Minimally invasive surgical (MIS) instruments are often preferred over traditional open surgical devices due to reduced post-operative recovery time and minimal scarring. Laparoscopic surgery is one type of MIS procedure in which one or more small incisions are formed in the abdomen of a patient and a trocar is inserted through the incision to form a pathway that provides access to the abdominal cavity. Through the trocar, a variety of instruments and surgical tools can be introduced into the abdominal cavity. The instruments and tools introduced into the abdominal cavity via the trocar can be used to engage and/or treat tissue in a number of ways to achieve a diagnostic or therapeutic effect.
Various robotic systems have recently been developed to assist in MIS procedures. Robotic systems can allow for more instinctive hand movements by maintaining natural eye-hand axis. Robotic systems can also allow for more degrees of freedom in movement by including an articulable “wrist” joint that creates a more natural hand-like articulation. In such systems, an end effector positioned at the distal end of the instrument can be articulated (moved) using a cable driven motion system having one or more drive cables that extend through the wrist joint. A user (e.g., a surgeon) is able to remotely operate the end effector by grasping and manipulating in space one or more controllers that communicate with a tool driver coupled to the surgical instrument. User inputs are processed by a computer system incorporated into the robotic surgical system, and the tool driver responds by actuating the cable driven motion system. Moving the drive cables articulates the end effector to desired angular positions and configurations.
One type of end effector is a combination vessel sealer and tissue grasper that has opposing jaws capable of closing down and “grasping” onto tissue. Once tissue is properly grasped, a knife can be advanced distally within a knife slot to transect the grasped tissue, and electrical energy may be applied (prior to, during, or after transection) to the end effector to seal and cauterize the transected tissue.
It is desirable to improve vessel sealers and their operation to make minimally invasive surgeries more effective and efficient.
The following figures are included to illustrate certain aspects of the present disclosure, and should not be viewed as exclusive embodiments. The subject matter disclosed is capable of considerable modifications, alterations, combinations, and equivalents in form and function, without departing from the scope of this disclosure.
The present disclosure is related to robotic surgical systems and, more particularly, to improved designs for tissue grasper end effectors.
One example end effector includes a first jaw having a first electrode and a first insulator secured thereto, and a second jaw having a second electrode and a second insulator secured thereto, the first and second jaws being pivotable between open and closed positions. A knife slot may be cooperatively defined in the first and second jaws and define a diamond-shape cross-section when the first and second jaws are in the closed position. A knife may be extendable into the knife slot and longitudinally movable within the knife slot.
A surgical tool disclosed herein includes a wrist including a proximal clevis and a distal clevis rotatably mountable to the proximal clevis at a first pivot axis, and an end effector rotatably coupled to the distal clevis at a second pivot axis, the end effector including opposing first and second jaws rotatably coupled to each other at a jaw pivot axis. The jaw pivot axis may be parallel to the second pivot axis and orthogonal to the first pivot axis, and a longitudinal axis of the end effector may be perpendicular to and intersects the jaw pivot axis.
Another example end effector includes opposing first and second jaws rotatably coupled to each other at a jaw pivot axis, a knife slot defined in one or both of the first and second jaws, and a knife coupled to a distal end of a drive rod and longitudinally extendable into the knife slot. A knife housing may be pivotably coupled between the first and second jaws at the jaw pivot axis and define a cavity sized to receive the knife. The drive rod may be actuatable to move the knife between a stowed position, where the knife is received within the cavity, and an extended position, where the knife is extended out of the cavity and into the knife slot.
In some embodiments, a second set of user input controllers 102b (shown in dashed line) may be operated by a second clinician 112b to direct operation of the robotic arms 106 and tools 108 via the control computer 104 and in conjunction with the first clinician 112a. In such embodiments, for example, each clinician 112a,b may control different robotic arms 106 or, in some cases, complete control of the robotic arms 106 may be passed between the clinicians 112a,b as needed. In some embodiments, additional robotic manipulators having additional robotic arms may be utilized during surgery on the patient 110, and these additional robotic arms may be controlled by one or more of the user input controllers 102a,b.
The control computer 104 and the user input controllers 102a,b may be in communication with one another via a communications link 114, which may be any type of wired or wireless telecommunications means configured to carry a variety of communication signals (e.g., electrical, optical, infrared, etc.) according to any communications protocol. In some applications, for example, there is a tower with ancillary equipment and processing cores designed to drive the robotic arms 106.
The user input controllers 102a,b generally include one or more physical controllers that can be grasped by the clinicians 112a,b and manipulated in space while the surgeon views the procedure via a stereo display. The physical controllers generally comprise manual input devices movable in multiple degrees of freedom, and which often include an actuatable handle for actuating the surgical tool(s) 108, for example, for opening and closing opposing jaws, applying an electrical potential (current) to an electrode, or the like. The control computer 104 can also include an optional feedback meter viewable by the clinicians 112a,b via a display to provide a visual indication of various surgical instrument metrics, such as the amount of force being applied to the surgical instrument (i.e., a cutting instrument or dynamic clamping member).
As illustrated, the surgical tool 200 includes an elongated shaft 202, an end effector 204, a wrist 206 (alternately referred to as a “wrist joint” or an “articulable wrist joint”) that couples the end effector 204 to the distal end of the shaft 202, and a drive housing 208 coupled to the proximal end of the shaft 202. In applications where the surgical tool is used in conjunction with a robotic surgical system (e.g., the robotic surgical system 100 of
The terms “proximal” and “distal” are defined herein relative to a robotic surgical system having an interface configured to mechanically and electrically couple the surgical tool 200 (e.g., the housing 208) to a robotic manipulator. The term “proximal” refers to the position of an element closer to the robotic manipulator and the term “distal” refers to the position of an element closer to the end effector 204 and thus further away from the robotic manipulator. Alternatively, in manual or hand-operated applications, the terms “proximal” and “distal” are defined herein relative to a user, such as a surgeon or clinician. The term “proximal” refers to the position of an element closer to the user and the term “distal” refers to the position of an element closer to the end effector 204 and thus further away from the user. Moreover, the use of directional terms such as above, below, upper, lower, upward, downward, left, right, and the like are used in relation to the illustrative embodiments as they are depicted in the figures, the upward or upper direction being toward the top of the corresponding figure and the downward or lower direction being toward the bottom of the corresponding figure.
