The present disclosure relates to surgical instruments and, in various arrangements, to surgical stapling and cutting instruments and staple cartridges for use therewith that are designed to staple and cut tissue.
The disclosed technology can be for systems, devices, and subsystems for surgical instruments for robotic surgeries. The surgical instruments can have several subsystems that can be independently actuated to provide a specific action, such as closing and opening of an end effector of the stapler, articulation of the end effector, rolling of the end effector, and firing of staples within the end effector.
The disclosed technology describes an articulation joint, which can be one of a number of subsystems and/or subcomponents for a surgical instrument. The articulation joint includes a plurality of concentric discs, each of the plurality of concentric discs having a concentric central opening. The articulation joint includes a center beam assembly including a proximal end and a distal end. A portion of the center beam assembly extends through the central opening of each concentric disc. The plurality of concentric discs are nestably stacked on the center beam assembly, and the center beam assembly compresses the plurality of concentric discs. The distal end of the center beam assembly is configured to couple to the plurality of concentric discs to an end effector of the surgical instrument. The proximal end of the center beam assembly is configured to couple the plurality of concentric discs to a shaft of the surgical instrument. The articulation joint can be combined with one or more of an end effector, articulation subsystem, firing subsystem, roll subsystem for implementation in the surgical instrument.
The disclosed technology describes a cable articulation subsystem, which can be one of a number of subsystems and/or subcomponents for a surgical instrument. The cable articulation subsystem includes a joint including a distal end. The cable articulation subsystem includes at least three articulation cables. A distal end of each articulation cable is coupled to the joint distal end. A proximal end of each articulation cable is discretely manipulable to cause rotation of the joint about at least one of a pitch axis and a yaw axis. The cable articulation subsystem can be combined with one or more of an end effector, articulation joint, firing subsystem, roll subsystem and housing for implementation in the surgical instrument.
The disclosed technology describes a cable articulation system, which can be one or more of a number of subsystems and/or subcomponents for a surgical instrument. The system includes a joint (300, 300′) including a distal end (306B). The system includes a shaft assembly (600A). The system includes a housing (700) coupled to the shaft assembly (600A). The system includes at least three articulation cables (402, 404, 406). A distal end (402A, 404A, 406A) of each articulation cable (402, 404, 406) is coupled to the joint distal end (306B) and extends from the joint and through the shaft assembly (600A). The proximal end (402B, 404B, 406B) of each articulation cable (402, 404, 406) is movably mounted in the housing (700). The proximal end (402B, 404B, 406B) of each articulation cable (402, 404, 406) is discretely manipulable to cause rotation of the joint (300) about at least one of a pitch axis (PA) and a yaw axis (YA).
The disclosed technology describes a cable articulation subsystem, which can be one of a number of subsystems and/or subcomponents for a surgical instrument. The cable articulation subsystem includes a joint including a distal end. The cable articulation subsystem includes only two continuous articulation cables, with a middle section of each continuous articulation cable being mechanically grounded to the joint distal end so as to functionally divide each continuous articulation cable into a first articulation cable and a second articulation cable. A proximal end of each first articulation cable and each second articulation cable is discretely manipulable to cause rotation of the joint about at least one of a pitch axis and a yaw axis.
The following detailed description should be read with reference to the drawings, in which like elements in different drawings are identically numbered. The drawings, which are not necessarily to scale, depict selected embodiments and are not intended to limit the scope of the invention. The detailed description illustrates by way of example, not by way of limitation, the principles of the invention. This description will clearly enable one skilled in the art to make and use the invention, and describes several embodiments, adaptations, variations, alternatives and uses of the invention, including what is presently believed to be the best mode of carrying out the invention.
Numerous specific details are set forth to provide a thorough understanding of the overall structure, function, manufacture, and use of the embodiments as described in the specification and illustrated in the accompanying drawings. Well-known operations, components, and elements have not been described in detail so as not to obscure the embodiments described in the specification. The reader will understand that the embodiments described and illustrated herein are non-limiting examples, and thus it can be appreciated that the specific structural and functional details disclosed herein may be representative and illustrative. Variations and changes thereto may be made without departing from the scope of the claims.
The terms “comprise” (and any form of comprise, such as “comprises” and “comprising”), “have” (and any form of have, such as “has” and “having”), “include” (and any form of include, such as “includes” and “including”) and “contain” (and any form of contain, such as “contains” and “containing”) are open-ended linking verbs. As a result, a surgical system, device, or apparatus that “comprises,” “has,” “includes” or “contains” one or more elements possesses those one or more elements, but is not limited to possessing only those one or more elements. Likewise, an element of a system, device, or apparatus that “comprises,” “has,” “includes” or “contains” one or more features possesses those one or more features, but is not limited to possessing only those one or more features.
As used herein, the terms “about” or “approximately” for any numerical values or ranges indicate a suitable dimensional tolerance that allows the part or collection of components to function for its intended purpose as described herein. More specifically, “about” or “approximately” may refer to the range of values ±20% of the recited value, e.g., “about 90%” may refer to the range of values from 71% to 99%.
