Cables and wiring in the robotic arms of surgical equipment

Abstract

The present invention provides an apparatus for performing electrosurgical procedures using an electrosurgical power generator, comprising: an articulated robotic arm; an electrosurgical gripper connected to the robotic arm at a distal end thereof; a flexible sleeve at least partially disposed in a bendable portion of the arm, the outer surface of the sleeve including a plurality of surface features defining a helical path about a central longitudinal axis of the sleeve; an actuation cable passing through an inner conduit of the sleeve and mechanically coupled to the gripper for opening and closing the gripper; and a conductive wire for providing an electrical connection from the power generator to the gripper, the wire being disposed on the outer side of the sleeve and engaging one or more of the surface features to pass through the one or more surface features along the helical path.

Description

[0001] Cross-reference to related applications

[0002] This patent application claims the benefit of U.S. Provisional Patent Application No. 62 / 897,293, filed September 7, 2019, the entire contents of which are incorporated herein by reference. Technical Field

[0003] This invention relates to surgical and electrosurgical devices for grasping, coagulating, sealing, manipulating, and / or cutting tissue. More specifically, this invention relates to electrosurgical devices including robotic arms, and means for wiring the mechanical cables and wires required for operating these devices and robotic arms within and through these robotic arms. Specifically, the invention is applicable to separating and retaining mechanical cables and wires within such paths of flexible portions of mechanical surgical arms. Background Technology

[0004] Minimally invasive surgery is well-known for its advantages. Instruments used in such surgeries typically have a surgical end effector located at the distal end of an articulated surgical arm (preferably with a minimal diameter), which is inserted through a small opening (e.g., a body wall incision, natural orifice) to reach the surgical site. In some cases, surgical instruments may pass through a cannula, and an endoscope may be used to provide images of the surgical site.

[0005] Surgical instruments utilizing end effectors have been developed that integrate tissue fusion and cutting, offering both convenience and precision. In some cases, the articulated surgical arm has one or more bending sections controlled by mechanical cables whose longitudinal movement affects the bending and ultimately controls the position of the end effector, altering its orientation relative to the longitudinal axis of the surgical arm. In some cases, the surgical arm is capable of bending backward relative to its longitudinal axis.

[0006] The current state of affairs in this field lacks apparatus and methods for providing optimal wiring of mechanical and electrical cables across the length of a surgical arm, particularly its flexible portions, wherein when the arm is partially bent, the wires are separated from the mechanical cables to avoid electrical and / or magnetic interference without stressing the wires, and when the corresponding portion of the arm is bent to a small radius of curvature, the wires are neither subjected to excessive tension nor excessive slack leading to contamination and wiring errors. Such apparatus and methods would optimally preserve the wires in the surgical arm for safe and efficient wiring. Summary of the Invention

[0007] According to the embodiments disclosed herein, an apparatus for performing electrosurgical procedures using an electrosurgical power generator includes: (a) an articulated robotic arm; (b) an electrosurgical gripper including a plurality of jaws and connected to the robotic arm at a distal end of the robotic arm; (c) a flexible sleeve at least partially disposed in a bendable portion of the arm, the outer surface of the sleeve including a plurality of surface features defining a helical path about a central longitudinal axis of the sleeve; (d) an actuation cable passing through an inner conduit of the sleeve and mechanically coupled to the gripper to enable movement of at least one jaw; and (e) a conductive wire for providing an electrical connection from the power generator to the gripper, the wire being disposed on the outer side of the sleeve and engaging one or more of the surface features to pass through the one or more surface features along the helical path.

[0008] In some implementations, the plurality of surface features may include discontinuous protrusions, and the helical path passes between the discontinuous protrusions.

[0009] In some embodiments, the plurality of surface features may include alternating parallel longitudinal ribs and grooves, wherein, for at least the longitudinal portion of the sleeve, the ribs and grooves are helically aligned about the central longitudinal axis of the sleeve, and the helical path passes through one of the grooves. In some such embodiments,

[0010] The plurality of surface features may include at least three ribs and at least three grooves. In some such embodiments, it is possible that, for the first longitudinal portion of the sleeve, the parallel ribs and the grooves are parallel to the central longitudinal axis, and for the second longitudinal portion of the cable sleeve, the parallel ribs are spirally wound around the central axis.

[0011] In some embodiments, the pitch of the helical path may fluctuate by less than ±50% along the length of the helical path. In some embodiments, the pitch of the helical path is constant, or fluctuates by less than ±10% along the length of the helical path.

[0012] In some embodiments, the pitch of the helical path can be at least one-third of the length of the central axis path of the corresponding portion of the sleeve. In some embodiments, the pitch of the helical path is at least one-half of the length of the central axis path of the corresponding portion of the sleeve. In some embodiments, the pitch of the helical path is at most equal to 1.5 times the length of the central axis path of the corresponding portion of the sleeve, or 1.25 times the length, or the length itself.

[0013] In some implementations, the ratio between the pitch and the helix amplitude of the helical path can be at least 10, at least 20, or at least 50.

[0014] In some embodiments, the flexible portion of the arm may include multiple flexible segments. In some embodiments, the flexible portion of the arm may include non-adjacent segments.

[0015] In some embodiments, the sleeve may be constrained to bend and / or straighten together with the flexible portion of the arm, and the path of the wire remains helical relative to the central longitudinal axis of the sleeve during bending and / or straightening. In some such embodiments, for any bend in the flexible portion of the arm up to a radius of curvature greater than twice the diameter of the flexible portion, the path of the wire may remain helical relative to the central axis of the sleeve during bending and / or straightening. In some embodiments, for any bend in the flexible portion of the arm up to a radius of curvature greater than 1.5 times the diameter of the flexible portion, the helical path of the wire may remain helical relative to the central axis of the sleeve during bending and / or straightening.

[0016] In some implementations, it is possible that the bending and / or straightening of the sleeve assembly does not significantly increase the tension in the line.

[0017] In some embodiments, the inner catheter may have a circular cross-section. In some such embodiments, the inner diameter of the inner catheter may be at least 0.5 mm and at most 2.0 mm.

