stitcher beam structure

Abstract

An end effector may have an upper jaw and a lower jaw. A wrist may connect the end effector to an elongated shaft. A beam member may be arranged to translate within the upper and lower jaws. An actuation assembly may have a pushing assembly and a traction assembly, the pushing assembly being configured to transmit compressive force to the beam member and the traction assembly being configured to transmit tension to the beam member.

Description

[0001] Cross-referencing of relevant application data

[0002] This application claims the benefit of U.S. Provisional Application No. 62 / 385,636, filed September 9, 2016, the entire disclosure of which is incorporated herein by reference for all purposes. Background Technology

[0003] Minimally invasive surgical techniques aim to reduce the amount of external tissue damaged during diagnostic or surgical procedures, thereby reducing patient recovery time, discomfort, and harmful side effects. Therefore, the use of minimally invasive surgical techniques can significantly shorten the average hospital stay for standard surgery. Furthermore, minimally invasive surgery can also reduce patient recovery time, patient discomfort, surgical side effects, and lost work time.

[0004] A common form of minimally invasive surgery is endoscopy, and a common form of endoscopy is laparoscopy, which is a minimally invasive examination and / or surgery within the abdominal cavity. Reloadable stapling devices can be used in conjunction with laparoscopic surgery. Remotely controlled stapling devices may include servo-controlled wrist joints that yaw and pitch at relatively large angles (e.g., up to and over 90 degrees). The articulation of such wrist joints can apply significant strain to the actuating components extending through the wrist. Summary of the Invention

[0005] The embodiments disclosed herein relate to a surgical device with a wrist capable of relatively large yaw and pitch angles. Such a wrist may have a yaw axis spatially separated from the pitch axis, wherein the yaw axis and pitch axis are perpendicular to each other, and a longitudinal axis defining an extension of an arm or shaft of a remote control device. In some cases, the yaw and pitch angles may reach 45 degrees, 60 degrees, or 90 degrees.

[0006] In many embodiments, the flexible actuation assembly extending through the wrist, which can yaw and / or pitch at relatively large angles, includes a pulling assembly and a pushing assembly. The flexible actuation assembly can be used to open and close the jaws of a surgical device and / or actuate other instruments, such as cutting and / or anastomosis devices. In many embodiments, the pushing element can transmit compressive force even when significant flexion is caused by high yaw and / or pitch angles through the wrist. In many embodiments, the pushing assembly does not transmit significant tension, and the pulling element is used to transmit tension for proximal movement and actuation of the surgical device. Similarly, the pulling element may not transmit significant compressive force. In many embodiments, the pushing and pulling assemblies are combined into the flexible actuation assembly to enable the flexible actuation assembly to be used to apply both compressive and tensile forces (i.e., pushing and pulling) to actuate the end effector of the surgical device.

[0007] The actuating component and the traction component may be integrated along a common axis, wherein the actuating component is arranged concentrically with respect to the traction component. In some embodiments, the actuating component includes a coiled spring, and the traction component includes a braided cable. Alternatively, the traction component may be arranged concentrically around the actuating component.

[0008] To achieve high wrist flexibility, the wrist assembly can consist of an outer link that defines the yaw and pitch geometry of the wrist assembly. The outer link can house the flexible portion of the actuator. However, compression of the actuator within the wrist can cause bending and reduce the efficiency of force transmission. To help mitigate these problems, inner links connecting the outer links to each other can be provided. The inner links can define channels that constrain and limit the lateral movement of the actuator, thereby reducing buckling.

[0009] Therefore, in one aspect, a device is described comprising an end effector, a beam member, a traction assembly, and a push assembly. The end effector includes an upper jaw and a lower jaw. A wrist connects the end effector to an elongated shaft. The beam member is arranged to translate within the upper and lower jaws. The beam member has a first portion for movably coupling to the upper jaw and a second portion for movably coupling to the lower jaw. The traction assembly is coupled to the beam member. The traction assembly is flexibly housed within the wrist and applies tension to the beam member. The push assembly is coupled to the beam member. The push assembly is flexibly housed within the wrist and applies compressive force to the beam member. In many embodiments, the wrist is configured to pitch and yaw when the traction and push assemblies are housed therein.

[0010] The traction assembly of the device can have any suitable configuration. For example, the traction assembly may include a thin cable. The traction assembly may include a braided sheath. The traction assembly may include multiple metal strips. The bending stiffness of the actuating wrist of the traction assembly, which causes the end effector to pitch relative to the thin axis, and the bending stiffness of the actuating wrist, which causes the end effector to yaw relative to the thin axis, can be the same.