During use of the surgical tool 200, the end effector 204 is configured to move (pivot) relative to the shaft 202 at the wrist 206 to position the end effector 204 at desired orientations and locations relative to a surgical site. To accomplish this, the housing 208 includes (contains) various drive inputs and mechanisms (e.g., gears, actuators, etc.) designed to control operation of various features associated with the end effector 204 (e.g., clamping, firing, cutting, rotation, articulation, etc.). In at least some embodiments, the shaft 202, and hence the end effector 204 coupled thereto, is configured to rotate about a longitudinal axis A1 of the shaft 202. In such embodiments, at least one of the drive inputs included in the housing 208 is configured to control rotational movement of the shaft 202 about the longitudinal axis A1.
The shaft 202 is an elongate member extending distally from the housing 208 and has at least one lumen extending therethrough along its axial length. In some embodiments, the shaft 202 may be fixed to the housing 208, but could alternatively be rotatably mounted to the housing 208 to allow the shaft 202 to rotate about the longitudinal axis A1. In yet other embodiments, the shaft 202 may be releasably coupled to the housing 208, which may allow a single housing 208 to be adaptable to various shafts having different end effectors.
The end effector 204 can exhibit a variety of sizes, shapes, and configurations. In the illustrated embodiment, the end effector 204 comprises a combination tissue grasper and vessel sealer that include opposing jaws 210, 212 configured to move (articulate) between open and closed positions. As will be appreciated, however, the opposing jaws 210, 212 may alternatively form part of other types of end effectors such as, but not limited to, a surgical scissors, a clip applier, a needle driver, a babcock including a pair of opposed grasping jaws, bipolar jaws (e.g., bipolar Maryland grasper, forceps, a fenestrated grasper, etc.), etc. One or both of the jaws 210, 212 may be configured to pivot to articulate the end effector 204 between the open and closed positions.
The pivoting motion can include pitch movement about a first axis of the wrist 206 (e.g., X-axis), yaw movement about a second axis of the wrist 206 (e.g., Y-axis), and combinations thereof to allow for 360° rotational movement of the end effector 204 about the wrist 206. In other applications, the pivoting motion can be limited to movement in a single plane, e.g., only pitch movement about the first axis of the wrist 206 or only yaw movement about the second axis of the wrist 206, such that the end effector 204 moves only in a single plane.
Referring again to
In some embodiments, the surgical tool 200 may be supplied with electrical power (current) via a power cable 214 coupled to the housing 208. In other embodiments, the power cable 214 may be omitted and electrical power may be supplied to the surgical tool 200 via an internal power source, such as one or more batteries or fuel cells. In such embodiments, the surgical tool 200 may alternatively be characterized and otherwise referred to as an “electrosurgical instrument” capable of providing electrical energy to the end effector 204.
The power cable 214 may place the surgical tool 200 in electrical communication with a generator 216 that supplies energy, such as electrical energy (e.g., radio frequency energy), ultrasonic energy, microwave energy, heat energy, or any combination thereof, to the surgical tool 200 and, more particularly, to the end effector 204. Accordingly, the generator 216 may comprise a radio frequency (RF) source, an ultrasonic source, a direct current source, and/or any other suitable type of electrical energy source that may be activated independently or simultaneously.
In applications where the surgical tool 200 is configured for bipolar operation, the power cable 214 will include a supply conductor and a return conductor. Current can be supplied from the generator 216 to an active (or source) electrode located at the end effector 204 via the supply conductor, and current can flow back to the generator 216 via a return electrode located at the end effector 204 via the return conductor. In the case of a bipolar grasper with opposing jaws, for example, the jaws serve as the electrodes where the proximal end of the jaws are isolated from one another and the inner surface of the jaws (i.e., the area of the jaws that grasp tissue) apply the current in a controlled path through the tissue. In applications where the surgical tool 200 is configured for monopolar operation, the generator 216 transmits current through a supply conductor to an active electrode located at the end effector 204, and current is returned (dissipated) through a return electrode (e.g., a grounding pad) separately coupled to a patient's body.
To operatively couple the end effector 204 to the shaft 202, the wrist 206 includes a first or “distal” clevis 402a and a second or “proximal” clevis 402b. The clevises 402a,b may alternatively be referred to as “articulation joints” or “linkages.” As described herein, the clevises 402a,b are operatively coupled to facilitate articulation of the wrist 206 relative to the shaft 202, thereby allowing the end effector 204 to articulate in yaw, pitch, or a combination of both yaw and pitch.
