A variety of surgical instruments include an end effector for use in conventional medical treatments and procedures conducted by a medical professional operator, as well as applications in robotically assisted surgeries. Such surgical instruments may be directly gripped and manipulated by a surgeon or incorporated into robotically surgical systems. In the case of robotically assisted surgery, the surgeon may operate a master controller to remotely control the motion of such surgical instruments at a surgical site. The controller may be separated from the patient by a significant distance (e.g., across the operating room, in a different room, or in a completely different building than the patient). Alternatively, a controller may be positioned quite near the patient in the operating room. Regardless, the controller may include one or more hand input devices (such as joysticks, exoskeletal gloves, master manipulators, or the like), which are coupled by a servo mechanism to the surgical instrument. In one example, a servo motor moves a manipulator supporting the surgical instrument based on the surgeon's manipulation of the hand input devices. During the surgery, the surgeon may employ, via a robotic surgical system, a variety of surgical instruments including an ultrasonic blade, a surgical stapler, a tissue grasper, a needle driver, an electrosurgical cautery probe, etc. Each of these structures performs functions for the surgeon, for example, cutting tissue, coagulating tissue, holding or driving a needle, grasping a blood vessel, dissecting tissue, or cauterizing tissue.
Examples of surgical instruments include surgical staplers. Some such staplers are operable to clamp down on layers of tissue, cut through the clamped layers of tissue, and drive staples through the layers of tissue to substantially seal the severed layers of tissue together near the severed ends of the tissue layers. Examples of surgical staplers and associated features are disclosed in U.S. Pat. No. 7,404,508, entitled “Surgical Stapling and Cutting Device,” issued Jul. 29, 2008; U.S. Pat. No. 7,434,715, entitled “Surgical Stapling Instrument Having Multistroke Firing with Opening Lockout,” issued Oct. 14, 2008; U.S. Pat. No. 7,721,930, entitled “Disposable Cartridge with Adhesive for Use with a Stapling Device,” issued May 25, 2010; U.S. Pat. No. 8,408,439, entitled “Surgical Stapling Instrument with An Articulatable End Effector,” issued Apr. 2, 2013; U.S. Pat. No. 8,453,914, entitled “Motor-Driven Surgical Cutting Instrument with Electric Actuator Directional Control Assembly,” issued Jun. 4, 2013; U.S. Pat. No. 9,186,142, entitled “Surgical Instrument End Effector Articulation Drive with Pinion and Opposing Racks,” issued on Nov. 17, 2015; U.S. Pat. No. 9,795,379, entitled “Surgical Instrument with Multi-Diameter Shaft,” issued Oct. 24, 2017; U.S. Pat. No. 9,808,248, entitled “Installation Features for Surgical Instrument End Effector Cartridge,” issued Nov. 7, 2017; U.S. Pat. No. 10,092,292, entitled “Staple Forming Features for Surgical Stapling Instrument,” issued Oct. 9, 2018; U.S. Pat. No. 9,717,497, entitled “Lockout Feature for Movable Cutting Member of Surgical Instrument,” issued Aug. 1, 2017; U.S. Pat. No. 9,517,065, entitled “Integrated Tissue Positioning and Jaw Alignment Features for Surgical Stapler,” issued Dec. 13, 2016; U.S. Pat. No. 9,622,746, entitled “Distal Tip Features for End Effector of Surgical Instrument,” issued Apr. 18, 2017; and U.S. Pat. No. 8,210,411, entitled “Motor-Driven Surgical Instrument,” issued Jul. 3, 2012. The disclosure of each of the above-cited U.S. patents is incorporated by reference herein in its entirety.
While several surgical instruments and systems have been made and used, it is believed that no one prior to the inventors has made or used the invention described in the appended claims.
While the specification concludes with claims which particularly point out and distinctly claim this technology, it is believed this technology will be better understood from the following description of certain examples taken in conjunction with the accompanying drawings, in which like reference numerals identify the same elements and in which:
The drawings are not intended to be limiting in any way, and it is contemplated that various embodiments of the technology may be carried out in a variety of other ways, including those not necessarily depicted in the drawings. The accompanying drawings incorporated in and forming a part of the specification illustrate several aspects of the present technology, and together with the description serve to explain the principles of the technology; it being understood, however, that this technology is not limited to the precise arrangements shown.
The following description of certain examples of the technology should not be used to limit its scope. Other examples, features, aspects, embodiments, and advantages of the technology will become apparent to those skilled in the art from the following description, which is by way of illustration, one of the best modes contemplated for carrying out the technology. As will be realized, the technology described herein is capable of other different and obvious aspects, all without departing from the technology. Accordingly, the drawings and descriptions should be regarded as illustrative in nature and not restrictive.
It is further understood that any one or more of the teachings, expressions, embodiments, examples, etc. described herein may be combined with any one or more of the other teachings, expressions, embodiments, examples, etc. that are described herein. The following-described teachings, expressions, embodiments, examples, etc. should therefore not be viewed in isolation relative to each other. Various suitable ways in which the teachings herein may be combined will be readily apparent to those of ordinary skill in the art in view of the teachings herein. Such modifications and variations are intended to be included within the scope of the claims.
For clarity of disclosure, the terms “proximal” and “distal” are defined herein relative to a human or robotic operator of the surgical instrument. The term “proximal” refers the position of an element closer to the human or robotic operator of the surgical instrument and further away from the surgical end effector of the surgical instrument. The term “distal” refers to the position of an element closer to the surgical end effector of the surgical instrument and further away from the human or robotic operator of the surgical instrument. It will be further appreciated that, for convenience and clarity, spatial terms such as “clockwise,” “counterclockwise,” “inner,” “outer,” “upper,” “lower,” and the like also are used herein for reference to relative positions and directions. Such terms are used below with reference to views as illustrated for clarity and are not intended to limit the invention described herein.
Aspects of the present examples described herein may be integrated into a robotically-enabled medical system, including as a robotic surgical system, capable of performing a variety of medical procedures, including both minimally invasive, such as laparoscopy, and non-invasive, such as endoscopy, procedures. Among endoscopy procedures, the robotically-enabled medical system may be capable of performing bronchoscopy, ureteroscopy, gastroscopy, etc.
