Instrument with parallel joints, surgical robot

Abstract

The embodiment of the application provides a surgical instrument and a surgical robot applying the same, the instrument comprising a long shaft, a joint assembly and a terminal device; the joint assembly has a parallel joint, the parallel joint comprising a proximal joint, a distal joint, an intermediate section, a constant-length cable pair and a driving cable pair; the intermediate section is connected between the proximal joint and the distal joint; one end of the constant-length cable pair is connected to the distal joint, and the other end is connected to the proximal joint; the distal end of the driving cable pair is connected to the distal joint, and the proximal end passes through the long shaft and is coupled to a driving device; the driving device drives the parallel joint to move laterally or longitudinally through the driving cable, and the lateral or longitudinal movement of the parallel joint can increase the movement range of the terminal device.

Description

Technical Field

[0001] This application relates to the field of medical devices, and in particular to an instrument for surgery and a surgical robot using the instrument. Background Technology

[0002] Minimally invasive surgery refers to a surgical procedure performed inside the human body using modern medical instruments and equipment such as laparoscopes and thoracoscopes. Compared to traditional surgical methods, minimally invasive surgery has advantages such as less trauma, less pain, and faster recovery.

[0003] With advancements in technology, minimally invasive surgical robot technology has matured and is widely used. A minimally invasive surgical robot typically includes a main control console and slave operating devices. The main control console sends control commands to the slave operating devices based on the surgeon's instructions, controlling the slave operating devices. The slave operating devices respond to these control commands and perform the corresponding surgical procedures. Instruments are connected to the drive mechanism of the slave operating devices to perform surgical procedures. The distal end of the instrument includes an end effector for performing surgical operations and joint components connected to the end effector that can move with multiple degrees of freedom.

[0004] Joint components provide a range of motion for end effectors. However, existing joint components have limited degrees of freedom of movement, which prevents them from providing a greater range of motion for end effectors. Furthermore, the motion accuracy of existing joint components needs to be improved. Summary of the Invention

[0005] Based on this, to solve the above problems, in a first aspect, this application provides a surgical instrument, which includes a long axis, a joint assembly, and an end effector, wherein the joint assembly is connected between the long axis and the end effector, and the joint assembly has a parallel joint, the parallel joint comprising:

[0006] Proximal joints;

[0007] The distal end of the proximal joint is connected to the proximal end of the intermediate segment;

[0008] The distal joint includes a first distal joint segment and a second distal joint segment, the first distal joint segment and the second distal joint segment are rotatably connected, and the first distal joint segment is connected to the distal end of the intermediate segment.

[0009] A first cable pair, one end of which is connected to the proximal end of the proximal joint or the long axis, and the other end is connected to the second distal segment;

[0010] The second cable pair includes at least a first drive cable, wherein the cable segment of the first drive cable in the distal joint and the cable segment in the proximal joint are located on opposite sides of the central axis of the intermediate segment, the first drive cable actuating the distal joint, and the distal joint actuating the proximal joint via the first cable pair.

[0011] In one specific embodiment, the distal end of the first drive cable is fixedly connected to the second distal segment.

[0012] In one specific embodiment, the second cable pair further includes a second drive cable, wherein the first drive cable and the second drive cable cross in the intermediate section.

[0013] In one specific embodiment, the cable segment of the first drive cable in the intermediate section intersects the central axis of the intermediate section.

[0014] In one specific embodiment, when the first drive cable is actuated, the intermediate section deflects relative to the long axis and causes the end device to laterally move relative to the long axis.

[0015] In one specific embodiment, when the end device moves laterally relative to the long axis, the lengths of the cable segments of the first drive cable in the distal joint and the cable segments in the proximal joint simultaneously shorten or lengthen.

[0016] In one specific embodiment, the first cable pair includes at least a first constant-length cable, wherein when the end device moves laterally relative to the long axis, the length of the cable segment of the first drive cable in the distal joint and the length of the cable segment of the first constant-length cable in the distal joint simultaneously increase or simultaneously decrease.

[0017] In one specific embodiment, the second cable pair further includes a second drive cable, wherein when the end device moves laterally relative to the long axis, the length change of the cable segment of the second drive cable in the distal joint is equal to the length change of the cable segment of the first drive cable in the distal joint.

[0018] In one specific embodiment, the first cable pair includes a first constant-length cable, the distal end of the first constant-length cable and the distal end of the first drive cable are both fixed to the second distal joint segment.

[0019] In one specific embodiment, the first drive cable includes a first fixing part fixed to the second distal joint segment, and the first constant length cable includes a second fixing part fixed to the second distal joint segment, with the first fixing part and the second fixing part located on the same side of the central axis.

[0020] In one specific embodiment, the first constant-length cable further includes a third fixing part fixed at the proximal joint, wherein the cable segment of the first drive cable in the distal joint and the third fixing part are located on opposite sides of the central axis.

[0021] In one specific embodiment, this application provides an instrument for surgery in which the first drive cable and the first constant-length cable are a single, continuous cable.

[0022] In a second aspect, this application provides a surgical instrument comprising a long axis, a joint assembly, and an end effector, the joint assembly being connected between the long axis and the end effector, the joint assembly including a parallel joint, the parallel joint comprising:

[0023] Proximal joints;

[0024] The distal end of the proximal joint is connected to the proximal end of the intermediate segment;

[0025] The distal joint, wherein the proximal end of the distal joint is connected to the distal end of the intermediate segment;

[0026] A first cable pair, the proximal end of the first cable pair being connected to the proximal joint, and the distal end of the first cable pair being connected to the distal joint.

[0027] A first drive cable, the distal end of which is connected to the distal joint, actuates the distal joint, and the distal joint actuates the proximal joint via the first drive cable.

[0028] In one specific embodiment, when the first drive cable drives the end device to move laterally relative to the long axis, the lengths of the cable segment of the first drive cable in the distal joint and the cable segment in the proximal joint simultaneously become shorter or longer.

[0029] In one specific embodiment, the first drive cable segment located in the distal joint and the cable segment located in the proximal joint are located on opposite sides of the central axis of the intermediate segment.

[0030] In one specific embodiment, the device further includes a second drive cable, wherein the first drive cable and the second drive cable cross in the intermediate section.

[0031] In one specific embodiment, the distal joint includes a first distal joint segment and a second distal joint segment, the first distal joint segment and the second distal joint segment are hinged together, the first distal segment is connected to the distal end of the intermediate segment, and the distal end of the first drive cable is connected to the second distal joint segment.

