Medical device with compact end effector drive mechanism having high clamping force

Abstract

An end effector drive mechanism has first and second pulleys configured as torque amplification tool assemblies and first and second jaws. Each pulley-jaw pair is configured as a kinematic assembly with a compact footprint that can amplify output to increase clamping force applied by the jaws. The end effector drive mechanism is within a pulley envelope defined by the first and second pulleys. In certain configurations, the tool assemblies are configured to generate clamping force independent of push-pull force applied on (or by) the jaws. In certain configurations, the tool assemblies are configured to prevent undesirable counter-rotation and limit the travel range of the jaws (or pulleys).

Description

[0001] Cross-references to related applications

[0002] This application claims priority and benefit to U.S. Provisional Patent Application No. 63 / 086,662, filed October 2, 2020, entitled “Medical Devices Having Compact End Effector Mechanisms with High Grip Force,” the disclosure of which is incorporated herein by reference in its entirety. Technical Field

[0003] The embodiments described herein relate to gripping tools, more specifically to medical devices, and even more specifically to endoscopic tools. In particular, the embodiments described herein relate to medical devices having an end effector driven by a compact, multi-part drive mechanism capable of generating high clamping forces while maintaining a compact form suitable for minimally invasive surgery. Background Technology

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

[0005] To achieve the desired movement of the wrist mechanism and end effector, known devices include a tension member (e.g., a cable or push / pull member) extending through the device and connecting the wrist mechanism to a mechanical structure configured to move the tension member to operate the wrist mechanism. For robots or remote operating systems, the mechanical structure is driven by an actuator (e.g., a motor) and can be operatively coupled to a processing system to provide a user interface for clinical users (e.g., surgeons) to control the device.

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

[0007] Reducing the size of the wrist mechanism and end effector can also reduce the amount of force applied by the end effector during surgery. For example, reducing the nominal size of the wrist mechanism can result in the end effector producing a lower clamping force than could be produced by a larger wrist mechanism. In many applications, the reduced clamping force may be undesirable. For example, a reduced clamping force in a needle driver can cause the suture needle to slip within the end effector when encountering higher external forces during suturing. Many known end effectors include a pair of jaws rotatably connected to the wrist mechanism at a pivot axis. Such known jaws include an input pulley connected to a drive source (e.g., a cable drive connection) for receiving input torque that causes the jaws to rotate to apply a clamping force to an object (e.g., a needle or tissue). However, reducing the size of the wrist mechanism and end effector (including the input pulley) also reduces the amount of torque produced for a given amount of cable tension. Furthermore, reducing the size of the wrist mechanism (including the input pulley) results in a smaller bend radius for the cable, which can reduce cable life. Cable tension is typically reduced to accommodate a smaller bend radius. Therefore, as mentioned above, increasing cable tension to maintain the desired clamping force may be undesirable.

[0008] Some known end effectors employ torque amplification drive mechanisms, which can generate increased clamping force without proportionally increasing cable tension. Known torque amplification end effector drive mechanisms typically include multiple kinematic linkages (e.g., additional pulleys or links coupling the input pulley to the jaws) to amplify the torque. For example, some known torque amplification drive mechanisms include additional linkages to increase the torque arm of the applied input force (e.g., from the cable), thereby increasing the output force. Therefore, known torque amplification drive mechanisms typically require a larger overall instrument diameter or jaw length to amplify the drive torque compared to non-amplification drive mechanisms. Consequently, known torque amplification features are generally incompatible with smaller-sized MIS instruments.

[0009] Furthermore, because known torque-amplified drive mechanisms include multiple kinematic links connecting input pulleys to the jaws, the motion of the jaws driven by such mechanisms can include rotational and translational components. For example, known end effectors typically include two or more jaws working together to perform a desired clinical function, such as a needle-driving tool clamping a needle for a suturing procedure. Such dual-jaw end effectors are designed to move between an open configuration suitable for loading a needle and a fully closed configuration for clamping the needle. However, some known torque-amplified drive mechanisms will produce both linear motion and rotational movement of the jaws as they move between the open and closed configurations. Therefore, in some cases, the clamping force generated by the torque-amplified drive mechanism may be affected by a linear “push-pull” force applied to the jaws. This functional coupling of push-pull and clamping forces can sometimes produce feedback that is not intuitive for the operator.

[0010] Therefore, there is a need for improved, compact endoscopic tools with torque-amplified end-effector drive mechanisms for driving end-effectors to perform a variety of clinical functions while maintaining desired overall tool size, DOF maneuverability, or other performance capabilities. Summary of the Invention

[0011] This summary introduces certain aspects of the embodiments described herein to provide a basic understanding. This summary is not a broad overview of the subject matter of the invention, and it is not intended to identify key or critically important elements or to define the scope of the subject matter. In some embodiments, an end effector drive mechanism has a first and second pulley configured as a torque-amplifying tool assembly, and a first and second jaw (which together serve as a tool drive mechanism). Each pulley-jaw pair is configured with a compact kinematic component that can amplify the output to increase the clamping force applied by the jaw. In some embodiments, the end effector drive mechanism is within a pulley envelope defined by the first and second pulleys. In some embodiments, the tool assembly is configured to generate a clamping force independent of the push-pull force applied to (or applied by) the jaw. In some embodiments, the tool assembly is configured to prevent unwanted reverse rotation and limit the range of travel of the jaw (or pulley).

[0012] In some embodiments, a device includes a U-shaped clamp, a center pin, a first tool assembly, a second tool assembly, and a jaw pivot pin, the center pin being coupled to the U-shaped clamp. The first tool assembly is coupled to the U-shaped clamp via the center pin and includes a first pulley and a first jaw. The first pulley includes a first input connector and a first output connector, and defines a first central opening and a first jaw pivot opening. The first input connector is coupled to a first tension member, and the center pin extends through the first central opening. When a first input torque is applied by the first tension member, the first pulley rotates about the center pin. The first jaw includes a first pulley connector coupled to the first output connector. The first jaw rotates when a portion of the first input torque is transmitted to the first jaw via an interface between the first pulley connector and the first output connector. The second tool assembly is coupled to the U-shaped clamp via the center pin and includes a second pulley and a second jaw. The second pulley includes a second input connector and a second output connector, and defines a second central opening and a second jaw pivot opening. The second input connector is coupled to a second tension member, and the center pin extends through the second central opening. When a second input torque is applied by the second tension member, the second pulley rotates about the central pin. The second jaw includes a second pulley connector coupled to the second output connector. The second jaw rotates when a portion of the second input torque is transmitted to the second jaw via the interface between the second pulley connector and the second output connector. The jaw pivot pin couples the first jaw to the second jaw via a jaw pivot axis. The first jaw and the second jaw are configured to rotate relative to each other about the jaw pivot axis. The jaw pivot pin extends through the first jaw pivot opening of the first pulley and the second jaw pivot opening of the second pulley.

[0013] In some embodiments, the first jaw pivot opening and the second jaw pivot opening are elongated. The jaw pivot pin is configured to translate relative to the center pin within the first jaw pivot opening and the second jaw pivot opening when at least one of the first pulley or the first jaw rotates relative to the U-shaped clamp.

[0014] In some embodiments, the first jaw pivot opening forms a first curved path, and the second jaw pivot opening forms a second curved path, which is different from the first curved path. The jaw pivot pin is configured to translate along a jaw pivot pin path defined by the intersection of the first curved path and the second curved path.

[0015] In some embodiments, the first pulley and the second pulley are located between the first jaw and the second jaw. In some embodiments, the first jaw and the second jaw are located between the first pulley and the second pulley.

[0016] In some embodiments, the center pin defines a central axis about which the pulley and the second pulley rotate. The first input connector is radially offset from the central axis by a first input radius. The first pulley envelope is defined as a cylindrical volume about the central axis, having an envelope radius equal to the first input radius. The first output connector, the first jaw pivot opening, the first pulley connector, and the jaw pivot axis are within the first pulley envelope.

[0017] In some embodiments, the first pulley has a non-circular shape and defines a long radius and a short radius. In some embodiments, the first input connector is offset from the long radius from the central axis.

[0018] In some embodiments, a device includes a U-shaped clamp, a center pin, a first tool assembly, a second tool assembly, and a jaw pivot pin, the center pin being coupled to the U-shaped clamp. The first tool assembly is coupled to the U-shaped clamp via the center pin and includes a first pulley and a first jaw. The first pulley includes a first input connector and a first output connector and defines a first central opening. The first input connector is coupled to a first tension member, and the center pin extends through the first central opening. When a first input torque is applied by the first tension member, the first pulley rotates about the center pin. The first jaw includes a first pulley connector coupled to the first output connector. When a portion of the first input torque is transmitted to the first jaw via the interface between the first pulley connector and the first output connector, the first jaw rotates. The second tool assembly is coupled to the U-shaped clamp via the center pin and includes a second pulley and a second jaw. The second pulley includes a second input connector and a second output connector and defines a second central opening. The second input connector is coupled to a second tension member, and the center pin extends through the second central opening. When a second input torque is applied by the second tension member, the second pulley rotates about the center pin. The second jaw includes a second pulley connector coupled to the second output connector. The second jaw rotates when a portion of the second input torque is transmitted to the second jaw via the interface between the second pulley connector and the second output connector. Both the first and second pulleys are located between the first and second jaws. A jaw pivot pin couples the first jaw to the second jaw via a jaw pivot axis. The first and second jaws are configured to rotate relative to each other about the jaw pivot axis, which is offset from the center pin.

[0019] In some embodiments, a device includes a U-shaped clamp, a center pin, a first tool assembly, a second tool assembly, and a jaw pivot pin, the center pin being coupled to the U-shaped clamp and defining a central axis. The first tool assembly is coupled to the U-shaped clamp via the center pin and includes a first pulley and a first jaw. The first pulley includes a first input connector and a first output connector and defines a first central opening. The first input connector is radially offset from the central axis by a first input radius and coupled to a first tension member. The center pin extends through the first central opening. When a first input torque is applied by the first tension member, the first pulley rotates about the center pin. The first pulley envelope is defined as a cylindrical volume about the central axis having an envelope radius equal to the first input radius. The first jaw includes a first pulley connector coupled to the first output connector. The first jaw rotates when a portion of the first input torque is transmitted to the first jaw via an interface between the first pulley connector and the first output connector. The second tool assembly is coupled to the U-shaped clamp via the center pin and includes a second pulley and a second jaw. The second pulley includes a second input connector and a second output connector and defines a second central opening. The second input connector is coupled to the second tension member, and the center pin extends through the second center opening. When a second input torque is applied by the second tension member, the second pulley rotates about the center pin. The second jaw includes a second pulley connector coupled to the second output connector. The second jaw rotates when a portion of the second input torque is transmitted to the second jaw via the interface between the second pulley connector and the second output connector. The jaw pivot pin couples the first jaw to the second jaw via a jaw pivot axis. The first jaw and the second jaw are configured to rotate relative to each other about the jaw pivot axis, which is offset from the center pin. The first output connector, the first pulley connector, and the jaw pivot axis are all within the first pulley envelope.

[0020] In some embodiments, a device includes a U-shaped clamp, a center pin, a first tool assembly, a second tool assembly, and a jaw pivot pin, the center pin being coupled to the U-shaped clamp and defining a central axis. The first tool assembly is coupled to the U-shaped clamp via the center pin and includes a first pulley and a first jaw. The first pulley includes a first input connector and a first output connector and defines a first central opening. The first input connector is radially offset from the central axis by a first input radius and coupled to a first tension member. The center pin extends through the first central opening. When a first input torque is applied by the first tension member, the first pulley rotates about the center pin. The first jaw includes a first pulley connector coupled to the first output connector. The first jaw rotates when a portion of the first input torque is transmitted to the first jaw via an interface between the first pulley connector and the first output connector. The second tool assembly is coupled to the U-shaped clamp via the center pin and includes a second pulley and a second jaw. The second pulley includes a second input connector and a second output connector and defines a second central opening. The second input connector is coupled to a second tension member, and the center pin extends through the second central opening. When a second input torque is applied by the second tension member, the second pulley rotates about the central pin. The second jaw includes a second pulley connector coupled to the second output connector. The second jaw rotates when a portion of the second input torque is transmitted to the second jaw via the interface between the second pulley connector and the second output connector. The jaw pivot pin couples the first jaw to the second jaw via a jaw pivot axis. The first jaw and the second jaw are configured to rotate relative to each other about the jaw pivot axis, which is offset from the central axis by a jaw pivot offset distance less than the first input radius.

[0021] In some embodiments, a device includes a U-shaped clamp, a center pin, a first tool assembly, a second tool assembly, and a jaw pivot pin, the center pin being coupled to the U-shaped clamp and defining a central axis. The first tool assembly is coupled to the U-shaped clamp via the center pin and includes a first pulley and a first jaw. The first pulley includes a first input connector and a first output connector and defines a first central opening. The first input connector is coupled to a first tension member. The center pin extends through the first central opening. When a first input torque is applied by the first tension member, the first pulley rotates about the center pin. The first output connector is radially offset from the central axis to define a first input link. The first jaw includes a first clamping portion and a first pulley connector coupled to the first output connector. The first jaw rotates when a portion of the first input torque is transmitted to the first jaw via the interface between the first pulley connector and the first output connector. The second tool assembly is coupled to the U-shaped clamp via the center pin and includes a second pulley and a second jaw. The second pulley includes a second input connector and a second output connector and defines a second central opening. The second input connector is coupled to the second tension member, and the center pin extends through the second center opening. When a second input torque is applied by the second tension member, the second pulley rotates about the center pin. The second jaw includes a second clamping portion and a second pulley connector coupled to the second output connector. The second jaw rotates when a portion of the second input torque is transmitted to the second jaw via the interface between the second pulley connector and the second output connector. The jaw pivot pin couples the first jaw to the second jaw via a jaw pivot axis. The first jaw and the second jaw are configured to rotate relative to each other about the jaw pivot axis to move between an open configuration and a closed configuration. When the first jaw and the second jaw are in the closed configuration, the first clamping portion contacts the second clamping portion. The end effector centerline is defined between the center axis and the jaw pivot axis. The first input link and the end effector centerline define an input link angle that increases as the first jaw and the second jaw move from the closed configuration toward the open configuration.

[0022] In some embodiments, the first input connector is radially offset from the central axis by a first input radius. A first pulley envelope is defined as a cylindrical volume around the central axis, having an envelope radius equal to the first input radius. The first output connector, the first pulley connector, and the jaw pivot axis are within the first pulley envelope.

[0023] In some embodiments, when the first jaw and the second jaw are in the closed configuration, the input link angle is less than ten degrees. In some embodiments, when the first jaw and the second jaw are in the closed configuration, the input link angle is less than five degrees. In some embodiments, the first pulley connector of the first jaw is located between the first clamping portion and the jaw pivot pin. In some embodiments, the jaw pivot pin is located between the first clamping portion and the first pulley connector of the first jaw.

[0024] In some embodiments, a device includes a U-shaped clamp, a center pin, a first tool assembly, a second tool assembly, and a jaw pivot pin, the center pin being coupled to the U-shaped clamp. The first tool assembly is coupled to the U-shaped clamp via the center pin and includes a first rotatable member and a first jaw. The first rotatable member includes a first input connector and a first output connector and defines a first central opening. The first input connector is coupled to a first tension member, and the center pin extends through the first central opening. When a first input torque is applied by the first tension member, the first rotatable member rotates about the center pin. The first jaw includes a first rotatable member connector coupled to the first output connector. When a portion of the first input torque is transmitted to the first jaw via an interface between the first rotatable member connector and the first output connector, the first jaw rotates. The second tool assembly is coupled to the U-shaped clamp via the center pin and includes a second rotatable member and a second jaw. The second rotatable member includes a second input connector and a second output connector and defines a second central opening. The second input connector is coupled to a second tension member, and the center pin extends through the second central opening. When the second input torque is applied by the second tension member, the second rotatable member rotates about the center pin. The second jaw includes a second rotatable member connector coupled to the second output connector. The second jaw rotates when a portion of the second input torque is transmitted to the second jaw via the interface between the second rotatable member connector and the second output connector. The jaw pivot pin couples the first jaw to the second jaw via a jaw pivot axis. The first jaw and the second jaw are configured to rotate relative to each other about the jaw pivot axis, which is offset from the center pin.

[0025] In some embodiments, the first rotatable member and the second rotatable member can be any one of a pulley, a connecting rod, or a gear. The first tension member and the second tension member can be any one of a cable, a belt, or a push-pull rod.

[0026] In some embodiments, the first rotatable member defines a first jaw pivot opening, and the second rotatable member defines a second jaw pivot opening. The jaw pivot pin extends through the first jaw pivot opening and the second jaw pivot opening. In some embodiments, the first rotatable member and the second rotatable member are located between the first jaw and the second jaw.

[0027] In some embodiments, the first output connector includes an external gear, and the first rotatable member connector includes an internal gear. A portion of the internal gear engages with a portion of the external gear at an engagement point to couple the first jaws to the first rotatable member. In some embodiments, the external gear is a sector gear, and the internal gear is a curved rack.

[0028] In some embodiments, the first tool assembly and the second tool assembly form an end effector, wherein the end effector centerline is defined between the center pin and the jaw pivot axis. The end effector is configured to move between a plurality of open and closed configurations. The engagement point is radially offset from the center axis to define a first input link. The first input link and the end effector centerline define an input link angle that remains substantially constant as the end effector moves from the closed configuration toward the open configuration.

[0029] In some embodiments, a device includes a U-shaped clamp, a center pin, a first jaw, and a second jaw, the center pin being coupled to the U-shaped clamp. The first jaw is coupled to the U-shaped clamp via the center pin and includes a clamping portion and a pulley portion. The pulley portion of the first jaw includes a first input connector coupled to a first tension member. The pulley portion of the first jaw has a non-circular shape and defines a first major radius and a first minor radius. The first input connector is offset from the center pin by the first major radius. The first jaw rotates when a portion of a first input force is transmitted from the first tension member to the first jaw. The second jaw is coupled to the U-shaped clamp via the center pin and includes a clamping portion and a pulley portion. The pulley portion of the second jaw includes a second input connector coupled to a second tension member. The pulley portion of the second jaw has a non-circular shape and defines a first major radius and a first minor radius. The second input connector is offset from the center pin by the first major radius of the pulley portion of the second jaw. When a portion of the second input force is transmitted from the second tension member to the second jaw, the second jaw rotates.

[0030] Other medical devices, related components, medical device systems, and / or methods according to the embodiments will be apparent to or become apparent to those skilled in the art after reading the following figures and detailed description. All such additional medical devices, related components, medical device systems, and / or methods included in this specification are intended to fall within the scope of this disclosure. Attached Figure Description

[0031] Figure 1 This is a floor plan of a minimally invasive remote-operated medical system for performing medical procedures such as surgical procedures, according to an embodiment.

[0032] Figure 2 yes Figure 1 A perspective view of the optional auxiliary units of the minimally invasive remote surgical system shown.

[0033] Figure 3 yes Figure 1 A perspective view of the user console of the minimally invasive remote surgical system shown.

[0034] Figure 4 yes Figure 1 The diagram shows a front view of the manipulator unit of a minimally invasive remote surgical system, which includes multiple instruments.

[0035] Figure 5 This is a schematic perspective view of a portion of a medical device according to an embodiment, having two tooling components configured to amplify input torque.

[0036] Figure 6 yes Figure 5 An illustrative perspective view of one of the tool components of the medical device shown, illustrating the pulley envelope.

[0037] Figure 7 , Figure 8A and Figure 8B It was intercepted along line XX. Figure 5 The side view of the medical device shown is to illustrate its first (partially open) configuration. Figure 7 ), second (closed) configuration ( Figure 8A ) and the third (fully open) configuration ( Figure 8B It is one of the tool components.

[0038] Figure 9 This is a schematic perspective view of a portion of a medical device according to an embodiment, having two tooling components configured to amplify input torque.

[0039] Figure 10 yes Figure 9 The medical device shown is illustrated in a side view along line XX, revealing a tool assembly.

[0040] Figure 11 This is a front view of a portion of a medical device according to an embodiment, having two tooling components configured to amplify input torque.

[0041] Figure 12 yes Figure 11 The side view of a portion of the medical device shown illustrates the rear pivoting / forward clamping topology of the tool assembly.

[0042] Figure 13A and Figure 13B yes Figure 12 The tool component shown is in the first (closed) configuration. Figure 13A ) and the second (open) configuration ( Figure 13B (Side view of )

[0043] Figure 14 yes Figure 12 The free-body diagram of the tool assembly shown illustrates the forces and torques acting on the various joints of the tool assembly.

[0044] Figure 15A and Figure 15B According to the embodiment, it has a front pivoting / forward clamping topology in a first (closed) configuration. Figure 15A ) and the second (open) configuration ( Figure 15B The tool component shown is a side view.

[0045] Figure 16 yes Figure 15A and Figure 15B The free-body diagram of the tool assembly shown illustrates the forces and torques acting on the various joints of the tool assembly.

[0046] Figure 17A and Figure 17B According to the embodiment, it has a rear pivoting / reverse clamping topology in a first (closed) configuration ( Figure 17A ) and the second (open) configuration ( Figure 17B The tool component shown is a side view.

[0047] Figure 18 yes Figure 17A and Figure 17B The free-body diagram of the tool assembly shown illustrates the forces and torques acting on the various joints of the tool assembly.

[0048] Figure 19A and Figure 19B According to the embodiment, it has a front pivoting / reverse clamping topology in a first (closed) configuration ( Figure 19A ) and the second (open) configuration ( Figure 19B The tool component shown is a side view.

[0049] Figure 20 It is a perspective view of the instruments in the first configuration of a surgical system.

[0050] Figure 21 It is by Figure 20 The area Z shown is an enlarged perspective view of the end effector and wrist assembly of the device.

[0051] Figure 22 yes Figure 21 An exploded perspective view of the distal portion of the instrument shown.

[0052] Figure 23 yes Figure 20 and Figure 21 An exploded perspective view of the end effector of the device shown.

[0053] Figure 24 yes Figure 21 The side view of the distal portion of the device shown illustrates the end effector in an open configuration.

[0054] Figure 25 It is in an open configuration. Figure 20 and Figure 21 An exploded perspective view of the end effector of the device shown.

