CN104487006B - 可互换的施夹器 - Google Patents

可互换的施夹器 Download PDF

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CN104487006B
CN104487006B CN201380034186.6A CN201380034186A CN104487006B CN 104487006 B CN104487006 B CN 104487006B CN 201380034186 A CN201380034186 A CN 201380034186A CN 104487006 B CN104487006 B CN 104487006B
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percussion
folder
jaw
drive device
axle
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CN104487006A (zh
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F·E·谢尔顿四世
C·O·巴克斯特三世
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Ethicon Endo Surgery Inc
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/128—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips
    • A61B17/1285—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for applying or removing clamps or clips for minimally invasive surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30—Surgical robots
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00367—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like
    • A61B2017/00398—Details of actuation of instruments, e.g. relations between pushing buttons, or the like, and activation of the tool, working tip, or the like using powered actuators, e.g. stepper motors, solenoids
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/0046—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable
    • A61B2017/00464—Surgical instruments, devices or methods, e.g. tourniquets with a releasable handle; with handle and operating part separable for use with different instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00477—Coupling

Abstract

本发明公开了一种用于夹住组织的外科装置(100)，所述外科装置可包括致动器，诸如柄部(700)或机械臂(32)，以及可替换的端部执行器(120)，所述端部执行器包括容纳在其中的多个夹(140)。在所述可替换的端部执行器(120)被使用之后，可将所述端部执行器从所述致动器拆卸，并可将新的端部执行器与所述致动器可操作地联接。每个可替换的端部执行器可包括用于将夹(140)推进到所述端部执行器的接收器中的击发驱动装置(160)和能够使定位在所述接收器内的夹变形的压接驱动装置(180)。

Description

可互换的施夹器
背景技术
多种紧固件可用于处理、夹紧、紧固、固定和/或保持组织。夹可相对于位于患者手术部位内的组织定位，并且随后变形以例如对该组织施加夹紧力。
附图说明
通过结合附图来参考本发明示例性实施例的以下描述，本发明的特征及优点及其获取方法将会变得更加明显，并可更好地理解发明本身，其中：
图1是施夹器的局部透视图；
图2是图1的施夹器的端部执行器的剖视图，包括可移除的夹仓、用于依次推进夹的往复式击发驱动装置、用于接收夹的接收器和用于使夹变形的压接驱动装置；
图3是处于打开构型的图1的施夹器的局部剖视图；
图4是处于闭合构型的图1的施夹器的局部剖视图；
图5是处于未击发状态的图2的端部执行器的剖视图；
图6是图2的端部执行器的剖视图，示出了处于部分击发状态的击发驱动装置，其中击发驱动装置的击发构件已将夹推进到接收器中；
图7是图2的端部执行器的剖视图，示出了与压接驱动装置接合到一起的击发驱动装置；
图8是图2的端部执行器的剖视图，示出了处于至少部分击发状态的压接驱动装置；
图9是图2的端部执行器的剖视图，示出了脱离击发构件的击发驱动装置；
图10是图2的端部执行器的剖视图，示出了处于其完全击发状态的压接驱动装置；
图11是处于部分回缩位置的图2的端部执行器的击发驱动装置的剖视图，其中该击发驱动装置与击发构件再次接合；
图12是脱离压接驱动装置的图2的端部执行器的击发驱动装置的剖视图；
图13是图2-12中示出的夹的透视图；
图14是图1-12中示出的包括多个夹的仓的前视图，其中该仓的部分已被移除以示出储存在该仓中的夹；
图15是图14的仓的侧视图，以部分被移除的形式示出，以示出储存在该仓内的夹；
图16示出了沿图15中的线16-16截取的图14的仓的横截面平面图；
图17是可与图1-12的施夹器或任何其他合适的施夹器结合使用的另选仓的侧视图，其中该仓以部分被移除的形式示出，以示出偏置构件以及定位在该偏置构件和包含于其中的夹中间的推板；
图18是根据至少一个另选的实施例的仓的侧视图，以部分被移除的形式示出，以示出偏置构件以及定位在偏置构件和包含于其中的夹中间的闭锁板；
图19是沿图18中的线19-19截取的图18的仓的横截面平面图；
图20是可与图1-12的施夹器或任何其他合适的施夹器结合使用的另外的另选仓的侧视图，其中该仓可包括以部分被移除的形式示出的外壳，以示出包括引导件的闭锁板，该引导件能够与限定于仓外壳中的引导件协作；
图21是沿图20中的线21-21截取的图20的仓的横截面平面图；
图22是根据至少一个实施例的击发驱动装置的正视图，包括旋转输入件、旋转输出件、与旋转输出件接合的击发螺母以及处于击发构型的传动装置；
图23是图22的击发驱动装置的透视图，示出了处于未击发位置的击发螺母；
图24是图22的击发驱动装置的透视图，示出了沿旋转输出件被推进的击发螺母以及从该击发螺母延伸的凸轮；
图25是图22的击发驱动装置的透视图，示出了与击发驱动装置的传动装置接合的击发螺母的凸轮并且传动装置处于反向构型；
图26是图22的击发驱动装置的透视图，示出了处于回缩位置的击发螺母和从击发螺母延伸的第二凸轮，所述凸轮与传动装置接合以将该传动装置从其反向构型转换成其击发构型；
图27是自动外科器械系统的透视图，该系统可操作地支持多个可与图2-12的施夹器或任何其他合适的施夹器一起使用的外科工具；
图28是外科工具的透视图，包括致动器模块、从致动器模块延伸的轴以及可替换的端部执行器；
图29是可与图2-12的施夹器或任何其他合适的施夹器一起使用的柄部致动器的透视图；
图30是图2中示出的关节运动接头的剖视图；
图31是另选致动器模块的后透视图，其可替代图28的致动器模块而使用，其中其外壳的至少一部分被移除；
图32是图31的致动器模块的一部分的分解图；
图33是图31的致动器模块的局部剖面图；以及
图34是图31的致动器模块的关节运动致动器的剖视图。
具体实施方式
本专利申请的申请人还拥有与本专利同一天提交的以下专利申请，这些专利申请各自的全部内容均以引用方式并入本文：
名称为“Flexible Drive Member”的美国专利申请序列号_____________，(代理人案卷号END7131USNP/120135)。
名称为“Multi-Functional Powered Surgical Device with ExternalDissection Features”的美国专利申请序列号_____________，(代理人案卷号END7132USNP/120136)。
名称为“Coupling Arrangements for Attaching Surgical End Effectors toDrive Systems Therefor”的美国专利申请序列号_____________，(代理人案卷号END7133USNP/120137)。
名称为“Rotary Actuatable Closure Arrangement for Surgical EndEffector”的美国专利申请序列号_____________，(代理人案卷号END7134USNP/120138)。