[0032] In one specific embodiment, one end of the first cable pair is connected to the proximal joint, and the other end is connected to the second distal joint segment of the distal joint.

[0033] In a third aspect, this application provides a surgical instrument comprising a long axis, a joint assembly, and an end effector, the joint assembly being connected between the long axis and the end effector, the joint assembly comprising at least a parallel joint, the parallel joint comprising:

[0034] A proximal joint, wherein the proximal end of the proximal joint is connected to the distal end of the long axis.

[0035] The distal end of the proximal joint is connected to the proximal end of the intermediate segment;

[0036] A distal joint, the distal joint connecting the end device and the intermediate segment;

[0037] A first cable pair, one end of which is connected to the proximal joint or the long axis, and the other end of which is connected to the distal joint;

[0038] The second cable pair includes at least a first drive cable and a second drive cable, which cross in the intermediate section.

[0039] In one specific embodiment, the distal ends of both the first drive cable and the second drive cable are connected to the distal joint.

[0040] In one specific embodiment, the first cable pair actuates the distal joint, and the second cable pair actuates the proximal joint to cause the end device to lateralize.

[0041] In a fourth aspect, this application provides a surgical robot, the surgical robot including a drive unit, a control system, and instruments, the control unit being used to send control signals to the drive unit, the instruments including a long axis, a joint assembly, and an end effector, the joint assembly being connected between the long axis and the end effector, the joint assembly including at least a parallel joint, the parallel joint including:

[0042] Proximal joints;

[0043] The distal end of the proximal joint is connected to the proximal end of the intermediate segment;

[0044] The distal joint, wherein the proximal end of the distal joint is connected to the distal end of the intermediate segment;

[0045] A first cable pair and a second cable pair, wherein one end of the first cable pair is connected to the proximal joint and the other end is connected to the distal joint, and the distal end of the second cable pair is connected to the distal joint, and the drive device responds to a control signal sent by the control device to drive the second cable pair to move, thereby causing the end effector to move laterally.

[0046] In one specific embodiment, the first cable pair includes a first drive cable and a second drive cable, which cross in the intermediate section.

[0047] In a fifth aspect, this application provides a surgical robot, the surgical robot including a drive unit, a control system, and instruments, the control unit being used to send control signals to the drive unit, the instruments including a transmission unit, a long shaft, a joint assembly, and an end effector, the transmission unit being coupled to the drive unit, the joint assembly being connected between the long shaft and the end effector, the joint assembly including at least a parallel joint, the parallel joint including:

[0048] Proximal joints;

[0049] The distal end of the proximal joint is connected to the proximal end of the intermediate segment;

[0050] The distal joint, wherein the proximal end of the distal joint is connected to the distal end of the intermediate segment;

[0051] A first cable pair, the first cable pair being connected between the proximal joint and the distal joint;

[0052] A first drive cable, the proximal end of which is connected to the transmission device and the distal end of which is connected to the distal joint, the drive device being used to drive the transmission device to move in response to a control signal sent by the control device, thereby simultaneously changing the length of the cable segment of the first drive cable in the distal joint and the cable segment in the proximal joint, causing the end device to move laterally.

[0053] The parallel joints of the device described in this application can provide a greater range of motion for the end effector of the device. Attached Figure Description

[0054] Figure 1 This is a schematic diagram of the main control console of a surgical robot according to one embodiment of this application;

[0055] Figure 2 This is a schematic diagram of the operating device of a surgical robot according to one embodiment of this application;

[0056] Figure 3 This is a schematic diagram of a surgical instrument according to one embodiment of this application;

[0057] Figure 4 This is a schematic diagram of a joint assembly of a device according to an embodiment of this application;

[0058] Figure 5 for Figure 4 The diagram shows the parallel joint translation state of the joint assembly.

[0059] Figure 6A This is a schematic diagram of a joint assembly, transmission device, and drive device according to another embodiment of this application;

[0060] Figure 6B for Figure 6A A schematic diagram of the joint assembly of the device shown after rotating 90 degrees around its axis.

[0061] Figure 7A A top view of joint segment 452 of parallel joint 400, showing the first and fourth drive cables being pulled in;

[0062] Figure 7B A schematic diagram of the parallel joint in a 400° longitudinal displacement state;

[0063] Figure 7C A top view of joint segment 452 of parallel joint 400, showing the first and third drive cables being pulled in;

[0064] Figure 7D Schematic diagram of the parallel joint 400 transverse displacement device;

[0065] Figure 8 This is a schematic diagram of the operating device and power unit of a surgical robot according to an embodiment of this application; Detailed Implementation

[0066] To facilitate understanding of this application, a more complete description will be provided below with reference to the accompanying drawings. Preferred embodiments of this application are shown in the drawings. However, this application can be implemented in many different forms and is not limited to the embodiments described herein. Rather, these embodiments are provided to provide a more thorough and complete understanding of the disclosure of this application.

[0067] It should be noted that when an element is referred to as being "set on" another element, it can be directly on the other element or there may be an intervening element. When an element is considered to be "connected" to another element, it can be directly connected to the other element or there may be an intervening element. When an element is considered to be "coupled" to another element, it can be directly coupled to the other element or there may be an intervening element. The terms "vertical," "horizontal," "left," "right," "above," "below," and similar expressions used herein are for illustrative purposes only and do not represent the only possible implementations. It should be understood that these spatially related terms are intended to cover different orientations of the device in use or operation, in addition to those depicted in the drawings. For example, if the device is flipped in the drawings, an element or feature described as "below" or "under" other elements or features would be oriented "above" other elements or features. Therefore, the example term "below" can include both above and below orientations.

[0068] The terms "distal" and "proximal" used in this article are directional terms commonly used in the field of interventional medical devices. "Distal" refers to the end furthest from the operator during the procedure, while "proximal" refers to the end closest to the operator. The term "coupling" used in this article can be broadly understood as two or more objects being connected in a certain way, or as two objects having a dynamic connection.

[0069] The term "instrument" is used herein to describe a medical device inserted into a patient's body to perform surgical or diagnostic procedures. This instrument includes an end effector, which may be a surgical tool used to perform surgical procedures, such as an electrocautery device, forceps, stapler, scissors, imaging equipment (e.g., an endoscope or ultrasound probe), and the like. Some instruments used in embodiments of this application further include an articulated component (e.g., a joint assembly) for the end effector, allowing the position and orientation of the end effector to be manipulated with one or more mechanical degrees of freedom relative to an instrument axis. Further, the end effector includes functional mechanical degrees of freedom, such as opening and closing clamps. The instrument may also include stored information that can be updated by a surgical system, whereby the storage system can provide one-way or two-way communication between the instrument and one or more system components.