[0055] Figure 26 and Figure 27 yes Figure 25 The side view of the first tooling component of the end effector shown indicates it is in a fully open configuration. Figure 26 ) and partially open configuration ( Figure 27 The end effector of ).

[0056] Figure 28 It is in a closed configuration that grasps the suture needle. Figure 20 and Figure 21 A side view of the end effector of the device shown.

[0057] Figure 29 This is an enlarged perspective view of the end effector and wrist assembly of the device according to an embodiment.

[0058] Figure 30 yes Figure 29 An exploded perspective view of the distal portion of the instrument shown.

[0059] Figure 31 yes Figure 29 An exploded perspective view of the end effector of the device shown.

[0060] Figure 32 yes Figure 29 The side view of the distal portion of the device shown illustrates the end effector in an open configuration.

[0061] Figure 33 and Figure 34 yes Figure 29 The side view of the first tooling component of the end effector shown indicates it is in a fully open configuration. Figure 33 ) and partially open configuration ( Figure 34 The end effector of ).

[0062] Figure 35 It is in a closed configuration that grasps the suture needle. Figure 29 A side view of the end effector of the device shown.

[0063] Figure 36 and Figure 37 According to the embodiment, it has a rear-pivoting / forward clamping topology in a first (closed) configuration. Figure 36 ) and the second (open) configuration ( Figure 37 The tool component shown is a side view.

[0064] Figure 38 and Figure 39 According to the embodiment, it has a rear-pivoting / forward clamping topology in a first (closed) configuration. Figure 38 ) and the second (open) configuration ( Figure 39 The tool component shown is a side view.

[0065] Figure 40 This is a side view of a tool assembly with non-circular pulleys according to an embodiment.

[0066] Figure 41 and Figure 42 This is a perspective view of a tool assembly with an oval-shaped single-piece pliers according to an embodiment. Figure 41 ) and side view ( Figure 42 ). Detailed Implementation

[0067] The embodiments described herein are advantageously applicable to various grasping, cutting, manipulating, and other driven tool component operations associated with minimally invasive surgery. Furthermore, the instruments described herein may include end effector tool assemblies configured to amplify input torque (or force) applied by a cable to generate high clamping force at the mating jaws of the tool assembly. Specifically, each tool assembly includes a pulley-jaw pair with a compact footprint, which can generate amplified output to increase the clamping force applied by the jaws. As shown herein, the mechanical advantage for amplifying the input torque is achieved by separating the pivot joints on which the jaws rotate about from the pivot point on which the pulley (to which the input torque is applied) rotates. Furthermore, as described, the pivot joints of the jaws are within the geometric envelope of the pulley. In this way, the tool assembly forms a first kinematic link and a second kinematic link, the first kinematic link rotating about a first pivot point and generating a first torque, and the second kinematic link rotating about a second pivot point and generating a second torque. This arrangement provides amplified output force to the endpoint of the second kinematic link (i.e., the jaws) while maintaining a compact profile similar to that of the directly driven (i.e., non-amplified) jaws.

[0068] In some embodiments, the drive mechanism (including kinematic links) for the pulley-jaw pair is maintained within a defined envelope to ensure the maintenance of desired functionality. For example, the drive mechanism of the embodiments described herein may be maintained within an envelope that is similar in size to (or the same size as) a conventional non-torque amplified end effector. In this way, certain operations, such as joint movements of the wrist along the pitch and yaw axes, manipulation of the suture needle to have a desired “projection distance,” etc., can be maintained while the end effector also generates a desired high clamping force at the jaw gripping portion. Additionally, by generating a high clamping force with reduced cable tension, the embodiments described herein can improve cable life. Therefore, the end effector drive mechanism described herein can be configured as an alternative or replacement drive mechanism for corresponding known end effector drive mechanisms. In some embodiments, the end effector drive mechanism is located within a pulley envelope defined by one or more pulleys in the jaw pulley pair. In some embodiments, the total jaw length (e.g., the gripping length from one of the pivot points) is maintained within a desired size range, for example, a length similar to that of a non-torque amplified end effector.

[0069] The described tool assembly can be configured with several different geometric arrangements of kinematic links formed by jaw-pulley pairs. These various geometric arrangements (referred to as "topologies") can produce certain desired functionalities. These different topologies can include variations in relative link lengths, angular connections between links, and relative positional joints of interconnecting links, as illustrated or described herein. The topologies described herein can produce desired performance, as described herein, by maintaining or controlling parameters such as the input disc angle (the angle at which input torque is applied to the input pulley), the movement of the arcuate slot (where the jaw pivot pin rests within the arcuate slot to control the movement of a pair of jaws (i.e., when the pin reaches the end of the slot)), or other features related to the desired movement and range of motion of the drive mechanism. For example, in some embodiments, the tool assembly can be configured to generate an amplified clamping force independent of the push-pull force applied to (or applied by) the jaws. In some embodiments, the tool assembly is configured to prevent undesirable reverse rotation and limit the range of travel of the jaws (or pulleys). In some embodiments, the tool assembly can be configured to be self-locking when its linkage mechanism moves beyond an eccentric state. In the self-locking configuration, the tool members (e.g., jaws) do not require any input torque to maintain grip on the target object. In some embodiments, this self-locking configuration may include an unlocking actuator to actively disengage the tool members, thereby releasing them from the self-locking state.

[0070] In some embodiments, the tool assembly may include a jaw-pulley pair having jaw pivot axes separate from the pulley (or central) pivot axis, wherein the jaw pivot axis is further away from the jaw tip than the central axis, but still within the envelope of the pulley. In other words, the central pivot axis lies between the jaw axis and the jaw tip. These embodiments are referred to as “rear-pivot” topologies. In other embodiments, the tool assembly may include a jaw-pulley pair having jaw pivot axes separate from the pulley (or central) pivot axis, wherein the central axis is further away from the jaw tip than the jaw pivot axis. In other words, the jaw pivot axis lies between the central pivot axis and the jaw tip, but still within the envelope of the pulley. These embodiments are referred to as “front-pivot” topologies.

[0071] In some embodiments, the tool assembly can be characterized as having a "forward gripping" topology or a "reverse gripping" topology, depending on whether certain link angles increase or decrease as the jaws move toward an open configuration (forward gripping). For example, in some embodiments, the tool assembly includes a jaw-pulley pair having a jaw pivot axis separate from the pulley (or center) pivot axis. The pulley is coupled to the jaws via an interface (such as a pin connector) (and transmits force to the jaws). In this way, the tool assembly forms a first kinematic link and a second kinematic link, the first kinematic link rotating about a first pivot point and generating a first torque, and the second kinematic link rotating about a second pivot point and generating a second torque. The interface between the jaws and the pulley also forms an input link through which input forces are transmitted to the jaws. The input link forms an input link angle with the end effector centerline. The input link angle changes as the pulley rotates to move the end effector from a closed configuration to an open configuration. In a forward gripping topology, the input link angle increases as the end effector moves from a closed configuration to an open configuration. In some embodiments, the forward gripping topology can generate an end effector where the amplified gripping force generated by the jaws is independent of the push-pull force applied to (or applied by) the jaws. In a reverse gripping topology, the input link angle decreases as the end effector moves from a closed configuration to an open configuration.

[0072] In some embodiments, the tool assembly may include two jaw-pulley pairs having jaw pivot axes separate from the pulley (or center) pivot axis. Therefore, rotation of the jaws relative to each other follows a different path than rotation of the pulleys about the central pivot axis. In some embodiments, the pulleys may define a slot within which a jaw pivot pin can translate as the jaws rotate relative to each other. Furthermore, the ends of the slot may constrain the movement of the jaw pivot pin to provide travel restriction at the clamping open configuration, thereby enhancing the performance of the end effector. In some embodiments, a first pulley may define a first curved path, and a second pulley may define a second curved path different from the first curved path. The jaw pivot pin is configured to translate along a jaw pivot pin path defined by the intersection of the first and second curved paths.

[0073] As used herein, the term “about” when used in conjunction with a referenced numerical indication means the referenced numerical indication plus or minus up to 10% of that referenced numerical indication. For example, the language “about 50” covers a range of 45 to 55. Similarly, the language “about 5” covers a range of 4.5 to 5.5.

[0074] As used herein, the term "target workspace" means anything within or related to the endoscopic working lumen (including the patient P's body, the tissues and organs within the lumen, and the tissues defining the lumen), and also refers to supporting structures used in MIS procedures (including coverings and cannulation supports, instruments and related accessories or medical devices, including needles, suture materials, implants, mesh, etc.). As used herein, the term "target tissue" means any tissue or organ that interacts with the target workspace, including the patient P's tissues and organs, natural tissues and organs introduced into the target workspace (including natural transplanted tissues and organs), artificial tissues and organs (including mechanical or electromechanical organs), and tissue and organ assistive devices (such as pacemakers, mesh materials, artificial skin, etc.).

[0075] The term "flexible" in relation to parts (such as mechanical structures, components, or component assemblies) should be interpreted broadly. Essentially, the term refers to a part that can be repeatedly bent and return to its original shape without significant plastic deformation. Some flexible parts can also be elastic. For example, a part (e.g., a bent portion) is said to be elastic if it has the ability to absorb energy during elastic deformation and then release the stored energy upon unloading (i.e., returning to its original state). Many "rigid" objects have a slight inherent elastic "bending" due to material properties, although these objects are not considered "flexible" (as used herein).

[0076] Flexible parts can have infinite degrees of freedom (DOF). Flexibility is a broad property describing an object and therefore depends on the materials forming the object as well as certain physical properties of the object (e.g., cross-sectional shape, length, boundary conditions, etc.). For example, the flexibility of an object can be increased or decreased by selectively including materials with desired elastic modulus, flexural modulus, and / or stiffness. Elastic modulus is a strength property of the constituent materials (i.e., inherent to the constituent materials) and describes the tendency of an object to elastically (i.e., non-permanently) deform in response to an applied force. In the presence of equal applied stresses, a material with a high elastic modulus will not deflect as much as a material with a low elastic modulus. Therefore, the flexibility of an object can be reduced, for example, by introducing a material with a relatively high elastic modulus into the object and / or constructing the object from a material with a relatively high elastic modulus. Examples of such parts include closed, bendable tubes (made of, for example...) Made of polymers, soft rubber, etc., helical springs, etc., can usually be bent into various simple or complex curves without significant cross-sectional deformation.

[0077] Other flexible parts can approximate such infinite-degree-of-freedom parts by using a series of closely spaced, short, interconnected links arranged like a serpentine "vertebra." In such a vertebral arrangement, each part is a short link in a kinematic chain, and the movable mechanical constraints between each link (e.g., pin hinges, cup and ball joints, movable hinges, etc.) allow one (e.g., pitch) or two (e.g., pitch and yaw) degrees of freedom for relative movement between the links. Short flexible parts can be used as single mechanical constraints (joints) and modeled as single mechanical constraints (joints), even if the flexible part itself can be a kinematic chain consisting of multiple connecting links with multiple DOFs or links with infinite DOFs, providing one or more degrees of freedom between two links in the kinematic chain.

[0078] As used in this specification and the appended claims, the term "distal" refers to the direction toward the working point, and the term "proximal" refers to the direction away from the working point. Thus, for example, the tool end closest to the target tissue would be the distal end of the tool, while the end opposite the distal end (i.e., the end manipulated by the user or coupled to the actuation shaft) would be the proximal end of the tool.

[0079] Furthermore, the choice of specific terms used to describe one or more embodiments and optional elements or features is not intended to limit the invention. For example, spatially relative terms (such as “below,” “under,” “lower,” “above,” “upper,” “proximal,” “farthest,” etc.) may be used to describe the relationship of one element or feature to another element or feature shown in the figures. In addition to the positioning and orientation shown in the figures, these spatially relative terms are intended to cover different positioning (i.e., translational placement) and orientation (i.e., rotational placement) of the device in use or operation. For example, if the device in the figures is flipped, an element described as “below” or “under” other elements or features will be “above” or “on” other elements or features. Thus, the term “below” can cover both above and below positioning and orientation. The device may be oriented in other ways (e.g., rotated 90 degrees or in other orientations) and the spatially relative narratives used herein are interpreted accordingly. Similarly, narratives of movement along (translation) and around (rotation) various axes encompass various spatial device positioning and orientations. The combination of body positioning and orientation defines the body posture.

[0080] Similarly, geometric terms (such as "parallel," "perpendicular," "arc," or "square") are not intended to require absolute mathematical precision unless the context indicates otherwise. Instead, such geometric terms allow for variations due to manufacturing or equivalent functions. For example, if an element is described as "arc" or "approximately arc," parts that are not precisely circular (e.g., slightly elliptical or polygonal parts) are still included in the description.

[0081] Furthermore, unless the context otherwise indicates, the singular forms “a,” “an,” and “the” are intended to include the plural forms as well. The terms “comprising,” “including,” “having,” etc., specify the presence of the said feature, step, operation, element, component, etc., but do not preclude the presence or addition of one or more other features, steps, operations, elements, components, or groups.

[0082] Unless otherwise indicated, the terms equipment, medical device, apparatus and variations thereof are used interchangeably.

[0083] The present invention is primarily based on the use of a commercially available product developed by Intuitive Surgical, Inc. of Sunnyvale, California. The implementation of a surgical system is described. An example of such a surgical system is daVinci. Surgical System (Model IS4000), da Vinci Surgical system (model IS4200) and daVinci Surgical system (model IS3000). However, those skilled in the art will understand that the inventive aspects disclosed herein can be embodied and implemented in various ways, including computer-aided, non-computer-aided, and hybrid combinations of manual and computer-aided embodiments and implementations. The embodiments shown on surgical systems (e.g., models IS4000, IS3000, IS2000, and IS1200) are presented by way of example only and should not be considered as limiting the scope of the inventive aspects disclosed herein. Where applicable, inventive aspects may be embodied and implemented in both relatively smaller handheld manual operating devices and relatively larger systems with additional mechanical support.

[0084] Figure 1This is a floor plan illustration of a computer-aided remote operating system. The illustration shows a medical device, a minimally invasive robotic surgical (MIRS) system 1000 (also referred to herein as a minimally invasive remote surgical system), for performing minimally invasive diagnostic or surgical procedures on a patient P lying on an operating table 1010. The system can have any number of components, such as a user control unit 1100 for use by a surgeon or other skilled clinician S during the procedure. The MIRS system 1000 may also include a manipulator unit 1200 (generally referred to as a surgical robot) and an optional assistive device unit 1150. The manipulator unit 1200 may include an arm assembly 1300 and a tool assembly removably coupled to the arm assembly. The manipulator unit 1200 can manipulate at least one removably coupled instrument 1400 (also referred to herein as a "tool") through a minimally invasive incision in the body or a natural orifice of the patient P while the surgeon S observes the surgical site and controls the movement of the instrument 1400 via the control unit 1100. Images of the surgical site are obtained by an endoscope (such as a stereoscopic endoscope) (not shown), which can be manipulated by manipulator unit 1200 to orient the endoscope. Auxiliary equipment unit 1150 can be used to process the images of the surgical site for subsequent display to the surgeon S via user control unit 1100. The number of instruments 1400 used at one time typically depends on factors such as diagnostic or surgical procedures and operating room space constraints. If it is necessary to change one or more of the instruments 1400 in use during the procedure, an assistant removes the instrument 1400 from manipulator unit 1200 and replaces it with another instrument 1400 from tray 1020 in the operating room. Although shown for use with instrument 1400, any instrument described herein can be used with MIRS 1000.

[0085] Figure 2 This is a perspective view of the control unit 1100. The user control unit 1100 includes a left-eye display 1112 and a right-eye display 1114 for presenting a coordinated stereoscopic view of the surgical site, enabling depth perception, to the surgeon S. The user control unit 1100 also includes one or more input control devices 1116, which in turn control 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 instruments 1400 associated with it, to provide the surgeon S with a remote presentation, or a perception where the input control unit 1116 is integrated with (or directly connected to) the instruments 1400. In this way, the user control unit 1100 provides the surgeon S with a strong sense of direct control over the instruments 1400. For this purpose, positioning, force, and tactile feedback sensors (not shown) can be used to transmit positioning, force, and tactile sensations from the instruments 1400 back to the surgeon's hand via the input control unit 1116.

[0086] User control unit 1100 Figure 1 In one embodiment, the user control unit 1100 and the surgeon S are shown in the same room as the patient, allowing the surgeon S to directly monitor the procedure, be physically present if necessary, and speak directly with an assistant, rather than via telephone or other communication medium. However, in other embodiments, the user control unit 1100 and the surgeon S may be in different rooms, entirely different buildings, or other remote locations from the patient, thus enabling remote surgical procedures.

[0087] Figure 3 This is a perspective view of the auxiliary equipment unit 1150. The auxiliary equipment unit 1150 may be coupled to an endoscope (not shown) and may include one or more processors to process captured images for subsequent display, such as via a user control unit 1100, or on another suitable display located locally and / or remotely. For example, in the case of using a stereoscopic endoscope, the auxiliary equipment unit 1150 may process the captured images to present a coordinated stereoscopic image of the surgical site to the surgeon S via a left-eye display 1112 and a right-eye display 1114. This coordination may include alignment between opposing images and may include adjusting the stereoscopic working distance of the stereoscopic endoscope. As another example, image processing may include compensating for imaging errors, such as optical aberrations, of the image capture device using previously determined camera calibration parameters.

[0088] Figure 4 A front perspective view of the manipulator unit 1200 is shown. The manipulator unit 1200 includes components (e.g., arms, linkages, motors, sensors, etc.) to provide manipulation of the instrument 1400 and imaging devices (such as a stereoscopic endoscope for capturing images of the site of the procedure) (not shown). Specifically, the instrument 1400 and imaging devices can be manipulated via a teleoperation mechanism having multiple joints. Furthermore, the instrument 1400 and imaging devices are positioned and manipulated through an incision or natural orifice in the patient P such that the software and / or kinematic telemotion centers are maintained at the incision or orifice. In this way, the incision size can be minimized.

[0089] Figure 5-8BThis is a schematic diagram of the distal portion of the instrument 2400 according to an embodiment. Instrument 2400, any other instrument described herein, or any component thereof may optionally be part of a surgical system that performs minimally invasive surgical procedures and may include a manipulator unit, a series of kinematic linkages, a series of cannulas, etc. Instrument 2400 (and any instrument described herein) can be used in any suitable surgical system (such as the MIRS system 1000 shown and described above) and can be configured to perform a variety of clinical functions, including suturing, cutting, or grasping tissue. Instrument 2400 includes a U-clamp 2610, an end effector 2460, a first tension member 2420 (which may be a cable, rod, or any other suitable structure for actuating the end effector 2460) and a second tension member 2440 (which may be a cable, rod, or any other suitable structure for actuating the end effector 2460). The instrument may include a shaft (not shown) coupling the U-clamp 2610 and the end effector 2460 to a mechanical structure (not shown). The mechanical structure can be any mechanical structure shown and described herein, and can be used to move each of the first tension member 2420 and the second tension member 2440 to actuate the end effector 2460. Specifically, the mechanical structure can be used to apply tension to the first tension member 2420 and the second tension member 2440 to optionally produce rotation of the U-clamp 2610 within an optional wrist assembly (i.e., pitch rotation; the term pitch is arbitrary), to cause the end effector 2460 to rotate relative to the U-clamp 2610 about a central axis A2 (i.e., yaw rotation; the term yaw is arbitrary), to cause the jaws of the end effector 2460 to rotate relative to each other (i.e., clamping rotation), or any combination of these movements.

[0090] In some embodiments, the U-clamp 2610 is part of the wrist assembly and is rotatably coupled to one or more additional links or U-clamps to provide rotation (i.e., pitch rotation) of the U-clamp 2610 about an instrument axis. In other embodiments, the U-clamp 2610 is directly coupled to the axis, and the instrument does not include pitch rotation degrees of freedom. The U-clamp includes a center pin 2683 that defines a central axis A2, and the end effector 2460 is coupled to this center pin. Although the center pin 2683 is shown as comprising two distinct segments, each coupled to a portion (or side) of the end effector 2460, in other embodiments, the center pin 2683 may be a single structure extending through the entire end effector.

[0091] The end effector 2460 includes a first tool assembly 2465 (which serves as a first jaw-rotatable member pair) and a second tool assembly 2485 (which serves as a second jaw-rotatable member pair). Although the first tool assembly 2465 and the second tool assembly 2485 are separate components that cooperate to form the end effector 2460, aspects of the first tool assembly 2465 described below (e.g., the identification of the kinematic linkage formed by the first tool assembly) apply to the second tool assembly 2485, and vice versa. The first tool assembly 2465 includes a first jaw 2462 coupled to a first rotatable member 2562. The first rotatable member 2562 can be any suitable structure for operatively coupling the first jaw 2462 to a first tension member 2420, such as a link, gear, or pulley. In some embodiments, the first rotatable member 2562 is a disc-shaped member rotatably coupled to a U-shaped clamp 2610 via a center pin 2683. Reference Figure 5 and Figure 6 The first rotatable member 2562 includes a first input connector 2564 and a first output connector 2572, and defines a central opening 2568. A central pin 2683 is coupled within the central opening 2568 to allow the first rotatable member 2562 to rotate about a central axis A2 relative to a U-shaped clip 2610, as indicated by arrow AA. A first tension member 2420 is coupled to the first rotatable member 2562 at the first input connector 2564. The first input connector 2564 can be any suitable connector or mechanism for securing the first tension member 2420 to the first rotatable member 2562. For example, in some embodiments, the first input connector 2564 can be an opening in which a cable crimping member is securely fastened. In other embodiments, the first input connector 2564 can be a protrusion around which the first tension member 2420 is securely wound. In other embodiments, the first input connector 2564 can be a pivot joint (e.g., a ball or socket) for allowing a push-pull rod to couple to the first rotatable member 2562. (Reference) Figure 6 The first tension member 2420 is coupled to the first rotatable member 2562 at a first input radius R1 from the central axis A2. Therefore, when the first tension member 2420 applies an input force F... P When applied to the first rotatable member 2562, an input torque is generated about the central axis A2 to rotate the first rotatable member 2562. Additionally, the first rotatable member 2562 defines a first envelope 2565 as a swept volume about the central axis A2, the first envelope 2565 having an envelope radius equal to the outermost distance (e.g., radius) of the first rotatable member 2562. In some embodiments, the first envelope 2565 has an envelope radius equal to a first input radius R1.

