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WO2023214251A1 - Câbles d'articulation, mécanismes d'articulation et instruments chirurgicaux articulés tels que destinés à être utilisés dans des systèmes chirurgicaux robotisés - Google Patents

Câbles d'articulation, mécanismes d'articulation et instruments chirurgicaux articulés tels que destinés à être utilisés dans des systèmes chirurgicaux robotisés Download PDF

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Publication number
WO2023214251A1
WO2023214251A1 PCT/IB2023/054254 IB2023054254W WO2023214251A1 WO 2023214251 A1 WO2023214251 A1 WO 2023214251A1 IB 2023054254 W IB2023054254 W IB 2023054254W WO 2023214251 A1 WO2023214251 A1 WO 2023214251A1
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WO
WIPO (PCT)
Prior art keywords
articulation
assembly
cable
surgical instrument
proximal
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/IB2023/054254
Other languages
English (en)
Inventor
Zachary S. HEILIGER
Russell W. Holbrook
Haralambos P. APOSTOLOPOULOS
Dylan R. Kingsley
Jason G. Weihe
William R WHITNEY
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Covidien LP
Original Assignee
Covidien LP
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Covidien LP filed Critical Covidien LP
Publication of WO2023214251A1 publication Critical patent/WO2023214251A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/70—Manipulators specially adapted for use in surgery
    • A61B34/71—Manipulators operated by drive cable mechanisms
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B34/00—Computer-aided surgery; Manipulators or robots specially adapted for use in surgery
    • A61B34/30—Surgical robots
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/00234—Surgical instruments, devices or methods for minimally invasive surgery
    • A61B2017/00292—Surgical instruments, devices or methods for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/003—Steerable
    • A61B2017/00318—Steering mechanisms
    • A61B2017/00323—Cables or rods

Definitions

  • ARTICULATION CABLES ARTICULATION MECHANISMS, AND ARTICULATING SURGICAL INSTRUMENTS SUCH AS FOR USE IN ROBOTIC SURGICAL SYSTEMS
  • This disclosure relates to surgical instruments and, more specifically, to articulation cables, articulation mechanisms, and articulating surgical instruments such as, for example, for use in robotic surgical systems.
  • Robotic surgical systems are increasingly utilized in various different surgical procedures.
  • Some robotic surgical systems include a console supporting a robotic arm.
  • One or more different surgical instruments may be configured for use with the robotic surgical system and selectively mountable to the robotic arm.
  • the robotic arm provides one or more inputs to the mounted surgical instrument to enable operation of the mounted surgical instrument, e.g., to rotate, articulate, and/or actuate the mounted surgical instrument.
  • distal refers to the portion that is being described which is farther from an operator (whether a human surgeon or a surgical robot), while the term “proximal” refers to the portion that is being described which is closer to the operator.
  • Terms including “generally,” “about,” “substantially,” and the like, as utilized herein, are meant to encompass variations, e.g., manufacturing tolerances, material tolerances, use and environmental tolerances, measurement variations, design variations, and/or other variations, up to and including plus or minus 10 percent. To the extent consistent, any of the aspects described herein may be used in conjunction with any or all of the other aspects described herein.
  • a surgical instrument configured for use with a surgical robotic system.
  • the surgical instrument includes a housing.
  • a shaft extends distally from the housing and includes a proximal portion, a distal portion, and an articulating portion disposed between the proximal and distal portions.
  • An end effector assembly is coupled to the distal portion of the shaft and an articulation assembly is disposed within the housing.
  • a plurality of articulation cables operably couple the articulation assembly and the articulating portion of the shaft such that, in response to actuation of the articulation assembly, tension on at least one articulation cable of the plurality of articulation cables is increased and tension on at least one other articulation cable of the plurality of articulation cables is decreased to thereby articulate the end effector assembly relative to the proximal portion of the shaft.
  • a coupling mechanism couples a proximal end portion of the articulation cable to the articulation assembly. The coupling mechanism is configured to maintain a minimum tension on and inhibit slacking of the articulation cable.
  • the coupling mechanism includes a coil spring disposed about the articulation cable and configured to bias the articulation cable relative to a component of the articulation assembly.
  • the coupling mechanism includes a leaf spring connected between the articulation cable and a component of the articulation assembly.
  • the coupling mechanism includes a compliant proximal cap engaged about a proximal end portion of the articulation cable and configured to act against a component of the articulation assembly.
  • the coupling mechanism includes a spring clip coupled between a stop associated with the articulation cable and a component of the articulation assembly.
  • the coupling mechanism includes a compliant tube including a first end portion fixed relative to the articulation cable and a second, opposite end portion configured coupled to a component of the articulation assembly.
  • the articulation assembly includes a collar corresponding to each articulation cable of the plurality of articulation cables.
  • Each collar is movable in a first direction to increase tension on the corresponding articulation cable and in a second, opposite direction to decrease tension on the corresponding articulation cable.
  • each collar may be threadingly engaged about a lead screw such that rotation of the lead screw translates the collar along the lead screw and/or the coupling mechanism may be coupled between the articulation cable and the corresponding collar.
  • each collar includes a first collar component and a second collar component coupled to one another via the coupling mechanism.
  • the first and second collar components are configured to move together with one another when tension on the articulation cable is above a minimum threshold and to decouple from one another and move separately from one another when tension on the articulation cable is at the minimum threshold.
  • the coupling mechanism is further configured to limit over-tensioning of the articulation cable.
  • Another surgical instrument configured for use with a surgical robotic system provided in accordance with this disclosure includes a housing; a shaft extending distally from the housing and including a proximal portion, a distal portion, and an articulating portion disposed between the proximal and distal portions; an end effector assembly coupled to the distal portion of the shaft; an articulation assembly disposed within the housing; and a plurality of articulation cables operably coupled between the articulation assembly and the articulating portion of the shaft.
  • Each articulation cable of the plurality of articulation cables includes an axial compliance feature configured to maintain a minimum tension on and inhibit slacking of the articulation cable.
  • the axial compliance feature may be a coil spring disposed between first and second sections of the articulation cable, a drawbar spring disposed between first and second sections of the articulation cable, or laser cuts defined within the articulation cable.
  • Still another surgical instrument configured for use with a surgical robotic system provided in accordance with this disclosure includes a housing; a shaft extending distally from the housing and including a proximal portion, a distal portion, and an articulating portion disposed between the proximal and distal portions; an end effector assembly coupled to the distal portion of the shaft; an articulation assembly disposed within the housing; and a plurality of articulation cables operably coupled between the articulation assembly and the articulating portion of the shaft.
  • At least one tensioning mechanism is provided and configured to maintain a minimum tension on and inhibit slacking of at least one articulation cable of the plurality of articulation cables.
  • the tensioning mechanism includes a bushing engaged about each of the articulation cables within the proximal portion of the shaft, stopper positioned distally of the bushings, and a spring configured to bias the stopper proximally against the bushings, thereby urging the articulation cables proximally.
  • the stopper may include a plurality of stopper portions, each corresponding to one of the bushings.