[0070] Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this application belongs. The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the application. The terms “and / or” and “and / or” as used herein include any and all combinations of one or more of the associated listed items.

[0071] One embodiment of the surgical robot in this application is as follows: Figure 1 and Figure 2 As shown, the surgical robot includes a main control console 10 and slave operating devices 20. The main control console 10 is located on the operator's side. The main control console 10 is used to send control commands to the slave operating devices 20 and display images acquired by the slave operating devices 20 based on the operator's actions. The operator can observe three-dimensional images of the patient's body provided by the imaging system through the main control console 10. By observing these three-dimensional images, the operator can immerse themselves in the experience and control the slave operating devices 10 to perform related operations (e.g., performing surgery or acquiring images of the patient's body). The main control console 10 includes a display device, armrests, a control signal processing system, an input device 11, and an observation device 12. The display device is used to display the images acquired by the imaging system. The armrests are used to support the operator's arms and / or hands, allowing for more comfortable operation of the input device 11. The observation device 12 is used to observe the images displayed on the display device. Depending on actual needs, the armrests or the observation device 12 can be omitted, allowing for direct observation. The operator controls the movement of the instrument on the slave operating device 10 through the operation input device 11. After the control signal processing system of the main console 10 processes the input signal of the input device 11, it sends a control command to the slave operating device. The slave operating device 20 responds to the control command of the main console 10 and performs the corresponding operation. In some embodiments, the control signal processing system can also be set in the slave operating device 20, for example, in the base of the slave operating device 20.

[0072] The operating device 20 is located on the patient's side for performing surgical procedures. The operating device 20 includes a base 25, a robotic arm 21, a cannula 23, a drive mechanism 22, and one or more instruments 30 detachably coupled to the drive mechanism 22. The robotic arm 21 is connected to the base 25. The cannula 23 enters the body through an incision. The distal ends of one or more instruments 30 pass through the cannula 23 into the body. Instruments 30 may be electrocautery devices, forceps, staplers, ultrasonic scalpels, etc., used for performing surgical procedures, or cameras (e.g., endoscopes) or other surgical instruments for acquiring images. In some embodiments, the cannula 23 may be omitted, for example, in surgical procedures that do not require pneumatic insufflation. In some embodiments, the base 25 may also be omitted, and the robotic arm 21 of the operating device 20 may be mounted on a wall, ceiling, or operating table.

[0073] The robotic arm 21 has two motion modes: the first motion mode is that the movement of the robotic arm 21 can drag the remote center of motion 24, thereby changing the relative position of the remote center of motion 24 and the base 25; the second motion mode is that, through algorithm control, the movement of the robotic arm 21 can cause the cannula 23 or the surgical machine 30 to move around the remote center of motion 24, and the position of the remote center of motion 24 relative to the base 25 is fixed.

[0074] The robotic arm 21 includes multiple joints 211, 212, 213, 214, and 215. Joint 211 is a vertical linear motion joint, while joints 212, 213, 214, and 215 are rotary motion joints. The rotation axes of joints 212, 213, and 214 are perpendicular to the horizontal plane. In the second motion mode, multiple joints 211, 212, 213, 214, and 215 work together to enable the sleeve 23 or multiple instruments to move around the remote motion center 24, and the position of the remote motion center 24 relative to the base 25 is fixed.

[0075] In some embodiments, the robotic arm may also take another form, defining a remote center of motion via mechanical means, allowing the cannula or instrument to rotate around this remote center of motion. For example, the robotic arm includes a parallelogram linkage with the instrument detachably mounted on its distal end. The parallelogram linkage may allow movement of the instrument or multiple mechanical degrees of freedom (e.g., all six Cartesian degrees of freedom, five or fewer Cartesian degrees of freedom, etc.). The parallelogram linkage is used to constrain and limit movement of the instrument near the remote center of motion on a surgical instrument that remains stationary relative to the patient.

[0076] Surgical robots typically also include an imaging system (not shown) that allows the operator to view the surgical site from outside the patient's body. This imaging system typically includes video image acquisition capabilities (e.g., an instrument 30 with image acquisition capabilities) and one or more video display devices for displaying the acquired images. Generally, the instrument 30 with image acquisition capabilities includes optics of one or more imaging sensors (e.g., CCD or CMOS sensors) that acquire images of the patient's body. These one or more imaging sensors may be positioned distal to the instrument 30 with image acquisition capabilities, and the signals generated by these sensors may be transmitted via cable or wirelessly for processing and display on the video display devices.

[0077] like Figure 3As shown, the device 30 includes a device housing 31, a long shaft 32, a joint assembly 33, multiple cables, and an end effector 34. The device 30 is detachably mounted on a power unit 22, which contains multiple drive units (not shown). The device housing 31 contains a transmission device (not shown), which includes multiple transmission units (e.g., winches). These transmission units are connected to the joint assembly 33 and the end effector 34 via multiple cables. Each transmission unit is coupled to multiple drive units (e.g., motors) of the drive unit and is driven by them. The drive units receive control commands from the control system and, according to these commands, drive the transmission units to move, thereby moving the joint assembly 33 and the end effector 34. The control system can be located in the main control console 10 or in the slave operating device 20. For example, the drive units rotate the transmission units to pull / tighten the cables, thereby controlling the movement of the joint assembly and the end effector. The end effector 34, via the joint assembly 3, can perform movements with multiple Cartesian degrees of freedom, such as translation (including lateral and / or longitudinal translation), pitch, and yaw. It is understood that translation and pitch, or translation and yaw, can move independently or simultaneously. The end effector 34 is used to perform surgical procedures. Depending on the needs of the surgical procedure, the end effector 34 can be an electrocautery device, forceps, stapler, scissors, ultrasonic scalpel, camera, imaging device, etc., where the camera or imaging device is used to acquire images of the inside of the human body.

[0078] In one embodiment of the present invention, such as Figure 4 As shown, the joint assembly 33 of the device includes a parallel joint assembly 200 and a wrist joint 300. The proximal end of the parallel joint assembly 200 is connected to the distal end of the long axis 32, the distal end of the parallel joint 200 is connected to the proximal end of the wrist joint 300, and the distal end of the wrist joint 300 is connected to the end device 34. The wrist joint 300 is used to perform pitch and / or yaw movements.

