Transmission systems for surgical instruments used in robotic surgery

Abstract

A surgical instrument (1) for use in robotic surgery, comprising a muscularly actuated hinged end (2) and at least one actuating muscular (3), and a rear end portion (4), the rear end portion comprising at least one elongated transmission body (5), the transmission body being movable along a longitudinal direction (X-X) coinciding with or parallel to the longitudinal extension axis of the at least one elongated body (5), at least a first resting wall (6) forming a first resting portion for a first lateral side (51) of the at least one elongated body (5); and at least a second resting portion (7) for a second lateral side (51) of the at least one elongated body (5) opposite to the first lateral side (51). two lateral sides (52); at least one return element (8) for at least one actuating rib (3), wherein the at least one actuating rib (3) is operably connected to the slender body (5) and is operably connected to the at least one return element (8); at least one slender body (5) includes a first lateral surface (11) on its first side (51), which first lateral surface can be slidably placed against the at least first resting wall (6); at least one slender body (5) includes a second lateral surface (12) on the second side (52), which second lateral surface can be slidably placed against the second resting portion (7).

Description

Technical Field

[0001] The present invention relates to a surgical instrument.

[0002] Furthermore, the present invention relates to a robotic surgery system comprising the surgical instrument. Background Art

[0003] Robotic surgical equipment is well known in the art and generally includes a central robotic tower (or cart) and one or more robotic arms extending from the central robotic tower. Each arm includes a motorized positioning system (or manipulator) for distally moving surgical instruments that can be attached thereto in order to perform a surgical procedure on a patient. The patient typically lies on a surgical table located in an operating room, where sterility is ensured to avoid bacterial contamination due to non-sterile parts of the robotic equipment.

[0004] US-10864051, WO-2017-064301, WO-2019-220407, WO-2019-220408, WO-2019-220409 and US-2021-059776 of the same applicant disclose a remotely operated robotic surgical system having one or more surgical instruments controlled by one or more master interfaces.

[0005] Typically, known surgical instruments for teleoperated robotic surgery comprise a proximal engagement portion (or rear end portion, according to the terminology commonly used in the art) having an interface intended to be operated by a robotic manipulator, an elongated element, such as a rod or shaft, an articulation device (e.g. a robotic wrist) and an operating terminal (e.g. a needle driver, scissors).

[0006] In known surgical instruments with articulated cuffs, it comprises a plurality of links moved by a plurality of tendons (or actuation cables). One or more terminal links may have a free end forming the aforementioned operating end and suitable, for example, for operating and / or manipulating needles and sutures directly on the patient's body to perform anastomosis or other surgical treatments.

[0007] In contrast to known surgical instruments comprising an articulating cuff, surgical instruments are also known that have a "snake-like" articulation arrangement, ie comprising a plurality of stacked vertebrae that are movable relative to one another by means of a plurality of actuating cables or tendons.

[0008] The proximal engagement (or rear end) portion of the surgical instrument typically includes a movable engagement body operably connected to an actuation rib for controlling the end effector of the surgical instrument itself and adapted to engage with a corresponding portion of an actuation interface of a robotic manipulator, such as shown in US-8142447.

[0009] In fact, in the field of robotic surgery, surgical instruments are components intended to be operated in a sterile environment, and a sterile barrier is usually inserted between the rear end portion of the instrument and the opposite portion of the actuation interface, so that the robotic manipulator is in a non-sterile area of ​​the operating setting. Therefore, the motor is usually placed in the manipulator, i.e. on the non-sterile side, and the surgical instrument has no motor.

[0010] The known transmission element at the proximal rear interface of the surgical instrument can be made in the form of a capstan or spool, which is suitable for unwinding and winding a portion of the tendon associated therewith, and correspondingly the electric actuator of the robotic manipulator can be a rotary actuator. The engagement between the rotary motorized actuator and the corresponding spool of the surgical instrument through the sterile barrier can be facilitated by including a rigid insert (such as a blade) on the sterile barrier.

[0011] In addition, robotic systems for surgery are also known, which use linear actuators, such as motorized pistons, which are suitable for transmitting controlled linear displacements to corresponding transmission elements under the control of appropriate electronic control devices, as shown in WO-2018-189729 and US-2015-0173730 representing the same applicant.

[0012] Therefore, in the rear end portion of the surgical instrument, a plurality of drive pistons adapted to be advanced and retracted along a linear path are included, these drive pistons proximally exposing their contact surfaces relative to the proximal engagement surface of the instrument so that they can be stressed by the motorized actuator. Distally, such drive pistons are operatively connected or connectable to corresponding actuating tendons. The springs influence the drive pistons within the body of the rear end portion of the instrument to maintain a state of minimum tension on the tendons operatively connected thereto.

