Apparatus and method for coupling a cable to a medical device

Abstract

The tool member is rotatably coupled to the distal end portion of the shaft and includes a drive pulley and a coupling spool. The mechanical structure is coupled to the proximal end portion of the shaft and includes a first winch and a second winch. The first winch and the second winch each include a first portion and a second portion. A distal portion of the cable is wrapped at least one turn around the coupling spool. A first proximal end of the cable is wrapped around the second portion of the first winch such that the second portion traverses a first portion of the first proximal end of the cable. A second proximal end of the cable is wrapped around the second portion of the second winch such that a second portion of the second proximal end of the cable traverses a first portion of the second proximal end of the cable.

Description

[0001] Cross-references to related applications

[0002] This application claims priority and benefit to U.S. Provisional Patent Application No. 62 / 975,927, filed February 13, 2020, entitled “Devices and Methods for Coupling a Cable to a Capstan of a Medical Device”, and U.S. Provisional Patent Application No. 62 / 975,928, also filed February 13, 2020, the disclosure of which is incorporated herein by reference in its entirety. Background Technology

[0003] The embodiments described herein relate to medical devices, and more specifically to endoscopic tools. More specifically, the embodiments described herein relate to devices including a tension cable and a mechanism for coupling the cable to any winch or end effector tool (which is coupled to the winch).

[0004] Known techniques for minimally invasive surgery (MIS) employ instruments to manipulate tissue that can be manually controlled or remotely controlled via computer assistance. Many known MIS instruments include therapeutic or diagnostic end effectors (e.g., forceps, cutting tools, or cauterization tools) mounted on a wrist mechanism at the distal end of an axis. During an MIS procedure, the end effector, wrist mechanism, and distal end of the axis can be inserted into a small incision or natural orifice in the patient to position the end effector at a working site within the patient's body. Optional wrist mechanisms can be used to change the orientation of the end effector relative to the axis to perform the desired procedure at the working site. Known wrist mechanisms typically provide the required degrees of freedom (DOF) for the movement of the end effector. For example, known wrist mechanisms are typically capable of changing the pitch and yaw of the end effector's reference axis. The wrist may optionally provide roll DOF for the end effector, or roll DOF may be implemented by rolling the axis. The end effector may optionally have additional mechanical DOFs, such as gripping or blade movement. In some cases, the mechanical DOFs of the wrist and end effector can be combined. For example, U.S. Patent No. 5,792,135 (filed May 16, 1997) discloses a mechanism in which a wrist and an end effector are combined to hold a DOF.

[0005] To achieve the desired movement of the wrist mechanism and end effector, known devices include a cable (e.g., a power cable) extending through an axis of the device and connecting the wrist mechanism to a mechanical structure configured to move the cable to operate the wrist mechanism. For robots or remote operating systems, the mechanical structure is typically motor-driven and operably coupled to a processing system to provide a user interface for clinical users (e.g., surgeons) to control the device.

[0006] Patients benefit from ongoing efforts to improve the effectiveness of MIS methods and tools. For example, reducing the size and / or operational footprint of axis and wrist mechanisms allows for smaller access incisions and reduces the space required at the surgical site, thereby reducing the negative effects of surgery such as pain, scarring, and poor healing time. However, manufacturing small medical devices that provide the clinical functionality required for implementing minimally invasive procedures can be challenging. Specifically, simply reducing the size of known wrist mechanisms by “shrinking” components does not provide an effective solution because the required component and material properties do not scale proportionally. For example, effective implementation of a wrist mechanism can be complex because cables must be carefully routed through the wrist mechanism to maintain cable tension throughout the entire range of motion and minimize the interaction (or coupling effect) of one axis of rotation on another. Furthermore, pulleys and / or contoured surfaces are often required to reduce cable friction, which extends device life and allows operation without applying excessive force to the cables or other structures within the wrist mechanism. Smaller structures (including cables and other components of the wrist mechanism) may result in increased localized forces that could lead to undesirable elongation of the cable during storage and use (e.g., “stretching” or “creep”), reduced cable life, etc.

[0007] Furthermore, wrist mechanisms typically provide specific degrees of freedom for the movement of an end effector. For example, for tweezers or other grasping tools, the wrist may be able to alter the pitch, yaw, and grip of the end effector. More degrees of freedom can be implemented via the wrist, but this requires additional actuating components in the wrist and axis, which will compete for space (given the size constraints required for MIS applications). Other degrees of freedom (such as roll or insertion / extraction via the movement of the master actuator) will also compete for space at or within the axis of the device.

[0008] Traditional architectures for wrist mechanisms in robotically controlled medical devices use cables to rotate winches in a rear-end mechanism, thereby rotating the portion of the wrist mechanism to which it is attached. For example, the wrist mechanism can be operatively coupled to three winches for rotation about a pitch axis, yaw axis, or clamping axis. Each winch can be controlled using two cables attached to it, allowing cables to be released on one side and pulled in on the other of equal length. Using this architecture, three degrees of freedom require a total of six cables extending from the wrist mechanism along the length of the main tube to the rear-end mechanism of the device. Effective implementation of the wrist and rear-end mechanisms can be complex because the cables must be carefully routed through the wrist mechanism, tooling components, and rear-end mechanism to maintain wrist stability throughout the entire range of motion and minimize the interaction (or coupling effect) of one rotational axis on another.

[0009] Some known architectures for robotically controlled medical devices use cables with crimping or other retention methods to secure them to winches or tooling components, which can increase the time and cost of manufacturing the medical devices. For example, the time required to crimp the cabling and secure it to the winch and / or end effector can be increased. Furthermore, the cables themselves can be very expensive. For instance, many conventional architectures for robotically controlled medical devices use cables made of materials such as tungsten or steel. Such cables can be constructed for a variety of applications but are also very expensive.

[0010] Therefore, there is a need for improved endoscopic tools (including improved rear-end mechanisms) to enable wrist manipulation with a small number of cables, facilitating instrument miniaturization, reducing instrument costs, and lowering manufacturing costs by reducing the number of required parts. Improved endoscopic tools are also needed that provide tighter control over the movement of the wrist mechanism and end effector, and may include cables formed from materials such as various polymers that can reduce costs. Endoscopic tools are also needed that include architectures that do not require cables, including crimped or otherwise retaining elements to secure the cables within the wrist mechanism, end effector, or rear-end mechanism. Summary of the Invention

[0011] This summary introduces certain aspects of the embodiments described herein to provide a basic understanding. This summary is not a broad overview of the subject matter of the invention, and it is not intended to identify key or critically important elements or to define the scope of the subject matter. In some embodiments, the medical device includes a shaft, a tool member, a mechanical structure, and a cable, wherein the shaft includes a distal portion and a proximal portion. The tool member is rotatably coupled to the distal portion of the shaft about an axis of rotation and includes a drive pulley and a coupling shaft. The mechanical structure is coupled to the proximal portion of the shaft and includes a first winch and a second winch. The first winch includes a first portion and a second portion. The second winch includes a first portion and a second portion. The cable includes a first proximal end, a second proximal end, and a distal portion and is routed along the shaft. The distal portion of the cable is routed around a drive surface of the drive pulley and wound around the coupling shaft at least one turn to secure the distal portion of the cable to the tool member. The first proximal end of the cable is routed around a drive surface of a first portion of the first winch and wound around a second portion of the first winch such that a second wound portion of the first proximal end of the cable crosses over the first wound portion of the first proximal end of the cable. The second proximal end of the cable is routed around the drive surface of the first portion of the second winch and wound around the second portion of the second winch, such that the second wound portion of the second proximal end of the cable crosses the first wound portion of the second proximal end of the cable.

[0012] In some embodiments, the cable of the medical device is formed of a polymer. In some embodiments, the cable of the medical device does not have a retaining feature. In some embodiments, the distal cable is wound around the coupling reel at least two turns. In some embodiments, the first proximal end of the cable is wound around the second portion of the first reel at least two turns, and the second proximal end of the cable is wound around the second portion of the second reel at least two turns. In some embodiments, the first slot and the second slot are defined within the second portion of the first reel, and the second slot crosses the first slot. In such an embodiment, the first proximal end of the cable is wound around the second portion of the first reel within the first slot, and the first proximal end of the cable is wound around the second portion of the first reel within the second slot, such that the second wound portion of the cable crosses the first wound portion of the cable.

[0013] In some embodiments, the medical device includes a shaft and a mechanical structure. The shaft includes a distal portion and a proximal portion, and the mechanical structure is coupled to the proximal portion of the shaft. The mechanical structure includes a winch having a first portion and a second portion. The first portion includes a drive surface configured to engage a cable such that rotation of the winch generates tension in the cable. A first slot and a second slot are defined within the second portion of the winch. The second slot intersects the first slot, and both the first and second slots are configured to receive a cable to secure the cable to the second portion of the winch. A termination opening is defined within the second portion.

[0014] In some embodiments, the medical device further includes a cable coupled to a winch. The cable extends along an axis and is wired around a drive surface of a first portion. The cable is wound around a second portion of the winch within a first slot and around a second portion of the winch within a second slot, such that a second wound portion of the cable crosses over a first wound portion of the cable. A termination end of the cable is coupled within a termination opening.

[0015] In some embodiments, the medical device includes a shaft having a distal portion and a proximal portion. An end effector is coupled to the distal portion of the shaft, and a mechanical structure is coupled to the proximal portion of the shaft. The mechanical structure includes a winch having a first portion and a second portion. The first portion includes a drive surface, and a termination opening is defined within the second portion. A first slot and a second slot are defined within the second portion, and the second slot intersects the first slot. A cable is routed along the shaft and includes a proximal end and a distal end. The distal portion of the cable is coupled to the end effector, and the proximal end of the cable includes a drive portion, a first winding portion, a second winding portion, and a termination portion. The drive portion of the cable is wound at least partially around the drive surface of the first portion of the winch. The first winding portion of the cable is wound around the second portion of the winch within the first slot, and the second winding portion of the cable is wound around the second portion of the winch within the second slot such that the second winding portion crosses the first winding portion. The termination portion is coupled within the termination opening.

[0016] In some embodiments, the drive surface of a first portion of the winch of the medical device is a circular groove surrounding the longitudinal axis of the winch and defines a diameter. A second portion of the winch is cylindrical around the longitudinal axis of the winch and defines a diameter larger than the diameter of the drive surface. In some embodiments, the first portion of the winch includes a first sidewall and a second sidewall, and the drive surface of the winch is located between the first and second sidewalls. In some such embodiments, a passage is defined within the first sidewall, and a first winding portion of a cable passes through the passage from the first portion of the winch and reaches a first slot for wiring. In some embodiments, the termination portion of the cable has a constant cross-sectional diameter. In some embodiments, a central hole is defined within the winch, and the winch includes a reinforcing rod within the central hole.

[0017] In some embodiments, a method of assembling a medical device is provided, wherein the medical device includes a shaft, an end effector movably coupled to a distal end of the shaft, a mechanical structure coupled to a proximal end of the shaft, and a cable. The cable includes a drive portion, a first winding portion, a second winding portion, and a termination portion. The method includes a winch that routes the cable from the end effector through the shaft wiring to the mechanical structure. The winch includes a first portion and a second portion. The first portion includes a drive surface, and each of a first slot, a second slot, and a termination opening is defined within the second portion. The method further includes winding at least a portion of the drive portion of the cable around the drive surface of the first portion of the winch. The first winding portion is wound around the second portion of the winch within the first slot, and the second winding portion is wound around the second portion of the winch within the second slot such that the second winding portion traverses the first winding portion. The termination portion is secured within the termination opening.

[0018] In some embodiments, the cable comprises a polymer. In some embodiments, the termination portion of the cable does not have a retaining feature. In some embodiments, the method further includes cutting the end of the cable to form the termination portion of the cable after winding a second winding portion.

[0019] In some embodiments, the medical device includes a shaft, a link, a tool member, and a cable having a distal portion and a proximal portion. The link is coupled to the distal portion of the shaft, and the tool member is rotatably coupled to the link about a rotation axis. The tool member includes a drive pulley and a coupling shaft. The drive pulley includes a drive surface at a first position along the rotation axis. The coupling shaft includes a winding surface at a second position along the rotation axis, offset from the first position. The cable includes a proximal end and a distal end. The proximal end of the cable is routed along the shaft, and the distal end of the cable includes a first pulley portion, a winding portion, and a second pulley portion. The first pulley portion of the cable is wound at least partially around a first portion of the drive surface of the drive pulley. The winding portion of the cable is wound around the winding surface of the coupling shaft. The second pulley portion of the cable is wound at least partially around a second portion of the drive surface of the drive pulley.

[0020] In some embodiments, the cable winding portion includes a first segment and a second segment, and the cable winding portion is wound around a coupling shaft such that the second segment intersects the first segment. In some embodiments, the cable winding portion is wound around the coupling shaft at least two turns. In some embodiments, a circular groove is defined within the coupling shaft, and the winding surface is within the circular groove. In some embodiments, the cable comprises a polymer. In some embodiments, the cable winding portion does not have a retaining feature.

[0021] In some embodiments, the medical device includes a link configured to be coupled to a distal portion of a shaft and a tool member rotatably coupled to the link about a rotational axis. The tool member includes a drive pulley and a coupling shaft. The drive pulley includes a drive surface configured to engage a cable such that tension applied by the cable along the drive surface generates a rotational torque about the rotational axis. The drive surface is located at a first position along the rotational axis. The coupling shaft includes a winding surface to which the cable is configured to be secured to the tool member. The winding surface is located at a second position along the rotational axis. The second position is offset from the first position along the rotational axis.

[0022] In some embodiments, the medical device further includes a cable coupled to a tool component. The cable extends along an axis and is wired around a first portion of the drive surface of a drive pulley. The cable is further wound around a winding surface of a coupling shaft at least one turn and wired around a second portion of the drive surface of the drive pulley. In some embodiments, the cable is wound around the winding surface of the coupling shaft at least two turns. In some embodiments, the cable is wound around the winding surface of the coupling shaft such that a second segment of the cable crosses over a first segment of the cable.

[0023] In some embodiments of the medical device, the drive pulley includes a jaw connecting protrusion, and the tool member includes a jaw separately constructed from the drive pulley. A connection opening is defined by the jaw; and the jaw connecting protrusion of the drive pulley is coupled within the connection opening of the jaw. In some embodiments, the tool member is a first tool member, the medical device includes a second tool member rotatably coupled to a link about a rotation axis, and the drive pulley includes a rotation-limiting protrusion configured to engage a shoulder of the second tool member to limit rotation of the first tool member relative to the second tool member about a rotation axis.

[0024] In some embodiments, the medical device includes a shaft, a link, a tool member, and a cable. The shaft includes a distal portion and a proximal portion. The link is coupled to the distal portion of the shaft, and the tool member is rotatably coupled to the link about a rotation axis. The tool member includes a drive pulley and a coupling shaft. The cable includes a proximal end and a distal end. The proximal end of the cable is routed along the shaft, and the distal end of the cable includes a first pulley portion, a winding portion, and a second pulley portion. The first pulley portion of the cable is at least partially wound around a first portion of the drive pulley. The winding portion of the cable is wound around a winding surface of the coupling shaft such that a first segment of the winding portion of the cable traverses a second segment of the winding portion. The second pulley portion of the cable is at least partially wound around a second portion of the drive surface of the drive pulley of the tool member.

