CN105792766A - 用于外科器械的击发触发器锁定构造 - Google Patents

用于外科器械的击发触发器锁定构造 Download PDF

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Publication number
CN105792766A
CN105792766A CN201480057836.3A CN201480057836A CN105792766A CN 105792766 A CN105792766 A CN 105792766A CN 201480057836 A CN201480057836 A CN 201480057836A CN 105792766 A CN105792766 A CN 105792766A
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China
Prior art keywords
surgical instruments
end effector
controller
motor
axle
Prior art date
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Pending
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CN201480057836.3A
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English (en)
Inventor
F·E·谢尔顿四世
J·R·摩根
S·G·哈尔
R·L·莱姆巴赫
E·A·谢林
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Ethicon Endo Surgery Inc
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Ethicon Endo Surgery Inc
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Application filed by Ethicon Endo Surgery Inc filed Critical Ethicon Endo Surgery Inc
Publication of CN105792766A publication Critical patent/CN105792766A/zh
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Abstract

一种外科器械系统可包括：一、外科器械(9000)，所述外科器械包括柄部、具有远侧端部的轴(9040)、和触发器(9014)；以及，二、能够附接到所述轴的端部执行器(9060)。所述器械还可包括击发构件和被构造成能够使所述击发构件(9020)朝所述远侧端部运动的马达(100)，其中所述触发器被构造成能够操作所述马达。所述外科器械系统还可包括被构造成能够检测一个或多个错误状态的多个传感器、多个指示器、以及与所述多个传感器和所述指示器通信的控制器，其中所述控制器被构造成能够选择性地启动所述指示器以指示检测到的所述错误状态。外科器械可包括多个致动器和多个致动器锁，其中所述控制器能够致动所述致动器锁中的一个或多个以指示检测到的所述错误状态。

Description

用于外科器械的击发触发器锁定构造
技术领域
本发明涉及一种外科器械，并且在各种构造中，本发明涉及被设计成用于切割和缝合组织的动力外科切割和缝合器械及其钉仓。
背景技术
外科缝合器通常用于将钉部署到软组织中，以例如尤其在组织被横切时减少或消除软组织的出血。诸如内切割器的外科缝合器可包括端部执行器，该端部执行器能够相对于细长轴组件运动或关节运动。端部执行器经常被构造成能够将软组织固定在第一钳口构件和第二钳口构件之间，其中第一钳口构件经常包括被构造成能够在其中可移除地存储钉的钉仓，第二钳口构件经常包括砧座。这类外科缝合器可包括用于使砧座相对于钉仓枢转的闭合系统。
如上文所述，外科缝合器可被构造成能够使得端部执行器的砧座相对于钉仓枢转，以便将软组织捕获于它们之间。在各种情况下，砧座可被构造成能够对软组织施加夹持力，以便将软组织牢固地保持在砧座和钉仓之间。然而，如果外科医生不满意端部执行器的位置，则外科医生通常必须启用外科缝合器上的释放机构来将砧座枢转成打开位置并且随后重新定位端部执行器。然后，钉通常由驱动器从钉仓部署，该驱动器横贯钉仓中的通道，使得钉抵靠砧座而变形，并且将软组织层固定在一起。如本领域所知，钉经常以若干钉线或排进行部署，以将组织层更可靠地固定在一起。端部执行器还可包括诸如刀的切割构件，在软组织层已经被缝合在一起之后，该切割构件在两排钉之间前进以切割软组织。
此类外科缝合器和执行器的尺寸和构造可被设计成通过套管针或其他进入开口插入体腔内。端部执行器通常联接到尺寸被设计成穿过套管针或开口的细长轴。细长轴组件通常可操作地联接到柄部，该柄部支撑用于控制端部执行器的操作的控制系统和/或触发器。为了有利于端部执行器在体内的正确定位和取向，许多外科器械被构造成能够有利于端部执行器相对于细长轴的一部分进行关节运动。
动力外科器械在Zemlok等人的名称为POWEREDSURGICALSTAPLINGDEVICE的美国专利申请公布US2009/0090763A1(下文中，“Zemlok‘763”)中有所公开，该专利申请公布的全部公开内容据此以引用方式并入本文。动力外科器械还在Zemlok等人的名称为POWEREDSURGICALINSTRUMENT的美国专利申请公布US2011/0278344A1(下文中，“Zemlok‘344”)(现在为美国专利8,201,721)中有所公开，该专利申请公布的全部公开内容据此以引用方式并入本文。
上述讨论仅是为了举例说明本发明技术领域中相关技术目前的每个方面，而不应当视为对权利要求范围的否定。
附图说明
通过结合附图来参考本发明实施例的以下说明，本发明的特征和优点以及其获取方法将会变得更加明显，并可更好地理解发明本身，其中：
图1为采用回缩构造的一种形式的外科器械的透视图；
图2为可结合本文所公开的各种外科器械使用的示例性加载单元的透视图；
图3为图2所示的加载单元的一部分的分解透视图；
图4为图1的外科器械的一部分的顶视图；
图5为图4所示的外科器械的一部分的局部侧视图，其中离合器组件处于脱离位置；
图6为回缩组件实施例及其回缩杠杆构造的一部分的顶视图；
图7为驱动单元的一种形式的局部分解图，其中其部分以剖面示出；
图8为外科器械的一部分的另一个顶视图，其中驱动单元锁定系统处于锁定位置；
图9为锁定制转杆组件的一种形式的顶视图；
图10为图9的锁定制转杆组件的侧正视图；
图11为图9和图10的锁定制转杆组件的底视图；
图12为齿轮箱外壳实施例的前视图；
图13为外科器械实施例的局部侧剖面图，其中其部分以剖面示出并且驱动单元锁定系统处于锁定取向；
图14为图13的外科器械的另一个局部侧剖面图，其中驱动单元锁定系统处于解锁取向；
图15为另一个外科器械实施例的顶视图，其中外壳的一部分被移除以暴露器械的驱动单元锁定系统构造的一部分；
图16为图15的外科器械实施例的局部侧剖面图，其中其部分以剖面示出，实线示出处于锁定取向的驱动单元锁定系统，并且虚线示出处于解锁取向的驱动单元锁定系统；
图17为图15和图16的外科器械实施例的另一个局部顶视图，其中实线示出致动之前的回缩杠杆的位置并且虚线示出初始致动之后的回缩杠杆的位置；
图18为图15-17的外科器械实施例的另一个局部顶视图，其中虚线示出处于完全致动位置的回缩杠杆；
图19为另一个外科器械实施例的一部分的局部顶视图，其中外壳的一部分被省去以暴露器械的驱动单元锁定系统，实线示出处于未致动位置的回缩杠杆，并且虚线示出初始致动之后的回缩杠杆；
图20为另一个外科器械实施例的局部顶视图，其中外壳的一部分被省去以暴露其处于锁定取向的驱动单元锁定系统；
图21为图20的外科器械实施例的另一个局部顶视图，其中驱动单元锁定系统处于解锁取向；
图22为外科器械和端部执行器的一部分的局部剖面侧视图，其中其回缩组件处于未致动取向；
图23为击发杆组件已被击发之后的图22的外科器械和端部执行器的另一个局部剖面侧视图；
图24为回缩组件已被致动以使驱动梁回缩返回到其在端部执行器内的起始位置之后的图23的外科器械和端部执行器的另一个局部剖面侧视图；
图25为处于预击发状态的另一个外科器械和端部执行器的一部分的局部剖面侧视图，其中其回缩组件处于未致动取向；
图26为击发之后的图25的外科器械和端部执行器的另一个局部剖面侧视图；
图27为图26的外科器械和端部执行器的另一个局部剖面侧视图，其中其回缩构件的闩锁处于未闩锁状态；
图28为图27的外科器械和端部执行器的另一个局部剖面侧视图，其中远侧击发杆部分处于回缩取向；
图29为另一个外科器械实施例的一部分的局部剖面图，其中其驱动联接器组件处于关节运动取向；
图30为图29的外科器械实施例的一部分的局部剖面图，其中其驱动联接器组件处于击发取向；
图31为图29和图30的外科器械的驱动联接器组件的放大破视图，其中以实线示出的联接器选择器构件处于关节运动取向并且以虚线示出的联接器选择器构件处于击发取向；
图32为另一个外科器械实施例的一部分的局部剖面图；
图33为图32的外科器械的一部分的放大局部剖面图；
图34为图32和图33的外科器械的一部分的另一个放大局部剖面图，其中其行进限制器处于其最远侧取向；
图35为图32-34的外科器械的另一个放大局部剖面图，其中其行进限制器处于其最近侧取向；
图36为沿图33中的线36-36截取的图33的外科器械的局部剖面图；
图37为图32-36的外科器械的一部分的局部透视图；
图38为根据本公开的各种实施例的外科器械的轴、衬圈、和未附接到轴的一次性加载单元的局部透视图；
图39为图38的轴、衬圈、和一次性加载单元的局部透视图，其中示出附接到轴的一次性加载单元；
图40为图38的轴、衬圈、和一次性加载单元的局部分解透视图；
图41为图38的轴、衬圈、和一次性加载单元的另一个局部分解透视图；
图42为图38的一次性加载单元的远侧附接部分的透视图；
图43为图38的一次性加载单元的远侧附接部分的另一个透视图；
图44为图38的轴的近侧附接部分的透视图；
图45为图38的轴的近侧附接部分的另一个透视图；
图46为图38的外科器械的衬圈和击发轴的透视图；
图47为图38的一次性加载单元、衬圈、和轴的局部透视剖面图，其中示出附接到轴的一次性加载单元；
图48为图38的一次性加载单元、衬圈、和轴的局部正视剖面图，其中示出未附接到轴的一次性加载单元；
图49为图38的一次性加载单元、衬圈、和轴的局部正视剖面图，其中示出附接到轴的一次性加载单元；
图50为沿图48所示的平面截取的图38的衬圈和轴的正视图；
图51为图38的一次性加载单元、衬圈、和轴的透视、局部剖面图，其中示出未附接到轴的一次性加载单元，并且还示出相对于轴处于初始取向的衬圈；
图52为图38的一次性加载单元、衬圈、和轴的透视、局部剖面图，其中示出未附接到轴的一次性加载单元，并且还示出相对于轴处于初始取向的衬圈；
图53为图38的一次性加载单元、衬圈、和轴的透视、局部剖面图，其中示出进入轴的一次性加载单元，并且还示出相对于轴处于初始取向的衬圈；
图54为图38的一次性加载单元、衬圈、和轴的透视、局部剖面图，其中示出进入轴的一次性加载单元，并且还示出相对于轴处于第二、旋转取向的衬圈；
图55为图38的一次性加载单元、衬圈、和轴的透视、局部剖面图，其中示出进入轴的一次性加载单元，并且还示出相对于轴处于第二、旋转取向的衬圈；
图56为图38的一次性加载单元、衬圈、和轴的透视、局部剖面图，其中示出完全插入轴内的一次性加载单元，并且还示出相对于轴处于第二、旋转取向的衬圈；
图57为图38的一次性加载单元、衬圈、和轴的透视、局部剖面图，其中示出完全插入轴内的一次性加载单元，并且还示出相对于轴处于初始取向的衬圈；
图58为图38的一次性加载单元、衬圈、和轴的透视、局部剖面图，其中示出完全插入轴内的一次性加载单元，并且还示出相对于轴处于初始取向的衬圈；
图59为根据本公开的各种实施例的外科器械的轴和未附接到轴的一次性加载单元的局部、透视、剖面图；
图60为图59的轴和一次性加载单元的局部、透视、剖面图，其中示出完全插入轴内的一次性加载单元，并且还示出处于未闩锁位置的闩锁；
图61为图59的轴和一次性加载单元的局部、透视、剖面图，其中示出完全插入轴内的一次性加载单元，并且还示出处于闩锁位置的闩锁；
图62为图59的轴和一次性加载单元的局部、正视、剖面图，其中示出完全插入轴内的一次性加载单元，并且还示出处于闩锁位置的闩锁；
图63为根据本公开的各种实施例的扭矩-电压曲线的示意图；
图64(a)为根据本公开的各种实施例的由脉宽调制电路递送的高占空比周期脉冲的示意图；
图64(b)为根据本公开的各种实施例的由脉宽调制电路递送的低占空比周期脉冲的示意图；
图65(a)为由图64(a)的脉宽调制电路的高占空比周期脉冲驱动的击发元件的示意图；
图65(b)为由图64(b)的脉宽调制电路的低占空比周期脉冲驱动的击发元件的示意图；
图66(a)-66(c)为根据本公开的各种实施例的具有主线圈组和辅助线圈组的脉宽调制电路的示意图；
图67为根据本公开的各种实施例的示出整个击发行程中的速度和扭矩的曲线图；
图68为根据本公开的各种实施例的示出击发行程期间的速度限制试验段的曲线图；
图69和图70为根据本公开的各种实施例的简化步进马达的示意图；
图71-73为根据本公开的各种实施例的混合步进马达的示意图；
图74(a)-74(c)为图71-73的混合步进马达的示意图，其中示出变化的极性；
图75为根据本公开的各种实施例的与内窥镜一起使用的包括触摸屏的显示器的透视图；
图76为显示在图75的显示器上的第一信息层的正视图，其中第一信息层包括由内窥镜观察的附加到外科器械的一次性加载单元(DLU)的视频反馈；
图77为显示在图75的显示器上的第二信息层的正视图，其中第二信息层包括用于经由触摸屏接收输入的控制面板；
图78为叠加在图76的第一信息层上的图77的第二信息层的正视图；
图79为叠加在图76的第一信息层上的图77的第二信息层的正视图，其中第二信息层包括当刀位于击发行程起始处附近时与刀进度相关的数字数据和刀进度的视觉表示；
图80为叠加在图76的第一信息层上的图77的第二信息层的正视图，其中第二信息层包括当刀位于击发行程的远侧端部附近时与刀进度相关的数字数据和刀进度的视觉表示；
图81为叠加在图76的第一信息层上的图77的第二信息层的正视图，其中第二信息层包括叠加在第一信息层所示的DLU中的刀的检测位置上的刀的符号表示；
图82为叠加在图76的第一信息层上的图77的第二信息层的正视图，其中第二信息层包括击发行程期间远侧推进刀的速度的图形表示；
图83为叠加在图76的第一信息层上的图77的第二信息层的正视图，其中第二信息层包括沿着DLU钳口的长度由DLU钳口施加到组织上的夹持力的图形表示；
图84为叠加在图76的第一信息层上的图77的第二信息层的正视图，其中第二信息层包括与DLU的取向相关的数字数据，并且其中第一信息层所示的DLU处于非关节运动取向；
图85为叠加在图76的第一信息层上的图77的第二信息层的正视图，其中第二信息层包括与DLU的取向相关的数字数据和DLU的取向的视觉表示，并且其中第一信息层所示的DLU处于关节运动取向；
图86为叠加在图76的第一信息层上的图77的第二信息层的正视图，其中示出来自使用者的用于经由图75的触摸屏来调整DLU的关节运动的输入；
图87为叠加在图76的第一信息层上的图77的第二信息层的正视图，其中示出用于控制DLU的示意图并且还示出来自使用者的用于经由图75的触摸屏操纵示意图来调整DLU的关节运动的输入；
图88为叠加在图76的第一信息层上的图77的第二信息层的正视图，其中示出响应于图86和图87所示的使用者输入的第一信息层中的处于关节运动取向的DLU；
图89为叠加在图76的第一信息层上的图77的第二信息层的正视图，其中示出来自使用者的用于经由图75的触摸屏来控制可运动钳口的闭合的输入；
图90为叠加在图76的第一信息层上的图77的第二信息层的正视图，其中示出响应于图89所示的使用者输入的第一信息层中的处于夹持取向的DLU的可运动钳口；
图91为用于图77的第二信息层的控制器界面的正视图；
图92为叠加在图76的第一信息层上的图77的第二信息层的正视图，其中第二信息层包括图91的控制器界面和进度条；
图93为示出用于反馈控制器与内窥镜、外科器械、和图75的显示器的通信系统的示意图；
图94为根据至少一个实施例的包括柄部和端部执行器的外科器械系统的分解图，所述外科器械系统包括多个指示器；
图95为根据至少一个实施例的包括多个指示器的外科器械系统的柄部的局部正视图；
图96为根据至少一个实施例的包括触发器锁的外科器械系统的柄部的局部剖面图，其中示出处于解锁状态的触发器锁；
图97为图96的柄部的局部剖面图，其中示出处于锁定状态的触发器锁；
图98为图96的触发器锁的剖面图，其中示出触发器锁处于其解锁状态；
图99为图96的触发器锁的剖面图，其中示出触发器锁处于其锁定状态；
图99A为概述外科器械的操作程序的流程图，所述操作程序用于评价外科器械是否已暴露于超过其阈值温度的温度并且确定向外科器械的使用者通知已超过阈值温度的方式；
图100为根据至少一个实施例的包括处于锁定状态的触发器锁的外科器械系统的柄部的剖面图；
图101为图100的柄部的剖面细部图，其中示出处于其锁定状态的触发器锁；
图102为图100的柄部的另一个剖面细部图，其中示出处于其解锁状态的触发器锁；
图103为被示出处于其锁定状态的图100的触发器锁的透视图；
图104为根据至少一个实施例的包括处于锁定状态的触发器锁的外科器械系统的柄部的局部剖面透视图；
图105为被示出处于解锁状态的图104的柄部的局部剖面透视图；
图106为被示出处于其锁定状态的图104的柄部的局部剖面左侧视图；
图107为被示出处于其锁定状态的图104的柄部的局部剖面右侧视图；
图108为被示出处于其解锁状态的图104的柄部的局部剖面左侧视图；
图109为被示出处于其解锁状态的图104的柄部的局部剖面右侧视图；
图110为示出可使用外科器械的控制器来处理从附接到外科器械的端部执行器接收的信号的步骤的处理流程图；
图110A为示出可从端部执行器提供到外科器械的参数阵列的示意图；
图111为示出用于使用图110的端部执行器和外科器械的步骤的处理流程图；
图112为根据至少一个实施例的示出外科器械的端部执行器和轴之间的互连部的示意图；
图113为图112的互连部的印刷电路板的平面图；
图114为根据至少一个实施例的外科器械的端部执行器的局部透视图；
图115为外科器械的轴和图114的端部执行器的局部透视图；
图116为附接到图115的轴的图114的端部执行器的剖面图；
图117为根据至少一个实施例的端部执行器和轴之间的互连部的剖面图；
图118为根据至少一个实施例的端部执行器和轴之间的互连部的剖面图；
图119为根据至少一个实施例的端部执行器和轴之间的互连部的剖面图；
图120为图119的互连部的细部图；
图121为根据至少一个实施例的包括砧座和砧座位置指示器的端部执行器的侧视图，其中示出处于打开位置的砧座；
图122为图121的端部执行器的侧视图，其中示出处于部分闭合位置的砧座；
图123为图121的端部执行器的另一个侧视图，其中示出处于部分闭合位置的砧座；
图124为图121的端部执行器的另一个侧视图，其中示出处于部分闭合位置的砧座；
图125为图121的砧座位置指示器的细部图，其中示出处于图121所示的位置的砧座；
图126为图121的砧座位置指示器的细部图，其中示出处于图122所示的位置的砧座；
图127为图121的砧座位置指示器的细部图，其中示出处于图123所示的位置的砧座；
图128为图121的砧座位置指示器的细部图，其中示出处于图124所示的位置的砧座；
图129示出了根据本文所公开的某些实施例的外科器械的剖面侧视图；
图130示出了用于对图129的外科器械提供功率的功率系统，其中功率系统与图129的外科器械的控制系统连通；
图131示出了连接到充电器座的图130的功率系统的电池组；
图132示出了图130的功率系统的功率管理电路；
图133示出了举例说明图130的功率系统的操作参数的示意性框图；
图134示出了根据本文所述的各种实施例的外科器械的功率源的透视图；
图135示出了根据本文所述的各种实施例的拆卸的图134的功率源的透视图；
图136示出了根据本文所述的各种实施例的包括完整可断开部分的图134的功率源的电路的电路图；
图137示出了根据本文所述的各种实施例的其中可断开部分已断开的图136的电路的电路图；
图138示出了根据本文所述的各种实施例的用于保护存储在存储器中的数据以防未授权访问的系统的框图；
图139示出了包括覆盖的数据访问入口的外科器械的功率源的透视图；
图140示出了处于未覆盖构型的图139的数据访问入口；
图141示出了包括内部数据访问入口的外科器械的功率源的透视图；
图142示出了根据本文所述的各种实施例的用于保护存储在存储器中的数据以防未授权访问的系统的框图；
图143示出了根据本文所述的各种实施例的外科器械的功率源的透视图；
图144示出了联接到外科器械的图143的功率源的透视图；
图145示出了根据本文所述的各种实施例的处于不同构型的图143的功率源的LED；
图146示出了根据本文所述的各种实施例的包括外壳的外科器械的侧视图；
图147示出了图146的外壳的侧视图，其中外部壳体被移除以暴露通过固定构件固定到外壳的可拆卸部件；
图148示出了图147的外壳的侧视图，其中可拆卸部件从外壳移除；
图149为示出限定在端部执行器的表面中的可检测的压痕、凹口、或条形码印记的示意图；
图150为可与条形码读取器一起使用的示例性条形码的示意图；
图151为根据至少一个实施例的包括条形码的端部执行器的轴的局部侧视图；
图152为根据至少一个实施例的包括条形码的外科器械的端部执行器的轴的局部正视图；
图153为根据至少一个实施例的包括条形码读取器的外科器械的柄部的局部透视图；
图154为示出其中定位有端部执行器的图153的条形码读取器的剖面图；
图155为根据至少一个实施例的外科器械的端部执行器和轴的分解透视图；
图156为根据至少一个实施例的外科器械的端部执行器和轴的分解透视图，其中端部执行器包括可释放地锁定在一起的击发构件的部分；
图157为通过锁定构件锁定在一起的图156的击发构件部分的局部透视图；
图158为图156的击发构件部分和锁定构件的局部透视图，其中示出击发构件的一部分被移除以显示将击发构件部分可释放地锁定在一起的锁定构件；
图159为释放致动器的图156的击发构件的分解图，所述释放致动器被构造成能够将锁定构件移动到解锁状态并且将击发构件部分解锁；
图160为图159的释放致动器与对应的轴释放致动器之间的互连部的局部分解图；
图161为图160的互连部的剖面图；
图162为包括马达、驱动轴、和滑动离合器的组件的分解透视图，所述滑动离合器被构造成能够在马达和驱动轴之间选择性地传输旋转；
图163为图162的组件的剖面图；
图164为图162的滑动离合器的偏置元件的透视图；
图165为图162的组件的剖面图，其中示出处于中间位置的滑动离合器的离合器元件；
图166为图162的组件的剖面图，其中示出处于前向位置的图165的离合器元件；
图167为图162的组件的剖面图，其中示出处于反向位置的图165的离合器元件；
图168为根据本公开的各种实施例的马达和齿轮组件的透视图；
图169为根据本公开的各种实施例的马达、齿轮组件、和音频反馈发生器的透视图；
图170为根据本公开的各种实施例的图169的齿轮组件的盘上的截齿的正视图，其中示出沿顺时针方向旋转的盘以及接合图169的音频反馈发生器的响片的截齿；
图171为根据本公开的各种实施例的图169的齿轮组件的盘上的截齿的正视图，其中示出沿逆时针方向旋转的盘以及接合图169的音频反馈发生器的响片的截齿；
图172为根据本公开的各种实施例的马达、具有多个盘的齿轮组件、和音频反馈发生器的透视图；
图173为根据本公开的各种实施例的通过图172的音频反馈发生器在击发行程末端附近产生的反馈的图形表示；
图174和图175为根据本公开的各种实施例的通过图172的音频反馈发生器在加载单元的关节运动极限附近产生的反馈的图形表示；
图176为示出用于操作外科器械的算法的示意图；
图177为示出用于操作外科器械的算法的另一个示意图；
图178为示出用于操作外科器械的算法的示意图；
图179为被构造成能够指示电池电压的电路；
图180为被构造成能够指示电池被充电的闪烁器电路图；
图181为根据至少一个实施例的与外科器械一起使用的诊断检查的示意图；
图182为示出电池的放电以及电池的电量低于最低电量水平时的功率切断的示意图；
图183为可保持的记录电池的操作和/或性能的信息表；
图184为电池诊断电路的示意图；
图185为根据本公开的各种实施例的与外科器械一起使用的密封马达和齿轮组件的透视图；并且
图186为根据本公开的各种实施例的图185的密封马达和齿轮组件的分解、正视、剖面图。
具体实施方式
本申请的申请人还拥有以下专利申请，所述专利申请与本申请同一天提交并且全文各自以引用方式并入本文：
-名称为FIRINGMEMBERRETRACTIONDEVICESFORPOWEREDSURGICALINSTRUMENTS的美国专利申请，代理人案卷号END7293USNP/130016；
-名称为SECONDARYBATTERYARRANGEMENTSFORPOWEREDSURGICALINSTRUMENTS的美国专利申请，代理人案卷号END7294USNP/130017；
-名称为ERRORDETECTIONARRANGEMENTSFORSURGICALINSTRUMENTASSEMBLIES的美国专利申请，代理人案卷号END7295USNP/130018；
-名称为ATTACHMENTPORTIONSFORSURGICALINSTRUMENTASSEMBLIES的美国专利申请，代理人案卷号END7296USNP/130019；
-名称为TAMPERPROOFCIRCUITFORSURGICALINSTRUMENTBATTERYPACK的美国专利申请，代理人案卷号END7297USNP/130020；
-名称为CLOSUREINDICATORSYSTEMSFORSURGICALINSTRUMENTS的美国专利申请，代理人案卷号END7298USNP/130021；
-名称为TORQUEOPTIMIZATIONFORSURGICALINSTRUMENTS的美国专利申请，代理人案卷号END7299USNP/130022；
-名称为SHROUDRETENTIONARRANGEMENTFORSTERILIZABLESURGICALINSTRUMENTS的美国专利申请，代理人案卷号END7300USNP/130023；
-名称为CONDUCTORARRANGEMENTSFORELECTRICALLYPOWEREDSURGICALINSTRUMENTSWITHROTATABLEENDEFFECTORS的美国专利申请，代理人案卷号END7301USNP/130024；
-名称为ENDEFFECTORDETECTIONSYSTEMSFORSURGICALINSTRUMENTS的美国专利申请，代理人案卷号END7302USNP/130025；
-名称为INTERACTIVEDISPLAYS的美国专利申请，代理人案卷号END7304USNP/130027；和
-名称为MOTOR-POWEREDARTICULATABLESURGICALINSTRUMENTS的美国专利申请，代理人案卷号END7305USNP/130028。
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、制造和用途原理。这些实施例的一个或多个实例已在附图中示出。本领域的普通技术人员将会理解，在本文中具体描述并示出于附图中的装置和方法为非限制性的示例性实施例，并且本发明的多个实施例的范围仅由权利要求书限定。结合一个示例性实施例进行图解说明或描述的特征可与其他实施例的特征进行组合。这些修改形式和变化形式旨在包括在本发明的范围之内。
术语“包括”(和包括的任何形式，例如“包括(comprises)”和“包括(comprising)”)、“具有”(和具有的任何形式，例如“具有(has)”和“具有(having)”)、“包含”(和包含的任何形式，例如“包含(includes)”、和“包含(including)”以及“含有”(和含有的任何形式，例如“含有(contains)”和“含有(containing)”)为开放式系动词。因此，“包括”、“具有”、“包含”或“含有”一个或多个元件的外科系统、装置、或设备具有这些一个或多个元件，但不限于仅具有这些一个或多个元件。同样，“包括”、“具有”、“包含”或“含有”一个或多个特征的系统、装置、或设备的元件具有这些一个或多个特征，但不限于仅具有这些一个或多个特征。
术语“近侧”和“远侧”在本文中是相对于操纵外科器械的柄部部分的临床医生来使用的。术语“近侧”是指最靠近临床医生的部分，并且术语“远侧”是指远离临床医生的部分。还应当理解，为简洁和清楚起见，本文可结合附图使用例如“竖直”、“水平”、“上”和“下”之类的空间术语。然而，外科手术器械在许多方向和位置中使用，并且这些术语并非限制性的和/或绝对的。
提供各种示例性装置和方法以执行腹腔镜式和微创外科手术操作。然而，本领域的普通技术人员将容易理解，本文所公开的各种方法和装置可用于许多外科手术和应用中，包括例如与开放式外科手术相结合。继续参阅本具体实施方式，本领域中的普通技术人员将进一步理解，本文所公开的各种器械可以任何方式插入体内，诸如通过自然腔道、通过形成于组织中的切口或穿刺孔等。器械的工作部分或端部执行器部分可被直接插入患者体内或可通过具有工作通道的进入装置插入，外科器械的端部执行器及细长轴可通过所述工作通道而推进。
图1示出了动力外科器械10，其在许多方面可类似于例如Zemlok‘763和/或Zemlok‘344中公开的外科器械(包括各种特征结构、部件、及其子部件)，这些专利的全文各自以引用方式并入本文。图1所示的外科器械10包括外壳12，所述外壳12具有柄部部分14以有利于器械的操纵和操作。因此，本文所用的术语“外壳”可涵盖手持式构造或可以其他方式手动操纵的构造。然而，术语“外壳”还可涵盖自动化外壳器械系统(例如，机器人控制的系统)的部分，所述自动化外壳器械系统不旨在为手持式的，而且可通过该系统的各个部件、部分、和/或致动器以其他方式进行操纵和致动。
形式为内窥镜部分的细长轴组件16从外壳12伸出并且被构造成能够可操作地附接到外科端部执行器，所述外科端部执行器被构造成响应于对其施加的击发动作来执行至少一个外科手术。此类外科端部执行器可包括例如直线切割器、抓紧器或其他装置，所述其他装置可包括一对钳口，其中一个钳口可相对于另一个钳口选择性地运动或者在一些构型中两个钳口均可相对于彼此运动。以另一个示例的方式，外科端部执行器可包括被构造成能够切割和缝合组织的装置，例如，如图2和图3中所示的“加载单元”20。外科端部执行器(例如加载单元20)例如能够可释放地附接到动力外科器械10的细长轴组件16，如本文更详细所述。
图2和图3示出了可与外科器械10一起使用的加载单元20的一种示例性形式。此类加载单元20可类似于全文以引用方式并入本文的上述美国专利申请公布中公开的加载单元以及例如公开内容以引用方式并入本文的名称为SURGICALSTAPLINGINSTRUMENTSWITHROTATABLESTAPLEDEPLOYMENTARRANGEMENTS的美国专利申请公布US2012-0298719-A1中公开的加载单元。
如在图2中可见，加载单元20包括括砧座组件22，所述砧座组件22被支撑以相对于操作地支撑其中的钉仓26的载体24而枢转行进。安装组件28可枢转地联接到仓载体24以形成关节运动接头27，所述关节运动接头27允许载体24围绕横向于纵向工具轴线“LA-LA”的关节运动轴线“AA-AA”枢转。参见图3，安装组件28可包括例如上部安装部分30和下部安装部分32。每个安装部分30、32可包括在其每一侧上的螺纹镗孔34，所述螺纹镗孔34的尺寸被设计成接纳螺栓(未示出)以将载体24的近侧端部固定到其上。一对中心定位的枢转构件36可通过一对联接构件38在上部安装部分和下部安装部分之间延伸，所述联接构件38接合外壳部分40的远侧端部。联接构件38可各自包括互锁近侧部分39，所述互锁近侧部分39被构造成能够容纳在形成于外壳部分40的近侧端部中的沟槽42中，以将安装组件30和外壳部分40保持在纵向固定位置。
如在图3中进一步可见，加载单元20的外壳部分40可包括各自被构造成能够容纳在外部壳体50内的上部外壳半部44和下部外壳半部46。外壳半部44的近侧端部可包括用于可释放地接合细长轴组件16的远侧端部的接合块48。块48可例如与细长轴组件16的远侧端部形成“卡口型”联接。本文较详细地描述了各种联接构造。外壳半部44、46可限定用于可滑动地容纳可轴向运动的驱动梁60的通道47。第二关节运动连接件70的尺寸可设定成可滑动地定位在形成于外壳半部44、46之间的狭槽72中。一对“防爆”板74可定位在邻近与驱动梁60的远侧端部相邻的外壳部分40的远侧端部，以防止驱动梁60在载体24的关节运动过程中向外凸出。
驱动梁60可包括远侧工作头62和近侧接合部分64。驱动梁60可由单个材料片或优选地由多个堆叠的片材制成。接合部分64可包括一对接合指状物，所述接合指状物的尺寸和构造被设计成以安装方式接合驱动构件66中形成的一对相应的保持狭槽。驱动构件66可包括近侧孔口67，所述近侧孔口67被构造成能够在加载单元20的近侧端部与外科器械10的细长轴组件接合时接纳击发杆的远侧端部。远侧工作头62可具有形成于其上的组织切割部分63。远侧工作头62还可包括一对销65，所述销65被构造成能够在远侧工作头62朝远侧驱动穿过钉仓26时接合砧座组件22以使其枢转到闭合位置，从而将组织夹持在砧座22和钉仓26之间。远侧工作头62上的组织切割部分63用于当支撑在钉仓26中的外科钉(未示出)以已知方式被驱动成与砧座22形成接触时切穿所夹持的组织。例如，远侧工作头62被构造成能够轴向地接合和推进可运动地支撑在钉仓26中的滑动件(未示出)。当驱动构件66沿远侧方向驱动滑动件时，滑动件接触与钉相关的推动器(未示出)并且使得推动器驱动钉离开仓26以与加载单元20的砧座22形成接合。
如在图1中可见，外科器械10包括被构造成能够产生旋转致动动作的马达100，所述旋转致动动作可用于例如将击发动作施加到加载单元20，如将在下文中更详细地论述。在至少一种形式中，例如，马达100被构造成能够将旋转致动动作施加到通常标定为82的击发构件组件。在一种构造中，例如，击发构件组件82包括驱动管102，所述驱动管102可旋转地支撑在外壳12内并且具有形成于其中的内螺纹(未示出)。击发杆104的近侧螺纹部分被支撑以与驱动管102螺纹接合，使得驱动管102的旋转导致击发杆104的轴向运动。击发杆104可与加载单元20中的驱动梁60的内部螺纹交接。如上述引用的Zemlok‘763和Zemlok‘344中较详细地论述，驱动管102沿第一方向(例如，逆时针)的旋转导致击发杆104沿远侧方向推进驱动构件60。驱动构件60在加载单元20内沿远侧方向的初始推进导致砧座22朝钉仓26枢转。砧座22由驱动构件60上的销65致动，所述销65用于在驱动构件60沿远侧方向“DD”进行初始驱动时使砧座22以凸轮方式运动到闭合位置。击发杆104和最终驱动构件60穿过加载单元20的附加远侧平移导致钉被驱动成与砧座22上的钉成形下表面形成接触。
如在图1中进一步可见，外科器械10可包括通常标定为109的关节运动系统。然而，外科器械10可包括本文详细公开的各种其他关节运动系统构造。在至少一种形式中，关节运动系统109可包括关节运动机构110，所述关节运动机构110包括关节运动马达112和手动关节运动钮114。关节运动马达112可通过动力关节运动开关116或者通过枢转手动关节运动钮114来致动。关节运动马达112的致动用于旋转关节运动机构110的关节运动齿轮118。关节运动机构110的致动可导致端部执行器(例如，加载单元20的仓/砧座部分)从其第一位置(其中其轴线与细长轴组件16的纵向工具轴线“LA-LA”基本上对准)运动到以下位置，其中端部执行器的轴线围绕例如关节运动轴线“AA-AA”相对于细长轴组件的纵向工具轴线“LA-LA”设置成一角度。有关关节运动机构110的各个方面的其他论述可存在于此前全文以引用方式并入本文的Zemlok‘763中。另外，整个公开内容以引用方式并入本文的名称为SURGICALSTAPLINGAPPARATUSWITHPOWEREDARTICULATION的美国专利7,431,188公开了可结合外科器械10使用的马达动力的能够关节运动的端部执行器。
在各种实施例中，外科器械可包括至少一个马达，所述至少一个马达可将击发动作施加到加载单元20并且/或者可将关节运动动作施加到关节运动系统109，如在别处更详细所述。马达100可例如由具有Zemlok‘763更详细描述的类型的功率源200来提供功率。例如，功率源200可包括可再充电电池(例如，铅基、镍基、锂离子基等等)。还可设想到，功率源200可包括至少一个一次性电池。一次性电池可例如为约9伏至约30伏。然而，可使用其他功率源。图1示出了其中功率源200包括多个电池单元202的一个示例。所使用的电池单元202的数量可取决于器械10的电流负载需求。
