CN104640515A - 用于具有可关节运动的端部执行器的外科器械的旋转驱动轴组件 - Google Patents

用于具有可关节运动的端部执行器的外科器械的旋转驱动轴组件 Download PDF

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CN104640515A
CN104640515A CN201380044568.7A CN201380044568A CN104640515A CN 104640515 A CN104640515 A CN 104640515A CN 201380044568 A CN201380044568 A CN 201380044568A CN 104640515 A CN104640515 A CN 104640515A
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drive
drive rod
end effector
assembly
gear
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CN104640515B (zh
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F·E·谢尔顿四世
J·S·斯韦兹
J·R·摩根
J·L·斯塔门
C·O·巴克斯特三世
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Ethicon Endo Surgery Inc
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    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B23—MACHINE TOOLS; METAL-WORKING NOT OTHERWISE PROVIDED FOR
    • B23K—SOLDERING OR UNSOLDERING; WELDING; CLADDING OR PLATING BY SOLDERING OR WELDING; CUTTING BY APPLYING HEAT LOCALLY, e.g. FLAME CUTTING; WORKING BY LASER BEAM
    • B23K26/00—Working by laser beam, e.g. welding, cutting or boring
    • B23K26/36—Removing material
    • B23K26/38—Removing material by boring or cutting
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/068—Surgical staplers, e.g. containing multiple staples or clamps
    • 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
    • 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
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30—Surgical robots
    • A61B34/37—Master-slave robots
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B23—MACHINE TOOLS; METAL-WORKING NOT OTHERWISE PROVIDED FOR
    • B23K—SOLDERING OR UNSOLDERING; WELDING; CLADDING OR PLATING BY SOLDERING OR WELDING; CUTTING BY APPLYING HEAT LOCALLY, e.g. FLAME CUTTING; WORKING BY LASER BEAM
    • B23K26/00—Working by laser beam, e.g. welding, cutting or boring
    • B23K26/36—Removing material
    • B23K26/40—Removing material taking account of the properties of the material involved
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/003—Steerable
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/003—Steerable
    • A61B2017/00305—Constructional details of the flexible means
    • A61B2017/00309—Cut-outs or slits
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/003—Steerable
    • A61B2017/00305—Constructional details of the flexible means
    • A61B2017/00314—Separate linked members
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/003—Steerable
    • A61B2017/00318—Steering mechanisms
    • A61B2017/00323—Cables or rods
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/003—Steerable
    • A61B2017/00318—Steering mechanisms
    • A61B2017/00323—Cables or rods
    • A61B2017/00327—Cables or rods with actuating members moving in opposite directions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/28—Surgical forceps
    • A61B17/29—Forceps for use in minimally invasive surgery
    • A61B2017/2901—Details of shaft
    • A61B2017/2902—Details of shaft characterized by features of the actuating rod
    • A61B2017/2903—Details of shaft characterized by features of the actuating rod transferring rotary motion
    • 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
    • A61B2034/305—Details of wrist mechanisms at distal ends of robotic arms
    • A61B2034/306—Wrists with multiple vertebrae
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B23—MACHINE TOOLS; METAL-WORKING NOT OTHERWISE PROVIDED FOR
    • B23K—SOLDERING OR UNSOLDERING; WELDING; CLADDING OR PLATING BY SOLDERING OR WELDING; CUTTING BY APPLYING HEAT LOCALLY, e.g. FLAME CUTTING; WORKING BY LASER BEAM
    • B23K2103/00—Materials to be soldered, welded or cut
    • B23K2103/02—Iron or ferrous alloys
    • B23K2103/04—Steel or steel alloys
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B23—MACHINE TOOLS; METAL-WORKING NOT OTHERWISE PROVIDED FOR
    • B23K—SOLDERING OR UNSOLDERING; WELDING; CLADDING OR PLATING BY SOLDERING OR WELDING; CUTTING BY APPLYING HEAT LOCALLY, e.g. FLAME CUTTING; WORKING BY LASER BEAM
    • B23K2103/00—Materials to be soldered, welded or cut
    • B23K2103/02—Iron or ferrous alloys
    • B23K2103/04—Steel or steel alloys
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    • B23—MACHINE TOOLS; METAL-WORKING NOT OTHERWISE PROVIDED FOR
    • B23K—SOLDERING OR UNSOLDERING; WELDING; CLADDING OR PLATING BY SOLDERING OR WELDING; CUTTING BY APPLYING HEAT LOCALLY, e.g. FLAME CUTTING; WORKING BY LASER BEAM
    • B23K2103/00—Materials to be soldered, welded or cut
    • B23K2103/08—Non-ferrous metals or alloys
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    • B23K—SOLDERING OR UNSOLDERING; WELDING; CLADDING OR PLATING BY SOLDERING OR WELDING; CUTTING BY APPLYING HEAT LOCALLY, e.g. FLAME CUTTING; WORKING BY LASER BEAM
    • B23K2103/00—Materials to be soldered, welded or cut
    • B23K2103/30—Organic material
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    • B23—MACHINE TOOLS; METAL-WORKING NOT OTHERWISE PROVIDED FOR
    • B23K—SOLDERING OR UNSOLDERING; WELDING; CLADDING OR PLATING BY SOLDERING OR WELDING; CUTTING BY APPLYING HEAT LOCALLY, e.g. FLAME CUTTING; WORKING BY LASER BEAM
    • B23K2103/00—Materials to be soldered, welded or cut
    • B23K2103/50—Inorganic material, e.g. metals, not provided for in B23K2103/02 – B23K2103/26
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    • Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10T—TECHNICAL SUBJECTS COVERED BY FORMER US CLASSIFICATION
    • Y10T29/00—Metal working
    • Y10T29/49—Method of mechanical manufacture
    • Y10T29/49826—Assembling or joining

Abstract

本发明公开了用于外科器械的驱动轴组件。各种形式包括多个可运动地联锁的接头段，所述多个可运动地联锁的接头段互连以形成柔性中空管。柔性辅助约束构件能够与所述多个可运动地联锁的接头段处于柔性约束接合，以保持所述联锁的接头段处于可运动的联锁接合，同时有利于所述驱动轴组件的挠曲。

Description

用于具有可关节运动的端部执行器的外科器械的旋转驱动轴组件
背景技术
多年以来，已经开发出多种微创机器人(或“远距离外科手术”)系统以增加外科手术的灵活性，并允许外科医生以直观的方式对患者进行手术。多个此类系统公开在以下美国专利中，所述每个美国专利全文以引用方式并入本文：名称为“Articulated Surgical Instrument For PerformingMinimally Invasive Surgery With Enhanced Dexterity and Sensitivity”的美国专利5,792,135、名称为“Robotic Arm DLUS For Performing SurgicalTasks”的美国专利6,231,565、名称为“Robotic Surgical Tool WithUltrasound Cauterizing and Cutting Instrument”的美国专利6,783,524、名称为“Alignment of Master and Slave In a Minimally Invasive SurgicalApparatus”的美国专利6,364,888、名称为“Mechanical Actuator InterfaceSystem For Robotic Surgical Tools”的美国专利7,524,320、名称为“Platform Link Wrist Mechanism”的美国专利7,691,098、名称为“Repositioning and Reorientation of Master/Slave Relationship in MinimallyInvasive Telesurgery”的美国专利7,806,891以及名称为“Surgical Tool WithWrited Monopolar Electrosurgical End Effectors”的美国专利7,824,401。然而，过去的多个此类系统已不能生成有效切割和紧固组织所需量值的力。此外，现有机器人外科系统在它们可操作的不同类型的外科装置的数量方面是有限的。
附图说明
当参考以下本发明示例性实施例的下列描述并结合附图时，本发明的特征和优点以及获得它们的方式将变得更加显而易见，并且本发明自身也更易于理解，其中：
本文以举例的方式结合以下附图描述各种示例性实施例，其中：
图1为一个机器人控制器实施例的透视图；
图2为可操作地支撑多个外科工具实施例的机器人系统的一个机器人外科臂车/操纵器的透视图；
图3为图2中示出的机器人外科臂车/操纵器的侧视图；
图4为具有定位连杆的车结构的透视图，该定位连杆用于可操作地支撑可与外科工具实施例一起使用的机器人操纵器；
图5为外科工具实施例和外科端部执行器实施例的透视图；
图6为用于将各种外科工具实施例附接到机器人系统的适配器和工具夹持器布置的分解组件视图；
图7为图6中示出的适配器的侧视图；
图8为图6中示出的适配器的底视图；
图9为图6和图7的适配器的顶视图；
图10为外科工具实施例的局部底部透视图；
图11为外科工具实施例的一部分的前透视图，其中为清楚起见省略了其一些元件；
图12为图11的外科工具实施例的后透视图；
图13为图11和12的外科工具实施例的顶视图；
图14为图11-13的外科工具实施例的局部顶视图，其中可手动致动的传动齿轮处于未致动位置；
图15为图11-14的外科工具实施例的另一个局部顶视图，其中可手动致动的传动齿轮处于初始致动位置；
图16为图11-15的外科工具实施例的另一个局部顶视图，其中可手动致动的传动齿轮处于致动位置；
图17为另一个外科工具实施例的后透视图；
图18为图17的外科工具实施例的侧正视图；
图19为图5的外科工具实施例的剖面图，其中端部执行器与外科工具的近侧轴部分分离；
图20为侧透视图，示出了互连的快速断开接头实施例的一部分；
图21为快速断开接头实施例的剖面图，其中端部执行器的远侧轴部分与近侧轴部分分离；
图22为图19-21的快速断开接头实施例的另一个剖面图，其中远侧轴部分已与近侧轴部分初始接合；
图22A为快速断开接头实施例的剖面图，其中远侧轴部分已与近侧轴部分初始接合；
图23为图19-22的快速断开接头实施例的另一个剖面图，其中远侧轴部分已附接到近侧轴部分；
图23A为图22A的快速断开接头实施例的另一个剖面图，其中远侧轴部分已附接到近侧轴部分；
图23B为图22A、22B的快速断开接头实施例的另一个剖面图，其中远侧轴部分已脱离近侧轴部分；
图24为沿图21中的线24-24截取的图19-23的远侧轴部分的剖面图；
图25为关节运动接头和端部执行器实施例的一部分的剖面图；
图26为图25的关节运动接头和端部执行器的一部分的分解组件视图；
图27为图26中所示的关节运动接头和端部执行器部分的局部剖面透视图；
图28为端部执行器和驱动轴组件实施例的局部透视图；
图29为驱动轴组件实施例的局部侧视图；
图30为驱动轴组件实施例的透视图；
图31为图31的驱动轴组件的侧视图；
图32为复合驱动轴组件实施例的透视图；
图33为图33的复合驱动轴组件的侧视图；
图34为呈现弓形或“挠曲”构型的图30和31的驱动轴组件的另一个视图；
图34A为呈现弓形或“挠曲”构型的驱动轴组件实施例的侧视图；
图34B为呈现弓形或“挠曲”构型的另一个驱动轴组件实施例的侧视图；
图35为另一个驱动轴组件实施例的一部分的透视图；
图36为图35的驱动轴组件实施例的顶视图；
图37为处于弓形构型的图35和36的驱动轴组件实施例的另一个透视图；
图38为图37中所示的驱动轴组件实施例的顶视图；
图39为另一个驱动轴组件实施例的透视图；
图40为处于弓形构型的图39的驱动轴组件实施例的另一个透视图；
图41为图39和40的驱动轴组件实施例的顶视图；
图42为图41的驱动轴组件实施例的剖面图；
图43为另一个驱动轴组件实施例的局部剖面图；
图44为图43的驱动轴组件实施例的另一个剖面图；
图45为另一个驱动轴组件实施例的一部分的另一个剖面图；
图46为图45的驱动轴组件的另一个剖面图；
图47为端部执行器实施例的局部剖面透视图，其中其砧座处于打开位置；
图48为图47的端部执行器实施例的另一个局部剖面透视图；
图49为图47和48的端部执行器实施例的侧面剖面图；
图50为图47-49的端部执行器实施例的另一个侧面剖面图；
图51为图47-50的端部执行器实施例的局部剖面透视图，其中其砧座处于闭合位置；
图52为图51的端部执行器实施例的另一个局部剖面透视图；
图53为图51和52的端部执行器实施例的侧面剖面图，其中其砧座处于部分闭合位置；
图54为图51-53的端部执行器实施例的另一个侧面剖面图，其中砧座处于闭合位置；
图55为另一个端部执行器实施例以及另一个细长轴组件实施例的部分的剖面透视图；
图56为闭合系统实施例的分解透视图；
图57为图56的闭合系统实施例的侧视图，其中砧座处于打开位置；
图58为端部执行器实施例内的图57和57的闭合系统实施例的侧面剖面图，其中其砧座处于打开位置；
图59为图58的闭合系统和端部执行器实施例的另一个剖面图，其中其砧座处于闭合位置；
图59A为采用图56-59的闭合系统实施例的另一个外科工具实施例的一部分的前透视图，其中为清楚起见省略了致动螺线管；
图60为另一个端部执行器实施例的分解组件视图；
图61为驱动系统实施例的局部透视图；
图62为图61的驱动系统实施例的一部分的局部前透视图；
图63为图61和62的驱动系统实施例的一部分的局部后透视图；
图64为处于第一轴向驱动位置的图61-63的驱动系统实施例的局部剖面侧视图；
图65为处于第二轴向驱动位置的图61-64的驱动系统实施例的另一个局部剖面侧视图；
图66为端部执行器和驱动系统实施例的剖面图，其中驱动系统能够击发击发构件；
图67为端部执行器和驱动系统实施例的另一个剖面图，其中驱动系统能够旋转整个端部执行器；
图68为端部执行器实施例和关节运动接头实施例的一部分的剖面透视图；
图69为图68中所示的端部执行器和关节运动接头实施例的剖面侧视图；
图70为另一个端部执行器和驱动系统实施例的剖面图，其中驱动系统能够旋转整个端部执行器；
图71为图70的端部执行器和驱动系统实施例的另一个剖面图，其中驱动系统能够击发端部执行器的击发构件；
图72为端部执行器实施例的剖面侧视图；
图73为图72的端部执行器实施例的一部分的放大剖面图；
图74为另一个端部执行器实施例的剖面侧视图，其中其击发构件已部分地驱动通过击发行程；
图75为图74的端部执行器实施例的另一个剖面侧视图，其中击发构件已驱动至其击发行程的端部；
图76为图74和75的端部执行器实施例的另一个剖面侧视图，其中其击发构件正回缩；
图77为另一个端部执行器实施例的剖面侧视图，其中其击发构件已部分地驱动通过其击发行程；
图78为工具驱动轴实施例的一部分的分解组件视图；
图79为图77的端部执行器的另一个剖面侧视图，其中其击发构件处于其击发行程的端部；
图80为图77和78的端部执行器的另一个剖面侧视图，其中击发构件正回缩；
图81为另一个端部执行器实施例的剖面侧视图，其中击发构件处于其击发行程的端部；
图81A为工具驱动轴和轴承段实施例的分解组件视图；
图81B为另一个工具驱动轴和轴承段实施例的分解组件视图；
图82为击发构件实施例的分解组件视图；
图83为图82的击发构件的透视图；
图84为安装在示例性工具驱动轴实施例的一部分上的图82和83的击发构件的剖面图；
图85为另一个击发构件实施例的分解组件视图；
图86为另一个击发构件实施例的后透视图；
图87为图86的击发构件实施例的前透视图；
图88为外科端部执行器的击发构件、工具驱动轴、楔形滑动件组件和对齐部分的透视图；
图89为图88的击发构件、工具驱动轴、楔形滑动件组件和对齐部分的侧正视图；
图90为其中未安装钉仓的处于闭合构型的图60的外科端部执行器的剖面正视图；
图91为根据本公开的各种示例性实施例的具有击发闭锁件的外科端部执行器的底视图；
图92为处于闭合且不可操作构型的图91的外科端部执行器的底部的一部分的透视图；
图93为处于闭合且不可操作构型的图91的外科端部执行器的剖面正视图；
图94为处于打开且不可操作构型的图91的外科端部执行器的端部正视图；
图95为处于闭合且不可操作构型的图91的外科端部执行器的端部正视图；
图96为处于闭合且可操作构型的图91的外科端部执行器的正剖面图，在其中的第一组位置中具有楔形滑动件组件和对齐部分；
图97为处于闭合且可操作构型的图91的外科端部执行器的另一个端部正视图；
图98为外科端部执行器的分解透视图，其中其一些部件以剖面示出，并且为清楚起见省略了其他部件；
图99为图98中所示的偏置元件的透视图；
图100为图98中所示的端部执行器驱动外壳的透视图；
图101为图98的外科端部执行器的剖面正视图，示出了处于第二组位置的偏置元件；
图102为图98的外科端部执行器的一部分的剖面图，示出了处于不可操作位置的工具驱动轴；
图103为图98的外科端部执行器的一部分的剖面图，示出了处于第一组位置的偏置元件；
图104为图98的外科端部执行器的一部分的剖面图，示出了处于第一组位置的偏置元件并且处于可操作位置的工具驱动轴；
图105为外科器械的端部执行器的剖面透视图，所述端部执行器包括能够驱动端部执行器的击发构件的驱动螺杆；
图106A为端部执行器的第一驱动螺杆的一部分的侧视图，所述第一驱动螺杆包括第一长度，其中所述第一驱动螺杆包括单线螺纹；
图106B为图106A的第一驱动螺杆的剖面端视图；
图107A为端部执行器的第二驱动螺杆的一部分的侧视图，所述第二驱动螺杆包括第二长度，其中所述第二驱动螺杆包括双线螺纹；
图107B为图107A的第二驱动螺杆的剖面端视图；
图108A为端部执行器的第三驱动螺杆的一部分的侧视图，所述第三驱动螺杆包括第三长度，其中所述第三驱动螺杆包括三线螺纹；
图108B为图108A的第三驱动螺杆的剖面端视图；
图109A为端部执行器的第四驱动螺杆的一部分的侧视图，所述第四驱动螺杆包括第四长度，其中所述第四驱动螺杆包括四线螺纹；
图109B为图109A的第四驱动螺杆的剖面端视图；
图110为与具有驱动螺杆的端部执行器一起使用的切割刀片的分解透视图；
图111为用于将旋转从驱动轴传输至端部执行器的驱动螺杆的齿轮传动构造的透视图，其中出于说明目的，所示齿轮传动构造的多个部分已移除；
图112为另一个外科工具实施例的透视图；
图112A为图112的外科工具的端部执行器布置的透视图；
图113为图112中所示的细长轴组件和快速断开联接器布置的一部分的分解组件视图；
图114为图112和113的细长轴组件的一部分的透视图；
图115为图112-114中所示的示例性快速断开联接器布置的放大分解透视图；
图116为图112-115的快速断开联接器布置的侧正视图，其中其锁定衬圈处于解锁位置；
图117为图112-116的快速断开联接器布置的另一个侧正视图，其中其锁定衬圈处于锁定位置；
图118为另一个外科工具实施例的透视图；
图119为图118的外科工具实施例的另一个透视图；
图120为图118和119的外科工具实施例的剖面透视图；
图121为关节运动系统的一部分的剖面透视图；
图122为处于中间位置的图121的关节运动系统的剖面图；
图123为处于关节运动位置的图121和122的关节运动系统的另一个剖面图；
图124为图118-120的外科器械实施例的一部分的侧正视图，其中为清楚起见省略了其多个部分；
图125为图118-120的外科器械实施例的一部分的后透视图，其中为清楚起见省略了其多个部分；
图126为图118-120的外科器械实施例的一部分的后正视图，其中为清楚起见省略了其多个部分；
图127为图118-120的外科器械实施例的一部分的前透视图，其中为清楚起见省略了其多个部分；
图128为图118-120的外科器械实施例的一部分的侧正视图，其中为清楚起见省略了其多个部分；
图129为图118-120的外科器械实施例的示例性反向系统实施例的分解组件视图；
图130为图129的反向系统的杠杆臂实施例的透视图；
图131为图129的反向系统的刀回缩器按钮的透视图；
图132为图118-120的外科器械实施例的一部分的透视图，其中为清楚起见省略了其多个部分，并且杠杆臂与反向齿轮处于可致动的接合；
图133为图118-120的外科器械实施例的一部分的透视图，其中为清楚起见省略了其多个部分，并且杠杆臂处于未致动位置；
图134为图118-120的外科器械实施例的一部分的另一个透视图，其中为清楚起见省略了其多个部分，并且杠杆臂与反向齿轮处于可致动的接合；
图135为图118-20的外科器械实施例的柄部组件部分的一部分的侧正视图，其中移位器按钮组件运动到一位置中，从而当致动驱动轴组件时将导致端部执行器的旋转；
图136为图118-120的外科器械实施例的柄部组件部分的一部分的另一个侧正视图，其中移位器按钮组件运动到另一位置中，从而当致动驱动轴组件时将导致端部执行器中的击发构件的击发；
图137为具有可锁定关节运动接头实施例的另一个外科工具实施例的一部分的剖面图；
图138为以一种构型进行关节运动的图137的外科工具的该部分的另一个剖面图；
图139为以另一种构型进行关节运动的图137和138的外科工具的该部分的另一个剖面图；
