Surgical stapling device with separate rotary driven closure and firing systems and firing member that engages both jaws while firing

Information

  • Patent Grant
  • 11207067
  • Patent Number
    11,207,067
  • Date Filed
    Thursday, February 21, 2019
    5 years ago
  • Date Issued
    Tuesday, December 28, 2021
    2 years ago
Abstract
A surgical instrument including a channel that is configured to support a replaceable surgical staple cartridge therein. An anvil is movably supported on the channel and is configured to selectively move between an open position and a closed position. A rotary driven closure system operably interfaces with the anvil and is configured to move the anvil between the open position and the closed position upon application of rotary opening and closing motions thereto. The instrument also includes a rotary driven firing drive shaft and an axially movable firing member that is in driving engagement with the rotary driven firing drive shaft and is configured for sliding engagement with the channel and the anvil upon application of rotary firing motions to the rotary driven firing drive shaft.
Description
BACKGROUND

The present invention relates to surgical instruments and, in various arrangements, to surgical stapling and cutting instruments and staple cartridges for use therewith that are designed to staple and cut tissue.





BRIEF DESCRIPTION OF THE DRAWINGS

Various features of the embodiments described herein, together with advantages thereof, may be understood in accordance with the following description taken in conjunction with the accompanying drawings as follows:



FIG. 1 is a perspective view of a powered surgical stapling system;



FIG. 2 is a perspective view of an interchangeable surgical shaft assembly of the powered surgical stapling system of FIG. 1;



FIG. 3 is an exploded assembly view of portions of a handle assembly of the powered surgical stapling system of FIG. 1;



FIG. 4 is an exploded assembly view of the interchangeable surgical shaft assembly of FIG. 2;



FIG. 5 is another partial exploded assembly view of a portion of the interchangeable surgical shaft assembly of FIG. 4;



FIG. 6 is a perspective view of another powered surgical stapling system;



FIG. 7 is an exploded assembly view of portion of a shaft assembly of the power surgical stapling system of FIG. 6;



FIG. 8 is an exploded assembly view of portions of a handle assembly of the powered surgical stapling system of FIG. 6;



FIG. 9 is a perspective view of another powered surgical stapling system;



FIG. 10 is a top view of a portion of the powered surgical stapling system of FIG. 9;



FIG. 11 is a partial perspective view of an articulation joint of the shaft assembly of the surgical stapling system of FIG. 9;



FIG. 12 is a top view of the articulation joint of FIG. 11;



FIG. 13 is a perspective assembly view of a firing member and a firing drive shaft;



FIG. 14 is a perspective view of portions of an end effector and articulation joint of the powered surgical stapling system of FIG. 9;



FIG. 15 is another perspective view of the end effector and articulation joint of FIG. 14;



FIG. 16 is a top view of an anvil of the end effector of FIG. 14;



FIG. 17 is another top view of the anvil of FIG. 16 attached to an elongate channel of the end effector of FIG. 14;



FIG. 18 is a cross-sectional view of the anvil and end effector of FIG. 17 taken along line 18-18 in FIG. 17;



FIG. 19 is another cross-sectional view of the anvil and end effector of FIG. 17 taken along line 19-19 in FIG. 17;



FIG. 20 is an exploded assembly view of a closure linkage assembly of the end effector of FIG. 14 and a closure drive shaft;



FIG. 21 is a perspective view of the closure linkage assembly and closure drive shaft of FIG. 20;



FIG. 22 is a partial perspective view of an anvil, closure linkage assembly, and closure drive shaft of another rotary powered surgical end effector;



FIG. 23 is a partial end elevational view of the anvil, closure linkage assembly, and closure drive shaft of FIG. 22, with the drive shaft shown in cross-section;



FIG. 24 is a side elevational view of an anvil, closure linkage assembly, rotary firing drive shaft, and closure drive shaft of another rotary powered surgical end effector with an anvil thereof in a closed position;



FIG. 25 is another side elevational view of the anvil, closure linkage assembly, rotary firing drive shaft, and closure drive shaft of FIG. 24 with the anvil in an open position;



FIG. 26 is a cross-sectional end view of the rotary powered surgical end effector of FIG. 24;



FIG. 27 is another cross-sectional end view of the rotary powered surgical end effector of FIG. 24;



FIG. 28 is a side elevational view of a portion of another rotary powered surgical end effector with an anvil thereof in an open position;



FIG. 29 is an enlarged partial perspective view of a portion of the rotary powered surgical end effector of FIG. 28;



FIG. 30 is a partial side elevational view of portions of the rotary powered surgical end effector of FIGS. 28 and 29, with the anvil thereof in an open position;



FIG. 31 is another partial side elevational view of portions of the rotary powered surgical end effector of FIG. 30, with the anvil thereof in a closed position;



FIG. 32 is a cross-sectional side view of a portion of the anvil and elongate channel of the rotary powered surgical end effector of FIG. 31;



FIG. 33 is a partial perspective view of another rotary powered surgical end effector with an anvil thereof in a closed position;



FIG. 34 is a side elevational view of a portion of the rotary powered surgical end effector of FIG. 33 with the anvil in an open position;



FIG. 35 is another side elevational view of a portion of the rotary powered surgical end effector of FIG. 34 with the anvil in a closed position;



FIG. 36 is a cross-sectional end view of a portion of the rotary powered surgical end effector of FIG. 33;



FIG. 37 is a partial cross-sectional side view of a rotary firing drive shaft and a rotary closure drive shaft of the rotary powered surgical end effector of FIG. 33;



FIG. 38 is a diagrammatical depiction of an end effector that employs a closure link arrangement for opening and closing jaws of the end effector, with the jaws shown in an open position;



FIG. 39 is another diagrammatical depiction of the end effector of FIG. 38, with the jaws in a closed position;



FIG. 40 is a diagrammatical depiction of another end effector that employs a closure link arrangement for opening and closing jaws of the end effector, with the jaws shown in an open position;



FIG. 41 is another diagrammatical depiction of the end effector of FIG. 40, with the jaws in a closed position;



FIG. 42 is a diagrammatical depiction of another end effector that employs a closure link arrangement for opening and closing jaws of the end effector, with the jaws shown in an open position;



FIG. 43 is another diagrammatical depiction of the end effector of FIG. 42, with the jaws in a closed position;



FIG. 44 is a side elevational view of portions of another surgical end effector with an anvil thereof shown in phantom lines in an open position;



FIG. 45 is an end view of the surgical end effector of FIG. 44;



FIG. 46 is a partial cross-sectional perspective view of the anvil of the end effector of FIG. 45;



FIG. 47 is a side elevational view of an anvil closure member of the surgical end effector of FIG. 44;



FIG. 48 is a side elevational view of a firing member of the surgical end effector of FIG. 44;



FIG. 49 is a partial side elevational view of the surgical end effector of FIG. 44 with an anvil thereof shown in phantom lines in an open position;



FIG. 50 is another partial side elevational view of the surgical end effector of FIG. 49, with an anvil thereof in a closed position;



FIG. 51 is another side elevational view of the surgical end effector of FIG. 50 with a firing member thereof beginning a firing process;



FIG. 52 is another side elevational view of the surgical end effector of FIG. 50 with the anvil closure member and the firing member being partially distally deployed in the end effector;



FIG. 53 is a perspective view of another powered surgical instrument;



FIG. 54 is a top view of a portion of the powered surgical instrument of FIG. 53;



FIG. 55 is a partial cross-sectional view of portions of the surgical end effector of the surgical instrument of FIG. 53;



FIG. 56 is a partial exploded assembly view of an anvil and end cap portion of the surgical end effector of the surgical instrument of FIG. 53;



FIG. 57 is a partial cross-sectional end view of the surgical end effector of the surgical instrument of FIG. 53;



FIG. 58 is a perspective proximal end view of a portion of an elongate channel of the surgical end effector of FIG. 57;



FIG. 59 is a partial side elevational view of a portion of the surgical end effector of FIG. 57, with some components shown in cross-section and with the anvil thereof in a closed position;



FIG. 60 is a cross-sectional end view of the surgical end effector of FIG. 59 taken along line 60-60 in FIG. 59;



FIG. 61 is a cross-sectional end view of the surgical end effector of FIG. 59 taken along line 61-61 in FIG. 59;



FIG. 62 is a partial bottom perspective view of the elongate channel and firing member of the surgical end effector of FIG. 59;



FIG. 63 is a perspective view of another powered surgical instrument;



FIG. 64 is a top view of the powered surgical instrument of FIG. 63;



FIG. 65 is a partial cross-sectional side view of a surgical end effector of the powered surgical instrument of FIG. 63, with a surgical staple cartridge being operably installed therein;



FIG. 66 is a perspective view of the surgical staple cartridge of FIG. 65;



FIG. 67 is partial perspective assembly view of an elongate channel portion of the surgical end effector of FIG. 65 and a bottom perspective view of the surgical staple cartridge of FIG. 66;



FIG. 68 is a side elevational view of a clip of the surgical staple cartridge of FIG. 67 in engagement with a portion of the elongate channel of FIG. 67 when the staple cartridge has been operably installed in the elongate channel;



FIG. 69 is a partial exploded assembly view of a firing lockout assembly of the surgical end effector of FIG. 65;



FIG. 70 is a top cross-sectional view of the firing lockout assembly of FIG. 69 in engagement with a portion of the surgical staple cartridge of FIG. 66;



FIG. 71 is a side cross-sectional view of the surgical end effector of FIG. 65 with a surgical staple cartridge operably installed therein and the firing lockout assembly in an unlocked position;



FIG. 72 is another side cross-sectional view of the surgical end effector of FIG. 65 with a surgical staple cartridge operably installed therein and the anvil thereof in an open position;



FIG. 73 is a partial cross-sectional side view of another surgical end effector with an anvil thereof in an open position and prior to installation of a surgical staple cartridge therein;



FIG. 74 is another partial cross-sectional side view of the surgical end effector of FIG. 73 after the anvil has started to close;



FIG. 75 is an exploded assembly view of a firing member and firing member lockout feature of the surgical end effector of FIG. 73;



FIG. 76 is an enlarged view of a portion of the firing member lockout feature of FIG. 75 in engagement with a portion of a surgical staple cartridge installed in an elongate channel of the surgical end effector of FIG. 73;



FIG. 77 is another enlarged view of a portion of the firing member lockout feature of FIG. 76 in a locked position prior to installation of a surgical staple cartridge into the elongate channel of the surgical end effector of FIG. 73;



FIG. 78 is a cross-sectional view of a portion of the surgical end effector of FIG. 73 and a camming assembly of a surgical staple cartridge installed in the end effector;



FIG. 79 is a cross-sectional side view of the surgical end effector of FIG. 73 with a surgical staple cartridge installed therein and the anvil thereof in an open position;



FIG. 80 is another cross-sectional side view of the surgical end effector of FIG. 73, with the anvil thereof in a closed position;



FIG. 81 is a perspective view of a portion of another surgical end effector with a surgical staple cartridge installed therein;



FIG. 82 is a perspective view of a portion of a firing member and a closure system of the surgical end effector of FIG. 81;



FIG. 83 is a cross-sectional end view of a portion of an elongate channel and closure shuttle of the surgical end effector of FIG. 81;



FIG. 84 is a partial perspective view of the surgical end effector of FIG. 81 prior to installing a staple cartridge therein;



FIG. 85 is another partial perspective view of the surgical end effector of FIG. 84 with a firing lockout member thereof in a locked position because no cartridge has been installed in the end effector;



FIG. 86 is another partial perspective view of the surgical end effector of FIG. 84 with a cartridge installed therein;



FIG. 87 is another partial perspective view of the surgical end effector of FIG. 86 with a portion of the cartridge removed to enable the firing lockout member to be viewed in engagement with the camming assembly of the cartridge;



FIG. 88 is another partial perspective view of the surgical end effector of FIG. 86 with a cartridge installed therein and a firing member of the surgical end effector moved distally forward; and



FIG. 89 is another partial perspective view of the surgical end effector of FIG. 86 with a portion of the cartridge omitted to enable the firing lockout member to be viewed in engagement with the camming assembly of the cartridge.





Corresponding reference characters indicate corresponding parts throughout the several views. The exemplifications set out herein illustrate various embodiments of the invention, in one form, and such exemplifications are not to be construed as limiting the scope of the invention in any manner.


DETAILED DESCRIPTION

Applicant of the present application owns the following U.S. Patent Applications that were filed on Feb. 21, 2019 and which are each herein incorporated by reference in their respective entireties:

    • U.S. Patent Application entitled METHODS FOR CONTROLLING A POWERED SURGICAL STAPLER THAT HAS SEPARATE ROTARY CLOSURE AND FIRING SYSTEMS, Ser. No. 16/281,658, now U.S. Patent Application Publication No. 2019-0298350;
    • U.S. Patent Application entitled STAPLE CARTRIDGE COMPRISING A LOCKOUT KEY CONFIGURED TO LIFT A FIRING MEMBER, Ser. No. 16/281,670, now U.S. Patent Application Publication No. 2019-0298340;
    • U.S. Patent Application entitled SURGICAL STAPLERS WITH ARRANGEMENTS FOR MAINTAINING A FIRING MEMBER THEREOF IN A LOCKED CONFIGURATION UNLESS A COMPATIBLE CARTRIDGE HAS BEEN INSTALLED THEREIN, Ser. No. 16/281,675, now U.S. Patent Application Publication No. 2019-0298354;
    • U.S. Patent Application entitled SURGICAL INSTRUMENT COMPRISING COOPERATING LOCKOUT FEATURES, Ser. No. 16/281,685, now U.S. Patent Application Publication No. 2019-0298341;
    • U.S. Patent Application entitled SURGICAL STAPLING ASSEMBLY COMPRISING A LOCKOUT AND AN EXTERIOR ACCESS ORIFICE TO PERMIT ARTIFICIAL UNLOCKING OF THE LOCKOUT, Ser. No. 16/281,693, now U.S. Patent Application Publication No. 2019-0298342;
    • U.S. Patent Application entitled SURGICAL STAPLING DEVICES WITH FEATURES FOR BLOCKING ADVANCEMENT OF A CAMMING ASSEMBLY OF AN INCOMPATIBLE CARTRIDGE INSTALLED THEREIN, Ser. No. 16/281,704, now U.S. Patent Application Publication No. 2019-0257578;
    • U.S. Patent Application entitled STAPLING INSTRUMENT COMPRISING A DEACTIVATABLE LOCKOUT, Ser. No. 16/281,707, now U.S. Patent Application Publication No. 2019-0298347;
    • U.S. Patent Application entitled SURGICAL INSTRUMENT COMPRISING A JAW CLOSURE LOCKOUT, Ser. No. 16/281,741, now U.S. Patent Application Publication No. 2019-0298357;
    • U.S. Patent Application entitled SURGICAL STAPLING DEVICES WITH CARTRIDGE COMPATIBLE CLOSURE AND FIRING LOCKOUT ARRANGEMENTS, Ser. No. 16/281,762, now U.S. Patent Application Publication No. 2019-0298343;
    • U.S. Patent Application entitled SURGICAL STAPLE CARTRIDGE WITH FIRING MEMBER DRIVEN CAMMING ASSEMBLY THAT HAS AN ONBOARD TISSUE CUTTING FEATURE, Ser. No. 16/281,660, now U.S. Patent Application Publication No. 2019-0298351;
    • U.S. Patent Application entitled SURGICAL STAPLING DEVICES WITH IMPROVED ROTARY DRIVEN CLOSURE SYSTEMS, Ser. No. 16/281,666, now U.S. Patent Application Publication No. 2019-0298352;
    • U.S. Patent Application entitled SURGICAL STAPLING DEVICES WITH ASYMMETRIC CLOSURE FEATURES, Ser. No. 16/281,672, now U.S. Patent Application Publication No. 2019-0298343; and
    • U.S. Patent Application entitled ROTARY DRIVEN FIRING MEMBERS WITH DIFFERENT ANVIL AND CHANNEL ENGAGEMENT FEATURES, Ser. No. 16/281,678, now U.S. Patent Application Publication No. 2019-2098355.


Applicant of the present application owns the following U.S. Provisional Patent Applications that were filed on Feb. 19, 2019 and which are each herein incorporated by reference in their respective entireties:

    • U.S. Provisional Patent Application Ser. No. 62/807,310, entitled METHODS FOR CONTROLLING A POWERED SURGICAL STAPLER THAT HAS SEPARATE ROTARY CLOSURE AND FIRING SYSTEMS;
    • U.S. Provisional Patent Application Ser. No. 62/807,319, entitled SURGICAL STAPLING DEVICES WITH IMPROVED LOCKOUT SYSTEMS; and
    • U.S. Provisional Patent Application Ser. No. 62/807,309, entitled SURGICAL STAPLING DEVICES WITH IMPROVED ROTARY DRIVEN CLOSURE SYSTEMS.


Applicant of the present application owns the following U.S. Provisional Patent Applications, filed on Mar. 28, 2018, each of which is herein incorporated by reference in its entirety:

    • U.S. Provisional Patent Application Ser. No. 62/649,302, entitled INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES;
    • U.S. Provisional Patent Application Ser. No. 62/649,294, entitled DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE ANONYMIZED RECORD;
    • U.S. Provisional Patent Application Ser. No. 62/649,300, entitled SURGICAL HUB SITUATIONAL AWARENESS;
    • U.S. Provisional Patent Application Ser. No. 62/649,309, entitled SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATING THEATER;
    • U.S. Provisional Patent Application Ser. No. 62/649,310, entitled COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS;
    • U.S. Provisional Patent Application Ser. No. 62/649,291, entitled USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TO DETERMINE PROPERTIES OF BACK SCATTERED LIGHT;
    • U.S. Provisional Patent Application Ser. No. 62/649,296, entitled ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES;
    • U.S. Provisional Patent Application Ser. No. 62/649,333, entitled CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONS TO A USER;
    • U.S. Provisional Patent Application Ser. No. 62/649,327, entitled CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION TRENDS AND REACTIVE MEASURES;
    • U.S. Provisional Patent Application Ser. No. 62/649,315, entitled DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK;
    • U.S. Provisional Patent Application Ser. No. 62/649,313, entitled CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES;
    • U.S. Provisional Patent Application Ser. No. 62/649,320, entitled DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS;
    • U.S. Provisional Patent Application Ser. No. 62/649,307, entitled AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS; and
    • U.S. Provisional Patent Application Ser. No. 62/649,323, entitled SENSING ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS.


Applicant of the present application owns the following U.S. Provisional Patent Application, filed on Mar. 30, 2018, which is herein incorporated by reference in its entirety:

    • U.S. Provisional Patent Application Ser. No. 62/650,887, entitled SURGICAL SYSTEMS WITH OPTIMIZED SENSING CAPABILITIES.


Applicant of the present application owns the following U.S. Patent Application, filed on Dec. 4, 2018, which is herein incorporated by reference in its entirety:

    • U.S. patent application Ser. No. 16/209,423, entitled METHOD OF COMPRESSING TISSUE WITHIN A STAPLING DEVICE AND SIMULTANEOUSLY DISPLAYING THE LOCATION OF THE TISSUE WITHIN THE JAWS.


Applicant of the present application owns the following U.S. Patent Applications that were filed on Aug. 20, 2018 and which are each herein incorporated by reference in their respective entireties:

    • U.S. patent application Ser. No. 16/105,101, entitled METHOD FOR FABRICATING SURGICAL STAPLER ANVILS;
    • U.S. patent application Ser. No. 16/105,183, entitled REINFORCED DEFORMABLE ANVIL TIP FOR SURGICAL STAPLER ANVIL;
    • U.S. patent application Ser. No. 16/105,150, entitled SURGICAL STAPLER ANVILS WITH STAPLE DIRECTING PROTRUSIONS AND TISSUE STABILITY FEATURES;
    • U.S. patent application Ser. No. 16/105,098, entitled FABRICATING TECHNIQUES FOR SURGICAL STAPLER ANVILS;
    • U.S. patent application Ser. No. 16/105,140, entitled SURGICAL STAPLER ANVILS WITH TISSUE STOP FEATURES CONFIGURED TO AVOID TISSUE PINCH;
    • U.S. patent application Ser. No. 16/105,081, entitled METHOD FOR OPERATING A POWERED ARTICULATABLE SURGICAL INSTRUMENT;
    • U.S. patent application Ser. No. 16/105,094, entitled SURGICAL INSTRUMENTS WITH PROGRESSIVE JAW CLOSURE ARRANGEMENTS;
    • U.S. patent application Ser. No. 16/105,097, entitled POWERED SURGICAL INSTRUMENTS WITH CLUTCHING ARRANGEMENTS TO CONVERT LINEAR DRIVE MOTIONS TO ROTARY DRIVE MOTIONS;
    • U.S. patent application Ser. No. 16/105,104, entitled POWERED ARTICULATABLE SURGICAL INSTRUMENTS WITH CLUTCHING AND LOCKING ARRANGEMENTS FOR LINKING AN ARTICULATION DRIVE SYSTEM TO A FIRING DRIVE SYSTEM;
    • U.S. patent application Ser. No. 16/105,119, entitled ARTICULATABLE MOTOR POWERED SURGICAL INSTRUMENTS WITH DEDICATED ARTICULATION MOTOR ARRANGEMENTS;
    • U.S. patent application Ser. No. 16/105,160, entitled SWITCHING ARRANGEMENTS FOR MOTOR POWERED ARTICULATABLE SURGICAL INSTRUMENTS; and
    • U.S. Design Patent Application Serial No. 29/660,252, entitled SURGICAL STAPLER ANVILS.


Applicant of the present application owns the following U.S. Patent Applications and U.S. Patents that are each herein incorporated by reference in their respective entireties:

    • U.S. patent application Ser. No. 15/386,185, entitled SURGICAL STAPLING INSTRUMENTS AND REPLACEABLE TOOL ASSEMBLIES THEREOF, now U.S. Patent Application Publication No. 2018/0168642;
    • U.S. patent application Ser. No. 15/386,230, entitled ARTICULATABLE SURGICAL STAPLING INSTRUMENTS, now U.S. Patent Application Publication No. 2018/0168649;
    • U.S. patent application Ser. No. 15/386,221, entitled LOCKOUT ARRANGEMENTS FOR SURGICAL END EFFECTORS, now U.S. Patent Application Publication No. 2018/0168646;
    • U.S. patent application Ser. No. 15/386,209, entitled SURGICAL END EFFECTORS AND FIRING MEMBERS THEREOF, now U.S. Patent Application Publication No. 2018/0168645;
    • U.S. patent application Ser. No. 15/386,198, entitled LOCKOUT ARRANGEMENTS FOR SURGICAL END EFFECTORS AND REPLACEABLE TOOL ASSEMBLIES, now U.S. Patent Application Publication No. 2018/0168644;
    • U.S. patent application Ser. No. 15/386,240, entitled SURGICAL END EFFECTORS AND ADAPTABLE FIRING MEMBERS THEREFOR, now U.S. Patent Application Publication No. 2018/0168651;
    • U.S. patent application Ser. No. 15/385,939, entitled STAPLE CARTRIDGES AND ARRANGEMENTS OF STAPLES AND STAPLE CAVITIES THEREIN, now U.S. Patent Application Publication No. 2018/0168629;
    • U.S. patent application Ser. No. 15/385,941, entitled SURGICAL TOOL ASSEMBLIES WITH CLUTCHING ARRANGEMENTS FOR SHIFTING BETWEEN CLOSURE SYSTEMS WITH CLOSURE STROKE REDUCTION FEATURES AND ARTICULATION AND FIRING SYSTEMS, now U.S. Patent Application Publication No. 2018/0168630;
    • U.S. patent application Ser. No. 15/385,943, entitled SURGICAL STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS, now U.S. Patent Application Publication No. 2018/0168631;
    • U.S. patent application Ser. No. 15/385,950, entitled SURGICAL TOOL ASSEMBLIES WITH CLOSURE STROKE REDUCTION FEATURES, now U.S. Patent Application Publication No. 2018/0168635;
    • U.S. patent application Ser. No. 15/385,945, entitled STAPLE CARTRIDGES AND ARRANGEMENTS OF STAPLES AND STAPLE CAVITIES THEREIN, now U.S. Patent Application Publication No. 2018/0168632;
    • U.S. patent application Ser. No. 15/385,946, entitled SURGICAL STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS, now U.S. Patent Application Publication No. 2018/0168633;
    • U.S. patent application Ser. No. 15/385,951, entitled SURGICAL INSTRUMENTS WITH JAW OPENING FEATURES FOR INCREASING A JAW OPENING DISTANCE, now U.S. Patent Application Publication No. 2018/0168636;
    • U.S. patent application Ser. No. 15/385,953, entitled METHODS OF STAPLING TISSUE, now U.S. Patent Application Publication No. 2018/0168637;
    • U.S. patent application Ser. No. 15/385,954, entitled FIRING MEMBERS WITH NON-PARALLEL JAW ENGAGEMENT FEATURES FOR SURGICAL END EFFECTORS, now U.S. Patent Application Publication No. 2018/0168638;
    • U.S. patent application Ser. No. 15/385,955, entitled SURGICAL END EFFECTORS WITH EXPANDABLE TISSUE STOP ARRANGEMENTS, now U.S. Patent Application Publication No. 2018/0168639;
    • U.S. patent application Ser. No. 15/385,948, entitled SURGICAL STAPLING INSTRUMENTS AND STAPLE-FORMING ANVILS, now U.S. Patent Application Publication No. 2018/0168584;
    • U.S. patent application Ser. No. 15/385,956, entitled SURGICAL INSTRUMENTS WITH POSITIVE JAW OPENING FEATURES, now U.S. Patent Application Publication No. 2018/0168640;
    • U.S. patent application Ser. No. 15/385,958, entitled SURGICAL INSTRUMENTS WITH LOCKOUT ARRANGEMENTS FOR PREVENTING FIRING SYSTEM ACTUATION UNLESS AN UNSPENT STAPLE CARTRIDGE IS PRESENT, now U.S. Patent Application Publication No. 2018/0168641;
    • U.S. patent application Ser. No. 15/385,947, entitled STAPLE CARTRIDGES AND ARRANGEMENTS OF STAPLES AND STAPLE CAVITIES THEREIN, now U.S. Patent Application Publication No. 2018/0168634;
    • U.S. patent application Ser. No. 15/385,896, entitled METHOD FOR RESETTING A FUSE OF A SURGICAL INSTRUMENT SHAFT, now U.S. Patent Application Publication No. 2018/0168597;
    • U.S. patent application Ser. No. 15/385,898, entitled STAPLE-FORMING POCKET ARRANGEMENT TO ACCOMMODATE DIFFERENT TYPES OF STAPLES, now U.S. Patent Application Publication No. 2018/0168599;
    • U.S. patent application Ser. No. 15/385,899, entitled SURGICAL INSTRUMENT COMPRISING IMPROVED JAW CONTROL, now U.S. Patent Application Publication No. 2018/0168600;
    • U.S. patent application Ser. No. 15/385,901, entitled STAPLE CARTRIDGE AND STAPLE CARTRIDGE CHANNEL COMPRISING WINDOWS DEFINED THEREIN, now U.S. Patent Application Publication No. 2018/0168602;
    • U.S. patent application Ser. No. 15/385,902, entitled SURGICAL INSTRUMENT COMPRISING A CUTTING MEMBER, now U.S. Patent Application Publication No. 2018/0168603;
    • U.S. patent application Ser. No. 15/385,904, entitled STAPLE FIRING MEMBER COMPRISING A MISSING CARTRIDGE AND/OR SPENT CARTRIDGE LOCKOUT, now U.S. Patent Application Publication No. 2018/0168605;
    • U.S. patent application Ser. No. 15/385,905, entitled FIRING ASSEMBLY COMPRISING A LOCKOUT, now U.S. Patent Application Publication No. 2018/0168606;
    • U.S. patent application Ser. No. 15/385,907, entitled SURGICAL INSTRUMENT SYSTEM COMPRISING AN END EFFECTOR LOCKOUT AND A FIRING ASSEMBLY LOCKOUT, now U.S. Patent Application Publication No. 2018/0168608;
    • U.S. patent application Ser. No. 15/385,908, entitled FIRING ASSEMBLY COMPRISING A FUSE, now U.S. Patent Application Publication No. 2018/0168609;
    • U.S. patent application Ser. No. 15/385,909, entitled FIRING ASSEMBLY COMPRISING A MULTIPLE FAILED-STATE FUSE, now U.S. Patent Application Publication No. 2018/0168610;
    • U.S. patent application Ser. No. 15/385,920, entitled STAPLE-FORMING POCKET ARRANGEMENTS, now U.S. Patent Application Publication No. 2018/0168620;
    • U.S. patent application Ser. No. 15/385,913, entitled ANVIL ARRANGEMENTS FOR SURGICAL STAPLERS, now U.S. Patent Application Publication No. 2018/0168614;
    • U.S. patent application Ser. No. 15/385,914, entitled METHOD OF DEFORMING STAPLES FROM TWO DIFFERENT TYPES OF STAPLE CARTRIDGES WITH THE SAME SURGICAL STAPLING INSTRUMENT, now U.S. Patent Application Publication No. 2018/0168615;
    • U.S. patent application Ser. No. 15/385,893, entitled BILATERALLY ASYMMETRIC STAPLE-FORMING POCKET PAIRS, now U.S. Patent Application Publication No. 2018/0168594;
    • U.S. patent application Ser. No. 15/385,929, entitled CLOSURE MEMBERS WITH CAM SURFACE ARRANGEMENTS FOR SURGICAL INSTRUMENTS WITH SEPARATE AND DISTINCT CLOSURE AND FIRING SYSTEMS, now U.S. Patent Application Publication No. 2018/0168626;
    • U.S. patent application Ser. No. 15/385,911, entitled SURGICAL STAPLERS WITH INDEPENDENTLY ACTUATABLE CLOSING AND FIRING SYSTEMS, now U.S. Patent Application Publication No. 2018/0168612;
    • U.S. patent application Ser. No. 15/385,927, entitled SURGICAL STAPLING INSTRUMENTS WITH SMART STAPLE CARTRIDGES, now U.S. Patent Application Publication No. 2018/0168625;
    • U.S. patent application Ser. No. 15/385,917, entitled STAPLE CARTRIDGE COMPRISING STAPLES WITH DIFFERENT CLAMPING BREADTHS, now U.S. Patent Application Publication No. 2018/0168617;
    • U.S. patent application Ser. No. 15/385,900, entitled STAPLE-FORMING POCKET ARRANGEMENTS COMPRISING PRIMARY SIDEWALLS AND POCKET SIDEWALLS, now U.S. Patent Application Publication No. 2018/0168601;
    • U.S. patent application Ser. No. 15/385,931, entitled NO-CARTRIDGE AND SPENT CARTRIDGE LOCKOUT ARRANGEMENTS FOR SURGICAL STAPLERS, now U.S. Patent Application Publication No. 2018/0168627;
    • U.S. patent application Ser. No. 15/385,915, entitled FIRING MEMBER PIN ANGLE, now U.S. Patent Application Publication No. 2018/0168616;
    • U.S. patent application Ser. No. 15/385,897, entitled STAPLE-FORMING POCKET ARRANGEMENTS COMPRISING ZONED FORMING SURFACE GROOVES, now U.S. Patent Application Publication No. 2018/0168598;
    • U.S. patent application Ser. No. 15/385,922, entitled SURGICAL INSTRUMENT WITH MULTIPLE FAILURE RESPONSE MODES, now U.S. Patent Application Publication No. 2018/0168622;
    • U.S. patent application Ser. No. 15/385,924, entitled SURGICAL INSTRUMENT WITH PRIMARY AND SAFETY PROCESSORS, now U.S. Patent Application Publication No. 2018/0168624;
    • U.S. patent application Ser. No. 15/385,910, entitled ANVIL HAVING A KNIFE SLOT WIDTH, now U.S. Patent Application Publication No. 2018/0168611;
    • U.S. patent application Ser. No. 15/385,903, entitled CLOSURE MEMBER ARRANGEMENTS FOR SURGICAL INSTRUMENTS, now U.S. Patent Application Publication No. 2018/0168604;
    • U.S. patent application Ser. No. 15/385,906, entitled FIRING MEMBER PIN CONFIGURATIONS, now U.S. Patent Application Publication No. 2018/0168607;
    • U.S. patent application Ser. No. 15/386,188, entitled STEPPED STAPLE CARTRIDGE WITH ASYMMETRICAL STAPLES, now U.S. Patent Application Publication No. 2018/0168585;
    • U.S. patent application Ser. No. 15/386,192, entitled STEPPED STAPLE CARTRIDGE WITH TISSUE RETENTION AND GAP SETTING FEATURES, now U.S. Patent Application Publication No. 2018/0168643;
    • U.S. patent application Ser. No. 15/386,206, entitled STAPLE CARTRIDGE WITH DEFORMABLE DRIVER RETENTION FEATURES, now U.S. Patent Application Publication No. 2018/0168586;
    • U.S. patent application Ser. No. 15/386,226, entitled DURABILITY FEATURES FOR END EFFECTORS AND FIRING ASSEMBLIES OF SURGICAL STAPLING INSTRUMENTS, now U.S. Patent Application Publication No. 2018/0168648;
    • U.S. patent application Ser. No. 15/386,222, entitled SURGICAL STAPLING INSTRUMENTS HAVING END EFFECTORS WITH POSITIVE OPENING FEATURES, now U.S. Patent Application Publication No. 2018/0168647;
    • U.S. patent application Ser. No. 15/386,236, entitled CONNECTION PORTIONS FOR DEPOSABLE LOADING UNITS FOR SURGICAL STAPLING INSTRUMENTS, now U.S. Patent Application Publication No. 2018/0168650;
    • U.S. patent application Ser. No. 15/385,887, entitled METHOD FOR ATTACHING A SHAFT ASSEMBLY TO A SURGICAL INSTRUMENT AND, ALTERNATIVELY, TO A SURGICAL ROBOT, now U.S. Patent Application Publication No. 2018/0168589;
    • U.S. patent application Ser. No. 15/385,889, entitled SHAFT ASSEMBLY COMPRISING A MANUALLY-OPERABLE RETRACTION SYSTEM FOR USE WITH A MOTORIZED SURGICAL INSTRUMENT SYSTEM, now U.S. Patent Application Publication No. 2018/0168590;
    • U.S. patent application Ser. No. 15/385,890, entitled SHAFT ASSEMBLY COMPRISING SEPARATELY ACTUATABLE AND RETRACTABLE SYSTEMS, now U.S. Patent Application Publication No. 2018/0168591;
    • U.S. patent application Ser. No. 15/385,891, entitled SHAFT ASSEMBLY COMPRISING A CLUTCH CONFIGURED TO ADAPT THE OUTPUT OF A ROTARY FIRING MEMBER TO TWO DIFFERENT SYSTEMS, now U.S. Patent Application Publication No. 2018/0168592;
    • U.S. patent application Ser. No. 15/385,892, entitled SURGICAL SYSTEM COMPRISING A FIRING MEMBER ROTATABLE INTO AN ARTICULATION STATE TO ARTICULATE AN END EFFECTOR OF THE SURGICAL SYSTEM, now U.S. Patent Application Publication No. 2018/0168593;
    • U.S. patent application Ser. No. 15/385,894, entitled SHAFT ASSEMBLY COMPRISING A LOCKOUT, now U.S. Patent Application Publication No. 2018/0168595;
    • U.S. patent application Ser. No. 15/385,895, entitled SHAFT ASSEMBLY COMPRISING FIRST AND SECOND ARTICULATION LOCKOUTS, now U.S. Patent Application Publication No. 2018/0168596;
    • U.S. patent application Ser. No. 15/385,916, entitled SURGICAL STAPLING SYSTEMS, now U.S. Patent Application Publication No. 2018/0168575;
    • U.S. patent application Ser. No. 15/385,918, entitled SURGICAL STAPLING SYSTEMS, now U.S. Patent Application Publication No. 2018/0168618;
    • U.S. patent application Ser. No. 15/385,919, entitled SURGICAL STAPLING SYSTEMS, now U.S. Patent Application Publication No. 2018/0168619;
    • U.S. patent application Ser. No. 15/385,921, entitled SURGICAL STAPLE CARTRIDGE WITH MOVABLE CAMMING MEMBER CONFIGURED TO DISENGAGE FIRING MEMBER LOCKOUT FEATURES, now U.S. Patent Application Publication No. 2018/0168621;
    • U.S. patent application Ser. No. 15/385,923, entitled SURGICAL STAPLING SYSTEMS, now U.S. Patent Application Publication No. 2018/0168623;
    • U.S. patent application Ser. No. 15/385,925, entitled JAW ACTUATED LOCK ARRANGEMENTS FOR PREVENTING ADVANCEMENT OF A FIRING MEMBER IN A SURGICAL END EFFECTOR UNLESS AN UNFIRED CARTRIDGE IS INSTALLED IN THE END EFFECTOR, now U.S. Patent Application Publication No. 2018/0168576;
    • U.S. patent application Ser. No. 15/385,926, entitled AXIALLY MOVABLE CLOSURE SYSTEM ARRANGEMENTS FOR APPLYING CLOSURE MOTIONS TO JAWS OF SURGICAL INSTRUMENTS, now U.S. Patent Application Publication No. 2018/0168577;
    • U.S. patent application Ser. No. 15/385,928, entitled PROTECTIVE COVER ARRANGEMENTS FOR A JOINT INTERFACE BETWEEN A MOVABLE JAW AND ACTUATOR SHAFT OF A SURGICAL INSTRUMENT, now U.S. Patent Application Publication No. 2018/0168578;
    • U.S. patent application Ser. No. 15/385,930, entitled SURGICAL END EFFECTOR WITH TWO SEPARATE COOPERATING OPENING FEATURES FOR OPENING AND CLOSING END EFFECTOR JAWS, now U.S. Patent Application Publication No. 2018/0168579;
    • U.S. patent application Ser. No. 15/385,932, entitled ARTICULATABLE SURGICAL END EFFECTOR WITH ASYMMETRIC SHAFT ARRANGEMENT, now U.S. Patent Application Publication No. 2018/0168628;
    • U.S. patent application Ser. No. 15/385,933, entitled ARTICULATABLE SURGICAL INSTRUMENT WITH INDEPENDENT PIVOTABLE LINKAGE DISTAL OF AN ARTICULATION LOCK, now U.S. Patent Application Publication No. 2018/0168580;
    • U.S. patent application Ser. No. 15/385,934, entitled ARTICULATION LOCK ARRANGEMENTS FOR LOCKING AN END EFFECTOR IN AN ARTICULATED POSITION IN RESPONSE TO ACTUATION OF A JAW CLOSURE SYSTEM, now U.S. Patent Application Publication No. 2018/0168581;
    • U.S. patent application Ser. No. 15/385,935, entitled LATERALLY ACTUATABLE ARTICULATION LOCK ARRANGEMENTS FOR LOCKING AN END EFFECTOR OF A SURGICAL INSTRUMENT IN AN ARTICULATED CONFIGURATION, now U.S. Patent Application Publication No. 2018/0168582;
    • U.S. patent application Ser. No. 15/385,936, entitled ARTICULATABLE SURGICAL INSTRUMENTS WITH ARTICULATION STROKE AMPLIFICATION FEATURES, now U.S. Patent Application Publication No. 2018/0168583;
    • U.S. patent application Ser. No. 14/318,996, entitled FASTENER CARTRIDGES INCLUDING EXTENSIONS HAVING DIFFERENT CONFIGURATIONS, now U.S. Patent Application Publication No. 2015/0297228;
    • U.S. patent application Ser. No. 14/319,006, entitled FASTENER CARTRIDGE COMPRISING FASTENER CAVITIES INCLUDING FASTENER CONTROL FEATURES, now U.S. Pat. No. 10,010,324;
    • U.S. patent application Ser. No. 14/318,991, entitled SURGICAL FASTENER CARTRIDGES WITH DRIVER STABILIZING ARRANGEMENTS, now U.S. Pat. No. 9,833,241;
    • U.S. patent application Ser. No. 14/319,004, entitled SURGICAL END EFFECTORS WITH FIRING ELEMENT MONITORING ARRANGEMENTS, now U.S. Pat. No. 9,844,369;
    • U.S. patent application Ser. No. 14/319,008, entitled FASTENER CARTRIDGE COMPRISING NON-UNIFORM FASTENERS, now U.S. Patent Application Publication No. 2015/0297232;
    • U.S. patent application Ser. No. 14/318,997, entitled FASTENER CARTRIDGE COMPRISING DEPLOYABLE TISSUE ENGAGING MEMBERS, now U.S. Patent Application Publication No. 2015/0297229;
    • U.S. patent application Ser. No. 14/319,002, entitled FASTENER CARTRIDGE COMPRISING TISSUE CONTROL FEATURES, now U.S. Pat. No. 9,877,721;
    • U.S. patent application Ser. No. 14/319,013, entitled FASTENER CARTRIDGE ASSEMBLIES AND STAPLE RETAINER COVER ARRANGEMENTS, now U.S. Patent Application Publication No. 2015/0297233; and
    • U.S. patent application Ser. No. 14/319,016, entitled FASTENER CARTRIDGE INCLUDING A LAYER ATTACHED THERETO, now U.S. Patent Application Publication No. 2015/0297235.


Applicant of the present application owns the following U.S. Patent Applications that were filed on Jun. 24, 2016 and which are each herein incorporated by reference in their respective entireties:

    • U.S. patent application Ser. No. 15/191,775, entitled STAPLE CARTRIDGE COMPRISING WIRE STAPLES AND STAMPED STAPLES, now U.S. Patent Application Publication No. 2017/0367695;
    • U.S. patent application Ser. No. 15/191,807, entitled STAPLING SYSTEM FOR USE WITH WIRE STAPLES AND STAMPED STAPLES, now U.S. Patent Application Publication No. 2017/0367696;
    • U.S. patent application Ser. No. 15/191,834, entitled STAMPED STAPLES AND STAPLE CARTRIDGES USING THE SAME, now U.S. Patent Application Publication No. 2017/0367699;
    • U.S. patent application Ser. No. 15/191,788, entitled STAPLE CARTRIDGE COMPRISING OVERDRIVEN STAPLES, now U.S. Patent Application Publication No. 2017/0367698; and
    • U.S. patent application Ser. No. 15/191,818, entitled STAPLE CARTRIDGE COMPRISING OFFSET LONGITUDINAL STAPLE ROWS, now U.S. Patent Application Publication No. 2017/0367697.


Applicant of the present application owns the following U.S. Patent Applications that were filed on Jun. 24, 2016 and which are each herein incorporated by reference in their respective entireties:

    • U.S. Design Patent Application Serial No. 29/569,218, entitled SURGICAL FASTENER, now U.S. Design Patent No. D826,405;
    • U.S. Design Patent Application Serial No. 29/569,227, entitled SURGICAL FASTENER, now U.S. Design Patent No. D822,206;
    • U.S. Design Patent Application Serial No. 29/569,259, entitled SURGICAL FASTENER CARTRIDGE; and
    • U.S. Design Patent Application Serial No. 29/569,264, entitled SURGICAL FASTENER CARTRIDGE.