在某些实施例中，外科器械10可包括辅助功率源以用于对外科器械10的至少一个马达提供功率。例如，现在参见图129，外科器械10可包括功率系统2000，所述功率系统2000可被构造成能够提供能量以用于外科器械10的操作。如图129所示，功率系统2000可布置在例如外壳12的柄部部分14中并且可包括主功率源2002和辅助或备用功率源2004。主功率源2002可被构造成能够在正常操作期间提供能量以用于外科器械10的操作，并且辅助功率源2004可被构造成能够在主功率源2002不能提供能量以用于外科器械10的操作时(例如，在主功率源2002耗尽和/或与外科器械10断开时)至少以有限的容量提供能量以用于外科器械10的操作。例如，辅助功率源2002可被构造成能够在外科手术期间在主功率源2002耗尽和/或与外科器械10断开的情况下提供能量以使外科器械10恢复到默认状态。
参见图1，如在别处更详细所述，功率源(例如功率源200)可提供功率以用于外科器械10的操作。例如，功率源200可对马达(例如马达100)提供功率以导致驱动管102沿第一方向的旋转并且最终导致击发杆104的轴向推进，由此将驱动梁60朝远侧驱动穿过加载单元20。另选地，功率源200可对马达100提供功率以导致驱动管102沿与第一方向相反的第二方向的旋转并且最终导致击发杆104的轴向回缩，由此可使驱动梁60朝近侧运动到其起始和/或默认位置。类似地，主功率源2002可被构造成能够在外科器械10的正常操作期间对马达100提供功率以推进和/或回缩击发杆104。另外，辅助功率源2004可被构造成能够在主功率源2002不能提供所需功率的情况下(例如，在主功率源2002耗尽和/或与外科器械10断开时)提供所需的功率以使击发杆104回缩到默认位置。
对上文进行进一步描述，如在别处更详细所述，外科器械10可被构造成能够记录和存储外科手术期间有关外科器械10的多种信息，例如，端部执行器20(参见图2)的关节运动角度、端部执行器20的致动状态、传感器读数、击发次数、组织厚度、和/或击发杆104的位置。在某些示例中，此类信息可记录和存储在易失性或临时性存储器单元中，例如，随机存取存储器(RAM)单元，所述易失性或临时性存储器单元可需要功率以保持存储的信息。在外科器械10的正常操作期间，主功率源2002(类似于在别处更详细描述的其他功率源)可提供所需的功率以保持外科器械10的易失性或临时性存储器单元内的存储信息。另外，辅助功率源2004可在主功率源2002不能提供所需功率的情况下(例如，在主功率源2002耗尽和/或与外科器械10断开时)提供所需的功率以临时性地保持所存储的信息。
在某些方面，外科器械10可包括具有Zemlok‘763所公开的类型和构造的控制系统2005，该专利全文以引用方式并入本文。有关此类控制系统2005的构造和操作的其他细节可得自该公布。例如，控制系统2005可被构造成能够通过使用者界面(例如，视觉或音频显示器)来向使用者产生或提供信息，例如警告或器械状态。控制系统2005所产生的信号或输入可例如响应于由使用者、器械部件提供的其他信号或输入，或者可为与器械10相关的一个或多个测量结果的函数。在外科器械10的正常操作期间，如在别处更详细所述，功率源(例如主功率源2002(参见图129))可提供所需的功率以允许控制系统2005执行其功能，包括通过使用者界面与使用者进行交互。另外，辅助功率源2004可在主功率源2002不能提供所需功率的情况下(例如，在主功率源2002耗尽和/或与外科器械10断开时)至少以有限的容量提供所需的功率以通过使用者界面与使用者进行临时性地交互。
现在参见图130，功率系统2000可包括可连接到主功率源2002和辅助功率源2004的功率管理电路2006。功率管理电路2006可包括半导体、计算机芯片、或存储器，或者可与它们选择性地相联。功率管理电路2006可被构造成能够将模拟或数字输入或信号发送到外科器械10的各个部件(包括但不限于控制系统2005、主功率源2002、和/或辅助功率源2004)，或者接收来自外科器械10的各个部件的模拟或数字输入或信号。在各个方面，功率管理电路2006可使用软件(所述软件可采用一个或多个算法)来进一步地调制输入信号以控制和监测外科器械10的各个部件，包括主功率源2002和/或辅助功率源2004。此类调制的输入信号可为由功率管理电路2006测量和/或计算的判据的函数，或者在一些情况下，可由另一个器械部件、使用者、或与功率管理电路2006可操作地通信的独立系统提供给功率管理电路2006。
再次参见图129，主功率源2002可包括一个或多个电池单元，这取决于器械10的电流负载需求。在各个方面，如图129所示，主功率源2002可包括电池组2008，所述电池组2008可包括例如彼此可串联连接的多个电池单元2010。电池组2008可为可替换的。换句话讲，电池组2008可从外科器械10断开并且移出，并且可由另一个类似电池组替换。在某些方面，主功率源2002可包括可再充电电池(例如，铅基、镍基、锂离子基等等)。电池单元2008可为例如3伏锂电池单元，例如CR123A电池单元，但例如在其他实施例中，可使用不同类型的电池单元，例如具有不同电压水平和/或不同化学品的电池单元。使用者可从外科器械10断开并且移出耗尽或用尽的电池组2008，并且连接已充电的电池组2008以对外科器械10提供功率。耗尽的电池组2008可随后进行充电和再利用。还可设想到，主功率源2002可包括至少一个一次性电池。在各个方面，一次性电池可为例如约9伏至约30伏。使用者可断开并且移出耗尽的一次性电池组2008，并且连接新的一次性电池组2008以对外科器械10提供功率。
如上所述，电池组2008可包括可再充电电池单元并且可例如可移除地布置在外壳12的柄部部分14内。在此类情况下，电池组2008可利用充电器座进行充电。例如，如图131所示，充电器座2012可通过以下方式连接到电池组2008：将电池组2008从其在柄部部分14中的位置移出并且将其连接到充电器座2012。如图131所示，充电器座2012可包括用于对电池组2008充电的功率源2014。充电器座2012的功率源2014可为例如电池(或多个串联连接的电池)、或将例如来自输电干线的交流电转换为直流电的AC/DC转换器、或为用于对电池组2008充电的任何其他合适的功率源。充电器座2012还可包括指示器装置，例如LED、LCD显示器等，以显示电池组2008的充电状态。
另外，如图131所示，充电器座2012可包括例如一个或多个处理器2016、一个或多个存储器单元2018、和i/o接口2020、2022。充电器座2012可通过第一i/o接口2020与功率组2008连通(经由功率组的i/o接口)以允许例如将存储在功率组2008的存储器中的数据下载到充电器座2012的存储器2020。在各种情况下，随后可经由第二i/o接口2022将下载的数据下载到另一个计算机装置，以供例如医院系统(在该医院系统中执行涉及器械10的手术)、外科室、器械经销商、器械制造商等进行评估和分析。
充电器座2012还可包括电量计2024以用于测量整个电池组2008的电池单元上的电量。电量计2024可与处理器2016连通，使得处理器2016可实时地确定电池组2008的适用性，以用于确保电池按预期方式来工作。
再次参见图129，辅助功率源2004可包括可设置在例如柄部部分14内的一个或多个电池单元2026。电池单元2026可为可再充电的(例如，铅基、镍基、锂离子基等等)。例如，电池单元2026可为3伏锂电池单元，例如，CR123A电池单元。另外，电池单元2026可被构造成能够在不从器械10移出的情况下进行再充电。例如，当主功率源2002连接到器械10时，可使用主功率源2002对电池单元2026充电。
参见图132，示出了功率管理电路2006的示例性实施例。除了别的以外，功率管理电路2006可被构造成能够监测与主功率源2002和/或辅助功率源2004的操作相关的电参数。例如，功率管理电路2006可被构造成能够监测主功率源2002和/或辅助功率源2004中的功率水平。如图132所示，功率管理电路2006可包括电量计2028，所述电量计2028可被构造成能够测量整个主功率源2002和/或辅助功率源2004上的电量。功率管理电路2006还可包括非易失性存储器2030(例如，闪存或ROM存储器)和一个或多个处理器2032。处理器2032可连接到并且可控制存储器2030。另外，处理器2032可连接到电量计2028以读取电量计2028的读数以及以其他方式控制电量计2028。另外，处理器2032可控制功率管理电路2006的输出装置，例如LED。
读者将会知道，电量计2024和/或2028可被构造成能够测量电压、电量、电阻、和/或电流。在某些示例中，电量计2024和/或2028可包括电池容量测量电路，所述电池容量测量电路可被构造成能够测量预定负载下的电压状态。
对上文进行进一步描述，处理器2032可将有关主功率源2002和/或辅助功率源2004的信息存储在存储器2030中。所述信息可包括(除了别的以外)可用的总电量、使用次数、和/或性能。另外，存储在存储器2030中的信息可包括功率管理电路2006可读取和存储的主功率源2002的ID值。此类ID可为例如功率管理电路2006通过RFID转发器2034读取的RFID。RFID转发器2034可从包括RFID标签的功率源读取RFID。ID值可被读取、存储在存储器2030中、并且通过处理器2032来与存储在存储器2030中或存储在与功率管理电路2006相关联的另一个存储器中的可接受的ID值列表进行比较，以确定例如与读取的ID值相关的可拆卸/可替换的主功率源2002是否被授权和/或适当。在此类情况下，如果处理器2032确定与读取的ID值相关的可拆卸/可替换的部件未被授权，则功率管理电路2006可被构造成能够防止器械10的使用，例如通过断开开关(未示出)以防止功率被递送到器械10。可被处理器2032用于评估以确定部件是否被授权和/或适当的各种参数包括例如日期代码、部件型号/类型、制造商、地域信息、和/或早前的错误代码。
对上文进行进一步描述，功率管理电路2006还可包括i/o接口2036以用于与另一个装置(例如计算机)连通，从而允许存储在存储器2030中的数据被下载到另一个装置以供例如医院系统(在该医院系统中执行涉及器械10的手术)、外科室、器械经销商、和/或器械制造商进行评估和分析。I/o接口2036可为例如有线或无线接口。
参见图133所示的框图，功率管理电路2006可将功率从主功率源2002和辅助功率源2004选择性地传输到外科器械10。例如，处理器2032可被编程以在主功率源2002可用于对器械10提供功率时允许功率从主功率源2002传输到器械10并且在主功率源2002不能对器械10提供功率时允许功率从辅助功率源2004传输到器械10。
在器械10的正常操作期间，处理器2032在主电池源2002被检测和授权后(如上所述)可允许主功率源2002对器械10提供功率。主功率源2002可持续对器械10提供功率，直至主功率源2002达到或下降到低于预定的最低电量水平，例如，当主功率源2002断开和/或耗尽时。功率管理电路2006可用于确定主功率源2002何时达到或下降到低于预定的最低电量水平。例如，处理器2032可被构造成能够使用电量计2028或另一个类似电量计来监测主功率源2002的电量水平并且检测电量水平何时达到或下降到低于存储在功率管理电路2006的存储器2030中的预定最低水平。此时，处理器2032可提示使用者来替换主功率源2002。功率管理电路2006可包括指示器，例如，LCD显示器、一个或多个LED，所述指示器被启动以提示器械10的使用者来替换主功率源2002。此外，处理器2032可被构造成能够在检测到主功率源2002的电量水平已达到或下降到低于预定最低水平时将器械10的供能从主功率源2002切换到辅助功率源2004。读者将会知道，可使用附加指示器来向使用者提供附加反馈。例如，指示器可用于向使用者提示器械10正从主功率源2002切换到辅助功率源2004，反之亦然。
对上文进行进一步描述，处理器2032可被编程以在主功率源2002连接到外科器械10时允许主功率源2002对辅助功率源2004充电。在某些示例中，辅助功率源2004一旦被主功率源2002完全充电到预定最高功率水平就可保持空闲，前提条件是主功率源2002保持能够对器械10提供功率。另外，功率管理电路2006可用于确定辅助功率源2004何时被充分充电。例如，处理器2032可被构造成能够使用电量计2028监测辅助功率源2004的电量水平，直至电量水平达到可存储在功率管理电路2006的存储器2030中的预定最高水平，此时处理器2032可停止主功率源2002对辅助功率源2004充电。功率管理电路2006可包括指示器，例如，LCD显示器、一个或多个LED等，所述指示器可被启动以在辅助功率源2004被充分充电时提示器械10的使用者。
再次参见图129，主功率源2002可容纳在器械10的柄部部分14的腔室2038内。为了替换主功率源2002，可移除柄部部分14的外部壳体以暴露腔室2038。在某些示例中，触发器或开关可与柄部部分14的外部壳体相关联，使得尝试移除柄部部分14的外部壳体可被处理器2032理解为触发事件以从主功率源2002切换到辅助功率源2004。
在利用新的主功率源2002替换外科器械10的主功率源2002时，功率管理电路2006可检查新的主功率源2002的授权，如上所述，并且在确认此授权后，功率管理电路2006可允许新的主功率源2002向器械10传输功率。另外，主功率源2002可对辅助功率源2004充电，如上所述。
外科端部执行器(例如加载单元20(图2和图3))可操作地联接到动力外科器械10(图1)的细长轴组件16。例如，现在参见图38-58，外科端部执行器(例如一次性加载单元(DLU)5502)能够可释放地附接到外科器械，例如，动力外科器械10(图1)。在各种实施例中，外科器械可包括轴5520，所述轴5520可接合例如DLU5502。在各种实施例中，衬圈(例如，可旋转衬圈5580)可相对于轴5520可释放地锁定DLU5502。此外，在各种实施例中，衬圈5580的旋转可有利于击发组件和/或关节运动组件的附接和/或对准，如本文所述。
在各种实施例中，DLU5502可包括远侧附接部分5504，并且轴5520可包括外管5554和近侧附接部分5522。当DLU5502固定到轴5520(图39)时，DLU5502的远侧附接部分5504可接纳轴5520的近侧附接部分5522。此外，可旋转衬圈5580可定位在轴5520的近侧附接部分5522周围，使得DLU5502的远侧附接部分5504也可定位在可旋转衬圈5580内。可旋转衬圈5580可固定到轴5502和/或近侧附接部分5504，并且在某些实施例中可旋转地固定到例如轴5502的近侧附接部分5504。在某些实施例中，当DLU5502固定到轴5520时，轴5520的近侧附接部分可接纳DLU5502的远侧附接部分。此外，在某些实施例中，衬圈5580可旋转地固定到DLU5502。
仍参见图38-58，当DLU5502在非附接位置和附接位置之间相对于外科器械的轴5520运动时，DLU5502可沿着由轴5520限定的纵向轴线平移。当DLU5502从非附接位置运动到附接位置时，DLU5502的远侧附接部分5504可插入轴5520的近侧附接部分5522内。例如，当DLU5502在非附接位置和附接位置之间运动时，DLU5502可沿着方向A(图39)平移。在某些实施例中，远侧附接部分5504和近侧附接部分5522之间的沟槽-狭槽接合可沿着由轴5520限定的纵向轴线引导DLU5502。主要参见图42，远侧附接部分5504可包括导轨5514。此外，主要参见图44，近侧附接部分5522可包括导槽5534。导槽5534的尺寸和构造可被设计成在DLU5502的近侧附接部分5504插入轴5520的远侧附接部分5522内时接纳并且引导导轨5514。例如，导槽5534可包括纵向狭槽，并且导轨5514可包括例如纵向脊。在某些实施例中，导槽5534和导轨5514可防止DLU5502相对于由轴5520限定的纵向轴线的扭转和/或旋转。
主要参见图38，远侧附接部分5504可包括第一对准标记5510(例如，第一箭头)，并且轴5520和/或衬圈5580可包括第二对准标记5590(例如，第二箭头)。第一对准标记5510和第二对准标记5590的对准可使导轨5514和导槽5534对准，这可有利于远侧附接部分5504附接到近侧附接部分5522。如本文所述，DLU5502沿着纵向路径朝轴5520的平移可相对于轴5520可释放地锁定DLU5502。在此类实施例中，可不需要LU5502相对于轴5520的旋转，以相对于轴5520附接DLU5502。事实上，可通过近侧附接部分5522和远侧附接部分5504之间的沟槽-狭槽接合来限制和/或防止DLU5502相对于轴5520的旋转，如本文所述。在各种实施例中，衬圈5580可相对于LU5502和/或轴5520旋转以将DLU5502可释放地锁定到轴5520。例如，如本文所述，衬圈5580可从初始取向(图53)旋转到第二取向(图54)并且随后返回到初始取向(图57)以将DLU5502锁定到轴5520。
主要参见图图42和图43，DLU5502的近侧部分5504可包括旋转键或肋5506。当DLU5502在非附接位置(图38)和附接位置(图39)之间沿着方向A(图39)运动时，旋转键5506可影响衬圈5580的旋转。例如，旋转键5506可使衬圈5580沿着方向B(图39)从初始取向旋转和/或偏置到第二取向。当衬圈5580偏置到第二取向时，远侧附接部分5504可插入近侧附接部分5522内。此外，当远侧附接部分5504完全插入近侧附接部分5522内时，旋转键5506可允许衬圈5580沿着方向C(图39)从第二取向旋转到初始取向。方向C可例如与方向B相反。如本文所述，当衬圈5580返回到初始取向时，衬圈5580可相对于近侧附接部分5522锁定远侧附接部分5504。仍参见图42和图43，旋转键5506可包括位于其近侧端部的旋转坡道5508。旋转坡道5508可接合轴5520的元件以影响例如旋转衬圈5580的旋转。
在各种实施例中，旋转坡道5508可影响定位在轴5520内的击发轴5540的旋转。例如，主要参见图47-50，击发轴5540可包括可从击发轴5540径向向外延伸的击发轴旋转器5544。当DLU5502插入轴5520内时，旋转键5506的旋转坡道5508可接合击发轴旋转器5544。在各种实施例中，旋转坡道5508可旋转击发轴旋转器5544，所述击发轴旋转器5544可旋转击发轴5540。例如，击发轴5540和击发轴旋转器5544可在第一取向(图53)和第二取向(图54)之间沿着方向B(图54)旋转。仍参见图47-50，击发轴5540可与可旋转衬圈5580接合。例如，可旋转衬圈5580可包括旋转器沟槽5584，所述旋转器沟槽5584的构造和尺寸可被设计成接纳并且/或者保持击发轴旋转器5544。击发轴旋转器5544可被旋转器沟槽5584保持，使得击发轴旋转器5544的旋转导致旋转衬圈5580旋转。在此类实施例中，将DLU5502插入轴5520内可例如通过击发轴旋转器5544沿方向B的旋转来导致可旋转衬圈5580沿方向B的旋转(图54)。
主要参见图44和图45，近侧附接部分5522可包括旋转键狭槽5524，所述旋转键狭槽5524可在远侧附接部分5504插入近侧附接部分5522内时接纳旋转键5506。在各种实施例中，旋转键狭槽5524可包括间隙凹口5526以用于接纳击发轴旋转器5544。例如，旋转键5506的近侧端部处的旋转坡道5508可使击发轴旋转器5544旋转到第二取向并且旋转到间隙凹口5526(图54)内。当DLU5502插入轴5520内时，旋转键5506可继续沿着旋转键狭槽5524运动。此外，当旋转键5506的远侧端部5509运动通过击发轴旋转器5544时，击发轴旋转器5544可反向旋转到第一取向(图58)，这可相应地使可旋转衬圈5580反向旋转到其初始取向。
在各种实施例中，可旋转衬圈5580可相对于轴5520和/或近侧附接部分5522偏置成初始取向。例如，弹簧5592可将锁定衬圈5580偏置到初始取向。弹簧5592可包括可相对于轴5520进行固定的近侧端部5594和可相对于衬圈5580进行固定的远侧端部5596。例如，弹簧5592的近侧端部5594可保持在轴5520的近侧弹簧狭槽5538(图51)中，并且弹簧5592的远侧端部5596可保持在例如可旋转衬圈5580的远侧弹簧狭槽5588(图46)中。在此类实施例中，衬圈5580的旋转可相对于弹簧5592的近侧端部5594移动弹簧5592的远侧端部5596，这可产生扭转力。因此，衬圈5580可防止从初始取向到第二取向的旋转，并且当衬圈旋转到第二取向时，弹簧5592可将衬圈5580反向偏置到初始取向。由于击发轴旋转器5544与衬圈5580接合，弹簧5592还可将击发轴5540偏置到其第一取向。
在各种实施例中，可旋转衬圈5580可包括将DLU5502锁定到轴5520的锁定棘爪5582。主要参见图46，锁定棘爪5582可从可旋转衬圈5580的内周边径向向内延伸。在各种实施例中，锁定棘爪5582可延伸到近侧附接部分5522中的棘爪狭槽5536(图44)内。主要参见图44，棘爪狭槽5536可形成导槽5534中的凹口。在各种实施例中，棘爪狭槽5536可从导槽5534延伸，并且可垂直于或基本上垂直于例如导槽5534。此外，当可旋转衬圈5580相对于轴5520在初始取向和第二取向之间旋转时，锁定棘爪5582可沿着棘爪狭槽5536运动。
在各种实施例中，锁定棘爪5582可接合DLU5502的远侧附接部分5504以相对于轴5520锁定DLU5502。例如，再次参见图42，远侧附接部分5504可包括导轨5514，所述导轨5514可具有限定于其中的锁定凹口5516。锁定凹口5516的构造和尺寸可被设计成在DLU5502完全插入近侧附接部分5522内时接纳可旋转衬圈5580的锁定棘爪5582。例如，当远侧附接部分5504完全插入近侧附接部分5522内时，远侧附接部分5504的锁定凹口5516可与近侧附接部分5522的棘爪狭槽5536对准。因此，锁定棘爪5582可沿着近侧附接部分5522中的棘爪狭槽5536滑动并且滑动到远侧附接部分中的锁定凹口5516内。此外，锁定棘爪5582可通过扭转弹簧5592偏置成与锁定凹口5516接合。例如，在击发轴旋转器5544离开旋转键5506的远侧端部5509之后，击发轴5540可反向偏置到第一取向并且可旋转衬圈5580可通过扭转弹簧5592反向偏置到初始取向。此外，当衬圈5580从第二取向反向旋转到初始取向时，其锁定棘爪5582可与导轨5514中的锁定凹口5516对准并且接合。
在各种实施例中，衬圈5580的旋转可有利于击发组件的附接和/或对准。例如，击发轴5540可在近侧端部5546和远侧端部5542之间延伸。近侧端部5546可具有旋转接头，所述旋转接头可允许击发轴5540在第一构型和第二构型之间的旋转。此外，远侧端部5542可具有用于附接DLU5502的元件的联接器。击发轴5540的旋转可有利于切割元件的附接。例如，当击发轴5540的远侧端部5542处的联接器旋转时，联接器可接合并且连接到DLU5502中的切割元件。在某些实施例中，联接器可包括卡口座，所述卡口座可接合DLU5502中的切割元件的对应卡口接收器。主要参见图40和图41，击发组件还可包括例如围绕击发轴5540定位在近侧端部5546和远侧端部5542之间的套管5550。
在各种实施例中，当击发轴5540在轴5520内旋转时，击发轴5540可旋转成与DLU5502中的击发轴狭槽5518对准。例如，当DLU5502完全插入并且附接到轴5520时，击发轴旋转器5544可与击发轴狭槽5518对准。然而，在各种实施例中，当DLU5502仅部分插入轴5520内时，击发轴旋转器5544可通过旋转键5506旋转成不与击发轴狭槽5518对准。换句话讲，击发轴旋转器5544可在击发轴5540处于第一取向时与击发轴狭槽5514对准，并且可在击发轴5540旋转到第二取向时与击发轴狭槽5514不对准。在此类实施例中，当DLU5502仅部分插入轴5520内时并且/或者在DLU5502通过可旋转衬圈5580可释放地锁定到轴5520之前，击发轴旋转器5544的击发路径可被远侧附接部分5504阻挡。击发轴5540和衬圈5580的整合可确保DLU5502在击发轴5540可击发和/或推进之前牢固地附接到轴5520。例如，外科器械不能击发，直至DLU5502中的切割元件联接到击发轴5540并且/或者直至击发轴5540例如在轴5520内适当地对准。
在某些实施例中，衬圈5580的旋转可有利于关节运动组件5559的附接和/或对准。主要参见图40和图41，关节运动组件5559可包括近侧关节运动杆5560、远侧关节运动杆5562、和关节运动连接器5566。此外，轴5520可包括近侧关节运动杆狭槽5528，并且DLU5502可包括例如远侧关节运动杆狭槽5512。在某些实施例中，近侧关节运动杆5560可与近侧关节运动杆狭槽5528对准，并且远侧关节运动杆5562可与远侧关节运动杆狭槽5512对准。现在参见图46，关节运动连接器5566可容纳在可旋转衬圈5580中。例如，可旋转衬圈5580可包括关节运动连接器狭槽5586，并且关节运动连接器5566能够可运动地定位在其中。
在各种实施例中，再次参见图40和图41，近侧关节运动杆5560可具有近侧凹口5572，并且远侧关节运动杆5562可具有远侧凹口5574。此外，关节运动连接器5566可包括近侧关节运动凸耳5568和远侧关节运动凸耳5572。近侧关节运动凸耳5568可保持在近侧关节运动杆5560的近侧凹口5572中。在某些实施例中，远侧关节运动凸耳5570能够可操作地接合远侧关节运动杆5562的远侧凹口5574。如本文所述，可旋转衬圈5580可在初始构型和第二构型之间旋转。当衬圈5580旋转时，容纳在其中的关节运动连接器5566也可相对于由轴5520限定的纵向轴线旋转。在各种实施例中，当关节运动连接器5566旋转时，关节运动连接器5566的近侧关节运动凸耳5568可保持定位在近侧关节运动杆5560的近侧凹口5572中。此外，当关节运动连接器5566与衬圈5580从第二取向旋转到初始取向时，关节运动连接器5566的远侧关节运动凸耳5570可运动成与远侧关节运动杆5562的远侧凹口5574接合。例如，当DLU5502完全插入轴5508内时，远侧关节运动杆5562的远侧凹口5574可与关节运动连接器5566的远侧关节运动凸耳5568对准。在此类实施例中，当可旋转衬圈5580反向旋转到初始构型时，远侧关节运动凸耳5568可滑动到远侧关节运动杆5562的远侧凹口5574内。当远侧关节运动凸耳5568定位在远侧凹口5574中时，关节运动组件5559可为已完全组装的。
主要参见图45，在各种实施例中，近侧关节运动杆狭槽5528可包括第一间隙5530和第二间隙5532。关节运动连接器5566的近侧关节运动凸耳5568和远侧关节运动凸耳5570可分别延伸到第一间隙5530和第二间隙5532内。在某些实施例中，当衬圈5580旋转时并且/或者当关节运动组件5559例如进行关节运动时，第一间隙5530和第二间隙5532可提供空间以供近侧关节运动凸耳5568和远侧关节运动凸耳5570运动。
现在参见图51-58，为了将DLU5502连接到外科器械的轴5520，使用者可使DLU5502的对准标记5510与轴5520和/或衬圈5580(图51)的对准标记5590对准。在保持对准标记5510、5590的对准期间，使用者可相对于轴5520沿着由轴5520限定的纵向轴线移动DLU5502。使用者可沿着直线或基本上直线的路径移动DLU5502，并且在各种实施例中，不必相对于例如轴5520旋转DLU。主要参见图53，DLU5502可继续相对于轴5520平移，并且远侧附接部分5504的导轨5514可装配到轴5520的近侧附接部分5522中的导槽5534(图44)内。当远侧附接部分5504运动到近侧附接部分5522内时，导槽5534可引导导轨5514并且可保持例如对准标记5510、5590的对准。换句话讲，导槽5534和导轨5514可防止DLU5502相对于轴5520的纵向轴线的旋转。主要参见图52，关节运动连接器5522的近侧关节运动凸耳5568可延伸到第一间隙5530内并且可定位在近侧关节运动杆5562的近侧凹口5572中，并且关节运动连接器5522的远侧关节运动凸耳5570可延伸穿过例如第二间隙5532。
主要参见图54，当远侧附接部分5504插入近侧附接部分5522内时，旋转键5506的旋转键坡道5508可邻接击发轴旋转器5544。旋转键坡道5508可将击发轴旋转器5544引导并且/或者导向到从旋转键狭槽5524延伸的间隙凹口5526内。此外，当击发轴旋转器5544运动到间隙凹口5526内时，击发轴5540可沿着方向B旋转。击发轴5540可从第一取向旋转到第二取向。击发轴5540的此类旋转可有利于击发轴5540的远侧端部5542与DLU5502中的切割元件的附接。此外，击发轴旋转器5544的旋转可通过击发轴旋转器5544与衬圈5580中的击发轴旋转器沟槽5584(图46)的接合使衬圈5580沿着方向B旋转。衬圈5580可例如从初始取向旋转到第二取向。另外，当衬圈5580旋转时，锁定棘爪5582可沿着轴5520中的棘爪狭槽5536运动。另外，衬圈5580的旋转可使弹簧5592的远侧端部5596旋转，因为弹簧5592的远侧端部5596可保持在衬圈5580中的远侧弹簧狭槽5588(图46)内。远侧端部5596相对于近侧端部5594的移位可产生扭转回弹力，所述扭转回弹力可例如将衬圈5580从第二取向偏转到初始取向并且可例如击发轴5540从第二取向偏转到第一取向。
主要参见图55，当衬圈5580朝第二取向旋转时，近侧关节运动凸耳5568可与近侧关节运动杆5560中的近侧凹口5572保持接合。此外，远侧关节运动凸耳5570可旋转以使得远侧关节运动凸耳5570提供用于DLU5502的远侧关节运动杆5562的间隙。参见图56，当衬圈5580和定位在其中的关节运动连接器5566旋转到第二取向时，DLU5502可完全插入轴5520内。在各种实施例中，当关节运动连接器5566旋转到第二取向时，远侧关节运动杆5562可离开关节运动连接器5566的远侧关节运动凸耳5570。此外，远侧关节运动凸耳5570能够与关节运动连接器5566中的远侧凹口5574可旋转地对准。仍参见图56，当DLU5502完全插入轴5520内时，击发杆旋转器5544可离开旋转键5506的远侧端部5509。
现在参见图57，当旋转键5506的远侧端部5509通过击发轴旋转器5544时，击发轴旋转器5544可沿着方向C旋转。例如，击发轴旋转器5544可沿着方向C从第二取向旋转到第一取向。此外，击发轴旋转器5544的旋转可导致衬圈5580沿着方向C从第二取向旋转到初始取向。在各种实施例中，弹簧5592可将击发杆5540偏置到其第一取向，并且可将衬圈5580偏置到其初始取向。例如，击发轴旋转器5544可定位在衬圈5580中的击发轴旋转器沟槽5584(图46)内，使得击发轴旋转器5544的旋转使衬圈5580旋转。由于关节运动连接器5566的远侧关节运动凸耳5570和远侧关节运动杆5562的远侧凹口5574的对准，关节运动连接器5566可随着衬圈5580的旋转而旋转，并且远侧关节运动凸耳5570可旋转成与远侧凹口5574接合。当远侧关节运动凸耳5570接合远侧凹口5574时，关节运动组件5559可为已组装的。此外，当击发轴旋转器5544沿方向C旋转时，击发轴5540的远侧端部5542可沿方向C旋转，这可有利于DLU5502中的切割元件附接到击发轴5540的远侧端部5542。
现在参见图58，衬圈5580的旋转还可使衬圈5580的锁定棘爪5582旋转到远侧附接部分5504的导轨5514中的锁定凹口5516内。例如，当DLU5502完全插入轴5520内时，锁定凹口5516可与棘爪狭槽5536对准，使得锁定棘爪5582可通过棘爪狭槽5536旋转到锁定凹口5516内。如本文所述，在击发轴旋转器5544离开旋转键5506的远侧端部5509之后，弹簧5592可偏置衬圈5580以沿方向C(图57)旋转。仍参见图58，当击发轴旋转器5544沿方向C旋转时，击发轴旋转器5544可运动成与DLU5502中的击发轴狭槽5518对准。击发轴旋转器5544与击发轴狭槽5518的对准可允许例如击发轴5540朝远侧推进以击发DLU5502。
如本文所述，可旋转衬圈5580可相对于轴5520可释放地锁定DLU5502。此外，衬圈5580的旋转可有利于例如关节运动组件5559的附接和/或对准、以及击发轴5540与DLU5502中的切割元件的附接和/或对准。此外，衬圈的旋转还可从轴解锁DLU5502、断开关节运动组件5559、和/或DLU5502中的切割元件断开击发轴5540。例如，当衬圈5580再次从初始取向旋转到第二取向时，锁定棘爪5582可脱离远侧附接部分5504中的锁定凹口5516。因此，远侧附接部分5504可例如沿着由轴5520限定的纵向轴线从近侧附接部分5522退出。在各种实施例中，DLU5502可从轴5520脱离，而无需相对于轴5520旋转DLU5502。然而，衬圈5580可相对于轴5520旋转，这例如可使远侧关节运动杆5562与衬圈5580中的关节运动连接器5566断开并且可使击发轴5540与DLU5502中的切割元件断开。
现在参见图59-62，一次性加载单元(DLU)或端部执行器5602能够可释放地附接到外科器械的轴5620。在各种实施例中，弹簧或多个弹簧例如可将DLU5602相对于轴5620偏置成锁定位置。例如，DLU5602能够通过卡口座可释放地附接到轴5620，并且弹簧可旋转DLU5602从而通过卡口式连接将DLU5602连接到轴5620。DLU5602可包括远侧附接部分5604，并且轴5620可包括例如近侧附接部分5622。当DLU5602固定到轴5620时，DLU5602的远侧附接部分5604可接纳轴5620的近侧附接部分5622。在其他实施例中，当DLU5602固定到轴5620时，轴5620的近侧附接部分可接纳DLU5602的远侧附接部分。
在各种实施例中，DLU5602的远侧附接部分5604可包括棘爪5606，所述棘爪5606可从远侧附接部分5604的一部分径向向外延伸。此外，棘爪5606可包括倾斜表面5608。如本文所述，当远侧附接部分5604插入近侧附接部分5622内时，棘爪5606的倾斜表面5608可接合弹簧(例如弹簧5636b)并且可使弹簧5636b变形。此外，棘爪5606可由近侧附接部分5622保持以将DLU5602可释放地锁定到轴5622。主要参见图59，轴5620的近侧附接部分5622可限定腔体5624。在各种实施例中，腔体5624的构造和尺寸可被设计成接纳DLU5602的远侧附接部分5604。此外，弹簧5636a、5636b可定位在腔体5624内。例如，第一弹簧5636a可定位在腔体5624的第一侧，并且第二弹簧5636b可定位在腔体5624的第二侧。弹簧5636a、5636b可相对于腔体5624对称或不对称。在各种实施例中，弹簧5636a、5636b的至少一部分可延伸到腔体5624内。例如，第二弹簧5636b的腿部5637可延伸到腔体5624内，并且第二弹簧5636的另一个腿部5637可例如保持在近侧附接部分5622中。
仍参见图59，近侧附接部分5622还可包括锁定狭槽5638，所述锁定狭槽5638例如可限定在腔体5624中并且/或者可经由腔体5624触及。锁定狭槽5638的构造和尺寸可被设计成接纳例如棘爪5606。在各种实施例中，锁定狭槽5638可保持棘爪5606以相对于轴5620可释放地锁定DLU5602。此外，在各种实施例中，近侧附接部分5622可包括闩锁5630。闩锁5630可在未闩锁位置(图59和图60)和闩锁位置(图61和图62)之间运动。在各种实施例中，闩锁5630可为弹簧加载的，并且弹簧5634可将闩锁5630偏置到闩锁位置。例如，闩锁5630可包括闩锁弹簧5634，所述闩锁弹簧5634可将闩锁5630偏置到和/或偏置成闩锁位置。闩锁位置可例如位于未闩锁位置的远侧。在某些实施例中，闩锁5630可包括拇指抓握件和/或脊5632以有利于闩锁5630从闩锁位置运动到未闩锁位置。例如，使用者可接合拇指抓握件5632并且朝近侧牵拉闩锁5630以对闩锁5630解锁。
在各种实施例中，闩锁5630能够可操作地阻挡或至少部分地阻挡锁定狭槽5638。例如，当闩锁5630处于闩锁位置(图61和图62)时，闩锁5630的臂5635可延伸到锁定狭槽5638的至少一部分上。闩锁5630可覆盖或至少部分地覆盖锁定狭槽5638，并且可防止和/或限制进入锁定狭槽5638。在某些实施例中，闩锁5630的臂5635可防止棘爪5606运动和/或滑动到锁定狭槽5638内。此外，当闩锁5630处于闩锁位置时，闩锁5630可接合弹簧5636a、5636b。例如，参见图61和图62，闩锁5630可支撑弹簧5636b，使得弹簧5636b的变形被限制和/或防止。此外，闩锁5630可支撑弹簧5636b，使得腔体5624不能接纳DLU5602的远侧附接部分5604。例如，弹簧5636b的至少一部分可阻挡腔体5624，这可防止远侧附接部分5604完全插入近侧附接部分5622内。在某些实施例中，近侧附接部分5622可包括多个弹簧，所述多个弹簧可将旋转力施加到远侧附接部分5604上以使远侧附接部分5604相对于近侧附接部分5622旋转。例如，近侧附接部分5622可包括一对弹簧或多于三个弹簧。在其他实施例中，近侧附接部分5622中的单个弹簧可试图使远侧附接部分5604相对于近侧附接部分5622旋转。除此之外或另选地，在各种实施例中，DLU5602的远侧附接部分5602可包括例如至少一个弹簧，所述至少一个弹簧可使远侧附接部分5602相对于近侧附接部分5622旋转。
在各种实施例中，当闩锁5630处于未闩锁位置(图59和图60)时，闩锁5630的臂5635可不阻挡和/或较少地阻挡锁定狭槽5638。例如，棘爪5606可装配穿过未闩锁的闩锁5630以装配到锁定狭槽5638内。此外，棘爪5606可穿过未闩锁的闩锁5630偏置到锁定狭槽5638内，如本文所述。此外，在各种实施例中，当闩锁5630处于未闩锁位置时，闩锁5630可脱离弹簧5636a、5636b。例如，闩锁5630未闩锁时，闩锁5630可不保护和/或限制弹簧5636a、5636b的变形。
