in the staple cartridge 1380. As described above, different initial positions of cutting element 1392 may result from bending of gripper 1306, drive rod stiffness 1391, as well as various distances such as, for example, distances 1332a and

1332c between reference points 1330 and 1331 that occur when the gripper 1306 is in its rectilinear orientation (FIG. 133) and articulated settings (FIG. 131). In different circumstances, when the distance 1323c is shorter than the distance 1323a, the cutting element 1392 can be placed at a further initial position in the staple cartridge 1380 (compared to its position, when the gripper 1306 is in its rectilinear position) before a predefined or predetermined displacement of the cutting element 1392 is applied to it and in various circumstances the cutting edge 1396 can be extended to a further position in the staple cartridge 1380 to position 1389c. Accordingly, when the distance 1323a is greater than the distance 1323c, the cutting element 1392 can be positioned closer to the staple cartridge 1380 (compared to its position when the gripper 1306 is in the fully bent position) before a predefined or fixed displacement of the cutting element 1392 is applied to it and in different circumstances cutting edge 1396 can be extended only to position 1389a. As above, the cutting edge 1396 can be extended to a position between position 1323a and position 1323c when the gripper 1306 is in a partially bent position (FIG. 134).

[0114] Referring again to FIG. 138, the staple cartridge 1380 may include a plurality of staple recesses, such as, for example, staple recesses 1385, and staples, such as, for example, staples 1381 (FIG. 137), placed in cavities 1385 for staples. In various embodiments, each staple 1381 may include one or more staple legs, such as, for example, 1381p and 1381d staple legs, wherein in at least one embodiment, each staple recess 1385 may be adapted to receive staple 1381 such that her leg 1381d of staple is located at the distal end 1385d of the staple recess 1385d and that her leg 1381p of the staple is located at the proximal end 1385p of the staple recess 1385p. In various embodiments, it may be desirable for the cutting edge 1396 of the cutting element 1392 to be stopped before it exceeds the end reference point 1386, wherein in some embodiments, the end reference point 1386 may, for example, be defined and run through the farthest leg or legs 1381d of the farthest staple or staples 1381. In various other embodiments, the end reference point 1386 may, for example, be determined and extend through any portion of the outermost staple cavities 1385. In some embodiments, an end reference point 1386 may be defined and extend through the nearest staple legs 1381p located in the farthest staple cavities 1385. Whenever the cutting edge 1396 is stopped before the end reference point 1386, the cutting edge 1396 may not make a cut beyond the tissue that has been sutured by staples 1381. In various embodiments, it may be desirable for the cutting edge 1396 to be stopped at least 3 mm before the end reference point 1386. In some embodiments, it may be desirable for the cutting edge 1396 to be stopped in the range between approximately 3 mm and approximately 7 mm before the end reference point 1386. In some other embodiments, a narrower range may be desirable. This document describes means and embodiments for controlling or limiting the extension of the cutting element 1392 and cutting edge 1396 within a staple cartridge 1380.

[0015] As indicated above, with reference to FIG. 131, 133 and 134, the guide member 1370 may move relative to the lock portion 1305 'and the shaft 1304, although in various circumstances the distal end of the guide member 1370 may be gripped and / or positioned opposite the lock portion 1305'. With reference now to FIG. 140, the drive rod, such as, for example, the drive rod 1390 ', may include a stop, such as, for example, the stop 1395', which can be adapted to contact the guide member 1370 in such a way that the distal extension of the drive rod 1390 'and cutting element 1392 may be limited by the guide element 1370. In particular in various embodiments, the limiter 1395 'may be adapted to contact the limiter reference point, such as the limiter reference point 1399, at the proximal end of the guide 1370 in such a way that when the limiter 1395' is in contact with the limiter reference point 1399 , the drive rod 1390 'can no longer be extended or at least significantly extended further into the staple cartridge 1380. When the stop 1395 'contacts the reference point 1399 and the guide 1370 contacts the lock portion 1305', the farthest end position of the cutting edge 1396 can be largely determined by the predefined or predetermined distance 1397 'between the limiting surface 1395' and the edge cutting 1396, which is described in detail below. In various embodiments, the stop 1395 'may include a downwardly facing flap or projection, which may include, for example, a perpendicular arm for attachment to, for example, a corresponding perpendicular arm of the stop point 1399.