名称为“Surgical End Effectors Having Angled Tissue-ContactingSurfaces”的美国专利申请序列号_____________，(代理人案卷号END7135USNP/120139)。
名称为“Interchangeable End Effector Coupling Arrangement”的美国专利申请序列号_____________，(代理人案卷号END7136USNP/120140)。
名称为“Surgical End Effector Jaw and Electrode Configurations”的美国专利申请序列号_____________，(代理人案卷号END7137USNP/120141)。
名称为“Multi-Axis Articulating and Rotating Surgical Tools”的美国专利申请序列号_____________，(代理人案卷号END7138USNP/120142)。
名称为“Differential Locking Arrangements for Rotary Powered SurgicalInstruments”的美国专利申请序列号_____________，(代理人案卷号END7139USNP/120143)。
名称为“Firing System Lockout Arrangements for Surgical Instruments”的美国专利申请序列号_____________，(代理人案卷号END7141USNP/120145)。
名称为“Rotary Drive Shaft Assemblies for Surgical Instruments withArticulatable End Effectors”的美国专利申请序列号_____________，(代理人案卷号END7142USNP/120146)。
名称为“Rotary Drive Arrangements for Surgical Instruments”的美国专利申请序列号_____________，(代理人案卷号END7143USNP/120147)。
名称为“Robotically Powered Surgical Device With Manually-ActuatableReversing System”的美国专利申请序列号_____________，(代理人案卷号END7144USNP/120148)。
名称为“Replaceable Clip Cartridge for a Clip Applier”的美国专利申请序列号_____________，(代理人案卷号END7145USNP/120149)。
名称为“Empty Clip Cartridge Lockout”的美国专利申请序列号_____________，(代理人案卷号END7146USNP/120150)。
名称为“Surgical Instrument System Including Replaceable EndEffectors”的美国专利申请序列号_____________，(代理人案卷号END7147USNP/120151)。
名称为“Rotary Support Joint Assemblies for Coupling a First Portionof a Surgical Instrument to a Second Portion of a Surgical Instrument”的美国专利申请序列号_____________，(代理人案卷号END7148USNP/120152)。
名称为“Electrode Connections for Rotary Driven Surgical Tools”的美国专利申请序列号_____________，(代理人案卷号END7149USNP/120153)。
申请人还拥有以下专利申请，这些专利申请各自的全部内容均以引用方式并入：
名称为“Surgical Instrument With Wireless Communication Between aControl Unit of a Robotic System and Remote Sensor”的美国专利申请序列号13/118,259，美国专利申请公布2011-0295270 A1；
名称为“Robotically-Controlled Disposable Motor Driven Loading Unit”的美国专利申请序列号13/118,210，美国专利申请公布2011-0290855 A1；
名称为“Robotically-Controlled Endoscopic Accessory Channel”的美国专利申请序列号13/118,194，美国专利申请公布2011-0295242；
名称为“Robotically-Controlled Motorized Surgical Instrument”的美国专利申请序列号13/118,253，美国专利申请公布2011-0295269 A1；
名称为“Robotically-Controlled Surgical Stapling Devices That ProduceFormed Staples Having Different Lengths”的美国专利申请序列号13/118,278，美国专利申请公布2011-0290851 A1；
名称为“Robotically-Controlled Motorized Cutting and FasteningInstrument”的美国专利申请序列号13/118,190，美国专利申请公布2011-0288573 A1
名称为“Robotically-Controlled Shaft Based Rotary Drive Systems ForSurgical Instruments”的美国专利申请序列号13/118,223，美国专利申请公布2011-0290854 A1；
名称为“Robotically-Controlled Surgical Instrument Having RecordingCapabilities”的美国专利申请序列号13/118,263，美国专利申请公布2011-0295295 A1；
名称为“Robotically-Controlled Surgical Instrument With Force FeedbackCapabilities”的美国专利申请序列号13/118,272，美国专利申请公布2011-0290856 A1；
名称为“Robotically-Driven Surgical Instrument With E-Beam Driver”的美国专利申请序列号13/118,246，美国专利申请公布2011-0290853 A1；以及
名称为“Surgical Stapling Instruments With Rotatable Staple DeploymentArrangements”的美国专利申请序列号13/118,241。
现在将描述某些示例性实施例，以从整体上理解本文所公开的装置和方法的结构、功能、制造和用途。这些示例性实施例中的一个或多个实例在附图中示出。本领域的普通技术人员将理解文中具体描述并在附图示出的装置和方法为非限制性示例性实施例，并且本发明的多个示例性实施例的范围仅由权利要求书限定。结合一个示例性实施例示出或描述的特征可与其他示例性实施例的特征进行组合。此类修改和变型旨在包括在本发明的范围之内。
在整篇说明书中使用的短语“在各种示例性实施例中”、“在一些示例性实施例中”、“在一个实施例中”或“在实施例中”等并不一定都指相同的实施例。此外，在一个或多个其他示例性实施例中，可按照任何合适的方式组合一个或多个示例性实施例的具体特征结构、结构或特征。此类修改变型旨在包括在本发明的范围之内。
在各种外科手术期间，外科医生或其他临床医生可将夹施加于患者的组织，以实现各种效果和/或治疗结果。参见图1，诸如施夹器100的外科器械例如能够将一个或多个夹施加于位于患者手术部位内的组织。现在参见图13，一般来讲，施夹器100可被结构化并被布置用于将夹140相对于组织定位，以便压缩夹140内组织。施夹器100能够使夹140变形，例如，如图3和图4所示，并且如下文进一步更详细地描述。每个夹140可包括基座142和从基座142延伸的相对的腿144。例如，基座142和腿144可包括任何合适的形状，并且可限定基本上U形的构型和/或基本上V形的构型。基座142可包括成角部分141，该部分通过接头143连接在一起。使用时，夹140的腿144可定位在组织的相对侧上，其中腿144可被推向彼此，从而压缩定位在腿144之间的组织。接头143能够允许基座142的成角部分141以及从其延伸的腿144向内变形。在各种情况下，当夹140被充分地压缩时，夹140能够屈服或塑性变形，虽然在变形的夹140内可发生一定量的弹性变形或回弹。