主要参见图59，当闩锁5630运动并且保持在例如近侧和/或未闩锁位置时，弹簧5636b可未被闩锁5630支撑。在此类实施例中，DLU5602可沿着方向A运动，使得远侧附接部分5604相对于近侧附接部分5622运动。主要参见图60，远侧附接部分5604的棘爪5606可接合弹簧5636b，并且可例如使弹簧5636b压缩和/或变形。在某些实施例中，棘爪5606的倾斜表面5608可沿着弹簧5636b滑动，并且可移动弹簧5636b的自由腿部5637。弹簧5636b的变形可产生回弹力，使得弹簧5636b可将回弹力施加到棘爪5606上。现在参见图61，回弹力可导致棘爪5606的旋转。例如，棘爪5606可沿着方向B旋转到限定于腔体5624中的锁定狭槽5638内。在各种实施例中，当使用者释放闩锁5630时，闩锁弹簧5634可使闩锁5630返回到未闩锁位置。此外，当闩锁5630返回到未闩锁位置时，闩锁5630的臂5635可阻挡或部分地阻挡锁定狭槽5638。在此类实施例中，当棘爪5606保持在锁定狭槽5638中时，远侧附接部分5604的棘爪5606能够相对于近侧附接部分5622被可释放地锁定。此外，在某些实施例中，闩锁5630可抵靠棘爪5606保持和/或支撑弹簧5636b，直至闩锁再次运动到未闩锁位置。在各种实施例中，为了从轴5620释放DLU5602，使用者可再次使闩锁5630从闩锁位置运动到未闩锁位置，使得棘爪5606可旋转离开锁定狭槽5638。在此类实施例中，棘爪5606的旋转再次使弹簧5636b压缩和/或变形，直至远侧附接部分5604从近侧附接部分5622退出。
对上文进行进一步描述，外科器械可被构造成能够识别或至少尝试识别已安装到外科器械的端部执行器。在某些实施例中，如下文进一步更详细所述，端部执行器可包括电触点，所述电触点可在端部执行器安装到轴时接合外科器械的轴上的对应电触点。在此类实施例中，外科器械的控制器可与端部执行器建立有线连接，并且控制器和端部执行器之间的信号通信可通过电触点来进行。如下文更详细所述，端部执行器可包括存储于其上的至少一个数据，所述至少一个数据可被控制器访问以识别端部执行器。所述至少一个数据可包括例如一个比特、多于一个比特、一个字节、或多于一个字节的信息。在某些其他实施例中，端部执行器可包括发射器，所述发射器可与外科器械的控制器进行无线信号通信。类似于上文所述，端部执行器可包括存储于其上的至少一个数据，所述至少一个数据可被发射到控制器以识别端部执行器。在此类实施例中，外科器械的控制器可包括接收器或使用接收器，所述接收器可接收来自端部执行器的发射。此类接收器可定位在例如外科器械的轴和/或柄部中。
读者将会知道，与控制器无线通信的端部执行器例如可被构造成能够发射无线信号。在各种情况下，端部执行器可被构造成能够发射一次或多于一次该信号。在某些情况下，端部执行器可被提示以在所需时刻发射信号和/或按照连续方式重复地发射信号。在一些情况下，端部执行器可包括开关，所述开关可在外科器械的端部执行器组装到外科器械之前、期间、和/或之后由外科器械的使用者进行操作。在各种实施例中，端部执行器开可包括通/断或功率开关，所述开关可被闭合或操作以启动端部执行器。在至少一个此类实施例中，端部执行器可包括至少一个功率源，例如电池，所述至少一个功率源可在通/断开关闭合时被发射器使用以发射信号。在端部执行器启动时，在各种情况下，端部执行器的控制器可被构造成能够产生信号并且通过发射器发射信号。在一些情况下，端部执行器可不发射信号，直至端部执行器被启动。此类构造可例如节省电池的功率。在某些实施例中，在端部执行器开关被致动之前，外科器械可布置在其可等到来自端部执行器的信号的操作模式。在各种情况下，外科器械可处于备用或低功率操作模式，其中一旦信号已被控制器接收，控制器就可将外科器械布置在全功率操作模式。在一些实施例中，端部执行器开关可指示端部执行器控制器以将信号发射到外科器械控制器。此类开关可包括或可不包括功率开关，然而，此类开关可被使用者选择性地致动以提示端部执行器在所需时刻和/或从后续所需时刻连续地发射信号。
现在转向图114，端部执行器(例如端部执行器9560)可包括可用于启动端部执行器9560的一个或多个电触点，例如触点9561。例如，现在转向图112，外科器械的轴9040可包括触点桥9562，所述触点桥9562可被构造成能够在端部执行器9560组装到轴9040时使触点9561中的两个或更多个短路或电连接。桥9562可接通电路，所述电路包括两个触点9561、电池9564、和限定在印刷电路板9565上的至少一个集成电路9566。对上文进行进一步描述，一旦电路被接通，电池9564就可对集成电路9566提供功率并且端部执行器9560可被启动。在各种情况下，限定在印刷电路板9565上的集成电路9566和天线9567可包括上文讨论的控制器和发射器。在某些实施例中，轴9040可包括偏置构件，例如，弹簧9563，所述偏置构件可被构造成能够将桥9562偏置成与电触点9561接触。在桥9562连接电触点9561之前和/或在端部执行器9560已脱离轴9040之后，电路可为打开的，来自电池9564的功率可不被提供到集成电路9566和/或提供到集成电路9566的功率可减小，并且端部执行器9560可处于未启动状态。由于上文所述，在此类实施例中，端部执行器的组装可因端部执行器组装到外科器械而被启动。在各种情况下，对上文进行进一步描述，端部执行器和外科器械可被构造和布置成使得端部执行器与外科器械的仅完整和适当组装将启动端部执行器。
如上所述，现在参见图111，端部执行器可附接到外科器械(由步骤9600所示)、被启动(由步骤9602所示)、并且随后通过外科器械进行评估(由步骤9604所示)。当外科器械正尝试评估来自启动的端部执行器的无线信号时，对上文进行进一步描述，外科器械可被构造成能够评价信号是否完整。在各种实施例中，端部执行器与外科器械之间的异步串行通信可用于评价由外科器械接收的信号是否完整。例如，端部执行器可发射包括起始位和/或停止位的信号，所述起始位在数据帧(例如，信息字节)之前，所述停止位在数据帧之后。在此类情况下，起始位、数据字节、和停止位可包括例如10位字符帧或位模式。在此类情况下，当外科器械的控制器可识别位模式的起始位和停止位时，控制器可假定在起始位和停止位之间接收的数据字节或数据位为正确的和/或换句话讲完整的。在各种情况下，起始位和/或停止位可包括下一信息字节被传输之前和/或前一信息字节被再次传送之前的停止周期。
对上文进行进一步描述，现在转向图110，外科器械的控制器可比较数据的位模式或某些位以确定其接收的塑化剂是否正确和/或换句话讲完整。在各种情况下，数据可被传输，以使得控制器可评估数据并且将数据与预期接收数据的位模式模板进行比较。例如，此类模板可被构造和布置成使得最显著数据位(例如，最左侧数据位)包括例如1。如果控制器能够识别出最显著数据位等于1，参见图110中的步骤9700，则控制器可对数据进行XOR操作并且将数据与可用于控制器的位模式模板进行比较，如步骤9702所示。XOR操作是已知的，并且为简明起见，其详细论述未提供于本文中。如果由外科器械接收的位模式匹配可用于控制器的位模式模板，则控制器将已识别出端部执行器。在识别出端部执行器时，控制器可访问例如可被控制器访问的存储器芯片中有关端部执行器的存储信息。如果控制器确定所接收的位模式中的最显著数据位不等于1，再次参见步骤9700，则控制器可执行移位操作。许多移位操作是已知的，例如，算术移位、逻辑移位和/或循环移位，所述移位操作可用于除去在所需位模式之前接收的异常数据位。在各种情况下，引导或最左侧0数据位可被除去，现在参见图110中的步骤9704，并且位模式可例如向左侧移位，直至引导位为1。此时，对上文进行进一步描述，可将移位的位模式与位模式模板进行比较以便识别端部执行器。如果移位的位模式不匹配位模式模板，则控制器可再次对位模式进行移位，直至位模式中的下一个1成为引导位并且可将新移位的位模式与位模式模板进行比较。此类移位和比较操作可被执行任何合适的次数，直至端部执行器被识别和/或外科器械认定端部执行器不能被识别。
读者将会知道，外科器械可包括有关端部执行器的任何合适数字的信息。当端部执行器已被外科器械识别出时，对上文进行进一步描述，外科器械可访问有关端部执行器的存储信息。例如，此类存储信息可例如向外科器械指示：1)为了完成击发行程，端部执行器中的击发构件必须推进的距离，和/或2)外科器械的马达应向击发构件施加的最大功率量或扭矩。此类信息或信息集对于每个端部执行器而言可为独特的，因此以某种方式识别端部执行器允许外科器械按照所需方式来操作。如果不存在此类信息，则外科器械可不能辨识完全利用端部执行器所需的行程长度并且/或者不能适当地限制其施加到击发构件的功率。在各种情况下，外科器械可依赖于传感器，所述传感器被构造成能够检测击发行程何时已完成和/或施加到击发构件的功率是否过量。此类传感器可防止外科器械的马达将超过率提供到并且损坏例如端部执行器的击发构件。
对上文进行进一步描述，某些端部执行器相比于其他端部执行器可更加强固，因此某些端部执行器能够耐受来自外科器械的马达的较大力。对应地，其他端部执行器可不太强固，因此可仅能够耐受来自马达的较小力。为了使外科器械确定施加到任何特定端部执行器的适当力，对上文进行进一步描述，外科器械必须识别附接到外科器械的端部执行器。如果端部执行器不能识别端部执行器，则外科器械可使用默认的操作程序或模式。在默认的操作模式中，外科器械的控制器可将马达可施加到端部执行器的击发构件的功率限制在最小或默认功率。最小功率可被选择为使得无论所使用的端部执行器如何，马达均将不损坏端部执行器。在一些情况下，用于可与外科器械一起使用的最弱或最不强固端部执行器的参数可被默认操作模式使用，使得无论所使用的端部执行器如何，外科器械均不将超过率提供到端部执行器。在各种情况下，马达动力外科器械的出现可导致端部执行器被提供过功率。换句话讲，先前被手动驱动外科器械使用并且基本上不能被此类手动驱动外科器械损坏的端部执行器可易于被马达动力外科器械损坏。此外，此类先前端部执行器可不包括将被马达驱动外科器械识别的技术，并且由于本文所述的默认操作程序，此类先前端部执行器仍可甚至与马达驱动外科器械一起使用。也就是说，默认操作程序也可使用其他默认参数。例如，默认操作程序可使用最小或默认的击发行程长度。在各种情况下，默认操作程序可采用可与外科器械一起使用的端部执行器的最短行程长度。在此类情况下，无论所使用的端部执行器如何，击发构件将不与端部执行器的远侧端部碰撞或撞击。
读者将会知道，外科器械包括有关可与外科器械一起使用的端部执行器的存储信息，可用于外科器械的信息可需要进行更新。例如，如果有关特定端部执行器的优选操作参数随时间推移而变化，则存储在每个外科器械内的信息可需要进行更新。此外，例如，当新的端部执行器被开发以用于与外科器械一起使用时，外科器械可需要进行更新。就外科器械不及时进行更新的情况而言，外科器械可不能识别端部执行器，并且因此可使用本文所述的默认操作程序。在各种实施例中，外科器械可不包括有关可与外科器械一起使用的端部执行器或至少某些端部执行器的存储信息。在此类实施例中，端部执行器可包括与端部执行器相关的存储信息或参数。此类参数可被外科器械访问和/或可被传送到外科器械。在各种情况下，对上文进行进一步描述，端部执行器与外科器械的组装可导致端部执行器发射可被外科器械接收的信号。另外类似于上文所述，端部执行器可被提示以发射信号。在各种情况下，该信号可通过有线和/或无线连接发射到外科器械。在某些实施例中，外科器械可提示端部执行器以发射信号。
对上文进行进一步描述，端部执行器可包括存储于其中的有关端部执行器的一个或多个参数。此类参数可存储在例如一个或多个存储器装置上。在各种情况下，此类参数可包括例如击发构件的所需击发速度、击发构件的所需回缩速度、击发构件将行进的距离或行程、由外科器械的马达施加到击发构件的最大扭矩、和/或在端部执行器事实上为关节运动式端部执行器的情况下端部执行器将进行关节运动的最大角度。某些关节运动式端部执行器公开于名称为ARTICULATABLESURGICALINSTRUMENTCOMPRISINGAFIRINGDRIVE的美国专利申请13/803,097中，该专利申请的全部公开内容以引用方式并入本文。就有关最大关节运动角度的参数而言，控制器可利用此参数来限制端部执行器的可关节运动部分进行关节运动的角度。在一些情况下，最大关节运动角度可为例如45度，如从外科器械轴的纵向轴线测得。就有关例如击发构件的击发速度和/或回缩速度的参数而言，此参数可传达例如用于击发构件的所需速度和/或马达的最大速度的百分比或分数。例如，当推进击发构件时，用于击发速度的值3可传达控制器应使马达例如在其最大速度的30％下操作。另外，例如，当回缩击发构件时，用于回缩速度的值5可传达控制器应使马达例如在其最大速度的50％下操作。就有关例如马达的最大扭矩的参数而言，此参数可传达例如马达的最大扭矩值和/或最大扭矩的百分比或分数。此外，就有关例如击发构件的行程长度的参数而言，此参数可传达击发构件将被推进和/或回缩的所需距离、和/或外科器械的最大行程长度的百分比或分数。例如，值60可指示击发行程应为例如60mm。在各种情况下，参数值可以任何合适的格式进行传送，包括例如二进制格式(包括数据位和/或字节)。参数阵列的示例性实施例示于图110A中。
在各种实施例中，对上文进行进一步描述，外科器械可被构造成能够按照特定的顺序从端部执行器获取参数。例如，从端部执行器发射的信号可包括例如起始位、用于第一参数(例如最大关节运动角度)的第一位模式、用于第二参数(例如击发速度)的第二位模式、用于第三参数(例如回缩速度)的第三位模式、用于第四参数(例如最大马达扭矩)的第四位模式、用于第五参数(例如行程长度)的第五位模式、和停止位。但这仅为一个示例。任何合适数量的参数可作为信号的一部分进行传送。此外，可使用任何合适数量的起始位和/或停止位。例如，起始位可在每个参数位模式之前并且/或者停止位可在每个参数位模式之后。如上所述，至少一个起始位和/或至少一个停止位的使用可有利于外科器械的控制器分析来自端部执行器的信号是否完整。在某些实施例中，可不使用起始位和/或停止位。此外，可从端部执行器发射多个信号，以便将端部执行器的参数传送到外科器械。
在各种情况下，对上文进行进一步描述，外科器械的控制器可利用检验和来评价其已从端部执行器接收的信号是否完整和/或其已接收的信号是否为授权的，即，来自识别的端部执行器。检验和可包括用于确保数据被无误差地存储、发射、和/或接收的值。其可通过以下方式来产生：计算例如数据的二进制值并且利用某个算法将二进制值组合在一起。例如，可将数据的二进制值加在一起，但可使用各种其他算法。在其中有关某些端部执行器的参数被存储在外科器械的实施例中，如上所述，也可存储每个此类端部执行器的检验和。在使用中，外科器械的控制器可访问参数数据和检验和值，并且在由参数数据计算检验和值(即，计算出被计算的检验和值)之后，控制器可将计算的检验和值与存储的检验和值进行比较。如果计算的检验和值等于存储的检验和值，则控制器可假定从外科器械的存储器检索的全部数据为正确的。此时，控制器可随后根据从存储器上载的数据来操作外科器械。如果计算的检验和值不等于存储的检验和值，则控制器可假定所检索数据中的至少一个数据为不正确的。在各种情况下，对上文进行进一步描述，控制器可随后例如在默认操作程序下操作外科器械、锁定外科器械的击发触发器、和/或以其他方式将事件传送给外科器械的使用者。在某些情况下，控制器可重新尝试从外科器械的存储器上载数据并且重新执行上文所述的检验和计算和比较。如果重新计算的检验和值和存储的检验和值匹配，则控制器可随后根据从存储器上载的数据来操作外科器械。如果重新计算的检验和值和存储的检验和值不相等，则对上文进行进一步描述，控制器可随后例如在默认操作程序下操作外科器械、锁定外科器械的击发触发器、和/或以其他方式将事件传送给外科器械的使用者。
在其中有关端部执行器的参数被存储在端部执行器的存储器中的实施例中，如上所述，检验和值也可存储在例如端部执行器中的存储器中。在使用中，外科器械的控制器可访问参数数据和存储的检验和值。在各种情况下，对上文进行进一步描述，端部执行器可发射一个或多个信号，所述一个或多个信号将参数和检验和值传送到外科器械。由于上文所述，存储的检验和值和参数可一起进行发射，并且为了本文的论述目的，由外科器械接收的外科器械可称为接收的检验和值。一旦参数数据已被接收，类似于上文所述，控制器就可由参数数据计算检验和值(即，计算出被计算的检验和值)并且将计算的检验和值与接收的检验和值进行比较。如果计算的检验和值等于接收的检验和值，则控制器可假定从端部执行器检索的全部参数数据为正确的。此时，控制器可随后根据从端部执行器上载的数据来操作外科器械。如果计算的检验和值不等于接收的检验和值，则控制器可假定所检索数据中的至少一个数据为不正确的。在各种情况下，对上文进行进一步描述，控制器可随后例如在默认操作程序下操作外科器械、锁定外科器械的击发触发器、和/或以其他方式将事件传送给外科器械的使用者。当参数数据通过例如一个或多个无线传输系统从端部执行器传送到外科器械时，此类事件可为较频繁的。在任何情况下，在某些情况下，控制器可重新尝试从端部执行器上载数据并且重新执行上文所述的检验和计算和比较。如果重新计算的检验和值和接收的检验和值匹配，则控制器可随后根据从端部执行器上载的数据来操作外科器械。如果重新计算的检验和值和接收的检验和值不相等，则对上文进行进一步描述，控制器可随后例如在默认操作程序下操作外科器械、锁定外科器械的击发触发器、和/或以其他方式将事件传送给外科器械的使用者。在各种情况下，由于上文所述，外科器械不需要存储有关端部执行器的任何信息，当利用端部执行器时所述信息用于操作外科器械。在此类情况下，有关用于确认数据完整性的端部执行器参数和检验和值的数据可完全存储在端部执行器上。外科器械可包括操作程序，所述操作程序仅需要来自端部执行器的足够输入以便使用端部执行器。用于可与外科器械一起使用的每个端部执行器的特定操作程序可为不需要的。单个操作程序可与每个端部执行器一起使用。由此，外科器械可不需要进行更新以包括例如用于附加端部执行器的操作程序和/或用于现有端部执行器的修改程序。
除了或取代本文所述的用于识别附接到外科器械的端部执行器的无线通信系统，现在转向图149-154，根据至少一个实施例的外科器械可包括用于扫描和识别端部执行器的装置。图153示出了包括条形码读取器11022的柄部11020，所述条形码读取器11022可被构造成能够扫描位于图151、图152和图154所示的端部执行器11060上的图149和图150所示的条形码。类似于本文所公开的其他实施例，端部执行器11060可包括例如轴部分、砧座11062、和/或钉仓11064，其中端部执行器11060的一个或多个部分可包括其上的条形码。在一些实施例中，端部执行器11060可包括定位在砧座11062和钉仓11064中间的可移除部件11063，所述可移除部件11063可在端部执行器11060已组装到外科器械之前或之后被移除。在图151中，条形码11065被示为定位在端部执行器11060的轴部分上。在图152中，条形码11065被示为定位在可移除部件11063上。在各种实施例中，外科器械的柄部11020可包括被构造成能够读取端部执行器上的条形码的条形码读取器，例如条形码读取器11024。例如，主要参见图154，柄部11020可包括内部条形码读取器部分11022，所述内部条形码读取器部分11022被构造成能够读取限定在端部执行器11060的轴上的条形码11065。在至少一种此类情况下，条形码读取器部分11022可包括槽11026，所述槽11026的尺寸和构造被设计成接纳端部执行器11060的轴，其中条形码读取器11024可安装在限定于槽11026中的开口11027内和/或相对其进行安装，使得条形码读取器11024可读取条形码11065。读者将会知道，许多条形码读取器和条形码协议是已知的，并且可使用任何合适的条形码。在一些情况下，条形码可包括例如双向信息，所述双向信息允许条形码在两个不同方向上进行读取。在一些情况下，条形码可使用多个信息层。在一些情况下，条形码协议可包括前导信息，所述前导信息之后为如下信息，所述信息将识别端部执行器并且/或者以其他方式将信息提供给外科器械以允许外科器械操作或利用特定操作程序操作。在一些情况下，条形码读取器可发射一个或多个光束，所述一个或多个光束可接触构成条形码的多个峰和谷。在一些情况下，条形码的谷可延伸到和/或限定在端部执行器的轴外壳内。发射的光束可反射回其可被解译的条形码读取器。也就是说，柄部11020的条形码读取器11024定位和布置在槽11026内，使得发射和反射的光束限制在或至少基本上限制在条形码读取器部分11022内。这样，条形码读取器11024可不会意外地或无意地扫描可存在于外科套件中的不同端部执行器，即，并非即将组装到外科器械的端部执行器的端部执行器。
在各种情况下，对上文进行进一步描述，可在端部执行器组装到外科器械之前使端部执行器穿过外科器械的条形码读取器。在各种另选的实施例中，外科器械可包括可移动条形码读取器，所述可移动条形码读取器可用于在端部执行器已组装到外科器械之后来扫描端部执行器的条形码。在任何情况下，一旦端部执行器已被识别，在至少一些情况下，控制器就可访问被构造成能够使用识别的端部执行器的操作程序。在某个方面，条形码可包括引导加载器。在其他情况下，如本文在别处所述，条形码可向控制器提供必要的信息或参数以使用通用的操作系统。在一些情况下，可利用序列号来识别每个端部执行器，使得任何两个端部执行器即使可为相同类型的端部执行器也可在其上具有两个不同的条形码。在此类情况下，控制器可被构造成能够拒绝使用先前已被外科器械扫描的端部执行器。此类系统可例如防止至少部分消耗的端部执行器被再次使用。
如上所述，端部执行器可被构造成能够通过有线连接和/或无线连接与外科器械通信。就有线连接而言，现在转向图115，端部执行器的近侧端部(例如端部执行器9960的近侧端部9969)可包括多个电触点9968，所述多个电触点9968可被布置成与设置在外科器械的轴9940的远侧端部9942之上和/或内部的多个电触点9948电连通。主要参见图116，每个电触点9968可包括至少部分地定位在元件腔体9965内的触点元件9967。每个电触点9968还可包括定位在触点元件9967和元件腔体9965的内侧壁中间的偏置构件，例如，弹簧9966。弹簧9966可被构造成能够径向向外偏置触点元件。触点元件9967从其突起的止挡件9964，所述止挡件9964可至少在端部执行器9960安装到轴9940之前被弹簧9966可运动地偏置成与元件腔体9965的另一个内侧壁接合。止挡件9964和元件腔体9965的侧壁之间的相互作用可防止触点元件9967的向外运动。当端部执行器9960安装到轴9940时，轴电触点9948可对抗由弹簧9966施加的偏置力来向内推压电触点9968的触点元件9967，如图116所示。在各种情况下，每对触点9948和9968可接通电路或连通通道9950。尽管示出了三对触点，但可使用任何合适数量的触点和/或连通通道。在各种实施例中，参见图117，轴触点10048可各自包括可运动元件10047和偏置弹簧10046，所述偏置弹簧10046被构造成能够推压可运动元件10047以抵靠对应的端部执行器触点10068。在某些实施例中，现在转向图118，端部执行器触点和轴触点中的一者或两者可包括柔性部分。例如，端部执行器可包括柔性触点10168，所述柔性触点10168可弹性接合对应的轴触点9948。
就上文所述的实施例而言，在各种情况下，端部执行器可沿着纵向轴线安装到轴。在此类情况下，主要参见图115，最近侧端部执行器触点9968将首先与最远侧轴触点9948电接触。读者将会知道，当这些触点形成接合时，端部执行器9960仍未完全附接到轴9940。尽管这些触点之间的此类接合可为临时的，即，在端部执行器9960较深地安置在轴9940内之前，但外科器械控制器可混淆或误译来自端部执行器9960的一个或多个信号。在端部执行器9940被完全安置之前，随着端部执行器触点9968的纵向阵列渐进地接触轴触点9948的纵向阵列，可产生此类混淆。在各种实施例中，外科器械的控制器可被构造成能够忽略通过触点传输的信号，直至最近侧端部执行器触点9968与最近侧轴触点9948接合。现在转向图119和图120，一个触点对可不同于另一个触点对，使得控制器可识别该对触点何时已配对并且因此可识别端部执行器何时已被完全安置。例如，外科器械的端部执行器和轴可包括第一对触点10248a、10268a，第二对触点10248b、10268b，和第三对触点10248c、10268c，其中第三对触点可不同于第一对触点和第二对触点。当第一对触点10248a、10268a已配对时，触点元件10267a可被向内推压，使得触点元件10267a的第一连接部分10263a接触通信路径9950a的第一路径部分9951a并且触点元件10267a的第二连接部分10264a接触通信路径9950a的第二路径部分9952a。在触点元件10267a的该位置，第一路径部分9951a和第二路径部分9952a均可通过触点元件10267a传输信号。当第二对触点10248b、10268b已配对时，触点元件10267b可被向内推压，使得触点元件10267b的第一连接部分10263b接触通信路径9950b的第一路径部分9951b并且触点元件10267b的第二连接部分10264b接触通信路径9950b的第二路径部分9952b。在触点元件10267b的该位置，第一路径部分9951b和第二路径部分9952b均可通过触点元件10267b传输信号。当第三对触点10248c、10268c已配对时，触点元件10267c可被向内推压，使得触点元件10467c的第一连接部分10263c不接触通信路径9950c的第一路径部分9951c，触点元件10267c的第二连接部分10264c不接触通信路径9950c的第二路径部分9952c并且接触第一路径部分9951c。在触点元件10267a的该位置，第一路径部分9951c可通过触点元件10267c传输信号。由于上文所述，当端部执行器已完全安置时第一、第二和第三组可与其相应的通道路径具有特定的连接构造，并且控制器可被构造成能够此完全接合的构造是否适当。例如，当端部执行器初始插入轴内时，第三触点10264c可初始接触第一轴触点10248a。在该位置，仅两个路径部分(即，9951a和9952a)能够将信号从端部执行器传送到控制器，由此控制器可被构造成能够检测到互连之间的压降，所述压降不同于当端部执行器被完全安置而使五个路径部分(即，9951a、9952a、9951b、9952b、和9951c)能够传送信号时产生的压降。类似地，端部执行器可进一步地插入轴内，直至第三触点元件10267c接触第二轴触点10248b并且第二触点元件10267b接触第一轴触点10248a。在该位置，仅四个路径部分(即，9951a、9952a、9951b、和9952b)能够将信号从端部执行器传送到控制器，由此控制器可被构造成能够检测到互连之间的压降，所述压降不同于当端部执行器被完全安置而使五个路径部分(即，9951a、9952a、9951b、9952b、和9951c)能够传送信号时产生的压降。
在某些情况下，当端部执行器组装到外科器械的细长轴时，操作者可接合端部执行器的驱动系统和/或关节运动系统以有利于例如端部执行器的闭合、击发、和/或关节运动。端部执行器可包括第一钳口、第二钳口和一个或多个传感器，所述一个或多个传感器被构造成能够检测第一钳口相对于第二钳口的位置。现在参见图121-124，端部执行器10360可包括第一钳口或砧座10362和第二钳口或钉仓10364，其中砧座10362可朝向和远离钉仓10364运动。通常，端部执行器10360通过套管针插入患者体内，在此处，端部执行器10360可不易于观察到，即使在内窥镜的辅助下亦是如此。因此，外科器械的使用者可不能容易地评价砧座10362相对于第二钳口10364的位置。为了有利于端部执行器的使用，如上所述，端部执行器10360可包括用于检测砧座10362的位置的传感器。在各种情况下，此类传感器可被构造成能够检测砧座10362和钉仓10364之间的间隙。某些传感器可被构造成能够检测砧座10362相对于钉仓10364的旋转位置。传感器公开于2013年3月13日提交的名称为STAPLECARTRIDGETISSUETHICKNESSSENSORSYSTEM的美国专利申请序列13/800,025和2013年3月13日提交的名称为STAPLECARTRIDGETISSUETHICKNESSSENSORSYSTEM的美国专利申请序列13/800,067中。2013年3月13日提交的名称为STAPLECARTRIDGETISSUETHICKNESSSENSORSYSTEM的美国专利申请序列13/800,025和2013年3月13日提交的名称为STAPLECARTRIDGETISSUETHICKNESSSENSORSYSTEM的美国专利申请序列13/800,067的整个公开内容以引用方式并入本文。无论所使用的传感器如何，砧座10362的位置可通过显示器传送给外科器械的使用者。此类显示器可位于外科器械的端部执行器10360和/或轴(例如轴10340)上。当显示器位于端部执行器上时，显示器可利用例如内窥镜进行观察。在此类情况下，显示器可定位在端部执行器上以使其不被套管针遮蔽，所述套管针允许端部执行器进入外科套件。换句话讲，显示器可被定位成使其在使用期间相对于套管针的远侧端部位于远侧。当显示器位于轴上时，显示器可定位在轴上以使其不被套管针遮蔽。换句话讲，显示器可被定位成使其在使用期间相对于套管针的近侧端部位于近侧。参见图121-124所示的实施例，显示器10390位于轴10340上。
继续参见图121，端部执行器10360的砧座10362示为处于完全打开位置。在砧座10362的该位置，端部执行器10360的击发构件10330处于近侧位置并且还未朝远侧推进。如将在下文中更详细所述，击发构件10330朝远侧推进以使砧座10362朝钉仓10364运动。图121所示的击发构件10330的位置可表示击发构件10300的未击发、最近侧位置。当砧座10362处于其完全打开位置时，主要参见图125，砧座显示器10390可不被点亮。读者将会知道，砧座显示器10390可在若干不同位置中的一个内示出砧座10362的位置。砧座显示器10390碰巧能够显示砧座10362的五个可能位置；然而，可设想到其他实施例，所述实施例可包括使用多于五个指示器或少于五个指示器的砧座显示器。随着砧座10362从其打开位置运动到其闭合位置，显示器10390可利用指示器10391-10395连续地示出砧座10362的位置。指示器10391示出了处于轻微闭合位置的砧座10362。指示器10392、10393和10394示出了处于部分闭合位置的砧座10362。指示器10395示出了处于完全闭合或平行位置的砧座10362。在比较图121和图122时，读者将会知道，击发构件10330已朝远侧推进以至少部分地闭合砧座10362。当砧座10362处于图122所示的位置时，砧座位置传感器可检测砧座10362的新位置并且砧座显示器10390的指示器10391可被点亮，如图126所示。在比较图122和图123时，击发构件10330已朝远侧推进以进一步地闭合、但未完全闭合砧座10362。当砧座10362处于图123所示的位置时，砧座位置传感器可检测砧座10362的新位置并且指示器10393可被点亮，如图127所示。在进一步比较图122和图123时，读者将会知道，砧座10362已被旋转例如约10度并且如果砧座10362已被旋转例如仅约5度，则砧座显示器10390的指示器10392将已被点亮。在比较图123和图124时，击发构件10330已朝远侧推进以完全闭合砧座10362。当砧座10362处于图124所示的位置时，砧座位置传感器可检测砧座10362的新位置并且指示器10395可被点亮，如图128所示。在进一步比较图123和图124时，读者将会知道，砧座10362已被旋转例如约10度并且如果砧座10362已被旋转例如仅约5度，则砧座显示器10390的指示器10394将已被点亮。
对上文进行进一步描述，端部执行器和/或外科器械可包括可被构造成能够控制砧座显示器10390的控制器。例如，当端部执行器包括砧座显示器10390，控制器可定位在端部执行器内。当外科器械的轴包括砧座显示器10390并且/或者外科器械的任何其他部分包括砧座显示器10390时，外科器械可包括控制器。在其他情况下，端部执行器和外科器械中的一者可包括砧座显示器10390，而端部执行器和外科器械中的另一者可包括控制器。在任何情况下，砧座位置传感器可与控制器进行信号通信。控制器可被构造成能够解译来自传感器的一个或多个信号以确定砧座10362的位置。控制器可与砧座显示器10390通信，以便点亮指示器10391-10395，如上所述。在各种情况下，每个指示器10391-10395可包括例如发光二极管。在此类情况下，每个发光二极管可被布置成与控制器的微处理器的输出通道电连通，使得控制器可选择性地点亮发光二极管，而这独立于其他发光二极管。在各种情况下，控制器可基于来自砧座传感器的数据连续地评估砧座10362的位置，并且利用此数据连续地更新被点亮的指示器。例如，当砧座10362正闭合或打开时，控制器可跟踪砧座10362的位置并且通过指示器10391-10395将此信息快速地显示给外科器械的使用者。此类情况可向使用者提供有关砧座10362的位置的实时或近实时反馈。在其他情况下，控制器可等待显示砧座10362的位置，直至砧座10362例如已停止运动或至少基本上停止运动一定时间段之后。读者将会知道，指示器10391-10395可表示砧座10362的分立位置；然而，可能情况是砧座10362可例如在其闭合时仅瞬时地穿过这些分立位置中的每一个。在各种情况下，控制器可利用算法以便确定哪个指示器将点亮。例如，控制器可应用算法，所述算法确定哪个指示器较精确地表示砧座10362的位置，即使砧座10362可不与可由指示器显示器10390表示的分立位置中的任何一个对准。在各种情况下，当砧座10362定位在由两个相邻指示器表示的两个分立位置中间时，控制器可点亮指示器显示器10390中的两个相邻指示器。
在各种情况下，对上文进行进一步描述，指示器10391-10395可各自包括发光二极管，所述发光二极管发射相同颜色的光或至少基本上相同颜色的光。在其他情况下，指示器10391-10395中的一个或多个可发射不同于另一个指示器10391-10395的颜色。例如，指示器10391可被构造成能够发射黄色，而指示器10392-10395可被构造成能够发射例如绿色。读者将会知道，参见图122，当砧座10362处于图122所示的部分闭合位置时，定位在砧座10362和仓10364之间的组织T可未被砧座10362充分地夹持，并且当与砧座10362的该位置相关的指示器10391被点亮黄色时，外科器械的使用者可被提醒以在移动端部执行器10360和/或继续击发过程之前保持谨慎。在一些情况下，指示器10361-10365中的每一个各自可被构造成能够发射多于一种颜色。例如，每个指示器10361-10365可包括被构造成能够发射绿色和红色的发光二极管。在此类情况下，指示器10361-10365可在指示砧座10362的该位置时发射绿色，如上所述，并且另选地，可在端部执行器10360和/或外科器械存在错误时发射红色。
如上所述，端部执行器的砧座可相对于钉仓在打开位置和闭合位置之间运动，并且外科器械系统可被构造成能够检测砧座的运动并将砧座的运动传送给使用者。也就是说，可设想到其中钉仓可相对于砧座运动的实施例。在至少一个此类实施例中，砧座可为固定的或不能枢转的。当固定或不能枢转时，砧座可从端部执行器框架的一部分刚性地延伸；然而，砧座从其延伸的端部执行器框架的该部分以及钉仓可相对于外科器械的端部执行器的另一部分或轴进行关节运动。无论端部执行器是否能够进行关节运动，在此类实施例中，钉仓能够相对于砧座枢转。本文所述的用于检测砧座的运动的系统和方法可适用于检测钉仓的运动。此外，本文所述的用于显示砧座的运动的系统和方法可适用于显示钉仓的运动。
在各种情况下，操作者可期望在击发行程期间回缩驱动构件。公开于Zemlok‘763中的外科器械采用回缩组件，所述回缩组件包括结合驱动管的手动驱动机械接口，所述驱动管通过使安装在柄部上的回缩杠杆进行棘轮运动来启动。如果在击发期间功率源中断或者马达或控制系统失效，此类构造据称允许外科医生回缩击发杆并且最终回缩加载单元驱动构件。然而，此类回缩组件可难以有效的操作，这是因为如下事实：马达和马达齿轮箱在棘轮运动(启动)期间保持接合。因此，该装置的回缩组件必须能够形成足够的扭矩以旋转齿轮箱中的齿轮以及马达轴，从而允许驱动管被手动地旋转。此类力的产生可将过度应力设置在回缩组件部件上，从而可导致回缩组件的重大故障。图1-28所示的外科器械10可被构造成能够具有独特和新型的回缩组件构造，由此可避免该问题和其他问题。
例如，外科器械10可包括回缩组件120，所述回缩组件120包括具有顶部部分126和底部部分128的回缩底座124。在各种形式中，回缩组件120通过驱动齿轮130和回缩齿轮132与驱动管102机械地交接。参见图5。驱动齿轮130不可旋转地附接到驱动管102，使得驱动齿轮130的旋转对驱动管102施加旋转。驱动齿轮130和回缩齿轮132可包括锥齿轮等以允许它们之间的相互啮合接合，如图5所示。回缩齿轮132可联接到第一心轴134(图4和图5)，所述第一心轴134基本上垂直于回缩底座124的顶部部分126和底部部分128并且在它们之间延伸。心轴134可被支撑以用于围绕心轴轴线“SA-SA”的旋转行进，所述心轴轴线“SA-SA”基本上垂直于外科器械10的纵向轴线“LA-LA”。参见图5。在各种形式中，回缩齿轮132可具有与其附接的第一正齿轮136。第一正齿轮136与第二正齿轮138交接，所述第二正齿轮138可操作地支撑在第二心轴137上，所述第二心轴137也即以基本上垂直的方式设置在回缩底座124的顶部部分126和底部部分128之间并且可围绕由其限定的第二轴轴线“SA’-SA’”旋转。第二正齿轮138被支撑以用于与第三正齿轮140啮合接合，所述第三正齿轮140设置在第一心轴134上。第三正齿轮140附接到单向离合器组件142的第一离合器部分144。离合器组件142还包括第一离合器部分144上方的可旋转地设置在第一心轴134上的第二离合器部分146。弹簧(未示出)可设置在第一离合器部分144和第二离合器部分146之间，由此将第一离合器部分144和第二离合器部分146保持在凸起的“非互锁”取向，如图5所示。