[0013] US-10582975, EP-3586780, WO-2017-064303, WO-2017-064306, WO-2018-189721, WO-2018-189722, US-2020-0170727 and US-2020-0170726, representing the same applicant, disclose various embodiments of surgical instruments for robotic surgery and microsurgery, which are designed to extremely miniaturize the articulating cuff and therefore the operating end or end effector.

[0014] Obviously, as the size of the articulated cuff actuated by means of a tendon decreases, each longitudinal shortening or lengthening of the tendon length activates a corresponding angular movement of the cuff of increasing magnitude. This requires consideration of increased tolerances in the rear end portion of the surgical instrument.

[0015] In the case of using a linear drive piston contained in the rear end portion, it is common practice to provide each elongated body with a pair of recirculating sliding ball bushings fixed to the body of the rear end portion of the surgical instrument. Typically, the two bushings in a pair are arranged at opposite ends of the elongated drive body.

[0016] However, the choice to use such sliding bushings is by no means without disadvantages.

[0017] In fact, the recirculating ball bushing is an expensive component and requires increased coupling tolerances with the elongated body, as well as increased longitudinal alignment tolerances, and also requires careful maintenance to avoid frequent failures. For example, the elongated body may suddenly interlock in the bushing and transmit a tearing motion.

[0018] Furthermore, the necessity of including two bushings renders the dimensions of the rear end portion of the body relatively large, and the determined minimum length of the drive piston also relatively large, since the two bushings must be mounted sufficiently far apart from one another to acceptably guide the elongated body and actually reduce the range of travel of the elongated body, thereby necessarily creating an inoperative center length of the elongated body.

[0019] Eliminating one of the two bushings of a pair does not solve the problem, since, although on the one hand it would allow an increase in the stroke of the elongated body with the same overall dimensions (i.e. length), on the other hand it would impose more frequent static and dynamic frictions, for example collisions of the elongated body due to minimum angular vibrations of the elongated body in the single remaining bushing and / or minimum bending deformations of the elongated body, which lead to tear transmission, as a result of which some tendons could suddenly become loose and not tightened and could therefore slip off (i.e. detach) the included return element, which is certainly undesirable in the field of robotic surgery.

[0020] Therefore, there is a need to provide a surgical instrument suitable for extremely miniaturized robotic surgery.

[0021] Furthermore, there is a need to create a miniaturized surgical instrument provided with the action transmission applied by the motorized actuators of a robotic system for reliable, reproducible and safe surgery without increasing the size of its components.

[0022] In addition, in a miniaturized surgical instrument for robotic surgery having a transmission piston whose action is transmitted by a motorized actuator of a robotic system, it is necessary to increase the effective stroke of the piston when the longitudinal dimension of the slender body and the longitudinal dimension of the rear end portion of the surgical instrument are equal, and it is necessary to reduce the longitudinal dimension when the effective stroke of the slender body is equal. Summary of the invention

[0023] The object of the present invention is to eliminate the disadvantages complained of with reference to the prior art.

[0024] This object and other objects are achieved by a surgical instrument according to claim 1 .

[0025] Advantageous embodiments are object of the dependent claims.

[0026] By the proposed solution it is possible to avoid including a pair of sliding linear bushings mounted on each elongated transmission body.

[0027] By means of the proposed solution, a more reliable and reproducible transmission action is achieved compared to known solutions of surgical instruments actuated by actuation muscles. BRIEF DESCRIPTION OF THE DRAWINGS

[0028] Further features and advantages of the present invention will become apparent from the following description of preferred examples of embodiments given by way of non-limiting example, with reference to the accompanying drawings briefly described below. It should be noted that references to "one" embodiment in the present disclosure do not necessarily refer to the same embodiment, but should be understood to mean at least one. In addition, for reasons of brevity and to reduce the total number of drawings, a particular drawing may be used to illustrate features of more than one embodiment, and not all elements of the drawing are essential to a particular embodiment.

[0029] Figure 1 is an axonometric view illustrating a robotic surgical system according to one embodiment.

[0030] Figure 2 is an isometric view illustrating a surgical instrument associated with a robotic manipulator of a robotic surgical system, according to one embodiment.

[0031] Figure 3 is an isometric view showing a robotic manipulator according to one embodiment, wherein a control device is schematically shown.

[0032] Figure 4 is an isometric view illustrating a surgical instrument according to one embodiment.

[0033] Figure 5 is a cross-sectional view showing a rear end portion of a surgical instrument according to one embodiment.

[0034] Figure 6 is a cross-sectional view showing a rear end portion of a surgical instrument according to one embodiment.

[0035] Figure 7 is a cross-sectional view showing a rear end portion of a surgical instrument according to one embodiment.