I. Exemplary Robotic Surgical System
A. Overview
Robotic surgical system (10) may include a surgeon's console (16) for use by a surgeon (18) during a surgical procedure. One or more assistants (20) may also participate in the procedure. Robotic surgical system (10) may include a patient side cart (22) (i.e., a surgical robot) and an electronics cart (24). Patient side cart (22) may manipulate at least one surgical instrument (26) (also referred to as a “tool assembly” or “tool”) through an incision in the body of patient (12) while surgeon (18) views the surgical site through surgeon's console (16). As will be described in greater detail below, surgical instrument(s) (26) and an imaging device (shown as an endoscope (28)) may be removably coupled with patient side cart (22). Electronics cart (24) may be used to process the images of the surgical site for subsequent display to the surgeon (18) through surgeon's console (16). Electronics cart (24) may be coupled with endoscope (28) and may include a processor (38) (shown schematically) to process captured images for subsequent display, such as to surgeon (18) on the surgeon's console (16), on a display (40) of electronics cart (24), or another suitable display located locally and/or remotely. The images may also be processed by a combination of electronics cart (24) and processor (38), which may be coupled together to process the captured images jointly, sequentially, and/or combinations thereof. Electronics cart (24) may overlay the captured images with a virtual control interface prior to displaying combined images to the surgeon (18) via surgeon's console (16).
B. Exemplary Surgical Instrument
C. First Exemplary End Effector
One or both of upper and lower jaws (150, 152) may be configured to pivot and thereby actuate end effector (116) between open and closed positions. Lower jaw (152) includes a removable staple cartridge (154). In the illustrated example, lower jaw (152) is pivotable relative to upper jaw (150) to move between an open, unclamped position and a closed, clamped position. In other examples, upper jaw (150) may move relative to lower jaw (152) (e.g., similar to end effector (210) of
Upper jaw (150) defines a surface that has a plurality of pockets (not shown) and operates as an anvil to deform staples ejected from staple cartridge (154) during operation. Staple cartridge (154) is replaceable, for example, by removing a used staple cartridge (154) from end effector (116) and inserting a new staple cartridge (154) into lower jaw (152). Staple cartridge (154) includes a staple cartridge body (156) that houses a firing assembly (158), a plurality of staple drivers (160) (also referred to as staple pushers), and a plurality of staples (162). As shown in
At an initial proximal position of wedge sled (170), knife member (172) is housed within staple cartridge body (156). The position of knife member (172) is controlled during a first portion of the movement of wedge sled (170) from proximal end (176) of staple cartridge body (156) to distal end (178) of staple cartridge (154), so that a cutting edge (194) of knife member (172) extends through vertical slot (180). Vertical slot (180) accommodates cutting edge (194) of knife member (172) as firing assembly (158) is moved toward distal end (178) of staple cartridge (154). Wedge sled (170) includes a guide member (190) that provides a bearing surface that cooperates with a similarly shaped surface of staple cartridge body (156) to guide wedge sled (170). Guide member (190) extends from a vertical rib member (192) of wedge sled (170), which forms a central portion of wedge sled (170). In some versions, knife member (172), or at least cutting edge (194), may be retracted below upper deck (188) of staple cartridge body (156) prior to firing assembly (158) reaching its distal most position adjacent to distal end (178) of staple cartridge (154).
D. Second Exemplary End Effector
During firing, cutting edge (240) of firing beam (216) enters vertical slot (226) toward distal end (242) of staple cartridge (218), severing tissue clamped between staple cartridge (218) and anvil (214). As best seen in
It will be appreciated that any one or more of the teachings described below may be combined with any one or more of the teachings described above in connection with
II. Exemplary Deflectable Firing Members for Surgical Staplers
In some instances, it may be desirable to provide a firing member (e.g., a push rod) for operatively coupling pusher member (166) with moveable member (128) to transmit proximal and/or distal motion therebetween during articulation of end effector (116) relative to a longitudinal axis defined by shaft assembly (114). It may also be desirable for such a firing member to be resistant to lateral/lateral misalignment during articulation of end effector (116) (e.g., via any suitable wrist architecture of end effector (116)), to thereby prevent the firing member from buckling. Each of the push rods (310, 410, 510, 610, 710, 810, 910, 1010, 1110) described below may provide one or more of these functionalities. As used herein, the term “lateral” shall be understood to mean any direction that is laterally oriented relative to an axis; or that is otherwise non-parallel with the axis. The term “lateral” should not be read as being limited to directions that are only perpendicular to the axis. While a direction that is perpendicular to the axis may constitute a “lateral” direction, other directions that are obliquely oriented relative to the axis may also constitute “lateral” directions.
A. First Exemplary Deflectable Firing Member
As shown in
Push rod (310) of the present version further includes a plurality of I-shaped slots (320a, 320b) each extending partially circumferentially about cylindrical tube (312), and each including a pair of longitudinal slot end portions (322) and an intermediate slot portion (324) extending circumferentially therebetween and having longitudinally-opposed proximal and distal surfaces (326, 328). More particularly, slots (320a, 320b) are arranged in diametrically-opposed pairs spaced apart from each other at equal intervals along the length of tube (312), such that a diametrically-opposed pair of bridges (330) extend circumferentially between the respective slot end portions (322) of each diametrically-opposed pair of slots (320a, 320b). In some versions, the portions of tube (312) extending longitudinally between longitudinally-adjacent pairs of slots (320a, 320b) may be referred to as “segments.” As described in greater detail below, slots (320a, 320b) may impart bending flexibility to push rod (310), while bridges (330) and/or surfaces (326, 328) may impart axial stiffness and/or lateral misalignment (e.g., skew) resistance to push rod (310).
In the present version, slots (320a, 320b) are arranged in alternating pairs of diametrically-opposed slots (320a) and diametrically-opposed slots (320b), such that the pairs of diametrically-opposed slots (320a) are each angularly offset from the pairs of diametrically-opposed slots (320b), with intermediate slot portions (324) of slots (320a) extending circumferentially between respective laterally outer regions of tube (312), and with intermediate slot portions (324) of slots (320b) extending circumferentially between respective laterally outer regions of tube (312). In this manner, bridges (330) defined between the respective slot end portions (322) of each pair of diametrically-opposed slots (320a) are positioned at such laterally outer regions of tube (312), and bridges (330) defined between the respective slot end portions (322) of each pair of diametrically-opposed slots (320b) are positioned at such laterally outer regions of tube (312). In some versions, slots (320a, 320b) may each be laser cut into tube (312). It will be appreciated that slots (320a, 320b) may each be formed in any other suitable manner.