应当理解，当驱动管102旋转时，驱动齿轮130将对第一正齿轮136、第二正齿轮138和第三正齿轮140以及对第一离合器部分144和相应的心轴134、137施加旋转。由于第二离合器部分146可围绕心轴134旋转并且可通过设置在它们之间的弹簧构造(未示出)偏置成不与第一离合器部分144接合，第一离合器部分144的旋转未被转换到第二离合器部分146。如在图5中可见，第一离合器部分144和第二离合器部分146包括多个互锁齿148，所述多个互锁齿各自具有平坦互锁表面和倾斜滑动表面。如将在下文中更详细所述，第二离合器部分146可由回缩杠杆150偏置成与第一离合器部分144啮合接合。齿148的滑动表面允许互锁表面彼此接触，使得第二离合器部分146的旋转导致第一离合器部分144旋转。第一离合器部分144的旋转同样还导致交接齿轮旋转，从而最终对驱动管102施加围绕纵向工具轴线LA-LA的旋转动作。
现在参见图6，回缩杠杆150可包括细长柄部部分152，所述细长柄部部分152包括凸轮部分154。凸轮部分154可包括开口，所述开口可容纳单向滚针离合器(未示出)，所述单向滚针离合器被支撑以与可附接到第一心轴134的配件(未示出)机械配合，从而允许回缩杠杆150围绕第一心轴134旋转。Zemlok‘763还描述了此类单向滚针离合器和配件构件的操作并且其全文以引用方式并入本文。在各种形式中，回缩杠杆150包括其上各自具有凸轮表面158的一个或多个凸轮构件156。在第一取向上，回缩杠杆150沿着外壳12的杠杆凹坑14进行设置，如图1所示。设置在第一离合器部分144和第二离合器部分146之间的弹簧用于偏置回缩杠杆150以抵靠回缩底座124的顶部部分126。如在图6中可见，凸轮构件156设置在回缩底座124的顶部部分126中的对应凸轮狭槽或凹坑160内。回缩杠杆150通过返回弹簧162保持在第一取向，所述返回弹簧162安装在回缩底座124的顶部部分126和回缩杠杆150的凸轮部分154之间。凸轮构件156和凸轮狭槽160还防止回缩杠杆150的旋转。
在使用中，当回缩杠杆150移出外壳12中的杠杆凹坑14(图1)时，凸轮构件156与对应的凸轮狭槽160交接以对抗定位在第一离合器部分144和第二离合器部分146之间的弹簧的偏置力沿着向下方向来偏置回缩杠杆150的凸轮部分154。此类向下运动压缩弹簧并且将第一离合器部分144和第二离合器部分146推压成互锁接合。凸轮部分154沿逆时针方向的旋转致动滚针离合器，所述滚针离合器与配件和第一心轴134交接。回缩杠杆150的连续致动使离合器组件142旋转，所述离合器组件142继而使正齿轮136、138、140以及回缩齿轮132和驱动齿轮130旋转。这继而使驱动管102围绕纵向工具轴线“LA-LA”旋转。由于击发杆104与驱动管102螺纹接合，驱动管102按上述方式的旋转导致击发杆104回缩(近侧轴向行进)到驱动管102内。
在操作中，马达100可被构造成能够使驱动管102沿着与回缩方向相反的方向(例如，沿着顺时针方向)围绕纵向工具轴线“LA-LA”旋转。驱动管102的此类旋转导致击发杆104沿着远侧方向“DD”轴向地运动。击发杆104和加载单元20的驱动构件60的这种推进在本文中可称为“击发”动作。如在图5中可见，例如，齿轮组件170用于实现所需的驱动扭矩量以沿远侧方向“DD”驱动击发杆104，从而致动加载单元20。齿轮组件170可包括联接到马达100的齿轮箱外壳172。例如，齿轮箱外壳172可通过螺杆103或其他机械紧固件和/或紧固件构造联接到马达外壳101。齿轮组件170和马达100可统称为“驱动单元”，通常标定为186。
齿轮箱外壳172可旋转地支撑在马达保持器部分190中，所述马达保持器部分190为一体形成的或者由外壳12以其他方式不可旋转地支撑。此类构造允许驱动单元186在外壳12内围绕纵向工具轴线“LA-LA”旋转，但防止其在外壳12内的轴向运动。马达100可例如由具有Zemlok‘763更详细描述的类型的功率源200和/或功率系统2000(图129)来提供功率。
为了有利于将电流提供到驱动单元180并且更具体地提供到马达100，可使用的独特的触点构造210。例如，触点构造210可包括支撑在马达外壳101上的环形负极马达触点212和环形正极马达触点114，如在图4中可见。固定的负极触点216可支撑在外壳12内以用于与负极马达触点112的滑动接触。类似地，当驱动单元180在外壳12内旋转时，固定的正极触点218可被支撑以用于与正极马达触点214的滑动接触。固定的负极触点216和正极触点218可包括柔性弹簧状触点以有利于驱动单元186在外壳12内的组装和调整。固定的负极触点216可通过负极引线220电联接到功率源200，并且固定的正极触点218可通过正极引线222电联接到功率源200。此类触点构造允许将电功率从功率源200提供到马达100，同时有利于驱动单元186在柄部外壳内围绕纵向工具轴线“LA-LA”的旋转。
参见图5，齿轮组件170可包括可操作地联接到马达轴107的行星齿轮构造。在一种构造中，例如，环形齿轮173可形成于齿轮箱外壳172的内表面上。主太阳齿轮171可联接到马达轴107。主太阳齿轮171可被支撑以与支撑在第一行星齿轮架174上的多个第一行星齿轮175啮合接合，使得它们也与环形齿轮173啮合接合。第一太阳齿轮176可形成于或者说是附接到第一行星齿轮架174上，并且可被支撑以与支撑在第二行星齿轮架177上的多个第二行星齿轮178啮合接合。第二行星齿轮178也可被支撑以与环形齿轮173啮合接合。第二太阳齿轮179可形成于或者说是附接到第二行星齿轮架177上，并且可被支撑以与多个第三行星齿轮181啮合接合。第三行星齿轮181可支撑在第三行星齿轮架180上以与环形齿轮173啮合接合。第三太阳齿轮183可形成于或者说是附接到第三行星齿轮架180上并且与多个第四行星齿轮187啮合接合，所述多个第四行星齿轮187可附接到输出轴单元184，所述输出轴单元184通过轴承185可旋转地支撑在齿轮箱外壳172内。第四行星齿轮187也可被支撑以与环形齿轮173啮合接合。
图7示出了用于将驱动单元186可旋转地支撑在外壳12内的一种构造。如在该图中可见，马达保持器190的马达安装毂192可包括可旋转地支撑于其中的齿轮箱外壳段196。在一种构造中，例如，齿轮组件170通过轴承185可旋转地支撑在齿轮箱外壳段196中。类似地，马达100通过轴承198可旋转地支撑在马达安装外壳部分13内。也可使用将驱动单元186可旋转地支撑在外壳12内的其他方法。
输出轴单元184可操作地联接到具有Zemlok‘763所公开的类型和构造的离合器230(图5)，该专利全文以引用方式并入本文。有关此类离合器230的构造和操作的其他细节可得自该公布。然而，在另选的实施例中，离合器230可由轴-轴联接器或套管构造替换，所述轴-轴联接器或套管构造用于有利于输出轴单元184直接联接到驱动管102。
当公开于Zemlok‘763中的外科器械的可轴向运动的驱动梁被卡住或者器械的功率丢失时，使用者不得不使用回缩组件来将驱动梁向后回缩到初始位置以有利于加载单元的移除。然而，有效的回缩是困难的，因为回缩系统不得不产生所需的足够扭矩量以反转齿轮组件中的多个齿轮构造。因此，此类回缩系统可极其难以有效地操作。
本文所公开的至少一个外科器械实施例采用独特和新型的可释放的驱动单元锁定系统(通常标定为240)以解决此问题。如将在下文中更详细所述，例如，当可释放的驱动单元锁定系统240处于“锁定”位置时，驱动单元186被防止在柄部外壳12内旋转。当外科器械被“击发”时，驱动单元186保持在锁定位置，以有利来自马达100的马达扭矩通过齿轮组件170最终传递到驱动管102。当期望启动回缩组件120时，使驱动单元锁定系统240运动到“解锁”位置，以允许驱动单元186在外壳12内自由地旋转，由此无需产生足够的回缩扭矩来反转齿轮组件170中的齿轮构造。在回缩组件120的操作期间，齿轮组件170可保持可操作地联接在马达100和驱动管102之间。在此类实施例中，尽管齿轮组件170保持可操作地联接到马达100和驱动管102，但驱动单元186的自由旋转可降低当齿轮构造反转以回缩驱动管102时驱动齿轮组件170所需的扭矩。这种所需扭矩的降低可改善回缩系统的有效性。
如在图8中可见，例如，回缩组件120的第三正齿轮140可包括解锁凸轮141，所述解锁凸轮141被构造成能够致动驱动单元锁定系统240的锁定制转杆组件250。锁定制转杆组件250的一种形式示于图9-11中。如在图10中可见，例如，锁定制转杆组件250可包括制转杆构件252，所述制转杆构件252具有形成于其中的锁定凹口254。锁定凹口254的尺寸可被设计成允许形成于齿轮箱外壳172的外部周边周围的一系列间隔开的第一锁定楔形件256从中自由地穿过。参见例如图12和图13。制转杆锁定楔形件258形成于锁定制转杆252上以用于与第一锁定楔形件256中的任何一个锁定接合，如将在下文中更详细所述。如另在在图8-11中可见，锁定制转杆组件250还可包括制转杆引导杆260，所述制转杆引导杆260被构造成能够可滑动地接纳在马达安装毂192中的通道194内。制转杆弹簧262轴颈连接在制转杆引导杆260上并且定位在制转杆构件252和马达安装毂192之间以将制转杆构件252的凸轮接合部分264偏置成与第三正齿轮140接合。
现在将参照图8、图13和图14来描述操作回缩组件120和驱动单元锁定系统240的一种方法。图13示出了处于锁定位置的驱动单元锁定系统240。如在该图中可见，制转杆构件252通过制转杆弹簧262偏置成远侧锁定位置。当处于该锁定位置时，制转杆构件252上的制转杆锁定楔形件258与齿轮箱外壳172上的第一锁定楔形件256中的相应一者锁定接合。当处于该位置时，回缩组件120还未被启动并且齿轮组件170被防止在外壳12旋转。通过压下主功率开关80(图1)对马达100的操作导致驱动管102的旋转并且最终导致击发杆104的轴向推进，由此将驱动梁60朝远侧驱动穿过加载单元20。
如果例如驱动梁60被卡在夹持在加载单元20中的组织内、或者马达100的功率丢失、或者由于某种其他原因马达100不能反转驱动管102的旋转以最终回缩击发杆104，则临床医生可使用回缩组件120来手动地回缩击发杆104和驱动梁60。图8示出了处于未致动位置的回缩组件120(例如，当驱动单元锁定系统240处于锁定位置)。为了开始手动回缩过程，临床医生牵拉回缩杠杆150以离开柄部外壳12中的杠杆凹坑14(沿“R”方向---参见图6)。回缩杠杆150沿“R”方向的运动导致回缩杠杆150的凸轮部分154在回缩底座124内的旋转。回缩杠杆150沿“R”方向的此类初始旋转导致解锁凸轮141接合制转杆构件252的凸轮接合部分264以将制转杆构件252偏置到解锁位置，由此允许驱动单元186在柄部外壳12内自由地旋转。回缩底座中的凸轮狭槽160被设置并且具有足够的长度以有利于回缩杠杆150的凸轮部分154的这种旋转行进而无需离合器组件142的初始脱离。因此，凸轮狭槽160可长于定位在先前回缩底座构造中的凸轮狭槽，以有利于在施加致动动作来导致驱动管102旋转之前的驱动单元组件186的解锁。例如，在至少一种构造中，凸轮狭槽160可为细长的，以有利于使回缩杠杆150旋转约十五度。当临床医生继续沿“R”方向旋转回缩杠杆150时，凸轮接合部分264将沿着解锁凸轮141的外周边骑跨在第三正齿轮140上。回缩杠杆150沿“R”方向的继续旋转导致凸轮部分154上的凸轮构件156与其相应凸轮狭槽160的端部接合，以沿着向下方向偏置凸轮部分154。此向下运动压缩定位在第一离合器部分144和第二离合器部分146之间的弹簧，以使其上的齿148彼此啮合接合。凸轮部分154沿逆时针方向的继续旋转可致动滚针离合器，所述滚针离合器与配件和第一心轴交接。回缩杠杆150的连续致动使离合器组件142旋转，所述离合器组件142继而使正齿轮136、138、140以及回缩齿轮132和驱动齿轮130旋转。这继而旋转驱动管102并且驱动击发杆104。
回缩杠杆150可被致动预定的行进量，直至回缩杠杆150的一部分邻接外壳12的一部分。然后，通过返回弹簧162使回缩杠杆150返回到其第一位置。此动作升高凸轮部分152，由此允许第二离合器部分146也向上运动并且脱离第一离合器部分144。滚针离合器可释放配件，由此允许回缩杠杆150返回到第一位置而不影响驱动管102的运动。一旦回缩杠杆150返回到第一位置，驱动单元186就再次保持在锁定位置。回缩杠杆150的棘轮运动或旋转可反复地重复，直至击发杆104已返回到所需位置。
由于齿轮箱外壳172在此旋转动作的施加期间自由地旋转，因此相比于操作先前回缩组件所需的扭矩，旋转驱动管102和齿轮组件170内的齿轮所需的扭矩量显著降低。此类构造还有利地用于在齿轮组件170保持驱动地联接到马达轴107期间防止将回缩组件所产生的扭矩力传递到马达轴107。换句话讲，在回缩组件120的操作期间，齿轮组件170可保持驱动地联接在马达轴107和驱动管102之间。此类构造不同于如下回缩构造，所述回缩构造公开于例如全文以引用方式并入本文的美国专利7,959,050中，但在回缩系统的启动期间导致传输部分的物理脱离或物理中断。
图15-18示出了除了下文描述的差异之外基本上类似于上述外科器械10的另一个外科器械310。如在图16中可见，器械310包括齿轮组件470，所述齿轮组件470包括例如可按上文所述的方式联接到马达100的齿轮箱外壳472。齿轮箱组件470和马达100可统称为“驱动单元”，通常标定为486。除了下文所述的差异之外，齿轮组件470可与齿轮组件170相同。
在至少一种构造中，齿轮箱外壳472不可旋转地支撑在马达保持器部分190中或者可与其一体形成，所述马达保持器部分190为一体形成的或者说是在外壳12内以本文所述的方式不可旋转地附接。由于在该构造中驱动单元486不旋转，其可直接以线连接到功率源。例如，马达100可按照Zemlok‘763所述的方式或其他合适的方式来提供功率。如在图16中可见，齿轮组件470可包括可操作地联接到马达轴107的行星齿轮构造。在一种构造中，例如，固定环形齿轮473可形成于齿轮箱外壳472的内表面上。主太阳齿轮471可附接到马达轴107。主太阳齿轮471可被支撑以与支撑在第一行星齿轮架474上的多个第一行星齿轮475啮合接合。第一行星齿轮475也可与环形齿轮473啮合接合。第一太阳齿轮476可形成于第一行星齿轮架474上并且与支撑在第二行星齿轮架477上的多个第二行星齿轮478啮合接合。第二行星齿轮478也可被支撑以与固定环形齿轮473啮合接合。第二太阳齿轮479可形成于或者附接到第二行星齿轮架477上，并且可被支撑以与支撑在第三行星齿轮架480上的多个第三行星齿轮481啮合接合。第三行星齿轮481与固定环形齿轮473啮合接合。第三太阳齿轮483可形成于或者说是附接到第三行星齿轮架480上。第三太阳齿轮483可被支撑以与多个第四行星齿轮487啮合接合，所述多个第四行星齿轮487可附接到输出轴单元484，所述输出轴单元484通过轴承185可旋转地支撑在齿轮箱外壳472内。所述多个第四行星齿轮487可与可锁定的环形齿轮485啮合接合，所述可锁定的环形齿轮485可旋转地安装在齿轮箱外壳472中。齿轮471、473、475、476、478、479、481和483在本文中可统称为齿轮系组件460。
可锁定的环形齿轮485可旋转地安装在马达保持器部分190(图16)中的环形腔体490内。腔体490的尺寸被设计成允许可锁定的环形齿轮485在其中围绕纵向工具轴线“LA-LA”的自由旋转。可锁定的环形齿轮485可安装在环形通道490中并且随后通过插塞构件492保持固定，所述插塞构件492被按压到或者说是保持在环形通道490内。
外科器械310还可包括驱动单元锁定系统540，所述驱动单元锁定系统540包括可运动的移位环组件542。在至少一种形式中，移位环组件542可包括例如移位环543，所述移位环543具有至少一个并且优选地多个例如销544形式的锁定构件。销544从移位环543突出并且被构造成能够与可锁定的环形齿轮485选择性地锁定接合。锁定销544中的每一个可滑动地接纳在插塞构件492中的相应通道546内。移位环542被支撑以用于通过附接到离合器夹具560的反转连接件550来轴向运动。如在图15中可见，离合器夹具560可包括弹簧夹具，所述弹簧夹具围绕第三正齿轮140的外周边的一部分进行夹持。离合器夹具560可在其上具有附接到移位器杆564的凸耳562。移位器杆564可为略微柔性的并且可枢转地联接到移位环542。在正常使用期间(即，当马达100正驱动击发杆104时)，锁定销544与可锁定的环形齿轮475锁定接合，以防止可锁定的环形齿轮475旋转，使得旋转扭矩被传递到输出轴单元484并且最终传递到驱动管102。
当临床医生期望使用回缩组件120来回缩击发杆104时，使回缩杠杆150从图15所示的起始位置沿“R”方向旋转。当回缩杠杆150旋转时，离合器夹具560与第三正齿轮140一起旋转，从而使得移位器杆564沿远侧方向“DD”移动移位环542。当移位环542沿远侧方向“DD”运动时，锁定销544运动成不与可锁定的环形齿轮485锁定接合，以允许可锁定的环形齿轮485相对于齿轮箱外壳472旋转。临床医生继续使回缩杠杆150棘轮运动到图18所示的端部位置。在例如至少一种构造中，回缩杠杆150需要仅旋转约十五度，以使得锁定销544脱离可锁定的环形齿轮485。在临床医生释放回缩杠杆150之后，返回弹簧162将使回缩杠杆150返回到起始位置并且临床医生可重复该过程，直至击发杆104回缩到期望的位置。由于可锁定的环形齿轮485在轴承外壳472内自由地旋转，因此驱动管102和输出轴单元484的旋转将不受齿轮组件470中的其他齿轮构造的抵制。由此，相比于在回缩过程中保持与齿轮组件中的齿轮构造可操作地接合的回缩构造，回缩击发杆104所需的棘轮运动扭矩量得以减小。此外，尽管所需的扭矩得以减小，但击发杆104可保持与齿轮组件470可操作地接合。换句话讲，击发杆104可保持可操作地联接到马达100。当移位环542接触马达安装毂192中的轴承185时，锁定销544锁定接合可锁定的环形齿轮485。在移位环接触马达安装毂192的轴承185或其他部分之后，离合器夹具560可被构造成能够相对于第三正齿轮140滑动。因此，驱动单元锁定系统540用于在将回缩动作施加至驱动管102期间有利于驱动单元的至少一部分在柄部外壳内的旋转，以减小回缩击发杆104所需的回缩扭矩量。
图19中的外科器械610与外科器械310基本上相同，不同的是离合器夹具560附接到第三正齿轮140以使得除去用于外科器械310中的反转连接件550。如在图18中可见，例如，移位器杆564直接连接到移位环542。回缩杆杠150按照上述方式的棘轮运动导致移位环542的运动并且导致锁定销544与可锁定的环形齿轮485的接合和脱离。
图20和21示出了除了以下差异之外与外科器械610基本上相同的另一个外科器械610’。在该构造中，例如，至少两个“叶片型”锁定弹簧620和环形齿轮锁定构件622支撑在齿轮组件470’的齿轮箱外壳472’上。如在图20中可见，每个锁定弹簧620和对应的锁定构件622支撑在齿轮箱外壳472’中的狭槽624内。在该构造中，附接到移位环542的锁定销544’被构造成能够接触并且向内按压对应的锁定弹簧620，以将对应的环形齿轮锁定构件622挤压成与可锁定的环形齿轮485锁定接合。当处于该位置(示于图20中)时，可锁定的环形齿轮485被防止相对于齿轮箱外壳472’旋转。当移位器杆564沿远侧方向“DD”牵拉移位环542时，锁定销544’脱离其对应的锁定弹簧620，这允许弹簧620挠曲到起始位置，以允许环形齿轮锁定构件622脱离可锁定的环形齿轮485，由此允许其相对于齿轮箱外壳472’旋转。因此，当回缩组件120启动时，可锁定的环形齿轮485相对于齿轮箱外壳472’自由地旋转，从而减小导致击发杆104沿近侧方向“PD”回缩所需的回缩扭矩量。
图22-24示出了如果在操作期间可操作地附接的外科器械的击发杆的远侧部分或其他部件被卡住或者用于推进击发杆组件的操作功率中断则用于选择性地手动回缩外科器械710的击发杆的远侧部分的另一个回缩组件构造。除了下文所述的差异之外，外科器械710在设计和操作上可类似于上文描述的和/或Zemlok‘763中公开的外科器械，该专利全文以引用方式并入本文。
如在图22-24中可见，外科器械710包括可操作地支撑击发杆组件720的外壳712。外壳712可例如可操作地支撑马达和齿轮组件(未示出)，以用于将旋转动作施加到驱动管，从而可导致击发杆组件720按照本文所述的各种方式进行轴向运动。在至少一种构造中，击发杆组件720可包括按照本文所公开的各种方式与驱动管可操作地交接的近侧击发构件或杆部分722。在其他外科器械构造中，近侧击发杆部分722可与其他驱动构造和系统可操作地交接，所述其他驱动构造和系统被构造成能够将轴向动作施加到近侧击发杆部分722。
如在图22-24中进一步可见，击发杆组件720还可包括远侧击发构件或杆部分724，所述远侧击发构件或杆部分724按照本文所述的各种方式可操作地联接到加载单元20的可轴向运动的驱动梁60的近侧端部。回缩连杆组件732形式的回缩组件730可枢转地联接在近侧击发杆部分722和远侧击发杆部分724之间。在示出的构造中，回缩连杆组件732包括致动器连接件734，所述致动器连接件734具有销接到近侧击发杆部分722的连接件柄部部分736。回缩连杆组件732还包括销接到致动器连接件734和远侧击发杆部分724的远侧回缩连接件738，如图所示。在例示的实施例中，外壳712包括朝远侧延伸的关节运动外壳部分714，所述朝远侧延伸的关节运动外壳部分714还可包括朝远侧延伸的轴外壳段716。当回缩连杆组件732响应于击发杆组件720的轴向运动沿远侧方向和近侧方向轴向地运动时，轴外壳段716可用于轴向地支撑回缩连杆组件732。为了有利于回缩连杆组件732相对于轴外壳段716的轴向运动，致动器连接件734延伸穿过形成于轴外壳段716中的狭槽718，如图所示。
图22示出了击发之前的击发杆组件720和回缩组件730的位置。图23示出了沿远侧方向“DD”击发之后的击发杆组件720和回缩组件730的位置。如果在击发过程中，临床医生希望将驱动梁60向后回缩到起始位置，则临床医生可仅握住致动器连接件734的连接件柄部部分736并且沿“R”方向进行枢转，如图24所示，由此沿近侧“PD”方向牵拉远侧击发杆部分724和驱动梁60。如图22和图23所示，在击发过程中，远侧击发杆部分724的近侧端部725可通常与近侧击发杆部分734的远侧端部735轴向地间隔开标定为“RD”的距离。例如，在通过驱动单元击发和正常回缩击发杆组件720期间，距离“RD”可保持不变。然而，当临床医生启动回缩组件时，远侧击发杆部分724的近侧端部725和近侧击发杆部分734的远侧端部735之间的距离(距离“RD’”)将小于距离“RD”。另外，如在图22中可见，驱动梁60的远侧工作头62的起始位置和远侧工作头62的结束位置之间(即，完整的击发行程之后)的距离由距离“FD”表示。如果需要，距离“RD”可为足够大的，以允许远侧击发杆部分724充分地回缩(即，运动到较靠近近侧击发杆部分722的远侧端部735)，从而使工作头62从结束位置返回到其起始位置。换句话讲，远侧击发杆部分724可回缩至少等于或大于击发距离“FD”的回缩距离。在此类构造中，例如，如果工作头65被卡在或以其他方式停在其结束位置，则回缩组件的启动可完全回缩驱动梁60，以使远侧工作头62回到其起始位置，其中远侧工作头62可允许砧座22枢转打开并且释放组织。
图25-28示出了可选择性地手动回缩的另选的击发杆组件720’。如图所示的击发杆组件720’包括可按照本文所公开的各种方式与驱动管可操作地交接的近侧击发杆部分722’。在其他外科器械构造中，近侧击发杆部分722’可与其他驱动构造和系统可操作地交接，所述其他驱动构造和系统被构造成能够将控制动作施加到近侧击发杆部分722’。击发杆组件720’还可包括远侧击发杆部分724’，所述远侧击发杆部分724’为至少部分地中空的并且按照本文所述的各种方式可操作地联接到加载单元20的可轴向运动的驱动梁60的端部。例如，远侧击发杆部分724’可在其中具有通道725，所述通道725的尺寸被设计成允许远侧击发杆部分724’在近侧击发杆部分722’上轴向地滑动回缩距离“RDD”。回缩距离可等于或大于击发距离“FD”，从而允许回缩组件730将驱动梁60回缩足够的距离，以便使其工作头62从结束位置“EP”运动到起始位置“SP”。参见图25。回缩组件730’可包括回缩闩锁732’。回缩闩锁732’可包括能够在闩锁位置(图25和图26)和未闩锁位置(图27和图28)之间运动的闩锁柄部735。当处于闩锁位置时，回缩闩锁732’附连远侧击发杆部分724’，以使其被防止在近侧击发杆部分722’和远侧击发杆部分724’上轴向滑动。当处于该取向时，近侧击发杆部分722’基本上作为整体而运动。因此，当处于闩锁取向时，击发杆组件720’可沿远侧方向“DD”击发到其结束位置“EP”，如图26所示。如果在击发行程期间驱动梁60被卡住或者器械的功率中断或丢失(或由于其他原因)，则临床医生可仅将回缩闩锁柄部735移动到未闩锁位置(图27)并且随后沿近侧方向“PD”手动地牵拉回缩闩锁732’，如图28所示。
本文所公开的各种回缩系统和构造可解决先前回缩构造常常遇到的某些缺陷，所述先前回缩构造用于回缩由外科端部执行器使用的马达动力驱动构件。例如，本文所公开的各种回缩构造可有利于将回缩动作手动地施加到驱动构件和/或相关联的驱动构造，而不会遇到通常由与马达相关联的齿轮/传输构造提供的阻力，同时允许齿轮/传输构造保持“驱动地”或物理地联接到马达。
因此，至少一个示例包括可具有击发构件组件的外科器械，所述击发构件组件可包括被支撑以用于沿远侧方向和近侧方向选择性地轴向运动的部分。所述器械还可包括包括驱动单元，所述驱动单元包括具有马达轴的马达。齿轮组件可驱动地联接到马达轴并且包括输出轴组件，所述输出轴组件被构造成能够与击发构件组件交接，使得当马达轴沿第一旋转方向旋转时击发构件组件的该部分被沿远侧方向进行轴向地驱动并且当马达轴沿第二旋转方向旋转时击发构件的该部分被沿近侧方向进行轴向地驱动。外科器械还可包括回缩组件，所述回缩组件与击发构件组件交接以用于在马达停用时将其他旋转动作沿第二旋转方向手动地施加到击发构件组件。外科器械还可包括锁定装置，所述锁定装置与回缩组件和驱动单元交接，以用于在齿轮组件保持驱动地联接到马达轴期间防止将其他旋转动作传递到马达轴。
根据另一个示例，外科器械可包括用于产生击发动作和回缩动作的驱动单元。所述器械还可包括外科端部执行器，所述外科端部执行器被构造成能够响应于对其施加的击发动作和回缩动作中的至少一个来执行至少一个外科功能。外科器械还可包括击发构件组件，所述击发构件组件可包括近侧击发构件部分，所述近侧击发构件部分与驱动单元可操作地交接并且被构造成能够从其可操作地接收旋转致动运动。击发构件组件还可包括远侧击发构件部分，所述远侧击发构件部分被支撑在近侧击发构件部分的远侧并且被构造成能够将击发动作和回缩动作传输到外科端部执行器。回缩组件可操作地联接到近侧击发构件部分和远侧击发构件部分。回缩组件可在未致动位置(其中回缩组件能够将击发动作和回缩动作从近侧击发构件部分传递到远侧击发构件部分)和致动位置(其中远侧击发构件部分相对于近侧击发构件部分轴向地运动)之间选择性地运动。
另一个外科器械示例可包括柄部外壳，所述柄部外壳包括与其可操作地联接的细长轴组件。细长轴组件可在其中支撑可轴向运动的击发杆。加载单元可操作地联接到细长轴并且被构造成能够与击发杆交接。驱动管可旋转地支撑在柄部外壳内并且与击发杆可操作地交接。外科器械还可包括具有马达轴的马达。马达可操作地支撑在柄部外壳内并且可操作地联接到功率源。齿轮组件可驱动地联接到马达轴并且包括输出轴组件，所述输出轴组件被构造成能够与驱动管交接，使得当马达轴沿第一旋转方向旋转时驱动管沿远侧方向驱动击发杆并且当马达轴沿第二旋转方向旋转时驱动管沿近侧方向驱动击发杆。回缩组件可与驱动管交接以用于在马达停用时沿第二旋转方向手动地对其施加其他旋转动作。锁定装置可与回缩组件和齿轮组件交接，以用于在马达组件保持驱动地联接到马达轴期间防止将其他旋转动作传递到马达轴。
再次参见图1-3，在各种实施例中，外科器械10的马达100可操作地联接到击发元件(例如击发元件60)，并且可在击发行程期间驱动击发元件60穿过端部执行器或DLU20。例如，在击发行程期间，击发元件60可切割组织并且/或者将钉击发到组织内。电池可将电流提供到例如马达100，并且提供到马达100的电流可与由马达100产生的扭矩相关。此外，由马达100产生的扭矩可与由击发元件60施加的击发力相关。马达上的电压可与例如马达100的角速度相关，所述角速度可与击发元件60的速度相关。现在参见图63，马达可限定扭矩-电压曲线5802。在各种实施例中，扭矩-电压曲线5802可在最优化电压V下具有最大扭矩T1。在例如高于和/或低于最优化电压V的电压下，由马达产生的扭矩可小于最大扭矩T1。例如，在1/2V的电压下，扭矩-电压曲线5802可具有例如小于T1的扭矩T2。
在各种实施例中，与马达进行信号通信的控制系统可将电流从电池提供到马达。在一些实施例中，控制系统可包括例如速度管理控件，所述速度管理控件可控制击发元件的速度。控制系统可包括例如可变电阻电路和/或电压调节电路，所述可变电阻电路和/或电压调节电路可控制提供到马达的电流和/或马达上的电压。在此类实施例中，控制系统可控制马达的扭矩和/或角速度，并且因此可控制联接到马达的击发元件的击发力和/或速度。例如，电压调节电路可调节马达上的电压以影响击发元件的速度。参见图63，如果电压调节电路例如将电压从理想电压V降到1/2V，则扭矩可降到小于最大扭矩T1的T2并且速度可例如调整为速度S2。
在各种实施例中，控制系统可包括脉宽调制电路，并且控制系统可将电流脉冲提供到马达。主要参见图64(a)-65(b)，电流可以恒定电压脉动。在各种实施例中，脉冲的占空比(即，每间隔或周期的脉冲的持续时间)可影响击发元件5804的击发速度。当占空比较高时(图64(a))，每个脉冲可为间隔的较长部分并且因此马达可例如以较快速度S1驱动击发元件5804。当占空比较低时(图64(b))，每个脉冲可为间隔的较短部分并且因此马达可例如以较慢速度S3驱动击发元件5804。在各种实施例中，脉宽调制电路可在马达的最优化电压V(图63)下来将电流脉冲提供到马达。在此类实施例中，可在不降低由马达产生的扭矩的情况下来控制击发元件5804的速度。例如，马达可例如在最优化电压V下操作以产生最大扭矩T1，并且可通过改变电压脉冲的宽度来使击发元件5804以降低的速度(例如速度S3)和/或任何合适的速度驱动穿过端部执行器。
在各种实施例中，电池可具有伏安极限或功率阈值。换句话讲，电池每单位时间可提供有限数量的能量。电池的功率阈值可与电池和/或电路设计相关。例如，电池和/或电路的热极限(例如，热容量和/或导线绝缘)可影响功率阈值。此外，电池的功率阈值可限制提供到马达的电流量。在各种实施例中，利用速度管理控制(例如，脉宽调制)的马达可不需要电池的最大伏安。例如，当电池在最大或最优化电压下提供电流脉冲以利用所需速度和最大或最优化扭矩驱动击发元件时，剩余电流可不用于驱动击发元件。在此类实施例中，剩余电流可用于产生附加扭矩。参见图66(a)-66(c)，马达可包括例如附加或辅助线圈组并且剩余电流可被选择性地引导到附加线圈组以产生附加扭矩。在此类实施例中，马达可例如在较低速度下产生较大扭矩。在各种实施例中，控制系统可例如基于电池的伏安极限来最大化提供到辅助线圈组的剩余电流。此外，在某些实施例中，控制系统可在击发行程的至少一部分期间优化由马达产生的扭矩。
仍参见图66(a)-66(c)，电池6002可将电流选择性地提供到马达6004。马达6004可包括例如主线圈组6006和辅助线圈组6008。在各种实施例中，与马达6004信号通信的控制系统6020可将电流选择性地引导到主线圈组6006和/或辅助线圈组6008。例如，控制系统6020可在第一操作状态期间将电流提供到主线圈组6006，并且可在第二操作期间将电流提供到例如主线圈组6006和辅助线圈组6008。在各种实施例中，开关(例如开关6010)可在打开位置和闭合位置之间运动以将电流选择性地提供到例如辅助线圈组6008。在各种实施例中，线圈组6006、6008可被单独地启动。此外，控制系统6020可包括脉宽调制电路6022，并且电池6002可将电流脉冲提供到例如线圈组6006、6008中的至少一个。在各种实施例中，主线圈组6006可联接到第一电路6030(图66(a))，并且第二线圈组可联接到独立于第一电路6030的第二电路6032(图66(a))。在其他实施例中，主线圈组6006和辅助线圈组6008可被布置成例如并联(图66(b))或串联(图66(c))。在某些实施例中，马达6004可包括例如至少一个附加主线圈组和/或至少一个附加辅助线圈组。
在各种实施例中，马达可在第一操作状态期间产生第一扭矩量，并且在第二操作状态期间产生第二扭矩量。第二扭矩量可例如大于第一扭矩量。此外，第二操作状态期间由辅助线圈组6006产生的附加扭矩可组织和/或限制击发元件在击发行期间的鄙闭锁。例如，参见图67，马达可在第一操作状态期间朝远侧驱动击发元件并且可在第二操作状态期间朝近侧驱动击发元件。在各种实施例中，相比于推进击发元件，马达可在回缩击发元件时产生更大的扭矩。在此类实施例中，可改善击发元件的回缩。如果击发元件被卡住，例如，组织对于击发元件而言太厚和/或太硬而不能切割和/或缝合，则例如可使用附加扭矩来回缩击发元件。仍参见图66，由马达产生的扭矩可在击发行程的“软”启动阶段5902期间逐渐地增加并且/或者可在击发行程的“软”止动阶段5904、5906期间逐渐地降低。例如，当推进击发元件时，马达可在击发行程开始时渐进地或缓慢地增加击发速度，并且可在击发元件完成击发行程的前向部分时渐进地或缓慢地降低击发速度。此外，在各种实施例中，马达可在回缩击发元件时立即或基本上立即产生最大扭矩和/或速度。马达可例如使用附加线圈组6008(图65(a)-(c))来最大化在回缩开始时产生的扭矩。
参见图68，控制系统可控制击发元件以在击发行程的试验段5912期间以较慢速度运动。例如，当推进击发元件时，击发元件初始以较慢速度运动，以确保端部执行器的选择和/或布置适用于靶组织。此外，如本文更详细所述，外科医生可接合致动器，例如开关或按钮，以例如致动马达并且启动端部执行器钳口的打开和闭合、击发元件的运动、和/或加载单元的关节运动。当在马达驱动动作开始处使致动器接合时启动试验段(例如，图68所指示的试验段5912)可允许外科医生“试验”外科动作，以确保预期的和/或适当地外科动作已被启动。例如，在某些实施例中，第一按钮可启动沿第一方向的马达驱动的关节运动，并且第二按钮可启动沿第二方向的马达驱动的关节运动。当外科器械旋转和/或“倒置”取向时，第一和第二按钮的位置可从标准位置旋转或者变为“反向”，如从操作者的角度来看。如果第一方向为预期的关节运动方向，则可期望确保加载单元在试验段期间沿第一方向进行关节运动，即，第一按钮实际上被致动。类似地，如果第二方向为预期的关节运动方向，则可期望确保加载单元在试验段期间沿第二方向进行关节运动，即，第二按钮被致动。在某些实施例中，外科动作的初始部分期间的试验段可为临床医生提供时间以在非预期外科动作已被启动的情况下改变和/或修改外科动作。如本文更详细所述，脉宽调制电路(例如脉宽调制电路6022)可实现外科动作的初始部分期间的试验段。
如上所述，马达控制器可被构造成能够利用脉宽调制操作马达6004。在各种情况下，马达控制器可例如将相同的脉宽调制用于主线圈组6006和辅助线圈组6008。在其他情况下，马达控制器可将第一脉宽调制信号用于主线圈组6006，并且将第二或不同脉宽调制信号用于辅助线圈组6008。在一些情况下，马达控制器可将脉宽调制信号用于线圈组6006、6008中的一者，但不用于另一者。此外，本文所述的教导内容可适用于具有多于两个线圈组的马达。例如，马达控制器可利用多个脉宽调制信号来操作多个线圈组。
在各种实施例中，马达可为例如有刷直流马达或无刷直流马达。在某些实施例中，马达可为步进马达，例如，混合步进马达。步进马达可提供旋转控制，使得编码器为不必要的。编码器的去除可例如降低马达的成本和/或复杂性。参见图69和图70，马达可为简化步进马达。例如，马达可包括围绕周边间隔开的四个电磁极。现在参见图71-74(c)，马达可为混合步进马达。混合步进马达可包括例如永磁体和电磁体。
公开于例如Zemlok‘763和Zemlok‘344中的现有外科器械构造使用两个独立马达。一个马达用于例如使驱动元件朝远侧推进穿过加载单元，这导致砧座的闭合、组织的切割、以及钉从支撑在加载单元中的钉仓的击发。另一个马达用于使加载单元围绕关节运动接头进行关节运动。有关用于使加载单元构造进行关节运动的其他细节还公开于美国专利7,431,188中，该专利的整个公开内容以引用方式并入本文。在此类装置中使用两个马达可增加复杂性并且增添外科器械的总体花费。例如，此类构造可使可在使用期间失效的回缩系统和其他机构的数量加倍。图29-31所示的外科器械810使用单个马达，所述马达可选择性地用于击发外科端部执行器和使外科端部执行器进行关节运动，所述外科端部执行器被构造成能够响应于对其施加的击发动作来执行至少一种外科手术。
