Guiding mechanism for surgical instruments and related devices, systems and methods

Abstract

The present application relates to guide mechanisms for surgical instruments and related devices, systems and methods. According to an exemplary embodiment, a surgical instrument includes a shaft and an actuating member that extends through a bore of the shaft and is operably coupled to an end effector. A sleeve is disposed around the actuating member and is located within the bore of the shaft. A flux conduit configured to deliver surgical flux to the end effector is at least partially received within a negative feature of the sleeve. According to another exemplary embodiment, a surgical instrument includes a shaft, a wrist mechanism that couples the end effector to the shaft, and an actuating member operably coupled to the end effector. The sleeve surrounds the actuating member and has a straight channel. A flux conduit operably coupled to the end effector is received within the straight channel. A portion of the flux conduit is loose in an area of ​​the shaft through which the sleeve does not extend.

Description

[0001] This application is a divisional application. The application date of the original application is May 15, 2017, the application number is "201780049812.7", and the name of the invention is "Guiding mechanism for surgical instruments and related equipment, systems and methods". Technical Field

[0002] This application claims priority to U.S. Provisional Application No. 62 / 362,344, filed on July 14, 2016, and U.S. Provisional Application No. 62 / 362,357, also filed on July 14, 2016, both of which are incorporated herein by reference in their entirety.

[0003] Aspects of the present disclosure relate to surgical instruments, related components, related systems, and related methods. Background Art

[0004] The benefits of minimally invasive surgery are well known and include less patient trauma, less blood loss, and faster recovery time compared to traditional open incision surgery. In addition, it is known to use remotely operated computer-assisted surgical systems (e.g., robotic systems that provide telepresence), such as the da Surgical Systems. Such teleoperated surgical systems may allow surgeons to operate with intuitive control and increased precision compared to manual minimally invasive surgery.

[0005] A remotely operated surgical system may include one or more surgical instruments or tools. Such tools may have various configurations to perform various types of surgical procedures. For example, a surgical instrument may be an electrosurgical instrument configured to seal, fuse, blend, ablate, cauterize, or otherwise treat tissue by applying electrical flux energy.

[0006] The physical size of instruments used for minimally invasive surgery can be relatively small in order to achieve the benefits associated with minimally invasive surgery described above. Therefore, space for various components of the instrument may be limited, such as actuation cables and / or rods for remotely controlling movement of the instrument and flux conduits (e.g., electrical conductors that are connected to an energy source of a surgical system and configured to transmit electrical current to an end effector of an electrosurgical instrument). Other flux conduits may include tubes for conveying gases or liquids, etc. It is desirable to provide surgical instruments and components thereof that facilitate efficient guidance and accommodation of various components (including flux conduits).

[0007] Furthermore, in instruments that include one or more connectors (e.g., toward the distal end portion of the instrument), additional space issues arise due to the need to route multiple cables through the instrument to provide actuation of the connector and / or end effector. It is desirable to provide a small diameter surgical instrument while providing multiple components for actuation, flux transmission, and other instrument functions. Summary of the invention

[0008] Exemplary embodiments of the present disclosure may solve one or more of the above problems and / or may exhibit one or more of the above desirable features.Other features and / or advantages may become apparent from the following description.

[0009] According to at least one exemplary embodiment, a surgical instrument includes a shaft having a proximal end, a distal end, and a bore extending from the proximal end to the distal end. The surgical instrument also includes an end effector coupled to the distal end of the shaft, and an actuating member extending through the bore of the shaft and operably coupled to the end effector. A sleeve is disposed around the actuating member and is located within the bore of the shaft. The sleeve includes a negative feature in the wall thickness of the sleeve, the negative feature extending along at least a portion of the length of the sleeve. A flux conduit configured to deliver surgical flux to the end effector extends from the proximal end of the shaft to the end effector, the flux conduit being at least partially received within the negative feature of the sleeve.

[0010] According to at least one exemplary embodiment, a method of forming a surgical instrument includes guiding an actuation member through a central bore of an instrument shaft and operably coupling the actuation member to an end effector at a distal end. The method also includes positioning a sleeve within the bore and at least partially surrounding the actuation member and operably coupling a flux conduit to the end effector so that the flux conduit can deliver surgical flux to the end effector. The method also includes guiding the flux conduit through the bore of the instrument shaft to the end effector by at least partially disposing at least a portion of the length of the flux conduit within a negative feature provided in a wall thickness of the sleeve.

[0011] According to at least one exemplary embodiment, a surgical instrument may include a shaft having a proximal end, a distal end, and a bore extending from the proximal end to the distal end. The surgical instrument may also include an end effector and a wrist mechanism coupling the end effector to the distal end of the shaft, the wrist mechanism being configured to articulate relative to the shaft about a neutral position. In addition, the surgical instrument may include an actuating member extending through the bore of the shaft and the wrist mechanism, the actuating member being operably coupled to the end effector. A sleeve may surround the actuating member at least within the wrist mechanism, the sleeve having a straight channel radially offset from the actuating member and extending along the sleeve at least within the wrist mechanism. A flux conduit may extend from the proximal end through the bore of the shaft to the distal end, the flux conduit being operably coupled to the end effector, the flux conduit being received within the straight channel of the sleeve, wherein a portion of the flux conduit is slack in a region of the shaft through which the sleeve does not extend.

[0012] According to at least one exemplary embodiment, a method of forming a surgical instrument may include guiding an actuation member through a central bore of an instrument shaft and operably coupling the actuation member to an end effector at a distal end, positioning a sleeve within the bore and at least partially surrounding the actuation member, and operably coupling a flux conduit to the end effector so that the flux conduit can deliver surgical flux to the end effector. The method may also include guiding the flux conduit through the bore of the instrument shaft to the end effector, wherein guiding includes at least a portion of the length of the flux conduit being at least partially disposed within a negative feature provided in a wall thickness of the sleeve, and forming a slack portion in the flux conduit at least when the wrist mechanism is in a neutral position, the slack portion being configured to move into and out of the negative feature in response to articulation of the wrist mechanism.

[0013] Other purposes, features and / or advantages will be explained in part in the following description, and in part will be obvious from the description, or can be learned by the practice of this disclosure and / or claims. At least some of these purposes and advantages can be realized and obtained by the elements and combinations particularly pointed out in the appended claims.