Applicant of the present application owns the following patent applications that were filed on Apr. 1, 2016 and which are each herein incorporated by reference in their respective entirety:

    • U.S. patent application Ser. No. 15/089,325, entitled METHOD FOR OPERATING A SURGICAL STAPLING SYSTEM, now U.S. Patent Application Publication No. 2017/0281171;
    • U.S. patent application Ser. No. 15/089,321, entitled MODULAR SURGICAL STAPLING SYSTEM COMPRISING A DISPLAY, now U.S. Patent Application Publication No. 2017/0281163;
    • U.S. patent application Ser. No. 15/089,326, entitled SURGICAL STAPLING SYSTEM COMPRISING A DISPLAY INCLUDING A RE-ORIENTABLE DISPLAY FIELD, now U.S. Patent Application Publication No. 2017/0281172;
    • U.S. patent application Ser. No. 15/089,263, entitled SURGICAL INSTRUMENT HANDLE ASSEMBLY WITH RECONFIGURABLE GRIP PORTION, now U.S. Patent Application Publication No. 2017/0281165;
    • U.S. patent application Ser. No. 15/089,262, entitled ROTARY POWERED SURGICAL INSTRUMENT WITH MANUALLY ACTUATABLE BAILOUT SYSTEM, now U.S. Patent Application Publication No. 2017/0281161;
    • U.S. patent application Ser. No. 15/089,277, entitled SURGICAL CUTTING AND STAPLING END EFFECTOR WITH ANVIL CONCENTRIC DRIVE MEMBER, now U.S. Patent Application Publication No. 2017/0281166;
    • U.S. patent application Ser. No. 15/089,296, entitled INTERCHANGEABLE SURGICAL TOOL ASSEMBLY WITH A SURGICAL END EFFECTOR THAT IS SELECTIVELY ROTATABLE ABOUT A SHAFT AXIS, now U.S. Patent Application Publication No. 2017/0281168;
    • U.S. patent application Ser. No. 15/089,258, entitled SURGICAL STAPLING SYSTEM COMPRISING A SHIFTABLE TRANSMISSION, now U.S. Patent Application Publication No. 2017/0281178;
    • U.S. patent application Ser. No. 15/089,278, entitled SURGICAL STAPLING SYSTEM CONFIGURED TO PROVIDE SELECTIVE CUTTING OF TISSUE, now U.S. Patent Application Publication No. 2017/0281162;
    • U.S. patent application Ser. No. 15/089,284, entitled SURGICAL STAPLING SYSTEM COMPRISING A CONTOURABLE SHAFT, now U.S. Patent Application Publication No. 2017/0281186;
    • U.S. patent application Ser. No. 15/089,295, entitled SURGICAL STAPLING SYSTEM COMPRISING A TISSUE COMPRESSION LOCKOUT, now U.S. Patent Application Publication No. 2017/0281187;
    • U.S. patent application Ser. No. 15/089,300, entitled SURGICAL STAPLING SYSTEM COMPRISING AN UNCLAMPING LOCKOUT, now U.S. Patent Application Publication No. 2017/0281179;
    • U.S. patent application Ser. No. 15/089,196, entitled SURGICAL STAPLING SYSTEM COMPRISING A JAW CLOSURE LOCKOUT, now U.S. Patent Application Publication No. 2017/0281183;
    • U.S. patent application Ser. No. 15/089,203, entitled SURGICAL STAPLING SYSTEM COMPRISING A JAW ATTACHMENT LOCKOUT, now U.S. Patent Application Publication No. 2017/0281184;
    • U.S. patent application Ser. No. 15/089,210, entitled SURGICAL STAPLING SYSTEM COMPRISING A SPENT CARTRIDGE LOCKOUT, now U.S. Patent Application Publication No. 2017/0281185;
    • U.S. patent application Ser. No. 15/089,324, entitled SURGICAL INSTRUMENT COMPRISING A SHIFTING MECHANISM, now U.S. Patent Application Publication No. 2017/0281170;
    • U.S. patent application Ser. No. 15/089,335, entitled SURGICAL STAPLING INSTRUMENT COMPRISING MULTIPLE LOCKOUTS, now U.S. Patent Application Publication No. 2017/0281155;
    • U.S. patent application Ser. No. 15/089,339, entitled SURGICAL STAPLING INSTRUMENT, now U.S. Patent Application Publication No. 2017/0281173;
    • U.S. patent application Ser. No. 15/089,253, entitled SURGICAL STAPLING SYSTEM CONFIGURED TO APPLY ANNULAR ROWS OF STAPLES HAVING DIFFERENT HEIGHTS, now U.S. Patent Application Publication No. 2017/0281177;
    • U.S. patent application Ser. No. 15/089,304, entitled SURGICAL STAPLING SYSTEM COMPRISING A GROOVED FORMING POCKET, now U.S. Patent Application Publication No. 2017/0281188;
    • U.S. patent application Ser. No. 15/089,331, entitled ANVIL MODIFICATION MEMBERS FOR SURGICAL STAPLERS, now U.S. Patent Application Publication No. 2017/0281180;
    • U.S. patent application Ser. No. 15/089,336, entitled STAPLE CARTRIDGES WITH ATRAUMATIC FEATURES, now U.S. Patent Application Publication No. 2017/0281164;
    • U.S. patent application Ser. No. 15/089,312, entitled CIRCULAR STAPLING SYSTEM COMPRISING AN INCISABLE TISSUE SUPPORT, now U.S. Patent Application Publication No. 2017/0281189;
    • U.S. patent application Ser. No. 15/089,309, entitled CIRCULAR STAPLING SYSTEM COMPRISING ROTARY FIRING SYSTEM, now U.S. Patent Application Publication No. 2017/0281169; and
    • U.S. patent application Ser. No. 15/089,349, entitled CIRCULAR STAPLING SYSTEM COMPRISING LOAD CONTROL, now U.S. Patent Application Publication No. 2017/0281174.


Applicant of the present application also owns the U.S. Patent Applications identified below which were filed on Dec. 31, 2015 which are each herein incorporated by reference in their respective entirety:

    • U.S. patent application Ser. No. 14/984,488, entitled MECHANISMS FOR COMPENSATING FOR BATTERY PACK FAILURE IN POWERED SURGICAL INSTRUMENTS, now U.S. Patent Application Publication No. 2017/0189018;
    • U.S. patent application Ser. No. 14/984,525, entitled MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWERED SURGICAL INSTRUMENTS, now U.S. Patent Application Publication No. 2017/0189019; and
    • U.S. patent application Ser. No. 14/984,552, entitled SURGICAL INSTRUMENTS WITH SEPARABLE MOTORS AND MOTOR CONTROL CIRCUITS, now U.S. Patent Application Publication No. 2017/0189020.


Applicant of the present application also owns the U.S. Patent Applications identified below which were filed on Feb. 9, 2016 which are each herein incorporated by reference in their respective entirety:

    • U.S. patent application Ser. No. 15/019,220, entitled SURGICAL INSTRUMENT WITH ARTICULATING AND AXIALLY TRANSLATABLE END EFFECTOR, now U.S. Patent Application Publication No. 2017/0224333;
    • U.S. patent application Ser. No. 15/019,228, entitled SURGICAL INSTRUMENTS WITH MULTIPLE LINK ARTICULATION ARRANGEMENTS, now U.S. Patent Application Publication No. 2017/0224342;
    • U.S. patent application Ser. No. 15/019,196, entitled SURGICAL INSTRUMENT ARTICULATION MECHANISM WITH SLOTTED SECONDARY CONSTRAINT, now U.S. Patent Application Publication No. 2017/0224330;
    • U.S. patent application Ser. No. 15/019,206, entitled SURGICAL INSTRUMENTS WITH AN END EFFECTOR THAT IS HIGHLY ARTICULATABLE RELATIVE TO AN ELONGATE SHAFT ASSEMBLY, now U.S. Patent Application Publication No. 2017/0224331;
    • U.S. patent application Ser. No. 15/019,215, entitled SURGICAL INSTRUMENTS WITH NON-SYMMETRICAL ARTICULATION ARRANGEMENTS, now U.S. Patent Application Publication No. 2017/0224332;
    • U.S. patent application Ser. No. 15/019,227, entitled ARTICULATABLE SURGICAL INSTRUMENTS WITH SINGLE ARTICULATION LINK ARRANGEMENTS, now U.S. Patent Application Publication No. 2017/0224334;
    • U.S. patent application Ser. No. 15/019,235, entitled SURGICAL INSTRUMENTS WITH TENSIONING ARRANGEMENTS FOR CABLE DRIVEN ARTICULATION SYSTEMS, now U.S. Patent Application Publication No. 2017/0224336;
    • U.S. patent application Ser. No. 15/019,230, entitled ARTICULATABLE SURGICAL INSTRUMENTS WITH OFF-AXIS FIRING BEAM ARRANGEMENTS, now U.S. Patent Application Publication No. 2017/0224335; and
    • U.S. patent application Ser. No. 15/019,245, entitled SURGICAL INSTRUMENTS WITH CLOSURE STROKE REDUCTION ARRANGEMENTS, now U.S. Patent Application Publication No. 2017/0224343.


Applicant of the present application also owns the U.S. Patent Applications identified below which were filed on Feb. 12, 2016 which are each herein incorporated by reference in their respective entirety:

    • U.S. patent application Ser. No. 15/043,254, entitled MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWERED SURGICAL INSTRUMENTS, now U.S. Patent Application Publication No. 2017/0231623;
    • U.S. patent application Ser. No. 15/043,259, entitled MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWERED SURGICAL INSTRUMENTS, now U.S. Patent Application Publication No. 2017/0231626;
    • U.S. patent application Ser. No. 15/043,275, entitled MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWERED SURGICAL INSTRUMENTS, now U.S. Patent Application Publication No. 2017/0231627; and
    • U.S. patent application Ser. No. 15/043,289, entitled MECHANISMS FOR COMPENSATING FOR DRIVETRAIN FAILURE IN POWERED SURGICAL INSTRUMENTS, now U.S. Patent Application Publication No. 2017/0231628.


Applicant of the present application owns the following patent applications that were filed on Jun. 18, 2015 and which are each herein incorporated by reference in their respective entirety:

    • U.S. patent application Ser. No. 14/742,925, entitled SURGICAL END EFFECTORS WITH POSITIVE JAW OPENING ARRANGEMENTS, now U.S. Patent Application Publication No. 2016/0367256;
    • U.S. patent application Ser. No. 14/742,941, entitled SURGICAL END EFFECTORS WITH DUAL CAM ACTUATED JAW CLOSING FEATURES, now U.S. Pat. No. 10,052,102;
    • U.S. patent application Ser. No. 14/742,914, entitled MOVABLE FIRING BEAM SUPPORT ARRANGEMENTS FOR ARTICULATABLE SURGICAL INSTRUMENTS, now U.S. Patent Application Publication No. 2016/0367255;
    • U.S. patent application Ser. No. 14/742,900, entitled ARTICULATABLE SURGICAL INSTRUMENTS WITH COMPOSITE FIRING BEAM STRUCTURES WITH CENTER FIRING SUPPORT MEMBER FOR ARTICULATION SUPPORT, now U.S. Patent Application Publication No. 2016/0367254;
    • U.S. patent application Ser. No. 14/742,885, entitled DUAL ARTICULATION DRIVE SYSTEM ARRANGEMENTS FOR ARTICULATABLE SURGICAL INSTRUMENTS, now U.S. Patent Application Publication No. 2016/0367246; and
    • U.S. patent application Ser. No. 14/742,876, entitled PUSH/PULL ARTICULATION DRIVE SYSTEMS FOR ARTICULATABLE SURGICAL INSTRUMENTS, now U.S. Pat. No. 10,178,992.


Applicant of the present application owns the following patent applications that were filed on Mar. 6, 2015 and which are each herein incorporated by reference in their respective entirety:

    • U.S. patent application Ser. No. 14/640,746, entitled POWERED SURGICAL INSTRUMENT, now U.S. Pat. No. 9,808,246;
    • U.S. patent application Ser. No. 14/640,795, entitled MULTIPLE LEVEL THRESHOLDS TO MODIFY OPERATION OF POWERED SURGICAL INSTRUMENTS, now U.S. Patent Application Publication No. 2016/02561185;
    • U.S. patent application Ser. No. 14/640,832, entitled ADAPTIVE TISSUE COMPRESSION TECHNIQUES TO ADJUST CLOSURE RATES FOR MULTIPLE TISSUE TYPES, now U.S. Patent Application Publication No. 2016/0256154;
    • U.S. patent application Ser. No. 14/640,935, entitled OVERLAID MULTI SENSOR RADIO FREQUENCY (RF) ELECTRODE SYSTEM TO MEASURE TISSUE COMPRESSION, now U.S. Patent Application Publication No. 2016/0256071;
    • U.S. patent application Ser. No. 14/640,831, entitled MONITORING SPEED CONTROL AND PRECISION INCREMENTING OF MOTOR FOR POWERED SURGICAL INSTRUMENTS, now U.S. Pat. No. 9,895,148;
    • U.S. patent application Ser. No. 14/640,859, entitled TIME DEPENDENT EVALUATION OF SENSOR DATA TO DETERMINE STABILITY, CREEP, AND VISCOELASTIC ELEMENTS OF MEASURES, now U.S. Pat. No. 10,052,044;
    • U.S. patent application Ser. No. 14/640,817, entitled INTERACTIVE FEEDBACK SYSTEM FOR POWERED SURGICAL INSTRUMENTS, now U.S. Pat. No. 9,924,961;
    • U.S. patent application Ser. No. 14/640,844, entitled CONTROL TECHNIQUES AND SUB-PROCESSOR CONTAINED WITHIN MODULAR SHAFT WITH SELECT CONTROL PROCESSING FROM HANDLE, now U.S. Pat. No. 10,045,776;
    • U.S. patent application Ser. No. 14/640,837, entitled SMART SENSORS WITH LOCAL SIGNAL PROCESSING, now U.S. Pat. No. 9,993,248;
    • U.S. patent application Ser. No. 14/640,765, entitled SYSTEM FOR DETECTING THE MIS-INSERTION OF A STAPLE CARTRIDGE INTO A SURGICAL STAPLER, now U.S. Patent Application Publication No. 2016/0256160;
    • U.S. patent application Ser. No. 14/640,799, entitled SIGNAL AND POWER COMMUNICATION SYSTEM POSITIONED ON A ROTATABLE SHAFT, now U.S. Pat. No. 9,901,342; and
    • U.S. patent application Ser. No. 14/640,780, entitled SURGICAL INSTRUMENT COMPRISING A LOCKABLE BATTERY HOUSING, now U.S. Patent Application Publication No. 2016/0256161.


Applicant of the present application owns the following patent applications that were filed on Feb. 27, 2015, and which are each herein incorporated by reference in their respective entirety:

    • U.S. patent application Ser. No. 14/633,576, entitled SURGICAL INSTRUMENT SYSTEM COMPRISING AN INSPECTION STATION, now U.S. Pat. No. 10,045,779;
    • U.S. patent application Ser. No. 14/633,546, entitled SURGICAL APPARATUS CONFIGURED TO ASSESS WHETHER A PERFORMANCE PARAMETER OF THE SURGICAL APPARATUS IS WITHIN AN ACCEPTABLE PERFORMANCE BAND, now U.S. Pat. No. 10,180,463;
    • U.S. patent application Ser. No. 14/633,560, entitled SURGICAL CHARGING SYSTEM THAT CHARGES AND/OR CONDITIONS ONE OR MORE BATTERIES, now U.S. Patent Application Publication No. 2016/0249910;
    • U.S. patent application Ser. No. 14/633,566, entitled CHARGING SYSTEM THAT ENABLES EMERGENCY RESOLUTIONS FOR CHARGING A BATTERY, now U.S. Patent Application Publication No. 2016/0249918;
    • U.S. patent application Ser. No. 14/633,555, entitled SYSTEM FOR MONITORING WHETHER A SURGICAL INSTRUMENT NEEDS TO BE SERVICED, now U.S. Patent Application Publication No. 2016/0249916;
    • U.S. patent application Ser. No. 14/633,542, entitled REINFORCED BATTERY FOR A SURGICAL INSTRUMENT, now U.S. Pat. No. 9,931,118;
    • U.S. patent application Ser. No. 14/633,548, entitled POWER ADAPTER FOR A SURGICAL INSTRUMENT, now U.S. Patent Application Publication No. 2016/0249909;
    • U.S. patent application Ser. No. 14/633,526, entitled ADAPTABLE SURGICAL INSTRUMENT HANDLE, now U.S. Patent Application Publication No. 2016/0249945;
    • U.S. patent application Ser. No. 14/633,541, entitled MODULAR STAPLING ASSEMBLY, now U.S. Pat. No. 9,993,258; and
    • U.S. patent application Ser. No. 14/633,562, entitled SURGICAL APPARATUS CONFIGURED TO TRACK AN END-OF-LIFE PARAMETER, now U.S. Pat. No. 10,159,483.


Applicant of the present application owns the following patent applications that were filed on Dec. 18, 2014 and which are each herein incorporated by reference in their respective entirety:

    • U.S. patent application Ser. No. 14/574,478, entitled SURGICAL INSTRUMENT SYSTEMS COMPRISING AN ARTICULATABLE END EFFECTOR AND MEANS FOR ADJUSTING THE FIRING STROKE OF A FIRING MEMBER, now U.S. Pat. No. 9,844,374;
    • U.S. patent application Ser. No. 14/574,483, entitled SURGICAL INSTRUMENT ASSEMBLY COMPRISING LOCKABLE SYSTEMS, now U.S. Patent Application Publication No. 2016/0174969;
    • U.S. patent application Ser. No. 14/575,139, entitled DRIVE ARRANGEMENTS FOR ARTICULATABLE SURGICAL INSTRUMENTS, now U.S. Pat. No. 9,844,375;
    • U.S. patent application Ser. No. 14/575,148, entitled LOCKING ARRANGEMENTS FOR DETACHABLE SHAFT ASSEMBLIES WITH ARTICULATABLE SURGICAL END EFFECTORS, now U.S. Pat. No. 10,085,748;
    • U.S. patent application Ser. No. 14/575,130, entitled SURGICAL INSTRUMENT WITH AN ANVIL THAT IS SELECTIVELY MOVABLE ABOUT A DISCRETE NON-MOVABLE AXIS RELATIVE TO A STAPLE CARTRIDGE, now U.S. Patent Application Publication No. 2016/0174972;
    • U.S. patent application Ser. No. 14/575,143, entitled SURGICAL INSTRUMENTS WITH IMPROVED CLOSURE ARRANGEMENTS, now U.S. Pat. No. 10,004,501;
    • U.S. patent application Ser. No. 14/575,117, entitled SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTORS AND MOVABLE FIRING BEAM SUPPORT ARRANGEMENTS, now U.S. Pat. No. 9,943,309;
    • U.S. patent application Ser. No. 14/575,154, entitled SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTORS AND IMPROVED FIRING BEAM SUPPORT ARRANGEMENTS, now U.S. Pat. No. 9,968,355;
    • U.S. patent application Ser. No. 14/574,493, entitled SURGICAL INSTRUMENT ASSEMBLY COMPRISING A FLEXIBLE ARTICULATION SYSTEM, now U.S. Pat. No. 9,987,000; and
    • U.S. patent application Ser. No. 14/574,500, entitled SURGICAL INSTRUMENT ASSEMBLY COMPRISING A LOCKABLE ARTICULATION SYSTEM, now U.S. Pat. No. 10,117,649.


Applicant of the present application owns the following patent applications that were filed on Mar. 1, 2013 and which are each herein incorporated by reference in their respective entirety:

    • U.S. patent application Ser. No. 13/782,295, entitled ARTICULATABLE SURGICAL INSTRUMENTS WITH CONDUCTIVE PATHWAYS FOR SIGNAL COMMUNICATION, now U.S. Patent Application Publication No. 2014/0246471;
    • U.S. patent application Ser. No. 13/782,323, entitled ROTARY POWERED ARTICULATION JOINTS FOR SURGICAL INSTRUMENTS, now U.S. Patent Application Publication No. 2014/0246472;
    • U.S. patent application Ser. No. 13/782,338, entitled THUMBWHEEL SWITCH ARRANGEMENTS FOR SURGICAL INSTRUMENTS, now U.S. Patent Application Publication No. 2014/0249557;
    • U.S. patent application Ser. No. 13/782,499, entitled ELECTROMECHANICAL SURGICAL DEVICE WITH SIGNAL RELAY ARRANGEMENT, now U.S. Pat. No. 9,358,003;
    • U.S. patent application Ser. No. 13/782,460, entitled MULTIPLE PROCESSOR MOTOR CONTROL FOR MODULAR SURGICAL INSTRUMENTS, now U.S. Patent Application Publication No. 2014/0246478;
    • U.S. patent application Ser. No. 13/782,358, entitled JOYSTICK SWITCH ASSEMBLIES FOR SURGICAL INSTRUMENTS, now U.S. Pat. No. 9,326,767;
    • U.S. patent application Ser. No. 13/782,481, entitled SENSOR STRAIGHTENED END EFFECTOR DURING REMOVAL THROUGH TROCAR, now U.S. Pat. No. 9,468,438;
    • U.S. patent application Ser. No. 13/782,518, entitled CONTROL METHODS FOR SURGICAL INSTRUMENTS WITH REMOVABLE IMPLEMENT PORTIONS, now U.S. Patent Application Publication No. 2014/0246475;
    • U.S. patent application Ser. No. 13/782,375, entitled ROTARY POWERED SURGICAL INSTRUMENTS WITH MULTIPLE DEGREES OF FREEDOM, now U.S. Pat. No. 9,398,911; and
    • U.S. patent application Ser. No. 13/782,536, entitled SURGICAL INSTRUMENT SOFT STOP, now U.S. Pat. No. 9,307,986.


Applicant of the present application also owns the following patent applications that were filed on Mar. 14, 2013 and which are each herein incorporated by reference in their respective entirety:

    • U.S. patent application Ser. No. 13/803,097, entitled ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE, now U.S. Pat. No. 9,687,230;
    • U.S. patent application Ser. No. 13/803,193, entitled CONTROL ARRANGEMENTS FOR A DRIVE MEMBER OF A SURGICAL INSTRUMENT, now U.S. Pat. No. 9,332,987;
    • U.S. patent application Ser. No. 13/803,053, entitled INTERCHANGEABLE SHAFT ASSEMBLIES FOR USE WITH A SURGICAL INSTRUMENT, now U.S. Pat. No. 9,883,860;
    • U.S. patent application Ser. No. 13/803,086, entitled ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK, now U.S. Patent Application Publication No. 2014/0263541;
    • U.S. patent application Ser. No. 13/803,210, entitled SENSOR ARRANGEMENTS FOR ABSOLUTE POSITIONING SYSTEM FOR SURGICAL INSTRUMENTS, now U.S. Pat. No. 9,808,244;
    • U.S. patent application Ser. No. 13/803,148, entitled MULTI-FUNCTION MOTOR FOR A SURGICAL INSTRUMENT, now U.S. Patent Application Publication No. 2014/0263554;
    • U.S. patent application Ser. No. 13/803,066, entitled DRIVE SYSTEM LOCKOUT ARRANGEMENTS FOR MODULAR SURGICAL INSTRUMENTS, now U.S. Pat. No. 9,629,623;
    • U.S. patent application Ser. No. 13/803,117, entitled ARTICULATION CONTROL SYSTEM FOR ARTICULATABLE SURGICAL INSTRUMENTS, now U.S. Pat. No. 9,351,726;
    • U.S. patent application Ser. No. 13/803,130, entitled DRIVE TRAIN CONTROL ARRANGEMENTS FOR MODULAR SURGICAL INSTRUMENTS, now U.S. Pat. No. 9,351,727; and
    • U.S. patent application Ser. No. 13/803,159, entitled METHOD AND SYSTEM FOR OPERATING A SURGICAL INSTRUMENT, now U.S. Pat. No. 9,888,919.


Applicant of the present application also owns the following patent application that was filed on Mar. 7, 2014 and is herein incorporated by reference in its entirety:

    • U.S. patent application Ser. No. 14/200,111, entitled CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS, now U.S. Pat. No. 9,629,629.


Applicant of the present application also owns the following patent applications that were filed on Mar. 26, 2014 and are each herein incorporated by reference in their respective entirety:

    • U.S. patent application Ser. No. 14/226,106, entitled POWER MANAGEMENT CONTROL SYSTEMS FOR SURGICAL INSTRUMENTS, now U.S. Patent Application Publication No. 2015/0272582;
    • U.S. patent application Ser. No. 14/226,099, entitled STERILIZATION VERIFICATION CIRCUIT, now U.S. Pat. No. 9,826,977;
    • U.S. patent application Ser. No. 14/226,094, entitled VERIFICATION OF NUMBER OF BATTERY EXCHANGES/PROCEDURE COUNT, now U.S. Patent Application Publication No. 2015/0272580;
    • U.S. patent application Ser. No. 14/226,117, entitled POWER MANAGEMENT THROUGH SLEEP OPTIONS OF SEGMENTED CIRCUIT AND WAKE UP CONTROL, now U.S. Pat. No. 10,013,049;
    • U.S. patent application Ser. No. 14/226,075, entitled MODULAR POWERED SURGICAL INSTRUMENT WITH DETACHABLE SHAFT ASSEMBLIES, now U.S. Pat. No. 9,743,929;
    • U.S. patent application Ser. No. 14/226,093, entitled FEEDBACK ALGORITHMS FOR MANUAL BAILOUT SYSTEMS FOR SURGICAL INSTRUMENTS, now U.S. Pat. No. 10,028,761;
    • U.S. patent application Ser. No. 14/226,116, entitled SURGICAL INSTRUMENT UTILIZING SENSOR ADAPTATION, now U.S. Patent Application Publication No. 2015/0272571;
    • U.S. patent application Ser. No. 14/226,071, entitled SURGICAL INSTRUMENT CONTROL CIRCUIT HAVING A SAFETY PROCESSOR, now U.S. Pat. No. 9,690,362;
    • U.S. patent application Ser. No. 14/226,097, entitled SURGICAL INSTRUMENT COMPRISING INTERACTIVE SYSTEMS, now U.S. Pat. No. 9,820,738;
    • U.S. patent application Ser. No. 14/226,126, entitled INTERFACE SYSTEMS FOR USE WITH SURGICAL INSTRUMENTS, now U.S. Pat. No. 10,004,497;
    • U.S. patent application Ser. No. 14/226,133, entitled MODULAR SURGICAL INSTRUMENT SYSTEM, now U.S. Patent Application Publication No. 2015/0272557;
    • U.S. patent application Ser. No. 14/226,081, entitled SYSTEMS AND METHODS FOR CONTROLLING A SEGMENTED CIRCUIT, now U.S. Pat. No. 9,804,618;
    • U.S. patent application Ser. No. 14/226,076, entitled POWER MANAGEMENT THROUGH SEGMENTED CIRCUIT AND VARIABLE VOLTAGE PROTECTION, now U.S. Pat. No. 9,733,663;
    • U.S. patent application Ser. No. 14/226,111, entitled SURGICAL STAPLING INSTRUMENT SYSTEM, now U.S. Pat. No. 9,750,499; and
    • U.S. patent application Ser. No. 14/226,125, entitled SURGICAL INSTRUMENT COMPRISING A ROTATABLE SHAFT, now U.S. Patent Application Publication No. 2015/0280384.


Applicant of the present application also owns the following patent applications that were filed on Sep. 5, 2014 and which are each herein incorporated by reference in their respective entirety:

    • U.S. patent application Ser. No. 14/479,103, entitled CIRCUITRY AND SENSORS FOR POWERED MEDICAL DEVICE, now U.S. Pat. No. 10,111,679;
    • U.S. patent application Ser. No. 14/479,119, entitled ADJUNCT WITH INTEGRATED SENSORS TO QUANTIFY TISSUE COMPRESSION, now U.S. Pat. No. 9,724,094;
    • U.S. patent application Ser. No. 14/478,908, entitled MONITORING DEVICE DEGRADATION BASED ON COMPONENT EVALUATION, now U.S. Pat. No. 9,737,301;
    • U.S. patent application Ser. No. 14/478,895, entitled MULTIPLE SENSORS WITH ONE SENSOR AFFECTING A SECOND SENSOR'S OUTPUT OR INTERPRETATION, now U.S. Pat. No. 9,757,128;
    • U.S. patent application Ser. No. 14/479,110, entitled POLARITY OF HALL MAGNET TO IDENTIFY CARTRIDGE TYPE, now U.S. Pat. No. 10,016,199;
    • U.S. patent application Ser. No. 14/479,098, entitled SMART CARTRIDGE WAKE UP OPERATION AND DATA RETENTION, now U.S. Pat. No. 10,135,242;
    • U.S. patent application Ser. No. 14/479,115, entitled MULTIPLE MOTOR CONTROL FOR POWERED MEDICAL DEVICE, now U.S. Pat. No. 9,788,836; and
    • U.S. patent application Ser. No. 14/479,108, entitled LOCAL DISPLAY OF TISSUE PARAMETER STABILIZATION, now U.S. Patent Application Publication No. 2016/0066913.


Applicant of the present application also owns the following patent applications that were filed on Apr. 9, 2014 and which are each herein incorporated by reference in their respective entirety:

    • U.S. patent application Ser. No. 14/248,590, entitled MOTOR DRIVEN SURGICAL INSTRUMENTS WITH LOCKABLE DUAL DRIVE SHAFTS, now U.S. Pat. No. 9,826,976;
    • U.S. patent application Ser. No. 14/248,581, entitled SURGICAL INSTRUMENT COMPRISING A CLOSING DRIVE AND A FIRING DRIVE OPERATED FROM THE SAME ROTATABLE OUTPUT, now U.S. Pat. No. 9,649,110;
    • U.S. patent application Ser. No. 14/248,595, entitled SURGICAL SYSTEM COMPRISING FIRST AND SECOND DRIVE SYSTEMS, now U.S. Pat. No. 9,844,368;
    • U.S. patent application Ser. No. 14/248,588, entitled POWERED LINEAR SURGICAL STAPLER, now U.S. Patent Application Publication No. 2014/0309666;
    • U.S. patent application Ser. No. 14/248,591, entitled SURGICAL INSTRUMENT COMPRISING A GAP SETTING SYSTEM, now U.S. Pat. No. 10,149,680;
    • U.S. patent application Ser. No. 14/248,584, entitled MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH ALIGNMENT FEATURES FOR ALIGNING ROTARY DRIVE SHAFTS WITH SURGICAL END EFFECTOR SHAFTS, now U.S. Pat. No. 9,801,626;
    • U.S. patent application Ser. No. 14/248,587, entitled POWERED SURGICAL STAPLER, now U.S. Pat. No. 9,867,612;
    • U.S. patent application Ser. No. 14/248,586, entitled DRIVE SYSTEM DECOUPLING ARRANGEMENT FOR A SURGICAL INSTRUMENT, now U.S. Pat. No. 10,136,887; and
    • U.S. patent application Ser. No. 14/248,607, entitled MODULAR MOTOR DRIVEN SURGICAL INSTRUMENTS WITH STATUS INDICATION ARRANGEMENTS, now U.S. Pat. No. 9,814,460.


Applicant of the present application also owns the following patent applications that were filed on Apr. 16, 2013 and which are each herein incorporated by reference in their respective entirety:

    • U.S. Provisional Patent Application Ser. No. 61/812,365, entitled SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY A SINGLE MOTOR;
    • U.S. Provisional Patent Application Ser. No. 61/812,376, entitled LINEAR CUTTER WITH POWER;
    • U.S. Provisional Patent Application Ser. No. 61/812,382, entitled LINEAR CUTTER WITH MOTOR AND PISTOL GRIP;
    • U.S. Provisional Patent Application Ser. No. 61/812,385, entitled SURGICAL INSTRUMENT HANDLE WITH MULTIPLE ACTUATION MOTORS AND MOTOR CONTROL; and
    • U.S. Provisional Patent Application Ser. No. 61/812,372, entitled SURGICAL INSTRUMENT WITH MULTIPLE FUNCTIONS PERFORMED BY A SINGLE MOTOR.


Numerous specific details are set forth to provide a thorough understanding of the overall structure, function, manufacture, and use of the embodiments as described in the specification and illustrated in the accompanying drawings. Well-known operations, components, and elements have not been described in detail so as not to obscure the embodiments described in the specification. The reader will understand that the embodiments described and illustrated herein are non-limiting examples, and thus it can be appreciated that the specific structural and functional details disclosed herein may be representative and illustrative. Variations and changes thereto may be made without departing from the scope of the claims.


The terms “comprise” (and any form of comprise, such as “comprises” and “comprising”), “have” (and any form of have, such as “has” and “having”), “include” (and any form of include, such as “includes” and “including”) and “contain” (and any form of contain, such as “contains” and “containing”) are open-ended linking verbs. As a result, a surgical system, device, or apparatus that “comprises,” “has,” “includes” or “contains” one or more elements possesses those one or more elements, but is not limited to possessing only those one or more elements. Likewise, an element of a system, device, or apparatus that “comprises,” “has,” “includes” or “contains” one or more features possesses those one or more features, but is not limited to possessing only those one or more features.


The terms “proximal” and “distal” are used herein with reference to a clinician manipulating the handle portion of the surgical instrument. The term “proximal” refers to the portion closest to the clinician and the term “distal” refers to the portion located away from the clinician. It will be further appreciated that, for convenience and clarity, spatial terms such as “vertical”, “horizontal”, “up”, and “down” may be 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/or absolute.


Various exemplary devices and methods are provided for performing laparoscopic and minimally invasive surgical procedures. However, the reader will readily appreciate that the various methods and devices disclosed herein can be used in numerous surgical procedures and applications including, for example, in connection with open surgical procedures. As the present Detailed Description proceeds, the reader will further appreciate that the various instruments disclosed herein can be inserted into a body in any way, such as through a natural orifice, through an incision or puncture hole formed in tissue, etc. The working portions or end effector portions of the instruments can be inserted directly into a patient's body or can be inserted through an access device that has a working channel through which the end effector and elongate shaft of a surgical instrument can be advanced.


A surgical stapling system can comprise a shaft and an end effector extending from the shaft. The end effector comprises a first jaw and a second jaw. The first jaw comprises a staple cartridge. The staple cartridge is insertable into and removable from the first jaw; however, other embodiments are envisioned in which a staple cartridge is not removable from, or at least readily replaceable from, the first jaw. The second jaw comprises an anvil configured to deform staples ejected from the staple cartridge. The second jaw is pivotable relative to the first jaw about a closure axis; however, other embodiments are envisioned in which the first jaw is pivotable relative to the second jaw. The surgical stapling system further comprises an articulation joint configured to permit the end effector to be rotated, or articulated, relative to the shaft. The end effector is rotatable about an articulation axis extending through the articulation joint. Other embodiments are envisioned which do not include an articulation joint.


The staple cartridge comprises a cartridge body. The cartridge body includes a proximal end, a distal end, and a deck extending between the proximal end and the distal end. In use, the staple cartridge is positioned on a first side of the tissue to be stapled and the anvil is positioned on a second side of the tissue. The anvil is moved toward the staple cartridge to compress and clamp the tissue against the deck. Thereafter, staples removably stored in the cartridge body can be deployed into the tissue. The cartridge body includes staple cavities defined therein wherein staples are removably stored in the staple cavities. The staple cavities are arranged in six longitudinal rows. Three rows of staple cavities are positioned on a first side of a longitudinal slot and three rows of staple cavities are positioned on a second side of the longitudinal slot. Other arrangements of staple cavities and staples may be possible.


The staples are supported by staple drivers in the cartridge body. The drivers are movable between a first, or unfired position, and a second, or fired, position to eject the staples from the staple cavities. The drivers are retained in the cartridge body by a retainer which extends around the bottom of the cartridge body and includes resilient members configured to grip the cartridge body and hold the retainer to the cartridge body. The drivers are movable between their unfired positions and their fired positions by a sled. The sled is movable between a proximal position adjacent the proximal end and a distal position adjacent the distal end. The sled comprises a plurality of ramped surfaces configured to slide under the drivers and lift the drivers, and the staples supported thereon, toward the anvil.


Further to the above, the sled is moved distally by a firing member. The firing member is configured to contact the sled and push the sled toward the distal end. The longitudinal slot defined in the cartridge body is configured to receive the firing member. The anvil also includes a slot configured to receive the firing member. The firing member further comprises a first cam which engages the first jaw and a second cam which engages the second jaw. As the firing member is advanced distally, the first cam and the second cam can control the distance, or tissue gap, between the deck of the staple cartridge and the anvil. The firing member also comprises a knife configured to incise the tissue captured intermediate the staple cartridge and the anvil. It is desirable for the knife to be positioned at least partially proximal to the ramped surfaces such that the staples are ejected ahead of the knife.



FIG. 1 illustrates the surgical instrument 1010 that includes an interchangeable shaft assembly 1200 operably coupled to a housing 1012. FIG. 2 illustrates the interchangeable shaft assembly 1200 detached from the housing 1012 or handle 1014. As can be seen in FIG. 3, the handle 1014 may comprise a pair of interconnectable handle housing segments 1016 and 1018 that may be interconnected by screws, snap features, adhesive, etc. In the illustrated arrangement, the handle housing segments 1016, 1018 cooperate to form a pistol grip portion 1019. FIGS. 1 and 3 depict a motor-driven surgical cutting and fastening instrument 1010 that may or may not be reused. In the illustrated embodiment, the instrument 1010 includes a previous housing 1012 that comprises a handle 1014 that is configured to be grasped, manipulated and actuated by the clinician. The housing 1012 is configured for operable attachment to an interchangeable shaft assembly 1200 that has a surgical end effector 1300 operably coupled thereto that is configured to perform one or more surgical tasks or procedures. As the present Detailed Description proceeds, it will be understood that the various forms of interchangeable shaft assemblies disclosed herein may also be effectively employed in connection with robotically-controlled surgical systems. Thus, the term “housing” may also encompass a housing or similar portion of a robotic system that houses or otherwise operably supports at least one drive system that is configured to generate and apply at least one control motion which could be used to actuate the interchangeable shaft assemblies disclosed herein and their respective equivalents. In addition, various components may be “housed” or contained in the housing or various components may be “associated with” a housing. In such instances, the components may not be contained within the housing or supported directly by the housing. The term “frame” may refer to a portion of a handheld surgical instrument. The term “frame” may also represent a portion of a robotically controlled surgical instrument and/or a portion of the robotic system that may be used to operably control a surgical instrument. For example, the interchangeable shaft assemblies disclosed herein may be employed with various robotic systems, instruments, components and methods disclosed in U.S. Pat. No. 9,072,535, entitled SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS, that is incorporated by reference herein in its entirety.


The previous housing 1012 depicted in FIG. 1 is shown in connection with an interchangeable shaft assembly 1200 (FIGS. 2, 4 and 5) that includes an end effector 1300 that comprises a surgical cutting and fastening device that is configured to operably support a surgical staple cartridge 4000 therein. The housing 1012 may be configured for use in connection with interchangeable shaft assemblies that include end effectors that are adapted to support different sizes and types of staple cartridges, have different shaft lengths, sizes, and types, etc. In addition, the housing 1012 may also be effectively employed with a variety of other interchangeable shaft assemblies including those assemblies that are configured to apply other motions and forms of energy such as, for example, radio frequency (RF) energy, ultrasonic energy and/or motion to end effector arrangements adapted for use in connection with various surgical applications and procedures. Furthermore, the end effectors, shaft assemblies, handles, surgical instruments, and/or surgical instrument systems can utilize any suitable fastener that can be gripped and manipulated by the clinician. As will be discussed in further detail below, the handle 1014 operably supports a plurality of drive systems therein that are configured to generate and apply various control motions to corresponding portions of the interchangeable shaft assembly that is operably attached thereto.


Referring now to FIG. 3, the handle 1014 may further include a frame 1020 that operably supports a plurality of drive systems. For example, the frame 1020 can operably support a “first” or closure drive system, generally designated as 1030, which may be employed to apply closing and opening motions to the interchangeable shaft assembly 1200 that is operably attached or coupled thereto. In at least one form, the closure drive system 1030 may include an actuator in the form of a closure trigger 1032 that is pivotally supported by the frame 1020. More specifically, as illustrated in FIG. 3, the closure trigger 1032 is pivotally coupled to the handle 1014 by a pin 1033. Such arrangement enables the closure trigger 1032 to be manipulated by a clinician such that when the clinician grips the pistol grip portion 1019 of the handle 1014, the closure trigger 1032 may be easily pivoted from a starting or “unactuated” position to an “actuated” position and more particularly to a fully compressed or fully actuated position. The closure trigger 1032 may be biased into the unactuated position by spring or other biasing arrangement (not shown). In various forms, the closure drive system 1030 further includes a closure linkage assembly 1034 that is pivotally coupled to the closure trigger 1032. As can be seen in FIG. 3, the closure linkage assembly 1034 may include a first closure link 1036 and a second closure link 1038 that are pivotally coupled to the closure trigger 1032 by a pin 1035. The second closure link 1038 may also be referred to herein as an “attachment member” and include a transverse attachment pin 1037.


Still referring to FIG. 3, it can be observed that the first closure link 1036 may have a locking wall or end 1039 thereon that is configured to cooperate with a closure release assembly 1060 that is pivotally coupled to the frame 1020. In at least one form, the closure release assembly 1060 may comprise a release button assembly 1062 that has a distally protruding locking pawl 1064 formed thereon. The release button assembly 1062 may be pivoted in a counterclockwise direction by a release spring (not shown). As the clinician depresses the closure trigger 1032 from its unactuated position towards the pistol grip portion 1019 of the handle 1014, the first closure link 1036 pivots upward to a point wherein the locking pawl 1064 drops into retaining engagement with the locking wall 1039 on the first closure link 1036 thereby preventing the closure trigger 1032 from returning to the unactuated position. Thus, the closure release assembly 1060 serves to lock the closure trigger 1032 in the fully actuated position. When the clinician desires to unlock the closure trigger 1032 to permit it to be biased to the unactuated position, the clinician simply pivots the closure release button assembly 1062 such that the locking pawl 1064 is moved out of engagement with the locking wall 1039 on the first closure link 1036. When the locking pawl 1064 has been moved out of engagement with the first closure link 1036, the closure trigger 1032 may pivot back to the unactuated position. Other closure trigger locking and release arrangements may also be employed.


An arm 1061 may extend from the closure release button 1062. A magnetic element 1063, such as a permanent magnet, for example, may be mounted to the arm 1061. When the closure release button 1062 is rotated from its first position to its second position, the magnetic element 1063 can move toward a circuit board 1100. The circuit board 1100 can include at least one sensor that is configured to detect the movement of the magnetic element 1063. In at least one embodiment, for example, a “Hall Effect” sensor (not shown) can be mounted to the bottom surface of the circuit board 1100. The Hall Effect sensor can be configured to detect changes in a magnetic field surrounding the Hall Effect sensor caused by the movement of the magnetic element 1063. The Hall Effect sensor can be in signal communication with a microcontroller, for example, which can determine whether the closure release button 1062 is in its first position, which is associated with the unactuated position of the closure trigger 1032 and the open configuration of the end effector, its second position, which is associated with the actuated position of the closure trigger 1032 and the closed configuration of the end effector, and/or any position between the first position and the second position.


In at least one form, the handle 1014 and the frame 1020 may operably support another drive system referred to herein as a firing drive system 1080 that is configured to apply firing motions to corresponding portions of the interchangeable shaft assembly attached thereto. The firing drive system 1080 may also be referred to herein as a “second drive system”. The firing drive system 1080 may employ an electric motor 1082 that is located in the pistol grip portion 1019 of the handle 1014. In various forms, the motor 1082 may be a DC brushed driving motor having a maximum rotation of, approximately, 25,000 RPM, for example. In other arrangements, the motor may include a brushless motor, a cordless motor, a synchronous motor, a stepper motor, or any other suitable electric motor. The motor 1082 may be powered by a power source 1090 that in one form may comprise a removable power pack 1092. As can be seen in FIG. 3, for example, the power pack 1092 may comprise a proximal housing portion 1094 that is configured for attachment to a distal housing portion 1096. The proximal housing portion 1094 and the distal housing portion 1096 are configured to operably support a plurality of batteries 1098 therein. Batteries 1098 may each comprise, for example, a Lithium Ion (“LI”) or other suitable battery. The distal housing portion 1096 is configured for removable operable attachment to the circuit board 1100 which is also operably coupled to the motor 1082. A number of batteries 1098 may be connected in series may be used as the power source for the surgical instrument 1010. In addition, the power source 1090 may be replaceable and/or rechargeable.


As outlined above with respect to other various forms, the electric motor 1082 can include a rotatable shaft (not shown) that operably interfaces with a gear reducer assembly 1084 that is mounted in meshing engagement with a with a set, or rack, of drive teeth 1122 on a longitudinally-movable drive member 1120. In use, a voltage polarity provided by the power source 1090 can operate the electric motor 1082 in a clockwise direction wherein the voltage polarity applied to the electric motor by the battery can be reversed in order to operate the electric motor 1082 in a counter-clockwise direction. When the electric motor 1082 is rotated in one direction, the drive member 1120 will be axially driven in the distal direction “DD”. When the motor 82 is driven in the opposite rotary direction, the drive member 1120 will be axially driven in a proximal direction “PD”. The handle 1014 can include a switch which can be configured to reverse the polarity applied to the electric motor 1082 by the power source 1090. As with the other forms described herein, the handle 1014 can also include a sensor that is configured to detect the position of the drive member 1120 and/or the direction in which the drive member 1120 is being moved.


Actuation of the motor 1082 can be controlled by a firing trigger 1130 that is pivotally supported on the handle 1014. The firing trigger 1130 may be pivoted between an unactuated position and an actuated position. The firing trigger 1130 may be biased into the unactuated position by a spring 1132 or other biasing arrangement such that when the clinician releases the firing trigger 1130, it may be pivoted or otherwise returned to the unactuated position by the spring 1132 or biasing arrangement. In at least one form, the firing trigger 1130 can be positioned “outboard” of the closure trigger 1032 as was discussed above. In at least one form, a firing trigger safety button 1134 may be pivotally mounted to the closure trigger 1032 by the pin 1035. The safety button 1134 may be positioned between the firing trigger 1130 and the closure trigger 1032 and have a pivot arm 1136 protruding therefrom. When the closure trigger 1032 is in the unactuated position, the safety button 1134 is contained in the handle 1014 where the clinician cannot readily access it and move it between a safety position preventing actuation of the firing trigger 1130 and a firing position wherein the firing trigger 1130 may be fired. As the clinician depresses the closure trigger 1032, the safety button 1134 and the firing trigger 1130 pivot down wherein they can then be manipulated by the clinician.


As indicated above, in at least one form, the longitudinally movable drive member 1120 has a rack of teeth 1122 formed thereon for meshing engagement with a corresponding drive gear 1086 of the gear reducer assembly 1084. At least one form also includes a manually-actuatable “bailout” assembly 1140 that is configured to enable the clinician to manually retract the longitudinally movable drive member 1120 should the motor 1082 become disabled. The bailout assembly 1140 may include a lever or bailout handle assembly 1142 that is configured to be manually pivoted into ratcheting engagement with teeth 1124 also provided in the drive member 1120. Thus, the clinician can manually retract the drive member 1120 by using the bailout handle assembly 1142 to ratchet the drive member 1120 in the proximal direction “PD”. U.S. Pat. No. 8,608,045, entitled POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY RETRACTABLE FIRING SYSTEM, discloses bailout arrangements and other components, arrangements and systems that may also be employed with the various instruments disclosed herein. U.S. Pat. No. 8,608,045, is hereby incorporated by reference herein in its entirety.