As illustrated, the proximal end of the distal clevis 402a may be rotatably mounted to the distal end of the proximal clevis 402b at a first pivot axis P1 of the wrist 206. First and second pulleys 404a and 404b (only the first pulley 404a is visible in
A plurality of drive members, shown as drive members 406a, 406b, 406c, and 406d, extend longitudinally within a lumen 408 defined by the shaft 202 (or a shaft adaptor) and extend at least partially through the wrist 206. The drive members 406a-d may form part of the actuation systems housed within the drive housing 208 (
The drive members 406a-d extend proximally from the end effector 204 and the wrist 206 toward the drive housing 208 (
In the illustrated embodiment, the drive members 406a-d each extend longitudinally through the proximal clevis 402b, and the distal end of each drive member 406a-d terminates at the first or second pulleys 404a,b, thus operatively coupling each drive member 406a-d to the end effector 204. In some embodiments, the distal ends of the first and second drive members 406a,b may be coupled to each other and terminate at the first pulley 404a, and the distal ends of the third and fourth drive members 406c,d may be coupled to each other and terminate at the second pulley 404b (
In the illustrated embodiment, the drive members 406a-d operate “antagonistically”. More specifically, when the first drive member 406a is actuated (moved in tension), the second drive member 406b naturally follows as coupled to the first drive member 406a, and vice versa. Similarly, when the third drive member 406c is actuated (moved in tension), the fourth drive member 406d naturally follows as coupled to the third drive member 406c, and vice versa. Antagonistic operation of the drive members 406a-d can open or close the jaws 210, 212 and can further cause the end effector 204 to articulate at the wrist 206. More specifically, selective actuation of the drive members 406a-d in known configurations or coordination can cause the end effector 204 to articulate about one or both of the pivot axes P1, P2, thus facilitating articulation of the end effector 204 in both pitch and yaw directions. Moreover, selective actuation of the drive members 406a-d in other known configurations or coordination will cause the jaws 210, 212 to open or close. Antagonistic operation of the drive members 406a-d advantageously reduces the number of cables required to provide full wrist 206 motion, and also helps eliminate slack in the drive members 406a-d, which results in more precise motion of the end effector 204.
In the illustrated embodiment, the end effector 204 is able to articulate (move) in pitch about the second or “pitch” pivot axis P2, which is located near the distal end of the wrist 206. Thus, the jaws 210, 212 open and close in the direction of pitch. Moving both articulation axes P1, P2 closer to the therapeutic jaw surface enables minimization of the distance between the remote center of motion, therapeutic surface, and articulation axis. Having the pitch pivot axis P2 as far distal as possible may be advantageous in providing a geometric advantage that helps an operator more easily get under vessels and facilitate blunt (touch) and spread dissection. This may also reduce the overall length of the end effector 204 and thereby improve surgeon access to patient anatomy during surgery by allowing discrete motion in smaller surgical spaces. This may also improve the robotic control of the instrument making user-applied motions seem more natural. This may further result in providing better reach to anatomy during dissection, such as for lymph node removal or other tissue mobilization. In other embodiments, however, the wrist 206 may alternatively be configured such that the second pivot axis P2 facilitates yaw articulation of the jaws 210, 212, without departing from the scope of the disclosure.
In the illustrated embodiment, first and second electrical conductors 412a and 412b also extend longitudinally within the lumen 408, through the wrist 206, and terminate at the end effector 204 to supply electrical energy thereto. More particularly, the first electrical conductor 412a terminates at a first or “upper” electrode 414a secured to the upper jaw 210, and the second electrical conductor 412b terminates at a second or “lower” electrode 414b secured to the lower jaw 212. In some embodiments, the electrical conductors 412a,b may each comprise a wire, but may alternatively comprise a rigid or semi-rigid shaft, rod, or strip (ribbon) made of a conductive material. The electrical conductors 412a,b may be partially covered with an insulative covering (overmold) made of a non-conductive material. Routing the electrical conductors 412a,b to the corresponding electrodes 414a,b, respectively, allows the end effector 204 to operate in bipolar RF operation.
In at least one embodiment, the electrical energy conducted through the electrical conductors 412a,b exhibits a frequency between about 100 kHz and 1 MHz. In a process known as Joule heating (resistive or Ohmic heating) the RF energy is transformed into heat within target tissue grasped between the jaws 210, 212 due the tissue's intrinsic electrical impedance, thereby increasing the temperature of the target tissue. Heating the target tissue achieves various tissue effects such as cauterization and/or coagulation, and thus may be particularly useful for sealing blood vessels or diffusing bleeding during a surgical procedure. Heating the target tissue may also cause desiccation of the tissue, which allows the tissue to be cut (dissected) more easily.
The drive rod 420 may comprise a rigid or semi rigid elongate member, such as a rod or shaft (e.g., a hypotube, a hollow rod, a solid rod, etc.), a wire, a ribbon, a push cable, or any combination thereof. The drive rod 420 can be made from a variety of materials including, but not limited to, metal (e.g., tungsten, nitinol, stainless steel, etc.), a polymer, or a composite material. The drive rod 420 may have a circular cross-section, but may alternatively exhibit a polygonal cross-section without departing from the scope of the disclosure.
Similar to the drive members 406a-d, the drive rod 420 may form part of the actuation systems housed within the drive housing 208 (
In the illustrated embodiment, the knife 416 is shown received within a knife housing 422 pivotably mounted to the end effector 204. As described in more detail below, the knife housing 422 defines a central passageway through which the knife 416 and the drive rod 420 are able to extend to move the knife 416 into and along the knife slot 418. Upon firing the end effector 204, the drive rod 420 is moved (urged) distally, which correspondingly moves the knife 416 out of the knife housing 422 and into the knife slot 418. After firing is complete, the drive rod 420 is retracted proximally, which pulls the knife 416 proximally and back into the knife housing 422 until it is desired to again fire the end effector 204.
Referring again to
According to embodiments of the present disclosure, the electrodes 414a,b provided in the end effector 204 may be designed to be thermally and mechanically symmetric and thereby configured to optimize performance of the end effector 204 when treating and cutting tissue grasped between the jaws 210, 212. Prior vessel sealer designs commonly include only a single, isolated electrode positioned on only one of the jaws, and the opposing jaw operates as the return path on the opposite side. This design configuration results in a difference in thermal mass causing asymmetric heat signatures on opposing sides of the tissue grasped between the jaws, which may affect tissue sealing performance. In contrast, the thermally and mechanically symmetric jaws 210, 212 described herein each include a corresponding powered electrode 414a,b, which results in a thermally balanced thermal mass on both sides (e.g., above and below) of the grasped tissue. The presently-disclosed electrodes 414a,b facilitate consistent and efficient heating of the electrodes 414a,b and the corresponding grasped tissues due to low and equal thermal mass on both sides of the tissue.