[0014] It is to be understood that both the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of the claims; rather, the claims should be entitled to their full scope, including equivalents. BRIEF DESCRIPTION OF THE DRAWINGS

[0015] The present disclosure can be understood from the following detailed description alone or together with the accompanying drawings. The accompanying drawings are included to provide a further understanding of the present disclosure, and the accompanying drawings are incorporated in and constitute a part of this specification. The accompanying drawings illustrate one or more exemplary embodiments of the present teachings and together with the description are used to explain certain principles and operations. In the accompanying drawings,

[0016] Figure 1A is a front view of an exemplary embodiment of a patient side cart of a teleoperated surgical system;

[0017] Figure 1B is a partial schematic diagram of an exemplary embodiment of a manipulator arm of a patient side cart with two electrosurgical instruments in an installed position, one of the two electrosurgical instruments being shown in electrical communication with a flux generator;

[0018] Figure 2 is a perspective view of an exemplary embodiment of a surgical instrument including an end effector;

[0019] Figure 3 is a cross-sectional view of an instrument and associated end effector according to an exemplary embodiment;

[0020] Figure 4 is based on Figure 3 Detailed partial perspective interior view of the instrument and end effector of an exemplary embodiment of the present invention;

[0021] Figure 5 is a partial detailed cross-sectional view of an instrument actuation cable, sleeve, and electrical conductors according to an exemplary embodiment;

[0022] Figure 6 is a partial detailed cross-sectional view of an instrument actuation cable, sleeve, and electrical conductors according to an exemplary embodiment;

[0023] Figure 7 is a partial detailed cross-sectional view of an instrument actuation cable, sleeve, and electrical conductors according to an exemplary embodiment;

[0024] Figure 8 is a partial perspective interior view of an interior portion of an instrument shaft, an end effector, and electrical conductors according to an exemplary embodiment;

[0025] Fig. 9 is a partial perspective interior view of an interior portion of an instrument shaft, sleeve, and electrical conductors according to an exemplary embodiment;

[0026] Fig.10 is a schematic diagram of a monopolar electrosurgical instrument according to an exemplary embodiment;

[0027] Fig.11 is a cross-sectional view of a distal end portion of a surgical instrument including a wrist and an end effector according to another exemplary embodiment;

[0028] Fig.12 yes Fig.11 A perspective view of the interior of the device;

[0029] Fig.13is a perspective view of a sleeve according to another exemplary embodiment;

[0030] Fig.14 is a perspective view of a sleeve according to yet another exemplary embodiment;

[0031] Fig.15 is a cross-sectional view of a sleeve according to yet another exemplary embodiment. DETAILED DESCRIPTION

[0032] The present disclosure contemplates various exemplary embodiments of surgical instruments configured to accommodate multiple components within the shaft of the instrument while maintaining a relatively small diameter of the shaft. For example, the surgical instruments of the present disclosure may be configured to accommodate one or more actuation members, such as one or more cables and / or rods, one or more electrical conductors, and a sleeve to support and orient the one or more actuation members within the bore of the shaft while maintaining a relatively small outer diameter of the shaft.

[0033] In order to maintain a relatively small diameter of the instrument shaft while being configured to accommodate the various components described above, the present disclosure contemplates various exemplary embodiments of surgical instruments having one or more flux conduits guided through a negative feature (e.g., a recess) of a sleeve, wherein the negative feature is disposed in a bore of the shaft of the surgical instrument and surrounds an actuating member extending along the shaft. In exemplary embodiments, the flux conduit may be an electrical conductor configured to transmit electrosurgical energy of the instrument. One or more flux conduits may be positioned in a negative feature formed in the sleeve. The negative feature may include a relief, a recess, a groove, etc. formed in the sleeve and configured to receive the flux conduit. The negative feature may follow a straight path along the length of the sleeve, a spiral path along the length of the sleeve, or a combination thereof; other geometries are also contemplated. In some exemplary embodiments, the negative feature may extend completely through the wall thickness of the sleeve from the inner surface of the sleeve to the outer surface of the sleeve. In some exemplary embodiments, the negative feature may extend partially into the wall thickness of the sleeve from the inner surface of the sleeve or from the outer surface of the sleeve. In some exemplary embodiments, the negative feature may extend through a central portion of the wall thickness of the sleeve, between the inner and outer surfaces. In some exemplary embodiments, the sleeve may include a plurality of separate sleeve segments, and the sleeve segments may be longitudinally spaced apart along the length of the shaft, such as by spacers. In some exemplary embodiments, the sleeve may include a relief (e.g., a cut, slit, etc.) formed partially or completely through the wall thickness of the sleeve to facilitate bending the sleeve in an area near the joint structure (e.g., wrist) of the shaft.

[0034] In some exemplary embodiments, the electrical conductor may be surrounded by an electrically insulating material, and the electrical conductor and the insulating material may be disposed within the negative feature of the sleeve. The electrical conductor may be separated from the sleeve by the electrically insulating material. In some exemplary embodiments, the sleeve may include an electrically insulating material, and the electrical conductor may be disposed in direct contact with the surface of the sleeve within the negative feature. In other exemplary embodiments, the electrical conductor may be surrounded by an electrically insulating material, and the electrical conductor and the insulating material may be spirally wound around the actuating member to form a sleeve. In other words, the sleeve may be formed entirely of an electrically insulating material surrounding the electrical conductor.

[0035] Exemplary embodiments of the present disclosure provide surgical instruments that maintain desired functionality while exhibiting desired small dimensions, such as the diameter of the instrument shaft. Additionally, exemplary embodiments of the present disclosure can provide such advantages while being configured for ease of manufacture, assembly, overall low cost, and the like.

[0036] As described above, according to various exemplary embodiments, the surgical instrument of the present disclosure is configured for use in a teleoperated computer-assisted surgical system (sometimes referred to as a robotic surgical system). Figure 1A , shows an exemplary embodiment of a patient side cart 100 of a teleoperated computer assisted surgical system to which surgical instruments are configured to be mounted for use. This surgical system may also include a surgeon console (not shown) for receiving input from a user to control instruments of the patient side cart 100, and an auxiliary control / vision cart (not shown), for example, as described in U.S. Publication No. US 2013 / 0325033, entitled “Multi-Port Surgical Robotic System Architecture,” published on December 5, 2013, and U.S. Publication No. US 2013 / 0325031, entitled “Redundant Axis and Degree of Freedom for Hardware Constrained Remote Center Robotic Manipulator,” published on December 5, 2013, each of which is incorporated herein by reference in its entirety. Non-limiting exemplary embodiments of teleoperated surgical systems that may utilize the principles of the present disclosure include the da (Model no.IS3000) Surgical systems, Single Site da Surgical system, or da Surgical Systems. However, one of ordinary skill in the art will appreciate that the present disclosure may be applied to a variety of surgical systems, including automated or manual (handheld) laparoscopic surgical systems.

[0037] like Figure 1A As shown in the exemplary embodiment of the present invention, the patient side cart 100 includes a base 102, a main column 104, and a main boom 106 connected to the main column 104. The patient side cart 100 also includes a plurality of arms 110, 111, 112, 113, each of which is connected to the main boom 106. The arms 110, 111, 112, 113 each include an instrument mounting portion 120 to which an instrument 130 can be mounted, which is shown attached to the arm 110. According to commands provided by a user at the surgeon's console, portions of the arms 110, 111, 112, 113 can be manipulators during a surgical procedure. In an exemplary embodiment, the signal(s) or input(s) transmitted from the surgeon's console are transmitted to the control / vision cart, which can interpret the input(s) and generate the command(s) or output(s) to be transmitted to the patient side cart 100 to cause the manipulation of the instrument 130 (only one such instrument is mounted on the surgeon's console) to occur. Figure 1A ) and / or a portion of the arm 110 to which the instrument 10 is coupled at the patient side cart 100.

