CN100444806C - Surgical Instruments - Google Patents

Abstract

A surgical instrument includes a first clamp and a second clamp opposite to the first clamp. The first driver enables the first clamp and the second clamp to move relative to each other on a plane. The first driver is engaged with a drive shaft, and the drive shaft is rotatable about a rotation axis arranged non-parallel, eg perpendicular, with respect to the plane. The instrument also includes a surgical component, such as a cutting and stapling element disposed within the first jaw. A second drive allows relative movement of the surgical component in a direction parallel to the plane. The second driver is engaged with a drive shaft rotatable about an axis of rotation disposed non-parallel to the plane.

Description

Surgical Instruments

This application is a divisional application of a patent application whose application date is January 2, 2003, application number is No.03803483.2, and the name is "surgical instrument".

Cross References to Related Applications

This application claims priority from US Patent Application Serial No. 60/346,656, filed January 8, 2002, the entire contents of which are hereby incorporated by reference.

This invention is related to U.S. Patent Application Nos. 09/510,923, filed February 22, 2000, U.S. Patent Application Nos. 09/723,715, filed November 28, 2000, and 09/836,781, filed April 17, 2001 US Patent Applications, US Patent Application No. 09/887,789, filed June 22, 2001, and US Patent Application No. 60/337,544, filed December 4, 2001, the contents of which are hereby incorporated by reference.

technical field

The present invention relates to a surgical instrument. In particular, the present invention relates to a clamping, cutting and stapling instrument for clamping, cutting, and stapling tissue.

Background technique

This document contains extensive descriptions of surgical instruments. Some of these surgical instruments are described in U.S. Patent No. 4,705,038 by Sjostrom et al; U.S. Patent No. 4,995,877 by Ams et al; U.S. Patent No. 5,249,583 by Mallaby; Patent No. 5,467,911; U.S. Patent Nos. 5,383,880, 5,518,163, 5,518,164, and 5,667,517 to Hooven; U.S. Patent No. 5,653,374 to Young et al; U.S. Patent No. 5,779,130 to Alesi et al; .

One type of surgical instrument is a linear suturing instrument, which is a guillotine-type instrument used to cut and staple a section of tissue. Figure 1A shows an example of such an apparatus as described in US Patent No. 3,494,533. The instrument shown in FIG. 1A includes opposing jaws that are movable in parallel relative to each other. A row of sutures is disposed within the first jaw, and the second jaw has an anvil for receiving and closing the sutures. A suture pusher is disposed within the first jaw and extends from the proximal end of the first jaw to the distal end of the first jaw. A drive shaft is located in the plane of motion of the first jaw and suture pusher and is connected to the first jaw and suture pusher. When activated, the drive shaft drives the suture pusher to simultaneously push all of the sutures against the suture guide structure in the anvil of the second jaw.

Other examples of surgical instruments are described in US Patent No. 4,442,964, US Patent No. 4,671,445, and US Patent No. 5,413,267. The surgical stapler includes opposing jaws movable parallel to each other, wherein a row of sutures is disposed within the first jaw and an anvil is provided in the second jaw for receiving and closing the sutures. A suture pusher is disposed within the first jaw and extends from the proximal end of the first jaw to the distal end of the first jaw. A drive shaft is located in the plane of motion of the first jaw and the suture pusher and is connected to the first jaw and the suture pusher. When activated, the drive shaft drives the suture pusher to simultaneously push all of the sutures against the suture guide structure in the anvil of the second jaw.

Another type of surgical instrument is a linear clamping, cutting and stapling instrument such as that described in US Patent No. 6,264,087. This instrument is used in surgery to cut cancerous or abnormal tissue from the gastrointestinal tract. A conventional linear clamping, cutting and stapling instrument is shown in perspective view in Figure IB. The instrument includes a pistol grip structure having an elongated shaft and a distal end. The distal end includes a pair of scissor-type gripping elements for gripping the open end of the colon closed. The anvil portion of one of the two scissor-type clamping elements can move or rotate relative to the overall structure, while the other clamping element remains fixed relative to the overall structure. Activation of the scissor elements, ie rotation of the anvil part, is controlled by a gripping trigger provided at the handle. In addition to the scissor-type device, the distal end also includes a suturing mechanism. The stationary clamping element of the scissor-type mechanism includes a suture magazine receiving area and a mechanism for driving the clamped end of the suture through the tissue and against the anvil portion, thereby suturing the previously opened end. The scissor-type elements may be integrally formed with the shaft, or may be removable so that various scissors and suturing elements may be interchanged.

Typically, these surgical instruments are used in a manner that after identifying cancerous or other abnormal tissue in the gastrointestinal tract (and after identifying the location of the cancerous tissue in the colon), the patient's abdomen is first opened to expose the bowel. The surgeon then removes the colonic canal on both sides of the cancerous tissue and sews closed the two open ends of the bowel (the end leading to the anus is the distal end and the end closest to the lower bowel is the proximal end). This temporary closure is intended to minimize contamination of the exposed abdomen with intestinal material. In particular, a temporary closure of the two open ends of the bowel can be achieved when the colon is positioned between the jaws of the surgical instrument. By activating the first drive mechanism, the surgeon can bring the jaws together. The second drive mechanism is then activated to drive a series of sutures and a cutting blade through the clamped end of the colon, thereby closing and transecting the end. The process is usually repeated on the other side of the cancerous or abnormal tissue.

One problem with the aforementioned surgical instruments is that the instruments can be difficult to manipulate. Since these devices are typically used on the body, such as inside a patient, the device should be constructed to operate within the patient's body. Conventional surgical instruments, such as those shown in Figures 1A and 1B, are difficult to handle, especially inside a patient.

Contents of the invention

According to one embodiment of the invention, the invention relates to a surgical instrument. The surgical instrument includes a first jaw and a second jaw opposite the first jaw. The first driver enables the first clamp and the second clamp to move relative to each other on a plane. The first driver engages a drive shaft that is rotatable about an axis of rotation that is non-parallel, such as perpendicular, to the plane. The instrument also includes a surgical component disposed within the first jaw. A second drive allows relative movement of the surgical component in a direction parallel to the plane. The second driver is engaged with a drive shaft rotatable about an axis of rotation disposed non-parallel to the plane.

According to one embodiment of the invention, the first drive mount is configured to couple to one end of a first rotational drive shaft at an angle, such as perpendicular to the first and second jaws of the electromechanical drive A planar arrangement in which the electromechanical drive rotates the first drive shaft. The first rotary drive shaft rotates in a first direction to open the jaws, and in a second direction opposite the first direction to close the jaws. The first drive may include, for example, a pair of spur gears, a worm and a worm gear in rotational and meshing relationship to each other. The first driver also includes an externally threaded screw, which is fixedly connected to one end of the worm wheel and engages with the internally threaded hole of the second clamp, so that the relative movement between the gears can make the first clamp and the second clamp Also relatively athletic.

As noted above, the surgical instrument may also include a surgical component, eg, a cutting element such as a knife, and a suturing element mounted to a pusher plate disposed within the first jaw. According to this embodiment, the second drive is arranged within the first clamp. The second drive is operable to move the surgical component in a direction parallel to the plane of motion of the first and second jaws. The second driver includes a second drive seat, and the second drive seat is arranged at an angle, such as being perpendicular to the plane.

According to one embodiment of the present invention, the second drive seat of the second drive is configured to couple to an end of a second rotary drive shaft at an angle, such as perpendicular to the first and second drive shafts of the electromechanical drive. A planar arrangement of two clamps, wherein the electromechanical drive rotates the second drive shaft. The second drive shaft rotates in a first direction to lower the operative component, and in a second direction opposite the first direction to raise the operative component. The second drive may include, for example, a pair of spur gears, a worm and a worm gear in rotational and meshing relationship to each other. Each of the pair of worm gears has a built-in internally threaded bore for engagement with a respective externally threaded screw fixedly attached to the surgical component. Rotation of the gears can cause relative movement of the surgical component as well.

Description of drawings

Figure 1A is a side view of a traditional surgical instrument;

Figure 1B is a perspective view of a conventional linear clamping, cutting and stapling instrument;

Figure 2 is a perspective view of an electromechanical surgical system according to one embodiment of the present invention;

Figure 3 is a side view of a cutting and stapling attachment in an extended position according to one embodiment of the present invention;

Figure 4 is a side view of the cutting and stapling attachment shown in Figure 3 in a retracted position;

Figure 5 is a side view of the cutting and stapling attachment shown in Figures 3 and 4 in a retracted position;

Figure 6 is a side view of the cutting and stapling attachment shown in Figures 3 to 5 in a retracted position;

Figure 7 is a top view of the cutting and stapling attachment shown in Figures 3 and 4;

Figure 8A is an exploded view of a cutting and stapling attachment according to one embodiment of the present invention;

Figure 8B is an exploded view of a cutting and stapling attachment according to another embodiment of the present invention;

Figure 9A is a perspective view of the cutting and stapling attachment shown in Figure 8A;

Figure 9B is a perspective view of the cutting and stapling attachment shown in Figure 8B;

10 is a side view, partially cut away, of the flexible shaft of the electromechanical surgical instrument shown in FIG. 2;

Figure 11 is a cross-sectional view of the flexible shaft taken along line 11-11 in Figure 10;

Figure 12 is a rear view of the first adapter of the flexible shaft shown in Figure 10;

Figure 13 is a front view of the second adapter of the flexible shaft shown in Figure 10;

14 is a schematic diagram of the motor arrangement of the electromechanical surgery system shown in FIG. 2;

Fig. 15 is a schematic diagram of the electromechanical surgical system shown in Fig. 2;

Fig. 16 is a schematic diagram of the encoder of the flexible shaft shown in Fig. 10;

Figure 17 is a schematic illustration of a storage device for a linear clamping, cutting and stapling instrument according to one embodiment of the present invention;

18 is a schematic diagram of a wireless remote control unit of the electromechanical surgery system shown in FIG. 2;

19 is a schematic diagram of a wired remote control unit of the electromechanical surgery system shown in FIG. 2;

Figures 20A to 20C show a flow chart of the main operating procedure for steps performed during operation of a surgical instrument according to an embodiment of the present invention;

Figures 21A to 21C illustrate a flowchart of the clamp closing routine of the main operating routine shown in Figures 20A to 20C according to one embodiment of the present invention;

22A to 22C show a flowchart of a calibration routine of the main operating program shown in FIGS. 20A to 20C according to one embodiment of the present invention;

Figure 23 shows a flow chart of the clamp opening routine of the main operating routine shown in Figures 20A to 20C according to one embodiment of the present invention;

24A to 24C show a flow chart of the clamping, cutting and stapling routine of the main operating routine shown in FIGS. 20A to 20C according to one embodiment of the present invention; and

25A to 25B show a flowchart of a detection program of the main operation flow shown in FIGS. 20A to 20C according to an embodiment of the present invention.

Detailed ways

An embodiment of a surgical instrument 11 according to the invention is shown in FIGS. 3 to 7 . Referring to Figures 3 and 4, an embodiment of a surgical instrument 11, such as a clamping, cutting, and stapling instrument, is shown. In this embodiment, the surgical instrument 11 includes a parallel split jaw arrangement having a second jaw 50 opposite a first jaw 80 . The first end 50a of the second clamp 50 is mechanically coupled to the first end 80a of the first clamp 80 . Opposing jaws 50 and 80 may remain parallel relative to each other. Alternatively, the opposing jaws 50 and 80 can be opened and closed in a scissor-like manner, wherein the first end 50a of the second jaw 50 is connected to the first end 80a of the first jaw 80 by a hinge or other rotatable member. Rather, it is mechanically connected such that the first clamp 80 is rotatably coupled to the second clamp 50 .

Fig. 3 shows the surgical instrument 11 in an open position, wherein the second jaw 50 and the first jaw 80 are in contact with each other at their first ends 50a and 80a. The first clamp 80 and the second clamp 50 can be held and moved within a longitudinal plane defined by the X and Y axes shown in FIG. 3 . A gear case 255 is mounted on one side of the first clamp 80 . The gear case 255 includes a first drive mount 180 connected to the first drive 150, which is schematically shown here for clarity. The first driver 150 is connected to the first end 50 a of the second clamp 50 to open and close the first clamp 80 and the second clamp 50 . In addition, the gear case 255 also includes a second driving base 310 .

Figure 4 shows the surgical instrument in a closed position. In the closed position, the second jaw 50 and the first jaw 80 contact each other at their first ends 50a and 80a and their second ends 50b and 80b. In the closed position, a section of tissue is clamped between the second jaw 50 and the first jaw 80 .

Figures 5 and 6 also show the surgical instrument 11 in the closed position. 5 and 6 schematically illustrate the coupling of the second drive seat 310 of the gear housing 255 to the second drive 261 . Second driver 261 is coupled to surgical element 262 . The surgical element 262 can include a cutting and stapling assembly 262, although other types of surgical elements are possible.

The second driver 261 is connected to the cutting and stapling assembly 262 to move the cutting and stapling assembly 262 from a first retracted position as shown in FIG. 5 to a second extended position as shown in FIG. 6 . Two drive seats are shown at the same time, that is, the first drive seat 180 and the second drive seat 310, and two corresponding drive shafts, that is, the first drive shaft 630 and the second drive shaft 632, of course, any Appropriate number of drive sockets and drive shafts. For example, a single drive shaft may also be provided to drive surgical instruments.

FIG. 7 is a top view of the surgical instrument 11 shown in FIGS. 3-6. FIG. 7 shows that the surgical instrument 11 is detachably or permanently connected to the electromechanical driver assembly 610 . The surgical instrument 11 shown in FIG. 7 includes a first driver 150 connected to a first motor 680 of a device 610 by a first drive shaft 630 through a first drive seat 180 . When the first actuator 150 is engaged with the device 610 , the first clamp 80 is operable to open and close relative to the second clamp 50 . In addition, the surgical instrument 11 shown in FIG. 7 includes a second driver 261 connected to the second motor 676 of the device 610 by the second drive shaft 632 through the second drive seat 310 . When the second driver 261 is engaged with the device 610, the cutting and stapling assembly 262 is operable to drive. As shown in Figure 7, the first drive base 180 and the second drive base 310 are arranged on the surgical instrument 11, so that the first drive shaft 630 and the second drive shaft 632 are at an angle, that is, perpendicular to X-Y shown in Figure 3 connected to the surgical instrument 11. That is, the first drive shaft 630 and the second drive shaft 632 are connected to the surgical instrument 11 in the Z-axis direction shown in FIG. 7 .

FIG. 8A is an exploded view of surgical instrument 11 according to one embodiment of the present invention, and FIG. 9A is a perspective view of surgical instrument 11 assembled. According to this embodiment, the second clamp 50 includes an anvil 505 connected to an anvil filler 509 by fasteners 527, such as rivets. The top 5052 of the anvil 505 includes a vertically arranged internal threaded hole 5051 . In addition, the anvil 505 also includes a plurality of suture guiding structures 5053 arranged in parallel along a region 5054 of the anvil 505, the suture guiding structures 5053 are opposite to the first jaw. A knife shim 520 is disposed between a plurality of suture guiding structures 5053 .