As illustrated, the upper insulator 502a may be overmolded onto the upper electrode 414a, and the lower insulator 502b may be overmolded onto the lower electrode 414b. Each insulator 502a,b may comprise a non-conductive material mated or otherwise coupled to the corresponding jaw 210, 212. Suitable non-conductive materials include, but are not limited to, nylon, polyphthalamide (PPA; e.g., GRIVORY® or THERMEC™), or a combination thereof.
The electrodes 414a,b and the insulators 502a,b may cooperatively define the knife slot 418 that guides the knife 416 (
The upper and lower electrodes 414a,b constitute mirror images of each other, and each electrode 414a,b provides and otherwise defines a planar sealing surface 506. When the jaws 210, 212 are closed, the planar sealing surfaces 506 are arranged substantially parallel to each other and a small gap is defined therebetween to receive (accommodate) tissue. The upper slot portion 504a bifurcates the planar sealing surface 506 of the upper electrode 414a, thereby defining left (first) and right (second) portions 508a and 508b of the upper electrode 414a. Similarly, the lower slot portion 504b bifurcates the planar sealing surface 506 of the lower electrode 414b, thereby defining left (first) and right (second) portions 510a and 510b of the lower electrode 414b.
The design and configuration of the lateral extents of the left and right portions 508a,b and 510a,b may be optimized for efficient thermal management. More specifically, the left and right portions 508a,b and 510a,b of each electrode 414a,b provide and otherwise define an outer lateral extent 512 extending from the corresponding planar sealing surface 506. In the illustrated embodiment, the outer lateral extent 512 (alternately referred to as the “perimeter” or “boundary”) extends away from the planar sealing surface 506 and away from the opposing jaw 210, 212; e.g., out of the plane of the planar sealing surface 506 and toward the body of the corresponding jaw 210, 212. In at least one embodiment, as illustrated, the outer lateral extent 512 extends from the corresponding planar sealing surface 506 at about a 90° angle, but could alternatively extend at an angle greater or less than 90°, without departing from the scope of the disclosure.
In some embodiments, as illustrated, one or more of the outer lateral extents 512 of the electrodes 414a,b may be embedded within a portion of the corresponding insulator 502a,b. As will be appreciated, this may help retain (secure) the electrode 414a,b to the insulator 502a,b without requiring mechanical fasteners, adhesives, or an interference fit. Moreover, embedding the outer lateral extents 512 in the insulator 502a,b may also be advantageous in reducing the conductive pathway through tissue extending on either lateral side of the jaws 210, 212. More specifically, embedding at least a portion of the outer lateral extents 512 within the insulator 502a,b may result in cooler tissue protruding out each lateral side of the jaws 210, 212 as compared to end effectors with entirely exposed lateral extents.
In the illustrated embodiment, the insulator 502a,b extends toward but stops short of the planar sealing surface 506. As a result the electrodes 414a,b may provide an electrically exposed edge 513 (e.g., radius, curvature, etc.) that provides the transition between the planar sealing surface and the lateral extent 512. In other embodiments, however, and as described in more detail below, the insulator 502a,b may extend to and terminate at the planar sealing surface 506, thus covering and otherwise encapsulating the edge 513. In such embodiments, the heat difference in the portions of the tissue protruding out each lateral side of the jaws 210, 212 may be even cooler as compared to temperatures where the electrodes 414a,b directly contact the tissue during sealing.
The left and right portions 508a,b and 510a,b of each electrode 414a,b may further provide and otherwise define an inner lateral extent 514 extending from the corresponding planar sealing surface 506 at the knife slot 418. The inner lateral extent 514 could alternately be referred to as or characterized as an inner lateral “perimeter,” “boundary,” or “face”. Similar to the outer lateral extents 512, each inner lateral extent 514 extends away from the planar sealing surface 506 and also away from the opposing jaw 210, 212; e.g., out of the plane of the planar sealing surface 506 and toward the body of the corresponding jaw 210, 212). In at least one embodiment, as illustrated, the inner lateral extent 514 extends away from the corresponding planar sealing surface 506 at about a 45° angle, but could alternatively extend at an angle greater or less than 45°, without departing from the scope of the disclosure.
One or more of the inner lateral extents 514 may be at least partially embedded within a portion of the corresponding insulator 502a,b. As will be appreciated, this may help retain (secure) the electrode 414a,b to the insulator 502a,b without the need of mechanical fasteners or an interference fit.
As forming integral parts of the corresponding upper and lower slot portions 504a,b, the inner lateral extents 514 help define the knife slot 418. In at least one embodiment, when the jaws 210, 212 are closed, the electrodes 414a,b at the inner lateral extents 514 cooperatively define a generally diamond-shaped cross-section 515 (
Moreover, the diamond-shape 515 of the electrodes 414a,b at the knife slot 418 is electrically exposed (e.g., not overmolded with the insulators 502a,b), which may provide a conductive pathway that creates uniform heating of tissue across the knife slot 418. This may create a thermal effect that helps desiccate tissue in the center of the knife slot 418, which makes the tissue easier to cut and ensures that the grasped tissue is fully sealed up to the cut location. Electrodes without the diamond-shaped cross-section 515 (i.e., entirely flat sealing surfaces) can fail to communicate sufficient thermal energy to the tissue at the knife slot. Having the diamond-shaped 515 knife slot 418, however, allows the thermal energy to radiate to and thereby efficiently desiccate the grasped tissue.