Referring now to
As shown in
As shown in
B. Second Exemplary Deflectable Firing Member
As shown in
Push rod (410) of the present version further includes a plurality of linear slots (420a, 420b, 420c) each extending partially circumferentially about cylindrical tube (412), and each including a pair of ends (422) and longitudinally-opposed proximal and distal surfaces (426, 428). More particularly, slots (420a, 420b, 420c) are arranged in diametrically-opposed pairs spaced apart from each other at equal intervals along the length of tube (412), such that a diametrically-opposed pair of bridges (430) extend circumferentially between the respective slot ends (422) of each diametrically-opposed pair of slots (420a, 420b, 420c). In some versions, the portions of tube (412) extending longitudinally between longitudinally-adjacent pairs of slots (420a, 420b, 420c) may be referred to as “segments.” As described in greater detail below, slots (420a, 420b, 420c) may impart bending flexibility to push rod (410), while bridges (430) and/or surfaces (426, 428) may impart axial stiffness and/or lateral misalignment (e.g., skew) resistance to push rod (410).
In the present version, slots (420a, 420b, 420c) are arranged in alternating pairs of diametrically-opposed slots (420a), radially obliquely-opposed slots (420b), and diametrically-opposed slots (420c), such that the pairs of diametrically-opposed slots (420a) are each angularly offset from the pairs of radially obliquely-opposed slots (420b), and further angularly offset from the pairs of diametrically-opposed slots (420c), with slots (420a) extending circumferentially between respective laterally outer regions of tube (412), with slots (420b) extending circumferentially between respective radially obliquely outer regions of tube (412), and with slots (420c) extending circumferentially between respective laterally outer regions of tube (412). In this manner, bridges (430) defined between the respective slot ends (422) of each pair of diametrically-opposed slots (420a) are positioned at such laterally outer regions of tube (412), bridges (430) defined between the respective slot ends (422) of each pair of radially obliquely-opposed slots (420b) are positioned at such radially obliquely outer regions of tube (412), and bridges (430) defined between the respective slot ends (422) of each pair of diametrically-opposed slots (420c) are positioned at such laterally outer regions of tube (412). In some versions, slots (420a, 420b, 420c) may each be laser cut into tube (412). It will be appreciated that slots (420a, 420b, 420c) may each be formed in any other suitable manner.
Referring now to
As shown in
As shown in
C. Third Exemplary Deflectable Firing Member
As shown, push rod (510) includes a cylindrical tube (512) extending distally from a proximal end (not shown) to a distal end (514) along a longitudinal axis, such as the longitudinal axis defined by shaft assembly (114). In some versions, the proximal end of cylindrical tube (512) may define an input surface for receiving forces from moveable member (128) and distal end (514) of cylindrical tube (512) may define an output surface for transmitting such forces to pusher member (166). Cylindrical tube (512) may be formed of any suitable material, such as a metal or polymer-based material. Push rod (510) also includes a lumen (516) defined by an interior surface of cylindrical tube (512). In some versions, lumen (516) may be configured to slidably receive a pull rod (not shown), as described below in connection with
Push rod (510) of the present version further includes a plurality of I-shaped slots (320a, 320b) defining corresponding bridges (330). Push rod (510) further includes a plurality of step-shaped slots (520) each extending partially longitudinally along cylindrical tube (512), and each including a pair of slot ends (522) and a plurality of linear slot portions (524) extending longitudinally therebetween and angularly offset from each other. More particularly, slots (520) are spaced apart from each other at equal intervals about the circumference of tube (512), such that a step-shaped bridge (530) extends circumferentially between each circumferentially-adjacent pair of slots (520). In some versions, the portions of tube (512) extending longitudinally between longitudinally-adjacent pairs of slots (320a, 320b) may be referred to as “segments.” As described in greater detail below, slots (320a, 320b, 520) may impart bending flexibility to push rod (510), while bridges (330, 530) and/or surfaces (326, 328) may impart axial stiffness and/or lateral misalignment (e.g., skew) resistance to push rod (510).
In the present version, slots (320a, 320b) are arranged in a manner similar to that described above in connection with
It will be appreciated that at least a distal portion of push rod (510) is configured to transition between the natural state shown in
For example, at least the distal portion of push rod (510) may be deflectable relative to the longitudinal axis of shaft assembly (114). In this regard, bridges (330, 530) may be sufficiently flexible to permit the distal portion of push rod (510) to deflect laterally outwardly from the longitudinal axis, while slots (320a, 320b, 520) may provide relief space for the longitudinally-adjacent and/or circumferentially-adjacent portions of tube (512) to flex into during deflection of the distal portion. In this manner, push rod (510) may conform to or otherwise accommodate articulation of end effector (116) relative to the longitudinal axis defined by shaft assembly (114) (e.g., via any suitable wrist architecture of end effector (116)).
At least the distal portion of push rod (510) may also be compressible along the longitudinal axis of shaft assembly (114). In this regard, slots (320a, 320b) may permit proximal surfaces (326) to be urged into engagement with the corresponding distal surfaces (328), while bridges (330) may be sufficiently rigid to inhibit engaged pairs of proximal and distal surfaces (326, 328) from skewing or otherwise shifting away from each other in a lateral direction during application of compressive axial loads thereto. In this manner, push rod (510) may transmit compressive axial loads, such as for transmitting distal motion from moveable member (128) to pusher member (166) to advance pusher member (166) distally, via bridges (330, 530) and/or engaged pairs of proximal and distal surfaces (326, 328), while resisting lateral misalignment of proximal and distal surfaces (326, 328) via bridges (330) to prevent push rod (510) from buckling. In other words, push rod (510) may have sufficient column strength to advance pusher member (166) distally, at least when push rod (510) is in the compressed state. In some versions, push rod (510) may also transmit tensile axial loads, such as for transmitting proximal motion from moveable member (128) to pusher member (166) to retract pusher member (166) proximally, via bridges (330, 530).