[0036] Figure 8 It shows Figure 7 Schematic diagram of the rear end portion of the apparatus, wherein the balance of forces is schematically illustrated.

[0037] Fig. 9 is a view showing a part of a rear end portion according to one embodiment.

[0038] Fig.10 is a plan view of a rear end portion according to one embodiment, wherein a rolling mechanism housed in a track of an elongated transmission body is visible.

[0039] Fig.11A , Fig. 11B and Fig. 11C is a diagram showing a portion of a back end portion according to one embodiment and in various operational configurations.

[0040] Fig.12 is a plan view of a rear end portion according to one embodiment, wherein a rolling mechanism housed in a track of an elongated transmission body is visible, wherein the track includes a groove for housing a rib.

[0041] Fig.13 is a cross-sectional view showing a rear end portion according to one embodiment.

[0042] Fig.14 is a cross-sectional view showing a rear end portion according to one embodiment.

[0043] Fig.15 is a cross-sectional view showing a rear end portion according to one embodiment.

[0044] Fig.16 is a cross-sectional view showing a rear end portion according to one embodiment.

[0045] Fig.17 is a cross-sectional view showing a rear end portion according to one embodiment.

[0046] Fig.18 and Fig.19 A front view and a perspective cross-sectional view are respectively shown of a rear end portion according to one embodiment, wherein some parts are transparent for clarity. DETAILED DESCRIPTION

[0047] Throughout the specification, references to "an embodiment" are intended to indicate that a particular feature, structure, or function described with respect to that embodiment is included in at least one embodiment of the present invention. Therefore, the phrase "in an embodiment" in various parts of this specification does not necessarily refer to the same embodiment. Furthermore, in one or more embodiments, particular features, structures, or functions, such as those shown in different figures, may be combined in any appropriate manner.

[0048] According to a general embodiment, a surgical instrument 1 for robotic surgery is provided, which includes a tendon-actuated articulated end 2 and at least one actuating tendon 3. The actuating tendon 3 can be a polymer tendon formed from woven polymer fibers. The articulated end 2 can be an articulated cuff-type end including a rotational joint for pitch and / or yaw, or can be a "snake-shaped" end including multiple vertebrae.

[0049] The surgical instrument 1 further comprises a transmission engagement portion 4 or rear end portion 4. Preferably, the rear end portion 4 is arranged proximally with respect to the articulation end 2. Between the rear end portion 4 and the articulation end 2, a rigid or flexible rod 17 or bar 17 or shaft 17 may be comprised.

[0050] The rear end portion 4 of the surgical instrument 1 comprises at least one elongated transmission body 5 (hereinafter also simply referred to as "elongated body"), which is movable along a longitudinal direction XX coinciding with or parallel to the longitudinal extension axis of the at least one elongated body 5. For example, the at least one elongated transmission body 5 comprises a transmission piston and / or a transmission rod.

[0051] According to a preferred embodiment, the at least one elongated transmission body 5 comprises an engagement surface 18 adapted to receive a pushing action applied by a motorized actuator 19 of a robotic manipulator 20 of the robotic surgical system 10. A sterile barrier (not shown) may be inserted between the motorized actuator 19 of the robotic manipulator 20 and the engagement surface 18 of the elongated transmission body 5, such that the pushing action applied by the motorized actuator 19 is transmitted to the elongated body 5 through the sterile barrier body.

[0052] The electronic control device 21 can be operatively connected to the robotic manipulator 20 such that the at least one motorized actuator 19 exerts a pushing action on the elongated body 5 under the control of the control device 21 .

[0053] At least one actuation rib 3 is operatively connected to said elongated transmission body 5. Thus, the pushing action applied by the motorized actuator 19 is transmitted to the at least one actuation rib 3 by means of the elongated body 5. According to a preferred embodiment, at least one actuation rib 3 is integral with the elongated body 5. For example, the head 31 of the actuation rib 3 is fixed to the elongated transmission body 5.

[0054] Preferably, the pushing action exerted by the motorized actuator 19 on the corresponding slender body 5 is transmitted in the form of a traction action substantially equivalent to the actuating rib 3 to actuate at least one degree of freedom (e.g. pitch and / or yaw and / or grip) of the articulated end 2 of the surgical instrument 1.

[0055] The rear end portion 4 of the surgical instrument 1 further comprises at least one rest wall 6 forming a first rest for a first lateral side 51 of the at least one elongated body 5. Thus, the at least one elongated body 5 comprises on its first side 51 a first lateral surface 11 which rests slidably against said at least one rest wall 6.

[0056] The rear end portion 4 of the surgical instrument 1 further comprises at least a second rest 7 for a second lateral side 52 of the at least one elongated body 5, which second lateral side is opposite to the first lateral side 51. Thus, the at least one elongated body 5 comprises on the second side 52 a second lateral surface 12 which slidably rests against the second rest 7.

