CN106028971A - 包括可伸展的击发构件的紧固件仓 - Google Patents

包括可伸展的击发构件的紧固件仓 Download PDF

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CN106028971A
CN106028971A CN201480076172.5A CN201480076172A CN106028971A CN 106028971 A CN106028971 A CN 106028971A CN 201480076172 A CN201480076172 A CN 201480076172A CN 106028971 A CN106028971 A CN 106028971A
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nail
slope
sliding part
securing member
fastener cartridge
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CN106028971B (zh
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F·E·谢尔顿四世
C·O·巴克斯特三世
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Ethicon Endo Surgery Inc
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    • A61B17/064—Surgical staples, i.e. penetrating the tissue
    • A61B17/0644—Surgical staples, i.e. penetrating the tissue penetrating the tissue, deformable to closed position
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    • A61B17/07207—Surgical staplers, e.g. containing multiple staples or clamps for applying a row of staples in a single action, e.g. the staples being applied simultaneously the staples being applied sequentially
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    • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
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Abstract

本发明公开了一种与外科器械(100)一起使用的紧固件仓。所述紧固件仓和/或外科器械可包括砧座(124)。所述紧固件仓可包括仓体(240)，所述仓体(240)包括平台和多个紧固件腔(244)。所述紧固件仓可包括至少部分地存储在所述紧固件腔内的紧固件(460)、和被构造成能够朝所述砧座移动所述紧固件的击发构件(790)。所述击发构件可包括被构造成能够朝所述砧座提升所述紧固件的第一斜坡(791a,791b)和第二斜坡(794a,794b)、以及用于使所述第一斜坡相对于所述第二斜坡伸展的装置。所述紧固件仓还可包括用于使所述第一斜坡相对于所述第二斜坡回缩的装置。在各种情况下，所述第一斜坡和/或所述第二斜坡可直接提升所述紧固件。在某些情况下，所述紧固件仓可包括通过所述第一斜坡和/或所述第二斜坡直接提升的紧固件驱动器。

Description

包括可伸展的击发构件的紧固件仓
技术领域
本发明涉及外科器械，并且在各种构造中，涉及被设计成切割和紧固组织的外科切割和紧固器械、其紧固件仓、和被设计用于与它们一起使用的外科紧固件。
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。外科缝合器诸如内切割器可包括例如端部执行器，该端部执行器可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，并且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，钉通常由滑动件从钉仓部署，该滑动件横贯钉仓中的通道，并使得钉抵靠砧座而变形，并且将软组织层固定在一起。滑动件可接合被定位在钉和滑动件之间的驱动器以从钉仓部署钉。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。钉通常通过端部执行器的砧座变形为“B形”。端部执行器还可包括切割构件诸如刀，该切割构件例如在软组织层已被缝合在一起之后在钉排之间行进以切除软组织。
此类外科缝合器和端部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。
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方案的以下说明，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为根据本公开的各种实施方案的外科器械的透视图；
图2为根据本公开的实施方案的图1的外科器械的柄部组件的分解透视图；
图3为根据本公开的各种实施方案的图1的外科器械的端部执行器的分解透视图；
图4为根据本公开的各种实施方案的图3的端部执行器的钉仓的透视图；
图5为根据本公开的各种实施方案的沿图4所示的平面截取的图4的钉仓的剖视透视图；
图6为根据本公开的各种实施方案的示于图4的钉仓中的钉的透视图；
图7为图6的钉的前正视图；
图8为图6的钉的后正视图；
图9为图6的钉的顶部平面图；
图10为图6的钉的底部平面图；
图11为图6的钉的右正视图；
图12为图6的钉的左正视图；
图13为图6的钉的透视图；
图14为根据本公开的各种实施方案的图6的钉和图3的端部执行器的滑动件的正视图，其示出了接触钉的初始驱动表面的滑动件的前端表面；
图15为图14的钉和滑动件的透视图，其示出了接触钉的初始驱动表面的滑动件的前端表面；
图16为根据本公开的各种实施方案的图14的钉和滑动件的正视图，其示出了接触钉的第二驱动表面的滑动件的后端表面；
图17为图14的钉和滑动件的透视图，其示出了接触钉的第二驱动表面的滑动件的后端表面；
图18-21为根据本公开的各种实施方案的图3的端部执行器的剖视正视图，其示出了钉从钉仓的击发进度；
图22为根据本公开的各种实施方案的图3的钉仓和滑动件的剖视正视图，其示出了处于未击发位置的钉；
图23为图22的仓和滑动件的剖视透视图，其示出了图22所示的处于未击发位置的钉；
图24为根据本公开的各种实施方案的图22的仓和滑动件的剖视正视图，其示出了处于部分击发位置的近侧钉对和处于未击发位置的剩余钉；
图25为图22的仓和滑动件的剖视透视图，其示出了图24所示的处于部分击发位置的近侧钉对和图24所示的处于未击发位置的剩余钉；
图26为根据本公开的各种实施方案的图22的仓和滑动件的剖视正视图，其示出了处于部分击发位置的多个钉对和处于部分变形构型的近侧钉对；
图27为图22的仓和滑动件的剖视透视图，其示出了处于图26所示的部分击发位置的多个钉对和处于图26所示的部分变形构型的近侧钉对；
图28为根据本公开的各种实施方案的图22的仓和滑动件的剖视正视图，其示出了处于进一步击发位置的多个钉对和处于进一步变形构型的近侧钉对；
图29为图22的仓和滑动件的剖视透视图，其示出了图28所示的处于部分击发位置的多个钉对和图28所示的处于部分变形构型的近侧钉对；
图30为根据本公开的各种实施方案的图22的仓和滑动件的剖视正视图，其示出了处于部分击发位置和部分变形构型的多个钉对以及处于射出位置和完全变形构型的近侧钉对；
图31为图22的仓和滑动件的剖视透视图，其示出了图30所示的处于部分击发位置和部分变形构型的多个钉对以及图30所示的处于射出位置和完全变形构型的近侧钉对；
图32A-32C示出了根据本公开的各种实施方案的用于由材料片使钉成形的方法；
图33为根据本公开的各种实施方案的通过图32A-32C所示的方法成形的钉的透视图；
图34为图33的钉的平面图；
图35为图33的钉的前正视图；
图36为图33的钉的侧正视图；
图37为根据本公开的各种实施方案的钉的透视图；
图38为图37的钉的平面图；
图39为图37的钉的前正视图；
图40为图37的钉的侧正视图；
图41为根据本公开的各种实施方案的钉的透视图；
图42为图41的钉的平面图；
图43为图41的钉的前正视图；
图44为图41的钉的侧正视图；
图45为根据本公开的各种实施方案的钉仓的透视图；
图46为沿图45所示的平面截取的图45的钉仓的剖视透视图；
图47为图45的钉仓的平面图；
图48为根据本公开的各种实施方案的钉的透视图；
图49为图48的钉的平面图；
图50为图48的钉的前正视图；
图51为图48的钉的侧正视图；
图52为根据本公开的各种实施方案的钉的透视图；
图53为图52的钉的平面图；
图54为图52的钉的前正视图；
图55为图52的钉的侧正视图；
图56根据本公开的各种实施方案的图4的钉仓的局部、剖视正视图，其示出了钉腔中的处于部分击发位置的钉；
图57为图56的钉仓的局部平面图，其示出了图56所示的处于部分击发位置的钉；
图58为图56的钉仓的局部、剖视正视图，其示出了图56所示的处于部分击发位置的钉；
图59根据本公开的各种实施方案的图56的钉仓的局部、剖视正视图，其示出了处于另一个部分击发位置的钉；
图60为图56的钉仓的局部平面图，其示出了图59所示的处于部分击发位置的钉；
图61为图56的钉仓的局部、剖视正视图，其示出了图59所示的处于部分击发位置的钉；
图62为根据本公开的各种实施方案的图56的钉仓的局部、剖视正视图，其示出了处于射出位置和变形构型的钉；
图63为图56的钉仓的局部平面图，其示出了图62所示的处于射出位置和变形构型的钉；
图64为图56的钉仓的局部、剖视正视图，其示出了图62所示的处于射出位置和变形构型的钉；
图65为根据本公开的各种实施方案的端部执行器的分解透视图，该端部执行器包括多个紧固件和被构造成能够从端部执行器射出紧固件的击发致动器；
图66为图65的紧固件击发致动器的第一部分的平面图；
图67为图66的第一部分的正视图；
图68为图65的紧固件击发致动器的第二部分的平面图；
图69为图68的第二部分的正视图；
图70为图65的端部执行器的剖视图，其示出了处于未击发、非伸展状态的击发致动器；
图71为图65的端部执行器的剖视图，其示出了处于伸展状态的击发致动器；
图72为图65的端部执行器的剖视图，其示出了处于伸展、推进状态的击发致动器；
图73为图65的端部执行器的剖视图，其示出了处于打开位置的端部执行器的砧座和处于未击发、非伸展状态的击发致动器；
图74为图65的端部执行器的剖视图，其示出了处于闭合位置的砧座和处于未击发、非伸展状态的击发致动器；
图75为以图73所示的构型示出的图65的端部执行器的剖视透视图；
图76为以图74所示的构型示出的图65的端部执行器的剖视图；
图77为图65的端部执行器的剖视图，其示出了处于伸展状态的击发致动器以及此外处于未推进位置的刀构件；
图78为图65的端部执行器的剖视图，其示出了处于推进、伸展状态的击发致动器和处于推进位置的刀构件；
图79为以图78所示的构型示出的图65的端部执行器的剖视透视图；
图80为以完全击发状态示出的图65的端部执行器的局部剖视平面图；
图81为以图80所示的构型示出的图65的端部执行器的剖视正视图；
图82为以图80所示的构型示出的图65的端部执行器的剖视透视图；
图83为图65的端部执行器的剖视正视图，其示出了处于回缩位置的刀构件；
图84为以图83所示的构型示出的图65的端部执行器的剖视透视图；
图85为以图74所示的非伸展构型示出的图65的端部执行器的击发构件的透视图；
图86为以图77所示的伸展构型示出的图65的端部执行器的击发构件的透视图；
图87为以恰在图80所示的完全击发构型之前的构型示出的图65的端部执行器的击发构件的透视图；
图88为以图80所示的完全击发构型示出的图65的端部执行器的击发构件的透视图；
