Transmission interface of a robotic system for microsurgical teleoperation and related robotic manipulator and microsurgical instrument

Abstract

Robotic surgery system comprising a robotic manipulator, comprising a plurality of actuation motors; and a surgical instrument, mounted to the robotic manipulator, comprising an articulated terminal comprising one or more joints actuated by actuation tendons; an actuation interface, adapted to receive a rotary actuation action imparted by the robotic manipulator, one or more actuation tendons for transmitting the rotary actuation action to the articulated terminal; wherein the robotic manipulator comprises a plurality of rotary transmission elements in operational connection with said plurality of actuation motors, the actuation interface of the surgical instrument comprises a plurality of spools to which said actuation tendons are wound to actuate the joints of the articulated terminal, each spool of said plurality comprises a toothed element arranged to receive the rotary actuation action imparted by the rotary transmission elements of the robotic manipulator.

Description

Transmission interface of a robotic system for microsurgical teleoperation and related robotic manipulator and microsurgical instrumentDESCRIPTION

[0001] . Field of the invention

[0002] . The present invention related to a robotic system for microsurgical teleoperation.

[0003] . In particular, the robotic system according to the invention comprises a robotic manipulator designed to interface with a microsurgical instrument.

[0004] . Background art

[0005] . The known robotic systems for surgical teleoperation generally comprise a plurality of robotic manipulators comprising motors and respective actuation interfaces arranged to control a sterile surgical instrument lacking motorized elements.

[0006] . The surgical instrument typically comprises a distal articulated terminal which is actuated by actuation tendons. The actuation tendons are typically arranged between the transmission interface (also known as "backend") and the movable parts of the articulated terminal, so that the actuation action delivered by the motors of the robotic manipulator is transmitted to the articulated terminal by virtue of the activation of the actuation tendons of the surgical instrument itself.

[0007] . In some known solutions, the actuation tendons are wound around discoidal spools rotatably mounted to the transmission interface frame of the surgical instrument. The motors of the robotic manipulator rotate the discoidal spools, generating tension in the tendons wound thereon. Typically, each discoidal spool controls a single actuation tendon associated with the two directions of the same degree of freedom, whereby it is common practice to have three (pitch-yaw-grip) or four (roll-pitch-yaw-grip) of them; otherwise it can be advantageous to provide three or four pairs of discoidal spools in the backend of the surgical instrument, i.e., three or four pairs of tendons having antagonistic effects, to move at least four degrees of freedom of the surgical instrument each tendon in a single direction.

[0008] . In known surgical instruments, the following degrees of freedom of the distal articulated terminal are typically controlled by antagonistic tendons: pitch, yaw, opening / closing i.e., grip or cut, and roll. In particular, articulated terminals are known comprising an articulated "wrist" and two "jaws" which are individually movable about a yaw axis, thus defining a relative degree of freedom of opening / closing about the same yaw axis.

[0009] . In order to house the discoidal spools of the actuation tendons, some known transmission interfaces are provided with a plate facing proximally, i.e., open to the robotic manipulator, thereby facing the discoidal spools of actuation to the respective motors of the manipulator. Since the torque applied by the motor depends on the radius thereof, it is usually desirable to maximize the diameter of the discoidal spools of the transmission interface of the surgical instrument for the engagement with rotary motors of corresponding diameter.

[0010] . Also for these reasons, typical embodiments of surgical instruments for robotic teleoperation provide for rotation axes of the discoidal spools oriented transversely, i.e., orthogonally with respect to the longitudinal extension axis of the shaft or rod of the surgical instrument (see for example the DAVINCI® product from INTUITIVE SURGICAL, INC., USA). An example of such a transmission is shown in US-2013-331857 as well as in US-2012-0199630. A large torque transfer arm is thus allowed from the motor to the respective actuator of the surgical instrument. However, this type of solution is not free from drawbacks and in particular the control of the degree of freedom of roll, i.e., of rotation of the articulated terminal about the longitudinal axis of the positioning rod or shaft is affected by severe complications: in detail, surgical instruments of this type use a pair of antagonistic tendons to rotate the positioning shaft or rod with respect to the backend, introducing a degree of freedom of roll inside the surgical instrument. Since the actuation tendons extend into the positioning shaft, the solutions of the above-described type necessarily require the tendons to be twisted inside the positioning shaft when the internal degree of freedom of roll is activated.

[0011] . The drawbacks shown above make that type of surgical instrument unsuitable for an extreme miniaturization of the distal articulated terminal for microsurgical applications, such as microsurgical, micro-laparoscopy for example for neurosurgical applications.

[0012] . In order to reduce these and other drawbacks, surgical instruments have been suggested, which are actuated by a number of tendons less than the degrees of freedom they possess, for example four tendons to control six movements as shown in US-9186221 , but this approach does not however solve the problem and requires the prediction of the internal degree of freedom of internal roll on the surgical instrument which undesirably stresses the actuation tendons.

[0013] . In addition, other examples of transmission interface between robotic manipulator and surgical instrument which do not require the presence of an internal degree of freedom of roll in the surgical instrument itself have been suggested.

[0014] . For example, the prior art document US-10786329 shows a robotic manipulator which has an annular extension, i.e., it extends circumferentially around a central through channel in which the surgical instrument is inserted, i.e., the rigid positioning shaft thereof. The surgical instrument has an enlarged backend portion which abuts against the annular manipulator when the positioning rod is inserted in the central through channel. In such a prior art solution, a plurality of motors are housed in the "doughnut" body around the central through channel, which engage respective transmission discs of the surgical instrument. The rotation of the manipulator around the through channel results in the joint rotation of the motors housed in the doughnut body itself and therefore of the surgical instrument about the axis of the positioning shaft (i.e., the degree of freedom of roll involves the instrument in the entirety thereof together with the annular manipulator). The rotation axis of the motors in this known example extends parallel to the longitudinal extension axis of the positioning rod or shaft of the instrument and therefore this solution still requires a certain radial size with respect to the positioning rod or shaft.