[0018] In some embodiments where the surface features include helical ribs, the maximum helical amplitude of the ribs on the outer surface of the sleeve can be at least 1.0 mm and at most 2.0 mm. In some such embodiments, the maximum helical amplitude of the ribs on the outer surface of the sleeve can be at least 1.25 mm and at most 1.5 mm.

[0019] In some implementations, the surface features can be integrally formed with the sleeve.

[0020] In some embodiments, the sleeve may include a thermoplastic elastomer, including rigid polyamides and flexible polyethers.

[0021] In some implementations, when electrically connected to an electrosurgical power generator, the electrosurgical gripper can provide at least a bipolar electrosurgical mode.

[0022] In some embodiments, the actuation cable may be mechanically coupled to the gripper such that rotation of the actuation cable about its central axis controls the movement of at least one jaw. In some embodiments, the actuation cable may be mechanically coupled to the gripper such that longitudinal movement of the actuation cable within the arm controls the movement of at least one jaw.

[0023] In some implementations, the surgical device may also include an electrosurgical power generator, and conductive wires may provide an electrical connection from the power generator to the gripping forceps.

[0024] According to the embodiments disclosed herein, a surgical device for use with a power source includes: a. an articulated robotic arm; b. a tool connected to the robotic arm at a distal end, the tool being electric or having at least one electrically powered auxiliary device mounted thereon; c. a flexible sleeve at least partially disposed in a bendable portion of the arm, the outer surface of the sleeve including a plurality of surface features defining a helical path about a central longitudinal axis of the sleeve; and d. a conductive wire for providing an electrical connection from a power source to the tool or to the mounted auxiliary device, the wire being disposed on the outer side of the sleeve and engaging one or more of the surface features to pass through the one or more surface features along the helical path.

[0025] In some implementations, the tool is a surgical tool.

[0026] In some implementations, the surgical instrument is selected from the group consisting of grasping forceps, tweezers, scissors, clamps, hooks, and lasers.

[0027] In some implementations, the tool and / or the auxiliary device is a camera, i.e., the conductive wire is used to provide an electrical connection from the power source to the camera.

[0028] In some implementations, the tool and / or the auxiliary device is a data acquisition tool—the conductive wire is used to provide an electrical connection from the power source to the data acquisition tool.

[0029] In some implementations, the data acquisition tool is or includes at least one of an electric thermometer, a camera, and an electric microphone.

[0030] In some embodiments, the tool and / or the auxiliary device includes an electrically powered lighting source (e.g., a light-emitting diode (LED)) – i.e., the conductive wire is used to provide an electrical connection from the power source to the lighting source.

[0031] In some implementations, the tool has at least one internal degree of freedom.

[0032] In some embodiments, it further includes an actuation cable that passes through the inner conduit of the sleeve and is mechanically coupled to the tool so as to: (i) modify the internal structure of the tool with respect to one or more of the degrees of freedom; and / or (ii) mechanically operate or actuate the tool.

[0033] In some embodiments, the plurality of surface features include discontinuous protrusions, and the helical path passes between the discontinuous protrusions.

[0034] In some embodiments, the plurality of surface features include alternating parallel longitudinal ribs and grooves, wherein for at least the longitudinal portion of the sleeve, the ribs and the grooves are helically aligned about the central longitudinal axis of the sleeve, and the helical path passes through one of the grooves.

[0035] In some implementations, the plurality of surface features include at least three ribs and at least three grooves.

[0036] In some embodiments, for the first longitudinal portion of the sleeve, the parallel ribs and the grooves are parallel to the central longitudinal axis, and for the second longitudinal portion of the cable sleeve, the parallel ribs are spirally wound around the central axis.

[0037] In some implementations, the pitch of the helical path has a fluctuation of less than ±50% along the length of the helical path.

[0038] In some implementations, the pitch of the helical path is constant, or the length of the helical path fluctuates by less than ±10%.

[0039] In some embodiments, the pitch of the helical path is at least one-third of the length of the central axis path of the corresponding portion of the sleeve.

[0040] In some embodiments, the pitch of the helical path is at least half the length of the central axis path of the corresponding portion of the sleeve.

[0041] In some embodiments, the pitch of the helical path is at most equal to 1.5 times the length of the central axis path of the corresponding portion of the sleeve, or 1.25 times the length, or the length itself.

[0042] In some embodiments, the ratio between the pitch and the helical amplitude of the helical path is at least 10, at least 20, or at least 50.

[0043] In some embodiments, the bendable portion of the arm includes multiple bendable segments.

[0044] In some embodiments, the bendable portion of the arm includes non-adjacent segments.

[0045] In some embodiments, the sleeve is constrained to bend and / or straighten together with the flexible portion of the arm, and the path of the wire is kept helical relative to the central longitudinal axis of the sleeve.

[0046] In some embodiments, for any bend in the bendable portion of the arm up to a radius of curvature greater than twice the diameter of the bendable portion, the path of the wire relative to the central axis of the sleeve remains helical in the bend and / or straightening path.

[0047] In some embodiments, for any bend in the bendable portion of the arm up to a radius of curvature greater than 1.5 times the diameter of the bendable portion, the helical path of the wire remains helical relative to the central axis of the sleeve during the bend and / or the straightening path.

[0048] In some implementations, the bending and / or straightening of the sleeve assembly does not significantly increase the tension in the line.

[0049] In some embodiments, the inner catheter has a circular cross-section.

[0050] In some embodiments, the inner diameter of the inner catheter is at least 0.5 mm and at most 2.0 mm.

[0051] In some embodiments, the maximum helical amplitude of the ribs on the outer surface of the sleeve is at least 1.0 mm and at most 2.0 mm.

[0052] In some embodiments, the maximum helical amplitude of the ribs on the outer surface of the sleeve is at least 1.25 mm and at most 1.5 mm.

[0053] In some implementations, the surface feature is integrally formed with the sleeve.