[0057] According to one embodiment, said second rest portion 7 comprises a low friction support surface, for example made of or coated with a low friction polymeric material, such as PTFE and / or UHMWPE.

[0058] The elongated transmission body 5 may be made of polished and / or ground metal, or may be made of a low friction polymer material such as PTFE.

[0059] When in operation, the pushing action P5 exerted by the motorized actuator 19 determines the sliding movement of the elongated body 5 relative to said second resting portion 7 of the rear end portion 4 and relative to said first resting surface 6 along the longitudinal axis XX.

[0060] Preferably, the rear end portion 4 of the surgical instrument 1 further comprises at least one return element 8 for returning the at least one actuation rib 3 , wherein the at least one actuation rib 3 is operatively connected to the at least one return element 8 .

[0061] By including said at least one return element 8, it is possible to position the traction action T3 of the actuation bar 3 at a distance D3 from the longitudinal axis XX of the elongated transmission body 5. In this way, when in operation, a torque is created tending to bring the second side 52 of the elongated body 5 closer to the second resting portion 7, while tending to bring the first side 51 of the elongated body closer to the first resting portion 6.

[0062] The balance of the transverse forces is given by the transverse reaction forces Y6 , Y7 of the sliding rest of the elongated body 5 on the first and second rest surfaces 6 , 7 .

[0063] According to a preferred embodiment, said resting wall 6 forming a first resting portion for said first side 51 of at least one elongated body 5 comprises a resting surface which is curved and convex. Preferably, the first lateral surface 11 of the first side 51 of the elongated body is convex, i.e. it forms a protrusion, for example an annular protrusion around the opening in which the body slides. For example, the first convex lateral surface 11 can be a disconnected surface, for example given by the union of two cones having a base at the sliding resting point with the elongated body 5.

[0064] Even more preferably, the first lateral surface 11 of the first side 51 of the elongated body is curved and convex, e.g. substantially cylindrical, e.g. cylindrical about the longitudinal extension axis XX of the elongated body 5, so as to form a spherical bearing (or a spherical hinge). In other words, the curved and convex lateral surface 11 of the elongated body 5 and the resting surface of the curved and convex resting wall 6 form a spherical joint or a spherical hinge while allowing longitudinal sliding of the elongated body 5. In this way, the risk of collisions of the elongated transmission body 5 under operating conditions is avoided or at least minimized. As a result, the elongated body 5 can be made compact, thereby reducing the longitudinal dimensions of the rear end portion 4.

[0065] According to one embodiment, at least the proximal portion of the elongated body 5 is substantially cylindrical, for example having a cylindrical geometry around the longitudinal extension axis XX of the elongated body 5 .

[0066] According to one embodiment, at least the proximal portion of the elongated body 5 is substantially cylindrical. The distal portion may include an enlarged portion, for example, which does not have a cylindrical geometry.

[0067] According to one embodiment, the elongated body 5 is a cylindrical body having a cylindrical outer surface around the longitudinal extension axis XX of the elongated transmission body 5 , wherein said cylindrical outer surface comprises said curved and convex resting surface of the resting wall 6 .

[0068] According to a preferred embodiment, the rear end 4 further comprises at least one pivotable mechanism 13, wherein the second rest 7 belongs to the pivotable mechanism 13. For example, the pivotable mechanism 13 is a wheel and / or an idler wheel and / or a rolling bearing. By including the second rest 7 formed on the pivotable mechanism 13 for the second side 52 of the elongated body, the sliding rest determines the rolling of the pivotable mechanism 13 on the lateral surface 12 of the elongated body 5 when in the operating state.

[0069] The rotation axis RR of the pivotable mechanism 13 is preferably fixed relative to the rear end portion 4. In other words, the rotation axis RR of the pivotable mechanism 13 is preferably fixed relative to said first rest surface 6 forming a first sliding rest.

[0070] The rotation axis RR of the pivotable mechanism 13 is preferably transverse with respect to the longitudinal direction XX of the elongated body 5 .

[0071] According to a preferred embodiment, the pivotable mechanism 13 further comprises the return element 8. In other words, the proximal engagement portion 4 comprises a pivotable mechanism 13 for the actuation rib 3 and the pivotable mechanism forms a rolling-sliding rest for the elongated body 5. Thus, the pivotable mechanism 13 assumes the dual function of the return of the actuation rib 3 and the sliding-rolling rest of the elongated transmission body 5. The rotation of the pivotable mechanism 13 can be determined solely by the sliding-rolling rest or also by the rotation resistance exerted by the actuation rib 3 mounted on the pivotable mechanism 13.