[0015] . The prior art document US-2021-0015572 shows an example of a transmission interface, between robotic manipulator and surgical instrument, by means of toothed shafts. Toothed shafts have also been employed within the transmission mechanism of the robotic manipulator itself, as shown for example in the prior art documents US-2021-0113282 and US-2022-0226058.

[0016] . Otherwise, transmission interface solutions for robotic surgery have been suggested, in which the transmission of the actuation torque delivered by the motors of the robotic manipulator occurs by converting it into a linear forward motion of a slider / piston.

[0017] . For example, the prior art document US-11311348 to the same Applicant shows a surgical instrument comprising in the backend thereof six transmission pistons directed parallel to the direction of the positioning rod and arranged radially equally spaced apart about the longitudinal axis of the rod which engage respective motors which advance linearly from the robotic manipulator. In this case, the degree of freedom of roll involves the surgical instrument in the entirety thereof together with the manipulator which rotates together with the surgical instrument about the axis of the positioning rod.

[0018] . The provision of the linear piston actuators allows keeping the friction low, which promotes miniaturization. For example, the prior art document WO-2023-047325 to the same Applicant suggests a surgical instrument with linear piston transmission particularly adapted to manage a miniaturized articulated terminal by virtue of the creation of a self-stabilizing mechanism for advancing the pistons in the backend of the surgicalinstrument.

[0019] . However, the radial arrangement of the transmission pistons as well as of the motors still imposes a certain radial size about the longitudinal axis of the positioning shaft or rod. A small radial size of the surgical instruments as well as of the robotic manipulators are highly desirable in microsurgical applications because they allow wide positioning freedom of two or more surgical instruments, where provided. The radial, i.e., transverse, proximal size of the backend or transmission interface of the instrument can be excessive in those microsurgical clinical applications which require access with at least two surgical instruments placed side by side and substantially parallel, so as to operate on the same working volume by accessing it from the same side such as, by way of illustration, the case in which both nostrils of a patient must be accessed simultaneously and with different instruments.

[0020] . From a mere design viewpoint, in order to deliver a certain torque, the motor components need a certain radial extension so as to create an advantageous torque arm and minimize the radial size of the motor components, which would mean simultaneously increasing the longitudinal dimension thereof to deliver greater force.

[0021] . Nevertheless, it must be considered that the longitudinal length of the positioning rod of the surgical instrument is also preferable to be limited, since the actuation tendons running inside the hollow body of the positioning rod or shaft are subject to undesirable phenomena of recoverable and non-recoverable elongation which are accentuated with the length of the actuation tendon itself.

[0022] . The need is thus strongly felt to provide a solution for surgical or microsurgical teleoperation which promotes the extreme miniaturization of the operating components while simultaneously ensuring a very high versatility and adaptability to various operating configurations.

[0023] . Meanwhile, the need is felt to keep the size of the surgical and microsurgical instruments, as well as the respective robotic manipulators, very small.

[0001] . Solution

[0002] . It is an object of the present invention to obviate the drawbacks complained of with reference to the prior art and suggest a solution to the needs mentioned above.

[0003] . This and other objects are achieved by a system according to claim 1 , as well as by an assembly according to claim 19.

[0004] . Some advantageous embodiments are the subject of the dependent claims.

[0005] . According to an aspect of the invention, a robotic surgery system comprises a robotic manipulator comprising a plurality of actuation motors, and a surgical instrument,mounted to the robotic manipulator. The surgical instrument comprises an articulated terminal comprising one or more joints actuated by actuation tendons, and an actuation interface, adapted to receive a rotary actuation action imparted by the robotic manipulator, and one or more actuation tendons for transmitting the rotary actuation action to the articulated terminal.

[0006] . The robotic manipulator comprises rotary transmission elements in operational connection with said plurality of actuation motors. The rotary transmission elements preferably comprise a plurality of internally toothed wheels and / or a plurality of transmission belts. The actuation interface of the surgical instrument comprises a plurality of spools to which said actuation tendons are wound for actuating the joints of the articulated terminal, each spool of said plurality comprising a toothed element arranged to receive the rotary actuation action imparted by the rotary transmission elements of the robotic manipulator.

[0007] . The rotary transmission elements of the robotic manipulator are arranged around the actuation interface body of the surgical instrument, to transmit the rotary actuation action to the transmission spools.

[0008] . The toothed elements of the spools are arranged on different longitudinal levels of the actuation interface body of the surgical instrument.

[0009] . In accordance with a preferred embodiment, the rotary transmission elements of the robotic manipulator are arranged stacked around the actuation interface body of the surgical instrument. In other words, the rotary transmission elements of the robotic manipulator are arranged on different longitudinal levels of the robotic manipulator.

[0010] . In accordance with an embodiment, the rotary transmission elements extend around the transmission interface over a portion of the circumferential extension thereof, for example an arc of circumference or a semi-circumference.

[0011] . In accordance with a preferred embodiment, the rotary transmission elements of said plurality of the robotic manipulator individually engage respective spools of said plurality of the surgical instrument. Preferably, each rotary transmission element, such as an internally toothed wheel or a transmission belt, engages a single corresponding toothed element of a single respective spool. The rotary actuation action imparted by the rotary transmission element of the manipulator to the respective spool is therefore aimed at operating a corresponding actuation tendon.

[0012] . In accordance with a preferred embodiment, said plurality of actuation motors comprises a plurality of output shafts which individually engage the respective rotary transmission elements of said plurality; where the output shafts of the actuationmotors are arranged on different longitudinal levels.

[0013] . In accordance with an embodiment, the output shafts of the actuation motors rotate about axes all parallel to the rotation axis of the rotary transmission elements. In accordance with an embodiment, the actuation motors of said plurality are arranged next to one another all on the same side of the rotary transmission elements, leaving the other side free, thus minimizing the size around the transmission interface of the surgical instrument.

