Apparatus and method for stress / strain isolation on force sensor unit

Abstract

A medical device includes a shaft including a proximal end portion and a distal end portion. A beam has a proximal end portion, a distal end portion, and a middle portion, and one or more strain sensors are located on the middle portion. The proximal end portion of the beam is matingly coupled to the distal end portion of the shaft to form an interface. The beam includes a discontinuity between the interface and the middle portion of the beam. In some embodiments, the medical device includes a link, and the distal end portion of the beam is matingly coupled to the link to form a second interface. A second discontinuity is between the second interface and the middle portion of the beam. In some embodiments, an anchor is coupled to the shaft, and the proximal end portion of the beam is matingly coupled to the anchor.

Description

[0001] Cross-reference to related applications

[0002] This application claims priority and benefit to U.S. Provisional Patent Application No. 63 / 026,321, filed May 18, 2020, entitled “Apparatus and Method for Stress / Strain Isolation on a Force Sensor Unit,” the disclosure of which is incorporated herein by reference. Technical Field

[0003] The embodiments described herein relate to medical devices, and more specifically to endoscopic tools. More specifically, the embodiments described herein relate to a device that includes a strain sensor on a cantilever beam coupled to an end effector for measuring the forces applied to the end effector during medical procedures. Background Technology

[0004] Known techniques for minimally invasive surgery (MIS) employ instruments to manipulate tissue, which 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. In MIS procedures, the end effector, wrist mechanism, and distal end of the axis are inserted into a small incision or natural orifice in the patient to position the end effector at the work site within the patient's body. An optional wrist mechanism can be used to change the orientation of the end effector relative to the axis to perform the desired procedure at the work site. In known instruments, the movement of the instrument as a whole provides the mechanical degrees of freedom (DOF) for the movement of the end effector, and the wrist mechanism typically provides the desired degrees of freedom (DOF) for the movement of the end effector relative to the axis of the instrument. For example, for forceps or other grasping tools, known wrist mechanisms are typically capable of changing the pitch and yaw of the end effector relative to the axis. The wrist may optionally provide a tilt degree of freedom for the end effector, or this tilt degree of freedom may be achieved via a rolling axis. The end effector may optionally have other mechanical degrees of freedom, such as grip or blade movement. In some cases, wrist and end effector mechanical degrees of freedom can be used in combination. For example, U.S. Patent No. 5,792,135 (filed May 16, 1997) discloses a mechanism in which wrist and end effector gripping degrees of freedom are combined.

[0005] To achieve the desired motion of the wrist mechanism and end effector, known instruments include cables that extend through the instrument's axis and connect the wrist mechanism to a mechanical structure that can be moved to operate the wrist mechanism. For robotic systems, the mechanical structure is typically motor-driven and operatively coupled to a processing system to provide a user interface for clinical users (e.g., surgeons) to control the instrument.

[0006] Patients benefit from ongoing efforts to improve the effectiveness of MIS methods and tools. For example, reducing the size and / or operating footprint of the axis and wrist mechanism allows for smaller access incisions and reduces space requirements at the surgical site, thereby reducing negative surgical consequences such as pain, scarring, and poor healing time. However, producing small medical devices that achieve the clinically desired functions of minimally invasive surgery is challenging. Specifically, simply reducing the size of known wrist mechanisms by “scaling down” components will not produce an effective solution because the required component and material properties will not scale proportionally. For example, an effective implementation of a wrist mechanism is complex because the cables must be carefully routed through the wrist mechanism to maintain cable tension throughout the entire range of motion and to 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, and this reduced cable friction extends device life and allows operation without excessive forces applied to the cables or other structures within the wrist mechanism. Increased local forces caused by smaller structures (including cables and other components of the wrist mechanism) can lead to undesirable cable elongation (e.g., “stretching” or “creep”) and shortened cable life during storage and use.

[0007] Some known systems include force sensing and associated tactile feedback during MIS surgery, which provides surgeons with greater immersion, realism, and intuitiveness. For effective tactile rendering and accuracy, force sensors are placed on surgical instruments and as close as possible to the interaction with anatomical tissue. One approach is to include a force sensor with an electrical strain sensor (e.g., a strain gauge) at the distal end of the surgical instrument axis to measure the strain applied to the instrument.

[0008] An example of a force sensor unit includes a cantilever beam attached between a distal tip component of an instrument (e.g., in some cases, a U-clamp or other wrist or end effector component) and the instrument shaft, extending back into the mechanical structure. Strain sensors are located on the beam and are used to sense strain in the X and Y directions (arbitrary Cartesian directions orthogonal to each other and to the longitudinal axes of the beam and the instrument shaft). For example, the strain sensor may include a full Wheatstone bridge (full bridge). A strain sensor bridge circuit is a circuit in which two circuit branches (typically connected in parallel with each other) are bridged at some midpoint by a third branch connected between the first two branches. Two full bridges are formed on each of two adjacent orthogonal sides of the beam to measure forces orthogonal to the longitudinal axes of the beam in the X and Y directions. In some cases, the strain sensors are divided into two groups, one located at the distal end of the beam and the other at the proximal end, to reject common modes. Because the beam is fixed to the distal portion of the instrument shaft, the strain sensors sense strain on the surface of the beam parallel to the longitudinal axis of the shaft. For example, these strains can be caused by forces applied along the longitudinal axis orthogonal to the beam. Forces applied along the sides of the beam (i.e., X or Y forces) are determined by subtracting strain measurements from the strain measurements of the entire bridge at the near and far ends of the beam's sides.

[0009] Strain sensors can withstand a variety of strain sources, including: the orthogonal force to be measured, torque, off-axis force, off-axis moment, compression / tension, torsion, ambient temperature, and temperature gradient. Each full-bridge cancels out the following strains: temperature, torsion, off-axis force, and off-axis moment. Therefore, each individual full-bridge output indicates the strain caused by force, torque, and compression / tension. Subtracting the output of the proximal full-bridge formed on the same side from the output value produced by the distal full-bridge on one side eliminates torque and compression / tension, thus producing the output value representing the orthogonal force to be measured. The spacing between the two sets of strain sensors (i.e., the strain sensor at the distal end of the beam and the strain sensor at the proximal end of the beam) determines the sensitivity of the force sensor unit, and a larger spacing results in better sensitivity. The total length of the beam and its cross-sectional area are constrained by the available space within the instrument shaft and the rigidity requirements of the device. Therefore, efforts to reduce the overall size of the instrument can lead to a reduction in the spacing between the strain sensors.

[0010] Furthermore, stress concentration zones, strain overload zones, and nonlinear stress distributions along the beam length occur at the interface between the beam and the components connected to it (i.e., the instrument shaft and the U-clamp or end effector). Therefore, strain sensors need to be placed outside these areas to properly perform force sensing and prevent damage to the strain sensors due to strain overload. Consequently, the design of the force sensor unit needs to meet two competing requirements: (i) positioning the strain sensors sufficiently far from the interface at the beam end, and (ii) maximizing the spacing between the two sets of strain sensors.

[0011] When the instrument axis rolls 360 degrees, the force sensor unit also needs to perform force sensing in a consistent manner. This means that the output signals of the X and Y strain gauges should follow the same sinusoidal distribution throughout the entire rolling motion range. This requirement for consistent force sensing imposes certain requirements on the cross-sectional shape of the cantilever beam.

[0012] Therefore, there is a need for improved endoscopic tools that have force-sensing capabilities and can address the aforementioned problems related to stress concentration, strain overload, and nonlinear force distribution at the interfaces between beam-to-beam connected components. Summary of the Invention

[0013] This summary describes 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 is not intended to identify key or essential elements or to depict the scope of the subject matter. In some embodiments, the medical device includes a shaft and a beam. The shaft includes a proximal portion and a distal portion. The beam has a proximal portion, a distal portion, and an intermediate portion between the proximal and distal portions of the beam. One or more strain sensors are located on the intermediate portion of the beam. The proximal portion of the beam is matingly coupled to the distal portion of the shaft to form an interface. The beam includes a discontinuity between the interface and the intermediate portion of the beam.

[0014] In some embodiments, the medical device further includes an anchor coupled to the distal portion of the shaft. The anchor includes a coupling portion, and the proximal portion of the beam is matingly coupled to the coupling portion of the anchor to connect the distal portion of the beam to the distal portion of the shaft.

[0015] In some embodiments, the discontinuity is a first discontinuity, the interface is a first interface, and the medical device further includes a link. A distal portion of the beam is matingly connected to the link to form a second interface, and the beam includes a second discontinuity between the second interface and a middle portion of the beam. In some embodiments, the first discontinuity includes a middle portion of the beam having a first cross-sectional area and a proximal portion of the beam having a second cross-sectional area, wherein the first cross-sectional area is different from the second cross-sectional area. The second discontinuity includes a distal portion having a third cross-sectional area, wherein the first cross-sectional area is different from the third cross-sectional area.

[0016] In some embodiments, the first discontinuity includes a proximal portion of a tapered beam, and the tapered proximal portion serves as a guide for aligning the beam with the anchor along the central axis of the shaft. In some embodiments, the second discontinuity includes a distal portion of a tapered beam, and the tapered distal portion serves as a guide for aligning the beam with the connecting rod along the central axis of the shaft. In some embodiments, the first discontinuity includes a first recessed region between a middle portion and a proximal portion of the beam, and the second discontinuity includes a second recessed region between a middle portion and a distal portion of the beam.

[0017] In some embodiments, the proximal portion of the beam includes a shape that is received in an opening of an anchor having a first corresponding shape in only one orientation, and the distal portion of the beam includes a shape that is received in an opening of a link having a second corresponding shape in only one orientation. In some embodiments, when the beam is coupled to the anchor, the proximal face of the middle portion of the beam is spaced apart from the distal face of the anchor, and when the beam is coupled to the link, the distal face of the middle portion of the beam is spaced apart from the proximal face of the link.