图140为沿图137中的线140-140截取的图137中所示的关节运动锁定系统实施例的剖面；
图141为沿图140中的线141-141截取的图140的关节运动锁定系统的剖面图；
图142为沿图137中的线142-142截取的图137的外科工具的一部分的剖面图；
图143示出当第一锁定环和第二锁定环处于夹紧或锁定构型时锁定线的位置，此时端部执行器已关节运动到图138中所示的第一关节运动位置中；
图144示出当第一锁定环和第二锁定环弹跳至其各自的松开或解锁位置时锁定线的位置，此时端部执行器已关节运动到图138中所示的第一关节运动位置；
图145示出当第一锁定环和第二锁定环处于夹紧或锁定构型时锁定线的位置，此时端部执行器已关节运动到图139中所示的第二关节运动位置中；
图146示出当第一锁定环和第二锁定环弹跳至其各自的松开或解锁位置时锁定线的位置，此时端部执行器已关节运动到图139中所示的第一关节运动位置；
图147为当端部执行器已相对于细长轴组件进行关节运动时锁定线的另一个视图；
图148为另一个端部执行器实施例的剖面图，其中其砧座组件处于闭合位置；
图149为图148的端部执行器实施例的另一个剖面图；
图150为图148和149的端部执行器实施例的另一个剖面图，其中砧座组件处于闭合位置；
图151为图148-150的端部执行器实施例的另一个剖面图，示出了能够驱动击发构件的驱动传动装置；
图152为图148-151的端部执行器实施例的另一个剖面图，其中驱动传动装置能够使整个端部执行器围绕纵向工具轴线旋转；
图153为沿图148中的线153-153截取的图148-152的端部执行器的剖面图，其中驱动传动装置能够致动砧座组件；
图154为沿图148中的线154-154截取的图148-153的端部执行器的剖面图，其中驱动传动装置能够击发击发构件；
图155为沿图148中的线155-155截取的图148-154的端部执行器的剖面图，其中驱动传动装置能够致动砧座组件；
图156为沿图148中的线156-156截取的图148-155的端部执行器的剖面图；
图157为另一个端部执行器实施例的剖面透视图；
图158为图157的端部执行器的细长通道的透视图；
图159为砧座弹簧实施例的透视图；
图160为图157的端部执行器的侧面剖面图，其中在击发构件已被驱动到其最远侧位置后砧座处于闭合位置；
图161为沿图160中的线161-161截取的图160的端部执行器的一部分的剖面图；
图162为图157、160和161的端部执行器的另一个侧面剖面图，其中击发构件正回缩；
图163为沿线163-163截取的图162的端部执行器的一部分的剖面图；
图164为图157和160-163的端部执行器的另一个侧面剖面图，其中击发构件处于其最近侧位置；
图165为沿图164中的线165-165截取的图157和图160-164的端部执行器的剖面图；
图166为在螺线管已将闭合管牵拉至其最近侧位置后图157和160-165的端部执行器的另一个侧面剖面图；
图167为沿图166中的线167-167截取的图157和图160-166的端部执行器的剖面图；
图168为在砧座处于打开位置时且在螺线管已将闭合管牵拉至其最近侧位置之后图157和160-167的端部执行器的另一个侧面剖面图；
图169为在击发构件已运动到其起始位置后图157和160-168的端部执行器的另一个侧面剖面图；
图170为图157和160-169的端部执行器的另一个侧面剖面图，其中砧座组件已闭合并且击发构件准备击发；
图171为用于将远侧轴部分联接到近侧轴部分的另一个快速断开结构的局部剖面图，所述远侧轴部分可附接到端部执行器，所述近侧轴部分可联接到机器人系统的工具安装部分或联接到柄部组件；
图172为图171的快速断开结构的另一个局部剖面图；
图173为图171和172的快速断开结构的近侧轴部分的端视图；
图174为图171和172的快速断开结构的可轴向运动的锁定衬圈实施例的剖面图；
图174A为图174的锁定衬圈实施例的透视图；
图175为图171和172的快速断开结构的另一个剖面图，示出了远侧驱动轴部分与近侧驱动轴部分的初始联接；
图176为图171、172和175的快速断开结构的另一个剖面图，示出了对应关节运动缆线段的初始联接；
图177为在远侧驱动轴部分已锁定到近侧驱动轴部分后图175的快速断开结构的另一个剖面图；和
图178为在对应关节运动缆线段已锁定在一起后图176的快速断开结构的另一个剖面图。
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：
1.美国专利申请序列号_____________，名称为“Flexible DriveMember”(代理人案卷号END7131USNP/120135)。
2.美国专利申请序列号_____________，名称为“Multi-FunctionalPowered Surgical Device with External Dissection Features”(代理人案卷号END7132USNP/120136)。
3.美国专利申请序列号_____________，名称为“CouplingArrangements for Attaching Surgical End Effectors to Drive SystemsTherefor”(代理人案卷号END7133USNP/120137)。
4.美国专利申请序列号_____________，名称为“Rotary ActuatableClosure Arrangement for Surgical End Effector”(代理人案卷号END7134USNP/120138)。
5.美国专利申请序列号_____________，名称为“Surgical EndEffectors Having Angled Tissue-Contacting Surfaces”(代理人案卷号END7135USNP/120139)。
6.美国专利申请序列号_____________，名称为“InterchangeableEnd Effector Coupling Arrangement”(代理人案卷号END7136USNP/120140)。
7.美国专利申请序列号_____________，名称为“Surgical EndEffector Jaw and Electrode Configurations”(代理人案卷号END7137USNP/120141)。
8.美国专利申请序列号_____________，名称为“Multi-AxisArticulating and Rotating Surgical Tools”(代理人案卷号END7138USNP/120142)。
9.美国专利申请序列号_____________，名称为“DifferentialLocking Arrangements for Rotary Powered Surgical Instruments”(代理人案卷号END7139USNP/120143)。
10.美国专利申请序列号_____________，名称为“InterchangeableClip Applier”(代理人案卷号END7140USNP/120144)。
11.美国专利申请序列号_____________，名称为“Firing SystemLockout Arrangements for Surgical Instruments”(代理人案卷号END7141USNP/120145)。
12.美国专利申请序列号_____________，名称为“Rotary DriveArrangements for Surgical Instruments”(代理人案卷号END7143USNP/120147)。
13.美国专利申请序列号_____________，名称为“RoboticallyPowered Surgical Device With Manually-Actuatable ReversingSystem”(代理人案卷号END7144USNP/120148)。
14.美国专利申请序列号_____________，名称为“Replaceable ClipCartridge for a Clip Applier”(代理人案卷号END7145USNP/120149)。
15.美国专利申请序列号_____________，名称为“Empty ClipCartridge Lockout”(代理人案卷号END7146USNP/120150)。
16.美国专利申请序列号_____________，名称为“Surgical InstrumentSystem Including Replaceable End Effectors”(代理人案卷号END7147USNP/120151)。
17.美国专利申请序列号_____________，名称为“Rotary SupportJoint Assemblies for Coupling a First Portion of a Surgical Instrumentto a Second Portion of a Surgical Instrument”(代理人案卷号END7148USNP/120152)。
18.美国专利申请序列号_____________，名称为“ElectrodeConnections for Rotary Driven Surgical Tools”(代理人案卷号END7149USNP/120153)。
申请人还拥有下列专利申请，这些专利申请各自的全部内容均以引用方式并入：
-美国专利申请序列号13/118,259，名称为“Surgical Instrument WithWireless Communication Between a Control Unit of a Robotic Systemand Remote Sensor”，美国专利申请公布2011-0295270 A1；
-美国专利申请序列号13/118,210，名称为“Robotically-ControlledDisposable Motor Driven Loading Unit”，美国专利申请公布2011-0290855 A1；
-美国专利申请序列号13/118,194，名称为“Robotically-ControlledEndoscopic Accessory Channel”，美国专利申请公布2011-0295242；
-美国专利申请序列号13/118,253，名称为“Robotically-ControlledMotorized Surgical Instrument”，美国专利申请公布2011-0295269A1；
-美国专利申请序列号13/118,278，名称为“Robotically-ControlledSurgical Stapling Devices That Produce Formed Staples HavingDifferent Lengths”，美国专利申请公布2011-0290851 A1；
-美国专利申请序列号13/118,190，名称为“Robotically-ControlledMotorized Cutting and Fastening Instrument”，美国专利申请公布2011-0288573 A1
-美国专利申请序列号13/118,223，名称为“Robotically-ControlledShaft Based Rotary Drive Systems For Surgical Instruments”，美国专利申请公布2011-0290854 A1；
-美国专利申请序列号13/118,263，名称为“Robotically-ControlledSurgical Instrument Having Recording Capabilities”，美国专利申请公布2011-0295295 A1；
-美国专利申请序列号13/118,272，名称为“Robotically-ControlledSurgical Instrument With Force Feedback Capabilities”，美国专利申请公布2011-0290856 A1；
-美国专利申请序列号13/118,246，名称为“Robotically-DrivenSurgical Instrument With E-Beam Driver”，美国专利申请公布2011-0290853 A1；和
-美国专利申请序列号13/118,241，名称为“Surgical StaplingInstruments With Rotatable Staple Deployment Arrangements”。
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会理解，在本文中具体描述并在附图中示出的装置和方法为非限制性的示例性实施例，并且本发明的各种示例性实施例的范围仅由权利要求书限定。另外，结合一个示例性实施例进行图解说明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。
图1示出了结合图2中示出的类型的从属机械臂车20使用的主控制器12。主控制器12和从属机械臂车20以及它们各自的部件和控制系统在本文中统称为机器人系统10。此类系统和装置的实例公开于美国专利7,524,320中，所述专利以引用方式并入本文。因此，除了对理解本文公开的各种示例性实施例所需要的细节以外，本文将不详细地描述此类装置的各种细节。众所周知，主控制器12通常包括如下主控制器(在图1中一般表示为14)：在外科医生通过立体显示器16观察手术时，所述主控制器由外科医生抓持并在空间中操控。主控制器12大体包括手动输入装置，该手动输入装置优选地以多个自由度来运动并通常进一步地具有用于致动工具的可致动的柄部(例如，用于闭合握紧钳口、向电极施加电势等)。
如可在图2中看出，机械臂车20能够致动多个外科工具，一般称为30。名称为“Multi-Component Telepresence System and Method”的美国专利6,132,368中公开了使用主控制器和机械臂车布置的各种机器人外科系统和方法，该专利申请的全部公开内容以引用方式并入本文。如图所示，机械臂车20包括基座22，在例示的实施例中，所述基座支撑有三个外科工具30。外科工具30各自由一系列可手动关节运动的连杆(一般称为装置接头32)和机器人操纵器34支撑。本文示出的这些结构具有在机器人连杆的大部分之上延伸的护盖。这些护盖可以是任选的，并且可在尺寸上有所限制或完全消除，以使用于操纵此类装置的伺服机构遇到的惯性最小化、限制运动部件的体积以避免碰撞、并且限制车20的总重量。车20通常具有适于在手术室之间搬运车20的尺寸。车20能够通常适于穿过标准的手术室门并放置到标准的医院电梯上。车20将优选地具有重量并包括轮(或其他运输)系统，所述轮系统允许由单个维护人员将车20定位在手术台附近。
现在参见图3，如图所示，机器人操纵器34包括限制外科工具30的运动的连杆38。连杆38包括由旋转接头以平行四边形布置方式联接在一起的刚性连接件，使得外科工具30围绕空间40中的某一点旋转，如在美国专利5,817,084中更完整地描述，所述专利的全部公开内容以引用方式并入本文。平行四边形布置方式将旋转限制为围绕轴40a(有时称为俯仰轴)枢转。支撑平行四边形连杆的连接件枢转地安装到装置接头32(图2)上，使得外科工具30进一步围绕轴40b(有时称为偏航轴)旋转。俯仰轴40a和偏航轴40b在远程中心42处相交，所述远程中心沿外科工具30的轴44对齐。当由操纵器50支撑时，外科工具30可具有另外的从动自由度，包括外科工具30沿纵向工具轴线“LT-LT”的滑动运动。当外科工具30沿工具轴线LT-LT相对于操纵器50(箭头40c)滑动时，远程中心42相对于操纵器50的基座52保持固定。从而，使整个操纵器总体上发生运动以重新定位远程中心42。操纵器50的连杆54由一系列马达56驱动。这些马达响应于控制系统处理器的命令而主动地使连杆54运动。还采用马达56来操纵外科工具30。图4中示出了另选的装置接头结构。在该实施例中，外科工具30由两个组织操纵工具之间的另选的操纵器结构50'支撑。
其他实施例可以包含多种另选的机器人结构，包括描述于名称为“Automated Endoscope System For Optimal Positioning”的美国专利5,878,193中的那些，该专利的全部公开内容以引用方式并入本文。另外，虽然结合外科工具30和主控制器12之间的通信描述了机器人部件和机器人外科系统的处理器之间的数据通信，应当理解，类似的通信可发生在操纵器、装置接头、内窥镜或其他图像捕获装置等的电路和机器人外科系统的处理器之间，所述机器人外科系统的处理器用于部件兼容性确认、部件类型识别、部件校正(诸如偏移等)通信、部件与机器人外科系统的联接确认等。
非常适于与机器人系统10一起使用的外科工具100示于图5中。如可在图中看出，外科工具100包括外科端部执行器1000，所述端部执行器包括直线切割器。外科工具100通常包括通过工具安装部分(通常称为300)可操作地联接到操纵器50的细长轴组件200。外科工具100还包括将工具安装部分300机械联接且电联接到操纵器的接口302。在图6-10中示出了一个接口302在图6-10中所示的实施例中，工具安装部分300包括工具安装板304，所述工具安装板可操作地支撑多个(图10中示出了四个)可旋转主体部分、从动盘或从动元件306，所述从动盘或从动元件各自包括从从动元件306的表面延伸的一对销308。一个销308比相同从动元件306上的其它销308更靠近每个从动元件306的旋转轴，这有助于确保从动元件306的正向角对齐。接口302可包括能够以安装方式接合安装板304的适配器部分310，如将在下文中进一步描述。所示适配器部分310包括电连接销312阵列(图8)，其可通过工具安装部分300内的电路板联接到存储器结构。虽然结合机械耦合元件、电耦合元件和磁力耦合元件在本文描述了接口302，应当理解，在其他实施例中可使用多种遥测形式，包括红外、电感耦合等。
如可在图6-9中看出，适配器部分310通常包括工具侧314和夹持器侧316。将多个可旋转主体320安装到浮动板318，所述浮动板相对于与适配器310主表面垂直的周围适配器结构具有有限的运动范围。当沿工具安装部分外壳的侧面(未示出)的杠杆或其他闩锁结构致动时，浮动板318的轴向运动有助于使可旋转主体320从工具安装部分300脱离。其他实施例可采用其他机构/结构以用于将工具安装部分300可释放地联接到适配器310。在图6-10的实施例中，通过弹性径向构件将可旋转主体320弹性地安装到浮动板318，所述弹性径向构件围绕可旋转主体320延伸到周边凹痕中。可旋转主体320可通过偏转这些弹性结构而相对于板318轴向运动。当设置在第一轴向位置(朝工具侧314)时，可旋转主体320自由旋转而没有角度限制。然而，当可旋转主体320朝工具侧314轴向运动时，突出部322(从可旋转主体320径向延伸)侧向地接合浮动板上的棘爪以便限制可旋转主体320围绕其轴线的角旋转。当驱动销332将可旋转主体320推动至受限的旋转位置直到销332与开口334’对齐(并滑动到其中)时，可使用该受限的旋转以协助可旋转主体320与机器人系统10的对应工具夹持器部分330的驱动销332驱动地接合。可旋转主体320的工具侧314上的开口334和夹持器侧316上的开口334’能够使工具安装部分300的从动元件306(图10)与工具夹持器330的驱动元件336准确地对齐。如以上关于从动元件306的内侧和外侧销308所述，开口334和334’位于距其各自的可旋转主体306的旋转轴线不同的距离处，以确保不与其预期的位置成180度对齐。另外，开口304中的每一个略微径向伸长，以适当地接收周边方向上的销308。这允许销308在开口334内径向滑动并适应工具100和工具夹持器330之间的一些轴偏差，同时使驱动元件和从动元件之间的任何角偏差和角侧隙最小化。工具侧314上的开口334可与夹持器侧316上的开口334’(以虚线示出)偏置约90度，如可在图9中明显看出。
在图6-10的实施例中，电连接器销340阵列位于适配器310的夹持器侧316上，并且适配器310的工具侧314包括用于从工具安装部分300接收销阵列(未示出)的狭槽342(图9)。除了在外科工具100和工具夹持器330之间传输电信号之外，可通过适配器310的电路板将这些电连接件中的至少一些联接到适配器存储器装置344(图8)。
在图6-10的实施例中，采用可拆卸的闩锁布置346来将适配器310可释放地附连到工具夹持器330。如本文所用，术语“工具驱动组件”在用于机器人系统10的上下文中时至少涵盖适配器310和工具夹持器330，并且其在图6中一般统称为110。如可在图6中看出，工具夹持器330包括第一闩锁销布置337，所述第一闩锁销布置的尺寸设定成被接收在设置于适配器310中相应的连接叉狭槽311中。另外，工具保持器330还具有第二闩锁销338，所述第二闩锁销的尺寸设定成被保持在适配器310中的相应闩锁连接叉313中。参见图8。闩锁组件315被可运动地支撑在适配器310上并具有形成于其中的可从第一闩锁位置(其中闩锁销338被保持在其相应的闩锁连接叉313内)和未闩锁位置(其中连接叉317与连接叉313对齐以使得第二闩锁销338可插入到闩锁连接叉313中或从闩锁连接叉313移除)偏置的一对闩锁连接叉317。采用一个或多个弹簧(未示出)来将闩锁组件偏置到闩锁位置。适配器310的工具侧314上的唇缘可滑动地接收工具安装外壳(未示出)的侧向延伸突出部。
现在参见图5和11-16，工具安装部分300可操作地支撑多个驱动系统以用于生成操作特定类型端部执行器所需的各种形式的控制运动，所述端部执行器联接到细长轴组件200的远侧端部。如图5和11-13所示，工具安装部分300包括通常称为350的第一驱动系统，所述第一驱动系统能够接收来自机器人系统10的工具驱动组件110的相应“第一”旋转输出运动并将第一旋转输出运动转换为要施加到外科端部执行器的第一旋转控制运动。在例示的实施例中，第一旋转控制运动用于使细长轴组件200(和外科端部执行器1000)围绕纵向工具轴线LT-LT旋转。
在图5和11-13的实施例中，第一驱动系统350包括管齿轮段354，所述管齿轮段被形成在(或附接到)细长轴组件200的近侧闭合管段202的近侧端部208上。近侧管段202的近侧端部208通过安装在工具安装板304上的向前的支撑支架352被可旋转地支撑在工具安装部分300的工具安装板304上。参见图11。管齿轮段354以与第一旋转齿轮组件360啮合接合的方式被支撑，所述第一旋转齿轮组件被可操作地支撑在工具安装板304上。如可在图11中看出，旋转齿轮组件360包括第一旋转传动齿轮362，当工具安装部分300联接到工具驱动组件110时，所述第一旋转传动齿轮联接到工具安装板304的夹持器侧316上的从动盘或从动元件306中的相应第一者。参见图10。旋转齿轮组件360还包括可旋转地支撑在工具安装板304上的第一旋转从动齿轮364。第一旋转从动齿轮364与第二旋转从动齿轮366啮合接合，第二旋转从动齿轮366继而与管齿轮段354啮合接合。将来自机器人系统10的工具驱动组件110的第一旋转输出运动施加到相应的从动元件306将从而引起旋转传动齿轮362的旋转。旋转传动齿轮362的旋转最终导致细长轴组件200(和外科端部执行器1000)围绕纵向工具轴线LT-LT(图5中由箭头“R”表示)旋转。应当理解，在一个方向上施加来自工具驱动组件110的旋转输出运动将引起细长轴组件200和外科端部执行器1000围绕纵向工具轴线LT-LT在第一旋转方向上旋转，并且在相对的方向上施加旋转输出运动将引起细长轴组件200和外科端部执行器1000在与第一旋转方向相反的第二旋转方向上旋转。
在图5和11-16的实施例中，工具安装部分300还包括通常称为370的第二驱动系统，所述第二驱动系统能够接收来自机器人系统10的工具驱动组件110的相应“第二”旋转输出运动并将第二旋转输出运动转换为要施加到外科端部执行器的第二旋转控制运动。第二驱动系统370包括第二旋转传动齿轮372，当工具安装部分300联接到工具驱动组件110时，所述第二旋转传动齿轮联接到工具安装板304的夹持器侧316上的从动盘或从动元件306中的相应第二者。参见图10。第二驱动系统370还包括被可旋转地支撑在工具安装板304上的第一旋转从动齿轮374。第一旋转从动齿轮374与轴齿轮376啮合接合，所述轴齿轮可运动地且不可旋转地安装到近侧驱动轴段380上。在该例示的实施例中，轴齿轮376通过一系列轴向键槽384被不可旋转地安装到近侧驱动轴段380上，所述轴向键槽使轴齿轮376能够在近侧驱动轴段380上轴向地运动，同时与其不可旋转地附连。近侧驱动轴段380的旋转导致第二旋转控制运动传输到外科端部执行器1000。
图5和11-16的实施例中的第二驱动系统370包括用于选择性地轴向移动近侧驱动轴段380的移位系统390，从而使轴齿轮376运动到与第一旋转从动齿轮374啮合接合以及脱离与第一旋转从动齿轮374啮合接合。例如，如可在图11-13中看出，近侧驱动轴段380被支撑在第二支撑支架382内，所述第二支撑支架附接到工具安装板304，使得近侧驱动轴段380可轴向地运动并相对于第二支撑支架382旋转。在至少一种形式中，移位系统390还包括被可滑动地支撑在工具安装板304上的移位器轭392。近侧驱动轴段380被支撑在移位器轭392中并且在其上具有一对衬圈386，使得移位器轭392在工具安装板304上的移动导致近侧驱动轴段380轴向运动。在至少一种形式中，移位系统390还包括与移位器轭392可操作地交接的移位器螺线管394。移位器螺线管394接收来自机器人控制器12的控制功率，使得当启动移位器螺线管394时，移位器轭392在远侧方向“DD”上运动。
在该例示的实施例中，轴弹簧396轴颈连接在近侧驱动轴段380上在轴齿轮376与第二支撑支架382之间，以使轴齿轮376在近侧方向“PD”上偏置成与第一旋转从动齿轮374啮合接合。参见图11、13和14。第二旋转传动齿轮372响应于机器人系统10生成的旋转输出运动而进行的旋转最终导致近侧驱动轴段380和与其联接的驱动轴部件(驱动轴组件388)围绕纵向工具轴线LT-LT旋转。应当理解，在一个方向上施加来自工具驱动组件110的旋转输出运动将导致近侧驱动轴段380且最终使附接到其上的其他驱动轴部件在第一方向上旋转，并且在相反的方向上施加旋转输出运动将导致近侧驱动轴段380在与第一方向相反的第二方向上旋转。当希望近侧驱动轴段380在远侧方向“DD”上移动时，如下文将更详细讨论，机器人控制器12启动移位器螺线管390以使移位器轭392在远侧方向“DD”上移动。
图17和18示出了另一个实施例，该实施例采用了图5和11-16中所示实施例的相同部件，不同的是该实施例采用了电池供电的驱动马达400以用于向近侧驱动轴段380提供旋转驱动运动。此类结构使得工具安装部分能够生成更高的旋转输出运动和扭矩，这在采用不同形式的端部执行器时可能是有利的。如可在这些图中看出，马达400通过支撑结构402附接到工具安装板304，使得联接到马达400的传动齿轮404保持与轴齿轮376啮合接合。在图17和18的实施例中，支撑结构402能够可移除地接合形成于工具安装板304中的闩锁凹口303，所述闩锁凹口被设计成在未采用马达400时有利于外壳构件(未示出)附接到安装板304。因此，为了采用马达400，临床医生将外壳从工具安装板304移除，然后将支撑结构的腿部403插入工具安装板304的闩锁凹口303中。通过对马达400通电，使近侧驱动轴段380和附接到其上的其他驱动轴部件围绕纵向工具轴线LT-LT旋转。如图所示，马达400为电池供电的。然而，在此类结构中，马达400与机器人控制器12交接，使得机器人系统10控制马达400的启动。在另选的实施例中，马达400可通过安装在马达400自身上或工具安装部分300上的通/断开关(未示出)手动地致动。在其他实施例中，马达400可接收电力并控制来自机器人系统的信号。
图5和11-16中所示的实施例包括通常称为410的可手动致动的反向系统，以用于在马达失效或通至机器人系统的电力失去或中断的情况下手动地将反向旋转运动施加到近侧驱动轴段380。例如，当驱动轴组件388被卡住或以其他方式受到束缚而会阻止驱动轴部件在仅有马达电力的情况下发生反向旋转时，此类可手动致动的反向系统410也可尤其有用。在例示的实施例中，可机械致动的反向系统410包括传动齿轮组件412，所述传动齿轮组件可选择性地与第二旋转从动齿轮376接合并且可手动地致动以将反向旋转运动施加到近侧驱动轴段380。传动齿轮组件412包括反向齿轮414，所述反向齿轮被可运动地安装至工具安装板304。反向齿轮414可旋转地轴颈连接在枢转轴416上，所述枢转轴通过狭槽418被可运动地安装至工具安装板304。参见图12。在图5和11-16的实施例中，可手动致动的反向系统410还包括可手动致动的传动齿轮420，所述传动齿轮包括具有形成于其上的弓形齿轮段424的主体部分422。主体部分422枢转地联接到工具安装板304以便围绕与工具安装板304基本上垂直的致动器轴线A-A(图11)选择性枢转行进。