The terms “proximal” and “distal” are used herein with reference to a robotic platform manipulating the housing portion of the surgical instrument. The term “proximal” refers to the portion closest to the robotic platform and the term “distal” refers to the portion located away from the robotic platform. It will be further appreciated that, for convenience and clarity, spatial terms such as “vertical”, “horizontal”, “up”, and “down” may be used herein with respect to the drawings. However, surgical instruments are used in many orientations and positions, and these terms are not intended to be limiting and/or absolute.
Furthermore, the use of “couple”, “coupled”, or similar phrases should not be construed as being limited to a certain number of components or a particular order of components unless the context clearly dictates otherwise.
Also, where alternative examples of certain aspects of the surgical instrument are described, in instances where the same reference numbers as that of previously described examples are used to label components in the alternative example(s), the structure and functionality of those components is the same unless otherwise noted.
Various exemplary devices and methods are provided for performing laparoscopic and minimally invasive surgical procedures. However, the reader will readily appreciate that the various methods and devices disclosed herein can be used in numerous surgical procedures and applications including, for example, in connection with open surgical procedures. As the present Detailed Description proceeds, the reader will further appreciate that the various instruments disclosed herein can be inserted into a body in any way, such as through a natural orifice, through an incision or puncture hole formed in tissue, etc. The working portions or end effector portions of the instruments can be inserted directly into a patient's body or can be inserted through an access device that has a working channel through which the end effector and elongate shaft of a surgical instrument can be advanced.
A surgical stapling system can comprise a shaft and an end effector extending from the shaft. The end effector comprises a first jaw and a second jaw. The first jaw comprises a staple cartridge. The staple cartridge is insertable into and removable from the first jaw; however, other embodiments are envisioned in which a staple cartridge is not removable from, or at least readily replaceable from, the first jaw. The second jaw comprises an anvil configured to deform staples ejected from the staple cartridge. The anvil is pivotable relative to the first jaw about a closure axis; however, other embodiments are envisioned in which the first jaw is pivotable relative to the second jaw. The surgical stapling system further comprises an articulation joint configured to permit the end effector to be rotated, or articulated, relative to the shaft. Other embodiments are envisioned which do not include an articulation joint. In other words, other elements described herein can be employed in embodiments where no articulation joint is provided without departing from the spirit and scope of the present disclosure. Similarly, the articulation joint can be employed in embodiments where other elements described herein are omitted.
A surgical instrument 1000 is illustrated in
The end effector 200 comprises a first jaw 202 and a second jaw 204 movable between an open position and a closed position. For clarity, first jaw 202 is herein also interchangeably used with “jaw 202” (which is also referred to in the art as a “channel”) and second jaw 204 is used interchangeably with “anvil 204”. The jaw 202 and anvil 204 may be elongated in form. The jaw 202 defines an elongated channel 208 for receiving a staple cartridge 210. The anvil 204 has a proximal end 204A, a distal end 204B, and a ramp surface 216 defined at the proximal end 204A, which is described in greater detail below with respect to
The anvil 204 further defines a longitudinally extending upper knife channel 224 (
The surgical instrument 1000 further comprises a knife firing subsystem 500 operable to close the anvil 204 during a closure stroke. After the end effector 200 is closed, the knife firing subsystem 500 (
The knife firing subsystem 500, explained further below in greater detail, includes a knife 206. The knife 206 is coupled to or integral with a knife sled 236. The knife sled 236 is the non-cutting element of the knife 206, and is also referred to as an I-beam. The knife sled 236 includes an upper knife tab 238 and a lower knife tab 246. The upper knife tab 238 includes a centrally disposed cylindrical upper knife tab portion 240 and at least one upper knife tab lateral wing 242 that extends away from the upper knife tab portion 240. While the term ‘cylindrical’ is used, the tab portion need not resemble a perfect cylinder. In some embodiments, the upper knife tab 238 includes a pair of lateral wings 242 configured to slidably ride in the upper knife channel 224 to move the anvil 204 between the open position, the grasping position, and the clamping position. Each lateral wing 242 may include a ramped surface 242A that engages the anvil ramp surface 216. The upper knife tab portion 240 defines an upper knife tab opening 244 that is configured to receive a barrel crimp coupled to a center cable 512, which is described in greater detail below. The lower knife tab 246 includes a centrally disposed cylindrical lower knife tab portion 248 and at least one lower knife tab lateral wing 250 that extends away from the lower knife tab portion 248. While the term ‘cylindrical’ is used, the lower knife tab portion 248 need not resemble a perfect cylinder. In some embodiments, the lower knife tab 246 includes a pair of lateral wings 250. The lower knife tab portion 248 defines a lower knife tab opening 252 that is configured to receive a barrel crimp coupled to a center cable 514, which is described in greater detail below,
The staple cartridge 210 comprises a cartridge body. In use, the staple cartridge is positioned on a first side of the tissue to be stapled, within the channel 208 of the jaw 202, and the anvil 204 is positioned on a second side of the tissue. The anvil 204 is moved toward the staple cartridge 210 to compress and clamp the tissue against the deck of the staple cartridge 210. Thereafter, staples removably stored in the cartridge body can be deployed into the tissue. The cartridge body includes staple cavities defined therein wherein staples are removably stored in the staple cavities. In some embodiments, the staple cavities are arranged in six longitudinal rows. In some embodiments, three rows of staple cavities are positioned on a first side of a lower knife channel 230 and three rows of staple cavities are positioned on a second side of lower knife channel 230.