[0018] In some embodiments, the medical device includes a shaft, a beam, an anchor, and a link. The shaft includes a proximal portion and a distal portion, and a central axis extending between the proximal and distal portions. The beam has a proximal portion, a distal portion, and an intermediate portion between the proximal and distal portions. The proximal portion of the beam has a first cross-sectional area, the intermediate portion has a second cross-sectional area, and the distal portion has a third cross-sectional area. The first cross-sectional area differs from the second and third cross-sectional areas. One or more strain sensors are located on the intermediate portion of the beam. The anchor is coupled to the distal portion of the shaft and includes a connecting portion. The proximal portion of the beam is matingly coupled to the connecting portion of the anchor. The link includes a connecting portion, and the distal portion of the beam is matingly coupled to the connecting portion of the link.

[0019] In some embodiments, the anchor connection portion is configured to receive an opening in the proximal portion of the beam, while the connecting rod connection portion is configured to receive an opening in the distal portion of the beam. In some embodiments, both the proximal and distal portions of the beam are tapered. The proximal portion serves as a guide for aligning the beam with the anchor along the central axis of the shaft, while the distal portion serves as a guide for aligning the beam with the connecting rod along the central axis of the shaft.

[0020] In some embodiments, the proximal portion of the beam includes a shape that is received in one orientation within an opening of an anchor having a first corresponding shape, and the distal portion of the beam includes a shape that is received in one orientation within an opening of a link having a second corresponding shape. In some embodiments, the proximal portion of the beam includes a D-shape and is configured to be received within a corresponding D-shaped opening of the anchor. In some embodiments, the distal portion of the beam includes a D-shape and is configured to be received within a corresponding D-shaped opening of the link. In some embodiments, the proximal portion of the beam is welded to the anchor, while the distal portion of the beam is welded to the link.

[0021] In some embodiments, the medical device further includes an outer shaft, and the shaft extends within a cavity of the outer shaft. In some embodiments, the shaft is movable relative to the outer shaft. In some embodiments, the outer shaft translates longitudinally relative to the shaft and beam along a central axis. In some embodiments, the shaft is rotatable relative to the outer shaft.

[0022] In some embodiments, one or more strain sensors include a first strain sensor located at a first position on the middle portion of the beam, and a second strain sensor located at a second position on the middle portion of the beam, the second strain sensor being spaced longitudinally from the first strain sensor.

[0023] In some embodiments, the first cross-sectional area of ​​the middle portion of the beam has a length and width defining a first outer surface, a second outer surface, a third outer surface, and a fourth outer surface. The first and second outer surfaces are oriented perpendicular to the third and fourth outer surfaces, and a first strain sensor is located on the first surface, while a second strain sensor is located on the first surface.

[0024] In some embodiments, the medical device includes a shaft, a link, a beam, and one or more sensors. The shaft includes a proximal portion and a distal portion. The distal portion of the shaft defines a first mating opening, while the link defines a second mating opening. The beam has a proximal portion, a distal portion, and an intermediate portion between the proximal and distal portions. The proximal portion of the beam is tapered and connected within the first mating opening. The distal portion of the beam is tapered and connected within the second mating opening. One or more sensors are located on the intermediate portion of the beam. In some embodiments, the one or more sensors are one or more strain sensors.

[0025] In some embodiments, the medical device further includes an outer shaft, and the shaft extends within a cavity of the outer shaft and is movable relative to the outer shaft. In some embodiments, the outer shaft is longitudinally translated relative to the shaft and the beam. In some embodiments, the shaft is rotatable relative to the outer shaft. In some embodiments, one or more sensors are one or more strain sensors, and include a first strain sensor located at a first position on the middle portion of the beam, and a second strain sensor located at a second position on the middle portion of the beam, the second strain sensor being longitudinally spaced from the first strain sensor. Attached Figure Description

[0026] Figure 1 This is a floor plan of a minimally invasive telemedicine system according to one embodiment, used to perform medical procedures such as surgical procedures.

[0027] Figure 2 yes Figure 1 A perspective view of the optional auxiliary units of the minimally invasive remote surgical system shown.

[0028] Figure 3 yes Figure 1 A perspective view of the user console of the minimally invasive remote surgical system shown.

[0029] Figure 4 yes Figure 1The diagram shows a front view of the manipulator unit of a minimally invasive remote surgical system, which includes multiple instruments.

[0030] Figure 5 This is a schematic diagram of a part of a medical device including a force sensor unit according to an embodiment.

[0031] Figures 6A-6D These are schematic diagrams of different embodiments of the force sensor unit.

[0032] Figure 7 This is a perspective view of a medical device according to an embodiment.

[0033] Figure 8A yes Figure 7 An enlarged perspective view of the distal portion of a medical device.

[0034] Figure 8B yes Figure 7 An enlarged perspective view of the distal portion of the medical device, with the outer axis removed.

[0035] Figure 9A yes Figure 7 A perspective view of the distal portion of a medical device.

[0036] Figure 9B yes Figure 7 A perspective view of the axis and anchor of the medical device.

[0037] Figure 10 yes Figure 7 Side view of the beam, distal link, and anchor of the medical device.

[0038] Figure 11 and Figure 12 They are Figure 10 An exploded view of the beam, distal link, and anchor, showing the distal perspective view. Figure 11 ) and near-side perspective view ( Figure 12 ).

[0039] Figure 13A and Figure 13B yes Figure 7 Side view of the beam of the medical device ( Figure 13A ) and perspective ( Figure 13B ).

[0040] Figure 14 yes Figure 7 A perspective view of the beam of a medical device, showing the strain sensor mounted on it.

[0041] Figure 15 yes Figure 11 An enlarged perspective view of the near end portion of the beam.

[0042] Figure 16AIt is a graph showing the relationship between stress and beam length generated by a computer model of a medical device according to an embodiment.

[0043] Figure 16B and Figure 16C yes Figure 16A The left side of the curve ( Figure 16B ) and the right side ( Figure 16C (A magnified view of )

[0044] Figure 17A This is a side view of a portion of a medical device according to another embodiment.

[0045] Figure 17B yes Figure 17A A side view of a portion of a medical device, with the outer axis removed for illustrative purposes.

[0046] Figure 18A yes Figure 17A Side view of the beam of the medical device.

[0047] Figure 18B yes Figure 18A A cross-sectional view of the beam.

[0048] Figure 19 and Figure 20 They are Figure 17B Different perspective views of the distal portion of the medical device, in which the outer sheath has been removed.

[0049] Figure 21A and Figure 21B They are Figure 17A Different exploded perspective views of the beam and proximal U-shaped clamp of the medical device.

[0050] Figure 22 yes Figure 17A A perspective view of the near end of the beam of the medical device.

[0051] Figure 23 yes Figure 17A A perspective view of the beams of the medical device. Detailed Implementation

[0052] The embodiments described herein can be advantageously used for a variety of grasping, cutting, and manipulating operations associated with minimally invasive surgery. The medical device or apparatus of this application is capable of movement in three degrees of freedom (e.g., about the pitch axis, yaw axis, and grasp axis). The embodiments described herein can further be used to determine the forces applied to (or applied by) the distal portion of the device during use.

[0053] The medical device described herein may include a force sensor unit having a cantilever beam and one or more strain sensors on the beam. The beam may have a discontinuity between the active portion of the beam where the strain sensors are placed and at least one interface between the beam and the connected mating component. Furthermore, one or more interfaces may be moved outside the active portion of the beam while maintaining the total length of the cantilever. The discontinuity between the active portion of the beam (with the sensors) and the interface portion of the beam (where the beam connects to the mating component) isolates the beam from undesirable stress / strain caused by mechanical interactions with other mating components. As a result, the stress applied to the beam remains substantially linearly distributed along the length of the beam, and any stress concentration or strain overload is moved to a portion of the beam outside the active portion.

[0054] As described herein, such discontinuities can be formed by varying the cross-sectional area of ​​the beam along its length, specifically by providing a different cross-sectional area for the active portion of the beam than for the portions outside the active portion. For example, in some embodiments, the beam may be provided with at least one end having a cross-sectional area different from that of the active portion of the beam. This end can connect the beam to mating components of a medical device, such as distal components (e.g., linkages, end effectors, etc.). The interface portion of the beam (e.g., at the distal portion) now becomes the contact interface between the beam and other mating components, causing stress build-up and potential strain overloads to move toward the interface portion of the beam rather than onto the active portion of the beam.

[0055] Discontinuities can be formed in various ways. For example, in some embodiments, the discontinuity is formed by one or more interface ends of a tapered beam, which can be coupled to mating components, such as distal components or links. In such embodiments, the tapered ends can also be used to aid in aligning the mating components during assembly. For example, in some embodiments, the tapered ends can be received in corresponding openings in the mating components to which the beam will be coupled. The tapered shape of the ends helps guide the insertion of the beam ends into the openings. Thus, the tapered ends can ensure that the central axis of the beam is aligned with the central axis of the instrument shaft, thereby improving the accuracy of force measurements.

[0056] In some embodiments, a discontinuity can be formed by providing a recessed region between the active portion of the beam and the interface portion of the beam. For example, the interface portion of the beam may include a cross-sectional area smaller than that of the active portion of the beam, and may also include an interface portion (e.g., a distal or proximal portion) that connects to a mating component (e.g., an instrument shaft on the proximal end or a distal component on the distal end). This connecting portion may have the same or a different cross-sectional area as the active portion of the beam.