图89为包括被构造成能够从紧固件仓射出紧固件的击发致动器的端部执行器的剖视图，其示出了处于未击发位置的击发致动器；
图90为图89的端部执行器的剖视图，其示出了处于部分击发位置的击发致动器；
图91为图89的端部执行器的钉仓体的平面图；
图92为与图91的仓体一起使用的击发致动器的透视图；
图93为图91的仓体的透视图；并且
图94为沿图93的线94-94截取的图91的剖视图。
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SURGICAL INSTRUMENTS WITH ARTICULATABLE SHAFT ARRANGEMENTS的美国专利申请，代理人案卷号END7343USNP/130300；
名称为SURGICAL STAPLES AND STAPLE CARTRIDGES的美国专利申请，代理人案卷号END7341USNP/130301；
名称为ARTICULATABLE SURGICAL INSTRUMENTS WITH SEPARATE AND DISTINCTCLOSING AND FIRING SYSTEMS的美国专利申请，代理人案卷号END7333USNP/130322；
名称为SURGICAL CUTTING AND STAPLING INSTRUMENTS WITH INDEPENDENT JAWCONTROL FEATURES的美国专利申请，代理人案卷号END7336USNP/130303；
名称为SURGICAL STAPLES AND STAPLE CARTRIDGES的美国专利申请，代理人案卷号END7331USNP/130304；
名称为SURGICAL STAPLES AND METHODS FOR MAKING THE SAME的美国专利申请，代理人案卷号END7335USNP/130305；
名称为SURGICAL STAPLES,STAPLE CARTRIDGES AND SURGICAL END EFFECTORS的美国专利申请，代理人案卷号END7332USNP/130306；
名称为SURGICAL FASTENER的美国外观设计专利申请，代理人案卷号END7338USDP/130307；
名称为FASTENER CARTRIDGE COMPRISING A FIRING MEMBER CONFIGURED TODIRECTLY ENGAGE AND EJECT FASTENERS FROM THE FASTENER CARTRIDGE的美国专利申请，代理人案卷号END7339USNP/130309；
名称为FASTENER CARTRIDGE COMPRISING A FIRING MEMBER INCLUDINGFASTENER TRANSFER SURFACES的美国专利申请，代理人案卷号END7340USNP/130310；
名称为MODULAR SURGICAL INSTRUMENTS的美国专利申请，代理人案卷号END7342USNP/130311；
名称为SURGICAL CUTTING AND STAPLING INSTRUMENTS WITH ARTICULATABLEEND EFFECTORS的美国专利申请，代理人案卷号END7334USNP/130312；和
名称为SURGICAL CUTTING AND STAPLING METHODS的美国专利申请，代理人案卷号END7330USNP/130313。
现在将描述某些示例性实施方案，以从整体上理解本文所公开的装置和方法的结构、功能、制造和用途的原理。这些实施方案的一个或多个实施例已在附图中示出。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方案，并且本发明的多个实施方案的范围仅由权利要求书限定。结合一个示例性实施方案进行图解说明或描述的特征可与其他实施方案的特征进行组合。这些修改和变型旨在涵盖于本发明的范围之内。
本说明书通篇提及的“多种实施方案”、“一些实施方案”、“一个实施方案”或“实施方案”等，意味着结合该实施方案描述的具体特征、结构或特性包括在至少一个实施方案中。因此，本说明书通篇出现的短语“在各种实施方案中”、“在一些实施方案中”、“在一个实施方案中”或“在实施方案中”等并不一定都指相同的实施方案。此外，在一个或多个实施方案中，具体特征、结构或特性可以任何合适的方式组合。因此，在无限制的情形下，结合一个实施方案示出或描述的具体特征、结构或特性可全部或部分地与一个或多个其他实施方案的特征、结构或特性组合。这些修改和变型旨在涵盖于本发明的范围之内。
本文所用术语“近侧”和“远侧”是相对于操纵外科器械的柄部部分的临床医生而言的。术语“近侧”是指最靠近临床医生的部分，术语“远侧”则是指远离临床医生定位的部分。还应当理解，为简洁和清楚起见，本文可以结合附图使用空间术语诸如“垂直”、“水平”、“上”和“下”。然而，外科器械能够在许多取向和位置使用，并且这些术语并非限制性和/或绝对化的。
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。
参见图1-3所示的示例性实施方案，外科器械100可包括柄部组件104、从柄部组件104伸展的轴114、和从轴114伸展的端部执行器120。主要参见图3，钉仓140可被加载到端部执行器120的第一钳口123的细长通道122内。在某些实施方案中，钉仓140可为例如一次性的和/或可替换的。除此之外或另选地，钉仓140可例如整合到端部执行器120内，并且/或者端部执行器120可例如为一次性的和/或可替换的。在各种实施方案中，外科器械100可为马达驱动的。例如，主要参见图2，马达106可定位在柄部组件104中。外科器械100的柄部组件104还可包括触发器108。触发器108的致动可影响例如端部执行器120的钳口123,124的闭合、钉160从钉仓140的击发、和/或击发杆156和切割元件158穿过端部执行器120的平移。
主要参见图3，钉160能够以可射出的方式定位在钉仓140中。例如，至少一个滑动件190可平移穿过钉仓140，以从钉仓140射出钉160。具有切割元件或刀158的击发杆156也可平移穿过钉仓140，以切割例如捕获在端部执行器钳口123,124之间的组织。如图3所示，击发杆156和切割元件158可从第一钳口123中的近侧位置运动到第一钳口123中的远侧位置。在各种实施方案中，例如定位在钉仓140和砧座124中间的组织可被钉160缝合，并且随后通过切割元件158进行切割。主要参见图4和图5，钉仓140可包括仓体142和限定于仓体142中的钉腔144。钉诸如钉160例如能够可移除地定位在钉腔144中。在某些实施方案中，每个钉腔144能够可移除地存储单个钉160。每个钉腔144可具有例如近侧端部146和远侧端部148，并且纵向侧壁150可在每个钉腔144的近侧端部146和远侧端部148之间伸展。如本文更详细地描述，钉腔144的近侧端部146、远侧端部148、和/或纵向侧壁150可在钉从钉腔144部署期间导向和/或支撑钉160。
现在参见图6-13，钉160可包括基部162、从基部162伸展的第一钉腿164、和从基部162伸展的第二钉腿166。基部162可具有例如近侧部分168和远侧部分170，并且基部162的中间部分172可被定位在例如近侧部分168和远侧部分170之间。如图6-13所示，第一钉腿164可从基部162的近侧部分168伸展，并且第二钉腿166可从基部162的远侧部分170伸展。钉腿164,166可包括例如尖端174，所述尖端174可具有尖的端部或基本上尖的端部。在各种实施方案中，尖端174可例如有利于刺穿到组织内和/或刺穿组织。在某些实施方案中，钉腿164,166可包括拐角边缘176，所述拐角边缘176可为例如尖锐的、或基本上尖锐的并且也可例如有利于刺穿到组织内和/或刺穿组织。在其他实施方案中，钉腿164,166可包括圆形的拐角边缘。
仍然参见图6-13，斜面184,186可被定位在钉腿164,166和基部162之间。例如，上部斜面184可在钉腿164,166和基部162之间伸展，并且/或者下部斜面186可在钉腿164,166和基部162之间伸展。当组织被钉160捕获时，组织可被压缩在基部162和变形的钉腿164,166之间，并且斜面184,186可接触压缩的组织。在各种实施方案中，斜面184,186可例如压缩捕获的组织，并且可例如防止基部162无意地刺穿和/或切割捕获的组织。
在各种实施方案中，钉160的基部162可相对于钉腿174,176为非对称的。例如，主要参见图10，第一轴线A可被限定在第一钉腿174和第二钉腿176之间，并且基部162可相对于第一轴线A为非对称的。基部162可为例如非线性的，并且可包括远离轴线A弯曲或挠曲的至少一个侧向波状部分178。基部162、或基部162的至少一部分可通过第二轴线B来限定。波状部分178可包括直的和/或弯曲的区域，并且可例如大致不平行于第一轴线A和第二轴线B。例如，波状部分178可远离第一轴线A弯曲或挠曲，包括直的部分或基本上直的部分，并且朝向第二轴线B弯曲或挠曲(图10)。
仍然参见图10，钉160的质心(COM)可偏离第一轴线A。在各种实施方案中，基部162的一部分可例如沿第二轴线B伸展，所述第二轴线B可平行于或基本上平行于第一轴线A。例如，基部162的中间部分172可平行于或基本上平行于第一轴线A。波状部分178可例如被定位在近侧部分168和中间部分172之间，并且另一个波状部分178可例如被定位在远侧部分170和中间部分172之间。波状部分178可例如使基部162的中间部分172侧向地偏离钉腿164,166和第一轴线A。在某些实施方案中，钉腿164,166可例如定位在由第一轴线A限定的第一平面中，并且基部162的中间部分172可定位在由第二轴线B限定的第二平面中。第二平面可例如平行于或基本上平行于第一平面，并且钉160的质心(COM)可定位在第一平面和第二平面之间。在此类实施方案中，钉160可包括腿形成平面，例如，由第一轴线A限定的平面，所述腿形成平面可从钉160的COM偏移。例如，钉160的变形可例如形成修改的“B形”，并且钉腿164,166可从钉基部162的中间部分172非共面地和/或侧向地偏移。在各种情况下，修改的“B形”钉形成物可例如接合、捕获、压缩、和/或影响更大体积的组织。另外，在某些情况下，修改的“B形”钉形成物可例如沿不同的和/或发散的方向对接合的组织施加力。修改的“B形”可限定沿三个不同方向伸展的组织截留区域。例如，组织截留区域的一部分可在两个方向上被腿164和腿166限定，并且组织截留区域的另一部分可在第三方向上被限定在基部162和腿164,166之间。
在各种实施方案中，钉基部162的中间部分172可包括纵向导向表面173。例如，如本文更详细地描述，当钉160从仓体142例如被击发和/或射出时(图4和图5)，纵向导向表面173可抵靠钉腔144中的导向表面150滑动和/或运动(图4和图5)。在此类实施方案中，纵向导向表面173可在部署期间平衡和/或稳定钉160。此外，钉基部162的中间部分172可包括可为例如平坦的或基本上平坦的组织接触表面175(图9)。在各种情况下，基部162的组织接触表面175可形成用于接触捕获的组织的平坦表面，所述平坦表面可提供宽的和/或平滑的表面以用于将压力施加和/或分布在捕获的和/或压缩的组织上。在此类实施方案中，例如，可降低和/或最小化钉160内的组织撕裂和/或创伤。
在各种实施方案中，钉160的基部162可包括多个驱动表面中的一个。例如，基部162可包括初始驱动表面180和第二驱动表面182。仍然参见图6-13，基部162的近侧部分168可包括例如初始驱动表面180，并且/或者基部172的中间部分172可包括第二驱动表面182。例如，近侧部分168可包括具有第一驱动表面180的凸块。第一驱动表面180的凸块可包括例如圆形表面和/或倾斜表面。第二驱动表面182可包括基部162的中间部分172上的斜坡。例如，第二驱动表面182可被定位在例如初始驱动表面180的远侧并且/或者定位在基部162的近侧部分168与远侧部分170之间。第二驱动表面182可包括例如倾斜表面或平面，并且可沿远侧部分170的方向向下倾斜(图7和图8)。