[0025] In some embodiments, the tool member includes a protrusion around which at least one of a first pulley portion, a winding portion, or a second pulley portion is wound. In some embodiments, the tool member includes a sidewall, a first protrusion, and a second protrusion, and the sidewall separates the drive pulley and the coupling shaft. The sidewall between the first and second protrusions defines an opening, and the winding portion of the cable is routed from the drive pulley to the coupling shaft via the opening. The first pulley portion of the cable is wound around the first protrusion, and the second pulley portion of the cable is wound around the second protrusion.

[0026] Other medical devices, related components, medical device systems, and / or methods according to the embodiments will be apparent to or become apparent to those skilled in the art after reading the following figures and detailed description. All such additional medical devices, related components, medical device systems, and / or methods included in this specification are intended to fall within the scope of this disclosure. Attached Figure Description

[0027] Figure 1 This is a floor plan of a minimally invasive remote-operated medical system for performing medical procedures such as surgical procedures, according to an embodiment.

[0028] Figure 2 yes Figure 1 A perspective view of the optional auxiliary units of the minimally invasive remote surgical system shown.

[0029] Figure 3 yes Figure 1 A perspective view of the user console of the minimally invasive remote surgical system shown.

[0030] Figure 4 yes Figure 1 The diagram shows a front view of the manipulator unit of a minimally invasive remote surgical system, which includes multiple instruments.

[0031] Figure 5 This is a schematic diagram of a part of a medical device according to an embodiment.

[0032] Figure 6 yes Figure 5 An enlarged view of a part of a medical device.

[0033] Figure 7A yes Figure 5 An enlarged perspective view of a winch for a medical device.

[0034] Figure 7B yes Figure 5 A side view of a portion of the cable of a medical device.

[0035] Figure 8 This is a perspective view of a winch according to another embodiment.

[0036] Figure 9 yes Figure 8 A perspective view of a winch, in which cables are coupled to the winch.

[0037] Figure 10 and Figure 11 This is a side view of the tool component according to an embodiment. Figure 10 ) and end view ( Figure 11 ).

[0038] Figure 12 and Figure 13 yes Figure 10 An end view of the tool component, shown as a cable wound around the drive pulley of the tool component. Figure 12 The cable is further wound inside the coupling shaft of the tool component. Figure 13 )Inside.

[0039] Figure 14 and Figure 15 Each is a different side view of the winch according to another embodiment.

[0040] Figure 16 yes Figure 14 and Figure 15 A side view of the winch, as shown Figure 14 The rotation is shown, and the cable is partially coupled to it.

[0041] Figure 17 yes Figures 14 to 16 A side view of the winch, with a rotating illustration showing the other side of the winch, where the cable is further partially coupled to it.

[0042] Figure 18 yes Figures 14-17 A side view of the winch, as shown Figure 15 The rotation shown, and where Figure 14 The cable is further partially coupled to it.

[0043] Figure 19 yes Figures 14-18 A side view of the winch, with a rotating illustration showing the components coupled to it. Figure 14 On the other side of the cable winch.

[0044] Figure 20 This is a perspective view of a portion of the mechanical structure according to an embodiment.

[0045] Figure 21 This is a perspective view of a medical device according to an embodiment.

[0046] Figure 22A It is a mechanical structure and Figure 21 An enlarged perspective view of a portion of the axis of a medical device.

[0047] Figure 22B yes Figure 22A An end view of the mechanical structure, with the outer casing removed.

[0048] Figures 23-25 Each is Figure 22A and Figure 22B Different side perspective views of the winch's mechanical structure.

[0049] Figure 26 yes Figure 21 An enlarged perspective view of the distal portion of a medical device.

[0050] Figure 27 yes Figure 21 A perspective view of the distal portion of a medical device, with the outer cover removed and the tool component in a closed position.

[0051] Figure 28 yes Figure 21 A top view of the distal portion of a medical device, with the outer cover removed and the end effector in a closed position.

[0052] Figure 29 yes Figure 21 A perspective view of the distal portion of a medical device, with the outer cover removed and the end effector in the open position.

[0053] Figure 30 yes Figure 21 A top view of the distal portion of a medical device, with the outer cover removed and the end effector in a closed position and oriented upwards (i.e., outside the page).

[0054] Figure 31 yes Figure 21 A perspective view of the wrist component of a medical device.

[0055] Figure 32 It is a partially exploded top view, and Figure 33A and Figure 33B Each is Figure 21 Different partial exploded perspective views of the wrist component of a medical device.

[0056] Figure 34 yes Figure 21 An enlarged top view of a portion of the end effector of a medical device.

[0057] Figure 35A yes Figure 21 A partial exploded perspective view of the end effector of a medical device.

[0058] Figure 35B and Figure 35C Each is Figure 21A partial exploded perspective view of the end effector of a medical device, in which... Figure 35C The diagram illustrates the relationship between the end effector and... Figure 35B The opposite side.

[0059] Figure 36A and Figure 36B yes Figure 34 and Figures 35A-35C Side view of a single tool component of the end effector ( Figure 36A ) and perspective ( Figure 36B ).

[0060] Figure 37 This is a perspective view of a portion of a medical device according to an embodiment.

[0061] Figure 38A yes Figure 37 A perspective view of the end effector of a medical device.

[0062] Figure 38B yes Figure 38A A partial exploded view of the end effector.

[0063] Figure 39A and Figure 39B Each is Figure 38A Side view of the different tool components of the end effector.

[0064] Figure 40 yes Figure 38A A partial exploded view of the end effector.

[0065] Figure 41 This is a perspective view of a portion of a medical device according to an embodiment.

[0066] Figure 42 yes Figure 41 A side view of the end effector of a medical device.

[0067] Figure 43 yes Figure 42 A side view of the tool component of the end effector.

[0068] Figure 44 This is a perspective view of a portion of a medical device according to an embodiment.

[0069] Figure 45 and Figure 46 yes Figure 44 Perspective view of the end effector of a medical device ( Figure 45 ) and side view ( Figure 46 ).

[0070] Figure 47 and Figure 48 Each is Figure 45 and Figure 46Side view of the different tool components of the end effector.

[0071] Figure 49 This is a perspective view of a portion of the end effector of a medical device according to an embodiment.

[0072] Figure 50 yes Figure 49 A side view of a portion of the end effector.

[0073] Figure 51 yes Figure 49 A perspective view of a portion of the end effector, with the cable wound inside the drive pulley and coupling shaft of the end effector.

[0074] Figure 52 yes Figure 49 A side view of a portion of the end effector, with the cable wound inside the drive pulley and coupling shaft of the end effector.

[0075] Figure 53 This is a perspective view of a schematic diagram showing a cable in a winding pattern being removed from an end effector, for illustrative purposes.

[0076] Figures 54A-54D Each diagram illustrates the part to be coupled to Figure 49 The steps in the winding sequence of the end effector cable.

[0077] Figure 55 This is a perspective view of the winch of a medical device according to an embodiment.

[0078] Figure 56 yes Figure 55 Front view of the winch.

[0079] Figure 57 yes Figure 55 Rear view of the winch.

[0080] Figure 58 yes Figure 55 A top view of the winch.

[0081] Figure 59 yes Figure 55 A bottom view of the winch.

[0082] Figures 60-66 Each diagram illustrates the part to be coupled to Figure 55 The steps in the winding sequence of the cable on the winch.

[0083] Figure 67 This is a side view of a portion of the cable according to an embodiment.

[0084] Figure 68 This is a side view of the tool component of a medical device according to an embodiment.

[0085] Figure 69 yes Figure 68 A side view of a tool component, illustrating a portion of the cable coupled to it.

[0086] Figure 70 This is a side view of a portion of the winch of a medical device according to an embodiment.

[0087] Figure 71 yes Figure 70 An enlarged view of a portion of the winch, illustrating a portion of the cable coupled to it. Detailed Implementation

[0088] The embodiments described herein can be advantageously used for a variety of grasping, cutting, and manipulating operations associated with minimally invasive surgery.

[0089] The medical device of this application enables movement in three degrees of freedom (e.g., about the pitch axis, yaw axis, and clamping axis) using only four cables, thereby reducing the total number of cables required, reducing the space required within the shaft and wrist, lowering the overall cost, and enabling further miniaturization of the wrist and shaft assemblies to facilitate MIS procedures. Furthermore, the device described herein includes one or more cables (which serve as tensioning members) formed of a polymer material and can be secured to a winch of a rear-end mechanism without retaining elements or other fixing features. The winch may be configured with grooves, and the cable may be wound around the winch and at least partially disposed within the grooves, such that a first wound portion of the cable traverses a second wound portion of the cable. This traverse configuration assists in securing the cable to the winch. The polymer material of the cable or a coating applied to the cable surface also provides sufficient friction to further assist in maintaining the cable secured to the winch without any additional mechanisms for securing the cable to the winch (e.g., placing the cable crimp within a guide slot, securing the cable to the winch with adhesive, etc.).

[0090] Furthermore, the instruments described herein may include tool components (e.g., grippers, blades, etc.) comprising jaws having coupling shafts and drive pulleys offset from each other along the axis of rotation of the tool component. The cables described herein may be wound around the drive pulleys and coupling shafts and held on the drive pulleys and coupling shafts by the frictional properties of the cables and by crossing a first portion of the cable over a second portion, as described in more detail below.

[0091] As used herein, the term “about” when used in conjunction with a referenced numerical indication means the referenced numerical indication plus or minus up to 10% of that referenced numerical indication. For example, the language “about 50” covers a range of 45 to 55. Similarly, the language “about 5” covers a range of 4.5 to 5.5.

[0092] The term "flexible" in relation to parts (such as mechanical structures, components, or component assemblies) should be interpreted broadly. Essentially, the term refers to a part's ability to be bent repeatedly and return to its original shape without damage. Some flexible components can also be elastic. For example, a component (e.g., a bent portion) is said to be elastic if it has the ability to absorb energy during elastic deformation and then release the stored energy upon unloading (i.e., returning to its original state). Many "rigid" objects have a slight inherent elastic "bending" due to material properties, although these objects are not considered "flexible" (as used herein).

[0093] As used in this specification and the appended claims, the term "distal" refers to the direction toward the working point, and the term "proximal" refers to the direction away from the working point. Thus, for example, the tool end closest to the target tissue would be the distal end of the tool, while the end opposite the distal end (i.e., the end manipulated by the user or coupled to the actuation shaft) would be the proximal end of the tool.

[0094] Furthermore, the choice of specific terms used to describe one or more embodiments and optional elements or features is not intended to limit the invention. For example, spatially relative terms (e.g., “below,” “under,” “lower,” “above,” “upper,” “proximal,” “farthest,” etc.) may be used to describe the relationship of one element or feature to another element or feature shown in the figures. In addition to the positioning and orientation shown in the figures, these spatially relative terms are intended to cover different positioning (i.e., translational placement) and orientation (i.e., rotational placement) of the device in use or operation. For example, if the device in the figures is flipped, an element described as “below” or “under” other elements or features will be “above” or “on” other elements or features. Thus, the term “below” can cover both above and below positioning and orientation. The device may be oriented in other ways (e.g., rotated 90 degrees or in other orientations) and the spatially relative narratives used herein are interpreted accordingly. Similarly, narratives of movement along (translation) and around (rotation) various axes encompass various spatial device positioning and orientations. The combination of body positioning and orientation defines the body posture.

[0095] Similarly, geometric terms (such as "parallel," "perpendicular," "arc," or "square") are not intended to require absolute mathematical precision unless the context indicates otherwise. Instead, such geometric terms allow for variations due to manufacturing or equivalent functions. For example, if an element is described as "arc" or "approximately arc," parts that are not precisely circular (e.g., slightly elliptical or polygonal parts) are still included in the description.

[0096] Furthermore, unless the context otherwise indicates, the singular forms “a,” “an,” and “the” are intended to include the plural forms as well. The terms “comprising,” “including,” “having,” etc., specify the presence of the said feature, step, operation, element, component, etc., but do not preclude the presence or addition of one or more other features, steps, operations, elements, components, or groups.

[0097] Unless otherwise indicated, the terms device, medical equipment, apparatus and variations thereof are used interchangeably.

[0098] The aspects of this invention are primarily based on the use of a commercially available daemon developed by Intuitive Surgical, Inc. of Sunnyvale, California. The implementation of a surgical system is described. An example of such a surgical system is daVinci. Surgical System (Model IS4000), da Vinci Surgical system (model IS4200) and da Surgical system (model IS3000). However, those skilled in the art will understand that the inventive aspects disclosed herein can be embodied and implemented in various ways, including computer-aided, non-computer-aided, and hybrid combinations of manual and computer-aided embodiments and implementations. The embodiments shown on surgical systems (e.g., models IS4000, IS3000, IS2000, and IS1200) are presented by way of example only and should not be considered as limiting the scope of the inventive aspects disclosed herein. Where applicable, inventive aspects can be embodied and implemented in both relatively small handheld manual operating devices and relatively large systems with additional mechanical support.

[0099] Figure 1This is a floor plan illustration of a computer-aided remote operating system. The illustration shows a medical device, a minimally invasive robotic surgical (MIRS) system 1000 (also referred to herein as a minimally invasive remote surgical system), for performing minimally invasive diagnostic or surgical procedures on a patient P lying on an operating table 1010. The system can have any number of components, such as a user control unit 1100 for use by a surgeon or other skilled clinician S during the procedure. The MIRS system 1000 may also include a manipulator unit 1200 (generally referred to as a surgical robot) and an optional assistive device unit 1150. The manipulator unit 1200 may include an arm assembly 1300 and a tool assembly removably coupled to the arm assembly. The manipulator unit 1200 is capable of manipulating at least one removably coupled instrument 1400 (also referred to herein as a "tool") through a minimally invasive incision in the body or a natural orifice of the patient P while the surgeon S observes the surgical site and controls the movement of the instrument 1400 via the control unit 1100. Images of the surgical site are obtained by an endoscope (e.g., a stereoscopic endoscope) (not shown), which can be manipulated by manipulator unit 1200 to orient the endoscope. Auxiliary equipment unit 1150 can be used to process the images of the surgical site for subsequent display to the surgeon S via user control unit 1100. The number of instruments 1400 used at one time typically depends on factors such as diagnostic or surgical procedures and operating room space constraints. If it is necessary to change one or more of the instruments 1400 in use during the procedure, an assistant removes the instrument 1400 from manipulator unit 1200 and replaces it with another instrument 1400 from tray 1020 in the operating room. Although shown for use with instrument 1400, any instrument described herein can be used with MIRS 1000.