[0092] The first output connector 2572 can be any suitable connector or mechanism that connects the first jaw 2462 to the first rotatable member 2562. Furthermore, the first output connector 2572 is matingly coupled to a first connector 2472 of the first jaw 2462 to transmit force from the first rotatable member 2562 to the first jaw 2462. In some embodiments, the first output connector 2572 can be a protrusion received within a corresponding opening. In other embodiments, the first output connector 2572 can be an opening within which the protrusion from the first jaw 2462 is received. Reference Figure 7 , Figure 7 The geometry of the first tool assembly 2465 is shown, and the first output connector 2572 is radially offset from the central axis A2, which is identified as L. I The input length of the jaws. Therefore, the coupling between the first pulley 2562 and the first jaw 2462 defines the rotation about the central axis A2, denoted as L. I The kinematic link. As shown in the figure, the first output connector 2572 and the kinematic link L I Within the first pulley envelope 2565. In other words, the jaw input length L I Less than or equal to the first input radius R1.

[0093] The first jaw 2462 includes a distal portion 2463 and a proximal portion 2467. The distal portion 2463 serves as a gripping portion to cooperate with the second jaw 2482 to contact tissue, grasp a needle, or perform other operations. The proximal portion 2467 includes a first connector 2472 that couples the first jaw 2462 to and transmits force from the first rotatable member 2562. The first jaw 2462 is rotatably coupled to the second jaw 2482 via a jaw pivot pin 2471, which defines a jaw pivot axis A. JP Therefore, when the torque applied to the first rotatable member 2562 by the first tension member 2420 is transmitted to the first jaw 2462, the first jaw 2462 rotates around the jaw pivot axis A. JP Rotate relative to the second jaw 2482 (and in some cases, the U-shaped clamp 2610), as indicated by arrow BB. See again. Figure 7 The pivot axis of the jaws A JP Offset from the central axis A2 along the end effector centerline CL. Jaw pivot axis A JP Also offset from the first connector 2472 is marked as L A The jaws apply a certain length. Therefore, the coupling of the jaws at the jaw pivot pin 2471 and the coupling of the first jaw 2462 and the first rotatable member 2562 at the first connector 2472 define the length about the jaw pivot axis A. JPRotation is labeled L A The kinematic link. As shown in the figure, the pivot axis A of the jaws... JP and kinematic link L A Within the first envelope 2565. Although Figure 7 The geometric layout of the first tool assembly 2465 is shown, but this layout (e.g., the jaw input length L) I and the clamping jaws apply length L A This also applies to the second tool component 2485.

[0094] The second tool assembly 2485 includes a second jaw 2482 connected to a second rotatable member 2582. The second rotatable member 2582 can be any suitable structure, such as a linkage, gear, or pulley, for operably coupling the second jaw 2482 to the second tension member 2440. In some embodiments, the second rotatable member 2582 is a disc-shaped member rotatably coupled to a U-shaped clamp 2610 via a central pin 2683. The second rotatable member 2582 includes a second input connector 2584 and a second output connector 2592, and defines a central opening 2588. The central pin 2683 is coupled within the central opening 2588 to allow the second rotatable member 2582 to rotate relative to the U-shaped clamp 2610 about a central axis A2, as indicated by arrow AA. The second tension member 2440 is coupled to the second rotatable member 2582 at the second input connector 2584. The second input connector 2584 can be any suitable connector or mechanism for securing the second tension member 2440 to the second rotatable member 2582. For example, in some embodiments, the second input connector 2584 may be an opening in which a cable crimping member is securely fastened. In other embodiments, the second input connector 2584 may be a protrusion around which the second tension member 2440 (e.g., a cable) is securely wound. In still other embodiments, the second input connector 2584 may be a pivot joint (e.g., a ball or socket) for allowing a push-pull rod to couple to the second rotatable member 2582. (See reference...) Figure 7 The second tension member 2440 is coupled to the second rotatable member 2582 at a second input radius R2 from the central axis A2. Therefore, when the second tension member 2440 applies an input force F... PWhen applied to the second rotatable member 2582, an input torque is generated about the central axis A2 to rotate the second rotatable member 2582. Additionally, the second rotatable member 2582 defines a second envelope 2585 as a swept volume about the central axis A2, the second envelope 2585 having an envelope size (e.g., radius) equal to the outermost dimension (e.g., radius) of the second rotatable member 2582. In some embodiments, the second envelope 2585 has an envelope radius equal to a second input radius R2. In some embodiments, the second input radius R2 is equal to a first input radius R1, and the second envelope 2585 is identical to the first envelope 2565.

[0095] The second output connector 2592 can be any suitable connector or mechanism for connecting the second jaw 2482 to the second rotatable member 2582. Furthermore, the second output connector 2592 is matingly coupled to a second connector 2492 of the second jaw 2482 to transmit force from the second rotatable member 2582 to the second jaw 2482. In some embodiments, the second output connector 2592 can be a protrusion received within a corresponding opening of the second jaw 2482. In other embodiments, the second output connector 2592 can be an opening within which the protrusion from the second jaw 2482 is received. Reference also applies to the second tool assembly. Figure 7 The second output connector 2592 is radially offset from the central axis A2 and is marked as L. I The input length of the jaws. Therefore, the coupling between the second rotatable member 2582 and the second jaw 2482 defines the rotation about the central axis A2, denoted as L. I The kinematic link. The second output connector 2592 and the kinematic link L. I Inside the second package, 2585.

[0096] The second jaw 2482 includes a distal portion 2483 and a proximal portion 2487. The distal portion 2483 serves as a gripping portion to engage with the first jaw 2462 to contact tissue, grasp a needle, or perform other operations. The proximal portion 2487 includes a second connector 2492 that couples the second jaw 2482 to and transmits force from the second rotatable member 2582. The first jaw 2462 is rotatably coupled to the second jaw 2482 via a jaw pivot pin 2471. Therefore, when torque applied to the second rotatable member 2582 by the second tension member 2440 is transmitted to the second jaw 2482, the second jaw 2482 relative to the first jaw 2462 (and the U-shaped clamp 2610) about the jaw pivot axis A. JP Rotate, as indicated by arrow BB. The jaws pivot axis A. JP The offset from the second connector 2492 is marked as L. AThe jaws apply a certain length. Therefore, the coupling of the jaws at the jaw pivot pin 2471 and the coupling of the second jaw 2482 and the second rotatable member 2582 at the second connector 2492 define the length about the jaw pivot axis A. JP Rotation is labeled L A The kinematic link. As shown in the figure, the pivot axis A of the jaws... JP and kinematic link L A Within the second envelope 2585.

[0097] Although the instrument 2400 is shown with a first jaw 2462 and a second jaw 2482 between a first rotatable member 2562 and a second rotatable member 2582, in other embodiments, the instrument 2400 (or any instrument shown herein) may be configured to have a first rotatable member 2562 and a second rotatable member 2582 between the first jaw 2462 and the second jaw 2482. In such embodiments, a jaw pivot pin 2471 extends through the first rotatable member 2562 and the second rotatable member 2582. Thus, in some embodiments, the first rotatable member 2562 optionally defines a jaw pivot opening 2569, and the second rotatable member 2582 optionally defines a jaw pivot opening 2589 to allow the jaw pivot pin 2471 to pass through. Figure 6-8BAn embodiment including optional jaw pivot openings is illustrated. As shown, a jaw pivot pin 2471 extends through a first jaw pivot opening 2569 and a second jaw pivot opening 2589. More specifically, both the first jaw pivot opening 2569 and the second jaw pivot opening 2589 are elongated to allow the jaw pivot pin 2471 to move relative to the first rotatable member 2562 and the second rotatable member 2582 during operation. The first jaw pivot opening 2569 includes a first end 2569A and a second end 2569B, and the second jaw pivot opening 2589 includes a first end 2589A and a second end 2589B. In some cases, the walls defining the first jaw pivot opening 2569 and the walls defining the second jaw pivot opening 2589 can constrain the movement of the jaw pivot pin 2471 during operation. In other words, the shape, size, or both shape and size of the first jaw pivot opening 2569 and the second jaw pivot opening 2589 can limit the movement of the jaw pivot pin 2471 during use. Although the first jaw pivot opening 2569 and the second jaw pivot opening 2589 are shown as curved (to define a curved path), in other embodiments, either or both of the first jaw pivot opening 2569 and the second jaw pivot opening 2589 can be a linear elongated slot. In other embodiments, either or both of the first jaw pivot opening 2569 and the second jaw pivot opening 2589 can have curved sections and linear sections. The size and shape of the jaw pivot openings can be selected to minimize the amount of material removed from the rotatable member (e.g., to maintain the structural stability of the rotatable member) while allowing the desired movement of the jaw pivot pin 2471 therein. In some embodiments, the shape of the jaw pivot opening can be curved because L I The rotation will move the position of the jaw pivot pin 2471 closer to or further away from the center pin 2683. In some embodiments, the path of the jaw pivot pin 2471 may be helical.

[0098] Although the movable members are shown and described as including jaw pivot openings 2569, 2589 because the instrument 2400 is configured to have a first jaw 2462 and a second jaw 2482 between the first rotatable member 2562 and the second rotatable member 2582, in other embodiments, the first rotatable member 2562 need not include the first jaw pivot opening 2569, and the second rotatable member 2582 need not include the second jaw pivot opening 2589 (see, for example...). Figure 5 ).

[0099] As shown in the figure, the first tool assembly 2465 and the second tool assembly 2485 have a rear-pivoting topology. Specifically, the jaw pivot axis A JP Offset from the central axis A2 along the end effector centerline CL (see...) Figure 7 The pivot axis of the jaws is further away from the jaw tips than the central axis A2. In other words, the central axis A2 is located at the jaw pivot axis A. JP Between the distal ends (or gripping portions) 2463 and 2483 of the jaws 2462 and 2482. Additionally, the first tool assembly 2465 and the second tool assembly 2485 have a forward gripping topology. (See reference...) Figure 7 The end effector centerline CL is defined by the central axis A2 and the jaw pivot axis A. JP Between (and perpendicular to the central axis A2 and the jaw pivot axis A) JP When the input force F P When applied to a rotatable component, input link L I Rotate around the central axis A2. Therefore, the input link L I The input link angle Θ is formed with the centerline CL of the end effector. When the rotatable component rotates to move the end effector 2460 from a closed configuration (… Figure 8A Move to open configuration ( Figure 7 , Figure 8B When the input link angle Θ increases, the input link angle increases. In other embodiments, the end effector may have a reverse clamping topology (wherein the input link angle decreases when the end effector moves from a closed configuration to an open configuration). Figure 7 )).

[0100] In use, the end effector 2460 can amplify the input force F. P This allows for the generation of a higher clamping force by the jaws 2462 and 2482 than that produced by a standard one-piece jaw and pulley system. As described below, the end effector 2460 (and each of the tool assemblies 2465 and 2485) includes additional kinematic linkage mechanisms to increase the applied input force F. P The torque arm is adjusted to increase the output clamping force. See below for reference. Figure 7 And 8 describes the general description of force amplification, Figure 7 Figure 8 shows the geometry of the first tool assembly 2465, but it also applies to the second tool assembly 2485. Additionally, the free-body diagrams and clamping force equations discussed below (e.g., referring to the end effector 4460) also apply to the end effector 2460.

[0101] As shown in the figure, the input force F P The input force F is applied to the input connector of the first rotatable member 2562. P By acting through the second input radius R2, an input torque T is generated around the central axis A2 in the direction indicated by arrow AA. I Input torque T IA combined input force F is applied across the entire first rotatable member 2562 within the plane of rotation of the first rotatable member 2562, such that a combined input force F is generated at the interface between the output connector 2572 (of the first rotatable member) and the first connector 2472 (of the first jaw 2462). I In this way, the input force F I The force F acts on the first jaw 2462. Specifically, when the first rotatable member 2562 rotates about the central axis A2 (arrow AA), the input force F... I This causes the first jaw 2462 to rotate around the jaw pivot pin 2471 (which defines the jaw pivot axis A). JP Rotate as shown by arrow BB. Input force F I The size is based on the input link L I The length of the input force F obtained. I By the ratio of length (R2 / L) I ) and input force F P Proportional. Similarly, the kinematic link L A (That is, the length of the jaws applied) is used as the input force F I The torque arm, the input force F I The rotation of the first jaw 2462 is driven by the interface of the first output connector 2572 and the first connector 2472 (of the first rotatable member). Input force F I perpendicular to the kinematic link L A The component is generated on the first jaw 2462 with length L A The applied torque is proportional. Because the kinematic link L A The length is longer than the input link L I The length of the tool assembly 2465 (due to the offset of the first output connector 2572 and the first connector 2472 from the jaw pivot pin 2471) provides amplified drive torque to the first jaw 2462 to drive its rotation. In other words, by separating the interfaces of the first output connector 2572 and the first connector 2472 on one side of the center pin 2683 and from the jaw pivot pin 2471 located on the other side of the center pin 2583, mechanical advantages can be obtained via the pulley-jaw pair. More specifically, because the distance from the output connector 2572 is greater when the jaw pivot pin 2471 is larger, the torque output is typically through a distance L. A and L I The amplification ratio is magnified. Therefore, by maximizing this ratio, the amplification amount can be increased.

[0102] Furthermore, the elongated shape of the first jaw pivot opening 2569 and the second jaw pivot opening 2589 allows relative movement between each rotatable member and its corresponding jaw (e.g., the second rotatable member 2582 and the second jaw 2482). The configuration of the first jaw pivot opening 2569 and the second jaw pivot opening 2589 also allows this relative movement while positioning the jaw pivot axis A... JP Input Link L I and kinematic link L A It remains within the second envelope 2585 (and the first envelope 2565). In other words, the disc-shaped proximal portion 2487 of the second jaw 2482 is held within the envelope defined by the disc-shaped second rotatable member 2582. Because the jaw pivot pin 2471 is located within each of the first jaw pivot opening 2569 and the second jaw pivot opening 2589, in some configurations, the sidewalls of the first rotatable member 2562 and the sidewalls of the second rotatable member 2582 can collectively restrict the movement of the jaw pivot pin 2471. For example, Figure 7 , Figure 8A and Figure 8B A second jaw pivot opening 2589 superimposed around the first jaw pivot opening 2569 is shown. (See diagram.) Figure 7 As shown, when the end effector 2460 is in a partially open configuration, the jaw pivot pin 2471 is located within the middle portion of each of the first jaw pivot opening 2569 and the second jaw pivot opening 2589. When the rotatable member rotates, the movement of the jaw pivot pin 2471 is guided within the jaw pivot pin envelope 2473. Specifically, the first jaw pivot opening 2569 and the second jaw pivot opening 2589 are shaped to allow movement of the jaw pivot pin 2471 along the end effector centerline CL. In other words, the jaw pivot pin 2471 is configured to translate along a jaw pivot pin path defined by the intersection of a first curved path (of the first jaw pivot opening 2569) and a second curved path (of the second jaw pivot opening 2589).

[0103] like Figure 8A As shown, when the end effector 2460 is in a closed configuration (e.g., gripping a pin), there is a gap between the jaw pivot pin 2471 and the second end 2589B of the second jaw pivot opening 2589 and the first end 2569A of the first jaw pivot opening 2569. By ensuring this end gap, the jaws will not stop prematurely (e.g., if the jaws are gripping a very thin object). Figure 8BAs shown, the rotatable member 2562 rotates in the direction CC, causing the first jaw 2462 to rotate to a fully open configuration as indicated by arrow DD. When the end effector 2460 is in the fully open configuration, the jaw pivot pin 2471 contacts the first end 2569A of the first jaw pivot opening 2569 and the second end 2589B of the second jaw pivot opening 2589. Therefore, further relative movement between each jaw and its corresponding rotatable member (e.g., the second jaw 2482 and the second rotatable member 2582) is stopped. In this way, the end effector 2460 includes an end stop to prevent over-rotation.

[0104] Although the end effector 2460 is shown with a first jaw 2462 and a second jaw 2482 between a first rotatable member 2562 and a second rotatable member 2582 (i.e., two jaws clamped between two rotatable members), in other embodiments, the two rotatable members may be between two jaws. Additionally, although the end effector 2460 is shown with a rear-pivoting topology, in other embodiments, the end effector may have a front-pivoting topology. For example, Figure 9 and Figure 10 This is a schematic diagram of the distal portion of an apparatus 3400 according to an embodiment. The apparatus 3400 includes a U-clamp 3610, an end effector 3460, a first tension member 3420, and a second tension member 3440. The first tension member 3420 and the second tension member 3440 may be cables, rods, or any other suitable structures for actuating the end effector 3460. The apparatus may include a shaft (not shown) coupling the U-clamp 3610 and the end effector 3460 to a mechanical structure (not shown). The mechanical structure may be any mechanical structure shown and described herein and may be used to move each of the first tension member 3420 and the second tension member 3440 to actuate the end effector 3460, as described herein.

[0105] In some embodiments, the U-clamp 3610 is part of a wrist assembly and is rotatably coupled to one or more additional links or U-clamps to provide rotation of the U-clamp 3610 about an instrument axis. In other embodiments, the U-clamp 3610 is directly coupled to the axis, and the instrument does not include pitch rotation degrees of freedom. The U-clamp includes a center pin 3683 that defines a central axis A2, and an end effector 3460 is coupled to the center pin. As shown, the center pin 3683 is a single structure passing through the first jaw 3462, the first rotatable member 3562, the second rotatable member 3582, and the second jaw 3562.

[0106] The end effector 3460 includes a first tool assembly 3465 (which serves as a first jaw-rotatable member pair) and a second tool assembly 3485 (which serves as a second jaw-rotatable member pair). Although the first tool assembly 3465 and the second tool assembly 3485 are separate components that cooperate to form the end effector 3460, aspects of the first tool assembly 3465 described below (e.g., the markings of the kinematic links formed by the first tool assembly) apply to the second tool assembly 3485, and vice versa. The first tool assembly 3465 includes a first jaw 3462 coupled to a first rotatable member 3562.

[0107] The first rotatable member 3562 can be any suitable structure, such as a linkage, gear, or pulley, for operably coupling the first jaw 3462 to the first tension member 3420. In this embodiment, the first rotatable member 3562 is rotatably coupled to the crescent-shaped member of the U-clamp 3610 via a central pin 3683. As described, the first rotatable member 3562 is shaped such that the jaw pivot pin 3471 is outside the outer edge of the first rotatable member 3562. Even though the jaw pivot pin 3471 is outside the structure of the first rotatable member 3562, it remains within the first envelope 3565 (which is a cylindrical volume about the central axis A2). The first rotatable member 3562 includes a first input connector 3564 and a first output connector 3572, and defines a central opening 3568. The central pin 3683 is coupled within the central opening 3568 to allow the first rotatable member 3562 to rotate relative to the U-clamp 3610 about the central axis A2, as indicated by arrow CC. The first tension member 3420 is coupled to the first rotatable member 3562 at the first input connector 3564. The first input connector 3564 can be any suitable connector or mechanism for securing the first tension member 3420 to the first rotatable member 3562, as described herein.

[0108] Figure 10 This is a side view showing the geometry of the second jaw 3482 and the second rotatable member, but this geometry also applies to the first tool assembly 3465. The first tension member 3420 has a first input radius (similar to) from the central axis A2. Figure 10 The second input radius R2 shown is coupled to the first rotatable member 3562. Therefore, when the first tension member 3420 applies the input force F... PWhen applied to the first rotatable member 3562, an input torque is generated about the central axis A2 to rotate the first rotatable member 3562. Additionally, the first rotatable member 3562 defines a first envelope 3565 as a cylindrical volume about the central axis A2, the first envelope 3565 having an envelope radius equal to the outermost dimension (e.g., radius) of the first rotatable member 3562. In some embodiments, the first envelope 3565 has an envelope radius equal to either a first input radius R1 or a second input radius R2.

[0109] The first output connector 3572 can be any suitable connector or mechanism that couples the first jaw 3462 to the first rotatable member 3562. Furthermore, the first output connector 3572 is matingly coupled to a first connector 3472 of the first jaw 3462 to transmit force from the first rotatable member 3562 to the first jaw 3462. In some embodiments, the first output connector 3572 can be a protrusion received within a corresponding opening in the first jaw 3462. In other embodiments, the first output connector 3572 can be an opening within which a protrusion from the first jaw 3462 is received. (See reference...) Figure 10 (It shows the geometry of the second tool assembly 3485, which also applies to the first tool assembly 3465), and the first output connector 3572 is identified as L, which is radially offset from the central axis A2. I The input length of the jaws. Therefore, the coupling between the first rotatable member 3562 and the first jaw 3462 defines the L-shaped jaw that rotates about the central axis A2. I The kinematic link. As shown in the figure, the first output connector 3572 and the kinematic link L I Within the first encapsulation 3565. In other words, the jaw input length L I It is less than the first input radius R1 or the second input radius R2.

[0110] The first jaw 3462 includes a distal portion 3463 and a proximal portion 3467. The distal portion 3463 serves as a gripping portion to engage with the second jaw 3482 to contact tissue, grasp a needle, or perform other operations. The proximal portion 3467 includes a first connector 3472 that couples the first jaw 3462 to and transmits force from a first rotatable member 3562. The first jaw 3462 is rotatably coupled to the second jaw 3482 via a jaw pivot pin 3471 that defines a jaw pivot axis A. JP Therefore, when the torque applied to the first rotatable member 3562 by the first tension member 3420 is transmitted to the first jaw 3462, the first jaw 3462 rotates around the jaw pivot axis A. JPRotate relative to the second jaw 3482 (and the U-shaped clamp 3610), as indicated by arrow DD. See again. Figure 10 (It applies to the first tool assembly 3465), jaw pivot axis A JP Offset from the central axis A2 along the end effector centerline CL. Jaw pivot axis A JP Also offset from the first connector 3472 is marked as L A The jaws apply a certain length. Therefore, the coupling of the jaws at the jaw pivot pin 3471 and the coupling of the first jaw 3462 and the first rotatable member 3562 at the first connector 3472 define the length about the jaw pivot axis A. JP Rotation is labeled L A The kinematic link. As shown in the figure, the pivot axis A of the jaws... JP and kinematic link L A Within the first envelope 3565. However, the jaws apply a length L. A It is greater than the first input radius R1 or the second input radius R2.