  • the tensioning mechanism includes a ring disposed about or disposed within the plurality of articulation cables and configured to bias the plurality of articulation cables towards an inwardly-bowed or an outwardly-bowed configuration, respectively.
  • the tensioning mechanism includes a plurality of floating pulleys, each configured to bias a portion of a corresponding articulation cable of the plurality of articulation cables off-axis.
  • FIG. 1 is a schematic illustration of a surgical robotic system including a control tower, a console, and one or more surgical robotic arms according to aspects of this disclosure;
  • FIG. 2 is a perspective view of a surgical robotic arm of the surgical robotic system of FIG. 1 according to aspects of this disclosure
  • FIG. 3 is a perspective view of a setup arm with the surgical robotic arm of the surgical robotic system of FIG. 1 according to aspects of this disclosure
  • FIG. 4 is a schematic diagram of a computer architecture of the surgical robotic system of FIG. 1 according to aspects of this disclosure
  • FIG. 5 is a perspective view of a surgical instrument provided in accordance with this disclosure configured for mounting on a robotic arm of a surgical robotic system such as the surgical robotic system of FIG. 1;
  • FIG. 6 is a rear perspective view of a proximal portion of the surgical instrument of FIG. 5, with an outer body removed;
  • FIG. 7 is a front perspective view of the proximal portion of the surgical instrument of FIG. 6, with further support components removed;
  • FIG. 8 is an enlarged, perspective view of the articulation sub-assembly of the surgical instrument of FIG. 5;
  • FIG. 9 is an exploded, perspective view of the articulation sub-assembly of the surgical instrument of FIG. 5;
  • FIGS. 10A and 10B are perspective and longitudinal, cross-sectional views, respectively, of a mechanism coupling an articulation cable of the surgical instrument of FIG. 5 with a lead screw collar of the articulation sub-assembly of the surgical instrument of FIG. 5 and configured to maintain tension on and/or inhibit slacking of the articulation cable;
  • FIGS. 11 and 12 are longitudinal, cross-sectional views of other mechanisms coupling an articulation cable of the surgical instrument of FIG. 5 with a lead screw collar of the articulation sub-assembly of the surgical instrument of FIG. 5 and configured to maintain tension on and/or inhibit slacking of the articulation cable;
  • FIGS. 13 A and 13B are longitudinal, cross-sectional and end views, respectively, of still another mechanism coupling an articulation cable of the surgical instrument of FIG. 5 with a lead screw collar of the articulation sub-assembly of the surgical instrument of FIG. 5 and configured to maintain tension on and/or inhibit slacking of the articulation cable;
  • FIG. 14 is a longitudinal, cross-sectional view of yet another mechanism coupling an articulation cable of the surgical instrument of FIG. 5 with a lead screw collar of the articulation sub-assembly of the surgical instrument of FIG. 5 and configured to maintain tension on and/or inhibit slacking of the articulation cable;
  • FIGS. 15 and 16 are longitudinal, cross-sectional and side views, respectively, of still yet other mechanisms coupling an articulation cable of the surgical instrument of FIG. 5 with a lead screw collar of the articulation sub-assembly of the surgical instrument of FIG. 5 and configured to maintain tension on and/or inhibit slacking of the articulation cable;
  • FIG. 17 is a longitudinal, cross-sectional view of a portion of a proximal segment of the shaft of the surgical instrument of FIG. 5 including a mechanism disposed therein and configured to maintain tension on and/or inhibit slacking of the articulation cable;
  • FIGS. 18 is a stopper configured for use with the mechanism of FIG. 17;
  • FIGS. 19-21 are side views of articulation cables incorporating various mechanisms configured to maintain tension on and/or inhibit slacking of the articulation cables of the surgical instrument of FIG. 5; and
  • FIG. 22-24 are schematic illustrations of still yet other mechanisms configured to maintain tension on and/or inhibit slacking of the articulation cables of the surgical instrument of FIG. 5.
  • This disclosure provides articulation cables, articulation mechanisms, and articulating surgical instruments that facilitate maintaining tension on and/or inhibiting slacking of the articulation cables.
  • the articulation cables, articulation mechanisms, and articulating surgical instruments of this disclosure are configured for use with a surgical robotic system, which may include, for example, a surgical console, a control tower, and one or more movable carts having a surgical robotic arm coupled to a setup arm.
  • the surgical console receives user input through one or more interface devices, which are interpreted by the control tower as movement commands for moving the surgical robotic arm.
  • the surgical robotic arm includes a controller, which is configured to process the movement command and to generate a torque command for activating one or more actuators of the robotic arm, which, in turn, move the robotic arm in response to the movement command.
  • a controller which is configured to process the movement command and to generate a torque command for activating one or more actuators of the robotic arm, which, in turn, move the robotic arm in response to the movement command.
  • a surgical robotic system 10 includes a control tower 20, which is connected to components of the surgical robotic system 10 including a surgical console 30 and one or more robotic arms 40.
  • Each of the robotic arms 40 includes a surgical instrument 50 removably coupled thereto.
  • Each of the robotic arms 40 is also coupled to a movable cart 60.
  • the one or more surgical instruments 50 may be configured for use during minimally invasive surgical procedures and/or open surgical procedures.
  • one of the surgical instruments 50 may be an endoscope, such as an endoscope camera 51, configured to provide a video feed for the clinician.
  • one of the surgical instruments 50 may be an energy based surgical instrument such as, for example, an electrosurgical forceps or ultrasonic sealing and dissection instrument configured to seal tissue by grasping tissue between opposing structures and applying electrosurgical energy or ultrasonic energy, respectively, thereto.
  • one of the surgical instruments 50 may be a surgical stapler including a pair of jaws configured to clamp tissue, deploy a plurality of tissue fasteners, e.g., staples, through the clamped tissue, and/or to cut the stapled tissue.
  • One of the robotic arms 40 may include a camera 51 configured to capture video of the surgical site.
  • the surgical console 30 includes a first display 32, which displays a video feed of the surgical site provided by camera 51 of the surgical instrument 50 disposed on the robotic arms 40, and a second display 34, which displays a user interface for controlling the surgical robotic system 10.
  • the first and second displays 32 and 34 are touchscreens allowing for displaying various graphical user inputs.
  • the surgical console 30 also includes a plurality of user interface devices, such as foot pedals 36 and a pair of handle controllers 38a and 38b which are used by a user to remotely control robotic arms 40.
  • the surgical console further includes an armrest 33 used to support clinician’s arms while operating the handle controllers 38a and 38b.
  • the control tower 20 includes a display 23, which may be a touchscreen, and outputs on the graphical user interfaces (GUIs).
  • GUIs graphical user interfaces
  • the control tower 20 also acts as an interface between the surgical console 30 and one or more robotic arms 40.
  • the control tower 20 is configured to control the robotic arms 40, such as to move the robotic arms 40 and the corresponding surgical instrument 50, based on a set of programmable instructions and/or input commands from the surgical console 30, in such a way that robotic arms 40 and the surgical instrument 50 execute a desired movement sequence in response to input from the foot pedals 36 and the handle controllers 38a and 38b.
  • Each of the control tower 20, the surgical console 30, and the robotic arm 40 includes a respective computer 21, 31, 41.