In some embodiments, one or both of the insulators 502a,b may provide or otherwise define a floor or “trough” section 516 extending laterally across the knife slot 418 and thereby structurally connecting the lateral sides of the corresponding insulators 502a,b. Each trough section 516 may form the bottom of the upper and lower slot portions 504a,b. Prior art insulators are often disconnected (separated) at the knife slot, but the insulators 502a,b described herein comprise monolithic components that extend across the knife slot 418 and opposing lateral sides are interconnected at the trough section 516. As will be appreciated, the trough section 516 may prove advantageous in simplifying the manufacture of the insulators 502a,b.
Referring specifically to
As illustrated, the lower insulator 502b may be overmolded onto the lower electrode 414b, and the lower electrode 414b and the lower insulator 502b cooperatively define the lower slot portion 504b of the knife slot 418. The lower slot portion 504b bifurcates the planar sealing surface 506 of the lower electrode 414b, thereby defining the left and right portions 510a,b of the lower electrode 414b.
As best seen in
As illustrated, each electrode 414a,b includes an elongate body 704 having a first or “distal” end 706a and a second or “proximal” end 706b opposite the distal end 706a. The body 704 may be made of a variety of rigid, conductive materials, such as a metal. Example conductive materials include, but are not limited to, stainless steel, aluminum, silver, copper, and alloys thereof. Alternatively, stainless steel could also be used as a substrate over which gold, silver, or platinum could be applied through a plating process. An elongate channel 708 (
Each electrode 414a,b may provide an electrical connector 710 positioned at and otherwise extending from the proximal end 706b. The electrical connector 710 provides a location where the first and second electrical conductors 412a,b can be placed in electrical communication with the electrodes 414a,b, respectively. More specifically, the first electrical conductor 412a terminates at and is electrically coupled to the electrical connector 710 of the upper electrode 414a, and the second electrical conductor 412b terminates at and is electrically coupled to the electrical connector 710 of the lower electrode 414b. In contrast to vessel sealers that incorporate a single electrical conductor and relies on a mechanical metallic drive train for the conductive return pathway on an opposing jaw, the presently-described electrical conductors 412a,b are routed directly to the corresponding electrodes 414a,b. While the upper and lower electrodes 414a,b may be mirror images of each other, each electrode 414a,b exhibits a different polarity. As will be appreciated, this direct routing and electrical communication minimizes electrical losses, which enables better signal integrity for driving system response and ensures more controlled impedance values that improve the ability to do distal sensing of tissue properties, and better detection of seal progression.
In some embodiments, the electrical connectors 710 may form an integral part of the corresponding electrode 414a,b from which it extends. In such embodiments, each electrode 414a,b and corresponding electrical connector 710 may comprise a stamped, metal part, which may prove advantageous in simplifying the manufacturing process of the electrodes 414a,b.
Moreover, in at least one embodiment, as illustrated, the elongate channel 708 defined in each electrode 414a,b may extend into the electrical connector 710, which forms or otherwise defines a generally U-shaped passage 712 (
As best seen in
In the illustrated embodiment, the distal clevis 402a is depicted as a monolithic, one-piece structure, but could alternatively be made of two or more component parts, without departing from the scope of the disclosure. As discussed in more detail below, the proximal end of the distal clevis 402a may be rotatably mounted to the distal end of the proximal clevis 402b, and vice versa, which allows the wrist 206 to articulate in “yaw” about the first pivot axis P1 (
The distal clevis 402a provides and otherwise defines a pair of outer lobes 802a and 802b and a pair of inner lobes 804a and 804b. The outer and inner lobes 802a,b and 804a,b each extend distally, and the inner lobes 804a,b interpose the outer lobes 802a,b. Each outer lobe 802a,b defines an axle aperture 806, and each inner lobe 804a,b defines a pin aperture 808. The axle and pin apertures 806, 808 are co-axially aligned along the second pivot axis P2 of the wrist 206 and configured to support first and second axles 810a (
The first and second pulleys 404a,b may be rotatably mounted to the distal clevis 402a at the first and second axles 810a,b, thereby being able to rotate about the second pivot axis P2. More specifically, the first pulley 404a may be received within a gap 812a defined between the first outer and inner lobes 802a, 804a and rotatably mounted to the first axle 810a, and the second pulley 404b may be received within a gap 812b defined between the second outer and inner lobes 802b, 804b and configured to be rotatably mounted to the second axle 810b.
In some embodiments, the first and second axles 810a,b may be secured (e.g., welded) to one or both of the axle and pin apertures 806, 808. In such embodiments, the pulleys 404a,b may be rotatably mounted to the first and second axles 810a,b, respectively, such that they are free to rotate. In other embodiments, however, the pulleys 404a,b may be secured (e.g., welded) to the first and second axles 810a,b. In such embodiments, the first and second axles 810a,b may be freely rotatable within the corresponding axle and pin apertures 806, 808. In yet other embodiments, the first and second axles 810a,b may be freely rotatable and not secured to any other component of the wrist 206, without departing from the scope of the disclosure.
As illustrated, a central gap 814 may be defined between the inner lobes 804a,b. The central gap 814 may be configured to accommodate the drive rod 420 and the electrical conductors 412a,b (
Referring briefly to
The jaw axle apertures 1002a,b of the upper jaw 210 are coaxially aligned, and the jaw axle apertures 1004a,b of the lower jaw 212 are also coaxially aligned. When the end effector 204 is properly assembled, the jaw axle apertures 1002a,b of the upper jaw 210 will be aligned coaxially with the jaw axle apertures 1004a,b of the lower jaw 212. More particularly, when the end effector 204 is assembled, the first jaw axle apertures 1002a, 1004a will be juxtaposed against each other, and the second jaw axle apertures 1002b, 1004b will be juxtaposed against each other such that all jaw axle apertures 1002a,b and 1004a,b will be axially aligned along the third pivot axis P3.