[0079] Specifically, the parallel joint assembly 200 includes a proximal joint 210, an intermediate segment 220, a distal joint 230, and a cable assembly. The proximal joint 210 includes a first proximal joint segment 211 and a second proximal joint segment 212 located at the proximal and distal ends of its rotation axis 213, respectively. The first proximal joint segment 211 is connected to the long axis 32, and the second proximal joint segment 212 is connected to the intermediate segment 220. The first proximal joint segment 211 and the second proximal joint segment 212 are pivotally connected, and the first proximal joint segment 211 and the second proximal joint segment 212 can rotate relative to each other about the rotation axis 213.

[0080] The distal joint 230 includes a first distal joint segment 231 and a second distal joint segment 232 located proximal and distal to its rotation axis 233, respectively. The first distal joint segment 231 is connected to the intermediate segment 220, and the second distal joint 232 is connected to the wrist joint 300. The first distal joint segment 231 and the second distal joint segment 232 are pivotally connected and can rotate relative to each other about the rotation axis 233. The rotation axes 213 and 233 are perpendicular to the plane of the paper.

[0081] The cable assembly includes a first cable pair and a second cable pair. One end of the first cable pair is fixedly connected to the proximal end of the proximal joint 210 or the long axis 32, and the other end is connected to the second distal joint segment 232. One end of the second cable pair is connected to the transmission device inside the instrument box 31, and the other end is fixedly connected to the second distal joint segment 232. The first cable pair is a constant-length cable, meaning that the total length of the parallel joint 220 within the joint assembly 33 remains essentially constant during movement. Specifically, the first cable pair includes a first constant-length cable 131 and a second constant-length cable 132, which are located on either side of the central axis a of the intermediate segment 220. The second cable pair includes a first drive cable 110 and a second drive cable 120, which cross in the intermediate section 220, that is, the cable segment 111 of the first drive cable 110 and the cable segment 121 of the second drive cable 120 cross.

[0082] The distal end of the first drive cable 110 is fixed to the second distal joint segment 232 via the first fixing part 110a, and its proximal end is fixed to the transmission device inside the instrument box 31. The cable segment 111 of the first drive cable 110 crosses the central axis a in the intermediate segment 220. Figure 4 When the parallel joint 200 shown is not translated, the cable segment 113 of the first fixing part 110a and the first drive cable 110 in the proximal joint 210 are located on opposite sides of the central axis a.

[0083] The distal end of the first constant-length cable 131 is fixed to the second distal joint segment 232 via the second fixing part 131a, and its proximal end is fixed to the first proximal joint segment 211 via the third fixing part 131b. When the parallel joint 200 is not translated, the first fixing part 110a and the second fixing part 131a are located on the same side of the central axis a of the intermediate segment 220, and the first fixing part 110a and the third fixing part 131b are also located on the same side of the central axis a. That is, as follows Figure 4 As shown, the first fixing part 110a, the second fixing part 131a and the third fixing part 131b are all located to the left of the central axis a of the intermediate section 220.

[0084] The distal end of the second drive cable 120 is fixed to the second distal joint segment 232 by the fourth fixing part 120a. The cable segment 121 in the intermediate segment 220 crosses the central axis a. The proximal end of the second drive cable 120 is fixed to the transmission device inside the instrument box 31. The first fixing part 110a and the fourth fixing part 120a are located on opposite sides of the central axis a.

[0085] The distal and proximal ends of the second constant-length cable 132 are fixed to the second distal joint segment 232 and the first proximal joint segment 211 respectively by the fifth fixing part 132a and the sixth fixing part 132b. The fourth fixing part 120a, the fifth fixing part 132a, and the sixth fixing part 132b are located on the same side of the central axis a of the intermediate segment 220. When the parallel joint 200 moves, the total length of the first and second constant-length cables 131 and 132 in the joint assembly 33 remains basically unchanged, and their length in the intermediate segment 220 also remains basically unchanged. The movement of the parallel joint 200 is described in detail below.

[0086] like Figure 5 As shown, when the transmission mechanism of the instrument box 31 is actuated by the external first drive mechanism to translate the end effector 34 as desired, the transmission mechanism actuates (e.g., rotates) to retract the first drive cable 110 and release the second drive cable 120. Because the first drive cable 110 is retracted, the lengths of the cable segment 112 in the distal joint 230 and the cable segment 113 in the proximal joint 210 both shorten. The distal joint 210 is actuated by the first drive cable 110, causing the first distal joint segment 231 to... The first and second distal joint segments 232 rotate relative to each other about the rotation axis 233 in the following manner: the left sides of the first and second distal joint segments 231 and 232 move closer to each other, so that the length of the cable segment 131c of the first constant-length cable 131 in the distal joint 230 becomes shorter; the right sides of the first and second distal joint segments 231 and 232 move further apart from each other, so that the distal joint 230 is in the shape of "<", and because the second drive cable 120 is released, the length of the cable segment 122 of the second drive cable 120 in the distal joint 230 becomes longer, and the change in the length of the cable segment 122 is equal to the change in the length of the cable segment 112 of the first drive cable 110.

[0087] Due to the aforementioned movement of the distal joint 210, the second constant-length cable 132 will be actuated by the distal joint 210, causing the cable segment 132c of the second constant-length cable 132 in the first distal joint segment 230 to become longer. Since the length of the second constant-length cable 132 in the joint assembly 33 remains constant, the second constant-length cable 132... The length of cable segment 132d in proximal joint 210 becomes shorter. Due to the shortening of cable segment 132d, proximal joint 210 will be actuated by second constant-length cable 132, causing the first proximal joint segment 211 and the second proximal joint segment 212 to rotate relative to each other about rotation axis 213 in the following manner: the right sides of the first proximal joint segment 211 and the second proximal joint segment 212 move closer to each other, and their left sides move further apart, and proximal joint 210 forms a ">" shape, thereby making the length of cable segment 131d of the first constant-length cable 131 in proximal joint 210 longer, and the length of cable segment 123 of the second drive cable 120 in proximal joint 210 longer, and the amount of change in the length of cable segment 123 is equal to the amount of change in the length of cable segment 113 of the first drive cable 110.