  • the computers 21, 31, 41 are interconnected to each other using any suitable communication network based on wired or wireless communication protocols.
  • Suitable protocols include, but are not limited to, transmission control protocol/internet protocol (TCP/IP), datagram protocol/internet protocol (UDP/IP), and/or datagram congestion control protocol (DCCP).
  • Wireless communication may be achieved via one or more wireless configurations, e.g., radio frequency, optical, Wi-Fi, Bluetooth® (an open wireless protocol for exchanging data over short distances, using short length radio waves, from fixed and mobile devices, creating personal area networks (PANs)), ZigBee® (a specification for a suite of high level communication protocols using small, low-power digital radios based on the IEEE 122.15.4-2003 standard for wireless personal area networks (WPANs)).
  • wireless configurations e.g., radio frequency, optical, Wi-Fi, Bluetooth® (an open wireless protocol for exchanging data over short distances, using short length radio waves, from fixed and mobile devices, creating personal area networks (PANs)
  • PANs personal area networks
  • ZigBee® a specification for a suite of high level communication protocols using small, low-power digital radios based on the IEEE 122.15.4-2003 standard for wireless personal area networks (WPANs)
  • the computers 21, 31, 41 may include any suitable processor (not shown) operably connected to a memory (not shown), which may include one or more of volatile, non-volatile, magnetic, optical, or electrical media, such as read-only memory (ROM), random access memory (RAM), electrically-erasable programmable ROM (EEPROM), non-volatile RAM (NVRAM), or flash memory.
  • the processor may be any suitable processor (e.g., control circuit) adapted to perform the operations, calculations, and/or set of instructions described in this disclosure including, but not limited to, a hardware processor, a field programmable gate array (FPGA), a digital signal processor (DSP), a central processing unit (CPU), a microprocessor, and combinations thereof.
  • FPGA field programmable gate array
  • DSP digital signal processor
  • CPU central processing unit
  • microprocessor e.g., microprocessor
  • each of the robotic arms 40 may include a plurality of links 42a, 42b, 42c, which are interconnected at joints 44a, 44b, 44c, respectively.
  • the joint 44a is configured to secure the robotic arm 40 to the movable cart 60 and defines a first longitudinal axis.
  • the movable cart 60 includes a lift 61 and a setup arm 62, which provides a base for mounting of the robotic arm 40.
  • the lift 61 allows for vertical movement of the setup arm 62.
  • the movable cart 60 also includes a display 69 for displaying information pertaining to the robotic arm 40.
  • the setup arm 62 includes a first link 62a, a second link 62b, and a third link 62c, which provide for lateral maneuverability of the robotic arm 40.
  • the links 62a, 62b, 62c are interconnected at joints 63a and 63b, each of which may include an actuator (not shown) for rotating the links 62b and 62b relative to each other and the link 62c.
  • the links 62a, 62b, 62c are movable in their corresponding lateral planes that are parallel to each other, thereby allowing for extension of the robotic arm 40 relative to the patient (e.g., surgical table).
  • the robotic arm 40 may be coupled to the surgical table (not shown).
  • the setup arm 62 includes controls 65 for adjusting movement of the links 62a, 62b, 62c as well as the lift 61.
  • the third link 62c includes a rotatable base 64 having two degrees of freedom.
  • the rotatable base 64 includes a first actuator 64a and a second actuator 64b.
  • the first actuator 64a is rotatable about a first stationary arm axis which is perpendicular to a plane defined by the third link 62c and the second actuator 64b is rotatable about a second stationary arm axis which is transverse to the first stationary arm axis.
  • the first and second actuators 64a and 64b allow for full three-dimensional orientation of the robotic arm 40.
  • the robotic arm 40 also includes a holder 46 defining a second longitudinal axis and configured to receive an IDU 52 (FIG. 1).
  • the IDU 52 is configured to couple to an actuation mechanism of the surgical instrument 50 and the camera 51 and is configured to move (e.g., rotate) and actuate the instrument 50 and/or the camera 51.
  • IDU 52 transfers actuation forces from its actuators to the surgical instrument 50 to actuate components (e.g., end effectors) of the surgical instrument 50.
  • the holder 46 includes a sliding mechanism 46a, which is configured to move the IDU 52 along the second longitudinal axis defined by the holder 46.
  • the holder 46 also includes a joint 46b, which rotates the holder 46 relative to the link 42c.
  • the robotic arm 40 also includes a plurality of manual override buttons 53 disposed on the IDU 52 and the setup arm 62, which may be used in a manual mode. The clinician may press one or the buttons 53 to move the component associated with the button 53.
  • the joints 44a and 44b include an actuator 48a and 48b configured to drive the joints 44a, 44b, 44c relative to each other through a series of belts 45a and 45b or other mechanical linkages such as a drive rod, a cable, or a lever and the like.
  • the actuator 48a is configured to rotate the robotic arm 40 about a longitudinal axis defined by the link 42a.
  • the actuator 48b of the joint 44b is coupled to the joint 44c via the belt 45a, and the joint 44c is in turn coupled to the joint 46c via the belt 45b.
  • Joint 44c may include a transfer case coupling the belts 45a and 45b, such that the actuator 48b is configured to rotate each of the links 42b, 42c and the holder 46 relative to each other. More specifically, links 42b, 42c, and the holder 46 are passively coupled to the actuator 48b which enforces rotation about a remote center point “P” which lies at an intersection of the first axis defined by the link 42a and the second axis defined by the holder 46. Thus, the actuator 48b controls the angle 0 between the first and second axes allowing for orientation of the surgical instrument 50.
  • the angles between the links 42a, 42b, 42c, and the holder 46 are also adjusted in order to achieve the desired angle 0.
  • some or all of the joints 44a, 44b, 44c may include an actuator to obviate the need for mechanical linkages.
  • each of the computers 21, 31, 41 of the surgical robotic system 10 may include a plurality of controllers, which may be embodied in hardware and/or software.
  • the computer 21 of the control tower 20 includes a controller 21a and safety observer 21b.
  • the controller 21a receives data from the computer 31 of the surgical console 30 about the current position and/or orientation of the handle controllers 38a and 38b and the state of the foot pedals 36 and other buttons.
  • the controller 21a processes these input positions to determine desired drive commands for each joint of the robotic arm 40 and/or the IDU 52 and communicates these to the computer 41 of the robotic arm 40.
  • the controller 21a also receives back the actual joint angles and uses this information to determine force feedback commands that are transmitted back to the computer 31 of the surgical console 30 to provide haptic feedback through the handle controllers 38a and 38b.
  • the handle controllers 38a and 38b include one or more haptic feedback vibratory devices that output haptic feedback.
  • the safety observer 21b performs validity checks on the data going into and out of the controller 21a and notifies a system fault handler if errors in the data transmission are detected to place the computer 21 and/or the surgical robotic system 10 into a safe state.
  • the computer 41 includes a plurality of controllers, namely, a main cart controller 41a, a setup arm controller 41b, a robotic arm controller 41c, and an instrument drive unit (IDU) controller 41 d.