主要参见图7和图8，钉中线M可被限定在第一钉腿164和第二钉腿166中间。钉中线M可例如对分钉160，并且可穿过钉160的质心(COM)。在各种实施方案中，第二驱动表面182可伸展跨过中线M。例如，第二驱动表面182可沿基部162的中间部分172伸展，并且可从中线M的近侧跨越到中线M的远侧。在此类实施方案中，在钉160通过滑动件190进行部署期间，如本文更详细地描述，滑动件190的斜坡192可在钉部署的一部分期间将钉160驱动到钉160的中线M处和/或附近。在各种实施方案中，第二驱动表面182的远侧端部还可包括将在下文更详细地描述的钉过驱动结构188。主要参见图7，钉过驱动结构188可包括基部162的中间部分172的最低点，并且在一些实施方案中，可例如与基部162的近侧部分168和/或远侧部分170的最低点竖直地对准。在其他实施方案中，钉过驱动结构188可定位在基部162的近侧部分168和/或远侧部分170的最低部分的竖直下方或上方。
在各种实施方案中，钉160的驱动表面180,182可为独立的和分立的。例如，驱动表面180,182可侧向和/或纵向地偏离，使得驱动表面180,182为不连接的和/或不毗连的。每个驱动表面可为例如分立的。初始驱动表面180可例如重叠第一平面(参见图10中的轴线A)，并且第二驱动表面182可例如重叠第二平面(参见图10中的轴线B)。在某些实施方案中，驱动表面180,182可为平行的。例如，初始驱动表面180可沿第一轴线A伸展(图10)，并且第二驱动表面180可沿第二轴线B伸展(图10)。在各种实施方案中，具有宽度x的侧向间隙(图10和图11)可例如被限定在初始驱动表面180和第二驱动表面182之间。在一些实施方案中，具有宽度y的纵向间隙(图10)可例如被限定在初始驱动表面180和第二驱动表面182之间。初始驱动表面180可例如位于第二驱动表面182的近侧。此外，基部的非驱动部分(例如近侧部分168和中间部分172之间的波状部分178的下部斜面186)可例如将初始驱动表面180和第二驱动表面182隔开。在各种实施方案中，波状部分178可例如横贯在由轴线A限定的第一平面和由轴线B限定的第二平面之间。
仍然参见图6-13，钉160的驱动表面180,182中的至少一个可与钉160一体形成。例如，驱动表面180,182可限定在钉160的基部162中。钉160可包括例如单个一体件，所述单个一体件可一体地包括驱动表面180,182。驱动表面180,182可包括例如单个一体件的边界表面或周边表面。在各种情况下，钉160可为例如无缝的，并且可例如不包括任何粘附的和/或重叠注塑的特征结构。此外，例如，基部162和钉腿164,166可为连续部件，并且基部162可一体地限定驱动表面180,182。在某些情况下，如本文更详细地描述，钉160可例如由单块材料冲压形成或以其他方式形成，并且可例如保持为单块材料。在各种情况下，驱动表面180,182可包括成形件的表面或平面。
现在参见图14-17，滑动件190可从仓体142中的腔144(图3)驱动钉160。在各种情况下，滑动件190可直接接触钉160并且/或者可直接驱动钉160。例如，滑动件190可包括斜坡或倾斜表面192，所述斜坡或倾斜表面192可接触钉160的至少一个驱动表面180,182。当滑动件190相对于钉160平移时，斜坡192可推动驱动表面180,182以提升钉160。在各种实施方案中，斜坡192的斜度可为沿其长度变化的。例如，斜坡192可被设计成在钉部署的至少一部分期间较快地和/或较慢地提升钉160。此外，斜坡192的斜度可基于钉驱动表面180,182的斜度来设计和/或选择。例如，斜坡192可限定大于、小于、和/或等于初始驱动表面180和/或第二驱动表面182的斜度的斜度。斜坡192斜度和驱动表面180,182斜度之间的关系可例如影响钉部署的速度。
仍然参见图14-17，滑动件190可包括至少一个侧向部分191a,191b。例如，滑动件190可包括单个侧向部分、一对侧向部分、和/或多于两个侧向部分。在各种情况下，每个侧向部分191a,191b可对应于可移除地定位在仓体142中的一排钉160。如图14-17进一步所示，侧向部分191a,191b可为纵向交错的。例如，在某些实施方案中，第一侧向部分191a可比第二侧向部分191b滞后或落后距离长度L(图14和图16)。在其他实施方案中，例如，侧向部分191a,191b可为纵向对准的并且/或者第二侧向部分191b可滞后或落后于第一侧向部分191a。在滑动件190包括多个侧向部分191a,191b的实施方案中，中间部分193可例如连接和/或桥接侧向部分191a,191b。
主要参见图14-17，滑动件190可在钉160的驱动表面180,182之间转移。换句话说，滑动件190可例如在钉160的初始驱动表面180上施加驱动力，并且可随后转变成在钉160的第二或第二驱动表面182上施加驱动力。在某些实施方案中，滑动件斜坡192可包括前端表面194和后端表面196。前端表面194可例如相邻于和/或连接到后端表面196，并且钉160可在前端表面194和后端表面196之间平滑地过渡。例如，前端表面194可接触钉160并且开始提升钉160，并且后端表面196可运动成与钉160接触并且继续提升钉160。在某些情况下，后端表面196可例如平滑地提升钉160，以脱离接合和/或远离前端表面194。
仍然参见图14-17，例如，前端表面194可与初始驱动表面180对准并且后端表面196可与第二驱动表面182对准。在手术时，斜坡192的前端表面194可首先接触钉160。例如，参考图14和图15，当滑动件190平移时，前端表面194可接触钉160的初始驱动表面180。倾斜的前端表面194可在初始驱动表面180上施加驱动力，由此可开始提升钉160的基部162。例如，钉160可通过前端表面194提升第一距离或第一高度。现在参见图16和图17，当滑动件190继续平移时，后端表面196可例如移动成与钉160的第二驱动表面182接触接合。倾斜的后端表面196可例如在第二驱动表面182上施加驱动力，由此可继续提升钉160的基部162。例如，钉160可通过后端表面194提升第二距离或第二高度。
在各种情况下，后端表面196可例如提升初始驱动表面180，使得初始驱动表面180远离并且/或者脱离接触斜坡192的前端表面194。例如，后端表面196可接触第二驱动表面182并且直接提升钉160，使得主驱动表面180被移动成与前端表面194脱离驱动接触。在其他实施方案中，前端表面194可驱动初始驱动表面180并且后端表面196可驱动第二驱动表面，以同时用于钉部署的至少一部分。当滑动件190继续平移时，后端表面196可提升基部162离开钉腔144(图4和图5)和/或可从仓140射出钉160(图4和图5)。例如，后端表面196的近侧部分可包括滑动件过驱动结构198。在各种实施方案中，滑动件过驱动结构198可伸展出钉腔144并且可提升钉过驱动结构188，即，基部162的中间部分172的最低部分(参见图7)，以离开钉腔144。
根据本公开的示例性专利申请的多个钉160的部署示于图18-21中。在某些实施方案中，多排钉腔144可限定在仓体142中。例如，多排钉腔144可限定在仓狭槽143的第一侧(图3)，并且多排钉腔144可限定在仓狭槽143的第二侧。图18-21示出了定位在仓体142内的两排钉腔144中的两排钉160。仍然参见图18-21，钉160a、钉160c、和160e可定位在例如较内侧排钉腔144中，并且钉160b、钉160d、和钉160f可定位在例如较外侧排钉腔144中。在各种实施方案中，第一内侧钉160a可被定位成比第一外侧钉160b更靠近仓狭槽143。例如，第一内侧钉160a可与仓狭槽143相邻，并且第一外侧钉160b可例如位于第一内侧钉160a和仓体142的侧面中间。在各种实施方案中，附加排的钉160可限定在仓体142中。例如，至少一排钉可定位在第一钉160a和仓狭槽143中间，并且/或者至少一排钉160可例如定位在第一外侧钉160b和仓体142的侧面中间。
主要参见图18，当滑动件190朝远侧运动时，第二侧向部分191b可接触第一内侧钉160a。第二侧向部分191b的前端表面194(图14-17)例如可开始提升第一内侧钉160a。现在参见图19，例如，当滑动件190继续朝远侧运动时，第二侧向部分191b的后端表面196(图14-17)可继续提升第一内侧钉160a，并且可使第一内侧钉160a运动到与端部执行器120的砧座152形成接触。另外，例如，第二侧向部分191b的前端表面194可运动到与第二内侧钉160c接触。在各种情况下，例如，第一侧向部分191a可运动到与第一外侧钉160b接触，同时第二侧向部分191b可运动到与第二内侧钉160c接触。在某些实施方案中，第一侧向部分191a和第二侧向部分191b之间的纵向滞后或偏移可对应于第一外侧钉160b和第二内侧钉160c之间的纵向距离。例如，第一侧向部分191a可比第二侧向部分191b滞后长度L(图14和16)，并且第一外侧钉160b可相对于第二内侧钉160c纵向地偏移长度L。在此类实施方案中，第一外侧钉160b和第二内侧钉160c的部署可例如为同时的和/或同步的。
现在参见图20，当滑动件190继续行进时，第二侧向部分191b的后端表面196可继续朝砧座152提升第一内侧钉160a。限定在砧座152中的钉成形凹坑154可捕获钉腿164,166，并且可使第一内侧钉160a变形。此外，例如，第二侧向部分191b可继续提升第二内侧钉160c，并且第一侧向部分191a可接续提升第一外侧钉160b。现在参见图21，当滑动件190继续朝远侧运动时，第二侧向部分191b可从钉腔144射出第一内侧钉160a。在各种情况下，滑动件过驱动结构198(图14-17)例如可提升钉过驱动结构188，以使钉基部162离开仓体142。当砧座124的钉成形凹坑154继续使第一内侧钉160a成形时，例如，第二侧向部分191b可继续提升第二内侧钉160c，并且第一侧向部分191a可继续提升第一外侧钉160b。另外，第二侧向部分191b可例如运动到与第三内侧钉160e接触，并且第一侧向部分191a可例如运动到与第二外侧钉160d接触。在各种情况下，与上文相似，第二外侧钉160d可相对于第三内侧钉160e纵向地偏移长度L(图14和图16)。
如本文所述，钉160可从仓140被相继地击发。例如，当滑动件190朝远侧运动时，滑动件190可从仓体142的近侧部分朝仓体142的远侧部分相继地击发钉160。如本文所述，滑动件190可在击发第二、较远侧内侧钉160c之前击发第一、较近侧内侧钉160c。在其他实施方案中，滑动件190可朝近侧平移以从钉仓击发钉160。在此类实施方案中，滑动件190可从钉仓140的远侧部分朝钉仓140的近侧部分相继地击发钉160。此外，钉160从钉仓140的击发可为步进的或同步的。例如，第一外侧钉160b和第二内侧钉160c可被同时击发，并且/或者例如，第二外侧钉160d和第三内侧钉160e可被同时击发。例如，滑动件190的第一侧向部分191a与滑动件190的第二侧向部分191b之间的纵向偏移可对应于第一排钉腔中的钉160与第二、不同排钉腔中的钉160之间的纵向距离。在此类实施方案中，钉160的部署可被定时，以使得第一排钉腔中的钉160与第二排钉腔中的钉160被同时击发。钉部署的定时或定步可改善击发期间的组织定位和/或布置。例如，组织的部分可通过端部执行器钳口123,124保持在适当位置(图3)，并且这些部分可被同时缝合。但在其他情况下，191a和191b之间的偏移可不同于钉排中的钉之间的偏移。
钉部署的示例性实施方案进一步地示于图22-31中。例如，钉160a,160b,160c，和160d能够被定位在仓狭槽140的两侧，并且能够以可射出的方式定位在限定于仓体142内的钉腔144中。主要参见图22和图23，钉160a,160b,160c，和160d可为未击发的，并且滑动件190可定位在仓体142的近侧。滑动件190可与仓体142中的成排的钉腔144对准。例如，第一滑动件190可与第一内侧排钉腔144中的钉160a,160c并且与第一外侧排钉腔144中的钉160b,160d对准，并且第二滑动件190可与第二内侧排钉腔144中的钉160a,160c并且与第二外侧排钉腔144中的钉160b,160d对准。例如，每个滑动件190的第一侧向部分191a可与外侧钉160b,160d对准，并且每个滑动件190的第二侧向部分191b可与内侧钉160a,160c对准。
主要参见图24和图25，第一内侧钉160a可相对于仓体142运动或提升到部分击发位置。例如，每个滑动件190的第二侧向部分191b可运动到与第一内侧钉160a接合。第二侧向部分191b的前端表面194可使第一内侧钉160a提升第一距离。随后，后端表面196可运动到与第一内侧钉160a接合，以进一步提升第一内侧钉160a。在各种实施方案中，例如，滑动件190的远侧平移可为协调的，并且狭槽143的每一侧的第一内侧钉160a可被同时击发。当第一内侧钉160a被提升时，每个钉160a的一部分可抵靠钉腔144的纵向导向表面150滑动或运动，并且纵向导向表面150可支撑和/或平衡由滑动件190产生的扭矩，如本文更详细地描述。