D. Fourth Exemplary Deflectable Firing Member
As shown, push rod (610) includes a cylindrical tube (612) extending distally from a proximal end (not shown) to a distal end (not shown) along a longitudinal axis, such as the longitudinal axis defined by shaft assembly (114). In some versions, the proximal end of cylindrical tube (612) may define an input surface for receiving forces from moveable member (128) and the distal end of cylindrical tube (612) may define an output surface for transmitting such forces to pusher member (166). Cylindrical tube (612) may be formed of any suitable material, such as a metal or polymer-based material. Push rod (610) may also include a lumen (not shown) defined by an interior surface of cylindrical tube (612). In some versions, the lumen may be configured to slidably receive a pull rod (not shown), as described below in connection with
Push rod (610) of the present version further includes a plurality of slots (620a, 620b) each extending partially circumferentially about cylindrical tube (612), and each including a pair of generally hook-shaped slot end portions (622) and a generally U-shaped intermediate slot portion (624) extending circumferentially therebetween and having longitudinally-opposed proximal and distal surfaces (626, 628). More particularly, slots (620a, 620b) are arranged in diametrically-opposed pairs spaced apart from each other at equal intervals along the length of tube (612), such that a diametrically-opposed pair of bridges (630) extend circumferentially between the respective slot end portions (622) of each diametrically-opposed pair of slots (620a, 620b). In some versions, the portions of tube (612) extending longitudinally between longitudinally-adjacent pairs of slots (620a, 620b) may be referred to as “segments.” As described in greater detail below, slots (620a, 620b) may impart bending flexibility to push rod (610), while bridges (630) and/or surfaces (626, 628) may impart axial stiffness and/or lateral misalignment (e.g., skew) resistance to push rod (610).
In the present version, slots (620a, 620b) are arranged in alternating pairs of diametrically-opposed slots (620a) and diametrically-opposed slots (620b), such that the pairs of diametrically-opposed slots (620a) are each angularly offset from the pairs of diametrically-opposed slots (620b), with intermediate slot portions (624) of slots (620a) extending circumferentially between respective laterally outer regions of tube (612), and with intermediate slot portions (624) of slots (620b) extending circumferentially between respective laterally outer regions of tube (612). In this manner, bridges (630) defined between the respective slot end portions (622) of each pair of diametrically-opposed slots (620a) are positioned at such laterally outer regions of tube (612), and bridges (630) defined between the respective slot end portions (622) of each pair of diametrically-opposed slots (620b) are positioned at such laterally outer regions of tube (612). In some versions, slots (620a, 620b) may each be laser cut into tube (612). It will be appreciated that slots (620a, 620b) may each be formed in any other suitable manner.
It will be appreciated that at least a distal portion of push rod (610) is configured to transition between the natural state shown in
For example, at least the distal portion of push rod (610) may be deflectable relative to the longitudinal axis of shaft assembly (114). In this regard, bridges (630) may be sufficiently flexible to permit the distal portion of push rod (610) to deflect laterally away from the longitudinal axis, while slots (620a, 620b) may provide relief space for the longitudinally-adjacent portions of tube (612) to flex into during deflection of the distal portion. In this manner, push rod (610) may conform to or otherwise accommodate articulation of end effector (116) relative to the longitudinal axis defined by shaft assembly (114) (e.g., via any suitable wrist architecture of end effector (116)).
At least the distal portion of push rod (610) may also be compressible along the longitudinal axis of shaft assembly (114). In this regard, slots (620a, 620b) may permit proximal surfaces (626) to be urged into engagement with the corresponding distal surfaces (628), while bridges (630) may be sufficiently rigid to inhibit engaged pairs of proximal and distal surfaces (626, 628) from skewing or otherwise shifting away from each other in a lateral direction during application of compressive axial loads thereto. In this manner, push rod (610) may transmit compressive axial loads, such as for transmitting distal motion from moveable member (128) to pusher member (166) to advance pusher member (166) distally, via bridges (630) and/or engaged pairs of proximal and distal surfaces (626, 628), while resisting lateral misalignment of proximal and distal surfaces (626, 628) via bridges (630) to prevent push rod (610) from buckling. In other words, push rod (610) may have sufficient column strength to advance pusher member (166) distally, at least when push rod (610) is in the compressed state. In some versions, push rod (610) may also transmit tensile axial loads, such as for transmitting proximal motion from moveable member (128) to pusher member (166) to retract pusher member (166) proximally, via bridges (630).
E. Fifth Exemplary Deflectable Firing Member
As shown, push rod (710) includes a cylindrical tube (712) extending distally from a proximal end (713) to a distal end (714) along a longitudinal axis, such as the longitudinal axis defined by shaft assembly (114). In some versions, proximal end (713) of cylindrical tube (712) may define an input surface for receiving forces from moveable member (128) and distal end (714) of cylindrical tube (712) may define an output surface for transmitting such forces to pusher member (166). Cylindrical tube (712) may be formed of any suitable material, such as a metal or polymer-based material. Push rod (710) also includes a lumen (716) defined by an interior surface of cylindrical tube (712) for slidably receiving pull rod (702).
Cylindrical tube (712) of the present version further includes an intermediate flexible mesh portion (720) having a plurality of strands (722) that are combined in a matrix extending between proximal and distal rigid collar portions (724, 726) of cylindrical tube (712). In some versions, intermediate mesh portion (720) may have a smaller inner diameter than that of one or both collar portion(s) (724, 726). Intermediate mesh portion (720) may have any suitable configuration, such as a webbed and/or coiled configuration. In some versions, strands (722) may be 3D printed together to form intermediate mesh portion (720). In other versions, strands (722) may be individually formed as separate wires and knitted or woven together in a pattern or in a random association. Any number of suitable texture patterns may be used as would be apparent to a person having ordinary skill in the art in view of the teachings herein. Lasering and/or soldering techniques may be used to impart strands (722) and/or intermediate mesh portion (720) with a variety of different mechanical properties. It will be appreciated that strands (722) and/or intermediate mesh portion (720) may each be formed in any other suitable manner. As described in greater detail below, intermediate mesh portion (720) including strands (722) may impart bending flexibility and/or axial stiffness to push rod (710).
As shown, pull rod (702) includes a shaft in the form of a braided cable (730) including a plurality of strands (731) and extending distally from a proximal end (732) to a distal aglet (734) along a longitudinal axis, such as the longitudinal axis defined by shaft assembly (114). As described in greater detail below, braided cable (730) may impart axial stiffness and/or lateral misalignment (e.g., skew) resistance to pull rod (702), which may in turn impart lateral misalignment (e.g., skew) resistance to push rod (710) via contact between an outer surface of pull rod (702) and lumen (716). In this regard, braided cable (730) may have a stiffness greater than that of intermediate mesh portion (720) and may have an outer diameter substantially equal to or slightly less than the inner diameter of at least intermediate mesh portion (720) of push rod (710) such that pull rod (702) may be slidable longitudinally relative to push rod (710) while providing radial support thereto. Braided cable (730) may be formed of any suitable material, such as high strength steel. It will be appreciated that the shaft of pull rod (702) may be provided in any other suitable form, such as a 3D printed and/or flexible rod.