[0038] According to an exemplary embodiment, the instrument mounting portion 120 includes an actuation interface assembly 122 and a cannula mount 124, wherein a force transfer mechanism 134 of the instrument 130 is connected to the actuation interface assembly 122. The cannula mount 124 is configured to hold a cannula 136 through which the shaft 132 of the instrument 130 can extend to the surgical site during a surgical procedure. As is familiar to those skilled in the art, the actuation interface assembly 122 contains various drive and other mechanisms that are controlled to respond to input commands at the surgeon's console and transfer force to the force transfer mechanism 134 to actuate the instrument 130.

[0039] although Figure 1A The exemplary embodiment of the present invention shows the instrument 10 attached only to the arm 110 for ease of viewing, but the instrument can be attached to any and each of the arms 110, 111, 112, 113. The instrument 10 can be a surgical instrument having an end effector as discussed herein. The surgical instrument having an end effector can be attached to and used with any of the arms 110, 111, 112, 113. However, the embodiments described herein are not limited to Figure 1A The exemplary embodiments of the present invention are described herein, and various other teleoperated computer-assisted surgical system configurations may be used with the exemplary embodiments described herein.

[0040] Other configurations of surgical systems are also contemplated, such as surgical systems configured for single-port surgery. Figure 1B , which shows a portion of an exemplary embodiment of a manipulator arm 1000 of a patient side cart with two surgical instruments 1010, 1020 in an installed position. A teleoperated robotic surgical system including a patient side cart having a manipulator arm 1000 may be configured according to exemplary embodiments described in U.S. Patent Application No. 14 / 070,184 filed on November 1, 2013 (titled "FLUX DISAMBIGUATION FOR TELEOPERATED SURGICAL SYSTEMS"), which is incorporated herein by reference. For simplicity, Figure 1B The schematic diagram of FIG. 1 shows only two surgical instruments, but as is familiar to those skilled in the art, more than two surgical instruments may be received in the mounting position at the patient side cart. Each surgical instrument 1010, 1020 includes an instrument shaft 1100, 1110 having a movable end effector at a distal end (see below). Figure 2 Discussion) or a camera or other sensing device, and may or may not include a wrist mechanism (not shown) to control movement of the distal end via articulation about a neutral position relative to the axis.

[0041] exist Figure 1B In an exemplary embodiment of the present invention, the distal end portions of surgical instruments 1010, 1020 are received by a single port structure 1200 for introduction into the patient. Other configurations of patient side carts that can be used in conjunction with the present disclosure can use several separate manipulator arms. In addition, the separate manipulator arms can include a single instrument or multiple instruments. In addition, the instrument can be a surgical instrument with an end effector, or can be a camera instrument or other sensing instrument used to provide information (e.g., visualization, electrophysiological activity, pressure, fluid flow, and / or other sensed data) of a remote surgical site during a surgical procedure.

[0042] Force transfer mechanisms 1070, 1080 are disposed at the proximal end of each shaft 1100, 1110 and are connected to actuation interface assemblies 1030, 1040 through sterile adapters 1050, 1060. Actuation interface assemblies 1030, 1040 include various internal mechanisms (not shown) controlled by a controller (e.g., at a control cart of a surgical system) to transmit force to force transfer mechanisms 1070, 1080 in response to input commands at a surgeon-side console of the surgical system to actuate instruments 1010, 1020. One or more diameters of the instrument shaft, wrist mechanism, and end effector are typically selected based on the size of the cannula to be used with the instrument and depending on the surgical procedure being performed. In various exemplary embodiments, the diameter of the shaft and / or wrist mechanism is, for example, about 4 mm, 5 mm, or 8 mm in diameter to match the size of some existing cannula systems. According to exemplary embodiments, one or more of surgical instruments 1010, 1020 may be communicated with flux source 1300 via flux transfer conduit 1320. For example, if the surgical instrument 1010 is an electrosurgical instrument, the flux delivery conduit 1320 is an electrical energy delivery cable and the flux source 1300 is an electrical energy generator.

[0043] Figure 2 2 is a schematic diagram of an exemplary embodiment of a surgical instrument 200. The surgical instrument 200 may include a force transfer mechanism 210, an end effector 220 at a distal end 224 of the surgical instrument, and a shaft 222 connecting the force transfer mechanism 210 and the end effector 220. The surgical instrument 200 may include one or more components to transfer forces between the force transfer mechanism 210 and the end effector 220. For example, one or more components 226 may connect the force transfer mechanism 210 to the end effector 220 to provide an actuation force to the end effector 220 by extending through an interior (e.g., a bore) of the shaft 222. By utilizing the component(s) 226, the force transfer mechanism 210 may actuate the end effector 220 to, for example, control a movable component of the end effector 220, such as one or more jaws.

[0044] The surgical instrument 200 may also include one or more articulation joints to assist in orienting the end effector. For example, the wrist 228 may be disposed at the distal end 224 of the shaft 222 and couple the end effector 220 to the shaft 222. Thus, the actuation member 226 may be configured to deflect (e.g., by elastic deformation) during articulation of the wrist 228 relative to the shaft about a neutral position. For example, in an exemplary embodiment, the actuation member 226 may include a metallic material, a polymer material, or the like. As a non-limiting example, the actuation member 226 may include a tungsten cable and may be solid, stranded, braided, or the like. The actuation member 226 may be configured as a "push / pull" member. In other words, the actuation member 226 may be configured to transmit the tension and pressure applied to the actuation member 226 to the end effector 220 through the force transfer mechanism 210 to operate the end effector 220 (e.g., to open or close the jaws of the end effector). For example, the actuation member 226 can be alternately translated in distal and proximal directions to operate the end effector 220 (eg, to open and close the jaws 232 , 234 of the end effector 220 ).

[0045] Optionally, the surgical instrument may include an additional wrist mechanism 229, such as Figure 2 Wrist 229 provides additional degrees of freedom of movement for end effector 220. For example, certain coordinated movements of wrist 228 and wrist 229 enable a generally lateral translation of end effector 220, such as Figure 2 Each wrist 228, 229 or additional wrists or other joint structures (not shown) can be associated with a corresponding actuation member extending through the shaft 222, and each of the joint structures (e.g., wrists 228, 229) can be configured to provide a degree of freedom to the end effector 220, such as pitch or yaw.

[0046] In an exemplary embodiment, one or more flux conduits may extend through the instrument shaft 222, e.g., from the force transfer mechanism 210 to the end effector 220. For example, in an exemplary embodiment, the end effector 220 comprises a bipolar electrocautery tool, and two electrical conductors (not shown) extend from the force transfer mechanism 210 and connect to respective jaws 232, 234 of the end effector 220. Electrical energy may be conducted and transmitted through the electrical conductors to the end effector 220 to perform an electrosurgical operation, such as, for example, cauterization, cauterization, sealing, fusing, blending, ablation, and the like.