  • the main cart controller 41a receives and processes joint commands from the controller 21a of the computer 21 and communicates them to the setup arm controller 41b, the robotic arm controller 41c, and the IDU controller 41 d.
  • the main cart controller 41a also manages instrument exchanges and the overall state of the movable cart 60, the robotic arm 40, and the IDU 52.
  • the main cart controller 41a also communicates actual joint angles back to the controller 21a.
  • the setup arm controller 41b controls each of joints 63a and 63b, and the rotatable base 64 of the setup arm 62 and calculates desired motor movement commands (e.g., motor torque) for the pitch axis and controls the brakes.
  • the robotic arm controller 41c controls each joint 44a and 44b of the robotic arm 40 and calculates desired motor torques required for gravity compensation, friction compensation, and closed loop position control of the robotic arm 40.
  • the robotic arm controller 41c calculates a movement command based on the calculated torque.
  • the calculated motor commands are then communicated to one or more of the actuators 48a and 48b in the robotic arm 40.
  • the actual joint positions are then transmitted by the actuators 48a and 48b back to the robotic arm controller 41c.
  • the IDU controller 41 d receives desired joint angles for the surgical instrument 50, such as wrist and jaw angles, and computes desired currents for the motors in the IDU 52.
  • the IDU controller 41 d calculates actual angles based on the motor positions and transmits the actual angles back to the main cart controller 41a.
  • the robotic arm 40 is controlled as follows. Initially, a pose of the handle controller controlling the robotic arm 40, e.g., the handle controller 38a, is transformed into a desired pose of the robotic arm 40 through a hand eye transform function executed by the controller 21a.
  • the hand eye function as well as other functions described herein, is/are embodied in software executable by the controller 21a or any other suitable controller described herein.
  • the pose of the handle controller 38a may be embodied as a coordinate position and role-pitch-yaw (“RPY”) orientation relative to a coordinate reference frame, which is fixed to the surgical console 30.
  • the desired pose of the instrument 50 is relative to a fixed frame on the robotic arm 40.
  • the pose of the handle controller 38a is then scaled by a scaling function executed by the controller 21a.
  • the coordinate position is scaled down and the orientation is scaled up by the scaling function.
  • the controller 21a also executes a clutching function, which disengages the handle controller 38a from the robotic arm 40.
  • the controller 21a stops transmitting movement commands from the handle controller 38a to the robotic arm 40 if certain movement limits or other thresholds are exceeded and in essence acts like a virtual clutch mechanism, e.g., limits mechanical input from effecting mechanical output.
  • the desired pose of the robotic arm 40 is based on the pose of the handle controller 38a and is then passed by an inverse kinematics function executed by the controller 21a.
  • the inverse kinematics function calculates angles for the joints 44a, 44b, 44c of the robotic arm 40 that achieve the scaled and adjusted pose input by the handle controller 38a.
  • the calculated angles are then passed to the robotic arm controller 41c, which includes a joint axis controller having a proportional-derivative (PD) controller, the friction estimator module, the gravity compensator module, and a two-sided saturation block, which is configured to limit the commanded torque of the motors of the joints 44a, 44b, 44c.
  • PD proportional-derivative
  • a surgical instrument 110 provided in accordance with this disclosure generally includes a housing 120, a shaft 130 extending distally from housing 120, an end effector assembly 140 extending distally from shaft 130, and an actuation assembly 190 disposed within housing 120 and operably associated with end effector assembly 140.
  • Instrument 110 is detailed herein as an articulating electrosurgical forceps configured for use with a surgical robotic system, e.g., surgical robotic system 10 (FIG. 1).
  • instrument 110 is equally applicable for use with other suitable surgical instruments, e.g., graspers, staplers, clip appliers, and/or in other suitable surgical systems, e.g., motorized, other power-driven systems, and/or manually-actuated surgical systems (including handheld instruments).
  • suitable surgical instruments e.g., graspers, staplers, clip appliers
  • suitable surgical systems e.g., motorized, other power-driven systems, and/or manually-actuated surgical systems (including handheld instruments).
  • Housing 120 of instrument 110 includes a body 122 and a proximal face plate 124 that cooperate to enclose actuation assembly 1100 therein.
  • Proximal face plate 124 includes through holes defined therein through which input couplers 191-194 of actuation assembly 190 extend.
  • a pair of latch levers 126 (only one of which is illustrated in FIG. 5) extending outwardly from opposing sides of housing 120 enable releasable engagement of housing 120 with a robotic arm of a surgical robotic system, e.g., surgical robotic system 10 (FIG. 1).
  • a window 128 defined through body 122 of housing 120 permits thumbwheel 440 to extend therethrough to enable manual manipulation of thumbwheel 440 from the exterior of housing 120 to permit manual opening and closing of end effector assembly 140.
  • shaft 130 of instrument 110 includes a distal segment 132, a proximal segment 134, and an articulating section 136 disposed between the distal and proximal segments 132, 134, respectively.
  • Articulating section 136 includes one or more articulating components 137, e.g., links, joints, etc.
  • a plurality of articulation cables 138 e.g., four (4) articulation cables, or other suitable actuators, extend through articulating section 136.
  • articulation cables 138 are operably coupled to distal segment 132 of shaft 130 at the distal ends thereof and extend proximally from distal segment 132 of shaft 130, through articulating section 136 of shaft 130 and proximal segment 134 of shaft 130, and into housing 120, wherein articulation cables 138 operably couple with an articulation sub-assembly 200 of actuation assembly 190 to enable selective articulation of distal segment 132 (and, thus end effector assembly 140) relative to proximal segment 134 and housing 120, e.g., about at least two axes of articulation (yaw and pitch articulation, for example).
  • Articulation cables 138 are arranged in a generally rectangular configuration, although other suitable configurations are also contemplated. Articulation sub-assembly 200 is described in greater detail below.
  • actuation of articulation cables 138 may be accomplished in pairs. More specifically, in order to pitch end effector assembly 140, the upper pair of cables 138 are actuated in a similar manner while the lower pair of cables 138 are actuated in a similar manner relative to one another but an opposite manner relative to the upper pair of cables 138. With respect to yaw articulation, the right pair of cables 138 are actuated in a similar manner while the left pair of cables 138 are actuated in a similar manner relative to one another but an opposite manner relative to the right pair of cables 138. Other configurations of articulation cables 138 or other articulation actuators are also contemplated.
  • End effector assembly 140 includes first and second jaw members 142, 144, respectively, pivotably coupled to one another about a pivot 150 and operably coupled to one another via a cam slot assembly 152 including a cam pin slidably received within cam slots defined within jaw members 142, 144, respectively, to enable pivoting of jaw member 142 relative to jaw member 144 and distal segment 132 of shaft 130 between a spaced apart position (e.g., an open position of end effector assembly 140) and an approximated position (e.g., a closed position of end effector assembly 140) for grasping tissue between tissue contacting surfaces 146, 148.
  • a bilateral configuration may be provided whereby both jaw members 142, 144 are pivotable relative to one another and distal segment 132 of shaft 130.
  • Other suitable jaw actuation mechanisms are also contemplated.