The first clamp 80 includes a housing frame 506 . The housing frame 506 includes a pair of guide structures 5061 disposed inside, along which a pair of ribs 5055 of the anvil 505 can move, so that the housing frame 506 can move parallel to the anvil 505 . Gear housing 255 is mounted to one side 5062 of housing frame 506 by fasteners 533 and 534, such as screws.

A quick connect coupling 511 is mounted on the gear housing 255 and is biased by a set of springs 538 . The gear housing 255 includes a first driving seat 180 and a second driving seat 310 . In this embodiment, the first drive base 180 includes a first pinion 508 a having one end 5081 extending through the aperture 2551 of the gear housing 255 and the other end 5082 of the pinion including spur gear teeth 5083 . The second drive base 310 includes a second pinion 508 b having one end 5084 extending through the second aperture 2552 of the gear housing 255 and the other end 5085 of the second pinion including spur gear teeth 5086 . The storage module 501 is disposed within the gear housing 255 and includes a connector 2554 that can extend through or be accessible to the aperture 2553 of the gear housing 255 . The storage module 501 is held in place in the gear housing 255 by an inner spacer 530 and an outer spacer 531 . The storage module 501 is also biased in its position by a spring 539 .

The first and second pinion gears 508a and 508b mesh with corresponding spur gears 529a and 529b, respectively. The first spur gear 529a includes a bore 5293 non-rotatably engaged with an end 5231 of the first worm 523a. The second spur gear 529b includes a bore 5294 non-rotatably engaged with an end 5234 of the second worm 523b. As shown in FIG. 8A , holes 5293 and 5294 and ends 5231 and 5234 may be square, for example. It will be appreciated that the holes 5293, 5294 and ends 5231, 5234 may be of any shape and configuration that provides a non-rotatable engagement therebetween.

In this embodiment, the first worm 523a has an end 5231 that is non-rotatably engaged with a bore 5293 of the first spur gear 529a, and a second end 5232 that includes circumferentially disposed threads 5233 . The second worm 523b has an end 5234 non-rotatably engaged with a bore 5294 of the second spur gear 529b, and a second end 5235 comprising circumferentially disposed threads 5236. The second end 5232 of the first worm 523a is disposed in the frame housing 506 , and the other end 5231 of the worm 523a extends through the through hole 5063 on the side of the frame housing 506 to engage with the first spur gear 529a in the gear housing 255 . The second end 5235 of the second worm 523b is disposed in the frame housing 506, and the other end 5234 of the worm 523b passes through the through hole 5064 on the side of the frame housing 506 to communicate with the second spur gear 529b on the gear housing 255. join.

In addition, a worm gear 522 is also provided in the frame housing 506 . The worm wheel 522 has circumferentially disposed teeth 5221 which engage with threads 5233 of the second end 5232 of the worm 523a. The worm gear 522 includes an inner bore 5222 through which the screw 521 is disposed. The screw 521 has a head 5211 with a portion 5212 non-rotatably engaged with the bore 5222 of the worm wheel 522 . The inner hole 5222 and the portion 5212 of the screw 521 may be complementary, for example, may be square. Screw 521 also includes a portion 5213 of head 5211 that extends through washer 537 and hole 5351 in backing plate 535 . The screw 521 may also have external threads 5214 that engage the internally threaded bore 5051 of the anvil 505 .

A worm gear 516 and a worm gear 517 are arranged in the frame housing 506 . The worm gear 516 and the worm gear 517 are located on opposite sides of the worm 523b. In particular, the worm gear 516 includes circumferentially disposed teeth 5161 that engage a first side of the worm 523b, and the worm gear 517 includes circumferentially disposed teeth 5171 that engage a second side of the worm 523b. . Worm wheel 516 includes a cylindrical protrusion 5162 that projects through hole 5352 in backing plate 535 . The positioning ring 536 a is engaged with the groove 5163 of the cylindrical protrusion 5162 , so that the worm wheel 516 can rotate around its vertical central axis 5165 relative to the backing plate 535 . Worm wheel 517 includes a cylindrical protrusion 5172 that protrudes through hole 5353 in backing plate 535 . The positioning ring 536b engages with the groove 5173 on the cylindrical protrusion 5172 so as to allow the worm wheel 517 to rotate about its vertical central axis 5175 relative to the backing plate 535 .

An externally threaded screw 504 is disposed through an internally threaded bore 5164 of the worm wheel 516 . An externally threaded worm 503 is provided through an internally threaded hole 5174 of the worm wheel 517 . Since the worm gears 516 and 517 are located and engaged on opposite sides of the worm 523b, the internally threaded bores 5164 and 5174 of the worm gears 516 and 517, and the externally threaded screws 504 and 503 may be provided with opposite threads to each other. In the illustrated embodiment, the internally threaded hole 5164 of the worm wheel 516 can also be a right-handed thread, meshing with the right-handed thread of the screw rod 504, and the internally threaded hole 5174 of the worm wheel 517 can also be a left-handed thread, meshing with the left-handed thread of the screw rod 503 . Both the screw rods 503 and 504 are fixedly connected to the top surface 5021 of the thrust plate 502 . The thrust plate 502 is located between opposite sides of the housing frame 506 .

Suture pusher 514 is attached to bottom surface 5022 of push plate 502 . The suture pusher 514 includes two parallel rows 5141 and 5142 of downwardly disposed teeth 5143 each corresponding to and aligned with a suture guide structure 5053 of the anvil 505 . A downward cutting knife 519 is disposed between the two parallel rows of downwardly disposed teeth 5143 of the suture pusher 514 .

The suture seat 513 is disposed below the suture pusher 514 . The suture block 513 includes a cartridge having vertically disposed slots 5132, each slot corresponding to a downwardly disposed tooth 5143 of the suture pusher 514, and a suture guide 5053 of the anvil 505. Correspondence and alignment. A suture 528 including a prong 5281 is disposed in each slot 5132 . The suture seat 513 also includes a longitudinally disposed slot 5131 extending through the suture seat 513 through which the knife 519 also passes. Suture seat 513 includes an aperture 5133 adjacent one end 5134 thereof.

The suture pallet 540 is attached to the lower parallel side 5066 of the frame housing 506 , or to the lower surface of the suture seat 513 . The suture pallet 540 is configured to cover the bottom surface of the suture seat 513 so that the sutures 528 remain in the suture seat 513 and prevent foreign matter from passing through the groove 5132 of the suture seat 513 when the surgical instrument 11 is transported. enter. The suture pallet 540 also has a through hole 5401 with a tapered or beveled side 5402 . The suture pallet 540 also has a gripping portion 5403, which can be gripped by a user.

The aperture 5133 of the suture holder 513 adjacent the end 5134 of the suture holder 513 is adapted to receive the end 5181 of the pin 518 . The end 5181 of the pin 518 is tapered so as to rest on the tapered side 5402 of the through hole 5401 of the suture pallet 540 . In this embodiment, pin 518 is maintained in a substantially vertical position so as to be perpendicular to suture seat 513 . The opposite end 5184 of the pin 518 includes a centrally disposed bore 5183 for receiving a spring 524 . Additionally, at the end 5184 of the pin 518 there is provided a lever 5182 which is connected vertically to the pin 518 . Spring 524 biases end 5181 of pin 518 into bore 5057 of anvil 505 when suture holder 540 is removed from surgical instrument 11 .

Cap 515 is attached to one end 5067 of frame housing 506, such as by welding. The latches 5151 and 5152 of the cartridge cap 515 engage with the grooves 5068 of the housing frame 506 . Cap 515 also includes an internally disposed aperture 5154 for receiving pin 518 . Bore 5154 of cartridge cap 515 includes a slot 5153 communicating therewith forming lever 5182 for guiding pin 518 . In this embodiment, the internally disposed aperture 5154 of the cartridge cap 515 does not extend through the top surface 5155 of the cartridge cap 515 ; instead, the spring 524 is retained within the internally disposed aperture 5154 . The biasing force of the spring 524 pushes the end 5181 of the pin 518 into the hole 5133 of the suture seat 513 and ensures the positioning of the suture seat 513 so that the groove 5132 can engage the downwardly disposed teeth of the suture pusher 514. 5143 and are aligned with the suture guide structure 5053 of the anvil 505. Cap 515 is also held in place by latch 526 , which is rotatably connected to housing frame 506 by fastener 507 . Housing top 510 is disposed between opposite sides 5062 and 5065 of housing frame 506 to protect components within housing frame 506 .

The embodiment shown in FIG. 8A includes a thin planar suture pallet 540 . The suture pallet 540 is configured to hold the suture 528 in the suture receptacle 513 when the surgical instrument is initially held in a closed position, for example, the first jaw 80 when the surgical instrument 11 is initially delivered to the user. and the second jaw 50 on opposite sides of the suture positioner 540 . This configuration of suture pallet 540 ensures that sutures 528 are seated within suture holder 513 during transport and prevents damage to sutures 528 and damage to suture guiding structure 5053 of anvil 505 . However, according to another embodiment of the invention, the surgical instrument 11 may also be initially in the open position. Figure 8B shows an exploded view of the surgical instrument 11 according to one embodiment of the present invention, while Figure 9B shows an assembled perspective view of the surgical instrument 11 shown in Figure 8B. More specifically, the structure of the suture pallet 525 shown in FIG. 8B enables the surgical instrument 11 to initially remain in the open position, for example, when the surgical instrument 11 is delivered to the user, the first clamp 80 and the second clamp 50 is separated.

As shown in Figure 8B, the suture pallet 525 is connected to the lower parallel edge 5066 of the frame housing 506 by a joint 5251 so that the suture 528 can be retained in the suture seat 513 to prevent, during transportation, Damage to the suture 528 and damage to the suture guiding structure 5053 of the anvil 505. The suture pallet 525 includes a pair of guide structures 5254 disposed along sides 5253a and 5253b that extend downwardly. The guide structure 5254 is in contact with the outer side 5056 of the anvil 505 so as to secure the first clamp 80 , eg, the housing frame 506 of the surgical device 11 parallel to the second clamp 50 , during transportation and handling. Thus, the guide structure 5254 can prevent misalignment of the first jaw 80 and the second jaw 50 that occurs when transporting the surgical instrument 11 with the first jaw 80 and the second jaw 50 in the open position.

It should be understood that the embodiments according to the present invention shown in FIGS. 3 to 9B include suturing and cutting elements in a guillotine-type arrangement. Move between end and far end. For example, in an alternative embodiment of the surgical instrument 11, including a gear connected to the suturing member and the cutting element, the gear moves between the proximal end and the distal end of the surgical instrument 11 through non-parallel Connected, for example, a drive shaft connected perpendicularly to the plane of motion of the first tongs 80 and the second tongs 50 is driven.

According to an embodiment of the present invention, the surgical instrument 11 can be used as an accessory of an electromechanical surgical system, such as the electromechanical driver part 610, or can also be integrally formed therewith. In another embodiment, the surgical instrument may also be attached to, or integral to, a mechanical drive.

FIG. 2 shows a perspective view of an electromechanical drive component 610 according to the invention. Examples of such electromechanical drive components are described in, for example, U.S. Patent Application No. 09/723,715, U.S. Patent Application No. 09/836.781, and U.S. Patent Application No. 09/887,789, each of which is incorporated in its entirety are expressly incorporated herein by reference. Electromechanical driver assembly 610 may include, for example, a remote power console 612 including a housing 614 having a front panel 615 . On the front panel 615 are mounted a display unit 616 and indicators 618a, 618b. Extending from the housing 614 is a flexible shaft 620 which is detachably attachable to the front panel via a first adapter 622 . The distal end 624 of the flexible shaft 620 may include a second adapter 626 suitable for removably attaching a surgical instrument, such as the above-described surgical instrument 11 , to the distal end 624 of the flexible shaft 620 . The second adapter 626 can be adapted to releasably connect with various surgical instruments or accessories. In another embodiment, the distal end 624 of the flexible shaft 620 may also be fixedly connected to, or integral with, the surgical instrument.

Referring to FIG. 10 , this figure is a side view of the flexible shaft 620 with partial cutaway. According to one embodiment, the flexible shaft 620 includes a tubular housing 628 that includes a coating or other sealing arrangement to form a fluid-tight seal between its internal conduit 640 and the external environment. tight seal). Housing 628 may be made of a biocidal elastomeric material that is compatible with physiological tissue. The shell 628 can also be made of autoclavable materials. The first rotary drive shaft 630, the second rotary drive shaft 632, the first control cable 634, the second control cable 635, the third control cable 636, the fourth control cable 637, and the data transmission cable 638 can be set In the inner conduit of the flexible shaft 620 and extends along its entire length. 11 shows a cross-sectional view of flexible shaft 620 taken along line 11 - 11 in FIG. 10 , and also shows cables 630 , 632 , 634 , 635 , 636 , 637 , 638 . Each distal end of the steering cables 634 , 635 , 636 , 637 is attached to the distal end 624 of the flexible shaft 620 . Each cable 630, 632, 634, 635, 636, 637, 638 may be retained within a respective housing.

The first rotary drive shaft 630 and the second rotary drive shaft 632 may form, for example, highly flexible drive shafts, eg braided or helical drive shafts. It will be appreciated that such highly flexible drive cables may have limited torque transmission characteristics and capabilities. It will also be appreciated that the surgical instrument 11 or other accessory coupled to the flexible shaft 620 requires a greater torque input than is transmitted through the drive shafts 630 , 632 . The drive shafts 630, 632 are therefore capable of transmitting lower torque at high speeds, which can be converted to low speed/high torque by gearing which can be provided on the surgical instrument or accessory and/or the remote power console 612 The distal end and/or the proximal end of the flexible shaft 620. Of course, it is understood that the gearing may be located anywhere along a kinetic chain between the motor on housing 614 and the surgical instrument or other accessory connected to flexible shaft 620 . The gears may include, for example, spur gears, planetary gears, harmonic gears, cycloidal drives, epicyclic gears, and the like.

Referring now to FIG. 12 , which is a rear end view of the first adapter 622 . The first adapter 622 includes a first connector 644, a second connector 648, a third connector 652, and a fourth connector 656, each of which is rotatably fixed to the first adapter 622. . Each connector 644 , 648 , 652 , 656 includes a respective groove 646 , 650 , 654 , 658 . As shown in FIG. 12, each groove 646, 650, 654, 658 may be hexagonal in shape. It will be appreciated, however, that the grooves 646, 650, 654, 658 may be of any shape and configuration suitable for non-rotatably engaging and rigidly connecting the connectors 644, 648, 652, 656 to the housing 612 fixedly. On the corresponding drive shaft of the motor unit inside. It will be appreciated that complementary protrusions are also provided on the corresponding drive shafts of the motor means to drive the drive elements of the flexible shaft 620 . It will also be appreciated that grooves may be provided on the drive shaft and complementary protrusions on the connectors 644, 648, 652, 656 as well. Any other connection means can also be provided as long as it can be non-rotatably and releasably connected to the connection pieces 644, 648, 652, 656 and the motor means drive shaft.

