The present invention generally concerns surgical instruments and, more particularly, surgical cutting and fastening instruments.
Endoscopic surgical instruments are often preferred over traditional open surgical devices since a smaller incision tends to reduce the post-operative recovery time and complications. Generally, these endoscopic surgical instruments include an “end effector”, a handle assembly and an elongated shaft that extends between the end effector and the handle assembly. The end effector is the portion of the instrument configured to engage the tissue in various ways to achieve a desired diagnostic or therapeutic effect (e.g., endocutter, grasper, cutter, staplers, clip applier, access device, drug/gene therapy delivery device, and energy device using ultrasound, RF, laser, etc.).
The end effector and the shaft portion are sized to be inserted through a trocar placed into the patient. The elongated shaft portion enables the end effector to be inserted to a desired depth and also facilitates some rotation of the end effector to position it within the patient. With judicious placement of the trocar and use of graspers, for instance, through another trocar, often this amount of positioning is sufficient. Surgical stapling and severing instruments, such as those described in U.S. Pat. No. 5,465,895, are examples of an endoscopic surgical instrument that successfully positions an end effector by insertion and rotation.
Two primary design approaches have been used in the past by various medical component manufacturers to reduce the overall cost of such endoscopic surgical instruments. While both attempts have been successful at addressing at least some of the user's needs, neither attempt has fully addressed all of those needs.
For example, the first design approach concerned the use of a disposable end effector for each firing. Such end effectors were fabricated from relatively weak components that can only be fired once before a new end effector is required since the end effector components are markedly deformed after each firing. This type of end effector employed an “I-beam” feature on the knife to prevent the anvil from deflecting away from the cartridge during firing. Since the I-beam is riding on a relatively weak anvil component, the I-beam deforms the portion of the anvil located directly underneath the I-beam feature. This combination of factors allows staple form to be improved while decreasing the forces required to actuate the device because the I-beam is only pulling the anvil material down to the correct position relative to the cartridge where its needed to form a staple at any given time.
While this approach improves staple form and lowers the force required to cut the tissue and deploy the staples, it has a number of disadvantages. First, having the surgeon dispose of an entire anvil, channel and cartridge after each firing adds a great deal of manufacturing expense. Second, the device often doesn't securely clamp the targeted tissue due to a combination of the relatively weak end effector components and the manner in which the anvil is actually clamped onto the tissue. The third issue is that the relatively weak end effector components can only reliably be used to fire on moderate tissue thicknesses and the components will not function on very thick tissues.
The second primary design approach taken in the past is to make much stronger end effector components that can be used for multiple firings. In this approach, only the cartridge assembly is replaced after each firing. Because the end effector components have to resist multiple firing loads, they are purposefully designed such that they do not deform after each firing. This design concept employs a different set of features on the knife to keep the anvil positioned relative to the cartridge during deployment of the staples to improve staple form. The combination of the stiffer end effector components and a different clamping mechanism allows this type of device to reliably exert high clamping loads so the surgeon can easily manipulate the desired tissue. The stiffer components also allow the end effector to be reliably used on relatively thick tissue samples.
One disadvantage of this approach, however, is that the features on the knife that prevent the anvil from deflecting away from the cartridge are now required to pull a very stiff anvil component down towards the cartridge. The knife is therefore attempting to pull an entire beam down towards the cartridge that is as long as the entire staple line instead of just pulling the anvil down in a localized region as on the previous device. This approach, therefore, generally must generate higher deployment forces due to the increased anvil drag loads on the knife.
Consequently there is a need for an end effector arrangement for a surgical cutting and fastening instrument that addresses the above-mentioned concerns by maintaining the same staple form quality, clamping performance and the ability to repeatedly deploy staples in thick tissue while lowering the amount of force required to deploy the staples and knife.
There is still another need for an end effector system that can be used with staple cartridges that are of identical length but have different staple line lengths.
In one general aspect, the present invention is directed to a disposable staple cartridge for a surgical cutting and fastening instrument that comprises a cartridge body that operably supports a plurality of staples therein. Various disposable staple cartridges of the present invention further include a disposable anvil member that is supportable relative to the cartridge body such that the anvil member is movable between a closed position wherein a bottom surface of the anvil member is adjacent a top surface of the cartridge body and an open position wherein the bottom surface of the anvil member is spaced away from the top surface of the cartridge body to permit tissue to be inserted therebetween. At least one tissue stop member is on the anvil member for contacting the tissue inserted between the bottom surface of the anvil member and the top surface of the cartridge body to orient the tissue relative to the staples supported within the cartridge body.