Turning now to FIGS. 2 and 5, the interchangeable shaft assembly 1200 includes a surgical end effector 1300 that comprises an elongate channel 1310 that is configured to operably support a staple cartridge 4000 therein. The end effector 1300 may further include an anvil 2000 that is pivotally supported relative to the elongate channel 1310. The interchangeable shaft assembly 1200 may further include an articulation joint 3020 and an articulation lock 2140 which can be configured to releasably hold the end effector 1300 in a desired position relative to a shaft axis SA. Examples of various features of at least one form of the end effector 1300, the articulation joint 3020 and articulation locks may be found in U.S. patent application Ser. No. 13/803,086, filed Mar. 14, 2013, entitled ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK, now U.S. Patent Application Publication No. 2014/0263541. The entire disclosure of U.S. patent application Ser. No. 13/803,086, filed Mar. 14, 2013, entitled ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK, now U.S. Patent Application Publication No. 2014/0263541, is hereby incorporated by reference herein. As can be seen in FIG. 4, the interchangeable shaft assembly 1200 can further include a proximal housing or nozzle 1201 comprised of nozzle portions 1202 and 1203.


The interchangeable shaft assembly 1200 can further include a closure system or closure member assembly 3000 which can be utilized to close and/or open the anvil 2000 of the end effector 1300. The shaft assembly 1200 can include a spine 1210 that is configured to, one, slidably support a firing member therein and, two, slidably support the closure member assembly 3000 which extends around the spine 1210. As can be seen in FIG. 5, a distal end 1212 of spine 1210 terminates in an upper lug mount feature 1270 and in a lower lug mount feature 1280. The upper lug mount feature 1270 is formed with a lug slot 1272 therein that is adapted to mountingly support an upper mounting link 1274 therein. Similarly, the lower lug mount feature 1280 is formed with a lug slot 1282 therein that is adapted to mountingly support a lower mounting link 1284 therein. The upper mounting link 1274 includes a pivot socket 1276 therein that is adapted to rotatably receive therein a pivot pin 1292 that is formed on a channel cap or anvil retainer 1290 that is attached to a proximal end portion 1312 of the elongate channel 1310. The lower mounting link 1284 includes lower pivot pin 1286 that adapted to be received within a pivot hole 1314 formed in the proximal end portion 1312 of the elongate channel 1310. See FIG. 5. The lower pivot pin 1286 is vertically aligned with the pivot socket 1276 to define an articulation axis AA about which the surgical end effector 1300 may articulate relative to the shaft axis SA. See FIG. 2.


In the illustrated example, the surgical end effector 1300 is selectively articulatable about the articulation axis AA by an articulation system 2100. In one form, the articulation system 2100 includes proximal articulation driver 2102 that is pivotally coupled to an articulation link 2120. As can be most particularly seen in FIG. 5, an offset attachment lug 2114 is formed on a distal end 2110 of the proximal articulation driver 2102. A pivot hole 2116 is formed in the offset attachment lug 2114 and is configured to pivotally receive therein a proximal link pin 2124 formed on the proximal end 2122 of the articulation link 2120. A distal end 2126 of the articulation link 2120 includes a pivot hole 2128 that is configured to pivotally receive therein a channel pin 1317 formed on the proximal end portion 1312 of the elongate channel 1310. Thus, axial movement of proximal articulation driver 2102 will thereby apply articulation motions to the elongate channel 1310 to thereby cause the surgical end effector 1300 to articulate about the articulation axis AA relative to the spine 1210. Further details concerning the construction and operation of the articulation system 2100 may be found in various references incorporated by reference herein including U.S. patent application Ser. No. 15/635,631, filed Jun. 28, 2017, entitled SURGICAL INSTRUMENT WITH AXIALLY MOVABLE CLOSURE MEMBER, now U.S. Patent Application Publication No. 2019/0000464, the entire disclosure of which is hereby incorporated by reference herein. In various circumstances, the proximal articulation driver 2102 can be held in position by an articulation lock 2140 when the proximal articulation driver 2102 is not being moved in the proximal or distal directions. Additional details regarding an example of an articulation lock 2140 may be found in U.S. patent application Ser. No. 15/635,631, now U.S. Patent Application Publication No. 2019/0000464, as well as in other references incorporated by reference herein.


In various circumstances, the spine 1210 can comprise a proximal end 1211 which is rotatably supported in a chassis 1240. In one arrangement, for example, the proximal end 1211 of the spine 1210 has a thread 1214 formed thereon for threaded attachment to a spine bearing 1216 configured to be supported within the chassis 1240. See FIG. 4. Such an arrangement facilitates rotatable attachment of the spine 1210 to the chassis 1240 such that the spine 1210 may be selectively rotated about a shaft axis SA relative to the chassis 1240.


Referring primarily to FIG. 4, the interchangeable shaft assembly 1200 includes a closure shuttle 1250 that is slidably supported within the chassis 1240 such that it may be axially moved relative thereto. The closure shuttle 1250 includes a pair of proximally-protruding hooks 1252 that are configured for attachment to the attachment pin 1037 (FIG. 3) that is attached to the second closure link 1038 as will be discussed in further detail below. In at least one example, the closure member assembly 3000 comprises a proximal closure member segment 3010 that has a proximal end 3012 that is coupled to the closure shuttle 1250 for relative rotation thereto. For example, a U shaped connector 1263 is inserted into an annular slot 3014 in the proximal end 3012 of the proximal closure member segment 3010 and is retained within vertical slots 1253 in the closure shuttle 1250. Such an arrangement serves to attach the proximal closure member segment 3010 to the closure shuttle 1250 for axial travel therewith while enabling the proximal closure member segment 3010 to rotate relative to the closure shuttle 1250 about the shaft axis SA. A closure spring 1268 is journaled on the proximal closure member segment 3010 and serves to bias the proximal closure member segment 3010 in the proximal direction “PD” which can serve to pivot the closure trigger 1032 into the unactuated position when the shaft assembly is operably coupled to the handle 1014.


In at least one form, the interchangeable shaft assembly 1200 may further include an articulation joint 3020. Other interchangeable shaft assemblies, however, may not be capable of articulation. As can be seen in FIG. 5, for example, a distal closure member or distal closure tube segment 3030 is coupled to the distal end of the proximal closure member segment 3010. The articulation joint 3020 includes a double pivot closure sleeve assembly 3022. According to various forms, the double pivot closure sleeve assembly 3022 includes an end effector closure tube 3050 having upper and lower distally projecting tangs 3052, 3054. An upper double pivot link 3056 includes upwardly projecting distal and proximal pivot pins that engage respectively an upper distal pin hole in the upper proximally projecting tang 3052 and an upper proximal pin hole in an upper distally projecting tang 3032 on the distal closure tube segment 3030. A lower double pivot link 3058 includes upwardly projecting distal and proximal pivot pins that engage respectively a lower distal pin hole in the lower proximally projecting tang 3054 and a lower proximal pin hole in the lower distally projecting tang 3034. See FIGS. 4 and 5. As will be discussed in further detail below, the closure member assembly 3000 is translated distally (direction “DD”) to close the anvil 2000, for example, in response to the actuation of the closure trigger 1032. The anvil 2000 is opened by proximally translating the closure member assembly 3000 which causes the end effector closure sleeve to interact with the anvil 2000 and pivot it to an open position.


As was also indicated above, the interchangeable shaft assembly 1200 further includes a firing member 1900 that is supported for axial travel within the spine 1210. The firing member 1900 includes an intermediate firing shaft portion 1222 that is configured for attachment to a distal cutting portion or knife bar 1910. The intermediate firing shaft portion 1222 may include a longitudinal slot 1223 in the distal end thereof which can be configured to receive a tab 1912 on the proximal end of the distal knife bar 1910. The longitudinal slot 1223 and the proximal end tab 1912 can be sized and configured to permit relative movement therebetween and can comprise a slip joint 1914. The slip joint 1914 can permit the intermediate firing shaft portion 1222 of the firing member 1900 to be moved to articulate the end effector 1300 without moving, or at least substantially moving, the knife bar 1910. Once the end effector 1300 has been suitably oriented, the intermediate firing shaft portion 1222 can be advanced distally until a proximal sidewall of the longitudinal slot 1223 comes into contact with the tab 1912 in order to advance the knife bar 1910 and fire the staple cartridge 4000 positioned within the channel 1310. The knife bar 1910 includes a knife portion 1920 that includes a blade or tissue cutting edge 1922 and includes an upper anvil engagement tab 1924 and lower channel engagement tabs 1926. Various firing member configurations and operations are disclosed in various other references incorporated herein by reference.


As can be seen in FIG. 4, the shaft assembly 1200 further includes a switch drum 1500 that is rotatably received on proximal closure member segment 3010. The switch drum 1500 comprises a hollow shaft segment 1502 that has a shaft boss formed thereon for receive an outwardly protruding actuation pin therein. In various circumstances, the actuation pin extends through a longitudinal slot provided in the lock sleeve to facilitate axial movement of the lock sleeve when it is engaged with the articulation driver. A rotary torsion spring 1420 is configured to engage the boss on the switch drum 1500 and a portion of the nozzle housing 1203 to apply a biasing force to the switch drum 1500. The switch drum 1500 can further comprise at least partially circumferential openings 1506 defined therein which can be configured to receive circumferential mounts extending from the nozzle portions 1202, 1203 and permit relative rotation, but not translation, between the switch drum 1500 and the nozzle 1201. The mounts also extend through openings 3011 in the proximal closure member segment 3010 to be seated in recesses 1219 in the spine 1210. Rotation of the switch drum 1500 about the shaft axis SA will ultimately result in the rotation of the actuation pin and the lock sleeve between its engaged and disengaged positions. In one arrangement, the rotation of the switch drum 1500 may be linked to the axial advancement of the closure tube or closure member. Thus, in essence, actuation of the closure system may operably engage and disengage the articulation drive system with the firing drive system in the various manners described in further detail in U.S. patent application Ser. No. 13/803,086, entitled ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK, now U.S. Patent Application Publication No. 2014/0263541, and U.S. Pat. No. 9,913,642, entitled SURGICAL INSTRUMENT COMPRISING A SENSOR SYSTEM, the entire disclosures of each being hereby incorporated by reference herein. For example, when the closure tube is in its proximal-most position corresponding to a “jaws open” position, the closure member segment 3010 will have positioned the switch drum 1500 so as to link the articulation system with the firing drive system. When, the closure tube has been moved to its distal position corresponding to a “jaws closed” position, the closure tube has rotated the switch drum 1500 to a position wherein the articulation system is delinked from the firing drive system.


As also illustrated in FIG. 4, the shaft assembly 1200 can comprise a slip ring assembly 1600 which can be configured to conduct electrical power to and/or from the end effector 1300 and/or communicate signals to and/or from the end effector 1300, for example. The slip ring assembly 1600 can comprise a proximal connector flange 1604 that is mounted to a chassis flange 1242 that extends from the chassis 1240 and a distal connector flange that is positioned within a slot defined in the shaft housings. The proximal connector flange 1604 can comprise a first face and the distal connector flange can comprise a second face which is positioned adjacent to and movable relative to the first face. The distal connector flange can rotate relative to the proximal connector flange 1604 about the shaft axis SA. The proximal connector flange 1604 can comprise a plurality of concentric, or at least substantially concentric, conductors defined in the first face thereof. A connector can be mounted on the proximal side of the connector flange and may have a plurality of contacts wherein each contact corresponds to and is in electrical contact with one of the conductors. Such an arrangement permits relative rotation between the proximal connector flange 1604 and the distal connector flange while maintaining electrical contact therebetween. The proximal connector flange 1604 can include an electrical connector 1606 which can place the conductors in signal communication with a shaft circuit board 1610 mounted to the shaft chassis 1240, for example. In at least one instance, a wiring harness comprising a plurality of conductors can extend between the electrical connector 1606 and the shaft circuit board 1610. The electrical connector 1606 may extend proximally through a connector opening 1243 defined in the chassis flange 1242. See FIG. 4. Further details regarding slip ring assembly 1600 may be found in U.S. patent application Ser. No. 13/803,086, entitled ARTICULATABLE SURGICAL INSTRUMENT COMPRISING AN ARTICULATION LOCK, now U.S. Patent Application Publication No. 2014/0263541, U.S. patent application Ser. No. 13/800,067, entitled STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, filed on Mar. 13, 2013, now U.S. Patent Application Publication No. 2014/0263552, and U.S. Pat. No. 9,345,481, entitled STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, for example. U.S. patent application Ser. No. 13/803,086, now U.S. Patent Application Publication No. 2014/0263541, U.S. patent application Ser. No. 13/800,067, now U.S. Patent Application Publication No. 2014/0263552, and U.S. Pat. No. 9,345,481 are each hereby incorporated by reference herein in their respective entireties.


As discussed above, the shaft assembly 1200 can include a proximal portion which is fixably mounted to the handle 1014 and a distal portion which is rotatable about a longitudinal axis. The rotatable distal shaft portion can be rotated relative to the proximal portion about the slip ring assembly 1600, as discussed above. The distal connector flange of the slip ring assembly 1600 can be positioned within the rotatable distal shaft portion. Moreover, further to the above, the switch drum 1500 can also be positioned within the rotatable distal shaft portion. When the rotatable distal shaft portion is rotated, the distal connector flange and the switch drum 1500 can be rotated synchronously with one another. In addition, the switch drum 1500 can be rotated between a first position and a second position relative to the distal connector flange. When the switch drum 1500 is in its first position, the articulation drive system may be operably disengaged from the firing drive system and, thus, the operation of the firing drive system may not articulate the end effector 1300 of the shaft assembly 1200. When the switch drum 1500 is in its second position, the articulation drive system may be operably engaged with the firing drive system and, thus, the operation of the firing drive system may articulate the end effector 1300 of the shaft assembly 1200. When the switch drum 1500 is moved between its first position and its second position, the switch drum 1500 is moved relative to distal connector flange. In various instances, the shaft assembly 1200 can comprise at least one sensor configured to detect the position of the switch drum 1500.


Referring again to FIG. 4, the chassis 1240 includes at least one, and preferably two, tapered attachment portions 1244 formed thereon that are adapted to be received within corresponding dovetail slots 1702 formed within a distal attachment flange portion 1700 of the frame 1020. See FIG. 3. Each dovetail slot 1702 may be tapered or, stated another way, be somewhat V-shaped to seatingly receive the attachment portions 1244 therein. As can be further seen in FIG. 4, a shaft attachment lug 1226 is formed on the proximal end of the intermediate firing shaft portion 1222. As will be discussed in further detail below, when the interchangeable shaft assembly 1200 is coupled to the handle 1014, the shaft attachment lug 1226 is received in a firing shaft attachment cradle 1126 formed in a distal end 1125 of the longitudinal drive member 1120. See FIG. 3.


Various shaft assembly embodiments employ a latch system 1710 for removably coupling the shaft assembly 1200 to the housing 1012 and more specifically to the frame 1020. As can be seen in FIG. 4, for example, in at least one form, the latch system 1710 includes a lock member or lock yoke 1712 that is movably coupled to the chassis 1240. In the illustrated embodiment, for example, the lock yoke 1712 has a U-shape with two spaced downwardly extending legs 1714. The legs 1714 each have a pivot lug 1715 formed thereon that are adapted to be received in corresponding holes 1245 formed in the chassis 1240. Such arrangement facilitates pivotal attachment of the lock yoke 1712 to the chassis 1240. The lock yoke 1712 may include two proximally protruding lock lugs 1716 that are configured for releasable engagement with corresponding lock detents or grooves 1704 in the distal attachment flange portion 1700 of the frame 1020. See FIG. 3. In various forms, the lock yoke 1712 is biased in the proximal direction by spring or biasing member (not shown). Actuation of the lock yoke 1712 may be accomplished by a latch button 1722 that is slidably mounted on a latch actuator assembly 1720 that is mounted to the chassis 1240. The latch button 1722 may be biased in a proximal direction relative to the lock yoke 1712. As will be discussed in further detail below, the lock yoke 1712 may be moved to an unlocked position by biasing the latch button in the distal direction which also causes the lock yoke 1712 to pivot out of retaining engagement with the distal attachment flange portion 1700 of the frame 1020. When the lock yoke 1712 is in “retaining engagement” with the distal attachment flange portion 1700 of the frame 1020, the lock lugs 1716 are retainingly seated within the corresponding lock detents or grooves 1704 in the distal attachment flange portion 1700.


When employing an interchangeable shaft assembly that includes an end effector of the type described herein that is adapted to cut and fasten tissue, as well as other types of end effectors, it may be desirable to prevent inadvertent detachment of the interchangeable shaft assembly from the housing during actuation of the end effector. For example, in use the clinician may actuate the closure trigger 1032 to grasp and manipulate the target tissue into a desired position. Once the target tissue is positioned within the end effector 1300 in a desired orientation, the clinician may then fully actuate the closure trigger 1032 to close the anvil 2000 and clamp the target tissue in position for cutting and stapling. In that instance, the first drive system 1030 has been fully actuated. After the target tissue has been clamped in the end effector 1300, it may be desirable to prevent the inadvertent detachment of the shaft assembly 1200 from the housing 1012. One form of the latch system 1710 is configured to prevent such inadvertent detachment.


As can be most particularly seen in FIG. 4, the lock yoke 1712 includes at least one and preferably two lock hooks 1718 that are adapted to contact corresponding lock lug portions 1256 that are formed on the closure shuttle 1250. When the closure shuttle 1250 is in an unactuated position (i.e., the first drive system 1030 is unactuated and the anvil 2000 is open), the lock yoke 1712 may be pivoted in a distal direction to unlock the interchangeable shaft assembly 1200 from the housing 1012. When in that position, the lock hooks 1718 do not contact the lock lug portions 1256 on the closure shuttle 1250. However, when the closure shuttle 1250 is moved to an actuated position (i.e., the first drive system 1030 is actuated and the anvil 2000 is in the closed position), the lock yoke 1712 is prevented from being pivoted to an unlocked position. Stated another way, if the clinician were to attempt to pivot the lock yoke 1712 to an unlocked position or, for example, the lock yoke 1712 was inadvertently bumped or contacted in a manner that might otherwise cause it to pivot distally, the lock hooks 1718 on the lock yoke 1712 will contact the lock lug portions 1256 on the closure shuttle 1250 and prevent movement of the lock yoke 1712 to an unlocked position.


Attachment of the interchangeable shaft assembly 1200 to the handle 1014 will now be described. To commence the coupling process, the clinician may position the chassis 1240 of the interchangeable shaft assembly 1200 above or adjacent to the distal attachment flange 1700 of the frame 1020 such that the tapered attachment portions 1244 formed on the chassis 1240 are aligned with the dovetail slots 1702 in the frame 1020. The clinician may then move the shaft assembly 1200 along an installation axis that is perpendicular to the shaft axis SA to seat the attachment portions 1244 in “operable engagement” with the corresponding dovetail receiving slots 1702. In doing so, the shaft attachment lug 1226 on the intermediate firing shaft portion 1222 will also be seated in the cradle 1126 in the longitudinally movable drive member 1120 and the portions of the pin 1037 on the second closure link 1038 will be seated in the corresponding hooks 1252 in the closure shuttle 1250. As used herein, the term “operable engagement” in the context of two components means that the two components are sufficiently engaged with each other so that upon application of an actuation motion thereto, the components may carry out their intended action, function and/or procedure.


At least five systems of the interchangeable shaft assembly 1200 can be operably coupled with at least five corresponding systems of the handle 1014. A first system can comprise a frame system which couples and/or aligns the frame or spine of the shaft assembly 1200 with the frame 1020 of the handle 1014. Another system can comprise a closure drive system 1030 which can operably connect the closure trigger 1032 of the handle 1014 and the closure tube 1260 and the anvil 2000 of the shaft assembly 1200. As outlined above, the closure shuttle 1250 of the shaft assembly 1200 can be engaged with the pin 1037 on the second closure link 1038. Another system can comprise the firing drive system 1080 which can operably connect the firing trigger 1130 of the handle 1014 with the intermediate firing shaft portion 1222 of the shaft assembly 1200. As outlined above, the shaft attachment lug 1226 can be operably connected with the cradle 1126 of the longitudinal drive member 1120. Another system can comprise an electrical system which can signal to a controller in the handle 1014, such as microcontroller, for example, that a shaft assembly, such as shaft assembly 1200, for example, has been operably engaged with the handle 1014 and/or, two, conduct power and/or communication signals between the shaft assembly 1200 and the handle 1014. For instance, the shaft assembly 1200 can include an electrical connector 1810 that is operably mounted to the shaft circuit board 1610. The electrical connector 1810 is configured for mating engagement with a corresponding electrical connector 1800 on the handle control board 1100. Further details regaining the circuitry and control systems may be found in U.S. patent application Ser. No. 13/803,086, now U.S. Patent Application Publication No. 2014/0263541, and U.S. patent application Ser. No. 14/226,142, now U.S. Pat. No. 9,913,642, the entire disclosures of each which were previously incorporated by reference herein. The fifth system may consist of the latching system for releasably locking the shaft assembly 1200 to the handle 1014.


The anvil 2000 in the illustrated example includes an anvil body 2002 that terminates in an anvil mounting portion 2010. The anvil mounting portion 2010 is movably or pivotably supported on the elongate channel 1310 for selective pivotal travel relative thereto about a fixed anvil pivot axis PA that is transverse to the shaft axis SA. In the illustrated arrangement, a pivot member or anvil trunnion 2012 extends laterally out of each lateral side of the anvil mounting portion 2010 to be received in a corresponding trunnion cradle 1316 formed in the upstanding walls 1315 of the proximal end portion 1312 of the elongate channel 1310. The anvil trunnions 2012 are pivotally retained in their corresponding trunnion cradle 1316 by the channel cap or anvil retainer 1290. The channel cap or anvil retainer 1290 includes a pair of attachment lugs that are configured to be retainingly received within corresponding lug grooves or notches formed in the upstanding walls 1315 of the proximal end portion 1312 of the elongate channel 1310. See FIG. 5.


Still referring to FIG. 5, in at least one arrangement, the distal closure member or end effector closure tube 3050 employs two axially offset, proximal and distal positive jaw opening features 3060 and 3062. The positive jaw opening features 3060, 3062 are configured to interact with corresponding relieved areas and stepped portions formed on the anvil mounting portion 2010 as described in further detail in U.S. patent application Ser. No. 15/635,631, entitled SURGICAL INSTRUMENT WITH AXIALLY MOVABLE CLOSURE MEMBER, now U.S. Patent Application Publication No. 2019/0000464, the entire disclosure which has been herein incorporated by reference. Other jaw opening arrangements may be employed.



FIGS. 6-8 depict a previous surgical cutting and fastening instrument 5010 that is configured to generate rotary drive motions for operating a surgical end effector 5012. The endoscopic surgical instrument 5010 comprises a handle 5006, a shaft 5008, and an articulating surgical end effector 5012 pivotally connected to the shaft 5008 at an articulation pivot 5014. An articulation control 5016 may be provided adjacent to the handle 5006 to effect rotation of the end effector 5012 about the articulation pivot 5014. It will be appreciated that various embodiments may include a non-pivoting end effector, and therefore may not have an articulation pivot 5014 or articulation control 5016.


The handle 5006 of the instrument 5010 may include a closure trigger 5018 and a firing trigger 5020 for actuating the end effector 5012. It will be appreciated that instruments having end effectors directed to different surgical tasks may have different numbers or types of triggers or other suitable controls for operating the end effector 5012. In one embodiment, a clinician or operator of the instrument 5010 may articulate the end effector 5012 relative to the shaft 5008 by utilizing the articulation control 5016, as described in more detail in pending U.S. Pat. No. 7,670,334, entitled SURGICAL INSTRUMENT HAVING AN ARTICULATING END EFFECTOR, the entire disclosure of which is incorporated herein by reference. The end effector 5012 includes in this example, among other things, a staple channel 5022 and a pivotally translatable clamping member, such as an anvil 5024, which are maintained at a spacing that assures effective stapling and severing of tissue clamped in the end effector 5012. The handle 5006 includes a pistol grip 5026 toward which the closure trigger 5018 is pivotally drawn by the clinician to cause clamping or closing of the anvil 5024 towards the staple channel 5022 of the end effector 5012 to thereby clamp tissue positioned between the anvil 5024 and channel 5022.


In the arrangement depicted in FIG. 7, the end effector 5012 includes, in addition to the previously-mentioned channel 5022 and anvil 5024, a cutting instrument 5032, a sled 5033, a staple cartridge 5034 that is removably seated in the channel 5022, and a helical screw shaft 5036. The cutting instrument 5032 may be, for example, a knife. The anvil 5024 includes pivot pins 5025 that are movably supported in corresponding slots in the channel 5022. In one arrangement, the anvil 5024 includes a tab 5027 at its proximate end that is inserted into a component of the mechanical closure system (described further below) to open and close the anvil 5024.


Still referring to FIG. 7, the shaft 5008 includes a proximal closure tube 5040 and a distal closure tube 5042 pivotably linked by a pivot link 5044. The distal closure tube 5042 includes an opening 5045 into which the tab 5027 on the anvil 5024 is inserted in order to open and close the anvil 5024, as further described below. Disposed inside the closure tubes 5040, 5042 may be a proximate spine tube 5046. Disposed inside the proximate spine tube 5046 may be a main rotational (or proximate) drive shaft 5048 that communicates with a secondary (or distal) drive shaft 5050 via a bevel gear assembly 5052a-c. The secondary drive shaft 5050 is connected to a drive gear 5054 that engages a proximate drive gear 5056 of the helical screw shaft 5036. The vertical bevel gear 5052b may sit and pivot in an opening 5057 in the distal end of the proximate spine tube 5046. A distal spine tube 5058 may be used to enclose the secondary drive shaft 5050 and the drive gears 5054, 5056. Collectively, the main drive shaft 5048, the secondary drive shaft 5050, and the articulation assembly (e.g., the bevel gear assembly 5052a-c) are sometimes referred to herein as the “main drive shaft assembly.”


A bearing 5038, positioned at a distal end of the staple channel 5022, receives the helical screw shaft 5036, allowing the helical screw shaft 5036 to freely rotate with respect to the channel 5022. The helical screw shaft 5036 may interface a threaded opening (not shown) of the knife 5032 such that rotation of the helical screw shaft 5036 causes the knife 5032 to translate distally or proximately (depending on the direction of the rotation) through the staple channel 5022.


Turning next to FIG. 8, the handle 5006 includes exterior lower side pieces 5059, 5060 and nozzle pieces 5061, 5062 that fit together to form, in general, the exterior of the handle 5006. A battery 5064, such as a Li ion battery, may be provided in the pistol grip portion 5026 of the handle 5006. The battery 5064 powers a motor 5065 disposed in an upper portion of the pistol grip portion 5026 of the handle 5006. The motor 5065 may drive a 90° bevel gear assembly 5066 comprising a first bevel gear 5068 and a second bevel gear 5070. The bevel gear assembly 5066 may drive a planetary gear assembly 5072. The planetary gear assembly 5072 may include a pinion gear 5074 connected to a drive shaft 5076. The pinion gear 5074 may drive a mating ring gear 5078 that drives a helical gear drum 5080 via a drive shaft. A ring 5084 may be threaded on the helical gear drum 5080. Thus, when the motor 5065 rotates, the ring 5084 is caused to travel along the helical gear drum 5080 by means of the interposed bevel gear assembly 5066, planetary gear assembly 5072 and ring gear 5078.


The handle 5006 may include a middle handle piece 5104 adjacent to the upper portion of the firing trigger 5020. The handle 5006 also may comprise a bias spring 5112 connected between posts on the middle handle piece 5104 and the firing trigger 5020. The bias spring 5112 may bias the firing trigger 5020 to its fully open position. In that way, when the operator releases the firing trigger 5020, the bias spring 5112 will pull the firing trigger 5020 to its open position. The distal end of the helical gear drum 5080 includes a distal drive shaft 5120 that drives a ring gear 5122, which mates with a pinion gear 5124. The pinion gear 5124 is connected to the main drive shaft 5048 of the main drive shaft assembly. In that way, rotation of the motor 5065 causes the main drive shaft assembly to rotate, which causes actuation of the end effector 5012. The ring 5084 threaded on the helical gear drum 5080 may include a post 5086 that is disposed within a slot 5088 of a slotted arm 5090. The slotted arm 5090 has an opening 5092 in its opposite end 5094 that receives a pivot pin 5096 that is connected between the handle exterior side pieces 5059, 5060. The pivot pin 5096 is also disposed through an opening 5100 in the firing trigger 5020 and an opening 5102 in the middle handle piece 5104.


The middle handle piece 5104 includes a backside shoulder 5106 that engages the slotted arm 5090. The middle handle piece 5104 also has a forward motion 5107 stop that engages the firing trigger 5020. The movement of the slotted arm 5090 is controlled by rotation of the motor 5065. When the slotted arm 5090 rotates counter clockwise as the ring 5084 travels from the proximate end of the helical gear drum 5080 to the distal end, the middle handle piece 5104 will be free to rotate counter clockwise. Thus, as the user draws in the firing trigger 5020, the firing trigger 5020 will engage the forward motion stop 5107 of the middle handle piece 5104, causing the middle handle piece 5104 to rotate counter clockwise. Due to the backside shoulder 5106 engaging the slotted arm 5090, however, the middle handle piece 5104 will only be able to rotate counter clockwise as far as the slotted arm 5090 permits. In that way, if the motor 5065 should stop rotating for some reason, the slotted arm 5090 will stop rotating, and the user will not be able to further draw in the firing trigger 5020 because the middle handle piece 5104 will not be free to rotate counter clockwise due to the slotted arm 5090.


Components of an exemplary closure system for closing (or clamping) the anvil 5024 of the end effector 5012 by retracting the closure trigger 5018 are also shown in FIG. 8. In the illustrated embodiment, the closure system includes a yoke 5250 connected to the closure trigger 5018. A pivot pin 5252 is inserted through aligned openings in both the closure trigger 5018 and the yoke 5250 such that they both rotate about the same point. The distal end of the yoke 5250 is connected, via a pin 5254, to a first closure bracket 5256. The first closure bracket 5256 connects to a second closure bracket 5258. Collectively, the closure brackets 5256, 5258 define an opening in which the proximate end of the proximal closure tube 5040 (see FIG. 7) is seated and held such that longitudinal movement of the closure brackets 5256, 5258 causes longitudinal motion by the proximal closure tube 5040. The instrument 5010 also includes a closure drive shaft 5260 disposed inside the proximal closure tube 5040. The closure drive shaft 5260 may include a window 5261 into which a post 5263 on one of the handle exterior pieces, such as exterior lower side piece 5059 in the illustrated embodiment, is disposed to fixedly connect the closure drive shaft 5260 to the handle 5006. In that way, the proximal closure tube 5040 is capable of moving longitudinally relative to the closure drive shaft 5260. The closure drive shaft 5260 may also include a distal collar 5267 that fits into a cavity in proximate spine tube 5046 and is retained therein by a cap.


In operation, when the yoke 5250 rotates due to retraction of the closure trigger 5018, the closure brackets 5256, 5258 cause the proximal closure tube 5040 to move distally (i.e., away from the handle end of the instrument 5010), which causes the distal closure tube 5042 to move distally, which causes the anvil 5024 to rotate about the pivot pins 5025 into the clamped or closed position. When the closure trigger 5018 is unlocked from the locked position, the proximal closure tube 5040 is caused to slide proximately, which causes the distal closure tube 5042 to slide proximately, which, by virtue of the tab 5027 being inserted in the opening 5045 of the distal closure tube 5042, causes the anvil 5024 to pivot about the pivot pins 5025 into the open or unclamped position. In that way, by retracting and locking the closure trigger 5018, an operator may clamp tissue between the anvil 5024 and channel 5022, and may unclamp the tissue following the cutting/stapling operation by unlocking the closure trigger 5018 from the locked position. Further details concerning the construction and operation of the existing surgical instrument 5010 may be found in U.S. Pat. No. 7,845,537, entitled SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES, the entire disclosure of which is hereby incorporated by reference herein. Other rotary drive arrangements configured for use with various forms of robotic systems are disclosed in U.S. Patent Application Publication No. 2016/0287251, entitled STAPLING END EFFECTOR CONFIGURED TO COMPENSATE FOR AN UNEVEN GAP BETWEEN A FIRST JAW AND A SECOND JAW, the entire disclosure of which is hereby incorporated by reference herein.


Turning next to FIGS. 9 and 10, another motor-driven surgical cutting and fastening instrument 10010 that may or may not be reused is depicted. In the illustrated embodiment, the instrument 10010 includes a housing 10012 that comprises a handle 10014 that is configured to be grasped, manipulated and actuated by the clinician. As can be seen in FIG. 9 for example, the instrument 10010 includes a shaft assembly 10200 that has a surgical end effector 10300 operably coupled thereto that is configured to perform one or more surgical tasks or procedures. In one arrangement, the shaft assembly 10200 comprises an interchangeable shaft assembly that is intended to be removably couplable to the handle assembly 10014 in the various manners disclosed herein. However, the shaft assembly 10200 may also comprise a dedicated shaft assembly that is not intended to be removed from the handle 10014. Only those specific components necessary to understand the functions and operation of the shaft assembly 10200 will be discussed in further detail below.


As can be seen in FIG. 9, for example, the surgical end effector 10300 comprises an elongate channel 10310 that is configured to operably support a staple cartridge 10400 therein. The end effector 10300 also includes an anvil 10500 that is pivotally supported relative to the elongate channel 10310. In one arrangement, for example, the anvil 10500 may be fabricated using various fabricating techniques described in U.S. patent application Ser. No. 16/105,101, entitled METHOD FOR FABRICATING SURGICAL STAPLER ANVILS, the entire disclosure of which is hereby incorporated by reference herein. The shaft assembly 10200 may further include an articulation joint 10250 that facilitates articulation of the surgical end effector 10300 about an articulation axis AA that is transverse to a longitudinal shaft axis LA. Other shaft assemblies, however, may not be capable of articulation. In the illustrated example, the shaft assembly 10200 comprises a proximal outer shaft tube or member 10210 that extends distally from a nozzle assembly 10202. A proximal end 10312 of the elongate channel comprises a tubular portion 10314 that is similar in size to the proximal outer shaft tube 10120 and is coupled to the distal end of the proximal outer shaft tube 10210 to form the articulation joint 10250. The articulation joint 10250 includes a double pivot shaft assembly 10252. See FIGS. 11 and 12. According to various forms, the tubular portion 10314 of the elongate channel 10310 includes upper and lower proximally projecting tangs 10316, 10318. See FIG. 11. An upper double pivot link 10320 includes upwardly projecting distal and proximal pivot pins that engage respectively an upper pin hole in the upper proximally projecting tang 10316 and an upper distal pin hole in an upper distally projecting tang 10212 on the proximal outer shaft tube 10210. A lower double pivot link 10322 includes downwardly projecting distal and proximal pivot pins that engage respectively a lower distal pin hole in the lower proximally projecting tang 10318 and a lower proximal pin hole in a lower distally projecting tang 10214 in the proximal outer shaft tube 10210. See FIG. 11. The shaft assembly 10200 also includes an internal spine member 10230 that is pivotally coupled to an insert assembly 10330 that is received within the tubular portion 10314 of the elongate channel 10310 and is attached thereto by, for example, welding, adhesive, fasteners, etc. A proximal end of the internal spine member 10230 may be rotatably coupled to a chassis (not shown) within the nozzle assembly 10202 in the various manners disclosed herein, for example. The distal end of the internal spine member 10230 may be pinned to the insert assembly 10330 to facilitate pivotal travel of the elongate channel 10310 relative to the internal spine member 10230.


In the illustrated example, the surgical end effector 10300 is selectively articulatable about the articulation axis AA by an articulation system 10260. In one form, the articulation system 10260 includes an articulation motor 10262 that is operably supported in the nozzle assembly 10202, for example. See FIG. 10. In other examples, the articulation motor 10262 may be operably supported in the housing 10012 or handle 10014 or other portion of a robotic system. Referring to FIG. 10, the articulation motor 10262 is coupled to an articulation drive gear 10264 that is in meshing engagement with a drive gear rack 10266 that is attached to or otherwise formed in a proximal articulation driver 10268. A distal end of the proximal articulation driver 10268 is pivotally coupled to a distal articulation link 10270. As can be seen in FIG. 12, an offset attachment lug 10272 is formed on a distal end 10271 of the proximal articulation driver 10268. A pivot hole is formed in the offset attachment lug 10272 and is configured to pivotally receive therein a proximal link pin 10276 formed on the proximal end 10274 of the distal articulation link 10270. A distal end 10278 of the distal articulation link 10270 includes a pivot hole that is configured to pivotally receive therein a channel pin 10332 formed on the insert assembly 10330. Operation of the articulation motor 10262 will cause axial movement of the proximal articulation driver 10268. Axial movement of proximal articulation driver 10268 will apply articulation motions to the elongate channel 10310 to thereby cause the surgical end effector 10300 to articulate about the articulation axis AA relative to the internal spine member 10230. Other articulation systems and arrangements may be employed in the various manners disclosed herein. In other embodiments, the surgical end effector may not be articulatable.


In at least one arrangement, the surgical end effector 10300 includes a firing member that is axially movable within the surgical end effector 10300 between a starting position and an ending position. As will be discussed in further detail below, the firing member may be configured to sever tissue that is clamped between the anvil 10500 and a surgical staple cartridge 10400 that is operably supported in the elongate channel 10310. In one arrangement, the staple cartridge 10400 includes lines of surgical staples or fasteners that are operably supported on corresponding drivers that are movably supported in the cartridge. As the firing member is driven distally, the firing member cooperates with a sled or camming assembly that is supported in the staple cartridge that serves to advance the drivers in a direction toward the closed anvil which causes the staples or fasteners supported thereon to pierce through the clamped tissue into forming contact with the underside of the closed anvil. Once the firing member has been distally advanced from its proximal starting position to its ending position within the end effector, it may be retracted back to its starting position to permit the anvil to be opened to facilitate removal of the cut/stapled tissue from the end effector. In other arrangements, the firing member may be left at the ending position wherein it is permitted to disengage from the anvil to facilitate opening of the anvil.


In at least one arrangement, the surgical instrument 10010 also employs a firing system 10600 that is configured to apply rotary drive motions to the firing member to drive the firing member between the starting and end positions. In the example depicted in FIG. 10, the firing system 10600 includes a firing motor 10602 that is operably supported in the nozzle assembly 10202, for example. In other examples, the firing motor 10602 may be operably supported in the housing or handle or other portion of a robotic system. The firing motor 10602 is coupled to a firing drive gear 10604 that is in meshing engagement with a driven gear 10606 that is attached to or otherwise formed in rotary firing drive shaft 10610. As can be seen in FIGS. 11 and 12, the firing drive shaft 10610 may be flexible to permit articulation of the surgical end effector 10300 in the manner described above.



FIG. 13 depicts one example of a rotary driven firing member 10620 that may be employed in the surgical end effector 10300. As can be seen in FIG. 13, the firing member 10620 comprises a body portion 10622 that includes two downwardly extending hollow mounting portions 10624 that are unthreaded and spaced from each other to receive a threaded drive nut 10630 therebetween. The threaded drive nut 10630 is threaded onto a threaded portion 10612 of the rotary firing drive shaft 10610. A distal end 10614 of the rotary firing drive shaft 10610 may be configured to be rotatably supported in a bearing (not shown) that is housed within the elongate channel and is configured to rotatably support the rotary firing drive shaft 10610 therein. The drive nut 10630 includes a vertical tab portion 10632 that is sized to extend through an axial slot in the bottom of the elongate channel. Two laterally extending channel engagement flanges 10634 are formed on the threaded drive nut 10630 and are configured to engage the bottom of the elongate channel. In addition, two laterally extending anvil engagement tabs 10626 are formed on the top of the firing member body 10622 and are configured to engage corresponding ledges formed in the anvil 10500 as the firing member 10620 is axially moved within the end effector 10300. In this arrangement, the firing member 10620 includes a camming sled engagement feature 10628 that is configured to operably engage a camming assembly that is movably stored in the staple cartridge. The camming sled or camming assembly (not shown) may include a tissue cutting member or a tissue cutting feature attached to the firing member 10620. The firing member 10620 may be stored within an unfired staple cartridge and is configured to be seated on the threaded drive nut 10630 when the cartridge is operably installed within the elongate channel. However, a variety of other rotary driven firing member arrangements may also be employed. For example, firing and tissue cutting members that are permanently threaded onto the rotary firing drive shaft may also be employed. In various aspects, as the firing member 10620 is distally driven through the surgical staple cartridge 10400, the firing member 10620, through the engagement of the anvil engagement tabs 10626 with the anvil 10500 and the engagement of the channel engagement flanges 10634 with the channel 10310, may serve to maintain a desired amount of tissue gap between a deck surface 10402 on the staple cartridge 10400 and a staple forming undersurface 10502 on the anvil 10500. See FIG. 9.


In the example depicted in FIGS. 10-21, in addition to a rotary driven firing system, the surgical instrument 10010 also includes a rotary driven closure system 10700 that is configured to apply rotary closure motions to the anvil 10500. As can be seen in FIG. 10, for example, in one arrangement, the rotary driven closure system 10700 comprises a closure motor 10702 that is operably supported in the nozzle assembly 10202, for example. In other examples, the closure motor 10702 may be operably supported in the housing or handle or other portion of a robotic system. The closure motor 10702 is coupled to a closure drive gear 10704 that is in meshing engagement with a driven gear 10706 that is attached to or otherwise formed in rotary closure drive shaft 10710. As can be seen in FIGS. 11 and 12, the closure drive shaft 10710 may be flexible to permit articulation of the surgical end effector 10300 in the manner described above.


In the illustrated example, the surgical end effector 10300 includes the anvil 10500 that includes a proximally-extending mounting tab 10510 that is configured to be pivotally attached to a distal insert portion 10334 of the insert assembly 10330. In alternative arrangements, the distal insert portion 10334 may be separate from the insert assembly 10330 and otherwise be attached to the proximal end portion 10312 of the elongate channel 10310 by welding, adhesive, fasteners, etc. In still other arrangements, the distal insert portion 10334 may actually comprise a portion of the elongate channel 10310 and be integrally formed therewith. In the illustrated arrangement, the anvil mounting tab 10510 includes a distal portion 10512 through which a transverse slot 10514 extends therethrough and is aligned with a transverse slot 10336 in the distal insert portion 10334 as well as a slot 10315 in the tubular portion 10314 of the elongate channel 10310. See FIG. 18. The anvil mounting tab 10510 is pivotally attached to the elongate channel 10310 by a rivet 10340. The anvil mounting tab 10510, as well as the distal insert portion 10334, are sufficiently robust to provide a sufficient amount of strength where the rivet 10340 operates which provides the ability to locate the pivoting attachment point above the centerline or midpoint of the end effector and thereby afford sufficient room therein for the firing member components and rotary drive components. Orbit forming of the rivet 10340 pivotally cinches the anvil mounting tab 10510 to the elongate channel 10310 and can remove excessive play or movement (tolerance slop) which serves to place the rivet 10340 in complete or significantly complete shear for resistance against closure loads. In addition, the relatively broad contact between such components may also serve to prevent or minimize twisting between the anvil mounting tab 10510 and the elongate channel 10310.


As can be seen in FIGS. 14, 15 and 17, the anvil 10500 is asymmetrically coupled to the elongate channel 10310. Stated another way, the location in which the anvil 10500 is attached to the elongate channel 10310 is laterally offset from the end effector centerline EC. In at least one arrangement, the rivet 10340 comprises solid core rivet with a diameter of 0.05″-0.1″ and an orbit formed head 10342 on one end of the rivet shank 10344 and a machined head 10346 on the other end of the rivet shank 10344. In one arrangement, the riveting is done in such a way that the rivet 10340 would hold a final formed height that would ensure intimate contact between the anvil mounting tab 10510 and the corresponding attachment portions of the elongate channel 10310. The “orbit formed” head 10342 would swell the rivet shank 10344 on that side of the anvil mounting tab 10510 and elongate channel portions which may prevent the rivet from rotating relative to that part while the other “pre-machined” side 10346 would not have a swelled shank portion which may permit the adjacent components to rotate. In one example, the rivet 10340 is fixed relative to the channel portion to avoid a condition wherein the anvil pivots freely relative to the insert and elongate channel.


The example illustrated in FIGS. 10-19 employs a rotary actuated closure system 10700 that is configured to apply opening and closure motions to the anvil 10500. In one arrangement, closure system 10700 comprises a closure linkage assembly 10716 that is pivotally coupled to the anvil mounting tab 10510 for pivotal travel relative thereto about a common closure axis CA. As can be seen in FIGS. 19 and 20, the closure drive shaft 10710 comprises a threaded drive segment 10714 that is configured to threadably engage a drive nut 10730 that is supported by a drive yoke 10720. The drive yoke 10720 includes two yoke arms 10722 that have unthreaded holes 10724 therethrough to permit the closure drive shaft 10710 to pass therethrough. The drive nut 10730 has a threaded hole 10732 therethrough that is threaded onto the threaded drive segment 10714 of the closure drive shaft 10710 and is received between the yoke arms 10722. A closure link 10740 is pivotally coupled to the drive yoke 10720 by a pin 10742. The closure link 10740 is also pivotally attached (pinned) to the anvil mounting tab 10510 by a pin 10744. See FIG. 19. As can be seen in FIG. 19, a spacer member 10746 is provided to fill the space between the closure link 10740 and spaced arms 10516 of the anvil mounting tab 10510. Alternatively, the closure link may be sized and shaped to fill in that space. As can be further seen in FIG. 19, a retainer tab 10311 is formed in the elongate channel 10310 to define an axial trough 10313 for slidably receiving the drive yoke 10720 therein. Rotation of the rotary closure drive shaft 10710 in a first rotary direction will cause the drive yoke 10720 to move distally and cause the closure link 10740 to pull the anvil mounting tab 10510 in an opening direction which causes the anvil 10500 to pivot to an open position about the pivot axis PA. Likewise, rotation of the rotary closure drive shaft 10710 in a second rotary direction will cause the drive yoke 10720 to move proximally and cause the closure link 10740 to push the anvil mounting tab 10510 in a closing direction which causes the anvil 10500 to pivot to a closed position about the pivot axis PA. In various aspects, the rotary driven closure system 10700 may be actuated during the actuation of the rotary driven firing system 10600 such that the closure system 10700 continues to apply additional closure motions to the anvil as the firing member is axially driven through the staple cartridge.