[0047] Reference now Figure 3 , the distal portion 324 of the instrument shaft 322 is shown in cross section. Figure 4 A jaw 332 of the end effector 320 (332 and 334) is in Figure 3320 and 336, with the other jaw omitted due to cross-section. The wrist joint 328 (also referred to as "wrist 328") is configured to couple the end effector 320 to the shaft 322 and enable articulation of the end effector 320 in one or more degrees of freedom (e.g., pitch and / or yaw). The actuation member 326 extends centrally through the bore 336 of the shaft 322 and is operably connected to the end effector 320 to operate the end effector 320, (e.g., to open and close the end effector 320). Figure 3 The jaws 332, 334 (not shown) in the Figure 3 In the exemplary embodiment of the present invention, the actuation member 326 is a push / pull actuator; however, the present disclosure is not limited thereto, and embodiments having, for example, one or more pull / pull actuators or other actuation member configurations configured to operate the end effector 320 are within the scope of the present disclosure. Figure 3 In an exemplary embodiment of the present invention, the actuation member 326 can be a metal cable, such as a tungsten cable, having a polymer coating, such as an ethylene tetrafluoroethylene copolymer (ETFE) coating. Those skilled in the art will appreciate that various other push / pull flexible actuation member configurations can be used in addition to metal cables.

[0048] The sleeve 338 is disposed in the bore 336 of the shaft 322 between the inner surface of the shaft 322 and the actuation member 326. The sleeve 338 can help to centrally position the actuation member 326 within the bore 336. The sleeve 338 can also protect the actuation member 326 from damage due to contact with components of the instrument shaft 322 (such as components of the wrist joint 328 that may have sharp or rough edges, etc.). In addition, in embodiments where the actuation member 326 is a push / pull element, the sleeve 338 is configured to constrain the bending of the actuation member 326 under compressive forces applied during operation, such as by a force transfer mechanism (e.g., force transfer mechanism 210 ( Figure 2 )) translates the actuation member 326 in the distal direction. Finally, the sleeve 338 can provide a low friction surface against which the actuation member 326 actuates the end effector 320 when moving proximally and distally.

[0049] The conductive members 340, 342 (also referred to as "conductors 340, 342" or "conductive assemblies 340, 342") conduct electrical current from an electrical energy source associated with a patient side cart (e.g., patient side cart 100 (FIG. 1)) to the jaws 332, 334 of the end effector 320 for performing an electrosurgical procedure such as cauterization, sealing, ablation, blending, fusing, electrocauterization, etc. The conductive members 340 and 342 may include a core of conductive material 341 (e.g., copper, aluminum, or other conductive material for flowing electrical current) surrounded by insulating material 343, as is familiar to those of ordinary skill in the art. Figure 3In some embodiments, the core conductive material 341 of the conductive members 340, 342 may be maintained at different potentials to provide a voltage difference to generate current between the jaws 332, 334 as needed to perform an electrosurgical operation, for example, using a bipolar power mode. Figure 3 , and includes another portion of the surgical instrument having a conductive material, such as, for example, instrument shaft 322 or actuation member 326 that can be maintained at different electrical potentials to generate a desired current.

[0050] In other exemplary embodiments, the surgical instrument may use a monopolar power mode, where one end effector component receives power from a conductive member and the electrical return is provided by an electrical ground. The electrical ground provides a reference potential that serves as a "ground" for the instrument. In various embodiments, the electrical ground is associated with the potential of the human body, the system ground of the power generator 2300, or a true ground. A monopolar instrument may be or may include a single end effector component instead of a jaw. Fig.10 An exemplary embodiment of a monopolar electrosurgical instrument 2000 is shown. The instrument 2000 includes a monopolar energy mode end effector 2200. With a patient side cart (e.g., Figure 1A The power generator 2300 associated with the patient side cart 100 (shown in FIG. 1 ) is operably coupled to the end effector 2200 and to one or more components configured to electrically ground the patient's body to a reference potential. For example, the power generator 2300 may be connected to a patient return pad 2202 that is in conductive contact with the patient. In some exemplary embodiments, the shaft 2220 of the instrument 2000 may extend through a cannula (not shown) that includes a conductive material that is operably connected to the power generator 2300. The power generator 2300 maintains the patient return pad 2202 and / or conductive portions of the cannula at a ground potential (e.g., a "zero" voltage or other reference potential) while the end effector 2200 is set to a different (e.g., higher) potential to generate a current through the end effector 2200 to perform an electrosurgical procedure.

[0051] The sleeve 338 can be formed of a material selected for frictional properties, compressive strength, temperature stability, resistance to sterilization processes (e.g., autoclave, ethylene oxide sterilization, gamma sterilization, e-beam sterilization, etc.), electrical isolation (e.g., dielectric strength), ease and cost of manufacturing, raw material costs, and / or other factors. As a non-limiting example, the sleeve 338 includes ETFE and is first formed by extrusion (e.g., into tubular form), and the resulting structure is subjected to a subtractive process, such as machining or cutting, to form the relief. As another non-limiting example, the sleeve 338 includes PTFE (polytetrafluoroethylene). The PTFE material is extruded into a paste having an appropriate cross-section, such as having Fig.15 The cross section shown in . The material is then sintered, cut to length, and heated and twisted to provide the appropriate amount of twist in different sections of the sleeve 338. During the heating and twisting, a mandrel can be placed in the inner cavity and recesses (such as recess 1551) to help maintain the shape of these internal passages. The flexibility and holes for cleaning in the sleeve 338 can be formed by a process such as drilling before or after heating and twisting. The sleeve 338 made of PTFE can be autoclaved. As a specific example, the sleeve 338 includes PTFE and has Fig.15 The cross-section shown in has a variable amount of twist along its length; 360 degrees of twist is produced in the wrist area, and no twist (0 degree twist) is produced in other areas (such as the joint where the conductor slides along the straight portion of the recess (e.g., recess 1551)).

[0052] As another non-limiting example, the sleeve 338 comprises a thermoplastic such as polyethylene or polyether block amide (forms of polyether block amide are known under the trademarks VESTAMID E and PEBAX). This type of sleeve 338 can be manufactured by twisting during extrusion, twisting shortly after extrusion in a secondary operation (while the material is still heated and ductile), or reheating and twisting in a secondary operation. As a specific example, the sleeve 338 comprises a Fig.15 The cross-section of the sleeve 338 is made of polyethylene material and is extruded with linear recesses 1550, 1551. After extrusion, the sleeve 338 is twisted in a secondary operation; 360 degrees of twist is produced in the wrist area, and no twist (0 degree twist) is produced in other areas (such as the joint where the conductor slides along the straight portion of the recess 1551).

[0053] Other suitable exemplary materials include other polymers, metal alloys, composite materials, etc. Other suitable exemplary forming processes include molding (e.g., injection molding), machining, additive manufacturing processes, etc. For example, in some embodiments, the sleeve 338 can be formed by injection molding portions of the sleeve 338 and assembling (e.g., bonding with heat, solvents, adhesives, etc.) the portions together. Injection molding the sleeve 338 into separate segments and subsequently connecting or attaching the separate segments can facilitate the manufacture of the sleeve 338, such as by injection molding, particularly in embodiments where the sleeve 338 includes a spiral recess, such as in conjunction with the following Figures 4 to 7 shown and discussed.

[0054] Reference now Figure 4 , which shows the distal portion 324 of the instrument, with the outer instrument shaft omitted for clarity, and the sleeve 338 including negative features through which flux conduits (such as conductive members 340 and 342) are guided. Figure 4 In an exemplary embodiment of the present invention, the negative feature includes a helical slot 344 formed in the sleeve 338 and extending along at least a portion of the length of the sleeve 338. The conductive members 340 and 342 are guided through the helical slot 344 of the sleeve 338. Figure 3 and Figure 4 As shown, the use of negative features, such as, for example, a helical slot 344, enables the conductive members 340 and 342 to be guided through the bore 336 ( Figure 3 ) and surrounds the actuation member 326 without increasing the diameter d of the bore 336 of the instrument shaft 322 ( Figure 3 ) to accommodate conductive components 340 and 342.