图11-14示出了处于第一未致动位置的可手动致动的反向系统410。在一个示例性形式中，致动器柄部部分426形成在主体部分422上或以其他方式附接到主体部分422。致动器柄部部分426相对于工具安装板304设定尺寸，使得在柄部部分426与工具安装板304之间建立少量过盈，以保持柄部部分426处于第一未致动位置。然而，当临床医生希望手动地致动传动齿轮组件412时，临床医生可易于通过将枢转运动施加到柄部部分426而克服过盈配合。如还可在图11-14中看出，当传动齿轮组件412处于第一未致动位置时，弓形齿轮段424脱离与反向齿轮414啮合接合。当临床医生希望将反向旋转驱动运动施加到近侧驱动轴段380时，临床医生开始将枢转棘轮运动施加到传动齿轮420。当传动齿轮420开始围绕致动轴线A-A枢转时，主体422的一部分接触反向齿轮414的一部分并且使反向齿轮414在远侧方向DD上轴向地运动，从而使驱动轴齿轮376脱离与第二驱动系统370的第一旋转从动齿轮374啮合接合。参见图15。当传动齿轮420枢转时，弓形齿轮段424与反向齿轮414啮合接合。传动齿轮420的继续棘轮运动导致反向旋转驱动运动施加到驱动轴齿轮376并最终施加到近侧驱动轴段380。临床医生可继续使传动齿轮组件412按照完全释放或使相关联的端部执行器部件反向所需的次数来多次进行棘轮运动。一旦已将所需量的反向旋转运动施加到近侧驱动轴段380，临床医生就可将传动齿轮420返回至起始或未致动位置，其中弓形齿轮段416脱离与驱动轴齿轮376啮合接合。当处于该位置时，轴弹簧396再一次将轴齿轮376偏置到与第二驱动系统370的第一旋转从动齿轮374啮合接合。
在使用中，临床医生可将控制命令输入至机器人系统10的控制器或控制单元，所述控制器或控制单元“机械地生成”输出运动，所述输出运动最终转移至第二驱动系统370的各种部件。如本文所用，术语“机械地生成”或“机械地生成的”是指通过对机器人系统马达和其他供电的驱动部件通电和控制而产生的运动。这些术语可区别于术语“可手动致动的”或“手动地生成的”，其是指临床医生采取的动作，该动作导致与由对机器人系统马达通电而生成的那些运动无关的控制运动。将机械地生成的控制运动在第一方向上施加到第二驱动系统导致第一旋转驱动运动施加到驱动轴组件388。当驱动轴组件388在第一旋转方向上旋转时，击发构件1200在远侧方向“DD”上从端部执行器1000中其起始位置朝其结束位置驱动。将机械地生成的控制运动在第二方向上施加到第二驱动系统导致第二旋转驱动运动施加到驱动轴组件388。当驱动轴组件388在第二旋转方向上旋转时，击发构件1200在近侧方向“PD”上从端部执行器1000中其结束位置朝其起始位置驱动。当临床医生希望将旋转控制运动手动地施加到驱动轴组件388时，驱动轴组件388在第二旋转方向上旋转，这导致击发构件1200在端部执行器中在近侧方向“PD”上运动。包含相同部件的其他实施例能够使得将旋转控制运动手动施加到驱动轴组件可导致驱动轴组件在第一旋转方向上旋转，这可用于辅助机械地生成的控制运动在远侧方向上驱动击发构件1200。
可用于击发、闭合和旋转端部执行器的驱动轴组件可被手动地致动和移动，从而即使在马达失效、机器人系统失去电力或发生其他电子故障的情况下，仍允许端部执行器释放并从手术部位以及腹部取出。柄部部分426的致动导致手动地生成致动或控制力，所述致动或控制力通过可手动致动的反向系统410的各种部件施加到驱动轴组件388’。如果柄部部分426处于其未致动状态，则其被偏置成脱离与反向齿轮414的可致动接合。柄部部分426的致动的开始使该偏置改变。柄部426能够按照完全释放击发构件1200和端部执行器1000所需的次数来重复致动多次。
如图5和11-16所示，工具安装部分300包括第三驱动系统430，所述第三驱动系统能够接收来自机器人系统10的工具驱动组件110的相应“第三”旋转输出运动并将第三旋转输出运动转换为第三旋转控制运动。第三驱动系统430包括第三驱动滑轮432，当工具安装部分300联接到工具驱动组件110时，所述第三驱动滑轮联接到工具安装板304的夹持器侧316上的从动盘或从动元件306中的相应第三者。参见图10。第三驱动滑轮432能够将第三旋转控制运动(响应于通过机器人系统10对其施加的相应旋转输出运动)施加到相应的第三驱动缆线434，所述第三驱动缆线可用于将各种控制或操纵运动施加到可操作地联接到轴组件200的端部执行器。如尤其可在图11和12中看出，第三驱动缆线434围绕第三驱动心轴组件436延伸。第三驱动心轴组件436枢转地安装到工具安装板304，并且第三张力弹簧438附接在第三驱动心轴组件436与工具安装板304之间以在第三驱动缆线434中保持所需量的张力。如可从图中看出，第三驱动缆线434的缆线末端部分434A围绕附接到工具安装板304的滑轮组440的上部部分延伸，并且缆线末端部分434B围绕滑轮组440上的槽轮滑轮或支座442延伸。应当理解，在一个方向上施加来自工具驱动组件110的第三旋转输出运动将导致第三驱动滑轮432在第一方向上旋转并且导致缆线末端部分434A和434B在相反的方向上运动以将控制运动施加到端部执行器1000或细长轴组件200，如下文将更详细讨论。即，当第三驱动滑轮432在第一旋转方向上旋转时，缆线末端部分434A在远侧方向“DD”上运动并且缆线末端部分434B在近侧方向“PD”上运动。第三驱动滑轮432在相反旋转方向上的旋转导致缆线末端部分434A在近侧方向“PD”上运动并且缆线末端部分434B在远侧方向“DD”上运动。
图5和11-16中所示的工具安装部分300包括第四驱动系统450，所述第四驱动系统能够接收来自机器人系统10的工具驱动组件110的相应“第四”旋转输出运动并将第四旋转输出运动转换为第四旋转控制运动。第四驱动系统450包括第四驱动滑轮452，当工具安装部分300联接到工具驱动组件110时，所述第四驱动滑轮联接到工具安装板304的夹持器侧316上的从动盘或从动元件306中的相应第四者。参见图10。第四驱动滑轮452能够将第四旋转控制运动(响应于通过机器人系统10对其施加的相应旋转输出运动)施加到相应的第四驱动缆线454，所述第四驱动缆线可用于将各种控制或操纵运动施加到可操作地联接到轴组件200的端部执行器。如尤其可在图11和12中看出，第四驱动缆线454围绕第四驱动心轴组件456延伸。第四驱动心轴组件456枢转地安装到工具安装板304，并且第四张力弹簧458附接在第四驱动心轴组件456与工具安装板304之间以在第四驱动缆线454中保持所需量的张力。第四驱动缆线454的缆线末端部分454A围绕附接到工具安装板304的滑轮组440的底部部分延伸，并且缆线末端部分454B围绕滑轮组440上的槽轮滑轮或支座462延伸。应当理解，在一个方向上施加来自工具驱动组件110的旋转输出运动将导致第四驱动滑轮452在第一方向上旋转并且导致缆线末端部分454A和454B在相反的方向上运动以将控制运动施加到端部执行器或细长轴组件200，如下文将更详细讨论。即，当第四驱动滑轮434在第一旋转方向上旋转时，缆线末端部分454A在远侧方向“DD”上运动并且缆线末端部分454B在近侧方向“PD”上运动。第四驱动滑轮452在相反旋转方向上的旋转导致缆线末端部分454A在近侧方向“PD”上运动并且缆线末端部分454B在远侧方向“DD”上运动。
如图5所示的外科工具100包括关节运动接头700。在此类实施例中，第三驱动系统430也可称为“第一关节运动驱动系统”，并且第四驱动系统450可在本文称为“第二关节运动驱动系统”。同样，第三驱动缆线434可称为“第一近侧关节运动缆线”，并且第四驱动缆线454可在本文称为“第二近侧关节运动缆线”。
图5和11-16中所示的实施例的工具安装部分300包括通常称为470的第五驱动系统，其能够使驱动杆组件490轴向地位移。驱动杆组件490包括延伸穿过近侧驱动轴段380和驱动轴组件388的近侧驱动杆段492。参见图13。第五驱动系统470包括被滑动地支撑在工具安装板304上的可运动驱动轭472。近侧驱动杆段492被支撑在驱动轭372中并且在其上具有一对保持器球394，使得驱动轭372在工具安装板304上的移动引起近侧驱动杆段492的轴向运动。在至少一个示例性形式中，第五驱动系统370还包括与驱动轭472可操作地交接的驱动螺线管474。驱动螺线管474接收来自机器人控制器12的控制功率。驱动螺线管474在第一方向上的致动将导致驱动杆组件490在远侧方向“DD”上运动，并且驱动螺线管474在第二方向上的致动将导致驱动杆组件490在近侧方向“PD”上运动。如可在图5中看出，端部执行器1000包括砧座部分，所述砧座部分可在将轴向闭合运动施加到闭合系统时在打开位置和闭合位置之间运动。在图5和11-16的例示的实施例中，采用第五驱动系统470来生成此类闭合运动。因此，第五驱动系统470也可称为“闭合驱动器”。
图5中所示的实施例包括外科端部执行器1000，所述外科端部执行器通过细长轴组件200附接到工具安装部分300。在该例示的实施例中，细长轴组件包括呈快速断开结构或接头210形式的联接结构，这有助于将轴组件200的远侧部分230快速附接到轴组件200的近侧轴部分201。快速断开接头210起到有助于快速附接和分离多个传动系部件的作用，所述多个传动系部件用于将来自驱动运动源的控制运动提供给可操作地联接到其上的端部执行器。例如，在图5和19所示的实施例中，快速断开接头210用于将端部执行器1000的远侧轴部分230联接到近侧轴部分201。
现在参见图19-23，联接结构或快速断开接头210包括近侧联接器构件212和远侧联接器构件232，所述近侧联接器构件能够可操作地支撑近侧传动系组件，所述远侧联接器构件能够可操作地支撑至少一个并且优选地多个远侧传动系组件。在图5和19的实施例中，第三驱动系统430(即，第一关节运动驱动系统)和第四驱动系统450(即，第二关节运动驱动系统)用于将关节运动动作施加到关节运动接头700。例如，第三驱动系统430用于将控制运动施加到具有缆线末端部分434A,434B的第一近侧关节运动缆线434以使端部执行器1000在第一锁定环和第二锁定环关节运动方向上围绕关节运动接头700进行关节运动。同样，第四驱动系统450用于将控制运动施加到具有缆线末端部分454A,454B的第二近侧关节运动缆线454以使端部执行器1000在第三和第四关节运动方向上进行关节运动。
参见图20，近侧联接器构件212在其中具有第一对沿直径相对的第一狭槽214和第二对沿直径相对的第二狭槽218(图20中仅可看到一个狭槽218)。第一近侧关节运动结构或连接件222被支撑在相对的第一狭槽214的每一个中。第二近侧关节运动结构或连接件226被支撑在第二狭槽218的每一个中。缆线末端部分434A延伸穿过近侧关节运动连接件222中的一者中的狭槽并附接到其上。同样，缆线末端部分434B延伸穿过另一近侧关节运动连接件222中的狭槽并附接到其上。缆线末端部分434A及其相应的近侧关节运动结构或连接件222以及缆线末端部分434B及其相应的近侧关节运动结构或连接件222统称为“第一近侧关节运动传动系组件”217。缆线末端部分454A延伸穿过近侧关节运动连接件226中的一者中的狭槽并附接到其上。缆线末端部分454B延伸穿过另一近侧关节运动连接件226中的狭槽并附接到其上。缆线末端部分454A及其相应的近侧关节运动结构或连接件226以及缆线末端部分454B及其相应的近侧关节运动结构或连接件226统称为“第二近侧关节运动传动系组件”221。
如可在图21中看出，远侧轴部分230包括支撑远侧联接器构件232的远侧外管部分231。远侧联接器构件232在其中具有第一对沿直径相对的第一狭槽234和第二对沿直径相对的第二狭槽238。参见图20。第一对远侧关节运动结构或连接件242被支撑在相对的第一狭槽234中。第二对远侧关节运动结构或连接件246被支撑在第二对狭槽238中。第一远侧缆线段444延伸穿过第一狭槽234中的一者和远侧关节运动连接件242中的一者中的狭槽以附接到其上。主要远侧缆线段445延伸穿过第一狭槽234中的另一者并且穿过另一远侧关节运动连接件242中的狭槽并附接到其上。第一远侧缆线段444及其相应的远侧关节运动连接件242以及主要远侧缆线段445及其相应的远侧关节运动连接件242统称为“第一远侧关节运动传动系组件”237。第二远侧缆线段446延伸穿过第二狭槽238中的一者和远侧关节运动连接件246中的一者中的狭槽并附接到其上。次要远侧缆线段447延伸穿过另一第二狭槽238并且穿过另一远侧关节运动连接件246中的狭槽以附接到其上。第二远侧缆线段446及其相应的远侧关节运动连接件246以及次要远侧缆线段447及其相应的远侧关节运动连接件246统称为“第二远侧关节运动传动系组件”241。
近侧关节运动连接件222中的每一个具有形成于其弹簧臂部分223上的齿状端部224。每个近侧关节运动连接件226具有形成于弹簧臂部分227上的齿状端部227’。每个远侧关节运动连接件242具有齿状端部243，所述齿状端部能够与近侧关节运动连接件222的相应一者的齿状端部224啮合地联接。每个远侧关节运动连接件246具有齿状端部247，所述齿状端部能够与相应近侧关节运动连接件226的齿状端部228啮合地联接。当近侧关节运动结构或连接件222,226分别与远侧关节运动连接件242,246啮合地连接时，第一和第二近侧关节运动传动系组件217和221分别可操作地联接到第一和第二远侧关节运动传动系组件237和241。因此，第三和第四驱动系统430,450的致动将致动运动施加到远侧缆线段444,445,446,447，如下文将更详细讨论。
在图19-23的实施例中，近侧外管段202的远侧端部250在其中具有一系列朝远侧延伸到狭槽254中的弹簧指252，所述狭槽能够在其中接收相应的弹簧臂部分223,227。参见图21(弹簧臂部分227未示于图21中但可见于图20中)。每个弹簧指252在其中具有棘爪256，当近侧关节运动连接件222,226处于中间位置(图23)时，所述棘爪适于接合形成于近侧关节运动连接件222,226中的相应凹坑258。当临床医生希望移除端部执行器1000或将端部执行器1000附接到近侧轴部分201时，第三和第四驱动系统430,450停靠在其中间未致动位置。
快速断开接头210的近侧联接器构件212和远侧联接器构件232可操作地支撑驱动构件联接组件500的相应部分，以便将近侧驱动杆段492可释放地联接到远侧驱动杆段520。近侧驱动杆段492包括近侧轴向传动系组件496，并且远侧驱动杆段520包括远侧轴向传动系组件528。驱动构件联接组件500包括驱动杆联接器或结构502，所述驱动杆联接器或结构包括接收结构或第一磁体504，例如稀土磁体等，其附接到远侧驱动杆段520的远侧端部493。第一磁体504具有形成于其中的接收腔506以用于接收第二结构或远侧磁体510。如可在图21中看出，远侧磁体510附接到渐缩安装构件512，所述渐缩安装构件附接到远侧驱动杆520的近侧端部522。
快速断开接头210的近侧联接器构件212和远侧联接器构件232可操作地支撑驱动构件联接组件500的其他相应部分，以便将近侧驱动轴段380与远侧驱动轴段540可释放地联接。至少一个示例性形式的近侧驱动轴段380包括近侧旋转传动系组件387，并且远侧驱动轴段540包括远侧旋转传动系组件548。当近侧旋转传动系组件387可操作地联接到远侧旋转传动系组件548时，驱动轴组件388被形成为将旋转控制运动传输到端部执行器1000。在例示的示例性实施例中，远侧驱动轴段540的近侧端部542具有形成于其上的多个(例如四个–图21中仅两个可见)结构或夹板指544。每个夹板指544具有形成于其上的附接夹板546，所述附接夹板的尺寸设定成被接收在近侧驱动轴段380的远侧端部部分381中的相应锁定结构或孔或狭槽383中。指544延伸穿过轴颈连接在远侧驱动轴段540的近侧端部542上的加强环545。
在图19-23中所示的实施例中，驱动构件联接组件500还包括解锁管514，以用于有助于在临床医生将端部执行器1000从外科工具100的近侧轴部分201分离时使第一和第二磁体504,510脱离。解锁管514延伸穿过近侧驱动轴段380并且其近侧端部517突出到近侧驱动轴段380的近侧端部385之外，如图19中所示。解锁管514相对于近侧驱动轴段380设定尺寸，以便在将解锁运动“UL”施加到其近侧端部517时可在其中轴向运动。柄部(未示出)附接到解锁管的近侧端部517以有利于将解锁运动“UL”手动施加到解锁管514或解锁运动“UL”。在其他方面与图19-23的实施例相同的其他实施例采用附接到工具安装板304并由机器人控制器12来供能的解锁螺线管(未示出)，或者采用附接到工具安装板的独立电池供电来施加解锁运动。
在例示的示例性实施例中，联接结构或快速断开接头210还包括外锁定衬圈260，所述外锁定衬圈滑动地轴颈连接在近侧外管部分202的远侧端部204上。外锁定衬圈260具有四个向内延伸的棘爪262，所述棘爪延伸到近侧外管部分202中的狭槽254的相应的一者中。通过参考图21-23，可理解快速断开接头210的使用。图21示出在联接在一起之前近侧轴部分201和远侧轴部分230的状况。如可在该图中看出，近侧关节运动连接件224,226的弹簧臂部分223,227分别自然径向地向外弹出。锁定衬圈260运动到其在近侧外管202上的最近侧位置，其中棘爪262在其中处于狭槽254的近侧端部。当临床医生希望将端部执行器1000附接到外科工具100的近侧轴部分201时，临床医生使远侧轴部分230与近侧轴部分201轴向对齐并联接接合，如图22中所示。如可在该图中看出，远侧磁体510坐置在驱动杆联接器502的腔506内并且磁性附接到近侧磁体504，从而将远侧驱动杆段520联接到近侧驱动杆段492。因此此类动作将远侧轴向传动系组件528可操作地联接到近侧轴向传动系组件496。此外，当轴部分201,230连接在一起时，夹板指544向内挠曲直到形成于其上的夹板546进入近侧驱动轴段380的远侧端部部分381中的锁定开口383。当夹板546坐置在其相应的锁定孔383内时，远侧驱动轴段540联接到近侧驱动轴段380。因此，此类动作从而将远侧旋转传动系组件548可操作地联接到近侧旋转传动系组件387。同样地，当使远侧联接器构件232和近侧联接器构件212以上述方式轴向对齐和接合，并且锁定衬圈260运动到其在近侧外管202上的最近侧位置时，远侧传动系组件可操作地联接到近侧传动系组件。
当临床医生希望将端部执行器1000从外科工具100的近侧轴部分201分离时，临床医生使第三和第四驱动系统430,450返回到其中间位置中。临床医生随后可使锁定衬圈260在近侧外管段202上朝近侧滑动到图22中所示的起始位置中。当处于该位置中时，近侧关节运动连接件222,226的弹簧臂部分使其齿状部分脱离远侧关节运动连接件242,246的齿状部分。临床医生随后可将解锁运动UL施加到解锁管514的近侧端部517以使解锁管514和附接到其上的解锁衬圈516在远侧方向“DD”上运动。当解锁衬圈516朝远侧运动时，其将夹板指544偏置成脱离与近侧驱动轴段380的远侧端部部分381中的相应孔383的接合，并接触渐缩安装部分512以迫使远侧磁体510脱离与近侧磁体504的磁接合。
图22A、23A和23B示出了另选的联接结构或快速断开接头组件210”，所述快速断开接头组件类似于上述快速断开接头210，不同的是采用电磁体504’来将远侧驱动杆段520联接到近侧驱动杆段492’。如可在这些图中看出，近侧驱动杆段492’是中空的以容纳导体505，所述导体从机器人系统10中的电力源延伸。导体505围绕一块铁508缠绕。当临床医生使远侧轴部分230与近侧轴部分201接合时，如图22A所示，电流可在第一方向上通过导体505，以使磁体504’吸引磁体510与之联接接合，如图23A中所示。当临床医生希望将端部执行器1000从外科工具100的近侧轴部分201分离时，临床医生使第三和第四驱动系统430,450返回到其中间位置中。临床医生随后可使锁定衬圈260在近侧外管段202上朝近侧滑动到图22A中所示的起始位置中。当处于该位置中时，近侧关节运动连接件222,226的弹簧臂部分使其齿状部分脱离远侧关节运动连接件242,246的齿状部分。临床医生可随后将解锁运动UL施加到解锁管514的近侧端部517以使解锁管514和附接到其上的解锁衬圈516在远侧方向“DD”上运动。此外，电流可在相反的方向上通过导体505以使电磁体504’排斥磁体510以有助于分离轴段。当临床医生朝远侧运动解锁管时，解锁衬圈516将夹板指544偏置成脱离与近侧驱动轴段380的远侧端部部分381中的相应孔383的接合，并接触渐缩安装部分512以进一步分离轴段。
上述联接结构或快速分离接头组件可提供多个优点。例如，此类结构可采用单个释放/接合运动，而不会处于半接合状态。此类接合运动可用于同时可操作地联接若干传动系组件，其中至少一些传动系组件提供不同于由其他传动系组件提供的控制运动的控制运动。例如，一些传动系可提供旋转控制运动并且可纵向地移动以提供轴向控制运动，并且一些传动系只可提供旋转或轴向控制运动。其他传动系组件可提供推/拉运动以用于操作各种端部执行器系统/部件。该独特而新颖的锁定衬圈布置确保远侧传动系组件锁定到其相应的近侧传动系组件或它们被解锁并可从其分离。当锁定在一起时，所有传动系组件均被锁定衬圈径向地支撑，从而阻止任何解联接。
图5和11-16中所示的外科工具100包括关节运动接头700，所述关节运动接头分别与第三和第四驱动系统430,450协作以便使端部执行器1000围绕纵向工具轴线“LT”进行关节运动。关节运动接头700包括近侧承窝管702，所述近侧承窝管附接到远侧外管部分231的远侧端部233并限定其中的近侧球承窝704。参见图25。近侧球构件706可运动地坐置在近侧球承窝704内。如可在图25中看出，近侧球构件706具有中心驱动通道708，所述中心驱动通道使远侧驱动轴段540能够延伸穿过其中。此外，近侧球构件706在其中具有四个关节运动通道710，所述关节运动通道有利于远侧缆线段444,445,446,447通过其中。如可在图25中进一步看出，关节运动接头700还包括中间关节运动管段712，所述中间关节运动管段具有形成于其中的中间球承窝714。中间球承窝714能够在其中可运动地支撑形成于端部执行器连接器管720上的端部执行器球722。远侧缆线段444,445,446,447延伸穿过形成于端部执行器球722中的缆线通道724，并通过被接收在端部执行器球722的相应通道728内的耳状物726附接到其上。可采用其他附接结构以用于将远侧缆线段444,445,446,447附接到端部执行器球722。
通常称为740的独特而新颖的旋转支撑接头组件示于图26和27中。所示旋转支撑接头组件740包括呈基本上圆柱形的端部执行器驱动外壳1010的连接器部分1012。第一环形座圈1014形成于圆柱形连接器部分1012的周边。旋转支撑接头组件740还包括形成于端部执行器连接器管720中的远侧承窝部分730，如图26和27所示。远侧承窝部分730相对于圆柱形连接器部分1012设定尺寸，使得连接器部分1012可在承窝部分730内自由旋转。第二环形座圈732形成于远侧承窝部分730的内壁731中。穿过远侧承窝730提供窗口733，所述窗口与其中的第二环形座圈732连通。如还可在图26和27中看出，旋转支撑接头组件740还包括环状轴承734。在各种示例性实施例中，环状轴承734包括塑性可变形、基本上圆形的环，所述环在其中具有切口735。切口在环状轴承734中形成自由端736,737。如可在图26中看出，环状轴承734具有处于其自然非偏置状态的基本上环形的形状。
为了将外科端部执行器1000(例如，外科器械的第一部分)联接到关节运动接头700(例如，外科器械的第二部分)，将圆柱形连接器位置1012插入远侧承窝部分730中以使第二环形座圈732与第一环形座圈1014基本上对准。然后将环状轴承的自由端736,737中的一者穿过端部执行器连接器管720的远侧承窝部分730中的窗口733插入对准的环形座圈1014,732中。为了有利于容易插入，窗口或开口733具有形成于其上的渐缩表面738。参见图26。环状轴承734基本上旋转到适当位置，并且由于其趋于形成圆形或环形，其往往在安装后不趋于穿过窗口733退出。一旦环状轴承734已插入对准的环形座圈1014,732中，端部执行器连接器管720就将可旋转地附连至端部执行器驱动外壳1010的连接器部分1012。此类结构使端部执行器驱动外壳1010能够相对于端部执行器连接器管720围绕纵向工具轴线LT-LT旋转。环状轴承734变成端部执行器驱动外壳1010随后在其上旋转的轴承表面。任何侧面加载均试图使环状轴承734变形，所述环状轴承被两个联锁座圈1014,732支撑和约束，从而防止损坏环状轴承734。应当理解，此类采用环状轴承734的简单而有效的接头组件在可旋转部分1010,730之间形成高度光滑的接口。如果在组装期间允许自由端736,737中的一者突出穿过窗口733之外(参见例如图27)，则可通过将环状轴承构件732通过窗口733取出来拆卸旋转支撑接头组件740。旋转支撑接头组件740允许轻松的组装和制造，同时还提供良好的端部执行器支撑，而且有利于对其旋转操纵。
关节运动接头700有利于端部执行器1000围绕纵向工具轴线LT进行关节运动。例如，当希望如图5所示那样使端部执行器1000在第一方向“FD”上进行关节运动，机器人系统10可对第三驱动系统430供电，使得第三驱动心轴组件436(图11-13)在第一方向上旋转，从而使近侧缆线末端部分434A并最终使远侧缆线段444在近侧方向“PD”上牵拉，并释放近侧缆线末端部分434B和远侧缆线段445，从而使端部执行器球722在承窝714内旋转。同样，为了使端部执行器1000在与第一方向FD相反的第二方向“SD”上进行关节运动，机器人系统10可对第三驱动系统430供电，使得第三驱动心轴组件436在第二方向上旋转，从而使近侧缆线末端部分434B并最终使远侧缆线段445在近侧方向“PD”上拉动，并释放近侧缆线末端部分434A和远侧缆线段444，从而使端部执行器球722在承窝714内旋转。当希望使端部执行器1000在如图5所示的第三方向“TD”上进行关节运动时，机器人系统10可对第四驱动系统450供电，使得第四驱动心轴组件456在第三方向上旋转，从而使近侧缆线末端部分454A并最终使远侧缆线段446在近侧方向“PD”上拉动，并释放近侧缆线末端部分454B和远侧缆线段447，从而使端部执行器球722在承窝714内旋转。同样，为了使端部执行器1000在与第三方向TD相反的第四方向“FTH”上进行关节运动，机器人系统10可对第四驱动系统450供电，使得第四驱动心轴组件456在第四方向上旋转，从而使近侧缆线末端部分454B并最终使远侧缆线段447在近侧方向“PD”上拉动，并释放近侧缆线末端部分454A和远侧缆线段446，从而使端部执行器球722在承窝714内旋转。
图5和11-16中所示的端部执行器实施例采用旋转和纵向运动，所述旋转和纵向运动从工具安装部分300传输通过细长轴组件以用于致动。用于将此类旋转和纵向运动(例如，扭转、拉伸和压缩运动)传输到端部执行器的驱动轴组件是相对柔性的，以有利于端部执行器围绕关节运动接头进行关节运动。图28和29示出了另选的驱动轴组件600，其可结合图5和11-16中所示的实施例或其他实施例一起使用。在采用快速断开接头210的图5中所示实施例中，近侧驱动轴段380包括驱动轴组件600的一段，并且远侧驱动轴段540相似地包括驱动轴组件600的另一段。驱动轴组件600包括驱动管602，所述驱动管具有在其中切割出的一系列环形接头段604。在该例示的实施例中，驱动管602包括近侧驱动轴段380的远侧部分。
驱动管602包括具有形成于其中的一系列环形接头段604的中空金属管(不锈钢、钛等)。环形接头段604包括多个松散联锁的燕尾形状606，其例如由激光在驱动管602中切割出，并用于促进邻接接头段604之间的柔性运动。参见图29。管材的此类激光切割形成柔性中空驱动管，其可用于压缩、拉伸和扭转。此类结构采用完全对径的切口，其经由“拼图块”构型与相邻部分联锁。然后这些切口沿中空驱动管的长度以阵列的形式重复，并且有时会被“时控的”或旋转以改变拉伸或扭转性能。