FIGS. 22 and 23 illustrate an alternate closure drive arrangement wherein the anvil mounting tab 10510′ of the anvil 10500′ is generally centrally supported within the end effector. The anvil mounting portion 10510′ may be pivotally coupled to the elongate channel 10310′ in the manner described above. In this arrangement, the rotary closure drive shaft 10710′ is hollow and concentrically supports the rotary firing shaft 10610′ therein. The rotary closure drive shaft 10710′ and the rotary firing drive shaft 10610′ are centrally disposed within the elongate channel 10310′ as can be seen in FIG. 23. The rotary firing drive shaft 10610′ rotatably extends through the rotary closure drive shaft 10710′ and includes a distal threaded portion 10612′ that is configured to threadably drive the firing member 10620 in the manner described above, for example.


The example illustrated in FIGS. 22 and 23 employs a rotary actuated closure linkage assembly 10716′ that is configured to apply opening and closure motions to the anvil 10500′. In one arrangement, the closure linkage assembly 10716′ comprises a proximal drive yoke assembly 10720′ and a distal drive yoke assembly 10750. The proximal drive yoke assembly 10720′ includes two spaced yoke arms 10722′ that have unthreaded holes 10724′ therethrough to permit the closure drive shaft 10710′ to pass therethrough. A proximal drive nut 10730′ is received between the spaced yoke arms 10722′ and includes a threaded hole for threadably engaging a proximal thread segment 10712′ on the rotary closure drive shaft 10710′. The proximal drive yoke assembly 10720′ is pivotally coupled to a proximal closure link 10740′ that is pivotally pinned to the anvil mounting portion 10510′. The distal drive yoke assembly 10750 includes two spaced yoke arms 10752 that have unthreaded holes 10754 therethrough to permit the closure drive shaft 10710′ to pass therethrough. A distal drive nut 10760 is received between the spaced yoke arms 10752 and includes a threaded hole for threadably engaging a distal thread segment 10714′ on the rotary closure drive shaft 10710′. The proximal threaded segment 10712′ and the distal threaded segment 10714′ are thread in opposite directions. The distal drive yoke assembly 10750 is pivotally coupled to a U-shaped distal closure link 10770 that is pivotally pinned to the anvil mounting portion 10510′. The U-shaped distal closure link 10770 affords the closure linkage assembly 10716′ with a symmetric load bearing arrangement. Rotation of the rotary closure drive shaft 10710′ in a first rotary direction will cause the proximal drive yoke 10720′ and the distal drive yoke assembly 10750 to axially move away from each other to pull the anvil mounting tab 10510′ in an opening direction causing the anvil 10500′ to pivot to an open position about the pivot axis PA. Likewise, rotation of the rotary closure drive shaft 10710′ in a second rotary direction will cause the proximal drive yoke 10720′ and distal drive yoke assembly 10750 to move towards each other and push the anvil mounting tab 10510′ in a closing direction causing the anvil 10500′ to pivot to a closed position about the pivot axis PA. Such arrangement may serve to apply generally higher closure forces to the anvil 10500′. It will be appreciated that the rotary firing drive shaft 10610′ is independently rotatable relative to the rotary closure drive shaft 10710′. In various aspects, the rotary driven closure system 10700 may be actuated during the actuation of the rotary driven firing system 10600 such that the closure system 10700 continues to apply additional closure motions to the anvil as the firing member is axially driven through the staple cartridge.



FIGS. 24-27 illustrate an another surgical end effector 10800 that employs a closure drive arrangement wherein an anvil mounting tab 10804 of an anvil 10802 is centrally supported within the end effector 10800 and two rotary closure shafts 10830 and 10840 are employed to apply closure motions to the anvil 10802. In this arrangement, a distal portion 10806 of the anvil mounting tab 10804 includes a pair of laterally extending pivot members 10808 that are adapted to be pivotally cradled in pivot cradles 10356 in upstanding walls 10354 of a distal mounting portion of the elongate channel 10310″. See FIG. 27. Thus, the pivot members 10808 are vertically movable or “floatable” within their corresponding pivot cradles 10356. In this arrangement, the rotary firing drive shaft 10610 (FIG. 26) is vertically supported above the rotary closure drive shaft 10710 (FIGS. 24 and 25). In the illustrated example, the rotary firing drive shaft 10610 includes a firing drive gear 10611 that is configured to drivingly engage a driven gear (not shown) on a distal firing drive shaft 10613 that is rotatably supported in the elongate channel 10310″ in the various manners described herein. See FIG. 27. A firing member drive nut 10630 is threaded on the distal firing drive shaft 10613 and serves to drive a firing member 10620 within the end effector 10800 as the rotary firing drive shaft 10610 is rotated in the manner described herein.


As can be seen in FIGS. 24 and 25, the rotary closure drive shaft 10710 includes a closure drive gear 10715 that is centrally disposed between a right distal closure shaft 10830 and a left distal closure shaft 10840. The right distal closure shaft 10830 includes a right driven gear 10832 that is in meshing engagement with the closure drive gear 10715 and the left distal closure shaft 10840 includes a left driven gear 10842 that is also in meshing engagement with the closure drive gear 10715. Rotation of the rotary closure drive shaft 10710 will result in the rotation of the right distal closure shaft 10830 in a first rotary direction and the rotation of the left distal closure shaft 10840 in a second rotary direction.


The example illustrated in FIGS. 24-26 employs a rotary actuated right closure linkage assembly 10850 and a rotary actuated left closure linkage assembly 10860 that are configured to apply opening and closure motions to the anvil 10802. In one arrangement, the right closure linkage assembly 10850 comprises a proximal drive nut assembly 10852 that is threaded onto the right distal closure shaft 10830 and is coupled to a right closure link 10854 that is attached to the anvil mounting tab 10804. Likewise, the left closure linkage assembly 10860 comprises a left drive nut assembly 10862 that is threaded onto the left distal closure shaft 10840 and is coupled to a left closure link 10864 that is attached to the anvil mounting tab 10804. In one arrangement, the diameter D of the right distal closure shaft 10830 and the left distal closure shaft 10840 may be approximately 0.078″. See FIG. 26. The space “E” between the right drive nut assembly 10852 and the left drive nut assembly 10862 may be approximately 0.093″ and the width “W” of the channel 10310″ may be approximately 0.256″. However, other sizes and shapes of end effector components may be employed. Rotation of the rotary closure drive shaft 10710 in a first rotary direction will cause the right drive nut assembly 10852 and the left drive nut assembly 10862 to move in a synchronized fashion to open the anvil 10802 in a balanced uniform manner. Rotation of the rotary closure drive shaft 10710 in a second rotary direction will cause the right drive nut assembly 10852 and the left drive nut assembly 10862 to move in a synchronized fashion to close the anvil 10802 in a balanced uniform manner and reduce any twisting moment on the anvil 10802 as the anvil 10802 is pivoted closed.


As can also be seen in FIGS. 24 and 25, the anvil mounting tab 10804 includes a domed or spherical distal surface portion 10809. A closure ring 10811 (FIG. 27) is movably journaled on the spherical distal surface portion 10809. As the anvil 10802 is pivoted to the closed position by the right closure linkage assembly 10850 and the left closure linkage assembly 10860, the closure ring 10811 serves to constrain the anvil 10802 to the elongate channel 10310″. FIG. 24 illustrates the anvil 10802 in a closed position. As can be seen in FIG. 24, the links 10854 and 10864 are nearly vertical (perpendicular) to the end effector axis EC. Such arrangement establishes a maximum moment arm MA for retaining the anvil 10802 in the closed position. FIG. 25 illustrates the anvil 10802 in an open position. For example, the anvil 10802 is pivoted upward at an angle that is approximately 20° from the horizontal as shown. When in that position, the links 10854 and 10864 are nearly horizontal (relative to each other) which results in the application of a reduced amount of closure force than was established when the anvil was moved to the closed position. In one arrangement, the links 10854 and 10864 may have a length L of approximately 0.150″, for example. In various aspects, the rotary driven closure system 10700 may be actuated during the actuation of the rotary driven firing system 10600 such that the closure system 10700 continues to apply additional closure motions to the anvil as the firing member is axially driven through the staple cartridge.



FIGS. 28-31 illustrate another surgical end effector 10800′ that employs a closure drive arrangement wherein an anvil mounting tab 10804′ of an anvil 10802′ is also centrally supported within the end effector 10800′ and two rotary closure shafts 10830 and 10840 are employed to apply closure motions to the anvil 10802′. See FIG. 29. In one arrangement, for example, the anvil 10802′ may be fabricated using various fabricating techniques described in U.S. patent application Ser. No. 16/105,101, entitled METHOD FOR FABRICATING SURGICAL STAPLER ANVILS, the entire disclosure of which is hereby incorporated by reference herein. In this arrangement, a distal portion 10806′ of the anvil mounting tab 10804′ includes a pair of laterally extending pivot members 10808′ that are adapted to be pivotally cradled in pivot cradles 10356″ in upstanding walls 10354″ of a distal mounting portion 10352″ of the elongate channel 10310″. See FIGS. 30 and 31. Thus, the pivot members 10808′ are vertically movable or “floatable” within their corresponding pivot cradles 10356″. In this arrangement, the rotary firing drive shaft 10610 (similar to that shown in FIG. 26) is vertically supported above the rotary closure drive shaft 10710 (FIGS. 24 and 25) in the elongate shaft. As was discussed above, in the illustrated example, the rotary firing drive shaft (not shown) includes a firing drive gear (not shown) that is configured to drivingly engage a driven gear (not shown) on a distal firing drive shaft 10613′ that is rotatably supported in the elongate channel 10310″ in the various manners described herein. See FIGS. 28 and 29. The distal firing drive shaft 10613′ is configured to threadably drive a firing member 10620′ within the end effector 10800′ as the rotary firing drive shaft and distal firing drive shaft 10613′ are rotated in the manners described herein.


As was described above, the rotary closure drive shaft 10710 includes a closure drive gear 10715 that is centrally disposed between a right distal closure shaft 10830 and a left distal closure shaft 10840. See FIGS. 29-31. The right distal closure shaft 10830 includes a right driven gear that is in meshing engagement with the closure drive gear 10715 and the left distal closure shaft 10840 includes a left driven gear 10842 that is also in meshing engagement with the closure drive gear 10715. Rotation of the rotary closure drive shaft 10710 will result in the rotation of the right distal closure shaft 10830 in a first rotary direction and the rotation of the left distal closure shaft 10840 in a second rotary direction. The example illustrated in FIGS. 30 and 31 employs a rotary actuated right closure linkage assembly 10850 and a rotary actuated left closure linkage assembly 10860 that are configured to apply opening and closure motions to the anvil 10802′. In one arrangement, the right closure linkage assembly 10850 comprises a proximal drive nut assembly 10852 that is threaded onto the right distal closure shaft 10830 and is coupled to a right closure link 10854 that is attached to the anvil mounting tab 10804′. Likewise, the left closure linkage assembly 10860 comprises a left drive nut assembly 10862 that is threaded onto the left distal closure shaft 10840 and is coupled to a left closure link 10864 that is attached to the anvil mounting tab 10804′. Rotation of the rotary closure drive shaft 10710 in a first rotary direction will cause the right drive nut assembly 10852 and the left drive nut assembly 10862 to move in a synchronized fashion to open the anvil 10802′ in a balanced uniform manner. Rotation of the rotary closure drive shaft 10710 in a second rotary direction will cause the right drive nut assembly 10852 and the left drive nut assembly 10862 to move in a synchronized fashion to close the anvil 10802′ in a balanced uniform manner and reduce any twisting moment on the anvil 10802′ as the anvil 10802′ is pivoted closed.


As can be seen in FIGS. 30-32, the anvil mounting tab 10804′ includes a domed or spherical distal surface portion 10809′. A closure ring 10811′ is movably journaled on the spherical distal surface portion 10809′. As the anvil 10802′ is pivoted to the closed position by the right closure linkage assembly 10850 and the left closure linkage assembly 10860, the closure ring 10811′ serves to constrain the anvil 10802 to the elongate channel 10310″. In the illustrated example, a pivot spring 10813′ is seated in each of the cradles 10356″ which serves to bias the pivot members 10808′ upward in their respective cradles 10356″. In at least one arrangement, a distal portion of the spherical surface portion 10809′ comprises a shallow notch area 10815′ that provides additional clearance for the closure ring 10811′ to enable the anvil 10802′ to pivot further open, for example, wherein the undersurface 10803′ of the anvil 10802′ is at least 20° (angle A) from the deck surface of the surgical staple cartridge seated within the channel 10310″. See FIG. 30. For example, the radial distance between the center of the pivot members 10808′ to the spherical surface 10809′ is designated as “r” in FIGS. 30 and 31. The radial distance from the centerline of the pivot members 10808′ to the notched area 10815′ is designated as “r”, wherein r′>r.



FIG. 30 illustrates the anvil 10802′ in a fully open position. As can be seen in FIG. 30, the closure ring 10811′ is approximately axially aligned with the pivot members 10808′ which serves to drive the pivot members 10808′ into the bottom of their respective cradle 10356″ and compress the pivot spring 10813′ therein. FIG. 31 illustrates the anvil 10802′ in the closed position wherein the closure ring 10811′ is slightly proximally axially offset from the pivot members 10808′ which permits the pivot springs 10813′ to bias the pivot members 10808′ upward within their respective cradles 10356″.


The closure rings in these embodiments essentially encircle the corresponding anvil and elongate channel portions. To facilitate opening of the anvil to a desired opening aperture or angle, the closure ring is permitted to move proximally to distally a small amount (e.g., 0.0″-0.1″) while being spring biased to the distal position. The ring does not induce closure but merely constrains the anvil and channel from moving apart vertically allowing a pivoting motion to occur between the two components. Such arrangement facilitates use of a thicker anvil particularly in the anvil mounting area which may improve anvil strength and reliability. This configuration may further enable the jaws (anvil and channel) to pivot in a fashion that improves the moment arm condition of the anvil proximal to the pivot location and facilitate opening of the end effector to greater opening angles. In various aspects, the rotary driven closure system 10700 may be actuated during the actuation of the rotary driven firing system 10600 such that the closure system 10700 continues to apply additional closure motions to the anvil as the firing member is axially driven through the staple cartridge.



FIGS. 33-35 illustrate another end effector 10900 that employs an alternate closure drive arrangement for opening and closing an anvil 10920 relative to an elongate channel 10910 thereof. The anvil 10920 includes an anvil mounting tab 10922 that protrudes proximally along a centerline of the anvil 10920 and is pivotally coupled to a proximal end 10912 of the elongate channel 10910 in the various manners disclosed herein. In one arrangement, for example, the anvil 10920 may be fabricated using various fabricating techniques described in U.S. patent application Ser. No. 16/105,101, entitled METHOD FOR FABRICATING SURGICAL STAPLER ANVILS, the entire disclosure of which is hereby incorporated by reference herein. In this arrangement, a rotary closure drive shaft 10710′ is hollow and concentrically supports a rotary firing drive shaft 10610′ therein. The rotary closure drive shaft 10710′ and the rotary firing drive shaft 10610′ are centrally disposed within the elongate channel 10910 as can be seen in FIG. 33. The rotary firing drive shaft 10610′ rotatably extends through the rotary closure drive shaft 10710′ and includes a distal threaded portion 10612′ that is configured to threadably drive a firing member 10620 in the manner described above, for example.


Referring to FIG. 33, a closure shuttle 10940 is supported for axial travel within the elongate channel 10910. The closure shuttle 10940 is threadably journaled on the threaded closure drive shaft 10710′ such that rotation of the threaded closure drive shaft 10710′ in a first direction causes the closure shuttle 10940 to move distally and rotation of the threaded closure drive shaft 10710′ in a second rotary direction causes the closure shuttle 10940 to move proximally within the elongate channel 10910. As can be seen in FIG. 33, a right closure link 10950 and a left closure link 10960 are pivotally coupled to the anvil mounting tab 10922. The right closure link 10950 also includes an actuation end 10952 that is received within a corresponding right actuation notch 10942 in the closure shuttle 10940 and the left closure link 10960 includes an actuation end 10962 that is received within a corresponding left actuation notch 10944 in the closure shuttle 10940. Also in the illustrated arrangement, a right drive notch 10954 is provided in the actuation end 10952 of the right closure link 10950 and a left drive notch 10964 is provided in the actuation end 10962 of the left closure link 10960. The drive notches 10954, 10964 are configured to drivingly engage the actuation notches 10942, 10944, respectively.



FIGS. 33 and 35 illustrate the closure shuttle 10940 in a proximal-most, retracted position. When in that position, the right and left closure links 10950, 10960 push up on the anvil mounting tab 10922 and cause the anvil 10920 to pivot about the pivot axis PA to a closed position. When the closure shuttle 10940 has been moved to its distal-most, extended position, the right and left closure links 10950, 10960 pull the anvil tab 10922 downward and pivot the anvil 10920 to the open position as shown in FIG. 34. FIG. 36 illustrates some exemplary dimensions of various components of the surgical end effector 10900. In one arrangement for example, the overall height “H” may be approximately 0.500″. The anvil height “AH” may be approximately 0.120″. The rivet passage may have a diameter “PD” of approximately 0.070″ and the base height “BH” may be approximately 0.310″, for example. Referring to FIG. 37, the hollow closure drive shaft 10710′ may have an internal diameter “ID” of approximately 0.100″ and an unthreaded outer diameter “UTD” of approximately 0.129″ and a threaded outer diameter “TD” of approximately 0.164″: The firing drive shaft 10610′ may have an unthreaded diameter “UTD′” of approximately 0.0668″ and a threaded outer diameter “TD′” of approximately 0.0854″, for example. Other diameters, component sizes and dimensions may also be employed.



FIGS. 38 and 39 are diagrammatical depictions of an end effector 10900′ that employs alternative closure link arrangements. As can be seen in those Figures, a distal closure link (or links) 10970 are pivotally pinned or otherwise pivotally coupled to an anvil 10920′ and an elongate channel 10910′. In addition, proximal closure links 10972 are attached to an anvil mounting tab portion 10922′ and are slidably coupled via a corresponding pin 10974 that is received in a corresponding axial slot 10911′ in the elongate channel 10910′ or in a closure shuttle or other member (not shown) that is configured to move the proximal closure links 10972 between a first position (FIG. 38) corresponding to an open position of the anvil 10920′ and a second position (FIG. 39) corresponding to the closed position of the anvil 10920′.



FIGS. 40 and 41 are diagrammatical depictions of an end effector 10900″ that employs alternative closure link arrangements. As can be seen in those Figures, a proximal end portion 10923″ of an anvil 10920″ is pivotally coupled to an elongate channel 10910″ by proximal mounting links 10980. The proximal mounting links 10980 (only one is shown in the Figures) are pivotally attached to the elongate channel 10910″ for pivotal travel relative thereto about a lower pivot axis LPA. The proximal mounting links 10980 are also pivotally coupled to the proximal end portion 10923″ for pivotal travel relative thereto about an anvil pivot axis APA. The end effector 10900″ further includes a closure linkage assembly 10982 that comprises at least one distal link 10984 and one proximal link 10986. In other arrangements, the closure linkage assembly 10982 comprises a pair of distal links 10984 (one on each side of the elongate channel) and a pair of proximal links 10986 (one on each side of the elongate channel). The distal link(s) 10984 is attached to the anvil 10920″ for pivotal travel about the anvil pivot axis APA as well as to the corresponding proximal link(s) 10986. The other end of the proximal link(s) is pivotally attached to the elongate channel 10910″. The closure linkage assembly 10982 is actuated by a slider pin or pins 10988 that are constrained to move axially either in the elongate channel or in a closure shuttle or other member (not shown) that is configured to move the pin(s) 10988 between a first position (FIG. 40) corresponding to an open position of the anvil 10920″ and a second position (FIG. 41) corresponding to the closed position of the anvil 10920″. As indicated, the closure linkage assembly 10982 could comprise a compound set of links. Such arrangement may have interactive surfaces that limit the rotation of one linkage with respect to the second linkage. In this manner, the closure of the anvil 10920″ for a given rate of angular rotation could induce first and second closure rate as well establish different mechanical advantages for closing the anvil. For example, a rapid rate of closure may be initially employed for an initial portion of the closure stroke of the closure actuator and then a slower rate of closure may be employed during the remaining portion of the closure stroke which may result in the application of increased closure forces to the anvil.



FIGS. 42 and 43 are diagrammatical depictions of an end effector 10900′ that employs alternative closure link arrangements. As can be seen in those Figures, a proximal end portion 10923′ end portion of an anvil 10920′ is pivotally coupled to the elongate channel 10910′ by proximal mounting links 10980. The proximal mounting links 10980 (only one is shown in the Figures) are pivotally attached to the elongate channel 10910′ for pivotal travel relative thereto about a lower pivot axis LPA. The proximal mounting links 10980 are also pivotally coupled to the proximal end portion 10923′ for pivotal travel relative thereto about an anvil pivot axis APA. The end effector 10900′ further includes a closure linkage assembly 10990 that comprises at least one distal link 10992 and one proximal link 10994. In other arrangements, the closure linkage assembly 10990 comprises a pair of distal links 10992 (one on each side of the elongate channel) and a pair of proximal links 10994 (one on each side of the elongate channel). The distal link(s) 10992 is attached to the anvil 10920′ for pivotal travel about the anvil pivot axis APA as well as to the corresponding proximal link(s) 10994. The other end of the proximal link(s) is pivotally attached to the elongate channel 10910′. The closure linkage assembly 10990 is actuated by a slider pin or pins 10988 that are constrained to move axially either in a corresponding slot in the elongate channel or in a closure shuttle or other member (not shown) configured to move the pin(s) 10988 between a first position (FIG. 42) corresponding to an open position of the anvil and a second position (FIG. 43) corresponding to the closed position of the anvil. The slider pin(s) 10988 is coupled to the proximal link(s) 10994. In the open state, the slider pin(s) 10988 is in the distal-most position (FIG. 42). To close the anvil 10920′, the slider pin(s) 10988 is moved in a proximal direction which pulls the proximal closure link(s) 10994 to the position shown in FIG. 43 wherein the distal closure link(s) 10992 pop over center to retain the anvil 10920′ in the closed state. The force vector during closure is provided by the proximal and distal closure links being in compression to thereby resist load generated by the tissue clamped in the end effector during closure.


Turning next to FIGS. 44-52, there is shown another surgical end effector 11000 that includes an anvil 11100 that is pivotally supported on an elongate channel 11010 that is configured to operably support a surgical staple cartridge (not shown) therein. This arrangement also employs two rotary actuation shafts—one for closure (i.e., moving the anvil and elongate channel between open and closed positions) and one for firing (i.e., axially moving a firing member) within the anvil and elongate channel. In the illustrated example, the anvil 11100 includes an elongate anvil body 11110 and an anvil mounting portion 11140. In one arrangement, for example, the anvil 11100 may be fabricated using various fabricating techniques described in U.S. patent application Ser. No. 16/105,101, entitled METHOD FOR FABRICATING SURGICAL STAPLER ANVILS, the entire disclosure of which is hereby incorporated by reference herein. A pair of anvil trunnions 11142 protrudes laterally from the anvil mounting portion 11140. Each anvil trunnion is pivotally supported in a corresponding trunnion cradle 11016 that is formed in a corresponding upstanding wall 11014 of a proximal end portion 11012 of the elongate channel 11010. See FIG. 44. The proximal end portion 11012 of the elongate channel 11010 may be pivotally coupled to an elongate shaft assembly 10200 of a surgical instrument 10010 of the type described herein, for example to facilitate articulation of the end effector 11000. In other arrangements, the elongate channel 11010 may not be capable of articulation. The anvil trunnions 11142 may be retained within their respective trunnion cradles 11016 by an anvil retainer (not shown) that may be similar in construction and operation to channel cap or anvil retainer 1290 that was described above.


In the illustrated example, the surgical end effector 11000 includes an anvil closure member 11200 and a firing member 11300 that are each independently controlled and axially movable. FIG. 47 illustrates one form of a closure member 11200 that may be employed. As can be seen in FIG. 47, the closure member 11200 includes a vertically extending closure body 11202 that has two bottom channel tabs 10204 laterally protruding therefrom. A portion of the closure body 11202 is configured to extend through a slot 11019 in a bottom surface 11018 of the elongate channel 11010 and channel tabs 11204 extend laterally outward to slidably engage the bottom of the channel 11010. Similarly, a pair of anvil engaging tabs 11206 protrude laterally from the top of the closure body 11202 to slidably engage the anvil 11100. The closure body 11202 includes a threaded through hole 11208 for threadably engaging a threaded portion 10712 of a rotatable closure drive shaft 10710 for axially driving the closure member 11200 in the various manners described herein.


As indicated above, the surgical end effector 11000 further includes an axially movable firing member 11300. FIG. 48 illustrates one form of a firing member 11300 that may be employed. As can be seen in FIG. 48, the firing member 11300 includes a vertically extending firing member body 11302 that has a tissue cutting surface 11303 as well as two bottom channel tabs 11304 laterally protruding therefrom. A portion of the firing member body 11302 is configured to extend through the slot 11019 in the bottom surface 11018 of the elongate channel 11010 and the channel tabs 11304 extend laterally outward to slidably engage the bottom of the channel 11010. See FIG. 45. Similarly, a pair of anvil engaging tabs 11306 protrudes laterally from the top of the firing member body 11302 to slidably engage the anvil 11100. The firing member body 11302 includes a threaded through hole 11308 for threadably engaging a threaded portion of a rotatable firing drive shaft such as a firing drive shaft 10610 described above. The distal firing shaft 10610 passes through an unthreaded clearance hole 11210 in the closure body 11202. See FIG. 47. The firing drive shaft 10610 extends axially down the elongate channel 11010 and is rotatably supported in a distal end portion thereof by a bearing (not shown) or other arrangement. Similarly, the closure drive shaft 10710 may extend axially down the elongate channel 11010 and to be rotatably supported in a distal end portion thereof by a bearing (not shown) or other arrangement. Thus, the firing member body 11302 similarly has an unthreaded clearance hole 11310 therethrough to accommodate the closure drive shaft 10710. It will be appreciated that in such arrangements, the closure drive shaft 10710 and the firing drive shaft 10610 may be supported in a vertical stacked arrangement so that they may be independently rotatable.



FIG. 46 illustrates one form of anvil 11100 with portions thereof shown in cross-section. The anvil mounting portion 11140 includes a central cross brace 11144 that serves to define an opening 11146 for accommodating the closure member 11200 therein when the closure member 11200 is in its proximal-most position which corresponds to an open position of the anvil 11100. As can be seen in FIG. 46, the anvil body 11110 defines an elongate slot 11112 for accommodating the firing member body 11302 and closure body 11202 therethrough. The firing member 11300 is located distal to the closure member 11200. The anvil engagement tabs 11306 on the firing member 11302 are configured to slidably engage corresponding first or lower ledges 11114 that are formed on each side of the slot 11112. As can be seen in FIGS. 49 and 50, the lower ledges 11114 taper slightly downward at their proximal ends to accommodate the anvil engagement tabs 11306 on the firing member 11300 when the anvil is pivoted to its open position. The anvil engagement tabs 11206 on the closure member 11200 are configured to slidably engage corresponding second or higher ledges 11116 that are formed on each side of the slot 11112. See FIG. 46. To open the anvil 11100, the closure drive shaft is rotated to threadably drive the closure member 11200 proximally into its proximal-most position (FIG. 49). When the closure member 11200 is in its proximal-most position, the anvil engagement tabs 11206 thereon apply a pivotal opening motion to the anvil 11100 to pivot the anvil open. The firing member 11300 is in its starting position so that the anvil engagement tabs 11306 of the firing member 11300 do not apply a closure motion to the anvil 11100.


To close the anvil 11100, the closure drive shaft 10710 is rotated in an opposite direction to distally advance the closure member 11200 into a closed position. The firing drive shaft 10610 may also be simultaneously rotated to distally advance the firing member 11300 into a starting position. When the closure member 11200 and the firing member 11300 are in those positions, the anvil 11100 is closed and the firing member 11300 is ready to be fired. Thus, assuming that an unspent surgical staple cartridge has been first operably supported in the elongate channel 11010 and the end effector 11000 was manipulated to capture the target tissue between the staple cartridge and the anvil, the user may close the anvil 11100 onto the tissue in the above described manner to ready the end effector to be fired. During this closing process, the firing drive shaft 10610 is rotated to drive the firing member 11300 distally into the clamped tissue to cut the tissue and cause the staples stored in the staple cartridge to be formed into the cut tissue on both sides of the cut. During this process, the closure member 11200 may also be driven distally to apply additional closure motions to the anvil 11100 and elongate channel 11010. Depending upon the amount of resistance experienced by the firing member 11300, for example, the closure member 11200 can be advanced with the firing member 11300, stop and then go again. The closure member 11200 may be advanced distally at a different rate from the firing member's rate of distal advancement. The distance DC between the closure member 11200 and the firing member 11300 may be controlled to balance the loads experienced during the firing process. See FIG. 52. For example, if the user wanted to decrease an amount of vertical load being experienced by the firing member 11300, the closure member 11200 could be moved closer to the firing member 11300 during advancement. The vertical loads experienced by the firing member 11300 may be increased by increasing the distance between the firing member 11300 and the closure member 11200.


Returning to FIGS. 47 and 48, the thickness t1 of the anvil engagement tabs 11206 on the closure member 11200 is greater than the thickness t2 of the anvil engagement tabs 11306 on the firing member 11300. In one arrangement, the length L1 of the anvil engagement tabs 11206 on the closure member 11200 is slightly less than the length L2 of the anvil engagement tabs 11306 on the firing member 11300. Likewise, the thickness t3 of the channel tabs 11204 on the closure member 11200 is greater than the thickness t4 of the channel tabs 11304 on the firing member 11300. In one arrangement, the length L1 of the channel tabs 11204 on the closure member 11200 are shorter than the length L3 of the channel tabs 11304 on the firing member 11300. In both cases, the diameters d1 of the threaded holes 11208, 11308 may be greater than the diameters d2 of the unthreaded through holes 11210, 11310. In addition, the relative attack angles between the anvil engagement tabs 11206, 11306 and their corresponding anvil ledges and the channel tabs 11204, 11304 and their corresponding channel ledges may be varied, the same or different. In one arrangement, the anvil engagement tabs 11306 on the firing member 11300 are arranged at a slightly higher attack angle relative to their corresponding anvil ledges than the attack angle of the anvil engagement tabs 11206 on the closure member 11200. In one arrangement, the channel tabs 11204 and 11304 ride on the same ledges that are formed in the bottom of the elongate channel 11010. See FIG. 45. The closure member 11200 and the firing member 11300 have separate acting paths which can permit the closure member to be designed to accommodate larger moment arms from the anvil pivot for better firing efficiency.


One advantage that may be experienced when using the foregoing configuration is that the closure member 11200 can be moved away from the firing member 11300 to gain a significant amount of mechanical advantage during closure. The closure member 11200 does not need to travel the complete length of the firing stroke. For example, if the closure member 11200 were to be advanced about half way down the end effector, the relative stiffness of the anvil 11100 would reduce the amount of load being encountered by the firing member 11300. A control system employing sensors (e.g., strain gauges, etc.) for detecting amounts of loads being experienced by the firing system components and closure system components, as well as algorithms, can be used to balance the loads being encountered by both systems. For example, a maximum threshold of vertical load experienced by the firing member 11300 can be set in the controller based on the geometry and composition of that firing member component. When the load approaches that threshold, the algorithm can automatically advance the closure member 11200 so that it absorbs more of the load and reduces the amount of load being experienced by the firing member 11300. In various aspects, as the firing member 11300 is distally driven through the surgical staple cartridge, the firing member 11300, through the engagement of the anvil engagement tabs 11306 with the anvil 11100 and the engagement of the channel engagement tabs 11304 with the channel 11010, may serve to maintain a desired amount of tissue gap between a deck surface on the staple cartridge and a staple forming undersurface on the anvil 11100. Other closure control methods may also be employed in connection with opening and closing the surgical end effector 11000 such as those disclosed in U.S. patent application Ser. No. 16/105,081, entitled METHOD FOR OPERATING A POWERED ARTICULATABLE SURGICAL INSTRUMENT, the entire disclosure of which is hereby incorporated by reference herein.



FIG. 53 depicts a surgical instrument 12000 that may be used to cut and staple tissue. The instrument comprises a housing 12010 that comprises a handle 12012 that is configured to be grasped, manipulated and actuated by the clinician. As can be seen in FIG. 53, for example, the instrument 12000 includes a shaft assembly 12100 that has a surgical end effector 12200 operably coupled thereto that is configured to perform one or more surgical tasks or procedures. The shaft assembly 12100 comprises an interchangeable shaft assembly that is intended to be removably couplable to the handle assembly 12012 in the various manners disclosed herein. However, in other arrangements, the shaft assembly 12100 may comprise a dedicated shaft assembly that is not intended to be removed from the handle 12012. In still other arrangements, the shaft assembly 12100 may be operably coupled to or operably interface with a robotic system that is capable of generating the rotary operating motions necessary to operate the surgical end effector in the various manners disclosed herein. Only those specific components necessary to understand the functions and operation of the shaft assembly 12100 will be discussed in further detail below.


In the illustrated example, the elongate shaft assembly 12100 includes an articulation joint 12120 that facilitates articulation of the surgical end effector 12200 about an articulation axis AA that is transverse to a longitudinal shaft axis LA. Other shaft assemblies, however, may not be capable of articulation. In the illustrated example, the shaft assembly 12100 comprises a proximal outer shaft tube or member 12110 that extends distally from a nozzle assembly 12014 as will be discussed in further detail below, the surgical end effector 12200 is operably attached to an end cap attachment feature 12400. In one arrangement, the end cap attachment feature 12400 comprises a tubular shape body 12402 that is similar in size to the proximal outer shaft tube 12110 and is coupled to the distal end 12112 of the proximal outer shaft tube 12110 to form an articulation joint 12120. The shaft assembly 12100 may also include an internal spine member (not shown) that is pivotally coupled to the end cap 12400. A proximal end of the internal spine member may be rotatably coupled to a chassis (not shown) within the nozzle assembly 12014 in the various manners disclosed herein, for example.


In the illustrated example, the surgical end effector 12200 is selectively articulatable about the articulation axis AA by an articulation system 12030. In one form, the articulation system 12030 includes an articulation motor 12032 that is operably supported in the nozzle assembly 12014, for example. See FIG. 54. In other examples, the articulation motor may be operably supported in the housing or handle or other portion of a robotic system. Referring to FIG. 54, the articulation motor 12032 is coupled to an articulation drive gear 12034 that is in meshing engagement with a drive gear rack 12036 that is attached to or otherwise formed in a proximal articulation driver 12038. A distal end of the proximal articulation driver 12038 is pivotally coupled to a distal articulation link (not shown) that spans the articulation joint and is coupled to the end cap 12400. Operation of the articulation motor 12032 will cause axial movement of the proximal articulation driver 12038. Axial movement of proximal articulation driver 12038 will apply articulation motions to the end cap 12400 and an elongate channel 12210 attached thereto to thereby cause the surgical end effector 12200 to articulate about the articulation axis AA relative to the shaft assembly 12100. Other articulation systems and arrangements may be employed in the various manners disclosed herein or in other embodiments, the surgical end effector may not be articulatable.


The surgical end effector 12200 further includes an anvil 12300 that is selectively pivotable relative to the elongate channel 12210 between open and closed configurations by a closure system 12500. In one arrangement, for example, the anvil 12300 may be fabricated using various fabricating techniques described in U.S. patent application Ser. No. 16/105,101, entitled METHOD FOR FABRICATING SURGICAL STAPLER ANVILS, the entire disclosure of which is hereby incorporated by reference herein. In at least one arrangement, the surgical end effector 12200 also includes a firing member 12620 that is axially movable within the surgical end effector 12200 between a starting position and an ending position. See FIG. 55. As will be discussed in further detail below, the firing member 12620 may be configured to sever tissue that is clamped between the anvil 12300 and a surgical staple cartridge 12700 that is operably supported in the elongate channel 12210. In one arrangement, the staple cartridge 12700 includes lines of surgical staples or fasteners (not shown) that are operably supported on corresponding drivers (not shown) that are movably supported in the cartridge. As the firing member 12620 is driven distally, the firing member 12620 cooperates with a sled or camming assembly (not shown) that is supported in the staple cartridge 12700 that serves to cam the drivers in a direction toward the closed anvil 12300 which causes the staples or fasteners supported thereon to pierce through the clamped tissue into forming contact with the underside of the closed anvil. Once the firing member 12620 has been distally advanced from its proximal starting position to its ending position within the end effector 12200, it may be retracted back to its starting position to permit the anvil 12300 to be opened to facilitate removal of the cut/stapled tissue from the end effector 12200. In other arrangements, the firing member 12620 may be left at the ending position wherein it is permitted to disengage from the anvil to facilitate opening of the anvil.


In at least one arrangement, the surgical instrument 12000 also employs a firing system 12600 that is configured to apply rotary drive motions to the firing member 12620 to drive the firing member between the starting and ending positions. In the example depicted in FIG. 54, the firing system 12600 includes a firing motor 12602 that is operably supported in the nozzle assembly 12014, for example. In other examples, the firing motor 12602 may be operably supported in the housing or handle or other portion of a robotic system. The firing motor 12602 is coupled to a firing drive gear 12604 that is in meshing engagement with a driven gear 12606 that is attached to or otherwise formed in rotary firing drive shaft 12610. The firing drive shaft 12610 may be flexible to permit articulation of the surgical end effector 12200 in the manner described above. As can be seen in FIG. 55, the firing member 12620 comprises a body portion 12622 that includes two downwardly extending hollow mounting portions 12624 that are unthreaded and spaced from each other to receive a threaded drive nut 12630 therebetween. The threaded drive nut 12630 is threaded onto a threaded portion 12612 of the rotary firing drive shaft 12610. A distal end 12614 of the rotary firing drive shaft 12610 may be configured to be rotatably supported in a bearing (not shown) housed within the elongate channel to rotatably support the rotary firing drive shaft 12610 therein. The drive nut 12630 includes a vertical tab portion 12632 that is sized to extend through an axial slot 12216 in the bottom surface 12211 of the elongate channel 12210. See FIG. 62. Two laterally extending retention flanges 12634 are formed on the vertical tab portion 12632 to slidably engage the bottom surface 12211 of the elongate channel 12210. In addition, two laterally extending anvil engagement tabs 12628 are formed on the top of the body portion 12622 of the firing member 12620 and are configured to engage the anvil 12300 as the firing member 12620 is axially moved within the end effector. The threaded drive nut 12630 is threaded onto a threaded portion 12612 of the rotary firing drive shaft 12610. A distal end of the rotary firing drive shaft 12610 may be configured to be rotatably supported in a bearing (not shown) housed within the elongate channel 12210 to rotatably support the rotary firing drive shaft 12610 therein. In various aspects, as the firing member 12620 is distally driven through the surgical staple cartridge 12700, the firing member 12620, through the engagement of the anvil engagement tabs 12628 with the anvil 12300 and the engagement of the laterally extending retention flanges 12634 with the channel 12210, may serve to maintain a desired amount of tissue gap between a deck surface 12702 on the staple cartridge 12700 and a staple forming undersurface 12307 on the anvil 12300. See FIG. 53.


In the illustrated example, in addition, to a rotary driven firing system 12600, the surgical instrument 12000 also includes a rotary driven closure system 12500 that is configured to apply rotary closure motions to the anvil 12300. As can be seen in FIG. 54, for example, in one arrangement, the rotary driven closure system 12500 comprises a closure motor 12502 that is operably supported in the nozzle assembly 12014, for example. In other examples, the closure motor 12502 may be operably supported in the housing or handle or other portion of a robotic system. The closure motor 12502 is coupled to a closure drive gear 12504 that is in meshing engagement with a driven gear 12506 that is attached to or otherwise formed in rotary closure drive shaft 12510. The closure drive shaft 12510 may be flexible to permit articulation of the surgical end effector 12200 in the manner described above.


As can be seen in FIG. 56, the anvil 12300 includes a proximally protruding anvil mounting tab 12310 that is configured to be pivotally coupled to a corresponding pivot lug portion 12404 of the end cap 12400. For example, the pivot lug portion 12404 is formed on a first or right side of the endcap centerline ECL and a corresponding anvil mounting portion 12312 of the anvil mounting tab 12310 is formed on a second or left side of the anvil centerline ACL that corresponds to (aligned with) the endcap centerline ECL when the two components are coupled together. When the anvil 12300 is movably coupled to the end cap 12400, the anvil centerline ACL and the endcap centerline ECL are aligned along an end effector axis or end effector center plane ECP that extends axially through a center of the end effector 12200. Stated another way, the end effector center plane ECP bisects the end effector 12200. See FIGS. 60 and 61. In one aspect, the pivot lug portion 12404 comprises a vertically extending pivot lug attachment face 12405 that is adapted to slidably confront a vertically extending anvil attachment face 12317 formed on a central portion 12316 of the anvil mounting tab 12310. Still referring to FIG. 56, the proximal end 12314 of the anvil mounting tab 12310 is laterally wider than the central portion 12316. When the anvil 12300 is attached to the end cap 12400, the proximal end portion 12314 of the anvil mounting tab 12310 is proximal to the pivot lug portion 12404 and the pivot lug attachment face 12405 and the vertically extending anvil attachment face 12317 movably confront each other along the centrally disposed end effector central plane ECP. See FIG. 60. In the illustrated arrangement, an upper surface 12303 of an anvil body portion 12302 of the anvil 12300 and the anvil mounting portion 12312 of the anvil mounting tab 12310 are rounded to match or at least approximately match the radius of the end cap 12400 to facilitate easy insertion of the surgical end effector and elongate shaft through a trocar, for example.


In one aspect, the anvil 12300 is pivotally coupled to the end cap 12400 by a rivet 12370 that extends through a passage 12360 in the anvil mounting portion 12312 of the anvil mounting tab 12310 and a corresponding passage 12406 in the pivot lug portion 12404 of the end cap 12400. In at least one arrangement, the rivet 12370 comprises a solid core rivet with a shank 12372 having diameter of, for example, 0.05″-0.1″ with an orbit formed head 12374 on one end and a machined end 12376 formed on the other end. See FIG. 57. The rivet 12370 may be installed such that it may maintain a final formed height that would ensure intimate contact between the anvil mounting portion 12312 and the pivot lug portion 12404. The orbit formed rivet head 12374 would swell the rivet shank 12372 on that side of the anvil 12300 or end cap 12400 preventing the rivet 12370 from rotating with respect to that component while the machined end 12376 would not have a swelled shank allowing the adjacent part to rotate with respect to the rivet 12370 and the other part (anvil mounting portion 12312 or pivot lug portion 12404). In the example illustrated in FIG. 57, the end of the rivet 12370 that is adjacent to the anvil mounting portion 12312 is orbit formed so that part of the rivet 12370 does not rotate relative to the anvil mounting portion 12312 and the part of the rivet 12370 extending through the end cap 12400 is free to rotate allowing the anvil 12300 to freely pivot relative to the pivot lug portion 12404. As can be seen in FIG. 57, the rivet shank 12372 has a predefined final form length RL that is sized to facilitate such rotational travel. Also, as can be seen in FIG. 56, in one arrangement for example, the end cap 12400 may have a length EL of approximately 0.675″. The anvil body 12302 may also be formed with downwardly extending tissue stop members 12305 that are configured to prevent the clamped tissue from extending proximally beyond the proximal-most staples or fasteners in a staple cartridge 12700 that is seated in the elongate channel 12210. In the illustrated example, the tissue stops 12305 may have a stop length SL of approximately 0.400″ and the distance PSD from a distal end of each tissue stop 12305 to the centerline of the passage 12360 is approximately 0.500″. This distance may correspond to the distance from the proximal-most staples or fasteners to the pivot axis PA about which the anvil 12300 pivots relative to the endcap 12400.


As can be seen in FIG. 58, a pair of channel attachment tabs 12214 protrude from a proximal end 12212 of the elongate channel 12210. The channel attachment tabs 12214 are configured to be seated in corresponding grooves 12408 in the endcap 12400. See FIG. 60. The tabs 12214 may be welded, glued, pinned etc. to the end cap 12400.


Turning now to FIGS. 55 and 59-61, the rotary driven closure system 12500 also comprises an axially movable closure shuttle 12520 that is in threaded engagement with a threaded portion 12512 of the closure drive shaft 12510. In the illustrated arrangement, the closure shuttle 12520 comprises a shuttle base portion 12522 that extends through a proximal cap slot 12410 formed in the bottom of the end cap 12400. A lateral flange 12524 extends laterally from each side of the shuttle base portion 12522 to slidably engage the bottom of the end cap 12400. See FIG. 55. As can be further seen in FIG. 55, the closure drive shaft 12510 is hollow to permit the firing drive shaft 12610 to concentrically extend therethrough. Thus, rotation of the closure drive shaft 12510 in a first rotary direction will cause the closure shuttle 12520 to move distally and rotation of the closure drive shaft 12510 in an opposite rotary direction will cause the closure shuttle 12520 to move in a proximal direction.