[0100] Figure 2 This is a perspective view of the control unit 1100. The user control unit 1100 includes a left-eye display 1112 and a right-eye display 1114 for presenting a coordinated stereoscopic view of the surgical site, enabling depth perception, to the surgeon S. The user control unit 1100 also includes one or more input control devices 1116, which in turn enable the manipulator unit 1200 ( Figure 1(As shown) the user control unit 1116 manipulates one or more tools. The input control device 1116 provides at least the same degrees of freedom as the instruments 1400 associated with it, to provide the surgeon S with a remote presentation, or a perception that the input control device 1116 is integrated with (or directly connected to) the instruments 1400. In this way, the user control unit 1100 provides the surgeon S with a strong sense of direct control over the instruments 1400. For this purpose, positioning, force, and tactile feedback sensors (not shown) can be used to transmit positioning, force, and tactile sensations from the instruments 1400 back to the surgeon's hand via the input control device 1116.

[0101] User control unit 1100 Figure 1 In one embodiment, the user control unit 1100 and the surgeon S are shown in the same room as the patient, allowing the surgeon S to directly monitor the procedure, be physically present if necessary, and speak directly with an assistant, rather than via telephone or other communication medium. However, in other embodiments, the user control unit 1100 and the surgeon S may be in different rooms, entirely different buildings, or other remote locations from the patient, thus enabling remote surgical procedures.

[0102] Figure 3 This is a perspective view of the auxiliary equipment unit 1150. The auxiliary equipment unit 1150 may be coupled to an endoscope (not shown) and may include one or more processors to process captured images for subsequent display, such as via a user control unit 1100, or on another suitable display located locally and / or remotely. For example, in the case of using a stereoscopic endoscope, the auxiliary equipment unit 1150 may process the captured images to present a coordinated stereoscopic image of the surgical site to the surgeon S via a left-eye display 1112 and a right-eye display 1114. This coordination may include alignment between opposing images and may include adjusting the stereoscopic working distance of the stereoscopic endoscope. As another example, image processing may include compensating for imaging errors, such as optical aberrations, of the image capture device using previously determined camera calibration parameters.

[0103] Figure 4 A front perspective view of the manipulator unit 1200 is shown. The manipulator unit 1200 includes components (e.g., arms, linkages, motors, sensors, etc.) to provide manipulation of the instrument 1400 and imaging equipment (e.g., a stereoscopic endoscope for capturing images of the site of the procedure) (not shown). Specifically, the instrument 1400 and imaging equipment can be manipulated via a remote manipulation mechanism having multiple joints. Furthermore, the instrument 1400 and imaging equipment are positioned and manipulated through an incision or natural orifice in the patient P such that the software and / or kinematic remote motion centers are maintained at the incision or orifice. In this way, the incision size can be minimized.

[0104] Figure 5Figure 7b is a schematic diagram of a portion of a medical device 2400 according to an embodiment. The device 2400 includes a shaft 2410, a cable 2420 (which serves as a first tensioning member), an end effector 2460, and a mechanical structure 2700. The mechanical structure 2700 may be configured to function as an “actuator” or “transmission device” or “transmission device assembly” to move one or more components of the medical device 2400 and / or interface with other parts of a surgical system (e.g., the manipulator unit 1200 described above). In some embodiments, the mechanical structure 2700 (and any mechanical structures described herein) may include one or more drive motors to generate force or torque to move components of the medical device 2400. In other embodiments, the mechanical structure 2700 (and any mechanical structures described herein) does not contain any motors. For example, in some embodiments, the mechanical structure 2700 (and any mechanical structures described herein) is coupled to a manipulator unit that includes one or more motors. The cable 2420 includes a first proximal portion 2421, a second proximal portion 2423, and a distal portion 2422. The first proximal portion 2421 and the second proximal portion 2423 are each coupled to the mechanical structure 2700, and the distal portion 2422 is coupled to the end effector 2460, as described in more detail below. The shaft 2410 includes a proximal portion 2411 and a distal portion 2412 and defines a lumen 2413.

[0105] The end effector 2460 is rotatably coupled to the distal portion 2412 of the shaft 2410 and includes at least one tool member 2462. The device 2400 is configured such that movement of the first proximal portion 2421 and the second proximal portion 2423 of the cable 2420 produces movement of the tool member 2462 about a first axis of rotation A1 (which serves as a yaw axis; the term yaw is arbitrary) in the direction of arrow AA. In some embodiments, the medical device 2400 may include a wrist assembly comprising one or more links (…) that couple the end effector 2460 to the distal portion 2412 of the shaft 2410. Figure 5 - Not shown in Figure 7b). In such an embodiment, movement of the first proximal portion 2421 and the second proximal portion 2423 of the cable 2420 can also generate the wrist assembly about the second rotation axis ( Figure 5 - Not shown in Figure 7b, but used as the pitch axis (the term pitch is arbitrary) refers to the movement of either the wrist assembly or the end effector 2460. (This document references...) Figures 21-3 6 describes an embodiment with a wrist component.

[0106] Tool member 2462 includes a contact portion 2464, a drive pulley 2470, and a coupling shaft 2467. The contact portion 2464 is configured to engage or manipulate target tissue during a surgical procedure. For example, in some embodiments, the contact portion 2464 may include an engagement surface serving as a gripper, cutter, tissue manipulator, etc. In other embodiments, the contact portion 2464 may be an energized tool member for cauterization or electrosurgical procedures. End effector 2462 is operatively coupled to mechanical structure 2700 such that tool member 2462 rotates relative to axis 2410 about a first axis of rotation A1 in the direction of arrow AA. In this way, the contact portion 2464 of tool member 2462 can be actuated to engage or manipulate target tissue during a surgical procedure. Tool member 2462 (or any tool member described herein) may be any suitable medical tool member. Furthermore, although only one tool member 2462 is shown, in other embodiments, instrument 2400 may include two or more movable tool members that cooperate in performing gripping or cutting functions.

[0107] The mechanical structure 2700 includes a housing 2760, a first winch 2710, and a second winch 2720. The housing 2760 (which serves as a frame) provides structural support for mounting and aligning components of the mechanical structure 2700. For example, the housing 2760 may define openings, protrusions, and / or supports for mounting shafts or other components. The first winch 2710 is mounted to the mechanical structure 2700 (e.g., within the housing 2760) via a first winch support member (not shown). For example, the first winch support member may be a base, a shaft, or any other suitable support structure to secure the first winch 2710 to the mechanical structure 2700.

[0108] The second winch 2720 is mounted to the mechanical structure 2700 (e.g., within the housing 2760) via a second winch support member (not shown). For example, the second winch support member may be a base, shaft, or any other suitable support structure to secure the second winch 2720 to the mechanical structure 2700. The first winch 2710 and the second winch 2720 are each operable to rotate about axis A3 in the DD direction, as shown for the first winch 2710. Figure 7A As shown.

[0109] Cable 2420 is routed between mechanical structure 2700 and end effector 2460, and is coupled to a first winch 2710 and a second winch 2720 of mechanical structure 2700. More specifically, a first proximal portion 2421 of cable 2420 is coupled to the first winch 2710 of mechanical structure 2700, cable 2420 extends from the first winch 2710 along shaft 2410, and a distal portion 2422 of cable 2410 is coupled to end effector 2460, as described in more detail herein. Although cable 2420 is shown as being in Figure 5 The cable 2420 extends within the internal cavity of the shaft 2410, but in other embodiments, the cable 2420 may be routed externally to the shaft 2410. The cable 2420 extends along the shaft 2410 from the end effector 2460, and a second proximal portion 2423 is coupled to the second winch 2720 of the mechanical structure 2700. In other words, both ends of a single cable (e.g., 2420) are coupled to and actuated by two separate winches of the mechanical structure 2700.

[0110] More specifically, the two ends of cable 2420, associated with the opposite direction of a single degree of freedom, are connected to two independent drive winches 2710 and 2720. This arrangement (often referred to as an anti-drive system) allows for independent control of the movement (e.g., pull-in or release) of each end of the cable. Mechanical structure 2700 generates movement of cable 2420, which operates to produce the desired articulation movement (pitch, yaw, or clamp) at end effector 2460. Thus, as described herein, mechanical structure 2700 includes components and controls to move a first portion of cable 2420 in a first direction (e.g., proximal direction) via first winch 2710 and a second portion of cable 2420 in a second opposite direction (e.g., distal direction) via second winch 2720. Mechanical structure 2700 can also move both the first and second portions of cable 2420 in the same direction. In this way, the mechanical structure 2700 can maintain the required tension within the cable to produce the desired movement at the end effector 2460.

[0111] However, in other embodiments, any medical device described herein may have both ends of the cable wound around a single winch. This alternative arrangement (often referred to as a self-resisting drive system) uses a single drive motor to operate both ends of the cable. Furthermore, in some alternative embodiments, cable 2420 comprises two cable segments, each having a distal portion coupled to end effector 2460 and a proximal portion wound around the winch.

[0112] As described above, cable 2420 is coupled to each of the first winch 2710 and the second winch 2720, as well as to end effector 2460. More specifically, the first proximal portion 2421 and the second proximal portion 2423 are each coupled to the respective first winch 2710 and second winch 2720 along a specific winding path. The winding path of the first proximal portion 2421 of cable 2420 on the first winch 2710 is described herein, and it should be understood that the second proximal portion 2423 can be coupled to the second winch 2720 in the same manner. Furthermore, the specific details described below with respect to the first winch 2710 also apply to the second winch 2720.

[0113] like Figure 7A As shown, the first winch 2710 includes a first portion 2715 having a drive surface 2713 and a second portion 2714. The first portion 2715 serves as a spool portion and the second portion serves as an anchoring portion for securing the cable 2420 to the winch 2710. Figure 7B As shown, the first proximal portion 2421 of the cable 2420 includes a drive portion 2427, a first winding portion 2425, a second winding portion 2426, and a termination portion 2424. The first proximal portion 2421 is coupled to a first winch 2710 such that a portion of the first proximal portion 2421 is wound around the drive surface 2716 of the first portion 2715 of the first winch 2710. The first proximal portion 2421 is then wound around a second portion 2714 such that a portion of the first winding portion 2425 of the cable 2420 crosses a portion of the second winding portion 2426 of the cable 2420. In some embodiments, at least one of the first winding portion 2425 and the second winding portion 2426 is wound around the first winch 2710 at least twice (e.g., ...). Figure 7A (As shown), or in other words, at least two turns around the winch 2710. In some embodiments, the first winding portion 2524 and the second winding portion 2426 do not need to be wound around the winch 2710 at least twice. Figure 7AAs shown, the first winding portion 2425 is wound once around the first winch 2710 (or one turn around the first winch 2710), and the second winding portion 2426 is wound twice around the first winch 2710 (or two turns around the first winch 2710). In some embodiments, at least one of the first winding portion 2425 or the second winding portion 2426 is wound around the first winch 2710 three times (e.g., three turns around the winch). In some embodiments, at least one of the first winding portion 2425 or the second winding portion 2426 is wound around the first winch 2710 more than three times. The multiple windings or turns of the cable 2420 around the first winch 2710 assist in maintaining the cable 2420 secured to the winch 2710 without the use of retaining elements (e.g., crimps in the cable, clamps or fasteners that couple the cable to the winch, etc.). In some embodiments, the cable termination portion 2424 is coupled to an opening or recess defined in the first winch 2710 to assist in securing the cable 2420 to the first winch 2710. In some embodiments, the opening or groove includes a clamp or a portion having a width or diameter smaller than that of the cable 2420, such that the termination portion 2424 is wedged into it.

[0114] As described above, the distal portion 2422 of cable 2420 is coupled to end effector 2460. More specifically, as Figure 5 As shown, cable 2420 extends from the first winch 2720 and is wired or wrapped around the end effector 2460. (As...) Figure 6 As shown, cable 2420 is first routed at least partially around the drive surface of drive pulley 2470 and across drive pulley 2470 to begin winding around coupling shaft 2467. Cable 2420 is wound around coupling shaft 2467 at least once and then crosses back to drive pulley 2470 before exiting and extending back to mechanical structure 2700. In some embodiments, cable 2420 is wound around coupling shaft 2467 more than once or once. For example, in some embodiments, cable 2420 is wound around coupling shaft two or three times and then crosses back to drive pulley 2470. The second proximal portion 2423 is then coupled to the second winch 2720 in the same manner as the first proximal portion 2421 is coupled to the first winch 2710.

[0115] With cable 2420 coupled to mechanical structure 2700 and end effector 2460, the rotational movement generated by first winch 2710 can move the first proximal portion 2421 of cable 2420 in direction BB, such as Figure 6 As shown. Similarly, the rotational movement generated by the second winch 2720 can move the second proximal portion 2423 of the cable 2420 in the direction CC, as shown. Figure 6As shown. For example, the first winch 2710 can be operable to produce rotational movement about axis A3, as... Figure 7A As shown. The second winch 2720 can similarly operate to produce rotational movement about an axis (not shown) parallel to axis A3. Therefore, each of the first winch 2710 and the second winch 2720 can... Figure 5 Rotate in the direction of arrow DD.

[0116] With each end of cable 2420 coupled to a separate winch, movement of a first portion of cable 2420 can be controlled by one winch (e.g., first winch 2710), and movement of a second portion of cable 2420 can be controlled by another winch (e.g., second winch 2720). Therefore, better control of the overall movement of end effector 2460 can be achieved. For example, first winch 2710 can be actuated to produce rotational movement about axis A3 in the direction of arrow DD, causing a first proximal portion 2421 of the cable to move in the first direction along arrow BB. Simultaneously, second winch 2720 can be actuated to produce rotational movement about an axis parallel to axis A3 in the opposite direction to first winch 2710, causing a second proximal portion 2723 of cable 2420 to move in the opposite direction to first proximal portion 2423 along arrow CC. Therefore, the opposite movement of the first proximal portion 2421 and the second proximal portion 2423 causes the end effector 2460 to rotate about the rotation axis A1 (connected to the end effector 2460 via cable 2420) (e.g., yaw movement).

[0117] Furthermore, the first winch 2710 can be actuated to produce rotational movement about axis A3 in the direction of arrow DD, while simultaneously, the second winch 2720 can be actuated to produce rotational movement about an axis parallel to axis A3 in the same direction as the first winch 2710, such that the first proximal portion 2421 of the cable and the second end portion 2423 of the cable 2420 move together in the same direction (along arrows BB and CC). The movement of the first proximal portion 2421 and the second proximal portion 2423 in the same direction causes the end effector 2460 to rotate about a second axis of rotation (not shown) in the direction of arrow AA (connected to the end effector 2460 via cable 2420) (e.g., pitch movement). Thus, the combination of the first winch 2710, the second winch 2720, and the single cable 2420 is operable to control the end effector 2460 of the instrument 2400 in at least two degrees of freedom (e.g., pitch and yaw).

[0118] Cable 2420 and any cables described herein can be formed from any suitable material. For example, in some embodiments, any cables described herein may be formed from ultra-high molecular weight polyethylene (UHMWPE) fibers. In some embodiments, any cables described herein may be constructed from a single strand or optical fiber. In other embodiments, any cables described herein may be constructed from multiple fibers braided or otherwise linked together to form a cable. In some embodiments, cable 2420 or any cables described herein may include a coating or other surface treatment to enhance the cable's frictional properties. This enhanced frictional property helps facilitate winding of cable 2420 onto a winch without slippage and eliminates the need for additional retaining features.