图30-34示出了另选的示例性微环形接头段604’，其包括多个激光切口形状606’，所述形状大致类似于松散联锁的、相对的“T”形状以及其中具有凹口部分的T形状。环形接头段604,604’基本上包括多个微关节运动扭转接头。即，每个接头段604,604’可传输扭矩，同时有利于每个环形接头段之间的相对关节运动。如图30和31中所示，驱动管602的远侧端部603上的接头段604D’具有远侧安装衬圈部608D，所述远侧安装衬圈部有利于附接到快速断开接头的部分或用于致动端部执行器的其他驱动部件等，并且驱动管602的近侧端部605上的接头段604P’具有近侧安装衬圈部608P’，所述近侧安装衬圈部有利于附接到其他近侧驱动部件或快速断开接头的多个部分。
每个特定驱动轴组件600的接头到接头运动范围可通过增加激光切口中的间距而增加。例如，为了确保接头段604’保持联接在一起而不显著削弱驱动管在所需运动范围内进行关节运动的能力，采用了辅助约束构件610。在图32和33中所示的实施例中，辅助约束构件610包括弹簧612或其他螺旋缠绕构件。在各种示例性实施例中，弹簧612的远侧端部614对应于远侧安装衬圈部608D并且比弹簧612的中心部分616更紧密地缠绕。相似地，弹簧612的近侧端部618比弹簧612的中心部分616更紧密地缠绕。在其他实施例中，约束构件610以所需节距安装在驱动管602上，使得约束构件还充当例如柔性驱动螺纹，以用于通过螺纹接合端部执行器和/或控制系统上的其他螺纹控制部件。还应当理解，约束构件可以具有可变节距这样的方式安装，以在驱动轴组件旋转时实现所需旋转控制运动的传输。例如，约束构件的可变节距布置方式可用于增强打开/闭合和击发运动，这将得益于不同于相同旋转运动的线性行程。在其他实施例中，例如，驱动轴组件包括中空柔性驱动轴上的可变节距螺纹，所述中空柔性驱动轴可围绕90度弯曲推动和牵拉。在其他实施例中，辅助约束构件包括围绕驱动管602外部或周边施加的弹性体管或涂层611，如图34A中所示。在另一个实施例中，例如，弹性体管或涂层611’安装在形成于驱动管602内的中空通道613中，如图34B中所示。
此类驱动轴布置包括复合扭转驱动轮轴，这允许优异的负载传输，同时有利于所需关节运动的轴向范围。参见例如图34和34A-B。即，这些复合驱动轴组件允许大的运动范围，同时保持将扭转在两个方向上传输的能力以及有利于拉伸和压缩控制运动传输穿过其中。此外，此类驱动轴布置的中空性质有利于其他控制部件从中穿过，同时提供改善的拉伸负载。例如，一些其他实施例包括延伸穿过驱动轴组件的柔性内部缆线，所述柔性内部缆线可有助于接头段的对齐，同时促进通过驱动轴组件来施加拉伸运动的能力。此外，此类驱动轴布置制造和组装相对容易。
图35-38示出驱动轴组件600’的段620。该实施例包括接头段622,624，所述接头段从管材材料(例如，不锈钢、钛、聚合物等)被激光切割出。接头段622,624保持松散地附接在一起，因为切口626是径向的并且在一定程度上渐缩。例如，耳状物部分628中的每一个具有渐缩外周边部分629，其被接收在具有渐缩内壁部分的承窝630内。参见例如图36和38。因此，不需要将接头段622,624附接在一起的组件。如可在图中看出，接头段622具有在其每个端部切割出的相对的枢转耳状物部分628，所述枢转耳状物部分枢转地接收在形成于相邻接头段624中的相应承窝630中。
图35-38示出驱动轴组件600’的小段。本领域的普通技术人员应当理解，耳状物/承窝可贯穿驱动轴组件的整个长度切割出。即，接头段624可具有在其中切割出的相对的承窝630以有利于与邻接接头段622的连接而使驱动轴组件600’的长度完整。此外，接头段624具有在其中切割出的成角度的末端部分632以有利于接头段624相对于接头段622进行关节运动，如图37和38中所示。在例示的实施例中，每个耳状物628具有关节运动停止部分634，其适于接触形成于接头段622中的相应关节运动停止部636。参见图37和图38。可在其他方面与段620相同的其他实施例未提供有关节运动停止部分634和停止部636。
如上文所指出，每个特定驱动轴组件的接头到接头运动范围可通过增加激光切口中的间距而增加。在此类实施例中，为了确保接头段622,624保持联接在一起而不显著削弱驱动管在所需运动范围内进行关节运动的能力，采用了呈弹性体套管或涂层640形式的辅助约束构件。其他实施例采用本文所公开的其他形式的约束构件及其等效结构。如可在图35中看出，接头段622,624能够围绕由枢转耳状物628和相应承窝630限定的枢转轴线“PA-PA”枢转。为了获得扩大的关节运动范围，驱动轴组件600’可围绕工具轴线TL-TL旋转，同时围绕枢转轴线PA-PA枢转。
图39-44示出了另一个驱动轴组件600”的段640。驱动轴组件600”包括多段驱动系统，所述多段驱动系统包括多个互连的接头段642，所述多个互连的接头段形成柔性中空驱动管602”。接头段642包括球式连接器部分644和承窝部分648。每个接头段642可通过例如金属注塑成型“MIM”制成，并且可由17-4、17-7、420不锈钢制成。其他实施例可由300或400系列不锈钢、6065或7071铝或钛加工而成。其他实施例可由例如塑料填充或未填充尼龙、Ultem、ABS或聚碳酸酯或聚乙烯模塑而成。如可在图中看出，球式连接器644为六边形形状。即，球式连接器644具有形成于其上的六个弓形表面646并且适于可旋转地接收在类似形状的承窝650中。每个承窝650具有由六个平坦表面654形成的六边形形状的外部部分652和径向形状的内部部分656。参见图42。每个接头段642在结构上是相同的，不同的是形成驱动轴组件600的远侧和近侧端部的最终接头段的承窝部分能够与相应控制部件可操作地配合。每个球式连接器644在其中具有中空通道645，其配合以形成穿过中空柔性驱动管602”的中空通道603。
如可在图43和44中看出，互连的接头段642容纳在约束构件660内，所述约束构件包括由例如柔性聚合物材料制成的管或套管。图45示出延伸穿过互连的接头段642的柔性内芯构件662。内芯构件662包括由聚合物材料制成的实心构件或由柔性聚合物材料制成的中空管或套管。图46示出了另一个实施例，其中约束构件660和内芯构件662两者均被采用。
驱动轴组件600”有利于通过可变半径关节运动接头传输旋转和平移运动。驱动轴组件600”的中空性质为附加控制部件或拉伸元件(例如，柔性缆线)提供空间以有利于拉伸和压缩负载传输。然而，在其他实施例中，接头段624不提供穿过驱动轴组件的中空通道。在此类实施例中，例如，球式连接器部分为实心的。经由六边形表面的边缘来转移旋转运动。较严格的容差可允许更大的负载能力。利用穿过驱动轴组件600”的中心线的缆线或其他拉伸元件，整个驱动轴组件600”可被旋转成弯曲，推动和牵拉而不限制运动范围。例如，驱动轴组件600”可形成弓形驱动路径、直线驱动路径、螺线型驱动路径等。
图5和47-54示出了一个外科端部执行器1000，其可有效地与机器人系统10一起使用。端部执行器1000包括直线切割器1002，所述直线切割器具有第一钳口1004以及可相对于第一钳口1004选择性地运动的第二钳口1006。在图5和47-54中所示的实施例中，第一钳口1004包括呈细长通道1020形式的支撑构件1019，其能够在其中可操作地支撑钉仓1030。第二钳口1006包括砧座组件1100。如可在图47、49、53和55中看出，砧座组件1100包括在其上具有钉成形表面1104的砧座主体1102。砧座主体1102具有通道1106，所述通道适于与细长通道1020中的安装孔1022对准。枢轴销或耳轴销(未示出)穿过孔1022和通道1104插入，以将砧座1100枢转地联接到细长通道1020。此类结构允许砧座组件1100围绕基本上横向于纵向工具轴线“LT-LT”(图48)的闭合轴线“CA-CA”在打开位置与闭合位置之间选择性地枢转，在打开位置中，钉成形表面1104远离钉仓1040的仓平台1044间隔开(图47-50)，在闭合位置(图51-54)中，砧座主体1102上的钉成形表面1104相对于仓平台1042成面对关系。
图5和47-54的实施例采用闭合组件1110，所述闭合组件能够接收来自第五驱动系统470的打开运动和闭合运动。第五驱动系统470用于轴向地推进和回缩驱动杆组件490。如上所述，驱动杆组件490包括近侧驱动杆段492，所述近侧驱动杆段与驱动螺线管474可操作地交接以从其接收轴向控制运动。近侧驱动杆段492通过驱动杆联接器502联接到远侧驱动杆段520。远侧驱动杆段520在一定程度上是柔性的，以有利于端部执行器1000围绕关节运动接头700进行关节运动，还有利于闭合运动和打开运动穿过其中轴向传输。例如，远侧驱动杆段520可包括缆线或钛、不锈弹簧钢或镍钛诺的层合结构。
闭合组件1110包括枢转地附接到细长通道1020的闭合连杆1112。如可在图48、51和52中看出，闭合连杆1112在其中具有开口1114，远侧驱动杆段520的远侧端部524延伸穿过所述开口。球526或其他结构附接到远侧驱动杆段520，从而将远侧驱动杆段520的远侧端部524附接到闭合连杆1112。闭合组件1110还包括一对凸轮盘1120，该对凸轮盘可旋转地安装在细长通道1020的侧面上。一个凸轮盘1120被可旋转地支撑在细长通道1020的一个侧面上并且另一个凸轮盘1120被可旋转地支撑到细长通道1020的另一个侧面。参见图60。一对枢转连接件1122附接在每个凸轮盘1120与闭合连杆1112之间。因此，通过驱动杆组件490使闭合连杆1112枢转行进将导致凸轮盘1120旋转。每个凸轮盘1120还具有从其突起的致动器销1124，所述致动器销可滑动地接收在砧座主体1102的相应凸轮狭槽1108中。
现在将描述第二钳口1006或砧座组件1100的致动。图47-50示出了处于打开位置的砧座组件1100。在端部执行器1000已相对于待切割和缝合的组织定位后，机器人控制器12可在第一或远侧方向“DD”上启动驱动螺线管474，这最终导致驱动轭472的远侧运动，从而引起驱动杆组件490在远侧方向“DD”上运动。驱动杆组件490的此类运动导致远侧驱动杆段520的远侧运动，从而引起闭合连杆1112从打开位置枢转至闭合位置(图51-54)。闭合连杆1112的此类运动引起凸轮盘1120在“CCW”方向上旋转。当凸轮盘在“CCW”方向上旋转时，致动器销1124与其各自的凸轮狭槽1108之间的相互作用引起砧座组件1100枢转闭合在靶组织上。为了释放靶组织，启动驱动螺线管474以在近侧方向“PD”上牵拉驱动杆组件490，这导致闭合连杆1112反向枢转行进到打开位置，从而最终引起砧座组件1100枢转回到打开位置。
图55-59示出了用于将打开运动和闭合运动施加到砧座1100的另一个闭合系统670。如可在图56中看出，例如，闭合系统670包括第一安装块或构件672，其可旋转地支撑第一闭合杆段680。第一闭合杆段680具有基本上半圆形的剖面形状。第一闭合杆段680的近侧端部682在其上具有第一球式连接器684，所述第一球式连接器被可旋转地支撑在形成于安装块672中的第一安装承窝673内。为了有利于通过关节运动接头700使端部执行器1000进行关节运动，第一闭合杆段680还具有与关节运动接头700重合的第一齿状部分686，如图58和59中所示。闭合系统670还包括第二安装块或构件674，其可旋转地支撑第二闭合杆段690。第二闭合杆段690具有基本上半圆形的剖面形状。第二闭合杆段690的近侧端部692在其上具有第二球式连接器694，所述第二球式连接器被可旋转地支撑在形成于第二安装块674中的第二安装承窝675内。为了有利于通过关节运动接头700使端部执行器1000进行关节运动，第二闭合杆段690还具有与关节运动接头700重合的第二齿状部分696，如图58和59中所示。
如还可在图56中看出，闭合系统670还具有第一枢转连接件676，所述第一枢转连接件附接到第一闭合杆段680的远侧端部682。第一枢转连接件676具有形成于其上的第一枢转耳状物677，所述第一枢转耳状物能够被可旋转地支撑在形成于第一闭合杆段680的远侧端部682中的第一承窝683内。此类结构允许第一枢转连接件676相对于第一闭合杆段680旋转。同样，第二枢转连接件678附接到第二闭合杆段690的远侧端部691，使得第二枢转连接件可相对于其旋转。第二枢转连接件678具有形成于其上的第二枢转耳状物1679，所述第二枢转耳状物能够延伸穿过第一枢转耳状物677中的开口以被可旋转地支撑在第二闭合杆段690的远侧端部1691中的第二承窝692内。此外，如可在图56中看出，第一和第二枢转连接件676,678彼此通过第二枢转连接件678上的键716可运动地键接，所述键被可滑动地接收在第一枢转连接件676中的狭槽717内。在至少一个实施例中，第一枢转连接件676通过第一连杆臂687附接到凸轮盘1120中的每一个，并且第二枢转连接件678通过第二连杆臂688附接到凸轮盘1120中的每一个。
在例示的实施例中，闭合系统670通过驱动螺线管474来致动。驱动螺线管474能够与第一和第二安装块672,674中的一者可操作地交接以向其施加轴向闭合运动和打开运动。如可在图56-59中看出，此类驱动结构还可包括第一枢转连接件与齿轮组件695，其通过延伸到第一枢转连接件与齿轮组件695中的狭槽696中的销685可运动地附接到第一安装块672。相似地，第二枢转连接件与齿轮组件697通过延伸到第二枢转连接件与齿轮组件697中的狭槽698中的销685可运动地附接到第二安装块674。第一枢转连接件与齿轮组件695具有可旋转地安装到其上的第一锥齿轮699A，并且第二枢转连接件与齿轮组件697具有可旋转地附接到其上的第二锥齿轮699B。第一和第二锥齿轮699A,699B被安装成与可旋转地安装在工具安装板302上的惰轮齿轮689啮合接合。参见图59A。因此，当使第一安装块672在远侧方向“DD”上推进(这也导致第一闭合杆段680和第一枢转连接件676在远侧方向DD上运动)时，锥齿轮689,699A,699B将导致第二闭合杆690和第二枢转连接件678在近侧方向“PD”上运动。同样，当使第一安装块672在近侧方向“PD”上推进(这也导致第一闭合杆段680和第一枢转连接件676在近侧方向PD上运动)时，锥齿轮689,699A,699B将导致第二闭合杆690和第二枢转连接件678在远侧方向“DD”上运动。
图58示出了处于打开位置的砧座1100。如可在该图中看出，第一闭合杆680略微邻近第二闭合杆690。为了闭合砧座，对驱动螺线管474供电以使第一闭合杆680在远侧方向“DD”上轴向地推进。此类动作引起第一枢转连接件676和第一连杆臂687使凸轮盘1120在逆时针“CCW”方向上旋转，如图59中所示。此类动作还导致第二闭合杆690的运动为近侧方向，从而引起第二枢转连接件678和第二连杆臂688也在逆时针“CCW”方向上牵拉凸轮盘1120。为了打开砧座，驱动螺线管474将轴向控制运动施加到第一安装块672以使第一和第二控制杆段680,690返回到图58中所示的位置。
图60中所示的端部执行器实施例1000包括通常称为748的驱动结构，其有利于将旋转控制运动选择性施加到端部执行器1000。端部执行器1000包括击发构件1200，所述击发构件通过螺纹轴颈连接在工具驱动轴1300上。如可在图61中看出，工具驱动轴1300具有形成于其上的轴承段1304，所述轴承段被可旋转地支撑在轴承套管1011中。工具驱动轴1300具有工具传动齿轮1302，所述工具传动齿轮与通常称为750的旋转传动装置可操作地啮合，所述旋转传动装置与细长通道1020可操作地交接，并且由细长轴组件200的一部分可操作地支撑。在一个示例性形式中，旋转传动装置750包括差速联锁组件760。如可在图64和65中看出，差速联锁组件760包括差速外壳762，所述差速外壳能够相对于端部执行器驱动外壳1010选择性地旋转并且随端部执行器外壳1010一起旋转。
远侧驱动轴段540附接到太阳齿轮轴752，所述太阳齿轮轴具有附接到其上的太阳齿轮754。因此，太阳齿轮754将在远侧驱动轴段540旋转时旋转。太阳齿轮754也将与远侧驱动轴段540一起轴向地运动。差速联锁组件760还包括多个行星齿轮764，所述多个行星齿轮可旋转地附接到差速外壳762。在至少一个实施例中，例如，采用三个行星齿轮764。每个行星齿轮764与形成于端部执行器驱动外壳1010内的第一端部执行器环形齿轮1016啮合接合。在图60所示的例示的示例性实施例中，端部执行器驱动外壳1010通过一对相对的附接耳状物1018(图60中仅可见一个附接耳状物1018)不可旋转地附接到细长通道1020的相应附接狭槽1024(图60中仅可见一个附接狭槽1024)中，所述附接狭槽形成于细长通道1020的近侧端部1021中。可采用将端部执行器驱动外壳1010不可运动地附接到细长通道1020的其他方法，或者端部执行器驱动外壳1010可与细长通道1020一体形成。因此，端部执行器驱动外壳1010的旋转将导致端部执行器1000的细长通道1020的旋转。
在图61-65中所示的实施例中，差速联锁组件760还包括形成于差速外壳762内的第二环形齿轮766以用于与太阳齿轮754啮合接合。差速联锁组件760还包括形成于差速外壳762中的第三环形齿轮768，所述第三环形齿轮与工具传动齿轮1302啮合接合。差速外壳762在端部执行器驱动外壳1010内的旋转将最终导致工具传动齿轮1302以及附接到其上的工具驱动轴1300的旋转。
当临床医生希望使端部执行器1000围绕关节运动接头700远侧的纵向工具轴线LT-LT旋转以将端部执行器定位在相对于靶组织的期望方向上时，机器人控制器12可启动移位器螺线管394以轴向地运动近侧驱动轴段380，使得太阳齿轮754运动到图65、67和70中所示的“第一轴向”位置。如上文详细描述，远侧驱动轴段540通过快速断开接头210可操作地联接到近侧驱动轴段380。因此，近侧驱动轴段380的轴向运动可导致远侧驱动轴段540和太阳齿轮轴752以及太阳齿轮754的轴向运动。如上文进一步描述，移位系统390控制近侧驱动轴段380的轴向运动。当处于第一轴向位置时，太阳齿轮754与行星齿轮764和第二环形齿轮766啮合接合，从而导致在太阳齿轮754旋转时行星齿轮764和差速外壳762作为一个单元而旋转。
近侧驱动轴段380的旋转通过第二驱动系统370来控制。近侧驱动轴段380的旋转导致远侧驱动轴段540、太阳齿轮轴752和太阳齿轮754的旋转。差速外壳762和行星齿轮764作为一个单元的此类旋转将旋转运动施加到端部执行器驱动外壳1010，该旋转运动具有足够的量级以克服端部执行器驱动外壳1010与中间关节运动管712的远侧承窝部分730之间的第一摩擦量F1，从而引起端部执行器驱动外壳1010以及附接到其上的端部执行器1000围绕纵向工具轴线“LT-LT”相对于远侧承窝管730旋转。因此，当处于此位置时，端部执行器驱动外壳1010、差速外壳762和行星齿轮764全部作为一个单元一起旋转。由于工具轴1300由轴承套管1011支撑在端部执行器驱动外壳中，工具轴1300也随端部执行器驱动外壳1010一起旋转。参见图61。因此，端部执行器驱动外壳1010和端部执行器1000的旋转不会导致工具驱动轴1300的相对旋转，该相对旋转会导致击发构件1200的位移。在例示的示例性实施例中，关节运动接头700远侧的端部执行器1000的此类旋转不会导致整个细长轴组件200的旋转。
当希望将旋转驱动运动施加到工具驱动轴1300以用于驱动端部执行器1000内的击发构件1200时，太阳齿轮754轴向地定位在“第二轴向”位置以脱离第二环形齿轮766，同时啮合接合行星齿轮764，如图61、62、64和66中所示。因此，当希望旋转工具驱动轴1300时，机器人控制器12启动移位器螺线管394以将太阳齿轮754轴向地定位成与行星齿轮764啮合接合。当处于该第二轴向或“击发位置”时，太阳齿轮754仅啮合接合行星齿轮764。
近侧驱动轴段380的旋转可通过第二驱动系统370来控制。近侧驱动轴段380的旋转导致远侧驱动轴段540、太阳齿轮轴752和太阳齿轮754的旋转。当太阳齿轮754在第一击发方向上旋转时，行星齿轮764也旋转。当行星齿轮764旋转时，它们也引起差速外壳762旋转。差速外壳762的旋转引起工具轴1300旋转，这是由于工具传动齿轮1302与第三环形齿轮768啮合接合。因为端部执行器驱动外壳1010与中间关节运动管712的远侧承窝部分730之间存在摩擦量F1，行星齿轮764的旋转不会导致端部执行器外壳1010相对于中间关节运动管712的旋转。因此，驱动轴组件的旋转导致工具驱动轴1300的旋转而不会使整个端部执行器1000旋转。
此类独特而新颖的旋转传动装置750包括单个驱动系统，所述单个驱动系统可选择性地旋转端部执行器1000或击发击发构件1200，取决于旋转驱动轴的轴向位置。可由此类结构提供的一个优点是其简化了必须横贯关节运动接头700的驱动。其也将中心驱动平移至细长通道1020的基部，使得工具驱动轴1300可存在于钉仓1040下以驱动击发构件1200。端部执行器可在关节运动接头的远侧能够旋转的能力可极大地改善相对于靶组织定位端部执行器的能力。
如上所指出的，当驱动轴组件定位在第一轴向位置时，驱动轴组件的旋转可导致整个端部执行器1000在关节运动接头700的远侧上旋转。当驱动轴组件定位在第二轴向位置(在一个实例中，邻近第一轴向位置)时，驱动轴组件的旋转可导致工具驱动轴1300的旋转。
图64和65中所示的旋转传动装置实施例包括差速锁定系统780，所述差速锁定系统能够将驱动轴组件保持在第一和第二轴向位置。如可在图64和65中看出，差速锁定系统780包括太阳齿轮轴752中与驱动轴组件的第一轴向位置对应的第一保持结构756以及太阳齿轮轴752中与驱动轴组件的第二轴向位置对应的第二保持结构758。在例示的示例性实施例中，第一保持结构包括太阳齿轮轴752中的第一径向锁定沟槽757，并且第二保持结构758包括形成于太阳齿轮轴752中的第二径向锁定沟槽759。第一和第二锁定沟槽757,759与至少一个弹簧偏置的锁定构件784协作，当驱动轴组件分别处于第一和第二轴向位置时，所述至少一个弹簧偏置的锁定构件适于保持接合锁定沟槽757,759。锁定构件784具有渐缩顶端786并被可运动地支撑在差速外壳762内。可采用径向波形弹簧782来将偏置力施加到锁定构件784，如图63中所示。当驱动轴组件轴向地运动到第一位置中时，锁定构件784卡合到与第一径向锁定沟槽7576接合。参见图65。当驱动轴组件轴向地运动到第二轴向位置中时，锁定构件784卡合到与第二径向锁定沟槽759接合。参见图64。在另选的实施例中，第一和第二保持结构可包括例如凹坑，所述凹坑与锁定构件784中的每一个对应。同样在另选的实施例中，其中驱动轴组件可轴向地定位在不止两个轴向位置中，可采用与那些轴向位置中的每一个对应的附加保持结构。
图70和71示出另选的差速锁定系统790，其能够确保驱动轴组件被锁定在多个预先确定的轴向位置中的一者中。差速锁定系统790能够确保驱动轴组件可定位在第一和第二轴向位置中的一者中，并且不会意外地定位在另一个轴向位置中，在该轴向位置中，驱动系统不能正确操作。在图70和71中所示的实施例中，差速锁定系统790包括附接到驱动轴组件的多个锁定弹簧792。每个锁定弹簧792与由尖峰部分798分隔的第一和第二锁定谷794,796一起形成。锁定弹簧792被定位成与形成于差速外壳762上的尖锁定构件763协作。因此，当尖锁定构件763坐置在第一锁定谷794中时，驱动轴组件保持在第一轴向位置中，并且当尖锁定构件763坐置在第二锁定谷796中时，驱动轴组件保持在第二轴向位置中。第一与第二锁定谷794,796之间的尖峰部分798确保驱动轴组件处于第一和第二轴向位置中的一者中并且不会停止在这两个轴向位置之间的轴向位置中。如果需要附加的轴向位置，则锁定弹簧可提供有与所需轴向位置对应的附加锁定谷。
参见图60、72和73，推力轴承1030被支撑在细长通道1020中的支架1026内。工具驱动轴1300的远侧端部部分1306被可旋转地接收在推力轴承1030内并且突起穿过其中。保持衬圈1032被固定或以其他方式附连到如图73所示的远侧端部1030，以完成安装。以这种方式使用推力轴承1030可使得当击发构件1200在细长通道1020内从起始位置击发到结束位置时其能够被“牵拉”。此类结构可最小化在高负载状况下工具驱动轴1300屈曲的风险。该独特而新颖的安装结构以及推力轴承1030的位置可产生随砧座负载而增加的坐置负载，这进一步增加了端部执行器稳定性。此类安装结构可基本上用于在高负载击发周期期间使工具驱动轴1300受到张力。这可避免需要驱动系统齿轮来旋转工具驱动轴1300同时抵抗轴1300的屈曲。保持衬圈1032的使用也可使结构易于制造和组装。当击发构件1200从起始位置驱动到结束位置时，击发构件1200能够接合砧座并将砧座保持在距仓平台的所需距离处。在该结构中，例如，当击发构件1200组件朝远侧顺着细长通道1020向下运动时，砧座的类似于悬臂梁的部分的长度变得更短且更硬，从而使细长通道1020的远侧端部处出现的向下负载的量级增加，进一步增加轴承坐置负载。
利用旋转驱动构件来击发、闭合、旋转等的优点之一可包括使用驱动轴的高机械优点来适应完成那些器械任务所需的高负载的能力。然而，当采用此类旋转驱动系统时，可能希望追踪驱动轴被驱动的旋转数量以在驱动轴或可运动端部执行器部件在远侧方向上被驱动的太远的情况下，避免驱动螺杆和其他器械部件的灾难性故障或损坏。因此，包括旋转驱动轴的一些系统在过去采用编码器来追踪马达旋转或采用传感器来监测可运动部件的轴向位置。编码器和/或传感器的使用需要附加接线、电子器件和处理电力来适应此类系统，这可导致器械成本增加。另外，系统的可靠性可能在一定程度上难以预测并且其可靠性取决于软件和处理器。
图74-76示出了机械行程限制系统1310，以用于在将击发构件1200从起始位置驱动到结束位置时限制击发构件1200的线性行程。行程限制系统1310采用工具驱动轴1300’，其中工具驱动轴1300’上的螺纹1308不延伸到驱动轴1300’的远侧端部部分1306。例如，如可在图74-76中看出，工具驱动轴1300’包括非螺纹区段1309。击发构件1200具有主体部分1202，所述主体部分具有一系列内螺纹1204，所述内螺纹适于通过螺纹与工具驱动轴1300’上的螺纹1308交接，使得当工具驱动轴1300’在第一击发方向上旋转时，击发构件1200在远侧方向“DD”上驱动直到其接触非螺纹区段1309，在此时击发构件1200停止其远侧推进。即，击发构件1200将朝远侧推进直到击发构件1200中的内螺纹1204脱离工具驱动轴1300’中的螺纹1308。工具驱动轴1300’在第一方向上的任何进一步旋转将不导致击发构件1200的进一步远侧推进。参见例如图75。
所示的示例性机械行程限制系统1310还包括远侧偏置构件1312，当击发构件1200已被推进到其远侧行程的端部(即，击发构件将不再随工具驱动轴在第一旋转方向上的旋转而朝远侧推进)时，所述远侧偏置构件能够被击发构件1200接触。在图74-76中所示的实施例中，例如，偏置构件1312包括定位在如图所示的细长通道1020内的片簧1314。图74示出了在被击发构件1200接触之前的片簧1314，并且图75示出了在被击发构件1200接触之后处于压缩状态的片簧1314。当处于该位置时，片簧1314用于将击发构件1200在近侧方向“PD”上偏置以当工具驱动轴1300’在第二回缩方向上旋转时使击发构件1200中的内螺纹1204能够重新接合工具驱动轴1300’。在工具驱动轴1300’在第二回缩方向上旋转时，击发构件1200在近侧方向上回缩。参见图76。
图77-80示出另一个行程限制系统1310’。行程限制系统1310’采用两部分工具驱动轴1300”。例如，在至少一个形式中，工具驱动轴1300”包括在其远侧端部1322中具有承窝1324的近侧工具驱动轴段1320，以及具有从其近侧端部1332突起的耳状物1334的远侧驱动轴段1330。耳状物1334的尺寸和形状被设定成被接收在承窝1324内，使得近侧驱动轴段1320上的螺纹1326与远侧驱动轴段1330上的螺纹1336协作形成一个连续驱动螺纹1340。如可在图77、79和80中看出，远侧驱动轴段1330的远侧端部1338延伸穿过推力轴承1032，所述推力轴承被可运动地支撑在细长通道1020的远侧端部1023中。即，推力轴承1032可在细长通道1020内轴向运动。远侧偏置构件1342被支撑在细长通道1020内以用于与推力轴承1032接触。图78示出了当工具驱动轴1300”在第一旋转方向上驱动时击发构件1200在远侧方向“DD”上驱动。图79示出了处于其行程的远侧端部的击发构件1200。工具驱动轴1300”在第一旋转方向上的进一步旋转引起推力轴承1032压缩偏置构件1342并且还允许远侧轴段1330在近侧段1320继续转动时滑动。近侧和远侧工具驱动轴段1320,1330之间的此类滑动阻止击发构件1200进一步朝远侧推进，击发构件1200进一步朝远侧推进最终会损坏器械。然而，在第一旋转运动已中止之后，偏置构件1342用于将远侧轴段1320在近侧方向上偏置，使得耳状物1334坐置在承窝1324中。然后，工具轴1300”在第二旋转方向上的旋转导致击发构件1200在近侧方向“PD”上的运动，如图80所示。