[0116] Accordingly, in at least one embodiment, when the bounding surface 1395 'of the drive rod 1390' contacts the guide element 1370, and the guide member 1370 contacts the gripper portion 1305 'of the grip 1306, final, the farthest position of the cutting edge 1396 relative to the end 1384 of the knife slot 1383 can be imposed by a predefined distance 1397 ', length of the guide slot in the guide element 1370, and the distance between reference point 1331 and the distal end 1384 of knife slot 1383. In various embodiments, the guide element 1370 may be made of a material with appropriate stiffness and geometry, which means that during use inside the guide slot 1370 there is very little, if any, deflection or deformation. Similarly, gripper 1306 can be made of a material with appropriate rigidity and geometry, which means that during use inside the knife slot 1383 there is very little, if any, deflection or deformation. As a result, in some embodiments, the guide slot inside the guide member 1370 and the knife slot 1383 may define a guide path that has a slight change in length, regardless of the position of the gripper 1306. However, in at least some embodiments, there may be some change in the length of the guide path. In particular, although the guide member 1370 may be located opposite the stop portion 1305 ', the relative alignment between the guide slot in the guide member 1370 and the guide slot 1321 in the lock portion 1305' may be different in different gripper settings 1306, resulting in different or at least slightly different lead track lengths as discussed in detail below.

[0117] As described above, the position of the gripper 1306 may affect the relative alignment between the guide member 1370 and the gripper 1306. With reference to FIG. 134, which shows the gripper 1306 in an approximately 45 degree orientation, although the guide member 1370 contacts the lock portion 1305 ', there may be a small space 1389 between the distal end of the guide member 1370 and the lock portion 1305'. When the gripper 1306 is bent more than as shown in FIG. 131, which shows the gripper 1306 in an approximately 75 degree orientation, the space 1389 between the guide member 1370 and the lock portion 1305 'may become larger, though slightly, although the guide member 1370 still contacts the lock portion 1305'. Such a change in the size of the space 1389 may cause a change in the length of the guide path, including the guide slot in the guide member 1370 and the knife slot 1383. However, despite such variations in the guide path length, the stop reference point 1399 may provide a reliable reference point at which the distal extension of the drive rod 1390 'may be stopped, as well as some means for stopping the cutting edge 1396 in a fixed position and / or in a narrower range positions, in the 1380 staple cartridge, regardless of the position of the gripper 1306. Under certain circumstances, the limiter 1395 'of the drive rod 1391 may contact the guide member 1370 and position the guide member 1370 against the lock portion 1305'. Such circumstances may occur, with reference to FIG. 133, e.g. when the gripper 1306 is in a straight or at least substantially straight orientation.

[0118] Accordingly, with reference to FIG. 140 and 141, the drive bar limiter 1395 '1391 may abut against the surface of the reference point 1399 of the guide member 1370 to inhibit extending towards the distal drive bar 1391, regardless of the orientation of the gripper 1306. In particular, with reference to FIG. 140, the bounding surface 1395 'can be adjacent to the surface of the reference point 1399 when the gripper 1306 is in a rectilinear orientation, and the like with reference to FIG. 141, the limiting surface 1395 'of the drive rod 1391 may also abut the reference point surface 1399 when the gripper 1306 is, for example, at an angle of approximately 66 degrees. Accordingly, as can be seen during the comparison of FIG. 140 and 141, the guide member 1370 has been pushed in a proximal direction by bending the gripper 1306. When the guide member 1370 has been pushed in the proximal direction, the surface of the reference point 1399 may also be pushed in the proximal direction, which may shorten the distance to the distal direction of the drive rod 1391. Accordingly, when the gripper 1306 is in a rectilinear orientation, the distance to the distal direction of the drive rod 1391 may be greater. Accordingly, in various embodiments, the distance over which the drive rod 1391 may be moved further can increase as the bending angle of the gripper 1306 increases. Summarizing, when gripper 1306 is in the bent position, cutting element 1392 may have a further initial position, however, this further initial position can be compensated by the proximal surface of reference point 1399 moved, which can limit displacement in the distal direction of the cutting element 1392 in such a way that the endmost position of cutting element 1392 is the same as or very close to him, final extreme position of cutting element 1392, when gripper 1306 is in a straight alignment. Similarly, when gripper 1306 is in a straight line, cutting element 1392 may have a closer initial position, however, this closer initial position can be compensated by the distal surface of reference point 1399, which can provide longer displacement in the distal direction of the cutting element 1392 in such a way that the endmost position of cutting element 1392 is the same as or very close to the endmost position of the cutting element 1392, when gripper 1306 is in the bent position.