[0088] Due to the opposing movements of the distal joint 230 and the proximal joint 210, the axis b of the end effector 34 is transversely displaced relative to the axis c of the major axis 32, thereby achieving the transverse displacement of the end effector 34 (i.e., Figure 5 The end effector 34 is shown to move laterally to the right. During this movement, the middle segment 220 deflects relative to the major axis 32, meaning that the central axis a of the middle segment 220 forms a non-zero angle with the axis of the major axis 32. After the lateral movement, the axis b of the end effector 34 and the axis c of the major axis 32 remain parallel. The lateral movement of the end effector 34 by the parallel joint 200 does not change the pitch or yaw angle of the end effector. It can be understood that in some embodiments, the axis b of the end effector 34 and the axis of the wrist joint 300 coincide in the zero-position straight state when the joint assembly is not in motion.

[0089] If the transmission device moves in the opposite way, thereby releasing the first drive cable 110 and pulling the second drive cable 120, the parallel joint 200 will move in the opposite way, that is, the distal joint 230 rotates into a ">" shape and the proximal joint 210 rotates into a "<" shape, thereby causing the end device 34 to move laterally to the left. The lateral movement of the parallel joint 200 can provide the end device 34 with a larger range of motion.

[0090] Compared to structures where the distal ends of the first and second drive cables 110 and 120 are fixed to the proximal joint to drive parallel joint movement, in this embodiment, the distal ends of the first drive cable 110 and the second drive cable 120 are fixed to the distal joint 230. When driving parallel joint movement, the travel distance of the first drive cable 110 and the second drive cable 120 is twice that of when they are fixed to the proximal joint, thus allowing the parallel joint movement to be driven with half the driving force. Furthermore, because the required driving force is reduced, the deformation of the first drive cable 110 and the second drive cable 120 is also reduced, improving the accuracy of parallel joint movement.

[0091] In some embodiments, the first drive cable 110 and the first constant-length cable 131 are formed from the same cable, that is, the first drive cable 110 and the first constant-length cable 131 are a single, continuous cable. The first fixing part 110a and the second fixing part 131a are clamps with a diameter larger than the cable diameter. These clamps are pressed into the second distal joint segment 232, thereby fixing the distal ends of the first drive cable 100 and the first constant-length cable 131 to the second distal joint segment 232. Similarly, the second drive cable 120 and the second constant-length cable 132 can also be formed from a single cable. It is understood that the fixing method of the first drive cable pair and the first constant-length cable pair is not limited to clamps; for example, welding can be used.

[0092] In some embodiments, the parallel joint 200 may also have only one drive cable whose distal end is fixed to the distal joint of the parallel joint, and the other drive cable may be replaced by another method (e.g., using spring return), or the distal end of the other drive cable may be fixed to the proximal joint of the parallel joint.

[0093] In some embodiments, for instruments that require only translational movement of the end-effector and not pitch or yaw movement of the end-effector (e.g., endoscopes with a camera as the end-effector), the joint assembly 33 of the instrument may also include only the parallel joint 200 and not the wrist joint 300.

[0094] In one embodiment, such as Figure 6A and 6B As shown, where Figure 6B for Figure 6AThe view after rotating the long axis 32 and joint assembly 43 90 degrees around the axis of the long axis. In this embodiment, the parallel joint 400 includes a proximal joint group, a distal joint group, an intermediate segment 420, and at least four cable pairs. The proximal joint group includes first and second proximal joints 410 and 440, and the distal joint group includes first and second distal joints 430 and 450. The first proximal joint 410 is connected between the proximal end of the intermediate segment 420 and the distal end of the second proximal joint 440. The second proximal joint 440 is connected between the proximal end of the first proximal joint 410 and the distal end of the long axis 32. The first distal joint 430 is connected between the distal end of the intermediate segment 420 and the proximal end of the second distal joint 450. The second distal joint 450 is connected between the proximal end of the wrist joint 300 and the distal end of the first distal joint 430.

[0095] The rotation axis 411 of the first proximal joint 410 and the rotation axis 441 of the second proximal joint are perpendicular to each other, and the rotation axis 431 of the first distal joint 430 and the rotation axis 451 of the second distal joint 450 are perpendicular to each other. The rotation axes 411 and 431 are perpendicular to the plane of the paper.

[0096] The four cable pairs of the parallel joint 400 include a second pair of constant-length cable pairs and two pairs of drive cable pairs. The first drive cable pair of the two drive cable pairs includes a first drive cable 310 and a second drive cable 320. The distal ends of the first and second drive cables 310 and 320 are fixed to the distal joint segment 453 of the second distal joint 450, and their proximal ends extend through the long shaft 32 and are connected to the first transmission unit 1101 of the transmission device in the instrument box 31. The first drive cable 310 and the second drive cable 320 cross in the intermediate segment 220.

[0097] The first constant length cable pair of the two pairs of constant length cables includes a first constant length cable 133 and a second constant length cable 134. The distal ends of the first and second constant length cables 133 and 134 are fixed to the distal joint segment 452 of the second distal joint 450, and their proximal ends are fixed to the proximal joint segment 442 of the second proximal joint 440. The first constant length cable 133 and the second constant length cable 134 are parallel in the intermediate segment 420.

[0098] like Figure 6B As shown, the second cable pair of the two pairs of drive cables includes a third drive cable 330 and a fourth drive cable 340. The distal ends of the third and fourth drive cables 330 and 340 are fixed to the distal joint segment 453 of the second distal joint 450, and their proximal ends extend through the long shaft 32 and are connected to the second transmission unit 1102 of the transmission device in the instrument box 31. The third drive cable 330 and the fourth drive cable 340 cross in the intermediate section 220.

[0099] The second constant-length cable pair of the two pairs of constant-length cables includes a third constant-length cable 135 and a fourth constant-length cable 136. The distal ends of the third and fourth constant-length cables are fixed to the distal joint segment 453 of the second distal joint 450, and their proximal ends are fixed to the proximal joint segment 442 of the second proximal joint 440. The third constant-length cable 330 and the fourth constant-length cable 340 are parallel in the intermediate segment 420. In other embodiments, the proximal ends of the four constant-length cables 133, 134, 135, and 136 may also be fixed to the distal end of the long axis 32. To more clearly illustrate the cables of the parallel joint 400, in Figure 6A The third and fourth constant-length cables 135 and 136 are not shown, nor are the portions of the third and fourth drive cables 330 and 340 within the joint assembly. Figure 6B The first and second constant length cables 133 and 134 are not shown, nor are the first and second drive cables 310 and 320.