现在参见图26和图27，当滑动件190相对于仓140继续平移时，滑动件190可运动到与第一外侧钉160b和第二内侧钉160c接合。在各种情况下，滑动件190可同时接触第一外侧钉160b和第二内侧钉160c。例如，当滑动件190的第二侧向部分191b可例如接触第二内侧钉160c时，滑动件190的第一侧向部分191a可接触第一外侧钉160b。主要参见图27，滑动件190的第一侧向部分191a和第二侧向部分191b的前端表面194可接合钉160b,160c的初始驱动表面180，并且可相对于仓体142提升钉160b,160c。另外，滑动件190的第二侧向部分191b的后端表面196可例如继续提升第一内侧钉160a。当第一内侧钉160a继续运动以离开钉腔144时，砧座152(图18-21)可开始使第一内侧钉160a变形。例如，钉成形凹坑154(图18-21)可捕获、翻卷和/或弯曲第一内侧钉160a的腿164,166。如本文所述，砧座152可例如使钉160a变形为修改的“B形”。
现在参见图28和图29，当滑动件190相对于钉仓140继续平移时，滑动件190的第二侧向部分191b可例如继续提升第一内侧钉160a，并且砧座152(图18-21)可例如使第一内侧钉160a继续变形。在各种情况下，滑动件190还可继续提升第一外侧钉160b和第二内侧钉160c。例如，滑动件190的后端表面196可运动到与第一外侧钉160b和第二内侧钉160c的第二驱动表面182接合，并且可例如向上提升钉基部162，使得钉腿164,166继续运动以离开仓体142。
现在参见图30和图31，当滑动件190相对于仓140继续平移时，滑动件190的第二侧向部分191b可继续同时提升第一内侧钉160a。例如，滑动件过驱动结构198(图16和图17)可提升第一内侧钉160a以完全离开仓体142，使得第一内侧钉160a从钉仓140被完全射出。在各种情况下，砧座152(图18-图21)可例如使第一内侧钉160a继续变形，并且第一内侧钉160a可在被提升到完全离开仓体142时完全变形。另外，滑动件190的后端表面196还可继续同时提升第一外侧钉160b和第二内侧钉160c。例如，第一侧向部分191a的后端表面196可提升或驱动第一外侧钉160b，并且第二侧向部分191b的后端表面196可例如提升或驱动第二内侧钉160c。此外，当第一外侧钉160b和第二内侧钉160c继续运动到离开钉腔144时，砧座152(图18-21)可开始使第一外侧钉160b和第二内侧钉160c变形。例如，钉成形凹坑154(图18-21)可捕获、翻卷和/或弯曲第一外侧钉160b和第二内侧钉160c的腿164,166。在各种情况下，滑动件190可相对于仓体142继续平移，并且滑动件190的第一侧向部分191a和第二侧向部分191b可继续定步和/或定时钉160从相邻和/或毗邻钉排的部署。滑动件190可从钉仓140的近侧部分到钉仓140的远侧部分来相继地击发钉160。在其他实施方案中，滑动件190例如可朝近侧运动并且可从钉仓140的远侧部分朝钉仓140的近侧部分击发钉160。此外，在某些情况下，钉和侧向滑动件部分之间的间距可例如影响钉的非同步部署。
现在参见图56-64，在各种情况下，当滑动件190移动钉160以完成击发进度时，钉腔144可导向钉160。例如，在各种情况下，滑动件190的前端表面194可接触钉160的初始驱动表面180，并且可通过初始驱动表面180(图56-58)在钉160上施加驱动力D1(图58)。前端表面194可沿着由轴线E(图57)和轴线F(图58)限定的平面向上提升钉160。如图57和图58所示，钉的质心(COM)可偏离轴线E和轴线F，并且在此类实施方案中，在由轴线E和轴线F限定的平面中施加到初始驱动表面180上的驱动力D1(图58)可产生扭矩Τ1(图58)。如本文更详细地描述，钉腔144可包括位于钉腔144的近侧端部146和远侧端部148之间的纵向侧壁150。在某些实施方案中，钉腔144可包括第一侧壁150a和第二侧壁150b。此外，如本文所述，侧壁150a,150b可抵抗钉160在击发期间的扭转。例如，当滑动件190的前端表面194沿着由轴线E和轴线F限定的平面驱动钉160的初始驱动表面180时，第二侧壁150b可抵抗对应于由滑动件190产生的驱动力D1的逆时针方向扭矩Τ1(图58)。当钉160通过滑动件190的前端表面194提升第一距离时，第二侧壁150b可导向并且支撑钉基部162的中间部分172。例如，钉基部162的中间部分172的平坦表面173可沿着第二侧壁150b滑动和/或抵靠第二侧壁150b运动。
现在参见图59-61，当滑动件190在初始驱动表面180和第二驱动表面182之间转变时，如本文所述，滑动件190的后端表面196可通过第二驱动表面182在钉160上施加驱动力D2(图61)。在各种情况下，滑动件190的后端表面196可沿着由轴线I(图60)和轴线J(图61)限定的平面向上提升钉160的基部162。如图60和图61所示，钉的质心(COM)可偏离由轴线I和轴线J限定的平面，并且在此类实施方案中，通过滑动件190的后端表面196施加在第二驱动表面182上的驱动力D2(图61)可产生扭矩Τ2(图61)。在比较图58和图61时，可以看出，驱动力D1在COM的第一侧被施加到钉160，并且驱动力D2被施加到COM的相对侧。在各种情况下，例如，扭矩Τ1可位于第一方向上，并且扭矩Τ2可位于第二方向上，并且第二方向可与第一方向相反。当后端表面196沿着由轴线I和轴线J限定的平面驱动钉160的第二驱动表面182时，第一侧壁150a可抵抗顺时针扭矩Τ2(图61)。当钉160通过后端表面194被提升第二距离时，第一侧壁150a可导向并且支撑钉基部162的近侧端部168和远侧端部170。例如，基部162的近侧端部168和远侧端部170可沿着第一侧壁150a滑动和/或抵靠其运动。
读者将会知道，在某些实施方案中，本文相对于钉的COM描述的各种钉和/或其特征结构可类似地适用于钉的几何中心。在各种情况下，钉诸如钉160例如可包括单一材料和/或可具有均一的成分。在此类实施方案中，钉的COM可对应于钉的几何中心。在其他实施方案中，钉可包括多种材料和/或不均一的成分。例如，钉可由已被焊接和/或以其他方式接合在一起的多个部分和/或多种材料形成。在某些实施方案中，可例如将具有至少两种不同材料的多个片材焊接在一起，并且可从包括不止一种材料的焊接片材的一部分切割钉。在某些实施方案中，可例如将具有至少两种不同材料的多个片材层合、轧制和/或密封在一起，并且可从包括不止一种材料的焊接片材的一部分切割钉。在此类实施方案中，钉的COM可偏离钉的几何中心。例如，钉的COM可侧向地和/或纵向地偏离钉的几何中心。
如图58和图61所示，滑动件190可在部署期间将竖直驱动力D1、D2施加到钉160上。读者将会知道，由滑动件190产生的驱动力也可包括水平分量。在各种实施方案中，当钉160由滑动件190提升时，钉腔144的近侧端部146和/或远侧端部148可导向并且支撑钉腿164,166。在各种实施方案中，钉腔144的近侧端部146和/或远侧端部148可平衡由驱动力的水平分量产生的扭矩。例如，当滑动件190朝远侧运动时，钉腔144的远侧端部148可抵抗钉160在部署期间的旋转或扭转。现在参见图62-64，后端表面196可继续提升钉160以离开钉腔144。例如，滑动件过驱动结构198可接触钉过驱动结构188，由此提升钉160的基部162以离开仓体140。
现在参见图45-47，钉仓诸如钉仓240例如可被加载到端部执行器120的细长通道122内(图3)。钉诸如钉160例如能够以可射出的方式定位在钉仓240中。例如，滑动件190(图14-17)可平移穿过钉仓240以从其射出钉160。在各种情况下，钉仓240可包括仓体242和限定在仓体242中的腔244。钉160能够例如可移除地定位在钉腔244中。例如，每个钉腔244能够可移除地存储单个钉160。此外，每个钉腔244可例如具有近侧端部246和远侧端部248，并且纵向侧壁250可在每个钉腔244的近侧端部246和远侧端部248之间伸展。类似于本文所述的腔144，近侧端部246、远侧端部248、和/或纵向侧壁250可在击发期间导向和/或支撑钉160。例如，纵向侧壁250可平滑由平移滑动件190施加到钉160上的扭矩。在各种情况下，腔244还可包括位于侧壁250之间的对角导向表面251。例如，近侧对角导向表面251a可在腔244的近侧端部246和腔244的侧壁250之间伸展。除此之外或另选地，远侧对角导向表面251b可在腔244的远侧端部248和腔244的侧壁250之间伸展。对角导向表面251a,251b可例如当钉160在钉腔244内被提升时导向和/或支撑钉160的波状部分178(图6-13)。例如，波状部分178的一部分可沿着对角导向表面251a,251b滑动和/或抵靠其运动。在此类构造中，对角导向表面251a,251b可例如平衡施加到钉160上的扭矩。
现在参见图32A-32C，可从材料片诸如材料片130切割、形成和/或压印钉诸如钉160。材料片130可例如为金属的，并且可包括例如不锈钢和/或钛。在各种情况下，材料片130可为基本上平坦的和/或光滑的。此外，在某些情况下，材料片130可在多个区域诸如第一区域134和第二区域136处为弯曲的、折叠的、波状的和/或卷曲的。材料片130可例如利用冲压机和/或压印机进行弯曲。材料片130的平坦的或基本上平坦的部分135a,135b，和135c可例如定位在区域134,136中间。第一区域134可例如位于平坦部分135a和135b中间，并且第二区域136可例如位于平坦部分135b和135c中间。在各种情况下，平坦部分135a和135c可例如为共面的，并且/或者平坦部分135b可例如平行于和/或基本上平行于平坦部分135a和/或平135c。主要参见图32A，多个平坦片材130a,130b,130c,130d,130e,130f可被堆叠，并且随后同时在区域134和136处进行弯曲。在其他实施方案中，片材130a,130b,130c,130d,130e,130f可例如单独进行弯曲，并且随后被堆叠。
在各种情况下，可从弯曲片材130切割、形成和/或压印钉160。例如，主要参见图32B，可将钉轮廓132描记、蚀刻、和/或切割到弯曲片130内。钉轮廓132可例如被加工和/或激光切割到弯曲片130内。在各种情况下，可使用电火花加工(EDM)线138来切割钉轮廓132。此外，在某些情况下，可同时切割多个堆叠片材130。在某些实施方案中，主要参见图32C，钉轮廓132可形成钉160的边界或周边。例如，钉轮廓132可形成钉160(图6-13和图33-36)，并且/或者例如可形成具有各种类似于钉160的特征结构的钉。在各种情况下，可将多个钉轮廓132切割到材料片130内，并且可由单个材料片130形成多个钉160。如图32B和图32C所示，EDM线138可同时穿过不止一个材料片130，以每次切割不止一个钉160。尽管六个片材130正同时被EDM线138切割，但任何合适数量的片材130可被同时切割。例如，线138可同时切割少于六个片材130或者同时切割多于六个片材130。
例如，参考图32C和图33-36，钉轮廓132可例如形成基部162和/或钉腿164,166。此外，钉轮廓132可包括至少一个一体地形成的钉驱动表面。例如，钉轮廓132可包括初始驱动表面180和/或第二驱动表面182。换句话讲，可在从材料片130切割钉160的同时加工和/或形成初始驱动表面180和/或第二驱动表面182。在某些情况下，片材130的弯曲或波状区域134,136(图32A和图32B)可形成钉160的波状部分178。此外，例如，片材130的侧向平坦部分135a和135c(图32A和图32B)可对应于钉腿164和166，并且片130的中间平坦部分135b(图32A和图32B)可对应于基部162的中间部分172。
在各种情况下，钉160的深度D1(图34和图36)可由材料片130的深度确定。例如，材料片130可基于其深度来选择，并且由材料片130形成的钉160可具有与材料片130相同的深度。此外，基部162和钉腿164,166的高度H1(图35)和宽度W1(图35)可由钉轮廓132确定。在各种情况下，钉轮廓132可沿着每个部件的长度提供钉部件的高度和/或宽度变化。例如，基部162的高度H1和/或钉腿164,166的宽度W1可沿其长度有所变化。此外，斜坡、台阶、和/或其他变型可由钉轮廓132限定，并且因此，钉160的几何形状可基于钉160和/或可与钉160一起使用的端部执行器120的目的、应用、和/或设计来选择和/或调控。