It will be appreciated that push rod (710) is configured to transition between the natural state shown in
For example, push rod (710) and pull rod (702) may each be deflectable relative to the longitudinal axis of shaft assembly (114). In this regard, strands (722) may be sufficiently flexible to permit the distal portion of push rod (710) to deflect laterally away from the longitudinal axis, while braided cable (730) may be sufficiently flexible to permit the distal portion of pull rod (702) to deflect laterally away from the longitudinal axis, such that push rod (710) and pull rod (702) may deflect laterally together. In this manner, push rod (710) and pull rod (702) may cooperatively conform to or otherwise accommodate articulation of end effector (116) relative to the longitudinal axis defined by shaft assembly (114) (e.g., via any suitable wrist architecture of end effector (116)).
At least the distal portion of push rod (710) may also be compressible along the longitudinal axis of shaft assembly (114). In this regard, strands (722) may be sufficiently flexible in the longitudinal direction to permit longitudinally-adjacent strands (722) to be urged into engagement with each other, while braided cable (730) may be sufficiently rigid in each radial direction to inhibit engaged pairs of strands (722) from skewing or otherwise shifting away from each other in a radial direction during application of compressive axial loads thereto. In this manner, push rod (710) may transmit compressive axial loads, such as for transmitting distal motion from moveable member (128) to pusher member (166) to advance pusher member (166) distally, via engaged pairs of strands (722), while resisting lateral misalignment of strands (722) via the radial support provided thereto by braided cable (730) to prevent push rod (710) from buckling. In other words, push rod (710) may have sufficient column strength to advance pusher member (166) distally, at least when push rod (710) is in the compressed state. In some versions, push rod (710) may also transmit tensile axial loads, such as for transmitting proximal motion from moveable member (128) to pusher member (166) to retract pusher member (166) proximally, via strands (722). In such cases, pull rod (702) may be omitted, and strands (722) may be sufficiently rigid in each radial direction to inhibit engaged pairs of strands (722) from skewing or otherwise shifting away from each other in a radial direction during application of compressive axial loads thereto in the absence of braided cable (730).
F. Sixth Exemplary Deflectable Firing Member
As shown in
As shown, push rod (810) further includes a central flexible shaft (830) extending longitudinally through the central bores of the stacked plurality of links (812). As described in greater detail below, flexible shaft (830) may cooperate with the central bores of links (812) to impart lateral misalignment (e.g., skew) resistance to push rod (810). Push rod (810) further includes first and second cables (832, 834), each wrapped helically about the stacked plurality of links (812) and extending distally from a proximal annular ring (840) to a distal annular ring (842) positioned at corresponding ends of the stacked plurality of links (812). In this regard, distal ring (842) may be seated against a radially outer surface of nose (822) of the distal-most link (812) and proximal ring (840) may be seated against the proximal end of the proximal-most link (812), such that the stacked plurality of links (812) is sandwiched between rings (840, 842). In some versions, one or both rings (840, 842) may be fixedly secured to the corresponding link (812). As described in greater detail below, first and second cables (832, 834) may cooperate with links (812) and rings (840, 842) to impart lateral misalignment (e.g., skew) resistance to push rod (810).
In the present version, first cable (832) is wrapped helically in a clockwise direction from a lateral lower region of proximal ring (840) to a lateral lower region of distal ring (842), and second cable (834) is wrapped helically opposite first cable (832) in a counterclockwise direction from a lateral upper region of distal ring (842) to a lateral upper region of proximal ring (840). Cables (832, 834) are each fixedly secured at their distal ends to distal ring (842) and are each fixedly secured at their proximal ends to first and second caps (844, 846), respectively, which are each positioned proximally of proximal ring (840), with intermittent portions of cables (832, 834) securely nested at periodic joints between longitudinally-adjacent pairs of links (812) (e.g., between a radially outer surface of nose (822) of the relatively proximal link (812) of each pair and a proximal end of the relatively distal link (812) of each pair). In this regard, cables (832, 834) each extend proximally through corresponding bores (not shown) in proximal ring (840) to the respective cap (844, 846), which is resiliently biased proximally away from proximal ring (840) by first and second compression springs (850, 852), respectively. It will be appreciated that caps (844, 846) may be resiliently biased proximally away from proximal ring (840) by any other suitable biasing member. In any event, such biasing of caps (844, 846) may assist in maintaining the respective cables (832, 834) in tension by pulling cables (832, 834) proximally, as indicated by arrows (A7, A8) in
With continuing reference to
As shown in
G. Seventh Exemplary Deflectable Firing Member
As shown, push rod (910) includes a plurality of segments in the form of individual links (912) flexibly stacked together in a columnar arrangement along a longitudinal axis, such as the longitudinal axis defined by shaft assembly (114). Each link (912) includes a generally spherical body (914), such that a proximal rounded side of a relatively distal link (912) may abut a distal rounded side of a longitudinally-adjacent, relatively proximal link (912). In some versions, the proximal side of the proximal-most link (912) may define an input surface for receiving forces from moveable member (128) and the distal side of the distal-most link (912) may define an output surface for transmitting such forces to pusher member (166). In the present version, each link (912) further includes a central bore (924) extending between the proximal and distal sides, the purposes of which are described below. Links (912) may each be formed of any suitable material, such as a metal or polymer-based material. As described in greater detail below, the rounded sides of longitudinally-adjacent links (912) may cooperate with each other to impart bending flexibility to push rod (910). Push rod (910) further includes a central cable (930) extending longitudinally through central bores (924) of the stacked plurality of links (912). As described in greater detail below, cable (930) may cooperate with central bores (924) of links (912) to impart lateral misalignment (e.g., skew) resistance to push rod (910).