[0111] The second tool assembly 3465 includes a second jaw 3482 connected to a second rotatable member 3582. Similar to the first rotatable member 3562, the second rotatable member 3582 is rotatably coupled to a crescent-shaped member of a U-clamp 3610 via a central pin 3683. The second rotatable member 3582 includes a second input connector 3584 and a second output connector 3592, and defines a central opening 3588. The central pin 3683 is coupled within the central opening 3588 to allow the second rotatable member 3582 to rotate relative to the U-clamp 3610 about a central axis A2, as indicated by arrow CC. A second tension member 3440 is coupled to a second pulley 3582 at the second input connector 3584. The second input connector 3584 can be any suitable connector or mechanism for securing the second tension member 3440 to the second rotatable member 3582, as described herein.

[0112] refer to Figure 10 The second tension member 3440 is connected to the second rotatable member 3582 at a second input radius R2 from the central axis A2. Therefore, when the second tension member 3440 applies an input force F... PWhen applied to the second rotatable member 3582, an input torque is generated about the central axis A2 to rotate the second rotatable member 3582. Additionally, the second rotatable member 3582 defines a second envelope 3585 as a cylindrical volume about the central axis A2, the second envelope 3585 having an envelope radius equal to the outermost dimension (e.g., radius) of the second rotatable member 3582. In some embodiments, the second envelope 3585 has an envelope radius equal to a second input radius R2. In some embodiments, the second input radius R2 is equal to a first input radius R1, and the second envelope 3585 is identical to the first envelope 3565. The second output connector 3592 can be any suitable connector or mechanism that couples the second jaw 3482 to the second rotatable member 3582. Furthermore, the second output connector 3592 is matingly coupled to a second connector 3492 of the second jaw 3482 to transmit force from the second rotatable member 3582 to the second jaw 3482. Reference Figure 10 The second output connector 3592 is radially offset from the central axis A2 and is marked as L. I The input length of the jaws. Therefore, the coupling between the second rotatable member 3582 and the second jaw 3482 defines the rotation about the central axis A2, denoted as L. I The kinematic link. As shown in the figure, the second output connector 3592 and the kinematic link L I Inside the second package, 3585.

[0113] The second jaw 3482 includes a distal portion 3483 and a proximal portion 3487. The distal portion 3483 serves as a gripping portion to engage with the first jaw 3462 to contact tissue, grasp a needle, or perform other operations. The proximal portion 3487 includes a second connector 3492 that couples the second jaw 3482 to and transmits force from the second rotatable member 3582. The first jaw 3462 is rotatably coupled to the second jaw 3482 via a jaw pivot pin 3471. Therefore, when a torque applied to the second rotatable member 3582 by the second tension member 3440 is transmitted to the second jaw 3482, the second jaw 3482 rotates about the jaw pivot axis A. JP Rotation relative to the first jaw 3462 (and the U-shaped clamp 3610), as indicated by arrow DD. Jaw pivot axis A. JP The offset from the second connector 3492 is marked as L. A The jaws apply a certain length. Therefore, the coupling of the jaws at the jaw pivot pin 3471 and the coupling of the second jaw 3482 and the second rotatable member 3582 at the second connector 3492 define the length about the jaw pivot axis A. JP Rotation is labeled L A The kinematic link. As shown in the figure, the pivot axis A of the jaws...JP and kinematic link L A Within the second pulley envelope 3585.

[0114] As described above, the first jaw 3462 defines a first central opening 3468, and the second jaw 3482 defines a second central opening 3488. As shown, a central pin 3683 extends through the first central opening 3468 and the second central opening 3488. Furthermore, both the first central opening 3468 and the second central opening 3488 are elongated to allow movement of the first jaw 3462 and the second jaw 3482 around the central pin 3683 during operation. Figure 10 As shown, the first central opening 3468 includes a first end 3468A and a second end 3468B, and the second central opening 3488 includes a first end 3488A and a second end 3488B. As described in more detail below, during use, the boundaries of the first central opening 3468 and the second central opening 3488 can constrain the movement of the jaws during operation. In other words, in some configurations, the shape, size, or both of the first central opening 3468 and the second central opening 3488 can limit the movement of the first jaw 3462 and the second jaw 3482 during use. Thus, the central opening (or slot) allows the jaws to translate relative to the central pin 3683 and the pulley. Although the first central opening 3468 and the second central opening 3488 are shown as curved (to define a curved path), in other embodiments, either or both of the first central opening 3468 and the second central opening 3488 can be a linear elongated slot. In other embodiments, either or both of the first central opening 3468 and the second central opening 3488 may have curved sections and linear sections. Although the crescent shape of the first rotatable member 3562 and the second rotatable member 3582 eliminates the need for jaw pivot openings in the rotatable members, in other embodiments, the end effector may include both an elongated central opening similar to the first central opening 3468 and the second central opening 3488, and an elongated jaw pivot opening similar to the first jaw pivot opening 2569 and the second jaw pivot opening 2589 described above.

[0115] As shown in the figure, the first tool assembly 3465 and the second tool assembly 3485 have a front pivoting topology. Specifically, the jaw pivoting axis A JP Along the centerline CL of the end effector (see Figure 10 The center axis A2 is offset from the pivot axis, which is further away from the jaw tip than the jaw pivot axis. In other words, the jaw pivot axis A2 is offset from the pivot axis. JPBetween the central axis A2 and the distal ends 3463 and 3483 of the jaws 3462 and 3482. Additionally, the first tool assembly 3465 and the second tool assembly 3485 have a forward-facing clamping topology. (See reference) Figure 10 The end effector centerline CL is defined by the central axis A2 and the jaw pivot axis A. JP Between (and perpendicular to the central axis A2 and the jaw pivot axis A) JP When the input pulley force F P When applied to the pulley, the input link L I Rotate around the central axis A2. Therefore, the input link L I The input link angle Θ is formed with the centerline CL of the end effector. The input link angle Θ increases as the rotatable member rotates to move the end effector 3460 from a closed configuration to an open configuration. In other embodiments, the end effector may have a reverse clamping topology (wherein the input link angle decreases as the end effector moves from a closed configuration to an open configuration).

[0116] In use, the end effector 3460 can amplify the input force F. P This allows for the generation of a higher clamping force by the jaws 3462 and 3482 than that produced by a standard one-piece jaw and pulley system. As described below, the end effector 3460 (and each of the tool assemblies 3465 and 3485) includes additional kinematic links to increase the applied input force F. P The torque arm is adjusted to increase the output clamping force. See below for reference. Figure 10 A general description of force amplification. Figure 10 The geometry of the second tool assembly 3485 is shown, but it also applies to the first tool assembly 3465. Furthermore, the free-body diagrams and clamping force equations discussed below also apply to the end effector 3460. As shown, the input force F... P The second input connector is applied to the second rotatable member 3582. Input force F P By acting through the second input radius R2, an input torque T is generated around the central axis A2 in the direction indicated by arrow CC. I Input torque T I An input force is applied across the entire second rotatable member 3582 within its plane of rotation, resulting in a combined input force at the interface between the second output connector 3572 (of the second rotatable member) and the second connector 3472 (of the second jaw 3482). In this way, the input force acts on the second jaw 3482. Specifically, as the second rotatable member 3582 rotates about its central axis A2 (arrow CC), the input force causes the second jaw 3482 to rotate about the jaw pivot pin 3471 (which defines the jaw pivot axis A). JPRotate as indicated by arrow DD. Input force F I The size is based on the input link L I The length, and the ratio of the input force obtained through the length (R² / L) I ) and input pulley force F P Proportional. Similarly, the kinematic link L A (That is, the applied length of the jaws) serves as the torque arm for the input force, which is transmitted via the interface of the second output connector 3572 and the second rotatable member connector 3472 to drive the rotation of the second jaw 3482. The input force is perpendicular to the kinematic link L. A The component is generated on the second jaw 3482 with length L A The applied torque is proportional. Because the kinematic link L A The length is longer than the input link L I Due to the length of the second output connector 3572 and the second connector 3472 being offset from the jaw pivot pin 3471, the tool assembly 3485 provides amplified drive torque to the second jaw 3482 to drive its rotation. In other words, mechanical advantages can be obtained via the pulley-rotatable member pair by separating the interfaces of the second output connector 3572 and the second pulley connector 3472 on one side of the center pin 3683 and separating them from the jaw pivot pin 3471 located on the other side of the center pin 3588.

[0117] Furthermore, the elongated shape of the first central opening 3468 and the second central opening 3488 allows for relative movement between each rotatable member and its corresponding jaws (e.g., the second rotatable member 3582 and the second jaw 3482). The configuration of the first central opening 3468 and the second central opening 3488 also allows for such relative movement while pivoting the jaws along axis A. JP Input Link L I and kinematic link L A It remains within the second envelope 3585 (and the first envelope 3565). In other words, the disc-shaped proximal portion 3487 of the second jaw 3482 is held within the envelope defined by the disc-shaped second rotatable member 3582. Because the center pin 3683 is located within each of the first center opening 3468 and the second center opening 3488, in some configurations, the sidewalls of the first jaw 3462 and the sidewalls of the second jaw 3482 can together restrict the movement of the jaws relative to the pulley. For example, Figure 10A first central opening 3468 is shown superimposed around a second central opening 3488. When the end effector 3460 is in a closed configuration (e.g., gripping a pin), the central pin 3683 has a gap (i.e., spaced apart) with the second end 3488B of the second central opening 3488 and the first end 3468A of the first central opening 3468. Therefore, further relative movement between each jaw and its corresponding rotatable member (e.g., the second jaw 3482 and the second rotatable member 3582) is not prematurely restricted. When the end effector 3460 is in a fully open configuration, the central pin 3683 contacts the first end 3488A of the second central opening 3488 and the second end 3468B of the first central opening 3468. Therefore, further relative movement between each jaw and its corresponding pulley (e.g., the second jaw 3482 and the second pulley 3582) is stopped. In this way, the end effector 3460 includes an end stop to prevent over-rotation.

[0118] Figure 11-14 This is a schematic diagram of the distal portion of a device 4400 having a rear-pivoting and forward-clamping topology according to an embodiment. Specifically, Figure 11 It is a front view of the instrument, and Figure 12 This is a side view of the instrument. Figure 13A and Figure 13B It is in the first (closed) configuration ( Figure 13A ) and the second (open) configuration ( Figure 13B An enlarged side view of a portion of the instrument 4400. Finally, Figure 14 This is a free-body diagram illustrating the forces and torques acting on various joints of the tool assembly. The device 4400 includes a U-clamp 4610, an end effector 4460, a first cable 4420 (which serves as a first tension member), and a second cable (not shown). The device may include an axis (not shown) coupling the U-clamp 4610 and the end effector 4460 to a mechanical structure (not shown). The mechanical structure may be any mechanical structure shown and described herein and may be used to move the cable to actuate the end effector 4460, as described herein. In some embodiments, the U-clamp 4610 is part of a wrist assembly and is rotatably coupled to one or more additional links or U-clamps to provide rotation of the U-clamp 4610 about the device axis. In other embodiments, the U-clamp 4610 is directly coupled to the axis, and the device does not include pitch rotation degrees of freedom. The U-clamp includes a center pin 4683 defining a central axis A2, and the end effector 4460 is coupled to this center pin.

[0119] The end effector 4460 includes a first tool assembly 4465 (which serves as a first jaw-pulley pair) and a second tool assembly 4485 (which serves as a second jaw-pulley pair). Although the first tool assembly 4465 and the second tool assembly 4485 are separate components that cooperate to form the end effector 4460, aspects of the first tool assembly 4465 described below (e.g., the designation of the kinematic link formed by the first tool assembly) apply to the second tool assembly 4485, and vice versa. Therefore, although some figures depict the first tool assembly 4465, this description applies to the second tool assembly 4485. The first tool assembly 4465 includes a first jaw 4462 coupled to a first pulley 4562, and the second tool assembly 4485 includes a second jaw 4482 coupled to a second pulley 4582. The first jaw 4462 includes a distal portion 4463 and a proximal portion 4467, and the second jaw 4482 includes a distal portion 4483 and a proximal portion 4487. Both proximal portions 4467 and 4487 include pulley connectors that couple the jaws to their mating pulleys and transmit force from the mating pulleys (e.g., proximal portion 4467 includes a first pulley connector 4472 that couples the first jaw 4462 to the first pulley 4562 and transmits force from the first pulley 4562). Additionally, the proximal portion 4467 of the first jaw 4462 is rotatably coupled to the proximal portion 4487 of the second jaw 4482 via a jaw pivot pin 4471, which defines a jaw pivot axis A. JP The distal portions 4463 and 4483 serve as clamping portions to cooperatively contact tissue, grasp needles, or perform other operations.

[0120] For example, such as Figure 12 As shown, when the end effector 4460 is in the closed configuration, the distal portions 4463 of the first jaw 4462 and the distal portions 4483 of the second jaw 4482 can work together to clamp the suture needle 4010. Specifically, the jaws can apply a clamping force Fgrip to clamp the needle 4010. A push-pull force Fpp can also be applied to (or applied by) the jaws. For example, when the end effector 4460 moves from an open configuration to a closed configuration due to the translational movement of the first jaw 4462 and the second jaw 4482 along the end effector centerline CL, the push-pull force Fpp can be applied by the jaws. As shown, both the first jaw 4462 and the second jaw 4482 have a pivot axis A from the jaws. JP The total length L to the ends of the first jaw 4462 and the second jaw 4482 O The first jaw 4462 and the second jaw 4482 each have a clamping length L from the central axis A2 to the ends of the first jaw 4462 and the second jaw 4482. gripThe distance from the tip of the jaws to the point where the needle 4010 is engaged is denoted as the tip-to-clamp distance Lttg.

[0121] The first pulley 4562 is a disc-shaped member rotatably coupled to the U-clamp 4610 via a central pin 4683. The first pulley 4562 includes a first input connector 4564 and a first output connector 4572, and defines a central opening 4568 and a first jaw pivot opening (not identified, but which may be similar to the jaw pivot opening 2569 described above). The central pin 4683 is coupled within the central opening 4568 to allow the first pulley 4562 and the second pulley 4582 to rotate relative to the U-clamp 4610 about a central axis A2, as indicated by arrow EE. A first cable 4420 is coupled to the first pulley 4562 at the first input connector 4564. The first input connector 4564 can be any suitable connector or mechanism for securing the first cable 4420 to the first pulley 4562, as described herein. Reference Figure 13A and Figure 13B The first cable 4420 is coupled to the first pulley 4562 at a first input radius R1 from the central axis A2. Therefore, when the input pulley force is applied to the first pulley 4562 by the first cable 4420, an input torque T is generated around the central axis A2. in To make the first pulley 4562 rotate, as Figure 11 and Figure 12 As indicated by arrow EE in the diagram. Additionally, the first pulley 4562 defines a first pulley envelope 4565 as a cylindrical volume about the central axis A2, and the first pulley envelope 4565 has an envelope radius equal to the outermost radius of the first pulley 4562. In some embodiments, the first pulley envelope 4565 has an envelope radius equal to the first input radius R1. In some embodiments, the first pulley envelope 4565 is the same as the pulley envelope defined by the second pulley 4582.

[0122] The first output connector 4572 can be any suitable connector or mechanism that couples the first jaw 4462 to the first pulley 4562 to transmit force from the first pulley 4562 to the first jaw 4462. In some embodiments, the first output connector 4572 can be a protrusion received within a corresponding opening of the first jaw 4462. In other embodiments, the first output connector 4572 can be an opening within which the protrusion from the first jaw 4462 is received. (See reference...) Figure 13A and Figure 13B The first output connector 4572 is radially offset from the central axis A2 and is marked as L. I The input length of the jaws. Therefore, the coupling between the first pulley 4562 and the first jaw 4462 defines the rotation about the central axis A2, denoted as L. IThe kinematic input link. Input link L I The input link angle is formed with the centerline CL of the end effector, and this input link angle changes as the first pulley 4562 rotates about the central axis A2. When the end effector 4460 is in the closed configuration (see...), Figure 12 and Figure 13A When ), the input linkage angle is marked as Θ. OFFSET When the pulley is in the open position (see...) Figure 13B and Figure 14 During rotation, the input link angle increases to Θ+Θ. OFFSET (also known as Θ) OVERALL The value of Θ. As described in more detail below, Θ OFFSET The value of Θ can be selected to minimize the effect of the push-pull force Fpp on the clamping force Fgrip. For example, in some embodiments, Θ OFFSET The value of Θ can be less than approximately 5 degrees. In some embodiments, Θ OFFSET The value can be approximately zero degrees. In other words, in some embodiments, when the end effector 4460 is in a closed configuration, the coupling between the first pulley 4562 and the first jaw 4462 is along the end effector centerline CL. As shown, the first output connector 4572 and the kinematic link L... I Within the first pulley envelope 4565. In other words, the jaw input length L I Less than or equal to the first input radius R1.

[0123] The proximal portion 4467 of the first jaw 4462 includes a first pulley connector 4472, which couples the first jaw 4462 to and transmits force from the first pulley 4562. Therefore, when an input torque T is applied to the first pulley 4562 by the first cable 4420... in When the transmission is passed to the first jaw 4462, the first jaw 4462 rotates about the jaw pivot axis A relative to the second jaw 4482 (and the U-shaped clamp 4610). JP Rotation, such as Figure 13A and Figure 13B As indicated by arrow GG, when the end effector is in its closed configuration, the jaw pivot axis A... JP Offset from the central axis A2 along the end effector centerline CL, which is defined by the central axis A2 and the jaw pivot axis A. JP Between (and perpendicular to the central axis A2 and the jaw pivot axis A) JP ),like Figure 12 As shown. Figure 13A and Figure 13B As shown, the pivot axis A of the jaws JP The offset distance from the central axis A2 is indicated as X. A The pivot axis A of the jawsJP Also offset from the first pulley connector 4472 is marked as L A The jaws apply a certain length. Therefore, the coupling of the jaws at the jaw pivot pin 4471 and the coupling of the first jaw 4462 and the first pulley 4562 at the first pulley connector 4472 define the length about the jaw pivot axis A. JP Rotation is labeled L A The kinematics of the applied link. The input link L is applied. A The end effector centerline CL forms an applied link angle, which is the first jaw 4462 about the central axis A2 and the jaw pivot axis A. JP Changes during rotation. When the end effector 4460 is in a closed configuration (see...). Figure 12 and Figure 13A When ), the input linkage angle is marked as Φ. OFFSET When the pulley is in the open position (see...) Figure 13B and Figure 14 During rotation, the applied link angle increases to Φ+Φ. OFFSET The value (also known as Φ) OVERALL As shown in the figure, the pivot axis A of the jaws... JP and kinematic link L A Within the first pulley envelope 4565.

[0124] As described above, both the first pulley 4562 and the second pulley 4582 define a jaw pivot opening (similar to jaw pivot openings 2569 and 2589 described above), through which a jaw pivot pin 4471 extends. More specifically, the jaw pivot opening is elongated to allow movement of the jaw pivot pin 4471 relative to the first pulley 4562 and the second pulley 4582 during operation (e.g., during relative movement between the jaws and the pulleys). Therefore, in some configurations (e.g., fully open), the walls of the pulleys defining jaw pivot can restrict the movement of the jaw pivot pin 4471. Specifically, as Figure 13A and Figure 13B As shown, when the jaws rotate relative to the pulley, the movement of the jaw pivot pin 4471 occurs within the jaw pivot pin envelope 4473 (where the movement along the end effector centerline CL is indicated as ΔX). A The jaw pivot opening can be of any suitable shape and size to restrict the movement of the jaw pivot pin 4471 during use.

[0125] like Figure 13A and Figure 13B As shown, the first tool assembly 4465 and the second tool assembly 4485 have a rear-pivoting topology. Specifically, the jaw pivot axis A JP It is further away from the tip of the jaws than the central axis A2. In other words, the central axis A2 is located at the jaw pivot axis A.JP Between the distal ends (or clamping portions) 4463 and 4483 of the jaws 4462 and 4482. Additionally, the first tool assembly 4465 and the second tool assembly 4485 have a forward clamping topology. Specifically, when the pulley rotates to move the end effector 4460 from a closed configuration ( Figure 13A Move to open configuration ( Figure 13B When ), the input link angle Θ increases.

[0126] In use, the end effector 4460 can amplify the input pulley force F. P This generates a higher clamping force, Fgrip, produced by the jaws 4462 and 4482 than that produced by a standard one-piece jaw and pulley system. Specifically, the input link L... I (including input link angle Θ) OFFSET ) and applying link L A The arrangement of the jaws and the length range of the claws can amplify the clamping force of Fgrip. Figure 14 A free-body drawing is provided showing the geometry of the first tool assembly 4465 when the end effector is in the open position. Input link L is considered separately. I The torque balance obtained around the central axis A2 is provided by equation (1), which can be reduced to produce equations (2) and (3) for the resultant force at the central axis A2.

[0127] Equation (1): ∑M dp =-T in +F i ·cos(θ+θ offset )·L i -F pp sin(θ+θ) offset )·L i =0

[0128] Equation (2):

[0129] Equation (3):

[0130] Consider applying the link L alone A Around the pivot axis A of the jaws JP The obtained torque balance can be provided by equation (4). Simplifying this equation (including replacing the expression with F) I Equation (5) generates the clamping force Fgrip. As shown in equation (5), the clamping force Fgrip includes the input torque T. in And the component of the push-pull force Fpp.

[0131] Equation (4):

[0132] ΣMa =-F i ·cos(φ+φ offset )·L a +F pp ·sin(φ+φ offset )·L a -F pp ·sin(φ)·(L o -L ttg )+F grip ·cos(φ)·(L o -L ttg Equation (5) = 0:

[0133]

[0134] If there is no push-pull force (i.e., Fpp = 0), the clamping force Fgrip is given by equation (6). As indicated, the clamping force increases with the increase of the angle. In addition, if the input link angle Θ is set to zero, the push-pull force Fpp has no effect on the clamping force Fgrip when the end effector 4460 is closed (see equation (7)).