[0014] . In accordance with an embodiment, the output shafts of the actuation motors rotate about axes all parallel to the rotation axis of the rotary transmission elements.

[0015] . Preferably, the surgical instrument comprises a positioning rod, extending between the actuation interface and the articulated terminal. In accordance with an embodiment, the rotation axis of the rotary transmission elements is parallel to the positioning rod, and preferably is coaxial with the positioning rod.

[0016] . The transmission interface of the surgical instrument is preferably substantially cylindrical or frustoconical in shape. The rotation axis of the rotary actuation action is preferably corresponding to the longitudinal extension axis of the cylindrical or frustoconical shape of the transmission interface of the surgical instrument. In accordance with an embodiment, the toothed elements protrude from the actuation interface of the surgical instrument to engage respective transmission elements of the robotic manipulator. In accordance with a preferred embodiment, said toothed elements protrude in a decreasing manner towards the positioning rod. In accordance with an embodiment, the body of the actuation interface portion of the surgical instrument is tapered and preferably frustoconical in shape.

[0017] . A sterile adapter can be interposed between the surgical instrument and the robotic manipulator, the sterile adapter comprising a body which extends about the rotation axis and a plurality of movable parts individually interposed between the rotary transmission elements of the robotic manipulator and the toothed elements of the surgical instrument.

[0018] . Therefore, the mutual engagement to transmit the actuation action between the rotary transmission elements of the robotic manipulator and the toothed elements of the spools of the surgical instrument can be direct or indirect, for example by interposing the sterile adapter.

[0019] . In accordance with an embodiment, the sterile adapter body is tapered in shape. The tapered shape can be frustoconical, and this is particularly advantageous when provided in combination with a frustoconical transmission interface of the surgicalinstrument.

[0020] . In accordance with an embodiment, the sterile adapter body comprises a distal through hole for receiving the positioning rod of the surgical instrument. The sterile adapter body can be formed by two separate piece portions, one of said two portions comprising said distal through hole and the other comprising the movable parts.

[0021] . In accordance with an embodiment, two robotic manipulators and two surgical instruments are provided, mounted to the two robotic manipulators, respectively; where the positioning rods of said two surgical instruments and / or the projections thereof on a predefinable plane form an angle therebetween. In accordance with an embodiment, said angle between the positioning rods of said two surgical instruments is variable; and where, preferably, each manipulator is mounted on an articulated-parallelogram positioning system. In accordance with an embodiment, said angle between the positioning rods of said two surgical instruments is about 8°.

[0022] . According to an aspect of the invention, an assembly comprises a robotic manipulator and a surgical instrument; where the robotic manipulator comprises a first portion provided with a plurality of actuation motors for controlling respective degrees of freedom of an articulated terminal of a surgical instrument associable with the robotic manipulator; said surgical instrument further comprising an actuation interface and coupling portion thereof; where each actuation motor of said plurality comprises, is coupled to and actuates one and only one related wheel with internal toothing of the robotic manipulator; the robotic manipulator further comprises a second portion, rotatable with respect to the first portion, and comprising an interface portion for said surgical instrument. Said wheel with internal toothing of the robotic manipulator engages a respective toothed counter-portion belonging to one or more transmission spools radially exiting from the actuation interface and coupling portion of the surgical instrument, resulting in the actuation of the articulated terminal of the surgical instrument.

[0023] . The surgical instrument is associated with the robotic manipulator and comprises an articulated terminal, an actuation interface, one or more spools radially exposed outside the actuation interface, where each spool comprises a respective toothed counter-portion, each toothed counter-portion engaging a respective wheel with internal toothing of the robotic manipulator, resulting in the actuation of the articulated terminal of the surgical instrument.

[0024] . In accordance with a preferred embodiment, the toothed counter-portions of the surgical instrument protrude in a decreasing manner towards the positioning rod. For example, the body of the actuation interface portion of the surgical instrument is taperedand preferably frustoconical in shape.

[0025] . In accordance with an embodiment, the internally toothed wheels are arranged on different levels or heights with respect to the length of the surgical instrument. Therefore, the actuation action of the respective degrees of freedom of the articulated terminal of the surgical instrument is a rotary actuation comprising rotary transmission elements.

[0026] . In accordance with an embodiment, the internally toothed wheels of the manipulator are part of a sterile drape with rigid insert and coupling interface to said manipulator and to said surgical instrument. A sterile adapter can also be provided, which mounts a plurality of rotatable rigid inserts interfacing between an internally toothed wheel of the robotic manipulator and a respective toothed counter-portion of the surgical instrument. In accordance with an embodiment, the sterile adapter body is tapered and preferably frustoconical in shape.

[0027] . The robotic manipulator can be mounted on a macro-positioner with parallelogram architecture. At least two robotic manipulators can be provided, each reorientable at a variable angle between the positioning rods of the two engaged surgical instruments; and where each robotic manipulator is mounted to a macro-positioner with parallelogram architecture.

[0028] . According to an aspect of the invention, a robotic manipulator for a surgical teleoperation system comprises a first fixed portion and a second rotatable portion comprising an interface portion for a surgical instrument. The surgical instrument in turn comprises an actuation interface counter-portion and an articulated terminal. The robotic manipulator further comprises a roll motor for rotating the interface portion for the surgical instrument about a roll axis, and a plurality of actuation motors for controlling respective degrees of freedom of the articulated terminal of the surgical instrument. The actuation motors of said plurality are all arranged on the first fixed non-rotatable portion of the robotic manipulator.

[0029] . The robotic manipulator further comprises a plurality of transmission elements for transmitting motion from the actuation motors of said plurality to the surgical instrument interface portion: Preferably, at least some transmission elements of said plurality comprise: an internally toothed wheel, and / or a transmission belt. In accordance with an embodiment, said transmission elements are all internally toothed wheels. Therefore, the actuation action of the respective degrees of freedom of the articulated terminal of the surgical instrument is a rotary actuation obtained by means of rotary transmission elements.