In the illustrated example, the axial movement of the closure shuttle 12520 is transferred to the anvil 12300 by a pivoting closure linkage assembly 12530. In one arrangement, the closure linkage assembly 12530 includes a first pivot arm 12540 and a second pivot arm 12550 that are each pivotally attached to the proximal end portion 12314 of the anvil mounting tab 12310 and suspended therefrom. As can be seen in FIG. 61, for example, the first pivot arm 12540 and the second pivot arm 12550 may be pivotally coupled to the proximal end portion 12314 of the anvil mounting tab 12310 by a pivot pin 12560 that defines a common proximal pivot axis PPA about which the pivot arms 12540 and 12550 can pivot. The first pivot arm 12540 comprises a first free end 12542 that is wider than the remaining portion of the first pivot arm 12540 and is configured to be movably and drivably engaged in a first drive groove 12526 in the closure shuttle base portion 12522. See FIG. 61. The first pivot arm 12540 is coupled to the anvil mounting tab 12310 at a first point FP that is located a first pivot arm distance FPD from the end effector center plane ECP. Likewise, the second pivot arm 12550 comprises a second free end 12552 that is wider than the remaining portion of the second pivot arm 12550 and is configured to be movably and drivably engaged in a second drive groove 12528 in the closure shuttle base portion 12522. The second pivot arm 12550 is coupled to the anvil mounting tab 12310 at a second point SP that is located a second pivot arm distance SPD from the end effector center plane ECP. In the illustrated arrangement the closure system is asymmetrically coupled to the anvil 12300. For example, as can be seen in FIG. 61, SPD>FPD. When the closure shuttle 12520 is driven in the distal direction DD, the pivot arms 12540 and 12550 by virtue of their engagement with the closure shuttle 12520 are caused to pivot in a first direction (clockwise CW in FIG. 59) which causes a pivotal opening motion to be applied to the anvil mounting tab 12310 to pivot the anvil 12300 about the pivot axis PA relative to the end cap 12400 to an open position. When the closure shuttle 12520 is axially moved in a proximal direction PD, the pivot arms 12540, 12550 pivot in a second direction (counterclockwise CCW in FIG. 59) which causes a closure motion to be applied to the anvil mounting tab 12310 to pivot the anvil 12300 about the pivot axis PA relative to the end cap 12400 to a closed position (FIG. 59). The larger free end portions 12542, 12552 of the pivot arms 12540, 12550, respectively are more robust than the remaining portions of the pivot arms to better distribute the closure forces through the pivot arms.



FIG. 63 depicts a surgical instrument 13000 that may be used to cut and staple tissue. The instrument includes a housing 13010 that comprises a handle 13012 that is configured to be grasped, manipulated and actuated by the clinician. As can be seen in FIG. 63, for example, the instrument 13000 includes a shaft assembly 13100 that has a surgical end effector 13200 operably coupled thereto that is configured to cut and staple tissue. As will be discussed in further detail below, for example, the surgical end effector 13200 comprises an elongated channel 13210 that is configured to operably support a replaceable surgical staple cartridge 13700 therein and an anvil 13300 that is movably supported relative thereto for movement between open and closed positions. The shaft assembly 13100 comprises an interchangeable shaft assembly that is intended to be removably couplable to the handle assembly 13012 in the various manners disclosed herein. However, in other arrangements, the shaft assembly 13100 may comprise a dedicated shaft assembly that is not intended to be removed from the handle 13012. In still other arrangements, the shaft assembly 13100 may be operably coupled to or operably interface with a robotic system that is capable of generating the rotary operating motions necessary to operate the surgical end effector in the various manners disclosed herein. Only those specific components necessary to understand the functions and operation of the shaft assembly 13100 will be discussed in further detail below.


In the illustrated example, the shaft assembly 13100 includes an articulation joint 13120 that facilitates articulation of the surgical end effector 13200 about an articulation axis AA that is transverse to a longitudinal shaft axis LA. Other shaft assemblies, however, may not be capable of articulation. In accordance with one aspect, the shaft assembly 13100 comprises a proximal outer shaft tube or member 13110 that extends distally from a nozzle assembly 13014 as will be discussed in further detail below, the surgical end effector 13200 is operably attached to an end cap attachment feature 13400. In one arrangement, the end cap attachment feature 13400 comprises a tubular shape body 13402 that is similar in size to the proximal outer shaft tube 13110 and is coupled to a distal end 13112 of the proximal outer shaft tube 13110 to form the articulation joint 13120. The end cap 13400 may also comprise a proximal portion of the elongate channel 13210. The shaft assembly 13100 may also include an internal spine member (not shown) that is pivotally coupled to the end cap 13400. A proximal end of the internal spine member may be rotatably coupled to a chassis (not shown) within the nozzle assembly 13014 in the various manners disclosed herein, for example.


In the illustrated example, the surgical end effector 13200 is selectively articulatable about the articulation axis AA by an articulation system 13030. In one form, the articulation system 13030 includes an articulation motor 13032 that is operably supported in the nozzle assembly 13014, for example. See FIG. 64. In other examples, the articulation motor may be operably supported in the housing or handle or other portion of a robotic system. Referring to FIG. 64, the articulation motor 13032 is coupled to an articulation drive gear 13034 that is in meshing engagement with a drive gear rack 13036 that is attached to or otherwise formed in a proximal articulation driver 13038. A distal end of the proximal articulation driver 13038 is pivotally coupled to a distal articulation link (not shown) that spans the articulation joint and is coupled to the end cap 13400. Operation of the articulation motor 13032 will cause axial movement of the proximal articulation driver 13038. Axial movement of proximal articulation driver 13038 will apply articulation motions to the end cap 13400 and the elongate channel 13210 attached thereto to thereby cause the surgical end effector 13200 to articulate about the articulation axis AA relative to the shaft assembly 13100. Other articulation systems and arrangements may be employed in the various manners disclosed herein. In other embodiments, the surgical end effector may not be articulatable.


As indicated above, the surgical end effector 13200 includes an anvil 13300 that is selectively movable relative to the elongate channel 13210 between open and closed configurations by a rotary driven closure system 13500. As can be seen in FIG. 64, in one arrangement, the rotary driven closure system 13500 comprises a closure motor 13502 that is operably supported in the nozzle assembly 13014, for example. In other examples, the closure motor 13502 may be operably supported in the housing or handle or other portion of a robotic system. The closure motor 13502 is coupled to a closure drive gear 13504 that is in meshing engagement with a driven gear 13506 that is attached to or otherwise formed in rotary closure drive shaft 13510. The closure drive shaft 13510 may be flexible to permit articulation of the surgical end effector 13200 in the manner described above.


As can be seen in FIG. 65, the anvil 13300 includes a proximally protruding anvil mounting tab 13310 that is configured to be pivotally coupled to a corresponding portion of the end cap 13400 by, for example, a rivet 13401 or other pivot arrangements disclosed herein. In the illustrated arrangement, the rotary driven closure system 13500 also comprises an axially movable closure shuttle 13520 that is in threaded engagement with a threaded distal closure shaft segment 13512 that is configured to be drivingly coupled the closure drive shaft 13510. In the illustrated arrangement, the closure shuttle 13520 comprises a shuttle base portion 13522 that extends through a proximal cap slot (not shown) that is formed in the bottom of the endcap 13400. A lateral flange (not shown) extends laterally from each side of the shuttle base portion 13522 to slidably engage the bottom of the endcap 13400 in the various manners disclosed herein. In one arrangement, for example, the anvil 13300 may be fabricated using various fabricating techniques described in U.S. patent application Ser. No. 16/105,101, entitled METHOD FOR FABRICATING SURGICAL STAPLER ANVILS, the entire disclosure of which is hereby incorporated by reference herein.


In the illustrated example, the axial movement of the closure shuttle 13520 is transferred to the anvil 13300 by a pivoting closure link assembly 13530. In one arrangement, the closure link assembly 13530 includes a pair of pivot arms 13540 (only one can be seen in FIG. 65) that are each pivotally attached to a proximal end portion 13314 of the anvil mounting tab 13310 and suspended therefrom. Each pivot arm 13540 comprises a free end 13542 that includes a notch 13544 that is configured to drivingly engage a corresponding drive groove 13526 in the closure shuttle base portion 13522. When the closure shuttle 13520 is driven in the distal direction DD, the pivot arms 13540, by virtue of their engagement with the closure shuttle 13520, pivot in a first direction to apply pivotal opening motion to the anvil mounting tab 13310. This opening motion causes the anvil 13300 to pivot to an open position. When the closure shuttle 13520 is axially moved in a proximal direction PD, the pivot arms 13540 pivot in a second direction which causes a pivot closure motion to be applied to the anvil mounting tab 13310 and pivot the anvil 13300 to a closed position.


As also indicated above, the surgical end effector 13200 is configured to operably support a replaceable surgical staple cartridge 13700 therein. The staple cartridge 13700 includes an onboard firing member 13820 that is configured to be rotatably driven between a starting and ending position within the staple cartridge 13700. The firing member 13820 comprises a vertically extending firing member body 13822 that has a tissue cutting surface 13824 formed thereon or attached thereto. A pair of channel engagement tabs 13826 extend laterally from the bottom of the firing member body 13822 and a pair of anvil engagement tabs 13828 extend from the top portion of the firing member body 13822 such that the firing member 13820 resembles an I-beam configuration when viewed from an end thereof. As can be seen in FIG. 66, in the illustrated example, the surgical staple cartridge 13700 comprises an elongate cartridge body 13702 that includes a deck surface 13707. The cartridge body 13702 further comprises a centrally disposed elongate cartridge slot 13704 that is configured to accommodate the axial travel of the firing member 13820 therein. Also in the illustrated example, three lines of surgical staple pockets 13706 are formed on each side of the elongate slot 13704 and open through the deck surface 13707. Each staple pocket 13706 may have a staple driver (not shown) associated therewith that supports a surgical staple or fastener (not shown) thereon.


As can be seen in FIG. 65, the cartridge body 13702 operably supports an onboard rotary firing drive shaft 13710. The firing drive shaft 13710 includes a proximal thread segment 13712, an unthreaded segment 13714 and a distal thread segment 13716 that extends from the unthreaded segment 13714 to an unthreaded distal end 13718. The unthreaded distal end 13718 of the firing drive shaft 13710 is rotatably supported in a distal bearing 13720 that is supported in a distal end 13703 of the cartridge body 13702. In the illustrated example, the firing member body 13822 is threaded onto the proximal thread segment 13712 when in a proximal-most, “loading position”. As can be seen in FIG. 66, a safety garage 13732 is formed on a proximal end 13730 of the cartridge body 13702 such that the tissue cutting surface 13824 is protected thereby (unexposed) when the firing member 13820 is in the loading position. When the firing member 13820 is in the loading position, the bottom of the firing member body 13822 is configured to extend through a loading opening 13214 in the bottom 13212 of the elongate channel 13210 during installation of the cartridge 13700 into the elongate channel 13210. As can be seen in FIG. 67, a channel slot 13216 is provided in the bottom 13212 of the elongate channel 13210 and extends distally from the loading opening 13214. When the staple cartridge 13700 is operably seated in the elongate channel 13210, the bottom portion of the firing member 13820 protrudes through the loading opening 13214 such that when the firing member 13820 is advanced distally, the firing member body 13822 is aligned with the channel slot 13216 and the channel engagement tabs 13826 are positioned to slidably engage the bottom 13212 of the elongate channel 13210 on each side of the channel slot 13216.


In one example, at least one C-shaped clip 13890 may be journaled within the cartridge body 13702 such that a center portion 13892 of the clip 13890 extends through the elongate cartridge slot 13704 in the cartridge body 13702 such that an upper leg 13894 of the clip 13890 rides on an inside surface or ledge 13708 in the cartridge body 13702 adjacent the cartridge slot 13704. A lower leg 13896 of the clip 13890 rides on a bottom surface 13213 of the channel bottom 13212 as shown in FIG. 68. When the cartridge 13700 is initially installed, the C-shaped clip(s) 13890 may be positioned proximally of the elongate channel slot 13216 such that the cartridge 13700 may be properly seated therein. When the firing member 13820 is distally advanced, the C-shaped clip(s) 13890 is advanced distally down the aligned cartridge slot 13704 and channel slot 13216 to provide additional stabilization of the cartridge 13700 during the firing operation.


As can also be seen in FIG. 67, in at least one arrangement, at least one cartridge locator member 13722 is formed on or otherwise attached to the cartridge body 13702 and is located and sized to be seated in a corresponding notch 13218 or other mating feature formed in the elongate channel 13210 to ensure that the cartridge 13700 is properly seated in the elongate channel 13210 during installation. In one example, locator members 13722 are formed on each lateral side of the cartridge body 13702. Also in the illustrated example, a drive shaft support cradle 13222 is formed on a distal end 13220 of the channel 13210 and is configured to rotatably cradle the unthreaded distal end 13718 of the firing drive shaft 13710 (proximal to the support bearing 13720). See FIG. 65.


Returning to FIG. 64, the surgical instrument 13000 also employs a rotary driven firing system 13800 that is configured to apply rotary drive motions to the firing member 13820 to drive the firing member 13820 between the starting and ending positions within the staple cartridge 13700. In the example depicted in FIG. 64, the rotary driven firing system 13800 includes a firing motor 13802 that is operably supported in the nozzle assembly 13014. In other examples, the firing motor 13802 may be operably supported in the housing or handle or other portion of a robotic system. The firing motor 13802 is coupled to a firing drive gear 13804 that is in meshing engagement with a driven gear 13806 that is attached to or otherwise formed in rotary firing drive shaft 13810. The firing drive shaft 13810 may be flexible to permit articulation of the surgical end effector 13200 in the manner described above. As can be seen in FIGS. 65 and 67, the firing drive shaft 13810 extends through the hollow distal closure shaft segment 13512 that is configured to be drivingly coupled to the closure drive shaft 13510 and has a drive coupler 13812 attached thereto. In one arrangement, the drive coupler 13812 comprises a female drive socket 13814 that is configured to drivably receive a corresponding male coupler 13724 on the firing drive shaft 13710. When the male coupler 13724 is brought into driving engagement with the female drive socket 13814, rotation of the firing drive shaft 13810 will result in rotation of the firing drive shaft 13710 in the surgical staple cartridge 13700.



FIG. 65 illustrates the firing member 13820 in the loading position. When in that position, the firing member 13820 may abut a collar portion 13726 of the male coupler 13724. As can also be seen in FIG. 65, the staple cartridge 13700 also includes a sled or camming assembly 13740 that is movably supported in the staple cartridge 13700. The camming assembly 13740 is threadably journaled on the firing drive shaft 13710 by a series of internal threads 13742. As can be seen in FIG. 65, when the firing member 13820 is in the loading position, the internal threads 13742 in the camming assembly 13740 are located on the unthreaded segment 13714 of the firing drive shaft 13710.


The illustrated example also employs an anvil lockout assembly 13900 that is configured to prevent the closure of the anvil 13300 until the cartridge 13700 has been properly seated in the elongate channel 13210. In one arrangement, the anvil lockout assembly 13900 comprises an anvil lockout member 13910 that is movably supported in the elongate channel 13210. Turning to FIGS. 69 and 70, in one arrangement, the anvil lockout member 13910 comprises a clip body 13912 that has a distal spring tab 13914 protruding laterally from a distal end thereof and a proximal key tab 13916 protruding laterally from an opposite lateral side of the clip body 13912. The clip body 13912 further includes a vertically extending lock tab 13918 that protrudes upward from the clip body 13912. As can be seen in FIGS. 69 and 70, the lockout member 13910 is axially movable between a distal locking position LP and a proximal unlocked position ULP. A lock spring 13920 is provided between a channel lug 13230 and the distal spring tab 13914 to bias the lockout member 13910 distally into the locked position LP. FIGS. 65 and 69 illustrate the anvil lockout assembly 13900 in the locked position LP. As can be seen in FIGS. 65 and 69, the vertically extending lock tab 13918 is vertically aligned with an anvil lockout protrusion 13930 formed on the anvil 13300. Thus, when the anvil lockout assembly 13900 is in the locked position, the user cannot move the anvil 13300 to the closed position.


In the illustrated arrangement, the cartridge body 13702 includes a key member 13760 that is configured to move the lockout member 13910 from the locked position LP to the unlocked position ULP when the cartridge 13700 has been properly seated within the elongate channel 13210. In one example, the key member 13760 comprises a proximally extending fin 13762 that is configured to contact the proximal key tab 13916 on the clip body 13912. When the cartridge 13700 has been operably seated in the elongate channel 13210, the fin 13762 moves the lockout member 13910 proximally from the locked position LP to the unlocked position ULP.


As can be seen in FIG. 71, the firing member 13820 may also be equipped with an onboard firing member lockout assembly 13840 that comprises a lockout member 13842 that is pivotally coupled to the firing member body 13822 by pivot pins 13846. The lockout member 13842 includes a sled latch 13848 that is configured to be engaged by the camming assembly 13740 when the camming assembly 13740 is in an unfired position. As can be seen in FIG. 71, the camming assembly 13740 includes a firing member ledge 13741 that is configured to engage the sled latch 13848 on the lockout member 13482. A lockout spring 13850 is mounted in the elongate channel 13210 and is configured to bias the lockout member 13842 downward such that if the camming assembly 13740 is not in its unfired position, a distal edge 13849 of the lockout member 13842 engages a distal edge of the loading opening 13214. When in that position, should the user inadvertently attempt to distally advance the firing member 13820, the lockout member 13842 contacts the distal edge of the loading opening 13214 to prevent the distal advancement of the firing member 13820.



FIGS. 65 and 67 illustrate insertion of a fresh, unfired staple cartridge 13700 into the end effector 13200. As the user inserts the cartridge 13700 into the channel 13210, the male coupler 13724 is inserted into the female coupler 13812 and the cartridge body 13702 is seated in the channel 13210 as shown in FIG. 72. When in that position, the fin 13762 biases the lockout member 13910 into an unlocked position. The user may then move the anvil 13300 to a closed position by activating the closure drive system 13500 (FIG. 64) to rotate the closure drive shaft 13510 in a first rotary direction to drive the closure shuttle 13520 in a proximal direction PD. Once the closure shuttle 13520 has moved the anvil 13300 to the closed position, the user may then activate the firing system 13800. As can also be seen in FIG. 72, the camming assembly 13740 has pivoted the firing member lockout member 13842 into an unlocked position. As the firing drive shaft 13810 is rotated in a first rotary direction, the proximal threaded segment 13712 of the cartridge firing drive shaft 13710 drives the firing member 13820 distally (distal direction DD). As the firing member 13820 moves distally, the camming assembly 13740 is urged into threaded engagement with the distal thread segment 13716 of the cartridge firing drive shaft 13710. Continued rotation of the cartridge firing drive shaft 13710 causes the firing member 13820 and the camming assembly 13740 to move distally to their respective ending positions. As the camming assembly 13740 is driven distally, the camming portions thereon drive the drivers that are supported in the staple cartridge 13700 toward the closed anvil 13300 such that the staples or fasteners supported thereon are forced through the tissue that is clamped between the anvil 13300 and the cartridge 13700 and into forming contact with the underside of the anvil 13300. The firing member 13820 is proximal to the camming assembly 13740 so that the tissue cutting surface thereon 13824 cuts the clamped tissue after it has been stapled. In various aspects, as the firing member 13820 is distally driven through the surgical staple cartridge 13700, the firing member 13820, through the engagement of the anvil engagement tabs 13828 with the anvil 13300 and the engagement of the channel engagement tabs 13826 with the channel 13210, may serve to maintain a desired amount of tissue gap between the deck surface 13707 on the staple cartridge 13700 and a staple forming undersurface 13302 on the anvil 13300. Once the camming assembly 13740 and firing member 13820 have reached their ending positions, the firing drive shaft 13810 may be rotated in a reverse rotary direction to drive the firing member 13820 and camming assembly 13740 back to their respective starting positions. Once the firing member 13820 has returned to the starting position, the closure drive shaft 13510 may be rotated in a second rotary direction to drive the closure shuttle 13520 in a distal direction DD to pivot the anvil 13300 to the open position (FIG. 72) to enable to the stapled tissue to be unclamped from the end effector 13200. In the example that includes the C-shaped clip(s) 13890, the clips are also driven distally by the camming assembly 13740 and/or firing member 13820 until the clip(s) 13890 reach an ending position wherein the lower leg(s) 13896 thereof are located in an opening (not shown) in the channel bottom 13212 to enable the spent cartridge 13700 to be removed from the elongate channel 13210.



FIGS. 73-80 depict another surgical end effector 14200 that is employed with a surgical instrument 14000 that is very similar to instrument 13000 described above. The surgical end effector 14200 is somewhat similar to end effector 13200 described above, except for the differences discussed below. At least some of the components of surgical instrument 14000 that are identical to the components of surgical instrument 13000 are set forth herein with like element numbers. The surgical end effector 14200 comprises an elongate channel 14210 that is configured to operably support a replaceable surgical staple cartridge 14700 therein. The surgical end effector 14200 further includes an anvil 14300 that is selectively pivotable relative to the elongate channel 14210 between open and closed configurations by the rotary driven closure system 13500 (FIG. 64). As can be seen in FIGS. 73 and 74, the anvil 14300 includes a proximally protruding anvil mounting tab 14310 that is configured to be pivotally coupled to a corresponding portion of an end cap 14400 that is either attached to or comprises a portion of the elongate channel 14210. The anvil mounting tab 14310 is attached to the end cap 14400 by, for example, a rivet 14401 or other pivot arrangements disclosed herein. The end effector 14200 also employs the rotary driven closure system 13500 described above. In one arrangement, for example, the anvil 14300 may be fabricated using various fabricating techniques described in U.S. patent application Ser. No. 16/105,101, entitled METHOD FOR FABRICATING SURGICAL STAPLER ANVILS, the entire disclosure of which is hereby incorporated by reference herein.


As was discussed above, the rotary driven closure system 13500 comprises an axially movable closure shuttle 13520 that is threaded onto a threaded distal closure shaft segment 13512 that is configured to be drivingly coupled the closure drive shaft 13510 (FIG. 64). In the illustrated arrangement, the closure shuttle 13520 comprises a shuttle base portion 13522 that extends through a proximal cap slot (not shown) that is formed in the bottom of the end cap 14400. A lateral flange (not shown) extends laterally from each side of the shuttle base portion 13522 to slidably engage the bottom of the end cap 14400 in the various manners disclosed herein.


In the illustrated example, the axial movement of the closure shuttle 13520 is transferred to the anvil 14300 by a pivoting closure link assembly 13530. In one arrangement, the closure link assembly 13530 includes a pair of pivot arms 13540 (only one can be seen in FIGS. 73 and 74) that are each pivotally attached to a proximal end portion 14314 of the anvil mounting tab 14310 and suspended therefrom. Each pivot arm 13540 comprises a free end 13542 that includes a notch 13544 that is configured to drivingly engage a corresponding drive groove 13526 in the closure shuttle base portion 13522. When the closure shuttle 13520 is driven in the distal direction DD, the pivot arms 13540, by virtue of their engagement with the closure shuttle 13520, apply a pivotal opening motion to the anvil mounting tab 14310 to pivot the anvil 14300 to an open position (FIG. 73). When the closure shuttle 13520 is axially moved in a proximal direction PD, the pivot arms 13540 pivot in a second direction which causes a pivot closure motion to be applied to the anvil mounting tab 13310 to pivot the anvil 13300 to a closed position (FIG. 80).


Unlike the surgical end effector 13200 wherein the firing member 13820 is contained within the replaceable surgical staple cartridge 13700, the surgical end effector 14200 employs a dedicated firing member 14820 that is permanently journaled on the rotary firing drive shaft 13810. In the illustrated example, the rotary firing drive shaft 13810 and the threaded distal closure shaft segment 13512 are rotatably supported in the elongate channel 14210. As will be discussed in further detail below, a portion of the rotary firing drive shaft 13810 that is distal to the threaded distal closure shaft segment 13512 includes a proximal threaded segment 13811, an unthreaded segment 13815, and a distal threaded segment 13817.



FIG. 75 illustrates one form of a firing member 14820 that may be employed with the end effector 14200. As can be seen in FIG. 75, the firing member 14820 comprises a body portion 14822 that includes two downwardly extending hollow mounting portions 14824 that are unthreaded and spaced from each other to receive a threaded drive nut 14830 therebetween. The threaded drive nut 14830 is configured to threadably engage the threaded segments 13811, 13817 of the rotary firing drive shaft 13810. The drive nut 14830 includes a vertical tab portion 14832 that is sized to extend through an axial slot 14216 in the bottom of the elongate channel 14210. Two laterally extending retention flanges 14834 are formed on the threaded drive nut 14830 and are configured to engage the bottom of the elongate channel 14210. In addition, two laterally extending anvil engagement tabs 14826 are formed on the top of the firing member body 14822 and are configured to engage the anvil 14300 as the firing member 14820 is axially moved within the end effector 14200. A tissue cutting surface 14828 is formed or attached to the firing member body 14822.


In this arrangement, the firing member 14820 includes a firing member lockout feature 14840 that is configured to prevent the distal advancement of the firing member 14820 from its starting position unless a fresh unfired staple cartridge has been properly seated in the elongate channel 14210. As can be seen in FIG. 75, in one example, the firing member lockout feature 14840 comprises a lockout body 14842 that has two spaced attachment legs 14844 protruding therefrom that extend around the mounting portions 14824 of the firing member body 14822. Each attachment leg 14844 includes an inwardly extending pivot pin 14846 that is adapted to be pivotally received in a corresponding slotted opening 14825 provided in the mounting portions 14824. The lockout feature 14840 further includes a sled latch 14848 that is configured for contact with a camming sled or assembly 14740 (FIG. 77) operably supported in a staple cartridge 14700.



FIGS. 76 and 77 illustrate the firing member 14820 in a proximal-most starting position. As can be seen in FIGS. 76 and 77, a firing lockout hole 14215 is provided through the bottom of the elongate channel 14210. A lockout spring 14850 is mounted in the elongate channel 14210 and is configured to bias the lockout feature 14840 downward such that, if a fresh unfired staple cartridge has not been properly loaded into the elongate channel 14210, a distal edge 14849 of the lockout body 14842 engages the angled distal edge 14217 of the firing lockout hole 14215. When in that position, should the user inadvertently attempt to distally advance the firing member 14820, the lockout feature 14840 prevents the distal advancement of the firing member 14820. As noted in FIG. 76, under high force “F2” the pins 14846 slide up their respective slot 14825. As the pins 14846 slide up their respective slots 14825, the proximal ends 14847 of the attachment legs 14844 engage a corresponding backstop wall 14827 that is formed on the mounting portions 14824 of the firing member body 14822 to reduce stress placed on the pivot pins 14846. See FIG. 76.


A fresh, unfired surgical staple cartridge 14700 contains a camming assembly 14740 that is located in a starting position that is proximal to the lines of staple drivers that are supported in the cartridge body. As used herein, the terms “fresh, unfired” means that the staple cartridge has all of its intended staples or fasteners in their respective unfired positions and the camming assembly is in a proximal unfired starting position. When a fresh, unfired surgical staple cartridge 14700 has been properly seated within the elongate channel 14210, a proximally extending unlocking portion 14742 on the camming assembly 14740 engages the sled latch 14848 on the lockout feature 14840 to pivot the lockout feature 14840 into an unlocked position wherein the lockout feature 14840 does not extend into the firing lockout hole 14215 in the elongate channel. FIG. 78 illustrates a camming assembly 14740 in the starting position. The remaining portions of the surgical staple cartridge 14700 have been omitted for clarity. As can be seen in FIG. 78, the camming assembly 14740 includes a segment of internal threads 14744 that has a length “a” that is less than the axial length “b” of the unthreaded portion 13815 on the rotary firing drive shaft 13810. The bottom 14746 of the camming assembly 14740 is open to enable the camming assembly 14740 to snap over the rotary firing drive shaft 13810 when the cartridge 14700 is seated in the elongate channel 14210.


In one example, the internal threads 14744 in the camming assembly 14740 are configured to only drive the camming assembly 14740 in the distal direction. For example, the internal threads 14744 may have a leading portion 14747 that is configured to facilitate threaded engagement with the threaded segment 13817 on the firing drive shaft 13810. However, the internal threads 14744 may have a trailing portion 14748 that is configured to prevent threaded engagement with the threads 13817 when the camming assembly 14740 has been driven to its ending position and the firing drive shaft 13810 is rotated in an opposite direction to drive the firing member 14820 back to the starting position. In FIGS. 79 and 80, the ending position of the camming assembly 14740 is illustrated in phantom lines. As can be seen in FIGS. 79 and 80, a distal portion 13819 of the firing drive shaft 13810 is devoid of threads. When the camming assembly 14740 has been distally driven into its ending position, the internal threads 14744 disengage the threaded segment 13817 of the firing drive shaft 13810. When the firing drive shaft 13810 is rotated in the opposite direction, the internal threads 14744 are designed to slip and not re-engage the threaded segment 13817 such that the camming assembly 14740 remains in the ending position within the staple cartridge 14700 as the firing member 14820 is retracted back to the starting position. Thus, once a staple cartridge 14700 has been spent (e.g., completely fired) the camming assembly 14740 is not returned to its starting position. Thus, if the spent cartridge were to be inadvertently re-installed in the end effector 14200, the camming assembly 14740 is not in position to unlock the lockout feature 14840. This condition may be assisted by interference with fallen staple drivers located within the cartridge body after the cartridge was fired. In addition, the internal threads 14744 may have a pitch diameter that is larger than a pitch diameter of the threads 13817 on the firing drive shaft 13810 to facilitate some “play” therebetween which may permit the firing member 14820 to make contact with the camming assembly 14740 as they are driven distally. Such arrangement may facilitate some movement of the camming assembly 14740 when the cartridge body 14702 is installed in the elongate channel 14210 while still establishing threaded driving contact with the threaded segment 13817 of the firing drive shaft 13810.


The end effector 14200 as depicted also includes an anvil lockout assembly 13900 that is configured to prevent the closure of the anvil 14300 unless a staple cartridge 14700 has been properly seated therein. Operation of the anvil lockout member 13910 was described above and will not be repeated for the sake of brevity.



FIG. 73 illustrates the surgical end effector 14200 without a surgical staple cartridge installed therein and with the anvil 14300 in a fully open position. As can be seen in FIG. 73, the closure shuttle 13520 is in its distal-most position. As can be further seen in FIG. 73, the vertically extending lock tab 13918 of the anvil lockout member 13910 is aligned with the anvil lockout protrusion 14930 that is formed on the anvil 14300. FIG. 74 illustrates that the anvil 14300 cannot be closed during the inadvertent actuation of the closure drive system. In FIG. 73, the closure shuttle 13520 has moved proximally from its starting position, but the anvil 14300 is prevented from closing due to the contact between the lock tab 13918 and the lockout protrusion 14930. As can also be seen in FIGS. 73 and 74, the firing member lockout feature 14840 is biased into the locked position wherein the lockout feature 14840 is aligned to contact the elongate channel bottom 14212. In the event that the user inadvertently actuates the firing drive system, the lockout feature 14840 will contact the bottom 14212 of the elongate channel 14210 to prevent the distal advancement of the firing member 14820.



FIG. 79 illustrates the end effector 14200 after a fresh, unfired surgical staple cartridge 14700 has been installed therein. As can be seen in that Figure, the camming assembly 14740 within the cartridge body 14702 is in a proximal-most, starting position wherein the unlocking portion 14742 on the camming assembly 14740 is in engagement with the sled latch 14848 on the lockout feature 14840. This contact between the unlocking portion 14742 and the sled latch 14848 moves the lockout feature 14840 into the unlocked position. As can also be seen in FIG. 79, a proximally extending fin 14762 on the cartridge body 14702 has biased the lockout member 13910 proximally from the locked position to the unlocked position to thereby permit the anvil 14300 to be closed. As was discussed above, the length a of the internal thread segment 14744 in the camming assembly 14740 is less than the length b of the unthreaded segment 13815 on the firing drive shaft 13810. In addition, a length “c” of the threads within the threaded firing nut 14830 is greater than the length b of the unthreaded segment 13815 on the firing drive shaft 13810. Thus: a<b<c.



FIG. 80 illustrates the surgical end effector 14200 of FIG. 79 with the anvil 14300 in the fully closed position. As can be seen in FIG. 80, the distal closure shaft segment 13512 has been rotated in the first rotary direction to cause the closure shuttle 13520 to move axially to its proximal-most position to thereby cause the closure link assembly 13530 to pivot the anvil 14300 to its fully closed position. As can be seen in FIG. 80, when the anvil 14300 is in the fully closed position, the pivot arms 13540 are nearly vertical relative to the drive shaft axis DSA. Such configuration results in the application of a maximum closure moment to the anvil (e.g., moment arm angle MA is approximately 90°). As can be further seen in FIG. 80, the anvil engagement features 14826 are aligned with corresponding elongate passages 14301 that are formed on each lateral side of the anvil slot to permit axial travel therein as the firing member 14820 is distally advanced from its starting position to ending position. To distally advance the firing member 14820, the user activates the firing drive system 13800 (FIG. 64) to rotate the firing drive shaft 13810 in a first rotary direction. As the firing member 14820 is driven distally, the firing member 14820 advances the camming assembly 14740 on the unthreaded segment 13815 until the segment of internal threads 14744 threadably engage the threaded segment 13817. Once threads 14744 are in threaded engagement with the threaded segment 13817, rotation of the drive shaft 13810 causes the camming assembly 14740 to continue to move distally. As the camming assembly 14740 moves distally, the camming surfaces thereon drive the staple drivers that are stored in the cartridge 14700 upward. The upward movement of the staple drivers causes the staples or fasteners supported thereon to pierce through the tissue that is clamped between the anvil 14300 and the cartridge 14700 and into forming contact with the staple forming underside 14303 of the anvil 14300. As the firing member 14820 is driven distally, the tissue cutting surface 14828 cuts through the clamped tissue after the fasteners have been formed in the tissue. The firing drive shaft 13810 continues to be rotated until the firing member 14820 has reached its ending position at which time, a sensor or sensors may stop the firing motor 13802 from rotating in the first direction. An instrument controller may then cause the firing motor 13802 to rotate in an opposite direction to retract the firing member 14820 back to its starting position or the controller may require the user to initiate a retraction rotation. In either event, the camming assembly 14740 remains in the distal end of the cartridge 14700. The user may then remove the spent cartridge from the end effector and discard it. Because the camming assembly 14740 remains in the distal end of the spent cartridge, should the spent cartridge be inadvertently mistaken for a fresh unfired cartridge and reloaded into the end effector, the lockout feature 14840 will remain in the locked position to prevent inadvertent firing of the firing member. As can be seen in FIG. 80, the axial length “e” of laterally extending retention flanges 14834 of the firing member 14820 is longer than the axial length “d” of the firing lockout hole 14215 in the bottom 14212 of the channel 14210. In addition, an installation hole 14213 is provided through a distal portion of the cartridge bottom 4212 to facilitate installation of the firing member 14820 therethrough. Thus, the axial length “f” of the installation hole 14213 is greater than the axial length “e” of laterally extending retention flanges 14834 of the firing member 14820. Thus: d<e<f.



FIG. 81 illustrates a portion of another surgical end effector 15200 with the anvil thereof omitted for clarity. The surgical end effector 15200 includes a two piece firing member 15820 that is axially driven between a starting position and an ending position within the end effector 15200. The end effector 15200 may employ a rotary closure shuttle 13520 that is axially driven by a closure drive shaft 13510 for applying opening and closing motions to the anvil. As was described above, the closure shuttle 13520 is supported for axial travel within the end cap 14400 as shown in FIGS. 82 and 83. See e.g., FIGS. 64 and 65 for further details concerning the opening and closing of the anvil. In addition, the two piece firing member 15820 is axially driven by a rotary firing drive shaft 13810 that extends through a distal closure drive shaft segment in the various manners disclosed herein.


As can be seen in FIG. 82, the firing member 15820 comprises a body portion 15822 that includes two downwardly extending hollow mounting portions 15824 that are unthreaded and spaced from each other to receive a threaded drive nut 15830 therebetween. The threaded drive nut 15830 is configured to threadably engage the threaded rotary firing drive shaft 13810. The drive nut 15830 includes a vertical tab portion (not shown) that is sized to extend through an axial slot (not shown) in the bottom of an elongate channel 15210 of the surgical end effector 15200. Two laterally extending retention flanges 15834 are formed on the threaded drive nut 15830 and are configured to engage the bottom of the elongate channel 15210. In addition, two laterally extending anvil engagement tabs 15826 are formed on the top of the firing member body 15822 and are configured to engage the anvil as the firing member 15820 is axially moved within the end effector 15200. In the illustrated example, the firing member 15820 is configured to operably interface with a camming assembly 15740 that has an onboard tissue cutting knife 15743 thereon. See FIGS. 87 and 89. In alternative arrangements, a tissue cutting surface is formed or attached to the body member 15822.


As can also be seen in FIG. 82, the firing member 15820 may also be equipped with an onboard firing member lockout assembly 15840 that comprises a lockout member 15842 that is pivotally coupled to the firing member body 15822. The lockout member 15842 includes a sled latch 15848 that is configured to be engaged by the camming assembly 15740 when the camming assembly 15740 is in an unfired position. As can be seen in FIGS. 87 and 89, the camming assembly 15740 includes a firing member ledge 15741 configured to engage the sled latch 15848 on the lockout member 15482. A lockout spring 15850 is mounted in the elongate channel 15210 and is configured to bias the lockout member 15842 downward such that if the camming assembly 15740 is not in its unfired position, a distal edge 15849 engages a distal edge of a lockout cavity 15214 in a bottom 15212 of the channel 15210. When in that position, should the user inadvertently attempt to distally advance the firing member 15820, the lockout member 15842 contacts the distal edge of the lockout cavity 15214 to prevent the distal advancement of the firing member 15820.



FIG. 84 illustrates the end effector 15200 prior to installation of a surgical staple cartridge 15700 (FIG. 81) therein. As can be seen in FIG. 84, the firing member 15820 is in its proximal-most starting position. FIG. 85 illustrates what happens if the firing member 15820 is inadvertently distally advanced when no cartridge is present. As can be seen in FIG. 85, the lockout member 15842 has been biased downward by spring 15850 such that the distal end surface 15849 of the lockout member 15842 has contacted the distal edge of the lockout cavity 15214 in the channel 15210 to prevent further distal advancement of the firing member 15820. FIGS. 86 and 87 illustrate the end effector 15200 with an unfired surgical staple cartridge 15700 operably loaded in the elongate channel 15210. As can be seen in FIG. 89, the firing member ledge 15741 on the camming assembly 15740 is in unlocking engagement with the sled latch 15848 on the lockout member 15482 which lifts the firing member 15820 out of locking engagement with the lockout cavity 15214. FIGS. 88 and 89 illustrate the position of the firing member 15820 after the firing process has been commenced and the firing member 15820 has started to move in the distal direction.


Various aspects of the subject matter described herein are set out in the following examples.


Example 1

A surgical instrument comprising a channel, an anvil, a rotary driven closure system, a rotary driven firing drive shaft, and an axially movable firing member. The channel is configured to support a replaceable surgical staple cartridge therein. The anvil is movably supported on the channel and is configured to selectively move between an open position and a closed position. The rotary driven closure system operably interfaces with the anvil and is configured to move the anvil between the open position and the closed position upon application of rotary opening and closing motions thereto. The rotary driven firing drive shaft is independently operable from the rotary driven closure system. The axially movable firing member is in driving engagement with the rotary driven firing drive shaft and is configured for sliding engagement with the channel and the anvil upon application of rotary firing motions to the rotary driven firing drive shaft.


Example 2

The surgical instrument of Example 1, wherein the axially movable firing member is supported in the replaceable surgical staple cartridge and is configured to removably interface with the rotary driven firing drive shaft when the replaceable surgical staple cartridge is operably seated in the channel.


Example 3

The surgical instrument of Examples 1 or 2, wherein the rotary driven firing drive shaft comprises a proximal rotary drive shaft and an onboard cartridge drive shaft. The proximal rotary drive shaft is rotatably supported by the channel and operably interfaces with a source of rotary firing motions. The onboard cartridge drive shaft is rotatably supported in the replaceable surgical staple cartridge and is in threaded engagement with the axially movable firing member supported therein, such that rotation of the onboard cartridge drive shaft in a first rotary direction moves the axially movable firing member from a starting position to an ending position within the replaceable surgical staple cartridge and rotation of the onboard cartridge drive shaft in a second rotary direction moves the axially movable firing member from the ending position to the starting position. The onboard cartridge drive shaft comprises a coupler configured to removably drivingly engage the proximal rotary drive shaft when the replaceable surgical staple cartridge is operably seated in the channel.


Example 4

The surgical instrument of Example 3, wherein the replaceable surgical staple cartridge comprises a camming assembly configured to drive surgical fasteners stored in the replaceable surgical staple cartridge into forming contact with the anvil when the camming assembly is moved from an unfired position to a completely fired position within the replaceable surgical staple cartridge.


Example 5

The surgical instrument of Example 4, wherein the camming assembly is configured to threadably engage the onboard cartridge drive shaft.


Example 6

The surgical instrument of Example 5, wherein the camming assembly is configured to threadably disengage the onboard cartridge drive shaft when the camming assembly has reached the completely fired position.


Example 7

The surgical instrument of Examples 4, 5, or 6, wherein the onboard cartridge drive shaft further comprises a proximal segment of drive threads configured for driving engagement with corresponding firing member threads on the axially movable firing member, a distal segment of drive threads configured to drivingly engage the firing member threads and camming assembly threads in the camming assembly, and an unthreaded central segment of the onboard cartridge drive shaft located between the proximal segment of drive threads and the distal segment of drive threads.


Example 8

The surgical instrument of Example 7, wherein when the camming assembly is in the unfired position, the camming assembly threads are located adjacent the unthreaded central segment of the onboard cartridge drive shaft.


Example 9

The surgical instrument of Examples 7 or 8, wherein the onboard cartridge drive shaft comprises an unthreaded end portion distal to the distal segment of drive threads that corresponds to the completely fired position of the camming assembly.


Example 10

The surgical instrument of Examples 1, 2, 3, 4, 5, 6, 7, 8, or 9, wherein the axially movable firing member comprises a tissue cutting surface.


Example 11

The surgical instrument of Examples 3, 4, 5, 6, 7, 8, 9, or 10, wherein the replaceable surgical staple cartridge comprises a garage portion configured to support the axially movable firing member therein when the axially movable firing member is in the starting position.


Example 12

The surgical instrument of Examples 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11, further comprising an anvil lockout assembly operably supported in the channel and configured to prevent movement of the anvil from the open position to the closed position unless the replaceable surgical staple cartridge is operably seated in the channel.


Example 13

The surgical instrument of Example 12, wherein the anvil lockout assembly comprises a lockout member movable from a locked position wherein the lockout member prevents the anvil from moving to the closed position and an unlocked position wherein the anvil is movable from the open position to the closed position, and wherein the replaceable surgical staple cartridge comprises a cartridge body operably storing a plurality of surgical fasteners therein and comprising an unlocking feature configured to move the lockout member from the locked position to the unlocked position when the replaceable surgical staple cartridge is operably seated in the channel.


Example 14

The surgical instrument of Examples 4, 5, 6, 7, 8, or 9, further comprising a firing member lockout assembly movable from a first position wherein the firing member lockout assembly prevents the axially movable firing member from moving from the starting position to the ending position and a second position wherein the firing member lockout assembly permits the firing member to move from the starting position to the ending position, wherein the camming assembly is configured to move the firing member lockout assembly into the first position when the camming assembly is in the unfired position.


Example 15

A surgical instrument comprising an elongate channel, an anvil, a rotary driven closure system, an axially movable firing member, a rotary driven firing system, an anvil lockout assembly, and a firing member lockout assembly. The elongate channel is configured to support a replaceable surgical staple cartridge therein. The anvil is movably supported on the elongate channel and is configured to selectively move between an open position and a closed position. The rotary driven closure system operably interfaces with the anvil and is configured to move the anvil between the open position and the closed position upon application of rotary opening and closing motions thereto. The axially movable firing member is supported for sliding engagement with the elongate channel and the anvil when the anvil is in the closed position. The rotary driven firing system operably interfaces with the axially movable firing member to move the axially movable firing member between a starting position and an ending position upon application of rotary firing and retraction motions thereto. The anvil lockout assembly is operably supported in the elongate channel and is configured to prevent movement of the anvil from the open position to the closed position unless the replaceable surgical staple cartridge is operably seated in the elongate channel. The firing member lockout assembly is movable from a first position wherein the firing member lockout assembly prevents the firing member from moving from the starting position to the ending position and a second position wherein the firing member lockout assembly permits the firing member to move from the starting position to the ending position.


Example 16

The surgical instrument of Example 15, wherein the replaceable surgical staple cartridge comprises a cartridge body and a camming assembly. The cartridge body operably stores a plurality of surgical fasteners therein. The camming assembly is configured to drive the surgical fasteners stored in the cartridge body into forming contact with the anvil when the camming assembly is moved from an unfired position to a completely fired position within the cartridge body. The camming assembly is configured to move the firing member lockout assembly into the first position when the camming assembly is in the unfired position and the cartridge body is operably seated in the elongate channel.