[0055] The helical geometry of the slot 344 provides length retention of the conductive components 340 and 342 during articulation of the wrist 328. For example, the pitch p of the helical slot 344 can be selected so that the conductive members 340 and 342 complete a full turn (i.e., extend 360 degrees) around the actuation member 326 between a position proximal to the wrist 328 and a position distal to the wrist 328. In embodiments having multiple wrist or joint structures, the helical slot 344 can be configured so that the conductive members 340 and 342 complete a full turn (i.e., extend 360 degrees) around the actuation member 326 between the proximal and distal ends of each wrist. Additionally or alternatively, the helical slot 344 can include various portions having different pitches, varying pitches, helical portions separated by linear portions, etc., or any other geometric shape. The sleeve 338 surrounds the actuating member 326 so as to guide and support the actuating member 326 approximately along the centerline of the instrument shaft while enabling the shaft to have an outer diameter that is smaller than the diameter required to accommodate both the thickness of the sleeve 338 and the thickness (e.g., diameter) of the conductive components 340, 342 within the radial space between the actuating member 326 and the interior of the shaft 322.

[0056] Figure 5 d is a detailed perspective cross-sectional view of a portion of the instrument shaft 322 taken in a plane orthogonal to the longitudinal axis of the instrument shaft 322. The actuation member 326 has a diameter d A and is surrounded by a coating 327 (e.g., a polymer coating as described above) having an outer diameter d c The actuation member 326 extends centrally through the bore 336 of the wrist joint 328. The conductive members 340 and 342 occupy an outer diameter d of the inner surface of the bore 336 and the coating of the actuation member 326. c As a non-limiting example, the actuation member 326 may have a diameter d of about 1 millimeter (1.0 mm) or less. A The outer diameter of the coating d c The diameter d of the actuating member 326 may be less than 2.0 mm, less than 1.0 mm, greater than 2.0 mm, etc. The coating may include a single layer of material or multiple layers of material and may be formed on the actuating member 326 by extrusion through one or more layers of heat shrink tubing, etc. The bore 336 may have a diameter of less than about 5.0 mm, less than 4.0 mm, less than 3.0 mm, etc. In this exemplary embodiment, the diameter d of the actuating member 326 is less than 5.0 mm, less than 4.0 mm, less than 3.0 mm, etc. A is approximately 0.5 millimeters (mm) and includes the outer diameter d cETFE coating 327 is approximately 1.0 mm. A bore 336 having a diameter of approximately 2.7 mm extends through wrist joint 328. When actuating member 326 is centered within wrist joint 328, there is a space between approximately 0.7 mm and 0.8 mm between the bore and actuating member 326. Conductive components 340 and 342 have an outer diameter of less than approximately 0.7 mm, such as less than approximately 0.5 mm, such as in the range of approximately 0.4 mm to approximately 0.5 mm, and in an embodiment include an ETFE insulating jacket having an insulating material 343 of the embodiment. As previously described, materials other than ETFE, such as PTFE, may also be used.

[0057] like Figure 5 As shown, the helical slot 344 extends completely through the wall thickness t of the sleeve 338. w In other words, the spiral slot 344 extends from the inner surface S of the sleeve 338. I Extends to the outer surface S O The "open" configuration of sleeve 338 can facilitate cleaning, sterilization, etc., where such processes depend on the flow of liquid or gas throughout the interior of instrument shaft 322. The conductive members 340 and 342 and the helical slot 344 can be sized so that the conductive members 340 and 342 fit with little to no clearance in the helical slot 344. This arrangement permits the conductive members 340 and 342 to support sleeve 338 and provide geometric strength to sleeve 338.

[0058] Reference now Figure 6 , an exemplary embodiment of the actuation member 326, the conductive members 340 and 342, and the sleeve 638 are shown. Figure 6 In the embodiment of the present invention, the sleeve 638 includes a spiral recess 646 that extends only partially through the sleeve 638. Figure 6 In the exemplary embodiment of the present invention, the spiral recess 646 is formed on the inner diameter of the sleeve 638, but is not Figure 3 and Figure 4 Unlike the spiral slot 344 in FIG. 6 , the spiral recess 646 only partially extends into the sleeve 638 and does not penetrate all the way into the outer surface S of the sleeve 638. O Therefore, the relatively thin (relative to the overall sleeve wall thickness t w ) portion 648 is disposed between the conductive components 340 and 342 and the bore 336 of the instrument shaft 322 ( Figure 3 Such a configuration may be implemented, for example, on the wrist 328 or the instrument shaft 322 ( Figure 3 ) during joint movement of the conductive components 340 and 342 (through which the conductive members 340, 342 are guided) to provide additional protection against wear.

[0059] Reference now Figure 7, showing another exemplary embodiment of the present disclosure. Figure 7 An exemplary embodiment is similar to Figure 6 The exemplary embodiment, however, on the outer surface S of the sleeve 738 O In other words, the spiral recess 746 is formed from the outer surface S of the sleeve 738. O Extends, but not through the entire wall thickness t w Extending to the inner surface S of the sleeve 738 I This arrangement leaves the sleeve disposed between the conductive members 340 and 342 and the actuation member 326 relatively thin (relative to the overall wall thickness of the sleeve between the inner and outer surfaces t w ) portion 748. Embodiments with the recess partially penetrating the inner surface of the sleeve (such as Figure 6 Compared with the embodiment of Figure 7 Embodiments in which the recess partially penetrates the outer surface of the sleeve can easily assemble and manufacture the instrument because the conductive members 340 and 342 can be easily wrapped around the outer surface of the sleeve and enter the recess.

[0060] Relative to Figure 3 , Figure 4 and Figure 5 An exemplary embodiment of Figure 6 and Figure 7 The presence of the relatively thin portion 648 or 748 of the sleeve 638 or 738 in the exemplary embodiment shown in FIG. 3 can provide additional rigidity and geometric strength to the sleeve 638, 738. In such embodiments, it may be desirable to include an opening (e.g., a hole) through the sleeve 638, 738 to facilitate cleaning of the surgical instrument, for example, to allow a cleaning fluid to circulate through the instrument shaft 322 ( Figure 3 )’s interior.