[0119] In some embodiments, cable 2420 and any cables described herein may be formed of a material having suitable temperature characteristics for use with cauterization devices. Such materials include, for example, liquid crystal polymers (LCPs), aramids, para-aramids, and polybenzodioxazole fibers (PBO). Such materials can provide frictional properties that enhance coupling and retention, for example, for coupling cable 2420 to winch 2710 and end effector 2460. This capability can also improve slip characteristics during operation of the medical device (e.g., help prevent cable slippage). Such materials may or may not require coatings or other surface treatments to enhance frictional properties.

[0120] In some embodiments, the winch may include one or more grooves or slots to facilitate cable winding to secure the cable to the winch. For example, Figure 8 and Figure 9 A winch 3710 according to another embodiment is illustrated. The winch 3710 can be incorporated into any medical device described herein. The winch 3710 includes a first portion 3715 (which serves as a spool portion) having a drive surface 3713 and a second portion 3714 (which serves as an anchoring portion for securing a cable to the winch 3710). In this embodiment, the second portion 3714 defines a first slot 3721 and a second slot 3722 intersecting the first slot 3721, and a termination opening 3720. Reference Figure 7B The cable shown is 2420. Figure 9The diagram illustrates a cable 2420 coupled to a winch 3710. More specifically, a first proximal portion 2421 of the cable 2420 is coupled to the winch 3710 such that a portion of the first proximal portion 2421 is wound around the drive surface 3716 of a first portion 3715 of the winch 3710, and then around a second portion 3714, such that a first wound portion 2425 of the cable 2420 is disposed within a first slot 3721, and a portion of a second wound portion 2426 of the cable 2420 is disposed within a second slot 3722. As described above with respect to the winch 2710, a portion of the first wound portion 2425 traverses a portion of the second wound portion 2426 of the cable 2420. Furthermore, although Figure 9 Not shown, but in some embodiments, at least one of the first winding portion 2425 and the second winding portion 2426 is wound around the winch 3710 at least twice, or in other words, at least two turns around the winch 3710. In some embodiments, at least one of the first winding portion 2425 or the second winding portion 2426 is wound around the winch 3710 three times (e.g., three turns around the winch). In some embodiments, at least one of the first winding portion 2425 or the second winding portion 2426 is wound around the winch 3710 more than three times. Multiple windings or turns of the cable 2420 around the winch 3710 assist in maintaining the cable 2420 secured to the winch 3710 without the use of retaining elements. In this embodiment, after winding around the second portion 3714, the termination portion 2424 of the cable 2420 is coupled within a termination opening 3720 defined in the winch 3710 to assist in securing the cable 2420 to the winch 3710.

[0121] Figures 10-13 An end effector 4460 according to an embodiment is illustrated. The end effector 4460 can be incorporated into any medical device described herein and can be configured to be the same as or similar to other end effectors described herein, and to function the same as or similarly. The end effector 4460 can be operatively coupled to a mechanical structure as described herein, such as mechanical structure 2700. For example, in some embodiments, the end effector 4460 can be coupled to an axis of the medical device via a linkage.

[0122] The end effector 4460 includes at least one tool member 4462, which may include a contact portion 4464, a drive pulley 4470, and a coupling shaft 4467. The contact portion 4464 is configured to engage or manipulate target tissue during a surgical procedure. For example, in some embodiments, the contact portion 4464 may include an engagement surface serving as a gripper, cutter, tissue manipulator, etc. In other embodiments, the contact portion 4464 may be an energized tool member for cauterization or electrosurgical procedures. The end effector 4462 may be operatively coupled to a mechanical structure (e.g., 2700) such that the tool member 4462 about a rotation axis A R Rotation. For example, drive pulley 4470 includes drive surface 4471, which is configured to engage cable 4420 ( Figure 12 and Figure 13 As shown in the diagram, the tension applied to the cable 4420 along the drive surface 4471 generates a tension around the rotation axis A. R The rotational torque. In this way, the contact portion 4464 of the tool member 4462 can be actuated to engage or manipulate target tissue during surgical procedures. In some embodiments, the tool member 4462 is coupled to a mechanical structure via a link coupled to a shaft.

[0123] The coupling shaft 4467 includes a winding surface 4476, at which the cable can be secured to the tool member 4462. The drive surface 4471 of the drive pulley 4470 is along axis A. R It is positioned at a first location on tool component 4462, and the winding surface 4476 is along axis A. R It is positioned at a second position offset from the first position. In other words, the driving surface 4471 and the winding surface 4476 are parallel to axis A. R They are spaced apart from each other in the direction of the direction.

[0124] Figure 12 and Figure 13 The diagram illustrates the wiring path of cable 2420 coupled to end effector 4460. More specifically, as described above for medical device 2400, cable 2420 (see above) Figure 7B (Description) can be derived from mechanical structure ( Figures 10-13 (not shown in the image) along the axis ( Figures 10-13 Wiring (not shown) extends and surrounds the first portion of the drive surface 4471 of the drive pulley 4470, as shown in the diagram. Figure 12 As shown by arrow 1. As shown by arrow 2, cable 2420 crosses drive pulley 4470 to begin winding around coupling shaft 4467. Cable 2420 is wound at least one turn around winding surface 4476 of coupling shaft 4467. In some embodiments, as Figure 13As shown, cable 4420 is wound three times around coupling shaft 4467 (as indicated by arrow 2). Then, before cable 2420 leaves end effector 4460 and extends back into the mechanical structure, cable 2420 crosses back to drive pulley 4470, where cable 2420 is routed around the second portion of drive surface 4471, as shown... Figure 13 As shown by arrow 3 in the image.

[0125] Figures 14-19 The diagram illustrates a winch 5710 according to an embodiment. The winch 5710 can be incorporated into... Figure 20 The mechanical structure 5700 shown (which can be used as an "actuator," "transmission device," or "transmission device assembly" to move one or more components of a medical device) or in any medical device described herein. Winch 5710 can be coupled to cable 5420 in a manner similar to that described above for winches 2710 and 3710. Figures 16-19 As shown in the diagram, the winch 5710 is used to drive or actuate the movement of an end effector (not shown) also coupled to the cable 5420. The winch 5710 includes a first portion 5715 (which serves as a spool portion) and a second portion 5714 (which serves as an anchoring portion for securing the cable to the winch 5710) having a drive surface 5716. In this embodiment, the drive surface 5716 is a circular groove defined between a first sidewall 5725 and a second sidewall 5726 of the winch 5710 around the longitudinal axis Ac of the winch 5710. The circular groove defines a first diameter D1, as shown in the diagram. Figure 14 As shown.

[0126] The second portion 5714 of the winch 5710 is cylindrical about the longitudinal axis Ac and defines a second diameter D2 that is larger than the first diameter D1 of the drive surface 5716. The second portion 5714 also defines a first slot 5721 and a second slot 5722 intersecting the first slot 5721, and a third slot 5724 intersecting the second slot 5722 and the first slot 5721. A passage 5723 is defined within a first sidewall 5725 and extends to intersect the first slot 5721. A termination opening or recess 5720 is defined within the third slot 5724 and configured to receive a termination portion of a cable, as described in more detail below. The termination opening 5720 may have a width or diameter smaller than that of the cable 5420, such that when a portion of the cable 5420 is disposed within the termination opening 5720, a frictional engagement holds the cable 5420 thereon. For example, in some embodiments, the termination opening 5720 forms a pinch to capture a portion of the cable 5420.

[0127] Figures 16-19The diagram illustrates a cable 5420 coupled to a winch 5710. As described above with respect to cable 2420, cable 5420 includes a first proximal portion 5421, a second proximal portion (not shown), and a distal portion (not shown). Although not shown in Figures 16-19 As shown herein, however, the distal portion can be coupled to any tool component described herein by any of the methods described herein. Although not shown in Figures 16-19 As shown, the second proximal portion can be coupled to the second winch in a similar manner to that described below for the first proximal portion 5421. Therefore, only a detailed description of the attachment of the first proximal portion 5421 to the winch 5710 is provided. The first proximal portion 5421 includes a first winding portion 5425, a second winding portion 5426, and a termination portion 5424 (see [link to documentation]). Figures 18-19 ).

[0128] As described above with respect to winches 2710 and 3710, the first proximal portion 5421 of cable 5420 can be coupled to and routed along a specific path to winch 5710 and secured to winch 5710 without the need for a separate retaining element. More specifically, the first proximal portion 5421 of cable 5420 is routed around the drive surface 5716 of the first portion 5715 (e.g., Figure 16 (As indicated by arrow 1 in the image) and through path 5723 (as shown in the image) Figure 16 (As indicated by arrow 2 in the image). Then the first proximal portion 5421 wraps around the second portion 5714 such that the first wrapped portion 5425 is positioned within the first slot 5721, as shown. Figure 17 As indicated by arrow 3 in the diagram. The first winding portion 5425 winds around the second portion 5714 at least once within the first slot 5721, or in other words, the first winding portion 5425 winds around the second portion 5714 at least one turn within the first slot 5421. In some embodiments, the first winding portion 5425 winds around the second portion 5714 at least two or at least three times within the first slot 5721, such as... Figure 17 As indicated by arrow 3 in the image.

[0129] Then, the proximal portion 5421 passes up into the second slot 5722 (as shown). Figure 18 (As indicated by arrow 4 in the image), and the second winding portion 5426 winds around the second portion 5714 within the second slot 5722 (as shown in the image). Figure 18 (As indicated by arrow 5 in the diagram), such that a portion of the second winding portion 5426 crosses a portion of the first winding portion 5425 of the cable 5420, as shown. Figure 18As shown. Multiple wraps or turns of cable 5420 around winch 5710 assist in securing cable 5420 to winch 5710 without using retaining elements. After being wound around the second portion 5714 within the second slot 5722, the termination portion 5424 of cable 5420 is routed into the third slot 5724 (as shown). Figure 19 (As indicated by arrow 6 in the diagram) and is captured or positioned within the termination opening 5720 to further assist in securing the cable 5420 to the winch 5710.

[0130] Figure 20 A portion of a mechanical structure 5700 is illustrated according to an embodiment in which a winch 5710 can be incorporated. The mechanical structure 5700 includes a first pair of winches: a first winch 5710 and a second winch 5720, and a second pair of winches: a third winch 5730 and a fourth winch (…). Figure 20 (Not shown in the image). Each pair of winches is operatively coupled to the tool component of an end effector (not shown), and two proximal portions of a single cable (e.g., cable 5420) are connected to the different winches of the winch pair.

[0131] Mechanical structure 5700 generates movement of cable 5420 (via winches), cable 5420 operating to produce desired articulated movement (e.g., pitch, yaw, cutting, or clamping) at the tool member of the end effector. For example, mechanical structure 5700 includes components and controls to move a first portion of the first cable 5420 in a first direction (e.g., proximal direction) via a first winch 5710 and a second portion of the first cable 5420 in a second opposite direction (e.g., distal direction) via a second winch 5720. Mechanical structure 5700 can also move both the first and second portions of the first cable 5420 in the same direction. Mechanical structure 5700 can also include components and controls to move the first portion of the second cable via a third winch 5730 and via a fourth winch (…). Figure 20 (Not shown) Moves a second portion of the second cable. In this way, the mechanical structure 5700 can maintain the required tension within the cable to produce the desired movement at the tool member of the end effector. For example, in some embodiments, the end effector may include two tool member portions (e.g., jaws for clamping) working together, wherein a first pair of winches controls movement of one of the two tool member portions and a second pair of winches controls movement of the other tool member portion. In another example, the end effector may include more than one tool member, wherein one pair of winches controls movement of the first tool member and another pair of winches controls movement of the second tool member.

[0132] Figures 21-36BThese are various views of the instrument 6400 according to an embodiment. In some embodiments, the instrument 6400 or any component thereof may optionally be part of a surgical system that performs surgical procedures and may include a manipulator unit, a series of kinematic linkages, a series of cannulas, etc. The instrument 6400 (and any instruments described herein) can be used in any suitable surgical system, such as the MIRS system 1000 shown and described above. The instrument 6400 includes a mechanical structure 6700, a shaft 6410, a wrist assembly 6500, an end effector 6460, and a cover 6415. Although not shown, the instrument 6400 also includes a first cable 6420 (a portion of which is in…) Figure 36A and Figure 36B The device 6400 is coupled to the wrist assembly 6500 and the end effector 6460 via a first cable 6420 (shown in the diagram) and a second cable (not shown), as described in more detail below. The device 6400 is configured such that movement of the first cable 6420 and the second cable causes the wrist assembly 6500 to rotate about a first axis of rotation A1 (see [reference]). Figure 27 and Figure 28 The rotation (i.e., pitch rotation) of the end effector 6460 around the second rotation axis A2 (see [reference], which serves as the pitch axis; the term pitch is arbitrary) is used for the rotation of the end effector 6460 around the second rotation axis A2. Figure 27 and Figure 28 The yaw rotation (which serves as the yaw axis), the cutting rotation of the tool component of the end effector 6460 about the second rotation axis A2, or any combination of these movements. Changing the pitch or yaw of the instrument 6400 can be performed by manipulating the cables in a manner similar to that described above for instrument 2400. Therefore, the specific movements of each cable to achieve the desired motion are not described below.

[0133] Shaft 6410 can be any suitable elongated shaft that couples wrist assembly 6500 to mechanical structure 6700. Specifically, shaft 6410 includes a proximal end 6411 coupled to mechanical structure 6700 and a distal end 6412 coupled to wrist assembly 6500 (e.g., a proximal link of wrist assembly 6500). Shaft 6410 defines a lumen (not shown) or multiple passages through which cables and other components (e.g., wires, ground wires, etc.) can be routed from mechanical structure 6700 to wrist assembly 6500. Cover 6415 (see...) Figure 26 It is disposed on at least a portion of the wrist assembly 6500 and the end effector 6460.

[0134] Although not shown, the first cable 6420 and the second cable each include a first proximal portion, a second proximal portion, and a distal portion. As described above with respect to cable 2420, the first and second proximal portions are each coupled to mechanical structure 6700 in the same manner as described above with respect to mechanical structure 2700 of device 2400 and in a more detailed manner as described below. In some embodiments, the cables may be constructed of a polymer as described above with respect to cable 2420.

[0135] Mechanical structure 6700 includes a base 6762 and a housing 6760, and the housing 6760 may be attached to the base 6762 via one or more fastening members. In some embodiments, the base 6762 and housing 6760 may partially or completely enclose components disposed within the mechanical structure 6700. The base 6762 and housing 6760 provide structural support for mounting and aligning components within the mechanical structure 6700. For example, the base 6762 defines a shaft opening 6712, within which the proximal end 6411 of a shaft 6410 is mounted. The base 6762 further defines one or more support surfaces or openings 6713 within which winches (6710, 6720, 6730, and 6740) are mounted and rotatably supported. In some embodiments, the housing 6760 includes one or more support surfaces or openings 6763 within which the winches are mounted. The opening 6763 of the housing 6760 can be axially aligned with the opening 6713 of the base 6762. In addition to providing mounting support for the internal components of the mechanical structure 6700, the base 6762 may also include external features (e.g., recesses, clips, etc.) that dock with a drive device (not shown). The drive device may be, for example, a handheld system or a computer-aided remote operating system, capable of receiving and manipulating the instrument 6400 to perform various surgical procedures. The drive device may include one or more motors to drive the winch of the mechanical structure 6700. In other embodiments, the drive device may be a component capable of receiving and manipulating the instrument 6400 to perform various operations.