One of the links 644 , 648 , 652 , 656 is non-rotatably fixed to the first drive shaft 630 and the other of the links 644 , 648 , 652 , 656 is non-rotatably fixed to the second drive shaft 632 . The remaining two of the connectors 644, 648, 652, 656 engage delivery elements that are used to apply tension to the steering cables 634, 635, 636, 637, thereby manipulating the distal end 624 of the flexible shaft 620 . The data transmission cable 638 is electrically and logically connected to the data connector 660 . The data connection 660 includes, for example, electrical contacts 662 corresponding to and equal in number to the wires in the data cable 638 . The first adapter 622 includes a key structure 642 to properly position the first adapter 622 on a mating complementary adapter device provided on a housing 612 . The keying structure 642 may be provided on either or both of the first adapter 622 and a mating complementary adapter arrangement provided on the housing 612 . The first adapter 622 may include a quick-connect type connector that engages the first adapter 622 to the housing 612 with a simple push action. Along with any of the connections 644, 648, 652, 656, 660, seals are provided so that a fluid seal can be provided between the interior of the first adapter 622 and the external environment.

Referring to FIG. 13 , it is a front view of the second adapter 626 of the flexible shaft 620 . In this embodiment, the second adapter 626 includes a first link 666 and a second link 668, each rotatably fixed to the second link 626, and each non-rotatably fixed to the second link 668. The distal end of a corresponding one of the first and second drive shafts 630,632. A quick connect type coupling 664 is provided on the second adapter 626 to removably secure the instrument 11 thereto. The quick connect type fitting 664 may be, for example, a swivel quick connect type fitting, a bayonet type fitting, or the like. A key structure 674 is provided on the second adapter 626 for properly aligning the instrument 11 with the second adapter 626 . The keying or other means of properly aligning the instrument 11 with the flexible shaft 620 may be provided on either or both of the second adapter 626 and the instrument 11 . In addition, the quick-connect type connector can also be provided on the instrument 11 as a quick-connect adapter 511 as shown in FIG. 8A . A data connection 670 with electrical contacts 672 is also provided on the second adapter 626 . Similar to the data connector 660 of the first adapter 622, the data connector 670 of the second adapter 626 includes contacts 672 electrically and logically connected to the wires of the data transmission cable 638 and the contacts of the data connector 660 662. Seals are also provided along with the connections 666, 668, 670 to provide a fluid seal between the interior of the second adapter 626 and the external environment.

An electromechanical driver element is provided inside the housing 614 of the remote power console 612 for driving the drive shafts 630, 632 and manipulating the cables 634, 635, 636, 637 to engage the electromechanical driver assembly 610 and the second The surgical instrument 11 connected to the device 626 works. In the embodiment shown in Figure 14, five electric motors 676, 680, 684, 690, 696 are provided in the remote power console 612, each powered by a power supply that may be provided in the remote power console . However, it will be appreciated that any suitable number of electric motors may be provided and that the electric motors may be operated from battery power, line current, DC power, electronically controlled DC power, and the like. It is also conceivable that the motor can also be connected to a DC power supply which in turn is connected to the line current so that the line current supplies the operating current of the motor.

Figure 14 schematically shows a possible arrangement of the electric motor. The output shaft 678 of the first motor 676 is engaged with the first connector 644 of the first adapter 622. At this time, the first adapter 622, and then the flexible shaft 620 is engaged with the housing 614 to drive the first drive. The shaft 630 and the first connection 666 of the second adapter 626 . Similarly, the output shaft 682 of the second motor 680 is engaged with the second connecting member 648 of the first adapter 622, and at this time the first adapter 622, and thus the flexible shaft 620, is engaged with the housing 614, thereby driving the second The drive shaft 632 and the second coupling 668 of the second adapter 626 . The output shaft 686 of the third motor 684 is engaged with the third connector 652 of the first adapter 622. At this time, the first adapter 622, and then the flexible shaft 620 is engaged with the housing 614 so as to pass through the first pulley assembly. 688 drives the first and second steering cables 634,635. The output shaft 692 of the fourth motor 690 is engaged with the fourth connector 656 of the first adapter 622. At this time, the first adapter 622, and then the flexible shaft 620 is engaged with the housing 614, so that the second pulley can pass through The device 694 drives the third and fourth steering cables 636,637. The third and fourth motors 684, 690 may be mounted on a bracket 1100 that is selectively movable between a first position and a second position via an output shaft 698 of a fifth motor 696 to align with the first position. Three and fourth electric motors 684, 690 are selectively engaged and disengaged, while the third and fourth electric motors are coupled to respective pulley assemblies 688, 694 so that the flexible shaft 620 can become tensioned and pulled as desired. Take control or get fluffy. It is contemplated that other mechanical, electrical, and/or electromechanical mechanisms, etc. may be used to selectively engage and disengage the manipulation structure. As an example, an electric motor may be arranged and have the structure described in U.S. Patent Application Serial No. 09/510,923, entitled "Bracket Assembly for Controlling a Steering Wire Mechanism in a Flexible Shaft," the entirety of which is The contents are expressly incorporated herein by reference.

It will be appreciated that any one or more of the electric motors 676, 680, 684, 690, 696 may be, for example, a high speed/low torque motor, a low speed/high torque motor, or the like. As noted above, the first rotary drive shaft 630 and the second rotary drive shaft 632 may be configured to transmit high speeds and low torques. As such, the first electric motor 676 and the second electric motor 680 may be configured as high speed/low torque electric motors. Optionally, the first electric motor 676 and the second electric motor 680 can also be configured as low speed/high torque electric motors, and between the first electric motor 676 and the second electric motor 680 and the corresponding first rotary drive shaft 630 and the second rotary drive shaft 632 A torque reduction/speed up gear unit is arranged between one of them. The torque reducing/increasing gearing may include, for example, spur gearing, planetary gearing, harmonic gearing, cycloidal drive, epicyclic gearing, and the like. It will be appreciated that any such gear arrangement may be disposed within the remote power console 612 or proximally of the flexible shaft 620 , such as within the first adapter 622 . As can be appreciated, gearing can be provided at the distal and/or proximal ends of the first rotatable drive shaft 630 and/or the second rotatable drive shaft 632 to prevent windup and damage thereof.

Referring to FIG. 15 , it is a schematic diagram of an electromechanical driver component 610 . The controller 1122 is disposed on the housing 614 of the remote power console 612 and is configured to control the electromechanical driver assembly 610 and the linear clamping, cutting and stapling instrument 11 or other surgical instruments or accessories connected to the flexible shaft 620 All functions and operations. A storage unit 1130 is also provided, which may include memory devices, eg, ROM elements 1132, RAM elements 1134, and the like. The ROM element 1132 is electrically and logically connected to the controller 1122 through a line 1136 , and the RAM element 1134 is electrically and logically connected to the controller 1122 through a line 1138 . RAM element 1134 may comprise any type of random access memory, such as magnetic memory, optical memory, magneto-optical memory, electronic memory, or the like. Similarly, ROM element 1132 may also include any type of read-only memory, for example, removable memory, such as a PC card or PCMCIA type device or the like. It will be appreciated that ROM element 1132 and RAM element 1134 may be configured as a single unit, or may be formed as separate units, and that ROM element 1132 and/or RAM element 1134 may also be provided as a PC card or PCMCIA type device.

The controller 1122 is also connected to the front panel 615 of the housing 614, specifically, to the display device 616 via a line 1154, and to the indicators 618a, 618b via corresponding lines 1156, 1158. Lines 1116, 1118, 1124, 1126, 1128 electrically and logically connect controller 112 to first, second, third, fourth, and fifth electric motors 676, 680, 684, 690, 696, respectively. A wired remote control unit (RCU) 1150 is electrically and logically connected to controller 1122 via line 1152 . A wireless remote control unit 1148 is also provided, which is connected to the receive/transmit unit 1146 via a wireless line 1160 , while the receive/transmit unit is connected to the transceiver 1140 via line 1144 . The transceiver 1140 is electrically and logically connected to the controller 1122 by a line 1142 . Wireless link 1160 may be, for example, an optical link, such as an infrared link, a wireless link, or any other form of wireless communication link.

Switching device 1186 may include, for example, an array of DIP switches and may be connected to controller 1122 via line 1188 . The switch device 1186, for example, may be configured to select one of a plurality of languages in which information and prompts are displayed on the display device 616. The information and notifications may relate, for example, to the operation and/or status of the electromechanical drive component 610 and/or the surgical instrument 11 connected thereto.

According to an embodiment of the present invention, the first encoder 1106 may be disposed in the second adapter 626 and its structure may be configured to respond to the rotation of the first drive shaft 630 and output a signal according to the rotation. The second encoder 1108 is also disposed within the second adapter 626 and is configured to respond to rotation of the second drive shaft 632 and output a signal based on the rotation. The signals output by each encoder 1106, 1108 can indicate the rotational position and direction of rotation of each drive shaft 630, 632. The encoders 1106, 1108 may include, for example, Hall effect devices, optics, and the like. Although the encoders 1106 , 1108 are described as being disposed within the second adapter 626 , it is understood that the encoders 1106 , 1108 may be disposed anywhere between the motor system and the surgical instrument 11 . It is contemplated that positioning the encoders 1106, 1108 within the second adapter 626 or at the distal end of the flexible shaft 620 would allow for an accurate measurement of the drive shaft's rotation. If the encoders 1106, 1108 were disposed proximally of the flexible shaft 620, twisting of the first and second rotational drive shafts 630, 632 could cause measurement errors.

FIG. 16 is a schematic diagram of an encoder 1106, 1108 that includes a Hall effect device. A magnet 1240 having a north pole 1242 and a south pole 1244 is non-rotatably mounted on the drive shafts 630 , 632 . The encoders 1106 , 1108 also include a first sensor 1246 and a second sensor 1248 that are separated by approximately 90° relative to the longitudinal or rotational axis of the drive shaft 630 , 632 . The outputs of the sensors 1246, 1248 are continuous and change their state as the polarity of the magnetic field located within the sensor's detection range changes. Thus, based on the output signals of the encoders 1106, 1108, the angular position of the drive shafts 630, 632 can be determined within a quarter of a circle, so that the direction of rotation of the drive shafts 630, 632 can be determined. The output signal of each encoder 1106 , 1108 is transmitted to the controller 1122 via a corresponding line 1110 , 1112 of the data transmission cable 638 . The controller 1122 can determine the position and/or position of components of the surgical instrument coupled to the electromechanical driver assembly 610 by tracking the angular coordinates and rotational direction of the drive shafts 630, 632 carried by the output signals of the encoders 1106, 1108. state. That is, by counting the number of revolutions of the drive shafts 630 , 632 , the controller 1122 can determine the position and/or status of components of the surgical instrument coupled to the electromechanical driver component 610 .

For example, the advancing distance between the first clamp 80 and the second clamp 50 and the push plate 502 is a function of, and can be determined by, the rotation of each drive shaft 630 , 632 . By determining the absolute position of the second clamp 50 and the push plate 502 at a certain point in time, the absolute position of the first clamp 80 and the push plate 502 at any time thereafter can be determined using the first clamp based on the output signals of the encoders 1106, 1108. The relative displacement of the two clamps 50 and the push plate 502, and the known screw moments of the screw rod 521 and the screw rods 503, 504 determine the push plate. When the surgical instrument 11 is first attached to the flexible shaft 620, the absolute position of the second jaw 50 and push plate 502 may be fixed and determinable. Alternatively, the position of the second clamp 50 and push plate 502 relative to, for example, the first clamp 80 may be determined from the output signals of the encoders 1106,1108.

The surgical instrument 11 may further include a data connection 1272 , sized and configured for electrical and logical connection to the connection 670 of the second adapter 626 , as shown in FIG. 8A . In this embodiment, data connector 1272 includes an equal number of contacts as wires 672 of connector 670 . The memory module 501 is electrically and logically connected to the data connector 1272 . The memory module 501 may be in the form of, for example, EEPROM, EPROM, etc., and may be loaded, for example, within the second jaw 50 of the surgical instrument 11 .

FIG. 17 schematically shows a memory module 501 . As shown in FIG. 17 , data connection 1272 includes contacts 1276 each electrically and logically connected to memory module 501 via a corresponding line 1278 . The memory module 501 can be configured to store, for example, serial number data 1180, accessory type identifier (ID) data 1182, and usage data 1184. The memory module 501 can additionally store other data. Both serial number data 1180 and ID data 1182 can be set as read-only data. The serial number data 1180 and /ID data 1182 may be stored in a read-only area of the memory module 501 . In this embodiment, the serial number data 1180 may be data used only to identify a particular surgical instrument, while the ID data 1182 may be data used to identify the type of accessory that may be, for example, connected to the system 610 other types of surgical instruments or accessories. Usage data 1184 represents usage of a particular accessory, for example, the number of times the first jaw 80 of the surgical instrument 11 is opened and closed, or the number of times the pusher plate of the surgical instrument 11 is advanced. The usage data 1184 may be stored in a read/write area in the memory module 501 .

It is contemplated that an accessory such as surgical instrument 11 coupled to distal end 624 of flexible shaft 620 may be designed and configured for one-time use only, or for multiple uses. The accessory can also be designed and configured to be used a predetermined number of times. Accordingly, the usage data 1184 can be used to determine whether the surgical instrument 11 has been used, and whether the number of uses has exceeded a predetermined maximum number of uses. As detailed below, if an attempt is made to use the accessory after the maximum number of uses allowed has been reached, an "error" condition is generated.

Referring again to FIG. 15 , when the surgical instrument 11 is initially connected to the flexible shaft 620 , the controller 1122 is configured to read ID data 1182 from the memory module 501 of the surgical instrument 11 . The memory module 501 is electrically and logically connected to the controller 1122 through the line 1120 of the data transmission cable 638 . Based on the ID data 1182 read, the controller 1122 is configured to read or select from the memory unit 1130 an operating program or algorithm corresponding to the type of surgical instrument or accessory connected to the flexible shaft 620 . The memory unit 1130 is configured to store operating programs or algorithms for various available types of surgical instruments or accessories. The memory unit 1130 selects and/or reads an operating program or algorithm. As mentioned above, the memory unit 1130 includes a removable ROM element 1132 and/or RAM element 1134 . In this way, the operating programs or algorithms stored in the memory unit 1130 can be updated, added, deleted, improved, or otherwise modified as required. The operating programs or algorithms stored in the memory unit 1130 can be customized according to, for example, the user's special needs. Data input devices, such as a keyboard, mouse, pointing device, touch screen, etc., can be connected to the memory unit 1130 through, for example, a data connection port to facilitate customization of operating programs or algorithms. Alternatively or additionally, the operating program or algorithm may be customized and pre-programmed in the memory unit 1130 remote from the electromechanical drive component 610 . It should be appreciated that the serial number data 1180 and/or usage data 1184 may also be used to determine which of a plurality of operating programs or algorithms to read or select from the memory unit 1130 . It can be appreciated that, as an option, the operating program or algorithm can also be stored in the memory module 501 of the surgical instrument 11 and transmitted to the controller 1122 through the data transmission cable 638 . Once the appropriate operating program or algorithm is read or selected by the controller 1122 or transmitted to the controller, the controller 1122 will start to execute the operating program according to the user's operation through the wired RCU 1150 and/or wireless RCU 1148 or algorithm. As described above, the controller 1122 is electrically and logically connected to the first, second, third, fourth, fifth electric motors 676, 680, 684, 690 via corresponding lines 1116, 1118, 1124, 1126, 1128 , 696 and configured to control the motors 676, 680, 684, 690, 696 according to the operating program or algorithm read, selected or transmitted via the respective lines 1116, 1118, 1124, 1126, 1128.