在至少一种形式中，例如，外科器械810可使用本文详细描述的各种外科器械中所用的多个相同部件。例如，外科器械810包括其中可操作地支撑马达100的外壳12，所述马达100被构造成能够产生旋转致动运动。马达100可操作地联接到齿轮组件820，所述齿轮组件820具有与其相联的能够选择性定位的驱动联接器组件840，所述驱动联接器组件840将在下文中进行更详细地描述。外科器械810还可包括通常标定为859的关节运动系统，所述关节运动系统与细长轴组件可操作地交接以用于将关节运动动作施加到外科端部执行器。在一种形式中，例如，关节运动系统859可包括通常标定为860的关节运动致动机构，所述关节运动致动机构除下文所述的差异之外可基本上类似于Zemlok‘763和/或Zemlok‘344和/或美国专利7,431,188中所公开的关节运动致动机构。例如，外壳12可包括其中安装有可旋转构件92的圆筒部分90。可旋转构件92可与细长轴组件的近侧端部交接以有利于细长轴组件相对于外壳12的旋转。可旋转构件92可操作地支撑关节运动钮和如美国专利7,431,188所公开的滑动离合器构造。此构造的主关节运动齿轮94由图29和图30中的虚线表示。主关节运动齿轮94可通过如上述美国专利7,431,188中所述的滑动离合器连接到主轴95，使得主关节运动齿轮94的旋转将导致主轴95的对应旋转。如其中更详细所述，关节运动钮可用作关节运动位置指示器。主轴95与J-通道构件96可操作地交接，所述J-通道构件96与关节运动连接件组件97的近侧端部交接。在一种形式中，关节运动连接件组件97可包括与加载单元20中的关节运动连接件70(图3)交接的近侧关节运动连接件98。
关节运动机构860还可包括关节运动驱动系构造870，所述关节运动驱动系构造870与主关节运动齿轮94和驱动联接器组件840可操作地交接。如在图29和图30中可见，关节运动驱动系构造870可包括关节运动驱动轴872，所述关节运动驱动轴872附接到驱动联接器组件840的输出部，如将在下文更详细所述。第一关节运动驱动齿轮873附接到关节运动驱动轴并且与第二关节运动传递齿轮874上的中心齿轮座圈875啮合接合，所述第二关节运动传递齿轮874可旋转地支撑在可旋转构件92内。因此，第一关节运动驱动齿轮873的旋转导致第二中心关节运动传递齿轮874的旋转。如在图29和图30中进一步可见，“第三”关节运动轴齿轮877安装到其上具有“第四”关节运动蜗轮878的第二关节运动轴876。第三关节运动轴齿轮877与第二中心关节运动传递齿轮875啮合接合，使得第一关节运动驱动齿轮873的旋转最终导致第三关节运动轴齿轮877和第二关节运动轴876的旋转。第四关节运动蜗轮878与主关节运动齿轮94啮合接合，使得第四关节运动蜗轮878的旋转导致主关节运动驱动齿轮94的旋转并且最终导致将关节运动动作施加到关节运动连接件组件97。如将在下文更详细所述，当驱动联接器组件840处于关节运动控制取向时，关节运动驱动轴872由马达100进行旋转。
如在图31中可见，马达100可操作地联接到齿轮组件820。齿轮组件820可包括联接到马达100的齿轮箱外壳822。例如，齿轮箱外壳822可通过螺杆103或其他机械紧固件和/或紧固件构造联接到马达外壳101。齿轮组件820可包括可操作地联接到马达轴107的行星齿轮构造821。在一种构造中，例如，环形齿轮823可形成于齿轮箱外壳822的内表面上。主太阳齿轮821联接到马达轴107。主太阳齿轮821与支撑在第一行星齿轮架824上的多个第一行星齿轮825啮合接合，使得它们也与环形齿轮823啮合接合。第一太阳齿轮826形成于或者说是附接到第一行星齿轮架824上，并且与支撑在第二行星齿轮架827上的多个第二行星齿轮828啮合接合。第二行星齿轮828也被支撑以与环形齿轮823啮合接合。第二太阳齿轮829形成于或者说是附接到第二行星齿轮架827上，并且与多个第三行星齿轮831啮合接合。第三行星齿轮831被支撑在第三行星齿轮架830上并且被支撑以与环形齿轮823啮合接合。第三太阳齿轮833形成于或者说是附接到第三行星齿轮架830上的轴延伸部832并且与附接到联接器齿轮的多个第四行星齿轮835啮合接合，所述联接器齿轮包括可旋转地支撑在轴延伸部832上的第四行星齿轮架834。另外，推力轴承836可轴颈连接在第四行星齿轮架834之间的轴延伸部832上。第四行星齿轮835与输出轴单元850啮合接合，所述输出轴单元850由齿轮箱外壳822可旋转地支撑。第二推力轴承836可支撑在第四行星齿轮和输出轴单元850之间，如在图30中可见。第四行星齿轮835被支撑以与内部齿轮座圈854啮合接合。
在例示的实施例中，输出轴单元850可操作地联接到具有Zemlok‘763所公开的类型和构造的离合器230，该专利全文以引用方式并入本文。有关此类离合器230的构造和操作的其他细节可得自该公布。然而，在另选的实施例中，离合器230可由轴-轴联接器或套管构造替换，所述轴-轴联接器或套管构造用于有利于输出轴单元850直接联接到驱动管102。
再次参见图31，主关节运动驱动齿轮837附接到关节运动驱动轴872并且与第四行星齿轮架834上的外部齿轮环838啮合接合。在各种形式中，驱动联接器组件840还可包括联接器选择器构件842，所述联接器选择器构件842可运动地联接到齿轮箱外壳822或外壳812的其他部分或者说是由其可运动地支撑。在至少一种构造中，联接器选择器构件842可与第一驱动轴保持器部分844和第一关节运动轴保持器部分846一起形成。第一驱动轴保持器部分844包括沟槽状、粗糙状等区域，所述沟槽状、粗糙状等区域被构造成能够不可运动地接合输出轴单元850上的第二驱动轴保持器部分845。类似地，第一关节运动轴保持器部分846包括沟槽状、粗糙状等区域，所述沟槽状、粗糙状等区域被构造成能够不可运动地接合第四行星齿轮架834上的第二关节运动轴保持器部分847。
可参照图29和图30来理解联接器组件840的操作。如在图29中可见，联接器选择器构件842被枢转到关节运动位置，其中第一关节运动轴保持器部分846与输出轴单元850上的第二关节运动轴保持器部分847不可运动地接合。当处于该位置时，输出轴单元850被防止围绕纵向轴线LA-LA旋转。因此，当处于该位置时，马达100的操作将导致第三太阳齿轮833的旋转，所述第三太阳齿轮833与第四行星齿轮835啮合接合。第四行星齿轮835的旋转将导致可自由旋转的第四行星齿轮架834的旋转。第四行星齿轮架834的此类旋转还将导致联接到关节运动驱动轴872的主关节运动齿轮837的旋转。关节运动驱动轴872的旋转将导致第一关节运动驱动齿轮873旋转并且驱动第二关节运动传递齿轮874。第二关节运动传递齿轮874的旋转导致第三关节运动传递齿轮和第四关节运动蜗轮878的旋转。第四关节运动蜗轮878的旋转将驱动主关节运动齿轮94，这将导致关节运动动作被施加到关节运动连接件97、70，从而最终导致加载单元20围绕关节运动接头的旋转。马达驱动轴107沿第一旋转方向的旋转将导致加载单元沿第一关节运动方向的关节运动，并且马达驱动轴107沿相反旋转方向的旋转将导致加载单元沿与第一关节运动方向相反的第二关节运动方向的关节运动。
接下来参见图30，联接器选择器构件842被枢转到驱动或击发位置，其中第一驱动轴保持器部分844与第四行星齿轮架834上的第二驱动轴保持器部分845不可运动的接合。当处于该位置时，第四行星齿轮架834被防止围绕纵向轴线“LA-LA”旋转。因此，当处于该位置时，马达100的操作将导致第三太阳齿轮833的旋转。第三太阳齿轮833与支撑在第四行星齿轮架834上的第四行星齿轮835啮合接合。由于第四行星齿轮架834因第一关节运动轴保持器部分846与第四行星齿轮架834上的第二关节运动轴保持器部分847之间的不可运动接合而被防止旋转，第四行星齿轮835的旋转将导致输出轴单元850的旋转。输出轴单元850可通过离合器组件230或通过直接联接来联接到驱动管102。因此，输出轴单元850的旋转导致驱动管102的旋转。如上所述，驱动管102的旋转导致击发杆(未示于图31中)的轴向运动。马达驱动轴107沿第一旋转方向的旋转将导致击发杆的远侧推进，并且马达驱动轴107沿相反方向的旋转将导致击发杆的近侧运动。在各种实施例中，加载单元20钳口的闭合(例如，砧座组件22相对于载体24的枢转)可使马达100与外科器械10的关节运动系统和/或击发系统联接和/或分离。例如，砧座组件22相对于载体24的闭合可使马达100与关节运动系统(例如，与关节运动驱动轴872)分离，并且可将马达100联接到击发系统(例如，输出轴单元850)。此外，砧座组件22相对于载体24的打开可使马达100与击发系统分离，并且可将马达100联接到关节运动系统。在此类实施例中，当加载单元20打开时马达100可影响加载单元20的关节运动，并且当加载单元20闭合时马达100可影响击发杆的击发。外科器械10可包括例如传感器和/或选择器。在某些实施例中，传感器可检测加载单元20钳口的闭合。此外，传感器可与选择器(例如联接器选择器构件842)进行信号通信。当砧座组件22例如相对于载体24打开和/或闭合时，选择器可使马达100与关节运动系统和/或击发系统联接和/或分离。相比于采用多个马达以使端部执行器进行关节运动并且击发端部执行器驱动构件的先前动力外科器械，采用本文所公开的各种驱动联接器构造的各种动力外科器械可代表巨大改进。
例如，至少一个外科器械包括限定纵向工具轴线的细长轴组件。外科端部执行器可操作地联接到细长轴组件以用于相对其的选择性关节运动。外科端部执行器可被构造成能够响应于对其施加的击发动作来执行至少一个外科手术。关节运动系统可与细长轴组件可操作地交接以用于将关节运动动作施加到外科端部执行器。击发构件组件可与细长轴组件可操作地交接以用于将击发动作施加到外科端部执行器。外科器械还可包括被构造成能够产生旋转致动运动的马达。驱动联接器组件可与马达和关节运动系统交接，使得当驱动联接器组件处于第一构型时，马达的操作将导致致动动作被施加到关节运动系统，由此导致外科端部执行器相对于纵向工具轴线的关节运动，并且当驱动联接器组件处于第二构型时，马达的操作将导致致动动作被施加到击发构件组件，由此导致击发构件组件将至少一个击发动作施加到外科端部执行器。
另一个外科器械示例可包括柄部，所述柄部具有可操作地联接到其的限定纵向工具轴线的细长轴组件。加载单元可操作地联接到细长轴组件并且被构造成能够响应于对其施加的击发动作来切断和缝合组织。加载单元可被构造成能够围绕关节运动接头相对于纵向工具轴线选择性地进行关节运动。外科器械还可包括关节运动系统，所述关节运动系统包括关节运动连接件组件，所述关节运动连接件组件由细长轴组件支撑并且被构造成能够与细长轴组件和加载单元中的一者中的关节运动接头部分可操作地交接。关节运动致动机构可由柄部支撑并且与关节运动连接件组件交接以对其施加关节运动致动动作。外科器械还可包括击发构件组件，所述击发构件组件与加载单元可操作地交接以对其施加击发动作。马达可由柄部可操作地支撑并且被构造成能够产生旋转致动运动。驱动联接器组件可与马达和关节运动致动机构交接，使得当驱动联接器组件处于第一构型时，马达的操作将导致致动动作被施加到关节运动系统，由此导致加载单元相对于纵向工具轴线的关节运动，并且当驱动联接器组件处于第二构型时，马达的操作将导致致动动作被施加到击发构件组件，由此导致击发构件组件将至少一个击发动作施加到加载单元。
另一个外科器械示例可包括限定纵向工具轴线的细长轴组件。外科端部执行器可操作地联接到细长轴组件以用于相对其的选择性关节运动。外科端部执行器可被构造成能够响应于对其施加的击发动作来执行至少一个外科手术。关节运动系统可与细长轴组件可操作地交接以用于将关节运动动作施加到外科端部执行器。击发构件组件可与细长轴组件可操作地交接以用于将击发动作施加到外科端部执行器。马达可被构造成能够产生旋转致动运动。外科器械还可包括以下装置，所述装置用于将输出动作从马达选择性地施加到关节运动系统和击发构件组件中的每一个。
在某些马达驱动外科器械中，马达可将触觉反馈提供给外科器械的操作者。例如，马达的旋转可例如根据马达旋转的方向和/或速度来产生振动动作或噪声。然而，各种马达可产生极小的噪声，并且因此对外科医生的触觉反馈可受到限制并且/或者可不被外科医生理解。例如，马达和/或传输设计中的各种修改和/或改进可降低由马达和/或传输设计产生的触觉噪声。在此类实施例中，可为有利的是修改马达和/或可操作地联接到马达的齿轮组件，以产生人工或故意的触觉反馈和/或其他感官反馈。在某些实施例中，外科器械可将反馈传送给外科医生，且无需使外科医生从操作位置转移目光。例如，马达和/或齿轮可产生触觉和/或听觉反馈以与外科医生通信。在此类实施例中，操作者无需观看显示屏例如来探知外科器械的操作状态或情况。如本文更详细所述，外科器械可传送例如马达的旋转方向，所述旋转方向可对应于例如击发构件的击发方向和/或加载单元的关节运动方向。除此之外或另选地，外科器械可例如在击发行程期间传送击发构件的速度和/或位置并且/或者可例如传送加载单元的关节运动的速度和/或程度。
在各种实施例中，如本文更详细所述，马达可操作地联接到击发组件和/或关节运动组件。现在参见图168，马达7010可驱动例如可接合齿轮组件7020的马达轴7014。在各种实施例中，键，例如马达轴7014上的键7016，可接合齿轮组件7020的一部分。在某些实施例中，齿轮组件7020可包括例如盘7022、7024，所述盘7022、7024可被构造成在通过键与马达轴7014接合时与马达轴7014一起旋转或轮转。例如，第一盘7022可包括沟槽(未示出)。此外，从马达轴7014延伸的第一键(未示出)可接合第一盘7022中的沟槽，使得第一盘7022在马达轴7014顺时针(CW)旋转时顺时针旋转并且在马达轴7014逆时针(CCW)旋转时逆时针旋转。在至少一个实施例中，第一键可在外科器械和/或其马达的整个操作期间保持与第一盘7022中的沟槽接合。
在某些实施例中，第一盘7022可相对于其沿马达轴7014的旋转轴线为平衡的。仍参见图168，块(例如块7026)可从第一盘7022延伸并且可将第一盘7022的质心移动成偏离第一盘7022的旋转轴线。例如，块7026可远离马达轴7014和/或远离第一盘7022的外周边延伸。换句话讲，块7026可打乱第一盘7022的平衡，导致第一盘7022的旋转失衡，并且因此在第一盘7022与马达轴7014一起旋转时产生离心力。因此，第一盘7022和块7026的旋转可产生触觉反馈，例如，外科器械外壳和/或柄部的振动或摇动。触觉反馈可对应于外科器械的操作状态或情况。此外，由第一盘7022和块7026的旋转产生的触觉反馈可依赖于马达轴7014的旋转速度。在此类实施例中，击发速度和/或关节运动速度也可例如被传送到外科医生。例如，第一盘7022可在马达轴7014较快地旋转时产生具有较高频率的触觉反馈并且在马达轴7014较慢地旋转时产生具有较低频率的触觉反馈。
类似于第一盘7022，在某些实施例中，第二盘7024可相对于其沿马达轴7014的旋转轴线为平衡的。仍参见图168，然而，块(例如，块7028)可从第二盘7024延伸并且可使其质心偏移。例如，块7028可远离马达轴7014和/或远离第二盘7024的外周边延伸。换句话讲，块7028可打乱第二盘7024的平衡，导致第二盘7024的旋转失衡，并且因此在第二盘7024与马达轴7014一起旋转时产生离心力。因此，第二盘7024和块7028的旋转可产生触觉反馈，例如，外科器械外壳和/或柄部的振动或摇动。触觉反馈可对应于外科器械的操作状态或情况。此外，由第二盘7024和块7028的旋转产生的触觉反馈可依赖于马达轴7014的旋转速度。在此类实施例中，击发速度和/或关节运动速度也可例如被传送到外科医生。在各种实施例中，第一盘7022和/或第二盘7024可包括例如类似于块7026和/或7028的附加块，所述附加块可例如进一步地有助于外科器械外壳和/或柄部的触觉响应。此外，在一些实施例中，马达轴7014可操作地接合齿轮组件7120的附加和/或不同盘以选择性地产生附加和/或不同的触觉反馈。
仍参见图168，第二盘7024可包括内周边7026。在各种实施例中，第二键7016可从马达轴7014延伸，并且可通过内周边7030可操作地接合第二盘7024。内周边7030可包括例如多个平坦表面7032和相邻平坦表面7032之间的多个弧形表面7034。每对平坦表面7032和弧形表面7034可限定沟槽，所述沟槽可被构造成接纳第二键7016。在某些实施例中，当键7016沿第一方向旋转时，键7016可邻接平坦表面7032并且被固定和/或保持在第二盘7024的沟槽中。在此类构造中，第二盘7024可与马达轴7014一起沿第一方向旋转。此外，在某些实施例中，当键7016沿与第一方向相反的第二方向旋转时，键7016可旋转通过弧形表面7034并且可被固定和/或保持在内周边7030中的沟槽内。换句话讲，键7016可相对于第二盘7024旋转。在此类构造中，马达轴7014可相对于第二盘7024沿第二方向旋转。因此，当马达轴7014沿第一方向旋转时，键7016可仅接合第二盘7024并且导致第二盘7024旋转。在某些实施例中，第一方向可对应于CW旋转，并且在其他实施例中，第一方向可对应于CCW旋转。
如本文所述，由于第二盘7024的接合可取决于马达轴7014的旋转方向，因此第二盘7024可仅在马达轴7014沿一个方向旋转时(例如，在马达7010沿一个方向驱动击发构件和/或沿一个方向旋转加载单元时)旋转。例如，第二盘7024可仅例如在马达7010回缩击发构件或顺时针旋转加载单元时旋转。第二盘7024的此类选择性接合可影响由外科器械产生的触觉反馈。换句话讲，可基于第二盘7024的选择性接合来产生不同和/或较大的触觉反馈。例如，在其中第二盘7024仅在马达7010旋转以回缩击发构件时旋转的实施例中，相比于击发构件的推进期间，在回缩期间可产生更大的触觉反馈。在回缩期间，第二盘7024还可有助于触觉反馈的产生，这可导致反馈力的较高或较大总和。在此类实施例中，由第一盘7022、第二盘7024产生的较大触觉反馈可向外科医生指示击发构件正通过马达7010进行回缩。在各种实施例中，根据上文所述，当马达轴7014沿一个方向旋转时仅第一盘7022可旋转，并且当马达轴7014沿相反方向旋转时两个盘7022、7024均可旋转。由此，当马达轴7014沿不同方向旋转时，盘7022、7024可产生不同的反馈。
现在参见图169，在某些实施例中，马达7010可驱动可接合齿轮组件7120的马达轴7014。在各种实施例中，键，例如马达轴7014上的键7016，可接合齿轮组件7120。类似于齿轮组件7020，齿轮组件7120可包括多个盘，例如，第一盘7122和第二盘7124。第一盘7122和第二盘7124可被构造成在通过键与马达轴7014选择性地接合时与马达轴7014一起旋转或轮转。例如，第一盘7122可包括沟槽(未示出)。此外，从马达轴7014延伸的第一键(未示出)可接合第一盘7122的沟槽，使得第一盘7122与马达轴7014一起旋转。在某些实施例中，在使用期间，第一键可不能从第一盘7122的沟槽脱离。第二盘7124可包括例如内周边7130，其类似于第二盘7024的内周边7030。内周边7130可包括多个平坦表面7132和多个弧形表面7134。如本文相对于图168所述，键7016可根据马达轴7014的旋转方向来选择性地接合和脱离第二盘7124的内周边7130。例如，当马达轴7014沿第一方向旋转时，键7016可接合第二盘7124，由此导致第二盘7124与马达轴7014一起旋转。此外，当马达轴7014沿第二方向旋转时，键7016可保持脱离第二盘，使得键7016可相对于第二盘7024在其内周边7130内旋转。
在各种实施例中，第一盘7122可包括至少一个截齿7126，并且第二盘7124也可包括至少一个截齿7128。当盘7122、7124旋转时，截齿7126、7128可撞击音频反馈发生器7140的元件。例如，截齿7126、7128可撞击音频反馈发生器7140的响片7142、7144。在各种实施例中，当第一盘7122旋转时第一盘7122的截齿7126可撞击并且挠曲第一响片7142，并且当第二盘7124旋转时第二盘7124的截齿7128可撞击并且挠曲第二响片7144。响片7142、7144的撞击和挠曲可导致响片7142、7144谐振并且产生听觉信号。换句话讲，第一和第二盘7122的旋转可产生音频反馈。此外，旋转盘7122、7124的旋转速度和/或从第一盘7122和第二盘7124延伸的截齿的数量和构造可影响听觉信号的频率。在此类实施例中，马达的速度和击发元件的对应击发速度和/或加载单元的关节运动速度可例如被传送给外科医生。
主要参见图170和图171，在各种实施例中，截齿7126、7128的几何形状可影响由音频反馈发生器7140产生的听觉信号。例如，截齿7126、7128可各自包括非衰减表面7150和衰减表面7152。非衰减表面7152可包括例如平坦表面并且衰减表面7152可包括例如弧形表面。在各种实施例中，在其中截齿7126的非衰减表面7150在旋转时位于截齿7126的衰减表面7152之前的情况下(图170)，响片7142的谐振可被截齿7126的后端衰减表面7152衰减和/或停止。例如，衰减表面7152的弧形几何形状可接触挠曲的响片7126，以防止和/或限制响片7126的振动或谐振。相反地，在其中截齿7126的衰减表面7152在旋转时位于截齿7126的非衰减表面7150之前的情况下(图171)，响片7142的谐振可不被截齿7126的非衰减表面7150衰减。例如，非衰减表面7150的平坦几何形状可避免和/或限制与挠曲响片7126的接触，使得响片7126的谐振被允许和/或不太受限制。换句话讲，盘7122、1724和相关截齿7126、7128的旋转方向可影响由外科器械产生的听觉反馈。因此，可在外科器械的使用期间将其操作状态通知给外科器械的操作者，且无需使外科医生从外科部位转移目光。例如，音频信号可在击发构件回缩时被衰减并且可在击发构件推进时不被衰减。在其他实施例中，音频信号可在击发构件推进时被衰减并且可在击发构件回缩时不被衰减。此外，在一些实施例中，例如，衰减的听觉信号可与加载单元沿一个方向的关节运动相对应，并且未衰减的听觉信号可与加载单元沿另一个方向的关节运动相对应。在各种实施例中，至少一个音频反馈发生器可单独使用和/或可结合至少一个触觉反馈系统来使用。此外，在一些实施例中，至少一个触觉反馈系统可单独使用和/或可结合至少一个音频反馈发生器来使用。音频反馈和触觉反馈可将不同的操作状态传送给外科医生并且/或者可将例如有关相同操作状态的双重反馈提供给外科医生。
在各种实施例中，外科器械可在击发元件接近和/或到达击发行程末端时和/或在加载单元接近和/或到达关节运动极限时产生反馈。在各种实施例中，此反馈可不同于和/或附加于整个击发行程期间和/或加载单元进行关节运动时所产生的反馈。因此，外科器械可向使用者通知例如击发行程接近完成和/或已完成并且/或者可向操作者通知加载单元接近关节运动极限和/或已达到关节运动极限。
现在参见图172，马达7010和马达轴7014可与齿轮组件7120可操作地接合，如上文更详细所述。此外，齿轮组件7120的盘7122、7124可接触音频反馈发生器7240，所述音频反馈发生器7240可类似于例如音频反馈发生器7140。例如，盘7122、7124上的截齿7126、7128可挠曲音频反馈发生器7240的响片7242、7244，由此导致响片7242、7244谐振并且产生听觉反馈。此外，音频反馈发生器7240可相对于齿轮组件7120运动或平移。如下文更详细所述，音频反馈发生器7240可选择性地运动成与盘7122、7124上的响片7242、7244接合和/或不接合以选择性地产生听觉信号。在其他实施例中，马达、齿轮组件和/或其盘可运动，使得盘的截齿选择性地运动成与音频反馈发生器的响片接合和/或不接合以选择性地产生听觉信号。
在各种实施例中，当击发构件在击发行程期间运动时，音频反馈发生器7240可在外科器械中平移。例如，在击发行程开始处，音频反馈发生器7240可与盘7122、7124的截齿7126、7128不对准。此外，当击发构件朝远侧运动并且/或者接近击发行程末端时，音频反馈发生器7240可运动到和/或运动成与盘7122、7124的截齿7126、7128对准。在此类实施例中，音频反馈发生器7240可在击发构件接近和/或到达击发行程末端时产生听觉反馈。参见图173，例如，反馈发生器可在击发构件处于接近和/或到达击发行程末端的位置范围内产生反馈例如以将击发构件的位置传送给外科医生。在此类实施例中，外科器械可将击发行程末端传送给操作者。例如，再次参见图172，当击发构件接近击发行程的远侧端部时，至少一个截齿7126、7128可与至少一个响片7242、7244对准。此时，外科器械可产生反馈以将击发构件的位置传送给外科医生。当每个截齿7126、7128与响片7242、7242中的一个对准时，可将较大的和/或不同的反馈传送给外科医生。此外，当击发构件回缩时，至少一个截齿7126、7128可再次与响片7242、7244不对准，使得将减小的和/或不同的反馈传送给外科医生。因此，当反馈发生器运动穿过击发行程时，反馈发生器可基于击发构件的位置来将变化的反馈传送给操作者。此外，齿轮组件7120可包括可运动成与音频反馈发生器7240接合和/或不接合的附加盘和/或截齿，并且/或者音频反馈发生器7240可包括可运动成与截齿接合和/或不接合的附加响片。在各种实施例中，音频反馈发生器可将击发构件的另选和/或附加位置传送给外科医生。例如，音频反馈发生器可在沿击发和/或回缩路径的长度的中点和/或递增点处传送听觉反馈。
现在参见图174和图175，也可使用可运动的反馈发生器来将加载单元的关节运动极限传送给外科医生。例如，图172所示的音频反馈发生器7240例如可随着加载单元的关节运动而平移。例如，当加载单元处于非关节运动构型时，音频反馈发生器7240可与盘7122、7124的截齿7126、7128不对准。此外，当加载单元进行关节运动时，音频反馈发生器7240可运动到和/或运动成与盘7122、7124的截齿7126、7128对准。在此类实施例中，音频反馈发生器7240可在加载单元接近和/或到达关节运动极限时产生听觉反馈。例如，再次参见图174和图175，反馈发生器可在击发构件处于接近和/或到达击发行程末端的位置范围内产生反馈以将击发构件的位置传送给外科医生。在此类实施例中，外科器械可将关节运动极限传送给操作者。例如，再次参见图172，当加载单元接近其关节运动极限(例如，接近四十五度)时，至少一个截齿7126、7128可与至少一个响片7242、7244对准。此时，外科器械可产生反馈以将击发构件的位置传送给外科医生。当加载单元更接近和/或到达关节运动极限时，每个截齿7126、7128可与响片7242、7244中的一个对准，并且可将较大的和/或不同的反馈传送给外科医生。此外，当加载单元进行关节运动以返回到非关节运动、中性位置时，至少一个截齿7126、7128可再次与响片7242、7244不对准，使得将减小的和/或不同的反馈传送给外科医生。因此，当反馈发生器运动穿过击发行程时，反馈发生器可基于加载单元的构型来将变化的反馈传送给操作者。
在各种实施例中，可为有利的是保护外科器械的某些部件以防流体接触。例如，使用期间与体液的无意接触可损坏外科器械，并且可限制和/或缩短外科器械的生命周期。此外，可为有利的是保护外科器械的某些部件以防灭菌期间的流体接触。例如，与灭菌和/或清洁流体的无意接触可损坏外科器械，并且可妨碍和/或限制外科器械的可重复使用性。在各种实施例中，外科器械的某些部件可被密封和/或保护以防流体接触。例如，外科器械中的电子器件可密封在环氧树脂中进行保护以防流体。外科器械的运动部件(例如，马达和/或齿轮组件的部分)也可被密封和/或保护以防流体接触。此类密封可例如适应各种运动部件的旋转。此外，在各种实施例中，此类密封还可有利于热传递，使得在外科器械操作期间产生的热被较有效地耗散。
现在参见图185和图186，在某些实施例中，马达7510和/或齿轮组件7520可被密封和/或保护以防使用期间和/或灭菌处理期间的流体。马达7510可类似于例如马达100，并且齿轮组件7520可类似于例如齿轮组件170。为了密封和保护马达7510，马达外壳(例如橡胶套管)可定位在外科器械10(图1)的外壳12(图1)内的马达7510周围。此类橡胶套管可限制马达7510的热传递，并且马达7510可易于过热。在其他实施例中，再次参见图185和图186，马达外壳可包括例如可定位在马达7510周围的蛤壳覆盖件7516。在各种实施例中，蛤壳覆盖件7516可包括例如可关节运动和/或卡扣在一起的至少两个部分。蛤壳覆盖件7516可允许马达7510和/或马达轴的旋转。另外，在某些实施例中，蛤壳覆盖件7516可有利于其中保持的马达7510的热传递。类似于触点构造210的触点构造7512(图186)例如可用于将电流提供到马达7510。触点构造7512可包括例如正极环形触点7514a和负极环形触点7514b(图186)，所述正极环形触点7514a和负极环形触点7514b例如可操作地连接到由蛤壳覆盖件7516保持的固定的正极触点7518a和负极触点7518b(图186)。此外，蛤壳覆盖件7516可包括环形密封件或垫圈7519，所述环形密封件或垫圈7519可例如邻接马达7510的周边并且将马达7510和触点构造7512密封在蛤壳覆盖件7516内。在某些实施例中，蛤壳覆盖件7516可包括金属材料，所述金属材料可例如有利于马达7510的热传递并且可防止马达7410的过热和/或损坏。
仍参见图185和图186，齿轮组件7520也可被密封和/或保护以防使用和/或灭菌期间的流体。例如，垫圈7522可定位在马达7510和齿轮组件7520的外壳之间，使得马达7510和齿轮组件7520形成不透流体的密封。此外，密封套管7530可围绕齿轮组件7520的外壳进行定位。密封套管7530可包括边缘7536，所述边缘7536可邻接蛤壳覆盖件7516和/或马达7510以在它们之间提供不透流体的密封。密封套管7530还可包括用于输出轴7524的开口7532。例如，齿轮组件7520的输出轴7524可延伸穿过开口7532，并且翅片7534可延伸到输出轴7524以提供不透流体的密封同时允许输出轴7524在开口7532内的旋转。在各种实施例中，密封套管7530和/或其边缘7536、垫圈和/或翅片7534可包括橡胶和/或另一种合适的材料以用于形成不透流体的密封。在各种实施例中，安装支架或马达保持器7540(类似于保持器190)例如可将密封的齿轮组件7520和马达7510保持在外科器械10(图1)的外壳12(图1)内。
图32-37示出了另一个外科器械910，其可包括本文所公开的其他外科器械的许多特征。在至少一种形式中，外科器械910可包括通常标定为860的关节运动致动机构，所述关节运动致动机构除下文所述的差异之外可基本上类似于Zemlok‘763、Zemlok‘344和/或美国专利7,431,188中所公开的关节运动机构。在其他构造中，外科器械可包括如本文所述的各种形式的其他关节运动致动机构。如在图32中可见，器械910包括外壳12，所述外壳12可包括其上安装有可旋转构件92的圆筒形安装部分90。可旋转构件92与细长轴组件16的近侧端部交接以有利于细长轴组件16相对于外壳12的旋转。此类构造允许外科医生使细长轴组件16和联接到其的加载单元20(或其他形式的外科端部执行器)围绕纵向工具轴线“LA-LA”选择性地旋转。可旋转构件92可以不可移除地安装在圆筒部分90上或者其可被设计成与其选择性地分离。
如本文所公开，根据所采用的外科端部执行器的类型和/或构造，可期望将电流提供到端部执行器。例如，端部执行器可使用需要电来启动的传感器、灯、致动器等等。然而，在此类构造中，使外科端部执行器围绕纵向工具轴线“LA-LA”旋转的能力可受到严重限制，因为将功率从电功率源通过细长轴输送到外科端部执行器或加载单元的导体系统可卷绕并且受到严重损坏---尤其是在细长轴已旋转多于一转的情况下。本文所公开的各种外科器械可使用通常标定为930的导体管理系统，所述导体管理系统可避免上述问题的。
再次参见图32，外科器械910可由电功率源200提供功率。电功率源可例如具有Zemlok‘763更详细描述的类型。例如，电功率源200可包括可再充电电池(例如，铅基、镍基、锂离子基等等)。还可设想到，电功率源200可包括至少一个一次性电池。在至少一个构造中，例如，一次性电池可为约9伏至约30伏。图32示出了其中电功率源200包括多个电池单元202的一个示例。所用电池单元的数量可取决于器械910的电流负载需求。还可设想到，电功率源可包括可用于外科套件中的交流源。例如，可使用外部功率线和插头(未示出)将交流电从外科套件中的出口输送到外科器械外壳和/或端部执行器中的各种部件、导体、传感器、开关、电路等。在其他应用中，外科器械910可从例如与其附接或者说是相联的机器人系统获得功率。
如在图32中进一步可见，导体管理系统930可包括主导体构件和线932，所述主导体构件和线932与电功率源200联接或者说是交接以用于从其接收功率。主导体构件932联接到支撑在可旋转构件92内的螺旋、卷轴、和/或可卷绕导体组件934。在一种构造中，例如，螺旋导体组件934可由带状导体936形成或者说是包括带状导体936，所述带状导体936以例如图36和37中所示的方式卷绕成螺旋形式。例如，螺旋导体组件934可由螺旋卷绕导体制成，所述螺旋卷绕导体可具有与螺旋卷绕弹簧(例如，扭转弹簧)类似的属性。在一种形式中，例如，导体936可卷绕成如图36和37所示的连续转或匝。在各种构造中，导体936可被卷绕一个或多个完整转。例如，图36和37所示的导体936被构造成多于四个完整转。
在各种形式中，导体936具有第一端部938，所述第一端部938可例如固定到外壳12的圆筒部分90。此外，导体936还具有第二端部940，所述第二端部940附接到可旋转构件92或者说是由其支撑以用于与其一起旋转行进。因此，当可旋转构件92围绕圆筒部分90沿第一可旋转方向旋转时，螺旋卷绕导体936卷绕成较紧密形式。相反地，当可旋转构件92沿第二可旋转方向旋转时，螺旋卷绕导体936的紧密度可降低。在其中可旋转构件92可移除地支撑在圆筒部分90上的这些构型中，螺旋卷绕导体936的第一端部938可移除地支撑在圆筒部分90中的狭槽或其他安装腔体942中。参见例如图36和图37。此外，主导体构件932可通过连接器组件933可拆卸地联接到螺旋导体组件934。具体地，可拆卸的连接器组件933可用于将主导体构件932联接到螺旋卷绕导体936的第一端部938，以有利于可旋转构件92从圆筒部分90的移除。在其中可旋转部分92不旨在从圆筒部分移除的其他构造中，螺旋卷绕导体936的第一端部938可以不可移除地附连到圆筒部分90并且主导体构件932可永久性地附连(例如，焊接)到螺旋卷绕导体936的第一端部。
螺旋卷绕导体936的第二端部940可通过粘合剂、机械保持器、卡扣特征结构等不可移除地附连到可旋转构件92。在另选的构造中，螺旋卷绕导体936的第二端部940可以可移除地支撑在提供于可旋转构件92中的狭槽或其他安装特征结构中，以有利于从可旋转部分92拆卸螺旋卷绕导体936。如在图32和33中可见，辅助轴导体构件944附接到螺旋缆线组件934的第二端部940。辅助轴导体构件944可支撑在可旋转构件92内并且延伸穿过中空细长轴组件16。例如，辅助轴导体构件944可穿过细长轴组件16延伸到其远侧端部，以与附接到其的其他导体、传感器、动力部件等交接，所述其他导体、传感器、动力部件等与外科端部执行器、加载单元等相联。因此，当临床医生相对于外壳12旋转可旋转构件92时，螺旋导体组件934，并且更具体地，螺旋卷绕导体936将卷绕成略微较紧密的螺旋，同时有利于将功率从功率源200施加到外科端部执行器、加载单元等。如果临床医生相对于外壳12沿相反方向旋转可旋转构件92，则螺旋卷绕缆线936将略微解卷绕，同时仍有利于将功率从功率源200施加到外科端部执行器、加载单元等上的各种部件、传感器等。
如在图34和35中进一步可见，导体管理系统930还可包括通常标定为950的旋转限制器组件。在至少一种构造中，例如，旋转限制器组件950包括限制器构件952，所述限制器构件952可运动地附接到可旋转构件92并且被构造成能够螺纹接合外壳12的圆筒90上的螺纹部分99。限制器952可包括一对相对凸块954，所述凸块954位于形成于可旋转构件92上的轴向翅片部分958的每一侧，如图33所示。当可旋转构件92在外壳12的圆筒部分90上旋转时，此类构造允许限制器952在可旋转构件92内轴向地运动。限制器构件952的相对端部960被构造成能够螺纹接合圆筒90的螺纹部分99。可旋转构件92的向内延伸的近侧止挡壁962和向内延伸的远侧止挡壁964用于限定当可旋转构件92在圆筒90上旋转时限制器942可轴向行进的行进距离“TD”。
图33示出了位于近侧止挡壁952和远侧止挡壁954之间的大致中间位置的限制器952。当处于该位置时，可旋转构件92相对于圆筒部分90沿第一方向的旋转将导致限制器沿远侧方向“DD”的轴向行进，直至限制器952接触远侧止挡壁964，如图34所示。同样，可旋转构件92相对于圆筒部分90沿相反方向的旋转导致限制器952沿近侧方向“PD”的轴向行进，直至其接触可旋转构件92的近侧止挡壁962。此构造由此限制可旋转构件92可围绕圆筒部分90完全旋转的次数，以避免螺旋导体组件934的意外损坏。例如，限制器组件950可允许临床医生使细长轴组件，并且更具体地可旋转构件92围绕圆筒部分90沿任一方向旋转至少一个完整转但不超过例如三个完整转。然而，转数，或更具体地，可旋转构件92在圆筒90上的可旋转行进量可通过调节行进距离“TD”的大小来调节。
图33示出了处于“中性”或“中央”位置的限制器952，其中限制器居中设置在远侧止挡壁954和近侧止挡壁952之间。在至少一种形式中，当细长轴组件16和可旋转构件92处于对应的中性位置时，偏置构件980可用于将限制器952偏置到中性位置。当临床医生对可旋转部分92施加旋转运动时，细长轴组件16将以上述方式旋转。然而，当对可旋转构件92和细长轴组件16施加的旋转运动中断时，偏置构件980将使限制器952返回到中性位置。
例如，至少一个外科器械可包括外壳，所述外壳可包括可旋转构件，所述可旋转构件支撑在外壳的安装部分上，以用于在旋转范围上围绕其旋转。限定纵向工具轴线的细长轴组件可操作地联接到可旋转构件，以用于与其一起围绕纵向工具轴线旋转行进。外科器械还可包括电功率源并且包括导体管理系统。导体管理系统可包括卷轴导体组件，所述卷轴导体组件可支撑在可旋转构件中并且可包括第一导体端部和第二导体端部，所述第一导体端部固定到外壳的安装部分，所述第二导体端部固定到可旋转构件以用于与其一起在旋转范围上旋转。导体管理系统还可包括主导体，所述主导体可支撑在外壳内并且被构造成能够将功率从电功率源传输到卷轴导体组件。轴导体可联接到卷轴导体组件以用于将电功率传输到细长轴组件的远侧端部。