现在参见图1和图2，施夹器100可包括轴110、端部执行器120和可替换的夹仓或盒130。参见图14-16，夹仓130可包括外壳132和定位在外壳132内的多个夹140。外壳132可限定夹140可堆叠于其中的储存室134。储存室134可包括侧壁，该侧壁围绕或至少基本上围绕夹140的周边延伸。再次参见图13，每个夹140可包括相对面，诸如位于夹140的相对侧上的顶面145和底面146，其中，当夹140堆叠在外壳132中时，夹140的顶面145可抵靠相邻夹140的底面146定位，并且其中夹140的底面146可抵靠另一个相邻夹140的顶面145定位。在各种情况下，夹140的底面146可朝一个或多个限定于外壳132中的支撑架或平台135面向下，而夹140的顶面145可远离支撑架135面向上。在一些情况下，夹140的顶面145和底面146可以是相同的，或至少基本上相同，而在其他情况下，顶面145和底面146可以是不同的。例如，图14-16中示出的夹140的叠堆包括五个夹140；然而，设想了其他实施例，其中夹140的叠堆可包括多于五个夹140或少于五个夹140。在任何情况下，夹仓130还可包括至少一个偏置构件，诸如偏置构件136，其例如定位在外壳132和夹140的叠堆中的顶部夹140的中间。如下文所更详细地描述，偏置构件136能够抵靠限定于外壳132中的支撑架135来偏置夹140的叠堆中的底部夹140，或者更具体地讲，底部夹140的底面146。偏置构件136可包括弹簧，和/或任何合适的压缩弹性元件，例如，该弹性元件能够向夹140施加偏置力，或至少向顶部夹140施加偏置力，该偏置力被向下传递穿过夹140的叠堆。
当夹140如上文所述抵靠支撑架135定位时，夹140可被支撑处于击发位置，其中夹140可被推进并且从仓130射出。在各种情况下，支撑架135可限定击发室149的至少一部分，其中夹140可被依次定位在击发位置中。在一些情况下，击发室149可被完全限定于仓130内，或者在其他情况下，击发室149可被限定于轴110和仓130内和/或被限定于轴110和仓130之间。在任何情况下，如下文进一步更详细地描述，施夹器100可包括击发驱动装置，该击发驱动装置可将击发构件推进到仓130中并且将夹140从其抵靠支撑架135定位的击发位置推动至已击发位置，在该位置其被接收在施夹器100的端部执行器120内。主要参见图14-16，仓130的外壳132可包括近侧开口或窗口133，其可与支撑架135对准或者至少基本上对准，使得击发构件可穿过近侧开口133进入仓130中并且将夹140朝远侧推出仓130。在至少一个此类实施例中，例如，外壳132还可包括远侧或排放开口或者窗口137，其也可与支撑架135对准，使得夹140可沿击发轴线139朝远侧被推进或击发，该击发轴线延伸穿过近侧开口133、击发室149和远侧开口137。
为了将夹140推出仓130，对上文进行进一步描述，击发驱动装置的击发构件可被推入仓外壳132中，并且在各种情况下，进入击发室149中。如下文进一步更详细地公开，击发构件可完全穿过仓130，以便将夹140推入其在端部执行器120内的已击发位置。当定位在击发室149中的夹140已被击发构件朝远侧推进之后，如上文所述，该击发构件可充分地回缩，使得偏置构件136可将另一个夹140抵靠支撑架135定位。在各种情况下，偏置构件136可将夹140抵靠击发构件偏置，而击发构件被定位在外壳132内。此类夹140可称为列队(queued)夹。在击发构件已充分地回缩并且已从列队夹140之下滑出后，偏置构件136可将夹140抵靠支撑架135偏置，在此情况下分阶段进行往复式击发构件的下一个行程。主要参见图2和图14-16，例如，仓130能够将夹140沿预先确定的路径诸如供应轴线138供应给击发室149。供应轴线138可横向于击发轴线139，使得夹140被送入击发室149，其送入方向不同于击发构件穿过击发室149的方向。在至少一个此类实施例中，例如，供应轴线138可垂直于或至少基本上垂直于击发轴线139。
再次参见图2，例如，轴110可包括仓孔或盒孔131，其尺寸可设定成并可被配置成在其中接收夹仓130。仓孔131的尺寸可设定成并可被配置成使得仓130的外壳132被紧密地接收在仓孔131内。限定仓孔131的侧壁可限制或至少基本上限制仓130相对于轴110的侧向运动。轴110和或仓130还可包括一个或多个锁件，所述锁件能够可释放地将仓130保持在仓孔131中。如图2所示，仓130可沿轴线被装载入仓孔131中，该轴线在至少一个实施例中平行于供应轴线138或与其共线。仍如图2所示，轴110还可包括从轴110的侧壁111延伸的垫或底座118，其中垫118能够被接收在仓130的外壳132内和/或与其接合。垫118的尺寸可设定成并可被配置成被紧密地接收在限定于仓外壳中的凹槽148内，使得垫118可限制或至少基本上限制仓130相对于轴110的侧向运动。垫118的尺寸可设定成并可被配置成将仓130在轴110内对准和/或支撑仓外壳132。
一旦夹仓130已被定位并且坐置在轴孔131内，现在参见图5和图6，可致动施夹器100的击发驱动装置160以将夹140从夹仓130如上文所述推进。击发驱动装置160可包括，例如，旋转驱动输入件诸如驱动螺钉161，以及可操作地与驱动螺钉161接合的可替换的击发螺母163。驱动螺钉161可包括至少一个驱动螺纹162，该螺纹可与延伸穿过击发螺母163的螺纹孔通过螺纹接合。在各种实施例中，施夹器100还可包括例如可操作地与驱动螺钉161联接的电动马达。在各种实例中，例如，驱动螺钉161可操作地与包括手持式器械或机械臂的外科器械系统的马达联接。在任何情况下，击发螺母163在轴110内的运动可被约束，使得当马达使驱动螺钉161围绕纵向轴线164旋转时，击发螺母163沿纵向轴线164运动。例如，当马达使驱动螺钉161沿第一方向旋转时，驱动螺钉161可朝端部执行器120朝远侧推进击发螺母163，如图6所示。当马达使驱动螺钉161沿与第一方向相反的方向旋转时，驱动螺钉161可使击发螺母163远离端部执行器120朝近侧回缩。轴110可包括一个或多个轴承，该轴承能够可旋转地支撑驱动螺钉161。例如，轴承159例如能够可旋转地支撑驱动螺钉161的远侧端部，如图5和图6所示。
击发驱动装置160还可包括从击发螺母163延伸的击发构件165，该击发构件可被击发螺母163朝远侧推进并且朝近侧回缩，如下文进一步更详细地描述。在比较图5和图6时，读者将注意到，击发螺母163和击发构件165已被从图5所示的近侧的未击发位置推进至图6所示的远侧的已击发位置，其中击发构件165已将夹140从夹仓130推进至端部执行器120中。主要参见图5，夹仓130被示出为包括多个储存于其中的夹140，其中夹140中的一个定位在击发位置中，如上所述。如图5和图6所示，击发构件165可包括远侧部分166，该远侧部分可沿击发轴线167被推进至钉仓130中，并且当击发构件165和击发螺母163朝远侧推进时接合定位在击发位置中的夹140。在一些情况下，击发构件165可包括线性构件，而在其他情况下，例如，击发构件165的远侧端部166可从击发构件165向上延伸。对上文进行进一步描述，击发构件165可将夹140沿击发轴线167朝远侧推出夹仓130并将其推入限定于端部执行器120中的接收腔122中。
在各种情况下，可将击发构件165附接到击发螺母163并且从击发螺母163朝远侧延伸，而在其他情况下，可通过击发致动器168将击发构件165和击发螺母163可操作地彼此连接。击发致动器168可在枢轴169处以能够枢转的方式安装到击发构件165，并可包括远侧臂170a和近侧臂170b，其可与限定于轴110的外壳112中的纵向狭槽113接合。在至少一个此类实施例中，臂170a,170b中的每个可分别包括从其延伸的突出诸如突出171a和171b，所述突出能够在纵向狭槽113内滑动。对上文进行进一步描述，击发螺母163还可包括从其延伸的击发销172，该击发销能够接合远侧臂170a，以便将致动器168和击发构件165朝远侧推进，如上文所述。使用时，再次参见图5和图6中示出的进程，击发螺母163可被驱动螺钉161朝远侧推进，其中定位在远侧臂170a和近侧臂170b中间的击发销172可接触远侧臂170a并将致动器168和击发构件165朝远侧驱动。当致动器168朝远侧推进时，由于可防止在轴狭槽113中滑动的突出171a和171b中的一者或两者相对于纵向轴狭槽113侧向运动，所以可防止致动器168围绕枢轴销169旋转，直到致动器168到达图6中示出的位置。
当致动器168已到达图6中示出的位置时，远侧突出171a可进入纵向狭槽113的远侧狭槽部分114中，该远侧狭槽部分能够向下枢转致动器168，或允许致动器168向下枢转，如图9所示。在至少一个此类实施例中，远侧突出171a可与远侧狭槽部分114的侧壁发生接触，该侧壁可向下引导远侧突出171a并且在致动器168被击发螺母163向前推进时，使致动器168围绕枢轴169枢转。处于此枢转位置时，从击发螺母163延伸的击发销172可不再与致动器168的远侧臂170a接合，其中，随后击发螺母163可独立于致动器168朝远侧运动，从而将致动器168和击发构件165留在后面。换句话说，纵向轴狭槽113的远侧端部114可停用击发构件165，其中，此时击发构件165的位置可表示击发构件165的完全被击发或最远侧位置。处于此位置时，夹140已被完全推进至接收腔或接收器122中。此外，处于此位置时，下一个待推进至接收腔122的夹140可抵靠击发构件165的顶面偏置，对上文进行进一步描述。