[0061] Reference now Figure 8 , which shows another exemplary embodiment of a surgical instrument 800 of the present disclosure. Figure 8 In an embodiment of the present invention, the conductive members 340 and 342 are helically wound around the actuation member 326 such that adjacent helical turns are close to or in contact with each other (i.e., there is no space between the helical turns of the conductive members 340 and 342). In other words, the helical turns of the conductive members 340 and 342 may have a pitch equal to about twice the cross-sectional dimension (e.g., diameter, width, or other cross-sectional dimension) of each of the conductive members 340 and 342. Figure 8The cross-sectional shape of the conductive members 340 and 342 in the embodiments of or any other embodiments described herein may be circular, rectangular, square, oval, or other shapes or combinations of shapes. In some exemplary embodiments, the conductive members may include multiple conductive cores within and separated by a single extruded insulating sheath. In exemplary embodiments where the surgical instrument 800 includes only a single conductive member, the pitch of the helical turns may be equal to the cross-sectional dimension (e.g., diameter) of the conductive member. With this arrangement, the insulating material 343 ( Figure 3 ) between the actuating member 326 and the instrument shaft 322 ( Figure 3 ) between the bores (not shown) to form a sleeve 838. The sleeve 838 including the insulating material 343 of the conductive member can provide a combination with Figure 3 For example, sleeve 838 of insulating material 343 including an electrically conductive member provides a relatively low friction surface against which actuation member 326 translates and can protect actuation member 326 from contact with instrument shaft 322 ( Figure 3 ) in the bore of the wrist member. The sleeve 838 can similarly provide support against bending as the actuation member 326 translates proximally and distally to operate the end effector 320. The insulating material 343 of the conductive member can include a polymer material such as ETFE, PTFE, or other electrically insulating material having sufficient strength and suitable frictional properties, such as those described above for the sleeves in other exemplary embodiments. Figure 8 In an exemplary embodiment of the present invention, the insulating material 343 of the conductive member can be characterized as an insulating jacket or sleeve, and the opening at the center of the insulating material 343 through which the conductor passes can be characterized as a negative feature. Thus, a negative feature is provided within the overall thickness of the sleeve via the passage through the insulating material 343 surrounding the conductive member. Now referring to Fig. 9 , another exemplary embodiment of a portion of a surgical instrument 900 is shown, with the outer instrument shaft omitted for clarity. In this embodiment, a sleeve 938 is disposed around the actuation member 326. The sleeve 938 includes a recess 950 through which the conductive components 340 and 342 are guided. Fig. 9 In an exemplary embodiment of the present invention, the recess 950 extends linearly along the length of the sleeve 938. The recess 950 may extend completely through the wall thickness of the sleeve 938, as shown in the above combination Figure 3 and Figure 4 Alternatively, the recess 950 may extend only partially through the wall thickness of the sleeve 938, as described above in conjunction with Figure 6 and Figure 7In embodiments where the recess 950 does not extend completely through the wall thickness of the sleeve 938, the sleeve 938 may be provided with an opening (e.g., a hole, not shown) to allow liquid and / or gas to flow through the entire interior of the shaft of the surgical instrument to facilitate sterilization and cleaning of the surgical instrument 900.

[0062] Because the conductive components 340, 342 are offset from the neutral bending axis of the instrument shaft (e.g., and also radially offset from an actuation member extending through the bore of the shaft), in some cases, Fig. 9 The linear cable guide shown in the figure may interfere with any full articulation of the wrist due to the conductive components 340, 342 being in tension and / or compression as the wrist articulates. In other words, the effective length of the linear (straight) recess 950 may increase or decrease as the wrist articulates. Therefore, in some exemplary embodiments, the sleeve of the present invention is configured with one or more recesses extending linearly along the length of the sleeve, and is further configured to facilitate the longitudinal movement of one or more flux conduits (e.g., conductive components 340 and 342) through the longitudinal recesses when one or more joint structures (e.g., wrist) of the instrument shaft articulates. For example, in some exemplary embodiments, one or more flux conduits may be provided with a portion of slack as they extend along the instrument shaft. When the joint structure articulates, the slack area of ​​the one or more flux conduits enables the flux conduits to move longitudinally through the linear recesses of one or more sleeve segments.

[0063] For example, now refer to Fig.11 , showing a cross-sectional view of a distal portion of instrument 1224. Instrument 1224 includes a portion of end effector 1220, such as an end effector including opposing jaws (due to the cross-sectional view, Fig.11 Only one jaw 1232 is shown in the figure. The shaft 1222 of the instrument 1224 includes at least one joint structure 1228, which is configured to enable the end effector 1220 to move with at least one degree of freedom (e.g., pitch and / or yaw) relative to the shaft 1222. The instrument 1224 includes a first sleeve segment 1252 and a second sleeve segment 1254 within the shaft 1222. The first sleeve segment 1252 and the second sleeve segment 1254 are longitudinally separated by a distance L. In the space spanning the distance L between the first sleeve segment 1252 and the second sleeve segment 1254, the conductive components 340, 342 are loosely coiled around the actuation member 1226 to form a slack area 1256 in the conductive components 340, 342. The slack region 1256 may be positioned proximal to all of the joint structures 1228 of the instrument 1224, or it may be positioned between the joint structures 1228 along the rigid portion of the shaft 1222. Fig.11As shown, the slack region 1256 is located proximal to at least one joint structure 1228 in the rigid portion 1223 of the shaft 1222. For example, the rigid portion 1223 of the shaft 1222 may be a portion of the shaft located between two joint structures, such as Figure 2 A portion of shaft 222 is shown between wrists 228 and 229. Additionally or alternatively, one or more slack regions may be located proximal to all joint structures of instrument shaft 1222 (not shown).

[0064] exist Fig.11 In an exemplary embodiment of the present invention, the conductive components in the slack region 1256 are loosely coiled around the actuation member 1226 to form the slack region 1256. In other exemplary embodiments, the conductive components 340, 342 may be directed along a non-linear path other than a spiral path to form the slack region 1256. For example, the conductive components may be arranged in a generally S-shape, U-shape, or other configuration to form the slack region 1256.

[0065] Fig.12 Shows Fig.11 The device 1224 is shown with the shaft 1222 omitted for clarity. The first sleeve segment 1252 and the second sleeve segment 1254 include a linear recess 1250 extending longitudinally along each of the first sleeve segment 1252 and the second sleeve segment 1254. When one or more joint structures 1228 ( Fig.11 ) when the joint structure 1228 is articulated, the tensile and / or compressive forces generated in the conductive components 340, 342 cause the conductive components 340, 342 to move within the recess 1250, stretching the length of the conductive components 340, 342 from the portion within the slack region 1256 or increasing the length of the portion of the conductive components 340, 342 within the slack region 1256. For example, if the joint structure 1228 is articulated to move the end effector 1220 in deflection, such as in the direction 1260, a portion of the conductive components 340, 342 is pulled from the slack region 1256 into the recess 1250 of the first sleeve segment 1252. If the joint structure 1228 is articulated to return the end effector 1220 to the Fig.12 1250 of the first sleeve segment 1252 is pulled out of the recess 1250 and back into the slack region 1256. Similarly, other articulations of the end effector 1220 in directions 1258 (e.g., pitch) and / or 1260 (e.g., yaw) cause a portion of the length of the conductive assembly 340, 342 to be pulled from the slack region 1256 into the linear recess 1250 and / or cause a portion of the length of the conductive assembly 340, 342 to be pushed from the linear recess 1250 into the slack region 1256.