Example 17

The surgical instrument of Example 16, wherein the rotary driven firing system comprises a rotary firing drive shaft operably supported in the elongate channel and operably interfacing with a source of rotary drive motions, and wherein the rotary firing drive shaft threadably engages the firing member and the camming assembly.


Example 18

The surgical instrument of Example 17, wherein the camming assembly is movably stored in the cartridge body and configured to threadably engage the rotary firing drive shaft when the cartridge body is operably seated in the elongate channel.


Example 19

The surgical instrument of Examples 17 or 18, wherein the camming assembly is configured to threadably disengage the rotary firing drive shaft when the camming assembly has reached the completely fired position.


Example 20

The surgical instrument of Examples 17, 18, or 19, wherein the rotary firing drive shaft further comprises a proximal segment of drive threads configured for driving engagement with corresponding firing member threads in the axially movable firing member, a distal segment of drive threads configured to drivingly engage the firing member threads and camming assembly threads on the camming assembly, and an unthreaded central segment located between the proximal segment of drive threads and the distal segment of drive threads.


Many of the surgical instrument systems described herein are motivated by an electric motor; however, the surgical instrument systems described herein can be motivated in any suitable manner. In various instances, the surgical instrument systems described herein can be motivated by a manually-operated trigger, for example. In certain instances, the motors disclosed herein may comprise a portion or portions of a robotically controlled system. Moreover, any of the end effectors and/or tool assemblies disclosed herein can be utilized with a robotic surgical instrument system. U.S. patent application Ser. No. 13/118,241, entitled SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS, now U.S. Pat. No. 9,072,535, for example, discloses several examples of a robotic surgical instrument system in greater detail.


The surgical instrument systems described herein have been described in connection with the deployment and deformation of staples; however, the embodiments described herein are not so limited. Various embodiments are envisioned which deploy fasteners other than staples, such as clamps or tacks, for example. Moreover, various embodiments are envisioned which utilize any suitable means for sealing tissue. For instance, an end effector in accordance with various embodiments can comprise electrodes configured to heat and seal the tissue. Also, for instance, an end effector in accordance with certain embodiments can apply vibrational energy to seal the tissue.


The entire disclosures of:

    • U.S. Pat. No. 5,403,312, entitled ELECTROSURGICAL HEMOSTATIC DEVICE, which issued on Apr. 4, 1995;
    • U.S. Pat. No. 7,000,818, entitled SURGICAL STAPLING INSTRUMENT HAVING SEPARATE DISTINCT CLOSING AND FIRING SYSTEMS, which issued on Feb. 21, 2006;
    • U.S. Pat. No. 7,422,139, entitled MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING INSTRUMENT WITH TACTILE POSITION FEEDBACK, which issued on Sep. 9, 2008;
    • U.S. Pat. No. 7,464,849, entitled ELECTRO-MECHANICAL SURGICAL INSTRUMENT WITH CLOSURE SYSTEM AND ANVIL ALIGNMENT COMPONENTS, which issued on Dec. 16, 2008;
    • U.S. Pat. No. 7,670,334, entitled SURGICAL INSTRUMENT HAVING AN ARTICULATING END EFFECTOR, which issued on Mar. 2, 2010;
    • U.S. Pat. No. 7,753,245, entitled SURGICAL STAPLING INSTRUMENTS, which issued on Jul. 13, 2010;
    • U.S. Pat. No. 8,393,514, entitled SELECTIVELY ORIENTABLE IMPLANTABLE FASTENER CARTRIDGE, which issued on Mar. 12, 2013;
    • U.S. patent application Ser. No. 11/343,803, entitled SURGICAL INSTRUMENT HAVING RECORDING CAPABILITIES, now U.S. Pat. No. 7,845,537;
    • U.S. patent application Ser. No. 12/031,573, entitled SURGICAL CUTTING AND FASTENING INSTRUMENT HAVING RF ELECTRODES, filed Feb. 14, 2008;
    • U.S. patent application Ser. No. 12/031,873, entitled END EFFECTORS FOR A SURGICAL CUTTING AND STAPLING INSTRUMENT, filed Feb. 15, 2008, now U.S. Pat. No. 7,980,443;
    • U.S. patent application Ser. No. 12/235,782, entitled MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT, now U.S. Pat. No. 8,210,411;
    • U.S. patent application Ser. No. 12/235,972, entitled MOTORIZED SURGICAL INSTRUMENT, now U.S. Pat. No. 9,050,083.
    • U.S. patent application Ser. No. 12/249,117, entitled POWERED SURGICAL CUTTING AND STAPLING APPARATUS WITH MANUALLY RETRACTABLE FIRING SYSTEM, now U.S. Pat. No. 8,608,045;
    • U.S. patent application Ser. No. 12/647,100, entitled MOTOR-DRIVEN SURGICAL CUTTING INSTRUMENT WITH ELECTRIC ACTUATOR DIRECTIONAL CONTROL ASSEMBLY, filed Dec. 24, 2009, now U.S. Pat. No. 8,220,688;
    • U.S. patent application Ser. No. 12/893,461, entitled STAPLE CARTRIDGE, filed Sep. 29, 2012, now U.S. Pat. No. 8,733,613;
    • U.S. patent application Ser. No. 13/036,647, entitled SURGICAL STAPLING INSTRUMENT, filed Feb. 28, 2011, now U.S. Pat. No. 8,561,870;
    • U.S. patent application Ser. No. 13/118,241, entitled SURGICAL STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS, now U.S. Pat. No. 9,072,535;
    • U.S. patent application Ser. No. 13/524,049, entitled ARTICULATABLE SURGICAL INSTRUMENT COMPRISING A FIRING DRIVE, filed on Jun. 15, 2012, now U.S. Pat. No. 9,101,358;
    • U.S. patent application Ser. No. 13/800,025, entitled STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, filed on Mar. 13, 2013, now U.S. Pat. No. 9,345,481;
    • U.S. patent application Ser. No. 13/800,067, entitled STAPLE CARTRIDGE TISSUE THICKNESS SENSOR SYSTEM, filed on Mar. 13, 2013, now U.S. Patent Application Publication No. 2014/0263552;
    • U.S. Patent Application Publication No. 2007/0175955, entitled SURGICAL CUTTING AND FASTENING INSTRUMENT WITH CLOSURE TRIGGER LOCKING MECHANISM, filed Jan. 31, 2006; and
    • U.S. Patent Application Publication No. 2010/0264194, entitled SURGICAL STAPLING INSTRUMENT WITH AN ARTICULATABLE END EFFECTOR, filed Apr. 22, 2010, now U.S. Pat. No. 8,308,040, are hereby incorporated by reference herein.


Although various devices have been described herein in connection with certain embodiments, modifications and variations to those embodiments may be implemented. Particular features, structures, or characteristics may be combined in any suitable manner in one or more embodiments. Thus, the particular features, structures, or characteristics illustrated or described in connection with one embodiment may be combined in whole or in part, with the features, structures or characteristics of one ore more other embodiments without limitation. Also, where materials are disclosed for certain components, other materials may be used. Furthermore, according to various embodiments, a single component may be replaced by multiple components, and multiple components may be replaced by a single component, to perform a given function or functions. The foregoing description and following claims are intended to cover all such modification and variations.


The devices disclosed herein can be designed to be disposed of after a single use, or they can be designed to be used multiple times. In either case, however, a device can be reconditioned for reuse after at least one use. Reconditioning can include any combination of the steps including, but not limited to, the disassembly of the device, followed by cleaning or replacement of particular pieces of the device, and subsequent reassembly of the device. In particular, a reconditioning facility and/or surgical team can disassemble a device and, after cleaning and/or replacing particular parts of the device, the device can be reassembled for subsequent use. Those skilled in the art will appreciate that reconditioning of a device can utilize a variety of techniques for disassembly, cleaning/replacement, and reassembly. Use of such techniques, and the resulting reconditioned device, are all within the scope of the present application.


The devices disclosed herein may be processed before surgery. First, a new or used instrument may be obtained and, when necessary, cleaned. The instrument may then be sterilized. In one sterilization technique, the instrument is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and instrument may then be placed in a field of radiation that can penetrate the container, such as gamma radiation, x-rays, and/or high-energy electrons. The radiation may kill bacteria on the instrument and in the container. The sterilized instrument may then be stored in the sterile container. The sealed container may keep the instrument sterile until it is opened in a medical facility. A device may also be sterilized using any other technique known in the art, including but not limited to beta radiation, gamma radiation, ethylene oxide, plasma peroxide, and/or steam.


While this invention has been described as having exemplary designs, the present invention may be further modified within the spirit and scope of the disclosure. This application is therefore intended to cover any variations, uses, or adaptations of the invention using its general principles.

Claims
  • 1. A surgical instrument, comprising: a channel configured to support a replaceable surgical staple cartridge therein;an anvil movably supported on said channel and configured to selectively move between an open position and a closed position;a rotary driven closure system operably interfacing with said anvil and configured to move said anvil between said open position and said closed position upon application of rotary opening motions and rotary closing motions thereto, wherein said rotary driven closure system comprises a rotary driven closure drive shaft;a rotary driven firing drive shaft independently operable from said rotary driven closure system and extending through said rotary driven closure drive shaft; andan axially movable firing member in driving engagement with said rotary driven firing drive shaft, wherein said axially movable firing member is configured for sliding engagement with said channel and said anvil upon application of rotary firing motions to said rotary driven firing drive shaft.
  • 2. The surgical instrument of claim 1, wherein said axially movable firing member is supported in said replaceable surgical staple cartridge and is configured to removably interface with said rotary driven firing drive shaft when said replaceable surgical staple cartridge is operably seated in said channel.
  • 3. The surgical instrument of claim 2, wherein said rotary driven firing drive shaft comprises: a proximal rotary drive shaft rotatably supported by said channel and operably interfacing with a source of rotary firing motions; andan onboard cartridge drive shaft rotatably supported in said replaceable surgical staple cartridge and in threaded engagement with said axially movable firing member supported therein such that rotation of said onboard cartridge drive shaft in a first rotary direction moves said axially movable firing member from a starting position to an ending position within said replaceable surgical staple cartridge and rotation of said onboard cartridge drive shaft in a second rotary direction moves said axially movable firing member from said ending position to said starting position, wherein said onboard cartridge drive shaft comprises a coupler configured to removably drivingly engage said proximal rotary drive shaft when said replaceable surgical staple cartridge is operably seated in said channel.
  • 4. The surgical instrument of claim 3, wherein said replaceable surgical staple cartridge comprises a camming assembly configured to drive surgical fasteners stored in said replaceable surgical staple cartridge into forming contact with said anvil when said camming assembly is moved from an unfired position to a completely fired position within said replaceable surgical staple cartridge.
  • 5. The surgical instrument of claim 4, wherein said camming assembly is configured to threadably engage said onboard cartridge drive shaft.
  • 6. The surgical instrument of claim 5, wherein said camming assembly is configured to threadably disengage said onboard cartridge drive shaft when said camming assembly has reached said completely fired position.
  • 7. The surgical instrument of claim 6, wherein said onboard cartridge drive shaft further comprises: a proximal segment of drive threads configured for driving engagement with corresponding firing member threads on said axially movable firing member;a distal segment of drive threads configured to drivingly engage said firing member threads and camming assembly threads in said camming assembly; andan unthreaded central segment of said onboard cartridge drive shaft located between said proximal segment of drive threads and said distal segment of drive threads.
  • 8. The surgical instrument of claim 7, wherein when said camming assembly is in said unfired position, said camming assembly threads are located adjacent said unthreaded central segment of said onboard cartridge drive shaft.
  • 9. The surgical instrument of claim 7, wherein said onboard cartridge drive shaft comprises an unthreaded end portion distal to said distal segment of drive threads that corresponds to said completely fired position of said camming assembly.
  • 10. The surgical instrument of claim 1, wherein said axially movable firing member comprises a tissue cutting surface.
  • 11. The surgical instrument of claim 10, wherein said replaceable surgical staple cartridge comprises a garage portion configured to support said axially movable firing member therein when said axially movable firing member is in a starting position.
  • 12. The surgical instrument of claim 1, further comprising an anvil lockout assembly operably supported in said channel and configured to prevent movement of said anvil from said open position to said closed position unless the replaceable surgical staple cartridge is operably seated in said channel.
  • 13. The surgical instrument of claim 12, wherein said anvil lockout assembly comprises a lockout member movable from a locked position wherein said lockout member prevents said anvil from moving to said closed position and an unlocked position wherein said anvil is movable from said open position to said closed position, and wherein said replaceable surgical staple cartridge comprises a cartridge body operably storing a plurality of surgical fasteners therein and comprising an unlocking feature configured to move said lockout member from said locked position to said unlocked position when said replaceable surgical staple cartridge is operably seated in said channel.
  • 14. The surgical instrument of claim 4, further comprising a firing member lockout assembly movable from a first position wherein said firing member lockout assembly prevents said axially movable firing member from moving from said starting position to said ending position and a second position wherein said firing member lockout assembly permits said axially movable firing member to move from said starting position to said ending position, wherein said camming assembly is configured to move said firing member lockout assembly into said second position when said camming assembly is in said unfired position and said replaceable surgical staple cartridge is seated in said channel.
  • 15. A surgical instrument, comprising: an elongate channel configured to support a replaceable surgical staple cartridge therein;an anvil movably supported on said elongate channel and configured to selectively move between an open position and a closed position;a rotary driven closure system operably interfacing with said anvil and configured to move said anvil between said open position and said closed position upon application of rotary opening motions and rotary closing motions thereto;an axially movable firing member supported for sliding engagement with said elongate channel and said anvil when said anvil is in said closed position;a rotary driven firing system coaxially aligned with said rotary driven closure system and operably interfacing with said axially movable firing member to move said axially movable firing member between a starting position and an ending position upon application of rotary firing and retraction motions thereto;an anvil lockout assembly operably supported in said elongate channel and configured to prevent movement of said anvil from said open position to said closed position unless said replaceable surgical staple cartridge is operably seated in said elongate channel; anda firing member lockout assembly movable from a first position wherein said firing member lockout assembly prevents said axially movable firing member from moving from said starting position to said ending position and a second position wherein said firing member lockout assembly permits said axially movable firing member to move from said starting position to said ending position.
  • 16. The surgical instrument of claim 15, wherein said replaceable surgical staple cartridge comprises: a cartridge body operably storing a plurality of surgical fasteners therein; anda camming assembly configured to drive said surgical fasteners stored in said cartridge body into forming contact with said anvil when said camming assembly is moved from an unfired position to a completely fired position within said cartridge body, wherein said camming assembly is configured to move said firing member lockout assembly into said second position when said camming assembly is in said unfired position and said cartridge body is operably seated in said elongate channel.
  • 17. The surgical instrument of claim 16, wherein said rotary driven firing system comprises a rotary firing drive shaft operably supported in said elongate channel and operably interfacing with a source of rotary drive motions, and wherein said rotary firing drive shaft threadably engages said axially movable firing member and said camming assembly.
  • 18. The surgical instrument of claim 17, wherein said camming assembly is movably stored in said cartridge body and is configured to threadably engage said rotary firing drive shaft when said cartridge body is operably seated in said elongate channel.
  • 19. The surgical instrument of claim 18, wherein said camming assembly is configured to threadably disengage said rotary firing drive shaft when said camming assembly has reached said completely fired position.
  • 20. The surgical instrument of claim 19, wherein said rotary firing drive shaft further comprises: a proximal segment of drive threads configured for driving engagement with corresponding firing member threads in said axially movable firing member;a distal segment of drive threads configured to drivingly engage said firing member threads and camming assembly threads on said camming assembly; andan unthreaded central segment located between said proximal segment of drive threads and said distal segment of drive threads.
CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of U.S. Provisional Patent Application Ser. No. 62/807,310, entitled METHODS FOR CONTROLLING A POWERED SURGICAL STAPLER THAT HAS SEPARATE ROTARY CLOSURE AND FIRING SYSTEMS, filed Feb. 19, 2019, of U.S. Provisional Patent Application Ser. No. 62/807,319, entitled SURGICAL STAPLING DEVICES WITH IMPROVED LOCKOUT SYSTEMS, filed Feb. 19, 2019, and of U.S. Provisional Patent Application Ser. No. 62/807,309, entitled SURGICAL STAPLING DEVICES WITH IMPROVED ROTARY DRIVEN CLOSURE SYSTEMS, filed Feb. 19, 2019, the disclosures of which are incorporated by reference herein in their entireties. This application claims the benefit of U.S. Provisional Patent Application Ser. No. 62/650,887, entitled SURGICAL SYSTEMS WITH OPTIMIZED SENSING CAPABILITIES, filed Mar. 30, 2018, the disclosure of which is incorporated by reference herein in its entirety. This application claims the benefit of U.S. Provisional Patent Application Ser. No. 62/649,302, entitled INTERACTIVE SURGICAL SYSTEMS WITH ENCRYPTED COMMUNICATION CAPABILITIES, filed Mar. 28, 2018, of U.S. Provisional Patent Application Ser. No. 62/649,294, entitled DATA STRIPPING METHOD TO INTERROGATE PATIENT RECORDS AND CREATE ANONYMIZED RECORD, filed Mar. 28, 2018, of U.S. Provisional Patent Application Ser. No. 62/649,300, entitled SURGICAL HUB SITUATIONAL AWARENESS, filed Mar. 28, 2018, of U.S. Provisional Patent Application Ser. No. 62/649,309, entitled SURGICAL HUB SPATIAL AWARENESS TO DETERMINE DEVICES IN OPERATING THEATER, filed Mar. 28, 2018, of U.S. Provisional Patent Application Ser. No. 62/649,310, entitled COMPUTER IMPLEMENTED INTERACTIVE SURGICAL SYSTEMS, filed Mar. 28, 2018, of U.S. Provisional Patent Application Ser. No. 62/649,291, entitled USE OF LASER LIGHT AND RED-GREEN-BLUE COLORATION TO DETERMINE PROPERTIES OF BACK SCATTERED LIGHT, filed Mar. 28, 2018, of U.S. Provisional Patent Application Ser. No. 62/649,296, entitled ADAPTIVE CONTROL PROGRAM UPDATES FOR SURGICAL DEVICES, filed Mar. 28, 2018, of U.S. Provisional Patent Application Ser. No. 62/649,333, entitled CLOUD-BASED MEDICAL ANALYTICS FOR CUSTOMIZATION AND RECOMMENDATIONS TO A USER, filed Mar. 28, 2018, of U.S. Provisional Patent Application Ser. No. 62/649,327, entitled CLOUD-BASED MEDICAL ANALYTICS FOR SECURITY AND AUTHENTICATION TRENDS AND REACTIVE MEASURES, filed Mar. 28, 2018, of U.S. Provisional Patent Application Ser. No. 62/649,315, entitled DATA HANDLING AND PRIORITIZATION IN A CLOUD ANALYTICS NETWORK, filed Mar. 28, 2018, of U.S. Provisional Patent Application Ser. No. 62/649,313, entitled CLOUD INTERFACE FOR COUPLED SURGICAL DEVICES, filed Mar. 28, 2018, of U.S. Provisional Patent Application Ser. No. 62/649,320, entitled DRIVE ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS, filed Mar. 28, 2018, of U.S. Provisional Patent Application Ser. No. 62/649,307, entitled AUTOMATIC TOOL ADJUSTMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS, filed Mar. 28, 2018, and of U.S. Provisional Patent Application Ser. No. 62/649,323, entitled SENSING ARRANGEMENTS FOR ROBOT-ASSISTED SURGICAL PLATFORMS, filed Mar. 28, 2018, the disclosures of which are incorporated by reference herein in their entireties.