图81示出了另一个行程限制系统1310”。在该实施例中，工具驱动轴1300具有形成于其上的耳状物1350，所述耳状物的尺寸和形状设定成被接收在轴承段1304中的承窝1352内，所述轴承段具有形成于其上或以其他方式附接到其上的工具传动齿轮1302。图81A和81B示出了不同的耳状物1350’(图81A)和1350”(图81B)，所述耳状物能够分别可释放地接合相应的承窝1352’和1352”。当击发构件1200已到达其行程的端部时，片簧1314被定位成被击发构件1200接触。工具驱动轴1300的进一步旋转将导致耳状物1350,1350’,1350”分别滑出承窝1352,1352’,1352”，从而阻止工具轴1300的进一步旋转。一旦中止将旋转运动施加到工具驱动轴1300，片簧1314就会将偏置运动施加到击发构件1200，以最终将工具驱动轴1300在近侧方向“PD”上偏置，从而将耳状物1350坐置在承窝1352中。工具驱动轴1300在第二旋转方向上的旋转将导致击发构件1200在近侧方向“PD”上回缩到起始位置。一旦击发构件1200已返回到起始位置，砧座1100随后可被打开。
在例示的示例性实施例中，击发构件1200能够在击发构件1200朝远侧推进穿过端部执行器时接合砧座1100以明确地将砧座与钉仓间隔开，从而确保闭合钉适当成形，尤其是当夹紧的组织的量不足以做到这点时。能够接合砧座并将砧座与钉仓或细长通道间隔开并且可用于该实施例和其他实施例中的其他形式的击发构件公开于名称为“Surgical Stapling InstrumentIncorporating an E-beam Firing Mechanism”的美国专利6,978,921中，所述专利的公开内容全文以引用方式并入本文。如可在图82和83中看出，击发构件1200的主体部分1202包括底脚部分1206，所述底脚部分向上接合细长通道1020中的通道狭槽1028。参见图60。相似地，刀片主体包括一对侧向突起的上部翅片1208。当随着砧座1100闭合而被击发时，上部翅片1208在纵向砧座狭槽1103内朝远侧推进，所述纵向砧座狭槽朝远侧延伸穿过砧座1100。砧座1100中的任何微量的向上偏转均可通过由上部翅片1208施加的朝下的力来克服。
一般来讲，闭合和推进击发构件即“击发”击发构件所需的负载可设想超过200lbs。然而，此类力要求可能需要击发构件中的内螺纹1204包括动力型螺纹构型的相对细的螺纹诸如梯形螺纹(Acme threads)。此外，为了向上部翅片1208提供足够的支撑以在击发构件1200朝远侧驱动穿过端部执行器时避免击发构件1200受束缚，可能希望击发构件中的至少5-15线螺纹在任何给定时间与工具驱动轴上的螺纹接合。然而，常规制造方法可能不适合在0.08英寸-0.150英寸直径开口内在击发构件主体1202中形成足够的螺纹且所述螺纹具有足够螺纹深度。
图82-84示出了击发构件1200’，所述击发构件可解决上述挑战中的至少一些。如可在这些图中看出，击发构件的主体部分1202’具有延伸穿过其中的中空轴承窝1210，所述中空轴承窝的尺寸设定成穿过其中接收工具轴。该实施例中的内螺纹通过一系列杆1214形成，所述杆横向地延伸穿过如图所示的轴承窝1210中的孔1212。如可在图84中看出，销1214搁置在工具驱动轴1300上的螺纹1308的节距的小直径上。
图85示出了另一个击发构件1200”，所述击发构件也可解决上述的制造挑战中的至少一些。如可在该图中看出，击发构件100”的主体部分1202”具有延伸穿过其中的中空轴承窝1210，所述中空轴承窝的尺寸设定成穿过其中接收工具轴。一对窗口1216形成于主体部分1202”中，如图所示。该实施例中的内螺纹1220形成于插头1218上，所述插头插入窗口1216中并通过焊接、粘合剂等附接在其中。图86和87示出了另一个击发构件1200”，其中通过形成于主体部分1202”中的进入窗口1230A,1230B实现进入到承窝1210中。例如，穿过承窝部分1210的一侧提供一对进入窗口1230A以使内螺纹段1232能够形成于承窝1210的相对壁内。穿过承窝部分1210的相对侧提供另一个进入窗口1230B，使得中心内螺纹段1234可形成于内螺纹段1232之间的相对壁中。螺纹段1232,1234协作以通过螺纹接合工具驱动轴1300上的螺纹1308。
端部执行器1000能够在其中可移除地支撑钉仓1040。参见图60。钉仓1040包括仓体1042，所述仓体能够与细长通道1020一起可操作地坐置。仓体1042在其中具有细长狭槽1046以用于容纳击发构件1200。仓体1042还限定上表面，本文称为仓平台1044。此外，在细长狭槽1046的每侧上提供两行交错的钉孔1048。钉孔1048可操作地支撑相应的钉驱动器1050，所述钉驱动器在其上支撑一个或两个外科钉(未示出)。多种此类钉驱动器布置是已知的并且可在不脱离本发明各种示例性实施例的精神和范围的情况下使用。
击发构件实施例也采用楔形滑动件组件1250以用于与可操作地支撑在钉仓1040内的钉驱动器驱动接触。如可在图60中看出，楔形滑动件组件1250包括至少两个楔形件1252，所述至少两个楔形件被取向用于与可操作地支撑在钉仓1040内的多行钉驱动器驱动接触。当击发构件1200朝远侧驱动时，楔形滑动件组件1250与击发构件1220一起行进，并且其上的楔形件1252迫使驱动器1050向上朝向闭合砧座1100。当驱动器1050向上驱动时，其上支撑的外科钉被驱动离开其各自的孔1048而形成与闭合砧座1100的钉成形表面1104的接触。
本文公开的各种示例性端部执行器实施例也可采用独特而新颖的击发闭锁件布置，所述击发闭锁件布置将防止当不存在仓、仓未适当地坐置在端部执行器内时和/或当已空仓仍然安装在端部执行器中时临床医生意外推进或“击发”击发构件。例如，如下文将更详细讨论，击发闭锁件布置可与工具驱动轴1300和/或击发构件1200相互作用以防止当存在上述状况之一时意外推进击发构件1200。
在例示的示例性实施例中，如果击发构件1200与例如仓体1042中的细长狭槽1046(图60)、细长通道1020中的通道狭槽1028以及砧座1100中的砧座狭槽1103适当对齐，则工具驱动轴1300在第一旋转或“击发”方向上的旋转将引起击发构件1200朝远侧驱动穿过钉仓1040。主要参见图90，细长狭槽1046、通道狭槽1028和/或砧座狭槽1103可在例如击发行程期间击发构件1200沿穿过外科端部执行器1000的路径运动时引导击发构件1200。例如，当击发构件1200处于可操作构型时，通道狭槽1028能够接收击发构件1200的底脚部分1206，并且砧座狭槽1103能够接收击发构件1200的上部翅片1208。当击发构件1200的一部分定位在通道狭槽1028和/或砧座狭槽1103中时，击发构件1200可与轴线A对齐或基本上对齐。例如，当击发构件1200从初始位置运动到相对于仓体1042的第二位置时，通道狭槽1028和/或砧座狭槽1103可引导击发构件1200并保持击发构件1200与轴线A的对齐。
如上文简要讨论，在各种外科钉仓实例中，外科钉被支撑在可运动钉驱动器上，所述可运动钉驱动器被支撑在仓体中。各种示例性端部执行器实施例采用楔形滑动件组件1250，当所述楔形滑动件组件朝远侧驱动穿过钉仓时，所述楔形滑动件组件能够接触钉驱动器以将钉驱动离开其在仓体中的各自的腔并与闭合砧座形成接触。在至少一个示例性实施例中，楔形滑动件1250定位在钉仓1040内。因此，每个新钉仓1040具有可操作地支撑在其中的其自己的楔形滑动件。当临床医生将新钉仓1040适当地坐置在细长通道中时，楔形滑动件1250能够以例如图60、88和89中所示的方式骑跨工具驱动轴1300并接合击发构件1200。如可在这些图中看出，示例性楔形滑动件组件1250可包括滑动件主体1414、凸缘1410和楔形件1252。当楔形滑动件组件1250定位在细长通道1020中时，滑动件主体1414可定位在工具驱动轴1300的一部分周围。当滑动件主体1414定位在工具驱动轴1300周围时，滑动件主体1414可被构造成使得滑动件主体1414避免与工具驱动轴1300接触。滑动件主体1414可包括例如轮廓1412，所述轮廓在工具驱动轴1300上方和/或周围弯曲。在此类实施例中，例如，凸缘1410在滑动件主体1414与楔形件1252中的每一个之间延伸。此外，滑动件主体1414在其中具有凹口1415，所述凹口能够在其中接收击发构件主体1203的一部分。主要参见图89，当击发构件1200接合楔形滑动件组件1250时，凸缘1410可基本上平行于击发构件1200的底脚部分1206延伸。
当新钉仓1040已适当地安装在细长通道1020中时，击发构件1200的初始致动(例如，通过旋转工具驱动轴1300)引起击发构件主体1203的一部分进入楔形滑动件1250中的凹口1415，从而导致击发构件1200与仓体1042中的细长狭槽1046(图60)、细长通道1020中的通道狭槽1028以及砧座1100中的砧座狭槽1103对齐，使击发构件1250能够朝远侧推进穿过钉仓1040。从而，楔形滑动件也可在本文称为“对齐构件”。如果钉仓1040未适当地安装在细长通道中，则击发构件1200的启动不会导致与楔形滑动件1250中的凹口1415的对齐接合，并且击发构件1200将仍然保持与细长通道1020中的通道狭槽1028和砧座1100中的砧座狭槽1103不对齐，从而防止击发构件1250被击发。
在新钉仓1040已适当地安装在细长通道1020中之后，临床医生通过将第一旋转运动施加到工具驱动轴1300来击发击发构件。一旦击发构件1250已朝远侧驱动穿过钉仓1250到达其最远侧位置，就将反向旋转运动施加到工具驱动轴1300以使击发构件1250返回到外科钉仓1040之外的其起始位置，从而使已空仓能够从细长通道1020移除并在其中安装新钉仓。当击发构件1250返回到其起始位置时，楔形滑动件1250保持在钉仓的远侧端部中并且不会随击发构件1200返回。因此，当击发构件1200朝近侧运动出钉仓1040和砧座中的砧座狭槽1103时，工具驱动轴1300的旋转运动引起击发构件1200稍微枢转到不可操作位置中。即，当击发构件1200处于不可操作位置(仓之外)时，若临床医生移除已空仓1040且未能用包含新楔形滑动件1250的新仓替换并且随后闭合砧座1110并尝试击发击发构件1200，由于不存在用以对齐击发构件1200的楔形滑动件，击发构件1200将无法朝远侧推进穿过细长通道1020。因此，此类结构防止临床医生在不存在仓时意外击发击发构件1200。
在此类示例性实施例中，当击发构件1200以可操作构型来取向使得击发构件1200可沿穿过端部执行器1000建立的路径运动时，击发构件1200可基本上与轴线A对齐。轴线A可基本上垂直于砧座1100的钉成形表面1104和/或钉仓1040的仓平台1044(图60)。在其他示例性实施例中，轴线A可相对于砧座1100的钉成形表面1104和/或钉仓1040的仓平台1044成角度地取向。另外，在至少一个示例性实施例中，轴线A可延伸穿过外科端部执行器1000的中心，并且在其他示例性实施例中，轴线A可定位在外科端部执行器1000的中心的任一侧上。
图91-97示出了外科端部执行器1400的一个示例性形式，其采用独特而新颖的击发闭锁件布置。如可在图91-95中看出，当击发构件1200处于初始位置时，击发构件1200处于不可操作构型，所述不可操作构型防止其穿过端部执行器的远侧推进，这是由于击发构件1200与通道狭槽1028和砧座狭槽1103不对齐。可通过通常称为1418的击发闭锁件使击发构件1200保持处于不可操作构型。主要参见图91-93，在至少一个形式中，例如，击发闭锁件1418包括形成于细长通道1020中的第一闭锁件沟槽或凹口1402。然而，在其他示例性实施例中，第一闭锁件凹口1402可在例如第一钳口1004、第二钳口1006、细长通道1020和/或砧座1100中形成开口。在各种示例性实施例中，第一闭锁件凹口1402位于外科端部执行器1400中，使得当击发构件1200处于不可操作构型时，第一闭锁件凹口1402保持接合击发构件1200的一部分。例如，第一闭锁件凹口1402可靠近、邻近和/或连接至细长通道1020中的通道狭槽1028。主要参见图91，通道狭槽1028沿其长度可具有狭槽宽度。在至少一个示例性实施例中，第一闭锁件凹口1402可从通道狭槽1028延伸，使得通道狭槽1028和第一闭锁件凹口1402的组合宽度超过通道狭槽1028的狭槽宽度。如可在图91中看出，当击发构件1200处于不可操作构型时，击发构件1200的底脚部分1206延伸到第一闭锁件凹口1402中，从而防止其穿过细长通道1020的意外远侧推进。
当新钉仓1040已适当安装在细长通道1020中时，击发行程的起始导致击发构件接合定位在钉仓1040内的楔形滑动件1250，从而使击发构件1200运动成与仓体1042中的细长狭槽1046、细长通道1020中的通道狭槽1028以及砧座1100中的砧座狭槽1103驱动对齐，以使击发构件1250能够穿过其中朝远侧推进。当击发构件1200相对于钉仓1040从初始位置运动到第二位置时，击发构件1200可运动经过例如第一闭锁件凹口1402。第一闭锁件凹口1402可具有例如大约0.25英寸的长度。在一些其他示例性实施例中，第一闭锁件凹口1402可具有例如大约0.15英寸至大约0.25英寸的长度，或例如大约0.25英寸至大约1.0英寸的长度。
主要参见图93和94，外科端部执行器1400可被构造成在击发构件1200处于不可操作构型时适应击发构件1200的上部翅片1208。例如，击发闭锁件1418可包括砧座1100中的第二闭锁件沟槽或凹口1404。在例示的示例性实施例中，例如，第二闭锁件凹口1404可靠近、邻近和/或连接至例如砧座1100中的砧座狭槽1103。砧座狭槽1103沿其长度可具有狭槽宽度。在至少一个示例性实施例中，第二闭锁件凹口1404可从砧座狭槽1103延伸，使得砧座狭槽1103和第二闭锁件凹口1404的组合宽度超过砧座狭槽1103的狭槽宽度。第二闭锁件凹口1404可在外科端部执行器1400中延伸一定长度或距离。击发构件1200可被构造成在击发构件1200处于不可操作构型时沿其长度接合第二闭锁件凹口1404。当击发构件1200相对于钉仓1040从初始位置运动到第二位置时，击发构件1200可运动经过例如第二闭锁件凹口1404。第二闭锁件凹口1404可具有例如大约0.25英寸的长度。在一些其他示例性实施例中，第二闭锁件凹口1404可具有例如大约0.15英寸至大约0.25英寸的长度，或例如大约0.25英寸至大约1.0英寸的长度。主要参见图93，第一闭锁件凹口1402可在第一方向X上从通道狭槽1028延伸，并且第二闭锁件凹口1404可在第二方向Y上从砧座狭槽1103延伸。在至少一个示例性实施例中，第一方向X可基本上与第二方向Y侧向地相对。在此类示例性实施例中，当击发构件1200运动到不可操作构型时，击发构件1200的底脚部分1206可枢转到第一闭锁件凹口1402中，并且击发构件1200的上部翅片1208可枢转到第二闭锁件凹口1404中。
主要参见图92-94，当击发构件1200以不可操作构型取向时，击发构件1200的相应部分接合第一和第二闭锁件凹口1402,1404。当击发构件1200处于不可操作构型时，击发构件1200可至少部分地定位在第一和第二闭锁件凹口1402,1404内。当击发构件1200运动到不可操作构型时，击发构件1200可移动到第一和第二闭锁件凹口1402,1404中。另外，当击发构件1200以可操作构型取向时，击发构件1200可脱离第一和第二闭锁件凹口1402,1404。
当击发构件1200以不可操作构型取向时(参见，例如图95)，外科端部执行器1400的一个或多个部分可阻挡击发构件1200并限制或防止击发构件1200运动穿过外科端部执行器1400。例如，当击发构件1200处于可操作构型时，第一钳口1004、第二钳口1006、细长通道1020和/或砧座1100能够阻挡击发构件1200。在一些示例性实施例中，第一闭锁件凹口1402具有形成于其上的第一阻挡表面或边缘1406(图91和92)并且第二闭锁件凹口1404具有形成于其上的第二阻挡表面或边缘1408(图94)。在击发构件1200处于不可操作构型时尝试击发击发构件1200将导致击发构件1200的相应部分接触第一和第二阻挡表面1406,1408中的一者或两者以阻止击发构件1200从初始位置朝第二位置运动。在至少一个示例性实施例中，外科端部执行器1400不必具有第一阻挡边缘1406和第二阻挡边缘1408两者。
图97-104示出了另一个示例性外科端部执行器实施例1500，其采用另一个示例性击发闭锁件布置。例如，如可在这些图中看出，外科端部执行器1500可包括细长通道1020、工具驱动轴1300和击发构件1200。外科端部执行器1500还可包括端部执行器驱动外壳1510(参见例如图100)。与本文所述的端部执行器驱动外壳1010相似，端部执行器驱动外壳1510可包括轴承套管1511和第三环形齿轮或外壳驱动构件768。轴承套管1511可被构造成使得工具驱动轴1300的轴承段1304能够可运动地定位在轴承套管1511中。当工具驱动轴1300在不可操作位置与可操作位置之间运动时，轴承段1304可在轴承套管1511中运动，如本文所述。轴承套管1511可包括镗孔1512，其具有细长剖面，例如剖面形状包括卵形、椭圆形和/或半圆形，其间具有纵向和/或平行侧面。在此类示例性实施例中，当工具驱动轴1300处于不可操作位置时，轴承段1304可抵靠或邻近镗孔1512的第一侧例如第一半圆定位。另外，当工具驱动轴1300处于可操作位置时，轴承段1304可抵靠或邻近镗孔1512的第二侧例如第二半圆定位。
工具驱动轴1300可在不可操作位置与可操作位置之间运动。如本文所述，钉仓1040的一部分和/或偏置构件1520可例如使工具驱动轴1300在不可操作位置与可操作位置之间运动。在例示的实施例和其他实施例中，当工具驱动轴1300处于可操作位置时，工具驱动轴1300的工具传动齿轮1302可与端部执行器驱动外壳1510的第三环形齿轮768接合。工具传动齿轮1302可为例如外齿轮，并且第三环形齿轮768可为例如内齿轮。当工具驱动轴1300从不可操作位置运动到可操作位置时，工具传动齿轮1302可运动到与第三环形齿轮768接合。另外，当工具驱动轴1300处于不可操作位置时，工具传动齿轮1302可脱离第三环形齿轮768。在至少一个示例性实施例中，当工具驱动轴1300从可操作位置运动到不可操作位置时，工具传动齿轮1302可运动脱离与第三环形齿轮768的接合。与本文所述的其他示例性实施例相似，当工具驱动轴1300与端部执行器驱动外壳1510中的第三环形齿轮768接合时，驱动系统750(图61)可例如在击发行程期间驱动击发构件1200穿过外科端部执行器1500的细长通道1020。
主要参见图101和102，当工具驱动轴1300处于不可操作位置时，轴承段1304可抵靠轴承套管1511的镗孔1512的第一侧定位。保持销1514(图98、100、101和103)可被构造成使轴承段1304抵靠镗孔1512的第一侧偏置，使得例如工具驱动轴1300保持处于不可操作位置，并且例如工具传动齿轮1302保持脱离与第三环形齿轮768的接合。在一些示例性实施例中，保持销1514可被弹簧加载，使得保持销1514对轴承段1304施加力以使工具驱动轴1300朝不可操作位置运动。工具驱动轴1300可保持处于不可操作位置直到另一个力克服由保持销1514施加的力以例如使工具驱动轴1300朝可操作位置运动，并例如使工具传动齿轮1302运动到与第三环形齿轮768接合。
主要参见图103和104，当工具驱动轴1300处于可操作位置时，轴承段1304可抵靠轴承套管1511的镗孔1512的第二侧定位。在各种示例性实施例中，由保持销1514(图98、100、101和103)施加的力可被克服以使轴承段1304抵靠镗孔1512的第二侧运动，使得例如工具驱动轴1300处于可操作位置，并且例如工具传动齿轮1302与第三环形齿轮768接合。如本文所述，偏置元件1520可对轴承段1304施加力，所述力克服例如由保持销1515施加的力。
外科端部执行器1500可包括偏置元件1520，所述偏置元件可在第一组位置(参见例如图103)与第二组位置(参见例如图101)之间运动。第二组位置可相对于端部执行器驱动外壳1510处于第一组位置的远侧。当偏置元件1520处于第一组位置时，偏置元件1520可被构造成例如使工具驱动轴1300运动到可操作位置。例如，当偏置元件1520处于第二组位置时，偏置元件1520可释放工具驱动轴1300，使得工具驱动轴可返回到不可操作位置。
偏置元件1520可为可定位在外科端部执行器1500中的独立元件。偏置元件1520例如可被可运动地保持在外科端部执行器1500中，并且例如能够与钉仓1040可操作地接合。钉仓1040可包括偏置元件1520。在一些示例性实施例中，偏置元件1520例如可与钉仓1040的楔形滑动件组件1250一体形成，并且偏置元件1520例如可被可运动地保持在钉仓1040中。在此类示例性实施例中，当楔形滑动件组件1250和/或击发构件1200在例如击发行程期间运动穿过细长通道1020时，偏置元件1520可运动穿过细长通道1020。
主要参见图99，偏置元件1520可包括偏置主体1522和从偏置主体1522延伸的腿部1526。偏置主体1522可定位在外科端部执行器1500中的工具驱动轴1300的一部分周围。在一些示例性实施例中，当偏置主体1522定位在工具驱动轴1300周围时，偏置主体1522可被构造成使得偏置主体1522避免与工具驱动轴1300接触。偏置主体1522可包括例如轮廓1524，所述轮廓在工具驱动轴1300上方和/或周围弯曲。腿部1526可沿细长通道1020的一部分延伸和/或在工具驱动轴1300的任一侧上延伸。偏置元件1520还可包括至少一个延伸件或楔形件1528。如本文所述，楔形件1528能够可运动地接合轴承套管1511和/或轴承段1304以使工具驱动轴运动到可操作位置中。偏置元件1520还可包括至少一个弹簧1530。弹簧1530可在初始构型(图101)与变形构型(图103)之间变形。弹簧1530可保持偏置元件1520相对于端部执行器驱动外壳1510处于第一组位置，直到力使弹簧1530从初始构型变形为变形构型。当弹簧1530从初始构型运动到变形构型时，偏置元件1520可相对于端部执行器驱动外壳1510从第二组位置运动到第一组位置。
主要参见图101，在将钉仓1040(图103)插入细长通道1020中之前，弹簧1530例如可处于初始构型，并且偏置元件1520例如可处于第二组位置。保持销1514可例如抵靠镗孔1512的第一侧来保持轴承段1304。在此类示例性实施例中，工具驱动轴1300可通过保持销1514而保持在不可操作位置。
现在参见图103，钉仓1040在细长通道1020中的安装使偏置元件1520朝近侧抵靠弹簧1530的力运动到第一组位置中，在第一组位置中，楔形件1528可运动地接合轴承套管1511和轴承段1304以将轴承段1304和工具驱动轴1300的工具传动齿轮1302偏置到与第三环形齿轮768啮合接合。然后，如本文所述的击发驱动系统的致动将导致击发构件1200的击发。在一些示例性实施例中，钉仓1040的一部分能够直接接触偏置元件1520以使偏置元件1520运动到第一组位置。在其他示例性实施例中，钉仓1040的一部分能够接触外科端部执行器1500中的另一个元件，例如击发构件1200，以使偏置元件1520可操作地运动到第一组位置。在其他示例性实施例中，钉仓1040具有与其一体形成的偏置元件1520。
在各种示例性实施例中，当如本文所述例如在击发行程期间当通过工具驱动轴1300将击发构件1200和/或楔形滑动件组件1250驱动穿过细长通道1020时，偏置元件1520可运动穿过外科端部执行器1500的细长通道1020。偏置元件1520可与钉仓1040的楔形滑动件组件1250一体形成和/或固定到钉仓1040的楔形滑动件组件1250。在此类示例性实施例中，当钉仓1040初始坐置在细长通道1020中时，楔形滑动件组件1250和偏置元件1520可相对于钉仓1040和/或细长通道1020定位在初始位置。偏置元件1520的初始位置可对应于第一组位置，使得偏置元件1520可运动地接合端部执行器驱动外壳1510的轴承套管1511以使工具驱动轴1300运动到可操作位置，如本文所述。在击发行程期间，楔形滑动件组件1250和偏置元件1520可远离例如初始或第一组位置运动。偏置元件1520可运动到例如第二组位置。当偏置元件1520运动经过第一组位置并进入第二组位置中时，偏置元件1520可不再接合端部执行器驱动外壳1510的轴承套管1511以保持工具驱动轴1300处于可操作构型。虽然当偏置元件1520运动到第二组位置中时偏置元件1520可不将工具驱动轴1300的工具传动齿轮1302偏置到与第三环形齿轮768接合，但钉仓1040中的通道狭槽1028、砧座狭槽1103和/或细长狭槽1046用于在击发取向上引导击发构件1200，所述击发取向将工具驱动轴1300的工具传动齿轮1302与第三环形齿轮768保持啮合接合，从而防止工具驱动轴1300在击发行程期间返回到不可操作位置。
在至少一个示例性实施例中，击发构件1200和/或工具驱动轴1300可在击发行程期间将楔形滑动件组件1250和/或偏置元件1520驱动到第二组位置。在各种示例性实施例中，在完成击发行程时，击发构件1200可返回到初始位置，然而，楔形滑动件组件1250(包括偏置元件1520)可保持处于例如第二组位置。击发构件1200可返回到例如外科端部执行器1500中的近侧位置，并且偏置元件1520可保持处于例如外科端部执行器1500中的远侧位置。当击发构件1200处于初始位置并且偏置元件1520处于第二组位置时，工具驱动轴1300的轴承段1304可在轴承套管1511中移动，使得工具驱动轴1300运动到例如不可操作位置，并且工具传动齿轮1302运动脱离与例如第三环形齿轮768的接合。在各种示例性实施例中，工具驱动轴1300可保持处于不可操作位置直到偏置元件1520被拉回到第一组位置和/或直到替换偏置元件1520定位在例如第一组位置。例如，将已空钉仓1040从细长通道1020移除并用替换钉仓1040替换，所述替换钉仓可包括位于其第一位置中的偏置元件1520。当替换钉仓1040定位在细长通道1020中时，其偏置元件1520将工具传动齿轮1302移动到与例如第三环形齿轮768接合，并移动到例如可操作位置中。在此类示例性实施例中，当无仓1040或已空仓1040坐置在细长通道1020中时，可防止外科端部执行器1500重新击发。此外，如果钉仓未适当坐置在细长通道1020中使得偏置元件1520未使工具驱动轴1300运动到与第三环形齿轮768啮合接合，击发构件1200无法击发。
如上所述，外科器械系统可包括外科外壳、可替换端部执行器组件和马达和/或致动器，所述可替换端部执行器组件可连接至外科外壳以在外科手段期间使用，然后在其已使用后与外壳断开，所述马达和/或致动器能够击发端部执行器。在各种情形中，外科医生可从若干不同的可替换端部执行器中选择以在外科手术期间使用。例如，外科医生可首先选择能够缝合和/或切入患者的组织的第一可替换端部执行器，其包括例如大约15毫米(“mm”)的钉仓长度，以在患者组织中形成第一切口。在此类实施例中，切割刀片和/或钉驱动滑动件可通过驱动螺杆沿钉仓的大约15mm长度推进，以切割和缝合大约15mm的患者组织。外科医生随后可选择也能够缝合和/或切入患者组织的第二可替换端部执行器，其可包括大约30mm的钉仓长度，以在患者组织中形成第二切口。在此类实施例中，切割刀片和/或钉驱动滑动件可通过驱动螺杆沿钉仓的大约30mm长度推进，以切割和缝合大约30mm的患者组织。外科医生还可选择能够缝合和/或切入患者组织的可替换端部执行器，其例如包括大约45mm的钉仓长度，以在患者组织中形成切口。在此类实施例中，切割刀片和/或钉驱动滑动件可通过驱动螺杆沿钉仓的大约45mm长度推进，以切割和缝合大约45mm的患者组织。外科医生还可选择也能够缝合和/或切入患者组织的可替换端部执行器，其例如包括大约60mm的钉仓长度，以在患者组织中形成切口。在此类实施例中，切割刀片和/或钉驱动滑动件可通过驱动螺杆沿钉仓的大约60mm长度推进，以切割和缝合大约60mm的患者组织。以上讨论的端部执行器的15mm、30mm、45mm和/或60mm长度是示例性的。可使用其他长度。在某些实施例中，例如，第一端部执行器可包括具有x的长度的钉仓，第二端部执行器可包括具有大约2*x的长度的钉仓，第三端部执行器可包括具有大约3*x的长度的钉仓，并且第四端部执行器可包括具有大约4*x的长度的钉仓。