The jaws 210, 212 may be pivotably coupled along the third pivot axis P3 using one or more jaw axles, shown as a first jaw axle 1006a and a second jaw axle 1006b. The first jaw axle 1006a may be configured to be received within the axially aligned first jaw axle apertures 1002a, 1004a, and the second jaw axle 1006b may be configured to be received within the axially aligned second jaw axle apertures 1002b, 1004b. Once the first and second jaw axles 1006a,b are properly installed, the jaws 210, 212 will be pivotable about the third pivot axis P3 between the open and closed positions.
Having the jaws 210, 212 rotatably (pivotably) coupled together at the third pivot axis P3 may prove advantageous for a variety of reasons. First, this can ensure that the center plane, the sealing surfaces (e.g., the planar sealing surfaces 506 of
Moreover, as mentioned above, the longitudinal axes A1, A2 (
Referring again to
More particularly, in the illustrated embodiment, the first pulley 404a may provide or define a first drive pin 904a (
In an alternative embodiment, the first and second drive pins 904a,b may be provided on the first and second jaw extensions 902a,b, and the first and second jaw apertures 906a,b may be provided on the pulleys 404a,b, or any combination thereof. Moreover, the jaw apertures 906a,b need not be through-holes, as depicted, but could alternatively comprise recesses defined in the jaw extensions 902a,b (or the pulleys 404a,b) and sized and otherwise configured to receive the drive pins 904a,b.
Selective actuation and antagonistic operation of the drive members 406a-d can open or close the jaws 210, 212. More specifically, because the jaws 210, 212 are eccentrically pinned to the pulleys 404a,b, as generally described above, selectively actuating the drive members 406a-d such that the pulleys 404a,b rotate in opposite angular directions may result in the jaws 210, 212 opening or closing about the third pivot axis P3. Selective actuation and antagonistic operation of the drive members 406a-d may also cause the end effector 204 to articulate at the wrist 206 in both pitch and yaw directions. More particularly, selectively actuating the drive members 406a-d such that the pulleys 404a,b rotate in the same angular direction may result in the jaws 210, 212 pivoting about the second pivot axis P2 and thereby moving the end effector 204 up or down in pitch. Moreover, selective actuation of a first connected pair of drive members 406a-d while relaxing a second pair of connected drive members 406a-d may cause the end effector 204 to pivot about the first pivot axis P1 (
Still referring to
In some embodiments, the arcuate slots 908a,b may be used to help prevent over-rotation of the jaws 210, 212 during operation. More specifically, each end of the arcuate slots 908a,b provides and otherwise defines a mechanical hard stop. As the jaws 210, 212 move to the open position, the axles 810a,b will traverse the corresponding arcuate slots 908a,b and may eventually engage the mechanical hard stop at an end of the arcuate slot 908a,b. Engaging the hard stop will prevent the jaws 210, 212 from pivoting further in the open direction, which could result in over-rotation and inadvertently achieving a controls singularity, which could lock the jaws 210, 212. If the drive pins 904a,b are over-rotated to a point that they rotate past (cross over) the longitudinal axis A1 of the shaft or the longitudinal axis A2 of the end effector 204 or otherwise become co-axially aligned, this could result in controls singularity, which creates unstable yaw positioning. Reaching controls singularity theoretically provides the jaws 210, 212 with the ability to rotate about different axes, thus eliminating finite control of yaw.
In other embodiments, however, the robotic controllers of the surgical tool 200 (
With reference to
In
The first and second pivot axes P1, P2 are separated from each other by a first axial length L1, and the jaw pivot axis P3 is separated from the second pivot axis P2 by a second axial length L2. According to embodiments of the present disclosure, the second axial length L2 may be equal to or smaller (shorter) than the first axial length L1. In combination with reduced compliments and simplified linkage of the jaws 210, 210 directly to each other, allows for a shorter mechanism that provides better access and dissection in the articulated postures. Accordingly, having a second axial length L2 equal to or shorter than the first axial length L1, may prove advantageous in providing easier access into tight anatomy.
Moreover, in combination with the knife 416 (
Referring again to
In the illustrated embodiment, the distal clevis 402a may provide and otherwise define one or more camming tabs 1206 (two shown in
In some embodiments, the distal clevis 402a may provide and otherwise define one or more first camming surfaces 1210a (two shown in
In the illustrated embodiment, the distal clevis 402a may provide and otherwise define one or more first spur gears 1212a (two shown in
In
As mentioned above, the knife 416 (mostly occluded) is aligned with and configured to traverse the knife slot 418 defined longitudinally in both the upper and lower jaws 210, 212. The knife housing 422 defines a cavity 1402 sized to receive and “stow” the knife 416 when not in use. The knife 416 is shown in
The knife housing 422 may be pivotably mounted to the end effector 204. More particularly, the knife housing 422 may be rotatably mounted between the upper and lower jaws 210, 212 when the jaws 210, 212 are pivotably coupled as described herein with reference to
Accordingly, the knife housing 422 is not fixed (e.g., immovably secured) to any portion of the end effector 204 or the wrist 206, but is instead pivotably secured between opposing central portions of the jaws 210, 212 when the end effector 204 is assembled. Allowing the knife housing 422 to pivot about the third pivot axis P3 (e.g., due to yaw) may prove advantageous in reducing strain on the knife housing 422 during use.