  • a longitudinally extending knife channel (not explicitly shown) is defined through the tissue contacting surface 146, 148 of one or both jaw members 142, 144.
  • a knife assembly including a knife rod (not shown) extending from housing 120 through shaft 130 to end effector assembly 140 and a knife (not shown) disposed within end effector assembly 140 between jaw members 142, 144 is provided.
  • the knife is selectively translatable through the knife channel(s) and between the jaw member 142, 144 to cut tissue grasped between tissue contacting surfaces 146, 148 of jaw members 142, 144, respectively.
  • the knife rod is operably coupled to a knife drive sub-assembly 300 (FIG.
  • actuation assembly 190 at a proximal end thereof to enable the selective actuation of the knife rod to, in turn, reciprocate the knife between jaw members 142, 144 to cut tissue grasped between tissue contacting surfaces 146, 148.
  • actuation assembly 190 As an alternative to a longitudinally advanceable mechanical knife, other suitable mechanical cutters are also contemplated, e.g., guillotine style cutters, as are energy based cutters, e.g., RF electrical cutters, ultrasonic cutters, etc., in static or dynamic configurations.
  • a drive rod 484 is operably coupled to cam slot assembly 152 of end effector assembly 140, e.g., engaged with the cam pin thereof, such that longitudinal actuation of drive rod 484 pivots jaw member 142 relative to jaw member 144 between the spaced apart and approximated positions.
  • drive rod 484 pivots jaw member 142 relative to jaw member 144 between the spaced apart and approximated positions.
  • other suitable mechanisms and/or configurations for pivoting jaw member 142 relative to jaw member 144 between the spaced apart and approximated positions in response to selective actuation of drive rod 484 are also contemplated.
  • Drive rod 484 extends proximally from end effector assembly 140 through shaft 130 and into housing 120 wherein drive rod 484 is operably coupled with a jaw drive subassembly 400 of actuation assembly 190 to enable selective actuation of end effector assembly 140 to grasp tissue therebetween and apply a jaw force within an appropriate jaw force range.
  • Tissue contacting surfaces 146, 148 of jaw members 142, 144, respectively are at least partially formed from an electrically conductive material and are energizable to different potentials to enable the conduction of RF electrical energy through tissue grasped therebetween, although tissue contacting surfaces 146, 148 may alternatively be configured to supply any suitable energy, e.g., thermal, micro wave, light, ultrasonic, ultrasound, etc., through tissue grasped therebetween for energy based tissue treatment.
  • suitable energy e.g., thermal, micro wave, light, ultrasonic, ultrasound, etc.
  • Instrument 110 defines a conductive pathway (not shown) through housing 120 and shaft 130 to end effector assembly 140 that may include lead wires, contacts, and/or electrically conductive components to enable electrical connection of tissue contacting surfaces 146, 148 of jaw members 142, 144, respectively, to an energy source (not shown), e.g., an electrosurgical generator, for supplying energy to tissue contacting surfaces 146, 148 to treat, e.g., seal, tissue grasped between tissue contacting surfaces 146, 148.
  • an energy source e.g., an electrosurgical generator
  • Actuation assembly 190 is disposed within housing 120 and includes an articulation sub-assembly 200, a knife drive sub-assembly 300, and a jaw drive sub-assembly 400.
  • Articulation sub-assembly 200 is operably coupled between first and second input couplers 191, 192, respectively, of actuation assembly 190 and articulation cables 138 such that, upon receipt of appropriate inputs into first and/or second input couplers 191, 192, articulation sub-assembly 200 manipulates cables 138 to articulate end effector assembly 140 in a desired direction, e.g., to pitch and/or yaw end effector assembly 140. Articulation sub-assembly 200 is described in greater detail below.
  • Knife drive sub-assembly 300 is operably coupled between third input coupler 193 of actuation assembly 190 and the knife rod such that, upon receipt of appropriate input into third input coupler 193, knife drive sub-assembly 300 manipulates the knife rod to reciprocate the knife between jaw members 142, 144 to cut tissue grasped between tissue contacting surfaces 146, 148.
  • Jaw drive sub-assembly 400 is operably coupled between fourth input coupler 194 of actuation assembly 190 and drive rod 484 such that, upon receipt of appropriate input into fourth input coupler 194, jaw drive sub-assembly 400 pivots jaw members 142, 144 between the spaced apart and approximated positions to grasp tissue therebetween and apply a jaw force within an appropriate jaw force range.
  • Actuation assembly 190 is configured to operably interface with a surgical robotic system, e.g., system 10 (FIG. 1), when instrument 110 is mounted on a robotic arm thereof, to enable robotic operation of actuation assembly 190 to provide the above detailed functionality. That is, surgical robotic system 10 (FIG. 1) selectively provides inputs, e.g., rotational inputs to input couplers 191-194 of actuation assembly 190 to articulate end effector assembly 140, grasp tissue between jaw members 142, 144, and/or cut tissue grasped between jaw members 142, 144.
  • actuation assembly 190 be configured to interface with any other suitable surgical systems, e.g., a manual surgical handle, a powered surgical handle, etc.
  • articulation sub-assembly 200 of actuation assembly 190 (FIGS. 6 and 7) is shown generally including a proximal base assembly 210, an intermediate base assembly 220, a distal base assembly 230, four proximal gear assemblies 240, 250, 260, 270, two coupling gears 280, 290, four distal gear assemblies configured as lead screw assemblies 340, 350, 360, 370 (although other suitable distal gear assemblies are also contemplated), and four guide dowels 380.
  • belts may be utilized to provide the coupling.
  • gearing components detailed herein may be replaced or supplemented with the use of belts instead of directly meshed gears, without departing from this disclosure.
  • multiple gears (and/or belts) may be provided in place of single gears (and/or belts) to provide a desired amplification or attenuation effect.
  • Each of the proximal, intermediate, and distal base assemblies 210, 220, 230, respectively, includes a base plate 212, 222, 232 defining four apertures 214, 224, 234 arranged in a generally square configuration.
  • Bushings 216, 226, 236 are engaged within the apertures 214, 224, 234 of each of proximal, intermediate, and distal base assemblies 210, 220, 230, respectively.
  • proximal gear assemblies Two of the proximal gear assemblies, e.g., proximal gear assemblies 240, 250, include inputs 244, while each proximal gear assembly 240, 250, 260, 270 includes an output 246.
  • a spur gear 248 is mounted on the respective gear shaft 242 of each proximal gear assembly 240, 250, 260, 270.
  • One pair of diagonally-opposed spur gears 248, e.g., spur gears 248 of proximal gear assemblies 240, 260 are longitudinally offset (e.g., more-distally positioned) relative to the other pair of diagonally-opposed spur gears 248, e.g., spur gears 248 of proximal gear assemblies 250, 270.
  • the two inputs 244 are positioned at a proximal end of articulation sub-assembly 200 to receive two rotational inputs for articulation, e.g., via surgical robotic system 10 (FIG. 1).
  • the output 246 of each proximal gear assembly 240, 250, 260, 270 extends distally into a corresponding bushing 226 disposed within an aperture 224 of base plate 222 of intermediate base assembly 220. As detailed below, this enables the output 246 of each proximal gear assembly 240, 250, 260, 270 to provide a rotational output to a corresponding lead screw assembly 340, 350, 360, 370, respectively.