在利用具有不同长度的可替换端部执行器的一些外科器械系统中，每个不同可替换端部执行器中的驱动螺杆可相同，但每个驱动螺杆的长度可不同以适应相关联的可替换端部执行器的不同长度。例如，包括30mm钉仓的可替换端部执行器可能要求驱动螺杆长于包括15mm钉仓的可替换端部执行器的驱动螺杆。然而，在此类外科器械系统的各情形中，利用相同的螺距和/或螺纹导程(下文将更详细描述)的每个驱动螺杆可要求马达将驱动轴旋转不同的数量或转数，取决于为了使每个端部执行器被完全击发而要使用的端部执行器的长度。例如，与提供15mm击发行程的驱动螺杆相比，提供30mm击发行程的驱动螺杆可需要两倍多的转数以便被完全致动。在此类外科器械系统中，可利用外科外壳与可替换端部执行器之间的电子通信以确保外科外壳中的电动马达对于附接的可替换端部执行器的长度转动正确数量的转数。例如，可替换端部执行器可包括电子电路，所述电子电路可被外科器械系统识别，使得外科器械系统可使马达对于附接的端部执行器转动正确数量的转数。除上述以外或作为上述的替代，可替换端部执行器可包括传感器，所述传感器感测端部执行器何时已被完全致动。在此类实施例中，传感器可与外壳中的控制器进行信号通信，所述控制器能够在接收到适当信号时停止马达。虽然适用于其预期目的，但外科外壳与可替换端部执行器之间的此类电子通信可增加此类外科器械系统的复杂性和/或成本。
如上概述，可在相同外科器械系统上使用具有不同长度的端部执行器。在上述外科器械系统中，具有不同击发长度的可替换端部执行器包括驱动螺杆，所述驱动螺杆旋转不同次数以适应不同击发长度。为了适应不同驱动螺杆所需的不同数量的转数，驱动驱动螺杆的马达被操作更长的持续时间或更短的持续时间和/或更多数量的转数或更少数量的转数，取决于需要的是更长的击发长度还是更短的击发长度。下述可替换端部执行器的实施例使包括马达的外科器械系统能够致动具有不同击发长度的端部执行器，所述马达能够转动固定或设定数量的转数。通过使马达操作固定数量的转数，外科器械系统识别端部执行器的长度的需要可能不必要。下述实施例中的每个端部执行器包括具有螺距和/或螺纹导程的驱动螺杆，所述螺距和/或螺纹导程使端部执行器的致动部分诸如切割刀片在马达的固定数量的转数中行进特定端部执行器的全长。
参见图105，驱动螺杆1700可在第一方向上旋转以使端部执行器1740的切割刀片1730在由箭头E指示的远侧方向上运动。在使用中，驱动螺杆1700可旋转固定或设定的次数以将切割刀片1730推进由图105中的长度L指示的完全击发长度。对于驱动螺杆1700的每次旋转，在某些实施例中，切割刀片1730可在箭头E的方向上运动一定的量，该量等于螺距、螺纹导程和/或驱动螺杆1700上的相邻螺纹绕组1708之间的距离，如下文将更详细描述。在各种实施例中，第一驱动螺杆可包括限定第一击发长度的第一组特性，而第二驱动螺杆可包括限定第二击发长度的第二组特性，其中第一组特性可不同于第二组特性。
现在参见图106A、107、108A和109A，除了上述之外，驱动螺杆上的螺纹绕组之间的距离可与驱动螺杆上的螺纹的角度成比例。换句话讲，螺纹布置在驱动螺杆上的角度可为驱动螺杆的一个特性，该特性限定驱动螺杆的螺距和/或螺纹导程。在驱动螺杆和驱动驱动螺杆的马达转动固定数量的转数的实施例中，在更长端部执行器中使用的更长驱动螺杆可利用比在更短端部执行器中使用的更短驱动螺杆更大的螺距和/或螺纹导程。图106A中的驱动螺杆1700包括单线螺纹A，所述单线螺纹A以相对于纵向轴线1701的角度α布置在驱动螺杆1700上，其中螺纹A限定具有长度X的螺距和/或螺纹导程。图106B示出了驱动螺杆1700和单线螺纹A的剖面图。在某些实施例中，驱动螺杆1700可包括多于一条螺纹，如下文将更详细描述。
图107A示出了驱动螺杆1700’，其可包括第一螺纹A’和第二螺纹B’。图107B示出了驱动螺杆1700’的剖面图，其中第一螺纹A’和第二螺纹B’以彼此大约180°的相差定位在驱动螺杆1700’上。在各种实施例中，与使用单线螺纹A’或B’的驱动螺杆相比，具有第一螺纹A’和第二螺纹B’的驱动螺杆可增加每单位长度的螺纹数。在驱动螺杆包括多于一条螺纹的情况下，从第一螺纹的绕组到第二螺纹的相邻绕组的距离称为“螺距”。从螺纹的一个绕组到相同螺纹的下一绕组的距离称为“螺纹导程”。对于具有单线螺纹的驱动螺杆，螺距和螺纹导程是相同的。例如，并且结合图107A，从螺纹A’的绕组到螺纹B’的相邻绕组的距离限定驱动螺杆1700’的螺距。从螺纹A’的绕组到螺纹A’的下一绕组的距离限定驱动螺杆1700’的螺纹导程。因此，图107A中的驱动螺杆1700’的螺纹导程等于X’并且螺距等于X’/2。图106A和106B中所示的驱动螺杆1700具有单线螺纹，因此螺距和螺纹导程均等于X。驱动螺杆的螺纹导程决定对于驱动螺杆的单次旋转，击发构件诸如切割刀片1730和/或钉驱动器将行进的长度。
返回到图107A，第一螺纹A’和第二螺纹B’各自以相对于驱动螺杆1700’的纵向轴线1701的角度β布置。角度β小于角度α并且图107A中的驱动螺杆1700’的螺纹导程X’大于图106A中所示的驱动螺杆1700的螺纹导程X。对于驱动螺杆1700’的单次旋转，切割刀片将沿驱动螺杆1700’运动长度X’。例如，螺纹导程X’可为图106A中所示的驱动螺杆1700的螺距或螺纹导程X的两倍，其中，因此，对于驱动螺杆1700’的单次旋转，与图107A的驱动螺杆1700’接合的切割刀片运动的距离将是与图106A的驱动螺杆1700接合的切割刀片的两倍。
图108A示出了驱动螺杆1700”其包括各自以相对于驱动螺杆1700”的纵向轴线1701的角度γ延伸的第一螺纹A”、第二螺纹B”和第三螺纹C”。图108B为驱动螺杆1700”的剖面图并且示出了以大约120°的相差布置的螺纹A”、B”和C”。角度γ小于图107A中的角度β并且图108A中的驱动螺杆1700”的螺纹导程X”大于图107A中所示的驱动螺杆1700’的螺纹导程X’。相似地，图109A示出了驱动螺杆1700”’，其可包括第一螺纹A”’、第二螺纹B”’、第三螺纹C”’和第四螺纹D”’，它们各自以相对于驱动螺杆1700”’的纵向轴线Z的角度δ延伸。图109B为驱动螺杆1700”’的剖面图并且示出了以大约90°的相差布置的螺纹。角度δ小于角度γ并且驱动螺杆1700”’的螺纹导程X”’大于图108A中的驱动螺杆1700”的螺纹导程。
示例性外科器械系统可包括外壳和外壳中的马达，所述马达能够转动固定数量的转数，从而导致连接的可替换端部执行器的驱动螺杆转动例如30转。外科器械系统还可包括多个可替换外科缝合器端部执行器，其中端部执行器中的每一个可包括由例如驱动螺杆驱动的切割刀片和/或钉驱动器。在至少一个此类实施例中，第一可替换端部执行器可包括具有例如15mm长度的钉仓。图2A和2B中所示的驱动螺杆1700可用于第一可替换端部执行器中。螺纹导程X可被设定为例如0.5mm，使得切割刀片和/或钉驱动器可在驱动螺杆1700的30转中行进钉仓的15mm长度。第二可替换端部执行器可包括具有例如30mm长度的钉仓以及驱动螺杆，诸如图107A和107B中所示的驱动螺杆1700”。驱动螺杆1700’的螺纹导程X’可被设定为例如1.0mm，使得切割刀片和/或钉驱动器可在驱动螺杆1700’的30转中行进钉仓的30mm长度。相似地，包括具有长度为例如45mm的钉仓的第三可替换端部执行器可包括驱动螺杆，诸如图108A和108B中具有1.5mm螺纹导程X”的驱动螺杆1700”，使得切割刀片和/或钉驱动器在驱动螺杆1700”的30转中行进钉平台的45mm长度。包括具有长度为例如60mm的钉仓的第四可替换端部执行器可包括驱动螺杆，诸如图109A和109B中具有2.0mm螺纹导程X”’的驱动螺杆1700”’，使得切割刀片和/或钉驱动器在驱动螺杆1700”’的30转中行进钉平台的60mm长度。
图110示出了从端部执行器1740的其余部分移除的图105的切割刀片1730。切割刀片1730包括驱动螺杆1700从中穿过的通道1732。侧部1736形成通道1732的内壁并且可包括凹槽，例如沟槽1734，其能够接收驱动螺杆1700上的螺纹1708。沟槽1734可以角度ε取向，所述角度对应于驱动螺杆1700上的螺纹1708的角度。例如，如果螺纹1708被设定为图106A中所示的角度α，则沟槽1734的角度ε也可被设定为角度α。相应地，沟槽1734的角度ε可被设定为例如与其一起使用的相应驱动螺杆的角度β、δ和/或γ。
在各种实施例中，如图110的分解视图所示，侧部1736可被组装成限定在切割刀片1730的轴部分1746中的窗口1738。在某些实施例中，切割刀片1730可包括一体的侧部。在至少一个实施例中，侧部可包括适当的沟槽角度ε，其匹配驱动螺杆1700上的螺纹1708的角度，所述螺纹可形成于限定在其中的通道1732中。为切割刀片1730提供适于特定驱动螺杆的沟槽角度ε可以多种方式完成。在某些实施例中，可提供通用切割刀片1730，其不包括组装成其轴部分1746的窗口1738的侧面部分1736，其中可提供不同组的侧部1736，使得可从所述不同组的侧部1736选择所需组的侧部1736，然后组装到通用切割刀片1730，从而可将此组件与具体驱动螺杆一起使用。例如，第一组侧部1736在组装到切割刀片1730时可使切割刀片1730能够与第一驱动螺杆一起使用，并且第二组侧部1736在组装到切割刀片1730时可使切割刀片1730能够与第二驱动螺杆一起使用，以此类推。在某些其他实施例中，切割刀片1730可提供有与其一体形成的侧部。在至少一个此类实施例中，沟槽1734可例如与丝锥以角度ε一起形成，所述角度匹配特定驱动螺杆1700的螺纹1708的角度。
图111示出了驱动螺杆1700经由设置在两者间的中间齿轮1720联接到驱动轴1750。驱动轴1750被马达转动。如上所述，马达可完成固定或设定数量的转数，因此，驱动轴1750可转动固定数量的转数R。在某些实施例中，由驱动轴1750转动的转数R的数量可等于由马达转动的转数的固定数量。在另选的实施例中，由驱动轴1750转动的转数R的数量可大于或小于由马达转动的转数的固定数量。在各种实施例中，布置在马达与驱动轴1750之间的一个或多个齿轮可使驱动轴1750完成比马达更多的转数或更少的转数。在某些实施例中，驱动轴1750可包括外花键齿轮1752，其围绕和/或附接到驱动轴1750的远侧端部1754。外花键齿轮1752可接合限定在中间齿轮1720中的内花键齿轮1724以将驱动轴1750的旋转传输到中间齿轮1720。因此，在至少一个实施例中，中间齿轮1720可完成与驱动轴1750相同的转数R。
中间齿轮1720可包括接合到齿轮1712的第二齿轮1722，齿轮1712围绕和/或附接到驱动螺杆1700的近侧端部1702。中间齿轮1720的第二齿轮1722限定第一直径D1，并且驱动螺杆1700的近侧端部1702上的齿轮1712限定第二直径D2。第二直径D2可不同于第一直径D1。当第一直径D1和第二直径D2不同时，它们可限定与1:1不同的齿轮齿数比。如图111中所示，在某些实施例中，直径D1可大于直径D2，使得驱动螺杆1700将完成比由驱动轴1750和中间齿轮1720转动的转数R更多的转数R’。在另选的实施例中，直径D1可小于直径D2，使得驱动螺杆1700将转动比由驱动轴1750和中间齿轮1720转动的转数R更少的转数R’。
中间齿轮1720的第二齿轮1722与驱动螺杆1700的齿轮1712之间的齿轮齿数比可被设定成使得当驱动轴1750完成其固定数量的转数时驱动螺杆1700完成一定数量的转数。如果中间齿轮1722为可替换端部执行器组件的部分，则每个可替换端部执行器组件中的中间齿轮1722与驱动螺杆1700之间的齿轮齿数比可被设定成使得外科外壳中的马达可转动固定数量的转数。例如，参见图111，假定驱动轴1750转动固定的30转且可替换外科缝合器包括15mm钉仓并且如果端部执行器包括具有0.25mm螺纹导程的驱动螺杆，则驱动螺杆将完成60转以将切割刀片和/或钉驱动器推进钉仓的15mm长度。在至少一个实施例中，中间齿轮1720的尺寸可被设定成使得第二内齿轮1722具有直径D1，所述直径D1为驱动螺杆1700的外齿轮1712的直径D2的两倍。因此，当驱动轴1750完成30转时，驱动螺杆1700将完成60转。如果第二可替换外科缝合器包括30mm钉仓，则具有0.25mm螺纹导程的驱动螺杆将完成120转以将切割刀片和/或钉驱动器推进30mm长度。可替换外科缝合器的中间齿轮1720的尺寸可被设定成使得第二内齿轮1722具有直径D1，所述直径D1为驱动螺杆1700的外齿轮1712的直径D2的四倍。因此，当驱动轴1750完成30转时，驱动螺杆1700将完成120转。
返回到图105，在某些实施例中，击发构件例如切割刀片1730的击发路径可为直线的。在某些实施例中，击发补片可为弯曲的和/或曲线的。在某些实施例中，驱动螺杆1708可为柔性的以使驱动螺杆1708能够跟随击发构件沿例如弯曲和/或曲线路径的侧向运动。在某些实施例中，击发构件可为柔性的或可包括至少一个柔性部分以使击发构件的多个部分能够例如沿弯曲和/或曲线路径相对于驱动螺杆1708侧向地位移，而击发构件的其余部分不相对于驱动螺杆1708侧向地位移。在某些实施例中，击发长度可通过击发构件沿击发路径运动的距离限定，而与总的净位移无关。在各种其他实施例中，击发长度可通过击发构件的总的净位移限定，而与击发路径无关。
在各种实施例中，可提供与外科器械系统一起使用的套件，所述套件包括具有不同长度的各种可替换端部执行器。在某些实施例中，所述套件可包括精选的具有不同长度的可替换端部执行器，外科医生可从中选择以供在对患者的外科手术中使用。所述套件还可包括每种长度的若干可替换端部执行器。在某些实施例中，所述套件可包括一系列不同长度的可替换端部执行器，其中所述系列针对特定外科手术是预先确定的。例如，某种外科手术可首先需要15mm切口，然后是第二个15mm切口，最后是30mm切口。用于该外科手术的外科套件可包括能够切入并缝合患者组织的三个可替换端部执行器。首先的两个可替换端部执行器可包括大约15mm长度，并且第三可替换端部执行器可包括大约30mm长度。
图112-117示出了另一个示例性细长轴组件2200，所述细长轴组件在其中具有另一个示例性快速断开联接器布置2210。在至少一个形式中，例如，快速断开联接器布置2210包括呈近侧外管段2214形式的近侧联接器构件2212，所述近侧外管段在其上具有管齿轮段354，所述管齿轮段能够以上述方式与第一驱动系统350交接。如上文所讨论，第一驱动系统350用于使细长轴组件2200以及可操作地联接到其上的端部执行器1000围绕纵向工具轴线“LT-LT”旋转。近侧外管段2214具有“颈缩”远侧端部部分2216，其能够在其上接收锁定管段2220。快速断开结构2210还包括呈远侧外管部分2218形式的远侧联接器构件2217，所述远侧外管部分2218基本上类似于上述远侧外管部分231，不同的是远侧外管部分2218包括颈缩近侧端部部分2219。远侧外部结构或燕尾接头2226形成于远侧外管段2218的近侧端部部分2219的端部上，其能够驱动地接合形成于近侧外管段2214的远侧端部部分2216上的近侧外部结构或燕尾接头2228。
图112-117中所示的示例性实施例采用上述闭合系统670的示例性实施例。快速断开联接器布置2210能够促进近侧闭合传动系组件可操作地联接到相应的远侧传动系组件。例如，如可在图113中看出，细长轴组件2200可包括呈第一近侧闭合杆段2230形式的第一近侧闭合传动系组件和呈第一远侧闭合杆段2240形式的第一远侧闭合传动系组件，它们能够通过快速断开联接器布置2210连接在一起。即，在至少一个示例性形式中，第一近侧闭合杆段2230具有形成于其远侧端部2232上的第一闭合接头结构或燕尾接头段2234。同样，第一远侧闭合杆段2240具有形成于其近侧端部2242上的第二闭合接头结构或燕尾接头段2244，其适于侧向可滑动地接合第一燕尾接头段2234。仍然参见图113，细长轴组件2200可包括呈第二近侧闭合杆段2250形式的第二近侧闭合传动系组件和呈第二远侧闭合杆段2260形式的第二远侧闭合传动系组件，它们能够通过快速断开联接器布置2210连接在一起。即，在至少一个示例性形式中，第二近侧闭合杆段2250具有形成于其远侧端部2252上的第三闭合接头结构或燕尾闭合接头段2254。同样，远侧第二远侧闭合杆段2260可具有形成于远侧第二闭合杆段2260的近侧端部2262上的第四闭合接头结构或燕尾闭合接头段2264，其适于侧向地接合第三燕尾接头段2254。
在例示的实施例和其他实施例中，第一近侧闭合杆段2230和第二近侧闭合杆段2250延伸穿过近侧驱动轴段380’。近侧驱动轴段380’包括近侧旋转传动系组件387’并且远侧驱动轴段540’包括远侧旋转传动系组件548’。当近侧旋转传动系组件387’可操作地联接到远侧旋转传动系组件548’时，驱动轴组件388’被形成为将旋转控制运动传输到端部执行器1000。在至少一个示例性实施例中，近侧驱动轴段380’基本上类似于上述近侧驱动轴段380，不同的是近侧驱动轴段380’的远侧端部部分381’具有形成于其上的远侧结构或燕尾驱动接头2270。相似地，远侧驱动轴段540’可基本上类似于上述远侧驱动轴段540，不同的是近侧结构燕尾驱动接头2280形成于其近侧端部542’上，其适于通过快速断开联接器布置2210驱动地接合远侧燕尾驱动接头2270。第一远侧闭合杆段2240和远侧第二闭合杆段2260也可延伸穿过远侧驱动轴段540’。
该示例性实施例还可包括关节运动联接接头2300，其与第三和第四驱动缆线434,454交接。如可在图113中看出，关节运动联接接头2300包括近侧关节运动管2302，其具有形成于其远侧端部2304上的近侧球接头段2306。近侧关节运动管2302包括用于穿过其中接收缆线末端部分434A’,434B’,454A’,454B’的通道2308。近侧球接头段2310被可运动地支撑在近侧球段2306上。近侧缆线段434A’,434B’,454A’,454B’延伸穿过通道2308以附接到近侧球接头段2310。近侧关节运动管2302、近侧球接头段2310和近侧缆线段434A’,434B’,454A’,454B’可统称为近侧关节运动传动系部分2314。
示例性关节运动联接接头2300还可包括远侧关节运动管2320，其具有形成于其近侧端部2322上的远侧球接头段2324。远侧球接头段2324具有形成于其上的第一远侧结构或燕尾接头2325，其适于驱动地接合形成于近侧球接头段2306上的第一近侧结构或燕尾接头2307，使得当第一远侧燕尾接头2325驱动地接合第一近侧燕尾接头2307时，远侧球接头段2324和近侧球接头段2306形成内关节运动球组件。此外，关节运动联接接头2300还包括被支撑在远侧球接头段2324上的远侧球段2330并且具有形成于其上的第二远侧结构或燕尾接头2332，其适于驱动地接合近侧球接头段2310上的第二近侧结构或燕尾接头2312。远侧缆线段444,445,446,447附接到远侧球段2340并且延伸穿过远侧关节运动管2320中的通道2328。当接合在一起时，近侧球接头段2310和远侧球接头段2324形成关节运动球2340，所述关节运动球被可运动地轴颈连接在内关节运动球上。远侧关节运动管2320、远侧球段2340和远侧缆线段444,445,446,4447可统称为近侧关节运动传动系组件2316。
如可在图115中看出，细长轴组件2200的远侧部分可被组装成使得下列接头段通过远侧联接器2217或远侧外管部分2218保持彼此对准以形成通常称为2290的远侧燕尾接头组件：2226、2332、2325、2280、2244和2264。同样，细长轴组件2200可被组装成使得近侧联接器构件2212或近侧外管段2214保持下列接头段彼此对准以形成通常称为2292的近侧燕尾接头组件：2228、2312、2307、2270、2234和2254。
端部执行器1000可如下可操作地联接到细长轴组件2200。为了开始附接，临床医生将锁定管段2220运动到图115和116中所示的第一解锁位置。如可在这些图中看出，锁定管段具有形成于其远侧端部2222上的邻接段2224。当处于解锁位置时，邻接段2224朝远侧突起超过近侧燕尾接头组件2292以形成邻接表面以用于使远侧燕尾接头组件2290与近侧燕尾接头组件2292侧向地连接。即，临床医生可将远侧燕尾接头组件2290与近侧燕尾接头组件2292侧向地对齐，然后将远侧燕尾接头组件2290滑动到与近侧燕尾接头组件2292侧向接合，直到远侧燕尾接头组件2290接触邻接段2224，此时所有相应的近侧和远侧接头段同时互连。然后，临床医生可将锁定管段2220朝远侧运动到第二锁定位置，如图117中所示。当处于该位置时，锁定管段2220覆盖快速断开接头2210并且防止远侧燕尾组件2290与近侧燕尾组件2292之间的任何相对侧向运动。
虽然上述各种示例性实施例能够与机器人系统可操作地交接并且至少部分地被机器人系统致动，端部执行器和细长轴部件可有效地结合手持式器械使用。例如，图118-120示出了手持式外科器械2400，其可采用上述的各种部件和系统以可操作地致动联接到其上的端部执行器1000。在图118-120中所示的示例性实施例中，快速断开接头2210用于将端部执行器1000联接到细长轴组件2402。为了有利于端部执行器1000围绕关节运动接头700的关节运动，细长轴组件2402的近侧部分包括示例性可手动致动的关节运动驱动器2410。
现在参见图121-123，在至少一个示例性形式中，关节运动驱动器2410包括四个可轴向运动的关节运动滑动件，所述关节运动滑动件被可运动地轴颈连接在近侧驱动轴段380’上在近侧外管段2214与近侧驱动轴段380’之间。例如，关节运动缆线段434A’附接到第一关节运动滑动件2420，其具有从其突起的第一关节运动致动器杆2422。关节运动缆线段434B’附接到第二关节运动滑动件2430，其与第一关节运动滑动件2420沿直径相对。第二关节运动滑动件2430具有从其突起的第二关节运动致动器杆2432。关节运动缆线段454A’附接到第三关节运动滑动件2440，其具有从其突起的第三关节运动致动器杆2442。关节运动缆线段454B’附接到第四关节运动滑动件2450，其与第三关节运动滑动件2440沿直径相对。第四关节运动致动器杆2452从第四关节运动滑动件2450突起。关节运动致动器杆2422,2432,2442,2452有利于通过关节运动环组件2460将关节运动控制运动分别施加到关节运动滑动件2420,2430,2440,2450。
如可在图121中看出，关节运动致动器杆2422,2432,2442,2452可运动地通过安装球2470，所述安装球轴颈连接在近侧外管段2404上。在至少一个实施例中，安装球2470可以多个段的形式制造，所述多个段通过适当的紧固件布置(例如，焊接、粘合剂、螺杆等)附接在一起。如图109中所示，关节运动致动器杆2422和2432延伸穿过近侧外管段2404中的狭槽2472以及安装球2470中的狭槽2474以使关节运动滑动件2420,2430能够相对于其轴向地运动。虽然未示出，关节运动致动器杆2442,2452延伸穿过近侧外管段2404和安装球2470中的相似狭槽2472,2474。关节运动致动器杆2422,2432,2442,2452中的每一个突出到安装球2470中的相应狭槽2474之外，以被可操作地接收在关节运动环组件2460中的相应安装承窝2466内。参见图122。
在至少一个示例性形式中，关节运动环组件2460由一对环段2480,2490制成，所述一对环段通过例如焊接、粘合剂、按扣特征结构、螺杆等连接在一起以形成关节运动环组件2460。环段2480,2490配合以形成安装承窝2466。关节运动致动器杆中的每一个具有形成于其上的安装球2468，所述安装球各自适于被可运动地接收在关节运动环组件2460中的相应安装承窝2466内。
关节运动驱动器2410的各种示例性实施例还可包括示例性锁定系统2486，其能够保持关节运动环组件2460处于致动位置。在至少一个示例性形式中，锁定系统2486包括形成于关节运动环组件2460上的多个锁定翼片。例如，环段2480,2490可由一定程度柔性的聚合物或橡胶材料制成。环段2480具有形成于其中的一系列柔性近侧锁定翼片2488，并且环段2490具有形成于其中的一系列柔性远侧锁定翼片2498。每个锁定翼片2388具有形成于其上的至少一个锁定棘爪2389，并且每个锁定翼片2398在其上具有至少一个锁定棘爪2399。锁定棘爪2389,2399可用于建立与关节运动球所需量的锁定摩擦，以将关节运动球保持就位。在其他示例性实施例中，锁定棘爪2389,2390能够配合地接合形成于安装球2470的外周边中的各种锁定凹坑。
可参照图122和123来理解关节运动驱动器2410的操作。图122示出了处于非关节运动位置的关节运动驱动器2410。在图123中，临床医生已手动地倾斜关节运动环组件2460以使关节运动滑动件2420在远侧方向“DD”上轴向地运动，从而朝远侧推进关节运动缆线段434A’。关节运动环组件2460的此类运动也导致关节运动滑动件2430在近侧方向上的轴向运动，这最终使关节运动缆线434B在近侧方向上牵拉。关节运动缆线段434A’,434B’的此类推动和牵拉将导致端部执行器1000以上述方式相对于纵向工具轴线“LT-LT”进行关节运动。为了使关节运动的方向反向，临床医生简单地使关节运动环组件2460的取向反向，从而引起关节运动滑动件2430在远侧方向“DD”上运动并引起关节运动滑动件2420在近侧方向“PD”上运动。关节运动环组件2460可被相似地致动以将所需的推动和牵拉运动施加到关节运动缆线段454A’,454B’。锁定棘爪2389,2399与安装球外周边之间生成的摩擦用于在端部执行器1000已关节运动到所需位置之后将关节运动驱动器2410保持就位。在另选的示例性实施例中，当锁定棘爪2389,2399被定位成被接收在安装球中的相应锁定凹坑中时，安装球将被保持就位。
在例示的示例性实施例和其他实施例中，细长轴组件2402与柄部组件2500可操作地交接。柄部组件2500的示例性实施例包括一对柄部外壳段2502,2504，其联接在一起以形成用于各种驱动部件和系统的外壳，如下文将更详细讨论。参见例如图118和119。柄部外壳段2502,2504可通过螺杆、按扣特征结构、粘合剂等联接在一起。当联接在一起时，柄部段2502,2504可形成包括手枪式握把部2506的柄部组件2500。
为了有利于端部执行器1000围绕纵向工具轴线“LT＝LT”的选择性旋转，细长轴组件2402可与通常称为2510的第一驱动系统交接。驱动系统2510包括可手动致动的旋转喷嘴2512，所述可手动致动的旋转喷嘴被可旋转地支撑在柄部组件2500上，使得其可相对于柄部组件2500旋转，以及在锁定位置与解锁位置之间轴向地运动。
外科器械2400可包括如上文所述的闭合系统670，以用于将打开运动和闭合运动施加到端部执行器1000的砧座1100。然而，在该示例性实施例中，闭合系统670被闭合触发器2530致动，所述闭合触发器枢转地安装到柄部框架组件2520，所述柄部框架组件被支撑在柄部外壳段2502,2504内。闭合触发器2530包括致动部分2532，所述致动部分枢转地安装到枢轴销2531上，所述枢轴销被支撑在柄部框架组件2520内。参见图124。此类示例性结构有利于朝向和远离柄部组件2500的手枪式握把部2506枢转行进。如可在图124中看出，闭合触发器2530包括闭合连接件2534，所述闭合连接件通过闭合线2535连接至第一枢转连接件与齿轮组件695。因此，通过使闭合触发器2530朝柄部组件2500的手枪式握把部2506枢转到致动位置中，闭合连接件2534和闭合线2535引起第一枢转连接件与齿轮组件695使第一闭合杆段680在远侧方向“DD”上运动以使砧座闭合。
外科器械2400还可包括闭合触发器锁定系统2536以保持闭合触发器处于致动位置。在至少一个示例性形式中，闭合触发器锁定系统2536包括枢转地联接到柄部框架组件2520的闭合锁定构件2538。如可在图125和126中看出，闭合锁定构件2538具有形成于其上的锁定臂2539，当闭合触发器2530朝手枪式握把部2506致动时，所述锁定臂能够骑跨在闭合连接件2532的弓形部分2537上。当闭合触发器2530已枢转到完全致动位置时，锁定臂2539落在闭合连接件2532的端部的后面并防止闭合触发器2530返回到其未致动位置。因此，砧座1100将被锁定在其闭合位置。为了使闭合触发器2530能够返回到其未致动位置并从而导致砧座从闭合位置运动到打开位置，临床医生简单地枢转闭合锁定构件2538直到其锁定臂2539脱离闭合连接件2532的端部，从而允许闭合连接件2532运动到未致动位置。