[0057] In some embodiments, discontinuities are provided at both the proximal and distal ends of the beam. For example, the beam may include a proximal interface portion coupled to, for example, the inner shaft of a surgical instrument (or another component of the surgical instrument), and a distal interface portion coupled to a distal component of the surgical instrument. In some embodiments, both the proximal and distal interface portions have a cross-sectional area different from the cross-sectional area of ​​the active portion of the beam. In some embodiments, both the proximal and distal interface portions are tapered. In some embodiments, one or both interface ends have the same shape (e.g., circular, square, rectangular, triangular, etc.) as the active portion of the beam, but have a different cross-sectional area. In some embodiments, the proximal portion of the beam may have the same shape and / or cross-sectional area as the distal portion of the beam. In some embodiments, the proximal portion of the beam may have a different shape and / or a different cross-sectional area than the distal portion of the beam. For example, in some embodiments, the distal portion of the beam may be tapered, while the proximal portion may not be tapered, but rather have a portion with a different cross-sectional area than the middle portion of the beam.

[0058] In some embodiments, the active portion of the beam is integrally or monolithically formed with one or more interface portions (e.g., proximal interface ends and / or distal interface ends). In some embodiments, one or more interface portions may be formed as separate components and attached to the active portion of the beam. For example, one or more interface portions may be welded to the active portion of the beam.

[0059] In some embodiments, to achieve uniform signal output throughout the entire instrument's rolling range, the beam's cross-sectional shape remains the same every 90 degrees around its central axis. In embodiments with a tapered interface, the interface can be used not only to provide stress isolation but also to improve the concentricity (axial alignment) between the beam and its mating parts, as described in more detail below.

[0060] As used herein, the term "about" when used in conjunction with a reference numeral indicates a range of up to 10 percent of that reference numeral. For example, the language "about 50" covers the range of 45 to 55. Similarly, the language "about 5" covers the range of 4.5 to 5.5.

[0061] The term "flexible" as associated with parts such as mechanical structures / components or component assemblies should be interpreted broadly. Essentially, the term indicates that a part can be repeatedly bent and return to its original shape without damage. Some flexible parts can also be elastic. For example, a part (e.g., a bent portion) is elastic if it has the ability to absorb energy during elastic deformation and then release the stored energy upon unloading (i.e., return to its original state). Many "rigid" objects have a slight inherent elastic "bending" due to material properties, although these objects are not considered "flexible" when the term is used herein.

[0062] As used in this specification and the appended claims, the term "distal" refers to the direction toward the working part, while the term "proximal" refers to the direction away from the working part. Thus, for example, the end of the tool closest to the target tissue will be the distal end of the tool, while the end opposite to the distal end (i.e., the end manipulated by the user or connected to the actuation shaft) will be the proximal end of the tool.

[0063] Furthermore, the specific words chosen to describe one or more embodiments and optional elements or features are not intended to limit the invention. For example, spatially relative terms such as “below,” “under,” “lower,” “above,” “upper,” “proximal,” “farthest,” etc., can be used to describe the relationship of one element or feature to another element or feature shown in the figures. These spatially relative terms are intended to cover different positions (i.e., translational placement) and orientations (i.e., rotational placement) of the device in use or operation, in addition to the positions and orientations shown in the figures. For example, if the device in the figures is reversed, an element described as “below” or “under” other elements or features will be “above” or “on” other elements or features. Thus, the term “under” can include both above and below postures and orientations. The device may be oriented in other ways (rotated 90 degrees or in other orientations), and the spatially relative descriptors used herein are described accordingly. Similarly, descriptions of movement along (translation) and about (rotation) various axes include various spatial device positions and orientations. The combination of body position and orientation defines the body posture.

[0064] Similarly, unless the context otherwise indicates, geometric terms such as “parallel,” “perpendicular,” “circular,” or “square” are not intended to demand absolute mathematical precision. Instead, such geometric terms allow for variations due to manufacturing or equivalent functions. For example, if an element is described as “circular” or “generally circular,” the description still includes parts that are not precisely circular (e.g., slightly elongated ovals or polygonal parts).

[0065] Additionally, unless the context clearly indicates otherwise, 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 stated features, steps, operations, elements, and / or components, but do not preclude the presence or addition of one or more other features, steps, operations, elements, components, or groups.

[0066] Unless otherwise stated, the terms “device”, “medical device”, “instrument” and their variants are used interchangeably.

[0067] The main aspects of this invention are based on the use of da The description uses an implementation of a surgical system sold by Intuitive Surgical, Inc., Sunnyvale, California. An example of such a surgical system is daVinci. Surgical system (model IS4000), da Vinci Surgical system (model IS4200) and daVinci Surgical system (model IS3000). However, those skilled in the art will understand that the various aspects of the invention disclosed herein can be implemented and practiced in various ways, including computer-aided, non-computer-aided, and mixed combinations of manual and computer-aided embodiments and implementations. Regarding da The embodiments of the surgical systems (e.g., models IS4000, IS3000, IS2000, and IS1200) are presented as examples only and should not be construed as limiting the scope of the various inventive aspects disclosed herein. Where applicable, the inventive aspects can be implemented and realized in relatively small, handheld, manually operated devices as well as in relatively large systems with additional mechanical support.

[0068] Figure 1This is a plan view of a computer-aided remote operating system. A medical device is shown, namely a minimally invasive robotic surgery (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 may have any number of components, such as a user control unit 1100 used by a surgeon or other skilled clinician S during the procedure. The MIRS system 1000 may further 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. When the surgeon S observes the surgical site and controls the movement of instruments 1400 via the control unit 1100, the manipulator unit 1200 can manipulate at least one removably coupled instrument 1400 (also referred to herein as a "tool") through a minimally invasive incision or natural orifice in the patient P's body. Images of the surgical site are obtained by an endoscope (not shown), such as a stereoscopic endoscope, which can be manipulated by the manipulator unit 1200 to orient the endoscope. An auxiliary device unit 1150 can be used to process the images of the surgical site for subsequent display to the surgeon S via the user control unit 1100. The number of instruments 1400 used at one time will typically depend on the diagnostic or surgical procedure, space constraints within the operating room, and other factors. If it is necessary to change one or more instruments 1400 in use during the procedure, an assistant removes the instrument 1400 from the manipulator unit 1200 and replaces it with another instrument 1400 from a tray 1020 in the operating room. Although shown for use with instrument 1400, any instrument described herein can be used with the MIRS 1000.

[0069] 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, which are used to present a coordinated stereoscopic view of the surgical site capable of depth perception to the surgeon S. The user control unit 1100 further 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 unit 1116 provides at least the same degrees of freedom as the associated instrument 1400, thus providing the surgeon S with a remote presentation, or a perception where the input control unit 1116 is integrated with (or directly connected to) the instrument 1400. In this way, the user control unit 1100 provides the surgeon S with a strong sense of direct control over the instrument 1400. For this purpose, position, force, strain, and / or tactile feedback sensors (not shown) can be employed to transmit position, force, and tactile sensation from the instrument 1400 back to the surgeon's hand via the input control unit 1116.

[0070] User control unit 1100 Figure 1 The surgeon is shown in the same room as the patient so that the surgeon S can directly monitor the surgery, 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 located in a different room from the patient, in a completely different building, or in another location far from the patient, thereby allowing for remote surgical procedures.

[0071] Figure 3 This is a perspective view of the auxiliary device unit 1150. The auxiliary device unit 1150 may be coupled to an endoscope (not shown) and may include one or more processors to process the 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 device 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. Such coordination may include alignment between relative images and may include adjusting the stereoscopic working distance of the stereoscopic endoscope. As another example, image processing may include compensating for imaging errors of the image capture device, such as optical aberrations, using previously determined camera calibration parameters.

[0072] Figure 4 A front perspective view of the manipulator unit 1200 is shown. The manipulator unit 1200 includes components for manipulating the instrument 1400 (e.g., arms, linkages, motors, sensors, etc.) and an imaging device (not shown), such as a stereoscopic endoscope, for capturing images of the surgical site. Specifically, the instrument 1400 and the imaging device can be manipulated via a telescopic mechanism with multiple joints. Furthermore, the instrument 1400 and the imaging device are positioned and manipulated through an incision or natural orifice in the patient P such that the kinematically remote center of the software and / or motion is held at the incision or orifice. In this way, the incision size can be minimized.

[0073] Figure 5This is a schematic diagram of a portion of the distal portion of a medical device 2400 according to an embodiment. The surgical instrument 2400 includes a shaft 2410, a force sensor unit 2800 including a beam 2810, one or more strain sensors (e.g., strain gauges) 2830 mounted on a surface along the beam 2810, and an end effector 2460 coupled to the distal portion of the surgical instrument 2400. The end effector 2460 may include, for example, articulated jaws or another suitable surgical tool coupled to a link 2510. In some embodiments, the link 2510 may be included within a wrist assembly having a plurality of articulated links. The shaft 2410 includes a distal portion coupled to the proximal portion 2822 of the beam 2810 to form a first interface 2832. In some embodiments, the distal portion of the shaft 2410 is coupled to the proximal portion 2822 of the beam via another coupling member (such as an anchor or connector, not shown). The shaft 2410 may also be coupled at the proximal portion to a mechanical structure ( Figure 5 (Not shown in the image), the mechanical structure is configured as one or more components of a mobile surgical instrument, such as, for example, an end effector 2460. The mechanical structure may be similar to the mechanical structure 7700 described in more detail below with reference to medical device 7400.