Referring now to Figure 18, it is a schematic diagram of the wireless RCU 1148. The wireless RCU includes a steering controller 1300 having a plurality of switches 1302 , 1304 , 1306 , 1308 disposed under a four-way rocker 1310 . Through the rocker 1310 , the switches 1302 , 1304 operate, and the third motor 684 controls the operation of the first and second steering cables 634 , 635 . Similarly, through the rocker 1310 , the switches 1306 , 1308 operate, and the fourth motor 392 controls the operation of the third and fourth steering cables 636 , 637 . It can be known that the rocker 1310 and the switches 1302, 1304, 1306, 1308 are arranged so that the operation of the switches 1302, 1304 can manipulate the flexible shaft 620 in the north-south direction, and the operation of the switches 1306, 1308 can be manipulated in the east-west direction. Flexible shaft 620. The north-south and east-west here are determined according to a relative coordinate system. Alternatively, instead of the rocker 1310 and the switches 1302, 1304, 1306, 1308, a digital joystick, an analog joystick, etc. may also be provided. Instead of rocker 1310 and switches 1302, 1304, 1306, 1308, potentiometers or any other type of actuator could also be used.

The wireless RCU 1148 further includes a steering engagement/disengagement switch 1312, the operation of which can control the operation of the fifth motor 696 to selectively engage and disengage with the steering mechanism. The wireless RCU 1148 also includes a two-way rocker 1314 having first and second switches 1316, 1318 operable thereby. Operation of these switches 1316, 1318 may control the electromechanical driver assembly 610, and any surgical instrument or accessory, such as a surgical instrument coupled to the flexible shaft 620, according to an operating program or algorithm corresponding to the connected instrument 11. Certain functions of the instrument 11. For example, operation of the two-way rocker 1314 may control the opening and closing of the first jaw 80 and the second jaw 50 of the surgical instrument 11 . The wireless RCU 1148 may also be provided with other switches 1320 whose operation may further control the electromechanical driver assembly 610 and accessories connected to the flexible shaft 620 according to an operating program or algorithm corresponding to the connected instrument. running. For example, operation of switch 1320 may initiate advancement of pusher plate 502 of surgical instrument 11 .

Wireless RCU 1148 also includes a controller 1322, which is electrically connected to switches 1302, 1304, 1306, 1308 via line 1324, switches 1316, 1318 via line 1326, switch 1312 via line 1328, and switch 1320 via line 1330. connect. The wireless RCU 1148 may include indicators 618a', 618b' corresponding to the indicators 618a, 618b of the front panel 615, and a display device 616' corresponding to the display device 616 of the front panel 615. If provided, indicators 618a', 618b' are electrically and logically connected to controller 1322 via respective lines 1332, 1334, and display device 616' is electrically and logically connected to controller 1322 via line 1336. Controller 1322 is electrically and logically connected by line 1340 to transceiver 1338 , and the transceiver 1338 is electrically and logically connected by line 1344 to receiver/transmitter 1342 . A power supply, such as a battery, is also provided in the wireless RCU 1148, so as to provide it with electric energy. In this way, the wireless RCU 1148 can control the operation of the electromechanical driver assembly 610 and the instrument 11 connected to the flexible shaft 620 via the wireless line 1160.

Wireless RCU 1148 may include switch 1346 connected to controller 1322 by line 1348. Operation of switch 1346 may transmit a data signal to transmitter/receiver 1146 via wireless link 1160 . The data signal includes identification data that identifies only the wireless RCU 1148. This identification data is used by the controller 1122 to prevent unauthorized operation of the electromechanical driver unit 610 and to prevent another wireless RCU from interfering with the operation of the electromechanical driver unit 610 . Each subsequent communication between the wireless RCU 1148 and the electromechanical surgical instrument 610 includes identification data. In this way, the controller 1122 can differentiate between wireless RCUs, thus allowing only one wireless RCU 1148-identifiable signal to control the operation of the electromechanical driver assembly 610 and the instrument 11 coupled to the flexible shaft 620.

Based on the position of each component of the instrument connected to the flexible shaft 620 (the position is determined based on the output signals of the encoders 1106, 1108), the controller 1122 can follow an operating program or algorithm corresponding to the connected instrument , selectively enable or disable the electromechanical driver component 610. For example, the activation function controlled by the operation of the switch 1320 is not available for the surgical instrument 11 unless the space or gap between the second jaw 50 and the first jaw 80 is determined to be within an acceptable range.

Please refer now to Fig. 19, which is a schematic diagram of wired RCU 1150. In this embodiment, the wired RCU 1150 includes substantially the same control elements as the wireless RCU 1148, so further description of these elements will be omitted. Similar elements are indicated in Figure 19 with additional superscripts. It is contemplated that the electromechanical driver assembly 610 and accessories connected to the flexible shaft 620, such as the functions of the surgical instrument 11, may be controlled by the wired RCU 1150 and/or the wireless RCU 1148. As an example, the wired RCU 1150 may be used to control the functions of the electromechanical driver assembly 610 and accessories connected to the flexible shaft 620 in the event of a wireless RCU 1148 battery failure.

As noted above, the front panel 615 of the housing 614 includes a display device 616 and indicators 618a, 618b. The display device 616 may include an alpha-numeric display device, such as an LCD display device. The display device 616 may also include an audio output device, such as a speaker, a buzzer, and the like. The display device 616 operates and is controlled by the controller 1122 according to the operating program or algorithm corresponding to the accessory connected to the flexible shaft 620 , such as the surgical instrument 11 . If no surgical instrument or accessory is so connected, then a default operating program or algorithm may be read or selected by or transmitted to the controller 1122 to control the operation of the display device 616, and the electromechanical drive components Other aspects and functions of the 610. If the surgical instrument 11 is connected to the flexible shaft 620, the display device 616 may display, for example, the gap between the second clamp 50 and the first clamp 80 as determined from the output signals of the encoders 1106, 1108. data, as described above.

Similarly, indicators 618a, 618b can be operated and controlled by controller 1122 according to an operating program or algorithm corresponding to accessory 11 , such as surgical instrument 11 , coupled to flexible shaft 620 . Indicator 618a and/or indicator 618b may include an audio output device, such as a speaker, buzzer, etc., and/or a visual indicator device, such as an LED, lamp, light, or the like. If the surgical instrument 11 is connected to the flexible shaft 620, the indicator 618a may indicate, for example, that the electromechanical driver assembly 610 is in an "on" state, and the indicator 618b may indicate, for example, that the second clamp 50 and the second Whether the gap between the clamps 80 is within an acceptable range. It will be appreciated that although only two indicators 618a, 618b are depicted, any number of additional indicators may be provided as desired. Additionally, it is also contemplated that while only a single display 616 is depicted, any number of additional displays desired could be provided if desired.

The display 616' and indicators 618a', 618b' of the wired RCU 1150, and the display 616'' and indicators 618a'', 618b'' of the wireless RCU 1148 are connected to the flexible shaft 620 according to the corresponding controllers 1322, 1322'. Similar operations and controls are carried out by the operating procedures or algorithms of the device.

As noted above, surgical instrument 11 may be configured to clamp, cut, and immobilize a portion of tissue. The operation of instrument 11 will be described below in connection with the removal of a cancerous or abnormal portion of a patient's bowel tissue, but this is only one type of tissue and one type of surgical procedure performed using surgical instrument 11 . Typically, the patient's abdomen is first opened to expose the bowel after cancerous or abnormal tissue within the gastrointestinal tract has been located. Upon remote action of the electromechanical actuator assembly 610, the first and second jaws 50, 80 of the surgical instrument 11 are advanced to an open position by the first actuator. As mentioned above, the surgical instrument can initially be held in the open position, thus eliminating the need to first advance the surgical instrument 11 into the open position. The intestinal tube next to the side of the cancerous tissue is placed between the opened first clamp 80 and the second clamp 50 . Through remote action, the first driver engages in the opposite direction, and the first clamp 80 and the second clamp 50 approach to clamp the intestinal tissue between them. Once the bowel is firmly clamped, the second driver engages, which causes the push plate (on which the suture pusher and knife are mounted) between the first position shown in Figure 5 and the second position shown in Figure 6 Move so that the bowel can be cut and stitched. Then, engage the second driver in the opposite direction, so that the suture pusher and the knife get back to the first position shown in FIG. Claw 50 returns to the open position. These steps are repeated on the other side of the cancerous tissue so that the intestinal tissue with the cancerous tissue can be resected, which is stapled at both ends to keep intestinal material from flowing through the opened abdomen.

More specifically, according to an embodiment of the present invention, the surgical instrument 11 is connected to the attachment adapter 626 of the electromechanical driver assembly 610 such that the first drive mount 180 engages the first drive shaft 630 of the electromechanical driver assembly 610, Whereas the second drive hole 310 engages with the second drive shaft 632 of the electromechanical drive part 610 . The pinion gear 508a is rotated by the rotation of the first drive seat 180 , which in turn is rotated by the rotation of the corresponding drive shaft 630 of the electromechanical driver component 610 . Clockwise or counterclockwise rotation of pinion 508a depends on the direction of rotation of motor 680 . The pinion gear 508b is rotated by the rotation of the second drive seat 310 which in turn is rotated by the rotation of the corresponding drive shaft 632 of the electromechanical driver part 610 . Clockwise or counterclockwise rotation of pinion 508b depends on the direction of rotation of motor 676 .

When the surgical instrument 11 is in the initial closed position as shown in FIG. 4, the first motor 680 is operated to place the surgical instrument in the open position. In particular, starting the first motor 680 corresponding to the first drive shaft 630 engaged with the first drive seat 180 can cause the pinion 508a to rotate in a first direction, for example, counterclockwise direction to turn. Since the circumferentially disposed teeth 5083 of the pinion 508a mesh with the circumferentially disposed teeth 5291 of the spur gear 529a, rotation of the pinion 508a causes the spur gear to rotate in a first rotational direction, for example clockwise, which Opposite to the direction of rotation of the pinion 508a. The inner hole 5293 of the first spur gear 529a is engaged with the end portion 5231 of the first worm 523a, thereby causing the first worm 523a to rotate in the same direction as the first spur gear 529a, ie clockwise. The thread 5233 of the worm 523a meshes with the teeth 5221 of the worm wheel 522, thereby making the worm wheel 522 rotate in a first rotation direction, for example, counterclockwise (viewed from the top direction). The inner hole 5222 of the worm wheel 522 engages with the portion 5212 of the head 5211 of the screw 521 , so that the screw 521 rotates in a first rotation direction, such as counterclockwise (viewed from the top direction). The external thread 5214 of the screw rod 521 is engaged with the thread of the internal thread hole 5051 of the anvil 505 , so that the anvil 505 moves in a downward direction, ie away from the frame housing 506 . In this way, the second clamp 50 is opened in a continuous manner. In the illustrated embodiment, the second jaw opens in parallel alignment with the first jaw 80 , eg, in one plane, and begins to separate from the first jaw 80 . The motor runs continuously in this way, and finally the surgical instrument 11 is in an open state, as shown in FIG. 3 , there is a space between the first clamp 80 and the second clamp 50 .

Next, the suture pallet 540 attached to the lower parallel edge 5066 of the frame housing 506 , or to the lower surface of the suture holder 513 , is removed. According to one embodiment, the suture holder is configured to pull the end 5181 of the pin 518 out of the through hole 5401 of the suture pallet 540 by pulling the lever 5182 of the pin 518 upward. The gripping portion 5403 of the suture pallet 540 can be grasped so that the suture pallet 540 can be pulled away from the surgical instrument 11 . Next, a section of tissue is placed between the first jaw 80 and the second jaw 50 . Along with suturing member seat 540 is removed from this surgical instrument 11, and this segment of tissue is placed between first clamp 80 and second clamp 50, the end 5181 of pin 518 is inserted into anvil block 505 hole 5057 and is held in the inserted position by the bias of spring 524 so that the length of tissue remains between the jaws.

The first motor 680 runs in reverse to place the surgical instrument in the closed position. Specifically, the first electric motor 680 corresponding to the first drive shaft 630 starts to act, and the first drive shaft engages with the first drive seat 180, thereby causing the pinion 508a to rotate in a second direction, such as clockwise. rotate. Since the circumferentially disposed gear teeth 5083 of the pinion gear 508a mesh with the circumferentially disposed gear teeth 5291 of the spur gear 529a, the rotation of the pinion gear 508a causes the spur gear 529a to rotate in a second direction, e.g., counterclockwise, i.e. The rotation direction is opposite to the rotation direction of the pinion gear 508a. The inner hole 5293 of the first spur gear 529a is engaged with the end 5231 of the first worm 523a such that rotation of the first spur gear 529a causes the first worm 523a to rotate in the same direction as the first spur gear 529a, i.e., Rotate counterclockwise. The thread 5233 of the worm 523a meshes with the gear teeth 5221 of the worm wheel 522, so that the rotation of the first worm 523a makes the worm wheel 522 rotate in the second direction, ie clockwise (viewed from the top). The inner hole 5222 of the worm gear 522 is engaged with the portion 5212 of the head 5211 of the screw 521, so the rotation of the worm gear 522 makes the screw 521 rotate in the second direction, clockwise (viewed from the top). The external thread 5214 of the screw 521 is engaged with the thread of the internal thread hole 5051 of the anvil 505 , thus, the rotation of the screw 521 makes the anvil 505 move upward, that is, toward the frame housing 506 . In this way, the second clamp 50 closes in a continuous manner and approaches the first clamp 80 . The continuous operation of the motor in this manner will eventually make the surgical instrument 11 in a closed state, as shown in FIG. 4 , wherein the tissue is clamped between the first clamp 80 and the second clamp 50 . In the closed state, the portion of tissue being stapled and cut is clamped between a pair of parallel disposed edges 5253 a and 5253 b of suture seat 513 and region 5054 of anvil 505 .

To begin the stitching and cutting procedure, the second motor 676 is activated to move the push plate 502 from a first raised position, eg, a retracted position, to a second lowered position, eg, an extended position. Specifically, the second electric motor 676 corresponding to the second drive shaft 632 starts to start. The second driving shaft 632 is engaged with the second driving base 310 , so that the second driving shaft 632 rotates in a first direction, such as counterclockwise, so that the pinion 508b rotates in the first direction, namely counterclockwise. Circumferentially disposed teeth 5086 of the pinion 508b mesh with circumferentially disposed teeth 5292 of a spur gear 529b, and rotation of the pinion 508b causes the spur gear 529b to rotate in a first direction, e.g., with the pinion 508b. Rotate clockwise in the opposite direction. The inner hole 5294 of the spur gear 529b is engaged with the end 5234 of the second worm 523b, so that the rotation of the spur gear 529b makes the second worm 523b rotate in the same direction as the second spur gear 529b, such as clockwise rotate. The thread 5236 of the worm 523b is engaged with the worm gear 5161 of the worm gear 516, so that the rotation of the second worm 523b makes the worm gear 516 rotate in a first direction, such as counterclockwise (viewed from the top). The threads of the internally threaded hole 5164 of the worm wheel 516 are engaged with the threads of the screw rod 504 . Since the screw 504 is non-rotatably connected to the push plate 502, the screw 504 and the push plate 502 move together in a downward direction. Simultaneously, the thread 5236 of the worm 523b is engaged with the gear teeth 5171 of the worm wheel 517, so that the rotation of the worm 523b causes the worm wheel 517 to first rotate eg clockwise (viewed from the top). The thread of the internally threaded hole 5174 of the worm wheel 517 is engaged with the thread of the screw rod 503 . Since the screw rod 503 is non-rotatably connected to the push plate 502 , the screw rod 503 moves in a downward direction together with the push plate 502 . In this way, the push plate 502 moves downward in a continuous manner, and the suture pusher 514 and knife 519 mounted to the bottom surface 5022 of the push plate 502 also move downward in a continuous manner.