[0100] The following describes in detail the longitudinal and transverse movements of the parallel joint 400, such as... Figure 7A As shown, Figure 7A This is a top view of the distal joint segment 453 of the second distal joint 450, as shown below. Figure 7A As shown, cables 310, 320, 330, 340, 134, 135, and 136 are not located near the rotation axis 431 of the first distal joint 430 or the rotation axis 451 of the second distal joint 450. Each cable 310, 320, 330, 340, 134, 135, and 136 is approximately 45 degrees away from the rotation axes 431 and 451, thus leaving installation space for the rotation axis components of each joint.

[0101] See you again Figure 6A The first drive unit 2000 is coupled to the transmission unit 1000. The first drive unit 2000 receives control signals sent by the control system. Specifically, the first drive unit 2101 of the first drive unit 2000 is coupled to the first transmission unit 1101 of the transmission unit 1000, and the second drive unit 2102 of the first drive unit 2000 is coupled to the second transmission unit 1102. The first drive unit 2000 can be coupled to the transmission unit 1000 through an intermediary component (e.g., a sterile adapter) or directly.

[0102] When the first drive unit 2000 responds to the first control signal sent by the control system, both the first drive unit 2101 and the second drive unit 2102 move in the same direction. For example, when both the first drive unit 2101 and the second drive unit 2102 rotate clockwise, the clockwise rotation of the first drive unit 2101 drives the first transmission unit 1101 to rotate clockwise, thereby pulling the first drive cable 310 and simultaneously releasing the second drive cable 320. The clockwise rotation of the second drive unit 2102 drives the second transmission unit to rotate clockwise, thereby releasing the third drive cable 330 and simultaneously pulling the fourth drive cable 340. Figure 7A As shown, F1 indicates pulling the first drive cable 310, and F2 indicates pulling the fourth drive cable 340. The combined force exerted by the first drive cable 310 and the fourth drive cable 340 on the distal joint segment 453 will cause the distal joint segment 453 of the second distal joint 450 to rotate counterclockwise around the rotation axis 451 (as shown). Figure 7B As shown, since the direction of the resultant force coincides with the direction of the rotation axis 431, the proximal and distal joint segments 433 and 432 of the first distal joint 430 do not rotate relative to the rotation axis 431.

[0103] Due to the rotation of the second distal joint 450, the four constant-length cables 133, 134, 135, and 136 will actuate the second proximal joint 440. The distal joint segment 443 of the second proximal joint 440 rotates clockwise relative to the rotation axis 441, while the proximal and distal joint segments 412 and 413 of the first proximal joint 410 do not rotate relative to the rotation axis 413, thereby achieving the effect of the parallel joint 400 as if from... Figure 6A The state shown in 6B is shifted longitudinally along the d direction to Figure 7B As shown, when both the first and second drive units rotate counterclockwise, the parallel joint 400 moves longitudinally in the direction opposite to d. After the longitudinal movement, the axis b of the end device 34 is parallel to the axis c of the major axis 32, and the central axis a of the intermediate section 420 is orthogonal to the first and second rotation axes 431 and 451.

[0104] When the first drive unit 2000 responds to the second control signal sent by the control system, the first drive unit 2101 and the second drive unit 2102 move in opposite directions. For example, when the first drive unit 2101 rotates clockwise and the second drive unit 2102 rotates counterclockwise, the first drive unit 2101 drives the first transmission unit 1101 to rotate clockwise, thereby pulling the first drive cable 310 and releasing the second drive cable 320. Conversely, the counterclockwise rotation of the second drive unit 2102 drives the second transmission unit 1102 to rotate counterclockwise, thereby pulling the third drive cable 330 and releasing the fourth drive cable 340. Figure 7CAs stated, F1 indicates pulling the first drive cable 310, and F3 indicates pulling the third drive cable 330. The resultant force exerted by the first and third drive cables 310 and 330 on the distal joint segment 453 of the second distal joint 450 causes the distal joint segment 433 of the first distal joint 430 to rotate counterclockwise around the rotation axis 431. Since the direction of this resultant force is the same as the direction of the rotation axis 451, the proximal and distal joint segments 452 and 453 of the second distal joint 450 do not rotate relative to their rotation axis 451.

[0105] Due to the rotation of the first distal joint 430, the four constant-length cables 133, 134, 135, and 136 will actuate the first proximal joint 410, causing the distal joint segment 413 of the first proximal joint 410 to rotate clockwise relative to its rotation axis 411, thereby achieving the parallel joint 400 as if from Figure 6A The state shown in 6B is shifted laterally along the e direction. Figure 7D The state shown indicates that when the first drive unit 2101 rotates counterclockwise and the second drive unit 2102 rotates clockwise, the parallel joint 400 is driven to move laterally in the direction opposite to e. After the lateral movement, the first rotation axis 431 is orthogonal to the central axis a of the intermediate segment 420, and the second rotation axis 451 is deflected relative to the central axis a of the intermediate segment 420, that is, the second rotation axis 451 forms a non-zero angle with the central axis a.

[0106] Since rotation axes 441 and 411 are perpendicular to each other, and rotation axes 451 and 431 are perpendicular to each other, the longitudinal and lateral directions of the parallel joint 400 are spatially perpendicular, i.e., direction e and direction d are spatially perpendicular to each other. For example, lateral movement is the translation of the parallel joint along the Y-axis in a Cartesian coordinate system, and longitudinal movement is the translation along the Z-axis. The parallel joint 400 does not change the pitch or yaw motion of the end effector 400 during longitudinal and lateral movements, thus increasing the range of motion of the end effector 400.

[0107] It is understood that in some embodiments, the device may not have a transmission device, and the drive cables of the device may be directly driven by the first drive device.

[0108] In some embodiments, the distal ends of the first drive cable pair 310, 320 are connected to the first distal joint 430, while the distal ends of the second drive cable pair 330, 340 are connected to the second distal joint 450.

[0109] In some embodiments, the distal ends of the first drive cable pairs 310, 320 are connected to the second proximal joint segment 410 or the intermediate segment 420, while the distal ends of the second drive cable pairs 330, 340 are connected to the second distal joint 450.

[0110] In some embodiments, the distal ends of the first and second drive cable pairs may also be connected to the second proximal joint segment 410 or the intermediate segment 420.