对上文进行进一步描述，例如，一旦夹140被定位在接收腔122内，压接驱动装置180就可使夹140变形。现在参见图3和图4，施夹器100的端部执行器120还可包括第一钳口123a和第二钳口123b，其中第一钳口123a和第二钳口123b可至少部分地限定接收室122。如图3和图4所示，第一钳口123a可包括第一通道124a并且第二钳口123b可包括第二通道124b，所述通道各自能够在其中接收和支撑夹140的至少一部分。第一钳口123a可通过销125a以能够枢转的方式联接到轴110的框架111，并且第二钳口123b可通过销125b以能够枢转的方式联接到框架111。使用时，压接驱动装置180能够使第一钳口123a朝第二钳口123b旋转，和/或使第二钳口123b朝第一钳口123a旋转，以便压缩定位于两者间的夹140。在至少一个此类实施例中，压接驱动装置180可包括凸轮致动器181，其能够使限定于第一钳口123a上的第一凸轮表面126a与第二钳口123b上的第二凸轮表面126b接合，以便使第一钳口123a和第二钳口123b朝彼此枢转。凸轮致动器181可包括衬圈，其至少部分地环绕第一钳口123a和第二钳口123b。在至少一个此类实施例中，衬圈可包括内凸轮表面182，其可成轮廓的接触钳口123a,123b的凸轮表面126a,126b，并向内朝向彼此驱动它们。在各种情况下，定位在限定于端部执行器120中的接收室122内的夹140可先相对于组织定位，再致动压接驱动装置180。在一些情况下，可先至少部分地致动压接驱动装置180，再将夹140相对于组织定位，以便至少部分地压缩夹140。在某些实例中，夹140和接收室122的尺寸可设定成并可被配置成使得当端部执行器120处于其未致动状态时，可向内偏置或弯曲夹140，如图3所示。在各种实例中，可致动压接的第一钳口123a和第二钳口123b，以弹性地压接和/或永久性地压接定位于两者间的夹140。
对上文进行进一步描述，击发螺母163能够致动压接驱动装置180。更具体地讲，现在参见图7，压接驱动装置180可包括可操作地与凸轮致动器181联接的压接致动器188，其中，在击发螺母163如上文所述朝远侧推进时，压接致动器188可被击发螺母163选择性地接合。在至少一个此类实施例中，击发螺母163还可包括第二击发销诸如从其延伸的击发销184，在击发螺母163推进击发致动器168时，该击发销能够接合压接致动器188。再次参见图7，压接致动器188定位在未致动位置，并且，当击发螺母163被充分地推进以接合压接致动器188的远侧臂190a时，击发螺母163可将压接致动器188向上旋转进入如图8所示的致动位置。仍如图8所示，例如，远侧臂190a和近侧臂190b可各自分别包括从其延伸的突出，诸如突出191a和突出191b，所述突出可定位在限定于轴110中的第二纵向狭槽诸如狭槽115内。在压接致动器188从其未致动位置围绕枢轴189向上旋转时，突出191a和突出191b可从纵向狭槽115的近侧弯曲端部116运动进入基本上线性的纵向狭槽115的一部分中。与上文相似，纵向狭槽115的侧壁能够约束压接致动器188沿纵向路径的运动，并且一旦压接致动器188已经向上旋转进入至少部分地致动位置时，该侧壁能够限制或防止压接致动器188的旋转，如上所述。如读者将理解的那样，击发驱动装置160的击发销172和压接驱动装置180的击发销184均从击发螺母163延伸。为了便于说明，击发销172和击发销184被示出为从击发螺母163的相同侧延伸；然而，据设想，击发销172可从击发螺母163的第一横向侧延伸，而击发销184可从击发螺母163的其他横向侧延伸。在此类情况下，击发致动器168可定位在驱动螺钉161的第一横向侧旁边，并且压接致动器188可定位在驱动螺钉161的相对横向侧旁边。相应地，纵向狭槽113可被限定于轴外壳112的第一横向侧中，而纵向狭槽115可被限定于轴外壳112的相对横向侧中。
对上文进行进一步描述，凸轮致动器181能够可操作地与压接致动器188联接，使得当压接致动器188被击发螺母163朝远侧推进时，凸轮致动器181可被朝远侧推进，如图8和图10所示，直到从远侧臂190a延伸的远侧突出191a到达纵向狭槽115的远侧端部117。在此类远侧位置中，凸轮致动器181可处于完全推进位置，并且定位在接收室122内的夹140可处于完全变形或压接构型。然后，凸轮致动器181可回缩，并且端部执行器120可再次打开。更具体地讲，驱动螺钉161可以相反的方向旋转，以便将击发螺母163朝近侧运动并且使凸轮致动器181回缩，其中，在某些实例中，端部执行器120还可包括偏置构件，其能够将第一钳口123和第二钳口123b从图4中示出的闭合的或已击发的位置偏置进入图3中示出的打开的或未击发的位置。在击发螺母163从其在图10中示出的位置回缩时，从击发螺母163延伸的击发销184可接合压接致动器188的近侧臂190b并且将压接致动器188以及从其延伸的凸轮致动器181如图12所示朝近侧运动。与上文相似，从压接致动器188的近侧臂190b延伸的近侧突出191b能够接触弯曲近侧端部116的侧壁，其中侧壁可向下引导压接致动器188并使压接致动器188围绕枢轴189旋转。此时，击发销184可不再与压接致动器188接合，凸轮致动器181可完全回缩，并且击发螺母163可相对于压接致动器188继续朝近侧回缩。
对上文进行进一步描述，现在参见图11，在击发螺母163朝近侧回缩时，击发螺母163能够重新接合击发致动器168。如上所述，当击发致动器168到达纵向狭槽113的远侧端部114时，击发致动器168被向下旋转，并且，因此当击发螺母163朝近侧回缩以重新接合击发致动器168时，击发致动器168仍可处于其向下旋转位置。如图11所示，从击发螺母163延伸的击发销172可接合击发致动器168的近侧臂170b，并且随着击发螺母163进一步回缩，击发螺母163可使击发致动器168向上旋转，使得分别从臂170a和臂170b延伸的突出171a和突出171b可再次进入纵向狭槽113的纵向部分。然后，击发螺母163可回缩直到击发致动器168和从其延伸的击发构件165已返回至图5所示的其起始的或未击发的位置。在这种情况下，当击发螺母163使击发构件165朝近侧回缩时，击发构件165可从夹仓130退出，使得新夹140可通过偏置构件136偏置到夹仓130的击发室中。一旦击发构件165和击发致动器168已回缩至其起始位置，并且下一个夹140已定位于击发室内，击发驱动装置160就可以再次被致动，以便使击发螺母163和击发构件165朝远侧运动，从而将下一个夹140推进到端部执行器120中。同样，当击发螺母163再次朝远侧运动时，击发螺母163可重新致动压接驱动装置180，以便使下一个夹140变形。然后，击发螺母163可回缩，以便再次重置压接驱动装置180和击发驱动装置160。可重复该过程，直到已经将足够数量的夹140施加到靶组织上和/或直到包含在夹仓130中的夹140耗尽。在需要另外的夹140的情况下，可将已空夹仓130从轴110移除并可将包含另外的夹140的替代夹仓130插入轴110中。在一些情况下，例如，可将至少部分地耗尽的夹仓130替换为相同的或至少几乎相同的替代夹仓130，而在其他情况下，可将夹仓130替换为其中包含大于或小于五个夹140的夹仓和/或其中包含除夹140之外的夹的夹仓。
再次参见图6-9，例示的实施例的击发螺母163能够在击发螺母163与压接致动器188接合的同时脱离击发致动器168。换句话说，在压接驱动装置180被启动的同时，击发驱动装置160可被停用。在各种情况下，例如，当纵向狭槽113的远侧端部114与第二纵向狭槽115的近侧端部116对准或至少基本上对准时，可以实现此类时间安排。在例示的实施例和/或任何其他适当的实施例中，击发驱动装置160的停用与压接驱动装置180的启动之间可以存在延迟。在一些情况下，可以产生在击发构件165的击发行程的结束与凸轮致动器181的击发行程的开始之间的此类延迟，以确保夹140在被凸轮致动器181变形之前已定位于接收室122内其完全坐置的位置。在各种情况下，例如，当纵向狭槽113的远侧端部114相对于第二纵向狭槽115的近侧端部116定位在近侧时，可以产生此类延迟。在例示的实施例和/或任何其他适当的实施例中，击发驱动装置160的停用可发生在压接驱动装置180的启动之后。在一些情况下，例如，可以产生击发构件165的击发行程的结束与凸轮致动器181的击发行程的开始之间的此类重叠，以便在夹140移至接收室122内其完全坐置的位置时向夹140施加至少一些向内压力，从而减少或消除夹140与接收室122侧壁之间的相对运动。在各种情况下，例如，当纵向狭槽113的远侧端部114相对于第二纵向狭槽115的近侧端部116定位在远侧时，可以产生此类重叠。
在图1的例示的实施例和/或任何其他适当的实施例中，现在转向图17，夹仓，诸如夹仓230例如可包括定位在偏置构件136与堆叠在夹仓230内的最顶层夹140中间的推板248。推板248可以是刚性的，或至少基本上刚性的，并且可包括第一支承面，偏置构件136可对其施加偏置力。推板248还可以包括第二支承面，其可将偏置力传递至最顶层夹140的顶面145。例如，推板248可由不锈钢材料片材构成，但推板248可具有任何合适的形状并且可由任何合适的材料构成。在某些情况下，推板248可以不附接到偏置构件136上，而在其他情况下，可将推板248附连到偏置构件136上，使得推板248不会从仓外壳132脱落。在各种情况下，推板248的尺寸可设定成并可被配置成使得其不能穿过限定于仓外壳132中的近侧开口133和/或远侧开口137。