[0074] Beam 2810 includes a middle portion 2820 (which serves as the active portion of the beam), a proximal portion 2822, and a distal portion 2824. Beam 2800 defines the beam's central axis A. B The beam 2810 can be aligned within its central axis. As shown, a strain sensor 2830 is coupled to the middle portion 2820 of the beam 2810. Therefore, the middle portion 2820 serves as the active portion of the beam 2810 to sense forces applied to the distal portion of the instrument 2400. Although shown as including only one strain sensor 2830, in other embodiments, the beam 2810 may include any number of strain sensors in any arrangement as described herein. The distal portion 2824 of the beam 2810 is coupled to the end effector 2460 via a link 2510. Specifically, the distal portion 2824 is matingly coupled to the link 2510 to form a second interface 2834. In some embodiments, the link 2510 may be, for example, a U-shaped clamp of the end effector 2460. In this embodiment, a discontinuity D is formed at the second interface 2834 between the distal portion 2824 of the beam 2800 and the link 2510. In other embodiments, a discontinuity may be formed at a first interface 2832. In other embodiments, discontinuities may be formed at both the first interface 2832 and the second interface 2834. The discontinuity D can isolate the intermediate portion 2820 of the beam 2810 from undesirable stress / strain caused by the mechanical interaction resulting from the mating connection with the link 2510, as described in more detail below.

[0075] Typically, during medical procedures, the end effector 2460 comes into contact with anatomical tissue, which may generate forces in the X, Y, or Z directions applied to the end effector 2460, and may also generate torques, such as torque MY about the Y-axis. Figure 5 As shown. One or more strain sensors 2830, which can be strain gauges, can be used to generate signals caused by forces in the X, Y, and Z directions. These signals can be used to measure strain in beam 2810, which can be used to determine the forces applied to end effector 2460 in the X and Y axis directions. For example, the signal from the distal strain sensor group 2830 can be subtracted from the signal from the proximal strain sensor group 2830. Any signal caused by Z-direction forces is identical on both sets of strain sensors and will be eliminated after subtraction. X-axis and Y-axis forces are transverse (e.g., perpendicular to) the Z-axis (within the central axis A). B (Parallel or collinear). This lateral force acting on the end effector 2460 can cause a slight bending of the beam 2810 (around one or both of the X-axis or Y-axis), which can produce tensile strain on one side of the beam 2810 and compressive strain on the other side. The strain sensor 2830 on the beam 2810 can measure this tensile and compressive strain.

[0076] In some embodiments, the device 2400 (or any device described herein) may include additional force sensors to measure one or more axial forces applied to the end effector 2460 (i.e., forces parallel to the beam's central axis A). B (In the Z-axis direction). An axial force sensor in an example surgical instrument may include a deflectable planar diaphragm sensor that deflects in response to a force. Alternatively, for example, a ferrite core within an inductor coil or a fiber Bragg grating formed within an optical fiber may be used. Other axial force sensor designs may be used to sense resilient axial displacement of shaft 2410 (e.g., relative to a proximal-mounted mechanical structure, not shown). An axial force F is applied to end effector 2460. Z This can cause shaft 2410 to be positioned along the central axis of the shaft (essentially parallel to the central axis A of the beam). B Axial displacement on the axis. Axial force F Z It can be in the proximal direction (e.g., by the reaction force generated by pushing tissue with an end effector) or in the distal direction (e.g., by the reaction force generated by pulling tissue grasped by an end effector).

[0077] As described above, applying X and Y forces to the end effector 2460 can generate stress concentration and strain overload at the interface between beam 2810 and its mating components (including shaft 2410 and link 2510 in this embodiment). Similarly, defects and non-uniformity in the connection between the distal end 2824 of beam 2810 and link 2510 (caused by variability between components, normal manufacturing tolerances, etc.) can generate nonlinear stress. This stress, in turn, can lead to erroneous strain readings from strain sensors. As described above, a discontinuity D is provided to transfer any such stress concentration and strain overload outside the intermediate portion 2820 (i.e., the active portion) of beam 2810 to the distal portion 2824 at the second interface 2834 between the distal portion 2824 and link 2510. In other words, the discontinuity D is used to isolate the intermediate portion 2820 from the undesirable stress / strain caused by the connection at the second interface 2834. In this embodiment, the discontinuity D is provided by a recessed region formed between the intermediate portion 2820 and the distal portion 2824 of the beam 2800. In other words, the distal portion 2824 includes a first cross-section having a first cross-sectional area smaller than that of the intermediate portion 2820 of the beam 2800 and an interface portion connecting to the link 2510. The interface portion may include a cross-sectional area that is the same as or different from that of the intermediate portion 2820 of the beam 2810. Therefore, a discontinuity in cross-sectional area along the length of the beam 2810 is formed between the intermediate portion 2820 and the distal portion 2824 of the beam 2810.

[0078] Figures 6A-6C This is a schematic diagram of an alternative embodiment of a force sensor unit that may be included in any surgical instrument described herein. Figure 6A A force sensor unit 3800 is shown, comprising a beam 3810 having a middle portion 3820 (which serves as the active portion of the beam), a proximal portion 3822, and a distal portion 3824. Although not shown, one or more strain sensors may be coupled to the middle portion 3820. The proximal portion 3822 may be coupled to a shaft (e.g., shaft 2410 or shaft 7410) of a surgical instrument, such as those described herein. The distal portion 3824 may be coupled to a distal component of a surgical instrument, such as an end effector, a link of the end effector, a distal tool, etc. For example, the distal portion 3822 may be coupled to a link 2510 or a link 7510. In this embodiment, a first discontinuity D1 is formed between the proximal portion 3822 and the middle portion 3820 of the beam 3810, and a second discontinuity D2 is formed between the distal portion 3824 and the middle portion 3820 of the beam 3810.

[0079] In this embodiment, the discontinuity D1 and discontinuity D2 are respectively provided as recessed regions formed between the proximal portion 3822 and the intermediate portion 3820, and between the distal portion 3824 and the intermediate portion 3820. As described above, in order to form the recessed regions, the proximal portion 3822 and the distal portion 3824 may each include first cross-sections 3825 and 3827, whose first cross-sectional areas are smaller than the cross-sectional area of ​​the intermediate portion 3820 of the beam 3810, and smaller than the cross-sectional areas of the second portions 3826 and 3828 connected to the mating component (which serve as interface portions). In this embodiment, the second portions 3826 and 3828 of the proximal portion 3822 and the distal portion 3824 each have a cross-sectional area substantially the same as that of the intermediate portion 3820 of the beam 3810.

[0080] In other embodiments, the cross-sectional area (or dimensions) of the second portion may differ from the cross-sectional area (or dimensions) of the intermediate portion. For example, Figure 6B A force sensor unit 4800 is shown, comprising a beam 4810 having a middle portion 4820 (which serves as the active portion of the beam), a proximal portion 4822, and a distal portion 4824. Although not shown, one or more strain sensors may be coupled to the middle portion 4820. The proximal portion 4822 may be coupled to a shaft (e.g., shaft 2410 or shaft 7410) of a surgical instrument, as described herein. The distal portion 4824 may be coupled to a distal component of a surgical instrument, such as an end effector, a link of the end effector, a distal tool, etc. (e.g., link 2510 or link 7510). In this embodiment, a first discontinuity D1 is formed between the proximal portion 4822 and the middle portion 4820 of the beam 4810, and a second discontinuity D2 is formed between the distal portion 4824 and the middle portion 4820 of the beam 4810.

[0081] In this embodiment, the discontinuity D1 and discontinuity D2 are respectively provided as recessed regions formed between the proximal portion 4822 and the intermediate portion 4820, and between the distal portion 4824 and the intermediate portion 4820. As described above, in order to form the recessed regions, the proximal portion 4822 and the distal portion 4824 may each include first cross-sections 4825 and 4827, whose first cross-sectional areas are smaller than the cross-sectional area of ​​the intermediate portion 4820 of the beam 4810, and smaller than the cross-sectional areas of the second portions 4826 and 4828 connected to the mating component (which serve as interface portions). In this embodiment, the second portions 4826 and 4828 of the proximal portion 4822 and the distal portion 4824 each have a cross-sectional area different from that of the intermediate portion 4820 of the beam 4810.

[0082] Figure 6CA force sensor unit 5800 is shown, comprising a beam 5810 having a middle portion 5820 (which serves as the active portion of the beam), a proximal portion 5822, and a distal portion 5824. Although not shown, one or more strain sensors may be coupled to the middle portion 5820. The proximal portion 5822 may be coupled to a shaft (e.g., shaft 2410 or shaft 7410) of a surgical instrument, as described herein. The distal portion 5824 may be coupled to a distal component of a surgical instrument, such as an end effector, a link of the end effector, a distal tool, etc. (e.g., link 2510 or link 7510). In this embodiment, a first discontinuity D1 is formed between the proximal portion 5822 and the middle portion 5820 of the beam 5810, and a second discontinuity D2 is formed between the distal portion 5824 and the middle portion 5820 of the beam 5810.

[0083] In this embodiment, the discontinuity D1 is provided by a proximal portion 5822 having a cross-sectional area different from (i.e., smaller) than that of the intermediate portion 5820. The discontinuity D2 is provided by a distal portion 5824 having a cross-sectional area different from (i.e., smaller) than that of the intermediate portion 5820.

[0084] Figure 6D A force sensor unit 6800 is shown, comprising a beam 6810 having a middle portion 6820 (which serves as the active portion of the beam), a proximal portion 6822, and a distal portion 6824. Although not shown, one or more strain sensors may be coupled to the middle portion 6820. The proximal portion 6822 may be coupled to a shaft (e.g., shaft 2410 or shaft 7410) of a surgical instrument, as described herein. The distal portion 6824 may be coupled to a distal component of a surgical instrument, such as an end effector, a link of the end effector, a distal tool, etc. (e.g., link 2510 or link 7510). In this embodiment, a first discontinuity D1 is formed between the proximal portion 6822 of the beam 6810 and the middle portion 6820 of the beam 6800, and a second discontinuity D2 is formed between the distal portion 6824 of the beam 6810 and the middle portion 6820.