[0111] In one embodiment, such as Figure 8 As shown, the cannula 23 and power unit 22 of the manipulator 40 are fixedly connected. The joint assembly 501 and end effector 502 of the instrument 500 extend distally (e.g., to the lesion) through the channel 23a of the cannula 23. The joint assembly 501 includes a parallel joint and / or a wrist joint. The control system 2301 of the surgical robot is used to control the linkage of five joints 211, 212, 213, 214, 215 of the manipulator 40's robotic arm, causing the cannula 23 to rotate around the remote center of motion (RCM). In some other embodiments, the robotic arm of the manipulator 40 may also be a robotic arm of other configurations, such as a parallelogram configuration.

[0112] The power unit 22 includes a first drive unit 2201, 2202 and a second drive unit 2213, 2214. The control system 2301 is coupled to the first drive unit 2201, 2202 and the second drive unit 2213, 2214. The control system 2301 controls the movement of the joint assembly 501 and the end effector 502 of the device 500 through the first drive unit 2201. The control system 2301 controls the movement of the camera 601 of the device 600 through the first drive unit 2202.

[0113] The power unit 22 has slide rails 2211 and 2212 on its frame. The first drive device 2201 and the second drive device 2202 are slidably mounted on the slide rails 2211 and 2212, respectively. The control system 2301 drives the first drive devices 2201 and 2202 to move along the slide rails by controlling the second drive devices 2213 and 2214. The instruments 500 and 600 are detachably mounted on the first drive devices 2201 and 2202, respectively. When the first drive devices 2201 and 2202 slide on the slide rails 2211 and 2202, they can drive the instruments 500 and 600 to perform feed motion in the direction f. That is, the control system 2301 controls the feed motion of the instruments 500 and 600 by controlling the second drive devices 2213 and 2214, so that the long axes 511 and 611 of the instruments move linearly along the axial direction of the channel 23a of the sleeve 23. In this embodiment, instrument 500 is a clamp surgical instrument, and instrument 600 is an endoscope. In other embodiments, instruments 500 and 600 can be other types of instruments, such as ultrasonic scalpels, staplers, etc.

[0114] In response to control commands from control system 2301, multiple joints of the robotic arm work together to rotate the sleeve 23 around a remote motion center RCM, thereby controlling the movement of the long axes of instruments 500 and 600 around the remote motion center RCM. While control system 2301 controls the sleeve 23 to rotate around the remote motion center RCM, in response to a first control command from control system 2301, a first drive unit 2201 drives the joint assembly 501 of instrument 500 to maintain the position and / or orientation of the end effector 502 of instrument 500, for example, maintaining the position and / or orientation of the end effector 502 relative to the coordinate system of the base 210 of the manipulator 40, or relative to the coordinate system of the patient's operating table.

[0115] In one embodiment, as the sleeve 23 rotates around the remote center of motion (RCM), in response to a first control command from the control system 2301, the first drive device 2201 drives the lateral and / or longitudinal movement of the parallel joints of the joint assembly 501, thereby maintaining the position and / or orientation of the end device 502 of the instrument 500 unchanged.

[0116] In one embodiment, as the sleeve 23 rotates about the remote center of motion (RCM), in response to a second control command from the control system 2301, the first drive device 2201 drives the wrist joint of the joint assembly 501 to pitch and yaw, thereby maintaining the position and / or orientation of the end device 502 of the device 500 unchanged.

[0117] In one embodiment, as the movable sleeve 23 rotates around the remote center of motion RCM, in response to a second control command from the control system 2301, the second drive device 2201 drives the long axis 511 of the instrument 500 to move axially along the channel 23a of the sleeve 23, thereby maintaining the position and / or orientation of the end device 502 of the instrument 500 unchanged.

[0118] The technical features of the above embodiments can be combined in any way. For the sake of brevity, not all possible combinations of the technical features in the above embodiments are described. However, as long as there is no contradiction in the combination of these technical features, they should be considered to be within the scope of this specification.

[0119] The embodiments described above are merely illustrative of several implementation methods of this application, and while the descriptions are relatively specific and detailed, they should not be construed as limiting the scope of the invention patent. It should be noted that those skilled in the art can make various modifications and improvements without departing from the concept of this application, and these all fall within the protection scope of this application. Therefore, the protection scope of this patent application should be determined by the appended claims.

Claims

1. An instrument for surgery, characterized in that, The instrument includes a long shaft, a joint assembly connected between the long shaft and the end effector, the joint assembly having parallel joints, the parallel joints comprising: a proximal joint; an intermediate segment, a proximal end of the proximal joint being connected to a proximal end of the intermediate segment; a distal joint, the distal joint comprising a first distal joint segment and a second distal joint segment, the first distal joint segment and the second distal joint segment being rotatably connected, the first distal joint segment being connected to a distal end of the intermediate segment; a first cable pair, one end of the first cable pair being connected to a proximal end of the proximal joint or on the long shaft, the other end of the first cable pair being connected to the second distal segment; a second cable pair, the second cable pair comprising at least a first drive cable, a cable segment of the first drive cable in the distal joint and a cable segment of the first drive cable in the proximal joint being on opposite sides of a central axis of the intermediate segment, the first drive cable actuating the distal joint, the distal joint actuating the proximal joint through a first cable pair, the first cable pair comprising at least a first constant length cable, a length of the cable segment of the first drive cable in the distal joint and a length of the first constant length cable in the distal joint changing simultaneously in length or in shortening when the end effector is traversed relative to the long shaft; the first drive cable and the first constant length cable being one continuous cable.

2. The apparatus of claim 1, wherein a distal end of the first drive cable being fixedly connected to the second distal segment.

3. The apparatus of claim 1, wherein the second cable pair further comprising a second drive cable, the first drive cable and the second drive cable crossing in the intermediate segment.

4. The apparatus of claim 1, wherein the cable segment of the first drive cable in the intermediate segment intersecting the central axis of the intermediate segment.

5. The apparatus of claim 1, wherein when the first drive cable is actuated, the intermediate segment deflects relative to the long shaft and causes the end effector to traverse relative to the long shaft.

6. The apparatus of claim 5, wherein the length of the cable segment of the first drive cable in the distal joint and the length of the cable segment of the first drive cable in the proximal joint changing simultaneously in length or in shortening when the end effector is traversed relative to the long shaft.

7. The apparatus of claim 1 wherein, the second cable pair further comprising a second drive cable, an amount of change in length of the cable segment of the second drive cable in the distal joint and an amount of change in length of the cable segment of the first drive cable in the distal joint being equal when the end effector is traversed relative to the long shaft.