在图1的例示的实施例和/或任何其他适当的实施例中，现在转向图18和图19，夹仓，诸如夹仓330例如可包括闭锁构件，在夹仓330内包含的所有夹140都从仓330射出之后，所述闭锁构件可定位在夹仓330的击发室149内。闭锁构件可包括闭锁板348，其可定位在偏置构件136与包含在夹仓330内的最顶层夹140的顶面145的中间。使用时，对上文进行进一步描述，可将夹140依次定位在夹仓130的击发室149中，然后朝远侧将其推出夹外壳132，其中，在最后一个夹140被推出夹外壳132并且击发构件165已从夹仓130退出之后，偏置构件136可抵靠架子135偏置闭锁板348。在该位置，闭锁板348可与近侧开口133和远侧开口137对准，使得击发构件165不能进入或至少基本上不能进入夹仓130。在此类情况下，闭锁板348可阻止击发构件165进入和穿过外壳132，因此，可防止在夹仓130用完夹之后施夹器100的意外击发。在施夹器100的操作者要致动击发驱动装置160并试图将击发构件165推进到已空夹仓130中的情况下，击发构件165会接触和邻接闭锁板348，其中，在此类情况下，可在击发构件165内产生压缩负载。施夹器100还可以包括离合器，其能够当击发构件165内产生的压缩负载超过某个量或预定量时滑动并可操作地将马达与驱动螺钉161断开。除了离合器之外或代替离合器，操作击发驱动装置160的施夹器100的马达和/或马达控制器例如可包括负载传感器，其能够检测击发构件165内生成的负载，并且当击发构件165内产生的负载超过某个量或预定量时，可以切断和/或减小供应给马达的电压和/或电流。在任何情况下，闭锁板348的尺寸可设定成并可被配置成使得当击发构件165接触闭锁板348时，闭锁板348不会通过远侧开口137和/或近侧开口133脱落。为了再次使用施夹器100，施夹器100的操作者可从轴110移除已空仓330并将例如新夹仓330插入轴110中。此时，夹140可定位在新夹仓330的击发室149内，并可将击发构件165朝远侧推进到新夹仓330中，以如上所述部署夹140。
在图1的例示的实施例和/或任何其他适当的实施例中，现在参见图20和图21，夹仓，诸如夹仓430例如可包括引导件，其能够限制或约束闭锁构件在夹仓430内的运动。与上文相似，闭锁构件可包括闭锁板448，例如，其可定位在偏置构件136与包含在夹仓430的外壳432内的最顶层夹140的顶面145的中间。使用时，与上文相似，当夹140依次从夹仓430中射出时，可将闭锁板448逐渐向下推入击发室149中。闭锁板448的尺寸可设定成并可被配置成使得其被紧密地接收在仓外壳432内，并使得可限制闭锁板448与外壳432之间的相对侧向运动，以便减小或防止闭锁板448在夹仓430内发生不对准的可能性。例如，在闭锁板448将会在夹仓430内发生不对准的情况下，可将闭锁板448结合在外壳432内并防止偏置构件136向夹140的叠堆施加适当的偏置力。如图20和图21所示，闭锁板438还可以包括从其延伸的引导构件447，引导构件447可被接收在限定于仓外壳432中的引导狭槽446内。引导构件447和引导狭槽446的尺寸可设定成并可被配置成使得引导构件447被紧密地接收在引导狭槽446内，并使得可限制闭锁板438与仓外壳432之间的相对侧向运动。引导狭槽446中的每一个可由相对的侧壁445限定，所述侧壁可将其间距离限定为等于或稍大于定位在其中的引导构件447的宽度，使得引导构件447可在相对的侧壁445之间滑动，其中侧壁445在引导狭槽446的顶部443与底部444之间。因此，尽管引导构件447和引导狭槽446能够如上所述限制其间的侧向运动，但例如，引导构件447和引导狭槽446能够允许在闭锁板438与仓外壳432之间沿与供应轴线138平行或共线的预先确定的路径进行相对运动。当闭锁板438被偏置构件136推入击发室149中时，如上所述，闭锁板438可抑制击发构件165的推进和施夹器100的操作，直到将已空夹仓430替换为另一个合适的夹仓。
在图1的例示的实施例和/或任何其他适当的实施例中，如上所述，驱动螺钉161可沿第一方向旋转，以朝远侧推进击发螺母163，并可沿第二或相反方向旋转，以使击发螺母163朝近侧回缩。为了使驱动螺钉161沿第一方向和第二方向旋转，可操作地与驱动螺钉161联接的电动马达可沿相应的第一方向和第二方向进行操作。在图1的例示的实施例和/或任何其他适当的实施例中，施夹器可使用只沿第一方向操作的马达，其中马达沿此单一方向的旋转可用于朝远侧推进击发螺母并使击发螺母朝近侧回缩。现在转向图22-26，可通过传动系统550将电动马达的输出传递至驱动系统560。传动系统550可包括沿单一方向操作的输入轴552，其中传动系统550可在第一状态或构型与第二状态或构型之间切换或转换，其中在第一状态或构型时，传动系统550使驱动系统560的驱动螺钉561沿第一方向旋转，在第二状态或构型时，传动系统550使驱动螺钉561沿第二或相反的方向旋转。图22-24中示出了传动系统550的第一状态，并且图25和图26示出了传动系统550的第二状态。
再次参见图22-24，输入轴552可包括安装于其上的输入齿轮551，其可操作地与移位器齿轮553联接或啮合地接合，使得将输入轴552的旋转传递至移位器齿轮553。就上文所述的所有齿轮而言，彼此操作地联接或啮合地接合的齿轮可包括例如可将一个齿轮的旋转传递至另一个的任何合适的齿布置方式。当输入轴552沿第一方向旋转时，移位器齿轮553沿第二或相反方向旋转。在传动系统的第一状态中，移位器齿轮553位于其中移位器齿轮553操作地与中间齿轮554联接的第一位置，其中如上所述当输入齿轮551使移位器齿轮553沿第二方向旋转时，中间齿轮554沿第一方向旋转。尽管未示出，但例如中间齿轮554可被可旋转地支撑在施夹器100的轴110内。中间齿轮554还能够可操作地与安装到驱动螺钉561的输出齿轮555联接，使得可将中间齿轮554的旋转传递至输出齿轮555。如上所述，当中间齿轮554被移位器齿轮553沿第一方向驱动时，中间齿轮554可沿第二方向驱动输出齿轮555和驱动螺钉561。与上文相似，可将击发螺母563可操作地与驱动螺钉561联接并将其适当地约束在轴110内，使得当驱动螺钉561沿第二方向旋转时，击发螺母563朝远侧推进，如箭头D所指示。
与上文相似，可将击发螺母563推进至图24中所示的其最远侧位置，以便将夹140从夹仓130推进到端部执行器120中并压接夹140，如上所述。如图23和图24所示，击发螺母563还可以包括从其延伸的凸轮杆569，其能够将传动系统550从其第一状态转换成其第二状态。通过比较图24和图25，读者将会注意到，移位器齿轮553可在传动系统550处于其第一状态的第一位置与传动系统550处于其第二状态的第二位置之间运动。更具体地讲，将移位器齿轮553安装到可围绕输入轴552旋转的移位器556上，使得移位器齿轮553可从其中移位器齿轮553与输入齿轮551和中间齿轮554可操作地接合的其第一位置和其中移位器齿轮553可操作地脱离中间齿轮554的其第二位置旋转。尽管当移位器齿轮553处于其第二位置时，移位器齿轮553可操作地脱离中间齿轮554，但移位器齿轮553能够与输入齿轮551和输出齿轮555可操作地联接，以便将旋转运动从输入轴552传递至驱动螺钉561。如图24和图25所示，移位器556可包括中心孔，输入轴552可延伸穿过该中心孔；然而，移位器556可不与输入轴552可操作地接合，因此，输入轴552的旋转不会使移位器556旋转，同样，移位器556的旋转也不会使输入轴552旋转。在任何情况下，移位器556还可以包括从其延伸的凸轮从动件558，当朝远侧推进击发螺母563时，凸轮从动件558可由限定于凸轮杆569上的凸轮568接合。当凸轮568接合凸轮从动件558时，凸轮568可使移位器556和移位器齿轮553在其第一位置与其第二位置之间旋转，如上所述。
当移位器齿轮553处于其第二位置并且传动系统550处于其第二状态时，如上所述，输入轴552和驱动螺钉561均可沿第一方向旋转。更具体地讲，当输入轴552沿第一方向旋转时，其可使输入齿轮551沿第一方向旋转，并且当移位器齿轮553与输入齿轮551直接接合时，移位器齿轮553将沿第二方向旋转。读者将会注意到，当传动系统550处于其第二状态时，移位器齿轮553沿第二方向旋转，相比之下，当传动系统550处于其第一状态时，移位器齿轮553沿第一或相反方向旋转。通过比较图24和图25，对上文进行进一步描述，读者将会理解，当传动系统550处于其第二状态时，中间齿轮554不再可操作地定位在输入齿轮551与移位器齿轮553中间，从而导致不同的旋转方向。因为在移位器齿轮553处于其第二位置时，移位器齿轮553与输入齿轮551和输出齿轮555可操作地接合，所以移位器齿轮553可使输出齿轮555和联接到输出齿轮555的驱动螺钉561沿第一方向旋转。当驱动螺钉561沿第一方向旋转时，如图25和图26所示，击发螺母563可朝近侧回缩，以允许端部执行器120重新打开并使击发构件165回缩。主要参见图26，击发螺母563还可以包括从其延伸的包括凸轮566的第二凸轮杆567，所述凸轮能够在击发螺母563朝近侧回缩到其完全回缩位置时，接触移位器556的凸轮从动件558。在此类情况下，凸轮566可将移位器556推回到其第一位置并与中间齿轮554可操作地接合，使得可将传动系统550重置成其第一状态并且可以再次致动施夹器100。