[0085] In this embodiment, the discontinuity D1 is provided by a proximal portion 6822 having a cross-sectional area different from (i.e., smaller) than that of the intermediate portion 6820. The discontinuity D2 is provided by a distal portion 6824 having a cross-sectional area different from (i.e., smaller) than that of the intermediate portion 6820. Furthermore, in this embodiment, the distal portion 6824 has a constant cross-sectional area along its length, while the proximal portion 6822 is tapered (i.e., has a cross-section that monotonically decreases at a constant rate along its length). The tapered shape of the proximal portion 6822 can facilitate the alignment of the beam 6810 with its mating component (e.g., an instrument shaft). For example, the tapered proximal portion 6822 can be matingly coupled within a portion of the shaft and can facilitate the alignment of the central axis of the beam 6810 and the central axis of the shaft.

[0086] Figure 7-15 These are various views of a medical device 7400 according to an embodiment. In some embodiments, the device 7400 or any component thereof may optionally be a part of a surgical system for performing surgical procedures, and it may include a manipulator unit, a series of kinematic linkages, a series of cannulas, etc. The device 7400 (and any devices described herein) can be used in any suitable surgical system, such as the MIRS system 1000 shown and described above. The device 7400 includes a mechanical structure 7700, an outer shaft 7910, and a shaft 7410 (see...). Figure 8B (See Figure 9, which serves as the inner shaft in this embodiment), including a force sensor unit 7800 with a beam 7810, a wrist assembly 7500, and an end effector 7460. Although not shown, the device 7400 may also include multiple cables connecting the mechanical structure 7700 to the wrist assembly 7500 and the end effector 7460. The device 7400 is configured such that selective movement of the cables generates the wrist assembly 7500 about a first rotation axis A1 (see Figure 9). Figure 8A (which is used as the pitch axis, the term pitch is arbitrary) rotation (i.e., pitch rotation), end effector 7460 about the second rotation axis A2 (see Figure 8A (This serves as the deflection axis, the term deflection being arbitrary) a deflection rotation, a cutting rotation of the tool component of the end effector 7460 about the second rotation axis A2, or any combination of these movements. Changes in the pitch or deflection of the instrument 7400 can be performed by manipulating the cables in a manner similar to that described below: for example, U.S. Patent No. 8,821,480 B2 entitled "Four-Cable Wrist with Solid Surface Cable Channel" (filed July 16, 2008) and U.S. Patent No. 6,394,998 B1 entitled "Surgical Instrument for Minimally Invasive Electrosurgical Applications" (filed September 17, 1999), the entire contents of which are incorporated herein by reference. Therefore, specific movements of each cable to achieve the desired motion are not described below.

[0087] Shaft 7410 includes a proximal end (not shown) connected to mechanical structure 7700 and a distal end 7412 connected to beam 7810 via anchor 7925 (see [link]). Figure 8B (and Figure 9). In some embodiments, the proximal end of shaft 7410 is coupled to mechanical structure 770 in a manner that allows shaft 7410 to move relative to mechanical structure 7700 along its central axis CA. Figure 8B (As shown). Allowing shaft 7410 to “float” in the Z direction facilitates the measurement of forces along the Z-axis, as described herein. In some embodiments, the proximal end of shaft 7410 may be movably coupled to mechanism 7700 via a four-bar linkage of the type shown and described in International Patent Application No. PCT / US2019 / 061883 (filed November 15, 2019), entitled “Surgical Instrument with Sensor Alignment Cable Guide,” the entire contents of which are incorporated herein by reference. Bushing 7914 is disposed at the distal end 7412 of shaft 7410 adjacent to anchor 7925. Bushing 7914 is located outside inner shaft 7410 and thus positioned between shaft 7410 and outer shaft 7910. Shaft 7410 also defines an inner cavity (not shown) and / or multiple channels through which cables and other components (e.g., wires, ground wires, etc.) can be routed from mechanism 7700 to wrist assembly 7500. Anchor 7925 may be received at least partially within the cavity of shaft 7410 and may be fixedly attached to shaft 7410 by adhesive bonding, welding or any other permanent connection mechanism (i.e., a connection mechanism that is not intended to be removed during normal use).

[0088] The outer shaft 7910 can be any suitable elongated shaft, which may be positioned above the shaft 7410 and include a proximal end 7911 that can be coupled to the mechanical structure 7700 and the distal end 7912. The outer shaft 7910 defines an inner cavity between the proximal end 7911 and the distal end 7912. The shaft 7410 extends within the inner cavity of the outer shaft 7910 and is movable relative to the outer shaft 791. For example, the shaft 7410 may be rotatable relative to the shaft 7910 and / or may be longitudinally translated in a direction parallel to the central axis CA of the shaft 7410. For example, in some embodiments, the proximal end 7911 of the outer shaft 7910 is fixedly coupled to the mechanical structure 7700, and the shaft 7410 is coupled to be movable relative to the mechanical structure 7701. In other embodiments, the outer shaft 7910 or a portion thereof may be movable relative to the mechanical structure 7700 (e.g., the outer shaft 7920 may be a telescopic shaft). Therefore, in some embodiments, the outer shaft 7910 is operatively coupled to the mechanical structure 7700 and can move or translate longitudinally relative to the shaft 7410 in a direction parallel to the central axis CA.

[0089] Mechanical structure 7700 generates movement of cables (not shown) to produce desired movement (pitch, yaw, or grip) at wrist assembly 7500. Specifically, mechanical structure 7700 includes components and controllers to move some cables in a proximal direction (i.e., pull in some cables) while allowing other cables to move distally by equal length (i.e., release or "release"). In this way, mechanical structure 7700 can maintain desired tension within the cables, and in some embodiments, can ensure that the length of the cables is maintained throughout the entire range of motion of wrist assembly 7500 (i.e., moved by an equal amount). However, in other embodiments, it is not necessary to maintain the length of the cables.

[0090] In some embodiments, the mechanical structure 7700 may include one or more mechanisms that produce translation (linear motion) of a portion of the cable. Such mechanisms may include, for example, a universal joint, a lever, or any other suitable mechanism that directly pulls (or releases) the end of any cable. For example, in some embodiments, the mechanical structure 7700 may include any mechanical structure (referred to as a rear-end assembly or actuator) or component described in U.S. Patent Application Publication No. US 20157 / 0047454A1 (filed August 15, 2014), entitled “Lever-Actuated Universal Plate,” or U.S. Patent No. US 6,817,974 B2 (filed June 28, 2001), entitled “Surgical Tool with Actively Positioned Tendon-Actuated Multi-Disc Wrist Joint,” each of which is incorporated herein by reference. However, in other embodiments, the mechanical structure 7700 may include a winch or other motor-driven roller that rotates or “wraps” a portion of any belt to produce the desired belt movement. For example, in some embodiments, the mechanical structure 7700 may include any mechanical structure (referred to as a back-end assembly or actuator) or component described in U.S. Patent No. 9,204,923 B2 entitled “Electronic Actuation of a Medical Device Using a Drive Cable” (filed July 16, 2008), the entire contents of which are incorporated herein by reference.

[0091] refer to Figure 8A The wrist assembly 7500 includes a proximal first link 7510 and a distal second link 7610. The first link 7510 includes a distal portion that connects at a joint to the proximal portion of the second link 7610, such that the second link 7610 rotates relative to the first link 7510 about a first axis of rotation A1 (which serves as the pitch axis; the term pitch is arbitrary). The proximal first link 7510 includes a proximal portion that connects to a beam 7810, as described in more detail below. The proximal first link 7510 defines a plurality of slots 7513 along a portion of its length (e.g., see...). Figure 8A , Figure 9A , Figure 10-12Cables for actuating the wrist assembly 7500 and end effector 7460 extend through the slot. The slot 7513 can also be used to introduce fluid for cleaning the instrument 7400. For example, when the outer shaft 7910 moves to a position adjacent to the distal end of the cover beam 7810 and the first link 7510 on the proximity side, the distal portion of the slot 7513 is exposed or accessible, allowing cleaning fluid to be introduced through the distal portion of the slot 7512. When the outer shaft 7910 moves proximally, the slot 7513 and the cables therein are also accessible for cleaning purposes.

[0092] The distal end of the second distal link 7610 is connected to the end effector 7460, allowing the end effector 7460 to rotate around the second axis of rotation A2 (see...). Figure 8A (It serves as a deflection axis (the term deflection is arbitrary)) rotation. The end effector 7460 may include at least one tool member 7462 having a contact portion 7464 configured to engage or manipulate target tissue during surgical procedures. For example, in some embodiments, the contact portion 7464 may include an engagement surface serving as a gripper, cutter, tissue manipulator, etc. In other embodiments, the contact portion 7464 may be an actuating tool member for cauterization or electrosurgery. The end effector 7460 is operatively coupled to the mechanical structure 7700 such that the tool member 7462 rotates about a first rotation axis A1 relative to the axis 7410. In this way, the contact portion 7464 of the tool member 7462 can be actuated to engage or manipulate target tissue during surgical procedures. The tool member 7462 (or any tool member described herein) may be any suitable medical tool member. Furthermore, although only one tool member 7462 is identified as shown, the instrument 7400 may include two tool members that cooperate in performing gripping or cutting functions. In other embodiments, the end effector may include two or more tool components.