[0011] The actuation assembly of the device can have any suitable configuration. For example, the actuation assembly may include an inner cavity surrounding the traction assembly. The actuation assembly may include a closely-coiled spring. The closely-coiled spring may have a cylindrical outer surface. The closely-coiled spring may have interlocking / intersecting convex and concave surfaces. The closely-coiled spring may include a helically cut tube. The actuation assembly may include a tube with a grooved pattern that reduces the bending stiffness of the tube while maintaining sufficient axial stiffness to transmit compressive forces to the beam member. The actuation assembly may include multiple actuation elements that separate under tension. The actuation assembly may include multiple spherical members. The traction assembly may define an inner cavity accommodating multiple spherical members. The spherical members may be linked by a flexible rod. The actuation assembly may include multiple separate elements having interface surfaces that restrict lateral relative sliding between the elements in one direction. The actuation assembly may include multiple separate elements having interface surfaces that inhibit relative torsion between the elements. The actuation assembly may include a stack of flat washers. The actuation assembly may include a stack of annular disks. The actuation assembly may include a stack of rectangular washers defining an inner cavity through which multiple metal strips extend. The actuation wrist of the actuation assembly can have the same bending stiffness for pitching the end effector relative to the elongated axis and for yawing the end effector relative to the elongated axis.

[0012] In another embodiment, a surgical tool is described, comprising an end effector, a beam member, and an actuation assembly. The end effector includes an upper jaw and a lower jaw. A wrist connects the end effector to an elongated shaft. The beam member is arranged to translate within the upper and lower jaws. The beam member has a first portion for movably coupling to the upper jaw and a second portion for movably coupling to the lower jaw. The actuation assembly includes a pushing assembly for transmitting compressive force to the beam member and a traction assembly for transmitting tension to the beam member. In many embodiments, the wrist is configured to pitch and yaw when the actuation assembly is housed therein.

[0013] The actuation components of a surgical instrument can have any suitable configuration. For example, a traction component may include an elongated cable. A traction component may include a braided sheath. A traction component may include multiple metal strips. The bending stiffness of the actuation wrist of the traction component, which causes the end effector to pitch relative to the elongated axis, and the bending stiffness of the actuation wrist, which causes the end effector to yaw relative to the elongated axis, may be the same. A push component may include an inner cavity surrounding the traction component. A push component may include a tightly coiled spring. A tightly coiled spring may have a cylindrical outer surface. A tightly coiled spring may have interconnected convex and concave surfaces. A tightly coiled spring may include a helical cut tube. A push component may include a tube with a grooved pattern that reduces the bending stiffness of the tube while maintaining sufficient axial stiffness to transmit compressive forces to the beam member. A push component may include multiple push elements that separate under tension. A push component may include multiple spherical members. A traction component may define an inner cavity accommodating multiple spherical members. The spherical members may be linked by flexible rods. The actuation assembly may include multiple separate elements having interface surfaces that restrict lateral relative sliding between the elements in one direction. The actuation assembly may include multiple separate elements having interface surfaces that inhibit relative torsion between the elements. The actuation assembly may include a stack of flat washers. The actuation assembly may include a stack of annular disks. The actuation assembly may include a stack of rectangular washers defining an inner cavity through which multiple metal strips extend. The actuation wrist of the actuation assembly can have the same bending stiffness for pitching the end effector relative to an elongated axis and for yawing the end effector relative to an elongated axis. A one-dimensional flexible rod array can be used as both a traction assembly and a actuation assembly. Nickel-titanium rods can be used as both a traction assembly and a actuation assembly. Attached Figure Description

[0014] Figures 1 to 6 A view of a surgical instrument according to some embodiments is shown.

[0015] Figure 7 and Figure 8 It shows Figures 1 to 6 A cross-sectional view of surgical instruments.

[0016] Figure 9 Examples of some embodiments are shown. Figures 1 to 6 An embodiment of the actuation component of a surgical instrument.

[0017] Figure 10 It shows Figure 9 A cross-sectional view of the actuation component.

[0018] Figure 11 It shows Figure 9 A cross-sectional view of the distal portion of the actuation component.

[0019] Figure 12It shows Figure 9 A cross-sectional view of the proximal portion of the actuation component.

[0020] Figure 13 and Figure 14 It shows Figures 1 to 6 An embodiment of the actuation component of a surgical instrument.

[0021] Figure 15 and Figure 16 It shows Figures 1 to 6 Another embodiment of the actuation component of a surgical instrument.

[0022] Figure 17 It shows Figures 1 to 6 An embodiment of the actuation component of a surgical instrument.

[0023] Figure 18 It shows Figures 1 to 6 Another embodiment of the actuation component of a surgical instrument.

[0024] Figure 19 It shows Figures 1 to 6 Another embodiment of the actuation component of a surgical instrument.

[0025] Figure 20 It shows Figures 1 to 6 A view of another embodiment of the actuation component of a surgical instrument.

[0026] Figure 21 and Figure 22 It shows Figures 1 to 6 Another embodiment of the actuation component of a surgical instrument.

[0027] Figure 23 It shows Figures 1 to 6 Another embodiment of the actuation component of a surgical instrument.