US Referenced Citations (2005)
Number Name Date Kind
1853416 Hall Apr 1932 A
2222125 Stehlik Nov 1940 A
3082426 Miles Mar 1963 A
3503396 Pierie et al. Mar 1970 A
3584628 Green Jun 1971 A
3626457 Duerr et al. Dec 1971 A
3633584 Farrell Jan 1972 A
3759017 Young Sep 1973 A
3863118 Lander et al. Jan 1975 A
3898545 Coppa et al. Aug 1975 A
3912121 Steffen Oct 1975 A
3915271 Harper Oct 1975 A
3932812 Milligan Jan 1976 A
4041362 Ichiyanagi Aug 1977 A
4052649 Greenwell et al. Oct 1977 A
4087730 Goles May 1978 A
4157859 Terry Jun 1979 A
4412539 Jarvik Nov 1983 A
4448193 Ivanov May 1984 A
4523695 Braun et al. Jun 1985 A
4608160 Zoch Aug 1986 A
4614366 North et al. Sep 1986 A
4701193 Robertson et al. Oct 1987 A
4735603 Goodson et al. Apr 1988 A
4788977 Farin et al. Dec 1988 A
4892244 Fox et al. Jan 1990 A
5010341 Huntley et al. Apr 1991 A
5026387 Thomas Jun 1991 A
5035692 Lyon et al. Jul 1991 A
5042460 Sakurai et al. Aug 1991 A
5084057 Green et al. Jan 1992 A
5100402 Fan Mar 1992 A
5129570 Schulze et al. Jul 1992 A
5151102 Kamiyama et al. Sep 1992 A
5156315 Green et al. Oct 1992 A
5158585 Saho et al. Oct 1992 A
5171247 Hughett et al. Dec 1992 A
5197962 Sansom et al. Mar 1993 A
5242474 Herbst et al. Sep 1993 A
5253793 Green et al. Oct 1993 A
5271543 Grant et al. Dec 1993 A
RE34519 Fox et al. Jan 1994 E
5318516 Cosmescu Jun 1994 A
5322055 Davison et al. Jun 1994 A
5342349 Kaufman Aug 1994 A
5383880 Hooven Jan 1995 A
5396900 Slater et al. Mar 1995 A
5397046 Savage et al. Mar 1995 A
5403312 Yates et al. Apr 1995 A
5403327 Thornton et al. Apr 1995 A
5413267 Solyntjes et al. May 1995 A
5415335 Knodell, Jr. May 1995 A
5417699 Klein et al. May 1995 A
5439468 Schulze et al. Aug 1995 A
5445304 Plyley et al. Aug 1995 A
5462545 Wang et al. Oct 1995 A
5465895 Knodel et al. Nov 1995 A
5467911 Tsuruta et al. Nov 1995 A
5474566 Alesi et al. Dec 1995 A
5485947 Olson et al. Jan 1996 A
5496315 Weaver et al. Mar 1996 A
5503320 Webster et al. Apr 1996 A
5531743 Nettekoven et al. Jul 1996 A
5545148 Wurster Aug 1996 A
5552685 Young et al. Sep 1996 A
5560372 Cory Oct 1996 A
5584425 Savage et al. Dec 1996 A
5610379 Muz et al. Mar 1997 A
5610811 Honda Mar 1997 A
5613966 Makower et al. Mar 1997 A
5624452 Yates Apr 1997 A
5626587 Bishop et al. May 1997 A
5643291 Pier et al. Jul 1997 A
5654750 Weil et al. Aug 1997 A
5673841 Schulze et al. Oct 1997 A
5673842 Bittner et al. Oct 1997 A
5675227 Roos et al. Oct 1997 A
5693052 Weaver Dec 1997 A
5695502 Pier et al. Dec 1997 A
5697926 Weaver Dec 1997 A
5706998 Plyley et al. Jan 1998 A
5718359 Palmer et al. Feb 1998 A
5725536 Oberlin et al. Mar 1998 A
5725542 Yoon Mar 1998 A
5735445 Vidal et al. Apr 1998 A
5735848 Yates et al. Apr 1998 A
5746209 Yost et al. May 1998 A
5749362 Funda et al. May 1998 A
5749893 Vidal et al. May 1998 A
5752644 Bolanos et al. May 1998 A
5762255 Chrisman et al. Jun 1998 A
5766186 Faraz et al. Jun 1998 A
5769791 Benaron et al. Jun 1998 A
5775331 Raymond et al. Jul 1998 A
5797537 Oberlin et al. Aug 1998 A
5800350 Coppleson et al. Sep 1998 A
D399561 Ellingson Oct 1998 S
5817093 Williamson, IV et al. Oct 1998 A
5820009 Melling et al. Oct 1998 A
5833690 Yates et al. Nov 1998 A
5836849 Mathiak et al. Nov 1998 A
5836909 Cosmescu Nov 1998 A
5843080 Fleenor et al. Dec 1998 A
5846237 Nettekoven Dec 1998 A
5849022 Sakashita et al. Dec 1998 A
5873873 Smith et al. Feb 1999 A
5878938 Bittner et al. Mar 1999 A
5893849 Weaver Apr 1999 A
5906625 Bito et al. May 1999 A
5942333 Arnett et al. Aug 1999 A
5947996 Logeman Sep 1999 A
5968032 Sleister Oct 1999 A
5980510 Tsonton et al. Nov 1999 A
5987346 Benaron et al. Nov 1999 A
5997528 Bisch et al. Dec 1999 A
6010054 Johnson et al. Jan 2000 A
6030437 Gourrier et al. Feb 2000 A
6036637 Kudo Mar 2000 A
6039734 Goble Mar 2000 A
6039735 Greep Mar 2000 A
6059799 Aranyi et al. May 2000 A
6066137 Greep May 2000 A
6079606 Milliman et al. Jun 2000 A
6090107 Borgmeier et al. Jul 2000 A
6099537 Sugai et al. Aug 2000 A
6109500 Alli et al. Aug 2000 A
6113598 Baker Sep 2000 A
6126592 Proch et al. Oct 2000 A
6126658 Baker Oct 2000 A
6155473 Tompkins et al. Dec 2000 A
6214000 Fleenor et al. Apr 2001 B1
6258105 Hart et al. Jul 2001 B1
6273887 Yamauchi et al. Aug 2001 B1
6301495 Gueziec et al. Oct 2001 B1
6302881 Farin Oct 2001 B1
6308089 von der Ruhr et al. Oct 2001 B1
6325808 Bernard et al. Dec 2001 B1
6325811 Messerly Dec 2001 B1
6341164 Dilkie et al. Jan 2002 B1
6391102 Bodden et al. May 2002 B1
6434416 Mizoguchi et al. Aug 2002 B1
6443973 Whitman Sep 2002 B1
6451015 Rittman, III et al. Sep 2002 B1
6454781 Witt et al. Sep 2002 B1
6457625 Tormala et al. Oct 2002 B1
6461352 Morgan et al. Oct 2002 B2
6466817 Kaula et al. Oct 2002 B1
6480796 Wiener Nov 2002 B2
6524307 Palmerton et al. Feb 2003 B1
6530933 Yeung et al. Mar 2003 B1
6551243 Bocionek et al. Apr 2003 B2
6569109 Sakurai et al. May 2003 B2
6582424 Fleenor et al. Jun 2003 B2
6585791 Garito et al. Jul 2003 B1
6618626 West, Jr. et al. Sep 2003 B2
6648223 Boukhny et al. Nov 2003 B2
6678552 Pearlman Jan 2004 B2
6679899 Wiener et al. Jan 2004 B2
6685704 Greep Feb 2004 B2
6699187 Webb et al. Mar 2004 B2
6742895 Robin Jun 2004 B2
6752816 Culp et al. Jun 2004 B2
6760616 Hoey et al. Jul 2004 B2
6770072 Truckai et al. Aug 2004 B1
6773444 Messerly Aug 2004 B2
6775575 Bommannan et al. Aug 2004 B2
6778846 Martinez et al. Aug 2004 B1
6781683 Kacyra et al. Aug 2004 B2
6783524 Anderson et al. Aug 2004 B2
6783525 Greep et al. Aug 2004 B2
6793663 Kneifel et al. Sep 2004 B2
6824539 Novak Nov 2004 B2
6846308 Whitman et al. Jan 2005 B2
6852219 Hammond Feb 2005 B2
6863650 Irion Mar 2005 B1
6869430 Balbierz et al. Mar 2005 B2
6869435 Blake, III Mar 2005 B2
6911033 de Guillebon et al. Jun 2005 B2
6937892 Leyde et al. Aug 2005 B2
6945981 Donofrio et al. Sep 2005 B2
6951559 Greep Oct 2005 B1
6962587 Johnson et al. Nov 2005 B2
6978921 Shelton, IV et al. Dec 2005 B2
6988649 Shelton, IV et al. Jan 2006 B2
7000818 Shelton, IV et al. Feb 2006 B2
7030146 Baynes et al. Apr 2006 B2
7032798 Whitman et al. Apr 2006 B2
7041941 Faries, Jr. et al. May 2006 B2
7044352 Shelton, IV et al. May 2006 B2
7044911 Drinan et al. May 2006 B2
7048775 Jornitz et al. May 2006 B2
7053752 Wang et al. May 2006 B2
7055730 Ehrenfels et al. Jun 2006 B2
7073765 Newkirk Jul 2006 B2
7077853 Kramer et al. Jul 2006 B2
7077856 Whitman Jul 2006 B2
7081096 Brister et al. Jul 2006 B2
7097640 Wang et al. Aug 2006 B2
7103688 Strong Sep 2006 B2
7104949 Anderson et al. Sep 2006 B2
7118564 Ritchie et al. Oct 2006 B2
7121460 Parsons et al. Oct 2006 B1
7137980 Buysse et al. Nov 2006 B2
7140528 Shelton, IV Nov 2006 B2
7143923 Shelton, IV et al. Dec 2006 B2
7143925 Shelton, IV et al. Dec 2006 B2
7147139 Schwemberger et al. Dec 2006 B2
7155316 Sutherland et al. Dec 2006 B2
7164940 Hareyama et al. Jan 2007 B2
7169145 Isaacson et al. Jan 2007 B2
7177533 McFarlin et al. Feb 2007 B2
7182775 Guillebon et al. Feb 2007 B2
7208005 Frecker et al. Apr 2007 B2
7230529 Ketcherside, Jr. et al. Jun 2007 B2
7232447 Gellman et al. Jun 2007 B2
7236817 Papas et al. Jun 2007 B2
7246734 Shelton, IV Jul 2007 B2
7278563 Green Oct 2007 B1
7294106 Birkenbach et al. Nov 2007 B2
7294116 Ellman et al. Nov 2007 B1
7296724 Green et al. Nov 2007 B2
7317955 McGreevy Jan 2008 B2
7328828 Ortiz et al. Feb 2008 B2
7334717 Rethy et al. Feb 2008 B2
7343565 Ying et al. Mar 2008 B2
7362228 Nycz et al. Apr 2008 B2
7371227 Zeiner May 2008 B2
7380695 Doll et al. Jun 2008 B2
7383088 Spinelli et al. Jun 2008 B2
7391173 Schena Jun 2008 B2
7407074 Ortiz et al. Aug 2008 B2
7422139 Shelton, IV et al. Sep 2008 B2
7423972 Shaham et al. Sep 2008 B2
7457804 Uber, III et al. Nov 2008 B2
7464847 Viola et al. Dec 2008 B2
7464849 Shelton, IV et al. Dec 2008 B2
7515961 Germanson et al. Apr 2009 B2
7568604 Ehrenfels et al. Aug 2009 B2
7575144 Ortiz et al. Aug 2009 B2
7597731 Palmerton et al. Oct 2009 B2
7617137 Kreiner et al. Nov 2009 B2
7621192 Conti et al. Nov 2009 B2
7621898 Lalomia et al. Nov 2009 B2
7637410 Marczyk Dec 2009 B2
7641092 Kruszynski et al. Jan 2010 B2
7644848 Swayze et al. Jan 2010 B2
7667592 Ohyama et al. Feb 2010 B2
7667839 Bates Feb 2010 B2
7670334 Hueil et al. Mar 2010 B2
7694865 Scirica Apr 2010 B2
7699860 Huitema et al. Apr 2010 B2
7720306 Gardiner et al. May 2010 B2
7721934 Shelton, IV et al. May 2010 B2
7721936 Shalton, IV et al. May 2010 B2
7736357 Lee, Jr. et al. Jun 2010 B2
7742176 Braunecker et al. Jun 2010 B2
7743960 Whitman et al. Jun 2010 B2
7753245 Boudreaux et al. Jul 2010 B2
7766207 Mather et al. Aug 2010 B2
7766905 Paterson et al. Aug 2010 B2
7770773 Whitman et al. Aug 2010 B2
7771429 Ballard et al. Aug 2010 B2
7776037 Odom Aug 2010 B2
7782789 Stultz et al. Aug 2010 B2
7784663 Shelton, IV Aug 2010 B2
7803151 Whitman Sep 2010 B2
7810692 Hall et al. Oct 2010 B2
7818041 Kim et al. Oct 2010 B2
7819298 Hall et al. Oct 2010 B2
7832612 Baxter, III et al. Nov 2010 B2
7833219 Tashiro et al. Nov 2010 B2
7836085 Petakov et al. Nov 2010 B2
7837079 Holsten et al. Nov 2010 B2
7837680 Isaacson et al. Nov 2010 B2
7841980 Minosawa et al. Nov 2010 B2
7845537 Shelton, IV et al. Dec 2010 B2
7857185 Swayze et al. Dec 2010 B2
7862560 Marion Jan 2011 B2
7862579 Ortiz et al. Jan 2011 B2
7865236 Cory et al. Jan 2011 B2
7884735 Newkirk Feb 2011 B2
7887530 Zemlok et al. Feb 2011 B2
7892337 Palmerton et al. Feb 2011 B2
7907166 Lamprecht et al. Mar 2011 B2
7913891 Doll et al. Mar 2011 B2
7918230 Whitman et al. Apr 2011 B2
7918377 Measamer et al. Apr 2011 B2
7920706 Asokan et al. Apr 2011 B2
7927014 Dehler Apr 2011 B2
7942300 Rethy et al. May 2011 B2
7954682 Giordano et al. Jun 2011 B2
7955322 Devengenzo et al. Jun 2011 B2
7956620 Gilbert Jun 2011 B2
7963433 Whitman et al. Jun 2011 B2
7966269 Bauer et al. Jun 2011 B2
7967180 Scirica Jun 2011 B2
7976553 Shelton, IV et al. Jul 2011 B2
7979157 Anvari Jul 2011 B2
7980443 Scheib et al. Jul 2011 B2
7982776 Dunki-Jacobs et al. Jul 2011 B2
7988028 Farascioni et al. Aug 2011 B2
7993140 Sakezles Aug 2011 B2
7995045 Dunki-Jacobs Aug 2011 B2
8005947 Morris et al. Aug 2011 B2
8007494 Taylor et al. Aug 2011 B1
8007513 Nalagatla et al. Aug 2011 B2
8010180 Quaid et al. Aug 2011 B2
8012170 Whitman et al. Sep 2011 B2
8015976 Shah Sep 2011 B2
8016855 Whitman et al. Sep 2011 B2
8025199 Whitman et al. Sep 2011 B2
8027710 Dannan Sep 2011 B1
8035685 Jensen Oct 2011 B2
8038686 Huitema et al. Oct 2011 B2
8038693 Allen Oct 2011 B2
8043560 Okumoto et al. Oct 2011 B2
8054184 Cline et al. Nov 2011 B2
8054752 Druke et al. Nov 2011 B2
8062306 Nobis et al. Nov 2011 B2
8062330 Prommersberger et al. Nov 2011 B2
8066721 Kortenbach et al. Nov 2011 B2
8074861 Ehrenfels et al. Dec 2011 B2
8075571 Vitali et al. Dec 2011 B2
8096459 Ortiz et al. Jan 2012 B2
8118206 Zand et al. Feb 2012 B2
8120301 Goldberg et al. Feb 2012 B2
8123764 Meade et al. Feb 2012 B2
8128625 Odom Mar 2012 B2
8131565 Dicks et al. Mar 2012 B2
8136712 Zingman Mar 2012 B2
8147486 Honour et al. Apr 2012 B2
8155479 Hoffman et al. Apr 2012 B2
8157145 Shelton, IV et al. Apr 2012 B2
8157150 Viola et al. Apr 2012 B2
8157151 Ingmanson et al. Apr 2012 B2
8160098 Yan et al. Apr 2012 B1
8160690 Wilfley et al. Apr 2012 B2
8161977 Shelton, IV et al. Apr 2012 B2
8170396 Kuspa et al. May 2012 B2
8172836 Ward May 2012 B2
8181839 Beetel May 2012 B2
8185409 Putnam et al. May 2012 B2
8206345 Abboud et al. Jun 2012 B2
8208707 Mendonca et al. Jun 2012 B2
8210411 Yates et al. Jul 2012 B2
8214007 Baker et al. Jul 2012 B2
8216849 Petty Jul 2012 B2
8220688 Laurent et al. Jul 2012 B2
8225643 Abboud et al. Jul 2012 B2
8225979 Farascioni et al. Jul 2012 B2
8229549 Whitman et al. Jul 2012 B2
8231042 Hessler et al. Jul 2012 B2
8241322 Whitman et al. Aug 2012 B2
8255045 Gharib et al. Aug 2012 B2
8257387 Cunningham Sep 2012 B2
8260016 Maeda et al. Sep 2012 B2
8262560 Whitman Sep 2012 B2
8292888 Whitman Oct 2012 B2
8295902 Salahieh et al. Oct 2012 B2
8308040 Huang et al. Nov 2012 B2
8321581 Katis et al. Nov 2012 B2
8322590 Patel et al. Dec 2012 B2
8328065 Shah Dec 2012 B2
8335590 Costa et al. Dec 2012 B2
8343065 Bartol et al. Jan 2013 B2
8346392 Walser et al. Jan 2013 B2
8360299 Zemlok et al. Jan 2013 B2
8364222 Cook et al. Jan 2013 B2
8365975 Manoux et al. Feb 2013 B1
8388652 Viola Mar 2013 B2
8393514 Shelton, IV et al. Mar 2013 B2
8397972 Kostrzewski Mar 2013 B2
8398541 DiMaio et al. Mar 2013 B2
8403944 Pain et al. Mar 2013 B2
8403945 Whitfield et al. Mar 2013 B2
8403946 Whitfield et al. Mar 2013 B2
8406859 Zuzak et al. Mar 2013 B2
8411034 Boillot et al. Apr 2013 B2
8413871 Racenet et al. Apr 2013 B2
8422035 Hinderling et al. Apr 2013 B2
8423182 Robinson et al. Apr 2013 B2
8428722 Verhoef et al. Apr 2013 B2
8439910 Greep et al. May 2013 B2
8444663 Houser et al. May 2013 B2
8452615 Abri May 2013 B2
8454506 Rothman et al. Jun 2013 B2
8461744 Wiener et al. Jun 2013 B2
8468030 Stroup et al. Jun 2013 B2
8469973 Meade et al. Jun 2013 B2
8472630 Konrad et al. Jun 2013 B2
8476227 Kaplan et al. Jul 2013 B2
8489235 Moll et al. Jul 2013 B2
8499992 Whitman et al. Aug 2013 B2
8500756 Papa et al. Aug 2013 B2
8503759 Greer et al. Aug 2013 B2
8505801 Ehrenfels et al. Aug 2013 B2
8506478 Mizuyoshi Aug 2013 B2
8512325 Mathonnet Aug 2013 B2
8512365 Wiener et al. Aug 2013 B2
8515520 Brunnett et al. Aug 2013 B2
8517239 Scheib et al. Aug 2013 B2
8521331 Itkowitz Aug 2013 B2
8523043 Ullrich et al. Sep 2013 B2
8546996 Messerly et al. Oct 2013 B2
8554697 Claus et al. Oct 2013 B2
8560047 Haider et al. Oct 2013 B2
8561870 Baxter, III et al. Oct 2013 B2
8562598 Falkenstein et al. Oct 2013 B2
8566115 Moore Oct 2013 B2
8571598 Valavi Oct 2013 B2
8573459 Smith et al. Nov 2013 B2
8573465 Shelton, IV Nov 2013 B2
8585694 Amoah et al. Nov 2013 B2
8590762 Hess et al. Nov 2013 B2
8591536 Robertson Nov 2013 B2
8595607 Nekoomaram et al. Nov 2013 B2
8596513 Olson et al. Dec 2013 B2
8596515 Okoniewski Dec 2013 B2
8604709 Jalbout et al. Dec 2013 B2
8608044 Hueil et al. Dec 2013 B2
8608045 Smith et al. Dec 2013 B2
8616431 Timm et al. Dec 2013 B2
8620055 Barratt et al. Dec 2013 B2
8620473 Diolaiti et al. Dec 2013 B2
8623027 Price et al. Jan 2014 B2
8627483 Rachlin et al. Jan 2014 B2
8627993 Smith et al. Jan 2014 B2
8627995 Smith et al. Jan 2014 B2
8628518 Blumenkranz et al. Jan 2014 B2
8628545 Cabrera et al. Jan 2014 B2
8631987 Shelton, IV et al. Jan 2014 B2
8632525 Kerr et al. Jan 2014 B2
8636190 Zemlok et al. Jan 2014 B2
8636736 Yates et al. Jan 2014 B2
8641621 Razzaque et al. Feb 2014 B2
8652086 Gerg et al. Feb 2014 B2
8652121 Quick et al. Feb 2014 B2
8652128 Ward Feb 2014 B2
8657176 Shelton, IV et al. Feb 2014 B2
8657177 Scirica et al. Feb 2014 B2
8663220 Wiener et al. Mar 2014 B2
8666544 Moll et al. Mar 2014 B2
8679114 Chapman et al. Mar 2014 B2
8682049 Zhao et al. Mar 2014 B2
8682489 Itkowitz et al. Mar 2014 B2
8685056 Evans et al. Apr 2014 B2
8688188 Heller et al. Apr 2014 B2
8690864 Hoarau Apr 2014 B2
8701962 Kostrzewski Apr 2014 B2
8719061 Birchall May 2014 B2
8720766 Hess et al. May 2014 B2
8733613 Huitema et al. May 2014 B2
8740840 Foley et al. Jun 2014 B2
8740866 Reasoner et al. Jun 2014 B2
8747238 Shelton, IV et al. Jun 2014 B2
8752749 Moore et al. Jun 2014 B2
8757465 Woodard, Jr. et al. Jun 2014 B2
8761717 Buchheit Jun 2014 B1
8763879 Shelton, IV et al. Jul 2014 B2
8768251 Claus et al. Jul 2014 B2
8771270 Burbank Jul 2014 B2
8775196 Simpson et al. Jul 2014 B2
8779648 Giordano et al. Jul 2014 B2
8790253 Sunagawa et al. Jul 2014 B2
8794497 Zingman Aug 2014 B2
8799008 Johnson et al. Aug 2014 B2
8799009 Mellin et al. Aug 2014 B2
8800838 Shelton, IV Aug 2014 B2
8801703 Gregg et al. Aug 2014 B2
8814996 Giurgiutiu et al. Aug 2014 B2
8818556 Sanchez et al. Aug 2014 B2
8820603 Shelton, IV et al. Sep 2014 B2
8820608 Miyamoto Sep 2014 B2
8827134 Viola et al. Sep 2014 B2
8840003 Morgan et al. Sep 2014 B2
8851354 Swensgard et al. Oct 2014 B2
8852174 Burbank Oct 2014 B2
8875973 Whitman Nov 2014 B2
8882662 Charles Nov 2014 B2
8886790 Harrang et al. Nov 2014 B2
8893949 Shelton, IV et al. Nov 2014 B2
8899479 Cappuzzo et al. Dec 2014 B2
8905977 Shelton et al. Dec 2014 B2
8912746 Reid et al. Dec 2014 B2
8914098 Brennan et al. Dec 2014 B2
8918207 Prisco Dec 2014 B2
8920414 Stone et al. Dec 2014 B2
8920433 Barrier et al. Dec 2014 B2
8930203 Kiaie et al. Jan 2015 B2
8930214 Woolford Jan 2015 B2
8931679 Kostrzewski Jan 2015 B2
8936614 Allen, IV Jan 2015 B2
8945095 Blumenkranz et al. Feb 2015 B2
8945163 Voegele et al. Feb 2015 B2
8955732 Zemlok et al. Feb 2015 B2
8956581 Rosenbaum et al. Feb 2015 B2
8960519 Whitman et al. Feb 2015 B2
8960520 McCuen Feb 2015 B2
8962062 Podhajsky et al. Feb 2015 B2
8967443 McCuen Mar 2015 B2
8967455 Zhou Mar 2015 B2
8968276 Zemlok et al. Mar 2015 B2
8968309 Roy et al. Mar 2015 B2
8968312 Marczyk et al. Mar 2015 B2
8968337 Whitfield et al. Mar 2015 B2
8968358 Reschke Mar 2015 B2
8974429 Gordon et al. Mar 2015 B2
8979890 Boudreaux Mar 2015 B2
8986302 Aldridge et al. Mar 2015 B2
8989903 Weir et al. Mar 2015 B2
8991678 Wellman et al. Mar 2015 B2
8992565 Brisson et al. Mar 2015 B2
8998797 Omori Apr 2015 B2
9002518 Manzo et al. Apr 2015 B2
9010611 Ross et al. Apr 2015 B2
9011366 Dean et al. Apr 2015 B2
9011427 Price et al. Apr 2015 B2
9016539 Kostrzewski et al. Apr 2015 B2
9017326 DiNardo et al. Apr 2015 B2
9020240 Pettersson et al. Apr 2015 B2
9023071 Miller et al. May 2015 B2
9027431 Tang et al. May 2015 B2
9028494 Shelton, IV et al. May 2015 B2
9035568 Ganton et al. May 2015 B2
9038882 Racenet et al. May 2015 B2
9043027 Durant et al. May 2015 B2
9044227 Shelton, IV et al. Jun 2015 B2
9044244 Ludwin et al. Jun 2015 B2
9044261 Houser Jun 2015 B2
9050063 Roe et al. Jun 2015 B2
9050083 Yates et al. Jun 2015 B2
9050120 Swarup et al. Jun 2015 B2
9052809 Vesto Jun 2015 B2
9055035 Porsch et al. Jun 2015 B2
9060770 Shelton, IV et al. Jun 2015 B2
9060775 Wiener et al. Jun 2015 B2
9066650 Sekiguchi Jun 2015 B2
9072523 Houser et al. Jul 2015 B2
9072535 Shelton, IV et al. Jul 2015 B2
9072536 Shelton, IV et al. Jul 2015 B2
9078653 Leimbach et al. Jul 2015 B2
9078727 Miller Jul 2015 B2
9084606 Greep Jul 2015 B2
9089360 Messerly et al. Jul 2015 B2
9095362 Dachs, II et al. Aug 2015 B2
9095367 Olson et al. Aug 2015 B2
9099863 Smith et al. Aug 2015 B2
9101358 Kerr et al. Aug 2015 B2
9101359 Smith et al. Aug 2015 B2
9101374 Hoch et al. Aug 2015 B1
9106270 Puterbaugh et al. Aug 2015 B2
9107573 Birnkrant Aug 2015 B2
9107662 Kostrzewski Aug 2015 B2
9107684 Ma Aug 2015 B2
9107688 Kimball et al. Aug 2015 B2
9107689 Robertson et al. Aug 2015 B2
9107694 Hendriks et al. Aug 2015 B2
9111548 Nandy et al. Aug 2015 B2
9113880 Zemlok et al. Aug 2015 B2
9114494 Mah Aug 2015 B1
9116597 Gulasky Aug 2015 B1
9119617 Souls et al. Sep 2015 B2
9119655 Bowling et al. Sep 2015 B2
9119657 Shelton, IV et al. Sep 2015 B2
9123155 Cunningham et al. Sep 2015 B2
9125644 Lane et al. Sep 2015 B2
9129054 Nawana et al. Sep 2015 B2
9137254 Bilbrey et al. Sep 2015 B2
9138129 Diolaiti Sep 2015 B2
9138225 Huang et al. Sep 2015 B2
9149322 Knowlton Oct 2015 B2
9155503 Cadwell Oct 2015 B2
9161803 Yates et al. Oct 2015 B2
9168054 Turner et al. Oct 2015 B2
9168104 Dein Oct 2015 B2
9179912 Yates et al. Nov 2015 B2
9183723 Sherman et al. Nov 2015 B2
9186143 Timm et al. Nov 2015 B2
9192375 Skinlo et al. Nov 2015 B2
9192447 Choi et al. Nov 2015 B2
9192707 Gerber et al. Nov 2015 B2
9202078 Abuelsaad et al. Dec 2015 B2
9204830 Zand et al. Dec 2015 B2
9204879 Shelton, IV Dec 2015 B2
9204995 Scheller et al. Dec 2015 B2
9216062 Duque et al. Dec 2015 B2
9218053 Komuro et al. Dec 2015 B2
9220502 Zemlok et al. Dec 2015 B2
9226689 Jacobsen et al. Jan 2016 B2
9226751 Shelton, IV Jan 2016 B2
9226766 Aldridge et al. Jan 2016 B2
9226767 Stulen et al. Jan 2016 B2
9232883 Ozawa et al. Jan 2016 B2
9237891 Shelton, IV Jan 2016 B2
9237921 Messerly et al. Jan 2016 B2
9241728 Price et al. Jan 2016 B2
9241730 Babaev Jan 2016 B2
9241731 Boudreaux et al. Jan 2016 B2
9247996 Merana et al. Feb 2016 B1
9250172 Harris et al. Feb 2016 B2
9255907 Heanue et al. Feb 2016 B2
9265585 Wingardner et al. Feb 2016 B2
9272406 Aronhalt et al. Mar 2016 B2
9277956 Zhang Mar 2016 B2
9280884 Schultz et al. Mar 2016 B1
9282962 Schmid et al. Mar 2016 B2
9282974 Shelton, IV Mar 2016 B2
9283045 Rhee et al. Mar 2016 B2
9283054 Morgan et al. Mar 2016 B2
9289211 Williams et al. Mar 2016 B2
9289212 Shelton, IV et al. Mar 2016 B2
9295514 Shelton, IV et al. Mar 2016 B2
9301691 Hufnagel et al. Apr 2016 B2
9301753 Aldridge et al. Apr 2016 B2
9301759 Spivey et al. Apr 2016 B2
9301810 Amiri et al. Apr 2016 B2
9302213 Manahan et al. Apr 2016 B2
9307894 von Grunberg et al. Apr 2016 B2
9307914 Fahey Apr 2016 B2
9307986 Hall et al. Apr 2016 B2
9314246 Shelton, IV et al. Apr 2016 B2
9314308 Parihar et al. Apr 2016 B2
9320563 Brustad et al. Apr 2016 B2
9325732 Stickle et al. Apr 2016 B1
9326767 Koch et al. May 2016 B2
9331422 Nazzaro et al. May 2016 B2
9332987 Leimbach et al. May 2016 B2
9333042 Diolaiti et al. May 2016 B2
9336385 Spencer et al. May 2016 B1
9341704 Picard et al. May 2016 B2
9345481 Hall et al. May 2016 B2
9345490 Ippisch May 2016 B2
9345546 Toth et al. May 2016 B2
9351726 Leimbach et al. May 2016 B2
9351727 Leimbach et al. May 2016 B2
9358003 Hall et al. Jun 2016 B2
9358685 Meier et al. Jun 2016 B2
9360449 Duric Jun 2016 B2
9364231 Wenchell Jun 2016 B2
9364249 Kimball et al. Jun 2016 B2
9364294 Razzaque et al. Jun 2016 B2
9370400 Parihar Jun 2016 B2
9375282 Nau, Jr. et al. Jun 2016 B2
9375539 Stearns et al. Jun 2016 B2
9381003 Todor et al. Jul 2016 B2
9381058 Houser et al. Jul 2016 B2
9386984 Aronhalt et al. Jul 2016 B2
9386988 Baxter, III et al. Jul 2016 B2
9387295 Mastri et al. Jul 2016 B1
9393017 Flanagan et al. Jul 2016 B2
9393037 Olson et al. Jul 2016 B2
9398905 Martin Jul 2016 B2
9398911 Auld Jul 2016 B2
9402629 Ehrenfels et al. Aug 2016 B2
9414776 Sillay et al. Aug 2016 B2
9419018 Sasagawa et al. Aug 2016 B2
9421014 Ingmanson et al. Aug 2016 B2
9433470 Choi Sep 2016 B2
9439622 Case et al. Sep 2016 B2
9439668 Timm et al. Sep 2016 B2
9439736 Olson Sep 2016 B2
9445764 Gross et al. Sep 2016 B2
9445813 Shelton, IV et al. Sep 2016 B2
9450701 Do et al. Sep 2016 B2
9451949 Gorek et al. Sep 2016 B2
9451958 Shelton, IV et al. Sep 2016 B2
9463022 Swayze et al. Oct 2016 B2
9468438 Baber et al. Oct 2016 B2
9480492 Aranyi et al. Nov 2016 B2
9485475 Speier et al. Nov 2016 B2
9492146 Kostrzewski et al. Nov 2016 B2
9492237 Kang et al. Nov 2016 B2
9493807 Little et al. Nov 2016 B2
9498182 Case et al. Nov 2016 B2
9498215 Duque et al. Nov 2016 B2
9498231 Haider et al. Nov 2016 B2
9516239 Blanquart et al. Dec 2016 B2
9519753 Gerdeman et al. Dec 2016 B1
9522003 Weir et al. Dec 2016 B2
9526407 Hoeg et al. Dec 2016 B2
9526499 Kostrzewski et al. Dec 2016 B2
9526587 Zhao et al. Dec 2016 B2
9532845 Dossett et al. Jan 2017 B1
9539007 Dhakad et al. Jan 2017 B2
9539020 Conlon et al. Jan 2017 B2
9542481 Halter et al. Jan 2017 B2
9546662 Shener-Irmakoglu et al. Jan 2017 B2
9554692 Levy Jan 2017 B2
9554794 Baber et al. Jan 2017 B2
9554854 Yates et al. Jan 2017 B2
9561038 Shelton, IV et al. Feb 2017 B2
9561045 Hinman et al. Feb 2017 B2
9566708 Kurnianto Feb 2017 B2
9572592 Price et al. Feb 2017 B2
9579503 McKinney et al. Feb 2017 B2
9585657 Shelton, IV et al. Mar 2017 B2
9592095 Panescu et al. Mar 2017 B2
9597081 Swayze et al. Mar 2017 B2
9600138 Thomas et al. Mar 2017 B2
9603024 Wang et al. Mar 2017 B2
9610114 Baxter, III et al. Apr 2017 B2
9622684 Wybo Apr 2017 B2
9622808 Beller et al. Apr 2017 B2
9628501 Datta Ray et al. Apr 2017 B2
9629560 Joseph Apr 2017 B2
9629623 Lytle, IV et al. Apr 2017 B2
9629628 Aranyi Apr 2017 B2
9629629 Leimbach et al. Apr 2017 B2
9630318 Ibarz Gabardos et al. Apr 2017 B2
9636188 Gattani et al. May 2017 B2
9636239 Durand et al. May 2017 B2
9636825 Penn et al. May 2017 B2
9641596 Unagami et al. May 2017 B2
9641815 Richardson et al. May 2017 B2
9642620 Baxter, III et al. May 2017 B2
9643022 Mashiach et al. May 2017 B2
9649110 Parihar et al. May 2017 B2
9649111 Shelton, IV et al. May 2017 B2
9649126 Robertson et al. May 2017 B2
9649169 Cinquin et al. May 2017 B2
9652655 Satish et al. May 2017 B2
9655616 Aranyi May 2017 B2
9656092 Golden May 2017 B2
9662116 Smith et al. May 2017 B2
9662177 Weir et al. May 2017 B2
9668729 Williams et al. Jun 2017 B2
9668732 Patel et al. Jun 2017 B2
9668765 Grace et al. Jun 2017 B2
9671860 Ogawa et al. Jun 2017 B2
9675264 Acquista et al. Jun 2017 B2
9675354 Weir et al. Jun 2017 B2
9681870 Baxter, III et al. Jun 2017 B2
9686306 Chizeck et al. Jun 2017 B2
9687230 Leimbach et al. Jun 2017 B2
9690362 Leimbach et al. Jun 2017 B2
9700292 Nawana et al. Jul 2017 B2
9700309 Jaworek et al. Jul 2017 B2
9700312 Kostrzewski et al. Jul 2017 B2
9700320 Dinardo et al. Jul 2017 B2
9706993 Hessler et al. Jul 2017 B2
9710214 Lin et al. Jul 2017 B2
9710644 Reybok et al. Jul 2017 B2
9713424 Spaide Jul 2017 B2
9717141 Tegg Jul 2017 B1
9717498 Aranyi et al. Aug 2017 B2
9717525 Ahluwalia et al. Aug 2017 B2
9717548 Couture Aug 2017 B2
9724094 Baber et al. Aug 2017 B2
9724100 Scheib et al. Aug 2017 B2
9724118 Schulte et al. Aug 2017 B2
9733663 Leimbach et al. Aug 2017 B2
9737301 Baber et al. Aug 2017 B2
9737310 Whitfield et al. Aug 2017 B2
9737335 Butler et al. Aug 2017 B2
9737355 Yates et al. Aug 2017 B2
9740826 Raghavan et al. Aug 2017 B2
9743016 Nestares et al. Aug 2017 B2
9743929 Leimbach et al. Aug 2017 B2
9743946 Faller et al. Aug 2017 B2
9743947 Price et al. Aug 2017 B2
9750499 Leimbach et al. Sep 2017 B2
9750500 Malkowski Sep 2017 B2
9750522 Scheib et al. Sep 2017 B2
9750523 Tsubuku Sep 2017 B2
9753135 Bosch Sep 2017 B2
9753568 McMillen Sep 2017 B2
9757126 Cappola Sep 2017 B2
9757128 Baber et al. Sep 2017 B2
9757142 Shimizu Sep 2017 B2
9757152 Ogilvie et al. Sep 2017 B2
9763741 Alvarez et al. Sep 2017 B2
9764164 Wiener et al. Sep 2017 B2
9770541 Carr et al. Sep 2017 B2
9775611 Kostrzewski Oct 2017 B2
9777913 Talbert et al. Oct 2017 B2
9782164 Mumaw et al. Oct 2017 B2
9782169 Kimsey et al. Oct 2017 B2
9782212 Wham et al. Oct 2017 B2
9782214 Houser et al. Oct 2017 B2
9788835 Morgan et al. Oct 2017 B2
9788836 Overmyer et al. Oct 2017 B2
9788851 Dannaher et al. Oct 2017 B2
9788902 Inoue et al. Oct 2017 B2
9788907 Alvi et al. Oct 2017 B1
9795436 Yates et al. Oct 2017 B2
9797486 Zergiebel et al. Oct 2017 B2
9801531 Morita et al. Oct 2017 B2
9801626 Parihar et al. Oct 2017 B2
9801627 Harris et al. Oct 2017 B2
9801679 Trees et al. Oct 2017 B2
9802033 Hibner et al. Oct 2017 B2
9804618 Leimbach et al. Oct 2017 B2
9805472 Chou et al. Oct 2017 B2
9808244 Leimbach et al. Nov 2017 B2
9808245 Richard et al. Nov 2017 B2
9808246 Shelton, IV et al. Nov 2017 B2
9808248 Hoffman Nov 2017 B2
9808249 Shelton, IV Nov 2017 B2
9814457 Martin et al. Nov 2017 B2
9814460 Kimsey et al. Nov 2017 B2
9814462 Woodard, Jr. et al. Nov 2017 B2
9814463 Williams et al. Nov 2017 B2
9820699 Bingley et al. Nov 2017 B2
9820738 Lytle, IV et al. Nov 2017 B2
9820741 Kostrzewski Nov 2017 B2
9826976 Parihar Nov 2017 B2
9826977 Leimbach et al. Nov 2017 B2
9827054 Richmond et al. Nov 2017 B2
9827059 Robinson et al. Nov 2017 B2
9830424 Dixon et al. Nov 2017 B2
9833241 Huitema et al. Dec 2017 B2
9839419 Deck et al. Dec 2017 B2
9839424 Zergiebel et al. Dec 2017 B2
9839428 Baxter, III et al. Dec 2017 B2
9839470 Gilbert et al. Dec 2017 B2
9839487 Dachs, II Dec 2017 B2
9844368 Boudreaux et al. Dec 2017 B2
9844369 Huitema et al. Dec 2017 B2
9844374 Lytle, IV et al. Dec 2017 B2
9844375 Overmyer et al. Dec 2017 B2
9844379 Shelton, IV et al. Dec 2017 B2
9848058 Johnson et al. Dec 2017 B2
9848877 Shelton, IV et al. Dec 2017 B2
9861354 Saliman et al. Jan 2018 B2
9861363 Chen et al. Jan 2018 B2
9861428 Trees et al. Jan 2018 B2
9864839 Baym et al. Jan 2018 B2
9867612 Parihar et al. Jan 2018 B2
9867651 Wham Jan 2018 B2
9867914 Bonano et al. Jan 2018 B2
9872609 Levy Jan 2018 B2
9872683 Hopkins et al. Jan 2018 B2
9877718 Weir et al. Jan 2018 B2
9877721 Schellin et al. Jan 2018 B2
9883860 Leimbach Feb 2018 B2
9888864 Rondon et al. Feb 2018 B2
9888914 Martin et al. Feb 2018 B2
9888919 Leimbach et al. Feb 2018 B2
9888921 Williams et al. Feb 2018 B2
9888975 Auld Feb 2018 B2
9895148 Shelton, IV et al. Feb 2018 B2
9900787 Ou Feb 2018 B2
9901342 Shelton, IV et al. Feb 2018 B2
9901406 State et al. Feb 2018 B2
9905000 Chou et al. Feb 2018 B2
9907550 Sniffin et al. Mar 2018 B2
9913642 Leimbach et al. Mar 2018 B2
9913645 Zerkle et al. Mar 2018 B2
9918730 Trees et al. Mar 2018 B2
9918778 Walberg et al. Mar 2018 B2
9918788 Paul et al. Mar 2018 B2
9922304 DeBusk et al. Mar 2018 B2
9924941 Burbank Mar 2018 B2
9924944 Shelton, IV et al. Mar 2018 B2
9924961 Shelton, IV et al. Mar 2018 B2
9931040 Homyk et al. Apr 2018 B2
9931118 Shelton, IV et al. Apr 2018 B2
9931124 Gokharu Apr 2018 B2
9936863 Tesar Apr 2018 B2
9936942 Chin et al. Apr 2018 B2
9936955 Miller et al. Apr 2018 B2
9936961 Chien et al. Apr 2018 B2
9937012 Hares et al. Apr 2018 B2
9937014 Bowling et al. Apr 2018 B2
9937626 Rockrohr Apr 2018 B2
9938972 Walley Apr 2018 B2
9943230 Kaku et al. Apr 2018 B2
9943309 Shelton, IV et al. Apr 2018 B2
9943312 Posada et al. Apr 2018 B2
9943377 Yates et al. Apr 2018 B2
9943379 Gregg, II et al. Apr 2018 B2
9943918 Grogan et al. Apr 2018 B2
9949785 Price et al. Apr 2018 B2
9962157 Sapre May 2018 B2
9968355 Shelton, IV et al. May 2018 B2
9980140 Spencer et al. May 2018 B1
9980769 Trees et al. May 2018 B2
9980778 Ohline et al. May 2018 B2
9987000 Shelton, IV et al. Jun 2018 B2
9990856 Kuchenbecker et al. Jun 2018 B2
9993248 Shelton, IV et al. Jun 2018 B2
9993258 Shelton, IV et al. Jun 2018 B2
9993305 Andersson Jun 2018 B2
10004491 Martin et al. Jun 2018 B2
10004497 Overmyer et al. Jun 2018 B2
10004500 Shelton, IV et al. Jun 2018 B2
10004501 Shelton, IV et al. Jun 2018 B2
10004527 Gee et al. Jun 2018 B2
10004557 Gross Jun 2018 B2
D822206 Shelton, IV et al. Jul 2018 S
10010322 Shelton, IV et al. Jul 2018 B2
10010324 Huitema et al. Jul 2018 B2
10013049 Leimbach et al. Jul 2018 B2
10016199 Baber et al. Jul 2018 B2
10021318 Hugosson et al. Jul 2018 B2
10022090 Whitman Jul 2018 B2
10022120 Martin et al. Jul 2018 B2
10022391 Chen et al. Jul 2018 B2
10022568 Messerly et al. Jul 2018 B2
10028744 Shelton, IV et al. Jul 2018 B2
10028761 Leimbach et al. Jul 2018 B2
10028788 Kang Jul 2018 B2
10034704 Asher et al. Jul 2018 B2
10037641 Hyde et al. Jul 2018 B2
10037715 Toly et al. Jul 2018 B2
D826405 Shelton, IV et al. Aug 2018 S
10039546 Williams et al. Aug 2018 B2
10039564 Hibner et al. Aug 2018 B2
10039565 Vezzu Aug 2018 B2
10041822 Zemlok Aug 2018 B2
10044791 Kamen et al. Aug 2018 B2
10045704 Fagin et al. Aug 2018 B2
10045776 Shelton, IV et al. Aug 2018 B2
10045779 Savage et al. Aug 2018 B2
10045781 Cropper et al. Aug 2018 B2
10045813 Mueller Aug 2018 B2
10048379 Markendorf et al. Aug 2018 B2
10052044 Shelton, IV et al. Aug 2018 B2
10052102 Baxter, III et al. Aug 2018 B2
10052104 Shelton, IV et al. Aug 2018 B2
10054441 Schorr et al. Aug 2018 B2
10058393 Bonutti et al. Aug 2018 B2
10069633 Gulati et al. Sep 2018 B2
10076326 Yates et al. Sep 2018 B2
10080618 Marshall et al. Sep 2018 B2
10084833 McDonnell et al. Sep 2018 B2
D831209 Huitema et al. Oct 2018 S
10085748 Morgan et al. Oct 2018 B2
10085749 Cappola et al. Oct 2018 B2
10095942 Mentese et al. Oct 2018 B2
10097578 Baldonado et al. Oct 2018 B2
10098527 Weisenburgh, II et al. Oct 2018 B2
10098635 Burbank Oct 2018 B2
10098642 Baxter, III et al. Oct 2018 B2
10098705 Brisson et al. Oct 2018 B2
10105140 Malinouskas et al. Oct 2018 B2
10105142 Baxter, III et al. Oct 2018 B2
10111658 Chowaniec et al. Oct 2018 B2
10111665 Aranyi et al. Oct 2018 B2
10111679 Baber et al. Oct 2018 B2
10117649 Baxter et al. Nov 2018 B2
10117651 Whitman et al. Nov 2018 B2
10117702 Danziger et al. Nov 2018 B2
10118119 Sappoketai. Nov 2018 B2
10130359 Hess et al. Nov 2018 B2
10130360 Olson et al. Nov 2018 B2
10130361 Yates et al. Nov 2018 B2
10130367 Cappola et al. Nov 2018 B2
10133248 Fitzsimmons et al. Nov 2018 B2
10135242 Baber et al. Nov 2018 B2
10136887 Shelton, IV et al. Nov 2018 B2
10136891 Shelton, IV et al. Nov 2018 B2
10136949 Felder et al. Nov 2018 B2
10143526 Walker et al. Dec 2018 B2
10143948 Bonitas et al. Dec 2018 B2
10149680 Parihar et al. Dec 2018 B2
10152789 Carnes et al. Dec 2018 B2
10154841 Weaner et al. Dec 2018 B2
10159044 Hrabak Dec 2018 B2
10159481 Whitman et al. Dec 2018 B2
10159483 Beckman et al. Dec 2018 B2
10164466 Calderoni Dec 2018 B2
10166025 Leimbach et al. Jan 2019 B2
10169862 Andre et al. Jan 2019 B2
10172687 Garbus et al. Jan 2019 B2
10175096 Dickerson Jan 2019 B2
10175127 Collins et al. Jan 2019 B2
10178992 Wise et al. Jan 2019 B2
10179413 Rockrohr Jan 2019 B2
10180463 Beckman et al. Jan 2019 B2
10182814 Okoniewski Jan 2019 B2
10182816 Shelton, IV et al. Jan 2019 B2
10182818 Hensel et al. Jan 2019 B2
10188385 Kerr et al. Jan 2019 B2
10189157 Schlegel et al. Jan 2019 B2
10190888 Hryb et al. Jan 2019 B2
10194891 Jeong et al. Feb 2019 B2
10194907 Marczyk et al. Feb 2019 B2
10194913 Nalagatla et al. Feb 2019 B2
10194972 Yates et al. Feb 2019 B2
10197803 Badiali et al. Feb 2019 B2
10198965 Hart Feb 2019 B2
10201311 Chou et al. Feb 2019 B2
10201349 Leimbach et al. Feb 2019 B2
10201364 Leimbach et al. Feb 2019 B2
10201365 Boudreaux et al. Feb 2019 B2
10205708 Fletcher et al. Feb 2019 B1
10206605 Shelton, IV et al. Feb 2019 B2
10206752 Hares et al. Feb 2019 B2
10213201 Shelton, IV et al. Feb 2019 B2
10213203 Swayze et al. Feb 2019 B2
10213266 Zemlok et al. Feb 2019 B2
10213268 Dachs, II Feb 2019 B2
10219491 Stiles, Jr. et al. Mar 2019 B2
10220522 Rockrohr Mar 2019 B2
10222750 Bang et al. Mar 2019 B2
10226249 Jaworek et al. Mar 2019 B2
10226250 Beckman et al. Mar 2019 B2
10226302 Lacal et al. Mar 2019 B2
10231634 Zand et al. Mar 2019 B2
10231733 Ehrenfels et al. Mar 2019 B2
10231775 Shelton, IV et al. Mar 2019 B2
10238413 Hibner et al. Mar 2019 B2
10245027 Shelton, IV et al. Apr 2019 B2
10245028 Shelton, IV et al. Apr 2019 B2
10245029 Hunter et al. Apr 2019 B2
10245030 Hunter et al. Apr 2019 B2
10245033 Overmyer et al. Apr 2019 B2
10245037 Conklin et al. Apr 2019 B2
10245038 Hopkins et al. Apr 2019 B2
10251661 Collings et al. Apr 2019 B2
10251725 Valentine et al. Apr 2019 B2
10258331 Shelton, IV et al. Apr 2019 B2
10258359 Kapadia Apr 2019 B2
10258362 Conlon Apr 2019 B2
10258363 Worrell et al. Apr 2019 B2
10258415 Harrah et al. Apr 2019 B2
10258418 Shelton, IV et al. Apr 2019 B2
10258425 Mustufa et al. Apr 2019 B2
10263171 Wiener et al. Apr 2019 B2
10265035 Fehre et al. Apr 2019 B2
10265068 Harris et al. Apr 2019 B2
10265072 Shelton, IV et al. Apr 2019 B2
10265090 Ingmanson et al. Apr 2019 B2
10265130 Hess et al. Apr 2019 B2
10271840 Sapre Apr 2019 B2
10271844 Valentine et al. Apr 2019 B2
10271850 Williams Apr 2019 B2
10271851 Shelton, IV et al. Apr 2019 B2
D847989 Shelton, IV et al. May 2019 S
10278698 Racenet May 2019 B2
10278778 State et al. May 2019 B2
10283220 Azizian et al. May 2019 B2
10285694 Viola et al. May 2019 B2
10285698 Cappola et al. May 2019 B2
10285700 Scheib May 2019 B2
10285705 Shelton, IV et al. May 2019 B2
10292704 Harris et al. May 2019 B2
10292707 Shelton, IV et al. May 2019 B2
10292758 Boudreaux et al. May 2019 B2
10292771 Wood et al. May 2019 B2
10293129 Fox et al. May 2019 B2
10299792 Huitema et al. May 2019 B2
10299870 Connolly et al. May 2019 B2
10305926 Mihan et al. May 2019 B2
D850617 Shelton, IV et al. Jun 2019 S
10307159 Harris et al. Jun 2019 B2
10307170 Parfett et al. Jun 2019 B2
10307199 Farritor et al. Jun 2019 B2
10311036 Hussam et al. Jun 2019 B1
10313137 Aarnio et al. Jun 2019 B2
10314577 Laurent et al. Jun 2019 B2
10314582 Shelton, IV et al. Jun 2019 B2
10321907 Shelton, IV et al. Jun 2019 B2
10321964 Grover et al. Jun 2019 B2
10327764 Harris et al. Jun 2019 B2
10335147 Rector et al. Jul 2019 B2
10335149 Baxter, III et al. Jul 2019 B2
10335180 Johnson et al. Jul 2019 B2
10335227 Heard Jul 2019 B2
10342543 Shelton, IV et al. Jul 2019 B2
10342602 Strobl et al. Jul 2019 B2
10342623 Huelman et al. Jul 2019 B2
10343102 Reasoner et al. Jul 2019 B2
10349824 Claude et al. Jul 2019 B2
10349941 Marczyk Jul 2019 B2
10350016 Burbank et al. Jul 2019 B2
10357246 Shelton, IV et al. Jul 2019 B2
10357247 Shelton, IV et al. Jul 2019 B2
10362179 Harris Jul 2019 B2
10363032 Scheib et al. Jul 2019 B2
10363037 Aronhalt et al. Jul 2019 B2
10368861 Baxter, III et al. Aug 2019 B2
10368865 Harris et al. Aug 2019 B2
10368867 Harris et al. Aug 2019 B2
10368876 Bhatnagar et al. Aug 2019 B2
10368894 Madan et al. Aug 2019 B2
10368903 Morales et al. Aug 2019 B2
10376263 Morgan et al. Aug 2019 B2
10376305 Yates et al. Aug 2019 B2
10376337 Kilroy et al. Aug 2019 B2
10376338 Taylor et al. Aug 2019 B2
10378893 Mankovskii Aug 2019 B2
10383518 Abu-Tarif et al. Aug 2019 B2
10383699 Kilroy et al. Aug 2019 B2
10384021 Koeth et al. Aug 2019 B2
10390718 Chen et al. Aug 2019 B2
10390794 Kuroiwa et al. Aug 2019 B2
10390825 Shelton, IV et al. Aug 2019 B2
10390831 Holsten et al. Aug 2019 B2
10390895 Henderson et al. Aug 2019 B2
10398348 Osadchy et al. Sep 2019 B2
10398434 Shelton, IV et al. Sep 2019 B2
10398517 Eckert et al. Sep 2019 B2
10398521 Itkowitz et al. Sep 2019 B2
10404521 McChord et al. Sep 2019 B2
10404801 Martch Sep 2019 B2
10405857 Shelton, IV et al. Sep 2019 B2
10405863 Wise et al. Sep 2019 B2
10413291 Worthington et al. Sep 2019 B2
10413293 Shelton, IV et al. Sep 2019 B2
10413297 Harris et al. Sep 2019 B2
10417446 Takeyama Sep 2019 B2
10420552 Shelton, IV et al. Sep 2019 B2
10420558 Nalagatla et al. Sep 2019 B2
10420559 Marczyk et al. Sep 2019 B2
10420620 Rockrohr Sep 2019 B2
10420865 Reasoner et al. Sep 2019 B2
10422727 Pliskin Sep 2019 B2
10426466 Contini et al. Oct 2019 B2
10426467 Miller et al. Oct 2019 B2
10426468 Contini et al. Oct 2019 B2
10426471 Shelton, IV et al. Oct 2019 B2
10426481 Aronhalt et al. Oct 2019 B2
10433837 Worthington et al. Oct 2019 B2
10433844 Shelton, IV et al. Oct 2019 B2
10433849 Shelton, IV et al. Oct 2019 B2
10433918 Shelton, IV et al. Oct 2019 B2
10441279 Shelton, IV et al. Oct 2019 B2
10441345 Aldridge et al. Oct 2019 B2
10448948 Shelton, IV et al. Oct 2019 B2
10448950 Shelton, IV et al. Oct 2019 B2
10456137 Vendely et al. Oct 2019 B2
10456140 Shelton, IV et al. Oct 2019 B2
10456193 Yates et al. Oct 2019 B2
10463365 Williams Nov 2019 B2
10463367 Kostrzewski et al. Nov 2019 B2
10463371 Kostrzewski Nov 2019 B2
10463436 Jackson et al. Nov 2019 B2
10470762 Leimbach et al. Nov 2019 B2
10470764 Baxter, III et al. Nov 2019 B2
10470768 Harris et al. Nov 2019 B2
10470791 Houser Nov 2019 B2
10471254 Sano et al. Nov 2019 B2
10478181 Shelton, IV et al. Nov 2019 B2
10478189 Bear et al. Nov 2019 B2
10478190 Miller et al. Nov 2019 B2
10478544 Friederichs et al. Nov 2019 B2
10485450 Gupta et al. Nov 2019 B2
10485542 Shelton, IV et al. Nov 2019 B2
10485543 Shelton, IV et al. Nov 2019 B2
10492783 Shelton, IV et al. Dec 2019 B2
10492784 Beardsley Dec 2019 B2
10492785 Overmyer et al. Dec 2019 B2
10496788 Amarasingham et al. Dec 2019 B2
10498269 Zemlok et al. Dec 2019 B2
10499891 Chaplin et al. Dec 2019 B2
10499914 Huang et al. Dec 2019 B2
10499915 Aranyi Dec 2019 B2
10499994 Luks et al. Dec 2019 B2
10507068 Kopp et al. Dec 2019 B2
10512461 Gupta et al. Dec 2019 B2
10512499 McHenry et al. Dec 2019 B2
10512514 Nowlin et al. Dec 2019 B2
10517588 Gupta et al. Dec 2019 B2
10517595 Hunter et al. Dec 2019 B2
10517596 Hunter et al. Dec 2019 B2
10517686 Vokrot et al. Dec 2019 B2
10524789 Swayze et al. Jan 2020 B2
10531874 Morgan et al. Jan 2020 B2
10531929 Widenhouse et al. Jan 2020 B2
10532330 Diallo et al. Jan 2020 B2
10536617 Liang et al. Jan 2020 B2
10537324 Shelton, IV et al. Jan 2020 B2
10537325 Bakos et al. Jan 2020 B2
10537351 Shelton, IV et al. Jan 2020 B2
10542978 Chowaniec et al. Jan 2020 B2
10542979 Shelton, IV et al. Jan 2020 B2
10542982 Beckman et al. Jan 2020 B2
10542991 Shelton, IV et al. Jan 2020 B2
10548504 Shelton, IV et al. Feb 2020 B2
10548612 Martinez et al. Feb 2020 B2
10548673 Harris et al. Feb 2020 B2
10552574 Sweeney Feb 2020 B2
10555675 Satish et al. Feb 2020 B2
10555748 Yates et al. Feb 2020 B2
10555750 Conlon et al. Feb 2020 B2
10555769 Worrell et al. Feb 2020 B2
10561422 Schellin et al. Feb 2020 B2
10561471 Nichogi Feb 2020 B2
10568625 Harris et al. Feb 2020 B2
10568626 Shelton, IV et al. Feb 2020 B2
10568632 Miller et al. Feb 2020 B2
10568704 Savaii et al. Feb 2020 B2
10575868 Hall et al. Mar 2020 B2
10582928 Hunter et al. Mar 2020 B2
10582931 Mujawar Mar 2020 B2
10582964 Weinberg et al. Mar 2020 B2
10586074 Rose et al. Mar 2020 B2
10588625 Weaner et al. Mar 2020 B2
10588629 Malinouskas et al. Mar 2020 B2
10588630 Shelton, IV et al. Mar 2020 B2
10588631 Shelton, IV et al. Mar 2020 B2
10588632 Shelton, IV et al. Mar 2020 B2
10588711 DiCarlo et al. Mar 2020 B2
10592067 Merdan et al. Mar 2020 B2
10595844 Nawana et al. Mar 2020 B2
10595882 Parfett et al. Mar 2020 B2
10595887 Shelton, IV et al. Mar 2020 B2
10595930 Scheib et al. Mar 2020 B2
10595952 Forrest et al. Mar 2020 B2
10602848 Magana Mar 2020 B2
10603036 Hunter et al. Mar 2020 B2
10603128 Zergiebel et al. Mar 2020 B2
10610223 Wellman et al. Apr 2020 B2
10610224 Shelton, IV et al. Apr 2020 B2
10610286 Wiener et al. Apr 2020 B2
10610313 Bailey et al. Apr 2020 B2
10617414 Shelton, IV et al. Apr 2020 B2
10617482 Houser et al. Apr 2020 B2
10617484 Kilroy et al. Apr 2020 B2
10624635 Harris et al. Apr 2020 B2
10624691 Wiener et al. Apr 2020 B2
10631858 Burbank Apr 2020 B2
10631912 McFarlin et al. Apr 2020 B2
10631916 Horner et al. Apr 2020 B2
10631917 Ineson Apr 2020 B2
10631939 Dachs, II et al. Apr 2020 B2
10639027 Shelton, IV et al. May 2020 B2
10639034 Harris et al. May 2020 B2
10639035 Shelton, IV et al. May 2020 B2
10639036 Yates et al. May 2020 B2
10639037 Shelton, IV et al. May 2020 B2
10639039 Vendely et al. May 2020 B2
10639098 Cosman et al. May 2020 B2
10639111 Kopp May 2020 B2
10639185 Agrawal et al. May 2020 B2