[0054] In some embodiments, the sleeve comprises a thermoplastic elastomer, which includes rigid polyamide and flexible polyether.

[0055] A remotely operated robotic surgical system includes: any of the devices disclosed herein; a patient-side console configured to interface with the surgical tool to actuate the surgical tool to perform one or more surgical procedures; and a surgeon-side console including one or more input devices configured to be manipulated by a surgeon and to transmit signals to control the surgical tool at the patient-side console. Attached Figure Description

[0056] The invention will now be further described by way of example with reference to the accompanying drawings, wherein the dimensions of the parts and features shown in the drawings are not necessarily selected to scale for ease of presentation and clarity. Furthermore, in some drawings, the relative dimensions of objects and the relative distances between objects may be exaggerated or reduced for convenience and clarity. In the drawings:

[0057] Figure 1 A simplified schematic diagram of a surgical system according to an embodiment of the present invention is shown.

[0058] Figure 2A A surgical arm unit according to an embodiment of the present invention is shown.

[0059] Figure 2B A robotic arm with a bendable portion including stacked links and end effector tools according to an embodiment of the invention is shown.

[0060] Figure 2C The result of the bendable portion of a bending robotic arm according to an embodiment of the present invention is shown.

[0061] Figure 2D A schematic diagram is shown of the central axis of the robotic arm used in this disclosure, the diameter of a portion of the robotic arm, and the radius of curvature of the bendable portion of the robotic arm.

[0062] Figure 3 The image shows a longitudinal cross-sectional projection of a portion of the robotic arm, illustrating the cables and wiring sleeves according to an embodiment of the invention.

[0063] Figure 4 A cover layer having a similarly curved cable sheath is schematically shown according to an embodiment of the invention. Figure 2C A bending robotic arm.

[0064] Figure 5A and Figure 5B The illustration schematically shows a sleeve with helical ribs and grooves as surface features according to an embodiment of the invention, and a partial enlargement thereof.

[0065] Figure 6A sleeve with protrusions as a surface feature according to an embodiment of the present invention is shown.

[0066] Figure 7 An embodiment of the present invention is shown. Figure 5A A sleeve with a spiral path.

[0067] Figure 8A yes Figure 7 The two-dimensional projection of the line.

[0068] Figure 8B and Figure 8C These are two-dimensional projections of lines with different pitches.

[0069] Figure 9 A schematic diagram of the pitch and helix amplitude used in this disclosure is shown.

[0070] Figure 10 An embodiment of the sleeve according to an embodiment of the invention is shown, having straight ribs and grooves on the outer surface of a first portion of the sleeve length and helical ribs and grooves on the outer surface of a second portion of the sleeve length. Detailed Implementation

[0071] According to the implementation scheme, the mechanical surgical arm may house a "mechanical" or "actuated" cable for actuating and controlling the movement of a surgical tool located at the distal end of the arm. An example of a surgical tool is a multi-jaw grasping forceps for electrosurgery. The grasping forceps preferably provide at least one bipolar electrosurgery mode typically used for fusion of tissues (e.g., blood vessels) or for general coagulation, cold cutting, tissue dissection, and tissue manipulation / retraction of tissue bundles. The grasping forceps may also provide a monopolar electrosurgery mode.

[0072] The “distal” end of the arm is defined herein as the end to which the surgical instrument is attached, i.e., the end furthest from the operator or user of the surgical device including the arm during normal surgical procedures. The term “mechanical” as used herein indicates that the cable is generally not used for conducting electricity and generally does not carry data, although in some embodiments, a “mechanical” cable may be used to carry data and / or serve as a grounding loop to complete the circuit.

[0073] Mechanical or actuation cables may extend the entire length of the arm or a portion thereof and may be directly or indirectly connected to one or more mechanical and / or electronic control elements, such as drives or actuators, at or near the proximal end of the arm. Depending on the mechanical arrangement of the arm and / or tool, surgical tools may be controlled directly or indirectly by longitudinal forces applied by the actuation cables (i.e., generating back-and-forth motion) or by rotational torque applied via the cables. It may be desirable to route the actuation cables through longitudinal conduits (such as tubes or sleeves) deployed around the central axis of the arm to maintain a straight wiring path, thereby allowing for maximum control of movement.

[0074] The robotic surgical arm may additionally house wires that, in the operational state of the surgical device, conduct power from a power source such as (but not limited to) an electrosurgical generator to the same surgical instrument controlled by an actuation cable. The wires can be single-wire, double-wire (or even triple-wire). If a single wire is used, the circuitry can be completed using an alternative return path (e.g., a metal arm housing or an actuation cable). It may be desirable to physically separate the wire paths from the actuation cable paths to avoid potential tangling, which could interfere with the function of the actuation cable and / or jeopardize the physical integrity of the less robust wires. Preferably, the wires are physically separated from and electrically insulated from the actuation cable, which is preferably coaxial with the central axis of the arm for maximum functionality. Therefore, if the wires pass through the arm in a straight path, they will inevitably be off-center. Keeping the wires in off-center wiring paths may require complex mechanical solutions and, in some cases, may impose excessive strain, stress, and / or shear forces on the portion of the wire passing through the flexible portion of the arm, even leading to tearing, especially when the arm is placed in repetitive backward bending positions.