  • the two coupling gears 280, 290 operably couple the spur gears 248 of each diagonally-opposed pair of spur gears 248. More specifically, the more-distal coupling gear 280 is disposed in meshed engagement with the more-distally disposed spur gears 248 of proximal gear assemblies 240, 260, while the more-proximal coupling gear 290 is disposed in meshed engagement with the more-proximally disposed spur gears 248 of proximal gear assemblies 250, 270.
  • a rotational input provided to input 244 of proximal gear assembly 240 rotates output 246 and spur gear 248 of proximal gear assembly 240 in a first direction to, in turn, rotate coupling gear 280 in a second, opposite direction which, in turn, rotates spur gear 248 and output 246 of proximal gear assembly 260 in the first direction.
  • a rotational input provided to input 244 of proximal gear assembly 250 rotates output 246 and spur gear 248 of proximal gear assembly 250 in a first direction to, in turn, rotate coupling gear 290 in a second, opposite direction which, in turn, rotates spur gear 248 and output 246 of proximal gear assembly 270 in the first direction.
  • only two rotational inputs are required to provide a rotational output at the output 246 of each proximal gear assembly 240, 250, 260, 270: one to the input 244 of proximal gear assembly 240 or proximal gear assembly 260, and the other to the input 244 of proximal gear assembly 250 or proximal gear assembly 270.
  • only two inputs 244 thus need be provided, e.g., input 244 of proximal gear assembly 240 and input 244 of proximal gear assembly 250.
  • Each lead screw assembly 340, 350, 360, 370 includes a lead screw 342 defining a proximal input end 343 and a distal dock end 345.
  • Each lead screw assembly 340, 350, 360, 370 further includes a collar 346 disposed in threaded engagement about the corresponding lead screw 342 such that rotation of the lead screw 342 translates the corresponding collar 346 longitudinally therealong.
  • the proximal input end 343 of the lead screw 342 of each lead screw assembly 340, 350, 360, 370 extends proximally into a corresponding bushing 226 disposed within an aperture 224 of base plate 222 of intermediate base assembly 220 wherein the proximal input end 343 is operably coupled with the output 246 of a corresponding proximal gear assembly 240, 250, 260, 270 such that rotation of outputs 246 effect corresponding rotation of lead screws 342.
  • the distal dock end 345 of the lead screw 342 of each lead screw assembly 340, 350, 360, 370 extend distally into and is rotationally seated within a corresponding bushing 236 disposed within an aperture 234 of base plate 232 of distal base assembly 230.
  • Lead screw assemblies 340, 350, 360, 370 similarly as with proximal gear assemblies 240, 250, 260, 270, are arranged to define a generally square configuration such that the lead screw 342 of each lead screw assembly 340, 350, 360, 370, includes two adjacent lead screws 342, e.g., a vertically-adjacent lead screw 342 and a horizontally-adjacent lead screw 342, and a diagonally-opposed lead screw 342.
  • the lead screws 342 of each diagonally-opposed pair of lead screws 342 define opposite thread-pitch directions.
  • lead screw 342 of lead screw assembly 340 may define a right-handed thread-pitch while the diagonally-opposite lead screw 342 of lead screw assembly 360 defines a left-handed thread-pitch.
  • lead screw 342 of lead screw assembly 350 may define a right-handed thread-pitch while the diagonally- opposite lead screw 342 of lead screw assembly 370 defines a left-handed thread-pitch.
  • each collar 346 is operably threadingly engaged about a corresponding lead screw 342 such that rotation of the lead screw 342 translates the corresponding collar 346 longitudinally therealong.
  • Each collar 346 includes a ferrule 348 configured to engage a proximal end portion of one of the articulation cables 138 (see FIGS. 5 and 9), e.g., via a crimped hook-slot engagement or other suitable engagement (mechanical fastening, adhesion, welding, etc.).
  • Guide dowels 380 are slidably received through sleeves 349 of collars 346, which are offset relative to the bodies of collars 346. As a result of this configuration, guide dowels 380 inhibit rotation of collars 346 in response to rotation of lead screws 342, thus helping to ensure that collars 346 are translated along lead screws 342 in response to rotational driving of lead screws 342.
  • articulation cables 138 may define flexible cables substantially the entire lengths thereof, including at proximal portions thereof.
  • articulation cables 138 may include rigid proximal tubes, e.g., coupled to articulation sub-assembly 200 and extending at least partially through proximal segment 134 of shaft 130 (see FIG. 5), and flexible distal cables secured to, e.g., crimped within, distal portions of the rigid proximal tubes and extending from proximal segment 134 of shaft 130 distally through articulating segment 136 to distal segment 132 of shaft 130.
  • proximal portions of articulation cables 138 herein includes either configuration: that is, wherein the proximal portions of the articulation cables 138 are flexible cable portions, or wherein the proximal portions of the articulation cables 138 are rigid tubes.
  • FIGS. 10A-24 various mechanisms configured to facilitate maintaining tension on and/or inhibiting slacking of articulation cables 138 (FIGS. 5 and 9) are detailed below. Although detailed separately, the mechanisms detailed below may be utilized in combination with one another. Further, although some of the mechanisms are detailed with respect to a single articulation cable 138 (FIGS. 5 and 9), such mechanisms may be utilized with multiple or all articulation cables 138 (FIGS. 5 and 9). In addition, the tension-maintaining and/or slack inhibiting mechanisms detailed below may be provided for use with any suitable surgical instruments and are not limited to surgical instrument 110 (FIG. 5) and/or surgical robotic system 10 (FIG. 1).
  • each collar 346 includes a ferrule 348 configured to engage a proximal end portion of one of the articulation cables 138 to fix the proximal end portion of the articulation cable 138 relative thereto.
  • articulation cable 138 may be operably coupled with ferrule 348 via a spring mechanism that provided additional tension to articulation cable 138 thereby maintaining tension on and/or inhibiting slacking of articulation cable 138.
  • articulation cable 138 is slidably disposed through ferrule 348 and includes a proximal cap 1010 fixedly disposed about the proximal end thereof proximally of ferrule 348.
  • a spring 1020 e.g., a coil spring, is disposed about articulation cable 138 and retained thereon between proximal cap 1010 and a stop 1030 fixed within or otherwise fixed relative to ferrule 348 of collar 346.
  • spring 1020 operably couples articulation cable 138 with collar 346 such that translation of collar 346 in a first direction compresses spring 1020 against proximal cap 1010 to thereby urge proximal cap 1010 in the first direction to tension articulation cable 138.
  • spring 1020 acts against proximal cap 1010 in the opposite direction (against the de-tensioning of articulation cable 138) to maintain at least a minimum tension on articulation cable 138, thereby inhibiting slacking of articulation cable 138.
  • articulation cable 138 may include a compliant proximal cap 1110 to maintain at least a minimum tension on articulation cable 138, thereby inhibiting slacking of articulation cable 138. More specifically, articulation cable 138 is slidably disposed through ferrule 348 and is fixedly engaged with proximal cap 1110. Proximal cap 1110 is positioned on a proximal side of ferrule 348 in abutting relation therewith.