[0066] The rotational (angled about the centerline) orientation of the linear recess 1250 may be selected based on the orientation in which the joint structure 1228 is moved to reduce the need for the conductor to move through the linear recess 1250. For example, still referring to Fig.12 , if the movement of the joint structure 1228 is primarily in direction 1258 (e.g., pitch), the linear recess 1250 and the conductive components 340, 342 may be guided so that they lie in a plane oriented orthogonal to direction 1258, which passes through the center of the shaft 1222. Thus, when the joint structure 1228 moves the end effector 1220 in direction 1258 (e.g., pitch), the conductive components 340, 342 remain aligned with the neutral axis of the shaft, and the conductive components 340, 342 do not need to move significantly to compensate for the movement of the joint structure 1228. Similarly, if the majority of the movement of the joint structure 1228 is in direction 1260 (e.g., yaw), the guidance of the conductive components 340, 342 may be, for example, in Fig.12 1254 is rotated 90 degrees in the orientation of the second sleeve segment 1254 shown in FIG. In embodiments where movement of the end effector 1220 is expected to be significant in both pitch and yaw directions, the orientation of the linear recess 1250 may be based on, for example, ease of assembly or other factors.

[0067] Because the slack areas 1256 do not coincide with the joint structures 1228 along the length of the shaft 1222, the first sleeve segment 1252 fully supports the actuation member 1226 and centers the actuation member 1226 within the joint structures 1228. The location of the slack areas 1256 can be selected to correspond to portions of the shaft 1222 that do not include any joint structures 1228, such that there are sleeve segments (e.g., the first sleeve segment 1252 and the second sleeve segment 1254) to support and prevent bending of the actuation member 1226 through any joint structures 1228. In some exemplary embodiments, the instrument 1224 can include multiple slack areas 1256 positioned between multiple sleeve segments.

[0068] exist Fig.12In an exemplary embodiment of the present invention, a rigid spacer 1257 surrounds the actuation member 1226 between the first sleeve segment 1252 and the second sleeve segment 1254. The rigid spacer 1257 maintains the longitudinal distance L between the first sleeve segment 1252 and the second sleeve segment 1254 and prevents the actuation member 1226 from bending along the distance L. The rigid spacer 1257 has a sufficiently small radial wall thickness to enable the conductive members 340, 342 to be guided along the length L between the outer surface of the rigid spacer 1257 and the inner surface of the rigid portion 1223 of the shaft 1222. Additionally or alternatively, the actuation member 1226 may include a rigid portion corresponding to the location of the (one or more) slack regions 1256 to alleviate (e.g., eliminate) the need for lateral support of the actuation member 1226 by the rigid spacer 1257 at this location.

[0069] The first sleeve segment 1252 and the second sleeve segment 1254 may be formed by extrusion without requiring additional cutting or machining steps to form the recess 1250. The first sleeve segment 1252 and the second sleeve segment 1254 may be formed of a material having a relatively low coefficient of friction to facilitate movement of the conductive members 340, 342 through the recess 1250. For example, in an exemplary embodiment, the first sleeve segment 1252 and the second sleeve segment 1254 may be formed of polytetrafluoroethylene (PTFE), ethylene tetrafluoroethylene copolymer (ETFE), or any of the materials discussed above in conjunction with other exemplary embodiments of the present disclosure.

[0070] In some exemplary embodiments, the sleeve of the present disclosure may include a sleeve configured and positioned at a location along the length of the sleeve to reduce the proximity of the sleeve to the joint structure (e.g., wrist 328 ( Figure 4 ) and 1228( Fig.11 )) of the spiral slots, slits and / or cuts to increase the bending stiffness. For example, see now Fig.13 , an embodiment of a sleeve 1338 is shown. The sleeve 1338 includes a helical relief 1362 extending over a portion of the sleeve 1338 that is positioned proximal to the joint structure (e.g., wrist 328) when the sleeve 1338 is assembled in the instrument. Fig.13 In the embodiment of the present invention, the conductive components 340, 342 ( Figure 4 ) are not guided through the spiral relief 1362; instead, the conductive components 340, 342 are guided through the linear (straight) recess 1350, and the sleeve 1338 can be combined with the above Fig.11 and Fig.12 The discussed instruments incorporate a slack area to allow the conductive components 340, 342 to move through the linear recess 1350 when any joint structure of the instrument is articulated. However, any of the sleeves described herein, such as sleeve 338 ( Figure 4)、638( Figure 6 )、738( Figure 7 )、938( Fig. 9 ), and 1252 and 1254 ( Fig.11 and Fig.12 ) may include such a relief to reduce the bending stiffness of the sleeve.

[0071] The spiral relief 1362 can be formed in the sleeve 1338 by, for example, a cutting process, while the linear recess 1350 can be formed by, for example, extrusion. The spiral relief 1362 can reduce the bending stiffness of the sleeve 1338 to facilitate the articulation of the joint structure. The width w of the spiral relief can be, for example, between about 0.01 inches (0.254 mm) and about 0.05 inches (1.27 mm). The sleeve 1338 includes an opening (e.g., hole 1364) to facilitate cleaning by allowing a cleaning fluid to flow between the exterior of the sleeve 1338 and the interior of the sleeve 1338. The spiral relief 1362 can extend partially or completely through the wall thickness of the sleeve 1338. Although Fig.13 1362, but the relief 1362 need not be spiral. For example, the sleeve 1338 may include a relief extending around at least a portion of the circumference of the sleeve 1338, a relief that may be oriented longitudinally along the sleeve 1338, or any other geometry or configuration that reduces the bending stiffness of the sleeve 1338.

[0072] Reference now Fig.14 , which shows another embodiment of a sleeve 1438 according to the present disclosure. Sleeve 1438 can be similar to sleeve 1338 in most aspects, but the width w of the spiral relief 1462 is less than Fig.13 1462 is a substantially rectangular shape with respect to the sleeve 1338 of FIG. 1460. The sleeve 1338 of FIG. 1460 is shown with the exception of the width of the spiral relief 1362 of the sleeve 1338 shown in FIG. 1460. For example, the width w of the spiral relief 1462 may be less than 0.01 inches (0.254 mm), and the width w may be substantially equal to the cutting width (i.e., kerf) of the cutting tool used to form the spiral relief. In some exemplary embodiments, the spiral relief 1462 may have a substantially zero width w and may be formed by a cutting tool having a small or negligible kerf (such as a razor, knife, etc.). The spiral relief 1462 may extend partially or completely through the wall thickness of the sleeve 1438. As described above in conjunction with Fig.13 As stated, the relief need not be helical, and any shape and / or configuration that helps reduce the bending stiffness of the sleeve 1438 is intended to be within the present disclosure.

[0073] Reference now Fig.15, shows a cross-sectional view of sleeve 1538. Sleeve 1538 includes an outer linear recess 1550 and an inner linear recess 1551 through which the flux conduit (e.g., conductive components 340 and 342) is guided. Fig.15 15. Two outer recesses 1550 and two inner recesses 1551 are shown, but some embodiments may include only inner recesses, only outer recesses, a single inner recess, and / or a single outer recess, etc. In some exemplary embodiments, sleeve 1538 includes a spiral relief, such as the one described above in conjunction with Fig.13 and Fig.14 The helical reliefs 1362 and 1462 discussed above. In some exemplary embodiments, the helical reliefs 1362, 1462 can extend partially through the wall thickness of the sleeve 1538 and intersect the internal recess 1551. This configuration provides a fluid path between the interior of the sleeve 1538 and the exterior of the sleeve 1538 through the helical reliefs 1362 and / or 1462. The sleeve 1338 can be made of any of the materials identified above in connection with other sleeve embodiments and can be formed by, for example, extrusion, injection molding, and other processes.