[0075] Therefore, it may be desirable to wind the wire around a sleeve or tube through which the actuation cable passes, and according to the embodiments disclosed herein, to use surface features provided by the outer surface of the sleeve to form a stable wire path around the outer surface. A helical wire path around the outer surface of the sleeve is desirable because the central axis of the helix can be coaxial with the central axis of the sleeve, through which the actuation cable passes at the center of the arm. As described below, the central axes of the sleeve and the arm remain coaxial with each other, or at least parallel to each other if not coaxial, while the flexible portion of the arm bends and straightens; although it appears deformed due to bending, the path of the helical wire path relative to the central axis of the sleeve remains helical. The bending of the flexible portion of the arm can include “extreme” bending, such as recurve constructions and S-curves, and in any such use, the sleeve remains coaxial (or parallel) to the arm. Forming a stable helical wire path centered on the central axis of the arm can have the advantages of reducing tension in the wire as the wire path bends with the flexible portion of the arm, and / or reducing the amount of slack provided in the wire during assembly. The wire can slide longitudinally within its helical path, allowing "excess" wire on the "inside" of a curve or bend to slide toward the "outside" of the curve or bend, where otherwise the wire would be under greater tension, or even become stretched or break. This sliding helical movement of the wire within its helical path is preferably unimpeded, or at least sufficiently unimpeded, such that bending and / or straightening of the sleeve assembly does not significantly increase the tension in the wire. Conversely, if the wire is wound or tied around a surface feature on the outer surface of the sleeve, this sliding is likely to be excessively impeded, and the tension in a portion of the wire (such as the portion in operation located on the "outside" of the curve or bend) will increase significantly.

[0076] Figure 1A schematic diagram of a typical prior art surgical system 100 according to an embodiment is shown. System 100 includes two surgical robotic arms 102. In other embodiments, a single surgical arm is provided. The size and / or shape of the surgical robotic arms 102 are preferably designed for insertion into a human body or patient 106. Each of the surgical robotic arms 102 is actuated by a corresponding motor unit 108. In this example, the surgical arms 102 and / or motor units 108 are supported by a patient support 116 attached to, for example, a bed, but may also be supported by a patient-side trolley.

[0077] The electrosurgical generator 112 supplies power to the arm 102 and the motor unit 108. As is known in the field of electrosurgery, the electrosurgical generator provides a high-frequency (e.g., radiofrequency) alternating polarity current. The electrosurgical generator 112 can be configured to provide different frequencies and / or power levels, for example, suitable for cutting and / or coagulating and / or sealing and / or drying and / or cauterizing tissue. A suitable, commercially available example of an electrosurgical generator 112 is the Covidien Force FX ESU electrosurgical generator. Power is supplied to the motor unit 108 via a cable 114 configured to deliver radiofrequency electrosurgical power.

[0078] The movement and / or electrosurgical charging of the surgical arm 102 are controlled by a console 118. The console 118 includes multiple user interfaces, including one or more of the following: an input device, such as an input device arm 120, wherein the console is configured to generate control signals based on the movement of the input device arm 120; a touchscreen display 128 configured to receive user input and / or display images of the surgical area, such as images collected by a camera inserted into the patient 106 using one of the surgical arms 102; and one or more additional user interfaces 130 (e.g., buttons, switches, etc.).

[0079] The console 118 includes a processor (not shown) configured to receive signals from user input and send control signals to the motor unit 108 and / or the electrosurgical generator 112. The foot pedal 126 and / or the electrosurgical generator 112 include a processor (not shown) configured to receive control signals (e.g., generated by a user pressing a portion of the foot pedal 126) to change the electrical power supplied to the motor unit 108 based on the control signals. The foot pedal control signals do not necessarily pass through the control unit processor.

[0080] The movement of the input device arm 120 controls the movement of the corresponding surgical device arm 102. The user 124 can position and / or move the input arm 120 by grasping the input device arm handle 127.

[0081] It may be desirable for the size and / or shape of a surgical arm to be designed for insertion into the human body. For example, the size and / or shape of the arm may be designed for insertion through a laparoscopic port and / or for performing laparoscopic surgery. For example, the size and / or shape of the arm may be designed for insertion through natural body orifices such as the vagina, anus, trachea, esophagus, or ear canal.

[0082] Now for reference Figure 2A Arm unit 204 includes a proximal end and a distal end, with a support unit 223 attached to arm 102 at the proximal end and an electrosurgical tool 224 (such as a multi-jaw grasping forceps illustrated) attached to arm 102 at the distal end. Examples of multi-jaw grasping forceps are intended to be non-limiting, and any suitable surgical tool can be used. Various non-limiting examples of grasping forceps tool designs are shown in the figures; in the disclosed embodiments, any electrically powered surgical tool actuated by an actuation cable is suitable for use as an electrosurgical tool. A flexible portion 200 of arm 102 is positioned along the length of the arm, closer to the distal end. The flexible portion 200 may include a series of stacked links 199 that provide external flexibility to arm 102; Figure 2B An example of multiple stacked links 199 in the bendable portion 200 of arm 102 is shown. (See example...) Figure 2B As shown, one or more segments of the arm 102 or the flexible portion 200 may have different diameters while sharing the same central longitudinal axis.

[0083] The flexible portion 200 of arm 102 may include non-adjacent segments. In other words, the flexible portion 200 may actually include multiple flexible portions with or without interspersed inflexible segments. Figure 2C A typical arm 102 is shown that bends at multiple locations along the bendable portion 200. Figure 2C The clockwise "route" reveals: rigid part 202 ( Figure 2C The arm 102 shown includes the nearest side portion; a flexible section 208, which includes a first flexible section within the length of the flexible portion 200; a rigid connection section 212; a flexible section 220, which includes a second flexible section within the length of the flexible portion 200; and a rigid section 216 to which the surgical tool 224 is connected. The rigid section 216 may accommodate mechanical means for transmitting controlled movement of the actuation cable to the surgical tool 224.

[0084] Any portion or segment of the bendable portion 200 of arm 102 may be bent to a radius of curvature R, which, for the purposes of this disclosure, is calculated as the radius of curvature of the central axis or centerline CL, as shown below for clarity. Figure 2DAs shown. In an embodiment, the lower limit of the radius of curvature R can be defined by the size and specific design of the bendable portion and its component links, as well as the diameter D of the arm 102. For example, the radius of curvature R can be limited to at least 3 times the diameter of the arm 102, or at least 2 times the diameter of the arm 102, or at least 1.5 times the diameter of the arm, or at least 1.25 times the diameter of the arm 102.