Making particular reference to
The staples are supported by staple drivers in the cartridge body. The drivers are movable between a first, or unfired position, and a second, or fired, position to eject the staples from the staple cavities. The drivers are retained in the cartridge body by a retainer which extends around the bottom of the cartridge body and includes resilient members configured to grip the cartridge body and hold the retainer to the cartridge body. The drivers are movable between their unfired positions and their fired positions indirectly by the sled 236. More specifically, the knife sled 236 is movable between a proximal position adjacent the proximal end and a distal position adjacent the distal end. A portion of the knife sled 236 (e.g., see
Further to the above, the sled 236 is moved distally and proximally by a firing rod 502. The firing rod 502 is configured to apply an indirect force to the sled 236, via push coils 508, 510 that directly engage the sled 236 (discussed in greater detail below) and push the sled 236 toward the distal end of the end effector 200. As the firing rod 502 is advanced distally, sled 236 rides in the lower knife channel 230 and the upper knife channel 224. At the onset of travel, the upper knife tab 238 rides along the anvil ramp surface 216. Specifically, as particularly seen in the sequence of
The surgical instrument 1000 further comprises a housing 700 and a shaft assembly 600A extending from the housing 700. The housing is configured to engage a robotic platform 2000. In some embodiments, the housing 700 may be configured as a handle (e.g., it may comprise a grip for a clinician). The shaft assembly 600A comprises a rotatable outer shaft 602 and an inner shaft 604, the outer shaft 602 being rotatably mounted to the housing about a rotation joint 606 (which may include one or more bearings). The inner shaft 604 is rotationally fixed to the outer shaft 602 and is configured such that articulation cables 402, 404, 406, 408, discussed in greater detail below, can be partially wound therearound without becoming tangled. As discussed in greater detail below, the housing 700 further comprises (1) a firing puck assembly 712 as part of the knife firing subsystem 500 operable to close the end effector 200, fire staples, and transect tissue, (2) a set of articulation puck assemblies 702, 704, 706, 708 as part of the articulation subsystem 400 operable to articulate the end effector 200 relative to the shaft assembly 600A, and (3) a shaft roll puck assembly 710 as part of the roll subsystem 600 configured to roll the outer shaft 602.
Referring to
As shown particularly in
Each concentric disc 302 further includes a rounded articulation pin proximal end 310A and a semi-spherical pin-receiving opening 316 defined in the articulation socket 308. As shown particularly in
Making particular reference to
The center beam 328 further includes a nitinol core 328A and stainless steel 328B wound over the nitinol core that allows the center beam 328 to resiliently flex in response to pivoting of one, some, or all of the concentric discs 302. The wound stainless steel 328B has clockwise braiding and counterclockwise braiding to prevent unwinding thereof.
The above-described articulation joint 300 forms a portion of the cable articulation subsystem 400 which allows for precise 360-degree movement of the end effector 200 about the articulation joint 300 with at least two degrees of freedom. In some embodiments, and dictated by the roll subsystem 600 as well as a need to limit the amount of wrap of the articulation cables 402, 404, 406, 408, the articulation joint is permitted about 320 degrees of roll within the overall system. The cable articulation subsystem 400 also includes a plurality of articulation cables 402, 404, 406, 408 each having a distal end 402A, 404A, 406A, 408A, coupled to the distal end 306B of the center beam assembly 306, and a proximal end 402B, 404B, 406B, 408B. More specifically, each distal end 402A, 404A, 406A, 408A can include a crimp that engages a cable retention opening 334A of the distal end retention disc 334 to maintain its positioning.
In other examples, with reference to
Each articulation cable 402, 404, 406, 408 includes a stainless steel material with clockwise braiding and counterclockwise braiding that prevent unwinding thereof. In other embodiments, other materials may be employed, such as polymer yarns and/or filaments, various metal cables (e.g., tungsten), and combinations thereof. Each articulation cable is discretely manipulable to cause rotation of the articulation joint 300 and end effector 200 about at least one of a pitch axis PA and a yaw axis YA.
In some embodiments, three articulation cables may be provided rather than the four cables 402, 404, 406, 408 depicted herein. However, four articulation cables 402, 404, 406, 408 circumferentially spaced approximately ninety degrees from one another (as shown) provides load splitting. Additionally, in alternative embodiments, three and fourth articulation cable configurations may be spaced non-symmetrically relative to one another.