闭合触发器2532通过闭合返回系统2540返回到未致动位置。例如，如可在图124中看出，闭合触发器返回系统2540的一个示例性形式包括闭合触发器滑动构件2542，所述闭合触发器滑动构件通过闭合触发器轭2544连接至闭合连接件2534。闭合触发器滑动构件2542被可滑动地支撑在柄部框架组件2520中的滑动腔2522内。闭合触发器返回弹簧2546定位在滑动腔2520内以将偏置力施加到闭合触发器滑动构件2542。因此，当临床医生致动闭合触发器2530时，闭合触发器轭2544使闭合触发器滑动构件2542在远侧方向“DD”上运动，从而压缩闭合触发器返回弹簧2546。当闭合触发器锁定系统2536脱离并且闭合触发器2530被释放时，闭合触发器返回弹簧2546使闭合触发器滑动构件2542在近侧方向“PD”上运动，从而使闭合触发器2530枢转到起始的未致动位置。
外科器械2400也可采用上述各种示例性驱动轴组件中的任何一种。在至少一个示例性形式中，外科器械2400采用第二驱动系统2550以用于将旋转控制运动施加到近侧驱动轴组件380’。参见图128。第二驱动系统2550可包括马达组件2552，所述马达组件被可操作地支撑在手枪式握把部2506中。马达组件2552可由可移除地附接到柄部组件2500的电池组2554供电或者其可由交流电源供电。第二传动齿轮2556可操作地联接到马达组件2552的驱动轴2555。第二传动齿轮2556被支撑用于与附接到驱动轴组件的近侧驱动轴段380’的第二旋转从动齿轮2558啮合接合。在至少一个形式中，例如，第二传动齿轮2556也可在马达驱动轴2555上相对于马达组件2552在由图128中的箭头“U”表示的方向上轴向运动。偏置构件例如盘簧2560或类似构件定位在第二传动齿轮2556与马达外壳2553之间，并用于将马达驱动轴2555上的第二传动齿轮2556偏置到与第二从动齿轮2558上的第一齿轮段2559啮合接合。
第二驱动系统2550还可包括击发触发器组件2570，所述击发触发器组件可运动地(例如枢转地)附接到柄部框架组件2520。在至少一个示例性形式中，例如，击发触发器组件2570包括第一旋转驱动触发器2572，所述第一旋转驱动触发器与相应开关/触点(未示出)协作，所述开关/触点与马达组件2552电连通，并且在启动时，引起马达组件2552将第一旋转驱动运动施加到第二从动齿轮2558。此外，击发触发器组件2570还包括回缩驱动触发器2574，所述回缩驱动触发器相对于第一旋转驱动触发器枢转。回缩驱动触发器2574与开关/触点(未示出)可操作地交接，所述开关/触点与马达组件2552电连通，并且在启动时，引起马达组件2552将第二旋转驱动运动施加到第二从动齿轮2558。第一旋转驱动运动导致端部执行器中的驱动轴组件和工具驱动轴旋转，以使击发构件在端部执行器1000中朝远侧运动。相反地，第二旋转驱动运动与第一旋转驱动运动相反，并且将最终导致驱动轴组件和工具驱动轴在旋转方向上旋转，从而导致端部执行器1000中的击发构件的近侧运动或回缩。
例示的实施例还包括可手动致动的安全构件2580，所述安全构件枢转地附接到闭合触发器致动部分2532并且可选择性地在第一“安全”位置与第二“关闭”位置之间枢转，在第一“安全”位置中，安全构件2580物理地阻止击发触发器组件2570的枢转行进，在第二“关闭”位置中，临床医生可自由地枢转击发触发器组件2570。如可在图124中看出，第一凹坑2582被提供于闭合触发器致动部分2532中，其对应于安全构件2580的第一位置。当安全构件2580处于第一位置时，安全构件2580上的棘爪(未示出)被接收在第一凹坑2582内。第二凹坑2584也被提供于闭合触发器致动部分2532中，其对应于安全构件2580的第二位置。当安全构件2580处于第二位置时，安全构件2580上的棘爪被接收在第二凹坑2582内。
在至少一些示例性形式中，外科器械2400可包括通常称为2590的可机械致动的反向系统，以用于在马达组件2552失效或电池电力失去或中断的情况下将反向旋转运动机械地施加到近侧驱动轴段380’。例如，当可操作地联接到近侧驱动轴段380’的驱动轴系统部件被卡住或以其他方式受到束缚而阻止驱动轴部件在仅有马达电力的情况下发生反向旋转时，此类机械反向系统2590也可特别有用。在至少一个示例性形式中，可机械致动的反向系统2590包括反向齿轮2592，所述反向齿轮被可旋转地安装在形成于柄部框架组件2520上的轴2524A上以与第二从动齿轮2558上的第二齿轮段2562啮合接合。参见图126。因此，当第二从动齿轮2558使驱动轴组件的近侧驱动轴段380’旋转时，反向齿轮2592在轴2524A上自由地旋转。
在各种示例性形式中，机械反向系统2590还包括呈杠杆臂2596形式的可手动致动的驱动器2594。如可在图129和130中看出，杠杆臂2596包括轭部分2597，所述轭部分具有穿过其中的细长狭槽2598。轴2524A延伸穿过狭槽2598A，并且形成于柄部外壳组件2520上的第二相对轴2598B延伸穿过其他细长狭槽以将杠杆臂2596可运动地附连至其上。此外，杠杆臂2596具有形成于其上的致动器翅片2597，所述致动器翅片可啮合接合反向齿轮2592。存在棘爪或过盈件，其保持杠杆臂2596处于未致动状态直到临床医生施加显著的力以使其致动。这防止其在反向的情况下意外起始。其他实施例可采用弹簧以将杠杆臂偏置成未致动状态。机械反向系统2590的各种示例性实施例还包括刀回缩器按钮2600，所述刀回缩器按钮被可运动地轴颈连接在柄部框架组件2520中。如可在图129和130中看出，刀回缩器按钮2600包括脱离翼片2602，所述脱离翼片能够接合第二传动齿轮2556的顶部。刀回缩器按钮2600通过刀回缩器弹簧2604偏置到脱离位置。当处于脱离位置时，脱离翼片2602被偏置到脱离与第二传动齿轮2556的接合。因此，直到临床医生希望通过按下刀回缩器按钮2600启动机械反向系统2590之前，第二传动齿轮2556都与第二从动齿轮2558的第一齿轮段2559啮合接合。
当临床医生希望将反向旋转驱动运动施加到近侧驱动轴段380’时，临床医生按下刀回缩器按钮2600以使第二从动齿轮2558上的第一齿轮段2559与第二传动齿轮2556脱离。然后，临床医生开始将枢转棘轮运动施加到可手动致动的驱动器2594，这引起其上的齿轮翅片2597驱动反向齿轮2592。反向齿轮2592与第二从动齿轮2558上的第二齿轮段2562啮合。可手动致动的驱动器2594的继续棘轮运动导致反向旋转驱动运动施加到第二齿轮段2562并最终施加到近侧驱动轴段380’。临床医生可继续使驱动器2594按照完全释放或反向相关联的端部执行器部件所需的次数来多次进行棘轮运动。一旦已将所需量的反向旋转运动施加到近侧驱动轴段380’，临床医生就将刀回缩器按钮2600和驱动器2594释放到其各自的起始位置或未致动位置，在该位置中，翅片2597脱离与反向齿轮2592的接合，并且第二传动齿轮2556再一次与第二从动齿轮2558上的第一齿轮段2559啮合接合。
外科器械2400也可与包括旋转传动装置750的端部执行器1000一起使用，如上文详细描述。如上文所讨论，当驱动轴组件处于第一轴向位置时，施加至其上的旋转运动导致整个端部执行器1000围绕关节运动接头700远侧的纵向工具轴线“LT-LT”旋转。当驱动轴组件处于第二位置时，施加至其上的旋转运动导致工具驱动轴旋转，这最终引起击发构件在端部执行器1000内致动。
外科器械2400可采用移位系统2610以用于选择性地轴向移动近侧驱动轴段380’，从而使轴齿轮376运动到与第一旋转从动齿轮374啮合接合以及脱离与第一旋转从动齿轮374啮合接合。例如，近侧驱动轴段380’被可运动地支撑在柄部框架组件2520内，使得近侧驱动轴段380’可在其中轴向地运动并旋转。在至少一个示例性形式中，移位系统2610还包括移位器轭2612，所述移位器轭由柄部框架组件2520可滑动地支撑。参见图124和图127。近侧驱动轴段380’在其上具有一对衬圈386(示于图124和128中)，使得柄部框架组件2520上的移位器轭2612的移动导致近侧驱动轴段380’轴向运动。在至少一个形式中，移位系统2610还包括移位器按钮组件2614，所述移位器按钮组件与移位器轭2612可操作地交接并延伸穿过柄部组件2500的柄部外壳段2504中的狭槽2505。参见图135和图136。移位器弹簧2616与柄部框架组件2520一起安装，使得其接合近侧驱动轴段380’。参见图127和图134。当移位器按钮组件2614被可滑动地定位在图135中所示的第一轴向位置与图136中所示的第二轴向位置之间时，弹簧2616用于为临床医生提供可听见的咔嗒声和触觉反馈，在第一轴向位置中，驱动轴组件的旋转导致端部执行器1000围绕纵向工具轴线“LT-LT”相对于关节运动接头700旋转(示于图67中)，在第二轴向位置中，驱动轴组件的旋转导致端部执行器中的击发构件轴向运动(示于图66中)。因此，此类结构使临床医生能够易于可滑动地定位移位器按钮组件2614，同时保持柄部组件2500。
图137-147示出了可锁定关节运动接头2700，除了下文讨论的差异外，所述可锁定关节运动接头在一个示例性实施例中基本上与上述关节运动接头700相同。在一个示例性实施例中，关节运动接头2700由关节运动锁定系统2710锁定和解锁。关节运动接头2700包括近侧承窝管702，所述近侧承窝管附接到远侧外管部分231的远侧端部233并在其中限定近侧球承窝704。参见图137。附接到中间关节运动管段712的近侧球构件706被可运动地坐置在近侧承窝管702内的近侧球承窝704内。如可在图137中看出，近侧球构件706具有中心驱动通道708，所述中心驱动通道使远侧驱动轴段540能够延伸穿过其中。此外，近侧球构件706在其中具有四个关节运动通道710，所述关节运动通道有利于远侧缆线段444,445,446,447通过其中。如可在图137中进一步看出，中间关节运动管段712具有形成于其中的中间球承窝714。中间球承窝714能够在其中可运动地支撑形成于端部执行器连接器管720上的端部执行器球722。远侧缆线段444,445,446,447延伸穿过形成于端部执行器球722中的缆线通道724，并通过被接收在端部执行器球722中的相应通道728内的耳状物726附接到其上。可采用其他附接结构以用于将远侧缆线段444,445,446,447附接到端部执行器球722。
如可在图137中看出，关节运动锁定系统2710的一个示例性形式包括锁定线或构件2712，其延伸穿过细长轴组件的远侧外管部分231和近侧承窝管702。锁定线2712具有附接到传送盘2722的近侧端部2720，所述传送盘被可操作地支撑在柄部部分2500(大体在图137中以虚线表示)中。例如，传送盘2722安装在心轴2724上，所述心轴联接到形成于柄部2500中的凸出部2726。致动器缆线或线2730附接到传送盘2722并且可由临床医生手动地致动(即，推动或牵拉)。在外科器械附接到机器人系统的其他实施例中，致动器缆线2730能够接收来自机器人系统的控制运动以致动传送盘2722。
如可在图143-146中看出，锁定线2712具有形成于其远侧端部2715上的一对解锁楔形件2714,2716。第一解锁楔形件2714能够与远侧锁定环2740的端部2742,2744可操作地交接，所述远侧锁定环轴颈连接在中间关节运动管712上。在如图143中所示的其正常“锁定”状态中，远侧锁定环2740将周向延伸的锁定或挤压力施加到中间关节运动管712以将中间关节运动管712挤压在端部执行器球722上，从而阻止其在承窝714内运动。如可在图143-146中看出，远侧锁定环2740的端部2742,2744是渐缩的以在其间限定锥形或V形开口2746，所述开口能够在其间接收第一解锁楔形件2714。
如可在图143-146中进一步看出，第二锁定楔形件2716能够与近侧锁定环2750的端部2752,2754交接，所述近侧锁定环2750轴颈连接在近侧承窝管702上。在如图143中所示的其正常“锁定”状态中，近侧锁定环27450将周向延伸的锁定或挤压力施加到近侧承窝管702以将近侧承窝管702挤压在近侧球构件706上，从而阻止其在近侧球承窝704内运动。如可在图143-146中看出，近侧锁定环2750的端部2752,2754是渐缩的以在其间限定锥形或V形开口2756，所述开口能够在其间接收第二解锁楔形件2716。
当关节运动接头2700被关节运动锁定系统2710的致动解锁时，端部执行器1000可通过致动远侧缆线段444,445,446,447以上述各种方式选择性地进行关节运动。可参照图138、139和143-146来理解关节运动锁定系统2710的致动。图143示出了第一和第二解锁楔形件2714,2716相对于远侧和近侧锁定环2740,2750的位置。当处于该状态时，锁定环2740防止端部执行器球722在承窝714内运动，并且锁定环2750防止近侧球构件706在承窝704内运动。为了解锁关节运动接头2700，在近侧方向“PD”上牵拉致动缆线2726，这最终导致锁定线2712在远侧方向“DD”上被推动到图144中所示的位置。如可在图144中看出，第一解锁楔形件2714已朝远侧在远侧锁定环2740的端部2742,2744之间运动以使环2740伸展而解除施加到中间关节运动管712的挤压力，从而允许端部执行器球722在承窝714内运动。同样，第二解锁楔形件2716已朝远侧在近侧锁定环2750的端部2752,2754之间运动以使环2750伸展而解除近侧承窝管702上的挤压力，从而允许近侧球构件706在承窝704内运动。当处于该解锁位置时，关节运动系统可被致动以便以上述方式将致动运动施加到远侧缆线段444,445,446,447，以使端部执行器1000进行关节运动，如图138和139中所示。例如，图143和144示出了在端部执行器1000已关节运动到图138中所示的位置中时第一和第二锁定楔形件2714,2716的位置。同样，图145和146示出了在端部执行器1000已关节运动到图139中所示的位置中时第一和第二锁定楔形件2714,2716的位置。一旦临床医生已使端部执行器关节运动到所需位置，临床医生(或机器人系统)将推动运动施加到致动缆线以使传送盘2722旋转并使锁定线2712运动到图143,145中所示的位置，从而允许锁定环2740,2750弹至其夹紧或锁定位置以保持端部执行器1000处于该锁定位置。
图148-156示出了另一个端部执行器实施例2800，除下文讨论的差异外，所述端部执行器实施例2800在一个示例性形式中基本上与端部执行器1000相同。端部执行器2800包括砧座组件2810，所述砧座组件通过对其施加旋转闭合运动而被打开和闭合。砧座组件2810被枢转地支撑在细长通道2830上以用于在打开位置(图148和149)与闭合位置(图150-153)之间选择性运动。除下文讨论的差异外，细长通道2830可基本上与上述细长通道1020相同。例如，在例示的实施例中，细长通道2830具有形成于其上的端部执行器连接器外壳2832，其可通过如上文所述的环状轴承734联接到端部执行器连接器管720。如可在图148中看出，端部执行器连接器外壳2832可操作地支撑其中的旋转传动装置组件2860。
如可在图148和149中看出，砧座组件2810包括一对砧座耳轴2812(图148中仅可见一个耳轴)，其被可运动地接收在形成于细长通道2830中的相应耳轴狭槽2814内。砧座组件2810的下侧还具有形成于其上的砧座开放滑道2816，以用于与击发构件1200’上的砧座枢轴销1201’枢转接合。除指出的差异外，击发构件1200’可基本上与上述击发构件1200相同。此外，砧座组件2810还包括闭合销2818，所述闭合销能够与旋转闭合轴2910可操作地接合，所述旋转闭合轴接收来自旋转传动装置组件2860的旋转闭合运动，如下文将更详细讨论。击发构件1200’可旋转地轴颈连接在工具驱动轴1300上，所述工具驱动轴被可旋转地支撑在细长通道2830内，所述细长通道能够支撑其中的外科钉仓(未示出)。工具驱动轴1300具有形成于其上的轴承段1304，所述轴承段被可旋转地支撑在形成于端部执行器连接器外壳2832中的轴承套管2834中。
在示例性的例示的实施例中，旋转传动装置组件2860包括旋转驱动轴2870，所述旋转驱动轴纵向地延伸穿过细长轴组件以与工具安装部分可操作地交接(如果端部执行器2800由机器人系统供电)或与柄部组件的击发触发器可操作地交接(如果要手动地操作端部执行器2800)。对于采用关节运动接头的那些实施例，旋转驱动轴2870的延伸穿过关节运动接头700的部分可包括本文所公开的任何柔性驱动轴组件。如果未采用关节运动接头，旋转驱动轴可为刚性的。如尤其可在图148和149中看出，旋转驱动轴2870具有形成于其上或附接到其上的旋转驱动头2872，所述旋转驱动头具有形成于其上的第一环形齿轮2874。此外，旋转驱动头2872还具有形成于其上的第二环形齿轮2876以用于与附接到旋转移位器轴2880的移位器齿轮2882选择性啮合接合。
移位器轴2880可包括上述旋转驱动轴组件中的任何一种，并且延伸穿过细长轴组件以与工具安装部分300(如果端部执行器2800被机器人系统驱动)或柄部组件(如果要手动地操作端部执行器)可操作地交接。在任一种情况中，移位器轴2800能够接收纵向移动运动以使移位器齿轮2882在旋转驱动头2872内纵向地移动，并且能够接收旋转驱动运动以使移位器齿轮2882旋转，如下文将更详细讨论。
如可在图148和149中进一步看出，旋转传动装置组件2860还包括具有主体2892的分动齿轮组件2890，所述主体的一部分被可旋转地支撑在旋转驱动头2872中的腔2873内。主体2892具有心轴2894，所述心轴可旋转地延伸穿过形成于端部执行器连接器外壳2832中的隔板2836中的心轴安装孔2838。主体2892还具有形成于其中的移位器环形齿轮2896以用于与旋转移位器轴2880上的移位器齿轮2882选择性啮合接合。分动齿轮2900安装到分动齿轮心轴2902，所述分动齿轮心轴从主体2892突出并且被可滑动地接收在隔板2836中的弓形狭槽2840内。参见图155和图156。分动齿轮2900与形成于旋转驱动头2872中的第一环形齿轮2874啮合接合。如可在图153-156中看出，弓形狭槽2840具有在其中突起的居中设置的柔性棘爪2842。棘爪2842形成于幅材2844上，所述幅材由棘爪泄压狭槽2846形成，所述棘爪泄压狭槽邻近弓形狭槽2840形成，如图155中所示。
旋转闭合轴2910具有轴承部分2912，所述轴承部分通过隔板2836中的相应开口被可旋转地支撑。旋转闭合轴2910还具有闭合传动齿轮2914，所述闭合传动齿轮能够与分动齿轮2900选择性啮合接合。工具驱动轴1300也具有工具传动齿轮1302，所述工具传动齿轮能够与分动齿轮2900选择性啮合接合。
现在将参考图148-155对端部执行器2800的操作进行阐释。图148和149示出了砧座组件2810处于打开位置的端部执行器2800。为了使砧座组件2810运动到图150中所示的闭合位置，移位器轴2880被定位成使得移位器齿轮2882与主体2892中的移位器环形齿轮2896啮合接合。移位器轴2880可被旋转而引起主体2892旋转以使分动齿轮2900与闭合轴2910上的闭合传动齿轮2914啮合接合。参见图153。当处于该位置时，锁定棘爪2842保持分动齿轮心轴2902处于该位置。然后，旋转驱动轴2870被旋转以将旋转运动施加到分动齿轮2900，这最终使闭合轴2910旋转。当闭合轴2910被旋转时，与砧座组件2810上的闭合销2818接合的旋转心轴部分2916导致砧座组件2810朝近侧运动，从而引起砧座组件2810在击发构件1200’上的砧座枢轴销1201’上枢转。此类动作引起砧座组件2810枢转到图150中所示的闭合位置。当临床医生希望朝远侧顺着细长通道2830向下驱动击发构件1200’时，移位器轴2880再一次被旋转以将分动齿轮心轴2902枢转到图154中所示的位置。同样，锁定棘爪2842保持分动齿轮心轴2902处于该位置。然后，旋转驱动轴2870被旋转以将旋转运动施加到工具驱动轴1300上的传动齿轮1302。工具驱动轴1300在一个方向上的旋转引起击发构件1200’在远侧方向“DD”上驱动。工具驱动轴1300在相反方向上的旋转将引起击发构件1200’在近侧方向“PD”上回缩。因此，在击发构件1200’能够切割并击发安装在细长通道2830中的钉仓内的钉的那些应用中，在击发构件1200’已被驱动至细长通道2830内的其最远侧位置之后，由旋转驱动轴组件2870施加到工具驱动轴1300的旋转驱动运动被反向以使击发构件1200’回缩回到图150中所示的其起始位置。为了从端部执行器2800释放靶组织，临床医生再次旋转移位器轴2800以再一次使分动齿轮2900与闭合驱动轴2910上的传动齿轮2914啮合接合。然后，通过旋转驱动轴2870将反向旋转运动施加到分动齿轮2900以引起闭合驱动轴2910旋转驱动心轴2916，从而引起砧座组件2810朝远侧运动并枢转到图148和149中所示的打开位置。当临床医生希望使整个端部执行器2800围绕纵向工具轴线“LT-LT”旋转时，移位器轴纵向地移动以使移位器齿轮2882与旋转驱动头2872上的第二环形齿轮2876和分动齿轮主体2892上的移位器环形齿轮2896同时啮合接合，如图152中所示。然后，旋转驱动轴2880的旋转引起整个端部执行器2800围绕纵向工具轴线“LT-LT”相对于端部执行器连接器管720旋转。
图157-170示出了另一个端部执行器实施例3000，其采用牵拉类型的运动来打开和闭合砧座组件3010。砧座组件3010被可运动地支撑在细长通道3030上以在打开位置(图168和169)与闭合位置(图157、160和170)之间选择性运动。除下文讨论的差异外，细长通道3030可基本上与上述细长通道1020相同。细长通道3030可以上述方式联接到端部执行器驱动外壳1010。端部执行器驱动外壳1010也可通过如上所述的环状轴承734联接到端部执行器连接器管720。如可在图157中看出，端部执行器驱动外壳1010可支撑如上所述的驱动结构748和旋转传动装置750。
如可在图160中看出，砧座组件3010包括一对砧座耳轴3012(图160中仅可见一个耳轴)，其被可运动地接收在形成于细长通道3030中的相应耳轴狭槽3032内。砧座组件2810的下侧还具有形成于其上的砧座开放凹口3016，以用于与击发构件3100上的上部翅片1208枢转接合。参见图168。除指出的差异外，击发构件3100可基本上与上述击发构件1200相同。在例示的实施例中，端部执行器3000还包括砧座弹簧3050，所述砧座弹簧能够在砧座耳轴3012上施加偏置力。砧座弹簧3050的一个形式示于图159中。如可在该图中看出，砧座弹簧3050可由金属线制成并且具有两个相对的弹簧臂3052，当砧座耳轴被接收在其各自的耳轴狭槽3032内时，所述弹簧臂能够支承在砧座耳轴3012上。此外，如可在图159中进一步看出，砧座弹簧3050具有形成于其中的两个安装环3054，所述安装环适于被可运动地支撑在形成于细长通道3030上的相应弹簧销3034上。参见图158。如下文将更详细讨论，砧座弹簧3050能够在细长通道3030内的弹簧销3034上枢转。如尤其可在图158中看出，细长通道的每个侧壁的部分3035凹进，以为砧座弹簧3050的运动提供间隙。
如可在图157和160-170中看出，端部执行器3000还包括闭合管3060，所述闭合管被可运动地支撑在细长通道3030上以用于在其上选择性纵向运动。为了有利于闭合管3060的纵向运动，图157和160-170中所示的实施例包括闭合螺线管3070，所述闭合螺线管通过连杆臂3072连接至闭合管3060，所述连杆臂枢转地固定或以其他方式附接到闭合管3030。当螺线管被致动时，连杆臂3072在远侧方向上被驱动，这使闭合管3060在细长通道3030的端部上朝远侧驱动。当闭合管3060朝远侧运动时，这引起砧座组件3010枢转到闭合位置。在另选的实施例中，螺线管可包括安装在端部执行器驱动外壳1010的远侧端部上的环形螺线管。闭合管将由金属材料制成，所述金属材料可被环形螺线管磁性吸引和排斥，从而导致闭合管的纵向运动。
在至少一个形式中，端部执行器3060还包括独特的砧座锁定系统3080以在其闭合在靶组织上时保持砧座组件3010锁定就位。在一个形式中，如可在图157中看出，砧座锁定系统3080包括砧座锁定杆3082，所述砧座锁定杆横向地延伸穿过细长通道3030，使得其端部被接收在形成于细长通道3030中的相应锁定杆窗口3036内。参见图158。参见图161，当闭合管3060处于其最远侧“闭合”位置，锁定杆3082的端部侧向地突出穿出锁定杆窗口3036之外，并延伸超过闭合管3060的近侧端部以防止其朝近侧运动出适当位置。锁定杆3082能够接合支撑在端部执行器驱动外壳1010中的螺线管触点3076。螺线管触点3076被接线至控制系统以用于控制螺线管3070。控制系统包括由电池或机器人系统或柄部组件中的其他电力源供应的电力源(无论是哪种情况)。
击发构件3100被可旋转地轴颈连接在工具驱动轴1300上，所述工具驱动轴被可旋转地支撑在细长通道2830内，所述细长通道能够支撑其中的外科钉仓(未示出)。工具驱动轴1300具有形成于其上的轴承段1304，所述轴承段被可旋转地支撑在形成于端部执行器连接器外壳2832中的轴承套管2834中，并且以上述方式与旋转传动装置750可操作地交接。工具驱动轴1300在一个方向上的旋转引起击发构件3100朝远侧驱动穿过细长通道3030，并且工具驱动轴1300在相反旋转方向上的旋转将引起击发构件1200”在近侧方向“PD”上回缩。如可在图157和160-170中看出，击发构件3100具有能够接合锁定杆3082的致动杆3102，如下文将更详细讨论。
砧座锁定系统3080还包括砧座牵拉组件3090以用于当闭合管3060已运动到其最远侧位置时将砧座选择性地牵拉到与闭合管3060楔入锁定接合，在所述最远侧位置中，闭合管3060的远侧端部与形成于砧座组件3010上的砧座凸缘3013接触。在一个形式中，砧座牵拉组件3090包括一对砧座牵拉缆线3092，所述砧座牵拉缆线附接到砧座组件3010的近侧端部并朝近侧突出穿过细长轴组件到达工具安装部分或柄部组件(无论是哪种情况)。牵拉缆线3092可附接到柄部组件上的致动器机构或联接到工具安装部分上的驱动系统中的一者，所述驱动系统中的一者能够将张力施加到缆线3092。
现在将描述端部执行器3000的操作。图168和169示出了处于打开位置的砧座组件3010。图168示出了处于最近侧位置的击发构件3100，其中新钉仓(未示出)可安装在细长通道3030中。闭合管3060也处于其最近侧未致动位置。另外，如可在图167中看出，当击发构件3100处于其最近侧位置时，致动杆3102已将锁定杆偏置到与螺线管触点3076接合，这使螺线管能够被启动以用于下一闭合序列。因此，为了开始闭合过程，旋转驱动轴752被致动以使击发构件3100运动到图169中所示的其起始位置。当处于该位置时，致动杆3102已在近侧方向上充分运动而使锁定杆3082能够运动脱离与螺线管触点3076的接合，使得当将电力供应至螺线管控制电路时，螺线管连接件3072被延伸。然后自动地或通过开关或柄部组件中的其他控制机构将控制电力施加到螺线管3070，这使闭合管3060朝远侧运动直到闭合管3060的远侧端部接触砧座组件3010上的凸缘3013，以引起砧座组件枢转闭合在击发构件1200”上，如图162中所示。如可在该图中看出，锁定杆3082被定位成防止闭合管3060在近侧方向上的运动。当处于该位置时，临床医生随后将张力施加到牵拉缆线3092以将砧座组件3010的近侧端部牵拉到与闭合管3060楔入接合而将砧座组件3010锁定在闭合位置中。然后，击发构件1200”可在远侧方向上被驱动穿过夹紧在端部执行器3000中的组织。一旦击发过程已完成。工具驱动轴在相反方向上被旋转以使击发构件3100返回到其起始位置，在所述起始位置中，致动杆3102再一次接触锁定杆3082以使其挠曲成与螺线管触点3076接触并将锁定杆3082的端部牵拉到细长通道3030中的窗口3036中。当处于该位置时，在将电力供应至螺线管控制系统时，螺线管3070使闭合管3060在近侧方向上回缩到图167和168中所示的其起始位置或打开位置。当闭合管3060朝近侧运动脱离与砧座组件3010的接合时，砧座弹簧3050将偏置力施加到砧座耳轴3012以将砧座组件偏置到图168中所示的打开位置。