主要参见图33-36，在各种情况下，钉160可被切割，以使得基部162的高度H1与钉腿164,166的深度D1无关和/或不同。例如，钉腿164,166的深度D1可对应于材料片130的深度，并且基部162可被切割成适当高度H1，所述适当高度H1可例如与材料片130的深度和/或对应的腿深度D1无关。所述适当高度H1可例如取决于钉160和/或可与钉160一起使用的端部执行器120(图3)的目的、应用、和/或设计。此外，基部162的高度H1也可沿其长度有所变化。例如，高度H1可例如在钉160的驱动表面处和/或附近并且/或者在钉腿164,166中的一者与基部162之间的角撑件处有所变化。钉轮廓132可例如沿着基部162的长度提供至少一个斜坡和/或台阶。钉轮廓132可例如包括斜坡或斜坡，所述斜坡或斜坡可形成基部162的第二驱动表面182。第二驱动表面182的斜度可通过钉轮廓132来选择、设计和实现。在某些实施方案中，基部162的高度H1可大于钉腿164,166的深度D1。在其他实施方案中，基部162的高度H1可等于或小于钉腿164,166的深度D1。相比而言，由弯曲线形成的钉的几何形状可基于初始线的尺寸而受到约束和/或限制。例如，在线形成的钉中，钉基部的高度通常对应于钉腿的宽度，所述钉腿的宽度通常对应于线的直径。尽管拉延和/或轧制例如可修改线的直径，但材料的体积限制和/或约束可容许的修改。
在各种情况下，钉腿164,166的宽度W1也可例如与钉腿164,166的深度D1和基部162的高度H1无关。钉腿164,166可例如基于钉160和/或可与钉160一起使用的端部执行器120(图3)的应用、目的、和/或设计而被切割成适当的宽度W1。在某些实施方案中，钉腿164,166可例如包括不同的宽度，并且/或者钉腿164,166的宽度可沿其长度渐缩、成台阶形式、或以其他方式变化。例如，钉腿164,166可在尖端174处渐缩，以形成刺穿边缘或刺穿点。
现在参见图37-40，可将钉轮廓232描记、切割、蚀刻、和/或加工到材料片130内(图32A和图32B)，并且可例如从材料片130形成类似于钉160(图33-36)的钉260。例如，钉260可包括基部262和从基部262伸展的钉腿264,266。在各种实施方案中，钉260可包括波状部分278，所述波状部分278可对应于形成钉260的材料片130(图32A和图32B)的弯曲和/或波状区域134,136。在某些实施方案中，钉260可例如包括波状部分278之间的中间部分272。此外，可沿着钉260的周边通过钉轮廓232形成至少一个驱动表面280,282。
类似于钉160，钉腿264,266的深度D1可对应于材料片130的深度。此外，在各种情况下，钉基部262的高度H2可与钉腿264,266的深度D1无关和/或与材料片130的深度无关。例如，如图37-40所示，钉基部262的高度H2小于钉基部162的高度H1(图33-36)，并且钉腿264,266的深度D2例如等于钉腿164,166的深度D1。在各种实施方案中，钉腿264,266的宽度W2也可与钉腿264,266的深度D2无关。钉基部262的高度H1和钉腿264,266的宽度W2可例如基于钉260和/或端部执行器120(图3)的目的、应用、和/或设计来选择。
现在参见图41-44，可将钉轮廓332描记、切割、蚀刻、和/或加工到材料片130内(图32A和图32B)，并且可例如从材料片130形成类似于钉160和260(图33-40)的钉360。例如，钉360可包括基部362和从基部362伸展的钉腿364,366。在各种实施方案中，钉360可包括波状部分378，所述波状部分378可对应于形成钉360的材料片130(图32A和图32B)的弯曲和/或波状区域134,136。在某些实施方案中，钉360可例如包括波状部分378之间的中间部分372。此外，可沿着钉360的周边通过钉轮廓332形成至少一个驱动表面380和382。
类似于钉160和钉260，钉腿364,366的深度D3对应于材料片130的深度。此外，在各种情况下，钉基部362的高度H3可与钉腿364,366的深度D3无关和/或与材料片130的深度无关。例如，如图41-44所示，钉基部362的高度H3大于钉基部162的高度H1(图33-36)并且大于钉基部262的高度H2(图37-40)，并且例如，钉腿364,366的深度D3等于钉腿164,166的深度D1并且等于钉腿264,266的深度D2。在各种实施方案中，钉腿364,366的宽度W3也可与钉腿364,366的深度D3无关。钉基部362的高度H3和钉腿364,366的宽度W3可例如基于钉360和/或端部执行器120(图3)的目的、应用、和/或设计来选择。
现在参见图48-51，钉诸如钉460例如可用于钉仓诸如钉仓140(图3-5)和/或钉仓240(图45-47)中。钉460可包括具有近侧部分468和远侧部分470的基部462。中间基部部分472可例如定位在近侧部分468和远侧部分470之间。如图48-51所示，第一钉腿464可从基部462的近侧部分468伸展，并且第二钉腿466可从基部的远侧部分470伸展。在各种情况下，钉腿464,466可例如为圆柱形的或基本上圆柱形的，并且可包括例如钉尖端474，所述钉尖端474可为渐缩的并且/或者包括锋利的边缘或点以用于刺穿组织。在其他实施方案中，钉腿464,466可例如包括圆形的和/或多边形的周边。钉基部462的中间部分472可包括可例如为平坦的或基本上平坦的组织接触表面473。在各种情况下，钉460可由例如线形成，所述线可例如被弯曲、扭曲、和/或以其他方式操纵以形成钉腿464,466和/或钉基部462。在各种实施方案中，线的直径可例如限定钉腿464,466的宽度和深度。在一些实施方案中，线可被拉延和/或轧制，以修改钉460的尺寸。在某些情况下，线基部462的中间部分462可进行成形和/或平坦化以形成组织接触表面473。在各种情况下，基部462可例如在两个平行的或基本上平行的板之间进行平坦化，使得基部462的组织接触表面473和底部表面475为平坦的或基本上平坦的并且/或者为平行的或基本上平行的。对基部162的修改可例如受到线的材料的体积的限制和/或约束。
仍然参见图48-51，钉460可包括斜面和/或角撑件。例如，斜面484可在第一钉腿464和基部462之间伸展，并且/或者斜面484可在第二钉腿466和基部462之间伸展。在某些实施方案中，斜面484可例如相对于在第一钉腿464和第二钉腿466之间伸展的纵向轴线G(图49)并且/或者相对于沿钉腿464,466的长度伸展的竖直轴线H(图51)为非对称的。例如，斜面484可远离轴线G和/或轴线H而伸展，并且因此，在某些实施方案中，基部462的中间部分472可偏离轴线G和/或轴线H。例如，基部462的质心可偏离由轴线G和轴线H限定的平面。在各种情况下，基部462的偏离中间部分472可形成用于接触捕获的组织的宽表面和/或平坦表面，由此可提供宽阔和/或平滑的表面以用于在捕获的组织上施加和/或分布压力。在此类实施方案中，可降低和/或最小化钉460内的组织撕裂和/或创伤。此外，类似于本文所述的钉160,260，和/或360，钉460可包括腿形成平面，例如，由轴线G和轴线H限定的平面，所述腿成形表面可例如偏离钉460的基部462的质心。
现在参见图52-55，钉诸如钉560例如可用于钉仓诸如钉仓140(图3-5)和/或钉仓240(图45-47)中。钉560可包括具有近侧部分568和远侧部分570的基部562。中间基部部分572可例如定位在近侧部分568和远侧部分570之间。如图52-55所示，第一钉腿564可从基部562的近侧部分568伸展，并且第二钉腿566可从基部562的远侧部分570伸展。在某些实施方案中，基部560的中间部分572可例如沿着轴线D(图53)伸展，所述轴线D可平行于和/或基本上平行于限定在第一钉腿564和第二钉腿566之间的轴线C(图53)。
在各种情况下，钉腿564,566可例如为圆柱形的或基本上圆柱形的，并且可包括例如钉尖端574，所述钉尖端574可为渐缩的并且/或者包括锋利的边缘或点以用于刺穿组织。在各种情况下，钉560可由线形成。例如，线可被弯曲、扭曲、和/或以其他方式操纵以形成钉560。仍然参见图52-55，线可在弯曲579a,579b,579c，和/或579d处进行操纵。例如，钉基部562可包括成角部分578，所述成角部分578可例如相对于钉基部562的中间部分572并且/或者相对于限定在第一钉腿564和第二钉腿566之间的轴线C为成角度地取向的。在各种实施方案中，形成钉560的线可例如在第一钉腿564和成角部分578a之间的579a处弯曲，在成角部分578a和中间部分572之间的579b处弯曲，在中间部分572和成角部分578b之间的579c处弯曲，并且/或者在成角部分578b和第二钉腿566之间的579d处弯曲。例如，基部562的中间部分572可侧向地偏离在第一钉腿564和第二钉腿566之间伸展的轴线C(图53)。
在各种实施方案中，线的直径可例如限定钉腿564,566和/或钉基部562的宽度和深度。在一些实施方案中，线和/或其一部分可被拉延和/或轧制，以修改钉560和/或钉560的元件的尺寸。此外，线可具有圆形的和/或多边形的周边。在某些实施方案中，线可例如被成一角度地切割，以形成钉尖端574。类似于本文所述的钉160,260,360和/或460，钉560可包括腿形成平面，例如，由轴线C限定的平面，所述腿成形表面可例如偏离钉560的基部562的质心。
除上述之外，现在转向图65，端部执行器诸如端部执行器120可包括定位在细长通道122内的钉仓240以及此外能够定位在钉仓240对侧的砧座124。在各种情况下，仓240可包括多个钉腔244、定位在钉腔244中的每个中的紧固件诸如钉460、和其中被构造成能够可滑动地接收刀158的纵向狭槽243。尽管钉460结合图65所示的实施方案被示出，但任何合适的钉或紧固件可与该实施方案一起使用，诸如钉160。大体参见图73和图74，端部执行器120可从可包括闭合管115的轴114伸展。当闭合管115朝远侧推进时，闭合管115可接触砧座124并且使砧座124在打开位置(图73)和闭合位置(图74)之间旋转。一旦砧座124已闭合，就可朝远侧推进刀158，以横切捕获在砧座124和仓240之间的组织。在本文所公开的某些端部执行器中，定位在端部执行器120内的仓还包括紧固件击发致动器诸如滑动件190，所述紧固件击发致动器可被刀158朝远侧推动以在刀158横切组织的同时从仓部署钉。参照图65所示的实施方案，钉仓可例如包括紧固件击发致动器诸如滑动件组件790，所述滑动件组件790可与刀158一起或并排被朝远侧推进以从仓240射出钉460。例如，缝合器的轴114可包括被构造成能够推进刀158的击发杆157以及此外被构造成能够推进滑动件组件790的推杆159。尽管击发杆157和推杆159可同时推进，但在各种情况下，它们的操作可被定时，以使得它们的初始远侧运动可相对于彼此为交错的，如将在下文更详细地描述。除了击发杆157和推杆159之间的初始相对运动之外，滑动件组件790可包括可相对于彼此运动的两个或更多个部分，如另外将在下文更详细地描述。
主要参见图66-69，滑动件组件790可包括第一滑动件部分792和第二滑动件部分793。第一滑动件部分792可包括内侧斜坡部分791a和外侧斜坡部分791b。如图66和图67所示，外侧斜坡部分791b相对于内侧斜坡部分791a为侧向定位的。外侧斜坡部分791b还相对于内侧斜坡部分791a朝远侧伸展。相似地，第二滑动件部分793可包括内侧斜坡部分794a和外侧斜坡部分794b。如图68和图69所示，外侧斜坡部分794b相对于内侧斜坡部分794a为侧向定位的。外侧斜坡部分794b还相对于内侧斜坡部分794a朝远侧伸展。在各种情况下，内侧斜坡部分791a被构造成能够提升或至少部分地提升内侧钉排，而外侧斜坡部分791b被构造成能够提升或至少部分地提升外侧钉排。如图67主要所示，内侧斜坡部分791a和外侧斜坡部分791b可各自包括斜坡表面，诸如分别包括斜坡表面795a和斜坡表面795b，所述斜坡表面795a和斜坡表面795b可分别在内侧钉排和外侧钉排中的钉下方滑动。内侧斜坡部分791a和外侧斜坡部分791b的斜坡表面795a和斜坡表面795b被构造成能够将钉从未击发位置提升到至少部分击发位置。在各种情况下，内侧斜坡部分791a和外侧斜坡部分791b的斜坡表面795a和斜坡表面795b可例如各自包括至少一个倾斜表面、弯曲表面、弧形表面、和/或凸状表面。