10653413 Worthington et al. May 2020 B2
10653476 Ross May 2020 B2
10653489 Kopp May 2020 B2
10656720 Holz May 2020 B1
10660705 Piron et al. May 2020 B2
10667809 Bakos et al. Jun 2020 B2
10667810 Shelton, IV et al. Jun 2020 B2
10667811 Harris et al. Jun 2020 B2
10667877 Kapadia Jun 2020 B2
10674897 Levy Jun 2020 B2
10675021 Harris et al. Jun 2020 B2
10675024 Shelton, IV et al. Jun 2020 B2
10675025 Swayze et al. Jun 2020 B2
10675026 Harris et al. Jun 2020 B2
10675035 Zingman Jun 2020 B2
10675104 Kapadia Jun 2020 B2
10677764 Ross et al. Jun 2020 B2
10679758 Fox et al. Jun 2020 B2
10682136 Harris et al. Jun 2020 B2
10682138 Shelton, IV et al. Jun 2020 B2
10686805 Reybok, Jr. et al. Jun 2020 B2
10687806 Shelton, IV et al. Jun 2020 B2
10687810 Shelton, IV et al. Jun 2020 B2
10687884 Wiener et al. Jun 2020 B2
10687905 Kostrzewski Jun 2020 B2
10695081 Shelton, IV et al. Jun 2020 B2
10695134 Barral et al. Jun 2020 B2
10702270 Shelton, IV et al. Jul 2020 B2
10709446 Harris et al. Jul 2020 B2
10716489 Kalvoy et al. Jul 2020 B2
10716615 Shelton, IV et al. Jul 2020 B2
10716639 Kapadia et al. Jul 2020 B2
10717194 Griffiths et al. Jul 2020 B2
10722222 Aranyi Jul 2020 B2
10722292 Arya et al. Jul 2020 B2
D893717 Messerly et al. Aug 2020 S
10729458 Stoddard et al. Aug 2020 B2
10729509 Shelton, IV et al. Aug 2020 B2
10733267 Pedersen Aug 2020 B2
10736219 Seow et al. Aug 2020 B2
10736616 Scheib et al. Aug 2020 B2
10736628 Yates et al. Aug 2020 B2
10736629 Shelton, IV et al. Aug 2020 B2
10736636 Baxter, III et al. Aug 2020 B2
10736705 Scheib et al. Aug 2020 B2
10743872 Leimbach et al. Aug 2020 B2
10748115 Laster et al. Aug 2020 B2
10751052 Stokes et al. Aug 2020 B2
10751136 Farritor et al. Aug 2020 B2
10751768 Hersey et al. Aug 2020 B2
10755813 Shelton, IV et al. Aug 2020 B2
D896379 Shelton, IV et al. Sep 2020 S
10758229 Shelton, IV et al. Sep 2020 B2
10758230 Shelton, IV et al. Sep 2020 B2
10758294 Jones Sep 2020 B2
10758310 Shelton, IV et al. Sep 2020 B2
10765376 Brown, III et al. Sep 2020 B2
10765424 Baxter, III et al. Sep 2020 B2
10765427 Shelton, IV et al. Sep 2020 B2
10765470 Yates et al. Sep 2020 B2
10772630 Wixey Sep 2020 B2
10772651 Shelton, IV et al. Sep 2020 B2
10772688 Peine et al. Sep 2020 B2
10779818 Zemlok et al. Sep 2020 B2
10779821 Harris et al. Sep 2020 B2
10779823 Shelton, IV et al. Sep 2020 B2
10779897 Rockrohr Sep 2020 B2
10779900 Pedros et al. Sep 2020 B2
10783634 Nye et al. Sep 2020 B2
10786298 Johnson Sep 2020 B2
10786317 Zhou et al. Sep 2020 B2
10786327 Anderson et al. Sep 2020 B2
10792118 Prpa et al. Oct 2020 B2
10792422 Douglas et al. Oct 2020 B2
10799304 Kapadia et al. Oct 2020 B2
10803977 Sanmugalingham Oct 2020 B2
10806445 Penna et al. Oct 2020 B2
10806454 Kopp Oct 2020 B2
10806506 Gaspredes et al. Oct 2020 B2
10806532 Grubbs et al. Oct 2020 B2
10813638 Shelton, IV et al. Oct 2020 B2
10813703 Swayze et al. Oct 2020 B2
10818383 Sedeh et al. Oct 2020 B2
10828028 Harris et al. Nov 2020 B2
10828030 Weir et al. Nov 2020 B2
10835245 Swayze et al. Nov 2020 B2
10835246 Shelton, IV et al. Nov 2020 B2
10835247 Shelton, IV Nov 2020 B2
10842473 Scheib et al. Nov 2020 B2
10842490 DiNardo et al. Nov 2020 B2
10842492 Shelton, IV et al. Nov 2020 B2
10842522 Messerly et al. Nov 2020 B2
10842523 Shelton, IV et al. Nov 2020 B2
10842575 Panescu et al. Nov 2020 B2
10842897 Schwartz et al. Nov 2020 B2
10849697 Yates et al. Dec 2020 B2
10849700 Kopp et al. Dec 2020 B2
10856768 Osadchy et al. Dec 2020 B2
10856867 Shelton, IV et al. Dec 2020 B2
10856868 Shelton, IV et al. Dec 2020 B2
10856870 Harris et al. Dec 2020 B2
10864037 Mun et al. Dec 2020 B2
10864050 Tabandeh et al. Dec 2020 B2
10872684 McNutt et al. Dec 2020 B2
10881399 Shelton, IV et al. Jan 2021 B2
10881401 Baber et al. Jan 2021 B2
10881446 Strobl Jan 2021 B2
10881464 Odermatt et al. Jan 2021 B2
10888321 Shelton, IV et al. Jan 2021 B2
10888322 Morgan et al. Jan 2021 B2
10892899 Shelton, IV et al. Jan 2021 B2
10892995 Shelton, IV et al. Jan 2021 B2
10893863 Shelton, IV et al. Jan 2021 B2
10893864 Harris et al. Jan 2021 B2
10893884 Stoddard et al. Jan 2021 B2
10898183 Shelton, IV et al. Jan 2021 B2
10898186 Bakos et al. Jan 2021 B2
10898280 Kopp Jan 2021 B2
10898622 Shelton, IV et al. Jan 2021 B2
10902944 Casey et al. Jan 2021 B1
10903685 Yates et al. Jan 2021 B2
10905415 DiNardo et al. Feb 2021 B2
10905418 Shelton, IV et al. Feb 2021 B2
10905420 Jasemian et al. Feb 2021 B2
10912559 Harris et al. Feb 2021 B2
10912580 Green et al. Feb 2021 B2
10912619 Jarc et al. Feb 2021 B2
10918385 Overmyer et al. Feb 2021 B2
10930400 Robbins et al. Feb 2021 B2
10932705 Muhsin et al. Mar 2021 B2
10932772 Shelton, IV et al. Mar 2021 B2
10932784 Mozdzierz et al. Mar 2021 B2
10932804 Scheib et al. Mar 2021 B2
10932806 Shelton, IV et al. Mar 2021 B2
10932872 Shelton, IV et al. Mar 2021 B2
10939313 Eom et al. Mar 2021 B2
10943454 Shelton, IV et al. Mar 2021 B2
10944728 Wiener et al. Mar 2021 B2
10945727 Shelton, IV et al. Mar 2021 B2
10952708 Scheib et al. Mar 2021 B2
10954935 O'Shea et al. Mar 2021 B2
10959727 Hunter et al. Mar 2021 B2
10959729 Ehrenfels et al. Mar 2021 B2
10959744 Shelton, IV et al. Mar 2021 B2
10959788 Grover et al. Mar 2021 B2
10960150 Zergiebel et al. Mar 2021 B2
10966791 Harris et al. Apr 2021 B2
10966798 Tesar et al. Apr 2021 B2
10973516 Shelton, IV et al. Apr 2021 B2
10973517 Wixey Apr 2021 B2
10973520 Shelton, IV et al. Apr 2021 B2
10973682 Vezzu et al. Apr 2021 B2
10980536 Weaner et al. Apr 2021 B2
10980537 Shelton, IV et al. Apr 2021 B2
10980560 Shelton, IV et al. Apr 2021 B2
10980610 Rosenberg et al. Apr 2021 B2
10987102 Gonzalez et al. Apr 2021 B2
10987178 Shelton, IV et al. Apr 2021 B2
10992698 Patel et al. Apr 2021 B2
10993715 Shelton, IV et al. May 2021 B2
10998098 Greene et al. May 2021 B2
20020049551 Friedman et al. Apr 2002 A1
20020072746 Lingenfelder et al. Jun 2002 A1
20030009111 Cory et al. Jan 2003 A1
20030093503 Yamaki et al. May 2003 A1
20030114851 Truckai et al. Jun 2003 A1
20030210812 Khamene et al. Nov 2003 A1
20030223877 Anstine et al. Dec 2003 A1
20040078236 Stoodley et al. Apr 2004 A1
20040199180 Knodel et al. Oct 2004 A1
20040199659 Ishikawa et al. Oct 2004 A1
20040206365 Knowlton Oct 2004 A1
20040243148 Wasielewski Dec 2004 A1
20040243435 Williams Dec 2004 A1
20050020909 Moctezuma de la Barrera et al. Jan 2005 A1
20050023324 Doll et al. Feb 2005 A1
20050063575 Ma et al. Mar 2005 A1
20050065438 Miller Mar 2005 A1
20050131390 Heinrich et al. Jun 2005 A1
20050143759 Kelly Jun 2005 A1
20050149001 Uchikubo et al. Jul 2005 A1
20050149356 Cyr et al. Jul 2005 A1
20050192633 Montpetit Sep 2005 A1
20050222631 Dalal et al. Oct 2005 A1
20050236474 Onuma et al. Oct 2005 A1
20050277913 McCary Dec 2005 A1
20060020272 Gildenberg Jan 2006 A1
20060025816 Shelton Feb 2006 A1
20060059018 Shiobara et al. Mar 2006 A1
20060079874 Faller et al. Apr 2006 A1
20060116908 Dew et al. Jun 2006 A1
20060184160 Ozaki et al. Aug 2006 A1
20060241399 Fabian Oct 2006 A1
20070010838 Shelton et al. Jan 2007 A1
20070016235 Tanaka et al. Jan 2007 A1
20070027459 Horvath et al. Feb 2007 A1
20070049947 Menn et al. Mar 2007 A1
20070078678 DiSilvestro et al. Apr 2007 A1
20070125828 Rethy Jun 2007 A1
20070167702 Hasser et al. Jul 2007 A1
20070168461 Moore Jul 2007 A1
20070173803 Wham et al. Jul 2007 A1
20070175955 Shelton et al. Aug 2007 A1
20070179482 Anderson Aug 2007 A1
20070191713 Eichmann et al. Aug 2007 A1
20070225556 Ortiz et al. Sep 2007 A1
20070225690 Sekiguchi et al. Sep 2007 A1
20070244478 Bahney Oct 2007 A1
20070249990 Cosmescu Oct 2007 A1
20070270660 Caylor et al. Nov 2007 A1
20070282333 Fortson et al. Dec 2007 A1
20070293218 Meylan et al. Dec 2007 A1
20080013460 Allen et al. Jan 2008 A1
20080015664 Podhajsky Jan 2008 A1
20080015912 Rosenthal et al. Jan 2008 A1
20080033404 Romoda et al. Feb 2008 A1
20080040151 Moore Feb 2008 A1
20080059658 Williams Mar 2008 A1
20080077158 Haider et al. Mar 2008 A1
20080083414 Messerges Apr 2008 A1
20080177258 Govari et al. Jul 2008 A1
20080177362 Phillips et al. Jul 2008 A1
20080200940 Eichmann et al. Aug 2008 A1
20080255413 Zemlok et al. Oct 2008 A1
20080262654 Omori et al. Oct 2008 A1
20080281301 DeBoer et al. Nov 2008 A1
20080281678 Keuls et al. Nov 2008 A1
20080296346 Shelton, IV et al. Dec 2008 A1
20080306759 Ilkin et al. Dec 2008 A1
20080312953 Claus Dec 2008 A1
20090036750 Weinstein et al. Feb 2009 A1
20090036794 Stubhaug et al. Feb 2009 A1
20090043253 Podaima Feb 2009 A1
20090046146 Hoyt Feb 2009 A1
20090048589 Takashino et al. Feb 2009 A1
20090076409 Wu et al. Mar 2009 A1
20090090763 Zemlok et al. Apr 2009 A1
20090099866 Newman Apr 2009 A1
20090182577 Squilla et al. Jul 2009 A1
20090206131 Weisenburgh, II et al. Aug 2009 A1
20090217932 Voegele Sep 2009 A1
20090234352 Behnke et al. Sep 2009 A1
20090259149 Tahara et al. Oct 2009 A1
20090259221 Tahara et al. Oct 2009 A1
20090307681 Armado et al. Dec 2009 A1
20090326321 Jacobsen et al. Dec 2009 A1
20090326336 Lemke et al. Dec 2009 A1
20100065604 Weng Mar 2010 A1
20100069942 Shelton, IV Mar 2010 A1
20100070417 Flynn et al. Mar 2010 A1
20100132334 Duclos et al. Jun 2010 A1
20100137845 Ramstein et al. Jun 2010 A1
20100168561 Anderson Jul 2010 A1
20100179831 Brown et al. Jul 2010 A1
20100191100 Anderson et al. Jul 2010 A1
20100198248 Vakharia Aug 2010 A1
20100217991 Choi Aug 2010 A1
20100235689 Tian et al. Sep 2010 A1
20100250571 Pierce et al. Sep 2010 A1
20100292535 Paskar Nov 2010 A1
20100292684 Cybulski et al. Nov 2010 A1
20110022032 Zemlok et al. Jan 2011 A1
20110071530 Carson Mar 2011 A1
20110077512 Boswell Mar 2011 A1
20110087238 Wang et al. Apr 2011 A1
20110105895 Kornblau et al. May 2011 A1
20110118708 Burbank et al. May 2011 A1
20110119075 Dhoble May 2011 A1
20110125149 El-Galley et al. May 2011 A1
20110152712 Cao et al. Jun 2011 A1
20110166883 Palmer et al. Jul 2011 A1
20110237883 Chun Sep 2011 A1
20110264000 Paul et al. Oct 2011 A1
20110306840 Allen et al. Dec 2011 A1
20120022519 Huang et al. Jan 2012 A1
20120059684 Hampapur et al. Mar 2012 A1
20120078247 Worrell et al. Mar 2012 A1
20120080336 Shelton, IV et al. Apr 2012 A1
20120116265 Houser et al. May 2012 A1
20120116381 Houser et al. May 2012 A1
20120130217 Kauphusman et al. May 2012 A1
20120145714 Farascioni et al. Jun 2012 A1
20120172696 Kallback et al. Jul 2012 A1
20120191091 Allen Jul 2012 A1
20120203785 Awada Aug 2012 A1
20120211542 Racenet Aug 2012 A1
20120245958 Lawrence et al. Sep 2012 A1
20120265555 Cappuzzo et al. Oct 2012 A1
20120292367 Morgan et al. Nov 2012 A1
20120319859 Taub et al. Dec 2012 A1
20130024213 Poon Jan 2013 A1
20130046182 Hegg et al. Feb 2013 A1
20130046279 Niklewski et al. Feb 2013 A1
20130066647 Andrie et al. Mar 2013 A1
20130090526 Suzuki et al. Apr 2013 A1
20130093829 Rosenblatt et al. Apr 2013 A1
20130116218 Kaplan et al. May 2013 A1
20130165776 Blomqvist Jun 2013 A1
20130178853 Hyink et al. Jul 2013 A1
20130206813 Nalagatla Aug 2013 A1
20130214025 Zemlok et al. Aug 2013 A1
20130248577 Leimbach Sep 2013 A1
20130253480 Kimball et al. Sep 2013 A1
20130256373 Schmid et al. Oct 2013 A1
20130267874 Marcotte et al. Oct 2013 A1
20130277410 Fernandez et al. Oct 2013 A1
20130317837 Ballantyne et al. Nov 2013 A1
20130321425 Greene et al. Dec 2013 A1
20130325809 Kim et al. Dec 2013 A1
20130331873 Ross et al. Dec 2013 A1
20130331875 Ross et al. Dec 2013 A1
20140001231 Shelton, IV et al. Jan 2014 A1
20140001234 Shelton, IV et al. Jan 2014 A1
20140005640 Shelton, IV et al. Jan 2014 A1
20140006132 Barker Jan 2014 A1
20140013565 MacDonald et al. Jan 2014 A1
20140029411 Nayak et al. Jan 2014 A1
20140033926 Fassel et al. Feb 2014 A1
20140035762 Shelton, IV et al. Feb 2014 A1
20140066700 Wilson et al. Mar 2014 A1
20140081255 Johnson et al. Mar 2014 A1
20140081659 Nawana et al. Mar 2014 A1
20140084949 Smith et al. Mar 2014 A1
20140087999 Kaplan et al. Mar 2014 A1
20140092089 Kasuya et al. Apr 2014 A1
20140107697 Patani et al. Apr 2014 A1
20140108035 Akbay et al. Apr 2014 A1
20140108983 William et al. Apr 2014 A1
20140148729 Schmitz et al. May 2014 A1
20140166724 Schellin et al. Jun 2014 A1
20140187856 Holoien et al. Jul 2014 A1
20140194864 Martin et al. Jul 2014 A1
20140204190 Rosenblatt, III et al. Jul 2014 A1
20140243799 Parihar Aug 2014 A1
20140243809 Gelfand et al. Aug 2014 A1
20140246475 Hall et al. Sep 2014 A1
20140249557 Koch et al. Sep 2014 A1
20140252064 Mozdzierz et al. Sep 2014 A1
20140263541 Leimbach et al. Sep 2014 A1
20140263552 Hall et al. Sep 2014 A1
20140303660 Boyden et al. Oct 2014 A1
20140305987 Parihar Oct 2014 A1
20150006201 Pait et al. Jan 2015 A1
20150025549 Kilroy et al. Jan 2015 A1
20150032150 Ishida et al. Jan 2015 A1
20150051452 Ciaccio Feb 2015 A1
20150051617 Takemura et al. Feb 2015 A1
20150053737 Leimbach et al. Feb 2015 A1
20150066000 An et al. Mar 2015 A1
20150070187 Wiesner et al. Mar 2015 A1
20150108198 Estrella Apr 2015 A1
20150133945 Dushyant et al. May 2015 A1
20150196295 Shelton, IV et al. Jul 2015 A1
20150199109 Lee Jul 2015 A1
20150272557 Overmyer et al. Oct 2015 A1
20150272571 Leimbach et al. Oct 2015 A1
20150272580 Leimbach et al. Oct 2015 A1
20150272582 Leimbach et al. Oct 2015 A1
20150297200 Fitzsimmons et al. Oct 2015 A1
20150297222 Huitema et al. Oct 2015 A1
20150297228 Huitema et al. Oct 2015 A1
20150297233 Huitema et al. Oct 2015 A1
20150297311 Tesar Oct 2015 A1
20150302157 Collar et al. Oct 2015 A1
20150310174 Coudert et al. Oct 2015 A1
20150313538 Bechtel et al. Nov 2015 A1
20150317899 Dumbauld et al. Nov 2015 A1
20150324114 Hurley et al. Nov 2015 A1
20150332003 Stamm et al. Nov 2015 A1
20150332196 Stiller et al. Nov 2015 A1
20160000437 Giordano et al. Jan 2016 A1
20160015471 Piron et al. Jan 2016 A1
20160034648 Mohlenbrock et al. Feb 2016 A1
20160038253 Piron et al. Feb 2016 A1
20160066913 Swayze et al. Mar 2016 A1
20160106516 Mesallum Apr 2016 A1
20160106934 Hiraga et al. Apr 2016 A1
20160158468 Tang et al. Jun 2016 A1
20160180045 Syed Jun 2016 A1
20160192960 Bueno et al. Jul 2016 A1
20160206202 Frangioni Jul 2016 A1
20160224760 Petak et al. Aug 2016 A1
20160235303 Fleming et al. Aug 2016 A1
20160249910 Shelton, IV et al. Sep 2016 A1
20160256160 Shelton, IV et al. Sep 2016 A1
20160278841 Panescu et al. Sep 2016 A1
20160287912 Warnking Oct 2016 A1
20160296246 Schaller Oct 2016 A1
20160302210 Thornton et al. Oct 2016 A1
20160310055 Zand et al. Oct 2016 A1
20160321400 Durrant et al. Nov 2016 A1
20160323283 Kang et al. Nov 2016 A1
20160342753 Feazell Nov 2016 A1
20160342916 Arceneaux et al. Nov 2016 A1
20160345857 Jensrud et al. Dec 2016 A1
20160350490 Martinez et al. Dec 2016 A1
20160361070 Ardel et al. Dec 2016 A1
20160374723 Frankhouser et al. Dec 2016 A1
20160374762 Case et al. Dec 2016 A1
20170000516 Stulen et al. Jan 2017 A1
20170000553 Wiener et al. Jan 2017 A1
20170027603 Pandey Feb 2017 A1
20170068792 Reiner Mar 2017 A1
20170079730 Azizian et al. Mar 2017 A1
20170086829 Vendely et al. Mar 2017 A1
20170086930 Thompson et al. Mar 2017 A1
20170105754 Boudreaux et al. Apr 2017 A1
20170116873 Lendvay et al. Apr 2017 A1
20170132374 Lee et al. May 2017 A1
20170132785 Wshah et al. May 2017 A1
20170143284 Sehnert et al. May 2017 A1
20170164997 Johnson et al. Jun 2017 A1
20170165012 Chaplin et al. Jun 2017 A1
20170172565 Heneveld Jun 2017 A1
20170172614 Scheib et al. Jun 2017 A1
20170177807 Fabian Jun 2017 A1
20170196583 Sugiyama Jul 2017 A1
20170196637 Shelton, IV et al. Jul 2017 A1
20170202591 Shelton, IV et al. Jul 2017 A1
20170202607 Shelton, IV et al. Jul 2017 A1
20170224332 Hunter et al. Aug 2017 A1
20170224334 Worthington et al. Aug 2017 A1
20170224428 Kopp Aug 2017 A1
20170231627 Shelton, IV et al. Aug 2017 A1
20170231628 Shelton, IV et al. Aug 2017 A1
20170245809 Ma et al. Aug 2017 A1
20170249432 Grantcharov Aug 2017 A1
20170262604 Francois Sep 2017 A1
20170265864 Hessler et al. Sep 2017 A1
20170273715 Piron et al. Sep 2017 A1
20170281171 Shelton, IV et al. Oct 2017 A1
20170281173 Shelton, IV et al. Oct 2017 A1
20170281186 Shelton, IV et al. Oct 2017 A1
20170281189 Nalagatla et al. Oct 2017 A1
20170290585 Shelton, IV et al. Oct 2017 A1
20170290586 Wellman Oct 2017 A1
20170296169 Yates et al. Oct 2017 A1
20170296173 Shelton, IV et al. Oct 2017 A1
20170296185 Swensgard et al. Oct 2017 A1
20170296213 Swensgard et al. Oct 2017 A1
20170303419 Collins et al. Oct 2017 A1
20170303984 Malackowski Oct 2017 A1
20170304020 Ng et al. Oct 2017 A1
20170312456 Phillips Nov 2017 A1
20170325813 Aranyi et al. Nov 2017 A1
20170325876 Nakadate et al. Nov 2017 A1
20170325878 Messerly et al. Nov 2017 A1
20170360438 Cappola Dec 2017 A1
20170360439 Chen et al. Dec 2017 A1
20170360499 Greep et al. Dec 2017 A1
20170367583 Black et al. Dec 2017 A1
20170367695 Shelton, IV et al. Dec 2017 A1
20170367754 Narisawa Dec 2017 A1
20170367771 Tako et al. Dec 2017 A1
20170367772 Gunn et al. Dec 2017 A1
20170370710 Chen et al. Dec 2017 A1
20180008359 Randle Jan 2018 A1
20180011983 Zuhars et al. Jan 2018 A1
20180050196 Pawsey et al. Feb 2018 A1
20180055529 Messerly et al. Mar 2018 A1
20180065248 Barral et al. Mar 2018 A1
20180078170 Panescu et al. Mar 2018 A1
20180098816 Govari et al. Apr 2018 A1
20180110523 Shelton, IV Apr 2018 A1
20180116662 Shelton, IV et al. May 2018 A1
20180116735 Tierney et al. May 2018 A1
20180122506 Grantcharov et al. May 2018 A1
20180125485 Beardsley May 2018 A1
20180125590 Giordano et al. May 2018 A1
20180132895 Silver May 2018 A1
20180144243 Hsieh et al. May 2018 A1
20180153574 Faller et al. Jun 2018 A1
20180153632 Tokarchuk et al. Jun 2018 A1
20180154297 Maletich et al. Jun 2018 A1
20180161716 Li et al. Jun 2018 A1
20180168575 Simms et al. Jun 2018 A1
20180168577 Aronhalt et al. Jun 2018 A1
20180168578 Aronhalt et al. Jun 2018 A1
20180168579 Aronhalt et al. Jun 2018 A1
20180168584 Harris et al. Jun 2018 A1
20180168590 Overmyer et al. Jun 2018 A1
20180168592 Overmyer et al. Jun 2018 A1
20180168597 Fanelli et al. Jun 2018 A1
20180168598 Shelton, IV et al. Jun 2018 A1
20180168606 Shelton, IV et al. Jun 2018 A1
20180168608 Shelton, IV et al. Jun 2018 A1
20180168609 Fanelli et al. Jun 2018 A1
20180168610 Shelton, IV et al. Jun 2018 A1
20180168614 Shelton, IV et al. Jun 2018 A1
20180168615 Shelton, IV et al. Jun 2018 A1
20180168618 Scott et al. Jun 2018 A1
20180168619 Scott et al. Jun 2018 A1
20180168621 Shelton, IV et al. Jun 2018 A1
20180168623 Simms et al. Jun 2018 A1
20180168625 Posada et al. Jun 2018 A1
20180168633 Shelton, IV et al. Jun 2018 A1
20180168646 Shelton, IV Jun 2018 A1
20180168647 Shelton, IV et al. Jun 2018 A1
20180168648 Shelton, IV et al. Jun 2018 A1
20180168649 Shelton, IV et al. Jun 2018 A1
20180168650 Shelton, IV et al. Jun 2018 A1
20180177383 Noonan et al. Jun 2018 A1
20180206884 Beaupre Jul 2018 A1
20180206905 Batchelor et al. Jul 2018 A1
20180214025 Homyk et al. Aug 2018 A1
20180221598 Silver Aug 2018 A1
20180228557 Darisse et al. Aug 2018 A1
20180233222 Daley et al. Aug 2018 A1
20180235719 Jarc Aug 2018 A1
20180242967 Meade Aug 2018 A1
20180263710 Sakaguchi et al. Sep 2018 A1
20180268320 Shekhar Sep 2018 A1
20180271520 Shelton, IV et al. Sep 2018 A1
20180271603 Nir et al. Sep 2018 A1
20180296286 Peine et al. Oct 2018 A1
20180303552 Ryan et al. Oct 2018 A1
20180304471 Tokuchi Oct 2018 A1
20180310986 Batchelor et al. Nov 2018 A1
20180317915 McDonald, II Nov 2018 A1
20180344318 Nicholas Dec 2018 A1
20180360456 Shelton, IV et al. Dec 2018 A1
20180368930 Esterberg et al. Dec 2018 A1
20190000478 Messerly et al. Jan 2019 A1
20190000565 Shelton, IV et al. Jan 2019 A1
20190000569 Crawford et al. Jan 2019 A1
20190001079 Zergiebel et al. Jan 2019 A1
20190005641 Yamamoto Jan 2019 A1
20190006047 Gorek et al. Jan 2019 A1
20190025040 Andreason et al. Jan 2019 A1
20190036688 Wasily et al. Jan 2019 A1
20190038335 Mohr et al. Feb 2019 A1
20190038364 Enoki Feb 2019 A1
20190053801 Wixey et al. Feb 2019 A1
20190053866 Seow et al. Feb 2019 A1
20190069949 Vrba et al. Mar 2019 A1
20190069964 Hagn Mar 2019 A1
20190070550 Lalomia et al. Mar 2019 A1
20190070731 Bowling et al. Mar 2019 A1
20190087544 Peterson Mar 2019 A1
20190104919 Shelton, IV et al. Apr 2019 A1
20190115108 Hegedus et al. Apr 2019 A1
20190125320 Shelton, IV et al. May 2019 A1
20190125321 Shelton, IV et al. May 2019 A1
20190125324 Scheib et al. May 2019 A1
20190125335 Shelton, IV et al. May 2019 A1
20190125336 Deck et al. May 2019 A1
20190125338 Shelton, IV et al. May 2019 A1
20190125339 Shelton, IV et al. May 2019 A1
20190125347 Stokes et al. May 2019 A1
20190125348 Shelton, IV et al. May 2019 A1
20190125352 Shelton, IV et al. May 2019 A1
20190125353 Shelton, IV et al. May 2019 A1
20190125354 Deck et al. May 2019 A1
20190125355 Shelton, IV et al. May 2019 A1
20190125356 Shelton, IV et al. May 2019 A1
20190125357 Shelton, IV et al. May 2019 A1
20190125358 Shelton, IV et al. May 2019 A1
20190125359 Shelton, IV et al. May 2019 A1
20190125360 Shelton, IV et al. May 2019 A1
20190125361 Shelton, IV et al. May 2019 A1
20190125377 Shelton, IV May 2019 A1
20190125378 Shelton, IV et al. May 2019 A1
20190125379 Shelton, IV et al. May 2019 A1
20190125380 Hunter et al. May 2019 A1
20190125384 Scheib et al. May 2019 A1
20190125387 Parihar et al. May 2019 A1
20190125388 Shelton, IV et al. May 2019 A1
20190125389 Shelton, IV et al. May 2019 A1
20190125430 Shelton, IV et al. May 2019 A1
20190125431 Shelton, IV et al. May 2019 A1
20190125432 Shelton, IV et al. May 2019 A1
20190125454 Stokes et al. May 2019 A1
20190125455 Shelton, IV et al. May 2019 A1
20190125456 Shelton, IV et al. May 2019 A1
20190125457 Parihar et al. May 2019 A1
20190125458 Shelton, IV et al. May 2019 A1
20190125459 Shelton, IV et al. May 2019 A1
20190125476 Shelton, IV et al. May 2019 A1
20190133703 Seow et al. May 2019 A1
20190142535 Seow et al. May 2019 A1
20190145942 Dutriez et al. May 2019 A1
20190150975 Kawasaki et al. May 2019 A1
20190159778 Shelton, IV et al. May 2019 A1
20190192157 Scott et al. Jun 2019 A1
20190192236 Shelton, IV et al. Jun 2019 A1
20190200844 Shelton, IV et al. Jul 2019 A1
20190200863 Shelton, IV et al. Jul 2019 A1
20190200905 Shelton, IV et al. Jul 2019 A1
20190200906 Shelton, IV et al. Jul 2019 A1
20190200977 Shelton, IV et al. Jul 2019 A1
20190200980 Shelton, IV et al. Jul 2019 A1
20190200981 Harris et al. Jul 2019 A1
20190200984 Shelton, IV et al. Jul 2019 A1
20190200985 Shelton, IV et al. Jul 2019 A1
20190200986 Shelton, IV et al. Jul 2019 A1
20190200987 Shelton, IV et al. Jul 2019 A1
20190200988 Shelton, IV Jul 2019 A1
20190200996 Shelton, IV et al. Jul 2019 A1
20190200997 Shelton, IV et al. Jul 2019 A1
20190200998 Shelton, IV et al. Jul 2019 A1
20190201020 Shelton, IV et al. Jul 2019 A1
20190201021 Shelton, IV et al. Jul 2019 A1
20190201023 Shelton, IV et al. Jul 2019 A1
20190201024 Shelton, IV et al. Jul 2019 A1
20190201025 Shelton, IV et al. Jul 2019 A1
20190201026 Shelton, IV et al. Jul 2019 A1
20190201027 Shelton, IV et al. Jul 2019 A1
20190201028 Shelton, IV et al. Jul 2019 A1
20190201029 Shelton, IV et al. Jul 2019 A1
20190201030 Shelton, IV et al. Jul 2019 A1
20190201033 Yates et al. Jul 2019 A1
20190201034 Shelton, IV et al. Jul 2019 A1
20190201036 Nott et al. Jul 2019 A1
20190201037 Houser et al. Jul 2019 A1
20190201038 Yates et al. Jul 2019 A1
20190201039 Widenhouse et al. Jul 2019 A1
20190201040 Messerly et al. Jul 2019 A1
20190201041 Kimball et al. Jul 2019 A1
20190201042 Nott et al. Jul 2019 A1
20190201043 Shelton, IV et al. Jul 2019 A1
20190201044 Shelton, IV et al. Jul 2019 A1
20190201045 Yates et al. Jul 2019 A1
20190201046 Shelton, IV et al. Jul 2019 A1
20190201047 Yates et al. Jul 2019 A1
20190201073 Nott et al. Jul 2019 A1
20190201074 Yates et al. Jul 2019 A1
20190201075 Shelton, IV et al. Jul 2019 A1
20190201077 Yates et al. Jul 2019 A1
20190201079 Shelton, IV et al. Jul 2019 A1
20190201080 Messerly et al. Jul 2019 A1
20190201081 Shelton, IV et al. Jul 2019 A1
20190201082 Shelton, IV et al. Jul 2019 A1
20190201083 Shelton, IV et al. Jul 2019 A1
20190201084 Shelton, IV et al. Jul 2019 A1
20190201085 Shelton, IV et al. Jul 2019 A1
20190201086 Shelton, IV et al. Jul 2019 A1
20190201087 Shelton, IV et al. Jul 2019 A1
20190201090 Shelton, IV et al. Jul 2019 A1
20190201091 Yates et al. Jul 2019 A1
20190201092 Yates et al. Jul 2019 A1
20190201102 Shelton, IV et al. Jul 2019 A1
20190201104 Shelton, IV et al. Jul 2019 A1
20190201105 Shelton, IV et al. Jul 2019 A1
20190201111 Shelton, IV et al. Jul 2019 A1
20190201112 Wiener et al. Jul 2019 A1
20190201113 Shelton, IV et al. Jul 2019 A1
20190201114 Shelton, IV et al. Jul 2019 A1
20190201115 Shelton, IV et al. Jul 2019 A1
20190201116 Shelton, IV et al. Jul 2019 A1
20190201118 Shelton, IV et al. Jul 2019 A1
20190201120 Shelton, IV et al. Jul 2019 A1
20190201123 Shelton, IV et al. Jul 2019 A1
20190201124 Shelton, IV et al. Jul 2019 A1
20190201125 Shelton, IV et al. Jul 2019 A1
20190201126 Shelton, IV et al. Jul 2019 A1
20190201127 Shelton, IV et al. Jul 2019 A1
20190201128 Yates et al. Jul 2019 A1
20190201129 Shelton, IV et al. Jul 2019 A1
20190201130 Shelton, IV et al. Jul 2019 A1
20190201135 Shelton, IV et al. Jul 2019 A1
20190201136 Shelton, IV et al. Jul 2019 A1
20190201137 Shelton, IV et al. Jul 2019 A1
20190201138 Yates et al. Jul 2019 A1
20190201139 Shelton, IV et al. Jul 2019 A1
20190201140 Yates et al. Jul 2019 A1
20190201141 Shelton, IV et al. Jul 2019 A1
20190201142 Shelton, IV et al. Jul 2019 A1
20190201145 Shelton, IV et al. Jul 2019 A1
20190201146 Shelton, IV et al. Jul 2019 A1
20190201158 Shelton, IV et al. Jul 2019 A1
20190201159 Shelton, IV et al. Jul 2019 A1
20190201594 Shelton, IV et al. Jul 2019 A1
20190201597 Shelton, IV et al. Jul 2019 A1
20190204201 Shelton, IV et al. Jul 2019 A1
20190205001 Messerly et al. Jul 2019 A1
20190205441 Shelton, IV et al. Jul 2019 A1
20190205566 Shelton, IV et al. Jul 2019 A1
20190205567 Shelton, IV et al. Jul 2019 A1
20190206003 Harris et al. Jul 2019 A1
20190206004 Shelton, IV et al. Jul 2019 A1
20190206050 Yates et al. Jul 2019 A1
20190206542 Shelton, IV et al. Jul 2019 A1
20190206551 Yates et al. Jul 2019 A1
20190206555 Morgan et al. Jul 2019 A1
20190206556 Shelton, IV et al. Jul 2019 A1
20190206561 Shelton, IV et al. Jul 2019 A1
20190206562 Shelton, IV et al. Jul 2019 A1
20190206563 Shelton, IV et al. Jul 2019 A1
20190206564 Shelton, IV et al. Jul 2019 A1
20190206565 Shelton, IV Jul 2019 A1
20190206569 Shelton, IV et al. Jul 2019 A1
20190206576 Shelton, IV et al. Jul 2019 A1
20190208641 Yates et al. Jul 2019 A1
20190254759 Azizian Aug 2019 A1
20190261984 Nelson et al. Aug 2019 A1
20190269476 Bowling et al. Sep 2019 A1
20190272917 Couture et al. Sep 2019 A1
20190274662 Rockman et al. Sep 2019 A1
20190274705 Sawhney et al. Sep 2019 A1
20190274706 Nott et al. Sep 2019 A1
20190274707 Sawhney et al. Sep 2019 A1
20190274708 Boudreaux Sep 2019 A1
20190274709 Scoggins Sep 2019 A1
20190274710 Black Sep 2019 A1
20190274711 Scoggins et al. Sep 2019 A1
20190274712 Faller et al. Sep 2019 A1
20190274713 Scoggins et al. Sep 2019 A1
20190274714 Cut et al. Sep 2019 A1
20190274716 Nott et al. Sep 2019 A1
20190274717 Nott et al. Sep 2019 A1
20190274718 Denzinger et al. Sep 2019 A1
20190274719 Stulen Sep 2019 A1
20190274720 Gee et al. Sep 2019 A1
20190274749 Brady et al. Sep 2019 A1
20190274750 Jayme et al. Sep 2019 A1
20190274752 Denzinger et al. Sep 2019 A1
20190290389 Kopp Sep 2019 A1
20190298340 Shelton, IV et al. Oct 2019 A1
20190298341 Shelton, IV et al. Oct 2019 A1
20190298342 Shelton, IV et al. Oct 2019 A1
20190298343 Shelton, IV et al. Oct 2019 A1
20190298347 Shelton, IV et al. Oct 2019 A1
20190298350 Shelton, IV et al. Oct 2019 A1
20190298352 Shelton, IV et al. Oct 2019 A1
20190298353 Shelton, IV et al. Oct 2019 A1
20190298354 Shelton, IV et al. Oct 2019 A1
20190298355 Shelton, IV et al. Oct 2019 A1
20190298356 Shelton, IV et al. Oct 2019 A1
20190298357 Shelton, IV et al. Oct 2019 A1
20190298464 Abbott Oct 2019 A1
20190307520 Peine et al. Oct 2019 A1
20190311802 Kokubo et al. Oct 2019 A1
20190314015 Shelton, IV et al. Oct 2019 A1
20190314016 Huitema et al. Oct 2019 A1
20190321117 Itkowitz et al. Oct 2019 A1
20190333626 Mansi et al. Oct 2019 A1
20190343594 Garcia Kilroy et al. Nov 2019 A1
20190374140 Tucker et al. Dec 2019 A1
20200000470 Du et al. Jan 2020 A1
20200046353 Deck et al. Feb 2020 A1
20200054317 Pisarnwongs et al. Feb 2020 A1
20200054320 Harris et al. Feb 2020 A1
20200054321 Harris et al. Feb 2020 A1
20200054322 Harris et al. Feb 2020 A1
20200054323 Harris et al. Feb 2020 A1
20200054326 Harris et al. Feb 2020 A1
20200054328 Harris et al. Feb 2020 A1
20200054330 Harris et al. Feb 2020 A1
20200078096 Barbagli et al. Mar 2020 A1
20200100830 Henderson et al. Apr 2020 A1
20200162896 Su et al. May 2020 A1
20200178971 Harris et al. Jun 2020 A1
20200261075 Boudreaux et al. Aug 2020 A1
20200261076 Boudreaux et al. Aug 2020 A1
20200261077 Shelton, IV et al. Aug 2020 A1
20200261078 Bakos et al. Aug 2020 A1
20200261080 Bakos et al. Aug 2020 A1
20200261081 Boudreaux et al. Aug 2020 A1
20200261082 Boudreaux et al. Aug 2020 A1
20200261083 Bakos et al. Aug 2020 A1
20200261084 Bakos et al. Aug 2020 A1
20200261085 Boudreaux et al. Aug 2020 A1
20200261086 Zeiner et al. Aug 2020 A1
20200261087 Timm et al. Aug 2020 A1
20200261088 Harris et al. Aug 2020 A1
20200261089 Shelton, IV et al. Aug 2020 A1
20200275928 Shelton, IV Sep 2020 A1
20200275930 Harris et al. Sep 2020 A1
20200281665 Kopp Sep 2020 A1
20200405375 Shelton, IV et al. Dec 2020 A1
20210000555 Shelton, IV et al. Jan 2021 A1
20210007760 Reisin Jan 2021 A1
20210015568 Liao et al. Jan 2021 A1
20210022731 Eisinger Jan 2021 A1
20210022738 Weir et al. Jan 2021 A1
20210022809 Crawford et al. Jan 2021 A1
20210059674 Shelton, IV et al. Mar 2021 A1
20210153889 Nott et al. May 2021 A1
Foreign Referenced Citations (51)
Number Date Country
2015201140 Mar 2015 AU
2795323 May 2014 CA
101617950 Jan 2010 CN
104490448 Mar 2017 CN
206097107 Apr 2017 CN
108652695 Oct 2018 CN
3824913 Feb 1990 DE
4002843 Apr 1991 DE
102005051367 Apr 2007 DE
102016207666 Nov 2017 DE
0000756 Oct 1981 EP
2732772 May 2014 EP
2942023 Nov 2015 EP
3047806 Jul 2016 EP
3056923 Aug 2016 EP
3095399 Nov 2016 EP
3120781 Jan 2017 EP
3135225 Mar 2017 EP
3141181 Mar 2017 EP
2037167 Jul 1980 GB
2509523 Jul 2014 GB
S5373315 Jun 1978 JP
2017513561 Jun 2017 JP
20140104587 Aug 2014 KR
101587721 Jan 2016 KR
WO-9734533 Sep 1997 WO
WO-0024322 May 2000 WO
WO-0108578 Feb 2001 WO
WO-0112089 Feb 2001 WO
WO-0120892 Mar 2001 WO
WO-03079909 Oct 2003 WO
WO-2007137304 Nov 2007 WO
WO-2008056618 May 2008 WO
WO-2008069816 Jun 2008 WO
WO-2008147555 Dec 2008 WO
WO-2011112931 Sep 2011 WO
WO-2013143573 Oct 2013 WO
WO-2014134196 Sep 2014 WO
WO-2015129395 Sep 2015 WO
WO-2016100719 Jun 2016 WO
WO-2016206015 Dec 2016 WO
WO-201 7011382 Jan 2017 WO
WO-201 7011646 Jan 2017 WO
WO-2017058695 Apr 2017 WO
WO-2017151996 Sep 2017 WO
WO-2017189317 Nov 2017 WO
WO-2017205308 Nov 2017 WO
WO-2017210499 Dec 2017 WO
WO-2017210501 Dec 2017 WO
WO-2018152141 Aug 2018 WO
WO-2018176414 Oct 2018 WO
Non-Patent Literature Citations (53)
Entry
US 10,504,709 B2, 12/2019, Karancsi et al. (withdrawn)
Engel et al. “A safe robot system for craniofacial surgery”, 2013 IEEE International Conference on Robotics and Automation (ICRA); May 6-10, 2013; Karlsruhe, Germany, vol. 2, Jan. 1, 2001, pp. 2020-2024.
Slocinski et al., “Distance measure for impedance spectra for quantified evaluations,” Lecture Notes on Impedance Spectroscopy, vol. 3, Taylor and Francis Group (Jul. 2012)—Book Not Attached.
Zoccali, Bruno, “A Method for Approximating Component Temperatures at Altitude Conditions Based on CFD Analysis at Sea Level Conditions,” (white paper), www.tdmginc.com, Dec. 2018 (9 pages).
Flores et al., “Large-scale Offloading in the Internet of Things,” 2017 IEEE International Conference on Pervasive Computing and Communications Workshops (PERCOM Workshops), IEEE, pp. 479-484, Mar. 13, 2017.
Kalantarian et al., “Computation Offloading for Real-Time Health-Monitoring Devices,” 2016 38th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EBMC), IEEE, pp. 4971-4974, Aug. 16, 2016.
Yuyi Mao et al., “A Survey on Mobile Edge Computing: The Communication Perspective,” IEEE Communications Surveys & Tutorials, pp. 2322-2358, Jun. 13, 2017.
Khazaei et al., “Health Informatics for Neonatal Intensive Care Units: An Analytical Modeling Perspective,” IEEE Journal of Translational Engineering in Health and Medicine, vol. 3, pp. 1-9, Oct. 21, 2015.
Benkmann et al., “Concept of iterative optimization of minimally invasive surgery,” 2017 22nd International Conference on Methods and Models in Automation and Robotics (MMAR), IEEE pp. 443-446, Aug. 28, 2017.
Trautman, Peter, “Breaking the Human-Robot Deadlock: Surpassing Shared Control Performance Limits with Sparse Human-Robot Interaction,” Robotics: Science and Systems XIIII, pp. 1-10, Jul. 12, 2017.
Miksch et al., “Utilizing temporal data abstraction for data validation and therapy planning for artificially ventilated newborn infants,” Artificial Intelligence in Medicine, vol. 8, No. 6, pp. 543-576 (1996).
Horn et al., “Effective data validation of high-frequency data: Time-point-time-interval-, and trendbased methods,” Computers in Biology and Medic, New York, NY, vol. 27, No. 5, pp. 389-409 (1997).
Stacey et al., “Temporal abstraction in intelligent clinical data analysis: A survey,” Artificial Intelligence in Medicine, vol. 39, No. 1, pp. 1-24 (2006).
Yang et al., “A dynamic stategy for packet scheduling and bandwidth allocation based on channel quality in IEEE 802.16e OFDMA system,” Journal of Network and Computer Applications, vol. 39, pp. 52-60, May 2, 2013.
Bonaci et al., “To Make a Robot Secure: An Experimental Analysis of Cyber Security Threats Against Teleoperated Surgical Robots,” May 13, 2015. Retrieved from the Internet: URL:https://arxiv.org/pdf/1504.04339v2.pdf [retrieved on Aug. 24, 2019].
Homa Alemzadeh et al., “Targeted Attacks on Teleoperated Surgical Robots: Dynamic Model-Based Detection and Mitigation,” 2016 46th Annual IEEE/IFIP International Conference on Dependable Systems and Networks (DSN), IEEE, Jun. 28, 2016, pp. 395-406.
Staub et al., “Contour-based Surgical Instrument Tracking Supported by Kinematic Prediction,” Proceedings of the 2010 3rd IEEE RAS & EMBS International Conference on Biomedical Robotics and Biomechatronics, Sep. 1, 2010, pp. 746-752.
Phumzile Malindi, “5. QoS in Telemedicine,” “Telemedicine,” Jun. 20, 2011, IntechOpen, pp. 119-138.
Allan et al., “3-D Pose Estimation of Articulated Instruments in Robotic Minimally Invasive Surgery,” IEEE Transactions on Medical Imaging, vol. 37, No. 5, May 1, 2018, pp. 1204-1213.
Kassahun et al., “Surgical Robotics Beyond Enhanced Dexterity Instrumentation: A Survey of the Machine Learning Techniques and their Role in Intelligent and Autonomous Surgical Actions.” International Journal of Computer Assisted Radiology and Surgery, vol. 11, No. 4, Oct. 2015, pp. 553-568.
Weede et al. “An Intelligent and Autonomous Endoscopic Guidance System for Minimally Invasive Surgery,” 2013 IEEE International Conference on Robotics ad Automation (ICRA), May 6-10, 2013. Karlsruhe, Germany, May 1, 2011, pp. 5762-5768.
Altenberg et al., “Genes of Glycolysis are Ubiquitously Overexpressed in 24 Cancer Classes,” Genomics, vol. 84, pp. 1014-1020 (2004).
Takahashi et al., “Automatic smoke evacuation in laparoscopic surgery: a simplified method for objective evaluation,” Surgical Endoscopy, vol. 27, No. 8, pp. 2980-2987, Feb. 23, 2013.
Harold I. Brandon and V. Leroy Young, Mar. 1997, Surgical Services Management vol. 3 No. 3. retrieved from the internet <https://www.surgimedics.com/Research%20Articles/Electrosurgical%20Plume/Characterization%20And%20Removal%20Of%20Electrosurgical%20Smoke.pdf> (Year: 1997).
Marshall Brain, How Microcontrollers Work, 2006, retrieved from the internet <https://web.archive.org/web/20060221235221/http://electronics.howstuffworks.com/microcontroller.htm/printable> (Year: 2006).
CRC Press, “The Measurement, Instrumentation and Sensors Handbook,” 1999, Section VII, Chapter 41, Peter O'Shea, “Phase Measurement,” pp. 1303-1321, ISBN 0-8493-2145-X.
Jiang, “‘Sound of Silence’: a secure indoor wireless ultrasonic communication system,” Article, 2014, pp. 46-50, Snapshots of Doctoral Research at University College Cork, School of Engineering—Electrical & Electronic Engineering, UCC, Cork, Ireland.
Li, et al., “Short-range ultrasonic communications in air using quadrature modulation,” Journal, Oct. 30, 2009, pp. 2060-2072, IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control, vol. 56, No. 10, IEEE.
Salamon, “AI Detects Polyps Better Than Colonoscopists” Online Article, Jun. 3, 2018, Medscape Medical News, Digestive Disease Week (DDW) 2018: Presentation 133.
Misawa, et al. “Artificial Intelligence-Assisted Polyp Detection for Colonoscopy: Initial Experience,” Article, Jun. 2018, pp. 2027-2029, vol. 154, Issue 8, American Gastroenterolgy Association.
Dottorato, “Analysis and Design of the Rectangular Microstrip Patch Antennas for TM0n0 operating mode,”Article, Oct. 8, 2010, pp. 1-9, Microwave Journal.
Miller, et al., “Impact of Powered and Tissue-Specific Endoscopic Stapling Technology on Clinical and Economic Outcomes of Video-Assisted Thoracic Surgery Lobectomy Procedures: A Retrospective, Observational Study,” Article, Apr. 2018, pp. 707-723, vol. 35 (Issue 5), Advances in Therapy.
Hsiao-Wei Tang, “ARCM”, Video, Sep. 2012, YouTube, 5 screenshots, Retrieved fromInternet: <https://www.youtube.com/watch?v=UIdQaxb3fRw&feature=youtu.be>.
Giannios, et al., “Visible to near-infrared refractive properties of freshly-excised human-liver tissues: marking hepatic malignancies,” Article, Jun. 14, 2016, pp. 1-10, Scientific Reports 6, Article No. 27910, Nature.
Vander Heiden, et al., “Understanding the Warburg effect: the metabolic requirements of cell proliferation,” Article, May 22, 2009, pp. 1-12, vol. 324, Issue 5930, Science.
Hirayama et al., “Quantitative Metabolome Profiling of Colon and Stomach Cancer Microenvironment by Capillary Electrophoresis Time-of-Flight Mass Spectrometry,” Article, Jun. 2009, pp. 4918-4925, vol. 69, Issue 11, Cancer Research.
Cengiz, et al., “A Tale of Two Compartments: Interstitial Versus Blood Glucose Monitoring,” Article, Jun. 2009, pp. S11-S16, vol. 11, Supplement 1, Diabetes Technology & Therapeutics.
Shen, et al., “An iridium nanoparticles dispersed carbon based thick film electrochemical biosensor and its application for a single use, disposable glucose biosensor,” Article, Feb. 3, 2007, pp. 106-113, vol. 125, Issue 1, Sensors and Actuators B: Chemical, Science Direct.
“ATM-MPLS Network Interworking Version 2.0, af-aic-0178.001” ATM Standard, The ATM Forum Technical Committee, published Aug. 2003.
IEEE Std 802.3-2012 (Revision of IEEE Std 802.3-2008, published Dec. 28, 2012.
IEEE Std No. 177, “Standard Definitions and Methods of Measurement for Piezoelectric Vibrators,” published May 1966, The Institute of Electrical and Electronics Engineers, Inc., New York, N.Y.
Shi et al., An intuitive control console for robotic syrgery system, 2014, IEEE, p. 404-407 (Year: 2014).
Choi et al., A haptic augmented reality surgeon console for a laparoscopic surgery robot system, 2013, IEEE, p. 355-357 (Year: 2013).
Xie et al., Development of stereo vision and master-slave controller for a compact surgical robot system, 2015, IEEE, p. 403-407 (Year: 2015).
Sun et al., Innovative effector design for simulation training in robotic surgery, 2010, IEEE, p. 1735-1759 (Year: 2010).
Anonymous, “Internet of Things Powers Connected Surgical Device Infrastructure Case Study”, Dec. 31, 2016 (Dec. 31, 2016), Retrieved from the Internet: URL:https://www.cognizant.com/services-resources/150110_IoT_connected_surgical_devices.pdf.
Draijer, Matthijs et al., “Review of laser speckle contrast techniques for visualizing tissue perfusion,” Lasers in Medical Science, Springer-Verlag, LO, vol. 24, No. 4, Dec. 3, 2008, pp. 639-651.
Roy D Cullum, “Handbook of Engineering Design”, ISBN: 9780408005586, Jan. 1, 1988 (Jan. 1, 1988), XP055578597, ISBN: 9780408005586, 10-20, Chapter6, p. 138, right-hand column, paragraph 3.
“Surgical instrumentation: the true cost of instrument trays and a potential strategy for optimization”; Mhlaba et al.; Sep. 23, 2015 (Year: 2015).
Nabil Simaan et al., “Intelligent Surgical Robots with Situational Awareness: From Good to Great Surgeons”, DOI: 10.1115/1.2015-Sep-6 external link, Sep. 2015 (Sep. 2015), p. 3-6, Retrieved from the Internet: URL:http://memagazineselect.asmedigitalcollection.asme.org/data/journals/meena/936888/me-2015-sep6.pdf XP055530863.
Anonymous: “Titanium Key Chain Tool 1.1, Ultralight Multipurpose Key Chain Tool, Forward Cutting Can Opener—Vargo Titanium,” vargooutdoors.com, Jul. 5, 2014 (Jul. 5, 2014), retrieved from the internet: https://vargooutdoors.com/titanium-key-chain-tool-1-1.html.
Anonymous: “Screwdriver—Wikipedia”, en.wikipedia.org, Jun. 23, 2019, XP055725151, Retrieved from the Internet: URL:https://en.wikipedia.org/w/index.php?title=Screwdriver&oldid=903111203 [retrieved on Mar. 20, 2021].
Nordlinger, Christopher, “The Internet of Things and the Operating Room of the Future,” May 4, 2015, https://medium.com/@chrisnordlinger/the-internet-of-things-and-the-operating-room-of-the-future-8999a143d7b1, retrieved from the internet on Apr. 27, 2021, 9 pages.
Related Publications (1)
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20190298346 A1 Oct 2019 US
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62807309 Feb 2019 US
62807310 Feb 2019 US
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62650887 Mar 2018 US
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62649291 Mar 2018 US
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