[0028] Figure 24 It shows Figure 23 A cross-sectional view of the driving component.

[0029] Figure 25 It shows Figures 1 to 6 Another embodiment of the actuation component of a surgical instrument.

[0030] Figure 26 It shows Figure 25 A view of a single element of the driving component.

[0031] Figure 27 It shows Figures 1 to 6 A cross-sectional view of another embodiment of the actuation component of a surgical instrument.

[0032] Figure 28 and Figure 29 It shows the wrist of the surgical instrument. Figure 27 A top view of a portion of the actuation component.

[0033] Figure 30 It shows Figures 1 to 6 Another embodiment of the actuation component of a surgical instrument.

[0034] Figure 31 and Figure 32 It shows Figures 1 to 6 A view of another embodiment of the actuation component of a surgical instrument.

[0035] Figure 33 It shows Figures 1 to 6 Another embodiment of the actuation component of a surgical instrument.

[0036] Figure 34 It shows Figures 1 to 6 A cross-sectional view of another embodiment of the actuation component of a surgical instrument.

[0037] Figure 35 It shows Figures 1 to 6 A view of the wrist component of a surgical instrument.

[0038] Figure 36 It shows Figure 35 A cross-sectional view of the wrist component.

[0039] Figure 37 A perspective view of an external linkage assembly according to some embodiments of the present invention is shown.

[0040] Figures 38 to 40 A method for assembling a wrist component according to some embodiments of the present invention is shown. Detailed Implementation

[0041] In the following description, various embodiments will be described. Specific configurations and details are set forth for illustrative purposes to provide a thorough understanding of the embodiments. However, it will be apparent to those skilled in the art that these embodiments may be practiced without the specific details. Furthermore, well-known features may be omitted or simplified so as not to obscure the described embodiments.

[0042] Figures 1 to 3A surgical instrument 10 is shown, comprising a proximal chassis 12, an instrument shaft 14, and a distal actuator 16 with upper jaws 18 articulated to clamp patient tissue. The proximal chassis 12 includes an input coupler 22, which can be connected to and driven by a corresponding output coupler of a remote surgical system (such as the system disclosed in Publication No. US 2014 / 0183244A1, which is incorporated herein by reference). The input coupler 22 is driven coupled to one or more input members disposed within the instrument shaft 14. The input members are driven coupled to the end effector 16. Figure 2 and Figure 3 As shown, the input coupler 22 of the proximal chassis 12 is adaptable to cooperate with various types of motor assemblies 13 (such as the stapler-specific motor assembly disclosed in U.S. Patent No. 8,912,746, or the general-purpose motor assembly disclosed in U.S. Patent No. 8,529,582, which is incorporated herein by reference).

[0043] Figures 4 to 6 Perspective, side, and top views of the distal end of a surgical instrument 10 including an end effector 16 are shown. The end effector 16 is movably connected to an instrument axis 14 via a wrist assembly 24. The wrist assembly 24 has at least two degrees of freedom and provides connection between the end effector 16 and the elongated instrument axis 14 for hinged end effector 16 relative to the instrument axis 14 about two orthogonal axes. The wrist assembly 24 is configured to yaw the end effector 16 relative to the instrument axis 14 about axis 2, which is perpendicular to axis 1 along which the instrument axis 14 extends. The wrist assembly 24 is also configured to pitch the end effector 16 relative to the instrument axis 14 about axis 3, which is perpendicular to axes 1 and 2. As shown, the yaw axis 2 is proximal to the pitch axis 3 (away from the end effector 16); however, this is not necessary, and in some embodiments, the yaw axis 2 is distal to the pitch axis 3.

[0044] Figure 7 and Figure 8 A cross-sectional view showing details of the end effector 16, including an upper jaw 18 and a lower jaw 26. The lower jaw 26 can be configured to receive and support a removable or non-removable suture magazine. The upper jaw 18 is pivotally coupled to the lower jaw 26 to hinge relative to the lower jaw 26 to clamp tissue. Beam member 28 from... Figure 7 The proximal state shown is driven to Figure 8 The distal position shown actuates the upper jaw 18. Movement of the beam member 28 can be used to forcibly secure the upper jaw 18 to the tissue relative to the lower jaw 26. Optionally, the beam member 28 may also allow tissue cutting and deployment of the suture device from the suture device chamber into the cut tissue.

[0045] The beam member 28 includes an upper beam portion 30 configured to slide within a track feature 32 of the upper jaw 18. The track feature 32 includes a ramp 34 for the upper beam portion 30 to engage from the nearest side parking area 36. Figure 7 The open position shown can be maintained by an elastic device (such as a spring) or opened and closed by an auxiliary mechanism (not shown). Partial closure of the upper jaw 18 can be influenced by the distal movement of the upper beam portion 30 toward the ramp 34. Full closure of the upper jaw 18 is achieved when the upper beam portion 30 moves distally past the ramp 34 and reaches the track feature 32. Proximal movement of the upper beam portion 30 away from the ramp 34 removes the closing force applied to the upper jaw 18 by the beam member 28. The elastic device or auxiliary mechanism can then open the closed or partially closed upper jaw 18. Therefore, the reciprocating motion of the upper beam portion 30 along the ramp 34 can open and close the end effector 16.