[0135] Equation (6):

[0136] Equation (7):

[0137] Figure 15A , Figure 15B and Figure 16 This is a schematic diagram of the distal portion of a tool assembly 5465 of an end effector having a forward pivoting and forward clamping topology according to an embodiment. Specifically, Figure 15A and Figure 15B It is when the end effector is in the first (closed) configuration ( Figure 15A ) and the second (open) configuration ( Figure 15B (This is a magnified side view of a part of the tool component 5465.) Figure 16 This is a free-body diagram illustrating the forces and torques acting on various joints of tool assembly 5465. Tool assembly 5465 can be incorporated into any of the end effectors or medical devices described herein and can be configured to be the same as or similar to other tool assemblies described herein, and function the same as or similar to other tool assemblies described herein. For example, tool assembly 5465 can be a first tool assembly of an end effector including a second tool assembly, similar to the end effector 4460 described above. Therefore, certain aspects of tool assembly 5465 and end effectors including tool assembly 5465 are not described in detail below, but should be understood as aspects similar to those of the end effectors described herein (e.g., end effector 4460). For example, although Figure 15A, Figure 15B and Figure 16 The U-shaped clamp is not shown, but it should be understood that the tool assembly 5465 can be rotatably coupled to the central axis A2 of the U-shaped clamp (similar to the U-shaped clamp 4610 or any other U-shaped clamp as shown herein).

[0138] Tool assembly 5465 includes jaws 5462 connected to pulley 5562. Similar to jaw 4462, jaw 5462 includes a distal portion and a proximal portion 5467. The proximal portion 5467 includes a pulley connector 5472 that couples jaw 5462 to and transmits force from its mating pulley 5562. Additionally, the proximal portion 5467 of jaw 5462 is rotatably coupled to the proximal portion of a second jaw (not shown) via a jaw pivot pin 5471, which defines a jaw pivot axis A. JP The distal portions of the two jaws serve as gripping portions to cooperatively contact tissue, grasp needles, or perform other operations, as shown and described above with reference to jaws 4462 and 4482.

[0139] Pulley 5562 is a disc-shaped component rotatably coupled to a U-shaped clamp (not shown) about a central axis A2. Pulley 5562 includes an input connector 5564 and an output connector 5572, and defines a central opening 5568 and a jaw pivot opening (not identified, but it may be similar to the jaw pivot opening 2569 described above). A central pin may be coupled within the central opening 5568 to allow pulley 5562 and a second pulley (of the second tool assembly (not shown)) to rotate relative to the U-shaped clamp about the central axis A2, as indicated by arrow EE. Cable 5420 is coupled to pulley 5562 at the input connector 5564. Reference Figure 15A and Figure 15B Cable 5420 is coupled to pulley 5562 at a first input radius R1 from the central axis A2. Therefore, when the input pulley force is applied to pulley 5562 by cable 5420, an input torque T is generated around the central axis A2. in This causes pulley 5562 to rotate, as indicated by arrow EE. Additionally, pulley 5562 defines a pulley envelope 5565 as a cylindrical volume about a central axis A2, and the pulley envelope 5565 has an envelope radius equal to the outermost radius of pulley 5562. In some embodiments, the pulley envelope 5565 has an envelope radius equal to the first input radius R1. In some embodiments, the pulley envelope 5565 is the same as the pulley envelope defined by the second pulley.

[0140] The output connector 5572 can be any suitable connector or mechanism that couples the jaws 5462 to the pulley 5562 to transmit force from the pulley 5562 to the jaws 5462. (Reference) Figure 15A and Figure 15B The radial offset of output connector 5572 from the central axis A2 is marked as L. I The input length of the jaws. Therefore, the coupling between pulley 5562 and jaws 5462 defines the rotation about the central axis A2, denoted as L. I The kinematic input link. Input link L I The input link angle is formed with the centerline CL of the end effector, and this input link angle changes as pulley 5562 rotates about the central axis A2. When the end effector is in the closed configuration (see...), Figure 15A The input linkage angle is marked as Θ. OFFSET When the pulley is in the open position (see...) Figure 15B During rotation, the input link angle increases to Θ+Θ. OFFSET (also known as Θ) OVERALL The value of Θ. As described in more detail below, Θ OFFSET The value of Θ can be selected to minimize the effect of the push-pull force Fpp on the clamping force Fgrip. For example, in some embodiments, Θ OFFSET The value of Θ can be less than approximately 5 degrees. In some embodiments, Θ OFFSET The value can be approximately zero degrees. In other words, in some embodiments, when the end effector is in a closed configuration, the coupling between pulley 5562 and jaw 5462 is along the end effector centerline CL. As shown, the output connector 5572 and the kinematic link L... I Within the pulley envelope 5565. In other words, the jaw input length L I Less than or equal to the first input radius R1.

[0141] The proximal portion 5467 of the jaws 5462 includes a pulley connector 5472, which connects the jaws 5462 to the pulley 5562 and transmits force from the pulley 5562. Therefore, when an input torque T is applied to the pulley 5562 via the cable 5420... in The transmission is passed to jaw 5462, which pivots relative to the second jaw (and the U-shaped clamp; not shown) about jaw pivot axis A. JP Rotation. As indicated by arrow GG. When the end effector is in its closed configuration, the jaws pivot along axis A. JP Offset from the central axis A2 along the end effector centerline CL, which is defined by the central axis A2 and the jaw pivot axis A. JP Between (and perpendicular to the central axis A2 and the jaw pivot axis A) JP ). Pliers pivot axis A JP And the central axis A2 is indicated as X A The pivot axis A of the jaws JP Also offset from pulley connector 5472 is marked as L AThe jaws apply a certain length. Therefore, the coupling of the jaws at the jaw pivot pin 5471 and the coupling of the jaws 5462 and pulley 5562 at the pulley connector 5472 define the length about the jaw pivot axis A. JP Rotation is labeled L A The kinematics of the applied link. The input link L is applied. A The end effector centerline CL forms an applied link angle, which is the angle at which the jaws 5462 rotate around the central axis A2 and the jaw pivot axis A. JP Changes during rotation. When the end effector is in a closed configuration (see...). Figure 15A When ), the input linkage angle is marked as Θ. OFFSET When the pulley is in the open position (see...) Figure 15B and Figure 16 During rotation, the applied link angle increases to Φ+Φ. OFFSET The value (also known as Φ) OVERALL As shown in the figure, the pivot axis A of the jaws... JP and kinematic link L A Within the pulley envelope 5565.

[0142] As described above, both pulley 5562 and the second pulley (not shown) define a jaw pivot opening (similar to jaw pivot openings 2569 and 2589 described above), through which jaw pivot pin 5471 extends. More specifically, the jaw pivot opening is elongated to allow movement of jaw pivot pin 5471 relative to the pulley during operation (e.g., during relative movement between the jaws and the pulley). Therefore, in some configurations (e.g., fully open), the wall of the pulley can restrict the movement of jaw pivot pin 5471. Specifically, as Figure 15A and Figure 15B As shown, when the jaws rotate relative to the pulley, the movement of the jaw pivot pin 5471 occurs within the jaw pivot pin envelope 5473.

[0143] As shown in the figure, tool assembly 5465 has a front-pivoting topology. Specifically, the central axis A2 is further away from the jaw tip than the jaw pivot axis A. In other words, the jaw pivot axis A... JP Between the central axis A2 and the distal end (or clamping portion) of the jaws 5462. Additionally, similar to the tool assembly 4465 described above, tool assembly 5465 has a forward clamping topology. Specifically, when the pulley rotates to move the end effector from the closed configuration ( Figure 15A Move to open configuration ( Figure 15B When ), the input link angle Θ increases.

[0144] In use, the end effector can amplify the input pulley force F. PThis generates a higher clamping force, Fgrip, produced by the jaws than a standard one-piece jaw and pulley system. Specifically, the input link L... I (including input link angle Θ) OFFSET ) and applying link L A The arrangement of the jaws and the length range of the claws can amplify the clamping force of Fgrip. Figure 16 A free-body drawing is provided showing the geometry of tool assembly 5465 when the end effector is in the open position. Input link L is considered separately. I The torque balance obtained around the central axis A2 is provided by equation (8), which can be reduced to produce equations (9) and (10) for the resultant force at the central axis A2.

[0145] Equation (8): ΣM dp =T in -F i ·cos(θ+θ offset )·L i -F pp sin(θ+θ) offset )·L i =0

[0146] Equation (9):

[0147] Equation (10):

[0148] Consider applying the link L alone A Around the pivot axis A of the jaws JP The obtained torque balance can be provided by equation (11). Simplifying this equation (including replacing the expression with F) I Equation (12) generates the clamping force Fgrip. As shown in equation (12), the clamping force Fgrip includes the input torque T. in And the component of the push-pull force Fpp.

[0149] Equation (11):

[0150] ΣM a =-F i ·cos(φ+φ offset )·L a +F pp ·sin(φ+φ offset )·L a +F pp ·sin(φ)·(L o -L ttg )+F grip ·cos(φ)·(L o -L ttgEquation (12) = 0:

[0151]

[0152] If there is no push-pull force (i.e., Fpp = 0), the clamping force Fgrip is given by equation (13). As indicated, the clamping force increases with the increase of the angle. In addition, if the input link angle Θ is set to zero, the push-pull force Fpp has no effect on the clamping force Fgrip when the end effector is closed (see equation (14)).

[0153] Equation (13):

[0154] Equation (14):

[0155] Figure 17A , Figure 17B and Figure 18 This is a schematic diagram of the distal portion of a tool assembly 6465 of an end effector having a rear-pivoting and reverse-clamping topology according to an embodiment. Specifically, Figure 17A and Figure 17B It is when the end effector is in the first (closed) configuration ( Figure 17A ) and the second (open) configuration ( Figure 17B (This is a magnified side view of a part of the tool component 6465.) Figure 18 This is a free-body diagram illustrating the forces and torques acting on various joints of tool assembly 6465. Tool assembly 6465 can be incorporated into any of the end effectors or medical devices described herein and can be configured to be the same as or similar to other tool assemblies described herein, and function the same as or similar to other tool assemblies described herein. For example, tool assembly 6465 can be a first tool assembly of an end effector including a second tool assembly, similar to the end effector 4460 described above. Therefore, certain aspects of tool assembly 6465 and end effectors including tool assembly 6465 are not described in detail below, but should be understood as aspects similar to those of the end effectors described herein (e.g., end effector 4460). For example, although Figure 17A , Figure 17B and Figure 18 The U-shaped clamp is not shown, but it should be understood that the tool assembly 6465 can be rotatably coupled to the central axis A2 of the U-shaped clamp (similar to the U-shaped clamp 4610 or any other U-shaped clamp as shown herein).

[0156] Tool assembly 6465 includes a jaw 6462 connected to a pulley 6562. Similar to jaw 4462, jaw 6462 includes a distal portion and a proximal portion 6467. The proximal portion 6467 includes a pulley connector 6472 that couples jaw 6462 to and transmits force from its mating pulley 6562. Additionally, the proximal portion 6467 of jaw 6462 is rotatably coupled to the proximal portion of a second jaw (not shown) via a jaw pivot pin 6471, which defines a jaw pivot axis A. JP The distal portions of the two jaws serve as gripping portions to cooperatively contact tissue, grasp needles, or perform other operations, as shown and described above with reference to jaws 4462 and 4482.

[0157] Pulley 6562 is a disc-shaped component rotatably coupled to a U-shaped clamp (not shown) about a central axis A2. Pulley 6562 includes an input connector 6564 and an output connector 6572, and defines a central opening 6568 and a jaw pivot opening (not identified, but it may be similar to the jaw pivot opening 2569 described above). A central pin may be coupled within the central opening 6568 to allow pulley 6562 and a second pulley (of the second tool assembly (not shown)) to rotate relative to the U-shaped clamp about the central axis A2, as indicated by arrow EE. Cable 6420 is coupled to pulley 6562 at input connector 6564. Reference Figure 17A and Figure 17B Cable 6420 is coupled to pulley 6562 at a first input radius R1 from the central axis A2. Therefore, when the input pulley force is applied to pulley 6562 by cable 6420, an input torque T is generated around the central axis A2. in This causes pulley 6562 to rotate, as indicated by arrow EE. Additionally, pulley 6562 defines a pulley envelope 6565 as a cylindrical volume about a central axis A2, and the pulley envelope 6565 has an envelope radius equal to the outermost radius of pulley 6562. In some embodiments, the pulley envelope 6565 has an envelope radius equal to a first input radius R1.

[0158] The output connector 6572 can be any suitable connector or mechanism that couples the jaws 6462 to the pulley 6562 to transmit force from the pulley 6562 to the jaws 6462. (Reference) Figure 17A and Figure 17B The output connector 6572 is radially offset from the central axis A2, which is marked as L. I The input length of the jaws. Therefore, the coupling between pulley 6562 and jaws 6462 defines the rotation about the central axis A2, denoted as L. I The kinematic input link. Input link L IThe input link angle is formed with the centerline CL of the end effector, and this input link angle changes as pulley 6562 rotates about the central axis A2. When the end effector is in a closed configuration (see...), Figure 17A When ), the input linkage angle is marked as Θ. OFFSET When the pulley is in the open position (see...) Figure 17B During rotation, the input link angle increases to Θ+Θ. OFFSET (also known as Θ) OVERALL The value of Θ. As described in more detail below, Θ OFFSET The value of Θ can be selected to minimize the effect of the push-pull force Fpp on the clamping force Fgrip. For example, in some embodiments, Θ OFFSET The value of Θ can be less than approximately 5 degrees. In some embodiments, Θ OFFSET The value can be approximately zero degrees. In other words, in some embodiments, when the end effector is in a closed configuration, the coupling between pulley 6562 and jaw 6462 is along the end effector centerline CL. As shown, output connector 6572 and kinematic link L I Within the pulley envelope of 6565. In other words, the jaw input length L I Less than or equal to the first input radius R1.

[0159] The proximal portion 6467 of the jaws 6462 includes a pulley connector 6472, which connects the jaws 6462 to the pulley 6562 and transmits force from the pulley 6562. Therefore, when an input torque T is applied to the pulley 6562 via the cable 6420... in The transmission is transferred to jaw 6462, which pivots relative to the second jaw (and the U-shaped clamp; not shown) about jaw pivot axis A. JP Rotation. As indicated by arrow GG. When the end effector is in its closed configuration, the jaws pivot along axis A. JP Offset from the central axis A2 along the end effector centerline CL, which is defined by the central axis A2 and the jaw pivot axis A. JP Between (and perpendicular to the central axis A2 and the jaw pivot axis A) JP ). Pliers pivot axis A JP And the central axis A2 is indicated as X A The pivot axis A of the jaws JP Also offset from pulley connector 6472 is marked as L A The jaws apply a certain length. Therefore, the coupling of the jaws at the jaw pivot pin 6471 and the coupling of the jaws 6462 and pulley 6562 at the pulley connector 6472 define the length about the jaw pivot axis A. JP Rotation is labeled L A The kinematics of the applied link. The input link L is applied. AThe end effector centerline CL forms an applied link angle, which is the angle at which the jaws 6462 rotate around the central axis A2 and the jaw pivot axis A. JP Changes during rotation. When the end effector is in a closed configuration (see...). Figure 17A When ), the input linkage angle is marked as Θ. OFFSET When the pulley is in the open position (see...) Figure 17B and Figure 18 During rotation, the applied link angle increases to Φ+Φ. OFFSET The value (also known as Φ) OVERALL As shown in the figure, the pivot axis A of the jaws... JP and kinematic link L A Within the pulley envelope 6565.

[0160] As described above, both pulley 6562 and the second pulley (not shown) define a jaw pivot opening (similar to jaw pivot openings 2569 and 2589 described above), through which jaw pivot pin 6471 extends. More specifically, the jaw pivot opening is elongated to allow movement of jaw pivot pin 6471 relative to the pulley during operation (e.g., during relative movement between the jaws and the pulley). Therefore, in some configurations (e.g., fully open), the wall of the pulley can restrict the movement of jaw pivot pin 6471. Specifically, as Figure 17A and Figure 17B As shown, when the jaws rotate relative to the pulley, the movement of the jaw pivot pin 6471 occurs within the jaw pivot pin envelope 6473.

[0161] As shown in the figure, tool assembly 6465 has a rear-pivoting topology. Specifically, the jaw pivot axis A... JP It is further away from the tip of the jaws than the central axis A2. In other words, the central axis A2 is located at the jaw pivot axis A. JP Between the distal end (or gripping portion) of the jaws 6462 and the tool assembly 6465. Additionally, tool assembly 6465 has a reverse gripping topology compared to tool assemblies 4465 and 5465. Specifically, when the pulley rotates to move the end effector from the closed configuration ( Figure 17A Move to open configuration ( Figure 17B When ), the input link angle Θ decreases.

[0162] In use, the end effector can amplify the input pulley force F. P This generates a higher clamping force, Fgrip, produced by the jaws than a standard one-piece jaw and pulley system. Specifically, the input link L... I (including input link angle Θ) OFFSET ) and applying link L A The arrangement of the jaws and the length range of the claws can amplify the clamping force of Fgrip. Figure 18A free-body drawing is provided showing the geometry of tool assembly 6465 when the end effector is in the open position. Input link L is considered separately. I The torque balance obtained around the central axis A2 is provided by equation (15), which can be reduced to produce equations (16) and (17) for the resultant force at the central axis A2.

[0163] Equation (15): ΣM dp =-T in +F i ·cos(θ+θ offset )·L i +F pp ·sin(-(θ+θ offset ))·L i =0

[0164] Equation (16):

[0165] Equation (17):

[0166] Consider applying the link L alone A Around the pivot axis A of the jaws JP The obtained torque balance can be provided by equation (18). Simplifying this equation (including replacing the expression with F) I Equation (19) generates the clamping force Fgrip. As shown in equation (19), the clamping force Fgrip includes the input torque T. in And the component of the push-pull force Fpp.

[0167] Equation (18):

[0168] ∑M a =-F i ·cos(-(φ+φ offset ))·L a -F pp ·sin(-(φ+φ offset ))·L a -F pp ·sin(φ)·(L o -L ttg )+F grip ·cos(φ)·(L o -L ttg ) = 0

[0169] Equation (19):

[0170]

[0171]

[0172] If there is no push-pull force (i.e., Fpp = 0), the clamping force Fgrip is given by equation (20). As indicated, the clamping force increases with the increase of the angle. In addition, if the input link angle Θ is set to zero, the push-pull force Fpp has no effect on the clamping force Fgrip when the end effector is closed (see equation (14)).

[0173] Equation (20):

[0174] Equation (21):

[0175] Figure 19A and Figure 19B This is a schematic diagram of the distal portion of a tool assembly 7465 of an end effector having a forward pivoting and reverse clamping topology according to an embodiment. Specifically, Figure 19A and Figure 19B It is when the end effector is in the first (closed) configuration ( Figure 19A ) and the second (open) configuration ( Figure 19B This is an enlarged side view of a portion of tool assembly 7465. Tool assembly 7465 may be incorporated into any of the end effectors or medical devices described herein and may be configured to be the same as or similar to other tool assemblies described herein, and function the same as or similar to other tool assemblies described herein. For example, tool assembly 7465 may be a first tool assembly of an end effector including a second tool assembly, similar to the end effector 4460 described above. Therefore, certain aspects of tool assembly 7465 and end effectors including tool assembly 7465 are not described in detail below, but should be understood as aspects similar to those of the end effectors described herein (e.g., end effector 4460). For example, although Figure 19A and Figure 19B The U-shaped clamp is not shown, but it should be understood that the tool assembly 7465 can be rotatably coupled to the central axis A2 of the U-shaped clamp (similar to the U-shaped clamp 4610 or any other U-shaped clamp as shown herein).

[0176] Tool assembly 7465 includes a jaw 7462 connected to a pulley 7562. Similar to jaw 4462, jaw 7462 includes a distal portion and a proximal portion 7467. The proximal portion 7467 includes a pulley connector 7472 that couples jaw 7462 to and transmits force from its mating pulley 7562. Additionally, the proximal portion 7467 of jaw 7462 is rotatably coupled to the proximal portion of a second jaw (not shown) via a jaw pivot pin 7471, which defines a jaw pivot axis A. JPThe distal portions of the two jaws serve as gripping portions to cooperatively contact tissue, grasp needles, or perform other operations, as shown and described above with reference to jaws 4462 and 4482.

[0177] Pulley 7562 is a disc-shaped component rotatably coupled to a U-shaped clamp (not shown) about a central axis A2. Pulley 7562 includes an input connector 7564 and an output connector 7572, and defines a central opening 7568 and a jaw pivot opening (not identified, but it may be similar to the jaw pivot opening 2569 described above). A central pin may be coupled within the central opening 7568 to allow pulley 7562 and a second pulley (of the second tool assembly (not shown)) to rotate relative to the U-shaped clamp about the central axis A2, as indicated by arrow EE. Cable 7420 is coupled to pulley 7562 at input connector 7564. Reference Figure 19A and Figure 19B Cable 7420 is coupled to pulley 7562 at a first input radius R1 from the central axis A2. Therefore, when the input pulley force is applied to pulley 7562 by cable 7420, an input torque T is generated around the central axis A2. in This causes pulley 7562 to rotate, as indicated by arrow EE. Additionally, pulley 7562 defines pulley envelope 7565 as a cylindrical volume about central axis A2, and pulley envelope 7565 has an envelope radius equal to the outermost radius of pulley 7562.

[0178] The output connector 7572 can be any suitable connector or mechanism that couples the jaws 7462 to the pulley 7562 to transmit force from the pulley 7562 to the jaws 7462. The radial offset of the output connector 7572 from the central axis A2 is designated as L. I The input length of the jaws. Therefore, the coupling between pulley 7562 and jaws 7462 defines the rotation about the central axis A2, denoted as L. I The kinematic input link. Input link L I The input link angle is formed with the centerline CL of the end effector, and this input link angle changes as pulley 7562 rotates about the central axis A2. When the end effector is in a closed configuration (see...), Figure 19A When ), the input linkage angle is marked as Θ. OFFSET When the pulley is in the open position (see...) Figure 19B During rotation, the input link angle increases to Θ+Θ. OFFSET (also known as Θ) OVERALL The value of Θ. As described in more detail below, Θ OFFSET The value of Θ can be selected to minimize the effect of the push-pull force Fpp on the clamping force Fgrip. For example, in some embodiments, Θ OFFSET The value of Θ can be less than approximately 5 degrees. In some embodiments, Θ OFFSETThe value can be approximately zero degrees. In other words, in some embodiments, when the end effector is in a closed configuration, the coupling between pulley 7562 and jaw 7462 is along the end effector centerline CL. As shown, the output connector 7572 and the kinematic link L... I Within the pulley envelope 7565. In other words, the jaw input length L I Less than or equal to the first input radius R1.