It will be appreciated that at least a distal portion of push rod (910) is configured to transition between the natural state shown in
For example, at least the distal portion of push rod (910) may be deflectable relative to the longitudinal axis of shaft assembly (114). In this regard, cable (930) may be sufficiently flexible to permit the distal portion of push rod (910) to deflect laterally away from the longitudinal axis via engagement between the rounded sides of longitudinally-adjacent pairs of links (912). In this manner, push rod (910) may conform to or otherwise accommodate articulation of end effector (116) relative to the longitudinal axis defined by shaft assembly (114) (e.g., via any suitable wrist architecture of end effector (116)). Cable (930) may be sufficiently rigid to inhibit engaged pairs of links (912) from skewing or otherwise shifting away from each other in a lateral direction during application of compressive axial loads thereto. In this manner, push rod (910) may transmit compressive axial loads, such as for transmitting distal motion from moveable member (128) to pusher member (166) to advance pusher member (166) distally, via engaged pairs of links (912), while resisting lateral misalignment of links (912) via cable (930) to prevent push rod (910) from buckling. In other words, push rod (910) may have sufficient column strength to advance pusher member (166) distally, even when push rod (910) is in the deflected state. In some versions, push rod (910) may also transmit tensile axial loads, such as for transmitting proximal motion from moveable member (128) to pusher member (166) to retract pusher member (166) proximally, via cable (930).
H. Eighth Exemplary Deflectable Firing Member
As shown, push rod (1010) includes a plurality of segments in the form of individual links (1012) flexibly stacked together in a columnar arrangement along a longitudinal axis, such as the longitudinal axis defined by shaft assembly (114). Each link (1012) includes a generally conical hub (1014), and further includes a generally hemispherical proximal socket (1020) extending distally from a proximal end of hub (1014) and a generally hemispherical distal nose (1022) extending distally from a distal end of hub (1014). Each socket (1020) is rounded radially inwardly toward the proximal end of hub (1014), and each nose (1022) is similarly rounded radially inwardly toward the distal end of hub (1014) such that the shape of each nose (1022) is generally complementary to that of each socket (1020). In this manner, the socket (1020) of a relatively distal link (1012) may matingly receive the nose (1022) of a longitudinally-adjacent, relatively proximal link (1012). In the example shown, each socket (1020) of a relatively distal link (1012) also partially receives the hub (1014) of the longitudinally-adjacent, relatively proximal link (1012). In some versions, socket (1020) of the proximal-most link (1012) may define an input surface for receiving forces from moveable member (128) and nose (1022) of the distal-most link (1012) may define an output surface for transmitting such forces to pusher member (166). Links (1012) may each be formed of any suitable material, such as a metal or polymer-based material. As described in greater detail below, sockets (1020) may each cooperate with the respective nose (1022) received therein to impart bending flexibility and/or axial stiffness to push rod (1010), while sockets (1020) may each cooperate with the respective hub (1014) partially received therein to impart lateral misalignment (e.g., skew) resistance to push rod (1010).
It will be appreciated that at least a distal portion of push rod (1010) is configured to transition between the natural state shown in
For example, at least the distal portion of push rod (1010) may be deflectable relative to the longitudinal axis of shaft assembly (114). In this regard, sockets (1020) may each be sufficiently wider than the portion of the respective hub (1014) received therein to permit the distal portion of push rod (1010) to deflect laterally away from the longitudinal axis via pivotable engagement between noses (1022) and sockets (1020) of longitudinally-adjacent pairs of links (1012). In this manner, push rod (1010) may conform to or otherwise accommodate articulation of end effector (116) relative to the longitudinal axis defined by shaft assembly (114) (e.g., via any suitable wrist architecture of end effector (116)). The portion the respective hub (1014) received within each socket (1020) may be sufficiently wide to inhibit engaged pairs of noses (1022) and sockets (1020) from skewing or otherwise shifting away from each other in a lateral direction during application of compressive axial loads thereto. In this manner, push rod (1010) may transmit compressive axial loads, such as for transmitting distal motion from moveable member (128) to pusher member (166) to advance pusher member (166) distally, via engaged pairs of noses (1022) and sockets (1020), while resisting lateral misalignment of links (1012) via cooperation between hubs (1014) and sockets (1020) to prevent push rod (1010) from buckling or jackknifing. In other words, push rod (1010) may have sufficient column strength to advance pusher member (166) distally, even when push rod (1010) is in the deflected state. In some versions, push rod (1010) may also transmit tensile axial loads, such as for transmitting proximal motion from moveable member (128) to pusher member (166) to retract pusher member (166) proximally, via engaged pairs of noses (1022) and sockets (1020).
I. Ninth Exemplary Deflectable Firing Member
As shown, push rod (1110) includes a plurality of segments in the form of individual links (1112) flexibly stacked together in a columnar arrangement along a longitudinal axis, such as the longitudinal axis defined by shaft assembly (114). Each link (1112) includes at least one proximal detent (not shown) and at least one distal pocket (not shown). In some versions, the shape of each detent is generally complementary to that of each pocket. In this manner, the pocket of a relatively proximal link (1112) may matingly receive the detent of a longitudinally-adjacent, relatively distal link (1112), while maintaining a slight separation therebetween. In some versions, links (1112) may each be 3D printed. As described in greater detail below, the pockets may each cooperate with the respective detent received therein to impart bending flexibility and/or axial stiffness to push rod (1110), while also cooperating with the respective detent to impart lateral misalignment (e.g., skew) resistance to push rod (1110). In the embodiment shown, push rod (1110) also includes a distal key (1150) extending distally from the distal-most link (1112) and having a generally truncated circular cross-sectional shape, the purpose of which is described below.
As shown, pusher member (1102) includes first and second flanges (184, 185) described above in connection with
It will be appreciated that at least a distal portion of push rod (1110) is configured to transition between the natural state shown in
For example, at least the distal portion of push rod (1110) may be deflectable relative to the longitudinal axis of shaft assembly (114). In this regard, the distal portion of push rod (1110) may be permitted to deflect laterally away from the longitudinal axis via pivotable engagement between detents and pockets of longitudinally-adjacent pairs of links (1112). For example, the detents may interact with the pockets to resist but not prevent pivoting between longitudinally-adjacent pairs of links (1112). In this manner, push rod (1110) may conform to or otherwise accommodate articulation of end effector (116) relative to the longitudinal axis defined by shaft assembly (114) (e.g., via any suitable wrist architecture of end effector (116)).