[0119] As described above, referring to FIG. 138, it may be desirable to stop the knife edge 1396 of the cutting element 1392 near the end reference point 1386. In various embodiments, with reference to FIG. 142, a surgical stapling instrument, such as, for example, surgical instrument 1400, may include a trigger system driven by a motor, such as, for example, a motor 1410. In use, the motor 1410 may be operated to extend the cutting element, such as, for example, cutting element 1392, through a gripper, such as gripper 1306, to the same or at least substantially the same end position further in the gripper 1306 in such a way that the knife edge 1396 is stopped near the end reference point 1398, regardless of the bending angle of the gripper 1306. Accordingly, in some embodiments, the engine 1410 may be, for example, positioned in the handle of the surgical instrument 1400. The surgical instrument 1400 may further include a trigger switch or trigger, e.g., located on and / or operably connected to the handle of the surgical instrument, wherein the switch or trigger may be operated to operatively connect the motor 1410 to a power source, such as, for example, a battery that can also be placed in the holder. In use, as described in the following detailed description, the trigger switch or trigger may be operated to provide energy from a power source to the motor 1410 to extend and / or retract the trigger rod 1466, drive rod 1390, and cutting element 1392.

[0120] Accordingly, in various embodiments, the motor 1410 may include a drive shaft 1411 operably connected to the pinion 1412, wherein the motor 1410 may be adapted to rotate the drive shaft 1411 and pinion 1412 in a first or clockwise direction and / or in the other counterclockwise direction. With reference again to FIG. 142, pinion 1412 may be operably connected to the rack 1413, wherein the rotational movement of the pinion 1412 may drive the rack 1413 in the distal direction D and / or in the proximal direction P depending on the direction in which the rack 1412 rotates. In various embodiments, the pinion 1412 and the rack 1413 may include teeth that can cooperate with each other to transfer the rotational movement of the gear 1412 to the linear or at least substantially linear movement of the rack 1413. As can also be seen in FIG. 142, the firing drive may further include a firing rod 1466 operably connected to the rack 1413 and, as detailed below, the driving rod 1390 may be operably connected to the firing rod 1466 in such a way that movement of the rack 1413 may be transmitted to the firing rod 1466 and 1390 drive rod. As above, with reference to FIG. 143, the drive rod 1390 can be operably connected to the cutting element 1392 in such a way that movement in the distal direction of the rack 1413 can cause the displacement of the cutting element 1392 in the distal direction and, accordingly, movement in the proximal direction of the rack 1413 can cause the movement closer to the cutting element 1392 .

[0121] Accordingly, in use, the surgeon may operate the surgical instrument 1400 by manipulating the trigger switch or trigger on the surgical instrument handle to extend the cutting element 1392 and ultimately stitching and / or cutting the tissue within the surgical instrument gripper. In various embodiments, the surgical instrument 1400 may further include a computer which may include one or more inputs, at least one of such inputs may be operably connected to a trigger switch in such a way that the computer can detect the operation of the trigger switch. In some embodiments, the computer may, for example, be located in a surgical instrument holder. In at least one embodiment, the operation of the switch may close the circuit, and in response to this, the computer may instruct the motor 1410 to rotate in a direction that causes the rack 1413 to move closer, i.e., in the direction of P. In particular, the computer may, in response to the switch input, close the circuit, allowing battery 1410 to energize the motor, which as a result may allow the motor 1410 to rotate the shaft 1411 and pinion 1412. Whenever the cutting element 1392 is pulled proximal through the rack 1413, the cutting element 1392 may be attracted to contact a reference point, such as, for example, a stop or reference point surface 1398 in the gripper 1306. When the cutting element 1392 contacts the reference point limiter 1398 and / or when the surgical instrument computer 1400 detects that the cutting element 1392 contacts the reference point surface 1398, the computer may, in at least one embodiment, open the circuit between the power source and the motor 1410 in such a way that the motor 1410 no longer rotates the pinion 1412 and that the pinion 1412 no longer drives the rack 1413 proximal.