[0085] The diameter D of the flexible portion 200 (or any segment thereof) of the mechanical surgical arm 102 suitable for electrosurgery can be in the range of 6 to 12 mm, or 7 to 11 mm, or 8 to 10 mm, or 8 to 9 mm. Different segments can be designed with different D values. The “length” of the link 199, i.e., when coupled in the non-bending flexible portion 200, can be in the range of 1.5 to 4 mm, or 2.0 to 3.25 mm, or 2.25 to 2.75 mm. Each link 199 can correspond to an arc of 5° to 15°, or 6° to 13°, or 7° to 11°, or 8° to 10° when the corresponding flexible portion 200 (or segment thereof) is flexed or bent to its maximum extent. The resulting radius of curvature R can be in the range of 10 to 20 mm, 11 to 16 mm, 12 to 15 mm, or 13 to 14 mm.

[0086] Now for reference Figure 3 The diagram shows a cross-sectional view of the distal portion of arm 102. A cable and wiring sleeve 210, whose cross-section is not shown, is shown disposed within the flexible portion 200 of arm 102.

[0087] The term "contained within" as used throughout this disclosure and the appended claims should be understood to include either the interchangeable terms "fully contained within" or "partially contained within". For example, although Figure 3 It is shown that the entire length of the sleeve 210 is included in the marked length of the flexible portion 200, but even if there is an overlap between the length of the sleeve 210 and the length of the flexible portion 200, such that one or both ends of the sleeve extend from the marked length of the flexible portion 200, Figure 3 The sleeve 210 will still be "set" within the flexible portion 200. Furthermore, as combined... Figure 2C The length of the flexible portion 200 discussed may include one or more rigid segments, such as rigid segment 212. The purpose, function, shape, and manufacture of sleeve 210 will be discussed further below. It may be desirable for the sleeve to have a central longitudinal axis coaxial with the central longitudinal axis CL of arm 102, such as... Figure 3 As shown.

[0088] Figure 4The effect of the bendable portion 200 of arm 102 bending on sleeve 210 is schematically shown. Sleeve 210 will obviously bend within the range of the bent bendable portion 200. However, it is desirable that sleeve 210 be suitably confined within the arm and have sufficient flexibility such that its central axis and the central axis CL of the arm remain coaxial (i.e., parallel) throughout the entire bending range associated with the radius of curvature R of the bendable portion 200 as described above. Although Figure 4 This illustration appears to show a single sleeve 210 representing the length of the bendable portion 200 of the extension arm 102, but in some embodiments, there may be more than one sleeve 210; for example, each bendable segment of the bendable portion 200 (e.g., segments 208 and 220) may have one sleeve. A thermoplastic elastomer having the physical properties of being able to repeatedly bend and straighten as described herein can be selected. The inventors have found that suitable materials for manufacturing the sleeve 210 are thermoplastic elastomers comprising rigid polyamides and flexible polyethers, examples of which are commercially available from Arkema, Colombes Cedex, France. Formulation. The sleeve can be manufactured using any method known in the art, including but not limited to molding, extrusion, and 3D printing. Additionally or alternatively, a sleeve with a helical surface feature can be made from an "unwound" sleeve having a surface feature that is not yet helical.

[0089] A sleeve can be deployed within the arm to route mechanical cables, such as actuation cables for transmitting or generating motion in a surgical instrument attached to the distal end of the arm, as well as electrical wires, such as wires providing power to the surgical instrument. According to one embodiment, the sleeve includes an inner or central longitudinal conduit through which the mechanical cables pass, and multiple surface features on the outer surface of the sleeve through which the wires can be routed, wherein the surface features can be used to retain the wires within a path (such as a helical path).

[0090] Figure 5A and Figure 5B A non-limiting example of a sleeve 210 having an inner conduit 110 and surface features on its outer surface 211 is shown. The inner conduit 110 may have a circular cross-section; this not only facilitates a regular helical path on the outer surface of the sleeve 210, but the circular cross-section also benefits the assembly and operation of the robotic arm 102. For example, the sleeve 210 including the circular cross-section inner conduit 110 does not need to be oriented in a specific way during assembly, and the sleeve 210 can be bent equally easily (with force) in all directions, etc. Different shapes can complicate assembly and / or affect the bending behavior of the sleeve 210. As shown in the figure, in Figure 5A In the middle, the actuation cable 240 passes through the inner conduit 110. Figure 5A and Figure 5BThe exemplary surface feature shown includes parallel helical ribs 248 alternating with helical grooves 249. Ribs 248 and grooves 249 are formed helically around the central longitudinal axis CL of the sleeve 210. 套管 And it extends the entire length of the outer surface 211. In some embodiments, the ribs 248 and slots 249 extend at least 70%, at least 80%, or at least 90% of the length of the outer surface 211. As will be described below, a wire (e.g., a segment of a wire) can remain in a spiral path defined by one of the slots, while the wire is subjected to at most moderate tension. Four ribs and four slots are consistently shown in the illustrative examples accompanying this disclosure. However, any reasonable number of ribs and slots can be implemented as surface features, from a minimum of three to a maximum of six or eight (or even ten) ribs and slots. If there are too few ribs, i.e., less than three, the wire may not remain in the spiral path; if there are too many ribs, there may not be enough space in the slots to accommodate the wire, depending on the physical dimensions of the wire. Although not shown in the figures, one or more slots 249 not occupied by wires can be used as paths for additional cables—mechanical cables, data cables, and / or electrical cables.

[0091] Figure 6 Another non-limiting example of a sleeve having an inner conduit 110 and surface features on its outer surface 211 is shown. In this example, the surface features include a plurality of protrusions 215. By passing a wire through the appropriate protrusions 215, the wire can be retained in a helical path. In another example (not shown), the protrusions 215 may have mushroom-shaped “caps” to better retain the wire in a helical path. In yet another example (also not shown), it is possible that only those protrusions 215 necessary to define the helical path are provided.