如上所述，可以通过包括电动马达的外科器械系统操作施夹器100的击发驱动装置。自动外科器械系统20在图27中示出并且可包括多个可活动臂30。每个臂30可包括致动器模块32，其包括能够为施夹器100的轴110和/或任何其他合适的外科器械提供旋转运动的电动马达。现在参见图28，端部执行器620可与施夹器的致动器轴610选择性地接合和脱离，其中端部执行器620可包括可联接到轴610的远侧端部611的近侧端部621。端部执行器620的近侧端部621可包括外部外壳629、延伸穿过外部外壳629的框架、延伸穿过框架的外驱动轴和延伸穿过外驱动轴的内驱动轴。相似地，轴610的远侧端部611可包括外部外壳619、延伸穿过外部外壳619的框架663、延伸穿过框架663的外驱动轴662和延伸穿过外驱动轴662的内驱动轴661。就轴610的远侧端部611而言，框架663、外驱动轴662和内驱动轴661可各自包括从其延伸的舌状连接器613的一部分和限定于其中的连接器沟槽612的一部分，其中舌状连接器613能够被接收在限定于端部执行器620的近侧端部621中的舌状沟槽623内，并且其中舌状沟槽612能够接收从端部执行器620的近侧端部621延伸的舌状连接器622。与跨越远侧轴端部611的框架663、外驱动轴662和内驱动轴661延伸的舌状连接器613类似，舌状连接器622可跨越端部执行器620的近侧端部621的框架、外驱动轴和内驱动轴延伸。另外，与跨越远侧轴端部611的框架663、外驱动轴662和内驱动轴661延伸的舌状沟槽612类似，舌状沟槽623可跨越端部执行器620的近侧端部621的框架、外驱动轴和内驱动轴延伸。在图28所示的构型中，在轴610的舌状连接器613侧向地滑入端部执行器620的舌状沟槽623内的同时，端部执行器620的舌状连接器622可以侧向地滑入轴610的舌状沟槽612内。由于此类组装，端部执行器620的框架可被牢固地联接到轴610的框架663，端部执行器620的外驱动轴能够可操作地联接到轴110的外驱动轴662，并且端部执行器620的内驱动轴能够可操作地联接到轴110的内驱动轴661。读者将会注意到，当将端部执行器620组装到轴610时，舌状连接器612的部分彼此对准，舌状沟槽613的部分彼此对准，舌状沟槽622的部分彼此对准，并且舌状连接器623的部分彼此对准。组装好后，轴110的外驱动轴662可使端部执行器620的外驱动轴旋转，并且轴610的内驱动轴661可使端部执行器620的内驱动轴旋转。当外驱动轴662和/或内驱动轴661旋转时，舌状连接器612的所述部分、舌状沟槽613的所述部分、舌状沟槽622的所述部分和舌状连接器623的所述部分可以不再对准。为了将端部执行器620从轴610移除，可将内驱动轴661和/或外驱动轴662旋转到舌状连接器612和623以及舌状沟槽613和622充分对准的一个或多个位置。
再次参见图28，轴610的外部外壳619还可以包括止动件614，其能够在端部执行器620横向滑动到轴610的远侧端部611上时限制端部执行器620的侧向运动。止动件614可提供一个基准，通过该基准端部执行器620的内驱动轴和轴610的内驱动轴661沿纵向轴线615对准，端部执行器620的外驱动轴和轴610的其他驱动轴662沿纵向轴线615对准，并且/或者端部执行器620的框架和轴610的框架663沿纵向轴线615对准。对上文进行进一步描述，内驱动轴661可延伸到致动器模块632中，所述致动器模块可包括可操作地与内驱动轴661联接的电动马达和/或齿轮系664，其能够使内驱动轴661旋转。此外，致动器模块632可包括可操作地与第二驱动轴662接合的第二电动马达和齿轮系，其能够驱动第二驱动轴662。如下文所更详细地描述，第二电动马达可用于使端部执行器620进行关节运动。另外，对上文进行进一步描述，轴610的外部外壳619和/或框架663还可以包括安装于其上的齿轮617，其与能够使轴610和端部执行器620围绕纵向轴线615旋转的电动马达和齿轮系618可操作地接合。例如，如果电动马达和齿轮系618沿第一方向操作，那么轴610和端部执行器620可围绕轴线615沿顺时针方向旋转，而如果电动马达和齿轮系618沿第二方向操作，那么轴610和端部执行器620可围绕轴线615沿逆时针方向旋转，以便对端部执行器620进行定位和取向。
如上所述，端部执行器620可以选择性地附接到轴610上和从其拆卸。读者将会注意到，结合端部执行器620和轴610讨论的原理可同样适用于图1中所公开实施例的端部执行器120和轴110等等。
这就是说，再次参见图27，机械臂30中的一个可以选择性地与施夹器的端部执行器120或作为另外一种选择，与任何其他合适的端部执行器，诸如外科缝合器的端部执行器接合。在此类情况下，端部执行器120可以选择性地与另一个端部执行器互换，因此，单个机械臂30可用于执行不止一个功能。换句话说，施夹器100可包括可替换的加载单元，所述加载单元可被替换成另一个施夹器加载单元和/或任何其他合适的可替换加载单元，或与其互换。现在参见图29，端部执行器120和施夹器100的轴110可以与包括柄部700的外科器械系统一起使用。柄部700可包括致动器701，其可朝夹持件702运转或挤压，以便向驱动螺钉161施加旋转运动，如上所述。在一些情况下，致动器701的旋转可通过机械方式传递至驱动螺钉161，而在其他情况下，致动器701可使操作地联接到驱动螺钉161上的马达运转。
对上文进行进一步描述，端部执行器120和施夹器100的轴110可沿施夹器100的纵向轴线对准。现在转向图30，端部执行器120和/或轴110还可以包括关节运动接头101，其能够允许端部执行器120相对于施夹器100的纵向轴线进行关节运动。轴110可包括外部外壳或框架部分119，其可包括近侧端部102并可包括关节运动接头101的远侧部分。近侧端部102可包括球形或至少基本上球形的端部102，例如，其可被接收在限定于关节运动接头构件103中的球形或至少基本上球形的腔体104内。关节运动接头构件103还可以包括球形或至少基本上球形的端部105，例如，其可被接收在限定于轴框架部分106中的球形或至少基本上球形的腔体107内。轴110的近侧端部102可以至少部分地被捕获在腔体104内，使得不能轻易地将近侧端部102从腔体104移除。这就是说，近侧端部102和腔体104的尺寸可设定成并可被配置成允许近侧端部102在腔体104内沿任何合适的方向旋转。还如图30所示，施夹器100还可以包括关节运动控制装置108a和108b，例如，其可以延伸穿过关节运动接头101并可以包括分别安装在安装孔109a和109b内的远侧端部，其中安装孔109a和109b限定于轴外壳119的近侧端部102内。使用时，可以推动和/或牵拉关节运动控制装置108a和108b，以便使近侧端部102在腔体104内运动。对上文进行进一步描述，关节运动接头构件103的端部105可被至少部分地捕获在限定于轴框架部分106中的腔体107内，使得不能轻易地将端部105从腔体107中移除。这就是说，端部105和腔体107的尺寸可设定成并可被配置成当如上所述轴端部102被致动器108a和108b推动和/或牵拉时，允许端部105在腔体107内沿任何合适的方向旋转。
对上文进行进一步描述，再次参见图30，例如，可由输入轴(诸如输入轴152)旋转驱动螺钉161。输入轴152可延伸穿过限定于轴框架部分106、关节运动接头构件103和轴外壳119的近侧端部102内的孔156。输入轴152可包括安装到其远侧端部的输入齿轮151，该输入齿轮能够可操作地与安装到驱动螺钉161的近侧端部的输出齿轮155联接。使用时，如上所述，输入轴152可被电动马达旋转，其中输入轴152可使驱动螺钉161旋转。如上所述，关节运动接头101能够允许端部执行器120和轴110的至少一部分相对于由施夹器100限定的纵向轴线进行关节运动。为了适应此类运动，输入轴152的延伸穿过关节运动接头101的至少一部分可为足够柔性的。
现在参见图31-35，例如，关节运动致动器108a和108b可被致动器模块(诸如模块832)操作。主要参见图31，致动器模块832可包括可旋转的关节运动驱动装置833，其能够推动和牵拉关节运动致动器108a和108b。关节运动驱动装置833可包括圆柱形或至少基本上圆柱形的衬圈835，其包括能够在其中接收轴框架106的至少一部分的孔837，以便可旋转地支撑衬圈835。关节运动驱动装置833还可以包括输入齿轮部分834，其可与电动马达和模块832的齿轮系831可操作地联接，其中当电动马达和齿轮系831被致动时，可使关节运动驱动装置833围绕轴框架106旋转。主要参见图32和图34，关节运动驱动装置833还可以包括限定于衬圈孔837的侧壁中的两个凸轮狭槽，但读者将会注意到，提供的视图中只示出了一个凸轮狭槽835a。凸轮狭槽835a能够接收从关节运动驱动装置108a延伸的凸轮从动件838a，其中凸轮从动件838a能够在凸轮狭槽835a内滑动。当关节运动驱动装置833旋转时，例如，凸轮狭槽835a的螺旋轮廓能够朝远侧推动凸轮从动件838a或朝近侧牵拉凸轮从动件838，这取决于关节运动驱动装置833的旋转方向。由于凸轮从动件838的近侧或远侧运动，凸轮致动器108a可分别朝近侧或远侧运动。尽管未示出，但关节运动驱动装置108b可包括凸轮从动件，类似于凸轮从动件838a，其能够在上文所述的其他凸轮狭槽内滑动。其他凸轮狭槽可被配置成使得当关节运动致动器108a因关节运动驱动装置833沿第一方向旋转而被关节运动驱动装置833朝远侧驱动时，可将关节运动致动器108b朝近侧牵拉。相似地，其他凸轮狭槽可被配置成使得当关节运动致动器108a因关节运动驱动装置833沿第二方向旋转而被关节运动驱动装置833朝近侧牵拉时，可以朝远侧驱动关节运动致动器108b。主要参见图32，轴框架部分106可包括限定于其中的间隙狭槽839，凸轮致动器838可延伸穿过间隙狭槽839。尽管结合致动器模块832讨论了上述特征结构，但此类特征结构可结合本文所公开的其他致动器模块使用。
实例
施夹器加载单元可包括轴，所述轴包括远侧端部、近侧端部和框架，所述框架包括能够可释放地附接到致动器的框架的框架连接器。施夹器加载单元还可以包括多个夹和从轴的远侧端部延伸的端部执行器，其中端部执行器包括第一钳口、可运动的第二钳口以及限定于第一钳口与第二钳口之间的接收器。接收器能够接收夹，其中第二钳口可朝第一钳口运动，以使定位在接收器中的夹变形。施夹器加载单元还可以包括击发驱动装置，其包括能够将夹推进到接收器中的远侧部分和包括驱动连接器的近侧部分，所述驱动连接器能够可释放地附接到致动器的驱动装置上。