[0093] Beam 7810 includes a proximal portion 7822, a middle portion 7820 (which serves as the active portion of beam 7810), and a distal portion 7824. Beam 7810 has a central axis A defined along its length. B (see Figure 10 One or more strain sensors 7830 (see...) Figure 13A and Figure 14 The strain sensor 7830 is mounted on the intermediate portion 7820 of the beam 7810. The strain sensor 7830 is not shown in some figures for illustrative purposes only. The strain sensor 7830 may be, for example, a strain gauge and can be used to measure the force applied to surgical instruments during surgical procedures, as described in more detail below. In this embodiment, the intermediate portion 7820 defines four side surfaces arranged perpendicularly to each other, on which the strain sensor 7830 may be mounted (see [reference]). Figure 14 This arrangement is also described and illustrated in PCT application number PCT / US18 / 61113, which is incorporated herein by reference. In this embodiment, the cross-section of the intermediate portion 7820 is approximately square. Therefore, the cross-sectional shape of the intermediate portion 7820 is the same for every 90-degree rotation. In this way, the output from the strain sensor 7830 (which is disposed on only two of the four sides of the intermediate portion 2820) will be within the entire rolling range of the shaft 7410 (i.e., the shaft 7410 around the central axis A). B (The rotation) remains consistent. For example... Figure 14 As shown, for redundancy purposes, a plurality of strain sensors 7820 are present on a given side surface at the proximal and distal portions of the middle portion 7820 of beam 7810. In some embodiments, only a single strain sensor 7830 may be present on a given side surface of each of the proximal and distal portions of the middle portion 7820 of beam 7810.

[0094] In this embodiment, both the distal portion 7824 and the proximal portion 7822 of beam 7810 are tapered, but each has a different cross-sectional shape and size than the other. As described above, in an alternative embodiment, the proximal portion 7822 and the distal portion 7824 may have the same cross-sectional shape and size. In this embodiment, the proximal portion 7822 defines an end cut-out region 7821 for manufacturing purposes (see...). Figure 15 It also provides clearance for the routing of electrical components (not shown) located within the shaft 7410 and anchor 7925. The proximal portion 7822 also defines a side cutout region 7823 (see...). Figure 15 The side cutout region provides an entrance to the interior of shaft 7410 (via cutout 7927 in the anchor) to allow routing of electrical wiring (not shown) to strain sensor 7830. For example, electrical wiring can extend from the proximal end of instrument 7400 through shaft 7410, exit cutout 7927, and extend along beam 7810 to strain sensor 7830.

[0095] Beam 7810 is connected to the distal portion 7412 of shaft 7410 via anchor 7925, and to the proximal link 7510 of wrist assembly 7500 (see example). Figure 8B-10 More specifically, anchor 7925 defines opening 7926 (see...). Figure 11 The opening 7926 can matingly receive the tapered proximal portion 7822 of the beam 7810. The anchor 7925 also defines a cutout 7927 through which wires can be routed. The proximal portion 7822 can be attached to the anchor 7925 by, for example, welding, adhesive, or other suitable joining methods. Similarly, the proximal link 7510 defines an opening 7515 (see...). Figure 12The opening 7515 can be matched to receive the distal portion 7824 of the beam 7810. The distal portion 7824 can be connected to the link 7510 by, for example, welding, adhesive or other suitable connection methods.

[0096] During use, the end effector 7460 contacts anatomical tissue, which may generate forces in the X, Y, or Z directions applied to the end effector 7450 (see [link to relevant documentation]). Figure 8B This can also generate torques around the respective axes. As described above for instrument 2400, strain sensor 7830 (see above) Figure 13A and Figure 14 The strain sensor 7830 can be used to generate signals caused by forces in the X, Y, and Z directions, and these signals can be used to measure strain in beam 7810, which in turn can be used to determine the forces applied to end effector 7460 in the X and Y axis directions. For example, the signal from the distal strain sensor group 7830 can be subtracted from the signal from the proximal strain sensor group 7830. Any signal caused by forces in the Z direction is identical on both strain sensor groups and will be eliminated after subtraction. Therefore, strain sensor 7830 can be used to determine the force applied to end effector 7460 transverse to (e.g., perpendicular to) the central axis A of beam 7810. B Because these forces are transmitted to beam 7810 in the X and Y directions (see Figure 8B Specifically, the lateral force acting on the end effector 7460 can cause a slight bending of the beam 7810, which can generate tensile strain on one side of the beam 7810 and compressive strain on the other side. A strain sensor 7830 is coupled to the beam 7810 to measure this tensile and compressive strain.

[0097] As described above, these X and Y forces can cause stress concentration and strain overload at the interface between beam 7810 and its mating component. This stress concentration and strain overload can lead to inaccurate readings at force sensor 7830. As described herein, to improve the accuracy of force measurement and reduce or eliminate this problem, a discontinuity is formed between beam 7810 and the connection interface between beam 7810 and its mating component. In this embodiment, this discontinuity is created by connecting beam 7810 to link 7510 and anchor 7925 via tapered distal portion 7824 and tapered proximal portion 7822, respectively. More specifically, as described above, distal portion 7824 has a cross-sectional area different from that of the intermediate portion 7820 of beam 7810 on which the force sensor is mounted. This creates a first discontinuity between distal portion 7824 and intermediate portion 7820, and provides stress concentration or strain overload that will be transmitted to the distal interface where distal portion 7824 is connected to link 7510. Similarly, the proximal portion 7822 has a cross-sectional area different from that of the intermediate portion 7820 of the beam 7810, which creates a second discontinuity between the proximal portion 7822 and the intermediate portion 782, and provides stress concentration or strain overload that will be transferred to the proximal interface where the proximal portion 7822 is connected to the anchor 7925.

[0098] Figure 16A This is a graph showing the beam stress as a function of the beam length in the computer model of the device 7400. Figure 16B This is an enlarged view of the graph showing the stress at the far end 7824 of the beam. Figure 16C This is an enlarged view of the graph showing the stress at the near end 7822 of the beam. (See image.) Figure 16A As shown, it is desirable that the stress load applied to beam 7810 along the middle portion (active portion) 7820 is substantially linear along the length of beam 7810. Figure 16B and 16C As best illustrated, nonlinear stress distribution may occur at the near and far ends of the beam. In this example, Figure 16B The nonlinear behavior in the tapered distal portion 7824 of the beam is illustrated, including the nonlinear increase in stress at the tapered end. In this example, Figure 16C The nonlinear behavior and significant stress overload at the near-end portion 7822 of the beam are shown. Therefore, by including a first discontinuity and a second discontinuity, the nonlinear behavior and stress overload are isolated from the active portion of the force-sensing beam 7810.

[0099] Figure 17A-23These are various views of a medical device 8400 according to an embodiment. In some embodiments, the device 8400 or any component thereof may optionally be a part of a surgical system for performing surgical procedures, and may include a manipulator unit, a series of kinematic linkages, a series of cannulas, etc. The device 8400 (and any device described herein) can be used in any suitable surgical system, such as the MIRS system 1000 shown and described above. The device 8400 includes a mechanical structure (not shown) that may be the same as or similar to the mechanical structure 7700, an outer shaft 8910, a shaft 8410 which serves as an inner shaft in this embodiment, a force sensor unit 8800 (including beam 8810), a wrist assembly 8500, and an end effector 8460. Although not shown, the device 8400 may also include a plurality of cables connecting the mechanical structure to the wrist assembly 8500 and the end effector 8460. The device 8400 is configured such that selective movement of the cables generates the wrist assembly 8500 about a first rotation axis A1 (see Figure 19 (which is used as the pitch axis, the term pitch is arbitrary) rotation (i.e., pitch rotation), end effector 8460 about the second rotation axis A2 (see Figure 19 (This serves as the deflection axis, the term deflection being arbitrary) a deflection rotation, a cutting rotation of the tool component of the end effector 8460 about the second rotation axis A2, or any combination of these movements. Changes in the pitch or deflection of the instrument 8400 can be performed by manipulating the cables in a manner similar to that described below: for example, U.S. Patent No. 8,821,480 B2 entitled “Four-Cable Wrist with Solid Surface Cable Channel” (filed July 16, 2008) and U.S. Patent No. 6,394,998 B1 entitled “Surgical Instrument for Minimally Invasive Electrosurgical Applications” (filed September 17, 1999), the entire contents of which are incorporated herein by reference. Therefore, specific movements of each cable to achieve the desired motion are not described below.

[0100] Shaft 8410 includes a proximal end (not shown) connected to a mechanical structure and a distal end 8412 connected to beam 8810 via anchor 8925 (see [link to beam 8810]). Figure 19 and Figure 20 In some embodiments, the proximal end of shaft 8410 is coupled to mechanical structure 770 in a manner that allows shaft 8410 to move relative to the mechanical structure along its central axis CA. Figure 19(As shown). Allowing shaft 8410 to “float” in the Z direction facilitates the measurement of forces along the Z-axis, as described herein. In some embodiments, the proximal end of shaft 8410 may be movably coupled to a mechanical structure via a four-bar linkage of the type shown and described in International Patent Application No. PCT / US2019 / 061883 (filed November 15, 2019), entitled “Surgical Instrument with Sensor Alignment Cable Guide,” the entire contents of which are incorporated herein by reference. Shaft 8410 also defines an inner cavity (not shown) and / or multiple channels through which cables and other components (e.g., wires, ground wires, etc.) can be routed from the mechanical structure to wrist assembly 8500. In this embodiment, the distal portion of shaft 8410 is at least partially received within the inner region 8931 of anchor 8925 and may be securely coupled to anchor 8925 via adhesive bonding, welding, or any other permanent coupling mechanism (i.e., a coupling mechanism not intended to be removed during normal use).