As the suture pusher 514 is lowered, the downwardly disposed teeth 5143 of the suture pusher 514 are advanced through the slots 5132 of the suture holder 513 . The suture 528 initially disposed in the groove 5132 of the suture seat 513 is pushed downwardly out of the lower opening of the groove 5132 and through the clamped tissue until the tip 5281 of the suture 528 contacts the corresponding anvil 505 The suture guiding structure 5053 of the The suture guiding structure 5053 bends and closes the tip 5281 of the suture 528 so that the tissue can be sutured. Simultaneously, the knife 519 that is installed on the bottom surface 5022 of push plate 502 passes through the groove 5131 that the suturing member seat 513 is arranged vertically, until this knife touches the knife pad 520 of anvil block 505, thereby can excise this clamped tissue .

After completing the suturing and cutting procedures, the second motor 676 is activated to move the push plate 502 from the second downward position to the first raised position. Specifically, the second motor 676 corresponding to the second driving shaft 632 is activated, and the second driving shaft corresponds to the second driving base 310 . Rotation of the second drive shaft 632 causes the pinion gear 508b to rotate in a second direction, such as a clockwise direction. The teeth 5086 of the pinion gear 508b mesh with the teeth 5292 of the spur gear 529b such that rotation of the pinion gear 508b causes the spur gear 529b to rotate in a second direction, eg, counterclockwise. The inner hole 5294 of the spur gear 529b engages with the end 5234 of the second worm 523b, so that the rotation of the spur gear 529b causes the second worm 523b to rotate in a second rotational direction, such as counterclockwise. The threads 5236 of the worm 523b mesh with the circumferentially disposed teeth 5161 of the worm wheel 516, so that the rotation of the worm 523b causes the worm wheel 516 to rotate in a second direction, eg clockwise (viewed from the top). The threads of the internally threaded hole 5164 of the worm wheel 516 engage with the threads of the screw 504, and since the screw 504 is non-rotatably connected to the push plate 502, the screw 504 and the push plate 502 move together in an upward direction. Simultaneously, the thread 5236 of the worm 523b engages with the gear teeth 5171 of the worm wheel 517, so that the rotation of the worm 523b makes the worm wheel 517 rotate in a second direction, such as counterclockwise (viewed from the top). The threads of the internally threaded hole 5174 of the worm wheel 517 engage with the threads of the screw 503, and since the screw 503 is non-rotatably connected to the push plate 502, the screw 503 and the push plate 502 move together in an upward direction. Like this, push plate 502 rises in a continuous manner, thereby the suture pusher 514 and knife 519 mounted on the bottom surface of this push plate 502 also rise to their initial retracted positions in a continuous manner.

After finishing cutting and stapling the tissue and returning the knife 519 to the retracted position, the first motor 680 is activated to place the surgical instrument in the open position. Specifically, the first motor corresponding to the first driving shaft 630 is started. The first drive shaft 630 is engaged with the first drive seat 180 , so the rotation of the first drive shaft 630 causes the pinion gear 508a to rotate in a first rotation direction, such as counterclockwise. The teeth 5083 of the pinion gear 508a are engaged with the teeth 5291 of the spur gear 529a such that rotation of the pinion gear 508a causes the spur gear to rotate in a first direction, eg clockwise. The inner hole 5293 of the first spur gear 529a is engaged with the end 5231 of the first worm 523a, so that the rotation of the first spur gear 529a makes the first worm 523a move in the same direction as the first spur gear 529a, as Rotate clockwise. The threads 5233 of the worm 523a are engaged with the teeth 5221 of the worm wheel 522, so that the rotation of the worm 523a causes the worm wheel 522 to rotate in a first direction, such as clockwise (viewed from the top). The inner hole 5222 of the worm wheel 522 engages with the portion 5212 of the head 5211 of the screw 521 , so that the rotation of the worm wheel 522 makes the screw 521 rotate in a first direction, such as counterclockwise (viewed from the top). The external thread 5214 of the screw 521 is engaged with the internal thread hole 5051 of the anvil 505 , so that the rotation of the screw 521 causes the anvil 505 to move in a downward direction, eg, move away from the frame housing 506 . Thus, the second clamp 50 is separated from the first clamp 80 until the surgical instrument 11 is in the open position, as shown in FIG. 3 , with a space between the first clamp 80 and the second clamp 50 .

Thereafter, the surgical instrument 11 is detached from the electromechanical driver part and replaced with another surgical instrument 11 so that the same clamping, cutting, and sewing procedures. The surgical instrument 11 may also be detached from the electromechanical driver assembly 610 once the second end of the intestine is also clamped, cut, and stapled. The operator can also discard the accessory or sterilize it for reuse if necessary.

It is to be noted that a calibration procedure should be performed before the surgical instrument 11 is started. This procedure is described in US Provisional Application Serial No. 60/337,544, filed December 4, 2001, entitled "Calibration of Surgical Instruments," the contents of which are incorporated herein by reference.

According to the embodiment of the invention shown in FIGS. 8A and 8B , the surgical instrument 11 may be non-reloadable, e.g., the operator cannot remove the suture holder 513 from the housing 506 for reuse. Subsequent rows of sutures 523 load the surgical instrument 11 so that the surgical instrument 11 cannot be reused for the same or other patients, or for the same or other procedures. Like this, after starting this surgical instrument 11 to suture a tissue part with the suturing element 528 in the suturing element seat 513, this surgical instrument 11 cannot start again to suture another part with a new set of suture elements 528 or a new suture element seat 513 organize. The surgical instrument 11 is configured as a non-reloadable type, since the surgical instrument 11 cannot be used on two different patients intentionally or unintentionally, nor can it be reused on the same patient, thereby reducing the risk of contamination or infection. However, according to one embodiment of the present invention, the surgical instrument 11 may also be of the reloadable type. For example, in this embodiment, the surgical instrument 11 may be configured such that certain components thereof may be removed from the surgical instrument 11 , thereby being replaceable with respect to the surgical instrument 11 . For example, according to one embodiment of the present invention, the bin cap 515, the pin 518, the suture pusher 514 on which the knife 519 is mounted, and the suture seat 513 to which the suture pallet 540 is attached form a system that can A replacement cartridge is detachably attachable to the housing 506 so that it can be removed from the housing 506 after use to replace another cartridge. The replaceable magazine box can be removed when the upper clamp 80 and the lower clamp 50 are in a fully open position, so as to prevent the magazine from being damaged when the upper clamp 80 and the lower clamp 50 are clamping, cutting and suturing part of the tissue. The box was accidentally removed. 8A and 8B include a guide rail 5091 on the anvil filler (filler) 509 that, when the upper jaw 80 and the lower jaw 50 are not in the fully open position, the guide rail and the suturing member The guide rail groove 5135 of the seat 513 is engaged, and when the upper clamp 80 and the lower clamp 50 are in a fully open position, the guide rail is not engaged with the guide rail groove, therefore, the sewing of the replaceable magazine box can be made The component holder 513 and other components can be slidably removed from the housing 506 for replacement. In an alternative embodiment, the suture holder 513 can slide in and out of the housing 506 so that after the first set of sutures 528 are used, the user can slide in a new set of sutures 528 in the housing 506. New suture holder 513 for suture 528 . Alternatively, after the first set of sutures 528 in the suture holder 513 has been used, the operator can replace the sutures 528 in the same suture holder 513 so that the same suture holder 513 can be reused. The pin 518 can be retracted from the aperture 5133 of the suture holder 513 so that the cartridge cap 515 can be removably or removably connected to the housing 506 .

According to another embodiment of the present invention, the surgical instrument 11 can also be configured with limited reloadability. For example, the surgical instrument 11 can be configured to allow only one replacement of the suture seat 513, so that only two clamping, cutting, and suturing operations are allowed on the same patient, for example, on the opposite side of the cancerous tissue, but the No more than two replacements of the suture holder 513 are allowed.

In another embodiment of the present invention, the surgical instrument 11 can also be configured to hold two sets of sutures 528 in the suture holder 513, the first set of sutures being used on one side of the cancerous part of the tissue, and the second set being used on the side of the tissue. The other side of the cancerous part. It should be understood that the surgical instrument 11 may be configured for any number of uses, the usage of which may be determined from the usage data 1184 . That is, the storage module 501 can be used to store data representing the number of times the surgical instrument 11 is reloaded. Thus, according to the operating program, the electromechanical driver assembly 610 may limit the number of reloads of the surgical instrument 11 based on usage information stored in the memory module 501 .

Operation of the reloadable surgical instrument 11 is similar to that of the non-reloadable surgical instrument 11 described above. However, the reloadability of the surgical instrument 11 allows the operator to perform additional steps during operation of the surgical instrument 11 . For example, once the surgical instrument 11 is initially in the open position, the operator can access the suture seat 513 and also check it to determine whether the suture 528 is ready and/or to determine whether it is necessary to suture it. The seat 513 is replaced with a more suitable suture seat 513. Similarly, once clamping, cutting, and sewing operations have been performed, and a set of sutures 518 is used, the operator can access the suture seat 513 again to replace the suture with another suture seat 513 Seat 513, or insert another set of sutures 518 on the same suture seat 513.

According to the embodiment of the present invention shown in Figures 8A and 8B, the surgical instrument 11 can be configured to operate in multiple operating ranges. This feature has the advantage that the surgical instrument 11 is well suited for use when tissue sections have different thicknesses. For example, according to one embodiment of the present invention, the surgical instrument 11 can be configured to change the distance between the upper jaw 80 and the lower jaw 50 when the surgical instrument 11 is in the closed position, or when the push plate 535 is in the closed position. In the fully extended position, the position of the push plate 535 relative to the upper jaw 80 can be changed. According to one embodiment, the surgical instrument 11 can be reloadable so that two or more suture holders 513 of different sizes can be used, for example, suture holders 513 of different thicknesses or to accommodate sutures 518 of different lengths suture holder. In this embodiment, the operator may choose to use one of two or more different suture receptacles 513 with sutures 528 of different sizes disposed therein. The suture set 513 may include a memory module that can be read by the controller 1122, so that the controller 1122 can identify the suture set 513 according to whether it includes sutures suitable for suturing tissues of corresponding thickness. Then, the controller 1122 can control the first drive shaft 630 during operation so that when the surgical instrument 11 is moved to the closed position, the distance between the upper jaw 80 and the lower jaw 50 is the same as the distance between the upper jaw 80 and the lower jaw 50 to be cut and passed. The thickness of the tissue to be sutured by the suturing member 523 is corresponding. Similarly, the controller 1122 can control the second drive shaft 632 so that when moved to the extended position, the push plate 535, the suture pusher 514, and the knife 519 are positioned to be cut and sutured by the suture 523. corresponding to the thickness of the tissue.

According to another embodiment of the present invention, non-reloadable surgical instruments 11 of different sizes corresponding to different thicknesses of tissue to be cut and stapled may also be used. In this embodiment, the memory module 501 of the surgical instrument 11 includes data readable by the controller 1122 enabling the controller 1122 to identify the surgical instrument 11 corresponding to a particular thickness of tissue to be cut and stapled.

In another embodiment of the invention, the controller 1122 is configured to provide more than one operating range for the same set of suturing elements 523 . For example, the controller 1122 can be configured to allow the operator to select settings corresponding to different thicknesses of tissue to be resected or stapled. For example, according to one embodiment, the controller 1122 is configured to activate the first drive shaft 630 to close the upper jaw 80 to a first position opposite the lower jaw 50 to clamp a tissue portion disposed therebetween. The operator can then choose whether to activate the second drive shaft 632 to resect and staple tissue, or whether to activate the first drive shaft 630 again to close the upper jaw 80 to the second position opposite the lower jaw 50 . This embodiment has the advantage that the operator does not need to preselect a specific size of the surgical instrument 11 or a replaceable cartridge for the surgical instrument 11 until the tissue to be excised and stapled is exposed and its thickness is determined. This arrangement prevents the operator from preselecting the wrong size or keeping a list of more than one available size.

The surgical instrument 11 may also be configured to automatically calibrate when connected to the electromechanical driver assembly 610 . For example, the controller 1122 may be configured to open or close the surgical instrument 11 prior to operation in order to determine the fully open or fully closed position of the surgical instrument 11 . According to one embodiment, the surgical instrument 11 and electromechanical driver assembly 610 are configured to perform an automatic calibration procedure independent of the presence and thickness of the suture pallet 540 by employing a mechanical hard-stop calibration assembly. As noted above, an example of a calibration procedure for surgical instruments is described in US Provisional Patent Application No. 60/337,544, the contents of which are incorporated herein by reference.

20A to 20C show a flow chart of the main operating routine for operating the surgical instrument 11 according to one embodiment of the present invention. According to an embodiment of the present invention, the main operating program is executed by the controller 1122, and it is understood that other or additional controllers, electronic devices, etc. may also be configured to execute some or all of the steps in the flow chart. Referring to FIG. 20A, in step 2002, the main operating program is initialized. This step 2002 may include, for example, the step of obtaining an operating program from the storage unit 1130 or from the storage module 501 of the surgical instrument 11 as described above. In step 2004, each corresponding storage location in RAM 1134 is cleared to " DLU current " (DLUPRESENT) flag (flag), " DLU former " (DLU OLD) flag, " DLU ready " (DLU READY) flag , "DLU FIRED" (DUL FIRED) flag, and "shaft test" (SHAFT TEST) flag are cleared. The term “DLU” refers to the surgical instrument 11 or other device or surgical instrument 11 or other device or accessory connected to the electromechanical driver assembly 610 . In step 2006, the end positions of the motors/tools, such as the motors 676, 680 driving the surgical instrument 11, are initialized. According to one embodiment of the present invention, the end position of the knife 519 is initialized at 0 mm, while the end position of the anvil 505 is initialized at 1.5 mm. In step 2008, the serial number of the surgical instrument 11, such as the ID data 1182 stored in the storage module 501 of the surgical instrument 11, is read from the storage module 501 and saved. According to an embodiment of the present invention, if reading and storing the serial number of the surgical instrument 11 fails, step 2008 will be repeated for a predetermined number of times within a predetermined time period, or repeated at predetermined time intervals. The predetermined number of times may be, for example, three times, and the predetermined time period may be, for example, 100 ms. An error condition may be determined if reading and saving the serial number of the surgical instrument fails, either initially or after a predetermined number of retries, in which case the operation ends as described below.

In step 2010, it is determined whether the ID data 1182 was successfully read and/or whether the ID data 1182 is valid. If it is determined in step 2010 that the ID data 1182 was not successfully read and/or the ID data 1182 is invalid, then in step 2012 control returns to the core routine, eg, the basic operating routine of the electromechanical driver assembly 610 . If it is determined in step 2010 that the ID data 1182 has been successfully read in step 2008 and/or the read ID data 1182 is valid, then, in step 2014, the feature of "DLU new" of the RAM 1134 is read bit. In step 2016, it is determined whether the "DLU new" flag is successfully read and/or whether the "DLU new" flag is valid. If it is determined in step 2016 that the "DLU new" flag has not been successfully read and/or the flag is invalid, then the control program enters step 2012 where control returns to the core program. If it is determined in step 2016 that the DLU NEW flag has been successfully read and/or valid, then the control program proceeds to step 2018.