[0122] Accordingly, in various embodiments, the surgical instrument 1400 may further include an encoder system that can detect when the cutting element 1392 contacts the surface of reference point 1398. In at least one embodiment, the rack 1413 may include a plurality of detectable elements 1414 arranged in a linear arrangement thereon and / or therein, wherein the encoder system may further include an encoder sensor 1415 adapted to detect detectable elements 1414 as they pass through the encoder sensor 1415 . In some embodiments, the detectable elements 1414 may include iron, which, when the elements 1414 pass in front of the sensor 1415, may generate magnetic field interference that is detected by the encoder sensor 1415. In some embodiments, detectable elements 1414 may include visible demarcations, such as, for example, protrusions, depressions, and / or colored lines that can be detected by the encoder sensor 1415. In any case, the encoder sensor 1415 can be operably connected to the computer in such a way that the computer can count detectable elements 1414 detected by the sensor 1415 when the rack 1413 is retracted or moved closer to P. In particular, in at least one embodiment, the encoder sensor 1415 can be operably connected to at least one of the computer inputs in such a way that the computer can receive one or more signals from the encoder sensor 1415. In any case, in various embodiments, the detectable elements 1414 may be positioned at predefined or predetermined distances from each other in such a way that the detection of subsequent detectable elements 1414 may indicate to the computer that the rack 1413 has been displaced by a fixed or unit distance. In at least one embodiment, such a fixed or unit distance may be, for example, 1 mm. In some embodiments, the motor may include an encoder motor, including an encoder system that is integrated with the encoder, for example, the encoder can, for example, measure the rotational movement of the motor shaft 1411 and, based on the size and configuration of the pinion 1412, estimate proximal motion and / or distal rack 1413.

[0123] In any case, the surgical instrument computer 1400 may be adapted to compare the output commands sent to the motor 1410 with the input signals received from the encoder sensor 1415 to determine whether there is a difference between the expected position and the actual position of the rack 1413 and the expected and actual position, respectively cutting element 1392. For example, FIG. 145 provides a graphical representation of what the computer can detect, i.e. the first range 1416a, which indicates that the rack 1413 is retracted toward the reference point limiter 1398 and the second range 1416b, which indicates that the cutting element 1392 is in contact with the reference point limiter 1398 and / or moves only slightly due to deformation of reference point limiter 1398 and / or cutting element 1392. With reference again to FIG. 145 the surgical instrument computer 1400 can compare the expected rack displacement 1413 based on the command or output provided to the motor 1410, which was represented by line 1417, with detected rack movement 1413 based on encoder sensor input signal 1415, which was presented on line 1418, and when there is a corresponding difference between the expected displacement and the actual displacement of the rack 1413, the computer may functionally disconnect the power source from the 1410 engine and / or otherwise instruct the 1410 engine to stop rotating the pinion 1412. At this point, the surgical instrument computer 1400 can register the position of the rack 1413 and cutting element 1392 as the "reference point position". In various embodiments, the computer may include a memory, such as, for example, a non-volatile random access memory (NVRAM) system that may be adapted to store such information and / or any other information regarding the position of the rack 1413 and the cutting element 1392 at any other point in the during the operation of the surgical instrument.