[0046] The beam member 28 also includes a lower beam portion 38 configured to slide within a track feature of the lower jaw 18. The lower beam portion 38 can actuate a slide plate (such as those disclosed in Publication No. US 2014 / 0183244A1) configured to eject the stitcher from the lower jaw 26 during distal movement of the beam member 28. Alternatively, the lower beam portion 38 can be integrated with such a slide plate.

[0047] Figure 9 A view of beam member 28 is shown. Here, the upper beam portion 30 includes an integrated cutting member 40 configured to cut tissue. However, in other embodiments, the tissue cutting device may be separate from or implemented into beam member 28 in a different manner. The upper beam portion 30 includes an upper flange 42 that extends laterally from the integrated cutting member 40. The upper flange 42 is configured to be directly integrated with track feature 32 and ramp 34. In a similar manner, lower flange 44 is configured to slide along the track feature of jaws 26. An elongated actuation assembly 46 is attached to beam member 28 for providing distal and proximal movement to beam member 28.

[0048] Figures 10 to 12A cross-sectional view of beam member 28 and actuation assembly 46 is shown. Actuation assembly 46 includes a push assembly 48 and a traction assembly 50. In the illustrated embodiment, push assembly 48 is configured as a tightly coiled spring and adapted to transmit compressive force from drive rod 52 to beam member 28. Push assembly 48 may be externally constrained by a sheath 54, which may be made of any suitable material, such as, for example, a lubricating polymer material like PTFE. The coiled design of push assembly 48 allows the compressive force to be effectively translated to beam member 28 to push beam member 28 in a distal direction. Push assembly 48 can be constructed in any suitable manner. For example, in some embodiments, push assembly 48 is made of coiled wire. In some embodiments, push member 48 is helically cut from a tube. In some cases, the compressive element (e.g., coil) of push assembly will separate under tension, and therefore in such cases, push assembly may be primarily used to transmit compressive force.

[0049] The traction assembly 50 may consist of any suitable element or more capable of reacting to tensile loads (e.g., braided cables or flexible rods). In the illustrated embodiment, the traction assembly 50 is held within the beam member 28 by a coiled portion 56. In some cases, the traction assembly 50 may relatively ineffectively transfer compressive forces from the drive rod 52 to the beam member 28 because it itself may have a tendency to collapse or bend, and therefore in such cases, the traction assembly 50 may primarily serve to transmit tension. The traction assembly 50 is adapted to transmit the tension applied by the drive rod 52 to the beam member 28. The drive rod 52 is located within the instrument shaft 14 and is caustically coupled to... Figure 1 One or more of the input couplers 22 shown. The traction assembly 50 allows tension to be efficiently transmitted from the drive rod 52 to the beam member 28, tractioning the beam member 28 in a proximal direction. The push assembly 48 and the traction assembly 50 operate in a complementary manner to provide distal and proximal movement to the beam member 28 by transmitting tension via the traction assembly 50 and compressive force via the push assembly 48. The transmission of tension via the traction assembly 50 and compressive force via the push assembly 48 enables the actuation assembly 46 to have a very flexible and compact design, characterized by allowing the actuation assembly 46 to translate within a wrist 24, which can be positioned at relatively large yaw and pitch angles during operation.

[0050] The actuating component 48 may have a cylindrical outer diameter to provide a substantially continuous outer profile and larger / harder line segments for a given fixed inner and outer diameter. For example, Figure 13 and Figure 14 A push assembly 48a is shown, which has a cylindrical outer surface 48aos. The push assembly 48a can be manufactured using any suitable method, such as grinding a coiled spring to form the cylindrical outer surface 48aos.

[0051] The actuating component 48 may include a tightly wound spring having interconnected convex / concave surfaces. For example, Figure 15 and Figure 16 A push assembly 48b is shown, which has interconnected convex / concave surfaces nested with adjacent sections of the coil to increase the distribution of contact stress and improve column stability relative to the coiled spring.

[0052] Driven component 48 is not limited to Figures 10 to 16 The tightly wound spring design shown is illustrated. For example, Figures 17 to 19 Flexible actuation components 48c, 48d, and 48e are shown, which can be formed from a solid tube by locally cutting a pattern into a solid tube near the wrist 24 to increase the bending flexibility of the actuation component at the wrist 24 without substantially reducing compressive stiffness. Actuation components 48c, 48d, and 48e can be formed by laser cutting a pattern into a tube made of any suitable material (e.g., a suitable metal, a suitable polymer-based material). Figure 17 In the push assembly 48c shown, the pattern enhances the flexibility of forming gaps in the tube and maintains the axial stiffness of keeping the material in place. Figure 18 The actuating assembly 48d shown has multiple circumferential slits arranged in a spiral pattern. Figure 19 In the push assembly 48e shown, the pattern forms separate interlocking segments, which provide flexibility while suppressing relative misalignment of the interlocking segments.