In another general aspect, the present invention is directed to an end effector for a surgical cutting and fastening instrument. Various embodiments of the end effector comprise an elongate channel having a proximal end that is attachable to a portion of the surgical cutting and fastening instrument. The elongate channel further has a distal end and is configured to support a disposable staple cartridge therein. The end effector further comprises a rigid top anvil plate that has a distal end and a proximal end. The proximal end is pivotally coupled to the proximal end of the elongate channel and is selectively pivotable between an open position wherein the distal end of the top anvil plate is away from the distal end of the elongate channel to permit a disposable staple cartridge to be seated within the elongate channel and a closed position wherein the top anvil plate is adjacent to the staple cartridge seated within the elongate channel in response to opening and closing forces, respectively, applied thereto from a drive system supported in the surgical cutting and fastening instrument. The rigid top anvil plate is configured to mate with a disposable anvil plate that is associated with the disposable staple cartridge seated within the elongate channel. A knife assembly is operably supported in the elongate channel and is coupled to the drive system of the surgical cutting and fastening instrument to drive the knife assembly from the proximal end of the elongate channel to the distal end and also return the knife assembly to the proximal end of the elongate channel. A wedge sled is associated with the knife assembly for travel therewith. The wedge sled is oriented to actuate staple drivers in the disposable staple cartridge that is seated in the elongate channel when the knife assembly is driven from the proximal end of the elongate channel to the distal end of the elongate channel.
In another general aspect, the present invention is directed to a disposable staple cartridge for a surgical cutting and fastening instrument. In various embodiments, the staple cartridge comprises a cartridge body that operably supports a plurality of staples therein. Disposable staple forming means is attached to the cartridge body such that disposable staple forming means is movable between a closed position wherein a bottom surface thereof is adjacent a top surface of the cartridge body and an open position wherein the bottom surface of the disposable staple forming means is spaced away from the top surface of the cartridge body to permit tissue to be inserted therebetween. Tissue stop means is on the disposable staple forming means for contacting the tissue inserted between the bottom surface of the disposable staple forming means and the top surface of the cartridge body to orient the tissue relative to the staples supported within the cartridge body.
In another general aspect, the present invention is directed to an end effector for a surgical cutting and fastening instrument that is constructed for use in connection with at least one of a plurality of staple cartridge bodies that each have a common length. Each staple cartridge body operably supports a plurality of staples therein that are aligned in at least one first line of staples and has at least one tissue stop associated therewith. The end effector is further constructed for use with at least one other staple cartridge body of another plurality of other staple cartridge bodies that are each equal in length to the common length of the staple cartridge bodies and each operably supports a plurality of other staples therein that are aligned in at least one other line of other staples that is longer than the lines of staples in the staple cartridge bodies. Various embodiment of such end effector comprise an elongate channel that is attachable to a portion of the surgical cutting and fastening instrument. The elongate channel is configured to support any one of the staple cartridge bodies and other staple cartridge bodies therein. A top anvil plate is pivotally coupled to the elongate channel and is movable between open and closed positions in response to opening and closing forces, respectively, applied thereto from a drive system supported in the surgical cutting and fastening instrument. The top anvil plate has at least one top tissue stop associated therewith configured to cooperate with at least one of the tissue stops associated with one of cartridge bodies when the cartridge body is seated within the elongate channel to orient tissue relative to the lines of staples therein. The at least one top tissue stop is further configured to orient tissue clamped between the top anvil and one of the other staple cartridge bodies when the other cartridge body is seated in the elongate channel such that the at least one top tissue stop orients the tissue relative to the at least one other line of other staples in the other staple cartridge body. A knife and staple driver assembly is operably supported in the elongate channel and is configured to receive forward driving and reversing motions from the drive system of the surgical cutting and fastening instrument such that when the knife and staple assembly is driven forward, the tissue clamped in the end effector is severed thereby and stapled by staples supported in the cartridge seated in the elongate channel.