除上述之外，第二滑动件部分793的内侧斜坡部分794a可包括内侧斜坡表面796a，并且相似地，第二滑动件部分793的外侧斜坡部分794b可包括外侧斜坡表面796b。在各种情况下，第一滑动件部分792的内侧斜坡表面795a被构造成能够与第二滑动件部分793的内侧斜坡表面796a相配合，以将内侧钉排中的钉从其未击发位置提升到其完全击发位置。更具体地讲，例如，内侧斜坡部分791a可将内侧钉排中的钉从未击发位置提升到部分击发位置，其中内侧斜坡部分794a可随后将钉从其部分击发位置提升到完全击发位置。在此类情况下，内侧钉排中的钉的提升动作可由第一滑动件部分792的内侧斜坡部分791a启动，转移到第二斜坡部分793的内侧斜坡表面796a，并且随后由第二斜坡部分793来完成。相似地，第一滑动件部分792的外侧斜坡表面795b被构造成能够与第二滑动件部分793的外侧斜坡表面796b相配合，以将外侧钉排中的钉从其未击发位置提升到其完全击发位置。更具体地讲，例如，外侧斜坡部分791b可将外侧钉排中的钉从未击发位置提升到部分击发位置，其中外侧斜坡部分794b可随后将钉从其部分击发位置提升到完全击发位置。在此类情况下，外侧钉排中的钉的提升动作可由第一滑动件部分792的外侧斜坡部分791b启动，转移到第二斜坡部分793的外侧斜坡表面796b，并且随后由第二斜坡部分793来完成。一旦内侧斜坡部分794a的顶点798已在钉下方穿过，内侧钉排中的钉的击发或提升动作就可完成。相似地，一旦外侧斜坡部分794b的顶点798已在钉下方穿过，外侧钉排中的钉的击发或提升动作就可完成。
再次参见图65，滑动件组件790可包括不止一个第一滑动件部分792和/或不止一个第二滑动件部分793。在各种情况下，滑动件组件790可包括第一组滑动件部分和第二组滑动件部分，所述第一组滑动件部分包括第一滑动件部分792和第二滑动件部分793，所述第二组滑动件部分包括第一滑动件部分792和第二滑动件部分793。在某些情况下，第二组滑动件部分可构成第一组的镜像。本文中为了简化滑动件组件790的说明目的，可参考仅一组滑动件部分；然而，读者应当理解，有关一组滑动件部分的操作也可适用于任何合适数量组的滑动件部分的同时操作。
除上述之外，仓240的外侧钉排(即，最远离通道243的排)可在内侧钉排(即，最靠近通道243的排)之前。换言之，外侧排中的钉的变形可在内侧排中的侧向相邻钉的变形之前或者至少略靠前开始。在其他情况下，仓240的外侧钉排(即，最远离通道243的排)可在内侧钉排(即，最靠近通道243的排)之后。换言之，内侧排中的钉的变形可在外侧排中的侧向相邻钉的变形之前或者至少略靠前开始。此外，尽管在限定于仓240中的通道243的每侧公开了两个钉排，但可设想到其他实施方案，其中在通道243的每侧存在多于两个钉排，诸如三个钉排。在此类实施方案中，滑动件组件被构造成能够在部署内侧钉排的同时、部署外侧钉排的同时、和/或相对于内侧钉排和外侧钉排按顺序阶段性地部署附加钉排。
如上所述，第一滑动件部分792能够相对于滑动件组件790的第二滑动件部分793运动。现在转向图70-72，滑动件组件790能够在初始、未击发构型(图70)和第二、伸展构型(图71和图72)之间运动。在滑动件组件790的初始、未击发构型中，主要参见图70，第一滑动件部分792塌缩在第二部分793内或者相对于其回缩。在至少一种此类情况下，第一滑动件部分792的远侧端部可未伸展超过第二滑动件部分793的远侧部分。在其他情况下，尽管未示出，但第一滑动件部分792的远侧端部可在第一滑动件部分792塌缩在第二部分793内时伸展超过第二滑动件部分793的远侧端部。继续参考图70，读者将进一步理解，钉460在其还未被朝砧座124提升时处于未击发位置。在比较图70和图71时，读者将注意到，第一滑动件部分792已相对于第二滑动件部分793伸展。在此类情况下，第一滑动件部分792的远侧端部相对于第二滑动件部分793的远侧端部被定位在远侧。第一滑动件部分792从其初始、未击发位置到其伸展位置的运动可将第一滑动件部分792的内侧斜坡部分791a和/或外侧斜坡部分791b定位在一个或多个钉460下方。在其他构型中，第一滑动件部分792从其初始、未击发位置到其伸展位置的运动可未将内侧斜坡部分791a和/或外侧斜坡部分791b定位在一个或多个钉460下方。在任何情况下，如图71所示，第一滑动件部分792的伸展可朝砧座124至少部分地提升至少一个钉460并且/或者使得至少一个钉460抵靠砧座124而至少部分地变形。在某些情况下，第一滑动件部分792的伸展可使得至少一个钉460被完全提升或抵靠砧座124而完全变形。在各种情况下，第二滑动件部分793可在第一滑动件部分792运动到其伸展位置时未被朝远侧推进；然而，在某些情况下，第二滑动件部分793的至少一些远侧运动可在第一滑动件部分792运动到其伸展位置时发生。
在比较图71和图72时，可注意到，第一滑动件部分792和第二滑动件部分793已被朝远侧推进，以朝砧座124提升钉460。第一滑动件部分792和第二滑动件部分793可随后被推进到端部执行器120的远侧端部，以完成端部执行器120的击发行程，这将在下文进行更详细地论述。在任何情况下，滑动件组件790在端部执行器120的击发行程期间的初始进程示于图70-72中。图70示出了处于回缩、未击发位置的滑动件组件790；图71示出了处于伸展、部分击发位置的滑动件组件790；并且图72示出了处于伸展、击发位置的滑动件组件790。如上所述，一个或多个推杆159可朝远侧运动，以便推进滑动件组件790以完成图70-72所示的进程。参考图70，推杆159被示为处于初始、未击发位置，其中推杆与第一滑动件部分792的近侧端部接触。在各种实施方案中，推杆159可包括从其远侧端部伸展的可接合第一滑动件部分792的接触凸缘155。继续参考图70，当在推杆159处于其初始、未击发位置时，推杆159可不与第二滑动件部分793接触。当推杆159朝远侧推进时，推杆159可使第一滑动件部分792朝远侧运动，直到接触凸缘155与第二滑动件部分793的近侧端部接触，如图71所示。其为第一滑动件部分792与第二滑动件部分793之间的这种相对运动，由此伸展滑动件组件790，如上所述。然后，推杆159可朝远侧推进，以便同时朝远侧推进第一滑动件部分792和第二滑动件部分793，如图72所示。
如上所述，端部执行器120被构造成能够同时缝合并且横切组织。再次参见图65，端部执行器120可包括击发构件或刀杆156，所述发构件或刀杆156包括被构造成能够在刀杆156朝远侧推进时横切组织的刀刃158。再次参见图70和图71，该一个或多个推杆159的初始远侧运动可未被传送到刀杆156。换言之，当滑动件组件790在其回缩位置(图70)和其伸展位置(图71)之间运动时，刀杆156可保持静止或保持至少基本上静止。在此类情况下，可至少在端部执行器击发行程的初始部分期间发生推杆159和刀杆156之间的相对运动。在比较图74和图77时，可以看出，一、推杆159已朝远侧推进以伸展滑动件组件790，以及二、刀杆156还未朝远侧推进。应当尤其注意刀杆156和推杆159的近侧端部。更具体地讲，推杆159可包括在其间伸展的驱动销759，所述驱动销759伸展穿过限定在驱动杆157中的驱动狭槽757，所述驱动狭槽757从刀杆156朝近侧伸展。如图74所示，当推杆159处于其近侧未击发位置时，驱动销759定位在驱动狭槽757的近侧端部中。如图77所示，当推杆159朝远侧推进时，驱动销759可在驱动狭槽757内朝远侧滑动，直到驱动销759到达驱动狭槽757的远侧端部。在此位置中，滑动件790已被完全伸展并且刀杆156还未与推杆159一起朝远侧推进。如图78和图79所示，一旦驱动销759接触驱动狭槽757的远侧端部，推杆156和刀杆159就可一起朝远侧推进。
除上述之外，刀杆156可包括被构造成能够分别接合砧座124和钉仓通道123的凸缘153和凸缘155。如图77所示，当刀杆156处于其近侧、未推进位置时，凸缘153可相对于限定在砧座124中的狭槽121定位在近侧。在刀杆156的此类位置中，凸缘155可定位在或可不定位在限定在仓通道123的内部和/或外部中的狭槽内。当刀杆156朝远侧推进时，凸缘153可进入砧座狭槽121内并且凸缘155可定位在仓通道狭槽内。在此类情况下，刀杆156可设定砧座124与定位在仓通道123内的钉仓之间的间隙或组织间隙距离。在各种情况下，当刀杆156朝远侧推进时，刀杆156可控制端部执行器120内的组织的成形高度和/或压缩。
上文所述的构造可在许多情况下为有利的，其中推杆159在推杆159推进刀158之前移动滑动件组件790。例如，通常期望在切割组织之前缝合组织，并且因此钉的成形领先于或至少充分地领先于由刀杆156对组织的横切。滑动件790和刀杆156的交错部署可有利于钉成形和组织切割之间的此类相对进程。此外，滑动件790可在其回缩、未击发构型中紧密地存储于端部执行器120中，以便允许端部执行器120的较短的近侧-远侧或纵向长度。换言之，可在至少部分塌缩状态下开始其击发行程的滑动件组件可需要较小的纵向空间。此外，由于滑动件组件790的纵向可伸展性，滑动件组件790的钉提升表面例如可为较长的并且可包括比一体滑动件浅的或缓和的斜坡角度。换言之，滑动件组件790的机械优点可因滑动件组件790的斜坡具有较长的可用纵向长度而得到改善。
现在转向图80-82，滑动件组件790和刀杆156可向远侧朝端部执行器120的远侧端部推进，以完成端部执行器120的击发行程。在各种情况下，当滑动件790接近端部执行器120的远侧端部时，第一滑动件部分792可接触钉仓的远侧端部245，并且相对于第二滑动件部分793和/或在其内回缩。更具体地讲，当第二滑动件部分793相对于第一滑动件部分792朝远侧推进时，远侧端部245可阻止第一滑动件部分792的远侧运动，以便完成击发行程。在各种情况下，第二滑动件部分793可朝远侧推进，直到其也接触钉仓的远侧端部245，而在其他情况下，击发行程可在第二滑动件部分793接触远侧端部245之前完成。在任一情况下，在推杆159的远侧凸缘155朝端部执行器120的远侧端部推动第一滑动件部分792和第二滑动件部分793的实施方案中，第一滑动件部分792可在第一滑动件部分792到达远侧端部时脱离推杆159，使得推杆159可相对于第一滑动件部分792推动第二滑动件部分793。在至少一种此类情况下，主要参见图77，钉仓的远侧端部可包括凸台241，所述凸台241被构造成能够向上朝砧座124提升第一滑动件部分792，使得推杆159可在第一滑动件部分792下方滑动。在此类情况下，第一滑动件部分792能够可操作地脱离第二滑动件部分793和推杆159。在各种情况下，凸台241可被定位和布置成使得第一滑动件部分792在钉仓中的全部钉已被部署和/或转移到第二滑动件部分793之后被向上提升，如上所述。此外，除上述之外，钉仓的远侧端部可包括被构造成能够提升第一滑动件部分792的第一凸台241和被构造成能够提升另外的第一滑动件部分792的第二凸台241。在各种情况下，凸台241被构造成能够同时同步地提升第一滑动件部分792。在一些情况下，凸台241被构造成能够按顺序提升第一滑动件部分792。
现在参见图85-88，图85示出了处于初始、未击发构型的滑动件组件790。除上述之外，推杆159可接触第一滑动件部分792的近侧端部789，并且朝远侧推动第一滑动件部分792，直到第一滑动件部分792的近侧端部789与第二滑动件部分793的近侧端部787齐平，如图86所示。此时，第一滑动件部分792可相对于第二滑动件部分793被完全伸展。然后，推杆156可同时推动近侧端部787和近侧端部789，以朝远侧推进滑动件组件790。另外如上所述，现在参见图87，第一滑动件部分792可例如被钉仓的远侧端部245止挡并且可被钉仓的凸台241向上提升。此时，第一滑动件部分792可相对于第二滑动件部分793和远侧凸缘155升高，使得第二滑动件部分793可相对于第一滑动件部分792并且至少部分地在其下方滑动，以便使滑动件组件790塌缩，如图88所示。在比较图87和图88时，可以看出，第二滑动件部分793运动到更靠近限定在第一滑动件部分792的底部平面中的凸缘788，并且可以看出，第一滑动件部分792的远侧端部789不再与第二滑动件部分793的远侧端部787对准。
现在参见图83和图84，在击发行程已完成之后，刀杆156和推杆159可朝近侧回缩。在各种情况下，可通过推杆159朝近侧牵拉刀杆156。更具体地讲，推杆159可相对于刀杆159朝近侧回缩，直到驱动销759接触驱动狭槽759的近侧端部。此时，推杆159可朝近侧牵拉刀杆156，直到刀杆156的凸缘153不再定位在砧座124的狭槽121内。然后，砧座124可在闭合管115被朝近侧牵拉时运动到其打开位置。在某些情况下，钉仓可包括可替换的钉仓。在此类情况下，用尽的钉仓可从仓通道122移除，并且如果需要，未用尽的钉仓可定位在仓通道122内，使得外科器械可被再次使用。