In step 2018, it is judged whether the surgical instrument 11 is new based on the DLU NEW flag. If it is determined in step 2018 that the surgical instrument 11 is new, then the control program proceeds to step 2026. In step 2026 , an automatic zeroing operation is performed on the surgical instrument 11 , and the control program proceeds to step 2028 . The auto-zero procedure in step 2026 will be explained below with reference to the flow charts shown in FIGS. 22A to 22C. If in step 2018 it is determined that the surgical instrument 11 is not new, control proceeds to step 2020 where the display device 616 of the electromechanical driver assembly 610 indicates that the surgical instrument 11 was not new as determined in step 2018. For example, in step 2020, the display device 616 may blink rapidly and/or emit an audio sound signal. In step 2022, a message such as "connect new DLU" will be displayed on the display device 616 . In step 2024, set the storage device, such as the "DLU original" flag of RAM 1134, thereby canceling all functions except the open function. In addition, set the memory device, such as the "DLU axis" and "auto-zero" flags of RAM 1134, to disable the activation of the axis test function and the auto-zero function. In step 2028, the "DLU check" timer, the "start button" timer, and the "start button" counter are reset.

After step 2028 is executed, the control program enters into the steps shown in the flow chart of FIG. 20B. In step 2030, it is determined whether the main motor power of the electromechanical driver part 610 is cut off. If it is determined in step 2030 that the main motor power supply has been cut off, the control program enters in step 2032 where a message such as "error 010-check the operator's manual" is displayed on the display device 616 in this step. In step 2034, an indication signal is provided, such as an audible signal that is repeatedly sent, such as once every second, until the electromechanical driver unit 610 is powered off. If in step 2030 it is determined that the main motor power has not been cut off, then in step 2036 the remote control reads the data. In step 2040, it is judged whether the "DLU original" flag is set in RAM 1134, for example. If the "DLU original" flag is set, then the control program proceeds to step 2054. If it is determined in step 2040 that the "DLU original" flag is not set, then the control program enters in step 2042, and in this step, judge the "start" key, such as the switch 1320 of the wireless RCU 1148, or the switch 1320 of the wired RCU 1150 ' is pressed. If it is determined in step 2042 that the "start" key is pressed, the control program enters in step 2044, where a start operation is performed. This start-up operation, which will be described later, is shown in Figs. 24A to 24C. If it is determined in step 2042 that the "start" key has not been pressed, then the control program proceeds to step 2046.

In step 2046, it is determined whether the "closed" key, such as the switch 1320 of the wireless RCU 1148 or the switch 1320' of the wired RCU 1150, is pressed. If it is determined in step 2046 that the "close" key is pressed, the control program proceeds to step 2048, in which a closing operation as shown in FIGS. 21A to 21C is performed. If it is determined in step 2046 that the "close" key is not pressed, then the control program enters step 2054, and in this step, it is judged whether the "open" key, such as the switch 1320 of the wireless RCU 1148 or the switch 1320' of the wired RCU 1150 is pressed. If it is determined in step 2054 that the "open" key is pressed, the control program proceeds to step 2056, in which an open operation as shown in FIG. 23 is performed. If it is determined in step 2054 that the "open" key has not been pressed, then the control program proceeds to step 2058.

In step 2058, it is judged whether any other key, such as any key of wireless RCU 1148 or wired RCU 1150 is pressed. If it is determined in step 2058 that a key is pressed, then the control program proceeds to step 2064. If it is determined in step 2058 that no key has been pressed, then the control program proceeds to step 2060. In step 2060, it is judged whether the start button timer exceeds a predetermined period of time, such as 10 seconds. If it is determined in step 2060 that the start button timer has indeed exceeded the predetermined period of time, then the start button timer and counter are reset in step 2062 . The control program then proceeds to step 2064, in which it is determined whether the start button counter has a value of "1". If in step 2064 it is determined that the start button counter has a value of "1", then control proceeds to step 2066 where the display of the anvil gap on the display device 616 resumes. After step 2066 is executed, the control program enters step 2050, in which the start button counter is reset. Afterwards, in step 2052, the core program (kernel) is called in so as to check whether the key is manipulated or released, and the program is carried out.

After step 2044, execute step 2052 or step 2060, and the control program enters the steps shown in FIG. 20C. In step 2068, it is determined whether the value of the DLU detection timer is greater than or equal to a predetermined value, such as 100ms. If it is determined in step 2068 that no value of the DLU check timer is greater than or equal to a predetermined value, then control proceeds to step 2082 . If it is determined in step 2068 that the value of the DLU check timer is greater than or equal to a predetermined value, then in step 2070, the DLU check timer is reset. In step 2072, the serial number of the DLU is read. In step 2074, it is determined whether the serial number of the DLU can be read. If it is determined in step 2074 that the serial number of the DLU cannot be read, then the "DLU current" flag in the RAM 1134 is cleared. If it is determined in step 2074 that the serial number of the DLU can be read, then in step 2078 the current flag of the DLU is set.

In step 2080, it is determined whether the serial number of the surgical instrument 11 has changed. If it is determined in step 2080 that the serial number has not been changed, then the control program enters in step 2082, in which the IDLE program is called. Thereafter, control returns to step 2030 . If in step 2080 it is determined that the serial number has not changed, then in step 2084 the serial number is stored in a temporary storage location. In step 2086, the serial number of the surgical instrument 11 is read. In step 2088, it is determined whether the DLU serial number can be read. If it is determined in step 2082 that the DLU serial number cannot be read, then the control program enters step 2082, in which the IDLE program is called. If it is determined in step 2088 that the DLU serial number can be read, then in step 2090 a comparison step is performed between the DLU serial number and the serial number stored in the temporary storage location. If it is determined in step 2090 that the comparison between the DLU serial number and the serial number stored in the temporary storage location was unsuccessful, then control proceeds to step 2082 where the IDLE program is called. If it is determined in step 2090 that the comparison between the DLU serial number and the serial number stored in the temporary storage location was successful, then in step 2092 the serial number of the surgical instrument 11 is read. In step 2094, it is determined whether the serial number of the DLU can be read. If it is determined in step 2094 that the serial number of the DLU cannot be read, then the control program proceeds to step 2082, where the IDLE program is called. If it is determined in step 2094 that the DLU serial number can be read, then in step 2096 a comparison step is performed between the DLU serial number and the serial number stored in the temporary storage location. If it is determined in step 2096 that the comparison between the DLU serial number and the serial number stored in the temporary storage location was unsuccessful, then control proceeds to step 2082 where the IDLE program is called. If it is determined in step 2096 that the comparison between the DLU serial number and the serial number stored in the temporary storage location was successful, then in step 2098 control returns to the core routine.

21A to 21C illustrate the jaw closure procedure for closing the jaws when the surgical instrument 11 is connected to the electromechanical driver assembly 610 . According to one embodiment of the present invention, although as described above, the closing procedure may be performed by the controller 1122, it is understood that other controllers, electric devices, etc. may also be used to perform some or all of the steps shown in FIGS. 21A to 21C. step.

Referring to FIG. 21A, in step 2101, the clamp closing procedure is initialized. In step 2104, it is determined whether the surgical instrument 11 is auto-zeroed, eg, whether an auto-zeroing operation has been performed or performed on it. If it is determined in step 2104 that the surgical instrument 11 has not been automatically zeroed, then in step 2106 an automatic zeroing operation is performed. The flowcharts of Figures 22A through 22C illustrate one embodiment of auto-zeroing. Then, in step 2108, wait for all keys of the remote device, such as wireless RCU 1148 or wired RCU 1150, to be released. In step 2110, control returns to the main operating routine of Figures 20A to 20C. If it is determined in step 2104 that the surgical instrument 11 has been automatically zeroed, then the control program proceeds to step 2112 where it is determined whether the flexible shaft 620 has been detected. If it is determined in step 2112 that the flexible shaft 620 is not detected, then in step 2114, a shaft detection routine is performed. Figures 25A-25B illustrate one embodiment of a shaft detection routine. If it is determined in step 2116 that the axis detection performed in step 2114 is not successful, the control program goes to step 2108 . As described above, in step 2108, the release of all keys of the remote device is awaited, and in step 2110, control returns to the main operating program.

If it is determined in step 2112 that the flexible shaft 620 has not been tested, or if it is determined in step 2116 that the shaft test for the flexible shaft was unsuccessful, then control proceeds to step 2118 where the surgical instrument 11 is marked For: no longer new. For example, in step 2118, data is written in the storage module 501 to indicate that the surgical instrument 11 is no longer new. In step 2120 it is determined whether the marking step 2118 was successful. If in step 2120 it is determined that the marking step 2118 was unsuccessful, then control proceeds to step 2122 where a message such as "Replace DLU" is displayed on display device 616. In step 2124, an audio sound signal is emitted. In step 2126, the release of all keys of the remote device 1148 or 1150 is awaited. Then in step 2128, control returns to the main operating routine shown in Figures 20A to 20C.

If it is determined in step 2120 that the marking procedure performed in step 2118 was successful, then control proceeds to step 2130. In step 2130, a value corresponding to the current position of the anvil 505 is obtained, and in step 2132 it is judged whether the value corresponding to the current position of the anvil 505 is greater than a value called "anvil gap green range". This "anvil gap green range" may be stored into a storage location such as storage unit 1130 . If it is determined in step 2132 that the value corresponding to the current position of the anvil 505 is greater than the "anvil gap green range" reference value, then in step 2134, a message such as "anvil closure" is displayed on the display device 616 , and set the message (msg) flag to a "0" value. If it is determined in step 2132 that the value corresponding to the current position of the anvil 505 is not greater than the "anvil gap green range" reference value, then in step 2136 it is judged whether the value corresponding to the current position of the anvil 505 Greater than the "Anvil Gap Blue Range" value called reference. If it is determined in step 2136 that the value corresponding to the current position of the anvil 505 is greater than the reference value of the "anvil gap blue range", then in step 2140, a display such as "green OK" is displayed on the display device 616. information, and set the information flag to "1" value. If it is determined in step 2136 that the value corresponding to the current position of the anvil 505 is not greater than the reference value of the "anvil gap blue range", then in step 2138, display such as "blue OK" on the display device 616 " information, and set the information flag to "2" value. In this way, the information displayed on the display device 616 can provide the user with an indication that the gap between the first clamp 80 and the second clamp 50 is in a range such as "green" (the tissue part is in the first predetermined thickness range) , still in the "blue" range (the tissue part is in the second predetermined thickness range). According to an embodiment of the present invention, the "green" range corresponds to a tissue part thickness ranging from about 1.5 mm to 2.0 mm, while the "blue" range corresponds to a tissue part thickness less than about 1.5 mm. After step 2138 or 2140 is executed, the control program proceeds to step 2142, in which step, for example, the graphic gap display is updated on the display device 616. After step 2134 or 2142 is executed, the control program enters into step 2144 shown in FIG. 21B.

Referring to the flowchart of FIG. 21B, in step 2144, it is judged whether the gap between the first clamp 80 and the second clamp 50 is greater than a predetermined value called "minimum anvil gap", the "minimum anvil gap" The seat gap" predetermined value may be stored in a memory location such as in memory unit 1130 . If it is determined in step 2144 that the gap between the first clamp 80 and the second clamp 50 is not greater than the "minimum anvil gap" predetermined value, then the control program enters step 2186 in the flow chart of step Figure 21C . If it is determined in step 2144 that the gap between the first clamp 80 and the second clamp 50 is greater than the "minimum anvil gap" predetermined value, then the control program goes to step 2146 . In step 2146, the value for speed is set to something called "closing speed", the value for torque is set to something called "closing torque", and the value for position Each of the above values can be stored in a storage location such as the storage unit 1130. In step 2148, movement of the jaws of the surgical instrument 11 is initiated and a stall timer is reset. In step 2150, it is judged whether the "close" key is released. If it is determined in step 2150 that the "close" key is released, then the control program enters step 2186 shown in the flowchart of FIG. 21 . If it is determined in step 2150 that the closing key is not released, then the control program enters step 2152, in which, it is judged whether the value of the stall timer is greater than a predetermined value called "closing stall", which can be Stored in a storage location such as storage unit 1130. If it is determined in step 2152 that the value of the stall timer is greater than the predetermined "closed stall" value, then in step 2154, it is determined that the gap between the first clamp 80 and the second clamp 50 of the surgical instrument 11 is equal to the value of the stall timer. Whether the corresponding value is called a “maximum anvil gap” value, the “maximum anvil gap” reference value can be stored in a storage location such as the storage unit 1130 . If it is determined in step 2154 that the value corresponding to the gap between the first jaw 80 and the second jaw 50 of the surgical instrument 11 is less than or equal to the value called "maximum anvil gap", then control enters In step 2186 shown in the flowchart of FIG. 21C. If it is determined in step 2154 that the value corresponding to the gap between the first jaw 80 and the second jaw 50 of the surgical instrument 11 is not less than or equal to the value called "maximum anvil gap", then in step In 2156, a message such as "failed to close" is displayed on the display device 616, for example. In step 2158, an audio sound signal is sent, and control proceeds to step 2186 shown in FIG. 21C.

Returning to step 2152, if the value of the stall timer is not greater than the predetermined "closed stall" reference value in step 2152, then control proceeds to step 2160 where a current anvil position is obtained. In step 2162, it is determined whether the position of the anvil 505 has changed. If it is determined in step 2162 that the position of the anvil 505 has changed, then in step 2164 the last known position of the anvil 505 is updated and the stall timer is reset. If it is determined in step 2162 that the position of the anvil 505 has not changed, then control proceeds to step 2166. In step 2166, it is determined whether the current position of the anvil 505 is less than or equal to a value called "Anvil Gap Green Range", which is stored in a storage location such as storage unit 1130. If it is determined in step 2166 that the current position of the anvil 505 is less than or equal to the value called "anvil gap green range", then the control routine enters in step 2168, where the current position of the anvil 505 is determined is less than or equal to a value referred to as "minimum anvil gap", which may be stored in a memory location such as memory unit 1130 . If it is determined in step 2168 that the current position of the anvil 505 is less than or equal to a predetermined value referred to as "minimum anvil gap", then control proceeds to step 2186 shown in the flowchart of Figure 21C. If it is determined in step 2168 that the current position of the anvil 505 is not less than or equal to a predetermined value called "minimum anvil clearance", then in step 2170, it is determined whether the jaws of the surgical instrument 11 have moved. If it is determined in step 2170 that the movement of the first jaw 80 and the second jaw 50 of the surgical instrument 11 has been completed, then the control program enters into step 2186 shown in the flowchart of FIG. 21C . If it is determined in step 2170 that the movement of the first jaw 80 and the second jaw 50 of the surgical instrument 11 has not been completed, then the control routine returns to step 2150 .