[0136] Mechanical structure 6700 includes a first winch 6710 and a second winch 6720 (see...) Figure 22B The diagram shows a mechanical structure 6700, with the housing 6760 removed for illustrative purposes, a third winch 6730, and a fourth winch. Each of the winches (6710, 6720, 6730, and 6740) is mounted to the mechanical structure 6700 (e.g., within the housing 6760) via a winch support member (not shown). The winch support member may be a base, a shaft, or any other suitable support structure to secure the winch to the mechanical structure 6700.

[0137] Each of the winches 6710, 6720, 6730, and 6740 is rotatably supported within a corresponding opening (e.g., opening 6713 of base 6762) and a corresponding opening 6763 of housing 6760 (as shown in Figure 22). Each of the winches 6710, 6720, 6730, and 6740 can be driven by a corresponding motor in a drive device. For example, the first winch 6710 can be driven to rotate about a first winch axis A3, the second winch 6720 can be driven to rotate about a second winch axis A4, the third winch 6730 can be driven to rotate about a third winch axis A5, and the fourth winch 6740 can be driven to rotate about a fourth winch axis A6.

[0138] A first cable 6420 is routed between the mechanical structure 6700, the wrist assembly 6500, and the end effector 6460, and is coupled to the first winch 6710 and the second winch 6720 of the mechanical structure 6700. A second cable is also routed between the mechanical structure 6700, the wrist assembly 6500, and the end effector 6460, and is coupled to the third winch 6730 and the fourth winch 6740 of the mechanical structure 6700. More specifically, referring to the first cable 6420, a first proximal portion of the first cable 6420 is coupled to the first winch 6710 of the mechanical structure 6700, the first cable 6420 extends from the first winch 6710 along the shaft 6410, is routed through the wrist assembly 6500, and a distal portion of the cable 6420 is coupled to the end effector 6460, as described above with respect to the device 2400. The first cable 6420 may extend within the internal lumen of the shaft 6410 or may be routed externally to the shaft 6410. The first cable 6420 then extends rearward from the end effector 6460 along the shaft 6410, and the second proximal portion is coupled to the second winch 6720 of the mechanical structure 6700. In other words, both ends of a single cable (e.g., the first cable 6420) are coupled to and actuated by two separate winches (winches 6710 and 6720) of the mechanical structure 6700.

[0139] More specifically, the two ends of a first cable 6420, associated with the opposite direction of a single degree of freedom, are connected to two independent drive winches 6710 and 6720. This arrangement (often referred to as an anti-drive system) allows for independent control of the movement (e.g., pull-in or release) of each end of the cable. Mechanical structure 6700 generates movement of the first cable 6420 and the second cable, which operates to produce the desired articulated movement (pitch, yaw, cut, or clamp) at the end effector 6460. Thus, as described herein, mechanical structure 6700 includes components and controls to move a first portion of the first cable 6420 in a first direction (e.g., proximal direction) via the first winch 6710 and a second portion of the first cable 6420 in a second opposite direction (e.g., distal direction) via the second winch 6720. Mechanical structure 6700 can also move both the first and second portions of the first cable 6420 in the same direction. The mechanical structure 6700 also includes components and controls for moving a first portion of the second cable in a first direction (e.g., a proximal direction) via a third winch 6730 and a second portion of the second cable in a second opposite direction (e.g., a distal direction) via a fourth winch 6740. The mechanical structure 6700 can also move both the first and second portions of the second cable in the same direction. In this way, the mechanical structure 6700 can maintain the required tension within the cable to produce the desired movement at the end effector 6460.

[0140] like Figures 23-25 As shown, the first winch 6710 includes a first portion 6715 (which serves as a spool portion) having a drive surface 6716, and a second portion 6714 (which serves as an anchoring portion for securing a cable to the winch 6710). In this embodiment, the drive surface 6716 is a circular groove defined around the longitudinal axis A3 of the winch 6710 between a first sidewall 6725 and a second sidewall 6726. The circular groove defines a first diameter D1, as... Figure 23 As shown.

[0141] The second portion 6714 of the first winch 6710 is cylindrical about the longitudinal axis A3 and defines a second diameter D2 that is larger than the first diameter D1 of the drive surface 6716. The second portion 6714 also defines a first slot 6721 and a second slot 6722 intersecting the first slot 6721, and a third slot 5724 intersecting the second slot 6722 and the first slot 6721. A passage 6723 is defined within a first sidewall 6725 and extends to intersect the first slot 6721. A termination opening 6720 is defined within the third slot 6724 and configured to receive the termination portion of the first cable. The termination opening 6720 may have a portion with a width or diameter smaller than the width or diameter of the cable, such that when a portion of the first cable 6420 is disposed within the termination opening 6720, a frictional engagement holds the cable 6420 thereon. For example, in some embodiments, the termination opening 6720 forms a pinch to capture a portion of the cable or a tapered lumen.

[0142] As described above, the first cable 6420 is coupled to each of the first winch 6710 and the second winch 6720, and is also coupled to the wrist assembly 6500 and the end effector 6460. More specifically, the first proximal portion and the second proximal portion are each coupled to the respective first winch 6710 and second winch 6720 along a specific winding path. The winding paths of the first proximal portion of the first cable 6420 on the first winch 6710 and the second proximal portion of the first cable 6420 on the second winch 6720 may be the same as or similar to the winding paths described above for winch 5700. Furthermore, the specific details described below for the first winch 6710 may also apply to the second winch 6720, the third winch 6730, and the fourth winch 6740. In addition, the second cable may be coupled to the third winch 6730, the wrist assembly 6500, the end effector 6460, and the fourth winch 6740 in the same or similar manner as described for the first cable 6420.

[0143] Although not shown, the first proximal portion of the first cable 6420 includes a first winding portion, a second winding portion, and a termination portion similar to those of the cable 2420 described above. As described above with respect to the winch 5700, the first proximal portion of the first cable 6420 can be coupled to and routed along a specific path to the first winch 6710 and secured to the first winch 6710 without the need for a separate retaining element. More specifically, the first proximal portion of the first cable 6420 surrounds the drive surface 6716 of the first portion 6715 (e.g., ...). Figure 23 (As indicated by arrow 1 in the image) and through passage 6723 (as shown in the image) Figure 23 (As indicated by arrow 2 in the diagram) wiring. Then the first proximal portion is wound around the second portion 6714, such that the first wound portion of the first cable 6420 is positioned within the first slot 6721, as shown in... Figure 24As indicated by arrow 3 in the diagram. The first winding portion winds around the second portion 6714 at least once within the first slot 6721, or in other words, the first winding portion winds around the second portion 6714 at least once within the first slot 6721. In some embodiments, the first winding portion winds around the second portion 6714 at least two or at least three times within the first slot 6721.

[0144] Then, the proximal portion of the first cable 6420 enters upward into the second slot 6722 (as shown). Figure 24 (As indicated by arrow 4 in the image), and the second winding portion winds around the second portion 6714 within the second slot 6722 (as shown in the image). Figure 25 (As indicated by arrow 5 in the image), so that a portion of the second winding portion is aligned with... Figure 18 A portion of the first winding of the first cable 6420 is traversed in a similar manner to that shown in the intermediate winch 5700. Multiple windings or turns of the first cable 6420 around the first winch 6710 assist in holding the first cable 6420 to the winch 6710 without the use of retaining elements. After winding around the second portion 6714 within the second slot 6722, the terminating portion of the first cable 6420 is routed into the third slot 6724 and captured or positioned within the terminating opening 6720 to further assist in securing the first cable 6420 to the first winch 6710.

[0145] refer to Figure 27 The wrist assembly 6500 (also referred to as the joint assembly) includes a first link 6510, a second link 6610, and a third link 6515. The first link 6510 has a proximal portion 6511 and a distal portion 6512. The proximal portion is coupled to a shaft 6410. The proximal portion 6511 may be coupled to the shaft 6410 via any suitable mechanism. For example, in some embodiments, the proximal portion 6511 may be matingly disposed within a portion of the shaft 6410 (e.g., via an interference fit). In some embodiments, the proximal portion 6511 may include one or more protrusions, recesses, openings, or connectors that couple the proximal portion 6511 to the shaft 6410. In some embodiments, the proximal portion 6511 may be welded, glued, or fused to the shaft 6410.

[0146] The distal portion 6512 includes a joint portion 6540, which is rotatably coupled to a mating joint portion 6640 of the second link 6610, as described in more detail below. The second link 6610 has a proximal portion 6611 and a distal portion 6612. The proximal portion 6611 includes a joint portion 6640 rotatably coupled to the joint portion 6540 of the first link 6510 to form a wrist assembly 6500 having a first axis of rotation A1 about which the second link 6610 rotates relative to the first link, such that... Figure 27 and Figure 28 As shown. The wrist assembly 6500 may include any suitable coupling mechanism. In this embodiment, the first link 6510 is coupled to the third link 6515 at 6517 via a pin joint, and the second link 6610 is coupled to the third link 6515 at 6618 via a pin joint (see example). Figure 28 and Figure 30 In this way, the third link 6515 can help maintain the coupling between the first link 6510 and the second link 6610 during the rotation of the second link 6610 relative to the first link 6510.

[0147] Furthermore, as described above, the distal portion 6512 of the first link 6510 is rotatably coupled to the joint portion 6540 of the mating joint portion 6640 at the proximal portion 6611 of the second link 6610. Specifically, the joint portion 6540 includes a series of teeth 6544 spaced apart by recesses, and the joint portion 6640 includes a series of teeth 6644 spaced apart by recesses (see, for example...). Figure 33A and Figure 33B A series of teeth 6544 and 6644 and recesses may be similar to those shown and described in U.S. Patent Application Publication No. US2017 / 0120457A1 entitled “Mechanical Wrist Joints with Enhanced Range of Motion, and Related Devices and Methods” (filed February 20, 2015), or similar to those shown and described in International Application No. PCT / US18 / 64721 entitled “Medical Tools Having Tension Bands” (filed December 10, 2018), each of which is incorporated herein by reference in its entirety. During rotation of the second link 6610 relative to the first link 6510, teeth 6544 engage teeth 6644. Furthermore, the joint portion 6540 has a curved surface 6541 that engages the curved surface 6641 of the joint portion 6640 during rotation of the second link 6610 relative to the first link 6510. Because the wrist joint (i.e., the joint between the first link 6510 and the second link 6610) is not a pin joint, the pitch axis A1 will move relative to the first link 6510 during the rotation of the second link 6610. In other words, the position of the pitch axis A1 will move with the roll of the second link 6610 relative to the first link 6510 (e.g., as seen in the top view).

[0148] like Figures 27-30As shown, the end effector 6460 is coupled to the second link 6610. More specifically, the distal portion 6612 of the second link 6610 includes a connector 6680 coupled to the end effector 6460, such that the end effector 6460 (e.g., the tool component of the end effector described in more detail below) rotates relative to the wrist assembly 6500 about a second rotation axis A2 (see, for example...). Figure 27 and Figure 28 The second axis of rotation A2 is not parallel to the first axis of rotation A1. Axis A2 serves both as a yaw axis (the term yaw is arbitrary) and as a cutting axis when the tool components rotate in opposite directions, as described in more detail below. Thus, the instrument 6400 provides at least three degrees of freedom (i.e., pitch about the first axis of rotation A1, yaw about the second axis of rotation A2, and cutting about the second axis of rotation A2). Connector 6680 can be any suitable connector to rotatably couple the end effector 6460 to the wrist assembly 6500. For example, in some embodiments, the first link 6510 may include a U-shaped clamp and a pin, such as the pin joint shown and described in U.S. Patent No. 9,204,923B2 (filed July 16, 2008) entitled "Medical Instrument ElectronicallyEnergized Using Drive Cables," which is incorporated herein by reference in its entirety.

[0149] like Figures 27-29 and Figures 34-36B As shown, the end effector 6460 includes a first tool member 6462 and a second tool member 6482. The first tool member 6462 includes a contact portion 6464, a drive pulley 6470, and a coupling shaft 6467. The contact portion 6464 is configured to engage or manipulate target tissue during a surgical procedure. For example, in this embodiment, the contact portion 6464 includes an engagement surface that serves as a cutter (e.g., a cutting blade). In other embodiments, the contact portion 6464 may serve as a gripper, tissue manipulator, etc., or may be an energized tool member for cauterization or electrosurgical procedures. The second tool member 6482 includes a contact portion 6484, a drive pulley 6480, and a coupling shaft 6487. The contact portion 6484 is configured to engage or manipulate target tissue during a surgical procedure. For example, in this embodiment, the contact portion 6484 includes an engagement surface that serves as a cutter (e.g., a cutting blade). In other embodiments, the contact portion 6484 can be used as a gripper, tissue manipulator, etc., or it can be an electrical tool component for cauterization or electrosurgical procedures. In this embodiment (e.g.) Figure 35AAs shown, drive pulley 6470 and coupling shaft 6467 can be formed as integral or integral parts welded (or otherwise coupled) to engagement portion 6464, and drive pulley 6480 and coupling shaft 6487 can be formed as integral or integral parts welded (or otherwise coupled) to engagement portion 6484. In some embodiments, engagement portions 6464 and 6484 can each be formed as two parts (a stamped part with opposing cut edges and a ridge), and drive pulleys 6470, 6480 and coupling shafts 6467, 6487 are formed of metallic material and processed or formed by metal injection molding.

[0150] The drive pulley 6470 of the first tool member 6462 defines a guide channel 6473 having a drive surface 6471, and the coupling shaft 6467 defines a spool channel 6475 having a winding surface 6476, for example, as Figure 34 and Figure 36A As shown. Similarly, the drive pulley 6480 of the second tool member 6482 defines a guide channel 6483 with a drive surface 6481, and the coupling spindle 6487 defines a spool channel 6485 with a winding surface 6486 (see example). Figure 34 Guide channel 6473 and spool channel 6475 are configured to receive the distal portion of the first cable 6420, and guide channel 6483 and spool channel 6485 are configured to receive the distal portion of the second cable, as described in more detail below. Figure 28 and Figure 34 As shown, for the first tool member 6462, the drive pulley 6470 is positioned at a first location along axis A2, and the coupling shaft 6467 is positioned at a second location along axis A2. In other words, the drive pulley 6470 and the coupling shaft 6467 are arranged along the same axis of rotation at a distance spaced apart from each other. The drive pulley 6480 and the coupling shaft 6487 of the tool member 6482 are similarly arranged.