[0030] . In accordance with an embodiment, the respective output shafts of the actuation motors of said plurality are arranged on different longitudinal levels. The internally toothed wheels or transmission belts are preferably arranged on different levels, as are the counter-toothed portions of the surgical instrument.

[0031] . Brief description of the drawings

[0032] . Further features and advantages of the invention will become apparent from the following description of preferred embodiments, given by way of non-limiting indication, with reference to the accompanying drawings which are briefly described below. Note that references to “an” embodiment in this disclosure do not necessarily refer to the same embodiment and are to be understood as at least one. Moreover, for reasons of conciseness and reduction of the total number of figures, a certain figure may be used to illustrate the features of more than one embodiment, and not all the elements of the figure may be necessary for a certain embodiment.

[0033] . Figure 1 A is a diagrammatic view pictorially showing a robotic system for microsurgical teleoperation, according to an embodiment.

[0034] . Figure 1 B is a diagrammatic view pictorially showing a portion of the robotic system for microsurgical teleoperation in Figure 1 A and in particular a robotic manipulator on which a surgical instrument is mounted.

[0035] . Figure 2 is an axonometric view showing a depiction of a microsurgical instrument mounted to a robotic manipulator, according to an embodiment.

[0036] . Figure 3 shows a vertical elevation view of a microsurgical instrument mounted to the robotic manipulator in Figure 2.

[0037] . Figure 4 A shows an axonometric view of the robotic manipulator in Figure 2 only.

[0038] . Figure 4 B shows a plan view of the robotic manipulator in Figure 4 A.

[0039] . Figure 5 shows a vertical elevation view of the surgical instrument in Figure2 only.

[0040] . Figure 6 shows a vertical elevation view of a detail of the transmission interface portion of the surgical instrument in Figure 6.

[0041] . Figure 7 pictorially shows an axonometric view of a microsurgical instrument mounted to a robotic manipulator, according to an embodiment.

[0042] . Figure 8 shows an externally toothed wheel of the microsurgical instrument engaging an internally toothed wheel of the robotic manipulator, according to an embodiment.

[0043] . Figure 9 A is a longitudinal section view showing a detail of a microsurgicalinstrument and a robotic manipulator, according to an embodiment.

[0044] . Figure 9 B shows an actuation motor and an internally toothed wheel of the robotic manipulator in Figure 9 A.

[0045] . Figure 10 pictorially shows an axonometric view of a microsurgical instrument mounted to a robotic manipulator, according to an embodiment.

[0046] . Figure 11 A shows a top view of a surgical instrument, according to an embodiment.

[0047] . Figure 1 1 B shows a cross-section view of the actuation interface portion of the microsurgical instrument in Figure 1 1 A.

[0048] . Figure 1 1 C shows a vertical elevation and section view of the actuation interface of the surgical instrument in Figure 11 A.

[0049] . Figure 12 shows a diagrammatic section view of an actuation interface portion of a microsurgical instrument, according to an embodiment.

[0050] . Figure 13 shows a diagrammatic section view of a sterile adapter with a sterile drape, according to an embodiment.

[0051] . Figure 14 shows a diagrammatic section view of an actuation interface portion of a microsurgical instrument, according to an embodiment.

[0052] . Figure 15 shows a diagrammatic section view of a microsurgical instrument mounted to a robotic manipulator, according to an embodiment.

[0053] . Figure 16 pictorially shows an axonometric section view of a sterile adapter with a sterile drape, according to an embodiment.

[0054] . Figure 17 pictorially shows an axonometric view of a sterile adapter with sterile drape, according to an embodiment.

[0055] . Figure 18 A diagrammatically shows an axonometric view of a microsurgical instrument being mounted to a robotic manipulator, according to an embodiment.

[0056] . Figure 18 B diagrammatically shows an axonometric view of a sterile barrier for a surgical instrument and a robotic manipulator in Figure 18 A.

[0057] . Detailed description of some embodimentsReference throughout this description to "an embodiment" means that a particular feature, structure or function described in relation to the embodiment is included in at least one embodiment of the present invention. Therefore, the formulation “in an embodiment” in various parts of this description do not necessarily all refer to the same embodiment. Moreover, particular features, structures or functions such as those shown in different drawings can be combined in any suitable manner in one or more embodiments.

[0058] . In accordance with a general embodiment, a robotic surgery system 1 (orrobotic surgical or microsurgical teleoperation system 1 ) is provided, comprising a robotic manipulator 10 and a surgical instrument 50 mounted to the robotic manipulator.

[0059] . The robotic manipulator 10 comprises a plurality of actuation motors 13 and a plurality of rotary transmission elements 15 in operational connection with the plurality of actuation motors 13. The rotary actuation elements preferably comprise internally toothed wheels. The actuation motors 13 of the robotic manipulator 10 are preferably controlled by a master control device (not shown) arranged on a master control station, according to a master-slave architecture. In other words, preferably a master control device controls the actuation motors of the robotic manipulator in real time, during a surgical or microsurgical teleoperation carried out by said system 1 .

[0060] . In accordance with an embodiment, the robotic manipulator 10 comprises a first portion 1 1 , or fixed portion 11 , provided with a plurality of actuation motors 13 for controlling respective degrees of freedom of an articulated terminal 51 of a surgical instrument 50 associable with the robotic manipulator 10. The robotic manipulator 10 further comprises a second portion 12 which is rotatable with respect to the first portion 11 and mounted thereto. The rotatable portion comprises said rotary transmission means 15. It is well understood that the term "fixed portion 1 1" is not intended to indicate a part of the manipulator which is not movable, but is intended to indicate the part of the manipulator with respect to which the second rotatable portion 12 rotates about the rotation axis X-X. In other words, it is also possible that the robotic system 1 comprises positioning mechanism capable of moving the manipulator by means of movement of the fixed portion 11 thereof, for example a rotation movement about a definable point such as a definable fulcrum point for laparoscopy along the positioning shaft 55 of the instrument.