[0179] The proximal portion 7467 of the jaws 7462 includes a pulley connector 7472, which connects the jaws 7462 to the pulley 7562 and transmits force from the pulley 7562. Therefore, when an input torque T is applied to the pulley 7562 via the cable 7420... in The transmission is transferred to jaw 7462, which pivots relative to the second jaw (and the U-shaped clamp; not shown) about jaw pivot axis A. JP Rotation. As indicated by arrow GG. When the end effector is in its closed configuration, the jaws pivot along axis A. JP Offset from the central axis A2 along the end effector centerline CL, which is defined by the central axis A2 and the jaw pivot axis A. JP Between (and perpendicular to the central axis A2 and the jaw pivot axis A) JP ). Pliers pivot axis A JP And the central axis A2 is indicated as X A The pivot axis A of the jaws JP Also offset from pulley connector 7472 is marked as L A The jaws apply a certain length. Therefore, the coupling of the jaws at the jaw pivot pin 7471 and the coupling of the jaws 7462 and pulley 7562 at the pulley connector 7472 define the length about the jaw pivot axis A. JP Rotation is labeled L A The kinematics of the applied link. The input link L is applied. A The end effector centerline CL forms an application link angle, which is the angle at which the jaws 7462 rotate around the central axis A2 and the jaw pivot axis A. JP Changes during rotation. When the end effector is in a closed configuration (see...). Figure 19A When ), the input linkage angle is marked as Θ. OFFSET When the pulley is in the open position (see...) Figure 19B During rotation, the applied link angle increases to Φ+Φ. OFFSET The value (also known as Φ) OVERALL As shown in the figure, the pivot axis A of the jaws... JP and kinematic link L A Within the pulley envelope 7565.

[0180] As described above, both pulley 7562 and the second pulley (not shown) define a jaw pivot opening (similar to jaw pivot openings 2569 and 2589 described above), through which jaw pivot pin 7471 extends. More specifically, the jaw pivot opening is elongated to allow movement of jaw pivot pin 7471 relative to the pulley during operation (e.g., during relative movement between the jaws and the pulley). Therefore, in some configurations (e.g., fully open), the wall of the pulley can restrict the movement of jaw pivot pin 7471. Specifically, as Figure 19A and Figure 19B As shown, when the jaws rotate relative to the pulley, the movement of the jaw pivot pin 7471 occurs within the jaw pivot pin envelope 7473.

[0181] As shown in the figure, tool assembly 7465 has a front-pivoting topology. Specifically, the central axis A2 is further away from the jaw tip than the jaw pivot axis A. In other words, the jaw pivot axis A... JP Between the central axis A2 and the distal end (or clamping portion) of the jaws 7462. Additionally, similar to the tool assembly 4465 described above, tool assembly 7465 has a reverse clamping topology. Specifically, when the pulley rotates to move the end effector from the closed configuration ( Figure 19A Move to open configuration ( Figure 19B When the input link angle Θ decreases, the end effector can amplify the input pulley force F in a manner similar to that described herein. P This allows Fgrip to generate a higher clamping force from the jaws than that produced by a standard one-piece jaw and pulley system.

[0182] Figure 20-28 Various views of an instrument 8400 with an end effector 8460 according to an embodiment are shown. The end effector 8460 has a rear-pivoting and forward-clamping topology, with pulleys between jaws. The instrument 8400, or any component thereof, may optionally be part of a surgical system that performs surgical procedures and may include a manipulator unit, a series of kinematic links, a series of cannulas, etc. Instrument 8400 (and any instruments described herein) can be used in any suitable surgical system, such as the MIRS system 1000 shown and described above. Instrument 8400 includes a mechanical structure 8700, a shaft 8410, a wrist assembly 8500, and an end effector 8460. Figure 22 As shown, the device 8400 also includes a first pitch cable 8405 and a second pitch cable 8406 that couple the mechanical structure 8700 to the distal U-shaped clip 8610 of the wrist assembly 8500. The device 8400 is configured such that movement of the first pitch cable 8405 and the second pitch cable 8406 produces rotation of the wrist assembly 8500 about a first rotation axis A1 (i.e., pitch rotation, the term pitch is arbitrary) (see [reference]). Figure 21 (See arrow HH in the image). The device 8400 also includes a first cable 8420 and a second cable 8440 that couple the mechanical structure 8700 to the end effector 8460. (As shown in the image) Figure 22 As shown, the first cable 8420 forms a cable loop having a first proximal portion 8421, a distal portion 8422, and a second proximal portion 8431. The distal portion 8422 is coupled to the input connector 8564 of the first pulley 8562, as described in more detail below. The first proximal portion 8421 and the second proximal portion 8431 are routed proximally to the mechanical structure 8700. The second cable 8440 forms a cable loop having a first proximal portion 8441, a distal portion 8442, and a second proximal portion 8451. The distal portion 8442 is coupled to the input connector 8584 of the second pulley 8582, as described in more detail below. The first proximal portion 8441 and the second proximal portion 8451 are routed proximally to the mechanical structure 8700. Movement of the first cable 8420 and the second cable 8440 produces a yaw rotation of the end effector 8460 about the second axis of rotation A2 (the term yaw is arbitrary) (see [reference]). Figure 21 The movement of the tool component of the end effector 8460 (as indicated by arrow JJ) around the second axis of rotation A2, or any combination of these movements, is considered. Specifically, yaw rotation occurs when the first and second cables are driven in the same direction. In this case, the jaws and pulleys move together as a unit without amplification. Conversely, clamping rotation involves driving the cables in opposite directions. Changing the pitch or yaw of the instrument 8400 can be performed by manipulating the cables (i.e., moving or changing the tension in the cables).

[0183] The shaft 8410 can be any suitable elongated shaft that couples the wrist assembly 8500 to the mechanical structure 8700. Specifically, the shaft 8410 includes a proximal end 8411 coupled to the mechanical structure 8700 and a distal end 8412 coupled to a proximal U-shaped clip 8510 of the wrist assembly 8500. The shaft 8410 defines a lumen (not shown) or multiple channels through which cables and other components (e.g., wires, grounding wires, etc.) can be routed from the mechanical structure 8700 to the wrist assembly 8500.

[0184] Mechanical structure 8700 functions as an actuator or transmission device or “transmission assembly” to move cables, thereby generating desired movement (pitch, yaw, or clamping) at wrist assembly 8500. Specifically, mechanical structure 8700 includes components and controls to move some cables in a proximal direction (i.e., pull some cables) while allowing other cables to move distally by an equal length (i.e., release or “release”). In this way, mechanical structure 8700 can maintain desired tension within the cables and can ensure that the length of the cables is maintained (i.e., moved by an equal amount) throughout the entire range of motion of wrist assembly 8500. In some embodiments, for example, mechanical structure 8700 can be any transmission assembly shown and described in International Patent Application No. PCT / US2017 / 062258 (filed November 14, 2017) entitled “Cable Length Conserving Medical Instrument,” which is incorporated herein by reference in its entirety. However, in other embodiments, it is not necessary to maintain the length of the cables.

[0185] In some embodiments, mechanical structure 8700 may include one or more linear actuators that produce translation (linear motion) of a portion of the cable. Such a mechanism may include, for example, a universal joint, a lever, or any other suitable mechanism to directly pull (or release) any end portion of the cable. For example, in some embodiments, mechanical structure 8700 may include any drive assembly or component described in U.S. Patent Application Publication No. US2015 / 0047454A1 (filed August 15, 2014), entitled “Lever Actuated Gimbal Plate,” or U.S. Patent No. US6,817,974B2 (filed June 28, 2001), entitled “Surgical Tool Having Positively Positionable Tendon-Actuated Multi-Disk Wrist Joint,” each of which is incorporated herein by reference in its entirety. However, in other embodiments, mechanical structure 8700 may include a winch or other motor-driven roller that rotates or “wraps” a portion of any cable to produce the desired cable movement. For example, in some embodiments, mechanical structure 8700 may include any back-end components or parts described in U.S. Patent No. 9,204,923B2 (filed July 16, 2008) entitled “Medical Instrument Electronically Energized Using Drive Cables,” which is incorporated herein by reference in its entirety.

[0186] Reference Figure 21-22The wrist assembly 8500 includes a first U-shaped clip 8510 (which serves as a proximal first link) and a second U-shaped clip 8610 (which serves as a distal second link). The first U-shaped clip 8510 has a proximal portion 8511 and a distal portion 8512. The proximal portion 8511 is coupled to the distal portion 8412 of the instrument axis 8410. The distal portion 8512 includes a joint portion rotatably coupled to a mating joint portion of the second U-shaped clip 8610. In this way, the first U-shaped clip 8510 and the second U-shaped clip 8610 form a wrist assembly 8500 having a first axis of rotation A1 (also referred to as a pitch axis), about which the second link 8610 is rotatable relative to the first link 8510. A pin 8543 extends through an opening 8542 at the distal end 8512 of the first U-shaped clip 8510 to rotatably couple the second U-shaped clip 8610 to the first U-shaped clip 8510.

[0187] The second U-clamp 8610 has a proximal portion 8611 and a distal portion 8612. As described above, the proximal portion 8611 includes a joint portion rotatably coupled to the first U-clamp 8510. The proximal portion 8611 also defines a connector 8652 to which the first pitch cable 8405 and the second pitch cable 8406 are coupled. The second U-clamp 8610 also includes a first pulley shaft 8618 and a second pulley shaft 8623, which support cable pulleys as described below. The distal portion 8612 of the second U-clamp 8610 is coupled to the end effector 8460 via a center pin 8683. In this way, the first tool assembly 8465 and the second tool assembly 8485 can rotate relative to the second U-clamp 8610 about a second axis of rotation (also referred to as the yaw axis) A2. Figure 21 As shown, the second rotation axis A2 (also known as the yaw axis) is not parallel to the pitch axis A1. Therefore, the instrument 8400 provides up to three degrees of freedom (i.e., pitch motion about the first rotation axis A1, yaw motion about the second rotation axis A2, and clamping motion about the second rotation axis A2).

[0188] A first U-shaped clip 8510 and a second U-shaped clip 8610 define one or more guide channels through which cables are routed, and the one or more guide channels are accommodating relative movement between the first U-shaped clip 8510 and the second U-shaped clip 8610. The first U-shaped clip 8510 and the second U-shaped clip 8610 also include one or more guide pulleys around which cables are routed to minimize cable friction and maintain a desired minimum bending radius of the cable during use. Figure 22 and Figure 24As shown, the first U-shaped clamp 8510 includes a first pulley 8516 and a second pulley 8521 around which a first cable 8420 is routed, and a third pulley 8526 and a fourth pulley 8531 around which a second cable 8440 is routed. The first pulley 8516 and the third pulley 8526 rotate around a pin 8543 on one side of the second U-shaped clamp 8610, and the second pulley 8521 and the fourth pulley 8531 rotate around the pin 8543 on the other side of the second U-shaped clamp 8610. The second U-shaped clamp 8610 includes a first pulley 8816 and a second pulley 8821 around which the first cable 8420 is routed, and a third pulley 8826 and a fourth pulley 8831 around which the second cable 8440 is routed. The first pulley 8616 and the third pulley 8626 rotate around the first axis 8618 of the second U-shaped clamp 8610, and the second pulley 8621 and the fourth pulley 8631 rotate around the second axis 8623 of the second U-shaped clamp 8610.

[0189] The end effector 8460 includes a first tool assembly 8465 (which serves as a first jaw-pulley pair) and a second tool assembly 8485 (which serves as a second jaw-pulley pair). Although the first tool assembly 8465 and the second tool assembly 8485 are separate components that cooperate to form the end effector 8460, aspects of the first tool assembly 8465 described below (e.g., the markings of the kinematic links formed by the first tool assembly) apply to the second tool assembly 8485, and vice versa. The first tool assembly 8465 includes a first jaw 8462 coupled to a first pulley 8562, and the second tool assembly 8485 includes a second jaw 8482 coupled to a second pulley 8582.

[0190] The first pulley 8562 is a disc-shaped component rotatably coupled to the second U-clamp 8610 via a center pin 8683. The first pulley 8562 includes a first input connector 8564 and a first output pin 8572, and defines a central opening 8568 and a first jaw pivot opening 8569. The center pin 8683 is coupled within the central opening 8568 to allow the first pulley 8562 to rotate relative to the U-clamp 8610 about a yaw axis A2, such that... Figure 21 As indicated by arrow JJ. As described in more detail below, the first jaw pivot opening 8569 is elongated to allow movement of the jaw pivot pin 8471 relative to the first pulley 8562 and the second pulley 8562. 8582. The distal end 8422 of the first cable 8420 is coupled to the first pulley 8562 at the first input connector 8564 via a cable crimp (not shown). The first output pin 8572 is matingly coupled within the first pulley opening 8472 of the first jaw 8462 to transmit force from the first pulley 8562 to the first jaw 8462.

[0191] The first jaw 8462 includes a distal portion 8463 and a proximal portion 8467. The distal portion 8463 serves as a gripping portion to engage with the second jaw 8482 to contact tissue, grasp a needle (e.g., needle 8010), or perform other operations. The proximal portion 8467 defines a first pulley opening 8472, a first jaw pivot opening 8469, and a first central opening 8468. As shown, a central pin 8683 extends through the first central opening 8468, which is elongated to allow linear movement of the first jaw 8462 and the second jaw 8482 about the central pin 8683 during operation. The first jaw 8462 is rotatably coupled to the second jaw 8482 via a jaw pivot pin 8471, which defines a jaw pivot axis A. JP (see Figure 25 The jaw pivot pin 8471 is rotatably coupled within the first jaw pivot opening 8469 (and the second jaw pivot opening 8489). Therefore, when the torque applied to the first pulley 8562 by the first cable 8420 is transmitted to the first jaw 8462, the first jaw 8462 relative to the second jaw 8482 (and the U-clamp 8610) about the jaw pivot axis A. JP Rotation. Because the jaws do not rotate relative to each other about the center pin 8683, there is some translational motion relative to the center pin 8683 when the jaws rotate, which is allowed by including the first center opening 8468 (and the second center opening 8488). Jaw pivot axis A JP The yaw axis A2 is deviated from the centerline CL of the end effector.

[0192] The second pulley 8582 is a disc-shaped member rotatably coupled to the second U-clamp 8610 via a center pin 8683. The second pulley 8582 includes a second input connector 8584 and a second output pin 8592, and defines a central opening 8588 and a second jaw pivot opening 8589. The center pin 8683 is coupled within the central opening 8588 to allow the second pulley 8582 to rotate relative to the U-clamp 8610 about a yaw axis A2. As described in more detail below, the second jaw pivot opening 8589 is elongated to allow movement of the jaw pivot pin 8471 relative to the second pulley 8582 and the first pulley 8562 during operation. The distal end 8442 of the second cable 8440 is coupled to the second pulley 8582 at the second input connector 8584 via a cable crimp (not shown). The second output pin 8592 is coupled to the second pulley opening 8492 of the second jaw 8482 to transmit force from the second pulley 8582 to the second jaw 8482.

[0193] The second jaw 8482 includes a distal portion 8483 and a proximal portion 8487. The distal portion 8483 serves as a clamping portion to engage with the first jaw 8462 (e.g., to grip the pin 8010). The proximal portion 8487 defines a second pulley opening 8492, a second jaw pivot opening 8489, and a second center opening 8488. As shown, a center pin 8683 extends through the second center opening 8488, which is elongated to allow movement of the second jaw 8482 and the first jaw 8462 about the center pin 8683 during operation. When torque applied to the second pulley 8582 by the second cable 8440 is transmitted to the second jaw 8482, the second jaw 8482 moves about the jaw pivot axis A. JP Rotate relative to the first jaw 8462 (and the U-shaped clamp 8610).

[0194] At an input radius from the yaw axis A2, a first cable 8420 is coupled to a first pulley 8562, and a second cable 8440 is coupled to a second pulley 8582. Therefore, when an input pulley force is applied to the pulleys by the cables, an input torque is generated around the yaw axis A2 to rotate the pulleys. Additionally, the first pulley 8562 and the second pulley 8582 enclose the pulley envelope 8565 (see...). Figure 25 The volume is defined as a cylindrical volume around the yaw axis A2, and the pulley envelope 8565 has an envelope radius equal to the outermost radius of the pulley.

[0195] The geometry and kinematic linkages formed by the first and second tool assemblies 8465 and 8485 are similar to those shown above for the first and second tool assemblies 4465 and 4485, and therefore will not be described in detail here. For example, the geometry of the jaws 4462 and 4482 (e.g., total length, clamping length, and tip-to-clamping distance) is the same as that of the jaws 8462 and 8482. Additionally, the jaw pivot axis A... JP The offset relative to the yaw axis A2 (in the rear pivot configuration) and the applied length L of the jaws 4462 and 4482. A The applied length is the same as that of the clamps 8462 and 8482. Similarly, the kinematic input link L... I The input links are confined within pulleys 4562 and 4582, and the input link angle Θ is the same as that of pulleys 8562 and 8582. Furthermore, as described above, these kinematic links and the input radius (similar to the radius R1 described herein) remain within the pulley envelope 8565.

[0196] Therefore, in use, the end effector 8460 can amplify the input pulley force to produce a higher clamping force by the jaws 8462, 8482 than that produced by a standard one-piece jaw and pulley system. As described herein with respect to end effector 4460, end effector 8460 (and each of the tool assemblies 8465, 8485) includes additional kinematic linkages to increase the torque arm on which the input pulley force is applied, thereby increasing the output clamping force.

[0197] Furthermore, the elongated shape of the first jaw pivot opening 8569 and the second jaw pivot opening 8589 allows relative movement between each pulley and its corresponding jaw (e.g., the second pulley 8582 and the second jaw 8482). The configuration of the first jaw pivot opening 8569 and the second jaw pivot opening 8589 also allows this relative movement while positioning the jaw pivot axis A... JP and kinematic links (e.g., input link L) I and applying link L A The jaws remain within the pulley envelope 8565. Because the jaw pivot pin 8471 is within each of the first jaw pivot opening 8569 and the second jaw pivot opening 8589, in certain configurations (e.g., fully open), the sidewalls of the first pulley 8562 and the second pulley 8582 can together restrict the movement of the jaw pivot pin 8471 and also restrict the rotation of the jaws (e.g., in the fully open configuration, see...). Figure 26 Similarly, the elongated shape of the first central opening 8468 and the second central opening 8488 allows the first jaw 8462 and the second jaw 8482 to move about the central pin 8683 during operation. Because the central pin 8683 is within each of the central openings 8468, 8488, the sidewalls of the first jaw 8462 and the second jaw 8482 can together restrict the movement of the jaws about the central pin 8683, and can also restrict the rotation of the jaws (e.g., in the fully open configuration, see...). Figure 26 ).

[0198] For example, Figure 26-28 The first jaw pivot opening 8569 (shown in dashed lines because it is behind the first jaw 8462) and the first center opening 8468 are shown. Figure 26As shown, when the end effector 8460 is in the fully open configuration, the jaw pivot pin 8471 contacts the second end 8569B of the first jaw pivot opening 8569. Although not shown, the opposite side of the jaw pivot pin 8471 may also contact the first end of the second jaw pivot opening 8589. Therefore, further relative movement in the "open" direction between each jaw and its corresponding pulley (e.g., the first jaw 8462 and the first pulley 8562) is stopped. Additionally, when the end effector 8460 is in the fully open configuration, the center pin 8683 may contact the second end 8468B of the first center opening 8468. Although not shown, the opposite side of the center pin 8683 may also contact the first end of the second center opening 8488. This contact also prevents further movement of the jaws in the "open" direction.

[0199] Conversely, when the end effector 8460 is in a fully closed configuration ( Figure 28 When the end effector 8460 is in a fully closed configuration, the jaw pivot pin 8471 has a gap with the first end 8569A of the first jaw pivot opening 8569 (i.e., spaced apart from the first end 8569A of the first jaw pivot opening 8569, even if the gap is only a small amount). Although not shown, the opposite side of the jaw pivot pin 8471 also has a gap with the second end of the second jaw pivot opening 8589. Therefore, further relative movement in the "closed" direction between each jaw and its corresponding pulley (e.g., the first jaw 8462 and the first pulley 8562) is not limited by the jaw pivot opening. By ensuring the end gap, the jaws will not stop prematurely (e.g., if the jaws are gripping a very thin object). In addition, when the end effector 8460 is in a fully closed configuration, the center pin 8683 has a gap with the first end 8468A of the first center opening 8468 (i.e., spaced apart from the first end 8468A of the first center opening 8468). In some embodiments, the amount of the gap is small and therefore may not be easily seen in the figures. Although not shown, the opposite side of the center pin 8683 also has a gap with the second end of the second center opening 8488. This gap also prevents the jaws from stopping prematurely when moving toward the "closed" direction.

[0200] Figures 29-35Various views of an instrument 9400 with an end effector 9460 according to an embodiment are shown. The end effector 9460 has a forward pivoting and forward clamping topology, and pulleys are positioned between jaws. The instrument 9400, or any component thereof, may optionally be part of a surgical system that performs surgical procedures and may include a manipulator unit, a series of kinematic links, a series of cannulas, etc. Instrument 9400 (and any instruments described herein) can be used in any suitable surgical system, such as the MIRS system 1000 shown and described above. Instrument 9400 may include the mechanical structure 8700 and shaft 8410 as described above. Instrument 9400 includes a wrist assembly 9500 and an end effector 9460. The instrument also includes a first pitch cable 9405 and a second pitch cable 9406 that couple the mechanical structure to a distal U-clamp 9610 of the wrist assembly 9500. The movement of the first pitch cable 9405 and the second pitch cable 9406 produces a rotation of the wrist assembly 9500 about the first rotation axis A1 (i.e., pitch rotation, the term pitch is arbitrary) (see...). Figure 29 (See arrow HH in the image). The device 9400 also includes a first cable 9420 and a second cable 9440 that couple the mechanical structure to the end effector 9460. (See arrow HH in the image). Figure 30 As shown, the first cable 9420 forms a cable loop having a first proximal portion 9421, a distal portion 9422, and a second proximal portion 9431. The distal portion 9422 is coupled to the input connector 9564 of the first pulley 9562, as described in more detail below. The first proximal portion 9421 and the second proximal portion 9431 are routed proximally to the mechanical structure 9700. The second cable 9440 forms a cable loop having a first proximal portion 9441, a distal portion 9442, and a second proximal portion 9451. The distal portion 9442 is coupled to the input connector 9584 of the second pulley 9582, as described in more detail below. The first proximal portion 9441 and the second proximal portion 9451 are routed proximally to the mechanical structure 8700. Movement of the first cable 9420 and the second cable 9440 produces a yaw rotation of the end effector 9460 about the second axis of rotation A2 (the term yaw is arbitrary) (see [reference]). Figure 29 The tool component of the end effector 9460 (arrow JJ in the diagram) can be moved by clamping rotation about the second axis of rotation A2, or any combination of these movements. Changes in the pitch or yaw of the instrument 9400 can be performed by manipulating the cable (i.e., moving or changing the tension in the cable).