[0092] It is necessary to limit the number of wire wounds or the number of wounds per unit length (i.e., the length of the wire or central axis) to avoid generating magnetic fields that interfere with the normal operation of the arm and / or surgical instruments or even magnetize the actuation cable. As mentioned above, the advantages of helically wound wire within a stable helical path can be achieved with a small number of wounds. For example, a sleeve with a length of 100 mm can be wound with no more than 3 helical rotations, or no more than 2 helical rotations, or even less. Therefore, whether for a single sleeve that runs through the entire flexible portion of the arm, or for any one of multiple sleeves or a portion thereof in multiple segments of the flexible portion of the arm, the pitch can be at least 1 / 3 or at least 1 / 2 of the length of the central axis path of the corresponding portion of the sleeve. In some embodiments, at least one complete helical rotation of the wire is necessary to allow helical slip within the wire path and other advantages, including avoiding electrical resonance with a helical path, and in other embodiments, four-fifths, three-quarters, or even two-thirds of the rotation may be sufficient. In some implementations, the pitch is at most 1.5 times the length of the central axis path of the corresponding portion of the sleeve, or at most 1.25 times that length, or at most the length itself.

[0093] Now for reference Figure 7 , Figure 5A and Figure 5B The sleeve 210 is shown as having a wire 255 arranged (in a corresponding portion) in a spiral path within one of the slots 249. As mentioned above, a moderate amount of wire winding is preferred to avoid generating a potentially problematic magnetic field around the actuating cable 240. Figure 7 In a specific instance, the pitch ensures that fewer than two strands of thread are wound around that particular sleeve. (To be clearer, in...) Figure 9 The usage of the terms pitch and helix amplitude as used in this disclosure and the appended claims is shown in the figure. The pitch adopted is preferably moderately volatile along the length of the sleeve 210, for example less than ±50%, or less than ±10% or 0%, i.e., kept constant (where “constant” means within a tolerance of ±2%).

[0094] Figure 7 The actual shape of line 255 is in Figure 8A This is shown in a two-dimensional projection. It's easier to see here that the wire 255 around the sleeve 210 has approximately (but not completely) two wraps. (See figure) Figure 9 As shown, since the pitch HP (in this disclosure, and in normal scientific use) is defined as the linear distance between adjacent “peaks” of the helix, it can be said that... Figure 8A The pitch HP of thread 255 is slightly greater than half the length of the central axis (CL) of the corresponding sleeve 210. In other words, if Figure 7If the length of the sleeve 210 is 100mm, then the corresponding value of HP will be greater than 50mm. Figure 8B and Figure 8C An example of line 255 with an alternative pitch HP is shown in the figure (in two-dimensional projection). Figure 8B The thread 255 in the middle has a pitch that is approximately one-third the length of the sleeve 210, while Figure 8C The thread 255 has a pitch approximately equal to the length of the sleeve 210. It will be apparent to those skilled in the art that... Figure 8B and Figure 8C Line 255 will need to have the same Figure 5A , Figure 5B and Figure 7 The sleeve 210 may have different forming ribs 248 and grooves 249, or alternatively, may require optional surface features (e.g. Figure 6 The sleeve 210 of the protrusion 215)

[0095] Figure 9 The terms pitch HP and helical amplitude HA used in this paper are shown. As previously stated, HP is the linear distance between consecutive helical peaks. HA is the distance (height) of the helical loop above the central axis CL of the helix. Specifically, as... Figure 7 As shown, the sleeve 210 with ribs 248 and grooves 249 can have an HA value between 1.0 and 2.0 mm, between 1.1 and 1.7 mm, or between 1.25 and 1.5 mm. The ratio between the pitch HP and the helical amplitude HA of the helical rib sleeve can be at least 10, at least 20, or at least 50.

[0096] Figure 10 An embodiment of sleeve 210 is shown, wherein the parallel alternating ribs 248 and grooves 249 are “straight” for the first portion of the sleeve length, i.e., parallel to the central axis of the sleeve, and “helical” for the second portion of the sleeve length. Such an embodiment may be particularly suitable for robotic arms when one or both ends of the sleeve are not accommodated in the flexible portion of the arm but in a rigid section adjacent to the flexible portion.

[0097] The present invention has been described in detail using its embodiments, which are provided by way of example and are not intended to limit the scope of the invention. The described embodiments include different features, and not all features are necessary in all embodiments of the invention. Some embodiments of the invention utilize only some features or possible combinations of these features. Variations of the described embodiments of the invention, as well as embodiments of the invention including different combinations of the features mentioned in the described embodiments, will occur to those skilled in the art.

[0098] Any feature or combination of features described in this document may be combined with any feature or combination of features described in U.S. Patent Application Serial No. 15 / 915,237, filed March 8, 2018 and published as U.S. Patent Publication No. 15 / 454,123, filed March 9, 2017 and published as U.S. Patent Publication No. 15 / 501,862, filed February 6, 2017 and published as U.S. Patent Publication No. 15 / 501,862; all of which are hereby incorporated herein by reference as if their entire contents were fully set forth herein.

[0099] In the specification and claims of this disclosure, the verbs “comprising,” “including,” and “having,” and their variations thereof, are used to indicate that the object of the verb is not necessarily a complete list of the components, parts, elements, or components of the subject of the verb. As used herein, unless the context clearly indicates otherwise, the singular forms “a,” “an,” and “the” include a plural of indicators. For example, the terms “a mark” or “at least one mark” may include multiple marks.

Claims

1. A surgical apparatus for use with a power source, the surgical apparatus comprising: a. an articulated mechanical arm; b. a tool connected to the mechanical arm at a distal end of the mechanical arm, the tool being motorized or the tool having at least one motorized assist device mounted thereto; c. a flexible sleeve disposed at least partially in a bendable portion of the mechanical arm, an outer surface of the flexible sleeve comprising a plurality of surface features defining a helical path about a central longitudinal axis of the flexible sleeve; and d. an electrically conductive wire for providing an electrical connection from a power source to a motorized tool or to a motorized assist device mounted on a tool, the electrically conductive wire being disposed on an outside of the flexible sleeve and engaged with one or more of the surface features so as to pass through the one or more surface features along the helical path; wherein the helical path is substantially wider than the electrically conductive wire in a manner that allows the electrically conductive wire to slide within the helical path between an inside of a bend and an outside of a bend, thereby preventing a substantial increase in tension in the electrically conductive wire during bending or straightening of the flexible sleeve.