At least the distal portion of push rod (1110) may also be compressible along the longitudinal axis of shaft assembly (114). In this regard, the slight separation between detents and pockets of longitudinally-adjacent pairs of links (1112) may permit such detents and pockets of longitudinally-adjacent pairs of links (1112) to be urged into engagement with each other, while the detents may be sufficiently rigid to inhibit engaged pairs of detents and pockets from skewing or otherwise shifting away from each other in a lateral direction during application of compressive axial loads thereto. In this manner, push rod (1110) may transmit compressive axial loads, such as for transmitting distal motion from moveable member (128) to pusher member (1102) to advance pusher member (1102) distally, via engaged pairs of detents and pockets, while resisting lateral misalignment of engaged pairs of detents and pockets to prevent push rod (1110) from buckling. In other words, push rod (1110) may have sufficient column strength to advance pusher member (1102) distally, at least when push rod (1110) is in the compressed state. In some versions, push rod (1110) may also transmit tensile axial loads, such as for transmitting proximal motion from moveable member (128) to pusher member (1102) to retract pusher member (1102) proximally, via engaged pairs of detents and pockets.
III. Exemplary Combinations
The following examples relate to various non-exhaustive ways in which the teachings herein may be combined or applied. It should be understood that the following examples are not intended to restrict the coverage of any claims that may be presented at any time in this application or in subsequent filings of this application. No disclaimer is intended. The following examples are being provided for nothing more than merely illustrative purposes. It is contemplated that the various teachings herein may be arranged and applied in numerous other ways. It is also contemplated that some variations may omit certain features referred to in the below examples. Therefore, none of the aspects or features referred to below should be deemed critical unless otherwise explicitly indicated as such at a later date by the inventors or by a successor in interest to the inventors. If any claims are presented in this application or in subsequent filings related to this application that include additional features beyond those referred to below, those additional features shall not be presumed to have been added for any reason relating to patentability.
A surgical stapling instrument comprising: (a) a shaft assembly extending along a longitudinal axis to a distal end; (b) an end effector at the distal end of the shaft assembly, wherein the end effector includes: (i) a first jaw, (ii) a second jaw, the first and second jaws being operable to transition between an open state and a closed state, and (iii) a driving assembly translatable distally relative to the first jaw and the second jaw to thereby transition the first and second jaws from the open state to the closed state; and (c) a flexible firing member configured to selectively advance the driving assembly distally and retract the driving assembly proximally, wherein the flexible firing member includes: (i) a plurality of segments, (ii) at least one axial force transmission feature configured to transmit axial forces between the segments, and (iii) at least one lateral alignment feature configured to resist lateral misalignment of the segments.
The surgical stapling instrument of Example 1, wherein the flexible firing member is deflectable laterally away from the longitudinal axis.
The surgical stapling instrument of Example 2, wherein the flexible firing member further includes a push rod configured to selectively advance the driving assembly distally and retract the driving assembly proximally, wherein the at least one axial force transmission feature is presented by the push rod.
The surgical stapling instrument of Example 3, wherein the at least one lateral alignment feature is presented by the push rod.
The surgical stapling instrument of Example 4, wherein the push rod includes a plurality of slots, wherein the at least one axial force transmission feature includes proximal and distal surfaces of the slots.
The surgical stapling instrument of Example 5, wherein the at least one lateral alignment feature includes bridges defined between the slots.
The surgical stapling instrument of any of Examples 5 through 6, wherein the plurality of slots includes at least one a plurality of I-shaped slots, a plurality of linear slots, a plurality of step-shaped slots, or a plurality of hook-shaped slots.
The surgical stapling instrument of any of Examples 3 through 7, wherein the push rod includes a mesh portion, wherein the at least one axial force transmission feature includes strands of the mesh portion.
The surgical stapling instrument of any of Examples 3 through 8, wherein the push rod includes a plurality of links flexibly stacked together in a columnar arrangement.
The surgical stapling instrument of Example 9, wherein the links each include a spherical body, wherein the at least one axial force transmission feature includes rounded proximal and distal surfaces of the links.
The surgical stapling instrument of any of Examples 9 through 10, wherein the links each include a conical body, wherein the at least one axial force transmission feature includes proximal sockets and distal noses of the links.
The surgical stapling instrument of any of Examples 9 through 11, wherein the at least one lateral alignment feature includes at least one cable engaged with the links.
The surgical stapling instrument of any of Examples 4 through 12, wherein the flexible firing member further includes a pull rod configured to retract the driving assembly proximally, wherein the pull rod is slidably received within the push rod, wherein the at least one lateral alignment feature is presented by the pull rod.
The surgical stapling instrument of Example 13, wherein the at least one lateral alignment feature includes a radially outer surface of the pull rod configured to radially support the push rod.
The surgical stapling instrument of any of Examples 1 through 14, wherein the flexible firing member further includes a distal key, wherein the driving assembly includes a keyway configured to receive and frictionally engage the distal key to secure the driving assembly against rotation relative to the flexible firing member about the longitudinal axis.
A surgical stapling instrument comprising: (a) a shaft assembly extending along a longitudinal axis to a distal end; (b) an end effector at the distal end of the shaft assembly, wherein the end effector includes: (i) a first jaw, (ii) a second jaw, the first and second jaws being operable to transition between an open state and a closed state, the first and second jaws being further operable to staple tissue, and (iii) a driving assembly translatable distally relative to the first jaw and the second jaw to thereby transition the first and second jaws from the open state to the closed state; and (c) a flexible push rod configured to selectively advance the driving assembly distally, wherein the flexible push rod includes: (i) a cylindrical tube, (ii) at least one pair of diametrically-opposed slots extending circumferentially about respective portions of the cylindrical tube, each slot including a proximal surface and a distal surface configured to selectively contact each other for transmitting axial forces therebetween, and (iii) a pair of diametrically-opposed bridges extending circumferentially between the pair of diametrically-opposed slots, wherein the bridges are configured to resist lateral misalignment of the proximal and distal surfaces from each other.
The surgical stapling instrument of Example 16, wherein the at least one pair of diametrically-opposed slots includes a pair of diametrically-opposed slots, wherein the at least one pair of diametrically-opposed bridges includes a pair of diametrically-opposed slots extending circumferentially between the pair of diametrically-opposed slots.
The surgical stapling instrument of Example 17, wherein the at least one pair of diametrically-opposed slots further includes a pair of diametrically-opposed slots longitudinally spaced apart from the pair of diametrically-opposed slots, wherein the at least one pair of diametrically-opposed bridges further includes a pair of diametrically-opposed slots extending circumferentially between the pair of diametrically-opposed slots.