另一个外科器械示例可包括外壳，所述外壳可包括可旋转构件，所述可旋转构件支撑在外壳的安装部分上。外科器械还可包括细长轴组件，所述细长轴组件限定纵向工具轴线并且可操作地联接到可旋转构件，以用于与其一起围绕纵向工具轴线旋转行进。外科器械还可包括电功率源和用于通过延伸穿过细长轴组件的导体从电功率源传输功率的装置。外科器械还可包括以下装置，所述装置用于将可旋转构件围绕安装部分的旋转行进量限制到以下旋转行进范围，所述旋转行进范围包括围绕安装部分的至少一个完整转并且不超过三个完整转。
如本文所述，端部执行器可附接到外科器械。另外如本文所述，外科器械可包括击发驱动装置，所述击发驱动装置被构造成能够从包括钉仓的端部执行器击发钉。现在转到图94所示的示例性实施例，例如，外科器械9000可包括柄部9010，所述柄部9010包括外壳、抓握部分9012、击发致动器9014、和定位在外壳内的马达。外科器械9000还可包括具有击发杆9020的轴9040，所述击发杆9020可通过马达朝远侧推进和/或朝近侧回缩。在某些情况下，端部执行器可包括可围绕关节运动接头相对于近侧部分进行关节运动的远侧部分。在其他情况下，端部执行器可不具有关节运动接头。外科器械还可包括被构造成能够使端部执行器的至少一部分进行关节运动的关节运动驱动装置。再次参见图94所示的示例性实施例，例如，外科器械9000可包括可被构造成能够围绕关节运动接头驱动端部执行器的远侧部分的关节运动致动器9070。图94所示的端部执行器(即，端部执行器9060)碰巧不是能够关节运动的端部执行器；然而，能够关节运动的端部执行器可与外科器械9000一起使用。如果非关节运动的端部执行器，例如端部执行器9060，与外科器械9000一起使用，则关节运动致动器9070的操作可不影响端部执行器9060的操作。
对上文进行进一步描述，端部执行器可包括对应于外科器械的驱动系统的驱动系统。例如，端部执行器9060可包括击发构件，所述击发构件可在端部执行器9060组装到外科器械时与外科器械9000的击发杆9020可操作地接合。类似地，端部执行器可包括关节运动驱动器，所述关节运动驱动器可在端部执行器组装到外科器械时与外科器械的关节运动杆可操作地接合。此外，端部执行器9060例如可包括近侧连接部分9069，所述近侧连接部分9069可在端部执行器9060附接到外科器械9000时安装到外科器械9000的轴9040的远侧连接部分9042。在各种情况下，在端部执行器可被正确地使用之前，可需要端部执行器的连接部分、驱动系统、和关节运动系统与外科器械的正确组装。
再次参见94，柄部9010可包括击发触发器9014，所述击发触发器9014在由外科器械9000的使用者致动时可被构造成能够操作柄部9010中的马达。在各种情况下，柄部9010可包括可被构造成能够检测击发触发器9014的致动的控制器。在一些情况下，击发触发器9014的致动可闭合与控制器进行信号通信的电路。在此类情况下，控制器可被构造成能够随后操作马达以朝远侧推进击发杆9020并且使端部执行器9060的钳口9062朝钳口9064运动。在一些情况下，柄部9010可包括至少一个传感器，所述传感器能检测施加到击发触发器9014的力和/或击发触发器9014运动的角度。一个或多个传感器可与控制器进行信号通信，其中控制器可被构造成能够基于来自传感器的一个或多个输入信号来调节马达的速度。柄部9010可包括安全开关9015，所述安全开关9015可需要在控制器将响应于来自击发触发器9014的输入来操作马达之前被压下。在各种情况下，安全开关9015可与控制器进行信号通信，其中控制器可电子锁定马达的使用，直至安全开关9015被压下。柄部9010还可包括回缩致动器9074，所述回缩致动器9074在致动时可导致马达沿相反方向操作，以回缩击发连9020并且允许钳口9062远离钳口9064运动。在各种情况下，回缩致动器9074的致动可闭合与控制器进行信号通信的电路。在一些情况下，安全开关9015可需要在控制器将响应于来自回缩致动器9074的输入来沿其反相反方向操作马达之前被压下。
在外科器械9000的使用之前和/或期间，外科器械9000和/或外科器械9000的某些系统可失效、无效和/或有缺陷。在某些情况下，此类缺陷和/或解决其的方式可对于外科器械的使用者不是显而易见的，从而可导致使用者失败。此外，此类不确定性可增加解决缺陷或“错误”所需的时间。外科器械9000对上述情况加以改善。再次参见图94，外科器械9000的控制器可被构造成能够检测外科器械9000的错误并且经由一个或多个指示器将该错误传送给外科器械9000的使用者。外科器械9000可包括一个或多个指示器，所述一个或多个指示器在由控制器启动时可指示错误的性质并且或者说是使使用者注意在某些方面有缺陷的外科器械9000的系统。例如，外科器械9000可包括端部执行器指示器9086，所述端部执行器指示器9086被构造成能够例如指示端部执行器还未组装到外科器械9010的轴9040。在各种情况下，外科器械9000可包括传感器，所述传感器可被构造成能够检测端部执行器何时已组装到轴9040并且/或者对应地能够检测端部执行器何时还未组装到轴9040。传感器可与控制器进行信号通信，使得控制器可接收来自传感器的信号并且探知端部执行器是否已组装到轴9040。如果控制器探知端部执行器还未组装到轴9040，则控制器可致动端部执行器指示器9086。在各种情况下，端部执行器指示器9086可包括灯，例如红灯。在一些情况下，端部执行器指示器9086可包括发光二极管，例如红色发光二极管。除了或代替上文所述，外科器械9000可包括与控制器进行信号通信的传感器，所述控制器可被构造成能够检测附接到轴9040的端部执行器先前何时已被使用。例如，此类传感器可被构造成能够探知存储于端部执行器内的至少一些钉已被击发和/或可被构造成能够探知端部执行器内的钉击发构件先前已被推进。在这种情况下，控制器可致动端部执行器指示器9086。因此，端部执行器指示器9086的启动可向外科器械9000的使用者发信号通知存在与端部执行器相关的一些错误并且此类错误应该或必须在操作外科器械9000之前加以解决。读者从图94将会知道，端部执行器指示器9086与轴9040的远侧端部相邻，并且在各种情况下可被定位于轴9040的远侧连接部分9042之上或附近。在各种情况下，端部执行器指示器9086可被定位于端部执行器9060上。在任何情况下，当端部执行器指示器9086被点亮时，由于上文所述，外科器械9000的使用者可快速地探知存在错误并且错误在某些方面与端部执行器有关。端部执行器指示器9086的点亮可向使用者指示端部执行器可未完全组装到轴9040并且/或者端部执行器可需要进行替换。
除了或代替端部执行器指示器9086，外科器械可包括一个或多个指示器。例如，外科器械9000可包括击发触发器指示器9081。击发触发器指示器9081可与外科器械9000的控制器进行信号通信，使得当控制器检测到例如与外科器械9000的击发驱动装置相关的错误时，控制器可启动击发触发器指示器9081。如图94所示，击发触发器指示器9081可定位在击发触发器9014附近。在这种情况下，外科器械9000的使用者在观察到击发触发器指示器9081的致动时，可推断出已发生与击发驱动装置相关的错误并且可开始诊断错误源。在一些情况下，例如，当外科器械9000的电池在某些方面已有缺陷时，控制器可启动击发触发器指示器9081。例如，如果电池的电压低于所需水平，则例如电池可不能够以所需方式操作马达并且击发触发器指示器9081可指示需要替换电池。在各种情况下，当控制器点亮指示器(例如端部执行器指示器9086和/或击发触发器指示器9081)时，控制器可当前致使外科器械9000的一个或多个操作系统不能操作。例如，当端部执行器指示器9086和/或击发触发器指示器9081例如被点亮时，控制器可被构造成能够使击发触发器9014与马达可操作地脱离，使得击发触发器9014的致动并未操作马达。击发触发器9014与马达的此类操作性的脱离还可向外科器械9000的使用者指示外科器械可已经历错误并且使用者应查看外科器械9000的指示器以探知该错误的性质。
再次参见图94的示例性实施例，外科器械9000可包括定位在回缩致动器9074附近的回缩致动器指示器9085。类似于上文所述，回缩致动器指示器9085可与控制器进行信号通信，其中如果控制器检测到例如与回缩驱动装置相关的错误，则控制器可点亮回缩致动器指示器9085。在各种情况下，如果在致动回缩致动器9074之前未压下安全开关9015，则控制器可点亮回缩致动器指示器9085。在此类情况下，回缩致动器指示器9085可用作压下安全开关9015的提示器。在某些情况下，外科器械9000可包括定位在安全开关9015附近的安全开关指示器9082。在一些情况下，当使用者在致动安全开关9015之前致动回缩致动器9074时，外科器械9000的控制器可点亮安全开关指示器9082。安全开关指示器9082可与控制器进行信号通信，其中如果控制器检测到例如击发系统不能在击发模式和回缩模式之间切换，则控制器可点亮安全开关指示器9082。外科器械9000可包括定位在关节运动致动器9070附近的关节运动致动器指示器9084。类似于上文所述，关节运动致动器指示器9084可与控制器进行信号通信，其中如果控制器检测到例如与关节运动驱动装置相关的错误，则控制器可点亮关节运动致动器指示器9084。外科器械9000可包括定位在轴连接部附近的轴指示器9083，所述轴连接部被构造成能够将轴9040附接到柄部9010。类似于上文所述，轴指示器9083可与控制器进行信号通信，其中如果控制器检测到例如与轴9040相关的错误，则控制器可点亮轴指示器9083。
现在转向图95，外科器械9100可包括具有指示器9190阵列的柄部9110，所述指示器9190阵列被构造成能够并且可操作以向外科器械9100的使用者指示可存在与外科器械9100和/或与其附接的端部执行器相关的一个或多个错误。指示器9190阵列可以任何合适的方式进行布置。在各种情况下，指示器9190阵列可被布置成例如外科器械9100和/或与其附接的端部执行器的形状或近似形状。在至少一种情况下，柄部9110的外表面例如可包括外科器械9100和/或附接到外科器械的端部执行器的图示。指示器9190阵列可相对于外科器械和端部执行器的轮廓以如下方式进行布置，所述方式被构造成能够传达正经历错误、已经历错误、和/或可需要评估以解决错误的外科器械9100和/或端部执行器的一部分。例如，该轮廓可被划分以示出端部执行器9060、轴9040、柄部9010、击发触发器9014、安全开关9015、反向致动器9074、和/或关节运动致动器9070。在各种情况下，例如，端部执行器指示器9192可定位在端部执行器9060的图示附近，轴指示器9193可定位在轴9040的图示附近，击发触发器指示器9191可定位在击发触发器9014的图示附近，安全开关指示器9195可定位在安全开关9015的图示附近，反向致动器指示器9196可定位在反向致动器9074的图示附近，并且/或者关节运动致动器指示器9194可定位在关节运动致动器9070的图示附近。在各种情况下，指示器9191、9192、9193、9194、9195、和/或9196中的每个可包括发光二极管。在一些情况下，每个发光二极管可包括红色发光二极管，所述红色发光二极管可由控制器点亮以指示错误的存在。在各种情况下，控制器可被构造成能够脉动发光二极管的点亮，这可减缩短使用者意识到指示器已被点亮所需的时间。在某些情况下，每个指示器可包括可发出多于一种颜色的发光二极管。在一些情况下，每个此类发光二极管可被构造成能够例如选择性地发射红色和绿色。如果未检测到与外科器械9100和/或与其附接的端部执行器的相关部分相关的错误，则控制器可被构造成能够利用绿色点亮发光二极管，或者另选地，如果检测到与外科器械9100和/或与其附接的端部执行器的相关部分相关的错误，则控制器可被构造成能够利用红色点亮发光二极管。
在一些情况下，如下文进一步更详细所述，例如当控制器点亮与致动器相关的指示器时，外科器械9000的控制器可锁定外科器械的致动器中的一者或多者，例如击发触发器9014、回缩致动器9074、和/或关节运动致动器9070。例如，控制器可在点亮击发触发器指示器9081时锁定击发触发器9014，可在点亮回缩致动器指示器9085时锁定回缩致动器9074，并且/或者可在点亮关节运动致动器指示器9084时锁定关节运动致动器9070。外科器械9000的柄部9010例如可包括击发触发器锁，所述击发触发器锁可被构造成能够选择性地“锁定”击发触发器9014并且防止击发触发器9014被致动。击发触发器锁可防止击发触发器9014被充分地致动以操作外科器械的马达。在至少一种此类情况下，击发触发器9014可被防止闭合击发触发器开关。在某些情况下，外科器械9000的控制器除了致动击发触发器锁之外还可被构造成能够使其电子锁定击发触发器9014，即，防止将电池功率提供到马达。在此类情况下，电子锁定和机械锁定可为冗余的；然而，机械锁定可向外科器械9000的使用者提供击发驱动装置已被可操作地停用的反馈。如上所述，外科器械9000的控制器还可例如通过击发触发器指示器9081提供反馈。通过这种方式，可向外科器械9000的使用者提供已发生错误的触觉反馈和/或视觉反馈。在一些情况下，触觉反馈可提示外科器械9000的使用者以开始搜索视觉反馈。例如，使用者可尝试致动击发触发器9014，并且在不能致动击发触发器9014时，使用者可随后查看该器械的点亮的指示器。在任何情况下，一旦错误已被解决，控制器就可通过停用击发触发器锁来解锁击发触发器9014。
现在转到图100，外科器械9000可包括可被构造成能够锁定击发触发器9014的击发触发器锁9390。击发触发器锁9390能够在图100、101、和103所示的锁定状态与图102所示的解锁状态之间运动。当端部执行器未组装到外科器械9000的轴9040时，击发触发器锁9390可偏置成其锁定状态。在此锁定状态下，击发触发器锁9330可防止或至少基本上防止击发触发器9014的致动。更具体地，击发触发器锁9390可包括轴支架9391、小齿轮9392、和柄部支架9393、和偏置构件(例如弹簧)，所述偏置构件可被构造成能够将轴支架9391偏置到近侧位置并且将柄部支架9393偏置到向下位置。轴支架9391的近侧位置和柄部支架9393的向下位置示于图101中。主要参见图101，柄部支架9393可包括孔9396并且击发触发器9014可包括突出部9395，所述突出部9395在柄部支架处于其向下位置时，突出部9395不与孔9396对准。更具体地，击发触发器9014可包括具有支点9397的摇臂开关，其中当柄部支架9393处于其向下位置时，击发触发器9014的摇动将导致从击发触发器9014延伸的至少一个突出部9395邻接柄部支架9393并且防止击发触发器9014被完全致动。
当端部执行器附接到轴9040时，对上文进行进一步描述，击发触发器锁9390可在其锁定构型和其解锁构型之间运动。在击发触发器锁9390的解锁构型中，主要参见图102，柄部支架9393可处于其向上位置。在柄部支架9393的向上位置中，限定在柄部支架9393中的孔9396与从击发触发器9014延伸的突出部9395对准。在此类情况下，可摇动击发触发器9014以致动击发触发器9014。更具体地，突出部9395可穿过孔9396，以允许击发触发器9014围绕支点9397的摇动。因此，根据上文所述，柄部支架9393在其向下位置和向上位置之间的运动分别锁定和解锁击发触发器9014。可使用各种机构来使柄部支架9393在其向下位置和其向上位置之间运动。在至少一个此类实施例中，再次参见图100，轴9040可包括击发锁定致动器9399，所述击发锁定致动器9399可在端部执行器组装到轴9040时通过端部执行器朝近侧移位。轴支架9391可被安装并且/或者可从击发锁定致动器9399朝近侧延伸，并且可包括限定于其上的齿9391a。齿9391a可与限定于小齿轮9392上的齿9392a啮合接合，使得当击发锁定致动器9399和轴支架9391朝近侧移位时，小齿轮9392可围绕轴线旋转。对应地，柄部支架9393可包括限定于其上的支架齿9393a，所述支架齿9393a也与小齿轮齿9392a啮合接合，因此，当朝近侧驱动轴支架9391时，柄部支架9393可从其向下位置驱动到其向上位置，由此解锁击发触发器9014。为了使柄部支架9393返回到其向下位置，可朝远侧运动轴支架9391，使得小齿轮9392沿相反方向旋转。在各种情况下，轴支架9391可因端部执行器从轴9040拆卸而朝远侧运动。
现在转向图96-97，柄部9010例如可包括触发器锁9290。触发器锁9290可包括外壳9291、可部署锁定销9292、保持器9293、和偏置构件9294，所述偏置构件9294被构造成能够使锁定销9294在图96和图98所示的未部署位置与图97和图99所示的部署位置之间运动。在各种情况下，保持器9293可由受热影响的温度敏感材料构成。在至少一种此类情况下，温度敏感材料例如可被构造成能够在固体和流体(例如，液体、悬浮液、和/或气体)之间和/或例如在固体材料和半固体材料之间转变。当温度敏感材料在固体和液体之间转变或至少部分地转变时，保持器9293可释放锁定销9294，以锁定柄部9010的击发触发器和/或任何其他合适的触发器。在各种情况下，锁定销9294在被部署时可向后滑动和/或以其他方式接合击发触发器。柄部可例如包括任何合适数量的触发器锁9290等，以选择性地锁定任何合适数量的触发器和/或按钮。读者将会知道，触发器锁9290可为不可复位的。在此类情况下，致动的触发器锁9290可永久性地锁定例如柄部的击发触发器，以使得该器械可不再被使用。该器械的击发触发器和/或任何其他触发器的永久性锁定可意指该器械无论如何不能够再被使用，而在其他情况下，永久性锁定可为不易于复位的并且可需要该器械被发送到例如有资格的技术人员或机构，所述技术人员或机构可评价该器械是否应该进行检修和再使用或者该器械是否应该被丢弃。当保持器9293的热敏感材料已至少部分地转变成流体时，技术人员可假定该器械被暴露于超过热敏材料的转变温度的温度。在各种情况下，例如，热敏材料的转变温度可为固体材料例如溶化、蒸发、和/或升华的温度。在任何情况下，可选择保持器9293的热敏感材料以及转变温度，以使得锁定销9294的释放可指示外科器械已暴露于超过特定或阈值温度的温度。在各种情况下，如果外科器械暴露于过高的温度，则其可损坏。例如，外科器械包括例如固态电子器件，所述固体电子器件在暴露于此类过高温度时可损坏。在此类情况下，器械的阈值温度和保持器9293的转变温度可相等或至少基本上相等，其中因此可假定，当触发器锁9290还未致动时器械还未暴露于超过阈值温度的温度，并且对应地，当触发器锁9290已致动时器械已暴露于超过阈值温度的温度，并且由此外科器械可已损坏或者可至少需要对其是否已损坏进行评估。
对上文进行进一步描述，当对外科器械进行灭菌时，外科器械可暴露于超过阈值温度和/或转变温度的温度。许多灭菌过程是已知的，其中若干灭菌过程包括将外科器械暴露于热的步骤。除了或代替触发器锁3290，外科器械可包括至少一个温度传感器，所述至少一个温度传感器可评估外科器械所经受的温度。在各种情况下，温度传感器可与外科器械的控制器进行信号通信，从而可被构造成能够评价外科器械是否已暴露于超过阈值温度的温度。在至少一种此类情况下，控制器可包括能够评估从温度传感器接收的信号的微处理器和算法。如果控制器确定已达到和/或已超过阈值温度，则控制器可永久性地防止该器械被操作。换句话讲，控制器可对外科器械施加电子锁定。类似于上文所述，器械的永久性锁定可意指可意指该器械无论如何不能够再被使用，而在其他情况下，永久性锁定可为不易于复位的并且可需要该器械被发送到例如有资格的技术人员或机构，所述技术人员或机构可评价该器械是否应该进行检修和再使用或者该器械是否应该被丢弃。读者将会知道，当外科器械进行灭菌时，可需要功率源来操作外科器械的控制器和/或传感器。外科器械的若干实施例包括在对外科器械灭菌之前移除的可移除电池或功率源，其中在此类情况下，可单独地对可移除电池进行灭菌和/或再处理。读者将会知道，一旦可移除功率源已从这些先前器械移除，控制器和/或传感器就可不具有足够的功率来监测外科器械的温度。本文所公开的外科器械的实施例可包括电池或功率源，所述电池或功率源在进行再处理时不从外科器械移除。此类电池可称为永久性电池，因为其在器械进行灭菌时可为控制器和/或温度传感器提供功率。在各种情况下，包括永久性电池的器械还可包括可移除的和/或可再充电的电池。在任何情况下，器械可具有足够的功率以检测和记录该器械所经受的温度。在至少一种情况下，器械的控制器可包括存储器芯片，所述存储器芯片被构造成能够将温度读数存储在例如温度寄存器中。在各种情况下，控制器可间歇地(即，以适当的采样速率)记录来自传感器的读数。在一些情况下，控制器可被构造成能够使得当其记录到高于特定温度的温度读数(即使低于阈值温度)时，控制器可增加采样速率。对应地，控制器可被构造成能够使得当其随后记录到低于特定温度的温度读数时，控制器可降低采样速率，例如返回到其初始采样速率。
现在转向图99A，示出了用于控制器的算法。在某些情况下，此算法可包括例如在外科器械已经受灭菌处理之后首次使用时用于外科器械的启动程序。启动程序可在器械已开启之后开始。当端部执行器组装到器械时，器械可自动地开启。在至少一种此类情况下，端部执行器与外科器械的组装可闭合与控制器进行信号通信的开关。除了或代替上文所述，器械可在例如柄部上的按钮和/或开关被压下时开启。在任何情况下，控制器可随后评估存储于存储器芯片中的温度读数，如上所述。例如，控制器可评估所存储的温度读数中的任一个是否等于或大于阈值温度。如果控制器确定全部存储的温度读数低于阈值温度，则控制器可继续其正常启动程序。如果控制器确定一个或多个存储的温度读数等于或超过阈值温度，则控制器可继续另选的程序。在至少一种情况下，控制器可例如通过实施电子锁定和/或机械锁定来永久性地禁用该器械，如本申请在别处所述。在某些其他情况下，控制器可允许器械被使用，即使控制器已确定一个或多个存储的温度读数等于或超过阈值温度。控制器可将该确定结果存储于其存储器中并且/或者通过显示器(例如发光二极管)向使用者指示先前已超过阈值温度并且随后继续其正常启动程序。在各种情况下，控制器可将阈值温度作为绝对最大值，即，等于或高于阈值温度的单个温度读数足以触发另选的启动程序或者永久性地锁定该器械。在其他情况下，例如，控制器可被构造成能够评估等于或高于阈值温度的温度读数模式是否足以触发另选的启动程序或永久性地锁定该器械，因为时间和温度均可为器械是否已受累于灭菌过程的考虑因素。
现在转向104-109，外科器械(例如外科器械9000)可包括柄部9410，所述柄部9410包括击发触发器锁定系统9490。柄部9410在许多方面类似于柄部9110，并且这些方面在本文中为简明起见不再赘述。类似于上文所述，击发触发器锁定系统9490可被构造成能够锁定和解锁击发触发器9414。另外类似于上文所述，击发触发器锁定系统9490可在端部执行器未组装到外科器械的轴9040时偏置到锁定状态(如图104-107所示)，并且在端部执行器完全组装到轴9040时运动到解锁状态(如图108和109所示)。对上文进行进一步描述，主要参见图108和图109，当端部执行器组装到轴9040时，端部执行器可朝近侧推压感测构件9499。感测构件9499可穿过轴9040从轴9040的远侧端部延伸到其近侧端部。在使用中，当端部执行器组装到轴9040时，端部执行器可邻接感测构件9499的远侧端部并且朝近侧推压感测构件9499，如上文所述。如图108和图109所示，当朝近侧推压感测构件9499时，感测构件9499可接触击发触发器锁定系统9490的摆动臂9486并且使摆动臂9486向上旋转。摆动臂9486可包括经由销9487可枢转地安装到柄部外壳的端部，所述销9487被构造成能够允许摆动臂9486围绕轴线旋转。摆动臂9486还可包括可被感测构件9499接触的凸轮从动件部分9488。在使用中，感测构件9499可使摆动臂9486在向下位置和向上位置之间运动，以便使击发触发器锁定系统9490分别在锁定位置和解锁位置之间运动。击发触发器锁定系统9490还可包括安装到摆动臂9486的锁定销9485，所述锁定销9485在摆动臂9486向上旋转时可被向上牵拉，并且相应地在摆动臂9486向下旋转时可被向下推压。锁定销9485可包括枢转地安装到摆动臂9486的上端和当锁定销9485处于其向下位置时延伸穿过限定在击发触发器9481中的孔9483的下端。在各种情况下，孔9483可限定在从击发触发器9414延伸的臂9482中。当锁定销9485定位在孔9483内时，击发触发器9414不可围绕其支点9484枢转，并且因此击发触发器9414不可被使用者致动。当锁定销9485处于其向上位置时，锁定销9485不可定位在孔9483内，并且因此击发触发器9414可被使用者致动。当端部执行器从轴9040拆卸时，感测构件9499可从其近侧位置运动到其远侧位置。换句话讲，如果不存在附接到轴9040的端部执行器，则偏置构件(例如弹簧9489)可将摆动臂9486向下偏置，并且因此将击发触发器锁定系统9490偏置到其锁定状态。此外，当端部执行器未组装到轴9040时，弹簧9489可通过臂9482将偏置力施加到感测构件9499并且朝远侧推压感测构件9499。
对上文进行进一步描述，感测构件9499和击发触发器锁定系统9490的操作可用于与外科器械的使用者通信。例如，当端部执行器未组装到轴9040时，感测构件9499被朝远侧偏置并且击发触发器9414将被锁定，其中如果使用者尝试致动击发触发器9414，使用者将快速地意识到外科器械的击发系统可存在错误。在该示例中，使用者将快速地意识到端部执行器需要被组装到轴9040以便使用外科器械。在各种情况下，如果端部执行器(尽管附接到轴9040)已被使用，则击发触发器可被锁定。在至少一种此类情况下，端部执行器可包括击发构件，所述击发构件在端部执行器组装到轴9040时如果定位在其最近侧位置则可朝近侧推压感测构件；然而，如果此击发构件在端部执行器组装到轴9040时已至少部分地推进，则感测构件不可被朝近侧推压并且因此击发触发器可保持锁定。同样，此类击发触发器锁定可向使用者传达击发驱动装置存在问题；即，在这种情况下，端部执行器已被使用。如果不存在此类触觉锁定，则使用者将经历以下情况，其中他们能够按下致动器但外科器械不响应按下的致动器，从而可能导致使用者的混淆。
如上所述，将先前未击发的端部执行器组装到轴9040可朝近侧推压感测构件，以解锁击发触发器。在各种情况下，感测构件和击发触发器锁定系统可被构造成能够使得击发触发器不被解锁，直至端部执行器完全组装到轴9040。如果端部执行器仅部分地组装到9040，则感测构件可未被足够地移位以解锁击发触发器。同样，此类击发触发器锁定可向使用者传达击发驱动装置存在问题；即，在这种情况下，端部执行器还未完全组装到轴9040。
如本文所述，端部执行器可组装到外科器械，所述外科器械可包括被构造成能够识别端部执行器的控制器。在一些情况下，当控制器被启动时，控制器可被构造成能够评价端部执行器的标识。在某些情况下，现在转到图176，当电池插入柄部内时，控制器可被启动。除了或代替上文所述，当控制器被启动时，控制器可被构造成能够评价外科器械的状态。例如，控制器可被构造成能够评价闭合系统的闭合构件的位置、击发系统的击发构件的位置、和/或关节运动系统的关节运动构件的位置。在某些情况下，外科器械可包括绝对定位传感器以检测击发构件的位置。此类传感器公开于2013年3月14日提交的名称为ARTICULATABLESURGICALINSTRUMENTCOMPRISINGAFIRINGDRIVE的美国专利申请序列13/803,097中，该专利申请的全部公开内容以引用方式并入本文。在一些情况下，外科器械可包括行程末端寄存器。此类行程末端寄存器可包括机械开关、计数器和/或触发器；和/或电子开关、计数器和/或包括存储于非易失性存储器中的数据的触发器。在此类实施例中，控制器可估计先前击发行程是否已完成。此类实施例在多种情况下可为有益的。例如，控制器可在外科手术过程中意外地断开或者说是失去功率，并且当控制器再启动时，控制器不能估计该器械是否为首次初始化或者该器械是否处于先前击发行程的中部。行程末端寄存器可有助于控制器辨别这两种情况。此外，未被器械的功率丢失或中断导致丢失或复位的行程末端寄存器可允许控制器估计外科器械是否在击发行程期间已丢失功率。如果控制器确定先前击发行程还未完成，则控制器可被构造成能够：一、允许将功率提供到马达以完成击发行程，以及/或者，二、允许将功率提供到马达以使击发构件、闭合构件和/或关节运动构件回缩到其起始或未致动位置。在各种情况下，控制器可向外科器械的使用者提供继续击发行程或使器械的机械系统和/或电子系统返回到其初始或未致动位置的选项。在此类实施例中，外科器械不可使这些系统自动地返回到其初始或未致动位置。在任何情况下，一旦外科器械处于其起始或未致动状态，先前击发的端部执行器就可从外科器械拆卸并且/或者未击发的端部执行器就可组装到外科器械。在各种情况下，如本文所述，外科器械可随后识别、或者至少尝试识别未击发的端部执行器。
现在转到图177，外科器械的控制器可执行器械和/或电池的诊断检查。例如，在控制器启动时，外科器械可评估外科器械是否已暴露于超过外科器械的阈值温度的温度，如本文所述。另外，例如，外科器械可评估电池的可用功率、电压、和/或电流，同样如本文所述。如果器械不能通过这些诊断测试中的一个或多个，则控制器可不将功率提供到马达、物理地锁定器械、并且/或者向外科器械的使用者指示此类失败。在此类情况下，器械可将此类失败记录在其存储器中，使得测试数据可有助于技术人员稍后评估器械。假设器械通过这些诊断测试，则类似于上文所述，器械也可记录与通过诊断测试相关的测试数据。在任何情况下，器械可随后继续评估器械是否处于起始或未致动状态并且评价端部执行器的标识。如本文所述，公开了用于识别端部执行器的程序。本文还公开了用于评价“智能”端部执行器或“愚笨”端部执行器是否附接到外科器械的程序。在各种情况下，“智能”端部执行器可为以下端部执行器，所述端部执行器可将参数和/或操作程序的至少一部分提供给外科器械以作为识别过程的一部分。“智能”端部执行器可为设法识别外科器械使用端部执行器的方式的端部执行器。在某些情况下，“愚笨”端部执行器为不以任何方式识别其将与外科器械一起使用的方式。根据上文的示例性操作程序概述于图178中。
如本文所述，电池可用于对外科器械提供功率。在各种情况下，外科器械和/或电池可被构造成能够评价电池是否可将足够的功率提供给外科器械以执行一种或多种功能。在某些情况下，外科器械和/或电池可被构造成能够向外科器械的使用者指示电池具有足够的功率以执行一种或多种功能。图179示出了被构造成能够指示电池的电压的电路。此类电路可存在于外科器械和/或电池中。在两种情况中的任一情况下，电路可包括可指示可由电池提供的电量、电压、和/或功率的多个指示器。例如，电路可包括三个指示器，所述三个指示器包括：被构造成能够指示电池包括至少第一电压的第一指示器、被构造成能够指示电池包括至少第二电压的第二指示器、和被构造成能够指示电池包括至少第三电压的第三指示器。如图179所示，电路12100可包括被布置成彼此并联的第一指示器电路12110、第二指示器电路12120、和第三指示器电路12130。当开关12101闭合时，来自电池的电势可施加在指示器电路12110、12120、和12130两端。第一指示器电路12110可包括齐纳二极管12111、发光二极管12112、和电阻器R112113。类似地，第二指示器电路12120可包括齐纳二极管12121、发光二极管12122、和电阻器R212123，并且第三指示器电路12130可包括齐纳二极管12131、发光二极管12132、和电阻器R312133。齐纳二极管12111、12121、和12131可各自具有不同的击穿电压。例如，第一齐纳二极管12111可具有例如11.5V的击穿电压，第二齐纳二极管12121可具有例如10V的击穿电压，并且第三齐纳二极管12131可具有例如8V的击穿电压。在此类实施例中，如果电池的电压大于或等于11.5V，则LED12112、12122、和12132将被点亮。全部LED的点亮可向外科器械的使用者指示电池具有满电量和/或具有至少足够的电量以执行外科器械所需的任何功能。如果电池的电压大于或等于10V，但小于11.5V，则LED12112和12122将被点亮；然而，LED12132将不被点亮。LED12112和12122的点亮而LED12132的不点亮可向外科器械的使用者指示电池具有小于满电量但至少足够的电量以执行外科器械所需的任何功能。如果电池的电压大于或等于8V，但小于10V，则LED12112将被点亮；然而，LED12122和12132将不被点亮。LED12112的点亮而LED12122和12132的不点亮可向外科器械的使用者指示电池正接近其电量的终点并且可具有或可不具有足够的电量以执行外科器械所需的某些功能。LED的这种显示可指示电池可需要进行替换。如果电池的电压小于8V，LED12112、12122、和12132中的任何一者将不被点亮。LED的这种显示可指示电池不能用于牢靠地执行外科器械的任何功能。尽管电路12100使用三个指示器电路12110、12120、和12130，但电路可包括多于三个指示器电路，所述多于三个指示器电路包括具有不同击穿电压的齐纳二极管。此类实施例可例如提供电池的电压的较精细等级指示。可设想到使用仅两个指示器电路的其他实施例。
在各种情况下，电池可包括电路，所述电路被构造成能够指示电池被充电和/或具有足够的电量以使其可与外科器械一起使用。在某些情况下，外科器械可包括电路，所述电路被构造成能够指示附接到外科器械的电池被充电和/或具有足够的电量以使其可与外科器械一起使用。在两种情况中的任一情况下，现在转向图180，电路12200可包括微处理器12201，所述微处理器12201包括与电池连通的一个或多个门极，所述电池可为例如9V电池。电路12200还可包括电容器12202，例如10微法拉电容器，所述电容器12202可从包括二极管12203和电阻器12204的电路接收功率。电路12200还可包括位于电容器12202的放电路径中的LED12205和电阻器12206。此类电路可导致LED12205间歇式脉动，前提条件是电池可将足够的功率提供到电路12200。在此类情况下，使用者可识别脉动的LED12205并且将知道电池具有将与外科器械一起使用的至少一些功率(即使不具有足够的功率)。如果使用者未识别到LED12205为脉动的，则使用者可假设电池缺乏将被使用的足够功率。
在各种情况下，如本文所述并且参见图284，电池和/或被构造成能够与电池一起使用的外科器械可包括诊断电路，所述诊断电路被构造成能够评估电池可提供的功率、电压、和/或电流。现在转向图184，公开了电池诊断电路12300。此类电路可被构造成能够评估已与外科器械一起使用之前、正与外科器械一起使用期间、和/或已与外科器械一起使用之后的电池。在各种情况下，电池可使用多于一次，并且在各种情况下，电池可为可再充电的或不可再充电的。电池的使用以及在电池的诊断评估期间获得的信息可存储于电池和/或外科器械中的存储器芯片中。图183示出了信息表12400，所述信息表12400代表可记录在存储器芯片上的信息的类型。例如，可记录使用次数。对于每次使用，例如，可记录电池充电或再充电的最大电压和/或最大电流。对于每次使用，例如，可记录使用期间经受的电流容量、以mA使用的电流、以Ah使用的电流、和/或最小电压。对于每次使用，例如，可记录电池充电的时间、电池使用的时间、充电时的电池的温度、和/或使用时的电池的温度。这些仅为可存储的信息的一些示例。在各种情况下，外科器械和/或技术人员可使用此类信息来评估例如电池的先前性能和/或电池被进一步使用的适用性。
在各种情况下，现在转向图182，电池和与电池一起使用的外科器械可包括电路，所述电路用于在电池的电量一旦下降到低于最低电量水平就切断电池。在一些情况下，锂离子电池单元如果在最低电量水平之下使用则可具有热事故，并且防止电池在该最低电量水平之下使用的切断电路可阻止此类热事故发生。
在各种情况下，现在转向图181，外科器械可包括控制器，所述控制器被构造成能够执行器械和/或组装到其的电池的诊断检查。例如，控制器可包括时钟和存储器芯片，所述存储器芯片被构造成能够评估和记录器械和/或电池何时已被使用。在某些情况下，如果器械和/或电池距其上次使用时间已有太长时间，则控制器可被构造成能够禁用该器械和/或电池。在某些情况下，器械和/或电池可包括一个或多个传感器，所述一个或多个传感器传感器可被构造成能够评估器械和/或电池的各种状态，例如温度、湿度、和/或器械和/或电池暴露于该温度和/或湿度的时间。控制器可被构造成能够评估传感器是否正确地操作，并且如果不是，则控制器可禁用该器械和/或电池。控制器还可被构造成能够评估器械和/或电池已使用的次数，并且如果使用超过特定数量，则禁用该器械和/或电池。控制器还可被构造成能够评估电池可提供的功率，如本文所述，并且如果可用功率不足，则禁用该器械和/或电池。
如本文所述，外科器械可包括用于采集反馈和/或其他器械状态信息的各种传感器。此外，外科器械可包括用于将反馈和/或器械状态信息提供给使用者的感官指示器。在某些情况下，内窥镜可与外科器械结合使用，以将附加的反馈和/或器械状态信息提供给使用者。如本文所述，例如，内窥镜和外科器械可与显示器进行信号通信，所述显示器可显示来自内窥镜和/或来自外科器械的传感器的反馈。现在参见图75-93，内窥镜5018(图93)可与显示器5002(图75)进行信号通信。在某些实施例中，显示器5002可包括例如平视显示器(HUD)和/或视频监视器。此外，显示器5002可为例如等离子屏幕、LCD屏幕、或电致发光屏幕。在各种实施例中，显示器5002可播放可包括例如视频反馈的第一信息层5010。视频反馈可为例如由内窥镜5018(图93)在手术部位观察的图像反馈，并且可示出例如由内窥镜5018观察的外科器械5020的至少一部分。