施夹器加载单元可包括轴，所述轴包括远侧端部、近侧端部、框架和轴承，所述框架包括能够可释放地附接到致动器单元的框架上并可从其拆卸的框架连接器。施夹器加载单元还可以包括多个夹和从轴的远侧端部延伸的端部执行器，其中端部执行器包括第一钳口、可相对于第一钳口运动的第二钳口，以及限定于第一钳口与第二钳口之间的接收器，其中接收器能够接收夹。施夹器加载单元还可以包括往复式旋转击发驱动装置，其包括具有螺纹的可旋转的驱动装置，其中可旋转的驱动装置被轴承可旋转地支撑，并且此外，击发螺母与可旋转的驱动装置的螺纹通过螺纹接合，其中当驱动装置沿第一方向旋转时，可将击发螺母朝远侧端部推进，其中当驱动装置沿与第一方向相反的第二方向旋转时，击发螺母可远离远侧端部回缩，并且其中击发螺母能够在击发螺母朝远侧端部推进时将夹推进到接收器中。
施夹器加载单元包括轴，所述轴包括远侧端部、近侧端部、框架以及用于可释放地将框架附接到致动器的连接装置。施夹器还可以包括多个夹和从轴的远侧端部延伸的端部执行器，其中端部执行器包括第一钳口、可运动的第二钳口和限定于第一钳口与第二钳口之间的接收器，其中接收器能够接收夹，并且其中第二钳口可朝第一钳口运动，以使定位在接收器中的夹变形。施夹器加载单元还可以包括用于将夹推进到接收器中的击发装置。
用于夹住组织的施夹器可包括轴，所述轴包括远侧部分、限定于远侧部分中的远侧开口，以及盒开口。施夹器还可以包括能够可移除地定位在盒开口中的盒组件，其中盒组件包括外壳、限定于外壳中的储存室、击发平台、可移除地定位在储存室内的多个夹，以及能够使夹朝击发平台偏置的偏置构件。施夹器还可以包括击发驱动装置，其能够将夹从盒推进穿过远侧开口。
与施夹器一起使用的盒组件可包括外壳、限定于外壳中的储存室、击发平台、可移除地定位在储存室内的多个夹，以及能够使夹朝击发平台偏置的偏置构件。
施夹器外科器械可包括具有远侧部分和仓容器的轴，以及可移除地定位在仓容器中的仓组件。仓组件可包括外壳、限定于外壳中的储存室、排放开口、可移除地定位在储存室内的夹叠堆，其中夹叠堆包括多个堆叠在彼此顶部的夹，以及能够将夹与排放开口对准的偏置构件。施夹器外科器械还可以包括击发驱动装置，其能够将夹从盒推进穿过排放开口。
与施夹器一起使用的仓组件可包括外壳、限定于外壳中的储存室、排放开口、可移除地在定位在储存室内的夹叠堆，其中夹叠堆包括堆叠在彼此顶部的多个夹，以及能够将夹与排放开口对准的偏置构件。
用于施加夹的外科装置可包括轴，所述轴包括远侧部分、限定于远侧部分中的装载口，以及排放开口。外科装置还可以包括能够可移除地定位在装载口中的夹仓，其中夹仓包括夹叠堆；能够将夹与排放开口对准的偏置构件；以及能够将夹从夹仓推进穿过排放开口的击发驱动装置。
可移除地与施夹器一起使用的夹仓可定位在施夹器的装载口中，其中夹仓可包括夹叠堆和能够将夹与排放开口对准的偏置构件。
用于施加夹的外科装置可包括轴、用于沿供应轴线供应多个夹的供应装置，和用于将夹沿击发轴线从预击发位置向已击发位置推进的击发装置，其中供应轴线横向于击发轴线。
用于夹住组织的施夹器包括轴、击发室、从轴延伸的端部执行器以及盒组件，其中端部执行器包括压接室，所述盒组件包括外壳、限定于外壳中的储存室、可移除地定位在储存室内的多个夹，以及能够依次将夹从储存室偏置到击发室内的偏置构件。施夹器还可以包括能够将定位在击发室中的夹推进到压接室中的往复式击发驱动装置，和定位在偏置构件与多个夹中间的闭锁板，其中偏置构件能够在所述多个夹全被推进到压接室中之后使闭锁板偏置到击发室中，并且其中闭锁板能够阻止击发驱动装置。
与施夹器一起使用的盒组件可包括外壳、限定于外壳中的储存室、可移除地定位在储存室内的多个夹，以及能够依次将夹从储存室偏置到击发室内的偏置构件。盒组件还可以包括定位在偏置构件与多个夹中间的闭锁板，其中偏置构件能够在所述多个夹全被从外壳推进之后使闭锁板偏置到击发室中，并且其中闭锁板能够阻止击发驱动装置进入击发室。
用于施加夹的外科装置可包括轴、具有接收器的端部执行器和仓，所述仓包括外壳、限定于外壳中的储存室、可移除地定位在储存室内的夹叠堆、击发平台，以及能够依次将夹从储存室偏置到击发平台上的偏置构件。外科装置还可以包括能够将定位在击发平台上的夹推进到接收器中的往复式击发驱动装置，以及定位在偏置构件与夹叠堆中间的闭锁构件，其中偏置构件能够在所有夹全被推进到接收器中之后使闭锁构件抵靠击发平台偏置，并且其中闭锁构件能够阻止击发驱动装置。
与施夹器一起使用的仓可包括外壳、限定于外壳中的储存室、可移除地定位在储存室内的夹叠堆、击发平台，以及能够依次将夹从储存室偏置到击发平台上的偏置构件。仓还可以包括定位在偏置构件与夹叠堆中间的闭锁构件，其中偏置构件能够在所有夹全被推出外壳之后使闭锁构件抵靠击发平台偏置，并且其中闭锁构件能够阻止击发驱动装置穿过外壳。
用于夹住组织的外科装置可包括轴、具有接收器的端部执行器和仓，所述仓包括外壳、限定于外壳中的储存室、可移除地定位在储存室内的夹叠堆、击发室，以及能够依次将夹从储存室偏置到击发室内的偏置构件。外科装置还可以包括能够在击发行程中将定位在击发室中的夹推进到接收器内的往复式击发驱动装置，和在所有夹全被推进到接收器内之后抑制击发驱动装置完成击发行程的阻止装置。
与施夹器一起使用的仓可包括外壳、限定于外壳中的储存室、可移除地定位在储存室内的夹叠堆、击发室，以及能够依次将夹从储存室偏置到击发室内的偏置构件。仓还可以包括阻止装置，其用于在所有夹全被从外壳推进之后抑制击发驱动装置完成击发行程。
可将本发明所公开的装置设计为单次使用后即进行处理，或者可将它们设计为可多次使用。然而，在任一种情况下，所述装置均可被修复，以在至少一次使用后再次使用。修复可包括如下步骤的任意组合：拆卸所述装置、然后清洗或替换特定部件以及随后重新装配。特别是，所述装置可被拆卸，而且可以任意组合选择性地替换或取出所述装置的任意数目的特定部件或部分。清洗和/或替换特定部件之后，所述装置可以在修复设施处、或者在即将进行外科手术前由手术团队重新装配以便随后使用。本领域的技术人员将了解到，装置的修复可利用多种用于拆卸、清洗/替换和重新装配的技术。此类技术的使用和所得修复装置全都在本申请的范围内。
尽管本发明已经结合某些公开的示例性实施例描述了本发明，但是可对那些示例性实施例进行多种修改和变型。例如，可采用不同类型的端部执行器。另外，在公开了用于某些部件的材料的情况下，均可使用其他材料。上述描述和以下权利要求旨在涵盖所有此类修改和变型。
公布于2011年12月13日、名称为SURGICAL CLIP APPLIER METHODS的美国专利8,075,571；公布于2011年10月18日、名称为CLIP APPLIER CONFIGURED TO PREVENT CLIPFALLOUT的美国专利8,038,686；和公布于2010年4月20日、名称为SURGICAL CLIP的美国专利7,699,860的全部公开内容据此以引用方式并入本文。
以引用方式全文或部分地并入本文的任何专利、专利公开或其他公开材料均仅在所并入的材料不与本发明所述的现有定义、陈述或其他公开材料相冲突的范围内并入本文。由此，在必要程度下，本文所明确阐述的公开内容将会取代以引用的方式并入本文中的任何相冲突的材料。如果据述以引用的方式并入本文但与本文所述现有定义、陈述或者其他公开材料相冲突的任何材料或其部分，仅在所并入的材料与现有公开材料之间不产生冲突的程度下并入本文。

Claims (21)

1.一种施夹器加载单元，该施夹器加载单元被构造成能够可释放地附接至外科器械的细长轴的远侧部分，该施夹器加载单元包括：
轴，所述轴包括：
远侧端部；
近侧端部；和
包括框架连接器的框架，所述框架连接器能够可释放地附接到所述外科器械的框架；
可替换的盒，该可替换的盒被构造成能够可释放地附接至所述施夹器加载单元，其中，所述可替换的盒包括多个夹；
端部执行器，所述端部执行器从所述轴的所述远侧端部延伸，其中所述端部执行器包括：
第一钳口；
可运动的第二钳口；和
接收器，所述接收器限定在所述第一钳口和所述第二钳口之间，其中所述接收器能够接收所述夹，并且其中所述第二钳口能够朝所述第一钳口运动，以在压接行程期间使定位在所述接收器中的所述夹变形；以及
击发驱动装置，所述击发驱动装置包括：
远侧部分，所述远侧部分能够在推进行程期间将所述夹推进到所述接收器中，其中，所述压接行程与所述推进行程是独立的、不同的行程；和
包括驱动连接器的近侧部分，所述驱动连接器能够可释放地附接到所述外科器械的驱动装置。
2.根据权利要求1所述的施夹器加载单元，其中，所述可替换的盒还包括：
外壳；
限定在所述外壳中的储存室，所述储存室能够可移除地储存所述多个夹；
击发室，其中所述击发室能够与所述击发驱动装置的所述远侧部分对准；和
偏置构件，所述偏置构件能够按顺序将所述夹从所述储存室偏置到所述击发室中。
3.根据权利要求2所述的施夹器加载单元，其中所述外壳还包括能够接收所述击发驱动装置的近侧开口。
4.根据权利要求3所述的施夹器加载单元，还包括定位在所述偏置构件和所述多个夹中间的闭锁板，其中所述偏置构件能够将所述闭锁板偏置成与所述近侧开口对准，以阻止所述击发驱动装置在所述夹已从所述可替换的盒射出之后进入所述储存室中。
5.根据权利要求2所述的施夹器加载单元，其中所述击发驱动装置能够沿击发轴线进入所述外壳中，其中所述偏置构件能够将所述夹沿供应轴线偏置到所述击发室中，并且其中所述供应轴线横向于所述击发轴线。
6.一种施夹器加载单元，包括：
轴，所述轴包括：
远侧端部；
近侧端部，其中，在所述近侧端部与所述远侧端部之间限定纵向轴线；
包括框架连接器的框架，所述框架连接器被构造成能够可释放地附接到致动器的框架；和
轴承；
多个夹，其中，每个所述夹均包括基座、自该基座延伸的至少一个腿，以及至少一个纵向面，并且其中第一夹的纵向面抵靠第二夹的纵向面定位；
端部执行器，所述端部执行器从所述轴的所述远侧端部延伸，其中所述端部执行器包括：