[0072] The sliding friction of the at least one actuating bar 3 on the return element 8 can be very low, so that the actuating bar 3 slides on the return element 8 without dragging it in rotation.

[0073] According to one embodiment, said at least one elongated body 5 comprises a longitudinal track 9 receiving at least a portion of said pivotable mechanism 13 .

[0074] According to one embodiment, a groove 15 is included between the second side 52 of at least one elongated body 5 and at least one pivotable mechanism 13, which accommodates the actuating rib 3 to avoid the actuating rib 3 coming into contact and being inserted between the pivotable mechanism 13 and the elongated body 5, thereby squeezing the actuating rib.

[0075] According to a preferred embodiment, said rear end 4 further comprises at least one elastic element 14 operatively connected to said at least one elongated body 5, which biases said at least one actuation rib 3. Preferably, the elastic element 14 is intended to move the elongated transmission body 5 away from the respective motorized actuator 19 along the longitudinal direction XX.

[0076] According to one embodiment, the elongated body 5 comprises a first longitudinal section 53 and a second longitudinal section 54, the first longitudinal section comprising the engagement surface 18 and the second longitudinal section being longitudinally opposite with respect to the first longitudinal section 53. For example, the first longitudinal section 53 is arranged proximally with respect to the second longitudinal section 54, and thus the second longitudinal section is arranged distally with respect to the first longitudinal section 53. According to a preferred embodiment, the first resting surface 6 rests on the first longitudinal section 53, and the second opposite resting portion 7 rests on the second longitudinal section 54 of the elongated transmission body 5.

[0077] According to one embodiment, the second longitudinal section 54 of the elongated body 5 comprises a wall 23 suitable for forming another rest for the first side 51 of the elongated body 5 to limit the transverse distance of the elongated body relative to the second rest 7 provided on the second side 52, and preferably provided on a transverse projection of the elongated body 5. In other words, the wall 23 faces away from the second lateral surface 12 and is provided on the second longitudinal section 54 of the elongated body 5.

[0078] According to one embodiment, the second longitudinal section 54 of the elongated body 5 comprises a transverse enlarged portion 22, for example made as a separate piece and then fixed to the elongated body 5, such as a tensioner 22, which comprises the second lateral surface 12 slidingly resting on the second resting portion 7 of the rear end portion 4. Preferably, the enlarged portion 22 comprises at least one longitudinally facing abutment wall 24 to form an abutment for the elastic element 14. Preferably, the elastic element 14 acts between the abutment wall 24 of the enlarged portion 22 of the elongated body 5 and the opposite second resting portion 25 of the rear end portion 4.

[0079] The enlarged portion 22 may comprise said track 9 and / or may comprise the end of the head 31 of the actuating bar 3 .

[0080] According to one embodiment, said first rest wall 6 forming a first rest for a first lateral side 51 of the elongated body 5 belongs to a hole edge delimiting a through hole in the body of the rear end portion 4. Said hole edge may have a substantially annular geometry, forming a spherical seat (or a spherical hinge). Said hole edge may comprise a further wall 26 facing towards a second lateral side 52 of the elongated body 5 and said further wall 26 may also form a spherical seat.

[0081] According to a preferred embodiment, for example Figure 5As shown, the degree of freedom of the articulated end 2 of the surgical instrument 1 is operatively connected to two resisting actuation ribs 3, 3', including at least one actuation rib 3 and a second actuation rib 3'. In this case, both resisting actuation ribs 3, 3' are associated with a corresponding elongated transmission body 5, 5', each of which is operatively associated with at least one resting wall 6, 6' (forming a first resting portion for a first lateral side of each elongated body 5, 5') and at least one second resting portion 7, 7' (on which the lateral surface 12, 12' of the elongated transmission body 5 rests) and at least one return element 8, 8' for each actuation rib 3, 3'. Therefore, similar to what has been described above, each elongated transmission body 5, 5' can be operatively connected to a corresponding return element 8, 8' and / or to a corresponding pivotable mechanism 13, 13'. In addition, similar to what has been described above, each elongated transmission body 5, 5' can be operatively connected to a corresponding elastic element 14, 14'. Furthermore, similar to what has been described above, each elongated transmission body 5, 5' may include an engagement surface 18, 18' adapted to receive a pushing action from a respective motorized actuator. Furthermore, similar to what has been described above, each elongated transmission body 5, 5' may include an enlarged portion 22'.