2. The surgical apparatus of claim 1, wherein the tool is a surgical tool.

3. The surgical apparatus of claim 2, wherein the surgical tool is selected from the group consisting of a scissors, a clamp, a hook, and a laser.

4. The surgical apparatus of claim 1, wherein the tool and / or the motorized assist device is a camera, the electrically conductive wire being for providing an electrical connection from the power source to the camera.

5. The surgical apparatus of claim 1, wherein the tool and / or the motorized assist device is a data acquisition tool.

6. The surgical apparatus of claim 5, wherein the data acquisition tool comprises at least one of a motorized thermometer, a camera, and a motorized microphone.

7. The surgical apparatus of claim 1, wherein the tool and / or the motorized assist device comprises a motorized illumination source.

8. The surgical apparatus of any one of claims 1 to 3, wherein the tool has at least one internal degree of freedom.

9. The surgical apparatus of any one of claims 1 to 3, further comprising an actuation cable passing through an inner conduit of the flexible sleeve and mechanically coupled to the tool so as to: (i) modify an internal configuration of the tool relative to one or more of the internal degrees of freedom; and / or (ii) mechanically operate or actuate the tool.

10. The surgical apparatus of any one of claims 1 to 3, wherein the plurality of surface features comprises non-contiguous protrusions between which the helical path passes.

11. The surgical apparatus of any one of claims 1 to 3, wherein the plurality of surface features comprises alternating parallel longitudinal ribs and slots, the parallel longitudinal ribs and slots being helically aligned about the central longitudinal axis of the flexible sleeve for at least a lengthwise portion of the flexible sleeve, the helical path passing within one of the slots.

12. The surgical apparatus of claim 11, wherein the plurality of surface features comprises at least 3 parallel longitudinal ribs and at least 3 slots.

13. The surgical apparatus of claim 11, wherein for a first lengthwise portion of the flexible sleeve, the parallel longitudinal ribs and the slots are parallel to the central longitudinal axis, and for a second lengthwise portion of the flexible sleeve, the parallel longitudinal ribs are helically wound about the central longitudinal axis.

14. The surgical apparatus of any one of claims 1 to 3, wherein a pitch of the helical wire path has a fluctuation of less than ± 50% along a length of the helical wire path.

15. The surgical apparatus of any one of claims 1 to 3, wherein a pitch of the helical wire path is constant, or has a fluctuation of less than ± 10% along a length of the helical wire path.

16. The surgical apparatus of any one of claims 1 to 3, wherein a pitch of the helical wire path is at least 1 / 3 of a length of a central longitudinal axis path of a corresponding portion of the flexible sleeve.

17. The surgical apparatus of any one of claims 1 to 3, wherein a pitch of the helical wire path is at least 1 / 2 of a length of a central longitudinal axis path of a corresponding portion of the flexible sleeve.

18. The surgical apparatus of any one of claims 1 to 3, wherein a pitch of the helical wire path is at most 1.5 times a length of a central longitudinal axis path of a corresponding portion of the flexible sleeve, or 1.25 times the length or the length itself.

19. The surgical apparatus of any one of claims 1 to 3, wherein a ratio between a pitch of the helical wire path and a helical amplitude is at least 10.

20. The surgical apparatus of any one of claims 1 to 3, wherein the bendable portion of the robotic arm comprises a plurality of bendable segments.

21. The surgical apparatus of any one of claims 1 to 3, wherein the bendable portion of the robotic arm comprises non-contiguous segments.

22. The surgical apparatus of any one of claims 1 to 3, wherein the flexible sleeve is constrained to bend or straighten with the bendable portion of the robotic arm, and a path of the electrically conductive wire remains helical relative to a bending or straightening path of the central longitudinal axis of the flexible sleeve.

23. The surgical apparatus of claim 22, wherein for any bend of the bendable portion of the robotic arm to a radius of curvature that is greater than twice a diameter of the bendable portion, the path of the electrically conductive wire remains helical relative to the bending or the straightening path of the central longitudinal axis of the flexible sleeve.

24. The surgical apparatus of claim 23, wherein for any bend of the bendable portion of the robotic arm to a radius of curvature that is greater than 1.5 times a diameter of the bendable portion, the helical wire path of the electrically conductive wire remains helical relative to the bending or the straightening path of the central longitudinal axis of the flexible sleeve.

25. The surgical apparatus of any one of claims 1 to 3, wherein the inner conduit has a circular cross-section.

26. The surgical apparatus of any one of claims 1 to 3, wherein the inner diameter of the inner conduit is at least 0.5 mm and at most 2.0 mm.

27. The surgical apparatus of claim 11, wherein the maximum helical amplitude of the parallel longitudinal ribs on the outer surface of the flexible sleeve is at least 1.0 mm and at most 2.0 mm.

28. The surgical apparatus of claim 11, wherein the maximum helical amplitude of the parallel longitudinal ribs on the outer surface of the flexible sleeve is at least 1.25 mm and at most 1.5 mm.

29. The surgical apparatus of any one of claims 1 to 3, wherein the surface features are integrally formed with the flexible sleeve.

30. The surgical apparatus of any one of claims 1 to 3, wherein the flexible sleeve comprises a thermoplastic elastomer comprising a rigid polyamide and a flexible polyether.

31. The surgical apparatus of any one of claims 1 to 3, wherein the ratio between the pitch and the helical amplitude of the helical wire path is at least 20.

32. The surgical apparatus of any one of claims 1 to 3, wherein the ratio between the pitch and the helical amplitude of the helical wire path is at least 50.

33. A teleoperated robotic surgical system comprising: The surgical apparatus of any one of claims 1 to 32; a patient-side console configured to interface with a surgical tool to actuate the surgical tool to perform one or more surgical procedures; and a surgeon-side console comprising one or more input devices configured to be manipulated by a surgeon and transmit signals to control the surgical tool at the patient-side console.