[0061] . The surgical instrument 50 comprises an articulated terminal 51 comprising one or more joints actuated by actuation tendons, an actuation interface 52, adapted to receive a rotary actuation action imparted by the robotic manipulator 10, one or more actuation tendons 56 for transmitting the rotary actuation action to the articulated terminal.

[0062] . The actuation interface 52 of the surgical instrument comprises a plurality of spools 54 to which said actuation tendons 56 are wound for actuating the joints of the articulated terminal 51 , and each spool of said plurality comprises a toothed element 53 arranged to receive the rotary actuation action imparted by the plurality of rotary transmission elements 15 of the robotic manipulator 10.

[0063] . The toothed elements 53 of the spools 54 are arranged on different longitudinal levels of the actuation interface body of the surgical instrument.

[0064] . The rotary transmission elements 15 of the robotic manipulator 10 arearranged around the body of the actuation interface 52 of the surgical instrument 50, to transmit the rotary actuation action to the transmission spools 54. The rotary transmission elements 15, such as internally toothed wheels and / or transmission belts, thus surround the respective toothed elements 53 of the spools 54 of the surgical instrument 50.

[0065] . In accordance with a preferred embodiment, the rotary transmission elements 15 of the robotic manipulator are arranged stacked around the body of the actuation interface 52 of the surgical instrument. The stacked arrangement allows reducing the transverse size of the manipulator and at the same time allows operating the toothed elements of the spools of the surgical instrument arranged on different levels longitudinally.

[0066] . As mentioned above, the articulated terminal 51 comprises one or more internal degrees of freedom (e.g., pitch, yaw, grip / cut) which are defined by one or more joints inside the instrument, and for example the articulated terminal is an articulated cuff, said internal degrees of freedom being actuated by providing said actuation motors 13. In particular, the degrees of freedom of the articulated terminal 51 which are controlled with the robotic manipulator 10 by means of movement of rotational joints actuated by tendons can comprise: pitch and / or yaw and / or opening / closing (grip, cut), and / or roll. In accordance with a preferred embodiment, the articulated terminal 51 comprises a plurality of links which are mutually articulated, forming at least one rotational pitch joint and one rotational yaw joint. The individual movement of two links mounted in the rotational yaw joint can result in the degree of freedom of opening / closing of the articulated terminal.

[0067] . The surgical instrument 50 can further comprise at least one degree of freedom of roll which can involve the rotation of the surgical instrument in the entirety thereof and therefore not be defined by a rotational joint inside the instrument, said degree of freedom of roll being actuated by a dedicated roll actuation motor 14. The rotational roll joint is here provided on the robotic manipulator 10 and therefore is not present in the articulated terminal, so that the surgical instrument 50 lacks the internal degree of freedom of roll. The roll rotation axis X-X is preferably through the articulated terminal 51 of the surgical instrument. In accordance with another embodiment, the degree of freedom of roll is formed by an internal joint of the surgical instrument 50 whereby it can also be actuated by one or more actuation tendons operated by the roll actuation motor 14. For example, the rotational roll joint can be arranged at the proximal end of the positioning rod. In this case, the roll rotation involves the positioning rod and the articulated terminal about an axis which is coincident with the longitudinal axis of the positioning rod.

[0068] . When in operating conditions, the action imparted by the actuation motors 13 of the manipulator is transmitted to the toothed elements 53 provided in the actuationinterface 52 of the surgical instrument 50 is in turn transmitted to the articulated terminal 51 by means of actuation tendons 56 working in traction. For example, said tendons 56 are actuation tendons formed by braided fibers (strands) such as polymeric or metallic fibers. One or more elastic elements (not shown) can be provided to maintain a minimum preload on the actuation tendons.

[0069] . The actuation motors 13, 14 of said plurality are, for example, all stepper motors and are preferably all mounted on the fixed part 11 (i.e., the part which does not rotate) of the robotic manipulator. In accordance with another embodiment, said actuation motors 13, 14 comprise at least one servomotor. Preferably, each actuation motor 13, 14 comprises a stator, a rotor, and an output shaft 18 integral with the rotor and transmitting the torque, and internally toothed wheels 15 and / or other transmission elements (transmission belts) are provided to transmit the torque from each output shaft 18 of the actuation motor 13 of the manipulator 10 to the actuation interface 52 of the surgical instrument 50, and in particular to the toothed elements 53 of the actuation interface. The volume size of each actuation motor is substantially cylindrical about a motor axis M-M. The motor axis M-M is preferably through the output shaft 18 of the motor in question and preferably through the center of the stator of the actuation motor itself.

[0070] . In particular, as shown for example in Figure 4 A-B, the actuation motors 13 of the internal degrees of freedom (e.g., pitch, yaw, grip) of the articulated terminal 51 of the surgical instrument 50 are connected to respective internally toothed wheels, while the actuation interface 52 of the surgical instrument 50 has a corresponding externally toothed wheel. The roll motor 14 can be associated with a transmission belt 26 for transmitting torque to an element 16 which results in the rotation of the surgical instrument about the roll axis X-X by grasping and moving a proximal section of the positioning rod or shaft 55. In accordance with a preferred embodiment, the roll motor 14 is arranged distally with respect to the other actuation motors 13 for the internal degrees of freedom of the surgical instrument 50.

[0071] . The actuation interface 52 of the surgical instrument 50 preferably also acts as a coupling interface to the robotic manipulator 10, for example by interposing a sterile adapter 21. The sterile adapter 21 comprising the movable parts thereof (e.g., toothed ferrules) which mesh with both said rotary transmission element 15 of the manipulator and said toothed element 53 of the spool 54 of the surgical instrument. The sterile adapter 21 is preferably provided with a coupling interface thereof, for example a snap-coupling mechanism, for coupling to a portion of the positioning rod or shaft 55 of the surgical instrument.