在各种实施例中，显示器5002可包括触摸屏5004。主要参见图75，使用者可与触摸屏5004进行交互以与显示器5002和外科器械5020相互作用。例如，触摸屏5004可与显示器5002通信，并且触摸屏5004的输入可调整和/或修改示于显示器5002上的信息。在此类实施例中，使用者可与显示器5002通信，而不使用显示器的附加输入，例如键盘和/或计算机鼠标。换句话讲，可不需要附加的输入工具和/或部件来调整和/或修改示于显示器5002上的信息。此外，在各种实施例中，触摸屏5004可易于进行清洁和/或灭菌。例如，触摸屏5004可包括平坦表面，所述平坦表面可易于在外科套件和/或手术室内擦拭清洁。除此之外或另选地，触摸屏5004可与外科器械5020直接地和/或间接地通信，使得触摸屏5004的输入对外科器械5020提供输入。使用者可为例如外科医生、操作者、和/或助手。
在各种实施例中，触摸屏5004可例如定位在显示器5002的至少一部分上，并且可移除地固定到显示器5002。例如，触摸屏5004可与多个显示器兼容，并且能够可释放地附接和脱离至少一个显示器。此外，在某些实施例中，触摸屏5004可为独立显示器，其可独立于显示器5002来操作。例如，可拆卸的LCD屏幕可包括触摸屏5004，并且可拆卸的LCD屏幕可叠加在显示器5002的至少一部分上。在其他实施例中，触摸屏5004可集成到显示器5002内。触摸屏5004可使用例如电阻技术、电容技术、超声束技术、和/或近场成像技术。
主要参见图93，在各种实施例中，反馈控制器5016可与外科器械5020、内窥镜5018、和/或显示器5002进行信号通信。在某些实施例中，反馈控制器5016与内窥镜5018之间的有线和/或无线连接5017可将来自内窥镜5018的视频反馈提供到反馈控制器5016。此外，反馈控制器5016与外科器械5020和/或外科器械5020的微控制器之间的有线和/或无线连接5019可将由外科器械5020测量和/或检测的反馈数据提供到反馈控制器5016。例如，各种传感器描述于本文中以及全部公开内容全文以引用方式并入本文的Zemlock‘263和Zemlock‘344中，并且各种传感器可检测反馈和/或器械状态信息。另外，反馈控制器5016和显示器5002之间的有线和/或无线连接5015可将来自外科器械5020的反馈数据和/或来自内窥镜5018的视频反馈提供到显示器5002。在至少一个实施例中，视频反馈可示于显示器5002上的第一信息层5010中，并且反馈数据可示于显示器5004上的第二信息层5012中。在其中包括触摸屏5004的可拆卸的LCD显示器定位在显示器5002上的实施例中，反馈控制器5016与可拆卸的LCD显示器之间的有线和/或无线连接可例如将反馈数据提供到可拆卸的LCD显示器并且/或者可将反馈数据从LCD显示器提供到反馈控制器5010。
主要参见图76，显示器5002可播放第一信息层5010，所述第一信息层5010可包括例如来自内窥镜5018(图93)的视频反馈。在各种情况下，视频反馈5010可包括作用于组织T的外科器械5020的图示。在各种实施例中，外科器械5020可类似于例如外科器械10(图1)，并且联接到外科器械的一次性加载单元(DLU)和/或端部执行器5022可类似于例如加载单元20(图2)。外科器械5020的DLU5022可相对于组织T进行关节运动，将组织T抓握和/或夹持在一对钳口之间，缝合组织T，并且/或者利用切割元件切割组织T，如本文所述。此外，可定位在手术部位处和/或附近的内窥镜5018可观察DLU5022，并且可将视频反馈和/或记录传输到反馈控制器5016(图93)。在各种实施例中，显示器5002上的第一信息层5010中的视频反馈可为外科器械5020的操作者提供手术部位的现场视觉反馈。
主要参见图77，显示器5002可显示第二信息层5012。此外，使用者可选择、移动、在尺寸方面调整、最小化、扩展、修改、和/或以其他方式调控第二信息层5012。例如，使用者可通过与触摸屏5004进行交互来调控第二信息层5012。如本文所述，第二信息层5012可包括来自外科器械5020的反馈数据和/或用于控制外科器械5020的控件。在各种实施例中，第二信息层5012可包括控制面板5030，并且触摸屏5004可用于选择和/或使用控制面板5030的特征结构。控制面板5030可通过触摸屏5004来折叠、调整尺寸、移动、和/或以其他方式调控。例如，使用者可通过选择最小化/最大化图标5032来最小化或折叠控制面板5030，并且可通过再选择最小化/最大化图标5032来最大化或展开控制面板5030。此外，使用者可例如通过在整个显示器5002上“拖放”控制面板5030来在显示器5002上移动控制面板5030。另外，使用者可通过“放大”和/或“缩小”触摸屏5004上的多个接触点来调整控制面板5030相对于显示器5002的尺寸。本领域的普通技术人员将会知道，可使用例如触摸屏5004的各种常规的和/或直观接触来修改和/或调控其第二信息层5012和/或控制面板5030。
仍参见图77，控制面板5030可包括多个菜单、类目、和/或类别。例如，控制面板5030可包括器械反馈菜单5036、显示菜单5060、和/或器械控制器菜单5070。使用者可使用控制面板5030来选择菜单和/或切换触摸屏5004的操作状态。例如，当使用者选择控制面板5030的器械控制器菜单5070时，触摸屏5004可将指令和/或控制传送到器械控制器5016(图93)和/或微控制器。在此类实施例中，如本文所述，触摸屏5004可在器械控制状态下操作。此外，当从控制面板5030选择显示菜单5060时，使用者可修改与第二信息层5012和/或显示器5002相关的设置。在此类实施例中，触摸屏5004可在设置修改状态下工作。除此之外或另选地，当器械反馈菜单5036被选择时，使用者可修改包含在第二信息层5012中的反馈数据。在此类实施例中，触摸屏5004可在反馈调控状态下操作。在各种实施例中，控制面板5030可包括额外的和/或更少的菜单、类目、和/或类别。此外，例如可根据使用者的偏好来修改控制面板5030的各种菜单、类目、和/或类别。菜单、类目、和/或类别可通过文字和/或符号示于第二信息层5012中。在各种实施例中，每个菜单5036、5060、5070下的类目可选择性地示于第二信息层5012中。例如，每个菜单5036、5060、5070下的类目可仅在相应的上覆菜单5036、5060、5070被使用者选择时才选择性地示于第二信息层5012中。在其他实施例中，使用者可例如手动地最小化和/或最大化对应于每个菜单5036、5060、和/或5070的类目和/或子类目。
仍参见图77，器械反馈菜单5036可包括多个反馈类目，并且可涉及外科手术期间由外科器械5020(图93)在测量和/或检测的反馈数据。如本文所述，外科器械5020可检测和/或测量例如可运动钳口在打开取向和闭合取向之间的位置、所夹持组织的厚度、所夹持组织上的夹持力、DLU5022的关节运动、和/或击发元件的位置、速度、和/或力。此外，与外科器械5020进行信号通信的反馈控制器5016(图93)可将感测的反馈提供到显示器5002，所述显示器5002可将反馈提供在第二信息层5012中。如本文所述，例如可基于使用者对触摸屏5004的输入来修改显示于第二信息层5012中的反馈数据的选择、设置、和/或形式。
在各种实施例中，控制面板5030的显示菜单5060可涉及多个类目，例如，单位体系5062和/或数据模式5064。在某些实施例中，使用者可选择单位体系类目5062以在单位体系之间(例如，在公制单位和美国惯用单位之间)切换。另外，使用者可选择例如数据模式类目5064，以在反馈数据的数字表示类型(图79-81)和/或反馈数据的图形表示类型(图82-83)之间切换。反馈数据的数字表示可显示为例如数值和/或百分比。此外，反馈数据的图形表示可显示为例如时间函数(图82)和/或距离函数(图83)。如本文所述，使用者可从控制面板5030选择器械控制器菜单5070，以输入用于外科器械5020(图93)的指令，所述指令可经由例如器械控制器5016(图93)和/或微控制器来执行。
现在参见图78，第二信息层5012可覆盖显示器5002上的第一信息层5010的至少一部分。此外，触摸屏5004可允许使用者相对于显示器5002上的下面第一信息层5010中的视频反馈来调控第二信息层5012。例如，使用者可操作触摸屏5004，以选择、调控、重新格式化、在尺寸方面调整、和/或以其他方式修改显示在第二信息层5012中的信息。在某些实施例中，使用者可使用触摸屏5004，以相对于示于显示器5002上的第一信息层5010中的外科器械5020来调控第二信息层5012。使用者可选择例如其控制面板5030的菜单、类目和/或类别，并且第二信息层5012和/或控制面板5030可被调整以反映使用者的选择。在各种实施例中，使用者可从对应于具体特征结构或示于第一信息层5010中的外科器械5020的特征结构的器械反馈类别5036选择类别。对应于使用者所选类目的反馈可相对于外科器械5020的特定特征结构移动、自身定位、和/或“卡扣”到显示器5002上的某一位置。例如，所选的反馈可移动到靠近和/或覆盖示于第一信息层5010中的外科器械5020的特定特征结构的位置。
参见图79和图80，如果使用者例如从器械反馈菜单5036选择刀进度类目5040，则与刀进度相关的感测数据和/或信息可例如相对于示于第一信息层5010中的DLU5022的刀来移动和/或“卡扣”到第二信息层5012中的某一位置。此外，在使用者从器械反馈菜单5036选择期望的类目之后，控制面板5030可折叠和/或最小化。与刀进度相关的反馈数据5052可示于显示器5002上第一信息层5010所示的DLU5022的检测刀附近，并且例如当刀平移和/或运动穿过DLU5022时，可在刀靠近击发行程的起始处的第一位置(图79)和刀靠近击发行程的远侧端部的第二位置(图80)之间运动。例如，当刀已平移距离Xmm时，与刀进度相关的数据5052可定位在第一位置(图79)中，并且当刀已平移距离Ymm时，与刀进度相关的数据5052可定位在第二位置(图80)中。在此类实施例中，操作者可通过观察屏幕5002上的反馈数据5052来跟踪击发行程期间的刀进度。例如，当DLU5022的刀例如被端部执行器钳口5024和/或组织T阻挡而不能观察时，操作者可基于反馈数据5052的变化值和/或反馈数据5052相对于下面第一信息层5010所示的DLU5022的移动位置来跟踪和/或近似DLU5020中的刀的位置。此外，显示器5002可结合刀进度的数字表示以及刀进度的图示表示和/或符号表示。例如，符号5054(例如箭头)例如可相对于下面第一信息层5010所示的DLU5022移动和/或延伸，以示出穿过DLU5022的刀进度。仍然参见附图79和图80，当刀例如从靠近击发行程(图79)的起始处的位置朝远侧向靠近击发行程(图80)的远侧端部的位置推进时，符号5054可例如朝远侧延伸。
在各种实施例中，使用者可从器械反馈菜单5036选择反馈数据的一个或多个不同类目，并且反馈数据的不同类目可显示在显示器5002上的第二信息层5012中。在此类实施例中，当使用者从器械反馈菜单5036选择反馈数据的不同类目时，反馈数据的数字表示和/或符号表示可相对于下面第一信息层5010所示的DLU5022移动到显示器5002上的适当位置。例如，如果使用者从器械反馈菜单5036选择钳口位置类目5038，则与可运动钳口在打开位置和夹持位置之间的位置相关的反馈数据例如可显示在第二信息层5012中，并且可移动到显示器5002上的外科器械5020的可运动钳口5024附近的位置。此外，如果选择刀速度类目5042，则与刀速度相关的反馈数据5058(图82)可显示在第二信息层5012中，并且可移动到显示器5002上的DLU5022中的刀附近的位置，这类似于上文所述的数字数据5052和/或符号5054。例如，如果使用者选择组织厚度类目5044，则与所检测的组织厚度相关的反馈数据可显示在第二信息层5012中，并且可移动到显示器5002上的测量组织T附近的位置。此外，在至少一个实施例中，第二信息层5012可包括可显示所检测的组织厚度的标度和/或标尺。使用者可例如相对于第一信息层5010所示的下面组织T经由触摸屏5004来移动标尺，这可有利于使用者理解组织厚度变化。例如，如果使用者选择端部执行器关节运动类目5046，则与DLU5022的关节运动相关的反馈数据5252(图84-88)可显示在第二信息层5012中，并且可移动到显示器5002上的DLU5022的关节运动接头5026(图84和图85)附近的位置。例如，如果使用者选择击发力类目5048，则与由刀施加到组织上的击发力相关的反馈数据可显示在第二信息层5012中，并且可定位在显示器5002上的DLU5022的刀附近。另外，例如，在击发行程期间，与由刀施加的击发力相关的反馈数据可随着刀相对于DLU5022移动而在第二信息层5012中移动。此外，如果选择夹持力类目5050，则与组织T上的夹持力相关的反馈数据5158(图83)可示于第二信息层5012中，并且可在下面第一信息层5010所示的DLU5022附近移动。在此类实施例中，例如，与夹持力相关的反馈数据5158可示出夹持期间和/或整个击发行程中沿DLU5022的长度和/或宽度的夹持压力变化。
在各种实施例中，第二信息层5012所示的反馈可随着第一信息层5010中的外科器械5020的对应特征结构而移动。例如，当DLU5022围绕手术部位进行操纵时，DLU5022可围绕显示器5002移动。在此类实施例中，与DLU5022相关的反馈(例如钳口位置数据和/或关节运动数据)例如可与DLU5022一起移动。相关反馈的移动可确保反馈保持在操作者的视野中，而无需操作者从显示器5002上的第一信息层5010所示的外科器械5020的对应特征结构转移目光。此外，相关反馈的移动可确保该反馈不阻挡操作者希望在显示器5002上观察的第一信息层5010所示的外科器械5020的特征结构。
在某些实施例中，使用者可选择多个反馈类目以同时在显示器5002上观察。此外，所选择的反馈可自动地布置在显示器5002上，以将相关数据按照不重叠的布置方式显示在第二信息层5012中。换句话讲，例如，显示在第二信息层5012中的反馈可不与显示在第二信息层5012中的其他反馈重叠；然而，此类反馈可与显示在显示器5002上的第一信息层5010的视频反馈重叠。在各种实施例中，当反馈数据相对于下面的第一信息层5010所示的外科器械5020移动和/或“卡扣”到屏幕上的某一位置时，使用者可通过将反馈数据“拖放”到第二信息层5012中的其他位置来替换默认位置。
现在参见图81，刀进度的符号表示5056(例如，刀和/或刀边缘的十字、靶心、和/或图形表示)可移动到与第一信息层5010所示的刀位置重叠的第二信息层5012中的位置。在某些实施例中，甚至当刀在显示器5002上不可见时(例如，如果刀的事先被阻挡)，刀的符号表示5056可移动并且/或者跟随屏幕5002上的DLU5022中的刀的检测位置。例如，在击发行程的起始处附近，符号表示5056可相对于的DLU5022处于第一位置，并且在击发行程末端附近，符号表示5056相对于DLU5022移动到第二位置。
在各种实施例中，使用者经由触摸屏5004选择的反馈可“卡扣”到显示器5002上的拐角、边缘、和/或其他预定位置。例如，仍参见图81，与刀进度相关的数字数据5052可移动到显示器5002的拐角。除此之外或另选地，使用者可与触摸屏5004进行交互，以将数字数据5052移动到触摸屏5004上的不同位置。基于第一信息层5010中的下面外科器械5020的位置，使用者可将数字数据5052移动到第二信息层5012中的某一位置，使得DLU5022的对应和/或特定特征结构不被数字数据5052阻挡和/或阻碍。除此之外或另选地，使用者可将数字数据5052移动到DLU5022的对应特征结构附近的位置，使得使用者可易于同时观察对应的DLU5022特征结构和数字数据5052。
参见图84和图85，来自反馈控制器5016(图93)的反馈数据的符号表示5254(图85)可包含在第二信息层5012中。例如，DLU5022的关节运动的符号表示5254(例如，张角和/或对弧)可示于第二信息层5012中，并且可移动到显示器5002上与第一信息层5010所示的外科器械5020的关节运动接头5026靠近和/或重叠的位置。例如，对弧可在由非关节运动的DLU5022(图84)限定的轴线A和由关节运动的DLU5022(图85)限定的轴线A’之间延伸。在某些实施例中，甚至当关节运动接头5026在屏幕上不可见时，关节运动角度的符号表示5254可见于第二信息层5012中。例如，如果关节运动接头5026未定位在内窥镜的视野内和/或被阻碍或阻挡，则关节运动角度的符号表示5254可向使用者提供关节运动的可见指示。在各种实施例中，符号表示5252可随着DLU5022的运动和/或关节运动而调整和/或变化。例如，符号表示5254可为箭头弧或线，所述箭头弧或线可从DLU5022的初始位置和/或非关节运动位置(图84)朝DLU5022的关节运动位置(图85)(如通过器械5020所检测)延伸。此外，在各种实施例中，符号表示5254可相对于第一信息层所示的DLU5022“卡扣”到某一位置，使得符号表示5254与DLU5022重叠和/或对准。例如，主要参见图85，关节运动角度的符号表示5254可移动到显示器5002上的第一信息层5010所示的关节运动接头5026处和/或附近，并且可在由处于初始和/或非关节运动位置的DLU5022限定的轴线A与当DLU5022进行关节运动时由DLU5022限定的轴线A’之间延长。
此外，在各种实施例中，与DLU5022的关节运动相关的数字数据5252可显示在显示器5002上的第二信息层5012中。此外，数据5252可随着DLU5022的关节运动而变化。例如，第二信息层5012可在DLU5022进行关节运动之前(图84)示出X°的关节运动，并且可在DLU5022进行关节运动之后(图85)示出Y°的关节运动。在各种实施例中，与DLU5022的关节运动相关的反馈数据5252可例如在第一信息层5010所示的外科器械5020的关节运动接头5026处和/或附近显示在第二信息层5012中。使用者可例如相对于显示在第一信息层5010中的视频反馈利用触摸屏5004来移动、在尺寸方面调整、最小化、和/或以其他方式调控显示在第二信息层5012中的关节运动数据5252。除此之外或另选地，使用者可与触摸屏5004进行交互，以将符号表示5254和/或数字数据5252移动到触摸屏5004上的不同位置。基于第一信息层5010中的下面外科器械5020的位置，使用者可将数字数据5252移动到第二信息层5012中的某一位置，使得DLU5022的特定特征结构不被数字数据5252阻挡和/或阻碍。除此之外或另选地，使用者可将数字数据5252移动到DLU5022的对应特征结构附近的位置，使得使用者可易于同时观察对应的DLU5022特征结构和数字数据5252。
现在参见图82，可例如通过触摸屏5004从控制面板5030的显示菜单5060选择图形表示。在此类实施例中，反馈5058的图形表示可显示在显示器5002上的第二信息层5012中。使用者可选择图形表示来观察来自外科器械5020和/或其控制器的相对于时间和/或空间的测量数据和/或感测数据。例如，使用者可期望观察整个击发行程中的击发元件的速度，并且因此可从器械反馈菜单5036(图78)选择刀速度类目5042(图78)。在此类实施例中，刀速度的图形表示5058可例如在击发行程期间持续获得数据点并且生长。在各种实施例中，在击发行程完成时，图形表示5058可示出刀的“软”启动周期5057和/或“软”止动周期5059。此外，图形表示5058可定位在显示器5002上，使得沿端部执行器钳口5024的长度的特定位置处的刀的速度对应于沿第一信息层5010所示的端部执行器钳口5022的长度的特定位置。例如，图形表示5058可开始于第一信息层5010所示的穿过DLU5022的刀路径的起始处和/或附近，并且可终止于例如第一信息层5010所示的穿过DLU5022的刀路径的末端处和/或附近。此外，如本文所述，图形表示5058可“卡扣”到屏幕上的适当位置，并且使用者可根据需要利用触摸屏5004来移动和/或在尺寸方面调整图形表示5058。在某些实施例中，击发速度的数字表示可与图形表示5058一起示于第二信息层5012中。
现在参见图83，在各种实施例中，使用者可期望观察沿端部执行器钳口5024的长度和/宽度的施加到组织T上的夹持力，并且因此，可从器械反馈菜单5036(图78)选择夹持力类目5050(图78)。在此类实施例中，夹持力的图形表示5158可示于第二信息层5012中。在一些实施例中，图形表示5158可相对于第一信息层5010所示的夹持组织布置在第二信息层5012中。例如，图形表示5158可开始于第一信息层5010所示的钳口5024的近侧端部处和/或附近，并且可例如终止于第一信息层5010所示的钳口5024的远侧端部处和/或附近。此外，如本文所述，图形表示5158可“卡扣”到屏幕上的适当位置，并且使用者可例如利用触摸屏5004来移动和/或在尺寸方面调整图形表示5158。在某些实施例中，图形表示可在使用期间有所变化以反应例如击发行程期间的夹持压力变化。
参见图86-88，在各种实施例中，使用者可与触摸屏5004进行交互，以经由器械控制器5016和/或微控制器来将控制和/或指令输入到外科器械5020。例如，使用者可输入以下控制，所述控制涉及使DLU5022进行关节运动、使端部执行器钳口5024夹持、推进和/或回缩切割元件、和/或从DLU5022射出钉。在各种实施例中，使用者可经由触摸屏5004从控制面板5030选择器械控制器类目5070以启动器械控制状态，使得使用者可经由触摸屏5004控制外科器械5020。当触摸屏5004被启动以用于器械控制时，使用者可与触摸屏5004进行交互以控制外科器械5020。例如，使用者可与第二信息层5012中的控制按钮和/或图标进行交互并且/或者可与触摸屏5004上对应于下面外科器械5020的位置进行交互，以例如将指令输入到外科器械5020。
例如，参见图86，使用者可与触摸屏5004进行交互，以指示例如DLU5022的期望的关节运动方向和程度。在某些实施例中，使用者可在触摸屏5004上从DLU5022处和/附近朝端部执行器5002的期望关节运动位置拖动接触点。参见图86，使用者可描记从第一信息层5010所示的DLU5022处和/或附近到DLU5022的期望关节运动位置的线或弧5352。例如，弧5352可从和/或近似从由DLU5022限定的轴线A延伸，并且弧5352可延伸到由DLU5022的期望关节运动位置限定的轴线A’。此外，弧5352可例如沿由箭头5354指示的方向延伸。在某些实施例中，当使用者经由触摸屏5004输入期望的关节运动时，弧5352可不出现在第二信息层5010中。在各种实施例中，触摸屏5004可将期望的关节运动角度传送到器械控制器5016(图93)和/或微控制器，这可实现DLU5022到期望关节运动角度的关节运动。现在参见图88，器械控制器5016(图93)和/或微控制器可例如基于使用者经由触摸屏5004的输入来实现DLU5022到轴线A’的关节运动。
主要参见图87，在各种实施例中，使用者可与第一信息层5012中的控制按钮、示意图、和/或图标进行交互，以将指令输入到外科器械5020。例如，第一信息层5012可包括符号或图标5356，并且使用者可移动和/或调控图标5356，以实现DLU5022的关节运动。在各种实施例中，图标5356可包括例如DLU5022的示意图。此外，使用者可将图标5356拖动到关节运动取向和/或旋转取向，以实现DLU5022的关节运动。在各种实施例中，线和/或弧5358可指示使用者期望的关节运动的方向和/或程度。例如，弧5358可从图标5356的非关节运动取向延伸到图标5356’的关节运动取向。关节运动的图标5356’可对应于例如DLU5022的期望关节运动。现在参见图88，器械控制器5016和/或微控制器可例如基于使用者经由触摸屏5004的输入来实现DLU5022到轴线A’的关节运动。例如，DLU5022可关节运动到由弧5358限定的张角，所述弧5358介于图87所示的非关节运动图标5356和关节运动图标5356’之间。
主要参见图89和图90，在各种实施例中，使用者可与触摸屏5004进行交互，以将与钳口5024闭合相关的指令输入到外科器械5020。在某些实施例中，使用者可在触摸屏5004上从可运动钳口5024处和/或附近朝可运动钳口5024的闭合取向拖动接触点，以启动钳口5024的闭合。例如，使用者可描记从第一信息层5010所示的可运动钳口5024处和/或附近到可运动钳口5024的期望闭合取向的线或弧5362(图89)。在各种实施例中，触摸屏5004可将闭合动作传送到器械控制器5016和/或微控制器，这可实现可运动钳口5024的闭合。在某些实施例中，由使用者描记在触摸屏5004上的弧5362可从或近似从由可运动钳口5024限定的轴线A延伸，并且弧5362可延伸到由可运动钳口5024的期望夹持取向限定的轴线A’(图90)。此外，弧5362可例如沿由箭头5364指示的方向延伸。现在参见图90，器械控制器5016和/或微控制器可例如基于使用者经由触摸屏5004的输入来实现可运动钳口5024到轴线A’的闭合。
现在参见图91和图92，在各种实施例中，使用者可与第一信息层5012中的控制按钮和/或图标进行交互，以将指令输入到外科器械5020。例如，第一信息层5012可包括控制界面5072，所述控制界面5072可包括例如按钮5074、5075、5076、5077、5078以用于将指令输入到器械控制器5016和/或微控制器。用于将指令输入到器械控制器5016(图93)和/或微控制器的按钮可涉及例如使DLU5022进行关节运动、使钳口5024闭合和/或夹持、击发和/或回缩切割元件、和/或从DLU5022射出钉。使用者可与触摸屏5004进行交互，以从控制界面5072选择按钮。主要参见图91，控制界面5072可包括例如停止/回缩按钮5474、暂停按钮5475、开始按钮5476、加速按钮5477、和/或减速按钮5478。使用者可例如接触开始按钮5476以启动击发行程和/或推进击发元件，接触暂停按钮5475以暂停击发行程，和/或接触停止/回缩按钮5474以停止击发行程和回缩击发元件。此外，使用者可与控制界面5072进行交互，以调节整个击发行程中的击发元件的速度。例如，使用者可接触加速按钮5477以增加击发元件的速度，并且使用者可接触减速按钮5478以降低击发元件的速度。使用者可例如在击发行程的“软”启动阶段之后和/或期间增加击发元件的速度，并且/或者可例如在到达击发行程末端的击发行程的“软”止动阶段降低击发元件的速度。在其他实施例中，控制界面5072可包括例如按钮和/或控件，以用于修改钳口5024的闭合和/或DLU5022的关节运动。在各种实施例中，当从控制面板5030选择器械控制器5070菜单时和/或当使用者以其他方式选择器械控制状态时，控制界面5072可“卡扣”到第二信息层5012中的某一位置。使用者可例如相对于第一信息层5010和/或显示器5002来移动、调整和/或调控控制界面5072。
在各种实施例中，参见图92，第二信息层5012可包括例如进度条5480，所述进度条5480可指示DLU5022中的击发元件的位置。进度条5480可在近侧端部5482和远侧端部5488之间延伸，并且可限定击发行程期间的击发元件的最近侧位置和最远侧位置。在各种实施例中，可例如沿着进度条5480来指示击发元件的位置。在某些实施例中，使用者可使用控制界面5072中的控件来调节击发行程。例如，使用者可与控制界面5072进行交互，以基于沿进度条5480的击发元件的指示位置来启动和/或终止击发行程的“软”启动阶段和/或“软”止动阶段。此外，进度条5480可包括测量标记和/或导标5484、5486，所述测量标记和/或导标5484、5486可被设定到例如进度条5480上的“软”启动和/或“软”止动阶段可开始和/或结束的位置。导标5484、5486可在击发行程期间向使用者提供视觉提示，以例如利用加速按钮5077启动和/或终止“软”启动周期，并且/或者利用减速按钮5078启动和/或终止“软”止动阶段。在各种实施例中，导标5484、5486的位置可由使用者预先设定。
仍参见图92，在各种实施例中，器械控制器5016和/或微控制器可基于导标5484、5486沿进度条5480的位置来自动地实现击发元件的速度变化。此外，使用者可与触摸屏5004进行交互，以移动和/或调控进度条5480并且由此修改击发行程的“软”启动和/或“软”止动阶段。例如，“软”启动和/或“软”止动阶段可被设定在近侧端部5482和远侧端部5488之间的沿进度条5480的预定位置处。在某些实施例中，使用者可与触摸屏5004进行交互，以移动和/或调节导标5484、5486沿进度条5480长度的位置。例如，使用者可通过拖动和释放导标5484、5486来将导标5484、5486设置在进度条5480上的多个位置之间，以延长和/或缩短击发行程的“软”启动和/或“软”止动阶段。在某些实施例中，使用者可与触摸屏5004进行交互，以移动和/或调节进度条5480的远侧端部5488的位置，从而延长和/或缩短击发行程。例如，使用者例如可朝近侧拖动远侧端部5488以缩短击发行程并且/或者可朝远侧拖动远侧端部5488以延长击发行程。在各种实施例中，器械控制器5016和/或微控制器可例如基于导标5484、5486和/或远侧端部5488沿进度条5480的修改位置来调节击发元件的速度和/或击发行程长度。
在各种实施例中，外科器械10可包括至少一个停用机构。如本文更详细所述，此类停用机构可阻止最终使用者擅改外科器械。例如，现在参见图134，示出了功率源2500。功率源2500可用于将功率提供到外科器械(例如，外科器械10(参见图1))，并且在许多方面类似于本文档在别处描述的其他功率源(例如，功率源200(参见图1))和Zemlok‘763更详细描述的其他类型的功率源，该专利全文已以引用方式并入本文。为了保护功率源2500以防擅改，功率源2500可被构造成能够在其被擅改的情况下变得不能操作或失活。例如，功率源2500可例如通过停止接收、存储、和/或传输能量而变得失活。阻止篡改可确保功率源2500在与外科器械10一起使用期间的正确操作。
参见图134和图135，功率源2500可包括外部壳体2502，所述外部壳体2502可包封功率源2500的各种部件，例如电池组2510。壳体2502可包括第一壳体2504和可分离地联接到第一壳体2504的第二壳体2506，如图135所示。在某些情况下，壳体2504和壳体2056可由热塑性材料(例如，聚碳酸酯)形成。另选地，可使用具有适当特性的其他材料。此外，壳体2504和壳体2506可通过一种或多种紧固技术(例如，粘合剂、焊接、互锁结构、和/或螺钉)进行相互联接。在一个示例中，壳体2504和壳体2506可经由卡扣配合型接合来固定到一起。在另一个示例中，壳体2504和壳体2506可通过紧固构件2508固定到一起，如图135所示。
参见图135-137，功率源2500可包括停用机构2512，所述停用机构2512可在功率源2500受到损害的情况下使得功率源2500不能操作。例如，如果壳体2502被擅改，则停用机构2512可使得功率源2500不能操作。如图135-137所示，停用机构2512可包括电路2514，所述电路2514可包括可断开部分2516(参见图136)。在某些示例中，可断开部分2516可由可易于断裂的导电材料构成。如图136所示，电路2514可联接到电池组2510并且可允许电流流过，前提条件是可断开部分2516保持完整。如图137所示，断开可断开部分2516可中断电路2514，由此终止通过其的电流流动。对上文进行进一步描述，如图135所示，电路2514可被定位成使得可断开部分2516可在第一壳体2504和第二壳体2506彼此分开时断裂，这可使得在不尽力修复断裂电路2514的情况下，功率源2500不能为外科器械10接收、存储、和/或提供功率。
参见图135，功率源2500可包括一个或多个电池单元，这取决于器械10的电流负载需求。在各种方面中，功率源2500可包括电池组，例如电池组2510，所述电池组可包括可彼此串联连接的多个电池单元。功率源2500可为可替换的。在某些方面，功率源2500可包括可再充电电池(例如，铅基、镍基、锂离子基等等)。电池单元可为例如3伏锂电池单元，例如CR123A电池单元，但在其他实施例中，可使用不同类型的电池单元(包括具有不同电压水平和/或不同化学品的电池单元)。使用者可从外科器械10断开和移出耗尽的功率源2500并且在其位置中连接已充电的功率源2500。耗尽的功率源2500可随后进行充电和再利用。还可设想到，功率源2500可包括至少一个一次性电池。在各个方面，一次性电池可为约9伏至约30伏。使用者可断开和移出耗尽的一次性功率源2500，并且连接新的一次性功率源2500以对外科器械10提供功率。
如上所述，功率源2500可包括可再充电电池单元并且能够可移除地布置在例如外壳12的柄部部分14内(参见图1)。在此类情况下，功率源2500可利用充电器座进行充电，所述充电器座可包括用于对功率源2500充电的功率源。如果功率源2500被擅改，如上所述，则可使用停用机构(例如，停用机构2512)来防止功率源2500被充电器座进行再充电。例如，电路2514可联接到电池组2510并且能够联接到充电器座，以允许充电器座对电池组2510进行再充电。如上所述，当第一壳体2504与第二壳体2506分开时，可断开部分2516(参见图135)可断开，由此中断流过电路2514的电流，这可防止充电器座对电池组2510进行再充电。这可有利于防止最终使用者擅改功率源2500，因为擅改功率源2500可使其不能行再充电以用于结合外科器械10的后续使用。
现在参见图138-141，功率源2500可包括数据存储单元，例如，存储器2552，所述数据存储单元可存储包括有关功率源2500的信息的数据，例如，总可用电量、使用次数、和/或性能。另外，存储器2552可存储有关外科器械10的数据，所述数据包括有关外科器械10在外科手术过程中的操作的各种信息(例如，各种传感器读数、击发次数、使用的仓数)和/或有关治疗患者的信息。存储器2552可包括用于存储软件的任何装置，所述装置包括但不限于ROM(只读存储器)、RAM(随机存取存储器)、PROM(可编程ROM)、EEPROM(电可擦除PROM)、和/或其他计算机可读介质。
对上文进行进一步描述，再次参见图138-141，功率源2500可包括数据访问入口，例如，I/O接口2550，以便访问存储于存储器2552中的数据。例如，I/O接口2550允许存储于功率源2500的存储器2552中的数据被下载到外部计算机装置以用于评估和分析。在某些情况下，I/O接口2550可为有线接口并且可操作地联接到停用机构2512，所述停用机构2512可包括可断裂连接部，所述可断裂连接部可被切断以防止通过I/O接口2550的数据传输。类似于停用机构2512的可断开部分2516，停用机构2554的可断裂连接部可被定位成使其可在壳体2502被破裂时(例如，在第一壳体2504和第二壳体2506彼此分开时)被切断。
对上文进行进一步描述，如图139-141所示，I/O接口2550可包括连接器2555，所述连接器2555可被构造成能够接纳来自外部计算机装置的对应连接器2556例如以允许数据在存储器2552和计算机装置之间传递。此外，连接器2554可由覆盖件(例如，枢转覆盖件2559)保护，所述枢转覆盖件2559可被构造成能够在锁定位置(参见图139)(其中连接器2554为未暴露的)与解锁位置(参见图140)(其中连接器2554被暴露以接纳对应连接器2556)之间运动。在一个示例中，可使用螺钉2558将枢转覆盖件2559固定到壳体2502。本公开可设想到用于可恢复地覆盖联接器2556的其他装置。对上文进行进一步描述，在某些示例中，连接器2554和2556可包括钥匙和锁型接合，其中连接器2554和2556可包括例如独特的互补几何形状，由此防止连接器2554接纳其他连接器，以便防止或至少限制存储于存储器2552内的数据的未授权访问。在某些示例中，连接器2554可定位在壳体2502内，如图141所示，以进一步限制存储于存储器2552中的数据的未授权访问。在此类情况下，可通过分开壳体2502的第一壳体2504和第二壳体2506来访问连接器2554。然而，如上文更详细所述，停用机构2512可在壳体2502破裂时使得功率源2500不能操作，这可进一步防止试图暴露连接器2554以访问存储于存储器2552中的数据。
参见图142，功率源2500可包括可管理储存于存储器2552中的数据的处理器2560。为了保护此类数据以防未授权访问，处理器2560可联接到破裂感测机构2562。例如，处理器2560可联接到电路2514并且可被构造成能够检测可断开部分2516的断裂。在一个示例中，破坏感测机构2562可包括被构造成能够检测壳体2502中的破裂的一个或多个传感器。在任何情况下，当检测到破裂时，处理器2560可被编程以例如通过删除或加密数据来防止对存储于存储器2552中的数据进行未授权访问。
参见图143-145，示出了外科器械2600。外科器械2600在许多方面类似于外科器械10(参见图1)和/或外科器械2100(参见图146)。例如，外科器械2600可包括外壳组件2602，所述外壳组件2602类似于外科器械2100的外壳组件2102和/或外科器械10的外壳12。此外，外科器械2600可包括功率源2500’，所述功率源2500’可用于将功率提供到外科器械2600并且在许多方面类似于本文档在别处描述的其他功率源(例如，功率源2500(参见图134))和Zemlok‘763更详细描述的其他类型的功率源，该专利全文已以引用方式并入本文。此外，如图143所示，功率源2500’可包括电量水平指示器2660，所述电量水平指示器2660可被构造成能够向使用者提供有关功率源2500’的电量水平的反馈。反馈可具有例如声音和/或光形式。功率源2500’可包括一个或多个发光二极管(LED)。处理器2560例如可被编程以控制LED，从而向使用者提供有关功率源2500’的电量水平的反馈，所述电量水平可通过例如电量计来测量。