[0201] The wrist assembly 9500 includes a first U-shaped clip 9510 (which serves as a proximal first link) and a second U-shaped clip 9610 (which serves as a distal second link). The first U-shaped clip 9510 has a proximal portion 9511 and a distal portion 9512. The proximal portion 9511 is coupled to the distal portion 9412 of the instrument axis 9410. The distal portion 9512 includes a joint portion rotatably coupled to a mating joint portion of the second U-shaped clip 9610. In this way, the first U-shaped clip 9510 and the second U-shaped clip 9610 form a wrist assembly 9500 having a first axis of rotation A1 (also referred to as a pitch axis), about which the second link 9610 is rotatable relative to the first link 9510. A pin 9543 extends through an opening 9542 at the distal end 9512 of the first U-shaped clip 9510 to rotatably couple the second U-shaped clip 9610 to the first U-shaped clip 9510.

[0202] The second U-clamp 9610 has a proximal portion 9611 and a distal portion 9612. As described above, the proximal portion 9611 includes a joint portion rotatably coupled to the first U-clamp 9510. The proximal portion 9611 also defines a connector to which the first pitch cable 9405 and the second pitch cable 9406 are coupled. The second U-clamp 9610 also includes a first pulley shaft 9618 and a second pulley shaft 9623, which support cable pulleys as described below. The distal portion 9612 of the second U-clamp 9610 is coupled to the end effector 9460 via a center pin 9683. In this way, the first tool assembly 9465 and the second tool assembly 9485 can rotate relative to the second U-clamp 9610 about a second axis of rotation (also referred to as the yaw axis) A2. Figure 29 As shown, the second rotation axis A2 (also known as the yaw axis) is not parallel to the pitch axis A1. Therefore, the instrument 9400 provides up to three degrees of freedom (i.e., pitch motion about the first rotation axis A1, yaw motion about the second rotation axis A2, and clamping motion about the second rotation axis A2).

[0203] A first U-shaped clip 9510 and a second U-shaped clip 9610 define one or more guide channels through which cables are routed, and the one or more guide channels are accommodating relative movement between the first U-shaped clip 9510 and the second U-shaped clip 9610. The first U-shaped clip 9510 and the second U-shaped clip 9610 also include one or more guide pulleys around which cables are routed to minimize cable friction and maintain a desired minimum bending radius of the cable during use. Figure 30As shown, the first U-shaped clamp 9510 includes a first pulley 9516 and a second pulley 9521 around which a first cable 9420 is routed, and a third pulley 9526 and a fourth pulley 9531 around which a second cable 9440 is routed. The first pulley 9516 and the third pulley 9526 rotate around a pin 9543 on one side of the second U-shaped clamp 9610, and the second pulley 9521 and the fourth pulley 9531 rotate around the pin 9543 on the other side of the second U-shaped clamp 9610. The second U-shaped clamp 9610 includes a first pulley 9816 and a second pulley 9821 around which the first cable 9420 is routed, and a third pulley 9826 and a fourth pulley 9831 around which the second cable 9440 is routed. The first pulley 9616 and the third pulley 9626 rotate around the first axis 9618 of the second U-shaped clamp 9610, and the second pulley 9621 and the fourth pulley 9631 rotate around the second axis 9623 of the second U-shaped clamp 9610.

[0204] The end effector 9460 includes a first tool assembly 9465 (which serves as a first jaw-pulley pair) and a second tool assembly 9485 (which serves as a second jaw-pulley pair). Although the first tool assembly 9465 and the second tool assembly 9485 are separate components that cooperate to form the end effector 9460, aspects of the first tool assembly 9465 described below (e.g., the markings of the kinematic links formed by the first tool assembly) apply to the second tool assembly 9485, and vice versa. The first tool assembly 9465 includes a first jaw 9462 coupled to a first pulley 9562, and the second tool assembly 9485 includes a second jaw 9482 coupled to a second pulley 9582.

[0205] The first pulley 9562 is a disc-shaped component rotatably coupled to the second U-clamp 9610 via a center pin 9683. The first pulley 9562 includes a first input connector 9564 and a first output pin 9572, and defines a central opening 9568 and a first jaw pivot opening 9569. The center pin 9683 is coupled within the central opening 9568 to allow the first pulley 9562 to rotate relative to the U-clamp 9610 about a yaw axis A2, as... Figure 29 As indicated by arrow JJ in the diagram. As described in more detail below, the first jaw pivot opening 9569 is elongated to allow movement of the jaw pivot pin 9471 relative to the first pulley 9562 and the second pulley 9582 during operation. The distal end 9422 of the first cable 9420 is coupled to the first pulley 9562 at the first input connector 9564 via a cable crimp (not shown). The first output pin 9572 is matingly coupled within the first pulley opening 9472 of the first jaw 9462 to transmit force from the first pulley 9562 to the first jaw 9462.

[0206] The first jaw 9462 includes a distal portion 9463 and a proximal portion 9467. The distal portion 9463 serves as a gripping portion to engage with the second jaw 9482 to contact tissue, grasp a needle (e.g., needle 9010), or perform other operations. The proximal portion 9467 defines a first pulley opening 9472, a first jaw pivot opening 9469, and a first central opening 9468. The proximal portion 9467 also includes a jaw pivot guide 9470. As shown, a central pin 9683 extends through the first central opening 9468, which is elongated to allow movement of the first jaw 9462 and the second jaw 9482 about the central pin 9683 during operation. The first jaw 9462 is rotatably coupled to the second jaw 9482 via a jaw pivot pin 9471, which defines a jaw pivot axis A. JP (see Figure 31 The jaw pivot pin 9471 is rotatably coupled within the first jaw pivot opening 9469 (and the second jaw pivot opening 9489) and supported by jaw pivot guides 9470, 9490. Therefore, when the torque applied to the first pulley 9562 by the first cable 9420 is transmitted to the first jaw 9462, the first jaw 9462 relative to the second jaw 9482 (and the U-clamp 9610) about the jaw pivot axis A. JP Rotation. The jaws pivot along axis A. JP The yaw axis A2 is deviated from the centerline CL of the end effector.

[0207] The second pulley 9582 is a disc-shaped member rotatably coupled to the second U-clamp 9610 via a center pin 9683. The second pulley 9582 includes a second input connector 9584 and a second output pin 9592, and defines a central opening 9588 and a second jaw pivot opening 9589. The center pin 9683 is coupled within the central opening 9588 to allow the second pulley 9582 to rotate relative to the U-clamp 9610 about a yaw axis A2. As described in more detail below, the second jaw pivot opening 9589 is elongated to allow movement of the jaw pivot pin 9471 relative to the second pulley 9582 and the first pulley 9562 during operation. The distal end 9442 of the second cable 9440 is coupled to the second pulley 9582 at the second input connector 9584 via a cable crimp (not shown). The second output pin 9592 is coupled to the second pulley opening 9492 of the second jaw 9482 to transmit force from the second pulley 9582 to the second jaw 9482.

[0208] The second jaw 9482 includes a distal portion 9483 and a proximal portion 9487. The distal portion 9483 serves as a clamping portion to engage with the first jaw 9462 (e.g., to grip a pin 9010). The proximal portion 9487 defines a second pulley opening 9492, a second jaw pivot opening 9489, and a second center opening 9488. The proximal portion 9487 also includes a jaw pivot guide 9490. As shown, a center pin 9683 extends through the second center opening 9488, which is elongated to allow linear movement of the second jaw 9482 and the first jaw 9462 about the center pin 9683 during operation. When torque applied to the second pulley 9582 by the second cable 9440 is transmitted to the second jaw 9482, the second jaw 9482 moves about the jaw pivot axis A. JP Rotation relative to the first jaw 9462 (and the U-shaped clamp 9610). Because the jaws do not rotate relative to each other about the center pin 9683, there is some translational movement relative to the center pin 9683 when the jaws rotate, which is allowed by including the first center opening 9468 (and the second center opening 9488).

[0209] At an input radius from the yaw axis A2, a first cable 9420 is coupled to a first pulley 9562, and a second cable 9440 is coupled to a second pulley 9582. Therefore, when an input pulley force is applied to the pulleys by the cables, an input torque is generated around the yaw axis A2 to rotate the pulleys. Furthermore, the first pulley 9562 and the second pulley 9582 define a pulley envelope as a cylindrical volume around the yaw axis A2, this pulley envelope having an envelope radius equal to the outermost radius of the pulleys.

[0210] The geometry and kinematic linkages formed by the first and second tool assemblies 9465 and 9485 are similar to those shown above for the first and second tool assemblies 5465 and 5485, and therefore will not be described in detail here. Furthermore, the geometry of the jaws 4462 and 4482 (e.g., total length, clamping length, and tip-to-clamping distance) is the same as that of the jaws 9462 and 9482. Additionally, the jaw pivot axis A... JP The offset relative to the yaw axis A2 (in the forward pivot configuration) and the applied length L of the jaws 5462 and 5482. A The applied length is the same as that of the 9462 and 9482 jaws. Similarly, the kinematic input link L... I The input links are confined within pulleys 5562 and 5582, and the input link angle Θ is the same as that of pulleys 9562 and 9582. Furthermore, as described above, these kinematic links and the input radius (similar to the radius R1 described herein) remain within the pulley envelope.

[0211] Therefore, in use, the end effector 9460 can amplify the input pulley force to produce a higher clamping force by the jaws 9462, 9482 than that produced by a standard one-piece jaw and pulley system. As described herein with respect to end effector 9460, end effector 9460 (and each of the tool assemblies 9465, 9485) includes additional kinematic linkages to increase the torque arm on which the input pulley force is applied, thereby increasing the output clamping force.

[0212] Furthermore, the elongated shape of the first jaw pivot opening 9569 and the second jaw pivot opening 9589 allows relative movement between each pulley and its corresponding jaw (e.g., the second pulley 9582 and the second jaw 9482). The configuration of the first jaw pivot opening 9569 and the second jaw pivot opening 9589 also allows this relative movement while positioning the jaw pivot axis A... JP and kinematic links (e.g., input link L) I and applying link L A The jaws remain within the pulley envelope. Because the jaw pivot pin 9471 is within each of the first jaw pivot opening 9569 and the second jaw pivot opening 9589, in some configurations, the sidewalls of the first pulley 9562 (and pivot pin guide 9470) and the second pulley 9582 (and pivot pin guide 9490) can collectively restrict the movement of the jaw pivot pin 9471, and thus also restrict the rotation of the jaws (e.g., in the fully open configuration, see...). Figure 33 Similarly, the elongated shape of the first central opening 9468 and the second central opening 9488 allows the first jaw 9462 and the second jaw 9482 to move about the central pin 9683 during operation. Because the central pin 9683 is within each of the central openings 9468 and 9488, the sidewalls of the first jaw 9462 and the second jaw 9482 can together restrict the movement of the jaws about the central pin 9683, and can also restrict the rotation of the jaws (e.g., in the fully open configuration, see...). Figure 33 ).

[0213] For example, Figure 33-35 The first jaw pivot opening 9569 (shown in dashed lines because it is behind the first jaw 9462) and the first center opening 9468 are shown. Figure 33As shown, when the end effector 9460 is in the fully open configuration, the jaw pivot pin 9471 contacts the second end 9569B of the first jaw pivot opening 9569. Although not shown, the opposite side of the jaw pivot pin 9471 may also contact the first end of the second jaw pivot opening 9589. Therefore, further relative movement in the "open" direction between each jaw and its corresponding pulley (e.g., the first jaw 9462 and the first pulley 9562) is stopped. Additionally, when the end effector 9460 is in the fully open configuration, the center pin 9683 contacts the second end 9468B of the first center opening 9468. Although not shown, the opposite side of the center pin 9683 may also contact the first end of the second center opening 9488. This contact also prevents further movement of the jaws in the "open" direction.

[0214] Conversely, when the end effector 9460 is in a fully closed configuration ( Figure 35 When the end effector 9460 is in a fully closed configuration, the jaw pivot pin 9471 has a gap with the first end 9569A of the first jaw pivot opening 9569 (i.e., spaced apart from the first end 9569A of the first jaw pivot opening 9569). Although not shown, the opposite side of the jaw pivot pin 9471 also has a gap with the second end of the second jaw pivot opening 9589. Therefore, further relative movement in the "closed" direction between each jaw and its corresponding pulley (e.g., the first jaw 9462 and the first pulley 9562) is not limited by the jaw pivot opening. Additionally, when the end effector 9460 is in a fully closed configuration, the center pin 9683 has a gap with the first end 9468A of the first center opening 9468 (i.e., spaced apart from the first end 9468A of the first center opening 9468). Although not shown, the opposite side of the center pin 9683 also has a gap with the second end of the second center opening 9488. This gap also prevents premature stopping of the jaws when moving toward the "closed" direction.

[0215] Although end effectors 8460 and 9460 are shown as tool assemblies having jaws coupled to a pulley (e.g., a first pulley 8562), in other embodiments, any instrument described herein may include a tool assembly having a kinematic link coupled to any suitable rotatable member to produce a desired amplified jaw as described herein. Such a rotatable member may include a lever, link, gear, or any other structure adapted to be coupled to the jaws and to transmit force from a tension member to the jaws. For example, Figure 36 and Figure 37 This is a schematic diagram of a tool assembly 10465 having a rear-pivoting and forward-clamping topology according to an embodiment. Specifically, Figure 36 and Figure 37 It is in the first (closed) configuration ( Figure 36 ) and the second (open) configuration ( Figure 37 The image shows a side view of a portion of tool component 10465. Tool component 10465 can be incorporated into any of the end effectors or medical devices described herein and can be configured to be the same as or similar to other tool components described herein, and function the same as or similar to other tool components described herein. For example, tool component 10465 can be the first tool component of an end effector comprising two tool components, similar to end effectors 4460, 8460, and 9460 described herein. Therefore, although... Figure 36 and Figure 37 Only the first tool assembly 10465 is shown; however, it should be understood that the end effector may include the first tool assembly 10465 and a second tool assembly (not shown), which are separate components that work cooperatively to form the end effector. Aspects of the first tool assembly 10465 (e.g., the identification of the kinematic link formed by the first tool assembly) apply to the second tool assembly (not shown). Furthermore, certain aspects of the tool assembly 10465 and the end effector including the tool assembly 10465 are not described in detail below, but should be understood as aspects similar to those of the end effectors described herein (e.g., end effectors 4460, 8460, 9460). For example, although... Figure 36 and Figure 37 The U-shaped clamp is not shown, but it should be understood that the tool assembly 10465 may be rotatably coupled to the central axis A2 of the U-shaped clamp (similar to U-shaped clamps 4610, 8610, 9610 or any other U-shaped clamp as shown herein).

[0216] Tool assembly 10465 includes jaws 10462 coupled to a rotatable member 10562. Similar to jaws 4462, 8462, and 9462, jaw 10462 includes a distal portion and a proximal portion 10467. The proximal portion 10467 includes a rotatable member connector 10472 that couples the jaw 10462 to and transmits force from its mating rotatable member 10562. Additionally, the proximal portion 10467 of jaw 10462 is rotatably coupled to the proximal portion of a second jaw (not shown) via a jaw pivot pin 10471, which defines a jaw pivot axis A. JP The distal portions of the two jaws serve as gripping portions to cooperatively contact tissue, grasp needles, or perform other operations, as shown and described above with reference to jaws 4462 and 4482 and jaws 8462 and 8482.

[0217] The rotatable member 10562 can be any suitable structure, such as a linkage, gear, or pulley, for operably coupling the jaws 10462 to the tension member 10420. The rotatable member 10562 is rotatably coupled to a U-clamp (not shown) about a central axis A2. The rotatable member 10562 includes an input connector 10564 and an output connector 10572, and defines a central opening 10568 and a jaw pivot opening (not identified, but which may be similar to the jaw pivot opening 2569 described above). A central pin may be coupled within the central opening 10568 to allow the rotatable member 10562 and a second rotatable member (of the second tool assembly (not shown)) to rotate relative to the U-clamp about the central axis A2. The tension member 10420 is coupled to the rotatable member 10562 at the input connector 10564. Tension member 10420 can be any suitable connector, such as a cable, belt, or push rod, that transmits force from a mechanical structure (not shown) to tool assembly 10465. Tension member 10420 is coupled to rotatable member 10562 at a first input radius R1 from the central axis A2. Therefore, when tension member 10420 applies an input force to rotatable member 10562, an input torque (similar to) is generated about the central axis A2. Figure 14 The input torque T shown in the free body diagram in This allows the rotatable member 10562 to rotate about the central axis A2. Because in this embodiment, the tension member 10420 does not wrap around the outer diameter or surface of the rotatable member 10562, the torque arm (or the distance between the input force and the central axis A2) changes with the rotation angle. Additionally, the rotatable member 10562 defines a rotatable member envelope 10565 as a cylindrical volume about the central axis A2, and the rotatable member envelope 10565 has an envelope radius equal to the outermost radius of the rotatable member 10562. In some embodiments, the rotatable member envelope 10565 has an envelope radius equal to the outermost portion of the rotatable member 10562. In some embodiments, the rotatable member envelope 10565 is the same as the rotatable member envelope defined by the second rotatable member.

[0218] The output connector 10572 can be any suitable connector or mechanism that connects the jaws 10462 to the rotatable member 10562 to transmit force from the rotatable member 10562 to the jaws 10462. The radial offset of the output connector 10572 from the central axis A2 is designated as L. I The input length of the jaws. Therefore, the coupling between the rotatable member 10562 and the jaws 10462 defines the rotation about the central axis A2, denoted as L. I The kinematic input link. Input link L IThe input link angle is formed with the centerline CL of the end effector, and this input link angle changes as the rotatable member 10562 rotates about the central axis A2. When the end effector is in a closed configuration (see...), Figure 36 When ), the input linkage angle is marked as Θ. OFFSET When the rotatable component is in the open position (see...) Figure 37 During rotation, the input link angle Θ increases to Θ+Θ. OFFSET (also known as Θ) OVERALL The value of Θ. As described in more detail above, Θ OFFSET The value of Θ can be selected to minimize the effect of the push-pull force on the clamping force applied by the tool component. For example, in some embodiments, Θ OFFSET The value of Θ can be less than approximately 10 degrees. In some embodiments, Θ OFFSET The value of Θ can be less than approximately 5 degrees. In some embodiments, Θ OFFSET The value can be approximately zero degrees. In other words, in some embodiments, when the end effector is in a closed configuration, the coupling between the rotatable member 10562 and the jaw 10462 is along the end effector centerline CL. As shown, the output connector 10572 and the kinematic link L... I Within the rotatable component envelope 10565.

[0219] The proximal portion 10467 of the jaw 10462 includes a rotatable member connector 10472, which connects the jaw 10462 to and transmits force from the rotatable member 10562. Therefore, when an input torque applied to the rotatable member 10562 by the tension member 10420 is transmitted to the jaw 10462, the jaw 10462 pivots relative to the second jaw (and the U-shaped clamp; not shown) about the jaw pivot axis A. JP Rotation. As indicated by arrow GG. When the end effector is in its closed configuration, the jaws pivot along axis A. JP Offset from the central axis A2 along the end effector centerline CL, which is defined by the central axis A2 and the jaw pivot axis A. JP Between (and perpendicular to the central axis A2 and the jaw pivot axis A) JP ). Pliers pivot axis A JP And the central axis A2 is indicated as X A The pivot axis A of the jaws JP Also offset from rotatable component connector 10472 is marked as L A The jaws apply a certain length. Therefore, the coupling of the jaws at the jaw pivot pin 10471 and the coupling of the jaws 10462 and the rotatable member 10562 at the rotatable member connector 10472 define the length about the jaw pivot axis A. JP Rotation is labeled L AThe kinematics of the applied link. The input link L is applied. A The end effector centerline CL forms an applied link angle, which is the angle at which the jaws 10462 revolve around the central axis A2 and the jaw pivot axis A. JP Changes during rotation. When the end effector is in a closed configuration (see...). Figure 36 When ), the input linkage angle is marked as Θ. OFFSET When the rotatable component is in the open position (see...) Figure 37 During rotation, the applied link angle increases to Φ+Φ. OFFSET The value (also known as Φ) OVERALL As shown in the figure, the pivot axis A of the jaws... JP and kinematic link L A Within the rotatable component envelope 10565.

[0220] As shown, both the rotatable member 10562 and the second rotatable member (not shown) can be shaped such that the jaw pivot pin 10471 extends to the outside of the rotatable member. Therefore, the rotatable member 10562 does not necessarily define the jaw pivot opening, as shown above in some embodiments.

[0221] As shown in the figure, tool assembly 10465 has a rear-pivoting and forward-gripping topology. Specifically, the jaw pivot axis A JP It is further away from the tip of the jaws than the central axis A2. In other words, the central axis A2 is located at the jaw pivot axis A. JP Between the distal end (or gripping portion) of the jaws 10462. Furthermore, when the rotatable member rotates to move the end effector from the closed configuration ( Figure 36 Move to open configuration ( Figure 37 When the input link angle Θ increases, the end effector can amplify the input force to generate a higher clamping force by the jaws than that produced by a standard one-piece jaw and pulley system. Specifically, the input link L... I (including input link angle Θ) OFFSET ) and applying link L A The arrangement of the jaws and the length range of the claws can amplify the clamping force.