8. The apparatus of claim 1, wherein the first cable pair comprising a first constant length cable, a distal end of the first constant length cable and a distal end of the first drive cable being fixed to the second distal joint segment.

9. The apparatus of claim 8, wherein, the first drive cable comprising a first fixed portion fixed to the second distal joint segment, the first constant length cable comprising a second fixed portion fixed to the second distal joint segment, the first fixed portion and the second fixed portion being on the same side of the central axis.

10. The apparatus of claim 9, wherein, the first constant length cable further comprising a third fixed portion fixed to the proximal joint, the cable segment of the first drive cable in the distal joint and the third fixed portion being on opposite sides of the central axis.

11. An instrument for surgery, characterised in that, The instrument includes an elongated shaft, a joint assembly coupled between the elongated shaft and an end effector, the joint assembly including a parallel joint, the parallel joint including: a proximal joint; an intermediate segment, a proximal end of the intermediate segment coupled to a distal end of the proximal joint; a distal joint, a proximal end of the distal joint coupled to a distal end of the intermediate segment; a first pair of cables, a proximal end of the first pair of cables coupled to the proximal joint, a distal end of the first pair of cables coupled to the distal joint; a first drive cable, a distal end of the first drive cable coupled to the distal joint, the first drive cable actuating the distal joint, the distal joint actuating the proximal joint through the first pair of cables, the first pair of cables including at least a first constant length cable, a length of a cable segment of the first drive cable in the distal joint and a length of a cable segment of the first constant length cable in the distal joint simultaneously increasing or simultaneously decreasing as the end effector traverses relative to the elongated shaft; the first drive cable and the first constant length cable being a single cable.

12. The apparatus of claim 11, wherein a length of a cable segment of the first drive cable in the distal joint and a length of a cable segment of the first drive cable in the proximal joint simultaneously decreasing or simultaneously increasing as the first drive cable actuates the end effector to traverse relative to the elongated shaft.

13. The apparatus of claim 11, wherein the cable segment of the first drive cable in the distal joint and the cable segment of the first drive cable in the proximal joint being on opposite sides of a central axis of the intermediate segment.

14. The apparatus of claim 11, wherein, the instrument further including a second drive cable, the first drive cable and the second drive cable crossing in the intermediate segment.

15. The apparatus of claim 11, wherein the distal joint including a first distal joint segment and a second distal joint segment, the first distal joint segment and the second distal joint segment being hingedly coupled, the first distal joint segment coupled to a distal end of the intermediate segment, a distal end of the second distal joint segment coupled to the first drive cable.

16. The apparatus of claim 15, wherein one end of the first pair of cables coupled to the proximal joint and the other end of the first pair of cables coupled to the second distal joint segment of the distal joint.

17. An instrument for surgery, characterised in that, The instrument includes an elongated shaft, a joint assembly coupled between the elongated shaft and an end effector, the joint assembly including a parallel joint, the parallel joint including: a proximal joint, a proximal end of the proximal joint coupled to a distal end of the elongated shaft an intermediate segment, a proximal end of the intermediate segment coupled to a distal end of the proximal joint; a distal joint, the distal joint coupled between the end effector and the intermediate segment; a first pair of cables, one end of the first pair of cables coupled to the proximal joint or the elongated shaft and the other end of the first pair of cables coupled to the distal joint; a second pair of cables, the second pair of cables including a first drive cable and a second drive cable, the first drive cable and the second drive cable crossing in the intermediate segment, the first pair of cables including at least a first constant length cable, a length of a cable segment of the first drive cable in the distal joint and a length of a cable segment of the first constant length cable in the distal joint simultaneously lengthening or simultaneously shortening as the end effector traverses relative to the long axis, the first drive cable and the first constant length cable being a single cable that does not break apart.

18. The apparatus of claim 17, wherein, The distal ends of the first drive cable and the second drive cable are connected to the distal joint.

19. The apparatus of claim 18, wherein, The first pair of cables actuate the distal joint and the second pair of cables actuate the proximal joint to cause the end effector to traverse.

20. A surgical robot, characterised in that, The surgical robot includes a drive device, a control system for sending control signals to the drive device, and an instrument, the instrument including a long axis, a joint assembly connected between the long axis and an end effector, the joint assembly including at least a parallel joint, the parallel joint including: a proximal joint; an intermediate segment connected at a proximal end to a distal end of the proximal joint; a distal joint connected at a proximal end to a distal end of the intermediate segment; a first pair of cables connected between the proximal joint and the distal joint, the first pair of cables including a first drive cable and a second drive cable, the first drive cable and the second drive cable crossing in the intermediate segment, the first pair of cables including at least a first constant length cable, a length of a cable segment of the first drive cable in the distal joint and a length of a cable segment of the first constant length cable in the distal joint simultaneously lengthening or simultaneously shortening as the end effector traverses relative to the long axis, the first drive cable and the first constant length cable being a single cable that does not break apart.

21. A surgical robot, characterized in that, The surgical robot includes a drive device, a control system for sending control signals to the drive device, and an instrument, the instrument including a long axis, a joint assembly connected between the long axis and an end effector, the joint assembly including at least a parallel joint, the parallel joint including: a proximal joint; an intermediate segment connected at a proximal end to a distal end of the proximal joint; a distal joint connected at a proximal end to a distal end of the intermediate segment; a first pair of cables connected between the proximal joint and the distal joint, the first pair of cables including a first drive cable and a second drive cable, the first drive cable and the second drive cable crossing in the intermediate segment, the first pair of cables including at least a first constant length cable, a length of a cable segment of the first drive cable in the distal joint and a length of a cable segment of the first constant length cable in the distal joint simultaneously lengthening or simultaneously shortening as the end effector traverses relative to the long axis, the first drive cable and the first constant length cable being a single cable that does not break apart. a first drive cable having a proximal end connected to the transmission device and a distal end connected to the distal joint, the drive device being configured to drive the transmission device in response to control signals sent by the control system to simultaneously change the length of the cable segment of the first drive cable in the distal joint and the length of the cable segment in the proximal joint such that the end device is traversed, the first cable comprising at least a first constant length cable, the length of the cable segment of the first drive cable in the distal joint and the length of the cable segment of the first constant length cable in the distal joint simultaneously increasing or simultaneously decreasing when the end device is traversed relative to the long axis, the first drive cable and the first constant length cable being a single cable that does not break.

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