如图143-145所示，功率源2500’可包括第一LED2662和第二LED2664。处理器2560可联接到LED2662和2664并且可被编程以在从电量计接收到功率源被完全充电的信号时点亮LED2662和2664两者。此外，处理器2560可被编程以在从电量计接收到功率源耗尽的信号时关闭LED2662和LED2664两者。此外，处理器2560可被编程以在从电量计接收到功率源具有用于外科器械2600的仅一次完整操作的足够电量的信号时仅点亮第一LED2662而不点亮第二LED2664。本公开可设想到用于提示使用者功率源2500’的电量水平的其他装置。
在某些实施例中，例如，外科器械10的各种部件可为可重复使用的并且各种部件可为可替换的。此外，外科器械10可被至少部分地组装、拆卸、和/或重新组装。例如，外科器械10可被至少部分地拆卸并且可例如与可重复使用的部件和替换部件进行重新组装。另外，外科器械10可在外科手术期间被至少部分地拆卸，以用于清洁、消毒、和/或再处理。随后，可例如重新组装外科器械10。如本文更详细所述，外科器械10的各种特征结构、组件和/或系统可有利于其拆卸和组装。例如，现在参见图146-148，示出了外科器械2100。外科器械2100在许多方面类似于外科器械10(参见图1)。例如，外科器械2100可包括类似于外科器械10的外壳12的外壳组件2102。此外，外壳组件2102可包括若干可拆卸部件2103，所述可拆卸部件2103能够可拆卸地固定到外壳主体2104，例如工作组件2106。外壳组件2102的其他部件能够可拆卸地固定到外壳主体2104。例如，外壳组件2102可包括可替换的功率源2108，所述可替换的功率源2108能够可拆卸地固定到外壳主体2104的柄部部分2110。功率源2108在许多方面类似于本文档在别处描述的其他功率源，例如，功率源200(参见图1)。
再次参见图147，外壳组件2102或者其部件中的一些或全部可为可重复使用的。换句话讲，外壳组件2102或者其部件中的一些或全部可用于多个外科手术中，所述外科手术之间可需要对外壳组件2102进行清洁、消毒、和/或再处理。通过简单和可重复方式可恢复地拆卸外壳组件2102或移除其部件中的一些或全部(例如，工作组件2106)的能力可简化外壳组件2012的清洁、消毒、和/或再处理的步骤并且/或者可降低成本。
参见图147，外壳组件2102可在外科手术之后被拆卸，并且所拆卸的外壳组件2102的部件(例如，外壳主体2104、工作组件2106和/或功率源2110)可单独地或结合其他部件进行清洁、消毒、和/或再处理，这取决于每个部件的特性和内部零件。在某些示例中，外壳主体2104可为一次性的。换句话讲，外壳组件2102可在外科手术之后被拆卸并且外壳主体2104可由新外壳主体2104替换。然而，剩余部件可进行清洁、消毒、和/或再处理，随后附接到新外壳主体2104。读者将会知道，外壳组件2102的其他部件也可为一次性的并且可由新的类似部件替换。
再次参见图146-148，外壳主体2104可被构造成能够允许外壳组件2102以简单的、可预测的、和可重复的方式进行组装和拆卸。例如，外壳主体2104可包括第一罩部分2112(参见图147)和能够可释放地附接到第一罩部分2112的第二罩部分2114(参见图146)。在一个示例中，罩部分2112和2114可包括卡扣配合型接合。罩部分2112和2114可适于彼此配对接合。在一个示例中，罩部分2112可包括多个凹构件2116(参见图147)，所述多个凹构件2116可呈圆柱形形状并且被构造成能够在罩部分2112和罩部分2114组装在一起时以卡扣配合接合方式接纳设置在罩部分2114上的对应凸构件(未示出)。
对上文进行进一步描述，工作组件2106可嵌套在第一罩部分2112中。如图147所示，第二罩部分2114可被移除以暴露嵌套在第一罩部分2112中的工作组件2106，以便允许使用者从外壳主体2104移除工作组件2106。如图147所示，工作组件2106可包括马达2118，所述马达2118可产生旋转动作以作用于端部执行器(例如，图2所示的加载单元20的仓/砧座部分)。马达2118在许多方面类似于本文档在别处描述的其他马达，例如，马达100(参见图1)。此外，工作组件2106还可包括传输组件2120，所述传输组件2120能够可操作地联接到马达2118并且在许多方面类似于本文档中在别处描述的其他传输组件，例如，齿轮组件170(参见图5)。此外，工作组件2106还可包括击发构件组件2122，所述击发构件组件2122可将由马达2118产生的旋转动作转换成可通过击发杆2124传输到端部执行器的轴向动作。击发构件组件2122在许多方面类似于本文档在别处描述的其他驱动组件，例如，击发构件组件82。
参见图147和图148，第一罩部分2112可包括被设计并且隔开以接纳工作组件2106的多个隔室。例如，如图147所示，罩部分2112可包括被隔开以容纳马达2118的马达嵌套隔室2126。在某些示例中，马达嵌套隔室2126可设计成以特定布置方式适配马达2118，以确保精确的组装。此外，马达嵌套隔室2126可包括组装说明，所述组装说明可例如被模塑到马达嵌套隔室2126的壁上，以确保正确的组装。例如，马达嵌套隔室2126的侧壁可被构造成能够紧密地接纳马达2118。此外，侧面可至少在一些方面进行非对称地构造以沿仅一个方向(即，正确取向)接纳马达2118。
类似地，如图147所示，罩部分2112可包括传输组件嵌套隔室2128，所述传输组件嵌套隔室2128可被隔开以容纳传输组件2120。此外，在某些示例中，传输组件嵌套隔室2128被设计成以特定布置方式适配传输组件2120，以确保精确的组装。例如，传输组件嵌套隔室2128的侧壁可被构造成能够紧密地接纳传输组件2120。此外，侧面可在至少在一些方面中进行非对称地构造以沿仅一个方向(即，正确取向)接纳传输组件2120。此外，传输组件嵌套隔室2128可包括组装说明，所述组装说明可例如被模塑到传输组件嵌套隔室2128的壁上，以确保正确的组装。类似地，如图147所示，罩部分2112可包括击发构件嵌套隔室2130，所述击发构件嵌套隔室2130可被隔开以容纳击发构件组件2122。此外，在某些示例中，击发构件组件嵌套隔室2130被设计成以特定布置方式适配击发构件组件2122，以确保精确的组装。例如，击发构件组件嵌套隔室2130的侧壁可被构造成能够紧密地接纳击发构件组件2122。此外，侧面可在至少在一些方面中进行非对称地构造以沿仅一个方向(即，正确取向)接纳击发构件组件2122。此外，击发构件组件嵌套隔室2130可包括组装说明，所述组装说明可例如被模塑到击发构件组件嵌套隔室2130的壁上，以确保正确的组装。读者将会知道，工作组件2106的其他部件也可提供在罩部分2112内的独特设计的容纳隔室中。读者还将会知道，工作组件2106的电触点也可嵌入罩部分2112的隔室内，以使得当正确组装时，可在工作组件2106、外壳组件2102的其他部件(例如，功率源2108)和/或外科器械2100的其他部件之间建立电连接。
对上文进行进一步描述，工作组件2106能够可分离地联接到击发杆2124，如图147所示，这可允许使用者将工作组件2106作为单个单元来移除并且重新连接到外科器械2100，以简化工作组件2106的拆卸和重新组装。在一个示例中，如图147所示，击发构件组件2122可包括中空管状远侧部分2132，所述中空管状远侧部分2132可包括远侧开口，所述远侧开口被构造成能够例如以卡扣配合型接合来接纳并且可释放地锁定到击发杆2124的近侧部分2134。
再次参见图147和图148，外壳组件2102的其他部件可以类似于工作组件2106的方式嵌套在罩部分2112中的专用隔室中。例如，罩部分2112可包括功率源嵌套隔室2136，所述功率源嵌套隔室2136可被隔开以容纳功率源2108。此外，在某些示例中，功率源嵌套隔室2136可被设计成以特定布置方式适配功率源2108，以确保精确的组装。例如，功率源嵌套隔室2136的侧壁可被构造成能够紧密地接纳功率源2108。此外，侧面可至少在一些方面进行非对称地构造以沿仅一个方向(即，正确取向)接纳功率源2108。另外，功率源嵌套隔室2136可包括组装说明，所述组装说明可例如被模塑到功率源嵌套隔室2136的壁上，以确保正确的组装。
对上文进行进一步描述，如图147和图148所示，某些使用者输入机构(例如，击发按钮2138和/或闭合开关2140)也可从外壳主体2104拆卸，所述外壳主体2104可包括被隔开以容纳击发按钮2138的击发按钮嵌套隔室2142和/或被隔开以容纳闭合开关2140的闭合开关嵌套隔室2144。此外，在某些示例中，击发按钮嵌套隔室2142可被设计成以特定布置方式适配击发按钮2138，以确保精确的组装。例如，击发按钮嵌套隔室2142的侧壁可被构造成能够紧密地接纳击发按钮2138。此外，侧面可在至少在一些方面中进行非对称地构造以沿仅一个方向(即，正确取向)接纳击发按钮2138。类似地，闭合开关嵌套隔室2144可被设计成以特定布置方式适配闭合开关2140，以确保精确的组装。例如，闭合开关嵌套隔室2144的侧壁可被构造成能够紧密地接纳闭合开关2140。此外，侧面可在至少在一些方面中进行非对称地构造以沿仅一个方向(即，正确取向)接纳闭合开关2140。此外，击发按钮嵌套隔室2142和/或闭合开关嵌套隔室2144可包括组装说明，所述组装说明可例如被模塑到击发按钮嵌套隔室2142和/或闭合开关嵌套隔室2144的壁上，以确保正确的组装。
再次参见147和图148，除嵌套隔室之外，罩部分2112可包括固定机构，以将外壳组件2102中的一些或全部可拆卸部件2103固定在其相应隔室中，从而确保可拆卸部件2103保持嵌套在其相应隔室中。此类固定机构可包括固定构件，所述固定构件可在解锁构型(参见图148)和锁定构型(参见图147)之间运动，以将外壳组件2102的可拆卸部件2103锁定到其在罩部分2112中的相应隔室。读者将会知道，可使用单个或多个固定构件来将一个或多个可拆卸部件2103固定到罩部分2112。此外，固定机构还可包括安全特征结构，所述安全特征结构可在不正确组装的情况下防止固定构件运动到锁定构型，以确保外壳组件2102的可拆卸部件2103的正确组装。如图147中的示例性实施例所示，工作组件2106可通过若干固定构件(例如，马达固定构件2148、传输组件固定构件2150、和/或击发构件组件固定构件2152)固定到罩部分2112。在某些示例中，如图147所示，可使用功率源固定构件2154、击发按钮固定构件2156、和闭合开关固定构件2158来分别固定功率源2108、击发按钮2138、和闭合开关2140。
固定构件可通过从解锁构型(参见图148)运动到锁定构型(参见图147)来夹持到可拆卸部件2103上。例如，马达固定构件2148可通过从解锁构型(参见图148)运动到锁定构型(参见图147)来夹持到马达2118上。在某些示例中，可拆卸部件2103中的一些或全部可包括轨道，所述轨道被构造成能够在固定构件从解锁构型运动到锁定构型时接纳固定构件。轨道可被定位成使得它们可仅在可拆卸部件2103正确地嵌套在罩部分2112中的相应隔室内时被对准以接纳运动的固定构件。例如，如果马达2118未正确地嵌套在马达嵌套隔室2126中，则马达固定构件2148可不与其轨道正确地对准，并且由此当马达固定构件2148从解锁构型运动到锁定构型时，马达固定构件2148可不进入轨道并且例如可邻接抵靠马达2118的外壁。在某些示例中，马达固定构件2148可被定位成使得如果当马达固定构件2148未处于锁定构型时使用者尝试组装罩部分2112和2114，则其可防止第一罩部分2112与第二罩部分2114配合接合。该构造可提示使用者重新检查外壳组件2102的已组装部件是否正确组装。
类似于马达固定构件2148，传输组件固定构件2150可接纳在传输组件2120上的专用轨道中，并且传输组件固定构件2150可被定位成使其仅在传输组件2120正确地嵌套在传输组件嵌套隔室2128中时才与其相应的轨道对准。另外，击发构件组件固定构件2152可接纳在例如击发构件组件2122上的专用轨道中，并且击发构件组件固定构件2152可被定位成使得其仅在击发构件组件2122正确地嵌套在击发构件组件嵌套隔室2130中时才与其相应的轨道对准。另外类似于马达固定构件2148，传输组件固定构件2150和/或击发构件组件固定构件2152可被定位成使得如果当传输组件固定构件2150和/或击发构件组件固定构件2152未处于锁定构型时使用者尝试组装罩部分2112和2114，则它们中的任一者可防止第一罩部分2112与第二罩部分2114配合接合。如上所述，可拆卸部件2103中的一些可被拆卸，可一起作为组件重新附接到罩构件2112，并且可通过多个固定构件进行固定。例如，工作组件2106可通过马达固定构件2148、传输组件固定构件2150和/或击发构件组件固定构件2152固定到罩部分2112，如图147所示。此类构造可提供正确组装的附加保险度，因为工作组件2106中的任何一个部件的不正确组装可防止其对应的固定构件到达锁定构型，这样如果使用者在固定构件中的至少一个未达到锁定构型时尝试组装罩部分2112和2114，则可防止第一罩部分2112与第二罩部分2114配合接合。
再次参见图147和图148，固定构件中的一些或全部能够可枢转地附接到第一罩部分2112并且可相对于第一罩部分2112从解锁构型(参见图148)运动到锁定构型(参见图147)，反之亦然。在某些示例中，第二罩部分2114可包括突起的固定构件(未示出)，当在外壳组件2102的组装期间，罩部分2112和2114被对准以用于配合接合时，所述突起的固定构件被构造成能够接纳在嵌套在第一罩部分2112中的可拆卸部件2103中的对应接纳构件(未示出)内。突起的固定构件确保可拆卸部件2103保持固定在第一罩部分2112中。此外，如果使用者在突起的固定构件例如因可拆卸部件2103的未正确组装而未与其对应的接纳构件正确地对准时尝试组装罩部分2112和2114，则突起的固定构件可防止第一罩部分2112与第二罩部分2114配合接合，这可提示使用者重新检查外壳组件2102的可拆卸部件2103的组装以便进行正确组装。读者将会知道，突起的固定构件和其相应的接纳构件的位置可被颠倒，以使得突起的固定构件能够从可拆卸部件2103突起并且可接纳在第二罩部分2114上的对应接纳构件中。在任何情况下，突起的固定构件和其对应的接纳构件彼此能够例如以卡扣配合型接合来可释放地附接。本公开可设想到其他接合机构。
对上文进行进一步描述，可拆卸部件2103中的一些或全部可包括凸轮表面，所述凸轮表面被构造成能够在第一罩部分2112的固定构件从解锁构型(参见图148)运动到锁定构型(参见图147)时接纳这些固定构件。凸轮表面可设置在可拆卸的部件2103中的一些或全部的外表面上并且在锁定构型下可允许对应的固定构件将压力施加到可拆卸部件2103上。例如，马达2118可包括沿其轨道的凸轮表面。当马达固定构件2148从解锁构型(参见图148)运动到锁定构型(参见图147)时，马达固定构件2148可沿马达2118上的凸轮表面行进，从而可允许马达固定构件2148将递增的压力施加到马达2118上，其中例如在锁定构型下具有最大压力。施加到马达2118的压力可有助于将马达固定在马达嵌套隔室2126中。
如上所述，端部执行器可包括可朝远侧推进以缝合和/或切割组织的击发构件。现在参见图155，端部执行器11260可包括具有砧座11262的第一钳口和具有钉仓11264的第二钳口。端部执行器11260还可包括：一、从砧座11262和钉仓11264朝近侧延伸的外壳和/或框架11261；和二、可相对于外壳11261、砧座11262、和仓11264运动的击发构件11266。端部执行器11260还可包括关节运动接头11230，所述关节运动接头11230被构造成能够允许砧座11262和仓11264通过关节运动驱动器11268进行关节运动。使用时，端部执行器11260可组装到外科器械的轴11240，例如使得：一、端部执行器外壳11261联接到被构造成能够支撑端部执行器外壳11261的轴外壳11241；二、端部执行器击发构件11266联接到被构造成能够推进和回缩端部执行器击发构件11266的轴击发致动器11246；和/或三、端部执行器关节运动驱动器11268联接到被构造成能够推进和回缩端部执行器关节运动驱动器11268的轴关节运动致动器11248。使用时，击发构件11266可朝远侧推进，以使砧座11262从其中组织可定位在砧座11262和仓11264中间的打开位置运动到其中砧座11262压缩组织抵靠仓11264的闭合位置。在各种情况下，击发构件11266可包括在击发构件11266朝远侧推进时被构造成能够接合第一钳口的第一接合构件和被构造成能够接合第二钳口的第二接合构件，以使得砧座11262可通过接合构件来朝钉仓11264进行枢转。为了重新打开端部执行器并且允许砧座11262返回到其打开位置，击发构件11266必须被充分地回缩。在各种情况下，击发构件11266可卡在至少部分击发的位置中，并且因此砧座11262不可被重新打开，由此使得外科器械难以从手术部位移除。
现在转到图156-161，端部执行器(例如，端部执行器11360)可包括击发构件，所述击发构件可允许端部执行器11360的砧座11262被重新打开，即使端部执行器11360的击发构件被卡在至少部分击发的位置中。更具体地，端部执行器11360可包括击发构件11366，所述击发构件11366包括可分离部分11366a和11366b，所述可分离部分11366a和11366b在各种情况下可被构造成能够允许砧座11262和仓11264之间的相对运动。主要参见图157和图158，当锁11390处于锁定状态时，可分离部分11366a和11366b可通过锁11390保持在一起，如图158所示。相应地，当锁11390处于解锁状态时，可分离部分11366a和11366b可相对于彼此运动。击发构件11366的可分离部分11366a可包括第一侧向部分11363a、第二侧向部分11367a、以及定位在侧向部分11363a和11367a中间的切割构件部分11365a。在各种情况下，侧向部分11363a和11367a可经由延伸穿过限定于其中的孔11396a的一个或多个销(图157和158中未示出)来保持到切割构件部分11365a。击发构件11366的可分离部分11366b可包括第一侧向部分11363b、第二侧向部分11367b、以及定位在侧向部分11363b和11367b中间的切割构件部分11365b。在各种情况下，侧向部分11363b和11367b可经由与从其延伸的底脚11396接合的至少一个保持构件(图157和158中未示出)来保持到切割构件部分11365b。读者将会知道，前述保持销将可分离部分11363a的各种部件保持在一起，同时前述保持构件将可分离部分11363b的各种部件保持在一起。读者还将会知道，锁11390在处于其锁定位置时将可分离部分11363a和11363b保持在一起。在各种情况下，主要参见图158，锁11390可包括第一锁定构件11397a以及第二锁定构件11397b，所述第一锁定构件11397a被构造成能够接合第一切割构件部分11365a的第一锁定部分11361a，所述第二锁定构件11397b被构造成能够接合第二切割构件部分11365b的第二锁定部分11361b。第一锁定部分11361a和第二锁定部分11361b可被构造成能够将切割构件部分11365a和11365b协作地并且可释放地保持在一起。在各种情况下，锁定部分11397a、11397b可将切割构件部分11365a和11365b保持在一起，使得切割构件部分11365a和11365b的相应切割表面11395a和11395b形成连续的、或至少基本上连续的切割表面。再次参见图158，锁11390的锁定部分11397a、11397b可被构造成能够分别协作地接合并且保持切割构件部分11365a和11365b的键11361a和11361b。在各种情况下，锁定部分11397a、11397b可在它们之间限定凹口11398，凹口11398被构造成能够在锁11390处于其锁定位置时接纳键11361a和11361b。当锁11390朝近侧进行牵拉时，锁定部分11397a和11397b可脱离键11361a和11361b。此时，锁11390可不再将切割构件部分11365a和11365b保持在一起。在这种情况下，因此，可分离部分11366a和11366b可相对于彼此运动。例如，可分离部分11366a可在钳口11262重新打开时与钳口11262一起运动，并且对应地，可分离部分11366b可与仓11264保持在一起。根据上文所述，当击发构件11366卡在例如至少部分击发的位置中时，可朝近侧牵拉锁11390以解锁可分离部分11366a和11366b。
如上所述，可朝近侧牵拉锁11390，以解锁击发构件11366的可分离部分11366a和11366b。现在转到图159，可通过锁定杆11391朝近侧牵拉和/或朝远侧推压锁11390。锁定杆11391可定位在端部执行器11360内并且可包括近侧端部11392和远侧端部11393。锁定杆11391的远侧端部11393可与锁11390接合。更具体地，在至少一个实施例中，远侧端部11393可包括从其延伸的突起，所述突起能够可滑动地定位在限定于锁11390中的细长狭槽11399内。为了朝近侧牵拉锁11390，可朝近侧牵拉锁定杆11391，直至突起接触细长狭槽11399的近侧端部11394，其中锁定杆11391的动作可被传递到锁11390。对应地，突起可被构造成能够接触细长狭槽11399的远侧端部11395，以便朝远侧推压锁11390。读者将会知道，再次参见图156，击发构件11366可包括限定于其中的一个或多个纵向狭槽11369，所述一个或多个纵向狭槽11369可被构造成能够允许锁定杆突起穿过其延伸并且接合锁11390，如上所述。
对上文进行进一步描述，主要参见图156和图160，锁定杆11391的近侧端部11392可包括被构造成能够被外科器械的轴11340的锁定致动器11348接合的附接部分。主要参见图160，锁定致动器11348可包括具有凹口的远侧端部11349，所述凹口例如可被构造成能够接纳锁定杆11391的近侧端部11392。锁定致动器11348还可包括近侧端部11347，所述近侧端部11347可由外科器械的使用者朝近侧牵拉和/或朝远侧推压，以便使得锁定致动器11348和锁定杆11391分别朝近侧和/或朝远侧运动。在使用中，当端部执行器11360组装到轴11340时，锁定杆11391的近侧端部11392可组装到锁定致动器11348的远侧端部11349。
如上所述，马达可用于推进和/或回缩击发构件，以部署来自端部执行器的紧固件并且/或者切割捕获在端部执行器内的组织。在各种情况下，马达可包括可旋转驱动轴，所述可旋转驱动轴的旋转可被转换成成平移运动并且传输到击发构件，例如切割构件和/或钉驱动器。在至少一种此类情况下，可旋转驱动轴可包括螺纹部分，所述螺纹部分与衬圈螺纹接合，所述衬圈包括限定于其中的螺纹孔，其中在使用中，衬圈可受到约束而不能旋转，使得驱动轴的旋转朝远侧推进驱动轴和/或朝近侧回缩驱动轴，这取决于驱动轴旋转的方向。在某些情况下，击发构件可被卡住和/或换句话讲可经受超过期望或预定的最大力或扭矩的力或扭矩。现在转到图162-167，马达组件12000可包括马达12010、轴12020、和滑动离合器组件12030，其中滑动离合器组件12030可限制马达12010可传输到轴12020的力或扭矩。在各种情况下，主要参见图162和图163，滑动离合器组件12030可在马达12010的可旋转驱动输出部12012与轴12020之间传输扭矩。现在参见图165-167，在各种情况下，驱动输出部12012可包括基本上圆形的外部轮廓部分12011和可为平坦的或至少基本上平坦的过渡表面12014。驱动输出部12012的外部轮廓还可包括限定于圆形轮廓部分12011和平坦表面12014之间的第一驱动肩部12016、以及限定于平坦表面12014的相对端和圆形轮廓部分12011之间的第二驱动肩部12018。
另外如图165-167所示，滑动离合组件12030可包括驱动元件12034，所述驱动元件12034通过偏置元件或弹簧12036偏置成与驱动输出部12012接合。驱动元件12034可至少部分地定位在限定于滑动离合组件12030的外壳12037中的保持狭槽内，使得驱动元件12034相对于外壳12037的运动可被限定在轴线上。读者将会知道，滑动离合组件的外壳12037可安装到轴12020，使得外壳12037和轴12020一起同步旋转。读者还将会知道，至少在某些情况下，驱动元件12034可将驱动输出部12012的旋转动作传输到外壳12037。更具体地，当驱动输出部12012沿如箭头12017所指示的第一方向旋转以朝远侧推进击发构件时，驱动输出部12012可相对于驱动元件12034旋转，直至第一驱动肩部12016与驱动元件12034接触。读者将会知道，第一驱动肩部12016可保持与驱动元件12034接触，前提条件是偏置构件12036能够抵抗或至少充分地抵抗驱动元件12034的径向向外运动。只要驱动元件12034与第一驱动肩部12016接触，马达12010就可使轴12020沿着朝远侧推进击发构件的方向旋转。在各种情况下，马达12010可将足够大的扭矩施加到驱动输出部12012，以使驱动元件12034径向向外移位，从而使得驱动输部出12012的第一驱动肩部12016滑过驱动元件12034，并且因此使得驱动输出部12012相对于驱动元件12304、滑动离合器外壳12037、和轴12020旋转。换句话讲，当施加到驱动输出部12012的扭矩超过预定的或最大的扭矩时，驱动元件12034可失效并且可操作地脱离马达12010。当施加到驱动输出部12012的扭矩下降到低于该预定的或最大的扭矩时，驱动元件12034可重新接合第一驱动肩部12016，并且因此，轴12020可与马达12010可操作地重新接合，使得轴12020通过马达12010的驱动输出部12012进行旋转。
对上文进行进一步描述，当驱动输出部12012沿如箭头12019所指示的第二方向旋转以朝近侧回缩击发构件时，驱动输出部12012可相对于驱动元件12034旋转，直至第二驱动肩部12018与驱动元件12034接触。读者将会知道，第二驱动肩部12018可保持与驱动元件12034接触，前提条件是偏置构件12036能够抵抗或至少充分地抵抗驱动元件12034的径向向外运动。只要驱动元件12034与第二驱动肩部12018接触，马达12010就可使轴12020沿着朝近侧回缩击发构件的方向旋转。在各种情况下，马达12010可将足够大的扭矩施加到驱动输出部12012，以使驱动元件12034径向向外移位，从而使得驱动输部出12012的第二驱动肩部12018滑过驱动元件12034，并且因此使得驱动输出部12012相对于驱动元件12034、滑动离合器外壳12037、和轴12020旋转。换句话讲，当施加到驱动输出部12012的扭矩超过预定的或最大的扭矩时，驱动元件12034可失效并且可操作地脱离马达12010。当施加到驱动输出部12012的扭矩下降到低于该预定的或最大的扭矩时，驱动元件12034可重新接合第二驱动肩部12018，并且因此，轴12020可与马达12010可操作地重新接合，使得轴12020通过马达12010的驱动输出部12012进行旋转。
在各种情况下，对上文进行进一步描述，第一驱动肩部12016和第二驱动肩部12018可具有相同构型。在某些情况下，第一驱动肩部12016可由第一曲率半径限定并且第二驱动肩部12018可由第二曲率半径限定。在一些情况下，第一曲率半径可与第二曲率半径相同。在此类情况下，马达12010可在沿第一方向12017旋转驱动输出部12012时施加的最大或滑动扭矩可与马达12010可在沿第二方向12019旋转驱动输出12012时施加的最大或滑动扭矩相同、或基本上相同。在一些情况下，第一曲率半径可不同于第二曲率半径。在此类情况下，马达12010可在沿第一方向12017旋转驱动输出部12012时施加的最大或滑动扭矩可与马达12010可在沿第二方向12019旋转驱动输出12012时施加的最大或滑动扭矩不同。在至少一种此类情况下，第一曲率半径可大于第二曲率半径，其中因此，沿第一方向12017的最大或滑动扭矩可小于沿第二方向12019的最大或滑动扭矩。换句话讲，相比于推进击发元件，当回缩击发元件时，马达12010可对轴12020施加较大的扭矩。当期望回缩击发元件以使外科器械的端部执行器可例如被重新打开并且从组织松开时，此类情况可为有利的。在至少一种情况下，第一曲率半径可小于第二曲率半径，其中因此，沿第一方向12017的最大或滑动扭矩可大于沿第二方向12019的最大或滑动扭矩。换句话讲，相比于回缩击发元件，当推进击发元件时，马达12010可对轴12020施加较大的扭矩。
对上文进行进一步描述，主要参见图163和图164，偏置构件12036可由弹簧衬圈12032弹性地支撑，所述弹簧衬圈12032定位在限定于滑动离合器外壳12037中的周向通道12031内。在此类情况下，弹簧衬圈12032和偏置构件12036可协作以施加径向向内的偏置力并且/或者抵抗驱动元件12034的径向向外运动。在各种情况下，弹簧衬圈12032可包括环形主体，所述环形主体包括第一自由端12033和第二自由端12034，其中环形主体可在上述径向向外的力施加到其时弹性地扩展并且在该径向向外的力已停止或减小时弹性地收缩。在这种情况下，弹簧衬圈12032的第一自由端12033能够相对于第二自由端12034运动。
可将本发明所公开的装置设计成单次使用后即进行处理，或者可将它们设计成是多次使用的。然而，在任一种情形下，所述装置均可进行修复，以在至少一次使用后再次使用。修复可包括拆卸装置、清洗或更换具体部件以及后续重新组装的其中任意几个步骤的组合。具体地，所述装置可拆卸，而且可以任意组合选择性地更换或移除所述装置的任意数目的特定零件或部件。清洗和/或更换特定部件后，所述装置可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，装置的重新修复可利用多种用于拆卸、清洗/更换和重新组装的技术。这些技术的用途以及得到的重新修复装置均在本发明的范围内。
优选的是，在手术前处理本文所述的发明。首先，获取新的或用过的器械，并根据需要进行清洗。然后可对器械进行灭菌。在一种灭菌技术中，将器械放置在闭合且密封的容器中，例如塑料或TYVEK袋中。然后将容器和装置置于可穿透该容器的辐射区，例如γ辐射、x-射线或高能电子。辐射使杀死器械上和容器中的细菌。然后将灭菌后的器械存储在消毒容器中。该密封容器使器械保持无菌直到在医疗设施中打开该容器为止。
以引用方式全文或部分地并入本文的任何专利、公布或其他公开材料均仅在所并入的材料不与本公开所述的现有定义、陈述或其他公开材料相冲突的范围内并入本文。同样地并且在必要的程度下，本申请明确阐述的公开内容取代了以引证方式并入本申请的任何冲突材料。任何以引用方式并入本文但与本文所述的现有定义、陈述或其他公开材料相冲突的任何材料或其部分，仅在所并入的材料和现有的公开材料之间不产生冲突的程度下并入本文。
尽管本发明已被描述为具有示例性的设计，但还能够在本公开的实质和范围内对本发明进行修改。因此本申请旨在涵盖采用本发明一般原理的任何变型、用途或修改型式。此外，本申请旨在涵盖本发明所属领域中属于已知或惯有实践范围内的与本公开不同的此类型式。

Claims (22)

1.一种外科器械系统，所述外科器械系统包括：
第一部件，所述第一部件包括：
第一连接部分；和
指示器，所述指示器与所述第一连接部分相邻；
第二部件，所述第二部件包括第二连接部分，其中所述第二连接部分能够与所述第一连接部分接合以将所述第二部件连接到所述第一部件；和
控制器，所述控制器被构造成能够检测所述第二部件是否正确地连接到所述第一部件，并且其中所述控制器被构造成能够在所述控制器检测到所述第二部件未正确地连接到所述第一部件时启动所述指示器。
2.根据权利要求1所述的外科器械系统，其中所述第一部件包括外科缝合器械，并且其中所述第二部件包括钉仓。
3.根据权利要求2所述的外科器械系统，其中所述外科缝合器械包括：
击发构件；
击发触发器，所述击发触发器能够致动以推进所述击发构件；和
触发器锁，所述触发器锁被构造成能够在所述控制器检测到所述第二部件未正确地连接到所述第一部件时防止所述击发触发器被致动并且向所述外科器械系统的使用者指示所述钉仓未正确地连接到所述外科缝合器械。
4.根据权利要求1所述的外科器械系统，其中所述指示器包括发光二极管。
5.一种外科器械系统，所述外科器械系统包括：
第一部件，所述第一部件包括第一连接部分；
端部执行器，所述端部执行器包括第二连接部分，其中所述第二连接部分能够与所述第一连接部分接合以将所述端部执行器连接到所述第一部件；
指示器，所述指示器邻近所述第一连接部分和所述第二连接部分之间的互连部；和
控制器，所述控制器被构造成能够检测所述端部执行器是否先前已被使用，并且其中所述控制器被构造成能够在所述控制器检测到所述端部执行器先前已被使用时启动所述指示器。
6.根据权利要求5所述的外科器械系统，其中所述第一部件包括外科缝合器械，并且其中所述端部执行器包括钉仓。
7.根据权利要求6所述的外科器械系统，其中所述外科缝合器械包括：
击发构件；
击发触发器，所述击发触发器能够致动以推进所述击发构件；和
触发器锁，所述触发器锁被构造成能够在所述控制器检测到所述端部执行器先前已被使用时防止所述击发触发器被致动并且向所述外科器械系统的使用者指示所述钉仓先前已被使用。
8.根据权利要求5所述的外科器械系统，其中所述指示器包括发光二极管。
9.一种外科器械系统，所述外科器械系统包括：
外科器械，所述外科器械包括：
柄部；
轴，所述轴从所述柄部延伸，其中所述轴包括远侧端部；
触发器；
击发构件；
马达，所述马达被构造成能够使所述击发构件朝所述远侧端部运动，其中所述触发器被构造成能够有条件地操作所述马达；和
控制器，所述控制器被构造成能够检测所述外科器械系统的错误状态，其中所述控制器被构造成能够在检测到所述错误状态时可操作地分离所述触发器和所述马达；和
端部执行器，所述端部执行器能够选择性地附接到所述轴。
10.根据权利要求9所述的外科器械系统，其中所述外科器械包括外科缝合器械，并且其中所述端部执行器包括钉仓。
11.根据权利要求10所述的外科器械系统，其中所述外科缝合器械还包括触发器锁，所述触发器锁被构造成能够在所述控制器检测到所述错误状态时防止所述击发触发器被致动并且向所述外科器械系统的使用者提示所述错误状态。
12.根据权利要求9所述的外科器械系统，其中所述外科器械包括多个指示器，其中所述控制器被构造成能够致动所述指示器中的至少一个以指示所述错误状态的来源。
13.根据权利要求9所述的外科器械系统，其中所述端部执行器包括一个或多个指示器，其中所述控制器被构造成能够致动所述指示器中的至少一个以指示所述错误状态的来源。
14.一种外科器械系统，所述外科器械系统包括：
外科器械，所述外科器械包括：
柄部；
轴，所述轴从所述柄部延伸，其中所述轴包括远侧端部；
触发器；
击发构件；
马达，所述马达被构造成能够使所述击发构件朝所述远侧端部运动，其中所述触发器被构造成能够操作所述马达；
多个传感器，所述多个传感器被构造成能够检测一个或多个错误状态；
控制器，所述控制器与所述多个传感器通信；
多个指示器，其中所述控制器与所述多个指示器通信，并且其中所述控制器被构造成能够选择性地启动所述指示器以指示检测到的所述错误状态；和
端部执行器，所述端部执行器能够选择性地附接到所述轴。
15.根据权利要求14所述的外科器械系统，其中所述外科器械包括外科缝合器械，并且其中所述端部执行器包括钉仓。
16.根据权利要求14所述的外科器械系统，其中所述多个指示器位于所述柄部上。
17.根据权利要求16所述的外科器械系统，其中所述多个指示器被布置成模拟所述外科器械的形状的构型。
18.根据权利要求17所述的外科器械系统，其中每个所述指示器包括发光二极管。
19.根据权利要求14所述的外科器械系统，其中所述外科器械还包括触发器锁，所述触发器锁被构造成能够在所述控制器检测到错误状态时防止所述击发触发器被致动。
20.一种外科器械，所述外科器械包括：
第一致动器，所述第一致动器用于执行所述外科器械的第一操作功能；
第二致动器，所述第二致动器用于执行所述外科器械的第二操作功能；
控制器，所述控制器被构造成能够检测所述外科器械的错误状态；
第一致动器锁，其中所述控制器与所述第一致动器锁信号通信，并且其中所述第一致动器锁被构造成能够在所述错误状态与所述第一操作功能相关时防止所述第一致动器被致动；和
第二致动器锁，其中所述控制器与所述第二致动器锁信号通信，并且其中所述第二致动器锁被构造成能够在所述错误状态与所述第二操作功能相关时防止所述第二致动器被致动。
21.根据权利要求20所述的外科器械，所述外科器械还包括：
第一指示器，所述第一指示器与所述控制器信号通信，其中所述控制器被构造成能够在所述错误状态与所述第一操作功能相关时致动所述第一指示器；和
第二指示器，所述第二指示器与所述控制器信号通信，其中所述控制器被构造成能够在所述错误状态与所述第二操作功能相关时致动所述第二指示器。
22.一种外科器械系统，所述外科器械系统包括：
第一部件，所述第一部件包括第一连接部分；
第二部件，所述第二部件包括第二连接部分，其中所述第二连接部分能够与所述第一连接部分接合以将所述第二部件连接到所述第一部件；
击发构件；
击发触发器，所述击发触发器能够致动以推进所述击发构件；
触发器锁；和
控制器，所述控制器被构造成能够检测所述第二部件是否正确地连接到所述第一部件，其中所述控制器被构造成能够在所述控制器检测到所述第二部件未正确地连接到所述第一部件时致动所述触发器锁以防止所述击发触发器被致动并且向所述外科器械系统的使用者指示所述钉仓未正确地连接到所述外科缝合器械。
CN201480057836.3A 2013-08-23 2014-08-19 用于外科器械的击发触发器锁定构造 Pending CN105792766A (zh)

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