Referring back to step 2166, if it is determined that the current position of the anvil 505 is greater than a value called "anvil gap green range", then the control program enters step 2172, where it is judged whether the current position of the anvil 505 is greater than a A value called "Anvil Gap Blue Range" may be stored in a memory location such as memory unit 1130 . If determine in step 2172 that the current position of the anvil 505 is greater than the value called "anvil gap blue range", then the control program enters step 2174, where it is judged whether the value of the information flag is "1". If it is determined in step 2174 that the value of the information flag is not "1", then in step 2176, the controller 1122 sets the value of the information flag to "1", and displays on the display device 616 such as " Green OK" message indicating that the user can use the "Green" cartridge corresponding to the particular thickness of tissue to be stapled. After step 2176 is executed, or if it is determined in step 2174 that the value of the information flag is "1", then the control program proceeds to step 2178.

If it is determined in step 2172 that the current position of the anvil 505 is not greater than a value called "anvil gap blue range", which may be stored in a storage location such as storage unit 1130, then in step 2180, it is determined Whether the value of the information flag is "2". If it is determined in step 2180 that the value of the information flag is not "2", then in step 2182, the value of the information flag is set to "2", and displays such as "blue" on the display device 616 OK" indicating that the user can use the "blue" cartridge corresponding to the specific thickness of tissue to be stapled. After step 2182 is executed, or after step 2180 determines that the value of the information flag is “2”, the control program enters step 2178 . In step 2178, the image gap display, for example on display device 616, is updated. In step 2184, an "in range" display, such as a light emitting diode, is turned on, and the "DLU enabled" flag in RAM 1134 of storage unit 1130 is set. After that, the control program enters step 2168.

After steps 2158, 2168, or step 2170 have been performed, control proceeds to step 2186, where the motor driving anvil 505, such as motor 680, is turned off. In step 2188, it is determined whether the value corresponding to the current gap state is less than or equal to a predetermined value called "maximum anvil gap", which may be stored in a memory location such as memory unit 1130, if in step 2188 If it is determined that the value corresponding to the gap is less than or equal to the predetermined value stored in the storage location called "maximum anvil gap", then the control program enters step 2192, and in this step, the graphic on the display device 616 is updated Gap display. If it is determined in step 2188 that the value corresponding to the gap is not less than or equal to the predetermined value called "maximum anvil gap", then in step 2190, wait for the release of all keys of the remote device, and in step In 2194 control returns to the main operating routine shown in Figures 20A to 20C.

FIGS. 22A through 22C illustrate one embodiment of an auto-zero routine for performing the auto-zero function of a surgical instrument 11 when the surgical instrument 11 is connected to the electromechanical driver assembly 610 . Although according to one embodiment of the present invention, the zero adjustment procedure as described above can be executed by the controller 1122, it is understood that other controllers, electronic devices, etc. can also be configured to execute some of the procedures shown in FIGS. or all steps. Referring to FIG. 22A, in step 2202, the auto-zero procedure is initialized. In step 2204, wait for the release of all keys of the remote device. In step 2206, a message such as "calibration" is displayed on the display device 616, for example. In step 2208, the "ready to start" flag and the "auto-zero OK" flag are reset. In step 2210, the current position of the anvil 505 is set to some value called an "auto-zero position", which may be stored in a memory location such as memory unit 1130 . In step 2212, the torque is set to some value called "auto-zero torque", which may be stored in a storage location such as memory unit 1130. In step 2214, the speed is set to a certain value A value called “Auto-Zero Speed” may be stored in a memory location such as memory unit 1130 . In step 2216, the destination location is set to a "0" value. In step 2218, a signal is sent to a motor corresponding to anvil 505, such as motor 680, to begin moving the anvil 505, thereby closing the jaws of the surgical instrument 11. In step 2220, the stall timer and last position are reset. The control program then executes the steps shown in the flowchart of Fig. 22B.

In step 2222, it is determined whether the value of the stall timer is greater than a value called "auto-zero stall", which may be stored in a memory location such as memory unit 1130. If it is determined in step 2222 that the value of the stall timer is greater than the predetermined value called "auto-zero stall", then control proceeds to step 2242 where the motor corresponding to anvil 505, such as motor 680, is turned off. If it is determined in step 2222 that the value of the stall timer is not greater than the predetermined value called "auto-zero stall", then the control program enters step 2224, where it is judged whether the current position of the anvil 505 is equal to the last Location. If it is determined in step 2224 that the current position of the anvil 505 is not equal to the last position, then in step 2226 the stall timer and last position are reset. If determine in step 2224 that the current position of the anvil 505 is equal to the final position, then the control program enters step 2228, where it is judged whether any key of the remote device, such as wireless RCU 1148 or wired RCU 1150, is pressed. If in step 2228 it is determined that any button of the remote device was pressed, then in step 2230 the stall timer and last position are reset. In step 2232, the anvil 505 is opened a predetermined distance called "anvil backup (backup)", its value can be stored in a storage location such as the storage unit 1130, or until the value of the stall timer exceeds the specified distance. The value of "Auto-Zero Stall", or a multiple thereof, such as a multiple of the "Auto-Zero Stall" value. In step 2232, a motor corresponding to anvil 505, such as motor 680, is turned off. In step 2234, an audio sound signal is emitted and a message such as "press the off key to recalibrate" is displayed on the display device 616, for example. In step 2236, the release of all keys of the remote device is awaited, and in step 2238 control returns to the main operating program, such as that shown in Figures 20A to 20C.

If in step 2228, it is determined that no key of the remote device is pressed, then the control program proceeds to step 2240, where it is determined whether the movement of the tongs is complete. If it is determined in step 2240 that the movement of the jaws is not complete, then control returns to step 2222. If it is determined in step 2240 that the movement of the jaws is complete, then control proceeds to step 2242 where the motor driving the anvil 505, such as motor 680, is turned off. In step 2244, both the distal position value and the proximal position value are set to 1.5 mm.

The control program then goes to the step shown in Fig. 22C. In step 2246, the stall timer and last position are reset in memory. In step 2248, the speed is set to a predetermined value called "opening speed", which may be stored in a memory location such as memory unit 1130. In step 2250, the target position is set to a predetermined value called "open target position", which may be stored in a memory location such as memory unit 1130, and the jaws of the surgical instrument 11 are caused to start moving. In step 2252, it is determined whether the value of the stall timer is greater than a predetermined value called "auto-zero stall", or a multiple thereof, such as a multiple of the "auto-zero stall" value. If it is determined in step 2252 that the value of the stall timer is not greater than the predetermined value called "auto-zero stall", then in step 2254 it is determined whether the current position of the anvil 505 is equal to its last position. If it is determined in step 2254 that the current position of the anvil 505 is not equal to its last position, then in step 2256, the stall timer and last position are reset. If determine in step 2254 that the current position of the anvil 505 is equal to the last position, then the control program enters in step 2258, where it is judged whether any key of the remote device, such as wireless RCU 1148 or wired RCU 1150, is pressed. If it is determined that the key of the remote device is pressed, then in step 2268, the motor driving the anvil 505, such as the motor 680, is turned off. In step 2270, a beep or other audio signal is sent to the user and a message such as "Press to close to recalibrate" is displayed on, for example, the display device 616 . In step 2272, the release of all keys of the remote device is awaited, and in step 2274, control returns to the main operating routine as shown in Figures 20A to 20C.

If it is determined in step 2258 that the button of the remote device, such as any button of the wireless RCU 1148 or the wired RCU 1150, is not pressed, then in step 2260 it is judged whether the movement of the clamp of the surgical instrument 11 is completed. If it is determined in step 2260 that the movement of the jaws is not complete, then control returns to step 2252. If it is determined in step 2260 that the jaws of the surgical instrument 11 have moved, then in step 2262, an anvil motor, such as motor 680, is turned off, and an audio signal is sent, or a signal such as "ready" is displayed on the display device 616. information. In step 2264, the "auto-zero OK" flag is set and the release of all keys on the remote device is awaited. In step 2266, control returns to the main operating routine as shown in Figures 20A through 20C.

FIG. 23 illustrates an embodiment of an open jaw procedure for opening a surgical instrument 11 when the surgical instrument 11 is connected to the electromechanical driver assembly 610 . Although the operations described above are performed by the controller 1122 according to one embodiment of the present invention, it is understood that other controllers, electronic devices, etc. may be used to perform some or all of the steps of the clamp opening procedure. Referring to FIG. 23, at step 2300, the clamp opening procedure is initiated. In step 2302, an "in range" display, such as a light emitting diode, is turned off and the "DLU ready" flag in memory is cleared. In step 2304, it is determined whether the "auto-zero" flag is set in the memory. If it is determined in step 2304 that the "auto-zero" flag is not set in the memory, then in step 2306, a message such as "press the off key to recalibrate" is displayed on the display device 616 . In step 2308, an audio signal (audible signal) or sound (chime) is sent to the user. In step 2310, wait for the release of all keys of the remote device. Thereafter, in step 2312, control returns to the main operating routine as shown in FIGS. 20A to 20C.

If it is determined in step 2304 that the "auto-zero" flag has been set, then in step 2314, the anvil torque is set to something called "opening torque", which can be stored in a storage unit such as 1130 memory location. At step 2316, the speed is set to a predetermined value called "opening speed", which may be stored in a memory location such as memory unit 1130. In step 2318, the clamp is targeted to a fully released position. In step 2320, a message such as "anvil open" is displayed on display device 616. In step 2324, the information flag in the memory is cleared. In step 2326, it is determined whether the "open" key of the remote device is released. If in step 2326 it is determined that the "open" key is released, then the control program proceeds to step 2328 where it closes the anvil motor, such as motor 680, and waits for the release of all keys of the remote device. In step 2330, the control program returns to the main operating program as shown in Figures 20A to 20C.

If it is determined in step 2326 that the "open" key has not been released, then in step 2332 an anvil gap value, such as the gap value between the first jaw 80 and the second jaw 50 of the surgical instrument 11, is obtained. In step 2334, a determination is made as to whether the gap is greater than a value referred to as "anvil fully open gap," which may be stored in a memory location such as memory unit 1130. If it is determined in step 2334 that the gap is greater than the value called "anvil fully open gap", then in step 2336 it is determined whether the information flag is set. If it is determined in step 2336 that the information flag is not set, then in step 2338 the information flag is set, and a message such as "anvil is fully opened" is displayed on the display device 616. Then the control program goes to step 2340. Similarly, if it is determined in step 2334 that the gap is not greater than the value called "anvil fully open gap", or if it is determined in step 2336 that the message flag is not set, then control proceeds to step 2340. In step 2340, it is judged whether the movement of the clamp of the surgical instrument 11 is completed. If it is determined in step 2340 that the movement of the jaws is not complete, then control returns to step 2326. If it is determined in step 2340 that the movement of the jaws of the surgical instrument 11 is complete, then the control program proceeds to step 2328 . As described above, in step 2328, the anvil motor 505, such as motor 680, is turned off and the release of all keys of the remote device is awaited. In step 2330 control returns to the main operating routine as shown in Figures 20A to 20C.

FIG. 24A shows a stapling initiation sequence for cutting and stapling a portion of tissue held between the upper and lower jaws of the surgical instrument 11 when the surgical instrument 11 is connected to the electromechanical driver assembly 610 . Although as described above, according to one embodiment of the present invention, the above-mentioned operations are performed by the controller 1122, it is understood that other controllers, electronic devices, etc. may also be configured to perform some or all of the steps of the stitch initiation procedure. Referring to FIG. 24A, in step 2400, the stitch initiation procedure is initialized. In step 2402, it is judged whether the "auto-zero OK" flag is set, if it is determined in step 2402 that the "auto-zero OK" flag is not set, then, in step 2404, on the display device 616 An error message such as "Press OFF to recalibrate" is displayed. If it is determined that the "auto-zero OK" flag is set, the control program goes to step 2406. In step 2406, it is judged whether the "DLU ready" flag is set. If it is determined that the "DLU ready" flag is not set in step 2406, then in step 2408, an error message such as "out of range" is displayed on the display device 616. If it is determined in step 2406 that the "DLU ready" flag is set, then the control program proceeds to step 2410. In step 2410, it is determined whether the "DLU enabled" flag is set. If it is determined in step 2410 that the "DLU start" flag is set, then in step 2412 it is determined that an error condition has occurred, and an error message such as "no seams" is displayed on the display device 616. If it is determined in step 2410 that the "DLU enabled" flag is not set, then the control program proceeds to step 2422 . After completing steps 2404, 2408, or 2412, control proceeds to step 2414 where the start button count is reset. In step 2416, an audio sound is played. In step 2418, wait for the release of all keys. In step 2420, control returns to the main operating routine as shown in Figures 20A to 20C.

As mentioned above, if it is determined in step 2410 that the "DLU Enabled" flag is not set, then control proceeds to step 2422 . In step 2422, the start button count is incremented. In step 2424, it is determined whether the start button is pressed for the first time. If it is determined in step 2424 that the start button is pressed for the first time, then in step 2426, a message such as "start button is ready" is displayed on the display device 616. In step 2428, the start button timer is reset. After execution of step 2428 is complete, control returns to step 2418, as described above. If it is determined in step 2424 that the start button is not pressed for the first time, then in step 2430 , a message such as the word "start" is displayed on the display device 616 . In step 2432, the usage count is decremented and the "DLU enabled" flag is set. According to an embodiment of the present invention, the control retries for a predetermined number of times, such as three times, within a predetermined time interval, such as 100 ms, so as to reduce the usage count.

The control program then enters step 2434 as shown in Figure 24B. At step 2434, an activation motor speed is set, for example the speed of the motor that activates the stitching element, such as motor 676. Additionally, at step 2434, a torque limit is set. At step 2436, the start motor position is set to a preset value called "start position", which may be stored in a memory location such as memory unit 1130, and causes the jaws of the surgical instrument 11 to begin moving. In step 2438, the last known position is set to a "0" value. Additionally, in step 2438, the startup and stall timers are reset and the error flag is cleared. In step 2440, it is determined whether the startup or stall timer has expired. If in step 2440 it is determined that the start or stall timer has expired, then in step 2452 the first motor, such as motor 676 is stopped. In step 2454, an error message such as "insufficient boot sequence" is displayed on the display device 616, for example. In step 2456, a sound or other audio signal is emitted and the error flag is set. After that, the control program goes to step 2458.

If in step 2440 it is determined that the startup or stall timer has not expired, then control proceeds to step 2442 . In step 2442, a determination is made as to whether the starter motor, such as motor 676, has completed its motion. If it is determined in step 2442 that the starter motor, such as motor 676, has completed its motion, then control proceeds to step 2452, as described above. If it is determined in step 2442 that the starter motor, such as motor 676, has not completed its motion, then control proceeds to step 2444. In step 2444, it is determined whether the current position of the anvil 505 is consistent with the last position of the anvil 505. If it is determined in step 2444 that the current position of the anvil 505 is inconsistent with the last position of the anvil 505, then in step 2446, the last position of the anvil 505 is set to be consistent with the current position of the anvil 505 , and reset the stall timer. After step 2446 is executed, or after step 2444 determines that the current position of anvil 505 is consistent with the last position of anvil 505, the control program enters step 2448. In step 2448, it is determined whether the knife, such as knife 519, has reached its intended position, such as a fully extended position. If it is determined in step 2448 that the knife has not reached its destination, then control returns to step 2440. If, in step 2448, it is determined that the knife has reached its destination, then in step 2450, controller 1122 deactivates a motor, such as motor 676.