[0101] The outer shaft 8910 can be any suitable elongated shaft, which may be positioned above the shaft 8410 and include a proximal end (not shown) that can be coupled to a mechanical structure and a distal end 8912. The outer shaft 8910 defines an inner cavity between the proximal end and the distal end 8912. The shaft 8410 extends within the inner cavity of the outer shaft 8910, and the inner shaft 8410 can move relative to each other. For example, the shaft 8410 can rotate relative to the outer shaft 8910 and / or can translate longitudinally in a direction parallel to the central axis CA of the shaft 8410. For example, in some embodiments, the proximal end of the outer shaft 8910 is fixedly coupled to the mechanical structure, and the shaft 8410 is coupled to move relative to the mechanical structure. In other embodiments, the outer shaft 8910 or a portion thereof can move relative to the mechanical structure (e.g., the outer shaft 8910 may be a telescopic shaft). Thus, in some embodiments, the outer shaft 8910 is operatively coupled to the mechanical structure and can move or translate longitudinally relative to the shaft 8410 in a direction parallel to the central axis CA.

[0102] A mechanical structure generates movement of cables (not shown) to produce a desired movement (pitch, yaw, or grip) at the wrist assembly 8500. Specifically, the mechanical structure includes components and controllers to move some cables in a proximal direction (i.e., pull in some cables) while allowing other cables to move distally by an equal length (i.e., release or "release"). In this way, the mechanical structure can maintain the desired tension within the cables, and in some embodiments, can ensure that the length of the cables is maintained throughout the entire range of motion of the wrist assembly 8500 (i.e., moved by an equal amount). However, in other embodiments, it is not necessary to maintain the length of the cables.

[0103] In some embodiments, the mechanical structure may include one or more mechanisms that produce translation (linear motion) of a portion of the cable. Such mechanisms may include, for example, a gimbal, a lever, or any other suitable mechanism that directly pulls (or releases) the end of any cable. For example, in some embodiments, the mechanical structure may include any mechanical structure (referred to as a rear-end assembly or actuator) or component described in U.S. Patent Application Publication No. US20157 / 0047454A1 entitled “Lever-Actuated Gimbal” (filed August 15, 2014) or U.S. Patent No. US 6,817,974 B2 entitled “Surgical Tool with Actively Positioned Tendon-Actuated Multi-Disc Wrist Joint” (filed June 28, 2001), each of which is incorporated herein by reference. However, in other embodiments, the mechanical structure may include a winch or other motor-driven roller that rotates or “wraps” a portion of any belt to produce the desired belt movement. For example, in some embodiments, the mechanical structure may include any mechanical structure (referred to as a back-end assembly or actuator) or component described in U.S. Patent No. 9,204,923 B2 entitled “Electronic Actuation of a Medical Device Using a Drive Cable” (filed July 16, 2008), the entire contents of which are incorporated herein by reference.

[0104] The wrist assembly 8500 includes a proximal first link 8510 and a distal second link 8610. The first link 8510 includes a distal portion that connects at a joint to the proximal portion of the second link 8610, such that the second link 8610 rotates relative to the first link 8510 about a first rotation axis A1 (which serves as the pitch axis; the term pitch is arbitrary). The proximal first link 8510 includes a proximal portion that connects to a beam 8810, as described in more detail below.

[0105] The distal end of the distal second link 8610 is coupled to the end effector 8460, allowing the end effector 8460 to rotate about a second axis of rotation A2 (which serves as a deflection axis; the term deflection is arbitrary). The end effector 8460 may include at least one tool member 8462 having a contact portion configured to engage or manipulate target tissue during surgical procedures. For example, in some embodiments, the contact portion may include an engagement surface serving as a gripper, cutter, tissue manipulator, etc. In other embodiments, the contact portion may be an actuating tool member for cauterization or electrosurgery. The end effector 8460 is operatively coupled to a mechanical structure such that the tool member 8462 rotates relative to the axis 8410 about a first axis of rotation A1. In this manner, the contact portion of the tool member 8462 can be actuated to engage or manipulate target tissue during surgical procedures. The tool member 8462 (or any tool member described herein) may be any suitable medical tool member. Furthermore, although only one tool component 8462 is identified as shown in the figure, the instrument 8400 may include two tool components that cooperate to perform clamping or shearing functions. In other embodiments, the end effector may include more than two tool components.

[0106] Beam 8810 includes a proximal portion 8822, a middle portion 8820 (which serves as the active portion of beam 8810), and a distal portion 8824. Beam 8810 defines a central axis A defined along the length of beam 8810. B (see Figure 18A One or more strain sensors 8830 (e.g.) Figure 18A The strain sensor 8830 (shown) is mounted on the intermediate portion 8820 of beam 8810. The strain sensor 8830 is not shown in some figures for illustrative purposes only. In this embodiment, the strain sensor 8830 is a foil strain gauge. The strain sensor 8830 can be used to measure the force applied to surgical instruments during surgical procedures, as described in more detail below. In this embodiment, the intermediate portion 8820 defines four side surfaces arranged perpendicular to each other, on which the strain sensor 8830 is mounted. In this embodiment, the cross-section of the intermediate portion 8820 is approximately square. Therefore, the cross-sectional shape of the intermediate portion 8820 is the same for every 90-degree rotation. In this way, the output from the strain sensor 8830 will be received throughout the entire rolling range of shaft 8410 (i.e., shaft 8410 about its central axis A). B (The rotation) remains consistent.

[0107] In this embodiment, beam 8810 includes an anchor 8925 located at the proximal portion 8822 of beam 8810 and a collar 8840 located near the distal portion 8824 of beam 8810. Therefore, in this embodiment, beam 8810 is integrally formed with anchor 8925 and collar 8840. The distal portion 8824 is tapered, and the proximal portion 8822 extends through anchor 8925. The intermediate portion 8820 of beam 8810 includes tongues 8844 and 8845, which serve as guides for alignment between the intermediate portion of beam 8810 and strain sensor 8830. In some embodiments, one (or both) of collar 8840 and anchor 8925 may be manufactured separately and then later coupled to the intermediate portion 8820 of beam 8810.

[0108] As described above, beam 8810 is connected to the distal portion 8412 of shaft 8410 via anchor 8925. Beam 8810 is connected to the proximal link 8510 of wrist assembly 8500 via distal portion 8824. In this embodiment, collar 8840 defines a plurality of slots 8842 in fluid communication with an opening 8846 on the distal side of collar 8840, the slots being similar to slot 7513 for medical device 7400. Slots 8842 receive cables (not shown) passing through them for actuating wrist assembly 8500 and end effector 8460. For example, the cables may extend from wrist assembly 8500 through opening 8517 of proximal link 8510 (see...). Figure 21A ), passing through opening 8846 and slot 8842.

[0109] The slot 8842 can also be used to introduce fluid for cleaning the instrument 8400. For example, when the outer shaft 8910 moves to a position adjacent to the cover beam 8810 and distal to the side collar 8840, the distal portion of the slot 8842 is exposed or accessible, allowing cleaning fluid to be introduced through the distal portion of the slot 8842. When the outer shaft 8910 moves proximally, the slot 8842 and the cables therein are also accessible for cleaning purposes. The collar 8840 also defines a cut portion 8843 and a central opening 8515. The cut portion 8843 of the collar 8840 is connected to the protrusion 8519 of the proximal link 8510 (see...). Figure 21B The beam 8810 is fitted together, and when the beam 8810 is attached to the proximal link 8510, the distal portion 8824 of the beam 8810 is received within the central opening 8515. The distal portion 8824 can be securely attached to the proximal link 8510 within the central opening 8515 by, for example, one or more welding, adhesives, or other suitable joining methods. The connection between the cutout portion 8843 and the protrusion 8519 prevents the proximal link 8510 and the distal portion 8824 of the beam 8810 from rotating relative to each other during assembly.

[0110] Anchor 8925 defines a plurality of openings 8929 that receive electrical wiring (e.g., for powering a cauterization tool for an end effector) and / or cables extending from collar 8840 for actuating wrist assembly 8500 and actuator 8460. For example, larger openings 8929 may be used for electrical wiring, while smaller openings 8929 may be used for cables. Anchor 8925 also defines a slot 8927 through which wiring for one or more sensors 8830 may be routed. For example, wiring may extend from one or more sensors 8830 on beam 8810 through slot 8927, through the lumen of shaft 8410, and to a mechanical structure proximal to the medical device 8400.

[0111] During use, the end effector 8460 contacts anatomical tissue, which may generate forces in the X, Y, or Z directions applied to the end effector 8460 (see [link to relevant documentation]). Figure 19 This can also generate torques about the various axes. As described above for instrument 2400, strain sensor 8830 (see...) Figure 13A and Figure 14 The strain sensor 8830 can be used to pick up signals caused by forces in the X, Y, and Z directions, and these signals can be used to measure strain in beam 8810, which in turn can be used to determine the forces applied to end effector 8460 in the X and Y axis directions. Therefore, strain sensor 8830 can be used to determine the forces applied to end effector 8460 that are transverse to (e.g., perpendicular to) the central axis A of beam 8810. B Because these forces are transmitted to beam 8810 in the X and Y directions (see Figure 19 Specifically, the lateral force acting on the end effector 8460 can cause a slight bending of the beam 8810, which can generate tensile strain on one side of the beam 8810 and compressive strain on the other side. A strain sensor 830 is coupled to the beam 8810 to measure this tensile and compressive strain.