[0124] When the cutting element 1392 makes contact with the reference point limiter 1398, the computer may instruct the motor 1410 to rotate the pinion 1412 in the opposite direction to extend the rack 1413 further, i.e. towards D. In at least one embodiment, the computer may reverse the voltage polarity supplied to the motor 1410 to cause rotation of the pinion 1412 in the opposite direction. In either case, the computer may instruct the engine 1410 to extend the cutting element 1392 to a predefined or predetermined distance to the reference point limiter 1398. In at least one such embodiment, the computer may allow the predefined or predefined voltage and / or current of the motor 1410 to be supplied from the power source for a predefined or predetermined time, which may, in various circumstances, extend the cutting element 1392 at a predefined distance. In some embodiments, the magnitude and / or duration of the voltage and / or current supplied to the motor 1410 may be adjusted based on the feedback provided to the computer. Accordingly, in at least one embodiment, the encoder sensor 1415 may be adapted to transmit to the computer a real or at least perceived displacement and position of the rack 1413 in such a way that the computer can compare the actual position of the rack 1413 with its expected position and properly compare the actual and the expected position of the knife edge 1396. In the event that the computer determines that, for example, the position of the edge 1396 of the knife is delayed relative to the expected position, the computer may increase the time and / or amount of energy supplied to the engine 1410 in such a way that the edge 1396 of the knife reaches the expected position or at least essentially nearby. Alternatively, in the event that the computer determines that, for example, the position of the knife edge 1396 exceeds the expected position, the computer may shorten the time and / or reduce the amount of energy supplied to the 1410 engine such that the knife edge 1396 does not exceed or at least substantially does not exceed the expected location.

[0125] Accordingly, in various embodiments, the predefined or predefined distance by which the cutting element 1392 is extended relative to the reference point limiter 1398 can be the same or at least substantially the same, regardless of the bending angle, if any, of the gripper 1306. As a result, in different circumstances, the knife edge 1396 may be stopped in the same or substantially the same position near the end reference point 1386. As can be seen, with reference to FIG. 138 and 143, reference point limiter 1398 and end reference point 1386 are located distal to the articulation of the surgical instrument and as a result the potential displacement of articulation elements, such as, for example, guide element 1370, as discussed above, may not affect the relative distribution of points references 1386 and 1398. In at least one exemplary embodiment, the reference point limiter 1398 may be located in the gripper staple channel 1306 and the end reference point 1398 may be set by certain elements of the staple cartridge 1380 located in the staple cartridge channel, as discussed below. In some other embodiments, reference point limiter 1398 and end reference point 1386 may be defined by staple cartridge elements, while in some embodiments, reference points 1398 and 1386 may, for example, be defined by staple cartridge channel elements. In any case, when the cutting element 1392 is opposite the reference point limiter 1398 and then extended further a predetermined distance, the cutting element 1392 and the knife edge 1396 may be placed in a secure manner or at least substantially reliable relative to the final reference point 1386.

[0126] In various embodiments, with reference to FIG. 144, the interconnection between the distal end of the trigger rod 1466 and the proximal end of the drive rod 1390 may allow relative movement between them. In at least one embodiment, a portion 1391 of the drive rod 1390 may include a collar or flap 1369 dependent therefrom, which may, for example, be located in a slot or groove 1467 in the firing rod 1466. As can be seen in FIG. 144, the width W2 of the slot 1467 is greater than the width W1 of the flap 1369, which means that the flap 1369 can slide proximal and / or distal in the slot 1467. As a result, in some embodiments, one or more spaces may be between the sides 1369p and 1369d of the flap 1369 and the sides 1467p and 1467d of the slot 1467. Such spaces in various circumstances may, for example, facilitate bending of gripper 1306, enabling at least some relative movement between the trigger rod 1466 and the drive rod 1390 to prevent or at least reduce the likelihood of unwanted deflection of the drive rod 1390 and / or the likelihood of unwanted inhibition of bending of the drive rod 1390 gripper 1306. In particular, in at least some circumstances, the drive rod 1390 may be moved proximal during bending of the gripper 1306 and in at least one embodiment, the slot 1467 may have a size adapted to receive such movement closer to the drive rod 1390. As described above, the distance the drive rod 1390 moves in the proximal direction may be directly proportional to the degree of bending of the gripper 1306, i.e. greater articulation of the gripper 1306 may result in greater proximal displacement (FIG. 146b) drive rod 1390 and correspondingly smaller bends of the gripper 1306 may result in less proximal displacement (FIG. 146a). In at least one embodiment, the width W2 of the slot 1467 may be such that the proximal side 1369p of the flap 1369 does not contact the proximal wall 1467p of the slot 1467. In any case, in various embodiments, the trigger drive of the surgical instrument 1400 discussed above can compensate or justify any space between the flap 1369 and the slot 1467 to position the cutting element 1392 in a desired position relative to the end reference point 1386.