Various embodiments of the present invention are described herein by way of example in conjunction with the following figures, wherein like numerals may be used to describe like parts and wherein:
As will be discussed in further detail below, various end effector embodiments include a pivotally translatable anvil assembly, which is maintained at a spacing that assures effective stapling and severing of tissue clamped in the end effector 300. In various exemplary embodiments, the handle 6 may include a pistol grip 26 towards which a closure trigger 18 is pivotally drawn by the clinician to cause clamping or closing of an a top anvil plate 340 toward cartridge 500 seated in an elongate channel 302 of the end effector 300 to thereby clamp tissue positioned between the top anvil plate 340 and the staple cartridge 500. A firing trigger 20 may be situated farther outboard of the closure trigger 18. In various embodiments, once the closure trigger 18 is locked in the closure position as further described below, the firing trigger 20 may rotate slightly toward the pistol grip 26 so that it can be reached by the operator using one hand. Then the operator may pivotally draw the firing trigger 20 toward the pistol grip 26 to cause the stapling and severing of clamped tissue in the end effector 300. Those of ordinary skill in the art will readily appreciate however, that other handle and drive system arrangements may be successfully employed in connection with various embodiments described herein and their equivalent structures without departing from the spirit and scope of the present invention.
It will be appreciated that the terms “proximal” and “distal” are used herein with reference to a clinician gripping the handle 6 of an instrument 10. Thus, the end effector 300 is distal with respect to the more proximal handle 6. It will be further appreciated that, for convenience and clarity, spatial terms such as “vertical” and “horizontal” are used herein with respect to the drawings. However, surgical instruments are used in many orientations and positions, and these terms are not intended to be limiting and absolute.
In general, various staple cartridges 500 include a cartridge body 502 that is divided by a central, elongated slot 508 which extends from the proximal end 504 of the cartridge body 502 towards its tapered outer tip 506. See
Positioned within the pockets 512 are staple-supporting drivers 532 which support staples 534 thereon. Depending upon the location (line) of staple-receiving pockets 512, the staple supporting drivers 532 may support one or two staples 530 thereon. The cartridge body 502 further includes four longitudinal slots 503, 505, 507, 509 extending from its proximal end 504 to its tapered outer tip 506 for receiving corresponding sled cams 328 formed on a wedge sled 326 in the end effector 300, the construction and operation of which will discussed in further detail below. See
As the present Detailed Description continues, the reader will also appreciate that various unique and novel aspects of various embodiments of the present invention enable many of the end effector components to fabricated from sheet metal to thereby reduce the overall costs of the end effector. Other end effector components may comprise machined parts.
Various end effectors of the present invention include an elongate channel 302 that is sized to removably receive and support the cartridge body 502 of a disposable cartridge 500 therein. The reader will understand that in various embodiments, the elongate channel 302 is configured to support any one of the like sized staple cartridge bodies regardless of the length of the lines of staples supported therein. A knife screw 304 is rotatably supported in the elongate channel 302. The knife screw 304 has a distal end 306 that has a distal thrust bearing 308 attached thereto that is rotatably supported by a distal bearing housing 310 formed in the distal end 303 of the elongate channel 302. See
Various embodiments of the present invention further include a knife assembly 320 that has a knife/sled bearing 322 that is threaded onto the threaded portion 312 of the knife screw 304. The knife assembly 320 supports a vertically extending blade 324 and a wedge sled 326 that supports the four sled cams 328. The reader will understand that, as the knife screw 304 is rotated in a clockwise direction, the knife assembly 320 and the wedge sled 326 is advanced toward the distal end 303 (direction “A”) of the elongate channel 302 and, when the knife screw 304 is rotated in a counterclockwise direction, the knife assembly 320 and wedge sled 326 is moved toward the proximal end 305 of the channel member 302 (direction “B”). As can be seen in