34. An apparatus for performing electrosurgical operations using an electrosurgical power generator, the apparatus comprising: a. an articulated robotic arm; b. an electrosurgical grasper comprising a plurality of jaws and connected to the robotic arm at a distal end thereof; c. a flexible sleeve disposed at least partially in a bendable portion of the robotic arm, an outer surface of the flexible sleeve comprising a plurality of surface features defining a helical wire path about a central longitudinal axis of the flexible sleeve; d. an actuation cable passing through an inner conduit of the flexible sleeve and mechanically coupled to the electrosurgical grasper to effect movement of at least one jaw; and e. a conductive wire for providing electrical connection from the power generator to the electrosurgical grasper, the conductive wire disposed on an outer side of the flexible sleeve and engaged with one or more of the surface features so as to pass through the one or more surface features along the helical wire path; wherein the helical wire path is substantially wider than the conductive wire in a manner that allows the conductive wire to slide within the helical wire path between a curved inner side and a curved outer side, thereby preventing a substantial increase in tension in the conductive wire during bending or straightening of the flexible sleeve. ​ 35. The apparatus of claim 34, wherein the plurality of surface features comprise non- contiguous protrusions between which the helical wire path passes.

36. The apparatus of claim 34, wherein the plurality of surface features comprise alternating parallel longitudinal ribs and slots, the parallel longitudinal ribs and the slots being helically aligned about the central longitudinal axis of the flexible sleeve for at least a lengthwise portion of the flexible sleeve, the helical wire path passing within one of the slots.

37. The apparatus of claim 36, wherein the plurality of surface features comprise at least 3 parallel longitudinal ribs and at least 3 slots.

38. The apparatus of any one of claims 36 or 37, wherein for a first lengthwise portion of the flexible sleeve, the parallel longitudinal ribs and the slots are parallel to the central longitudinal axis, and for a second lengthwise portion of the flexible sleeve, the parallel longitudinal ribs are helically wrapped about the central longitudinal axis.

39. The apparatus of any one of claims 34 to 37, wherein a pitch of the helical wire path has a fluctuation of less than ± 50% along a length of the helical wire path.

40. The apparatus of any one of claims 34 to 37, wherein a pitch of the helical wire path is constant, or has a fluctuation of less than ± 10% along a length of the helical wire path.

41. The apparatus of any one of claims 34 to 37, wherein a pitch of the helical wire path is at least 1 / 3 of a length of a central longitudinal axis path of a corresponding portion of the flexible sleeve.

42. The apparatus of any one of claims 34 to 37, wherein a pitch of the helical wire path is at least 1 / 2 of a length of a central longitudinal axis path of a corresponding portion of the flexible sleeve.

43. The apparatus of any one of claims 34 to 37, wherein a pitch of the helical wire path is at most 1.5 times a length of a central longitudinal axis path of a corresponding portion of the flexible sleeve, or 1.25 times the length or the length itself.

44. The apparatus of any one of claims 34 to 37, wherein a ratio between a pitch of the helical wire path and a helical amplitude is at least 10.

45. The apparatus of any one of claims 34 to 37, wherein the bendable portion of the robotic arm comprises a plurality of bendable segments.

46. The apparatus of any one of claims 34 to 37, wherein a bendable portion of the robotic arm comprises non-contiguous segments.

47. The apparatus of any one of claims 34 to 37, wherein the flexible sleeve is constrained to bend or straighten with the bendable portion of the robotic arm, and the path of the conductive wire remains helical relative to a bending or straightening path of the central longitudinal axis of the flexible sleeve.

48. The apparatus of claim 47, wherein for any bend of the bendable portion of the robotic arm to a radius of curvature that is greater than two times a diameter of the bendable portion, the path of the electrically conductive wire remains helical with respect to the bent or straightened path of the central longitudinal axis of the flexible sleeve.

49. The apparatus of claim 48, wherein for any bend of the bendable portion of the robotic arm to a radius of curvature that is greater than 1.5 times a diameter of the bendable portion, the helical wire path of the electrically conductive wire remains helical with respect to the bent or straightened path of the central longitudinal axis of the flexible sleeve.

50. The apparatus of any one of claims 34-37, wherein the inner conduit has a circular cross-section.

51. The apparatus of any one of claims 34-37, wherein the inner conduit has an inner diameter of at least 0.5 mm and at most 2.0 mm.

52. The apparatus of any one of claims 36-37, wherein a maximum helical amplitude of the parallel longitudinal ribs on the outer surface of the flexible sleeve is at least 1.0 mm and at most 2.0 mm.

53. The apparatus of any one of claims 36-37, wherein a maximum helical amplitude of the parallel longitudinal ribs on the outer surface of the flexible sleeve is at least 1.25 mm and at most 1.5 mm.

54. The apparatus of any one of claims 34-37, wherein the surface features are integrally formed with the flexible sleeve.

55. The apparatus of any one of claims 34-37, wherein the flexible sleeve comprises a thermoplastic elastomer comprising a rigid polyamide and a flexible polyether.

56. The apparatus of any one of claims 34-37, wherein the electrosurgical forceps provide at least a bipolar electrosurgical mode when electrically connected to the electrosurgical power generator.

57. The apparatus of any one of claims 34-37, wherein the actuation cable is mechanically coupled to the electrosurgical forceps such that rotation of the actuation cable about a central longitudinal axis thereof controls the motion of the at least one jaw.

58. The apparatus of any one of claims 34-37, wherein the actuation cable is mechanically coupled to the electrosurgical forceps such that longitudinal movement of the actuation cable within the robotic arm controls the motion of the at least one jaw.

59. The apparatus of any one of claims 34-37, further comprising an electrosurgical power generator, wherein the electrically conductive wire provides an electrical connection from the power generator to the electrosurgical forceps.

60. The apparatus of any one of claims 34-37, wherein a ratio between a pitch and a helical amplitude of the helical wire path is at least 20.

61. The apparatus of any one of claims 34-37, wherein a ratio between a pitch and a helical amplitude of the helical wire path is at least 50.

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