[0151] like Figure 35AAs shown, each of the first tool member 6462 and the second tool member 6482 includes a guide slot 6465 formed in a specific shape, which receives a guide block 6466 coupled to the respective drive pulleys 6470 and 6480. In this way, a contact portion 6464 can be formed separately from the drive pulley 6470 and the coupling shaft 6467 and can be subsequently attached to the drive pulley 6470 and the coupling shaft 6467. Similarly, a contact portion 6484 can be formed separately from the drive pulley 6490 and the coupling shaft 6487 and can be subsequently attached to the drive pulley 6490 and the coupling shaft 6487. This arrangement allows the contact portions 6464 and 6484 to have the same design, whether used as a right (or "lower") tool member or a left (or "upper") tool member. Each tool member is formed by coupling the guide block 6466 within the respective guide slot 6465. Figure 35B and Figure 35C As shown, guide block 6466 and guide slot 6465 are shaped such that contact portion 6464 is held in a fixed position relative to drive pulley 6470 and coupling shaft 6467, and contact portion 6484 is held in a fixed position relative to drive pulley 6490 and coupling shaft 6487. Guide block 6466 includes pin 6469, which is configured to travel along the path defined by guide slot 6465 to limit the angle of rotation of first tool member 6462 relative to second tool member 6482 by the pin. Tool members 6462 and 6482 are rotatably coupled to second link 6610 via corresponding pins (not shown), which are disposed within central openings 6468 and 6488 of tool members 6462, which are aligned with opening 6689 of second link 6610.

[0152] The end effector 6460 is operatively coupled to the mechanical structure 6700, causing tool members 6462 and 6482 to rotate about the rotation axis A2. For example, the drive surface 6471 of the drive pulley 6470 is configured to engage a first cable 6420, such that tension applied by the first cable 6420 along the drive surface 6471 generates a rotational torque about the rotation axis A2. Similarly, the drive surface 6481 of the drive pulley 6480 is configured to engage a second cable, such that tension applied by the second cable along the drive surface 6481 generates a rotational torque about the rotation axis A2. In this way, the contact portions 6464 of tool member 6462 and 6484 of tool member 6482 can be actuated to engage or manipulate target tissue during surgical procedures.

[0153] As described above, both the first cable 6420 and the second cable extend from the mechanical structure 6700 and are coupled to the end effector 6460. More specifically, the distal portion of the first cable is coupled to the first tool member 6462 of the end effector 6460, and the distal portion of the second cable is coupled to the second tool member 6482 of the end effector 6460. Figure 36A and Figure 36B The diagram illustrates the cable routing for the first cable 6420 on the first tool member 6462, and it should be understood that the second cable can be routed in the same manner and coupled to the second tool member 6482.

[0154] As described above, the first cable 6420 can extend from the mechanical structure 6700, wherein a first proximal portion of the first cable 6420 is coupled (as described above), extends along the shaft 6410, and is wired around a first portion of the drive surface 6471 of the drive pulley 6470, as... Figure 36A and Figure 36B As indicated by arrow 1 in the diagram, the first cable 6420 crosses the drive pulley 6470 to begin winding around the coupling shaft 6467, as shown. Figure 36A and Figure 36B As indicated by arrow 2 in the diagram. In this embodiment, cable 6420 is wound three times around the winding surface 6476 of coupling shaft 6467. In an alternative embodiment, cable 6420 is wound less than or more than three times around coupling shaft 6467. Then, before cable 6420 leaves end effector 6460 and extends back to mechanical structure 6700, cable 6420 crosses back to drive pulley 6470 (e.g., ...). Figure 36B As shown in the best example, in this case, cable 6420 is wired around the second portion of drive surface 6471, as... Figure 36B As indicated by arrow 3 in the diagram. After exiting the end effector 6460, the second proximal portion of the cable 6420 then extends rearward along the shaft 6410 and is coupled to the second winch 6720 in the same manner as the first proximal portion of the cable 6420 is coupled to the first winch 6710.

[0155] With cable 6420 coupled to mechanical structure 6700 and end effector 6460, the rotational movement generated by first winch 6710 and second winch 6720 can respectively cause movement at first tool member 6462 and second tool member 6482. Therefore, as previously described, better control of the overall movement of end effector 6460 (and tool members 6462 and 6482) can be achieved. For example, first winch 6710 is operable to generate movement about axis A3 ( Figure 22AThe rotational movement of the first cable 6420 (as shown in the diagram) causes the first proximal portion of the first cable 6420 to move in a first direction. The second winch 6720 is similarly operable to produce rotational movement about axis A4 (parallel to axis A5) and cause the second proximal portion of the cable 6420 to move in the opposite direction. Therefore, the opposing movement of the first and second proximal portions of the cable 6420 causes the first tool member 6462 to rotate about axis A2 (connected via cable 6420) (e.g., yaw movement). Movement of the first and second proximal portions of the cable 6420 in the same direction causes the first tool member 6462 to rotate about axis A1 (e.g., pitch movement). Similar movement of the second tool member 6482 can be achieved by rotation of the third winch 6730 and the fourth winch 6740, which are coupled to the second tool member 6482 via the second cable.

[0156] Figures 37-40 Another embodiment of an end effector is illustrated, which can be used with or incorporated into any of the medical devices described herein. End effector 7460 is shown coupled to wrist assembly 7500 and shaft 7410. Wrist assembly 7500 and shaft 7410 may be configured to be the same as or similar to wrist assembly 6500 and shaft 6510 and function the same as or similarly to wrist assembly 6500 and shaft 6510. Therefore, specific details regarding wrist assembly 7500 and shaft 7410 are not described.

[0157] The end effector 7460 includes a first tool member 7462 and a second tool member 7482. The first tool member 7462 includes a contact portion 7464, a drive pulley 7470, and a coupling shaft 7467. The contact portion 7464 is configured to engage or manipulate target tissue during a surgical procedure. For example, in this embodiment, the contact portion 7464 includes an engagement surface that serves as a gripper. In other embodiments, the contact portion 7464 may serve as a cutter, tissue manipulator, etc., or it may be an electrically powered tool member for cauterization or electrosurgical procedures. The second tool member 7482 includes a contact portion 7484, a drive pulley 7480, and a coupling shaft 7487. The contact portion 7484 is configured to engage or manipulate target tissue during a surgical procedure. For example, in this embodiment, the contact portion 7484 includes an engagement surface that serves as a gripper. In other embodiments, the contact portion 7484 may serve as a cutter, tissue manipulator, etc., or it may be an electrically powered tool member for cauterization or electrosurgical procedures. In this embodiment, the drive pulley 7470 and the coupling shaft 7467 can be formed as an integral or integral part with the engagement portion 7464, and the drive pulley 7480 and the coupling shaft 7487 can be formed as an integral or integral part welded (or otherwise coupled) to the engagement portion 7484. In other embodiments, the engagement portions 7464 and 7484 can each be formed as separate parts (stamped parts), and the drive pulleys 7470, 7480 and the second portions 7467, 7487 are formed of metal material and processed or formed by metal injection molding.

[0158] For example, such as Figure 39A and Figure 39B As shown, the drive pulley 7470 of the first tool member 7462 defines a guide channel 7473 with a drive surface 7471, and the coupling shaft 7467 defines a spool channel 7475 with a winding surface 7476. Similarly, the drive pulley 7480 of the second tool member 7482 defines a guide channel 7483 with a drive surface 7481, and the coupling shaft 7487 defines a spool channel 7485 with a winding surface 7486. The guide channel 7473 and the spool channel 7475 are configured to receive the distal portion of a first cable (not shown), and the guide channel 7483 and the spool channel 7485 are configured to receive the distal portion of a second cable (not shown). Figure 39A and Figure 39BAs shown, the drive pulley 7470 is positioned at a first position along axis A2, and the coupling shaft 7467 is positioned at a second position along axis A2. In other words, the drive pulley 7470 and the coupling shaft 7467 are positioned at a distance spaced apart from each other along the same axis of rotation. Similarly, the drive pulley 7480 and the coupling shaft 7467 of the tool member 7482 are positioned at the first and second positions respectively along the same axis of rotation (i.e., axis A2).

[0159] like Figure 37 As shown, tool components 7462 and 7482 are rotatably coupled to the second link 7610 of the wrist assembly 7500 via corresponding pins (not shown). These pins are disposed within the central openings 7468 and 7488 of tool components 7462 and 7482, respectively. The central openings 7468 and 7488 of tool components 7462 and 7482 are connected to the opening 7689 of the wrist assembly 7500 (see [link]). Figure 37 )alignment.

[0160] The end effector 7460 can be operatively coupled to the mechanical structure in the same or similar manner as described with respect to the previous embodiments, such that tool members 7462 and 7482 rotate about the rotation axis A2. For example, the drive surface 7471 of the drive pulley 7470 is configured to engage a first cable (not shown), such that tension applied by the first cable along the drive surface 7471 generates a rotational torque about the rotation axis A2. Similarly, the drive surface 7481 of the drive pulley 7480 is configured to engage a second cable (not shown), such that tension applied by the second cable along the drive surface 7481 generates a rotational torque about the rotation axis A2. In this way, the contact portions 7464 of tool member 7462 and 7484 of tool member 7482 can be actuated to engage or manipulate target tissue during surgical procedures.

[0161] As described above with respect to the previous embodiment, both the first cable (not shown) and the second cable (not shown) can extend from the mechanical structure (as described herein) and be coupled to the end effector 7460. More specifically, the distal portion of the first cable is coupled to the first tool member 7462 of the end effector 7460, and the distal portion of the second cable is coupled to the second tool member 7482 of the end effector 7460.

[0162] As described above with respect to end effector 6460 and cable 6420, a first cable may extend from the mechanical structure, wherein a first proximal portion of the first cable is coupled to the mechanical structure (as described above), extends along shaft 7410 and is wired around a first portion of drive surface 7471 within guide channel 7473 of drive pulley 7470. In this embodiment, the first cable passes through opening 7477 and partially wraps around drive pulley 7470, then passes through passage 7479 communicating with spool channel 7475 of coupling shaft 7467 (see...). Figure 38B The cable is then wound at least one turn around the winding surface 7476 of the coupling shaft 7467 within the spool channel 7475. The cable then returns through opening 7479 and enters the guide channel 7473 of the drive pulley 7470, then exits through the opposite end of opening 7477 and extends along shaft 7410 back to the mechanical structure. The second tool component 7482 may similarly include opening 7492 (see...). Figure 39B ) and pathway 7493 (see Figure 40 The second cable (not shown) can be coupled to the second tool component 7482 in the same manner.

[0163] Figures 41-43 Another embodiment of an end effector is illustrated, which can be used with or incorporated into any of the medical devices described herein. End effector 8460 is shown coupled to wrist assembly 8500 and shaft 8410. Wrist assembly 8500 and shaft 8410 may be configured to be the same as or similar to wrist assembly 6500 and shaft 6510, and function the same as or similarly to wrist assembly 6500 and shaft 6510. Therefore, specific details regarding wrist assembly 8500 and shaft 8410 are not described.

[0164] The end effector 8460 includes a first tool member 8462 and a second tool member 8482. The first tool member 8462 includes a contact portion 8464, a drive pulley 8470, and a coupling shaft 8467. The contact portion 8464 is configured to engage or manipulate target tissue during a surgical procedure. For example, in this embodiment, the contact portion 8464 includes an engagement surface that serves as a gripper. In other embodiments, the contact portion 8464 may serve as a cutter, tissue manipulator, etc., or it may be an energized tool member for cauterization or electrosurgical procedures. The second tool member 8482 includes a contact portion 8484, a drive pulley 8480, and a coupling shaft 8487. The contact portion 8484 is configured to engage or manipulate target tissue during a surgical procedure. For example, in this embodiment, the contact portion 8484 includes an engagement surface that serves as a gripper. In other embodiments, the contact portion 8484 may serve as a cutter, tissue manipulator, etc., or it may be an energized tool member for cauterization or electrosurgical procedures. In this embodiment, the drive pulley 8470 and the coupling shaft 8467 can be formed as an integral or integral component welded (or otherwise coupled) to the joining portion 8464, and the drive pulley 8480 and the coupling shaft 8487 can be formed as an integral or integral component having the joining portion 8484. In other embodiments, the joining portions 8464 and 8484 can each be formed separately (stamped components), and the drive pulleys 8470, 8480 and the second portions 8467, 8487 are formed from metallic material and processed or formed by a metal injection molding process.

[0165] like Figure 42 As shown, the drive pulley 8470 of the first tool member 8462 defines a guide channel 8473 with a drive surface 8471, and the coupling shaft 8467 defines a spool channel 8475 with a winding surface 8476. Similarly, the drive pulley 8480 of the second tool member 8482 defines a guide channel 8483 with a drive surface 8481, and the coupling shaft 8487 defines a spool channel 8485 with a winding surface 8486. As in the previous embodiment, the guide channel 8473 and the spool channel 8467 are configured to receive the distal portion of a first cable (not shown), and the guide channel 8481 and the spool channel 8485 are configured to receive the distal portion of a second cable (not shown). Figure 42 As shown, the drive pulley 8470 is positioned at a first position along axis A2, and the coupling shaft 8467 is positioned at a second position along axis A2. In other words, the drive pulley 8470 and the coupling shaft 8467 are positioned at a distance spaced apart from each other along the same axis of rotation. Similarly, the drive pulley 8480 and the coupling shaft 8467 of the tool member 7482 are positioned at the first and second positions respectively along the same axis of rotation (i.e., axis A2).

[0166] Tool components 8462 and 8482 are rotatably coupled to the second link 8610 of the wrist assembly 8500 via corresponding pins (not shown). The pins are disposed in the central openings 8468 and 8482 of the tool component 8462 and 8482, respectively, which are aligned with the opening 8689 of the wrist assembly 7500.

[0167] The end effector 8460 can be operatively coupled to the mechanical structure in the same or similar manner as described with respect to the previous embodiments, such that tool members 8462 and 8482 rotate about the rotation axis A2. For example, the drive surface 8471 of the drive pulley 8470 is configured to engage a first cable (not shown), such that tension applied by the first cable along the drive surface 8471 generates a rotational torque about the rotation axis A2. Similarly, the drive surface 8481 of the drive pulley 8480 is configured to engage a second cable (not shown), such that tension applied by the second cable along the drive surface 8481 generates a rotational torque about the rotation axis A2. In this way, the contact portions 8464 and 8484 of the tool member 8462 can be actuated to engage or manipulate target tissue during surgical procedures.

[0168] As described above with respect to the previous embodiments, both the first cable (not shown) and the second cable (not shown) can extend from the mechanical structure (as described herein) and be coupled to the end effector 8460. More specifically, the distal portion of the first cable is coupled to the first tool member 8462 of the end effector 8460, and the distal portion of the second cable is coupled to the second tool member 8482 of the end effector 8460 in the same manner as described above with respect to tool members 6462 and 6482.

[0169] Figures 44-48 Another embodiment of an end effector is illustrated, which can be used with or incorporated into any of the medical devices described herein. End effector 9460 is shown coupled to wrist assembly 9500 and shaft 9410. Wrist assembly 9500 and shaft 9410 may be configured to be identical or similar to wrist assembly 6500 and shaft 6510 and function identically or similarly to wrist assembly 6500 and shaft 6510. Therefore, specific details regarding wrist assembly 9500 and shaft 9410 are not described.