[0082] According to one embodiment, for example Figure 4 As shown, the surgical instrument 1 includes six slender transmission bodies 5, each of which is operably connected to an actuation rib 3. Preferably, the six slender transmission bodies 5 include three pairs of resisting slender transmission bodies 5, 5' for actuating three degrees of freedom (e.g., pitch, yaw and grip) of the surgical instrument 1. For example, each pair of ribs terminates at a link of the articulated end 2. For example, each pair of ribs can actuate one degree of freedom. According to one embodiment, the surgical instrument 1 includes six actuation ribs 3 formed by three pairs of resisting actuation ribs. Preferably, the articulated end 2 includes a link and a joint that define at least the pitch, yaw and grip degrees of freedom of the articulated end 2, and each pair of ribs is connected to a single link of the articulated end 2: for example, a pair of resisting ribs connected to the same end link can actuate the deflection degree of freedom and the grip degree of freedom (i.e., opening / closing) of the link.

[0083] Referring to the above description, for example Figure 8 , Fig. 9 and Fig.11A-C, according to one embodiment, the first rest wall 6 forms a spherical rest element (for example by means of a convex surface forming a cylinder or annulus) for an elongated transmission body 5 (for example a cylindrical body, such as a rod), and the second rest part 7 and the return element 8 are both formed by said pivotable mechanism 13, which is dragged in rotation by the axial (longitudinal) movement of the elongated transmission body 5, and at least one actuating rib 3 is fixed to said elongated transmission body 5 and is wound around the pivotable mechanism 13. In this embodiment, the spherical bearing (that is, the sliding contact between said convex first rest wall 6 and said convex second rest part 7) allows to minimize the contact area during sliding, and therefore minimize the sliding friction, while the pivoting mechanism 13 in rolling contact with the elongated transmission body 5 allows to further reduce the sliding friction, while the tension of the actuating rib 3 pulls the elongated transmission body 5 towards the pivoting mechanism 13. In this way, the contact area with the movable elongated transmission body 5 is minimized, thereby minimizing the resistance to the longitudinal movement of the elongated transmission body 5.

[0084] Referring to the above description, for example Fig.18 and Fig.19 As shown, according to one embodiment, both the second rest 7 and the return element 8 are formed by said pivoting mechanism 13 (e.g. a roller) which is dragged in rotation by the movement of the elongated transmission body 5, and at least one actuating rib 3 is fixed to the elongated transmission body 5 and is wound around said pivoting mechanism 13. In this embodiment, the pivoting mechanism 13 can be dimensioned so as to reduce the rotation angle of the pivoting mechanism 13 to a minimum and, for example, have a diameter substantially equal to the distance between the elongated transmission body 5 and the positioning axis of the surgical instrument. Thanks to this embodiment, the path of the actuating rib can be shortened.

[0085] Providing such a pivot mechanism 13 with a diameter substantially equal to the distance between the elongated transmission body 5 and the positioning axis of the surgical instrument allows simplifying the assembly line of the components of the rear interface of the surgical instrument and simplifying the assembly line of the actuating ribs.

[0086] Providing such a pivot mechanism 13 with a diameter substantially equal to the distance between the elongated transmission body 5 and the positioning shaft of the surgical instrument also allows the path of the actuation rib 3 between the elongated transmission body 5 and the positioning shaft of the surgical instrument to be substantially guided by means of a single body. In the case where a plurality of actuation ribs are provided, this also allows the plurality of ribs to be arranged in a radial (i.e. radial pattern) relative to the bore of the hollow positioning shaft in a precise and simple manner. The radial pattern can allow all actuation ribs to be manufactured of the same length, since each rib path can be made of the same length with radial orientation. The outer edge of the pivot mechanism can include recesses to accommodate the actuation ribs.

[0087] The pivot mechanism 13 can be dimensioned to reduce its own obstruction (i.e. size), for example by cutting out a portion of the pivot mechanism that is inactive when in use (e.g. by cutting out one or more circular segments), for example cutting out an arc from which the actuating bar 3 does not deploy when in the working state. In this way, the shape of the roller (pivot mechanism 13) can be optimized.

[0088] For example, the pivot mechanism 13 may include two opposing curved arcs 27 having a radius centered on the axis of rotation of the pivot mechanism and a straight segment 28 connecting the two opposing arcs 27, wherein the actuating rib 3 is wrapped around at least a portion of each of the two opposing arcs 27 and it is also attached (i.e., glued and / or frictionally contacted) to the straight segment 28.

[0089] As described above, providing a pivotable mechanism 13 with a relatively large diameter, wherein the actuating tendon 3 is wound around the pivotable mechanism, applying a tensile load and attached to at least one segment of the pivotable mechanism 13, enables the pivotable mechanism to operate essentially as a lever having a fulcrum on the axis of rotation of the pivotable mechanism. In other words, when in operation, such a pivotable mechanism 13 rotates back and forth only a small portion of a circle. Therefore, by adjusting the position of the fulcrum, i.e. the axis of rotation of the pivotable mechanism 13 and the radius of such relative arc 27, it is allowed to adjust the transmission ratio between the force applied to the elongated transmission element 5 and the tension of the actuating tendon in the shaft 17. Therefore, the term "pivoting mechanism" also means a lever having a fulcrum, for example, a part of the housing coupled to the rear end 4 of the surgical instrument, and a pivotable cam.