[0127] An exemplary sequence of operation of the surgical instrument in accordance with some of the embodiments described above will now be presented. In use, the surgeon can unlock the gripper 1306 and bend the gripper 1306 by positioning it against the tissue at the site of surgery and exerting force distal along the axis of the roller 1304 in such a way that the gripper 1306 rotates relative to the roller 1304. When the gripper 1306 is properly bent, the gripper 1306 can be locked in position, the gripper 1306 can be positioned such that the tissue is placed between the staple cartridge 1380 and the anvil 1312, and the anvil 1312 can be closed to clamp the tissue. As a result of bending the gripper 1306, which will be described in detail below, the drive rod 1390 may move in the proximal direction and as a result a space may be created between the side 1369d of the flap 1369 and the side

1467d slots 1467. Once the surgeon accepts the position of the tissue in the closed gripper 1306, it can activate a trigger switch or trigger, which can be detected by the surgical instrument computer. As described above, the computer may order the motor 1410 to withdraw the rack 1413 closer. In various circumstances, the computer may use pulse width modulation to limit the energy supplied to the motor 1410 and to slowly pull the rack 1413. When the rack 1413 is moved in the proximal direction, the rack 1413 may pull the firing bar 1466 in the proximal direction so that the side 1467d of the slot 1467 contacts the side 1369d of the flap and as a result the space between side 1467d and side 1369d can be eliminated. When side 1467d meets side 1369d, rack 1413 and trigger rod 1466 may pull cutting element 1392 closer proximate until cutting element 1392 makes contact with reference point stop 1398. In various embodiments, the pulse width modulation applied to the 1410 motor may be calibrated such that the force exerted on the rack 1413 by the 1410 motor does not exceed a certain maximum or peak force, such as, for example, 30 lbf (133.45 N) and / or 40 lbf (177.93 N). By setting such a maximum force, damage to the rack 1413, the release bar 1466, the drive bar 1390, as well as the cutting element 1392 can be avoided in at least one embodiment, for example. In either case, the encoder system and the surgical instrument computer described above can detect when the cutting element 1392 contacts the reference point limiter 1398 and the energy supplied to the motor 1410 can be disconnected. Accordingly, in some embodiments, the encoder system and computer may determine if the cutting element 1392 moves freely towards the reference point limiter 1398 or whether the cutting element 1392 has contacted the reference point limiter 1398 and that certain components such as the 1398 limiter the reference point and cutting element 1392 began to deform elastically or plastically. In this reference position, the cutting element 1392 contacts the reference point limiter 1398 (FIG. 143) and there is a space 1469 between the side 1467p of the slot 1467 and the side 1369p of the flap 1369. In various embodiments, the computer may instruct the motor 1410 to extend the rack 1413 in distal direction D such that the side 1467p of slot 1467 contacts the side 1369p of flap 1369. In at least one such embodiment, the rack 1413 may be extended further to a predefined or predetermined distance, such as, for example, about 0.15 "(3.81 mm), to eliminate 1469 space and possibly additional distance, such as, for example, about 0.025 "(0.06 mm), In order to assure, that space 1469 has been eliminated and in at least one embodiment ensures that the cutting element 1392 has at least slight discontinuous contact with the reference point stop 1398. The new position may be registered by the computer as yet another reference position and may be referred to as the "initial" position. In various embodiments, the motor 1410 may stop the movement of the cutting element 1392 in an initial position and / or continue to move the cutting element 1392 distally to a predefined distance continuously. As described above, the rack 1413 and the cutting element 1392 can be moved further the same distance relative to the reference point stop 1398 and / or the initial distance of the cutting element 1392 regardless of the bending angle, if any, of the gripper 1306. Accordingly, the cutting element 1392 and its knife edge 1396 may be moved to the same end position further relative to reference point 1398 and / or the distal end 1384 of knife slot 1383. In any case, after the cutting element 1392 is extended to its farthest position, the computer may instruct the motor 1410 to withdraw the rack 1413 and the cutting element 1392 in a proximal direction so that the anvil 1312 can be opened again. In some embodiments, the surgical trigger or switch may be operated in such a way that the computer instructs the engine 1410 to stop the cutting element 1392 not far from its distal end position.