The shaft assembly 600A and housing 700 also form portions of the cable articulation subsystem 400. More specifically, each articulation cable 402, 404, 406, 408 extends from the articulation joint 300 and through the shaft assembly 600A to the housing 700. The proximal end 402B, 404B, 406B, 408B of each articulation cable (402, 404, 406) is movably mounted in the housing 700 which causes the above-mentioned rotation of the articulation joint 300 and end effector 200. In some embodiments, the housing 700 includes articulation puck assemblies 702, 704, 706, 708 with rotatable capstans 702B, 704B, 706B, 708B, discussed in greater detail below, about which corresponding proximal ends 402B, 404B, 406B, 408B of the articulation cables 402, 404, 406, 408 are windably mounted thereto. As shown in
The articulation cables 402, 404, 406, 408 are routed through the shaft assembly 600A such that they are disposed between the outer shaft 602 and the inner shaft 604, with the articulation cables 402, 404, 406, 408 being able to partially wind therearound without becoming tangled. The inner shaft 604 also prevents the articulation cables 402, 404, 406, 408 from interfering with other components running down the center of the instrument 1000 (through the inner shaft 604).
The articulation cables 402, 404, 406, 408 are routed and coupled to the end effector 200 via the articulation joint 300 such that movement thereof in a proximal direction (via winding about the capstans 702B, 704B, 706B, 708B) causes the end effector 200 to pivot in a predetermined manner about the articulation joint 300. For example, actuation of the first articulation cable 402 in the proximal direction causes rotation of the end effector 200 upwards and to the left, actuation of the second articulation cable 404 in the proximal direction causes rotation of the end effector 200 upwards and to the right, actuation of the third articulation cable 406 in the proximal direction causes rotation of the end effector 200 downwards and to the left, and actuation of the fourth articulation cable 408 in the proximal direction causes rotation of the end effector 200 downwards and to the right. Similarly, movement of two articulation cables simultaneously will result in blended movement of the end effector 200. By way of example, movement of both the first articulation cable 402 and the second articulation cable 404 at the same rate causes only upwards pivoting of the end effector 200 (i.e., there is little to no horizontal component to the rotation). As will be appreciated by those skilled in the art, this configuration provides for the above-mentioned precise 360-degree movement of the end effector about the articulation joint 300 with at least two degrees of freedom and about 320 degrees of roll.
In further examples, and with reference to
By way of example,
The distal end retention disc 334′ has (1) a disc portion 335′ that includes a plurality (e.g., four) of first cable retention openings 334A′ and a plurality (e.g., four) of second cable retention openings 334C′ and (2) a pin portion 336′ extending form the disc portion 335′. Adjacent first cable retention openings 334A′ and second cable retention openings 334C′ have a first relief 334B′ formed therebetween on a first side of the distal end retention disc 334′. In currently described two-cable articulation system, these openings 334A′, 334C′ are sub-divided into pairs of first cable retention openings 334A′ (e.g., the left side openings 334A′ shown in
With continued reference to
In the above example, all the openings 334A′, 334C′ associated with a respective continuous cable (e.g., cable 400A′) are aligned along a vertical axis. However, alternative configurations of distal end retention discs and/or articulation cable routings may be employed without departing from the spirt and scope of the present disclosure. Some exemplary alternatives are depicted in
For example, as seen in
Referring primarily to
The knife firing subsystem 500 is configured in a manner to enable articulation of the end effector 200 while still enabling proper functionality of the knife 206. To that end, the first push rod 504 includes a first flexible section 508 and the second push rod 506 comprises a second flexible section 510. As particularly shown in
With continued reference to
Further to the above, depending on the manner in which the end effector 200 is pivoted about the articulation joint 300, the bend radius for the first push coil 508 and the second push coil 510 can differ. For example, in the configuration shown in
More specifically, the differential 520 couples the first push rod proximal end 504B and the second push rod proximal end 506B to the firing rod 502, and the differential 520 permits relative axial movement between the first push rod 504 and the second push rod 506 (e.g., as depicted from
Further to the above, as particularly exemplified in
Further, as shown in
In order to permit roll of the shaft outer shaft 602, which is discussed in greater detail below, the differential 520 is mounted in the shaft assembly 600A and is coupled to the firing rod 502 such that it is rotatable about a roll axis RA. As a result, the pinion bar 526 is axially constrained relative to the firing rod 502 and freely rotatable relative thereto.
Turning now to the roll subsystem 600, the roll subsystem includes the above-mentioned shaft assembly 600A, rotation joint 606, shaft roll puck assembly 710, which is discussed in greater detail below. As discussed in the foregoing paragraph, the rotatable nature of the differential 520 is also a feature of the roll subsystem. The shaft assembly 600A includes the previously discussed rotatable outer shaft 602 and the inner shaft 604. As shown in the exploded view of
Turning now primarily to
Further to the above, the housing includes four articulation puck assemblies 702, 704, 706, 708, provided that four articulation cables 402, 404, 406, 408 are employed in the presently described surgical instrument. A first articulation puck assembly 702 is used cooperatively with the first articulation cable 402. Likewise, the second articulation puck assembly 704 is used cooperatively with the second articulation cable 404, the third articulation puck assembly 706 is used cooperatively with the third articulation cable 406, and the fourth articulation puck assembly 708 is used cooperatively with the first articulation cable 408. In use, the first articulation cable 402 winds on and off the first articulation puck assembly 702, the second articulation cable 404 winds on and off the second articulation puck assembly 704, the third articulation cable 406 winds on and off the third articulation puck assembly 706, and the fourth articulation cable 408 winds on and off the first articulation puck assembly 708.