如图83和图84所示，当刀杆156和推杆159回缩时，塌缩滑动件组件790可留在端部执行器120的远侧端部中。在用尽的钉仓从仓通道122移除的情况下，塌缩滑动件组件790可与仓一起从端部执行器120移除。在某些情况下，钉仓可在推杆159和刀杆156回缩时为未完全用尽的。在此类情况下，滑动件组件790可仅在钉仓内部分地推进并且可不塌缩返回到其未伸展构型。当钉仓随后从仓通道123移除时，一些钉可仍定位在其钉腔中。
如本文所述，钉仓和/或缝合器械的击发致动器或滑动件可包括被构造成能够在未击发位置和击发位置之间提升或部署钉的一个或多个倾斜斜坡表面。例如，滑动件可包括被构造成能够部署第一钉排的第一倾斜斜坡表面和被构造成能够部署第二钉排的第二倾斜斜坡表面等等。每个倾斜斜坡表面可包括连续表面，所述连续表面被构造成能够接合对应钉排中的每个钉并且提升钉，直到它们已抵靠定位在钉仓对侧的砧座而完全变形。限定每个倾斜斜坡表面的连续表面可包括任何合适数量的轮廓，例如，一个或多个线性表面和/或一个或多个弯曲表面。在各种情况下，连续表面可直接接合对应钉排中的每个钉并且可在钉排从其未击发位置运动到其完全击发位置时保持与该排中的钉连续地接合。在钉已到达其完全击发位置之后，倾斜斜坡表面可脱离该钉。这种构造可以用于具有能够相对运动的部件的滑动件诸如滑动件组件790和/或未由能够相对运动的部件构成的滑动件诸如由一体材料件构成的滑动件。
在各种情况下，击发致动器或滑动件可包括一个或多个倾斜斜坡表面，其中每个倾斜斜坡表面由两个或多个配合驱动表面构成。例如，现在转向图92，滑动件890可包括第一倾斜斜坡表面891a，所述第一倾斜斜坡表面891a由初始或第一驱动表面895a和第二或最终驱动表面896a构成。第一倾斜斜坡表面891a的初始驱动表面895a和最终驱动表面896a被构造成能够相配合以使第一钉排中的钉在未击发位置和击发位置之间提升。参见图89-92，当滑动件890朝远侧运动穿过钉仓时，初始驱动表面895a可例如接触钉160，并且将钉160从其未击发位置(图89)提升到部分击发位置(图90)。然后，滑动件890可朝远侧推进，使得最终驱动表面896a可使钉160在其部分击发位置和其完全击发位置之间提升。在各种情况下，初始驱动表面895a可接触钉160的初始驱动表面180以将钉160提升到其部分击发位置，并且最终驱动表面896a可接触钉160的第二驱动表面182，以将钉160提升到其最终击发位置。在此类情况下，钉160可从初始驱动表面895a转移到最终驱动表面896a以完成其部署或击发。参见图92，一旦第一倾斜斜坡表面891a的顶点898已在钉160的第二驱动表面182下方穿过，钉160的部署或击发就可完成。
除上述之外，再次参见图92，第一倾斜斜坡表面891a的初始驱动表面895a和最终驱动表面896a被构造成能够配合地部署第一钉排内的钉。滑动件890可包括附加的倾斜斜坡表面，以部署附加的钉排。例如，滑动件890可包括具有初始驱动表面895b和最终驱动表面896b的第二倾斜斜坡表面891b，所述初始驱动表面895b和最终驱动表面896b被构造成能够配合地部署第二钉排内的钉。在各种情况下，例如，滑动件890还可包括任何合适数量的倾斜斜坡表面，例如诸如类似于第一倾斜斜坡表面891a的被构造成能够部署第三钉排内的钉的第三倾斜斜坡表面、以及类似于第二倾斜斜坡表面891b的被构造成能够部署第四钉排内的钉的第四倾斜斜坡表面。在任何情况下，倾斜驱动表面的驱动表面诸如驱动表面895a,895b,896a，和896b可包括任何合适的构型，诸如线性轮廓和/或弯曲轮廓。继续参考图92，第一倾斜斜坡表面891a可包括位于初始驱动表面895a和最终驱动表面896a中间的过渡驱动表面897a。相似地，第二倾斜斜坡表面891b可包括位于初始驱动表面895b和最终驱动表面896b中间的过渡驱动表面897b。在各种情况下，过渡驱动表面可包括一个驱动表面和另一个驱动表面之间的过渡结构。在一些情况下，过渡驱动表面可例如包括同时驱动钉160的初始驱动表面180和第二驱动表面182的表面。在各种情况下，倾斜斜坡表面可包括任何合适数量的驱动表面。
在各种情况下，除上述之外，初始驱动表面895a可相对于最终驱动表面896a被侧向地定位。在某些情况下，初始驱动表面895a和最终驱动表面896a可彼此连接。在其他情况下，初始驱动表面895a和最终驱动表面896a可彼此不连接。在各种情况下，初始驱动表面895a可由第一高度限定并且最终驱动表面896a可由高于第一高度的第二高度限定。在某些情况下，初始驱动表面895a可沿着第一纵向轴线来限定并且最终驱动表面896a可沿着第二纵向轴线来限定。在某些情况下，第一纵向轴线和第二纵向轴线可为平行的。在一些情况下，初始驱动表面895a可由第一平面限定并且最终驱动表面896a可由平行于第一平面的第二平面限定。在其他情况下，第一纵向轴线和第二纵向轴线可为不平行的。在一些情况下，第一纵向轴线和第二纵向轴线可沿着会聚的方向伸展。在其他情况下，第一纵向轴线和第二纵向轴线可沿着不会聚的方向伸展。在各种情况下，除上述之外，第一倾斜表面891a的过渡驱动表面897a可沿着平行于第一纵向轴线和/或第二纵向轴线的轴线来限定。在某些情况下，过渡驱动表面897a可沿着不平行于第一纵向轴线和/或第二纵向轴线的轴线来限定。在各种情况下，除上述之外，第一倾斜表面891a的过渡驱动表面897a可被限定在平行于第一平面和/或第二平面的平面内。在一些情况下，过渡驱动表面897a可与初始驱动表面895a和/或最终驱动表面896a共面。在某些情况下，过渡驱动表面897a可被限定在与第一平面和/或第二平面不同的平面内。在各种情况下，除上述之外，过渡驱动表面897a可将初始驱动表面895a连接到最终驱动表面896a。
上文结合倾斜斜坡表面891a、初始驱动表面895a、最终驱动表面896a、和过渡驱动表面897a提供的论述可例如同样适用于倾斜斜坡表面891b、初始驱动表面895b、最终驱动表面896b、和过渡驱动表面897b。
在各种情况下，除上述之外，第一倾斜斜坡表面891a可平行于第二倾斜斜坡表面891b。在其他情况下，第一倾斜斜坡表面891a可不平行于第二倾斜斜坡表面891b。在各种情况下，第一倾斜斜坡表面891a可由第一高度限定并且第二倾斜斜坡表面891b可由第二高度限定。在一些情况下，第一高度可与第二高度相同。在此类情况下，由第一倾斜斜坡表面891a成形的第一钉排和由第二倾斜斜坡表面891b成形的第二钉排可成形为相同的高度。在其他情况下，第一高度可与第二高度不同。在此类情况下，由第一倾斜斜坡表面891a成形的第一钉排和由第二倾斜斜坡表面891b成形的第二钉排可成形为不同的高度。2012年11月27日公布的名称为SURGICAL STAPLING DEVICES THAT PRODUCE FORMED STAPLES HAVINGDIFFERENT LENGTHS的美国专利No.8,317,070的公开内容全文以引用方式并入本文。
如上所述，滑动件可直接驱动和部署存储于仓内的钉和/或任何其他合适的紧固件。换言之，滑动件可直接接触钉，其中在滑动件和钉中间不存在驱动器。此类构造不同于包括支撑钉的多个驱动器的构造。在此类构造中，滑动件接合驱动器以提升钉。在这些构造中，驱动器通常被构造成能够从其中存储钉的钉腔完全射出钉。更具体地讲，驱动器被构造成能够提升钉，使得钉在处于其完全击发位置时被完全定位在钉仓的顶部表面或平台上方。为了将钉完全提升到钉仓的平台上方，驱动器也可被至少部分地提升到平台上方。此类构造的特征可在于过驱动钉。本文论述的许多教导内容可适用于包括直接驱动钉的一个或多个滑动件的实施方案以及此外包括多个驱动器的实施方案，所述驱动器由一个或多个滑动件来驱动以便驱动钉。例如，滑动件890结合其中滑动件890直接驱动钉160的实施方案来论述；然而，滑动件890也可用于包括被构造成能够从钉腔部署钉的驱动器的实施方案中。在此类实施方案中，每个驱动器可包括例如类似于被构造成能够被初始驱动表面895a接合的第一驱动表面180的第一驱动表面以及例如类似于被构造成能够被最终驱动表面896a接合的第二驱动表面182的第二驱动表面。
在本文所公开的其中钉被滑动件直接驱动(即，不使用驱动器)的实施方案中，除上述之外，钉可被滑动件本身完全提升到平台上方或被过驱动。现在转向图91-94，滑动件890被构造成能够部分地伸展到仓142的平台表面141上方。更具体地讲，第一倾斜斜坡表面891a的顶点898和第二倾斜斜坡表面891b的顶点898可在倾斜斜坡表面891a和891b穿过腔144和/或在腔144之间穿过时伸展到平台表面141上方，以例如从钉腔144射出钉160。在此类情况下，滑动件890被构造成能够部分地伸展到限定在平台表面141中的钉腔开口上方。在各种情况下，仓142还可包括定位在成排钉腔144内和/或与其对准的多个覆盖件145。例如，覆盖件145可定位在钉腔排内的相邻钉腔144中间。在某些情况下，覆盖件145可相对于钉腔144定位在近侧和/或远侧。在各种情况下，主要参见图94，倾斜斜坡表面891的顶点898可在覆盖件145下方穿过。在此类情况下，每个覆盖件145可包括底部表面诸如弧形底部表面147，所述底部表面例如被构造成能够允许倾斜斜坡表面891在其下方穿过。继续参考图94，仓142可例如包括其中被构造成能够可滑动地接收第一倾斜斜坡表面891a的第一纵向狭槽149和被构造成能够接收第二倾斜斜坡表面891b的第二纵向狭槽149。在各种情况下，仓142可包括被构造成能够接收滑动件890的倾斜斜坡表面的多个纵向狭槽149。在某些情况下，纵向狭槽149可由覆盖件145和钉腔144限定。在一些情况下，每个纵向狭槽149可对应于钉腔144的纵向排，其中纵向狭槽149可将钉腔排内的钉腔144设置成彼此连通，使得穿过纵向狭槽149的倾斜斜坡表面可穿过钉腔144，如上文所概述。
在各种情况下，仓的平台被构造成能够直接接触正被紧固的组织和/或支撑正被紧固的组织。在某些情况下，仓组件例如可包括定位在平台上的层，诸如组织厚度补偿件，这在以下专利中有所公开：2010年9月30日提交的名称为IMPLANTABLE FASTENERCARTRIDGE COMPRISING A SUPPORT RETAINER的美国专利申请序列No.12/894,369(现在为美国专利申请公布No.2012/0080344)、2011年4月29日提交的名称为STAPLE CARTRIDGECOMPRISING STAPLES POSITIONED WITHIN A COMPRESSIBLE PORTION THEREOF的美国专利申请序列No.13/097,856(现在为美国专利申请公布No.2012/0080336)、和2011年9月23日提交的名称为CURVED END EFFECTOR FOR A STAPLING INSTRUMENT的美国专利申请序列No.13/242,066(现在为美国专利申请公布No.2012/0080498)。2010年9月30日提交的名称为IMPLANTABLE FASTENER CARTRIDGE COMPRISING A SUPPORT RETAINER的美国专利申请序列No.12/894,369(现在为美国专利申请公布No.2012/0080344)、2011年4月29日提交的名称为STAPLE CARTRIDGE COMPRISING STAPLES POSITIONED WITHIN A COMPRESSIBLEPORTION THEREOF的美国专利申请序列No.13/097,856(现在为美国专利申请公布No.2012/0080336)、和2011年9月23日提交的名称为CURVED END EFFECTOR FOR A STAPLINGINSTRUMENT的美国专利申请序列No.13/242,066(现在为美国专利申请公布No.2012/0080498)的整个公开内容以引用方式并入本文。在各种情况下，再次参见图93，平台141和覆盖件145被构造成能够直接接触组织。在此类情况下，覆盖件145可伸展到平台141上方，并且因此平台141和覆盖件145可包括不平坦的支撑表面。在各种情况下，覆盖件145可将额外的压缩力施加到直接定位在每个纵向钉排上方和/或附近的组织。这种额外的压缩压力可在钉形成过程之前、期间、和/或之后推压存在于组织内的流体以离开钉线，这因而可促进组织内的较好钉成形和/或钉保持。覆盖件145还被构造成能够夹持定位在钉仓和砧座之间的组织，尤其是沿着发生钉成形的钉线。覆盖件还被构造成能够在钉正从钉凹坑射出时支撑钉，以对钉形成过程提供局部控制。2010年9月29日提交的名称为STAPLE CARTRIDGE的美国专利申请序列No.12/893,461(现在为每个专利申请公布No.2012/0074198)和2013年3月27日提交的名称为TISSUE THICKNESS COMPENSATOR COMPRISING A CUTTING MEMBERPATH的美国专利申请序列No.13/851,676的整个公开内容以引用方式并入本文。