A surgical stapling instrument comprising: (a) a shaft assembly extending along a longitudinal axis to a distal end; (b) an end effector at the distal end of the shaft assembly, wherein the end effector includes: (i) a first jaw, (ii) a second jaw, the first and second jaws being operable to transition between an open state and a closed state, the first and second jaws being further operable to staple tissue, and (iii) a driving assembly translatable distally relative to the first jaw and the second jaw to thereby transition the first and second jaws from the open state to the closed state; and (c) a flexible push rod configured to selectively advance the driving assembly distally through the second jaw, wherein the flexible push rod includes: (i) a plurality of links stacked together in a columnar arrangement, each link including a proximal socket and a distal nose configured to be received within the proximal socket of an adjacent link for transmitting axial forces therebetween, and (ii) at least one cable engaged with the links and configured to resist lateral misalignment of the links from each other.
The surgical stapling instrument of Example 19, wherein the at least one cable includes a pair of cables wrapped about the plurality of links.
IV. Miscellaneous
Any one or more of the teachings, expressions, embodiments, examples, etc. described herein may be combined with any one or more of the teachings, expressions, embodiments, examples, etc. described in U.S. Pat. No. 9,060,770, entitled “Robotically-Driven Surgical Instrument with E-Beam Driver,” issued Jun. 23, 2015, the disclosure of which is hereby incorporated by reference herein in its entirety.
Any one or more of the teachings, expressions, embodiments, examples, etc. described herein may be combined with any one or more of the teachings, expressions, embodiments, examples, etc. described in U.S. Pat. App. No. [Atty. Ref. No. END9348USNP1], entitled “Methods of Operating a Robotic Surgical Stapler,” filed on even date herewith; U.S. Pat. App. No. [Atty. Ref. No. END9348USNP2], entitled “Multi-Threshold Motor Control Algorithm for Powered Surgical Stapler,” filed on even date herewith; U.S. Pat. App. No. [Atty. Ref. No. END9348USNP3], entitled “Variable Response Motor Control Algorithm for Powered Surgical Stapler,” filed on even date herewith; U.S. Pat. App. No. [Atty. Ref. No. END9348USNP4], entitled “Powered Surgical Stapler Having Independently Operable Closure and Firing Systems,” filed on even date herewith; U.S. Pat. App. No. [Atty. Ref. No. END9348USNP5], entitled “Firing System Features for Surgical Stapler,” filed on even date herewith; U.S. Pat. App. No. [Atty. Ref. No. END9348USNP6], entitled “Multiple-Sensor Firing Lockout Mechanism for Powered Surgical Stapler,” filed on even date herewith; U.S. Pat. App. No. [Atty. Ref. No. END9348USNP7], entitled “Proximally Located Firing Lockout Mechanism for Surgical Stapler,” filed on even date herewith; U.S. Pat. App. No. [Atty. Ref. No. END9348USNP8], entitled “Cartridge-Based Firing Lockout Mechanism for Surgical Stapler,” filed on even date herewith; U.S. Pat. App. No. [Atty. Ref. No. END9348USNP9], entitled “Sled Restraining Member for Surgical Stapler,” filed on even date herewith; U.S. Pat. App. No. [Atty. Ref. No. END9348USNP10], entitled “Firing Member Tracking Feature for Surgical Stapler,” filed on even date herewith; U.S. Pat. App. No. [Atty. Ref. No. END9348USNP11], entitled “Adjustable Power Transmission Mechanism for Powered Surgical Stapler,” filed on even date herewith; and/or U.S. Pat. App. No. [Atty. Ref. No. END9348USNP12], entitled “Firing Bailout System for Powered Surgical Stapler,” filed on even date herewith. The disclosure of each of these applications is incorporated by reference herein in its entirety.
It should be appreciated that any patent, publication, or other disclosure material, in whole or in part, that is said to be incorporated by reference herein is incorporated herein only to the extent that the incorporated material does not conflict with existing definitions, statements, or other disclosure material set forth in this disclosure. As such, and to the extent necessary, the disclosure as explicitly set forth herein supersedes any conflicting material incorporated herein by reference. Any material, or portion thereof, that is said to be incorporated by reference herein, but which conflicts with existing definitions, statements, or other disclosure material set forth herein will only be incorporated to the extent that no conflict arises between that incorporated material and the existing disclosure material.
Versions described above may be designed to be disposed of after a single use, or they can be designed to be used multiple times. Versions may, in either or both cases, be reconditioned for reuse after at least one use. Reconditioning may include any combination of the steps of disassembly of the systems, instruments, and/or portions thereof, followed by cleaning or replacement of particular pieces, and subsequent reassembly. In particular, some versions of the systems, instruments, and/or portions thereof may be disassembled, and any number of the particular pieces or parts of the systems, instruments, and/or portions thereof may be selectively replaced or removed in any combination. Upon cleaning and/or replacement of particular parts, some versions of the systems, instruments, and/or portions thereof may be reassembled for subsequent use either at a reconditioning facility, or by an operator immediately prior to a procedure. Those skilled in the art will appreciate that reconditioning of systems, instruments, and/or portions thereof may utilize a variety of techniques for disassembly, cleaning/replacement, and reassembly. Use of such techniques, and the resulting reconditioned systems, instruments, and/or portions thereof, are all within the scope of the present application.
By way of example only, versions described herein may be sterilized before and/or after a procedure. In one sterilization technique, the systems, instruments, and/or portions thereof is placed in a closed and sealed container, such as a plastic or TYVEK bag. The container and system, instrument, and/or portion thereof may then be placed in a field of radiation that can penetrate the container, such as gamma radiation, x-rays, or high-energy electrons. The radiation may kill bacteria on the system, instrument, and/or portion thereof and in the container. The sterilized systems, instruments, and/or portions thereof may then be stored in the sterile container for later use. Systems, instruments, and/or portions thereof may also be sterilized using any other technique known in the art, including but not limited to beta or gamma radiation, ethylene oxide, or steam.
Having shown and described various embodiments of the present invention, further adaptations of the methods and systems described herein may be accomplished by appropriate modifications by one of ordinary skill in the art without departing from the scope of the present invention. Several of such potential modifications have been mentioned, and others will be apparent to those skilled in the art. For instance, the examples, embodiments, geometrics, materials, dimensions, ratios, steps, and the like discussed above are illustrative and are not required. Accordingly, the scope of the present invention should be considered in terms of the following claims and is understood not to be limited to the details of structure and operation shown and described in the specification and drawings.