[0072] . In accordance with another embodiment, the contact between the rotary transmission elements 15 of the manipulator and the toothed elements 53 of the surgical instrument 50 is a direct contact, without the interposition of any other element, i.e., without the interposition of a sterile adapter.

[0073] . The rotary transmission elements 15 of the manipulator 10 are preferably individually operated, by means of a respective actuation motor 13 thereof.

[0074] . In accordance with an embodiment, the rotary transmission elements 15 of the manipulator 10 are actuated in a coordinated manner, for example in pairs with antagonistic effects on the same degree of freedom. The coordinated actuation is preferably managed by an electronic controller which transmits command signals to both antagonistic actuation motors and thus to both antagonistic rotary transmission elements. In accordance with an embodiment, the coordinated actuation includes coordinating the actuation of the roll motor 14 with the actuation of all the other actuation motors 13 to promote the roll rotation of the surgical instrument in the entirety thereof while it is meshed, i.e., engaged, with said internally toothed wheels 15.

[0075] . In order to engage the respective internally toothed wheels 15 of the rotatable portion 12 of the robotic manipulator 10, the toothed elements 53 are preferably provided at least partially protruding from the body of the transmission interface 52 of the surgical instrument 50, and preferably they protrude transversely or radially with respect to the longitudinal axis X-X of the surgical instrument.

[0076] . As mentioned above, the rotary transmission elements 15 are preferably all coaxial. The element 16 for transmitting the roll actuation to the instrument is also preferably provided as a ring coaxial to the roll axis X-X.

[0077] . The rotary transmission elements 15 can comprise a plurality of toothed semi-circumferences, and in particular internally toothed half-wheels, as shown for example in Figure 7. Where the toothed semi-circumferences are all provided open towards the same side, this embodiment also allows the surgical instrument 50 to approach the robotic manipulator 10 substantially from the front (arrow F), in addition to from the back, i.e., "from the top" (arrow B) in Figure 7.

[0078] . In accordance with an embodiment, at least six internally toothed wheels (rotary transmission elements) are provided, which engage respective six externally toothed counter-portions (toothed elements) of the surgical instrument 50, where each externally toothed counter-portion belongs to a spool thereof which winds a respective actuation tendon thereof, and where the spools are provided in pairs with antagonistic effects on the same joint of the articulated terminal. Therefore, the provision of six internallytoothed wheels which engage respective six externally toothed counter-portions of the instrument allows controlling three rotational joints of the articulated terminal and moving them with antagonistic effect.

[0079] . In accordance with an embodiment, the profiles of the rotary transmission elements 15 of the manipulator and of the respective toothed elements 53 are conical profiles, to facilitate the insertion of the surgical instrument inside the cavity 17 delimited by the rotary transmission elements 15 of the robotic manipulator 10.

[0080] . The rotary transmission elements 15 of the manipulator 10 are preferably arranged in sequence, one after the other, along the longitudinal extension direction of the surgical instrument, and in particular of the actuation interface.

[0081] . In accordance with a preferred embodiment, the rotary transmission elements 15 of the manipulator 10 are stacked on top of one another and are all coaxial, and preferably all coaxial with the longitudinal axis of the positioning rod 55 of the surgical instrument 50.

[0082] . The rotary transmission elements 15 15, although coaxial, do not necessarily all have the same radius / diameter, and in accordance with an embodiment, the radius / diameter of the rotary transmission elements 15 is decreasing to facilitate the insertion of a surgical instrument.

[0083] . The toothed elements 53 of the actuation interface 52 of the instrument 50 are also preferably protruding in a decreasing manner, as shown for example in Figure 14, in which toothed portions 53 are shown mounted coaxially two by two but having a different radius / diameter (indicated here by a, b, c, d) so as to protrude progressively less when approaching the positioning rod or shaft 55. As shown for example in Figure 15, the body of the actuation interface 52 can itself be tapered, i.e., narrowing, towards the positioning shaft or rod 55, and for example the body of the actuation interface 52 of the surgical instrument can be substantially frustoconical in shape.

[0084] . The actuation motors 13 of the manipulator 10 are preferably arranged adjacent to one another but arranged on different longitudinal levels to each actuate, by means of the respective output shaft 18, only one of said stacked rotary transmission elements 15. In accordance with a preferred embodiment, the actuation motors 13 are all arranged parallel to one another, i.e., all having the motor axis M-M thereof (rotation of the output shaft 18) parallel, and preferably the roll motor 14 is also mounted with the motor axis M-M thereof parallel to the other motor axes of the actuation motors 13. Preferably, all the motor axes M-M of the actuation motors 13 and 14 are parallel to one another and parallel to the axis X-X. For example, said actuation motors are all arranged on the sametransverse side, avoiding cluttering the other opposite side of the rotary transmission elements. It is thus possible to minimize the size where two surgical instruments are provided, mounted on respective manipulators so that the angle 0 between the positioning rods 55 of the surgical instruments is variable, until it becomes substantially null, i.e., less than 10° and for example substantially equal to 8°. It is therefore possible to minimize the overall size. The angle 0 can be defined as a projection of the two rods on a predefinable plane, for example the vertical plane and / or the horizontal plane and / or a plane which is the lying plane of both rods of said surgical instruments.

[0085] . As mentioned above, to receive the surgical instrument 50 and in particular the transmission interface 52, the robotic manipulator 10 defines an internal longitudinal through cavity 17 inside the internally toothed wheels 15 which are arranged stacked. Distally from the longitudinal through cavity 17 of the manipulator 10, an insertion guide element can be provided, for example comprising one or more lead-in walls 25 which can belong to the manipulator itself (rotatable portion 12) or to the sterile adapter 21 (rotatable). For example, said one or more lead-in walls 25 comprise a convex toroidal wall extending around a distal through hole receiving the positioning rod or shaft 55. In accordance with another embodiment, said one or more lead-in walls 25 comprise a tapered wall, i.e., which narrows by moving in the distal direction.