The first articulation puck assembly 702 includes a first articulation puck 702A, a first capstan 702B, and a first torsion spring 702C. The first articulation puck 702A is provided on an outer face of the lower frame 700B and directly engages the robotic platform 2000. The first capstan 702B is coupled to the first articulation puck 702A and winds the first articulation cable 402 therearound. The first capstan 702B is rotationally affixed to a first pivot pin 726 (which is integral with the first articulation puck 702A). The first capstan 702B is biased by a first torsion spring 702C in a retracting direction to maintain a minimum level of tension in the first articulation cable 402, such as while decoupled from the robotic platform 2000. As the first articulation puck assembly 702 does not include any gearing, the diameter of the first capstan 702B is what dictates the mechanical advantage achieved.
Making reference to
In use, and for example, rotation of the first capstan 702B by the robotic platform 2000, via the first articulation puck 702A, in a first direction winds the first articulation cable 402 around the first capstan 702B, which results in the end effector 200 pivoting upwards and to the left about the articulation joint 300. As discussed earlier, this upwards movement of the end effector 200 is compensated for in the knife firing subsystem by the differential 520. Rotation in the opposite direction by the first articulation puck 702A unwinds the first articulation cable 402 to return the end effector 200 to a position substantially coaxial with the shaft assembly 600A (e.g., coaxial with the roll axis RA).
The second articulation puck assembly 704 includes a second articulation puck 704A, a second capstan 704B, and a second torsion spring 704C. The second articulation puck 704A is provided on an outer face of the lower frame 700B and directly engages the robotic platform 2000. The second capstan 704B is coupled to the second articulation puck 704A and winds the second articulation cable 404 therearound. The second capstan 704B is rotationally affixed to a second pivot pin 728 (which is integral with the second articulation puck 704A). The second capstan 704B is biased by a second torsion spring 704C in a retracting direction to maintain a minimum level of tension in the second articulation cable 404. As the second articulation puck assembly 704 does not include any gearing, the diameter of the second capstan 704B is what dictates the mechanical advantage achieved.
In use, and for example, rotation of the second capstan 704B by the robotic platform 2000, via the second articulation puck 704A, in a first direction winds the second articulation cable 404 around the second capstan 704B, which results in the end effector 200 pivoting upwards and to the right about the articulation joint 300. As discussed earlier, this upwards movement of the end effector 200 is compensated for in the knife firing subsystem by the differential 520. Rotation in the opposite direction by the second articulation puck 704A unwinds the second articulation cable 404 to return the end effector 200 to a position substantially coaxial with the shaft assembly 600A (e.g., coaxial with the roll axis RA).
The third articulation puck assembly 706 includes a third articulation puck 706A, a third capstan 706B, and a third torsion spring 706C. The third articulation puck 706A is provided on an outer face of the lower frame 700B and directly engages the robotic platform 2000. The third capstan 706B is coupled to the third articulation puck 706A and winds the third articulation cable 406 therearound. The third capstan 706B is rotationally affixed to a third pivot pin 730 (which is integral with the third articulation puck 706A). The third capstan 706B is biased by a third torsion spring 706C in a retracting direction to maintain a minimum level of tension in the third articulation cable 406. As the third articulation puck assembly 706 does not include any gearing, the diameter of the third capstan 706B is what dictates the mechanical advantage achieved.
In use, and for example, rotation of the third capstan 706B by the robotic platform 2000, via the third articulation puck 706A, in a first direction winds the third articulation cable 406 around the third capstan 706B, which results in the end effector 200 pivoting downward and to the left about the articulation joint 300. As discussed earlier, this downwards movement of the end effector 200 is compensated for in the knife firing subsystem by the differential 520. Rotation in the opposite direction by the third articulation puck 706A unwinds the third articulation cable 406 to return the end effector 200 to a position substantially coaxial with the shaft assembly 600A (e.g., coaxial with the roll axis RA).
The fourth articulation puck assembly 708 includes a fourth articulation puck 708A, a fourth capstan 708B, and a fourth torsion spring 708C. The fourth articulation puck 708A is provided on an outer face of the lower frame 700B and directly engages the robotic platform 2000. The fourth capstan 708B is coupled to the fourth articulation puck 708A and winds the third articulation cable 408 therearound. The fourth capstan 708B is rotationally affixed to a fourth pivot pin 732 (which is integral with the fourth articulation puck 708A). The fourth capstan 708B is biased by a fourth torsion spring 708C in a retracting direction to maintain a minimum level of tension in the third articulation cable 408. As the fourth articulation puck assembly 708 does not include any gearing, the diameter of the fourth capstan 708B is what dictates the mechanical advantage achieved.