[0053] The drive component 48 can be formed by any suitable configuration of separate interface segments. For example, Figure 20 A push assembly 48f made of a stack of flat washers is shown. Figure 21 and Figure 22 A 48g pusher assembly made of stacked annular disks is shown. Figure 23 and Figure 24 A push assembly 48h, made of a stack of conical washers, is shown. Each of the conical washers has a non-planar interface surface (e.g., a spherical interface surface), which interact to suppress relative lateral movement of the conical washers to enhance alignment with a traction assembly 50 extending through the center of the conical washers. Due to the shape of the conical washers, the push assembly 48h accommodates bending in any direction transverse to the local axial direction of the actuation assembly 46 via relative sliding in any direction between adjacent conical washers.

[0054] The drive component 48 can be formed by stacking any suitable non-axisymmetric interface segments. For example, Figure 25 A push assembly 48i made of a stack of separate, non-axisymmetric components 70 is shown. Figure 26A different view of one of the components 70 is shown. In the illustrated embodiment, component 70 has a laterally oriented protruding region 72 and a laterally oriented recessed region 74, the recessed region 74 being shaped to receive and abut against the protruding region 72 of an adjacent component 70. The protruding region 72 and the recessed region 74 are shaped to limit relative sliding between adjacent components 70 with respect to region 72, the region 74 extending laterally to the local extension direction of the actuating assembly 48i. Interface regions 72 and 74 also serve to suppress relative torsion between adjacent components 70 about the local extension direction of the actuating assembly 48i, thereby suppressing torsion of the actuating assembly 48i between its proximal and distal ends.

[0055] The actuation component 46 may include a stack of elongated metal strips. For example, Figure 27 It shows Figures 1 to 6 A cross-sectional view of the actuation assembly 46j of a surgical instrument. The actuation assembly 46j includes an elongated metal strip 76 configured to respond to both compressive and tensile loads, while accommodating torsional forces transverse to the plane of the actuation assembly 46j and along its length. The actuation assembly 46j includes an outer sheath 78 having a rectangular channel 80 through which the metal strip 76 extends from the proximal end to the distal end of the actuation assembly 46j. The outer sheath 78 constrains the stacking of the metal strips 76 to prevent lateral buckling of the metal strips 76 when subjected to compressive loading during distal advance of the beam member 28. Figure 28 The torsion of the actuation assembly 46j and the associated torsion of the metal strip 76 are shown in response to the rotation of the end effector 16 relative to the instrument axis 14. Figure 29 The diagram shows the deflection of the metal strip 76 near the wrist assembly 24 in response to the reorientation of the end effector 16 relative to the instrument axis 14.

[0056] The actuation assembly 46 may include a stack of elongated metal strips for transmitting tensile loads between the drive rod 52 and the beam member 28, and a stack of rectangular washers for transmitting compressive loads between the drive rod 52 and the beam member 28. For example, Figure 30An isometric view of an actuation assembly 46k is shown. The actuation assembly 46k includes a stack of metal strips 76 attached to and extending between and from the drive rod 52 and the beam member 28. In the actuation assembly 46k, the metal strips 76 transfer tensile loads from the drive rod 52 to the beam member 28 during proximal retraction. The actuation assembly 46k further includes a stack of rectangular washers 82 that transfer compressive loads from the drive rod 52 to the beam member 28 during distal advancement. The actuation assembly 46k further includes an inner sheath 84 having a cavity accommodating the rectangular washers 82 and an outer sheath 86 having a cavity accommodating the inner sheath 84. In the illustrated embodiment, the outer sheath 86 has a series of grooves 88 near the wrist assembly 24 to increase the flexibility of the outer sheath 86 to flex laterally across the plane of the metal strips 76 in response to reorientation of the end effector 16 relative to the instrument axis 14 via the wrist 24.

[0057] The actuation assembly 46 may include a plurality of flexible actuating rods. For example, Figure 31 It shows Figures 1 to 6 A side view of the distal portion of the actuation assembly 46m of a surgical instrument. The actuation assembly 46m includes three flexible actuating rods 90 adapted to transmit tension from the drive rod 52 to the beam member 28 and compressive force from the drive rod 52 to the beam member 28m. The three flexible actuating rods 90 are aligned in a common plane to accommodate bending of the actuating rods 90 transverse to the common plane. Each of the three flexible actuating rods 90 is arranged between the drive rod 52 and the beam member 28m to accommodate torsion of the actuating rod 90 in response to rotation of the end effector 16 relative to the instrument axis 14. Figure 32 An end view of the beam member 28m of the actuation assembly 46g is shown, which shows a hole 92 in the beam member 28m, through which the actuation rod 90 is coupled to the beam member 28m.