[0086] . In accordance with an embodiment, a sterile barrier 20 is provided between robotic manipulator 10 and surgical instrument 50, comprising said sterile adapter 21. The sterile barrier 20 further comprises, preferably, a sterile drape 19. As mentioned above, the sterile adapter 21 preferably comprises a body extending about the roll axis X-X and a plurality of movable parts 22, such as rigid inserts which are substantially coaxial rings, where the movable parts 22 are rotatable about the rotation axis X-X with respect to the sterile adapter body. Said rotatable rigid parts 22 of the sterile adapter 21 are preferably protruding both internally and externally from the body of the sterile adapter 21 to engage both the rotary transmission means 15 of the manipulator and the toothed elements 53 of the spools 54 of the surgical instrument 50.

[0087] . In accordance with a preferred embodiment, the sterile adapter 21 comprises a body of tapered shape, i.e., narrowing, towards the positioning rod 55 of the surgical instrument. This embodiment is particularly advantageous when provided in combination with the decreasing radius / diameter of the internally toothed wheels (i.e., the rotary transmission elements) to facilitate the insertion of a surgical instrument. The body of the sterile adapter 21 preferably comprises an opening which makes it pass through at least the rod or shaft 55 of the instrument 50.

[0088] . The sterile barrier 20 can further comprise a second sterile adapter portion 23, provided as a separate piece from the aforesaid sterile adapter body 21 , and for example fixed to the sterile drape 19. Said second separate portion 23 of the sterile adapter 21 can comprise a through hole for receiving the positioning rod or shaft 55 of the instrument 50 and is fixed to the opposite side of the cavity 17 of the robotic manipulator with respect to the side in which the surgical instrument 50 is inserted.

[0089] . The robotic manipulator 10 can be mounted on an articulated-parallelogram macro-positioner 2 belonging to a robotic system for microsurgical teleoperation 1 , as shown for example in Figure 1 A. The provision of the articulated-parallelogram macropositioner 2, which is preferably a passive, non-motorized system, and moved by the manual action of an operator, allows varying the angle 0 between the positioning shafts or rods 55 of two or more surgical instruments 10. Preferably, there are provided two manipulators 10 are which can belong to or be mounted on two different macro-positioners 2, for example. The two macro-positioners can be mounted on the same cart 3 or tower or they can belong to different carts or towers, thereby creating a modular solution. Preferably, at least two manipulators 10 are provided, each having a surgical instrument 50 thereof and each manipulator being mounted on a macro-positioner 2 thereof to change the orientation of the surgical instrument 50, and the roll axes X-X of the two surgical instruments 50 are non-parallel to each other defining said angle 0, which is preferably less than 10°.

[0090] . The joint provision of a system 1 having two articulated-parallelogram macro-positioners 2 and manipulators having the motors arranged on only one side, reducing the size on the other side approaching the other manipulator, allows strongly reducing the angle 0 between the surgical instruments 50 and this can promote clinical applications in micro-neuro-surgery and the like. A cart 3 or support or tower can be provided, on which the articulated parallelogram macro-positioner 2 is mounted, and for example the cart or support or tower comprises wheels or other ground contact members for the movement thereof in the operating room. For example, each articulated- parallelogram macro-positioner 2 is movable in height Z with respect to the cart 3 and / or is movable in a horizontal direction Y and / or is rotatable W with respect to the horizontal direction, as well as tiltable with respect to the vertical direction to change the angle 0 between the surgical instruments 50. The angle 0 between the surgical instruments is preferably coincident with the angle between the axes of the respective manipulators 10, and is obtained, as mentioned above, by means of a projection of the rods of the two surgical instruments on a predefinable plane.

[0091] . By virtue of the features described above, provided in mutual combination or not in particular embodiments, it is possible to meet to the aforementioned needs, thus achieving the aforementioned advantages, and in particular:

[0092] . -it is possible to minimize the transverse size of the surgical instrument as well as of the robotic manipulator, and thus of the manipulator-instrument assembly;

[0093] . - the arrangement of the rotary transmission elements on several stacked levels allows keeping the transverse size of the manipulator compact, as well as the arrangement of the toothed elements of the spools on different longitudinal levels of the instrument allows keeping the transverse size of the instrument compact;

[0094] . - therefore, the manipulator-instrument assembly has a small transverse size, allowing a plurality of manipulators to be arranged substantially side by side and very close to one another, each mounting a respective surgical instrument, so as to have the positioning rods of the surgical instruments oriented substantially parallel to one another (e.g., forming by themselves or a projection thereof an angle of 10° on a definable plane);

[0095] . - by virtue of the suggested solutions, a system for microsurgical teleoperation is provided, which is capable of arranging two microsurgical instruments each having a rigid positioning shaft or rod placed side by side and substantially parallel, i.e., where the respective shafts or rods form an angle less than 10°, for example of substantially 8°, without losing operation accuracy and reliability or performance;

[0096] . - it is possible to orient the surgical instruments in a convergent manner with a small or very small angle therebetween, i.e., with an angle between the positioning rods of the articulated terminals of the surgical instruments less than 10°;

[0097] . - it is possible to mount the motors on the non-rotating part of the manipulator, reducing the inertias involved;

[0098] . - it is possible to insert the manipulator of the surgical instrument into a longitudinal cavity in the longitudinal direction, first inserting the articulated terminal and then the positioning rod or shaft by relative movement in the longitudinal direction.

[0099] . It is well understood that the combinations of features disclosed in the appended claims form an integral part of the present disclosure.