As indicated above, the knife housing 422 (
As mentioned above, the knife 416 may be operatively coupled to the distal end of the drive rod 420 (shown in dashed lines in
In some embodiments, as illustrated, a flexible sheath 1502 (e.g., a hypotube or the like) may cover all or a portion of the drive rod 420. The sheath 1502 may support and help prevent buckling of the drive rod 420 upon assuming compressive loads during articulation of the wrist 206 and opening and closure of the jaws 210, 212. Similar to the drive rod 420, the flexible sheath 1502 may be made of a variety of flexible materials including, but not limited to, a metal or metal alloy (e.g., a nickel-titanium alloy or “nitinol”), a metallic coil, a plastic or thermoplastic material, a composite material, or any combination thereof.
Upon firing the end effector 204 (
As best seen in
The knife housing 422 may define a central conduit 1602 that extends to and communicates with the cavity 1402. The drive rod 420 is extendable through the central conduit 1602 and able to translate longitudinally therethrough when transitioning the knife 416 between the stowed and extended positions. In some embodiments, the distal end of the sheath 1502 may be received within the central conduit 1602. In at least one embodiment, for example, the knife housing 422 may be secured to the distal end of the sheath 1502, such as being overmolded onto the sheath 1502. In other embodiments, the knife housing 422 may be secured to the distal end of the sheath 1502 via welding, an adhesive, a shrink-fit or interference engagement, or any combination of the foregoing.
In
In some embodiments, to help ease the transition from the cavity 1402 to the knife slot 418 when the end effector 204 is articulated, at least one of the leading corners 1608, 1610 of the knife 416 may be rounded or chamfered. In the illustrated embodiment, the lower leading corner 1608 of the knife 416 is rounded, while the upper leading corner 1610 defines a sharp angle. As will be appreciated, the rounded, lower leading corner 1608 may prove advantageous in creating a smooth sliding transition for the knife 416 as it enters the knife track 418.
In other embodiments, the lower leading corner 1608 may define a sharp angle, and the upper leading corner 1610 may alternatively be rounded or chamfered. In yet other embodiments, both leading corners 1608, 1610 may be rounded or chamfered, without departing from the scope of the disclosure.
As illustrated, the drive rod 420 is directly pushed without any redirect pulleys being used in the end effector 204. Those skilled in the art will readily appreciate that this can simplify the proximal end of the wrist 206 and the instrument as a whole, which can reduce costs.
Also shown in
As illustrated, the drive rod 420 extends along the instrument axis B1, and the electrical conductors 412a,b are arranged on radially opposite sides (e.g., above and below) of the drive rod 420. In the illustrated embodiment, the electrical conductors 412a,b are arranged above and below the drive rod 420, but could alternatively be arranged on opposing left and right sides of the drive rod 420, without departing from the scope of the disclosure. Accordingly, the drive rod 420 may be centered (centrally-located) relative to the cross-section of the wrist 206, which can help ensure that the controls length compensation is symmetric and the parasitic load imparted on the articulation system is symmetric, such that clamp force variation relative to a particular pose of the end effector 204 is consistent and predictable.
As shown in the process algorithm 1800, a user sends a command signal to request firing of the knife 416, as at 1802. The user may send the command signal to the robotic surgical system 100 (
If, however, the jaw angle between the jaws 210, 212 is determined to be un-acceptably closed, as at 1814, the system may be programmed to disable the knife 416, as at 1816. As will be appreciated, if the knife 416 were to be fired (extended along the knife slot 418) with the jaws 210, 212 open past a predetermined angle, the knife 416 could be completely exposed and potentially dislodge from the knife slot 418. Upon disablement of the knife 416, the user may then be prompted to reengage the tissue between the jaws 210, 212 or re-energize the electrodes 414a,b, as at 1818. The process algorithm 1800 may then return to the first step, as at 1802, and the process will repeat itself.
Embodiments disclosed herein include:
A. An end effector that includes a first jaw having a first electrode and a first insulator secured thereto, a second jaw having a second electrode and a second insulator secured thereto, the first and second jaws being pivotable between open and closed positions, and a knife slot cooperatively defined in the first and second jaws and defining a diamond-shape cross-section when the first and second jaws are in the closed position, wherein each electrode provides an inner lateral extent that cooperatively defines the diamond-shape cross-section, and wherein a length of at least one of the inner lateral extents is greater than a thickness of a corresponding one of the first or second electrodes.
B. A surgical tool includes a drive housing, an elongate shaft that extends from the drive housing, and an end effector arranged at a distal end of the elongate shaft. The end effector includes a first jaw having a first electrode and a first insulator secured thereto, a second jaw having a second electrode and a second insulator secured thereto, the first and second jaws being pivotable between open and closed positions, and a knife slot cooperatively defined in the first and second jaws and defining a diamond-shape cross-section when the first and second jaws are in the closed position. The surgical tool further includes a drive rod extending from the drive housing and terminating at the end effector, and a knife operatively coupled to the drive rod and extendable into the knife slot, wherein the drive rod is actuatable to longitudinally move the knife within the knife slot, wherein each electrode provides an inner lateral extent that cooperatively defines the diamond-shape cross-section when the first and second jaws are in the closed position, and wherein a length of at least one of the inner lateral extents is greater than a thickness of a corresponding one of the first or second electrodes.