In use, and for example, rotation of the fourth capstan 708B by the robotic platform 2000, via the fourth articulation puck 708A, in a first direction winds the fourth articulation cable 408 around the fourth capstan 708B, which results in the end effector 200 pivoting downwards and to the right about the articulation joint 300. As discussed earlier, this downwards movement of the end effector 200 is compensated for in the knife firing subsystem by the differential 520. Rotation in the opposite direction by the fourth articulation puck 708A unwinds the fourth articulation cable 408 to return the end effector 200 to a position substantially coaxial with the shaft assembly 600A (e.g., coaxial with the roll axis RA).
Of course, and as discussed above, synchronous movement of various combinations of the puck assemblies 702, 704, 706, 708 enables the clinician (via the robotic platform 2000) to position the end effector 200 at any orientation.
Additionally, as shown particularly in
Further to the above, the shaft roll puck assembly 710 includes a shaft roll puck 710A, a first screw gear 710B, and a second screw gear 710C. The shaft roll puck 710A is provided on an outer face of the lower frame 700B, is integral with a fifth pivot pin 734, and directly engages the robotic platform 2000. The first screw gear 710B is coaxial with and rotatable with the shaft roll puck 710A. The second screw gear 710C is meshed with the first screw gear 710B and coupled with the rotatable outer shaft 602.
In use, and for example, rotation of the first screw gear 710B by the robotic platform 2000, via the shaft roll puck 710A, in a first direction turns the second screw gear 710C to roll the outer shaft 602 (e.g., in a clockwise direction about the roll axis RA), as discussed in greater detail above. Rotation of the first screw gear in an opposite second direction causes the outer shaft 602 to roll in an opposite direction (e.g., a counterclockwise direction about the roll axis RA).
Further to the above, the firing puck assembly includes a firing puck 712A, a drive gear 712A1, a geartrain 712B, and a driven gear or pinion 712C. The firing puck 712A is provided on an outer face of the lower frame 700B, is integral with a sixth pivot pin 736, and directly engages the robotic platform 2000. The drive gear 712A1 directly rotates with the firing puck 712A. As particularly shown in
In use, and for example, rotation of the firing puck 712A by the robotic platform 2000 causes rotation of the drive gear 712A1, which in turn drives the geartrain 712B to rotate the pinion 712C. Depending on the direction of rotation of the firing puck 712A, the firing rod 502 is either moved in a distal direction (i.e., towards the end effector 200) to close the anvil 204 and/or fire the knife 206 or a proximal direction (i.e., towards a rear of the housing 700) to retract the knife 206 and/or open the anvil 204.
The disclosed technology described herein can be further understood according to the following clauses:
Clause 1. An articulation joint (300) for a surgical instrument (1000) comprising: a plurality of concentric discs (302), each of the plurality of concentric discs (302) having a concentric central opening (304); a center beam assembly (306) comprising a proximal end (306A) and a distal end (306B), a portion of the center beam assembly (306) extending through the central opening (304) of each concentric disc (302), the plurality of concentric discs (302) being nestably stacked on the center beam assembly (306), the center beam assembly (306) compressing the plurality of concentric discs (302), the distal end (306B) of the center beam assembly (306) being configured to couple to the plurality of concentric discs (302) to an end effector (200) of the surgical instrument (1000), and the proximal end (306A) of the center beam assembly (306) being configured to couple the plurality of concentric discs (302) to a shaft (602) of the surgical instrument (1000).
Clause 2. The articulation joint (300) of clause 1, wherein each of the plurality of concentric discs (302) comprises: an articulation socket (308); an articulation pin (310) protruding outwardly from the articulation socket (308); a first push coil opening (312A) defined through the articulation socket (308) and configured to receive a first push coil (508) therethrough; and a first articulation cable opening (314A) defined through the articulation socket (308) and configured to receive a first articulation cable (402) therethrough.
Clause 3. The articulation joint (300) of clause 2, wherein each concentric disc (302) further comprises a second push coil opening (312B) defined through the articulation socket (308) and configured to receive a second push coil (510) therethrough.
Clause 4. The articulation joint (300) of any one of clauses 2-3, wherein each concentric disc (302) further comprises: a second articulation cable opening (314B) defined through the articulation socket (308) and configured to receive a second articulation cable (404) therethrough; a third articulation cable opening (314C) defined through the articulation socket (308) and configured to receive a third articulation cable (406) therethrough.
Clause 5. The articulation joint (300) of clause 4, wherein each concentric disc (302) further comprises: a fourth articulation cable opening (314D) defined through the articulation socket (308) and configured to receive a fourth articulation cable (408) therethrough.
Clause 6. The articulation joint (300) of any one of clauses 2-5, wherein each concentric disc (302) further comprises: a rounded articulation pin proximal end (310A); and a semi-spherical pin-receiving opening (316) defined in the articulation socket (308).
Clause 7. The articulation joint (300) of clause 6, wherein each rounded articulation pin proximal end (310A) is pivotally engaged in an adjacent pin-receiving opening (316) of an adjacent concentric disc (302).