如上所述，主要参见图58、图61、和图64，钉腔诸如钉腔144可包括例如第一侧壁150a和第二侧壁150b，所述第一侧壁150a和第二侧壁150b被构造成能够例如在钉在未击发位置和击发位置之间提升时导向钉诸如钉160。在各种情况下，侧壁150a,150b可被构造和布置成使得当钉160处于其未击发位置时钉160的整体被定位在侧壁150a,150b中间。在其他情况下，主要参见图22-31，钉腔144的侧壁150被构造成能够当钉160处于其未击发位置时钉160的整体的一部分被在定位在侧壁150中间。例如，限定在仓体142中的钉腔144的最外侧排中的钉160的基部162可在钉160处于其未击发位置时未被侧壁150中的至少一个支撑。然而，当钉160被向上提升时，钉160的基部162可随后被侧壁150中的两者支撑。现在转向图93和图94，仓142的钉腔144中的一些诸如腔144a可例如仅在其提升动作结束时支撑基部162的两侧。在任何情况下，尽管限定在仓体142中的钉腔144的侧壁在未击发位置可不完全支撑钉160，但再次参见图3和图65，钳口122的仓通道123可至少部分地支撑钉160。换言之，仓体142和仓通道123可配合以限定钉腔144，以便在钉160的整个提升动作中支撑和/或包围钉160。例如，仓体142和仓通道123可在钉160处于其未提升位置时相配合以支撑和/或包围钉160。在一些情况下，在钉160的提升动作期间的某些时刻，仓通道123可不再支撑和/或包围钉160，并且在此类情况下，仓体142可完全支撑钉160以完成提升动作的剩余部分。在至少一个实施方案中，仓通道123和仓体142可相配合以支撑钉160完成提升动作的一半或大约一半。在其他实施方案中，仓通道123和仓体142可相配合以支撑钉160完成提升动作的一少半或一多半。在一些情况下，仓体142和仓通道123可在钉160的整个提升动作中配合地支撑和/或包围钉160。
本文所述的各种实施方案在线性端部执行器和/或线性紧固件仓的上下文中有所描述。此类实施方案以及其教导内容可应用于非线性端部执行器和/或非线性紧固件仓，诸如例如，圆形和/或波状外形端部执行器。例如，各种端部执行器包括非线性端部执行器公开于2011年2月28日提交的名称为“SURGICAL STAPLING INSTRUMENT”的美国专利申请序列No.13/036,647(现在为美国专利申请公布No.2011/0226837)中，该专利申请据此全文以引用方式并入。另外，2012年9月29日提交的名称为“STAPLE CARTRIDGE”的美国专利申请序列No.12/893,461(现在为美国专利申请公布No.2012/0074198)据此全文以引用方式并入。2008年2月15日提交的名称为“END EFFECTORS FOR A SURGICAL CUTTING AND STAPLINGINSTRUMENT”的美国专利申请序列No.12/031,873(现在为美国专利No.7,980,443)也据此全文以引用方式并入。公布于2010年12月7日的名称为SURGICAL INSTRUMENT HAVINGRECORDING CAPABILITIES的美国专利No.7,845,537的整个公开内容以引用方式并入本文。2011年5月27日提交的名称为SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLEDEPLOYMENT ARRANGEMENTS的美国专利申请序列No.13/118,241(现在为美国专利申请公布No.2012/0298719)的整个公开内容全文以引用方式并入本文。
可将本文所公开的装置设计为单次使用后即进行处理，或者可将它们设计为可多次使用。然而，在任一种情形下，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/或置换特定部分后，该装置可以在修复设施处重新组装以便随后使用，或者在即将进行外科手术前由外科队重新组装。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。在一种消毒技术中，将所述器械放置在闭合且密封的容器中，例如塑料或TYVEK袋中。然后将容器和器械置于可穿透该容器的辐射场，例如γ辐射、x-射线或高能电子。辐射杀死器械上和容器中的细菌。然后可将灭菌后的器械储存在无菌容器中。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。据称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 (25)

1.一种紧固件仓组件，包括：
仓体，所述仓体包括：
平台；
多个紧固件腔；
多个紧固件，其中每个所述紧固件至少部分地存储在所述紧固件腔内；以及
滑动件，所述滑动件被构造成能够从所述紧固件腔射出所述紧固件，其中所述滑动件包括：
第一斜坡，所述第一斜坡被构造成能够将所述紧固件从第一位置提升到部分提升位置；和
第二斜坡，所述第二斜坡被构造成能够从所述部分提升位置和射出位置提升所述紧固件，其中所述第一斜坡能够相对于所述第二斜坡运动。
2.根据权利要求1所述的紧固件仓组件，其中所述滑动件被构造成能够在击发行程期间在近侧未击发位置、中间部分击发位置、和远侧击发位置之间运动，其中当所述滑动件处于所述近侧未击发位置时，所述第一斜坡至少部分地塌缩在所述第二斜坡内，并且当所述滑动件处于所述中间部分击发位置时，所述第一斜坡相对于所述第二斜坡为伸展的。
3.根据权利要求2所述的紧固件仓组件，其中当所述滑动件处于所述远侧击发位置时，所述第一斜坡至少部分地塌缩在所述第二斜坡内。
4.根据权利要求3所述的紧固件仓组件，其中所述仓体包括远侧端部，并且其中所述滑动件被构造成能够接触所述远侧端部以使所述第一斜坡相对于所述第二斜坡塌缩。
5.根据权利要求1所述的紧固件仓组件，其中所述滑动件能够在击发行程期间在未击发位置、部分击发位置、和击发位置之间运动，其中当所述滑动件处于所述未击发位置时，所述第一斜坡相对于所述第二斜坡处于回缩位置，并且当所述滑动件处于所述部分击发位置时，所述第一斜坡相对于所述第二斜坡处于伸展位置。
6.根据权利要求4所述的紧固件仓组件，其中当所述滑动件处于所述击发位置时，所述第一斜坡处于所述回缩位置。
7.根据权利要求1所述的紧固件仓组件，其中所述多个紧固件被布置成至少一个纵向排。
8.根据权利要求1所述的紧固件仓组件，其中所述多个紧固件被布置成多个纵向排。
9.根据权利要求1所述的紧固件仓组件，其中所述第一斜坡被构造成能够直接接合所述紧固件，并且所述第二斜坡被构造成能够直接接合所述紧固件。
10.根据权利要求1所述的紧固件仓组件，还包括多个紧固件驱动器，其中所述紧固件驱动器被定位在所述紧固件下方，并且所述第一斜坡和所述第二斜坡被构造成能够直接接合所述紧固件驱动器以从所述紧固件腔射出所述紧固件。
11.根据权利要求1所述的紧固件仓组件，还包括砧座。
12.一种与包括砧座的外科器械一起使用的紧固件仓组件，所述紧固件仓包括：
仓体，所述仓体包括：
平台；
多个紧固件腔；
多个紧固件，其中每个所述紧固件至少部分地存储在所述紧固件腔内；以及
击发构件，所述击发构件被构造成能够朝所述砧座移动所述紧固件，其中所述击发构件包括：
第一斜坡，所述第一斜坡被构造成能够朝所述砧座提升所述紧固件；和
第二斜坡，所述第二斜坡被构造成能够朝所述砧座提升所述紧固件，其中所述第一斜坡能够相对于所述第二斜坡运动。
13.根据权利要求12所述的紧固件仓组件，其中所述击发构件能够在击发行程期间在近侧未击发位置、中间部分击发位置、和远侧击发位置之间运动，其中当所述击发构件处于所述近侧未击发位置时，所述第一斜坡至少部分地塌缩在所述第二斜坡内，并且当所述击发构件处于所述中间部分击发位置时，所述第一斜坡相对于所述第二斜坡为伸展的。
14.根据权利要求13所述的紧固件仓组件，其中当所述击发构件处于所述远侧击发位置时，所述第一斜坡至少部分地塌缩在所述第二斜坡内。
15.根据权利要求14所述的紧固件仓组件，其中所述仓体包括远侧端部，并且其中所述击发构件被构造成能够接触所述远侧端部以使所述第一斜坡相对于所述第二斜坡塌缩。
16.根据权利要求15所述的紧固件仓组件，其中当所述击发构件处于所述击发位置时，所述第一斜坡处于回缩位置。
17.根据权利要求12所述的紧固件仓组件，其中所述多个紧固件被布置成至少一个纵向排。
18.根据权利要求12所述的紧固件仓组件，其中所述多个紧固件被布置成多个纵向排。
19.根据权利要求12所述的紧固件仓组件，其中所述第一斜坡被构造成能够直接接合所述紧固件，并且所述第二斜坡被构造成能够直接接合所述紧固件。
20.根据权利要求12所述的紧固件仓组件，还包括多个紧固件驱动器，其中所述紧固件驱动器被定位在所述紧固件下方，并且所述第一斜坡和所述第二斜坡被构造成能够直接接合所述紧固件驱动器以从所述紧固件腔射出所述紧固件。
21.根据权利要求12所述的紧固件仓组件，还包括砧座。
22.一种与包括砧座的外科器械一起使用的紧固件仓组件，所述紧固件仓包括：
仓体，所述仓体包括：
平台；
多个紧固件腔；
多个紧固件，其中每个所述紧固件至少部分地存储在所述紧固件腔内；以及
击发构件，所述击发构件被构造成能够朝所述砧座移动所述紧固件，其中所述击发构件包括：
第一斜坡，所述第一斜坡被构造成能够朝所述砧座提升所述紧固件；
第二斜坡，所述第二斜坡被构造成能够朝所述砧座提升所述紧固件；和
伸展装置，所述伸展装置用于使所述第一斜坡相对于所述第二斜坡伸展。
23.根据权利要求22所述的紧固件仓组件，还包括用于使所述第一斜坡相对于所述第二斜坡回缩的回缩装置。
24.一种紧固件仓组件，包括：
仓体，所述仓体包括：
平台；
多个紧固件腔；
多个紧固件，其中每个所述紧固件至少部分地存储在所述紧固件腔内；以及
滑动件，所述滑动件被构造成能够从所述紧固件腔射出所述紧固件，其中所述滑动件在第一位置具有第一长度并且在第二位置具有第二长度，并且所述第二长度不同于所述第一长度。
25.根据权利要求24所述的紧固件仓组件，其中所述第二位置包括所述击发行程的终点，并且所述第二长度短于所述第一长度。
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US14/138,518 US9763662B2 (en) 2013-12-23 2013-12-23 Fastener cartridge comprising a firing member configured to directly engage and eject fasteners from the fastener cartridge
US14/138,505 US9585662B2 (en) 2013-12-23 2013-12-23 Fastener cartridge comprising an extendable firing member
US14/138,481 US9968354B2 (en) 2013-12-23 2013-12-23 Surgical staples and methods for making the same
US14/138,489 US9687232B2 (en) 2013-12-23 2013-12-23 Surgical staples
US14/138,530 US9549735B2 (en) 2013-12-23 2013-12-23 Fastener cartridge comprising a firing member including fastener transfer surfaces
US14/138,505 2013-12-23
US14/138,465 US10265065B2 (en) 2013-12-23 2013-12-23 Surgical staples and staple cartridges
US14/138,475 US20150173749A1 (en) 2013-12-23 2013-12-23 Surgical staples and staple cartridges
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