[0222] In some embodiments, the tool assembly may include jaws coupled to the rotatable member in such a way that the connection point (and thus the input link L) is such that... I The angular position of the jaws is essentially constant, regardless of the rotational orientation of the jaws, rotatable components, and / or tool assembly. This arrangement advantageously minimizes the effect of the push-pull force (applied by the jaws) on the clamping force (applied by the jaws). This arrangement also saves space and ensures that the rotatable components and associated kinematic links remain within the desired envelope. As an example, Figure 38 and Figure 39 This is a schematic diagram of a tool assembly 11465 having a rear-pivoting and forward-clamping topology according to an embodiment. Specifically, for example, Figure 38 and Figure 39 This is a schematic diagram of a tool assembly 11465 having a rear-pivoting and forward-clamping topology according to an embodiment. Specifically, Figure 38 and Figure 39 It is in the first (closed) configuration ( Figure 38 ) and the second (open) configuration ( Figure 39 The image shows a side view of a portion of tool component 11465. Tool component 11465 can be incorporated into any of the end effectors or medical devices described herein and can be configured to be the same as or similar to other tool components described herein, and function the same as or similar to other tool components described herein. For example, tool component 11465 can be the first tool component of an end effector comprising two tool components, similar to end effectors 4460, 8460, and 9460 described herein. Therefore, although... Figure 38 and Figure 39 Only the first tool assembly 11465 is shown; however, it should be understood that the end effector may include the first tool assembly 11465 and a second tool assembly (not shown), which are separate components that work cooperatively to form the end effector. Aspects of the first tool assembly 11465 (e.g., the identification of the kinematic link formed by the first tool assembly) apply to the second tool assembly (not shown). Furthermore, certain aspects of the tool assembly 11465 and the end effector including the tool assembly 11465 are not described in detail below, but should be understood as aspects similar to those of the end effectors described herein (e.g., end effectors 4460, 8460, 9460). For example, although... Figure 38 and Figure 39 The U-shaped clamp is not shown, but it should be understood that the tool assembly 11465 may be rotatably coupled to the central axis A2 of the U-shaped clamp (similar to U-shaped clamps 4610, 8610, 9610 or any other U-shaped clamp as shown herein).

[0223] Tool assembly 11465 includes jaws 11462 coupled to a rotatable member 11562. Similar to jaws 4462, 8462, and 9462, jaw 11462 includes a distal portion and a proximal portion 11467. The proximal portion 11467 includes a rotatable member connector 11472 that couples the jaw 11462 to and transmits force from its mating rotatable member 11562. As shown, the rotatable member connector 11472 includes a toothed portion (which functions as an internal gear) that engages with a toothed portion of an output connector 11572 of the rotatable member 11562. The rotatable member connector 11472 may be a rack or a bent portion and may be coupled to the jaws 11462 in any suitable manner. In some embodiments, the rotatable member connector 11472 may be integrally formed with the jaws 11462. Additionally, the proximal portion 11467 of the jaw 11462 is rotatably coupled to the proximal portion of the second jaw (not shown) via a jaw pivot pin 11471, which defines the jaw pivot axis A. JP The distal portions (not shown) of the two jaws are used as gripping portions to cooperatively contact tissue, grasp needles, or perform other operations, as shown and described above with reference to jaws 4462 and 4482 and jaws 8462 and 8482.

[0224] The rotatable member 11562 can be any suitable structure, such as a pulley, for operably coupling the jaws 11462 to the tension member 11420. The rotatable member 11562 is rotatably coupled to a U-clamp (not shown) about a central axis A2. The rotatable member 11562 includes an input connector 11564 and an output connector 11572, and defines a central opening 11568 and a jaw pivot opening (not identified, but which may be similar to the jaw pivot opening 2569 described above). A central pin may be coupled within the central opening 11568 to allow the rotatable member 11562 and a second rotatable member (of the second tool assembly (not shown)) to rotate relative to the U-clamp about the central axis A2. The tension member 11420 is coupled to the rotatable member 11562 at the input connector 11564. The tension member 11420 can be any suitable connector for transmitting force from a mechanical structure (not shown) to the tool assembly 11465, such as a cable, belt, or push-pull rod. Tension member 11420 is coupled to rotatable member 11562 at a first input radius R1 from the central axis A2. Therefore, when tension member 11420 applies an input force to rotatable member 11562, an input torque (similar to...) is generated about the central axis A2. Figure 14 The input torque T shown in the free body diagram inThis allows the rotatable member 11562 to rotate about the central axis A2. Additionally, the rotatable member 11562 defines a rotatable member envelope 11565 as a cylindrical volume about the central axis A2, the rotatable member envelope 11565 having an envelope radius equal to the outermost radius of the rotatable member 11562. In some embodiments, the rotatable member envelope 11565 has an envelope radius equal to the outermost portion of the rotatable member 11562. In some embodiments, the rotatable member envelope 11565 is the same as the rotatable member envelope defined by the second rotatable member.

[0225] As shown in the figure, the output connector 11572 has a toothed portion (which functions as a gear) that couples the jaws 11462 to the rotatable member 11562 to transmit force from the rotatable member 11562 to the jaws 11462. The toothed portion of the output connector 11572 engages the toothed portion of the rotatable member connector 11472 along its length, and its center point is marked as the engagement point MP. Therefore, the engagement point MP is the point where maximum engagement occurs between the output connector 11572 and the rotatable member connector 11472. Because the coupling is not a fixed point but occurs along the length of the rotatable member connector 11472, the engagement point MP remains substantially constant as the rotatable member 11562 and the jaws 11462 rotate.

[0226] The radial offset of output connector 11572 from the central axis A2 is marked as L. I The jaw input length. In other words, the gear portion of the output connector 11572 has a radius L. I Therefore, the coupling between the rotatable member 11562 and the jaws 11462 defines the area designated L. I The kinematic input link. However, unlike tool assemblies 8465, 9465, and 10465, the input link L... I It does not rotate around the central axis A2. Therefore, the input link L I The input link angle is formed with the centerline CL of the end effector and remains substantially constant as the rotatable member 11562 rotates about the central axis A2. In this embodiment, the input link angle remains substantially zero. Specifically, when the end effector is in a closed configuration (see...), the input link angle remains substantially constant. Figure 38 When ), input link L I It is substantially coaxial with the centerline CL, and the input link angle is zero. When the rotatable component is in the open position (see...) Figure 39 During rotation, the input link angle remains zero. As shown in the figure, the output connector 11572 and the kinematic link L... I Within the rotatable component envelope 11565. In other words, the jaw input length L I Less than or equal to the first input radius R1.

[0227] The proximal portion 11467 of the jaw 11462 includes a rotatable member connector 11472, which connects the jaw 11462 to and transmits force from the rotatable member 11562. Therefore, when an input torque applied to the rotatable member 11562 by the tension member 11420 is transmitted to the jaw 11462, the jaw 11462 pivots relative to the second jaw (and the U-shaped clamp; not shown) about the jaw pivot axis A. JP Rotation. As indicated by arrow GG. When the end effector is in its closed configuration, the jaws pivot along axis A. JP Offset from the central axis A2 along the end effector centerline CL, which is defined by the central axis A2 and the jaw pivot axis A. JP Between (and perpendicular to the central axis A2 and the jaw pivot axis A) JP ). Pliers pivot axis A JP And the central axis A2 is indicated as X A The pivot axis A of the jaws JP Also offset from rotatable component connector 11472 is marked as L A The jaws apply a certain length. Therefore, the coupling of the jaws at the jaw pivot pin 11471 and the coupling of the jaws 11462 and the rotatable member 11562 at the rotatable member connector 11472 define the length designated L. A The kinematics of the applied link are similar to the input link, the applied link L. A Basically not around the pincer pivot axis A JP Rotation. Apply input to link L. A The end effector centerline CL forms the applied link angle, when the jaws 11462 revolve around the central axis A2 and the jaw pivot axis A. JP During rotation, the angle of the applied link changes only minimally (if any). When the end effector is in a closed configuration (see...), Figure 38 When the rotatable component is in the open position (see...), the applied link is substantially coaxial with the centerline CL, and the applied link angle is zero. Figure 39 During rotation, because the engagement point MP does not move, the applied linkage angle only changes to the jaw pivot axis A. JP The degree of change. As shown in the figure, the pivot axis A of the jaws. JP and kinematic link L A Within the rotatable component envelope 11565.

[0228] As shown in the figure, tool assembly 11465 has a rear-pivoting and forward-gripping topology. Specifically, the jaw pivot axis A JP It is further away from the tip of the jaws than the central axis A2. In other words, the central axis A2 is located at the jaw pivot axis A.JP Between the distal end (or gripping portion) of the jaws 11462. In use, the end effector can amplify the input force to generate a higher gripping force by the jaws than that generated by a standard one-piece jaw and pulley system. Specifically, the input link L... I and applying link L A The arrangement of the jaws and the length range of the claws can amplify the clamping force.

[0229] Although the end effector described herein is shown as a tool assembly comprising jaws coupled to a pulley having a substantially circular shape (e.g., first pulley 8562), in other embodiments, any instrument described herein may include pulleys or rotatable members having any suitable shape. For example, although end effector 4460 is shown as having a pulley characterized by a constant input radius R1, in other embodiments, end effector 4460 or any other end effector described herein may include pulleys or rotatable members having a variable input radius. In some embodiments, the end effector may include a non-circular pulley (e.g., a pulley having an oval, elliptical, or egg-shaped shape). Positioning the input connector (e.g., the point where the input force is applied) at the maximum radius will produce a higher input torque than would occur using a smaller constant radius design.

[0230] Figure 40 This is a schematic diagram of the distal portion of a tool assembly 12465 of an end effector having a rearward pivoting and forward clamping topology with non-circular pulleys, according to an embodiment. Tool assembly 12465 may be incorporated into any of the end effectors or medical devices described herein and may be configured to be the same as or similar to other tool assemblies described herein, and function the same as or similar to other tool assemblies described herein. For example, tool assembly 12465 may be a first tool assembly of an end effector including a second tool assembly, similar to end effectors 4460, 8460, and 9460 described above. Therefore, certain aspects of tool assembly 12465 and end effectors including tool assembly 12465 are not described in detail below, but should be understood as aspects similar to those of end effectors described herein (e.g., end effectors 4460, 8460, or 9460). For example, although... Figure 40 The U-shaped clamp is not shown, but it should be understood that the tool assembly 12465 can be rotatably coupled to the central axis A2 of the U-shaped clamp (similar to the U-shaped clamp 4610 or any other U-shaped clamp as shown herein).

[0231] Tool assembly 12465 includes jaws 12462 coupled to pulley 12562. Similar to jaw 4462, jaw 12462 includes a distal portion and a proximal portion 12467. The proximal portion 12467 includes a pulley connector 12472 that couples jaw 12462 to and transmits force from its mating pulley 12562. Additionally, the proximal portion 12467 of jaw 12462 is rotatably coupled to the proximal portion of a second jaw (not shown) via a jaw pivot pin 12471, which defines a jaw pivot axis A. JP The distal portions of the two jaws serve as gripping portions to cooperatively contact tissue, grasp needles, or perform other operations, as shown and described above with reference to jaws 4462 and 4482.

[0232] Pulley 12562 is a non-circular member (e.g., oval or egg-shaped member) rotatably coupled to a U-shaped clamp (not shown) about a central axis A2. In some embodiments, pulley 12562 is characterized by a larger long radius R1 and a smaller short radius R2. Pulley 12562 includes an input connector 12564 and an output connector 12572, and defines a central opening 12568. A central pin may be coupled within the central opening 12568 to allow pulley 12562 and a second pulley (of a second tool assembly (not shown)) to rotate relative to the U-shaped clamp about the central axis A2. Cable 12420 is coupled to pulley 12562 at input connector 12564 at a long radius R1 (from the central axis A2). Therefore, when the input pulley force F... P When applied to pulley 12562 via cable 12420, an input torque T is generated around the central axis A2. in To rotate pulley 12562, as indicated by arrow EE. As shown, the major radius R1 is greater than the nominal radius and minor radius R2 of pulley 12562. Therefore, the input torque T... in Greater than the input pulley force F P The torque generated is applied to a smaller, constant-radius pulley. In this way, the end effector can amplify the input pulley force F. P This generates a higher clamping force from the jaws than that generated by a circular pulley (e.g., as described herein, Fgrip; see example). Figure 14 Furthermore, end effectors with non-circular shapes can amplify the input force F. P This allows for a higher clamping force than that produced by the single-piece or two-piece design described herein. Specifically, the oval shape of pulley 12562 increases the input force F applied thereon. PThe torque arm increases the output clamping force. Although the input connector 12564 is shown at the long radius R1, in other embodiments, the input connector 12564 may be at any suitable location along the oval pulley 12562.

[0233] Although the end effector described herein is shown as having a two-piece tool assembly (i.e., including a jaw coupled to a pulley) to facilitate increased input force amplification, in other embodiments, certain aspects described herein may be included in an end effector having a single-piece tool assembly. In other words, in some embodiments, the end effector may include a single-piece jaw configured to amplify the input force to maximize the clamping force. For example, in some embodiments, the end effector may include a jaw with a non-circular pulley portion to increase the input torque for a given input force.

[0234] Figure 41 An end effector 13460 according to an embodiment is shown. Figure 42 A first jaw 13462 of an end effector is shown. The end effector 13460 includes a first jaw 13462 and a second jaw 13482. The first jaw 13462 includes a distal portion 13463 and a proximal portion 13467, and the second jaw 13482 includes a distal portion 13483 and a proximal portion 13487. Both proximal portions 13467 and 13487 include an input connector (only a second input connector 13584 for the second jaw 13482 is shown). In use, a cable (not shown) can be coupled to the second input connector 13584. The distal portions of both jaws serve as gripping portions to cooperatively contact tissue, grasp needles, or perform other operations as shown and described above.

[0235] The proximal portions 13467 and 13487 of each jaw are non-circular (e.g., they are oval or egg-shaped components). For example... Figure 42 As shown, the proximal portion 13467 is characterized by a larger long radius R1 and a smaller short radius R2. In some embodiments, the input connector is located at the long radius R1. Therefore, when the input pulley force is applied by the cable (not shown) to the proximal portion 13467 of the first jaw 13462, an input torque T is generated about the central axis. in This causes the jaws 13462 to rotate. As shown in the figure, the major radius R1 is greater than the nominal radius and minor radius R2 of the proximal portion 13467. Therefore, the input torque T in Greater than the input pulley force F PThe torque is applied to a smaller, constant-radius pulley. In this way, the end effector can amplify the input pulley force to produce a higher clamping force generated by the jaws than that produced by a standard constant-radius (i.e., circular) one-piece jaw. Specifically, the oval shape of the proximal portion 13467 increases the torque arm on which the input force is applied, thereby increasing the output clamping force.

[0236] Figure 42 A free-body diagram showing the geometry of the first jaw 13462 is provided. The torque balance achieved about the central axis A2 is provided by equation (22), which can be simplified to produce the axis of equation (23).

[0237] Equation (22): ∑M dp =0

[0238] Equation (23): T force +F Grip,y ×L Grip cos(Φ)=0

[0239] Input torque T in (or T) force The equation (as indicated in equation (23)) is given by the product of the input force and the torque arm (in this case, R1). Therefore, by increasing the torque arm, the clamping force F can be increased. grip,y .

[0240] In other embodiments, the input connector is located at any suitable location along the proximal portion 13467, for example, at the actuation radius R. A In other embodiments, the attachment point is not at a fixed position along the proximal portion 13467, but will vary with the orientation of the jaws, the orientation of the wrist assembly (not shown), or both. In such embodiments, the force amplification will vary with the orientation of the jaws, the orientation of the wrist assembly, or both. For example, in Figure 42 In the jaw orientation shown, the torque arm can be based on the intermediate radius between the long radius R1 and the short radius R2 (shown as the actuation radius R). A At this orientation (e.g., at angle Φ), the force amplification is less than the maximum possible amplification. For this embodiment, the maximum force amplification will only occur when the jaws are fully open (at 90 degrees to CL) and the cable leaves the jaws at R1. Conversely, when the jaws are fully closed, the circular pulley relative to radius R2 will have no mechanical advantage because the torque arm will be based on the short radius at this jaw orientation.

[0241] While various embodiments have been described above, it should be understood that they are presented as examples only and not as limitations. Where the methods and / or diagrams above indicate certain events and / or flow patterns occurring in a certain order, the order of certain events and / or operations may be modified. Although embodiments have been specifically shown and described, it should be understood that various changes in form and detail may be made.

[0242] For example, any instrument (and components thereof) described herein may optionally be a part of a surgical assembly for performing minimally invasive surgical procedures and may include a patient-side trolley, 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 occlusion, thrombosis, stones, uterine fibroids, bone metastases, adenomyosis, or any other body tissue. The examples of target tissues presented are not exhaustive. Additionally, target structures may also include artificial materials (or non-tissues) within or associated with the body, such as graft fixation molds, portions of artificial tubes, fasteners within the body, etc.

[0243] For example, any tool component can be constructed from any material, such as medical-grade stainless steel, nickel alloys, titanium alloys, etc. Furthermore, any link, tool component, tension member, or part described herein can be constructed from multiple parts subsequently connected together. For example, in some embodiments, a link can be constructed by connecting individually constructed parts together. However, in other embodiments, any link, tool component, tension member, or part described herein can be constructed as a single unit.

[0244] Although various embodiments have been described as combinations of specific features and / or components, other embodiments may have any combination of features and / or components from any of the embodiments discussed above. Various aspects have been described in the general context of medical devices (more specifically surgical instruments), but the inventive aspect is not necessarily limited to use in medical devices.

[0245] For example, although device 8400 includes a wrist 8500 that allows for additional degrees of freedom (e.g., pitch rotation about a first rotation axis A1), in other embodiments, device 8400 or any other device described herein need not include a wrist assembly. In some embodiments, the device may include an end effector similar to end effector 8460 that allows for amplification of input force but does not include a wrist mechanism.

Claims

1. An apparatus comprising: U-shaped clip; A center pin is coupled to the U-shaped clamp; A first tool assembly, which is coupled to the U-shaped clamp via the center pin. The first tool assembly includes a first pulley and a first jaw. The first pulley includes a first input connector and a first output connector. The first input connector is coupled to the first tension member. The first central opening is defined by the first pulley. The center pin extends through the first center opening. When the first input torque is applied by the first tension member, the first pulley rotates around the central pin. The pivot opening of the first jaw is confined within the first pulley. The first jaw includes a first pulley connector coupled to the first output connector, and The first jaw rotates when a portion of the first input torque is transmitted to the first jaw via the interface between the first pulley connector and the first output connector; The second tool assembly is coupled to the U-shaped clamp via the center pin. The second tool assembly includes a second pulley and a second jaw. The second pulley includes a second input connector and a second output connector, the second input connector being coupled to the second tension member. The second central opening is defined by the second pulley. The center pin extends through the second center opening. When the second input torque is applied by the second tension member, the second pulley rotates around the central pin. The pivot opening of the second jaw is limited within the second pulley. The second jaw includes a second pulley connector coupled to the second output connector, and The second jaw rotates when a portion of the second input torque is transmitted to the second jaw via the interface between the second pulley connector and the second output connector; as well as A jaw pivot pin, which couples the first jaw to the second jaw via a jaw pivot axis. The first and second jaws are configured to rotate relative to each other about a pivot axis of the jaws, and The jaw pivot pin extends through the first jaw pivot opening of the first pulley and the second jaw pivot opening of the second pulley.

2. The device according to claim 1, wherein: The central pin defines a central axis, and the first pulley and the second pulley rotate about the central axis; and The pivot axis of the jaws is offset from the central axis.

3. The device according to claim 1, wherein: The pivot opening of the first jaw is elongated; The second jaw pivot opening is elongated; and The jaw pivot pin is configured such that when the first jaw rotates relative to the U-shaped clamp, the jaw pivot pin translates relative to the center pin within the first jaw pivot opening and the second jaw pivot opening.

4. The device according to claim 3, wherein: The pivot opening of the first jaw is defined by the side wall of the first pulley; The second jaw pivot opening is defined by the sidewall of the second pulley; and The translation of the jaw pivot pin is constrained by the sidewalls of the first pulley and the second pulley.

5. The device according to claim 3, wherein: The first jaw pivot opening is the first curved path; The second jaw pivot opening is a second curved path, which is different from the first curved path; and The jaw pivot pin translates along the jaw pivot pin path defined by the intersection of the first curved path and the second curved path.

6. The device according to claim 1, wherein: The first central opening is a first central slot; The center pin is disposed within the first center slot; and The first central slot is sized to allow the first jaw to translate relative to the central pin when the first jaw and the second jaw rotate relative to each other about the jaw pivot axis.

7. The device according to claim 1, wherein the first pulley and the second pulley are located between the first jaw and the second jaw.

8. The device according to any one of claims 1-7, wherein: The first jaw includes a first clamping portion at the distal end of the first jaw; and The second jaw includes a second clamping portion at the distal end of the second jaw.

9. The device according to claim 8, wherein: The first pulley connector of the first jaw is located between the first clamping portion and the jaw pivot pin; and The first central opening of the first pulley is located between the first input connector and the first jaw pivot opening.

10. The device according to claim 8, wherein: The jaw pivot pin is located between the first clamping portion and the first pulley connector of the first jaw; and The first central opening of the first pulley is located between the first input connector and the first jaw pivot opening.

11. The device according to claim 1, wherein: The central pin defines a central axis, and the first pulley and the second pulley rotate about the central axis. The first input connector is radially offset from the central axis by a first input radius; The first pulley envelope is defined as a cylindrical volume around the central axis, having an envelope radius equal to the first input radius; and The first output connector, the first jaw pivot opening, the first pulley connector, and the jaw pivot axis are all within the first pulley envelope.

12. The device according to claim 11, wherein: The first output connector is radially offset from the central axis by the input length of the first jaw; The pivot axis of the jaws is radially offset from the central axis by a distance equal to the pivot axis of the jaws; and Each of the first jaw input length and the distance of the jaw pivot axis is less than the first input radius.

13. The device of claim 12, wherein both the first output connector and the first pulley connector are offset from the jaw pivot axis by an applied length greater than the first jaw input length.

14. The device of claim 13, wherein the applied length is greater than the first input radius.

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