[0058] The actuation assembly 46 may replace the traction assembly 50 with an element that transfers compressive and tensile loads from the drive rod 52 to the beam member 28. For example, Figure 33An actuation assembly 46n is shown, which includes a nickel-titanium wire 50a in place of the traction assembly 50. The nickel-titanium wire 50a transmits compressive and tensile loads from the drive rod 52 to the beam member 28 for distal advancement and proximal retraction of the beam member 28. In the illustrated embodiment, the actuation assembly 46n includes a spring 48n, which may be a tightly coiled spring, but is not required. The spring 48n may be configured to share the transmission of compressive loads from the drive rod 52 to the beam member 28 with the nickel-titanium wire 50a during distal advancement of the beam member 28. The spring 48n may also be configured not to share the transmission of compressive loads from the drive rod 52 to the beam member 28 with the nickel-titanium wire 50a during distal advancement of the beam member 28. In many embodiments, the primary function of the spring 48n is to provide radial support to the nickel-titanium wire 50a such that the diameter of the nickel-titanium wire is consistent with the diameter of the drive rod 52. The nickel-titanium wire 50a can be attached to each of the beam member 28 and the drive rod 52 by any suitable method, such as, for example, forging brazing, welding, etc.

[0059] In some embodiments of the actuation assembly 46, the pushing member 48 is disposed within the cavity of the traction member 50. For example, Figure 34 An actuation assembly 46o is shown, comprising a push assembly 48o and a traction assembly 50o having an inner cavity in which the push assembly 48o is disposed. The configuration of the actuation assembly 46o differs from other embodiments described herein, wherein the push assembly 48o concentrically surrounds the traction assembly 50o. In the actuation assembly 46o, the traction assembly 50o includes a sheath (e.g., a braided sheath) encapsulating the push assembly 48o. The push assembly 48o includes a plurality of spherical members (e.g., ball bearings) coupled by a flexible rod 66. Both the push assembly 48o and the traction assembly 50o are actuated by a drive rod 52, which is dromatically coupled to... Figure 1 One or more of the input couplers 22 shown.

[0060] Figure 35 and Figure 36 Perspective and sectional views of the wrist assembly 24 are shown. The wrist assembly 24 includes a proximal outer link 100, an intermediate outer link 102, and a distal outer link 104. These three links determine the pitch and yaw motions of the wrist assembly 24. As shown, the interface between the proximal outer link 100 and the intermediate outer link 102 determines the yaw motion of the wrist assembly 24. The interface between the distal outer link 104 and the intermediate outer link 102 determines the pitch motion of the wrist assembly 24. However, in an alternative wrist configuration, this relationship can be reversed, such that the wrist assembly 24 pitches between the proximal outer link 100 and the intermediate outer link 102 and yaws between the distal outer link 100 and the intermediate outer link 102 (e.g., by rotating the end effector 16 90 degrees relative to the wrist assembly 24).

[0061] The cable portion 106 tensions the wrist assembly 24 and actuates to apply movement to the wrist assembly. In one embodiment, the cable portion 106 may be individually secured to a portion of the distal outer link 104. In functionally equivalent alternative embodiments, such as Figure 35 As shown, cable portion 106 loops around a portion of distal outer link 104. Looping cable portion 106 around distal outer link 104 secures cable portion 106 to distal outer link 104 and prevents cable portion 106 from slipping. In any embodiment, tension is applied to a single cable portion 106 to be pulled to articulate the wrist. Differential forces applied to cable portion 106 can actuate the wrist assembly to pitch and yaw at various angles. Cable portion 106 can be driven to couple to... Figure 1 One or more input couplers 22 are shown. The wrist assembly also includes a proximal inner link 108 and a distal inner link 110, which will be discussed in detail below.

[0062] Notice Figure 37 It shows an exemplary embodiment of connector 112, which is illustrated in Figure 53 and Figure 36 The interface between the external links is shown. Connector 112 includes a first link 114 and a second link 116. The first link 114 may include teeth 116 and 118 and a bearing protrusion 122. Disc 720 may include pins 124, 126, and 128 and a bearing protrusion 130. According to an exemplary embodiment, the protrusions 122 and 130 of the first link 114 and the second link 116 may include channels allowing cable portions 106 to pass through. Because the bearing protrusions 122 and 130 are located outside the central bores 134 and 136, the cable portion 106 extending through the channels adjacent to the bearing protrusions 122 and 130 is also located outside. This allows transmission through other mechanisms of the central bores 134 and 136. The actuation motion between the links is determined by the shape of the pins and teeth that engage and disengage during motion. Bearing protrusions 122 and 130 include curved surfaces that engage at a point throughout the angular motion to help reduce compressive strain on the pins and teeth.