  • Proximal cap 1110 is axially compliant such as, for example, as a result of laser-cut compliance features 1112 formed therein (as shown), via forming proximal cap 1110 at least partially from a resiliently flexible material, incorporating a spring into proximal cap 1110, or in any other suitable manner.
  • compliant proximal cap 1110 operably couples articulation cable 138 with collar 346 such that translation of collar 346 in a first direction compresses compliant proximal cap 1110 and urges proximal cap 1110 in the first direction to tension articulation cable 138.
  • compliant proximal cap 1110 acts against the de-tensioning of articulation cable 138 to maintain at least a minimum tension on articulation cable 138, thereby inhibiting slacking of articulation cable 138.
  • a leaf spring 1220 and a fixed support 1230 may be configured to maintain at least a minimum tension on articulation cable 138, thereby inhibiting slacking of articulation cable 138.
  • articulation cable 138 is slidably disposed through ferrule 348 and includes a proximal cap 1210 fixedly disposed about the proximal end thereof on a proximal side of ferrule 348.
  • Fixed support 1230 is fixed relative to ferrule 348 or is defined by a portion of ferrule 348 on a distal side thereof and may be configured to slidably receive articulation cable 138 therethrough.
  • Leaf spring 1220 is engaged at a first end thereof to proximal cap 1210 and at a second end thereof to fixed support 1230. In this manner, leaf spring 1220 operably couples articulation cable 138 with collar 346 such that translation of collar 346 in a first direction pulls leaf spring 1220 to thereby urge proximal cap 1210 in the first direction to tension articulation cable 138.
  • leaf spring 1220 is flexed to act against proximal cap 1210 in the opposite direction (against the de-tensioning of articulation cable 138) to maintain at least a minimum tension on articulation cable 138, thereby inhibiting slacking of articulation cable 138.
  • a spring clip 1320 and a stop 1330 may be configured to maintain at least a minimum tension on articulation cable 138, thereby inhibiting slacking of articulation cable 138.
  • articulation cable 138 is slidably disposed through ferrule 348 and includes a proximal cap 1310 fixedly disposed about the proximal end portion thereof on a proximal side of ferrule 348.
  • Stop 1330 is fixed, e.g., crimped, onto articulation cable 138 on a distal side of ferrule 348.
  • Spring clip 1320 includes a proximal portion 1322 that is captured by collar 346 and a distal portion 1324 that engages stop 1330.
  • a pair of spring legs 1326 interconnect proximal portion 1322 and distal portion 1324 with one another. In this manner, spring clip 1320 operably couples articulation cable 138 with collar 346 such that translation of collar 346 in a first direction pulls distal portion 1324 of spring clip 1320 to thereby urge stop 1330 in the first direction to tension articulation cable 138.
  • FIG. 14 illustrates another configuration for operably coupling articulation cable 138 with collar 346 to maintain at least a minimum tension on articulation cable 138, thereby inhibiting slacking of articulation cable 138.
  • articulation cable 138 extends through a compliant tube 1420 and ferrule 348 to a proximal cap 1410 disposed proximally of ferrule 348 and fixedly engaged about articulation cable 138.
  • Compliant tube 1420 includes a proximal hub 1422 disposed at a proximal portion thereof and fixed relative to ferrule 348.
  • a distal portion of compliant tube 1420 securely engages articulation cable 138, via one or more crimps 1424 crimping the distal portion of compliant tube 1420 to articulation cable 138.
  • Compliant tube 1420 is axially compliant such as, for example, as a result of laser-cut compliance features 1426 formed therein (as shown), via forming compliant tube 1420 at least partially from a resiliently flexible material, via a spring disposed therein or between portions thereof, or in any other suitable manner.
  • Articulation cable 138 is pre-tensioned during assembly such that under normal operating conditions where at least this pre-tension is maintained on articulation cable 138, compliant tube 1420 is stretched, against the bias thereof, to define a relatively elongated configuration. In this condition, proximal cap 1410 is maintained in proximal abutment with proximal hub 1422. In this manner, under normal operating conditions where at least the pretension is maintained on articulation cable 138, articulation cable 138 behaves substantially as if compliant tube 1420 and proximal hub 1422 were removed and proximal cap 1410 were fixed relative to ferrule 348.
  • the bias of compliant tube 1420 operates to take up slack, thereby maintaining tension on articulation cable 138. More specifically, in the event of slackening, the bias of compliant tube 1420 contracts compliant tube 1420 to a relatively contracted length. As compliant tube 1420 is contracted in this manner, compliant tube 1420 (due to the crimps 1424 crimping the distal portion of compliant tube 1420 to articulation cable 138) pulls articulation cable 138 proximally, thereby taking up slack in articulation cable 138 and thereby maintaining tension on articulation cable 138.
  • proximal pulling of articulation cable 138 urges proximal cap 1410 to a proximally-spaced position relative to proximal hub 1422, as illustrated in FIG. 14.
  • the spring force associated with compliant tube 1420 only kicks in to take up slack and maintain tension as needed and does not impart substantial effect to the system in the absence of such loss of tension. .
  • At least some of above-detailed mechanisms not only maintain at least a minimum tension on articulation cable 138, thereby inhibiting slacking of articulation cable 138, but the compliance features of the springs and/or other components also inhibit over-tensioning of articulation cable 138, thus inhibiting snapping, breaking, or elongation of articulation cable 138. Some or all of the following aspects also provide both compliance to maintain at least a minimum tension as well as compliance to inhibit over-tensioning, as can be appreciated.
  • collar 346 may include inner and outer collars 1510, 1520, respectively.
  • Inner collar 1510 defines interior threading 1512 on an interior surface thereof and exterior threading 1514 on an exterior surface thereof.
  • Inner collar 1510 is threadingly engaged about lead screw 342 via engagement of interior threading 1512 with the threading of lead screw 342.
  • rotation of lead screw 342 translates inner collar 1510 along lead screw 342.
  • Outer collar 1520 includes interior threading 1522 disposed on an interior surface thereof.
  • Outer collar 1520 is threadingly engaged about inner collar 1510 via engagement of exterior threading 1514 of inner collar 1510 with interior threading 1522 of outer collar 1520.
  • Outer collar 1520 further includes ferrule 348, which is configured to fixedly retain a proximal end portion of articulation cable 138.
  • outer collar 1520 and inner collar 1510 may initially translate together to thereby decrease tension on articulation cable 138; however, once the tension on articulation cable 138 reaches a minimum threshold, outer collar 1520 and inner collar 1510 no longer translate together; rather relative rotation between 1 outer collar 1520 and inner collar 1510 is effected such that further translation of inner collar 1510 is not imparted to outer collar 1520 and, thus, further de-tensioning is inhibited, thereby inhibiting slacking of articulation cable 138.
  • collar 346 may include distal and proximal collars 1610, 1620, respectively, similarly as detailed above with respect to inner and outer collars 1510, 1520 of FIG. 15 except that, rather than threaded engagement between the collars, distal and proximal collars 1610, 1620 are operably coupled to one another via complementary, engaged cam surfaces 1612, 1622.