[0090] The elastic element 14 may be a conical axial helical spring.

[0091] According to a general embodiment, a robotic surgery system 10 is included, which includes at least one surgical instrument 1 according to any of the above embodiments. The robotic surgery system 10 can be suitable for teleoperated robotic surgery according to a master-slave architecture. For example, the robotic surgery system 10 can include a master console, the master console includes an ungrounded master control device, and the position and orientation of the master control device is detected by an electromagnetic and / or optical tracking system.

[0092] The robotic surgical system 10 comprises at least one robotic manipulator 20 comprising at least one motorized actuator 19 adapted to exert a pushing action P5 on said at least one elongated body 5 of the rear end portion 4 of the surgical instrument 1 .

[0093] Preferably, the surgical instrument 1 is detachably associated with the robotic manipulator 20 .

[0094] Preferably, the robotic surgery system 10 further includes at least one electronic control device 21 .

[0095] Preferably, the robotic surgical system 10 further comprises a sterile barrier, such as a sterile drape, between the robotic manipulator 20 and the rear end portion 4 of the surgical instrument 1 .

[0096] It is known that the combination of features, structures or functions disclosed in one or more of the appended claims forms an integral part of the present description.

[0097] By means of the above features provided individually or in combination with each other in specific embodiments, the above needs can be met and the above advantages can be obtained, in particular:

[0098] -Avoid including sliding bushings;

[0099] - With the same longitudinal dimensions, it can increase the effective stroke of the elongated body;

[0100] - it allows to reduce the longitudinal dimensions with the same effective stroke of the elongated body;

[0101] - the traction action of the tendons pulls the elongated body against the rolling mechanism;

[0102] - elastic elements ensure minimum preload on the ribs;

[0103] -The risk of the rib slipping relative to the return element is minimized;

[0104] - Allows the elongated body to oscillate, i.e. tilt relative to the longitudinal direction, without causing collisions;

[0105] - A surgical instrument is created which is suitable for extreme miniaturization of the articulated end and which at the same time is able to transmit the actuation forces to the articulated end in a precise, reproducible and safe manner;

[0106] - the deviation between the pushing action P5 and the pulling action T3 causes a torque to be generated in order to stabilize the system;

[0107] - creates a stable, self-stabilizing transmission system that works optimally even with high traction loads on the tendons, thus also generating high thrust;

[0108] -The volume dimensions of the rear end section remain compact;

[0109] - said distal section comprising the elongated body facing the second side, namely in a sliding rolling seat on said rolling mechanism and operatively connected to said actuating bar, substantially creating a load-bearing constraint.

[0110] It shall be understood that the combination of features disclosed in the attached claims forms an integral part of the present disclosure.

[0111] In order to meet specific, possible needs, those skilled in the art may make numerous changes and modifications to the above-described embodiments, and may replace elements with other functionally equivalent elements without departing from the scope of the appended claims.