Clause 8. The articulation joint (300) of any one of clauses 2-7, wherein the concentric disc opening (304) is defined in the articulation pin (310) of each concentric disc (302).
Clause 9. The articulation joint (300) of any one of clauses 2-8, wherein the articulation socket (308) comprises a socket disc (318) and a pin retention socket (320).
Clause 10. The articulation joint (300) of any one of clauses 1-9, further comprising a fastener (322) configured to couple the distal end (306B) of the center beam assembly (306) to the end effector (200).
Clause 11. The articulation joint (300) of any one of clauses 1-10, wherein the distal end (306B) of the center beam assembly (306) comprises distal end retention disc (334) that defines a first articulation cable retention opening (334A) configured to retain a first articulation cable distal end (402A).
Clause 12. The articulation joint (300) of any one of clauses 1-11, wherein the articulation joint (300) has at least two degrees of freedom.
Clause 13. The articulation joint (300) of any one of clauses 1-12, wherein the center beam assembly further comprises a center beam (328) extending through each of the concentric discs (302), a jack screw (330), and a second disc retention bearing (332), the jack screw (330) being threadably coupled with the second disc retention bearing (332) to adjust a compressive force of the center beam (328).
Clause 14. The articulation joint of any one of clauses 1-12, wherein the center beam assembly further comprises a center beam (328), the center beam (328) further comprising a nitinol core (328A) and stainless steel (328B) wound over the nitinol core, the center beam (328) resiliently flexing in response to pivoting of at least one of the concentric discs.
Clause 15. The articulation joint of clause 14, wherein the stainless steel comprises clockwise braiding and counterclockwise braiding over the nitinol core.
Clause 16. The articulation joint (300) of any one of clauses 1-15, the distal end (306B) of the center beam assembly (306) being configured to abut a knife sled (236).
Clause 17. The articulation joint (300) of any one of clauses 1-16, further comprising a plurality of pins (336) that constrain a rotational degree of freedom between adjacent concentric discs (302) about a roll axis (RA).
Clause 18. The articulation joint (300′) of any one of clauses 1-10 and 12-17, wherein the distal end (306B) of the center beam assembly (306) comprises an integrally formed distal channel retainer (340′) that (1) defines at least one articulation cable retention opening (342′) configured to retain a first articulation cable distal end and (2) is configured to directly connect to an end effector (200) of the surgical instrument (1000).
Clause 19. The articulation joint (300) of any one of clauses 1-10 and 12-17, wherein the distal end (306B) of the center beam assembly (306) comprises distal end retention disc (334′) that defines a pair of first articulation cable retention openings (334A′) configured to retain and reroute a continuous articulation cable (400A′) so as to functionally divide the continuous articulation cable into a first articulation cable (404′) and a second articulation cable (408′).
Clause 20. The articulation joint (300) of clause 19, wherein the distal end retention disc (334′) further defines a pair of second articulation cable retention openings (334C′) configured to reroute the continuous articulation cable (400A′).
Clause 21. The articulation joint of clause 20, wherein each second articulation cable retention opening (334C′) is disposed between the pair of first cable retention openings 334A′.
Clause 22. The articulation joint (300) of any one of clauses 20-21, wherein one of the first articulation cable retention openings (334A′) and one of the second cable retention openings (334C′) are adjacent one another, and a first relief (334B′) is formed between the one of the first articulation cable retention openings (334A′) and the one of the second cable retention openings (334C′) on a first side of the distal end retention disc 334′.
Clause 23. The articulation joint (300) of clause 22, wherein the other of the first articulation cable retention openings (334A′) and the other of the second cable retention openings (334C′) are adjacent one another, and another first relief (334B′) is formed between the other of the first articulation cable retention openings (334A′) and the other of the second cable retention openings (334C′) on the first side of the distal end retention disc 334′.
Clause 24. The articulation joint of any one of claims 20-23, wherein a second relief (334D′) is formed between the pair of second articulation cable retention openings (334C′).
Clause 25. An articulation joint assembly (200, 300) comprising: the end effector (200) of any one of clauses 1a-22a; and the articulation joint (300) of any one of clauses 1b-24b coupled to the end effector (200).
Clause 26. A cable articulation subsystem (400) for a surgical instrument comprising: a joint (300) comprising a distal end (306B); and at least three articulation cables (402, 404, 406), a distal end (402A, 404A, 406A) of each articulation cable (402, 404, 406) being coupled to the joint distal end (306B), and a proximal end (402B, 404B, 406B) of each articulation cable (402, 404, 406) being discretely manipulable to cause rotation of the joint (300) about at least one of a pitch axis (PA) and a yaw axis (YA).
Clause 27. The cable articulation subsystem (400) of clause 26, the joint comprising the articulation joint (300) of any one of clauses 1b-15b.
Clause 28. The cable articulation system (400) of any one of clauses 26-27, wherein each articulation cable distal end (402A, 404A, 406A) comprises a crimp (402A, 404A, 406A), each crimp (402A, 404A, 406A) engaging a respective articulation cable retention opening (326) defined in the joint (300).