[0074] In various exemplary embodiments described and illustrated herein, the flux conduit comprises an electrical conductor. However, the present disclosure is not intended to be limiting and contemplates other flux conduits, such as tubes for transmitting light, gas, liquid, vacuum, and other types of flux. Furthermore, while various exemplary embodiments described and illustrated herein comprise two conductive members, the present disclosure contemplates other numbers of flux conduits, such as one conduit, or more than two conduits, being directed through the sleeve.

[0075] This description and the accompanying drawings showing exemplary embodiments should not be considered as limiting. Without departing from the scope of this specification and the claimed invention (including equivalents), various mechanical, composition, structure, electrical and operational changes can be carried out. In some cases, known structures and technologies are not shown or described in detail to avoid blurring the present disclosure. The same numbers in two or more figures represent the same or similar elements. In addition, the elements described in detail with reference to an embodiment and their related features can be included in other embodiments that are not specifically shown or described in any practicable situation. For example, if an element is described in detail with reference to an embodiment, and the element is not described with reference to the second embodiment, but the element may also be required to be included in the second embodiment.

[0076] For the purposes of this specification and the appended claims, unless otherwise indicated, all numbers expressing quantities, percentages or ratios, as well as other numerical values ​​used in the specification and claims should be understood as being modified in all instances by the term "about", provided that they have not been so modified. Therefore, unless indicated to the contrary, the numerical parameters set forth in the specification and the appended claims are approximate values ​​that may vary depending upon the desired properties sought to be obtained. At the very least, each numerical parameter should at least be construed in light of the number of reported significant digits and by applying ordinary rounding techniques, and not attempting to limit the application of the doctrine of equivalents to the scope of the claims.

[0077] It should be noted that, as used in this specification and the appended claims, the singular forms "a," "an," and "the," as well as any singular use of any word, include plural referents unless expressly and unambiguously limited to one referent. As used herein, the term "include" and its grammatical variations are intended to be non-limiting, such that recitation of items in a list is not to the exclusion of other like items that can be substituted or added to the listed items.

[0078] In addition, the terms of this description are not intended to limit the present invention. For example, spatially relative terms, such as "below", "below", "lower", "above", "upper", "near side", "distal side", etc., can be used to describe the relationship between an element or feature and another element or feature shown in the figure. These spatially relative terms are intended to cover the different positions (positions) (that is, positions (locations)) and orientations (that is, rotational placement) of the equipment in use or operation other than the positions and orientations shown in the figures. For example, if the equipment in the figure is flipped, the elements described as "below" or "below" other elements or features will be "above" or "on" other elements or features. Therefore, the exemplary term "below" can cover both the position and direction of the upper and lower parts. The equipment can be oriented in other ways (rotated 90 degrees or in other orientations), and the spatially relative descriptors used in this article are interpreted accordingly.

[0079] In view of the disclosure herein, further modifications and alternative embodiments will be apparent to those of ordinary skill in the art. For example, systems and methods may include additional components or steps that are omitted from the figures and descriptions for clarity of operation. Therefore, this specification is to be interpreted as illustrative only and is intended to teach those skilled in the art the general manner of implementing the content of this teaching. It should be understood that the various embodiments shown and described herein will be considered exemplary. Elements and materials and the arrangement of these elements and materials may replace those shown and described herein, parts and processes may be reversed, and certain features of this teaching may be used independently, which will be apparent to those skilled in the art after benefiting from the description herein. The elements described herein may be changed without departing from the spirit and scope of this teaching and the following claims.

[0080] It is to be understood that the specific examples and embodiments set forth herein are non-limiting and that modifications in structure, dimensions, materials, and methods may be made without departing from the scope of the present teachings.

[0081] Other embodiments of the present disclosure will be apparent to those skilled in the art from consideration of the specification and practice of the invention disclosed herein. The specification and examples are intended to be considered exemplary only, and the appended claims are to be given their fullest scope, including equivalents, under applicable law.

Claims

1. A surgical instrument comprising: a shaft having a proximal end, a distal end, and a bore extending from the proximal end to the distal end; End effector; a wrist mechanism coupling the end effector to the distal end of the shaft, the wrist mechanism configured to articulate about a neutral position relative to the shaft; an actuation member extending through the bore of the shaft and the wrist mechanism, the actuation member operably coupled to the end effector; a sleeve surrounding the actuation member at least within the wrist mechanism, the sleeve having a straight channel radially offset from the actuation member and extending along the sleeve at least within the wrist mechanism; as well as a flux conduit extending through the bore of the shaft from the proximal end to the distal end, the flux conduit being operably coupled to the end effector, the flux conduit being received within the straight channel of the sleeve, wherein a slack portion of the flux conduit is relaxed in a region of the shaft through which the sleeve does not extend, and wherein, in response to articulation of the wrist mechanism from the neutral position, the slack portion of the flux conduit moves into the straight channel of the sleeve and an effective length of the straight channel of the sleeve changes.

2. The surgical instrument of claim 1, wherein the flux conduit is an electrosurgical energy flux conduit.

3. A surgical instrument according to claim 1 or 2, wherein the slack portion includes a length of the flux conduit coiled around the actuation member.

4. A surgical instrument according to claim 1 or 2, wherein the sleeve includes a first sleeve segment and a second sleeve segment, and wherein at least when the wrist mechanism is in the neutral position, the slack portion of the flux conduit is positioned in the longitudinal space between the first sleeve segment and the second sleeve segment. 5 . The surgical instrument of claim 4 , further comprising a rigid spacer disposed around the actuation member between the first sleeve segment and the second sleeve segment.

6. The surgical instrument of claim 5, wherein the rigid spacer has an outer diameter that is smaller than an outer diameter of the first sleeve segment and the second sleeve segment.

7. The surgical instrument of claim 5, wherein the slack portion of the flux conduit is directed around an outer surface of the rigid spacer at least in the neutral position of the wrist mechanism.

8. A method of forming a surgical instrument, comprising: guiding an actuation member through the central bore of the instrument shaft and operably coupling the actuation member to the end effector at the distal end; positioning a sleeve within the bore and at least partially surrounding the actuation member within a wrist mechanism coupling the end effector to the shaft, the wrist mechanism being articulatable about a neutral position relative to the shaft, wherein the sleeve includes a straight channel in a wall thickness of the sleeve, and the straight channel has an effective length configured to change in response to articulation of the wrist mechanism; operably coupling a flux conduit to the end effector so as to enable the flux conduit to deliver surgical flux to the end effector; as well as directing the flux conduit through the bore of the instrument shaft to the end effector, wherein the directing comprises: disposing at least a portion of the length of the flux conduit at least partially within the straight passage of the sleeve, and At least when the wrist mechanism is in the neutral position, a slack portion is formed in the flux conduit, the slack portion being configured to move into and out of the straight channel in response to articulation of the wrist mechanism. 9 . The method of claim 8 , wherein directing the flux conduit to form the slack portion comprises coiling the flux conduit around the actuation member.

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