In various embodiments of the present invention, a top anvil plate 340 is pivotally coupled to the proximal end 305 of the channel member 302 by a pair of trunnion pins 342 that are sized to be received in oval-shaped pivot holes 311 provided through the side walls 309 of the channel member 302. In various embodiments, the top anvil plate 350 is fabricated from rigid material to minimize any deflection or warpage of the top anvil member during use. The top anvil plate 340 is designed to mate with a bottom anvil plate 350 that is attached to the proximal end 504 of the staple cartridge 500 by at least one, and preferably two springs 352. In various embodiments, one portion 353 of each of the springs 352 is attached to the cartridge body 502 by adhesive, slots, mechanical fasteners, etc. The other portion 354 of each of the springs 352 is attached to the bottom surface 356 of the bottom anvil plate 350 by adhesive, slots, mechanical fasteners, etc. See
In various embodiments, the bottom anvil plate 350 maybe directly attached to the cartridge body 302 and packaged therewith. However, in other embodiments, the bottom anvil plate 350 may be separately packaged and installed on the cartridge 500 prior to use by the user. For example, the top surface 503 of the cartridge body 502 may be provided with a pair of slots or other retention formations that are adapted to retain the portions 353 of the springs 352 therein. In other embodiments for example, the bottom anvil plate 350 may be attached to the top anvil plate by snapping, etc. Thus, it will be appreciated that in various embodiments of the present invention, the bottom anvil plate 350 does not necessarily have to be attached to the staple cartridge body 502. The bottom anvil plate 350 merely has to be “associated with” a particular corresponding staple cartridge. As used in the context, the term “associated with” means that the bottom anvil 350 plate is configured to be aligned with a particular staple cartridge such that when the staples in the cartridge are deployed into the bottom anvil plate 350, the bottom anvil plate 350 causes the staples 534 to be formed in a desired manner and is intended to encompass those arrangements wherein the bottom anvil plate 350 is directly coupled to the cartridge body 502, temporarily attached to the top anvil plate 340, and those arrangements wherein the bottom anvil plate 350 is otherwise held in registry with the staple cartridge body 502 between the top anvil plate 340 and the staple cartridge body 502 during the deployment of the staples 534 into tissue clamped in the end effector 300.
In various embodiments for example, the bottom anvil plate 350 is provided with a pair of stiffener rails 360 that extend along each lateral edge 359 of the bottom anvil plate 350 such that when the cartridge/bottom anvil plate assembly, generally designated as 370, is installed in the elongate channel 302, the top anvil plate 340 is received between the stiffener rails 360 to form an anvil assembly 372. The reader will appreciate that the stiffener rails 360 serve to stiffen the anvil assembly 372 and may serve to snappingly attach the bottom anvil plate 350 to the top anvil plate 340. In various embodiments, the bottom anvil plate 350 may be stamped or otherwise folded or formed out of sheet metal or similar material or thin deflectable plate material, such that after use, it is disposed of with the staple cartridge body 502. Hence, for various embodiments of the present invention, the bottom anvil plate 350 may be referred to herein as a “disposable anvil plate” or a “disposable anvil”.
In addition, a longitudinal slot 362 may be provided through the center of the bottom anvil plate 350 for receiving the upper end of the knife assembly 320 therethrough. A sufficient amount of space may be provided between the bottom surface 341 of the top anvil plate 340 and the upper surface 357 of the bottom anvil plate 350 such that the laterally extending guide tabs 330 formed on the upper end of the knife assembly 320 serve to ride on the upper surface 357 of the bottom anvil plate 357 and urge the bottom anvil plate 350 toward the cartridge body 502 as the knife assembly 320 and wedge sled 326 are driven through the cartridge 520 to cut the tissue and deploy the staples 534. In addition, a longitudinal slot 343 may be provided in the bottom surface 341 of the top anvil plate 340 to accommodate the top end of the knife assembly 320 therein.