[0112] Reference numerals list

[0113] 1. Surgical instruments

[0114] 2. Articulated end

[0115] 3. Actuator muscles

[0116] 4. Transmission joint part, or rear end part

[0117] 5. Slender transmission body

[0118] 6. Shelf wall forming the first shelf portion

[0119] 7. Second shelf

[0120] 8. Return component

[0121] 9. Longitudinal track

[0122] 10. Robotic surgical system

[0123] 11. First lateral surface

[0124] 12. Second lateral surface

[0125] 13. Pivotable mechanism

[0126] 14. Elastic element

[0127] 15. Grooves

[0128] 17. Axis

[0129] 18.Jointing surface

[0130] 19. Motorized Actuator

[0131] 20. Robotic manipulator

[0132] 21. Control device

[0133] 22. Horizontal slender part

[0134] 23. Another shelf wall on the second side

[0135] 24. Abutment portion for elastic element

[0136] 25. Abutment portion for elastic element

[0137] 26. The other wall of the hole edge

[0138] 27. Arc of pivotable mechanism

[0139] 28. Straight segment of pivot mechanism

[0140] 31. Muscle head

[0141] 51. A first lateral side of the elongated body

[0142] 52. The second lateral side of the elongated body

[0143] 53. The first longitudinal section of the elongated body

[0144] 54. The second longitudinal section of the elongated body

[0145] XX. Vertical direction

[0146] D3. Distance

[0147] P5. Driving force

[0148] T3. Traction effect

[0149] Y6, Y7 lateral reaction force

Claims

1. A surgical instrument (1) for use in robotic surgery, comprising: a muscularly actuated hinged end (2), and at least one actuating rib (3), and The backend part (4) comprises: at least one elongated transmission body (5) movable along a longitudinal direction (XX), said longitudinal direction coinciding with or being parallel to the longitudinal extension axis of said at least one elongated transmission body (5); at least a first rest wall (6) forming a first rest for a first lateral side (51) of at least one elongated transmission body (5); at least a second rest portion (7) for a second lateral side (52) of at least one elongated transmission body (5) opposite to said first lateral side (51); at least one return element (8) for at least one actuating rib (3); in: The at least one actuating rib (3) is operatively connected to the elongated transmission body (5) and is operatively connected to the at least one return element (8); At least one elongated transmission body (5) comprises, on a first side (51) thereof, a first lateral surface (11) which rests slidably against said at least first resting wall (6); The first resting wall (6) comprises a convex resting surface; And among them: At least one elongated transmission body (5) comprises, on its second side (52), a second lateral surface (12), which second lateral surface rests slidably against the second resting portion (7); The rear end portion (4) further comprises at least one pivotable mechanism (13), and the second resting portion (7) belongs to the pivotable mechanism (13), so that the sliding resting of the second lateral surface (12) of the elongated transmission body (5) on the second resting portion (7) determines the rolling of the pivotable mechanism (13); And among them: The at least one actuating rib (3) is integral with the elongated transmission body (5); The at least one return element (8) positions the traction action (T3) applied by the actuating rib (3) at a certain distance (D3) from the longitudinal axis (XX) of the slender transmission body (5), so that the actuating rib (3) applies a traction action (T3) which generates a torque intended to bring the second side (52) of at least one slender transmission body (5) towards the second rest portion (7) of the pivotable mechanism (13) and to bring the first side (51) of the slender transmission body towards the convex surface of the first rest portion (6).

2. The surgical instrument (1) according to claim 1, wherein: The at least one actuating rib (3) comprises a head (31) which is terminally fixed to the elongated transmission body (5).

3. The surgical instrument (1) according to claim 1 or 2, wherein: The pivotable mechanism (13) further comprises the return element (8).

4. The surgical instrument (1) according to claim 1 or 2, wherein: The at least one elongated transmission body (5) comprises a longitudinal track (9) receiving at least a portion of the pivotable mechanism (13).

5. The surgical instrument according to claim 1 or 2, wherein: A groove (15) for receiving the actuating rib (3) is included between the second side (52) of at least one elongated transmission body (5) and at least one pivotable mechanism (13), thereby preventing the actuating rib from contacting and interposing between the pivotable mechanism (13) and the elongated transmission body (5).

6. The surgical instrument according to claim 1 or 2, wherein: The axis of rotation (RR) of the at least one pivotable mechanism (13) is fixed relative to the rear end portion (4) of the surgical instrument, and the rotation axis is fixed relative to the first resting wall (6) of the rear end portion (4); And / or wherein the rotation axis (RR) is oriented transversely with respect to the longitudinal direction (XX).

7. The surgical instrument (1) according to claim 1 or 2, wherein: The rear end portion (4) further comprises at least one elastic element (14) operatively connected to the at least one elongated transmission body (5), which biases the at least one actuating rib (3).

8. The surgical instrument (1) according to claim 1 or 2, wherein: The convex resting surface of the first resting wall (6) is substantially cylindrical.

9. The surgical instrument (1) according to claim 1 or 2, wherein: The first lateral surface (11) of the first side of the elongated transmission body (5) is curved and convex.

10. The surgical instrument (1) according to claim 9, wherein: The first lateral surface (11) of the first side of the elongated transmission body (5) is substantially cylindrical.

11. The surgical instrument (1) according to claim 1 or 2, wherein: The rest surface of the first rest wall (6) forms a spherical sliding contact for the first side (51) of the at least one elongated transmission body (5).

12. The surgical instrument (1) according to claim 1 or 2, comprising a plurality of actuation ribs (3) arranged radially relative to a central portion of the rear end portion.

13. The surgical instrument (1) according to claim 1 or 2, wherein: The pivotable mechanism (13) has an extension equal to the distance between the elongated transmission body (5) and the axis (17) of the surgical instrument; and wherein the actuating rib (3) is attached to at least a section of the pivotable mechanism (13).

14. A robotic surgery system (10), comprising: at least one surgical instrument (1) according to any one of the preceding claims, and At least one robotic manipulator (20) comprising at least one motorized actuator (19) adapted to exert a pushing action (P5) on said at least one elongated transmission body (5) of the rear end portion (4) of the surgical instrument.

Images