  • Distal collar 1610 is threadingly engaged about lead screw 342 such that rotation of lead screw 342 translates distal collar 1610 along lead screw 342.
  • Proximal collar 1620 includes ferrule 348, which is configured to fixedly retain a proximal end portion of articulation cable 138.
  • distal collar 1610 may initially pull proximal collar 1620 distally to thereby decrease tension on articulation cable 138; however, once the tension on articulation cable 138 reaches a minimum threshold, the engaged, complementary cam surfaces 1612, 1622 of distal collar 1610 and proximal collar 1620, respectively, slip past one another, disengaging distal and proximal collars 1610, 1620 from one another such that distal and proximal collars 1610, 1620 no longer translate together; rather, further translation of distal collar 1610 is not imparted to proximal collar 1620 and, thus, further de-tensioning is inhibited, thereby inhibiting slacking of articulation cable 138.
  • articulation cables 138 are shown extending through proximal segment 134 of shaft 130.
  • a stopper 1710 disposed within proximal segment 134 of shaft 130 is slidably disposed about about each articulation cable 138 distally of fixed bushings 1720 fixedly engaged about articulation cables 138.
  • a rim 1730 is defined within and fixed relative to proximal segment 134 of shaft 130.
  • a biasing spring 1740 is retained between stopper 1710 and rim 1730 and is configured to bias stopper 1710 proximally, thereby urging bushings 1720 proximally to bias articulation cables 138 proximally.
  • Stopper 1710 may include separate stopper portions 1712a, 1712b, 1712c, 1712d each corresponding to one of the articulation cables 138 and movable relative to at least one other stopper portion 1712a, 1712b, 1712c, 1712d, e.g., independently thereof.
  • a common spring 1740 may be provided (as shown), or separate springs for each portionl712a, 1712b, 1712c, 1712d may be provided.
  • stopper 1710 may be a single component that moves in unison, e.g., without the above-detailed portions.
  • stopper 1710 may include one or more access passages 1750 configured to permit passage of actuation components therethrough.
  • articulation cable 138 may incorporate mechanisms therein to maintain at least a minimum tension on articulation cable 138, thereby inhibiting slacking of articulation cable 138. More specifically, as shown in FIG. 19, articulation cable 138 may include first and second sections 1902, 1904 interconnected by a coil spring 1910. In response to de-tensioning of articulation cable 138, e.g., in response to urging first section 1902 toward section 1904, coil spring 1910 absorbs any slack, thereby maintaining at least a minimum tension on articulation cable 138 and inhibiting slacking of articulation cable 138.
  • FIG. 20 illustrates a similar configuration (providing a similar function) except that, rather than a coil spring, a drawbar spring 2010 is disposed between and interconnects first and second sections 2002, 2004 of articulation cable 138.
  • FIG. 21 illustrates articulation cable 138 include one or more axially rigid sections 2102 and one or more axially compliant sections 2104.
  • the one or more axially compliant sections 2104 absorb any slack, thereby maintaining at least a minimum tension on articulation cable 138 and inhibiting slacking of articulation cable 138.
  • FIGS. 22 and 23 illustrate a plurality of articulation cables 138 extending longitudinally, e.g., as articulation cables 138 extend through proximal segment 134 of shaft 130 (FIG. 5; see also FIG. 17).
  • a resilient ring 2210 is disposed interiority of articulation cables 138 and biased to urge articulation cables 138 radially outwardly from ring 2210, towards an outwardly-bowed configuration.
  • ring 2210 biases those articulation cables 138 further radially outwardly, e.g., to bow further outwardly, thereby maintaining at least a minimum tension on the articulation cables 138 and inhibiting slacking of the articulation cables 138.
  • a resilient ring 2310 is disposed about articulation cables 138 and biased to urge articulation cables 138 radially inwardly from ring 2310, towards an inwardly-bowed configuration.
  • ring 2310 biases those articulation cables 138 further radially inwardly, e.g., to bow further inwardly, thereby maintaining at least a minimum tension on the articulation cables 138 and inhibiting slacking of the articulation cables 138.
  • articulation cables 138 function as elongated leaf spring-like structures.
  • FIG. 24 illustrates floating pulleys 2410 supporting portions of articulation cables 138 extending between articulation sub-assembly 200 and shaft 130. More specifically, floating pulleys 2410 are positioned to receive portions of articulation cables 138 (with the portions of articulation cables 138 at least partially conforming thereto) and urge the portions of articulation cables 138 off-axis. Floating pulleys 2410 are biased via springs 2420 that act to urge floating pulleys 2410 to positions that urge articulation cables 138 further off-axis.

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  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Robotics (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Manipulator (AREA)

Abstract

La présente invention concerne un instrument chirurgical configuré pour être utilisé avec un système robotisé chirurgical, comprenant un boîtier, une tige s'étendant de manière distale à partir du boîtier et comprenant une partie proximale, une partie distale, et une partie d'articulation disposée entre les parties proximale et distale, un ensemble effecteur d'extrémité couplé à la partie distale de la tige, un ensemble d'articulation disposé à l'intérieur du boîtier, et une pluralité de câbles d'articulation couplés de manière fonctionnelle entre l'ensemble d'articulation et la partie d'articulation de la tige. En réponse à l'actionnement de l'ensemble d'articulation, la tension sur au moins un câble d'articulation est augmentée et la tension sur au moins un autre câble d'articulation est diminuée pour ainsi articuler l'ensemble effecteur terminal. Un mécanisme de couplage couple une partie d'extrémité proximale de chaque câble d'articulation à l'ensemble d'articulation et est configuré pour maintenir une tension minimale sur et inhiber le relâchement du câble d'articulation.
PCT/IB2023/054254 2022-05-02 2023-04-25 Câbles d'articulation, mécanismes d'articulation et instruments chirurgicaux articulés tels que destinés à être utilisés dans des systèmes chirurgicaux robotisés Ceased WO2023214251A1 (fr)

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US20210307853A1 (en) * 2015-03-10 2021-10-07 Covidien Lp Robotic surgical systems, instrument drive units, and drive assemblies
US20210369368A1 (en) * 2020-05-27 2021-12-02 Covidien Lp Tensioning mechanisms and methods for articulating surgical instruments such as for use in robotic surgical systems
US11241290B2 (en) * 2016-11-21 2022-02-08 Intuitive Surgical Operations, Inc. Cable length conserving medical instrument

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Publication number Priority date Publication date Assignee Title
US20190269388A1 (en) * 2012-11-02 2019-09-05 Intuitive Surgical Operations, Inc. Operating self-antagonistic drives of medical instruments
US20140257333A1 (en) * 2013-03-07 2014-09-11 Intuitive Surgical Operations, Inc. Hybrid manual and robotic interventional instruments and methods of use
US20210307853A1 (en) * 2015-03-10 2021-10-07 Covidien Lp Robotic surgical systems, instrument drive units, and drive assemblies
US20180080533A1 (en) * 2015-04-03 2018-03-22 The Regents Of The University Of Michigan Tension management apparatus for cable-driven transmission
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