[0100] . In order to meet specific, contingent needs, those skilled in the art may make several changes and adaptations to the above-described embodiments and can replace elements with others which are functionally equivalent, without departing from the scope of the appended claims.LIST OF REFERENCE SIGNS

Claims

CLAIMS1. A robotic surgery system (1 ) comprising:- a robotic manipulator (10), comprising a plurality of actuation motors (13); and- a surgical instrument (50), mounted to the robotic manipulator, comprising- an articulated terminal (51 ) comprising one or more joints actuated by actuation tendons;- an actuation interface (52), adapted to receive a rotary actuation action imparted by the robotic manipulator (10),- one or more actuation tendons (56) for transmitting the rotary actuation action to the articulated terminal; wherein- the robotic manipulator comprises a plurality of rotary transmission elements (15) in operational connection with said plurality of actuation motors (13), and wherein-the actuation interface (52) of the surgical instrument comprises a plurality of spools (54) to which said actuation tendons (56) are wound to actuate the joints of the articulated terminal,- each spool of said plurality comprises a toothed element (53) arranged to receive the rotary actuation action imparted by the rotary transmission elements of the robotic manipulator;- the toothed elements (53) of the spools (54) are arranged on different longitudinal levels of the body of the actuation interface (52) of the surgical instrument; and wherein- said plurality of rotary transmission elements (15) is arranged around the body of the actuation interface (52) of the surgical instrument, to transmit the rotary actuation action to the transmission spools (54).

2. A system according to claim 1 , wherein the rotary transmission elements (15) of the robotic manipulator are arranged stacked around the body of the actuation interface (52) of the surgical instrument and engage the toothed elements (53) of the respective spools (54).

3. A system according to any one of the preceding claims, wherein the rotary transmission elements extend around the transmission interface over a portion of the circumferential extension thereof, for example over a semi-circumference.

4. A system according to any one of the preceding claims, wherein the rotary transmission elements (15) of said plurality of the robotic manipulator individually engage respectivespools (54) of said plurality of the surgical instrument.

5. A system according to any one of the preceding claims, wherein said plurality of actuation motors (13) comprises a plurality of output shafts (18) individually engaging respective rotary transmission elements (15) of said plurality; and wherein the output shafts (18) of the actuation motors are arranged on different longitudinal levels.

6. A system according to claim 5, wherein the output shafts (18) of actuation motors rotate about axes all parallel to the rotation axis of the rotary transmission elements.

7. A system according to any one of the preceding claims, wherein the actuation motors (13) of said plurality are arranged next to one another all on the same side of the rotary transmission elements.

8. A system according to any one of the preceding claims, wherein the rotary transmission elements comprise a plurality of internally toothed wheels and / or a plurality of transmission belts.

9. A system according to any one of the preceding claims, wherein the surgical instrument (50) comprises a positioning rod (55), extending between the actuation interface (52) and the articulated terminal (51 ); and wherein the rotation axis of the rotary transmission elements is parallel to the positioning rod (55), and preferably is coaxial with the positioning rod.

10. A system according to any one of the preceding claims, wherein the toothed elements (53) protrude from the actuation interface (52) of the surgical instrument.

11. A system according to claim 10, wherein said toothed elements protrude in a decreasing manner towards the positioning rod (55).

12. A system according to claim 11 , wherein the body of the actuation interface portion (52) of the surgical instrument is tapered and preferably frustoconical in shape.

13. A system according to any one of the preceding claims, wherein a sterile adapter (21 ) is interposed between the surgical instrument and the robotic manipulator, the sterile adapter comprising a body extending about the rotation axis and a plurality of movable parts (22) individually interposed between the rotary transmission elements (15) of the robotic manipulator and the toothed elements (53) of the surgical instrument.

14. A system according to claim 13, wherein the body of the sterile adapter is tapered, preferably frustoconical, in shape.

15. A system according to claim 13 or 14, wherein the sterile adapter body comprises a distal through hole for the positioning rod of the surgical instrument; and wherein, preferably, the sterile adapter body is formed by two separate piece portions, one of said two portions comprising said distal through hole and the other comprising the movableparts (22).

16. A system according to any one of the preceding claims, wherein two robotic manipulators (10) and two surgical instruments (50) are provided, mounted to the two robotic manipulators, respectively; wherein the positioning rods of said two surgical instruments and / or the projections thereof on a predefinable plane form an angle therebetween.

17. A system according to claim 16, wherein said angle between the positioning rods of said two surgical instruments is variable; and wherein, preferably, each manipulator is mounted on an articulated-parallelogram positioning system.

18. A system according to claim 16 or 17, wherein said angle between the positioning rods of said two surgical instruments is of about 8°.

19. An assembly comprising a robotic manipulator and a surgical instrument; wherein the robotic manipulator (10) comprises:- a first portion provided with a plurality of actuation motors (13) for controlling respective degrees of freedom of an articulated terminal (51 ) of a surgical instrument (50) associable with the robotic manipulator; said surgical instrument further comprising an actuation interface and coupling portion (52) thereof; wherein each actuation motor (13) of said plurality comprises, is coupled to and actuates one and only one related wheel (15) with internal toothing of the robotic manipulator;- a second portion comprising an interface portion (14) for said surgical instrument (50); wherein said wheel (15) with internal toothing of the robotic manipulator engages a respective toothed counter-portion (53) belonging to one or more transmission spools (54) radially exiting from the actuation interface and coupling portion (52) of the surgical instrument, resulting in the actuation of the articulated terminal (51 ) of the surgical instrument; and wherein the surgical instrument (50) is associated with the robotic manipulator (10) and comprises- an articulated terminal (51 ),- an actuation interface (52)- one or more transmission spools (54) which are radially exposed outside the actuation interface; and wherein each transmission spool (54) comprises a respective toothed counter-portion (53), each toothed counter-portion engages a respective wheel with internal toothing of the robotic manipulator, resulting in the actuation of the articulated terminal of the surgicalinstrument.

20. An assembly according to claim 19, wherein the toothed counter-portions (53) of the surgical instrument protrude in a decreasing manner towards the positioning rod (55).

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