第一钳口；
可运动的第二钳口；和
接收器，所述接收器限定在所述第一钳口和所述第二钳口之间，其中所述接收器被构造成能够接收所述夹，并且其中所述第二钳口能够朝所述第一钳口运动，以在压接行程期间使定位在所述接收器中的所述夹变形；以及
击发驱动装置，所述击发驱动装置包括：
远侧部分，所述远侧部分被构造成能够在推进行程期间将所述夹推进到所述接收器中，其中，所述推进行程在所述压接行程开始之前停止；
包括驱动连接器的近侧部分，所述驱动连接器被构造成能够可释放地附接到所述致动器的驱动装置；
可旋转的驱动构件，所述可旋转的驱动构件由所述轴承可旋转地支撑，其中所述可旋转的驱动构件包括螺纹；以及
击发螺母，所述击发螺母通过螺纹与所述驱动构件的所述螺纹接合，其中所述击发螺母能够使得所述驱动构件的旋转将所述击发螺母朝所述轴的所述远侧端部推进，以将所述夹推进到所述接收器中。
7.根据权利要求6所述的施夹器加载单元，还包括能够使所述第二钳口朝所述第一钳口运动的压接驱动装置，其中所述压接驱动装置能够与所述击发驱动装置按顺序致动。
8.一种施夹器加载单元，包括：
轴，所述轴包括：
远侧端部；
近侧端部，其中，在所述近侧端部与所述远侧端部之间限定纵向轴线；
包括框架连接器的框架，所述框架连接器被构造成能够可释放地附接到致动器的框架；和
轴承；
多个夹，其中，每个所述夹均包括基座、自该基座延伸的至少一个腿，以及至少一个纵向面，并且其中第一夹的纵向面抵靠第二夹的纵向面定位；
端部执行器，所述端部执行器从所述轴的所述远侧端部延伸，其中所述端部执行器包括：
第一钳口；
可运动的第二钳口；和
接收器，所述接收器限定在所述第一钳口和所述第二钳口之间，其中所述接收器被构造成能够接收所述夹，并且其中所述第二钳口能够朝所述第一钳口运动，以使定位在所述接收器中的所述夹变形；
击发驱动装置，所述击发驱动装置包括：
远侧部分，所述远侧部分被构造成能够将所述夹推进到所述接收器中；
包括驱动连接器的近侧部分，所述驱动连接器被构造成能够可释放地附接到所述致动器的驱动装置；
可旋转的驱动构件，所述可旋转的驱动构件由所述轴承可旋转地支撑，其中所述可旋转的驱动构件包括螺纹；以及
击发螺母，所述击发螺母通过螺纹与所述驱动构件的所述螺纹接合，其中所述击发螺母被构造成能够使得所述驱动构件的旋转将所述击发螺母朝所述轴的所述远侧端部推进，以将所述夹推进到所述接收器中；以及
压接驱动装置，该压接驱动装置被构造成能够使所述第二钳口朝向所述第一钳口运动，其中，所述压接驱动装置被构造成能够与所述击发驱动装置按顺序被致动；
其中，所述轴还包括退动器，其中所述击发驱动装置还包括能够接合所述夹的击发构件以及与所述击发构件可操作地接合的第一致动器，其中所述击发螺母朝所述轴的所述远侧端部的推进能够使所述第一致动器和所述击发构件朝所述轴的所述远侧端部滑动，其中当所述第一致动器到达所述退动器时，所述退动器能够使所述第一致动器可操作地脱离所述击发螺母，其中所述压接驱动装置还包括第二致动器，并且其中当所述击发螺母朝所述轴的所述远侧端部推进并致动所述压接驱动装置时，所述击发螺母能够接合所述第二致动器。
9.根据权利要求8所述的施夹器加载单元，其中所述击发螺母能够在所述第一致动器已接触所述退动器之后可操作地接合所述第二致动器。
10.根据权利要求8所述的施夹器加载单元，其中所述击发螺母能够在所述第一致动器接触所述退动器的同时可操作地接合所述第二致动器。
11.根据权利要求8所述的施夹器加载单元，其中所述第二致动器定位成比所述第一致动器更靠近所述轴的所述远侧端部。
12.根据权利要求8所述的施夹器加载单元，还包括关节运动接头，所述关节运动接头可旋转地连接所述轴的所述近侧端部和所述远侧端部。
13.一种施夹器加载单元，包括：
轴，所述轴包括：
远侧端部；
近侧端部；
包括框架连接器的框架，所述框架连接器能够可释放地附接到致动器单元的框架并可从其拆卸；以及
轴承；
多个夹，其中，每个所述夹均包括基座和至少一个腿，其中每个所述夹均能定位在储存位置与击发位置之间，并且其中当所述夹定位在所述储存位置时，所述多个夹的每个所述基座定位在处于所述储存位置的另一所述夹的所述基座附近；
端部执行器，所述端部执行器从所述轴的所述远侧端部延伸，其中所述端部执行器包括：
第一钳口；
第二钳口，所述第二钳口能够相对于所述第一钳口运动；以及
接收器，所述接收器限定在所述第一钳口和所述第二钳口之间，其中所述接收器能够接收所述夹，并且其中所述第二钳口能够朝所述第一钳口运动，以在压接行程期间使定位在所述接收器中的所述夹变形；
往复式旋转击发驱动装置，所述往复式旋转击发驱动装置包括：
包括螺纹的可旋转的驱动装置，其中所述可旋转的驱动装置由所述轴承可旋转地支撑；以及
击发螺母，所述击发螺母通过螺纹与所述可旋转的驱动装置的所述螺纹接合，其中当所述驱动装置沿第一方向旋转时，所述击发螺母能够朝所述远侧端部推进，其中当所述驱动装置沿与所述第一方向相反的第二方向旋转时，所述击发螺母能够远离所述远侧端部回缩，并且其中当所述击发螺母朝所述远侧端部推进时，所述击发螺母能够在推进行程期间将所述夹推进到所述接收器中，并且其中所述推进行程在所述压接行程开始之前停止。
14.根据权利要求13所述的施夹器加载单元，还包括能够使所述第二钳口朝所述第一钳口运动的压接驱动装置，其中所述压接驱动装置能够与所述击发驱动装置按顺序致动。
15.一种施夹器加载单元，包括：
轴，所述轴包括：
远侧端部；
近侧端部；
包括框架连接器的框架，所述框架连接器被构造成能够可释放地附接到致动器单元的框架和从所述致动器单元的框架拆下；和
轴承；
多个夹，其中，每个所述夹均包括基座和至少一个腿，其中每个所述夹均能定位在储存位置与击发位置之间，并且其中当所述夹定位在所述储存位置时，所述多个夹的每个所述基座定位在处于所述储存位置的另一所述夹的所述基座附近；
端部执行器，所述端部执行器从所述轴的所述远侧端部延伸，其中所述端部执行器包括：
第一钳口；
能相对于所述第一钳口运动的第二钳口；和
接收器，所述接收器限定在所述第一钳口和所述第二钳口之间，其中所述接收器被构造成能够接收所述夹；以及
往复式旋转击发驱动装置，所述往复式旋转击发驱动装置包括：
包括螺纹的可旋转的驱动装置，其中所述可旋转的驱动装置由所述轴承可旋转地支撑；以及
击发螺母，所述击发螺母通过螺纹与所述可旋转的驱动装置的所述螺纹接合，其中当所述驱动装置沿第一方向旋转时，所述击发螺母能够朝所述远侧端部推进，其中当所述驱动装置沿与所述第一方向相反的第二方向旋转时，所述击发螺母能够远离所述远侧端部地退回，并且其中当所述击发螺母朝所述远侧端部推进时，所述击发螺母能够将所述夹推进到所述接收器中，
压接驱动装置，该压接驱动装置被构造成能够使所述第二钳口朝向所述第一钳口运动，其中，所述压接驱动装置被构造成能够与所述击发驱动装置按顺序被致动；
其中，所述轴还包括退动器，其中所述击发驱动装置还包括击发构件以及与所述击发构件可操作地接合的第一致动器，其中所述击发螺母朝所述轴的所述远侧端部的推进能够使所述第一致动器和所述击发构件朝远侧滑动，以将所述夹推进到所述接收器中，其中当所述第一致动器到达所述退动器时，所述退动器能够使所述第一致动器可操作地脱离所述击发螺母，其中所述压接驱动装置还包括第二致动器，并且其中在所述击发螺母朝所述轴的所述远侧端部推进时，所述击发螺母能够接合所述第二致动器。
16.根据权利要求15所述的施夹器加载单元，其中所述击发螺母能够在所述第一致动器已接触所述退动器之后可操作地接合所述第二致动器。
17.根据权利要求15所述的施夹器加载单元，其中所述击发螺母能够在所述第一致动器接触所述退动器的同时可操作地接合所述第二致动器。
18.根据权利要求15所述的施夹器加载单元，其中所述第二致动器定位成比所述第一致动器更靠近所述轴的所述远侧端部。
19.根据权利要求15所述的施夹器加载单元，还包括关节运动接头，所述关节运动接头可旋转地连接所述轴的所述近侧端部和所述远侧端部。
20.根据权利要求15所述的施夹器加载单元，还包括盒组件，所述盒组件包括：
外壳；
限定在所述外壳中的储存室，所述储存室能够可移除地储存所述多个夹；
击发室，其中所述击发室能够与所述击发驱动装置的所述远侧部分对准；和
偏置构件，所述偏置构件能够按顺序将所述夹从所述储存室偏置到所述击发室中。
21.一种施夹器加载单元，该施夹器加载单元被构造成能够可释放地附接至外科装置的细长轴的远侧部分，该施夹器加载单元包括：
轴，所述轴包括：
远侧端部；
近侧端部，其中，在所述近侧端部与所述远侧端部之间限定纵向轴线；
框架；以及
连接装置，所述连接装置用于将所述框架可释放地附接到所述外科装置；
盒组件，该盒组件能够可释放地附接至所述施夹器加载单元，该盒组件包括：
多个夹，其中，每个所述夹均包括沿着所述纵向轴线延伸的纵向部分，其中所述夹的每个所述纵向部分定位在另一所述夹的纵向部分附近；
外壳；
被限定在所述外壳中的储存室，该储存室被构造成能够可移除地储存所述多个夹；
击发室；和
偏置构件，该偏置构件被构造成能够在进给行程期间沿垂直于所述纵向轴线的方向将所述夹从所述储存室偏置到所述击发室中；和
端部执行器，所述端部执行器从所述轴的所述远侧端部延伸，其中所述端部执行器包括：
第一钳口；
可运动的第二钳口；以及
接收器，所述接收器限定在所述第一钳口和所述第二钳口之间，其中所述接收器能够在推进行程期间接收所述夹，其中所述推进行程在所述进给行程之后发生，并且其中所述第二钳口能够朝所述第一钳口运动，以在压接行程期间使定位在所述接收器中的所述夹变形；以及
击发装置，所述击发装置用于将所述夹推进到所述接收器中。
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