图171-178示出了另一个示例性细长轴组件3200，所述细长轴组件在其中具有另一个示例性快速断开联接器布置3210。在至少一个形式中，例如，快速断开联接器布置3210包括呈近侧外管段3214形式的近侧联接器构件3212，在一个结构中，所述近侧外管段可在其上具有管齿轮段354，当装置要受机器人控制时，所述管齿轮段能够以上述方式与第一驱动系统350交接。然而，在另一个实施例中，近侧外管段3214可以上述方式与安装到柄部组件的可手动致动的旋转喷嘴2512交接。如上文所讨论，机器人控制的应用中的第一驱动系统350或手持式结构中的旋转喷嘴2512用于使细长轴组件3200和可操作地联接到其上的端部执行器围绕纵向工具轴线“LT-LT”旋转。参见图171。近侧外管段3214具有能够在其上接收锁定衬圈的“颈缩”远侧端部部分3216。
在图171-178中所示的示例性实施例中，细长轴组件3200包括近侧驱动轴段380”，除下文讨论的差异外，所述近侧驱动轴段可基本上与上述近侧驱动轴段380相同，并且能够以本文所公开的各种方式接收来自机器人系统或柄部组件的旋转和轴向控制运动。例示的实施例可与如上所述的关节运动接头700一起使用，并且包括关节运动缆线434和454，所述关节运动缆线可以本文所述的各种方式联接到关节运动控制驱动器。近侧填充材料3220被提供在近侧外管段3214内以便为关节运动缆线末端部分434A,434B,454A,454B提供轴向支撑。每个关节运动缆线末端部分434A,434B,454A,454B延伸穿过通过近侧填充材料3220提供的相应近侧关节运动通道3222。每个关节运动缆线末端部分434A,434B,454A,454B还具有附接到其上的近侧关节运动夹3224，所述近侧关节运动夹能够在相应关节运动通道3222内滑动。近侧关节运动夹3224可由金属或聚合物材料制成，并且各自具有一对柔性夹臂3226，该对柔性夹臂各自具有形成于其上的紧固件夹板3228。同样，近侧驱动轴段380”被可运动地接收在近侧填充材料3220中的轴通道3230中。驱动轴连接夹3240位于其上。在一个示例性形式中，驱动轴连接夹3240在其上形成有中心管状连接器部分3242和两个柔性夹臂3244，所述夹臂各自在其上具有紧固件夹板3248。
如可在图171、172和176-178中进一步看出，快速断开结构3210还包括呈远侧外管段3252形式的远侧联接器构件3250，所述远侧外管段3252基本上类似于上述远侧外管部分231，不同的是远侧外管段3252包括颈缩近侧端部部分3254。远侧外管段3252可操作地联接到本文所公开的各种类型的端部执行器1000并且包括远侧驱动轴段540”，除了下文指出的差异外，所述远侧驱动轴段可基本上类似于上述远侧驱动轴段540。远侧填充材料3260提供在远侧外管段3252内以便为远侧关节运动缆线段444,445,446,447提供轴向支撑。每个远侧关节运动缆线段444,445,446,447延伸穿过通过远侧填充材料3260提供的相应远侧关节运动通道3262。每个远侧关节运动缆线段444,445,446,447还具有附接到其上的远侧关节运动卡口柱3270，所述远侧关节运动卡口柱能够在相应近侧关节运动夹3224的夹臂3226之间滑动。每个远侧关节运动卡口柱3270能够通过相应夹臂3226上的紧固件夹板3228保持接合。同样，远侧驱动轴段540”被可运动地接收在远侧填充材料3260中的远侧轴通道3264中。远侧驱动轴卡口柱3280附接到远侧驱动轴段540”的近侧端部，使得其朝近侧突出超过远侧关节运动卡口柱3270。图172示出了远侧驱动轴卡口柱3280(以虚线表示)相对于远侧关节运动卡口柱3270的位置。远侧驱动轴卡口柱3280能够通过驱动轴连接夹3240上的相应夹臂3244上的紧固件夹板3248保持接合。
如可在图171-178中看出，示例性快速断开联接器布置3210还包括可轴向运动的锁定衬圈3290，所述锁定衬圈被可运动地轴颈连接在远侧外管段3252的颈缩近侧端部部分3254。如尤其可在图174中看出，锁定衬圈3290的一个形式包括外锁定套管3292，所述外锁定套管的尺寸设定成分别被可滑动地接收在近侧外管段3214和远侧外管段3254的颈缩部分3216,3254上。外锁定套管3292通过桥3295联接到中心锁定主体3294。桥3295能够滑动穿过远侧外管段3254的颈缩部分3254中的远侧狭槽3255以及近侧外管段3214的颈缩部分3216中的近侧狭槽3217，其被可滑动地接收在远侧外管段3252的颈缩近侧端部部分3254内并且还可滑动地延伸到近侧外管段3214的颈缩部分3216中。如可在图174中进一步看出，中心锁定主体3294具有多个通道3296，以用于穿过其中接收关节运动柱和夹。同样，中心锁定主体3294具有中心驱动轴通道3298，以用于在其中可运动地接收远侧驱动轴段540”。
现在将描述示例性快速断开联接器布置3210的用途。首先参见图171和172，远侧联接器构件3250与近侧联接器构件3212轴向地对齐，使得桥3295与近侧外管段3214的颈缩部分3216中的狭槽3217对齐，并且远侧驱动轴卡口柱3280与近侧驱动轴连接器夹3240上的中心管状连接器部分3242对齐。然后，使远侧联接器构件3250与近侧联接器构件3212邻接接合以引起远侧驱动轴卡口柱3280滑动到中心管状段3214中，并最终与近侧驱动轴连接器夹3240上的紧固件夹板3248保持接合。此类动作也引起每个远侧关节运动卡口连接器柱3270通过近侧关节运动连接器夹3224上的紧固件夹板3228保持接合，如图176中所示。应当理解，当远侧驱动轴卡口柱3280插入在夹臂3244之间时，夹臂3244向外挠曲直到紧固件夹板3248接合柱3280上的肩部3281。同样，当每个远侧关节运动卡口柱3270插入在其相应的连接器臂3226之间时，连接器臂3226向外挠曲直到紧固件夹板3228接合柱3270上的肩部3271。一旦远侧驱动轴段540”已连接至近侧驱动轴段380”并且远侧关节运动缆线段444,445,446,447已分别连接至关节运动缆线末端部分434A,434B,454A,454B，使用者即可将外锁定套管3292朝近侧滑动到图177和178中所示的位置。当处于该位置时，中心锁定主体3294防止夹臂3244,3226向外挠曲，从而将远侧联接器构件3250锁定至近侧联接器构件3212。为了将远侧联接器构件3250与近侧联接器构件3212断开，使用者将外锁定套管392运动到图175和176中所示的位置，然后将联接器构件3250,3212拉开。当将相对的轴向分离运动施加到联接器构件3250,3212时，夹臂3244和3226被允许挠曲分别脱离与远侧驱动轴卡口柱和远侧关节运动卡口柱的接合。
非限制性实例
一个示例性形式包括与机器人系统一起使用的外科工具，所述机器人系统包括工具驱动组件，所述工具驱动组件操作地联接到机器人系统的控制单元，所述控制单元可由来自操作者的输入来操作并且能够机械地生成输出运动。在至少一个示例性形式中，外科工具包括驱动系统，所述驱动系统能够与机器人系统的工具驱动组件的对应部分交接以用于从其接收机器人式生成的输出运动。驱动轴组件与驱动系统可操作地交接并且能够接收来自驱动系统的机器人式生成的输出运动并将控制运动施加到与驱动轴组件可操作地交接的外科端部执行器。可手动致动的控制系统与驱动轴组件可操作地交接，以将手动地生成的控制运动选择性地施加到驱动轴组件。
结合另一个一般示例性形式提供了与机器人系统一起使用的外科工具，所述机器人系统包括工具驱动组件，所述工具驱动组件操作地联接到机器人系统的控制单元，所述控制单元可由来自操作者的输入来操作并且能够向支撑在工具驱动组件上的至少一个可旋转主体部分提供至少一种旋转输出运动。在至少一个示例性形式中，外科工具包括具有至少一个部件部分的外科端部执行器，所述至少一个部件部分响应于施加到其上的控制运动而可在第一与第二位置之间相对于其至少一个其他部件部分选择性运动。细长轴组件可操作地联接到外科端部执行器并且包括至少一个齿轮传动部分，所述至少一个齿轮传动部分与至少一个可选择性地运动的部件部分可操作地连通。工具安装部分可操作地联接到细长轴组件并且能够与工具驱动组件(当联接到其上时)操作地交接。至少一个示例性形式还包括具有从动元件的工具安装部分，所述从动元件被可旋转地支撑在工具安装部分上并且能够用于驱动与工具驱动组件的至少一个可旋转主体部分中的对应的一者的接合，以从其接收对应的旋转输出运动。驱动系统与从动元件可操作地接合而对其施加机械地生成的致动运动以引起至少一个齿轮传动部分中的对应的一者将至少一个控制运动施加到可选择性地运动的部件。可手动致动的反向系统与细长轴组件可操作地交接以对其选择性地施加手动地生成的控制运动。
根据另一个示例性一般形式，提供了与机器人系统一起使用的外科工具，所述机器人系统包括工具驱动组件，所述工具驱动组件操作地联接到机器人系统的控制单元，所述控制单元可由来自操作者的输入来操作并且能够机械地生成旋转输出运动。在至少一个示例性形式中，外科工具包括旋转驱动系统，所述旋转驱动系统能够与机器人系统的工具驱动组件的对应部分交接以用于从其接收机械地生成的旋转输出运动。旋转驱动轴组件与旋转驱动系统可操作地交接并且能够接收来自旋转驱动系统的机械地生成的旋转输出运动并将旋转控制运动施加到与旋转驱动轴组件可操作地交接的外科端部执行器。可手动致动的反向系统与旋转驱动轴组件可操作地交接，以将手动地生成的旋转驱动运动选择性地施加到旋转驱动轴组件。
另一个示例性形式包括外科缝合装置，所述外科缝合装置包括细长轴组件，所述细长轴组件具有远侧端部并限定纵向工具轴线。所述装置还包括端部执行器，所述端部执行器包括细长通道组件，所述细长通道组件包括能够可操作地支撑其中的外科钉仓的部分。砧座相对于细长通道组件被可运动地支撑。外科缝合装置还包括旋转接头，所述旋转接头将细长通道组件联接到细长轴组件的远侧端部以有利于细长通道组件围绕纵向工具轴线相对于细长轴组件的远侧端部选择性地旋转。
另一个示例性形式包括旋转支撑接头组件以用于将外科器械的第一部分联接到外科器械的第二部分。在至少一个示例性形式中，旋转支撑接头组件包括第一部分中的第一环形座圈和第二部分中的第二环形座圈，当第二部分与第一部分连接时，所述第二环形座圈能够与第一环形座圈基本对准。环状轴承被支撑在对准的第一环形座圈和第二环形座圈内。
结合另一个示例性一般形式提供了旋转支撑接头组件，以用于将外科端部执行器联接到外科器械的细长轴组件。在至少一个示例性形式中，旋转支撑接头组件包括外科端部执行器上的圆柱形连接器部分。第一环形座圈提供于连接器部分的周边中。承窝提供于细长轴上并且尺寸设定成在其中接收圆柱形连接器部分，使得圆柱形连接器部分可相对于承窝自由地旋转。第二环形座圈提供于承窝的内壁中并且能够在圆柱形连接器部分被接收在承窝内时与第一环形座圈基本对准。窗口提供于承窝中并与第二环形座圈连通。具有自由端的环状轴承构件可穿过该窗口插入对准的第一环形座圈和第二中。
结合另一个示例性一般形式提供了用于将外科器械的第一部分可旋转地联接到外科器械的第二部分的方法。在各种示例性形式中，该方法包括在第一部分中形成第一环形座圈以及在第二部分中形成第二环形座圈。该方法还包括将第一部分插入第二部分中使得第一环形座圈和第二环形座圈基本对准，以及将环状轴承插入对准的第一环形座圈和第二环形座圈内。
另一个示例性形式包括用于外科器械的驱动轴组件，其包括多个可运动地联锁的接头段，所述接头段互连而形成柔性中空管。柔性辅助约束构件被安装成与多个可运动地联锁的接头段柔性约束接合，以保持联锁的接头段处于活动联锁接合，同时有利于驱动轴组件的挠曲。
根据另一个一般示例性形式，提供了用于外科器械的复合驱动轴组件，其包括多个可运动地联锁的接头段，所述接头段由激光在中空管中切割出，并且所述中空管具有远侧端部和近侧端部。柔性辅助约束构件与多个可运动地联锁的接头段柔性约束接合，以保持联锁的接头段处于可运动的联锁接合，同时有利于驱动轴组件的挠曲。
根据又一个示例性一般形式，提供了用于外科器械的驱动轴组件，其包括多个可运动地互连的接头段，其中至少一些接头段包括由六个基本上弓形的表面形成的球式连接器部分。承窝部分的尺寸设定成能在其中可运动地接收邻接接头段的球式连接器部分。中空通道延伸穿过每个球式连接器部分以形成穿过驱动轴组件的通道。驱动轴组件还可包括柔性辅助约束构件，其被安装成与多个可运动地互连的接头段柔性约束接合，以保持接头段处于可运动的互连接合，同时有利于驱动轴组件的挠曲。
另一个示例性形式包括形成外科器械的柔性驱动轴组件的方法。在各种示例性实施例中，该方法包括提供中空轴以及利用激光在中空轴中切割出多个可运动地互连的接头段。该方法还包括将辅助约束构件安装在中空轴上以保持可运动地互连的接头段处于可运动的互连接合，同时有利于驱动轴组件的挠曲。
结合另一个示例性形式提供了形成外科器械的柔性驱动轴组件的方法。在至少一个示例性实施例中，该方法包括提供中空轴以及利用激光在中空轴中切割出多个可运动地互连的接头段。每个接头段包括一对相对的耳状物，其中每个耳状物具有渐缩外周边部分，所述渐缩外周边部分被接收在具有渐缩内壁部分的对应的承窝内，所述渐缩内壁部分与对应耳状物的渐缩外周边部分协作以在其中可运动地保持对应的耳状物。
另一个示例性一般形式包括用于外科器械的旋转驱动结构，其具有可操作地联接到其上的外科端部执行器。在一个示例性形式中，旋转驱动结构包括能够生成旋转驱动运动的旋转驱动系统。驱动轴组件与旋转驱动系统可操作地交接并可在第一位置与第二位置之间选择性地轴向运动。旋转传动装置与驱动轴组件和外科端部执行器可操作地交接，使得当驱动轴组件处于第一轴向位置时，由旋转驱动系统向驱动轴组件施加旋转驱动运动中的一者将引起旋转传动装置向外科端部执行器施加第一旋转控制运动，并且当驱动轴组件处于第二轴向位置时，由旋转驱动系统向驱动轴组件施加旋转驱动运动将引起旋转传动装置向外科端部执行器施加第二旋转控制运动。
结合另一个示例性一般形式提供了与机器人系统一起使用的外科工具，所述机器人系统包括工具驱动组件，所述工具驱动组件操作地联接到机器人系统的控制单元，所述控制单元可由来自操作者的输入来操作并且能够生成输出运动。在至少一个示例性形式中，外科工具包括工具安装部分，所述工具安装部分能够与机器人系统的一部分可操作地交接。旋转驱动系统被工具安装部分可操作地支撑并与工具驱动组件交接以从其接收对应的输出运动。细长轴组件从工具安装部分可操作地延伸并且包括驱动轴组件，所述驱动轴组件与旋转驱动系统操作地交接。驱动轴组件可在第一位置与第二位置之间选择性地轴向运动。外科工具还包括外科端部执行器，所述外科端部执行器被可旋转地联接到细长轴组件以便相对于其选择性旋转。旋转传动装置与驱动轴组件和外科端部执行器可操作地交接，使得当驱动轴组件处于第一轴向位置时，由旋转驱动系统向驱动轴组件施加旋转驱动运动中的一者将引起旋转传动装置向外科端部执行器施加第一旋转控制运动，并且当驱动轴组件处于第二轴向位置时，由旋转驱动系统向驱动轴组件施加旋转驱动运动将引起旋转传动装置向外科端部执行器施加第二旋转控制运动。
结合又一个示例性一般形式提供了外科器械，所述外科器械包括柄部组件以及被柄部组件可操作地支撑的驱动马达。细长轴组件从柄部组件可操作地延伸并且包括驱动轴组件，所述驱动轴组件与驱动马达可操作地交接并且可在第一位置与第二位置之间选择性地轴向运动。外科端部执行器被可旋转地联接到细长轴组件以便相对于其选择性旋转。旋转传动装置与驱动轴组件和外科端部执行器可操作地交接，使得当驱动轴组件处于第一轴向位置时，由驱动马达向驱动轴组件施加旋转驱动运动将引起旋转传动装置向外科端部执行器施加第一旋转控制运动，并且当驱动轴组件处于第二轴向位置时，由驱动马达向驱动轴组件施加旋转驱动运动将引起旋转传动装置向外科端部执行器施加第二旋转控制运动。
各种示例性实施例还包括用于外科器械的差速锁定系统，所述外科器械包括由旋转驱动轴组件供能的外科端部执行器，所述旋转驱动轴组件可在多个离散的轴向位置之间运动。在至少一个形式中，差速锁定系统包括旋转驱动轴组件上的至少一个保持结构，其对应于离散的轴向位置中的每一个。至少一个锁定构件相对于旋转驱动轴组件被可操作地支撑以便当旋转驱动轴组件运动到与至少一个保持结构相关联的离散的轴向位置时保持与至少一个保持结构的接合。
结合另一个示例性一般形式提供了用于外科器械的差速锁定系统，所述外科器械包括由旋转驱动轴组件供能的外科端部执行器，所述旋转驱动轴组件可在第一轴向位置与第二轴向位置之间运动。在至少一个示例性形式中，差速锁定系统包括差速外壳，所述差速外壳与旋转驱动轴组件和外科端部执行器可操作地交接。至少一个弹簧偏置的锁定构件被差速外壳可操作地支撑以便当旋转驱动轴组件处于第一轴向位置时保持与旋转驱动轴组件的第一部分的接合，并且当旋转驱动轴组件处于第二轴向位置时，所述至少一个弹簧偏置的锁定构件还能够保持接合旋转驱动轴组件的第二部分。
结合又一个示例性一般形式提供了用于外科器械的差速锁定系统，所述外科器械包括由旋转驱动轴组件供能的外科端部执行器，所述旋转驱动轴组件可在第一轴向位置与第二轴向位置之间运动。在至少一个示例性形式中，差速锁定系统包括差速外壳，所述差速外壳与旋转驱动轴组件和外科端部执行器可操作地交接。至少一个弹簧构件提供于旋转驱动轴组件的一部分上，其中每个弹簧构件限定第一保持位置和第二保持位置，所述第一保持位置对应于旋转驱动轴组件的第一轴向位置，所述第二保持位置对应于旋转驱动轴组件的第二轴向位置。锁定构件被差速外壳可操作地支撑并且对应于所述至少一个弹簧构件中的每一个以便当旋转驱动轴组件处于第一轴向位置时与其保持接合，使得锁定构件保持接合处于第一保持位置的对应弹簧构件，并且当旋转驱动轴组件处于第二轴向位置时，锁定构件保持接合处于第二保持位置的对应弹簧构件。
各种其他示例性实施例包括外科器械，所述外科器械包括端部执行器和近侧旋转传动系组件，所述近侧旋转传动系组件可操作地联接到旋转和轴向控制运动的源。近侧旋转传动系组件可响应于对其施加的轴向控制运动而纵向地移动。外科器械还包括远侧旋转传动系组件，所述远侧旋转传动系组件可操作地联接到端部执行器以对其施加旋转控制运动。近侧轴向传动系组件可操作地联接到轴向控制运动的另一个源。远侧轴向传动系组件可操作地联接到端部执行器以对其施加轴向控制运动。所述器械还包括联接结构以用于使近侧旋转传动系组件与远侧旋转传动系组件以及近侧轴向传动系组件与远侧轴向传动系组件同时附接和分离。
结合另一个一般方面提供了联接结构以用于将端部执行器附接到对应的近侧传动系组件，所述端部执行器包括能够将多个控制运动施加到端部执行器的多个远侧传动系组件，所述近侧传动系组件与驱动运动的源连通。在一个示例性形式中，联接结构包括每个近侧传动系组件的远侧端部上的近侧附接结构以及近侧联接器构件，所述近侧联接器构件能够在其中可操作地支撑每个近侧传动系组件，使得其上的近侧附接结构保持处于基本联接对齐。远侧附接结构提供于每个远侧传动系组件的近侧端部上。当使之与其联接接合时，每个远侧附接结构能够可操作地接合对应近侧传动系的远侧端部上的近侧附接结构。远侧联接器构件可操作地联接到端部执行器并且能够在其中可操作地支撑每个远侧传动系以保持其上的远侧附接结构处于基本联接对齐。锁定衬圈可从解锁位置运动到锁定位置，在所述解锁位置中，远侧传动系组件可脱离对应的近侧传动系组件，在所述锁定位置中，远侧传动系组件保持与其对应的近侧传动系组件联接接合。
结合另一个一般方面提供了外科器械，所述外科器械包括端部执行器，所述端部执行器能够响应于对其施加的驱动运动而执行外科活动。所述器械的一个示例性形式还包括驱动运动的源以及第一近侧传动系组件，所述第一近侧传动系组件与所述驱动运动的源可操作地交接，以用于从其接收对应的第一驱动运动。第二近侧传动系组件与所述驱动运动的源可操作地交接，以用于从其接收对应的第二驱动运动。第一远侧传动系组件与端部执行器可操作地交接并且当将第一近侧传动系组件可操作地联接到其上时能够接收来自第一近侧传动系组件的对应第一驱动运动。第二远侧传动系组件与端部执行器可操作地交接并且当将第二近侧传动系组件可操作地联接到其上时能够接收来自第二近侧传动系组件的对应第二驱动运动。所述器械还包括联接结构，所述联接结构包括第一联接构件，所述第一联接构件在其中可操作地支撑第一和第二近侧传动系组件。联接结构还包括第二联接构件，所述第二联接构件在其中可操作地支撑第一和第二远侧传动系组件并且能够与第一联接构件轴向对齐，使得当第二联接构件与第一联接构件轴向地对齐时，第一远侧传动系组件与第一近侧传动系组件轴向对齐以与其可操作地接合，并且第二远侧传动系组件与第二近侧传动系组件轴向对齐以与其可操作地接合。锁定衬圈被可运动地轴颈连接在第一和第二联接构件中的一者上并且能够在解锁位置与锁定位置之间运动，在所述解锁位置中，第一和第二远侧传动系组件可分别与第一和第二近侧传动系组件分离，在所述锁定位置中，第一和第二远侧传动系组件分别保持与第一和第二近侧传动系组件可操作地接合。
根据另一个一般方面，提供了外科仓，所述外科仓包括仓体，所述仓体限定穿过其中的路径以用于可操作地接收外科器械的击发构件。外科仓还包括对齐构件，所述对齐构件被可操作地支撑在仓体中并且当击发构件被驱动至与其接触时能够使击发构件从不可操作构型运动到可操作构型，在所述不可操作构型中，击发构件与所述路径不对齐，在所述可操作构型中，击发构件与所述路径对齐。
根据又一个一般方面，提供了用于外科器械的端部执行器。在至少一个形式中，端部执行器包括支撑构件，所述支撑构件具有狭槽以及与狭槽相邻的闭锁件凹口。端部执行器还包括击发构件，所述击发构件可在不可操作构型与可操作构型之间运动，其中当其处于可操作构型时，击发构件与狭槽对齐并且被构造成在狭槽中平移，并且其中当其处于不可操作构型时，击发构件与闭锁件凹口接合并且与狭槽不对齐。
另一个示例性实施例包括外科器械，所述外科器械包括细长通道，所述细长通道能够在其中可移除地支撑仓。在至少一个形式中，仓包括仓体和对齐构件，所述对齐构件被可运动地支撑在仓体内以便在其中从第一位置运动到第二位置。外科器械还包括击发构件，所述击发构件相对于细长通道被可操作地支撑，以便在对其施加致动运动时在起始位置与结束位置之间运动。击发构件不能从起始位置运动到结束位置，除非击发构件与仓体中的对齐构件可操作地接合。
另一个示例性实施例包括用于外科器械的端部执行器。在至少一个形式中，端部执行器包括细长通道，所述细长通道能够在其中可移除地支撑仓。击发构件相对于细长通道被可操作地支撑，以便在起始位置与结束位置之间运动。工具驱动轴与击发构件可操作地接合以便在由驱动结构对其施加致动运动时使击发构件在起始位置与结束位置之间运动。工具驱动轴可从不可操作位置运动到可操作位置，在所述不可操作位置中，工具驱动轴脱离与驱动结构的可操作接合，在所述可操作位置中，工具驱动轴与驱动结构可操作地接合。端部执行器还包括对齐构件，所述对齐构件被可运动地支撑以便与工具驱动轴接触以在将仓安装在细长通道中时使工具驱动轴从不可操作位置运动到可操作位置。
另一个示例性实施例包括外科器械，所述外科器械包括细长通道和仓，所述仓被可移除地支撑在细长通道中。击发构件相对于细长通道被可操作地支撑，以便在起始位置与结束位置之间运动。工具驱动轴与击发构件可操作地接合以便在由驱动结构对其施加致动运动时使击发构件在起始位置与结束位置之间运动。工具驱动轴可从不可操作位置运动到可操作位置，在所述不可操作位置中，工具驱动轴脱离与驱动结构的可操作接合，在所述可操作位置中，工具驱动轴与驱动结构可操作地接合。外科器械还包括对齐构件，所述对齐构件被可运动地支撑以便与工具驱动轴接触以在将仓安装在细长通道中时使工具驱动轴从不可操作位置运动到可操作位置。
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，所述装置均可进行修复，以在至少一次使用后再次使用。重新恢复可包括如下步骤的任意组合：拆卸该装置、然后清洗或置换某些部分以及随后组装。特别是，所述装置可以拆卸，而且可以任意组合选择性地置换或移除该装置任意数目的特定零件或部分。清洗和/或置换特定部分后，该装置可以在修复设施处重新组装以便随后使用，或者在即将进行外科手术前由外科手术队重新组装。本领域的技术人员将会知道，装置的修复可利用多种用于拆卸、清洗/置换和重新组装的技术。这些技术的使用以及所得的修复装置均在本发明的范围内。
尽管本文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。
以引用方式全文或部分地并入本文的任何专利、专利公开或其它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、陈述或其它公开材料相冲突的范围内并入本文。由此，在必要的程度下，本文所明确阐述的公开内容将取代以引用方式并入本文的任何相冲突的材料。如果据述以引用方式并入本文但与本文所述的现有定义、陈述或其它公开材料相冲突的任何材料或其部分，仅在所并入的材料和现有的公开材料之间不产生冲突的程度下并入本文。

Claims (21)

1.一种用于外科器械的驱动轴组件，所述驱动轴组件包括：
多个可运动地联锁的接头段，所述多个可运动地联锁的接头段互连以形成柔性中空管；和
柔性辅助约束构件，所述柔性辅助约束构件与所述多个可运动地联锁的接头段处于柔性约束接合，以保持所述联锁的接头段处于可运动的联锁接合，同时有利于所述驱动轴组件的挠曲。
2.根据权利要求1所述的驱动轴组件，其中所述柔性辅助约束构件围绕所述柔性中空管的外周边延伸。
3.根据权利要求1所述的驱动轴组件，其中所述柔性中空管形成中空通道，并且其中所述辅助约束构件被接收在所述中空通道内。
4.根据权利要求1所述的驱动轴组件，其中所述辅助约束构件包括螺旋缠绕构件，所述螺旋缠绕构件围绕所述中空管的周边延伸。
5.根据权利要求4所述的驱动轴组件，其中所述中空管包括近侧端部和远侧端部，并且其中所述螺旋缠绕构件包括中心部分以及近侧端部部分和远侧端部部分，并且其中所述近侧端部部分和远侧端部部分比所述中心部分缠绕得更紧密。
6.根据权利要求1所述的驱动轴组件，其中所述辅助约束构件包括位于所述柔性中空管上的弹性体管。
7.根据权利要求1所述的驱动轴组件，其中所述联锁的接头段中的至少一些包括：
球式连接器部分；
承窝部分，所述承窝部分的尺寸设定成在其中可运动地接收邻接的联锁的接头段的所述球式连接器部分；和
中空通道，所述中空通道延伸穿过所述球式连接器部分和承窝部分。
8.根据权利要求7所述的驱动轴组件，其中所述球式连接器部分包括基本上六边形的形状。
9.根据权利要求8所述的驱动轴组件，其中所述球式连接器部分包括形成所述基本上六边形的形状的六个弓形表面。
10.根据权利要求7所述的驱动轴组件，其中所述辅助约束构件包括位于所述柔性中空管上的弹性体管。
11.一种用于外科器械的复合驱动轴组件，所述驱动轴组件包括：
多个可运动地联锁的接头段，所述多个可运动地联锁的接头段由激光在中空管中切割出，所述中空管具有远侧端部和近侧端部；和
柔性辅助约束构件，所述柔性辅助约束构件与所述多个可运动地联锁的接头段处于柔性约束接合，以保持所述联锁的接头段处于可运动的联锁接合，同时有利于所述驱动轴组件的挠曲。
12.根据权利要求11所述的复合驱动轴组件，其中所述辅助约束构件包括螺旋缠绕构件，所述螺旋缠绕构件围绕所述中空管的周边延伸。
13.根据权利要求12所述的驱动轴组件，其中所述螺旋缠绕构件包括中心部分以及近侧端部部分和远侧端部部分，并且其中所述近侧端部部分和远侧端部部分比所述中心部分缠绕得更紧密。
14.根据权利要求11所述的驱动轴组件，其中所述辅助约束构件包括位于所述柔性中空管上的弹性体管。
15.一种用于外科器械的驱动轴组件，所述驱动轴组件包括：
多个可运动地互连的接头段，其中至少一些接头段包括：
球式连接器部分，所述球式连接器部分由六个基本上弓形的表面形成；
承窝部分，所述承窝部分的尺寸设定成在其中可运动地接收邻接的接头段的所述球式连接器部分；和
中空通道，所述中空通道延伸穿过每个球式连接器部分以形成穿过所述驱动轴组件的连续通道，并且其中所述驱动轴组件还包括：
柔性辅助约束构件，所述柔性辅助约束构件与所述多个可运动地互连的接头段处于柔性约束接合，以保持所述接头段处于可运动的互连接合，同时有利于所述驱动轴组件的挠曲。
16.根据权利要求15所述的驱动轴组件，其中所述柔性辅助约束构件包括柔性管，所述柔性管围绕所述驱动轴组件延伸以在所述驱动轴组件挠曲时保持所述接头段处于可运动的互连接合。
17.根据权利要求15所述的驱动轴组件，其中所述柔性辅助约束构件包括延伸穿过所述通道的柔性构件。
18.根据权利要求16所述的驱动轴组件，还包括延伸穿过所述通道的柔性芯构件。
19.一种形成用于外科器械的柔性驱动轴组件的方法，所述方法包括：
提供中空轴；
利用激光在所述中空轴中切割出多个可运动地互连的接头段；以及
将辅助约束构件安装在所述中空轴上以保持所述可运动地互连的接头段处于可运动的互连接合，同时有利于所述驱动轴组件的挠曲。
20.根据权利要求19所述的方法，其中安装包括将螺旋缠绕构件围绕所述中空轴的周边安装。
21.根据权利要求19所述的方法，其中安装包括将柔性管围绕所述中空轴的周边安装。
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