[0170] The end effector 9460 includes a first tool member 9462 and a second tool member 9482. The first tool member 9462 includes a contact portion 9464, a drive pulley 9470, and a coupling shaft 9467. The contact portion 9464 is configured to engage or manipulate target tissue during a surgical procedure. For example, in this embodiment, the contact portion 9464 includes an engagement surface that functions as a gripper. In other embodiments, the contact portion 9464 may function as a cutter, tissue manipulator, etc., or it may be an energized tool member for cauterization or electrosurgical procedures. The second tool member 9482 includes a contact portion 9484, a drive pulley 9480, and a coupling shaft 9487. The contact portion 9484 is configured to engage or manipulate target tissue during a surgical procedure. For example, in this embodiment, the contact portion 9484 includes an engagement surface that functions as a gripper. In other embodiments, the contact portion 9484 may function as a cutter, tissue manipulator, etc., or it may be an energized tool member for cauterization or electrosurgical procedures. In this embodiment, the drive pulley 9470 and the coupling shaft 9467 can be formed as an integral or integral component welded (or otherwise coupled) to the contact portion 9464, and the drive pulley 9480 and the coupling shaft 9487 can be formed as an integral or integral component welded (or otherwise coupled) to the contact portion 9484. In some embodiments, the contact portions 9464 and 9484 can each be formed as two parts (stamped parts), and the drive pulleys 9470, 9480 and the coupling shafts 9467, 9487 are formed of metal material and processed or formed by metal injection molding.

[0171] like Figures 47-48 As shown in the preferred embodiment, the drive pulley 9470 of the first tool member 9462 defines a guide channel 9473 with a drive surface 9471, and the coupling shaft 9467 defines a spool channel 9475 with a winding surface 9476. Similarly, the drive pulley 9480 of the second tool member 9482 defines a guide channel 9483 with a drive surface 9481, and the coupling shaft 9487 defines a spool channel 9485 with a winding surface 9486. As in the previous embodiment, the guide channel 9473 and the spool channel 9467 are configured to receive the distal portion of a first cable (not shown), and the guide channel 9481 and the spool channel 9485 are configured to receive the distal portion of a second cable (not shown). Figure 46 and Figure 47As shown, the drive pulley 9470 is positioned at a first position along axis A2, and the coupling shaft 9467 is positioned at a second position along axis A2. In other words, the drive pulley 9470 and the coupling shaft 9467 are positioned at a distance spaced apart from each other along the same axis of rotation. Similarly, the drive pulley 9480 and the coupling shaft 9467 of the tool component 9482 are positioned at the first and second positions respectively along the same axis of rotation (i.e., axis A2), as shown. Figure 46 and Figure 48 As shown.

[0172] Tool components 9462 and 9482 are rotatably coupled to the second link 9610 of the wrist assembly 9500 via corresponding pins (not shown). The pins are disposed in the central openings 9468 and 9482 of the tool component 9462 and 9482, respectively, which are aligned with the opening 9689 of the wrist assembly 9500.

[0173] The end effector 9460 can be operatively coupled to the mechanical structure in the same or similar manner as described with respect to the previous embodiments, such that tool members 9462 and 9482 rotate about the rotation axis A2. For example, the drive surface 9471 of the drive pulley 9470 is configured to engage a first cable (not shown), such that tension applied by the first cable along the drive surface 9471 generates a rotational torque about the rotation axis A2. Similarly, the drive surface 9481 of the drive pulley 9480 is configured to engage a second cable (not shown), such that tension applied by the second cable along the drive surface 9481 generates a rotational torque about the rotation axis A2. In this way, the contact portions 9464 of tool member 9462 and 9484 of tool member 9482 can be actuated to engage or manipulate target tissue during surgical procedures.

[0174] As described above with respect to the previous embodiments, both the first cable (not shown) and the second cable (not shown) can extend from the mechanical structure (as described herein) and be coupled to the end effector 9460. More specifically, the distal portion of the first cable is coupled to the first tool member 9462 of the end effector 9460, and the distal portion of the second cable is coupled to the second tool member 9482 of the end effector 9460 in the same manner as described above with respect to tool members 6462 and 6482.

[0175] [Start New Materials] Figures 49-5 Figure 4 illustrates a portion of another embodiment of an end effector that can be used with or incorporated into any of the medical devices described herein. Figures 49-52Figure 54 illustrates a portion of an end effector 10460, which can be coupled to a wrist assembly (e.g., wrist assembly 9500) and a shaft (e.g., shaft 9410) of a medical device.

[0176] The end effector 10460 may include a first tool component 10462 and a second tool component (not shown), which are configured to be similar in function to, for example, the first tool component 9462 and the second tool component 9482 described above. The following description pertains only to the first tool 10462, and it should be understood that the second tool may be configured to be identical to and function identically to the first tool 10462. Figures 49-51 As shown, the first tool component 10462 includes a drive pulley 10470 and a coupling shaft 10467. In this embodiment, the drive pulley 10470 and the coupling shaft 10467 may be formed as integral or monolithic components welded (or otherwise coupled) to a contact portion (not shown) of the tool component 10460. In some embodiments, the contact portion may be formed as two parts (stamped parts), and the drive pulley 10470 and the coupling shaft 10467 may be formed of a metallic material and processed or formed by a metal injection molding process.

[0177] like Figure 49 and Figure 50 As shown in the preferred embodiment, the drive pulley 10470 defines a guide channel 10473 having a drive surface 10471 and includes two protrusions 10472 defining an opening 10474 therebetween. The coupling spindle 10467 defines a spool channel 10475 having a winding surface 10476. As in the previous embodiment, the guide channel 10473 and the spool channel 10467 are configured to receive a cable (e.g.,...). Figures 51-54D The distal portion (as shown) is described in more detail below. Figure 51 As shown in the side view, the drive pulley 10470 is positioned at a first position along axis A2, and the coupling shaft 10467 is positioned at a second position along axis A2. In other words, the drive pulley 10470 and the coupling shaft 10467 are positioned at a distance spaced apart from each other along the same axis of rotation.

[0178] As described herein with respect to other embodiments, the first tool member 10462 and the second tool member (not shown) are rotatably coupled to the link of the wrist assembly via corresponding pins (not shown). More specifically, the pins are disposed within the central opening 10468 of the first tool member 10462 and the central opening (not shown) of the second tool member (not shown), the central opening 10468 of the first tool member 10462 and the central opening of the second tool member aligning with the opening of the wrist assembly.

[0179] The end effector 10460 can be operatively coupled to a mechanical structure in the same or similar manner as described with respect to the previous embodiments, such that the first tool member 10462 and the second tool member (not shown) rotate about the axis of rotation A2. For example, the drive surface 10471 of the drive pulley 10470 is configured to engage the first cable 10420 (described below and in... Figures 51-54D As shown in the diagram, the tension applied by the first cable 10420 along the drive surface 10471 generates a rotational torque about the rotation axis A2. Similarly, the drive surface of the drive pulley of the second tool member (not shown) is configured to engage the second cable (not shown), such that the tension applied by the second cable along the drive surface of the second tool member generates a rotational torque about the rotation axis A2. In this way, the contact portion of the first tool member 10462 and the contact portion of the second tool member (not shown) can be actuated to engage or manipulate target tissue during surgical procedures.

[0180] As described above with reference to the previous embodiments, both the first cable 10420 and the second cable (not shown) can be coupled to a mechanical structure (as described herein) and extend to and be coupled to the end effector 10460. More specifically, the distal portion 10422 of the first cable 10420 is coupled to the first tool member 10462 of the end effector 10460, and the distal portion of the second cable (not shown) is coupled to the second tool member (not shown) of the end effector 10460, as referred to below. Figures 52-5 4. Description is made for the first cable 10420. The second cable may be coupled in the same manner.

[0181] The first cable 10420 and the second cable each include a first proximal portion 10421, a second proximal portion 10423, and a distal portion 10422 (see example). Figure 51 and Figure 52 ),and Figure 5 The cable 2420 shown is the same as or similar to that described above. As described above with respect to cable 2420, the first proximal portion 10421 and the second proximal portion 10423 are respectively coupled to the mechanical structure of the medical device (see below for reference). Figures 55-66(more detailed description), and the distal portion 10422 is coupled to the end effector (i.e., the first tool component and the second tool component). In some embodiments, the cable may be constructed of a polymer as described above with respect to cable 2420.

[0182] In this embodiment, the first cable 10420 is coupled to the first tool member 10462 of the end effector 10460, such as Figure 51 and Figure 52 As shown. It should be understood that the second cable (not shown) can be coupled to the second tool member (not shown) of the end effector 10460 in the same manner. More specifically, in this embodiment, the distal portion 10422 of the first cable 10420 is wound around the first tool member 10462 and then extends along the axis of the medical device, and the first proximal portion 10421 is coupled to the first winch and the second proximal portion 10423 is coupled to the second winch of the mechanical structure of the medical device (described below). The second cable is similarly coupled to the second tool member and routed along the axis and coupled to the third and fourth winches of the mechanical structure.

[0183] Figure 53 This is a schematic diagram of a cable in a wound configuration removed from tool component 10462 for illustrative purposes. Figures 54A-54D The illustration shows the steps involved in winding and coupling the first cable 10420 to the first tool member 10462. To couple the first cable 10420 to the first tool member 10462, the distal portion 10422 is placed below and against the bottom side of the winding surface 10476 within the spool channel 10475 (i.e., the side furthest from the protrusion 10472), as shown below. Figure 53 and Figure 54A As indicated by arrow 1 in the diagram. In other words, approximately the middle portion of the first cable 10420 is placed against the bottom of the winding surface 10476, with cable lengths L1 and L2 extending upwards on each side of the middle portion, as shown. Figure 54A As shown. A portion of each length L1 and L2 of the first cable 10420 extending from each side of the winding surface 10476 is then wound around the winding surface 10476 in the opposite direction, first crossing each other at the top side of the winding surface 10476 (i.e., the side closest to the protrusion 10472) within the spool channel 10475, as Figure 53 and Figure 54BAs indicated by arrow 2 in the diagram. In other words, length L1 is wound counterclockwise, and length L2 is wound clockwise. Then, portions of each length L1 and L2 of the first cable 10420 are wound around the winding surface 10476 in opposite directions (L1 counterclockwise and L2 clockwise), again traversing each other partially around the winding surface 10476 within the spool channel 10475 at the bottom side of the winding surface 10476 and towards the top of the spool channel 10475, as shown. Figure 53 and Figure 54C As indicated by arrow 3 in the diagram. Then, a portion of each length L1 and L2 of the first cable 10420 is routed through the opening 10474 defined between the protrusions 10472 of the drive pulley 10470, as shown. Figure 53 and Figure 54D Arrow 4 in the middle indicates (and also shows in Figure 51 and Figure 52 (In the middle). The dimensions (e.g., diameter or width) of the opening 10474 may be smaller than the nominal dimensions (diameter or width) of the cable 10420, such that force is required to allow lengths L1 and L2 of the cable 10420 to pass through the opening 10474. For example, in some embodiments, the opening 10474 may have a nominal diameter or width that is approximately half the diameter or width of the cable 10420. In some embodiments, the cable 10420 may be a polymer cable capable of deforming when subjected to force through the opening 10474. Thus, when the cable 10420 passes through the opening 10474, the cable can deform to fit through the opening 10474. For example, in some embodiments, the cable 10420 has a circular cross-section before passing through the opening 10474 and may deform into a different shape as it passes through the opening 10474. In other words, the cable 10420 may not maintain a circular cross-section. Then, each length L1 and L2 of the first cable 10420 on the opposite side of the opening 10474 is routed in opposite directions along the drive surface 10471 within the guide channel 10473, as follows: Figure 53 and Figure 54D As indicated by arrow 5 in the image.

[0184] When the first cable 10420 is coupled to the first tool member 10462, the contact surface of the cable 10420 and the frictional force abut against the winding surface 10476 of the coupling shaft 10467 and along the drive surface 10471 of the drive pulley 10470, holding the cable 10420 to the first tool member 10462 without the use of additional fastening or retaining components. Furthermore, as described above, the size of the opening 10474 is smaller than the size of the cable 10420, creating increased friction between the cable 10420 and the first tool member 10462, and the contact between the surfaces of the cable 10420 and the protrusion 10472 provides additional engagement surfaces and increased friction between the cable 10420 and the first tool member 10462. This increased friction between the first tool member 10462 and the cable 10420 helps to maintain the coupling of the cable 10420 to the first tool member 10462. The increased friction also reduces the likelihood of the cable 10420 slipping during operation of the medical device.

[0185] By winding the cable counterclockwise for length L1 and clockwise for length L2 within the spindle channel 10475, neither length L1 nor L2 will always be wound on top of the other. Similarly, by winding both lengths L1 and L2 of the cable in opposite winding directions, this cable winding pattern prevents one length portion L1 or L2 from always being under the other. For example, see reference... Figure 54A A portion of length L1 is located innermost within a portion of the left spool channel 10475, and a portion of length L2 is located innermost within a portion of the right spool channel 10475. In this way, the effect of the tension applied to the cable 10420 by either length L1 or length L2 will have a more consistent effect on the frictional force maintaining the coupling of the cable 10420 to the first tool member 10462. This further prevents slippage of the cable 10420 during operation of the medical device when tension is applied to it.

[0186] After being coupled to the first tool member 10462, each length L1, L2 of the first cable 10420 (including the first proximal portion 10421 and the second proximal portion 10423) then passes through or is routed along the shaft from the first tool member 10462 and reaches the first and second winches of the mechanical structure, as described below. For example, the first proximal portion 10421 and the second proximal portion 10423 of the first cable 10420 may extend within the internal cavity of the shaft or may be routed externally to the shaft and coupled to the first and second winches of the mechanical structure.

[0187] More specifically, the first proximal portion 10421 is coupled to the first winch 10710. Figures 55-66(As shown in the figure) and the second proximal portion 10423 is coupled to the second winch (not shown) of the mechanical structure of the medical device (described below). The following description describes the coupling of the first winch 10710 and the first proximal portion 10421 of the first cable 10420 to the first winch 10710, but it should be understood that the second proximal portion 10423 of the first cable 10420 can be coupled to the second winch in the same manner. In addition, the wiring of the second cable (not shown) between the end effector and the mechanical structure is not described below, but it should be understood that the second cable can be wired and coupled to the third and fourth winches in the same manner as the first cable.

[0188] More specifically, the two ends of a first cable 10420, associated with the opposite direction of a single degree of freedom, are connected to two separate drive winches (a first winch 10710 and a second winch (not shown)). This arrangement (generally referred to as the counter-drive system described above with respect to the previous embodiment) allows for independent control of the movement (e.g., pull-in or release) of each end of the cable. Mechanical structures generate movement of the first cable 10420 and the second cable, which operates to produce the desired articulated movement (pitch, yaw, cut, or clamp) at the end effector 10460. Thus, as described herein, the mechanical structure includes components and controls to move a first portion of the first cable 10420 in a first direction (e.g., a proximal direction) via the first winch 10710 and a second portion of the first cable 10420 in a second opposite direction (e.g., a distal direction) via the second winch (not shown). The mechanical structure can also move both the first and second portions of the first cable 10420 in the same direction. The mechanical structure also includes components and controls for moving a first portion of the second cable (not shown) in a first direction (e.g., a proximal direction) via a third winch (not shown) and a second portion of the second cable in a second opposite direction (e.g., a distal direction) via a fourth winch (not shown). The mechanical structure can also move the first portion of the second cable and the second portion of the second cable in the same direction. In this way, the mechanical structure can maintain the required tension within the cable to produce the desired movement at the end effector 10460.