After step 2450 or 2456 is completed, control proceeds to step 2458. At step 2458, the "in range" display, such as a light emitting diode, is turned off and the "DLU ready" flag is cleared. At step 2460, the motor current limit is set to the global limit. At step 2462, the anvil 505 is initiated to move back to its original position. At step 2464, the last known position is set to "0" and the cycle and stall timers are reset. In step 2466, as shown in FIG. 24C, a determination is made as to whether the cycle timer is greater than a predetermined value referred to as "timer start", which may be stored in a memory location such as memory unit 1130. If it is determined in step 2466 that the cycle timer is greater than a predetermined value called "timer start", then in step 2468, it is determined whether an error flag has been set. If it is determined in step 2468 that the error flag is not set, then in step 2470 , an error message such as "insufficient start sequence" is displayed on the display device 616 . After step 2472 has been executed, or if it is determined in step 2468 that the error flag is not set, then the control program enters step 2482.

If in step 2466 it is determined that the cycle timer is not greater than a predetermined value referred to as "timer start", then in step 2474 it is determined whether the stall timer is greater than a predetermined value referred to as "timed stall", which A value may be stored in a memory location such as memory unit 1130, or a multiple thereof may be stored, such as a multiple of a "timed stall" value. If, in step 2474, it is determined that the stall timer is greater than the predetermined value referred to as "timed stall", then control passes to step 2468, as described above. If in step 2474 it is determined that the stall timer is not greater than the predetermined value referred to as “timed stall”, then control proceeds to step 2476 . In step 2476, it is determined whether the current position of the anvil 505 is the same as the last position of the anvil 505. If it is determined in step 2476 that the current position of the anvil 505 is the same as the last position of the anvil 505, then in step 2478, the last position of the anvil 505 is set to be the same as the current position of the anvil 505, and reset the stall timer. After step 2478 is executed, or after determining in step 2476 that the current position of the anvil 505 is the same as the last position of the anvil 505, the control program goes to step 2480. In step 2480, it is determined whether a knife, such as knife 519, is fully retracted. If it is determined in step 2480 that the knife is not fully retracted, then control returns to step 2466. If it is determined in step 2480 that the knife has been fully retracted, or after performing steps 2468 or 2472 as described above, then in step 2482, a motor, such as motor 676, is stopped. In step 2484, it is determined whether an error flag is set in the memory. If it is determined in step 2484 that an error flag has been set in the memory, then the control routine enters step 2488 and returns to the main operating routine. If it is determined in step 2484 that the error flag is not set, a message such as "starting complete" is displayed on the display device 616 . Thereafter, in step 2488, control returns to the main operating routine.

FIG. 25A shows the shaft detection routine for the electromechanical drive component 610 corresponding to the shaft detection. Although as described above, according to one embodiment of the present invention, the axis detection program is executed by the controller 1122, it can be appreciated that other controllers, electronic devices, etc. can also be configured to perform some or all of the axis detection program step. Referring to FIG. 25A, in step 2500, the axis detection routine is initialized. In step 2502, the torque, speed, and position of a knife motor, such as motor 676, are set to jog a corresponding rotatable drive shaft, such as rotatable drive shaft 632. In step 2504, wait for a predetermined period of time called "Start Detection Time Exceeded", which value may be stored in a memory location such as memory unit 1130, or wait for knife 519 to complete movement. In step 2506, a determination is made as to whether a time period referred to as "Boot Detection Time Exceeded" has expired. If it is determined in step 2506 that the predetermined time period referred to as "start detection time exceeded" has expired, then in step 2508, a message such as "error 006-see operator's manual" is displayed on the display device 616. information. At step 2510, an audible signal is emitted periodically, such as once per second, until power to the electromechanical driver assembly 610 is turned off.

If it is determined in step 2506 that the predetermined time period called "start detection time exceeds" is not full, then in step 2512, wait for a predetermined time period called "start stop time", which can be stored In a storage location such as storage unit 1130, thereby ensuring that the knife 519 completes the movement. In step 2514, it is determined whether the remote position is less than a predetermined position called "start detection position", the value of which may be stored in a storage location such as storage unit 1130. If it is determined in step 2514 that the far-end position is not less than the predetermined position called "start detection position", then in step 2516 it is determined that an error condition has occurred, and the display device 616 displays such as "replace flexible axis" error message. In step 2518, an audio sound is emitted and an error flag is set. After step 2518 is completed, or it is determined in step 2514 that the remote position is less than the "start detection position", control proceeds to step 2520. In step 2520, the remote position is set to an initial position, or home position. In step 2522, wait for a predetermined period of time called "Start Detection Time Exceeded", which is stored in a memory location such as memory unit 1130, or wait for the knife to complete movement. At step 2524, a determination is made as to whether a predetermined period of time referred to as "Start Detection Time Exceeded" has expired. If it is determined in step 2524 that the predetermined time period referred to as "startup detection time exceeded" is full, then in step 2526, a message such as "error 006 - see operator's manual" is displayed on display device 616. At step 2528, an audio signal is issued until power to the electromechanical driver assembly 610 is turned off. If it is determined in step 2524 that the time is not full, as shown in the flow chart of FIG. 25B , it is judged in step 2530 whether to set the error flag. If an error flag is set in step 2530, then in step 2536, wait for the release of all keys of the remote device. Thereafter, in step 2538, control returns to the main operating program in step 2538. If it is determined in step 2530 that the error flag is not set, then in step 2532, the axis test flag is set to "1". Then at step 2534, control returns to the main operating routine as shown in Figures 20A to 20C.

One problem with traditional surgical instruments is that they can limit the angle of approach of the instrument when in use. As noted above, conventional surgical instruments typically use an instrument axis that is perpendicular to the portion of tissue to be cut and stapled. When conventional instruments are used on a body, such as a patient, the instrument is limited to a single angle of approach for cutting and stapling sections of tissue.

In contrast, the surgical instrument 11 of the present invention does not limit the angle of approach at which the device is used. As previously mentioned, the surgical instrument 11 according to various embodiments of the present invention includes drive shafts 630 and 632 that are at an angle, for example, to the plane of motion of the first jaw 80 relative to the second jaw 50 A vertical angle is attached to the first clamp 80 . Thus, when the surgical instrument 11 is used on a body, such as a patient, the surgical instrument 11 is not limited to a single approach angle. Conversely, multiple approach angles are available, which allows the operator to more effectively use the surgical instrument on various tissue sections.

Another problem with conventional surgical instruments is that the instruments are difficult to manipulate within the patient's body. For example, when using conventional surgical instruments to clamp or staple tissue sections that are not easily manipulated, there is a need for dexterity in the surgical instruments. For example, where a portion of gastrointestinal tissue is located adjacent to the anal stump, that portion of tissue cannot be moved prior to or during the procedure. Conventional surgical instruments cannot be used in this location due to the operator's desired angle of approach interfering with the patient's pelvis.

In contrast, surgical instruments 11 according to various embodiments of the present invention are much less difficult to operate in a patient's body. For example, in the case that the above-mentioned part of the gastrointestinal tissue is located adjacent to the anus stump, the surgical instrument 11 may be located at the endmost part of the gastrointestinal tissue closest to the anus. In this way, the drive shafts 630 and 632 are arranged at an angle, such as perpendicular, relative to the movement plane of the first clamp 80 relative to the second clamp 50, which can improve the operational flexibility of the surgical instrument 11 in the patient's body.

The above descriptions are only preferred embodiments of the present invention, and are not intended to limit the present invention. For those skilled in the art, the present invention may have various modifications and changes. Any modifications, equivalent replacements, improvements, etc. made within the spirit and principles of the present invention shall be included within the protection scope of the present invention.

Claims (44)

1. A surgical instrument comprising: first clamp; a second clamp opposite to the first clamp; The first driver can make the first tongs and the second tongs move relatively in a plane, the first driver is engaged with the first rotary drive shaft, and the first rotary drive shaft can rotate around the relative The planes of non-parallel arrangement of the axes of rotation rotate. 2. The apparatus of claim 1, further comprising: a surgical component disposed within the first jaw; and a second drive for relative movement of the operative component in a direction parallel to the plane, the second drive being engaged with a second rotational drive shaft, the second rotational drive shaft being displaceable non-parallel with respect to the plane The axis of rotation rotates. 3. The instrument of claim 2, wherein the surgical component comprises a cutting element. 4. The instrument of claim 2, wherein the surgical component comprises a suture element. 5. The instrument of claim 2, wherein said surgical component comprises a push plate on which a cutting element and a stapling element are mounted. 6. The apparatus of claim 1, further comprising an electromechanical drive to rotate said first rotational drive shaft. 7. The instrument of claim 1, wherein an axis of rotation of the first rotary drive shaft is perpendicular to the plane in which the first and second jaws move. 8. The apparatus of claim 1 , wherein the first rotational drive shaft rotates in a first direction to extend the jaws and rotates in a second direction opposite to the first direction to cause the Clamp closed. 9. The instrument of claim 1, wherein said first driver comprises at least two spur gears, a worm and a worm wheel in rotational and meshing relationship to each other, and one end fixedly connected to said worm wheel and connected to said second spur gear. The internally threaded holes of the two clamps are engaged with an externally threaded screw, and the rotation of the gear can make the first and second clamps move relative to each other. 10. The apparatus of claim 2, further comprising an electromechanical drive to rotate said second rotational drive shaft. 11. The instrument of claim 2, wherein an axis of rotation of the second rotational drive shaft is perpendicular to the plane in which the first and second jaws move. 12. The instrument of claim 11 , wherein the second rotational drive shaft rotates in a first direction to extend the surgical component and rotates in a second direction opposite to the first direction to cause the surgical component to extend. The surgical component is retracted. 13. The instrument of claim 2, wherein the second driver comprises two spur gears and a worm in rotational and meshing relationship to each other, and a pair of additional worm gears, each of the pair of additional worm gears Each has a centrally disposed internally threaded hole for engagement with a corresponding one of a pair of externally threaded screws fixedly connected to the operative component, rotation of the gears enables relative movement of the operative component. 14. The apparatus of claim 2, further comprising an electromechanical drive comprising a first rotary drive shaft for driving the first drive, and a second drive shaft for driving the second drive. Rotate drive shaft. 15. The apparatus of claim 14, wherein said electromechanical drive further comprises at least one electric motor means for driving each of said first and second rotational drive shafts. 16. The apparatus of claim 15, wherein said electromechanical drive comprises a first motor arrangement for driving said first rotary drive shaft, and a second motor arrangement for driving said second rotary drive shaft. motor unit. 17. A surgical instrument comprising: a first rotary drive shaft rotatable around the axis of rotation; first clamp; a second clamp opposite the first clamp; and The first driver causes the first and second clamps to move relative to each other according to the rotation of the first rotary drive shaft in a plane, the plane being non-parallel to the rotation axis. 18. The apparatus of claim 17, further comprising: a surgical component disposed within the first jaw, and a second drive for relative movement of the surgical component in a direction parallel to the plane, the second drive being engaged with a second rotational drive shaft about a non-parallel arrangement with respect to the plane The axis of rotation rotates. 19. The instrument of claim 18, wherein the surgical component comprises a cutting element. 20. The instrument of claim 18, wherein the surgical component comprises a suturing element. 21. The instrument of claim 18, wherein said surgical component comprises a push plate upon which said cutting element and stapling element are mounted. 22. The apparatus of claim 17, further comprising an electromechanical drive to rotate said first rotational drive shaft. 23. The instrument of claim 17, wherein an axis of rotation of the first rotational drive shaft is perpendicular to the plane in which the first and second jaws move. 24. The apparatus of claim 23, wherein said first rotational drive shaft is rotated in a first direction to extend said jaws and rotated in a second direction opposite to said first direction to cause said Clamp closed. 25. The apparatus of claim 17, wherein said first driver comprises at least two spur gears, a worm and a worm wheel in rotational and meshing relationship to each other, and one end fixedly connected to said worm wheel and connected to said second spur gear. The internally threaded holes of the two clamps are engaged with an externally threaded screw, and the rotation of the gear can make the first and second clamps move relative to each other. 26. The apparatus of claim 18, further comprising an electromechanical drive to rotate said second rotational drive shaft. 27. The instrument of claim 26, wherein the axis of rotation of the second rotational drive shaft is perpendicular to the plane in which the first and second jaws move. 28. The instrument of claim 27, wherein the second rotational drive shaft rotates in a first direction to extend the surgical component and rotates in a second direction opposite to the first direction to cause the The surgical component is retracted. 29. The apparatus of claim 18, wherein the second driver comprises at least two spur gears and a worm in rotational and meshing relationship to each other, and a pair of additional worm gears, one of the pair of additional worm gears Each has a centrally disposed internally threaded bore for engagement with a respective one of a pair of externally threaded screws fixedly connected to the operative component, rotation of the gears causing relative movement of the operative component. 30. The apparatus of claim 18, further comprising an electromechanical drive comprising a first rotary drive shaft for driving the first drive, and a second drive shaft for driving the second drive. Rotate drive shaft. 31. The apparatus of claim 30, wherein said electromechanical drive further comprises at least one electric motor means for driving each of said first and second rotational drive shafts. 32. The apparatus according to claim 31 , wherein said electromechanical drive comprises a first motor arrangement for driving said first rotary drive shaft, and a second motor arrangement for driving said second rotary drive shaft. motor unit. 33. The apparatus of claim 31, further comprising a control system for controlling said motor means. 34. The apparatus of claim 33, wherein the control system is disposed within the housing. 35. The apparatus of claim 34, further comprising a remote control unit in communication with said control system for controlling said motor means via said control system. 36. The apparatus of claim 35, wherein the remote control unit comprises at least one of a wired remote control unit and a wireless remote control unit. 37. The apparatus of claim 33, further comprising a sensor corresponding to said first rotational drive shaft, said sensor responsive to and outputting a signal in accordance with rotation of said first rotational drive shaft. 38. The apparatus of claim 37, wherein the control system determines at least one of a rotational position and a rotational direction of the first rotational drive shaft based on the output signal of the sensor. 39. The apparatus of claim 33, wherein the control system includes a first storage unit. 40. The apparatus of claim 39, wherein said first storage unit is adapted to store a plurality of operating programs, at least one of said operating programs corresponding to a cutting and stapling element coupled to an end of an elongated shaft. 41. The apparatus of claim 40, wherein the control system is configured to identify a surgical device attached to the end of the elongated shaft as a cutting and stapling instrument, wherein the cutting and stapling element is attached to the elongated shaft. One of multiple types of surgical devices on the end of the long axis, the control system can at least one of read and select from the first storage unit according to the cutting and stapling elements Get the operating procedure. 42. The apparatus according to claim 41 , wherein said control system identifies said cutting and stapling apparatus based on data read from a second memory unit disposed within said cutting and stapling apparatus and acts as a link to The type of surgical device on the elongated shaft. 43. The apparatus of claim 42, further comprising a data cable disposed within said elongated shaft, said data cable being logically and electrically connected to said control system and logically and electrically connected to said control system. Describe the second storage unit. 44. A surgical instrument comprising: motor; a first rotary drive shaft rotates around a rotation axis under the action of the motor; first clamp; a second clamp opposite the first clamp; and The first driver causes the first and second clamps to move relative to each other in a plane according to the rotation of the first rotary drive shaft, the plane and the rotation axis are not parallel.

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