Another unique and novel aspect of the present invention is the ability of various end effector embodiments to be effectively used in connection with staple cartridges that have different staple line lengths “L”. For example, various embodiments of the present invention employ tissue stops 364 on the bottom anvil plate 350. In addition, to support these “first” tissue stops 364 on the anvil plate 350, a pair of top tissue stops 344 are formed on the top anvil plate 340 to backup and abut (otherwise “cooperate with”) the first tissue stops 364 when the cartridge assembly 500 is installed in the channel as shown in
In other embodiments wherein no staple forming pockets are formed in the bottom surface 341 of the top anvil plate 340, a bottom anvil plate 350 may be employed as described above for those staple cartridges 500 that have longer lines of staples that can rely solely on the top tissue stops 344 to orient the tissue so as to prevent the tissue from going all the way back into the anvil/cartridge arrangement and thereby result in tissue being cut but not stapled. Thus, as can be seen in
A drive assembly for operating various embodiments of the end effector 300 will now be described with reference to
As can be seen in
A series of four tapered sections 416 are formed on the distal end 415 of the tapered clutch member 412. A series of male splines 418 are formed in the interior of the tapered sections 416. See
Also in various embodiments, a closure nut 440 is received on the distal drive shaft portion 402. As can be seen in
More specifically and with reference to
The operation of various embodiments of the present invention will now be described with reference to
The reader will appreciate that when the end effector 300 is in the open position depicted in
As the closure nut 440 is driven in the proximal direction, the proximal end 449 of the closure nut 440 contacts the thrust bearing 434 which forces the clutch plate 420 in the proximal direction against the force of clutch opening spring 432. Further travel of the closure nut 440 in the proximal direction drives the clutch plate 420 onto the tapered sections 416 of the tapered clutch member 412 which causes the male splines 418 therein to engage the female splines 408 on the distal drive shaft portion 402. Such engagement of the male splines 418 in the tapered clutch member 412 with the female splines on the distal drive shaft portion 402 causes the tapered clutch member 412 and the drive gear 414 to rotate with the distal drive shaft portion 402. Drive gear 414, in turn, rotates the knife screw gear 316 which causes the knife screw to rotate and drive the knife assembly distally (“B: direction”).
As the knife assembly 320 is driven distally, the laterally extending guide tabs 330 engage the top surface of the bottom anvil plate 350 and serve to pull the bottom anvil plate 350 downward to further clamp the tissue between the bottom anvil plate 350 and the cartridge body 502. The knife blade 324 on the knife assembly 320 cuts the tissue and the cams 328 on the wedge sled 326 serves to drive the staple supporting drivers 532 upward which drive the staples 534 toward the bottom anvil plate 350. As the legs 536 of the staples 534 are driven into the corresponding staple forming pockets 358 in the bottom anvil plate 350, they are folded over. See
When the knife assembly 320 moves distally, the retainer arm 466 no longer is in contact with the ramp surface 321 of the knife assembly 320 which enables the retainer arm 466 and the upper portion 462 of the closure lock spring 460 to spring upwardly which further enables the retainer lip 464 on the closure lock spring 460 to retainingly engage the distal end of the closure nut 440 to prevent it from moving distally. See
As the knife assembly 320 moves in the proximal direction on the knife screw 304, the closure threads 406 on the drive shaft 402 begin to screw back into the threaded hole portion 442 in the closure nut 440. During this process, the ramp surface 321 of the knife assembly 320 again contacts the end of the retainer arm 466 which serves to bias the upper portion 462 of the closure lock spring 460 toward the bottom of the elongate channel 302 to permit the retainer lip 464 to disengage from the distal end of the closure nut 440 thereby permitting the clutch opening spring 432 to bias the clutch assembly 410 and closure nut 440 distally. As the closure nut 440 moves distally, the closure hook 346 on the top anvil plate rides up the ramp 444 on the closure nut until the closure nut 440 reaches the open position wherein the closure tab 448 contacts the tab relief groove 348 in the top anvil plate 340 and the closure nut 440 moves the anvil assembly 372 to the open position. A second conventional sensor or contact 315 is mounted within the proximal end portion 305 of the elongate channel 302 for sensing when the closure nut 440 is in the open position and communicates with the motor to cause it to stop. See
As indicated above, a variety of different motor/control arrangements may be employed to power the drive shaft portion 402. For example, in various embodiments when the closure trigger 18 is actuated, that is, drawn in by a user of the instrument 10, the motor 600 may commence the above described closing process. A third sensor 315′ may be used in the elongate channel member 302 to sense when the closure nut 404 has moved into the closed position (shown in Figure). When the third sensor 315′ senses that the closure nut 440 is in that position, the sensor 315′ may cause the motor 600 to stop rotating. Thereafter, if the surgeon is satisfied with the clamping of the tissue in the end effector 300, the surgeon may actuate the firing trigger 20 or other actuator arrangement to activate the motor 600 to rotate the drive shaft 402 which drives the knife screw 304 in the above-mentioned manner.
It will be appreciated from the foregoing discussion, that various embodiments of the present invention represent vast improvements over prior surgical cutting and fastening end effectors and cartridges to be used with such instruments. In particular, various embodiments of the present invention enable different cartridge configurations to be used in the same end effector. Other features of at least some of the embodiments of the present invention involve the provision of staple cartridges that are more economical to manufacture and which require lower firing forces to be generated by the instrument to cut and staple tissue. In addition, another feature of various embodiments of the present invention provide end effectors that can be used to repeatedly deploy staples into thick tissue utilizing firing forces that are generally lower than those firing forces required by at least some prior end effector arrangements.