[0189] like Figures 55-59 As shown, the first winch 10710 includes a first portion 10715 (which serves as a spool portion) having a drive surface 10716 and a second portion 10714 (which serves as an anchoring portion for securing a cable to the winch 10710) having a coupling surface 10733. In this embodiment, the drive surface 10716 is a circular groove defined around the longitudinal axis Ac of the winch 10710.

[0190] The second portion 10714 of the first winch 10710 is cylindrical about the longitudinal axis Ac. The second portion 10714 also defines a first slot 10721 extending along the longitudinal axis Ac and a second slot 10722 intersecting (or transverse to) the first slot 10721. In some embodiments, the first slot 10721 is perpendicular to the second slot 10722. The second portion 10714 also defines a top slot 10724, which is defined between two posts 10727 and 10728 and intersects the first slot 10721. Figure 55 and Figure 56 As shown, guide opening 10729 and inlet opening 10730 are each defined on a first side or front side of winch 10710. When a first cable 10420 is coupled to winch 10710, guide opening 10729 can serve as a positioner guide, as described below. In some embodiments, the size of guide opening 10729 is set to be larger than the size (e.g., diameter or width) of cable 10420, such that cable 10420 can be placed within guide opening 10729 without applying force or friction between winch 10710 and cable 10420. In some embodiments, the size (e.g., diameter or width) of guide opening 10729 can be set to be smaller than the size (e.g., diameter or width) of cable, such that a pinch created between winch 10710 and cable 10420 captures a portion of cable 10420. In some embodiments, guide opening 10729 may be a tapered lumen. The access opening 10730 can be used to provide access for a cutting tool to cut the first cable 10420 after the first cable 10420 has been coupled to the winch 10710, as described in more detail below. Figure 57 As shown, an elongated slot 10732 is defined on the second side or back side of the winch 10710. The elongated slot 10732 can be used to route the first cable 10420 to the drive surface 10716, as described in more detail below.

[0191] As described above, after being coupled to the first tool member 10462 of the end effector 10460, the first proximal portion 10421 of the first cable 10420 extends along or through the shaft and reaches the first winch 10710 of the mechanical structure for coupling to the first winch 10710. The first proximal portion 10421 of the first cable 10420 is routed along a specific path on the winch 10710 and secured to the winch 10710 without requiring a separate retaining element (e.g., a coil, a retaining member on the cable, etc.).

[0192] More specifically, the first proximal portion 10421 of the cable 10420 includes a terminal portion 10424, a first winding portion 10425, a second winding portion 10426, and a drive portion 10427, as shown below. Figure 67 As shown. Figure 60 As shown, a first proximal portion 10421 of the first cable 10420 extends from the end effector 10460 and is positioned within a guide opening 10729, such that the terminal portion of the first cable 10420 extends through an entry opening 10730 at a selected distance. During coupling of the cable 10420 to the winch 10710, the guide opening 10729 assists in positioning the cable 10420 within the first slot 10721. A portion of the proximal portion 10421 (including the first winding portion 10425) extends upward through the first slot 10721 and over the third slot 10724 for wiring (e.g., Figure 60 (As indicated by arrow 1 in the image). Figure 61 As shown, a portion of the first cable 10420 then passes through the first slot 10721 on the second side of the winch 10710 and through the second slot 10722, and is wound around the coupling surface 10733 toward the first side of the winch 10710, as shown. Figure 61 As indicated by arrows 2 and 3 in the diagram. Then, a portion of the first cable 10420 is routed within the second slot 10722 on the first side of the winch 10710 and returns through the first slot 10721, as shown in the diagram. Figure 62 As indicated by arrows 4 and 5 in the diagram. Figure 63 As shown, a portion of the first cable 10420 is routed through the first slot 10721 on the second side of the winch 10710, and a second portion of the cable 10420 (including the second winding portion 10426) is routed in the opposite direction toward the first side of the winch 10710 through the coupling surface 10733 of the second slot 10722 and wound around the coupling surface 10733 of the second slot 10722, traversing the first winding portion 10425, as shown. Figure 63 As indicated by arrows 6 and 7 in the diagram. Then a portion of the first cable 10420 is wrapped twice around the coupling surface 10733, as shown in the diagram. Figure 64 As indicated by arrow 8, it again traverses the first winding portion and crosses the terminal portion 10424 of the cable 10420, which extends along the drive surface 10733 and within the guide opening 19729 and the entry opening 10732. Figure 65 As shown, a portion of the first cable 10420 then wraps around the coupling surface 10733 back to the second side of the winch 10710, as indicated by arrow 9, then passes downward through the elongated slot 10732, as indicated by arrow 10, and then around the drive surface 10716, as indicated by arrow 11. Figure 66 As shown, a portion of the first cable 10420 is wound around the drive surface 10716 to the first side of the winch 10710 and extends to the end effector 10460, as indicated by arrow 13.

[0193] After the first cable 10420 is coupled to the winch 10710, the proximal portion 10421 can be cut to remove excess cable. For example, as Figure 66 As shown, a cutting tool (not shown) can cut the end portion of the first cable 10420 at position C within the opening 10730. For example, the end can be cut using a thermal cutter or by fusing the end or other suitable cutting tools. The length of the first cable 10420 is configured such that it can be coupled to the end effector 10460 and then to the winch 10710, resulting in slack in the cable during transport and storage. In other words, the cable 10420 is not under tension during transport and storage. By limiting cable tension during storage, cable stretching can be reduced or eliminated.

[0194] With the first cable 10420 coupled to the mechanical structure (not shown) and the end effector 10460, the rotational movement generated by the first winch 10710 and the second winch (not shown) can respectively cause movement at the first tool member 10462 and the second tool member (not shown). Therefore, as described above, better control over the overall movement of the end effector 10460 (and the tool member) can be achieved.

[0195] While many embodiments described herein illustrate tool components with coupling shafts separate from the drive pulley (e.g., 10462), in other embodiments, any tool component described herein may include coupling portions also within the drive pulley portion (or parts of the drive pulley portion) (e.g., where a cable is wound to couple the cable to the tool component). In this way, the tool geometry can be simplified by eliminating separate coupling shafts. For example, in some embodiments, the winding groove may be defined by the drive surface of the drive pulley. Such grooves may be linear (e.g., ...). Figure 68 and Figure 69 (As shown) or it can be curved or have a serrated or folded pattern (such as...) Figure 70 and Figure 71 (As shown in winch 11710). This construction increases the contact surface between the coupling portion and the cable, thereby improving the retention of the cable by the tool components.

[0196] Figures 68-69 An alternative embodiment of a tool component of an end effector is illustrated, the tool component including a groove within a drive surface of the tool component. More specifically, tool component 11462 includes a drive pulley 11470, the drive pulley 11470 including a drive surface 11471 and a coupling portion 11467 defined by the drive surface 11471. The coupling portion 11467 includes a groove having a winding surface 11476. Figure 69As shown, cable 11420 can be wound around drive pulley 11470 on winding surface 11476 within coupling portion 11467 to couple cable 11420 to tool member 11462, and then contact drive surface 11471 of drive pulley 11470. For illustrative purposes, cable 11420 is shown in cross-sectional view. Figure 69 (and Figure 71 In this embodiment, cable 11420 is wound twice around the winding surface 11476. In an alternative embodiment, the cable may be wound once or more than two times around the winding surface. The construction of cable 11420 may be the same as or similar to that of the cable described herein (e.g., cable 2420 described above).

[0197] Similar to the winches of the medical devices described herein, although many described embodiments show winches having a first portion with a drive surface (which serves as a spool portion) and a second portion with a coupling surface (which serves as an anchoring portion for securing the cable to the winch) (e.g., 10710), in alternative embodiments, the winch may include a portion comprising both a drive surface portion and a coupling surface portion. For example, as described above with respect to tool component 11462, in some embodiments, the coupling groove and surface may be defined by the drive surface of the winch. Such a groove may be linear (e.g., ... Figure 67 and Figure 68 For tool component 11462 shown, it may be curved or have a serrated or folded pattern, such as Figure 70 and Figure 71 As shown. This construction increases the contact surface between the coupling portion of the winch and the cable, thereby improving the winch's retention of the cable.

[0198] Figure 70 and Figure 71 The illustration shows a portion of a winch, which includes both a coupling surface and a drive surface. Figure 70 and Figure 71 As shown, the winch 11710 includes a portion 11715 having a drive surface 11716, which serves as a spool portion. In this embodiment, the drive surface 11716 is within a circular groove defined around the longitudinal axis Ac of the winch 11710. The drive surface 11716 defines a groove 11722 having a coupling surface 11733, which serves as an anchoring portion to secure the cable 11420 to the winch 11710. The groove 11722 has a serrated pattern to further increase the contact surface between the winch and the cable 11420, thereby improving the retention of the cable 11420 by the winch 11710. In this embodiment, the cable 11420 is shown wound two turns around the coupling surface 11733. In an alternative embodiment, the cable may be wound one or more turns around the coupling surface 11733.

[0199] While various embodiments have been described above, it should be understood that they are presented as examples only and not as limitations. Where the methods and / or diagrams above indicate certain events and / or flow patterns occurring in a certain order, the order of certain events and / or operations may be modified. Although embodiments have been specifically shown and described, it should be understood that various changes in form and detail may be made.

[0200] For example, any instrument (and components thereof) described herein may optionally be a part of a surgical assembly that performs minimally invasive surgical procedures and may include a manipulator unit, a series of kinematic linkages, a series of cannulas, etc. Therefore, any instrument described herein can be used with any suitable surgical system, such as the MIRS system 1000 shown and described above. Furthermore, any instrument shown and described herein can be used to manipulate target tissue during surgical procedures. Such target tissue can be cancer cells, tumor cells, lesions, vascular occlusion, thrombosis, stones, uterine fibroids, bone metastases, adenomyosis, or any other body tissue. The examples of target tissues presented are not exhaustive. Additionally, target structures may also include artificial materials (or non-tissues) within or associated with the body, such as graft fixation molds, portions of artificial tubes, fasteners within the body, etc.

[0201] For example, any tool component can be constructed from any material (e.g., medical-grade stainless steel, nickel alloys, titanium alloys, etc.). Furthermore, any link, tool component, tensioning member, or part described herein can be constructed from multiple parts subsequently connected together. For example, in some embodiments, a link can be constructed by connecting individually constructed parts together. However, in other embodiments, any link, tool component, tensioning member, or part described herein can be constructed as a single unit.

[0202] Although instruments are generally shown as having a tool member rotation axis (e.g., axis A2) orthogonal to the rotation axis of the wrist component (e.g., axis A1), in other embodiments, any instrument described herein may include a tool member rotation axis offset from the rotation axis of the wrist component by any suitable angle.

[0203] Although various embodiments have been described as combinations of specific features and / or components, other embodiments may have any combination of features and / or components from any of the embodiments discussed above. Various aspects have been described in the general context of medical devices (more specifically surgical instruments), but the inventive aspect is not necessarily limited to use in medical devices.

Claims

1. A medical device comprising: A shaft, comprising a distal portion and a proximal portion; as well as A mechanical structure coupled to the proximal portion of the shaft. The mechanical structure includes a winch. The winch comprises a first part and a second part. The first portion of the winch includes a drive surface configured to engage a cable of the medical device, such that rotation of the winch generates tension in the cable to actuate the end effector of the medical device. The first slot and the second slot are each defined within the second portion of the winch. The second slot intersects with the first slot. The first slot and the second slot are each configured to receive the cable to secure the cable to the second portion of the winch; The cable extends along the axis, winds around the drive surface of the first portion of the winch, and includes a first winding portion and a second winding portion; and The cable is wound around the second portion of the winch within the first slot and the second slot, such that the second wound portion of the cable crosses over the first wound portion of the cable.

2. The medical device according to claim 1, wherein: The winch includes two posts and a third slot between the two posts, and The third slot is configured to receive the cable to secure the cable to the second portion of the winch.

3. The medical device according to claim 1, wherein: The opening is defined within the second portion of the winch; The cable includes a terminal section; and The terminal portion of the cable is inserted into the opening of the second portion of the winch.

4. The medical device according to claim 1, wherein: The second portion of the winch includes a coupling surface; and The cable is wound at least two turns around the coupling surface of the second portion of the winch within at least one of the first slot or the second slot.

5. The medical device according to claim 1, wherein: The cable is wound at least two turns around the second portion of the winch in each of the first and second slots.

6. The medical device according to any one of claims 3-5, wherein: The cable comprises a polymer.

7. The medical device according to claim 3, wherein: The terminal portion of the cable does not retain features.

8. The medical device according to claim 1, wherein: The end effector is coupled to the distal portion of the shaft; The cable is routed along the axis and includes a proximal portion and a distal portion; The distal portion of the cable is coupled to the end effector; The proximal portion of the cable includes a driving portion, a first winding portion, a second winding portion, and a termination portion; The drive portion of the near-end portion of the cable is at least partially wound around the drive surface of the first portion of the winch; The first winding portion of the near-end portion of the cable is wound around the second portion of the winch within the first slot; The second winding portion of the near-end portion of the cable is wound around the second portion of the winch within the second slot, such that the second winding portion crosses the first winding portion; The opening is defined within the second portion of the winch; as well as The terminating portion of the near-end portion of the cable is inserted into the opening of the second portion of the winch.

9. The medical device according to claim 8, wherein: The winch rotates about the longitudinal axis; The drive surface of the first portion of the winch is a circular groove surrounding the longitudinal axis of the winch and defining a first diameter; and The second portion of the winch is cylindrical around the longitudinal axis of the winch and defines a second diameter larger than the first diameter.

10. The medical device according to claim 9, wherein: The first portion of the winch includes a first sidewall and a second sidewall; and The drive surface of the first portion of the winch is located between the first sidewall and the second sidewall.

11. The medical device according to claim 10, wherein: The passage is confined within the first sidewall; and The first winding portion of the near-end portion of the cable passes through the passageway from the first portion of the winch and reaches the first slot.

12. The medical device according to any one of claims 8-11, wherein: The termination portion of the cable does not retain features.

13. The medical device according to any one of claims 8-11, wherein: The termination portion of the cable has a constant cross-sectional diameter.

14. The medical device according to claim 12, wherein: The termination portion of the cable has a constant cross-sectional diameter.

15. The medical device according to any one of claims 8-11, wherein: The cable comprises a polymer.

16. The medical device according to claim 12, wherein: The cable comprises a polymer.

17. The medical device according to claim 13, wherein: The cable comprises a polymer.

18. The medical device according to claim 14, wherein: The cable comprises a polymer.

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