[0063] Due to the enhanced range of motion provided by joint 112, the wrist including joint 112 can provide the desired amount of motion, such as + / - 90 degrees in the pitch or yaw directions, in a more efficient manner with fewer parts. In previous wrist structures where each joint was limited to a maximum roll angle of approximately 45 degrees, several such tandem joints were required for the entire wrist mechanism to achieve a relatively large roll angle. As shown, a single joint can provide a roll angle limit of up to 90 degrees. As a result, the manufacturing cost and complexity of wrists including one or more joints 112 can be reduced while still achieving the desired control of the articulation. Additionally, the multiple teeth and corresponding multiple pins included in links 114 and 116 of joint 112 provide enhanced timing to help precisely position links 114 and 116, including, for example, returning the disc to a neutral position (e.g., zero-angle roll alignment), and enhance the smoothness of movement between links 114 and 116, such as when links 114 and 116 rotate relative to each other. According to an exemplary embodiment, the wrist may include multiple joints 112 to achieve a greater range of motion (reaching roll-limiting angles), such as, for example, a wrist with a range of motion of up to + / - 180 degrees in the pitch or yaw direction. Additional details regarding joints 112 and other joints that may be used with the embodiments disclosed herein are disclosed in International Publication No. WO 2015 / 127250, which is incorporated herein by reference.

[0064] like Figure 36 As shown, the proximal inner link 108 and the distal inner link 110 are spatially separated along axis 1 and offset from each other by 90 degrees. Therefore, only the proximal inner link 108 is shown in part. The radial surfaces of the proximal inner link 108 and the distal inner link 110 include protrusions (e.g., configured as U-shaped clamps 140). The U-shaped clamps connect between recesses (e.g., configured as U-shaped clamps 142) on the intermediate surface of the outer link. The U-shaped clamps 140 and the clamps 142 define the distance between the clamps of the outer link, which is otherwise passive and does not change the joint mobility of the outer link, which is determined by the tooth and pin geometry. Each side of the proximal inner link 108 and the distal outer link 110 includes a commonly aligned U-shaped clamp for each connection of the outer link to a total of four U-shaped clamps to each inner link 108, 110. Each pair of U-shaped clamps 140 is separated to provide an internal channel 144 for the actuation assembly 46.

[0065] An additional inner sheath 146 is provided for further support of the actuation assembly 46. The actuation assembly 46 slides axially within the inner sheath 146. The inner sheath 146 is fixed to the distal portion of the wrist assembly 24 and flexes flexibly with the movement of the wrist assembly 24, but does not move axially. The inner sheath 146 and the inner channel 144, provided by the inner link, are used to guide and constrain the actuation assembly 46 during axial movement. The inner sheath 146 and the inner channel 144 prevent the actuation assembly from buckling under compressive loads (i.e., distal movement during cutting and mating). Previous wrist designs, such as those disclosed in the aforementioned International Publication No. WO 2015 / 127250, rely on a tensioned cable to hold the outer link in place. This is unsatisfactory because the compressive force generated when the actuation assembly 46 moves in the distal direction can cause the cable to slack. However, when the actuation assembly 46 moves in the distal direction, the U-shaped clamps 140 of the inner links 108 and 110 advantageously hold the outer link in place, thus maintaining the structure of the wrist assembly 24.

[0066] Each internal link may have, for example: Figures 38 to 40 The two-piece structure shown also depicts the technique used to assemble the inner link to the outer link. Figure 38 In the middle, the first link portion 108a and the second link portion 108b of the proximal inner link 108 are positioned to place the U-shaped clamp 140 into the U-shaped clamp 142 of the intermediate outer link 102. The first link portion 108a and the second link portion 108b are inserted at a certain angle such that the gear teeth 148 of each portion mesh with each other, so that these portions are aligned with... Figure 39 In the illustrated configuration, gear teeth 148 are assembly aids that do not require pins or other fasteners and are not used for movement outside of assembly. However, in some embodiments, fasteners may be used instead of gear teeth. After connecting rod portions 108a and 108b are assembled into the complete inner proximal connecting rod 108, the proximal outer connecting rod 100 is assembled onto the remaining exposed U-shaped clamping pin 140, becoming... Figure 40 The construction shown. In one embodiment, as Figure 40 As shown, the near-side outer connecting rod 100 is also a two-piece structure.

[0067] Other variations are within the spirit of the invention. Various aspects, embodiments, implementations, or features of the described embodiments may be used alone or in any combination. Various aspects of the described embodiments associated with the operation of surgical instruments may be implemented in software, hardware, or a combination of hardware and software. Therefore, while the invention is readily adaptable to various modifications and alternative configurations, certain illustrative embodiments thereof have been shown in the accompanying drawings and described in detail above. However, it should be understood that the invention is not intended to be limited to one or more specific forms disclosed; rather, the invention is intended to cover all modifications, alternative configurations, and equivalents falling within the spirit and scope of the invention as defined in the appended claims.