Each of embodiments A and B may have one or more of the following additional elements in any combination: Element 1: wherein the first insulator and the first electrode cooperatively define a first slot portion that bifurcates a first planar surface of the first electrode into first left and right portions, and the second insulator and the second electrode cooperatively define a second slot portion that bifurcates a second planar surface of the second electrode into second left and right portions, and wherein the first and second slot portions cooperatively define the knife slot when the first and second jaws are in the closed position. Element 2: wherein the first left and right portions each provide an outer lateral extent extending away from the first planar surface and embedded within the first insulator, and the second left and right portions each provide an outer lateral extent extending away from the second planar surface and embedded within the second insulator. Element 3: wherein each outer lateral extent provides an electrically exposed edge that provides a transition between the outer lateral extent and the first and second planar sealing surfaces. Element 4: wherein the outer lateral extents are embedded within the first and second insulators such that the first and second insulators provide a flush interface with the first and second planar sealing surfaces, respectively. Element 5: wherein the first left and right portions each provide the inner lateral extent extending away from the first planar surface, and the second left and right portions each provide the inner lateral extent extending away from the second planar surface. Element 6: wherein the inner lateral extents of the first and second left and right portions cooperatively define the diamond-shape cross-section when the first and second jaws are in the closed position. Element 7: wherein each of the insulators defines a trough section extending laterally across the knife slot and thereby structurally connecting lateral sides of the first and second insulators. Element 8: wherein each electrode provides an elongate body with opposing distal and proximal ends, and an elongate channel is defined in the body and extends between the distal and proximal ends to form part of the knife slot. Element 9: further comprising a first electrical connector extending from the proximal end of the first electrode and configured to receive a first electrical conductor to provide electrical energy to the first electrode, and a second electrical connector extending from the proximal end of the second electrode and configured to receive a second electrical conductor to provide electrical energy to the second electrode. Element 10: wherein each electrical connector defines a generally U-shaped passage such that each electrode is connected at both the distal and proximal ends, and wherein the knife is extendable into the knife slot by extending at least partially through the U-shaped passage of each electrical connector. Element 11: wherein the first and second electrical connectors extend away from corresponding planar sealing surfaces of the first and second electrodes, respectively, such that a gap is defined between the first and second electrical connectors that accommodates the knife.
Element 12: wherein the first insulator and the first electrode cooperatively define a first slot portion that bifurcates a first planar surface of the first electrode, and the second insulator and the second electrode cooperatively define a second slot portion that bifurcates a second planar surface of the second electrode, and wherein the first and second slot portions cooperatively define the knife slot when the first and second jaws are in the closed position. Element 13: wherein the first planar surface provides opposing outer lateral extents extending away from the first planar surface and embedded within the first insulator, and the second planar surface provides opposing outer lateral extents extending away from the second planar surface and embedded within the second insulator. Element 14: wherein the inner lateral extent of each electrode is provided by the first and second planar surfaces and each inner lateral extent extends away from the first and second planar surfaces, respectively. Element 15: wherein each electrode provides an elongate body with opposing distal and proximal ends, and an elongate channel is defined in the body and extends between the distal and proximal ends to form part of the knife slot. Element 16: further comprising a first electrical connector extending from the proximal end of the first electrode, a first electrical conductor extending from the drive housing and coupled to the first electrical connector to provide electrical energy to the first electrode, a second electrical connector extending from the proximal end of the second electrode, and a second electrical conductor extending from the drive housing and coupled to the second electrical connector to provide electrical energy to the second electrode. Element 17: wherein each electrical connector defines a generally U-shaped passage such that each electrode is connected at both the distal and proximal ends, and wherein the knife is extendable into the knife slot by extending at least partially through the U-shaped passage of each electrical connector. Element 19: wherein the first and second electrical connectors extend away from corresponding planar sealing surfaces of the first and second electrodes, respectively, such that a gap is defined between the first and second electrical connectors that accommodates the knife.
By way of non-limiting example, exemplary combinations applicable to A and B include: Element 1 with Element 2; Element 2 with Element 3; Element 2 with Element 4; Element 1 with Element 5; Element 5 with Element 6; Element 8 with Element 9; Element 9 with Element 10; Element 9 with Element 11; Element 12 with Element 13; Element 12 with Element 14; Element 15 with Element 16; Element 16 with Element 17; and Element 16 with Element 18.
Therefore, the disclosed systems and methods are well adapted to attain the ends and advantages mentioned as well as those that are inherent therein. The particular embodiments disclosed above are illustrative only, as the teachings of the present disclosure may be modified and practiced in different but equivalent manners apparent to those skilled in the art having the benefit of the teachings herein. Furthermore, no limitations are intended to the details of construction or design herein shown, other than as described in the claims below. It is therefore evident that the particular illustrative embodiments disclosed above may be altered, combined, or modified and all such variations are considered within the scope of the present disclosure. The systems and methods illustratively disclosed herein may suitably be practiced in the absence of any element that is not specifically disclosed herein and/or any optional element disclosed herein. While compositions and methods are described in terms of “comprising,” “containing,” or “including” various components or steps, the compositions and methods can also “consist essentially of” or “consist of” the various components and steps. All numbers and ranges disclosed above may vary by some amount. Whenever a numerical range with a lower limit and an upper limit is disclosed, any number and any included range falling within the range is specifically disclosed. In particular, every range of values (of the form, “from about a to about b,” or, equivalently, “from approximately a to b,” or, equivalently, “from approximately a-b”) disclosed herein is to be understood to set forth every number and range encompassed within the broader range of values. Also, the terms in the claims have their plain, ordinary meaning unless otherwise explicitly and clearly defined by the patentee. Moreover, the indefinite articles “a” or “an,” as used in the claims, are defined herein to mean one or more than one of the elements that it introduces. If there is any conflict in the usages of a word or term in this specification and one or more patent or other documents that may be incorporated herein by reference, the definitions that are consistent with this specification should be adopted.
As used herein, the phrase “at least one of” preceding a series of items, with the terms “and” or “or” to separate any of the items, modifies the list as a whole, rather than each member of the list (i.e., each item). The phrase “at least one of” allows a meaning that includes at least one of any one of the items, and/or at least one of any combination of the items, and/or at least one of each of the items. By way of example, the phrases “at least one of A, B, and C” or “at least one of A, B, or C” each refer to only A, only B, or only C; any combination of A, B, and C; and/or at least one of each of A, B, and C.