[0112] As described above, these X and Y forces can cause stress concentration and strain overload at the interface between beam 8810 and its mating component (proximal link 8510). This stress concentration and strain overload can lead to inaccurate readings at force sensor 8830. As described herein, to improve the accuracy of force measurement and reduce or eliminate this problem, a discontinuity is formed between beam 8810 and the connection interface between beam 8810 and its mating component. In this embodiment, the discontinuity is created by the connection between beam 8810 and link 8510, but since anchor 8925 is integral with beam 8810, it is not necessary to create a discontinuity at the proximal portion 8822 of beam 8810. More specifically, as described above, the distal portion 8824 has a different cross-sectional area than the cross-sectional area of ​​the middle portion 8820 of beam 8810 on which force sensor 8830 is mounted. This creates a discontinuity between the distal portion 8824 and the intermediate portion 8820, and provides stress concentration or strain overload that will be transmitted to the distal interface where the distal portion 8824 is connected to the link 8510.

[0113] Although various embodiments have been described above, it should be understood that they are merely exemplary and not limiting. 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. While embodiments have been specifically shown and described, it should be understood that various changes in form and detail may be made.

[0114] For example, any instrument (and components thereof) described herein may optionally be part of a surgical assembly for performing 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 in 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 occlusions, thrombosis, stones, uterine fibroids, bone metastases, adenomyosis, or any other body tissue. The examples of target tissues presented are not an exhaustive list. Additionally, target structures may also include artificial materials (or non-tissues) inside or associated with the human body, such as, for example, scaffolds, portions of artificial tubes, internal fasteners, etc.

[0115] For example, any component of the surgical instruments described herein can be constructed from any material, such as medical-grade stainless steel, nickel alloys, titanium alloys, etc. Furthermore, any of the links, tool members, beams, shafts, cables, or other components described herein can be constituted from multiple components subsequently joined together. For example, in some embodiments, a link can be constructed by connecting separately constructed components together. However, in other embodiments, any of the links, tool members, beams, shafts, cables, or components described herein can be constructed integrally.

[0116] Although the device is typically shown as having a rotation axis of the tool component (e.g., axis A2) perpendicular to the rotation axis of the wrist component (e.g., axis A1), in other embodiments, any device described herein may include a tool component rotation axis offset from the rotation axis of the wrist component at any suitable angle.

[0117] Although various embodiments have been described as combinations of specific features and / or components, other embodiments may also have any combination of features and / or components from any of the embodiments described above. While aspects have been described in the general context of medical devices, and more specifically surgical instruments, aspects of the invention are not necessarily limited to use in medical devices.

Claims

1. A medical device comprising: A shaft including its proximal and distal portions; A beam, comprising a proximal portion, a distal portion, and an intermediate portion between the proximal portion and the distal portion of the beam; Multiple cables for actuating the end effector and wrist assembly, the multiple cables being spaced apart from the beam; as well as One or more strain sensors on the middle portion of the beam; as well as An anchor connected to the distal portion of the shaft. The anchor includes a connecting portion, and The proximal portion of the beam is matched with the connecting portion of the anchor to form an interface; The beam includes a discontinuity between the interface and the intermediate portion of the beam.

2. The medical device according to claim 1, wherein: The interface is a first interface, and the discontinuous part is a first discontinuous part; The medical device includes a linkage; The distal portion of the beam is matingly connected to the connecting rod to form a second interface; and The beam includes a second discontinuous portion between the second interface and the intermediate portion of the beam.

3. The medical device according to claim 2, wherein: The middle portion of the beam has a first cross-sectional area at the first discontinuity; The near-end portion of the beam has a second cross-sectional area at the first discontinuity; The distal portion of the beam has a third cross-sectional area at the second discontinuity; and The first cross-sectional area is different from the second cross-sectional area and the third cross-sectional area.

4. The medical device according to claim 2, wherein: The central axis of the shaft is defined between the proximal portion of the shaft and the distal portion of the shaft; The proximal portion of the beam includes a tapered guide for aligning the beam with the distal portion of the shaft along the central axis of the shaft; and The distal portion of the beam includes a tapered guide for aligning the beam with the connecting rod along the central axis of the shaft.

5. The medical device according to claim 2, wherein: The first discontinuity includes a first recessed region between the middle portion of the beam and the proximal portion of the beam; and The second discontinuity includes a second recessed region between the middle portion of the beam and the distal portion of the beam.

6. The medical device according to claim 1, wherein: The distal portion of the shaft includes an anchor; The anchor includes a connecting portion; and The proximal portion of the beam is matingly connected to the connecting portion of the anchor to connect the distal portion of the beam to the distal portion of the shaft.

7. The medical device according to claim 6, wherein: The anchor includes an opening; The opening includes a shape; and The proximal portion of the beam includes a shape that is received within the shape of the opening of the anchor in only one orientation.

8. The medical device according to any one of claims 1 to 4, wherein: The middle portion of the beam includes a near end face and a far end face; The anchor includes a distal end face; The connecting rod includes a proximal end face; When the beam is connected to the anchor, the proximal end face of the middle portion of the beam is spaced apart from the distal end face of the anchor; and When the beam is connected to the link, the distal end face of the middle portion of the beam is spaced apart from the proximal end face of the link.

9. A medical device comprising: A shaft, comprising a proximal portion, a distal portion, and a central axis extending between the proximal portion and the distal portion; A beam comprising a proximal portion, a distal portion, and an intermediate portion between the proximal portion and the distal portion. The near-end portion of the beam has a first cross-sectional area. The distal portion of the beam has a second cross-sectional area different from the first cross-sectional area, and The middle portion of the beam has a third cross-sectional area that is different from the first cross-sectional area; One or more strain sensors on the middle portion of the beam; Multiple cables for actuating the end effector and wrist assembly, the multiple cables being spaced apart from the beam; An anchor connected to the distal portion of the shaft. The anchor includes a connecting portion, and The proximal portion of the beam is matingly connected to the connecting portion of the anchor; as well as A link, the link including a connecting portion, wherein the distal portion of the beam is matingly connected to the connecting portion of the link.

10. The medical device according to claim 9, wherein: The connecting portion of the anchor includes an opening configured to receive the proximal portion of the beam; as well as The connecting portion of the link includes an opening configured to receive the distal portion of the beam.

11. The medical device according to claim 9, wherein: The proximal portion of the beam is a tapered proximal portion, and the distal portion of the beam is a tapered distal portion; The tapered proximal portion is a guide for aligning the beam with the anchor along the central axis of the shaft; as well as The tapered distal portion is a guide for aligning the beam with the connecting rod along the central axis of the shaft.

12. The medical device according to claim 9, wherein: The anchor includes an opening; The link includes an opening; The proximal portion of the beam includes a shape that is received within the opening of the anchor in only one orientation; and The distal portion of the beam includes a shape that is received within the opening of the link in only one orientation.

13. The medical device according to claim 9, wherein: The anchor includes a D-shaped opening; The connecting rod includes a D-shaped opening; The proximal portion of the beam includes a D-shaped shape configured to be received within the D-shaped opening of the anchor; as well as The distal portion of the beam includes a D-shaped portion configured to be received within the D-shaped opening of the link.

14. The medical device according to claim 9, wherein: The proximal portion of the beam is welded to the anchor; and The distal portion of the beam is welded to the connecting rod.

15. The medical device according to claim 9, wherein: The medical device includes an outer shaft; The outer shaft includes an inner cavity; The shaft extends within the cavity of the outer shaft; and The shaft is movable relative to the outer shaft.

16. The medical device according to claim 15, wherein: The outer shaft is translated longitudinally relative to the shaft and the beam along the central axis.

17. The medical device according to claim 15, wherein: At least one of the shaft and the outer shaft rotates relative to the other of the shaft and the outer shaft.

18. The medical device according to claim 9, wherein: The one or more strain sensors include a first strain sensor and a second strain sensor; The first strain sensor is located at a first position on the middle portion of the beam; and The second strain sensor is located at a second position on the middle portion of the beam, and the second strain sensor is spaced apart from the first strain sensor in a direction along the length of the beam.

19. The medical device according to claim 18, wherein: The middle portion of the beam includes a first outer surface, a second outer surface, a third outer surface, and a fourth outer surface; The third cross-sectional area of ​​the middle portion of the beam has a length along the first outer surface and the third outer surface and a width along the second outer surface and the fourth outer surface; The first outer surface and the second outer surface are oriented perpendicular to the third outer surface and the fourth outer surface; and Both the first strain sensor and the second strain sensor are located on the first outer surface.

20. A medical device comprising: A shaft, comprising a proximal portion, a distal portion, and a first mating opening defined in the distal portion of the shaft; The link, in which the second mating opening is defined; A beam comprising a proximal portion, a distal portion, and an intermediate portion between the proximal portion and the distal portion; Multiple cables for actuating the end effector and wrist assembly, the multiple cables being spaced apart from the beam; as well as One or more sensors on the middle portion of the beam; The proximal portion of the beam is tapered and connected within the first mating opening; and The distal portion of the beam is tapered and connected within the second mating opening.

21. The medical device according to claim 20, wherein: The one or more sensors are one or more strain sensors.

22. The medical device according to claim 20, wherein: The medical device includes an outer shaft; The outer shaft includes an inner cavity; The shaft extends within the cavity of the outer shaft; as well as The shaft is movable relative to the outer shaft.

23. The medical device according to claim 22, wherein: The outer axis is translated longitudinally relative to the axis and the beam.

24. The medical device according to claim 22, wherein: At least one of the shaft or the outer shaft rotates relative to the other of the shaft and the outer shaft.

25. The medical device according to claim 20, wherein: The link is part of the wrist assembly.

26. The medical device according to claim 20, wherein: The one or more sensors include a first strain sensor and a second strain sensor; The first strain sensor is located at a first position on the middle portion of the beam; and The second strain sensor is located at a second position on the middle portion of the beam, and the second strain sensor is spaced apart from the first strain sensor in a direction along the length of the beam.

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