[0068] Unless otherwise stated herein or obviously contradicted by the context, the use of the terms “a” and “an” and “the”, and similar indicators, in the context of describing the invention (particularly in the context of the appended claims), shall be construed as encompassing both the singular and plural. Unless otherwise stated, the terms “comprising,” “having,” “including,” and “containing” shall be construed as open-ended terms (i.e., meaning “including but not limited to”). The term “connected” shall be construed as partially or wholly contained, attached, or joined together, even with some interference. Unless otherwise stated herein, the description of numerical ranges herein is intended only as a shorthand method of individually referring to each individual value falling within the range, and each individual value is incorporated into this specification as if it were individually referenced herein. Unless otherwise stated herein or obviously contradicted by the context, all methods described herein may be performed in any suitable order. Unless otherwise stated, the use of any and all examples or exemplary language (e.g., “such as”) provided herein is intended only to better illustrate embodiments of the invention and does not constitute a limitation on the scope of the invention. Nothing in the specification should be construed as indicating that any unclaimed element is essential to the practice of the invention.

[0069] This document describes preferred embodiments of the invention, including the best mode known to the inventors for carrying out the invention. Variations of those preferred embodiments will become apparent to those skilled in the art upon reading the foregoing description. The inventors expect those skilled in the art to appropriately employ these variations, and the inventors desire that the invention be practiced in ways different from those specifically described herein. Therefore, the invention includes all modifications and equivalents of the subject matter described in the appended claims as permitted by applicable law. Furthermore, unless the context clearly contradicts this, the invention includes any combination of all possible variations of the foregoing elements.

Claims

1. A surgical device, comprising: An end effector, the end effector comprising an upper jaw and a lower jaw; Instrument axis; A wrist assembly movably connects an end effector to an instrument axis, wherein the wrist assembly is operable to hinge the end effector relative to the instrument axis about two orthogonal axes relative to the instrument axis, wherein the wrist assembly includes an inner sheath, a proximal outer link, a proximal inner link, an intermediate outer link, a distal inner link, and a distal outer link, wherein the intermediate outer link is pivotally coupled to the proximal outer link via the proximal inner link for hinged relative to the proximal outer link about a first axis of the two orthogonal axes, wherein the distal outer link is pivotally coupled to the intermediate outer link via the distal inner link for hinged relative to the intermediate outer link about a second axis of the two orthogonal axes, wherein each of the proximal inner link and the distal inner link includes an internal channel through which the inner sheath extends, and wherein the inner sheath flexibly bends with movement of the wrist assembly but does not move axially; A beam member arranged to translate within the upper jaw and the lower jaw, the beam member having a first portion for movably coupling to the upper jaw and a second portion for movably coupling to the lower jaw; as well as An actuation assembly including a pushing assembly and a traction assembly, the pushing assembly including a plurality of spherical members, wherein the traction assembly defines an inner cavity receiving the plurality of spherical members and is configured to transmit tension to the beam member, wherein the pushing assembly is configured to transmit compressive force to the beam member, wherein the actuation assembly extends through the inner channel, and wherein during movement of the actuation assembly relative to the inner sheath, the inner sheath guides and constrains the actuation assembly.

2. The surgical device of claim 1, wherein the traction assembly comprises a braided sheath.

3. The surgical device of claim 1, wherein the spherical member is connected by a flexible rod.

4. A surgical instrument, comprising: An end effector, the end effector comprising an upper jaw and a lower jaw; Instrument axis; A wrist assembly movably connects an end effector to an instrument axis, wherein the wrist assembly is operable to hinge the end effector relative to the instrument axis about two orthogonal axes relative to the instrument axis, wherein the wrist assembly includes an inner sheath, a proximal outer link, a proximal inner link, an intermediate outer link, a distal inner link, and a distal outer link, wherein the intermediate outer link is pivotally coupled to the proximal outer link via the proximal inner link for hinged relative to the proximal outer link about a first axis of the two orthogonal axes, wherein the distal outer link is pivotally coupled to the intermediate outer link via the distal inner link for hinged relative to the intermediate outer link about a second axis of the two orthogonal axes, wherein each of the proximal inner link and the distal inner link includes an internal channel through which the inner sheath extends, and wherein the inner sheath flexibly bends with movement of the wrist assembly but does not move axially; A beam member arranged to translate within the upper jaw and the lower jaw, the beam member having a first portion for movably coupling to the upper jaw and a second portion for movably coupling to the lower jaw; as well as An actuation assembly including a pushing assembly and a traction assembly, the pushing assembly including a plurality of spherical members and transmitting compressive force to the beam member, the traction assembly defining an inner cavity receiving the spherical members and transmitting tension to the beam member, wherein the actuation assembly extends through the inner channel, and wherein during movement of the actuation assembly relative to the inner sheath, the inner sheath guides and constrains the actuation assembly.

5. The surgical instrument of claim 4, wherein the spherical member is connected by a flexible rod.

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