[0128] As described above, in various embodiments, the position of the cutting member 1392 relative to the reference point limiter 1398 at the proximal end of the staple cartridge channel or staple cartridge 1380 can be determined or tested by the methods described above. In some embodiments, the position of the cutting element 1392 relative to another reference point, such as a reference point at the distal end of the staple cartridge channel and / or staple cartridge 1380, can be determined or tested. In at least one such embodiment, the distance between the reference point limiter 1398 and the distal end of the staple cartridge channel may be determined by extending the cutting element 1392 distal from the reference point limiter 1398 and / or the initial position until the cutting element 1392 contacts the further end of the staple cartridge channel. In this reference position, the computer can register such positions in its memory and based on such information calculate the maximum cutting length of the cutting element 1392 that is possible, as well as adjust the previously defined or fixed distance that is required to travel by the cutting element 1392 during use . Such a test can be carried out before the staple cartridge is placed in the staple cartridge channel and before the gripper is placed in the patient's body.

[0129] As described above, the surgical instrument may include a gripper that can be bent relative to the shaft of the surgical instrument. Also as described above, the gripper can be selectively locked in position relative to the shaft. With reference to FIG. 147 and 148, the surgical instrument may include a gripper, including a gripper lock member 1500 that can be bent about pivot axis 1502. As with gripper lock member 300, gripper lock member 1500 may include a plurality of teeth 1512 and a plurality of recesses 1514 disposed around the perimeter of lock member 1500 that can pivot about hinge axis 1502 when the gripper is bent. In at least one such embodiment, each cavity 1514 may be between two teeth 1512. In various embodiments, the surgical instrument may further include a lock member 1538, which may include a tooth 1536 adapted to be inserted into one of the depressions 1514 in the gripper lock member 1500. In use, the tooth 1536 can be detached from the recesses 1514 to allow the gripper, including the lock member 1500, to rotate to the required position in which the lock 1538 can then be extended in a distant direction so that the tooth 1536 is inserted into and connected to the recess. 1514. Under certain circumstances, the lock tooth 1536 may not be aligned with the recess 1514 when the lock 1538 is extended in the distal direction. In some embodiments, the lock tooth 1536 and / or gripper lock teeth 1512 may include one or more oblique or inclined surfaces that can be adapted to cause a slight rotation or indexing of the gripper lock member 1500 to a position where the recess 1514 is aligned with the tooth 1536 locks.

[0130] The devices disclosed herein may be designed to be removed after one use, or may be designed to be used repeatedly. In any case, however, the device may be regenerated for reuse after at least one use. Regeneration can include any combination of steps to disassemble the device, clean or replace individual components, and then reassemble. In particular, the device can be dismantled, and any number of individual components 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 reassembled for further use in a regeneration facility or by a surgical team immediately prior to surgery. Those skilled in the art will be aware that device regeneration may involve a variety of different techniques for dismantling, cleaning / replacing components, and reassembly. The use of such techniques, as well as the resulting refurbished equipment, is within the scope of this application.

[0131] Preferably, the invention described herein will be prepared before surgery. First, a new or used instrument is obtained and cleaned if necessary. The instrument can then be sterilized. According to one sterilization technique, the instrument is placed in a closed and airtight container, such as a bag made of plastic or TYVEK. The packaging and instrument are then placed in a radiation field that can penetrate the packaging, such as gamma radiation, X-rays or high energy electron radiation. Radiation destroys bacteria found on the instrument and in the packaging. The sterilized instrument can then be stored in sterile packaging. The sealed package allows the device to remain sterile until it is opened in a medical facility.

ETHICON LLC, Puerto Rico Representative:

EP 2 075 328 B1 Z-16526/17