Clause 29. The cable articulation subsystem (400) of any one of clauses 26-28, further comprising: a shaft assembly (600A); and a housing (700) coupled to the shaft assembly (600A), each articulation cable (402, 404, 406) extending from the joint and through the shaft assembly (600A), the proximal end (402B, 404B, 406B) of each articulation cable (402, 404, 406) being movably mounted in the housing (700).
Clause 30. The cable articulation subsystem (400) of clause 29, where the shaft assembly (600A) further comprises: a rotatable outer shaft (602); and a fixed inner shaft (604) nested within the outer shaft (602), each articulation cable (402, 404, 406) extending between the outer shaft (602) and the inner shaft (604) and configured to wrap around the inner shaft (604) upon rotation of the outer shaft (602).
Clause 31. The cable articulation subsystem of any one of clauses 29-30, the housing (700) further comprising: at least three capstans (702B, 704B, 706B, 708B), the proximal end (402B, 404B, 406B, 408B) of each articulation cable being windably mounted to a respective capstan of the at least three capstans.
Clause 32. The cable articulation subsystem of any one of clauses 26-31, wherein each of the at least three articulation cables comprise stainless steel with a clock wise braid and with a counterclockwise braid.
Clause 33. The cable articulation subsystem of any one of clauses 26-32, wherein the at least three articulation cables (402, 404, 406) comprises at least four articulation cables (402, 404, 406, 408).
Clause 34. The cable articulation subsystem of clause 33, wherein the at least four articulation cables (402, 404, 406, 408) are circumferentially spaced approximately ninety degrees from one another.
Clause 35. A cable articulation subsystem (400′) for a surgical instrument comprising: a joint (300, 300′) comprising a distal end (306B); and only two continuous articulation cables (400A′, 400B′), a middle section of each continuous articulation cable being mechanically grounded to the joint distal end (306B) so as to functionally divide each continuous articulation cable into a first articulation cable (402′, 404′) and a second articulation cable (406′, 408′), and a proximal end (402B, 404B, 406B, 408B) of each first articulation cable (402, 404) and each second articulation cable (406, 408) being discretely manipulable to cause rotation of the joint (300, 300′) about at least one of a pitch axis (PA) and a yaw axis (YA).
Clause 36. The cable articulation subsystem (400′) of clause 35, wherein the joint distal end (306B) comprises a distal end retention disc (334′) comprising a disc portion (335′) and a pin portion (336′) extending from the disc portion (335′), the disc portion (335′) comprises a plurality of articulation cable retention openings (334A′, 334B′), and each continuous articulation cable (400A′, 400B′) extends through at least four articulation cable retention openings of the plurality of articulation cable retention openings (334A′, 334B′).
Clause 37. The cable articulation subsystem (400′) of clause 36, wherein the disc portion (335′) comprises at least twelve articulation cable retention openings (334A′, 334B′) each continuous articulation cable (400A′, 400B′) extends through six articulation cable retention openings of the at least twelve articulation cable retention openings (334A′, 334B′), and each continuous articulation cable (400A′, 400B′) wraps partially around the pin portion (336′).
Clause 38. The cable articulation subsystem (400′) of clause 36, wherein one (400A′) of the exactly two continuous articulation cables extends only on a first lateral side of the disc portion (335′) and the other (400B′) of the exactly two continuous articulation cables extends only on a second lateral side of the disc portion (335′).
Clause 39. The cable articulation subsystem (400′) of clause 36, wherein each continuous articulation cable (400A′, 400B′) wraps entirely around the pin portion 336′.
Clause 40. The cable articulation subsystem (400′) of any one of clauses 36-39, further comprising one or more frictional pads (460A), each frictional pad being sandwiched between one of the exactly two continuous articulation cables (400A′, 400B′) and the disc portion (335′).
Clause 41. The cable articulation subsystem (400′) of any one of clauses 36-39, further comprising one or more leaf springs (460B′), each leaf spring (460B′) applying a compression force to one of the exactly two continuous articulation cables (400A′, 400B′) to increase a frictional force between the one of the exactly two continuous articulation cables and the disc portion (335′).
The embodiments described above are cited by way of example, and the present invention is not limited by what has been particularly shown and described hereinabove. Rather, the scope of the invention includes both combinations and sub combinations of the various features described and illustrated hereinabove, as well as variations and modifications thereof which would occur to persons skilled in the art upon reading the foregoing description and which are not disclosed in the prior art.
This application claims the benefit of and priority to U.S. Provisional Patent Application No. 63/515,020 filed Jul. 21, 2023 (Attorney Docket END9566USPSP1) and U.S. Provisional Patent Application Ser. No. 63/640,289 filed Apr. 30, 2024 (Attorney Docket END9566USPSP2), the disclosures of which are expressly incorporated herein by reference.
Number | Date | Country | |
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63515020 | Jul 2023 | US | |
63640289 | Apr 2024 | US |