Any patent, publication, or information, in whole or in part, that is said to be incorporated by reference herein is incorporated herein only to the extent that the incorporated material does not conflict with existing definitions, statements, or other disclosure material set forth in this document. As such the disclosure as explicitly set forth herein supersedes any conflicting material incorporated herein by reference.
The invention which is intended to be protected is not to be construed as limited to the particular embodiments disclosed. The embodiments are therefore to be regarded as illustrative rather than restrictive. Variations and changes may be made by others without departing from the spirit of the present invention. Accordingly, it is expressly intended that all such equivalents, variations and changes which fall within the spirit and scope of the present invention as defined in the claims be embraced thereby.
The present application is related to the following U.S. patent applications, which are incorporated herein by reference in their entirety: MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING INSTRUMENT WITH USER FEEDBACK SYSTEM Inventors: Frederick E. Shelton, IV, John Ouwerkerk and Jerome R. Morgan (K&LNG 050519/END5687USNP) MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING INSTRUMENT WITH LOADING FORCE FEEDBACK Inventors: Frederick E. Shelton, IV, John N. Ouwerkerk, Jerome R. Morgan, and Jeffery S. Swayze (K&LNG 050515/END5693USNP) MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING INSTRUMENT WITH ADAPTIVE USER FEEDBACK Inventors: Frederick E. Shelton, IV, John N. Ouwerkerk, and Jerome R. Morgan (K&LNG 050513/END5694USNP) MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING INSTRUMENT WITH ARTICULATABLE END EFFECTOR Inventors: Frederick E. Shelton, IV and Christoph L. Gillum (K&LNG 050692/END5769USNP) MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING INSTRUMENT WITH MECHANICAL CLOSURE SYSTEM Inventors: Frederick E. Shelton, IV and Christoph L. Gillum (K&LNG 050693/END5770USNP) SURGICAL CUTTING AND FASTENING INSTRUMENT WITH CLOSURE TRIGGER LOCKING MECHANISM Inventors: Frederick E. Shelton, IV and Kevin R. Doll (K&LNG 050694/END5771USNP) GEARING SELECTOR FOR A POWERED SURGICAL CUTTING AND FASTENING STAPLING INSTRUMENT Inventors: Frederick E. Shelton, IV, Jeffrey S. Swayze, Eugene L. Timperman (K&LNG 050697/END5772USNP) SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES Inventors: Frederick E. Shelton, IV, John N. Ouwerkerk, and Eugene L. Timperman (K&LNG 050698/END5773USNP) SURGICAL INSTRUMENT HAVING A REMOVABLE BATTERY Inventors: Frederick E. Shelton, IV, Kevin R. Doll, Jeffrey S. Swayze and Eugene Timperman (K&LNG 050699/END5774USNP) ELECTRONIC LOCKOUTS AND SURGICAL INSTRUMENT INCLUDING SAME Inventors: Jeffrey S. Swayze, Frederick E. Shelton, IV, Kevin R. Doll (K&LNG 050700/END5775USNP) ENDOSCOPIC SURGICAL INSTRUMENT WITH A HANDLE THAT CAN ARTICULATE WITH RESPECT TO THE SHAFT Inventors: Frederick E. Shelton, IV, Jeffrey S. Swayze, Mark S. Ortiz, and Leslie M. Fugikawa (K&LNG 050701END5776USNP) ELECTRO-MECHANICAL SURGICAL CUTTING AND FASTENING INSTRUMENT HAVING A ROTARY FIRING AND CLOSURE SYSTEM WITH PARALLEL CLOSURE AND ANVIL ALIGNMENT COMPONENTS Inventors: Frederick E. Shelton, IV, Stephen J. Balek and Eugene L. Timperman (K&LNG 050702/END5777USNP) SURGICAL INSTRUMENT HAVING A FEEDBACK SYSTEM Inventors: Frederick E. Shelton, IV, Jerome R. Morgan, Kevin R. Doll, Jeffrey S. Swayze and Eugene Timperman (K&LNG 050705/END5780USNP)